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Home My WebLink About22316-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No: Z-26248 Date: 01/29/99 THIS CERTIFIES that the building ACCESSORY Location of Property: 505 TRACK AVE CUTCHOGUE (HOUSE NO.) (STREET) (HANLET) County Tax Map No. 473889 Section 137 Block l____Lot 20 Subdivision Piled Map No. __ Lot No. __ conforms substantially to the Application for Building Permit heretofore filed in this office dated AUGUST 23, 1994 pursuant to which Building Permit No. 22316-Z dated SEPTEMBER 12, 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 ACCESSORY INGROUND SWIMMING POOL WITH FENCE TO CODE AS APPLIED FOR. The certificate is issued to DOUGLAS JENCKS of the aforesaid building. (OWNER) SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL ELECTRICAL CERTIFICATE NO. PLUMBERS CERTIFICATION DATED Rev. 1/81 N/A N 330232 N/A 10/17/94 FORM NO.3 TOWN OF BOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N.Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) N~ 22316 Z Permission Is hereby granted to: A...R.,eilly & Sons, Inc. a/c Jean-Partite Courtland ........................................................................ 4'~£~', ~RTZN) P.O. Box 98 I~attituck, N.Y. I 1952 to ......... ..c..o.~.s.?..c.L .,..?F. ?...s..s..o..,.!' ~Ec.?.?~..~...z~...?.! .Lo..o.~. ?.~.. ?..c! ..,..,..c.~.o..s.~ .................. AS A~PLtED FOR. NOTE: DECK SURROff~DS NOT INCLUDED. at premises located at ....... ?..0,.5.,,.~..t~/..C.~,..A...V~...: ......................... .C, ~..C.~ .O.~..1)~...,... ~... ~.: ................................... CountyTax Map No. 1000 Section ............ !.3..7. ........ Block ......... .1. ............... Lot No ..... .2,.0, .................... AUGUST 23, 94 pursuant to application da~ed .......................................................... ] 9 ................ and approved bythe Building Inspector. ~ee S./~E-..~.,.~.. Rev, 6/30/80 BLDG, DEPT. TOWN OF SOUTHOLI) Form No. 6 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL 765-1802 LICATION FOR CERTIFICATE OF OCCUPANCY ~'This application must be filled in by typewriter OR 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 ail 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 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 Vpre-existing" land uses: 1. Accurate survey of property showing all property lines, streets, building and unusual hatural 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. ~. Fees 1. Certificate of Occupancy - New dwelling $25.00, Additions to dwelling $25.00, Alterations to dwelling $25.00, Swimming pool~, 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 Date ......... f. ~y: .... ~ ................... 4aw Construction .......... Old Or Pre-existi~_~gBuilding ..... '..~,i~:[.~flylO[~ POOl ~ocation of Property..[ House No. Street Ha~et )nwer o~ O~ers of c~ope~Ey ......... ~ ........................................... · .. · · · ~ounty T~ Map No 1000, Section ........... Block ................ Lot ...................... ;ubdivision · ... Filed Map Lot ........ {ealth Dept. Approval....... .................. . Underwriters Approval ......................... >lanning Board Approval ........................ /~ ~equest for: Temporary Certificate ........... Final Certicate ........... FOUNDATION FOUNDATION 2. ROUGH FRAME & .PLUMBING {1st) (2nd) INSULATION PER N. STATE ENERGY CODE FINAL ADDITIONA'L COM~E /- THE NEW YORK BOARD OF FIRE UNDERWRITERS 1185077 BUREAU OF ELECTRICITY ~ 85 .JOHN STREET, NEW YORK. NEW YORK 10038 Date O¢'~O~E~ ~.7,1.Qg~ Application No. onfile ~6527794/94 N 3~23~ only the electrtcal equipment ~ ~scdbed below a~ intr~uced by t~ applicant ~d on the a~ve application number in the prem~es of ~ PATRICE ~R~.~D, 505 TRACK A~N~], C~CHOG~, in the fottowlng tocation; ~ Basement ~ Ist Ft. ~ 2nd ~. (~AR/O~ Section Bilk Lot n~s examined on OC~E~ 13 ~ 19')g and found to be in compliance with the NaHon~ Elect~c~ Code. SYSTEMS OTHER APPARATUS: $ E R V I C OF C~. COND, GE HI*LEG OF N~UTRAL ROSL~J{ ELECTRIC P.O.BOX 164 CUTCHOGUE, NY, 11935 LIC~ #36'77~E GENERAL MANAGER ~'L 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. THE NEW YORK BOARD OF FIRE UNDERWRITERS 1 1185¢577 BUREAU OF ELECTRICITY ~- 8S JOHN STREET, NEW YORK, NEW YORK 10038 /)at~ OCTOBF~R 17,~994 ~pplicationNo. onfile ~)652779t/94 N 330232 THIS CERTIFIES THAT only the electrical equipment as deserlbed below and introduced by the applicant named on the above application number in the premises of JEAN PATR'[C~] COURTLAND, 505 TRACK AVENI]~, CUTCHOGU~ N,Y. in the following location; ~ Bmsement [] Ist FI. [] 2nd Fi, GAR/OUT Section Block Lot · , OC'~'OB~R 13 199~ and found to be in compliance with the National Electrical Code. DRYERS FURNAC MOT~RS F FUTURE APPLIANCE FEEDERS SPECIAL REC'P! SERVICE DISCONNECT Io. OF S -~QUIP 1,~2W 1~3W 3~'3W 3,~4W O~E~C~CO;~D OTHER APPARATUS: SWI~{ING POOL,-<[ TIHE CI~3CKS 40 G,F.C.I.--I * (SWIF~4ING POOL) This cert~ficate covers compliance at the date o~ inspection onl¥~ Because of unusual -environments it ~s advisable trO have frequent test/and or repair,~ made by a qualified person. TIME CLOCKS BELL IUNITHEATERS MULTI-OUTLET SYSTEMS A~T. A,V.p$, TRANS. I~, j .,? NO. OF FEET I I V I C E <<< Corlt~rnued on Page EXHAUST FANS A~T, H P DIMMERS WATTS A. W O NO OF HI-LEG A. W G. NO OF NEUTRALS A, W G, OF CC. CONO OF H~-[~:(~ OF NEUTRAL GENERAL MANAGER This certificate must not be altered in any manner; return to the office of the Board if incorrect. Inspectors may be identified by their credentials. COPY FOR BUILDING DEPARTMENT. THIS COPY OF CERTIFICATE MUST NOTBE ALTERED IN ANY MANNER. '' Note" ag I 'Son" ,D~ onasg~ tO ,..t:', :' , ~,: 90° point of'Corn'e~;s TYPE ~2 ', /4, minimum standard? for resldeotlal poops, If diving boards or slides are to De used SI)a & Peel IosllMe s minimum standards )riot to tos n lng diving boards or s des Spa & Foe esl ule. 2111 E senflower Ave,ue. Alexalldria. VA 2~314 * ~38.0083 , 4~$R4, U,S.A, I 510 SUMPTER DRIVE FORT WA¥1~E. I~PlA~A. 219 432-87'31 RECTANGLE 765-1802 BUILDING DEl:FF. INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] FRAMING [ ] INSU~LATION [ ~F~AL ] FIREPLACE & CHIMNEY 765-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] FRAMING [ ] INSULATION [~INAL [ ] FIREPLACE & CHIMNEY DATE ~ ~ INSPECTOR NEW YORK BOARD OF FIRE UNDERWRITERS 1175003 BUREAU OF ELECTRICITY ~ 85 JOHN STREET. NEW YORK, NEW YORK 10038 /).re HAY 23,1995 Applleat;on No.../,~ 87~44695/95 ~ N 35276~ THIS CERTIFIES THAT o~y t~ electrical equipme~t~ ~ ~scrlb~ be~ a~ i~tr~uc~ by ~ ap~ican( ~m~ o~ t~e e~e ~pp~icatio~ ~ber i~ the prem~s of / ~, ~TIN/GEL~, ~1475 ~DAY ~UE, ~TTITUCK, N.Y. u~s examined on MAY 19,L95 and found to be in compliance with the NaHonaf Electdcal Code. FIXTURS OUTLETS SWITCHES FIXTURES RANGES OVENS DISH WASHERS EXHAUST FANS ORYRRS SYSTEMS NO. OF FEET OTHER APPARATUS: made by a qualified permon. E R V I C NO, O~ CC. COND. PER ~/ OF CC, COND. NO. OF NEUTRAtS AWG, OF NEUTRAL Q.C, [.I~C, TRIC INC. P.O.BOX 518 LAURF, L, NY, 11948 L!C. #3823~E GENERAL 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"~?dd~entials. COPY FOR BUILDING DEPARTMENT. THIS COPY OF CERTiFiCATE MUST NOT BE ALTEfiED IN ANY MANNER. .! .................... : ....................................... ~ ....................... F¢ fro D~agor Point 'o,f 90rners ', minimum stondards for residoottal pools, if divlog boalds or slides are to be used Pool IOstltute's mlnlmum standards prior to mtall,tg diviog boards or shdes 510 SUI~IPTER DRIVE FORT WAYNE, IND)ANA, :.. A6Ol)4~ U.S.A. 219-432-8731 ;PREO0-1 RECTANGLE i- FORM NO. 1 ' K',c TOWN OF SOUTHOLD ,:j f"'" ? 3'"~/1 [,',,. BUILDING DEPARTMENTToWN HALL BLDG. DEPT. ~ SOUTHOLD, N.Y. 11971 TOWN OF,SOt, ri'HOLDJ , TEL.: 765-1802 ×drained .............. pproved...~./.0 ., l~Pe=it No. ~.~ ~¢.~.~ Disapproved a/c ..................................... APPLICATION FOR BUILDING PERMIT INSTRUCTIONS BOARD OF HEALTH ...... ?,., 3 SETS OF PLANS .......... SURVEY ' CIIECK .................... SEPTIC FOF, H CALL ..... . . . . HAIL TO: Date .............. , 19. a. This application must be completely filled in by typewriter or in ink and submitted to the Building Inspector, with 3 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 streets or areas, and giving a detailed description of layout of property must be drawn on the diagram which is part of this appli- bation. c. The work covered by tiffs 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 admi,t authorized inspectors on premises and in building for necessa~ inspections. ' . ~.':. L,Z.. ~-7.c ~ ~....4. 5.9.~..L....&Te(...c. .. ..... '. -- (Signature of applicant, or name, if a corporation) .0... ?. (Mailing address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. ~'/~v~-~ .~...)x~...,~..' .zT.~.C .............................. ............... Name of owner of premises ........ .~.ZT..)~... *.'..~....,~]'~... ~ .C~: .... .~..' .... C. 0..Ct..~..T~.../O..... ~ ~/./. ........... (as on the tax roll or latest deed) If appl~~,~~uthorized officer. ......... ~ ~;'~;;r'ai~ ;~'~r') ......... 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. "7~d ~'/"~/<; . . C~'-'-f-~'d'-/° 6'ed~z~, ,///~ ./..o..5. ?-;*~c .... ~-~z- C~ ~-~o ~ ~ ~< .27., ~ House Number Street Hamlet County Tax Map No. 1000 Section ........ l.~..7 ..... Block ....... [ .......... Lot ..... .~..O.. ......... Subdivision ..................................... Filed Map No ............... Lot ............... (Name) State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy ............. .~...6x.g. ./../~..~fW./.~././~..c:- ................. . .... b. Intended use and occupancy ............. //f.C-~.</~..d .~',~-. ('..~.... ~ .I.Z."~....~. fl.O..L-. ............ 3. Nature of work (cheek which applicable): New Building .......... Addition .......... Alterati6n ...... Repair .............. RemovaI .............. Demolition ............ Other Work ..... i .~.' i ..... ~i tc'~(~?~'h drcg (Description) 4. Estimated Cost Fee (to be paid on filing this application) 5. If dwelling, number of dwelling units .............. Number of dwelling units on each floor ................ · Ifgarage, number of cars .... : .............................................. ...... ......... . .. 15. If business, commercial or mixed occupancy, specify nature and extent of each type of use ..................... ?. Dimensions of existing structures,, if any: Front ............... Rear .............. Depth ............... Height ............... Number of Stories ........................................................ Dimensions of same structure with alterations or additions: Front ................. Rear .................. Depth ' Height Number of Stories ~ 8. Dimensions of entire new construction: Front ............... Rear ............... Depth .............. Height Number of Stories { Size of lot: Front .......... i ............ Rear ...................... Depth ..................... Date of Purchase .................... , ......... Name of Former Owner ................. ". .......... Zone or use district in which prlemises are situated .......... ./~.~-~./.~...~..¢../.~.cr. ........................... Does proposed construction vioJate any zoning law, ordinance or regulation ....... ~ ............... 2 ... Will lot be regraded ~/A/~ . · ' ' .... r ................ Will excess fill be removed from premises: ~ No Name of Owner of premises .. O¢.o,('¢ ~i'~. ~.. ..... Address . .~(..~f.. C/.tt.7'Phone No...,~.. ~.¢.-~: .~..~'7.. 6.. Name of Architect ......... ~ · ~.,. .............. Address ................... Phone No. Name of Contractor..~]... ~...t.~. ?...~.~..~ .... Address ...~.~.?~../7~. ('.. Phone No. ~.. ~.'i ~'~? ?.'ii 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 ali buildings, wh~'ther existing or proposed, and. indicate all set-back dimensions from property lines. Give street and blocklnumber or description ac.cording to deed, and show street names and indicate whether interior or corner lot. 10. 11. 12. 14. 785-I~-I02 9 AM TO 4 PM FO~ THE F()t.L~)WJNf~ D~SP~CTIOt~$: ~, FOUNDA'FIOR~ - '~NO RE~IJlRED FOR POURED CONCREI'E 2, RO~K~H - FRAMfHG & P[iJ~glNG 4. FtrdAL ' CONS'I'RUC'F~O~ MUST 8E COIV~PLETE FOR (%0, ALL CO~STRUCYIOh~ SHALL ~EET CODES. NOT RESPONSIBLE FOR DESCG~i 08 CONSTRUCTION ERRORS STATE OF NEW YORK/,.:_ ".S COUNTY OF /: ~-~2-/~ ~ ...... /~/~F~./~. ......... ~ ..... .~... · [J~.-. . being duly sworn, deposes and says that he is the applicant (Name of individual signihg contract) above named. (Contractor, agent, corporate officer, etc.) ~ of said owner or owners, and is dull, authorizeri to perform or have performed the said work and to make and file this application; that all statements contained 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 flied therewith. Sworn to before me this 5~~c'¢ 9 .~.~/~ d ' ' ' ' . Notary Publi~, .'.~..~. ~'~~~.... '. County / .~'~ //~ //)/0 ~ ~ ~ , ~ ,x , . ' c/711 /%1 !1.~ ,/~Il I I ~mi~lon Expirea Deoom~? 8~ 19~