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Home My WebLink About30876-Z FORM NO.4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No: Z-32035 Date: 11/29/06 THIS CERTIFIES that the building ABOVE GROUND POOL AVE (STREET) Block 1-- CUTCHOGUE (HAMLET) Location of Property: 4910 PEQUASH (HOUSE NO.) County Tax Map No. 473889 Section 110 Lot 27 SUbdivision Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated JANUARY 3, 2005 pursuant to which Building Permit No. 30876-Z dated JANUARY 3, 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 "AS BUILT" ACCESSORY ABOVE GROUND SWIMMING POOL IN THE REQUIRED REAR YARD WITH FENCE TO CODE AS APPLIED FOR. The certificate is issued to LAUREN ZAMBRELLI (OWNER) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A ELKCTRICAL CERTIFICATE NO. N-557722 05/07/01 PLUMBERS CERTIFICATION DATED N/A ~ized Signature Rev. 1/81 Form No.6 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL 765-1802 ~ W/O~ ~ JAN 3 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: 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. 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 I Pfu:, b ~ Do. /l3lo'S Newconstruction:~~ /OQ<(- \O~~Pr~istingBUilding: (check one) Location of Property: ~C\~O ~uf'\C;)'h A-v ~ House No. Street , Owner or Owners of Property: ~O r.e Y""\ ~ ~ m6,-e\ \l \ \ 0 Block DO -? Hamlet Suffolk County Tax Map No 1000, Section Lot 0-;)-'1 Permit No. 3~ ~ 7 r. Jj'::- Health Dept. Approval: Planning Board Approval: Filed Map. Lot: Dateofpermit.~Applicant: ~0("-e1{"\ 2Co\~6'e\lt F~:::^-7- S 511~~ Subdivision Request for: Temporary Certifi':...~ Fee Submitted: $ 0- ~. (5U f}-.,~ .11'-10' c.o~3.:?0.35 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. 30876 Z Date JANUARY 3, 2005 Permission is hereby granted to: LAUREN ZAMBRELLI 4910 PEQUASH AVENUE CUTCHOGUE,NY 11935 for : INSTALLATION OF AN ABOVE GROUND SWIMMING POOL IN THE REQUIRED REAR YARD "AS BUILT" AS APPLIED FOR at premises located at 4910 PEQUASH AVE CUTCHOGUE County Tax Map No. 473889 Section 110 Block 0003 Lot No. 027 pursuant to application dated JANUARY 3, 2005 and approved by the Building Inspector to expire on JULY 3, 2006. Fee $ 300.00 ~~ f Authorized Signature ORIGINAL Rev. 5/8/02 11"-.0111 _l.AJUUCl.j,c. , . ~ . . - ----.--.- . lQoo343'.. . .r.. '.' .' .... . '. :.:. DIM.... , ,'" .... '., ., .,t~',_Tit:l1 .....;w...... , .......I~..i-r..;/~.n-a...:~~: . '~r.~~; .... .. ...... I ....~' '~."/":--~" ""\' . . . :. .~ . ".... "... .,.,:,...'), ..... ,';'. ...'.....-.....:~I --...... ,~" ..::.l.... '. 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[ ] FOUNDATION 2ND [] INSULATION [ ] FRAMING ~FINAl (fOO 1) [ ] FIREPLACE & CHIMNEY [ ] FIRE SAFETY INSPECTION REMARKS: - DATE / -/0- OS INSPECTOR ~~ , FIELD INSPECTION REPORT DATE . COMMENTS FOUNDATION (1ST) ~~ -.1- \\:i ---------~c-------------------- :r (!t:.' ~J> . , . . ~ If\~ ~ FOuNDATION (2ND) . q: . Z 0 --F' ...5;) -- -.-. C1~ ROUGH FRAMING & ~ l'l PLUMBING ---0" .. . sf I"" ~ :t: . :P~ 1\' ~ INSULATION PER N. Y. " STATE ENERGY CODE - \", .----....------..- , ...-.-----.--.- ___no n____ ~"'.,';~,+ .,,(1 l-:-/D ~O // d,.( . - '.. ,,- _A Pi' - ,_ / r _0 ~-~-~- ~~ . ~ '/~<s: A~ .~- - .J..V - ".-- h j.I'-h", -:-;;- -I- ~ If - ~~ /)0 ~~ .- ..L V tiF- ~ .Dn "._', -A ..9 \ FINAL _~'L-/- Fl~~~ rI- ~ U- -'+- ~ .~..; "7 t t ' ,..~, I ftJ-f 3- 0'<;' f/,i:;{ h .~ "~d1C,. aL. !fA ~ .~v ~ ~" b rJ.f...{ I~ 01\ r.. _ c.. (}/It- 0 ,., .10 /7 v V ~ ADDmONAL COMMENTS :: i:> . ~~ . f.~ . r .JWJ , 'll - -. lP~ ..(--';j 0 Z ..--- - 0:: l'l -- :z~ " . i>; l'l 'll - ~ .0 c TOWN ".--'., Of SOOTHOLD '~OPERTY ~ECORD CARD /\ J ;11-.] , OWNER RES. 210 LAND SEAS. IMP. ?.:Jd ~/()o L{oe> %0 AGE NEW 00 ~.aso~.y' NORMAL Farm Acre Tillable 1 Tillable 2 Tillable, 3 Woodland Swampland Brushland House Plat Total /;~ C. .e Vd.~,J ;I/-i? N )lent! hJ1 S .r.::r. .J-("Hv /-4 VI LLAGE ) DISTRICT SUB. LOT /2. Cvfc 46 E 'J ;, ...-~~;'-. - ;<.J p c. ACREAGE I' c:l..o / TYPE OF BUILDING . . &.y~J. I CB. VL. FARM I MISC:. COMM. IND. / TOTAL DATE 2./00 .::J.e>o //..Lfd ~tO-$O Ie r. q BUILDING CONDITION BELOW 7', @ $ <> <> "" .... 0 <.\ ABOVE ' Value Per Acre Value re cli::J :;b- J3/7 '1 " i-.. ,f I '\~; ~ $' <:j ~ ! , il I I .. , , " ; , , i , ,~; , i I~ , . ..... "- , .." --- 0/ )-- ~ '- '/... '" ~ 'i... " '" ~ r~'" , ... ~ ~ ..c 8 8 .. u: u: '2 1;; "1J i.i: c: ~ N ~ ~ 0 .. .. ..c ';: 0 u E E .. 8 .. ~ ~ 8 0 . .. .. co u: of I a:: . . . ~ ~ , ~ ~ ~ ~ \J ~ ~, ~ ;. ..c ..c ~ ~ , 0 &. " c.. -, ~ ~ ~ r-- l~ J - C - A -:;;: . " . I"'" l '1 I.. G.. :\ ~ ~ I...; ...... , '\ , . ~ i I I .! ! too. \ '0 f I ~ ;1 (") I .. . . .-.- ""~., ,... . "j -.-,\ I # I I r------- --------------- ------ --- .. '..". -.,--.,,-.._.,.'.,--~~~-".. ...-.-....,., 0'05 -"3.00,8' ZS'~. 'QlJ.~H,IlfO\U~1.0'~~" o i----r- ,--1 0 . .. . ,. . I .; I , . tn, i iif 1'1 i '51'., 'I' 11 . II i /.~tl; IUPI,Ihllllj z" 0 i . I pll 1!11 I IilU11 +. ~ o w ~ w U. J I' . ~ i'", 141 \ f ~ ~lg21!Q; . . j m "i · ,_, L!~ "J '"T=~ ,""'N\ 3?'iZl2m.L x l"\J , --..:r, O"i :-0. u) ~ ~~ ~~" ,-- I i -0 (J'<fOO III ! J____ "/03N SI3~'.::;I .. If\ ~ Q J~ 2- I I I I I I ., . , I u.i I '3 :81 QJ i~8 .~i 1 ~ JI .;J ~~_.~ O,()G-'M OOSI Z$;'N ,. I . -J' ~...,. ..-4. .~.. ..Jl~. , . lit, ~' 0 ,'. .....;J ~. ~N~a;t.. ..~..4 0 .~~lli ; L ~ II ~I . ~'l. ..~.......,.~......j -~s>.L~J . Jt:1:J1 wOlI:2 ~t~j.~. ~ to "'1 ~ ;;\3% ON d>VW CD ::l.:ltiS - "S.153 <:lOOM.LS'v'3 .;10 dIot\..J ~ . '. " '21 .101 i,' '~~ ',/. ~ ~. :'. ,:.-' .!', p~- ~. ;. 3d87{,r;; BUILDING PERMIT APPLICATION CHECKLIST Do you have or need the following, before applying? Board of Health 4 sets of Building Plans Planning Board approval Survey Check Septic Form N.Y.S.D.E.C. Trustees Contact: 'F SOUTHOLD . NG DEPARTMENT IMLL .IOLD, NY 11971 ,631) 765-1802 (631) 765-9502 . northfork.net/Southold/ PERMIT NO. mined ,proved isapproved ale t ~3 f/~ 20 0 S- '- ~ ,20€5- Mail to: 7h ,200P , Phone: Expiration /' .;/ LV.... . IBuilding Inspector APPLICATION FOR BUILDING PERMIT JI\N 3 ';)or.;6 Date / Ie:!- 20 0 .s '- INSTRUCTIONS a. ~s_~plication MUSt be ~;;mpletely filled in by typewriter or in ink and submitted to the Building Inspector with 4 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 strects 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. 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 0 emolition as herein described. The applicant agrees to comply with all applicable laws, ordinances, building code, hou' ode, and re . ons, and to admit 1 authorized inspectors on premises ~$mlFltl\1\sary inspections. REOOIBEI) Name of owner of premises (Name and title of corpo~ ANCY OR Builders License No. Plumbers License No. Electricians License No. Other Trade's License No. 1. Location of land on which proposed work will ~one: ~~er l>s~~?~h , vZ County Tax Map No. 1000 Section Subdivision \\D Block (70'3 Filed Map No. Lot Lot (Name) . 3. Nature of work (check which applicable): New Building Repair Removal Demolition Addition Other Work Alteration '~O\ (Description) 4. Estimated Cost ~(ooO Fee 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, commercial 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 8. Dimensions of entire new co~struction: Front Height '6\ ~ cil..\ Number of Stories 9. Size oflot: Front Rear Rear Depth Depth 10. Date of Purchase ~ 1&0\00 Name of Former Owner II. Zone or use district in which premises are situated 12. Does proposed construction violate any zoning law, ordinance or regulation? YES NO J<- - - 13. Will lot be re-graded? YES_NO ~ Will excess fill be removed from premises? YES_NO_ 14. Names of Owner of premises Lll""<-'-" L"",bod~~ddress ~SIO Ve'1.lVA-":,\' Phone No.t,-=) 137<) - 0 S I~ Name of Architect Address Phone No Name of Contractor Address Phone No. 15 a. Is this property within 100 feet ofa tidal wetland or a freshwater wetland? *YES_NO ~ * IF YES, SOUTHOLD TOWN TRUSTEES & D.E.C. PERMITS MAY~~ REQUIRED. b. Is this property within 300 feet of a tidal wetland? * YES_NO ~ * IF YES, D.E.C. PERMITS MAY BE REQUIRED. ,. 16. Provide survey, to scale, with accurate foundation planflJ}dAis~es to'7o"ertY!~~::S.e I"C L 0 ~ d 17. If elevation at any point on property is at 10 feet or.jj~lo~' ;nu~t p~ovide topograph.!~~ data on survey. STATE OF NEW YORK) SS: COUNTY OF $J Fr.,,,- ) LA u \l..f,...... Z A {"r\ bfl.... II.]" being duly sworn, deposes and says that (s)he is the applicant (Name of individual signing contract) above named, (S)He is the 0 UJ N e.-.... (Contractor, Agent, Corporate Offi9er, etc.) 1::'(: :_' of said owner or owners, and is duly authorized to perform or have perfOlliled the sai~ ~iahd to make and file this application; that all statements contained in this application are true to the be~1)fhis~owledge an9 l?elief; and that the work will be performed in the manner set forth in the application filed ~~~tli, j ., . Sworn to before me this In..J dayof :::rAN""''''1 2005 ~~i~ ~"b'fA~/~3~~,c State 01 New York No. 01JU6059406 Qualified In Suffqlk County 0 Commission Expires May 29, 20 ~