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HomeMy WebLinkAbout40070-Z ',o�gt1FF0(4eoG Town of Southold 9/18/2015 , P.O.Box 1179 cf,t y53095 Main Rd "p'''# Southold,WNew York 11971 10h 17 CERTIFICATE OF OCCUPANCY No: 37785 Date: 9/18/2015 THIS CERTIFIES that the building AS BUILT ALTERATION Location of Property: 540 Takaposha Rd, Southold SCTM#: 473889 Sec/Block/Lot: 87.-6-9 Subdivision: Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated 9/8/2015 pursuant to which Building Permit No. 40070 dated 9/9/2015 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"alterations to an existing one family dwelling as applied for. The certificate is issued to Panella Ralph&Elaine Rev Trust of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL ELECTRICAL CERTIFICATE NO. 40070 9/8/2015 PLUMBERS CERTIFICATION DATED uth rued lignature .,fry TOWN OF SOUTHOLD ��4��uFFoa,r�o� BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, NY y 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#: 40070 Date: 9/9/2015 Permission is hereby granted to: Panella Ralph L Revoc Trt & Panella Elaine B Revoc Trt PO BOX 1643 Southold, NY 11971 To: "As built" alterations as applied for. Additional certification may be required. At premises located at: 540 Takaposha Rd, Southold SCTM # 473889 Sec/Block/Lot# 87.-6-9 Pursuant to application dated 9/8/2015 and approved by the Building Inspector. To expire on 3/10/2017. Fees: • AS BUILT - SINGLE FAMILY ADDITION/ALTERATION $400.00 CO -ALTERATION TO DWELLING $50.00 Total: $450.00 #0, Buil•'- - - •ector og,i%pf S"u4 49 'Town Hall Annex �� ~® l0 Telephone(631)765-1802 � 54375 Main Road : lig * ; Fax(631)765-9502 P.O.Box 1179 % G Southold,NY 11971-0959 =.e. ..\ 1� roger.richert(a�town.southold.ny.us A 00 Coli , �,a i BUILDING DEPARTMENT TOWN OF SOUTHOLD CERTIFICATE OF ELECTRICIAL COMPLIANCE SITE LOCATION Issued To. Ralph Panella Address: 540 Takaposha Road City: Southold St: New York Zip: 11971 Building Permit#: 40070 Section. 87 Block: 6 Lot 9 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 17 Ceiling Fixtures HID Fixtures Service 3 ph Hot Water GFCI Recpt 2 Wall Fixtures Smoke Detectors 1 Main Panel A/C Condenser Single Recpt Recessed Fixtures 14 CO Detectors Sub Panel NC Blower Range Recpt 40A Fluorescent Fixture Pumps Transformer Appliances DW Dryer Recpt Emergency Fixtures Time Clocks Disconnect Switches 10 Twist Lock Exit Fixtures TVSS Other Equipment: "AS BUILT" - Electical Survey- "No Visual Defects" 2- Paddle Fans Notes 67r.. ./-A--se.fe --) Inspector Signature: Date: September 8, 2015 Electrical 81 Compliance Form.xls 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 $15.00 Date./ i - g- New Construction: Old or Pre-existing Building: V (check one) Location of Property: 5 Lip TAkpo os h A- . 'sv v 1,01D House No. Street Hamlet Owner or Owners of Property:)g.)Phi-R?' f oloc.73-4-e4iNE; E,694n1F///$ gt-v4%,7R�., Suffolk County Tax Map No 1000, Section 8 9- Block (o Lot 7 Subdivision Filed Map. Lot: Permit No. Lim-10 Date of Permit. Applicant: Health Dept.Approval. Underwriters Approval: Planning Board Approval: Request for: Temporary Certificate Final Certificate: (check one) Fee Submitted: $ 60 ' �� App icant Signature r , F' „ ,,,,,, ,,��OFSOU o�. ' Ty c€ ?? --_!coutiv,$;;” 14\.1 yga TOWN OF SOUTHOLD BUILDING DEPT. ,0.07' ' r 765-1802 INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] INSULATION [ ] FRAMING /STRAPPING [ ] FINAL [ ] FIREPLACE & CHIMNEY [ ] FIRE SAFETY INSPECTION [ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRATION [ ] ELECTRICAL (ROUGH) pi ELECTRICAL (FINAL) REMARKS: eru 5r-e5e-,70c iq5 DSc-ea-7' DATE 14(6 INSPECTOR • FIELD INSPECQN RE?OR'P DAACOMZZkITS • . . _ - • FOUNDATION(1ST) • , 2 1 t : ; c....,.... 1 • FOUNDATION(2ND) --^- - • ,.., . ts.� . . O • • • • • • ROUGH FRAMING& :. • 2. PLUMBING ._._,.,� • •• - • kzi INSULATION PER N.Y. .. d STATE ENERGY COBE ,',, . ._ . . • .. . • r _ ANAL �.'V • .d• ./r , i• t , • . ;!' I —�- . � . • ,� o • • z ril• ... .1 . . . / r ' , .. ' .i • l . . • • v t y I • j + • • T 2• r ' {y,� • TOWN OF SOUTHOLD ' BUILDING PERMIT APPLICATION CHECKLIST BUILDING DEPARTMENT Do you have or need the following,before applying? TOWN HALL ' ' ' - '• 1 " , 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. 6,,10 7L ! Check t _ , ,-• ,! . , Septic Form • N.Y.S.D.E.C. Trustees C.O.Application A--5' Flood Permit - Examined q ' ,20 l Single&Separate -- Storni-Water Assessment Form ' Contact: Approved l q ,2015 ;l Mail to: Disapproved a/c _ - .. Phone: 7 ' I / 'f3 . Expiration 3116 2011 - ` ' L" I w , Buildin Spector :.`.: li i LiSEP 201 -J PPLICATION FOR BUILDING PERMIT L __ Date 9- $ 20 l LPG DEP r - ' " 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,b,e,commenced.before issuance of Building Permit. - , - d.Upon approval of this application,the Building Ins'pebtor will issue a Building'Permit to die applicant. Such a permit shall be kept on the premises available for inspection throughout the work. , e.No building shall be occupied'o'r`us'edin whole or iri'part dor 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 B.uilding) epartmentfor.the'issuance of a Building Permit pursuant to the Building Zone Ordinance of the Town;of•Southold,,Suffo)k County;NewYdrk, 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. - (Sig�of applicant or name,if a corporation) t,, , ,c7 , 4.44_11,41-/- S yi2,1<f 'oshfi- RI ` Soul-h191a )r /) cy9-1 `. (Mailing address of applicant) ' State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder Name of owner of premises, PqN E114:1-1RAJA L. R,eure. :1-4 cjAI E-- 8, proic Lip Ro vuC. 1"iz . (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; ' 1. ' 1. Location of land on which proposed work will be done: - T..- 9 l'°171/wT v 81/-"1477.°''/ 4 s 'by,Lci. 6-1-(0' 7,A-k14 Pas 1.a4 -br -4a 1.4 la, f y i 1 c'-7/ House Number Street ry.. .i,,el ,, i3;t ,;4,_ Iamlet ',,,,,,o;i 'e 'Ssal} ,ail.-11.m+"'ii icy County Tax Map No. 1000 Section ' 9- B1'ob1N ?-iiy L !." ,_ Lot 7 \.:nt.:I3)'1QQ 41e".i 3f;?bfii,,,A,+, 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 ���a�•v��y- b. Intended use and occupancy 3. Nature of work(check which applicable): Nev Building Addition Alteration Repair Removal, Demolition Other Work (Description) 4. Estimated Cost , Fee (To be paid on filing this application) 5. If dwelling, number of dwelling units' 1 Number of dwelling units on each floor rJ( t If garage, number'of cars' 1 6. If business, commercial or mixed occupancy, specify nature and extent of each type of use. /v14- 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-,' •. _-1-r ;<;t% :.; Rear*,i ; r; Depth Height Number of Stories ' , 4 9. Size of lot: Front Rear • •• �,.,ti,; • . Depth 10. Date of Purchase ;1-•, 'Nam'e of Form'et Owner" t . • j' 11. Zone or use district in which premises are:situated •• ' ° ', `'� ` '" 12. Does proposed con'strrruction'v�iolate arty zoning'la• w;ordinarice'o ' rregiilation?-YES NO 13. Will lot be re-graded? YES NO . ,Will excessfill be'r riioved from premises? YES NO' 14. Names of Owner.of premises . , ,,., }: Address ,201.. , . .Phone No., Name of Architect, . �. ,,,., ,..,.,:k . .1 .'1Address. :. _ . :;:�.�. .Phone No :,. . Name of Contractor • `i Addressa a r`J,• .',-Phone No: - . 15 a. Is this property;within-•100'feet of'a tidal wetland_or.a freshwateetland?'*,YES' • °NO * IF YES, SOUTHOLD TOWN TRUSTEES&•D:E:C'.�PERMITr w '1VIA:X',BErREQUIRED.' - ' b. l s this property'within 300'feet of a tidal wetldrid?*`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 Fs-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 (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. Sworn to before me this day o 20 I 5_ 44\rN)--f-- 6f\-- 1 a✓ON t �l✓ NotaryPublic CONNIE to BUNCH ignature of Applicant Notary Public,State of New York No.0181.16185060 Qualified In Suffolk County Commission Expires April 14,2.141.(4-• RmwATER Scott A. Russell fr?-e-i-Thi?),-%. \T SUPERVISOR 1 rn ( + z ; MANAGEMENT AGt]EM)EN T SOUTHOLD TOWN HALL-P.O.Box 1179 .. 13-- 07 1 ��.. 53095 Main Road-SOUTHOLD,NEW YORK 11971 ~": 2� p`- '�� Town of iso u th o l cl V - CHAPTER 236 - STORMVVATER MANAGEMENT WORK SHEET ( TO BE COMPLE IED BY THE APPLICANT) •{ DOES THIS PROJECT INVOLVE ANY OF THE FOLLOWING: . Yes No (CHECK ALL THAT APPLY) • 0 F:fA. Clearing, grubbing, grading or stripping of land which affects more than 5,000 square feet of ground surface. 0 154 B. Excavation or filling involving more than 200 cubic yards of material : _ within any parcel or any contiguous area. . ❑ifC. Site preparation on slopes which exceed 10 feet vertical rise to 100 feet of horizontal distance. (]dD. Site preparation within 100 feet of wetlands, beach, bluff or coastal erosion hazard area. i El EN E. Site preparation within the one-hundred--year floodplain as depicted - on-FIRM Map of any watercourse, _ I-F. installation of new or resurfaced- impervious surfaces of 1,0 square- -_-- feet or more, unless prior approval of a Stormwater Management Control Plan was received by the Town and the proposal includes : in-kind replacement of impervious surfaces. . If you answered NO to all of the questions above, STOP! Complete the Applicant section below with your Name, Signature, Contact Information, Date & County Tax Map Number! Chapter 236 does not apply to your project. If you answered YES to one or more of the above, please submit Two copies of a Stormwater Management Control Plan and a completed Check List Form to the Building Department with your Building Permit Application. APPLICANT: (Property Owner-Design Professional,Agent.Contractor,Other) S.C.T.NI_ '�: ]000 Date P Y Dnuict NAME- ?f \p`. L. 1:3AN W1 9 Pt) Section Block Lot rr 44-4_',,..,...i .< `A=' < 1()R JB). iLl (7 DL-PAP:rN{ENI r t;:::1.-. ONLY ".. Contact Int ormat lore (U 3/_ T/pJ`))173 r..." .."�' Reviewed By: - - — — - - - - — — — — - - — - - — Date - ( -0 Property Address / Location of Construction Work: © I Approved for proceaatng Budding Permit _ • t: ata ita 14 . t Stormwater Management Control Plan Not Required v (26/'-110 1 , i .)y i/91./ Stormwater Management Control Plan is Required (Forward to Engineering Department foi Pc view I FORM ' ':DMC-I) TOS \,]AY 20I,i ," ///-- 0�,fipF S0045;- ;Y. . Town Hall Annex i I�q . :� •t• 4:-• Telephone (631)765-1802 54375 Main Road v, i��" " !; '�.? (631)765-gg50� . :4V. roger.richert own.southo d.ny.0 P.O. Box 1179 �'.r_::." � Southold,NY 11971-0959 O- Q '••+. =`• -4. ' l� l,. UU(I' ��•''�� �%' Ai BUILDING DEPARTMENT i U'4 �` l TOWN OF SOUTHOLD 0- (.4) APPLICATION FOR ELECTRICAL INSPECTION REQUESTED BY: —&134111/ Date: 611.-5 Company Name: Name: License No.: Address: Phone No.: JOBSITE INFORMATION: (*Indicates required information) *Name: ' )fAOk PckiiiCLi *Address: 3-(A9 `rRg-R p®S h-A- R e fj *Cross Street: ltilY-g ov 2 4-cv t?- cv *Phone No.: (1A1 -- )q) --•-- 1 /43 Permit No.: Pr-e -C/o 4 Obi 17 Tax Map District: 1000 Section: 8 4. Block: !p Lot: q, *BRIEF DESCRIPTION OF WORK (Please Print Clearly) / . fi5 G4 //' (Please Circle All That Apply) *Is job ready for inspection: YES / 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 ' ?ouu il- c3° 0?- el° el 82-Request for Inspection Form 1(°:°1161 /�p�p� 1(161 ��^^'' RETAIN STORM WATER RUNOFF PURSUANT TO CHAPTER 236 OF THE TOWN CODE.: APP"LVED AS NOTED DATE: g # _6® FEE: llj,II Y. NOTIFY BUILDING DEPARTMENT AT 765-1802 8 AM TO 4 PM FOR THE FOLLOWING INSPECTIONS: 1. FOUNDATION - TWO REQUIRED FOR POURED CONCRETE 2. ROUGH - FRAMING & PLUMBING 3. INSULATION 4. FINAL - CONSTRUCTION MUST BE COMPLETE 1=O9 G.O. ALL CONSTRUCTION SHALL MEET THE REQUIREMENTS CF THE CODES OF NEW YORK STATE. NOT RESPONSIBLE FOR DESIGN OR CONSTRUCTION ERRORS. COMPLY WITH ALL CODES OF NEW YORK STATE & TOWN CODES AS REQUIRED AND CONDITIONS OF IOUTTIOLDIOWN-PIMNG130ARD— SOUTheaTOWN-TRteTEES--- 4MS.BEC OCCUPANCY OR USE IS UNLAWFUL WITHOUT CERTIFECAT7 OF OCCUPANCY r O.NTrRSEri uJimn WJ 4-1417E129.F. WitioIA L 4 71 EN 6.04-9z- r..A)T' an HL 3 A\^, ii LdiX16 u'v - 0 0 _ o P© 71/ II ,1f7U1 3 S�C.i!o,J 9A-Rtte t, Anl i N D 0'02 N n /IL-4 - RR-i-)0),) -k L._.7-7(46-7-mc, D £l5 No 4-VD 14-7071141. 44'43-PERS RE ,Uj 1L(L .0 PSN 0-10 111-1) M-!roR.11=LY S,i t"5y - k fie &0§1 P-Lc? - RL,L kA))r3DOtA15 6R Pt),A72‘5E,f G12'.95'111c4\17-