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HomeMy WebLinkAbout29441-Z FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No: Z-32183 Date: 02/05/07 THIS CERTIFIES that the building ABOVE GROUND POOL Location of Property: 380 MADISON ST GREENPORT (HOUSE NO. ) (STREET) (HAMLET) County Tax Map No. 473889 Section 40 Block 5 Lot 18 Subdivision Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated MAY 28, 2003 pursuant to which Building Permit No. 29441-Z dated MAY 29, 2003 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 ABOVE GROUND SWIMMING POOL IN THE REQUIRED REAR YARD WITH FENCE TO CODE AS APPLIED FOR. The certificate is issued to GARY C & CARLA L BLASKO (OWNER) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A ELECTRICAL CERTIFICATE NO_ 1166388 09/24/03 PLUMBERS CERTIFICATION DATED N/A / lx_e Aut rize `Signature Rev. 1/81 Form No.6 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL 765-1802 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: 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 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 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. a�\ l New Construction \'� Old or Pre-existing Building: (check one) p % ' Location of Property: `s mO,dk SO(n � Gy-� 1� House No. Street Hamlet )(Owner or Owners of Property:Gacu -k- a nir Suffolk County T__ ``axMap No 1000, Section 4C) Block 5 Lot 1 fs Subdivision G N � Filed Map. Lot: Permit No. D `qql Date of Permit. Applicant: Health Dept. Approval: Underwriters Approval: Planning Board Approval: Request for: Temporary Certificate Final Certificate: (check one) Fee Submitted: $ Applicant Signature �C .? ()g0 Co 2.3011 �3 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. 29441 Z Date MAY 29, 2003 Permission is hereby granted to: GARY C & CARLA L BLASKO 15 MADISON STREET GREENPORT,NY 11944 for CONSTRUCTION AN ABOVE GROUND SWIMMING POOL IN THE REQUIRED REAR YARD WITH FENCE TO CODE AS APPLIED FOR at premises located at 380 MADISON ST GREENPORT County Tax Map No. 473889 Section 040 Block 0005 Lot No. 018 pursuant to application dated MAY 28, 2003 and approved by the Building Inspector to expire on NOVEMBER 29, 2004 . Fee $ 150 . 00 R (QAZrijqnA ORIGINAL Rev. 5/8/02 o �Irs��n�nrrrrr�rr3fl r rL3r PLrr3rL3r3rL3 Fr3EI 55' BY THIS CERTIFICATE OF COMPLIANCE THE 5 NEW YORK BOARD OF FIRE UNDERWRITERS 5 C5 BUREAU OF ELECTRICITY c5 40 FULTON STREET — NEW YORK, NY 10038 5 5 CERTIFIES THAT S 5 Upon the application of upon premises owned by 5 5 CARLA&GARY BLASKO CARLA&GARY BLASKO5 5 15 MADISON ST 15 MADISON ST 5 5 GREENPORT, NY 11944 GREENPORT, NY 11944 5 Located at 15 MADISON ST GREENPORT, NY 11944 5 7c Application Number: 1166388 Certificate Number. 1166388 Section: Block: Lot: Building Permit: BDC: NS37 5 Described as a Residential occupancy,wherein the premises electrical system consisting of 5 electrical devices and wiring, described below, located inlon the premises at: rj 5 Outside,Pool/Spa, 5 5 was inspected in accordance with the National Electrical Code and the detail of the installation,as set forth below,was 5 rj found to be in compliance therewith on the 24th Day of September,2003. 5 5 Name OTY Rate Rating gEglift Type 5 Appliances and Accessories 5 5 Pool/Spa Bonding 1 0 5 5 5 Wiring and Devices 5 Receptacle 1 0 20 amp Pool/Spa 5 GFCI Circuit Breaker 1 0 20 amp Pool/Spa 5 (Swimming Pool):This certificate covers compliance at the date of inspection only. Because of unusual environments it is advisable to have 75 5 frequent test and/or repairs made by a qualified person. 5 5 5 5 S 5 5 5 Sea, 5 5 5 5 1 of 1 55 This certificate may not be altered in any way and is validated only by the presence of a raised seal at the location indicated. o rrrJrJArr3crcrrJ� rJr�PrJr f- rJDI crrJ1 co 765-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION IST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] INSU TION [ ] FRAMING [ FINAL [ ] FIREPLACE & CHIMNEY REMARKS: LfJ DATE IN ECTO FIELD INSPECTION REPORT DATE COMMENTS .e s FOUNDATION(1ST) S C FOUNDATION(2ND) M z - o ROUGH FRAMING& PLUMBING 1 INSULATION PER N.Y. STATE ENERGY CODE -3 FINAL ADDITIONAL COMMENTS C O Z m � O c x S t _ _ TOWN OF SOUTHOLD PROPERTY RECORD--CARD b , OWNER STREET j '") VILLAGE DISTRICT SUB. LOT FGkMER OWNERHe,-MerlrC.,Qo„fJ! N f E� p ACREAGE S- ED. J?ovELLa S / W TYPE OF BUILDING RES. �!'0 SEAS. VL. FARM q COMM. IND. I CB. MISC. Est. Mkt. Value LAND IMP. TOTAL DATE REMARKS , `� a D Go o goo / 2o d % o a--t3- a- J ..3 2 ate S YJ.�yT-1 .�-T'v• Jl LL'4�' meg. j °l �L-5 ' G U N 0 (5 9 Lb i2 28/ 8 %is �iR. �sf of r?ovcrt�o %o f� C. gavrtlo 3700 ` q`7 e 2 ��0 —A,14//0 1551- oSbG+d AGE BUILDING C Dill 7 NEW NORMAL BELCF BOVE FRONTAGE ON WATER Farm Acre Value Per Acre Value FRONTAGE ON ROAD Tillable 1 BULKHEAD 9� /02- B a$Ffb adds-Nm Tillable 2 DOCK 1� Tillable 3 Woodland Swampland Brushland ,ew House Plot Total n■■Ji■■N■n■■■■■N NI�■�n■■■nni s■■n M. .. Foundat' _ Both Extension rFloors Extension Ext. Walls terior Finish a } Extension Fire Place Heat Porch Roof Type Porch Rooms I st Floor 3reezeway Patio Rooms 2nd Floor It- • •.- L S i0 �•rmer 0 r e Ro►a (c•a as) �Q a5s'l�� NORh` SURVEY OF PROPERTY H AT GREENPORT PS- ta TOWN OF SOUTHOLD N/off PAR�s" 1ze•6� 8 SUFFOLK COUNTY , N. Y. V ; 1000-Io-o5-1e H 76.p6♦0 E O SCALE : 1' - 20' r� NO OCTOBER 0. IM E,PE' Z SEPT. 25,20021coaa. Jadk J y_ l 1 p W � Y+J' ^ O f: In N CERTIFIED TO, ` LASKO LOS S ,{q �Vc�\E 1 A CARLAl GARY BBLASKO CONTINENTAL CAPITAL CORP. -:3 � FIDELITY TITLE INSURANCE 2 TA. COMPANY OF NEW YORK TITLE NO. FNT 3817501 LOT NUMBERS REFER TO MAP OF FLEETFIELD" FILED r .• `/L`V IN THE SUFFOLK COUNTY CLERKS OFFICE AS MAP o _Nf NO. 1351. M'c16 NEW YO L015 11 AREA - 15,166 sq.,ft. Ir y S75 N/p FE .1 rNF An AL-1 ?N JP AOD+➢ON TO THIS SlavE. S A 13-A9O° t+ JF to T 205 OF eE IrO •OPa PATE EDP,.CATION"AA i63/ ' 'E5`- $C[G FAX!63/1 765-3020 Ex.F- a SECIOO. T2N-SURDIV19i 2. AIL ERTF:^_A71 NC RE-i N, -"L :A,+O FGP .v:5 MAP AND iJPICS T`(EPEfF JN.v 6 �. (1. PiC-} fGP SAI( Vu CJP,E-q 9EAF TME +MPRE55EC SEAT OF 'ME SJR'+E'JR 230 /:P ELEF D PEE` AM, " '.A'IRE APPEARS HEREON - 98-33 TOWN OF SOUTHOLD BUILDING PERMIT APPLICATION CHECKLIST BUILDING DEPARTMENT Do you have or need the following,before applying? TOWN HALL Board of Health SOUTHOLD,NY 11971 3 sets of Building Plans TEL: (631) 765-1802 Planning Board approval FAX: (631) 765-9502 Survey www. northfork.net/Southold/ PERMIT NO. Check Septic Form N.Y.S.D.E.C. Trustees Examined 120 Contact: Approved 20_ Mail to: Disapproved a/c Phone: Expiration 120 Building Inspector 'ALICATION FOR BUILDING PERMIT L Date S 2 , 20� INSTRUCTIONS a. Thi pplic ` on MUST be completely filled in by typewriter or in ink and submitted to the Building Inspector with 3 sets of plans, ac 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 pursu t to the Building Zone Ordinance of the Town of Southold, Suffolk County,New York,and other applicable Laws, Ordinanc s or Regulations, for the construction of buildings, additions,or alterations or for removal or demolition as herein describ$d. The applicant agrees to comply with all applicable laws, ordinances, building code, housing code, and regulations, and to 4dmit authorized inspectors on premises and in building for necessary inspections. 6� & (Signature of- plicant or name, if a corporation) (Mailing address of applicant) State whether applicant ise, , lessee, agent, architect, engineer, general contractor, electrician, plumber or builder Name of owner of premises (S fLr / i ����(j Q..S �n (As on the tax roll or latest deed) If applicant is a corporation, signature of duly authorized officer (Name and title of corporate officer) Builders License No. Plumbers License No. Electricians License No. Other Trade's License No. 1. Location f lanon which proposed work will be done: /S 3� 1-naLylscm Ci— ; Y-e e�t7c�) r House Ntinber Street Hamlet / CountyTax Map No. 1000 Section �Q Block S Lot leg, Subdivision Filed Map No. I,ot�. (Name) -- 2. State existing use and occupancy ofremises and intended use and occupancy of proposed construction: a. Existing use and occupancy i CUL n(2 - Fr t rr)C(/Z[ b. Intended use and occupancy 3. Nature of work(check which applicable): New Building Addition Alteration Repair Removal Demolition Other Work At)nVe- C�,ML5rl � _ (Description) 4. Estimated Cost 2-750 Fee (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. If business, commercial or mixed occupancy, specify nature and extent of each type of use. 7. Dimensions of existing structures, if any: Front Rear Depth Height Number of Stories Dimensions of same structure with alterations or additions: Front Rear Depth Height Number of Stories 8. Dimensions of entire new construction: Front Rear Depth Height Number of Stories 9. Size of lot: Front Rear Depth 10. Date of Purchase Name of Former Owner 11. Zone or use district in which premises are situated 12. Does proposed construction violate any zoning law, ordinance or regulation? YES NO-2�, 13. Will lot be re-graded? YES NO-Y'Will excess fill be removed from premises? YES_NO)� 60-YL 4D } ��, �I 14. Names of Owner of premisesddress/S )I-4aAi n SPhone No. 4-7? - 36 2Zo Name of Architect Address Phone No Name of Contractor Address Phone No. 15 a. Is this property within 100 feet of a 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. 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) SS: COUNTY OFS/vfFoc�) �LZ (� �Q being duly sworn, deposes and says that(s)he is the applicant (Name of individual signing contract)above named, (S)He is the ow r z (Contractor, Agent,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 performed in the manner set forth in the application filed therewith. Sworn to before me this -da(`y o/f�20V Notary Public Signat e of Applicant ELIZABETH A STATHIS NOTARY PUBLIC,State of New York No.()I ST6008173,Suffolk County Term Expires A . s D 1 e •EURIFER AUTOMATIC MO MY9ALNTE• NO INTLRRT 1� FOOL CLEANER NI Rea SI49 FOR 12 YONTNB- 'r ' "'•SOLAR COYER ISA/ISAI Beg.w 5129 aft•THE ORIGINAL EZ GRAIN WINTER COYER NOR ONO)by.ro 5299 N OF ANY 46'Of 87 OLD POOL IN THIS AO No ombinable vdth an other o r CONCORD N �� � r A •tlmdw AIL AIUNINaR CUPLRO faa.N&m Raan6 t•t&E �� I141�. NZ •CaaplxeA�AIUMOIUN fegry amawds IY x IB'Oval_..._..$699 .........$898 IY x 18'Oval........$1999__.. 2198 WW*P*and 0eik IY x 24'Ovd............799._...._....998 •Inlpound Style Beaded Prim liwr •CREA. -A-POOL 15'x 24'04._.........e99........_1098 1.:........1399......._ 8 .Indu in W CMe L Iaddw OI ham u to 20 wall 5'.x 24' a ,Not aralloW In SeAu m ..........279 . • A, P pOttems IErx33,on, __......999............1198 IS'x 30'Ord..........2799............2998 6'Top wNh Girder Slam Uprfahn. IB'x33'Oral_.___1199............1398 FuNy Whmdxed Iinm and frame 18'x 33'04......._.2999............3198 Not availahle in Round PACKAGE PRICE 1 PACKAGE PRICE 12 Round •AayAHIII IRM......sl"My9....IIL163 s �� CHOICE OP F&-ma $� ��� 15'laand_........1899......_..:3098 B'Aaund..._....1999...��4198 21'Round.........2099........_....2298 24'Rou d..........2199 ' ......__.-2998 27R9und......._1399___,.-.2598 • e ` •LTD ® e • 30'Round._.....2699........_._2898 •CREATE-A-POOL On,from up N 20 w4l paaerm PAC l •Fully winterized liner and frame HILT 2 NP SMD FI I y v nrm r®eN •Not available in Smithtown •DELUXE F PC.CHEMICAL KIT • •DELUXE VACUUM KIT •7 PC.MAINTENANCE KIT •: Nw rembuiable wiai a other ower am -Pam 9"41810 IT Round.......... ...__. .• 11'x 18'Ovd........S1049.......$120 IS'Round............ ._.__ L i 12'Round 12'x 24'Oval 1349 ..1548 18'Rmmd.......... $•��� 16'x36'Ovd. 1549 ._1899 21'Ramd........_. YY++ 16'z 32'Ovd. 1699 .:.1898 14'Round......_..I • -CRN NU 18'x33'Oml. 1749 ..1918 17'Romd..--_.11 _ - AGE PRICE 30'Rwnd.._..._1 PACK PACKAG��_ • • • • ARaEEN Ronk --1 gzm rno $ 0 0 rtt v 0 Aa 1- 4r 306 a T 105 Z0Qr 0 n. "�O"'1 m 7D O � ^ AA' ='1 Z m :q n� ' No O1 m o , gig �+ BUILDING PERMIT EXAMINER CHECK LIST DATE REVIEWED: _/ /03 APPLICANT: 'DATE SUBMITTED: _/_/03 SCTM# DISTRICT: 1,000, SECTION: , BLOCK: , LOT: SUBDIVISION: ADDRESS: CITY: ZONING DISTRICT': CONFORMING? BUILDING PERMITS OPEN/EXPIRED- BP -Z/ C/0 Z- , INFO _/BP -Z/C/0 Z- , INFO BP -Z/ C/0 Z__' INFO /BP -Z/C/0 Z- , INFO PRE CO: Y OR N BP -Z/ C/o Z- , SINGLE & SEPARATE CERTIFICATION-REQUIRED NOTES: LOTS 40,000SF-100-24.Lot recognition.(CREATED before June 30,1983),UNDERSIZED JL41S,F dANA"17-W-25.Merger.(A nonconfonningat any time after 7/1/. REQ. LOT SIZE: ACT. LOT SIZE: REQ. LOT COV. ACT. LOT COV. REQ. FRONT PROP, FRONT REQ SIDE ACT. SIDE REQ. REAR PROP. REAR REQ. HEIGHT PROP.HEIGHT PROJECT DESCRIPTION: 1/U/ dL ESTIMATED PROJECT COST: AR ITECT/ENG EER: FAST TRACK WATER FRONT? DESCRIPTION: PANEL #: FLOOD ZONE: , COMPLIANCE: APPROVALS REQUIRED SUFFOLK COUNTY HEALTH DEPT: YES or NO, (BED #): DTE: / / PERMIT#: TOWN SEPTIC RECEIPT: Y or N NEW YORK STATE DEC: PRE-PEC 9/1/75 YES or NO SOUTHOLD TOWN TRUSTEES: YES or NO TOWN ZONING BOARD APPROVAL: YES or NO TOWN PLAN. BOARD APPROVAL: YES or NO TOWN HISTORICAL PRE (SPLIA): YES or NO NEW YORK STATE CODE COMPLIANCE (SEE PAGE 2): YES or NO NOTES: FEE STRUCTURE: FOUNDATION: SF FIRST FLOOR: SF SECOND FLOOR: SF OTHER: SF INIT OTHER TOTAL TOTAL: SF FEE FEE FEE 1. ( SF)- (_ SF)= SF X $ _$ +$ +$ _ $ _ 2. ( SF)- (— - SF)= SF X $ _$ _+$ _+$ _ $ 3. (-SF)- ( _SF)= SF X $ _$ +$ _+$ _ $ FINAL TOTA $ NEW YORK STATE CODE COMPLIANCE CHECKLIST USE/OCCUPANCY CLASSIFICATION: HEIGHT/FIRE AREA: TYPE OF CONSTRUCTION: DESIGN CRITERIA: ENGINEERED/PRESCRIPTIVE FULL FRAMING DESIGN ELEMENTS: HEADERS: Y/N WALL STUDS: Y/N GIRDERS: Y/N CEILING JOISTS: Y/N FLOOR JOISTS: Y/N ROOF RAFTERS: Y/N LUMBER SPECIES AND GRADE: Y/N DESIGN LOAD CALCULATIONS: Y/N SHOULD INCLUDE LIVE,DEAD,SNOW,SEISMIC AND WIND(INCLUDING UPLIFT AND EXPOSURE) WINDOW AND DOOR SCHEDULE: MISSLE TEST REQUIREMENTS: Y/N EGRESS, LIGHT, VENT: Y/N LOAD PATHS: Y/N ROOF TO FOUNDATION NAILING/CONSTRUCTION SCHEDULE: Y/N MEANS OF EGRESS: Y/N PLUMBING RISER DIAGRAM: Y/N LOCATION OF FIRE PROTECTION EQUIPMENT: Y/N TRUSS DESIGN: Y/N CERTIFICATION: Y/N ENERGY CALLS: Y/N TOTAL COMPLIENCE? Y/N (RETURN TO PAGE ONE)