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HomeMy WebLinkAbout30996-ZFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY NO: Z-31284 Date: 11/18/05 T~IS CERTIFIES t~at the ~uildlng INGROUND SWIMMING POOL Location of Property: 1005 HARBOR LA CUTCHOGUE (HOUSE NO.) (STREET) (HAMLET) County Tax Map No. 473889 Section 97 Block 6 Lot 12.4 Subdivision Filed Map No. __ Lot No. __ conforms substantially to the Application for Building Permit heretofore filed in this office dated MARCH 8, 2005 pursuant to which Building Permit No. 30996-Z dated MARCH 9, 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 IN THE REQUIRED REAR YARD AS APPLIED FOR. The certificate is issued to MICHELLE LUNDEN (OWNER) of the aforesaid building. SUFFOLK COUNTYDEPARTME~T OF~LTHAPPROVAL N/A EL~-rKICAL C~KTIFICATE NO. 6391 PLUMBERS C~TIFICATION DA'£~U N/A 05/25/05 Authorized Signature Rev. 1/81 Form No. 6 . TOWN OF SOUTitOLD BIJILD/NG DEPARTMENTTowN HALL 765-1802 APPLICATION FOR CERTIFICATE OF OCC This application mu~t 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. ApprovM of electrical installation from Board o f Fire Underwriters. 4. Sw~m statement fr~m p~umber certifying that th~ s~der used in system c~ntains ~ess than 2/~ ~ ~f ~ % ~ead. 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. Ifa 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 New Construction: Location of Property: ~ 0 ~ q~ House No. Owner or Owners of Property: ~ tC~e Suffolk County Tax Map No 1000, Section Subdivision PermitNo. ~--9~ a~ (0 _Dateofeermit. Health Dept. Approval: Planning Board Approval: Request for: Temporary Certificate Date. Old or Pre-existing Building: Sti~eet Io~ (check one) Block ~1~ Filed Map. Applicant: Hamlet Lot ~ /~'~/ Lot: Underwriters Approval: Final Certificate: L,~ (check one) Fee Submitted: $ co Applicant 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. 30996 Z Date MARCH 9, 2005 Permission is hereby granted to: for : INSTALL~TION OF AN MICHELLE & ~LNO LUNDEN 1005 HARBOR L~/qE CUTCHOGUE,NY 11935 INGROUND SWIMMING POOL IN THE REQUIRED REAR YARD FENCED TO CODE at premises located at 1005 HARBOR LA CUTCHOGUE County Tax Map No. 473889 Section 097 Block 0006 Lot No. 012.004 pursuant to application dated MARCH 8, 2005 and approved by the Building Inspector to expire on SEPTEMBER 9, 2006. Fee $ 150.00 ORIGINAL Rev. 5/8/02 TOWN OF SOUTHOLD BUILDING DEPT. 765-1802 INSPECTION FOUNDATION 1ST [ ] ROUGH PLBG. FOUNDATION 2ND [ ] INSULATION ~ ] FRAMING/STRAPPING ~/~FINAL ~~ FIREPLACE & CHIMNEY [ ] FIRE SAFETY INSPECTION REMARKS: DATE / 0 --/~'- 0 _.~ INSPECTOR FIELD INSPECTION REPORT I DATE FOUNDATION (1ST) COMMENTS FOUNDATION (2ND) ROUGH FRAMING & PLUMBING INSULATION PER N. Y. STATE ENERGY CODE FINAL TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, NY 11971 TEL: (631) 765-1802 FAX: (631) 765-9502 www. nort#fork.net/Southold/ Examined ~? .20 0f ^pp ved ,:o C Disapproved a/¢ Expiration ,20 0~ PERMIT NO. - ~LDG. DEPT. TOW~ OF $t3U"n.~OLD Building Inspector BUILDING PERMIT APPLICATION CHECKLIST Do you have or need the following, before applying? Board of Health 4 sets of Building Plans Planning Board approval Survey Check Septic Form N.Y.S.D.E.C. Tmst~es Contact: Mail to: Phene'~ 3 - 73 /g~' APPLICATION FOR BUILDING PERMIT Date INSTRUCTIONS 20 6~ 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 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 authorized inspectors on premises an~lit~ I~l~tl~gJ(~{~ections. ME~'I THE REQUIREMENTS OF THE "IMMEDIATELY" CODES OF NEW YORK STATE. ENCLOSE POOL TO CODE UPON COMPLETION BEFORE "WATER' OCCUPANCY OIL.- USE IS UNLAWFUL (Maili6gaddress ofapplic State whether applicant is owner, lessee, ag~l~q[h~F~'[~'~t~ctor, electric!an, plumber or builder OF OCCUPANCY Name of owner of premises ~\c)~,t.J~P~ t-.~_xc, c),o_~, APPP?"79 ~,S NOTED (As on the tax roll or la~ras~61.eed)z/q/,r' ,~0 99 {~ ~-~ .......... Ifapptlicant]sac°rp°r~a~a°~'s]gnature°fduly~l~tllig~g4~fl~0&e'6""~r/,xt_,~ ~,~-~ '~'/ ~gY'. /~-~-~' /x, ~ . ~ k ! ~ ~ . l,q~lJ~11~ffill:l'iO~l::~lirlqJAFEE' [~(9. ///(Ns4neandtltl(ioT'e~rPorateofficer) "EQUI"E[~ NOTIFY B ,~42 9~-:,RTM[NT AT ~ ~ 765-1802 ,M 20 49M FC.R THE Builders License No. FOLLOWlN(: 'IS~ECTI©NS: Plumbers License No. 1. FOUND FOR P£ ~RED ~ .NCRETE Electricians License No. 2. ROL'%~ - r?~,M[,IG & PLUMBING Other Trade's License No. 3 I~Y: ~ffION -. r,rqAL - CON$'rEU3TION MUST 1. Location of land on which proposed work will be done: ;B COMPLETE F~' ~ C.O. ~C~c~' ?~C~([Oor' ~ CoA-C$-'<~4~L~iONSTRUCTIO~ SHALL MEET THE House Number Street HqllII~IEMENTS OF THE CODES OF NEW YORK STATS. NOT R SPONmLE FOR County Tax Map No. 1000 Section q~-~ Block (47 OE$1GN 0~ Subdivision Filed Map No. ; ' Lot : ~ ,4. ~ame) fi.ETtaS STOSU ~SSUANT TO SECTION 4~4 0¢ OF TSE TOWS COOE. ature fq~p'licant orname, ifa corporation)O State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy I~-~ch~xc¢ b. Intended use and occupancy Nature of work (check which applicable): New Building Repair Removal Demolition 4. Estimated Cost ~ 5. If dwelling, number of dwelling units If garage, number of cars Addition Alteration Other Work .5,.~xo-~x.,_x. ~ \ '-[Description) Fee (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 Stodes 8. Dimensions of entire new construction: Front Height Number of Stories Rear Depth 9. Size oflot: Front ~\ ~-~- Rear I&ct. E \ Depth 10. Date of Pumhase 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 fi.om premises? YES ~/ NO 14. NamesofOwnerofpremisesl, a~c~,~e._ C.~c,~-- Address lq~&~,t~ I~dk~ PhoneNo. Name of Architect Address Phone No Name of Contractor Address Phone No. 15 a. Is this property within 100 feet of a tidal wetland or a freshwater wetland? *YES NO c~ * 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 fee.~ 0r b,elb~v, must provid'e topographical data on survey STATE OF NEW YORK) SS: COUNTY OF <_~¢.~ ~ ~,~t_~,.C._.~ being duly swom, deposes and says that (s)he is the applicant (Name of individual signing contract) above named, is the (Contractor, Agent, C~[porate Officer, ~t¢.~ 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 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,~albefore me thisl~ Orlq t Is [ dayo_f I~lJI 200( J