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39819-Z
Town of Southold �� P.O. Box 1179 53095 Main Rd Southold, New York 11971 CERTIFICATE OF OCCUPANCY No: 37596 Date: THIS CERTIFIES that the building AS BUILT ALTERATION Location of Property: 1955 Bay Shore Rd, Greenport SCTM #: 473889 Sec/Block/Lot: 53.4-10 Subdivision: Filed Map No. 6/10/2015 6/10/2015 Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated 6/1/2015 pursuant to which Building Permit No. 39819 dated 6/1/2015 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" MINOR ALTERATION TO AN EXISTING ONE FAMILY DWELLING AS APPLIED FOR The certificate is issued to Brandvold, John & Brandvold, Marion of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL ELECTRICAL CERTIFICATE NO. PLUMBERS CERTIFICATION DATED 37606 02-07-2013 l Au t d Si ature Permit #: 39819 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) Permission is hereby granted to: Brandvold, John & Bran 1425 Plandome Rd Manhasset, NY 11030 Marion Date: 6/1/2015 To: construct an "as built" Alteration as applied for: Replaces BP# 37606 At premises located at: 1955 Bay Shore Rd, Greenport SCTM # 473889 Sec/Block/Lot # 53.-4-10 Pursuant to application dated To expire on Fees 11/30/2016. 6/1/2015 and approved by the Building Inspector. PERMIT RENEWAL $200.00 Total: $200.00 Building Inspector �goFFoc��oTOWN OF SOUTHOLD moo �y BUILDING DEPARTMENT a 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 #: 37606 Date: 11/1/2012 Permission is hereby granted to: Brandvold, John & Brandvold, Marion 1425 Plandome Rd Manhasset, NY 11030 1 To: construct an "as built" Alteration as applied for At premises located at: 1955 Bay Shore Rd, Greenport SCTM # 473889 Sec/Block/Lot # 53.-4-10 Pursuant to application dated 10/25/2012 and approved by the Building Inspector. f To expire on 5/3/2014. I Fees: SINGLE FAMILY DWELLING - ADDITION OR ALTERATION $400.00 CO - ALTERATION TO DWELLING $50.00 Total: 1$450.00 Building Inspector i OL'�' 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 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. /l - 7- - / Z New Construction: Old or Pre-existing Building: (check one) Location of Property: � � 1 044d—��ee & r -- y / ?L Dose No.� Street Hamlet f--t- Owner or Owners of Property: --�Y /l.� R `_r/w.) d -D Lt'� Suffolk County Tax -Map No 1000, Section Block q Lot / Q Subdivision Filed Map. Lot: Permit No. a Date of Permit.-// - / / 2, Applicant: Health Dept. Approval: Underwriters Approval: Planning Board Approval: Request for: Temporary Certificate Final Certificate: (check one) Fee Submitted: $ V < /YU pplicant Signature Town Hall Annex 54375 Main Road P.O. Box 1179 Southold, NY 11971-0959 BUILDING DEPARTMENT TOWN OF SOUTHOLD Telephone (631) 765-1802 Fax (631) 765-9502 roper.richertCa)town.southold.nv.us CERTIFICATE OF ELECTRICIAL COMPLIANCE SITE LOCATION Issued To: Brandvold Address: 1955 Bayshore Rd City: Greenport St: NY Zip: 11944 Building Permit* 37606 Section: 53 Block: 4 Lot: 10 WAS EXAMINED AND FOUND TO BE IN COMPLIANCE WITH THE NATIONAL ELECTRIC CODE Contractor: DBA: C -Cat Co License No: 953 -me SITE DETAILS Office Use Only Residential X Indoor X Basement Service Only Commerical Outdoor x 1st Floor x Pool New Renovation 2nd Floor Hot Tub Addition x Survey Attic Garage INVENTORY Service 1 ph Heat Duplec Recpt 2 Ceiling Fixtures HID Fixtures Service 3 ph Hot Water GFCI Recpt 1 Wall Fixtures 2 Smoke Detectors Main Panel A/C Condenser Single Recpt Recessed Fixtures 2 CO Detectors Sub Panel A/C Blower Range Recpt Fluorescent Fixture Pumps Transformer Appliances Dryer Recpt Emergency Fixtures Time Clocks Disconnect Switches 2 Twist Lock F1 Exit Fixtures TVSS Other Equipment: Notes: Inspector Signature: Date: Feb 7 2013 Electrical_Certificate(1).xls OE SO(/TyO� ��yCO►►uN 0�� TOWN OF SOUTHOLD BUILDING DEPT. 765-1802 INSPECTION [ ]FOUNDATION 7ST [ ]ROUGH PLBG.. [ ]FOUNDATION 2ND[ ]INS ION I I FRAMING/STRAPPING [,PrOoloNAL [ ]FIREPLACE &CHIMNEY [ ]FIRE SAFETY INSPECTION [ ]FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRATION [ ]ELECTRICAL (ROUGH) [ ]ELECTRICAL (FINAL) REMARKS: DATE � " � � v INSPECTOR 32�e��L TOWN OF SOUTHOLD BUILDING DEPT. 765-1502 INSPECTION.. [ ]FOUNDATION 1ST [ ] R GH PLBG. [ ]FOUNDATION 2ND [ INSULATION [ FRAMING/ STRAPPING [ ]FINAL [ ]FIREPLACE & CHIMNEY [ ]FIRE SAFETY INSPECTION [ ] FIRE RESISTANT CONSTRUCTION [ ]FIRE RESISTANT PENETRATION [ ]ELECTRICAL (ROUGH) [ ]ELECTRICAL (FINAL) REMARKS: --- �/,,�- n ll� DATE— INSPECTOR OE SOUjyOlo 7e7) G • �O cOUNi'1,� TOWN OF SOUTHOLD BUILDING DEPT. 765-1802 INSPECTION [ ] FOUNDATION:IST. [ ] ROU PLUMBING [ ] FOUNDATION 2ND [ ] 1 ULAN ION [ ] FRAMING/ STRAPPING [ FINAL [ ] FIREPLACE A CHIMNEY [ ] FIRE SAFETY INSPECTION [ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRATION [ ] ELECTRICAL (ROUGH) [ ] ELECTRICAL (FINAL) [ ] CODE VIOLATION [ ] CAULKING DATE FIELD ]NORMON REPORT DATE COMAONTS L c FOUNDATION (1ST) . .1....�..w...r.w.............. FOUNDAM; (IND) y ROUGH MlOnNQ & y PLUDOM CA� n l% IN$UL• ATION PEA N. Y. H STATE ENERGY CbDE 4 .FINAL ADDITIONAL COMMENTS oo . 00 bob 4 TG Ri23 cmdii (JkP o Z . m LA • f b 't { TOWN OF SOUTHOLD BTTTLDING DEPARTMENT TOWN HALL SOUTHOLD, NY 11971 TEL: (631) 765-1802 FAX: (631) 765-9502 South oldTown.NorthFork.net Examined 20 o - Approved 207/ Disapproved a/c -4 Ex )iration L' 9 E C E W n� OCT 2 5 2012 PERMIT NO. 3 7('©� BUILDING PERMIT APPLICATION CHECKLIST Do you have or need the following, before applying? Board of Health �! 4 sets of Building Plans_ Planning Board approval_ --"4 Survey Check Septic Form N.Y.S.D.E.C. Trustees C.O. Application_ Flood Permit Single & Separate Storm -Water Assessment Form Contact: Mail to: C1.14V- Phone: 5376 Building Inspector APPLICATION FOR BUILDING PERMIT BLDG. DEPT. I Date , 20 TONIN OF SOUTHOLD 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 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 Pen -nit 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 wort: 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. ature 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 1:5 VA'/UG M. (As on the tax roll or 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 o um ch proposed wo Street W deed) Hamlet County Tax Map No. 1000 Section Block Lot /a Subdivision Filed Map No. Lot 2. State existing use and occupancy of premises and intended use and occu ncy of a. Existing use and occupancy 4. 5. 6. 7. b. Intended use and occupanczv �ctlon: ?-1--f Nature of work (check which applicable): New Building Addition Alteration_ Repair Removal Demolition Other Work (Description) Estimated Cost Cd 0 f 0 Fee (To be paid on filing this application) If dwelling, number of dwelling units / Number of dwelling units on each floor If garage, number of cars If business, commercial or mixed occupancy, specify nature and extent of each type of use. Dimensions of existing structures, if any: Front Height Number of Stories Rear Dimensions of same structure with alterations or additions: Front Depth Height Number of Stories Dimensions of entire new construction: Front Height Number of Stories 9. Size of lot: Front 10. Date of Purchase Rear Name of Former Owner 11. Zone or use district in which premises are situated Rear epth _Depth Rear Depth 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_ 14. Names of Owner of premises 4adAl � Address Phone No. Name of Architect IVIW 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. M�[�7 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 r 11\6 1e of i dividual signing contract) above named, (S)He is the being duly sworn, deposes and says that (s)he is the applicant CONNIE D. BUNCH Notary Public, stag of Now York No. 01 BU6t 85050 d,UC6111IVU III 31.111®11( UOUnly (Contractor, Agent, Corporate Officer, etc.) Commission EVires April 94, �QLL 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 .nn ��DD^^,^ ,, aT day of © Cil 20 % Notary Public Signature dApplicant El Town Hall Annex 54375 Main Road P_O. Box 1179 Southold, NY 11971-0959. ESTED BY -- Telephone (631) 765-1802 rogerAcheriCa 'ou(v�n souigo�d.ny.us BUILDING DEPARTMENT 'OWN OF SOUTHOLD APPLICATION FOR ELECTRICAL INSPECTION Company Name: Name:'-'- -- - -- -- -: License No.: Cj g M Address: Phone No.: ce �\- 2 g o - 3 Date: JOBSITE INFORMATION: (*Indicates required information) *Name: *Address: *Cross Street: *Phone No.: Permit No.: Tax Map District 1000 Section: Block: Lot: H3 *BRIEF DESCRIPTION OF WORk (Please Print Clearly) � � e _S:r-,J t 0 C5, 1� L A4)--P--Gem = (Please- Circle All That Apply) *Is job -ready. -for inspection: NO _ . _ Rou 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 I 82 -Request for Inspection Form Southold Town Building Department ���tgUFFOL,�cD P.O. Box 1179 0 53095 Main Rd o _ Southold, New York 11971 (631) 765-1802 Parcel ID: 53.4-10 Permit #: 37606 Permit Date: 11/1/2012 Expiration Date: 5/3/2014 BUILDING PERMIT RENEWAL LETTER Dated: 5/4/2015 Applicant: Brandvold, John & Brandvold, Marion Location: 1955 Bay Shore Rd, Greenport Work Description: RESIDENTIAL ALTERATION construct an "as built" Alteration as applied for A FEE OF $200.00 IS REQUIRED TO RENEW THIS BUILDING PERMIT. Owner: Brandvold, John & Brandvold, Marion Address: 1425 Plandome Rd Manhasset, NY 11030 The permit listed above has expired. No work is permitted or authorized beyond the expiration date. Please submit the above fee made payable to the Town of Southold. Mail to the Town of Southold Building Department, P.O. Box 1179, Southold, New York 11971 THANK YOU, SOUTHOLD TOWN BUILDING DEPT. SURVEY 0'F . LOT 3.2 AMENDED MAP'A" PECONIC BAY ESTATES FILE No. 1124 FILED MAY 19. 19'33 SITUATED AT ARSHAMGMAQliE TOWN OF SOUTHOLD .SUFFOLK COUNTY, NEW YORK _ S.C. TAX No. 1000-53-04-10 SCALE 1"=20' SEPTEMBER 18, 2002 APRIL 4. 2306 LOCATED FZfiGGED %T.TIANCS UYL' S_P1EL1°DY 15. 2006 ADDED M_7—t BOUNDS OESC. AROUND LCT AREA ABOVE EL 5.0 FEERt&RY 2. 2007 *OUNDATION LOCATION 1L'LY 13. 2006 FINAL SURVEY AREA = 16,655.00 sq. ft. (To T0: LINE) 0.382 ac. S.C.D.H.S. NUMBER RIO -04-0145 \� s 6,>• 00 4 0. ti10 - '°ti \ 4 A, aO"�"Ojr 3 � \ _ 1 d o� N/a 4 A, 9�'/ `OR *o ,� � F JPS �q�•s �•F t A �0 • ;o�•LJa ti '� . o. o y, 4.�.��\ 4? rG .� oQ� Grp•' ,`' \ -i : •V - itis• � 6' // �YWeo, a�yE � I spa�_� . - O. OHO v �'O l TOtea_ L'O• Q p M1 m (�% F `� •O � ,'.• .. �n L �.1. _ _ ______AAAA • ._—� . 0 OTL *: L r�. J 1. THIS PROPERTY IS IN FLOOD ZONE AE (EL. 8) R 0 1� C3'O�p FLOOD INSURANCE RATE MAP No. 36103CO159 G V ill @ r s ZONE A--: PASE FLOOD ELEVATIONS DI TERAIIN-D 0�.16 �2. ELEVATIONS ARE REFERENCED TO N.G.V.O. 1929 DATUM UNAL'iN0RRa1 N:7O 1iDi/ DR A:AIIAIN M. UCS SM" Is A vpuimll SEC109 OF 1NL KW VOU STATC UP•IA1ma9rRY410YFJ1D SE'A•'L Orfl "D 0910SUD SEAL Nor x CpaRrOlEO To eE A Nim TIUI[ oal•Y CpaF1GTp5 NNWFa NTADIN SNALL flYN tl1lY YD YNE 1�(R5011 NMI UImY 1NE SUASfY ' 6 PflF➢AiED. NID pi IS DEWiF 70 IIE iR1E COHFANY 9OVDVJMDJ6IL AOWCT AND mom DoINIJ VA Lww NJUI . AND TD INE 491t CE5GIJta OF TME tmm R6n- iuno7mATmNS AR[ MOI TAAAlpVIQm. 1NE ODs1010E OF RICHT5 of WAY ANO/OR 10000= DF RECORD, IF ANY. NOT sm" ARE Nov GuARANIEEo. Nathan Taft Corwin III Land Surveyor TNe 5,-,, — Suo'dm'SJma -- SRe Pk%hS — Caasf+udba LayvA PRONE (831)727-2090 Fa. (631)727-1727 - OF;to LCC4TED AF UAIL046 ADDRESS' 322 Roanoke A.4aue RftdIeod. Ne Yah 11901 P.O. Ba: 1931 FGvcmead. 14n York 11901- C- -� cm X:r7i �o G HA-fAG-c To t LC'f CP-Je A -5e n-.1- , F FL -0 IJ T� S tnE� n ti 1-t ClG-A-r 'p I*Ae--1 3oNs 3\ K 0 S TACT u R. V"- C N A -'N 4-4jr S, �L L '� � M t�tS s� o N s, s t' L•rs , /�rl D �p.ccs ��►r� ��,hJS 5v �� Lttn b Y 4.a tea. �3"rN DO D .f -�WZlrallt'=;Tlkl�#ARWRTA —Old APPROVED AS NOTED j DATE, 11� t ?' FEE:__. BY NOTIFY BUILDING DE AR�TMENA1' 765-1802 8 AM TO 4 PM FOR THE FOLLOWING INSPECTIONS: 1. FOUNDATION - TWO REQUIRED FOR POURED CONCRETE 2. ROUGH - FRAMING, PLUMBING, STRAPPING, ELECTRICAL & CAULKING 3. INSULATION 4. FINAL - CONSTRUCTION & ELECTRICAL MUST BE COMPLETE FOR C.O. ALL CONSTRUCTION SHALL MEET THE -�•..,,,,,_ REQUIREMENTS OF THE CODES OF NEW ' ytuu"SfATE. NOT RESPONSIBLE FOR DESIGN OR CONSTRUCTION ERRORS. I gyY SCALE: ; APPROVED BY: DRAWN B� DATE: REVISED T t j I r. I � � -- —� ---`- -2---z-yrs-=-t��'__ S.7JL�t.�ratra=fir �