HomeMy WebLinkAbout36465-Z agUFFOc Town of Southold Annex 6/23/2011
°Gym 54375 Main Road
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' Southold,New York 11971
CERTIFICATE OF OCCUPANCY
No: 35019 Date: 6/23/2011
THIS CERTIFIES that the building HVAC
Location of Property: 1355 Deep Hole Dr,Mattituck,
SCTM#: 473889 Sec/Block/Lot: 115.43-12.1
Subdivision: Filed Map No. Lot No.
conforms substantially to the Application for Building Permit heretofore filed in this officed dated
6/3/2011 pursuant to which Building Permit No. 36465 dated 6/9/2011
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:
central air conditioning for a one family dwelling as applied for.
The certificate is issued to Leone,Anthony&Leone,Angela
(OWNER)
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL .
ELECTRICAL CERTIFICATE NO. 36465 6/20/11
PLUMBERS CERTIFICATION DATED
VAuthorized Signature
�g�FFO(�-Cow
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
co x TOWN CLERK'S OFFICE
o . 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#: 36465 Date: 6/9/2011
Permission is hereby granted to:
Leone, Anthony & Leone, Angela
PO BOX 1564
Mattituck, NY 11952
To: installation of an air conditioning system as applied for
At premises located at:
1355 Deep Hole Dr, Mattituck
SCTM # 473889
Sec/Block/Lot# 115.-13-12.1
Pursuant to application dated 6/3/2011 and approved by the Building Inspector.
To expire on 12/8/2012.
Fees:
SINGLE FAMILY DWELLING -ADDITION OR ALTERATION $200.00
CO -ALTERATION TO DWELLING $50.00
Total: $250.00
Building Inspector
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 2l10 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.andunusual 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: evu-'n TI'Lc
House No.4 Street Hamlet
Owner or Owners of Property:
Suffolk County Tax Map No 1000, Section Block 1 Lot- c�-
Subdivision Filed Map. Lot:
Permit No. Date of Permit. Applicant:
Health Dept.,Approval: Underwriters Approval:
Planning Board Approval:
Request for: Temporary Certificate Final Certificate: 4 (check one)
Fee Submitted: $ D-
Applicant Signature
SO�ryolo
Town Hall Annex Telephone(631)765-1802
54375 Main Road N Fax(631)765-9502
P.O.Box 1179 G Q
Southold,New York 11971-0959 '' �� roger.riche rt(-town.southold.ny.us
�yCOUNT`I,Oc�
BUILDING DEPARTMENT
TOWN OF SOUTHOLD
CERTIFICATE OF ELECTRICIAL COMPLIANCE
SITE LOCATION
Issued To: A&A Leone
Address: 1355 Deep Hole Dr City: Mattituck St: NY Zip: 11952
Building Permit#: 36465 Section: 115 Block: 13 Lot: 11&12
WAS EXAMINED AND FOUND TO BE IN COMPLIANCE WITH THE NATIONAL ELECTRIC CODE
contractor: DBA: Pariti Electric License No: 40723-me
SITE DETAILS
Office Use Only
Residential X Indoor X Basement X Service Only
Commerical Outdoor X 1st Floor Pool
New Renovation 2nd Floor Hot Tub
Addition Survey Attic Garage
INVENTORY
Service 1 ph Heat Duplec Recpt Ceiling Fixtures HID Fixtures
Service 3 ph Hot Water GFCI Recpt Wall Fixtures Smoke Detectors
Main Panel A/C Condenser 1 Single Recpt Recessed Fixtures CO Detectors
Sub Panel A/C Blower 1 Range Recpt Fluorescent Fixture Pumps
Transformer Appliances Dryer Recpt Emergency Fixtures Time Clocks
Disconnect 1 Switches 1 Twist Lock Exit Fixtures TVSSEl
Other Equipment: central air conditioning with service disconnect at condenser
Notes:
Inspector Signature: Date: June 20 2011
81-Cert Electrical Compliance Form
OF SOUlyolo
00umv,�c�
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
[ ] ELECTRICAL (ROUGH) P��ELECTRICAL (FINAL)
REMARKS:
DATE
INSPECTOR '
f}din Q,l:idlS's.6}`r'.L':wl: I
TOWN OF SOU'THOLD tj.m;j pVq fz" UILDING PERMIT APPLICATION CHECKLIST
BUILDING DEPARTMENT oojn;byip vc - yjrw.ApWc Do you have or need the following,before applying?
TOWN HALL Board of Health
SO.UTHOLD, NY 11971 4 sets of Building Plans P)r cZ G ti
TEL: (631) 765-1802 Planning Board approval
FAX: (631) 765-9502 / Survey
South oldTown.NorthFork.net PERMIT NO. 3�p 7 � S Check
Septic Form
N,Y.S.D.E.C.
Trustees
Flood Permit
Examined 6 20 Single&Separate
Storm-Water Assessment Form
Contact:
Approved 20 Mail to:
Disapproved a/c
Phone: _
Expiration / ,20_Lk- i 1 ("3/— s-1•3
�n r Building Inspector
D
V LICATION FOR BUILDING PERMIT
JUN -_ 2 2011 Date , 20
INSTRUCTIONS
This applic
WN be comp etely filled in by typewriter or in ink and submitted to the Building Inspector with 4
� „�f�
sets of p e. ee 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 Pen-nit.
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.
`ANC"' OR (S' 'ature of 1'c t or name, if a corporation)
s;S UNLAWFUL
(Mailing address of applicant) I j
W(—(1-1 CERTIFICATE"',� A P d
Stai ffvh�ol Of wrier, lessee, agent, architect, engineer, general contractor�Q� �cf� ,r r or builder
DATE_,B.P. # 3—��-
6 LVf4fi4-X,
FEE: / BY
Name of owner of premises 1__�AI@jIFY BUILDING DEP RTMENT AT
'70C WO 8 AM(As on the tax roll or 140Et S:G INSPECTION R THE
If applicant is a corporation, signature of duly authorized officer 1. FOUNDATION-TWO REQUIRED
FOR POURED CONCRETE
(Name and title of corporate officer) 2. ROUGH•FRAMING,PLUMBING,
STRAPPING;ELECTRICAL&CAULKING
Builders License No. . 3. INSULATION,
Plumbers License No. EL�r`�1r� � 4. FINAL-CONSTRUCTION&ELECTRICAL
Electricians License No. MUST BE COMPLETE FOR-C.O.
Other Trade's License No. owim MEQUIR
ALL CONSTRUCTION SHALL MEET THE
REQUIREMENTS OF THE CODES OF NEW
YOR1. Location of lan on which proposed work will bc..done: D S K N ORE. NOT RESPONSIBLE FOR
CONSTRUCTION ERRORS.
C 3 5 T � 1 'L �L 12 ✓�.. A-T' i T,-t c.lL
House Number Street Hamlet
County Tax Map No. 1000 Section // Block /J 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 T5 i 15N
.. R '• / f 1
b. Intended use and occupancy
3. Nature of work(check which applicable): New Building. Adc �t.Ozi + iteration
Repair Removal Demolition Other
.J r!L 1 l '(I7escr%pfion)
4. Estimated Cost �/� S'�' Fee �?S'T
(To be,&f o'n fiiirig't is applicatfon)
'..r, �
5. If dwelling, number of dwelling units I Number of dwelling unitsi on,each,floor{;
If garage, number of cars
6. If business, commercial or mixed occupancy,:specify nature and extent,of,eachitype;ofuse.
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 ` r.... Height Number of Stories
y{rid x yE 5 S(�Y.-. -t •., 1" $;+ ..
.l..
8. Dimensions of entire'new construction: Front Rear Depth
Height Number of Stories
9. Size of lot: Front Rear Depth
10. Date of Purchase Name of Former Owner
11. Zone or use district in which premises are situated
12. Does proposed construction violate any zoning law, ordinance or regulation? YES NO
13. Will lot be re-graded? YES NO Will excess fill be removed from premises? YES NO
14. Names of Owner of premises Address Phone No.
Name of Architect Address Phone No
Name of Contractor Address Phone No.
15 a. Is this property within 100 feet of a tidal wetland or a freshwater wetland? *YES NO
* IF YES,_SOU THOLD TOWN TRUSTEES & D.E.C. PERMITS MAY BE REQUIRED.
b. Is this property within 300.feet of a tidal wetland? " YES NO
* IF YES, D.E.C.-PERMITS MAY BE REQUIRED.
16. Provide surve};)to scale, with accurate foundation plan and distances to property lines.
17. If elevation at any-point on.property is at 10 feet or below, must provide topographical data on survey.
18. Are there any covenants and restrictions with respect to this property? * YES NO
* IF YES, PROVIDE A COPY.
STATE OF NEW YORK)
SS:
COUNTY OF )
being duly sworn, deposes and says that(s)he is the applicant
(Name of individual signing contract) above named,
(S)He is the ti$�g
(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
3 day of /v(A 20 l l
E00
OBERT MANNINO
Notary Publicublic-State of New York Sig i t re of Applicant
O.01 MA6190601ied 16 Nassau County
sion Expires
i
i
��°F SOveyo
Town Hall Hall Annex P
lO hone(631)765-1802
I Jf J Telephone
54375 Main Road N ax(631)765-9502
P.O.Box 1179 • �Q roger.richert[ town.southold.ny.us
Southold,NY 11971-0959
BUILDING DEPARTMENT
TOWN OF SOUTHOLD
APPLICATION FOR ELECTRICAL INSPECTION
REQUESTED BY: Date:
Company Name: Par., }i" w-t Coil k•C !l rr1C -
Name: c C,�a r A(-c
License No.: Z
Address:
S v cS ('� ✓ o r-a6 Y /t z�
Phone No.: . 7
JOBSITE INFORIVIATION: (*Ind.icates required information)
*Name: / r/ f ��� -+- ✓L, �l� G-?�-�J .
*Address: /t3 J (� � )C- t t2 ✓�: tilt
*Cross Street: M` a_l
*Phone No.:
Permit No.: �r JA
Tax-Map District: 1000 Section: �� r" Block: Lot:
*BRIEF DESCRIPTION OF WORK (Please Print Clearly) TA.S VT t t
�✓lS�c led l 2 Pd c j 02 q Sw.4--c ii . W , %'C 4 C04 o P� (k kc<,?d?e�
(Please Circle All That Apply)
*Is job ready for inspection: YES NO Rough In Final
*Do-you need a Temp Certificate: YES Q
Temp Information (if needed)
*Service Size: 1 Phase 3Phase 100 150 200 300 350 400 Other
*New Service: Re-connect Underground Number of Meters Change of Service Overhead
Additional Information: PAYMENT DUE WITH APPLICATION
82=Request for Inspection Form
Petro
30 Old Dock Road
Yaphank,NY 11980
(S16)686.19S0
(800)OIL.HEAT
Fax:(S16)686.1994 NEW SPLIT SYSTEM P E T R O
Heating Oil and Services
/riles T��T
Dear
t�
We are pleased to submit our proposal to provide central air conditioning for your
home.. We propose to furnish and install a central air conditioning system in accordance
with the following conditions and specifications. 0 0-1—J �
Condensing unit: (outside) SEER ton, high
efficiency unit set upon pre-fab mounting pad, with electrical disconnect switch.
Location to be agreed upon at the time of installation.
Air Handler: (inside) matching ,V SEER ton, high efficiency modular air
handler, mounted in the area. Safety condensate drain pans will be
mounted beneath the air handler. Primary and secondary condensate water will be
piped outside as required.
Ductwork: All ductwork will be designed, fabricated, and installed in accordance with
The Society of Heating .and Air Conditioning Engineers Standards within the limits of
existing construction conditions. All ductwork will be high grade galvanized sheet
metal. Individual supply air branches will be high quality insulated flex duct connected
to floor, ceiling or upper wall mounted diffusers.. The ( 9 Sup Drop) air supply
registers will all contain manual air volume balancing dampers. All .painting and/or
redecoration will not be the responsibility of Petro Inc.
Return Air: One (1) centrally located return air filter grille will be mounted in a
central location agreed upon at the time of installation.
P.iphig: The refrigeration lines connecting the condensing units (outside) to the air
handler (inside) will be field piped with insulated copper.tubing concealed in aluminum
leader piping..
Electrical wiring: All wiring of the systems will be connected to the existing electrical
service and panel box. All wiring to be done according to local codes.
OPERATING LOCATIONS IN:HICKSVILLE•MASPETH Nassau Lic.No.143600630000
PLAINVIEW•PORT WASHINGTON•RIVERHEAD Suffolk Lic.Nos.3134-I;2901-RE
SOUTHAMPTON•WESTBURY•YAPHANK. NYC Lic.No.678944
Design Conditions: This system is designed and engineered to maintain 15 to 18
degree Fahrenheit inside ambient air temperature difference with the outside ambient air
temperature to 90 degrees dry bulb and 67 degrees wet bulb:
Thermostat: One (1) programmable heating/cooling thermostat with fan switch to be
installed at location agreed upon at the time of installation near the return area.
Guarantee:' One (1) year guarantee on workmanship and materials, additional 9-year
warranty of the compressor carried by the manufacturer. (90,days for Non-Petro Cust)
Total Price: $_ 00
Should you require further information, please contact the undersigned. Our
opportunity to submit this proposal is appreciated, and we shall do all we can to merit
your. confidence.
Scott W. Place
Equipment Representative
(516) 686 - 1627 .
Acceptance
/7
Date ®"
f Zf f i�L/'"'.Gi1'y <rrvriLr L
-------------
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alteration or addition
to this survey Is a violation of
sectim nos of the Now York 80ft —7—Ar
Education Law.
Copies of this survey rneP not
the Land surveyor's Inked uW or
embossed sea]shall not be o0rdidGrOd VA IV
to be a valid true copy.
ll Guarantees Indicated hereon SW nm
only to the person for whom the survey
is prepared,and on his behalf to the
tWe company,governmental agency OW 0
lending Institutic n,isled hereon and N -LS
to the assignees at the lending Intl- L D SVP
tution.Guarantees are not transfambW
to additional Institutions or subsequot
owners.
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Unauthoriz*d alteration or addition
to this survey Is a violation of t
f the New York Slsla
Education Law
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Copies of ibis survey map not bow" OF ri
the land sunsvo seal Or inked s or Q �CK VAIV
embossed sea,shall not be oonsldsnd T
to be a valid true copy. C10
Guarantees indicated hereon shall run
only to the person for whom the survey
is prepared,and on his behalf to the 1
title Compa:y,;;aaernmental agency and o
lending instituti<o;isted hereon and p No.
to the assignees of the lending Intl- LAND�JP
tution.Guarantees are not transferable
to additional Institutions or subwpuntrr^
owners.
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