HomeMy WebLinkAbout33309-Z
FORM NO.4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Office of the Building Inspector
Town Hall
Southold, N.Y.
CERTIFICATE OF OCCUPANCY
No: Z-32556
Date: 08/23/07
THIS CERTIFIES that the building INGROUND SWIMMING POOL
Location of Property: 205 GRANGE
(HOUSE NO.)
County Tax Map No. 473889 Section 75
RD EXT
(STREET)
Block 4
SOUTH/PEC
(HAMLET)
Lot 11
SUbdivision
Filed Map No.
Lot No.
conforms substantially to the Application for Building Permit heretofore
filed in this office dated
AUGUST 10, 2007 pursuant to which
Building Permit No. 33309-Z
dated
AUGUST 10, 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 ACCESSORY INGROUND SWIMMING POOL IN THE REQUIRED REAR YARD WITH FENCE
TO CODE AS APPLIED FOR.
The certificate is issued to KENNETH D. & SUSAN MICKALIGER
(OWNER)
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL
N/A
ELECTRICAL CERTIFICATE NO.
N-535157
08/31/00
PLUMBERS CERTIFICATION DATED
N/A
Signature
Rev. 1/81
Y\!\C\;/
Form No.6
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN HALL
765-1802
APPLICATION FOR CERTIFICATE OF OCCUPANfY
This application must be filled in by typewriter or ink and submitted to the Building DeJar.tm~t with the following:
AUG 2 3
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 2/1 0 of I % 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:
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
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 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. <("JJkD1
New Construction:
Old or Pre-existing Building:
cR 65 6r-0--f)~ R-d. {;ff .
House No. Street
I<ef\~ and :::\~ /1;{1cJ<rl11~(1
075 Block ODO t./ Lot
(check one)
3Dt1JJ)Dld
Location of Property:
Hamlet
Owner or Owners of Property:
Suffolk County Tax Map No 1000, Section
DII
Subdivision
Filed Map.
Lot:
Pennit No
Date of Permit.
Applicant:
Health Dept. Approval:
Underwriters Approval:
Planning Board Approval:
Request for:
Temporary Certificate
Final Certificate:
(check one)
Fee Submitted: $ 6/5. ~
~~
Applicant Si at e
6-..u. ,), I Y5
CO -c 3:155G
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.
33309 Z
Date AUGUST
10, 2007
permission is hereby granted to:
KENNETH D SUSAN MICKALIGER
205 GRANGE RD EXT
SOUTHOLD,NY 11971
for :
ACCESSORY INGROUND SWIMMING POOL IN THE REQUIRED REAR YARD
WITH FENCE TO CODE AS APPLIED FOR. (REPLACES BP #26698Z)
at premises located at
205 GRANGE RD EXT
SOUTH/PEC
County Tax Map No. 473889 Section 075
Block 0004
Lot No. 011
Building Inspector to expire on FEBRUARY ,2009.
pursuant to application dated AUGUST 10, 2007 and approved by the
Fee $
150.00
'-
Authorized S gnatu
ORIGINAL
Rev. 5/8/02
3330 c;.c-
1
TOWN OF SOUTHOLD BUILDING DEPT.
765.1802
INSPECTION
[ ] FOUNDATION 1 ST
[ ] FOUNDATION 2ND
[ ] FRAMING I STRAPPING
[ ] FIREPLACE & CHIMNEY
[ ] FIRE RESISTANT CONSTRUCTION
[ ] ROUGH PLBG.
[ ] INS~N
[~AL
[ ] FIRE SAFETY INSPECTION
[ ] FIRE RESISTANT PENETRAnON
REMARKS:
DATE
[/11D 7
INSPECTOR
'IELD INSPECTION REPORT DATE COMMENTS
==~=====================~========"=====~=================================================
~ It II
!L____JI______ __ _ _________________.___________.. -.-------~---------
" n.
II It
~--------~----~n. ., _, _' __n_n__nnn n_n___'_n__ ___nn,_ _,___no,
II II
[-------JJ------------- --------- --. - -~------- ------ -----------------~---- I--~
~----1: -----~--- -- -------.---.--------------------------~
II II
~--------il-------.--.- - -----,.~---_.---.-.- -------------.---------.--------.--.
;2~~!!2~~~~~i~~1~~~~~~~~~~~=~=~~~~~~~=~~~~~~~~====~=~=~~=~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
II II
n II
If- .Jl
II II
II II
Tf------JI
II II
II U
If-----~_JI
II II
II II
II
r U
II II
,,_____---.JI
II II
II 11
~=====~~~~~=~~~==========t,==~~~~~~W~=~================================~=====~=~~==~====~
II II
II II
.. II
ii II
II II
ft ~
II II
t- II
II II
II- II
11 II
II ~
II II
II II
~====~===========~=~====[=~~;t~============================================~========
II 11
It-- II
II II
I' II
I "I
II ~
~----<I
II ~
II II
II ~
==-======================1========&=======================================================
'OUNDA TI ON
( 1ST)
(OUGH FRAME &
PLUMBING
lNSUI.ATION PER N. Y.
STATE ENERGY
CODE
FINAL
:=========================================================================================
ADDITIONAL COMMENTS:
"'
'"
fi
>-<
>-l
~~
~
z
0&
"l
~~
~
~ ,~
~ ~
l
~{
?\
Eil
>
5~
[il~
"'
>-l
"FORM NO. 1
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN HALL
SOUTHOLD. N.Y. 11971
TEL: 765-1802
BOARD OF HEALTH ...............
3 SETS OF PLANS ...............
SURVEY ...................."....
CHECK .........................
SEPTIC FORM ...................
NOTIFY:
CALL . M'.f: ~~~~.....
KxaoUned.................. LO.... ~
Approved...:J.~::--.l........\-~::..::. Pennit lb. ..:2k.(;.~f.1...
Disapproved alc ..................................
MAIL TO:....................
....................................
....................................
........................................................... ...........
...(~ii~:G~
APPLICATION FOR BUILDING PERMIT
Date... ?/~'?....... 20.<<>.
INSTRUCTIONS
a. '!his application DUSt be ~letely filled in by typewriter or in ink and subnitted to the Building Inspector wil
3 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 pranises or J1lblic
streets or areas, and giving a detailed description of layout of property DUSt be drawn on the diagran ,,,hich is part of
this application.
c. The work covered by this application may not be C<JlIrenced before issuance of Building Permit.
d. Upon approval of this application. the Building Inspector will issue a Building Permit to the applicant. Such
pennit shall be kept on the premises available for inspection throughoot the work.
e. lb building shall be occupied or used in ....,le or in part for any purpose """tever \mtil a Certificate of
O:cupancy shall have been granted by the Building Inspector.
APPLICATI(}i( IS IEREBY MAlE to the Building Jlepartment for the issuance of a Building Permi t pursuant to the
Building Zone Ordinance of the Town of Soothold. Suffolk llimty. New York, and other applicable Laws, Ordinances nr
Regulations. for the construction of buildings. additions or alterations. or for rel1D\1al or danolition. as herein
described. The applicant agrees to'~ly with all applicable laws. ordinances, building code, hwsing code, and
regulat'ions, and to adnit authorized inspectors on premises and in building for necessary inspectioos.
(l&/u. y ;?oocs..LJf.,(".
.............................................................
(Sigpature of applicant, or name. if a corporation)
.f.9:. /J.t!!. .?i... &qm:1YJllc.~...
(Mailing address of applicant) /r I J1...-
State w:.ether applicant is a.nert lessee, agent, architect, erigineer, general contractor, electrician, plUTber or builder
.. ......... .... .... ...... .C;;@~:~.....~~.. .................................................
NatE of <Mler of pranises ............ /(,t:f!J.I!.}/97!... -r.. ..J.":cer.eJ?:I!.... .t1J(Gc.I9."(G:~.....................
(as on the tax roll or latest deed)
Builders License to. .... u. . 8:8.0. . ff
Plumbers License NO. .........................
Electricians License lb. ... r:.. : C. (Jr.. . ~ r
Other Trade's License to. ....................
I. location of land on .ttich proposed work will be done... ...Gfl./11:!ID6:.. .~... .t::Y:-f.?J!g(f!:'!.......
... .-t:~-?:............. .G".l!-!:J:>:'!YfL .@?&.?...I;)!I."............. .J2!.~ /.7m.yl?.?.0t.............
ibJse IUJher Street lIanlet
llimty Tax Map to. IlXXl Section. . . . ~7 .c . . . . .. Block ....... '-:f. . . . . .. Lot .... .Ii. .. . . . . .
Subdivision :..s:~nt...../t!fH.a~.../.~ Filed Map to. ....(l.t1>:'-... Int ...k?........
(NatE )
2.
State existing use and ""M'P"""Y of premi'M intended use and occupancy of proposed construction:
Exi . " , {/7/__T>iH" .
a. stIng use and occupancy .......... .... ....r.<t".v.~':'.'..r.rI.............. ...................................
b. Intended use and occupancy ...........1J.:6f. t. (?~.7J.tJh... .IN..V:1-/.... .L~.............
. ,.' '''f..l.>'j: ',.,."!1;:.( \,~~" .-v
__.1t..l'l.,;..i...;,q.....'\';'-r.1.1T
.
).
!'.Illlre of ""rk (died< "lid, applicable): New lkJilding .......... Addition .......... Alteration. ....r..
Herair ............ Ramval ............. llenDlition ............ Other lik>rk S':tRJ.*'-~.I.'h6..it.~f./.~t-
(Description)
Estimated (".ost ........ g@..~... fee ........... ... ..... ... ..... .:. ................
I..
(to be paid on filing this application)
5. If dl..,lIing, l1lJlber of dwelling mits ............ tlJrber of dwelling mits on each floor ................
If gar-age, IlLIl'>er of cars ......................................
6. If business, canrercial or mixed occupancy, specify nature and extent of each type of use......................
7.
I)irrensions of existing stnlCtures, if any: FronL................ Rear ............... Depth
lie ight ......................... tlJrber of Stories ......................
nh:rensions of sare stnICture with alterations or additions: Front................... Rear..................
Depth .................... lleight .................... tlJrber of Stories ...............
8.
OiIT~nsions of entire new CCKlstnK:tioo: Front................. Rear............... Depth
lIeight ......................... tlJrber of Stories .....................
9.
Size of lot: Front.................... Rear .................... Depth
10. Oate of Pllrd.ase ..................... Nare of Fonrer Omer ........................................
II. Zone or use district in ...ich premises are situated ..............................................................
12. llnes proposed collstruction violate any zoning law, ordinance or regulation: ........................
13.
II,.
Will lot be regraded .................... Will excess fill be removed froB prenises: YES Rl
Nares of Omer of prenises .~..f}1(r:!?1:U.(~ Address .W.bf!.~&.~. Phone lb.
Nare of Ardlitect .................. ...... ............. Address.............................. Phone lb. ..............
Nare of (".ootractor .. .f!-tlf.!4... ~.l.:I.....I?:r!.<:-:. Address . .I.'-f?:. ~<'Y.. ?f.. .t?f!!m~ lb. 'J/t.? :.SrQ.6
15. Is this property within 300 feet of a tidal ""tland? * YES .......... Rl..........
*IF YF..8, &uJ11J D 'l'CHl TRUSlER:; l'Il1t1IT MAY BE ~RElJ.
PLOT DIAGRAM
.
l.ocate clearly and distinctly all buildings, wther existing or proposed, and indicate all set-back dim>nsions
from property lioes. Give street and block rudJer or description according to deed, and sha.i street nanes and i"",icate
""'-..ether interior or corner lot.
UIMMEDIATEL VU
ENCLOSE POOL TO CODE
( UPON COMPLETION
JCtr ~
ApPR VrL . -.
DATE: '1\2\ <>1), 'J---
E: \ 5b F: ': ""'- -. - c- -
G 0-,_:"", ~--
~o'e P~~~I:!> _-
FOLLOWING INSPECTIONS
, FOUNDATION . TWO REQUiFiH.
FOR POURED CONCRETE
2. ROUGH - FRAMING & PLUMBING
3. INSULATION
4. FINAL - CONSTRUCTION MUST
BE COMPLETE FOR C.O.
ALL CONSTRUCTION SHALL M[:E i
THE REQUIREMENTS OF THE NY
STATE CONSTRUCTION & ENERGY
CODES. NOT RESPONSIBLE FOR
DESIGN OR CONSTRUCTION ERRORS
OCCUPANCY OR
USE IS UNLAWFUL
"IITHOUT CERTIFICATE
- OCCUPANCY
Sli\m (~, tI~ ~lK,
mJNty (w .. j. It: Eh>.4.(. .. s.<; UNDERWRITERS CERTIFICATE
..7Y~~111-.1+:':..1!/.. ../1.:(:1/0... :Jtt.:........ _ .being duly ~m, deposes and ~~~If~~t he is the applicant
(Hare of individual ~ignillg contract)
above n.-.red,
lie is the ...._......__........~~~.....................................................
(Contractor, .rsgent, corporate officer, etc.)
of said owner or owners, md is duly authorized to perform or have perfonred the said work rod to IIBke and file this
applicat ion; Lhal: all sLalenEllts contained in Lhis application are true Lo the best of his knowledge and belief; and
that the ""rk wi II be perf 0"",,1 in roler set forth in the application filed therewith.
flwom 10 before lie thi"
........I.~......day of
lbtary Public ...
v
'Sl
il..
cpm0
,
lDtll--fY\
STEP
APPUCA TlON
LIGHT
APPLICATtON
_IGHT
;:ENT€Rl;D
~" ~o
8" 60
2' 3'
6'
6'
3"
LIGHT .
CENTfREO 6
30
,
6"
6"
4'
w
,-
ocr
l-
t!)
f-
<X
'"
,
6
'7 LIGHT .
CENTERED 4
II'"
1)",
'J'
~
I
~
'0)
,
IX
~
G'
6'
6'
O~I
-or
.,. liGHT '
..--l CE'" EREO 6
~~E-.Il~~ 'l"(J'B ()
l!-i:.' l'AHl:LS
1-4' l""-III.IH"
..-6" II./J)[US CLlJUU:.x lAHe.L."I
L'iI-IUlACi:i
1-90. cOPn~c. CORtiF.K Sl":I"
I-H.'. Jl" r.oPING sTBAIG:il1: S;:;')
l.....mn. LINEll
NOI'E~ TYPoS' 0 POOL. INS"J".4.LLA-rJO.'" Of"
OlV/NG EQUIPMBNT IS p/fOttflUr,gn
16' J. '32.' RECTANGl.E
4' I~ - 6" PANELS T'r PE 11.
4 -4' PANELS
4 _CORNER PANELS
0' 2.0 - BRACES
I -90. COPING CORNER SET
l _ L6 )( 32 COPING STRAIGHT SET
I - VINYL LINER
8"
4"
40
IS' ... 36' RECTANGLE
14-6' PANELS lYPE lJ:
4 -4' PANELS
22. - BRACES
4 -COltNER PANELS
I _90C> COPING CORNER SET
I -18 X 36 COPING STRAIGHT
I -VINYL LINER
,_._....~-,...
.................:._".-._...._....~.." ,
.,.,
I ' B ----j -1. [-". A ---1
~ ~rTr=:=JJ
! '-. J_~l~l'
~EJ:F-t-G~H - -l~.--LL
NOlO: Diagonals given to
90~ point 01 comers.
SIZE A S C D E F G H J . l
14 X 28 14' 28' 7' 34 B' 12' 4' 4' 4'S 5' 3'S"
16 X 3 '6' 3Z 0' )' a '4 56 4'. 4". 7' 4'B
18'X 36 '8' ).' a 3'4 , ,.' S'6 "6 46 g' 4'.
zox 40 20' 40' 34 I ;j 7' 4' .' Il' 5'2
;t,L1.MIU4COl'
IAo,,",,_
f1a.Y!1'fA[!lE
,.H[L
r- 0 'i40CCH:lI(ll [((I(
. l"O' "lrl'calfo.",m.
"" .v.o..'rtF
I
5'
."
60
..T...........rc
un..._ -..
1.-..._....__.....01;...
.-......
,.,""'\I_..-.Ull........._'
-.- .--.
'.H~~:r~..=:.r;'..
....u....._....._.OCU..T....-.
.... '_'1: _u..........,...'
~Ir..'... .....~.,-
L_...r...._._..."'_..
_.._........rc.,II.(..n..._..TI.
SET
S'
6'
NOTE:
~
ALL CORNERS ARE 6~' RADIUS. EVERY
JOINT USEs A BRACE. AlL CORNER
SECTIONS ARE I' X I'.
L~4;~'..Ml'4EL
$11 H.PJ(lllIttl ,lIAt w...t. ........"
......."..... 11I41UI)1
PREOO-I
4"
5'
ObI'" ....u,
.......-...........-.........."....
.",......."'...,_..
_....NG ..u....c..
.O"r
ZO'1C 40' RECTANGLE
--
TYPE =
5'
16-0' PANELS
4-4' PA NELS
4-CORNER PANELS
24 -BRACES
1-90" COPlNG CORNER SET
1-20 )( 40 COPI"G STRAIGHT
I-VIN'H. LINEA
..,..........a....
a"Y".
RECTANGLE
nil 'IIOCIIU'II"O.~"'TI'" ,.IIIWOM$O.....
,..........~_.....-.._._.._..I.._..
... ...__-__ ....,..........._ t1._._.._..ch
..- ~....- ....... -,............-.....-.-...............,.
---...,....------..-............
""'......-- ""---...-.....-..--
.........~~_.......-..-..........
..........._ 1.._.......__...................--....
......-_1...............-- -_.--~
_.__fIl'__,.........-.---
1lOIl: lime :i.4imllli:a5 Uttlpl, 'M_ IItI lm::flJl S:u Ir4 f'e(lIlIIftk4e 'II\I~ ___ UI'41':S "I :UNUItJ :~ II ","". Ilolnl III ='dI'... '1611I lftI'
:11~~::::~=~:::~:~:I:::r:I~~::::.~:~~lt::~=..l!r:.'i=~s2~:.n~'==:a,:..,::\~~~
6'
00
6'
<',
,.....--
,
\
I
,10'- rM:1/-d/d/;'
__,., JI .
W"A:v-'::';"'-
I
~ I ~
~ I
~
, I
~I
, I
~! ,
'{\ i \)
"I ~
:l
. 1:
~ll .......
<, -~I
"""'< .e-4 /e:JP.tt:1&J'
I --1/ 5- e3'-Vo~w
ew.//
I 0..:::..:>9CE ~ ~~E#.PO.er
40T
f
\ ~
\,
\ '~
M..,./'fI ~ ~ ~
-- ~.c(0 ~~. on' 6n?"7"'~)
~CI<7d~.:>' ;':;;. /M.Y dq/7 .'-
6'1f".-9vc;E Rt1f-9.t? &-76'V~ew'
,
_~= 5CJ '..!'.d4d?-
i
~" \'",:~
i ~,
',<;;::)
~
\J
~
~
,
~
"
~
.
;, ;. ~
~ . II>
. '~
'." fl~
;/ . ~ I
,l .,\ h.
.,' Zz:.' '.t
-- ---
--", \
'\
\
\
{\
-IA/>/J;~euvy W-:.:'~WAW'~,W''''''.c-/--
..:~.o ~QA'W")>fat' ,
;;1<:,.,::J7h'-":)... N. Yo , !
- -I'
..b."C:..-,T/aA/' ~t:J,pr#.:J.tp, ~u,.~~ e'G\l.Wry, "v-y," I
~.~~/?A--;'" lc . :Je.tp"rNt:J&.P UW~;I &,~..:::' .;t hA";lI'/' ,,9A?'~/c~J7Tar /~x.':.e9NC~ 4.!~__.1
, . ---I
1)12d\7-2,1~~ ..
______.._,,_ ji-.~~~1;'<A..La//
;,.- <~.:
<Vo/tI
fj~
,
,
~s:
\.'
<;l
~
,L. ,. )(.... ....
.--'0
~
.;
-: (~~
~''''''
< ~~,~
X1 ~'d
"...,11[" :ti
~
L.",~T~ /0
,..,""p,,...-.-. ~JiY/N' .~~6""cx~,y
~,f/,l' 4#- 7e:JP,TN )I;u&;w'/1b>>e,7 -,L"'/,,:<:'N..,~7\t;
p".,nr'.v~"Cd';"e.a~ /jV-P'
~i!AM<!"'. /,,'-#4'
THE NEW YORK BOARD OF FIRE UNDERWRITERS PAGE 2
1185146 BUREAU OF ELECTRICITY
I" 40 FULTON STREET, NEW YORK, NY 10038
Dale }l.UGUST 31,2000 Application No. onflle 10783J.00/00 N 535157
THIS CERTIFIES THAT
only the electrical equipment as described below and introduced by the applicant ruuned on the above application number is in the premises of
KEN HICKALIGER, 205 GRANGE ROAD EXTENTION. SOUTHOLD, NY
In the following IoCtllion; D Basement D l,t FL D 2nd FL OUT Section Block Lot
was examined on AUGUST 22, 2000 and found to be in compliance with the NatiolUll Electrical Code. _
FIXlURE
0UTLE1S RECEPlACIIS SWI1CHES I
FIXTURES
FLUORESCENT OTHER
RANGES
AMT. IC.W.
COOKING DECKS OVENS DISH WASHERS EXHAUST FANS
AMr. K.W. AMT. K.W. AMT. IC.W. AMI. H.P.
DRYERS FURNACE MOTORS FUTURE APPLIANCE FEEDERS SPECIAL REC'PI. nME CLOCKS BELL UNIT HEATERS MUlTI.OUTlET DIMMERS
SYSTEMS
AMT. K.W. OIL H.P. "AS H.P, AMT. NO. A.W.G. AMf. AMP. AMT. AMPS. TRANS. AMT. H.P. NO. OF FEET AMT. WAITS
SERVICE DISCONNECT NO. OF S E R V C E
METER NO. OF CC COND. A.W.Q. A.W.G. A.W.G.
AMT. AMP. TYPE EQUIP. l' 2W l'3W 3'3W 3'4W .... OF ce. CONDo NO. OF HI-LEG OF HI-LEG NO. OF NEUJRALS OF NEUJRAl
OTHER APPARAlUS:
RAYNOR, FRANK L,
P.O. BOX 1065
1800 HARBOR LANE
CUTCHOGUE" NY. 11935
LIC.#4926
~ ,:,,-t ~ .....
)^ ,.~, .L:!..~\.
\, '1 ' .,., ,It'
[f 1 'tJ}.
? ,.,,' ' . r'
'/t ' / 1-.l':. <:~ ,'J~j"~ :
(
Ll2~
GENERAL MANAGER
Per
Thll certlllcate mUI' not be allered In any manner; return to the olllce 01 the Board "'ncortecl. Inlpectors may be Identllled by their cr_nllall.
~:"_4~
'" .
,
11 ,.\
~. '.
OOPY FOR ElUILDING DE ARTMENT. ''!'HIS COPY OF' CERTIFICATE MUST NOT BE ALTERED IN ANY MANNER.
THE
NEW YORK BOARD OF FIRE
BUREAU OF ELECTRICITY
40 FULTON STREET, NEW YORK, NY 10038
10783100/00
UNDERWRITERS
PAGE 1
1185146
I
Date AUGUST 31,2000
THIS CERTIFIES THAT
Application No. on file
N 535157
only the electrical equipment as described below and introduced by the applicant named on the above application number is in the premises of
KEN HICKALIGER. 205 GRANGE ROAD EXTENTION, SOUTHOLD., NY
in the following location; 0 Basement 0 1st FL 0 2nd Fl. OUT Section Block Lot
was examined on AUGUST 22, 2000 and found to be in compliance with the National Electrical Code. '
FIXlURE
OUTLETS
IECEPTACIIS SWITCHES INCANDUCE
FIXTURES
FLUORESCENT
OTHER
RANGES
AMT. K.W.
COOKINQ DECKS OVENS
AMY. K.W. AMT. !C.W.
DISH WASHERS EXHAUST FANS
AMY. !C.W. AMY. H.P.
1
;;
1
DRYERS
FURNACE MOTORS
FUTURE APPLIANCE FEEDERS SPECIAL IEC'PT. TIME CLOCKS
AMY. !C,W.
OIL
H.P. ~AS
H.P.
AMT.
NO.
A. W. G. AMr. AMP. AMT. AMPS.
BEll
TRANS.
UNIT HEATERS MUlTI.OUTlET
SYSTEMS
AMT. H.P. NO. OF FEET
DIMMERS
AMr. WArn
1
20 1
40
AMT.
AMP.
TYPE
NO. OF 5 E
METER
EQUIP. I' 2W I' 3W 3' 3W 3' 'W NO.OF..fRC.COND.
R
A.W.G.
OF ce. CONDo
v
SERVICE DISCONNECT
NO. OF H!-lEG
C
A..W.$.
OF HI-LEG
E
NO. Of NEutRAlS
A..W.W.
OFNEUTRA.1
OTHER APPARATUS:
SWnnUNG POOL-l
GFCI-l
'(SW1lnf.tNG POOL) This certificate
covers compliance at the date of
inspection only. Because of unusual
environments it is advisable to
nave frequent test/and or repairs
made by a qualified person.
<<<: Continued on Page 2 >>>
\ . - ( .. L ....".
~ ",,:. 'I"'~" ~ ",,<'f'"'
... ~ (' ,.l.,' . ." ~'
"j ~,' ., ... 1 - -J \ "..
. . , ~ f.
.. . L.l.~,. ^c"."
". -',
. ~ :-.. t \ ~} I . 0/
"f ,,- . '....' '. ,t
. ~ ;~
LlL
GENERAL MANAGER
...
>~
..........
~~
..
Per
Thll certlncote must not be altered In any manner; retum to the office of the Board If Incorrect. Inlpectors may be Identified by their credentials.
""\""
--:-'" 4-_ ~
COPY FOR BUILDING DEPARTMENT. THIS copy OF CERTIFICATE MUST NOT BE ALTERED IN ANY MANNER.
FORM NO. 3
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Town Hall
southold, N.Y.
BUILDING PERMIT
PERMIT
(THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL
COMPLETION OF THE WORK AUTHORIZED)
~'?,~O,
NO. ~Z Date AUGUST 2, 2000
Permission is hereby granted to:
KENNETH D MICKALIGER
PO BOX 1927
SOUTHOLD,NY 11971
for :
ACCESSORY INGROUND SWIMMING POOL AS APPLIED ~ WITH FENCE TO CODE,
at premises located at
205 GRANGE RD EXT
SOUTH/PEC
County Tax Map No. 473889 Section 075
Block 0004
Lot No. 011
pursuant to application dated JULY
Building Inspector.
10, 2000 and approved by the
Fee $
150.00
ORIGINAL
Rev. 2/19/98