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zr.¢rai Town of Southold Annex 7/5/2014 P.O. Box 1179 _ 54375 Main Road �► �F, Southold,New York 11971 CERTIFICATE OF OCCUPANCY No: 37004 Date: 7/5/2014 THIS CERTIFIES that the building AS BUILT ALTERATION Location of Property: 440 Longview Ln, Southold, SCTM#: 473889 Sec/Block/Lot: 88.4-53 Subdivision: Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this officed dated 4/10/2014 pursuant to which Building Permit No. 38789 dated 4/17/2014 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"alteration to closets into half bath in an existing one family dwelling as applied for. The certificate is issued to Costello,Paula (OWNER) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL ELECTRICAL CERTIFICATE NO. 38789 4/29/14 PLUMBERS CERTIFICATION DATED 7/2/14 John W. Reichert 7 iz Signa ure TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, NY �rxxa 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#: 38789 Date: 4/17/2014 Permission is hereby granted to: Costello, Paula C/O Kathleen Costello 930 Jacobs Ln Southold, NY 11971 To: as built" converseion of closets to half bath as applied for At premises located at: 440 Longview Ln, Southold SCTM # 473889 Sec/Block/Lot# 88.-4-53 Pursuant to application dated _ 4/10/2014 _ and approved by the Building Inspector. To expire on 10/17/2015. Fees: AS BUILT- SINGLE FAMILY ADDITION/ALTERATION $414.40 CO -ALTERATION TO DWELLING $50.00 Total: $464.40 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 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 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: IIff Old or Pre-existing Building: (check one) /� Location of Property: T , Q � P Svc L" House No. Veet Hamlet Owner or Owners of Property: ka Wee A, (,)ite fu/4 FG r Po(A,6, (.411a a Suffolk County Tax Map No 1000, Section (9 Block C7 t Lot Q S^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: $ ant Sign it SO�ryolo Town Hall Annex Telephone(631)765-1802 54375 Main Road Fax(631)765-9502 P.O. Box 1179 G • �� roger.riche rt(-town.southold.ny.us Southold,NY 11971-0959 couffm BUILDING DEPARTMENT TOWN OF SOUTHOLD CERTIFICATE OF ELECTRICIAL COMPLIANCE SITE LOCATION Issued To: Paula Costello Address: 440 Longview Ln City: Southold St: NY Zip: 11971 Building Permit#: 38789 Section: $$ Block: 4 Lot: 53 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 Service Only Commerical Outdoor 1st Floor X 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 1 Wall Fixtures 1 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 Fixtures Time Clocks Disconnect Switches F2 Twist Lock Exit Fixtures TVSS Other Equipment: AS BUILT, bathroom, 1-exhaust fan Notes: Inspector Signature: Date: April 29 2014 81-Cert Electrical Compliance Form.xls rr� n JUL -2 2014 CERTIFICATION Date: Building Permit No. A� Owner: Qs� 1.11 -�` �d 7� lAt��� � �I C) (Please print) Plumber: TO/o N W RC/G F!c R1 (Please print) I certify that the solder used in the water supply system contains less than 2/10 of 1% lead. (Plumbers Signature) Sworn to before me this day of IBJ►' 20 Notary Public, SA& County LINDA S.CARLSON Notary Public, State of New York No.01 CA6137178 Oualified in Suffolk County Commission Expires Nov. 14,20 SOUlyOlo # # Ulm,� TOWN OF SOUTHOLD BUILDING DEPT. 765-1802 INSPECTION [ ] FOUNDATION IST [ ] ROUGH PLUMBING [ ] FOUNDATION 2ND [ ] INSULATION ( ] FRAMING / STRAPPING [ ] FINAL [ ] FIREPLACE & CHIMNEY [ ] FIRE SAFETY INSPECTION [ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRATION [ ] ELECTRICAL (ROUGH) ELECTRICAL (FINAL) [ ] CODE VIOLATION [ ] CAULKING REMARKS: DATE T - INSPECTOR�� �o��,oF so�ryo� '� G • O TOWN OF SOUTHOLD BUILDING DEPT. 765-1802 INSPECTION [ ] FOUNDATION IST [ ] ROUGH P MBING [ ] FOUNDATION 2ND [ ] INS TION [ ] FRAMING / STRAPPING [ INAL [ ] FIREPLACE A CHIMNEY [ ] FIRE SAFETY INSPECTION [ ) FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRATION [ ] ELECTRICAL (ROUGH) [ ] ELECTRICAL (FINAL) [ ] CODE VIOLATION [ ] CAULKING REMARKS: DATE INSPECTOR FIELD DATE COMMENTS FOUNDATION(1ST) C- FOUNDATION(2ND) M • z ROUGH FSG& PLUMBING c.. INSUL•ATION PES N.Y. STATE ENERGY CODE - r f FINAL { ADDZTI6I4AL COMMENTS G . �o z m 4 n 0 uN z i i E 1 i 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 Examined )[117, Flood Permit 20H Stone-Water Assessment Form � Contact: Approved "/ �20 Mail to: ,( Disapproved a/c :4 Phone: �/� � I�� ���J Expiration ;� ,20 Building Inspector i APR g ! APPLICATION FOR BUILDING PERMIT 2014 Date -1 , 20_Ly --- INSTRUCTIONS iJ completely filled in by typewriter or in ink and submitted to the Building Inspector with 4 a. s a �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. nature of appli t or e,if a corporation) ALL PLU!"I'DIIV�YVASTE (Mailing address of applica t) —� &WATER LIRRNES NEED State whether applicant is owner, lessee,agen , rch�tect�e0nineerC', general contractor, electrician, plumber or builder Name of owner of premises v S a p f (�� CJS II DvQTE_ ±i? 1 B.P. # 3 � As on the tax roll or latest deed)) FEE: If applicant is a corporation, signature of duly authorized officer NOTIFY BUILDING D" 765-1802 8 AM TO 4 PM (Name and title of corporate officer) F(_ LLOWING INSPECTIONS: 1. OUNDATION-TWO REQUIRED Builders License No. t°°'�� `"" ` �� .�-? FOR POURED CONCRETE ,. 2 ROUGH-FRAMING,PLUMS'^dG, Plumbers License No. 1� STRAPPING; ELECTRICAL Electricians License No. 3 INSULATION c Other Trade's License No. I iNAL-CONSTRUCT'r,r '?UST BE CO%!,aL::F "' 1. L cation ofJa d on which pr posed work will be done:�� CONSTRUCTI ,N n �° �0 1 JIREMENTS 0F House Number Street Hamlet SIGN OR CONSTRUCTION �.,<, -_. County Tax Map No. 1000 Section © Block 0 –1 Lot 62 S 3 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 I le -y�,� �Tc�_>° I �4 b. Intended use and occupancy�� y ��m� �S. , �� C-�P 3. Nature of work(check which applicable):New Building Addition Alteration Repair Removal Demolition Other Worker t j 1. Cwie f Jz Bu 3/ x 61 3 t7 (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 1 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 r � � 9. Size of lot: Front J&U Rear /c2 c7 Depth IFF) 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 f0-A th dl 14. Names of Owner of premises fa vw1 U (U, �-t�� 0 Address V J .bc,,Ls " Phone No. 92/ 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 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 NOV N * IF YES, PROVIDE A COPY. STATE OF NEW YORK) SS: COUNTY(( OF ) {� VBG ► Ud being duly sworn,deposes and says that(s)he is the applicant (Name of individualignin contract)agove named, (S)He is the (Contractor,Agent,CorporAte Officer,etc.) 9X of said owner or owners, and is duly authorized to jRrforL or have performed the said work and to make and file this application; that all statements contained in this application are Sue tc& best of his knowledge and belief,and that the work will be performed in the manner set forth in the applica&%0a%& with. n O Sworn to before me this :sW � w day of 20 N = y 2 o Imom � Notary Publi Signature RnpRWant O Z i q��OTr SO�jryo Town Hall Annex 1R Telephone(631)765-1802 54375 Main Road cn ,,aaxx(631)765-95Q2� P.O.Box 1179 G @ roger.richert IOWn.SOUtIl011CS nV us Southold,NY 11971-0959 �O i BUILDING DEPARTMENT TOWN OF SOUTHOLD APPLICATION FOR ELECTRICAL INSPECTION - REQUESTED BY: 1), t t Date: �3 Company Name: .. Name: License No.: f Address: Phone No.: f JOBSITE INFORMATION: (*Indicates required information) *Name: C v w Ail *Address: *Cross Street: *Phone No.: I 3 Permit No.: Tax-Map District: 1000 Section: Block: [ Lot: *BRIEF DESCRIPTION OF WORK (Please Print Clearly) , i I t (Please Circle All That Apply) Is job ready for inspection: a YES/ NO � *Do-you need a Temp Certificate: Rough In Final YES/ NO . 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 APPL I I APR 23 82=Request for Inspection Form v BL-DG. DEPT. TOWN OF WUTHOLD 4y TOWN OF SOUTHOLD PROPERTY RECORD CARD OWNER SIFT G VILLAGE DIST. SUB. LOT OWNER N, E ACRS. . W TYPE OF BUILDING P M1 !+. t f"ii ,.l a _ ,,. ' `• fig ?.:'.. RES.,�? SEAS. VL. FARM COMM. CB. MICS. Mkt. Value LAND IMP. TOTAL DATE REMARKS 44r Z2 Z 4 3S ,41er-2 i", 00 AGE Bt T DING CONDITION NEW NORMAL 1_UW ABOVE FARM Acre aue Per Value Acre Ilabie FRONTAGE ON WATER Aland ( FRONTAGE ON ROAD 'leadowl.ond I DEPTH House Plot BULKHEAD i Total, DOCK ■■ ■■■■ ■■■■■■■■■■■ ■■■■ do-, �.* * --� _ n# ■■■■■■■■■■■■■■■Nfu� N■■ ■■■■■ ■■■■■■■■■■■■■■■■■■■!'■ ■■INION = i a ■■■■■■■■■ a����r�■�r■t■iNNNIN■■■■INN ■ ■■■■■■■ ■■■■■■■■�!�■liri■■■■■■■ ■�■■■■NINN■INN■■■NN ■i�l1■IN■N■N■■ ■■■N■■■■■■N■■■■■■ ■i�1l■■■INN■INN NNE ■■■N■■■ININ■■■■N■■INN■INININION NNNN■ ■■■INN■W■■■INN■NNINNINNININNNINNINN Base ent Ext. Walls Inferior Finish Fire Place Recreation Room Rooms 2nd Floor Dormer Driveway ��� . .. . -0-� L'=° 40 �5'•- "> -' AQP OF .20GE27-Y y O = i tort tic oz ti AT �...� —- UK/Css O-NsCrt✓i,3� NofC� /Of�vtrlS�a3 � VI E yV . 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