HomeMy WebLinkAbout28261-ZFORM NO. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Office of the Building Inspector
Town Hall
Southold, N.Y.
CERTIFICATE OF OCCUP;%NCY
No: Z-29336
Date: 04/01/03
THIS CERTIFIES that the building ACCESSORY
Location of Property: 325 PAVILION CT SOUTHOLD
(HOUSE NO.) (STREET) (~LAMLET)
Co%~nty T~X Map No. 473889 Section 88 Block 6 Lot 13.19
subdivision Filed Map No. -- Lot No. --
conforms substantially to the Application for Building Permit heretofore
filed in this office dated APRIL 9, 2002 pursuant to which
Building Peri, it No. 28261-Z dated APRIL 11, 2002
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 ACCESSORY INGROUND SWIMMING POOL WITH FENCE TO CODE AS APPLIED FOR.
The certificate is issued to MICHAEL J KELLY
( OWNER
of the aforesaid building,
SUFFOLK COUN/"fDEPARTMENT OF HEALTHAPPRO~L~J~
ELECTRICAL CERTIFICATE NO.
PLUMBERS CERTIFICATION
Rev. 1/81
N/A
63071 05/29/02
N/A
Author~ z;d~ S~-gnat ur~
FORM NO. 3
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Town Hall
Southold, N.Y.
(THIS
BUILDING PERMIT
PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL
COMPLETION OF THE WORK AUTHORIZED)
PERMIT NO. 28261 Z Date APRIL 1t, 2002
Permission is hereby granted to:
ZOUMAS (KELLY)
WADING RIVER,NY 11792
for :
CONSTRUCTION OF A/q INGROUND SWIMMING POOL WITH FENCE TO CODE IN
THE REQUIRED REAR YARD AS APPLIED FOR
at premises located at
County Ta,x Map No. 473889 Section 088
pursuant to application dated APRIL
Building Inspector.
325 PAVILION CT
Block
9, 2002
SOUTHOLD
0006 Lot No. 013.019
and approved by the
Fee $ 150.00
Authorized Signature
COPY
Rev. 2/19/98
Form No. 6
TOWN OF SOUTHOLD
BUILDINGTOWN 765-1802 DEPARTMENT HALL
APPLICATION FOR CERTIFICATE OF OCCUPANCY
This application must be filled in by typewriter or ink and submitted to the Building Department with the following:
ho
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 2/10 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.
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 Building Inspector shall state the reasons therefor in writing to the applicant.
1. Certificate of Occupancy - New dwelling $25.00, Additions to dwelling $25.00, Alterations to dwelling $25.00,
Swimming pool $25.00, Accessory building $25.00, Additions to accessory building $25.00, 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 $15.00, Commercial $15.00
~' Date. ~l~llo 3
New Construction: ~m~,,,~ '¢~ I Old or Pre-existing Building:
LocationofProperty: ~ x~cx,~\~ ~c~ Co,~ k %9~q4~'0/~
House No. Street
(check one)
Hamlet
Owner or Owners of Property: ~\,4h0~\
14qg% ~q
Suffolk County Tax Map No 1000, Section
Subdivision Awx ~e/ 6~oce~
Permit No. ;~ ~Oh, l
Health Dept. Approval:
Planning Board Approval:
DateofPermit. q I~1C~5~
Underwriters Approval:
Block Or~c~ ~, Lot
Filed Map. Lot:
Applicant: ~2o~ma,5 C~r~5%t,~,~,~,-~
Request for: Temporary Certificate
Fee Submitted: $ <05 oo
Final Certificate:
(check one)
/~¥~pplicant Signature
Electrical ZnspecHon CerH£ica e
Date
5/29/02
Electrical Inspection Service, Inc.
375 Dunton Avenue
East Patchogue, NewYork 11772
(631) 286-6642
AD=licatiot~ #
63071
Issued to: Mike Kelly
Street: 325 Pavilion Ct.
Village: Southold
Section: 88 Block: 6
Introduced by: Hank's Electric Inc. (L)
Zip: 11971
Lot: 13.19
Town: Southold
Lic.# 2675-E
w~ exam/ned and found fo be in comp/lance wi~h fhe I~Honnl Electeical ~'od~
[] Commercial []NV Defects [] Pool [] lst FIoor [~lndoor []Basement [] Hot Tub
[] Residential [] Der. Garage []Attic []2nd FIoor {~Outdoor [] Addition [Survey
Switches Receptacles Fixtures
2 1 1
Dishwasher Washer/Amp Dryer/Amp
GFI Heaters A/C Fans
Oven Range/Amp Garbage Disposal
Furnace Oil Gas Circulator Smoke Detector Bell Transformer
Meter Amps Phase
Other EquipmenC
t/merlpool pane/
UG/OH Telephone
Television Carbon Monoxide
Building Permit #
Hug~ S, Surdi
President
Rough Inspection:
Inspector: Ed Scavelli
Final [nspection: 5/28/02
[nspector: Ed Scavelli
This certificate must not be altered in any manner. Inspectors may be idenUfied by their credentials
appttcanu ~-4~-~--~,-Z ~ "',~ Reviewed
Owners Nmlle:
Architect/ ~ Date ~-
Engineer: -- Submilied cC/c)/
SCTM #:
Single & separate Requtreo
cerl~ ficatiofl
,.~
Project Descd~ / ~ ~
Subdivision
FA.o_..-.
Proposed _ 6)~c : [Rear Yard _ ~ Pfor~ I
REOUIRED FOR REVIEW
Permit
NO YES Number
Suffolk County Health' Dept.
New York State D, E. C.
Town Trustees
Town Zoning Board approval:
Town Planning Board approval:
Flood Plane Elevation ???
Flood Zone:
Notes:
LOT AREA, 32.183 ,q. fl.
F. FL. ELEV.=
GAR. ELEV.-- 13.8
DA"TL~r'~ NGYD
LOT NO. I$
N. 2B*04'04" E,
S. 28'04'04" W.
21L40'
"OPEN SPACE'*
~Tfie existence of right of ways an~l or easements
of record, if any~ not shown are not guaranteed.
2-BI-2002 LOCATED DRIVEWAY
PlO-BO02 ADD BLDG. SETBACK
8-1&-2OOI'FINAL SURVEY
4-$0-2001FOL~DATION COCATtO~I
[ ]
[ ]
[ ]
[ ]
765-1802
BUILDING DEPT.
INSPECTION
FOUNDATION 1ST
FOUNDATION 2ND
FRAMING
[ ] ROUGH PLBG.
[ ] IN,,/SI~ATION
[ ,~INAL
& CHIMNEY
//-/,/
FIELD INSPECTIO1N' REPORT i DATE
FOUNDATION (1ST) --
FO~ATION (2ND)
RO~G~ F~G &
PL~B~G ~
STATE ENERGY CODE
TOWN OF SOUTHOLD
BUILDING DEFARTMENT
TO;VN HALL
SOUTHOLD, NY 11971
TEL: (631) 765-1802
FAX: (631) 765-9502
Examined _/~
20_/;)
Disapproved a/c
___,20___
PERMIT NO.
BUILDING PERMIT APPLICATION CHECKLIS
Do you have or need the following, belbre applym~
Board of Health
3 sets of Bu/lding Plans
planning Board approval
Survey
Check
Septic Form
N.Y.S.D.E.C.
Trustees
Contact:
APPLICATION FOR BUII~DING PERMIT
INSTRUCTIONS
completely filled in by typewriter or in ink and submitted to the Building Inspector with 3
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 ora 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 rD 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..,,/~/-,~/-/-~ ~ ~- .~_ /...
US[[V~'vuls rRn~/UNLAWFU, OnL :: REQUIRED, s e, ./~ ' r(tSi~ture_/o~ppliclmt or name, ifa corporation~
WITHOUT CERTIFICATE i NMccoMs iouA?-'roEcoL
ENC 0 0Vlmling address dfJapphcant)
OF OCCUPANCY uPo co LmOn " '
BEFORE '~NATER'°
State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder
Name of owner of premises ~)Q~/(>~l~ ~/~
(As once tax roll or
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.
LDpROVE, D AS NOTED
_~. . /).~ g~
la,es l
76S-1802 ~ AM TO 4 PM FOR THE
F(XJ.OWlN6 INSPECTIONS:
1. FOUNDATION - TWO REQUIRED
FOR POURED CONCRETE
ROUGH . FRAMING & PLUMBING
2. INSULATION
4. FINAL - CONSTRUCTION MUST
BE COMPLETE FOR C.O.
AU. CONSTRUCTION SHALL MEET
THE REQUIREMENTS OF THE N.Y.
STATE CONSTRUCTION & ENERGY
Location of land o!1 which proposed work will be done: .............. ONSIBLE FOR
House Number ..... Street ~ ...............
County Tax IV~ap No. J 0pQ Section
Subdiv/sion/} Iq/~ [ .~//~ lr't~0
Filed Map No. Lot
2.
State existing use and occupancy of premises agd antl~ndexl u~e and occupancy of proposed construction:
a. Ex/sting use and occupancy "~'i
b. Intended useandoccupancy ~6~ ~''
3. Nature of work (check which applicable): New ...l~di~~ Addition Alteration
Repair Removal Demolition -- Other Work
4. Estimated Cost ~ Fee
(Description)
If dwelling, number of dwelling units
If garage, number of cars
(To be paid on filing this application)
Number of dwelling units on each floor
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
Height_ Number of Stodes
Depth
Dimensions of same structure with alterations or additions: Front Rear
Depth_ Height. Number of Stories,:,
8. Dimensions of entire new construction: Front
Height Number of Stories
Rear _Depth
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 NOT~
13. Will lot be re-graded? YES ~(~ NO Will excess fill be removed fi.om premises? YE~ NO~
14. Names of Owner otf~[emises~$(~S[ ~"~,] ]7 Addre~' ~
lt err Phone N~o~l
Name ofArchitec{,.%,-'~., _i~,~/~V~ It~/)tO..~ Address .~b'(4-~'~,.l~ Phone
Name of Contractor ,~_~_ ?"~, ~O~.e F¥~ (-l"Address ~m~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. : ~ :'~ ....
f
16. Provide survey, to scale, with accurate foundation plan and dj.stances to property lines.
17. If elevation at any point on property is at 10 feet or below, must provkte'topographical data on survey..
STATE OF NEW YORK)
SS:
COUNTY OF )
~%~[~ ~~~ being duly sworn, deposes and says that (s)he is the applicant
' (Narn*r~£~vi~~~C~t~ ~bove named,
(S)He is the
(Cog~f~r, Agent, Corporate Officer, etc.)
of said~owner Or owners~ and' i~ dllly aulh~rized to perform or have performed the said work and to make and file tlfis application;
that all statements contained ih this applialttion are tree to the best of his knowledge and belief; and that the work will be
perf~)rmed ' ~'
re'the manner ~.et .forth m the~ a~pllcat~on filed therewath.