The URL can be used to link to this page

Home My WebLink About30426-ZFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY NO: Z-31072 Date: 08/01/05 THIS CERTIFIES that the building ACCESSORY Location of Property: 875 LIGHT HOUSE RD (HOUSE NO.) County T~x Map No. 473889 Section 54 subdivision SOUTHOLD (STREET) (HAMLET) Block 3 Lot 26.8 Filed Map No. __ Lot No. __ conforms substantially to the Application for Building Permit heretofore filed in this office dated JI/NE 21, 2004 pursuant to which Building Permit No. 30426-Z dated JUNE 22, 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 AS APPLIED FOR. The certificate is issued to DEAN & CHIHO MACHADO (OWNER) of the aforesaid building. SUFFOLK COUNTbf DEPARTMENT OF HEALTH APPROVAL N/A ELECTRICAL CERTIFICATE NO. 5053 09/17/04 PLUMBERS CERTIFICATION D~£~u3 N/A Authorized Signature Rev. 1/81 Form No. 6 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL 765-1802 APPLICATION FOR CERTIFICATE OF OCCUPANCY ,JUL 2 2005 ' This application must be filled in by typewriter or ink and subnfitted to the Buildiug Department with the following: A. For new building or new use: I. Final survey of property with accurate location of all buildings, property lines, streets, and unusual natural or topographic tbatures. 2. Filial 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 coutains 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 buildiug. 6. Submit Planning Board Approval of completed site plan requirements. B. For existing buildings (prior to April 9, 1957) non-conforming uses, or bnildings 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 tire applicant. C. Fees 1. Certificate of Occupancy - New dwelling $25.00, Additions to dwelling $25.00, .Mterations to dwelling $25.00. Swi~mning pool $25.00, Accessory building $25.00, Additions to accessoD' buildiog $25.00, Businesses $50.00. 2. Certificate of Occupancy on Pre-existing Building - $100.00 3. Cop3' of Certificate of Occupancy - $.25 4. Updated Certificate of Occupancy ~ $50.00 5. Temporary Certificate of Occupancy - Residential $15.00, Corrm~ercial $15.00 New Construction: Old or Pre-existing Building: Location of Property: ~5~7ff L~ ,~ ~4-~.9 cxS~-- ltousc No. Street Owner or Owners of Property: ~...I~Q a~t~d ChlhO Suffolk County Tax Map No 1000, Seclion C,)~-g'~ Block (check one) Hamlet Subdivision Permit No. Health Dept. Approval: Filed Mai). Date of Pemfit. ~[22-/0q Applicant: __ Underwriters Approval: Planning Board Approx al: Request for: Temporary Certificate Final Certificate: (check one) Fee Submitted: Co ~cant Signature FORM NO. 3 TOWN OF SOUTHOLD BUILDING DEPARTMENT Town Hall Southold, N.Y. (THIS BUILDING PERMIT PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) PERMIT NO. 30426 Z Date JUNE 22, 2004 Permission is hereby granted to: ASSOCIATES INC GENDOT PO BOX 534 WADING RIVER,NY 11792 for : CONSTRUCTION OF AN IN-GROUND SWIMMING POOL IN THE REQUIRED REAR YARD AS APPLIED FOR WITH FENCE TO CODE. at premises located at 875 LIGHT HOUSE RD County Tax Map No. 473889 Section 054 Block pursuant to application dated JUNE 21, 2004 SOUTHOLD 0003 Lot No. 026.008 and approved by the Fee S 150.00 ~~// Ant h/ri ze~ S~ ORIGINAL Rev. 5/8/02 Nassau Suffolk Electrical Inspections, Inc. 5A Canal Street * Center Moriches, New York 11934 * Tel: 631-878-3500 * Fax: 631-878-3764 Application: 5053 Issued to: Machado Address: Village: Date:9/17/04 875 Lighthouse Rd Southold Introduced By: Avey Electric License #:2069-ME was examined and approved up to the above date and was in compliance with the NEC Basement 2nd floor Cooa~ ,~-~rcial Hot Tub /~ion Switches' Receptacles Fixtures G.F.h Timeclock Whirlpool 2 3 1 1 1 Ovea Carbon Fans Dishwasher Washer/Amps Dryer/Amps Range/Amps Monoxide Smoke Bell Furnace Oil Gas Heat Zones Detectors Transformers Meter Amps Phase Motors 2 :)ther Equipment: Inground pool :)ut,Res Permit#: 30426-Z This certificate must not be altered in any manner 765-1802 BUILDING DEPT, INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] INSULATIO~I [ ]FRAMING ~FINAL [ I FIREPLACE & CHIMNEY [ I FIRE SAFETY INSPECTION REMARKS: INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] IN~J~ATION [ ] FRAMING [~']"FINAL [ ] FIREPLAC~.~CHIMNEY [ ]FIRE SAFETY INSPECTION R E M A R KS :,~.~ ~/~f../~~/~'~-~ ~ DATE ~ INSPEC Fl]ELD INSPECTION P-~EPORT DATE I COMMENTS FOUNDATION (1ST) FOUNDATION (2ND) PLLr~B1NG INSULATION PER N. ¥. STATE ENERGY CODE ~0~ CO~TS TOXVN OF SOUTHOLD BUILDIN,~ DEPARTMENT TOWN HALL SOUI~itOLD, NY 11971 TEL: (631) 765-1802 FAX: (631) 765-9502 www. northfork, net/Southold/ Examined '~' /J/~ -t~.. .20 Approved__ Disapproved ac Expiration PERMIT NO. ~ggtid~ ~ - BUILDING PERMIT APPLICATION CHECKLIST Do you have or need the following, before applying? Board of Health 3 sets of Building Plans ~ Planning Board approval Survey f Check ~/ Septic Fom~ N.Y.S.D.E.C. Trustees Contact: Mail to: Date ~,//~- .20 O~ 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 belbre 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 be kept on the premises available tbr 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'eD' 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 ma3, authorize, in writing, the extension of the permit for an addition six months. Thereafter, a new permit shall be required. .ad?PLICATION 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, fbr the construction of buildings, additions, or alterations or tbr 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. (Signature of applicant or name, if a corporation) (Mailing address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder Name of owner of premises (As on the tax 1'oll or latest deed) If applicant is a corpo, ration,tsignature of duly authorized officer ~--- (lq~me arid title of c~-rporate 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: House Number Street Hamlet Count.,,' Tax Map No. 1000 Section Subdivision--~,o (Name) Block 49 B Lot ..gal,, Filed Map No..,',o t'.~'ff. Lot 2. State existing use and occupancy of premises and intended use and occupancy of proposed constructionq. a. Existing use and occupancy ~ .~7-~r r~z,"*~- 72~vz-~/~-- ,* b. Intended use and occupancy_~ 3. Nature of work (check which applicable): New Building_ Repair Removal 4. Estimated Cost ~t'-'f/Ooa ~o 5. If dwelling, number of dwelling units If garage, number of cars Demolition Fee Addition Alteration r.~ ~ (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 type of use. 7. Dimensions of existing structures, if any: Front ,/-/~) ' Height ~,¢~'/ Number of Stories ,~ Rear Depth Dimensions of same structure with alterations or additions: Front Depth. Height_ Number of Stories Rear 8. Dimensions of entire new construction: Front Height Number of Stories Rear .Depth 9. Size of lot: Front /2t9 ' Rear / ?~9 t Depth 10. Date of Purchase Name of Former Oxvner 11. Zone or use district in which premises are situated 12. Does proposed construction violate any zoning law, ordinance or regulation? YES__ NO A/ 13. Will lot be re-graded? YES ~' NO Will excess fill be removed from premises? YES NO 1-' 14. Names of Owner of premises-rw_,a~ Name of Architect Name of ContractorF'~,w~ Address~,a,w,~,,~~ x~ Phone No. ~ - Address ~"'~-~ Phone No Address ,~, ~Phone No. ~.¢- 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 ~ * 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) ~--~d-'/~'- ~/~/'//'~//~ being duly sworn, deposes and says that (s)he is the applicant (Name of individual signing contract) above named, (S)He is the (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 tree to the best of his knowledge and beliefi and that the work will be performed in the maturer set forth in the application filed therewith. ~,~'orn to before me this Claire L. Glow Notary Public, State of New York NO. 01GL4879~05 Qualified in Suffolk Cou~t,~/. Commission Expires Dec. 8. Signature of Applicant JOB No. 02-15 REV,,'22,O~ REV02,~2,04 REV03~OU04 ~^N~< ~,DD~EC~<~DRIVEWAV s'rONEDR~VEW,~¥ TAX I.D. NO. 1000-54-03-26.8 LOT 1 LIGHTHOUSE ROAD [ 49.5' ] .... 0 PO~E ..... ~ ~ ~1°18'20"E 1"0.00' .. ¢ LP 41' WOOD DECK WOOD 2 ST FRAME DWELLING t ,, %~ ~.-~o c LOT 3 N 41°18'20"W 170.00' LOT 4 THE LOCATION OF WELLS, $?TIC TANKS AND CESSPO0',?.', HEREON APE F~L~] '~.~'.;~ :'~,',:; ~0~'.~ Ar-~g c;:: DAT~, O31'AiNED F;'~O;vi GT~..~Si:,3. FILE MaP NO. 10656 8/01/2001 ~n~ot 0uaran_teed~ ........................ CERTIFIED ONLY TQ: DEAN MACHADO ULSTER SAVINGS BANK COMMONWEALTH LAND TITLE INSURANCE COMPANY By DESTIN G. GRAF N.Y S. LIC NO. 50~067~ ....... SURVEY OF: LOT 2 MINOR SUBDIVISION FOR LIGHTHOUSE ROAD 26 SOUTHOLD, TOWN OF SOUTHOLD SUFFOLK COUNTY. NEW YORK SURVEY DATE: 07/09/03 SCALE: 1"-60' DESTIN G. GRAF LAND SURVEYOR P O. BOX 704 Rocky Point, New York, 11778 631-821-3442 i ~.~ zO O0 ,,,,.' 0 C Ooz ~o0 - ~- ~zE ~ I-- ~',,~ o o o . )- "' rr 't n D~~ O>LH