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Home My WebLink About21494-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No Z-23669 Date MAY 31, 1995 THIS CERTIFIES that the buildin~ Location of Propert~ 38675 MAIN ROAD House No. County Tax Map No. 1000 Section 15 Subdivision Filed Map No. ACCESSORY ORIENT, NEW YORK Lot 17.4 Lot No. Street Block 2 Hamlet conforms substantially to the Application for Building Permit heretofore filed in this office dated J~NE 10, 1993 pursuant to which Building Permit No. 21494-Z dated JUNE 22, 1993 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 SWI~4ING POOL WITH FENCE ENCLOSURE 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 STEPHEN A. KELEMAN N/A N-284143 - JULY 27, 1993 N/A Rev. 1/81 FORM NO.3. TOWN OF $OUTHOLD BUILDING DEPARTMENT 1OWN V, AU. $OUTHOLD, N.Y. No BUILDING PERMIT [THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) Dote ...,, .~../~rr.....~.... ................................... 19..?/,~.. 2:~494 Z Permission Is hereby granted to: . __ __ ...................... .~~f .~....,..>~..~ ............. .~ ...... , ,o ............... . . . . . . ?. . . . . , . './. . . . . . . . . .'./. . . . . , . . . , , '.,v ? ' at premises located at....~..~....~.........~.....,.~......~...~.. ............................................................. CountyTax Map No. 1000 Section ....... .,~'.~".. ......... Block ............. ~ ....... Lot No ......... ,/.....~..~...~...... pursuant to application dated .~ ......... .~.,,/',Z.,,,.O.. ............................... Building Inspector, Fee $.../.~,.~..~. 19.~.'.~., ....... and approved bythe ~,/BuJldlng inspector Rev. 6/30/80 Form No. 6 TOWN OF SOUTROLD BUILDING DEPARTMENT TOWN HALL 765-1802 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: ~ Final survey of property with accurate location of all buildings, property lines, streets, and~unusual natural or topographic features. ~.. Final Approval from Health Dept. of water supply and sewerage-disposal(S-9 form). Approval of electrical installation from Board of Fire Underwriters.~fSC/~z~ Sworn statement from plumber certifying that the solder used in system contains less than 2/10 of 1% lead. Commercial building, industrial building, multiple residences and similar buildings and installations, a certificate of Code Compliance from architect or engineer responsible for the building. Submit Planning Board Approval of completed site plan requirements. For,~ existing. . buildings,, (prior to April 9, 1957) non-conforming uses, or buildings and pre-exzstlng 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. Fees ~ 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 - $100.00 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.OO October 20 1993 Date ............. ~ ........................... ~ew Construction ..... ~ ..... Old Or Pre-existing Building ................. ~ocation of Property 38675 Main Road House No. Street Hamlet )nwer or Owners of Property... Stephen Keleman ~Ounty Tax Map No 1000, Section. 15 .Block. 2 ~7. j. ~bdivision JoVan J. Fitzsimmons ..................................· . Filed~ Map ........... · Lot ...................... 'e · N 21494-Z rmzt ~ o ................ Date Of Permit...0~/73 A~ ~.. Tortorella Swimnin ols ......... ~ ........................ g.~p..., Inc. !ealth Dept Approval Underwriters Approval ~lanning Board Approval ........................ equest for: Temporary Certificate ........... Final Certicate ...... ee Submitted: $ ............................. ~ ........ .... ............. :.. (1st) FOUNDATION (2nd) ROUGH FRAME & .FLUMBING INSULATION PER N. STATE ENERGY CODE FINAL ADDITIONAL COMMENTS: 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 March 16, 1995 Mr. Matthew Hallock 4365 Wells Road Peconic, NY 11958 Re: Stephen Kelemen - BP#21494-Z (Inground Pool & fence) Prem: 38675 Main Road, Orient 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 outdated. $25.00 No Health Department Approval on file. xx No final inspection has been made. No Plumber Solder Certificate on file. (All permits involving plumbing being issued after April 1, 1984). BUILDING PERMIT # 21494-Z** Please contact our office on this matter. Thank you for cooperation. $OUTHOLD TOWN BUILDING DEPT. ** - THIS PERMIT DOES NOT INCLUDE ANY DECKING. (516) 283-7373 FAX (516) 283-7387 1764 NORTH HIGHWAY SOUTHAMPTON, L.l., N.Y. 11968 Town Of Southold Building Department 53095 Main Road Post Office Box 1179 Southold, New York 11971 August 12, 1993 J TOWN OF SOU'¥i'{O[~!? ......... i Re: Stephen Keleman - Permit #21494 Z To Whom It May Concern: At this time I would like to request a final inspection of the above-referenced swimming pool. I have enclosed a copy of the electrical underwriters certificate and permit for your records. If you need any further information or have any questions, please do not hesitate to call the office. erely yours, Donna M. Troyan MEMBER NATIONAL SPA & POOL INSTITU]E 0 OFI=IOE OF BUlLDIN~ INSPECTO. INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLBG. FOUNDATION 2ND [ ] INSULATION [ ] FRAMING [ ] FINAL REMARKS: ~ DATE 765-1802 BUILDING DEPT. INSPECTION FOUNDATION 1ST [ ] ROUGH PLBG. / FOUNDATION 2ND [ ]/~SULATION ./ FRAMING ~] FINAL REMARKS: DATE INSPECTOR 765-1802 BUILDING DEPT. INSPECTION FOUNDATION 1ST [ ] R/~/UGH PLBG. ~ORAUMNIDNA~ION 2ND [ ]~FiNSUALLATION ] FIREPLACE &/C~NEY THE NEW YORK BOARD OF FIRE UNDERWRITERS [0@f~6~ BUREAU OF: ELECTRICITY ......... ~ 8B JOHN STREET. NEW YORK, NEW YORK 10038 ir t h' ' 'o~Oa~er ,J}/LY 27,1993 Application No. onfile 913'78293/9~ ~ 284143 THIS CERTIFIES THAT o~y the e~trical ~ulpme~t ~ ~scrib~ bel~ a~ intr~uc~ by t~ applica~t ~ed on ~he a~ application number in the prem~es of i~ thefotlo~nR loca~ion~ ~ B~,ement ~ Is~ FI. ~ 2nd FI. OUT Section Bilk Lot ~s examlned on 3~[s~ 22~993 and found W be in compliance with the N~on~ Elect~cal Code. DRYERS FURNACE MOTORS FUTURE APPLIANCE F~EDER~ ~T. K.W. OIL H.P. GAS H P. A~T, NO, A W, G. SERVICE DISCONNECT I ~.oF I s METER environmeats it, i~ advisable to }lave ~requenb Lest/and or repairs made b~ a qualified per~on RANGES iPECIAL REC'PT R COOKING DECKS OVENS DISH WASHERS TIMECLOCKS BELL JUNITHEATERSUNITHEATERS MULTI-OUTLET V I C E EXHAUST FANS DIMMERS NO, OF CC COND, A W G. NO, OF Hi. LEG A W G, ~O. OF NEUTRALS A, W, G. PER ~' OF CC, COND, OF HI.LEG OF NEUTRAL 11782 G~NERAL 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 ~US~NOT BE ALTERED N ANY MANNER THE NEW YORK BOARD OF FIRE UNDERWRITERS BUREAU OF ELECTRICITY BB JOHN STREET, NEW YORK, NEW YORK 10038 THIS CE~IFIES THAT o~y the e~trical ~uipment ~ ~scribed be~w a~ intr~uced by t~ ap~icant Mm~ on t~ a~ve appl~ation number in the prem~es of K~M~N, MAIN ROAD~ )RI~INI', N,Y in the following h,catio,; ~ B~sement ~ Ist Fl. ~ 2nd FL OUT .%ctlo, Bilk Lot ~s examined on J ~ L ~ 2 ~ ~ ~ ~ ~ ~ and found to be in complianfe ~ith the Naffonal ElectHcal Code. IXTUR$ L I FIXTURES RANGES IC~INGDECKSI OVENS IDISHWASHERS EXHAUST FANS SERVI~ DI~ONNECT ~ ~F S E ' R 'V ' I ' C E ' ~I AMP Type ~U,~ 1~2w l~aW 3~3W 3~4W O O~EI~COND OF~C~gND NO OF HILEG O~L~ ~ OFNEUTRALS OTHER APPARATUS: TIME CLOCKS-AMP.40-1 PAN~I, BOARDS:I-2 CI'R, 100 ~MWIMMING POOL) ~his certificate cover~ compliance at the date of GENERAL MAHAGER 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, THE NEW YORK BOARD OF FIRE UNDERWRITERS BUREAU OF ELECTRICITY aS JOHN STREET, NEW YORK, NEW YORK t0038 THIS CERTIFIES THAT o~y the electrical ~uipment ~ ~scrib~ be~w a~ int~uc~ by t~ applicant ~med on the a~e application number in the premhes of in the foBowing location; ~ Basement ~ Ist Fl. ~ 2nd Fl. Section Bilk Lot ~s examined on 0 f~0 ~ 07~995 and found to be in ~ompliance with the Na~onal Electdcal Code. DRYRRS I FURNACE MOTORS I FUTURE APPLIANCE FEEDERS SERVICE DISCONNECT RANGES SPECIAL REC'PT NO. OF J S', R TIME CLOCKS BELL UN T HEATERS MULTI-OUTLET SYSTEMS AMT. AMpS TRANS. NO, OF FEET V I? C NO OF HI-LEG A W G, OF HI-LEG EXHAUST FANS DIMMERS O & S CON~RAgTOR BOX 215 80UY~O[,D, NY, 1~97t GENERAL MANAGER This certificate must not be altered in any manner; return to the office of the Roard if incorrect. Inspectors may be identified by their credentials. COPY FOR B~ILOING DEPARTMENT. THIS COPY OF CERTIFICATE MUST~OT BE ALTERED~ IN ANY[ MANNER~ BOARD OF HEAl. IH FORMNO. 1 3 SETS OF FLAN$ TOWN OF SOUTHOLD SURVEY BUILDING DEPARTMENT CIIECK TOWN HALL SEFTIC FOR,~! ............. SOUTHOLD, N.Y. 11971 Examined ...... , I ~ TO: Disapproved a/c ' REQUIRED ~ . ~, ~. ctor) Date ....... INSTRUCTIONS ~ a. T~s application must be completely filled in by Wpewhter or in ink and submitted to the Bulldog Inspector, with 3 sets of plans, accurate plot plan to scale. Fee according to 'schedule. ~ b. Plot pl~ show~g location of lot and of bulldogs on premises, relationship to adjoining premises or pubic stree[s or areas, and giv~g a det~led description of layout of property must be drawn on the diagram which is pa~ of this appli- cation. c, The work covered by t~s application may not be commenced before issuance of Building Pemit. d. Upon approval of this application, the Building Inspector will i~sued a Bufld~g Pe~it to the app~cant. Such pe~it sh~l be kept on the premises available for ~spection ~roughout the work. e. No building shall be occupied or used in whole or in p~t for any purpose whatever until a Ce~ificate'of Occup~cy shall have been granted by ~e Building Inspector. APPLICATION IS HEREBY MADE to the BuildEg Dep~ment for the issuance of a B~lding Pemit pursuant to the Building Zone Ordinance of the Town of Southold, -Suffolk County, New York, ~d other app~cable Laws, Ord~ces or Regulations, for the const~ction of bufld~gs, additions or altera~ipns, or for removal or demolition, as here~ described. The app~cant agrees to comply with all app~cable laws, ordinances? bufldEg code, housing code, and regulations, and to admit authorized ~svecto~ on ~remise~,and E build~g for necessa~ inspections. (Signatur~ of applicant, or name, if a corporation) ,(Mailing address of applicant) e State whether applicant is' owner, lessee,' agent, architect, engineer, generaJ contractor, electrician, plumber or builder. Name of owner of premises . .~ .~.~ ~ < I~ ~ ~ ~ - (as on the tax roll or latest deed) If ap~nt is a, corporatien, signatur~f duly authorized officer. ~ (Name and title of co~orate officer, Plumber's License No. Electrician's License No ....................... Other Trade's License No. ~ - 1. Location of land on which proposed work will be done. ~ ~' Itouse Number Street Hamlet Cou'ntyTaxMapNo.,000Sect,on...:../¢.7... ...... B,ock .... ' Subdivision . ~J3~..O ( 'J ~"' ?~ , )L ~_ 5' r ,'~,'~ o,~) Filed Map No. '~ "~ ...... . .............................. ' .............. Lot .... ............. (Name) 2: State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existinguscandoccupancy tc ~_ x' t cJ ~ ,..~ d , ~ ( . b. Intended use and occupancy 5' ,4 · 3.Nature of work (check which applicable): New Building ........... Addition .......... Alteration .......... Repair Removal Demolition .... : Other Work -<'"-"~'"' '.~.. ,~ · .. (Description) ' 4. Estimated Cost . . . .~f...o: .~..~. .................... Fee ...................................... (to be paid on filing this application) 5. If dwelling, number of dwelling units .... .'7~. / .'ff. .... '.. Number of dwelling units on each floor....'?~.//.,o.. ........ · If garage, number of cars ............ :?.f.,0, ...................................................... 6. If business, cmnmercial or mixed occupancy, specify nature and extent of each type of use ..................... 7. Dimensions of existing structures, if any: Front ....... ~ ...... Rear .... .-w-7.. ....... Depth ............... Hight N fSt i e ............... um bet o or es ........................................................ Dimensions of shme structure, with alterations or additions: Front ....'7: ............ Rear .. ~ .............. Depth .... ' ........ ~ ......... Height -- . ............ Number of Stories .... .-77.. ' .......... 8. Dimensions of entire new construction: Front ..... /. ~. ....... Rear ............... Depth . ,-,~.~.: ....... Height ....... .~. [/'-r.. Number of Stories ...... . .P-~. [./'r: .......... , ................................ ,~. Size of tot: Front ....... l ./.~.. ' Rear ...... ./..>-'.3.'-. ..........Depth . .'?. ~?. .............. 10. Date of Purchase '~. .... Name of Former Owner .'~. 11. Zone or use district in which premises are situated ..................................................... 12. Does proposed construction violate any zoning law, ordinance or regulation: .... ~ .............. ~ ...... 13. Will lot be regraded ....... ; p:,...o. ................ Will excess fill be removed from_.~remises: (Yesd ~ No 14. Name of Owner of premises .5.../~.c..(.~../2..~..fiJ.... Address '7?../J.~.'.~...'~f.'.?::: .':JP~hone No. ?..~..~....>. Name of Architect ........................... Address ................... Phone No .............. t - C rc ~._, ...~o .c-r'o ~ I { q t~</4 ''~ - ~/t~ ~'~ ~'~ No Name of ont a tor . .'-~. ...... ~ ............... Address ............. _....& ..Phone ........... .~... 1.5. is th±$ property ~ith±n 300 feet of a t±dal wetland? *Yes~..*.'-.'.~..'~./~..~..)~.... tlf yes, $outhold Town Trustees Permit may be requSred. ', PLOT DIAGRAM Locate clearly and distinctly all buildings, whether existing or proposed, and. indicate all set-back dknensions from property hnes. Give street and block number or description according to deed, and show street names and indicate whethe interior or corner lot. Al' 'DAli NOTIFY BUILDING DEPART 765-1802.9 AM TO 4 PM FOR THE FOLLOWING INSPECTIONS: 1. FOUNDATION - TWO REQUIRED FOR POURED CONCRETE 2. ROUGH o FRAMING & PLUMBING 3. INSULATION· 4. FINAL CONSTRUCTION MUST 8E COMPLETE FOR C.O. ALL CONSTRUCTION SHALL MEET THE REQUIREMENTS OF THE N.Y. STATE CONSTRUCTION & ENERGY CODES. NOT RESPONSIBLE FOR DESIGN OR CONSTRUCTION ERRORS STATE OF NEW YORKA,/ // ° S cou ¥ OF. ./f. c f /C. . . · · .~..~../7.,~/.../.--_~.d..~'...~..~O.d( .~.. f./..~ ..... · ........... being duly sworn, depose~ and says that he is the applicant (Name of individual signing contract) above named. te is the ..... . .................... C.'.~....:~..4..r-.~....~...(-. .......... (Contractor, agent, corporate officer, etc.) · f said owner or owners, and is duly authorized to perform or have performed the said work and to make and file this pplication: that all statements contained in this application am true to the best of his knowledge and belief; and that the .'ork will be performed in the manner set forth in the application filed therewith. .worn to before me this · ........ · ~.'~...~.~ .... '...dayof....~./,~.~...~).. .... 19~..~ - ...... .............. ..... ~or^~ ~umc. s*~*.a*~ ,o.~ '~o,'k /./ (Signature of applicant) N. BB 2~, O0 ~r.