The URL can be used to link to this page

Home My WebLink About28247-ZFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No: Z-29580 Date: 07/18/03 T~IS CERTIFIES that the building ACCESSORY Location of Property: 170 CHABLIS PATH SOUTHOLD (HOUSE NO.) (STREET) (HAMLET) Co%~nty Tax Map No. 473889 Section 51 Block 3 Lot 3.18 Subdivision Filed Map No. __ Lot No. __ conforms substantially to the Application for Building Permit heretofore filed in this office dated APRIL 4, 2002 pursuant to which Building Pe~it No. 28247-Z dated APRIL 5, 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 PETER J & DIANE VANMATER (OWNER) of the aforesaid building. S~FFOLK COI3NT~f DEPAR~b~NT OF ~{ APPROVAL ELEC~IC-~L CERTIFIC3~ NO. PLI~B}~RS CERTIFIC3~TION DA'I~U3 Rev. 1/81 N/A 1051982 04/18/03 N/A A~th~ize~Sig~n~e~ FORM NO. 3 TOWN OF SOUTHOLD BUILDING DEPARTMENT Town Hall Southold, N.Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL COMPLETION OF THE WORK AUTHORIZED) FULL PERMIT NO. 28247 Z Date APRIL 5, 2002 Permission is hereby granted to: PETER J VANMATER PO BOX 1764 SOUTHOLD,NY 11971 for : CONSTRUCTION OF A_N IN-GROUND SWIMMING POOL IN THE REQUIRED REAR YARD AS APPLIED FOR at premises located at 170 CHABLIS PATH SOUTHOLD County Tax Map No. 473889 Section 051 Block 0003 Lot No. 003.018 pursuant to application dated APRIL 4, 2002 and approved by the Building Inspector. Fee $ 150.00 ~d Signaturl~ ORIGINAL Rev. 2/19/98 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: 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 frorn 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, bt~lding 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, lhe 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 New Construction: Location of Property: Old or Pre-existing Building: (check one) House No. Street Owl:lerorOwnersofProperty: ~"',~"~.__ ~ Suffolk County Tax Map No 1000, Section ~ I Subdivision Permit No. D~g~ Date of Permit. Hamlet Block % Lot Filed Map. Lot: Applicant: Health Dept. Approval: Planning Board Approval: Request for: Temporary Certificate Fee Submitted: $ ~ ~'. ~ c_ Underwriters Approval: Final Certificate: (check one) Applicant Signature BY THIS CERTIFICATE OF COMPLIANCE THE NEW YORK BOARD OF FIRE UNDERWRITERS BUREAU OF ELECTRICITY 40 FULTON STREET - NEW YORK, NY 10038 CERTIFIES THAT Upon the application of upon premises owned by G & S ELECTRICAL CONTR. PETER VAN MATER BOX 215 170 CHABLIS PATH SOUTHOLD, NY 11971, SOUTHOLD, NY 11971 Located at 170 CHABLIS PATH SOUTHOLD, NY 11971 Application Number: 1051982 Certificate Number: 1051982 Section: Block: Lot: Building Permit: BDC: NS11 Described as a Residential occupancy, wherein the premises electrical system consisting electrical devices and wiring, described below, located in/on the premises at: Outside, Pool/Spa, was inspected in accordance with the National Electrical Code and the detail of the installation, as set forth below, was found to be in compliance therewith on the 18th Day of Aprit, 2003. Name Q'IT R~te R~ting (~ircuit Type Appliances and Accessories Time Clock/Switch 1 0 Pool/Spa Bonding I 0 Wiring and Devices Switch 1 0 General Purpose Receptacle 1 0 20 amp Pool/Spa Fixture 1 0 Pool/Spa GFCI Circuit Breaker 2 0 20 amp Pool/Spa (Swimrmng 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 made by a qualified person, seal 1 of 1 This certificate may not be altered in any way and is validated only by the presence of a raised seal at the location indicated. BUILDING PERMIT EXAMINER CHECK LIST APPLICANT: ~/~ /~vr~t.._- SCTM# DISTRICT: 1,000, SECTION: STREET ADDRESS: I~o (~gl~J.~ PROJECT DESCRIPTION: "T'-.~'I> ESTIMATED PROJECT COST: ~ [2 BLOCK: ~ , LOT: DATE ISSUED: / /02 DATE REVIEWED: q/~-/02 DATi~'SUBMITTED: ,q /1~_~/02 SUBDiVISION: ARCHITECT / ENGINEER: iD/a[ FAST TRACK? SINGLE & SEPARATE CERTIFICATION-REQUIRED? AI~ NOTES: ~ LOTS 40,000SF -100-24 Lot rccognition.(CREATED before June 30, 1983), UNDERSIZED LOTS FROM JAN.1997 100-25 Merger (A nonconlbm]ing at any time after 7/1/83) ZONiNG DISTRICT: REQ. LOT SIZE:~'o~o,o REQ. FRONT ro RE Q . REAR r o CONFORMING? 3to ACT. LOT SIZE: ¥~,,oc:~ REQ. LOT COV. PROP. FRONT PROP. REAR ~' REQ SDE WATER FRONT? t/~ DESCRIPTION: PANEL #: 125-~g' FLOOD ZONE: /K _, ACT. LOT COV. / APPROVALS REQUIRED SUFFOLK COUNTY HEALTH DEPT: YES or~, (BED #):.__ TOWN SEPTIC RECEIPT: Y or~ NEW YORK STATE DEC: Pge-gec 9n/?s YES or ~ SOUTHOLD TOWN TRUSTEES: YES orffi TOWN ZONING BOARD APPROVAL: YES or~' TOWN PLAN. BOARD APPROVAL: YES or~ TOWN HISTORICAL PRE (SPLIA): YES o1~ NYS ENERGY: YES O13~: ~_ EGRESS (18 H min.? 4 i"~total) ~ VENT (SQ. FT. x 4%) ,~//~ BUILDING PERMITS OPEN/EXPIRED: BP -Z / C/0 25- - HAVE PRE CO'S: Y OR N BP -Z / C/0 Z- NOTES: DTE: / / PERMIT #:R1 O- LIGHT (SQ. FT. x 8%) FEE STRUCTURE: FOUNDATION: FIRST FLOOR: SECOND FLOOR: OTHER: TOTAL: SF SF SF SF SF 1. (_ .SF)- ( SF)= SFX$ SFX$ 2. ( SF)- ( SF)= =$ =$ INIT OTHER TOTAL FEE FEE FEE +$ +$ +$ = $ 765-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION 1ST [ ] FOUNDATION 2ND [ ] FRAMING [ ] ROUGH PLBG. [ ] ~ATION [,(./]/FINAL [ ] FIREPLACE & CHIMNEY FIELD INSPECTION REPORT I DATE [ COMMENTS FOUNDATION (1ST) FOUNDATION (2ND) ROUG~ F~G & PL~G ~SU~ATION PER N. Y. STATE ENERGY CODE F~ ~D~ON~ CO~S TOWN OE SOUTHOL£ BUILDING DEPARTM] TOWN HALL SOUTHOLD, NY 11971 TEL: 765-1802 Examtned //~7~~'' Approved Disapproved Wc __, 20 ~- __, 20 ~ BUILDING PERMIT APPLICATION CHECKLIS Do you have or need the folloWing, before applying ? Board of Health 3 sets of Building Plans ~ Survey_ w/ Check_ ~ Septic Form N.Y.S.D.E.C. Trustees Contact: Mail to: 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 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 a Certificate of Occupancy is issu~ed by the Buildfi~g 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 Yorlq 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 prem/ses and in building for necessary inspections. (Signature of apphcant or name, ifa corporation) (Mailing address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, phunber or builder Name of owner of premises'~-P~'~7'~ (as on the tax roll or latest deed) If applicant is a corporation, signature of duly authorized officer -- --(~un-e anWt~le of co, orate officer) - Builders License No. Phmibers License No. Electricians License No. Other Trade's License No. Location of land on which proposed work will be done: /70 House Number Street Hamlet County Tax Map No. 1000 Section ~,~'7 Block ,~' Subdivisiond~lt¢-~c.~,o4~ ~--- u,4~t~ ,~.,4~'~I~ Filed Map No. ame) Lot 3. 0/o° Lot /~ 2. State existing use and occupancy of premises and intended use and occupancy of proposed con§traction: a. Existing use and occupancy ~.~ :~,~ ~---~. ~ b. Intended use and occupancy Nature of work (check which applicable): New Building Repair Removal Demolition Addition 4. Estimated Cost /~: z.v_~.o~ Fee -z~/~'~,co6 5. If dwelling, number of dwelling units If garage, number of cars Alteration (Description) (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 ~,.~ t Rear f_~ ~ ~ Depth Height ~.~,5~/ 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 Height Number of Stories 9. Size of lot: Front ,/L,,,,2. ~ ~ Rear //_,~, Rear Depth 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: /c~(D 13. Will lot be re-graded .~'~'3 Will excess fill be removed from premises: ~ NO 14. Names of Owner ofpremise~'-~'~,~ ~,,~ Address. Phone No. Name of Architect Address,~,~o,~ Phone No Name ofContractor~x,~( -ae~'~ ~.-~ Addressw-o--~ ~t ~,~,-Phone No. 15~ Is this property within 100 feet of a tidal wetland? *YES NO ,~ __ · IF YES, SOUTHOLD TOWN TRUSTEES 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. STATE OF NEW YORK) __~'-/~.~/-7 /a/J/~A/ being duly sworn, deposes and says that (s)he is the applicant (Name of individ~ual signing contract) above named, (S)He is the (Contractor, Agent, Corporate Officer, etc.) of said owner or owners, and is duly authorized to perform or have performed the said work and to make and file tlfis 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. CLAIRE g GLEW Notaw Public, State of New York No. 01 GL4879505 Qualified irt Suffolk Commission F-Koires Dec. 8, C ~ S igna~r--~-o f App lic ant ill N. 70' ~$' 00" W. ~4~ 4~' _N o~§ >