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Home My WebLink About12208-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hail Southold, N.Y. Certificate Of Occupancy THIS CERTIFIES that the building I~nground swimming pool 155 Fishermans Beach Road Cutchogue, N.Y. Location of Property p~;~ ~ Ho ....................... ' .................................. s . Street Hamlet County Tax Map No. 1000 Section ... 1. ~. ! ...... Block .. 01 .Lot 041 Subdivision .M./.q .P..e.c.o.n..i.c..B.a.y.. ?.r.o.p..s...I.n.c. :Filed Map No ........ 786 .............. Lot No. 3 conforms substantially to the Application for Building Permit heretofore filed in this office dated Se.ptem. ber 7, 19 82 pursuant to which Btfilding Permit No. 12208 Z dated March 24, 19.8.3 ............................. , 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 ......... Inground Swimming Pool The certificate is issued to Thomas E. Samuels (owner, ~e~ee~ox of the aforesaid building. Suffolk County Department of Health Approval UNDERWRITERS CERTIFICATE NO ............. ~ .6 9.5.2. 6. .9 ............................. Rev. 1/81 Building Inspector BUILDING ~N.o fi.HIS PERMIT MUST BE KEPT oNtHE COMPLETION OF THE WORK AUTHORIZED) 12208 Z bate Pen nission is hereby granted to7- at p,remi$eS Io~ated at ............................... .;. ....... UNTIL ~ULL ; o;; ::. o... '~ ~l~..ot NO. ........................ ii. 19..~, and approved by t~e FORM NO. 6 TOWN OF SOUTHOLD Building Department Town Hall Southold, N.Y. 11971 765- 1802 APPLICATION FOR CERTIFICATE OF OCCUPANCY BLDG, DEPT, ~ ~ TOWN OF SOUTHOL D Instructions This application must be filled in typewriter OR ink, and submitted m ~ to the Building Inspec- tor with the following; for new buildings 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 of Health Dept, of water supply and sewerage disposal-iS-9 form or equal). 3, Approval of electrical installation from Board of Fire UnderWriters. 4. Commercial buildings, Industrial buildings, Multiple Residences and similar buildings and installa- tions, a certificate of Code compliance from the Architect or Engineer responsible for the building. 5. Submit Planning Board approval of completed site plan requirements where applicable. For existing buildings (prior to April 1957). Non-conforming uses, or buildings and "pre-existing" land uses: 1. Accurate survey of p~operty showing all property lines, streets, buildings and unusual natural or topographic features. 2. Sworn statement of owner or previous owner as to use, o~cupancy and condition of buildings. 3. Date of any housing code or safety inspection of buildings or premises, or other pertinent informa- tion required to prepare a certificate. Fees: 1, Certificate of occupancy $5.00 2. Certificate of occupancy on pre-existing dwelling 3. Copy of certificate of occupancy $1.00 4.Vacant Land C.O. $5.00 5. Updated C.O. $15.00 $15.00 Date ................ New Building ............. Old or Pre-existing Building ............ ,Vacant Land .... .~ ........ Location of Property . .T..'~', .?~ .~. ?~. .............. '-~' · · ~t "' ~ ................. ~ ...... /t .... House No, v Street V Ham/et Owner or Owners of Property .~.(~ ...(~...E."~.~(.~.~' .............................. County Tax Map No. 1000 Section ............... Block ...; ........... Lot ................ Subdivision. ' ............... Filed Map No ........... Lot No .............. / Permit No, .1'.2.2.0, .8~. , . Date of Permit .......... Applicant ,..'~ ~,'.~[,~/. ..... Health Dept. Approval ........................ Labor Dept. Approval ........................ Underwriters Approval ........................ Planning Board Approval ...................... Request for Temporary Certificate ......... Final Certificate ...... ~ ........... Fee Submitted $.,..~,',0.0... ,~...~ ~ii~ i iii Construction on above described building an~~ble codes and regulations. Applicant .... I, .4~.~d~,. ¢ ,~% .............................. Rev. 10-10-78 7~-~ BUILDING DEPT. INSPECTION FOUNDATION IST []ROUGH PLBG. FOUNDATION 2ND []INSULATION FRAMING []FINAL REMARKS: DATE INSPECrTOR 76S-3,802 BUILDING DEPT. INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLBG. FOUNDATION 2ND [ ] INSULATION FRAMING [~FINAL REMARKS: ~,~-- INSPECTOR FIELD INSPECTION FOUNDATION FOUNDATION 2. (1st) (2nd) ROUGH FRAME & PLUMBING INSULATION PER N. Y. STATE ENERGY qODE FINAL /~ DATE COMMENTS ADDITIONAL COMMENT~: -it PERMI~ SSUEDTO ADDRESS OF NEW YORK STATE DEPARTME~ OF ENVlRONME~TA~ ~oNsERVATI~N UNDER THE ENVIRONM~[~TAL CON~E~¥A' ARTICLE 15, (Pr~tecHon of ~ater). ' ~}AR~I~E~!~ (T ARTICLE 2~; Freshwater Wetland) :~?l~Lt'[~ ~ · By: En/9~t Fisherman!'8 Be'ach Road, Cutahogt}e, NY 119S5 S06tl LOCATION'O~ PROJECT (Section of slream~ tidal wetland, dam, building) ' pool ~th outside d~ns~ons of 45. x 5G ~cCo~d~n~ Lot 3. ~teei~al excavated ~or pool to be ~ed a~ Ris~urb~ce :~o vegetation o~ topography '~i~hin Nassau ,~ut, Cutchog~ COUWTY GENERA[ COND.LT I ?. The permi(lee shall tile in the office or'the appropriate Regional' ? 8~ ours m adva~e~ofdhe Hmo of Commencement ~nd shall also notify him. romptly in w i~in~ o the ~omp~etion of the work, 2. The pe~mil~ed~wor~ shah be subjecJ to inspection byan aulhoflzed rde~ the work suspended ~ Ihe public interest so requires. ~ is L AS a Cpnd on o he ssuence of [hJs per, it, the ahplieant has.a~- by and ibHity lot MI.da~a~es, dJrecl o~ indirect, of whalevef~nalure, and by whom- os~s of every n~e a~d description resultln~ from the s~Jd project. 4. Any m~er~aJ dredged in Ihe prosecution o~the work herein permJlled cbnt E~II be r~mov~'~ evenly. Witbou~ leavin~ ht~e ~efuse plies, ridges across the ~d oLl~e~wal¢f~Y o~ flogd plain or deep holes that may have a ten~ency to ~u~e Jnj~r~ 16 navigable dbe~nels o[ to the b~nks bi the w~terway. S: ~ny nt~{~r~a, '0 b~ deposited or dumped u~d~r this permit, ~ithe, in meal ~e Wat~wa? or o~ sho~e ~b~ hi~-wate m~ s~ I b~ ~e~S ted o~:~r remove t (he ~ocalit~.~hOwP On ~he drawms heralD attached, and, if~so ~scr~bed; hereon, w h n or beh nd ~ 8DOd ~nd substantial bdlkhead or b~l~heags, such s wall ~revent~ ~rS~ape 0 ~e ma e~ aJ ~nto the'wale~way. ~ Ther~ s~al~l be [m unreasonable interference with navigaHon by the tO p ~ork herein authOr)zed, : ' ~ he Dos oa~(he st udture~or we k hereimauthorized, or if/ in th~ opiQIop ~ 'b6 'D~ ~b Env r~n%ental Conservation it: sba [ caus~ unre~sonable~ bsffuctio~ lo.~the~free navtgalmn of said w~]ers or fl~ f.lows.or.~ad~r ~e heglth, sa[~ ~o welfare of he ~ople of the S~ate or loss or de{tructlo~; he na ur~l ~{~rce~ of~ he State, the own6 may be Ordered'by the;OeK~rt- ed{ lo remove Or, alter th~ structural work, obstrd~tions, or hazards caused' - ' ~6reb~ withou~ 6~ense lothe State; and if, upon t'he expira{ioh Or fe~Oc~oA:: f I~is permit :~t~e structure, f lb .excavation~ or othe? m~iflcatio~'~qf t'he ,atercoutse he~ a~tho~ized sba I .no b~: co~lete~ the~bwner~: ~halb ~thbu~ exp~as~ ~ e'S~ a~e a~d o suchexte~t a~ ~ s~h t me a~ mad~e~ '~ lhe Depart~em of Env?nmemat Conservation ~ay [eqm~e, rem?~ all or ondmoq the nawgable and flood capacdy pf the watercourse. No~ cla~~ s~all 10-B2-0740 NO. J PERMIT EXPIRATION DATE J Decembe~ 31~ 1983 ~(a!e of Ne~v ~;ork shall in no case bp liable for any damage or ~b~k herein ~uthorized which may be caused by or u[e ,ol~ration~',undertake~ by the State for the conservation or navigation~ ~O~ lot othe't purposes, and no claim or tight to h~ accrue ~f~m any such damage. ithe disp!ay df~lights and Signals on any work hereby authorized by law~ ~d~ch lights and signals as may be pre- fited Stat~e~ Coast Guard shall be installed and maintained xpense of the Owner, out; uedef this permit shah be performed in accor- gifi~erihg practice and in a workmanlike.mariner. I~s 24 or 25, the Department reserves the right time and after due notice and hearing to perm~ 'n such a manner as t~ay be found to expiration or revocation of th~s permit, the a~khorized has ~ot been completed, the 1se to the ~State, and to such extent and in such of Environmental Conservation may require, udcomplet~d structure or fill and restore the claim Shall be made against the State pi New o~ alteration. construed as conveying to the applicant any with the riparian rights of others as authomzlng t e impairment of any rights, or p(ksogal property held or vested in a person not a SPECIAL CONDITIONS . ; ~ Back~sh system shall be located a minimum of 100~ ~landwa~diof the' tidal wetland Douncsry. SEE ATTAGMED ADDITIONAL CONDITIONS oe~ob,er :ZS~, cC: NTSDEg Law Enforcement USA FORM NO. 3 TOWN OF SOUTHOLD : BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N.Y. NOTICE OF DISAPPROVAL File No ................................ To ......... ;0 .... VLE^SE TAKE NOT~CE that your applicaQon aatea .. ~.. Z ........... , ~ ~ for pe~it to const~ct...~.. VO~.~/~/~.~ ............ at County Tg~ No. l~Section...~ ...... Block ..~ ........ Lot .~.~ ..... 8ubdivisio~ ~,..~ ~ Filed Map NO.. Z~ ......... Lot ~o.. ,~ ............ h a.d dlsa toved on ,he follow~ ound~ ~~ ff~ ~ ~ BUILDING DE~ ! ~ INSPECTION ] FOUNDATION ~.ST [ ] ROUGLHi~ LBG. ]FOUNDATION 2ND [ ] INSuLA,~I~N [ ],FINAL [ ] FRAMING REMARKS: [ ] FOUNDATION 1ST [ ~] ROUGH:tb, ~/3G. FOUNDATION 2ND [ ULATio~ FRAMING R£MARKS: ~ DATE 113503~ THE NEW YORK BOARD OF FIRE UNDERWRITERS ~ : BUREAU OF ELECTRIGIT~ 85 JoHN STREET, NEW ~ORK, NE~V ~ORK 10038 Tom ~ in the following location; [~ Basement .~.~,,,..,i.,~do,, J~me 2, 1983 FIXTURE RECEPTACLES SWITCHES OUTLETS 3 DRYERS [~ 1st Fl. [] 2nd FI. Section Block Lot be in com~lla~ce with the requiretnents of this Board. to FIXTURES RANGES OVENS DISH WASHERS EXHAUST FANS FLUORESCENT VAPOR SYSTEMS NO. OF FEET E OTHER APPARAI~US: 1-G.F.C.I. 1- oF CC. C~hD A+W,G OF HI-LEG A W O. OF NEUTRAL THE NEW YORK BOARD OF FI!RE UNDERWRITERS ~.0L%~3'~4 BUREAU OF ELECTRICiITY V 40 FULTON STREET, NEW YORKi NY~,~ 10038 Date ~'~AY 29,1998 Application No. on file 16~87998/98 N A54842 THIS CERTIFIES THAT : only the electrical equipment as described below attd introduced by the applicant named oil the above applica~on number is in the pretnises of TOH SAHUELS, F/SHERMENS BEACH ROAD, CUTCHOGUE, i',lY in the following location; [] Basement [] Ist FI. [] 2nd Fl. OUT ' Section Block Lot was examined on }MY !9,1998 and found to be in compliance with the National Electrical Code. FIXTURE FIXTURES RANGES OVENS DISH WASHERS EXHAUST FANS OUTLETS FLUORESCENT OTHER DRYERS SYSTEMS NO. OF FEET }THER APPARATUS: SWI~ING POOL~! POOL *NO VISUAL DEFMCTSE "An electrical survey has been made of the exposed electrical equipment in the premises indic~ted." "No obvious 5?%se. tisfactor¥ condition was foun~. B,J,MLEC~ CO. BOX 16,STIIJ.WATER AVE. CUTCHOGUE, NY, 11935 This certtfica~ must not be alfred in any manner; ~turn ~ the S R I C PER ffi LIC.= NO, OF HI-LEG GENERAL MANAGER .. may be idle~tified by their credentials. FORM NO. 1 TOWN OF SOUTHO[D BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N.Y. 11971 TEL.: 765-180;~ APPLICATION 'FOR BUILDING PERMIT INSTRUCTIONS a. This application must be 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 buildhlgs 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 appli- cation. 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 issued 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 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, build.lng code, housing code, and regulations, and to admit authorized inspectors on premises and in building for necessary inspe~~ ~. ~i. ~: .~.C~: ........................ (Signature of applicant, or name, if a corporation) . . State whether applicant is owner, lessee, agent, architect, en~neer, general contractor, electrician, plumber or builder. Name of owner of premises ~ (as on the tax roll or latest deed) If applicant is a corporation, signature of duly authorized officer. (Name and title of ~rporate officer) Plumber's License No ......................... Electrician's License No. ~ ./.~e. ~.//~----~..~..~.. Other Trade's License No ...................... :~ j.~ff'- ~--,~/~,igT~/~j~ /~A 1. I.ncation of land onwhMhnrnnn~aawnrkwi/1 ho dana k.~~ ~ ~* _ ..... ....................... t~ .OU. ~e. ~q.u~n. b~r.. ...... ~'' ' ~ir;;i ...... ~/' ' ' ' ' ' '~1'~;; ............ ~ ~/) ...... · County '~ax ~ap No. i000Sect, on .... H/ ......... Block.... ~.~. .......... Lot.....~.~ ...... Subdivision.(~.~..~..~n~.~~...~.:FiledMapNo.Xl z9 _ , --r. ,~[N ) ~'a "~"~"~' ....... 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 hich ap licable): New Building .......... Addition .......... Alteration .. Repair .............. Removal .... Demolitf~n th*h ~ w v ~,,'.~,~ '~.,~,~ ~!~._ ;~ Ir'" crC> / ' , (Descripti6n) ' 4. EstimatedCost .'~. !~./. OOt~, O0 ~A~ /'~ ~ (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 ..... i ................................................................... 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 ....................... ~J .............. '":.... ~.'J ......... Dimensions of sam~ structure with alterations or additions Front .~.~ . Rea~ }' '~--q . Depth ..... .~. ~ ........... ... Height ...~tg~l~.: ......... Number of St/eries ............. ! ....... 8. Dimension~ of entire new constrUction Fron~/... ~..,~. / Rear ~1. ~ n~,,*h Height ~ ..... Num~,er of Stories .............. ~ ............................ r ............. 9. Size of.l(l~: Front .... ."~--..~_~. ........... Rear .~:..~'..~.. . Depth ~- ~'~' '~- <~- ~a..~ 10. Date of Purchase ... '/'~'Z '! .................. Name of ~'o'r~'r'6~v~;;' 11. Zone or use district in which premises are situated ....... t . ~. 12. Does proposed construction violateJmy zoning law, ortJinan~e or regulation: .... ,ltt~.: ...................... 13. Will lot be regraded .~~-~ce~s fill be removed fl;om premises:. Yes 14..N..ame of Own.er of premt~es~... ~.~!~....~.. ddress .~ Phone No..~.. ~. ~.--.~.~.g~,. Name of Archatect .......... i ................. Address .... .~. ............. Phone No ................ Name of Contractor ......... i ................. Address ................... Phone No .............. PLOT DIAGRAM Locate clearly and distinctly all ibuildings, whether existing or proposed, and, indicate all set-back dimensions from property lines. Give street and block ~umber or description according to deed, and show street names and indicate whether interior or corner lot. .~.~ ~ t~,[x~ STATE OF NEWJ~OP~ .o .... ~.g~./~. ~ .Ot~t~. ~ ............ being duly sworn, deposes and says that he is the applicant ~--~--. (Name of individual signing contract) above named. He is the ~ ................ (Contractor/agent, corporate officer, etc.) of said owner or owners, ~d is duly authorized to perform or have perfomed the said work and to m~e ~d file this application;, that all statements contained ~ this application are true to the best of his ~owledge and belief; and that the work will be perfomed in the m~ner set forth in the application filed therewith. Sworn to before me this ............ .... ~Y ~t~[[LI ................ N~ARY'PUa C, State 0f New York (Signature of applicant) No 4116725, Term Expi*es ~aaveh