HomeMy WebLinkAbout17140-z FORM NO. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Office of the Building Inspector
Town Hall
Southold, N.Y.
CERTIFICATE OF OCCUPANCY
No 219783 Date MARCH ll, 1991
TAIS CERTIFIES that the building OUTSIDE SPA (HOT TUB)
Location of Property 8335 MAIN ROAD EAST MARION
House No. Street Hamlet
County Tax Map No. 1000 Section 31 Block 02 Lot 32.1
Subdivision Filed Map No. Lot No.
conforms substantially to the Application for Building Permit heretofore
Filed in this office dated JUNE 16, 1988 pursuant to which
Building Permit No. 171402 dated JUNE 21, 1988
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 OUTSIDE SPA INSTALLATION (HOT TUB)
The certificate is issued to DONNA IGLESIAS
(owner)
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A
UNDERWRITERS CERTIFICATE N0. N043413 NOV. 2, 1988
PLUMBERS CERTIFICATION DATED N/A
11~~--~~c~,.
Building spector
Rev. 1/81
Fosai xo. s
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN HALL
SOUTHOLD, N. Y.
BUILDING PERMIT
CfHIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL
COMPLETION OF THE WORK AUTHORIZED)
N _ 01714 0 Z Date .
Permission is hereby gronted tto~~:
~
3. S . `
I . . . . .
MA.. ~ •`~..:.....J..1..9..3..5~.
...................t.-...............................
to ...~;e?!':^.-9/.!h-exc~":...4^.~?....41c!-u!cv~=4~:....~?'~'.°!r.....QYIiO~°..~..):`~Xa':5:~?.L.f^..~^......rf.:4~!-,.[...
1-,,
at premises located at 335......{t".I.S3..lea....k,:'.~.............F.?:~V'...~
.°~....~~-..,rQ~.
County Tax Map No. 1000 Section .......Q..3.~....... Block Lot No......se~..~:.`..~......
pursuant to opplicotion doted .......~.!(.4t.Y.l~•-........~.~P..........., 19.~~.~.., and approved by the
Building Inspector. /
Fee ~o'S/~..../
......,~R~~'
. 9 ...~eC
Buildin I for
Rev. 6/30/80
Form No. 6
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
inspector with the following: 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 Boar3 of Fire Underwriters.
' 4, Sworn statement from plumber certifying that the solder used in system contains
' less than 2/10 of 17, 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.OC, Additions to dweiii.ng $25.G0,
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 - $5.00 over 5 years - $10.00
4. Updated Certificate of Occupancy - $50.00
5. Temporary Certificate of Occupancy - Residential $15.00, Commercial $15.00
Date , ;g~, ,
'yew Construction........ Old Or Pre-existing Building.
.
Location of Property... ,$.~~5, , , ~0..~-n..~ 1 3
House No. Street Hamle
Onwer or Owners of Property,. ~~?',~.cq „Sc~ plht~ . . . . . . _ .
County Tax Map No 1000, Section............Block..orZ,,,,,,,,,,,,,Lot.,.,c,~;~; .
Subdivision.....
............................Filed Map............Lot............. .
i'ermit No.~~~~.L~,,.......Date Of Permit. ~°'O?~;,b,~' ,,,,,Applicant
!tealth Dept. Approval ..........................Underwriters Approval..~!~..................
Tanning Board Approval....-
tequest for: Temporary Certificate........... Final Certieate..,?,,,,,,,
gee Submitted:
~u /97~ APIfI. ANT
c'1E4.D,i~«:i'~C:iU;J ~~UnTn ~ COMMENTS +
=S'Yn
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- - H 0
FOUWDATION ^ ( 1st ) = ~y,,
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FOUNDATIOW (2nd) rh ~
2.
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P,OUGH FRAME &
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PLUMBING
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INSULATIOPI PER N. Y, y
STATE ENERGY
CODE
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ADDITIOPIAL COMMENTS: x
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BUILDING DEPT.
1 NSPECTIC~N
[ ]FOUNDATION 1ST [ ] ROUGH PLBG.
[ ]FOUNDATION 2ND [ ]INSULATION
[ ]FRAMING [FINAL ~
REMARKS: ~r Imo. C~.e~ G C'.
0 0 irY ~A/1~ a
i
DATE 8' INSPECTOR
o~~F~a~K~oGy
VICTOR LESSARD ~ ~ Town Hall, 53095 Main Road
PRINCIPAL BUILDING INSPECTOR = z P.O. Box 1179
(516) 76s-1ao2 N ~ Southold, New York 11971
FAX (516) 76s-1823
o~~ol ~ ~~p~-
OFFICE OF BUILDING INSPECTOR
TOWN OF SOUTHOLD
June 25, 1990
Gertrude Iglesias
8335 Main Road
East Marion, N.Y. 11939
Re: B.P. #171402 OUTSIDE SPA (HOT TUB)
Dear Ms. Iglesias:
I am writing to you regarding the above Building Permit.
The permit has expired and you have never had an inspection and
you have not obtained a Certificate of Occupancy.
You are now in violation of the Code of the Town of South-
hold. Please contact our office to set up and inspection. If
there is any electric you will need an Underwriters Certificate.
Please take care of this immediately. Thank you.
Yours truly,
c.c. Secretary
Cross Devices
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Drawings Not ttt Scale
NOTES
A. UPPER BENCH C. STEPS
FOR ACCESSORIES B. LOWER BENCH D. AIR INDUCTION HOLES ~ MANIFOLD
SEE REVERSE SIDE GENERAL: These spas are constructed with vacuum formed sheet acrylic
reinforced with chopped fiberglass and polyester resin. The HILO I inground
spa is equipped w'sth molded air induction chambers. The spa is required
to be plumbed with IAPMO listed materials, spa fittings, etc.
° Copyright 1982 Polynesian, Inc., U.S.A. AD 80 - 19
(5
6) 765 802 o~~S~FFO(~-COG
VICTOR LESSARD, Principal y~ SCOTT L.HARRIS,Supervisor
CURTIS HORTON, Senior y z Southold Town Hall
VINCENT R. WIECZOREK, Ordinance p ^r P.O. Box 1179, 53095 Main Road
ROBERT FISHER, Assistant Fire ~ Southold, New York 11971
Building Inspectors ~~l #t Fax (516) 765-1823
Telephone (516) 765-1800
THOMAS FISHER
GARY FISH
OFFICE OF BUILDING INSPECTOR
TOWN OF SOUTHOLD
February 28, 1991
Gertrude Iglesias
8335 Main Road
East Marion, N.Y. 11939
Re: B.P. # 171402 OUTSIDE SPA (HOT TUB)
Dear Ms. Iglesias:
On June 25, 1990 I sent you a letter explaining that your
Building Permit had expired and you have not had an inspection
and you do not have a Certificate of Occupancy.
You are in violation of the Code of the Town of Southold.
If you do not take care of this it will be necessary to issue an
Order to Remedy Violation Notice. Please contact our office so
we can resolve this matter.
Yours truly,
~~~p~ v~e-
Secretary
(516) 765 802 o~pS~FFO(,F-~oG
VICTORLESSARD,Principal y` SCOTT L.HARRIS,Supervisor
CURTIS HORTON, Senior y Southold Town Hall
VINCENT R. WIECZOREK, Ordinance ~ P.O. Box 1179, 53095 Main Road
ROBERT FISHER, Assistant Fire ~ p!~ Southold, New York 11971
'~O,( ~`a Fax (516) 765-1823
Building Inspectors ~ Telephone (516) 765-1800
THOMAS FISHER
GARY FISH
OFFICE OF BUILDING INSPECTOR
TOWN OF SOUTHOLD
February 28, 1991
Gertrude Iglesias
8335 Main Road
East Marion, N.Y. 11939
Re: B.P. # 171402 OUTSIDE SPA (HOT TUB)
Dear Ms. Iglesias:
On June 25, 1990 I sent you a letter explaining that your
Building Permit had expired and you have not had an inspection
and you do not have a Certificate of Occupancy.
You are in violation of the Code of the Town of Southold.
If you do not take care of this it will be necessary to issue an
Order to Remedy Violation Notice. Please contact our office so
we can resolve this matter.
Yours truly,
Secretary
o~~FFO~K~,G
VICTOR LESSARD ~ Town Hall, 53095 Main Road
PRINCIPAL BUILDING INSPECTOR I~ < P.O. Box 1 179
(516) 76s-iao2 ~ ~ Southold, New York 1 1971
FAX (516) 765.1823 ~ ~
OFFICE OF BUILDING INSPECTOR
TOWN OF SOUTHOLD
June 25, 1990
Gertrude Iglesias
8335 Main Road
East Marion, N.Y. 11939
Re: B.P. #171402 OUTSIDE SPA (HOT TUB)
Dear Ms. Iglesias:
I am writing to you regarding the above Building Permit.
The permit has expired and you have never had an inspection and
you have not obtained a Certificate of Occupancy.
You are now in violation of the Code of the Town of South-
hold. Please contact our office to set up and inspection. If
there is any electric you will need an Underwriters Certificate.
Please take care of this immediately. Thank you.
Yours truly,
,~/~e~., ~A l~e-~-
c.c. Secretary
Cross Devices
oS~Ff OIK~~G
VICTOR LESSARD ~O~' L Town Hall, 53095 Main Road
PRINCIPAL BiJILDING INSPECTOR = Z P.O. Box 1179
(516) 765-1802 r°n ~ Southold, New York 11971
FAX (516) 765-1823 yoj'~Ol ~ ~a0~'
OFFICE OF BUILDING INSPECTOR
TOWN OF SOUTHOLD
June 25, 1990
Gertrude Iglesias
8335 Main Road
East Marion, N.Y. 11939
Re: B.P. #171402 OUTSIDE SPA (HOT TUB)
Dear Ms. Iglesias:
I am writing to you regarding the above Building Permit.
The permit has expired and you have never had an inspection and
you have not obtained a Certificate of Oceugancy.
You are now in violation of the Code of the Town of South-
hold. Please contact our office to set up and inspection. If
there is any electric you will need an Underwriters Certificate.
Please take care of this immediately. Thank you.
Yours truly,,I
G-scJ ~.e, C/d-e--
c.c. Secretary
Cross Devices
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Q r~ BOARD OF HEALTH
U\Y/ / 3 SETS OF PLANS
FORM NO. 1 SURVEY
(fj I TOWN OF SOUTHOLD CHECK .
BUILDING DEPARTMENT SEPTIC FORM
t31~oG. Derr. TOWN HALL
TOWN OFSOUTHOLO vOUTHOLD,N.Y.11971 NOTIFY
TEL.~,765.1802 CALL
MAIL T0:
Examined ..~.,fl~?1A.. y~..., 19~g.
~ ~
Approved ! ]9 Permit No. ~.7.l.~V..'L_ ~
Disapproved a/c
(Building Inspector)
APPLICATION FOR BUILDING PERMIT
Date 19}~.~~
^ 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 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
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 i val or demolition, as herein described.
The applicant agrees to comply with all applicable laws, ordinances, buildin e, housi code, regulations, and to
admit authorized inspectors on premises and in building for necessary inspe to ~s~4~
lgriature of"applicant, or name, ifJa corporarton)
~s~c .............4"~:..~. ~ .
(Mailing address of applican~
State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder.
Y
...............................Y
.........9J v<sv/Z .
Name of owner of premises ........~Tr'.''~`~dC° •~"~~e S~ q S • • • . •
(as on the tax roll or latest deed)
If applicant i orpo do ign re of duly authorized officer.
~-r-•~-
(Name and title of corporate officer)
Builder's License No . .
Plumber's License No . .
Electrician's License No . .
Other Trade's License No .
1. Location of land on which proposed work will be done . .
..Q'.~.7.:~.....!r`7.-52i~E'/...!~C?a.~ 4:~`~.~.. ~/~r~o•YI
House Number Street Hamlet
County Tax Map No. 1000 Section .......~1.......... Block Lot ...`.g`~':
Subdivision Filed Map No. Lot...............
(Name)
2. State existing use and occupancy of premises and intended use ando/ccu ancy of proposed, construction:
a. Existing use and occupancy ~ P/~h
b. Intended use and occupancy . • • ~ l • • ~
G1J ~o ~ ~ / '~rl'C° He /psw ~-~1~./~
~ _
~
( P .
3. Nature of work check which a ~licable): New Building Addition Alteration , . .
p q
~ a wal . Demolition Other;~or(c~:~r' ~S?~/~ .
Re air ~ Rem a cription)
4. Estimated Cost Fee .
r, (to be paid on filing this application)
5. If dwelling, number of dwelling units ;e\.. Number of dwelling units on each floor . .
If garage, number of cars . .............r...................................................
6. If business, commercial or mixed occupancy, specify~natu3c and extent of each type of use . . . . .
7. Dimensions of exis ing structure
g ~ s, if any: Front , . ear Depth'.....8.' ~ .
Hei ht ..../02........NurrberofStories......'.~~... ~.2~6q,,,,,,,,,,,,,,,,,,,
De th g. th alterations or additions: Front fir........... Rear .
i
upensrons o same structure w{• • Height l,~ N~rnrhet"af-S~te~zs ~~e:G4....... .
' 8. Dimensions of entire new construction: Front , , , . , Rear Depth , , .
Height .Number of Stories . .
9. Size of lot: Front . I~ettr- /.a2...ffC:S Hepth . .
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: !'~d........... .
13. WIll lot be regraded . . Wi11 excess fill~e remgved from remises: Yes No
14. Name of Owner of remises ~'rr7S-l+~ , , ~~iL,"s:~, Address ,~.r°!'~~ .~°.':bO.'! '~`!':~~~one No..'S.!~7.:'P.~-Z~,.
P
Name of Architect . , ...Addrass Phone No .
Name of Cont actor ~'J~fiS'~...'~K'S4crs.. , ..i, ,Address/~.e,~.sGh Cur 5~s-/
3' .Phone Noa.?9,P,-; , ,
15.Is thi property located within 100 feet of a tidal wetland? *YES...~.~~ '
*I:f yes, Southold Towq Trustees Permit may be required.
j PLOT DIAGRAM
Locate clearly d distinctly all! buildings, whether existing or proposed, and, indicate all set-back dimensions from
property lines. Give str et and block pumber or description according to deed, and show street names and indicate whether
interior or corner lot. I ~ ~
/ ~
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I~ Surro~NO( .~e.,re
STATE OF NEW YORK, / _
CQ~NTY OF ~$~S + ~ ~ G/ql/ a'~s-~`~
• • `v` ~ 'T ~ "s being duly sworn, deposes and says that he is the applicant
(Name of individual si Wing contract)
above named.
He is the ......./,1',!f!so.~ ~~'C7Gc2~1 ~1v~7a!2 .
I (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 I
................./~....dayofi.....-_........, 19~~
Notary Public, .../'F/, ~ ~41~:!U~fC.-.-, , , , , , County
r~1,Ea It o~voE .
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e
a s~u9lolk
tau .
i TermEeplresM~roh30,1 I (Signature of applicant)