HomeMy WebLinkAbout18265-Z FORM N0. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Office of the Building Inspector
Town Hall
Southold, N.Y.
CERTIFICATE OF OCCUPANCY
No: Z-32232 Date: 03/08 07
THIS CERTIFIES that the building
Location of Property: 3650 EUGENE'S ROAD
(HOUSE N0.) (STREET) (HAMLET)
County Tax Map No. 473889 Section 97 Block 8 Lot 6
Subdivision Filed Map No. Lot No.
conforms substantially to the Application for Building Permit heretofore
filed in this office dated pursuant to which
Building Permit No. 18265-Z dated JULY 6, 1989
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 AS APPLIED FOR.
The certificate is issued to MARY E. GILBERT
(OWNER)
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A
ELECTRICAL CERTIFICATE NO. N-235880 OS 15 92
PLUMBERS CERTIFICATION DATED N/A
A horized 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 Apri19, 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 [o 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 S25.OQ, 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: (check one)
Location of Property: ~ Q ~ ~4
House No. Street Hamlet
Owner or Owners of Property: ~
Suffolk County Tax Map No 1000, Sec on ~ Block ~ Lot ~i
Subdivision t Filed Map. Lot:
Permit No. ~r6oZ~J"~ Date of Permit. ~ 16 ~ ~ Applicant_
Health Dept. Approval Underwriters Approval:
Planning Board Approval:
Request for: Temporary Certificate Final Certificate: (check one)
Fee Submitted: $ a s , (1'0
l
pplicant Signature
eo ~3~32 _ _
roses xa s
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)
N°- 18265 Z gate 19..~~
Permission is hereby grouted to:
~~:~.......~........~a....l~~n......p....~ .
.....fit a ~ .`E:g
.
..~~cQ::...~-,c,...n~-:w.~.~.. i~w...:P..~...~r...sa.......~.....~~~,Q-rl..
at premises located ot ....w~..~5.a..........''!1•R*A.....F.-:~:.........•~rtrtir~•S,~M-Y.~M~`-~.........
County Tox Map No. 1000 Section Q9.~.......... Black Lot No.......Q~..........
pursuant to application dated ......~.~!,A•MA.....a-.~ 19a.~..., and approved by the
Building Inspector.
Fee s..l.~~.:•.'
L1..'...Q:'4 ~
Building Inspector
Rev. 6/30f80
ig~~s-~
THE NEW YORK BOARD OF FIRE UNDERWRITERS PAGPS 1
1165Q34 BUREAU OF ELECTRIGITV
85 JOHN STREET, NEW YORK, NEW YORK 10038
Dew NAY 191'1994 Application No. on file ~77Q9¢yQ~/1~)3 It ~4h`I I'9
THIS CERTIFIES THAT
only the electrical equipment oa described 6elafo and introduced 6y the applicant nomad on the obooe application number in the premLes of
NARY E. Y.t~'NN6DF, afi5@ RQGN;N~;i FF)., CIIRCNOCIIK, N.Y.
in the follouinq location; ~ Basement ? ls[ FI. ? 2nd Fl. QTI5 .Section Block Lot
9 6 y-+
uws examined on NA ~ 1 ~ 1 1' and found to be in compliance with the requirements u/this Board. $
FIXTURE FIXTURES RANGES COOKING DKK$ OVENS DISHWASHERS EXHAUST FANS
OUTLET$ ECEPTACLE$ SWITCHES ~NCANDESCENiFll10RE5CENi OTNEfl AMi. K. W. AMi. K.W. AMT. K.W. AML. K.W. AMi. M. P.
1 l
DRYERS FURNACE MOTORS FUTURE A?PIIANCF FEFDER$ $PECIAI RFC'PT TIME CUXK$ RHt UNIT HEATERS MULTI.OUTLlT DIMMERS
AMi. K. W. Oll H. P. GAS H. v. AMT. NO. A. w. G. AMT. AMP. AMT. AMPS. TRANS. AMT, fl, P SYSTEMS /JAi WA1T5
NO.OF iFET
t f
SERVICE DISCONNKT NO.OF S E R V 1 C E
MFTFR NO.Of CC. COND. A. W G. A. W. G. A. W. G i
AML AMP. TYPE EQUIP l~a'tW I,P OW DHOW 3$AW PER! OF CC.COND. NO. OF NI-LEG Of HbIEG NO. Of NEUTRALS OF NEUTRAL ~
OTHER AP?ARATUS:
SWINNTNG p00b-1.
RSCRPTA%LSS-71td.P' C.1.-1
'13WINNIN4; POOL) Th15 r,eeCificaCe
coveT~ ~omlllia?,,~e at: the da!.~~ .:~f
innpect.il~n only Pecriuse aF unusuiwl
env9tennents it. i.s .~dvl3sbie r.c ~
tract Frequent keatfand or cel;;~irs ~
made L•t a qui{l.if4ed treTSOn.
JOSEPH A. P6TERSER LIC.C~t42~"E E
S5 5I LVRR COT.T RD. 6ENERAE MANAGRR
('.UTCHOCUB, NY, 17935
Perl1
This certificate must not be altered in any manner; return to the office of the Board if incorrect. Inspectors may be identified by their credentials.
COPY FOR BUILDING DEPARTMENT. THIS COPY OF CERTIFICATE MUST NOT BE ALTERED IN ANY MANNER.
o~,~oe souryo
y~~
TOWN OF SOUTHOLD BUILDING DEPT.
765.1802
1 NSPECTION
[ ]FOUNDATION 1ST [ ]ROUGH PLBG.
[ ]FOUNDATION 2ND [ ]INSULATION
[ ]FRAMING /STRAPPING ~ FINAL
[ ]FIREPLACE 8~ CHIMNEY [ ]FIRE SAFETY INSPECTION
[ ] RRE RESISTANT CO.,NOSTRUCTION [ ]FIRE RESISTANT PENETRATION
REMARKS:
C r
DATE °2r °27 ~ ~ ~ INSPECTOR .is~,.-
765-1802
BUILDING DEPT.
1 NSPECTION
[ ]FOUNDATION 1ST [ ]ROUGH PLBG.
[ ] FOUNDATION 2ND [ INSULATION
( ]FRAMING [ L1'FiNAL
[ ] FIREPLACE A CHIMNEY
REMARKS:
DATE ~ 1 ~ INSPECTOR
~~~(P
765-1802
BUILDING DEPT.
INSPECTION
[ ]FOUNDATION 1ST [ ]ROUGH PLBG.
[ ]FOUNDATION 2ND [ ]INSULATION
[ l FRAMING [ INAL
[ ] FIREPLACE A CHIMNEY
REMARKS: ~--y c
:f
. ~
r
DATE ~ INSPECTOR '~1
:1~L0 I::SPc .iU.. ~~Jn:~ I~ C`vMMENT°
-a ~
1. m o0
a
H
_ y V
r'OUIJDATI01! (1st) ~
~
'OUNDATIOIJ
(2nd) _ _ m~~
z
o W
P,OUGH FRAME
PLUMBING
y
3. a
I17SULATIOII PER N. Y. . •
STATE ENERGY
CODE
4 . -s?U.r/ D y
FIIJAL ~
ADDITIONAL COMMENTS x 4
a ~ off- d- ~
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9
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m
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~ H
S
b
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ib
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STEP 2' WORK AREA
B I OPTIONAL AROUND L
~ g=0"FINIS`;ED DEPTH r3=4"~I~ISHED DEPTH
C
K D
~ -
G~F ~ E ~2" SAND OR
L8.2"EXCAVATION VERMICULITE C'cMENT
EPTH
D
S/LEA C ~ E F G H J K REF. PO/.VTS PDOLS BY P~U~ GU~L~
l6 X 3 2 /(o' 32' 3'b" 7'b" y' " 7' y'b., B , 3S' 9'
/bX3G /6' sb' 3'6" //6" /y' 6' 'f'b" 7' y'6" 8' 39' S70. RECTANGLE
' . , a a . , u „ , i ,
i9 x 6 /B ~ 36 36 /%G /Y r /o a y'b 7' Y'6 8 `10 3'~~ DATi 1-1 S'8'~ ORAwMi EY : ~.A./~
zo' yo' 3b' /3 /56 6 6 S /O' S 8' y'1 9
S:AIC fYONE CKO ~T: P.G.
' WATER CA>ACITT NO $T ED US. GAL.
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EUG Y~
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2~~3(i~E 6AaA5 a y
N 6A39 4~' dean a~a < MAP OF ,
Z DESCR/BED PROPERTY
N~
r ~
~ a,,~;E p~ AT CUTCHOCUE
vn C ~ ~
~ TOWN OF SOUTHOLO
- ~ a5, . ~ $ SUFFOLK CO., N. Y.
W nsll 4 e u n r
$
O i.. '
~ O E rn"c Apo\~i8~"~3..~ ~ -...a_ ..1I o.: _
rair ~ 1 ~ N
n ~~+'~~'~'I
Z. ~
~ OCCUMNC'r OR
r SN[061 ~ \
fi
s gip„ ` _ \ USE IS UNLAwfU~ -
~ ~ r ~ ~ wITi10UT CER'tiFICATE
~e _o,
~ ar cmw sVe ~ ~ ~
o _ ~R , ~ a^~RDYED AS NOTED
o .ann -
o ~pN-
~ ' n ~ onTE ~Y_Q._. s.e rr db zt
FEE /SD• ~__-pv
_ - o ~."n , j7, i~ N / F NOTit-v 6u~~ n~~d.- °nRTly>JENT Ar cE-RT/PIED TO:
y 4 705 181)2 rt ~ • ~ f011 THE THE D/ME SAVINGS BANK
,S. Rpog~'00"W 5 FOLLOWING ..%~Et7i.; T/COR T/TLE GUARANTEE CO
'j 5.00 1. fOUNOATiOfti - T~- -'?UIRN
FOR POURED Ct~"!~ FOR:
- 2- ROUGH PRA."~r1. p. ~-o'NG f GARY WATTS &
$ '.INSULJITION ~ BARBARA WATTS
4. HNAI - CONSTRUCTION iV+~57
' fE
C~OMpPIETE FOR C.C. -
, s ALL ra
V~NTRUCT~N SHALL MEET ~ nr~~r.-ar~AVS o~+.oaw ...o-en ~aesr anal
THE IIEOIJNIEIMENTS OF THE N.Y.
} E'D1?E OON=TINKra710N ~ ENERGY donack QSSOCIaf,@S
GOON. IIOr I~NOMgOLE FOR laid SurveyoB and
AREA ~ 72,129 ~ ~~ERflORB Can5u1t111Q~8R
6B2acRES 313 west main street
riverhead,new york U9Q1
. ' (516) 369-1717 (212) 746-
ANA I11~l~ ~t ~
r~rrt^ fi'r' 111Adf~ ' 1F1•rot~`+ f~'
B0,\RD OF HEALTH
FORtrt NO. 1 3 SETS OF L,1NS ~ ~ ~ '
SURVEY
TOWN OF SOUTHOLD CHECK .9t.S$fRl. ; S (.~O,OT~.. ' •
BUILDING DEPARTMENT SEPTIC FOR:1 • •
T06VNHALL
~OUTHOLD, N.Y. 1171 NOTIFY %7 p~--
o TEL.: 7G5~1302 CALL DC$~:~~.~q • , •
Examined. 19~°I t•1AIL T0:
.\pprovcd . l.. •~P, , , , 19 $9. Permit NoJ. 8 a~.s ~ •
Disapproved a/c D
• .AM t T~
(Building Inspector) ~~WN
APPLICATION FOR EUILDING PERMIT
• Date ~
INSTRUCTIONS
a. This application must be completely filled in by typewriter or in ink and submitted to the Building Insprtor, x
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 pub(ie;t
or areas, and giving a detailed description of layout of property must be drawn on the diagram which is part of chi;
.anon.
c. The work covered by this application may not be commenced before issuance of Building Permit.
d. Upon approval of this application, the Buildin; Inspector will issued a Building Permit to the applicant. Such pc
s~all 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 whatever until a CerIificatc of Occup:
` shall have been granted by the Building Inspector.
APPLICATION IS HEREBY 7v1ADE to the Buildin; Department for the issuance of a Building Permit pur-,::ant tc
3uilding Zone Ordinance of the Town of Southold, Suffolk County, New York, and other applicable Lams, O:d~•7W.c:
Regulations, for the construction of buildings, additions or alterations, or for removal or demolition, as hezei.•7 des:r.`
lice applicant agrees to comply with all applicable laws, ordinances, buildinc code, housin, code, and r=;ulat:ors, ar.:
=dmit authorized inspectors on premises and in building for necess spye~ctt s.
(Signature of applicant, or name, if a corpo:ation)
• •.Po3ox a14~~~o~Tt+~+rrlPror.~?.)Y
(Mailing address of applicant) . •l ~ Q b~
State •whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, p1umL•er o: built.
..............'RG Er~l'?-' .
\ameofoivncrofpremises ..aErTS~j...G•t•LPJ~RT
(as on the tar roll orlac~s[ deed) • • • • ~ • • • •
!f applicant is a corporation, signature of duly authorized officer.
• • • . • • (Name and title of corporate officer)
Builder'sLicenscNo......,`Z2~,,,,,,,,,,,,,,,,
Plumber's License No .
Electrician's License No. . • , , , , , , , , , , , , , , ,
OtlicrTradc's Liccnsc No .
Location of land on which proposed work will be done. ,3,~? . _ ~ (j ENS
house Number ~ Street ~ U~" • • • • • • • • • • •
Hamlet
County Tai \lap No. 1000 S~CtiOn . , ~ , , , , , , , , , : Block ~ ~
Lot.. O 1;
Subdivision F.iIcJ 11ap Yo.
(Name)
Lot...............
State c~isting use and occupancy of premises and intcnd~d use and occupancy oCproposcd constn¢tion•
a. Existing use and occupancy 51.17 ~N C~ _ . , , , , . _ • . • .
b. Intended use and occupancy . , 51 a S ~ ~T. , V I N 1,1 N ,~,W 1"vii"~~l'fl I h76 . •~o O L -
. ...i..... .
i
. r•,
3. Nature of work (check which a
Repair , , • , • PPlicable): t`''cw 11ui1Jin
• Removal g Addition .
Demolition •Vt_:atton
4• Estimated Cost . Other ll'ork .
If dsvcllinS, nutnbcr of Jwclling units • . • • • . • • • • • • ~ - • ~ • "
If gara:c, number of cars • • • • ito be paid on Tiling thi; aPplicatto
6. IC • Number oCdwclling'ttnits on each floor.. • •
business commcrual or mixed occupant • • ~ • • ' •
7. Dimensions of existma.Stzuctures, iC an ) specify nature . ~ • ~ • • • • • • ~ ' ' ' ' ' " • • • • • • • . • • • • ~ •
t' Y: FROnt . and extent of each type of use .
~~i,deri#io~n~....~', 5~~•~(? Number of Stories , Rear , • • • • .
~ s7riseturc with alteration DcPth .
(5th soradditions:Front..•••~~•~~
' 8. i~ttcn Ilcicltt Rear
eight~~cly construction: Front • • • • • Number of Stories . • • • • • ~ •
9. ~j.. Number of Stories Rear ,
10. ate~~~'" ' Depth
r...;,t Rear ~
11. ne or use district in
~e~ Depth . -
.......Name of Fot-mcr Owner
l.. Does ro Premises arc situated • ~ • " "
P Posed construction eiolate any zoning law, ~ ~ • • • • ~ ~ ~ • •
13. 1l'ill lot be regraded ordinance or regulation:
!4. NamcoCO~vnerofprcmiscs.•~•~~••--~ .ll'illcxccssfillhcrcmov.•.~•~~~•••••••.••..•-.•
Name of Architect • ~ • • • ' ' ' • • • • • • .Address , cd from premises: • • .Yc: • •
Name otContractor ..................Address Pltonc No, • •
15*Is this property located• .............Address.......•'•"•""'•PhonrNo............
If yes Sou vitltin 300 Fect of~ a tidal ~„~~"'Phone No...
> thold Tovn Trustees Permit may be requiredetland. *yES-,.,tip
Locate clearly ~ - PLOT DIACR,ID1
and disti.•rctly all buildincs, whether existing or proposed
property Lines. Git•e strew and black number or description according
interior orcorncrlot. and•indicat_ alt set•bacl: dL:.r-:
e to decd, and show street names and ' ~ ton;
rndct..tc wnc
TATL OF \ElY YORK,
~UXT1' OF S.S
. • . - .(~~..r~~ of individual signing contract) • • • ~ • ~ • being dul swo
~ovc named. ' ' Y rn, deposes and says that he is the aPPlicar
is tltc . •
..........................~G'Yl2 ~ .
said owner or otvncrs, and is duly autltoriud tto pcorfo rmnor lorvc pcrformicd'tttccs,id •sv • - • . • • • • • . • . • , • • • • •
~lintion: that all statcincnts contained in this application arc true [o the best of his knou'IeJge anJ bclieC•
rg wdl be performed in tltc manner set forth in the application G1cJ thcrcwitlt• or), and to make and file thi:
°m to heiorc me this .and that the
.....a.7~.....
O _ _ _ 19~.~.
~a~; Pu~bli~~,~
4% ~-~d-U~O.~~ ~~~y...... County:
~Y ~
~ ~COOPEp lbrt • • .
` ~~a6Dsan81~1~~
U i •(Si^narureofapplicant)
6 ~ .
• It
F
H
A ~~F• ~ A
T
STEP 2' WORK AREA
i OPTIONAL AROUND l
~ g=O"flNiSl-IED DEPTH r3=4"~IIVISHED DEPTH
C
K D
-
~~-F--~- E ~2" SAND OR
s=2'EXCAVATION vERMICVLJTE C'cMENT
pEPTH
S/ZE A C ~ E F G H T K REF. PO/A/TS POOLS By /~HUL GU~«
iGX32 /b' 32, 3'b" /y' , y'b" 8' 3S'9'
/bxac 3e' 3'b" /ib" /y' 6' Y'b" y'b" 8' 39' STD. AECTANGtE
igs 6 /B' 36' 3'b" /%G° (o, yob" 7, y.b" 8~ ~i3.~
20' y0' 3'6" /3' /5 (r" 6' 6" S' /O' S' 8' '15/'9" DATA 1-1 S-8^/ ORA`~? t'I : F.A.
ZO' S:ALE NONE CKO •T: PG.
~ WATER CADAC~TT NO $T EP tiS. GAL.