HomeMy WebLinkAbout31120-Z
FORM NO. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Office of the Building Inspector
Town Hall
Southold, N.Y.
CERTIFICATE OF OCCUPANCY
No: Z-31656
Date: 07/07/06
THIS CERTIFIES that the building ISP
CREEK LA
(STREET)
Block ~
SOUTHOLD
(HAMLET)
Location of Property: 625 COREY
(HOUSE NO.)
County Tax Map No. 473889 Section 78
Lot 25
SUbdivision
Filed Map No.
Lot No.
conforms substantially to the Application for Building Permit heretofore
filed in this office dated
MAY 10, 2005 pursuant to which
Building Permit NO. 31120-Z
dated
MAY 10, 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 THOMAS W & MELISSA A CARLO
(OWNER)
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL
N/A
ELECTRICAL CERTIFICATE NO.
6437
06/15/05
PLUMBERS CERTIFICATION DATED
N/A
~~~
Kuthorized Signature
Rev. 1/81
~
Form No.6
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN HALL
765-1802
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APPLICATION FOR CERTIFICATE OF OCCUP~~CY Jlll 3' S \ \
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This application must be filled in by typewriter or ink and submitted to the Building D~i~,tl1e.LqllC::'}'i~
A. For new building or new nse: .
I. 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 ceIiificate
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
I. 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.
New Construction: Old or Pre-existing Building:
Location of Property: 02)' {"'~ Gf.e{ LOA-....
House NoJ7 Street
Owner or Owners of Property: I ~ .,j ~k "'-
Suffolk County Tax Map No 1000, Section .-; X-
(check o~
~A/I.~cX
C~
Block Lf
Hamlet
Lot
.1)
Subdivision
Permit No. 311:LD
Date of Permit.
Filed Map.
Applicant:
Underwriters Approval:
Lot:
Health Dept. Approval:
Planning Board Approval:
Request for:
Temporary Certificate
Final Certificate:
_ (check one)
~
Fee Submitted: $ ;)~,
CD 2: 3> \\..7 \...,
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ApplicanfSignature
.
Nassau Suffolk Electrical Inspections, Inc.
5A Canal Street · Center Mariches, New Yark 11934. Tel: 631-878-3500 . Fax: 631-878-3764
Application: 6437
Date:61l5/05
Issued to: Carlo
Address: 625 Corey Creek Lane
Village: Southold
By: Bethel Electric
License#:2880-ME
was examined and approved up to the above date and was in compliance with the NEC
Attic
Residential lRl
Comrerdal
Pdcfrtion
R:loIlRl
Hct Tub
1st Roar
2nd floor
Del Gaage
8::'S=llm
Switches Receptacles Fixtures G.F.1. Timeclock Heater
2 3 2 2
Fans Dishwasher Washer/Amps Dryer/Amps Oven Carbon
Range/Am ps Monoxide
Furnace Oil Gas Heat Zones Whirlpool Bell
Transformers
Meter Amps Phase Motors
2
Other Equipment: 1-Salt generator
ut,Res
%~~A!~ :J1eccrica1.'Tnsfo:iRo- &>
T-r"!Y./.;gMj2~
This certificate must not be altered
10 any marmer
Section:
78
Block: 04
Lot:25
311d-oL
TOWN OF SOUTHOLD BUILDING DEPT.
765.1802
INSPECTION
[ ] FOUNDATION 1 ST [] ROUGH PLBG.
[ ] FOUNDATION 2ND [] INSULATIO~L..' ,,\
[ ] FRAMING I STRAPPING M FINAL ~ 0-0'(/
[ ] FIREPLACE & CHIMNEY [ ] FIRE SAFETY INSPECTION
REMARKS:
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INSPECTOR ~t ~
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.
31120 Z
Date MAY
10, 2005
Permission is hereby granted to:
PATRICIA A DURYEE
625 COREY CREEK LANE
SOUTHOLD,NY 11971
for :
CONSTRUCTION OF AN IN-GROUND SWIMMING POOL IN THE REQUIRED
at premises located at
625 COREY CREEK LA
SOUTHOLD
County Tax Map No. 473889 Section 078
Block 0004
Lot No. 025
pursuant to application dated MAY
10, 2005 and approved by the
Building Inspector to expire on NOVEMBER 10, 2006.
Fee $
150.00
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ORIGINAL
Rev. 5/8/02
- TOWN- OF SOUTHOLD PROPERTY RECORD CARD
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STREET 25 VILLAGE DIST. sua.
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SEAS. VL. - FARM
LAND IMP. TOTAL DATE
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LOT #..2...
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TYPE OF aUILDING
COMM. ca. MICS. Mkt. Value
REMARKS
AGE aUILDING CONDITION
NEW NORMAL aELOW AaOVE
FARM Acre Value Per Value
Acre
Tillable FRONTAGE ON WATER
Woodland FRONTAGE ON ROAD
Meadowland DEPTH
House Plot aULKHEAD
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Total DOCK
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ExtensiO~; 4X:~/--/;l.' Ii " '" , "
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Extension i
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Extension
Foundation ?,c', Both 2- Dinette,
Porch .5 xl/~ 6',) .s(; ), f I Basement :;;-1/ / / Floors tJ~~4 K. I
Perc)l) ...( ,K ;'3 = '160' Ext. Walls Irk, / e/4D Interior Fi'nish 5c.. LR. 1
I':UVS;: 51( )- /0,3(,. ;.25 ~.57 / Fire Place 1 I Heot (J !3./3 00,4) /
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FIELD INSPECTION REPORT COMMENTS ,
DATE
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FOUNDATION (1ST) :::~
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FlLEbAUG.JS. /967 A$ MAP NO. 492.3
A T SA YVIEW
TOWN OFsoqrHOLO
SUFFOLK COUNTY; NY.
TAX MAP NO. f(l()g-M-q4-25
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BUILDING DEPARTMENT
TOWN HALL
SOUTHOLD, NY 11971
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TEL: 765-1802
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I:SUlLJ..l!NU l-bKMH Ar't'LiCAnUN CHECKLIS
Do you have or need the following, before applying
Board of Health
3 sets of Building Plans
Survey
Check
Septic Form
N.Y.S.D.E.C.
Trustees
Contact:
.
PERMIT NO.
Examined
Approved
Disapproved ale
Mail to:
I
Phone:
l"'I (~~ P \fl ~ ill" I Building s
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In~ MAY 0" lU, .'
UU L. _.~ I.IDl J LICA TION FOR BUILDING PERMIT
H ). pl=:PT
Tl""i' l' ':>,'\-II!-,<,'"'21!' Date
INSTRUCTIONS
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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 oflot 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 throughO\lt the work.
e. No building shall be occupied or used in whole or in part for any purpose what-so-ever until a Certificate of Occupan
is issued by the Building Inspector.
APPLICA nON IS HEREBY MADE to the Building Department for the issuance of a Building Permit pursuant to the
Building Zone Ordinance of the Town of South old, 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 nece~sary inspections.
,
State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder
O~ISTi<^CSffl1<-
Name of owner of premises Wll1..u\N\ CJ\1<...l'O
(as on the tax roll or latest deed)
.'
ature 0 f
title of corporate officer)
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Builders Licens No. '3:s i?> ~
Plumbers License No.
Electricians License No.
zegg M.b-
Other Trade's License No.
1.
S01.Cft\O'L-b
County Tax Map No. 1000 Section
Subdivision
78
Hamlet
. Block 04
Filed Map No.
Lot
Lot
25'
(Name)
) State existing use and occupancy of premise
a. Existing use and occupancy
intended use and occupancy of proposed construction:
b. Intended use and occupancy
~
l. Nature of work (check which applicable): New Building
Repair Removal Demolition
Addition Alteration
Other Work~l.l1t-()S.Rllrl.MI";P~
t ~ ~ ~ (Description)
(to be paid on filing this application)
Number of dwelling units on each floor
I. ~stimated cost-1.O-, 01rD
If dwelling, number of dwelling units
If garage, number of cars
Fee
'. If business, commercial or mixed occupancy, specify nature and extent of each type of use.
Dimensions of existing structures, if any: Front
Height Number of Stories
Rear
Depth
Dimensions of same structure with alterations or additions: Front
..
Rear
Depth
Height
Number of Stories
Dimensions of entire new construction: Front
Height 1 Number of Stories
Size oflo!: Front t Rear_LOS-
Rear
Depth
O. Date of Purchase
Depth
22-7
Name of Former Owner
I. Zone or use district in which premises are situated
2. Does proposed construction violate any zoning law, ordinance or regulation: l---O
3. Will lot be re-graded k.JO Will excess fill be removed from premises;@) NO
4. Names of Owner o~remisestA1l\~ C~f) AddreSS~-~O.]AS .g3'f)
Name of Architect ~----'-_ Address eNo '24e-11U::>.
Name of Contractor Address C' No. ~S. 161 P
5. Is this property within 100 feet of a tidal wetland? *YES NO K
. IF YES, SOUTHOLD TOWN TRUSTEES PERMITS MAYBE REQUIRED
6. Provide survey, to scale, with accurate foundation plan and distances to property lines.
7. If elevation at any point on property is at 10 feet or below, must provide topographical data on survey.
TATE OF NEW YORK)
S .
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:OUNTY OF
3)He is the
C-LJ ff~ ~ . being duly sworn, deposes and says that (s)he is the applicant
(Name of individual signing contract) above named,
C~~.
(Contractor, Agent, Corporate Officer, etc.)
f said owner or owners, and is duly authorized to perform or have performed the said work and to make and file this application;
lat all statements contained in this application are true to the best of his knowledge and belief; and that the work will be
"rformed in the manner set forth in the application filed therewith.
w'm-'~~';:f~
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Notary Public
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PETER BOOTH
Notary Public, State of New York
No. 01 B06092004, Suffolk County
Term Expires Mal' 12. 2007
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ALL CONSTRUQTION SHALL
MEET THE REQUIR~MENTS OF THE
CODES OF NEW YORK STATE.
APPROVED AS NOTED
DATE: ;)1~\-S B.P.# l
FEE: :i? \ <;Q BY:
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
BE COMPLETE FOR C.O.
ALL CONSTRUCTION SHALL MEET THE
REQUIREMENTS OF THE CODES OF N
YORK STATE. NOT RESPONSIBLE FOR
DESIGN OR CONSTRUCTION ERRORS.
UNDERWRITERSCERTIACA~'
REQUIRED
I" LDNG. 1LB...D5 ON
lloCE Of' PANEL
lIEl.DED lOP "BOTTOM
~ ~ AND COVER
O~ u:LD& IUlll-1
""""-""""""
COMPLY WITH ALL qODE
NEW YORK STATE & Tq,WN
AS REQUIRED AND COtjJDITI
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So..1-!U,C' TC'\,1\ :;A
SO . .,!ldJNN GOOARO
SOUTHOLC iG\'\'N TRUST ES
N.Y.S. DEe
FLOOD WNE fJ ~
COMPLY WITH CHAPTeR. 4
FLOOD DAMAGE PREV~NTIO
SOUTHOlD TOWN CODE.
OCCUPANCY OR
USE IS UNLAWFUL
Vv. ; 'iOUT CERTIFICATE
Cf-- OCCUPANCY
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TYP. PANEL STIFFNER
IO-~. &aF~6CREW>
5PI>aD .. 12'" o.c..
CONCRETE OR UX)D DECK UP TO
COPlNGfBT01J.EReJ_ _ _
5LOf'fD ........,.. AfOM POOl."'__
6TI'f'BoER lSEYOICI)
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MO u..Il:>ISTlRBED &.RTI-I TI-ROU6!-l
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TYPICAL WALL SECTION AT 'A' FRAME
POOL DIMENSIONS
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POOLS, INC.
3510 v AN5 MEMORIAL l-IIGHWA"""
SOl-l lA, NSJJ YORK 11118
(631) 585-1618
POOL TYPE, L-5l-IAPE REV.
JAMES DEERK05KI. P.E.
260 DEER PATl-I
MA TTITUCK, NB1J YORK 11~2
sCALE N. T .5.
DATE
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