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Town of Southold Annex 5/13/2014
' P.O.Box 1179
+ 54375 Main Road
';'$ 41 Southold,New York 11971
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CERTIFICATE OF OCCUPANCY
No: 36919 Date: 5/13/2014
THIS CERTIFIES that the building OTHER
Location of Property: 1245 August Ln, Greenport,
SCTM#: 473889 Sec/Block/Lot: 53.-4-44.21
Subdivision: Filed Map No. Lot No.
conforms substantially to the Application for Building Permit heretofore filed in this officed dated
5/5/2014 pursuant to which Building Permit No. 38852 dated 5/5/2014
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:
CENTRAL AIR CONDITIONING FOR A ONE FAMILY DWELLING AS APPLIED FOR
The certificate is issued to Hecht,Richard
(OWNER)
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL
ELECTRICAL CERTIFICATE NO. 38852 05-13-2014
PLUMBERS CERTIFICATION DATED
e 0 Clei,Vi. ,....'\,.....
'uthorized Signature
T" ' TOWN OF SOUTHOLD
'+ s"-a\
BUILDING DEPARTMENT TOWN CLERK'S OFFICE
SOUTHOLD, NY
'7 *
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#: 38852 Date: 5/5/2014
Permission is hereby granted to:
Hecht, Richard
C/O Marcia A. Schmidt
611 Hickory St
Westbury, NY 11590
To: central air conditioning as applied for.
At premises located at:
1245 August Ln, Greenport
SCTM # 473889
Sec/Block/Lot# 53.-4-44.21
Pursuant to application dated 5/5/2014 and approved by the Building Inspector.
To expire on 11/4/2015.
Fees:
SINGLE FAMILY DWELLING-ADDITION OR ALTERATION $200.00
CO -ADDITION TO DWELLING $50.00
ELECTRIC $90.00
Total: $340.00
4
i _
Building Inspector
&3/- Y5t7
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
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$15.00
-
Date. 3--� "02 070/y
New Construction: Old or Pre-existing Building: ✓ (check one)
Location of Property: 5-
House
e No. Street Hamlet
Owner or Owners of Property: *(--6-44() ' L A-A—"
Suffolk County Tax Map No 1000, Section S3 Block `/ Lot y`/. .1/
Subdivision Filed Map. Lot:
Permit No. Date of Permit. Applicant:
Health Dept.Approval: Underwriters Approval:
Planning Board Approval:
Request for: Temporary Certificate Final Certificate: (check one)
Fee Submitted:$
Ap► • ant . ure
yt7,
e,•%c SO!/r,�o
Town Hall Annex ��� �O l0 Telephone(631)765-1802
54375 Main Road ■ � t Fax(631)765-9502
P.O.Box 1179 ;;Ol �'0 rroger.richert(a�town.southold.ny.us
Southold,NY 11971-0959 : '�`
�OOUO\Y .,./'.
,�4
BUILDING DEPARTMENT
TOWN OF SOUTHOLD
CERTIFICATE OF ELECTRICIAL COMPLIANCE
SITE LOCATION
Issued To: estate of Marcia Schmidt
Address: 1245 August Lane City: Greenport St: NY Zip: 11944
Building Permit#: 38852 Section: 53 Block: 4 Lot: 44.21
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 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 X Single Recpt Recessed Fixtures CO Detectors
Sub Panel A/C Blower X Range Recpt Fluorescent Fixture Pumps
Transformer Appliances Dryer Recpt Emergency Fixtures Time Clocks
Disconnect Switches Twist Lock Exit Fixtures TVSS
Other Equipment: as built inspection of central air conditioner-OK
NO VISUAL DEFECTS
Notes:
Inspector Signature: Date: May 13 2014
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. 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 Li D (G�—; :5' )7
Building Inspector
Hv:, fl ■,--', u
) 4
APPLICATION FOR BUILDING PERMIT
\\ _k ____-_\
' i 1 IAAY - 5 2014 Date S- a , 20 /r
,. INSTRUCTIONS
a. This l lei a.49) b- t omp etely filled in by typewriter or in ink and submitted to the Building Inspector with 4
s is ofEla 1i'`'°'' o p an 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 L./j 2a
(A 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 workk will be done:
/oZ qj oS --
House Number eel Hamlet
County Tax Map No. 1000 Section .53 Block y Lot 94‹ 2"/
Subdivision d4,474...41....4 , •n4.1..., 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
Gt,( scr � %+�c-t
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 ry'f
9. Size of lot: Front Rear Depth
10. Date of Purchase Name of Former Owner Lgelc.c.tit .
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 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
ame of' dividual signing contract)above named, CONNIE D.BUNCH
Notary Public,State of New York
(S)He is the %- No.01806185050
(Contractor,Agent, Corporate Officer,etc.) Commission Expires April 14,201
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
day of LU 20 t
TOO WA I\/) Ahbk
Notary Public Signature of Applicant
if.A1 80040%,
Town Hall Annex ; 411 *' Telephone(631)765-1802 i>
54375 Main Road ` �auc(631)76g5Q
P.O.Box 1179 ; G Q � rogersicherter lOwn.SOU O .nv.US
Southold,NY 11971-0959 se -44 4 111•
CVYtI ys% o'
BUILDING DEPARTMENT
TOWN OF SOUTHOLD
APPLICATION FOR ELECTRICAL INSPECTION
- REQUESTED BY: 4• Date: 2cr
Company Name: (Fi9,yaie.
Name: ` �C�►3� -�f�
License No.:
Address: P--
Phone No.:
JOBSITE INFORMATION: (*Indicates required information)
*Name: /et-eft-1, -�- .
*Address: /,,2 y5' oY �
*Cross Street: .30( •
*Phone No.:
Permit No.: 3
Tax Map District: 1000 Section: S3 . Block: y Lot: qq 2 /
*BRIEF DESCRIPTION OF WORK(Please Print Clearly) •
"AA-
it-f./);
(Please Circle All That Apply)
*Is job ready for inspection: ® 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
l
82-Request for Inspection Form 6 , 5,) `f
-J I f
o,,,pF SO(/1�04\`
i* *i
N,OUNT1, ,,
TOWN
,/1,) � J OF SOUTHOLD BUILDING DEPT.
765-1802
INSPECTION
[ ] FOUNDATION 1ST [ ] ROUGH PLUMBING
[ ] FOUNDATION 2ND [ ] INSULATION
[ ] FRAMING / STRAPPING [ ] FINAL
[ ] FIREPLACE & CHIMNEY [ ] FIRE SAFETY INSPECTION
[ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRATION
[ ] ELECTRICAL (ROUGH) V] ELECTRICAL (FINAL)
[ ] CODE VIOLATION [ ] CAULKING
REMARKS:
DATE /3 / .e(00.
INSPECTOR
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44- I2-- 40 182 ,47
S11F'FOLK CODNTYD PA.UPVIITOPREA 121 SERVICES
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E LOCATION dF WELLS,WATER SERVICE
r LINES, SEPTIC TANKS AND CESSPOOLS
SHOWN HEREON ARE FIELD OBSERVA-
TIONS AND OR DATA OBTAINED FROM
OTHERS,
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Unauthon0ed alteration or addition to this document is a notation of Section 7209 SURVEY OF: :-/-"' 9 ^
of the New York State Education Law.
Certifications n his e to th indicated Tole shall run very to the person and Lending d is prepared r c GIi"T fi'(.‘.7 461...
•
and on hb behalf to the Tale Company,Governmental Agency and Lending
Institution hated hereon.and to the assignees of the lending institutions or subse•
quent owner A4*Aft: V 2 146 -raw o� Ttk+A
Copses of this document not bearing the professional's inked seal or embossed
seal shell not be considered a veld we copy- )
The offsets specific(or os eanldus)shown hereon are structures to the e the rehab are 40 (.4,il NEW \�K.)/
lore specific purpose nsi use and n here n are not intended t e guide pro the erection es a of 'v ' (<
fences,retaining wails,pools,patios,planting areas,addition to buildings or any other
construction.
The esratonce of right of ways and/or easements of record.If any,not shown are N:L-,� DATE: 1;)Z[)1 P //
not guaranteed. _
40
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CERTIFIED ONLY TO: y DESTI
G.GRAF„�I DESTIN G. GRAF
W IL.LIAM f2 04i✓Etc A740 /�AU12 E -P, 0 ;'- 1
® "�I `* LAND SURVEYOR
by , '� 1�.s1: 1`t 73 WOODLAWN ROAD
9
DESTIN G.GRAF N.Y.S.LIC No.50067 NIrPP ROCKY POINT,NEW YORK 11778
TAX I.D.No. loon -.5 J—D 4 - 44 2,1 . "ID ' v PHONE(516)821-3442