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HomeMy WebLinkAbout22278-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No Z-24191 Date MARCH 5, 1996 THIS CERTIFIES that the building Location of Property 1565 JACOBS LANE House NO. Street County Tax Map No. 1000 Section 79 Block 6 Lot 4.3 Subdivision Filed Map No. Lot No. ACCESSORY BOUT~OLD~ NEW YORK Hamlet conforms substantially to the Application for Building Permit heretofore filed in this office dated AUGUST 8, 1994 pursuant to which Building Permit No. 22278-Z dated AUGUST 24, 1994 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 SWIPING POOL WITH FENCE IN REAR YARD AS APPLIED FOR The certificate is issued to (owner) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL UNDERWRITERS CERTIFICATE NO. PLUMBERS CERTIFICATION DATED JACK & KARIN THILBERG N/A N-326786 - SEPTEMBER 13, 1994 N/A Rev. 1/81 //ldi~g Inspector FORM NO.$ TOWN OF $OUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N.Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED1 22278 Z Permission Is hereby granted to: A. R'KILLY & $0~$, [NC. - A/C - THT-LI~'R. RG P.O. BOX 98 ~T~CK, ~ 11952 to CONSTRUCT AN ~CRO~ POOL H~ FENCE ~N ~ YA~ AS APPLIED FOR. CouniyTax Map No. 1000 Section ....... .?.~. ............. Block ............. ~ ........... LotNo. 6.3 pursuant to application dated ................ .A.~.G.~.$%....g., ........................ 19..9..6. ........... and approved by tho Building Inspector. Rev. 6/30/80 BLDG. DEPT. ~TQ_._WN. OF SOUTHOI.D Form No. 6 TOWN OF SOUTIIOLD BUILDING DEPARTMENT TOWN I~LL 765-1802 A~PLICATION FOR CERTIFICATE OF OCCUPANCY This application must be filled in by typewriter OR ink and submitted to the building inspector with the f611owing: 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 FAre 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 bu%lding, multiple residences and similar buildings and installations, a certificate of Code Compliance from architect or engineer responsible for she 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 proporty 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 stote 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 Building - $i00.00 3. Copy of Certificate of Occupancy - $5.00 over 5 years - $10.00 4. Updated Certificate of Occupancy - $50.00 5. Temporary Certificate of Occupancy - Residential $15.00, Commercial $15.00 pate ..... ~.. ~< New Construction.~O. .......L Old Or Pre-existing Building ................ . Location of Property ........... , House No. ' Street Hamlet ~/~ ~ 4~.~ ~//z~ Onwer or Ouners of ~roper y ................ Co~n,y ~x ~p ~o ~000, S,~io,.............7~ ~ .~oc~ .... ~. ......... ~o~,3 ......................... Filed Map ............ Lot ................. Permit Xo..~ ~..Date Of Permit..~7~/.C~..Applicant. Ilealth Dept. Approval ........................ Uuderwriters Approval .......... Planning Board Approval ........................ Request for: Temporary Certificate ........... Final Certicate...~, ....... Fee Submitted: $ ............................. ~. 5%5q ... ~7.~... ....... ~ ............ ^PPI,IC^F~T Co% 3, q ltI I 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 February 14, 1996 Mr. Jack Thilberg 1565 Jacobs Lane Southold, NY 11971 Re: Building Permit #20644-Z (porch add.)*** Premises: 1565 Jacobs Lane, Southold Suff. Co. Tax Map #1000-79-6-4.3 During a review of our files it was noted that the above building permit has expired, and a Certificate of Occupancy has never been issued. According to the Code of the Town of Southold, Article XXVIII 100-284, it is unlawful to occupy or use a structure until a Certificate of Occupancy has been issued. Please contact this office as soon as possible so that we may clear up this matter. Thank you for your cooperation in this matter. Very truly yours, SOUTHOLD TOWN BUILDING DEPT. - ALSO BP#22278-Z EXPIRES 2/24/96 AND HAS NEVER HAD ANY INSPECTIONS. PLEASE CONTACT US ASAP TO RECTIFY THIS SITUATION. THIS IS FOR A SWIMMING POOL & FENCE. Print Key Output 5738SSl V2R3M0 931217 SOUTHOLD Page 1 02/13/96 14:26:12 Display Device : X5 User : CLAIRET NYSRPS ASSESSMENT INQUIRY DATE : 2/13/96 473889 SOUTHOLD SCHOOL SOUTHOLD SCHOOL ROLL SEC TAXABLE PRCLS 1 FAMILY RES TOTAL RES SITE 79.-6-4.3 TOTAL COM SITE 1565 JACOBS LA ACCT NO 10 = OWNER & MAILING INFO ===!=MISC ! .... = ....... == ASSESSMENT DATA ...... ===== iRS-SS ! **CURRENT** RES PERCENT THILBERG JACK H & KAREN M 1565 JACOBS LANE ! 1 !LAND 2,300 **TAXABLE** SOUTHOLD NY 11971 ! BANK !TOTAL 8,300 COUNTY 7,831 AR092 **PRIOR** TOWN 7,831 ! !LAND 2,300 SCHOOL 8,300 ! !TOTAL 8,300 ==DIMENSIONS ===! .... === SALES INFORMATION ........ ===== ACRES 2.34 !BOOK 10664 SALE DATE 07/01/88 SALE PRICE 205,900 !PAGE 00404 PR OWNER RIVERSIDE HOMES INC ....... TOTAL EXEMPTIONS 1 ......... ====!== TOTAL SPECIAL DISTRICTS CODE AMOUNT PCT INIT TERM VLG HC OWN CODE UNITS PCT TYPE 41121 469 .15 90 !FD028 !WW020 !SW011 Fl=NEXT PARCEL F3=NEXT EXEMPT/SPEC 75.10- 03-013 F6=GO TO INVENTORY F9=GO TO XREF VALUE F4=PREV EXEMPT/SPEC F10=GO TO MENU NEW YORK BOARD OF FIRE UNDERWRITERS ].185~77 ~"~ BUREAU OF ELECTRICITY ~-- ~" ' 85 JOHN STREET, NEW YORK, NEW YORK 10038 D, te S~PT~HBER ~3,1994 ~pplic, Hon No. o,,fil~ G6391494/9~ N 326786 THIS CE~IFIES THAT o~y t~ electrical equipment ~ &scdbed be~w a~ int~uc~ by t~ applicant ~med on the a~e application number in the prem~es of JACK THILBERG, 1565 JACOBS ~ $OUTHO~, N.Y. i. the followlng h,catio,; ~ B~,e,nent ~ Ist FI. ~ 2nd ~. O~ Section Bilk Lot u~s examined on SEPT~R ~7,1994 and found to be in compl~nce with the Na~on~ E~ct~ Code. $ERVI~ DI~ONNECT ~. OF S R I C made by a ql~alt~ied person. ROSLAKEI~CTRIC P.O.BOX 164 CU~CHOGUI~, NY, 11935 LIC.#,3677-~ OENEilAL MANAGE~R This certificate must not be altered in any manner; return to the office of the Board if incorrect. Inspectors ma), be identified by their credentials. COPY FOR BUILDING DEPARTMENT. THBS COPY OF CERT~FICA'~E MUST NOT BE ALTERED IN ANY IV~ANN~R, T. HE NEW YORK BOARD OF FIRE UNDERWRITERS ~.185077 ~,>~ BUREAU OF ELECTRICITY ~-- ,., ~, 85 JOHN STREET. NEW YORK, NEW YORK 10038 O. te ~ SEPTF~4BER 13,:[994 /IpplicationNo. onfile 06391494/94 N 326786 THIS CERTIFIES THAT JACK THILB~RG, 1565 JAC. OBS LANE~ ~OUTHOLD, N.Y. in the follo~ing location{ [] Basement [] Ist FI. [] 2nd FL OUT Section BIo~k Lot · ~ SEPTEMBER 07,1994 and found to be in compliance with the National Electrical Code. AMT. K.W, OIL H.P. GAS H,P. AMT, NO. A,W O S SERVICE DISCONNECT 1 NO. OF I OTHER APPARATUS: SWI~ING POOL- 1 TIME CLOCKS 40 AMP-I G.F.C.I.-1 * (SWIMMING POOL) This certificate covers compliance at the date of ~nspection only. Because of unusual environments it is advisable 'to have frequent test/and or repairs RANGES K W, SPECIAL REC'P1 TIME CLOCKS BELL UNIT HEATER! MULTI-OUTLET  SYSTEMS A/~T. AMPS TRANS. NO. OF FEET V I C E NO. O~CC~COND. EXHAUST FANS AMT. H P, DIMMERS A,VJ. WATTS A*W,G Ne. OF HI-LEG A. W, G* NO, OF NEUTRAL~ A.W. G, OF CC. COND, OF HI-LEG OF NEUTRAL <<< Continued on Page 2 >>> 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 ~N ANY MANNER. FOUNDATION FOUNDATION 2. ROUGH FRAME & .FLUMBING iNSULATION PER N. STATE ENERGY CODE FI~;AL (1st) (2nd) o ADDITIONA'L COMMENTS: UPON, BEFORE SURVEY OF LOT 3 MAP OF CROWLEY ESTATES FIU[~ DEC, 12, ~ FI~E NO. o~ A'T BA YVIEW TOWN OF SOUTHOLD SU,,'"~"OLK COUNTY, N. K 10(?0- 79- 06 - 4.3 Scale 1" = 50' " Oct. 15, ,1987 ,' Dec. 18, 'lgBT(under const.) ' April 14, 1988 (final) standards for title ~un~ye al e~tabllzhed .by lhe L, I, A, L S, end oppro~red end ~do~d for luefi u~e by The Ne~ York "*~E~.V~~NGINEERS, P.C ' P,O. BO~ ~ MAIN ROAD.~ $OOT~OLD, "N.Y. BLDG,-DE p,T. UNDER~IT£RS CERTIFICATE REQUIRED ~he sewaf[e disposal and wale~ s ~ply location have b~,en inspected by this CERTIFIED TO' FIRST AMERICAN TITLE INSURANE CUMRANY OF NEW YORN RI' ??HEAD SA VINGS BANK ..!4':/~ H, 7~ILBERC~ ' i(AF'/::N Id, THILBERG BC~.H. # 87S0136 ¥ OF ;ET ,HT SET Note: Diagonals given to 90° point of corners. FRAIGHT EXCAVATION NOTES: t,, LOgATE TOP OF POOL AT' LJ~AS'T 8' /~eOVE GLE TYPE~ RNER SET STRAIGHT SET ,RS ARE 6~ RADIUS. EVERY 3 A BRACE, ALL CORNER ARE I' X I'. 510 SUMPTER DRIVE FORT WAYNE, INDIANA, 4680,1, U.S.A. 219-'~32.8731 PREO0 -I ~~.~ ~..~ ~- ~"~ RECTAN6Lff 'rills BROCHURE IS FOR ILLUOTRATIVE PURPOSES ONLY The manufaclurer makes only those representabons which ale sta~ed m dS written warranty. Any other representations, stalemonts, or contracts made by the dealer and or the contractor to the cuslomer regard~Pg any malmlals produced by the manufacturer are almbu~ab~e ~o Ihs dealer and/ or the cmlttactor on¥ The dea~er or contractor who sefls or mslalls your pool is P~ independent contractor and not an agent or emp[oyee ol the manu[ac~ 'er The construction melhods dlus[rated are suggestiops and apply on!y to normal ground conditions There may be addlt~ona~ precau- Pool InsflhJte, 2111 Eisenflower Avempe, Alexaellrta, VA 22314 · 703/83fl-I]083 765-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ]/~!SULATION [ ] FRAMING [ ~] FINAL ] FIREPLACE & CHIMNEY REMARKS: DATE INSPECTOR CROWLEY ESTATES A 'T BA YVIEW TOWN OF SOUTHOLD SU,;,~'OLK COUNTY, N Y. '10(?0 - 79 - 06 - 4.3 , Scale 1~'' = 50/ Oct, 15, 1987 " Dec. 18, '1987(under const.) April 14, 1988 (final) /~/~M.ED~Ly,, ' /UPON COMPLElION BEFORE "WATER'* BLDG. DEPT. TOWN OF SO ;~THOLD the bl.~ L 5. ~nd app~ and ~dop~ for m~ ~ by T~ New Yo~ ~f~a&d oilier CERTIFIED TO, FIRST AMERICAN TITLE INSURANE C'c)MPANY OF NEW YORK R.!' %¢~HEAD SAVINGS BANK ..7~'./', H. THILB£RG i(A.,:(t:;N M, THILBERG 8750135 ~ OF Note: Diagonals given to 90° point of corners. ;ET HT SET GLE TYPE ,'l I I RNER SET STRAIGHT SET ~RS ARE 6* RADIUS. EVERY $ A BRACE. ALL CORNER ARE I' X I~ ,,~imum slandards for resideelial pools. If diving boalds or slides a~o to bo used pa & Pool Instlhfle, 2111 Eisenhawer Aveooe, Alexandria, VA 22314 · 7031838-0083 510 SUMPT[R DRIV~ FORT WAYNe. INDIANA. 46804, U.S.A. 219 432'8731 PREO0-1_ _ [ ,/3a"= i'~~~ BLDG. DEPT. WN OF SOUTHOLD -'"'~lt' i' TOWN o. SOUT,OLD 199 : ~ BUILDING DEPARTMENT 8 l~4 I~~ TOWN HALL aln~ ~~ ~ SOUTHOLD, N.Y. 11971 : .... .............. APPLICATION FOR ~ILDING PERMIT BOARD OF HEALTH .~.,.o ·, 3 SETS OF PLA~S .......... SURVEY ................... CIIECK ......... HAlL TO: 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. s' b. Plot plan showing location of lot and of buildings on premises, relationship to adjoining premises or public streets 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. ¢. 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 ail applicable laws, ordinances, building code, housing code, and regulations, and to admit, authorized inspectors on premises and in building for necessary inspections. . ... d..... ~4--/.~>. ~ .~. ~.e .~.s . .._z2Y.. r, -- (Signature of applicant, or name, if a corporation) (Mailing ~ddress of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. Name of owner of premises ........ .~./~..'(-.....~...P~..~: .... .~.( ...... .~..././7/.~./~ .~-~..~. .................. /~. (as on the tax roll or latest deed) If applicant ~t~ corporatio~/S;tgn31i~e of d~uly authorized officer. .... ......... Builder's License No. ~../,. ?..~.o9. ~ , Plumber's License No ......................... Electrician's License No.. ~..J(~.(... ~-.~..~.'~.ff"x~( C Other Trade's License No .................... '.. 1. Location of land on which proposed work will be done .................................................. .../.3'..C:. ........ ~...a:. .... >.,-~..~; ........... .37.~...~.~,~.~. ~ ..... .:..-. :. ...... 1< ?.'2./ .... flous~ Nmnber Street Hamlet County Tax Map No. 1000 Section ........ ?.2. Block ..... .~..~. ......... Lot ....... q:..~.. ...... Subdivision ...... .~ ~. 0..c~. ~..L-~ ..... .~. ~'~---~'.~.,... Filed Map No ............... Lot ....... .~.. ..... (Name) 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy, .~...ff~./~t~--/.~ .~,.~, ~:~. ,5,~.~,,~!~.~ .............. b. Intended use and occupancy ............. ~.~.A~..t~U4~.C~C9.6.... ~ ~,,'~( '~C 3. Nature of work (check which applicable): New Building ........ ; · Addition .......... Alterfition ...... ' .... Repair .............. Removal ............. Demolition .............. Other Work ..... ~ ..... ~':,! ' ' (Description) 4. Estimated Cost ..... ~O00' c-'r'O .~. f.3.~. ~ ............................ Fee .......... .~ .................. I (to be paid on filin~ this application) 5. If dwelling, number of dwelling: units ............... Number of dwelling units on each* floor.,.; ............. If garage, number of c~s 6. If business, commercial or mixdd occupancy, specify nature and extent of each type of use .................... 7 Di ensions of ex' ting structures ifa Fro t Rea D pth · m is , ny: n ............... r .............. e .............. Height ............... Number of Stories ....................................................... Dimensions of same structure With alterations or additions: Front Rear ~ Height Number of Stories Depth ......................................................... ~ . , ....... 8. Dimensions of entire new constructmn: Front ............... Rear ............... Depth ............... Height Number of Stories 9 Size of lot: Front ~ Rear Depth I0. Date of'Purchase ......... , . Na f F Owner · t .................. me o ormer ............................. 11. Zone or use district in which prbmises are situated ..... . ......]~..~?:./~..C'7.//f~. ................ . 12. Does proposed construction vioiate any zoning law, ordinance or regulation: ........ ~ ....... . ..... 13. Will lot be regraded ........ .~.0 ............... Will excess fill be removed from premises: ~ 'No 14. Name of Owner of premises .. 7~.c/J/:r.'.Z¢ ...... 'Address ...,ff'~-~'77c/o~./,C~... Phone No ................ Name of Architect ........................... Address .... Phone No ............... 15. 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 alll buildings, wh~ther existing or proposed, and~ indicate all set-back dimensions from properly lines. Give street and block !number or description according to deed, and show street names and indicate whether interior or corner lot. FOR POURED CONCRETE ~J fi~ONOD (~llOd ~JO~ 2 ~OUGH * FRAMING & PLUMBING 4, FINAL CONSTRUCTION MUST BE COMPLETE FOR C.C. ALE CONSTRUCTION SHALL ME~ TH~ REQUIREMENTS OF THE N.~ STATE CONSTRUCTION & ENERGY CODES. NOT RESPONSIBLE FOR DE~IGN OR CONSTRUCTION ERRORS (Name o~ mdw~duai szgm~g co~t:act) above ~amcd. (Contractor, agent, corporate office~, etc.) of said ownc~ or owners, ~d is dulyi authored to perform or haw peffo~ed the said wor~ and to m~e and file this application; that aH statements contained ~ th~s application a~e truc to the best o~his ~nowlc~ge and belief; and that the work will be perfo~ed in the m~ner,set forth ~ the application filed therewith. Swom to before~ ; ~ ~ ....... Nota~ eubli~~~ ~ounty ~ OJ ' ., ....... ..: ....