HomeMy WebLinkAbout25633-ZFORM NO. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Office of the Building Inspector
Town Hall
Southold, N.Y.
CERTIFICATE OF OCCUPANCY
No: Z-28513
Date: 06/13/02
THIS c~KTIFIES that the building ACCESSORY
Location of Property: 1390 COUNTRY CLUB DR CUTCHOGUE
(HOUSE NO.) (STREET) (H3kMLET)
County Tax Map No. 473889 Section 109 Block 3 Lot 2.15
Subdivision Filed Map No. __ Lot No. __
conforms substantially to the Application for Building Permit heretofore
filed in this office dated MARCH 3, 1999 pursuant to which
Building Petit No. 25633-Z dated MARCH 22, 1999
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 JAMES H & RUTH ANN M CON-NOR
(OWNER)
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL
ELECTRICAL c~KTIFICATE NO.
PLUMBERS CERTIFICATION DA'rk~3
N/A
N 493840 07/08/99
N/A
Signature
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. 25633 Z Date MARCH 22~ 1999
Permission is hereby granted to:
JAMES H CONNOR
PO BOX 77
NEW SUFFOLK~NY 11956
for :
CONSTRUCTION OF AN ACCESSORY INGROUND SWIMMING POOL WITH FENCE TO
CODE IN THE REQUIRED REAR YARD AREA AS APPLIED FOR.
at premises located at 1390
County Tax Map No. 473889 Section 109
pursuant to application dated MARCH
Building Inspector.
COUNTRY CLUB DR CUTCHOGUE
Block 0003 Lot No. 002.015
3 99 and approved by the
Fee $ 150.00
Rev. 2/19/98
This
Form No. 6
'I'OWN OF SOUTHOLD
BUILDING DEPARTMENT
TO.tN HALL
765-1802
APPLICATION FOR CERTIFICATE OF OCCUPANCY
application must be filled in by typewriter or h~k and submitted to the Building Department with the following:
For new building or new use:
l. Final survey of property with accurate location of all buildings, property lines, streets, and unusual natural or
topographic features.
Final Approval fl~om Health Dept. of water supply and sewerage-disposal (S-9 form).
3. Approval of electrical installation from Board of Fire Underwriters.
4. Sworn statement fi'om plumber certifying that the solder used in system contains less than 2/10 of 1% lead.
5. Cormnercial building, industrial building, multiple residences and similar buildings and installations, a certific
of Code Compliance from architect or engineer responsible for the building.
· 6. Submit Planning Board Approval of completed site plan requirements.
For existing buildings (prior to April 9, 1957) non-conforming uses, or buildings and "Pre-existing" land us{
t. 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. Ifa Certificate of Occupan{
is denied, the Building Inspector shall state the reasons therefor in writing to the applicant.
Fe~8
1..'Certificate of Occupancy- New dwelling $25.00, Additions to dwelling $25.00, Alterations to dwelling $25.0(
gwimming pool· $25.00, Accessory building·S25.00, Additions to accessory building $25.00, Businesses $50.0,
2. Certificate of Ocoupaney on Pre-existiag Building - $100.00
3. Photocopy of Certificate of 0ccupaney - $ 0.25
4. Updated CertificatO of Occupancy- $50.00
5. Temporary Certificate ofOcoupancy - Residential $15.00, Commercial $15.00
<°.7
New Conatmeti°n: /~X Old or Pr~-=xisfing Building:
House'~lo. Street - -
· Suffolk County Tax- Map No 1000, Section . "7 ~
Subdivision
P ermit No¢,9, ~
Health Dept. Approval:
Plannkug Board Approval:
· Request for: Temporary Certificate
Submitted: $
Fe'e
c__
Block __~ Lot ~4,.~-, i.,
Filed Map._ Lot:
DateofPermit. gttl'&~'a{,~a~ Applicant: ~'~~ Underwriters Approval:
Final Ce~ificate: ~ck one)
~~plicant si~ature - -
a~-/,q-.z-2, I5 +'~N OF SOUTHOLD PROPERTY RECORD CARD ///?~
3WNER . ' [ · I$IREET /3~'0 VILLAGE ' DIST. SUB. LOT ,~'
:O~MER ~3WNER
:s. 3// s~s.
LAND IMP.
Ioble
~dowlond
u~o Plot
N
W
VL../~ FARM
TOTAL DATE
ACR.
0
TYPE OF BUILDING
FRONTAGE ON WATER
FRONTAGE ON ROAD
DEPTH
BULKHEAD
"'-No cqo a-x-'~b 5-5-qgob
COMM. CB. MICS. Mkt. Value
REMARKS
B LLLI)JI 3 vl IT H I T
Reviewed:
Owners Name.ff'~r'~'~'
Architect/ '~ Date
Engineer: Submitted:
SCTM #:
,2.
District: 1,000 Section: ]/O 7 Block: Lot:
Single & sep~ate Requ~ed
cemfication: (Yes / NO)
Subdivision/O ~_ ~')~. ~. ~
~ame: (~~
Req.
Zoning Distlict: ~--1~'
[Lot size:
Req~
[Front Yard __ Proposed:
Project Description:
AGENCY PERMITS
ql~ ~/OO Actual:q~ al'O~--.l~8[Lotcoverage,,'~_. _. _~Proposed:
Req. Req.
[Side Yard Proposed: ] [Rear Yard __ Proposed:
REOUIRED FOR REVIEW
Suffolk County Health Dept.
New York State D.E.C.
Town Trustees
Town Zoning Board approval:
Town Planning Board approval:
Flood Plane Elevation ???
Flood Zone:
Notes:
N.A. NO
Permit
YES Number
765-1802
BUILDING DEPT.
INSPECTION
~DATE
,UGH FRAME &
PLUMBING
|SULATION PER N. Y.
STALE ENERGY
CODE
H
II #
II u
II
, II
FINAL
ADDITIONAL COI~4ENTS:
"NAP OF COUNTRY CLUB ESTATES"
FILED ZN THE OFFICE OF THE CLERK
OF SUFFOLK COUNTY ON 0CT.17, ~978
AS MAP NUMBER 6736
SUFFOLK COUNTY TAX NAP NUMBER
~000-~0900-0300-0020i5
RUTH ANN CONNOR
SURVEYED
SEPT.
~997
WETLANDS LOCATION BY SURVEYOR
SC,HD REF ¢ RJ0-97-~38
II. r E, L},- r,-, ~,,?EOE