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HomeMy WebLinkAbout35289-ZTown of Somhold Annex P.O. Box 1179 54375 Main Road Southold, New York 11971 6/17/2013 CERTIFICATE OF OCCUPANCY No: 36294 Date: 6/12/2013 THIS CERTIFIES that the building ALTERATION Location of Property: 1355 Sm/th Road, Peconic, SCTM #: 473889 Sec/Block/Lot: 98.-4-14 Subdivision: Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this officed dated 1/4/2010 pursuant to which Building Permit No. 35289 dated 1/6/2010 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: ceiling fan as applied for. The certificate is issued to Charles F Vansant (OWNER) of the aforesaid builffmg. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL ELECTRICAL CERTIFICATE NO. PLUMBERS CERTIFICATION DATED 35289 6/6/13 FORM NO. 3 TOWN OF SOUTHOLD BUILDING DEPARTMENT Town Hall Southold, N.Y. BUII2]ING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) PERMIT NO. 35289 Z Date JA/qUARY 6, 2010 Permission is hereby granted to: CHARLES VANS~LNT 1355 SMITH RD PECONIC,NY 11958 for : INSTALLATION OF A CEILING FAN AS APPLIED FOR at premises located at 1355 SMITH RD County Tax Map No. 473889 Section 098 pursuant to application dated JANUARY Building Inspector to expire on JULY PECONIC Block 0004 Lot No. 014 4, 2010 and approved by the 6, 2011. Fee $ 200.00 Authorized Signature ORIGINAL Rev. 5/8/02 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 3. 4. 5. B. For existing buildings (prior to April 9, 1957) non-conforming uses, or buildings and I. Accurate survey of property showing all property lines, streets, building and unusual natu features. 2. A properly completed application and consent to inspect signed by the applicant. If a Cert 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, Alteratio~ Swimming pool $50.00, Accessory building $50.00, Additions to accessory building $50. 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 topographic features. Final Approval from Health Dept. of water supply and sewerage-disposal (S-9 fonn). Approval of electrical installation from Board of Fire Underwriters. Sworn statement from plumber certifying that the solder used in system contains less than 2/10 of 1% lead. Commercial building, industrial building, multiple residences and similar buildings and installations, a certificate of Code Compliance from architect or engineer responsible for the building. Submit Planning Board Approval of completed site plan requirements. ~-ex' ~ii~sl ~ 7~ ~_~ t~(~=::~Id o topo raphi ~ s=to welhn'~g $ 0, B[lsinesses $5p.00. Old or Pre-existing Building: t~ (check one) Street Hamlet ~ Block ~ Lot tL/ New Construct, l~ Location o f Propert~,JHou~se-~No.~"- C / ~'~'5'-~ Owner or Owners of Prope~ ' Suffolk County Tax Map No 1000, Section Subdivision Filed Map. Permit No. ~ ~)'~5-(5} Date of Permit. Applicant: Underwriters Approval: Health Dept. Approval: Planning Board Approval: Lot: Request lbr: Temporary Certificate Fee Submitted: $ --.~5 · iD ~ Final Certificate: (check one) Applicant Signature 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 Issued To: Charles Vansant (Smith) Address: 1285 Smith Rd City: Peconic St: NY Zip: 11958 Building Permit #: 35289 Section: 98 Block: 4 Lot: 14 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 ~ Indoer ~ Basement ~ Service Only ~ Commerical Outdoor 1st Floor Pool New Renovation 2nd Floor Hot Tub Addition Survey Attic Garage INVENTORY Servicelph ~ Heat ~ Duplec Recpt ~ Ceiling Fixtures ~ HID Fixtures ~Wall Fixtures Smoke Detectors Service 3 ph Hat Water GFCI Recpt 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 Lcck Exit Fixtures L__J TVSS Other Equipr~t: installation of paddle fan (1) Inspector Signature: Date: June 6 2013 Eiectrical_Certiflcate.xls 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 iNSPECTOR~~~----~ 54375 ~ ~ P.O. Box 11'79 $outi~old, NY 119'714)959 BUILDING DEPARTMENT TOWN OF $OUTHOLD APPLICATION FOR ELECTRICAL INSPECTION Company Name: Name: Ucense No.: Address: Phone No.: JOBSITE INFORMATION: *Name: *Address: *Cross Stree[: *Phone No.: Permit No.: TaxMap District: (*Indicates required information) ooo Se ti0n: *BI~IEF DESCRIPTION OF WORK (Please Print Clearly) (P!e~e Cite All That ~ply) ~s ~b ready for insp~i0n: *~-~u need a Temp Ce~te: Block: YES I NO Rough In YES / NO Final Temp Information (If- needed] *Service Size: 1 Phase ~New Service: Re-connect Additienal Information: 3Phase 100 150 200 300 350 400 Other Underground Number of Meters Change of Service overhead PAYMENT DUE WITH APPLICATION 82-Request for Inspection Form TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, NY 11971 TEL: (631) 765-1802 FAX: (631) 765-9502 SoutholdTown.NorthFork.net Examined Approved Disapproved a/c 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 Su~,e~ Check Septic Form N.Y.S.D.E.C. Trustees Flood Permit Storm-Water Assessment Form Contact: Mail to: Ph°ne:-~'~q' C~[5 ~ Expiration ~/&, 20/~' /~....__  Building Inspector APPLICATION FOR BUILDING PERMIT Date ~/'~J'~ , 20~ ,..a. Tbi~~ompletely filled in by typewriter or in ink and submitted to the Building Inspector with 4 se ~ot 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 slreets 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 pemfit 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 ~vhat so ever until the Building Inspeclor issues a Certificate of Occupancy. £. 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 thc property have been enacted in the interim, the Building Inspector may authorize, in writing, the extension of the permit tbr an addition six months. Thereafter, a new permit shall be required. APPLICATION IS HEREBY MADE to the Building Department for the issuance ora Building Permit pursuant to the Building Zone Ordinance 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 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. ~ ~~~__~ (Signature of applicant or name, ifa corporanon) ALL CONS' '- ,idERE©U i DE WR ; E IflCATE (.';(,;DES OF NE. RE UiEF..D (Mailing address of applicant) State whether applicant is o~ner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder Nameofownerofpremises 7. (As on the tax roll or latest'deed} t . 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. 1. Location of land on which proposed work will be done: House Number Street Hamlet County Tax Map No. 1000 Section ~,~O Block g2, ,,t-/~C~ Subdivision Filed Map No. Lot '/~ Lot State existing use and occupancy of premises and in-'Tended use and occupancy of proposed construction: a. Existing use and occupancy I l_ _ t b. Intended use and occupancy ~("~r'~*.{'-~ c~--~9 Nature of work (check which applicable): New Building. Repair Removal Demolition Estimated Cost If dwelling, number of dwelling units If garage, number of cars Fee Addition Alteration Other Work ..r~.~1-~-L Ct~:r-~.:r_~& F~t,s (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 Rear Height Number of Stories .Depth Dimensions of same structure with alterations or additions: Front Depth Height Number of Stories Re@r,, ¢ . 8. Dimensions of entire new construction: Front Rear Height Number of Stories 9. Size of lot: Front Rear _Depth 10. Date ofPurchase [,IP/OT/T--'a'~ Name of Former Owner Depth 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 eta 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 * 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, rnhs['l~rovide 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 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 Yor~ (S)He is the No. 01BU6185050 (Contractor, Agent, Corporate Officer, etc.) Oualitied iff sultolk t;ount~ Commission Expires April 14, 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. Swq)rn to before me tl3ks day of~L,~C,,X,~64'v~ 20 [ 0 Notary Public Signature of Applicant Town Hall Annex 54375 Main Road P.O. Box 1179 Southold. NY I 1971-0959 Telephone (631) 765-1802 Fax (631) 765-9502 BUILDING DEPARTMENT TOWN OF SOUTHOLD March 29, 2011 Charles Vansant 3 Dana Circle Milford, MA 01757 . RE: 1355 Smith Road, Peconic TWO WHOM IT MAY CONCERN: The Following Items Are Needed To Complete Your Certificate of Occupancy: '~-~-'~ Application for Certificate of Occupancy. (Enclosed) ~ Electrical Underwriters Certificate. ~ A fee of 50.00. __ Final Health Department Approval. __ Plumbers Solder Certificate. (All permits involving plumbing after 4/1/84) __ Trustees Certificate of Compliance. (Town Trustees#765-1892) __ Final Planning Board Approval. __ Final Fire Inspection from Fire Marshall. __ Final Landmark Preservation approval. BUILDING PERMIT: 35289-Z ceiling fan Town Hall Annex 54375 Main Road P.O. Box 1179 Southold. NY 11971-0959 March 8, 2013 BUILDING DEPARTMENT TOWN OF SOUTHOLD Charles Vansant 200 Exchange St Unit 513 Providence, RI 02903 Re: 1355 Smith Rd, Peconic TO WHOM IT MAY CONCERN: The Following Items (if Checked) Are Needed To Complete Your Certificate of Occupancy: Application 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 4/1184) 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: 35289 - Ceiling Fan Telephone (631) 765-1802 Fax (631 ) 765-9502