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HomeMy WebLinkAbout37278-Z z " TOWN OF SOUTHOLD moo y BUILDING DEPARTMENT z 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#: 37278 Date: 6/6/2012 Permission is hereby granted to: Wren, John &Wren, Sharon 23 Lake Dr Somers, NY 10589 To: install a HVAC system to an existing dwelling as applied for At premises located at: 225 Hippodrome Dr, Southold SCTM # 473889 Sec/Block/Lot# 66.-2-32 Pursuant to application dated 6/1/2012 and approved by the Building Inspector. To expire on 12/6/2013. 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 Thus application must be filled in by typewriter or ink and submitted to the Building Department with the following: For neiv building or a.eivuse: 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 DepL 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, mtiltiple residences and similar buildings and installations,a certificate of Code Compliahce•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: I. 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. F-Les 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_ Tem_porary Certificate of Occupancy -Residential$15.00,Commercial$15.00 Date. (0 l� 7-- New Construction: Old or Pre-existing Building: '� (check one)- Location of Property: House No. � o L7 Street Hamlet r Owner or Owners of Property: ,J o /-4, S —/wAAg A.( 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: eck one)- ee Subnutted.- $ .16, an Si nature r S-�z U16 � Eoer� ooXhvr� D � IN 7/ JUN e AI2 OF Re�7 ( SecP � .� Qtiv �{S'I 36 kE t FIELD INSPECrION REPORT DATE COMMENTS tZ FOUNDATION(IST) ----- ,---. -------------- FOUNDATION(ZND) � z vo ROUGH FRAMING& 4 PLUMBING � INSULATION PER N.Y. . H STATE ENERGY CODE 4 FINAL ADDITIONAL COMMENTS o . rn GDz , TOWN C,f� O� ll JoHOLD BUILDING PERMIT APPLICATION CHECKLIST BUILDIN4GEPARTMENT 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.NorthForlc.net PERMIT NO. 1�� Check Septic Form N.Y.S.D.E.C. D E C E W E Trustees C.O.Application Flood Permit Examined d6 204 J U N 2012 Single& Separate � Storm-Water Assessment Form BLDG.DEPT. Contact: Approved 20_� TOWN OF SOUTHOLD Mail to: Disapproved a/c Phone: Expiration 20�3 TO Lie 10-e' 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 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,tlie 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 demoli ion as herein described.The applicant agrees to comply with all applicable laws, ordinances, building code, housing code, and1i ulations, and to admit authorized inspectors on premises and in building for necessary inspections. OCCUPANCY OR !J F IS UNLAWFUL (Signa ure of applicant or name, if a corporation) WITHOUT CERTIFICATE V 'PROVED AS NOTED I ",.r,,,C "? �� M adze ofa 1' ant State whether applicant is owner, lessee agent architect engineer eneral cA"At ' o �l:ctri n uilder pP b b � g Not+FY BUILDING DEPARTMENT AT V649U2 6 AM TO 4 PM FOR THE 1 L / F0UNDATION-TWO REQUIRED Naive of owner of premises 4 �f-�/F/t°�� �- ���✓`� FOR POURFn rONCRE TEiL`: (As on the tax roll or 19teRQ11;-)fRAMING;PLUMBING,, If applicant is a corporation, signature of duly authorized officer STRAPPING, ELEbTRICiAL-b CAUI.KI�G 3. INSULATION �. 4. FINAL,-,CONSTRUCTION S ELECTRIC L (Name and title of corporate officer) mu&*E E COMPLETE-FOR-C:O.,.. Builders License No. Plumbers License No. ALL CONSTRUCTION SHALL MEETTHE ' Electricians License No. REQUIREMENTS OF THE CODES OF NEW Other Trade's License No. YORK STATE. NOT RESPONSIBLE FOR DESIGN OR CONS TfZU T10N ERRORS, 1. Location of land on which proposed work will be done: House Number Street Hamlet County Tax Map No. 1000 Section Block Z Lot U Subdivision Filed Map No. Lot 2. State existing use and occupancy of premises and intendgd use and occupancy of proposed construction: a. Existing use and occupancy L Li i2es c- r(. b. Intended use and occupancy 3. Nature of work (check which applicable): New-Building Addition Alteration Repair Removal Demolition Other.Woik -T,v�+/�c� r/r✓,bq (Description) 4. Estimated Cost % 7 U 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 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 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 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? *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 elevatiowq,ally,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,NE*, ,Y- QRK), . COUNTY OF c'u'C'J `; i,i'�;' •.:„' .: (it;�r%l; ,.`.: .. being duly sworn, deposes and says that(s)he is the applicant (Name of'.iM4id signing contract) above named, CONNIE D. BUNCH Notary Public, State of New York a.�a air)f i,e 4.�ent ,ui'. i •,: S He is the �.! . - ;a F :, No.01 BU6185050 ( ) Q Srufio!K County (Coiatractor;Agent, Corporate Officer, etc.) Commission Expires April t ,��Co of said owner br%Wii1r% fafid i§-duly)duthorized to perform or have performed the'said work and to make and file this application; that all statementsT&�Rtali ed`iiii"ttlii's"application afe true to the best of his knowledge\ nd belief; and that the work will be performed in the miits�e` �rtlitiiil[e appFiati.ori.ifiled therewith. Sworn to before me this day of 20 1�- Notary Public Signatur of Applicant Town Hall Annex l [ Telephone(631)765-1802 54375 Main Road y ,,aaxx(631)765 g5Q2� P.O.Box 1179 G roger.rldhert(cr. i©Wn.soutKo ny us Southold,NY 11971-0959 coul . BUILDING DEFA,RTMENT TOWN OF SOUTHOLD APPLICATION FOR ELECTRICAL INSPECTION ED REQUEST BY: ��a �t�i � !it/��n� . Date: v- Company Name: Name: License No.: Address: Phone No.: JOBSITE INFORMATION: (*Indicates required information) *Name: Jv 4- *Address: -2- 2 S' t`�i /T��70-,,767 *Cross Street: *Phone No.: Permit No.: Tax-Map District: 1000 Section: Block: L Lot: L *BRIEF DESCRIPTION OF WORK (Please Print Clearly) JPJease Circle All That Apply) *ls 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 Additional Information: PAYMENT DUE WITH APPLICATION :82-Request for Inspection Form 0 Survey dtd 051607.Jos Ingegno.pdf Page 1 of 1 momialham@gmail.com Survey dtd 051607.Jos Ingegno.pdf Save in Goagle Dues! Download original Sham File Yew Help Search the document. •S"rys_ 6m . '0 10 7; Y. M e w- a r ' % 11 S https://does.google.com/viewer?a=v&pid=gmail&attid=0.2&thid=137a87a4d4b4935b&mt=... 6/1/2012 'II�IIIIII III II' Office Location:LONG ISLAND Proposal Date 05/01/2012 Job Number 13703937 Sears Home Improvement Products,Inc. Customer Name 012F59 P.O.Box 522290 JOHN WREN 1024 Florida Central Parkway S,:,Customer's Home Phone Customer's Work Phone Longwood,FL 32750-7579 (914) 277-4821 (914) 769-4000 Home Improvement Products phone 800 469-4663 Street Address ESTIMATE AND PROPOSAL Contractor License/Registration Number 225 HIPPODROME DR NYC 1225166;Nassau County H1809170000;Putnam city State Jzip Code Heating & Cooling County PC3159-A;Rockland County H-9990-A6-00-00; SOUTHOLD NY 11971 Is installation within city limits? Suffolk County 41506-H;Westchester County Installation Address County SUFFOLK (Yes/No): YES WC-1 8371-H06;Yonkers 4213 Billing Address(if different from above) City State Zip Code Project Consultant Name&License No.(if applicable) VICTOR LUPIS Description of the Project and Description of the Significant Materials to be Used and Equipment to be installed SYSTEM INFORMATION: Equipment Brand:CARRIER (Split System/Package/Dual Fuel/Straight Cool/Heat Pump/Furnace): SEER: 15.50 Cooling BTU: 34000.00 KW: HP AIR HANDLER Q R 410A EQUIPMENT SPECIFICATIONS: FURNACE FUEL: (Gas/Oil/LP Gas/Electric): Existing New MODEL#OF NEW COMPONENT AFUE(up to): Heating BTU: ❑ ® FURNACE/FAN COIL FV4CNF003T00 ELECTRICAL: ❑ ® CONDENSER UNIT 25HPA636AO03 ® CONNECT TO EXISTING ELECTRICAL ❑ ❑ EVAPORATOR COIL ❑ INSTALL NEW AMP MAIN PANEL ❑ ❑ PACKAGE UNIT ❑ NEW DISCONNECT ❑ FURNACE ❑ CONDENSER ❑ ® THERMOSTAT 1F82-261 ❑ NEW GFI OUTLET ❑ATTIC LIGHT&RECEPTACLE ❑ ❑ HUMIDIFIER Other: ❑ ❑ AIR CLEANER DUCT WORK: ❑ ❑ UV LIGHT ❑ RE-USE EXISTING DUCT SYSTEM ❑ ❑ EVAP COOLER ® INSTALL NEW DUCT SYSTEM WITH# 7 NEW RUNS MISCELLANEOUS: ❑ REBUILD PLENUM (Supply/Return): ❑ ® LINE SET 50 ® PAD "x ❑ NEW TRUNK LINE(S) (Supply/Return): ❑ ® DRAIN LINE 10 ❑ CONDENSATE PUMP ❑ NEW RETURN GRILL(S) X X ❑ ® AUXILIARY DRAIN PAN ❑ Other ❑ EXISTING RETURN GRILL SIZE ❑ REPLACE REGISTER(S)# ❑ DUCT CLEANING Other: FLUE VENTING AND/OR CHIMNEY: ❑ Use existing vent or chimney ❑ Install new chimney liner Size: ❑ PVC Vent Pipe for High-Efficiency Furnace ❑ Horizontal ❑ Vertical ❑Type-B Vent Pipe ❑ Stainless Steel Vent Pipe ❑ 1 Pipe Installation ❑ 2 Pipe Installation ❑ Combustion Air ❑ Existing ❑ Modify SPECIAL INSTRUCTIONS:CARRIER 3 TON HEAT PUMP... 7 DUCT SYSTEM 4 DROPS...QUALIFIES FOR LIPA CREDID 49746-HS All of the above check boxes and "Special Instructions" section have been reviewed and Customer(s)initials explained to me. SH1-NY (Dig.) Rev 01/27/12 Page 1 of 3 II I II III III III Job Number: 13703937 APPROXIMATE START DATE and APPROXIMATE COMPLETION DATE: The work will start approximately 2 WEEK (Approximate Start Date) It will be substantially completed by approximately 2WEEKS (Approximate Completion Date) These dates are subject to change at the time the contract is accepted by Sears Home Improvement Products, Inc. ("Sears")or at any other time by mutual written agreement.Customer understands that the Approximate Start Date is only an estimated date and the Customer will be contacted prior to this date to schedule the actual start date. ASBESTOS ABATEMENT:This Estimate and Proposal assumes that there are no asbestos containing materials ("ACMs")that would be disturbed in the performance of the installation work. If upon further inspection by the contractor or others it is learned that ACMs have to be disturbed to perform work,then Customer must arrange and pay for abatement of asbestos by a qualified person prior to the start or continuation of work. If Customer fails to arrange for necessary asbestos abatement within thirty(30)days, Sears may cancel this contract upon Customer(s)initials written notice to Customer. PLEASE NOTE that Sears is not responsible for correcting any existing code violations or pre-existing conditions of any ductwork,piping,electrical supplies or equipment not being replaced at this time. If additional work is required,it will be the Customer's responsibility.Any additional charges will be quoted and approved prior to the start of any additional work. Customer(s)initials I IF THE CONTRACT PRICE INCLUDES: Price A copy of the terms and conditions of the Master Protection Agreement or Re- -Year Master Protection Agreement ❑ $ pair Protection Agreement(as applicable)have been provided to Customer. -Year Repair Protection Agreement ❑ $ Customer(s)initials The TOTAL PRICE including all labor,material,taxes and any applicable discount is$ 13,605.00 Contract Price a_$13,605.00 State Sales Tax( 8.63 %) $ 0.00 Local Sales Tax( o.oo %) $ o.oo Customer Payment is due prior to Sears'placement of Special Order for products. Total Amount Due $13,605.00 The form and method by which the Customer(s)will pay is described in a separate Cash/Credit Customer(s)initials Card Payment Addendum made a part of and incorporated into this contract by reference. NOTICE TO BUYER:YOU,THE BUYER,MAY CANCEL THIS TRANSACTION AT ANY TIME PRIOR TO MIDNIGHT OF THE THIRD BUSINESS DAY(FIFTH BUSINESS DAY IN ALASKA,FIFTEENTH BUSINESS DAY IN NORTH DAKOTA IF YOU ARE AGE 65 OR OLDER)AFTER THE DATE OF THIS TRANSAC- TION.SEE THE ATTACHED NOTICE OF CANCELLATION FORM FOR AN EXPLANATION OF THIS RIGHT. ADDITIONAL PROVISIONS Proposal and Approval.Sears offers to furnish the materials and arrange for their delivery and installation as specified on the first page and/or the attached sketches and specification sheets for the TOTAL PRICE shown.This offer must be,approved by the Installation Department.If this is a credit sale or a payment on completion sale,it must be approved by the Credit Sales Department.If this proposal is not approved or the installation cannot be made in accordance with the law,this offer will be withdrawn and any payments you have made will be refunded to you.Any materials left over after the installation has been completed are Sears property and will be removed by Sears. Installation.I understand that Sears will not install the materials but will arrange for the installation.Sears is not responsible for materials or installation NOT furnished or arranged by Sears.Sears'installation contractor(s)will obtain all building permits required by local law.For homes located in historic or landmark zoning districts,Customer will be responsible for,obtaining required approvals and related permits prior to the commencement of work on this contract. Authorization. I authorize Sears to:(1)arrange for a contractor(licensed where required by law)to make the installation of materials;(2)issue a work order for this installation to a contractor;(3)inspect the installation;and(4)pay the contractor when the installation is complete if I have signed a certificate that the installation has been completed to my satisfaction. Delays in Installation.I agree that Sears is not responsible for delays in delivery or installation due to weather,fire,strikes,war,government regulations or any causes beyond Sears'control. Oral Agreements and Changes in Contract.I understand that there are no oral agreements between Sears and me.Everything I expect Sears to do has been included in writing in this contract.Nothing can be changed in this contract unless it is in writing on a separate form accepted by me and Sears. Responsibility of Buyer. I agree that any information or measurements that I give to Sears are correct and complete. I am responsible for any special work described in this contract. Electrical&Plumbing Service. I will provide adequate electrical and/or plumbing service(s)to run any newly installed appliances or other furnishings. If the electrical and/or plumbing service(s)do not meet the standards of the utility company or electrical and/or plumbing codes,I will make the necessary changes at my expense unless Sears has agreed in this contract to make the changes. Payment.I will pay Sears the cash price that covers the price of material and installation as shown on the first page. Warranty Information.Appropriate product warranty documents will be given to me by Sears.Sears'Warranty on Installation is: SEARS'LIMITED WARRANTY ON INSTALLATION In addition to any manufacturer warranty extended to you on the product(s)used(which warranty becomes effective the date the merchandise is installed),if the workmanship(or application)of any Sears'arranged installation proves faulty within one year after the completion of installation,then upon notice from you Sears will cause such faults to be corrected by repair at no additional cost to you. If Sears determines that repair is not commercially practicable or cannot be timely made,then,at Sears'sole discretion,Sears may elect to provide replacement or refund.Service under this Limited Warranty is available by calling Sears Home Improvement Products at 1-800-222-5030,Option 4.This warranty gives you specific legal rights,and you may also have other rights that vary from State to State. SHI-NY (Dig.) Rev 01/27/12 Page 2 of 3 Job Number: 13703937 NOTICE TO BUYER 1. DO NOTSIGN THEAGREEMENT IFANY OFTHE SPACES INTENDED FOR THE AGREED TERMS TO THE EXTENT OF THEAVAILABLE INFORMATION ARE LEFT BLANK. 2. YOU ARE ENTITLED TO A COPY OF THIS AGREEMENT AT THE TIME YOU SIGN IT.KEEP IT TO PROTECT YOUR LEGAL RIGHTS. 3. YOU MAY PAY OFF THE FULL UNPAID BALANCE DUE UNDER THE AGREEMENT AT ANY TIME,AND IN SO DOING YOU SHALL BE ENTITLED TO A FULL REBATE OF THE UNEARNED FINANCE AND INSURANCE CHARGES. 4. YOU MAY CANCEL THIS TRANSACTION AT ANY TIME PRIOR TO MIDNIGHT OF THE THIRD BUSINESS DAY[FIFTH BUSINESS DAY IN ALASKA, FIFTEENTH BUSINESS DAY IN NORTH DAKOTA IF YOU ARE AGE 65 OR OLDER]AFTER THE DATE OF THIS TRANSACTION.SEE THE ATTACHED NOTICE OF CANCELLATION FORM FOR AN EXPLANATION OF THIS RIGHT. FAILURE TO EXERCISE THIS OPTION, HOWEVER, WILL NOT INTERFERE WITH ANY OTHER REMEDIES AGAINST THE RETAIL SELLER YOU MAY POSSESS. IF YOU WISH,YOU MAY USE THIS PAGE AS NOTIFICATION BY WRITING"I HEREBY RESCIND"AND ADDING YOUR NAME AND ADDRESS.A DUPLICATE OF THIS RECEIPT IS PROVIDED BY THE SELLER FOR YOUR RECORDS. 5. IT SHALL NOT BE LEGAL FOR THE SELLER TO ENTER YOUR PREMISES UNLAWFULLY OR COMMIT ANY BREACH OF THE PEACE TO REPOSSESS GOODS PURCHASED UNDER THIS AGREEMENT. NOTICE TO NEW YORK RESIDENTS ONLY Any contractor,subcontractor,or materialman who provides home improvement goods and services pursuant to your home improvement contract and was not paid may have a valid legal claim against your property known as a mechanics lien.Any mechanics lien filed against your property may be discharged.Payment of the agreed-upon price under the home improvement contract prior to filing a mechanics lien may invalidate such lien.The owner may contact an attorney to determine his rights to discharge the mechanics lien. In accordance with Subdivision Four of Section 71-A of the New York Lien Law,Sears has posted a bond with SAFECO INSURANCE COMPANY OF AMERICA,a surety company licensed by the State of New York,guarantying the proper application by Sears of any cash payments or cash deposit received from the customer under this home improvement contract prior to the substantial completion of the work.The surety bond is in lieu of the escrow requirements of the New York Lien Law.Written notification of any and all claims asserted by the customer under this bond,along with a copy of the customer's contract,should be sent to:Sears Home Improvement Products,Inc.,P.O.Box 522290,Longwood,FL 32752-2290. NOTICE TO NEW YORK CITY RESIDENTS ONLY The Contractor agrees to furnish the Buyer with a"Certificate of Workers'Compensation Insurance"prior to commencement of work pursuant to the Contract. 05/01/2012 05/01/2012 Customer's signature Date Customer's signature Date Accepted by Sears Home Improvement Products,Inc:("Sears")on 05/01/2012 by. Date Management Representative SH1-NY (Dig.) Rev 01/27/12 Page 3 of 3