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27758-Z
FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No: Z-28520 Date: 06/14/02 THIS CERTIFIES that the building ACCESSORY Location of Property: 1560 ORCHARD ST ORIENT (HOUSE NO. ) (STREET) (HAMLET) County Tax Map No. 473889 Section 25 Block 5 Lot 1 Subdivision Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated OCTOBER 2, 2001 pursuant to which Building Permit No. 27758-Z dated OCTOBER 5, 2001 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 FENCE TO CODE AS APPLIED FOR. The certificate is issued to MARGARET SMILOW & YAO TAKAMI (OWNER) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A ELECTRICAL CERTIFICATE NO. 57484 12/11/01 PLUMBERS CERTIFICATION DATED N/A Aut rize Signature Rev. 1/81 Form No.6 TOWN OF SOUTHOLD BUILDING DEPARTMENT ��—R-- r� --- TOWN HALL 765-1802 r i � .; 14 APPLICATION FOR CERTIFICATE OF OCCUP.4�)"1 This application must be filled in by typewriter or ink and submitted to the Building Dpartm,, ti4o1,1� l ding: A. 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 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. 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. 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. J(4 0. -.e' /ql 20v2_ New Construction: Old or Pre-existing Building: (check one) Location of Property: D R Gg-+kb S 0 fZ h5—AF House No. Street �" Hamlet Owner or Owners of Property: k�}✓( FT P �7W/�mrC Suffolk County Tax Map No 1000, Section D 2 S Block O e n Lot 6: B Subdivision Filed Map. Lot: Permit No. ���^� Date of Permit. Applicant: Health Dept. Approval: Underwriters Approval: Planning Board Approval: Request for: Temporary Certificate Final Certificate (check one) Fee Submitt&00_ � 47-1 B`D ( / j�7 I Applichrit Signature - 1 '1 Electrical Inspection Certificate Date Electrical Inspection Service, Inc. Application# 12/11/01 375 Dunton Avenue 57484 East Patchogue, New York 11772 (631)286-6642 Issued to: Margie Smilow _ Street: 1560 Orchard St. Village: Orient Zip:11957 Town:Southold Section: Block: Lot: Introduced by: James T. Ridge (L) Lic.# 1895-E was examined and found to be in compliance with the Nat/anal Electrical Code ❑ Commercial [INV Defects W Pool ❑lstF/oor ❑Indoor El Basement ❑ Hot Tub © Residential ❑ Det. Garage ❑Attic ❑2nd Floor ❑Outdoor ❑ Addition ❑Survey Switches Receptacles Fixtures GFI Heaters A/C Fans ' 2 3 1 Dishwasher Washer/Amp Dryer/Amp Oven Range/Amp Garbage Disposal Furnace Oil Gas Circulator Smoke Detector Bell Transformer Meter Amps Phase UG/OH Telephone Television Carbon Monoxide ❑! ❑ Other Equipment: Buil "nit# Hugo S. Surdi President Rough Inspection: Inspector: Quentin Reynolds Final Inspection: 12/11/01 Inspector: Quentin Reynolds This certificate must not be altered in any manner.Inspectors may be identified by their credentials f c, TOWN OF SOUTHOLD PROPERTY RECORD CARD ce _ OWNER STREET 1560 VILLAGE DIST.1 SUB. LOT I I Qnt . FORMtR OWNER N E ACR. 1`10� � Idon t.4 4 T ! ff S W TYPE OF BUILDING I� RES.- SEAS. VL. FARM COMM. CB. MICS. Mkt. Value LAND IMP. TOTAL DgATE� j REMARKS 1600 /!o a Tillable FRONTAGE ON WATER Woodland FRONTAGE ON ROAD E Meadowland q17 �¢ �!� 6 7 DEPTH Aoo ' House Plot 1600 1 6 BULKHEAD Total Q ■■■■■■■■■■■■■■■■ ■■■ - - ■■■■■■■� I!1� 1■■■■■ ■■■ ■■■■■■NIIISMA■M■■■■■■■ - ■■■■■■■U■■■■MI■■■■■■ ■■■■■■ ■■■■■■■ ■■■■■ FoundatiorMAE HOW Rooms 1st Floor -'Zvr �TT r-(�Tr Applicant/ Date Owners Name: -," 1 a c Reviewed: O o Architect/ Date Cngineer: Submitted: /O O/ SCTM #: District: 1 000 SecQcin: 02-5- Block: 5 Lot: Project n Subdivision Location: /,rL o �rtJ�d.-ail �0'/ �� Nance: Sin&le&separate Required certification: (Yes/No) A O s Rcq. Req. . /ailing.Dislrice 11,0(size: Actua ` I (Lot coverage�Propnsed Rcq. Rcq. r �" / Req. (front Yard Proposed:_J (Side Yard Proposed: _) [Rear Yard 0 Proposed. 4% Project Description: l5 7P AGENCU ERMITS Permit �UIRED FOR REVIEW Number Suffolk County Health'Dept. f New York State D. E. C. Town Trustees Town Zoning Board approval: Town Planning Board approval: Flood Plane Elevation??? Flood Zane: I�To tes• � J( -- [� 1 � ✓ �� . 0 7-7 765-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION IST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] INS ATION [ ] FRAMING [ INAL [ ] FIREPLACE & CHIMNEY REMARKS. R-oi d' C� ��� DATE INSPECTO FIELD SaxINSPECTION REPORT - DATE COMriENTS e=ae=a.=ca=ems . • _ -------- -----__=���xxxaaaa=maeeasaceavcxax FOUNDATION ( IST) q FOONDATIONc (2ND) BOUGH FRAME & o C/) PLUMBING C INSULATION PER N. Y. STATE ENERGY ? CODE FINAL J ::-n .ADDITIONAL COMMENTS: �E f� S o N � c lrj I n - - BOARD OF HEALTH . . . FORM NO. 1 3 SETS OF PLANS . . . . . . TOWN OF SOUTHOLD SURVEY � _ _ BUILDING DEPARTMENT CHECK . . aa�O`0, , . , , TOWN HALL SEPTIC F0RN _ . . . . . . . . . . SOUTHOLD, N.Y. 11971 TEL.: 765-1802 NOT i FY s Examined .V. .r!�; 5— • CALL . . . . . _ _ _ . . . . . . . . }��C t1AIL TO: Approved . . . . ...•. S-. . . j�Permit No. . �7 . . . Disapproved a/c . . . . . . _ . . . . . . . . . . (Buildin, nspector) D APPLICATION FOR BUILDING PERMIT _ �b BLDG.OOOFdim PT INSTRUCTIONS a. This application must be completely filled in by typewriter or in ink and submitted to the Building Inspector, with sets 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 stree or areas, and giving a detailed description of layout of property must be drawn on the diagram which is part of this app 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 perm 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 Occupant 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 tt Building Zone Ordinance of the Town of Southold, Suffolk County, New York, and other applicable Laws, Ordinances c Regulations, for the construction of buildings, additions or alterations, or for removal or demolition, as herein describes The applicant agrees to comply with-all applicable laws, ordinances, building code, housing code, and regulations, and t admit authorized inspectors on premises and in building for necessary inspect• s. "IMMEDIATELY" �. .:`.� . . . . . . . . . . . . . . . . . . . ENCLOSE POOL TO CODE (Sign a of applicant, or name, if a corporation) UPON COMPLETION /� BEFORE"WATER" 17b.. . . . . Uu� l . .Ru (Mailing address of applicant) E T 6T State whether applicant is owner, lesseeOC jj.A , agent, architect, engineer, general contraC or a piogiber or builder, Name of owner of premises . . r2 yY4 j l-�� e► A. � . . {as on the tax roll or latest d If applicant is a c p ration, signature of duly authorized officer. _ NO IFY BUILDING DEPA AT . . . . .. . ^!�' OCCUPANCY 0'R '11114802FOL19 AM TO 4NM FOR THE (Iv an title of corp//orate officer) USE IS UNLAWFUL 1. FOUNDATION • TWO REQUIRED Builder License No. 'C �.7.tP. �� 06FORPOUREDCONCRETE ' / . . . . . . . .�.1ju T CERTIFICATE ROUGH . FRAMING A PLUMBING Plumber's License No. . . � � 4c;) OF OCCUPANCY a INsuw m {� 4 FINAL • CONSTRUCTION MUST Eiectricia;�'; License No. . . . �.C7. ./. • BE COMPLETE FOR C.O. • • ALL CONSTRUCTION SHALL MEET UNDERWRITERS CERTIFICATE THE REQUIREMENTS OF THE N Other Trade's License No. .Y. REQUIRED STATE CONSTRUCTION A ENERGY CODES, NOT RESPONSIBLE FOR 1. Location of land on which proposed work will be done. . . . . . . . . . . . . . . . . . DESiGN OR T U i /-� /� /� j/� ,o .�4lr$. R. �lQM.�Ri1Q8S. . c� �Y �. . . . . . . . . . . . . dL_ d. � r . . . . . . . . . . . . . . . . . . . . 12.1 .Ic?� �... ., house Number Strcet _ Hamlet ,. County Tax Map No. 1000 Section . . . :. .::5 . . . . . . . Block . . . . . . .� } Subdivision .►.LIA� 4. . . .I((C'y� . . jQ� Filcd Map No. . .�.Q.-T.�� Lot . . . l . . . . . . . . . . . (Name 1 State existing use and occupancy of Premises and intended use and occupancy of proposed construction`fJ . a. Existing use and occupancy . . .�eCb—A• b. Intended use and occupancy ("` t� •�. ,�, , • pe e�0.�. �e SO y -3. Nature of work (check which applicable): New Building . . . . . Addition . . . . . . . . . . Alteration Repair . . . . . . . . . . . . . . Removal . . . . . . . . . . . . . . Demolition th R l Y '^ .. .. L . +u l: . p � I b(Description) . . 4. Estimated Cost . . b'C3-U. . . . . . . . Fe(e�. . ... . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . (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 . . . . . . . . . . 6. If business, commercial or mixed occupancy, specify nature'and extent of.each type•of use. . . . . . . . . . . 7. Dimensions of existing structures,if any: Front . . . . . . . . . . .. . : . . ' • . • • • Height . Number of Stories . . . . . Rear Depth . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . _ _ Dimensions of same structure.with alterations or addi. tions: Front Depth . . . . . . . . . . . . . . . . . Rear . . . . . . . . . . . . . . . . . . Height . . . . . . . . . .. . . Number of Stories . 8. Dimensions of entire new construction: Front . Rear . Depth Height . . . ; . . . . . Number of Stories . • ' • ' • ' `:: Size of tut: Front �. . . . . . . Rear , .�30, :�� D'epth SQ.._.f.Q �P:. . 11. Zone or use district in which Name of Former Ownpr` ._. ~ ' 10. Date of Purchase . . • . • premises are situated . . . . . . . . . . . . . . . . . . . . S + t . . . . , . , . . , , • • • • • • .12. Does proposed construction violate any zoning law, ordinance or regulation: .IQ 13. Will lot be re-raded . . Will excess fill be reritove psemases Yes 14. Name of Owner of premises 9f:1' Pr q•J, `l h o w �_1`IQ . . Address JIP4. YlC �hor�eio,-.,> Name of Architect . Address . Phone No. Name of Contractor.TO!' :}Q r+�(�r- ,I�o� Q� , • Address 7.19 QQ $ :.7 : 15. Is this C t property within 300 feet of a tidal wetland? *Yes No. . . . . *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. OY ZA=911A z, " sl 1VA 1A CT IWA R Sl',; 'T ♦/�!� p�{y y Y jE//y���l w%.y�.#V+iSay:..1�5� (p' .r' :3 �r� 0 • Try+ .'31 i�1k�,���;1,1 t.•7 � i• „<. .4i� i' . 8yM2#t� S �+�!{'�/�lY vT 1 f +J iP^+,� � ^' •1 �:: a5¢� .. TATE OF �<., iA al ,2•, '" OUNTY �� + (Nartt c` i6ai S• ±. j . . . being duly sworn, deposes and says that he is the applicant �itYS ntract ove lamed..'' is two iAr..'�;t..� , ;� yt (Contractor, agent, corporate officer, etc.) A 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 fn this application are true to the best of his knowledge and belief;and that the )rk will be performed in the manner set forth in the application filed therewith. •orn to before me this . . . . . .(•`. . . . .. . . .day of. . . . . . �� ' tary Public, _. ) < County . . . . . CHU WANG Notary Public, State of New York r No. 01 WA6002716 " ' • • • . . . . . . . . . . . . . . . Qualified in Suffolk County (Signature. .of a lic Commission Ekpires Feb. 17,2002 PP ant). ,BOND BEAM.AND FLOOR SHALL BE - POOL DECK SHALL OE PAYED W17H MASONRY, OR " .,rIFORCED GUN ECONGRE7�GUNITEWyRH*'OF POURED IN PLACE CONCRETE ,;FTE SHALL MEETOR.IXCEED 4,000 P5.1. EXPANSION JOINT 26 DAY5.STEEL REINFORCING BARS SHALL ' ' .: - _ ..�.,... . ,.�.a .. a►;�(S..F14+LANT 15 OPnONAL) .... CONFORM TO ASTM A6M,GRADE 60. - r 6"X 6"F9057900F CERAMIC TILE WATERLEVEL 0 L,=WTER OFCE?AMICTILE " '; - ` Iid Lk •.+:: • •, - •• • Y _ IN POOL WALLS WITH A WATER DEPTH OF 5'-0"OR - L55, RE=63AR5 SHALL 3E PLACED HORIZ0N7ALLYzw �6ot �OjM AND VERTICALLY® 12"0.G .r -:' 4. IN POOL WALLS WITH A WATER DEPTH GREATER - ` ` /��/ - MINIMUM SIZE OF COPING STONE SHALL 3E 1 t1" '+ ` m o THAN 5'-OOf '; ADDITIONAL VERTICAL BARS SHALL BES 9 • THICK BY 12 WIDE � c INSERTED TO CREATE VERTICAL 3AK SPACING 0 6 O.0 7HE5E 3AR5 SHALL START r7i OM THE TOP OF - - 4"SAND BASE, WHEN NECES,51"%RY TO AID THE WALL AND SHALL BE 3EITAT THE BOTTOM TO +< �� DRA/NAGE IN SLOW.DRAINING SOIL f°a$ EMEND 24"HORIZONTALLY INTO TrlE FLOOR: POOL WALLS AND FLOOR SHALL BET'THIO AND .._ THE VERTICAL Rc 3AR5®12"�.C:5HALL 5E BENT _ ; BOND 3FAM SHALL 3E 10"WICE X 12"HIGH. AS SHOWN IN THE BOND BEAM. -- f` 4-#4 BA95 SHALL 3E SPLICED TO FORM UNL E:5 OT"HE.ZWI5E 5PF",71ED OR REQUIRED, #3 ' CONTINUOUS REINFORCING W!7;1IN BOND SEAM 3A95 SHALL 3E TYPICAL . IN rZIOR F lN15H ON GUNITE SHAI! 5= ,, NORMAL FLOOR REiNFCRCING SHALL CONSIST OF - - ZE-BAR5 PLACE?Ai K10r'7AN0' (000) TO EACH °. TROWEL✓-0N "�.fAR3LE✓UST O 7r-'EZ 9112„O C _ RAD1U5 AT IN 1=Z5EC'10N OF GvNI1 c WALLANC FLOOR YARIE;. "�� _ •'/ j C91J5HED STONE, WHEN NE_E;SAgY TO,;Z DRAINAGE IF GROUND WATEEK IS ENCGUNI Z;Z� IN r; ^• - -_ _' SLOW DRAINING SOIL G U N IT.E POOL . • b 42'ao.e. S''T�FtT i6 182 S2 1 �S CD f7 m m QIy 4Z.- 7 � 0Y F12."0.T ! > it; Pj � ! s ! Q110OL54 i `- � 2�. I ��\� J , VACAN7; LAR. I - I SUFFOLK-COI TY HEA Ifif�.pEPARTMEN SINGLE FAMILY MILY D` �pr� NO. N.D. REF. _ I. LOT NG'� DATE aCT 0 / {� ' THE ,,Lc THE SAGE DISPOSAL ND PL •ACILITIES FOR IS 2.E�EVA T LOCA IN HAVE BEEN INSY T S DEPA NT ND FOUNdTQ BE SATISF C P r .thief Of _ ewater Manag (� c�#lon ° 98� W� st 01 f 3S Z Fye �< tri _ P.IZI` �ro� ins; , t30A �� ;�? - � �#��f} ;.p'"�j'�"��','�'�9.�'•'�'"�k�r�''� �v«h NNP�7 .�;� 'a�7�.� t r. � .. �i�� - �u•�j„�a,�w why n d'A" .#' �td, F y-.t. xp a ..a mss., �.147F�.+, "a _ SUFFOLK CO.-HEALTH DEPT. APPROVAL H. S. NO. S5-5U-60 • I t STATEMENT OF INTENT THE WATER SUPPLY AND SEWAGE OISPOSA SYSTEMS FOR THIS RESIDENCE WIL CONFORM TO THE STANDARDS OF Th SUFFOLK CO. DEPT. OF HEALTH SERVICE (S) 1 APPLICANT n r r.r7D 7- SUFFOLK COUNTY DEPT. OF HEALI i� �•" moi`- I� lL'ti/: CiG- r SERVICES — FOR APPROVAL C CONSTRUCTION ONLY -- -- -----. DATE: `-• I r ( I /`f' H. S. REF. NO.. 95 SG '6O APPROVED: Hi — SUFFOLK CO. TAX MAP DESIGNATION: tEfN.. DIST. SECT. BLOCK PCL. N IUCQ 025 - . 5 t ��' Grp OWNERS ADDRESS: 30 Fr FrN AVENUE NEW YO 1214 , NY. kOOt: , 1 SCALE - 50'=1212-889- 6643. I 1 A2EA- 61,7'0 5.F 1 9 DEED: L. N/A P. J- IZDN PI FE TEST HOLE STAMP ntl �.1 TL.E TV-8�-041 E38 to tt»�*72cn-is a f i mnon of S-crion 72i_:�tM Mrr.York FCt'Sn _S508-02916 Fievation"""' co';, of thN sem"J M". rat I!•!sruv, W 64th.aw M4 ot:v n i tX bo n`.Er to b.r Vtd11t`tn!m COMM Guarso ttm r-r fw�WRl the vu^' 'IG 70 MAP OF BAYVIEW FAR�}�FILEO IN PrOW84;.C`. Nobshsgto:is L.E f11C'c. �.f'F i C:E A:, MAP NO 704 5. � t t+u�orrrm.tovtrr rtmtttel=s-ter _ _ br«n4 mcmution listed hereon e,•i 2.F f"E IL TU MEAt4 �E� LEVEL m Cannes of the brant tnsti i to rrYY.iotY;ffKrJNRIOfIi Or rjb*oqul UJ AMENDED APR-.40#1985 AMENDED JULY31,1985 N ------ SEAL AUG.41966 °F M W yo G QANTE 3D AIOKLH E[AbJIG. TQUST W hr�P`rrK Ayr Pt G yo OGS +, I r IpAA F- • ¢ a, RODERICK MAN TUYL. C. Z. ' ICE LAND SURVEYORS LAI10 :. 1 6NEir_nI���atalk i � ix p�. 4,°s�.x�� F^