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Home My WebLink About30430-ZPORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y- CERTIFICATE OF 0CCUPA~CY No: Z-30391 Date: 08/31/04 THIS CERTIFIES that the building ACCESSORY Location of Property: 1155 ~RBOR LA (HOUSE NO.) (STREET) (HAMLET) County Tax Map No. 473889 Section 97 Block 6 I~t 12.3 Subdivision Filed Map No. __ Lot No. __ CUTCHOGUE conforms substantially to the Application for Building Permit heretofore filed in this office dated J~/NE 21~ 2004 pursuant to which Building Permit No. 30430-Z dated JUNE 23, 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 ABOVE GROU~ SWIMMING POOL IN THE REQUIRED REAR YARD "AS BUILT" AS APPLIED FOR. The certificate is issued to WILLIAM & ELEANOR J PORTE ( O~NER ) of the aforesaid building. SUFFOLK COUNT~ DEPARTMENT OF H~LT~ APPRO~L~J~ N/A ELECTRICAL CERTIFICATE NO. 2016801 08/06/04 PLUMBERS CERTIFICATION DATED N/A ~Authoriz ed Signature Rev. 1/81 FOP24 NO. 3 TOWN OF SOUTHOLD BUILDING DEPARTMENT Town Hall Southold, N.Y. (THIS BUII~DING PERMIT PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) ~EPdC~IT NO~ 30430 Z Date JI/NE 23, 2004 Permission is hereby granted to: WILLIAM & ELEANOR J FORTE 1155 HARBOR LANE CUTCHOGUE,NY 11935 for INSTALLATION OF AN ABOVE GROUND SWIMMING POOL IN THE REQUIRED REAR YARD "AS BUILT" AS APPLIED FOR at premises located at 1155 HARBOR LA County Tax Map No. 473889 Section 097 Block pursuant to application dated JUNE 21, 2004 Building Inspector to expire on DECEMBER 23, CUTCHOGUE 0006 Lot No. 012.003 and approved by the 2005. Fee $ 300.00 Authorized Signature ORIGINAL Rev. 5/8/02 Form No. 6 TOX, X~ OF SOUTHOLD BUILDING DEP.kRTMENT TO~.$Tq HALL 765-1802 APPLICATION FOR CERTIFIC.XTE OF OCCUPAN~[~i ~UO 2'~ ~ i"ii This apphcatlon must be fdled m by typewriter or mk and subnutted to the Building DepaZrtment, yvi~;lh~ fol:fG~,m--g-t A. For new building or new use: 1. Final survey of property with accurate location of all buildings, propel13' lines, sl2-eets, and unusuai natural or topographic features. 2. Final Approval fromHealthDept, of water supply and sewerage-disposal (S-9 fora0. 3. Approval of .electrical installation from Board of Fhe Underwriters. 4. Sworn staten~?nt from plumber ce~ifyirfg that the solder used in system contains less than 2/10 of 1% lead. 5. CcrmmercSql ~ufldin~ ~dus~ml building, mulrdple residences and sLmilar buildings and installations, a certificate of Code Con:jpl£ance from, m:chitect or en~kueer responsible for the building. 6. Subrni~ PlmmJng Board 6p~roval of completed site plan requiremants. For existing buildings (prior to April 9, 1957) non-conforming uses, or buildings and "pre-existing" land uses: 1. Accurate surxey of property showing aH property lines, streets, building and unusual natural or topograp}dc f~atures. 2. A properly completed application and consent to inspect signed by the applicant. If a Cetlificate of Occupancy is denieg,, the Building Inspector shall state the reasons therefor in writing to the applicant. C. Fees 1. Certificate of Occupancy - New dwelling $25.00, Additidns to dwelling $25.00, Alterations to dweilJxrg $25.00, Swimming pool $25.00, Accessory building $25.00, Addifiorm 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: !"/"~- Old or Pre-existing Building: (check one) House No. Street ~ '1~__~ Hamlet Owner or Owners ofProperty: ,~Z~4~ ,, -/::) - Suffolk Comity Tax Map No 1000, Section~Block ~1~ Lot I~1~ ,. Subdivision Filed Map. ~" Lot: Health Dept. Approval: Undenvriters Approval: Planning Board Approval: ~ Request for: Temporary Certificate Fee Submitted: $ Final Certificate: ~ (check one) BY THIS CERTIFICATE OF COMPLIANCE THE NEW YORK BOARD OF FIRE UNDERWRITERS BUREAU OF ELECTRICITY 40 FULTON STREET ~ NEW YORK, NY 10038 CERTIFIES THAT Upon the application of upon premises owned by JIM SAGE ELEC. INC. P.O. BOX 38 GREENPORT, NY 11944-0038, WILLIAM FORTE 1155 HARBOR LA CUTCHOGUE, NY 11935 Located at 1155 HARBOR LA CUTCHOGUE, NY 11935 Application Number: 2016801 Certificate Number: 2016801 Section: Block: Lot: Building Permit: BDC: ns11 Described as a occupancy, wherein the premises electrical system consisting of electrical devices and wiring, described below, located in/on the premises at: Outside, Pool/Spa~ A visual inspection of the premises electrical system, limited to electrical devices and wiring to the extent detailed herein, was conducted in accordance with the requirements of the applicable code and/or standard promulgated by the State of New York, Department of State Code Enforcement and Administration, or other authority having jurisdiction, and found to be in compliance therewith on the 6th Day of August, 2004. Name QTY Rate Rating Ci~:uit Type Appliances and Accessories Pool/SpaBonding 1 0 Wiring and Devices Kcccptacle 1 0 GFCI Receptacle 1 0 20 amp Pool/Spa (Swimming Pool): This certificate covers compliaace at the date of inspection ordy. Because of unusual enxSronments it is advisable to have frequent test ma&or repairs made by a qualified person. seal 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 I~atio~ in~licated. Applicanq ' . 0wners Name: /'O/~ ~ _ Architecff Engineer: ';- ., $CTM #: District: 1,000 Section: .~"7 [Mock: 6-Lot: Submiaed Subdivision Nanle: ] [$idcYard t~_{'roVo~:~ I Project Description: A~-~. ttg~ ' ' AGENCSO~ERMITS REQUIRED FOR REVIEW N.A. Suffolk County Health Dept. 'e~ New York State. D. E: C. ~ Town Trustees j Town Zoning Board approval: J Town planning Board approval: ~ Flood Plane Elevation ??'? Flood Zone: NO YES Permit . Number N°tes: 765-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION 1ST [ ] FOUNDATION 2ND [ ] FRAMING [ ] ROUGH PLBG. [ ] INSULATION [ ] FINAL [ ] FIREPLACE & CHIMNEY [ ] FIRE SAFETY INSPECTION R//~MARKS::~ ~_~.~~Z ~,~ ~ ~~ DAT~ ~/~~ 765-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION 1ST [ ] FOUNDATION 2ND [ ] FRAMING [ ] ROUGH PLBG. [ ] INSU~N [~'J~NAL [ ] FIREPLACE & CHIMNEY [ ] FIRE SAFETY INSPECTION REMARKS: . . __ DATE INSPECTOR 765-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND []/INSULATION [ ] FRAMING [~']/FINAL '~ [ ] FIREPLACE & CHIMNEY [ ] FIRE SAFETY INSPECTION REMARKS: INSPECTOR FI~LD~TSPECTIONREPORT'I. DATE l CObIM~FS '' FO~DATION (2~) ROUGH F~I~G & ~ PL~G ~' ~S~ATION P~ N.Y. ~ STA~ E~E~GY CODE ~DITIO~ CO~NTS , ~ TOWN so Ti q D BUILDING DEPARTM~ENT T Og~2~T HALL SOUTItOLD, NY 11971 TEL: (631) 765-1802 FAX: (631) 765-9502. ~vw. northfork.netJSouthold/ BUILDiNG PERMIT APPLICATION CHECKLIST Do you have or need tke fo[lowing, before appl3~ng? Board of Heakh 4 sets of Building Plans Planning hr)rd approvaI Survey Cheek :fr- Septic Form N.Y.S:D.I~:C. Trustees PEILMIT NO. 30 Examined /~ /o~} ,20 05~ Contact: Approved /~ ]~,"2~. 20 ~ ? Mail to: Disapproved Expixafion Building Inspector APPLICATION FOR BUILDING PERMIT ! INSTRUCTIONS 2 ....... ;-: :- :-' TT~ ..... ~ ---~--~s~non MUST be completely filled in by typewriter or in izdc and submitted to the Building Inspec*or with 3 sets of plm't¢, accurate plot plum to scale. Fee aeeord, ing to schedule. "b. Plot plan showing location of lot and o£buZldings on premises, relationsb2p to adjoining premises or public slzeets or areas, and watenvays. c. The work covered by tkis application ma5' 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 skall be kept on tb.e premises ax'affable for .inspection throughout the worlc e. No building shall be occupied or used in whole or in part for an5' purpose whax so ever tmtil the Building Inspector issues a Certificate of Ocanpanc3. f. EverF' buitdmg permit shall expire if the work authorized i,.a4.not cormnenced witM2 12 months after the date of issuance or has not been completed with22 18 months from such date. If ho zoinng amemdmemts or other regulations affecting the property have been enacted in the interim, the Building Inspector may authorize, in writing, the exte,~siou of the perm/t for an addition six months. Thereafter, a new perm/t shall be required. APPLICATION IS HEREBY ~£M3E to the Building Department for the issuzmce cfa Braiding Permit pursuant to the BuildJ2g Zone Ordinance of the Town of Southold, Suffolk County, New York, and other applicable Laws, Ordinances or Regulations, for the construction of binldings, additions, or alterations or for remos~ or demohtion as herein described. The applicant agrees to comply with all applicable laws, ordi2ances, building code, housing code, and regulations, and to admit authorized inspectors on premises and in building for necessary inspections. ~E oOOL TO CODE COMPLETION gEFC, FIE 'WATER" 0GGUPANCY ca USE IS UNLAWFUL (Silage ofa ca t or name, ifa corporation) WITHOUT CERTIFICATE (Mailing address of applicant) State x~~ffl~, lessee, agent, m'cht~t, en~eer, general con,actor, ~tfici~, plmber or build~ ron : If applicant is a co~oration, silage of duly authofiz~ officer : NOTIFY BUI~I~ DEP~TM~ AT (Name and title of corporate officer) Builders License No. Plumbers License No. Electricians Lidense No_ Other Trade's License No. 1. Location oflm~d o,n )vhich proposed work will be done: House Number Street 765-.1802 8AM TO4PM FORTHE FOLLOWING 'INACTIONS: 1. FOUNDATION - TWO REQUIRED 2. ROUGH - FRAMING & PLUMBING $. INSULATION 4. FLNN. - COaSTRU.CT .~..U ~ BE COMPLETE FOR C.O. . ALL C~NSTF'IC7 ' ' q~ALL ',lEFT THE M"T'-," ~R:_JUEtEi2~E~TE, //F'~....~J~-,' OFNEW · / ~--7~-~, ~/CI/__'-~ORK/t~-,J-AT~E. N~,~ 'i~--~P~N$1BLE FOR ~a,zzfie~ESlGN Off CONSTRUCTION ERRORS. County Tax Map No. 1000 Section 0 q? Block ~ Subdivision Filed Map No. (Name) rLot · /c~', x_~ Lot 2.* State .existing use and-6ccupabcy of premises att~d ',m. !ended use and occupancy of proposed cpns .t[ugt~on: b. ,-=ded use and oc npanoy 3. · · f~J Alteration 3. Nature ofxvork (check:~vhich applicable): New Btjilding Repair Remox-al Demolition 4_ Estimated Cost 5. If dwelling, number of dwelling units If garage, number of cars Addition Other Work Fee (Description) (To be paid on filing this application) Number 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. 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 consCmction: Front Rear Height Number of Stories _Depth 9. Size of lot:Front Rear .Depth 10_ Date of Purchase Name of Former Oxxaxer 11. Zone or use district in xvhich premises are situated 12. Does proposed construction xfolate any zoning law, ordinance or regulation? YES__ NO __ 13. Will lot be re-graded? YES__ NO__Will excess fill be removed from premises? YES __ NO__ 14. Names of Oxvner of premises Name of Architect Name of Contractor Address Phone No. Address Phone No Address Phone No. 15 a. Is th/s property xvithin 100 feet of a tidal wetland or a I~eshwater wetland? *YES __ NO __ * IF YES, SOUTHOLD TOWN TRUSTEES & D.E.C. PERMITS MAY BE REQUIRED. b. Is this propertyxvithin 300 feet of a tidal xvefl~nd? * IF YES, D.E.C. PERMITS MAY BE REQUIRED. 16. Proxdde sui'vey, to Scale, with accurate foundatiqn plan and.distange,5:to property lines. 17. If elevation at any point on property is at I0 ~e~l~ l~o[4,r%rnr~§t provide topographical data on survey. STATE OF NEW YORK.) ~ame of ~xSd~I si~ng con.ct) above named, , - ~.. ~ ;,(Co~ractor A.eat Co. orate Officer, ~c.) being duly sworn, deposes and says that (s)he is the applicant of said owne~:la?5ox~s,: and..i~*d ..ui}~uthorized to perform or have performed the said work mad to make and file this application; that all. statements contained hi this appl3cation are true to the best of his knowledge and belief; and that the work will be performed hi the manner set forth ~n_the application filed therewith. Signature of Applicant Claire L. {Slew Notary Public, State of New York No. 01GL4679505 O0ali§ed in Suffolk Counlv Commission Expires Dec- 8, ~(~ COMP, AINT REPORT ADDRESS PHONE~ HOW RECEIVED, TEL. MAIL~ IN'PE~ON ~ LOCATION O~ COMPLAINT ACTION 'TAKEN. FILE # (IF APPLICABLE) · RE-INSP DATE