HomeMy WebLinkAbout33779-Z
FORM NO. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Office of the Building Inspector
Town Hall
Southold, N.Y.
CERTIFICATE OF OCCUPANCY
Date: 06/23/08
No: Z-33117
THIS CERTIFIES that the building ACCESSORY
Location of Property: 1230
(HOUSE NO.)
County Tax Map No. 473889 Section 31
OLD ORCHARD LA
(STREET)
Block 6
EAST MARION
(HAMLET)
Lot 26
Subdivision
Filed Map NO.
Lot No.
conforms substantially to the Application for Building permit heretofore
filed in this office dated
APRIL 1, 2008 pursuant to which
Building Permit No. 33779-Z
dated
APRIL 2, 2008
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 CHARLES J & ANNA L WOZNICK
(OWNER)
of the aforesaid building.
SUFFOLK COONTY DEPARTMENT OF HEALTH APPROVAL
N/A
09/13/89
ELECTRICAL CERTIFICATE NO.
N 091494
PLUMBERS CERTIFICATION DATED
N/A
Rev. 1/81
,
.
Form No.6
TOWN OF SOUTHOLD
BillLDING DEPARTMENT
TOWN HALL
765-1802
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APPLICATION FOR CERTIFICATE OF OCCUPANCY
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This application must be fiJled in by typewriter or ink and submitted to the Building Department with the foJlowing:
A. For new building or new use:
I, Final survey of property with accurate location of aJl 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 instaJlation 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 instaJlations, 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 shaJl state the reasons therefor in writing to the applicant
C. Fees
L Certificate of Occupancy - New dwelling $25,00, Additions to dweJling $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.
(p -;;2.0 -C)R
Old or Pre-existing Building: V
{)/d (Jrchar-J ~he.-
Street
ha.. Wo z n I~k
~/
I
(check one)
/::a..,f l1~r;on
Hamlet
(S-R: r zen b.-7r It)
h Lot ;::), ~
New Construction:
Location of Property: /;;; 3 tJ
House No.
Owner or Owners of Property: --.A n
Suffolk County Tax Map No 1000, Section
Block
Subdivision
Filed Map. Lot:
Date of Pernllt t:> Ii 7/0'6 ApplicantA VI n (?L 'vIh ZYll c.1<
. (~f~rz-cnb~/...)
Underwnters Approval:
Pemlit No.!3 3779 z.
Health Dept Approval:
Planning Board Approval:
Request for: Temporary Certificate
Fee Submitted: $ ;;2.5. () 0
(,u-2- ?>~ I \\
ec-l~~/\
Final Certificate:
v'
(check one)
~ ....~!:!f'-~~,.,-!'-':::';.~'~..!$;r
'. . .<'''':__._.._..~~~.~. h .<..
THE NEW YORK BOARD OF FIRE
"..:.:~':!1,''''''''
1\"'~~".-,.~__,_ _
J ;)<_'i! -~:-: 'I
UNDERWRITERS
f'A'r:
Doff'
BUREAU OF ELECTRICITY
SEPn:Mf\;:k'. r'~R~OHN STREET. NEW YORK. N~n-TP1~~J~.f38
Applicotion 1'.io. on fil~
N (lq1494
I
THIS CERTIFIES THAT
only the electrreal equipment CUI d.euribed belo..., and introduced by the applkant named on the above applieodon number in the premiu8 oj
CHhR[,jo:S ~OZIlICK. or,!) ORCHARD I,ANE. I.nll], jo;AS'I' MARJlil\f. Ii. Y.
OUT
;n t""fo/lOldnR loc.fi6ttISA!~~,t 0 I.. Fl. 0 2nd n .'iffaon Block Lot
U'fIS examined on andJound to be in complion('(' u.'ith the rpquiremenltc oj this Board.
1
2
FIXTURES
INCANDESCENT fLUORESCENT
2 1
OTHER
RANGES
AMY. K.W.
COOKING DECKS
AMT. K.W.
OVENS
AMT. K.W.
DISH WASHERS EXHAUST FANS
AMI. K.W, AMT. H.P.
FIXTURE
OUTLETS
2
ICEPTACUS SWITCHES
DRVERS
FURNACE MOTORS
RJTUII APPlIANCE FEEDERS SPECIAL I!C'" TIME CLOCKS
AMI. K.W.
C>L
H.P. GAS
H.P.
AMT.
NO.
A. W. G. AMT. AMP. AMT. AMPS.
BELL UNIT HEATERS MULTI.OUTLET
SYSTEMS
TRANS. AMT H. P. NO. OF FlET
DIMMERS
AMT.
AMP.
TYPE
NO. Of S E
MITER
EQUIP. 112W 1,3W 3.3W 3'4W NO. OfPEic.e.COND.
R V
A. W. G. NO. Of HHEG
Of CC. CONDo
C E
c:. t~1\rG NO. OF NEUTRALS
A.W.G.
Of NEUTRAL
AMY. WAnS
1
20
40
SERVICE DISCONNECT
OTHER APPARATUS:
G.F.C.I:-1
"(SWIMMING POOL) This certIficate
covers compliance at the date of
inspection only. Because of unusual
environments it is advisable to
have frequent test and/or repairs
II@de by a qualified person.
JODY PllMlU,O
PAT LANE
KATTITUCK. NY. 11952
LIC.'2300-E
~R~
P 117=-
er.:__~
may be identif.j~d by their credentials.
This certjficate must not be altered in any manner; return to the oHice of the Board if incorred. Inspectors
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
(THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL
COMPLETION OF THE WORK AUTHORIZED)
PERMIT NO.
33779 Z
Date APRIL
2, 2008
permission is hereby granted to:
CHARLES J & ANNA WOZNICK
PO BOX 44
EAST MARION,NY 11939
for :
ACCESSORY INGROUND SWIMMING POOL IN THE REQUIRED REAR YARD
WITH FENCE TO CODE AS APPLIED FOR.
(Replaces BP#18369-Z)
at premises located at
1230 OLD ORCHARD LA
EAST MARION
County Tax Map No. 473889 Section 031
pursuant to application dated APRIL
Block 0006
Lot No. 026
1, 2008 and approved by the
Fee $
150.00
Building Inspector to expire on OCTOBER
ORIGINAL
Rev. 5/8/02
~_ NO. .
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)
33J7r-z:
N~ --18369 z
Dote ..~Q........................................... 1.Jl:l...
Permission is ha~~~g[~...~..~...:;{..~..yd?ut u/~
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~~;;.....~......... .............~......n..(............................................................
at premises located ot ..L6?~..Q.......&&.~ad..L.a:t?.f....................................
............................................~~....7.:?J~....................................................................
................................................................................................................................................................
County Tax Map No. 1000 Section .........3/.... Block ...............~... Lot No. ........~.~......
pursuant to application doted .........;;(-'2/.................................... 19J.:'9... and approved by the
Building Inspector.
Fee $"/~
Rev. 6/30/80
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33 779c
TOWN OF SOUTHOLD BUILDING DEPT.
765.1802
INSPECTION
[ ] FOUNDATION 1 ST
[ ] FOUNDATION 2ND
[ ] FRAMING I STRAPPING
[ ] FIREPLACE & CHIMNEY
[ ] FIRE RESISTANT CONsnulcnON
REMARKS:
[ ] ROUGH PLBG.
[ ] I~LATION
[~INALM.
[ ] FIRE SAFETY INSPECTION
[ ] FIRE RESISTANT PENETRATION
<
DATE 6117/&9
I
INSPECTOR
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-------------
TOWN OF SOUTHOLD BUILDING DEPT.
765.1802
INSPECTION
[ ] FOUNDATION 1 ST
[ ] FOUNDATION 2ND
[ ] FRAMING I STRAPPING
[ ] FIREPLACE & CHIMNEY
[ ] FIRE RESI~ CONSTRUCTION
REMAR~Y~ ,
[ ] ROUGH PLBG.
[]~L .
[yfFIN~L ~ '
[ ] FIRE INSPECTION
[ ] FIRE RESISTANT PENETRATION
it<
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W'-t ~ ;;'_M~ fjJ> 41~~-Y
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DATE
INSPECTOR
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765-1802
BUILDING DEPT.
INSPECTION
[ ] FOUNDATION 1ST [ ] ROUGH PLBG.
[ ] FOUNDATION 2ND [ ] INSULATION
[ ] FINAL
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DATE
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!lELD I:;SPEC710:J
1. -,
FOUNDATION (1st)
------
FOUNDA nON
(2nd)
2.
ROUGH FRAME &
PLUMBING
3.
INSULATION PER N. Y.
STATE ENERGY
CODE
4.
FINAL
liD';;:: II
II
COMMENTS
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ADDITIONAL COMMENTS:
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FORM NO.1
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN HALL
~OUTHOLD. N.Y. 11971
- TEL.: 765.1802
Examined. .r-Iv.........., 19.ff!( 33 ?7q~
Approved... .t;//?......, 1& Permit No.!q...?~? .j'
BOARD OF HEALTH ............
3 SETS Of PLANS .1/...........
SURVEY V.LJJ.' ?:.,...............
CHECK .I/tr..V>!QI.Q............
SEPTIC FORH ................
NOTIFY
CALL
HAIL
.................... .
TO:
Disapproved alc .....................................
.. ..m..~.:,i~~. ill .<AP~~;:;:~~I~
- BLDG. DEPT.
TOWN OF SOUTHOLD
Date... 7/:)1.. .... .., 1'2.~
INSTRUCTIONS
a. This application must be completely filled in by typewriter or in ink and submitted to the Building Inspector, with 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 premises or public streets
or areas, and giving a detailed description of layout of property must be drawn on the diagram which is part of this appli-
cation.
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 issued a Building Permit to the applicant. Such 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 whatever until a Certificate of Occupancy
shall have been granted by the Building Inspector. .
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 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<<.lJO'!*li~ ~1Ud 'tegulations, and to
admit authorized inspectors on premises and in building for necessary inspections. _ .
. . "IMMEOIATElY'" '1i~~~t~fr;~r~rt;~;~:.if~d~ation')'"
. E~~J'c~~DE . fJ. ~/.-. . .'f~.<t.': ~i. /.21)# J71M!<;:.Iv!: Y. .. . .
BEFORE "WATER" . <Mrlil;i~ address o( ~pp1iqnn 1/7'j'z..,.
~ I'...~' i, ..
State whether applicant is owner, lessee, agent, architect, engineer, generaL,F\lA~(~~o.!i-electrician, phuvper or builder.
........... "'t:N~.... (!.,q;y,~............... .." .~". ."......... ........ '.'... .............
V-~ . .;", "..
Ctnr. . . / A2,' '..J'; '\ . .... .'
Name of owner of premises ............... .tJ-.'/;:-:$'/,~: //!'~IV/9... ._}~~,1..(j(1,,~.)llK'" .......;........
rt (as on the tax roll QIi4a~d~) ,)l"'h'!3fjll.;'I'"
t1_-- ~10'1 .. WI"r!R""'V")' .j'
If pI' t is a corpor . f d Iy authorized officer. ' . ,R \. '..' All)"
U(~ (\j.~ '
~~E IS ~N~~~I~~1t
'H;!\TUQU "'\I
\i, i \ n ~N\j ,
nC OCCUP
\,.,,'.''.'
(Name and tit of corp officer)
Builder's License No. .. ~.9'?-.. ~ .11...1< .'. . . . . . . .
Plumber's License No. ........................
Electrician's License No. ......................
Other Trade's License No. .....................
1. Location ofland on which proposed work will be done. .. . Qt. a . . . QItCY.lffz.!J. . .t/jzl/t;. .~:r: t1!I.~;;6:tI
. . . . .lJJo. . . . . . . . . . . . . . . . . . . O?-!2. . . . Qt.~~1? . . hlfr!t--:-. . . . . . . . . . f:"?'H.T. M/ke;, (If!.. . . .
House Num ber Street' Hamlet
County Tax Map No. I 000 S~ction ..... .1/.. .. .... Block ....... h.. . .. .... Lat.....?: (;.. .. .. .. ..
Subdivision. ..... . ..... .. . .. . . .... . .. ... . ....... Filed Map No. . .s:/).13. .... Lot.. j?..r':. .... .
(Name)
, State existing Use and occupancy of premises and intend~d use and Occupancy of proposed construction:
~. Existing use and occupancy ...... . . . . . . . . (?.tr.!//J. t1Y.1:X ~ . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
b. Intended use and occupancy ................~ (I;?t':'! 17 If!-:. . . . ~. !.t. t!. . . ~!-,... . . . .. .. . .
) w / I~'" l"f C I'IIL
I~Cf;
3. Nature of work (check which applicable): New Building. , . .... " .. Addition..... ..... Alteration . V.....
Repair .............. Removal.... . . . . . . . . .. Demolition .............. Other Work. . . . . .~ . . . . .
(Description)
4. Estimatc'dCost......... ~"'~"""""""'" Fee....................................
(to be paid on filing this application)
5. If dwelling. number of dwelling units. . . . . . . . . . . . . .. Number of dwelling units on each floor. . . . . . . . . . . . . . .
If garage. number of cars .................................................... ..................
6. If business. commercial or mixed occupancy, specify nature and extent of each type of use. . . . . . . . . . . . . . . . . . . .
7. Dimensions of existing structures, if any: Front. . .. . . . . . . . . . . . . Rear . .". . . . . . . . . . .. Depth..............
Height ............... Number of Stories. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Dimensions of same structure with alterations or additions: Front ................. Rear.................
Depth. . . . . . . . . . . . . . . . . . . . . . Height. . . . . . . . . . . . . . . . . . . . . . Number of Stories. . . . . . . . . . . . . . . . . . . . .
8. Dimensions of entire new construction: Front. . . . . . . . . . . . . .. Rear............... Depth .... '. . . . . . . . . .
Height ............... Number of Stories. . . . . . . . . . . . . . ; . . . . . . . . . . . . . . . . . . . . . . . , . . " . ~ . . . . . . . . . .
9. Size of lot: Front. . . . . . . . . . . . . . . . . . . . " Rear...................... Depth .....................
10. Date of Purchase ............................. Nam!f..of Former Owner ............................
II. Zone or Use district in which premises are situated. . . . . . . .i.':~( t:l tirYT/.4. t,.. . . :~,t, .. . . . . . . . . . . . . . . . . . . .
12. Does proposed construction violate any zoning law, ordinance or regulation: ......~......................
13. Will lot be regraded ...... .~.. ............... Will excess fill be removed from premises: " ~ ; Nc
14. Name of Owner of premises '" ~N!.cte:::..... . Address .~. .l"';1.~!l~hone No. ..............
Name of Architect .... K1 . 'J . . . . . . . . . . . . . . . . . Address. . . '/~. ~:~. . . . . . . . Phone No. . . . . . . . . . . . ; . .
Name of Contractor .. "'y.' : f"l fIt.? 7...-:. ...J~ Address. . . nurrY.l/P:.~/~. . Phone No. ?-? J: g,e.";. .
15.Is this property located within300 feet of a tidal wetland? *YES....NO,lc(..
*If yes, Southold Town Trustees Permit may be required.
PLOT DIAGRAM
Locate clearly and distinctly all buildings, whether existing or proposed, and, indicate all set-back dimensions frorr
property lines. Give street and block number or description according to deed, and show street names and indicate whethel
interior or corner lot.
5 ~-- F .
r~~DASIIOTED
DATe:~B.P.1I ~3 (,7~
t~~I~,.~tPA;JJ~
765-1802 9 AM to . PM FOR THE "
FOLLOWING INSPECTIONS:
1. FOUNDATION . TWO REQUIRED
FOR POURED CONCRETE
2. ROUGH . FRAMING . PLUMBING
3. INSULATION
4. FINAL . CONSTRUCTION MUST
BE COMPlETE FOR C.O.
AU CONSTRUCTION SHALl. MEET
THE REQUIREMENTS OF tHE N.Y.
STATe CONS11lUCTION . tiNERGY
CODES. NOr flE8PON8I8I!E FOR
DESIGN OR CONS1RUCTION EMORS
~ "FZ-(,nvdJ
'"f'~.'''
"IMM"6blAtEl~~
ENCLOSE f'OOL TO~OE
UPON COMPLETION
BEFORE "WATER"
r L_,QS~._
~"Vj"'''"lWII(
STATEOFNEW\:ORI:>., c: S5
COUNTY OF . . .<)4-{~i:1J.y /. . . . .
'" No~.~~.. .Il.:.. .1f./:fl.?'-: I.... ...J.?!-.:...
(Name of individual signing contract)
above named.
being duly sworn, deposes and says that he is the applicant
He is the................... .~I'1:c:r.tfhC......................................................
(Contractor, agent, corporate officer, etc.)
of said owner or owners. and is duly authorized to pc,rform or have performed the said work and to make and file this
application; that all statements contained in this appliqtion are true to the best of his knowledge and belief' and that the
work will be perfomled in the manner set forth in the application hIed therewith. .
Sworn to before me this '
. . . . . . . . . . . . . . . .~. r. . . . . .day of .. . . . . n. . . . . . . . .,;9fJ
Notary Public, . .~.. .k. .DJ. {!~....... County .
HtI.EN It DE WE M
IIOIMl'I PUBLIC, StIlI el :::-.-
No..7l1187~J.le.v
lena Expores ....
applicllI1t)