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HomeMy WebLinkAbout34870-Z FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No: Z-33868 Date: 07/31/09 THIS CERTIFIES that the building HEATING SYSTEM Location of Property: 175 SOUNDVIEW AVE MATTITUCK (HOUSE NO. ) (STREET) (HAMLET) County Tax Map No. 473889 Section 99 Block 3 Lot 1 Subdivision Filed Map No_ Lot No_ conforms substantially to the Application for Building Permit heretofore filed in this office dated JULY 15, 2009 pursuant to which Building Permit No_ 34870-Z dated JULY 15, 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 "AS BUILT" HEATING SYSTEM TO CONVERT SEASONAL DWELLING TO YEAR ROUND ONE FAMILY DWELLING AS APPLIED FOR. The certificate is issued to VIRGINIA S MEYRAN (OWNER) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A ELECTRICAL CERTIFICATE NO_ 10715 07/29/09 PLUMBERS CERTIFICATION DATED N/A AOZhorized Signature Rev. 1/81 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$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 Date. &waq New Construction: Old or Pre-existing Building: (check one) Location of Property: I ­1'64W4 UI L%.V H-J Lw- /M 71-t7uC�- House No. Street Hamlet Owner or Owners of Property: VjeAfV16 Suffolk County Tax Map No 1000, Section S'9 Block 3 Lot [, Subdivision Filed Map. Lot: Permit No. e�) )D Date of Permit.-4 • ©q Applicant: Health Dept. Approval: Underwriters Approval: Planning Board Approval: Request for: Temporary Certificate Final Certificate: (check one) Fee Submitted: $ C) Y CG -L6- Applicant Signa e f�. E C E � V E D SUFFOLK BUREi� U of ELECTRICAL JUL 31 M INSPECTORS, i 40 Nottingham Drive, Middle Island, NY 11953 BLDG.DEPT. Telephone:631 4958136 • Fax:631 980 6455 • E-Mail: SBEIG WN OF SOUTHOLD ' CERTIFICATE OF ELECTRICAL COMPLIANCE Applicant: Sabat Electric Certificate No.: 10715 Rough In Inspection Date: July 29 ,2009 Final Inspection Date: July 29 ,2009 Application No.: 10715 Building Permit No.: Suffolk County Tax Map No.: This Certificate of Electrical Compliance is limited to the inspection and compliance of electrical equipment and/or work described below, installed by the applicant named above, located at the premise of and not after the final inspection date above: All Owner: Virginia Meyran Site Location: 175 Soundveiw Ave., Mattituck, NY 11952 Owner's Address (if different): +❑Residential Indoor R Basement El Service ❑Shed ❑Commercial 0 Outdoor [:1 First Floor El Pool El Hottub 0 New 0 Renovation 0 Second Floor El Attic 0 Garage ....... ........................ .............................. ❑Addition 0Survey Other:!furnace wiring INVENTORY , Single Phase Heat 1 Duplex Recpt Ceiling Fixture l HID Fixtures I Three Phase Hot Water GFCI Recpt Wall Fixture Smoke ——' — Main Panel AC Cond l Single Recpt Recessed Fixture CO Detect Sub Panel AC Blower Range Recpt Flourescent I Pumps " Transformer Appliances Dryer Recpt Emergency Time Clock — - - Disconnect Switches l Twist Lock Exit Fixtures [ TVSS ;, ........... .., GFCI Breaker Heat Pump Electric Heat Pool Luminaire j Exhaust Fan ....................: ............ Other Equipment:Hot Air oil fired furnace wiring `The electrical work and/or equipment described above were inspected and appear to be in compliance with local, state and national electrical code requirements and this office. Applicant: Sabat Electric License No.: 4204ME Inspected By: Gene Surd! Date Of Certificate: Jul 29 ,2009 c Signature: 9; 2^ 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. 34870 Z Date JULY 15, 2009 Permission is hereby granted to: VIRGINIA S MEYRAN 175 SOUNDVIEW AVE MATTITUCK,NY 11952 for AS BUILT - INSTALL HEATING SYSTEM CONVERSION FROM SEASONAL DWELLING TO YEAR ROUND AS APPLIED FOR. at premises located at 175 SOUNDVIEW AVE MATTITUCK County Tax Map No. 473889 Section 099 Block 0003 Lot No. 001 pursuant to application dated JULY 15, 2009 and approved by the Building Inspector to expire on JANUARY 15, 2011. Fee $ 200 . 00 Authorized Signature ORIGINAL Rev. 5/8/02 o sol/ to fcwz--d_� - tg 7ocollm N �O TOWN OF SOUTHOLD BUILDING DEPT. 765-1802 INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PL13G. [ ] FOUNDATION 2ND [ ] INSULATION [ ] FRAMING / STRAPPING [�FINAL [ ] FIREPLACE & CHIMNEY [ ] FIRE SAFETY INSPECTION [ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRATION z REMARKS: � 1 4 � v � f DATE s ® 9 INSPECTOR OF SOUryo�o 3 � 70 �- oourm,��' TOWN OF SOUTHOLD BUILDING DEPT. 765-1802 INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] INSULATION [ ] FRAMING / STRAPPING [/FINAL [ ] FIREPLACE & CHIMNEY [� ]\FIRE SAFETY INSPECTION [ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRATION REMARKS: DATE �� � 9— INSPECTOR � �� _ FIELD INSPECTION REPORT DATE COMMENTS 1� oC� FOUNDATION(1ST) G � - -------- --------------- O FOUNDATION(2ND) t z . o. U ROUGH FRAMING& y PLUMBING r n INSULATION PER N.Y. y STATE ENERGY CODE Q.j)r 0 4qi i ✓7-� a FINAL J e ' 6 �- b ADDITIONAL COMMENTS � O z U Ui 3 O z 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 SoutholdTown.NorthFork.net PERMIT NO. V Check Septic Form N.Y.S.D.E.C. Trustees 9 { Flood Permit Examined `J ,20 �� Storm-Water Assessment Form Contact: Approved ,2001 Mail to: Disapproved a/c Phone: 917 36 Expiration )20 A- b ?' T" 631 49,r-S_1_3 g Building Inspector APPLICATION FOR BUILDING PERMIT Date 11 , 2009 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 =ffpb buil r� c s 3 p�t ins. ON LEAD CONTENT BEFORE TIFICATE OF OCCUPANCY USE IS -UNLAWFUL 1� i1Yl.= tdnO- ., DER Signature of a licant name if a corporation) SOLDER USED IN,WATER WITHOUT CERTIFICAYrg pp name, 'if SYSTEM.CANNOT OF OCCUPANCY ; � � w'I E}CC€ED V1.0 OF 1% LEAD.. (Mailing address of applicant)* �� r„ ALL CONSTRUCTION SHALL pp � � IFNS ATH� p State whether applicant is owner, lessee ar Vtt r contractor, electrician lumber or builder ' cogs or-'NE a�������;51 , UNDERWRITER&CERTIFIGH APPROVED' AS NOTED Name of owner of premises V 1 irlr LATE:Z42_ f_ B.P.## `3 �(As on the tax roll or later€deed Ott . If applicant is a corporation, signature of duly authorized officer NOTIFY,.a! '65 1kIENT- 802 8,alvi u 4 PMR I FOR THET (Name and title of corporate officer) rOLLOWING INSPECTIONS: I-. FOUNDATION - TWO REQUIRED FOR`POURED CONCRETE Builders License No. 2. ROUGH - FRAMING & PLUMBING Plumbers License No. 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 l?� S6JAA6 VIMJ Y& OT RESPONSIBLE FOR House Number Street net DD1R-1T UCTION ERRORS. County Tax Map No. 1000 Section 99 Block �3 Lot / Subdivision Filed Map No. Lot 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy •n b. Intended use and occupancy F. Q w ,T-4 JE x iS t N 6 d Cai- 3. Nature of work(check which applicable): New Building Addition Alteration Repair Removal Demolition Other Work ax (—,IV 6 ��_ (Description) 4. Estimated Cost 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 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 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. Q 1p . .10 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''r : Ysii 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�k411 1Rw� being duly sworn, deposes and says that (s)he is the applicant (Name of individual signing c ntract) 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. Sworn to before me this day of 20 _ -- MKITOTH .� Notary Public Notary ubliSeo New Yor Signature of A licant Qualified in Suffolk County Commission Expires July 28,2 /off TOWN OF � . SO UT HOLD PROPERTY RECORD CARD nR . STREET 7 VILLAGE415TRICT SUB. LOTY1lC� S M Ave . A FORMER OWNER E � UYl 'V`; �� N : T l%Q/� ACREAGE W X_ TYPE OF BUILDING ' RES.. :p SEAS. VL. FARM COMM. IIND. I . I IEst.. at.VMISC. alue LAND IMP. TOTAL DATE. REMARKS w f b p G /3a o . . , /) SV �V d oZ 7A� 3 0 a . / a/. 7� �� z —v�111 110 rn Nl ,,an d..pce a s eQl . �L z IL ING O Of 7 • � L �N RMAL B OW ALB 1FRONTAGE ON. WATER' �d Farm Acre Value Per Acre Value FRONTAGE ON ROAD Tillable 1 BULKHEAD . . Tillable 2 DOCK Tillable. . 3 , Woodland Swampland Brushland Housejlot.r Total ■ ss� ®N■■rN I • A/ } SMOVArYE'D FOR ow wa AL • �• - __ } ME-Y9- --4'1V A M-4 ONO t� 4h;c+::Ns(•,''tT"'+9 E:�.el`9'PGi'f9h9 4^r£E.°�'"i1?t.17B � . 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