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HomeMy WebLinkAbout41994-Z ��Q�gl1FFOt,�COGy Town of Southold 11/17/2017 P.O.Box 1179 o + 53095 Main Rd Southold,New York 11971 CERTIFICATE OF OCCUPANCY No: 39348 Date: 11/17/2017 THIS CERTIFIES that the building AS BUILT ALTERATION Location of Property: 715 Pike St,Mattituck SCTM#: 473889 Sec/Block/Lot: 140.-2-22 Subdivision: Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated 9/21/2017 pursuant to which Building Permit No. 41994 dated 9/27/2017 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 as applied for. (Main front house) The certificate is issued to Gildersleeve,James&Diane of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL ELECTRICAL CERTIFICATE NO. 41994 10/31/2017 PLUMBERS CERTIFICATION DATED ho ' d Signature �gaFFnt� TOWN OF SOUTHOLD BUILDING DEPARTMENT y z 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#: 41994 Date: 9/27/2017 Permission is hereby granted to: Gildersleeve, James & Diane PO BOX 514 Mattituck, NY 11952 To: legalize "as built" alterations to existing single-family dwelling as applied for. Additional certification may be required. At premises located at: 715 Pike St, Mattituck SCTM # 473889 Sec/Block/Lot# 140.-2-22 Pursuant to application dated 9/21/2017 and approved by the Building Inspector. To expire on 3/29/2019. Fees: SINGLE FAMILY DWELLING-ADDITION OR ALTERATION $400.00 CO -ALTERATION TO DWELLING $50.00 Total: $450.00 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 I% 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: f/ (check one) Location of Property: 7/5 j .ffe STr e e fi /I/• V House No. Street Hamlet Owner or Owners of Property: 'Tames It I e_ DI a ,qtd L C. ( �� j r]erS IEe Ue— bI Suffolk County Tax Map No 1000, Section Block Lot L.� 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: $ 0 /,1AAM_ k � 44L&4ei�� Applicant Signature OF SOUry®�® Town Hall Annex Telephone(631)765-1802 54375 Main Road N Fax(631)765-9502 P.O.Box 1179 G Q roger.richertOtown.southold.ny.us Southold,NY 11971-0959 COUNTY, BUILDING DEPARTMENT TOWN OF SOUTHOLD CERTIFICATE OF ELECTRICIAL COMPLIANCE SITE LOCATION Issued To: Gildersleeve Address: 715 Pike Street city,Mattituck st: New York zip: 11952 Building Permit#: 41994 Section: 140 Block: 2 Lot: 22 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 X 1st Floor X Pool New Renovation 2nd Floor X Hot Tub Addition Survey X Attic X 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 A/C Condenser Single Recpt Recessed Fixtures CO Detectors Sub Panel A/C Blower Range Recpt Fluorescent Fixture Pumps Transformer Appliances Dryer Recpt Emergency Fixture Time Clocks Disconnect Switches Twist Lock Exit Fixtures TVSS Other Equipment: "Front Building" Whole House. Notes: "AS BUILT" - "ELECTRICAL SURVEY" - "NO VISUAL DEFECTS" Inspector Signature: —� Date: October 17, 2017 0-Cert Electrical Compliance Form.xls pF SOU��®l Town Hall Annex Telephone(631)765-1802 54375 Main Road c� Fax(631)765-9502 P.O.Box 1179 G Southold,NY 11971-0959 ® • �o roger.rich ert(-town.so Litho Id.ny.us COUNTY, BUILDING DEPARTMENT TOWN OF SOUTHOLD CERTIFICATE OF ELECTRICIAL COMPLIANCE SITE LOCATION Issued To: Gildersleeve Address: 715 Pike Street city.Mattituck st: New York zip: 11952 Building Permit#: 41994 Section: 140 Block: 2 Lot: 22 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 X 1st Floor X Pool New Renovation 2nd Floor X Hot Tub Addition Survey X 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 A/C Condenser Single Recpt Recessed Fixtures CO Detectors Sub Panel A/C Blower Range Recpt Fluorescent Fixture Pumps Transformer Appliances Dryer Recpt Emergency Fixture Time Clocks Disconnect Switches Twist Lock Exit Fixtures TVSS Other Equipment: "Rear Building" Whole House. Notes: "AS BUILT" - "ELECTRICAL SURVEY" - "NO VISUAL DEFECTS" Inspector Signature: Date: October 17, 2017 0-Cert Electrical Compliance Form(1).xls SO!/lyolo TOWN OF SOUTHOLD BUILDING DEPT. 765-1802 INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLEIG. [ ] FOUNDATION 2ND [ ] INSULATION [ ] FRAMING / STRAPPING [ ] FINAL [ ] FIREPLACE & CHIMNEY [ ] FIRE SAFETY INSPECTION [ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRATION [ ] ELECTRICAL (ROUGH) �� ELECTRICAL (FINAL) REMARKS: 0 DATE �� INSPECTOR FIELD INSPECTION REPORT7 DATE COMMENTS FOUNDATION(1ST) y -------------------------------------- FOUNDATION(2ND) v' I z 0 ROUGH FRAMING& H PLUMBING r r� INSULATION PER N.Y. STATE ENERGY CODE FINAL ADDITIONAL COMMENTS --� CV ala. d y UR I r M `�, in w� �Z el cp z d r� b H r 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 Southold townny.gov PERMIT NO. Check Septic Form N.Y.S.D.E.C. Trustees C.O.Application ' �J Flood Permit Examined ,20Single&Separate l Truss Identification Form Storm-Water Assessment Form Contact: Approved ,2011 Mail to: Vi— Disapproved a/c Pho Expiration ,20 jJ in pector v LICATION FOR BUILDING PERMIT SEP 2 1 2017 , 20 INSTRUCTIONS a. T� •- mpletely filled in by typewriter or in ink and submitted to the Building Inspector with 4 sets of plans, accurate p o plan o sca e. 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, and regulations, and to admit authorized inspectors on premises and in building for necessary inspections. (Signatur of applicant or name,if a corporation) (Mailing address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder Name of owner of premises _� �,�i�,�,a ( � ��t l acn (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. 1. Location of land on which iroposed work will be d ne: House Number Street Hamlet County Tax Map No. 1000 Section t q Blpctk,';'':;�� Lot �� r 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 dditionAlterationRepair Removal Demolition ther Wor © e, fflWWftZ- 1z (Description) \Estimated Cost Fee (To be paid on filing this application) If dwelling, number of dwelling units Number of dwelling units on each floor If garage; number of cars If business, commercial or mixed occupancy, specify nature and extent of each type of use. Dimensions of existing structures, if any: Front Rear Depth eight Number of Stories Dimensions of same structure with alterations or additions: Front Rear Depth Height Number of Stories Dimensions of entire new construction: Front Rear 1 F-aj 'Deptli�t�''v: 3 Height Number of Stories ,Y ' Size of lot: Front Rear Depth 1 . Date of Purchase Name of Former Owner 1vone 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 1) aures of Owner of premises :��'rsl t Address 71,5' P%fe S I- Phone No. 9 Name of Architect Address 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 OFS � f1 oyy\95 �-1 I I G�Q V s�QQ.�� 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 this d y of S �� 20l-7 vv\ky� 0,'AAAA�,Ly NotaryNEM Pub ivBROWN s Notary o Applicant otary Public,State of New York Si g nrpp No.01BR4908712 Quarfied in Suffolk Courtly Commission Expires October ,b e LmkA Pex Affidavit I,James H. Gildersleeve retired plumber reside at 715 Pike Street front house have installed a pex pipe to the outside faucets using no solder joints. James H. Gildersleeve `?A �cp - pF SO(/Tyol ; � o i Town Hall Annex Telephone(631)765-1802 � 54375 Main Road ax(631)765-,95q2. P.O.Sox 1179 G er.richert own_souttlol&n s Southold,NY 11971-0959 f I- BUILDING DEPARTMENT I TOWN OF SOUTHOLD APPLICATION FOR ELECTRICAL INSPEC N IQ . 1 REQUESTED BY- /f me-5- d- :D �� J I i � 6 ; , Date: Company Name: Name: `- - License No.: i- Address: , Phone No.: �- JOBSITE INFORMATION: (*Indicates required information) *Name: - 7j *Address: *Cross Street: �-o fie, Lt,? *Phone No.: ,�g�9�a� Permit No.: `}-I q�[ Tax-Map District: 1000 Section: Block:_ Lot: *BRIEF DESCRIPTION OF WORK (Please Print Clearly) i - I (Please Circle All That Apply) *Is job ready for inspection: (g)/ NO Rough In Final *Do-you need a Temp Certificate: YES ! NO I Temp Information (if needed)., *Service Size: 1 Phase 3Phase 100 150 200 300 350 400 Other I . *New Service: Re-connect- Underground Number of Meters Change of Service Overhead f Additional Information: PAYMENT DUE WITH APPLICATION I - 82-Request for Inspection Form � 0 f f AP R VED AS NOTED R DATE. �7B.P.# - FEE: ,6b. BY: Additional NOTIFY BUILDING DEPr��?I AT Certification 765-1802 8 AM TO 4 PM FOR THE fired. FOLLOWING INSPECTIONS: ffty Be ReQ 1. FOUNDATION - TWO REQUIRED FOR POURED CONCRETE 2. ROUGH - FRA?:':',t':' PLUMBING 3. INSULAT:r' 4. FINAL.- ° ! MUST BE COM; `. C.C. ALL CONST` - SHALL MEET THE ELECTRICAL REQUIREMER THE CODES OF NEW INSPECTION REQUIRED YORK STATE. NOT RESPONSIBLE FOR DESIGN OR CONSTRUCTION ERRORS. COMPLY WITH ALL CODES TOWN RETAIN STORM WATER RUNOFF NEW YORK STATE &TO RE O CODE. 236 PURSUANT TCH AS REQUIRED AND CONDITIONS OF OF THE TOW �y�►d-�tAidPHP�BOARD S(�d�►0��f�.ES OCCUPANCY OR USE IS UNLAWFUL-, WITHOUT CERTIF� � I b 0 OCCUPANCY M' P lox 1'Farm W-A Y F I El Pi L-"' i ^R 1 1 MANUFACTURED N U. S . P REWAY IN l�.F l•' n '�A r WISCONSIN RAPIDS, INISCQN$J,, ti RREPLACE STOVE U =J y MODEL NUMBER TYPE i9a MINIMUM CLEARANCE TO COMBUSTIBLE CONSTRUCTION IN INSTALLATIONS SHOWN = —• r � 2 21 20i w ra , 36" TO B "IN-STALLED W TH PREWAY LABELED FIREPLACE STOVE RAR, , LOWER CHIMNEY CONNECTOR PART NO. Y12481 AND UP R CHIMNEY CONNECTOR PART NO. Y12479 479! 1N CONa „1VNCTION WITH APPROVED LOW—HEAT APPLIANCE TYPE OR MASONRY CHIMNEY. • 1. C. B. 0. RE EARCH REPORT Pik?. d► L • CCR SIDING 18 Ducky Lane, Mastic Beach, New York 11951 (516)281-4931 Chu Stb 3 t S "llrl01 PROPOSAL SUBMITTED TOPHONE DATE 1Ao1CS �� IIlbfi5 (�UC ,?- � STREET --+ ( I( F 5 4 1 F f d JOB NAME CITV,STATE,ZIP CODE M 4 "{ (L fJ 'A JOB LOCATION ARCHITECT DATE OF PLANS k JOB PHONE Wo hereby propose to furnish materials and labor necessary for the completion of: 61, Ic 1�►a•� C W ft�fl VjIn) zwto 0a. � �� k, � tA "Lb,,-4 y o Lk s C ,, v✓ ; r3 L t,4� 3-' W rJ DG,�.s s Q- 5 w x y� D N W tV; N .L"L1',t S C,; 3 1 -0- 1'i -D- i -7 Vj 10 tl. V-�S l.s' S �1 �.3 D - 1-r IJ 3 30 X t wJrjnuw 3 33 �- M W . iJ VV (& 5 4 4,-r ,. r u - t rJ, nt-b o wr �e Vropuse hereby to furnish material and labor—complete in accordance with above specifications.for the sum of: dollars(S ) Payment to be made as follows: All material la guaranteed to he as specified All work to be completed in a substantial workmanlike manner according to specifications submitted,per standard practices Any Authorized alteratlonordevlatlonrromabovespecificationsInvolvingextracostswillbeexecutedonly Signature upon wrttan ord6ra,and will become an extra charge over and above the estimate. All agreements contingent upon strikes,accidents or delays beyond our control. Owner to + carry fire,tornado an*other necemary insurance Our workers are fully covered by Note: This proposal may be Workmen's Compensation Insurance. withdrawn by us if not accepted wkthkn , days. �lcceFith. The above prices,specifications and conditions are satlsfactory and are hereby accepted. You are authorized to do the work as specified. Signature Payment will be made as outlined above. Date of Acceptance Signature