HomeMy WebLinkAbout32507-Z
FORM NO.4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Office of the Building Inspector
Town Hall
Southold, N.Y.
CERTIFICATE OF OCCUPANCY
Date: 03/12/07
No: Z-32238
THIS CERTIFIES that the building INGROUND SWIMMING POOL
Location of Property: 95 VISTA
(HOUSE NO.)
County Tax Map No. 473889 Section 83
PL
(STREET)
Block 1
CUTCHOGUE
(HAMLET)
Lot 21
Subdivision
Filed Map No.
Lot No.
conforms substantially to the Application for Building Permit heretofore
filed in this office dated
NOVEMBER 15, 2006 pursuant to which
Building Permit No. 32507-Z
dated
NOVEMBER 21, 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 ACCESSORY INGROUND SWIMMING POOL IN THE REQUIRED REAR YARD WITH
FENCE TO CODE AS APPLIED FOR.
The certificate is issued to FREDERICK & CAROLYN LUBANSKI
(OWNER)
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL
N/A
ELECTRICAL CERTIFICATE NO.
4217
01/29/07
PLUMBERS CERTIFICATION DATED
N/A
~iZ:!:!!::-
Rev. 1/81
Form No.6
TOWN OF SOUTHOLD MAR 9..
BUILDING DEPARTMENT
TOWN HALL
765-1802
.{1),
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 I % lead.
5. Commercial building, industrial building, multiple residences and similar buildings and installations, a cel1ificate
of Code Compliance from architect or engineer responsible for the building.
6. Submit Plmming 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 Certilicate or 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 10 dwelling $25.00,
Swimming pool $25.00, Accessory building $25.00, Additious to accessory building $25.011. Businesses $50.00.
(2.. Cel1iticate of Occupancy on Pre-exIsting Building - $100.00
3. Copy ofCeI1ificate of Occupancy - $.25
4. Updated Certificate of Occupancy - $50.00
5. Temporary CeI1ificate of Occupancy - Residential $15.00, Commercial $15.00
Date. -Ir;~<../'1T OLo~
New Construction: .. Old or Pre-existing Building: _~'_ (check onc)
Location ofPropcl1y: ___9.5... ._.'-iL~li;] PI.... A e E Cu rz Ho ('~uE::) Nlj. /19.30._____
House No. Street II;nnlet
Owner or Owners ofl'roperty: _Ul(be:..f.,c "'-<. 0/ ~~(> '-'tN... Lu 6.BrlS J:.L_.
Suffolk County Tax Map No 1000, Section ___0.7.3_ Block _...L.._~.___ I nl
<:Z/
Subdivision
Pern1it No .3;'$07 L
Date of Permit.
___._ Filed Map. _'_'___,,,
Applicant:.___..~_.
Lot
Health Dep!. Approval: _...__
Underwriters Approval:
Planning Board Approval: _. ._....
Request for:
Temporary CertIticate._ ___.
FInal Certiticate:
./
____n__________
(check one)
Fee Submitted: $
~J.V.71 Fe ~
c.o "t 3.1J ,) ~
fL~~~.J~
Ap icant Signatur
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.
32507 Z
Date NOVEMBER 21, 2006
Permission is hereby granted to:
FREDERICK LUBANSKI
95 VISTA PLACE
CUTCHOGUE,NY 11935
for :
CONSTRUCTION OF AN INGROUND SWIMMING POOL IN THE REAR YARD AS
APPLIED FOR, FENCED TO CODE
at premises located at
95 VISTA PL
CUTCHOGUE
County Tax Map No. 473889 Section 083
Block 0001
Lot No. 021
pursuant to application dated NOVEMBER 15, 2006 and approved by the
Building Inspector to expire on MAY 21, 2008.
Fee $
150.00
~
(
{!LL
Authorized Signature
ORIGINAL
Rev. 5/8/02
SUFFOLK
:.:. I. [ f~ i C /~.
: N S P C (: T 0 f1: S,
BUREAU0'
40 Nottingham Drive, Middle Island, NY 11953
Telephone: 6314958136. Fax: 6319806455. E-Mail: SBEIGS@gmail.com
CERTIFICATE OF ELECTRICAL COMPLIANCE
Applicant: Raymond Electrical Contracting Corp.
Rough In Inspection Date: 1/13/2007
Application NO: 4217
Suffolk County Tax Map NO: 88 1 21
Final Inspection Date: 1/13/2007
Certificate NO: 4217
Building Permit NO:
This Certificate of Electrical Compliance is limited to the inspection and compliance of electrical equipment
and/or work descrjbed below, installed by the applicant named above, located at the premise of and not
,
after the final inspection date above:
Owner: Lubanski
Address: 95 Vista Place, Cutchogue, NY 11955
Address of Inspection Site: 95 Vista Place, Cutchogue, NY 11955
X Residential Indoors Basement Service Shed
Commercial Outdoors 1st Floor X Pool Other:
X New Renovation 2nd Floor Hot tub
Addition Survey Attic Garage
Inventory
Service 10 Heat Duplex Recpt Ceiling Fix HID Fix
Service 30 1 Time Clock 2 Switches Wall Fix Smoke Det
Main Panel Hot Water 1 GFCI Recpt Recessed Fix Co Det
8 Ckt Sub- Panel GFCI Breaker 1 Single Recpt Fluorescent Fix Pump
Disconnects Dryer Recpt Range Recpt A/C Blower Emergency Fix
Transformers Exhaust Fan Appliance A/C Cond Exit Fix
Twist Lock TVSS 1 Heat Pump Electric Heat 1 Pool Luminaire
Other Equipment: Pump and Pool Winterized at time of Inspection
The electrical work and/or equipment described above were inspected and appear to be in compliance with
local, state and national electrical code requirements and this office.
Applicant: Raymond Electrical Contracting Corp.
Inspected by: _ i/-'7,?surdi
Signature: ~
License No: 5414-ME
Date of Certificate: 1/29/2007
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TOWN OF SOUTHOLD BUILDING DEPT.
765.1802
INSPECTION
[ ] FOUNDATION 1 ST
[ ] FOUNDATION 2ND
[ ] FRAMING I STRAPPING
[ ] FIREPLACE & CHIMNEY
[ ] FIRE RESISTANT CONSTRUCTION
REMARKS:
n/
[ ] ROUGH PLBG.
[ ] INSULATION
P(l FINAL
[ ] FIRE SAFETY INSPECTION
[ ] FIRE RESISTANT PENETRAnON
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DATE 3 ~ 8' - (')7
INSPECTOR
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FIELD INSPECTION REPORT , DATE I COMMENTS
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OWNER
TOWN OF SOUTHOLD PROPERTY RECORD CARD
)1-8'
STREET C/5
V'S/A fj.'f:;c[
VILLAGE
DIST.
SUB.
LOT
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N
I . 52-
TYPE OF BUILDING
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wIfENC~ rf. BONNE
SEAS. VL
COMM. CB. MISe. Mkt. Value
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~ES. '.2 /6
LAND
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/2.(.1 j
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AGE
NEW
FARM
nllable 1
nllable 2
iillable 3
~oodland
;wampland
lrushland
~ouse Plot
--
'otal
5
FARM
IMP.
REMARKS
DATE
/
BUILDING CONDITION
NORMAL
BELOW
ABOVE
Acre
Value Per
Acre
_d
Volue
/
FRONTAGE ON WATER
FRONTAGE ON ROAD
DEPTH
BULKHEAD
--
DOCK
,
-~
I
>l !
., I COLOR
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TRIM 1'72
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2' \....., .....1 .,.
I I 21 4 . '
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M. Bldg. .26 x. 4'3 = 1-"4~ IA""~I 3'. 2-.s 417'1{)/ Foundotion ?~ Bath I 1)2- Dinette
" ,~.,,. i,.t:,
Extensian ID 'i( 13 =- \30) Basement T u LL..... Floors OAK K. I
-
Extension Ext. Walls wd S\~'i_':.S. Interior Finish -5 "K. , LR, \
Extension Fire Place Heat W\!\J BiS DR. ,
- ,
Type Roof GA~LE. Roams 1 st Floor <= SR. -::s
Porch ~>(\q,:,:\'4 .-50 5'7~ Recreation Room Rooms 2nd Floor FIN. B.
Porch Dormer
Breezeway { Driveway
Garage. :2-1 x 2.4- :::>o.'t.;:, I ' 2,..';' BeAI
11)( I'/,' =\43> ~ (..,4'7
-f>crtie...- ~ 18.l'/q~ c --'4:'<': JJ.C .
O. B. "'Ie, ;?SNJALt. IJc
Total S(""Sk,
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN HALL
SOUTHOLD, NY 11971
TEL: (631) 7q5-1802
FAX: (631) 765-9502
www. northfork.netJSouthold!
PERMIT NO.
3d- SO 7 c::::
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 Fonn
N.Y.SD.E.C.
Trustees
Contact:
Mail to: -SWln1 KIr1'~ fcx..)s
4-11 e.{ ~ z 5<:1 #2 ce:k.Lj fit-
11I.8
Phone: 144~'6loo
1(/1L-,20~
!11++-,2~
Examined
Approved
Disapproved ale
Expiration
'5 ~, 20-L2K-
._-~-"-~ . ,--
r (:'- i";
!
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I ;~
, .~
rC,,^ ~
Building Inspector
)\1 I 5' "'~
APPLICATION FOR BUILDING PERMIT
Date WoJiWlbx \0
,20~
INSTRUCTIONS
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 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 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.
"IMMED,l ~ TEL Y"
E~~CLOSE POQL To COJE
UPON COMP(cETK'N
BEFORE "VY" T CoR"
{!ctM
(Si alure of applicant or name, if a corporation)
CER~ IfIC/Tn>N Of . n
NAILING & CONNLClll)I'J~. 116 \l\st-a... r lo..a.. {.u.......iz.f1OgU.~
REQUIRED. (Mailing address ofapp Icant)
State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electriciim, plumber or builder
ovJ{\.e"f
u..bM6\"-.. ,,,-net CCll"ol fllAtf!:lckk /, B.p.n '5.:J.:S'ole:
(As on the tax roll or late~ed) 1)7.). f2Y: H:~.-:--
If applicant is a corporation, signature of dul~eE#AFlcATE NOTIFY BUILD iN::; C"P/ClTMENT AT
REQUIRED 765..1802 8 AM TO 4 PM FOR THE
FOLLOWiNG INSPECTiONS:
1. FOUNDATION - TWO REQUIRED
Builders License No. ,P-.' 4-';;2..\-\ OCCUP ANCY OR FOR POURED COc,CRETE
Plumbers License No. WFUL 2. ROUGH.. FRAMING & PLUMBING
3. INSULATION
Electricians License No.
Other Trade's License No. RTIFICA ~~J~LO~~~E~~T~;~T~~. MUST
OE nCCUPANCY ALL CONSTRUCTION SHALL MEET THE
I. Location of land on which propose~'fork will be aone: REQUIREMENTS OF THE CODES OF NEW
6 1610. r/Ia.u...RETAINSTORM' ~S if Nl1f1~~ONSIBLE FOR
House Number Street PURSUANT TO SEC': i
OF THE m:.N CO'~
Section () g ~ Bloc/(. '.. .' j
",1 Cu.-.Jct\o:)ae- Filed Map No:"
,;1,: ',"
(Name and title of corporate officer)
Name of owner of premises
htu...
Lot c!).. 1
Lot to
County Tax Map No.1 000
Subdivision~lfch H11[s
(Name)
.' .,t'.",,?!;" l'
2. State existing use and occupancy of premises and ~tended use and occupancy of proposed construction:
a. EXlstmg use and occupancy Sin 6 \<:: ~d'1 (-tS,tl.en.u.. ,
b. Intended use and occupancy 1(l~1 I 11~ {O"'-f1P pllol
I<+~l.ro M.
.
Addition
Other Work
Alteration
3. Nature of work (check which applicable): New Building
Repair Removal Demolition
(Description)
4. Estimated Cost -$/6;000'
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. If business, 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 construction: Front
Height Number of Stories
Rear
Depth
9. Size oflol: Front
Rear
Depth
10. Date of Purchase
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_
13. Will lot be re-graded? YES ./ NO_Will excess fill be removed from premises? YES_NO ../'
. C~OS"e
14. Names of Owner of premises heJ. Lu.oo.I\Gt..i Addresst16 '" I~ (\ Phone No. 12>4-- 110 <jq
Name of Architect L.W> JOhf\50'" Address 1\ oS uv.><<t1.t~ PS Phone No '331- ~l 05
Name of Contractor RAna.y--reocJedu...- Address 'kIt ~<.~6A- Phone No. ,44-'?'OO
~.lU-tP-+
IS 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.13MT
. =',~:~.~
16. Provide survey, to scale, with accurate foundation plan and distances to propert~ tines.
, ~<<...
'1J:~' .:.1:
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 OF )
~0J1.tLu. 1: Qoo..ecteY' being duly sworn, deposes and says that (s)he is the applicant
(Name of individual signing contract) above named,
(S)He is the
Co0\--{(l{{O ~
(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 knciW!ectge and belief; and that the work will be
performed in the manner set forth in the applica(iolt filed therewith:
Sworn to before me this
10 day of
'-
20~
KATHl.EEN QUIGLEY
NOTARY PUBLIC, State of New YOltc
No.01QU6124124
dUIlilIed In Suffolk County
Com/IllUillll Eloplm A/ll'Ilz5, 20~
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