HomeMy WebLinkAbout30055-Z FORM NO. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Office of the Building Inspector
Town Hall
Southold, N.Y.
CERTIFICATE OF OCCUPANCY
No: Z-30742 Date: 02/03/05
THIS CERTIFIES that the building ACCESSORY
Location of Property: 835 CRITTEN LA SOUTHOLD
(HOUSE NO. ) (STREET) (HAMLET)
County Tax Map No. 473889 Section 70 Block 11 Lot 3
Subdivision Filed Map No. Lot No.
conforms substantially to the Application for Building Permit heretofore
filed in this office dated JANUARY 30, 2004 pursuant to which
Building Permit No. 30055-Z dated JANUARY 30, 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 IN THE REQUIRED
REAR YARD AS APPLIED FOR.
The certificate is issued to JOSEPH M LISA S. GARCIA
(OWNER)
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A
ELECTRICAL CERTIFICATE NO. 4124 05/25/04
PLUMBERS CERTIFICATION DATED N/A
Authorized 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. 30055 Z Date JANUARY 30 , 2004
Permission is hereby granted to :
JOSEPH M & ORS GARCIA
PO BOX 142
SOUTHOLD,NY 11971
for
CONSTRUCTION OF AN IN-GROUND SWIMMING POOL IN THE REQUIRED REAR YA
RD AS APPLIED FOR
at premises located at 835 CRITTEN LA SOUTHOLD
County Tax Map No. 473889 Section 070 Block 0011 Lot No. 003
pursuant to application dated JANUARY 30 , 2004 and approved by the
Building Inspector to expire on JULY 30 , 2005 .
Fee $ 150 . 00
A iz d Signature
ORIGINAL
Rev. 5/8/02
Form No.6
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
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
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. !!ti✓1�kdy � � 5
- t
New Construction: Old or Pre-existing Building: (check one)
Location of Property: 3 Cv-l#(V".S LZCVL l rt i
House No. +_ /�`` Street Hamlet
Owner or Owners of Property: J jt°%� V,�rG l et
Suffolk County Tax Map No 1000, Section 070 Block Do 1 ( Lot Lid 3
Subdivision Filed Map. Lot:
Permit No. Date of Permit. Applicant:
Health Dept. Approval: Underwriters Approval:
Planning Board Approval:
Request for: Temporary Certificate Final Certificate: ck one)
CCU r^
Fee Submitted: $ 25
P i tur
Nassau Suffolk Electrical Inspections, Inc.
5A Canal Street•Center Moriches,New York 11934•Tel:631-878-3500 •Fax: 631-878-3764
Application: 4124 Date: 5/25/04
Issued to: Garcia
Address:. 915 Crittens Lane
Village: Southold Introduced By:B&R Mechanical Lic#: 2761-E
was examined and approved up to the above date and was in compliance with the NEC
Mc 1st Hoon Pbsklertal® Podlm Det Garage
Bimenat 2rdd floor OMT=dal Hot Ttb AdOm
Switches Receptacles Fixtures G.F.I. Pool Panel Heater
1 2 1 1 1 1
Fans Dishwasher Washer/Amps Dryer/Amps Oven Carbon
Range/Amps Monoxide
Furnace Oil Gas Heat Zones Smoke Bell
Detectors Transformers
Meter Amps Phase Motors
1
Other Equipment: Inground pool
ut,Res
Roo�
Iffis certificate must not be altered
in any manner
BUILDING PERMIT EXAMINER CHECKLIST
tg-,�,. DATE REVIEWED: / /3()/03
APPLICANT:
` ��`' " `✓ DATE SUBMITTED: �/,�/03
SCTM#DISTRICT: 1,000, SECTION: , BLOCK: _ff _, LOT: �j SUBDIVISION( "O,,,f,),-,�h
ADDRESS: �'>,5 CITY; ZONING DISTRICT:V7V CONFORMING?4
BUILDING PERMITS OPEN/EXPIRED: PRE CO: Y OR N
BP _ -Z/C/0 Z-_ , INFO /BP -Z/C/0 Z-
BP _-Z/C/0 Z- , INFO /BP -Z/C/0 Z- , INFO
SINGLE & SEPARATE CERTIFICATION-REQUIRED NOTES:
COTS 40,000SF-100-24. t recognition.(CREATED before June 30,1983),UNDERSIZED LOTS FROM JANA 997 100-25.Merger.(A nonconfonning at any time after
REQ. LOT SIZE. ��.q ACT. LOT SIZE: T COV.�.�ACT. LOT COV.
REQ. FRONT S PROP. FRONT ACT. SIDE
REQ. REAR T- PROP. REAR REQ. HEIGHT PROP. HEIGHT
PROJECT DESCRIPTION: Axx ,p r Z
ESTIMATED PROJECT COS _� ARCHITECT/ENGINB �.
WATER FRONT? !�p DESCRIPTION. PANEL # FLOOD ZONE:'`
APPROVALS REQUIRED
SUFFOLK COUNTY HEALTH DEPT: YES or , (BED#): DT / / PERMIT#:
TOWN SEPTIC RECEIPT: Y or N
NEW YORK STATE DEC: PRE-DEC 9/1/7 S or NO DTE: / / PERMIT#:
SOUTHOLD TOWN TRUSTEES: YES or NO DTE / / PERMIT #:
TOWN ZONING OARD APP VAL: YES or NO DTE: /_/_ PERMIT#:
TOWN PLAN. B RD OVAL: YES or NO DTE / /_ PERMIT#:
TOWN HISTORICAL PRE (SPLIA): YES or N
NEW YORK STATE CODE COMPLIANCE (SEE PAGE 2): S or NO
NOTES:
FEE STRUCTURE: FOUNDATION: SF
FIRST FLOOR: SF
SECOND FLOOR: SF
OTHER: SF INIT OTHER TOTAL
TOTAL: SF FEE FEE FEE
L (_SF)- ( ____SF)= SFX $ =$ +$ +$ =$
2. (_SF)- ( ____—SF)= SFX $ =$ +$ +$ _$
3. (_SF)- (_SF)= SF X $ _$ +$ +$ _ $
FINAL TOTAL: $ �
NEW YORK STATE CODE COMPLIANCE CHECKLIST
CLIMATIC/GEOGRAPHIC DESIGN CRITERIA:
Ground Snow Load:45 Wind Speed: 120MPH Seismic Design Category: B
Weathering: Severe Frost Depth: 36" Termite:M-H Decay: S-M
Design Temp: I1 Ice Shield Underlay: YES Flood Hazards:
USE/OCCUPANCY CLASSIFICATION:
HEIGHT/FIRE AREA:
TYPE OF CONSTRUCTION:
DESIGN CRITERIA: ENGINEERED/PRESCRIPTIVE
FULL FRAMING DESIGN ELEMENTS: Y/N
HEADERS: Y/N WALL STUDS: Y/N GIRDERS: YIN
CEILING JOISTS: Y/N FLOOR JOISTS: Y/N ROOF RAFTERS:Y/N
LUMBER SPECIES AND GRADE:Y/N
DESIGN LOAD CALCULATIONS: Y/N
LIVE: Y/N DEAD:Y/N SNOW: Y/N SEISMIC:Y/N WIND: Y/N
WINDOW AND DOOR SCHEDULE:
MISSLE TEST REQUIREMENTS: Y/N
EGRESS 5.7 S.F.: Y/N
LIGHT 8%: Y/N
VENT 4%: Y/N
NAILING/CONSTRUCTION SCHEDULE: Y/N
MEANS OF EGRESS: Y/N
PLUMBING RISER DIAGRAM: Y/N
LOCATION OF FIRE PROTECTION EQUIPMENT: Y/N
TRUSS DESIGN: Y/N
CERTIFICATION: Y/N
ENERGY CALCS: Y/N
TOTAL COMPLIENCE? Y/N (RETURN TO PAGE ONE)
1 _ 3 TOWN OF SOUTHOLD PROPERTY RECORD CARD
:POW R �� �! SG r--� STREET ti" VILLAGE DISTRICT SUB. LOT
70- 17 (s,�v
OR. R OWNE VALon t4j N E ACREAGE
S W TYPE OF BUILDING
:RES. /_t I SEAS. VL. FARM COMM. IND. CB. MISC. Est. Mkt. Value
LAND IMP. TOTAL DATE REMARKS ,
i
cc
G c 1 U CD
L AGE `. 7 UI DING COND T ON lZ o2coo - - 12-01 2 II "P
NEW NORMAL BELOW ABOVE FRONTAGE ON WA ER
Farm Acre Value Per Acre Value FRONTAGE ON ROAD ` 3
Tillable 1
Tillable 2 -- --- - — - �'BAE�IE' ( ! %% '
Tillable 3
)h L
Noodland (� Z3`47 3 -�C�`y2 tf � �U
Swampland
3rushland
-Iouse Plot
Total
I
1 I I
C1 fi,CA
M. Bldg. Fo ndation Bath I
i
It
Extension Basement �1 ,i Floors
Extension Ext. Walls ° Interior Finish i e� —
Extension Fire Place Heat
1 Porch Roof Type
L- r� � - -
Z_ or -� ac
I � s
,.moi----- - ---- -- -- � � ,
r- Porch - —_--
i �� Rooms 1st Floor
Breezeway
Patio Rooms 2nd Floor �I
Garage o = Driveway - -- Dormer
I I
i
i
3ooss Z
765.1802
BUILDING DEPT.
INSPECTION
[ ] FOUNDATION IST [ ] ROUGH PLBG.
[ ] FOUNDATION 2ND [ ] INSULATION
[ ] FRAMING FINAL � 00L�
[ ] FIREPLACE & CRIMNEY [ ] FIRE SAFETY INSPECTION
REMARKS: ,7 � �' ��
DATE � /� - �S! INSPECTOR
FIELD INSPECTION REPORT DATE COMMENTS
c�
FOUNDATION(1ST)
--------------------------------------
FOUNDATION
-----------------------------------FOUNDATION(2ND)
O
z
0
--- c>\0
ROUGH FRAMING& - --
- �
PLUMBING
r
INSULATION PER N.Y.
y
STATE ENERGY CODE
FINAL
ADDITIONAL COMMENTS
v
- p
Z
-- z
x
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WN OF SOUTHOLD BUILDING PERMIT APPLICATION CHECKI_,ISTfr
JILDING I)EPARTMENT Do you have or need the following,before applying?
)" HALL Board of Health
WTHOLD, NY 11971 3 sets of Building Plans
Planning Board approval
�L: (631) 765-1802
Survey
�X: (631) 765-9502 S�2__ _
PERMIT NO. ��/ C-� Check
Septic Form
N.Y.S.D.E.C.
Trustees
a=ed ,20 Contact:
proved d 20
Mail to: c
sapproe
v d a/c �-a% --,
Phone: -..2-Li L/
piration o 20
Build' g Ins r
IAN ,� �� APPLICATION FOR BUILDING PERMIT
Date - - tom_, 20
INSTRUCTIONS
a. This application MUST be completely filled in by typewriter or in ink and submitted to the Building Inspector with 3
:s 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
;as, 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
ill 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
ues a Certificate of Occupancy.
f. Every building permit shall expire if the work authorized has not commenced within 12 months after the date of
.lance or has not been completed within 18 months from such date. If no zoning amendments or other regulations affecting the
,perty have been enacted in the interim,the Building Inspector may authorize, in writing, the extension of the permit for an
inion six months. Thereafter, a new permit shall be required.
APPLICATION IS HEREBY MADE to the Building Department for LL,: issuance of a Building Permit pursuant to the
ilding Zone Ordinance of the Town of Southold, Suffolk County,New York, and other applicable Laws, Ordinances or
gulations, for the construction of buildings, additions, or alterations or for removal or demolition as herein described. The
)licant agrees to comply with all applicable laws, ordinances,building code, housing code, and regulations, and to admit
horized inspectors on premises and in building for necessary inspections.
/ (Sign e ,applicant or naive, if a corporation)
(Mailing address of applicant)
to whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder
ne of owner of premises �} .p V} I }Cl?,
(As on the tax roll or latest deed)
pplicant is a corporation, signature of duly authorized officer
(Name and title of corporate officer)
lders License No.
nbers License No.
;tricians License No.
er Trade's License No.
�ocation of land on which proposed work will be done:
i�t sT e
-louse Number Street Hamlet
=:ounty Tax Map No. 1000 Section Block C Lot J
subdivision Filed Map No.____ Lot
a. Existing use ana occupancy 1, L`D 112 4 LJ T)/-t C—
b. Intended use and occupancy �I
3. Nature of work (check which applicable): New Building Addition Alteration
Repair Removal Demolition _Other Work
(Description)
4. Estimated Costoo , ' 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
9. Size of lot: Front i,;� 11 7 Rear Depth
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 law, ordinance or regulation?YES NO
13. Will lot be re-graded? YES NO Will excess fill be removed from premises? YES NO
g16_55 Og%TiENt, LA-
14. Names of Owner of premises LC-_2L Pd i5�i/ ddress Sr���r�+oc D Phone No. 7y
71b'- lo- 3855
Name of Architect Li EJOFLe,iti> Address l� Aige Phone No 0-3 _-01 /0.5—
Name of Contractor c ' Address -PotZT 0EFF�Phone No. Cv3I- 7gy- g/0 0
'-471 PST, a sp
1-5 a. Is this property within 100 feet of a tidal wetland or a freshwa°teer`�ve a�n� S 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 property 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_�
A/t �h y T /`�j��F�"il_��� being duly sworn, deposes and says that(s)he is the applicant
(Name of individual signing contract) above named,
(S)He is the C 0/(-)i Xlq( T�'/L
(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 applicati,
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 -�
day of (1 _20�
Notary Public S' titre of Applicant
I
NOREEN L HAGER G
N IC,STATE OF NEW
OUALIFIFD iN SUFFOLK COUNTY
RFO.NO.01HA452643
OWISSION EXPIRES-
SURVEY OF
CRITTENS LANE LOT 48
R=50.0' N
A=78.54' MAP OF SOUTHWOOD
GONC
MON b SITUATE
0
LOT 49 SOUTHOLD TOWN OF SOUTHOLD
FENCE CORNER W �
°°"G s 89�28'4o"E UFFOLK COUNTY, N.Y.
MON /N D 4' 200.00
WOOD F�NCE GENERALLY ON LINE
z � (FIL7ER 12.1 _ MON MON
_ N FENCE � POOL ° m SURVEYED FOR: JOSEPH M. GARCIA
OQ r HOUSE • �l
C) I _ sHEOE 6.3 JOSEPH GARCIA a/k/a JOSE GARCIA
CONSUELO GARCIA
28 5'I 0.0' I 1L,3. ASPHALT DRIVEWAY
GARAGE It I IN-GROUND POOL I I Y
N FM 2141
LLJ # GUARANTEED T0:
v Q DATE FILED NOV 24, 1953 JOSEPH M. GARCIA
�' 9 3 JOSEPH GARCIA o/k/a JOSE GARCIA
TM 1000-070-011-003
— F7 m CONSUELO GARCIA
O I BRICK DECKING AROUND POOL ° Ld FIDELITY NATIONAL TITLE INS. CO.
NORTHWEST MORTGAGE OF NEW YORK, INC.
ct
METAL FENCE AROUND POOL
WALK V) 6.2 39.7
aS
m2:n r z Ln W
O
A � N
39.7'
32.6' p
w o Fy
N �
M� Iw SURVEYED: 19 OCTOBER 1999 '
' J J
OO I I SCALE 1"= 30'
4
CONIC
z w MON AREA = 29,895 S.F.
OR
coNc I 0.688 ACRES
' MON
9B.40'
z GUARANTEES IN ICATED HERE ON SHALL RUN
ONLY TO THE PERSON FOR WHOM THE SURVEY SURVEYED BY
IS PREPARED, AND ON HIS BEHALF TO THE
(— W, TITLE COMPANY, GOVERNMENTAL AGENCY, STANLEY J. ISAKSEN, JR.
O W END LENDING INSTITUTION, IF LISTED HEREON, AND
t0' FENCE tH Off LINE TO THE ASSIGNEES OF THE LENDING INSTITUTION. P.O. BOX 294
CD GUARANTEES ARE NOT TRANSFERABLE TO �/,�
O N, LINK FENCE SOi,�AI LOT 47 ADDITIONAL INSTITUTIONS OR SUBSEQUENT OWNERS NEW SUFFOLK. N.Y. 1 1956
Gf .�5'38
ME1P� fEN GHAIN 631 -7 4-58J5
5 UNAUTHORIZED ALTERATION OR ADDITION TO 7HlS
7 �`
CONC S SURVEY IS A VIOLATION OF SECTION 7209 OF
MON \ THE NEW YORK STATE EDUCATION LAW.
COPIES OF THIS SURVEY MAP NOT BEARING _ — — -- ---
THE LAND SURVEYORS EMBOSSED SEAL SHALL I C E N S E R N D _��I R V_YC�R
NOT BE CONSIDERED TO BE A VALID TRUE
1, 27 DEC 04 UPDATE SURVEY. COPY NYS Lic. ' o. 4927.3 99R834
-7 5'-2'' C)
1011
�01 10,
A El & 4 Ili t7-, Lu
S C—Q 0 A N C, 1")F APP OV D AS NOTED
z
DAT B.P.#
za
FEE: Q Z
Q
NOTIFY BUILDING DIE <Ln STMENT AT
--E] 765-1802 8 AM TO 4 PM FOR THE CL
0
>
FOLLOWING INSPECTIONS: ci
z
1. FOUNDATION - TWO REQUIRED
FGR POURED GONQRSTE
2. ROUGH - FRAMING & PLUMBING
co
3. INSULATION
O P8 \\I-lx 4. FINAL - CONSTRUCTION MUST Bill
TOMTODIVIPLETE FOR C.O. FFom ftf�pl = 0
ALL CONST �"5pMkll- MEET THE
REQUIREME OF THE CODES
ol 16' L
. ;E LOMP Pwp
�'"-L ME
S HE CODES
Y 7
'7E P
YORK STATE., 10
DESIGN OR C NSTR ION ERRORS.
fO WA5t fo IT-TLEN5
Ya PLUMBING SCHEMATIC
PLAN CONCP\M WALLS 10
B
WMP,LIKE C,
10,1111,col-1-11-1-11�,-15"'115 WMP\IIW
e
LLJ
4 V�
plall�19 Mm,Xf Af N z a
Imr,mg)'Oms
LLI
�2 a \// Lu Z
to -4 5ANIP POITOM
<
0 ::E
V��
COPING Aw WALK x C/
SECTION A
RR
13Y 011p5 't E 'NLA WR&r51 rourf P comcplrlE
bP�n Tl�s \j o
wl W-JT CERTI
10,
NOTES
I. S1RL1Cf11'E IS DESIGNED FOR U5 DEL. A5
V VVrJ-N7
WHERE f1f GROUND WASP TAUE 15 A MINMW 9 4'-8"6EI.ON \\j\\%\\j\\j
fl,f ITOP05N9 FIWEP 6PAa.
SECTION B 2. t3ACKflILWHCLMMTH
1'H CLEAN MOOT5ANII2I2WI5- PONOMION
llfWIrAHf Of DACKNILL TO NgW fIf HE01f OF frf WASP IN ME POOL WALL SEC7
13Y mom Wft N 01 A I
3. WALK5 fO SMOOTH.NON*IDfYFT,9,OFEP AWAY FROM POOL
4 WASP 1215IF05AL WILL 13F 1,411W TO OMN6 MCIFTIM fO%If 4"4 6"
LOCAL CONVIfa6. VV A P Ru
5-27-03
D DAMAGE EN710N