HomeMy WebLinkAbout31455-Z
FORM NO.4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Office of the Building Inspector
Town Hall
Southold, N.Y.
CERTIFICATE OF OCCUPANCY
Date: 07/12/06
No: Z-31671
THIS CERTIFIES that the building INGROUND SWIMMING POOL
(STREET)
Block 7
SOUTH/PEC
(HAMLET)
Location of Property: 2265 MILL RD
(HOUSE NO.)
County Tax Map No. 473889 Section 67
Lot 5.1
Subdivision
Filed Map NO.
Lot No.
conforms substantially to the Application for Building Permit heretofore
filed in this office dated SEPTEMBER 13, 2005 pursuant to which
Building Permit No. 31455-Z
dated SEPTEMBER 19, 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 IN THE REQUIRED REAR YARD WITH FENCE
TO CODE AS APPLIED FOR.
The certificate is issued to MARYLOU KING
(OWNER)
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL
N/A
ELECTRICAL CERTIFICATE NO.
2282
12/02/05
PLUMBERS CERTIFICATION DATED
N/A
~riZ~
Rev. 1/81
JUL
6
Form No.6
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN HALL
765-1802
13 m/11l:0-€ HV
1107(-1 l1ifl( f-A1
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APPLICATION FOR CERTIFICATE OF OCCUPANCY
TItis 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 Dep!. 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 I % lead.
5. Commercial building, industrial building, multiple residences and similar buildings and installations, a cer1ificate
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 $1:U!!lf Accessory building $25.00, Additions to accessory building $25.00, Businesses $50.00.
2. b.lifiLO"le or uccupancy 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
'7-5-() 0
Date.
New Construction:'/ Old or Pre-exisJ~ Building: ,Ii- (check one)
Location of Property: 2265 Ill; / / I-iiH -e; f'tffL! c , H
House No. . Street" " Hamlet
Owner or Owners of Property: /17~;b l-<' /LIJ7 /1l {LA -U itc
Suffolk County Tax Map No 1000, Section Block Lot
Subdivision
Permit No 3/4' 55.2-
Date of Permit.
Filed Map.
Applicant:
Lot:
Health Dep!. Approval:
Planning Board Approval:
Underwriters Approval:
Request for: Temporary Certificate _
Fee Submitted: $ 25. rv
Final Certificate:
./
(check one)
&v:. -70 5~:r-
eo c'1I(,7!
?&v~l!.<iLmvr--iJ1()
SUFFOLK
BUREAUOf
ELECTRICAL
INSPECTORS,inc
40 Nottingham Drive, NY 11953
Telephone: 1 631 495 8136 . Fax: 1631 9806455. E-Mail: SBEI1@hotmail.com
CERTIFICATE OF ELECTRICAL COMPLIANCE
Applicant: Raymond Electric
Rough In Inspection Date: 12/2/2005
Application NO: 2282
Suffolk County Tax Map NO: 67 7
5.1
Final Inspection Date: 12/2/2005
Certificate NO: 2282
Building Permit NO: 314552
This Certificate of Electrical Compliance is limited to the inspection and compliance of electrical equipment
and/or work described below and installed by the Applicant named above, and located at the premise of:
Owner: King
Address: 2265 Mill Lane, Peconic, NY 11001
Address of Inspection Site: 2265 Mill Lane, Peconic, NY 11001
X Residential Indoors Basement Service Shed
Commercial X Outdoors 1st Floor X Pool Other:
X New Renovation 2nd Floor Hot tub
Addition Survey Attic Garage
Inventory
Service 10 Heat Duplex Recpt Ceiling Fix HID Fix
Service 30 1 Time Clock 2 Switches Wall Fix Smoke Det
Main Panel Hot Water 1 GFCI Recpt Recessed Fix Co Det
8 Ckt Sub- Panel GFCI Breaker 1 Single Recpt Fluorescent Fix 1 Pump
Disconnects Dryer Recpt Range Recpt AlC Blower Emergency Fix
Transformers Exhaust Fan Appliance AlC Cond Exit Fix
Twist Lock TVSS 1 Heat Pump Electric Heat 1 Pool Luminaire
Other Equipment: l-Minerlizer
The electrical work and/or equipment described above were inspected and appear to be in compliance with
local, state and national electrical code requirements and this office.
Applicant: Raymond Electric
License No:
5141-ME
Inspected by: /1 ~.bdi
Signature: ~.
Date Certifiate Date: 12/11/2005
FORM NO. 3
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Town Hall
Southold, N.Y.
BUIWING PERMIT
(THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL
COMPLETION OF THE WORK AUTHORIZED)
PERMIT NO.
31455 Z
Date SEPTEMBER 19, 2005
permission is hereby granted to:
M NORMAN KING
2265 MILL RD
PECONIC, NY
for :
CONSTRUCTION OF AN INGROUND SWIMMING POOL IN THE REQUIRED REAR
YARD AS APPLIED FOR
SOUTH/PEC
at premises located at
2265 MILL RD
County Tax Map No. 473889 Section 067
Block 0007
Lot No. 005.001
pursuant to application dated SEPTEMBER 13, 2005 and approved by the
Building Inspector to expire on MARCH
19, 2007.
Fee $
150.00
,~~
I Authorized Signature
ORIGINAL
Rev. 5/8/02
;/~S5"7--
TOWN OF SOUTH OLD BUILDING DEPT.
765.1802
INSPECTION
[ ] FOUNDATION 1 ST [] ROUGH PLBG.
[ ] FOUNDATION 2ND [] INSULATION , \
[ ] FRAMING I STRAPPING [(<J FINAL ~ ~ Ct: ~
[ ] FIREPLACE & CHIMNEY [ ] FIRE SAFETY INSPECTION
REMARKS:
r~ ~ ~I"
.~ ex!\,
DATE 7--' -0 C
INSPECTOR ~,~
3 PfS-S Z-
TOWN OF SOUTH OLD BUILDING DEPT.
765.1802
INSPECTION
[ ] FOUNDATION 1 ST [] ROUGH PLBG.
[ ] FOUNDATION 2ND [] INSULATION
[ ] FRAMING I STRAPPING [;q FINAL
[ ] FIREPLACE & CHIMNEY [ ] FIRE SAFETY INSPECTION
REMARKS: lo-oe ~ ~d-~
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DATE ''''/(,-OG INSPECTOR ~.~
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FIELD INSPECTION REPORT DATE COMMENTS U>
-":I
FOUNDATION (1ST) ~~
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INSULATION PERN. Y. ~6
STATE ENERGY CODE ...
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BUILDING DEPARTMENT
TOWN HALL
SOUTHOLD, NY 11971
TEL: (631) 765-1802
FAX: (631) 765-9502
www.northfork.net/Southold/
PERMIT NO.
'51'1)" \' r
Do you have or need the following, before applying?
Board of Health
3 sets of Building Plans
Planning Board approval
Survey
Check
Septic Form
N.Y.S.D.E.C.
Trustees
~~:~~;f'
Examined
Approved
Disapproved ale
Expiration
31'1-,20QL
Contact:
- Mail to: 3..u;m ~ril) ~Dls
Lj '7 t y2q ~ l "Sit ~c.~ p-+
'1*, 'il180 11178
Phone:
/~
I Building Inspector
r:-: _ ---,
r~ r:; ;1 r;; n WI [' "J:
, ,"' l ... Ii c sir, ,
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T(,~~' -,-~L :,: ;-:J'JLD
APPLICATION FOR BUILDING PERMIT
Date
Sept-
/2, fD05 ,20_
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 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, Sutfolk 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.
ALL CONSTRUCTION ::)HALL
MEEI THE REQUIREMENTS OF THE
ctleESOF NEWVOBKSTATE.
"IMMEDIAT t:L Y"
ENCLOSE POOL TO CODE
UPON COMPLETION
BEFORE "WATER"
RETAIN STORM WATER RUNOFF
PURSUANT TO SECTION 45.1 DC .
State whether applicant is owJOfl, tfte~itect, engineer, general contractor, electrician, plumber or builder
()1J.l~~
County Tax Map No. 1000 Section
Subdivision
1.0"1
A~
DATE: :5- B.P. # ,31P;-S- b
or latesl=l!E~d) lSl) BY:
NOTIFY BUilDING DEPARTMENT AT
765.1802 8AM TO H': FOR THE
FOllOWING INSPECTIO~IS:
1. FOUNDATION. w,n REQU'RED
fOR POURED CONC'iETE
2. ROUGH. FRAMIN::' & F~I,MBING
3. iNSULATION
4. l=INAl . CONS:PL'~,'ON M\JST
13E COMPLETE ". ri C,C),
Alt CONSTRUCT ON SHALL MEET THE
REQUIREMENTS OF THE CODES OF NEW
YORK STATE. NOT RESPONSIBLE FOR
RS CERTlFlCATfIam e
IlEOUIIlED
Block -,
Filed Map 'Wo: ):';.:,~ ;',;, .'
~o{m/)f\ \<.,(1,"
(As on the tax ro
If applicant is a corporation, signature of duly authorized officer
Name of owner of premises
Builders License No. bt14 I ~ ~
Plumbers License No.
Electricians License No. );{l.R76 ~
Other Trade's License No.
I. Location of land on which proposed work will be done:
6 il Une ~c-o-nk.
House Number Street
Lot ..5. J
Lot
(Name)
,,:......
. , ......;..:.. \ l\V;
~'l.':., . c, (~ht.. <,
,".; . :),7 (';~), :.," w .':' 'I. ':
State existing use and occupancy of premises and i~ended use and oGcupancy of proposed construction:
a. Existing use and occupancy ~nS\R ~m 11,.( {QSlcI"llt"o
b. Intended use and occupancy Ine,W1 111~{D>l^d.J~() J ~~l.jO ~~Ie.
Nature of work (check which applicable): New Building
Repair Removal Demolition
Addition
Other Work
Alteration
(Description)
Estimated Cost * 15,000 J
Fee
'. If dwelling, number of dwelling units
If garage, number of cars
(To be paid on filing this application)
Number of dwelling units on each floor
l. Ifbusiness, commercia] or mixed occupancy, specify nature and extent of each type of use.
7 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
3. Dimensions of entire new construction: Front
Height Number of Stories
Rear
Depth
I. Size oflol: Front
Rear
Depth
10. Date of Purchase
Name of Former Owner
"
] I. Zone or use district in which premises are situated
12. Does proposed construction violate any zoning law; ordinance or regulation? YES_NO ~
13. Will lot be re-graded? YES /NO _Will excess fill be removed from premises? YES_NO"---:
] 4. Names of Owner of premises01ilr~loLl N b,(rYIOI\~~Addres~ ~ 105 m 1]1 UJ... Phone No.51Ir,1'5- '(1'/4 L/
Name of Architect =~{'\ Address 115 ube-r'fl1 AVt Phone No 3cl-~I0'5
NameofContractot It od<'eY,PA' Addressilc11 ~.t'2.'5A- Phone No. lUL!- iloa
, ~~""','.'
. ..",", ,,- .~., Jl
]5 a. Is this property within 100 feet ofa tidal wetland ora freshwaterwetlanoV ~M~S'::;;', NO
* IF YES, SOUTHOLD TOWN TRUSTEES &,D.E.C. PERMJXS'MA.W~~D.
b. Is this property within 300 feet of a tidal wetland? * YES_NO.-L
* IF YES, D.E.C. PERMITS MAY BE REQUIRED. _
.
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16. Provide survey, to scale, with accurate foundation plan alJ:d'(li~iiln6es to propewyYIhes',"
. -> ,.l/iU - ;\}~ ,"."
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 OF )
~~: j~d*id~~~~~;n~c~~ ~ve named~e~~~.~~I~.SW~~,._d:~~ ~d says that (s)he is the applicant
) .....,; 1"",'ili':'.w~';"',)\J\"')l"
(S)Heisthe OvU'I\.w- ", ..~J,;' :;,,; I ~)i ::,;.
(Contractor, Agent, Coiporate'6fficer,efc.T: "~., ~:,
; lo :~..l ' t'.r'-:J
.~.' ,..~ I I 1 .
of said owner or owners: and is duly aut?ori~ed to perform ?r hav~ perf~~ Jlle~id work and to make and file this application;
that all statements contamed m thIS appl1catlOn are true to the bsst dfliis'kr!(lwledg'e.and belief; and that the work will be
performed in the manner set forth in the application filed therewith,
Sworn to before me thi
I :)... day of
2005"",,;, . ;, ",c,'.;.','
~, ""'07C<F;7 4'?i lJ/l/NJ -!;i--j-
KA TKLEeN QUIGLEY Signature of Applicant '
NOTARY PUBlIC, Slate 0( New YllItc
No. 01QU81Z4124
0UIIIIIId In SulIaIk Counly
Con. -'11. e.,.,.. Apnl25. 2O.!9.
/~O
OWNER
'-TOWN OF SOUTHOLD ~OPERTY RECORD CARB-'-
STREET 22.6 DISTRICT SUB. LOT
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7
ACREAGE
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DicKey & O'Y\
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FARM
COMM.
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Ia-!:. >1(1//u
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I Est. Mkt. Value
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TOTAL
DATE
REMARKS
.-
LAND
---_....~
IMP.
HJ
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13 ~
00
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2 )
Farm
Acre
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-jllable 2
DOCK
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Irush la~d
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~ause Plat
-otal
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iveway
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. TOWN PROPERTY - lTD
/111'1-/1 - ~ 7- 7- ?t' OF SOUTHOLD RECORD CARD
.
OWNER ... VILLAGE :;;/;/.1 "
STREET DIST. SUB. LOT t} ,,..-
'f .,.. ,
(-..\ a h.A../lA'A. A t/a 174 ~ . <) . '7 3fl) , . .. /f
cd AA.'.f.) ~ ~ '.,(, )
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tORMER OWt4'ER - N E ACR. ,.,
.0 T/
S W TYPE OF BUILDING
R.ES. SEAS. VL. .fIr FARM COMM. CB. MICS. Mkt. Value
. .
LAND IMP. TctrAL DATE REMARKS
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.
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AGE BUILDING CONDITION
NEW NORMAL BELOW ABOVE ,
FARM Acre Value Per Value j
Acre' .' . . ,i pi'" r- I) tlillM'I,1' W
il ,,,
!
Tillable FRONTAGE ON WATER
Woodland FRONT AGE ON ROAD 5'e'
Meadowland DEPTH ~7
House Plot BULKHEAD
Total DOCK
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xtension
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orch Basement Floors K.
orch Ext. Walls Interior Finish . lR.
.
reezeway Fire Place Heat DR.
arage I Type Roof Rooms 1 st Floor SR.
~tio Recreation Room . FIN. B
Rooms 2nd Floor
. B. Dormer Driveway
otal
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SIZE I A B C D E F G ... CAP.
fEET FT. n: FT. rT. no n: n: son I 5AoL
HOTES-..
WALKS TO 8~ SMOOTH - NON 5K1D TYPE. SLOPED
AWAY FROio( POOL
16'1 3,' WATER DISPOSAL SHALL BE L1 MITEO TO OWNEJ(S
IS 3Z 8 8 IZ . . 51Z I~OO PROpERTY TO SUIT LOCAl. R( G ULA TI 0 N S
16' . 36.116 JG IZ . IZ . . 5~6120!X:0
ZO'.. .0' ZO 40 I IZ 10 IZ S S 800 2"',000
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