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HomeMy WebLinkAbout38547-Z y11F�l,f Town of Southold Annex 7/21/2014 P.O.Box 1179 z 54375 Main Road '� ♦ Southold,New York 11971 CERTIFICATE OF OCCUPANCY No: 37035 Date: 7/21/2014 THIS CERTIFIES that the building HVAC Location of Property: 28850 Route 25, Cutchogue, SCTM#: 473889 Sec/Block/Lot: 102.-6-21 Subdivision: Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this officed dated 11/26/2013 pursuant to which Building Permit No. 38547 dated 12/6/2013 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: GAS HEATING SYSTEM TO AN EXISTING SINGLE FAMILY DWELLING The certificate is issued to Blados Jane K Family Trt (OWNER) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL ELECTRICAL CERTIFICATE NO. PLUMBERS CERTIFICATION DATED i Auth Si ature 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#: 38547 Date: 12/6/2013 Permission is hereby granted to: Blados Jane K Family Trt PO BOX 228 Cutchogue, NY 11935 To: Oil to Gas Conversion At premises located at: 28850 Route 25, Cutchogue SCTM # 473889 Sec/Block/Lot# 102.-6-21 Pursuant to application dated 11/26/2013 and approved by the Building Inspector. To expire on 6/7/2015. Fees: FURNACEBOILER -RESIDENTIAL $200.00 CO-NEW CONSTRUCTION/ALTERATION/REPAIR $50.00 Total: $250.00 Building Inspector 11/14/2013 11;17 FA)L i Form Na 6 ' TOWN OF SOUTHOLD ' HU MING DEPARTMNT ' TOWN RALL 765.18M APPLICATION FOR CERTIFICATE OF OCCUPANCY This application must be lille-fln by typewriter or ink and submitted to the Building Department whit the followiag: A. For new buRding or new use: 1. Final survey ofpropetty with accurate location of all buildings,property lines,streets,and unusual natural or topograpbie features. 2. Final Approval from Health Dept,of water supply and sawerage-disposal(8-9 form). 3. Approval of electrical installation from Board of Fire Underwriters. 4. Swoon statement from plumber certifying float the solder used in system contains loss than 2/10 of 1%lead. S. Conu nercial building,industrial building,in ultiple residences and similar buildino and iostallations,a catifiaate of Code Compliance;from arcWteet or engineer responsible for the building. 6. Subunit Planning Board Approval of completed site plant requirements. ' B. For existing buildings(prior to April 9,1957)non-conforming uses,or buildings and"pro-existing"laud nese: 1. Accurate survey of property showing all property lines,streets,building and unusual natural or topographic features, 2. A properly oounpleted application and consort to inspect signed by the applicant.If a Cer0cate of Occupancy is denied,the Building Inspector shall state the reasons therefor in writing to the applicant. C. Foes 1. Certificate of Occupancy-New dwelling$50.00,Additions to dwelling$50.00,Alterations to dwelling$50.00, Swinuning pool$50.00,Accessory building$50.00,Additions to accessory building$5400,Businesses$50.00- 2. Certificate of Occupancy on Pre-existing Building- $100.00 3. Copy of Certificate of Occupancy-S.25 4. Updated Certificate of occupancy- $50.00 S. Temporary Certificate of Occupancy-.Residential$15.00,Coxztmernial$15.00 Date. 1��WA.11 New Construction: ii-�� Old or Pro-existing B 'lding: o (check one) Location of Property• V 70C-a(-- U House No. {� (Street Hamlet Owner or Ownem of Property: 1_JL• l [ L�� ' Suffolk County Tax Map No 1000,Section k O:�-0 V Block Ob (D Lot 0@ Subdivision Filed Map. Lot: Permit No. Date of Pei:utit. Applicant: Health Dept.Approval: Underwriters Approval: Plaaning Board Approval: Request for. Temporary Certificate• Final Certificate: (cbec one) Fee Submitted:$ ican S' . i �� ti���Of SOUjyol o TOWN OF SOUTHOLD BUILDING DEPT. 765-1802 INSPECTION [ ] FOUNDATION 1ST [ ] ROU PLUMBING [ ] FOUNDATION 2ND [ ] SULATION [ ] FRAMING / STRAPPING [' FINAL [ ] FIREPLACE & CHIMNEY [ ] FIRE SAFETY INSPECTION [ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRATION [ ] ELECTRICAL (ROUGH) [ ] ELECTRICAL (FINAL) [ ] CODE VIOLATION [ ] CAULKING REMARKS: DATEINSPECTOR FIELD IN SPORT DATE COMMENTS W ro ]FOUNDATION(1ST) � O —rte FOUNDATION(2ND) z O 0 ROUGH FRAMINQ& PLUMBING . d INSULATION PER N.Y. h STATE ENERGY CODE FINAL ADDITIONAL COMMENTS to V1 m U x " 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 Q� ^], Survey SoutholdTown.NorthFork.net PERMIT NO. p `7 Check Septic Form N.Y.S.D.E.C. Trustees Flood Permit Examined 20 Storm-Water Assessment Form Contact: Approved .20 Mail to: Disapproved alc�i� 1:; P Phone: Expiration 20 Building Inspe APPLICATION FOR BUILDING PERMIT Date ,20 FI� INSTRUCTIONS NOV 2 0 2013 a.This application ST be completely filled in by typewriter or in ink and submitted to the Building Inspector with 4 sets of plans,accurate plot pl to sc e.Fee according to schedule. l fa s owing location f lot and of buildings on premises,relationship to adjoining premises or public streets or areas,ar�1d 'Ayl*,I D �s 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 o pli ant or name,if a corpo ti n Of (I S3; 3 r ((�M(aailing�address of applicant State whether applicant is owner,lessee,agent,architect,engineer,general contractor,'e�lectl�ician,pl , builder Name of owner of premises aAk (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. �ibTS !Y1 Electricians License No. Other Trade's License No. 1. Location of land on which pro o ed work will be done: �IS1650 mcg; N W, hol 1P House Number Street Hamlet County Tax Map No. 1000 Section U0 al 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 b. Intended use and occupancy 3. Nature of work(check which applicable):New Building Addition Alteration: Repair Removal Demolition Other Work G%' ) ( n fS J n �o�`©0 (description) 4. Estimated Cost 1 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 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 swom,deposes and says that(s)he is the applicant (Name of individual signing contract)above named, (S)He is the (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. Sw fore me this/ day of /V 2013 Notary Public o p Notary PabT ate of New York No.01GA629M27 Qualified in Suffolk County commission Expires W1101 1 y � r APP 01'ED Au NOTED DATE B.P. c C�upp,N C�k NC) ,FY Bti!L DING c;PARTMEN ` \ L 765 1802 8 •1A,M ,C 4 PM FOP r E N nF nYl FOLLOWING r-._u�SONS �7 0 1. FOUNDATION - TWO R--C FOR POURED CONCRc; (* �N� 2. ROUGH - FRAMING & o� 3. INSULATION 4. FINAL - CONSTRUCT-- BLDG. � BLDG.DEPT. BE COMPLETE FO I _ TOWN OF SOUTHOLDs ALL CONSTRUCTIC" `.';FST THE REQUIREMENTS Or S OF NE'N Independence Ratings K,. YORK STATE. NOF FS!BLE FOR DESIGN OR MINSTP,,j-i 10N ERRORS. til +tppt8 t . Ad �!F (t>tpvnd� Meir + * , ' rf4 •� isf.: IiIf11r' :"Rlii , ;=l� .:.. i4�. .: W., 'Ifl11a1 ��•b16�.. : . -::. _ r; IN3 62 51 44 38 158 61.0 80.0 83.1 81.9 350 4x15 IN4 105 87 76 65 271 81.3 80.0 83.1 82.0 420 1 5x15 INS 140 115 100 86 358 81.6 80.3 83.1 82.0 485 6x15 IN6 175 144 125 108 450 81.8 80.6 83.2 82.1 555 6x15(5) IN7 210 173 150 130 542 82.1 80.9 83.2 82.1 620 7x15 INS 245 202 176 . 152 633 81.1 80.0 83.2 82.2 690 7x15(5) IN9 280 231 201 174 725 81.4 80.3 1 83.2 82.2 760 1 8x15 . M IN10(3) 315 260 225 195 812 83.5 82.5 815 8 x15(5) M11(3) 349 288 250 216 1 900 83.5 $2.5 885 9x15 IN12 385 318 276 239 1 996 1 83.5 82.5 $15 9x15 *LP avaAabie on IN3-IN9 1. "S shown aro for Installations at sea kvd and elevadom up to 2,000 ft.for ww devatkns, reduce r0V 4%for each 1,000 ft above sea level 1:.y' s 6L 2. Outputs,and iatM19S are based oa atearn combustion e�Aciency of 82.5W Waber wmbusdan d11dem is 83.5%. 3.For Caned n buNds any:rediae W and*AM by 3% 4.15 R.height is measurod from too of M(tlaod to too of . S.IN6,INS,&1N30-Canada 00*:Imes-di mep diameter by!1• o Working Pressure:15 PSI Steam,30 PSI water o N 0 0 0 ` � t 0