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Home My WebLink About34156-Z FORM NO. 4 i TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No: Z-33578 Date: 03/04/09 THIS CERTIFIES that the building ELECTRIC Location of Property: 65490 MAIN RD GREENPORT (HOUSE NO. ) (STREET) (HAMLET) County Tax Map No_ 473889 Section 53 Block 5 Lot 12.6 Subdivision Filed Map No_ Lot No_ . conforms substantially to the Application for Building Permit heretofore filed in this office dated SEPTEMBER 10, 2008 , pursuant' to which Building Permit No.. 34156-Z dated SEPTEMBER 12, 2008 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 ELECTRIC UPGRADE FOR COTTAGE #29, AS APPLIED FOR. The certificate is issued to BREEZY SHORES COMNTY INC . (OWNER) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A ELECTRICAL CERTIFICATE NO_ 4017162 11/07/08 PLUMBERS CERTIFICATION DATED N/A thor' zed Szgnature Rev. 1/81 Form No.6 TOWN OF SOUTHOLD Q �R BUILDING DEPARTMENT D U TOWN HALL 765-1802 MAR - 3 2009. APPLICATION FOR CERTIFICATE OF OC UP Cy BLDG.DE TT. This application must be filled in by typewriter or ink and subinitted to the Build g DepartTIIiA 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. Corninercial 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) nou-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 $25.00, Additions to dwelling$25.00, Alterations to dwelling $25.00, Swirnrning 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, Conunercial $15.00 Date. �� b S , O 9 New Construction: Old or Pre-existing Building: t/ (check one) Location of Properly: S/� 3 (V rD . e >°Z h 0 r� W24' House No. Street Hamlet Owner or Owners of Property: tit"Der 2, Sto4� wln� Low jzj' (30 0 r) Grp"L Suffolk County Tax Map No 1000, Section U Block Lot / 2 - b Subdivision Filed Map. Lot: Permit No. Date of Permit. Applicant: ► +" 2,p e yt 2 Health Dept. Approval: Underwriters Approval: V Plaruung Board Approval: Request for: Temporary Certificate Final Certificate: (check one) Fee Submitted: $ '32S-)S _t_ �'�, �� pplicant Signature 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. 34156 Z Date SEPTEMBER 12, 2008 Permission is hereby granted to: SHORES COMMUNITY BREEZY PO BOX 546 GREENPORT,NY 11944 for REPLACE AND UPGRADE EXISTING ELECTRIC AT COTTAGE $#29 . UNDERWRITERS CERTIFICATE WILL BE REQUIRED PRIOR TO OCCUPANCY. at premises located at 65490 MAIN RD GREENPORT County Tax Map No. 473889 Section 053 Block 0005 Lot No. 012 . 006 pursuant to application dated SEPTEMBER 10, 2008 and approved by the Building Inspector to expire on MARCH 12, 2010 . Fee $ 200 . 00 , / ut Signa ure ORIGINAL Rev. 5/8/02 [JgcfrJr nrJ�rJ�rJ�r 1�rJ�cPr.PrJ�r�rJ�rJ�rJ�rJ�rJr�rJ�i�rPcPrJ�rJ�rJ�rJ�r�rJ�rJ�cPrJ��r.Jar_PrJ�cPrIPrJ�cPEJ'L J�Ell , LrJ�rJ�rJ�cPr�rJ�r�cPc l�r�r�r fr�rJL cE 5 BY THIS CERTIFICATE OF COMPLIANCE THE 5 5 NEW YORK BOARD OF FIRE UNDERWRITERS 5 5 RITERS 5 5 BUREAU OF ELECTRICITY e �j 40 FULTON STREET — YORK, NY 10038 5 5 NEW 5 5 CERTIFIES THAT 5 . 5 5 5 . Upon the application of upon premises owned by .. 5 5 5 . SC] DANIEL 1MLCENSKI ELEC.CONTR. ERIC SCHMIDT PO BOX 319 65490 MAIN ROAD S SOUTHOLD, NY 11971, GREENPORT, NY 11944 S S 5 Located at 29 BREEZY SHORES GREENPORT, NY 11944 5 5 5 SApplication Number: 4017162 Certificate Number: 4017162 5 5 5 5 Section: Block: Lot: Building Permit: 34156 BDC: 5 5 NS37 5 5 �J Described as a Residential occupancy, wherein the premises electrical system consisting of 5 5 electrical devices and wiring, described below, located in/on the premises at: 5 5 First Floor,Detached Garage,Outside,Attic, 5 5 5 A visual inspection of the premises electrical system, limited to electrical devices and wiring to the extent detailed 5 5 herein, was conducted in accordance with the requirements of the applicable code and/or standard 5 5 promulgated by the State of New York, Department of State Code Enforcwent and Adlo ei�seatic��ld8or other 5 authority having jurisdiction, and found to be in compliance therewith on the Day of C5 Name OTY Rate Rating Circuits TvDe 5 cAlarm and emergency equipment 5 5 Sensor 1 0 0 CarMoNSmoke 5 S Sensor 6 0 0 Smoke 5 Appliances and Accessories 5 5 Range 1 0 50 Amps 5 water Heater 1 0 4.5 KW 5 Panels C 5 1 100 20 5 5 1 50 3 ej Wiring And Devices c� Fixture 33 0 Incandescent 5 SOutlet 33 0 Fixture rrr5+++ 5 Outlet 78 0 Gen,Purpose 5 Receptacle 8 0 GFCI 5 5 Receptacle 52 0 Gen,Purpose 5 5 Switch 25 0 Gen,Purpose 5 5 5 5 sea/ 5 5 Continued on Next Page 1 of 2 5 5 - 5 5 5 5 This certificate may not be altered in any way and is validated only by the presence of a raised seal at the location indicated. 5 5 0 r�rJ�r�r�rJ�I;J�cPcJ'rJ�rJrJcPcJ'cP'RpLrL3rL3r rL3rL3 Cj'L3rL3rL3 Jar immuulmi.Jar.Jar:JooloorJorJ�r�rJ�rJ�r�rJ�rJ�rJ�rJ�r�PrJ�rJrJ�rJ�r..1�rJ�rJ�cPrJ�rJ�cPr�r.PrJ�rJ� a rJ�[P[.ft�.P[J�CJr P[.n[P[J rr [1MPLr Jr@@rL3r JLrL3IaPL r.P[P[ 5'[.( 010Y�rJ�rJ�rJ�[ J BY THIS CERTIFICATE OF COMPLIANCE THE 5 5 NEW YORK BOARD OF FIRE UNDERWRITERS S 5 S 5 BUREAU OF ELECTRICITY e j 40 FULTON STREET — NEW YORK, N 10038 5 5, Y 5 CERTIFIES THAT 5 5 Upon 5 5 . p the application of upon premises owned by 5 5 5 5 5 DANIEL WILCENSKI ELEC.CONTR. ERIC SCHMIDT 5 PO BOX 319 65490 MAIN ROAD 5 SOUTHOLD, NY 11971, GREENPORT, NY 11944 5 5 Located at 29 BREEZY SHORES GREENPORT, NY 11944 5 5 5 S Application Number: 4017162 Certificate Number: 4017162 5 S C5, 5 Section: Block: Lot: Building Permit: 34156 BDC` NS37 5 5 5 Described as a Residential occupancy, wherein the premises electrical system consisting of rj 5 electrical devices and wiring, described below, located in/on the premises at: C5� First Floor,Detached Garage,Outside,Attic, 5 5 5 5 A visual inspection of the premises electrical system, limited to electrical devices and wiring to the extent detailed 5 5 herein, was conducted in accordance with the requirements of the applicable code and/or standard promulgated by the State of New York, Department of State Code Enforcement and Administration, or other 5 5 authority having jurisdiction, and found to be in compliance therewith on the nth Day of November, 2008. 5 5 Name CITY Rate Ratine Circuits T-e 5 5 5 5 S 5 5 5 5 5 5 5 5 5 5 5 5 5 S 5 5 5 5 5 5 seal S 2 of 2 5 5 5 5 5 5 This certificate may not be altered in any way and is validated only by the presence of a raised seal at the location indicated. 5 rJ�rJ�r.!'tPr�rJrJ�rJ�r l�r..!rJor l�r�[.t'2rJ�t1�rJ�rJ�r�r..l'r nr�rJ�rJ�r..IrJ'r.TrJ�r1rJUMPRI�rRPM' UPPI.1" rL3j'cPcPcPr..pLpLpr-pc nr..!'cPrJ0�9 0f 9Pr POPE IUMIN-L IN 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 Q /(l/_ Survey SoutholdTown.NorthFork.net PERMIT NO. 7 J(f/ Check Septic Form N.Y.S.D.E.C. Trustees Flood Permit Examined 120 Storm-Water Assessment Form Contact: Approved ,20 �� Mail to: Disapproved a/c i COMPLI� Expiration Z ,20/0 NEW YORK STATE & TOWN CODES AS REQUIRED AND CONDITIONS OF rTWN Building Inspector SOUTHOLD TOWN ZBA APPLICATION FOR BUILDI SOUTHOLD TOWN PLANNING BOARD, 02008 SOUTMOLD TOWN TRUSTEES Date , 20N.YS;DEC G.DEPT. INSTRUCTION SO!!THOLD 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 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. OCCUPANCY OR A( l USEIS UNLAWFUL 0 v (Signature of applicant or name,i corporation) WITHOUT CERTIFICATE 15 8 WADS WoP-T K h ve-,. /s AofA mohi'cA c A OF OCCUPANCY (Mailing address of applicant) 9 OYO5 State whether applicant is,owner, lessee, agent, architect, engineer, general contractor, electrician,plumber or builder O W h e, Name of owner of premises /r/A P- A 12.Q4 tie"0 e n RY a /. - AED AS NOTED (As on the tax roll or late9tAJ 8-P•#1 If applicant,is.a corporation, signature of duly authorized officer FEE ILL, BY: (� d t Qf c�r�p NOTIFY BUILDING DEPARTMENT AT ALL Garon ;I IUIV,�tiHL ate officer) _ 765-1802 8 AM TO 4 PM FOR THE FOLLOWING INSPECTIONS: B� T Fc EMENTS OF THE 1. FOUNDATION - TWO REQUIRED � � � ' FOR POURED CONCRETE Plum n o. ,�.,,.. ,.._:_...,,. Electricians License No. 2. ROUGH - FRAMING & PLUMBING Other Trade's License No. 3. INSULATION 4. FINAL - CONSTRUCTION MUST BE COMPLETE FOR C.O. 1. Location of land on which proposed work will be done: ALL CONSTRUCTI N SHALL MEET THE 5 ot a 81 y p THE CODES OF NEW House Number Street HaIYORK STATE. NOT RESPONSIBLE FOR DESIGN OR CONSTRUCTION ERRORS. County Tax Map No. 1000 Section 0 5 Block 0 D U 5 Lot 011 . 006 Subdivision Filed Map No. Lot 2. State existing use and occupancy of premises and intended use and occupancy of proposed constructio�i: a. Existing use and occupancy S y M me- A- 14 0 uS.2 b. Intended use and occupancy S AM E 3. Nature of work (check which applicable): New Building Addition Alteration Repair Removal Demolition Other Work ge-P L W e e Le T 1Z i^c- (Description) 4. Estimated Cost / 6 , o o D 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 occupy•cy, specify nature and extent of each type of use. ,.,_,; �.,- ,.�....,;�,;-, ,,. ::.;., r: T :: ,T��r , , •��.. 7. Dimerigioiis of`e isting..structures„if any:-Fronk Rear Depth Height, , r, . `lfumbe('of Stories Dimensions,.of sarne.struptwre with alterations or additions: Front Depth Fleight Number of Stories. st 1 C%l P� 4 8. Dimensions of entire new_-construction:Front Rear J Depth, i Height Y Number of Stories 9. Size of lot: Front Rear Depth 10. Date of Purchase APR-i• l 9-0 0 O Name of Former Owner SA G e- 11. Zone or use district in which premises are situated 12. Does proposed construction violate any zoning law, ordinance or regulation? YES NO x 13. Will lot be re-graded? YES NO X Will excess fill be removed from premises? YES NO r68 wgo.twor?41' 4ve uo 14. Names of Owner of premisesMP!44ize�- e1'Den1Z Address5my M Man;cw 04 9oy hone 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 X 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:. �,Ji 9iVe 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''o;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 ) being duly sworn, deposes and says that(s)he is the applicant (Name of individual signing contract) above named, CONNIE D:.BUNCH AIN11Tf lv?R�Tl k`i I1 '.a Nota►YNo,OlbU6185050w Yotlt (S)He is the �;-� " - - lmed.in Suffolk coty (Contractor,Agent, Corporate ffl%e ,,etc.) Commission1 pires April 14n 0' 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 day of 20_P& I d, ( cJ Notary Public Signature of Applicant