HomeMy WebLinkAbout38110-Z a'`"~ "z^ Town of Southold Annex 6/26/2013
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.i~ e, P.O. Box 1179
= 54375 Main Road
'i! Sonthold, New York 11971
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CERTIFICATE OF OCCUPANCY
No: 36320 Date: 6/26/2013
THIS CERTIFIES that the building SHED
Location of Property: 1520 Bray Ave, Laurel,
SCTM 473889 SecBlock/Lot: 126.-7-27
Subdivision: Filed Map No. Lot No.
conforms substantially to the Application for Building Permit heretofore Tiled in this otficed dated
6/10/2013 pursuant to which Building Permit No. 38110 dated 6/18/2013
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:
"as built" shed as applied for.
The certificate is issued to Burrowes, Catherine V.
(OWNER)
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL
ELECTRICAL CERTIFICATE NO. 38110 6/25/13
PLUMBERS CERTIFICATION DATED
Autho Signatu e
~y~io~',TL TOWN OF SOUTHOLD
~y BUILDING DEPARTMENT
TOWN CLERK'S OFFICE
~'a~~~ SOUTHOLD, NY
y ! ~ tea,,.
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 38110 Date: 6/18/2013
Permission is hereby granted to:
Burrowes, Catherine
1520 Bray Ave
Laurel, NY 11948
To: "As Built" Shed
At premises located at:
1520 Bray Ave, Laurel
SCTM # 473889
Sec/Block/Lot # 126.-7-27
Pursuant to application dated 6/10/2013 and approved by the Building Inspector.
To expire on 12/18/2014.
Fees:
AS BUILT -ACCESSORY $318.00
CO -ACCESSORY BUILDING $50.00
Total: $368.00
Building Inspect
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 features.
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. Sworn statement from plumber certifying that the solder used in system contains less than 2/10 of 1 % lead.
5. Commercial 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 Approvalof completed site plan requirements.
S. For existing buildings (prior to April 9, 1957) non-conforming uses, ar buildings and "pre-existing" land uses:
1. Accurate survey ofproperty showing all property lines, streets, building and unusual natural or topographic
features.
2. A properly completed 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
I. Certificate ofOccupancy -New dwelling $50.00, Additions [o 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
5. Temporary Certificate of Occupancy -Residential $15.00, Commercial $ 15.00
Dale. ~ U
New Construction: Old or Pre-existing Building: (check one)
Location of Property: ~ 5aL ~t'~-i ~(/`Q_, ~~.l.l.~--2~
House N//o. Street Hamlet
Owner or Owners of Property: l,G:~1LE <~L~F~t~~~~/~
Suffolk County Tax Map No 1000, Section ~ a ~ Block / Lot
Subdivision Filed Map. Lot:
Permit No. ' Date of Permit. Applicant:
Health Dept. Approval: Underwriters Approval:
Planning Board Approval:
Request for: TemporaryCertificate Final Certificate: (check one)
Fee Submitted: $
Applicant Signature
rYL~^~rzz~
S~FFO(K~,
Town Hall Annex ~pp~ OOy Telephone (631) 765-1802
54375 Main Road g ~ Fax (631) 765-9502
P.O. Box 1179 0 • ~ '
Southold, NY 11971-0959 da,01 ,?a~0{~.r{ rooer.richert@town.southold.ny.us
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BUILDING DEPARTMENT
TOWN OF SOUTHOLD
CERTIFICATE OF ELECTRICIAL COMPLIANCE
SITE LOCATION
Issued To: Catherine Burrowes
Address: 1520 Bray Ave City: Laurel St: NY Zip: 11948
Building Permit 38110 Section: 126 Block: 7 Lot: 27
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 X Indoor X Basement Service Only
Commedcal Outdoor X 1st Floor X Pool
New Renovation 2nd Floor Hot Tub
Add'Rion Survey Attic Garage
INVENTORY
Service 1 ph Heat Duplec Recpt 1 Ceiling Fixtures HID Fixtures
Service 3 ph Hot W a[er GFCI Recpt 2 Wall Fixtures 1 Smoke Detectors
Main Panel A/C Condenser Single Recpt Recessed Fixtures CO Detectors
Sub Panel A/C Blower Range Recpt Fluorescent Fixture Pumps
Transformer Appliances Dryer Recpt Emergency Fixtures Time Clocks
Disconnect Switches 2 Twist Lock Exit Fixtures TVSS
Other Equipment: storage shed
Notes:
Inspector Signature: ~~b~~ Date: June 25 2013
Electrical Certificate.xls
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81 ~ ° o,~~,oFSUa,~
3 6
TOWN OF SOUTHOLD BUILDING DEPT.
765.1802
INSPECTION
[ ]FOUNDATION 1ST [ ]ROUGH PLBG.
[ ]FOUNDATION 2ND [ ] INSULATION
[ ]FRAMING /STRAPPING [ Vj/FINAL
[ ]FIREPLACE & CHIMNEY [ ]FIRE SAFETY INSPECTION
[ ]FIRE RESISTANT CONSTRUCTION [ ]FIRE RESISTANT PENETRATION
[ ]ELECTRICAL (ROUGH) [ ]ELECTRICAL (FINAL)
REMARKS:
DATE a~ ~ g /3 INSPECTOR ~
~~,OF S0I/jyo
J. #
I ti~ J,
~ry TOWN OF SOUTNOLD BUILDING DE 4~ l~~
765-1802 r! ~p ~
2~ ~
~ ~ 1 NSPECTION ~
[ ]FOUNDATION 1ST [ ]ROUGH PLBG.
[ ]FOUNDATION 2ND [ ]INSULATION
[ ]FRAMING /STRAPPING [ ]FINAL
[ ]FIREPLACE & CHIMNEY [ ]FIRE SAFETY INSPECTION
[ ]FIRE RESISTANT CONSTRUCTION [ ]FIRE RESISTANT PENETRATION
[ ]ELECTRICAL (ROUGH) ~ ELECTRICAL (FINAL)
REMARKS:
~tit~J~ LrGcZ ~ c~
DATE ~0 2 ~ 3 INSPECTOR
~o~~Of SO!/l~~
Town Eiall Mnex ~ ~ Telephone (631) 765-1804
54375 Main Road
P.O. Box 1179 G.~ Q roger.richert(t~~own souUlO~d.nv.us
Southold, NY 11971-0959 -
~~t,
BUILDING DEPARTMENT
TOW1~I OF SOUTHOLD
APPLICATION FOR ELECTRICAL INSPECTION
REQUESTED BY: ~wC.h ~j A~.h,GS .Date:
Company Name:
Name:
License No.:
Address: 2-p ~ a S ~Aa t^ ~d {v c ~ S.Z
JOBSITE INFORMATION: (*Indicates required information)
*Name: ~5~-k o~" G~-vrhti ~l ~wo WAGS
*Address: ~ C, Zp Pjr ~ L~
'Cross Street:
'Phone No.:
Permit No.: "~j ~ / / GS
Tax Map District: 1000 Section: _ Z Block: Lot: 'Z~
*BRIEF DESCRIPTION OF WORK (Please Print Clearly)
(Please Circle All That Apply)
*Is job ready for inspection: YES / NO Rough In Final
*Do you need a Temp Certificate: YES / NO
Temp Information (If needed)
'Service. Size: 1 Phase 3Phase 100 150 200 300 350 400 Other
*New Service: Reconnect Underground Number of Meters Change of Service Overhead
Additional Information: PAYMENT DUE WITH APPLICATION
82-Request for Inspection Fonn -
FIELD • NiLEPOAT DATE CONIMBPTfS
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FOUNDATION (1ST) ~
C
FOUNDATION (ZND)
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0
•
ROUGH FRAD2RVG &
PLUMING r~
1
INSULATION PEIi N. Y. H
STATE ENERGY CODE
O:
FINAL
ADDITIONAL CONIMENTS
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TOWN OF SOUTHOLD BUII,DING PERMIT APPLICATION CHECKLIST
BUILDING DEPARTMENT Do you have or need the following, before a 1 ' 7
TOWN HALL PP Ymg
SOUTHOLD, NX 11971 Board ofIiealth
TEL: (631) 765-1802 4 sets of Building
Pla~-
FAX: (631) 765-9502 Planning Board approval
www. northfork.net/Southold/ pE Survey
R114I'T NO. Oz'z Check
Septic Farm
N.Y.S.D.E.C.
Examined 20~ Trustees
Contact:
Approved 20
Disapproved a/c Mail to:
' Phone:
Expiration 20
I D i Building Inspector
JUN 1 U 2013 l1 JI
,APPLICATION FOR BUILDING PERiVIIT
` Date June 10,
~_.___t~'-~--- - - INSTRUCTIONS ,2013
a. This application MUST be completely filled in by typewriter or in ink and submitted to the Building Inspector with 3
sets of plans, accurate plot 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 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 for inspection throughout the work.
e. No building shall be occupied or used in whole or in part for any purpose what so ever until the Building Inspector
issues a Certificate of Occupancy.
f. 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 the
property have been enacted in the interim, the Building Inspector may authorize, in 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 Deparhnent for the issuance of a Building Permit pursuant to the
Building Zone Ordinance of the Town of Southold, Suffolk County, New York, and other applicable Laws, Ordinances or
Regtrlations, for the construction of buildings, additions, or alterations or for removal or demolition as herein described. The
applicant amt®~~T},~~Ilafl6lQls, ordinances, building code, housing code, and re
authoritg4p~~p~peg~~ecessary inspections, g~ations, and to admit
AS REQUIRED ~ OF
SOUi ~,NN ZE 1 ,
(Signature of applicant or name, if a corporation)
UTHOLD ~ ;aVN P. r~u 80ARD
"THOLD`IvWN-~ ; .:S P.O. Box 1424, Mattituck NY 11952
(Mailing address of applicant)
4'.Y.S D~~
State whether applicant is owner, lessee, agent, azchitect, engineer, general contractor, electrician, plumber or builder
Agent
A,S NOTED
Name of owner of premises Gwen Gaines,, as Executrix of the $}4'cTl£' ~ 3~1P
e n ,deceased
(As on the tax roll or west dee „y:
If applicant is a corporation, signature of duly authorized officer NOTIFY BUILGI~ u~ C' ^.PTr."ENT AT
765-1802 8 AM TO 4 Ph4 FOR THE
(Name and title of corporate officer) FOLLOWING INSPECTIONS:
Builders License No. FOR POURED C'vNGHL:TE
Plumbers License No. 2. ROUGH - FRAMING R PLU";r,I~tiG
Electricians License No. 3. INSULATION
Other Trade's License No. 4. FINAL -CON ~THUCTION MUST
BE COMPLETE FCfi J.
1. Location of land on which proposed work will be done; ALL CONSTP.UCTP~ r~l SH.1lL MEET THE
REQUIREMENTS OF THE ODES OF NE1h
1520 Bray Avenue 'k(~146f~]ATE. NOT RESPONSIBLE FOR
House Number Street tOR CONSTRUCTION E
County Tax Map No. 1000 Section 126 Block 7 ~ ~ L;ot. 27 i
Subdivision Section Ong of Property of George Filed Mapp No. 861 Lot 56
L. Tuthil an s tuate at Laure Town of Southo~
filed 1/15/29
2. State existing use and occupancy of premises and intended use and occupancy of proposed constuction;
a. Existing use and Occupancy residential -one family residence
b. Intended use and occupancy residential -one family residence
3. Nature of work (check which applicable): New Building Addition~Alteration
Repair Removal Demolition Other Work "as built" shed
(Description)
4. Estimated Cost Fee
(To be paid on filing this application)
5. If dwelling, number of dwelling units Number of dwelling units on each floor
If garage, number of cars
6. If business, commercial or mixed occupancy, specify nature and extent of each type of use.
(shed)
7. Dimensions of existing structures( if any: Front 14' 3" Reaz 14' 3" Depth 10' 2"
Height 11' Number of Stories 1
Dimensions of same structure with alterations or additions:'front Rear
Depth Height Number of Stories ~t~i,1.
8. Dimensions of entire new construction: Front Reaz Depth
Height Number of Stories
9. Size of lot: Front 50' Reaz 50' Depth is0'
10. Date of Purchase 7/14/2004 Name of Former Owner Russell J. Zellner
11. Zone or use district in which premises are situated residential
12. Does proposed construction violate any zoning law, ordinance or regulation? YES_ NO x
13. Will lot be re-graded? YES_ NO x Will excess fill be removed from premises? YES_ NO x
Executrix of the Estate of Catherine V. Burrowes, deceased
14. Names of Owner of premises Gwen Gaines, as/Address 20105 Main Rd, Matti?hone No. 734-1118
Name of Architect Address uc ' Phone No
Name of Contractor Address Phone No.
15 a. Is this properly within 100 feet of a tidal wetland or a freshwater wetland? *YES NO x '
* IF YES, SOUTHOLD TOWN TRUSTEES & D.E.C. PERMITS MAY BE REQURED.
b. Is this property within 300 feet of a tidal wetland? * YES NO x
* IF YES, D.E.C. PERMITS MAY BE REQUIRED.
1
16. Provide survey, to scale, with accurate foundation plan and distances to property lines.
(see attached) -
17. If elevation at any point on property is at 10 feet or below, must provide topographical data on survey: -
STATE OF NEW YORK) ~
SS:
COUNTY OF SUFFOLK )
ABIGAIL A. WICKI3AM being duly sworn, deposes and says that (s)he is the applicant
(Name of individual signing contract) above named,
(S)He is the Agent
(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 lmowledge and belief; and that the work will be
performed in the manner set forth in the application filed therewith.
Sworn to for me this
d ~ y of June 20 13
1
Notary, bli Abigai~ Ae oW.i4~~~i6ant g
am, A ent
DONNA McGAHAN
NotaryNob01~M0aa51489 York
Qualified In Suffolk Cou
Commlaslon Explrea Au®. 18,
70~
i.nw urEicts
WICKHAM, BRESSLER & GEASA, P.C.
13015 MAIN ROAD. P.O. BOX 1424
MAT I~ITUCK. LONG ISLAND
ERIC J. BRESSLER NEW YURK 11952 WILLIAM WICKIIAM (06-02)
AnIGAIL A. WICKIIAM
JANh; r GP:ASA 631-298-8353
11?LEPAX NO. 631-298-8565
wwblaw@aoLcom
June 10, 2013
Attn: Damon Rallis, Sr. Building Inspector
Town of Southold Building Department ~ ~I ~ 1'
53095 Main Road ~ I I
P.O. Box 1179 ~ JUN i
Southold, New York 11971 ~--1 0 2013 i ~ i
Re: Building Permit Application for "As Built" Shed ~
Property owned by Gwen Gaines, as Executrix of the to"~~~
Estate of Catherine V. Burrowes, deceased
1520 Bray Avenue, Laurel, NY - SCTM# 1000-126-7-27
Dear Damon:
Enclosed are the following items in connection with our client's building permit application
for the "as built" shed at the above premises:
1. Building Permit Application;
2. Sketch and photographs of the shed;
3. Survey of the property dated May 16, 2013 showing the shed; and
4. Application fee in the amount of $368. payable to Town of Southold.
The $368. check includes the $50. Certificate of Occupancy application fee.
Very trfu~ly~~yo~urs,
O.i„9' ,ail/
aawrem Abigail A. Wickham
e„c~.
30/slad6dappasbui62013
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SURVEY OF LOT 56 N
"SUBDIVISION MAP, SECTION ONE OF PROPERTY OF GEORGE L TUTHILL AND OTHERS"
FILED IN THE OFFICE OF THE CLERK OF THE COUNT' OF SUFFOLK
ON JANUARY 15, 1929 AS MAP NO. 861 N/ _ E
SITUATE: LAUREL
TOWN: SOUTIIOLD s
SUFFOLK COUNTY, NY
SURVEYED 05-16-2013
SUFFOLK COUNTY TAX #
1000- 126-7-27
CERTIFIED T0~
MARK DICKERSON
CHICAGO TITLE INSURANCE SERVICES. LLC
WELLS FARGO HANK, N.A.
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Area =7,5°OSq Ft. JOHN C. ENLERS LAND SURVEYOR
Area = O. 1 721 Acres
GRAPHIC SCALE ~ ZQ' 6 EAST MAIN STREET N.Y.S. LIC. NO. 50202
RIVERYIEAD, N.Y. 11901
369-6286 Fax 369-8267