HomeMy WebLinkAbout22931-zFORM NO. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Office of the Building Inspector
Town Hall
southold, N.Y.
CERTIFICATE OF OCCUPANCY
No Z-24118 Date
JANUARY 17, 1996
THIS CERTIFIES that the building ACCESSORY
400 & 680 JACOBS LANE &
Location of Property 10612 MAIN BAYVIEW ROAD BOUT~OLD NY
House No. Street Hamlet
County Tax Map No. 1000 Section 88 Block i Lot 10
Subdivision Filed Map No. Lot No.
conforms substantially to the Application for Building Permit heretofore
filed in this office dated J%FLY 21, 1995 ~ursuant to which
Building Permit No. 22931-Z dated AUGUST 9, 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 AN ACCESSORY ABOVE GROUND MWII~4ING POOL WITH FENCE
TO CODE IN 'r~u~ REQUIRED REAR yARD OF A SINGLE FAMILY
DWELLING AS APPLIED FOR.
The certificate is issued to
CHESTER & pARKER DICKERSON
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL
H047981
UNDERWRITERS CERTIFICATE NO.
PLUMBERS CERTIFICATION DATED
Rev, 1/81
DECEMBER 1, 1995
N/A
Buildin'
FORM NO,3
TOWN OF 8OUTHOLD
BUILDING DEPARTMENt'
TOWN HALL
$OUTHOLD, N.Y.
BUILDING PERMIT
(THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL
COMPLETION OF THE WORK AUTHORIZED)
N9 22931 Z
pursuantto ~ppiicatlon dated ............ ~~...~-- .......... lg.. a~ ,d approved
bythe
Building Inspec~
.....
6/30/80
,)AI~ / 6/996
--' -, nG DEPT.
.. ,,,~', _-..
AP?LICATION FOR CERTT-IrlCATE O~ OCCUPANCY
TOWN OF SOUTIIOLD
BUILDING DEPARTMENT
TOWN ~[ALL
765-[802
AD
This application must be filled in by typewriter OR ink and submitted to the building
inspector with the following: for new bnilding 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.
Sworn statement fro~ plu~ber 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.
For existing buildings (prior to April 9, 1957) non-conforming uses, or buildings and
"pre-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 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 buildi,g $25.00,
Additions to accessory building $25.00. Businesses $50.00.
2. Certificate of Occupancy on Pre-existinM Buildine - $100.00
3. Copy of Certificate of Occupancy - $20.00
4. Updated Certificate of Occupancy - $50.00
5. Temporary Certificate of Occupancy - Residential $15.00., Commercial $15.00
New Construction .... ~ ..... Old Or ~re-existing Building .................
House No. Hamlet
:ou,,tyNe iooo, Section...C.e. ....... Bloc, .... / ........... ot./.O .................
Subdivision .................................... F[lud Map ............ Lot ........... .,j/ ........
;iealth Dept. Approval .......................... Underwriters Approval .........................
'fanning Board Approwll ........................
;(equest for: Temporary Certificate ........... Finul Certicate ...........
Tee Submitted:
r_.,¢ ':2_ ;;:,qttl{
THE NEW YORK BOARD OF ,FIRE r UNDERWRiTERS ~ ~
8057633 , ' * BUREAU OF ELECTRIC T~' ·
~ .,~ JOH, STREET. ,EW.YORK ,EW YORK ~oo~s
' 10701495/95 H, e~9~ '~
O,t~ DECE~ER e[ ~1995 ~ Application No. on file ' ~ ~ ~
THIS CERTIFIE~ THAT ; '
o~y the el~trical ~uipment ~ ~scdb~ be~w a~ i~t~uced by t~ appl~ant Mm~ co the a~e applicatton number m t~e prem~ses of
J~S M.DIC~RSON, iO6~2 BA~I~W RO~, SOU~HO~, N~Tf. ~ ;
and found to b~ ~n ~ompl~nce ~h the ~nal Elect~ ~Code~
DRYERS MOTORS FUTURE APPLIANCE FEEDERS TiME CLOCKS
MU~TI-OUTLET DIMMERS
SYSTEMS
~40. OF FEET
*NO VISUAL DEFECTS:
AWG.
TH S S YOUR e a FOR SER¥ CE RENDERED AND S N~i~ Ar C~TISCA~4PU&N~E TH S BILL PAYABLE ~ T'E NEW YOI{K OFfiCE, R~ JOHN
JAM~S M, DICK~RSON
10612 BAYVIEW ROAD
SOUTHOID, NY, 1~971'
"jPI~ASE REfiT BY ~K' OR MONEY
'm~s cas...TRY M^,~ W,LL. ~,
..,S~ OF s,.~.. ,
Per L
"An electrical
survey has been made of the exposed
electrical equipment in the.
premisesindicated." ~'N0L ~ ....... :
unsatisfactory condition was found.:,
Town Hall, 53095 Main Road
P. O. Box 1179
Southold, NewYork 11971
Fax (516) 765-1823
Telephone (516) 765-1802
OFFICE OF THE BUILDING INSPECTOR
TOWN OF SOUTHOLD
January 11, 1996
Mr. James Dickerson
10612 Main Bayview Road
Southold, NY 11971
To Whom This May Concern:
We are unable to complete your Certificate of Occupancy
because of the following reasons:
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 # 22931-Z
Please contact our office on this matter.
cooperation.
Thank you for
SOUTHOLD TOWN BUILDING DEPT.
765-1802
BUILDING DEPT.
INSPECTION
[ ] FOUNDATION 1ST
[ ] FOUNDATION 2ND
[ ] FRAMING
[ ] ROUGHfPLBG.
[ /~ I~ATION
[~'] FINAL
[ ] FIREPLACE & CHIMNEY
DATE /~/~
iNSPECTO~
765-1802
BUILDING DEPT.
INSPECTION
[ ] FOUNDATION 1ST [ ] ROUGH PLBG.
[ ] FOUNDATION2ND ,[ ] I,~JLATION
[ ] FRAMING , '[~INAL
[ ] FIREPLACE"& CHIMNEY°'
DATE PEC~~
FOUNDATION (IST)
FOUNDATION (2ND
INSULATION PER N. I.
ST~Tg
CODE
~DITIONAL CO~S
Town Hall, 53095 Main Road
P, O. Box 1179
Southold, New York 11971
Fax (516) 765-1823
Telephone (516) 765-1802
OFFICE OF THE BUILDING INSPECTOR
TOWN OF SOUTHOLD
ORDER TO REMEDY VIOI~TION
Date: July 19, 1995
TO: Chester & Parker Dickerson
155 Mountain View Manor
Torrington, CT 06790
PLEASE TAKE NOTICE there exists a violation of:
Zoning Ordinance Chapter 45 - Section 45.8
Other Applicable Laws, Ordinances or Regulations
at premises hereinafter described in that:
An above qround swimming pool has been installed without a
Buildinq Permit.
In violation of
Southold Town Code
YOU ARE THEREFORE DIRECTED AND ORDERED TO comply with the
law and remedy the conditions above mentioned IMMEDIATELY
The premises
are situated at:
to which this ORDER TO REMEDY VIOLATION refers
680 Jacobs Lane
Southold, NY 11971
SUFFOLK COUNTY TAX MAP #1000-88-1-10 - A/C ZONE
Failure to remedy the conditions aforesaid and to comply with the
applicable provisions of law may constitute an offense punishable
by fine or imprisonment or both. ~ ~t ~
£ng Inspector '
JMB:cmt /
(Cert. Mail)
:, 'JUL 2qtlffii
FORM NO. 1
: ~ ,'~OWN OF SOUTHOLD
'BUILDING DEPARTMENT
,: TOWN HALL
INSTRUCTIONS
BOARD OF IIEALTII o .., ......
3 SETS OF PLANS ..........
SURVEY ...................
CIIECK .....................
S E pT~,I C FO lltl ..............
I'IA I L~.~O: ./ .
Date..-f./P-./. .......... 19 g4~
a. This apl~lication must be completely filled in by typewriter or in ink and submitted to the Building Inspector, with 3
sets, of plans, accnrate plot plan to scale. Fee according to schedule.
b. Plot plan showing location of lot and of buildh~gs on premises, relationship to adjoining premises or public streets
or "areas, and giving a det~led description of layout of property ~nust be drawn on the diagram which is part of this appli-
cadou.
c. The work covered by this application may not be com~nenced before issuance of Building Permit.
d. Upon approval of this application, the Building Inspector will i~sued 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 p~t for any purpose whatever.unfil a Certificate of Occupancy
shall haw been granted by the Building Inspector.
APPLICATION IS IIEREBY MADE to the Building Department for the issuance of a Building Permit pursuant to the
Bnilding Zone Ordinance of the Town of Soutb01d, Suffolk County, New York, m~d other appScable Laws, Ordinances or
Regulations, for the construction of buildh~gs, 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, aud regulations, and to
admit authorized inspectors on premises and h~ building_~ for.necessaw jn~p¢~tiop~.
...~h.~..~ ...... ~. : ....... ~;~. ;;; ; ......
-- ~gnature of applicant, or name, if a p t'on)
State whether applicant is owner~e~ ageut, architect, engineer, general contractor, electrician, plmnber or builder.
...............................................
,au, own, +. .... ....... ' ...... .........
(as ou the. tax roll or lates~ deed)~R_VE
'' Rppl'c,n[ iS ~ corporation, signature of duly authorize,
t~EOIA~Y'r" -
E~LOSE ~ ~ FEE: ~ BY:~~
: ~ ~'~ ~,R~ ~
Builders License No. , ~Y~L~'~'~.. ~. FOLLO~NG INSPECTIONS:
1. FOUNDATION - TWO REQUIRSD
FOR POURED CONCRETE
2. ROUGH - FRAMING & PLUMBING
S. INSULATION
4. FINAL '- CONSTRUCTION MUST
BE COMPLETE FOR C.O.
ALL CONSTRUCTION SHALL MEET
THE REQUIREMENTS OF THE N.Y.
1. Locatiou of land on which proposed work will be done .................... STATE .CONSTRUCTION. &..E4~.~G¥ ·.
· .. ¢ 0 .~.['.~ .................... O ........ ~.~IRUOTI~N .E*~a~ · .
llouse Number Hamlet
Connty Tax Map No. 1000Section ...~.~. BIock..~..J. '... Lot..~./.¢ .......
Filed Map No. Lot ...... : ........
Subdivision ........ . ...........................................
(Nmne) .
2: State existing use aud occupancy of premises and intended use and occupancy of proposed constn~cdon:
a. Existing use and occupancy...~.~ .... ~:d~.~.j.--~..,.Ifl380,, ......................
b. Intended use anti occupancy ............ ~ff. ,'..l~nu,~,~}~.~) ...............
'3. Nature of work (check which alpplicable): New Building .......... Addition .......... Alteration .... : .....
Repair .............. Renyoval .............. Demolition
~ (to be paid on filing this application)
5. If dwelling, · ~ .
number of dwelhng umts ............... Number 0f dwelling units on each floor ..............
If garage number of cars '
6 If business commercial or mixed occupancy specify nature and extent of each t }e ....................
7 ..... ' ~ . ' Yl of use
. Dnnens~ons ol ex~stmg structures ffanv Fro~t n .....................
' "~' Depth
lleight Nmhber of Stories ..................
............... ~ith alterations ..........................................
Dimensions of shine structure or additions: Front
De ~ ...................... e ~t .......... . '
.... ,.. Number of Stories ' .
8. Dimens OhS of entire new cons ction: Front . .: Rear ............. Depth ..............
Height ............... Number of Stories ...................
9 Si , ' .... ~ ................................
. ze of lot: Front ......... ,. ............ Rear .................. Depth ....
10. Date of Purchase ..................
' N f Fo OW
11 Z di i .......... ~ .................. amc o m~er ncr .................
t in wi i I i ituated
. one or ose str c i c 1 prem scs are s ............. ,. ' ...........
Does proposed constroction violate any zoning law, orr nm~ce or regulation: ..... '~ ..................
13. ?11 lot ~regrad~l ....... Xh"~ .... X'~t' ....... Will es~~ fill ~re~ugved from premises: Yes No
Na ne of Arc fitect aaa .... lgq~t~&~O~y~ ., . '
Name of Contractor ........ ~ ................. Address ................... Phone No ..............
15. I.s th~s property within g00 feet of a tidal. 'wetland'/ eyes ........ No.~ .....
· If yes~ Southold Town Trustees Permit may be required. .
... 4 PLOT DIAG~
Locate clearly and distinctly alli.bnildings, whether existing or proposed, and, indicate all set-back dimensions from
property lines. Give street and block humber or description according to deed, and show treet nines and intimate whether
interior o ncr lot.
¸ lq/
~TATE OF NE ' ~,: A · . ..~
COUNTy 0~..~,.: ~'~ ,., /7~~ ....... . --~---~
.... [""' '0~' ~~ .'t"7-'~--*-~* ' f.~'( *A~..~.'~'6~. · . . being duly sworn, deposes and says that he is the applicant
(N~ni~}g con tract) '
above named. ~ ' '
e is tile ~ ~ g~
:- ~ (Contractor, agent, cori)orate officer, etc.)
of said owner or owners, ~d is dulyiauthorized to perform or llave performed the saki work and to make and file this
application; that all statements contaified in this application are true to the best of his knowledge and belief; and that the
work will be performed in the ~ &et forth in the app ication filed therewith.
Swom to berore me this A ' /~
.................. /~ay ~ &.. I/.~ ~. L~ .... '..'..., ~9 ~.~
' / _ R~;~vSCOTV.~. ' ~ ~,, x_.
// ~BLE~u~o~,.v. . ~.,. ~.~ ..... ~~ :~ ....
~ ~.4725089.~IkCou~/ ', ' (SJgnatur~ o~applicant)
Term E~ir~a~ 3~. ~9~ ,
SU~OLK COUNTY DEPARTMENT OF HEALTH SER¥1CE,g
FOR APPROVAL ~ CON$'[RI.ICTION OF
$in~,le F~,-~nily Resid~a~'~.ce 0 ty
.~- ' -~ :.. ~
· ,NOV' 1~..i~86 '~- :.
"S.C DEUT.'OF .
:H:AL?H SERVICES . '