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Home My WebLink About37307-Z &UFF04 Town of Southold Annex 7/5/2012 o� any P.O.Box 1179 co 54375 Main Road c► Southold,New York 11971 CERTIFICATE OF OCCUPANCY No: 35797 Date: 7/5/2012 THIS CERTIFIES that the building ALTERATION Location of Property: 14909 Route 25, East Marion, SCTM#: 473889 Sec/Block/Lot:' 23.4-2.3 Subdivision: Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this officed dated 6/11/2012 pursuant to which Building Permit No. 37307 dated 6/19/2012 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 to two bathrooms in an existing one family dwelling as applied for.' - The certificate is issued to Norman&Marjorie Whitehead III (OWNER) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL ELECTRICAL CERTIFICATE NO. 37307 6/14/12 PLUMBERS CERTIFICATION DATED 6/29/12 Mike Jacoby � o utho ed S' ature " TOWN OF SOUTHOLD 4�g11FfD�,�-��li BUILDING DEPARTMENT ' TOWN CLERK'S OFFICE o . SOUTHOLD, NY yyP�r �t 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#: 37307 Date: 6/19/2012 Permission is hereby granted to: Whitehead III, Norman &Whitehead, Marjorie 2 Martha Cir Barrington, RI 02806 To: construct "as bit" alterations to an existing dwelling as applied for At premises located at: 14909 Route 25, East Marion SCTM # 473889 Sec/Block/Lot# 23.-1-2.3 Pursuant to application dated 6/11/2012 and approved by the Building Inspector. To expire on 12/19/2013. Fees: SINGLE FAMILY DWELLING -ADDITION OR ALTERATION $473.60 CO -ALTERATION TO DWELLING $50.00 Total: $523.60 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 1% lead. . S. 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 Ruilding 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$50.001 2. Certificate of Occupancy on Pre-existing Building- $100.00 3. Copy of Certificate o€.Occupaincy-$25 4. Updated Certificate of Occupancy- $50.00 5. Temporary Certificate of Occupancy -Residential$I.5.0%Commercial$15.00 Date. / 1 ) 1 -2 New Construction: Old or Pre-existing Building: ' (check one) Location of Property: U /"f fa /A yLO q % H A 12/o AJ House No. Street Hamlet Owner or Owners of Property-_ _10 2 M A/j �� n► " MIA 1'Z J d�� i �,ti1 i-T 14 A 7 Suffolk County Tax Map No 1000, Section Block Lot Subdivision Filed Map. Lot: Permit No. Date of Permit. Applicant: Health Dept.Approval: Underwriters Approval: Planning Board Approval: Request for: Temporary Certificate Final Certificate: (check one) Fee Submitted-. $ pplicant Signature pF SO!/r�olo Town Hall Annex Telephone(631)765-1802 54375 Main Road Fax(631)765-9502 P.O.Box 1179 Q roger.riche rt(-town.southold.ny.us Southold,NY 11971-0959 cOUNTY,� BUILDING DEPARTMENT TOWN OF SOUTHOLD CERTIFICATE OF ELECTRICIAL COMPLIANCE SITE LOCATION Issued To: Norman Whitehead Address: 14909 Main Rd City: East Marion St: NY Zip: 11939 Building Permit#: 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 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 Ceiling Fixtures HID Fixtures Service 3 ph Hot Water GFCI Recpt 2 Wall Fixtures 4 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 RTime Clocks Disconnect Switches 8 Twist Lock HExit Fixtures TVSS El Other Equipment: 2 bathrooms, 2-exhaust fans Notes: Inspector Signature: Date: June 14 2012 81-Cert Electrical Compliance Form.xls y� Town Half, 53095 Main Road y Fax (516) 765-1823 P. O. Box 1179 ur telephony (5is)765-1802 Southold, New York 11971 OFFICE OF THE EUILbING INSPECTON TOWN OF EOUTHOLb C f; R T I F I C A T I O I'f t)ATE: °2 I3uildihq Permit No, ? — 1ttnet: r ,.kw- (please P int) plumber! (please ptint) i cettify that .the solder used in the Watet supply bit8tetn contains less than 2/10 of 1% lead. 4--. l (Plumber Signature) CONNIE D. BUNCH Notary Public, State of Now York No.01 BU6185050 Sworn to before the this Qualified in Suffolk County a,p Commission Expires April 14, _Q94k - day of 19 a 01.�p Notaty Publics Cotinty "� SOUT�06 7e- 3 e7 TOWN OF SOUTHOLD BUILDING DEPT. 765-1802 INSPECTION . [ ] FOUNDATION 1 ST [ ] 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: r` DATE INSPECTOR' ANGEL B. CHORNO . ARCHITECT 51020 MAIN ROAD SOOTHOLD NY. 11971 (631) 765- 6530 FAX (631) 765- 4643 June 2V 2012 Building Department Town of Southold Re: Whitehead Residence East Marion NY # 373072 - 1000-23-01-2.3 To the best of my knowledge , the above referenced work was done in compliance with the NYS Plumbing Code of the time in which it was built. Angel B. Chorno AIA JUN 27 2012 FLE AiQ BLDG.DEPT. 19 TOWN OF SOUTHOLD W �✓ :, , -4- ' F OF ..I,D INSPECTION REPORT DATE COMMENTS = FOUNDATION(181) --- --------------------- O FOUNDATION(ZND) r ' z H ROUGH FRANYING& y PLUMBING (A a! INSULATION PER N.Y. STATE ENERGY CODE caz 1 JNAL ADDITIONAL COMMENTS �- O z rn 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. Check Septic Form N.Y.S.D.E.C. Trustees C.O.Application Flood Permit v ro Examined 120 Single&Separate Storm-Water Assessment Form Contact: Approved ,20 Mail to: Disapproved a/c JJ II Phone: 7 v Expiration 120 E C E Building Inspector l PLICATION FOR BUILDING PERMIT ' J U N 1 1 2012 Date , 20 BLDG.DEPT. INSTRUCTIONS _ TfflNN OF SOUTHOLD _a_'This 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 wort: 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) (Mailing address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician,plumber or builder Name of owner of premises IV O?-M/4/J �^' � M/fZT O rz %E 6J 1-E ►'T D (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 proposed work will be done: 1 tt 10 01 M A I nJ r,100 6_65"-T M r1 R' 10 i' J House Number Street Hamlet County Tax Map No.' 1000 Section 93 Block 1 Lot- 69 " -3 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 S iN G L C ,q-r-r 1 P E 5 r b. Intended use and occupancy P UL- F� i o o X-1 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, commerci or mixed occupancy, specify nature and extent of each type of use. 7. Dimensions of existing str tures, 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 construc 'on: Front Rear Depth Height Nu ber of Stories 9. Size of lot: Front Re Depth 10. Date of Purchase Name o Former Owner 11. Zone or use district in which premises are situated 12. Does proposed construction violate any zoning law, ordi ance or regulation? YES NO 13. Will lot be re-graded? YES NO Will excess fill be r oved 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? '` NO * IF YES, SOUTHOLD TOWN TRUSTEES &D.E.C. PERMITS MAY BE REXYES ED. 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 * 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, i,;ONNiE D.BUNCH (S)He is the ti0j;rfy public,State of New York (Contractor, Agent, Corporate Officer, etc.) No.p15W 000050 Oualifi d in Suffolk county a ;; M _ of said owner or owners, and is duly authorized to perform or have performed the saiKM011 c 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 wort:will be performed in the manner set forth in the application filed therewith. Sworn to before me this day of ��_ 20 Notary Public Signature of Applicant 0f SO�lyo Town Hall Annex Telephone(631)765-1802 54375 Main Road P.O.Box 1179 G ro er6�-g9 UU22 Southold,NY 11971-0959 �Q —'riCheCttOIA�l SOuthold nV US BUILDING DEPARTMENT TOWN OF SOUTHOLD APPLICATION FOR ELECTRICAL INSPECTION REQUESTED BY: Date: Company Name: Name: License No.: Address: /4 g G 1 i 4 ft t a o-A-D Phone No.: & 3 / — q-q - ()�F I JOBSITE INFORMATION: (*Indicates required information) o �— *Name: /ll 1Z_M�--A1 W H i i&�A-h *Address- 1440 G M 'i i n/ /'La A -0 EA�S A-2i o n1 N *Cross Street: *Phone No.: -7 Permit No.: PCN a i A Tax-Map District: 1000 Section:-- Block: Lot: "BRIEF DESCRIPTION OF WORK(Please Print Clearly) A TIC PLC c3 r--I S �LOc3 i� ;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 kdditional Information: PAYMENT DUE WITH APPLICATION .824Request for Inspection Form Nip pLUMBEP CERTIFICATION -� NLEAD CONTENT BEFORE _ - - C ERTIFICATE OF OCCUPANCY SOLDER USED IN VVA TER SUppL y`SYSTEM CANNOT EXCEED?110 OF 1% LEAD. Q a .0 CCUPANCY OR Jf 8 APPROVED AS NOTED is-g.P. # 07 ;�BY Z i iFY BUILDING DE ARTMENT AT 0 i5-1802 8. AM TO 4 PM FOR THE'k, OLLOWING INSPECTIONS: . 1 1. FOUNDATION -TWO REQUIRED.` FOR PQURED CONCRETE 2 ROUGH-FRAMING,PLUMBING, . -- STRAPPING, ELECTRICAL&CAULKI G 3 INSULATION ., 4 FINAL-CONSTRUCTION&ELECTRIC L' MUST BE COMPLE'E FOR C.O. ALL CONSTRUCTION SHALL MEET THE EQUIREMENTS OF THE CODES OF NEW RK STATE, NOT RESPONSIBLE FOR -- C ESIGN OR CONSTRUCTION ERRORS, ELECTRICAL INSPECTIU,` REOWR! EO -- T PLUMBING AIL"PLUMBING WASTE s ^- &WATER LINES NEED 'I' STING,BEfORECOVERING 1000-23-01-2.3 EO ARo �R e. "�y .WHItEHEAD RESIDEN °AT1`: s-11-12 CE _ East Marion - CO �� TOWN OF SOUTHOLD NY'. . . SK-1 9j•:079150 •�O 0F N�`� CHORNO ASSOCIATES architects., SOUTHOLD,NEW YORK