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HomeMy WebLinkAbout42777-Z �o�g�yEFOt,��oGy Town of Southold 7/17/2015 o - P.O.Box 1179 d' 53095 Main Rd Southold,New York 11971 CERTIFICATE OF OCCUPANCY No: 39757 Date: 7/10/2018 THIS CERTIFIES that the building AS BUILT ALTERATION Location of Property: 475 Richmond Rd., Southold SCTM#: 473889 Sec/Block/Lot: 51.-6-22 Subdivision: Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated 6/1/2018 pursuant to which Building Permit No. 42777 dated 6/12/2018 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"bathroom in an existing one family dwelling as applied for. The certificate is issued to Carrig,Marie of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL ELECTRICAL CERTIFICATE NO. 42553 7/5/2018 PLUMBERS CERTIFICATION DATED Au o ' e Signature �gUfFO(�Co TOWN OF SOUTHOLD ��o Gyp BUILDING DEPARTMENT 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#: 42777 Date: 6/12/2018 Permission is hereby granted to: Carrig, Marie Richmond Rd PO BOX 84 Southold, NY 11971 To: legalize as built alterations to an existing single family dwelling (bathroom) as applied for. At premises located at: 475 Richmond Rd., Southold SCTM # 473889 Sec/Block/Lot# 51.-6-22 Pursuant to application dated 6/1/2018 and approved by the Building Inspector. To expire on 12/12/2019. Fees: AS BUILT- SINGLE FAMILY ADDITION/ALTERATION $443.20 CO -ALTERATION TO DWELLING $50.00 Total: $493.20 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 G Date. 0 New Construction: Old or Pre-existing Building: V (check one) Location of Property: y7 tic lal_ 04 d (Q �OLJ//1 b[ House No. n Street Hamlet Owner or Owners of Property: GL/yL / Suffolk County Tax Map No 1000, Section Jam" / Block C1 Lot vZ v? 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: $ Applicant Signature 0 Town Hall Annex Telephone(631)765-1802 54375 Main Road N Fax(631)765-9502 P.O.Box 1179 ® �Q roger.rich ert(a)_town.Southold.ny.us Southold,NY 11971-0959 BUILDING DEPARTMENT TOWN OF SOUTHOLD CERTIFICATE OF ELECTRICIAL COMPLIANCE SITE LOCATION Issued To: Carrig (Dickerson) Address: 475 Richmond Road city;Southold st: New York zip: 11971 Building Permit#: 42777 Section: 51 Block: 6 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 Service Only Commerical Outdoor 1st Floor X Pool New Renovation 2nd Floor Hot Tub Addition Survey Attic Garage INVENTORY Service 1 ph Heat Duplec Recpt Ceding Fixtures Service 3 ph Hot Water GFCI Recpt 1 Wall Fixtures 1 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 11 TVSS Other Equipment: "AS BUILT' - "ELECTRICAL SURVEY' - "NO VISUAL DEFECTS" Notes: As Built Bathroom Izl- <7 Inspector Signature: Date: July 5, 2018 0-Cert Electrical Compliance Form.xls pF SOUryolo • �o TOWN OF SOUTHOLD BUILDING DEPT. 765-1802 INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ULATION [ ] FRAMING / STRAPPING [V] FINAL [ ] FIREPLACE & CHIMNEY [ ] .FIRE SAFETY INSPECTION [ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRATION [ ] ELECTRICAL (ROUGH) [ ] ELECTRICAL (FINAL) REMARKS: -I �I WIC- VGA,) k6& .e� ire ,O�inM� �fil1 (-)Y (' DATE INSPECTOR SOUTy� * # TOWN OF SOUTHOLD BUILDING DEPT. 765-1802 INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] INSULATION [ ] FRAMING /STRAPPING [FINAL k;���� [ ] FIREPLACE & CHIMNEY [ ] FIRE SAFETY INSPECTION [ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRATION [ ] ELECTRICAL (ROUGH) [ ] ELECTRICAL (FINAL) [ ] CODE VIOLATION [ ] CAULKING REMARKS: IL 04ktwJ DATE INSPECTOR OF 50UlyOlo # TOWN OF SOUTHOLD BUILDING DEPT. °`ycou765-1802 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) [ ] CODE VIOLATION [ ] CAULKING REMARKS: DATE �� INSPECTOR�r A FIELD INSPECTION REPORT DATE COMMENTS FOUNDATION(IST) H -------------------------------------- 'FOUNDATION -----------------------------------'FOUNDATION (2ND) O ROUGH FRAMING& PLUMBING S INSULATION PER N.Y. STATE ENERGY CODE FINAL on ADDITIONAL COMMENTS ` ' 6(- n ® Og � Z � rn 4J O a\ z d b _ H 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 Southoldtownny.gov PERMIT NO. Check Septic Form N.Y.S.D.E.C.- Trustees C.O.Application Flood Permit Examined 20 Single&Separate Truss Identification Form 1� Storm-Water Assessment Form Contact: Approved 20 •�`� '�U���zy�.A �if��/'sni-i Disapproved c TOS O — Phone: / Expiration 1'Z xci Building Inspector APPLICATION FOR BUILDING PERMIT r c1un� / , 20 INSTRUCTIONS Date 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 shal l 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 Dlepartment 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) X80 /Yl�,./ • l� �at7��� !�y_ (Mailing addr s of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician,plumber or builder Name of owner of premises moi' (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 Traded.License'Nd:; 1. Location;of larid�,o11ME 10h.p oposed work will be done: z Al 119 7 House Number Street Hamlet County Tax Map No. 1000 Section Block f�,/ Lot �o� Subdivision riled Map No. Lot 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy_moi no l i _-Pn 0 . b. Intended use and occupancy S 7 3. Nature of work (check which applicable):New Building rAd'ditiJ)Q%'rC5oVA Alte ation Repair Removal, Demolition Other Work " escription) Estimated Cost Fee . (To be paid on filing this application) If dwelling, number of dwelling units �i r of.dwehngu sineach floor If garage, number of cars . . If business, commercial or mixed 66cupancy, specify nature and exAt of ac- pe of use. ,7! Dimensions of existing structures, if any: Front ,., =P;, ` FRearr Depth Height ..Number of Stories '�'h' - I � f , Dimensions of same structure with alterations or additions: Front Rear Depth Height Number of Stories Dimensions of entire new construction: Front Rear Depth Height Number of Stories' . A` Size of lot: Front Rear Depth ,,1<Date of Purchase Name of Former Owner 1 one or use district in which premises are situated JeDoes 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 <-T NO * IF YES, SOUTHOLD TOWN TRUSTEES'& D.E.G. PERMITS MAY 13E 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 , �� yr LJ;�KP�sde� 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. TRACEY L. DWYER NOTARY PUBLIC,STATE OF NEW YORK Sworn to before me this NO.olDW6306900 da f 20 QUALIFIED IN SUFFOLK COUNTY y oCO MISSION EXPIRES JUNE 30, � Notary Public Signature of Applicant W � o $11fF01��, BUILDING DEPARTMENT- Electrical Inspector TOWN OF SOUTHOLD Town Hall Annex- 54375 Main Road {� V l5 00 0 Southold, New York 11971 9 D Q � p�� Telephone (631) 765-1802 - FAX ( 7655023 201$ roger.richert(cr)town.southoId.ny.us APPLICATION FOR ELECTRICAL INSPECTION BUMDINGDEPT. TOWN-oy REQUESTED BY: - _ _ "- - _ -_" _ - Date: - - Company Na e: Name: License No.: Address: Phone No.: JOB SITE INFORMATION: (All Informatio Required) Name: C f Address: -RichfflaVD6 'ICA Cross Street: Phone No.: 1p 1 502.A C5 a I Bldg.Permit#: ? t mail: Fax Map District: 1000 Section: Block: (a Lot: BRIEF DESCRIPTION OF WORK (Please Print Clearly) aAN- rocrm ,�on Circle All That Apply: Is job ready for inspection?: YES / NO Rough In Final Do you need a Temp Certificate?: YES / NO Issued On Temp Information: (All information required) Service Size 1 Ph 3 Ph Size: A # Meters Old Meter# New Service - Fire Reconnect- Flood Reconnect- Service Reconnected - Underground - Overhead # Underground Laterals 1 2 H Frame Pole Work done on Service? Y N Additional Information: PAYMENT DUE WITH APPLICATION Request for Inspection Forrn.xls V� . ALL CpD�S pOEs . ,r �..�a l�s~'.re���� �'� TpWN A E oNs of T7- RED ?�• ki\ff ........................ 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