HomeMy WebLinkAbout30149-Z FORM ITO. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Office of the Building Inspector
Town Hall
Southold, N.Y.
CERTIFICATE OF OCCUPANCY
No: Z-30811 Date: 03/08/05
THIS CERTIFIES that the building ACCESSORY
Location of Property: 7080 SKUNK LA CUTCHOGUE
(HOUSE NO. ) (STREET) (HAMLET)
County Tax Map No. 473889 Section 104 Block 5 Lot 10
Subdivision Filed Map No. Lot No.
conforms substantially to the Application for Building Permit heretofore
filed in this office dated MARCH 10, 2004 pursuant to which
Building Permit No. 30149-Z dated MARCH 11, 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 PAUL & EMMA O'DONNELL
(OWNER)
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A
ELECTRICAL CERTIFICATE NO. 4043 05/05/04
PLUMBERS CERTIFICATION DATED N/A
Au horized Signature
Rev. 1/81
Form No.6
TOWN OF SOUTHOLD
BUILDING DEPARTMENT DE( c . .
TORN HALL 7 ;_t1J�t
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.
S. 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. Gam/ 6/ 12.0,0 y
New Construction: Old or Pre-existing Building: (check one)
Location of Property: 9-080 Z&4.2— C OG J
House No. Street Hamlet
Owner or Owners of Property: R+V't--f ElIgAJ 9- 0
Suffolk County Tax Map No 1000, Section 10'P Block Lot 1p
Subdivision Filed Map. Lot:
Permit No. O/ZI'7 -peelp Date of Pernut Applicant:_P,QVk .i-AWMA 0:4* U,1'9t L-
i
Health Dept. Approval: Underwriters Approval:
Planning Board Approval:
Request for: Temporary Certificate Final Certificate: !/ (check one)
Fee Submitted: $
Applicant Signature
Cc �3o6 I I
Mar 06 05 09:09p Paul O'Donnell +1 212 741-1762 p.2
Nassau Suffolk Electrical Inspections, Inc.
SA Canal Street• CenterMorkbes,NewYork 11934 •Tel:631-878,3500 a Fm 631-876-3764
Application: 4043 Date: 5/5/04
Issued to: O'Donnell
Address:. 7080 Skunk Lane
Village: Cutchogue latlnduwd By:Bethel Electric L#. 2880-ME
tined erdate and was in compliance with the NEC —
Attic 1st Floor F4ddertiall$1 P0010 DetGNAP
8a$11TWt 2udt1tlor Cotmle11ad HotTtlb Additan
switches Receptacles Fisb+rea G.F.J. Timeclock Whirlpool
2 3 1 1 1 1
Fans Dishwasher Washer/Amps Dryor/Ampe Oven Carbon
RanpslAm pa Monoxide
Furnace Oil Gas Heat Zones Smoke Bell
Dabotorc Transformers
Heeler
Meter Amps Phase Motors
i
cher Equipment: Ingrounn Pool
i
ut,Res
This certificate trust not be altered
in any mamter
Section: 104 Block: 5 LoC010.000
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. 30149 Z Date MARCH 11, 2004
Permission is hereby granted to :
PAUL & EMMA O ' DONNELL
12 WEST 18TH ST APT 6E
NEW YORK,NY 10011
for
CONSTRUCTION OF AN INGROUND SWIMMING POOL IN THE REQUIRED REAR
YARD, FENCED TO CODE
at premises located at 7080 SKUNK LA CUTCHOGUE
County Tax Map No. 473889 Section 104 Block 0005 Lot No. 010
pursuant to application dated MARCH 10 , 2004 and approved by the
Building Inspector to expire on SEPTEMBER 11, 2005 .
Fee $ 150 . 00
Authorized Signature
ORIGINAL
Rev. 5/8/02
765.1802
BUILDING DEPT.
INSPECTION
[ ] FOUNDATION 1 ST [ ] ROUGH PLBG.
[ ] FOUNDATION 2ND [ ] INSULA ION
[ ] FRAMING KFINAL b cll�- Y- fo C)
Z-)
[ ] FIREPLACE & CHIMNEY [ ]] FIRE SAFETY INSPECTION
REMARKS: VL
DATE 2- 3 O 74 INSPECTOR ,`:�f
TOWN OF SOUTHOLD ROPERTY RECORD CARD /'-
OWNER STREET 7 C\ g0 VILLAGE DISTRICT SUB. LOT
c--,&i t, Emma
FORMER OWNER NE y ACREAGE
�r1��
Ba V 1�v e, roa dGbafe`� �,2 3�
S TYPE OF BUILDING
Z19NE- Ti _ c
RES.ZSEAS. VL. FARM COMM. IND. I CB. MISC.
ULAND IMP. TOTAL DATE REMARKS 16 71 Z.
/(� � 2 7 r7 S�/ 3 �:,e��i✓c Se we.I � t e S w/ � z e?j 7/
yo v a o 06 -2v, 50 - < < /
4n o 7�29f� .['(./� /.�SS� Ada/ dQ�/er
c /; jai &
_
7 � s/» e o I o1a�03- cam�fq(o-�ec�2ll O'l��nn�ll r,a� - �1{Osy�
�GE �c3o B � I84C�CONDiTI N
J
NEW NORMAL BELOW ABOVE ,r)
Farm Acre Value Per Acre Value a G V(f C
Tillab.le I t oig
Tillable 2
Tillable 3
VNoodland
Swampland
3rushlap V
HouseF�o ^ "MOO
Total
l � F
At
8
_ 8z
Y '
i
3
i
4. Bldg' 2-4 X32 = 7 1? �,� 381 () Foyndation CPn"� Bath
tensi i 5 X k?t _ '270 3, Z� �7$ Basement aGG Floors ��� �-
xtension Ext. Walls Vear OrcpRR Interior Finish g!'uW'Y
xtension Fire Place I Heat
Porch Attic
4 Porch Rooms 1st Floor
reezeway Patio Rooms 2nd Floor
iarage f VyyiS� w Y
8= ., 6
). B.
53lu �
-foAnn . . .. - . � . - •2scx�F'SI
APPR(OD AS NO D
e 4
O D A.P.a
F BY:
N IFY BUILDING DEPARTM T AT VIV IIL X_tLjEQ,
7 1602 SAM TO 4 P FO THE / 1 YPICAL �1lY�l
F OWING INSPECTIONS: LETAIL
FO JETE
PLUMBING prCUPANCY OR
4. FINAL - C. MUST USE-IS UNLAWFVJ ,.
BE COMPLETE FORR C. �"O WAsTE
ALL CONSTRUCTION SHA6i'AAEE �ITHOUT CER- t�
REQUIREMENTS OF TF.= CQ? 9ENfWp FloCA
YORK STATE. NOT RESPONLE FOR OF OCCUPANCY Tr--2 sTtZPtu�tZ
DESIGN OR CONSTRUCTION ERRORS.
it /tea 7T'7 Sl-trintf-
NCLOSE POOL 0 CODE
UPON COMB ETION PCb�
BEFORE " TER' � TZ] J L
_ UApERWRfTERSt
REQUIRED 46
C-0r(\PP.C.T�p 5CN�1(IA'[1C PIP11`1G ��WGM'T
�� MINT-��PTH OF Pac�L FL's DEC.rC L�l�l
_pIV�►.�G 91!SoANZ+-�, To nnE=f---r N,s,F, 'RfifVmTt
u DIST0v Z!-p�&--r: E:_p,ZnA gE NtU1MUM AT 8'-6.1
• '�a4E4SiCf�: ,, ,-
51 z A B C A1z�A Von e
•-zd 40 866 a .
i
ft�t_1.�G'.:�-� �Al•i= HO`;�. .�', +�A✓�rC•n.�� O'vonnal
�AV�nw. % 7010 SKS 1 k 1
NTE G/th �' °. v10� vQ
FI _T�� ARE=A _ 5G„ 1=T � Oi' '!!•R �, .G 7
ran ie u, un:uaa P.z
BAY AVENUE
N 79'12'10 E - 100.00'
a
P N
u v
0
aav¢ uMEwr vm hum tWmRW �'
a
v t .6• ^1 CID �I
SAYE �' O
u � N
4 C�
y U C
z6s D
P ITT
o u
Prrasc� QeL p' rrl
propos C/
0- 00
s'Alb
;! -100
o � r
1 ,
1 = 3Q �y, i
Z Y / .
Ib 1;5 ? !
P/PAC��a����9YYYYYY
d 79'f2'10'W e00o saml aF rR01+. 100.00 �'
R/F txAIER I Ef/F RtEBd/avWpx
owrwos Meaee efe et rxu fae
(RIW KAWMI ne aAlKlOIY - .
6/16a1�i0116 oMlF W K
�tM1�MCN�i.IBOE Y� )1
W KMMIFIS>Rr lnoeeseWARt SURVLYD}. 15 SEPIFAIBER 2003 V�
glM7af It Ml MIdN�1[W I
ApOEya MOP146 M fla�YeMS
eraF 1'= 20'
Il9M�®lWG9/MIAO�9 Mf
Kaw�aa�r s MFS = 13.000 S.F.
OR
SURtees a<na nartra�MFraee OF 0.7„ E
ACR
DESCRIBED
PROPERTY
aai smwfE
CUTCHOGUE, TOWN OF SOUfliOLD
SUFFOLK COUNTY, N.Y.
SURVEYED FOR- PAUL OWNNELL
EMMA O'DONNELL SURVEYED BY
R1/ 1000-10s-05-010 STANLEY J. ISAKSEN. JR.
P.O. RQK 294
NEW SUrFOLK. N.Y. 11956
wR M FON:
C
*- M
535
FRA. OWNIVELL
Eom ovumm 9
7261
FIELD INSPECTION REPORT DATE
COhIMENTS
�1 .e
FOUNDATION(IST) _
^3
------------------------------------
A
FOUNDATION(2ND) — -
qo .Cil
� r
z
� o
CJ
op
dr
ROUGH FRAMING& y
x
PLUMING
5
T-
r-
S
a
INSULATION PER N.Y. r
STATE ENERGY CODE
'-1
r-
FINAL
ADDITIONAL COMMENTS Q
z
z
1
d y
z
x
l �
a
v
rn
�e
y
TOWN OF SOUTHOLD BUILDING PERMIT APPLICATION CHECKLIST
BUILDING DEPARTMENT Do you have or need the following,before applying?
TOWN HALL 0 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. O/ 2-2'� Check
Septic Form
N.Y.S.D.E.C.
_ �/ Trustees
Examined 11-1 . 200`1 Contact:
Approved// 20L�l Mail to:
Disapproved a c
_ Phone:
Expiration /1/ .20QD--
,Building Inspector
APPLICATION FOR BUILDING PERMIT
'R to Date 120
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 Perrrut.
d. Upon approval of this applicatiop, 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.
E 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.
(Signd1
Lure of applicant or name, if a corporation)
(Mailing address of applicant)
State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plurnber or builder
P I I xg
Name of owner of premises
(As on the tax roll or latest deed)
If applicant is a cootp ration, signature of duly authorized officer
(Name and title of corporate officer)
Builders License No.
Plumbers License No.
Electricians License No.
Other Trade's License No.
1. Location of land on which proposed work will be done:
7060 SrUAK- LAtJG C lff4loaUP
House Number Street HaInlet
County Tax Map No. 1000 Section `J4 Block bS Lot 010
Subdivision Filed Map No. Lot
(Name)
2. State existing use and occupancy of premises and intended use and occupancy of proposed construction:
a. Existing use and occupancy `
b. Intended use and occupancy
3. Nature of work(check which applicable): New Building_ Alteration
Alteration
Repair Removal Demolition Other Work Gy b
(Description)
4. Estimated Cost 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�,s
8. Dimensions of entire new construction: Front Rear Depth
Height Number of Stories
9. Size of lot: Front 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
14. Names of Owner of premises Rt/I O Diffe(( —Address ?Dfo –gX1(1 k W Phone No. �l2 4LI2 381 C)
Name of Architect Address Phone No
Name of ContractorEAST(alb POOL ('-ll><a Address353CO R148 Phone No. 7 "? o0
�CCx11C�
15 a. Is this property within 100 feet of a tidal wetland or a freshwater wetland? *YES NO
* 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_ X
* IF YES, D.E.C. PERMITS MAY BE REQUIRED. 7�
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 OA
2: �' /y �1 2 ,tom being duly sworn,deposes and says that(s)he is the applicant
(Nafne of individual signing co tract)above named,
(S)He is the )vjZd c c Z.
(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 /
/Gtn� day of UCc 20 (] /
Notary Public Xignatue of Applicant
GAIL L.ASSEITO
Notary Public,State of New York
Nu.OtA.c022543
QueliPed in S.1folk county_ O
Canmiwion Expires Jen.18,
om
z
v z
w
o in o 0
W
LUW
W Q D
EY G
NI PF1,1 11-0111 III IF W p O
=r ��Ir�II W (-)
l
FI IF I I Tu P1
I-
I ,wFT
_D _ � d
U)
rlulr Iro III Z CD
111
,� Cl I �' s . � _hI, ,III III.111111 111 , ��� .,Ia I u PrnO o U
PIF l -1 n1= P1'II
O
ul nnF nn FIIFII
_ _ m
O
1 .D
m_ D
II N
1 n1 Y
\ a
o
D 1 '1 '� I •'Li ��
rn 1 U O
P. 1 1 Ii 1
11 11
1
11
II �
11 11
II 11
1
11
0 0 y 30, 7•`
,F 6
A m
LU w
tJl I 1 a J'1U
lU
O
u
11 C
I I r`i
m
1l
1111
0 1
n
y_L
1
1
('
�.. I I I 8�3
,� � I �
1n
1
11 _ - D11I
I
_ 1111 iF II 1
.0
I1,
11 �
1 a 1 a _
I�
FOUNDAMN PLAN
IIII
LL
O
IL
b� •,�o�®_��,��,®®�,.,w �1,1� 11�11�.1.11n11.m11.��1�.�w