HomeMy WebLinkAbout26971-Z FORM NO. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Office of the Building Inspector
Town Hall
Southold, N.Y.
CERTIFICATE OF OCCUPANCY
No: Z-28186 Date: 01/28/02
THIS CERTIFIES that the building ADDITION
Location of Property: 2300 PINE NECK RD SOUTHOLD
(HOUSE NO. ) (STREET) (HAMLET)
County Tax Map No. 473889 Section 70 Block 9 Lot 7
Subdivision Filed Map No. Lot No.
conforms substantially to the Application for Building Permit heretofore
filed in this office dated SEPTEMBER 25, 2000 pursuant to which
Building Permit No. 26971-Z dated DECEMBER 14, 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 DECK ADDITION TO AN EXISTING ONE FAMILY DWELLING AS APPLIED FOR.
The certificate is issued to GEORGE L SCHWAB III & GERALDINE L.
(OWNER)
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A
ELECTRICAL CERTIFICATE NO. N/A
PLUMBERS CERTIFICATION DATED N/A
Authorized ignature
Rev. 1/81
FORM NO. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Office of the Building Inspector
Town Hall
Southold, N.Y.
CERTIFICATE OF OCCUPANCY
No: Z-28187 Date: 01/28/02
THIS CERTIFIES that the building ADDITION
Location of Property: 2300 PINE NECK RD SOUTHOLD
(HOUSE NO. ) (STREET) (HAMLET)
County Tax Map No. 473889 Section 70 Block 9 Lot 7
Subdivision Filed Map No. Lot No.
conforms substantially to the Application for Building Permit heretofore
filed in this office dated SEPTEMBER 25, 2000 pursuant to which
Building Permit No. 26971-Z dated DECEMBER 14, 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 ALTERATION AND DECK ADDITION TO AN EXISTING ACCESSORY INGROUND
SWIMMING POOL WITH FENCE TO CODE AS APPLIED FOR.
The certificate is issued to GEORGE L SCHWAB III & GERALDINE L.
(OWNER)
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A
ELECTRICAL CERTIFICATE NO. N/A
PLUMBERS CERTIFICATION DATED N/A
Authorized S' 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. 26971 Z Date DECEMBER 14, 2000
Permission is hereby granted to :
GEORGE L SCHWAB III
2300 PINE NECK RD
SOUTHOLD,NY 11971
for
ALTERATION TO AN EXISTING ISP & ADDITION TO EXISTING SINGLE FAMILY
DWELLING AS APPLIED FOR. TWO CO' S WILL BE REQUIRED.
at premises located at 2300 PINE NECK RD SOUTHOLD
County Tax Map No. 473889 Section 070 Block 0009 Lot No. 007
pursuant to application dated SEPTEMBER 25, 2000 and approved by the
Building Inspector.
Fee $ 169 . 40
Authorize Signature
ORIGINAL
Rev. 2/19/98
TOWN OF SOUTHOLD
BUILDING DEPARTMVNT
TOWN HALL
765-1802
APPLICATION FOR CERTIFICATE OF OCCUP Cy
This application must be filled in by typewriter or ink and submitted to the Building Department with the following:
A. For new building or new use:
1. Final survey of property with accurate location of all buildings, property Iines, 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 iu 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 eadsting buildings(prior to April 9, 1957)non-conforming uses,or buildings and"pre-eidstfng"laud 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. Photocopy of Certificate of Occupancy-$0.25
4. Updated Certificate of Occupancy- $50.00
5. Temporary Certificate of Occupancy- Residential$15.00,Commercial$15.00
Date.
New Construction: Old or Pre-exis ' Building: � (check one
zzOO ti e- We ,e- & d
Location of Pro �1. � c- d
Mouse No.o.° I Street Hamlet
Owner or Owners of Property: �-�� c r /C1 h e- Z,
Suffolk County Tax Map No 1000, Secdoxt _cj Block - — Lot
Subdivision Filed Map. Lot:
Permit No. �� /f 7/ Z Date of Permit. 3 tstn?_Applicant: �d o ►
Health Dept.Approval: Underwriters Approval:
Planning Board Approval:
Request for. Temporary Certificate, Final Certificate: (check one)
Fees ubmitted: $
�►� �Sl rlic c,1L A4 pk,
O g 1 AMlicant Signature
Td Wd80:20 Z00Z bZ 'Uef 92S£ S9z T29 : 'ON XdA aNdOH ONINNdld NMOL Q'10Hinos woNj
71 f,�
765-1802
BUILDING DEPT.
INSPECTION
[ ] FOUNDATION IST [ ] ROUGH PLBG.
[ ] FOUNDATION 2ND [ ] 1 TION
1 FRAMING I
[ ] FIREPLACE CHIMNEY
REMARKS:
Lool
DATE INSPECTO
FIELD INSPECTION REPORT DATE - COMMENTS 5(_i
==xxsxa=Skxx===asxxa=axx=x�xxa==x==s==.xx�x===x=x===x==xxxcxa-xxxaaxs=a=a=.xx===xxx===xx==c
11
I II
H
FOUNDATION ( 1ST)
I�
I
FOUNDATION (2ND)
- -------------
II
n z
ROUGH FRAME & ii u O
PLUMBING II ij
n
ii
aamxxxxxxx------=.oxxxxa
INSULATION PER N. Y.
STATE ENERGY I rte'
CODE u
u w
7;7,7?,T-
Ile
II ji H �4
lo� _
II II
FINAL Amu
if 1If
1
aaaa=aaca=axaa=xxxxaxaaxs�sxx=ax � � r
ADDITIONAL COMMENTS: _
=eaaacacaxxxa=xxxx=axxxxaxxxxx=axaaxxx==axxxxasa x_-xea==x�=xxxxcxxexxxxx=xxxxxs=r-xxxxxx
AA
a
l
n
O
z
r�
b
H
v
BOARD OF HEALTH . . . . . . . . . . . .
3 SETS OF PLANS . . . . . . . . . . . .
FORM NO. 1 SURVEY . . . . . . . . . . . . . . . . . . . . .
TOWN OF SOUTHOLD CHECK
• •
BUILDING DEPARTMENT SEPTIC FORM . . . . . . . . . . . . . . . .
TOWN HALL
SOUTHOLD, N.Y. 11971 NOTIFY * X65 _ ��88
TEL.. 765.1802 CALL
� .,a�A� . . . . . . . . . . . . . . . .
Examined • . . . . . . . . MAIL TO :,
Approved . . .�?�.�a. . . . . . . .."0Q. Permit No. .?��ll1. .
Disapproved a/c . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
. . . . . . . . . . . ._. . . . . . . . ._1_� . . . . . . .
. . . . . . . . . . . . . . . . . . . . . . . . .
3 (Building Inspector)
SEP Z5 20M APPLiCAT10N FOR BUILDING PERMIT
LiaL.e . . . . . . . !. .. 'feef
INSTRUCTIONS . . ., . .
a. This application must be completely filled in by typewriter or in ink and submitted to the Buildin., Inspector, with 3
sets of plans,accurate plot pian 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
or areas, and giving a detailed description 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 approval of this application, the Building Inspector will issued 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 MADE to the Building Department for the issuance of a Building Permit pursuant to the
Buildina Zone Ordinance of the Town of Southold, Suffolk County, New York, and other 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, housinti code, and regulations, and to
admit authorized inspectors on premises and in building for necessary inspections.
. . . . . . . . . . . . . . . '61 a, i c
•(Signature or applicant, or name, if a corporation
. . . !�. ?c. . .:(\;,01,11V0V 16r Ale, .
(Mailing address of applicant)
State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder.
. . . . . . . . .Gti d. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
C n
Nameof owner of premises . . . .M. . ! . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
(as on the tax roll or latest deed)
If applicant is a corporation, signature of duly authorized officer.
. • • • • • • (Name and title of corporate officer)
Builder's License No. . .� b :, .f►, ,�. , , , , , ,
Plumber's License No. . . . . . . . . . . . . . . . . . . . . . . . .
Electrician's License No. . . . . . . . . . . . . . . . . . . . . . .
Other Trade's License No. . . . . . . . . . . . . . . . ... . . . . .
1. Location of land on which proposed work will be done;
170
house Number Street Hamlet
County Tax flap No. 1000 Section . . . . . . . . . . . . . . Bloek . . . . , , , , . ! . , , , , , , , Lot . . . . . . .7. . . . . . .
Subdivision . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Filed Alap No. Lot . . . . . . . . . . . . ... .
State existing use and occupancy of premises and intended use and Occupanc
CLy of proposed construction:
a. Existing use and occupancy . . . . . :` .. .. .. .. �.(�'. . . . C�!..
.. ,
_ tR oY ;,tdcar,� •;ai•`! •..�. .+:�1L'Ff;l�!. . . . . . . . . . . . . . . . .
b. Intended use and . . . ;�. . ... . �:. . . . . C��� ,E1 t t~Ui'c r, if.tzvt
occupancy L jt; ?i�x4 gnsj . . . . . . . . . . . . . . . . . . . .
3. Nature of work (check which applicable'): New Building . . . . . . . . . . Addition . . . . . . . . . . Alteration . . . . . . . .
Repair . . . . . . . . . . . . Removal . . . . . . . . . . . . . . Demolition . . . . . . . . . . . . . .Swi;nning pool. n . pp .•. . .
Tennis Court . . . . . . . Accessory Building. . . . . . . . . . Fence . . . . . . .Other Work: .•.�✓• l�. . .
4. Estimated Cost . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Fee . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . • .
(to be paid on filing this application)
5. If dwelling,number of dwelling units . . . I. . . . . . . . . . . Number of dwelling units on each floor . . . . . . . . . . . . . . . . .
Ifgarage. number of cars • • • • • • • • • • • • • • • • • • • . . . . . . . . . . . . . . . . . . . . . . . . • • • • • • •
6. If business, commercial or mixed occupancy, specify naturf and extent of each type of use . . . . . . . . . . . . >. . . . . . . . .
7. Dimensions of existing structures,if any: Front . . ?Q . . . . . . . Rear ?.0. . . . . . . . . Depth . . .3A . . . . . . . . . .
Height . . . . . . . . . . . . . . . Number of Stories . I. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . >a/ . . . . . . . . . . . . .
Dimensions of same structure with alterations or additions: Front . . .7Q: . . . . . . . . . . . Rea . . . . . . . . . . . . . . . . . .
Depth . . . . . . .3� . . . . . . . . . . . Height . . . . . . . . . . . . . . . . . . . . . Number of Stories . . . . . . . . . . . . . . . . . . . . .
8. Dimensions of entire new construction: Front . . . . . . . . . . . . . . . Rear . . . . . . . . . . . . . . . Depth . . . . . . . . . . . . . .
Heiglit . . . . . . . . . . . . . . . Numbelr of Stories . . . . . . . . . . . . . . . . . . . . . .
9, Size of lot: Front . . . A Q0 . . . Rear . . . .1.Qo�. . . . . . . . . . . . . . Depth . .'��0�. . . . . . . . .
10. Date of Purchase . . . .�W. .! • .� 73. . . . . . . . . . .Name of Former Owner . . . . .S�M � • • •4au!r. . . • • • • . .
11. ;gone or use district in which premises are situated . . . . . . . . . . . . . . . . . . . . . . . / . . • • • • • • • • • • • •
12. Docs proposed construction v'olate any zoning law, ordinance or regulation: . . �J.�'. • . . • • • • • • • • • • • • • • • • • • - • •.
13. Will lot be regraded . . . . . . (. . . . .Will excess fill be removed from premises: Yes . No . .
14. Name of Owner of premises . . .1. . C4 !�!�t►? . . Address 4q . r.� /!i�'C�2. �bPhone No. • -6�5 /X . . . .
Name of Architect . . . . n . . . Address . . . Phone No. . . . . . . . .
r r / ►a �S Uig!v. . . . .1.i 7 r. . e'01) rvf-le,� /9&Phone No. . .74�.: 1 M-0
Name of Contractor . . . . . .Address �.: :: � •
15 .1s this property located within 100 feet of a tidal wetland? *YES . . . .NO.�e\. .
*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.
STATE OF NEW YORK, S.S
COUNTY OF . . . . . . . . . . . . .
. . . . . . . . . . . . . . . . . a�1I! '—'-I . . . .4� T . . ``.t'� . . being duly sworn, deposes and says that he is the applicant
(Name of individual signing contract)
above named.
Heis the . . . . . . . . . . . . . . . . . . . . . C. .N'. . . . *% . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . :. .
(Contractor, agent, corporate officer, etc.)
of said owner or owners, and is duly 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 to before me this
. . . . . . . . . . . . . day of. •,�g ��
Notary Public,-,�. . . . . . •: . . •unty
ELIZABETH A STATMS
NOTARY PUBLIC,State of New York � . . . .
�' (Si-nature nt)T� �
f _
y2 xz2- 19-Of
��. Asn
'K
044
{E `N 152 3� , MAP AF LANG /10ST
sOUT"O1-0
O �Z #
IAC 53*or�� +1 J' U F f`4 L.K. CO UTIT Y,
CECT '
J, ^i,
v `
WkJ,-f2.FLOO
a
+- • - � r� YI pip i
w J 1 0 1
2 o A2,El' 19,503 IS.F `�_4A6 AC
4 3 ,
(� v SURVEYEC'-JAW,ib 19-75
Z 8 r��1�M EI�%a E;
NOV.V.2 1 z
r _Y _
J -
PL
%o
s
= r+^'"` '" c3..��. - �.,, ��� ��x-- _vi• i '^L:,. '�'� f�i� ,.,iz,,•>'°"_ 1 r a. .w�' .i.-�.€.. .s = _
BUILDING PERMIT REVIEW CHECK LIST
DATE REVIEWED: 12-11 /ad
l �
APPLICANT NAME: eo rq DATE SUBMITTED: tj /, /Ca
SCTM# --- DISTRICT: 1,000 SECTION: /";'D BLOCK:_ LOT: _
PROJECT LOCATION /
STREET: Z Soo nje �ecK Aoa,X CITY: -5r SUBDIV. NAME:
ARCHITECT/ENGINEER: o FAST TRACK: YES oR NO
SINGLE& SEPARATE CERTIFICATION-REQUIRED: YES oO OTES:
ZONING: PERMIT IMATE AMOUNT:_$ 00
ZONING DISTRICT 4 R80 AC CONFORMING: YES oR(O REQUIRED LOT SIZE: `OX SIFT.
WHERE ACTUAL LOT SIZE FROM?TAX CARD Sw ur ACTUAL LOT SIZE: ITSd3 SQFT.
Q
REQUIRED REQUIRED REQUIRED
FRONT3S'PROPOSED: SIDE YD: '/ ' PROPOSED: /o '/.,/� ' REAR: �'PROPOSED: '
LOT COVERAGE: ALLOWED:�'d % EXISTING: sf % NEW: sf % TOTAL:3?,Vsfif/%
CORNER? YES oR NO WAT ER FRONT? YES oR NO DESCRIPTION:
LOTS 40,000SF--100-24. Lot recognition. (CREATED before June 30, 1983), UNDERSIZED LOTS FROM
JAN.1997 100-25. Merger. (A nonconforming at anytime after July 1, 1983.)
PROJECT DESCRIPTION: A i �R N/D:
AGENCY PERMITS REQUIRED FOR REVIEW
NEEDE
TOWN SPETIC PERMIT: YES or
SUFFOLK COUNTY HEALTH DEPT: YES or 0, (BED #): DTE:—/—/ PERMIT#:R10-
NEW YORK STATE DEC: PRE-DEC 9/1/75 YES or
SOUTHOLD TOWN TRUSTEES: YES or
TOWN ZONING BOARD APPROVAL: YES or NQ
TOWN PLAN. BOARD APPROVAL: YES or 69)
FLOOD COMPLIANCE ZONE: PRE-FIRM 3i18i8o PANEL #: /66 FLOOD ZONE:_,
NYS ENE GY: YES O N : EGRESS:��-4 UEN --eaI GHI•
NOTES9f .r4
....��e..s/"o•� /��-3f
t tJ I / Q)NG ns e .AQ
1 G GK rS Q fJr el" O - C C- CL
FEE STRUCTURE: FOUNDATION: SF
FIRST FLOOR SF
SECOND FLR SF INIT OTHER TOTAL
Jecff TOTAL: SF FEE FEE FEE
TOT( 79 7 SF)- ( saU SF)=2g 7 SF X $ •2.6 =$ +$ _15* +$ ^ _$
of
yN '7 H rYS+3G •s,� `�x� A,a ��� I N 'RC1
/`—Circ.-I '�� �d•.(Tl/�cLl �a�e'.j i�5 �O't�1•"�_.'_ �I'I �j/
2)_ 4
.3�
� � S Ap_el"/c
�t'/r-w � 3 APPROVED AS NOTED
k -lee < DATE: /1 a d B.P.# -24 7/JL
FEE: BY
NOTIFY BUILDING DEPARTMENT AT
/// 765-1802 9 AM TO 4 PM FOR THE
FOLLOWING INSPECTIONS:
1 FOUNDATION - TWO REQUIRED
FOR POURED ETE
7/3 S �c ctai r<ll. 2 ROUGH - FRAMING NG & PLUMBING
;NSULATION
CONSTRUCTION MUST
fiJ ,(_4eA7-XA.4ce4,441LwjK
/ RF C.`;'11PLETE FOR C.O.
AL':_. <. �tUCTION SHALL MEET
TOF THE N.Y.
RU ;TION & ENERGY
R ;���+�,II�LE FOR
f3 i,rr-.j
o-4 i'ONSTRUCTION ERRORS
8'
V/ k n t
3 'aJl�or� ' t e. 5 � �` t'4�' ' 'f F. �av E C: ! l• �r
�xg "IMMEDIATELY"
f*CLOSE POOL TO CODE
UPON COMPLETION
BEFORE`WATER'
vim`
it
-Solo 14
�r
)-3o pr
b I
sin r
fl �w
0.
IG7�T
?RDE 52 �OOL�
�/ tl
k� P6sr5 I x i
1
190 V&
mY S
a.•r 6
! F
6 ! 0• gi ,
I
MIS
� yy
p I �
�.
— — A
( y
l �
y q
.0
7sIXG a ^. 1
p
I