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Home My WebLink About31693-ZFORM NO. 4 TO'TN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY Mo: Z-31369 Date: 01/03/06 T~tIS CERTIFIES that the building INGROUND SWIMMING POOL Location of Property: 275 MID FARM RD SOUTHOLD (ROUSE NO.) (STREET) (HAMLET) Coua~ty Tax Nap No. 473889 Section 63 Block 7 Lot 22 Subdivision Filed Map No. __ Lot No. __ conforms substantially to the Application for Building Permit heretofore filed in t~uis office dated DECEMBER 27r 2005 pursuant to which Building Permit Mo. 31693-Z dated DECEMBER 27, 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 INGROUND SWIMMING POOL WITH ON GPJ~DE WOOD DECK AROUND WITH FENCE TO CODE AS APPLIED FOR. (NOTE: THIS SWIMMING POOL WAS INSTALLED IN 1994.) ~e certificate is issued to GEORGE R & MARGARET M. SULLIVAN (OWNER) of the aforesaid building. SUFFOLK COUIqTY DEPARTME~TOF~ALT~APPRO~-AL N/A EL~-rKICAL C~TIFICATE NO. N-322799 08/09/94 PLL~BEILg CERTIFICATION DATmU N/A ~!~iz~Signature Rev. 1/81 Form No. 6 TOWN OF $OUTItOLD BUILDING DEPARTMENT TOWN HALL 765-1802 APPLICATION FOR CERTIFICATE OF OCCUPANCY This application must be filled in by typewriter or ink and subrrfitted to the Building Department with the following: A. For new building or new use: 1. Final sm'vey 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 Undenvriters. 4. Sworn statement from plumber certifying that the solder used in system contains less than 2/10 of 1% lead. 5. Conwnercial building, industrial building, multiple residences and si~rfilar buildings and installations, a certificate of Code Compliance from architect or engineer responsible for the building. 6. Submit Plamfing Board Approval of completed site plau requirements. Bo 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, Additious to dwelling $25.00, Alterations to dwelling $25.00, Swimming pool $25.00, Accesss~ry building $25.00, Additions to access6ry buildii~g $25.00, Businesses $50.00. 2. Certificate of Occupancy on Pre-existing Building- $100.00 3. Copy of Certificate of Occupanc); - $.25 4. Updated Certificale of Occupancy - $50.00 5. Temporary Certificate of Occupancy - Residential $15.00, Conunercial $15.00 New Construction: Old or Pre-existing Building: _ LocationofProperty: c~'''~''T'- .,~'/~.,,q~,-a7 ~o--"/t:} (check one) House No. Owner or Owners of Property: Suffolk County Tax Map No 1000, Section Subdivision Permit No. ~ b ~ ~ ~£ Date ol7 Perm Jr. HealthDept. Approval: Plarafing Board Approval: Request for: Temporary Certificate Fee Submitted: $ ,:.G~_ Street Hamlet Block Filed Map. 9 ]0 ~ Applicant: Underwriters Appro,~al: Fiual Certificate: 7 Lot Lot: (check one) Applicanl Signature THE NEW YORK BOARD OF FIRE UNDERWRITERS ..... · eURE^U OF E~.£C'rR~crrY I 8S JOHN STREET. NEW YORK, NEW YORK 10038 in the foilo~in~ h,catlon; ~ B~,ement ~ I,t FI. ~ 2~d FI. ()~ ,~tion Bilk t~s exa~nlned on t~ 1¢ .: :'- :f' ~ ] ~ [ g'~ and found to be in compliance with the N~onal Electdc~ Code. Lot EXHAUST FANS fiXTURE t~ RXTURES RANGES COOKING DECKS OVENS DISH WASHERS =.o: wwE.o.o, cc. LD .wo E,.,,. _ SWIHHING POOL-- ! TIHE C~OCKS-A}U'. 40-- t G.F.C.I-I G.F ~ {SWD~{ING POOL} This certificate cove~'-s compliance at the date of ~lns[,ection only. Because of unusual e[~v[ronments it is advisable to have ~requent r. est/and o~: repairs <<< Continued on Page 2 >>> 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. COPY FOR BUILDING DEPARTMENT. THIS COPY OF CERTIFICATE MUST NOT BE ALTERED IN ANY MANNER. THE NEW YORK BOARD OF FIRE UNDERWRITERS BUREAU OF ELECTRICITY 85 JOHN STREET, NEW YORK, NEW YORK 10038 Date · ,4pplicalion~No. onfile ~'5 t 752c'4/94 N ~2~ 799 ,~;',?~:E .:~'~/ ~'" ~ . TM Hr[' '~P3~ RO~, SOi~HO~, N.Y. thefollowln~ location; ~ ~,e~ent ~ Ist ~'1. ~ 2~d FI. O~ .~tion ~l~k ~t made' by a ,tu~l.~fied person. ~C~lffi, ~, 11935 : ' 11 COPY FOR BUILDING DEPARTMENT. THIS COPY OF CERTIFICATE MUST NOT BE ALTERED IN ANY MANNER. 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. 31693 Z Date DECEMBER 27, 2005 Permission is hereby granted to: GEORGE R SULLIVAN PO BOX 837 SOUTHOLD,NY 11971 for : CONSTRUCT AN INGROUND POOL WITH FENCE ENCLOSURE AS APPLIED FOR. AMENDED TO INCLUDE DECK AROUND POOL. THIS PERMIT REPLACES 22111. at premises located at County Tax Map No. 473889 Section 063 pursuant to application dated DECEMBER Building Inspector to expire on JUNE Fee $ 365.00 275 MID FARM RD SOUTHOLD Block 0007 Lot No. 022 27, 2005 and approved by the 27, 2007. ORIGINAL Rev. 5/8/02 TOWN OF SOUTHOLD BUILDING DEPT. 765-1802 INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ]I~ATION [ ] FRAMING / STRAPPING [ ~] FINAL [ ] FIREPLACE & CHIMNEY [ ] FIRE SAFETY INSPECTION REMARKS: ~'-./~ ~ DATE ~ INSPECTOR TOWN OF SOUTHOLD BUILDING DEPT. 765-1802 INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ [ ] FRAMING / STRAPPING [~/]~FINAL [ ] FIREPLACE & CHIMNEY [ ] FIRE SAFETY INSPECTION REMARKS: ~'~--~ -~/,,,a-~ J ~-~/,~"/'/~ ~ DATE e: Diagonals given to 90° point of corners. SIZE A B C 'I 14'x 28'~ i4/ 28' 7'~ 16' x 32' 16' 32' I-" 18'x 56' 18' $S' 8-, 20'x 40' 20' 40' 8'6" ~ ~OF 2) R SET ; TT ;,SET OF 2) ,PING )RNER SET .E TYPE 'mm' "~"' · ? 1994 . TOwN ERS (SET OF 2) ;S COPING r,,IG CORNER SET [7 E F G H J K L :-, 4" 8' 12' 4' 4' 4'6" 5' 3'8" ~"-,4." 8' 14; 5'6" 4'6" 4'6" ?' 4'8' 3'4": 12' 14' 5'6" 4'6" 4'6" 9' 4'8" 3'-4 13'6" 15'6" ?' 4' 6' 8' 5'2" 51-~ SUMPTER DRIVE FORT WAYNE. INDIANA, 4;~04. U.S.A. PREO0 - 5 219.432 8731 3/32" = I [,',...a~a RECTANGLE THIS BROCHURE IS FOR ILLUSTRATIVE PURPOSES ONLY Ti-I- I FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT ~ 2 0 I TOWN HALL SOUTHOLD, N.Y. 11971 TEL.: 765-1803 Disapproved a/c ..................................... ~PPklC~TIO~ FO~ BHIkDI~G INSTRUCTIONS BOARD OF HEALTH ......... 3 BETS OF PLANS .......... SURVEY ................... CHECK .................... SEPTIC P O E~'l .............. CALL . MAIL TO: a. Tbfis 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 giving a detailed description of layout of properW must be drawn on the diagram which is part of this appli- chtion. 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 issued a Building Permit to the applicant. Such 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 whatever until a Certificate of Occupancy shall have been granted 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, 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. · ....~:. ~q.~.: Y..,t...~..sl,..~.: .......... (Signature of applicant, or name, if a corporation), (Mailing address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. ........................ Gby...~...~.......oo. ~..~?.~.,..~. ~..~ ....................................... Name of owner of premises ........... ~1~.~ .... ~ q.4~..~.~(.~qq ............... (as on the tax roll or latest deed) If applica~oration~n~e ~duly authorized officer. '~:d tit~~'o~ficer, Builder's License No .... ~[, .2f?.. t~ .... Plumber's License No ......................... Electrician's License No.....~..~.~..~/..C....]~..~'.C..7'~.. t C.~ Other Trade s Ltcens~ No ...................... Location of land on which proposed work will be done. ~. 6 cc ~ L t'~ ~ 7 ..... ~.747 ............ .a..,.0..~.~.~.....~...,'~.., ........ d?0.-.:.7~..:..o. .... .t4:y.:../(9.. ?/... House Number Street Hamlet County Tax Map No. I000 Section ......... ~..? ..... Block ....... ~ ........ Lot ...... ?...~. ........ Subdivision ..................................... Filed Map No ............... Lot ............... (Name) 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy ........... ~'~P'~f~.~.../~....~.. ....................................... b. Intended use and occupancy ............. .~...~. (.~...t~...7~(../~?.....t.~../...7'~......~....O?.~.. .................. 3, Nature of work (check which applicable): New Building .......... Addition ........ ~ .¥0M~er~ti~--,i./ ....... Repair .............. Removal .............. Demolition .............. O~~'~. ....... ~'/.I ~ 00'~-~ j~ ¥~escription ) 4. Estimated Cost .................................. Fee ...................................... (to be paid 5. If dwelling, number of dwelling units ................ Number o f dwelling units on~¢~!!!lllll~. 3 ........ · If garage, number of cars ........................................................................ 6. If business, commercial or mixed occupancy, spec/fy nature and extent of each type of use ..................... 7. Dimensions of existing structures, if any: Front ............... Rear .............. Depth ............... I/eight ............... 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 o~F~er Owner ............................. 11. Zone or use district in which premises are situated .......... i.~o .4 .' ........... t~2D ....................... 12. Does proposed construction violate an~ goning law, ordinance or regulation: ................................ 13. Will lot be regraded ........ ~. .... ~ ........... Will excess fill be removed from premis~: ~ No 14. Name of Owner of premises . .~.t4. ¢'.c. t..W..~.. ..... Address ................... Phone No ................ Name of Architect ..... ¢, ................ ~.. Address .~/Phone No. Name of Contractor... .:get:': V...r. ..... Address ii '2/: i .'./. Phone No ........ Is this property within 300 feet of a tidal wetland? *Yes ........ No ......... *If yes, Southold Town Trustees Permit may be required. PLOT DIAGRAM Locate clearly and distinctly all buildings, whether existing or proposed, and. indicate all set-back dimensions from. property lines. Give street and block number or description according to deed, and show street names and indicate whether interior or comer lot. 15. APP~OY[~ A,S NOTEO NOTi~ ~BU*LDING DE~ '7d5-~O2 9 AM TO 4 PM FOR THE COLLOWING INSPECTIONS: ~. cO[~DATiON ~0 REQUIRED gO~ POURED cONCRETE 2. ~3~)GH ' FRAMING & ,: C:~,'.~L CONSTRUCTION MUST I-;: CO?)~PLET[: FOR -~t:~.;-'-~, (~p- i:O;,~' ;RUCTION ERROP:~ STATE OF NEW Y(~RK_ . c c couwrY OF .... ...... t~.Q.~...rl.,/./~....~.... JO..(/..~/.,-.~.... ~ ........... being duly sworn, deposes and says that he is the applicant (Name of individual signing contract) above named. 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 thh, ....... ":> . ..... .... " '::' ' Notary~~~ ~l,: Co nty ~ ~ ///"~: / ....... / auatifi~in48--~u=Suff~k Co"ray ~'~' ... L~'~~..// ........ '"t 'If ...... '.' Commission Expires De~ember ~,, "19..~,.,. / ¢ ($ig~Au/re of applicant)