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HomeMy WebLinkAbout39868-Z j�PFO(k Town of Southold 9/28/2015 P.O.Box1179 53095 Main Rd o��dl # Southold,New York 11971 CERTIFICATE OF OCCUPANCY No: 37797 Date: 9/28/2015 THIS CERTIFIES that the building ADDITION/ALTERATION Location of Property: 53930 Route 25, Southold SCTM#: 473889 Sec/Block/Lot: 61.-4-19.1 Subdivision: Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated 6/11/2015 pursuant to which Building Permit No. 39868 dated 6/11/2015 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: handicap ramp and restroom additions to an existing church as applied for. The certificate is issued to United Methodist Church of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL ELECTRICAL CERTIFICATE NO. 39868 7/1/2015 PLUMBERS CERTIFICATION DATED A ci Sign ure ,,rrS, 0 -- TOWN OF SOUTHOLD y17 o eirl ¢� � BUILDING DEPARTMENT TOWN CLERK'S OFFICE ' SOUTHOLD, NY :!* foo 7 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 #: 39868 Date: 6/11/2015 Permission is hereby granted to: United Methodist Church PO BOX 1286 Cutchogue, NY 11935 To: construct ramp for entrance and toilet room addition. Replaces 11768. At premises located at: 53930 Route 25, Southold SCTM # 473889 Sec/Block/Lot# 61.-4-19.1 Pursuant to application dated 6/11/2015 and approved by the Building Inspector. To expire on 12/10/2016. Fees: PERMIT RENEWAL $15.00 CO -COMMERCIAL $50.00 Tota • $65.00 Building Inspector FORM NO. 2 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N. Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) N? 11768 Z Date pliti7y , 19122' Permission is hereby granted to: - 761 - Ca' to ..a2%..1%-e:C‹.C'. /- '2 2. .?�✓.'d' "... o? ..sa :. . lC l/ �'G� at premises located at ... 91--k ......./1 !/. /2......, 0f, County Tax Map No. 1000 Section ....a6"/ Block ...0 Lot No. . ,/ pursuant to application dated ....{„0Ire- � , 19.:.6 , and approved by the Building Inspector. Fee $../... � Building Inspector Rev. 6/30/80 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 properlycompleted 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$25.00,Additions to dwelling$25.00,Alterations to dwelling$25.00, Swimming pool$25.00,Accessory building$25.00,Additions to accessory building$25.00,Businesses$50.00. Certificate of Occupancy on Pre-existing Building- $100.00 a_ ccs o.i C. 4CI Q 3. Copy of Certificate of Occupancy-$.25 I a_ �_7 i�, 4. Updated Certificate of Occupancy- $50.00 � "`— 5. Temporary Certificate of Occupancy-Residential$15.00, Commercial$15.00 9 ` Date. L ""- New Construction: Old or Pre-existing Building: (check one) Location of Property: S ` I ,� ,( (e�`L 2 S) �1 , House No. Street Hamlet Owner or Owners of Property: i•y � C (–)1 dor - 111411u �–� . ur" Suffolk County Tax Map No 1000, Section ( i Block "f Lot ) 9 , Subdivision Filed Map. i� Lot: Permit No. \ \ Date of Permit. 1 ����Applicant: � 1 Wt� C C d-'l -C_ VHealth Dept. Approval: Underwriters Approval: Planning Board Approval: Request for: Temporary Certificate Final Certificate: (check one) Fee Submitted: $ Applicant Signature CONSENT TO INSPECTION nt the undersigned, do(es) hereby state: Owner(s)Name(s) That the undersigned (is) (are)the owner(s) of the premises in the Town of Southold, located at J3 (tJ f-r) `�/ which is shown and designated on the Suffolk County Tax Map as District 1000, Section LQ , Block Z—' , Lot I 61 , ' That the undersigned (has) (have) filed, or cause to be filed,,an application4n the Southold Town B ilding Inspector's Office for the following: f�Q_ C /Y\C(A./C)) 4 ,k pp (J Y ke--eArno 1 I —7 U That the undersigned do(es) hereby give consent to the Building Inspectors of the Town of Southold to enter upon the above described property, including any and all buildings located thereon, to conduct such inspections as they may deem necessary with respect to the aforesaid application, including inspections to determine that said premises comply with all of the laws, ordinances, rules and regulations of the Town of Southold. The undersigned, in consenting to such inspections, do(es) so with the knowledge and understanding that any information obtained in the conduct of such inspections may be used in subsequent prosecutions for violations of the laws, ordinances, rules or regulations of the Town of Southold. Dated: C Q S �� it---L (Signature) (Vrintd Name) (Signature) (Print Name) 'I,��, iii.��.._ 100' pF SOUjya Town Hall Annex . Telephone(631)765-1802 54375 Main Road it ilig ills z Fax(631)765-9502 P.O.Box 1179 % G Southold,NY 11971-0959 ;, br ,r• �0�•1� roger.richert(a�town.southold.ny.us o . coin . BUILDING DEPARTMENT TOWN OF SOUTHOLD CERTIFICATE OF ELECTRICIAL COMPLIANCE SITE LOCATION Issued To: United Methodist Church Address: 53930 Route 25 City: Southold St: New York Zip: 11971 Building Permit# 39868 Section: 61 Block: 4 Lot. 19.1 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 Indoor X Basement Service Only Commerical X Outdoor 1st Floor X Pool New Renovation 2nd Floor Hot Tub Addition Survey Attic Garage INVENTORY Service 1 ph Heat Duplec Recpt Ceiling Fixtures 1 HID Fixtures Service 3 ph Hot Water GFCI Recpt Wall Fixtures Smoke Detectors Main Panel NC Condenser Single Recpt Recessed Fixtures CO Detectors Sub Panel NC Blower Range Recpt Fluorescent Fixture Pumps Transformer Appliances Dryer Recpt Emergency Fixtures Time Clocks Disconnect Switches 1 Twist Lock Exit Fixtures TVSS Other Equipment: AS BUILT - Electrical Survey- No Visual Defects Notes: Pre-Existing Bathroom 1-Base Board Electric Heater Inspector Signature: _ Date: July 1, 2015 Electrical 81 Compliance Form xis 3'786 8-a---- „,,,,,,,,,,,, /s•T \ . #75. r24fx%) ��y00UNiY��a �� Aith c� TOWN OF SOUTHOLD BUILDING DEPT. 765-1802 INSPECTION. . [ ] FOUNDATION 1ST [ ] ROUGH PLUMBING • [ ] FOUNDATION 2ND [ ] IN ATION [_ ] FRAMING /STRAPPING [ FINAL [ ] FIREPLACE & CHIMNEY [ ] FIRE SAFETY INSPECTION [ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRATION [ ] ELECTRICAL (ROUGH) [ ] ELECTRICAL (FINAL) [ ] CODE VIOLATION [ ] CAULKING REMARKS: fr6 v. a.rp_t2/-7-4,6‘,4f ita-7d&deig,e_O )66 Ar 414 I •'ic I t 7,07) • DATE C77V/i--- INSPECTOR sD„,A,:__, ., :. .. , cc , , --yreolimicroo ii- \ik 1 TOWN OF SOUTHOLD BUILDING DEPT. 765-1802 INSPECTION .41 { , FOUNDATION 1ST [ ] ROUGH PLUMBING [ ] FOUNDATION 2ND [ ] INSULATION [ ] FRAMING / STRAPPING [ ] FINAL [ ] FIREPLACE & CHIMNEY [ ] FIRE SAFETY INSPECTION [ ] FIRE RESISTANT CONSTRUCTION [il FIRE RESISTANT PENETRATION [ ] ELECTRICAL (ROUGH) WELECTRICAL (FINAL) [ ] CODE VIOLATION [ ] CAULKING REMARKS: c16-4 /4/-S V-74,(4,t---Ct° '--- „.------- , r , DATE ) "7 1 ' INSPECTOR ' i iff AllilliP."-- ' Angel B. Chorno, AIA Architect 51020 Main Road Southold, New York 11971 (631) 765-6530 I i JUL 16 T',!15 I Li, July 16, 2015 , Southold Town ti:.iluing Department l r` j1 ''`' Town Hall. Annex Main Road Southold, NY 11971 Re: Southold United Methodist Church SCTM # 1000-61-4-19. 1 Building Permit #39868Z Dear Ladies/Gentlemen: This is written to confirm that work performed including the foundation, framing, insulation, plumbing and ramp construction, with respect to the above referenced permit [ramp and bathroom] N.;nre 'onstructed in accordance with the state, building code ai. the time of construction. Sincerely, Angel B. Chorno, AIA Allier ell4P4A42 . ,C,CkED 4 - �:Q , ` o.0 cn.x. 2• �..�. .� OF NO FIELD INSPECTIvN DATE COMMENTS — i PCrO it?Q FOUNDATION ( 1st ) Ij FOUNDATION (2nd)) � o;:ks 2 . .. okj, ROUGH FRAME & PLUMBING `° • I \ 3 . INSULATION PER N . Y . y A STATE ENERGY CODE FINAL Q o ADDITIONAL COMMENTS : ks -P.LCQ`j A (JO O6-14 Y�1��c6� • • Y e G Q FI F tel. .] r • x r- 1-3 • H 1h.`;/82/r'a a < ..5 I'04;6 cA04,✓ s (axt a nap) FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N.Y. 11971 TEL.: 765-1802 ep Examined k7C.,./-/e/ z , 19 cr 39 -‘)8 Application No("I( Approved <"(`/ , 19� Permit No. ./7.76. i ��--- Disapproved a/c - s-"— -- //6/ . (Building Inspector) APPLICATION FOR BUILDING PERMIT Date . . . .V1 UJ4.'. .a... ., 196'7- INSTRUCTIONS a. This application must be completely filled in by typewriter or in ink and submitted ..f to the Building Inspector,with 3 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 giving a detailed description of layout of property must be drawn on the diagram which is part of this appli- cation. 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 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 whatever until a Certificate of Occupancy shall have been granted by the Building Inspector. . 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 buildings for necessary inspections. S©omfercb aviret i/'cd` /abiX r C --/PRCl/ (Signature of applicant, or name, if a corporation) Pa ,SOX 61, Si✓a OSA = (Mailing address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. Name of owner of premises 'rry 17 -6 Uri)e7 Altrliob i s;— CAI adz!z l (as on the tax roll or latest deed) If applicant is a r corp ration, signature of duly authorized officer. 4e .,,.m..-e.r /3r. 772✓.t!e-rs, (Name and title of corporate officer) Builder's License No. /i/ "4' Plumber's License No. Electrician's License No. 2--F`L Other Trade's License No. 1. Location of land on whichicproposed work will be done. 63 %�/_) MA-1 fir !c c4 , -Co-aII-rv--��j House Number Street Hamlet CJ fS 52 X ci 7.7 County Tax Map No. 1000 Section Block Lot 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 Ca^i v2 c ?. , b. Intended use and occupancy 6'.. -/-. Icorri1-1--14/7-" `0- ,CSC 111tf° 3. Nature of work (check which applicable): New Building Addition Alteration Repair Removal Demolition Other Work - - _ (Description) 4. Estimated Cost 02oz> '_-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 "' - 4S"0 Rear . 6 I'ypDepth .Fr) Height Number of Stories Dimensions of same structure with alterations or additions: Front Yr Rear (0 i Depth 8S- Height Number of Stories 8. Dimensions of entire new construction: Front Rear Depth Height Number of Stories 9. Size of lot: Front 16 7 Rear . . .f 6 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: 13. Will lot be regraded 410 Will-excess fill be removed from premises: Yes No 14. Name of Owner of premises %? W4,!?'P. 4Address "'fru, / ), c?.it d Phone No. ?Iir: 'Q209.f. . . . Name of Architect Address Phone No. Name of Contractor I?ic* Tps7,-Moor `44P Addresses l4 " Phone No. f/.'1'off • PLOT DIAGRAM Locate clearly and distinctly- all buildings, whether existing or proposed, and indicate all set-back dimensions from property lines. Give street and block number or description according to deed, and show street names and indicate whether. interior or corner lot. - !4 Rtdrvrr leofm 36-16 , I - - - r r 17_ I • 1 -713 115 • II lig 1)/41/ii Rte4) STATE OF NEW YORK, S.S COUNTY OF S ' I0-ac P. vl2 AJS' being duly sworn, deposes and says that he is the applicant (Name of individual signing contract) above named. He is the . . . PA s 3c901? v>r J'.!2 t!S%t`r - -(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 of , 191r.4– Notary.Public, . . . . . . / . . . . . County ' EDITH A. GUY NOTARY PUBLIC, State of_New Y41 No. 52-4602497 • -• -Qualified in Suffolk County - .. - - (Signature of applicant), ataimisskin 30, 1� • - ' _..-7.-----�:..._..:..:._�--.._-_._.>:_�-::,:x::-,:,�>A-,:.::� :,.,�,a<,�.'-;�_._x�. -� -�- ,�-<-:; �.;� +te ___....._..__._..._ ..,..�:�;-�;z -�` 'M'"`"'�-�•'F��'° "�"" CAS ONLY I LL+�C-FteckL�k SECS1RITaY�FE�Al'URES�STED�©' BA�CKINDICATF4N '� IlE--„SING O„/COPYIN r � 8r_.�.. ,SMF: T, .• MO RET ,5 CAPITAL ONE,NI1.' 9369. , . W�1.L�A 50-791/2.14 '`1 -'~ :51020 Main Road ,ii" ;5' 11 7'1-4616' ,S : ', 1', ;Southold;:NY,.. 9 ,,.: ii ^4 631 765-.4653 ;:. t I, ''' S CCOU NT' -Iw .`'ATTORNEY:BUSIN�S .A _, l _ M•PAY TO THE I I $ D' 776 ORDER OF ,, ,E- C�-rz.��f 1,-'X) DOLLARS P i1ti ,:, ,-, ATAMPERRESISTANTTONERAREA A r' coN 7s� ..- :k�. -c=0"134.•mat z:� _ ,.,.r� .ys_ ',},..: _ . - r y: ,F_ +P "sy; { F T. N �� 0 d� tet'. 55 AA n�^ e ,tt �h • > �S r,F�'+`°!' ib. 1 .t Q-' rRj.•:'�•e ��5. P•i frm e.f. ter.rerM1d il1k. - "$4 ...�.. > . . ry, .yV�; '"!'f [ �• j • iCornpanyNarne: - - Name: License No.: I- j _ Address: _ - j.- Ph . - . one No.: 1 ; - - is JOBSITE INFORMATION: (*indicates required information) - I *Name: 1 *Address: S3 Cl t--AA t 13 e - - a-`,„A \cl • I *Cross Street: ; :e::;: .P : Iosi. b 3q (,92--z. I. - Tax-Map District: 1000 Section: (j y - Block: 1--t Lot: .\ Ci , *BRIEF DESCRIPTION OF WORK(Please Print Clearly) - - _ • i • 1 1 - - i • (Please Circle All That Apply) I - is job ready for inspection: ,I � �_ S ES NO. Rough In c ) i- *Do you need a Temp Certificate: YES/� _ _ �- _ --' _� _ - I- k -. emp Information (If needed) - - , - *Service Size: 1 Phase 3Phase 100 150 200 300 350 400 Other I - *New Service: Re-connect Underground Number of Meters Change of Service Overhead Additional information: PAYMENT DUE WITH APPLICATION ef.., ._, -in), 1 82-Request for Inspection Form i I I n J F 1 . 0 z M&' owrCs' • S;2cEr s ISB/ -- y1 �. me-wow/cc= t . ____ -, - -, 0 C UCCIjPALCY , i, USE iS JN1MNFU1 . ----- 3S-'/o" , t _ yfiTHOffiCERTWICia W 1- ) r‘ CS '^ 0 13- z OCCUPANCY _ :,:, _ Y 4 3 1 T t 0 Z V r o \ _____ U 4 -e— 33 y— I oc L÷ y s c iz;i' It .- \ H • _ l3 in a Arc)c) AS 'NOTED C7 DATE: 7- for B.P. `# /74,,,, . . AT BY : %r1 NOTIFY BUILDING DEPAR MENT AT j 765-1802 9 AM TO 4 PM FOR T �c, HE cJ FOLLOWING INSPECTIONS: UIRED 1 '' 1, FOUNDATION - TWO RE �nFOR POURED CONCRETE i� �; 2. ROUGH - FRAMING & PLUMBING 3. INSULATION i 4. FINAL - CONSTRUCTION MUST ! BE COMPLETE FOR C. O. ALL CONSTRUCTION SHALL MEET THE REQUIREMENTS OF THE N, Y. STATE CONSTRUCTION & ENERGY . „ . CODES. NOT RESPONSIBLE FORd• DESIGN OR CONSTRUCTION ERRORS — • i t OC .''' PANC11 ell,':"' , . f la.i E. i y r b �„1L I( -cr till1VJE1 CERTFIC'TE „ ,i1-6( v . rf , -Ar (IC eqlkiitY- ,Prj , ......____________T_______,--;:,,,,,...t.),17 a kit . • r�r y� r e ili S'n I NC � To Mir*W �/.i6� ,NS,.Ard c�lL/uc., co �4 ;J/a V • W.,LL5, F�q. 0 V _ f_vmn,✓,, To BG /,J Ho-wran Aim/ ”- -- - - - - - - - - - -- - - - -- - - - - - - '' - - �zxG ��� �G.o�. 1 ' e- ii at.s ag C i'2At)y I BLOC,( FavAlb/i--rIo 7 TO 'UMWM o-rw csivacN FO ,P r'Oi.) FOu vAnTiO,J O AP i; : zD AS NOTED/e i f(�aB.P. # / ®ATE �;�� FEE: t______5::—BY z AIS', NOTIFY BUILDING DEPAR MENT AT 765-18029ANS INSPECTIONS: PM M:FOR THE FOLLOWINGTWO REQUIRED 1. FOUNDATION - FOR POURED CONCRETE 2. ROUGH - FRAMING & PLUMBING 6'o " I.— �' o''--I 3. INSULATIONCONSTRUCTION MUST FINAL I BE COMPLETE FOR C. O. rALL CONSTRUCTION SHALL MEET S THE REQUIREMENTS TION & ENERGY ���w�rr 11Z� STATE CONSTRUCTION FOR B'-tvc,rrue,Nd»rGT( 1,,, -�,b, CODES. NOT '."...%<‘:'\* DESIGN OR CONSTRUCTION ERRORS. r 5 ,i Rdr'ST j?c A-2>b/rime, -Sova-/ Sr66' SOt;'iroLI OA'cm-b. ill E7trODS67- CJIURcN iy ". ii i , _ 234 ,/,.,41;,/ , 1, , ------. 7-7---2-4 t.,..., _........ • i -. . . . r--- , > . . 1. . — _ .19 eiPacc_66Y....4q. ...t. . , iti.• . . . • •-, . ..s,rz-tpc)5 . . -- -\,.. . - . t , - zbi,a- A4/111--- ' . . ..Yi., < . 1 . . . . . ._....,- , ...___:...., , . _,. i . ._.'=___ _ • i ., II eiggi7 MOM • 161111111 ti MI. -7-45---- -.50.... :i , • ,-, l.9 , • ,14/7/747Z1_47T_CfCliti-E.S___' . , JUL - 6 203 il . .., .44 a 9r? aPic--- BIDG DPI 1-0V!If Of-SOUTHOLD . ... _ • . • - • • titED A ., . ', '.. - - ' '' - ' 'DATE: 7-2-15 . ,\ -• • • • •••'90 ,s, ' . '3•*c,‘, B• c/to.''.'-‘ SOUTHOLD .UNITED c.. •, \,+:, 1.• (n ! '. _ • tu•• • i A 1.•• • •vr Vpritit 0, _i , • , i .4. . ' METHODIST.CHURCH.',.. 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