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Home My WebLink About31375-ZFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No: Z-31303 Date: 11/29/05 THIS CERTIFIES that the building INGROLrND SWIMMING POOL Location of Property: 300 GARDINERS LA SOUTROLD (HOUSE NO.) (STREET) (HAMLET) County Tax Map No. 473889 Section 70 Block 8 Lot 12 Su]0divislon Filed Map No. __ Lot No. __ conforms substantially to the Application for Building Permit heretofore filed in this office dated AUGUST 15, 2005 pursuant to which Building Permit No. 31375-Z dated AUGUST 17, 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 STACEY A/TN NORKLUN (OWNER) of the aforesaid building. SUFFOLK CO%~Ti"fDEPARTMENTOFH]~ALTHAPPRO~-AL N/A ELBt-i~IC3~L CERTIFICATH NO. 2065 pLUMBERS CERTIFICATION DA'r~u N/A ~o/os/o5 Rev. 1/81 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 thc 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. Swam 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: 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. Itl2U ; New Construction: Location of Property: c'/ Old or Pre-existing Building: (check one) House No. Street Hamlet Owner or Owners ofProperty: . .q3cC-x;4~ -fix- No~V.2\t,m Suffolk County Tax Map No 1000, Section -'] O Block Lot Subdivision Permit No. 53 Health Dept. Approval: Date of Permit. Filed Map. Lot: Applicant: S%Ctr-6~ ..& . /Lto,ck, a~ Underwriters Approval: Planning Board Approval: Request for: Temporary Certificate Final Certificate: ~ (check one) Fee Submitted: co 13130.3 Applio~t Signature :~::~:~ S U F FO LK B U R EAU o, !i?: I N S P E C T 0 R S, i n c 40 Nottingham Drive, NY 11953 CERTIFICATE OF ELECTRICAL COMPUANCE i}iii Applicant: Raymond Electric i iiRough In Inspection Date: 10/5/2005 Final inspection Date: 10/5/2005 ?~iApplication N°: 2065 Certificate N°: 2.065 i?~iSu.o.k Coun~ Tax.ap .o: 70 8 12 Bu.d,ng Perm,t.% ::i ::Th s Certificate of Electrical Compliance is limited to the inspection and compliance of el~--'trical equipment i!.~ and/or work described below and installed by the Applicant named above, and located at the premise of: ii!iii Owner: Norklun ?Address 300 Gardiners Lane, Southold, NY 11971 ~.~=::i:Address of Inspection Site: 300 Gardiners Lane, Southold, NY 1197! ii X Residential Indoors Basement Service Shed ~ii?~ Commercial X Outdoors [st Floor X Pool Other: .ew Renovat,on 2nd F, oor .or tub ?:::: Addition Survey Attic Garage ?:i~:: Inventory Service 11~ i Heat Duplex Recpt Ceiling Fix HiD Fix Service 31~ 1 Time Clock 3 Switches Wall Fix Smoke Der Main Panel Hot Water 1 GFC! Recpt Recessed Fix Co Der 8 Ckt Sub- Panel GFCT Breaker i Single Recpt Fluorescent Fix i Pump Disconnects Dryer Recpt Range Recpt A/C Blower Emergency Fix Transformers Exhaust Fan Appliance A/C Cond Exit Fix Tw,st Lock .eat pump E,ectr, c.eat 2 Poo, Lum,na,re Other Equipment: 1-hlineralizer :.::ii?i The electrical work and/or equipment described above were inspected and appear to be in compliance with iiilil local, state and national electrical code requirements and this office. 'i Applic~ant: Raymond I=lectdc Licen~ No: 5141-U1= 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. 31375 Z Date AUGUST 17, 2005 Permission is hereby granted to: STACEY ANN NORKLUN PO BOX 780 SOUTHOLD,NY 11971 for : CONSTRUCTION OF AN IN GROUND SWIMMING POOL IN THE REQUIRED REAR YARD AS APPLIED at premises located at 300 GARDINERS LA SOUTHOLD County Tax Map No. 473889 Section 070 Block 0008 Lot No. 012 pursuant to application dated AUGUST 15, 2005 and approved by the Building Inspector to expire on FEBRUARY 17, 2007. Fees 15O.0O ~~ 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 //-'/Y - 03-" 'Z Z 0 0 ( ( U 0 FrI~,LD INS..PECTION REPORT FOUNDATION (1ST) FOUNDATION (2ND) DATE COMMENTS ROUGH FRAMING & PLUMBING INSULATION PER N. Y. STATE ENERGY CODE FINAL ADDITIONAL COMMENTS TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, NY 11971 TEL: (631) 765-1802 FAX: (631) 765-9502 ; NO.. Buildin~ spector i '5 } ....... I {I ~PLICATION FOR BULDING ................ 1 ' INSTRUCTIONS 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. Trustees Contact: Mail to: Phone: PERMIT Date ~]lO ,20 O,5- a. inls apph~atton MIfS~ be ~o'~pletely fi led tn by typewriter or tn 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 ora 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. (Signature of.a~plicant or name, ifa corporation) (Mailing address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder Nameofownerofpremises S¥o.e,~ ~,. (As on the tax roll or latest deed) If applicant is a corporation, signature of duly authorized officer (Iqame and title of corporate officer) Builders License No. Plumbers License No. Electricians License No. Other Trade's License No. 1. Location of land on which proposed ,work will be done: 300 House Number Street Hamlet County Tax Map No. 1000 Section Subdivision {Name) Block ~ Filed Map No. Lot Lot 2. State existing use and occupancy of premises and intetlded use and occupancy of proposed construction: a. Existing use and occupancy ~'.1c:'. 5DLo~-,~A~5 b. Intended use and occupancy 3. Nature of work (check which applicable): New Building Repair Removal Demolition 4. Estimated Cost /~ arQ' 5. If dwelling, number of dwelling units If garage, number of cars I / Addition Alteration OtherWork ~'b~"'~"'""~ ~ (Description) Fee Number of dwelling units on each floor (To be paid on filing this application) 1 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 Stories Rear 8. Dimensions of entire new construction: Front Height Number of Stories Rear Depth 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 ofpremises?;ffOx~ k/Ox' ~.lu,, Address Name of Architect Address Name of Contractor Address Phone No. Phone No Phone No. 15 a. Is this property within 100 feet of a tidal wetland or a freshwater wetland? *YES__ * IF YES, SOUTHOLD TOWN TRUSTEES & D.E.C. PERMITS MAY BE REQUIRED. b. is this property within 300 feet ufa tidal wetland? * YES__ NO __ * IF YES, D.E.C. PERMITS MAY BE REQUIRED. NO 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, must provide topographical data on survey. STATE OF NEW YORK) SS: COUNTY OF ~ ~ being duly swum, deposes and says that (s)he is the applicant (Name of individual signing contract) above named, (S)He is the (Contractor, 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 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. Sworn to before me th'lxe~ LYNDA M. BOHN NOTARY PUBLIC, State of New York No, 01 B06020932 Qualified in Suffolk Coun~.., Term Expires March 8, 200.J Signature of Applicant ~' u~v~'r"E o l=o 98ZH. AN 'J. NIOd A~lDO'd ¥..¢'g 'DN1 '"o']YD~tdO~ '1 Ad NV'rj SlOOd ~ Bupll Sd31~; d N3 NYNO"d/M 'd V"iA D N VJ. D3"cl 9f×,91