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HomeMy WebLinkAbout29389-ZFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEP~RTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No: Z-29842 Date: 11/17/03 T~IS CERTIFIES that the building ACCESSORY Location of Property: 2810 WESTPHALIA RD (HOUSE NO.) (STREET) County Tax ~ap No. 473889 Section 114 Block 7 Subdivision Filed Map No. __ Lot No. __ MATTITUCK (HAMLET) Lot 5.2 conforms substantially to the Application for Building Permit heretofore filed in this office dated MAY 15, 2003 pursuant to which Building Permit No. 29389-Z dated MAY 19, 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 WITH FENCE TO CODE AS APPLIED FOR. ~e certificate is issued to DANA FOX of the aforesaid building. (OWNER) S~-FFOLK CO[~l"f DEPAR~T OF ~{EAL~{ APPROVAL N/A ELRC~IC-~L CERTIFICA~ NO. 1070589 09/02/03 PLUMBERS CERTIFICATION DA'r~u3 N/A ure Rev. 1/81 Form No. 6 TOg~,~N 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 tbe following: A. For new building or new use: 1. Final survey of property with accurate location of all buildings, property liues, 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 fi'om Board of Fire Undenvriters. 4. Sworn statement from plumber certifying that rim solder used in system contains less thau 2,10 of 1% lead. 5. Commercial building, industrial building, multiple residences and sinfilar 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. Bo 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. Certi~cate ~f ~ccupancy - New dw~~~ing $25.~~~ Additi~ns t~ dwe~~ing $25.~~~ A~terati~ns t~ dwe~~ing $25.~~~ Swinmfing 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 Old or Pre-existing Buildi~ng: {check one) New Construction: Location of Property: House No. Owner or Owners of Property: ~_ tal'&l~ ~--~'A Suffolk County Tax Map No 1000, Section ~ ! q; Block 7 Lot ff Subdivision Permit No. ~ Health Dept. Approval: Date of Permit. Filed Map. Applicant: Undel~,riters Approval: Lot: Platming Board Approval: Request for: TemporaD, Certificate Final Certiiicate: ~ (check one) App-'It'd'cant Si~ 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. 29389 Z Date MAY 19, 2003 Permission is hereby granted to: DANA FOX 305 PRIVATE ROAD MATTITUCK,NY 11952 for : CONSTRUCTION OF AN INGROUND SWIMMING POOL WITH FENCE TO CODE IN THE REQUIRED REAR YARD at premises located at 2810 WESTPHALIA RD County Tax Map No. 473889 Section 114 Block pursuant to application dated MAY 15, 2003 Building Inspector to expire on NOVEMBER 19, MATTITUCK 0007 Lot No. 005.002 and approved by the 2004. Fee $ 150.00 Authorized Signature COPY Rev. 5,'8./02 BY THIS CERTIFICATE OF COMPLIANCE THE NEW YORK-BOARD Of FIRE UNDERWRITERS BUREAU OF ELECTRICITY STREET ~ NEW YORK, NY 30038 40 .F,.~IL TO N Upon the application of CERTIFIES THAT upon premises owned by DANA P. FOX 305 PRIVATE RD. MATTITUCK, N.Y. 11952, DANA FOX 305 PRIVATE ROAD MATTITUCK, NY 11952 Located at 305 PRIVATE ROAD MATTITUCK, NY 11952 Application Number: 1070589 Cerlificate Nunlber: 1070589 Section: 114 Block: 0007 Lot: 005.002 Building Permit: 28296Z BDC: NS11 Described as a Residential occupancy, wherein the premises electrical system consisting of electrical devices and wiring, described below, located in/on the premises at: Basement, First Floor, Second FLoor. house & pool, Attached Garage. Outszde, Attic, PooL"Spa, was inspected Jn accordance with the National Electrical Code and the detail of the installation, as set forth below, was found to be in compliance therewith on the 2nd Alarm and Emergency Equipment Sensor I 0 Senior 9 9 Appliances and Accessories Exhaust Fa~ 4 0 Dish Washer 1 0 Hydro Massage rub, Resfdem~dl 1 0 Furnace 1 0 Pump Motor 1 0 Air Cenditicner i 0 Pooh'Spa Bonding 1 0 Time Clo.;k Su, itch 2 0 Panels Day of September, 2003. .R ut,mZ ~7!~uit Type Carbon Mot, oxide Smoke F.H.P. 1.2 KW Gas i H.P 48.000 BTU I 100 18 ' Wiring and De,ices Receptacle 62 0 General Pu[pose Sx~ltch 55 0 General Pu,~pose - Fixrare 3'~ 0 Incandescent This ceKificate may not t~e altere~ ,n any way and }5 validated only by the presence of a ra:seO sea} at the location indicated. 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 [he appi~cebon of upon premises owned by DANA P. FOX 305 PRIVATE RD. MA'H'ITUCK, N.Y. 11952, Located at Application Number: 1070589 Sec[ion' 114 Block: 0007 Described as a Residenttal 305 PRIVATE ROAD MATTITUCK, NY 11952 Lot: DANA FOX 305 PRIVATE ROAD MATTITUCK, NY 11952 Certificate Number:. 1070589 005.002 Building Permit: 28296Z BDC: NS11 occupancy, wherein the premises electrical system consisting of electrical devices and wiring, described below, located in/on the premises at: Basement, First Floor, Second Flocr, _house & pool,. Anached Garage, Outstde, Arum Poo[~Spa, was inspected in accordance w;th the National Electrical Code and the detaii of the installation, as set forth below, was found to be in compliance therewith on the 2nd Name gTY ..~j.e_ Duttmers 3 0 Paddle Fan 5 0 Receptacle 1 0 Receptacle 8 0 Fixture I 0 Switch 1 0 Receptacle i 0 Receptacle 2 0 GFCICircmt Breaker 3 0 Service 1 Phase 3W Service Rating 200 AmFeres Service Disconnect: Meters: I Day of September, 2003. Ratinu C~rcuit T~pe 20 amp 20 amp 20 amp 2OO (Swimming Pool): This certificate cov2rs compJ:ance al thc date of mspechoa only. Because frequent test and or repairs made by a qu,dlfied person 2 of 2 This certificate may not be aJtered in any waj and is validated only by the presence or a Laundry GFCI Poor/Spa General Purpose GFCI Pool'Spa Pool,Spa cb ~f ,musuai ~nv,roq.~nts ~t is advisable to ~ve seal raised seal at the location indicated Town Hall, 53095 Main Road P.O. Box 1179 Southold, New York 11971-0959 BUILDING DEPARTMENT TOWN OF SOUTHOLD September 24, 2003 Dana Fox 305 Private Road Mattituck, NY 11952 RE: 2810 Westphalia Rd., Mattituck Fax (631) 765-9502 Telephone (631) 765 - 1802 To Whom This May Concern: We are unable to complete your Certificate of Occupancy because of the following reasons: xx An application for Certificate of Occupancy is not on file. (Enclosed) No Underwriters Certificate on file. xx The check is (not on file.)$25.00 No Health Department Approval on file. No final inspection has been made. No Plumber Solder Certificate on file. (All permits involving plumbing being issued after April 1, 1984). BUILDING PERMIT # 29389-z Please contact our office on this matter. cooperation. Thank you for SOUTHOLD TOWN BUILDING DEPT. 765-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ].~JI.ATION [ ] FRAMING [ ~" FINAL [ ] FIREPLACE & CHIMNEY DATE INSPECTOR FIELD INSPECTION REPORT I DATE COMMENTS FOUNDATION (IST) FOUNDATION (2ND) PLUMBING INSULATION PER N. Y. STATE ENERGY CODE FINAL ADDITIONAL COMMENTS TOgVN OF $OUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, NY 11971 TEL: (631) 765-1802 ...... FAX: (631) 765-9502 w~v. northfor k.net/Southold/ PERMIT NO. Examined ..q/! ? .20 o2, Approved ~/?// ? .20 Dtsapproved a c Expiration ! 1/j~ . 200~c i BUILDING PERMIT APPLICATION CHE.C. KLIST Do you have or need the following, before applying? Board of Health 3 sets of Building Plans Platming Board approval Survey Check Septic Form N.Y.S.D.E.C. Trustees Contact: Mail to: Building Inspector APPLICATION FOR BUILDING PERMIT INSTRUCTIONS Date :5"-//9/ .20,05 a. Tiffs 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 plm~ 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 Pemfit. 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. Ex et3' building permit shall expire if the work authorized has not conunenced 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 pem~it shall be required. APPLICATION IS HEREBY MADE to the Building Department for the issuance ora Building Pemfit pursuant to the Building Zone Ordinance of the Town of Southold, Suffolk Count)', 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 wfth all applicable laws, ordinances, building code, housing code, and regulations, and to admit authorized inspectors on premises and in building for necessary inspections. "IMMEDIATELY" ENCLOSE POOL TO CODE UPON COMPLETION BEFORE "WATER" OCCUPANCY OF{ USE IS UNLAWFUL (Signature of applicant or name. if a corporation) WITHOUT CERTIFICAT-. .o.. OF' OCCUPANCY (Mailing address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder Name of owner of premises ff applicant is a corporation,signature of dui',' authorized officer (Name and title of corporate ofricer) Builders License No. /om/d,, ? -/7.2- Plumbers License No. Electricians License No. Other Trade's License No. 1. Location of land on which proposed work will be done: House Number Street UNDERWRITERS CERTIFICATE APPROVED AS NOTED (As on the tax roll or latest dee~EE: 7~ BY:~ NOTI~ BUILDING DEPARTME~ AT 765-1802 8AM TO 4PM FOR THE FOLLOWING INSPECTIONS: 1. FOUNDATION - TWO REQUIRED FOR POURED CONCRETE 2. ROUGH - FRAMING & PLUMBING 3. INSULATION 4. FINAL - CONSTRUCTION MUST BE COMPLETE FOR C.O. NJ.. CONSTRUCTION SHALL MEET THE REQUIREMENTS OF THE CODES OF NEW YORK STATE. NOT RE$PONSIBLE FOR >~z.~=~.___._,~_. OR --e2ON-.m~-._~ _manor8. Hamlet County Tax Map No. 1000 Subdivision W9,,*/0/4 :z-ox (Name) Section //5/ Block g) 7 Filed Map No. Lot 5'..~q Lot 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy _p b. Intended use and occupancy 3. Nature of work (check which applicable): New Building Repair Removal Demolition 4. Estimated Cost ~'/~. ~,oo. oo 5. If dwelling, number of dwelling units If garage, number of cars Fee Alteration (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 tFtpe of use. 7. Dimensions of existing structures, if any: Front ;57 ' Rear _-57 ' Depth ~ ~- ' Height .~;~' Number of Stories ,,~ Dimensions of same structure with alterations or additions: Front Depth Height. Number of Stories Rear 8. Dimensions of entire new construction: Front Rear Height Number of Stories 9. Size of lot: Front ,/~/ Z Rear ~,/~ Depth 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? "/'ES__ NOJ<~ 13. Will lot be re-~aded? YES )<' NO__Will excess fill be removed from premises? YES k' NO__ 14. Names of Owner of premises-p~a Name of Architect Name o f C ontracto r (~ p~ vt, ac Address~,¢/o ~o~d-d~'/t~. ~ Phone No. ~2~o~- ~-~5~,~7 Address Phone No Address~o '-~o~ ,~ a~,-~et*.z,,e--Phone No. ?_? ~,'- 2d_,~ 5-' l 5 a. Is this property within 100 feet of a tidal xvetland 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 * [F 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 bel0,¥/~ .l'BI~st 15ro~ide t0.15ographical data STATE OF NEW YORK) SS: :." : ' ' COU~?~O.~'' .. ) . ~ · ~.,~.~z~~ _/~d,~::~-.~ · (~me of i~ividual si~g contract) above named, (Contractor, Agent, Co¢orate Officer, etc.) duly sworn deposes and says that (s/he is the applicant of said owner or owners, and. is duty authorized to perform or have performed the said work and to make and file this 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 manner sef forth ha the application filed therewith. Signature of Applicant PlA Vd ~0 3903 SURVEYED FOR DANA FOX SURb~YED 17 AUCcST~ 2C'C'! SCALE 1"=]0' AREA= 18,711.256 ©R 0.430 ADRES ZONED R40 ~ C 55 '07'JO "£ $o' R,A¢ -- 100.0' .1~ N/F SCHELIN 35' 07' 3~ 20.6' GARAGE S Jg' 42' 00" W B L END 100.0' 16.6 2.0'- 2-STORY RESIDENCE 39.0' F,~,l t00C,-!!4 07-5 2 4,3 NOR TH ROAD SOIP, C4C~- 179.85 CO.~','TOOR. L!NES IN !92.0 .".0~'£' BEIVCH USE~ kS~.~ 1_o30, C,U,4R4H TEED TO DANA FOX E/DEL!Tr NAPONAL ~I?LE IN5. DO. OF Nf' 4. 15 SEP 2003 FINAL SU'RVEY. 3 !9 ..,UNE £002 LOCA Z-E POURED CONCRETE FOUNDA ?ION 2 2~ APRIL 2002 SHO~t' R/[~ DA?A C'N MAP ?0 MA??ITUCK CREEK 09 APRIL 2002 SQdARE OFF HOUSE, 4DD CON~OuR LINES IN DA ?UM, CORRECF 1EST HOLE DA ?E. 5U,PVE'"ED B f