HomeMy WebLinkAbout41042-Z Town of Southold 10/11/2016
P.O.Box 1179
C3
1U ;x 53095 Main Rd
o'$ dap` Southold,New York 11971
CERTIFICATE OF OCCUPANCY
No: 38572 Date: 10/11/2016
THIS CERTIFIES that the building AS BUILT ALTERATION
Location of Property: 965 Pike St, Mattituck
SCTM#: 473889 Sec/Block/Lot: 140.-2-25
Subdivision: Filed Map No. Lot No.
conforms substantially to the Application for Building Permit heretofore filed in this office dated
9/20/2016 pursuant to which Building Permit No. 41042 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"boiler/gas hot water heater as applied for.
The certificate is issued to Kelleher,Faye
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL
ELECTRICAL CERTIFICATE NO.
PLUMBERS CERTIFICATION DATED
orized Signature
�SUFFD(��O TOWN OF SOUTHOLD
Sao a BUILDING DEPARTMENT
y TOWN CLERK'S OFFICE
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#: 41042 Date: 9/29/2016
Permission is hereby granted to:
Kelleher, Faye
965 Pike St
PO BOX 983
Mattituck, NY 11952
To: legalize the "as bit" installation of a boiler/gas hot water heater
At premises located at:
965 Pike St, Mattituck
SCTM # 473889
Sec/Block/Lot# 140.-2-25
Pursuant to application dated 9/20/2016 and approved by the Building Inspector.
To expire on 3/31/2018.
Fees:
AS BUILT- SINGLE FAMILY ADDITION/ALTERATION $400.00
CO - N TO DWELLING $50.00
Total: $450.00
i
Buildi g Inspector
It
Form No.6
TOWN OF SOUTHOLD-tU Q �)
BUILDING DEPARTMENT
TOWN HALL
765-1802 ®®
APPLICATION FOR CERTIFICATE OF OCCUPANC"
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$15.00
Date_
New Construction: Old or Pre-existing Building: ,/ (check one)
jj
Location of Property: f f K II_e S'1 r e.,"IJ� M01, f-[Vt cic-
House No. Street I- Hamlet
Owner or Owners of Property: S e 4 �2 e 11e r
Suffolk County Tax Map No 1000,Section 0 Block Lot S
Subdivision 1 i1 Filed Map. Lot:
Permit No. _l v Date of Permit. Applicant: L 1 11 ��of Ru rtl e r
Health Dept.Approval: Underwriters Approval:
Planning Board Approval: /
Request for: Temporary Certificate Final Certificate: V (check one)
Fee Submitted:$ v
pplicant Signatur
ecx6 r
SOU�*�®l
Town Hall Annex Telephone(631)765-1802
54375 Main Road en Fax(631)765-9502
P.O.Box 1179 • iQ roger.riche rto_town.southoId.ny.us
Southold,NY 11971-0959
BUILDING DEPARTMENT
TOWN OF SOUTHOLD
CERTIFICATE OF ELECTRICIAL COMPLIANCE
SITE LOCATION
Issued To: Kelleher
Address: 965 Pike Street City: Mattituck St: New York Zip: 11952
Budding Permit#: 41042 Section: 140 Block: 2 Lot. 25
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 X Indoor X Basement X Service Only
Commerical Outdoor 1st Floor Pool
New Renovation 2nd Floor Hot Tub
Addition Survey X Attic Garage X
INVENTORY
Service 1 ph Heat GAS Duplec Recpt Ceding Fixtures HID Fixtures
Service 3 ph Hot Water GAS GFCI Recpt Wall Fixtures Smoke Detectors
Main Panel A/C 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 F1 Switches El Twist Lock Exit Fixtures TVSS
Other Equipment: "AS BUILT" - "ELECTRICAL SURVEY" - "NO VISUAL DEFECTS"
Notes: Inspection of Electrical Services in House and Garage, Hot Water Heater and
Gas Furnace
Inspector Signature: Yeo--V� Date: October 11, 2016
0-81-Cert Electrical Compliance Form.xls
J SO(/Tyolo
V
o • , �� l
TOWN OF SOUTHOLD BUILDING DEPT-
765-1602
INSPECTION
[ ] FOUNDATION IST [ ] ROUGH PLEIG.
[ ] FOUNDATION 2ND [ ] INSULATION
[ ] FRAMING / STRAPPING [ ] FINAL
[ ] FIREPLACE & CHIMNEY [ ] FIRE SAFETY-INSPECTION
[ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRATION
[ ] ELECTRICAL (ROUGH) ELECTRICAL (FINAL)
REMARKS:
clef
DATE �r �� INSPECTO
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STATE ENERGY GORE
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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) 765-9502 Survey
SoutholdTown.NorthFork.net PERMIT NO. (d c� 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
Phone:
Expiration � � ,20� `
D ������ Building Inspector
V
APPLICATION FOR BUILDING PERMI
SEP 202016
Date q ' 20 / 6
BUILDING DEPT. INSTRUCTIONS
TOWP-199§9Vfflff9WST 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 co e, and regulations,and to admit
authorized inspectors on premises and in building for necessary inspections. ��� A 4v4covL d✓L
r-Ae-cJo r
;Signature of appli nt or name,if a corporation)
g Co rl e Cour Ter Je 6t �Ay,
(Mailing address of applicant) 61 777
State whether applicant is owner, lessee, agent, architect, engineer, generall contractor, electrician, plumber or builder
>C�cujr OT e ��-a}e
Name of owner of premises 'FQ 2 r
(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.
Plumbers License No.
Electricians License No.
Other Trade's License No.
l. Location of land on which roposed work ill be done-
Location
(�� di e S� CP_ � C 1�,
House Number Street Hamlet
County Tax Map No. 1000 Section +0 Block, Lot
` m
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
b. Intended use and occupancy
3. Nature of work(check which applicable): New Building Addition Alteration
Repair Removal Demolition Other Work N64,0
(Descri tion)
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 nRear.- ,;� •„-- y
Depth Height Number of Stories`
8. Dimensions of entire new construction: Front RearDepth
Height Number of Stories
9. Size of lot: Front Rear 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? YES NO
13. Will lot be re-graded? YES NO Will excess fill be removed from premises? YES NO
14. Names of Owner of premises Address Phone No.
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 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 on survey.
18. Are there any covenants and restrictions with respect to this property? * YES NO
IF YES, PROVIDE A COPY.
STATE OF NEW YORK)
SS:
COUNTY OF
1 10zh4 A AJA(, r-t^ 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 knowl e ftd belief; and that the work will be
performed in the manner set forth in the application filed therewith.
orn to before me t
o day o 201(,
CH
Notary Publi Notary Public,State of D. a of Ne
w York Signature of Appli t
No.01 BU6185050
Qualified in Suffolk County
Commission Expires April 14,b)�110
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of soUjyo D
Town Hall Annex Jf lephone(631)765-1802 Do
54375 Main Road cis acax({ 7- q2 SIS
P.O.Box 1179 G • O rogendchert t0 O d
Southold,NSC 11971-0959
i
_ FLMDIlITG DEPT. �
TOWN OF SOMOLD i
BUILDING DEPARTMENT
TOWN OF SOUTHOLD j
APPLICATION FOR ELECTRICAL INSPECTION
i
REQUESTED BY: L'Vlaa iA Eqp rE-A el r- Date: �q j
Company Name:
Name: '
w5ar
License No.:
Address: 5 i 4 re 41 I N C. N Y 1176—a s
Phone No.: ( 3 0
i
JOBSITE INFORMATION: (*Indicates required information) �^
*Name: L` r e tai' E T ee 14-er
*Address: 5- e lCJt5 2
*Cross Street: nne
*Phone No.: (e 3 I +73— 5 s
Permit No.:
IbA
Tax-Map District: 1000 Section: Block: Lot:
*BRIEF DESCRIPTION OF WORK(Please Print Clearly
(Please Circle All That Apply)
*Is job ready€or inspection:
YES 'NO Rough In Final i
*Do you need a Temp Certificate: YES
t.�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 Overhead
i
Additional Information: PAYMENT DUE WITH APPLICATION
I
82-Request for Inspection Form
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INVOICE {a;
Mattituck Plumbing&Heating Corp-
P.O.Box 1429 - 10680 Main Road
Mattituck,NY 11952-0993 ', sIiiv 164420-A
KEL-965
t,iCuiSfo > 'No�
Telephone:631-298-8393,
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Warehouse:MAIN
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DANIEL KELLEHER -
965 PIKE STREET'
P.O.BOX 983 x 11952 N'
MATTITU
CK,NY 11952 MATTITUC ,NY .
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Telephone:298-9467-
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Delfino Insulation Co. , Inc. Proposal
317 Burman Blvd. Phone: (631 329-7181
Calverton,NY 11933 Fax: (631329-7159
Proposal No.: 29373
Date: 9/21/2016
Burger,Joe Job Address: IN/PIKE ST/REMOVAL
965 Pike St 965 PIKE ST
Mattituck, NY 11952 MATTITUCK, NY 11952
Fax: (631)473-7555
Phase: Removal
Work Area Inventory Item
REMOVE-Remove Existing Insula R-1 i Kraft 15 x 93 CT990215
See mike q.leave garbage bags on site
Remove Insulation in Crawrlsspac R-19 Kraft 15 x 93 CT990985
Removal Total: $400.00
Phase: Crawl
Work Area Inventory Item
Crawispace R-19 Kraft 15 x 93 CT990985
Crawl Total: $200.00
We propose hereby to furnish materials&labor in accordance with the above specifications for the sum of: $600.00
Payment to be made in full,plus any applicable sates tax,In accordance with the*Terms stated herein.
All material is guaranteed to be as specified.All work to be completed in a workman like manner according to standard practices,
Any alterations or deviation from above specifications involving extra costs will be executed only upon written orders and will become an extra change over and above
the estimate. All agreements contingent upon strikes,accident or delays beyond our control.Owner to carry fire,tornado and outer necessary insurance. Our workers
are fully covered by workman's compensation insurance.The undersigned hereby agrees that in the event legal action is instituted to enforce payment o(-an outstanding
balance,a reasonable amount will be added thereto for attomey's fees and legal costs,as-well as the prevailing statue interest rate fron the date the original amount was
due.
ALL JOBS ARE C.O.D UNLESS PRIOR CREDIT APPROVAL HAS BEEN ACCEPTED.
ALL DEBRIS IS TO BE BAGGED AND LEFT ON SITE.
ALL FOAM APPLICATIONS REQUIRE A 50%DEPOSIT AND SIGNED PROPOSAL PRIOR TO COMMENCEMENT OF WORK
Note:This proposal may be withdrawn by us if not accepted within 30 days.
FOAM JOBS:it is advised that all persons and pets vacate the premises during the spray foam application and for a period of 24hrs there after while foam is curing.All
foam Is sprayed to a nominal thickness.
`ACCEPTANCE OF PROPOSAL-
The above prices,specfiaations and conditions are satisfactory and are hereby accepted. You are authorized to do the work as specified.
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