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Home My WebLink About37789-ZTown of Southold Annex P.O. Box 1179 54375 Main Road Southold, New York 11971 5/13/2013 CERTIFICATE OF OCCUPANCY No: 36235 Date: 5/13/2013 THIS CERTIFIES that the building Location of Property: SCTM #: 473889 Subdivision: OTHER 500 Goose Creek Ln, Southold, Sec/Block/Lot: 79.-1-4 Filed Map No. conforms substantially to the Application for Building Permit heretofore 2/4/2013 pursuant to which Building Permit No. 37789 was issued, and conforms to all of the requirements of the applicable provisions of the law. The occupancy for wttich this certificate is issued is: Lot No. filed in this officed dated dated 2/6/2013 ACCESSORY GENERATOR AS APPLIED FOR The certificate is issued to Mallgraf, Robert & Mallgraf, Phyllis (OWNER) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL ELECTRICAL CERTIFICATE NO. PLUMBERS CERTIFICATION DATED 37789 03-10-2013 Authorized Signature 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 #: 37789 Date: 2/6/2013 Permission is hereby granted to: Mallgraf, Robert & Mallgraf, Phyllis 500 Goose Creek Ln PO BOX 371 Southold, NY 11971 To: install a accessory generator as applied for At premises located at: 500 Goose Creek Ln, Southold SCTM # 473889 Sec/Block/Lot # 79.-1-4 Pursuant to application dated 214/2013 To expire on 8/8/2014. Fees: and approved by the Building Inspector. ALTERATION OF ACCESSORY BUILDINGS $ 100.00 CO - ACCESSORY BUILDING $50.00 ELECTRIC $85.00 Total: $235.00 Building Inspector 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 featur6s. 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. Sw~rnstat~m¢ntfr~mphimb~rc~rtifyingthatthesu~derusedinsystemcontains~es~than2/~f~%~ead. . 5. Commea'oial building, industrial building, multiple residences and similar buildings and installations, a certificate of Code ComPliance'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~ 1. Accurate sur~y of property showing all property lines, struts, building and unusual natural or topographic feature. 2. A properly ~o~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. 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 Temporary Certificate of Occupancy - Residential $15.00, Commercial $15.00 New Construction: Location of Property: Hous~ No. Owner or Owners of Property: · Suffolk County Tax Map No 1000, Section Subdivision -- H~lth Dept. ApprOval; Planning Board Approval: Request for: Temporary Certificate Old or Pre~cxisting Building: Street Foe Submitted: $ Date of Permit. (cheek one) Hamlet q Block / Filed Map. ,-- <~ - - 6o-- / '~ . Applicant:. Underwriters Approval: Final' Certificate: (cheek one) 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 rorer r chert~,town southold.ny.us CERTIFICATE OF ELECTRICIAL COMPLIANCE SITE LOCATION Issued To: R & P Mallgraf Address: 500 Goose Creek Lane City: Southold St: NY Zip: 11971 Building Permit #: 37789 Section: 79 BIook: 1 Lot: WAS EXAMINED AND FOUND TO BE IN COMPLIANCE WITH THE NATIONAL ELECTRIC CODE Contractor: DBA: Peconic Electric License No: SITE DETAILS Office Use Only Residential ~ Indoor ~ Basement ~ Serv~ceOnly ~ Commedcal Outdoor 1st Floor Pool New Renovation 2nd Floor Hot Tub Addition Sun/W Attic Garage INVENTORY Servicelph ~ Heat U DuplecRecpt ~ Ceiling Fixtures ~ HiD Fixturec ~ Service 3 ph Hot Water GFCI Recpt Wall Fixtures Smoke Dotectors Main Panel A/C Condenser Single Recpt Recessed Fixtures CO Dotectors Sub Panal A/C Blower Range Recpt Fluerescent Fixture Pumps Transformer Appliances Dryer Recpt Emergency Fixtures Time Clccks Disconnect Switches Twist Look E~it Fixtures TVSS Other Equipr~ent: 10kw generator with transfer switch Inspector Signature: v Date: April 10 2013 Elect dcaLCertificate.xls TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, NY 11971 TEL: (631) 765-1802 FAX: (631) 765-9502 SoutholdTown. NorthFork.net PERMIT NO. Exalnined ~ C . 20 (.'~ App,-oved "~' .20 Disapproved a/c Expiration Building Inspector BUILDING PERMIT APPLICATION CHECKLIST DO yoLI have or need the following, bei-bre applying? Board of Health 4 sets of Building Plans Planning Board approval Sarvey Check Septic Form N.Y.S.D.E.C. Trustees C.O. Application Flood Permit Single 8,: Separate Storm-Water Assessment Form Mail to: Phone: ILICATION FOR BUILDING PERMIT Date -.,~-,/.-( ,20/3 INSTRUCTIONS pletely filled in by typewriter or in ink and submitted to the Building Inspector with 4 sets of plans, accurate plot p[all 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 no! be commenced be£ore 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 iii whole or in part for any purpose xxhat so ever tmtil the Building Inspector issues a Certificate of Occupancy. f. Every building permit shall expire if the worl, authorized has not commenced witbin 12 months after tbe date of issuance or has not been completed witlfin 1 8 months from such date. If no zoning amendments or otber regulatioas afl'ecting the property bave been enacted in the interim, the Building Inspector may authorize, mv, riting; the extension oftbe permit for an addition six htonths. Thereafter, a new permit shall be required. ~ APPLICATION [S HEREBY MADE to tbe Building Department tbr the issuance of a Building Permit pursuant to the Building Zone Ordiaance of the Town of Southold, Suflblk County. New York. and other applicable Laws. Ordinances or Regulations, for the construction of buildings, additions, or alterations or fbr removal or demolition as herein described. The applicant agrees to comply ~vith all applicable laws, ordinances, building code, bousing code, and regulations, and to admit authorized inspectors on premises and in building for neces'sary inspections. (Signature of applicant or name. ifa corporation) State whether applicant is~essee, agent, arcNtect. Name of owner of premises t~ ~,e~z r~ .") "..: , -;, ~ ,tM: k,.~r.-,on the tax roll or! If ttpplicant is a co,'poration, sig'r~{*di;e 0c,a akil¥o,k e nrlSce,' (Name and title ot corpqra~.D~cer~ Builders License No. 'tf:: )J] UNH/IHU;3? '- Plumbers License No. Electricians Licensc No. Other Trade's License No. Location of land on which proposed work will be done: ,lq, ~. .... ltouse Number Street ELECTriCAL Hamlet CountyTax UapNo. 1000 Section 7~ Block ' / :'" Lot Subdivision h/O/9 ~ Filed Map No. Lot State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy ~lE"q~D~-~d F- b. Intended use and occupancy /0E c5 i;D ~ 3. Nature of work (check which applicable): New Building Repair Removal Demolition 4. Estimated Cost J'.Dr7'. ¢'wo. --- 5. If dwelling, number of dwelling units If garage, number of cars P/cNE Fee Addition Alteration Other Work tN_qT~.I- ff-.~r-:/v eh ,~'re~ (Description) (To be paid on filing this application) Number of dwelling units on each floor / 5-r~,r~4 ~aor,~ 6. If business, commercial or mixed occupancy, specify nature and extent of each type of use. 7. Dimensions of existing structures, if any: Front ~q / Rear ~ ' Depth Height //,, ~ Number of Stories / Dimensions of same structure with alterations or additions: Front :~,~ tn ~ Depth Height. Number of Stories Rear No 8. Dimensions of entire new construction: Front ?/t~ m,4,q~aE Rear Height 9. Size of lot: Front 10. Date of Purchase 11. Zone or use district in wbicb premises are situated Number of Stories Rear 7~r.- I Name of Former Owner Depth Depth 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 o¥v~-~-,~ r~ m,~.,~,~kddress · ~:~Phone No. O g t- 7 6X- ~t3 ~ Name of Architect NoN~ '~ddress Phone No NameofContractor ~e~c g~¢~Rt~ Address S~r~mpr~.. ~/.~ Phone No. ~5~ ~*&w~ 15 a. Is this property within 100 feet of a tidal wetland or a t~eshwater wetland? *YES ~ NO ~ · IF YES, SOUTHOLD TOWN TRUSTEES & D.E.C. PERM1TS MAY BE REQUIRED. b. Is this property within 300 feet ora tidal wetland? * YES ~ NO~ · IF YES. D.E.C. PERMITS MAY BE REQUIRED. 16. Provide survey, to scale, with accurate foundation plan and distances to property lines. 1 7. !f elevation at any point on property is at 10 feet or belo,x, must provide topographical data on survey. 18. Are there any covenants and restrictions with respect to this property? * YES__ · IF YES, PROVIDE A COPY. NO ~'~ STATE OF NEW YORK) SS: COUNTY OF ) being duly sworn, deposes and says that (s)he is tbe applicant (Name of individual signing contract) above named. COtCNIE D. BUNCH Notary g~.'13} o. State of New York ',. ¢!BU~185050 (S)He is the O, : }r~, n $- iolk County (Contractor, Agent, Corporate Officer, etc.) Ocr: :,,:a Z:;~,> ;cs April 14,'2 e.,.)~ of said owner or owners, and is duly authorized to perform or bave performed the said work and to make and file tiffs application; that all statements contained in this application are tree to the best of bis knowledge and belief; and that the work will be performed in the rnanner set forth in the application filed therewith. Swpr0 ~ before me th~ t , . da,y. of , 0Z3_ Notary Public Signature of ApplicaJ~t~~ BU~[ ~I~G DEP~ TOWN OF $OUTHOLD ,.APPLICATION FOR FI I=CTRIC_AL iNSpECTiON Company Nam e: /V~/Y E Name: License No.: ~ddreSS: :Phone No.: ,~_~/_ ~/~_<'_ ~./ JOBSITE INFORMATION: (*Indicates required information) *Name: ~o[SEWT ~, ~/ *P~ne No.: ~.~/_y~_ T~.MapDla~: .., 1~0 S~i0n:_ ~. B~: ~E BES~IRION OF WORK (~ ready for inspecl~: *Do-~ou ~ a Temp Cerlfficate: Temp Information (if. needed) *Sen~ce Size: 1 Phase ~ 8~o~: Re-oonneot' Additienal Information: Final 3Phase (~ 150 200 300 350 .400 Other Underground Number of Metem Change of Service Overhead PAYMENT DUE WITH APPLICATION 82-Req~es{ for Inspection Form Page 1 of l Subj: Inspection for Electrical Date: 5/11/2013 11:44:37 A.M. Eastern Daylight Time From: rich @peconicelectric.com To: Boardroomrcm@aol.com CC: sara@peconicelectric.com, steve@ peconicelectric.com Hi Bob, I called the town to inspect the work and provide you with a certificate. If you would, please follow up with them so you receive the certificate for your C of O. Thank you, If we can be of further assistance, please let us know ! Rich tach waght - Prind?al Peconic Electric PO Box 13 Southampton, NY, 11969 North Fork: 631.298.7700 Shelter Island: 631.765.5556 Hamptons: 631.288.6098 Fax :631.849.4612 Emaih Rich ~ peconicelectric.com www.peconicelect ric.com Pecon;c Electric Saturday, May 11, 2013 AOL: BoardroomRCM T~ x_ 20' .E. IGHT M~p MALLG~,AF / t t I I t ' T]~'I~U~ENT