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HomeMy WebLinkAbout31657-ZFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No: Z-31421 Date: 01/31/06 THIS CERTIFIES that the building ACCESSORY Location of Px~perty: 2015 GABRIELLA CT MATTITUCK (HOUSE NO.) (STREET) (HAMLET) County Tax Map No. 473889 Section 108 Block 4 Lot 7.53 Subd/vision Filed Map No. __ Lot No. __ conforms substantially to the Application for Building Permit heretofore filed in this office dated DECEMBER 6, 2005 purs,,~-t to which Buildin~ Pex~it No. 31657-Z dated DECEMBER 6, 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 AS APPLIED FOR. The certificate is issued to LISA JACKSON (OWNER) of the aforesaid building. S~F~3LKCOUNT~I~PARTMENTOFHEALTHAPPROVAL N/A ELECTRICAL c~KTIFICATH NO. 31207 PLDMBE~S u~KTIFICATION DA'£~u N/A 08/27/99 ~~~ U ~.'}10 ri z ~ d~ S//S~'~e l ~nl ~nat ur e Rev. 1/81 Form No. 6 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN ItALL 7~1802 CERTIFICATE OF OCCUPA~ APPLICATION FOR This application must be filled in by typewriter or ink and submitted to the Building Department with the following: 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 installation, s, a certificate of Code Compliance from architect or engineer responsible for the building. 6. Submit Planning Board Approval of completed site plan reqUirements. Bt 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. Co 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 House~qo. Suffolk County Tax Map No 1000, Section New Construction: / Location ofProperty'c~ I ~ Street Subdivision Filed Map. Old or Pre-existing Building: (check one) Ha~et Permit No. Sl Health Dept. Approval: Planning Board Approval: Request for: Tem~oraryfi_ Fee Submitted: $ Underwriters Approval: ~ificate D.4T£: ELECTRIC41. ", ......... 1,\51/..( 110:\ M:RI, I(. I: I.~'(.. ~ - $:"3 I)[.'\'?'(~,',, . I'1.\'1 [: EAS'TP. II¢'II(IGI I'. \'Ell }(IRK 11--2 ,.i 16~ £~t6-664Z ~I:A, IGE: Matfltuck ADDRESS.. 2015 Cr.~Hella CoUrt ISSUED TO: Lisa.]d, ck.~on Sbuthold. INTRODUCED R. C Electric LOCATION: ' DI~WAgHER Dln.:p OTHI~ · Out~deRe~ident I 50~ Wa~qol light BLUE ORIGINAL YELLOW cOPY '% ~r p~ COPY /cation of land on which proposed ' Work w,I h. d,~.. 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. 31657 Z Date DECEMBER 6, 2005 Permission is hereby granted to: LISA JACKSON PO BOX 476 MATTITUCK,NY 11952 for : CONSTRUCT ACCESSORY INGROUND SWIMMING POOL WITH FENCE TO CODE AS APPLIED FOR. THIS PERMIT REPLACES BP 25935. at premises located at 2015 GABRIELLA CT County Tax Map No. 473889 Section 108 Block pursuant to application dated DECEMBER 6, 2005 Building Inspector to expire on JUNE 6, MATTITUCK 0004 Lot No. 007.053 and approved by the 2007. 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: ~,f"~/~,~ C.~. DATE '/~/~ INSPECTOR ~DATION (]ST) ~0NDATION (2ND) ~Gl~l FI~A~ & PLUI.~ING ,~SULATION PElt N. Y. S~ATE ENERGY CODE FIliAL N ADDITIOHAL COI~EI~S: C m ~ ~ ~ 0 0 ~ -I Z Z 0 © Z Z m ~ o° ~ o o Examined ................ ,19... Approved ...~.. ] .t.O ........ FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N.Y. 11971 TEL,: 765-1803 19 Permit ;> 2 Disapproved a/c ..................................... ~(Buildin~' n~ector) APPLICATION FOR BUILDING PERMIT ~SSTRUCTIOSS "0A~" or .S^~.T. .7%. ,. .. 3 S~TS or PLa.~s .......... SURVEY ................... CllECK .................... SEPTIC FORH .............. Date ................... 19... 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 a~eas, and giving a detailed description of layout of property must be drown on the diagram which is part of this appli- cation. 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,/l~pusing code, and ~egulations, and to admi.t authorized inspectors on premises and in building for necessary inspections,. ,/_,/. ' . ~ ' · ..~ state whether applicant .ee (Signature of applicant, or name, if a corporation) ; ~/J(~iii~8,address of applicant) architec-h.~llgtpr, m',~g/e~ ~t~'l~tor, electrician, plumber or builder. Name of owner of pre~~.,...~(.././.~e~O'O~(. ................................................ If applicant is a corporat~q~~fly authorized officer. B uil ,er,s,JJcense ~.~ff~ .Ti .-- -~"~'~' '--"~"'"~ .... , ..... Plumber¢s a*'~l~3 ¢,O ~'.;~" License' N6'.'T/.' ~ ;7 7 .................. Electrician's License No ....................... Other Trade's License No ...................... 1. Location of land on which proposed work will be done .................................................. .................... ............. o7-: ........................ ./V../...: ..... House Number Street ' Hamlet County Tax Map No. 1000 Section ..../. O.~. ......... Block ...~.. ............ Lot..Z<~.~ '~.~... Subdivision.../~..~. ...... (iq'a~) ...... ' .......... Filed Map No ............... Lot ............... 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy .... ~./~.~7-~.~......~ ........................................... b Intended use and occupancy ..O°.~../~e-'~.././y~.F,L: .~..O..O.,/~ ............................... 3. Natureofwork (check which applicable): New Building .......... Addition .......... Alteration .......... Rebair .............. Removal .............. Demolition .............. Other Work..~.. .......... /,/. f~ i.. ........... ~o X ~'///y'~.~CgoV~ ,~O0~, (Description) 4. Estimated Cost.. ~...O.~. .......... Fee .................. .&?/.~r~r....~.~... (to be paid on filing this application) $. 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~ature and extent of each type of use ....... 7. Dimensions of existing structures, if any: Front.. ,.~. ........ Rear ..'.~. ........ 'Dept'l~. 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: ................ ' 13. Will lot be regraded ............ .. .............. Will excess fill be ~;emoved from premises: Yes No 14. Name of Owner of premises ,~f,~'~.. ~-~../f',,C~d~t' .... Ad dress~i:Y,~.. ~'..~C?.~... Phone No. Name of Architect ........................... Address .................. Phone No ................ Name of Contracto~'./'.(~l~,~',~'. ~. Address ~-,,~'f~' i...,(If~.' ..... Pho~,No.f-~.~.: ~.~'/f~.... 15. 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 whe~er interior or comer lot. IS UNLAWFUL :: -- CE IFICATE OCCUPANCY ,, 2 ROU6N - ~ PLUMBING ~~ 3 ~NSU~ .,~ STATE OF NEW YORK, S.S COUNTY OF ................. .... ~)~_~/,t'l/~'.../~,~./1/~. ................. being duly (Name of individual signing contract) above named. ALL MEET THE THE N,Y. STATE & ENERGY CODES. FOR DESIGN ¢ ERRORS sworn, deposes and says that he is the applicant of said owner or owners, and is duly authorized to perfo?rrmSr 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 this ...... ~.3 ............... day of . ."~.~. 1~ .............. 19 .C~. t IllqHll l I11 ... · ............................................. ~ ~ - - t [~i lc. st::f~ t~f i,.,w ;ci~ Si nature of a 'c~t £ o 060-1