HomeMy WebLinkAbout38676-Z �o��11FFU(,�C Town of Southold 10/29/2015
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P.O.Box 1179
�' w 53095 Main Rd
otol *.ao� Southold,New York 11971
CERTIFICATE OF OCCUPANCY
No: 37875Date: 10/29/2015
THIS CERTIFIES that the building GENERATOR
Location of Property: 1077 Bay Home Rd, Southold
SCTM#: 473889 Sec/Block/Lot: 56.-5-39
Subdivision: Filed Map No. Lot No.
conforms substantially to the Application for Building Permit heretofore filed in this office dated
2/5/2014 pursuant to which Building Permit No. 38676 dated 2/20/2014
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:
ACCESSORY GENERATOR AS APPLIED FOR
The certificate is issued to Kornman,Peter&Kornman,Mary
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL
ELECTRICAL CERTIFICATE NO. 38676 10-23-2015
PLUMBERS CERTIFICATION DATED
V59
Authorized Signature
' ufFO��� TOWN OF SOUTHOLD
e/s,� ; BUILDING DEPARTMENT
TOWN CLERK'S OFFICE
}go �� 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#: 38676 Date: 2/20/2014
Permission is hereby granted to:
Kornman, Peter& Kornman, Mary
55E86thSt
New York, NY 100281059
To: install an Accessory Generator as applied for
At premises located at:
1077 Bay Home Rd, Southold
SCTM # 473889
Sec/Block/Lot# 56.-5-39
Pursuant to application dated 2/5/2014 and approved by the Building Inspector.
To expire on 8/22/2015.
Fees:
ACCESSORY $100.00
ELECTRIC $85.00
CO -ACCESSORY BUILDING $50.00
Total: $235.00
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:
I. 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:
I. 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$15.00
Date. 4211--/
New Construction: Old or Pre-existing Building: ✓ (check one)
Location of Property: ,11t77 �/ /kin �/�o,qa,
House No. f/ Street Hamlet
Owner or Owners of Property: 1/A�f�/�.y//.�—�/
Suffolk County Tax Map No 1000, Section Block .0..5- Lot 3�i
Subdivision Filed Map. Lot:
Permit No. Date of Permit. Applicant:
Health Dept.Approval: Underwriters Approval:
Planning Board Approval:
Request for: Temporary Certificate Final Certificate: (check one)
Fee Submitted:$
Opplic.nt Sig ature
�,,'// ilii .
a soup:
Town Hall Annex . Telephone(631)765-1802
54375 Main Road Fax(631)765-9502
P.O.Box 1179 G �bar I.
Southold,NY 11971-0959 '=;(4, •O',i1 roper.richert(a�town.southold.ny,us
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BUILDING DEPARTMENT
TOWN OF SOUTHOLD
CERTIFICATE OF ELECTRICIAL COMPLIANCE
SITE LOCATION
Issued To: Kornman
Address: 1077 Bay Home Road City: Southold St: New York Zip: 11971
Building Permit#: 38676 Section. 56 Block: 5 Lot: 39
WAS EXAMINED AND FOUND TO BE IN COMPLIANCE WITH THE NATIONAL ELECTRIC CODE
Contractor: DBA: REP Electric License No: 46288-ME
SITE DETAILS
Office Use Only
Residential X Indoor Basement Service Only
Commerical Outdoor X 1st Floor Pool
New X Renovation 2nd Floor Hot Tub
Addition Survey Attic Garage
INVENTORY
Service 1 ph Heat Duplec Recpt Ceiling Fixtures 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 A/C Blower Range Recpt Fluorescent Fixture Pumps
Transformer Appliances Dryer Recpt Emergency Fixtures Time Clocks
Disconnect Switches Twist Lock Exit Fixtures TVSS
Other Equipment: 20 kw Stand By Generator with 200A Auto Transfer Switch
Notes:
Inspector Signature: i _:! Date: October 23, 2015
Electrical 81 Compliance Form.xls
II
tP TOWN OF SOUTHOLD,' w v.t„lt�;; gwe� BUILDING PERMIT APPLICATION CHECKLIST
BUILDING DEPARTMENT; +f ,;";4 ,;
. �.,s ;�:.;r+:� tx�<<, 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 n Survey
SoutholdTown.NorthFork.net PERMIT NO. grg'-f? '
Check
Septic Form
N.Y.S.D.E.C.
Trustees
Flood Permit
Examined .. ,20 • , - Storm-Water Assessment Form
Contact:
•
Approved ,20
Disapproved a/c
Phone: 603/-c.14//-116;17
Expiration ,20
Building Inspector
APPLICATION FOR BUILDING PERMIT
Date Oe9— f,6/ , 20 fiti
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 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 rx
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.
� �antj r)BB°NC8 R
• 4=. gna�f applicant or name,if a corporation)
l c=' a � I �a�.��` c;1001-/ �/lit�'vten-Q. 'Ai.. • ftb /
��� � 1. P.)1 i' 6 (Mailing aflpit ss of.applicgnt),
State whether applicant is owner, lessee'agent, architect, engineer, general contractor, ctri is ,rplutaribOuilder
�a DATE
(Jo�'7>�/ f� — ®�c BY
FEE.
Name of owner of premises �f—n1�'1 �/�� OT180IFY BUILDING AING D 4 PMT FORT t�
��65-1Rm 8 AM TO 4 PM THL
(As on the tax roll or late4to,&,,rii YVING INSPECTIONS'
If applicant is a corporation, signature of duly authorized officer 1 FOUNDATION-TWO REQUIRED
FOR POURED CONCRETE
(Name and title of corporate officer) 2 ROUGH FRAMING,PLUMBING,
STRAPPING, ELECTRICAL&CAULKIN
Builders License No. 3. INSULATION
4 FINAL-CONSTRUCTION &ELECTRICAL
Plumbers License No. C/2� �� . MUST BE COMPLETE FOR C 0
Electricians License No. '7 ' ALL CONSTRUCTION SHALL MEET
THE
NEN
Trade's License No.
t. 8 ruG`�,Sv'�L REQUIREMENTS OF THE CODES
!INSPECTION ra7V, YORK STATE NOT RESPONSIBLE FOR
1. Location of land on which proposed work will be done:
DESIGN OR CONSTRUCTION ERRORS
6,1 ,.moi- A/1'Dae/ �,O
House Number Street Hamlet
County Tax Map No. 1000 Section .57/ Block f2G--- 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 Shd6ZEit V
b. Intended use and occupancy 5, i?e-
3. Nature of work(check which applicable):New Building Addition Alteration
Repair Removal Demolition -oTh i= Ivor , y, ii?
(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
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
`� Jr
9. Size of lot: Front /1214 7L Rear /A_ 7L! Depth ®
10. Date of Purchase Name of Former Owner
11. Zone or use district in which premises are situated g
12. Doeszoninglaw,ro osed construction violateordinance or regulation? YES NO
p p any � g
13. Will lot be re-graded? YES NO Will excess fill be removed from premises?YES NO
14.Names of Owner of premises 4.9,4146I/10.) t1.`if Address , i y_ /h ?Phone No. 5w/- 4 c` , 3iij
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 V 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 o survey.
18. Are there any covenants and restrictions with respect to this property? * YES -.".�,�! O
* IF YES, PROVIDE A COPY. 441
i
STATE OF NEW YORK)
SS:
COUNTY OFS J 1k.)
� /-f- being duly sworn,deposes and says that(s)he is the applicant
(Na of in vidual si ning contract)above named,
(S)He is the &:(J724-70(4—._
(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.
4Swor Gb fore me this
day of /bt(AJ ry 20/Ll
/ ..' '4.°'' IL-I.r., s , • 40,L,,...,. Z.
otary Pubbcf` ,wy Notary Public.Stele ofNew York a Sig i.ture of •pplicant
* )* Na 010R6110392
%, Qualified a Su�lh County
Y ``s•' C
�'��� nna�N 05/13/20
,��,,,i'oaSO6lol ,`
Town Hall Annex i . • ; Telephone(631)765-1802 _
54375 Main Road �`...../p,
cn @ ,1 (631)7659g5Q2
P.O.Box 1179 ; V. • 1 rocier.richert tOWn.Sggi5: .nv.uS
Southold,NY 11971-0959 .. 0 \O i •
•
BUILDING DEPARTMENT
TOWN OF SOUTHOLD
APPLICATION FOR ELECTRICAL INSPECTION
• REQUESTED BY: - a - - e C re, 6e- i
-t q(� late: /yI
Company Name: \ b a— t � K��`C •
Name: " - a .i..)0(_( oC. 1
License No.: Z V---sr - .
Address: ' k 0 I e-.)0X 635.- -01-447-1(. -kcc ,-- / /' V k"
-
Phone No.:_ .:73 / 7 ? 6,03y -
JOBSITE INFORMATION: (*Indicates required information)beV1 U v-i- (p Lto ,
*Name: - ,/ ,n ,,,.,,4-7J - C 0,1
*Address: Jo•7_7 .6A1, — • A • s 0-117- 4
*Cross Street: -
*Phone No..: 9/q/ 94-5--_33P-/ -
Permit No.:
Tax-Map District: - 1000 . Section: . --.4,,,, Block: e_s---- Lot „3/
*BRIEF DESCRIPTION OF WORK(Please Print Clearly) �n1TA'1 L �# •
.
) . .
( 490 WlA) ?Cop,mito -1-roonfeiu 5-1,o i-Jr.h . . .
(Please Circle All T at Apply) .
*Is job ready for inspection: YES/ 0= Rough I Final
*Do•you need a Temp Certificate: YESQE •
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 .
6e/iie�, 79- o'7 -- edk u .60 f` .
Cly. cts-e- f r2 s —
82-Request forInspectiion Form
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� \ LOT COVGYMAP ` �o 4� _L ,
.' J // �- / `� r . _ EXISTING HOUSE DECK 2,459.9 SQ.FT. 10.55%
O Uj O / \ . t PROPOSED ADDITIONS- •F6.5.6_SQ.FT. 0.72%
Q �0 �o. ��� / \ LOT SIZE /�BO�RIP RAP 22,383.3 SQ.
BOG � / \
Os TOT' LOT COVERAGE 2,625.5 SCS'• I .71%
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4) ' �(6// -1-6.91 \\ --/‹"P 9 PROPOSED HOUSE * DECK 2,6I 9.5 SQ.FT.
•• C� 2619.5 x I x 0. 17 445.3 C.F.
Uj / ZONE X • , E�r� G' WALKWAY AND DRIVEWAY 2615.5 5Q. FT. /
2615.5 x .6 x . 17 = 266.8 C.F.
MOH ps1L \ ', O
• T,y7� 4)P,L� •• IXISTANKNG enc oh ? \ •'PJ 4.45.3 C.F. + 266.8 C.F. = 712. 1 C.F. REQUI-. P `
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. %. -,0 �— ♦\ PECONIC SURVEYORS, P.C. J
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COUNTY OF: SUFFOLK, NEW YORK O,P S \ y '
�� A�o , "•� -O.SEALED, AND 1
SURVEYED: MAY 25, 2004 " F,o \ `�� / " SOId' 13 IN ACCORDANCE
TAX MAP# 1000-56-5-39 �!�- 15-
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BY: WALLACE T. BRYAN �� G \ �3 / -3. , -; -
LAND SURVEYOR '�� ��F� \ 0 ' - .sir KO RN IU AN F= _ _�
FOR: PETER C. KORNMAN J ass ,i ,P/ 00 <<'•Tr• • `
MARY C. KORNMAN 964-7 \ `- ' • Co v0 ! 2I 12120 1 1 ,'/` 'z`7 _
AREA = 24,786 S.F.± . , ' \• ' ��°�� ,•'� ¢get/,�h O REV. O 1/1 7/ 1 2 4fi
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1�/ [=A1f�1h��ATr1ER DESIGN ASSOCIATES, INC. ,---1,;:.-f:--
°°" 205 BAY AVFNUE "' „_ _
I "=30'-0° GREENFORT, N.Y. 11944 FEB 2 1 2012
63 ;-477-9752 (Fax) G31-477-0973
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