HomeMy WebLinkAbout37810-Z Town of Southold Annex 9/26/2013
P.O. Box 1179
54375 Main Road
Southold, New York 11971
~ *
CERTIFICATE OF OCCUPANCY
No: 36536 Date: 9/26/2013
THIS CERTIFIES that the building OTHER
Location of Property: 35 ORCHARD ST., NEW SUFFOLK,
SCTM 473889 Sec/Block/Lot: 117.-5-32
Subdivision: Filed Map No. Lot No.
conforms substantially to the Application for Building Permit heretofore filed in this officed dated
1/14/2013 pursuant to which Building Permit No. 37810 dated 2/14/2013
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:
100a overhead electric service and accessory Generator as applied for.
The certificate is issued to MICHELE CHAUSSABLE
(OWNER)
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL
ELECTRICAL CERTIFICATE NO. 37810 1/28/13
PLUMBERS CERTIFICATION DATED
-
Authorized Signature
TOWN OF SOUTHOLD
~ BUILDING DEPARTMENT
~ G TOWN CLERK'S OFFICE
SOUTHOLD, NY
f
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 37810 Date: 2/14/2013
Permission is hereby granted to:
MICHELE CHAUSSABLE
_
P.O. BOX 117
NEW SUFFOLK, NY 11956
To: INSTALL AN ACCESSORY GENERATOR AS APPLIED FOR.
At premises located at:
35 ORCHARD ST., NEW SUFFOLK
SCTM # 473889
Sec/Block/Lot # 117.-5-32
Pursuant to application dated 1/14/2013 and approved by the Building Inspector.
To expire on 8/16/2014.
Fees:
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
. _ APPL[CATION 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).
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:
I. Accurate survey of property showing all property lines, streets, building and unusual natural or topographic
features. `
2. A properly competed 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 [o the applicant.
C_ Fees
1. Certificate ofOccupancy -New dwelling $50.00, Additions to dwelling $50.00, Alterations [o 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 Buildi 100.00
3. Copy of Certificate of Occupancy $.2S
4. Updated Certificate of Occupancy - $50.00
S. Temporary Cenificate of Occupancy -Residential $15.00, Commercial $ 15.00
Date. ! i i I ~ 3
New Construction: Old or Pre-existing Building: ~ (chetAck11 one) ~ ~J 1
Location of Property: ~5 ~ J~~ l ~ ~T IV ~ ~ l~~` c~'~ N / ~ 'T
House No. 11 1 Street I - Hamlet
Owner or Owners of Property: ~ I C VIP l O. ~~Gl 1/x~S ~ ~.±~i
Suffolk County Tax Map No 1000, Section ~ ~ 3 g8 ~ Block U ~ S -3 a- Lot
Subdivision p~ Filed Map. Lot:
Permit No. ~~OIl~ Date of Permit. Applicant:
Health Dept. Approval: Underwriters Approval:
Planning Board Approval:
Request for: Temporary Certificate Final Certificate: (check one)
Fee Submitted: $ ~Q • ~f~~___
Applicant Signature
~o~~pf SO~jyolo
Town Hall Annex Telephone (631) 765-1802
54375 Main Road ~ ~ Fax (631)765-9502
P.o. sox 1 r79 ~ o roger.richert(t~town.southold.ny.us
Southold, NY 11971-0959 ~
BUILDING DEPARTMENT
TOWN OF SOUTHOLD
CERTIFICATE OF ELECTRICIAL COMPLIANCE
SITE LOCATION
Issued To: Michele Chaussabel
Address: 35 Orcha2rd Street City: New Suffolk St: NY Zip: 11956
Building Permit#: J~ 8 1 ~ Section: 11 ] Block: 5 Lot: 32
WAS EXAMINED AND FOUND TO BE IN COMPLIANCE WITH THE NATIONAL ELECTRIC CODE
contractor: DBA: Pumillo Electric License No: 2300-me
SITE DETAILS
Office Use Only
Residential X Indoor X Basement X Service Only
Commerical Outdoor X 1st Floor Pool
New Renovation 2nd Floor Hot Tub
Addition Survey Attic Garage
INVENTORY
Service 1 ph 100a Heat Duplec Recpt Ceiling Fixtures HID Fixtures
Service 3 ph Hot Water GFCI Recpt Wall Fixtures Smoke Detectors
Main Panel 100a A/C Condenser Single Recpt Recessed Fixtures CO Detectors
Sub Panel A/C Blower Range Recpt Fluorescent Fixture Pumps
Transformer Appliances Dryer Recpt Emergency Fixture Time Clocks
Disconnect 100a Switches Twist Lock Exit Fixtures TVSS
other Equipment: 100a overhead service, 7 kw stand by generator with automatic transfer switch
Notes:
r 7
Inspector Signature: ~c.~~,t.~ ~-~eY,~-•"~ Date: Jan 28 2013
81-Cert Electrical Compliance Form.xls
i
_ ~o~~,oe:ouryo6
,F®#
TOWN OF SOUTHOLD BUILDING DEPT.
765-1802
INSPECTION
[ ]FOUNDATION 1ST [ ]ROUGH PLBG.
[ ]FOUNDATION 2ND [ ]INSULATION ~
[ ]FRAMING /STRAPPING [ ]FINAL
[ ]FIREPLACE 8~ CHIMNEY [ ]FIRE SAFETY INSPECTION
[ ]FIRE RESISTANT CONSTRUCTION [ ]FIRE RESISTANT PENETRATION
[ ]ELECTRICAL (ROUGH) ~ ELECTRICAL (FINAL)
REMARKS:
~
DATE ] Z~ ~ INSPECTOR _
l l e
FIELD NF:E40RT DATE COMMENTS
~ eroa
FOUNDATION (1ST) ~
a=
y
FOUNDATION (2ND) ~
z
0
~~jj~
ROUGH F'I2p14IINCr & ~ y
PLUMBIIVG
C7
H
INSULATION PER N. Y.
STATE ENERGY CODE ,
FINAL
ADDITIONAL COMMENTS
r _ r
f
0
m
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TOWN OF SOUTHOLU I3UII,DING PERMIT APPLICATION CHECKLIST
BUILDING DEPARTMENT Do you have or need the followin„ before applying?
TOWN HALL F3oard of Health
SOUTHOLD, NY 11971 d sets of Building Plans
TEL: (631) 765-1802 Planning Board approval
FAX: (631) 765-9502 Survey
SoutholdTowaNorthFork.net PERMIT NO. 3~ Check
Septic Fonn_ _
N.Y.S.D.E.C.
Trustees
CO. Application _
Flood Permit
6~samined_ 20 z3 ~ ~ ~ ~ ~ Single & Separate
Storm-Water Assessment Foam
U D
tr/~N ~ 4 ~ Contact:
Approved _ , ?0 ~ Mail ~~cS~~
Disapproved a/c 1i
_ - FtD' C'EPT.
TO! f D~ ~^%.'iN01.0 Phone: _ _
Expiration ~ f
Inspector
APPLICATION FOR BUILDING PERMIT
Date ~ ~ 11 ~ 13 , 20
INSTRUCTIONS
a. This application MUST be completek tilled in by typewriter or in ink and submitted to the Building Inspector with 4
sets of plans, accurate plot plan to scale. Fec 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 ~s~ill issue a Building Permit to the applicant_ Such a permit
shall be kept on the premises available for inspection throughout [he work.
c No building shall be occupied or used in whole or in par[ for any purpose ~+hat so ever until the Building Inspector
issues a Certiticate 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 I8 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 Department for the issuance of a Building Permit pursuant to the
Building Zone Ordinance of the l'own of Southold, Suffolk County, Neva York, and other applicable Laws, Ordinances or
Regulations, for the construction of buildings, addition,- or alterations or tiu 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, if a corporation)
(Mailing address of applicant)
..,e
State whether applicant is owner. lessee, agent architect. engineer, general contractor. e)/ectr cian, plumber or builder
Ltd YLPlt.
I / Q ~ uUn . ~ t`t ~ ~ ~i_I~ I
Name of owner of premises ~ lC_V'L-tA \ Vl/a ~~/~S 01~~r -igOd g i f6 dom.-rr3~tc
(As on the tax roll or IateFO¢1@2>~'ING INSPECTIONS:
If applicant is a corporation, signature of duly authorized ofticer 1. FOUNDATION -TWO REQUIRED
FOR POURED CONCRETE
2 ROUGH-FRAMING, PLUMBING.
(Name and title of corporate ofticer) STRAPPING, ELECTRICAL & CAULKING
Builders License No. 3. INSULATION
Plumbers License No. 4 FINAL -CONSTRUCTION & ELECTRICAL
MUST BE COMPLETE FOR C 0
Electricians License No ALL CONSTRUCTION Pu'~ , r~nr ~ rHE
Other Trade's LicenseN~l~`,4~~~;~t~t ='i3 REQUIREMEtdTS ~
Yn4K STATE ~ to
1. [,a~t~ of land on which pr~ sed wo Jk~ill h~donc: ~ t~ U'G2r ' U_~;, „~u,,h~ ;~S
5 - ~ ~a~ ~ ~
House Number Street Hamlet
1~~,-S Lot 3~--
County Tax Map No. 1000 Section ~-7 3 g $~f E31ock
Subdivision Filed Map No. Lot
2. State existing use and occupancy of premises and intended use and occupancy of proposed construction:
a. Existing use 2nd occupancy Y~"~ ~1 GtO.r~ P ri
b. Intended use and occupancy it
3. Nature of work (check which applicable): New Building Addition Alteration
Repair Removal Demolition- Other WorkTNS`fi4~ C~~-1'G~{'~D1~L-
(Description)
4. Estimated Cost ~'Gv o 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 cmrt tk i
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 `a-~
Dimensions of same structure with alterations or additions: Front 5 b Rear S ~
Depth ~=t.~' Height 30 ' Number of Stories
8. Dimensions of entire_new construction: Front ~rz m~ Rear - Depth
Height - Number of Stories -
9. Size of lot: Front- 1 Jr Rear ~ ~ 0 Depth -7 5
10. Date of Purchase q ~ ~ Name of Former Owner ti~ u CV1 ~t2~~IGt'~P-
1 1. Zone or use district in which premises are situated `j 2 cl
12. Does proposed construction violate any zoning law, ordinance or regulation? YES NO_~
Li. Will lot he re-graded? i'ES NO ? Will excess fill be removed i~rom 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 RF•.QUIRED.
b. [s this property w'_thin 300 feet of a tidal wetland? * YES NO
* tF YES, D.E.C. PEF:MITS 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 NO ?
* IF YES, PROVIDE A COPY.
STATE OF NEW YORK.)
SS:
COUNTY 0~,~)
, a u.5 S a 6~ ~ being duly sworn, deposes and says that (s)he is the applicant
(Name of indivi ual signing conU'act) above named,
(S)He is the
(Contractor, Agent, Corporate OFticer, etc.)
of said owner or owners, and is duly authorized to perform or have performed the said work and Co make and file this application;
that all statements contained in this application are true to the best of his I:nowledge and belief; and that die work will be
performed in the manner set forth in the application tiled therewith.
Sworn to before me thjs__
~ day of -~en~tr~ 20 / dANETV.sTEwaar ~ ~ ' ~
T NOTARY PUBLIC STATE OF NEW'XO • ~ ~
SUFFOLK COUNTY
f N0.52.48833485
Notary Public COMM.EXPIREBNanmbor Signature of Applicant
~O~~Of S(1(/lyo~
'T`own Hall Annez ~ ~ Telepho(~neg (63ll 76SI802
54375 MainAoad t~ ~ rpp2r.flCllert WIt1SO~.nY.US
P.O. Box 1179 •eo,
- Southold, NY 11971-0959 l~/y~~,,,~
"vYlf l 1,
BUILDING D[RARTMF,N"I'
TOWPIOFSOUTHOLD
APPLICATION FOR ELECTRICAL INSPECTION
REQUESTED BY: ~ a1J ~ i ~ Date: / - /3
Company Name: t LO ~
Name: ~ \ lit n-1 ~ f ~
License No.:
Address: l ?ljo~`3 ~Z IV f ~
Phone No.: ~
JOBSITE INFORMATION: (*Indicates required information)
YName: /1~j ~/~~~c C/~/~'GjS~SAJ~-
"Address: ~ S-T2 ~ ~
`Cross Street: ~ G? ~ L ~ i N L " , 19
'Phone No.: ~
Permit No.:
Tax Map District: 1000 Section: Block: Lot:
*BRIEF DESCRIPTION OF WORK (PI ase Print Cleady)
< ,N~ c=~i~2~/~T®2 , ~at7oryi~iT ~ %/1.9~S~r+- s~i ~C
~ (Please Circle AlI That Apply) 3~
~Is job ready for inspection: t~/~~ ~
~NO Rough In Fina
~ DO you need a Temp Certificate: ~ NO
Temp Irtfarmation (If needed)
*Service Size: 1 Pha 3Phase 100 150 200 300 350 400 Other
*New Service: Re-connect Underground Number of Meters Change of Servic Overhead
Additional Information: PAYMENT DUE WITH APPLICATION
G v'w Gam. °a ~~CsSx^~},.~
82-Request for inspection corm Y ~ ~ " "
I t~(I~
~o~~OF SOUj~<o
Town ~ ~ ~ T~deFFpaairrw~(6n6egg (631~~)gg7yy6gg5pQ.1~~802
P.O. Boz It79 ' t~er.flChert(t~t044r11li0UG101tl ny US
Soud~old, IdY 11971-0959 ryrye~,,,~,,,,,,,~
~"WIIII.
BUIIDING DFPAR'I'MF1V'T
Town or sotrr>i~o><.n
APPf_ICATION FOR ELECTRICAL INSPECTION
REQUESTED BY: " i ~ Date: / - /3
Company Name: ~/J~ i Lp ~
Name: O~ \ U Vh 7 9
License No.: />lj, ~
Address: / a`3~ ~Z ~
Phone No.: ~ ~ 6
JOBSITE INFORMATION: ("~in)dicates required information)
'Name: / G~?C~ L. ~ C~i~(~l ,~~AJ ~2-
`Address: j ~ A~Ll~ S-T2 ~ ~
`Cross Street: c G+J ~ ~~j L ~ ~lJ L J 9
`Phone No.:
Permit No.:
Tax Map District: 1000 Section: Block: Lot:
"BRI DESCRIPTION OF WORK (PI ase Print Clearly)
~ !~E/) ~OD ~I1iv b~ SCnFJlc~--~ ~N~ /NS7 7 !Qw
1 C~~~~7®2- /~~t70/yi~~T L %~G4~~~S~i~dn.~~- ~cJ/ TC
(Please Circle AN That Appiy) 3~ A"~`'f/ ~
"Is job ready for inspection: ~NO Ro h In / na
u9
( Do you need a Temp Certificate: ~ NO
Temp Information (If needed)
rp~ "Service Size: ~ 3Phase 100 150 200 300 350 .400 Other
*New Service: Re-connect Underground Number of Meters Change of Se Overhead
Additional Information: PAYMENT DUE WITH APPLICATION
/GV p~E3~ f7~ ~J'°~ SL~/2(/ ~-L'~
~ ,~'w Gam. ~ ~ ,/,~~CS~_~~yI
$2-Request for inspection Form 1 ~f I
I I
:[~~,c~c~:~~1t' ~`~L~~3~'~1'C?RS, Pogo
P.O. Box 909
1230 TRAVELER STREET
SOUTHOLD, N.Y. 11971
631-765-5020• Fnx 631-765-1797
John T. A9ctzger, L.S.
February 4, 2013
RE: 35 Orchazd Street
New Suffolk, NY 11956
Ms. Michelle Cusumano
To Whom It May Concern:
Please be advised the generator located on the above property, SCTM # 1000-117-OS-32,
is at elevation 7.2 NAVD 88 and is shown in FEMA Zone X as designated on FIRM
3610300501 H.
Sincerely,
John T Me
Peco ~,.,~i0rrv~dLs `
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' ~ ~ t~, I ° chance of being equaled or exce~
ZONE AE . ~ ~ area subject ro flooding by the ,
° _
EL6~ _ LI'4 ?+OCER,IL Zones A, AE, AH, AO, AR, A99,
~ '~GRATHWOHC ROAD' {:f ~ ZONE X ~ - t o
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4 ~ WAVEfACTION a * TUTHILL RO ~ - ~ ~ ~ Fl~ationsc
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k '(EL7 ( ~ + •.1' ~ ~ .,y •P~ ~ ~ t e~~ ZONE VE ZONE AR Special Floc I
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GEOR ~ ZONE X
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power. Because Engines Matter. Fuel Consumption) 0.92 gal/hr (LP Vapor)
(at t/z Load) 80 ftn/hr (NG)
Durable Outdoor Enclosure -Painted steel helps provide Fuel Consumption) 1.58 gal/hr [LP Vapor)
years of rust proof, oul;door protection -perfect for [at Full Load) 137 tt3/hr (NG)
extreme Weather COnd~tIODS. Dimensions (L x W x H) with base 30.4" x 24.5" x 33.5"
Weight (generator only) 299 lbs.
Limited 2-Year Parts +~nd Labor Warranty' -Your Briggs
Limited Warranty' 2-Years Parts and Labor
8 Stratton guarantee cf quality and performance.
Turn-Key Extras Included Battery Charger, Heur Meter, Polymer Installation Pad
-`Warranty details available at briggsandstratton.rom i This generator is rated in accortlance with UL (Underwriters Laboratories) 2200 (stationary engine generator
assemblies) end CSA (Canadian Standards Association) standard C22.2 No. 900-04 [motors and generators].
t Fuel consumption rates are estimated based on normal operating conditions. Generator operation may be
a ~E ~ yready affected by elevation and the cycling operation of multiple electrical appliances -fuel Flow rates may
~ vary depending on these factors.
AUTOMATIC TRANSFER SWITCH SPECIFICATIONS (Sold Separately)
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Common Features 120/240 Voltage, 2 Poles, 60Hz Frequency,
NEMA 3R, UL 10D6 Listed
Circuits 10
Amps 50A
Service Entrance Disconnect' No
Dimensions (L x W x H) 14.5" x 5.4" x 21.2"
Weight 30 lbs.
'Review local codes ro determine if a trensfer switch with separate service entrance disconnect is required.
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AVAILABLE ACCESSORIES
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BR10086.STRATTON POWER PRODUCTS GROUP, LLC ~BRIGGS6STRATfON¦
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POST OFFICE BOX 702
MILWAUKEE, WI 5320'1 USA
I iGSODD72-1/12 Copyright. r~72012 All rights reserved. ~ ~ ~ ~ ~