HomeMy WebLinkAbout26665-Z FORM NO. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Office of the Building Inspector
Town Hall
Southold, N.Y.
CERTIFICATE OF OCCUPANCY
No: Z-28048 Date: 11/02/01
THIS CERTIFIES that the building ACCESSORY
Location of Property: 2200 ALDRICH LA LAUREL
(HOUSE NO.) (STREET) (HAMLET)
County Tax Map No. 473889 Section 125 Block 1 Lot 2 .21
Subdivision Filed Map No. Lot No.
conforms substantially to the Application for Building Permit heretofore
filed in this office dated JULY 18, 2000 pursuant to which
Building Permit No. 26665-Z dated JULY 24, 2000
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 ABOVE GROUND SWIMMING POOL WITH FENCE TO CODE AS APPLIED FOR.
The certificate is issued to THOMAS & DONNA LYNN WESTERMANN
(OWNER)
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A
ELECTRICAL CERTIFICATE NO. PENDING 10/26/01
PLUMBERS CERTIFICATION DATED N/A
A hor' ed Si nature
Rev. 1/81
FORM NO. 3
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)
PERMIT NO. 26665 Z Date JULY 24, 2000
Permission is hereby granted to:
THOMAS WESTERMANN
PO BOX 411
LAUREL,NY 11948
for
CONSTRUCTION OF AN ACCESSORY ABOVE GROUND SWIMMING POOL WITH FENCE
TO CODE AS APPLIED FOR.
at premises located at 2200 ALDRICH LA LAUREL
County Tax Map No. 473889 Section 125 Block 0001 Lot No. 002 . 021
pursuant to application dated JULY 18, 2000 and approved by the
Building Inspector.
Fee $ 50. 00
Authoriz 'gnature
COPY
Rev. 2/19/98
Form No. 6G
f TOWN OF SOUTHOLD
j BUILDING DEPARTMENT
TOWN HALL D `
765--1.802
APPLICATION FOR:CERTIFICATE OF OC UP Cy
A. This application must be filled in by typewriter OR in o t e uilding
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.
2.4 Final Approval ftom 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 buildin:
and installations, a certificate of Code Complianoe 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 .an(
-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.conseut 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 dwellipg $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 onPre-•existing Buildine - $100.00
3. Copy of Certificate of Occupancy -
4: Updated Certificate of Occupancy - $50.00
5: Temporary Certificate of Occupancy - Residential $15 00, C erci 1 $15.00
:Date .. . ..�. . �.. .Q.Q. .. .
New Construction: . ' Old Or Pre-existing Building: .... ..... . . . . ..
Location of Property....:L 2.a..�..I;t..��iC:h. .L.4.hf f . ... .. .. ... .. .. .. .. `-u lc Y'•.•4 .,. • • . • 1 . .. .
' House No. Street Hamlet
• Onwer or. Owners of Property,. . .:::.5?�:`a:S...a.'?:�...Y. �..�'1!^.a. .. 5./. .1/70. AlRn.11. . . . . .. .
County Talc Map No 1000, Section. .. /.. .Block. 6 a ,. Lot.*.
Subdivi.sion.. .. . ..4.: . . . 4 . . . . . . . . .. . . . . iled Map. . . . . . . . . . . .Lot. . .. . . : . . .. . . . . . . . . .
Permit No. . . . .. .� .�, . .Date Of Permit... . . ,�
Q.Q.Applicant. . . . . .. . .... . . .. ... . . . . . . . ..
Health Dept. Approval. .. . . . . . .. . . ... .. .. .. .... .Underwriters Approval. .... B. . .. ... . . . . . . . . .
Planning Board Approval.
Request for: Temporary Certificate. .. .. . . . . . . Final Certicate. . . . . . . . . . .
• tee Submitted. $. .. .',.. . ., . . . .. . . . . . ..
0qCY
C . . . . . . .. . . . . . .:. .. . . . :. . .. . . . . ... . . . . . . . ... . .
THE NEW YORK BOARD OF FIRE UNDERWRITERS PAGE 1
8085845 BUREAU OF ELECTRICITY
F 40 FULTON STREET, NEW YORK, NY 10038
Date NOVEMBER 05,2001 Application No. on file 13329701/01 H 073342
THIS CERTIFIES THAT
only the electrical equipment as described below and introduced by the applicant named on the above application number is in the premises of
THOMAS WESTERMANN, 2200 ALDRICH LANE, LAUREL, NY
in the following location; ® Basement ❑ 1st Fl. ❑ 2nd FL OUT Section Block Lot
was examined on OCTOBER 26,2001 and found to be in compliance with the National Electrical Code.
FIXTUREFIXTURES RANGES COOKING DECKS OVENS DISH WASHERS EXHAUST FANS
OUTLETS RECEPTACLES SWITCHES INCANDESCU4 FLUORESCENT OTHER AMT. K.W. AMT. K.W. AMT. K.W. AMT. K.W. AMT. I N.P.
1
DRYERS FURNACE MOTORS FUTURE APPLIANCE FEEDERS SPECIAL REC'PT.I TIME CLOCKS BELL UNIT HEATERS MULTI-OUTLET DIMMERS
SYSTEMS
AMT. K.W. OIL N.P. GAS N.P. AMT. NO. A.W.G. AMT. AMP. AMT. I AMPS. TRANS. AMT. I N.P. NO.OF FEET AMT. WATTS
1 20
SERVICE DISCONNECT NO.OF S E R V I C E
METER
AMT•
AMP. TYPE EQUIP. 1 0 2W11 0 JW S 0 JW J 0 4W NO.OF CC CORD. A.W.G. A.W.G. A.W.-6.
FER 0 OF CC.CORD. NO.OF HIAJIG Of HIARG NO.Of NEUTRALS OF NEUTRAL
J_ T_
OTHER APPARATUS:
SWIMMING POOL-1
G.F.C.Ir-1
*(SWIMMING POOL) This certificate .P
covers compliance at the date of ISS'
inspection only. Because of unusual
environments it is advisable to
Have frequent test/and or repairs
made by a qualified person.
<<< Continued on Page 2 >>>
GENERAL MANAGER
Per
This certificate must not be offered 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.
THE NEW YORK BOARD OF FIRE UNDERWRITERS PAGE 2
8085845 BUREAU OF ELECTRICITY
F 40 FULTON STREET, NEW YORK, NY 10038
Date NOVEMBER 05,2001 Application No. on file 13329701/01 H 073342
THIS CERTIFIES THAT
only the electrical equipment as described below and introduced by the applicant named on the above application number is in the premises,of
THOMAS WESTERMANN, 2200 AWRICH LANE, LAUREL, NY
in the following location; ® Basement ❑ Ist Fl. ❑ 2nd Fl. OUT Section Block Lot
was examined on OCT0 3ER 26,2001 and found to be in compliance with the National Electrical Code.
FIXTUREFIXTURES RANGES COOKING DECKS OVENS DISH WASHERS EXHAUST FANS
ounmRECEPTACLES SWITCHES INCANDESCENJ FLUORESCENT OTHER AMT. K.W. AMT. K.W. AMT. K.W. AMT. K.W. AMT. N.P.
DRYERS FURNACE MOTORS FUTURE APPLIANCE FEEDERS SPECIAL REC-PT.1 TIME CLOCKS BELL UNIT HEATERS MULTI-OUTLET DIMMERS
SYSTEMS
AMT. K.W. OIL N.P. GAS N.P. AMT. NO. A.W.G. AMT. AMP. AMT. AMPS. TRANS. AMT. I N.P. NO.OF FEET AMT. WATTS
SERVICE DISCONNECT NO.OF S E R V I C E
METER NO.OF CC COND. A.W.6. A.W.G. A.W.O.
AMT•
AMP. TYPE ECUIP. 1 TW 1 JW J 0 JW J 0�W PER a OF CC.GOND. NO.OF NI-LEG OF NI-LEO NO.OF NEUTRALS OF NEUTRAL
' Y
OTHER APPARATUS:
THOMAS WESTERMANN L
P. 0. BOX 411
LAUREL, NY, 11948 GENERAL MANAGER
11
Per
TINS cermeate 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.
765-1802
suauiNc DEPT.
INSPECTION
[ ] FOUNDATION IST [ ] ROUGH PLBG.
[ ] FOUNDATION 2ND [ ] IN TION
[ ] FRAMING [ FINAL
[ ] FIREPLACE & CHIMNEY
REMARKS:
DATE INSPECTOR
BUILDING DEPT.
INSPECTION
[ ] FOUNDATION IST [ ] ROUGH PLBG.
[ ] FOUNDATION 2ND [ ] INSULATION
[ ] FRAMING [ ] FINAL
[ ] FIREPLACE & CHIMNEY
REMARKS:
DATE 1613 � � INSPECTO
__ R u - -
j
II II I ` - ro
it
FOUNDATION ( IST) ii n -- --- -- --- - --- - - --- ) V�
II II I----
II
FOUNDATION---- -ND)
----------------
==____ ________ _______________________________________________________ 1 �b
u °
II II
II II
ROUGH FRAME & u
----------------
PLUMBING
Tr--
INSULATION
r —INSULATION PER N. Y. u H
u-- ii
STATE ENERGY i� it H
lul---- il
CODE a ii
u it
�V �y
�u u • H
It it r
ij
If
FINAL
------------
ADDITIONAL COMME
�Hd
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o �
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BOARD ON HEALTH . . . . . . . . . . . . . . .
FORM NO. 1 3 SETS OF PLANS . . . . . . . . . ,
TORN OF SOUTHOLD SURVEY
BUILDING DEPARTMENT CHECK . . . . . •
TOWN HALL SEPTIC FORM
SOUTHOLD, N.Y. 11971 DEC . .
TEL: 765-1802 TRUSTEES . . . .... . .. . ..•• • • - • •
NOTIFY: -Examined ... CALL . . . . . . • -
. ..........., �0.... I _ MAIL T0: � •� ��Z
Permit No. �`� ..�Z . . . . . . . . . . . . . . . . . . . .
Disapproved a/c .........................it1k.... ..................................
..................................
...................................... .... ..........
nn-►.r,__ • • • ........
(Buildingtor)
APPLICATION FOR BUILDING PERMIT
irll � 7 �$ d6
82000
1'
F INSTRUCTIONS
�..." �� ti mrst be armpletel filled in b
> Y y typewriter or in ink and submitted to the Building Inspector w
ate plot plan to scale. Fee according to schedule.
b. Plot plan .,location of lot and of buildings on premises, relationshipto adjoining
streets or areas, and giving a detailed description of layout of property d ia premises of public
perry
this application. P must be drawn on the diagram which is part of
c. !tie work covered by this application may not becorm�enced before issuance of Building Permit.
d. Upon approval of this application, the Building Inspector will issue 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 MALE to the Building Department for the issuance of a Building Permit
purmiant the
Building Zone Ordinance of the Town of Southold, Suffolk County, New York, and other applicable Laws, Orditnances 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, housicode, and
regulations, and to admit authorized inspectors on premises and in bu°ing
'lding for necessary bans
(Signature of applicant, or name, if a corporation)
po Aax 9W L4urle / t1no
...-"Nailing.address.of•applicant) 'I. ..
State whether applicant is owner, lessee agent architect, engineer, '
> a8 � cla
.................................
........ �.,....,general.contractor,•electrician,.plumber or builder
Name of owner of premises
.
(as on the tax roll or latest deed) .......................................... .
If applicant is a corporation, signature of duly authorized officer.
• • • •
(Name andtitleofcorporateofficer)•••••-•-
Builders License No. .........................
Plumbers License No. .........................
Electricians License No. .....................
Other Trade's License No. ....................
1. Z ? o G La(tt�
I.ncati of land on which proposed work will be done., lo!r c L 4 n
Housei.... .Z 0......8treet.... ..........
��
C �• Hamlet •�Q I,(1^ /
County Tax Map No. 1000 tion .I Z S- 7.-2 Block P
• ................ Lot ................
Subdivision .. :0., t r�' ... �'. ,*.ft Filed Map No. ..7.F,�Q k 2
(Name) ..............
2. 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 .... ................( 0
0 �- /..............................
..
3. Nature of work (check which applicable): New Wilding .......... Addition ...... iter ti /
RR�epair. ............ moval ............. Demolition ............ Other Wo .. ,aVF :j/`attlgp/
ription) /a6
4. Estimated Cost �.a.�:�o.......... fee ..............................................
(to be paid on filing this application)
5. If &selling, member of dwelling units ............ Number ofA&A.ling units on each floor ................
Ifgarage, cumber 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 .................
lleight ......................... Number of Stories ......................
Dimensions of same structure with alterations or additions: Front ............... Rear ...............
Depth .................... Heiglht .................... Itimber of Storie? ...............
8. Dimensions of entire new construction: Front ...7 7+3.q0 ?�•7............. Depth ,,,,,,,,,,,,,
Height .....................j... Numberxxof Stories .....................
9. Size of lot: Front ..6 Q . 40 Rear ................ Depth .................
10. Date of Purchase .... /
�. /.�./!.P.... Name of Former Owner ...... \.......................
Il. 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 .................... Will excess fill be removed from premises: YES NO
14. Names of Owner of premises ........................... Address .............................. Phone No. ............
Name of Architect .................................... Address .............................. Phone No. ............
IJ.ame of Contractor ................................... Address .................... ........Phone No. ............
15. Is tlhis property within 300 feet of a tidal wetland? * YES .......... NO .. ....
*IF YES, SOUIIlOiD Tad1 TIAL-11 S PMffT MAY BE W4HRED.
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.
APPROVED AS NOTED
a
"'"WED
•!A�A,�E DATE: a oo BAART�E
El vv/LOSL, �p!'Z%EI,.V.• FEE: SbON COMP 0 CODE NOTIFY BUILDINGNT AT
BEFORE •. LION 765-1802 9 AM TO 4 PM FOR THE
WATER•• FOLLOWING INSPECTIONS:
1 FOUNDATION - TWO REQUIRED
FOR POURED CONCRETE
OCCUPANCY OR 3. INSULATION FRAMING & PLUMBING
USE IS UNIL °1 '• K 4. FINAL - CONSTRUCTION
BE COMPLETE FOR C O. MUST`
ALL CONSTRUCTION SHALL MEE
WITHOUT C �F ICATE THE REQUIREMENTS OF THE N.Y..'
-ty STATE CONSTRUCTION & ENERGY
✓ CODES. NOT RESPONSIBLE FOR
DESIGN OR CONSTRUCTION ERRORS
srnlE OF ram YORK, ,r „ / ..
�L, �'S UNDERWRITERS CERTIFICATE
Wwry Or ... Ck REQUIRED
'••e..�-e �... � ..........being duly sworn, deposes and says that he is the applicant
(Nave of individual signing contract)
above named,
Ile i s tine .... ..........C'....
....................../ � 1 'l ('l ...............................................
(Contractor, agent, corporate officer., etc.)
of said owner or owners, and is drily authorized to perform or have performed the said work and to make and file this
application; that all statements contained in this application are true to the best of his knowledge and belief; and
that the work will be performed in the manner set forth in the application filed therewith.
Sworn tobeforeere this
... �.d..........d of .....:.2000..
Notary Rmblic ... ./`:. .....
OYCE M.WILKINS .... .............................
ary public,State of New York (Signature of Applicant)
No.4952246,..1.1 anaU�
Term Exp
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FINAL SURVEY 7-JULY-97
cOUNDATION LOCATION 19-JUNE-97 JOB NO 97-50 FILE NO. LAUREL ESTATES
IH! OF/6ET5 (CSE DIMENSIONS) GUARANTEES INDICiTtO HiQOh SURVEYED FOR
;HOWN HEREON FROM THE &HALL RUN OMY TO THE �V
;TRUCTURfS TO THE PROPERTY FOaTCHHAND ON $4vMBEH�LF TO• LOT NUMBER 12
NES ARE FOR A SPEC: V+. .1 .,. ._CMP4N','. �OVERNY.N'�•
;SSE AND USF
AND HCY rA. Ar_ENC-e AND .ENDING INSTI'
'F NOT NOT INTRJCEo Ta cwlcc THE AND TO trt A P OF LAUREL ESTATES E A S T� S EC. 1
eCTION FENCES. ° iUnCr: USTc[• OF riG�.
G.'♦'�iIT/C'j ,ME .;SSIGD.EES OF TME it LADING
ALlS. ►OOlS. PATIQS. '"1 NT•..•.�.. T :.Gt
RE.-IS. ADaTION 5UItDINGS INS ?U',ON •GJARAN EE; SITUATED AT LAU R EL
R ANY OTFfR ccrATRucXoN NOT i Ai`ASFERA'-:E TG T!ON^:
'.NS Till'TION: G2 4U65EGUEN'
NAUTHORIZED ALTERATION oR 0, Nfg-; TOWN OF SO U T H O L D, SUFFOLK COU N TRY; N.Y.
�DInGN TO THIS S,*VEY .S A coh{. .F THIS SLAVEY MAP NOT = 50 DATE 2- 2S-1997
JtATeON OF SECTIO^+ 7?04 ` BEARItiG THE LAND 3UR•:EYOR'S SCALE 1"
IE New Yrwr "".< :-vKArKyv iNKEC SEA: OR EMBOSS DATE 4-4-19195
.
,w ,, ,� ;_,,.•,. . -�01&E N FILED MAP NO. 787 C
�
GUARANTEED ONLY TO gi. TRA/yC,
O X MAP NO.10 0 0-12 5-1- 2.21 (REF•ONLY)DISK
a.� yay HAROLD F. TRANCH4N JR. P.C. _
LAND SURVEYOR
Y
SUCCESSOR TO WILLIAM G. METER
�9ID•. 866 WADING RIVER—MANOR RD. WADING RIVER,
NEW YORK, 11792
It Y. LIC. N
�r F C" SFO J41 516-929-4695
.