HomeMy WebLinkAbout38611-Z
Town of Southold Annex
~yOFw[~ 1/27/2014
P.O. Box 1179
r~r Main Road
54375 Southold, Southold, New York 11971
CERTIFICATE OF OCCUPANCY
No: 36736 Date: 1/27/2014
THIS CERTIFIES that the building AS BUILT ADDITION
Location of Property: 525 Rocky Point Rd, East Marion,
SCTM 473889 Sec/Block/Lot: 31.-1-5.5
Subdivision: Filed Map No. Lot No.
conforms substantially to the Application for Building Permit heretofore filed in this officed dated
12/18/2013 pursuant to which Building Permit No. 38611 dated 1/6/2014
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" DECK ADDITION WITH PARTIAL CANOPY TO A SINGLE FAMILY DWELLING AS APPLIED
FOR
The certificate is issued to Kohler, Joseph & Kohler, Carolann
(OWNER)
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL
ELECTRICAL CERTIFICATE NO. 38611 01-24-2014
PLUMBERS CERTIFICATION DATED
Autho F12rature
Pow. TOWN OF SOUTHOLD
x BUILDING DEPARTMENT
® TOWN CLERK'S OFFICE
as SOUTHOLD, NY
1~s
~ nrrsan4 n
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 38611 Date: 1/6/2014
Permission is hereby granted to:
Kohler, Joseph & Kohler, Carolann
525 Rocky Point R
East Marion, NY ii
To: Construction of an "as built" deck addition with partial canopy as applied for.
At premises located at:
525 Rocky Point Rd, East Marion
SCTM # 473889
Sec/Block/Lot # 31.-1-5.5
Pursuant to application dated 1/1/1900 and approved by the Building Inspector.
To expire on 7/8/2015.
Fees:
AS BUILT - SINGLE FAMILY ADDITION/ALTERATION $920.00
CO - ADDITION TO DWELLING $50.00
Total: $970.00
Building s ec
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:
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 I% 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
1. 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.
New Construction: Oldor~ Pre-existing Building: (check one)
Location of Property: 5~) 5 Pc)p Y Ppo 12w ~.p. &p _
House No. Street Hamlet
Owner or Owners of Property: _ 0s~~;-o 1 wi _
Suffolk County Tax Map No 1000, Section ~J ( Block Lot
Subdivision A~°POF- kA1L%-MAjj4dtJ h&04,- _ Filed Map. 8 (S t Lot: ~?C
Permit No. Date of Permit. Applicant: _
Health Dept. Approval: Underwriters Approval:
Planning Board Approval:
Request for: Temporary Certificate Final Certificate: (check one)
Fee Submitted: $
r
i
Applicant Signa u
pf S0 P4" o
Town Hall Annex y yy Telephone (631) 765-1802
54375 Main Road T T Fax (631) 765-9502
P.O. Box 1179
Southold, NY 11971-0959 • ~O roger. riche rt(a)town.southoId.ny.us
o~yCOU~,N~
BUILDING DEPARTMENT
TOWN OF SOUTHOLD
CERTIFICATE OF ELECTRICIAL COMPLIANCE
SITE LOCATION
Issued To: Joseph Kohler
Address: 525 Rocky Point Rd City: East Marion St: NY Zip: 11939
Building Permit* 38611 Section: 31 Block: 1 Lot: 5.5
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 Basement Service Only
Commerical Outdoor X 1st Floor Pool
New Renovation 2nd Floor Hot Tub
Addition Survey X Attic Garage
INVENTORY
Service 1 ph Heat Duplec Recpt Ceiling Fixtures HID Fixtures
Service 3 ph Hot Water GFCI Recpt Wall Fixtures 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 Twist Lock Exit Fixtures TVSS
Other Equipment: "as built" no visible defects, 4-post lights on deck railing
Notes:
Inspector Signature:- Date: Jan 24 2014
81-Cert ElecMcal Compliance Form.xls
TOWN OF SOUTHOLD BUILDING DEPT.
765.1802
INSPECTION
[ ] FOUNDATION 1ST [ ] ROUGH PLEIG.
[ ] FOUNDATION 2ND [ ] INSU
[ ] FRAMING / STRAPPING [ INAL
[ ] FIREPLACE & CHIMNEY [ ] FIRE SAFETY INSPECTION
[ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRATION
[ ] ELECTRICAL (ROUGH) [ ] ELECTRICAL (FINAL)
r I
REMARKS: /Z A-id
DATE INSPECTOR
TOWN OF SOUTHOLD BUILDING DEPT.
765.1802
INSPECTION
[ ] FOUNDATION 1ST [ ] ROUGH PLEIG.
[ ]FOUNDATION 2ND [ INS
[ ] FRAMING / STRAPPING [ FINAL
[ ] FIREPLACE & CHIMNEY [ ] FIRE SAFETY INSPECTION
[ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRATION
[ ] ELECTRICAL (ROUGH) [ ] ELECTRICAL (FINAL)
REMARKS: DATE INSPECTOR
OF SON
orcawlvTOWN OF SOUTHOLD BUILDING DEPT.
765.1802
INSPECTION
[ ] FOUNDATION 1ST [ ] ROUGH PLEIG.
[ ] FOUNDATION 2ND [ ;],!INAULATION
[ ] FRAMING / STRAPPING [ FINAL
[ ] FIREPLACE & CHIMNEY [ ] FIRE SAFETY INSPECTION
[ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRATION
[ ] ELECTRICAL (ROUGH) [ ] ELECTRICAL (FINAL)
REMARKS: OK 71~ C'. 0,.
DATE 4~ INSPECTOR u
DATE C'aNII1t$NTS. •
FOUNDATTON (1ST) - ~ ~
f
FOUNDATION (2ND)
fi
' J1 0
Pou(m FfiglVillV; &
PLUMING
INSULATION PER N. X,
STATE ET (;y CODE
•
FINAL
w
ADDMONAL Cobzv s
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TOWN OF SOUTHOLD BUILDING PERMIT APPLICATION CHECKLIST
BVII W NG DEPARTMENT Do you have or need the following, before applying?
4
1 OWN HALL Board of Health
SOUTHOLD, NY 11971 4 sets of Building Plans
TEL: (631) 765-1802 Planning Board approval
FAX: (631) 765-9502 Q Survey
SoutholdTown.NorthFork.net PERMIT NO. L-l~G ~1 Check
Septic Form
N.Y.S.D.E.C.
Trustees
C.O. Application
Flood Permit
Examined b 20 ILA Single & Separate
Storm-Water Assessment Form
Contact:
Approved , 20Tf Mail to:
Disapproved a/c
Phone: 77 -b a
Expiration 120t
r But mg 2013
APPLICATION FOR BUILDING PERMIT
DEC 18
Date .20
INSTRUCTIONS
rc-^ poi o
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, 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)
State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder
Name of owner of premises 3O_1~LPEI
(As on the tax roll or latest deed)
If applicant is a corporation, sigltature of duly authorized officer
(Name and titleorcp,i3 o.ratg officer)
Builders License No:
Plumbers License No.
Electricians License No.
Other Trade's License No.
1. Location of 1 1d on which r osed wo will be done:
/J C- k- t4 Al .
House Number Street Hamlet
County Tax Map No. 1000 Section 31 Block Lot
473 '?9 131 ) -,S- , _r
Subdivision p~t2~%ftkoj) k",ex 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 c7t N` GE, 'F wm 6, "q JAIL iM . L&II=
b. Intended use and occupancy 5r=~M C-~
3. Nature of work (check which applicable): New Building Addition Alteration
Repair Removal Demolition Other Work DaC~
(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 5 f - ~e 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 r
Height Number of Stories
f
9. Size of lot: Front 1 cb~ Rear t a Depth -5A
10. Date of Purchase Name of Former Owner
11. Zone or use district in which premises are situated K60
12. Does proposed construction violate any zoning law, ordinance or regulation? YES NO X
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 X
* 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 A
* 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 A
* IF YES, PROVIDE A COPY.
STATE OF NEW YORK)
SS:
COUNTY OF )
being duly sworn, deposes and says that (s)he is the applicant
(Name of individual signing contract) above named, CONNIE D. BUNCH
Notary Pulft, 8M9 of Now York
(S)He is the NO.01BUf318b060
(I~ In S1
(Contractor, Agent, Corporate Officer, etc.) Commlealon Explroe AprA 14, 1,
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.
S rn tg before y e t Ks TM ~
'}-y~ da o 20 j
" &u d, S
Notary Public ignature of A cant
ho~~Of SOUryolo
Town Hall Annex Jr J~r Telephone (631) 765-1802
54375 Main Road
P.O. Box 1179 Q ro ecrichert
Southold. NY 11971-0959
JAN172014
J
BUILDING DEPARTMENT
TOWN OF SOUTHOLD s ,r
APPLICATION FOR ELECTRICAL INSPECTION u
REQUESTED BY Q 1 Date:
Company Name:
Name:
License No.: ( .
Address:
i-
Phone No.:
JOBSITE INFORMATION: (*Indicates required information)
i
*Name: OS
i
*Address: w0c
*Cross Street: ^~ss
*Phone No.: 7 1 rz j
X4/ - r°
Permit No.:
Tax-Map District: 1000 Section: Block: Lot:
*BRIEF DESCRIPTION OF WORK (Please Print Clearly) E
i
(Please Circle All That Apply)
*Is job ready for inspection: Y / NO Rough In Final
*Do you need a Temp Certificate: _ YE / NO
Temp Information (if needed)
*Service Size: 1 Phase 3Phase 100 150 200 300 350 .400 Other I .
*New Service: Re-connect Underground Number of Meters Change of Service Overhead
Additional Information: PAYMENT DUE WITH APPLICATION
i
82-Request for Inspection Form n x.
QQ 111777..
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