HomeMy WebLinkAbout20761-zFORM NO. 4
TOWN OF SOUTBOLD
BUILDING DEPARTMENT
Office of the Building Inspector
Town Ball
southold, N.Y.
CERTIFICATE OF OCCUPANCY
No Z-24218 Date
MARCH 15, 1996
THIS CERTIFIES that the buildin~
Location of Property 1450 SMITH ROAD
House NO.
County Tax Map No. 1000 Section 98
Subdivision
ACCESSORY
PECONIC, NEW YORK
Street
Block 3
Filed Map No.
Hamlet
Lot 24
Lot No.
conforms substantially to the Application for Building Permit heretofore
filed in this office dated J~NE 24, 1992 pursuant to which
Building Permit No. 20761-Z dated JI~NE 24, 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 INGROUND SWIMMING POOL WITH DECKADDITIONAS APPLIED FOR.
The certificate is issued to CAROL ANNESS
(owner)
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL
UNDERWRITERS CERTIFICATE NO.
PLUMBERS CERTIFICATION DATED
N/&
N--243093 -- J~LY 17, 1992
N/A
Building Inspector
Rev. 1/81
lvOR~ NO. O
?OWN OF SOUTHOLD
BUILDING D£PARTMENT
TOWN HALL
SOUTHOLD, N. Y.
BUILDING PERMIT
(THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL
COMPLETION OF THE WORK AUTHORIZED)
N~N? 20761Z
Permission is hereby granted to:
~.....~.~ ...... .~.. .....................................................
...... ~ '~. ~
,o....c..~z.~ ....... .~.~ ...... ~.-..~~ ........ ~.~.~.~.~.~......~. .....
.... /.~ ....... ~,~ ~.
~t p~emises I~ted at .......... ~ .................................................................................
Coun~ Tox Mop No. I000 Section ....~ ........ Bilk ......~ ......... Lot No .....~ ..........
pu~uant to application dat~ ....................................... , 19..~ and approv~ by the
Building Inspector.
Fee $ ........................
Rev. 6/30/80
Form No. 6
'[OWN OF 8ODTHOLD
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:
l. 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.
Sworn statement from plumber certifying that the solder used in system contains
less than 2/[0 of i% 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
"pre-existing" land uses:
i. 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
i. 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-existinK Buildine - $100.00
3. Copy of Certificate of Occupancy - $20.00
4. Updated Certificate of Occupancy - $50.00
5. Temporary Certificate of Occupancy - Residential $15.00, Commercial $15.00
Date .3r.l ..........................
~ew Co~struction ........... Old Or Pre-existing BuildiDg .................
ocation of Pro,ertl. ......
House No, Street Hamlet
Om*er or Owners o~ Property .............................
County Tax Map ~o lO00,'Section....~ ....... Block .... %~ .......... Lot....~..~. ...............
Subdivision .................................... Filed Map ............ Lot ......................
Permit ~o..~.O...7~.~.~..~.....Date Of Permit.~..~..~..~..~.I~,~...ApplicantA.~.~.~..i!!y.,~...~.~..~.~. ....
Health Dept. Approval .......................... Underwriters Approval .........................
Planning Board Approval ........................
Request for: Temporary Certificate ........... Fi~sl Oertieate, ~/
Fee Submitted:
co
APPI', [ CANT
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 8, 1996
Ms. Carol Asness
1350 Smith Road
Peconic, NY 11958
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
XX
not on file. (Enclosed)
No Underwriters Certificate on file.
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 # 20761-Z
Please contact our office on this matter.
cooperation.
Thank you for
SOUTHOLD TOWN BUILDING DEPT.
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 26, 1996
Ms. Carol Asness
1350 Smith Road
Peconic, NY 11958
Re: Building Permit ~20761-Z - (pool & deck)
Premises: 1450 Smith Road, Peconic
surf. Co. Tax Map 41000-98-3-24
During a review of our
building permit has expired,
never been issued.
files it was noted that the above
and a Certificate of Occupancy has
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.
FOU~__~DA'TION ( 1 s t )
FOUNDATION (2nd)
2.
ROUGH FRAME &
-PLUMBING
INSULATION
PER N.
STATE ENERGY
CODE
FI;;AL
ADDITIO~A'L COMMENTS
THE NEW YORK BOARD OF FIRE UNDERWRITERS
BUREAU OF ELECTRICITY
85 JOHN STREET, NEW YORK, NEW YORK 10038
Date
THIS CERTIFIES THAT
only the olectrlcal equipment ~ ~scrib~ be~w a~ intmduc~ by t~ applicant ~med on the above application number in the premises of
in the following locatlon; ~ Basement ~ Ist ~7. ~ 2nd FI. OBT Sectlo. Bilk Lot
~.s examined on ~ ~ [~ ~ [ 0 , ]. 9 ~ ~ and found to be in compllance wlth the requiretnent s ~f this Board.
ESXTUR~
OUTLETS SWITCHES
DRYERS
FIXTURES RANGES OVENS DISH WASHERS EXHAUST FANS
INCANDESCENT FLUORESCENT
OTHER
OTHER APPARATUS:
S E R
AWG
OF CC. COND,
C
NO OF HI-LEG
E
A W G NO OF NEUTRALS A W, G,
OF HI.LEG OF NEUTRAL
~'{~I~/~[N~ POOL) Tl~i.~ certificat~
covera compliance at the date
made by a qualified
GE~$EAL MANAGER
Peril ',
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 Nor BE ALTERED IN ANY MANNER.
MAE OF ARROWHEAD cOVE FILE
'~ N 07' 00'00' W
100.18'
tD
0
-4
00" E
ioo,Oo'
sMiTH ROAD
(prN~te road)
h4oo.oo'
LOo
0
*-4
I00,00' $ I0° ~3' 00'
SMITH ROAD
Cprivate road)
0
Z
1,,?,00,00'
0
%
JUN 2 4
i'
~t~O'W' ( :, ,; :,
Examined . .' ...... , 19
Approved ...... ~./f. ~.fl~. ..... 19 .~.,d~. Permit No..~.../~..//Z.
Disapproved a/c .....................................
FORM NO. 1
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN HALL
SOUTHOLD, N.Y. 11971
TEL.: 765-1802
BOARD OF HEALTII .........
3 SETS OF PLANS
SURVEY
CIIECK
SEPTIC FORN ..............
CALL .... ....
MAlL TO:
./(Building Inspector)
APPLICATION FOR BUILDING PERMIT
INSTRUCTIONS
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
~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 cbmmenced 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 apphcable Laws, Ordinances or
{egulations, for the construction of buildings, additions or alterations, or for removal or demolition, as herein described.
?lie 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 insnections
(Signature of applicant,, Of narne,~if a corporation)
(Mailing address of ~pplicant)- '
gtate whether applicant is owner, lessee, agent, architect, engineer, general contracim', eiectricianl plumber or builder.
qame of owner of premises ....... ~'~...~...Q .,~..~'.0..~ .... ./~../ff.~.'~..ff.'. ..............................
,/,~. (as on the t,ax roll or latest deed)
'fap~ corporation, sigaatcr'~duJ~, authorized officer. . '
Bmlder s License No ..........................
Plumber's License No ............... . ........
Electrician's License No .......................
Other Trade's License No ......................
Location of land on which proposed work will be done ......... 4r7.~..~ ?.~./....,~...~. ~ ...... .~.../~....d/'. .......
............... .................... ,4x 7. ,
Ilouse Number Street Hamlet
County Tax Map No. 1000 Section ...... 0.. 9.~ ....... Block ...... .(53 ........ Lot .... .~.". ~ ..........
Subdivision ..................................... Filed Map No ............... Lot ...............
(Name)
State existing use and occupancy of premises and intended use and occupancy o'f proposed construction:
a. Existing Use and occupancy ............ .~..~../~..~. ~.../~..c-
b. Intended use and occupancy ....... /k~d~ r/'~z~'/'7'"""""""""'~~
property lines. Give street and block number or descriptioh
interior or corner lot.
3. Nature of work (check which applicable): New Building .......... Addition .......... Alteration ..........
Repair .............. Rem(~val .............. Demolition .............. Other Work ......
Po y.-! O,-e_tc. - .....
.~./~.,/ O..OQ ,~ (Description)
4. Estimated Cost
(to be paid on filing this application)
5. If dwelling, number of dwelling units ............... Number of dwelling units on each floor ................
· If garage, number of cars ..... i ...................................................................
6. If business, commercial or mixeq occnpancy, specify nature and extent of each type of use .....................
7. Dimensions of existing structure~, if any: Front ............... Rear .............. Depth .............
Height ............... Number of Stories ........................................................
Dimensions of same structure wiih alterations or additions: Front ................. Rear ..................
Depth .................... i. Height ...................... Number of Stories ......................
8. Dimensions of entire new construction: Front ............... Rear ............... Depth ...............
Height .. ............. Number of Stories ........................................................
9 Size of lot: Front .....
· · .....~ .......... Rear ...................... De.pth ....................
10. Date of Purchase ......... ! · '
· . ........ Name of Former Owner ............................
11. Zone or use district in which premises are situated ........ ,~.~/.,'~.2/~/,,~ ..............................
12. Does proposed construction violate any zoning law, ordinance or regulation: ....... ~. .....................
13. Will lot be regraded ........ d'~. ................. Will excess fill be removed from premises: 4..~. No
14. Nmne of Owner of premises . i,/]:SA/~d'3' Address .. ~..~. o~ t C.~ .... Phone No. .~.j ,57...
Name of Architect ..... ~ ............... Address .................. p
..... · . hone No ................
Name of Contractor .~.: .~.4~.~.c.19..' .~..~. ......... Address ...~/.~PF2?....~q..C/f,_ ..... PhoK,~No..
Is this property within 300 feet of a tidal wetland? *Yes ........ No..<
· If yes, Southold T~wn Trustees Permit may be required.
... i PLOT DIAGRAM
Locate clearly and distinctly all Suildings, whether existing or proposed, and. indicate all set-bask dimensions from
according to deed, and show street names and indicate whether
-- APPROVED AS NOTED
OTIFY SUlLDING DEPARrMEN AT
765-1802 9 AM ~ 4 PM FOR THE
FOLLOWING INSPECTIONS: '
I, FOUNDATION ~O REQU RED
FOR POURED CONCRETE
2. ROUGH . FRAMING & PLUM lING
3, INSULATION
4. FINAL CONSTRUCTION ~'UST
C Off C.O
BE ,OMPLETE F
ALL CONSTRUCTION SHALL MEET
THF RF(~UIREMENTS OF HE NY,
STATE CONSTRUCTION ~ ENERGY
('ODES NOT RESPONSIBLE FOR
DES;!t'/iN OR CONGFRUCTIOI'~ ERRORS
(Name of individual signin
boys ~8~ed.
[e is the .......................
"IMMEDIATELY"
ENCLOSE POOL TO CODE
UPON COMPLETION
' BEFORE"WATER"
OCCUPANCY OR
,USE IS UNLAWFUL
W THOUT CERTIFICATE
UNDERWRITERS CERTIFICATE
REQUIRED
· · .~[.. ' .....being duly sworn, deposes and says that he is the applicant
contract)
(Contractor, agent, corporate officer, etc.)
f said owner or owners, and is duly at~thorized 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 selt forth in the application flied therewith.
worn to before me this
,