HomeMy WebLinkAbout36753-Z �sgffat/ Town of Southold Annex 10/21/2011
o CG 54375 Main Road
C. x Southold,New York 11971
CERTIFICATE OF OCCUPANCY
No: 35252 Date: 10/21/2011
THIS CERTIFIES that the building AS BUILT ALTERATION
Location of Property: 3610 Bridge Ln, Cutchogue,
SCTM#: 473889 See/Block/Lot: 84,541
Subdivision: Filed Map No. Lot No.
conforms substantially to the Application for Building Permit heretofore filed in this officed,dated
9/27/2011 pursuant to which Building Permit No. 36753 dated 10/13/2011
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:
"as built"second floor alterations as applied for.
The certificate is issued to Damiani,Brad&Damiani,Denise
(OWNER)
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL
ELECTRICAL CERTIFICATE NO. 36753 9/12/11
PLUMBERS CERTIFICATION DATED 10/17/11 Burt's Reliable Inc
r
Autho ed'Signature
TOWN OF SOUTHOLD
�g11FF0(,�caG
l BUILDING DEPARTMENT
H a TOWN CLERK'S OFFICE
SOUTHOLD, NY
�z
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 #: 36753 Date: 10/13/2011
Permission is hereby granted to:
Damiani, Brad & Damiani, Denise
3610 Bridge Ln
PO BOX 1082
Cutchogue, NY 11935
To: obtain a permit for"as built" second floor alterations as applied for
At premises located at:
3610 Bridge Ln, Cutchogue
SCTM # 473889
Sec/Block/Lot# 84.-5-11
Pursuant to application dated 9/27/2011 and approved by the Building Inspector.
To expire on 4/13/2013.
Fees:
SINGLE FAMILY DWELLING-ADDITION OR ALTERATION $832.00
CO -ALTERATION TO DWELLING $50.00
Total: $882.00
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 2110 of I Wlead.
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:
L. 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-blew 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_ Certificates of Occupancy on Preexisting Building- $100.00
3. Copy of Certificate of Occupancy-$.25
4. Updated Certificate ofOccupahcy- $50.00
5. Temporary Certificate of Occupancy-Residential$.15.00, Commercial$15.00
Date. d r2 6 —
New Construction: Old or Pre-existing Building: ' 1/ (check one)
Location of Property: tO/O /1/
House No. Street #Harnlet
Owner or Owners of Property: A je P T:1
Suffolk bounty Tax Map No 1000, Section �S Block_ C� _ Lot h/
Subdivision Filed Map. Lot:
Permit NQ. Date of Permit. Applicant:
Health Dept.Approval: Underwriters Approval: e'e5
Planning Board Approval:
Request for: Temporary Certificate Final Certificate: (check one)-
Fee Submitted: $
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��.P�n-�.o�• or�rK.�cJ
Ammlicant Signature
pF SOUryolo
Town Hall Annex Telephone(631)765-1802
54375 Main Road Fax(631)765-9502
P.O.Box 1179 �o roger.riche rt(aD-town.southold.ny.us
Southold,NY 1 1 97 1-0959
o�ycoUM`I,�
BUILDING DEPARTMENT
TOWN OF SOUTHOLD
CERTIFICATE OF ELECTRICIAL COMPLIANCE
SITE LOCATION
Issued To: Brad Damiani
Address: 3610 Bridge Lane City: Cutchogue St: NY Zip: 11935
Building Permit#: Section: $4 Block: 5 Lot: 11
WAS EXAMINED AND FOUND TO BE IN COMPLIANCE WITH THE NATIONAL ELECTRIC CODE
Contractor: as built DBA: License No:
SITE DETAILS
Office Use Only
Residential X Indoor X Basement Service Only
Commerical Outdoor 1st Floor Pool
New Renovation 2nd Floor X Hot Tub
Addition Survey Attic Garage
INVENTORY
Service 1 ph Heat Duplec Recpt 11 Ceiling Fixtures HID Fixtures
Service 3 ph Hot Water GFCI Recpt 1 Wall Fixtures 2 Smoke Detectors 1
Main Panel A/C Condenser Single Recpt Recessed Fixtures CO Detectors
Sub Panel A/C Blower Range Recpt Fluorescent Fixture Pumps
Transformer Appliances Dryer Recpt Emergency Fixtures Time Clocks
Disconnect F1 Switches 5 Twist Lock Exit Fixtures 11 TVSS
Other Equipment:
Notes:
Inspector Signature: Date: Sept 12 2011
81-Cert Electrical Compliance Form
SO!/Tyo
Town Hall Annex l� Telephone(631)•76571$0.2
54375 Main Road Fax(631),7FS-9502
P.O.Box 1179 • Q
Southold,New York 11971-0959
C4UNT`1,�
BUILDING DEPARTMENT
TOWN OF SOUTHOLD
CERTIFICATION
Date:
Building Permit No. to S 3
Owner: �jq a...��ti l S C- �, 1.4 w b
(Please print)
Plumber: 1�1 G� eQ-J�r-do l e Inc
(Please.print)
I certify that the solder used in.the water supply system contains less.than 2/ 0 1%a.
lead.
(Plumbers Signatpre)
Sworn to before me this Il`
day of QcAo 7e-r 20
Notary Public; SC)A)(t(- County
BERNADETTE L.TAPLIN
NOTARY(PUBLIC#4844893
State of New York
Residing in Suffolk County
Comp►6ti00vi""N 7 X713
f OF SO�IyO�o
� 7 r3
TOWN OF SOUTHOLD BUILDING DEPT.
765-1802
INSPECTION
[ ] FOUNDATION 1ST [ ] ROUGH PLBG.
[ ] FOUNDATION 2ND [ ] IN LATION
[ ] FRAMING/STRAPPING [ FINAL
[ ] FIREPLACE & CHIMNEY [ ] FIRE SAFETY INSPECTION
[ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRATION
[ ] ELECTRICAL (ROUGH) [ ] ELECTRICAL (FINAL)
REMARKS:
DATE �® �� INSPECTOR
F1ELD 1NSPECTZ0 REPORT DATE COMA NTS.
FOUNDATION(1ST) rA
FOUNDATION(2ND)
ROUGH�'�CF&
PLUMBING
11'dSUL•A1'ION PER N.Y.
H
STATE ENERGY CODECOL A.
. .
f
. C
FINAL
.. .. ...
ADDITIONAL.COMMENTS .
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Ultz
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TOWN OF SOUTHOLD BUILDING PERMIT APPLICATION CHECKLIST
BUILDING DEPARTMENT bo 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. 3 4,75 3 Check
Septic Form
N.Y.S.D.E.C.
Trustees _
2 Flood Permit
Examined C o - 13 20 I Single&Separate
Storm-Water Assessment Form
] Contact:
Approved I 0 0 20 1 Mail to:
/ Phone:
Expiration_ — ! 20 -.
OMUST
Building Inspector
I
LICATION FOR BUILDING PERMIT
Date — 7 20INSTRUCTIONS
mpletely 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.
(Signature of applicant or name, if a corporation)
3l Mo ir, %;l,�ti� CL7,'C11,I/,-
(Mail' g address of applicant)
90
State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder
Name of owner of premises &OV /V �.E}®y119161/�
(As on the tax 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.
1. Location of land on which pro osed work will be done:
House Number Street Hamlet
County Tax Map No. 1000 Section Block 6---Lot- l/
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 1�we
b. Intended use and occupancy -7Za
3. Nature of work(check which applicable): New Building Addition Alteration__
Repair Removal Demolition Other Work
(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
Depth Height Numbe!ofSt6ries -
8. Dimensions of entire new construction: Front Rear = Dleth r�
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 �y�r`�'�'s` 7?���%ow.Address 341e 12,v,�,,�`��eC�� phone No. 7-7/z1�2
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 NO4
* 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.
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.
18. Are there any covenants and restrictions with respect to this property? * YES NO A
* IF YES, PROVIDE A COPY.
STATE OF NEW YORK)
SS:
COUNTY OF )
• r
being duly sworn, deposes and says that(s)he is the applicant
(Name of individual signing contract) above named,
LONNIE D.BUNCH
(S)He is the Notary Public,State of New York.
(Contractor, Agent, Corporate Officer, etc.) Qualified in Suffolk County
Commission Expires April 14,2 �
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.
�Sw r•n to before me thi
�day of 20
Notary Public Signature of Applicant
pF SO(/to
own klail ARAQYIAGS j0 NMI Telephone(631)7g65--1802
4375 d30 9018CA roQer.rlchertE iow l.sou IIol6y.us
P.Q. ox 1179.Q G� Q
Sou 1111 �5� d35'
a�jj �
�1 LI11 Q �I iJ a IJILDING DEPARTMENT
TOWN OF-b JTHOLD
APPLICATION FOR ELECTRICAL]NSPECTION
REQUESTED BY: ) Date:
Company Name:
Name:
License No.:
Address:
Phone No.:
JOBSITE INFORMATION: (*Indicates required information)
*Name: P Q/-)-L?
*Address: t 0 6 ►a/�,r �Air/c% G fC_,o ti "I 1! 9ES�
*Cross Street: �n col• L4F5--
*Phone No.: 6 70-
Permit No.:
Tax-Map District: 1000 Section:. .9 I-f Block: Lot:
*BRIEF DESCRIPTION OF WORK(Please Print Clearly)
(Please Circle All That Apply)
*Is job ready for inspection: YES / NO Rough In Final
*Do-you need a Temp Certificate: YES / NO
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
3675-3
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REQUIRED W C° o N
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SOUTHOL NNING Bccon a 0 c"(,�{.� APPROVED AS NOTEDn _. SOUT TOWIJTRI 'EES �,j LL
3'O ROOF VENT \ Oc `r� N
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DATE �� �r B.P. # 3b��3 -y..��-�-�-- . .S.DEC � a.
3 2ND. FLOOR PLAN F� �3���® BY
12 „k V4 ' — it NOTIFY BUILDING DEPARTMENT AT
WO L!V 13' SCALE. 1 -O 765-1802 8 AM TO 4 PM FOR THE of NE1N
FOI'LOJVING INSPECTIONS:
1. FOUNDATION -TWO REQUIRED .j► F�. ,�
C.
.I
FOR POURED CONCRETE
3 2. RQIJGH-FRAMING,PLUMBING,
STRAPPING, ELECTRICAL&CAULKING "' w
c °-o1 TOAPROVED 3. INSULATION y 2 Now SEPTIC SYSTEM
4. FINAL-CONSTRUCTION &ELECTRICAL ~o. 052���
SLOPE'1/4"PER FOOT PITCH TO DRAIN MUST BE COMPLETE FOR C.O.1-
OFESg�pN� SHEET NO:
ALL CONSTRUCTION SHALL MEET THE
(� l� REQUIREMENTS OF THE CODES OF NEW
PLUMBING SCHEMATIC J C,� hk/k�,
YORK STATE. NOT RESPONSIBLE FOR
N.T.S. .� G�4� DESIGN OR CONSTRUCTION ERRORS.