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HomeMy WebLinkAbout19765-z FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N. Y. CERTIFICATE OF OCCUPANCY No Z-20628 Date APRIL 6, 1992 THIS CERTIFIES that the building INGROUND POOLJDECKING Location of Property 14070 SOUNDVIEW AVENUE SOUTHOLD NY House No. Street Hamlet County Tax Map No. 1000 Section 54 Block 3 Lot 2 Subdivision Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated APRIL 3, 1991 pursuant to which Building Permit No. 19765-Z dated APRIL 5, 1991 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 POOL WITH DECKING AROUND POOL AS APPLIED FOR. The certificate is issued to DAVID O. PHILLIPS (owner) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A UNDERWRITERS CERTIFICATE NO. N 188702 MAY 28 1991 PLUMBERS CERTIFICATION DATED N/A ~C~ _ wilding "inspector i Rev. 1/81 108[ NO. A TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N. Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL CQMPLETION OF THE WORK AUTHORIZED) N a 1 9 7 6 5 Z Date 6~.`";`"P.... ~ 19.q l.. Permission is hereby granted to: ~ 1 c ~1......~~~... :~.....~...yn~....1.1...7.. Q . ta ..~:~^.:~~....~.le??...!:Y:°J.l~:.fld:~~~.....~f7~ j...~::,Re..~::~q..j....` 1: ~.5.:"''^::~.. a premises I~ i~at ..~..~.d..7~....J..~.i?~^~ilV..A5f4.s1.....1.ZG.U.:4.........lrr!.:c:!?~-:..... . .g County Tax Map No. 1000 Section ......fl.~~:T:...... Black Lot No... ~..~a:........... ' pursuant to application dated 19..5..., and approved by the Building Ingspector. u Fee s,~!.q.:s~... Building Inspector e Rev. 6/30/80 ~u1'?~l" ~ 7-y~ ~ Form No. 6 ~ ~ ~y? L.~a„mLJ'\V/ t'r?,~f ~ 1f t,c-l~ jJ ao/ To~~ of souTHOL~ ~ qpR - $ ~ 4 BUILDING DEPARTMENT ; ~.Q,~. ) t{ Orb a'`~"~ TOWN HALL 6LD=a. t)EYT. y " 1!~ 76s-lso2 s®w~ ~F suu ~~n~ APPLICATION FOR CERTIFICATE OP 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, Ap~roval of electrical installation from Board of Pire Underwriters. 4. Sworn statement from plumber certifying that the solder used in system contains less than 2/10 of 17 lead. S. 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. r B, For existing buildings (prior to April 9, 19x7) uon-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 $2x.00, Additions to dwelling $2x.00, Alterations to dwelling $25.00, Swimming pool $25.00, Accessory building $25.00, Additions to accessory building $2x.00. Businesses $x0.00. 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 $15.0`0, Commercial $15.00 Date t",~,~ `~Z New Construction~Qp.~:.... Old Or Pre-existing Building.........~ Locatior, of Property.~:~Q`}fi2......So:sc~a~..~-w. ~~•z............s.?~e4a.C°T~4~.~ . House No.' Street Hamlet Onwer or Owners of Property.. Q~?; ,~.5 . County Tax Map No 1000,`Section...~;-a,;,,,,,Block.....~,.........Lot.,.~c:...... Subdivision~F':~:~+?4©~+..~.U~O~~,S.....\\. ...Filed Map.~b"1,~....Lot...r~ Permit No, ~~:'~.1.~.~,Z,..Date Of Permit..~\5\~,'~,,,,,Applicant Health Dept. Approval ..........................Underwriters Approval..................,...... Planning Board Approval ' Request for: Temporary Certificate........... Final Certicate „ I'ee Submitted: $..oC.Se~Q,,,,,,,,,,,,,,,,,,, r ~~~z . ~ APPLICANT INSPECTORS .r ~~r,,_ t- Victor Lessard F-.~~Jta=O(;~~~a,., Principal Building Inspector ,Q~\; ~ Curtis Horton i-:~ " SCOTT L. HARRIS, Supervisor Senior Building Inspectrn ~ v~ w Southold Town Hall Thomas Fisher ; Building Inspector i ' P.O. Box 1179, 53095 Main Road Gary Fish '{°/'J . 1 Southold, New York 11971 Building Inspectrn K ~ ~ ~ ~ Fax (516) 765-1823 Vincent R. Wieczorek ~~w Telephone (516) 765-1800 Ordinance Inspector Robert Fisher Assistant Fire Inspector OFFICE OF BUILDING INSPECTOR Telephone (516) 765-1802 TOWN OF SOUTHOLD APRIL 1, 1992 SWIM KING POOLS, INC. 471 RTE 25-A ROCKY POINT, NY 11778 RE: MR. MRS. DAVID PHILLIPS To Whom This May Concern: We are unable to complete your Certificate of Occupancy because of the following reasons: xxx An application'for Certificate of Occupancy is not on file. (Enclosed) No Underwriters Certificate on file. xxx The check is 1~~~Il~not on file.) $25.00 No Health Department Approval on file. No final inspection has been made. No Plumber Solder Certificate on file. (All permits involving plumbing being issued after April 1, 1984). BUILDING PERMIT # 19765-Z Please contact our office on this matter. Thank you for cooperation. SOUTHOLD TOWN BUILDING DEPT. CC: MR. MSS. DAVID PHILLIPS THE NEW YORK BOARD OF FIRE UNDERWRITERS ` s 'P'Olr>O'~3 BUREAU OF ELEGTRIGITY 85 JOHN STREET, NEW YORK, N W YORK 0038 r~l~~! :<i , r13ha ~~~3~fl~~t~~at r~ ~.iFSSrcl2 Date Application No. on file THIS CERTIFIES THAT only the electrical equipment as deacri6ed 6eloto and introduced 6y the oppficant named on Lhe shove application numher in the premiaea of P'H~tLJ,~S"S, 'i.f9U'Tf) SlSltt~l6V11+;W AVf;Nk)'h:. if7i@1'Sib6.Pr. PLY, t7t)'3' in thefollotcing facottar}}> .~i~IQp3a~ment ? fst Fl. ? 2nd FY, Section Block Lot Loos exmnined mr I~At~ and fowed to 6e in coneplianve u~irh the requirerrr,ents of this Roard. FIXTURE ECEPTACLE$ SWITCHES FIXTURES RANGES COOKING DECKS OVENS DISH WASHERS EXHAUST FANS OUTLETS INCANDESCENT RUOAESCENi OTNER PMT. K W AMT. K,W PMT KW AMi K. W AMT H P f ) ) DRYERS FURNACE MOTORS FUTURE APPLIANCE FEEDERS SPECIAL REC'PT TIME CLOCKS gEll UNIT HEATERS MULTI-OUTLET DIMMERS SYSTEMS AMT K. W OR M. P GAS N. P AMT. NO A W. G AMi AMP. AMi AMPS TRANS. AMi N P. NO. OF FEET AMi WAiiS 1 4 f3 I~ SERVICE DISCONNECT NO.OF S E R V I C E METER NO OF CC. COND. A W G A W. G. A W G. AMi AMP. TYPE EOUIp. 1,9' ]W I ,e' 3W ~ $ 3W 3 q aw pER $ Of CC COND NO OF HI-LEG Of HbLEG NO Of NEUTRALS OF NEUTRAL I OTHER APPARATUS: y y :iStll$lI'€.V.1dl"r 1PQCtiI^"! ST'fii:7PL RFC73P'fP't<'Li{:i '!_-,?(lPP1P1f±N'f a-.2 *(SW7:MPI7YVC, FQ(Ifl} `hfr%n !'f.•r4,'L1:'f<,':Y't~ CUVt?1"LS C07R~)-118k1 c.'N di: 4:~~1(T C3, A't t~ f1;P isa&Tt"s=f~i<>n. Tin.Sy 17s~CattEe e,t unusua~d. F,nv~r.UnnltauY.s 1. f' is 24v:i.t;ala7,~ t<T 1»Tr~e Pri:queTAt t,o-~s{. anrlfnl: Tc~g>A,iTs ma+1c~ by i+ yual,i,Pisd ~1?rsulz. C/~l~-~~ B`ANK'S P:G1St"t'k[~C f, 7.C°,#;;E"75-F ' '1 ~'t Sffi;'yl~ pAS`('itRr~ tt)} GENERAL MANAGER SE'"I'AtJRi^t'i~, avY, i'l"1;i3 Perk t This certificate must not be altered in any manner; return to the office of the Board if incorrect. Inspectors may fDe identified by their credentials. COPY FOR BUILDING DEPARTMENT. THIS COPY OF CERTIFICATE MUST NOT BE ALTERED IN ANY MANNER. ~ 4~ b}~ ~ F s ~ APR ~ l99i ~ ' i ~ , d . ~ ~~.~wv~e ~ . ~ !'a { _ ~ .r-- - ~ i ~ , ~ ~ f ~f ~ { ~ I ~ I~~ ~ ~ ~ . } i L,. ~ ~ I...~ C....~ i ~ I ~ IN ~ i i i ; I b\J i i i ~ i . I ~1 ~ ~ i.. .i.,, .L , I ~ ~ . i~. r d 1..._ i ~ . ~ i. ~ I I I' j.... j ~ a ~ ~ ~ ~ ~ ~i ~ h x...... j i 1 1.. i,~ ~ 1 I~~ ~ t i y- h A L....i.... i I i I E, .,,f iF-~--''J3---~+ i f, ..j .,.....1._...~_......., ~ ..G , ~ , . , . ~ . a ::E . ~ ; i I ~ ~ ~ ~ _W.w. . 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Y. • • STATE ENERGY CODE z } 31 z 4. ~ H FI;JAL G °s z ADDITIOPIAL COMMENTS: ~ x . . . ri ' x ~ H 9 _ ~ H ~ H ~r z ~x a • ~ H ,^Y x C1 q ro H t i,~ e w da... rc.zt zi.+~ u,~. rS±~ti. ,~,..o~:di -a,.... ,a-jn,$aa~es-. x;'a.....,,.~"W.,mda-swaeavaw~a.ar5„k~,_z¢w:~tvra. "A~~~nb~auc3~Si#4i~.~i~..a1~`m^'c--".. I BOARD OF HEALTH ~ 3 SETS OF PLANS ~ FORMNO.1 SURVEY .i icryl TOWN OF SOUTHOLD CHECK - k~ BUILDING DEPARTMENT SEPTIC FORM TOWN HALL ®LO'` SOUTHOLD, N.Y. 11971 NOTIFY CbF ; ,i R7 r,_7GWN A ~.n~ ~ TEL.: 765.1802 CALL . i MAIL T0: Examined ...w. 9 5.... 191. Permit No.~ 97~~~. Approved 19, Disapproved a/c , ..1.1`:...... I (Building Inspector) APPLICATION FOR BUILDING PERMIT I Date 19 . I~ INSTRUCTIONS a. This application must be completely filled in by typewriter 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 pf lot and of buildings on premises, relationship to adjoining premises or public streets or areas, and giving a detailed desc;iption of layout of property must be drawn on the diagram which is part of this appli- cation. c. The work covered by this application may not be commenced before issuance of Building Permit. d. Upon appro al of this application, the Building Inspector will issued a Building Permit to the applicant. Such permit shall be kept on the~pl"'ise~r~i~i2~1~3~.,i~spection throughout the work. e. No building s~ia11'~b~~d$u~a~ used in whole or in part for' any, pu poke whatever until a Certificate of Occupancy shall have been granf~$€b1s ~B,; dy]p sector. ~ ""~~~~%~=•z*~'s " ~ ~ t5 APPLICATION I~'~~~?~3~I1~1to the Building Department +l°4 B~f3e~ja uilding Permit pursuant to the Building Zone Ordinance of the Town of Southold, Suffolk County, N - ther 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 admit authorized ins ectors on reitsises a nd in building for necessary inspections. P P ' (Signature of applicant, or name, ~f a corporation) (Mailing address of applicant) /~Y State whether applicant is owner,~,lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. ~IjO.4c1YJ./.............................................................. p ~.l/ Name of owner of remises ~~1/~/F~.S . (as on the tax roll or latest deed) If applicant is a corporation, signature of duly authorized officer. ...........................I' (Name and title of corpoFate officer) ALL CONTRACTOR'S MUSTI,BE SUFFOLK COUNTY LICENSED Builder's License No. .......'i. GrO.~. Plumber's Licensela'dl~~) tl~~ Electrician's License No. ....~,..G>~ ~P. ~5.~..... Other Trade's License No. ...I! . . . . . 1. Location of land on which prop~sed work will be done . . /...o ~ .U . tl/j 1;,1~~P.e~ ..,~v~........'....S,.~clDy~ dl.c.~ . House Nwnber I ~S/treet Hamlet County Tax Map~~N)) o. 10~0/0 Section C~ S . , , Block .......Jd.......... Lot , . Subdivision , ..!tll~.r?'./,lG+~~d.~ ~.~.D`Qf`?.~... Fled Map No. Lot S... . (Name) 2. State existing use and occupancy of pr~,e~m+ises and/intended lise and occupancy of proposed construction: a. Existing use and occupancy .I~,..../.~,k'S l sl-P//•G,~2 . / ~ b. Intended use and occupancy I. 18~ .~t/~. l~dll.(.J. t1... ~GlJ!~'Y?,{l J.~~. y' . ,Qd~.. ~/~qC~-. ~d ed~l.e, iy~'a8 ^-~oo~ ,~je~/~..~ ~P~/C~i/~ RI'p~A?/~Su~~rn~~1/~ V 1 3. Natur~of work (check which applicable): New Building , Addition Alteration . Repair' Removal , Demolition Other Work . . !8'~3~ /n q/~ad~~( S~/mI-n~/!q ~ ~ / X r~-8' (JJ6dc~ .Pc~/G ~ escri Eton ~ P ) / ~Pc•/G ~Y /'dJ/1 ~ ~dd / ~ 4. Estimated Cost d. d Fee . ` (to ba paid 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 busittess, commercial or mixed occupancy, specify nature and extent of eacfi type of use . 7. 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 . - Dimensions of entire new constmction: Front : Rear Depth . Height ...............Number of Stories........................................................ 9. Size of]ot:Front Rear........'.............. Depth 10. Date of Purchase .............................Name of Former Owner . 1 1. Zone or usa district in which premises are situated . 12. Does proposed construction violate any zoning law, ordinance or regulation : . 13. Will lot be regraded ............................Will excess fill be removed from premises: Yes No 14. Name of Owner of premises ....................Address ...................Phone No............... . Name of Architect ...........................Address ...................Phone No................ . Name of Contractor ..........................Address ....:..............Phone No............... . 15. Is this property located within 300 feetyof a tiidal wetland? *Yes No *If yes, Southold Town Trustees PermitPLO"1' DIAGKAMed. ' Locate clearly and distinctly all buildings, whether existing or proposed, and, indicate al] 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. MEDIATELY'" ~a ~ APPR UE A~ ~4(1TE1~ FEE: ~ •~Zi RY _~G%G~.... . AC~~.IP~~ 9bs No~f9FV ~i.s9Lp~NG D~:PA~Tn~~.w~r ~~;r' USA W ~,~~~~.~~x~;~~",~~ ~6e~-1Rt72 ;-a Anr rc, ~ ~=0~9 1~saE ,A ~ ~ Fal~oti~rrsue sr~~~cc-rt~nsix u94T~~~ ~~.'x'~~~~.~t~,~;,~, v. Fot1ND~rsa~+ ntucsc;~c~s3l~~rl OF QCC~p~d~~~;~ FQR Ut~uR~:I~ cot~c~ETI: 2. Rn~ltas-i - FRAnn9~;c~ 1~ 1~~_Un~9s~NC~ . 9NSULATICIN 4. F91ti1AL - ~;C3PdSTRUGTIQN tVlUST t3E f'C?MPLETE FOR t;.U ALL CC}Nea'TRUI:T4ON SHALL IVlEET THE RECiUiREdUlENTS OP THE N.Y, S7ATF. CC7NSTRUCT9ON F4 ENERGY CODES. P~[aT RESPONSIBl.9s FL3R DESIGN t?R CONSTRUCTIt']N ERRt3RS STATE OF NEWxo UNDER4VRl7fRSl~RTlACA7E COUNTY OF ..Jf~:~l. G//~-:..,... S'S REQWREp ~aJ~ d ~h~ S being duly sworn, deposes and says that he is the applicant (Natne of individual signing contract) above named. He is the ................Q G(~/~-el~,.......:....................................................... (Contract;or., agent, corporate officer, etc.) of said owner or owners, and is duly authorized to perform or have performed the said wgrk and to make and file this application; that all statements contained in this application are true to the best of hi~4cnowledge and belief; and that the work will be performed in the manner set forth in the application filed therewith. Swom to before me this , ~ ~ pp Notary Public, .........`~:~~~(~~--.vv............ 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