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HomeMy WebLinkAbout30405-Z FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No: Z-31561 Date: 05/09/06 THIS CERTIFIES that the building INGROUND SWIMMING POOL Location of Property: 5896 SOUND AVE MATTITUCK (HOUSE NO. ) (STREET) (HAMLET) County Tax Map No. 473889 Section 121 Block 4 Lot 27.1 Subdivision Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated JUNE 14, 2004 pursuant to which Building Permit No. 30405-Z dated JUNE 17, 2004 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 RANDALL S & LAURA A. OLSEN (OWNER) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A ELECTRICAL CERTIFICATE NO. 2016861 04/29/05 PLUMBERS CERTIFICATION DATED N/A uthorized Signature Rev. 1/81 c 07C ? 2, Form No.6 TOWN OF SOUTHOLD f 5 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 Date. 5�� M, New Construction: Old or Pre-existing Building: (check one) Location of Property: House No. Street Hamlet Owner or Owners of Property: ^^-� Suffolk County Tax Map No 1000, Section l a'1 1 Block 000H Lot la__]o 00 Subdivision Filed Map. p Lot: _ Permit No. �L405Z Dale of Permit �O V1 Applicant: Health Dept. Approval: Underwriters Approval: Planning Board Approval: / Request for: Temporary Certificate Final Certificate: y/ (check one) Fee Submitted: $ nr, Applicant Signature Co 12 3/-561 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. 30405 Z Date JUNE 17, 2004 Permission is hereby granted to: RANDALL S OLSEN PO BOX 73 MATTITUCK,NY 11952 for CONSTRUCTION OF AN INGROUND SWIMMING POOL IN THE REQUIRED REAR YARD, FENCED TO CODE AS APPLIED FOR at premises located at 5896 SOUND AVE MATTITUCK County Tax Map No. 473889 Section 121 Block 0004 Lot No. 027 . 001 pursuant to application dated JUNE 14 , 2004 and approved by the Building Inspector to expire on DECEMBER 17, 2005 . Fee $ 150 . 00 Authorized Signature ORIGINAL Rev. 5/8/02 -4 '7 is otp 4-- 3 c� O rcJ 2nr_!t?fflLrL3rdpr [J� �frJ rJcPrJ r� r l�r�r1rJrJ�r PiJ�iJcPiJrJ�rJ�iJrJcPrJrP r IcJrJrJcPrJ�r�rJrJrJcJr lrJ�rJ�rJrJ�iJ�PiJ@frJ� 0 01 CSU BY THIS CERTIFICATE OF COMPLIANCE THE S NEW YORK BOARD OF FIRE UNDERWRITERS 5 SBUREAU OF ELECTRICITY 5 5 40 FULTON STREET — NEW YORK, NY 10038 5 CC 5CERTIFIES THAT 5 Upon the application of upon premises owned by 5 S 5 5 RAYNOR FRANK L. RANDALL OLSEN 5 1800 HARBOR LN./BOX 1065 5896 SOUND AVENUE �5 CUTCHOGUE, NY 11935, MATTITUCK, NY 11952 Located at 5896 SOUND AVENUE MATTITUCK, NY 11952 CSU 55 e5 Application Number: 2016861 Certificate Number: 2016861 5� Section: Block: Lot: Building Permit: BDC: nsl1 5 Described as a occupancy, wherein the premises electrical system consisting of 5 5 electrical devices and wiring, described below, located in/on the premises at: e5 Second Floor,Outside,Attic,Pool/Spa,Porch/Deck, 5 A visual inspection of the premises electrical system, limited to electrical devices and wiring to the extent detailed 5 5 herein, was conducted in accordance with the requirements of the applicable code and/or standard Spromulgated by the State of New York, De��rtment of StateACt e�0��forcement and Administration, or other CU 5 authority having jurisdiction, and found to be in compliance ther I h on the Day of 5 5 Name OTY Rate Rating Circuit Tvoe 5 5 Miscellaneous 5 5 certificate covers-entire 2nd CSU 5 floor-front porch and swimming S 5 pool CSU 5 Alarm and Emergency Equipment 5 Sensor 1 0 Carbon Monoxide SSensor 5 0 Smoke C 5 Appliances and Accessories 5 5 Pool/Spa Bonding 1 0 C 5 Exhaust Fan 1 0 F.H.P. 5 ,SS Air Conditioner 1 0 24.000 BTU 5 5 Wiring and Devices 5 5 Switch 2 0 Pool/Spa 5 CSU Receptacle 1 0 20 amp Pool/Spa 5 5 Fixture 1 0 Pool/Spa j 5 Outlet 19 0 Fixture 5 Fixture 19 0 Incandescent seal Outlet 29 0 General Purpose 5 Continued on Next Page 1 of 2 �5± This certificate may not be altered in any way and is validated only by the presence of a raised seal at the location indicated. 5 o � � cnrJ�rJ�cn rJ�t� r�r�rs cnrr�cn t:n cnrJcP rnrJ�rJ�rJ� f7 O rJ QP ��rPrJ�cJrJr��PrJcPrJcPrJ�rJ�cPr�rl�r�rJc PrJrJrJ�r�rJrJrJLFL3pLLrL3rE3fL3rJc r3dETr Jr Pf o 5 BY THIS CERTIFICATE OF COMPLIANCE THE 5 NEW YORK BOARD OF FIRE UNDERWRITERS 5 5 BUREAU OF ELECTRICITY 5 5 40 FULTON STREET — NEW YORK, NY 10038 5 5 CERTIFIES THAT S 5 Upon the application of upon premises owned by 5 RAYNOR FRANK L. RANDALL OLSEN 5 5 HARBOR1800 1065SOUND CUTC OGUE, NY 1935, MATTITUCK, NY19 2 5 5 5 r7c Located at 5896 SOUND AVENUE MATTITUCK, NY 11952 5 Application Number: 2016861 Certificate Number: 2016861 S 5 Section: Block: Lot: Building Permit: BDC: ns11 5 5 5 Described as a occupancy, wherein the premises electrical system consisting of 5 electrical devices and wiring, described below, located in/on the premises at: Second Floor,Outside,Attic,Pool/Spa,Porch/Deck, A visual inspection of the premises electrical system, limited to electrical devices and wiring to the extent detailed 5 5 herein, was conducted in accordance with the requirements of the applicable code and/or standard 5 promulgated by the State of New York, Deportment of StateA 1 50k.forcement and Administration, or other 5 5 authority having jurisdiction, and found to be in compliance therc�w'I on the Day of Name OTY Rate Ratin Circuit Type 5 Receptacle 22 0 General Purpose 5 5 Switch 24 0 General Purpose 5 S Paddle Fan 4 0 5 5 Receptacle 1 0 20 amp Laundry 5 5 Receptacle 1 0 30 amp Dryer 5 [5J Receptacle 4 0 GFCI 5 5 Disconnect 1 0 60 amp Air Conditioner 5 ,C] (Swimming Pool):This certificate covers compliance at the date of inspection only. Because of unusual environments it is advisable to have 5 5 frequent test and/or repairs made by a qualified person. 5 5 5 5 seal 5 5 2 of 2 �5± This certificate may not be altered in any way and is validated only by the presence of a raised seal at the location indicated. 5 5 D r� cP rJ�rrr IrJ�rcn cPrJ!fl! 12�rPcnrltrr ffl'L3 rL3PLJnrJ�c ncP O OF SOGTyolo f©} TOWN OF SOUTHOLD BUILDING DEPT. 765.1802 INSPECTION [ ] FOUNDATION 1 ST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ =FINAL ATION FRAMING / STRAPPING [ [ ] FIREPLACE & CHIMNEY ] FIRE SAFETY INSPECTION REMARKS: 4 Tr'` c. .0- DATE 0`� °`l D6 INSPECTOR -z- 765-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION 1 ST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] INSULATION [ ] FRAMING [FINAL 10D0L [ ] FIREPLACE & CHIMNEY [ ] FIRE SAFETY INSPECTION REMARKS: 0� o s DATE INSPECTOR 765.1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION 1 ST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] INSULATION [ ] FRAMING [v]fINAL� -) [ ] FIREPLACE & CHIMNEY [ ] FIRE SAFETY INSPECTION REM KS: DATE a INSPECTOR 4o5 765-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION IST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] INSULATION [ ] FRAMING [ 'FINAL [ ] FIREPLACE A CHIMNEY [ ] FIRE SAFETY INSPECTION REMARKS• �vc C /° foI4 , A-L4; DATE �" ° INSPECTOR [ ,8tr_ FIELD INSPECTION REPORT DATE COMMENTS FOUNDATION(1ST) -� y ------------------------------------- as FOUNDATION(2ND) — • z 0 ROUGH FRAMING& t� PLUMBING y n INSULATION PER N.Y. y STATE ENERGY CODE $ L. O \iJ l L \ i\.tt 1N GT FINAL $1�rC4c ADDITIONAL COMMENTS O 03 a e•. ea �! or '0 �z m z Vy� � b J � y " z x x e i c— — T TOWN OF SOUTHOLD 04OPERTY RECORD CARD OWNER STREET 6 VILLAGE DISTRICT SUB. LOT 2ndu FORMER OWNER N E ACREAGE \ '� PY)evleve {�. vJo2Ss►2e.�t;G s�P� °' r.2 c _ w� C- o,,(-rt V' eVC- 7�7m © TYPE OF BUILDING � S W �Fy RES.,,?ic SEAS. VL. FARM COMM. IND. CB. MISC. LAND IMP. TOTAL DATE REMARKS I -T -1ooX2Gc� -3 /0 00 1200 sal ria N- R T J' S^ / v to # 02 I�VtL� Ao -P j So 6 6-16) o �� � � x/30/ 7 / 8f- ID C 83 - zcmhek Ors . NlcesSner$ors. iV l(�p255Y1Q� d 70O �f3�o S000 0o (o Q 'L AGE BUILDING CONDITION NEW NORMAL BELOW ABOVE -�, s k -I— Farm Acre Value Per Acre Value v Tillable 1 O 1721, Tillable 2 x9 986 Ckt l ti nS t-6U'fCr&- '6Y)S _ Tillable 3 Woodland Swampland ^ ... Brushland House Plot Total TOWN OF SOUTHOLD BUILDING PERMIT APPLICATION CHECKLIST BUILDING DEPARTMENT „� ' 4 ' Do you have or need the following,before applying? TOWN HALL Board of Health SOUTHOLD, NY 11971 3 sets of Building Plans_ TEL: (631) 765-1802 Planning Board approval FAX: (631) 765-9502 Survey ,l www. northfork.net/Southold/ PERMIT NO. 3o�oS Z-- Check I/ Septic Form N.Y.S.D.E.C. Trustees Examined,20_Q_q_ Contact: Approved G I f)/ 20� Mail to: Disapproved a/c / / one• 73X—ILLS Expiration, 20 0-5� Building Inspector APPLICATION FOR BUILDING PERMIT Date �o�// 20_0/ INSTRUCTIONS 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 rN 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. "IUAYEDWTELT1 ENCLOSE POOL TO COD! (Signature of applicant or name,if a corporation) UpOm COMPLETION SEFORE'WATER" LNERII.YAfiERSCERTMIE REQUIRED 9 9 (Mailing address of applicant) ALL CONSTRUCTION SHALL State whether applicant is owner, less et"qWhM&ft l contraARROYMASO D or builder CODES OF NEW YORK STATE. DATE: 7 &P.s 3,) of z4 /rr).U ✓'G 3Z F BY: Name of owner of premises eG.5EA-) NOTIFY BUILDING DEPARTMENT AT (As on the tax roll or IaCgM INSPECTIONS: If applicant is a co oration, signature of duly authorized officer 1. FOUNDATION - TWO REQUIRED «T Z—� �� woe 5 FOR POURED CONCRETE (Name and title of corporate OR 2• ROUGH - FRAMING & PLUMBING 10JV V 3. INSULATION Builders License No. IL 4. FINAL - CONSTRUCTION MUST Plumbers License No. BE COMPLETE FOR C.O. Electricians License No. WITN(11 IT r`FRTIFi(`� ALL CONSTRUCTION SHALL MEET THE TE REQUIREMENTS OF THE CODES OF NEW Other Trade's License No. YORK STATE. NOT RESPONSIBLE FOR OF OCCUPANCY DESIGN OR CONSTRUCTION ERRORS. 1. Location of land on which proposed work will be done: 5&80 Sa)AjD .9ue. 11077'-1 ' House Number Street Hamlet County Tax Map No. 1000 Section /,2/ Block G/ Lot ,?2 / Subdivision Filed Map No. Lot (Name) ■■■■■I■■■■■■■■■■■■■■■ ■■■■■■ICS!■�■■■■■■■■■ Bldg.M. Extension Basement Floors Extension Ext. Walls Interior Finish Extension Fire Place Heat Porch Attic Porch Rooms Ist Floor DrivewayBreezeway Patio Rooms 2nd Floor Garage % 7J go -� 2. State existing use and occupancy of premises and intended use and occupan�yiiof proposed construction: a. Existing use and occupancy y�y SAVEs - b. Intended use and occupancy 3. Nature of work (check which applicable): New Building Additwn Alteration Repair Removal Demolition therWo l,,a.42':_M 4,,, 1,•�,�r, xuL (Description) 4. Estimated Cost 4/yoap.ou Fee 4j, 0 uo (To be paid on filing this application) 5. 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 nature and extent of each type of use. 7. Dimensions of existing structures, if any: Front y/2, 3 Rear </o. 3) Depth �- Height /S' Number of Stories / Dimensions of same structure with alterations or additions: Front Rear Depth Height Number of Stories S. Dimensions of entire new construction: Front Rear Depth Height Number of Stories 9. Size of lot: Front ao Rear /i7. 9 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 NOS'' 13. Will lot be re-graded? YES NO Will excess fill be removed from premises? YES NO_ 14. Names of Owner of premises'7c ,d,tl o is.< i Address -!5a&4, A-, ."-i llPhone No. Name of Architect Address Phone No Name of Contractor Gd t7.v -xo_s L>n Address-Ft, -ems 9 c,,<a,,...,, Phone No. 73/-766 t- 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 NOS * IF YES, D.E.C. PERMITS MAY BE REQUIRED. ' 43 +A103MM, .1009 320aj 16. Provide survey, to scale, with accurate foundation plan an(M'Aiias 1A7P1RNR�.Vljines. `' '3a9MOD6409L, A3TAW 6110;36 17. If elevation at any point on property is at 10 feet or below, must provide topographical data on survey. STATE OF NIAJYORK) 3h' i4' G 4 _ �3 S: COUNT being duly swom, 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.) .. Ari fnnr � of said owner or owners, and is duly.authodzed to perform or ha4jiddor{ned tk s`�U wok ehd to make and file this application; that all statement's contained in this application are true to the best;p oM,}c* leF and that the work will be performed in toe manner set forth in the,application filed therewith! tit v :ins Swom ore me this Notary Public Signature of Applicant Claire L. Glow Notary Public, State of New York No. 01 GL4879505 Qualified in Suffolk Counlx ��L Commission Expires Dec. 8,�!J SCJ BUILD T 'tet T -rtT- r i IT :� - , IJ" yr Applicant/ Date Owners Narn4 J t� Reviewed: / Architect/ Date Engineer: Submitted: I SCTM District: 1.000 Section: Block: L_ Lot: 9L ll Project --- Subdivision Location: Name: Single& separate Required certification: (Yes/No Req Req. Inning District: ��i Jl.ot size: Actual: Ut covers e + Req, - Req. r R [r'ront 1'ar Proposed: I (Side Yard _ proposed: J [Rear Yard —� Proposed- ) Project Description: A.GENCU .RMITS Permit UIRED FOR REVIEW N.A. NO _yam Numbe Suffolk County Health Dept. New York State D. E. C. / Town Trustees Town Zoning Zoning Board approval: Town Planning Board approval: . . 1. Flood Plane Elevation??? 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TRN1M N✓•M . e•wsa r•�,ow•,+►� VrY fs..ye,s.nwr�.y ....ti. .d,N•4.wd•.....�.....i1 wd•w a�� uw wru em+.—. a.,..ma...in.� it+.,... .r'ds.,.�s`•e...�..�....r.. tAAY it,x36�'�wN� '+•w �•.�. r 717..R4)/wOOe7 'w...r+•.,..w�' my E1E(TANGLF 64 RAM �•uaw.1010 rw...r rws• .. rN-GROUND SWIMMNG POOL WILL BE CONSTRUCTED OF STEEL WALLS SUPPORTING A VINYL LINER THAT WILL HOLD APPROXIMATLY 27,500 GALLONS OF WATER- FENCE ATERFENCE WILL BE AT LEAST 1• HUGH WITH SELF CLOSING GATES THAT WILL MEET TOWN CODES. LA go 516/ A uk 3 a sa N x tn m .?yx m N 9 xtD 9 m IZ CERTIFIED TO: m FIRST AMERICAN T E N005 ap m NORTHOGUE FORKABSTF BANI w. FRAM W. 5$ RANDALL OLSEN HOSE LAURAL A. OLSEN B6 •Y.O a ,nn 9c.'� ,� / / `E1 `E WELL fir lap cam, . F (51 cONc" �frf Rpm �1 N - �*H�N V m < •. n 6 'mo FSE - 1�� 9 IE MINIMUM ESTMUSHED 4D ADOPTED y SPATE LAND \m LI, Pi T Lg DgF \ P ���pp J NI$gttd A