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Home My WebLink About37391-ZTown of Southold Annex P.O. Box 1179 54375 Main Road Southold, New York 11971 3/12/2013 CERTIFICATE OF OCCUPANCY No: 36168 Date: 3/12/2013 THIS CERTIFIES that the building Location of Property: SCTM #: 473889 Subdivision: WINDOWS 18375 Route 25, Mattituck, Sec/Block/Lot: 115.-2-12 Filed Map No. conforms substantially to the Application for Building Permit heretofore 7/10/2012 pursuant to which Building Permit No. 37391 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: window replacement and new electric service in an existing one family dweltin~ as applied for. Lot No. filed in this officed dated dated 7/24/2012 The certificate is issued to William & Judith Barker (OWNER) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL ELECTRICAL CERTIFICATE NO. PLUMBERS CERTIFICATION DATED 37391 2/26/13 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 #: 37391 Permission is hereby granted to: William & Judith Barker PO BOX 728 Mattituck, NY 11952 Date: 7/24/2012 To: Alterations to a Single Family Dwelling; Window Replacement, as applied for. At premises located at: 18375 Route 25, Mattituck SCTM # 473889 Sec/Block/Lot # 115.-2-12 Pursuant to application dated To expire on 1/23/2014. Fees: 7110/2012 and approved bythe Building Inspector. CO - ALTERATION TO DWELL1NG SINGLE FAMILY DWELLING - ADDITION OR ALTERATION Total: $50.00 $200.00 $250.00 Building Inspector Form No. 6 TOWN OF $OUTHOLD BUILDING DEPARTMENT TOWN HALL '765-1802 APPLICATION FOR CERTIFICATE OF occUPANcy This application must be f'flled 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 prol~rty with aoourate location o f all buildings, property lines, streets, and unusual natural or · topograplfic featur~. 2. Final Approval from Health D~pt. of water: supply and sewerage.disposal (S.9 form). 3. Approval ofelcctfioal installation from Board 6fFire Underwriters. · 4. 'Sw.orn statement from plumbor certifying that the solder used in system contains leas than 2/I0 of I% Icad.. 5. Commemial building, industrial building, mUltiple reaid~aoea and similar buildings and installations, a certificate of Code Compliaaoe'from amhite~t or engineer responsible for the building: 6. Submit planuing Boand Approval of completed site plan requirements. B. For existing buildings (prior to April 9, 1957) tion-co.nforming uses, or buildings and "Pre-existing" laud uses: 1. Accurate survey of proPerty showing all property line~,'streets, building and unusual natumi or topographic features. 2. A properly ~mpleted application and consent to inspect signed by the applicant. If a Certificate of Occupancy is denied, the Building Inspector shall state the reasons therefor in writing to the applicant. C. Fees 1. Ccttificaie of Occupancy - New dwelling $50.00, Additions to dwelling $50.00, Alterations to dwelling $50.00, · Swiramir~g pogl $50.00, Accessory building $50.00, Additions to accessory building $50.00, Businesses $50.00. 2. Certificate of Occupancy on Pre-existing Building - $I00.00 3. Copy of Certificate of Occupancy - $:25 4. Updated Certificate of Occupancy - $50.00 5. Tempo?sty Certificate Of Occupancy - Residential $15.00, Commercial $15.00 New Construction: Location of Proper~y: /t~..~ 75 Date. Old °r Pre-existing Building:'/~'g//~o't~cA~j (cheek one) House NO. Owner or Owners o~' Property: ~f//la m. l~ffolk County T~ Map No1000, S~tiqn ~a~si0n l~anit lqo' ~ 7 ~c~/ I-t~nflth D~pt. Approval: Planning Board Approval: Request for: Temporary Certificate Fee Submitted: $ Da~ofPermit. Street Bioek Lot Filed Map. Lot: Undetwriter~ Approval:.. Final Certificate: (check one) Hamlet Town Hall Annex 54375 Main Road P.O. Box 1179 Southold, NY 11971-0959 BUILDING DEPARTMENT TOWN OF SOUTHOLD Telephone (631) 765-1802 Fax (631) 765-9502 roqer.richert~.town.southold, ny.us CERTIFICATE OF ELECTRICIAL COMPLIANCE SITE LOCATION ssued To: Judith Barker Address: 18375 Main Rd (rt-25) City: Mattituck St: NY Zip: 11952 3uilding Permit #: 37391 Section: 1 1 5 Block: 2 Lot: 12 WAS EXAMINED AND FOUND TO BE IN COMPLIANCE WITH THE NATIONAL ELECTRIC CODE Contractor: homeowner DBA: License No: SITE DETNLS Office Use Only Commerical Outdoor 1st Floor Pcol New Renovation 2nd Floo~ Hot Tub Addition Survey Attic Garage INVENTORY Service 3 ph Hot Water GFCI Recpt Main Panel A/C Condenser Single Recpt Sub Panel NC Blower Range Recpt Transformer Appliances Dryer Recpt Disconnect Swffches Twist Lock Other Equipment: Ceiling Fixtures R HID Fixtures Wall Fixtures ~ 13J Smoke De~ectors Recessed Fixtures ~j~ CO Datect~'s Fluorescent Fixture ~ Pumps Emergency Fixtures ~.~ Time Clecks Exit Fixtures ~ TVSS 200a overhead service, 3-exhaust fans, 1-40a oven circuit, 6-ARC fault circ. Breal Inspector Signature: Date: Feb 26 2013 Electdcal_Certificate.xis TOWN OF SOUTHOLD BUILDING DEPT. 765-1802 INSPECTION [ ] FOUNDATION 1ST [ ] FOUNDATION 2ND [ ] FRAMING / STRAPPING [ [ ] FIREPLACE & CHIMNEY [ [ ] FIRE RESISTANT CONSTRUCTION [ ~ELECTRICAL (ROUGH) [ REMARKS: [ ] ROUGH PLBG. [ ]INSULATION ]FINAL ]FIRE SAFETY INSPECTION ]FIRE RESISTANT PENETRATION ]ELECTRICAL (FINAL) DATE TOWN OF SOUTHOLD BUILDING DEPT. 765-1802 INSPECTION [ ]FOUNDATION 1ST [ ]FOUNDATION 2ND [ ]FRAMING/STRAPPING [ ]FIREPLACE & CHIMNEY [ ] ROUGH PLBG. [ ] INSULATION [ ] FINAL [ ] FIRE SAFETY INSPECTION [ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRATION [ ] ELECTRICAL (ROUGH) ~ ELECTRICAL (FINAL) REMARKS: DATE INSPECTO~ TOWN OF SOUTHOLD BUILDING DEPT. 765-1802 INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] IN~IJLATION [ ] FRAMING/STRAPPING [~FINAL [ ] FIREPLACE & CHIMNEY [ ] FIRE SAFETY INSPECTION [ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRATION [ ] ELECTRICAL (R~OUG.) ~,, [ ] ELECTRICAL (FIliAL) REMARKS: TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, NY 11971 TEL: (631) 765-1802 FAX: (631) 765-9502 SoutholdTown. NorthFork. net Examined 7~'-- Approved Expiration 1 t 2012 BLDC OEP[. IO/~N or SOUTHO[ D PERMIT NO. BUILDING PERMIT APPLICATION CHECKLIST Do you have or need the following, before applying? Board of Health 4 sets of. Building Plans Oq} ~ {~ Planning Board approval Op'k°'4~-~ Survey Check c:~.~'-O ,~) 0 Septic Form N.Y.S.D.E.C. Trustees C.O. Application Flood Permit Single & Separate Storm-Water Assessment Form Contact: Mail to: Phonee'~ ~j Building Inspector PPLICATION FOR BUILDING PERMIT Date ., 20 INSTRUCTIONS a. This application MUST be completely filled in by typewriter or in ink and submitted to the Building Inspector with 4 sets of plans, accnrate plot platt to scale. Fee according to schedule. b. Plot platt 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 lbr inspection throughout tile work. e. No building shall be occupied or used itt whole or in part for any purpose what so ever until the Building Inspector issues a Certificate of Occupancy. f. Every building permit sball expire if the work authorized bas/tot commenced within 12 months after the date of issuance or has not been completed with in 18 mouths from such date. If no zoning amendments or other regulations affecting the property have been enacted in the interim, rite Building Inspector may authorize, itl 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 Depamnent for the issuance ora 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 1o 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. (Signature of applicant or name, ifa corporation) B, K2q &'/tT L I/qYZ (M/filing address &applicant) State whether applicant is o~ her. lessee, agent, architect, engineer, general contractor, electrician, plumber or builder Nameofownerofpremises ~-)l /]la tgh t~qF~ ~.L, OI/ ~/ P~ 'ff)a E /{e,,<, (As on the tax roll or latest deed) If applicant is a corporation, signature of duly authorized officer (Name and title of corporate officer) Builders License No. Plumbers License No. Electricians License No. Other Trade's License No. Location of land on which proposed work will be done: House Number Street County Tax Map No. 1000 Section Block ° Haml[t Lot Subdivision Filed Map No. Lot 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy b. Intended use and occupancy Nature of work (check which applicable): New Building Repair Removal Demolition Estimated Cost Fee If dwelling, number of dwelling units If garage, number of cars Addition Other Work Alteration (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__ 14. Names of Owner of premises ~_~' Name of Architect Name ofContractor~,a,ar__ fforvb~'-rachb~ 15 a. Is this property within 100 feet cfa 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 of a tidal wetland? * YES NO~V~ * IF YES, D.E.C. PERMITS MAY BE REQUIRED. NO ~ Will excess fill be removed from premises? YES NO Address;~06 728, Irlttt-]~ ht~).~. Phone No. 031. pO.S-- 5.3oo Address Phone No AddressT'lvOIttv3:,_,°ouqr~olO Phone No. ___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 beloxv, must provide topographical data on survey. 18. Are there any covenants and restrictions with respect to this property? * YES__ NO · IF YES, PROVIDE A COPY. STATE OF NEW YORK) SS: COUNTY OF .) being duly sworn, deposes and says that (s)he is the applicant (Name of individual signing contract) above named, (S)He is the (Contractor, Agent, Corporate Officer, etc.) of said owner or owners, and is duly authorized to perform or have performed the said work and to make and file this application; that all statements contained in this application are true to the best of his knowledge and belief: and that the work will be performed in the manner set forth in the application filed therewith. Sworn to befo~'e me this day of 20 Notary Public Signature of Applicant Town H~II/~.ncx 54~5 M~n Road P.O. Box 11~9 Soulhold, NY 11971-0~59 TOWN OF SOOTHOLD Telephone (631) 765-1809 APPLICATION FOR ELECTRICAL INSPECTION BY: Company Name: Date: Name: License No.: Address: Phone No.: JOBSITE INFORMATION: (*Indicates required information) *Address: /~3-7~- ,/'7~¢C-~ ~ ~ . *Cross Street: L/')~ ~¢¢_.,~ ~ ~ / ~ ~ *Phone No.: 1000 Section: //'3' Block: ~ Lot: Permit No.: Tax.Map District: *BRIEF DESCRIPTION OF WORK (Please Print Cleady) {Please Circle All That Apply) *Is job ready for inspect on: *Do-you need a Tamp Certificate: YES ~ Rough In YES / NO Final Tamp Information (If needed] *Service Size: 1 Phase 3Phase 100 150 (~ 300 350 400 Other ~New Service: Re-connect Underground Number of Meters ~ of Service~.. Overhead Additienal Information: PAYMENT DUE WITH APPLICATION ,82~Requestforlnspec~on Form ARE_A-ti,369 SQ. FTC. SURVEY OF PROPERTY 'AT MATTITUCK TOWN OF SOUTHOLD SUFFOLK COUNTY, N.Y. 1000-!!5-02-12 SCALE: 1'--20' 755-5020 F P.O. BOX 909~ ,~o ~_.._.,,,~; 1~o~o4