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30664-Z
FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No: Z-31186 Date: 10/05/05 THIS CERTIFIES that the building ACCESSORY Location of Property: 500 ESPLANADE SOUTHOLD (HOUSE NO. ) (STREET) (HAMLET) County Tax Nap No. 473889 Section 88 Block 6 Lot 13 .51 Subdivision Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated SEPTEMBER 21, 2004 pursuant to which Building Permit No. 30664-Z dated SEPTEMBER 24, 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 IN THE REQUIRED REAR YARD AS APPLIED FOR. The certificate is issued to JEFFREY S & STACY ANN CLAUSEN (OWNER) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A ELECTRICAL CERTIFICATE NO. 93979C 11/15/04 PLUMBERS CERTIFICATION DATED N/A tho zed ignature Rev. 1/81 Form No.6 (Z-7p 22TOWN OF SOUTHOLD r BUILDING DEPARTMENT —� TOWN HALL?.OLD 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 I% 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 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. q— — OBJ New Construction: _ Old or Pre-existing Building: (check one) J Location of Property: _ Sf7 0 T ha FsjIOC')a d-e S oy-f House No. S eet Hamlet Owner or Owners of Property: Ct us cx' a 47159-61 Suffolk County nn_ Yl Tax Map No 1000, Section Block (7�� Sp Lot _O 13 , Q 6 J'T � Subdivision 2 �I S til D res Filed Map. Lot: PermitNo. —J 0 �-4_Date of Permit. 9 a' Applicant: '�I VY el r� �Q O l S Health Dept. Approval: Underwriters Approval: J Planning Board ,approval: Request for: Temporary Certificate _Final Certificate: (check one) Fee Submitted: ant Signature c0w 311g' 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. 30664 Z Date SEPTEMBER 24 , 2004 Permission is hereby granted to: JEFFREY S CLAUSEN 500 THE ESPLANADE SOUTHOLD,NY 11971 for CONSTRUCTION OF AN INGROUND SWIMMING POOL IN THE REQUIRED REAR YARD AS APPLIED FOR TO THE CONDITIONS OF THE PLANNING BOARD C&R' S at premises located at 500 ESPLANADE SOUTHOLD County Tax Map No. 473889 Section 088 Block 0006 Lot No. 013 . 051 pursuant to application dated SEPTEMBER 21, 2004 and approved by the Building Inspector to expire on MARCH 24, 2006 . Fee $ 150 . 00 n Authorized Signature ORIGINAL Rev. 5/8/02 M Electrical Inspection Certificate k Issue Date Electrical Inspection Service, Inc. Application Number M 11/15/2004 375 Dunton Avenue 93979C East Patchogue, New York 11772 11 (631)28"642 _ r Issued To: Mr. Jeffery Clausen Street: 500 The Esplanade Village: Southold Zip: 11971 Town: Southold Section: 88 Block: 6 Lot: 13.51 Contractor: Hank*s Electric Inc. (L) Lic. # 2675-E W Was examined and found to be in compliance with the National Electrical Code. _- W ❑ Commercial ❑ NV Defects ❑X Pool ❑ 1st Floor ❑ Indoor ❑ Basement ❑ Hot Tub M 1. 5 © Residential ❑ Det. Garage ❑ Attic ❑ 2nd Floor I] Outdoor ❑ Addition ❑ Survey Ilk Switches Receptacles Fixtures GFI Heaters A/C Fans Dishwasher Washer/Amps Dryer/Amps Oven Range/Amps Microwaves Furnace Oil Gas Circulators Smoke Detector Bell Transformer Meter Amps Phase UG/OH Jacuzzi Television CO Detector Bldg. Permit. 44 Other Equipment 130/220v raintight sub panel we 1 20/220V pool receptacle *,: c 1 time clock Hugo S. S di President xx Rough Inspection: Inspector: - ' Final Inspection: 11/11/2004 w* Inspector: John McMahon III This certificate must not be altered in any manner. Inspectors may be identified by their credentials. IWB *11 MILIWA �06� �� 765.1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION IST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] INS ON [ ] FRAMING [ FINAL [ ] FIREPLACE & CHIMNEY [ ] FIRE SAFETY INSPECTION REMARKS: DATE �3 �� INSPECTOR i LOT AREA x,41,069 Sq,Ft. NOTE:MAXIMUM CLEARING OF LOT IS LIMITED TO 57°%. F*FL.ELEV GAR.,ELEV. i I 23 Aef,:, "o ey z MAIN BAYVIEW R� D° 9 r� N O M M OPEN SPACE � 275.00' S.60'12'20"E. 10 v 02 W — ri.o LLL P `T a z p I O 41 ' VI h b Z O W M a N � � M 2 271.36' 1 N.60+04'58"W LOT NUMBER 48 I 3-21-2.01 �Aa4 Ckonnq Lm° 12-I4-2c411 Rcvd°d flC QNMDa IDA I tMa1ul01N) 9uMdlNru[ rtWluim st°Nll JOB NO. 00-354 FILE NO. ANGEL SHORES rury N[R[ON FROM ,1f/ RNALL RUN m o w 11M91s ucruaa YO nl[ rn0.[et P.ut YA1oM M sum N /U SURVEYED FOR rl ° t M1 GFC aIC OF IMn0. ANO ON MN [WUI _ �� I n -u vu r• ml¢ cavAN,- LOT NUMBER 49 19 L 1 Yf- M1 N ANR Yi(iL OF Til ANR ro MAP OF`ANGEL SHORES f f' uFtivw AVAftM1NN[a All .. 1.. LVA' lA uResoulN,nocl I v ^ ueNl SITUATED AT BAYVIEW � I} " 1 c•i c,++ npn TOWN OF SOUTHOLD,SUFFOLK COUNTY,NEW YORK es SCALE 1" _ '30' , DATE 9-26-2000 '•''"""""'`' FILED MAP NO. 9729 DATE 8-23-1995 .GUARANTEED ONLY TO TAX MAP NO. 1000-88-6-13.51 (REF.ONLY)DISK 193 HAROLD F. TRANCHON JR. P.C. LAND SURVEYOR 1866 WADING RIVER—MANOR RD. WADING RIVER, p,c(A�(�-F T�,,•s-{^'�` S/!_ NEW YORK, 11792 Y. LIC. NO. 048992 516-929-4695 p F. TRANCHON JR. PENN. LIC. NO. 21115-E FIELD INSPECTION REPORT DATE COMMENTS m FOUNDATION(1ST) x --------------------------------- c FOUNDATION(2ND) TI O O O ROUGH FRAMING& M PLUMBING r r INSULATION PER N.Y. STATE ENERGY CODE r n V 0 FINAL ADDITIONAL COMMENTS ^z m z L� W � V �' � y �+ Z U_ O C+7 Com" C Cil H a GOWN OF SOUA[OLD BUILDING PERMIT APPLICATION CHECKLIST 3UILDING DEPARTMENT Do you have or need the following,before applying? GOWN HALL Board of Health 30UTHOLD,NY 11971 3 sets of Building Plans CEL: (631) 765-1802 Planning Board approval ?AX: (631) 765-9502 Survey PERMIT NO. .3[7 6 & Check Septic Form N.Y.S.D.E.C. Trustees ?xamined 20_QV Contact: tipproved 20jLj� Mail to:'s U) m t n Po o I5 Nsapproved a/c 4-71 R�-e 2.6A- oC.�4 P+ Phone:-10J30 I l 118 expiration 3�-� 20Q,6 B�Inspector z 12004 APPLICATION FOR BUILDING PERMIT Date Oe I 200¢ INSTRUCTIONS F— a. This application MUST be completely filled in by typewriter or in ink and submitted to the Building Inspector with 3 ets of plans, accurate plot plan to scale.Fee according to schedule. b. Plot plan showing location of lot and of buildings onpremises, relationship to adjoining premises or public streets or reas, 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 hall 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 :sues a Certificate of Occupancy. f. Every building permit shall expire if the work authorized has not commenced within 12 months after the date of suance or has not been completed within 18 months from such date.If no zoning amendments or other regulations affecting the -operty have been enacted in the 3nterlm6 the Building Inspector may authorize, in writing,the extension of the permit for an edition six months. Thereafter,a now permit shall be required. APPLICATION IS HEREBY MADE to the Building Department for the issuance of a Building Permit pursuant to the uildiug Zone Ordinance of the Town of Southold, Suffolk County,New York, and other applicable Laws, Ordinances or egulations, for the construction of buildings,additions,or alterations or for removal or demolition as herein described. The Lplicant a sttrcal n y-= all all applicable laws, ordinances,building code,housing code,and regulations, and to admit ttho inspectors on premis t �r_eons "IMMEDIATEL Y" REEFED ENCLOSE POOL TO GC GH UPON COMPLITI N (Si ture o pplicant or name, if a co oration eEFORewAre4 OCCUPANC3YOR 50c) he C pla e USM UNLAWFUL (Mailing address of applicant) ate wapplicant is owner, i ;Fgc@MT4Teral contractor, electrician, plumber or builder e OF OCCUFANCY Y C APPROVED AS NOTED une of owner of premises 500 Te- ES ►a-Aode (As on the tax roll or lates(Iff" BUILDING DEPARTMENT AT applicant is a corporation, signature of duly authorized officer 765.1802 SAM TO 4 PM FOR THE FOLLOWING NVECTI (Name and title of corporate o SF11W, I. FOUNDATION - TWO UIRED THE REQUIREMEr.-� OF7liE FOR POURE(�CONCRE dlders License No. 1 L4 I a CODES OF NEW YORK STATE 2. ROUGH - FRAMING 8 PLUMBING umbers License No. 3. INSULATION -etriciafrs License No. A(o-7 G 4. FINAL - CONSTRUCTION MUST her Trade's License No. BE COMPLETE FOR C.O. ALL CONSTRUCTION SHALL MEET THE NTS OF THE CODES OF NEW Location of land on 'ch posed work will be done: STATE NOT RESPONSIBLE FOR e 'Sni OR CONSTRUCTION ERRORS. House NumberStr Hamlet County Tax Map No. 1000 Section�_Blocic Lot 13 .5 I Subdivision_ �.1 �hO��S Filed Map No. 9-IA9 Lot a. Existing use and occupancy S i �41[ IZi m i!u y( S t der CP R. b. Intended use and occupancy. i IlS4) DV dJ�` d I Vl(#fO1111A n00 3. Nature of work (check which applicable): New r POO ! Addition Alteration Repair Removal Demolition Other Work W (Description) 4. Estimated Cost $115,000 ` 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. 7. Dimensions of existing structures, if any: Front Rear Depth Height Number of Stories Dimensions of same 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 11. Zone or use district in which premises are situated 12. Does proposed construction violate any zoning law, ordinance or regulation?YES_NO ✓ 13. Will lot be re-graded? YES / NO—Will excess fill be removed from premises?YES ---'NO 14. Names of Owner of premise C A Address DOTrie ne No. 'Ibb'9539 Name of Architect Address t 16 LAt&hj AW Phone Noval-a.105 Name of Contractor Address t1-"I i �25F4- Phone No. '14 U- '2)106 a& -1 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"il i—prWa aphical data on survty. ai `3N K STATE OF NEW YORK) moJAG' SS: ^ 't4' a.90:qae COUNTY OF Ste) } ^(iV. •j being dulyt*mm,.Qo& that(s)he is the applicant (Name of in 'vidual signing contract) above nan1gL, - r ,0 'Tl' '.I (S)Heisthe tC. swtinr (Contra4tp�,Agent, Corporate 0 etc.) of said owner or ow4ers,apd is „Iv autkoiized to perform or have performed the said work and to make and file this applicatic that all statements contained in�tElis app116ation are true to the best of his knowledge and belief; and that the work will be performed in theimauner set f6t&infi)�•application filed therewith. Sworn to before me this Q.0w dayof-= 20u�..� otaryPublic , .. ., i of Applicant v,• ER NZWYM .COUNTY COMMiSSI(A EAPIR:S UMT PF 1 L V ly LJ I L��- Applicant/ Date. Owners Name:.. _� �.S . Reviewed: o Architect/ Date Cagineer: J^ Submitted: SCTM #: District: 1 00 Section: 13lock: Project n 7 Subdivision Location: S—G'J j� 2 _ — Name: t $in&le 8 separate Required �� certification: (Yes f No) Req Req %otting District (Lol size: _ Actua (Lot coverage J�`Y'rupasedG I Req. Req_ Req _ tpront Vard Proposed: r �ProPosed:__A_I_(Re&r Yard ,,iliff' Proposed- Project Description: f 5 /f ---------------- AGENCIERAHIS Permit REQU ED FOR REVIEW N.A. NO YM Number Suffolk County Health-Dept. New York State. D. E.C. Town Trustees Town Zoning Board approval: _ Town Planning Board approval: Flood Plane Elevation??? Flood Zone: NoPs• Z LLJ 10" p„ :�4 } Vo z z0 z � c/- Q f N0 N o w > Y � zOO E o TO FILTER FROM FII TER FROM%W 7. 10' T L' FLTERANt7RW A TO WASTE TO MTM\6 PLUMBING,.SCHEMATIC g PLAN CMOTTEW&L5 10 FOR&O CONCRETE 5TEP5 WATER 1W WATER LIQ Lu g 4 ROI, W FOAM KTMN Z LM ANO CONCRETE E Z .. w \� C4 to �" SAND 130TTOM \ a COPINGANF/WALK SECTION A Form T5 `. 6Y O(I ERS 3500 P51 POLKP CONOT a vim uMv 2" TO q" SAND . GRFI7E 5 10 5' \�\\ a a Ll NOTES I' UE ME aMV WATER ME AM"OF '-"WN f1E fROE05EV MEW CRAVE. SECTION B z. afE L of OWNEARiN.FREEOF� M1VVERS. VO NO P1LON ��f�E �foEx�En .fIOfOFfWWEE INftFM WALL SECTION BY MGRS 1HNJ 8" 3. wRA5100E 5MOOTN,NON 5KIV r"O.GPEVAWAY fWM rOa. 4. WATERVI`ROS&%KLPEI.IMITEpfOpMMM"Uf05W 5-27-03 LOCAL LONVIfa6 t