HomeMy WebLinkAbout29250-ZFORM NO. 4
TOWN OF SOUTHOLD
BUILDING DEPA=RTMENT
Office of the Building Inspector
Town Hall
Southold, N.Y.
CERTIFICATE OF OCCUPANCY
No: Z-29733
Date: 09/24/03
THIS CERTIFIES that the building ACCESSORY
Location of Property: 505 BITTERSWEET LA CUTCHOGUE
(HOUSE NO.) (STREET) (HAMLET)
County Taxx ~ap No. 473889 Section 104 Block 2 Lot 6
Subdivision Filed Map No. __ LOt NO. __
conforms substantially to the Application for Building Permit heretofore
filed in this office dated MARCH 27, 2003 pursuant to which
Building Permit No. 29250-Z dated MARCH 28, 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 IN THE REQUIRED REAR YARD WITH
FENCE TO CODE AS APPLIED FOR.
The certificate is issued to FRANK & TINA CENTO
(OWNER)
of the aforesaid building.
SIIFFOLKCOUiTi"fDEPARTME/~TOF~RALTHAPPROV~J~ N/A
ELRL-rKICAL C~TIFIC3%TH NO. 3466
PLUMBERS CERTIFICATION DA'r~u3 N/A
os/~4/o3
it~lgnature
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)
PEP~4IT NO. 29250 Z Date MARCH 28, 2003
Permission is hereby granted to:
FR3kNK & TINA CENTO
84 WYATT ROAD
GARDEN CITY,NY 11530
for :
CONSTRUCTION OF AN INGROUND SWIMMING POOL IN THE REQUIRED REAR
YARD AS APPLIED FOR
at premises located at 505 BITTERSWEET LA CUTCHOGUE
County Tax Map No. 473889 Section 104 Block 0002 Lot No. 006
pursuant to application dated MARCH 27, 2003 and approved by the
Building Inspector to expire on SEPTEMBER 28, 2004.
Fee $ 150.00
Authorized Signature
COPY
Rev. 5/8/02
Form No. 6
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN HALL
765-1802
, 'i I! - 8
APPLICATION
FOR
CERTIFICATE OF O UPANCY
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. Commemial building, industrial building, multiple residences and similar buildings and installations, a certificate
of Code Compliance from architect or engineer responsible for the building.
6. Subnfit 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
~f Oxcupanc~ - New dwelling $25.00, Additions to dwelling $25.00, Alterations to dwelling $25.00,
( S.._~wimming p~ol $2~.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: ~-0 5-
House No.
Owner or Owners of Property: -~h~}~
Suffolk County Tax Map No 1000, Section
Date.
Old or Pre-existing Building: (check one)
Street ) Hamlet
O- --V:rph
I 0q Block 0 aO2. Lot 0~']0
Subdivision
Permit No.
Health Dept. Approval:
Filed Map. Lot:
DateofPermit. /'/}~Ch;2~/2&gYApplicant: "~/~0~ ~"~/~ ~T'~
Planning Board Approval:
Request for: Temporary Certificate Final Certificate:
Fee Submitted: ,, ~ (ff0,A/~/~ pt~
(check one)
Applicant Signature
Underwriters Approval:
Nassau Suffolk Electrical Inspections, Inc.
5A Canal Street * Center Moriches, New York 11934 · Tel: 631-878-3500 · Fax: 631-878-3764
Application: 3466
Issued to: Canto
Address:. 505 Bittersweet Lane
Village:Cutchogue
Date: 5/14/03
introduced By: Bethel Electric
Lic#:2880-E
was examined and approved up to the above date and was in compliance w/th the NEC
Switches Receptacles Fixtures GF.L Timeclock Whirlpool
2 3 2 2 1
Oven Carbon
Fans Dishwasher ! Washer/Amps Dryer/Amps Range/Amps Monoxide
Furnace Oil Gas Heat Zones Smoke Bell
Detectors Transformers
Meter Amps Phase Motors
1-3/4~1 'tl2Hp
3ther Equipment: Inground Pool
:)ut,Res
Section: 104 Block: 2 Lot: 6
This certificate must not be altered
in any manner
BtJt-L-DtNG:fzE4~'[ I T ~. ~ ~ ~ ~ ,~ LC I7[C<7-K-L~
Applicant/
Owners Nmne:
Architect/
Engineer:
SCTM ~,:
/o
District 1,000 Secuol; Blod _ Lo ~,
Reviewed:
Submilted:
Projec Subdivision
Single & separal¢ Reamr¢o
ced~ficalion' (Yes / No)
[Front Ymd Pro-~seo ~] [S~dc Yard
Project Description: I <~ .lcD-
AGENC'II?ERMITS
REQUIRED FOR REVIEW
Permit
l'~O YI~S ~tutlber
Suffolk County Health Dept.
New York State D. E. C.
Town Trustees
Tovm Zoning Board approval:
Town Planning Board approval:
Flood Plane Elevation 777
Flood Zone:
Note~:
7G5-:1.802
BUILDING DEPT.
INSPECTION
[ ] FOUNDATION 1ST [ ] ROUGH PLBG.
[ ] FOUNDATION2ND [ ]INSULATION
[ ] FRAMING [ ~'~INAL
[ ] FIREPLACE & CHIMNEY
765-1802
BUILDING DEPT.
INSPECTION
[ ] FOUNDATION 1ST
[ ] FOUNDATION 2ND
[ ] FRAMING
[ ] FIREPLACE & CHIMNEY
REMARKS:
[ ]ROUGH PLBG.
[ ] INFLATION
[ ~"~INAL
/?
INSPECTOR~//~/~
765-1802
BUILDING DEPT.
INSPECTION
[ ] FOUNDATION IST [ ] ROUGH PLBG,
[ ] FOUNDATION2ND [ ] IN~~.,~
[ ] FRAMING [
[ ] FIREPLAC~ & CHIMNEY
DATE
INSPECTOR
FOUNDATION (1ST)
FOUNDATION (2ND)
ROVG~ ~V~G &
pL~G
~S~ATION PER N. Y.
STATE ENERGY CODE
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN HALL
SOUTHOLD, NY 11971
TEL: (631) 765-1802
FAX: (631) 765-9502
www. northfork.net/Southold/
Examined
Approved
/~w-g_ ,2003
20a _
Disapproved Wc
Expiration ?.~_~_ ,20_O,~
PERMIT NO. o2 ¢O ~ ~
BUILDING PERMIT APPLICATi6N CHECKLIST
Do you have or need the following, before applying?
Board of Health
3 sets of Building Plans
Planning Board approval
Survey_
Check
Septic Form
N.Y.S.D.E.C.
Trustees
Contact:
Building Inspector
APPLICATION FOR BUILDING PERaVIIT
INSTRUCTIONS
__, 20 r:y _
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 adjoi~ing prernises 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 co]xamenced 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 Sonthold, 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, building code, housing :ode, and regulations, and to admit
authorized inspectors on pranfises and in building for necessary hisp~Nxr~
,,,--- -,'-,-. -- .... ,,OCCUPANCY
NCLO*E OOLTO COD USE IS IINLAWF Jt
WITHOUT
· OF OCCUPANCY
State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder
dZ._" UNOERI~RITERS CERTIFICATE ' ' ~
- JlE~.:~.[RED
(As on the tax roll or latest~a.R~'- ·
If applicant is a corporation, signature of duly authorized officer
~I~g~II~rBUILDiNG DEPARTMENT A
(Name m~d title of corporate officer)
Builders License No.
Plumbers License No.
Electricians License No.
Other Trade's License No.
1. Location of land on.which prgposed work will be done:
House Number Street
County Tax Map No. 1000 Section
Subdivision
(Name)
?~6~,1802 9 'AM TO 4 PM FOR THE
I~OLLOWING INSPECTIONS:
FOUNDATION - TWO REOUIRED
FOR POURED CONCRETE
ROUGH ,. FRAMING & PLUMBING
INSULAIION. -
t FINAL C~NSTRDCTION MUST
BE COMPLETE FOR C.O.
&LL CO~$TI~U~TIOlY SHALL MEFT
u ~TATE '~.O~TR~ION & ~NERC'/
H~]ctCODES. NOT ~SlB'LE
DESIGN OR CONSTRUCTION ERRORS
Filed Map No.
2. State existing use and occupancy of premises and intended use and occupancy of proposed constru6~ion:
a. Existing use and occupancy
c~
b. Intended use and occupancy
3. Nature of work (check which applicable): New Building_ Addition
Repair Removal Demolition Other Work
4. Estimated Cost Fee
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
Height. Number of Stories
Rear .Depth
Dimensions of same structure with alterations or additions: Front
Depth. Height. Number of Stories
Rear
8. Dimensions o f 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 __ NO
13. Will lot be re-graded? YES'X,,. NO Will excess fill be removed from premises? YES ~ NO
14. Names of Owner of premises ,~'~-~t& ,~ Ce~-z) Address ~ff- Bnq~_.qveePzt/~ Phone No.~/6
Name of Architect Address Phone No
NameofContractor~.~-£c,*v-'a~,~-~o~-~ Z T-,,~ Address /~fi~z, c lqde ,~td PhoneNo.
1
5
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 lin~s.
17. If elevation at any point on property is at 10 feet or below, must provide topographical data on survey.
STATE OF NEW YORK)
SS:
COUNTY OF )
~flZ9//~'~7 ~fl , ~C~-~rl~St~ being duly sworn, deposes and says that (s)he is the applicant
(N~'me of individu~tr~e0 above named,
(S)He is the ~)'~ ~3(--
t ' (Contra~or, Agent, Corporate Officer, etc.)
of said owner or owners, and is duly aut.~orized to perform or have performed the said work and to make and file ti'tis application;
that all statements contained in this appli~cation are tree to the best of his knowledge and belief; and that the work will be
performed fin the manner set forth in the'gpplication filed therewith.
Sworrl to before me this_
~:)t'~Tt''x day of~~,~ 20 0~)__
-Il Notary Public
NOTARY PUBLIC, ~ate ~ N~II~I~
Nc. 01GA604~4~
Qualified in Suffolk ~C~.. ~/
Commission Expires A~gu~ 1~
Ii