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Home My WebLink About38126-Z ~ N~ ply Town of Southold Annex 8/2/2013 ~1A P.O. Box 1179 54375 Main Road `d ~p Southold, New York 11971 CERTIFICATE OF OCCUPANCY No: 36426 Date: 8/2/2013 THIS CERTIFIES that the building AS BUILT ALTERATION Location of Property: 935 Pazk Way, Southold, SCTM 473889 SecBlock/Lot: 70.-11-13 Subdivision: Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this ot5ced dated 6/21/2013 pursuant to which Building Permit No. 38126 dated 6/25/2013 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" basement bathroom as applied for. The certificate is issued to Bohn, Robert & Bohn, Susan (OWNER) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL ELECTRICAL CERTIFICATE NO. 38126 7/10/13 PLUMBERS CERTIFICATION DATED 8/2/13 Walter Marcze ki, Jr. l t rued ignat e TOWN OF SOUTHOLD ~ ~ BUILDING DEPARTMENT TOWN CLERK'S OFFICE ~ ~~a SOUTHOLD, NY 'fit ~t 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 38126 Date: 6/25/2013 Permission is hereby granted to: Bohn, Robert 8 Bohn, Susan 935 Park Way Southold, NY 11971 To: "As Built" basement bathroom as applied for At premises located at: 935 Park Way, Southold SCTM # 473889 Sec/Block/Lot # 70.-11-13 Pursuant to application dated 6/21/2013___ and approved by the Building Inspector. To expire on 12/25/2014. Fees: AS BUILT -SINGLE FAMILY ADDITION/ALTERATION $438.40 CO -ALTERATION TO DWELLING $50.00 ELECTRIC $90.00 Total: $578.40 Building Inspector Furm N2 G 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: I . 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 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 survey of property 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 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 5. Temporary Certificate of Occupancy -Residential $15.00, Commercial $15.00 Date. ~o / f ~1 / t 3 New Construction: Old or Pre-existing Building: (check one) Location of Property: ~35 ~HQ-K~N14 ~v~Y10~V House Nom. Street Hamlet Owner or Owners of Property: t(u~j 1=(L ~ ~j~-(/.) Suffolk County Tax Map No 1000, Section Block Lot Subdivision Filed Map. Lot: Permit No. Date of Permit. Applicant: Health Dept. Approval: Underwriters Approval: Planning Board Approval: Request for: Temporary Certificate Final Certificate: (check one) Fee Submitted: $ Applicant Signature gt1FF0(,~c Town Hall Annex 4~ Telephone (631) 765-1802 54375 Main Road ~ ? Fax (631) 765-9502 P.O. Box 1179 G • ,g Southold, NY 11971-0959 "j~OI ~ ,'.~0~' rooer.richertCciltown.southold.nv us BUILDING DEPARTMENT TOWN OF SOUTHOLD CERTIFICATE OF ELECTRICIAL COMPLIANCE SITE LOCATION Issued To: Rob Bohn Address: 935 Park Way City: Southold St: NY Zip: 11971 Building Permit 38126 Secticn: 70 Block: 11 Lot: 13 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 X Service Only Commerical Outdoor 1st Floor Pod New Renovation 2nd Floor Hot Tub Addition Survey X Attic Garage INVENTORY Service 1 ph Heat Duplec Recpt 1 Ceiling FiMUres HID Fixtures Service 3 ph Hot W ater 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 FiMure Pumps Transformer Appliances Dryer Recpt Emergency FiMUres Time Clocks Disconnect Switches 3 Twist Lock Exd Fixtures TVSS other Equipment: basement bathroom, 1-exhaust fan Notes: Inspector Signature: ~`~9,c~ ~!~~--~U Date: July 10 2013 Electrical Certificate.xls ~o~~pF SO(/jyo~ Town Hall Annex ~ ~ Telephone (831)965-1802 54375 Main Road Fax (631) 765.9502 P.O. Box (179 G Southold, New York 11971-0959 ~U1/111 ti BLJTLDING UBPARTMENT' TOWN OF SOUTIiOLD CERTIFICATION Date: Building Pmermit No. 3 ~ I Z (o Z Owner: C o ~ ~O 1"1~ 11 (Please print) Plumber: 4.11(°! (,3fZP '?S I ` 1 1~ (Please print) I certify that the solder used in the water supply system contains less than 2/10 of 1 °lo lead. ~ ~d'cz ~ ~ lumbers Signa{ure) Sworn to before me this 2,1 ~ dayof~ 20 J3 ~ ~ ~ Notary Publ cl SD to off H a v~yrt< ' No. O18U61850:5+ 4uaGfied in Suffolk Car-. Dn° Commission Expires Aprilt~,'__6J(y Notary Public, S_ U y~->-u vim- Coun(y 3 _ C ~.~,OFSOUT~ TOWN OF SOUTNOLD BUILDING DEPT. 765.1802 1 NSPECTION [ ]FOUNDATION 1ST [ ]ROUGH PLBG. [ ]FOUNDATION 2ND [ ]INS N [ ]FRAMING /STRAPPING [ FINAL [ ]FIREPLACE & CHIMNEY [ ]FIRE SAFETY INSPECTION [ ]FIRE RESISTANT CONSTRUCTION [ ]FIRE RESISTANT PENETRATION [ ]ELECTRICAL (ROUGH) [ ]ELECTRICAL (FINAL) REMARKS: ~~-~-5_S U~~ ~ ~l ~ ~7~~ DATE Y~ (3 INSPECTOR 3 ~~Z o~~~~,~ TOWN OF SOUTHOLD BUILDING DEPT. 765-1802 1 NSPECTION [ ]FOUNDATION 1ST [ ]ROUGH PLBG. [ ]FOUNDATION 2ND [ ]INS N [ ]FRAMING /STRAPPING [ FINAL [ ]FIREPLACE & CHIMNEY [ ]FIRE SAFETY INSPECTION [ ]FIRE RESISTANT CONSTRUCTION [ ]FIRE RESISTANT PENETRATION [ ]ELECTRICAL (ROUGH) [ ]ELECTRICAL (FINAL) REMARKS: v DATE INSPECTOR o~,~oF soury~ #~®f TOWN OF SOUTNOLD BUILDING DEPT. M~ X65., 802 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: GK DATE ~ INSPECTO ~ ~ ' FIDlLD ~ REPOA~ D ~ ' b 80UNDA~'ION (131 ~ ~a FOUPIDA,TIOIV (2ND) t~'a z 0 ~1 ~ . ROUGH P`A~NIIIVG & PLiJNIBIlVG INSLJ7.ATION PE2iN. Y. STATE ENERGY CODE lJ J, . ~ _ ~ FINAL Z ADDTTIONAL CCINIIVIENTS PlLG ~ / , ~d - ~ ~ ~a . ,TOWN OF SOUTHOLD BUILDING PERMIT APPLICATION CHECKLIST BUILDING DEPARTMENT Do you have or need the following, before applying? TOWN HALL Board of Health SOUTHOLD, NY 11971 a sets of Building Plans TEL: (631) 765-1802 Planning Board approval FAX: (631) 765-9502 Survey SoutholdTown.NorthFork.net PERMIT NO. p`ri~/~k Check _ Septic Form ( ~ i•e i ),I~ ~ ~ V.Y.S D.G.C. ~Irustees _ I t-%! ~ C.O. Application ii ` - _ I Flood Permit _ _ Examined ~/y~ ...0 V ~ ~ , ~ ~ ~ ~~N 2 ~ Single & Separate Sturm-Water Assessment Form L_-----~~ ~t - - T~.. n Contact: Approved E Z~. 30 ~ - Mail to: Disapproved a/c _ 'L Phone: % Expiration _ •~O ~ 20 Building Inspector APPLICATION FOR BUILDING PERMIT Date ~ 2 ~ , 20 INSTRUCTIONS a. This application MUST be completely filled in by h~pewriter or in ink and submitted to the Building Inspector with 4 sets of plans, accurate plot plan to scale. Pee 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. o. 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. £ 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 he required. APPLICATION IS HEREBY MADE to the Building Department 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 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 necessarc inspections. (Signature of applicant or name, if a corporation) (Mailing address ofapplican[) State whether applicant is owner, lessee, agent, architect engineer, general contractor, electrician, plumber or builder Name of owner of premises ~p Q j QX /J (As on the tax roll or latest deed) 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 lone: ~~~'~t~2 ~c c.a~-~So ~ bt a l.~ House Number Street ~ Han let County Tax Map No. 1000 Section~d Block l~Lot Subdivision Filed Map No. Lot 2. State existing use and occupancy of premises and intended use and occupancy of roposed onstruction: a. Existing use and occupancy , S~ I-e ~iaw~ , ~ ~ b. Intended use and occupancy _ 3. Nature of work (check which applicable): New Building Addition Alteration Repair Removal Demolition Other Work (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. 7. Dimensions of existing structures, if any: Front Rear Depth Height Number of Stories Dimensions of same structure with alterations or additions: Front Rear Depth Height Number of Stories 8. Dimensions of entire new construction: Front Rear Depth Height Number of Stories 9. Size of lot: Front Rear Depth 10. Date of Purchase Name of Former Owner 1 1. 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 Address Phone No. Name of Architect Address Phone No Name of Contractor 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. h. Is this property within 300 feet of a tidal wetland? YF:S_ NO * IF Y$S, 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 I O feet or below, must provide topographical data on survey. t 18. Are there any covenants and restrictions with respect to this property? *YES NO * IF YES, PROVIDE A COPY. STATE OF N W YO IK) COUNTY OF 0 V~ being duly sworn, deposes and says that (s)he is the applicant (Name of individual signing contract~)a~bopve named, (S)He is the ~~J (Contractor, Agent, Corporate Officer, etc.) of said owner or owners, and is duly authorized to perform or have performed the said worl: 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. Sworq ~o before me this da~of~ ~ C~ 20 ~ 3 Notary VI TOTH ~6~ ~ Notary Public Commfss~wn~F~plres)~Iy28 2I11~ Signature of Applicant ~o~~Of SO~jryo Town Hall Annex ~ Telephone (631) 765-1802 54375 Main Road ~ ~ 7g~y py P.O. Box Iv9 G~ ' ~ roger_richertcaltown soUT1101tl nV US Southold, NY l 1971-0959 l~ ~VUII l t~ BUILDING DEPARTMENT TOWN OF SOUTHOLD APPLICATION FOR ELECTRICAL INSPECTION REQUESTED BY: ~6 Nr-I Date: ~j Company Name: '~o{~ o~Tar+c Name: License No.: Address: Phone No.: JOBSITE INFORMATION: (*Indicates required information) *Name: ~0 8 zs ~ iJ *Address: q ~ S ~ F}2 K wl>~ ~ o ~ nI *Cross Street: ~,N ~ N < < r -~J" *Phone No.: te,3 1 7 fv 5' 8 S~Z Permit No.: _ Tax Map District: 1000 Section. ~ h Block: Lot: *BRIEF DESCRIPTION OF WORK (Please Print Clearly) I (Please Circle AN That Apply) *Is job ready for inspection: YES NO Rough In Final ' *Do-you need a Temp Certificate: YES / Temp Information (If needed) *Service Size: 1 Phase 3Phase 100 150 200 300 350 400 Other *New Service: Re-connect Underground Number of Meters Change of Service Overhead Additional Information: PAYMENT DUE WITH APPLICATION ~I 82-Request for Inspection Form ~Q. U~'"~ ~o~~OF SO~Tyolo Town Hall Annex yy Telephone (631) 765-1802 54375 Main Road ~ T Fax (631) 765-9502 P.O. Box J 179 G ~ Southold, NY l 1971-0959 ~ ~'`OOUNTI BUILDING DEPARTMENT TOWN OF SOUTHOLD JUIy 12, 2013 Robert & Susan Bohn 935 Park Way Southold, NY 11971 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 youretectrician) A fee of $50.00. Final Health Department Approval. PlUmberS SOlder CertlflCate. (All permits involving plumbing after 4N/84) -Form Encl sed Trustees Certificate of Compliance. (town trustees # Ts5-~asz) Final Planning Board Approval. (Planning # ~s5-~s38) Final Fire Inspection from Fire Marshall. Final Landmark Preservation approval. Final inspection by Building Dept BUILDING PERMIT: 38126 - "As Built" Basement Bathroom ~r-In~ ~eslbF_,?Ce ~X5'Stl N(~ B/aTl-{ (Zuo,M how ~ S+a l 2S ~ 3 ~ ~A2 Kin ~ Sow i~,oi ~ tJ`i l I`d~ I APP~~RO~~VE~_D AS NO i cD CERTIFICATION OF DATEJ7/ 3 B P NAILING & CONNECTIONS FEE:gy REQUIRED. NOTIFY BUILDING DE~~? ^?'NT AT 765-1802 8 AM TG 4 Fi:; FUR THE FOLLOWING INSPECTIONS t u,~p 1. FOUNDATION -TWO F;~ •~UIRED ALLPLUMv 6~1'1~~1 TE FOR POURED CONCRE''E & WATER LIMA NEED 2. ROUGH -FRAMING. PLUM9!NG. p ~ T~S71NG BEFQRE CpVERiNG STRAPPING. ELECTRICAL 8 CAU! KING p 3. INSULATION 4. FINAL -CONSTRUCTION 8 ELECTRICAL ~ 2 MUST BE COMPLETE FOR C.O. PLUMBER CEg7aT10N ALL CONSTRUCTION SHALL MEET THE ON LEAD CONTENT BEfQRE REQUIREMENTS OF THE CODES G>• t.~6'J CERTIFICATEOFpeC(lPANCY YORK STATE. NOTRESPONSBLE~~~R O DESIGN OR CONSTRUCTION ERROF.S - SOLDF_R USED IN DATER S Huw~ ~ SUF:'' Y . TEM CANNOT EXCEi~D<'~vOFI%LEAD. ~ ' QVI~~ !'ll:~i,) I~ 3F i;~ UI~LAWF~~. (o rp~ f~ I~~ li R~9 ~ ry;'T~~-~„T CERTIFIC~~TE L r JUN 0 2013 D 'J~~i -~~,.^,'~'~t` _ ~ti U ~1'1~0~~?r+~ ~~do2 ~ et~r: o~rr. Te~:~~r. ~r seuTHOlo ELECTRICAL INCPF~TID~ REAl11RED t ~t~l ~orz~ ~.r'.r1'~" ~ F NEiy j, ~ ~P~ FOPO E < 09. STAG ~o fox Ife2 * hQc, ~?~ry~t1 LI ~ ~LU51~ 5 YSTF i^/) S _ I I O ~ rig- R~J~ci 1~[.7^ r a u ~ ~ T ~ i= , ~1LL Y~L WftS) i~= HNO ~c c~R-- s~~~ $ PI'S ' 3ac~ 0'7 0 7 ~ o. 48 y~~. I S