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Home My WebLink About29087-ZFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No: Z-29266 Date: 02/13/03 THIS CERTIFIES that the building ALTERATION Location of Property: 45475 MAIN RD (HOUSE NO.) County Tax Map No. 473889 Section 75 Subdivision Filed Map No. SOUTHOLD (HAMLET) (STREET) Block 2 Lot 12 Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated AUGUST 7, 2002 pursuant to which Building Permit No. 29087-Z dated JANUARY 9, 2003 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 ALTERATION TO AN EXISTING COMMERCIAL BUILDING AS APPLIED FOR. The certificate is issued to MICHAEL SCICCHITANO ( OWNER ) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A ELEC-rRICAL CERTIFICATE NO. 71785H 02/05/03 PLUMBERS CERTIFICATION DATED N/A u gnature Rev. 1/81 FORM NO. 3 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) PERMIT NO. 29087 Z Date JANUARY 9, 2003 Permission is hereby granted to: ROBERTA HERING 45475 MAIN ROAD SOUTHOLD,NY 11971 for : CONSTRUCTION OF AN "AS BUILT" BATHROOM AS APPLIED FOR at premises located at 45475 County Tax Map No. 473889 Section 075 pursuant to application dated AUGUST Building Inspector to expire on JULY MAIN RD SOUTH/PEC Block 0002 Lot No. 012 7, 2002 and approved by the 9, 2004. Fee $ 400.00 Rev. 5/8/02 ORIGINAL Form No. 6 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL 765-1802 APPLICATION FOR CERTIFICATE OF OCCUPANCY FEB 102003 This application must be filled in by typewriter or ink and submitted to the Building Department with the following: Ao Co 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 architcct or engineer responsible for the building. 6. Submit Platming Board Approval of completed site plan requirements. 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. Fees I. Certificate of Occupancy - New dwelling $25.00, Additions to dwelling $25.00, Alterations to dwelling $25.00, Swimming pool $25.00, Accessory building $25.00, Additions to accessory building $25.00, 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 New Construction: Location of Property: Date. February 10, 2003 Old orPre-existing Building: 454751tmln Rd (check one) Southold House No. Street Owneror Owners of Property: l~ichael Seicch£tano Suffolk County Tax Map No 1000, Section 75 Subdivision Permit No. 29087 Health Dept. Approval: Planning Board Approval: Request for: Date of Permit. I/9/03 Temporary Certificate Block 2 Filed Map. Applicant: Underwriters Approval: Final Certificate: xx (check one) Hamlet Lot 12 Lot: Fee Submitted: $ 50.00 Applicant Signature ;NOTED t PNFFOR TH [ ~NS: ~0 REQUIRE tETE ~ & PLUMBING NOTIFY BUI,LDING 765-1802,9 AM TO FOLLO.,~I~G INSPECTI( 1. FOUNDATION - FOR POURED CONCRETI ~ ROUGH. [ LNSULATION' 4. i~INAL ; CONSTRUCTION MUST ~ COMPLETE FOR C.O. ,ALL'CONSTRUCTION SHALL MEET 'THE REQUIREMENTS 0.~ THE N.Y. 'STATE CONSTRUCTION & ENERGY :CODES. NOT RESPONSIBLE FOR DESIGN OR CONSTRUCTION ERRORS OCCUPANCY OR. USE IS UNLAWFUL o WITHOUT CERTIFICATE F OCCUPANCY UND~RWRnTRS CERTIFICATE R£OUIRF. D OHORNO ASSOOIATB8 · 'Ji CHORNO ASSOCIATES ~'_ ', . .' '1, '~':: - "~ k ARCHITECTS* PLANNERS *INTERIOR DESIGN \~ t', ~. "' ..,r '"'~ / ~3.,~ EDGEMONTAVENUE QUAKERTOWN, PA 18951 ', "' ;.~" ~,\ ~ ~,.9 (215) 538-2070 ~ ? ,~.~.¢~- October 1 2002 Building Department Town of Southold New York Re: As built bathroom Ms Roberta Hedng 45475 Main Road Southold NY SCTM # 1000-75-2-12 This letter is to state that the above referenced bathroom met the applicable codes at the time of construction (1979). Issue Date 2/5/2003 Electrical Inspection Certificate Electrical Inspection Service, Inc. 375 Dunton Avenue East Patchogue, New York 11772 (631) 286-6642 Issued To: Heart of the Home Street: 45475 Main Road Village: Southold Zip: Section: Block: Lot: Contractor: Application 71785H 11971 Town: Southold Lic. # Was examined and found to be in compliance with the National Electrical Code. ~ Commercial ~ NV Defects ~ Pool ~ 1st Floor X~ Indoor [] Basement ~ Hot Tub [] Residential [~ Det. Garage [] Attic [] 2nd Floor ~ Outdoor [~ Addition [~ Survey Switches Receptacles Fixtures GFI Heaters A/C Fans 2 2 1 Dishwasher Washer/Amps Dryer/Amps Oven Range/Amps Microwaves Furnace Oil Gas Circulators Smoke Detector Bell Transformer Meter Amps Phase UG/OH Jacuzzi / Bldg. Permit: Other Equipment Bathroom Television CO Detector Hugo S, Surdi President Rough Inspection: 02/04/2003 Inspector: Ed Scavelli Final Inspection: 02/04/2003 Inspector: Ed Scavelli This certificate must not be altered in any manner. Inspectors may be identified by their credentials. BUILDING PERMIT EXAMINER CHECK LIST APPLICANT: PROJECT DESCRIPTION: ESTIMATED PROJECT COST: DATE REVIEWED: / / DATE SUBMITTED. : , SL;13DIV[SI(IN; ARCHITECT/ENGINrEER: FAST TRACK? SINGLE & SEPARATE CERTIFICATION-REQUIRED? NOTES: LOTS 40,000SF -100-24 Lot recognition (CRF. A'[IEI) be/hie Jtme 30, 1983/, IJNDERSIZED I OT'q FROM ,IAN.1997 100 25 b,Ie~g¢l {,,\ ncmconfi~nning at any time ZONING DISTRICT: REQ. LOT SIZE: REQ. FRONT REQ. REAR CONFORMING? ACT. LOT SIZE: _ _ _ REQ. LOT COV. PROP. ERONT REQ SIDE PROP. REAR REQ. HEIGHT ACT. LOT COV. ACT. SIDE PROP. HEIGHT WATER FRONT? PANEL #: FLOOD ZONE: DESCRIPTION: APPROVALS REQUIRED SUFFOLK COUNTY HEALTH DEPT: YES or NO, (BED #):__ TOWN SEPTIC RECEIPT: Y or N NEW YORK STATE DEC: ~'R~-ImC 9/~/?$ YES or NO SOUTHOLD TOWN TRUSTEES: YES or NO TOWN ZONING BOARD APPROVAL: YES or NO TOWN PLAN. BOARD APPROVAL: YES or NO TOWN HISTORICAL PRE (SPLIA): YES or NO DTE: / / PERMIT #:RI0- NYS ENERGY: YES OR NO : EGRESS (18 H min.? 4 sq total) VENT (SQ. FT. x 4%). BUll.DING PERMITS OPEN/EXPIRED: BP -Z / C/0 Z- HAVE PRE CO'S: Y ORN BP -Z / C/0 Z- NOTES: LIGHT (SQ. FT. x 8%) FEE STRUCT[IRE: FOUNDATION: SF FIRST FLOOR: SF SECOND FLOOR: SI: OTHER: SIr INIT TOTAL: SF FEE 1. (__ $E)- 2. ( SE)- __ SF):" SI: X $ =$ +$ __SF)= SFX $ =$ +$ +$ =$ # PAGE 01 CHORNO AS~OC~IATBB TOWN OF SOUTHOLD BUILDIN. G DEPARTMENT TOWN HALL- SOUT-HOLD, NY 11971 TEL: (631) 765-1802 FAX: (631) 765-9502 Examined ,20 O~- 20 R~.-- BUILDING PERMIT APPLICATION CHECKLIST Do you have or need the following, before applying'? Board of Health 3 sets of Building Plans Planning Board approval Survey Check Septic Form N.Y.S.D.E.C. Trustees Contact: Mail to: Phone: Expiration 17 ,;~ Building }(l(;ector- ~ff'~ ~" ':"-' APPLICATION FOR BUILDING PE~IT ~ q ~"~q ~ Date .20 ~i ~ ' 7~ ~ INSTRUCTIONS ' ~ ~~ completely anna in by t~ewfiter or in i~ ~d sub~tted to the Building ~spector with 3 sets~ac~ate plot plan to scale. Fee according to schedule. b. Plot plan showing location of lot and of b~l~ngs on pre~ses, relations~p to adjoi~ng pre~ses or public streets or areas, and wate~ays. c. The work covered by this application may not be co~enced before issu~ce of Building Pe~t. d. Upon approval of this application, the Building ~spector will issue a Building Pe~t to the applicant. Such a pe~it shall be kept on the premises available for inspection t~ou~out the work. e. No building shall be occupied or used in whole or in pan for any p~ose what so ever ~til the Building Inspector issues a Cenificate of Occupancy. f. Eve~ building pe~t shall expire if the work autho~zed has not co~enced witch 12 months aker the date of issuance or has not been completed within 18 months kom such date. If no zoning ~en~ents or other re~lations affecting the property have been enacted in the interim, the Building ~spector may authorize, in writing, the extension of the pe~it for an addition six months. Thereafter, a new pe~t shall be required. ~PLICATION IS HE,BY M~E to the Building Dep~ment for the issuance of a Building Pe~t pursuant to the Building Zone Ordin~ce of the Town of Southold, Suffolk County, New York, and other applicable Laws, Ordinances or Re~lations, for the construction of buildings, additions, or alterations or for removal or demolkion as herein described. The applicant a~ees to comply with all applicable laws, ordinances, building code, housing code, ~d re~lations, and to admit authorized inspectors on pre~ses and in building for necessa~ inspections. (S{gnamre of ap~lic~t'or n~e,- if a co~oration) (MailNg address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder Name o f owner o f preYnises ~QO ~./Z/~ (As on th~5~ax 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. Location of land on which proposed ~work will be done: /w a f,6 /dv d House Number Street Hamlet County Tax Map No. 1000 Section Subdivision (Name) 75- Block Filed Map No. Lot Lot State existing use and occupancy of premises and intended use a,nd occupancy of proposed constmction~ a. Existing use and occupancy b. Intended use and occupancy Nature of work (check which applicable): New Building Repair Removal Demolition 4. Estimated Cost o2~ ~'t~ O 5. If dwelling, number of dwelling units If garage, number of cars Addition Alteration Other Work Fee (Description) (To be paid on filing this application) Number of dwelling units on each floor 6. If business, commercial or mixed occupancy, specify nature and extent of each type of use. 7. Dimensions of existing structures, if any: Front Height. Number of Stories Rear Depth Dimensions of same structure with alterations or additions: Front Depth Height Number of Stories Rear 8. Dimensions of entire new construction: Front Rear Height Number of Stories 9. Sizeoflot: Front Rear Depth 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 Name of Architect Name of Contractor Address Phone No. Address Phone No Address Phone No. 15 a. Is this property within 100 feet of a tidal wetland or a freshwater wetland? *YES * 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 MAX/BE REQUIRED. 16. Provide survey, to scale, with accurate foundation plan and distances to property lines. NO 17. If elevation at any point on property is at 10 feet or below, must provide topographical data on survey. STATE OF NEW YORK) SS: COUNTY OF o~i2:)/'&/'~) / '~t.~-'~t c:e' ~'~ t~ '/r//d~ ~/~ 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 tree 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. Swomgojaefore me this _ _~r-7 7t~ day of CLAIRE L. GLEW Notary Public, State ~_ _N_ew York No. O1GL4879~U~ Qualified in Suffolk Cot~tY~ ~ Commission Ex,oires Dec. 8, ~ Signature of Applicant