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HomeMy WebLinkAbout29368-Z FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No: Z-29453 Date: 00/52/10 THIS CERTIFIES that the building ACCESSORY Location of Property: 370 PHEASANT PL GREENPORT (HOUSE NO. ) (STREET) (HAMLET) County Tax Map No. 473889 Section 53 Block 4 Lot 44 .37 Subdivision Filed Map No. Lot NO. conforms substantially to the Application for Building Permit heretofore filed in this office dated MAY 9, 2003 pursuant to which Building Permit No. 29368-Z dated MAY 9, 2003 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 IN REQUIRED REAR YARD AS APPLIED FOR. The certificate is issued to WARREN & BRENDA J JENSEN (OWNER) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A ELECTRICAL CERTIFICATE NO_ H-065999 10/19/99 PLUMBERS CERTIFICATION DATED N/A T'�' C", a�" Authorized Signa re 117 Rev. 1/81 FORM NO. 3 TOWN OF SOUTHOLD BUILDING DEPARTMENT Town Hall Southold, N.Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) PERMIT NO. 29368 Z Date MAY 9, 2003 Permission is hereby granted to: WARREN & BRENDA J JENSEN 370 PHEASANT PLACE GREENPORT,NY 11944 for CONSTRUCT AN ACCESSORY INGROUND SWIMMING POOL WITH FENCE TO CODE IN THE REQUIRED REAR YARD AREA AS APPLIED FOR. THIS PERMIT REPLACES BP#25899 . at premises located at 370 PHEASANT PL GREENPORT County Tax Map No. 473889 Section 053 Block 0004 Lot No. 044 . 037 pursuant to application dated MAY 9, 2003 and approved by the Building Inspector to expire on NOVEMBER 9, 2004 . Fee $ 150 . 00 Author ed Signa ure COPY Rev. 5/8/02 FORM NO. 3 TOWN OF SOUTHOLD BUILDING DEPARTMENT Town Hall Southold, N.Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) PERMIT NO. 25899 Z Date JULY 26, 1999 Permission is hereby granted to: WARREN & BRENDA J JENSEN 370 PLEASANT PLACE GREENPORT,NY 11944 for CONSTRUCTION OF AN ACCESSORY INGROUND SWIMMING POOL WITH FENCE TO CODE IN THE REQUIRED REAR YARD AREA AS APPLIED FOR. at premises located at 370 PHEASANT PL GREENPORT County Tax Map No. 473889 Section 053 Block 0004 Lot No. 044 .037 pursuant to application dated JULY 20 1999 and approved by the Building Inspector. Fee $ 150. 00 Autho ' zed Sigr9ture ORIGINAL Rev. 2/19/98 Form No.6 TOWN OF SOUTHOLD BUILDING DEPARTMENT g 7n02 TOWN HALL 765-1802 APPLICATION FOR CERTIFICATE OF OCCUPANS YY- -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 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. B. 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. C. Fees 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. Ma9 9, 2003 New Construction: aaB Old or Pre-existing Building: (check one) Location of Property: 370 Pheasant Place GreaWort House No. Street Hamlet Owner or Owners of Property: Warren 6 Brenda Jansen Suffolk County Tax Map No 1000, Section 53 Block 4 Lot 44.37 Subdivision Filed Map. Lot: Permit No. 29368 Date of Permit. 5/9/03 Applicant: Health Dept. Approval: Underwriters Approval: Planning Board Approvals Request for: Temporary Certificate Final Certificate: ffi (che ne) Fee Submitted: $ 25.00 3 0 Vt e C0 Z-- JIys3 THE NEW YORK BOARD OF FIRS, U,ND°ERWRITERS PAGE 1 8077464 BUREAU OF ELECTRI01, 40 FULTON STREET, NEW YORK,'rl 78 Date OCTOBER 19,1999 Application No. on file1 9;9199" H 065999 THIS CERTIFIES THAT only the electrical equipment as described below and introduced by the applicant dd'ra ¢on the shove application number is in the premises of .R; WARREN & BRENDA JENSEN, 370 PHEASANT PLACE, GREENPORT, N in the following location; ❑ Basement ❑ 1st Fl. ❑ 2nd Fl. OUT Section Block Lot was examined on OCTOBER 12,1999 and found to be in compliance with the National Electrical Code., FIXTUREFIXTURES RANGES COOKING DECKS OVENS DISH WASHERS EXHAUST FANS OUTLETS RECEPTACLES SWITCHES INCANDESCENTI FLUORESCENT OTHER AMT. K.W. AMT. I K.W. AMT. K.W. AMT. K.W. AMT. H.P. 1 1 1 DRYERS FURNACE MOTORS FUTURE APPLIANCE FEEDERS SPECIAL REC'PT. TIME CLOCKSBELL ",UNIT HEATERS MULTI-OUTLET DIMMERS AMT. K.W. OIL N.P. GAS H.P. AMT. NO. A.W.G. AMT. AMP. 4101T.,> :AMSYSTEMS PS: TRAN� .AMt; H.P. NO. TE FEET AMT. WATTS 1 20 1`. , 40 1 K; SERVICE DISCONNECT NO.OF S E R V T C E METER AMT. AMP. TYPE EQUIP. 1 0 2W 1 0 SW 3 0 3W 3 0 4W NO.OF CC COND. AWS G 1 •. A.W.G. A.W.G. PER 0 OF CC.¢&15 NO'OF HI-�G.. ,'' OF HI-LEG NO.OF NEUTRALS OF NEUTRAL 4 OTHER APPARATUS: SWIMMING POOL-1 G.F.C.I:-1 *(SWIMMING POOL) This certificate covers compliance at the date of inspection only. Because of unusual environments it is advisable to have frequent test/and or repairs w j made by a qualified person. �. <<< Continued on Page 2 >>> GENERAL MANAGER Per '---+ This certificate must not be altered in any manner; return to the office of the Board 1f.[no'000.'Inspeclbrs May be identified by their credentials. COPY FOR BUILDING DEPARTMENT. THIS COPY OF CERTIFICATE ,MUST NOT BE ALTERED IN ANY MANNER. THE NEW YORK BOARD OF FI', .E UN©,E,RWRITERS PAGE 2 8077464 BUREAU OF ELECTRI4 1 ^: 4 F 40 FULTON STREET, NEW YORK, N1 100311 ' OCTOBER 19 1999 19,174'799/99 H 065999 Date � Application No. on file � . THIS CERTIFIES THAT v ^y only the electrical equipment as described below and introduced by the applicant n4lin l oA the above apt lication number is in the premises of WARREN & BRENDA JENSEN, 370 PHEASANT PLACE, GREENPORT,.VNYn ': in the following location- ❑ Basement ❑ lst FL ❑ 2nd Fl. OUT r Section Block Lot was examined on OC'�'QBER 12,1999 and found to be in compliance with the National Electrical Code., FIXTUREFIXTURES RANGES COOKING DECKS; OVENS DISH WASHERS EXHAUST FANS OUTLETS RECEPTACLES SWITCHES INCANDESCENTI FLUORESCENT I OTHER AMT. K.W. AMT. K.W. AMT. I K.W. AMT. I K.W. AMT. H.P. DRYERS FURNACE MOTORS FUTURE APPLIANCE FEEDERS SPECIAL REC'PT. TIME CLOCKS. 'BELL UNIT HEATERS MULTI-OUTLET DIMMERS SYSTEMS AMT. K.W. OIL H.P. GAS H.P. AMT. NO. A.W.G. AMT. AMP. AMI, AMJK$ TRANS,;, AMT; H.P. NO.OF FEET AMT. WATTS SERVICE DISCONNECT NO.OF METER S E R U" ,. 1 C E AMT. AMP. TYPE EQUIP. 1 0 2W 1 0 3W 3 0 3W 3 0 4W NO.OF CC COND. A.W.Q,, A.W.G. A.W.G. PER 0 OF CC. OND.' t�Flf�,OF HI LEG OF HI-LEG NO.OF NEUTRALS OF NEUTRAL r OTHER APPARATUS: WARREN JENSEN ( L L 370 PHEASANT PLACE GREENPORT, NY, 11944 GENERAL MANAGER 11 Per - This certificate must not be altered in any manner; return to the office of the Board if 4hcorrect•.InSpectOr&may be identified by their credentials. COPY FOR BUILDING DEPARTMENT. THIS ATE 14Q§T NO; .BE ALTERED IN ANY MANNER. 765-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION IST ( ) ROUGH PLBG. [ ] FOUNDATION 2ND [ ] 1 LATION [ ] FRAMING FINAL [ ] FIREPLACE A CHIMNEY REMARKS: a,b- ,�z �Zq7 DATE O INSPECTO 765-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION IST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] INSULATION [ ] FRAMING [ ] FINAL [ ) FIREPLACE A CHIMN REMARKS; DATE INSPECTOR (.0 INSPECTJONMPORT-- -DATE-»N ---COMMENTS NDATI ON ( IST) ki - — --- — q e V NDATION (2ND) ------------------- It N p M W u v n � � IGH FRAME S PLUMBING q n u NY u p Y M ._ SULATION PER N. Y. LZp n A STATE ENERGY a -p 4 CODE p G N N � p N p p N N nj p � Cel tri � 1 N 1111 d ` N N N P FINAL N N N ADDITIONAL C0124ENTS: b .n . l� ca 1 GH z o � anr BOARD OF HEALTH . . . . . . . . . . ... . . . �tM No. 1 3 SETS OF PLANS . . . . . . . . . . . . . . . 2 111 To4iN FI,SOUTHOLD SURVEY . . . . . . . . . . . . . . . . . . . . . . . . BUILDI DEPARTMENT CHECK . . . . . . . . . . . . . . . . . . . . . . . . . BLDG. DEP WN1HALL SEPTIC FORM . . . . . . . . . . . . . . . . . . . TOWN OESOU7 sHOLD' N.Y. 11971 65-1802 NOTIFY: RR ag3�g CALL . . . �. . 6 . . Exand *a/ 77.,,.., 19.qq!� qct MAIL TO: . . . . . . . . . . . . . . . . . . . . App ..., 191. Permit No. ......�.�f.!.� .................................. Disae .................................. ...................................................... ' . .... .........Vl� tor;)4 ......... (Building APPLICATION FOR BUILDING PERMIT Date. . ) P . . . . . . . , 19go(. INSTRUCTIONS a. 'this application Dust be completely filled in by typewriter or in ink and submitted to the Building Inspector w 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 giving a detailed description of layout of property must be drawn on the diagram which is part of this application. 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 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 whatever until a Certificate of Occupancy shall have been granted by the Building Inspector. APPLICATION IS HEREBY MAIE 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 amply with all applicable laws, inances, building code, housing code, and regulations, and to admit authorized inspectors on premises and in it for "nspec 'ons. .. .. ..... . .: .... / Signature of appli name, if a corporation) 9.Y...,!?ylw. -er�-y.... .. (Mailing address of applicant) /('tJ 2 State whether applicant is owner, lessee, agent,.architect, engineer, geuleral contractor, electrician, plurber or builde � �CU?1�J? ................................................ Name of owner of premises ..........w✓�; 121.�1! f....Q ���.. ...... :rt✓ .............................. (as on the tax roll or latest deed) If li a on i go of duly authorized officer. ....... ... ....... . . .. ................... ( and title of corporate o��f//cerqQ / Builders License No. .....G:�. I]i�...l PlumbersLicense No. .......y.�................. Electricians License No. ...Vj..fk6/..C.� l ' Other Trade's License No. .................... 1. Location of land on which proposed work will be done.............................................................. 3.?�. P./ ....... lee' ca -r.................... House Number Street ,/ Hamlet CaNoo. 11000 Sect County Tax Map Section .....503 '/. ..... Block ....�. ...... lot .r.�. r Subdivision ....!Z:: T..Alm !k ........... Filed Map No.. .��r.. �...... lot .....J•J•-... (Name) 2. State existing use and ocanpancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy ��L. .(f�,?,L.�r77/�- � b. Intended use and occupancy .......... f�:'.�.r�.vr Y1.:. :....I:J ?./7/.... ..........t.• 4... :.. 3. Mature'of work (dieck which applicable): New Building .........-' dditiori'.. � Alteration ........ tiepair ............ Removal ............. Demolition ............ Other wo---�n S':.LaJi Mvlt ........... `(Description) 4. Estimated Cost .....L. ............... fee ........................ ............... (to be paid on filing this application) 5. If (Lulling, number of dwelling units ............ Number of dwelling units on each floor Ifgarage, number of cars ...................................... 6. If business, comercial or mixed occupancy, specify nature and extent of each type of use...................... 7. Dimensions of existing structures, if any: Front................ Rear ............... Depth ................. Height ......................... timber of Stories ...................... Dimensions of same structure with alterations or additions: Front ............... Rear ............... Depth .................... Height .................... Number of Stories ............... S. Dimensions of entire new construction: Front ................ Rear ............... Depth .............. Height ......................... [umber of Stories ..................... 9. Size of lot: Front .................... Rear .................... Depth .................... 10. Date of Purchase ..................... Name of Former Owner ........................................ I1. Zone or use district in which premises are situated .........../.4�T��fl !.nN .............................. 12. Does proposed construction violate any zoning law, ordinance or regulation: ........................ 13. Will lot be regraded ........ ...... Will excess fill be removed from premises: YRS ��,tL�f- 14. Nares of owner of premises .... �.:........... Address ..... !Y.Y.:.S........ Phone No. .............. Name of Architect ...................�.................. Address .............................. Phone No. .............. Nam of Contractor ............ Address .::!114117.2/.............Phone No. .........`�.` . 15. Is this property within 300 feet of a tidal wvtland? * YES .......... NO .......... *IF YES, SQIHl<HD TOWN TROS'IFES PUMIT MAY BE ME IJIRFD. PLOT DIAGRAM Locate clearly and distinctly all buildings, whether existing or proposed, and indicate all set-back dimensions from property lines. Give street and block number or description according to deed, and show street nares and indicate wihether interior or corner lot. SIATE OF Nov YoiR, 0011N1T OF .....J.K..C. zK...y./ ......&onvk ..... ....!`.'4!.u' ....V.`.'.:.......—Iheing duly sworn, deposes and says that he is the applicant (Name of individual signing contract) above named, /'��l [Ie is the ....................-:".:'!!....................................................................... (Contractor, agent, corporate officer, etc.) of said owner or owners, and is duly authorized to perform or have performed the said work tax] 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. Shorn to yyf��q� ;g me this ,."rrte i Notary I. :.. 4igmture .. .L of pplicant) awlIleurf d Ns�wµYyor�k , Vir"o 8 . ✓ JUL-12-99 MON 11 :31 RM SCHEMIIRI HOMES INC 615 929 5378 P.81 AOR No., AUr-35 a ATE. SPRVICE EINES, SEPTIC TANKS AND CESSPOOLS $HOWN HEREON ARE FIELD OBJERVA- 7IONS AND OR DATA OBTAINED KRONI ..,.� THERS, UNDERWRITERS CERT ICATE \� OCCUPANCY R REQUIRED o� \USIS UNL FUL R=25.00 9 VVITHOUT CE TIFICATE OT 2a �° oo .3Q.2r GIGO OCCUPAN Y A\ \ f• XXX 3 � ll ° 4N DO APPROVE AS N D DATE: Zb&tqiB.P. # FEE: BY: NOTIFY BUILDING DEPA 9 n0 A' 765-1802 8 AM O 4 PM FO#-,, E FOLLOWING IN ONS: 1 FOUNDATION TWO REQUI FOR POURED ETE 4. 2. ROUGH - t PLUMBING 3. INSULATION 4. FINAL - CON RUCTt" %UST BE COMPLETE R C.O. �'jOL LOT 36 ALL CONSTRUCT ON SHALL MEET THE REQUIREME TS OF THE N.Y. i STATE CONSTRUCTION 14 ENERGY p' rano "IMMEDIATELY CODES. NOT R SPONSIBLE FOR 1k DESIGN OR CONS RUCTION ERRORS ENCLOSE POOL TOC DE UPON COMPLETIO BEFORE "WATER Ir ^>I �F " 'w,°°"''^,"'°""o'o"'•'a"°'v'�""' SURVEY -OF: LOT 35 ,o.e..w.o.a.w fua •„vim MAP OF " „ �• x".�i " .. AURUST ACRES, SECTION I mt rnr_ n ,m�aw�"mrwouwo® ARSHAM,OMAQUE, TOWN OF SO'UTH;''_D _e�.ro..g �A SUFFOLK, NEW YORK wn "--'v�r ae +wv wms a mq a un,m ww rc DATE: 7-1;c 41 SCALE: V'- .^•' CERTIFIED ONLY TO: 1Q•� fW, DESTIN G. GRAF W+rXILEfJ�TENSE,J ANO gaoJM 3'a.1hZ1 p£6YI. _ LAND SURVEYOR 4ii4."G!�rwn.'[AN�1"lE SrJr L oY7 WOUCL AWN Roes QESTIN' r. GRA NA.S. UG N0R000 DINT, NEW CORK 11'778 lAY, I,D. No. 1000-53-04-44.37 CA• - P E (318) 821-4-142 BUILDING PERMIT REVIEW CHECK LIST Applicant/ Date Owners Name. Reviewed: `'i''✓ Architect/ Date Engineer: Submitted: / SCTM #: 37 District: 1,000 Section: �_ Block: Lot: Project41Subdivision j0 Location: Name: Single&separate Required / certification: es o Req. R Zoning DistrictX �V [Lot size: Actual: •. �`3 [Lot coverage �1! roposed:----� Req Req. Req. [Front Yard Proposed:_� [Side Yard Proposed: 1 [Rear Yard Proposed: ] Project Description: •� �jr-� AGENCY PERMITS Permit REQUIRED FOR REVIEW N.A. NO YES Number Suffolk County P Health Dept. V New York State D. E. C. Town Trustees Town Zoning Board approval: Town Planning Board approval: Flood Plane Elevation ??? Flood Zone: Notes: ' C, .� + \�'..d �aro•_.-:T irnas�ll lPaeum a+9�1'+I�J �-, 1 59 ` WIN IM NMI Mqj �i�lis Ila i t a�c�R.a:� sir �� e.aa�tzui 1 _ k. 1 �IaQ�IQAlIIIlI�L� 1t��I�IE ��Tq � �� �A�]AETSfIE"X711�'lIyS7R°�!2171"'4'4^SI61'ip"�7 �It�P'�t7+�R��+��iP +"'•:. ����r� .::j.�,�eTa��I'„Z.1►���I�� �C��fr.11iiilJl�' .7(�,iq���A���.1y�7{/g1�����i.:R3vi'k.¢-i� .: :L�(L�•��.iQ■:�`��:]'��:; �—y.,�1-• lc . , +'J- � .' ''y 1 It `MPs• •-31E ro4+.•. FOR iL 1. 1 1 `�►� � � ` .sir 1 1 1' �• i IA Iin - � �� ■ _ � r1CJ�__.4111_ (i .��I �I � II `Itt.I��rR�tLr �ra.r^,� IIIIII�I ,1.4,. �, � tom"•' � � i� "�ol . Ito < � •/.inner t N 2'`•��..{ a. 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