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Home My WebLink About28080-ZFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No: Z-28856 Date: 09/10/02 THIS c~TIFIES that the building ALTERATION Location of Property: 2040 CALVES NECK RD SOUTHOLD (HOUSE NO.) (STREET) (HA~4LET) County Tax Map No. 473889 Section 70 Block 4 Lot 41 Sut)di¥ision Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated FEBRUARY 8, 2002 pursuant to which Building Permit No. 28080-Z dated FEBRUARY 12, 2002 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 ALTERATION OF PROPANE HEATING SYSTEM TO NATURAL GAS IN AN EXISTING ONE FAMILY DWELLING AS APPLIED FOR. · ~he certificate is issued to MICHAEL J HENCHY (OWNER) of the aforesaid building. SUFFOLK COUNRqf DEPARTMENT OF HF~%LTH APPROVI~L N/A BLEOrRICAL CERTIFICATE NO. N/A N/A PLUMBERS C~TIFICATION DA'l'~u Rev. 1/81 Author{z~d Signat~ FORM NO. 3 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) PERMIT NO. 28080 Z Date FEBRUARY 12, 2002 Permission is hereby granted to: MICHAEL J HENCHY 119 TULLAMORE RD GARDEN CITY,NY 11530 for : CONVERSION OF EXISTING PROPANE HEATING SYSTEM TO A NATURAL GAS at premises located at 2040 County Tax Map No. 473889 Section 070 pursuant to application dated FEBRUARY Building Inspector. Fee $ 150.00 CALVES NECK RD SOUTHOLD Block 0004 Lot No. 041 8, 2002 and approved by the ~h<Tr~i gna t~ COPY Rev. 2/19/98 Form No. 6 TOWN OF SOUTHOLD I~U1LDING DEPARTMENT TOWN ItALL 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 a 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. 2. Certificate of Occupancy on Pre-existing Building - $100.00 3. Copy of Certificate of Occupancy - $25.00 4. Updated Certificate of Occupancy - $50.00 5. Temporary Certificate of Occupancy - Residential $15.00, Commercial $15.00 New Construction: Location of Property: Old or Pre-existing Building: Date. (check one) House No. Owner or Owners of Property: P/[ { tN ~ SuffotkCounty T~axMap Ne 1909, Section Subdivision Permit No. 0'~ 0 gO - 7-. Health Dept. Approval: Plamfing Board Approval: Request for: Temporary Certificate Date of Permit. Street 0 3 ock Filed Map. Applicant: Underwriters Approval: Hamlet Lot: Final Certificate: ~'/ (check one) Fee Subnfitted: $ ~-X" ~ 14113 Home EnergY Services Home Improvement Contract [] KEYSPAN ENERGY SOLUTIONS, LLC 222-40 96TH AVENUE QUEENS VILLAGE, NEW YORK 11429 Phone: (718) Fax: (718) License No. NYC 0988597 Nassau HIC # H 3601500000 Suffolk HIC # 27, 478-HI Order No. Scheduled Date(s) of Work Performance QTY. DESCRIPTION OF WORK I MATERIALS [~INIT PRICE TOTAL / / , 0 Cash ~{~ ~~ ~0 CARD TYPE (Circle One) ViSA Maste~ard Discover AMEX Cr~it Card No. ExPiration Date NOTICE TO NEW YORK CITY AND NASSAU COUNTY CUSTOMERS ONLY - YOU, THE BUYER, MAY CANCEL THIS TRANSACTION AT ANY TIME PRIOR TO MIDNIGHT OF THE THIRD BUSINESS DAY AFTER THE DATE OF THIS TRANSACTION. SEE THE A'I-rACHED NOTICE OF CANCELLATION FORM FOR~N EXPLANATION OF THIS RIGHT. CustornerSi~lnature ,, KeySpan Ho/e .~e~y Services// For Service, please call 1-888-222-RELY (735~) 765-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLBG. / [ ] FOUNDATION2ND [ ] I~ULATION [ ] FRAMING [,,/J FINAL [ ] FIREPLACE & CHIMNEY FIELD INSPECTION REPORT I DATE I COMMENTS FOUNDATION (1ST) FOUNDATION (2ND) ROUGH FRAMING & PL~B~G STATE ENERGY CODE F~ ~D~ION~ CO~ENTS TOWN HA ]r~L SO'HOLD, NY 11971 TEL: 765;,1802 , ExA~-d . 20~ Approved ,20 Disapproved aJc FEB - 8.ptio l~ona ' svnmmG pmmrr. msmvc o s Date d ~*o: 7, / ,20o~ sets ofp~s, acc~.plotp~ ~ s~.~d~g$o ~e. ' b. Plot p~ ~g lo.on 0f~ ~d of~q~ ~ ~ ~fio~ m ~ni~g p~s or pubhc s~cetS < APPLICATION IS HEREBy MADE .to 1~ Bxn~s D~ ~=m for ~'i~mm=,~ 0£ a Bafldiag ?errmt pursuam ~o ~ Zone ~,~o, of~'T~ of~l~ ~ ~, N~'Y~'~ ~~ ~ws, ~d~nces or a~t ~e~ to ~"' 2'~ ~ ~ ~ hw~ ~d;~, ~l~g ~ ~ ~ ~d ~~. ~ to admit (Name and title Of corporate OffiO~r) Builders Liceals¢ No. ' Plumbers License'No. Electricians License No. Other Trade's License No. 1. Location ofland on which propo,ed work will l~ d0ne: House N~rmb~ Stre~ ., County TaxM_ap No: 1000 Sect[on r)O ' Sub&Vision ... "~'~ """ FOR THE 165-1802 ': FOLLOW'`.'? . , . 1. FOU "'" ' - '~ ,, ~ ~SQUIRED ' ~R ' ~ FINAL , >r'F:Tr'UC"Y:ON MUST ~( ~- .... ALL CONS':'~ ~ :~ ~ALL MEET THE R~Cr'RE "~ THE N.Y. BTATE CON~ ~ ~ ' ~: ENERGY D~iGN Gn -G;~='~L~ ~ ~ ERRORS mo k ' q' Fil*d/vlap No..' ' . ot o Natur~ of work.(~ee.k which at~llieable): N~. Buil~'. Addit:on Repa/r R~rnow~l Demolition .Oth,r Work o-.~ - . O)escdp~on) Estimated Cost , ~oO ~ ' . F~o ,' · ' (to be paid on 61ing thi.q application) If dwelling, n~mb~r of dwelling tm!ts.. ! Numb~ of dwelling milts on each floor If 9arage, number of oars ' Iflzms~ss, commeroial or mlxed.ooc~ancy, specify llailaro and ~lteilt.0f each ~pe ofnse. Dim~nsi0ns off, sting struota~s; ffau:~ Front .' R~r ~ Height. . Number of .Stod~s ., Dimensions of same structure with alt~atl0ns or additions: Front' . Rear Depth Height Number of Stodes Dimemions Of ereriri~ new c°nstmctio..· Front Rem' Height ' ' ' ' 'Number of St°rios' DeWrh 9. S/ze of lot: Front . Rear . Depth 10. Date of Pm-chase 1 1. Zone or use district in'whibh premi~ a~e si0;~_~:l ' ' 12. Does proposed.constmctmn violate my zon/~g l~w, ord~n~a2ee or ~gnla~ Alteration 13. W///lot be rergraded' ' Will excess.~! be removed.from premises: YES NO 14. Names of Owner Oflarerr&qes . Address ., Phone No. Name.of Architect'. Addre~ , ' Phone No ' 15. ts tNs property wit~,~: 100 feet o£a tid~l wettamt? *YES. ' NO - ]y x-ss, SOUTr~OLD ~5WN tRUStS ?.mum'rs ~ 6. Pro-~id~ sur~ey, to scal~, with aex,~.io fouuaatim vlan md d/sm~'to