HomeMy WebLinkAbout33275-Z
FORM NO. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Office of the Building Inspector
Town Hall
Southold, N.Y.
CERTIFICATE OF OCCUPANCY
No: Z-32509
Date: 08/06/07
THIS CERTIFIES that the building HOT TUB
Location of Property: 1400 DELMAR
(HOUSE NO.)
County Tax Map No. 473889 Section 127
DR
(STREET)
Block 4
LAUREL
(HAMLET)
Lot 16
Subdivision
Filed Map No.
Lot NO.
conforms substantially to the Application for Building Permit heretofore
filed in this office dated
JULY 23, 2007 pursuant to which
Building Permit No. 33275-Z
dated
JULY 25, 2007
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 HOT TUB ADDITION TO AN EXISTING ONE FAMILY DWELLING AS APPLIED FOR.
The certificate is issued to LYNN & ADRIENNE O'NEIL
(OWNER)
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL
N/A
ELECTRICAL CERTIFICATE NO_
3038295
07/06/07
PLUMBERS CERTIFICATION DATED
N/A
~
~ized Signature
Rev. 1/81
..
Form No.6
/., \ TOWN OF SOUTHOLD
~.. \ BUILDING DEPARTMENT
\ . ". . l TOWN HALL
\ \ jlj\.. 'L ~'. , '\ 765-1802
\. -, __::: ...::'~~iLICATION FOR CERTIFICATE OF OCCUPANCY
Th~;~~lled 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. Connnercial 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
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. JVlJi J 'i 2-dO
New Construction:
Old or Pre-existing Building:
/ 'fJ6 lJe)mqr- f);'yt3
House No. Street
( check one)
LaG/ref I
Location of Property:
;
,
Hamlet
L 1nn ani Ac/rle/J/le
Suffolk County Tax Map No 1000, Section J 2 7
Subdivision )'1dJ/J/J't it/lire! LiJlJ'l7ry Es t t(;S
Permit No. 33J.. 'l!:: Date. of Permit [-;).'::::, -I:)(
61J/e; /
Block (J 'f ,eM
Filed Map. S-Lf8'C:>
Applicant: L '1 n h
Underwriters Approval:
Lot OJe,. OM
Lot: 56
() '1fB; )
Owner or Owners of Property:
I,
Health Dept Approval:
Planning BmlrdApproval:
Request fof' Temporary Cerlificate
Fee Submitted: $
Final Cerlificate:
V'
(check one)
H &1 J[Q
.z; Applicant Signature
t-o -Z::: ~ a.. ":\ 0 \
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I, BY THIS CERTIFICATE OF COMPLIANCE THE I
~ NEW, YORK BOARD.. OF FIRE UNDERWRITERS ~
~ 8UREAU OF ' ELECTRICITY _ ~
~ 40 FULTON STREET - NEW YORK, NY 1 0038 ~
~ ' CERTIFIES THAT ~
~' ~
~ Upon the application of ' upon pretl]ises owned by ~
,~ ~-
ii1l LYNN B ONEIL LYNN O'NEIL fi!!
~ 20 HILL DRIVE 20 HILL DR ~
~ GLEN HEAD,NY 11545 GLEN HEAD, NY 11545 ~
1 Located at 1400 DELMAR DR LAUREL, NY 119481
~,3038295 3038295 ~
ii!I Application Number: Certificate Number: ii!I
,~ ~
, ~ Section: Block: Lol:, ,Building Permit: _ -BDC:, ns11 ~
,~ Described as a _ occupancy, wherein 'the premises electrical system consisting,of , ~
, ~ ' electrical devices and wiring, described below, located in/on th~ premises al: ~
, ~ Basement, hot tub & service, Outside, ~
~ ~
~ A visual inspection of the premises elect(ical system, limited to electrical devices and wiring to the extent' detailed ~
~ herein, 'was conducted in 'accordance with the requirements of the applicable code' and/or standard ~
~ promulgated by the State of New York, Departme~tof state Code Enforceme~t and Adminj?tration, or other ~
~ authority having jurisdiction, and found to be in compliance therewith on'the 6tb Day of July, 2007, ~
,~Name -- - 'OTY 'Rate Rating - Circui~' 'Tvee ~
@! Miscellaneous @!
~ as built-2002-GFI disconl)ect ~
~ for self contained hot tub + ~
~ 200 amp-service ~
'I ~~~i:~::td Devices I, 0 50a Pooll Spa I
@!GFCICircuitBreakerO 0 50a Pool! Spa, '@!
- ~ S,ervice - ~ :-' .
~' I- Pha~e 3W ~ervice Rating '200 Amperes ~
~ Service Discomlect: - I - 200 cb ~
~ Meters': I ' ~
~ Ail: as built inspe~tion, oftbe, delineated -ekctrical installat{on,' determined that an obvious ,hazard, is,n~t ,pre-sent and the installation- is believed, to ~
m:J he in comformancewith the applicable reference standard forthe estimated-period of construction of the- premises wiring system., ' - F.!l
~ ~
~ ~
~ ~
~ seal ~
1 I of I 1
'.1 This certificate may not be altered in any way and is validated only by the presence of a raised seal at the location indicated. 1
~ ~
..@].@]
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.
33275 Z
Date JULY
25, 2007
permission is hereby granted to:
LYNN & ADRIENNE O'NEIL
20 HILL DRIVE
GLEN HEAD,NY 11745
for
HOT TUB "AS BUILT" AS ApPLIED FOR
at premises located at
1400 DELMAR DR
LAUREL
County Tax Map No. 473889 Section 127
Block 0004
Lot No. 016
pursuant to application dated JULY 23, 2007 and approved by the
Building Inspector to expire on JANUARY 25, 2009.
Fee $
500.00
L.Cu~
( Authorized Signature
ORIGINAL
Rev. 5/8/02
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,ITUA TE. LAUREL
"OJI'lH, 5OI1THOLD
iUFFOLK GOUNT'(, NY
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JOHN C. EHLERS LAND SURVEYOR
6 EAST MAIN-S'rREBT :tr.Y.s. UC. NO. S{OO1
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TOWN OF SOUTHOLD BUILDING DEPT.
765.1802
INSPECTION
[ ] ROUGH PLBG.
[ ] INSULATION
~ FINAL
[ ] FIRE SAFETY INSPECTION
[ ] FIRE RESISTANT PENETRATION
DATE
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INSPECTOR # ~
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FIELD INSPECTION REPORT DATE I '. COMMENTS
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PERMIT NO. ?i9-1"{ e.-
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
nY.S.D.E.C.
Trustees
Contact:
TOW~ OF SOUTHOLD
BUlLBstNG D.. EPARTMENT
TOWN l . "LL'
SOUTHO , NY 11971
TEL: (631) 765-1802
FAX: (631) 765-9502
www.northfork.net/Southold/
Examioed
( ,20M
~20n1
Approved
Disapproved a! c
Mail to:
Phone:Eb-~ <'J ~. 3/ Y- '1
1~ ~ ,20~ /JCJ..L ~-Mr;^~cft(y-{\
~_ '. \ f'l- Bmldmg Inspector WeT I u.b hlf4.w J 0 c)Cu;f
---.; .\ t..uW/\ - ~ CW\ {Jd'
\: . .~ Jl \ . \ ~.btA.c.k. '{W\...~
\\ >', 50\. L" .'~ ~~ . ,0 APPLICATION FOR BUILDING PERMIT U
\,.J'\\.~../\_ ."~_ Date ~~ I}
b-,,;~ INSTRUCTIONS
Expiration
,20 d 7
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 adinit
authorized inspectors on premises and in building for necessary inspections.
Signature of applicant or name, if a corporation)
"IMMEDIATELY" JI,}} II / / jJ j /J/V
ENCLOSE POOL,TO CODE ALL CONSTRUCTION SHALL 2 () 11/ i / ,fJrlre . & / IJA 11C4 j 1/ //,)/fr
UPON COMPLETION M~ THE REQUiF'EMENTS OF THE . (Mailiog'address of applicant)
BEFORE 'WATER' . CODES OF NEW YORKSTAIE. .
State whether applicant is owner,lessee, agent, architect, engineer, general contractor, electrician, plumber or builder
(. .... .' ~M~"
APPROVED ,tJS ~!OTED
-
flU
Name of owner of premises
l hh a.n) r 7JJ1 {J"O
(As on the tax roll or latesfJifed) J ... p",
If applicant is a corporation, signature of duly authorized officer ~2T;FY BUIL?I,,::" D' \R7'~ENr /'.T
(Name and title of corporate off~g9IjPAt.tQ'(Q8 . ;~~-L~~~:I"~ ':;~"i>T~:;. n..::;~: FOR THE
U.SE ISUNLAWFU.L 1. F~ADATION .. TWO REQI,JrRED
. FuR POURED C:;,\ICF,E"F'
Builders Lie. ense No. IFICATE 2 ROUGH
Plumbers LIcense No. 3: INSULAT1~~:AMING & P_LIMB/NG
Electricians License No. OF ~(' r'i~ MCY 4. FINAL.. CONSTRUCiON ~IJST
Other Trade's License No. ND~.. . ~r.~:RTiFICATE BE COMPLE;: FOR e.o.
..... ' REOOlRgD" ~~~~~~MSTERUCTON SHALL MEET THE
1. . Location ofland on )3\hiC.P. propose9-rorJ<: will be'd6rie:' ;.. NTS OF TO:" CODES OFNEW
l~ 6 I../c!mqr L/NI//8 (7f//r<'J YQRK STATE. NOT RESPONSIBLE FOR
House Number Street Hamlet' , '. ERRORS,.
County Tax Map No. IpOO Sec~ipn
Subdivision LDlUre/ L()unTr
(Name)
Block {j '-1:-. (1 a
Filed Map No. o'f8'~
Lot a/(;.061l
Lot Sd
3. Nature of work (check which applicable): New Building
Repair Removal Demolition
4. Estimated Cost" I /, CI J.(.:1 (]
,
Addition
Other Work
Alteration
v
(Description)
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 construction: Front
Height Number of Stories
Rear
Depth
Rear
Depth
I1qi-fin
hUJe rJi'es, 7nc.
,
9. Size oflot: Front
10. Date ofpurchasel!t"1usfra, lOaf
;. '
Name of Fonner Owner
II. Zone or use district in which premises are situated
12. Does proposed construction violate any zoning law, ordinance or regulation? YES_NO v""
13. Will lot be re-graded? YES_NO / Will excess fill be removed from premises? YES ~ NO V
Phone No.
Phone No
Phone No.
14. Names of Owner of premises
Name of Architect
Name of Contractor
Address
Address
Address
15 a. Is this property within 100 feet of a tidal wetland or a freshwater wetland? *YES ~ NO v'"
* 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.
, 'A
.i'd~' ' , =it .~," i- 1, '
17. If elevation at any point on property is at 10 feetorbelow, must provide topbgriip'lilical dilta,on survey'):
18. Are there any covenants and restrictions with respect to this property? * YES_NO ~
* IF YES, PROVIDE A COPY.
STATE OF NEW YORK)
SS:
COUNTY OF !JjJ.SS,4u-.)
/" .. (1/". . be~!\quI)! ~'ti'JB\"~1P:qs~s~~ says that (s)he is the applicant
(N ~ e of IndIVIdual SIgnIng contract) above named, ,.,' '.,oJ ) ",]) ,: "''!:, ! :,,,) ''oJ ',;...' ",":
(S)Heisthe L iJ/J ()' AftlL J!fiW<,iH) ;, .... . i
- . ~ W ;Jf./< (Contractor, A&~hT,'c;€i1Jora.i~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 truetQJhe beslot.fus,knoWledge and belief; and that the work will be
performed in the manner set forth in the application filed there\'l~1fII\U~)3F
Sworn to before me this
17 day of
~:y~"~CES'C'AMf" ~ s~tZ!:P
'. tate 0 New York
No.01C15055531
. Q~aJlfled in Nassau County P
Commission Expires February 12, P\ t) liP
Town
of Southold
Erosion, Sedimentation & Storm-Water Run-off ASSESSMENT FORM
PROPERTY LOCATION: S.C.T.M. #:
I'COO ldoll h
District Section Block Lot
THE FOLLOWING ACTIONS MAY REQUIRE THE SUBMISSION OF A
STORM-WATER, GRADING, DRAINAGE ANO EROSION CONTROL PLAN
CERTIFIED BY A DESIGN PROFESSIONAL IN THE STATE OF NEW YORK.
----------------------------------------------------
Item Number: (NOTE: A Check Mark ( ~) for each Question is Required for a Complete Application)
-------------------------------------------------~-
1 Will this Project Retain All Storm-Water Run-Off Generated by a Two (2") Inch Rainfall on Site? ~ n
(This item will include all run-off created by site clearing and/or construction activities as well as all Site I..:::J
Improvements and the permanent creation of impervious surfaces.)
[J
Yes
No
""
2
Does the Site Plan and/or Survey Show All Proposed Drainage Structures Indicating Size & Location?
This Item shall include all Proposed Grade Changes and Slopes Controlling Surface WaterFlow!
[J '"
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3
Will this Project Require any Land Filling, Grading or Excavation where there is a change to the Natural
Existing Grade Involving more than 200 Cubic Yards of Material within any Parcel?
Will this Application Require Land Disturbing Activities Encompassing an Area in Excess of
Five Thousand (5,000) Square Feet of Ground Surface?
4
5
Is there a Natural Water Course Running through the Site?
Is this Project within the Trustees jurisdiction or within One Hundred (100') feet of a Wetland or Beach?
6
Will there be Site preparation on Existing Grade Slopes which Exceed Fifteen (15) feet of Vertical Rise to
One Hundred (1 DO') of Horizontal Distance?
7
Will Driveways, Parking Areas or other Impervious Surfaces be Sloped to Direct Storm-Water Run-Off
into and/or in the direction of a Town right-of-way?
8
Will this Project Require the Placement of Ma!erial, Removal of Vegetation and/or the Construction of
any Item Within the Town Right-of-Way or Road Shoulder Area?
(This item will NOT include the Installation of Driveway Aprons.)
9
Will this Project Require Site Preparation within the One Hundred (100) Year Floodplain of any Watercourse?
NOTE: If Any Answer to Questions One through Nine is Answered with a Check Mark in the Box, a Storm.Water, Grading,
Drainage & Erosion Control Plan is Required and Must be Submitted for Review Prior to Issuance of Any Building Pennit!
----------------------------------------------------
EXEMPTION:
Yes
l!!!
Does this project meet the minimum standards for classification as an Agricultural Project?
Note: If You Answered Yes to this Question, a Storm-Water, Grading, Drainage & Erosion Control Plan is NOT Required!
~
----------------------------------------------------
STATE OF NEW YORK, N~5,Jfu.-.
COUNTY OF .......7jf~.....;:..71........ SS
That I, ...~.~~/..~........... being duly sworn, de~oses and says that he/she is the applicant for Penm4
(Name of individual signing DoCt.lment)
I... /\;'II/f.'L
And thatGtshe is the ..... ..Cf.N./!/.......k!.... IV.. ....1......... ........................ .... ................... ...,................................................ ...........
(Owner, Contractor, Agent, Corporate Officer, etc.)
Owner and/or representative of the Owner of Owner's, 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 perfonued in the manner set forth in the application filed herewith.
Sworn to before me this;
....................../2................ day of '" ..
..............,2o.tl.:7
'\
, ~IJ Jl:IJ
............ . .........................................................
(Signature of Appllcant)
Notary Public: ....
JEAN E. CIAMPI
No.01'CI5055531
Qualified in Nassau County & J{)
Commission Expires Februarv 12, IF "
.
.
TOWN OF SOUTHOLD PROPERTY RECORD CARD
.
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_ OWNER
1'1-''1
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STREET
Im4l-' .[j.....'Ve.
VILLAGE
DIST.
SUB.
LOT#$"O
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ACR.
S
W
TYPE OF BUILDING
FARM COMM. CB. MICS. Mkt. Value
LAND
IMP.
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TOTAL
DATE
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tr Zl.r~
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dOl:?
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lad
(100
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AGE
NEW
FARM
BUILDING CONDITION
NORMAL
BELOW
ABOVE
Acre
Value Per
Acre
Value
Tillable
FRONTAGE ON WATER
FRONTAGE ON ROAD
DEPTH
IYCJ
Woodland
Meadowland
!
/f2
House.f!9t...,..
Total
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DOCK
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M. Bldg. ... ~ p .
ExtensIon I bD'1 r I!.:!! ..-
02/ X;;('-I 3z.~ 3(" ~ ~
Extension .
t. X (&' "^ 105' 300 ..3;;1.1-/ I
Extension
f,\ 12aX5D-n 3.b!J ,15 <17 Foundation PC. Sath Dinette
L)~ <: II( ::. ~
Porch Bosement F,)L L- Floors () F/I< K.
Porch Ext. Walls W.oD Interior Finish LR.
WIi1l-L BS>
Breezeway Fire Place No Heat ,Ii=' < DR.
Garage (p;<. f ~, .. C9o/ Type Roof I Rooms 1 st Floor SR.
~~ ('\(:<7' 7t>;A-rt>f:..<::9ioJ r 0 cJ
Patio Recreation Room Rooms 2nd Floor FIN. B
-
O. B. Dormer Driveway
14 k'J,6 I
Total ./
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ESTIMATES ARE FOR LABOR ONLY,.MATERIAL ADDITIONAL WE WILL NOT BE RESPONSIBLE FOR LOSS OR DAMAGE'
CAUSES BY FIRE, THEFT, TESTING OR ANT OTHER CAUSES BEYOND OUR CONTROL. . ' .J
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G:' into the warm, swirling waters of your Caldera. spa and
$i>~~~J'\.t1.yfeel the transformation begin. Offi",IH"T"b
KA6I~i'<3f'~.~..~tf~r the soothing comfort of Sponsor for
the exclusive Caldera hydromassage jets. Cares and stress
clisappear. Life's little aches 'Vld pains soon fade away.
Your Caldera spa can also!;lreathe new life and
into gatherings with family and friends.
Because when you come home to Caldera, you come to
life. It's your perfect way to feel better instandy. Anytime.
2
Wl:1YSo Many Choose Caldera
..,.....'.........
..... /
Caldera spa are perfectly positioned
to massage you right where your
body stores its stress.
Conveniently located controls
let you easily adjust the feel of
the jets to precisely suit your
needs. You'll receive just the right
massage in just the right places.
At the same time, high-performance pumps and
manifold plumbing assure strong and steady water
pressure at each jet.
And it's all designed to enhance the enjoyment of
your Caldera spa experience. .
Customize your massage
with the incredible
VersaSsage'" jet. Simply
adjust the nozzle position
for a direct stream or a
variety of rotating
paitiros and speeds.
The American
InstitiIreofStress
StresS reduction is an
iniporto11treason jofspa ~e~
Tlitit'swhy we are ;P'roudtdbe
the officio/hqttub sponsorof
the Americim I,1!fti!!f/~i.etff[i+;