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HomeMy WebLinkAbout31187-Z FORM NO. 4: TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No: Z-31002 Date: 06/22/05 THIS CERTIFIES that the building ACCESSORY Location of Property: 8555 MAIN RD EAST MARION (HOUSE NO. ) (STREET) (HAMLET) County Tax Map No. 473889 Section 31 Block 3 Lot 13 Subdivision Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated JUNE 7, 2005 pursuant to which Building Permit No. 31187-Z dated JUNE 7, 2005 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 JEAN E DEAN & ORS (OWNER) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A ELECTRICAL CERTIFICATE NO_ N519285 05/06/81 PLUMBERS CERTIFICATION DATED N/A t ori3l4d Si ature Rev. 1/81 Ctu - 73 - dy6 S L r— Form No.6 u l ( 2 2005 �)I TOWN OF SOUTHOLD BUILDING DEPARTMENT _ 1 TOWN HALL aLD,= DEFT. 765-1802 ipWr_ps c -rttn,p - - I 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-emoting"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 a 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. 2.2. Certificate of Occupancy on Pre-existing Building- $100.00 3. Copy of Certificate of Occupancy-$25.00 4. Updated Certificate of Occupancy- $50.00 5. Temporary Certificate of Occupancy- Residential$15.00,Commercial $15.00 Date. S�!)1 aS New Construction: Old or Pre-existing Building (check one) Location of Property: 8SS-5- M PC,N Ia. ,, EAST- M 04izt DN , N�( 114 3 q House No. Street �� Hamlet Owner or Owners of Property: Es cF"J F~ �LCEw��}rVi /�},�µ Om*"a /fAju Suffolk County Tax Map No 1000, Section 031 Block c7 3 Lot /.3 Subdivision Filed Map. Lot: Permit No. I 1 8 7 Date of Permit. 6e ?10.5 Applicant: Health Dept. Approval: Underwriters Approval: Planning Board Approval: Request for. Temporary Certificate Final Certificate: (check one) Fee Submitted: $ App i ant Signa, e/ CID 3 i K2 iE1 THE NEW YORK BOARD OF FIRE UNDERWRITERS BUREAU OF ELECTRICITY ,3Ll 85 JOHN STREET. NEW YORK, NEW YORK 10038 Date 1963. +s Aj01. application No.onfilr 1• + .a N 5 '1 1(,t J THIS CERTIFIES THAT y� �z only the electrical equipment as described below and introduced 6v the applicant named an the above application number in the premises of n LL'. IF":3aiF 77,15 LCt.ZS, Min, Ishit 1-lariut., N. Y. in thefollowine location: LJ, OLatSldi'. Basement U Ist Fl. U 2nd FL Section 8/uK•k Lot tea.want inert on :lay 4, 1961 and found to he in compliance with rite requirements of this Board. FIXTURE FIXTURES RANGES COOKINGDECKS OVENS DISH WASHERS EXHAUST FANS OUTLETS RECEPTACLES SWITCHES INCANDESCENT FLUORESCENT MrsnK AMT K W AMI K N AMT KW AMT K W AMi H P 'L 1 DRYERS FURNACE MOTORS FUTURE APPLIANCE FEEDERS SPECIAL RECPT TIME CLOCKS BELL UNIT HEATERS MULTI-OUTLET DIMMERS SYSTEMS AMI K W OIL H.P. GAS H.P AMT. NO 4 W G AMT. AMP AMT AMPS TRANS. AMT. H v NO.OF FEET AMT WATTS 1 ?� SERVICE DISCONNECT NO.OF S E R V I C E i METER NO OF CC GOND. A.w G A w.G A.w.G AMT AMP. TYPE EQUIP I,e'xw 1$]W ]$]W ]$LW PER 9 OF C' COND NO OF Hb LEG OF HI NO.OF NEUTRALS -- _ LEG OF NEUTRAL OTHER APPARATUS: 1 Gri (jwimung Pool) This certificate covers co Wliance at the date of inspection Only. x_ 3'cause of Lawbual travinonments :it is advisable to have frequent test zutd/o, r2pair3 made by a qualified person. K. Phil. Gordon ZZ Dean Stmt Port Jefferson 6taL.Wa, id. Y. 1.1776 1a.c:41101 GENERAL MANAGER Per 11 - c This certificate must not be altered in any manner; return to the office of the Board if incorrect. Inspectors may be identified by their credentials. COPY FOR BUILDING DEPARTMENT. THIS COPY OF CERTIFICATE MUST NOT BE ALTERED IN ANY MANNER. 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. 31187 Z Date JUNE 7 , 2005 Permission is hereby granted to: JEAN E DEAN & ORS PO BOX 224 EAST MARION,NY 11939 for CONSTRUCT INGROUND SWIMMING POOL. THIS PERMIT REPLACES BP11117 . at premises located at 8555 MAIN RD EAST MARION County Tax Map No. 473889 Section 031 Block 0003 Lot No. 013 pursuant to application dated JUNE 7 , 2005 and approved by the Building Inspector to expire on DECEMBER 7 , 2006 . Fee $ 150 . 00 Authorized Signature ORIGINAL Rev. 5/8/02 311 � 7 � 765-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION IST [ ] ROUGH PLBG. [ ) FOUNDATION 2ND [ ] INSJULATION [ ] FRAMING [ 'FINAL [ ] FIREPLACE & CHIMNEY [ ] FIRE SAFETY INSPECTION REMARKS: DATE INSPECTOR FIELD i = ro � 3 � H _ FOUNDATION ( 1st ) _I c FOUNDATION ( 2nd ) m 2 . z ROUGH FRAME & o �' r PLUMBING cn H �.. 3 . m m INSULATION PER N . Y . 3 :y STATE ENERGY QODE 3 4 . H FINAL v z ID i z(1 ADDITIONAL COMMENTS : m • x ro a J '3 H ' S m a r H T m ro H TOWN OF SOUTHOLD PROPERTY RECORD CARD OWNER STREET Q,f5 VILLAGE DIST. SUB. LOT IE-AA1 E � N 9� 045, i Q/h HCl ZS �v FORMER OWNER N - G, ACR. FoS W TYPE OF BUILDING RRtST J, �iRowN aANc /N RES.21,O SEAS. VL. FARM COMM. CB. ICS* Mkf. Value LAND IMP. TOTAL DATE REMARKS 0 lJ CJ or7 0-0 6-13177 trgA d 1 7& Y Quri CAH/r1 FBn°owN W ANo ro T E wO PS, S3 0 0 \ L �o oU 00 `/ z9 ?/ 2 6 $ 1,5 60 Shoo Soo AGE BUILDING CONDITION NEW NORMAL BELOW ABOVE FARM Acre Value Per Value Acre Tillable FRONTAGE ON WATER Woodland FRONTAGE ON ROAD 0 Q �° Meadowland DEPTH House Plot BULKHEAD Total DOCK v v v v Y COLOR /Y67vR4 L TRIM o r - � ° 3 s \ 1 s 1 1 17 a qk , M. BI .sf' o2tlXa 01 I +. Extensi I 1eXZ7S S Extension ole2 X D yS 7 .� 'I Extension Foundation S fo � Bath Dinette u } 1 p 'A ;2 Z = Z z p 5O Basement Floors �7/ter I K. perchX /� _ OC, Ext. Walls dU�J S , Interior Finish LJ`r�� �� LR. "� 7vvL �FOo . Fire Place /Vo Heat F DR. Garage Type Roof Rooms lst Floor BR. j -- Patio Recreation Room Rooms 2nd Floor FIN. B j O. B. S /t k /D O Dormer Driveway Total ��� .ty�.{'yl .� Cbe ir- 3 34. z lNY�o1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE �//// SOUTHOLD, N. Y3� '�� Examined .... !/.G.�L..... i........., 19.�D.. " __' Application No. �����................... n Approved . ... ✓�/ ......fl1 ......... 19.e.. Permit No. ................. Disapproved a/c ....................... ::............®'..................... .......... .'....................... L.. ..... . .. . ..... ......................... (Building Inspector) APPLICATION FOR BUILDING PERMIT 11 Date ....t/1.r .t............. 19. �.... INSTRUCTIONS a. This application must be completely filled in by typewriter or in ink and submitted in triplicate 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 of areas, and giving a detailed description of layout of property must be drawn on the diagram which is part of this application. 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 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 whatever until a Certificate of Occupancy shall have been granted by the Building Inspector. 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 buildings for necessary inspections. ! L�1 ( jnature app�nt, or no if a corporation) i S w 'n {...� r' .� ....L.c.l.t4..t.................... (Address of pplicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. ................................................................... . ... . . .. ../ ....... ........ ..................................................................................... Name of owner of premises .....R..E7. y m.u.I:d.......�J ..C...&......................................................................................... If applicant is a corporate, signature of duly authorized officer. ........................................................................................ (Name and title of corporate officer) Builder's License No. ................ ,i.�............................. Plumber's License No. ................ .l� . . Electrician's License No. ..... /..U.l..ri........................ Other Trade's License No. 1t......................... 1. Location of land on which proposed/ workw( /be done. Map No.: ........................................ Lot No. ........................ Streetand Number .............y.�. l ...1.4 X ......................................................................... . ....................... �sss Municipality 2. State existing use and occupancy of premises and intended se and occupancy of proposed construction: C. Exisiting use and occupancy ..........�. 1 } )[..�. .. ....I ..C4 .C,Jha .............................. b. Intended use and occupancy .. .�tl.`2: ... .1 ..��. !. .Cl .../.�.UU�.f��.�:4LaC�... f J JJ 3. Nature of work (check which applicable): New Building .................. Addition ............ .. . Alteration ... . Repair .................. Removal .................. Demolitior.................... Other Work ........ ..._.................... ....... ..... . (Description) 4. Estimated Cost ...,)..7..�.-�........................................Fee .................................................................................. .. . . (to be paid on filing this application) 5. If dwelling, number of dwelling units ..........................Number of dwelling units on each floor ...- ............. ... .. Ifgarage, number of cars ....................................... .............................................................................................. .. .. 6. If business, commercial or mixed occupancy, specify nature and extent of each type of use ......_.. ........... 7. Dimersions of existing structures, if any: Front ............................ Rear ................................ Depth .................... Height ........................ Number of Stories ................ .................................................................. Dimensions of some 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 ........................................................ Rear .......................................... Depth .......................... . ... 10. Date of Purchase ........................................................Name of Former Owner J-..I..... `:r c: uLj .............................. 11. Zone or use district in which premises are situated ................................................................................... ...... .. . 12. Does proposed construction violate any zoning law, ordinance or regulation: ................................................. ..... 13. Will lot be regraded ............................ Will excess fill be removed from premises: ( V) Yes ( ) No 14. Name of Owner of premises . l-}.. /.Y.1.6.N.'.b....J.).lw,/:�Y..1........ AddressYYlRaN...t."!A...........Uone No. ;a. ..:a.._ Name of Architect /.f................... ............ Address ... ...................... Phone No. ...:::::.............. Noma of Contractork.)4,uj.Y.1. KtChy.....F.:O.0.tk ............... Address/�f.�I,S/..t...1L.�.S;t :�.h:l�hone No. ...lff.`-/...c�"71,..... J PLOT DIAGRAM Locate clearly and distinctly all buildings, whether existing or proposed, and indicate all set-back dimensions from property lines. Give street and block number or description according to deed, and show street names and indicate whether interior or corner Ict. STATE OF NEW YORK, COUNTY OF cS.S ....................... ..................being duly sworn, deposes and say; that he is the applicam (Name of individual signing contract) above named. '' ll Heis the ............................. ... GU..... .............................................................................................. ................. ..... . (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 thor the work will be performed in the manner set forth in the-application filed therewith. Sworn tgbgfore me this / . ...L..��.............. day of ... ..Y7 .., (t. '.. . ..... Notary Public, ...... .SV I� :................. County . %...�E . (Signature ... A.-1 c...... /..e..,.............. ... a/ 2- FORM NO-2 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTH'OLD, N: Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) 311 $7 V 1�.1�.� Z Date .... ..... .. :<..4.......l1 ./............., Permission is hereby granted to: .........Al'Ic.114Ka.. .. .......�.�rL�.!.�: ............................... to ...... it ...... !t(��1. O.�r./z. .?...... ...... .r, ,Ct. at.premises located at .................6�� ...... . Q!/. .....<.1.G7. "�7 -. ......... e^�d.` ................................................................................................................................................................. County Tax Map No. 1000 "Section ...Q.j el......... Block ...cy..5............ Lot No. .. 1... ....... �.,..., / `�................. 19G�./..., and approved by the pursuant to application dated ... .. �,/,�.1.'�l•� •••••••••••• Building Inspector. !' Fee $.�...�... ....... ......... ..................................... ............... Building Inspector . Rev. 6/30/80 Iry ST ,+ _.-.r Bl� a -� ED c_-'c S.T,., .:FTE cop!tG L~ w ® A I \� e y GRADE O �O I G_TI ON A- SLOPE SLCac O = -�_ ^� a f 1 i i I O — �� tam ,�� I C d • YO ,,'CK .CWENS^ CGR'�ING° co v �F 1 I f F `- "c'E ^J°.D� EACH F w j SKIMMERS C- 'TE- B�CCK WA; }} RETURNS I L wEG� c -- ED FOAM am" TO FILTER �"EN L;',ER I, 4 ➢' f � o-_ -0C EO'.D e. SEE TYPICAL c— FROM SKIMMERS -T-- 4vALL SECTION FI-TERond PUMP mvZ3E a �' • v _� rr ,� TO RETURNS FROM FILTER L- 2°- 4� SAND BOTTOM PEJ CONCRETE .Q-- e'. ,6`CONC h sP SES. .. i i6_c VERS TY PC.t. L V. A L L S E .r O N WALKS TO BE � , �H _ ►.0'q SKID TY a: S�GaE T--- -� czI - ;ATEpFROM D SP`PG�- -NN__ EE T - --- R�PERTY TC �0CA� oL v 'ED Q G�'•'ERS T _J SC EGULAT10r s — _ s-e� a PP^RT ,e PERGLASS f,� ,. U a NJED ' / 3 STEPS E A H }OI i � I i N i PIECE ®�a 15� '-•� E A Bim— D E I F G I Z,-EAI CGP I r CGNC BLOCK O _ PiERS h i / V2 FT Fz c F- G s -� I I a T FT FT i FT FT . 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