Loading...
HomeMy WebLinkAbout38622-Z Town of Southold Annex 1/24/2014 P.O. Box 1179 54375 Main Road Southold, New York 11971 CERTIFICATE OF OCCUPANCY No: 36732 Date: 1/24/2014 THIS CERTIFIES that the building ELECTRICAL Location of Property: 90 Oak Ave, Southold, SCTM 473889 Sec/Block/Lot: 77.-2-6 Subdivision: Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this officed dated 1/14/2014 pursuant to which Building Permit No. 38622 dated 1/14/2014 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: electrical survey and as built hot water heater as applied for The certificate is issued to Markowitz, Carolyn (OWNER) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL ELECTRICAL CERTIFICATE NO. 38622 1/10/14 PLUMBERS CERTIFICATION DATED Auth Signatur y~e 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 38622 Date: 1/14/2014 Permission is hereby granted to: Markowitz, Carolyn 734 Stewart Ave Bethpage, NY 11714 To: electrical survey and as built hot water heater as applied for. At premises located at: 90 Oak Ave, Southold SCTM # 473889 Sec/Block/Lot # 77: 2-6 Pursuant to application dated 1/14/2014 and approved by the Building Inspector. To expire on 7/16/2015. Fees: ELECTRIC $125.00 AS BUILT - SINGLE FAMILY ADDITION/ALTERATION $200.00 CO - ADDIT O DWELLING $50.00 al: $375.00 Building Inspector Form No. 6 TOWN OFSOUTHOLD I , ~J~ 15 BUILDING DEPARTMENT V~ v VVV TOWN HALL 765-1802 1 v J10 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. New Construction: Old or Pre-existing Building: (check one) Location of Property: HoaseeNo. ` Streetr Hamlet Owner or Owners of Property: ~i~G C~a~ - 7t=r--v coo-tTr75~.5 LI-c Suffolk County Tax Map No 1000, Section Block Lot Subdivision Filed Map. Lot: Permit No. _1*r~4 Date of Permit. Applicant: Health Dept. Approval: Underwriters Approval: Planning Board Approval: Request for: Temporary Certificate Final Certificate: (check one) Fee Submitted: $ +Air i pF SOUjyolo Town Hall Annex yy yy Telephone (631) 765-1802 54375 Main Road T T Fax (631) 765-9502 P Box 117 ~ Southold, , NY 11971 1-0959 roger. riche rt(cDtown.southoId.nv.us 11M,~ BUILDING DEPARTMENT TOWN OF SOUTHOLD CERTIFICATE OF ELECTRICIAL COMPLIANCE SITE LOCATION Issued To: Tim Hill Address: 90 Oak Ave City: Southold St: NY Zip: 11971 Building Permit#: 38622 Section: 77 Block: 2 Lot: 6 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 X 1st Floor X Pool New Renovation 2nd Floor Hot Tub Addition Survey X Attic Garage INVENTORY Service 1 ph 100a Heat Duplec Recpt 9 Ceiling Fixtures 6 HID Fixtures Service 3 ph Hot Water 1 GFCI Recpt Wall Fixtures 1 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 4 Twist Lock Exit Fixtures TVSS Other Equipment: ELECTRICAL SURVEY--no visual defects, 1-exhaust fan, 1-well pump, 1- hot water heater Notes: Inspector Signature: Date: Jan 10 2014 81-Cert Electrical Compliance Form.xls DATA COMN[NT3. i 71 ~ FOUNDATION (1S2) FOMMAXION (2ND) O ~ 9 IZOTJ(m nwmo & o l PLU;VIBTNG MULATION PMN X. C STATE Wi.GMGY cone . d FINAL ADDITTOfPAL COMKIE T$ 0: -a 1 c • o N~ 0 z d 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. Check Septic Form N.Y.S.D.E.C. Trustees Flood Permit Examined ,20 Storm-Water Assessment Form Contact: Approved , 20 Mail to: Disapproved a/c Phone: Expiration , 20 Building Inspector APPLICATION FOR BUILDING PERMIT Date 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, housing code, and regulations, and to admit authorized inspectors on premises and in building for necessary inspections. ~SC nature of applicant or name, if a corporation) :19 41: C(Mailin addr s fapplicant) c~ CPIs,., rY l0(3C3 State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder OLeo L)L Name of owner of premises t/ wC'7L P r~~Cs C (As on the tax roll or latest deed) If applic is a c r ration, signature of duly authorized officer 0,1 LAku - ame and t oI'corodrate 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 done: 90 t4sz AkA House Number Street Hamlet County Tax Map No. 1000 Section Block 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 ~t IS~iy~h /k(= b. Intended use and occupancy w F{ y ~s~ 3. Nature of work (check which applicable): New Building Addition Alteration Repair Removal Demolition Other Work L(~i LLa2"YZ IAA ( (Description) 4. Estimated Cost Fee (To be paid on tiling 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_ NOWill 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. b. Is this property within 300 feet of a tidal wetland? * YES NO * 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 ) being duly sworn, deposes and says that (s)he is the applicant (Name of individual signing contract) above named, COW41E D. BUNCH Notary Public, State of New Yolk (S)He is the No. 01BUS186M (Contractor, Agent, Corporate Officer, etc.) Commieetoe Etgtree Aprfi 14, 2_ 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 SS'k-f~\ day of 20L~ .1`4 Notary Public Signature o Applicant 1-8 168 GOOSE CREEK COTTAGES LLC 22_10 1007 23 OXFORD RD. WHITE PLAINS, NY 10606.3607 Date /U - Town Hal: Pay tot a cQQ~ 07 1- ` $'f 54375 Mai P.O. Bo (7-l,~_ Dollars: Southold, "1 C1 ibank' WIEMIK NA En hw NIMMIMONECKLYENUE , NT1RE PlNNBT. NY~tOWS Memo +1:021000CJ"89~ 2? 1007 - f A° REQUESTED BY: Date: Company Name: Name: License No.: Address: a) _ r ( S Phone No.: 01 K ( r Es JOBSITE INFORMATION: (*Indicates required information) *Address: *Cross Street: cis lv( r *Phone No.: ~j (c( Permit No.: Tax Map District: 1000 Section. Block. Lot. *BRIEF DESCRIPTION OF WORK (Please Print Clearly) a e cam,' SckrUe,c, (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-connect Underground Number of Meters Change of Service Overhead Additional Information: PAYMENT DUE WITH APPLICATION 4 I a~s - 82-Request for Inspection Form *,G S