HomeMy WebLinkAbout24832-zFORM NO. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
office of the Building Inspector
Town Hall
Southold, N.Y.
CERTIFICATE OF OCCUPANCY
No: Z-26589
Date: 07/23/99
THIS CERTIFIES that the building ACCESSORY
Location of Property: 175 EMORY RD CUTCHOGUE
(HOUSE NO.) (STREET} (HAMLET)
County Tax Map No. 473889 Section 103 Block 4 Lot 39
Subdivision Filed Map No. __ Lot No. __
conforms substantially to the Application for Building Permit heretofore
filed in this office dated APRIL 1, 1998 pursuant to which
Building Permit No. 24832-Z dated APRIL 15, 1998
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 WITH FENCE TO CODE IN THE REQUIRED REAR YARD
AS APPLIED FOR.
The certificate is issued to CLAIRE CHAPMAN
of the aforesaid building.
(OWNER)
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL
ELECTRICAL CERTIFICATE NO.
PLUMBERS CERTIFICATION DATED
Rev. 1/81
M/a
N 455186
N/A
Building Ins~ctor
06/03/98
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.
24832 Z Date APRIL 15 98
Permission
is hereby granted to:
C CHAPMAN A/C CHITUK POOLS
PO BOX 9
CUTCHOGUE~NY 11935
for :
CONSTRUCT AN ACCESSORY INGROUND SWIMMING POOL WITH FENCE TO CODE
IN THE REQUIRED REAR YARD OF A SINGLE FAMILY DWELLING AS APPLIED FOR.
at premises located at 175
County Tax Map No. 473889 Section 103
pursuant to application dated APRIL
Building Inspector.
EMORY RD CUTCHOGUE
Block 0004 Lot No. 039
1 98 and approved by the
Fee $ 150.00
Building I nspe~or~
ORIGINAL
Rev. 2/19/98
BUILDING DEPARTMENT
TOWN HALL
765-1802
APPLICATION FOR CERTIFICATE OF OCCUPANCY
mo
filled in by typewriter OR ink and submitted to the buildin
~ector with the following: 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 build~
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 t0 April 9, 1957) non-conforming uses, or buildings a
~pre-exist~g" 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 a consent to inspect signed by the applican
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 Buildinm - $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
Location of Property..l.~.,~...~.~...~.~.[ ......
..
County Tax Ma; No i000, Section../.0 .~. ...... Bi'ck. ~ .......... ~ot .............. '- ·
Subdivision .................................... Filed Map ............ Lot ..................
Permit No ~W~ Applicant ......
................ Date Of Permit ...................................
Health Dept Approval Underwriters Approval ·
Planning Board Approval ........................
Request for: Temporary Certificate ........... Final Certicate ...........
Fee Submitted: $ ............................. v- "
....
THE NEW YORK BOARD OF FIRE UNDERWRITERS 1
1185077 BUREAU OF ELECTRICITY
~' 40 FULTON STREET, NEW YORK, NY 10038
Date JUNE 03,1998 Application No. onfite 16115798/98 N 455186
THIS CERTIFIES THAT
only the electrical equipment as described below and introduced by the applicant trained on the above application number is in the premises of
CLAIR CHAPMAN, 175 EMOR¥ ROAD, CUTCHOGDE, NY
in the following location; [] Basement [] 1st FL [] 2nd FI. OUT Section Block
was examined on MA~ 29 ~ 1998 and found to be in compliance with the National Electrical Code.
FIXTURE RANGES COOKING DECKS OVENS DISH WASHERS
OUTLETS
Lot
EXHAUST FANS
DRYERS
SYSTEMS
OTHER APPARATUS:
SWIMMING POOL- 1
TIHE CLOCKS 40 AMP-1
G.F.C.I-1
E R,
OF CC. COND.
C
NO, OF HI-LEG
OF NEUTRAL
- l
Per llGENERAL MANAGER
This certificate must not be altered In any manner; return to the office of the Board if incorrect. Inspectors may be Identified by their credentials.
ROSLAK EI~CTRIC
P.O.BOX 164
CUTCHOGUE, NY, 11935-2453
COPY FOR BUILDING DEPARTMENT. THIS COPY OF CERTIFICATE MUST NOT GE ALTERED IN ANY MANNER,
Town Hall, 53095 Main Road
P.O. Box 1179
Southold, New York 11971
Fax (516) 765-1823
Telephone (516) 765-1802
BUILDING DEPARTMENT
TOWN OF 8OUTItOLD
June 23, 1999
Chituk Pools, Ltd.
P.O. Box 9
Cutchogue, NY 11935
RE: Claire Chapman,
175 Emory Rd.,
Cutchogue.
To Whom This May Concern:
We are unable to complete yocr~Certificate of Oc6upancy
because of the following reasons:
XX An application for Certificate of Occupancy is
not on file. (Enclosed)
No Underwriters Certificate on file.
XX The check is (not on file.)$25.00
No Health Department Approval on file.
No final .inspection has been made.
No Plumber Solder Certificate on file.
(All. permits involving plumbing being
issued after April 1, 1984).
BUILDING PERMIT # 24832-Z
Please contact our office on this matter.
cooperation.
Thank ¥ou for
SOUTHOLD TOWN BUILDING DEPT.
Town Hall, 53095 Main Road
P.O. Box 1179
Southold, New York 11971
Fax (516) 765-1823
Telephone (516) 765-1802
BUILDING DEPARTMENT
TOWN OF SOUTHOLD
June 23, 1999
Chituk Pools, Ltd.
P.O. Box 9
Cutchogue, NY 11935
RE: Claire Chapman,
175 Emory Rd.,
Cutchogue.
To Whom This May Concern:
We are unable to complete your Certificate of Occupancy
because of the following reasons:
XX An application for Certificate of Occupancy is
not on file. (Enclosed)
No Underwriters Certificate on file.
XX The check is (not on file.)$25.00
No Health Department Approval on file.
No final inspection has been made.
No Plumber Solder Certificate on file.
(All permits involving plumbing being
issued after April 1, 1984).
BUILDING PERMIT # 24832-Z
Please contact our office on this matter.
cooperation.
Thank you for
SOUTHOLD TOWN BUILDING DEPT.
FOUNDATION (1st)
FOUNDATION
2.
ROUGH FRAME &
.PLUMBING'
(2nd)
INSULATION PER N.
STATE ENERGY
CODE
FINAL
765-1802
BUILDING DEPT.
INSPECTION
765-1802
BUILDING DEPT.
INSPECTION
[ ] FOUNDATION 1ST
[ ] FOUNDATION 2ND
[ ] FRAMING
[ ] FIREPLACE & CHIMNEY
REMARKS:
[ ] ROUGH PLBG.
[ ] INSULATION
[ ~~I~L
7GS-I.802
BUILDING DEPT.
INSPECTION
[ ] FOUNDATION 1ST [ ] ROUGH PLBG.
[ ] FOUNDATION2ND [ ]INSULATION
[ ] FRAMING [ ] FINAL
[ ] FII CHIMNEY
REMARKS:
BUILDING
FOLLO ,W, lNG INSPECTIONS:
~. FOUNDATION.; 'TWO REQUIRED
FoJ3 POURED CONCRETE. .,,..
.2: ROUGH - FRAMING &: PLUM[~ING
.3. ;NSU. LATION. ~
4. FK~AL CONST~LICTIoN MUST
' BT'COMPLETE FOR C.O., ".
ALL CONSTRUCTION SHALl;
'¥HE REQUIREMENTS (~ THE N.~
STATE CONSTRUCTION'~ EN~RG~ ' "'.. ,"',
C(' ~)FS NOT ~ RESPONSibLE FO~
'" ' · '" ' SUFFOLK 'CO. HEALTH
' 'H
. .' ATEMENT Or IN ,"
', ,;, THE WATER SUPPLY. AND. SEW~GE, DIS~&L
.: ,:/" '~, ,." ', ,L' ",, ~ - SYSTE~
',,,. ,. ~,, ,.. .. ,CONFORM TO THE STANDARDS OF THE
~'~~. .. ~FFOLK,, , ~. CO. DEPT. OF HEALTH'~ERVICES..: ., ,,"" :
,, ~ ., .... , , (~) , ,,,~,
'SUFFOLK. COUNTY DEPT. OF ~ALTH
';~ .$~RVICE5 - FOR A~PROVA'ik,. OF
..... CONSTR UCT'~N ONLY ~ ,,.' ,-., '
.' ,'.... ,, , ,. ::;., ,:,,,. , .. ,
', '" H S .'NO.; ,
,... . .... ' -. 'O~ST.
/~,' , ,,",, "~' ' '. ,,. , .,. , . 0~.~-'~' '_~.. ~..~"':.-: '; ..... "'
'"
' "*" ~ ' ' ' s?,~k ".
, , . . .,, 'TEST HOCE ' ~AMp '
· i . I., :',, ,~.,, '.,. '
.,.* .... .;..,. : <..,, ,. .... ,:,.-.,.~. ',,, ..,.,. , .'. , ,,. ... ', ~,,,' ?..
..r, ,, - .,
~L,L,G, ¥; kYT. '
FORH NO.
TOWN OF SOUTHOLD
BUILDING DEPARTHEIqT
TOWN HALL
SOUTBOLD, N.Y. 1197 I
TEL: 765- 1802
Disapproved a/c ................................ · ·
AI~I,ICATION FOR BUILBING PERMIT
fNSTRUCTJONS
I~OARI) OF ItEALTII ...............
3 SETS OF PLANS ...............
SURVEY ........................
CItECK .........................
SEPTIC FORH ...................
NOTIFY:
~A[L TO: ....................
a. This application r~st be caupletely filled in by type~r~iter or in ink and submitted to the l~lilding Inspector with
3 sets of plans, accurate plot pla" to scale. Fee according to schedule.
b. Plot pla. slmwing location of lot and of h~ildings on premises, relationship to adjoining premises or pablic
streets or areas, a.d giving a detailed description of layout of property n~st be draw. on the diagram ~icJ~ is part of
this application.
c. The ~ork covered by this application may not be cctxaeoced before issuance of Dailding Pemit.
d. Upon approval of fl~is application, the P~ilding Inspector xeill isane a B~ilding Permit to the applicant. Such
permit shall be l~pt: on the premises available for inspection thronghont the work.
e. No h~ilding shall be occupied or used in M~ole or in part for any parpose x~hatever until a Certificate of
Occupancy shall trove l~ee grant:ed by t[~a Building Inspector.
fiPPI.ICK~ICI~ IS l~g~¥ lq~g to the Building Uepartnmnt for the issuance of a Building Permit parsaant t:o the
Building Zone ordimaoce of the T(xm of So~thold, Suffolk C~xmty, New York, and other applicable La~s, Ordinances or
Regulations, for the constpaction of beildings, additions or alterations, or for removal or darolition, as herein
described. The applicant agrees to cc~ply with all applicable laws, ordinances, building code, h~asing cede,
re~nalatiorm, and to admit a~thorized inspectors on premises and in building for necessary inspections.
... ..............
(Signature of applicant, or name, if a corporat:ion)
(Nailing address of applica"C)
State ~tmther applicant is o~aer, lessee, agent, architect, engineer, general contractor, electrician, plmtmr or builder.
Name of o~er of premises .. ~..~/. t~..... ~/~'.~... .........................................................
(as on the tax roll or latest deed)
If applicant is a corporat:i~on,/sis~at~re of duly a"thorized officer.
......
(Nam and title of corporate officer)
Builders Liceese No. f.&.-/.~. ,7...: ./f.._~. .......
Plua~hers License No ..........................
Electricians License No ......................
Off,er Traders I.ieense No .....................
I~)cation of land on M~ich propnsed ~ork will be done ..............................................................
..... ..................... ,ZT../¢. ........................... ......................
lk~se Ns~i~er Street Ha~l et:
County Tax Nap No. I000 Section..,~.~.~. ....... Block....~.. .......... Lot ..... ~.~. .......
aaxiivision .~.ccm .... q..~...~. .............. Filed t~ap No..~.~..~../. ...... lot ..,~.~ .........
St:ate existing use and occapa"cy of prendses and intended use md occul~ncy of proposed construction:
a. isting ...........................................
J f garage, rllli~r of cars ..... J .................................
~m~ of Archi Leer I
Is thi~ pml~rt? ~ithin ~) f~'t of n tidal ~l:Jnr~l? * ~L~ ~
Iix:ate e]oarJy ar~ dJstimtl'ly a~l I~JldJ~s, ~ther exisl;iJ~ or proT~d, m~] J~Jcate all ~t--i~zk dJn~rmions ,
(,~ st~t ~serlptmn acco~mg ~o de~l, a~ d~ sLreet
x~LJ~r interior or co~r ]o1:. I
......... :I .................... IK~JIIJ~ duly .m~n~ de~×~.~__.~ ~I'KJ ~]s that he ~s ~Lhe aj~)J J~ml;
Ik~ iS the 0 ...........................................................
((~xJtractor, nl~ellt~ c~orlx)rate officer, etc.)
of said ~K~r or (~-s. m~ ]n duly ~horiz~l to I~rfonn or ha~ i~rfor.~d the ,aid ~[k m~l Lo rake a~x] file this
Jl~d i~1 I.his nl~l icaLJo, nre In~ to the I~8L o[ hi, k~x~lc¢ll~ n~ Ix~iie[~ lJIgl
ii~llJlRr ~et forLh in Lhe al?/Jcnti(,1 fi[mi tl~rmith.
ap[)l [cati~; thai. nil 8Lal:~ent.~ conta
lilat Lhe ~)rk will I~ I~rl'ont~l
~Jrn Io i~[or~ I1e IhJ.q