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Home My WebLink About30893-ZFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY NO: Z-31187 THIS CERTIFIES that the building ACCESSORY Date: 10/05/05 Location of Property: 1080 KIMBERLY LA SOUTHOLD (HOUSE NO.) (STREET) (HAMLET) County Tax Map No. 473889 Section 70 Block 13 Lot 20.14 Subdivision Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated JANUARY 11, 2005 pursuant to which Building Permit No. 30893-Z dated JANUARY 11, 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 WITH FENCE TO CODE AS APPLIED FOR. The certificate is issued to PETER C HAEFFNER (OWNER) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A ELECTRICAL CERTIFICATE NO. 6155 12/01/04 PLUMBERS CERTIFICATION DATED N/A or' ed S gnature Rev. 1/81 P 28 i �^J mow, — rr:o�o Form No. 6 TOWN 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 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 14% 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, Swimtnin oo 5.00, Accessory building $25.00, Additions to accessory building $25.00, Businesses $50.00. 2.ettt icate 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 Date. -i/- 2 2.Do s' New Construction: —Tor Old or Pre-existing Building: (check Sonne) Location of Property: House No. {� Street Hamlet Owner or Owners of Property: ` ,au C. Suffolk County Tax Map No 1000, Section 74D Block 13 ^Za Lot Subdivision Filed Map. , L Lot: _ Permit No. �� Date of Permit. Applicant:_ �eAWFPW(A iL Health Dept. Approval: Underwriters Approval:`y-1 :P -Lir Planning Board Approval Request for: Temporary Certificate Final Certificate: V (check one) Fee Submitted: $1� may,%.De Applicant ure ca �. 31187 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. 30893 Z Permission is hereby granted to: PETER C HAEFFNER 37 FRANKLIN COURT GARDEN CITY,NY 11530 for : Date JANUARY 11. 2005 CONSTRUCTION OF AN ACCESSORY INGROUND SWIMMING POOL WITH FENCE TO CODE AS APPLIED FOR. THIS PERMIT REPLACES BP 27934. at premises located at 1080 KIMBERLY LA SOUTHOLD County Tax Map No. 473889 Section 070 Block 0013 Lot No. 020.014 pursuant to application dated JANUARY 11, 2005 and approved by the Building Inspector to expire on JTTT,Y Fee $ 150.00 TT. znnF_ ORIGINAL Rev. 5/8/02 30 8-q 4 (eNmWed -7L)- r3_ �, r tl a'193W Nassau Suffolk Electrical Inspections, Inc. 5A Canal Street • Center Moriches, New York 11934 • Tel: 631-878-3500 • Fax: 631-878-3764 Application: 6155 Date: 12/1/04 Issued to: Haeffner Address: 1080 Kimberly Lane Village: Southold By: Evergreen Electric License#: 4536-E was examined and approved up to the above date and was in compliance with the NEC Attic 1st Floor Residential ❑x Pool 0 Det Garage Basement 2nd floor Corrrrlerdal Hot Tub Addition i1P0/i Pw This certificate must not be altered in any manner Switches Receptacles Fixtures G.F.I. Timeclock Whirlpool 1 1 1 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 Inground Pool 1 Other Equipment: Out,Res i1P0/i Pw This certificate must not be altered in any manner FIELD INSPECTION REPORT DATE FOUNDATION OST) �w ot �a ROUGH BRAHK a c .PLUMBING UUMATION PER N. Y. �= STATE ENERGY CODE C VUWAL Ed APUTIONAL COHMMS: 765.1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION IST [ ] FOUNDATION 2ND [ ] FRAMING [ ] ROUGH PLBG. [ ] INSU TION [ INAL [ ] FIREPLACE & CHIMNEY [ ] FIRE SAFETY INSPECTION DATE `/ 1216 J INSPECTOR IV VY 14 Vr 0V 1r1VL11 BUILDING DEPARTMENT TOWN HALL SOUTHOLD, NY 11971 TEL: 765-1802 Examined if -A f 20J_ Approved (i 10-9 , 20 D I Disapproved a/c tiU1LL)INt.i YbKMII AYYLIUAf1UN UREC:KL15 301513 Rjwl PERMIT NO. _ _,� 7 % 3 i 7--- WITHOUT z Do you have or need the following, before applying Board of Health 3 sets of Building Plans Survey Check Septic Form N.Y.S.D.E.C. Trustees Contact: Building i ie- m tray.,....✓ Phone: Q r : APPLICATION FOR BUILDING PERMIT Date 2001 NOV 1 3 L:j INSTRUCTIONS a., e c mpletely filled in by typewriter or in ink and submitted to the Building Inspector with 3 sets of lans, Fee according to schedule. . of 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 a Certificate of Occupar is issued 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, SuffolkCounty, 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 inspectio IMMEDIATELY" USE IS U LAWFUL (Signa a of applicant or name, if a corporation) „ENGLOBE POOL TO CODE UPON COMPLETION BEFORE "WATER" WITHOUT CERTIFICATE OF OCCUPANCY 102 OLD RIVERHEAD RD, WESTHAMPTON BCH NEW YORK, (�?i1i%address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, �l�builder GENERAL CONTRACTOR REQUIRED Name of owner of premises SALLY HAEFFNER (as on the tax roll or If applicant is a corporation, signature of duly authonzed officer t (Name and title of corporate officer) Builders License No. 9585HI Plumbers License No. Electricians License No Other Trade's License AS NOTED 768-118019 AM TO 4 PM FOR THE FOLLOWING INSPECTIONS: L FOUNDATION • TWO REQUIRED FOR POURED CONCRETE S ROUGH • FRAMING t PLUMBING ML INSULATION 4 FINAL • CONSTRUCTION MUST BE COMPLETE FOR C.O. ALL CONSTRUCTION SHALL MEET THE REGUMMSNTS OF THE N.Y. STATE CONSTRUCTION S ENERGY CODES. NOT RESPONSIBLE FOR Location of land on which proposed work will be done: OESION OR CONSTRUCTION ERRORS 1080 KIMBERLY LANE SOUTHOLD House Number Street Hamlet County Tax Map No. 1000 Section 70 Block 13 Lot 20.14 Subdivision Filed Map No. Lot (Name) Jtate CXISt!n„g RSC &nC oCC`JDan.CV of ^re—sSeS ^.^r 'n:eneed yse !tn2 nCCU,n nCy n°n-nnngP2 rnnq•��• n a. Existing use and occupancy_ SINGLE FAMILY DWELLING b. Intended use and occupancy_ Nature of work (check whi.:h applicable): New Building X Addition Alteration Repair_ Removal Demolition Other Work SWIMMING POOL (Description) Estimated Cost 5 o c o Fee —�- (.to be paid on filing this application) If dwelling, number of dwelling units If garage, number of cars Number of dwelling units on each floor__ If business, commercial or mixed occupancy, specify nature and extent of each type of use. Dimensions of existing structures, if any: Front Rear Height Number of Stories Depth Dimensions of same structure with alterations or additions: Front Rear Depth Height Number of Stories Dimensions of entire new construction: Front Rear Depth Height Number of Stories Size of lot: Front Rear Depth 0. Date of Purchase Name of Former Owner I Zone or use district in which premises are situated Does proposed construction violate any zoning law, ordinance or regulation: 3. Will lot be re -graded Will excess fill be removed from premises: YES NO 4. Names of Owner of premises Address Phone No. Name of Architect Address Phone No Name of Contractor JOHN R. SCHOECK Address 1 o2 OLD RTVF.R- Phone No. 631 -288-5222 HEAD RD,WHB 5. Is this property within 100 feet of a tidal wetland? *YES • IF YES, SOUTHOLD TOWN TRUSTEES PER.?MM M4V%J1t"QVMD a 6. Provide survey, to scale, with accurate foundation plan and die tines. 7. If elevatio.G apy pQjrl4rty is at 10 feet or below, must provide topographical data on survey. TATE OF NEW YORK) SS: OUNTY OF C. ) _" ...,`r.`:. being duly sworn, deposes and says that (s)he is the applicant (Nintt~vidyiFit ve named, i)He is the zq tf A t CGOVAMICTOR gent, Corporate Officer, etc.) i saidgwtier;gfef,Vif�M yd to perform or have performed the said work and to make and file this application; at all statements contained irww ti are true to the best of his knowledge and belief-, and that the work will be :rformtd,q tW0mg*wg04qrji in ation filed therewith. wom><dilfoletAll3hNJ, ; :, JI7t V0* AM i i yptWit 4TF- f � � TnM •! enl�f - tgn re of Applicant ROXANNE ROAD O 11 N 84. 77, 70" E A T" 759.08' v� I� �'•`- S BI. 7f' 90' W ! 79755• -- ��~ >9 �I CLEVAT1a6 ARE � To "Vd TM ruler Npp/y eM surra dieposal s7slems /or !tis residence rI/ can/orm to the standards o/ The Wink Canty Depd .M o/ Hedb Sar isrs. LERTrYIT Sra94 R Ti AI MMI NOTE, LOT NUMBERS REFER TO 'MAP Or PARADISE By THE SAY' FILED NOV. 4, 1976 FILE NO. 6463 AT THE OFFICE OF THE SUFFOLK COUNTY CLERK. AREA a 47.367sq.dt. ,IIIA SURVEY F PROPS r AT SOUTH " TOWN OF SOUTHOLD SUFFOLK COUNTY, N. Y. 1000 - 70 - 18 - 20.14 Scale 1" = 40' No v. 7, 1988 P t^ Sept 7994 (loLv aran) Aar+' 24 IM (fffW) ef, ,8. BLDG. n/sraK count aVART1OIT of 1EN.h, L6RV1GE6 FOR AeeRovM. K mu:llur�tox arLr 93 SO 52 AAR,OVFD CERTY'FD 77P . : o - • 1 T Z TM bealims of re& ad'"Wook �r6'�11°�• Mo. Mrem are hon•. laid ebiNwhoAs and os km data oblamed ham ofh � N.Y.S. LIC. NO. 996/8 I� �'•`- S BI. 7f' 90' W ! 79755• -- ��~ >9 �I CLEVAT1a6 ARE � To "Vd TM ruler Npp/y eM surra dieposal s7slems /or !tis residence rI/ can/orm to the standards o/ The Wink Canty Depd .M o/ Hedb Sar isrs. LERTrYIT Sra94 R Ti AI MMI NOTE, LOT NUMBERS REFER TO 'MAP Or PARADISE By THE SAY' FILED NOV. 4, 1976 FILE NO. 6463 AT THE OFFICE OF THE SUFFOLK COUNTY CLERK. AREA a 47.367sq.dt. ,IIIA SURVEY F PROPS r AT SOUTH " TOWN OF SOUTHOLD SUFFOLK COUNTY, N. Y. 1000 - 70 - 18 - 20.14 Scale 1" = 40' No v. 7, 1988 P t^ Sept 7994 (loLv aran) Aar+' 24 IM (fffW) ef, ,8. BLDG. n/sraK count aVART1OIT of 1EN.h, L6RV1GE6 FOR AeeRovM. K mu:llur�tox arLr 93 SO 52 AAR,OVFD CERTY'FD 77P . OUM M 77E SAA "LOR VEId7tW AB.R7RACT COW. cawwOd9E4L TH LAM 717LE NSMANCE c0. • 1 T m TM bealims of re& ad'"Wook �r6'�11°�• Mo. Mrem are hon•. laid ebiNwhoAs and os km data oblamed ham ofh � N.Y.S. LIC. NO. 996/8 !4•Penf b a4e•.Ian r/N a• Mles 1 lulr4 /N YB• rrnlr a ••NehNI � /PFCON/L' b't/RVFYORS, N• L1A.L6. ••ly/r I s •fePNf r •se en y A• N••' YM s1 . Lw 15161 765 - 5020 Tlw Au4WN•e. P. O. BOX 909 MAIN ROAD SOUTHOLD, N.Y. 11971 88-679 ; ThW- I—V I- Mb Applicant/Date Owners Name: 'r Reviewed: Architect/ Date Engineer: Submitted: 11113 O SCTM #: District: 1.000 Sec�on: ?0 Block: J 3 Lot: �•1 ProjectSubdivision [J Location: ORO ��i w } - _ Name:_ Sin&le 8 separate Required certification: (Yes / No) 1 eq Rey. 7_rniing,t)istricl: �i o(siic: VV0 Actual: 7 l (Lot coverage +roixiscd ) Req. i• eq � Req. Req. / (front Yard Proposed: ) (Side Yard Proposed: J (Rear Yard �— Proposed• Project Description: f S P AGENCUERMITS Permit �ZUIRED FOR REVIEW j NO YM Number Suffolk County Health.Dept. New York State D. E. C. Town Trustees V , Town Zoning Board: approval: / Town Planning Board approval: / Flood Plane Elevation ??? Flood Zone: . Notes: • ��- I • 6,50-ri/IM',