HomeMy WebLinkAbout41005-Z ��r, IFOtp�Q� Town of Southold 9/29/2016
P.O.Box 1179
53095 Main Rd
Southold,New York 11971
CERTIFICATE OF OCCUPANCY
No: 38527 Date: 9/28/2016
THIS CERTIFIES that the building ADDITION/ALTERATION
Location of Property: 515 Private Rd#12, Southold
SCTM#: 473889 See/Block/Lot: 78.-6-10.1
Subdivision: Filed Map No. Lot No.
conforms substantially to the Application for Building Permit heretofore filed in this office dated
9/13/2016 pursuant to which Building Permit No. 41005 dated 9/20/2016
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, including conversion of seasonal to year round use as applied
for.
The certificate is issued to Stegner,Daniel&Patricia
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL
ELECTRICAL CERTIFICATE NO. 41005 8/17/2016
PLUMBERS CERTIFICATION DATED 9/28/2016 Cutchogue East Plu Bing
m
Auth ed Signature
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN CLERK'S OFFICE
o • 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#: 41005 Date: 9/20/2016
Permission is hereby granted to:
Stegner, Daniel & Patricia
470-12 Windy Point Ln
Southold, NY 11971
To: legalize "as built" alterations to an existing single family dwelling as applied for.
At premises located at:
515 Private Rd #12, Southold
SCTM # 473889
Sec/Block/Lot# 78.-6-10.1
Pursuant to application dated 9/13/2016 and approved by the Building Inspector.
To expire on 3/22/2018.
Fees:
AS BUILT- SINGLE FAMILY ADDITION/ALTERATION $496.00
CO -ALTERATIQbLTO DWEL G $50.00
Total: $546.00
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:
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$15.00
Date. gjlSj1G
New Construction: Old or Pre-existing Building: ✓ (check one)
Location of Property: SIS P'T t�PNis 5ovTt+at,
O
House No. Street Hamlet
Owner or Owners of Property: Deva PA;T- S T6 4 iv Er—
Suffolk County Tax Map No 1000, Section -7'9 Block lr, Lot lo- 1
Subdivision Filed Map. Lot:
Permit No. 0 S Date of Permit. Applicant: RJ tRS12.T' %arzrz p.-r T'
Health Dept.Approval: Underwriters Approval:
Planning Board Approval:
Request for: Temporary Certificate Final Certificate: (check one)
Fee Submitted:$ Su
Applicant Signature ,
SOl/jyolo
Town Hall Annex Telephone(631)765-1802
54375 Main Road Fax(631)765-9502
P.O.Box 1179 G aQ roger.riche rt(c-town.southoId.ny.us
Southold,NY 11971-0959
BUILDING DEPARTMENT
TOWN OF SOUTHOLD
CERTIFICATE OF ELECTRICIAL COMPLIANCE
SITE LOCATION
Issued To: Stegner
Address: 515 Private Road#12 City: Southold St: New York Zip: 11971
Building Permit#: L+ 100 I- 40868 Section: 78 Block: 6 Lot: 10.1
if11�AS EXAMINED AND FOUND TO BE IN COMPLIANCE WITH THE NATIONAL ELECTRIC CODE
Contractor. DBA: Jim Sage Electric License No: 3635-E
SITE DETAILS
Office Use Only
Residential X Indoor X Basement Service Only X
Commerical Outdoor X 1st Floor Pool
New Renovation 2nd Floor Hot Tub
Addition Survey Attic Garage
INVENTORY
Service 1 ph 150A Heat Duplec Recpt Ceiling Fixtures HID Fixtures
Service 3 ph Hot Water GFCI Recpt Wall Fixtures Smoke Detectors
Main Panel 150A AIC 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 150A Switches Twist Lock E)dt Fixtures TVSS
Other Equipment: 150A OVER HEAD SERVICE
Notes:
Inspector Signature: Date: August 17, 2016
OOElectrical 81 Compliance Form.xis
Town Hall Annex Telephone(631)765-1802
54375 Main Road Fax(631)765-9502
P.O.Box 1179 4C
Southold,NY 11971-0959 (,y `�
TV
D [�C[E0 V BUILDING DEPARTMENT
D TOWN OF SOUTHOLD
' [RSEP 2 8 2016
BIDING DEPT.
TOWNOFSOIITHOLD CERTIFICATION
Date: . K� .
Building Permit No.
Owner: St e - h e
(Please print)
Plumber: ��C�. ► ihr7[nd( (,,(/ G d !/� I /Vol/j
(Please print)
I certify that the solder used in the water supply system contains Iess than 2/10 of I%
lead.
d1l /."/—�'
� '� pp (Plumbers Signature)'
Sworn to before me this oQ�`t't'1
day ofd L/l , 20
Notary PublicCounty Notary OMNI State of
New York
No.01 BU6195050
Quallfted in Suffolk County °�
Commission Expires April 14,20Q6
FIELD lN'SpETg;ON nEVORx DATA C01vLS
m
FOUNDA�ON (1ST)
- - -----... .�- • _ .....--- -
FOUNDATION' (2NI3)
ROUGES YR NDNQ&
PLUMBING - - .
o
INSULATION PEA N.-Y. Ute'
STATE ENERGY C'ODB
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 s._� '4 ..,; , •" ,,, 4 sets of Building Plans
TEL: (631) 765-1802 Planning Board approval
FAX: (631) 765-9502 x AIA,'o® Survey
SoutholdTown.NorthFork.net PERMIT NO. Check
Septic Form
N.Y.S.D.E.C.
Trustees
C.O.Application
Flood Permit
Examined 20 Single&Separate
Storm-Water Assessment Form
Contact:
Approved ,20 Mail to:
Disapproved a/c -7 /
P L Phone: !
Expiration ,20 m i� ®�� �
D
� i ding nspec, r ,
PLICATION FOR"BUILDING PERMIT
SEP 113' '2016' ' Date SEPT IZ - , 20 1(p
t INSTRUCTIONS
ING l3]EPT. "
a. t' �IDcompletely.filled in by typewriter or in ink and submitted,to theBuilding Inspector with 4
sets of plansxa a 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'buildirig 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,and regulations,and to admit
authorized inspectors on premises and in building for necessary inspections.
(Signature of applicant or name,if a corporation)
Q�Q t V,*tvx Tb ry -2.43 44 C i c,H o q cf 4', ^/y
(Mailing address of applicant)
State whether applicant is owner, lessee, agent, rchitect, engineer, general contractor, electrician, plumber or builder
Name of owner of premises 'D4A) t PAT S'rG C, N Ell
,. .,,ti: ;;,•..;,1 (As on the tax roll or latest deed) '
If applicant is'a corporation, signature-of duly authorized officer'
(Name and tltle,of;corporate-officer)
Builders License No.
Plumbers License No.
Electricians License No.
Other Trade's License No.
1. Location of land on which proposed work will be done:
51 S W IN oma( PT L-AN F..
House Number Street Hamlet
County Tax Map No. 1000 Section -1 T'S Block Go Lot lo'
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 S I N SLE Fri m it 04 Hfo M E
b. Intended use and occupancy St N q LC FW C
3. Nature of work(check which applicable): New Building Addition Alteration
Repair -v,' -Removal Demolition Other Work
(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: Fro�t 32.4 Rear 32. 4. Depth Z4 (C'
Height l5 Number of Stories I
Dimensions of same structure with alterations or additions: Front 32. 4. Rear 32.14
Depth Height ► s Number ofi`Stories '. . '
T
8. Dimensions of entire new construction: Front Rear k4 Depth 2z Co� a-; 1
Height IS Number of Stories I Lt.,(ZPca2s IJNL.Y,)
9. Size of lot: Front 1001, Rear 59•-70 Depth 129•S M
10. Date of Purchase S G Name of Former Owner T• 17. F oI, EFs=Ga"' :`;,`=mp:; 'A'"`x'11
11. Zone or use district in which premises are situated R.£51 L.,E N T1 A L
12. Does proposed construction violate any zoning law, ordinance or regulation? YES NO X
13. Will lot be re-graded? YES NO x Will excess fill be removed from premises? YES NO x
DAN t par 4`Io wiNoY pt LAME
14. Names of Owner of premises STc 4 Nta- Address SoVT1-�<'t'6. NY Phone No. 631--765- 5(635
Name of Architect — Address — Phone No
Name of Contractor INLAND 140 M ES 1 N1 Address 3ks Wes-1 pNAt+%A Phone No. 631- Z4 8 9(6-R6
Qoap, mP-TTiT%1clC
15 a. Is this property within 100 feet of a tidal wetland or a freshwater wetland? *YES NO X
* IF YES, SOUTHOLD TOWN TRUSTEES &D.E.C. PERMITS MAY BE REQUIRED.
b. Is this property within 300 feet of a tidal wetland? * YES x 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 on survey. No
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 )
P,0 R EIZT r4►2/Z A,71- 1 bein dul sworn deposes and says that )lb� e t� I icant
(Name of individual signing contract)above named, g y p CONNI D. �sUhl'GFpp
Notary Public,State of New York
No.01 BU6185050
(S)He is the Qualified in Suffolk County I•
(Contractor,Agent, Corporate Officer, etc.) Commission Expires April 14,4_
of said owner or owners, and is duly authorized to pe form 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
day of
Notary Public Signature of Applicant
TOWN OF SOUTHOLD PROPERTY RECORD CARD
OWNER STREET VILLAGE DIST.1 SUB. LOT.
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7F SEC770H 72090E THE NEW YORK STATE EDUCATION LAW ECONIC'S ORS, P.0
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Mr Robert Barratt PE,4295 Vanston Road, Cutchogue, NMCRO'V[E
Tel 631734 2730 Email robertbarratt o o tonline.n D
Sept 21, 2016 UP 2 1 2096
To: Southold Building Dept,Town Hall Annex, (By Hand)
Subject:515 Windy Point Lane,Southold, NY,SUM #1000-78-6-10.1 SIIMDING DEPT.
TOWNOFSOMOLD
Gentlemen,
The owner of the subject property Mr. Dan Stegner invited me to inspect his house, and my notes and
conclusion are set out below:
Notes
The external walls and the attic floor are insulated R13 in walls and several inches in attic
Crawl space ventilation under the first floor was installed and a insulation mat was placed on the
compacted soil
Original windows have been replaced,and the total window area is less than 15%of the external wall
area.The bedroom window has been converted to a high performance E4 glass egress window
The un-heated porch was enclosed and this helps conserve energy in the winter
The central heating furnace room and external above-ground fuel tank were professionally updated.
Kitchen and bathroom fixtures and appliances have been replaced,a new floor installed in the living
room,and a window style air-conditioner installed in living room wall
Based upon my inspection and Peconic Surveyors survey#16-056, 1 prepared Drawing#90216 Rev 0
Conclusion
To the best of my knowledge and professional judgment the construction of this house was conducted
in accordance with the building codes and regulations that were in use at the time of construction.
Respectfully submitted,
F
Q.
Robert Barratt PE
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s_y JV1 , H ALL CODES OF
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ALL CONSTRCTION SHALL,ME E T THE
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)0Robert Barratt PE, 4295'Vanston-Road, Cutchogue, NY 11935,
�j 0. 13,4 Tel 631875 0275 robertbarratt@optonline.net
CXTIEKNAI.-
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111(4 These plans are an instrument of the service and are the property of the
P -I&M
.,IETW C
• S-ro 09 C- It-IS design professional whose seal"is affixed hereto. Infringements will be
prosecuted to the fullest extent of the law. Contractor shall verify all field
,08-186b conditions and dimensions and be solely responsible for field fit. The
4 1%5t- design professional assumes no liability for omissions due to unknown or
t unforeseen field conditions and or additions based upon comments not
SIC Al-ra 1" 4 f+ 1, formally acknowledged as revisions to these plans.