HomeMy WebLinkAbout39826-Z ee
� f"3R"' -
�, c0 - Town of Southold 12/14/2015
I P.O.Box 1179
�"' 'r, ‘, 53095 Main Rd
y,,y� , a„'s'' Southold,New York 11971
CERTIFICATE OF OCCUPANCY
No: 37958 Date: 12/14/2015
THIS CERTIFIES that the building RESIDENTIAL ADDITION
Location of Property: 7500 New Suffolk Ave, Mattituck
SCTM#: 473889 Sec/Block/Lot: 115.-17-17.26
Subdivision: Filed Map No. Lot No.
conforms substantially to the Application for Building Permit heretofore filed in this office dated
' 5/20/2015 pursuant to which Building Permit No. 39826 dated 6/2/2015
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:
screened porch addition to a one family dwelling as applied for.
The certificate is issued to Tozar James QPRT&Tozar Elaine QPRT
- of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL
ELECTRICAL CERTIFICATE NO. 39826 10/21/2015
PLUMBERS CERTIFICATION DATED r ,j�//,�/�
34.--c-...„
Autho ed Signature
ont-_ TOWN OF SOUTHOLD
�# 66 BUILDING DEPARTMENT
0.
TOWN CLERK'S OFFICE
p�, 4 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#: 39826 Date: 6/2/2015
Permission is hereby granted to:
Tozar James QPRT & Tozar Elaine QPRT
7500 New Suffolk Ave
Mattituck, NY 11952
To: Screened porch addition to a single family dwelling as applied for.
At premises located at:
7500 New Suffolk Ave, Mattituck
SCTM # 473889
Sec/Block/Lot# 115.-17-17.26
Pursuant to application dated 5/20/2015 and approved by the Building Inspector.
To expire on 12/1/2016.
Fees:
SINGLE FAMILY DWELLING -ADDITION OR ALTERATION $307.20
CO -ADDITION TO DWELLING $50.00
$357.20
/ 41)
Building Inspecto
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. 5 !c/ / 2b g c
New Construction: Old or Pre-existing Building: X (check one)
Location of Property: 1 3 oo I 4 Su FO I- / J- M/sn—
House No. Street Hamlet
JOwner or Owners of Property: It TO7 ..
Suffolk County Tax Map No 1000, Section IBlock ( 7 Lot 11
M Mew)._ *
Subdivision b ' G'F � 0E14 kT I,1p.'rjfrocr Filed Map. b/'-I/8 7 Lot: 40
N° 0,77
Permit No. Date of Permit. Applicant: Do(04,0 Fel 02, kettirrzer
Health Dept. Approval: Underwriters Approval:
Planning Board Approval:
Request for: Temporary Certificate Final Certificate: (check ne)
Fee Submitted: $
Applicant Signature
pliii;PV SO-0-45,----- _
Town Hall Annex ��� �® �® : Telephone(631)765-1802
54375 Main Road Fax(631)765-9502
P.O.Box 1179 ‘,..74.: ��
�� roper.richertic' town.southold.ny.us
Southold,NY 11971-0959 - a
'®-IrC®UNl1,* .0•
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,01
BUILDING DEPARTMENT
TOWN OF SOUTHOLD
CERTIFICATE OF ELECTRICIAL COMPLIANCE
SITE LOCATION
Issued To. Tozar
Address: 7500 New Suffolk Avenue City: Mattituck St: New York Zip: 11952
Building Permit#: 39826 Section: 115 Block 17 Lot: 17.26
WAS EXAMINED AND FOUND TO BE IN COMPLIANCE WITH THE NATIONAL ELECTRIC CODE
Contractor: DBA: Twin Fork Electric Inc. License No: 3488-E
SITE DETAILS
Office Use Only
Residential X Indoor Basement Service Only
Commence! Outdoor 1st Floor X Pool
New Renovation 2nd Floor Hot Tub
Addition Survey Attic Garage
INVENTORY
Service 1 ph Heat Duplec Recpt 5 Ceiling Fixtures HID Fixtures
Service 3 ph Hot Water GFCI Recpt Wall Fixtures Smoke Detectors
Main Panel A/C Condenser Single Recpt Recessed Fixtures 3 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: "Screen Porch", 1- Paddle Fan
Notes.
A.
Inspector Signature: w , �►' ,� 6 Date: October 21, 2015
v
Electrical 81 Compliance Form.xls
5)42 ,
�O��OF SO!/Ty�lo`
sVcreOutrN$70"11
TOWN OF SOUTHOLD BUILDING DEPT.
765-1802
INSPECTION
[ ] FOUNDATION 1ST [ ] ROUGH PLUMBING
[ ] FOUNDATION 2ND [ ] INSULATION -
[ ] FRAMING / STRAPPING [ ] FINAL
[ ] FIREPLACE & CHIMNEY [ ] FIRE SAFETY INSPECTION
[ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRATION
[ ] ELECTRICAL (ROUGH) [ ] ELECTRICAL (FINAL)
[ ] CODE VIOL ION [ ] CAULKING
REM RKS:
DATE INSPECTOR 21.64"/- V
,,O��OF SOUj�pl
4,4 -1,(e,
O
TOWN OF SOUTHOLD.BUILDING. DEPT.
765-1802
iNSPECTION-
FO9NDATION -IST [ ] ROUGH PLUMBING
[ ] UNDATION 2ND [ ] INSULATION
[ ] FRAMING / STRAPPING [ ] FINAL
[ ] FIREPLACE & CHIMNEY [ ] FIRE SAFETY INSPECTION
[ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRATION
[ ] ELECTRICAL (ROUGH) [ ] ELECTRICAL (FINAL)
[ ] CODE VIOLATION [ ] CAULKING
REMARKS:
/7 644/t641 ,r '(499/
/%d4 X01
•
DATE INSPECTOR 1 /
'���o*OF SOblyo`
*,
-0/1?
TOWN OF SOUTHOLD BUILDING DEPT.
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) ELECTRICAL (FINAL)
REMARKS:
DATE " 1 ° " / INSPECTO
3C7 64
orO'v
* *
'
Af
TOWN OF SOUTHOLD BUILDING DEPT.
765-1802
INSPECTION
[ FOUNDATION-IST [ ] ROUGH PLUMBING
[ ] FOUNDATION 2ND [ ]
[ ] FRAMING / STRAPPING [L• ] FINAL
[ ] FIREPLACE & CHIMNEY [ ] FIRE SAFETY INSPECTION
[ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRATION
[ ] ELECTRICAL (ROUGH) [ ] ELECTRICAL (FINAL)
[ ] CODE VIOLATION [ ] CAULKING
REMARKS: 19tV' • -
DATE A2/7/5----- INSPECTOR
FIELD III6EgITON REPORT DATE coto EDITS . . .r ,
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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) 765-9502Survey
�SoutholdTown.NorthFork.net PERMIT NO.� 2G Check
Septic Form
N.Y.S.D.E.C.
Trustees
C.O.Application
Flood Permit
Examined ,20 Single&Separate
Storm-Water Assessment Form
`2---- ( ') Contact: {-
Approved ,20 Mail to: DONipt,o rEl LEP---
Disapproved a c 1531' 161 a i ifYIMI i Pxr
' '4", Phone: 29 6- S45 Q7
Exp;
, p
7nh// ��
II I ung If isp:, tor
MAY 19 2015 I J,
APPLICATION FOR BUILDING PERMIT
DT
TC;^,ie�u .;;�u;HOLD Date /5/ ( 9 , 201 S
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
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, nd regulations, and to admit
authorized inspectors on premises and in building for necessary inspections. cti,.ok
•
(Signature of applicant or name, if a corporation)
lIG92 NIS17 UB
(MMiling address of applicant)
State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder
i . C IT GF
Name of owner of premises M 5 * LLA 1 Ni E To Z21
(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. 7No IN
Plumbers License No. P-)A'
Electricians License No. FeN P i rJ 6
Other Trade's License No.
1. Location of land on which proposed work will be done:
15 00 ilt ` Si 9 F® 4UE. , Mk.--Tri T vc,r_
House Number Street Hamlet
County Tax Map No. 1000 Section ( 1 Block I—1 Lot 17 . 2 6
n
Subdivision 1\Upoi 11-pieDoK Vli:ln1 AT i �1 j1J Filed Map No. 2)121/87 Lot 4-0
N0 X17
2. State existing use and occupancy of premises and intended use and occupancy of proposed construction:
a. Existing use and occupancy 511.16LE. FAM I L 4' LLL If—)6
b. Intended use and occupancy SiSMt':
3. Nature of work (check which applicable): New Building Addition )C Alteration
Repair Removal Demolition Other Work
(Description)
4. Estimated Cost 77CD /060 1 Fee
(To be paid on filing this application)
5. If dwelling, number of dwelling units I 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, 82.. fT Rear G 2 Fr Depth (P,5 "Fr
Height 2--) Ti Number of Stories
Dimensions of same structure with alterations or additions: Front 5I riie Rear EA if
Depth e' rt Height SW1t. Number of Stories ITO 11r € 6" 3
8. Dimensions of entire new construction: Front (1' fr Rear 267 FT Depth 1 4 FT
Height 14 Pr Number of Stories /
9. Size of lot: Front �J IT Rear 2O 5 j Depth 21'5
r
10. Date of Purchase 12-' 200 t5 Name of Former Owner paw N i bA21 4:7 -e-1.4(1/4)6,
11. Zone or use district in which premises are situated
12. Does proposed construction violate any zoning law, ordinance or regulation? YES NO X.
13. Will lot be re-graded? YES NO)C Will excess fill be removed from premises? YES X. NO
15c° Nrw 5LIFFeLa=Life-
14.
w/e14. Names of Owner of premisesas4E 'TOUR Address MA-Trr Tom Phone No. 2•9b.4171
Name of Architect aNI'j AddressTAi 4, MP riTuex- Phone No 29& -5250
Name of Contractor Pt-Note/4 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 X
* IF YES, D.E.C. PERMITS MAY BE REQUIRED.
16. Provide survey, to scale, with accurate foundation plan and distances to property lines. I
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 X
* IF YES, PROVIDE A COPY.
STATE OF NEW YORK)
SS:
COUNTY OF )
_DG )>4L0 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 thi
/p_day of /%.k! 20 ' PATRICIA RICHERT
Notary Public State of New Yo
!� ' , No.30-4741154
NotaryPublic Qualified in,Nassau/1617 Signature f Applicant
Commission Expires '/ b
•.i
`d('" C- STORMWA\TJER
Scott A. Russell
SUPERVISORMANAGEMENT
SOUTHOLD TOWN HALL-P.O.Box 1179 r O w JP'�i Town of Southold
Main Road-SOUTHOLD,NEW YORK 11971 ��4, ,
'.i/O( ;» .1 �.
CHAPTER 236 - STORMWATER MANAGEMENT WORK SHEET
( TO BE COMPLETED BY THE APPLICANT )
ii DOES THIS PROJECT INVOLVE ANY OF THE FOLLOWING: '
Yes No (CHECK ALL THAT APPLY)
❑® A. Clearing, grubbing, grading or stripping of land which affects more
than 5,000 square feet of ground surface.
1:1® B. Excavation or filling involving more than 200 cubic yards of material i
within any parcel or any contiguous area. • ,
• ►N _ _ ' - . - .. . .•_s is _o.es rich exceed 10 feet vertical rise to
100 feet of horizontal distance.
0 n D. Site preparation within 100 feet of wetlands, beach, bluff or coastal
erosion hazard area.
❑Et E. Site preparation within the one-hundred-year floodplain as depicted
on FIRM Map of any watercourse.
0 rig F. Installation of new or resurfaced impervious surfaces of 1,000 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.
. - - - - -- - - - -- --- -- - S.C.T.M. #: 1000 Date:
APPLICANT: (Property Owner.Design Professional,Agent,Contractor,Other) District
NAME: ir t L1- Pc N 1 t 1lr7 f i 1142 5/1w//5
�•,,,i Section Block Lot
"``rk'FOR BUILDING DEPA :lrl ' USE
Contact information 29 Cp) ^ 545
.Tr xu,nera
Reviewed By:
Date. 5-11-1
Property Address/ Location of Construction Work:1 —
500 NE-L1 -0 , FOk..>< 'w -A 0 t rf
Approved for processing Building Permit.
Stormwater Management Control Plan Not Required.
NI tt- -1-1-
\ \-co 01 , Stormwater Management Control Plan is Required
(Forward to Engineering Department for Review.)
FORM 4 SMCP-TOS MAY 2019
Ty
Town Hall Annex 41 - Telephone(631)765-1802
i[
54375 Main Road ; (631)765- 5Q
CA roger.richert "own.sout�io11 .ny.us
- P.O.Box 1179
Southold,NY 11971-0959 \ 44' if
COWL gill
BUILDING DEPARTMENT
TOWN OF SOUTHOLD
APPLICATION FOR ELECTRICAL INSPECTION
REQUESTED BY: Date:
•
Company Name: %ears' oa f. &Zcav(4c_
Name: 1�� - d 4 r -�7c-
License No.: etinef.
Address: f o 6dw To-vv,-r- ,k l //,c v7,
Phone No.:, 72-2. — yo/0
JOBSITE INFORMATION: (*Indicates required information)
*Name: J
*Address. 1n-0 AM'4)
*Cross Street: f i u Lisaiu e-
*Phone No.:
Permit No.: F.Wp
Tax Map District: 1000 Section: Block: Lot:
*BRIEF DESCRIPTION OF WORK(Please Print Clearly) CkAs--w-ePQ
Att ' '-An-0
(Please Circle All That Apply)
*Is job ready for inspection: alr 0 Rough In , MO
*Do you need a Temp Certificate: YES / �O
- 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 Overhea4 tVQ1b
Additional Information: PAYMENT DUE WITH APPLICATION iC), 6'
R9..Pcuiunc*forIncow-rtinn Form
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