Loading...
HomeMy WebLinkAbout38812-Z ''`r Town of Southold Annex 4/29/2014 . P.O. Box 1179 is 54375 Main Road "$ it`,' Southold,New York 11971 CERTIFICATE OF OCCUPANCY No: 36877 Date: 4/29/2014 THIS CERTIFIES that the building GENERATOR Location of Property: 2055 Grand Ave, Mattituck, SCTM#: 473889 Sec/Block/Lot: 107.-8-5 Subdivision: Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this officed dated 4/16/2014 pursuant to which Building Permit No. 38812 dated 4/25/2014 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: ACCESSORY GENERATOR AS APPLIED The certificate is issued to Deerkoski,Gladys (OWNER) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL ELECTRICAL CERTIFICATE NO. 38812 04-23-2014 PLUMBERS CERTIFICATION DATED Z67.1----? - Authorized Signature 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#: 38812 Date: 4/25/2014 Permission is hereby granted to: Deerkoski, Gladys PO BOX 248 Mattituck, NY 11952 To: Installation of a generator as applied for. At premises located at: 2055 Grand Ave, Mattituck SCTM # 473889 Sec/Block/Lot# 107.-8-5 Pursuant to application dated 4/16/2014 and approved by the Building Inspector. To expire on 10/25/2015. Fees: ACCESSORY $100.00 CO -ACCESSORY BUILDING $50.00 Total: $150.00 /L- Building Inspector o Town Hall Annex ��� ~O l0 : Telephone(631)765-1802 54375 Main Road ∎ * ill Fax(631)765-9502 ■P.O. Box 1179 : G Q ,� Southold,NY 11971-0959 `'�Ol� �0,,�� roper.richert(C�town.southold.ny.us COUtfrO ...° •Igi BUILDING DEPARTMENT TOWN OF SOUTHOLD CERTIFICATE OF ELECTRICIAL COMPLIANCE SITE LOCATION Issued To: Deerkoski Address: 2055 Grand Ave City: Mattituck St: NY Zip: 11952 Building Permit#: 38812 Section: 107 Block: 8 Lot: 5 WAS EXAMINED AND FOUND TO BE IN COMPLIANCE WITH THE NATIONAL ELECTRIC CODE Contractor: DBA: Glens Electric License No: 4770-me 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 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 NC Blower Range Recpt Fluorescent Fixture Pumps Transformer Appliances Dryer Recpt Emergency Fixtures Time Clocks Disconnect Switches Twist Lock Exit Fixtures TVSS Other Equipment: 20KW standby generator with 200a transfer switch Notes: iiiiprjarallik Inspector Signature: a_,, _ Date: April 23 2014 v p 81-Cert Electrical Compliance Form.xls 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. 3 s 1 a • - Check Septic Form _--- N.Y.S.D.E.C. ') , '^ -------- Trustees ;1 lI I I Flood Permit Examined 20 , ! :1 I I Storm-Water Assessment Form Z % J APR 1 (� X014 f ,��' ontact: / I Approved 20 � Mail to: Disapproved a/c �n1 r ��► ___________ Phone:r -/� ExExpiration ,20 Building Inspccto 1 e, APPLICATION FOR BUILDI PE APR 0VED AS NOTED . DATE: j2r/iy B.P.# ma-" Date '� /� , 20`� INSTRUCTIONS FEE: /OU B NICS:IFIY~itiaiciiiEIVIMINTcolitipletely filled in by typewriter or in ink and submitted to the Building Inspector with 4 sets ofifialWacattiktePottRath ggiaTelEFee according to schedule. FOW-PA •E a `li ireigeation of lot and of buildings on premises,relationship to adjoining premises or public streets or areas,tadcc : 11' - TWO REQUIRED E.Ph8 r 4ocad�FEhis a'�? lication may not be commenced before issuance of Building Permit. 2. �.`1���i.: 'Ki�bfistli'i�W.::1 ion,the Building Inspector will issue a Building Permit to the applicant. Such a permit shall tie ,l.`C`cfi`i' r raises available for inspection throughout the work. 4. - ;• - .Q i s �T g� �{0Ted or used in whole or in part for any purpose what so ever until the Building Inspector issuesAt - •• M T THE if the work authorized has not commenced within 12 months after the date of RE � �� i ssouary Sgt •\89' ,o-W h> months from such date.If no zoning amendments or other regulations affecting the p peq, Nie Aerb� s }ugt R e 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 Soutbold,.Suffo-1knCounty,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. .tS"C.,„..„ il EEL (SigITa f applicant or name,if a corporation) < '.. ?o &,c CC / . ttt 7N 9YJ- (Mailing address of applicant f/ State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician,plumber or builder Name of owner of premises r4 E/i,C d' CIA D ys rPe kns(z/ (As on the tax roll or latest deed) If applicant is a corporation, signature of duly authorized officer (Name and title of corporate officer) OCCUPANCY OR Builders License No. USE IS UNLAWFUL Plumbers License No. ITHQUT cERTIRCATE Electricians License No. Other Trade's License No. OF OCCUPANCY 1. Location of land on which proposed work will be done: .205-5- 6,44,i p 141/4/&-- du rvce----- House Number Street Hamlet County Tax Map No. 1000 Section / a 1 Block it Lot 5 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 b. Intended use and occupancy 3. Nature of work(check which applicable):New Building Addition Alteration Repair Removal' Demolition Other Work &-E-e/X02 fit 7a ae (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 14. Names of Owner of premises:: ;I p 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 3`00 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 individ i pg,cpptract)above named, CONNIE D.BUNCH ::"-1 Notary Public,State of New York (S)He is the gR # gk "� « r No 018U6185050 (C n4ra*tq ,Aunt,Corporate Officer,etc.) Qualified in Suffolk County Commission Expires April 14 2)j L of said owner or owners,and is dtl'y authorizedf o perform or have performed the said work and to make and file this application; that all statements coat:iileait/iii5 a'ppli-�ti rare true to the best of his knowledge and belief; and that the work will be performed in the manner set forth in tfe ppll'c ttion filed therewith. Sworn to before me this 2 `4 day of ;Atli 20 E0-0'bNi•ia Notary Public S',*!tune of Applicant Town Hall Annex l * Telephone(631)765-1802 54375 Main Road , g QQ22 P.O.Box 1179 ; Q �� rooer.richert(d town SOUtI101tl.ny.us Southold,NY 11971-0959 ; �� �O'1t , COUNTl,N BUILDING DEPARTMENT TOWN OF SOUTHOLD APPLICATION FOR ELECTRICAL INSPECTION REQUESTED BY: Date: /6 l Company Name: Name: License No.: Address: l<- /_ cc' ieie's/a,,P% /&/�J • Phone No.: . as/- / JOBSITE INFORMATION: (*Indicates required information) *Name: *Address: © r *Cross Street: *Phone No.: C'3/— c2F5.- g`/ Permit No.: •i. , -- Tax.Map District: 1000 Section: Block: • Lot: *BRIEF DESCRIPTION OF WORK(Please Print Clearly) (Please Circle All That Apply) is job ready for inspection: �/ NO Rough In YES *Do.you need a Temp Certificate: erd . I 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 82-Request for Inspection Form 3. Nature of work (check which applicable): New Building Addition X Alteration Repair Removal Demolition Other Work (Description) 4. Estimated Cost... 2A,rj00.00 Fee (to be paid on filing this application) 5. If dwelling,number of dwelling units 1 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 321 Rear 4Q f Depth 261 Height a t Number of Stories 1x Dimensions of same structure with alterations or additions: Front 32' Rear....MI Depth lib t Height X5' • Number of Stories 1 8. Dimensions of entire new construction: Front Rear Depth Height Number of Stories 9. Size of lot: Front LQQ t Rear 1001 Depth 1..cg t 10. Date of Purchase PRA", .1953 Name of Former Owner Win„ H. & Harry E. Mason 11. Zone or use district in which premises are situated 12. Does proposed construction violate any zoning law,ordinance or regulation: IQ 13. Will lot be regraded_--._CIA Will excess fill be removed from premises: (x) Yes [ ] No 14. Name of Owner of premises ..201.176...&...n 4131,9 DeerIcoskL, Iattituck 298-8121 (Address) (Phone No.) Name of Architect (Address) (Phone No.) Name of Contractor (Address) (Phone No.) PLOT DIAGRAM Locate clearly and distinctly all buildings,whether existing or proposed,and indicate all set-back dimensions from property lines.Give street and block number or descr1(iption according to deed,and show street names and indicate wheth- er interior or corner lot. $50:ha ikl ,t_i re e. /�dd ,T'°�' 0-4 ao A/'eLcJ o eV 6C/VegfiT6 e_ l 7Y e--r- (°24 ) . k..,... . > KoHLE3ei- / -1 -� f o n & b s \ a° Fr > 5 ../N 4. Si/ FT -) i STATE OF NEW YORK, ) 1K��T V l uVJ ila . k. COUNTY OF .S1/4-, R.G\\4■.— ) rS V.9,—, �ci. C.c.., 'c..)E g.R\SQ,SK<\ being duly sworn,deposes and says that he is the applicant above named. (Name of individual signing contract) He is the 0WSN Q0., (Contractor,agent,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. Si-(r TERRI LEE UM day of VQ.. .IZS)CA itY PUBLIC, S5 B2 t rl1 York c' ied 57--8166 43o 1i 7 Qualified in F�utnik County Notary Public, ..S—\-...-74,17:-.,-...— issio L CF �J. 14::.7� (Signature of applicant)