HomeMy WebLinkAbout29562-ZFORM NO. ~
TOW~OF SOUTHOLD
BUILDING DEPARTMENT
Office of the Building Inspecnor
Town Hall
Southold,
CERTIFICATE OF OCCUPANCY
No: Z-29948
Date: 01/07/04
THIS CERTIFIES that the buildln§ ACCESSORY
Location of Property: 2060 HIGHLAiqD RD
(HOUSE NO.) STREET)
County Tax Map No. 473889 Section 102 Block 8
Subdivision Filed Map No.
Lot 28
Lot No.
CUTCHOGUE
~F~AMLET)
conforms substantially 5o the Application for Building Permit heretofore
filed in this office dated JULY 11, 2003 pursuant to wluich
Building Permit No~ 29562-Z dated JULY 11, 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 ACCESSOHY tNGROUND SWIMMING POOL WITH FENCE TO CODE AS APPLIED FOR.
he certificate is issued to WILLIAM F & VIVIA~ VELEZ
(OWNER
of the aforesaid building.
SUFFOLK COU1F~Y DEP~RT~4ENT OF
EI~ECTRICAL CERTIFICA~ NO. N 555998 04 fl6/01
PLUMBERS CERTIFICATION DA~f~D N/A
Rev. 1/81
FORM NO. 3
TOW~ 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)
PEP/~iT' NO. 29562 Z Date JULY 11~ 2003
Permission is hereby granted mo:
WILLIAM F & VIVIAi~ VELEZ
2060 HIGHLAAID ROAD
CUTCHOGUE,NY 11935
for :
CONSTRUCTION OF AN ACCESSORY IGP WITH FENCE TO CODE IN THE
REQUIRED REAR YARD AS APPLIED FOR. REPLACES BP 26913
at premises located at 2060
County Tax Map No. 473889 Section 102 BlOck 0008
pursuant to application dated JULY
Building Inspector to expire on JANUARY 11, 2005.
HIGHLAND RD
CUTCHOGUE
Lot No. ~28
11, 2003 and approved by th~
Fee $ 150.00
Authori~gd Signafure
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
PEPd~IT~0. 26913 Z
Date NOVEMBER 14, 2000,
Permission is kereby granted to:
VIVIAN VELEZ
2060 HIGHLAND RD
CUTCHOGUE,NY 11935
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
County Tax Map No. 473889 Section 102
pursuant to application dated OCTOBER
Building Inspector.
2060 HIGHLAND RD CUTCHOGUE
Block 0008 Lot No. 1028
23, 2000 and approved by t~
Fee $ 150.00
Authori e~ SignatUre
Rev. 2/19/98
ORIGINAL
NRR 2'0 ~03 01=Z:~P~ SOUTHOLD BUILDING 632 765
Form ~o~ 6
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN HALL
765-1802
APPLICATION FOR CERTIFICAT~ OF OCCUPANCY
This application tuust be fllled in by typewriter er ink mid submitted to ~fhe Building Department with the following:
For new bulIdi~g or new
1. Final sureey of prepay with accurate location o f all buildings, property lines, sire*ts, and unusual natural or
topographic features.
2. Final Approval £rom Health Dept. of water supply anct saw--age-disposal (S-9 form),
3. Apprpv~ of e[¢ctrieal'instaZlati~n ~omBoard of Fis¢.Undekwriters. ~
4, Swo¢~m~pent from,piranhaS: eex'tif~g that the solder used in s~Y~,, em com}i ,n,,s less than 2/10 of 1% lead.
$. C~mi~.'erci~l bu, itding;~dustrial baildktg, multiple residences and s~rr~'.lar buildings and installations, a
q{Co~ C~p~ianc; ~otu arcl~t~t or engiu?r respgn~ibl¢ for the building.
6, S{~bmii Pia~fiti~ Board Appro~t of~ ccrmpleted site plan requirem~ts.
For~tsttla~b~idings(prlorto~p~rflg, l~9$7)Uon-conformlnguses, or buddmgs and pr~-exlsting landuses,
~ A~a~ae ~aY of pmpert~ sk0ivtug zll property lines, streets, buiti:hng and unu~uaI natural or topographic
features.
2. Apr~r_l~*~eompleted appheati~n and consan~ to inspect signed by tl~e applicant. If a Certificate of Occupancy is
distain, t]~ t~uilding Impector shall ~tat¢ the reasons there, Iht in writing to the applicant.
C, Fee~
t. Cer~',~.mate of Occupancy - New dwelling $25,00, Additions to dwelling $25,00, A[temticn~ ~o dwell/rig $25.00,
S~ngpool $25.00, Accessory bu{ldiag $25.00, Ad~tions to accessory bu[~fl[~g $25.00, Bus'asses
2. Certifi~e bfOccup~ey on Pr~existing Building - $100.~
3. Cop~of~ificate of.O~up~e~ -
4 Upd~ Certificate of Occupancy - $50.00 ' 0
5. T~or~C~ificateofOceup~cy- ~eddenti~ $15.00, Co~ercial $15. 0.
Old or Pre-ax2sting Building:
New Construction;
Hous~ No, /~tre~t '~
Ow~ or Owners of Prope~: ~ .
Suffolk Com~ T~ Map No I000, Section . ] O ~ Block GOO ~
Date o~P~it.
File;* Map.
. Applicant:
Underwriters Approval:
Health Dept. Approval:
Planning Board Approval;
(cheek one)
Lot
Request for: Temporary Certificate
.~,*e Submitted: ~ / 7.~ ~d~
Final
03/20/03
Lot:
Hamlet
op.1
Tiff 12:50 [TX/RX. NO 9S72] ~0Ol
check one)
Applicant Signature
BQA Ft!D OF
THE-NEW YORK
I0250~8 ' BUREAU OF,~LEGTRI~y.!~,~ ~ .:
40 PULTON STREET, NEW ¥ORI~; ~YJ:~88~: '
D~e ~pH~a~n No. on fi~ , ~
THI~ GER~i~I~ T~&T
only the ele~cat equipment ~ de~bed be~w ~ bt~d by ~ ~pli~ t
was examined on a~ found to be tn c¢mpl~ with the N~ongl ~leR~ca! ~ode~ .
ERWRITERS
~ number is in the pries of
RE~EPTAe~'S SWITCHEs i S': ,, ; EXHAUST FANS
OTHER
DRYERS FURNacE MOTORS FUTURE A=PLiANCE FEEDERS 5F.=diAL ~C ~T fM[~'L~N~ DIMMERS
. I ~
SERVICE DISCONNECT S E R . : , .C E
OTHER APPARATUS:
SW~G POOL-1
GENERAL MANAGER
DOPY FOR BUILDING DEPARTMENT. THIS COPY NOT SE ALTERED IN ANY MANNER.
THE NEW' YORK BOARD 'OF FIRE *u~NDERWRITERS ~ 2
102~05;~ , BUREAU OF ELECTRICiTy,~:~ ~ ~..' ~
40 F~TON STREET, NEW yORK, NY 10o~:/ '
~ .~ ....... ~01 N 5559~
Date ~p~on No. on ~le
THIS CERTIFIES THAT '
on~ ~e el~c~e~ e~e~ as des~ed ~ ~ i~oduced by the a~t ~med on t~ ~o~ a~lic~ ~r ~ ~ ~e prem~es of
in the fo~wing ~ca~ng ~ B~m~ ~ ~st~ FL ~ 2~ FL ~ .... ~
was ~x~ed on a~ found ~ be ~ comp~ with th~ N~onal El~al Code. ~
: FIGURES ~ . OVENS DISH
O~HER APPARATUS:
T
This certificate must not be affe~ed In any manner; return to the office of the Board if incorrect. Inspectors may be identified by their credentials.
COPY FOR SUILD~NG DEPARTMENT THIS COPY OF CERTIFICATE MUST NOT BE ALTERED IN ANY MANNER.
Town Hall. 53095 Main Road
P.O. Box 1179
Southord. New York 11971-0959
Fax .631) 765-9502
Telephone (63]) 765-1802
BUILDING DEPARTMENT
TOWN OF SOUTHOLD
March 4, 2003
William Velez
2060 Highland Road
Cutchogue, NY 11935
To Whom It May Concern:
It has come to our attention that building permit numbers 26913Z and 26923Z, for
construction of an in ground swimming pool and deck at 2060 Highland Road,
Cutchogue, Suffolk County Tax Map Number 1000-102-8-28 has expired and you are
in violation of Southold Town Code.
In order to rectify this matter, the following is required:
1.)
2.)
3.)
Immediate renewal of permit number 26913Z and 26923Z: Please
submit a check for $300.00, made payable to the Town of Southold.
noting the original permit numbers on the check.
Inspections required: Once you have renewed the above referenced
pern~tt, it is your obligation to schedule any required inspections and
submit any required certifications.
Certificate of Occupancy required for the expired permit: Once
you have passed the above referenced inspections, you may apply for a
certificate of occupancy.
Without a certificate of occupancy from this office, any use of your property is a
violation of Southold Town Code (45-15) and New York State law. If you have any
questions, please feel' free to call this office at (631) 765-1802 between the hours of 8:00
a.m. and 4:00 p.m.
Authorized Signature
CC: File
' · , , ' ONlY JUtDCONFBi~NO Rli~4'rB~UI~N~'H~ CERTIFICATE
. ,'~s~~ ' ~m - ~ 1000000.
· . ' ' !o/27/0o ~l 12:oi [~ ~o 5~79] ~0o!
ZO0~ Z,~r~ 3~Z £CT6TgS~T~ ~'T~ SO:~T ~ O0/TC/OT
INSTRL
PART L
WORK~RS'
CERTI~ICA~ DISABILI~ i ~W
Complete PART I O~LY and ~av= your;D~sabillty Bene~ I~u~ Ca~Jer ¢ompl&~e PART IL
TO ) BY ~PLO~R P011~ ~: D7~I
27 ~7 SM[THT0~NBOULEYARD
NESCONSET NY, 1i?&7 _
d LIFE INSURANCE LO-OF AMERICA
cation is hereby mede to the CARRIER for a Certifie~q~ compliance with the Disability Ber~efits Law.
Telephone No. _ ~ l-- ~ ~[
TO BE COMPL~ BY DIS~IU~ BEEF.S CARRI~ '
CERTIFicATEOFCOMPUANCEH DISABILI BENEFITS
and that the policy covers:
*a, ~ ALL of the. EMPLO~'S emp]0Yees eUg~le under the New York Disability Ben~l;; Law.
*b, ~ ONLY th~ following ~cla;s or ceases of the EMPLO~R's empioyee~
Date Signed 09/'I511~9g
Telephone No. (51B) a29-Ble0 Title VICE--PRESIDENT
*IMPORTANT: if: BOX "a' is CHECKED, this certificate is COMPLETE. Mail it directly to .the er~ployer.
if BOX "b"ie CHECKED, This certificate is NOT COMPL~E ;or p~rpos~e~ Section~i20, Sub~ B Of
the D~sabHity Benefits L~w~ It ~ust be mailed ~or completion ~ t~e W~rkers' ~ompensati~n Board.
Disability Benefits Bureau. 180 Liv ngston Street, Brooklyn. New York 11248-0005.
J PART IlL TO BE. COMPLE~D BY WORK'S' COMPENSATION BOARD ( Only ii $O~,'"b" of P~ m has been ch~ed )
State of New York
WORK~RS' COMP~SA~ON BOARD
~ There ~s oh file with th~ Workers' Compensation ~oard. Certificates of Insurance indicating that t~e above-named
employer has complied, w~th ~e Disability Benefits Law ~th respect to all of hi,/her employees.
DIS~IL~ BENEF~S BURE~
Date
Telephone No.
LL
., PRC liw-~r
765-~,802
BUILDING DEPT.
INSPECTION
[ ] FOUNDATION 1ST [ ] ROUGH PLBG.
[ ] FOUNDATION 2ND [ ]~SULATION
[ ] FRAMING [ ~'/FINAL
[ ] FIREPLACE & CHIMNEY
REMARKS:
DATE
765-1802
BUILDING DEPT.
INSPECTION
[ ] FOUNDATIONIST [ ] ROUGHPLBG.
[ ] FOUNDATION2ND [ ]IN~J~LATiON
[ ] FRAMING i'll/FINAL
[ ] FIREPLACE & CHIMNEY
REMARKS:
DATE
INSPECTOR
765-Z,802
BUILDING DEPT.
INSPECTION
[ ]FOUNDATION 1ST [ ] ROUGH PLUG?
[ ]FOUNDATION 2ND [_ ]~ i
[ ]F~ING [ ~"~NAL
[ ] FIREPLACE & CHIMNEY
REMARKS: {"~'/~-~
/
DATE
INSPECTOR
- DA'I~ CO~IE~S
If,
It
(2ND)
iSULATION PER ~.
STATE ENERGY
CODE
FORld NO. ]
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOI~I HALL
SOI1TttOLD, N.Y. l 197 I
TEL: 765-1802
D£~pp, oved a/c ..................................
/-~ (Building
APPLICATION FOR BUILDING PERMIT
INSTRUCTIONS
BOARD OF HEALTH ...............
3 SETS OF PLANS ...............
SURVEY ........................
CHECK .........................
SEPTIC FORM ...................
DEC : ............................
TRUSTEES ....... : ..............
-NOTIFY:
CALL ..................
MAIL TO: ....................
a. ~his applicatian unst be coupletely filled in by typewriter or in ink and submitted to the I~ilding Inspector wi
3 sets of plans, accurate plot pl.a~ to scale. Fee . .a~.o.,rdi~ to schedule, l
b. Plot plan stx~ locat~o~ of lot and of b~itdings on premises, relationship to adjoining I~'~tises or t~blic
streets or areas, and givina a detailed descriptian of layout of Urol~r~ m~st be drawn on dae diagram which is l~rt of
dais applicat fan.
c. The ~ork covered by this application r~ay not be ca~sced before issuaace of Buildi~ Peri,itl
- d. Utxm approval of this application, the Buildir~ Inspector v~ill issue a Building Permit to the applicant. Sudl
pelmlt ~hall be.kept on [the premises available for iuspectio~ throuahout the work.
e. No buildinE shall be occupied or used in mtaole or in par~ for any purpose vtaatever antil ~ C~rtificate of
OCCul~nCy shall have been Ermated by the Buildln~ Inspector.
/IPI'LICATf(I~ IS ~ HAE~ to the Buildin~ Delft for the issuance of a Building Permit pur ~s~t to the
Buildin~ Zone Ordina~:e of ~ Town of Southold, Suffolk County, New York, and other applicable Laws, Ordinances or
l~]latioas, for tile corlstl~ctioe of buildi~s, additions or alterations, or for re,:m-al or demolitic as herein
described. ~ ~pplicant al~ees to co~91y ~{th all applicable laws, ordLn~-~_es, baildi.-4~ code, housi codei and
reaulatlor~, al~d to admit ~lthorized inspectors on premis~s a~d in building for necessary inspection~
(Signature of applican_~, or hare, ~ a eor~ratioa)
(Mailir~ address of appli~i [} ~
State llt~ther ap~licaot is owller, lessee, a~ent, archit~t, en~ineer~ Eeneral contractor, electricia~ ~plt~ber or hei]de~
(as on ~he tax ~oll or latest deed) '~ '/ ~/'~/ff"
of ..... ......................
If applicator i$ a corporation, siganrure of dul7 anthori~d officer.
(Nauru and title of corporate officer)
Builders License No ..........................
Plumbers License No ..........................
EIectriciams Liceuse NO ......................
Other Trade's License N6 .....................
]. Ix~atiou of land on ~aich proposed work will he done .................... f ........................ I .................
.... A/~'~; .......... '0 ....... i~i ..................... ~ ..... 7 .... u'" ~22' .... '~i[' ...............
coanty Tax ~ ~,. ,om ~--~ian .ff..q.~.l:L2. ,~lo~ .j.f...~. ....... ~, ~.:.~.~....
Subdivision .~.]., ~1.~....~ ~..~.~, Filed Map No . ' Lot' 7
~(~) .......... L' -
2. State existing use and eecut~ncy of pr~ises mad intended ~ and oc~ of proposed constreation:
a. Existiug use and occupancy ...... .~i.~.~.~..~..t.~~ ............................................
b. Inter.led use ar~ occupancy .............................................................................
15.
~ ~ ' ~Z~ (Oescription)
~.i~t~ co~t'~ ..... /.,..~.o:%.. .......... ~ ..~/..~.o,:..~..o. ........... i .................
(to be paid on filing this application)
If d~lling, m, nber of d~lling traits ..... /. ...... NL~r of d~lling units on each floor ..... ~. .........
I~ garage~ r~ber of cars ...... ~ .............................
If lmsiness, ccmrercial Or mixed occupancy, specify nature and extent of each type of use ....... ../~....~. ........
Dimensions of existing structures, if amJ: [front ................ Rear ............... Depth .................
tleight ......................... Rtraber of Stories ........ ..~ ...........
Dimensions of sane strucL~re wlrh alterations or additions: Front ............... Rear ...............
Depth .................... tteight .................... limber of Stories ...............
e tire ............... ..............
tleight ......................... Number of Stories .....................
Size of lot: Front ....~, ....~. ......... Rear .................... l~pth ....................
~te o~ ~a,~ ../..~d~..Z.,/Z.7... "~ o~ ~o~r 0~ .... ~.d: ~....~.e./.C ~ ..........
Z~e or use district in uhi~h premises are s~tuated ..............................................................
Does proposed construction violate any zoning la% ordinance or regulation: .... .~....D.~ ......
Will lot be re~nded ....... ~.. }/ill excesa ~ill be removed rrm pr~mises: [ l~o/ hD
l~e of ~rchitect .................................... Mdress .~..~.~..~. ..... k~ .............. ~ .......
· . . - . ........... ~ ~/~:':;~;/~': ...............
Is th~s property mthm 300 feet o~ a tidal ~etland? * Y~S .................. [~-~ ~ '
PLOT DIAGRAM
I~cate clearly and dis%!.,nctly ail buildings, ~hether existing or proposed, and indicate ail set-bsek d~amnsions
property hnes. g~!~.:~E.and block ntml~r or description according to deed, and ~how street narms and indicate
~hether interior or eorn~.~'~. '}
ADATION ' 'P, NO REQUIRED
~ POURED CONCRETE
· ' M & PLUMBING
.~G . FPd~MING
!NAL coNSTRUCTION MUST
~a cO~.LETE ~OR C.O.
CONSTRUCTION
is the ...................................................................................................
(~tractor, ~ent, co.rate officer, etc.)
'
~d mr or ~rs, ~ is &ly mthori~ to ~rfom or hm ~r~ fl~ mid m& ~ to ~ ~ file this
j~licatia~; ~at all statmts cmtai~
H~THER ~KE5~ (SJ~t~re of A~lic~t)~
Qu~lifi~ in Suffolk Coun~~