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FORM NO. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Office of the Building Inspector
Town Hall
Southold, N.Y.
CERTIFICATE OF OCCUPANCY
No: Z-25995 Date: 09/29/98
THIS CERTIFIES that the building ADDITION
Location of Property: 1305 PARK AVE SOUTHOLD
(HOUSE NO.) (STREET) (HAMLET)
County Tax Map No. 473889 Section 56 Block 1 Lot 2.6
Subdivision Filed Map No. Lot No.
conforms substantially to the Application for Building Permit heretofore
filed in this office dated JULY 18, 1995 pursuant to which
Building Permit No. 22923-Z dated AUGUST 2, 1995
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 & DECK ADDITION TO EXISTING ONE FAMILY DWELLING
AS APPLIED FOR.
The certificate is issued to PHILIPPE C & MICHELLE LEONARD
(OWNER)
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A
ELECTRICAL CERTIFICATE NO. N365096 10/02/95
PLUMBERS CERTIFICATION DATED N/A
J
Building Inspe or
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)
y)
NR 22923 Z Date
Permission Is hereby granted to;
~~r/`
-c .cam........... /..~~7/..........
y
to S !!LGl tl ~J ~ ~
r........,.~.........~ .........~'~-'~i<%......
at premises located at........ !,YT
/ .Y
County Tax Map No. 1000 Section Block ®1.......... Lot No.
pursuant to application dated .Ile,,,.............,........, 19'..X. and approved by the
Building Inspector.
Fee
..~C~/,.....
/ B ding Inspector
Rev. 6/30/80
Form No. 6
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN HALL t
765-1802
APPLICATION FOR CERTIFICATE OF OCCUPANCY
A. This application must be filled in by typewriter OF, ink and submitted to the building
inspector 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 17 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, building and
unusual natural or topographic features.
2. A properly completed application and a 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
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 Buildine - $100.00
3. Copy of Certificate of Occupancy- .251~.
4. Updated Certificate of Occupancy - $50.00
5. Temporary Certificate of Occupancy - Residential $15.00, Commercial $15.00
Date ~J Pr~ClfGlh(!C!.. ~Q J.`',! y
New Construction..... . Old Or Pre-existing Building
Location of Property..43OS. 106*o-~... 4ve........ ~!~+or!~
House NO. Street Hamlet
Onwer or Owners of Property. L.~~~~lvlBG C`'t ...t...l.c..I
County Tax Map No 1000, Section..;'/ ........Block.. ( Lot..r? `4;
4 2.7
G.dct~i ~t??MG/~
Subdivision
L ..Filed Map..MT Lot...~?r
Permit No..221??3 A ..`D,ate Of Permit..0/151..... Applicant./,..`'. t,/.'fir..
Health Dept. Approval ...4~R! .................Underwriters
Planning Board Approval. (..A
Request for: Temporary Certificate........... Final Certicate...
Fee Submitted: $
mac,- .S 51 ~~1 . .
e ~C)~C~S APPLICANT
rzrT,n'INSPRC'LiON_RBPOR'fDATE
T_ - m - COMMENTS
H
PDUNDATLON (IST) jl II
V4
FOUNDATION (2Np) I ra
n ~
ROUGH FRAME S I O O
PLUMBING i~ -
11
II
INSULATION PER N. Y.
STATE ENERGY ~~-j~~---
Alz:
ri
CODE -I'-_~7?- L~l- 02
lelll~
it
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FINAL '!I .vnocO*2,o S'C~S~(- _
nuzxzoNAl, coMMENTS:
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O
THE NEW YORK BOARD OF FIRE UNDERWRITERS PAGE 2
1001071 BUREAU OF ELECTRICITY
F 83 JOHN STREET, NEW YORK, NEW YORK 10038
ate OCTOBER 02,1995 Application No. on file 10191895195 N 365096
. ERTIFIES THAT
only,thha electrical equipment as described below and introduced by the applicant named on the above application number in the premises of
r 101
PHILIPPE LEONARD, 1305 PARK AVENUE, SOUTHOLD, N.Y.
in thefollowing location; ? Basement ? Ist Fl. ? 2nd F1, GAR/OUT Section Block Lot
was examined on S ''PTEMBEiR 25 f 1995 and found to be in compliance with the National Electrical Code.
fIXTURE FCEPTACLES SWITCHES FIXTURES RANGES COOKING DECKS OVENS DISHWASHERS EXHAUST FANS
OUTLETS INCANDESCENT FLUORESCENT OTHEn MIT K W. AMT K. W. AMT. K W. AMT. K. W. AMT. H. P.
t
DRYERS FURNACE MOTORS FUTURE APPLIANCE FEEDERS SPECIALREC'PT TIMECLOCKS BELL UNITHEAIIERS PAULTI.OUTLET DIMMERS
I AMT. K. W. OIL H. P. GAS H. P. AMi NO. A. W. G. AMT. AMP PMT. AMPS TRANS. AMT. H P SYSTEMS pMT. WAIIS
NO. OF FEET
F
i
SERVICE DISCONNECT NO. OF S E R V I C E
MEIER
1
AMT. AMP. APE EQUIP. Is, 2W ,e' 3W 3 $ SW 3,e' dW NO. IF PER gCOND. OF Cf CO NO NO OF MbIEG OF X' IEG ~'~O Of NEUTRALS OF A. G. NEUTRAL
I
OTHER APPARATUS:
i
fi
I
k
4
G & S CONTRACTOR LIC.#578-E
BOX 215
SOUTHOLD, NY, 11971 GENERAL MANAGER
1.1
Per
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.
E COPY FOR BUILDING DEPARTMENT. THIS COPY OF CERTIFICATE MUST NOT BE ALTERED IN ANY MANNER.
THE NEW YORK BOARD OF FIRE UNDERWRITERS PATE 1
1001.071 BUREAU OF ELECTRICITY
F -A 88 JOHN STREET, NEW YORK, NEW YORK 10038
4 Date OCTOBER 02.. ,1995 Application No. on file 10191895/95 N 365096
THIS CERTIFIES THAT
only the electrical equipment as described below and introduced by the applicant named on the above application number in the premises of
PHILIPPE LEONARD, 1305 PARK AVENUE, SOUTHOLD, H.Y.
in thefollowing location; ? Basement ? 1st Fl. ? 2nd Fl. GAR/OUT Section Block Lot
was examined on SEPTEMBER 25,1995 and found to he in compliance with the National Electrical Code.
FIXTURE FIXTURES RANGES COOKING DECKS OVENS DISHWASHERS EXHAUST FANS
OUTLETS ECEPTACLES SWITCHES INCANDESCENT FLUORESCENT OTHEfl AMT. K W AMT. K W. AMT. K.W 11 MIT. K W. AMT. H. P..
2 1 2. 2
DRYERS FURNACE MOTORS FUTURE APPLIANCE FEEDERS SPECIAL REC'PT TIME CLOCKS FELL UNIT HEATERS MULTI-OUTLET DIMMERS
AMT. K. W. OIL H. P. GAS H. P. AMT. NO. A. W. G. AMT AMP. MIT AMPS, TRANS. AMT H P. SYSTEMS NO. OF FEET AMT. WATTS
1 201 1
SERVICE DISCONNECT NO. OF S E R V I C E
AMT. AMP. TYPE METER 102W 1 ,e 3W 3 6 3W 3 B' AW NO. OF CC. COND. A. W. G. NO. OF HIAEG A. W. G NO. OF NEUTRALS A. W G.
EQUIP. PER 9 OF CC. COND. OF HI.LEG Oi NEUTRAL
OTHER APPARATUS: -
SWIMMING POOL-1
TIME CLOCKS-AMP.90-1
G.F.C.I-1
*(SWIMMING 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 p
made by a qualified person.
<<< Continued on Page 2
GENERAL MANAGER
Per
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.
COPY FOR BUILDING DEPARTMENT. THIS COPY OF CERTIFICATE MUST NOT BE ALTERED IN ANY MANNER.
VFW/( ea
c~ Gyp
Town Hall, 53095 Main Road Fax (516) 765-1823
P.O. Box 1179 Oy O~~ Telephone (516) 765-1802
Southold, New York 11971
BUILDING DEPARTMENT
TOWN OF SOUTHOLD
September 28, 1998
Mr. & Mrs. Philippe Leonard
1305 Park Avenue
Southold, New York 11971
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 # 22923-Z
Please contact our office on this matter. Thank you for
cooperation.
SOUTHOLD TOWN BUILDING DEPT.
r
M-1802
BUILDING DEPT.
INSPECTION
[ ] FOUNDATION I ST [ ] ROUGH PLBG.
[ ] FOUNDATION 2ND [ ] 1 LATION
[ ] FRAMING [ FINAL
[ ] FIREPLACE CHIMNEY
REM KS: /1`T1K
DATE INSPECTOR
765-1802
BUILDING DEPT.
INSPECTION
[ ] FOUNDATION 1ST [ ] ROUGH PLBG.
[ ] FOUNDATION 2ND [ }INS ATION
[ ] FRAMING [ INAL
[ ] FIREPLACE A CHIMNEY
RE KS:
d
DATE INSPECT
765-1802
BUILDING DEPT.
INSPECTION
[ ] FOUNDATION 1ST [ ] ROUGH PLBG.
[ ] FOUNDATION 2ND [ ] INSULATION
[ ] FRAMING [ ] FINAL
[ ] FIREPLACE & CHIMNEY
k REMARKS:
r--
,ate ~ "
DATE J J- INSPECTOR
765-1802
BUILDING DEPT.
INSPECTION
[ ] FOUNDATION 1ST [ ] RO H PLBG.
[ ] FOUNDATION 2ND [ ] 1 SULATION
[ ] FRAMING [ FINAL
[ ] FIREPLACE & CHIMNEY
RE ARKS
DATE 1S INSPECTO
BOARD OF HEALTH
II FORM NO.1 3 SETS OF LA11S
N y TOWN OFSOUTHOLD SURVEY . . . . . . . . .
JUL I Es BUILDING DEPARTMENT CHECK .
.
TOWN HALL SEPTIC FORM
SOUTHOLD, N.Y. 11971
TEL.: 765-1802 NOTIFY
-pp---- ` /.65'.S.l
CALL /L f.. CIA I L O:
-Examined . . . . . 19
.
Approved ..../y......., 19!x. Permit No..~
Disapproved a/c
~ a Inspect~ .
( )
APPLICATION FOR BUILDING PERMIT
Date 1 19 S
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 sheets
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, building code, housing code, and regulations, and to
admit authorized inspectors on premises and in building for necessary inspections.
(Signature of applicant, or name, if a corporation)
(Mailing address of applicant)
State whether applicant is owner, lessee, agent, /architect, engineer, general contractor, electrician, plumber or builder.
O. G?.,P1 GK / (/G...........................................................
Name of owner of premises ~PLi.r.~l~J~.4.. L7he~ Ahe-ie//~ °CJn~.^
(as on the tax roll or latest deed)
If applicant is a corporation, signature of duly authoriied officer.
(Name and title of corporate officer)
Builder's License No .
.
Plumber's License No.
Electrician's License No.
Other Trade's License No .
1 . Location of land on which proposed work will be done .
i 3OS P.~!c r< f~''~ Sav7.o........... I
House Number Street Hamlet
County Tax Map No. 1000 Section ...O5~......... Block / Lot la.
Subdivision . , Filed Map No. X0.3. Lot ...,~Z
(Name) ,
2: State existing use and occupancy of premises and intended use and'oe-cupancy of proposed construction:
, -
a. Existing use and occupancy .
b. Intended use and occupancy
3. Nature of work (check which applicable): New Building Addition Alteration
p t oval Demolition Other Work $c?1Mnataf„/~q9/,
(Description)
10 dpCl L
.....6 ,
4. Estimated Cost Fee
(to be paid on filing this application)
5. If
garage ' g g,lunits Number of dwelling units on each floor
tr
of
6. If If business, nu number
....i
i l a~ r m ind occupancy, specify nature and extent ofoach type of use
7. Dimnsions of existing structures, if any: Front Rear, Depth .
Height Number of Stories .
Dimensions of saute structure with alterations or additions: Front Rear . . .
Depth 11 Height Number of Stories
Fr uction: Front Rear Depth
98. . Size Dime of lot: Dimensions of out . .entire. . .new.conRear Depth
Height of Stories .
10.
Date of Purchase
1 1. Zone or use district in which pr' ' ' ' ' ' ' • . Name of Former Owner . .
Cmisesare situated
12, Does proposed construction violate any zoning law, ordinance or regulation: .
13. Will lot be regraded Will excess fill be removed from premises: Yes No
14. Name of Owner of premises .
emises Address Phone No. 71p5 ~SSg$ .
Name of Architect Address Phone No........ .
Name of Contractor .
.................Address ...................Phone No. 74r S. ~l~~.. .
15. Is this property within 300 feet of a tidal wetland? *Yes........ No.........
*if yes, Southold 'own Trustees Permit may be required.
PLOT DIAGRAM
Locate clearly and distinctly all 11 buildings, whether existing or proposed, and, indicate all set-back dimensions from
property lines. Give street and block number or description according to deed, and show street names and indicate whether
interior or corner lot. 5-ee- %1 ~Gye~
Sv~^v4l ys
I
I
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I
II
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COUNTY OFi~I+-E tt $.S
F/
/ ele • . • • • • • being duly sworn, deposes and says tha ie is the applicant
(Name of individual signing contract)
above named.
CC 0 Lr//Ve r
15IIe 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 this
application; that all statements contaiPed 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.
Sworn to before lire this
• .i' ,
.lre b l-4 ..day of . . . Fs•~ l 19-l?
Notary Public, County No. 81269 ®SeSuffo' of
Not L ABETH A N N LL r' , Lo .
York - (Sign applicant)
Term Expires October 31,19W
Definition to be added to section 606.3
Of the New York State Uniform Fire
Prevention and Building Code.
Swimming pool- A structure
intended for bathing, swimming
or diving purposes, made of
concrete, masonry, metal or
other impervious materials,
and provided with a recirculating
and/or controlled water supply.
_AMENDMENT TO THE NEW YORK STATE
UNIFORM FIRE PREVENTION AND BUILDING CODE
SWIMMING POOL ENCLOSURE
720.1
shall beGeneral
providedRequirements.
with e an s enclosure outdoor swimmshingalpools
comply with the following:
a. Shall be at least 4 feet in height and have a maximum
'vertical clearance to, grade of 2 inches.
b. Where a picket-type fence is provided, horizontal
openings between pickets shall not exceed 3'h inches.
c. Where a chain-link fence is provided,, the openings
between links shall not exceed-2-3/8--inches. -
d. Enclosure shall be constructed so as not to provide
footholds.
e. Pickets and chain-link twists shall extend above the
upper horizontal bar.
f. Such enclosure shall have railings and posts within
the enclosure, which shall be capable of resisting a
minimum lateral load of 150 lbs. applied midway.between
posts and at top of posts respectively. Enclosure,
fence material or fabric shall be capable of with-
standing a concentrated lateral load of 50 lbs. applied
anywhere between supports on an area 12 inches square,
without failure or permanent deformation. Gates pro-
vided in the enclosure, shall be self-closing and self'
latching with the latch handle located within the en-
closure and at least 40 inches above grade.
g. A wall of a dwelling is permitted to serve as part of
the enclosure under the following conditions:
i. Windows in the wall shall have a latching device
at least 40 inches above the floor.
ii. A swinging door in the wall, shall be self-
closing and self-Latching.
iii. A sliding door in the wall, shall have a self-
latching device.
720.2 - Exemptions.
a. Above-ground pools with at least 46 inches between pool
decking or pool top and adjoining grade, are exempt from
the requirements of Part 720.1 provided that their access
ladder or steps can be blocked in an approved manner when
not intended for use.
b. A pool Less than 24 inches deep is exempt from the re-
quirementz of Part 720.1.
Loo o CREEK pR1VE
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LOT 1f 1O ro 41.0' ^4 Z\
19.3' QAV Q
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DECK aI
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26.7' - $ LOT f2
POND Pop'
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LOT f3
NOTE$ LOT NUMBERS REFER TO "SUBDIVISION MAP SURVEY OF PROPERTY
OF LONG POND ES TA TES, SECTION ONE" '/AT S`QUT/ TOLD
FILED S OFFICE IN THE SUFFOLK COUNTY TOWN OF SDUTNOLD
CLERK'S AS AS MAP NO. 8037.
w SUFFOLK COUNTY, N. Y.
' 1000-56-01-2.6
SCALE 1" = 30'
AUG. 4, 1998
AREA = 40,790 sq ft
ANY AL TE9A710M OR ADDITION TO PIS SURVEY 6 A VIOLATION
OF SCOW 7209 OF W AEW YOW STATE EDUCATION LAW, n
EXOfPT AS PER SECTION M09-SUL VOW 2. ALL CERTFICANOWS N.Y.S. LIC. NO. 496/8
AfREON ARF VA FOR rHS AL4P Ann COPES TAEREOF ontY
MAP_~ Q~t~s BEgR II E MWSSED SEAL OF 77C SMVEYOR
D swiwa APPEARStOWLN N C _ S DRS, P.C.
AORTIrLLY TO CORKY wrrR SAD LAW TAE TERM ALTERED OY' 4 0
&WT 6£ USED BY ANY AAn ALL SINVEYORS UFUZ#6 A COPY
OF AAbThElt SLIPVEYOR'S MAP. TERMS SLK.'N AS INSPECTED' AAn N L ER STREET
~RDG~tr•r0-Dg rE' ARE NOT IV CaWUAnL*f WITH W LA w. , W .Y. 11971
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- X6/0 "IMMEDIATELY"
I ENCLOSE POOL ETION CODE EFOREWATT UPON COMPL o
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RcY¢i~+y BEFORE'WpTEfl" w !1 3c ~ I
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ENCLOSE POO UPON COMPLETIO~N
BEFORE "WATER"
UNDERWRITERS CERTIFICATE
i REQUIRED
I
I
t OC OCCUPANCY OR
I
UC USE IS UNLAWFUL
j Wl WITHOUT CERTIFICATE
I OF OF OCCUPANCY
I ' APPROVED AS NOTED
e DATE; BP-
~ F N FEE. 3 ^ u BY. NOTIFY BUILDING OEPART ENT AT
7 796.1802 9 AM TO 4 PM FOR THE
; F FOLLOWING INSPECTIONS:
i 1. FOUNDATION - TWO REQUIRED
I PLOT PLAN 56PIE /s 1< z FOR POURED CONCRETE 2. ROUGH - FRAMING m PLUMBING
3 3. INSULATION
4 4. FINAL - CONSTRUCTION MUST
BE COMPLETE FOR C.O. ALL CONSTRUCTION SHALL MEET
A THE REQUIREMENTS OF THE N.Y.
i STATE CONSTRUCTION 8 ENERGY
c CODES. NOT RESPONSIBLE FOR
o' o DESIGN OR CONSTRUCTION ERRORS
Ff 'Ij ' ,I.I 1 '
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_x0611 hold NY 11971
IYI ~05~ ~~zi y ~ Cr.eeJe
Scale '.i
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SGc Sc~Le Yiy Z^o„ mar a=,1 1
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