HomeMy WebLinkAbout22334-zFORM NO. 4
TOWN OF 5OUTHOLD
BUILDING DEPARTMENT
Office of the Building Inspector
Town Hall
Southold, N.Y.
CERTIFICATE OF OCCUPANCY
No Z-24705
Date OCTOBER 28, 1996
THIS CERTIFIES that the building
Location of Propert~ 1560 BRIDGE LANE
House No.
County Tax Map No. 1000 Section 85
Subdivision
ACCESSORY
CUTCHO~UE, N.Y.
Street Hamlet
Block 2 Lot 30
Filed Map No. Lot No.
conforms substantially to the Application for Building Permit heretofore
filed in this office dated AUGUST 26, 1994 pursuant to which
Building Permit No. 22334-Z dated SEPTEMBER 15, 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 ENCLOSURE IN REAR YARD
AS APPLIED FOR.
The certificate is issued to
KEVIN J. & CHERYL A. LYNCH
(owners)
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL
UNDERWRITERS CERTIFICATE NO.
PLUMBERS CERTIFICATION DATED
Rev. 1/81
N-330233 - OCTOBER 17, 1994
Building- I ns~t6~'
FORM NO.3
TOWN OF $OUTHOLD
BUILDING DEPARTMENT
TOWN HALL
SOUTHOLD, N.Y.
22334
BUILDING PERMIT
(THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL
Rev. 6/30/80
Permission Is hereby granted to:
Coun~Tax Map No. 1000 Section ...... ~ ...... Block ....... ~ ............LotNo...~,~ ...............
Building Inspector.
]form No. 6 ~F~V~:ZiDD t:fO 0~/o~(~
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN HALL
765-I802
APPLICATION 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 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 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 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 Buildin~ - $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 ..........................
~ew Co~strnction ........... Old Or Pre-e×isting Building .................
Location of Property .....................................
House No. Street Hamlet
Onwer or Owners of Property....~..~.~3..?.~.~...~O..~.....~..~/.~. ~..~.. ~.~.~. ~.<; .................
County Tax ~ap ~o 1000, Section ............ Block ..... ~ ........ Lot .................
Subdiv±sion..-..M:." ' . ......Filed .... [ .................
Health Dept. Approval .......................... Underwriters Approval .........................
Planning Board Approval ........................
Request for: Temporary Certificate ........... Final Certicate....'~... ....
Fee Submitted: $ .............................. .~ '
~' THE NEW YORK BOARD OF FIRE UNDERWRITERS
1185077
BUREAU OF ELECTRICITY
~ STREET, NEW YORK, NEW YORK 10038
BS
JOHN
D.t~ OCTOB~R 17, I994 ~ppli~.tio. ~o.
THIS CERTIFIES THAT
KEVIN LYNCH, 156~ BRJ:DGF, I2~,, CUTCHOGUE, N.Y.
in thefollowinglocation~ [] Basement [] Ist Ft. [] 2nd FI.
C ' , *' Section Block Lot
t~sexamlnedon 0 ~,rl~)B~J['{ 13,199~ and found to be in compliance with the National Eloctricnl Code.
FIXTURE FIXTURES RANGES COOKING DECKS OVENS DiSH WASHERS EXHAUST FANS
P.O.BOX
C(JTCHOGU~, NY, 1.1935 GENERAL MANAGER
This certificate must not be altered in any manner; return to the office of the Board if incorrect. Inspecto,rsl 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 Pa .m 1
1185077 BUREAU OF ELECTRICITY
~- 88 JOHN STREET, NEW YORK, NEW YORK 10038
Da,e OCTOt~ER 17,1994 Application No. onfile 06527694/94 N 330233
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
IfEVIN LYNCH~ 1.560 BRIDGE ]'.~%NE, CUTCHO~Lrf,~, N.Y.
in the followlng location; [] Be~sement [] Ist Ft. [] 2nd ["1. (~AR/OU'f .Section Block Lot
~s examined on OCTOBER 13,1994 and found to be in compliance with the National Electrical Code.
AMT, K, W, OIL H.P. GAS H, P AN~T NO, A. W ~
OTHER APPARATUS:
SWIHMING POOL' 'I
TIHE CLOCKS 4~3
~ (SWIMMING POOL) This cert:[ficate
covers co~tpliance at the date of
~nspectien only. Becanse of unusual
~nvironments it is advisable to
have ~requent test/and or repairs
made by a qualified person.
<',~< ConLJnued on Pa~e 2 >>~
RANGES
~ECIAL REC'PT
R
COOKING DECKS OVENS DISH WASHERS
TIME CLOCKS ~ELL UNIT HEATERS MULTI-OUTLET
A,v,r A~P$. TRANS.~ NSO!fSOT:/~IsET
V I C E
EXHAUST FANS
H P
DIMMERS
WATTS
NO OF CC COND, A W G NO OF HI-LEG A W G, qO OF NEUTRALS A, W G,
PER ~' OF CC, COND OF HI-LEG 0~ N~UTRAL
GENERAL MAHAGER
Pet*
This certificate must not be altered in any manner; return to the office of the 8oard if incorrect. Inspectors may be identified by their credentials.
COPY FOR BUILDING DEPARTMENT. THIS COPY OF CERTIFICATE MUST NOT BE ALTERED IN ANY MANNER.
Town Hall, 53095 Main Road
P. O, Box 1179
Southoid, New York 11971
Fax (516) 765-1823
Telephone (516) 765-1802
OFFICE OF THE BUILDING INSPECTOR
TOWN OF SOUTHOLD
September 22, 1995
A. Reilly & Sons, Inc.
P.O. Box 98
Shore Acres
Mattituck, NY 11952
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. $25.00
No Health Department Approval on file.
No final inspection has been made.
No Plumber Solder Certificate on file.
(All permits involving plumbing being
issued after April 1, 1984).
BUILDING PERMIT # 22334-Z
Please contact our office on this matter.
cooperation.
Thank you for
SOUTHOLD TOWN BUILDING DEPT.
cc: Lynch
3NDA_.TION ( 1 s t )
H;DATIOH ' ' '
{'2nd
'GH FRAHE & ..
ULATIO~! PER N.
STATE E~ERGy
CODE
ADDITIO~;A'L CO!-~EHTS:
765-1802
BUILDING DEPT.
INSPECTION
[ ] FOUNDATION IST [ ] ROUG/H/~_BG-
[ ] FOUNDATION 2ND [ ] ~UI. ATION
[ ] FRAMING [,//]/FINAL
[ ] FIREPLACE~HIMNEY
REMARKS: ~~.,..
LS
ORNER SET
qG STRAIGHT SET
RECTANGLE
ERS ARE'6// RADIUS. EVERY
~.$ A BRACE° ALL CORNER
ARE
standards for residential pools. If diving boards or sires are k) be used
Poo) JflslJluJe's rpmlm,utl ~tandards prior lo installing diviilg boards or slides
'fRIS BROCHURE IS FOR ILLU~ITRATIVE PURPOSES ONLY
Th~' manulaclurer makes only those representahons which are stated m
irs wll(ren warrarity Any other represenlahOnSl sratemer~l$, m'corttra¢~$
made ny the daffier end or the contractor to the customer regarding any
m[de,~a[$ produced by Ihe manufaclurer are attributable lo Ihe dearer a nd/
or :r~; contractor only. The dealer or contraclor who sells or installs your
poet is an ~ndepe~denl co~lrector and not an agent Or employee el the
menulacturer. The construction methods illust{aled are .~ug.0eslions and
apply only to normal ground condfl~cn~ There may be add~l*onal precau-
tN 0/~'
Note: Diagonals g~ven to
90° point of corners.
SET
GHT SET
.ER SET
)TRAIGHT' SET
ORNER SET
qG STRAIGHT SET '
4680~. U.S,A.
PREO0-1
510 ~.UMPTER DRIVE FORT WAYNL I~DIANA,
219.432.8731
3/32"=
RECTANGLE
BLDG, DEPT.
-~-- ~.~T(~WN OF SOUTHOLD
....
77.-: ......
~LICATION FOR BUILDING PERMIT
FORM NO. 1
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN HALL
SOUTHOLD, N.Y. 11971
TEL.: 765-1802
INSTRUCTIONS
BOARD OF HEALTH .."."~., ....
3 SETS OF PLANS ..........
SURVEY ...................
CIIECK ........
CALL ...................
HAIL TO:
Date .............. , 19
a. Th/s application must be completely tilled in by Wpewriter 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 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 tbJs 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
~egulations, 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.
.../].:../~',t,. ~. ~-...3.o..~..s....-~..c ..........
- (Signature of applicant, or name, if a corporation)
· #..o....~.~?..7.~,. j'.~:./~.
(Mailing address of applicant)
State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder.
.G.~z-~. m~....-.e..~...~.,~..~. ~. ....................................
Name of owner of premises ............ l.~. ~'?:1./.~...../?.~..~. .... .C~../s.~..q./. .... .L. ~.,4/..C/~. ..................
/,---) (as on the tax roll or latest deed)
If appli orporation, si ure of duly, authorized officer. "~ ·
(Name and title o~ corporagl~ml~cer) "~
Builder's License No .................... ~ .....
Plumber's License No .........................
Electrician's License No...~.O..~;~../~...
Other Trade's License No ......................
1. Location of land on which proposed work will be done .......... .~..~...~.../~...~..~..~.. ......................
.../..~7..o. ............. ~..n/~.~.~.~.. ~.r~..~., ...... ..~..~. ~..~:.....W.,. ~.. .... /(~.~.-...
House Number Street Hamlet
County Tax Map No. 1000 Section ....... .~.~.. ...... 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 ............ .~..~../.~.tJ"YV .~../.,~'~..-,- ............ ,,'-'~.~{'~- ~ · ~-r~-:-~, ..............
b. Intended use and occupancy ....... A~.../..'~..t~. ~.~-~. . .L~. ~-~/ ' .~.O~. ~i~,.~>,
.......... ~..~;~.,.,. · ~/;,:. ~ ".!,;.~ '~; ..........
Repair .............. RemOval .............. Demolition .............. Other Work ..... ,~ .......
, ' ', (Description)
4. Estimated Cost ..... Fee .............. t. .............
~ (to be paid on filing ti/is application)
5. If dwelling, number of dwellin-!units Number of dwelling units on each floor ~
If garage, number of cars ... 4 ............ , ................. - ......... ?'. '.
6. If business, commercial or mixed occupancy, specify(nature and· kextent~ of each,type of use ...~.... ...............
7 ..... ~ if any Front Rear Depth
· D~menslons of existing structures, .... ; ..... ,
Height ............... Number of Stories ........................................................
Dimensions of same structure with alterations or additions: Front ................. Rear .................
Depth .................... l..Height .......... ... .. .. ,,. '..NumberofStories ...... ~
8 iQ tru ti F ....... ' .......
· Dimens ns of entire new cons c on: ront .............. '.,. Rear ............... Depth .............
Height Number of Stories~, ' ' '
9. Size of lot: Front ........... ! .......... Rear ....... '" Depth
10. Date of Purchase ........... ' ......... . ......... Name of Former Owner
I 1. Zone or use district in which pr~mises are situated ...... .~/~4~-?7~.( ........................... ....
12 DO dco truct' ' let i glaw din'" ' latio'~/.i ''~ ...................
· es propose ns lOB VlO e any zon n , or ance or regu ......... "
13. Will lot be regraded ......... i ................... Will excess fill be removed from premises: Yes No
14. Name of Owner of premises ...i..Z.~../u..c.[/~ ........ Address ...C.q;~-~ff.~'C<'.... Phone No...7..?~..-: .~.(~..
Name of Architect .......... i ................ Address .................. Phone No.
Name of Contra;tor... ~... ~'.' 7~4 ~i~'. ~.4 .Y~.~.. Address....~.' ~Sr'~i.. Phone No. i ~t~i'i~ff}/i~i
15. Is th±s property w±th±n 300 feet of a t±dal wetland? *Yes ........ No...J~....
*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 from
property lines. Give street and block ~umber or description according to deed, and show street names and indicate whether
interior or comer lot. .
"IMMEDIATELY"
ENCLOSE POOL TO CODE
UPON COMPLETIO~
BEFORE "WATEW'
UNBERWRITEBS (;ERTiFIOATE
REQUIRED
&PI i0,V£D AS 0T£D
ml~ BUILDING DEp~-
765-~802 9 AM TO 4 P~ FOR THE
FOLLOWING INSPECTIONS:
1. FOUNDATION ~0 REQUIRED
FOR POURED CONCRETE
2. ROUGH. FRAMING (~ PLUMBING
4. FINAl,. CONSTRUCTION MUST
BI: COMPLE'r[ For~ C.O.
AL.L CONSTRUCTION SHALL MEET
THE REQUIREMENTS OF THE
STATE CONSTRUCTION ~ ENERGY
CODES, NOT RESPONSIBLE FOR
DESIGN OR CONSIRUCIION
STATE OF NEW Y. ORr~KZ
......- /~,r~/~ ~4...~. ..... /~/~.. ~. .... q~.' .... being auly sworn, eposes ana says that he is t~e applicant
(Name of individual signing contract)
above named·
Heis the [
~ (Contractor, agent, corporate officer, etc.)
of said owner or owners, ~d is duly[ authorized to perform or have perfomed the said work and to m~e and file this
application; that all statements contaiped ~ this application are true to the best of his knowledge and belief; and that the
work w~l be perfomed in thg m~ner set forth in the application filed therewith·
Sworn to before me t~s~ ~ A ",
.............. '.day~5~., 19 ~
~W ~bll~ 8tale of N~ Y~ ..... / .... 7 .~.~.. ~. 7~/~ ...........
Ne. 4879505 ~/ 'Si ns'
· - , ~ ~ e of applicant)
Qualified In Surfak Coun~ ~ (~igna~e,