HomeMy WebLinkAbout37498-ZTown of Southold Annex
P.O. Box 1179
54375 Main Road
Southold, New York 11971
10/18/2012
CERTIFICATE OF OCCUPANCY
No: 36011 Date: 10/18/2012
THIS CERTIFIES that the building HOT TUB
Location of Property: 50025 Route 25, Southold,
SCTM #: 473889 Sec/Block/Lot: 70.-5-1
Subdivision: Filed Map No.
conforms substantially to the Application for Building Permit heretofore
9/7/2012 pursuam to which Building Permit No.
was issued, and conforms to all of the requirements of the applicable provisions of the law. The occupancy for
which this certificate is issued is:
"as built" hot tub as applied for.
Lot No.
filed in this officed dated
37498 dated 9/7/2012
The certificate is issued to
Paterson, John & Paterson, Lynn
(OWNER)
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL
ELECTRICAL CERTIFICATE NO.
PLUMBERS CERTIFICATION DATED
37498 10/17/12
~ign~ti~re
Town of Southold Annex
P.O. Box 1179
54375 Main Road
Southold, New York 11971
10/19/2012
CERTIFICATE OF OCCUPANCY
No: 36012 Date: 10/19/2012
THIS CERTIFIES that the building SHED
Location of Property: 50025 Route 25, Southold,
SCTM #: 473889 Sec/Block/Lot: 70.-5-1
Subdivision: Filed Map No.
conforms substantially to the Application for Building Permit heretofore
9/7/2012 pursuant to which Building Permit No.
was issued, and conforms to all of the requirements of the applicable provisions of the law. The occupancy for
which this certificate is issued is:
"as built" shed as applied for.
Lot No.
filed in this officed dated
37498 dated 9/7/2012
The certificate is issued to
Paterson, John & Paterson, Lynn
(OWNER)
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL
ELECTRICAL CERTIFICATE NO.
PLUMBERS CERTIFICATION DATED
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN CLERK'S OFFICE
SOUTHOLD, NY
BUILDING PERMIT
(THIS PERMIT MUST BE KEPT ON THE PREMISES
WITH ONE SET OF APPROVED PLANS AND SPECIFICATIONS
UNTIL FULL COMPLETION OF THE WORK AUTHORIZED)
Permit #: 37498
Permission is hereby granted to:
Paterson, John & Paterson, Lynn
50025 Route 25
Date: 9/712012
PO BOX 378
Southold, NY 11971
To;
construct "as built" hot tub & shed as applied for
At premises located at:
50025 Route 25
SCTM # 473889
Sec/Block/Lot # 70.-5-1
Pursuant to application dated
To expire on 3/9/2014.
Fees:
9/7/2012
and approved by the Building Inspector.
SWIMMING POOLS - ABOVE-GROUND WITH REQUIRED FENCING
ALTERATION OF ACCESSORY BUILDINGS
CO - SWIMMING POOL
CO - ACCESSORY BUILDING
Total:
Building Inspector
$500.00
$200.00
$50.00
$50.00
$800.00
Form No. 6
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN HALL
765-1802
APPLICATION FOR CERTIFICATE OF OCCUPANCY
This application must be filled in by typewriter or ink and submitted to the Building Department with the following:
A. For new building or new use: 1. Final survey of property with accurate location of all buildings, property lines, streets, and unusual natural or
topographic features.
2. Final Approval from Health Dept. of water supply and sewerage-disposal (S-9 form).
3. Approval of electrical installation from Board of Fire Underwriters..
4. Sworn statement from plumber certifying that the solder used in system contains less than 2/I 0 of 1% lead.
5. Commercial building, industrial building, multiple residences and similar buildings and installations, a certificate
of Code Co~npliance from architect or engineer responsible for the building.
6. Submit Planning Board Approval of completed site plan requirements.
B. For existing buildings (prior to April 9, 1957) non-conforming uses, or buildings and "pre-existing" land uses:
I. Accurate survey of property showing all property lines, streets, building and unusual natural or topographic
features.
2. A properly completed application and consent to inspect signed by the applicant, ifa Certificate of Occupancy is
denied, the Building Inspector shall state the reasons therefor in writing to the applicant.
C. Fees
I. Certificate of Occupancy - New dwelling $50.00, Additions to dwelling $50.00, Alterations to dwelling $50.00,
Swimming pool $50.00, Accessory building $50.00, Additions to accessory building $50.00, Businesses $50.00.
2. Certificate of Occupancy on Pre-existing Building- $100.00
3. Copy of Certificate of Occupancy - $.25
'-' 4. Updated Certificate of Occupancy- $50.00
5. Temporary Certificate of Occupancy - Residential $15.00, Commercial $15.00
Date.
[~ (check one)
Old or Pre-existing Build!ng.!
Street
House No.
New Construction:
Location of Property:
.Date of Permit.
· Owner or Owners of Property: ,~ ~
Suffolk County Tax Map No ! 000, Section
Subdivision
Health Dept. Approval:
Planning Board Approval:
Request for: Temporary Certificate
Fee Sub,nitted: $ /-~'"0, ~)-~
Hamlet
7o -..5" eot /
Block
Filed Map.
Applicant:
Underwriters Approval:
Lot:
Final Certificate:
(check one)
licant Signature
Town Hall Annex
54375 Main Road
P.O. Box 1179
Southold, NY 11971-0959
Telephone (631) 765-1802
Fax (631) 765-9502
ro.qer, richert~town.southold, ny. us
BUILDING DEPARTMENT
TOWN OF SOUTHOLD
CERTIFICATE OF ELECTRICIAL COMPLIANCE
SITE LOCATION
Issued To: John Paterson
Address: 50025 Main Rd (RT 25) City: Southold St: NY Zip: 11971
Building Permit #: 37498 Section: 70 Block: 5 Lot:
WAS EXAMINED AND FOUND TO BE IN COMPLIANCE WITH THE NATIONAL ELECTRIC CODE
Contractor: as built DBA: License No:
SITE DETAILS
Office Use Only
Residential R Ind°or ~ Basement ~ Service Only~
Commerical Outdoor 1 st Floor Pool
New Renovation 2nd Floor Hot Tub
Addition Survey Attic Garage
INVENTORY
Service 3 ph Hot Water GFCI Recpt Wall Fixtures ~.~ Smoke Detectors
Main Panel NC Condenser Single Recpt Recessed Fixtures ~ CO Detectors
Sub Panel NC Blower Range Recpt Fluorescent Fixture ~ Pumps
Transformer Appliances Dryer Recpt Emergency Fixtures~.~ Time Clocks
Disconnect Switches Twist Lock Exit Fixtures ] I TVSS
Other Equipment: self contained hot tub with GFCI protected disconnect
Notes:
Inspector Signature:
Date: Oct 17 2012
81-Cert Electrical Compliance Form.xls
TOWN OF SOUTHOLD BUILDING DEPT.
765-1802
INSPECTION
[ ] FOUNDATION 1ST [ ] ROUGH PLBG.
[ ] FOUNDATION 2ND [ ] IN/,SU~TION
[ ] FRAMING / STRAPPING [ ~ FINAL
[ ] FIREPLACE & CHIMNEY [ ] FIRE SAFETY INSPECTION
[ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRATION
[ ] ELECTRICAL (ROUGH) [ ] ELECTRICAL (FINAL)
REMARKS: ~'~'/~/~ ~
DATE
INSPECTOR
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN HALL
SOUTHOLD, NY 11971
TEL: (631) 765-1802
FAX: (631) 765-9502
SoutholdTown. NorthFork.net
Examined ?/ 7 , 20] ~
Approved
Disapproved a/c
Expiration 3 ] ,) ' 20 ]¢
SEP - 7 2012
BLDG. DEPT.
[O,",/Di OF SOUTHOLD
PERMIT NO.
BUILDING PERMIT APPLICATION CHECKLIST
Do you have or need the following, before applying?
Board of Health
4 sets of Building Plans
Planning Board approval
Survey
Check
Septic Form
N.Y.S.D.E.C.
Trustees
C.G. Application
Flood Permit
Single & Separate
Storm-Water Assessment Form
Contact:
Mail to: fO ~,~ 7~c~
Phone:
APPLICATION FOR BUILDING PERMIT
INSTRUCTIONS
Date ., 20
a. This application MUST be completely filled in by typewriter or in ink and submitted to the Building Inspector with 4
sets of plans, accurate plot plan to scale. Fee according to schedule.
b. Plot plan showing location of lot and of buildings on premises, relationship to adjoining premises or public streets or
areas, and waterways.
c. The work covered by this application may not be commenced before issuance of Building Permit.
d. Upon approval of this application, the Building Inspector will issue a Building Permit to the applicant. Such a permit
shall be kept on the premises available for inspection throughout the work.
e. No building shall be occupied or used in whole or in part for any purpose what so ever until the Building Inspector
issues a Certificate of Occupancy.
f. Every building permit shall expire if the work authorized has not commenced within 12 months after the date of
issuance or has not been completed within 18 months from such date. If no zoning amendments or other regulations affecting the
property have been enacted in the interim, the Building Inspector may authorize, in writing, the extension of the permit for an
addition six months. Thereafter, a new permit shall be required.
APPLICATION IS HEREBY MADE to the Building Department for the issuance of a Building Permit pursuant to the
Building Zone Ordinance of the Town of Southold, Suffolk County, New York, and other applicable Laws, Ordinances or
Regulations, for the construction of buildings, additions, or alterations or for removal or demolition as herein described. The
applicant agrees to comply with all applicable laws, ordinances, building code, housing code, and regulations, and to admit
authorized inspectors on premises and in building for necessary inspections.
Name of owner of premises
If applicant is a corporation, signature of duly authorized officer
~'nature of.~I~ant or name, if a corporation)
(Mailing address of applicant)
:';"'" " ":' APPROVEDIASNOTE ' r r
State whether applicant is ow'ne'( le~'S%;' hgent, 'architeCt, engineer, general contractor, electrician, p umoe o builder
DATE: 9/./(~ B.P.# ~ 7q~y
~~ ~~ NOTIFY ~UILD~NO DEDAaTMENT AT
.'~-.' .... ' ~<, 'w a ,.,., THE
(As on the tax roll p,( l~9~k~¢)p~ '".a;:; r q~
(Name and title of corporate officer)
Builders License No. ,,I
Plumbers License No. ~NC;~.c:~r-_ ~,,'~_ FO GOOfi
Electricians License No. UF'3N COMPLETION
Other Trade's License No. BEFORE, "WATEFI"
Location of land on which proposed work will be done:
House Number Street
Block
County Tax Map No. 1000 Section
Hamlet I AL
ELEGTRG. ,
$PECTION EQO ED
Subdivision Filed Map No. Lot
State existing use and occupancy of premises and intended use and occupancy of proposed construction:
a. Existing use and occupancy ~,,,t ?/e ~.~:,,t, 4,.,, -~.ap~', e/e~c e
b. Intended use and occupancy
3. Nature of work (check which applicable): New Building. Addition Alteration
Repair Removal Demolition Other Work
Estimated Cost Fee
If dwelling, number of dwelling units
If garage, number of cars
(Description)
(To be paid on filing this application)
Number of dwelling units on each floor
6. If business, commercial or mixed occupancy, specify nature and extent of each type of use.
7. Dimensions of existing structures, if any: Front
Height Number of Stories
Rear
Depth
Dimensions of same structure with alterations or additions: Front
Depth Height Number of Stories
Rear
8. Dimensions of entire new construction: Front
Height Number of Stories
Rear Depth
9. Size of lot: Front Rear Depth
10. Date of Purchase
Name of Former Owner
11. Zone or use district in which premises are situated
12. Does proposed construction violate any zoning law, ordinance or regulation? YES__ NO
13. Will lot be re-graded? YES NO Will excess fill be removed from premises? YES__
14. Names of Owner of premises ~t~d,d ~,'8.'~..x.o,d Address Phone No.
Name of Architect Address Phone No
Name of Contractor '5',~7..- F' Address Phone No.
NO
15 a. Is this property within 100 feet of a tidal wetland or a freshwater wetland? * YES · IF YES, SOUTHOLD TOWN TRUSTEES & D.E.C. PERMITS MAY BE REQUIRED.
b. Is this property within 300 feet cfa tidal wetland? * YES__ NO
· IF YES, D.E.C. PERMITS MAY BE REQUIRED.
NO
16. Provide survey, to scale, with accurate foundation plan and distances to property lines.
17. If elevation at any point on property is at 10 feet or below, must provide topographical data on survey.
18. Are there any covenants an.d, restrictions with respect to this property? * YES
· IF YES, PROVID~W~i0~P~i'I* ! --
NO
STATE OF NEW YOP-c~-
SS:
COUNTY OF .... )
being duly sworn, deposes and says that (s)he is the applicant
(Name of individual signing contract) above named, CONNIE D. BUNCH
Notary Public, State of New York
(S)He is the.. No. 01BU6185050
. -~ ~, Qualifieo in ~uttolk County
"' (Contr~?~,r~ ~g. ent, Corporate Officer, etc.) Commission Expires April 14,
of said owner or owners, a~d. lis duly author.:ized tX) p;rfor... ~.,~m.~erformed the said work and to make and file this application;
that all statements contained jwihis,.applic~ti~ ~re true to the bOs}'0t'i~s ~r~o. wlgdge and belief; and that the work will be
performed in the manner S~t fortli if~ tl~e .tlpi31'ieation filed therewith.
Sworn to before me tliig
"7--/43 day of , -~'?. ?,q~4 20
Notary Public
Town Hall Annex
$4375 Main Road
P.O. Box 1179
Southold, NY 11971-0959
Telephone (651) ?§$-1802
. (631) 7 ~
ro.qer, rlchertdt~n.sgu~[~J, ny. us
BUILDING DEPARTMENT
TOWN OF SOUTHOLD
APPLICATION FOR ELECTRICAL INSPECTIO'N
REQUESTED BY:
Company Name:
Name:
License No.:
~,dd. ress:
Phone No.:
Date:
JOBSITE INFORM.~.~_T. LON: (*Indicates required information)
*Name: _~_~
*Address:
*Cross Street:
*Phone No.:
Permit No.:
Tax Map District: 1-000 Section: ?O
*BRIEF DESCRIPTION OF WORK (Please Pdnt Cleady)
/
Block:
Lot:
(Please Circle All That Apply)
*Is job ready for inspection:
*Do· you need a Temp Certifi,cate:
I
Temp Information(If neededJ
*Service Size: I Phase
*New Service: Re-connect
Additional Information:
3Phase
Underground
YES / NO Rough In
YES / NO
100 1'50· 200 300 350 400
Number of Meters Change of serVice ~ve1
PAYMENT DUE WITH APPLICATION \~ \1
82-Reeuest for Insoection Form
Final.
11971
Town of Southold
Building Department
Town Hall
Southold, N.Y. 11971
John Paterson
50025 Main Rd
Southold, N.Y.
1000-70-5-1
To Whom It May Concern,
In order to get a pre existing C.O. for the above property it was necessary to
obtain a permit for a pre-existing second bathroom in the above residence and in
accordance to instructions received from the building department, show this
bathroom was built prior to occupancy by Mr. Paterson. To accomplish this the
previous owner, Mr. Raymond Terry, was contacted.
During the conversation with Mr. Terry it was determined that the bathroom was
constructed between 1946 and 1950.
I hereby certify the above information to be correct.
Sworn to before me this
r yof Aao - 20
Notary. Pu~ '