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31579-Z
FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No: Z-31320 THIS CERTIFIES that the building ACCESSORY Date: 12/06/05 Location of Property: 1490 SKUNK LA CUTCHOGUE (HOUSE NO.) (STREET) (HAMLET) County Tax Map No. 473889 Section 97 Block 3 Lot 11.3 Subdivision Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated NOVEMBER 2, 2005 pursuant to which Building Permit No. 31579-Z dated NOVEMBER 4, 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 "AS BUILT" ACCESSORY POOL HOUSE AS APPLIED FOR. The certificate is issued to WAYNE J & MARY O MOTT (OWNER) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A ELECTRICAL CERTIFICATE NO. H 069531 10/13/00 PLUMBERS CERTIFICATION DATED Aut orized Signature Rev. 1/81 PERMIT NO 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) 31579 Z Permission is hereby granted to: for Date NOVEMBER 4, 20 WAYNE J & MARY 0 MOTT 1490 SKUNK LANE CUTCHOGUE,NY 11935 CONSTRUCTION OF AN AS BUILT POOL HOUSE IN THE REQUIRED REAR YARD AS APPLIED FOR. ADDITIONAL CERTIFICATIONS MAY BE REQUIRED. at premises located at 1490 SKUNK LA CUTCHOGUE County Tax Map No. 473889 Section 097 Block 0003 Lot No. 011.003 pursuant to application dated NOVEMBER 2, 2005 and approved by the Building Inspector to expire on MAY 4, 2007. Fee $ 300.00 C ORIGINAL Rev. 5/8/02 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 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 New Construction: Location of Property: House No. Owner or Owners of Property: Old or Pre-existing Building: Suffolk County Tax Map No 1000, Section Subdivision Permit No. 3 / S'7 Health Dept. Approval: Planning Board Approval: Date of Request for: Temporary Certificate Fee Submitted: $ Date. 116.", /< Street Block Filed Map. Applicant: Underwriters Approval: _ (check one) Hamlet Lot If j Lot: Final Certificate: (check one) Applicant S' nature TOWN OF SOUTHOLD BUILDING DEPT. 765.1802 INSPECTION [ ] FOUNDATION 1 ST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] INSULATION [ ] FRAMING/ STRAPPING XFINAL -- [ ] FIREPLACE & CHIMNEY [ ] FIRE SAFETY INSPECTION REMARKS: l- k` C�4_ ©'k . DATE^� ��� INSPECTOR "o ' TME NEW YORK BOARD OF FIRE UNDERWRITERS PAGE 1. 8081659 BUREAU OF ELECTRICITY F 40 FULTON STREET, NEW YORK, NY 10038 Date OCTOBER 13, 2000 Application No. on file 11058780/00 H 069531 THIS CERTIFIES THAT only the electrical equipment as described below and introduced by the applicant named on the above application number is in the premises of ,VAYNE J. MOTT, 1100 SKUNK LANE, CUTCHOGUE, NY in the following location; ❑ Basement ❑ 1st Fl. ❑ 2nd Fl. GAR/OUT Section Block Lot was examined on OCTOBER 05 , 2000 and found to be in compliance with the National Electrical Code. OTHER APPARATUS: STORAGE SHED -1 PA_NELBOARDSs1-3 CIR. 30 cG. F. C. I, —1 W,P YNE J. 111OTT 11.00 SKUNK DANE CUTCHOGUE, NY, 11935 GENERAL MANAG ),, J Per This certificate must not be altered In any manner; return to the office of the Board if Incorrect. Inspectors may be identified by their credentials. CEPTACLES SWITCHES INCANDESCENT FIXTURES RANGES COOKING DECKS OVENS DISH WASHERS EXHAUST FANS FLUORESCENT OTHER AMT. K.W. AMT. K.W. AMT. K.W. AMT. K.W. AMT. H.P. 4 3 3 FURNACE MOTORS FUTURE APPLIANCE FEEDERS SPECIAL REC'PT. TIME CLOCKS BELL UNIT TRANS. HEATERS MULTI -OUTLET SYSTEMS NO. OF FEET DIMMERS OIL H.P. GAS H.P. AMT. NO. A. W. G. AMT. AMP. AMT. AMPS. AMT. H.P. AMT. WATTS fSERVICE CONNECT NO. OF METER EQUIP. S E R V I C E TYPE 1 0 2W 1 0 3W 3 0 3W 3 0 4W NO. OF CC COND. PER 0 A. W. G. OF CC. COND. NO. OF HI -LEG A. W. G. OF HI -LEG NO. OF NEUTRALS A.WG OF NEUTRAL OTHER APPARATUS: STORAGE SHED -1 PA_NELBOARDSs1-3 CIR. 30 cG. F. C. I, —1 W,P YNE J. 111OTT 11.00 SKUNK DANE CUTCHOGUE, NY, 11935 GENERAL MANAG ),, J Per This certificate must not be altered In any manner; return to the office of the Board if Incorrect. Inspectors may be identified by their credentials. FIELD INSPECTION REPORT DATE COMMENTS FOUNDATION (IST) J u -------------------------------------- FOUNDATION (2ND) r � z ROUGH FRAMING & PLUMBING 0 y r� r� -- - INSULATION PER N. Y. STATE ENERGY CODE S r ' y - — FINAL^ r --------------- _ ADDITIONAL COMMENTS d' ✓ d O Z r= Lr\ l .a J O x -- — y d b I TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, NY 11971 TEL: (631) 765-1802 FAX: (631) 765-9502 www. northfork.net/Southold/ Examined_ / X1 , 20 Approved` ` t% 20 Disapproved a/c Expiration '20 22005 PERMIT NO. BUILDING PERMIT APPLICATION CHECKLIST Do you have or need the following, before applying? Board of Health_ 4 sets of Building Plans Planning Bo4rd approval Survey Check�� 3Q Septic Form N.Y.S.D.E.0_ Contact: Mail Phone:,,52,5— &5 90 APPLICATION FOR BUILDING PERMIT Date / O ✓ Z 20 0,' INSTRUCTIONS a, This application MUST be completely filled in by typewriter or in ink and submitted to the Building Inspector with 4 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 and in building for necessary inspections. (Signature of applinift or ruinte, if a corporation) I Q box �ap U2lhtu�(Mailing addre, s olicant) `I C J I i n0 I State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder Name of owner of premises W cty /1 L H 0 f 1 6 1_ 1 Q -y a H J (As on the tax roll or latest dech) If applicant is a corporation, signature of duly authorized officer (Name 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 pro osed work will be done: `I l/0D 9�t CST House Number Street t r, ': a?Hamlet r, rth+M r � Z County Tax Map No. 1000 Section i0�ua„t» ; '-ft Lot Subdivision Filed Map No.aarotn Lot (Name) 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy b. Intended use and occupancy C:Ce'KC • ori t.y 3. Nature of work (check which applicable): New Building_ Addition Alteration Repair Removal Demolition Other Work 4. Estimated Cost d C) Fee 5. If dwelling, number of dwelling If garage, number of cars _ (Description) (To be paid on filing this application) Number of dwelling units on each 6. If business, commercial or mixed occupancy, specify nature and extent of each type of use. 7. Dimensionsof xisting structures, if any: Front � f Rear /L1 t Depth Z Height % g/ e dt Number of Stories / Dimensions of same structure with alterations or additions: Front 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 Rear 12. Does proposed construction violate any zoning 1 ordinance or regulation? YES NOy 13. Will lot be re -graded? YES �t NO V Will excess fill be removed from premises? YES NO `N 14. Names of Owner of premises oJE_Address I1 0 0 Un hone No. Name of Architect Address Phone No Name of Contractor g; I! G o •' m a - Address h G; hone No. Cf �fi I y C- tLh oMv 2 15 a. Is this property within 100 feet of a tidal wetland or a freshwater wetlandd? *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, must provide topographical data on survey. STATE OF NEW YORK) // SS: COUNTY OPk L o i I ; 5Q � i e q fw being duly sworn, deposes and says that (s)he is the applicant (Name of individual signinj contract) above named, (S)He is the A A Q G — (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. Swom to before me this day of 20_0,5 /) h t% '�S't4J -CWL KV U!��_SiiNc Public ature of A licant Nfty p New Moth Q� 2007 /r FD. CM. N/F MIRAGLIA vvv S 85°50'/4' --'N85°50/4 W �l (� 0 25.23' EAR TH B \ GRAVEL DRIVEWAY-_ PROPOSED EASEMENT �Cb "'0 In 0o b (� 0 (IV0 / GARAGE STORYS 68052'52"E CHAIN LINK WOOD FRAM E/DE, FENCE FO 253/ FRAME RESIDENCE CM. SHEDN POOL HOUPelA PERWDW96B IN GROUND N/F M/RAGL I A� 8' y0 O)r POOL � (U. C.) 45.8' CHICKEN COOP m U) TM -f 1000- 097-03-I L 3 FOUND IRON PIPE: FD. IP 11 CONCRETE MONUMENT= FD. CM GUARANTEED T0� WAYNE ✓ MOTT MARY 0. MOTT TOWN OF SOUTHOLD /Jl SC 2- S 87' 25' 40 " W SURVEY OF DESCRIBED PROPERTY SITUATE CUTCHOGUE, TOWN OF SOUTHOLD SUFFOLK COUNTY, N.Y. SURVEYED FOR: WAYNE ✓. MOTT MARY 0. MOTT 27 JULY 05 ADO POOL HOUSE 9 PERGOLA UTILITY POLE - O; 2 RAIL FENCE N/F HOOPER 135' 564.98' 273.27' FE1 SI a, Lu W Q N- IR CoO Lu Z Q J FD /P Y Z k Cn \V SURVEYED 20 APRIL, 1996 / SCALE, 1" z 50' AREA= 107,563.20 SF or �0 2.4693 Acres SURVEYED BY* STANLEY J. ISAKSEN, JR PO. BOX 294 NEW SUFFOLK, NY, L1956 (516) 734-5835 p ON Ion n0 •ue- o pr o f R -xp a. zpr11 2'x °1 n x NOi 5 2'x1 xt ^ 1 12 1850 m Ype • o Pacmg wbmn np ntanl ever P mPaon ce-Mle per ra 3 ommm po-ne I pe! ri np a to p P Ammon apt-nel ea ap el ng el 1p pxee ling Idol apo INmp on 1 M. ce m a er M1e R mown ace-na Ic oplon er ]-t +ime ee en m M Wre r emmm ea per WP to lePp q,t aePM I noes e e e9 ole Ana pc eceaalleor; t lu Delo 2 t ,2 aM-ne ,1 pc aonp pne e to ei b1 o pal r2v4 a WO or Wmp eWs n -Mle per me 4 n -nae per a u an a W el, 2.164 FaM-Mllod per IM �oN, Ord dal w Maknq 4- o4M per el 4 p n1eIXp 2-6 M aleee e n W acnm e Ipc ng a t x 010ec In or op me ace-nelleaeaTr 'fifer po 1 ce.nae px a o4t pn pw to or s -Mi per pe en a W n 2-t oe.n pm ems wlW ae r . qr zones sen a moan ne Pa6 per euPW g ea np, impr pars. Dae a e x n wn or coolers 7 Mlol1 W m B 2'a.c ora Palls 'wipe e' e u Pones B EO eppelB R ra peM 2. etlpe ypa.m wal ce 5CN er5 Dar sWpo p mpt w xe Per d+Ppdt leB. a n0 xtp or ! �e e ariz or palls w sae e' 15 ae .ours peneepreeter ID per auppprt r ep. r • ee np arixe - per suppprt B par a ea np ix 0or or North Elevation SCALE: 1/4" = 1'-0" South Elevation SCALE: 1/4" = P-0" �,-r ANI � it . � � � r. •.Y._ APPROVED AS NOTED DATE:J-1,,yB.P. p FEE: lxu BY. l NOTIFY BUILDING DEPARTMENT AT 765-1802 8 AM TO 4 PM FOR THE FOLLOWING INSPECTIONS: 1. FOUNDATION - TWO REQUIRED FOR POURED CONCRETE 2 ROUGH - FRAMING & PLUMBING 3. INSULATION 4. FINAL - CONSTRUCTION MUST m d. `p u= 12 - v o N o BE COMPLETE FOR C 0 ALL CONSTRUCTION SHALL MEET THE REQUIREMENTS OF THE CODES OF NEW YORK STATE. NOT RESPONSIBLE FOR DESIGN OR CONSTRUCTION ERRORS. OCCUPANCY OR UNLAWFUL UT CERTIFICAT CUPANCY T7�ME,ET �o o 2 o Z Y TION SHALLEMENTSOF THE YORK STATE. West Elevation SCALE: 114" = 1'-0" OOD ZONE COMPLY WITH CHAPTER "467 FLOOD DAMAGE PREVENTION SOUTHOLD TOWN CODE. COMFI V WITH ALL CODES OF & TOWN CODI CONDITIONS LD TOWN ZBA .D TOWN PLANNING -D TOWN TRUSTEES C MCS M E W° 0 E m 7Q) H M 2 -