HomeMy WebLinkAbout27310-Z FORM NO. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Office of the Building Inspector
Town Hall
Southold, N.Y.
CERTIFICATE OF OCCUPANCY
No: Z-28516 Date: 06/13/02
THIS CERTIFIES that the building ACCESSORY
Location of Property: 6175 OREGON RD CUTCHOGUE
(HOUSE NO. ) (STREET) (HAMLET)
County Tax Map No. 473889 Section 95 Block 1 Lot 4
Subdivision Filed Map No. Lot No.
conforms substantially to the Application for Building Permit heretofore
filed in this office dated APRIL 25, 2001 pursuant to which
Building Permit No. 27310-Z dated MAY 11, 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 ROBERT SCHREIBER
(OWNER)
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A
ELECTRICAL CERTIFICATE NO. 1040817 03/21/02
PLUMBERS CERTIFICATION DATED N/A
or' ed Si4nature
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. 27310 Z Date MAY 11 , 2001
Permission is hereby granted to:
ROBERT SCHREIBER
168 OREGON ROAD
CUTCHOGUE,NY 11935
for .
CONSTRUCTION OF ACCESSORY INGROUND SWIMMING POOL IN REQUIRED
REAR YARD WITH FENCE TO CODE AS APPLIED FOR.
at premises located at 6175 OREGON RD CUTCHOGUE
County Tax Map No. 473889 Section 095 Block 0001 Lot No. 004
pursuant to application dated APRIL 25, 2001 and approved by the
Building Inspector.
Fee $ 150 . 00
Authorized Signature
COPY
Rev. 2/19/98
Form No.6 n
TOWN OF SOUTHOLD
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 Department with the following:
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 statemeri 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. Copy of Certificate of Occupancy-$25.00
4. Updated Certificate of Occupancy- $50.00
5. Temporary Certificate of Occupancy- Residential $15.00, Commercial$15.00
Date. Co � 10 '0 2--
New
New Construction: Old or Pre-existing Building: / (check one)
Location of Property: Co 1 7 5 D P_E(t q 0 N> .
House No. Street Hamlet
Owner or Owners of Property:�o l3T c rt 2 E' 1 b C-Q-
Suffolk County Tax Map No 1000, Section �,S Block z Lot
Subdivision Filed Map. Lot:
Permit No. Date of Permit. Applicant: �p p MT M• SC+4'2.1 Q E*_-
l0s-50 }0
Health Dept. Approval: Underwriters Approval: 10,4 Q 21 -7-
Planning
1 -7-Planning Board Approval: /
Request for: Temporary Certificate Final Certificate: / (check one)
Fee Submitted: $
04J � aw)
� �
C, , Applicant Signature
o �
a
5 BY THIS CERTIFICATE OF COMPLIANCE THE �5+
5 NEW YORK BOARD OF FIRE UNDERWRITERS
5
5 BUREAU OF ELECTRICITY
5 40 FULTON STREET — NEW YORK, NY 10038
5 CERTIFIES THAT
5
5 Upon the application of upon premises owned by
5
5 JOS.PETERSON ELEC. *SCHREIBER
5 85 SILVER COLT RD. 6175 OREGON ROAD
5 CUTCHOGUE, NY 11935, CUTCHOGUE, NY 11935
5
5 Located at 6175 OREGON ROAD CUTCHOGUE, NY 11935
5
5 Application Number. 1055070 Certificate Number: 1055070
5
5 Section: Block: Lot: Building Permit: BDC: NS11
5
Described as a Residential occupancy,wherein the premises electrical system consisting of
Selectrical devices and wiring,described below, located in/on the premises at:
5 Detached Garage,Outside,Pool/Spa,
5
5
5 was inspected in accordance with the National Electrical Code and the detail of the installation,as set forth below,was
5 found to be in compliance therewith on the 24th Day of May,2002.
5 Name OTY Rate Rating Circuit jype
5 5 Appliances and Accessories
Time Clock/Switch 1 0 40 Amps
5 Cj Pool/Spa Circulator Pump/Motor 1 0 1.5 H.P.
Pool/Spa Bonding 1 0
5 Wiring and Devices
5 Switch 4 0 General Purpose
5 Fixture 5 0 Pool/Spa
GFCI Circuit Breaker 2 0 20 amp Pool/Spa
5 Receptacle 1 0 GFCI
5(Swimming Pool):This certificate covers compliance at the date of inspection only. Because of unusual environments it is advisable to have
frequent test and/or repairs made by a qualified person.
5
5
5
5
5 seal
5
5 1 of 1
SThis certificate may not be altered in any way and is validated only by the presence of a raised seal at the location indicated.
5
5BY THIS CERTIFICATE OF COMPLIANCE THE
5 -1--
NEW YORK BOARD OF FIRE UNDERWRITERS
SBUREAU OF ELECTRICITY � r
40 FULTON STREET -- NEW YORK, NY 10038
C CERTIFIES THAT
5 Upon the application of upon premises owned by
JOS.PETERSON ELEC. ROBERT SCHREIBER
5 85 SILVER COLT RD. 6175 OREGON ROAD
CUTCHOGUE, NY 11935, CUTCHOGUE, NY 11935
5 Located at 6175 OREGON ROAD CUTCHOGUE, NY 11935
Application Number. 1040817 Certificate Number: 1040817
5 Section: Block: Lot: Building Permit: BDC: NS11
Described as a Residential occupancy,wherein the premises electrical system consisting of
5 electrical devices and wiring,described below, located in/on the premises at:
Detached Garage,Outside,
was inspected in accordance with the National Electrical Code and the detail of the installation,as set forth below,was
found to be in compliance therewith on the 21st Day of March,2002.
[7 Nam QTY Rate Rating Circ i im
�JJ Service
1 Phase 3W Service Rating 200 Amperes
Service Disconnect: 1 200 CB
Meters: l
5
5
5
5
5 sea,
1 of 1
This certificate may not be altered in any way and is validated only by the presence of a raised seal at the location indicated.
X73 /o
M-1802
BUILDING DEPT.
INSPECTION
[ ] FOUNDATION IST [ ] ROUGH PLBG.
[ ] FOUNDATION 2ND [ ] INSULATION
[ ] FRAMING [ FINAL /
[ ] FIREPLACE & CHIMNEY
l
R ARKS. l-- 4r jZ)
(—V&fCxjc,
DATE a INSPECTOR
�7310 �-
765-1802
BUILDING DEPT.
INSPECTION
[ ] FOUNDATION IST [ ] ROUGH PLBG.
[ ] FOUNDATION 2ND [ ] INSU TION
[ l FRAMING [ INAL
[ ] FIREPLACE & CHIMNEY
REMARKS:
4
DATE 611.- INSPECTOR
FIELD INSPECTION REPORT DATE COMMENTS-----------------------
�I
II II
e O
N
FOUNDATION ( 1ST)
II I
I I Cbn �
FOUNDATION (2ND)______ ��
=______--__-- --_==_ ____=`=_______________________________________________
�I
II jj
ROUGH FRAME h It it
V
PLUMBING
� x �
j
_=====ec=e
INSULATION PER N. Y.
STATE ENERGY —�j
CODE
IIS
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n y
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II ry
FINAL II II
----II n
ADDITIONAL C — NTS:
F-I 0
z
—_ to
{ FORM NO.3
TOWN OF SOUTHOLD
R BUILDING DEPARTMENT
TOWN HALL
SOUTHOLD,NY 11971
` - --- TEL:765-1802
BUILDING PERMIT APPLICATION CHECKLIST:
Do you have or need the following,before applying?:
Board of Health?
3 sets of Building Plans
Survey
Check
Septic Form
N.Y.S.D.E.C.
Trustees
',xamined 20 ? ""
Lpproved 200 PERMIT NO.,Q L/
hsapproved a/c t
' av�c9-
Building Inspector
APPLICATION FOR BUILDING PERMIT
Date 2061
, 20d/
INSTRUCTIONS
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 sale. 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 application.
c. The work covered by this application may not be commenced before issuance of Building Permit.
d.Wpon approval of this application, the Building Inspector will issue a Building Permit to the applicant. Such a 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
3uilding Zone Ordinance of the Town of Southold, Suffolk County,New York, and other applicable Laws, Ordinances or
tegulations, 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
Luthorized inspectors on premises and in building for necessary inspections.
�li7uK �ut.5 L r�
(Signature of applicant or name,if a corporation)
�i v c-3px 9 L'u�eNUGt+:, Ny'
(Mailing address of applicant)
')tate whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician,plumber or builder
name of owner of premises 3E2
(as on the tax roll or latest deed)
f applicant is a corporation, signature of duly authorized officer
ee"- zd4r_ CL:; Es�
(Name and title of corporate officer)
3uilders License No._ ,,G
?lumbers License No.
3lectricians License No.
Dther Trade's License No.
V.,: .^"
1. Location of land on which proposed work will be done:
6/7- 62c4cw iZl� M/177zTuC�
House Number Street Hamlet
County Tax Map No. 1000 Section 9S Block / Lot 'y
Subdivision Filed Map No. Lot
(Name)
2. State existing use and occupancy of premises and intended use and occupancy of proposed construction:
a. Existing use and occupancy �2 57o2y ?:�py:5
b. Intended use and occupancY_2 s7o/2y Ns. 4,-vTN iN/so(jl) .3 'D w4 -��n.� buL
3. Nature of work (check which applicable): New Building Addition Alteration
Repair Removal Demolition er Wor -,— �;Z_�
41-fl 4, 'Po
(Description)
4. Estimated Cost - jZ, Gyv. vv Fee
(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 may' Rear 3E, y ' Depth y7 '
Height j. , Number of Stories _�2
--BA2AJ: ;-'zcvvT Sr z' / lee"V2 SS. 2/ -DL=Pxi�l 5.Z z'
Dimensions of same structure with alterations or additions: Front Rear
Depth Height Number of Stories
8. Dimensions of entire new construction: Front :9 Rear Depth
Height Number of Stories
9. Size of lot: Front -!?w, 3(0' Rear 3cx�. vc)' Depth 3ay.yU
10. Date of Purchase Name of Former Owner
11. Zone or use district in which premises are situated I
12. Does proposed construction violate any zoning law, ordinance or regulation: ")U
13. Will lot be re-graded yes Will excess fill be removed from premises: NO
14. Names of Owner of premises7u&-? xNxf sz Address/.j75-0n,4�.. Phone No. 73z/ GsS
Name of Architect Address Phone No
Name of Contractor Address Phone No.
15. Is this property within 300 feet of a tidal wetland? *YES NO X
• IF YES, SOUTHOLD TOWN TRUSTEES PERMITS MAY BE REQUIRED
16. Provide survey, indicate scope of project, to scale, with distances to property lines.
17. If elevation at any point on property is at 10 feet of below, must provide topographical data on survey.
STATE OF NEW YORK)
SS:
COUNTY OF )
4G'6'equz�- being duly sworn, deposes and says that(s)he is the applicant
(Name of individual signing contract) above named,
(S)He is the le
(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 29-z::->
' iC
Nstgny lftgk STATHIS Signature of Applicant
NOTARY PUBLIC,State of New York
No.01ST6008173,Suffolk Courty
Term Expires June 8. Qhl
I
APPR014EDASNOTED - - - - - - - - - - - - - - - - - t
DATE: S B.P. #C2
731 �i !� f
FEE: L`6-b�
BY:
NOTIFY BUILDING DE ARTAJI-NT AT .Z
, SUBDIVISION PLAN FOLLOWING
02 9 AS C �d PI�l FOR TP!
FOLLOWING INSPc['i?ONS
1 FOUNDATION eVVO RECtl ::
ROBERT
IOT SCfi�E l FORPOURFDi�xh^RiTF p�O L a ryHw4
2. ROUGH - FRA �i(�f� R PI � �'j
3. INSULATIONDEV - �4� bl f
SI TUATE: MATTI TUCK 4. FINAL _ CONS�,�;,r=�
�/�}� u BE COMPLETE Ft)r C.O W a 4 I
7O/ N: SOUTHOLD ALL CONSTRUCTION Stiµ.' 1.1�
THE REQUIREMENTS OF TIBC: „ � 0.: uvE
;'SUFFOLK COUNTY NY STATE CONSTRUCTION & ENr,
/97 ;
/ CODES. NOT RESPONSIBLE 1 N) JNF 1
DESIGN OR CONSTRUCTION ERRG'_: I s
SURVEYED II-17-aG
AMENDED 10- y� .P
24-00,10-�O-DO 5 s� � qu 0-
R
IS UNLAWFUL
SUFFOLK COUNTY TAX # � i
'y ��
CUT CERTIFICATE �3 �,
CERTIFIED TO:
Q OCCUPANCY
ROBERT SGHREIBER "IMMEDIATELY
PEGONIG LAND TRUST �O
ao ENCLOSE POOL TO CODEUPON
o BEFORE "WATER N
) 1)
i
—f C
134'Plain Paneh(08-009) L
2.6'Moot Paeh(041116) �-F•---
1.4'Main Panel(08-016) E f a N J K J
1.90°Caner Set(08-020)
$' $' n 8' 12-Economy Braes(08-210) SIZE A 6 G D E F d H J K L
1-Steil Hardware Kit(08-204) ;W x eo• t0 45- 5-6' re' 13'V 1s'e• 7' r 6, r s•r
1-20x40=(coping 6'Radus(10-003) m mN• •a Krw .
Ci 1-90°Copog Sat(10.0041 F00$4TOD OFlgr Za 40 s e re• tr6• u e r e r r 5-r
8' 1-Ymyl t;na(see options below) TYPICAL CORNER ASSEMBLY ADJUSTABLE BRACE
t • • r—r-5-
8 Ata 6's Remove 2-(08-009)8'ponehend
8' 1408-016)4'p". Insert 1-(01-006)6'step
and 1-108.013)1'panels.
(i 8'Star Remove 2-(08.00918'pmwh and M•M,.
4' 1-(08-016)4'po el. Insert 1-(01.002)8'step
j and 2-(08-014)6'panels. n,�
e .
$ $ 8 $ CORNERS
STEEL PANEL OPTIONS
® ...
I
Replace"'plain panels(08.009)with: m
1.8'Slna1N11er pawl(08-011) PANELS
2-8'inlet panels(08-010) r o:••w
1-8'light panel(08-012)
8'Steel Step(side)Remove
8' n8• H-6:(03-605-CS),(03-605-LS),(03-605-RS) 2-(08.009)8'pawls. Insert
1-8:(03.205-(S),(03-205-LS),(03-205-RS) 1-(08-301)8'steel step,
S-14:(03.305-CS),(03-305-IS),(03-305-RS) 1{08-013)1'panel 1{08-161)
6 J,.'
d and
7� 1{0845.x1168ls14 filler pond.
VINYL LINER OPTIONS NSPI TYPE 111 1-(10083)steelstop set and 1-0"85)coop ng�Fcaner set requaed.See page 1.
8 6, r868'Steel Step(end)Renew2-(08.009)8'panels and1-(08.016)4'panel. Insert1-(08.301)8'steel6 7 x F fit, panels
2-(08.015)55po els omf
8 8 $ TOPAZ STERLING STONETITE 2408.210)Kwomy braes.
(03 6051 (03.1051 103-3051 1-(10.083)steel step coping set
and 2-00.085)caping caner
NON DIVING UNERS sets required. See page 1. Anenr•$$o..n.T b Ta• " b w ArAr$•«5- dF,=rwP 1.
NOH6(03-643) 1.8(03.243) 5-14(03.343) dgmvd b pool « mi.ro6k,0•« P W'Ir
ADDITIONAL . Ilan DOCLWIW a Foo eLUSTRATM WRPO FS ONLY car rams Pomsa,W—51e NIWIR MWE
Vicipmah FwP m.L-*.J dww"A•web•.h�d.w w.d v.m.~ FT wxTnt a 464011 es. (2191 4324731
given t0 90°point Of(OrnatT. [hM dw dlaw$Jam�w**e Fle$"d spa a d Pool «•/ q +w"-"T•« F P O O Lai R
NOTESGENERAL • • InrNu w90 Wil miniimen$bad«d$ins m d.rd pod. M .•.«"! �.po.rme a.F e..5-.»w..F.
x di.ina haaid$«dWn m b be uwd wA*n.pool$P4aw P•AmI M"en o*&ftb6 b Ar deelw/acne•wow edr The FRN-00S
I.M.«.ml di•waerm an bons Ime.umnbm on d poab. i.Sal b h•.•mwwrm bwina cagoriry d 7000 Ps.r. 7.6ca neon Jill b•7 Aon d a.wrd. owd Ar nrmdx.e•rL inwvc%on$and*•Naeand Spa 8 Ped deo4r«mneatb.Nr•e,«:wd,1«• hen•�d"&A
].1°c•b d I0'e« Mnbr'$mbwme•OW,!6r$prior b Jj"V board$« mNacb.and i$na m•nem or eeplepe d FwP The eemuuoim
bol dw•rior$P0°I a Oar 6'ob•w wmauidwp fol m&•nil•bow d paneb and bmp�d. +kiln on Are pael$. F«in$5kppraanalim � N$R m�nimun meed$�Meard hw.an «d aoplT«A/'ie normd Nv mu
S ..rwrHa,*a•n.rpa 5-w meF.wl M.o d od7731 i�7%87e obnia I Eir Aw.« pv'nd "°d �/« MAT 20'X 40'
1995 RECTANGLE 6 RADIUS
t••T•$•M IMF.Fa•T M.TM FOOW.•I!
J
IN-GROUND SWIMMING POOL WILL BE CONSTRUCTED OF STEEL WALLS SUPPORTING A
VINYL LINER THAT WILL HOLD APPROXIMMATLY 35,000 GALLONS OF WATER.
FENCE WILL BE CHAIN LINK CONSTRUCTION,4'H[GH WITH SELF CLOSING GATES THAT
WILL MEET TOWN CODES.