HomeMy WebLinkAbout30507-Z FORM NO. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Office of the Building Inspector
Town Hall
Southold, N.Y.
CERTIFICATE OF OCCUPANCY
No: Z-30758 Date: 02/11/05
THIS CERTIFIES that the building ACCESSORY
Location of Property: 300 LATHAM LA ORIENT
(HOUSE NO. ) (STREET) (HAMLET)
County Tax Map No. 473889 Section 15 Block 9 Lot 1.10
Subdivision Filed Map No. Lot No.
conforms substantially to the Application for Building Permit heretofore
filed in this office dated JULY 20, 2004 pursuant to which
Building Permit No. 30507-Z dated JULY 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 INGROUND SWIMMING POOL IN THE REQUIRED REAR YARD WITH FENCE
TO CODE AS APPLIED FOR.
The certificate is issued to WILLIAM & CYNTHIA ARNOLD
(OWNER)
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A
ELECTRICAL CERTIFICATE NO. 2040642 01/25/05
PLUMBERS CERTIFICATION DATED �J N/A
thq zed/Signature
Rev. 1/81
60 Form No.6
Qnw"# 'n 9 TOWN OF SOUTHOLD
11 q 5 7 BUILDING DEPARTMENT -B 7 .
TOWN HALL
765-1802
APPLICATION FOR CERTIFICATE OF OCCUPANCY
This application must be filled igSy.)etMter or ink and submitted to the Buildine 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. -2
New Construction: Old or Pre-existing Building: (check one)
Location of Property: ?jC> LIgNe, C)VLkerWT^
House No. Street Hamlet
Owner or Owners of Property: W�\ .\-1 A*%A Cg t-- ' t F\ A a n9 a l.p
Suffolk County Tax Map No 1000, Section S Block 09 Lot I C)
Subdivision L KkN D'S Cn1D Filed Map. S9 09 Lot: 10
Permit No. 3050-7 -Z- Date of Permit. '7-V6-0 Applicant:
Health Dept. Approval: Underwriters Approval: \ I ZS10 S
Planning Board Approval:
Request for: Temporary Certificate Final Certificate: `� (check one)
Fee Submitted: $ 02 SOO
Ow
Applicant Signature
IJI��oZ_�13 6w 5;v8'
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. 30507 Z Date JULY 23 , 2004
Permission is hereby granted to:
WILLIAM & CYNTHIA ARNOLD
PO BOX 60
ORIENT,NY 11957
for
CONSTRUCTION OF AN INGROUND SWIMMING POOL IN THE REQUIRED REAR
YARD, FENCED TO CODE
at premises located at 300 LATHAM LA ORIENT
County Tax Map No. 473889 Section 015 Block 0009 Lot No. 001 . 010
pursuant to application dated JULY 20, 2004 and approved by the
Building Inspector to expire on JANUARY 23 , 2006 .
Fee $ 150 . 00
4z, 6' l-
Authorized Signature
ORIGINAL
Rev. 5/8/02
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f5� BY THIS CERTIFICATE OF COMPLIANCE THE 5
5 NEW YORK BOARD OF FIRE UNDERWRITERS 5
5 BUREAU OF ELECTRICITY 5
5 40 FULTON STREET — NEW YORK, NY 10038 C�
CERTIFIES THAT 5
5 Upon the application of upon premises owned by
5 5
5 5 G & S ELECTRICAL CONTR. WILLIAM ARNOLD 5
P.O. BOX 215 300 LATHAM LN
5 SOUTHOLD, NY 11971, ORIENT, NY 11957 5
5 �5+
Located at 300 LATHAM LN ORIENT, NY 11957 5
Application Number: 2040642 Certificate Number: 2040642 5
5 5
5 Section: Block: Lot: Building Permit: BDC: ns11 r5
Described as a occupancy, wherein the premises electrical system consisting of 5
electrical devices and wiring, described below, located in/on the premises at: 5
Outside, Pool/Spa,
5 A visual inspection of the premises electrical system, limited to electrical devices and wiring to the extent detailed 5
5 herein, was conducted in accordance with the requirements of the applicable code and/or standard
5 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 25th Day of January, 2005. 5
Name QTY Rate Razing Circuit Twe 5
5 Appliances and Accessories 5
5 Time Clock;'Switch 1 0 5
5 Pool/Spa Bonding 1 0 5
Motors l 0 F.H.P. rj
Pool/Spa Circulator Pump Moto 1 0 H.P. 5
5 Panels 5
51 60 4 5
5 Wiring and Devices 5
5 Fixture 1 0 Pool/Spa
5 Receptacle 1 0 General Purpose 5
5 Receptacle 1 0 GFCI 5
5 Receptacle l 0 20 amp Pool/Spa C
5 Switch 2 0 General Purpose 5
5 (Swimming Pool):This certificate covers compliance at the date of inspection only. Because of unusual envirnrnicnts it is isable to have 5
5 frequent test and,or repairs made by a qualified person.
sea/ S
5 5
5 1 of 1 55
This certificate may not be altered in anyway and is validated only by the presence of a raised seal at the location indicated. 5
5 5
D LrL3rL3L3r@rJcPL rPcPrJcP rJrJrJ11 111rJ rJ� rlr� rJ L7
765.1802
BUILDING DEPT.
INSPECTION
[ ] FOUNDATION 1 ST [ ] ROUGH PLBG.
[ ] FOUNDATION 2ND [ ] 1 LATION
[ ] FRAMING [ FINAL
[ ] FIREPLACE & CHIMNEY [ ] FIRE SAFETY INSPECTION
REMARKS: '
DATE INSPECTOR
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1
FIELD INSPECTION REPORT DATE COMMENTS
FOUNDATION(IST)
O l
------------------------------------
FOUNDATION(2ND)
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ROUGH FRAMING&
PLUMBING
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INSULATION PER N.Y. rn tt--
STATE ENERGY CODE y
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FINAL
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ADDITIONAL COMMENTS
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BUILDING DEPARTMENT Do you have or need the following,before applying?
TOWN HALL Board of Health
SOUTHOLD, NY 11971 3 sets of Building Plans
TEL: (631) 765-1802 Planning Bo approval
FAX: (631) 765-9502 Survey
www. northfork.net/Southold/ PERMIT NO. 3 D 57)7e Checker )t/)D
Septic Form
N.Y.S.D.E.C.
Trustees
Examined,20__VKf_ Contact:
f�vJ;m 1ltR� Pa>Is
Approved�j,20 0-f Mail to:
Disapproved aic 1 2-I'.0 2 5P �
Phone: ►1718
Expiration 1573 , zo ab -l4-9)0
Building Inspector
II II. 20011 APPLICATION FOR BUILDING PERMIT
iDate JLL�U ( � , 20o4
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 lie 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
issAs 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.
i
"IMMEDIATELY" REQUIRED
ENCLOSE POOL TO CODE (Si atur%f applicant or name, if a corporation)
UPON COMPLETION
BEFORE"WATER" ' TION
MEET T�HcE REQUIREMENTS OF THE (Mailing address of applicant)
State whether applicant is owner, lessee, ag�tlt-arr1 Fe9W1rSJ0val contractor, electrician, plumber or builder
APPRM AS NOTO
n DATE B.P.
Name of owner of premises �l l &A6_Ctndm Af rxA,o I ME !S� Q„�(r„ fi
(As on the tax roll or latest BOLDING DEPARTMENT AT
If applicant is a corporation, signature of dutygtecl.q rOR 785.1802 a AM TO 4 PM FOR THE
(d(�( AANN FOLLOWING INSPECTIONS:
(Name and title of corporate officer 1.IS UNLAWFUL 1. FOUNDATION • TWO REQUIRED
t� FOR POURED CONCRETE
Builders License No. a k4 t a 14 WITHOUT CERTIFICATE 2.3 INSULATION
- FRAMING 8 PLUMBING
Plumbers License No. v
Electricians License No. a lQ-j i 4. FINAL • CONSTRUCTION MUST
Other Trade's License No. BE COMPLETE FOR C.O.
ALL CONSTRUCTION SHALL MEET THE
REQUIREMENTS OF THE CODES OF NEW
1. Location of land on which proposed work will be don YORK STATE. NOT RESPONSIBLE FOR
app L_0_-�O rn LAn'e" - DESIGN OR CONSTRUCTION ERRORS.
House Number Street Hamlet
County Tax Map No. 1000 S cti on )EJ Block O q Lot I • 10
Subdivision [ Q ki IS Filed Map No. 5-i09 Lot 10
(Name)
State existing use and occupancy of premises and inten(�)j use and occupancy of proposed construction:
a. Existing use and occupancy a'in -e m164 (QS)Ide'IC.Q
b. Intended use and occupancy
o2oX �1b Rio ostd In four\d 19061 u)*,(;4Lc �v code
Vol
Nature of work (check which applicable): New )fig Addition Alteration
Repair Removal—Demolition—Other Work
� (Description)
Estimated Cost A'10,00c Fee
(To be paid on filing this application)
If dwelling, number of dwelling units Number of dwelling units on each floor
If garage, number of cars
i. If business, commercial or mixed occupancy, specify nature and extent of each type of use.
Dimensions of existing structures, if any: Front Rear Depthj- +:
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
�. Size of lot: Front C 1 5 ,60 Rear 1 q 0. 3(o r 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
14. Narnes of Owner of premises Address Phone No.
Name of Architect 30b n Address 115 be-✓ Phone No 331-o11U 5
Name of Contractor. T• OCh Address -11 e2.5A Phone No. 94 4 —S 10 0
P+
15 a. Is this property within 100 feet of a tidal wetland or a freshwater weflan. ? *YES NQ A11031 „1
* 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 REQUIRAq:.
IT-
16. Provide survey, to scale, with accurate foundation plan and distances to.property lines.
17. If eleva6n;IA �p&tidii'#bperty is at 10 feet or below, must provide topographical data on survey.
STATE 5VWr" RK) --- -
8S:
COUNT'?OP —
q�Rg Xuly$id'&rit„eepJA 'and says that (s)he is the applicant
(Nafne of in f-�Vidual signiirg'cbntract) above namj0,. 1.,j..
.. .yy., ; ;, y
(S)He is the ' 0;91e4-% •Lt -r
�r
(Contractor, Agent, Corporate O Icer,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 dpplication 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.
r
Sworn to before me this
Aa Y day of 20_¢
Notary Public /ignpvure of Applicant
NOREEN L.HAGER 1 `
NMX'I' PUB'iL dTA'PEOFNEWYOER
Oi..,LIFiFj i%_UFFOLK COUNTY
KEG.NO 01KA4526433
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SURVEY OF
LOT 10
LAND'S
A MA1P OF END
TTI
LOT O FILE No.5909 FILED MAY 3, 1973
SITUATED AT
S 88.57'40" E 204.55' ORIENT POINT
TOWN OF SOUTHOLD
wl l N SUFFOLK COUNTY, NEW YORK
0o S.C. TAX No. 1000-15-09-1 .10
I SCALE 1"=40'
of LD FEBRUARY 22, 2001
_ - I LOT 10 MARCH 21, 2001 REVISED PROP. WELL h CESSPOOL LOCATION
m _ c SEPf.20, 2001 FOUNDATION LOCATION
h JANUARY 7, 2002 ADDED SEPTIC SYSTEM & WELL LOCATION
SEPTEMBER 20, 2002 FINAL SURVEY
NOVEMBER 15, 2002 REVISED SEPTIC SYSTEM MEASUREMENTS
AREA = 41,781.49 sq. ft.
0.959 ac.
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THE iSKTENCE OF RIGHT OF WAYS OFFICES LOCATED AT M4Lm AODRESS
NID/OR CAulloas a etoDPD, r 1360 f4 ANDK E AVOAIE PA an 1931
f NIY NOT 5110WH tlr HOT QMRAN/EID.
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V •
Applicant/
..� .� .
Owners NamDate.
e:. 16 C Reviewed: 3
Architect/ Date
Engineer- Submitted:
SCTM #:
District: 1.000 Sec(ion: �S Block: Lot: _� /0
Project � � 1
,o ^� Subdivision
Location: 3� ut,;,.-, O`er . , -- Nance:
$in&le& separate Required
certification: f Yes/.No)
Req' Rcq.
Zoning t)islrice 115to (Lot size: Actual: I (l of covers e � ,
� ropes
Req. Req jf
(Bron(Yard Proposed:—�_I. ( Y r Proposed: (Rear Yard� Proposed-
Project
roposed•Project Description: 5•/'.
AGENCIUE UM Permit
REQUIRED FOR REVIEW N.A. NO YES Number
Suffolk County Health-Dept. `
New York State. D. E.C.
Town Thmtees
Town Zoning Board approval:
Town Planning Board approval: /
Flood Plane Elevation???
Flood Zone:
Notes.-
s