HomeMy WebLinkAbout29541-Z FORM NO. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Office of the Building Inspector
Town Hall
Southold, N.Y.
CERTIFICATE OF OCCUPANCY
No: Z-30529 Date: 11/04/04
THIS CERTIFIES that the building ACCESSORY
Location of Property: 3070 PECONIC LA PECONIC
(HOUSE NO.) (STREET) (HAMLET)
County Tax Map No. 473889 Section 74 Block 3 Lot 15
Subdivision Filed Map No. Lot No.
conforms substantially to the Application for Building Permit heretofore
filed in this office dated JUNE 30, 2003 pursuant to which
Building Permit No. 29541-Z dated JULY 2, 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 IN THE REQUIRED REAR YARD WITH FENCE
TO CODE AS APPLIED FOR.
The certificate is issued to LEE I & MARIE BENINATI
(OWNER)
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A
ELECTRICAL CERTIFICATE NO. 78854C 08/06/03
PLUMBERS CERTIFICATION DATED N/A
Y - X-z
//1hori ed S'gnature
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. 29541 Z Date JULY 2 , 2003
Permission is hereby granted to:
LEE I & MARIE BENINATI
PO BOX 522
PECONIC,NY 11958
for
CONSTRUCTION OF AN INGROUND SWIMMING POOL IN THE REQUIRED YARD
AS APPLIED FOR FENCED TO CODE
at premises located at 3070 PECONIC LA PECONIC
County Tax Map No. 473889 Section 074 Block 0003 Lot No. 015
pursuant to application dated JUNE 30, 2003 and approved by the
Building Inspector to expire on JANUARY 2 , 2005 .
Fee $ 150 . 00
Authorized Signature
ORIGINAL
Rev. 5/8/02
'76-9-5333
Form No.6
TOWN OF SOUTHOLD
BUILDING DEPARTMENT e
TOWN 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
w denied,the Building Inspector shall state the reasons therefor in writing to the applicant.
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.
� 7 - 0
New Construction: Old or Pre-existing Building: check one) (!��
Location of Property: Q O 0 Al I Q AJ i Q (✓ U
House No. Street / mlet
Owner or Owners of Property: 'kC/U/ ,/�/ A"T 7 [�c�� r � 1 E
Suffolk County Tax Map No 1000, Section{ Block 3 Lot S
Subdivision Filed Map. Lot:
Permit No. Date of Permit. Applicant:
Health Dept. Approval: Underwriters Approval:
Planning Board Approval: r/
Request for: Temporary Certificate Final Certificate: eck one)
Fee Submitted: $
pplicant Signa e
r'G 0
Electrical Inspection Certificate
Issue Date Electrical Inspection Service, Inc. Application Number
08/06/2003 375 Dunton Avenue 78854C
East Patchogue, New York 11772 _
(631)286-6642
Issued To: Lee Beninati
Street: 3070 Peconic Lane
Village: Peconic Zip: 11958 Town: Southold
Section: 74 •Block: 3 Lot: 15
Contractor: Hank*s Electric Inc. (L) Lic. # 2675-E
Was examined and found to be in compliance with the National Electrical Code.
❑ Commercial ❑ NV Defects ❑X Pool ❑ 1st Floor ❑ Indoor ❑ Basement ❑ Hot Tub
X❑ Residential ❑ Det.Garage ❑ Attic ❑ 2nd Floor X❑ Outdoor ❑ Addition ❑ Survey
Switches Receptacles Fixtures GFI Heaters A/C Fans
2 1 2 1
Dishwasher Washer/Amps Dryer/Amps Oven Range/Amps Microwaves
Furnace Oil Gas Circulators Smoke Detector Bell Transformer
Meter Amps Phase UG/OH Jacuzzi Television CO Detector
Bldg. Permit:
Other Equipment
1-Pool Panel
1-Motor
1-Time Clock Hugo S. Surdi
President
Rough Inspection: 08/05/2003
Inspector: Ed Scavelli
Final Inspection: 08/05/2003
Inspector: Ed Scavelli
This certificate must not be altered in any manner. Inspectors may be identified by their credentials.
U ILD]
Applicant/ � Date.
Owners Name: al A 0A, Reviewed: 7 a 3
Architect/ ��� Date
'rigmeer: Submitted: 3a p
SCTNI #: ��
District: 1 X O Section: —1_ 13100 : 3 Lot:
hrojec(
Subdivision
Location: .QCeM-LG
. / t
# e (iat separate
cufication: 1Ys/No)
Req. Req.
--
Lolling Uis(ricl: 11,01 size: Acuial: 1 (Lot coverage I'roposcJ
Rcy, Rcq.
Pro � Req. I
(I�'ronl Pard )- (Side Yard Proposed: �"�'__-1 (Rear Yard >
I roposedi tO 7
Project Description:
AGENCRVERMITS P erm i t
REQUIRED FOR REVIEW N.A. NO 'YES Number
Suffolk County Health Dept. -Z_
New York State D. E. C.
Town Trustees
Town Zoning Board approval:
Town Planning Board approval: _
Flood Plane Elevation???
Flood Zone: ��
Notes:
a
1
765-1802
BUILDING DEPT.
INSPECTION
[ ] FOUNDATION IST [ ] ROUGH PLBG.
[ J FOUNDATION 2ND [ ] INS ATION
[ ] FRAMING [ FINAL
[ ] FIREPLACE & CHIMNEY [ ] FIRE SAFETY INSPECTION
REMARKS: ouc
fl.J
/�Cr�<.+iZ a .�✓ate
DATE INSPECTOR
765-1802
BUILDING DEPT.
INSPECTION
[ ] FOUNDATION iST [ ] ROUGH PLBG.
[ ] FOUNDATION 2ND [ ] 1 CATION
[ ] FRAMING [ FINAL
[ ] FIREPLACE & CHIMNEY [ ] FIRE SAFETY INSPECTION
REMARKS:
dil
DATE � � � d INSPECTOR
FIELD INSPECTION REPORT DATE COADMgTS
vl
FOUNDATION(1ST) ►=� .
c
FOUNDATION(2ND) t�7
. 2
_ o
ROUGH FRANmVG&
PLUMBING
INSULATION PER N.Y. ,,3
STATE ENERGY CODE
a
FINAL d
ADDMONAL COMMENTS
3
5 '
0 _.
Z.
a
O
d
TOWN OF.SOUTHOLD BUILDING PERMIT APPLICATION CHECKLIST
BUILDING DEPARTMENT Do you have or need the followhig,bef r e applying?
TOWN HALL Board of Health
SOUTHOLD,NY 11971 3 sets of Building Plans
TEL: (631) 765-1802 Planning Board approval
FAX: (631) 765-9502 Survey
www. northfork.net/Southold/ PERMIT NO. Check
Septic Form
N.Y.S.D.E.C.
Trustees
Examined Q 20 Contact: klftg
Approved a 2 Mail to Im QCol Is
Disapproved a/c 4-71 RJe_ 2 5#q
Phone: RDCk_L4 P+ • 1a.4
Expiration C 20(
_ -7414 -8tov
uilding Inspector
JUN 3 0 2000
A PLICATION FOR BUILDING PERMIT
Date` �p 30 , 2063
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 until the Building Inspector
issues a Certificate 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 from such date. If no zoning amendments or other regulations affecting the
property have been enacted in the interim, the Building Inspector may authorize, in writing, the extension of the permit for an
addition six months. Thereafter, a new permit shall be required.
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 County,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 code, and regulations, and to admit
authorized inspectors on premises and in building for necessary inspections.
:t
(Signature of applic nt or name,if a corporation)
3 -7 0�e_CU n t C LAr1c,
(Mailing address of applicant)
State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder
6Wfle4' i
Name of owner of premises Lem an 0, ,Max I g, Re- +'1 �(�aA� ,
(As on the tax roll or latest deed)
If applicant is a corporation, signature of duly authorized officer
(Name and title of corporate officer)
Builders License No. a 1L}- I 'D_ +t
Plumbers License No.
Electricians License No. (D`I
Other Trade's License No.
1. Location of la which proposed work will e:
tor"70 rli C )Laa 9,-- cow C..
House Number Street ``�� ,, Hamlet
County Tax Map No. 1000 SectionV 4 Block b J, Lot I �J
Subdivision Filed Map No. _ Lot
(Name)
W
10
2. State existing use and occupancy of premises and 'ntended use and gccupancy of proposed construction:
'
a. Existing use and occupancy I n I' I us C- '
b. Intended use and occupancy P'L- )C3 1,o f' 0,46Lr1 1.e_- to 1 h CIOUb O.P WS
�� sc In08r000 ►
3. Nature of work (check which applicable): New Brig ) Addition Alteration
Repair Removal DemolitionO her Work
(Description)
4. Estimated Cost-4 10,600 06 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
8. Dimensions of entire new construction: Front Rear Depth
Height Number of Stories
90. Size of lot: Front Rear
—Depth "l (o(o•P-5
10. Date of Purchase Name of Former Owner
11. Zone or use district in which premises are situated 6LCrf'
12. Does proposed construction violate 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 Owner of premises Lee ge(li A" Address 307 o"-RConi c L&- Phone No."765- 1749'
Name of Architect 1-eW'_�On Address hlangCwe)Phone No $a- 5q-07
Name of Contractor I e*- Address 4')1 Z 6 t4 Phone No. 7u4-8 10 b
o&Lj-4 +. t�4►t,1 qt
15 a. Is this property within 100 feet of a tidal wetland or a freshwater wetland? *YES NO-k.--
•
* 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 MAY BE REQUIRED.
16. Provide survey, to scale, with accurate foundation plan and distances to prc perty lines.
17. If elevation at any point on property is at 10 feet or below, must provide topographical data on survey.
STATE OF NEW YORK)
SS:
COUNTY OF f I
aln r-1Pe) �, '�P�1ll �(1 CL'71 being duly sworn, deposes and says that (s)he is the applicant
(Name of individual signing contract) above named,
(S)He is the oWn e(—
(Contractor,Agent, Corporate Officer, etc.)
of said owner or owners, and is duly authorized to perform or have performed the said work and to make and file this application;
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 manner set forth in the application filed therewith.
Sworn to before me this
,36`!-L-) day of ] U0-2r 2003
ci &&� -a
Notary Public Signature of Applicant
NOREEN L HAGER
KVTABY PUBLIC.STATE OF NEW YOU
QUALIFIED IN SUFFOLK COUNTY
REG.NO.01
C� WM
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