HomeMy WebLinkAbout30679-Z
FORM NO. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Office of the Building Inspector
Town Hall
Southold, N.Y.
CERTIFICATE OF OCCUPANCY
Date: 12/20/06
No: Z-32083
THIS CERTIFIES that the building INGROUND SWIMMING POOL
Location of Property: 3430
(HOUSE NO.)
County Tax Map No. 473889 Section 55
BOISSEAU AVE
(STREET)
Block 3
SOUTHOLD
(HAMLET)
Lot 9
Filed Map No.
Lot No.
Subdivision
conforms substantially to the Application for Building Permit heretofore
filed in this office dated SEPTEMBER 24, 2004 pursuant to which
Building Permit No. 30679-Z
dated
OCTOBER 1, 2004
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 RICHARD & MICHELLE FEELEY
(OWNER)
of the aforesaid building.
N/A
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL
12/16/04
ELECTRICAL CERTIFICATE NO.
2036201
N/A
PLUMBERS CERTIFICATION DATED
Signature
Rev. 1/81
_1
",!~--
Form No.6
TOWN OF SOUTHOLD
BUll,DING DEPARTMENT
TOWN HALL
765-1802
~ (j1J81Y'If' 1~'7
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IE" . 20CB
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. Pinal survey of property with accurate location of all buildings, property lines, streets, and unusual natural or
topographic features.
2. Pinal 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:
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 Occupaucy 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. IJ. jEt .(0
New Consttuction:
v
Location of Property: 3.4&:J
House No.
Owncr or Owners of Property: . rK'f'l1t!d
13::0 i Sse..c.u...J
Old or Pre-existing Building:
A\/en~
Street
(check one)
5-u .Jh) lei
Hamlet
1 M.ichelle ;:~eleA-/
.
Suffolk County Ta\, Map No 1000, Section _. 55 Block.3 '_ Lot .__9___
Subdivision __yJ/A-_______. ____ Filed Map. __. Lot: ___
Permit No. -~'1.9......._ Date ofPermit.--'.Qj,dQ'd_ Applicant: f'edUf--LhLh1J:::ltd5.
Health Oept. Approval: _. ViA Underwriters Approval: OfJ f1~
. ,~ --- ---"-------------_..-
,JIlt
.
[-tel
Planning Board Approval:
Request for:
Temporary Certificate
Pinal Certificate:
v
( check one)
';;5.Db
Fee Submitted: $
~ 1 {53l
CO~3dOS'3
---rUfYltJJ.e Lu JJ J. Jet
Applicant Signature .
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.
30679 Z
Date OCTOBER
1, 2004
Permission is hereby granted to:
R & M FEELEY
3430 BOISSEAU AVE
SOUTHOLD,NY 11971
for :
CONSTRUCTION OF AN INGROUND SWIMMING POOL IN THE REQUIRED REAR
YARD AS APPIED FOR FENCED TO CODE
at premises located at
3430 BOISSEAU AVE
SOUTHOLD
County Tax Map No. 473889 Section 055
Block 0003
Lot No. 009
pursuant to application dated SEPTEMBER 24, 2004 and approved by the
Building Inspector to expire on APRIL
1, 2006.
Fee $
150.00
-~ C-iL.
f Authorized Signature
ORIGINAL
Rev. 5/8/02
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This certificate may not be altered in any way and is validated only by the presence of a raised seal at the location indicated. ~
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I Located at
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I Section:
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BY THIS
NEW YORK BOARD OF FIRE UNDERWRITERS
CERTIFICATE OF COMPLIANCE THE
BUREAU OF ELECTRICITY
40 FULTON STREET - NEW YORK, NY 10038
CERTIFIES THAT
Upon the appl ication of
upon premises owned by
DANIEL WILCENSKI ELEC.CONTR.
P. O. BOX 319
SOUTHOLD, NY 11971,
RICHARD FEELEY
3430 BOIFFEAU AVENUE
SOUTHOLD, NY 11971
3430 BOISSEAU AVENUE SOUTHOLD, NY 11971
Certificate N um ber:
2036201
2036201
Block:
Lot:
Building Permit: 30679Z
BDC:
ns11
Described as a Residential 0-599 square ft. occupancy, wherein the premises electrical system consisting of
electrical devices and wiring, described below, located inion the premises at:
Outside, PooVSpa,
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 andlor 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 16th Day of December, 2004.
Name OTY Rate Ratioll Circuit IYm:
Appliances and Accessories
Time Clock/Switch
Paoli Spa Bonding
Wiring and Devices
Fixture
Receptacle
Receptacle
Switch
o
o
1 0
I 0
1 0
1 0
20 amp
Paoli Spa
Paoli Spa
GFCI
General Purpose
(Swimming Pool): This certificate covers compliance at the date of inspection only. Because of unusual environments it is advisable to have
frequent test and/or repairs made by a qualified person.
seal
of I
J' '1 iJ C2J ~ iJ',J '1.'1 TO - 'TO'f' T iJ
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TOWN OF SOUTHOLD BUILDING DEPT.
765.1802
INSPECTION
[ ] FOUNDATION 1 ST [] ROUGH PLBG.
[ ] FOUNDATION 2ND [] I~ATION
[ ] FRAMING I STRAPPING [n-FlNAL
[ ] FIREPLACE & CHIMNEY [ ] FIRE SAFETY INSPECTION
REMARKS:
DATE 11--1 \~ IO~
INSPECTOR
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FIELD INSPECTION REPORT DATE COMMENTS . 11
FOUNDATION (1ST) ~~
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INSULATION PER N. Y. 15
STATE ENERGY CODE ,
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,_. "'''''' OF IiEALTH SeRVICES
, VAL OF CONS'!'RU
A SING-- E C'TEn WORI(S FoR
j. , L FAMlLYRESfDENCl!:
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TOWN OF SOUTHOUD:
BUILDING DEPARTMENT
TOWN HALL ~rp 2 4 2004
SOUTHOLD, NY 11971
TEL: (631) 765-1802
FAX: (631) 765-9502
www.northfork.netlSouthoIdI PERMIT NO.
/7 I ,2oL
Iblt ,20~
,
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 v'
!JOe- 7q -e:: Check ./
Septic F onn
N.Y.S.D.E.C.
Trustees
Contact:
Mail to:
Examined
Approved
Disapproved alc
It! I ,20~
,
~73Y-?~v5
Expiration
,~ilfr
I Building Inspector
APPLICATION FOR BUILDING PERMIT
Date V.:J?
INSTRUCTIONS
,20~
a. This application MUST be completely 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 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 ofthe Town of Southold, 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 necessary inspections.
~J.l17I./K PC>l!L:;' ~77:>
MMEOIA TE (Signature of applicant or name, if a corporation)
ENCLOSE POOL TO CODE
UPON COMPLETION tLCONSTRUCTlONSHALL'f"t' <309 '7, ~~II<>~<.oG; ;Uy //93:>
BEFORE "WATER" ME . THE REaUIREMENTS OF ItiE (Mailing address of applicant)
State whether applicant is owner, lessee, ~Jm~a9&N~ ~~~I6rieral contractor, electrician, plumber or builder
Builders License No.
Plumbers License No.
Electricians License No.
Other Trade's License No.
APPR9VE9-A&NefED
Nameofownerofpremises'Z~II,4Zl> ... HIC!JIetL.6 c€' ey DATE: /o/t/'/ B.P.I 30
(As on the tax roll or lalil!t:deed) ISO . BY' t;;.
If applicant is a corpor~ signature of duly authorized officer NOTIFY BUILDIN':> DEPARTMENT AT
/.-~ ~ L 'he €S 765-1802 8 AM TO 4 PM FOR THE
(Name and title of corporate officer) 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 NEW
NOT RESPONSIB
OR CONSTRUCTION ERRORS.
(' pYlf J7:f'ALTt.J!?
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County Tax Map No. 1000 Section
Subdivision 7/CII/Fii!:1:> ;P6C'l..EY
(Name)
1.
55
Lot d 9
Lot
2. State exis~~ use and occupancy of premises and intended use and occupancK ~ proposed construction:
a. EXIsting use and occupancy / -J.. ~d,iZy ?ii!. '77PO;m.E:?<-+"~ \, >
b. Intendeduseandoccupancy/t.:Y~ ~ Z&S~e; ~:rAt dU-<f,'7hM1T> 4~l,^"....,Ah"'7 ~
3. NatiIre of work (check which applicable): New Building Addition Alteration
Repair Removal Demolition ~~.erwor /A~17/hM:<p -<,>",,,-,,/-(',."$ ="-
'---:- (Description)
4. Estimated Cost $/.3"Al'o.oo Fee /I /SZJ 00
(To be paid on filing this application)
5. If dwelling, number of dwelling units Number of dwelling units on each floor
If garage, number of cars
6. Ifbusiness, commercial or mixed occupancy, specify nature and extent of each type of use.
7. Dimensions of existing structiIres, if any: Front .s5'
Height ?</ Number of Stories /?L
Rear CAV'
Depth _ -=f,y
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
Depth
Rear
9. Size of/ot: Front
/P'T/
Rear
,
/oy
Depth ?~JV'
10. Date of Purchase
Name of Former Owner
,
11. Zone or use district in which premises are situated '7Z&7:>/7)hIM/'r//-/L-
12. Does proposed construction violate any zoning law, ordinance or regulation? YES_NO ~
"
13. Will lot be re-graded? YES X NO_Will excess fill be removed from premises? YES~ NO_
14. Names of Owner of premises '2'~l> rHElFl"
Name of Architect
Name of Contractor ~/nI! ~~ L..?/:>
Address 3~3<> 13uISSe14V,u€ Phone No. 7606'- oJ',!p??
d ~p h
A dress P one No
Address ?'<' <3O>J 9 ,..",,~Phone No. ?3"'~?6o~5'
15 a. Is this property within 100 feetofa tidal wetland or a freshwater wetland? *YES_NO~
* IF YES, SOUTHOLD TOWN TRUSTEES & D.E.C. PERMITS MAY BE REQUIRED.
b. Is this property within 300 feet of a tidal wetland? * YES_NO ~
* IF YES, D.E.C. PERMITS MAY BE REQUIRED.
"V J3TAI03MMI"
16. Provide survey, to scale, with accurate foundation plan and distances to property lines.laO~. ':J: f:;:,q "7.,?.J?II'I:l
, ." ',,' ,. ,":)IA()"j:JA lilt ' '. ~,"l,.1
. '..1("', . :'"" " ',,' ......Yl ,. ~~ ~ ~3:6
17. If elevation at any point on property is at l;Q{etlfbt beloW; must1JTOVidi ~aphical data on survey, .
, T
, -
"
STATE OF NEW YORK)
C. CLIi~:
COUNTY OF~r.T~:;,C f.'lq!l
EI.I~".fI:~1/ 7~' being duly sworn, deposes and says that (s)he is the applicant
(Name of individual signing co~t~c:t) above named,
-._,.._-,,~._~--. ..
"'\
~4I7:e/1C.rfl JC.
(contractor, Agent, Corporate Officer, etc,)
(S)He is the;. " "
'. .'~ ,.,. ,. .
of said owner or own. ers, and is dul:y authorized to perform or have perf<lf!lle.4 W: ,s#4~9l;Wd to make and file this application;
that all stat~!ll.!loJItained in this application are true to the best (lfhls ~1Jdg1:iahdi\uiliJf; and that the work will be
performed in the manner set forth.Jn.the.ap'tlliciition filed therewith; ':" \;, I i\ i UIj ; ~ '"I :;; l' I
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3TA:':.TS3J ~:;~gnature of Applicant
Claire L. Glew
Notary Public, State of New York
No,01GL4879505
Qualified In Suffolk CouOlN""",
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