HomeMy WebLinkAbout31433-Z
FORM NO. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Office of the Building Inspector
Town Hall
Southold, N.Y.
CERTIFICATE OF OCCUPANCY
No: Z-31847
Date: 09/29/06
THIS CERTIFIES that the building INGROUND SWIMMING POOL
Location of Property: 4365
(HOUSE NO.)
County Tax Map No. 473889 Section 70
OAKLAWN AVE
(STREET)
Block 10
SOUTHOLD
(HAMLET)
Lot 11
Subdivision
Filed Map No.
Lot No.
conforms substantially to the Application for Building Permit heretofore
filed in this office dated SEPTEMBER 6, 2005 pursuant to which
Building Permit No. 31433-Z
dated SEPTEMBER 7, 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 IN THE REQUIRED
REAR YARD AS APPLIED FOR.
The certificate is issued to SONIA POLAK
(OWNER)
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL
N/A
ELECTRICAL CERTIFICATE NO.
7182
08/26/06
PLUMBERS CERTIFICATION DATED
N/A
~ize~
Rev. 1/81
.....
rv.J
Form No.6
TOWN OF SOUTH OLD
BUILDING DEPARTMENT
TOWN HALL
765-1802 I I 5 '
J '
,- i
APPLICATION FOR CERTIFICATE OF OCCUPAN T '. "-~
This application must be filled in by typewriter or ink and submitted to the Building Depart~nt'w~~~~~-f~iiof1~g~
A. For new building or new use:
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 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:
I. Accurate survey of property showing all property lines, streets, building and unusual natural or topographic
features.
L 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.
41--
Is UO&
,
New Construction:
Old or Pre-existing Building:
,./'
(check one)
5nu +hoM
Hamlet
Location ofproperty: tf3fo~ 0 "k 1111"') Ave. f-x T
House No. Street
Owner or Owners of Property:
..L: .
:=)n 0')/ t>-
c . -=r (") \ A-k
2/1:S xyt1
Block
(")olO
Lot L)/I
Suffolk County Tax Map No 1000, Section
Subdivision
Filed Map.
Date of Permit. o9h7ll('"' Applicant: . --->7)' 4.
/ I __v
Underwriters Approval:
Lot:
,-"Permit No. ."31 '/33
;::b&lc
~ .
Health Dept. Approval:
Planning Board Approval:
Request for:
Temporary Certificate
Final Certificate:
./
(check one)
Fee Submitted: $ n!5'.d)
c-k/v ~aI~
Applicant SI ature
~.!ID~5
Q.O SC3f8l{1
31 IfJ3 7-
TOWN OF SOUTHOLD BUILDING DEPT.
765.1802
INSPECTION
[ ] FOUNDATION 1 ST [] ROUGH PLBG.
[ ] FOUNDATION 2ND [] INSULATION
[ ] FRAMING I STRAPPING .P1 FINAL
[ ] FIREPLACE & CHIMNEY [ ] FIRE SAFETY INSPECTION
REMARKS:
y~~
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DATE t - 1 - 0 ,
INSPECTOR *~
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.
31433 Z
Date SEPTEMBER 7, 2005
permission is hereby granted to:
SONIA POLAK
4365 OAKLAWN AVE EXT
SOUTHOLD,NY 11971
for :
CONSTRUCTION OF AN INGROUND SWIMMING POOL IN THE REQUIRED REAR
YARD FENCED TO CODE AS APPLIED FOR
at premises located at
4365 OAKLAWN AVE
SOUTHOLD
County Tax Map No. 473889 Section 070
Block 0010
Lot No. 011
pursuant to application dated SEPTEMBER 6, 2005 and approved by the
Building Inspector to expire on MARCH 7, 2007.
Fee $
150.00
Lt~c~
Authorized Signature
ORIGINAL
Rev. 5/8/02
.
Nassau Suffolk Electrical Inspections, Inc.
5A Canal Street + Center Moriches, New York 11934 + Tel: 631-878-3500 + Fax: 631-878-3764
Application: 7182
Date:8/23/06
Issued to: Polak
Address:4365 Oaklawn Ave Ext.
Village: Southold
Introduced By:: Avey Electric
License#:2069-ME
was examined and approved up to the above date and was in compliance with the NEe
Attic 151 Floor Residential [E] Pod[E] Del Gerage
8asEllad 2m floor Corrrrercial I-bl T lb Pddition
. ,'J
Switches Receptacles Fixtures G.F.1. Timeclock Smoke
Detectors
Fans Dishwasher Washer/Amps Dryer/Amps Oven Carbon
Range/Amps Monoxide
Furnace Oil Gas Heat Zones Whirlpool Bell
Transformers
Meter Amps Phase Motors
Other Equipment:
Inground Pool
Out Res
~=A;;t#d<iikcmcalg~im>_ &>
-'~~~ ~
This certificate must not be altered
III any manner
"
~
FIELD INSf.ECTION REPORT DATE
FOUNDATION (1ST)
n....______..___n_n.__.______nn c-----..
FOUNDATION (2ND)
ROUGH FRAMING &
PLUMBING
INSULATION PER N. Y.
ST ATE ENERGY CODE
FINAL
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COMMENTS
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ADDITIONAL COMMENTS
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AGE
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Total
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TOWN OF SOUTHOLD PROPERTY RECORD CARD
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ACREAGE ,( ;
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TYPE OF BUILDING
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TOTAL
DATE
REMARKS
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FRONTAGE ON WATER
FRONTAGE ON ROAD / l, J Y I 2 ;-'~.,.-/
BULKHEAD
Value Per Acre
Value
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PERMIT NO.
'3/13'3 C;:c
J:\UJ..L,L!ll~\J r J:;,l'\J.VllJ.JU. . ~.-... -- - .
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
Contact: (l II' n
(.. M.;i~:"0w\m )L\~ t"Cbls
-5Y7 \ ~~ 26
, Phone: <\<Dc.lc.y (J.-t- tJ-L
,\II B
"lLtLt -\S I 00
faWN OF SOUTR1LD
WILDING DEPARTMENT
rOVVN HALL
;OUTHOLD, NY 11971
LEL: (631) 765-1802
lAX: (631) 765-9502
I /"
9/ G ,20~
'1 h, 20 U1
,-
,xamined
\.pproved
)isapproved alc .
'3/7 ,20~
I
tC-il-
tluilding )'nspector
,xpiration
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6 '200S
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I.
APPLICATION FOR BUILDING PERMIT
Date--.9 -/p- D 5
,20_
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INSTRUCTIONS
a. This application MUST be completely filled in by typewriter or in ink and submitted to the Building .In.spector with 3
ets 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
reas, and waterways, '
c. The work covered by this application may not be co=enced 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
hall 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
:sues a Certificate of Occupancy.
f. Every building permit shall eXpire if the work authorized hii.s not co=enced within 12 months after the date of
suance or has not been completed within 18 months from such date. If no zoning amendments or other regulations affecting the
:operty have been enacted in the :interim, tho Building Inspector may authorize, in writing, the extension of the permit for an
ldition six months. thereafter" a new permit shall be roquired. '
APPLICATION IS HEREBY MADE to the Buildfug Department for the issuance of a Building Permit pursuant to the
uilding Zone Ordinance of the Town of Southold, Suffolk County, New York, and.other applicable Laws, Ordinances or
egulations, for'the construction of buildings, 8;dditions, or alterations or for removal or demolition as herein described. The
lplicant agrees to comply with all applicable laws, ordinances, building code, housing code, and regulations, and to admit
lthorized inspectors on premises and in building for necessary inspections.
"IMMEDIA TEL Y"
ENCLOSE POOL TO CODE
UPON COMPLETION
BEFORE "WATER"
" ,
OCCUPANCY tJ l(
USE IS UNLAWf1)L
WITHOUT CE~TI ftOAfE'
OF OCCUPANCY
ate whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder
() - ()t \/ ' ~DERWRIlERSCERTlFICAn APPROVED At;. NOTED
00111 ~ t"o ~"- R~IllIlR~n *'''' L 33 t;;
DATE: B.P, # '?, j ,.
une of owner of premises lo '5 0 oJL. \ a uJ f'l A;vt,. y,' " ."
(As on the tax. roll' or Jatesjjom BUILDING DEFt",-MENT AT
applicant is a corporation, signature of duly authorized officer 765-1802 8 AM TO 4 PM FOR THE
FOLLOWING INSPECTIONS:
(Name and title of corp. orate officer) ALL CONSTRUe -ION SHALL 1. FOUNDATION. TWO REQUiRED
. I FOR POURED CONCRETE
f) l' I I" d MeET TIjE REQUIREMENTS OF THE 2. ROUGH - FRAMING & PLUMBING
<^ '-t d-- CODES OF NEW YORK STATE. 3. INSULATION
4. FINAL. CONSTRUCTION MUST
BE COMPU:-~ - .. ';
AEl AIN srORM WATER RUNOFF.:LL CJNS:c" _'cL M,D THE
I"UH:)UAN r TO SECTION 45.10C REQUIREMENTS OF THE CODES OF NEW
. . J!\WU CODE YORK STATE. NOT RESPONSIBLE FOR
Location of land o~hich proposed wor ooni!l!' IGN QRo CQNSlTRUCTION ERRORS
(p~' . () -+ . t.t 1/"\010\ .
House Number Street Hamlet
e applicant or name. if. corporation)
~~ Pt \JY
(M.i1ing .ddre~s of .pplicant) \ In 8-
rilders License No.
unbers License No.
~ctricians License No. hi. liiiS I::
b.er Trade's License No~
":.J_hi;i;(.Il.1"i':
County Tax Map No.1 000 Section
Subdivision
'10
~'I;'! ,A ",~'l(o.l
Block ,. J.~."",:
.J. J :: ,,' .'
Filed Map No.
. t.,
Lot
Lot
J }
a. Existing use and occupancy z"n3k-iim; 1'1 VeSM1rUlP./
b. Intendeduseandoccupancy \n~ll Ifl5fDUJ'\.d ?oL'
3.. Nature of work (check which applicable): New~qooL Addition
Repair Removal Demolition Other Work
~ .
. 4. Estimated Cost L5,ooo./ . Fee
.
Alteration
(Description)
5. 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
6. Ifbusiness, conunercial or mixed occupancy, spe.cify 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
8. Dimensions of entire new construction: Front
Height Number of Stories
Rear
Depth
9. Size oflot: Front
Rear
Depth
10. Date of purchase
Name of Former Owner
... .. ....
16. Provide survey, to scale, with accurate foundation plan an.d .~ to pr~).ines. . . V ,.~ i . ,-- '" . "r. .,
. .o'.' . ....LJ:.JI". ..1.
17.If elevation at any point on property is at 10 feet orbelo~, mui1;to\Ade t6~d~~hica1 dataion's~Y:'; .' -;,._.CJl
.,;~q. ..... -,,'" .,.,-
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STATE OF NEW YORK)
SS:
COUNTY OF )
~a.l\.0J.1 ---r l20 d. (eke....- be~~' duly sworn, deposes and says that (s)he is the applicant
(Name of individual signing contract) above named, .
. , .. ~.; "'l:~!
(S)He is the
con-\-lo..ckt> I'
(Contractor, Agent, Cotporate Officer, etc,)
of said owner or owners, and is duly authorize<lilo ped'oniQ,<:Jr~Ye performed the said work and to make and file this applicatic
that all statements contained in this application ar~l!J1e t.o,tho b.Cllt;~f~!l-kIlo:wledge and beliefj and that the work will be .
performed in the manner set forth in the application filed therewith: '- . ". .'
Sworn to before me thi
{,-, da of
KA TRLEEN QUIGLEY
NOTARY PUBlIC. _ofNewYOlt<
No.01QU8124124
Q_In~Counly
COmmission Expkes 1\IlltI25. 2O.Q.ff
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. ("'.. ......"( }A..~
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,".,," .....:..r: ..
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,.
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1-"1
SECTION
"f:1. 3 - 3/8' BARS
FORM TIES
~..
~
...
-
.
.0
. .
...
3500lb
POURED CONCRETE
r FORM TIE
1 24"' MAX
~- .~ "
O X---~-
-- ---
-
;!
~Y PICA L
PLAN
WALL
3/0' BAR'3
NOTES: PROPOSEO POOL FOR:
WALKS TO BE SIIIlPOTH, NON-SKID TYPE
SLOPED AWAY F~,OM POOL.
WATER DISPOSAI!1SHALL BE LIMITED TO
OWNERSPROPER1Y TO SUIT LOCAL REGULATIONS.
SKIMMERS J
~
TO FILTER
~ROM SKIMMERS
. F"lLTERond PUMP
TO RETURNS
TO WASTE
FROM FILTER
P I PI N G
ARRANGEMENT
7i B'I
I'. 16~ CONe
~Ik.OCK PI[II,
_, (2)
. .
I
_oJ
.....
...
. ,
10,
t
T'----
I .
FIBERGLASS
MOULDED
I PIECE
.
...
11
- I 13" I--
8" O'
-113'~
STEP
I.
OPTIONAL
TYPE
.
CONTRACTOR:
RANDY T. RODECKER, INC.
SWIM KING POOLS
ROUTE 25A.
ROCKY POINT, NY 11778