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HomeMy WebLinkAbout34801-Z FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No: Z-33817 Date: 07/08/09 THIS CERTIFIES that the building HEATING SYSTEM Location of Property: 5430 WESTPHALIA RD MATTITUCK. (HOUSE NO. ) (STREET) (HAMLET) County Tax Map No. 473889 Section 113 Block 11 Lot 19 Subdivision Filed Map No_ Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated JUNE 19, 2009 pursuant to which Building Permit No_ 34801-Z dated JUNE 19, 2009 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 HEATING SYSTEM AS APPLIED FOR. The certificate is issued to WILLIAM H SPARKE JR & CLAIRE P (OWNER) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A ELECTRICAL CERTIFICATE NO_ 3011744 10/23/06 PLUMBERS CERTIFICATION DATED N/A thorized Signature Rev. 1/81 Form No;6. :. TOWN-OF SOUTHOLD ' BUH DING:DEPARTMENT TOWN HALL 765-1802 0 0 APPLICATION-FOR CERTICATE.OF OCCUPANCY. - This.application.must be filled in by typewriter or ink and submitted to the Building Department with. A, For nevv building or'new use: 1. . Final survey of.piopeirty with.accurate location of all buildings,property lines;.streets,and unusual natural,or ' .;topographiceatvres:. 2: 'Final Approval from Health Dept.of-.water•supply and.sewerage-disposal:( -9 form). . 3. 'Approval of electrical installation fi om Board of Fire:Undervriters. . 4. . Sworn sig(=. ent from plumber certix`yi�ig thatthe solder used in system cpntains less than 2/10 of I%,lead., S. Commercial:building;in ustrtal build g;multiple residences,and siini ar buildings and installations;,a certificate of.Code.Compliance:from arehitect.oi-engineer r' onsible-for.the:.building. 6. Submit 1plaiinin Board. meal of com feted site fan rep g: App .P p equirements.. B.: For existing buildings(prior to AFrii.9,1957)nvn-conforming.uses,or.buildings aizd uprc-existing't.land•uses: I. Accurate survey of property- ylne steets,:bhg gd•unusual.n rtopographicu -features. . I. 'A properly completed•appiicatioii�and consent to.inspect.signed by the applicant:If a Certificaw.of.Occupancy.'is denied_,:the wilding.Inspector shalhstate tfie reasons therefor in writing;to the applicant. = : C. Fees I. , Certificate:afoccupancy=.New dwelling.$25;00;Additions to dwelling:$25.00,Alterations to>dwelling$25 Swir nciing pool$25:00,Accessory building-$25:00,Additions to accessory building$2.5.00,Businesse $50.00 s ;' . 2: Certificate of Occupancy:on Pre-existing Building- $100.OU 3:.. Copy of Certificate,of Occupancy=$:25 4-. .:Updated Certificate of Occupancy- $5-0:00 5: 'temporary.Certificatc of.Occupan�y-Residential$15.00.Commercial$15.00 . Dat ep, . New.Construction: .:, Old or Pre=existing Building:. check one Location'of Property: .. IN�'f- .� 4'L t.l� 1�. . ;-4 4 4)4-�✓G Rouse No. ;.. .-Street, Hamlet: . Owner or Owners.of Property: : l�y`1.L;4.1 Suffolk County Tax Map-No,4.000;.Section l,l "7,L Block- ®D >-. Lot d Subdivision Filed Map.' .lot: hermit No. Date of Permit; :® l �v Applicant:_ r L.A- i f t�' _ 69 GZ 1ti Health Dept..Approval:. Underwriters Approval: Planning Board Approval:._ . Request.for: Temporary Certificate: , . : Final.Certificate: (check one) V Fee Submitted: $. - eecp" �,311 II Applicant Signature ' . MINo 5 BY THIS CERTIFICATE OF COMPLIANCE THE 5 5 NEW YORK BOARD OF FIRE UNDERWRITERS 5 5 5 5 BUREAU OF ELECTRICITY 5 5 40 FULTON STREET - NEW YORK, NY 10038 c� 5 CERTIFIES THAT S l 5 5 Upon the application of upon premises owned by 5 5 5 WILLIAM SPARKE WILLIAM SPARKE C5 5 PO BOX 437 PO BOX 437 5 5 MATTITUCK, NY 11952 MATTITUCK, NY 11952 5 5 5 5 Located at 5430 WESTPHALIA MATTITUCK, NY 11952 CcU Number:um 3011744 e ca N b Certificate 5 r5j Application Number: 3011744 C 5 5 5 5 Section: Block: Lot: Building Permit: /`7 Y� BDC: ns11 5 5 5 5 Described as a occupancy, wherein the premises electrical system consisting of 5 electrical devices and wiring, described below, located in/on the premises at: C5 5 storage shed,Outside, CJ 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 promulgated by the State of New York, Department of State Code Enforcement and Administration, or other 5 authority having jurisdiction, and found to be in compliance therewith on the 23rd Day of October,2006. 5 Name QTY Rate Rating Circuit Type 5 Miscellaneous 5 5 out door storage shed 5 5 with attic space 5 as built-1998 5 5 Wiring and Devices 5 5 Outlet 3 0 Fixture 5 5 Fixture 3 0 Incandescent 5 Outlet 3 0 General Purpose Receptacle 1 0 General Purpose 5 5 5 Switch . 3 0 General Purpose S Receptacle 1 0 GFCI 5 5 An as built inspection,of the delineated electrical installation,determined that an obvious hazard is not present and the installation is believed to 5 be in comformance with the applicable reference standard for the estimated period of construction of the premises wiring system. 5 5 5 5 - 5 5 Seal 5 I I of . . 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 5 o ����������������������������������������������������������� o 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. 34801 Z Date JUNE 191 2009 Permission is hereby granted to: WILLIAM H & CLAIRE SPARKE P.O. BOX 437 MATTITUCK,NY 11952 for INSTALLLATION OF HEATING SYSTEM .AS APPLIED FOR. REPLACES EXPIRED, BP # 31746 i at premises located at 5430 WESTPHALIA RD MATTITUCK County Tax Map No. 473889 Section 113 Block 0011 Lot No. 019 pursuant to application dated JUNE 19, 2009 and approved by the Building Inspector to expire on DECEMBER 19, 2010 . Fee $ 150 . 00 Authorized Signature. ORIGINAL Rev. 5/8/02 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. 34801 Z Date JUNE 19, 2009 Permission is hereby granted to: WILLIAM H & CLAIRE SPARKE ._ P.O. BOX 437 MATTITUCK,NY 11952 for INSTALLLATION OF HEATING SYSTEM AS APPLIED FOR. REPLACES EXPIRED BP # 31746 at premises located at 5430 WESTPHALIA RD MATTITUCK County Tax Map No. 473889 Section 113 Block 0011 Lot No. 019 pursuant to application dated JUNE 19, 2009 and approved by the Building Inspector to expire on DECEMBER 19, 2010 . .Fee $ 150 . 00 az -� Authorized Signature ORIGINAL Rev. 5/8/02 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. 31746 Z Date JANUARY 20 , 2006 Permission is hereby granted to: V q3 WILLIAM SPARKE 5430 WESTPHALIA RD MATTITUCK,NY 11952 for INSTALLATION OF A HEATING SYSTEM AS APPLIED FOR at premises located at 5430 WESTPHALIA RD MATTITUCK County Tax Map No. 473889 Section 113 Block 0011 Lot No. 019 pursuant to application dated JANUARY 18, 2006 and approved by the Building Inspector to expire on JULY 20, 2007 . Fee $ 150 . 00 Authorized Signature ORIGINAL Rev. 5/8/02 SOUlyolo TOWN OF SOUTHOLD BUILDING DEPT. 765-1802 INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] INSULATION [ ] FRAMING / STRAPPING [,FINAL [ ] FIREPLACE A CHIMNEY [ ] FIRE SAFETY INSPECTION [ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRATION REMARKS: DATE INSPECTOR FIELD INSPECTION REPORT DATE COMMENTS FOUNDATION(1ST) y 1 � ------------------------------------ N C FOUNDATION(2ND) U -� z � o CA ROUGH FRAMING& CrJ PLUMBING y r INSULATION PER N.Y. y STATE ENERGY CODE r FINAL ................................. ADDITIONAL COMMENTS 0 Z m: y z x y . x d b y s 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 www. northfork.net/Southold/ PERMIT NO. I (o i Check Septic Form N.Y.S.D.E.C. Trustees Examined I ,20�� Contact: Approved �' ,20 b(7 Mail to: Disapproved a/c Phone:_�]7� - Expiration 7 ,2007 I / — 3 ; 7' 0J i fcad'-1, ` N F [1 �! w�4 i 7 Building Inspector LT JAN1 jJ'` `T=aAPPLICATION FOR BUILDING PERMIT % ­G.S is T HOLD Date 3,guvA gy l y '' , 20 o 6 INSTRUCTIONS 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. VND15RWRITERS CERTIFICATE REQUIRED ALL CONSTRUCTION SHALL (Signature of applicant or name,if a corporation) OCCUPANCY OR MEET THE REQUIREMENTS OF THE CODES OF NEW YORK STATEzs- _r��.Hf�;�3u�d-.,.USE,.- ,.USE IS;UNLAWFUL y_ (Mailing address of applicant) 'r®T FEOOD ZONE AWTHQUVERTJF i t"hsee, t r c e E ntractor, electrician, lumbe or builder OF OCCUPANCY F1-001XDAMAGE PREVENTION APPROVED ��. �T�� SO11THIOLD T016A/n-G(D1)- Name of owner of premises tom,LLi41/ S r&e-1 DATE: SO B.F.r_ 31 d (As on the tax roll or lates€M-ed ,5 :,-_ BY:. If applicant is a corporation, signature of duly authorized officer NOTIFY BUILC,:,VL. ut7P,"37MENT AT 765-1802 8 4U, Tr' :! FOR THE (Name and title of corporate officer) FOLt."''`�Ilv� lils�t: 1. FOUNDATION - TV,"') REEQUIRED FOR POURED CONCRETE Builders License No. 2. ROUGH - FFA`:ING & PLUMBING Plumbers License No. 35'y 9 — P 3. INSULATION Electricians License No. 4. FINAL - CONSTRUCTION MUST Other Trade's License No. BE COMPLETE FOR C.O. ALL CONSTRUCTION SHALL MEET THE 1. Location of land on which proposed work will be done: REQUIREMENTS OF THE CODES OF NEW SY30 W= T t_ P1ti4 ri, t u N 1 9YORK STATE. NOT RESPONSIBLE FOR a House Number Street / Ady he -`:ate, WU9 rs,^u�R 1�11l1�3 lllltiii(7(:tiff vallllU°I County Tax Map No. 1000 Section I I3 Block TWS,8i Sk uli ceziq-' Subdivision Filed Map No. Lot (Name) 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 Removal Demolition Other Work o r 4 Z C A s -Co ,✓�t.rr, l3Yrn (Description) 4. Estimated Cost f 2,9 2 5 b o 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 occupancy, specify nature and extent of each type of use. 7. Dimensions of existing structures, if any: Front Rear Depth Height Number of Stories Dimensions of same structure with alterations or additions: Front Rear Depth Height Number of Stories 8. Dimensions of entire new construction: Front Rear Depth Height Number of Stories 9. Size of lot: Front Rear 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 w,itpant Spi4jKa% Address S',t3o wt..TrPg41—f-i 9-9Phone No.(o1) )?'77 Name of Architect Address Phone No Name of Contractor Kav C?Nn t't�,H.�,tii NrQ7K4 ^4. Address !2 4 seAlw 7 $Ldj'• Phone No. (.V— f I 15 a. Is this property within 100 feet of a tidal wetland or a freshwater wetland? *YES NO * IF YES, SOUTHOLD TOWN TRUSTEES &D.E.C. PERMITS MAY BE REQUIRED. b. Is this property within 300 feet of a tidal wetland? * YES NO * IF YES, D.E.C. PERMITS MAY BE REQUIRED. ' :''^ '` '`!`'' '�j 16. Provide survey, to scale, with accurate foundation;plan and distances',tq property lines. r �•': i 1 . .e...✓ .tit.,L.+ 00 17. If elevation at any point on property is at 10 feet or below, must provide topographical data'onts'Ev 3 i e STATE OF NEW YORK) SS: COUNTY OF§ttf-rt'1LCL (T n�M—r-Pa C -�fc being duly sworn, deposes and says that(s)he is the applicant (Name 6f individual signing contract) above named, (S)He is the Pw4�� (Contractor,Agent, Corporate Officer, etc.) of said owner or owners, and is duly authorized to perform or have performed the said work and,to make and file this application; that all statements contained in this application are true to the best of his knowledge and belief, and that the work will be performed in the manner set forth in the application filed therewith. Sworn to 109re y e this/ �y 20 of a NdkFy Public COL gW Sigjqf e of Applicant Notary Public State of Naw Ybdt No.O1�E6097127 Qualitiad.i, Suffolk r iflonfnwsiai'�ros 1 .2007 1 TL-aT - � �� O�•1``� ...� _n... .SnNDy !ice ,�• t" {� 7 3 .... ... ' ]t i ate c ,•� 1j�----1'; - CrX�RAYb L + • L01-10v L OT I 4NA 0 r T � i � _ � �j SURve•yt-r� �r� I 3 W I L. L A 1 .1 . � A >� 1 � >,J f� 1 S 7 3 .5_�'� •'�? i:. I C1CS.0 l --...._. _.. ... ....._._._..._..._...._._ :.--.-,... _ : .__:-�_�� ,►,n, s I 1 1%n p t z.. .... ..... ... _ _.._.._... _......... 0 . 91TU&Ttz AT i z 4.. Z, LL A . A y SiiNI7 Pr �.�1 f!\!.\T 1 �4...�C i'� LT.U�nVE TOWN or-SOUTI40Ln,.W.>: 14/ ' .W Ir { ir or {!(( ..s t i C� h� 9NY$R,'C01,l f'CtC�1 CT•!OM I — �utr L.L UNAUTHORIlED ALTERATION OR ADDITION L fT ; I' ���� TO THIS SURVEY IS A VIOLATION OF SECTION 7209 OF THE 14EW YGRK STATE EDUCATION LAW. i i I c, t r T un� - &s s u!/ L '66.4 C L1;V. fq _ r Ql nT,'5QuT-'4wL-5T C,0�N�� or rrZr Allst-,5 COPIES OF THIS SURVEY MAP NOT BEARING 7' -1 6 (3%. 1 1 1 THE LAND SUrVEYOR'S INKED SEAL OR •L,Q-j tVIJ/AP�1+f'�� St•I�?�YN fiC ('�C1.TC7 EMBOSSED SEAL SHALL NOT BE CONSIDERED • - r _ j TO BE A VALID TRUE COPY. "!N&P of LOTS NT /M'•f I QCt/,,L,% - rROpfrRZ'Y OF VA'`.P3-C`•r3L-lt-.t- J F'1Lt:D 1 GU ARAf:TE;S INDICATED HEREON SHALL RUN ONLY TO TH, ri:.: ?;J FOR WHOM THE SURVEY ►r. ; u I vT� �, ``' IN rt-0!r SUf; F•ot.f� C0�3�tTY C�EfZIC' IS FREFAIiED, A:.1 0,. Nis CcIiALF TO THE {, d -fl-lr.tr 93 &[O f''!e T415 AN t:) To ` TITLE CORiFANY, i'r:iVLRi:;+iFN,AL AGENCY AN LLNDI::C= fI i;'STiIU .1N LISTED HJZt ON, AND } i k ur�l1P OP TOtAI>"1V.00f? FSL LJ AS j t i7 j TO THE AL'S C S CF WE LENDING INSTI- �C��'; //./-�(a Ne 175. I TUTiON. GUA!:AP:7E.S A..• NQT TRANSFERABLE { TO ADDITIONAL INS fl.UU.:wS OK SUBSEQUEN ' + �m OyC�►`J h, g } I OWNERS. .....0lU/NRn1-4T1:'LD TO-Tt•th U.S. L-1,A-1` i:T L.P: L) J f t•l• � �� � th,l�Ut�.J:,S�ICI;'COfh(°.^atJY .'.�l�lf� TV 3 SQUT1-tOLC� S/_/�ll:.lCCS f'�/�NIL 1 !� SUM'VLY�r�° //\/`l�Cl•f ?9, 1�3;� '� ti.scr.Nser� LNWD 'S K.�kyc;��a {t t�t��� yAt�ti4. AlA69C6P JULY IO,i974 Cri�r�Nj'c�r�'j Midco International Inc. I EC200 & EC300 Power Gas Burner Page 1 of 2 ' y as i � s .. ......... ... ....... .... .. ......... ......:........... 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