HomeMy WebLinkAbout27302-Z FORM NO. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Office of the Building Inspector
Town Hall
Southold, N.Y.
CERTIFICATE OF OCCUPANCY
No: Z-29502 Date: 06/09/03
THIS CERTIFIES that the building ACCESSORY
Location of Property: 715 BAY AVE MATTITUCK
(HOUSE NO. ) (STREET) (HAMLET)
County Tax Map No_ 473889 Section 143 Block 4 Lot 3
Subdivision Filed Map No_ Lot No.
conforms substantially to the Application for Building Permit heretofore
filed in this office dated MARCH 16, 2001 pursuant to which
Building Permit No. 27302-Z dated MAY 10, 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 MARTIN J & ROSE C. TARPEY
(OWNER)
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A
ELECTRICAL CERTIFICATE NO_ H-072623 08/29/01
PLUMBERS CERTIFICATION DATED N/A
horized 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. 27302 Z Date MAY 10, 2001
Permission is hereby granted to:
MARTIN J JR TARPEY
595 BAY AVNEUE
MATTITUCK,NY 11952
for
CONSTRUCTION OF INGROUND SWIMMING POOL WITH FENCE TO CODE AS
APPLIED FOR.
at premises located at 715 BAY AVE MATTITUCK
County Tax Map No. 473889 Section 143 Block 0004 Lot No. 003
pursuant to application dated MARCH 16, 2001 and approved by the
Building Inspector.
Fee $ 150 . 00
Authorized Signature
COPY
Rev. 2/19/98
Form No.6 � ..� F7
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN HALL —6
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:
I. 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 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. Certi icate o ecupancy on Pre-existing Building- $100.00
3. Copy of Certificate of Occupancy- $.25
4. Updated Certificate of Occupancy- $50.00
5. Temporary Certificate of Occupancy-Residential $15.00, Commercial $15.00
Date.
New Construction: —7 Old or Pre-existing Building:
1 ;
�_ ,' (check one)11ne
Location of Property: / S 6 CAU (- ` M tk C4
House No. St eet Hamlet
Owner or Owners of Property: ad 1O, let - �,r L —Q✓
Suffolk County Tax Map No 1000, Section 4 3 3 lock 4 Lot
Subdivision (( rFiled Map. Lot:
Permit No. C� I S —Date of Permit,�y,1� q_1-IP►p3hcant:
Health Dept. Approval:_ _Underwriters Approval:
Planning Board Approval:
Request for: Temporary Certificate Final Certificate: (check one)
Fee Submitted: $
��� Appliean nature
("Nu- � Vim. C_- --Tz),rte 0_
Ca 2 �9SoZ 1�
THE NEW YORK BOARD OF FIRE UNDERWRITERS PAGE 1
8085018 BUREAU OF ELECTRICITY
F 40 FULTON STREET, NEW YORK, NY 10038
Date AUGUST 29,2001 Application No. on jle 12979841/01 H 072623
THIS CERTIFIES THAT 11 '13&.7.-2:
only the electrical equipment as described below and introduced by the applicant named on the above application number is in the premises of
TARPEY, BAY AVENUE, MATTITUCK, NY
in the following location; ❑ Basement ❑ Ist Fl. ❑ 2nd Fl. OUT Section Block Lot
was examined on AUGUST 09,2001 and found to be in compliance with the National Electrical Code.
FIXTUREFIXTURES RANGES COOKING DECKS OVENS DISH WASHERS EXHAUST FANS
ounm RECEPTACLES SWITCHES INCANDESCEO FLUORESCENT OTHER AMT. K.W. AMT. K.W. AMT. K.W. AMT. K.W. AMT. H.P.
1 2 1
DRYERS FURNACE MOTORS FUTURE APPLIANCE FEEDERS SPECIAL REC'PT. TIME CLOCKS BELL UNIT HEATERS MULTI-OUTLET DIMMERS
SYSTEMS
AMT, K.W. OIL H.P. GAS H.P. AMT. NO. A.W.G. AMT. AMP. AMT. AMPS. TRANS. AMi. H.P. NO.OF FEET AMT. WATTS
1 20 1 40
SERVICE DISCONNECT NO.OF S E R V I C E
METER NO.OF CC GOND. A.W.G. A.W.G. A.W.G.
n
AMP. TYPE EpL►IP. 1 2w 1 t JW J t JW 3 0 IW PER 0 OF CC.COND. NO.OF HI-LEG OF NI-LEG NO.OF NEUTRALS OF NEUTRAL
- I I I 1--_ _T
OTHER APPARATUS:
SWIMMING POOL-1
G.F.C.I:-1
'(SWIMMING POOL) This certificate 1 � ✓ _
rovers compliance at the date of { 1
inspection only. Because of unusual
environments it is advisable to
Have frequent test/and or repairs
made by a qualified person.
L
<<< Continued on Page 2 >>a
GENERAL MANAGER
Per
This cerffAcate mutt 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.
THE NEW YORK BOARD OF FIRE UNDERWRITERS PAGE 2
8085018 BUREAU OF ELECTRICITY
F 40 FULTON STREET, NEW YORK, NY 10038
Date AUGUST 29,2001 /2919801/01 H 072623
Application No. on file
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
TARPEY, BAY AVENUE, MATTITUCK, NY
in the following location; ❑ Basement ❑ Ist Fl. ❑ 2nd Fl. OUT Section Block Lot
was examined on AUGUST 09,2001 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. H.P.
DRYERS FURNACE MOTORS FUTURE APPLIANCE FEEDERS SPECIAL REC'PT. TIME CLOCKS BELL UNIT HEATERS MULTI-OUTLET DIMMERS
SYSTEMS
AMT. K.W. OIL M.P. GAS N.P. AMT. NO. A.W.G. AMT, AMP. AMT. AMPS. TRANS. AMT. H.P. NO.OF FEET AMT. WATTS
SERVICE DISCONNECT NO.OF S E R V I C E
METER NO.OF CC COND. A.W.G. A.W.G. A.W.G.
AMTL,
AMP. TYPE EQUIP. 1/ZW 1/JW S/JW 3 0 4W PER a OF CC.COND. NO.OF NI•LEG OF HIAIG NO.OF NEUTRALS OF NEUTRAL
OTHER APPARATUS:
GEORGE GEDNEY L
P. 0. BOX 1464
TOP GUN ELEC. GENERAL MANAGER
SOUTHOLD, NY, 11971
Per
This certificate 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.
70-1802
BUILDING DEPT.
INSPECTION
[ ] FOUNDATION IST [ ] ROUGH PLBG.
[ ] FOUNDATION 2ND [ ;;INAL
IN ION
[ ] FRAMING [
[ ] FIREPLACE & CHIMNEY
REMARKS: O1:6QCy-�ce,
DATE ! INSPECTOR
FIELD INSPECTION REPORT DATE _ COMMENTS
FOUNDATION OST)
FOUNDATION (2ND) II I
I�JI
n
ROUGH FRAME &
---p
PLUMBING I
—II
INSULATION PER N. Y.
STATE ENERGY u
;1
CODE I ii
1
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I I H
Ile%y / 1
FINAL u iiCIE IN
a up
ADDITIONAL NTS:
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.a
t i FORM NO.3
TOWN OF SOUTHOLD
MR 6 ; ;; 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
Examined 20
Approved (2- 2066( PERMIT NO. 97330a�r--
Disapproved a/c
uildi Inspector
APPLICATION FOR BUILDING PERMIT
Date //fo 12061
INSTRUCTIONS
a. This application MUST be completely filled in by typewriter or in ink and submitted to the Building Inspector with 3
sets 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. Upon approval of this application, the Building Inspector will issue a Building Permit to the applicant. Such a 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 hate been granted by the Building Inspector .
APPLICATION IS HEREBY MADE to the Building Department for the issuance of a Building-Permit pursuant to the
Building 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, housing code, and regulations, and to admit
authorized inspectors on premises and in building for necessary inspections.
CFftTuK �ucw5 G71�
(Signature of applicant ormame,if a corporation)
(Mailing address of applicant)
State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician,plumber or builder
t4 C)
Name of owner of premises "/9,YZ7-/ tV
(as on the tax roll or latest deed)
If applicant is a corporation signa a ofd ly authorized officer
2,-, _ _ � (
'(Name and title of corporate officer)
Builders License No. i&� iG 7
Plumbers License No.
Electricians License No.
Other Trade's License No.
1. Location of land on which proposed work will be done:
-9 S 't3�W
House Number Street Hamlet
County Tax Map No. 1000 Section /`/3 Block / Lot 3
SubdivisioFiled 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 67yzy cg t1a6E
b. Intended use and occupancy z K74a,/ �u_uE,c .v
3. Nature of work (check which applicable): New Building Addition_ Alteration
Repair Removal DemolitionCher Work 'Pod-
(Description)
4. Estimated Cost___cQ ADO 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 3d Rear ZS' Depth 5-S'
Height 30' Number of Stories z
Dimensions of same structure with alterations or additions: Front Rear
Depth Height Number of Stories
8. Dimensions of entire new construction: Front Rear Depth
Height Number of Stories
9. Size of lot: Front -311, 31 ' DoOth 21-22o '
10. Date of Purchase Name of Former Owner
11. Zone or use district in which premises are situated
12. Does proposed construction violate any zoning law, ordinance or regulation: Ny '
13. Will lot be re-graded tr'e5 Will excess fill be removed from premises: ejS�NO
14. Names of Owner of premises mW;>,A) ;W#z'Pi5' Address 6-�s 27,4k. A6e,, .hone No. 25 - 5p5'7
Name of Architect Address Phone No
Name of Contractor n4i;%A� Txels ayr' -, Addresses -eLk 9 etic."&,ePhoneNo. 73v-26/.S
15. Is this property within 300 feet of a tidal wetland? *YES NO Y—
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)
S:
COUNTY O
17A�174�ltl being duly swom, deposes and says that(s)he is the applicant
(Name of individual signing contract)above named,
(S)He is the /_U.C172/�C7o
(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 fore me this
ay of 2
�+� {gam,, Signature f Applicant
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Qualified in Suffolk Courr��Y���
rrmmission Exottes Dec.S,r,�4
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