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HomeMy WebLinkAbout42825-Z gyp% c9nt,-.061, Town of Southold 8/3/2018 y P.O.Box 1179 a _ 53095 Main Rd Southold,New York 11971 CERTIFICATE OF OCCUPANCY No: 39824 Date: 8/3/2018 THIS CERTIFIES that the building RESIDENTIAL ADDITION Location of Property: 475 Midfarm Rd, Southold SCTM#: 473889 Sec/Block/Lot: 63.-7-24 Subdivision: Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated 6/28/2018 pursuant to which Building Permit No. 42825 dated 6/28/2018 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: ADDITION INCLUDING A DECK TO AN EXISTING ONE FAMILY DWELLING AS APPLIED FOR The certificate is issued to Carlsen Jenny E Liv Trust of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL ELECTRICAL CERTIFICATE NO. 42825 07-10-2018 PLUMBERS CERTIFICATION DATED 07-10-2018 G ge BeW Jr A th ed Signature i Q�SAF ocxcA TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE ay.• o�V 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#: 42825 Date: 6/28/2018 Permission is hereby granted to: Carlsen Jenny E Liv Trust C/O Jenny E. Carlsen PO BOX 363 Southold, NY 11971 To: CONSTRUCT AN ADDITION TO KITCHEN AND DECK AS APPLIED FOR. Replaces BP# 19972 At premises located at: 475 Midfarm Rd SCTM # 473889 Sec/Block/Lot# 63.-7-24 Pursuant to application dated 6/28/2018 and approved by the Building Inspector. To expire on 12/28/2019. Fees: PERMIT RENEWAL $75.00 $75.00 Building Inspector i FOXX No. s 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) 1 N o 9972 Z Date ............ . .:s .........:.........................., Permission is hereby granted to: .::: :.. ....... ................... ...... .................... ............................................. x......11.9.4.. ...... .... to ............. .. ........s .:.... ..... :. .G� ... ::4....G � �. ... .. ....�..�...... ..... �( u. .. ....uo..... .o a .......• .. .....u..........u•u.u.u..... .... u... ...... atpremises located at ... t..........:yl. ... ....cd.............. .. .. .. .. ..... County Tax Map No. 1000 Section ....... '�.... Block ....... .)...... Lot No. .. ..!.............. pursuant to application doted ......... ...�l.:. ........�..�................... 19.11..., and approved by the Building Inspector., Fee $.. :........ Bw dingW Inspector Rev. 6/30/80 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: ,{ (check one) �/ Location of Property: y� 1 � �1 d�crn PC L{ �SD 7j�, wy House No. /� Street Hamlet " Owner or Owners of Property: L' e/i-K JS611 Suffolk County Tax Map No 1000, Section Block 7 Lot 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 SOUry®l Town Hall Annex Telephone(631)765-1802 54375 Main Road C*42 Fax(631)765-9502 P.O.Box 1179 �Q roger.richert(cD-town.southold.ny.us Southold,NY 11971-0959 Q ��c4UNTY,�� BUILDING DEPARTMENT TOWN OF SOUTHOLD CERTIFICATE OF ELECTRICIAL COMPLIANCE SITE LOCATION Issued To: Carlsen Jenny E Liv Trust Address: 475 Midfarm Road city,Southold st: New York zip: 11971 Building Permit#: 42825 Section: 63 Block. 7 Lot: 24 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 10 Ceiling Fixtures 2 HID Fixtures Service 3 ph Hot Water GFCI Recpt 2 Wall Fixtures Smoke Detectors Main Panel A/C Condenser Single Recpt Recessed Fixtures 5 CO Detectors Sub Panel A/C Blower Range Recpt Fluorescent Fixture Pumps Transformer Appliances pW Dryer Recpt 30A Emergency Fixture Time Clocks Disconnect Switches 3 Twist Lock Exit Fixtures TVSS Other Equipment: "AS BUILT" - "ELECTRICAL SURVEY" - "NO VISUAL DEFECTS" Notes: "Kitchen Renovation" 40A Electric Cook Top, 1- Range Hood, 30A Electric Oven. Inspector Signature: Date: July 10, 2018 0-Cert Electrical Compliance Form.xls Town Hall Annex Telephone(631)765-1802 54375 Main Road Fax(631)765-9502 P.O.Box 1179 Southold,NY 11971-0959 BUILDING DEPARTMENT TOWN OF SOUTHOjLD JUL 1 0 2018 13UELDING DEPT. TOWN OF FVDWHOLD ,C E R T I F I N Date:- / , 2- Building Permit No. q Owner:-Z-P--�r\v Clew-Askv) (Please print) Plumber:. (Please print) I certify that the solder used in the water supply system contains less than 2JI 0 of I% lead. Sworn to before me this day of 20 Notary Publi -Couqtyl- WNIA L BERRY qg*-P6bk,SWO of WOW ftl!- klo.01BE4604689 t pF 50UlyO� # TOWN OF SOUTHOLD BUILDING DEPT. °`ycouMv,�f'' 765-1802 INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] ULATION [ ] FRAMING /STRAPPING [ FINAL [ ] FIREPLACE & CHIMNEY [ ] FIRE SAFETY INSPECTION [ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRATION [ ] ELECTRICAL (ROUGH) [ ] ELECTRICAL (FINAL) [ ] CODE VIOLATION [ ] CAULKING REMARKS: i,� Vt • DATE INSPECTOR �aoF souryo (S - * # TOWN OF SOUTHOLD BUILDING DEPT. courm, 765-1802 INSPECTION 16 /. [ ] FOUNDATION 1ST [ ] ROUGH PLBG. 6 [ ] FOUNDATION 2ND [ ] INSULATION [ ] FRAMING /STRAPPING [ ] FINAL wzg [ ] FIREPLACE & CHIMNEY_ [ ] FIRE SAFETY INSPECTION [ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRATION [ ] ELECTRICAL (ROUGH) ELECTRICAL (FINAL) [ ] CODE VIOLATION ( ] CAULKING REMARKS: DATE INSPECTOR OF SOUIyO� # TOWN OF SOUTHOLD BUILDING DEPT. cou765-1802 INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] INLATION [ ] FRAMING /STRAPPING [ FINAL [ ] FIREPLACE & CHIMNEY [ ] FIRE SAFETY INSPECTION [ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRATION [ ] ELECTRICAL (ROUGH) [ ] ELECTRICAL (FINAL) [ ] CODE VIOLATION [ ] CAULKING REMARKS: oy- lain DATE INSPECTOR _'L D, iNS"?C; ON, - JJDA: COMMENTS a, 1 . OUt1DATION ( 1st ) FOUNDATION ( 2nd ) 2 . "� ,SL7F - z ROUGH FRAME & v •PLUMBING INSULATION PER N . Y. STATE ENERGY ' CODE b l 4 . u1� s � y �C sw FINAL • z ADDITIONAL -COMMENTS : r%3 x �=2,�'/7 �� x"15•QO 5 QUO - :. 45 q 01 - X 1 - H •I�Yi x - rn _,,. .. �... - _. - - .,._ ., ., .. - - - .. w_.,_... , - .. .'r =-��'.3�:;Nvs�a-::se`�%F;v'c%a:sz'xra•at���;,;:..`a;�hc,;,•., .- '' -.. B0,1FD OF HE.ILTFi . . . . . . . . . FORM NO. 1 3 SETS OF PL.I?JS . . . . . . J4 1991 Ei� TOWN OF SOUTHOLD SUI:VEY . . _ , , * * . . . . * * BUILDING DEPARTMENT CIICCK TOWN HALL SEPTIC rOR:I _ _ �LOF SOI TI`G. SOUTHOLD, N.Y. 11971 _ . �°QII�'fV �F�Otl1'I�®Lid ` TEL.. 765-1802 ':o � TiF'f � 2 / xamincd . . . 1;. 5►. 19 9.� CHILL MAIL T0 : pproved . . . -4 a-.�. ., 19 T. Permit No. j.q g 7 4 � � . . . . . . - . - . . . . . {isapproved a/c . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . _ ® . . . . . . . . . . . . (Building, Inspector) APPLICATION FOR BUILDING PERMIT /_ � Date . . . . .�/. �P!. . 19 1/ INSTRUCTIONS a. This application must be completely filled in by typewriter or in ink and submitted to the Building Inspector, with 3 s 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 areas, and hiving a detailed description of layout of property must be drawn on the diagram which is part of this appli- Cion. 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 issued a Building Permit to the applicant. Such permit 11 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 whatever until a Certificate of Occupancy 11 have been Granted by the Building Inspector. APPLICATION IS HEREBY MADE to the Building Department for the issuance of a Building Permit pursuant to the lding Zone Ordinance of the Town of Southold, Suffolk County, New York, and other applicable LawsOrdinances or ;ulations, for the construction of bu;ldings, additions or alterations, or for removal or demolition, as herein described. applicant agrees, to comply with all applicable laws, ordinances, building co e, housing code, and regulations, and to -lit authorized inspectors on premises and in building for necessary inspections (Signature of applicant, or name, if a corporation) (Mailing address of applicant) to whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. . . . . . . . . . . . . . . . . . . ne of owner of premises �C n/? y. . .(� /.r�f?. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ' . . . . . . . . . . . . . as on the t.7t roll or latest deed) pplicant is a corporation, signature of duly authorized officer. . . . (Name and title of corporate officer) Builder's,License No. . .�,� �!f 3 /Y. Plumber's License No. . . . . .. . .. , , , . , ��a�� p-,-� Electrician's License No. Other Trade's License No. . . . . . . . . . . . . . . . . . . . . . .ocation of land on which proposed work will be done. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . souse Number • _ . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Street ^y . . Hamlet ounty Tax Map No. 1000 Section . . . .. . . . , , , , • , , . , . Block . . . .Cq� l/�.S /�eG/C . . . . . . . . . . . . . . . Lot . . . . . . . . . . . . . . . ,bdivision . . . . . . . . . . . . . . . . . Filed hlap (Name) No. Lot . . . . . . . . . . . . . .. . . . . . . . . . . . . . . . ate existing use and occupancy of premises and intended use and occupancy of proposed construction: Existing use and occupancy . . . ..��.'�,�I e,. ,fes, e Intended use and Occupancy dC h eh u !i �� • ' ,''. •' ;fit �•T,,;'. . • . Py . . . . . . . . . . . . . . . .y. . . . . . . . . . . . . . . . . . . . . -; ;, , ;.•';p`Ee,ta�/.t:1 ..•iI`9�.4 Fv��1{�,".`.°ZJ '$.l]`'1'6�. . . . . . . . . . . . 3. Nature of work (check which applicable): New Building Repair . . . . . . . . . . . . . . Rem Addition . . . . . . . . . . .�IteratIon . . . . . . Removal . . . . . I . . . . . . . . Demolition . . . or`k,.l, R'4 . . . . . . . . Other W :� .�. . .,. . . . . . . 4. Estimated Cost . . f .©.�. . . . . . . . . . . . . . . . . . . . . . . . . . . (Description). . Fcc S. If dwellin�� (to be paid on filing this application) b, 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 e • • • • ' ' 7. Dimensions of existing s each tyl�c of fisc : . . . . . . . . . . . . . . . . . . structures, if any: Front . ,. Ilea Height . Number of Stories . . . . . . . . . . . . . . Depth . . . . . . . . . . . . . . . Dimensions of same ' ' G�'��'�� •��• • • . . . . . . . . . . . . . . . me structure kvith alterations or additions: Frorft • ' • • ' ' ' ' ' ' ' ' ' Depth . . . Height Rear . . . . . . . . . . . . . . . . 8. Dimensions of entire new construction: Front ' ' ' ' ' ' ' Number of Stories . . . . . . . . . . . . . . . . . . . . . . Height . . . . . . . . . . . . . . . . . Rear. . . . . . . . . . . . . . . . Depth . . . . 9. Size of lot: • Number of Stories ' ' Front . . . . . . . . . .0. Date ofPtrrc . . . . . . . . . . . . . . . . . . . . . . Rear . . . . . . . . . . . . . . . . . . . . . . Depth . . . . - . . . . . . . . . . . . Purchase . Name . . . . . . . . . . . . . . . . . . of Former Owner . . . . . . . . I. Zone or use district in which premises are situated . . . . . . . . ' • . • . ' - ' ' ' ' ' ' ' ' ' ' ' ' ' '. Does proposed construction violate any zoning law, ordinance y'p or rentrlation: /Y3. Will lot be regraded . . Will excess fill be removed from premises: Yes No 4. -Name of Owner of premises . .v�itrx. �A/1'�.IEl� • , Address /� �I S Name of Ar-chitec-t'- -: . - - - _ - - !'7_ iti�1. _ rf�� Plione No.7r-._�f��`:� Name of Contractor . �(t'/,E•G• /SCff� • • ' ' ' ' Address . . . . . . . . . . . . . . . . . Phone No. . . . . . . . . • 3. Is this property 'o• • • • • • A wetland? s!!�� , , U SC-.w/ , phone o. , Z3;•� G� P p ty within 300 feet of a tidal wetland? 'No. *Yes No. *If yes, Southold Town Trustees Permit may be required. PLOT DIAGRAM Locate clearly and distinctly all buildings, whether existing or proposed, and,indicate all set-back dimensions from roperty lines. Give street and block number or description according to deed, and show street names and indicate whether )tenor or corner Iot. �OI dye �� / u yiWe, JE OF NEW YO ' 1NTY OF � ,�• S'S , • . • • . . . . being duly sworn, deposes and says that lie is the applicant (Name of individual signing contract) 'c named. the . . . . . . . . . . . . . . . . . . . . . . . . . (Contractor, agent, corporate officer, etc.) id owner or owners, and is duly authorized to perform or have performed the said work and to make and file this cation; that all statements contained in this application are trtie to the best of his knowledge and belief;and that the will be performed in the manner set forth in the application filed therewith. 11 to before me this ;17 . . . ` k e. day Ofn . . . c� .c (. -Y Public, . . .� v 19 . . . -c �. County ROBERT 1.tCOT y R. ,`• ROTARY PUBLIC, to of NX . . . . . . .2l/ . . . . . . . . . 4725089,Su o1 ft (Signature of applicant fthaMAY 341 ) TOWN OF SOUTHOL DD BUILDING DEPARTMENT- Electri fmC a V n Hall Annex - 54375 Main Roa O )TI 11 9 2018 Southold, New York 11971-0959 lephone (631) 765-1802 - FAX (631) 765-9502 roger.riche rtCa)town.southold`.nV.upU`DINGDEPT. ,OTGLD R ELECTRICAL INSPECTION - - Date: Z CZ 7 - - Name: a4�Lin/ License No.: email: Address: ,S' p 6 o -6� Phone No.: 4 2 JOB SITE INFORMATION: (All Information Required) Name: C1 1 /✓ Address: q7,S Cross Street: Phone No.: — -- 2- _ Xi Bldg.Pernnit#: �{y�y� email: & Tax Map District: 1000 Section: 3 Block: '07 Lot: "2 BRIEF DESCRIPTION OF XRKlease Print Clearly) Circle All That Apply: Is job ready for inspection?: ES NO Rough In ina Do you need a Temp Certificate?: YES / 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 to Q Request for Inspection FormAs /C Q o i��� O soUryol h O Town Hall,53095 Main Road Fax(631)765-9502 P.O.Box 1179 G • Q Telephone(631)765-1802 Southold,New York 11971-0959 '� a �yCoUNTY,� ' BUILDING DEPARTMENT TOWN OF SOUTHOLD May 30th, 2007 Jenny E. Carlsen P.O. Box 363 Southold, N.Y. 11971 RE: 475 Midfarm Rd. (Deck& kitchen addition) SCTM# 63 7 24 Dear Ms. Carlsen, Please be advised that your Building Permit# 19972 issued June 25th, 1991 has expired. According to the Code of the Town of Southold, a Certificate of Occupancy must be issued prior to use of the structure. To renew your Building Permit,please submit a fee of 50.00; at that time we can schedule an inspection by one of our Building Inspector's. If you have any questions, please call us at 631-765-1802. Respectfully, SOUTHOLD TOWN BUILDING DEPT. Southold Town Building Department .' 54375 Main Road Permit#: 19972 Southold,New York 11971 Permit Date: 6/25/1991 Q ` (631)765-1802 �1 Expiration Date: 12/25/1992 Parcel ID: 63.-7-24 BUILDING PERMIT RENEWAL LETTER FINAL NOTICE Dated: 3/2/2011 Applicant: JENNY E CARLSEN Location: 475 MIDFARM RD SOUTHOLD, N.Y. 11971 Work Description: RESIDENTIAL ADDITION CONSTRUCT AN ADDITION TO KITCHEN AND DECK AS APPLIED FOR. A FEE OF $50.00 IS REQUIRED TO RENEW THIS BUILDING PERMIT, THANK YOU. Owner: JENNY E CARLSEN Address: PO BOX 363 SOUTHOLD,N.Y. 11971 . The permit listed above has expired. Please contact our office as soon as possible to begin the renewal process. All work on the project must stop on the expiration date. THANK YOU, SOUTHOLD TOWN BUILDING DEPT. �r \ o� !n !�l �I flog+-thn:ITe i alta s on or addition to this surway is ro liltion of ctiori/!,.I of t o ewsYork Stahl Education Law. V/ " //rj?, ?c; --files of this senva,I map not bearing �9 iha laid sunreyo o ked sea!a (� embossod seal s all not be considered to tnr a valid truo co". i�•1%,c1 L Grantees Inds t hereon shall run cnly to tha perso for whom the surror is werjurvd,and n is brhsif to tho thda Company,gqwr it anta1 ajercy and - --"-----.----____ _ ler„fjn y in: itut �t&J ho:etDn nud to the aoauinre,pt a landing Im-d- �' tution.Guar4nt.s i re not transfarahie ��� Fa C^/ - ��'c�� F,, -i, •,Y� tprdditipnaiinsltu ons orsubseauenf pY✓t3C1'S. r% &kl D 4UG Vki L-i= lJ TOT”E-- GI,ID !ci �14 7T p F f�1 E c'C.//- v c '</r'r:'' J i t i-\/ (-I 1 C V' I IV r�' v O tb :�� �t?°Iti4S2F < ~ ' /L ( 71� I i wizy -�•_-'' �I •-1 _I:= :'.f - I - ' i I I •I•' T- - j, ;���;'�~-_:f .7�Bii !- , {;; � f � .' I B� - I 8r y I-•.r,B 34 JN j ---i- - - i-- -- i-=-►-- - -;—i- �'/dye I--1-- I T a --:- � � , t—�aR=10EF�Eie1 ovE�Q �---•- - --- ;•s,449 - o cn NON�- ' -f--NI I �( �:�%'R0t ' AIM. 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