HomeMy WebLinkAbout31892-Z
FORM NO.4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Office of the Building Inspector
Town Hall
Southold, N.Y.
CERTIFICATE OF OCCUPANCY
No: Z-32010 Date: 11/17/06
THIS CERTIFIES that the building HOT TUB
Location of Property: 345
(HOUSE NO.)
County Tax Map No. 473889 Section 79
COLONIAL RD
(STREET)
Block ~
SOUTHOLD
(HAMLET)
Lot 26
Subdivision
Filed Map No.
Lot No.
conforms substantially to the Application for Building Permit heretofore
filed in this office dated
MARCH 20, 2006 pursuant to which
Building Permit No. 31892-Z
dated
APRIL 7, 2006
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 INSTALLATION OF AN "AS BUILT" HOT TUB AS APPLIED FOR.
The certificate is issued to THOMAS H & JEANETTE HARRIS
(OWNER)
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL
N/A
ELECTRICAL CERTIFICATE NO.
3010793
10/20/06
PLUMBERS CERTIFICATION DATED
N/A
~ ar-/J/JA
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uthorized Signature
Rev. 1/81
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Form No.6
TOWN OF SOUTHOLD
'i BUILDING DEPARTMENT
, I i TOWN HALL
,~ I 765-1802
I APPLICATION FOR CERTIFICATE OF OCCUPANCY
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1/9 7 )
NOV.' 2J05
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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:
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 I % 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 compicted 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.
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.
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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:
C()/on/a./ ,(d
Street
v-
( check one)
Sou-Hr IJ Id
Location of Property: 3l(~
House No.
Hamlet
Owner or Owners of Property: 7'/1()ma. s Ho ( ::S-~die HttrnS
Suffolk County Tax Map No 1000, Section 079.oCJ Block 00. CJO
Lot C)f).~.(JtXJ
Subdivision
Permit No., 31 ffr,;, - :z.
Date of Permit.
Filed Map.
Applicant:
Underwriters Approval:
Lot:
Health Dept. Approval:
Planning Board Approval:
Request for:
Temporary Certificate
Final Certificate:
Fee Submitted: $
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BY THIS CERTIFICATE OF COMPLIANCE THE
NEW YORK BOARD OF FIRE UNDERWRITERS
BUREAU OF ELECTRICITY
40 FULTON STREET - NEW YORK, NY 10038
CERTIFIES THAT
Upon the application of
upon premises owned by
JIM SAGE ELEC. INC.
PO BOX 38
GREENPORT, NY 11944-0038,
THOMAS HARRIS
345 COLONIAL RD.
SOUTHOLD, NY 11971
345 COLONIAL RD. SOUTHOLD, NY 11971
3010793
Application Number:
Certificate Number:
3010793
Section,
Block,
Lot
Building Permit,
BDC,
ns11
Described as a occupancy, wherein the premises electrical system consisting of
electrical devices and wiring, described below, located in/on the premises at
hot tub, Outside,
A visual inspection of the premises electrical system, limited to electrical devices and wiring to the extent detailed
herein, was conducted in accordance with the requirements of the applicable code and/or standard
promulgated by the State of New York, Department of State Code Enforcement and Administration, or other
authority having jurisdiction, and found to be in compliance therewith on the 20th Day of October, 2006.
Name OTY Rate Ratin~ Circuit IY1lJ;:
Miscellaneous
covers power to self
contained hot tub
Wiring and Devices
GFCI Circuit Breaker
GFCI Circuit Breaker
o
o
20 amp
30 amp
Paoli Spa
Pc 011 Spa
seal
I of I
This certificate may not be altered in any way and is validated only bY the presence of a raised seal at the localion indicated.
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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.
31892 Z
Date APRIL
7, 2006
Permission is hereby granted to:
THOMAS H HARRI S
SOUTHOLD,NY 11971
for :
INSTALLATION OF AN "AS BUILT" HOT TUB AS APPLIED FOR
at premises located at
345 COLONIAL RD
SOUTHOLD
County Tax Map No. 473889 Section 079
Block 0006
Lot No. 026
pursuant to application dated MARCH 20, 2006 and approved by the
Building Inspector to expire on OCTOBER 7, 2007.
Fee $
300.00
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I Authorized Signature
ORIGINAL
Rev. 5/8/02
-.
3/ ~ q #-:2--
TOWN OF SOUTHOLD BUILDING DEPT.
765.1802
INSPECTION
[ ] FOUNDATION 1 ST [] ROUGH PLBG.
[ ] FOUNDATION 2ND [] INSULATION
[ ] FRAMING I STRAPPING [ ] FINAL
[ ] FIREPLACE & CHIMNEY [ ] FIRE SAFETY INSPECTION
REMARKS:
r~ ~; ~ ffi't-;-+-
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DATE
~-I'f-a~
f
INSPECTOR ~.~
FIELD INSPECTION REPORT DATE
FOUNDATION (1ST)
FOUNDATION (2ND)
ROUGH FRAMING &
PLUMBING
INSULATION PER N. Y.
STATE ENERGY CODE
FINAL
.
COMMENTS
.
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. ADDITIONAL COMMENTS
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TOWN OF SOUTHO\.D
BUILDING DEPARTMENT
TOWN HALL
SOUTHOLD, NY 11971
TEL: (631) 765-1802
FAX: (631) 765-9502
www.nortbfork.net!Soutboldl
PERMIT NO.
.g f f <1,;L 7'::r
BUILDING PERMIT APPLICATION CHECKLIST
Do you have or need the following, before applying?
Board ofHealth
4 sets of Building Plans
Planning Board approval
Survey
Check
Septic Fonn
N.Y.S.D.E.C.
Trustees
Contac:t:
Examined
Approved
Disapproved ale
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Mail to: 7 SlIAM/fA/ AVE.
K'&7J-IH~ NY //7/{/
Phone: /.1'I-rrS--S'f/flf
tol?
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BuIlding Inspector
Expiration
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APPLICATION FOR BUILDING PERMIT
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Date
()3/<<.t7
,
.20~
\
\ INSTRUCTIONS
.
.. This opplication ~ completely filled in by typewriter or in ink and submitted to the Building Inspector with 3
, sets ofplllrul' acc!JIaIejlloiplan to scale. Fee according to schedule.
\ '.b. Plot 'pian sbowing location oflot and ofhuildings on premises, relationsbip 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 Pennit.
d. Upon approval of this application, the Building Inspector will issue a Building Pennitto the opplicant. Such a permit
sball 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 sball expire if the work authorized has not commenced within 12 months afu:r 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.
APPLlCA nON IS HEREBY MADE to the Building DepaI1ment fur the issuance of a Building Permit pursuant 10 the
Building Zone Ordinance of the Town of Southold, Suffolk County, New York, and other opplicable Laws, Ordinances or
Regulations, for the construction of buildings, additions, or alterations or for removal or demolition as herein described. The
opplicant agrees to comply with allopplicable laws, ordinances, building code, housing code, and regulations, and to admit
authorized inspectors on premises and in building for oeeessary inspections.
~~~aco~nuion)
"7 fEAA1'AV AV~ 4'ETIT~A/Y /17/P
(Mailing address applicant)
State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder
Name of owner of premises
E:r K PA'AP7'IAA5' .s'"ERV~.e'"f.
H. hlARRIS-
(As on the tax roll or latest deed)
If applicant is a corporation, signature of duly authorized officer
AGEA/T J
,
k'EV.zA/ G: ..f'A}j
iNt:7MAS
(Name and title of corporate officer)
Builders License No. IS5'",II-H
Plumbers License No.
Electricians License No.
Other Trade's License No.
I. Location o,f jw1d on which proposed work will be done:
3~,L, ct7L.QA/.:z:AL RgAP
House Number Street
5t:7t1 rllt9~P
Hamlet
County Tax Map No. 1000 Section
Subdivision ><
(Name)
079
Block t),{'
Filed Map No. X
Lot
Lot
01/
X
" ,r..
2. State existiAg use and occupancy of premises and intended use and occupancy of proposed construction:
a Existing use and occupancy OU;:" FAMILY PJ./ELLIIVG
b. Intended use and occupancy (JIVe: &MrLY PL,/~L.L:rA/G
3. Nature of work (check which applicable): New Building
Repair Removal Demolition
Addition
Other Work
Alteration
MAIIVUJY RM.f DB"1t"
(Description)
4. Estimated Cost
Fee
5. If dwelling, number of dwelling units I
If garage, number of cars ;;Z
(To be paid on filing this application)
Number of dwelling units on each floor /
:?~ /
.X
;X? ;
6. If business, commercial or mixed occupancy, speciJy nature and extent of each type of use.
7. Dimensions of existing structures, if any: Front
Height Number of Stories
:?;l I 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
10. Date of Purchase
J?tJ ;
11/<</97
JDlS" ,-
Name of Fonner Owner K EA'U ),/..7:
,(7- f't1?
G/lE.IG I tlJ.-f.
9. Size of lot: Front
Rear
I
J~t7
Depth
11. Zone or use district in which premises are situated
12. Does proposed construction violate any zoning law, ordinance or regulation? YES_NO X
13. Will lot be re-graded? YES_ NOX Will excess fill be removed from premises? YES_ NOX
14. Names of Owner of premises 'TNttM/ff Ii N-Ur/fAddress 1~ CfJIL4NUi-RP. Phone No. iJ'rl-7i'5"- fll.?S-
Name of Architect 'lADY fHA'UfMH Address LEVfT7IJWA/; NY Phone No &"14'- 77/--107
Name of Contractor Address Phone No.
15 a.ls this property within 100 feetofa tidal wetland or a tTeshwaterwetland? -YES_NO X
- IF YES, SOUTHOLD TOWN TRUSTEES & D.E.C. PERMITS MAYBE REQUIRED.
b. Is this property within 300 feet of a tidal wetland? - YES_ NO X
- IF YES, D.E.C. PERMITS MAYBE REQUIRED.
16. Provide survey, to scale, with accurate foundation plan and distances to property lines.
17. If elevation at any point on property is at 10 feet or below, must provide topographical data on survey.
STATE OF NEW YORK)
, I SS:
COUNTYOF~
K EVIY G: RAY being duly sworn, deposes and says that (s)he is the applicant
(Name of individual signing contract) above named,
(S)He is the
-4G"EA/T; E;r/(" P-fAF7:Z"A./6 feR VICes;
(Contractor, Agen~ Corporate Officer, etc.)
of said owner or owners, and is duly authorized to perform or 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
perfonned in the manner set forth in the application filed therewith.
Swom to before me ~~ D '-
dO day of 20 )0
'rtthA . ~
Notary Public
'~H~
Signature 0 icant
Len LC'1~'.~,,)LO
No~J.rY Pl.:;::::. :.... l ,', ,:;./ York
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STEPS UP TO HOT
TUB ONLY, FROM ON
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ACCESSORY HOT TUB
APPLICATION
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SCTM 1000-079.00-06.00-026.000
I'iQTCS:
1. THIS SURVEY HAS BEEI, Pf,U'pi'[[J II' U)I~JUI',C'iIOI~ WllH P. LUII.L'IIK.
D[PARTMEI~T APPLlCATIOI".
2. SURVEY HAS BEEN BASED 0" FIUD MAl, TAX IJAr' , Dr! D [)[SCI(lfIIUI~,
AND FIELD MEASURLMENTS W,DE 0" ll!l [jp,'II. SHCi\'M
3. NOTE THAT UNf,ECORDED DOCUMLN1S OR PNlOL p.GI,[EM[ NE WiT II, EVIUl.IKl.
MAY AFFECT ANALYSIS SHOWN HERE or,.
4. UNDERGROUND STRUCTURES OR 01 HER FEA'IlJRES l,eJl VISI13L1 TO SUINf YOR
THAT MAY INDICATE EASEMENT OR UTIli I, RICHTS I~I\Y r,01 8[ SIWVm.
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SURVEY OF PROPERTY
SITUATE AT
BAYVIEW, TOWN OF SOUTHOLD
SUFFOLK COUNTY, NEW YORK
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L ~ POOL . 13.1
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POOL ~~
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CONCRETE ELOCK Il
RE"TNNING WALl
127.28'
CERTIFIED ONLY TO:
HARRIS
SURVEYED OCTOBER 20, 2005
UNWTHORIZED ALTERA.TlON OR ADDI1'ION
TO THIS SURVEY IS A VIOLATION OF
SECTION 7208 OF THE NEW YORK SlATE
EDUCATION lAW.
COPIES OF THIS SURVEY MAP NOT
BfJ,.RING THE LArm SURVEYOR'S INKED
SEAL OR EMeOSSED SEAL SH.t..LL NOT BE
COt~SIDERED TO BE A VAUD TRUE COPi,
GU,l..R,l..NTE[S OR CERTItICATlONS INDIG.L.TED
HEREON SHALL RUN ONLY TO THE PERSOt~
fOR \I.'HaM THE SURVEY IS PREPAReD, AND
ON HIS EEKAlF TO THE TIRE COMPANY,
GOVERNMENTAL AGENCY AND LENDING
INSTITUTION LISTED HEREON, AND TO THE
ASSIGI~EES OF THE LENDING INSTITUTION.
GUARANTEES OR CERTIFICATIONS A~E NOT
TRF.NSFERABLE TO ADDlTIONAl INSTITUTION~
OR SUSSEQUENT OWNERS.
DORANNE E. TAY, L.S.
OMS LAND SURVEYING COMPANY
P.O. BOX 410
MASTIC, N.Y. '11950
TEL. (516) 660 - 9489
SCA.LE 1" '" 30'
EMBOSSED SE,t..L t.,rxo $IGN,L,TURE
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DDRANNE E TA~
LICENSE NO. 50008
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