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Home My WebLink About32486-ZFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY Noe Z-32985 THIS CHRTIPIHS that the building ADDITION Location of Property: 1565 JACOBS LA SOUTHOLD (HOUSE NO.) (STREET) (HAMLET) County Tax Map No. 473889 Section 79 Block 6 Lot 4.3 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. 32486-Z dated NOVEMBER 15, 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 SUNROOM ADDITION TO AN EXISTING ONE FAMILY DWELLING AS APPLIED FOR. The certificate is issued to JACK H & KAREN M THILBERG (OWNER) of the aforesaid building. SIIFPOLR CODNTY DEPARTMENT OF HEALTH APPROVAL N/A ELHCTRICAL CHRTIFICATH NO. 3013488 11/06/06 PLDMBSRS CERTIFICATION DATBD N/A \, on ed Si ature Date• 04/16/08 Rev. 1/81 FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. OF OCCUPANCY No: Z-32986 THIS CSRTIPIHS that the building ACCESSORY Location of Property: 1565 JACOBS LA SOUTHOLD (HOUSE NO.) (STREET) (HAMLET) County Tax Map No. 473889 Section 79 Block 6 Lot 4.3 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. 32486-2 dated NOVEbIDER 15, 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 AS BUILT ACCESSORY GAZEBO, DECK AND FISH POND FENCED TO CODE AS APPLIED The certificate is issued to JACK H & KAREN M THILBERG (OWNER) of the aforesaid building. SIIFFOLR CODN'PY DHPARTMHNT OF HBALTH APPROVAL N/A SLSCTRICAL CERTIFICATB NO. N/A PLDFBHRS CBRTIPICATION DATBD N/A Aut q ize Si ature Date• 04/16/08 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 Plaiming 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 ofOccupancy - $.25 4. Updated Certificate of Occupancy - $50.00 5. 'T'emporary Certificate of Occupancy -Residential $15.00, Commercial $15.00 Date. ,-~'/-~J~~f/ f~~' New Construction: Old or Pre-existing Building: (check one) Location of Property: /~'G'~ 3H ~ TJ lrfs ~ R ~~ s~~71/OL House No. Street Hamlet Owner or Owners of Property: J~A G !C ~- e~Lf R l~ ~~N// ~L~~Lr Suffolk County Tax Map No 1000, Section 7/ Block Subdivision Filed Map. Permit No. 3~ ~~ Date of Permit. ~~-~ 5 ~~~ Applicant: Elcdth llept. Approval: Plamxing Board Approval: Request for: Temporary Certificate Fee Submitted: $ Underwriters Approval: Lot Lot: Final Certificate: (check one) sw„~ ~~o,i, ~-~ ~ ~~a~t~s r~ ~ ~~I(35 ~~crr~°(~s'. ode, 6-~~e~o ~'~a,~ +--fi~~ ~or~ C~~u >~tt~~vf:~cl1 ~:~~~~~~ App icant Signature ~ c.~y ,yam FORM NO. 3 TOWN OF SOUTHOLD BUILDING DEPARTMENT Town Hall Southold, N.Y. BUILDING PERMIT PERMIT NO (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) 32486 Z Date NOVEMBER 15, 2006 Permission is hereby granted to: JACK H & KAREN M THILBERG 1565 JACOBS LANE SOUTHOLD,NY 11971 for CONSTRUCT A SUNROOM ADDITION ON THE REAR OF A SINGLE FAMILY DWELLING AS APPLIED FOR. THIS PERMIT REPLACES BP 24606. ..J -(~ -UC~ ~~ ~ "~ ca'ic~~ Q~C,L'.l.y U C`~tZ-C.~.~', V <,LL ~. ~..L,p~ ~ ~'1 C'k at premises located at 1565 JACOBS LA SOUTHOLD County Tax Map No_ 473889 Section 079 Block 0006 Lot No. 004.003 pursuant to application dated NOVEMBER 15, 2006 and approved by the Building Inspector to expire on MAY Fee $ 75.00 15, 2008_ ORIGINAL Rev. 5/8/02 FORM N0.3 TOWN OF SOUTNOID BUILDING DEPARTMENT TOWN NALL SOUTHOLD, N.Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) 3=~`/fr7r ie v ~,,,, ~~ Date.....JAI1tIJARY........1.5 ........................... 19...9.8.... ~Y°~ Z Permission is hereby granted To: ....... J.AGK.,.H...&...KAREN...t7...Tli I LBERG .................... .......1565...) ACIIBS..LAME ........................................... ....... SOLISHOLD.,.N.Y...1197..L ........................................ to .....CIIMS7LlCT...~..SUNRTIOM..(aDA1T.EIIN...OAt...T.HE..REAR...OF....m..SZAIGLE...F.l1M.I.LY. .........DkIELL.I.NG.. AS.. AF'P.. Li ED.. F. aR ........................................................................................ of premises located aT ................1.Sb.5.....JACABS..LA. SA U.T. HA 1,i1........... ................................................................................................................................................................ County Tax Map No......4.7..3889,,,,,, Section ...Q.7..9 .............. Block .....QQ12l~........ Lot No..QQ4.,,.0.0~.... pursuant to application dated ... DE:,CEM)~,lrF:,,,,, 15,,,,,,,,,,,,,,,,,,,,,,,,, t 9..... 9~...., and approved by the Building Inspector. Fee S........75 ., 00..... ~ Rev. 6!30/60 BY THIS CERTIFICATE OF COMPLIANCE THE NEW YORK BOARD OF FIRE UNDERWRITERS BUREAU OF ELECTRICITY 40 FULTON STREET - NEW YORK, NY 10038 CERTIFIES THAT Upon the application of upon premises owned by JACK THILBERG 1565JACOBSLN SOUTHOLD, NY 11971 Located at 1565 JACOBS LN SOUTHOLD, NY 11971 Application Number: 3013488 Section: Block: Lot: JACK THILBERG 1565 JACOBS LN SOUTHOLD, NY 11971 Certificate Number: Building Permit: 24606 3013488 BDC: ns11 Described as a occupancy, wherein the premises electrical system consisting of electrical devices and wiring, described below, located in/on the premises at: Firs[ Floor, A visual inspection of the premises electrical 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, Department of State Code En forcement and Administration, or other authority having jurisdictio n, and found to be in compliance therewith on the 6th Day of November, 2006. Name ~ Rate Ratine Circuit Tvoe Miscellaneous sun room with one recpticle for self contained hot tub Wiring and Devices Receptacle 1 0 GFCI Switch 1 0 General Purpose Lighting track 3 0 ft Receptacle 1 0 20 amp PooU Spa seal 1 of ] This certificate may not be altered in any way and is validated only by the presence of a raised seal at the location indicated. ~z~~~~ TOWN OF UTHOL ILDIN ,DEPT. 765.1802 ~ 1 NSPECTION [ [ ]FOUNDATION 1ST [ ]FOUNDATION 2ND [ ]ROUGH PLBG. [ ]INSULATION [ ]FRAMING /STRAPPING [ ]FINAL `~- / ~~ ] FIREPLACE A CHIMNEY [ ]FIRE SAFETY INSPECTION REMARKS: ~~ e~ .4S ~- zoo /1~c~ 1~' ( 'r ~r c9-~ 1J ~~ ~~ Wit. DATE l l ~ INSPECTOR 1' 11:1.11 I Il:i 1'lilf f 1 uu uv rrr.r ~.~ -' uw rc \~ ~ 'n. 1 I~UI!t111 A'I"lQll^^~~(1tIU )~~ ^ ! v1 1111111:11 F1l nlll! /, _.z p 1'1.!11111 11111 r -' .....~......~.....,....., ~.~.... ~.,~........ .a. .......... ......~n.............+~........~.............. ~........~ ~~....~..........~..~~.......... n....... 1111:;111,n'I'I1111 I'I'.Il 11, T. • ~ _ ~. r -~ I ___...-_ !1'1'A'I'1! I!I1I; I111Y , '" Clllll! / i /r ~ • ~ ~ ~ ~: Fry/t . P 1 Ilnl. ~~ ~~ s , .. ' ....~.., ~...... ~.... _........._..._ ~ ~ nllll l'I'Itllln 1. C(ll ltil;l l'I'!11~A ^~(}'_3~ /]~~Q ? ^ ~ .~ d e i-n ti a.c!,c~ t. O ~ W i~ ~ ~ - - ~ ~ . 1 , 1 -I - 1 I 1 1 I f r .1 !r!!ri.a •." M R D FOEM N0. I D 1'1 LS TOGN OF SOUTl10Ln BUILDING DEPARTMENT TONN MALI. SOlITU0L0, N.Y. 11971 T~ 765-1802 BLDG/. DCEPL ;i; lixanined. ~,,.,,1~~./~.. ~., 19.... ~~ /' Approved.. !l.,l ~~t~, 19.... Permit No . ... .......... nisapprweded a/c .................................. ................. ... IArilding Inspector) ICAI'i0N FOR 6UiLDING PERMl'f INSTRUCTIONS EOARD OF HEAi.TH ~........... ' 3 SETS ........ ..... . OF ~i.ANS . / SURVEY ............... CIIECR .~.1).Q~ ................ SEPTIC FORN .. ................. NOTIFY: CALL . ~~.v '.. ~.ol . MAII. TO :.................... Date.. /.5... ~C~ ~'.. , 19.97 a. 'this application oust be caq~le[ely filled in by typecvri ter or in ink and submitted [o the R~ilding Tnspector wi tF 3 sets of plans, accurate plot plan to scale. Fee according [o scJxdule. b. Plot plan shoring location of lot and of buildings on premises, relationship Co adjoining premises or public streets or areas, and giving a detailed description of. layout of property mist be drawn on the diagram which is par[ of this application. c. 'H~e work covered by [Ilia application may rot be camm~cecl before issuance of Building Permit. d. Upon approval of this application, the 1luildifg inspector will issue a Ruilding Permit Co tlm applicant. Such permit shall be kept on the premises available for inspection througlx:ut tt~e work. e. No building shall be occupied or used in wlale or in part for arty purpose whatever until a Cec[ificate of Occupancy shall have been granted by tl~e Building Inspector. APPI.ICAPI(N IS 11ClZEEY MADE Co the Building Department for the issuance of a Building Permit pursuant Co [he Building Tone Ordinance of the Town of Southold, Suffolk County, New York, and other applicable laws, Ordi~nmces or Regulations, for the caistruction of Ixrildirgs, arklitions or alterations, or for rerwal or demolition, as herein described. The applicant agrees to ca~ly with all applicable laws, ordinances, building code, housing code, and regulations, and to admit authorized inspectors on premises and in bull 'ng for necessary inspections. S' Cure of applicant, or nape, 'f a corporation) SSG ~.:? ~G.aB~: L R.. 1.(Tf!alD. ~!//9J/ (Mailing address of applicant) State whether applicant is owner, lessee, agent, arrl~itect, engineer,general contractor, electrician, plunber or builder. Name of owner of premises ~J f7G.~~.?:':.~/.`1'e~'~^:.... f ~l~r:~~n1T ............................................ (as on tt~e tax roll or latest deed) If applicant is a mrporaCion, signature of duly arttarized officer. ......................................................... (Name arcl title of corporate officer) Builders License No. .~:3 ./. $ . 7,._~1,. Pl~nbers License No. ....... ................... Electricians i.icense No . ..................... Other Trade's License No . .................... I. location of lan[1 on wi~icl~ proposed work will be done .............................................................. ....~ S~.S ...............~F714.~5...1 9.........................~P..LLT~vIb............................ lkxrse Nunber Street q // ~~,,yyHanlet Cau~ty Tax Map Nu. 1000 Sectiu~ ..e~ /......... Block .... X!......... Int .Y~..~j~.'.~.... Subdivision . ~~?QLC>L.~~.. F~.`T.~z'T.~:S.. Filed Map No. vR4,J.5'4....... lot ....3 ........ (Name) 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy ......Q ~./.~..T.~A..JIt'f ~j,,,/~/C 1/5~ .............................. ~ 'A4.M102 ..................... h. Intended use and occupancy ......... ~ 11. J QN......... ,yrpy. I T1' :pnq Yhuio.•, •• 'r'~r Y nr AroN;~< nr bs;p,;r,,O~ f6udtKr-~,. ~p a=1 ./Eye;,+, z~,,,~, -3 m.~T _. _._ _: 3. Mature of work (deck whid~ appticahle): Nrv 1h~ilding ......._.. Acklition .~....Altera[)on~' -::1..:1 /" f Itelxiir ............ Rrnwal ............. Uemli[iai ............ Other Work .................................'~.li (Oescr)p q' 4. EsCiun[ed Cost ..Jl. ~2. O b O.C........ Fee .•~~ `a :.' .. (lo be paid on filing this appaea~--- --,~ I ~`l , Ci.`1 5. if ~hxlling, ~xniier of dwelling units .......__... lirdx:r of chaelling cmi[s on eadi:Fl~,~.AJ^c r "-' ,~;,;",'.M7f If garage, cxnber of cars .............. ........................ 6. If Ix~siress, canrercial or mi~md occ~ipancy, specify nature and extenC of eadi type of use ...................... 7. Ilinensia~s of existing s[nxaures, if any: Front ............... Rear ............... ikpth ................. IleigliC ......................... Number of Stories ...................... Dimensions of sere s[xucture with alterations or additions: Front ............... Rear ............... I)epU~ .................... IleiglLL' .................... Nni~er of Stories ............... ~ )i pp ~ ;~ 0. Dimensiau of entire new conseruction: lrront ... /..~•........ Rear ............... Depth . O..G........ u Ilei(~LL ...~.~ ............... .. Nui~er of Stories .... ~............... 8 0.`........ Rear ....%.~.~ f Depth .. J,lvl ` 9. Site of lot: LtonC .....~... ............ r........... I(1. hate of Nin9~ase ..................... Name of Poorer (Amer ........................................ II. &x~e or use districC in ebid~ premises are situa[ed .............................~~..~~............................... 12. Does proposed cnastruction,v/iolate any coning tau, ordinance or regulation: ....l./(? ................ 13. Will ]ot be regraded .... !~ 4T.........._ Will eucess fill be renrrved from prm~ises: YES ~ i ...a'. 14. Nares of Owrer of praaises .~flG:~ f~. l~/~L,B~!?G-s. Address l~G.~..J.9L.~~..~A.... Axam No. .71.J ~ ~~. Nare of Ardii[ecC . GAO k'G~..~Iszd!0.~........ Acklress .............................. Ilxxie No. N[me of Contractor .~//S~i1T~GiPL~,~i1~iff7.!+¢.L~mft4Ac41ress .!!!~/~O..t4~~T.1~11~~•Fi~'~.~~..I1xme No. 7.ni7;yL,fJ,<2O IS. is this property within 300 feet of a tidal w~tlarcl? * YES .......... NO ..l~....... *IF YLS, SOUIICHI) 7Ud1 7idIS1LL+S Fli(31Pf MAY [iE RC(~11RFD. PL0'f OfAGRAM locate clearly an) distinctly all. buildings, wl~e[lier existing or proposed, and indicate all set-hack dimensions frcm prt>[~erty lines. Give street acd block nnber or description according to deed, aid show street names and i.rclicate whetl~er interior or corner ]ot. SI'A Il? (A~ Nti) YIM21(, SS ..._...,(f?G~4..h'..Ty~1~.fr.~G' ....................Ix•iiy; duly swum, delx~ses a~xl says that lie is the a1~~LicanC (Nare of i~xlividual. signing cuitracC) above ~w~~ecl, Ik is tlie .....~1-f!~4..~C ............................................................................... (CcmCractor, agent, corporate officer, etc.) of said cxa~er or u+ners, arxl is ihily auUarized Co perform or I~-rve perforned Ilse said work a~xl Co make and file this alAilicaCirn~; that all statenents amtained in this appl.icacicxi are tole Co Use hest of his knwledge a~xl belief; aixl thaC the work will be performed in the marnier sec torch in the application filed U~erewith. ~k~orn to he fore np lJiis .........~~`.'~. ...day of c Ct Notary I~iblic ...,y ,f-:¢?u~::~L!:'. i ~.~ ~ • .... .s~~f/.... ... .. .. . .... ' ,tk~l]ire of AppLicemC) 1bf(n - =.. ..t .b I C~G~C~ -'"'T~- ~a-4 3 I TOWN OF SOUTHOLD PROPERTY RECORD CARD ~~ ,~ In STREET ~s VILLAGE DIST. SUB. LOT "? -FORMER 041INER N E S W TYPE OF BUILDING ~ ~ ~. RES. Z I v , SEAS.. VL. FARM COMM. t ~~~~~ _ `~ Z .3 LAND IMP. TOTAL DATE REMARKS \\ ~Ov ~,• ~~7 1 -,Ir ~,•~-I~Cy - U Y ) 3 I - _ ,7_;-.,~,:~ .. S- ~ ~~ _ {~>rv o _, ~-4>ffZ'3'Z to le:E-,~! 7 v ~ ~oupl ~ cv S f 88 _ to z ~ I(,' ' .I - vrl~l 1~ F go oi0,r/ ~ ~aoo Sao -7800 ~ i 71 g- LID~C-,~-1' <~<- ~i~ ~rs~~o~f-lttra~~ -{ '" '1r ~~'~n, a.3oo (0 8.3oa z.'.3 93 IO /~ 8t;-.dP#1%Sc`~ - c~~gdd,'{tor k;c ~`/ Ooc7 ` -~ ,- __ c ~ ri 1 I ~ - a-~ ~ `~ ~ S1c~ ZI - P~ 06~ - ~~ f rn e><;sr,' dP~ ~~ 8 a . app . I ~ _ n L '~eN N.c, alas d FRONTAGE ON WATER TILLABLE ~'"If"'" ~"'' 74 FRONTAGE ON ROAD { ~n WOODLAND DEPTH ~ ~. MEADOWLAND BULKHEAD HOUSE/LOT 1 ~"~"' ~4c~r~ TOTAL to U U _ .G.-~.~ .~ 5. COLOR N ~= t TRIM VJ~d-~ l~ i Iii 2 °~ x'`~U= ~ I Z ~',l~ ~~~ ~oQ Foundation ce. Bath 1 t/,L Dinette Extension Basement u sue Floors ~~ W Kit Extension Ext. Walls Interior Finish ~~Z L.R. ~ Extension Fire Place ,~ t- Heat ~ ~I~ D.R. Patio Woodstove ( BR. J Porch /,Z ~ yo ,~ ~ 93 ,2,a' 8o Dormer ~~~ ~.~ Fin. 8. Deck 1(o~Zp ~ 3ya ,Z5 $(7 Attic Breezeway Rooms 1st Floor Garage y ~ a `4~0, I , Z ~~ 6 0p Driveway Rooms 2nd Floor O.B._ RUS No ~'F l~ IOv Pool nn 1., rov~.,Q ~ Iro01 t~ `a -. • _ ~ 0 2~ 0931 ~, , ~~~~ Town Hall, .53095 Main Road P.O. Box 1179 Southold. New York 1 1 97 1-0959 y~i~~pF SOpTyo:,^ o ~ ,mo o # ~ ~ ~ Q, ~~r~ ~~~y00UNTY O~~iL~ BUILDING DEPARTMENT TOWN OF SOUTHOLD October 16`h, 2006 Jack & Kazen Thilberg 1565 Jacobs Lane Southold, N.Y 11971 RE: 1565 Jacobs Ln. (sunroom) SCTM# 079 0006 004.003 Deaz Mr. & Mrs. Thilberg, Fax (631)765-9502 Telephone (631) 765- 1802 Please be advised that your Building Permit #24606 issued January 15th, 1998 has expired. According to the Code of the Town of Southold, a Certificate of Occupancy must be issued prior to use of the structure. To renew your Building Permit, please submit a fee of $75.00 at that time we can schedule an inspection by one of our Building Inspector's. If you have any questions, please call us at 631-765-1802. Respectfully, SOUTHOLD TOWN BUILDING DEPT. .. r q s I---__ r. C .~ ~~ ~; w ___ _ _ __ _ i 3 ' ~ _.~_. ~- p~:~~ , 6 <- G f1ZGQo o~ ~~ . ~ 3~ ~~ o ~~ 0 y4 ~" c ,o. I 0 i 30 ~~ O C ~~~~ M Qv h ~a ~~ ~ly c ~~~ s ~''~ ~''F ~ q~. 4~res ~~ ® ~~~ (yqC '~-'Tj 1. SUFfQ t`bl1WTY D,{E~,(P~ARTM~ OF DATE SI~~9FtltlHS. REf~fdD.GS~7 ~c /-?~ The sewage disposal and water supply }acilities for this location have been inspected by tha Department and/or other tes nd fou to atisf aM ory. Chief Bureau of Wasit3ve[er Maa9mmwr CERTIFIED TOE FIRST AMERICAN TITLE /NSURANE COMPANY OF NEW YORK R.1 i~ F RHEAD SA VINGS BANK JOCK H. THILBERG KAREN M. THILBERG B.mX # 87501'18 ~O ~~ l \ 5 Np,QTy Bq yV~Fw ~, ~ ~pq0 j '' _. +~- i ~~~ ~. ~r ~ ,~,e ~ ~, , ~,9. E ~ `_ 1~0~~~ ~ f62 ~ •T ```~ ~~ V """ ,, ~ g,Q N V~ ~' Br ~, w ~~ w ~o ~~ Q s / ,~~ ~, k SURVEY OF LOT 3 MAP OF CRO WLEY ESTATES ~ aEC. rz lase >~ nb s2s~s A ~T BA YVIEW TOWN OF SOUTHOLD SUFFOLK COUNTY, N. Y. 1000 - 79 - 06 - 4.3 Scale 1" . 50' • Oct. 15, 1987 Oec. 18.7987(under const., Apri! 14, 1988 (final) ~~ / ~~~ ~vq~ Preparod hi aaoordanes vrkh tAe standards for tiNe surveys m estab7= the L 1. A L 5. and approved and for such trss by The Nerr York;b:~+" title Assodation. ...,~~1 ,~ :' , ...'1.