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HomeMy WebLinkAbout20502-z V FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY Nc Z-22248 Date APRIL 8, 1993 THIS CERTIFIES that the building ACCESSORY Location of Property 2800 SIGSBEE RD & 10810 PECONIC BAY BLVD. LAUREL House No. Street Hamlet County Tax Map No. 1000 Section 126 Block 6 Lot 1 Subdivision Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated MARCH 20, 1992 pursuant to which Building Permit No. 20502-Z dated MARCH 26, 1992 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 DECK AROUND & FENCE ENCLOSURE. The certificate is issued to CHARLES L & JANE P. KIRBY (owners) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A UNDERWRITERS CERTIFICATE NO. N-237883 - JUNE 8, 1992 PLUMBERS CERTIFICATION DATED N/A Xe4z Bu' ding Inspector Rev. 1/81 roans NO. s TOWN OF SOUTHOLD 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 °-N? 20502Z Date ~/2/M 19.2?- Permission is hereby rante t x.~.... p at premises located at .../0. yTfR I...................r ............7.............................................................. . r County Tax Map No. 1000 Section ........ZAL... Block ..............A.... Lot No........./ i pursuant to application dated 19.iE... and approved by the Building Inspector. Fee s.lc~... C/~-~l~~G~r••• •..~f.~.~--....... fir.... ........'~C~...... Building" for Rev. 6/30/80 Form No. 6 7 0 a 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT MAR 2 3 1993 765N L 765-1802 F r. Ali'-?'.°:~. APPLICATION FOR CERTIFICATE OF OCCUPANCY A. 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. B.' For existing buildings (prior to April 9, 1957) non-conforming uses, or buildings and '.'pre-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 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 $15.00 Date New Construction........... Old Or Pre-existing Bu,4ding Location of Property ......5 ~l.`id't-ce!...'.:"a.o ......U~ u- House No. Street Hamlet r6 0 Onwer or Owners of Property..~(- -e.5... h ? r.l?.~ County Tax Map No 1000, Section Block ................Lot...................... Subdivision ....................................Filed Map............ Lot................ Permit No.eZQ,512A.Z..... Date Of Permit.`?X~ .J,<O.....Applicant..J~'. R Z~ Icy a ~o n5. nc. Health Dept. Approval ..........................Underwriters Approval......................... Planning Board Approval Request for: Temporary Certificate........... Final Certicate........... Fee Submitted: $ ~su o 5l3`I ice r l~'S Crin/~ Z.. . C(ry APPLICANT II THE NEW YORK BOARD OF FIRE UNDERWRITERS PAGE 1 r1.001381 BUREAU OF ELECTRICITY I 88 JOHN STREET, NEW YORK, NEW YORK 10038 Date JUNE 08, 1,992 Application No. on file 08069192/92 N 237$€13 THIS CERTIFIES THAT I only the electrical equipment as described below and introduced by the applicant nomedon the above application number in the premises of JAN8 KIRBY, 2705 SIGROE ROAD, NATTITIICK, N.Y, in thefollowinq location; © Basement ? Ist Fl. ? 2nd Fl. OUT Section Block Lot was examined on MAY 26 , t 9 9 ? andfound to be in compliance with the requirements of this Board. J FIXTURE ECEPTACLES SWITCHES FIXTURES RANGES COOKING DECKS OVENS DISH WASHERS EXHAUST FANS OUTLETS INCANDESCENT nUORESCENT OTHER Ami. K W. AMT. K W. AMi K.W WT. K W AMT. N P. 1 2 It DRYERS FURNACE MOTORS FUTURE APPLIANCE FEEDERS SPECIALRECPT TIME CLOCKS BELL UNIT HEATERS MULTI-OUTLET DIMMERS AMT. K. W. OIL H. P. GAS H. P. AMT. NO. A. W. G. AMT AMP. AMT. AMPS TRANS. pMT H P SYSTEMS AMT WAITS NO. OF FEET 1 F 11 Q0 SERVICE DISCONNECT No. Of S E R V I C E METER NO OF CG COND A W G A. w G A W G, AMT. AMP. TYPE EQUIP 1.02W 103W 393W 3A 4W PER . OF CC.COND NO. OF HI LEG OF W G NO. OF NEUTRALS OF NEUIEAL 0 HI LE OTHER APPARATUS: ` a SWIMMING Pt}OG 1 C. P.C.Tt-1 ~ *(SWIMMING POOL) This certiflGate covers oompliaooe at the, date of inspection only, Because of unusual, ~ environments it, is advisable to Crave frequent testlaud or repairs made by a qualified person. p G!~~~"l JOpY PUNI'GGO LZC.#2:100_N PAT DANE GENERAL MANAGER NATTTTUCK, NY, 11952 /G Perk 1 1 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. r'1cLJ JA:E ~i:MMLNT^ Q a ~ r'OUNDATION (1st) ?OUNDATION (2nd) _ - _ ~v 2. , I o~ o ?OUCH FRAME & -PLUMBING ( \O H 3. m m I17SULATIOi1 PER N. Y. I .-3 STATE ENERGY II CODE i _ Gf !'Y~ - d~,vJj H I y~/G~U?L/J2iG ...5 ~fCG- ~f /~~L- L?Y/G+~,EJ,~- FINAL C~w 10 X62 fr/,5 ADDITIONAL COMMENTS: m if /I Ell x H O r C C~ H ~soz M-1802 BUILDING DEPT. INSPECTION [ J FOUNDATION 1ST [ J ROUGH PLBG. [ ] FOUNDATION 2ND [ ] INSULATION [ ] FRAMING [ FINAL ~L REMARKS: L<Lf -,A/ ~H~c1 GAfr- ~ CCd~ ~1 r 4e DATE INSPECTOR 765.1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION 1ST [ I ROUGH PLBG. [ ] FOUNDATION 2ND [ ] INSULATION [ ] FRAMING ( v]'FINAL REMARKS: DATE 111110ph3 INSPECTOR BOARD OF HEALTH FORM NO. 1 3 SETS OF PLANS TOWN OFSOUTHOLD SURVEY j BUILDING DEPARTMENT CIIECI . TOWN HALL SEPTIC FORM s MAR 2 4 199 SOUTHOLD, N.Y. 11971 TEL.: 765-1802 NOTIFY; CALL D.~ 4 (7...... , . EXamn ~l ,,,,,.19MAIL TO: Approved / , 19~. Permit No. 2 cy . . Disapproved a/c / (B ding pector) APPLICATION FOR BUILDING PERMIT Date 197~:- INSTRUCTIONS 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 ,r areas, and giving a detailed description of layout of property must be drawn on the diagram which is part of this appli- "ation. 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 hall 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 hall 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 luilding Zone Ordinance of the Town of Southold, Suffolk County, New York, and other applicable Laws, Ordinances or Zegulations, for the construction of buildings, additions or alterations, or for removal or demolition, as herein described. ,-he applicant agrees to comply with all applicable laws, ordinances, building code, housing code, and regulations, and to dmit authorized inspectors on premises and in building for necessary inspections. / /LGsI4L.~l rA vs . ¢ (Signature of applicant, or name, if a corporation) (Mailing address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician; plumber or builder. c b~~A~s...ow T Y'z?<........................................... \lame of owner of premises PAVAtx-q 4,g ; , , . K ! 90 (as on the tax roll or latest deed) f applic t a corporatio ign re of my authorized officer. (Name and title of core officer) Builder's License No. 20.- A/ . Plumber's License No . Electrician's License No. .10#t:av&y ....~Zf~e ~ Other Trade's License No . Locat'o of land on which pro s work will be done. sl(S ~G`. " , , , , , , , , , , , , , ! Z! .4?4w dt?. 1 5 (louse Number Street Hamlet County Tax Map No. 1000 Section c. 410 Block CQ Lot t 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 b. Intended use and occupancy . . 3. Nature of work (check which applicable): New Building • • • • • • Addition Alteration Repair epbval Demolition Other Wo k . .4'0W 4. Estimated Cost U 4i 6 • &0 0 ra ~ C4qDescription) Fee (to be afd on filing this application) 5. If dwelling, number of dwelling Units Number of dwelling units on each floor If garage, number of cars . 6. If business commercial or mixed occupancy, specify nature and extent of each type of use . 7 Dimensions of existing structures, if any: Front Rear Depth Height Dimensions of Numlber of Stories . with alterations or additions: Front Rear . Depth Height Number of Stories 8. Dimensions of entiresnewtconstruction: Front Rear ...............Depth , . Height mber of Stories 9. Size of lot: Front Rear , Depth . 1 11. Zone or use 0. Date of Purchase premises Name of Former Owner 12. Does district in construction violmiles are situated ~S$!,?~fh 77~9L tany zoning law, ordinance or regulation: 13. Will lot be regraded Will excess fill be removed from premises: r' es No 14. Name of Owner of premises rG6 . Address Phone No. 5. Is Name of this Architect Address . , • . Phone No. r~~ . Name of Contractor ,f2E1~~.`'r Son Address . /l?77?T r~1~, , , Phone No..~'7 * :.4C~Q.b. property within 3 00 feet of a tidal wetland? 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 number or description according to deed, and show street names and indicate whether interior or corner lot. S AP RO 0 AS NOTED DATE: 42' BA li 00 FEE~ Br: NOTIFY U G DEPARTM T 765-9802 S AM TO 4 PM FOR THE FOLLOWING INSPECTIONS: 9. FOUNDATION - TWO REQUIRED FOR POURED CONCRETE 2. ROUGH - FRAMING & PLUMBING " 3. INSULATION 4, FINAL - CONSTRUCTION MUST BE COMPLETE FOR C.O. ALL CONSTRUCTION SHALL MEET THE REQUIREMENTS OF THE N.Y. STATE CONSTRUCTION & ENERGY COCIES. NOT RESPONSIBLE FOR CTSIGN OR CONSTRUCTION ERRORS ;TATE OF NEW YORK :OUNTY OF . .:CC. • ~~S//$ (Name individual ..!signing . 4; being duly sworn, deposes and says that he is the applicant contract) bove named. [e f s is the On TJI I G~?Zb7~.................. . (Contractor, agent, corporate officer, etc.) said owner or owners, and is duly authorized to perform or have performed the said work and to make and file this )plication; that all statements contained in this application are 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. wom to before me this f oZ roS! NavcP~ 19 , 4 day otary Public, • County ROBERT I! SC JR. NOTARY PUB41C, of N.Y. No. 47250391 olk Cou &i • Totmy31.18of applicant) I i - r- - - . ! SUFFOLK CO. HEALTH DEPT. APPRC . , XIJr ` NCY O CND, LES L_0112BY NER$CERTIFICATE J NE.1`• f` ~ 7[ BY tv STATEMENT OF INTENT REQUIRED I THE WATER SUPPLY AND SEWAGE DISPO:. x,. J ';IUT ~TIFICAE 'i SYSTEMS FOR THIS RESIDENCE W''J;. Q ! CONFORM TO THE STANDARDS OF THE 9_ p N' ~F~f~t~+ _ _ stn c L SUFFOLK CO DEFT. OF HEALTH SERVICES. ~l APPLICANT IMMEDIATELY" j EN C2SCF;OOL TO C9QE- SUFFOLK COUNTY DEPT. OF HEALTH - - 2d 1- ,BEFORE 'WA - Y - - ` ? SERVICES - FOR APPROVAL OF Lo\ `F TER„ CONSTRUCTION ONLY -O DATE C {H.f. REF. NO. 87 _~G-218 Z - _ ( - - - All APPROVED: { °Hg '~r.~5559 f1 i r.'Ei~-• 4 - m + n soecA ' - wFFOUC cn Twx MAP DESacXArtoN: ..7,a,;cZ COST. - SECT. BLOCK 4PCL. tcx--_ , 7 6--'- i ri ` - ZN//SIG7 .~I r J/• OWNERS ADDRESS . ~ ~ _ ~ ~ +~I r•~R/~~ Y~•~- _ r• ^I.. .4 L~.t-S,FV4 •x,21 ~ J 111 _ 4 11 - - ~ ' y"- . _ . - 'lit ~ '+SraZ ,~1'T _ ~ ~i'_.t!` _ _ " ?..t.. L- - - ? R'T DEED: L'Z3' i - - - S ^~p TEL. _ r'te'. .J J~tz ~X_ _r tsp. Yw AIM YOASW 5 Lr-w t - ENCLOSE POOL TO CODE s~ a. UPON COMPLETION * I Ya11C IrC OnM MMYA4ti _ >af "-PEFfIR; -WATF' ' ~ - - - • I tI d h Wgroe, ~ tnlMr^m" MN' ~ - - ~~'AFi~.TATL-367_ _ I ~ xF r cuvl'.,ISSN.m•fva++11 . - ~ f lry_t p,~~„F',[N9111KWMOYw ' i ' UNDERWRITERS CERTIFICATE d. REQUIRED ; ,us Tst9 IEu r y i Ad 41;V V~IfSt E~£~/FT.,.i'~ f >T1JTLK " cwt - LICEi[9£D 1~kf1D i t_~~~ - OREEMORT - NEW YORK i -