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HomeMy WebLinkAbout29101-ZFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No: Z-29935 Date: 12/30/03 THIS CERTIFIES that the building ACCESSORY Location of Property: 1540 JACKSON ST NEW SUFFOLK (HOUSE NO.) (STREET) (HAMLET) Cothnty T~ Map NO. 473889 Section 117 Block 10 Lot 12,4 subdivision Filed Map No. __ Lot No, -- conforms substantially to the Application for Building Permit heretofore filed in this office dated JANUARY 9, 2003 pursuant to which Building Permit No. 29101-Z dated JANUARY 14~ 2003 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 CLAIRE & ALLYSON MANNING (OWNER) of the aforesaid building. SIIFI~LK CO~ DBPART~I~T OF t{F~%LTH APPROVAL N/A EI~EC~ICAL CERTIFIC-~q~ NO. 1156387 08/07/03 pLI3MBERS CERTIFICATION D/¥~d3 N/A nature 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. 29101 Z Date J~kNUARY 14, 2003 Permission is hereby granted to: ALLISON MANNING 1540 JACKSON ST NEW SUFFOLK, NY for : CONSTRUCTION OF ~N ACCESSORY INGROUND SWIMMING POOL IN THE REQUIRED REAR YARD AS APPLIED FOR at premises located at County Tax Map No. 473889 Section 117 pursuant to application dated JANUARY Building Inspector to expire on JULY 1540 JACKSON ST NEW SUFFOLK Block 0010 Lot No. 012.004 9, 2003 and approved by the 14, 2004. Fee $ 150.00 Authorized Signature ORIGINAL Rev. 5/8/02 Form No. 6 ~owNDESOI/IHOLD BUILDING DEPARTMENT TOWN HALL 765-1802 APPLICATION FOR CERTIFICATE OF OCCUPANCY This application must be filled in by typewriter or ink and submitted to thc 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. 1. Certificate of Occupancy - New dwelling $25.00, Additions to dwelling $25. J~0, Alterations to dwelling $25.00, Swinuning 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, Commcmial $15.00 Date. December 30, 2003 New Construction: xx Old or Pre-existing Building: (check one) Location of Property: 1540 Jackson St Suffolk House No. Owner or Owners of Property: l~nning Suffolk County Tax Map No 1000, Section Subdivision Permit No. 29101 Health Dept. Approval: Planning Board Approval: Request for: Temporary Certificate Fee Submitted: $ 2~ .00 Date of Permit. Street Hamlet ! 17 Block 10 Lot 12.4 Filed Map. Lot: I / 14/03 Applicant: Underwriters Approval: Final Certificate: x (check one) Applicant Signature BY THIS CERTIFICATE OF COMPLIANCE THE NEW YORK BOARD OF FIRE UNDERWRITERS BUREAU OF ELECTRICITY STREET ~ NEW YORK, NY 10038 40 FULTON CERTIFIES THAT Upon the application of upon premises owned by DOROSKI ELEC. INC ALLISON MANNING P.O. BOX 781 1540 JACKSON STREET CUTCHOGUE, N.Y. 11935, NEW SUFFOLK, NY 11956 Located at 1540 JACKSON STREET NEW SUFFOLK, NY 11956 Application Number: 1156387 Certificate Number: 1156387 Section: Block: Lot: Building Permit: BDC: NS11 Described as a Residentia! occupancy, wherein the premises electrical system consisting electrical devices and wiring, described below, located in/on the premises at: Outside, Pool/Spa, 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 7th Day of August, 2003. Name QTY Rate Rating Circuit Type Appliances and Accessories Pool/Spa Bonding 1 0 Time Clock/Switch 2 0 Furnace 1 0 Gas Panels 1 50 3 Wiring and Devices Receptacle 2 0 20 amp Pool/Spa Switch 2 0 General Purpose Receptacle 1 0 GFCI Fixture 1 0 Pool/Spa (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. seal 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. BUt-LD} NG-t -a¢t GI- EC - Applicant/ Owners Name: Architect/ Engineer: SCTM #: District: L_00~0 Section · Date Submilted Io ,.o~ I.ocanon: /3 ~L~ ~, -- Name Single & separate Reqmred iff A cemfication ~es / N~3 ~/ ~ Req Req [JVronl Yaa-d prorJoscd: __] [Side Yard ~t~_ /ltoposed ~] [Rear Yard _ Project Description: / 3 C~ AGENC~x~:I?ERMIT$ REQUIRED FOR REVIEW N.A. NO YES P..ermit Number 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: Notek: 765-1802 BUILDING DEPT. INSPECTION ] FOUNDATION 1ST ] FOUNDATION 2ND ] FRAMING [ ] ROUGH PLBG. [ ] INSULATION [ ~FINAL ] FIREPLACE & CHIMNEY DATE INSPECTOR FOVN~A~ON Os~) ROUGH FRAMING & STA~ ~ CODE TOWN OF SOUTHOLD BUILDIN~ DEPARTMENT TOWN HALL SOUTHOLD, NY 11971 TEL: 765-1802 Examined ~ /l'J ,20 0 ¥ Approved d/t{ ,200.~ _ Disapproved igc PERMIT NO. 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 Contact: Mail to: / Building Inspector APPLICATION FOR BUILDING PERMIT Date 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 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 what-so-ever tmtil 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 Coanty, 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/c.~de, and regulations, and to admit authorized inspectors on premises and in building for necessary inspections. 'q M M E D ~ATE LY" 8t0um (Si~e of a"'pblica~t-/)na~, ~-a corporation) TO°ODE UPON CO;'F'~LETION B£FD,~E. "WATER" (Mailing address ofapplicanO State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder ~q Name of owner of premises ~]]kfOlq (as on the tax roll or latelll~ed) 15-o. BY: Z ~ If applicant is a corporation, signature of duly authorized officer OCC[IPANCY O~ USE !$ ~NLA~FUL WITHOUT CERTIFICATE OF OCCUPANCY (Name and title of corporate officer) Builders License No. Plumbers License No. Electricians License No. Other Trade's License No. 'q'~(a- k~ ] NOTIFY BUILDING DEPARTMENT AT 765-180~ 9 AM TO 4 PM FOR THE FOLLOWING INSPECTIONS: 1. FOUNDATION - TWO REQUIRED FOR POURED CONCRETE 2, ROUGH - FRAMING & PLUIvIBING 3. INSULATION 4. FINAL - CONSTRUCTION MUST BE COMPLETE FOR C.O. ALL CONSTRUCTION SHALL MEET THE REQUIP, EMENT$ OF THE N~Y. STATE CONSTRUCTION & ENERGY CODES. NOT RESPONSIBLE FOR DESIGN OR CONSTRUCTION ERROR~ 1. Location of land on which proposed work will be done: I ¥ ~ 0.'Ta er_~ o t~ ,~'hee e r House Number Street County Tax Map No. 1000 Section Subdivision (Name) 113 Hamlet , : Block J{~ ~. Lot 012, 4 , Filed Map No. Lot State ~'istin~ use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy '----~ lfie~d., b. Intended use and occupancy ~ ~e~c~c ~'~0~M~,aJq /~2:. Nature of work (check which applicable): New Building_ Repair Removal Demolition Estimated Cost 1~ O'00 - Fee If dwelling, number of dwelling units If garage, number of cars ..---- Addition Alteration Other Work~d~x0tvd .i~o L. (Description) (to be paid on filing this application) Number of dwelling units 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 Rear Depth ~ ~/2 --> ~ Height. Number of Stories Dimensions of same structure with alterations or additions: Front Rear Depth Height. Number of Stodes Dimensions of entire new construction: Front Height Number of Stories Rear .Depth Size of lot: Front ~ OO ' Rear 1(3t3' Depth c~D~O ' O. Date of Purchase Name of Former Owner 1. Zone or use district in which premises are situated 2. Does proposed consti-uction violate any zoning law, ordinance or regulation: ~J O. 3. Will lot be re-graded ~0, ~ ~colWill excess fill be removed from premises: ~) NO 4. Names of Owner of premises ~li~gg ~t~l,,t~ Address L~to~J~t'.r,.51;)~ S-} Phone No. Name of Architect'-DxO[t~s g '~e, illg Address:~l~Phone No Name of Contractor ~ ~'omtos ~oo/s . Address .t~ ,~- ~ ~[d[~rPhone No. ?lac4 5. Is this prope~y within 100 feet of a tidal wetland? *YES NO · IF YES, SOUTHOLD TOWN TRUSTEES PERMITS MAY BE REQUIRED 4q6-- 5. Provide survey, to scale, with accurate foundation plan and distances to property lines. 7. If elevation at any point on property is at 10 feet or below, must provide topographical data on survey. FATE OF NEW YORK) SS: : ' OUNTY OF~.~rOLK ) ~ '~}O~. ' ' being duly sworn, deposes and says that (s)he is the applicant (Name of individual signing contract) above .gamed, ;)He is the (Contractor, Agent, Corporate Officer, etc.) said owner or owners, and is duly authorized to perform or have performed the said work and to make and file this application; at all statements contained in this applicatioware true to the best of his knowledge and beliefi and that the work will be ~rformed in the manner set forth in the applicatipn filed therewith. ~om to before me this ~ day of I- <J Notary Phblic 2003 MARGARET A. BANNWARTH Notary Public, State of New York No. 01BA6021t 11 Qualified in SuffoJk County Commission Expires March 8, '~0~, Signatu~ of Applicant WOOD FRAME RESIDENCE CHIMNEY NOt I~VEFER,~X 10 ¥ ~ v' / / N/F' GIRARDS cy SURVEYED: 25 SEPTEMBER 2002 SCALe 1 "=JO' AREA = 20,343.54 S.F. OR 0.467 ACRES TM~ t 000-; ! 7 - 1 O- 012,4 SURVEY OF DESCRIBED PROPERTY SITUATE NEW SUFFOLK, TOWN OF' SOUTHOLD SUF'F'OLK COUNTY, N.Y, SURVEYE*~ /:'OR: ALLISON MANNING GgAf~NTEEO TO. ALLISON STANLEY .J: ISAI<SEN, ,JR P O 'BbX'294 ': NEW_ ~UF'F:OLK. N:¥. ; 1956 631-73~-5835 ~..