HomeMy WebLinkAbout36843-Z �O�gUFFOi,��o� Town of Southold Annex 12/22/2011
54375 Main Road
y Southold,New York 11971
CERTIFICATE OF OCCUPANCY
No: 35356 Date: 12/21/2011
THIS CERTIFIES that the building AS BUILT ALTERATION
Location of Property: 260 Founders Path, Southold,
SCTM#: 473889 Sec/Block/Lot: 64.-2-24
Subdivision: Filed Map No. Lot No.
conforms substantially to the Application for Building Permit heretofore filed in this officed dated
11/21/2011 pursuant to which Building Permit No. 36843 dated 11/30/2011
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"shower stall in half bath as applied for.
The certificate is issued to Sherman,David&Benitez,Roberto
(OWNER)
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL
ELECTRICAL CERTIFICATE NO. 36843 12/12/11
PLUMBERS CERTIFICATION DATED 11/9/11 ,,7 NYPC
l
Auto ed S'gnature
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
2 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#: 36843 Date: 11/30/2011
Permission is hereby granted to:
Sherman, David & Benitez, Roberto
101 Clark St
Brooklyn, NY 11201
To: install shower stall in half bath as applied for
At premises located at:
260 Founders Path, Southold
SCTM #473889
Sec/Block/Lot# 64.-2-24
Pursuant to application dated 11/21/2011 and approved by the Building Inspector.
To expire on 5/31/2013.
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 ofproperty 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 1% lead.
5. Commercial building,industrial building,midtiple 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.
D. For existing buildings(prior to April 9, 1957) non-conforming uses,or buildings and"pre-existing"land uses--
I- Accurate survey_of property showing all property lines,streets,building and-unusual natural or topographic
features_
2. A properly c-pmpleted 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 S50.00;
Swimming pool 150.00,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. /112 41AK
New Construction: Old or Pre-existing(B'uilding: (check one)
Location of Property: . 26 fo ou&j D 4 047 7-1
House No. Street p Hamlet
Owner or Owners of Property: DAV
Suffolk County Tax Map No'1000,Section Bock Lot
'Subdivision Filed Map. Lot:
Permit No. Date of Permit. Applitt
Health Dept.Approval: Underwriters Approval:
Planning Board Approval:
Request for. Temporary Certificate Final Certificate: (check one)
Fee Submitted: $ �'� v
4DDlicant ignature �, J/'t1UgJV2�if� �
SO(/r�,olo
Town Hall Annex Telephone(631)765-1802
54375 Main Road Fax(631)765-9502
P.O.Box 1179 a roger.richert(-town.southold.ny.us
Southold,NY 11971-0959
olyCOU
BUILDING DEPARTMENT
TOWN OF SOUTHOLD
CERTIFICATE OF ELECTRICIAL COMPLIANCE
SITE LOCATION
Issued To: David Sherman/Roberto Benitez
Address: 260 Founders Path City: Southold St: NY Zip: 11071
Building Permit#: 36843 Section: Block: Lot:
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 Basement Service Only
Commerical Outdoor 1st Floor X Pool
New Renovation 2nd Floor Hot Tub
Addition Survey X Attic Garage
INVENTORY
Service 1 ph Heat Duplec Recpt Ceiling Fixtures HID Fixtures
Service 3 ph Hot Water GFCI Recpt 1 Wall Fixtures 1 Smoke Detectors
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 Switches F]2 Twist Lock F1 Exit Fixtures 11 TVSS
Other Equipment: as built 1 st floor bathroom, 1 exhaust fan
Notes:
Inspector Signature: Date: Dec 12 2011
81-Cert Electrical Compliance Form
ZF S0!/To
Town Hall Annex Telephone(631)76571802
54375 Main Road Pax(631),765-9502
P.O.Box 1179 G Q
Southold,New York 1 197 1-0959 �' �O
e4[1NT`1,� .
BUILDING DEPARTMENT
TOWN OF SOUTHOLD
CERTIFICATION
Date: Q
Building Permit No. t0 I
Owner:
(Please print)
Plumber:
(Please print)
I certify that the solder used in the water supply system contains less.than 2/10 of I%.
lead.
umbers Signs re) ,
Sworn to before me this
day of AV 0V 20 �(
CLAINE L.13LEW
Notary Publi&, public qw5 C0 NOW ounty
QualifiedExpires Dec S
Commisaissim io�
TOWN OF SOUTHOLD BUILDING DEPT.
765-1802
INSPECTION
[ ] FOUNDATION 1 ST [ ] ROUGH PL
[ ] FOUNDATION 2ND [ ] INS TION
[ ] FRAMING/STRAPPING [ INAL
[ ] FIREPLACE & CHIMNEY [ ] FIRE SAFETY INSPECTION
[ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRATION
[ ] ELECTRICAL (ROUGH) [ ] ELECTRICAL (FINAL)
REMARKS:
k `o CT->j �
. DATE - l ] INSPECTOR
�OF SO(/l�, - -
# O#
VX
TOWN OF SOOT -D-B LDING DEPT.
65-1802
IN 0N '
[ ] FOUNDATION 1ST [ ] ROUGH PLBG.
[ ] FOUNDATION 2ND [ ] IN ATION
[ ] FRAMING/STRAPPING [ FINAL
[ ] FIREPLACE A CHIMNEY [ ] FIRE SAFETY INSPECTION
[ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRATION
[ ] ELECTRICAL (ROUGH) [ ] ELECTRICAL (FINAL)
REMARKS:
DATE INSPECTOR
F SOpr�o
�J TOWN OF SOUTHOLD BUILDING DEPT.'
765-1602
INSPECTION
[ ] FOUNDATION 1 ST [ ] ROUGH PLBG.
[ ] FOUNDATION 2ND [ ] INSULATION
[ ] FRAMING/STRAPPING [ ] FINAL
[ ] FIREPLACE & CHIMNEY [ ] FIRE SAFETY INSPECTION
[ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRATION
[ ] ELECTRICAL (ROUGH) ELECTRICAL (FINAL)
REMARKS:
DATE t INSPECTOR'
pf S0(/Tyo
o�ycour�n,��'
TOWN OF SOUTHOLD BUILDING DEPT.
765-1802
INSPECTION
[ ] FOUNDATION 1ST [ ] ROUGH PL13G.
[ ] FOUNDATION 2ND [ ] INSULATION
[ ] FRAMING/STRAPPING [L}�INAL ��S
[ ] FIREPLACE A CHIMNEY [ ] FIRE SAFETY INSPECTION
[ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRATION
[ ] ELECTRICAL (ROUGH) [ ] ELECTRICAL (FINAL)
REMARKS:
V �
DATE (O- INSPECTOR �'
FIELD INSPECTION REPORT DATE COM M.NTS
FOUNDATION(1ST)
FOUNDATION(?.ND)
O
ROUGH FRAMlNCF& y
PLUMBING
INSULATION PER N.Y.
H
STATE ENERGY CODE
Y
FINAL ca
ADDITIONAL COMMENTS
' � O
Z
. m
e
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
�-j�
SoutholdTown.NorthFork.net PERMIT NO. g ( Check
Septic Form
N.Y.S.D.E.C.
Trustees
C.O.Application
Flood Permit
Examined ,20 n Single&.Separate
DE .u U E Storm-Water Assessment Form
ontact: DAVID
Approved `'20 (� NOV 2 1 2011 Mail to: Pb &'$�L 1(s7Z
Disapproved a/c 1A AT����' � ((9S2
B 0 OUTT Phone: 01 29k O&S"
TOWN OF SOUTHOLD
Expiration 8 20_ 3 11
Building Inspector
APPLICATION FOR BUILDING PERMIT
Date , 20
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 leas not commenced within 12 months after the date of
issuance or has not been completed within 18 months from such date: I'f no zoiiing amendments or other regulations affecting the
property have been enacted in the interim, tlie.Building Inspector may authorize, in writing,the extension of the permit for an
addition six months. Thereafter, a new permit.slihll 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 corpor io )
(Mailing address of applicant)
State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder
A6- .Aj T
r
Name of owner of premises /DAV 1)^SffF9/4A 1J 206sR I-o"is 2 X) /rz
(As on1the 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 proposed work will be done:
2(00 0U—D u's PR�7l'f a.IiclA IGO rouNOUS PA-_K j 36 0H-6LI6
House Number Street //� Hamlet l
County Tax Map No. 1000 Section l0 I Block 2 Lot Z1
�f
i
r
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 O N5 FA ,1411- J D tlyf LL/ /VC,--
b. Intended use and occupancy iy !c. Ff}wj/L�J bWLLL/ /V(r
3. Nature of work(check which applicable): New Building Addition Alteration
Repair Removal Demolition Other Work 400 swoklCie S��
0o Ta 'VXLr7 JV&- ' 2-6 e�scription)
4. Estimated Cost .2 0 0V �qeo/�r4Fee, /
�; (To be paid on filing this application)
5. If dwelling, number of dwelling units`' : `,,� "Nlirinber 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.
y'
7. Dimensions of existing structures, if ariy: 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 7S
10. Date of Purchase /L/� 3 9 Name of Former Owner ��G,+��}�iD 4 N4kQ'( no rscH Mot of
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
Pavrb 51ffVa04AA) C./o 1).'7;4-1U✓ta24; &OR
14. Names of Owner of premises 90SVitTo Mini/7T"PLAddress Phone No. W &-FO YS'7-
Name of Architect Address PO 6dy- 1(-3'Z Phone No
Name of Contractor Address HAT -11VCt A hone No.
11952
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.
16. Provide survey,to scale, with accurate foundation plan and distances to property lines.
17. If elevation at,any point on property is at 1 b 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 )
D,qv red �U,3T- J J+ MA/ V Z*24. being duly sworn, deposes and says that(s)he is the applicant
(Name of individual signing contract) above named,
/1/+ �Al7- CONNIE D.BUNCH
(S)He is the f7 tT Notary Public,State of New York
(Contractor, Agent, Corporate Officer, etc.) Qualified in Suffolk County
Commisslon Expires April 14.2 0/�1
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 I
at `J-F— day of 20 I, .
Notary Public Signature of Applicant/
jf so
Town Hall Annex Y elephone(631)765-1802
54375 Main Road Fax(631)765-9502
P.O.Box 1179 .\\
en Aft-
Southold,NY 1 1 97 1-0959
coum
BUILDING DEPARTMENT
TOWN OF SOUTHOLD (,
December 15, 2011
David Jannuzzi, Atty ll
PO Box 1672
Mattituck, NY 11952
RE: Sherman/Benitez,260 Founders Path,Southold
TO WHOM IT MAY CONCERN:
The Following Items Are Needed To Complete Your Certificate of Occupancy:
Application for Certificate of Occupancy. (Enclosed)
Electrical Underwriters Certificate. (contact your electrician)
A fee of$50.00
Final Health Department Approval.
Plumbers Solder Certificate. (All permits involving plumbing after 411/84)
Trustees Certificate of Compliance. (Town Trustees#765-1892)
Final Planning Board Approval. (Planning#765-1938)
Final Fire Inspection from Fire Marshall.
Final Landmark Preservation approval.
BUILDING PERMIT : 36843-Z alteration to bathroom
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? i L Er SH• Southold,N.Y. 11971
syoH/E `PLUMBING P
631-765-2075 —phone,
631-765-5715—f
• I - DO • � �y ALL PLUMBING WASTE fax
�H, &WATER LINES NEED 516-398-8753-cell
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j UMBER CERTIFICATION
0 LEAD CONTENT BEFORE
CE TIFICATE OF OCCUPANCY
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