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Home My WebLink About31082-Z FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No: Z-31092 Date: 08/08/05 THIS CERTIFIES that the building ACCESSORY Location of Property: 430 PINE TREE RD CUTCHOGUE (HOUSE NO.) (STREET) (HAMLET) County Tax Map No. 473889 Section 104 Block 1 Lot 9.2 Subdivision Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated APRIL 26, 2005 pursuant to which Building Permit No. 31082-Z dated APRIL 26, 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 MICHAEL JORDAN (OWNER) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A ELECTRICAL CERTIFICATE NO. 2053589 05/19/05 PLUMBERS CERTIFICATION DATED N/A Authorized Signature Rev. 1/81 S1 Form No.6 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL 765-1802 APPLICATION FOR CERTIFICATE OF OCCU �P ;1_; ' 3 ZOOS T This application must be filled in by typewriter or ink and submitted to the Building ep [me t with the fotlo ving: A. For new building or new use: ` 1. Final survey of property with accurate location of all buildings, property lines, streets. and unusual statural 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 l% 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 Buitding- $100.00 3. Copy of Certificate of Occupancy -$.25 4. Updated Certificate of Occupancy- $50.00 5. Temporary Certificate of Occupancy-Residential $15.00, Commercial $15.00 Date. Y - Z — New Construction: Old or Pre-existing Building: (check one) Location of Property: �f �o House No. Street Hamlet Owner or Owners of Property: iM/ t KU -To,-da Suffolk County Tax Map No 1000, Section /v� Block Lot Subdivision Filed Map. Loc Permit No. 106 Date of Permit Applicant: Health Dept. Approval Underwriters Approoal: Planting Board Approval Request for: Temporary Certificate Final Certificate: t� (check one) Fee Submitted: $ Appl ran Signature ❑° CnCnLnCnLnCrr3PLr.nr�rr3PLC.r@ffl33r@rr3r1L[Mr[IC.n C.nC.IC.�f�C.�C.�C.�C.�LILI�C.�C� LI�C.I� C.I�LnC.nLI�LI�LI�C.I�C.I�LI�C.I�[�L�CPC.I�C.I�LI�LI� E° 5 BY THIS CERTIFICATE OF COMPLIANCE THE 5 NEW YORK BOARD OF FIRE UNDERWRITERS 5 5 BUREAU OF ELECTRICITY 5 55 40 FULTON STREET — NEW YORK, NY 10038 r5 S CERTIFIES THAT Upon the application of upon premises owned by 5 ROSLAK ELECTRIC MICHAEL JORDAN P.S BOX 164 430 NY 11935-2453, CUTCHOGUEENYD11935 5 �5 55 Located at 430 PINETREE RD CUTCHOGUE, NY 11935 5 5 55 5 Application Number: 2053589 Certificate Number: 2053589 rrr5 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 5 Outside, PooLSpa, 5 5 A visual inspection of the premises electrical system, limited to electrical devices and wiring to the extent detailed 5 herein, was conducted in accordance with the requirements of the applicable code and/or standard 5 5 promulgated by the State of New York, Department of State Code Enforcement and Administration, or other 5 5 authority having jurisdiction, and found to be in compliance therewith on the 19thDay of May,2005. 5 5 Name QTY Rate Ratine Circuit Type 5 5 Appliances and Accessories 5 5 Time Clock/Switch l 0 5 5 Furnace l 0 Gas 5 PooL'Spa Bonding l 0 5 5 Wiring and Devices 5 Receptacle 1 0 20 amp Pool'Spa 5 5 Fixture 1 0 POOL Spa 5 5 Receptacle 1 0 GFCI 5 Switch 2 0 General Purpose 5 (Swimming Pool):This certificate covers compliance at the date of inspection only. Because of unusual environments it is advisable to have 5 5 frequent test and or repair made by a qualified person. 5 5 5 5 seal 5 1 of l 5 5 This certificate may not be altered in any way and is validated only by the presence of a raised seal at the location indicated. 5 5 5 l7 rrurJ�rJ�r1'crNrrrurJ�r.PrPr�rJ�r�r1'ar� rJ� rru r�rrurru rJ�rJ-� r.PrJ�r� rnrJ�rJ'dJ'a o 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. 31082 Z Date APRIL 26, 2005 Permission is hereby granted to : MICHAEL JORDAN 430 PINE TREE RD CUTCHOGUE,NY 11935 for CONSTRUCTION OF AN ACCESSORY INGROUND SWIMMING POOL WITH FENCE TO CODE IN REQUIRED REAR YARD AS APPLIED FOR. (THIS REPLACES BP #26267-Z) at premises located at 430 PINE TREE RD CUTCHOGUE County Tax Map No. 473889 Section 104 Block 0001 Lot No. 009 . 002 pursuant to application dated APRIL 26, 2005 and approved by the Building Inspector to expire on OCTOBER 26, 2006 . Fee $ 150 . 00 i utho ized Signature ORIGINAL Rev. 5/8/02 FIELD.INSPECTION REPORT DATE COMMENTS W ------------- n If rod FOUNDATION ( IST) If`- —ll N FOUNDATION (2ND) �� ° _--_-- _— -------------- Id �b ----------------- -------------------- II ii II JI------- ROUGH FRAME 6 ri it PLUMBING n II ii-- II II b It II �I --11 - F INSULATION PER N. Y. it n STATE ENERGY it It JI---- it CODE u11 In,II II I it— It II fl— te7II��I'I FINAL n n 0 ADDITIONAL COMMENTS: — T 9 ti M N N N O x m Z 765.1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION 1 ST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] INSULATION [ ] FRAMING [� FINAL 4 : [ ] FIREPLACE & CHIMNEY [ ] FIRE SAFETY INSPECTION REMARKS: o� DATE INSPECTOR 765.1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] INS ION [ ] FRAMING [ FIN [ ] FIREPLACE & CHIMNEY [ ] FIRE SAFETY INSPECTION T MARKS: l� � DATE INSPECTOR TOWN OF SOUTHOLD BUILDING DEPT. 765.1802 INSPECTION [ ] FOUNDATION 1 ST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] INSULATION [ ] FRAMING / STRAPPING FINAL [ ] FIREPLACE A CHIMNEY [ ] FIRE SAFETY INSPECTION REMARKS: `' �- � - -t4� G DATE '��j o S' INSPECTOR 765-1 802 BUILDING DEPT. INSPECTION [ ] FOUNDATION 1 ST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] INSULATION [ ] FRAMING FINAL [ ] FIREPLACE & CHIMNEY [ ] FIRE SAFETY INSPECTION REMARKS: / DATE — os INSPECTOR BOARD OF HEALTH . . . . . . . . . . . . . . . FORM NO. 1 3 SETS OF PLANS . . . . . . . . . . . . . . . TOWN OF SOUTHOLD SURVEY . . . . . . . . . . . . . . . . . . . . . . . . BUILDING DEPARTMENT CHECK . . . . . . . . . . . . . . . . . . . . . . . . . TOWN HALL SEPTIC FORM . . . . . . . . . . . . . . . . . . . SOUTHOLD, N.Y. 11971 TEL: 765-1802 NOTIFY: CA .73y:�� . . . . Exmined.................. g19..�.,.... MAIL TO: . . . . . . . . . . . . . . . . . . . . Approved.......''1I......, 49. Permit No. �� .............. .................................... Disapproveda/c .................................. .................................... (Building Inspector) PLICATION FOR BUILDING PERMIT - � 1319A9 � �. Date. . LZ,!/- . . . . . . . . . 19`�. . - INSTRUCTIONS Li a.—Mtii application must be completely filled in by typewriter or in ink and submitted to the building Inspector wi 3 sets of plans, accurate plot plan to scale. Fee according to schedule. b. Plot plan stowing location of lot and of buildings on premises, relationship to adjoining premises or public streets or 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 ray not he eamenced 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 MALE 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. tel :.C�f!7.!/•5:..-..�i��>�,r�s.�� (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 .........C� cw..7/Z L'7CJZ....................................................................................... Nameof owner of premises ................................................................... (as on the tax roll or latest deed) If applicant is a corporation, signature of duly authorized officer. ��c�� Y.. / ... ..�.�. ............... (Nene and title of corporate officer) Builders License No. ../.cel,,.(4i 7./.' ..... Plumbers License No. ......................... Electricians License No. ..................... Other Trade's License No. .................... I. location of land on which proposed work will be done.............................................................. ......�3u....................P/Avg...7l�- ...................... ................... House Number Street Hamlet Canty Tax Map No. 1000 Section ...,/Q ....... Block .......I....... hot ..�.��.......... Subdivision „/''f�Kr..-cY.?D ail................. Filed Map No. /./7,9......... Lot ............... (Nam) 2. State existing use and occupancy of premises and intended use and occupancy of �/ proposed Construction: Existing risting use and occupancy .i4...�To14'f ........................................... b. Intended use and occupancy _. ..__.. ..,.,.__....._,- ..�.. .,....u.ug .......... evw cion .......... Atteration .......... Repair ............ Removal ............. llamlition ............ r Work (Description) 4. Estimated Cost/10Y.4XIL).............. fee O .... . .................................... (to be paid on filing this application) 5. If duelling, number of duelling units ............ Naber of duelling units on each floor Ifgarage, number of cars ...................................... 6. If business, oomnercial or surd occupancy, specify nature and extent of each type of use...................... 7. Dimensions of existing structures, if any: Front...,�V?.......... Rear ... i ......... Depth ............ !eight ...&.................... Naber of Stories .?.............. Dimensions of same structure with alterations or additions: Front ............... Rear ............... Depth .................... Height .................... Nnber of Stories ............... 8. Dimensions of entire new construction: Front ................ Rear ............... Depth .............. Height ......................... Number of Stories ..................... i 9. Size of lot: Front ............. Rear .../.�y........... Depth ........... 10. Date of Purchase ..................... Nam of Former Owner ........................................ II. Zone or use district in wbidn premises are situated ....................1........................ 12. Does proposed construction violate any zoning lar, ordinance or regulation: ..NQ..i' ..4........ 13. Will lot be regraded ............ Will excess fill be removed from premises: (!§�::) NO 14. Names of Owner of premises ..... Address .6'.30. ...... Phone No. ZTV SV.G,3. Uweof Architect .................................... Address ..........9.................... Phone No. ............. Nam of Contractor L:71�...... Address�f.v.4�A.':1..�rsll 'IA�,r:�......Phone No.735!�I.LY 3. Is this property within 300 feet of a tidal wetland? * YES .......... NO . ..... *IF YES, SOU[fi(HD IUAN TRU5IEES PERMIT MN! RE REQIIRED. 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 slow street nares and indicate whether interior or corner lot. SrNIE or NW Comfy LF ��.1.•/.w•,1-Irk.• ...iG4. 4f!v�......C/ /7v .......................being duly swum, deposes and says that he is the applicant (Nacre of individual signing contract) above named, lieis Live .....:(�l�Y.?: TU... ......................................................................... (Contractor, agent, corporate officer, etc.) or 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. Shorn Co bet me this I. 1..'.. ay 19.�Z. ... Notary !fie%sw York (Signature of Applicant) NolsryNo.01GL4878605 QuaiRied in Suffolk Coffaz Commission Expires Dec.8, e 0 0