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Home My WebLink About38462-Z '4 Town of Southold Annex 12/6/2013 P.O. Box 1179 54375 Main Road Southold, New York 11971 f CERTIFICATE OF OCCUPANCY No: 36632 Date: 12/6/2013 THIS CERTIFIES that the building AS BUILT ALTERATION Location of Property: 1305 Hiawathas Path, Southold, SCTM 473889 Sec/Block/Lot: 78.-3-55 Subdivision: Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this officed dated 10/22/2013 pursuant to which Building Permit No. 38462 dated 10/29/2013 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" alterations (bedroom and bathroom) to an existing single family dwelling as applied for. The certificate is issued to Gunselman Irv Ast Mngt Tr (OWNER) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL ELECTRICAL CERTIFICATE NO. 38462 11-14-2013 PLUMBERS CERTIFICATION DATED 12-05-2013 Lynn Olson Autho ' Signatur 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 38462 Date: 10/29/2013 Permission is hereby granted to: Gunselman IrvAst Mngt Tr PO BOX 18 - Peconic, NY 11958 To: construct "as built" alterations to an existing single family dwelling as applied for At premises located at: 1305 Hiawathas Path, Southold SCTM # 473889__ Sec/Block/Lot # 78.-3-55 Pursuant to application dated 10/22/2013 and approved by the Building Inspector. To expire on 4/30/2015. Fees: AS BUILT - SINGLE FAMILY ADDITION/ALTERATION $564.00 CO - ALTERATION TO DWELLING $50.00 Total: $614.00 Building Inspector 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 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. / 0 3 New Construction: X Old or Pre-existing Building: (check one) Location of Property: 3~ 1x t^ House No. Street Hamlet Owner or Owners of Property: 1/1~ ~UNSr~i7?G ~ Suffolk County Tax Map No 1000, Section -7 Sj Block 3 Lot Subdivision GG Filed Map. Lot: _ Permit No. Date of Permit._Lb -Zq 13 Applicant: Health Dept. Approval: Underwriters Approval: Planning Board Approval: Request for: Temporary Certificate Final Certificate: (check one) Fee Submitted: $ Applicant Signature pF SO!/jyolo Town Hall Annex 411 Telephone (631) 765-1802 54375 Main Road T Fax (631) 765-9502 P Box 1179 Southold, , NY 11971-0959 roger. riche rt(a)town.southoId.ny.us ~1~00UNiV ,N~ BUILDING DEPARTMENT TOWN OF SOUTHOLD CERTIFICATE OF ELECTRICIAL COMPLIANCE SITE LOCATION Issued To: Gunselman Address: 1305 Hiawathas Path City: Southold St: NY Zip: 11971 Building Permit#: 38462 Section: 78 Block: 3 Lot: 55 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 NX Basement Service Only Commerical Outdoor 1st Floor Pool New Renovation 2nd Floor Hot Tub Addition Survey Atfic Garage INVENTORY Service 1 ph Heat Duplec Recpt 9 Ceiling Fixtures HID Fixtures Service 3 ph Hot Water GFCI Recpt 1 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 Fixture Time Clocks Disconnect Switches 6 Twist Lock Exit Fixtures TVSS Other Equipment: 1-exhaust fan Notes: Inspector Signature: Twat L~=- Date: Nov 14 2013 81-Cert Electrical Compliance Form.xls 12-03-13;17:09 298047; Town Hall Annex Tetophoge (631).76571802 54 0. Mean Road BOX 1179 Fax (631) 761.9502 Southold Ne . New York 1111 971-0959 r~ BUILDINo D13PARTMPNC TOWN OF 80DTHOLD CERTIFICATION p Date: J~ Building Permit No. 3 0 Owner: Gunsea,t . (Please print) Plumber. L.YAIAI OZ S a4l (Please print) lead. certify that the solder used in the water Supply system contains leas.dum 2/10 of 1% _ (Plumbers.Signatluo Sworn to before we this State of QuC: County cT` ~ day of (',Q ZQ ~3 On this -3- day of befor~r me personally appeared tors pl$Or~ to k wn to be the and ack who executed the )l~Gl?4_ foregoing instrument, , and acknowledged that he . executed the same as his free a and de d/ - SEAL (signed)'_'1.___ - Notary Public, SC&A ~ ounty Notary Public COMMONWEALTH OF PENNSYLVANIA Notarial Seal Marsha Diane Florance, Notary Publk Hallstead Boro, Susquehanna County My Commisslon Expires June 14, 2014 M(mh=r W:nn,vlvania ASSOdation dNOtaries TOWN OF SOUTHOLD BUILDING DEPT. 765.1802 INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLEIG. [ ] FOUNDATION 2ND [ ] IN ATION [ ] FRAMING / STRAPPING [ lj"F~INAL [ ] FIREPLACE & CHIMNEY [ ] FIRE SAFETY INSPECTION [ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRATION [ ] ELECTRICAL (ROUGH) [ ] ELECTRICAL (FINAL) REMARKS: DATE 08 /j INSPECTOR l or5ji SO4ry TOWN OF SOUTHOLD BUILDING DEPT. 765.1802 INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLEIG. [ ] FOUNDATION 2ND [ ] 1 LATION [ ] FRAMING / STRAPPING [ FINAL [ ] FIREPLACE & CHIMNEY [ ] FIRE SAFETY INSPECTION [ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRATION [ ] ELECTRICAL (ROUGH) [ ] ELECTRICAL (FINAL) REMARKS: me=` O- DATE 1Z D3 l3 INSPECTOR J "eta, WC, SECB - - is PROFESSIONAL ENGINEER 1725 HOBART ROAD / PO Box 616 SOUTHOLD, NEW YORK 11971 I TEL: 631.765.2954 FAX: 631.614.3516 • e-mail:joseph@fischetti.co DEC _ 3 2013 i' Date: 3 December 2013 `1 D Reference: 1305 Hiawatha Path Southold Town Building Department Main Road Southold, NY 11971 Mr. Verity, I recently inspected the property the above referenced property to view the completed conversion of the dining room to a bedroom and bath. To the best of my knowledge I certify the conversion has been completed in accordance with New York State Building Codes and in accordance with plans last revised by me on December 3, 2013. 1 noted during my inspection a battery operated carbon monoxide unit on the wall adjacent to the bedroom entry door. pf NE{ q O. os roFES ova BOARD CERTIFIED IN STRUCTURAL ENGINEERING FIELD IIEPM DATE CONS W 0 ro FOUNDATION (IST) FOUNDATION (2ND) 7 o ROUGH FRAMING & PLUAMING z y INSULATION PIM N. Y. STATIC ENERGY CODE p ! d Cz r c Oz ell FINAL ADDMONAL COMMNTS t4 -j O I I - 2574,37/3- z 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 4 sets of Building Plans TEL: (631) 765-1802 Planning Board approval FAX: (631) 765-9502 Survey SoutholdTown.NorthFork.net PERMIT NO. 3L6 L Check Septic Form N.Y.S.D.E.C. Trustees Examined /0 Flood Permit o~ 20 13 Storm-Water Assessment Form Contact: Approved, 203 Mail to: Disapproved a/c Phone: Expiration , 20_L5 Building Inspector APPLICATION FOR BUILDING PERMIT Date ld 20 INSTRUCTIONS a. This application MUST be completely filled in by typewriter or in ink and submitted to the Building Inspector with 4 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 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, housin d regulations, and to admit authorized inspectors on premises and in building for necessary inspections. (Signature of applicant or name, if a corporation) ~(D 20 14Q ryl /oc, S (Mailing a5ldress of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder Name of owner of premises Z4&-C_W ITt"il t~iYf C', (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 e done: /30,5- c!R wQ IQ 1 A ~J /V qqa i~1 iw House Number Street Hamlet f County Tax Map No. 1000 Section 7R Block 3 Lot Subdivision Filed Map No. Lot 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy 3 IgcoQ b. Intended use and occupancy `n X 3. Nature of work (check which applicable): New Building Addition X 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 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 /7aA" ~ &Un aIq'-t- 14. Names of Owner of premises Address l30S wzhone 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. b. Is this property within 300 feet of a tidal wetland? * YES NO X * 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 NO * IF YES, PROVIDE A COPY. STATE OF NEW YORK) SS: COUNTY //OF&) - ~t tk ci e ae-i7-~ being duly sworn, deposes and says that. (s)he is the applicant (Name of individual signing contract) above named, (S)He is the q, 67~- (Contractor ent, 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. Sworn to before me this da f P')j 20 f. ETSY A. PERKINS NotMj*4ftWIC, State of New York Signature of Applicant No. 01PE6130636 Oualified In Suffolk County Commission Expires July 16, Scott A. Russell O1°5111FQ k James A. Richter, R.A. SUPERVISOR Michael M. Collins, P.E. z SOUTHOLD TOWN HALL - P. O. Box 1179 53095 Main Road - SOUTHOLD, NEW YORK 11971 Telephone (631) - 765 -15600 Fax (631) - 765 - 9015 MICHAEL.COLLINS@TOWN.SOUTHOLD.NY.US JAMIE.RICHTERWrOWN.SOUTHOLD.NY.US Office of the Engineer Town of Southold STORMWATER MANAGEMENT CONTROL PLAN REVIEW COVER SHEET (TO BE COMPLETED BY THE APPLICANT) TO: ENGINEERING DEPARTMENT PLEASE ATTACH THE FOLLOWING DOCUMENTS or INFORMATION: FROM: BUILDING DEPARTMENT ? Copy of completed Application for Building Permit i DATE: /0 - ZS - 1 3 El Stormwater Management Control Plan APPLICANT: ~d~< ( /~/J ~~j)l(tyl, ? Completed Chapter 236 Stormwater Review Checklist S.C.T.M. 3 - J S - - - - - - , PROPERTY ADDRESS: 130,%- 1- Gc /n/ A ?04 J 9 w~4e lr) BRIEF PROJECT DESCRIPTION: C'~~nL fn Ems-. - ~~u~ p1~ ~ zoo FOR ENGINEERING DEPARTMENT USE ONLY Reviewed By: Date: ? Approved: ? Additional Information Required: ;`~~soFrorr~ DATE: IU S x CHAPTER 236 APPLICANT: Gun N" Stormwater Review Checklist S.C.T.M.#: PHYSICAL ADDRESS: Stormwater Management Control Plan Requirements Yes No NA If No or NA, Please Provide Additional Information 1. Plan drawn to scale of not less than 60 feet to the inch showing: a. location and description of property boundaries b. total site acreage c. existing and natural and man-made features on and within 500 feet ? l~ of the site boundary as required in §236-17(C)(2). 62 d. test hole data indicating soil characteristics and the depth to water (G e. proposed limits of clearing and the total area of proposed land U disturbance £ existing and proposed contours of the site (minimum 2' interval) g. location of all existing and proposed structures, roads, driveways, / sidewalks, drainage improvements and utilities h. spot grade and finished floor elevations for existing and proposed structures i. location of the swimming pool discharge ring j. location of proposed soil stockpile area(s) k. location of the proposed construction entrance/staging areas 1. location of the proposed, concrete washout area m. location of all proposed erosion and sediment control measures i 2. Plan includes calculations showing that the stormwater improvements are sized to capture, store and infiltrate on-site the runoff from all impervious surfaces generated b a two-inch rainfall 3. Detail drawings (required for plan approval) provided for: a. erosion and sediment controls b. construction entrance c. inlet structures (e.g. catch basins, trench drains, etc.) d. leaching structures (e.g. infiltration basins, swales, etc.) i REVISED 7/24/2013 q so Town Hall Annex Telephone (631) 765-1802 54375 Main Road P.O. Box 11179 roger. riche rt(dfox w(63n"MtRooh ny. us ,--3amhoW, NY 11971-0959 Cow BUI11)ING DEPARTMENT TOWN OF SOUTHOLD APPLICATION FOR ELECTRICAL INSPECTION REQUESTED BY: UdAQ)Q6 Date: J) Company Name: TbLiiij Name: License No.: Address: C;1,12 hfffu P04 MATT-owk- A)l )(C/)-z-- Phone No.: ~,-(13 OT05F 01~3 OKI JOBSITE INFORMATION: (*Indicates required information) *Narne: GAWSCI "A01 tsiq& c,( L y"tv 616o xt & )nQj To (J)e A *Address: 'P~ /30f H1,)wATHA'JP*q 50(411~,VLP I *Cross Street: Mcal ~V., P06,0ok Svez(A5 FA-kM , C7- e2da~ *Phone No.: 60::7 ts:7 :7 Permit No.: Tax Map District: 1000 Section: &-7 b( Block: Z Lot:.SS- *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: Re-oonnect Underground Number of Meters Change of Service Overhead Additional Information: PAYMENT DUE WITH APPLICATION 82-Request for Inspection Form )ORE, ATTORNEY AT LAW M(RDM(D .020 20 M Main Road athold, NY 11971 LETTER (631) 765.4330 - pcmoore@mooreattys.com o~tia 2 -/3 To NOV 2.2_.2013 4joct I ~i 13';5'y ....V4~ PtTt-lf~:'s _-SIGNED El Please reply El No reply necessary L' In - : 1. 4, 17 'to g.< ~,n.:H rW f'~.'l,. , r -Ts^?••i's~*n...3, ett IrA ~ ~ t ~ `.l~' `t1!~ a $~.m ~'!I ~ ~a"' :cr fKL//.. U TI 4 I V ) ,<JM f m' 'n~° ;'-•+F.: ^;e: ~•.et;,:•'+vy~yni'j~^' ia:3'~ IuA;ZA1J;i> TOE 4:k j U^""T Of.,D uc 5au 'Tt~'7 i ~c.o T T1lOL43AiltQAl 8LLTJ~~~ < : OF SGJT~L L 1j U9-V4;YgD APRIL '90.,;S •N ,~Y f. ~1 t ' + • Ian Tu L'~ 5d 41, Eileen 5a leen Santora • Residential Designer losepn Fls~n~ttl, re 631-734-2794 • CUtchO NY 1725 Hobart Road • Southold, NY 11971 9ue, 631-765-2954 1~2' iVIZ I dIN~W r~q-' G" L~ 4n ALI, 4 l3S0" ~ /O cio~aeo ~-O f- Z 3 z~~ 3 2 3` FA CI$ ~nr _ 4' a tt =er04- S° uaj> `1 u GLYI)a 9/LL I TGAr-r~ov~+a Gp~i~a U S~PF LK_ f.lrY C , I I t<M I Lc ctrl RL2YI,1l.f U_I2.15~P DI/au4~.A1'1- I~~„dT~l DEt~ GiF.PfIL ~`thTL'W 1163~i~ ~ I r LT' fzG 4,- I'~" ?CoS~ I VI-4T k t4 /'W'o2P'~P V .~I N IJ c . ~ r1 ; ~ kt _ ~~4 wuD I'I G Low GLO1 / LW19 -t 4- N.Y.S. Energy Code L ' - Prescriptive envelope required for additions less than 500sf. air; l~ This addition meets or exceeds N.Y.S. minimum code requirements. ~~11 ~ ~ mtt ~ t y~ r t 4~, _ a I~ i ~ N.J~~'PVIV - 'I ~ IF~I~-I.GTIDIV rv~la~M _ -E,/15TICA WALL- 01 ~A RUMP/E WALL F? r1 ' MEW l-IG J , Te! 9 3 EP 3,Y7L/ PPT_ Ii01IF~ PI:LUING U!1 IP ' i~', 19~ ~ AIt1 M F I1 701: I FOI 1 L„ INSPEC F OF,S K2 TV- I I-(0J, IJN - TwoI.EOUIFFI FOR POIJ!"I00UiCP IF j ROUGH - FRAmIING, PLJI'L!I i = STRAPPING ELECTRILAI e. wI_I ,1 aF NEW a INSULATION hp IscyF y0fl I FINAL- CONSTRUCI ON ELLC I I IC L CO MUST SL COMPLETE FGI, C 0 r ALL COPTS FRUC LON SHALL MELT II IF REQUIRCMEN FS OF THE (,ODES OF IFMI E J: ~~~~-III----JJIIII DF_SIGid OE COPI°fRUL L~~~. Opp 525N5 , SLURP ,~ZI j3 /~3 F I P5T", L0012,_!~ nl.! 1~R`f,~AV~D GUwSELNYAN SCALE: IL Bill 11 APPROVED BY DRAWN BY V//nn 1 IIIO~yr REVI6E0 DATE CG~V~p~ f.pr ~~J~~~U f_n LJ(~L1 Ir-H I~IV DRAWING NUMBER 12 IOF