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Home My WebLink About30848-ZFORM NO. 4 TO~¢ OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No: Z-30674 Date: 01/05/05 THIS CERTIFIES that the building ACCESSORY Location of Property: 1030 COUNTRY CLUB DR (ROUSE NO.) (STREET) (HAMLET) County Tax Map No. 473889 Section 109 Block 3 Lot 2.13 Subdivision Filed Map No. __ Lot No. -- CUTCHOGUE conforms substantially to the Application for Building Permit heretofore filed in this office dated DECEMBER 15, 2004 pursuant to which Building Permit No. 30848-Z dated DECEMBER 15, 2004 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 GERALYN J WIESER (OWNER) of the aforesaid building. SI/FFOLKCOI~q~YDEPAR~]~T OF }I~2kL~{;kPPROV;kL N/A ELECTRICAL CERTIFICATE NO. 2648 04/05/02 PLUMBERS CERTIFICATION DATED N/A ' ~zed Signature Rev. 1/81 FORM NO. 3 TOWN OF SOUTHOLD BUILDING DEPARTMENT Town Hall Southold, N.Y. (THIS BUILDING PERMIT PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) PEP34IT NO. 30848 Z Date DECEMBER 15, 2004 Permission is hereby granted to: GERALYN J WIESER PO BOX 1143 CUTCHOGUE,NY 11935 for : CONSTRUCTION OF AN INGROUND SWIMMING POOL WITH FENCE TO CODE AS APPLIED FOR. THIS PERMIT REPLJtCES BP 29954. at premises located at 1030 COUNTRY CLUB DR CUTCHOGUE County Tax Map No. 473889 Section 109 Block 0003 Lot No. 002.013 pursuant to application dated DECEMBER 15, 2004 and approved by the Building Inspector to expire on JUNE 15, 2006. Fee $ 150.00 Au%hori zed Signature ORIGINAL Rev. 5/8/02 Form No. 6 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL 765-1802 APPLICATION FOR CERTIFICATE OF.QCCUPANCY This application must be filled in by typewriter or ink and subm tted to the Bnilding Department 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 Board of Fire Underwriters. 4. Sworn statement from plumber certifying that the splder used in system contains less than 2/10 of 1% lead. 5. Commercial building, industrial building, multiple residences and similar buildings and installations, a certificate of Code Compliance fi.om 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 uses: I. Accurate survey of properW 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. Co Fees 1. Certificate of Occupancy - Nexv dwelling $25.00, Additions to &veiling $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 4. Updated Certificate of Occupancy- $50.00 5. Temporary Certificate of Occupancy - Residential $15.00, Commercial $15.00 New Construction: Location of Property: House No. Owner or Owners of Property: Suffolk County Tax Map No 1000, Section Subdivision Cd~g~,~ ~, eermitNo, r--yQ~--z/Z_ DateofPermit. Health Dept. Approval: Planning Board Approval: Request for: Temporary Certificate Fee Submitted: $ Old or Pre-exist/ag Building: (check one) Block tO0o,~ Lot Filed Map.. Lot: Underwriters Approval: Final Certificate: 'check one) Nassau Suffolk Electrical Inspections, Inc. 5A Canal Street * Center Moriches, New York 11934 * Tel: 631-878-3500 * Fax: 631-878-3764 Application No: 2648 Date:4~5~02 Issued to: Weiser Address: 1030 Country Club Dr Village: Cutchogue Zip: 11935 Introduced By: W J Kubacki Electric License#:3186-E was examined and found to be in compliance with the National Electrical Code ,attic 1st Fl(x~r Re~identi~ [] Basernert ~ floor Cc~q~q-~-ciaJ ~ Tub NV De~ects Switches Receptacles Fixtures G.F.I. Microwave Whirlpool 2 2 2 Oven Carbon Fans Dishwasher Washer/Amps Dryer/Amps Range/Amps Monoxide Furnace 0 il G as Circulators Sm oke Bell Detectors Transformers Other Meter Amps Phase Motors Equipment Inground Pool 1-11/2HP 1-Pool Heater,Gas Out,Res This certificate must not be altered in any manner 765-1802 BUILDING DEPT. INSPECTION [ ]FOUNDATION 1ST [ ] ROUGH PLBG. [ ]FOUNDATION 2ND [ ]~INSULATION [ ]FRAMING ~'~J-.~INAL /o~ o [ ] FIREPLACE & CHIMNEY [ ] FIRE SAFETY INSPECTION REMARKS: //~~ ~ ~ ~ ~ DATE / ~ '- ~-3 -- O ~- INSPECTOR -~--__~ ELD INSPECTION RKPORT DAT~ C(3{"~IENTS ~UNDAT ION (]ST) )UNDATION (2ND) II ~UGH FRAI~ & PLUMBING ,SULATION PER N. Y. STATE ENERGY CODE II ,= 6...I TOWN OF SOUTHOLD Illlir' BUILDING DEPARTMEI~!.. TOWN HALL , - SOUTHOLD, NY 11971 L -7.:.~.' · . ~' - ~LC~ a~ TEL: 765-1802 '. ~ .... -'--~ ..... ~ ''~ J PERMIT NO. ~~ Examined ,20 Approved (O~O~ ~. ~) ~k ,20___ Disapproved a/c N/~¥ ~ "~RMIT APPLICATION CHECKLIST / Building .a ect°r 3 sets of Building Plans Survey. Check Septic Form N.Y.S.D.E.C. Trustees Contact: Mail to: APPLICATION FOR BUILDING PERMIT Date ,~//6 ,20 ~/ 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 waterways. c. The work covered by this application may not be commenced before iJsuance 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 what-so-ever until a Certificate of Occupancy is issued by the Building Inspector. APPLICATION IS I-I~REBY 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 applic .an~t agrees to comply with all applicable laws, ordinances, building code, authorized inspectors on premises and in building for necessary inspections. State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder Name of owner of premises ./~OZ tOz,,~,'O (as on the tax roll or latest deed) If applicant is a corporation, signature of duly authorized officer (Name and title of corporate officer) Builders License No. Plumbers License No. Electricians License No. Other Trade's License No. 1. Location of land on which proposed work will be done: /o,Bo ~,o.~.~ c..z~c.~ ~-~. House Number S~eet County Tax Map No. 1000 Section Subdivision~--4/n. t4 ~,/o,~ ( ame) Block ~ Filed Map No. a. Existing use and occupancy ~ ~-o,-zs,' ,~?'. ,,~. ~ b. Intended use and 0ccupancy / ,_~o7~' ~'2'. /~:~. ~v:,~ ,~,~.~_,~,o~ ,~o/~-t~t,~. ~aoL 3. Nature of work (cheek which applicable): New Building Repair Removal 4. Estimated Co st .,~/,,9. ,~rxo. oo 5. If dwelling, number of dwelling units If garage, number of cars ~.Aa__dit/~al~ Alteration Demolition cOt_her Wo__~/,~-~o~c~2> ~,~,,'~-'~,,~ (Des~pfion) (to be p~d on fil~g ~is application) Numb~ of dwelling units on each floor 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 ,~0' Number of Stories Rear ~' Depth ~' Dimensions of same structure with alterations or additions: Front Rear Depth Height Number of Stories 8. Dimensions of entire new construction: Front Height Number of Stories Rear Depth 9. Size of lot: Front Z'~o ' Rear _~¢/. ' 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: 13. Will lot be re-graded Will excess fill be removed fxom premises: YES ~ 14. Names of Owner of premises~,i~.,~d21~i~_Address ,,o~ ~r e~ Phone No. ,~'-~,o/7 Name of Architect Address e.~,~o.,~ Phone No Name of Contractor Address Phone No. W 15. Is this property within 100 feet of a tidal etland. *YES NO · IF YES, SOUTHOLD TOWN TRUSTEES PERMITS MAY BE REQUIRED 16. Provide survey, to scale, with accurate foundation plan and distances to property lines. 17. If elevation at any point on property is at I 0 feet or below, must provide topographical data on survey. STATE OF NEW YORK) SS: COUNTY OF ) ~-~/fi/t~,~_) ~l'ff~ being duly sworn, deposes and says that (s)he is the applicant (Name of individual signing contract) above named, (S)He is the (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 ~vill be performed in the manner set forth in the application filed therewith. Sworn to before me this _ _ ~ .~f,,! day of /'fiT~/ 20 O I Nota~bl~c / GERARD M. LAN6 of Applicant 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. 29954 Z Date DECEMBER 17, 2003 Permission is hereby granted to: GEP~ALYN J WIESER PO BOX 1143 CUTCHOGUE,NY 11935 for : CONSTRUCTION OF A/q INGROUND SWIMMING POOL WITH FENCE TO CODE AS APPLIED FOR. THIS PERMIT REPLACES BP#27399. at premises located at County Tax Map No. 473889 Section 109 pursuant to application dated DECEMBER Building Inspector to expire on JUNE Fee $ 150.00 1030 COUNTRY CLUB DR CUTCHOGUE Block 0003 Lot No. 002.013 17, 2003 and approved by the 17, 2005. /~~A~ o/r/'/ed ~Signat ure ORIGINAL Rev. 5/8/02 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. 27399 Z Date JUNE 13, 2001 Permission is hereby granted to: GEP~ALYN J WIESER PO BOX 1143 CUTCHOGUE,NY 11935 for : CONSTRUCTION OF INGROUND SWIMMING POOL AS APPLIED FOR WITH FENCE TO CODE. at premises located at County Tax Map No. 473889 Section 109 pursuant to application dated MAY Building Inspector. 1030 COUNTRY CLUB DR CUTCHOGUE Block 0003 Lot No. 002.013 23, 2001 and approved by the Fee $ 150.00 ~Authorize~ Signature ORIGINAL Rev. 2/19/98 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 Department 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 Board of Fire Underwriters. 4. Sworn statement from plumber certifying that the solder used in system contains less than 2/10 of 1% 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. 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. New Construction: Location of Property: 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 4. Updated Certificate of Occupancy- $50.00 5. Temporary Certificate of Occupancy - Residential $15.00, Commercial $15.00 Old or Pre-existing Building: (check one) /050 0Iv 6b/ r,fa_. House No.Street amlet Owner or Owners of Property: Suffolk County Tax Map No 1000, Section Subdivision Permit No. C~g,.¢3 ~q'~.5 , Date of, Permit. Health Dept. A~ Block Filed Map. Applicant: Underwriters Approval: Plaiming Board Approval: Final Certificate: Request for: Temporary Certificate Fee Submitted: $ ~ Lot: Appl~ant ~ (check one) Nassau Suffolk Electrical Inspections, Inc. 5A Canal Street * Center Moriches, New York 11934 * Tel: 631-878-3500 * Fax: 631-878-3764 Application No: 2648 Date:4/5/02 Issued to: Weiser Address: 1030 Country Club Dr Village: Cutchogue Zip: 11935 Introduced By: W J Kubacki Electric License#: 3186-E was examined and found to be in compliance with the National Electrical Code Switches Receptacles Fixtures G.F.I. Microwave Whirlpool 2 2 2 Oven Carbon Fans Dishwasher Washer/Amps Dryer/Amps Range/Amps Monoxide Smoke Bell Furnace Oil G as C irculetors Detectors Tmnsformers )ther Meter Amps Phase Motors :quipment Inground Pool 1-11/2HP I-Pool Heater,Gas }ut,Res This certificate must not be altered in any manner I DATE: FEE: ~.~ NOTIFY BUILDING ENT AT 765-1802 9 AM TO 4 PM THE~ FOLLOWING INSPECTIONS: . 1 FOUNDATION - TWO RE~IUIRED. FOR pOURED CONCRETE 2. ROUGH - FRAMING & PLLJiIVlBING 3. INSULATION 4. FINAL - CONSTRUCTION BE COMPLETE FOR C,O. ALL CONSTRUCTION SHALL MEET THE REQUIREMI~NTS OF THE N.Y, STATE CONSTRUCTION & ENERGY CODES, NOT RESPONSIBLE FO'R DESIGN OR CONSTRUCTION ERRORS ocCuP^Nc¥ oR USE IS UNLAWFUL ¥7)THOUT CERTIFICATE OF OCCUPANCY 'T ENCLosE POoL TO SU~ F~ 3OWN OF ~OUTHO~ SCAL~, M~FFO~ COUNTY, NEW ~RK No. YOUNG 6YOUNG ~ooo,~.~. RIVER~AD~ NEW YORK TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, NY 11971 TEL: 765-1802 Examined __, 20__ Approved ~lt%~, C)X __,20__ Disapproved a/c PERMIT NO. BUILDING PERMIT APPLICATION CHECKLIST 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 Contact: Mail to: / Buil~ng~,,~ector APPLICATION FOR BUILDING PERMIT Date ,~"//6- ,20 ~/ 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 adjoirfing premises or public streets or areas, and waterways. c. The work covered by this application may not be commenced before issuance of Building Permit. d. Upon approval of th/s 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 what-so-ever until a Certificate of Occupancy is issued 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 applican~t agrees to comply with all applicable laws, ordinances, building code, authorized inspectors on premises and in building for necessary inspections.// l~of ag code, and regulations, and to admit pplicant or name, ifa corporatio (Mailin~addr~ss of a~plicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder Name of owner of premises ~?'Td,,q,,2~/~ (as on the tax roll or latest deed) If applicant is a corporation, signature of duly authorized officer (Name and title of corporate officer) Builders License No. Plumbers License No. Electricians License No. Other Trade'sLicenseNo. Location of land on which proposed work will be done: /030 Co~,_o?,'zv- c~..ow~ ~-~. House Number Street County Tax Map No. 1000 Section Subdivisioru~v~_~ ~,~ 6 ame) Block ~ '-' 'Lot -'-'~.-r ~J''~ ~ '~ Filed Map No. ~ ?,~, Lot ..~ 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy 3. Nature of work (check which applicable): New Building Repair Removal 4. Estimated Cost-~?eg. 5. If dwelling, number of dwelling units If garage, number of cars ..~ ~ Alteration Demolition cOt~her Wo_~Lk)/,~.~-,~, ~.~2> ,..-,~,.,.,.,.,,..~ ~ (Des~ption) Fee ~/~ o~ (to be p~d on filing this application Nmb~ of dwelling ~its on each floor If business, commercial or mixed occupancy, specify nature and extent of each type of use. Dimensions of existing structures, if any: Front Height ,~' Number of Stodes Rear Dimensions of same structure with alterations or additions: Front Depth. Height Number of Stories Rear 8. Dimensions of entire new construction: Front Rear Height Number of Stories 9. Size oflot: Front Z'~o' Rear _~-/~. ' Depth ,~_~O' 10. Date of Purchase Name of Former Owner 11. Zone or use district in which premises are situated ~-~5, ,-n~-~ ~2'/~& 12. Does proposed construction violate any zoning law, ordinance or regulation: ADO .Depth 13. Will lot be re-graded ¢~ Will excess fill be removed from premises: YES ~ 14. Names of Owner of premises~u~v~a/~_Address/,~ eoo~r ~ ~,~ Phone No. Name of Architect Address c_.-~e,,.~ Phone No Name of Contractor Address Phone No. 15. Is this property within 100 feet of a tidal wetland? *YES NO ~'/ * IF YES, SOUTHOLD TOWN TRUSTEES PERMITS MAY BE REQUIRED 16. Provide survey, to scale, with accurate foundation plan and distances to property lines. 17. If elevation at any point on property is at 10 feet or below, must provide topographical data on survey. STATE OF NEW YORK) SS: COUNTY OF ) ~-¢d~/~f.x2 /-~)/-K='-5~,~ being duly sworn, deposes and says that (s)he is the applicant (Name of individual signing contract) above named, (S)He is the d~t.2~lgt~._ (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 tree 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 Not ary/PubI~c GERARD M. LANG ature of Applicant