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Home My WebLink About37278-ZTOWN 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 #: 37278 Date: 6/6/2012 Permission is hereby granted to: Wren, John & Wren, Sharon 23 Lake Dr Somers, NY 11)589 Toz install a HVAC system to an existing dwelling as applied for At premises located at: 225 Hippodrome Dr, Southold SCTM # 473889 Sec/Block/Lot # 66.-2-32 Pursuant to application dated To expire on 12/6/2013. Fees: 6/1/2012 and approved by the Building Inspector. SINGLE FAMILY DWELLING - ADDITION OR ALTERATION $200.00 CO - ALTERATION TO DWELLING $50.00 Total: $250.00 Building Inspector Form No. 6 TOWN OF $OUTItOLD 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 ofprol~rty with accurate'location of all buildings, property lines streets, and unusual natural, or topographic features. 2.Final Approval from Health D.epC of water supply and sewerage-disposal (8-9 form). 3.Approval of electrical installation from Board 6f Fire Undenvriters. 4.Sw. om statement from plumber c~tifying that the solder used in sysWan contains less than 2/10 of 1% lead. 5. Commeroial building, industrial building, multiple residences and similar buildings and installations, a certificate of Code Compliaaee~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~ don-conforming use% or buildings and "Pre-existing" land uses." I. Acourate survey o f property showing all property lines,'streels, building and unusual natumi or topographic features. 2_ A properly ca~mpleted application and consent to inspect signed by the applicant. If a Certificate of ~c'cupancy is denied, the Building Inspector shall state the reasons therefor in writing to the applicant. C. Fees I. Certifica!e of Occupancy - New dwelling $50.00, Additions to dwelling $50.00, Alterations to dwelling $50.00, Swimming po01 $50.00, A~¢essory building $50.00, Additions to accessory building $50.00, Businesses $50.00: ~. Ce~:tifieate of Occupancy on Pre-existing Building - $100.00 3. Copy of Certificate of Occupancy - $:25 4_ UpdatedCertificateofOccupancy. $50.00 5. Temporary Certificate of Occupancy - Residential $15.00, Commercial $15.00 Date. Co /, /~2..- _ Old or Pm-existing Building: ' _ (check one) Street Hamlet .,.~c)./','4 ~' 3 tt.~l~, ?~C),~,~;~~ Da~ of Permit. b/ew Construction: Loeation of Property: Owner or Owners of Property: Hous~ NO. Suffolk County Tax Map No 1000, Section 8tflxlivisi0n Permit No. H~tlth ~ Approval: Planning Board Approval: Request for: Temporary Certificate =ee Submmed: $ Filed Map. Applicant:.. Lot: Underwrite~ Approval: Final Certificate: (check one) plicauf Signature JUN - 8 2012 BEDG DEPT. TOWN OF SOUTHOLD I~oUNDATION (15T) . ROUOH ~O & ~8~ON PER N. Y. STA~ E~R~ CODE TOWNL'~DOi,I~OLD BUILDIN ~?ARTMENT TOWN HALL SOUTHOLD, NY 11971 TEL: (631) 765-1802 FAX: (631) 765-9502 SoutholdTown. NorthFork.net Examined Approved Disapproved a/c Expiration __ PERMIT NO. .3.7) 7~ BUILDING PERMIT APPLICATION CHECKLIST Do you have or need the following, before applying? JUN - ! 2012 BtDG DEPT. Board of Health 4 sets of Building Plans Planning Board approval Survey Check Septic Form N.Y.S.D.E.C. Trustees C.O. Application Flood Permit Single & Separate Storm-Water Assessment Form Contact: Mail to: Building Inspector Phone: APPLICATION FOR BUILDING PERMIT 20 C a. This application MUST be completel3 filled in by typewriter or in ink and sobmitted to the Building Inspector with 4 sets of plans, accurate plot plan to scale. Fee according to schedule. b. Plot Nan 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 nmy not be commenced beIbre issuaoce of Building Permit. d. Upon approval of this application, the Building Inspector will issue a Building Permit tolpe applicant. Such a permit shall be kept on the premises available for inspectiou throughout the work. e. No building shall be occupied or used in whole or in pan for any purpose what so ever until the Building Inspector issues a Certificate of Occupancy. f. Eve~ building permit shall expire if the work authorized has not commenced within 12 months a~er the date of issuance or has not been completed withio 18 months from such date. If oo zoning amendments or other regulations affecting the prope~ have been enacted iu the interim, the Building Inspector may authorize, in writing, the extension of the pemit for an addition six months. Thereafter, a new permit shall be required. APPLICATION IS HEREBY MADE to the Buildiog Depaament for the issuance of a Building Permit pursuant to the Building Zone Ordinance of the Town of' Southold, Suffolk CounW, New York, and other ap~cable Laws, Ordinances or Regulations, for the coostruction of boildings, additions, or alterations or for removal or demoli~n as herein described. The applicant agrees to comply with all applicable laws, ordinances, building code, housing code, and ~ulations, and to admit authorized inspectors on premises and in building for necessary inspections 7 ~ OCCUPANCY' OR , !JSE IS UNLAWFUL (Sig.~ureofapplZ~nt or name, ifa co.oration) ,NITHOd, CERTIF,uAT... cROVED AS NOTED State whether applicant is o~ner, lessee, agent, architect, engineer, general c~P/d~t~i~n, ui der ~8D~ BUILDING DEPARTMENT AT :'" c~,; ;-(~,L ?~'lg02 ~ AM TO 4 PM FOR Nameofownerofpremises . C*r(~ C ~f*~,,,.r ~/~d'~ FOUNDATI~.~RE~IRED FOR ~URFD eO~_~E, (As on the tax roil or I~e~)FRAMING, ~MB~, STRAP~NG, ELECTRICAL l If'applicant is a corporation, signature of duly authorized officer 3 ~SU~TION 4 (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: }louse Number Street FINAL- CONSTRUCTION & EUECTRI~AL rvt~ COMPLETE FOR C.O. I. ~ ALL CONSTRUCTION ~ ~ ~ REQUIREMENTS OF THE CODES YORK STATE. NOT ~ Hamlet County Tax Map No. 1000 Section Block Lot-~' 2. Subdivision Filed Map No. Lot ,~'~__ State existing use and occupancy of premises and inten~¢qd use and occupancy of proposed construction: a. Existing use and occupancy --(~..~?/~ -~,d,, ,~5,,~,,,-r c. b. Intended use and occupancy Nature of work (check which applicable): New Building. Repair Removal Demolition Estimated Cost / ~ 70 o If dwelling, number of dwelling units If garage, number of cars Fee Addition Aheration Other Work _T.¥1'~/4 t t_ ,t./c./t4 ~ (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 NO__ 14. Names of Owner of premises Name of Architect Name of Contractor Address Phone No. Address Phone No Address Phone No. 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 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 elevatio~iat any point on property is at 10 feet or below, 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) O. ,ti?' SS: COUNTY OF¢l~/-i'll~)"'o:' ;% (Name ofin~i~dh signing contract) above named, (S)Heisthe ,~ ~- O~ ~ (Cogtractor, Agent, Corporate Officer, etc.) of said owner ~~ ~uly au~oriz~d to perform or have performed the said work and to make and file this application; tbat all statements~i~q~ ~lication are true to the best of his knowledge and belief; aad that tbe work will be perfomed in the m~~':i~liCa$ian filed therewith. Sworn to before me this ~ '~"~'-_ dayof C~ 20 Notary Public being duly sworn, deposes and says that (s)be is the applicant CONNIE D. BUNCH Notary Public, State of New York No. 01BU6185050 Gua;i[iud ii, SuffoiK t;ountv Commission Expires Apri, Town Hall Annex 54375 Main Road P.O. Box 1179 Soutt~old, NY 11971-0959 Tclcphone (631) 765-1802 BUn.nn~ D~PART~Mr TOWN OF SOUTHOLD APPLICATION FOR ELECTRICAL INSPECTION BY: Company Name: Date: Name: License No.: Address: Phone No.: JOBSITE INFORMATION.', (*indicates required information) *Name: .... ~o ,:~,~' ,-~ -(>~.4/&"'/ 6C}*/~ ~'>. / *Address: *Cross Street: *Phone No.: Permit No.: Tax-Map District: 1000 Section: *BRIEF DESCRIPTION OF WORK (Please Pdnt Clearly) Block: Lot: (Please Circle All That Apply) *Is job ready for inspect on: *Do.you need a Temp Certificate: Temp Information (If-neededJ *Service Size: 1 Phase ~New Service: Re-connect Additienal Information: 3PhaSe YES / NO Rough In YES / NO Final 100 150 200 300 350 400 Other Underground Number of Meters Change of Service Overhead PAYMENT DUE WITH APPLICATION Survey dtd 051607.Jos Ingegno.pdf Page 1 of 1 Sun~/dtd 051607.Jos tngegno.lx:lf https://d~cs.g~~g~¢.~~m/viewer?a=v&pid=gma~&at~d=~.2&thid=~37a87a4d4b4935b&mt=... 6/I/2012 IIIIIIIIII III III Looation: LON SLA O 3uslo~ner's Home Phone Customer's Work Phone Longwood, FL 32750-7579 (914) 277-4821 (914) 769-4000 Home Improvement Products Phone(800) 469~,663 street Address ESTIMATE AND PROPOSAL Cont~acta' License/Registration Number 225 HIPPODROME DRU *;,~ r' I; ,, NYC 1225166; Nassau County H1809170000; Putnam CityStateZipCode neat,ny & ,.ooi,ny Cou,ty PC3159-A; Rockland County H-9990-A6q)0~0 SOUTHOLD NY 11971 IS installation within city limits? Suffolk County 41506-H; Westchester County installation Address Count,/ SUFFOLK (Yes/No): YEs ~/C-18371-H06; Yonkers 4213 Billing Address {t~ different from above) City State Zip Code VZCTOR~roject CoP~s~JJtantLUPzSName & Lic~se NO. (~ applicable) Description of the Project and Description of the Si~]nificant Materials to be Used and Equipment to be installed SYSTEM INFORMATION: Equipment Brand: CARRZER (Split System/Package/Dual Fuel/Straight Cool/Heat Pump/Furnace): SEER: 15.50 .Cooling BTU: 34000.00 KW: HP AIR HANDLER E~ R-410A EQUIPMENT SPECIFICATIONS: FURNACE FUEL: {Gas/Oil/LP Gas/Electric): Existing New MODEL # OF NEW COMPONENT AFUE (up to): Heating BTU: [] [] FURNACE/FAN COIL FV4CNFOO3TOO ELECTRICAL: [] [] CONDENSER UNIT 25HPA636AO03 [] CONNECTTO EXISTING ELECTRICAL [] [] EVAPORATOR COIL [] INSTALL NEW AMP MAIN PANEL [] [] PACKAGE UNIT [] NEW DISCONNECT [] FURNACE [] CONDENSER [] [] THERMOSTAT iF82-26I [] NEWGFI OUTLET [] ATTIC LIGHT&RECEPTACLE [] [] HUMIDIFIER Other: [] [] AIR CLEANER DUCT WORK: [] [] UV LIGHT [] RE-USE EXISTING DUCTSYSTEM [] [] EVAP COOLER [] INSTALL NEW DUCT SYSTEM WITH # 7 NEW RUNS MISCELLANEOUS: [] REBUILD PLENUM (Supply/Return): [] [] LINESET so [] PAD__"x __ [] NEWTRUNKLINE(S) (Supply/Return): [] [] DRAIN LINE lO [] CONDENSATE PUMP [] NEW RETURN GRILL(S) __ X__ __ X __ [] [] AUXILIARY DRAIN PAN [] Other [] EXISTING RETURN GRILL SIZE [] REPLACE REGISTER(S)~ [] DUCT CLEANING Other: FLUE VENTING ANBIOR CHIMNEY: [] Use existing vent or chimney [] Install new chimney liner Size: [] PVC Vent Pipe for High-Efficiency Fumsce [] Horizontal [] Vertical [] Type-B Vent Pipe [] Stainless Steel Vent Pipe [] 1 Pipe Installation [] 2 Pipe Installation [] Combustion Air [] Existing [] Modify SPECIALINSTRUCTIONS:CARRZER 3 TON HEAT PUMP,.. 7 DUCT SYSTEM 4 DROPS,..QUALEF~ES FOR L~PA CREDID 49746-H5 All of the above check boxes and "Special Instructions" section have been reviewed and Customer(s) initials explained to me SH1-NY (Dig.) Rev 01/27/12 Page 1 of 3 IIIIIIIIII IIIIII Job Number: APPROXIMATE START DATE and APPROXIMATE COMPLETION DATE: The work will start approximately 2 WEEK (Approximate Start Date) It will be substantially completed by approximately 2WEEKS (Approximate Completion Date) These dates are subject to change at the time the contract is accepted by Sears Home Improvement Products, Inc. ("Sears") or at any other time by mutual written agreement. Customer understands that the Approximate Start Date is only an estimated date and the Customer will be contacted prior to this date to schedule the actual start date. ASBESTOS ABATEMENT: This Estimate and Proposal assumes that there are no asbestos containing materials ("ACMs") that would be disturbed in the )erformance of the installation work. If upon further inspection by the contractor or others it is learned that ACMe have to be disturbed to perform work, then Customer must arrange and pay for abatement of asbestos by a qualified person prior to the start or continuation of work. If Customer fairs to arrange for necessary asbestos abatement within thirty (30) days, Sears may cancel this contract upon Customer(s) initials ~ written notice to Customer ......'~ PLEASE NOTE that Sears is not responsible for correcting any existing code violations or pm-existing conditions of any duch~rk, piping, electrical supplies or equipment not being replaced at this time. If additional work is required, it will be the Customer's responsibility. An)' additional char~]es will be quoted and approved pdor to the start of any additional work. Customer(s) initials ~ THE CONTRACT PRICE INCLUDES: Price A copy of the terms and conditions of the Master Protection Agreement or Re- __-Year Master Protection Agreement [] $ )air Protection Agreement (as applicable) have been provided to Customer. __-Year Repair Protection Agreement [] $ Customer(s) initials ~b. The TOTAL PRICE iacluding all labor, meterial, taxes and any applicable discount is $ ].3,605.00 Contract Pdce $]_3,605.00 StateselesTax( 8.63 %) $ 0.00 Local Sales Tax ( o. oo %) $ o. 00 Customer Pa)'ment is due pdor to Sears' placement of Special Order for products. Total Amount Duels ].3,605. oo The form and method by which the Customer(s) will pay is described in a separate Cash/Credit Customer(s) initials ~ Card Pa)'ment Addendum mede a part of and incorporated into this contract by reference ...... NOTICE TO BUYER: YOU, THE BUYER, MAY CANCEL THIS TRANSACTION AT ANY TIME PRIOR TO MIDNIGHT OF THE THIRD BUSINESS DAY (FIFTH BUSINESS DAY IN ALASKA, FIFTEENTH BUSINESS DAY IN NORTH DAKOTA IF YOU ARE AGE 65 OR OLDER) AFTER THE DATE OF THIS TRANSAC- TION. SEE THE A]-fACHED NOTICE OF CANCELLATION FORM FOR AN EXPLANATION OF THIS RIGHT. ADDITIONAL PROVISIONS Proposal and Approval. Sears offers to furnish the materials and arrange for their delivery and installation as specif'~:~l on the first page and/or the attached sketches and specification sheets for the TOTAL PRICE shown. This offer must be approved by the Installation Department. If this is a credit sale or a payment on completion sale, it must be approved by the Credit Sales Department. If this proposal is not approved or the installation cannot be made in accordance with the law, this offer will be withdrawn and any payments you have made will be refunded to you. Any materials left over after the installation has been completed are Sears property and will be removed by Sears. Installation. I understand that Sears will not install the materials but will arrange for the installation. Sears is not responsible for materials or installation NOT famished or arranged by Sears. Sears' installation contractor(s) will obtain all building permits required by local law. For homes located in histodc or landmark zoning diatdcts, Customer will be responsible for obtaining required approvals and related permits prior to the commencement of work on this contract. Authorization. I aathodze Sears to: (1) arrange for a contractor (licensed where required by law) to make the installation of materials; (2) issue a work order for this installation to a contractor; (3) inspect the installation; and (4) pay the contractor when the installation is complete if I have signed a certificate that the installation has been completed to my satisfaction. Delays in Installation. I agree that Sears is not responsible for delays in delivery or installation due to weather, fire, strikes, war, govemmect regulations or any causes beyond Sears' control. Oral Aoreements and Cha _npos in Contract. ~ understand that there are no oral agreements between Sears and me. Everything I expect Sears to do has been included in writing in this contract. Nothing can be changed in this contract unless it is in writing on a separate form accepted by me and Sears. Responsibili _fy of Buyer. I agree that any information or measurements that I give to Sears are correct and complete. I am reeponsib~e for any special work described in this contract. Electrical & Plumbing_ Service. I will provide adequate electrical and/or plumbing service(s) to run any newly installed appliances or other furnishings. If the electrical and/or plumbing service(s) do not meet the standards of the utility company or electrical and/or plumbing codes, I will make the necessary changes at my expense unless Sears has agreed in this contract to make the changes. Payment. I will pay Sears the cash pdce that covers the price of matedal and installation as shown on the first page. Warranty Information. Appropriate product warranty documents will be given to me by Sears. Sears' Warranty on Installation is: SEARS' LIMITED WARRANTY ON INSTALLATION In addition to any manufacturer warranty extended to you on the product(s) used (which warranty becomes effective the date the merchandise is installed), if the workmanship (or application) of any Sears' arranged installation proves faulty within one year after the completion of installation, then upon nofise from you Sears will cause such faults to be corrected by repair at no additional cost to you. If Sears detormines that repair is not commercially practicable or cannot be timely made, then, at Sears' sole discretion, sears may elect to provide replacemerd or refund. Service under this Limited Warranty is available by calling Sears Home Improvement Products at 1-800-222-5030, Option 4. This warranty gives you specific legal rights, and you may also have other dghts that vary from State to State. SH1-NY (Dig.) Rev 01/27/12 Page 2 of 3 IIIII II II IIII III Job Number: 37o39 7 NOTICE TO BUYER 1. DO NO1- SIGN THE AGREEMENT IF ANY OF 1-HE SPACES INTENDED FOR THE AGREED TERMS TO 1-HE EX1,ENT OF THE AVAILABLE INFORMATION ARE LEFT BLANK. 2. YOU ARE ENTITLED TO A COPY OF THIS AGREEMEN1- Al- 1-HE TIME YOU SIGN IT. KEEP IT TO PROTECT YOUR LEGAL RIGHTS. 3. YOU MAY PAY OFF THE FULL UNPAID BALANCE DUE UNDER THE AGREEMENT AT ANY 1,1ME, AND IN SO DOING YOU SHALL BE ENTITLED TO A FULL REBATE OF THE UNEARNED FINANCE AND INSURANCE CHARGES. 4. YOU MAY CANCEL THIS TRANSACTION Al' ANY TIME PRIOR TO MIDNIGHT OF THE THIRD BUSINESS DAY [FIFTH BUSINESS DAY IN ALASKA, FIFTEENTH BUSINESS DAY IN NORTH DAKOTA IF YOU ARE AGE Ii5 OR OLDER] AFTER THE DATE OF THIS TRANSACt,ION. SEE THE ATTACHED NOTICE OF CANCELLATION FORM FOR AN EXPLANATION OF 1,HIS RIGHT. FAILURE TO EXERCISE THIS OPTION, HOWEVER, WILL NOT IN1,ERFERE WITH ANY OTHER REMEDIES AGAINSt, 1,HE RETAIL SELLER YOU MAY POSSESS. IF YOU WISH, YOU MAY USE THIS PAGE AS NOTIFICATION BY WRITING "1 HERESY RESCIND" AND ADDING YOUR NAME AND ADDRESS. A DUPLICATE OF THIS RECEIPT IS PROVIDED 8Y THE SELLER FOR YOUR RECORDS. 5. IT SHALL NO1, BE LEGAL FOR THE SELLER TO ENTER YOUR PREMISES UNLAWFULLY OR COMMIT ANY BREACH OF THE PEACE TO REPOSSESS GOODS PURCHASED UNDER THIS AGREEMENT. NOTICE TO NEW YORK RESIDENTS ONLY Any contractor, subcontractor, or materialman who provides home improvement goods and services pursuant to your home improvement contract and was not paid may have a valid legal claim against your property known as a mechanics lien. Any mechanics lien filed against your property may be discharged. Payment of the agreed-upon price under the home improvement contract prior to filing a mechanics lien may invalidate such lien. The owner may contact an attorney to determine his rights to discharge the mechanics lien. In accordance with Subdivision Four of Section 71-A of the New York Lien Law, Sears has posted a bond with SAFECO INSURANCE COMPANY OF AMERICA, a surety company licensed by the State of New York, guarantying the proper application by Sears of any cash payments or cash deposit received from the customer under this home improvement contract prior to the substantial completion of the work. The surety bond is in lieu of the escrow requirements of the New York Lien Law. Written notification of any and all claims asserted by the customer under this bond, along with a cop~/of the customer's contract, should be sent to: Sears Home Improvement Products, Inc., P.O. Box 522290, Lon~wnod, FL 32752-2290. NOTICE TO NEW YORK CITY RESIDENTS ONLY The Contractor agrees to furnish the Buyer with a "Certificate of Workers' Compensation Insurance" prior to commencement of work pursuant to the Contract. Customer's signature 05/01/20~2 05/0]/2012 Date Customer's signature Date /~h~-- Management Representative Accepted by Sears Horne Improvement Products, inc. (,Sears,) on O5/01/2012 Date SH1-NY (Dig,) Rev 01/27/12 Page 3 of 3