HomeMy WebLinkAbout37313-Z Fat Town of Southold Annex 7/11/2012
P.O.Box 1179
co 54375 Main Road
Southold,New York 11971
CERTIFICATE OF OCCUPANCY
No: 35816 Date: 7/11/2012
THIS CERTIFIES that the building AS BUILT ALTERATION
Location of Property: 480 N Bayview Road Ext, Southold,
SCTM#: 473889 Sec/Block/Lot: 78,941
Subdivision: Filed Map No. Lot No.
conforms substantially to the Application for Building Permit heretofore filed in this officed dated
5/30/2012 pursuant to which Building Permit No. 37313 dated 6/20/2012
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"bedroom in unfinished basement and"as built"second floor alterations in an existing one family dwelling as
applied for.
The certificate is issued to Hanlon,Robert&Frankel,Jessica
(OWNER)
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL
ELECTRICAL CERTIFICATE NO. 37313 6/25/12
PLUMBERS CERTIFICATION DATED
Autho ' e ign ure
�su�Foc� TOWN OF SOUTHOLD
BUILDING DEPARTMENT
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 #: 37313 Date: 6/20/2012
Permission is hereby granted to:
Hanlon, Robert & Frankel, Jessica
PO BOX 178
Orient, NY 11957
To: alter basement & second floor "As Built" as applied for
At premises located at:
480 N Bayview Road Ext, Southold
SCTM # 473889
Sec/Block/Lot# 78.-9-41
Pursuant to application dated 5/30/2012 and approved by the Building Inspector.
To expire on 12/20/2013.
Fees:
SINGLE FAMILY DWELLING-ADDITION OR ALTERATION $1,373.60
CO -ALTERATION TO DWELLING $50.00
Total: $1,423.60
Building Inspector
J
For
m No.6
TOWN OF SOUTHOLD. 5 d
1 BUILDING DEPARTMENT p
X
TOWN HALL
1 765-1802
v ,. 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 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) rion-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 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 $1.5_00,Commercial$15.00
Date.
New Construction: Old or Pre-existing Building:' (check one)
Location of Property: ll Hamlet
House No. Street
lcx
Owner or Owners of Property: ✓
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: $
Applicant Signature
pF SO(/ryolo
Town Hall Annex Telephone(631)765-1802
54375 Main Road Fax(631)765-9502
P.O.Box 1179 Q roger.richert(a-)town.southo Id.ny.us
Southold,NY 11971-0959
C4UNT`I,Nc�
BUILDING DEPARTMENT
TOWN OF SOUTHOLD
CERTIFICATE OF ELECTRICIAL COMPLIANCE .
SITE LOCATION
Issued To: Hanlon-Frankel
Address: 480 North Bayview Rd Ext City:Southold St: NY Zip: 11971
Building Permit#: 37313 Section: 78 Block: 9 Lot: 41
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 X Service Only
Commerical Outdoor 1st Floor Pool
New Renovation 2nd Floor X Hot Tub
Addition Survey X Attic Garage
INVENTORY
Service 1 ph Heat Duplec Recpt 29 Ceiling Fixtures 1 . HID Fixtures
Service 3 ph Hot Water GFCI Recpt 1 Wall Fixtures 3 Smoke Detectors
Main Panel A/C Condenser Single Recpt Recessed Fixtures 8 CO Detectors
Sub Panel A/C Blower Range Recpt Fluorescent Fixture Pumps
Transformer Appliances Dryer Recpt Emergency Fixtures Time Clocks
Disconnect Switches 12 Twist Lock ri Exit Fixtures 11 TVSS
Other Equipment: 1-combination smoke/co detector,3-paddle fans, 2-exhaust fans
Notes:
Inspector Signature: Date: June 25 2012
81-Cert Electrical Compliance Form.xls
OF SO�ryo�o
coumv, elf
\ � l
TOWN OF SOUTHOLD BUILDING DEPT.
765-1802
INSPECTION
[ ] FOUNDATION 1 ST [ ] ROUGH PLBG.
[ ] FOUNDATION 2ND [ ] INSULATION
[ ] FRAMING/STRAPPING [ ] FINAL
[ ] FIREPLACE A CHIMNEY [ ] FIRE SAFETY INSPECTION
[ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRATION
[ ] ELECTRICAL (ROUGH) lytiiA.ECTRICAL (FINAL)
REMARKS:
DATE 6 Z- INSPECTO
-7313 �oF soor
TOWN OF SOOT ING DEPT.
765-1802
I N S PE ION
[ ] FOUNDATION 1ST [ ] ROUGH PLBG.
[ ] FOUNDATION 2ND [ ] INS ATION
[ ] FRAMING/STRAPPING [ 'FINAL
[ ] FIREPLACE & CHIMNEY [ ] FIRE SAFETY INSPECTION
[ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRATION
[ ] ELECTRIC (ROUGH) [ ] ELECTRICAL (FINAL)
r? '.
REMARK J �
12= S
DATE INSPECTOR
OF SO(/lyo�
3, 73
Cou'
TOWN OF SOUTHOLD BUILDING DEPT.
765-1802
INSPECTION
[ ] FOUNDATION 1ST [ ] ROUGH PLBG.
[ ] FOUNDATION 2ND [ ] INS TION
[ ] FRAMING/STRAPPING [ INAL
[ ] FIREPLACE A CHIMNEY [ ] FIRE SAFETY INSPECTION
[ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRATION
[ ] ELECTRICAL (ROUGH) [ ] ELECTRICAL (FINAL)
REMARKS: C�
DATE INSPECTOR
FIELD INVECr N REPORT DATE COMMENTS
EFOUNDATION(1ST) W...�
- -------------------------------
FOUNDATION(2ND) ml
• z
ROUGH FRAMING& y
PLUMBING
Ell
VIER
INSULATION PER N.Y.
H
STATE ENERGY CODE
Y
FINAL
Z
ADDITIONAL COMMENTS
O
Z
W �
tyi
C
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. 7 Check
Septic Form
N.Y.S.D.E.C.
Trustees
C.O.Application
r I "�p
Flood Permit
Examined v a� ,20 `� Single&Separate
Storm-Water Assessment Form
:
Approved ,20Mail to:
BLDG. DE
Disapproved a/c —7
Phone: 1�� g �J� :
Expiration 20
Building Inspector
APPLICATION FOR BUILDING PERMIT
Date r v� , 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 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, housiTfg cod ,and regulation , and to admit
authorized inspectors on premises and in building for necessary inspections.
A-t
(Signature of applicant or name, if a corporation)
0 h'0v /g ej ))2/r/'; /'V
(Mailing address of applicant)
State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician,plumber or builder
11 PF1 iG c.-r /.1 ow/y6x
Name of owner of premises c A
(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 wl ich proposed work will be done:
House Number Street G Hamlet ,
County Tax Map No. 1000 Section 0 Block 9 Lot 7 1
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 wo STo92 S!y6A17-14 t- l7G1/6Lc//V�-
b. Intended use and occupancy
3. Nature of work(check which applicable): New Building Addition Alteration
Repair Removal Demolition Other Work 4.5 BvrL%
(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. A✓
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 Height Number of Stories
8. Dimensions of entire new construction: Front Rear Depth
Height Number of Stories
9. Size of lot: Front Rear Depth
10. Date of Purchase -2'n� 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 IVI
14.Names of Owner of premises ?o 13r' Mao Address gdX t phone No.65t
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 V
* 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
* IF YES, PROVIDE A COPY.
STATE OF NEW YORK)
S:
COUNTY OF
S�
:j�nl ,t" 4'n—I' 1, I n1--) being duly sworn, deposes and says that(s)he is the applicant
(Name of individual signing contract) above named,
(S)He is the 0 W- - -'P2 V(- �
(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 efore me thi %
dayof 20 k
VICKI TOTH
Notary Public State of New York
`f06190696
Notary Public Qualified in suffolk County Signature of Applicant
Commission Gpires July 28,2 L
y m TOWN OF SOUTHOLD FWPERTY RECORD CARD
OWNER STREET ZY 4f 0 VILLAGE DIST. SUB. ,LOT
FORMER OWNER N E ACR:
S I W TYPE OF BUILDING
' I
40. �t�8 t�//S g k
RES. SEAS. VL. FARM COMM. CB. MICS. Mkt, Value a-•:
LAND IMP. TOTAL DATE REMARKS
31y,4 e-,
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-
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6 7o '0-0 - // /0
AGE BUILDING CONDITION
NEW NORMAL BELOW ABOVE
FARM Acre Value Per Value
Acre
Tillable FRONTAGE ON WATER
Woodland FRONTAGE ON ROAD /S-
,M, eadowl•ond DEPTH a2
Houseo �'' BULKHEAD
Tdto DOCK
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Town Hall Annex 41: P. I Telephone(631)765-1802
S4375 Main Road N ax(631)765 50Q22
P.O.Box 1179 G. roger.nchert(eown. outPold.ny.us
Southold,NY 11971-0959
BUILDING DEPARTMENT
TOWN OF SOUTHOLD
APPLICATION FOR ELECTRICAL INSPECTION
REQUESTED BY: Date:
Company Name: .
Name: .
License No.:
Address:
Phone No..
JOBSITE INFORMATION: (*ind.icates required information)
*Name: A
*Address: $ C) /1/d&-
*Cress Street: ✓"qTg 7�f
*Phone No.: (25Z/ g6S- E-364 o e ! 7� • ,T/ . J
Permit No.:
Tax-Map District: - 1000 Section: `7 i Block: Lot:
*BRIEF DESCRIPTION OF WORK (Please Print Clearly) GINS 4A,0 oeragT' o7V
{Please Circle All That Apply)
*is job ready for inspection: YE / 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
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PLUMBED?CERTIFICATfO'V
ON'LEAD CONTEN 1 br.::,r iE
r ` . ._._� " ;, ,'. 'K i e? Dk k Y : i c,r .;=t L:: :►6 ,;�; � - � RTIFICATE OF OCCI_J PANCY
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PLY SYSTEM Q;j,,',!N0T
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WAS
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NCCU
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�•, ECC � MC�
-SEt'ri, ._ 1�ci+r f'I.A JUN 2 0 2012
1 APPROVED AS NOTED
Imo. �
P,#_. BLDG.DEPT.
A -- TOWN OF SOUTHOLD
< _ _
,' 4.)TIFY BUILDING DE. ARTMFN7 AT
i . _ _ __.._.. 1—� I�jt�l , � y � 765-1802 8 AM TO 4 PM FOR THE
E -- ICAL
FOLLOWING INSPECTIONS:
1. FOUNDATION-TWO REQUIRED INSPECTION EQUI—RED
FOR POURED CONCRETE
'�-o GJ✓-ILtn� 1514..1-to 35,i 0 S' fC �' r <: �t-
_ M A.F,e. ,'� 2. ROUGH-FRAMING,PLUMBING, 5 A.
\ STRAP N ,ELECTRICAL&CAULKING w
N at r n s N. �--- _., / 3. INSULATIONrp ,
� & k � 'Q �r � 1 4. FINAL-CONSTRUCTION&ELECTRICAL
MUST BE COMPLETE FOR C.O. Q 1
ALL CONSTRUCTION SHALL MEET THE 1
REQUIREMENTS OF THE CODES OF NEW J k � ;
_ YORK STATE. NOT RESPONSIBLE FOR ` `�
' 4fr � � DESIGN OR CONSTRUCTION ERRORS.
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