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HomeMy WebLinkAbout36787-Z Of Fat 4, Town of Southold Annex 7/26/2012 P.O.Box 1179 �'. 54375 Main Road oy �1W Southold,New York 11971 ,� .. .. ..__ .....-�... CERTIFICATE OF OCCUPANCY No: 35845 Date: 7%26/2012 ' THIS CERTIFIES that the building AS BUILT ALTERATION Location of Property: 5855 New Suffolk Avenue,Mattituck, SCTM#: 473889 Sec/Block/Lot: 115.-5-18 Subdivision: Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this officed dated 10/26/2011 pursuant to which Building Permit No. 36787 dated 11/1/2011 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"interior alterations to kitchen,bedroom,baths, walk-in closets and utililty room and existing deck addition " replaced in kind as applied for. The certificate is issued to Vergari,Joseph&Julie 1 "' (OWNER) of the aforesaid building. V SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL ELECTRICAL CERTIFICATE NO. 36787 6/13/12 PLUMBERS CERTIFICATION DATED 7/23/12 Mattituck Plumbing&Heating Auth rized Signature TOWN OF SOUTHOLD Ag11FED(�- �s BUILDING DEPARTMENT y z TOWN CLERK'S OFFICE oy . 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#: 36787 Date: 11/1/2011 Permission is hereby granted to: Vergari, Joseph & Julie 3 Wilder Ln Huntington, NY 11743 To: 'As Built' Alterations (Interior) to a Single Family Dwelling; Kitchen, Bedroom, Baths, Walk-in.Closets., Utility Room, as applied for. Amd— 1�.e_C�k bY\. �_Q s s re� L `t n I<�t. G'_1 At premises located at: 5855 New Suffolk Avenue, Mattituck, NY SCTM # 473889 Sec/Block/Lot# 115.-5-18 Pursuant to application dated 10/26/2011 and approved by the Building Inspector. To expire on 5/2/2013. Fees: CO -ALTERATION TO DWELLING $50.00 SINGLE FAMILY DWELLING-ADDITION OR ALTERATION $1,097.60 Total: $1,147.60 Building Inspector rr'z TOWN OF SOUTHOLD O�g�fFD(,�c BUILDING DEPARTMENT CO ' TOWN CLERK'S OFFICE SOUTHOLD, NY 'z'�nril 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#: 36730 Date: 10/3/2011 Permission is hereby granted to: Vergari, Joseph & Vergari, Julie 3 Wilder Ln Huntington, NY 11743 To: electric for"as built" renovation (plans to come & trustees) At premises located at: 5855 New Suffolk Ave. Mattituck SCTM # 473889 Sec/Block/Lot# 115.-5-18 Pursuant to application dated 10/3/2011 and approved by the Building Inspector. To expire on 4/3/2013. Fees: ELECTRIC $125.00 Total: $125.00 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 1% lead. 5. Commercial building,industrial building,multiple residences and similar buildings and installations,a certificate of Code Compliauce-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 G°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-Neu dwelling$50.60,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. Certifieate 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$15.00 Date- - - . New Construction: Old or Pre-existing Building:' check one Location of Property: ' 5-PS_5 7-V a J< House No. Street Hamlet Owner or Owners of Property: lt-vg�P kl A(fir v _ Suffolk County Tax Map No'1000,Section Block Lot Subdivision Filed Map. Lot: Permit No. Date of Permit. Applicant- Health Dept.Approval: Underwriter's Approval: Planning Board Approval: Request for: Temporary Certificate Final Certificate: (check one) Fee Submitted:$ QAL/ 1"j pplicant Sign t re �*qf so�ryo Town Hall Annex �O l� Telephone(631)765-1802 54375 Main Road Fax(631)765-9502 P.O.Box 1179 roger.richertCab-town.southold.ny.us Southold,NY 11971-0959 CoU�m,� ' BUILDING DEPARTMENT TOWN OF SOUTHOLD CERTIFICATE OF ELECTRICIAL COMPLIANCE SITE LOCATION Issued To: Julie&Joe Vergari Address: 5855 New Suffolk Ave City: Mattituck St: NY Zip: 11952 Building Permit#: 36787 Section: 115 Block: 5 Lot: 18 WAS EXAMINED AND FOUND TO BE IN COMPLIANCE WITH THE NATIONAL ELECTRIC CODE Contractor: DBA: REP Electric License No: 46288-me SITE DETAILS Office Use Only Residential X Indoor X Basement X Service Only Commerical Outdoor X 1st Floor X Pool New Renovation 2nd Floor X Hot Tub Addition Survey Attic Garage INVENTORY Service 1 ph 200a Heat 1-oil Duplec Recpt 11 Ceiling Fixtures 3 HID Fixtures Service 3 ph Hot Water GFCI Recpt 4 Wall Fixtures 3 Smoke Detectors 4 Main Panel 200a A/C Condenser 4 Single Recpt Recessed Fixtures' 43 CO Detectors Sub Panel A/C Blower 4 Range Recpt Fluorescent Fixture 2 Pumps Transformer Appliances N29 Dryer Recpt Emergency Fixtures Time Clocks 00a Disconnect 2 Swatches Twist Lock Exit Fixtures TVSS Other Equipment: 3- combination smoke/co detector, 2-exhaust fans, 15-ft wire mold, 2-40a ovens 1-30a cook top, 10 landscape lights Notes: Inspector Signature: Date: June 13 2012 81-Cert Electrical Compliance Form.xls JUL 2 4 2012 .r, Hall, 53095 Main Road Oy Fax (631) 765 s 5: P O Box 1 179 � ��O i BLDG. DEPT. e c 1'ew York 11971.0959 TOWN DFSDUTHOLD BUILDING•DEPARTMENT TOWN OF SOUTH=TOLD CERTIFICATION Date: ;L 3 Building Permit No. ? b77 7 r• owner: J U l l e' a"J h a- 'r-1 • (Please,pP nt)' P I u ni b e r: a94' u je—/' (Please print) I certify that the solder used in the water supply system contains less than 2/10 of I lead. IL (PI rs Signature) Sworn to before me this —, 23 j.1v o 20 / DENISE KING Notary Public,State of New York Registration #01 K16041757 Qualified in Suffolk County Votary Public, County My Commission Expires May 15,2 0 OF SOpT�olo -17 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. k ELECTRICAL (ROUGH) [ ] ELECTRICAL (FINAL) REMARKS: LA57'lXJ✓' r DATE �' INSPECTORS`` 7 - �OF SO(/j - - • yo o�yco ,� TOWN OF SOUTHOLD BUILDING DEPT. 765-1802 INSPEC7 ION [ ] FOUNDATION 1ST ;[ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] INSULATION [�RAMING/STRAPPING [ ] FINAL [ ] FIREPLACE & CHIMNEY [ ] FIRE SAFETY INSPECTION [ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRATION [ ] ELECTRICAL (ROUGH) ` [ ] ELECTRICAL (FINAL) REMARKS: I DATE r 1 _INSPECTORZY�� L pf SOpryOlo cOUM'{,� TOWN OF SOUTHOLD BUILDING DEPT. 765-1802 INSPECTION [ ] FOUNDATION 1ST [ ] RO GH PLBG. [ ] FOUNDATION 2ND [ INSULATION [ ] FRAMING/STRAPPING [>FIRE AL [ ] FIREPLACE A CHIMNEY [ AFETY INSPECTION [ ] FIRE RESISTANT CONSTRUCTION [ RESISTANT PENETRATION [ ] ELECTRICAL (ROUGH_) [ ] ELECTRICAL (FINAL) REMARKS: -�-- � - i DATE INSPECTOR SOUI,y�� cOUM'I,N TOWN OF SOUTHOLD BUILDING DEPT.- 765-1802 INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLOD. [ ] FOUNDATION 2ND [ ] INSULATION [ ] FRAMING/STRAPPING [ ] FINAL [ ] FIREPLACE & CHIMNEY [ ] FIRE SAFETY INSPECTION [ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRATION. [ ] ELECTRICAL (ROUGH) ELECTRICAL (FINAL) r REMARKS: DATE f �� INSPECTOR Of SO!/ryo� 367F7 o� • 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) [ ] ELECTRICAL (FINAL) REMARKS: DATE 7_/9— IINSPECTOR FIELD INSPECTXON REPORT DATE COMMENTS. FOUNDATION(1ST). on wM� NNFP }� w V, FOUNDATION(2ND) vl`�- z c ROUGH PRIMING& y PLUI MING r INSULATION PER N.Y. H STATE ENERGY CODE C� « r FINAL ADDITIONAL COMMENTS 1�4 �i� Gt�.s + SI co. S - al c •�C� TOWN OF SOUTHOLD � �t BUILDING PERMIT APPLICATION CHECKLIST BUILDING DEPARTMENT Q`u r``b ��C Do you have or need the following,before applying? TOWN HALL Board of Health SOUTHOLD, NY 11971 14 4 sets of Building Plans TEL: (631) 765-1802 Planning Board approval FAX: (631) 765-9502 ( Q,Vy Sul-Vey South oldTown.NorthFork.net PERMIT NO. Check 3 / p-�r-� Septic Form C�3 b / N.Y.S.D.E.C. Trustees C.O. Application Flood Permit Examined Q 20 l Single& Separate Storm-Water Assessment Form ` II l 1 Contact: Approved ( l ( 20 0 l Mail to: ni�a�_,To`d a/c Phone: Expiration � � ,20 f 6 Building Inspector APPLICATION FOR BUILDING PERMIT Date 10 — 3 , 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 Oan 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, ousing code, aid regulations, and to admit 01 authorized inspectors on premises and in building for necessary inspections. (Signature of applicant or name, if a corporation) a Co�v,e9 c S'-r I�oN k Al (Mailing address of applicant) i! 7 86 State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder G"ENEg7 A( CoOV-Rlr_7462- Name of owner of premises UOC-4 f go,"w500/V VEA,i4 R (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. 2.S&51 — y Plumbers License No. 2 3(o fo — Al p Electricians License No. 1f 6 24$ — AA Other Trade's License No. 1. Location of land on which proposed work will be done: 5 855 NEW 64 EFQ uc A-vE 41A-Ti 7VC le- House Number Street Hamlet County Tax Map No. 1000 Section 1 1 5 Block S 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 , VA c,4,,NT. b. Intended use and occupancy Ree. 3. Nature of work (check which applicable): New Building Addition Alteration Repair Removal Demolition Other Work (Description) 4. Estimated Cost ($- ao 6)00. 0 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 25 ' Number of Stories Q CZjW-0 Dimensions of same structure with alteratio_ns_..o_r_additions: Front_ Rear Depth Height Number of Stories 8. Dimension_s of entire new construction: Front Rear Depth Height Number of Stories 9. Size of lot: Front 27 2. . ( Rear 3 50 . 00 Depth S-00 . 0 0 10. Date of Purchase _7 ' @ ' Name of Former Owner L 11. Zone or use district in which premises are situated R C5 12. Does proposed construction violate any zoning law, ordinance or regulation? YES NO 13. Will lot be re-graded? YES X NO Will excess fill be removed from premises? YES NO RUn f, N1/ 14. Names of Owner of premises J 4'.l NWZ&A Pi Address WI LDE4 LA Phone No. 516 51 O 521 q Name of Architect Address Phone No Name of Contractor , f e.troc d I i C.-•1-�c. Address ioo 6,3*xAG S't Phone No. CP-5 / Q el S`a o 0 12on k. , N'/ (t^e Sd 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 o✓ * 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 06(,t // (11 r being duly sworn, deposes and says that(s)he is the applicant (Name of individual signid contract) above named, (S)He is the to e y- (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 he_/ 20r )19 _,�41 al f BEDELL State of New v�. otary Pu i No.0 BE6099317 Signature of App Qua i iied n Suffolk Cou-cy Commission Expires Sept.2a,� f s (01-a) C) Town of Southold Erosion, Sedimentation .& Storm-Water Run-off ASSESSMENT FORM PROPERTY LOCATION: s.c.T.M.#: THE FOLLOWING ACTIONS MAY REQUIRE THE SUBMISSION OF A 01 1000 1 g STORM-WATER,GRADING,DRAINAGE AND EROSION CONTROL PLAN isTi tact -ce on _IPocW__ — o[�— CERTIFIED BY A DESIGN PROFESSIONAL IN THE STATE OF NEW YORK. SCOPE OF WORK - PROPOSED CONSTRUCTION ITEM# / WORK ASSESSMENT Yes No a. What is the Total Area of the Project Parcels? (Include Total Area of all Parcels located within Will this Project Retain All Storm-Water Run-Off the Scope of Work for Proposed Construction) 3 Acre 5 Generated by a Two(2")Inch Rainfall on Site? (S.F./Acres) (This item will include all run-off created by site b. What is the Total Area of Land Clearing clearing and/or construction activities as well as all and/or Ground Disturbance for the proposed tj) Site Improvements and the permanent creation of construction activity? impervious surfaces.) (S.F./Acres) PROVIDE BRIEF PROJECT DESCRIPTION (P ovide Addilfonal Pa es as Needed 2 Does the Site Plan and/or Survey Show All Proposed s ) Drainage Structures Indicating Size&Location?This n I item shall include all Proposed Grade Changes and R 210)rn�? G'x 5 t 5+]n rt 4-e Ll� Slopes Controlling Surface Water Flow. I�► 3 Does the Site Plan and/or Survey describe the erosion Qti tM U) !7�rVli rl wi s+zt b I artrt and sediment control practices that will be used to control site erosion and storm water discharges. This LZ ° �a+1ri A d titM rc�i.d t�M item must be maintained throughout the Entire Construction Period. f (Cct r�„c �em9 tla � 4 Will this Project Require any Land Filling,Grading or 1 Excavation where there is a change to the Natural Existing Grade Involving more than 200 Cubic Yards 14 Te-1-10 r WO 2 K of Material within any Parcel? 5 Will this Application Require Land Disturbing Activities F Encompassing an Area in Excess of Five Thousand (5,000 S.F.)Square Feet of Ground Surface? 6 Is there a Natural Water Course Running through the General DEC SWPPP Requirements: Site? Is this Project within the Trustees jurisdiction — or within One Hundred(100')feet of a Wetland or Submission of a SWPPP is required for all Construction activities involving soil Beach? disturbances of one(1)or more acres; including disturbances of less than one acre that are part of a larger common plan that will ultimately disturb one or more acres of land; 7Will there be Site preparation on Existing Grade Slopes including Construction activities involving soil disturbances of less than one(1)acre where which Exceed Fifteen(15)feet of Vertical Rise to the DEC has determined that a SPDES permit is required for storm water discharges. One Hundred(100')of Horizontal Distance? (SWPPP's Shall meet the Minimum Requirements of the SPDES General Perm it 8 Will Driveways,Parking Areas or other Impervious for Storm Water Discharges from Construction activity-Permit NoEl X .GP-0-10-001.) Surfaces be Sloped to Direct Storm-Water Run-Off El1.The SWPPP shall be prepared prior to the submittal of the Not.The Not shall be submitted to the Department prior to the commencement of construction activity. Into and/or in the direction of a Town right-of-way? 2.The SWPPP shall describe the erosion and sediment control practices and where 9 Will this Project Require the Placement of Material, required,post-construction storm water management practices that will be used and/or constructed to reduce the pollutants in storm water discharges and to assure Removal of Vegetation and/or the Construction of any compliance with the terms and conditions of this permit.In addition,the SWPPP shall Item Within the Town Right-of-Way or Road Shoulder identify potential sources of pollution which may reasonably be expected to affect the Area?(mils Item will NOT Include the Installation of Driveway Aprons.) quality of storm water discharges. NOTE: If Any Answer to Questions one through Nine is Answered with a Check Mark 3.All SWPPPs that require the Post-construction storm water management practice in a Box and the construction site disturbance is between 5,000 S.F.81 Acre in area, component shall be prepared by a qualified Design Professional Licensed in New York a Storm-Water,Grading,Drainage d Erosion Control Plan is Required by the Town of that is knowledgeable in the principles and practices of Storm Water Management. Southold and Must be Submitted for Review Prior to Issuance of Any Building Permit (NOTE: A Check Mark(4)and/or Answer for each Question is Required for a Complete Application) STATE OF NEW YORK, CONNIE D.BUNCH COUNTY OF.... wy� ................SS Not"Public,State of New York JULI/h V�Y rat No.01 BU61 85050 That I................................................ bei Qua M in Suf �.lty'a` D) being duly sworn,deposes (Name of individual signing Document)•• � �' a IiJ (IIO L' ' ^F+ sfc t for P rmi And that he/she is the ................................C.w Aje—y2_ ............................ (Owner,Contractor,Agent,Corporate Officer,etc.) Owner and/or representative of the Owner or Owners,and is duly authorized to perform or have performed the sa make and Fie this application;that all statements id work and to 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 die application filed.herewidi. Swom to before me this; ............[.:4... ........ y 2U ..........day o .............. l Notary Public: ...�) \rn/�Q ..... .. . ................... ................ ...... FORM - O sI7 O a ure o licanl) �o'of SO(/l�,Ql 0 Town Hall Annex Telephone(631)765-1802 54375 Main Road ax(631)765- 512 P.O.Box 1179 G Q roger.richert c—own.south�o d.ny.us Southold,NY 11971-0959 'Q a` S 4UNT`I, BUILDING DEPARTMENT TOWN OF SOUTHOLD APPLICATION FOR ELECTRICAL INSPECTION REQUESTED BY: Vok VA pekroc Date: Company Name: Name: License No.: < 2 Address: Pd &OX (p3S M -t'TI iUGk Phone No.: JOBSITE INFORMATION: (*Indicates required information) *Name: J (1 e Joe ye 4a C l' *Address: 5 8 S S t4ew *Cross Street: A/L�A oo� I JLo �m *Phone No.: Permit No.: Tax-Map District: 1000 Section: 1 1 5 Block: 5 Lot: /8 *BRIEF DESCRIPTION OF WORK (Please Print Clearly) P-eA4040_ 1 04 nc'L Z w' ®k re o,.G -�v+v✓.e ou (Please Circle All That Apply) *Is job ready for inspection: YES /10 Rough In Final *Do you need a Temp Certificate: ES 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 Date 11 2 File # TOWN OF SOUTHOLD COMPLAINT REFERRAL FORM Location of Complaint: r '� � SCTM # Property Owner: Phone Address: NATURE OF COMPLAINT: 7r ACTION TAKEN: o��- 04 Optional: Complainant: r ���- By Phone Mail In Person .� Address /4 D — Phone: Report Taken By: / Date Date Referred to Code Enforcement: --------------------------------------------------------------------------------------------------------------------- CODE ENFORCEMENT REPORT SITE INSPECTION REPORT/DATE: ACTION/DATE: So�ryo Town Hall Annex ~� l0 Telephone(631)765-1802 54375 Main Road 4 Fax(631)765-9502 P.O.Box 1179 Southold,NY 11971-0959 0 �Q �yCOUNT`I,�c� BUILDING DEPARTMENT �J TOWN OF SOUTHOLD w 1(i(JIJ�- '1 � y 20, 2012 Joseph & lie Dve, D , 3 Wilder e Huntington, NY . 5 Newck TO WHOM IT.MAY CONCERN: The Following Items Are Needed To Complete Your Certificate of Occupancy: 1 Application for Certificate of Occupancy.(Enclosed) Lf Electrical Underwriters Certificate. (contact your electrician) A fee of$50.00. Final Health Department Approval. Plumbers Solder Certificate. All permits involving plumbing after 4/1/84 P 9P 9 ) 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: 36787 — "As Built" Alterations BUILDING PERMIT EXAMINER CHECKLIST Date Submitted: I b�°�gT� Date Reviewed: 3 I n , J Applicant: � Owner: Architect/Eikgifteer— dC - Estimated Cost: SCTM# 1000 — 5 _�Subdivision: Zone: Conforming? r Property Address: City: Pre COs? Building Permits (Open/Expired): BP -Z/C/o z- ,Info: BP -Z/C/o Z- ,Info: BP -Z/C/o Z- , Info: BP -Z/C/o Z- ,Info: BP -Z/C/o Z- ,Info: Single& Separate Search Required? Y org Determination: ' Sl`�RMWlt.7 : .R" ct.FF: REQ. Lot Size: ACT. Lot Size: REQ. Lot Cov. ao7b ACT. Lot7Cov. REQ.Front ACT. Front REQ Side ACT. Side REQ. Rear ' PROP. Rear REQ. Height. 35/ ACT. Height R E 4, j;*Tii SIDES - ACT � f , Project D%c iption: Waterfront. or M - A If yes, water body: Panel# U Flood Zode: R. 1 ead/Bluff 'stance: ADDITIONAL APPROVALS REQUIRED PLAN S(4) SIGNED, sF,4j.E:D SuRVE.Y oR S'ITE PI-AIV If yes;*Bed#: _ *Date: _/_/ *Permit#: Town Septic: Y-NSuffolk County Health: Y orO - If no, certification required: Y or N Received: Y or N By: NYS DEC: PRE-DEC 9iiizs Y oraN - Date: / /_ Permit#: or NJ Letter— Notes: Southold Trustees: Y orV- Date: _/ / Permit#: or NJ Letter=Notes: Southold ZBA: Y or Date: / / Permit#: —Notes: Southold Planning: Y wo- late: '/ /_ Permit#: —Notes: Town Landmark C of A: Y o N TE: _/ /_ *NYS CODK ompliance(page 2): Y or N CaNTA&CT49 4ic�NSt IS/4BILITy E-1/tBlt,l Ty �VoRk^/ENS COMAp -il/S4T-10, / Notes: e Fee Structure: Calculation: Foundation: I I SF 8 7 X $ , ".=$ .3 LM ro First Floor: 534 SF +Initial Fee: $ OL-o ® , 00 Second Floor: S SF +Additional Fee $ Other: SF SF X$ , =$ Total: SF +Initial Fee: $ +Additional Fee �_�: $ S- 8-0 C of © FEE) S�. 9d *'J A S B U I L T FEE ,- Q�. �® TOTAL: $ I Q ! / NEW YORK STATE CODE COMPLIANCE CHECKLIST CLIMATIC/GEOGRAPHICDESIGN CRITERIA: t Ground Snow Load:20 Wind Speed: 120MPH Seismic Design Category:B Weathering: Severe Frost Depth: 3611, Termite: M-H' Decay: S-M Design Temp: 11 -lee Shield Underlay:YES Flood Hazards: USE/OCCUPANCY CLASSIFICATION: HEIGHT/FIRE AREA: TYPE OF CONSTRUCTION: DESIGN CRITERIA: ENGINEERED/PRESCRIPTIVE FULL FRAMING DESIGN ELEMENTS: Y/N HEADERS: Y/N WALL STUDS: Y/N GIIZDERS1 YIN CEILING JOISTS: YIN FLOOR JOISTS:Y/N ROOF RAFTERS: YIN LUMBER SPECIES AND GRADE: YIN WINDOW AND DOOR SCHEDULE: -NIISSLE TEST REQUIREMENTS: Y/N EGRESS 5.7 S.F.: Y/N ti LIGHT 8%: Y/N VENT 4%: Y/N NAILING/CONSTRUCTION SCHEDULE: Y/N MEANS OF EGRESS: Y/N PLUMBING RISER DIAGRAM: Y/N LOCATION OF FIRE PROTECTION EQUIPMENT: YIN TRUSS DESIGN: Y/N CERTIFICATION: YIN ENERGY CALCS: YIN (RESCHECK) TOTAL-COMPLIENCE? Y/N (RETURN TO PAGE ONE) 4+ - 1�12t * 44' ' _ I _NoT e.' 4 , Wof k To COMPLY WITH r//F jze'Sla�N Tig L coDE' o F NE w YoR K —2 010 " Iv " Ca 3PL� 1h ITH �►LL CODES OF - - -� _ 4- N'T� NEW YORK STATE & TOWN CODES AS REQUIRED ANfl-CONDiTiONS-fl. r )) I I I t I PLUMB._R CERTIFICATION t+ , sou� ow PLUMBING 7-6 7- 6 '7- 6 _ 6 -3 'V ZBA /'- �- � _ 7 - 6 �- �- � � */ ,' \ � ON LEAD CONTENT BEFORE _ — co p SOUTHOLD TOW NN�NGBOARD CFRTfFICATE OFOCCUPANCY AL5TE WATER LINS'S NEED ACEMENT DEo�i �` / SOU T HOL ONJN TRUST �_ SOLDER TESTING Q i USED IN WATER BEFORE COVERING V w ' Gr, SUPPL I"SYSTEM CANNOT _ ,,,, p o r ._ ��.� I I U ci I 14 x 6 rDE C/1/,V G / �� EXCEED 2/10 OF 1%LEAD. '��'�� D AS INCITED` B.P. # ( � ��'`8 Ac.Q . - I 2- 11 'i4 6VL NDR 2-Z�i6 BY I (>W �� — — I ' Y BUILDING DEPARTMENT AT 1302 8 AM TO 4 PM FOR THE FOLLOWING INSPECTIONS: I) , I ti , w NDaw ExIsT ELECTRICAL 1 FCUNDATION-TWO REQUIRED 4 0 INSPECTION HEW 0�6TGM El`! i _NET" I��Q?UI��� 2 RFOR OUGH�FRAMING,PLUMBING, , I I + fxTv�t�S I STRAPPING, ELECTRICAL &CAULKING -- 3. INSULATION a�rd poST' ovErz 0 � Q I 4. FINAL-CONSTRUCTION &ELECTRICAL Z coy p)EI-ow CTY P.) - r 1~'X 15T, p.}� . y 3 r• P ' MUST BE COMPLETE FOR C.O. U' x y �� b _ � � ALL CONSTRUCTION SHALL MEET THE EX I ST, I4 A''f ROOM REQUIREMENTS OF THE CODES OF NEW I) f RRaE Z �xl 5T, t�RSE M ENT =0 u N a ) O Ertl 5T M�� YORK STATE. NOT RESPONSIBLE FOR 11 � aLn _ 1 o DESIGN OR CONSTRUCTION ERRORS. )< w i x co _0 W p II � I� C4 11 � E . _ ,I,C. �-.c. -.f W. C{.. I) I 2x8 Aoca NE>^v w�.t, f AooR,t I � I � r • 11 , � I✓X IC T. �JT►WTY E7� E�• EX. Col. , rPX1 �x�ST, . . 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