HomeMy WebLinkAbout38561-Z Town of Southold Annex 6/18/2014
P.O.Box 1179
54375 Main Road
"8 1 !1 , Southold,New York 11971
CERTIFICATE OF OCCUPANCY
No: 36977 Date: 6/18/2014
THIS CERTIFIES that the building ALTERATION
Location of Property: 2675 Indian Neck Ln, Peconic,
SCTM#: 473889 Sec/Block/Lot: 86.-5-13
Subdivision: Filed Map No. Lot No.
conforms substantially to the Application for Building Permit heretofore filed in this otficed dated
12/2/2013 pursuant to which Building Permit No. 38561 dated 12/11/2013
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:
2nd FLOOR ALTERATIONS TO AN EXISTING SINGLE FAMILY DWELLING AS APPLIED FOR.
The certificate is issued to Pontino,Deborah
(OWNER)
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL
ELECTRICAL CERTIFICATE NO. 38561 05-15-2014
PLUMBERS CERTIFICATION DATED 05-23-2014 Cutcho e East Plumbing&Heating
Aut d Si ature
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN CLERK'S OFFICE
I& 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#: 38561 Date: 12/11/2013
Permission is hereby granted to:
Pontino, Deborah
2675 Indian Neck Ln
Peconic, NY 11958
To: Alterations (2nd floor) to an existing single family dwelling as applied for.
At premises located at:
2675 Indian Neck Ln, Peconic
SCTM # 473889
Sec/Block/Lot# 86.-5-13
Pursuant to application dated 12/2/2013 and approved by the Building Inspector.
To expire on 6/12/2015.
Fees:
SINGLE FAMILY DWELLING -ADDITION OR ALTERATION $200.00
CO -ALTERATION TO DWELLING $50.00
Total: $250.00
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
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: Old or Pre-existing Building: (check one)
Location of Property: -Z_C�
House No. Street Hamlet
Owner or Owners of Property: / J TG ,�l
Suffolk County Tax Map No 1000, Section Block Lot ( 3
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: $
appant Signature
pF SOyol.
Town Hall Annex O Telephone(631)765-1802
54375 Main Road Fax(631)765-9502
P.O. Box 1179 roger.riche rt(ab-town.southold.ny.us
Southold,NY 11971-0959 �e01� �� --
�OUNTY,�
BUILDING DEPARTMENT
TOWN OF SOUTHOLD
CERTIFICATE OF ELECTRICIAL COMPLIANCE
SITE LOCATION
Issued To: D Pontino
Address: 2675 Indian Neck Ln City: Peconic St: NY Zip: 11958
Building Permit* 38561 Section: 86 Block: 5 Lot: 13
WAS EXAMINED AND FOUND TO BE IN COMPLIANCE WITH THE NATIONAL ELECTRIC CODE
Contractor: DBA: DOroski Electric Inc License No: 2941-e
SITE DETAILS
Office Use Only
Residential X Indoor X Basement Service Only
Commerical Outdoor 1st Floor Pool
New Renovation X 2nd Floor X Hot Tub
Addition Survey Attic X Garage
INVENTORY
Service 1 ph Heat Duplec Recpt 22 Ceiling Fixtures 6 HID Fixtures
Service 3 ph Hot Water GFCI Recpt 3 Wall Fixtures 2 Smoke Detectors 5
Main Panel A/C Condenser Single Recpt Recessed Fixtures 2 CO Detectors 1
Sub Panel A/C Blower Range Recpt Fluorescent Fixture 3 Pumps
Transformer Appliances Dryer Recpt 1-30 Emergency Fixture Time Clocks
Disconnect Switches 12 Twist Lock Exit Fixtures TVSS
Other Equipment:
Notes:
Inspector Signature: Date: May 15 2014
81-Cert Electrical Compliance Form.xls
Not 311
Town Hall Annex Telephone(631)765-180.2
54375 Main Road
Fax(631):765-95112
P.O.Box 1179
Southold,New York 11971-0959
BUILDING IMPARTMENT
TOWN OF SOUTHOLD
CERTIFICATION
L
Date:5" 2 :5
Building Permit No. �� I
Owner: �� yl—�-I h
(Please print)
P lumber: C Lr
�J 1- 14
_
(Please print)
I certify that the solder used in the water supply system contains less.than 2/10 of 1%
lead.
j"
(Plumbers Signature)
Sworn to before me this a:2)r
day of 20
CONNIE D. BUNCH
Notary Public,State of New York
No.01 BU6185050
Qualified in Suffolk County
Notary Public, County Commission Expires April 14,2V�p
r4f so
TOWN OF SOUTHOLD BUILDING DEPT.
765-1802
INSPECTION
I FOUNDATION IST I ROUGH PLUMBING
FOUNDATION 2ND ] INSULATION
FRAMING / STRAPPING FINAL
FIREPLACE & CHIMNEY FIRE SAFETY INSPECTION
FIRE RESISTANT CONSTRUCTION FIRE RESISTANT PENETRATION
%ELECRICAL (ROUGH)
T ELECTRICAL (FINAL)
ODE VIOLATION CAULKING
REMARKS:
DATE . INSPECTOR��
�o�aof souryo6
TOWN OF SOUTHOLD BUILDING DEPT.
765.1802
1, NSPEC T N
[ ] FOU ATION 1 ST [ ROUGH PLBG.
[ ] UNDATION 2ND [ ] INSULATION
[ ' FRAMING /STRAPPING [ ] FINAL
[ ] FIREPLACE & CHIMNEY [ ] FIRE SAFETY INSPECTION
[ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRATION
[ ] ELECTRICAL ROUGH) [ ] ELECTRICAL (FINAL)
REMARKS:
f
n
DATE INSPECTOR
3 S�s� � -
�o,*of soulyo6
TOWN OF SOUTHOLD BUILDING DEPT.
765-1802
INSPECTION
[ ] FOUNDATION 1ST [ =ION
PLBG.
FOUNDATION 2ND [
[ ] FRAMING /STRAPPING [ ] FINAL
[ ] FIREPLACE & CHIMNEY [ ] FIRE SAFETY INSPECTION
[ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRATION
[ ] ELECTRICAL (ROUGH) [ ] ELECTRIC AL)
REMARKS: l J
DATE INSPECTOR
pf SO(/r�o�
TOWN OF SOUTHOLD BUILDING DEPT.
765-1802
INSPECTION
[ ] FOUNDATION IST [ ] ROUGH PLUMBING
[ ] FOUNDATION 2ND [ ] INSULATION
[ ] FRAMING I STRAPPING [ ] FINAL
[ ) FIREPLACE A CHIMNEY [ ] FIRE SAFETY INSPECTION
[ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRATION
[ ] ELECTRICAL (ROUGH) [�] ELECTRICAL (FINAL)
I
[ ] CODE VIOLATION [ ] CAULKING
REMARKS.
DATE l 1 INSPECTOR Z`
i
O��OF SOpl�Ol
� o
TOWN OF SOUTHOLD BUILDING DEPT.
765-1802
INSPECTOI
[ ] FOUNDATION IST [ ] RO H PLUMBING
[ ] FOUNDATION 2ND [ ] SULATION
[ ]
FRAMING / STRAPPING [ FINAL
[ ] FIREPLACE A CHIMNEY [ ] FIRE SAFETY INSPECTION
[ ) FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRATION
[ ] ELECTRICAL (ROUGH) [ ] ELECTRICAL (FINAL)
[ ] CODE VIOLATION [ ] CAULKING
REMARKS:
C-YC-X -
r
DATE INSPECTOR
1: ! I '1' 0 • Weis) I I:N
Im
• 1 •
PLUMING
FAI'd I All 111111101111111111
INSUIA, TI
•
STATE BNERGY CODE
--------------------------------
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-ADDITIONAL COMNINTS
mWl s ,��� PAW■. WINr .►!
Of MAI 0 0 I Ma ME
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•
—
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
www.northfork.net/Southold/ PERMIT NO. 3oS6 Check
Septic Form
N.Y.S.D.E.C,
Trustees
Examined ,20 Contact:
Approved ,20 Mail to:
Disapproved a/c
_ Phone:
Expiration '�-r ,20�� 1
� Building Inspector
�i DEC - 2 2013
APPLICATION FOR BUILDING PERMIT
Date_ NOVeMQe?,r2,1 , 20 13
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 premise!;�: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 pgrmit 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.
��r1l�.ylvcn�T �8T'InSG
(Signature of applicant or name,if a corporation)
(F>oX I R.7 P�Cory t e N .
(Mailing address of applicant)' �cl
;a'
State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician,slumber or builder
Name of owner of premises Ems'• PD"'t t n3 ()�
(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 wort:will be done:
2(0 7 S ( N tit A--r,3 rjClc- L-&fQ E
House Number Street Hamlet
i
County Tax Map No. 1000 Section Block d s Lot 3
Subdivision Filed Map No. Lot
(Name) -
2. State existing use and occupancy of premises and intended use and occupancy of proposed-construction:
a. Existing use and occupancy C-LE fl" 0 EN ce�
b. Intended use and occupancy L rJ C'4 -- FA11 fg.. S �C)
3. Nature of work (check which applicable): New Building Addition Alteration
Repair Removal Demolition O her Work
AT>D F,"-E w t N X00 w S � i" 1e (Description)
4. Estimated Cost Fee cF 2-"Jo
(To be paid on filing this application)
5. If dwelling, number of dwelling units hJA- Number of dwelling units on each floor Nom'
If-garage, number of cars /\I
6. If business, commercial or mixed occupancy, specify nature and extent of each type of use. _ Nth .
7. Dimensions of existing structures, if any: Front 94 ,31 Rear '`{' • 3 Depth 3
Height 1,31-011 Number of Stories 2-
N O C°WAWGla i
Dimensions of same structure with alterations or additions: Front 3' Rear
Depth ?q 4 a 1 Height 2-7 `-0 Number of Stories 2--
8.
8. Dimensions of entire new construction: Front IST A Rear h3 A—. Depth "NI-A'
Height N&' Number of Stories ry'ht-
9. Size of lot: Front x'00. O t Rear Q U 1 Depth �' / TD L—131 3 C/
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 DeB. PONT IO'O Address UIS Nc. Phone No.-734 60` l 3
Name of Architect Address Phone No
Name of Contractor EN U • S't. (r4C, Address Pd 6DK fa.'7 Phone No.
713 -74
' p�CpNIG N`{It`3'S8
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 1/
* 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.
STATE OF NEW YORK)
SS:
COUNTY OF 5U'<%FC7�t�.1G-,`
being duly sworn, deposes and says that(s)he is the applicant
(Name of individual signing contract)above named,
(S)He is the co 111j CONME D.BUNCHNo"mi-Oft SUM Of Y * .
(Contractor, Agent, Corporate Officer, etc.) No.018uelea 0
QueRHrd in&Pok Ow*
A4
004
of said owner or owners, and is duly authorized to perform or have performed the saQW61 �nc�Piielms 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 t
2- r\d day of to—Z-424 6 20
Notary Public Signature of Applicant
TOM H011 Annex � Telephone(631)7654 W
84
P..00
.Box 1179 ro4er.
Southold,NY 11971-UIISU � ;¢�
BUILDING DEPARTM&NT
TOWN OF SOUTHOLD
APPLI96710LE13 ELECIRIQL INEP CMN
A
REQUESTED 8Y: o�r-o :c Date: /y- y
mpeny Name:
.1N
Name:
Lk No.: 2
Address: C `Zox 7 9 c C,* Qy--j
Phone No.: G s 732 7�Z 3
JOSSITE INFORMAT ION: (Indicates required infDrrnation)
`Name: �1 �o h1 i�► o
"Address: a L S..- N a►J ¢,G G......-. �'C dw�G .r.� rr..r_.....r..
'Cross Street:
'Phone No.:
��/y��}
t o mit No.• 3
Tax Map District: 1000 Section: Ei�0 lot:
"BRIEF DES IPTION OF WORK (Please Print Clearly) ,a
(Please Circle All That jkppiy) � ( T-ly
'Is job ready for inspecticin: YE NO Royu h In Fines
To you need a Temp Cortificate: YES J NO
Temp Infomation (If rw*dud3
*Some* Size: 1 Phs ae 3Phe" 100 150 SOC' 300 350 400 Other
.N" Service: Re-conrwct Underground Number of NNters Change of Servios Ovsrhssd
AddltiorW Information: PAYMENT t1"JI
11 Hi MAR 17 2014r
82-Request for Inspection Pc rrn ^
3I
-Padt
d to
Fame
Environment East, Inc.
2885 Indian Neck Lane
P.O. Box 197
1� Peconic, New York 11958-0197
631-734-7474
Fax: 631-734-5812
�'�ooaoo�
March 20, 2014
I�
i
;__..
Southold Town Building Department E
P O Box 1179
Southold, NY 11971 i
MAR 2 N14
.
Re: Permit#38561 Pontino Residence
To Whom It May Concern;
Enclosed are plans showing amendments that the home owner would like to make to the above
mentioned permit.
Please let us know if there are any questions or additional fees.
Sincerely,
Judy McAfee
ANY ALTERA77ON OR ADDI 77ON TO THIS SURVEY IS A KOLA TION
OF SEC77ON 7209OF THE NEWof PON�N� EXCEPT AS PER SEC ON 7209YSUBDIW-q J UALL-CCER77 LAW
NPR�P HEREON ARE VALID FOR THIS MAP AND COPIES THEREOF ONLY IF
N J�N SAID MAP OR OSE SIGNATUREI APPEARS HEREON IMPRESSED SEAL OF THE SURVEYOR SURVEY OF PROPERTY
AT PECONIC
TOWN OF SO UTHOLD
N SUFFOLK COUNTY,, MY
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ALL CODES OF
NEW YJ - K Sl i & TOWN CODES
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YORK STATE. NOT RESPONSIBLE FOR
DESIGN OR CONSTRUCTION ERRORS. OF OCCUPANCY
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