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Home My WebLink About37328-Z r O�glaFFa( c � Town of Southold Annex 9/4/2012 y� P.O.Box 1179 Goeb '-'ts X, 54375 Main Road oy �g,� Southold,New York 11971 CERTIFICATE OF OCCUPANCY No: 35931 Date: 9/4/2012 THIS CERTIFIES that the building OTHER Location of Property: 625 Indian Neck Ln,Peconic, SCTM#: 473889 Sec/Block/Lot: 86.4-4.24 Subdivision: Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this officed dated 6/18/2012 pursuant to which Building Permit No. 37328 dated 6/26/2012 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: conversion to gas heat as applied for. The certificate is issued to Molnar,John&Molnar, Lisa (OWNER) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL ELECTRICAL CERTIFICATE NO. PLUMBERS CERTIFICATION DATED Auth d Si ture u�z TOWN OF SOUTHOLD ��o y BUILDING DEPARTMENT TOWN CLERK'S OFFICE 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#: 37328 Date: 6/26/2012 Permission is hereby granted to: Molnar, John & Molnar, Lisa 625 Indian Neck Ln Peconic, NY 119581719 To: Convert to gas heat as applied for At premises located at: 625 Indian Neck Ln, Peconic SCTM # 473889 Sec/Block/Lot# 86.-1-4.24 Pursuant to application dated 6/18/2012 and approved by the Building Inspector. To expire on 12/26/2013. 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: . For ne'vv building or nely-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. 'Sw.orn statement from plumber certifying that the solder used-in system contains less than 2l10 of 1% lead. 5. Commercial building,industrial building,multiple residences and similar buildings and installations,a certificate of Code CompIiance'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 features. showing all property lines,streets,building and unusual natural or topographic 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 - I. Certificaie of Occupancy- New dwelling$50.00, Additions to dwelling$50.00,Alterations to dwelling$50.00; Swimming pool$50.00,Accessory building$50.00, A.dditions to accessory building$50.00, Businesses$50.00. 2. Certificate of Occupancy on Pre-existing Building- $100.00 3. Copy of Certificate of.Occupaincy-$25 4. Updated Certificate of Occupancy- $50.00 5. Temporary Certificate of Occupancy -Residential$15.00,Commercial.$15.00 Date. ti New Construction: Old or Pre-existing Building: I/ (check one) Location of Property: , Ou J C/ House No. Street Hamlet Owner or Owners of Property:— � _6�� , Suffolk County Tax Map No'1000, Section CO•D(j Block �{ d 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). :ee Submitted: $ plicaiit Signature �o��OF SOpT�o`o TOWN OF SOUTHOLD BUILDING DEPT. 765-1802 INSPECTION . . [ ] FOUNDATION 1ST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] 1 LATION. [ ] FRAMING/STRAPPING FINAL [ ] FIREPLACE A CHIMNEY [ ] FIRE SAFETY INSPECTION [ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRATION [ ] ELECTRICAL (ROUGH) [ ] ELECTRICAL (FINAL) REMARKS: DATE INSPECTOR FIEL :� SON REPORT DATE COMMENTS FOUNDATION(1ST) - ---,--- �,.-. -------------- FOUNDATION(2ND) cn ROUGH FRAMING& PLUAMING . Cq INSULATION PER N.Y. STATE ENERGY CODE / Ld V FINAL cl S J l2 ADDITIONAL COMMENTS O z • m ,L 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 C E jJ n(j Flood Permit Examined 20 Q lU' U V Single&Separate L./ Storm-Water Assessment Form L4,20 JUN � 8 2012 Contact:Approved /0- Mail to: Disapproved a/c TOWN OF SOUTHOLD Phone: Expiration 20_3 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 1 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 Pen-nit. 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.ln.spector 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 inspection (Signature of applicant or name, if a corporation) '9`fi. , t :� =L �:�c<% �Tf— ?C7 a (Mailing address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician plumber or builder tit 0*a r 3' Name of owner of premises �i 1Ts '� —W� BY (As on the tax roll or latest.cie.q l�8 AM TO 4 1V . If applicant is a corporation, signature of duly authorized officer 1=°r..-QW G INSPECTIOtj;51 10ATION-TWO REC!' RLD (Name and title of corporate officer H-FPOUREDCONCRETE (N p ) � ROUGH RgIMI�NQ,PLUMBING, Builders License No. ELECTRICAL 'SAPPING,ELECTRICAL&CAULKINr Plumbers License No. 1 EQUIR DNSULATION 4 FINAL-CONSTRUCTION 3 ELEC7'Rc��. Electricians License No. MUST BE COMPLETE FOR C.O. Other Trade's License No. ALL CONSTRUCTION SHALL MEET THE REQUIREMENTS OF THE CODES OF NEW 1. Location of land on which proposed work will be done: YOS K STATE. NOT FESPONSIBLE FOR 14N ��ClL Lac _, 'A�. sTRucrlory E RORS:.:,.;: House Number Street Hamletw*y;., County Tax Map No. 1000 Section Block �F , Lot c)-.?, 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 b. Intended use and occupancy 3. Nature of work(check which applicable): New Building Addition Alteration Repair Removal Demolition Other Work ,Szee UT\ (Description) 4. Estimated Costrcx, C)U -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 existirig,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`]ront Rear Depth 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 or3,e9ulation? 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 Address Phone No. Name of Architect Address Phone No Name of Contractor - j /Address 2-S�D(Z,MiV_ Phone No. �1- C10;�-cl o 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 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 individnt7 ryco tract)above named, (S)He is the to, 4Cbritractor, Agent, Corporate Officer, etc.) of said owner or owi3'ers aNd? s duy:autliorized to perform or have performed the said work and to make and file this application that all statements.c_bt�d�ed,iri tll�s.;application;are true to the best of his knowledge and belief; and that the work will be performed in the mat�i�ier set,foh apttlle;.applieation filed therewith. S orn to b IOHN,ALFINO- M, State of New Yor O i ay 01 AL6120231 Qualified in Suffolk County Commission,Expires Dec mb r 13,20/_�' b Signature of Applicant TA- - - 011 19111111C . 9:I=1A 1 • • - I • —-- �l _—..-- i — i heato t —44G P:r s There are models and sizes available for every installation and environment. 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