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Home My WebLink About37850-ZTown of Southold Annex P.O. Box 1179 54375 Main Road Southold, New York 11971 CERTIFICATE OF OCCUPANCY 5/31/2013 No: 36271 Date: 5/31/2013 THIS CERTIFIES that the building OTHER Location of Property: Whistler Ave, Fishers Island, SCTM #: 473889 Sec/Block/Lot: 12.-1-11 Subdivision: Filed Map No. conforms substantially to the Application for Building Permit heretofore 3/1/2013 pursuant to which Building Permit No. Lot No. filed in this officed dated 37850 dated 3/7/2013 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: GAS HEAT AS APPLIED FOR The certificate is issued to Lamb, Donald & Lamb, Karen (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 #: 37850 Permission is hereby granted to: Lamb, Donald & Lamb, Karen 3950 Country Club Rd ~'outville, VA 24175 Date: 3/7/2013 To: Gas heat conversion as applied for. At premises located at: Whistler Ave, Fishers Island SCTM # 473889 Sec/Block/Lot # 12.-1-11 Pursuant to application dated To expire on 9/6/2014. Fees: 3/1/2013 and approved by the Building Inspector. FURNACE/BOILER - RESIDENTIAL $200.00 CO - RESDENTIAL $50.00 Total: $250.00 Form No. 6 TOWN O~ $O~OLD BUILDING DEPARTMENT TOWN HALL 765-1802 APPLICATION FOR CERTIFICATE OF occUPANcy llns application must be filled tn by typewriter or ink and submitted to the Building Department with the following'. ~ For new building or new use: I. Final survey of property with accurate'location of all buildings, property lines, sheets, and unumal natural or topographic features. 2. Final Approval from Health D~pt. of water supply and sewerage-disposal (S-9 form). 3- Approval of electrical installation from Board 0fFire Underwritem. · 4. 8w.~mstatementfr~mphimb~rcertifyingthatthes~deru$edinsystemc~ntainsl~sthan2/~%~ead. . 5. Commemiat building, industrial building, multiple re,~idences and similar buildings and installations, a certificate of Code Cotnpliance'from architect or engineer responsible for the bnildiag= .6. Submit planning Board Approval of completed site plan requirements. For existing buildings (prior to April 9, 1957) non-conforming uses, or buildings and "pre-existing" land nses~ 1_ Accurate survey of property showing all property lines, streets, building and unusual naturai or topographic features. 2_ A properly c~mpleted 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 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 GU Pre-ex~sting Building $100.00 3 Copy of Certificate of Occupancy - $:25 ~I Updated Certificate of Occupancy $5000 5 Temporary Certificate of Occupancy - Residential $15.00, Commercial $15.00 New Construction: l.ocation of Property: Old or Pre-existing Building: (check one) House No. Dwner or Owners of Property: -luffolk County Tax Map No 1000, Section gubdivision · ermit No. '~'~ ~/~ Date of Permit. lealth Dept. Approval: 'lanning Board Approval: ~equest for: Temporary Certificate Street Hamlet Block Filed Map. Applicant: Underwriters Approval: _ Final Certificate: (check one /\p[~hcanl Stgnalul¢ TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN IIALL SOUTHOLD, NY 11971 TEL: (631) 765-1802 FAX: (631) 765-9502 SoutholdTown. North Fork. net BUILDING PERMIT APPLICATION CHECKLIST Do you have or need the following before applying? Board of Heagh 4 sets of Building Plans Planning Board approval Survey Check Septic Form Disapproved a/¢ N Y S.D E.C Flood Permit Storm-Water Assessment Form BE COMli~_T~ ~i.~se No. ALL C 0 N S T~. U ~,~iNo. SI-,It~,,~ ~c :"r · ' ~jc ~pos~ work will ~ done: REQUIREMENTS O~'~Eb ~S 1 ~ YO~ STATE. ~d~SIBLE F~t DESIGN O~ CONST~UOTION Coun~ T~ MapNo. 1000 ~ection ~ ~ BIoc~ Subdivision I Lot II Filed Map No. Lot Mail to: =. , : BXfli44in~nspe~tor ~ INSTRUCTIONS Date ,20 a. ~i~ ~g~ ~UST be eom ~letely filled in by Wpe~iter or m ~ ~d submitted to ~e Building l~ctor ~m 4 sera nf nla~ a&~r~ ~l~ t~ ~lo ~ :e according to schedule. ~~ ~l~r~ Ob.5~o ~,~C,T~FY *~,.~o~,S~Z~,AT D~.~ L~ ~ FOLLOWlN~f ~El~or~tio~, si~atum of duly ~ulhoriz~d ofl~er L FOUNDAT!~ - TWr~ mc~UIRFn FO, USE IS UNLAWFUL 2. ~OU~H .~t~M~r~e WITHOUT CERTIFICATE 3. INSIJLAT~b~ Lic¢n~ No. ~ ~ .~ ¢q ~ 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 3. Nature of work (check which applicable): New Building_ Addition Alteration Repair Removal Demolition Other Work {'tm (Description) 4. Estimated Cost Fee (To be paid on filing this application) 5. I f dwelling, number of dwelling units Number of dwelling units on each floor If garage, number of cars 6. I f business, commercial or mixed occupancy, specify nature and extent of each type of use. 7. Dimensions o f existing structures, if any: Front Height. Number of Stories Rear _Depth Dimensions of same structure with alterations or additions: Front Depth Height Number of Stodes 8. Dimensions o f entire new construction: Front Height Number of Stories Rear Rear Depth 9. Size of lot: Front Rear _Depth 10. Date of Purchase 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 of a tidal wetland or a freshwater wetland? *YES NO__ * 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 * IF YES, D.E.C. PERMITS MAY BE REQUIRED. 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 and restrictions with respect to this property? * YES · IF YES, PROVIDE A COPY. NO STATE OF NEW YORK) ('~ _' SS: COUNTY OF~-~LLC / ~ (Name of individual signing contract) above named, (S)H~e is the ~.~J'-- (Con"tra~tor, 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. ' day of · 20 ~.~ ~ KARL~ S. HF~°~IH Signature of Applicant NOTARY PUBLIC, STATE OF NEW YORK NO. 01HE6222563 QUALIFIED IN SUFFOLK COUNTY COMMISSION EXPIRES 05/24/2014 Town Hall Annex 54375 Main Road EO. Box 1179 Southold, NY I 1971-0959 Telephone (631) 765-1802 Fax (631) 765-9502 BUILDING DEPARTMENT TOWN OF SOUTHOLD May 20, 2013 Donald & Karen Lamb ~ ..4pr3950 Country Club Rd ~)~ [ (~ Troutville, VA 24175 RE: VVhistler Ave, Fishers Island SCTM # 12.-1-11 TO WHOM IT MAY CONCERN: The Fo~'ing Items (if Checked) Are Needed To Complete Your Certificate of Occupancy: /- App cat on for Certificate of Occupancy (Enclosed) Electrical Underwriters Certificate. (contact your electrician) __ A fee of $50.00. __~ Final Health Department Approval. __ Plumbers Solder Certificate. (All permits involving plumbing after 411184) __ Trustees Certificate of Compliance. (Town Trustees # 765-1892) __ Final Planning Board Approval. (Planning # 765-1938) __ Final Fire Inspection from Fire Marshall. __ Final Landmark Preservation approval. __ Final inspection by Building Dept BUILDING PERMIT: 37850 - Gas Heat Conversion Tn n leTube I) [ I) $ Ii l) Excel lence High Efficiency Condensing Stainless Steel Wall Mounted Gas Boiler with Built in "Tank-in-Tank"Indirect Fired Water Heater. The Prestige Excellence Model Condensing Boiler also incorporates a 14 gallon Indirect Fired Water Heater in the cabinet that is capable of producing 180 gph of domestic hot water. 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