The URL can be used to link to this page

Home My WebLink About30271-Z FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No: Z-30317 Date: 07/27/04 THIS CERTIFIES that the building ACCESSORY Location of Property: 1205 TUTHILL RD EXT SOUTHOLD (HOUSE NO.) (STREET) (HAMLET) County Tax Map No. 473889 Section 55 Block 6 Lot 15 .52 Subdivision Filed Map No_ Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated APRIL 26, 2004 pursuant to which Building Permit No_ 30271-Z dated APRIL 29, 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 JOSEPH H L SANDRA S KOLLEN JR (OWNER) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A ELECTRICAL CERTIFICATE NO_ 2010376 07/06/04 PLUMBERS CERTIFICATION DATED N/A f/'�Z2 th ize 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. 30271 Z Date APRIL 29 , 2004 Permission is hereby granted to : J L S KOLLEN 1205 TUTHILL RD EXT SOUTHOLD,NY 11971 for CONSTRUCTION OF AN INGROUND SWIMMING POOL IN THE REQUIRED REAR YARD AS APPLIED FOR, FENCED TO CODE at premises located at 1205 TUTHILL RD EXT SOUTHOLD County Tax Map No_ 473889 Section 055 Block 0006 Lot No. 015 . 052 pursuant to application dated APRIL 26 , 2004 and approved by the Building Inspector to expire on OCTOBER 29, 2005 . Fee $ 150 . 00 Authorized Signature ORIGINAL Re-, . 5/8/02 Form No.6 TOWN OF SOUTHOLD ^ BUILDING DEPARTMENT TO-AIN 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: A. 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. 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. j 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. 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$15.00 Date. —7b< New Construction: Old or Pre-existing Building: (check one) Location of Property #�'� t� ��a.'L�✓ / �< [� Dil7 2 iG House No. Street Hamlet _ a Owner or Owners of Property: MOZ �>IM$ J-11— �11ce, Qn- !' S scf9: Suffolk County,Tax Map No 1000, Section 0 5� Block �t9 , Lot ArAdum Subdivision g`hlijj Qv;Ar7' M 8 Filed Map. l f Lot: y Permit No. Date of Permit. Applicant: Health Dept.Approval: Underwriters Approval: Planning Board Approval: Request for: Temporary Certificate Final Certificate: c3 (check one) Fee Submitted: $ a- ) � , r Applicant Signature .rrr=+++ r�r�rrJ�J�r?PrJ�CrJi?fr.Pr��f�rPr�rJ�rJ�cPf�r ��f�Rrs�r��J�r�Plr�?�rannrJ�rJ�r�cP rrPJ'r?nrJ�r�P rr� 0 BY THIS CERTIFICATE OF COMPLIANCE THE 5 5 NEW YORK BOARD OF FIRE UNDERWRITERS 5 BUREAUTY 40 FULTTON STREET F C NEW YORK, NY 10038 5 CERTIFIES THAT 5 5 55 5 Upon the application of upon premises owned by 5 DOUBLE R. CONTR./R. RAGEN JOSEPH &SANDRA KOLLEN 5 165 EADS ST. 1205 TUTHILL RD. EXT. 5 5 W. BABYLON, NY 11704, SOUTHOLD, NY 11971 r5j Located at 1205 TUTHILL RD. EXT. SOUTHOLD, NY 11971 Application Number: 2010376 Certificate Number: 2010376 e Section: Black: Lot: Building Permit: 30271 BDC: nsll 5 Described as a Residential 0-599 square ft. occupancy, wherein the premises electrical system consisting of 5 electrical devices and wiring, described below, located in/on the premises at: 5 Basement,Outside,Pool'Spa, A visual inspection of the premises electrical system, limited to electrical devices and wiring to the extent detailed 5 herein, was conducted in accordance with the requirements of the applicable code and/or standard 5 C5 promulgated by the State of New York, Department of State Code Enforcement and Administration, or other C� 5 authority having jurisdiction, and found to be in compliance therewith on the 6th Day of July, 2004. 5 5 5 Dame OTY Rate Ratiue Circuit Tw)e trr5r++ Appliances and Accessories 5 Pool'Spa Bonding 1 0 5 Time C1ocldSwitch 1 0 � 5 Panels 5 1 40 2 5 5 Wiring and Devices 5 Receptacle 1 0 20 amp Pool'Spa 5 Ss itch 2 0 General Purpose 5 Fixture 1 0 Pool Spa Receptacle 1 0 GFCI (Swimming Pool):This certificate covers compliance at the date of inspection only. Because of unusual environments it is advisable to have 5 frequent test and%or repairs made by a qualified person- 5 � e7� seal 5 I of L This certificate may not be altered in any way and is validated only by the presence of a raised seal at the location indicated. 5 5 rJ�rJ��fr?Pr��J ocJ ocJr?nrJ�cfr?n�J'ocJ'r?J?J'rJ�PrJcJ�JrscJr?PrJ�rJ�cJr?Pc1rl�cJ': 11121151101E! 31151]!Ili �rsrJrJ�rJ��J acJ�J�f�JcPrlrsr�rrL3.III?PLrL3 PL.PU IJ C ._ TOWN OF SOUTHOLD PROPERTY RECORD CARD -- -- — _ u,. . --- . — D—I T. J _ L_O=TOWNER STREET V�.LLAGE `tV �"P"'•+"" I l C"uJI'} a _ HLOvrln , 1,le, ACR. / I REMARKS — t TYPE OF BLD. NA PROP. CLASS10 LAND IMP. TOTAL DATE y/e VAL...Ajc, 2- FRONTAGE ON WATER TILLABLE FRONTAGE ON ROAD WOODLAND DEPTH MEADOWLAND BULKHEAD HOUSE/LOT TOTAL NONE■■■■■■■■■■■■■■■■ OMEN■ONE■■■■■■■■■■■■ • • - _ MEMO■■N■■■■■■■■■M■EN 0 ONE qn .., ■■■■■■■■■■■MM■■E■MOEN mom" ■■ ■■■■■M■MEMSEI1■■■■■■■ ■■■Emma NMIIENMEM■■ ■M■■MMEN■ICi11E11■■■■■■E NEON■E■■�I■It�11■■■■■■■ �■iiiiiii=i=i�i■� IN no 765.1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION IST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] INSULATION [ ] FRAMING [ FINAL fe„-e. [ ] FIREPLACE & CHIMNEY [ ] FIRE SAFETY INSPECTION REMARKS: � -U7 c.� j2 A I�§ DATE t INSPECTOR C FIELD INSPECTION REPORTT DATE CONLl-IENTS 0 m FOUNDATION(1ST) — ------ -- -------------------------------------- FOUNDATION(2-ND) — --- — — n � 2 -- O ROUGH FRAMING& PLUMBING INSUL ATION PER N.Y. STATE ENERGY CODE !7A le C5 r� --- FINAL -- ADDITIONAL COMMENTS -O — m m a o a a a GOWN Ot SOUTHOLD BUILDING PERMIT APPLICATION CHECKLIST 3UILDING DEP 4RTYMNP Do you have or need the following,before applying? GOWN HALL Board of Health ;OUTHOLD,NY 11971 3 sets of Building Plans CEL: (631) 765-1802 Planning Board approval +AX: (631) 765-9502 Stnvey PERMIT NO. 3c)=:k 7/Z-- Check Septic Form N.Y.S-D.E.C. Trustees i;amined 20 Contact: .5Lk)!n,.\ n- 5 approved 20 Mail to-.—LI-7 1 )isapproved a/c P-�-W (i7.7 Phone: `I'�j I GC) expiration f a 20Q� Building Inspector APPLICATION FOR BUILDING PERMIT Date Q pre j JL4 200+ - INSTRUCTIONS _.-a,-T-]ns application MUST be completely filled in by typewriter or in ink and submitted to the Building Inspector with 3 ets of plans, accurate plot plan to scale.Fee according to schedule. b. Plot plan showing location of lot and of buildings onpremises, relationship to adjoining premises or public streets or reas, 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 hall 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 the Building Inspector :sues a Certificate of Occupancy, f Every building permit shall eXpire if the work authorized has not commenced within 12 months after the date of suance or has not been completed within 18 months from such date.If no zoning amendments or other regulations affecting the -operty have been enacted in the'iuterim,the Building Inspector may authorize, in writing,the extension of the permit for an edition six months. Thereafter, a new permit shall be required- APPLICATION equiredAPPLICATION IS HEREBY MADE to the Building Department for the issuance of a Building Permit pursuant to the wilding Zone Ordinance of the Town of Southold, Suffolk County,New York, and other applicable Laws, Ordinances or egulati f�o�r, LbUildings, additions, or alterations or for removal or demolition as herein described. The P lrpable laws, ordinances,building code,housing code, and regulations, and to admit rrh wilding for necessary inspections. OCCUPANCY OR �� i a�IATELY" (Signa of Iicant or name,if a corporation) ENOL:3E POOL TO CODE USE IS UNLAWFUL L{-�I e z5F} 1117 BEFORRUPON "WATER COMPLETION OF WITHOUT ,, ITHOUTppCERTIFI{;AT ��g address of applicant) ate whether applicant is owner, lesseeage9deA, ' Yer, general contractor, electrician, plumber or builder `1 mRV_ rMRS CERTfFiXEE APP OV D AS NOTED Inrn ''' )))a.i c ta, gyne of owner of premise ; _i C77A){� tI Yl/� Sl1. .,,rGZ 4{lin FEE �✓� BY ��---- ' (As on the tax rollor latRT ff&PIL ING�EPAAThAENT�{T applicant is a corporation, signature of duly authorized officer 765-1802 8 AM TO 4 PM FOR THE FOLLOWING INSPECTIONS: (Name and title of corporate officer) 1. FOUNDATION . TWO REQUIRED FOR POURED CONCRETE 2. ROUGH • FRAMING 8 PLUMBING alders License No. �, 14 I a1-4 3. INSULATION ambers License No. 4. FINAL - CONSTRUCTION MUST 'etricians License No. BE COMPLETE FOR C.O. her Trade's License No. A1,1. CONSTRUCTION SHALL MEET THE REQUIREMENTS OF THE CODES OF NEW Location of land on wht�c $roposed work will be done: \(1 YORK GNSTpARTE. NOT RESPONSIBLE FOR LL+h I { �1� - 1C{ c 1,L u—f 12 Q Ldp �N ERRORS. 1 COT House Number Street Hamlet County Tax Ma�}�No. 1000 Section ET5 Block � Lot 5, sow Subdivision kh 0 f?Q/Q t)S Filed Map No. eq I Lot a.o� Existing use and occupancy IN f2cSidencp_ b. Intended use and occupancy C SeAL °rif :AA 6 O 1 ° 3.. Nature of work (check which applicable): News Cd Addition Alteration Repair Removal Demolition Other Work (Description) 4. Estimated Cost 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 Rear Depth Height Number of Stories Dimensions of same structure with alterations or additions: Front Rear Depth Height Number of Stories 3. Dimensions of entire new construction: Front Rear Depth Height Number of Stories 9. Size of lot: Front q8 Rear 3q.05_, 7a.3a Depth 1 b0 20)516-sq. Acl� . 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 lav, ordinance or regulation?YES_NO_/ 13. Will lot be re-,graded? YES ,/NO—Will excess fill be removed from premises? YES ---fNO_ 14. Names of Owner of premisesj osh oijenAddress I QYIU hi II Q&• Phone No. 7 (a 'S Name of Architect Address er Phone No 33 h� 16 5 Name of Contractor Q Address `? (2 Phone No. f74q–G.o d 15 a. Is this property within 100 feet of a tidal wetland or a freshwater wetland? *YES NO t� * IF YES, SOUTHOLD TOWN TRUSTEES &D.E.C. PERMITS MAY BE REQUIRED. b. Is this property within 300 feet of a tidal wetland? * YES—NO * IF YES, D.E.C. PERMITS MAYBE REQUIRED. 16. Provide survey, to scale, with accurate foundation plan and distances to property lines._ =t 17. If elevation at any point on property is at 10 feet or below_, must provide topographical data on 1survey. STATE OF NEW YORK) SS: COUNTY OF being dilly Sworn, deposes?and says that(s)he is the applicant (Name o n'divtdual si g contract) above named, (S)He is-the s( ..v.. g Corporate U. Contractor, Agent, Co orate Officer, etc.) of said owner or owners, and is duly authorized to perform or have performed the said work and to make and Me this applicatic 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 mantxer set forth in the application filed therewith S.z om to before ine this Z � dayof - - °•20 I - . - i- ..Nptary Public ignature of Applicant NOREEN L 11AGEFt 'ML eommjssION EXPIRES / ' . - Co y N P alt z uj 2"to h"5 DOftoM Z 41, < 34-' SECTION N Q � C �- LU a- '00.1 5io s' ® (c4) � 61 c ® SECTION B VORM 10" WAilT UNW C GMP FOAM 13MEN \ HWk AN17 CONCH B // POW fl�5 3500 P51 POLM19 CONCITT� VINYL LINM 211 TO 4115M19 a. -cam WALLS SECTION FOIRMED COMC. STEps NOTES \` I. 5ff9YTM 15 GESIGPEG F07 U5E DEI-ON GP,PM MV 01\L Y IN ha'A5 Mm WE QZOIN� f0 f L rc' MIA Fork WASER fAPLE 15 A MINIMUM OF 4`6" MWW 1TU PWI`05EG FIN151W 6PAVE. fPOri,5riNU \ NVE2 AW Putt? 2,13PCITLL WIfN CLEAN Efvr1H,FSE a POOf5 ANG MM 5. GO NOf&LOW fl-E MCK OF JEM0 G\4 0 13ACK LL fO MEW fHE FE16K OF 11-f WATU IN WE POU,PY MOLE WN S",OR fl-E tO�tiL;NS WMIZ fO EX TEG PPCKFILL DY MOM THAN 8' . f0lIPS c 3.NALKS t0 PE 5fv10GTN,NON SKID tTYPE,ti-OPEG AWAY FPfIM POO- �a .1-22-03 PLUMBING SC�1EWA;1IC A.WAfEP,915'05Pi.gIPLL PE LIMlfEG fO OWNEK51"WOPEM fO 5UIf LOCAL F.EGU.AflON5