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Home My WebLink About24014-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT office of the Building Inspector Town Hall Bouthold, N.Y. CERTIFICATE OF OCCUPANCY No: Z-26869 Date: 01/03/00 THIS CERTIFIES that the building ACCESSORY Location of Property: 1575 PINE NECK RD (HOUSE NO.) (STREET) (HAMLET) County Tax Map No. 473889 Section 70 Block 5 Lot 41 BOUTHOLD Subdivision Filed Map No. __ Lot No. -- conforms substantially to the Application for Building Permit heretofore filed in this office dated MARCH 21, 1997 pursuant to which Building Permit No. 24014-Z dated MARCH 28, 1997 was issued, and conforms to all of the requirements of the applicable provisions of the law. The occupancy for which thus certificate is issued is INGROUND SWIMMING POOL WITH FENCE TO CODE AS APPLIED FOR. The certificate is issued to JOSEPH GERGYES of the aforesaid building. (OWNER) SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL ELECTRICAL CERTIFICATE NO. PLUMBERS CERTIFICATION DATED Rev. 1/81 N/A 15862 04/30/97 Authorized Si~ature lrOB~l~ NO. ~1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N. Y. BUILDING PERJ~AIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) is hereby grant~'d to: .... ~./~...~.....(_~....../..~.o.../.~. .... .~...~:.~......~.~ ................ .... at premises I~ted at ......... ~.~ ......... : ...... ~..~ ~ ~ ~o. ~0~o s.~,,o. ........ ~ ........ ~k ....... ~ ........ ~o~ ~o...~Z ............. pu~uant to application dat~ ............... Building Inspector. Rev. 6/30/80 Thi --a~ffi[~ag'£~n ~;~t'% lied in by typewriter OR ink and submitted to the bull inspector with the following: for new building or new use: 1. Final survey of property with accurate location of all buildings, property li streets, and unusual natural or topographic features. 2. Final Approval from Health Dept. of water supply and sewerage-disposal(S-9 fo 3. Approval of electrical installation from Board of Fire Underwriters. 4. Sworn statement from plumber certifying that the solder used in system contai less than 2/10 of 1% lead. 5. Commercial building, industrial building, multiple residences and similar bui and installations, a certificate of Code Compliance from architect or enginee responsible for the building. 6. Submit Planning Board Approval of completed site plan requirements. For existing buildings (prior to April 9, 1957) non-conforming uses, or building Vpre-existing" land uses: i. 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 appl~ If a Certificate of Occupancy is denied, the Building Inspector shall state t 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. Additions to accessory building $25.00. Businesses $50.00. 2. Certificate of Qccupancy on Pre-existing Buildin~ - $i00.00 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 ~. 7 .~. ~ ~ ........... New Construction ........... Old Or Pre-exi~ting Building ........ Location of Property .... Z~.~.~"~. ......... ~!..l"~.....~.?r,.'~... ]]..~-i] ~r~ House No. Street Hamlet Onwer or Owners of Property...~..~.~. ........................................... ... · .'2..0.s' WI County Tax Map No 1000, Section ....... .. Block ......... .. ... .. Lot ........ ...... Subdivision Filed Map Lot ......... Permit No ........ Date Of Permit ................ Appiicant ..................... Health Dept Approval Underwriters Approval . .. Planning Board Approval ........................ Request for: Temporary Certificate ........... Final Certicate ........... 57 f7 ~AT~: 4/~0797 ELECTRICAL INSPECTION SER F1CE /NC. 375 D UNTO N A VENUE EM ST PA TCHO G UE, .WE W YORK 11772 .. (516) 286-6642 15862 ~PLICATION Aro. ON PTLE V1LL4GE: ADDRESS; ISSUED TO: SO[r£HOLD ro~{~q: SOUTHOLD ; sTs P~'¥R ,vrc('I( ROAD JOSEPH GER G YES INTRODUCEDBK. R. C. ELECTRIC CORPORATION LICNo: 1610-E was ~:amined on 4~$0.97 and found to be to compliant* ~v~th the National Elect~tl Code LOCATION: Base. 1st 2nd 3rd Attic DeL (;m-age Hot Tub P~OI SI97TCHES ' ' ' RECEPT.4~,ES FLYTURES H~T~ F~S G~J. ' ' ~ CO~.:c , ~: OTHEr' POOL 1-20AMP 220 V SPEC~L 1-2~ T~E CLOCK 1-POOL NO Vl$ JAl. DEFECTS BUILDING PERMIT No, 765-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] IN/SULATION / [ ] FRAMING ,~ [ ~.4flNAL [ ] FIREPI. ACE&CHIMN~Y DATE INSPECT~ 765-t802 BUILDING DEPT. INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ .] ~ [ ] FRAMING [/__.~'*'FINAL [ ] FIREPLACE & CHIMNEY. ,..,'J t -' TO\¥tq or- '~otlTl'lOl,.rj. tj.y, "IMMEDIATELY" ENCLOSE POOLTO CODE UPON COMPt,ETION BEFORE >1 i~'q F-' 1--1 E- C I~ BLDG. DEPT. FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N.Y. 11971 TO~W'N OF SOUL, IOL,D_~.,j TEL.: 765-1803 Disapproved a/c ..................................... // . (Buildin,,Inspector~' j~PLICATION FOR BUILDING PERMIT INSTRUcTIONs BOARD OF HEALTH ..".~.... 3 SETS OF PLA~;S SURVEY CIIEcK .................. SEPTIC FOR~I CALL ....... MAIL TO:~ . ..... Date .................. 19.9 a. This application must be completely filled in by typewriter or in ink and submitted to the Building Inspector, with {ets 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 stre~ or areas, and giving a detailed description of layout of property must be drawn on the diagram which is par~ of this aplc 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 appIicant. Such peru 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 Occupma, 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 tJ Building Zone Ordinance 9f.t~ Town of Southold Suffolk County New York, and other applicable Laws Ordinances Regulations> fo~ th,e co~ngfl'bdtYon of buildings, additions or alterations, or for removal or demolition, as herein describe The applicant a'g~ees,l~ comply with all applicable laws, ordinances, building code, housing code, and regulations, and admi,t authorized inspectors on premises and in building for necessary inspq~tions. . ~ ~ (~,g~n~u~re2f~ap~pl~.nt~ o..r_~n_~_i~f a corporation) (Mailing address of applicant) State whether,applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builde .......... ..... Name of owner of premises ....x~..~..(~...~_~,....~...~_~. ~. ;t~ r,.' :~.~, ................................... (as'B'ff'il{~ ~[¢~4',},oil or latest deed) If applicant is a corporation, signature of duly authorized officer. (Name and title of corporate officer) Builder's License No..../'[ .-~..../~..~...~....~... ..... Plumber's License No ......................... Electrician's License No. /..(?.J..0..~ ..~-...-. ...... Other Trade's License No ...................... 1. Location of land on which pxopo, sed work will be don~ .._ ........... ,~ .................................. ....... ...... ............... llouse Number Street Hamlet Count axMap o. lo0osection ....V..O .......... Block ........ Lo, .... ¥.[ .......... Subdivision ' Filed Map No. ~,~.C/..~. ......... Lot...~. ......... (Name) 2. State existing use and occupancyfTy/t2 ~ ~a', ~,] ~°f presses and intended use a,nd occupancy of proposed construction: b. Intendeduseandoccupancy~~ ~'~ ~ ~. ~' . ' .............. ;. .~..Q~..'.~.~.... 3. Nature of work (check which applicable): New Building .......... Addition .......... Alteration ... Repair .............. Removal ............ Demolition .............. Other ~Work . i . ~/Description~ 4. EstimatedCost.q~.~.).b.'/..I.~..-,-~__ .................... Fee .................................... ~ ~'x (to be paid on filing this application) 5. If dwellin=, number of dwelling units ....XX. .......... Number of dwelling units on each floor .............. · If garage, number of cars .............. x,x ...................................................... 6. If business, commercial or mixed occupancy, s}~c,~ify nature and extent of each type of use ................... 7. Dimensions of existing structures, if an~y~! Front ..~ ........... Rear .............. Depth ............. Height ............... Number ,o,f St,o.n'es ... ~.~,. ............................................... ' Dimensions of same structure with al, te.r.a~ditlo~s: Front ................. Rear ................ Depth ...................... Heig[~ ........ .N.,, ......... Number of Stories .............. . ...... 8. Dimensions of entire new construction,.'~.Fro, nt .......... .~.. Rear ............... Depth ............. Height ............... Number of Stories. ~ ......... .~ .............................. ; ......... 9. Size of lot: Front ................... Rear..~. ~. ;..~ .......... Depth .................... 10. Date of Purchase ................. L' ': ', .... Name of Foh~er Owner ........................... 1 I. Zone or use district in which premises are situated ............... x.. ................................... 12. Does proposed construction violate any zoning law, ordinance or regulation: . .~(,-) ................ ~--;-~ ..... 13. Will lot be regraded ...... J~ .O..~.~ .............. Will excess fill~ removed from premises: 14. Nam~ of Owner of premises~q .~..(~.'.~ ('.~..'-~ .~.~... Address J.~..~. Fz&~ ./~..~,~... Phone No./~..-%.~x~7./..~.~..~' Name of Architect ...... ~ ............ Address ........ cr ,- -~Or~tcPh°ne No ........ Name of Contractor )~]0~.~.~ ri ~ ~.O C.~. ~.~ ~-~ddress ...~. t~. ~td/~.(< o. ~.d Phone No. b .~. Is this property within 300 feet of a tidal wetland? *Yes .... .. .. No.....~.:. *If yes, Southold Town Trustees Permit may be required. PLOT DIAGRAM Locate clearly and distinctly all buildings, whether existing or proposed, and. indicate all set-back dimensions fro property lines. Give street and block number or description according to deed, and show street names and indicate wheth. 15. °'IMMEDIATEL .... ENCLOSE POOL TO UPON COMPLETION BEFORE "WATER" UNDERWRITERS CERTIFICATE REQU}RED ~v4~ PO(.I~ED CONCRETE &L CO~TRUCT~ON COMPLETE ~OR C,O, STATE OF NEW YORK, S.S COUNTY OF .... , ............. .. J~?. ~....~.. [~ .d~.~.. ~ {/~[.Q~.[. ~ ............ being duly sworn, deposes and says that he is the applical (Name of individual signing contract) above named. 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 th application; that all statements contained in this application are true to the best of his knowledge and belief; and that ti work will be performed in th~ manner set fortk in the application filed therewith. Sworn to before me this ...... ~. ............. day of.. ~...~. ...... , 19~.~ Notary Public^ ...... ~-,~.{..~.~. O/..~. .............. · x DONNA M.~./~/~//./. :/ff '.County ri \__~ _~...,., ~/~ --"7~' J ,~tNotary Public, Stei~xff'l~K,7.Yla'rl~. [ )I)YI/YlIt If I /,F]~ JX If~ No. 4891784' (Signature ofapplicar ~.--,--- ~ - ~v- ' ' ' * ~'~] ~-' OualifiedinSuffoikCounty -- Commission Expires June 01, I ~ · -- ~ °° :1