HomeMy WebLinkAbout30449-ZFORM NO. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
office of the Building Inspector
Town ~all
Southold, N.Y-
CERTIFICATE OF OCCUPANCY
No: Z-30433 Date: 09/16/04
THIS CERTIFIES that the building ACCESSORY
Location of Property: 45 WALI~3T PL MA_TTITUCK
(HOUSE NO_) (STREET) (~LET)
County Tax Map No. 473889 Section 142 Block 1 Lot 12
Subdivision Filed Map No. __ Lot No. __
conforms substantially to the .Application for Building Permit heretofore
filed in this office dated JUNE 25, 2004 pursuant to which
Building Permit No. 30449-Z dated J73IFE 28, 2004
was issued, and conforms to all of the requirements of the applicable
provisions of the law. The occupancy for which this certificaue is issued
is ABOVE GROUI~D SWIMMING POOL IN THE REQUIRED PJ~AR YARD WITH FENCE TO
CODE AS APPLIED FOR.
· ~he certificate is issued to GREGORY C & STACEY M. SCHEITZER
(OWI~ER)
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTHAPPROVAL N/A
ELRCI~ICAL CtL~TIFICAI]~ NO. 2013165 08/13/04
PLUMBERS CERTIFICATION DATED N/A
Authorized Signature
Rev. 1/81
FORM NO. 3
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Town Hall
Sounhold, N.Y.
BUILDING PERMIT
(THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL
COMPLETION OF THE WORK AUTHORIZED)
'P~P~IT NO. 30449 Z Date JUNE 28, 2004
Permission is hereby granted to:
GREGORY C SCHWEITZER
PO BOX 493
MATTITUCK,NY 11952
for :
CONSTRUCTION OF AN A~OVE GROUND SWIMMING POOL IN THE REQUIRED REAR
YARD WITH FENCE TO CODE AS APPLIED FOR
at premises located at 45 WALNUT PL MATTITUCK
County Tax Map No. 473889 Section 142 Block 0001 Lot No. 012
pursuant to application dated JI/NE 25, 2004 and approved by the
Building Inspector to expire on DECEMBER 287~LQ~5.~ - ~
Fee S 150.00 /~~/~i~X('
ORIGINAL
Rev. 5/8/02
Form No_ 6 -
TOWN OF SOUTHOLD
BUILDI1NG DEPARTMENT
TOW~ HALL '
765-1802
APPLICATION FOR CERTIFICATE OF OCCUPANCY ' ~' _ ....
Tliis applicalion must be filled ~n by typewriter or ink and subn~Imd to the Building Department
A. For new building or new use:
1_ Final survey of property with accurate location of all buildings property lines slree~s, and unusual natural or
topographic features.
2. Final Approval from Hgalth Dept of water supply and sewerage.disposal (S_9 form)-
3, Approval of electrical installation ~om Board of Fire Underwriters_
4. Sw~om statement from ptmuber c~-fifymg that the solder used in system cov~in~ less than 2/10 of 1% lead_
5. ' Commercial lmilding,'~ndus~al buildiug~ multiple residences and similar buildings and installations~ a certificate
of Code Compliance from arct&ect or engineer responsible for the budchng_
6_ Submit Planning Board Appro-fal of completed ~ plan requirements_
B. For exEnting bm'ldings (prlor to April 9,1957) non-conformhlg uses, or buildings and "pre. e~sting- land uses:
I.Accurate'sotvey ofpropem.: showing all property lines, s~reets, building and unusual natural or topographic
features.
2_A Properly completed application and a consent to inspect signed by the applicant If a Cerlfficate of Occupancy
is denied, the Building Inspector shall state the reasons therefor in writing to the applicant.
C. Fees 1. Certificate of Occupancy - New dwelimg $25.00~ Additions to dwelling $25.00~ Alterations to dwelling $25_00,
Sw~mmln5 pool $25_00~ Accessory budding $25.00, Additions to accessory budding $25.00~ Businesses $50.00.
2. Certificate of Occupanc3- on Pre-e~ Budding - $100.00
3. Copy, ol-Certitlcate of Occupancy - $25.00
4. Updated Certific~c of Occupancy - $50.00
5. Temporary Ccrifficate of Occupancy - Residential $15.00, Commercial $15.00
ate. 7 2
New Conmruction: Old or Pre-existing Budding: (check one) .
O~,~¢r or Owners of Property: /---d
,SuffolkCoantyTaxMapNol000, Secfian 7385 ~ [0~. ' [ ~t
Sub&vision
2 7lg
Health Dept Approval:
Planning Board Approval:
Request for: Tempormy Certificate
Fee Submitted: $ ~__F~
Filed Map. Lot:
Date of Permit. [0 fref 2002Applicant /~//~' F' · t-/(
/~/~ Underwriters Approval:
Final Certificate: J (check one)
5O¥
Applicant Signalure ~
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
GOODALE ELECTRIC CONT INC
P. O. BOX 1190
MA'I-I'iTUCK, NY 11952,
GREG SCHWEITZER
45 WALNUT PLACE
MAI-I'ITUCK, NY 11952
Located at
45 WALNUT PLACE MATTITUCK, NY 11952
Application Number: 2013165
Certificate Number: 201'3165
Section: Block: Lot: Building Permit: BDC: ns11
Described as a occupancy, wherein the premises electrical system consistin8 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 wirin§ to the extent detailed
herein, wes 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 t3~ Day of August, 2004.
Name QTY Rate Rating Circuit Type
Miscellaneous
pool & service
Appliances and Accessories
Time Clocl~'Swimh 1 0
Wiring and Devices
Receptacle 1 0 GFCI
Receptacle I 0 20 amp Pool/Spa
Service
l Phase 3W Service Rating 200 Amperes
Service Disconnect: I 200 cb
Meters: l
(Swimming Pool): This ccn'r~icate covers compliance ar the date of inspection only. Because of unusual enx4ronments it is advisable to have
firequent test and/or repairs made by a qualified person.
~ea/
1 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.
765-1802
BUILDING DEPT.
INSPECTION
¸lL
[ ] FOUNDATION 1ST
[ ] ROUGH PLBG.
[ ] FOUNDATION 2ND [ ]/INSULATION
[ ] FRAMING [v-] FINAL ~,~
[ ] FIREPLACE&CHIMNEY
REMARKS:
DATE
INSPECTOR
Fl~F~{I~PECTION'REPORT
FOUNDATION (IST)
FO~DA~ON (2~)
ROUGH ~G &
~S~ATION
STATE ENERGY CODE
SO~OLD, ~ 1~71 ~?;- ~.. ,.
TEL' 631 7 - ~ .... ..:~. ~z~_ ,
.( ) 65 ..... .
F~: (63~1) 765-9502 -~'"'~P~ '
BLrl~DING PERMIT APPLICATION CHECKLIST
Do you hax~e or need the following, before, applying?
Board of [-Iealth
4 sets of Building Plans
Planning Board approval
Survey
Check
Septic Form_
N.Y.S.D~EiC.
Trustees
Contact:
APPLICATION FOR BUILDING PER3,IIT
Date d-"--~.r',~ ~-% ,20Oq
INSTRUCTIONS
a. This application MUST be completely filled in by typewriter or in ink aad submkted to the Building Inspector wkh 4
sets of plans, accm:ate plot plan to scale. Fee according xo schedule.
b. Plot plan showing location of lot mad of buildings on premises, relationship to adj oiz~ng premises or public streets or
areas, and wate~vays.
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 Permk to the applicant. Such a permit
shall be kept on the premises available for inspection tkroughofft the work·
e. No building shall be occupied or used in whole or ih part for any purpose what so ever until the BuZlding Inspector
issues a CerLificate of Occupancy.
f_ Every building permit shall expire if the work authorized has not commenced within 12 months after the date of
issuance or has not been completed within 18 months fi-om su~t~ date. If no zoning amendments or other regulations affecting the
property have been enacted in the interim, the Building Inspec!dr may authorize, in wr/ting, the extension of the permit for an
addition slx months. Thereafter~ r~6w permit shall bi r~6quh:ed~i
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, ~uffolk CQunty, New York, and other applicable Laws, Ordinances or
Regulations, for the construction of buildings, additions, or alt.emtioas or for removal or demolition as herein described. The
applicant a~ees to comply with all applicable laws, ordinanges?uilding code, ligusing/fode, and regulations, and to adinit
authorized inspectors on premises and in building for necessao ihzspections_
(Signature of applicant or name, ff a corporation)
(Mailing address of applicant)
State whether applicant is o,~mer, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder
Name of owner o f premises -4- ~
· (A~n ~,e .ax r,,h ,,~ .at.st de~d)
If apphcant is a corporation, signature of duly authorized officer
(Name and title of corporate officer)
Builders License No.
Plumbers License No.
Eleciricians License No.
Other Trade's License No.
1. Loca[ion of land on Which proposed work will be done:
House Number Street'
Hamlet
Count5' Tax IVlap No. 1000 Section Iq-Z__ Block (
Subdivision Filed Map No.
2, ~{~'fe exzstmguse and occupancy of prermses and intended use and occ¢~a~cy:~ofproposed const~l~ctton. a_ . Ex~stmg use and occupancy /J~q-~Z~
b. Intended use and occupancy/~_.
3. Nature of work {check ~vhich applicable): NeW Building
Demolition
4.
5.
Repair Rembvai
Estimated Cost ~ ~
If dwelling, nmuber of dwelhng units
If garage, number of cars
Fee
~AlteratJ on
(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 tTpe of use.
7_ Dimensions of existing structures, if any: Front
Height Number 6f'S~tories
_Depth ~ ~-~.
Dimensions of same structure with alterations or additions: Front ~ q,2 Rear
Depth ~,~:~}/-. Height_ Number of Stories ~-
8_ Dimensions o f entke new construction: Front
Height
9_ Size of lot: Front
10_ r)ate'of Purchase
Rear _Depth
Number of Stories
Rear ~0,0{ Depth
Name of Former Owner ~-i~ i~'~
1 l. Zone or use district in which - '
premtses are situated
12. Does proposed construction violate any zon, jng law, ordinance or regulation? YES_ NO
13. Will lot be re-graded? YES NO c//Will excess fill be removed from premises? YES NO
14. Names of O~mer of premises ~-~za~ A:ddressq?5' ~C.I~°-~ Phone
Name of ~'chtect Ad,ess Phone No
Name of Contractor Address Phone No.
15 a. Is this property within 100 feet of a tidal wetland or a freshwater xvetland? *YES
* IF YES, SOUTHOLD TOWN TRUSTEES & D.E.C: PERMITS M_AY BE REQUIRED.
b. Is this property within 300 feet of a tidal wetland? * Y'ES NO
* IF YES, D.E.C. PEP. MITS IVE{¥ BE REQUIRED.
NO ¸V/'
16. Prov/de 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 OFNEW YORK)
SS:
cOUnTY or,5 Llq)
~ro_~ SCI,-xLDF_~ 'Jl-~_~Oe..~ be/~gdulyswom, deposes and saysthat (s)heis the applicant
(Name of ~hdix'idual signing corrLrac0 guove named;
(S)He is the
(Contractor, Agent, Corporate Officer, etc.)
of said owner or turners, and is duly author/zed to perform or have performed the said work and to make and file tkis 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 mariner set forth in the application f'fled therewith.
Sworn to before me t?ds
Notary Public z
Si=maature of Applicant
THERESA A. FOSTER
Nota~ Public, State of New
No. 01FO4823157, Suffolk Coun~
Term Expire~ Deoembef 3t, 20