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HomeMy WebLinkAbout30437-Z FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No: Z-31179 Date: 09/26/05 THIS CERTIFIES that the building ACCESSORY Location of Property: 725 JACOBS LA SOUTHOLD (HOUSE NO. ) (STREET) (HAMLET) County Tax Map No. 473889 Section 88 Block 1 Lot 1.3 Subdivision Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated JUNE 10, 2004 pursuant to which Building Permit No. 30437-Z dated JUNE 23, 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 IN THE REQUIRED REAR YARD WITH FENCE TO CODE AS APPLIED FOR. The certificate is issued to MELISSA & WILLIAM E. DONLAN III (OWNER) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A ELEC'T'RICAL CERTIFICATE NO. 4453 07/27/04 PLUMBERS CERTIFICATION DATED N/A AiKhorized Signature Rev. 1/81 Form No.6 TONNIN OF SOUTHOLD BUILDING DEPARTMENT TORN 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 the following: A. For new building or new use: L 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-existing" land uses: L 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 I. 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, Cormirierciat S 15.00 Date. New Construction: Old or Pre-existing Building: ✓ (check one) Location of Property: 7�rJ _ `MP.C�2 LP �JJ(JbY�U�yI House No. Street 1 Hamlet Owner or Owners of Property: I�� I l i ().,�•l 6 � w—W—L g\A-o lq;c,- Wan Suffolk County Tax Map No 1000, Section 47_.,_0 Block Lot O. Subdivision ' I I Filed Map. Lot: Permit No. 3U t3� Date of Petnut. Applicant:_[-Aon Health Dept. Approval: _Underwriters Approval: V Planning Board Approval: Request for: Temporary Certificate Final Certificate: (check one) Fee Submitted: $ �95• r Applicant Signature 01 co Nassau Suffolk Electrical Inspections, Inc. 5A Canal Street Center Moriches, New York 11934 • Tel:631-878-3500 • Fax: 631-878-3764 Application:4453 Date:7-27-04 Issued to: Dolan Address: 725 Jacobs Lane Village: Southold Introduced By:Bethel Electric License#:2880-ME -acrd Nvas in.;cnlpliance with the NEC i ,& 1stl-loor Rem© Aoao DetGafage Basenlalrt 2ndff= UnTnercial HotTtb Pddillonis Switches Receptacles Fixtures G.F.I. Heaters Whirlpool 2 2 2 1 1 Fans Dishwasher Washer/Amps Dryer/Amps Oven Carbon Range/Amps Monoxide Furnace Oil Gas Heat Zones Smoke Bell Detectors Transformers _ Meter Amps Phase Motors 1 ther Ecuipment: m Inground Pool 1-Timeclock S certificate must not be altered in any manner Section#:88 Block#:0001 Lot#:001.003 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. 30437 Z Date JUNE 23 , 2004 Permission is hereby granted to: WILLIAM E DOLAN III 725 JACOBS LANE SOUTHOLD,NY 11971 for CONSTRUCTION OF AN INGROUND SWIMMING POOL IN THE REQUIRED REAR YARD FENCED TO CODE at premises located at 725 JACOBS LA SOUTHOLD County Tax Map No. 473889 Section 088 Block 0001 Lot No. 001 . 003 pursuant to application dated JUNE 10, 2004 and approved by the Building Inspector to expire on DECEMBER 23 , 2005 . Fee $ 150 . 00 Authorized Signature ORIGINAL Rev. 5/8/02 o��,OF SOUT,y� 3oq- 3 7z ® TOWN OF SOUTHOLD BUILDING DEPT. 765.1802 INSPECTION [ ] FOUNDATION 1 ST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] INSULATION [ ] FRAMING / STRAPPING 19FINAL [ ] FIREPLACE A CHIMNEY [ ] FIRE SAFETY INSPECTION REMARKS: �o DATE INSPECTOR ID L(3 765.1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] INSULATION [FRAMING b'tc-E [ ] FINAL [ ] FIREPLACE & CHIMNEY [ ] FIRE SAFETY INSPECTION REMARKS: )�DO( e`^^ &a o.VC• DATE 2C' ° `E INSPECTOR 3 043-7 765.1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION 1 ST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] INSULATION [ ] FRAMING FINAL [ ] FIREPLACE 770i Y [ ] FIRE SAFETY I ECTION REMARKS: la 1 M110, DATE INSPECTOR ��tOWN OF SOUTHOLD PROPERTY RECORD CARD — ly- OWNER STREET,y VILLAGE DIST.I SUB. LOT illi �. YY�Pi1�S�- C/lt�(`� 5 D_ S� Il/1l. FORMER OWN911 NU E QP MI n s.n g,� W TYPE OF BUILDING hqo ID RES. 2l o SEAS. FARM COIMM. CB. MICS. Mkt. Value LAND IMP. TOTAL DATE REMARKS .7/ N6 ✓i k AL C, /HM:, PNI - ����('�TAM� e X 62 E dae S 33iE/A ✓ Ci. C, w /a' b S�1 �,�L fro 4 w ✓�9 o-o �1 �?79- pp0 7-6 EU BUIL t C Dffi NGS13e/j( �i /7_3o LL�r _N OR L BEL X .VE -L - / t Yi Es - 46 A4cC.at4hq 4o'K— SD,j2pa e -7 f2COG z,� 6��/ - /i sL2P✓ rtI i�'1�/ Se/6rAllasm�.'�Gt,Cv✓ Tillable FRONTAGE ON WATER 410101 0 _ I 1 7 I -1� wY'/u/ nY5�T��— Woodland FRONTAGE ON ROAD Meadowland DEPTH 4 2vUp 9 P #*a .)sS- rew If n -N/O ID House Plot BULKHEAD I _ - ¢ r_N Total DOCK P cZ�43 _flGudlwl)) 101 ` - c1 .'� 4 ■■■■■■■■■■■■■■■■■■■■■■■■ ■■M■■�■WIR EENMEM■■■■■■EI■■C NOON■■■■oM■M■©■■N■31■■I==NOON■■ e y ■■■■■■■N■■■■■■■■■!1■■El ME SEEMS ME w 2 MEN ■I NOON■ 1�� ■■■■■■■■■■■■■■cc!0 ■■■■ ■■■■■Il1+■Eo■gil ■■■■■■■■ ■ ■ ■ ;., .. ■■■■■Ousamom�1■iN■NONE ■■■■■■■■ ` ' "` -"� � „`i .` ■■■■■M�_�■■■■■■�'� NOON■■■ ■ _. ■■■�■■■■■■■■■■■■■ ■■■■■■■ ■ ■■■ M■■EME■■■E■■■■■■■■■■NOON ■ ■■■■■■■■■■■■SEEMS■■EM■■■■■■■■ ■ ■■■M■■■M■■■■MM■■■■= ■ MEN ■■■■■■■■■■■■■■■■■■ ■ ■■■■■MOON NE■■■■■M■■■■ I o � a --B'�FINISHED �' DETAIL - A OE?TH 1 _ 4' ?+-�-- +' SEE 13 i go? DETAIL-A HZ 4--FRAME DETAIL DECK SUPPORT DETAIL 33' t MANDATORY RIPE L FLOAT 12 4-fAal M INCHES FOUR SLOPE CHANGE tUroUx uHi 21' 2. * = wcL A L) L 711�KC y 2,-4, STAQ rINLSHEn ',. n'" DEPTH 2 114CHES SANS kOIES r m OR VERMICULITE 3'3' 1) 1MS IS A TYPE ❑ POOL. DEPTH AND SHAPE OF POOL 9OC4 PANEL t6' 9• 6' _8. 2, — RESTiB IALWCODE 20DDO DA6l�IT(ANSI/NSPI-5 1995) AND ti JNTERNATIDAL HEIGHTWtA 1946 FOR RESIDENTIAL USE. r � a' w 2) ALL A-FRAME BRACES WILL BE MU'JN" WIT)i A IfN/4+tf ❑F Q) CUBIC F-30T OF COKCRETE, OR A °D 6' PWIEED CONTINUOS CONCRETE ?ERiMETER COLLAR. 3) DIVFG IS NOT PERMITTED 1N TMS POOL. 4) '433 DIVING' LABELS M+JS' BE INSTALLED AROUND „ WARNJN61 PERIKE-ER OF POOH. ' ® SVIMMTNG POOLS ARE DANGEROUS WHEN USED TNPREIPERLY. d o CONSULT YOUR DEALER FOR SAFETY DUOIRMAT)ON ON THE 1 N T E R PATRUE—L v m SAff USE OF SWIMMIK DOOLS. T IS THE R_SPUNSIBILITY - o n OF TOWN OFFICIALS, BUILDERS AN� HOMEOWNERS TO FOLLOW1 NOTE, P00L DESIGN BY BUILDER w i ALL SAFETY RECOMMENDATIONS Or N,SP.1., ALL LOCAL AND HOME OWNER. 20' X 33' X 4ORDIRAWES MD EWIPME4T MANUFACTURERS. I U— DATEiD6/03/04 CA • m m o DRAWN BY- P.T. ACADREF-St)Izos 4 s FIELEt INSPECTION REPORT DATE COMMENTS �a FOUNDATION(1ST) W y ------------------------------------- FOUNDATION -------------------------------- FOUNDATION(2ND) _en 0 J 4� ✓) ROUGH FRAMING& PLUMBING Ll O U INSULATION PER N.Y. STATE ENERGY CODE /� V a 4'Iti� t ►x ccrn� ACA? z'3 Ic cal 5 ! . lC I` \/(otr, FINAL f V 0 oal a c c o k CL' 05 01— ADDITIONAL COMMENTS r �. ll e .ac L o Z VI 4'h 11-4 t V t! ecQ C'— :E m L9.1 0 TOWN OF SOUTHOLD BUILDING PERMIT APPLICATION CHECKLIST BUILDING DErARTMENT Do you have or need the following,before applying? TOWN HALL Board of Health SOUTHOLD, NY 11971 4 sets of Building Plans TEL: (631) 765-1802 Planning Board approval FAX: (631) 765-9502 Survey www. northfork.net/South6ld/ PERMIT NO. 3d � — Check Septic Form N.Y.S.D.E.C. Trustees Examined 20 09' Contact: Approved,20 ` Mail to: Disapproved a'c Phone:/Ae, Expiration 20057- Building Inspector rQ t�PPLICATION FOR BUILDING PERMIT Date 6 7/ OY 20 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,acedite 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 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 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. 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 /��i�4��j(�s�gf�Qr��} emises and in building for necessary inspections. VVVUr/i1VV i V� IMMEDIATELY" E M � USE 15 UNLAWFUL ENcM PODL To COD (Signature of applicant or name, if a corporation) UP C WITHOUT CERTIFICATE BEFpq "WATT S— S �� OF OCCUPANCY UNDEMIERSCMIFRAI (Mailing address f applicant) ALL CONSTRUCTION SHALL REWIRED State whether appl iTpE MLgMS=tMTWct, engineer, general contractor, electrician, plumber or builder �w61 e v,CODES OF NEW YORK STATE. APPROVED AS NOTED DATE B.p. Name of owner of premises (As on the tax roll or latest dI4*JFY BUILDING DEPARTMENT AT If applicant is a corporation, signature of duly authorized officer 7651802 SAM TO 4 PM FOR THE FOLLOWING INSPECTIONS: (Name and title of corporate officer) I. FOUNDATION - TWO REQUIRED FOR POURED CONCRETE Builders License No. 2. ROUGH - FRAMING & PLUMBIIK; 3. INSULATION Plumbers License No. 4. FINAL - CONSTRUCTION MUST Electricians License No. BE COMPLETE FOR C.O. Other Trade's License No. 14 Z z-4/S `/y - ht ALL CONSTRUCTION SHALT, MEET THE REQUIREMENTS OF THE CODES OFNEW 1. Location of land on which proposed work will be done: YORK ATE. RESPONSI E FOR 72S � - 0 b S Ctt�e Sov+�OR = 011 House Number Street Hamlet County Tax Map No. 1000 Section /0 0 D Block gg Lot 61 — 1 - 3 Subdivision e e r C.e 1 cP 4a r oA Filed Map No. to 5"9 6 Lot (Name) 2. State existing use and occupancy of premises and intended use and occupancy of proposed con tnftion: a. Existing use and occupancy Simj2je �T l Inn a V'e S 1 Pur CCS T- b. Intended use and occupancy Q U d ° +rout o'F 5W r wt w° i ti4 r30c 3. Nature of work (check which applicable): New Building Addition po o Alteration Repair Removal Demolition Other Work (Description) 4. Estimated Cost Z f 0 c.> 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. A)M // O � O ' 7. Dimensions of existing structures, if any: Front Io Rear 6 Depth _, S Height < go , Number of Stories 2 Dimensions of same structure with alterations or additions: Front /y Rear—A) Depth A)C— Height A/G Number of Stories a 8. Dimensions of entire new construction: Front 2-0 v- `fO Rear /L x / Z Depth `/-S Height Number of Stories 9. Size of lot: Front /fU Rear /SO Depth y90 10. Date of Purchase 3 Name of Former Owner I ° C�U r>< c , �✓b��e riS �E LT 11. Zone or use district in which premises are situated 0 0 12. Does proposed construction violate any zoning law, ordinance or regulation? YES_NO >C 13. Will lot be re-graded? YES NO X Will excess fill be removed from premises? YES X NO 14. Names of Owner of premises bo/a^ Address 72t Sgco los L&. Phone No. rb 3/ 765- Ffou-q Name of Architect Address Phone No Name of Contractor /1/lep q +o v+x oa Is Address Af 1/l Manoe-v?((d'hone No. 43/ 399 1/3470 - lxlltr;Zslgnrr° 6 �, ♦c $G11h Fools 31( S✓Hec'- oil 5a' tk Icor 15 a. Is this property within 100 feet of a tidal wetland Q a freshwater wetland? *YES NO X * IF YES, SOUTHOLD TOWN TRUSTEES & D.E.C. FERMITS MAY BE REQUIRED. ?{ 1 b. Is this property within 300 feet of a tidal wetland;* Y $� * IF YES, D.E.C. PERMITS MAY BE REQUIRED. 16. Provide survey, to scale, with accurate foundation plan m$diftn�es toy property'lines.` 17. If elevation at any point on property is at 10 feet or beloW,•�nust proirit ,.1W.og tapn survey. STATE OF NEW YORK) , COUNTY OF S f Cg I , ) being duly swom, deposes and says that(s)he is the applicant ' 7aine of individual signing contract)above named, (S)He is the CjjN ag- (Comfadtor, 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 applii ation 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. Swom-to before me his /0 day of 20�q Ti�Ila otary Public Signature of Applicant JOYCE M. Notary Pubic State of MnLKlNS New York No.4952246,SuffolkC�my Term Explm June 12, a 0 0;) \ SURVEY OF LOT 1 h� a93o?0'F F/��0+� cR�IyL lr9A DEERFIELDMAP F FARM O'Qt/t. 1> OF FILE N.. 105% FILED MARCH 27. 2001 �� lyF �'S� SITUATED AT H oO �T� +SAYVIEWk SE'S'' TOWN OF SOUTHOLD v ti;`Fq� SUFFOLK COUNTY, NEW YORK 8Z3B�W,N� S.C. TAX No. 1000-88-01-1.3 SCALE I"= 40' APRIL 10, 2001 FEBRUARY 27, 2002 REVISED PROPOSED HOUSE 4P APRIL 14. 2003 REVISED PROPOSED HOUSE c AUGUST 5, 2003 FOUNDATION LOCATION O MARCH 9, 2004 FINAL SURVEY APRIL 8, 2004 REVISED SEPTIC SYS. TIES PER S.C.D.H.S. •. MAY 14, 2004 REVISED SEPTIC SYS. TIE ry� ' JUNE 9. 2004 ADDED PROPOSED POOL AREA = 43,650.00 sq. ft. LOTQi / ?y 1.002 ac. n SAFE HARBOR TITLE INSURANCE COMPANY N A� \ ba, e• , •• o^� P• • • , WEBSTfR BANK 1Y1WAM DOLAN III MELISSA DOLAN 41 A ^ q41.• • p�. 9 o eBPag I FIMMi aaT y ][ , x 0.6• a rF P y7 1 8000 6'; A110E OF HIV M� 16MO1r 0 -i s > me�: o ANDS a ias 1im o wrii�ua W119i `ZY� '•' •C' b + ,yn i'S` saws laf:wo wtAs n�eRllb w mm mm �aTHwt nom. N-f �_ • . • e • �) Zo a w eF aI10E!m-NM rILCB/IIM. ~ b �,/<S`1 �O(A �py�} ,�t/•y^y S. 4i OrFSM Ai K ls YdM I M Nall. 40 ''A-0 i^ <F/`J IO 47 ' • Yom/ e \ SEPTIC SYSTYY YL'ASU%YBNTS 4` 3 VO Na1ML GGAw'.• 11G96E rn6ar \�Lr� sEPr1c YAMc 3r u• _ •• �( y LEACHING POOL 1 M• 3°• PERm M1 POM® •9 P Y LEACHING POOL 2 M• 1. 1O1 IIgMI vm sm r� HMD J LEACHING POOL 3 M• w lIN!.Bs_0.MIDN . /r�� wrunnmm Pllawlal al P9E1°10M " ,r' �4, w�ns1 sl�era°ac�11i laws rPx w �t j._ C p11Kd HPN. J6 . ,6/•]�l. -4 �Of__ ___� 1101 a/1ar. =b ; .�m� kxpom L d Surveyor '�� AAE m1.IsM"wHNP Am+•ANNo TwP S•+wr SIAu,rAm - 9A PIaw - Cam&u:MOn Lww W a RI'M`A "OF 1 A� 111WI1.1J01Ar°Aa1A0.9[ Prerw.c MINE (631)72'7t- � FD° (631)727-1727 ATH1ME/M6MOSILML OF OWI W WAYS OFFICES LMATO A7 MILK AOwEW PMI [1a11r13+rs a :c= F M1I NOF 010011 NIE Iwf aYAN11R0. .722 IgYOAE AVE" PO. Bo. 1631 ME79f/D, IAM TMM 111 501 OYMr111AN, 111M YM 11901-0065 �' - ._ILD -r z 14 T� Applicant/ Date. Owners Name: GtJ Reviewed: Architect/ Date Engineer: — Submitted: 4�/ SCTM a: District: 1.000 Section: _ 13 lock: Project Location Subdivision Name: Single& separate Required certification: (Yes/No) Req. Req Zoning District (1,0(size: _ a (Lot coverage 2P7� �� 1 rotx�ud Req. Req. „/ Req. [f=ront Yard Proposed: _) [Side Yar /� roposed: ,_[Rear Yard--L=— Proposed V Project Description: AGENCHRERMITS Permit I UIRED FOR REVIEW N.A. NO YES u be Suffolk County Health Dept. f New York State D. E. C. / Town Trustees Town Zoning Board approval: Town PIannmi g Board approval: / Flood Plane Elevation??? Flood Zone: s,. lYotes: •