HomeMy WebLinkAbout29297-Z
FORM NO. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Office of the Building Inspector
Town Hall
Southold, N.Y.
CERTIFICATE OF OCCUPANCY
No: Z-33171
Date: 07/22/08
THIS CERTIFIES that the building ACCESSORY
Location of Property: 195 SELAH
(HOUSE NO.)
County Tax Map No. 473889 Section 106
LA
(STREET)
Block 9
MATTI TUCK
(HAMLET)
Lot 4.5
Subdivision
Filed Map No.
Lot No.
conforms substantially to the Application for Building Permit heretofore
filed in this office dated
APRIL 11, 2003 pursuant to which
Building Permit No. 29297-Z
dated
APRIL 15, 2003
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 IN GROUND SWIMMING POOL WITH FENCE TO CODE AS APPLIED FOR.
The certificate is issued to MICHAEL J & SUSAN R SCHMIDT
(OWNER)
of the aforesaid building.
SUFFOLK COUNTY DEPARTMEIIIT OF HEALTH APPROVAL
N/A
ELECTRICAL CERTIFICATE NO.
3483
OS/20/03
PLUMBERS CERTIFICATION DATED
N/A
~9-~
~tho~zed ignature
Rev. 1/81
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Form No.6
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN HALL
765-1802
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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 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 buildiugs (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, ~.ee~ertificate of Occupancy _ New dwelling $25.00, Additiont'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
Location of Property:
/
;9.s
House No.
Date.
tr /. () ~
New Construction:
Old or Pre-existing Building:
~'--H#-
Street
L.4 A../t
(check one)
~~rriNck-
Hamlet
Owner or Owners of Property: 1-1 ((!.,IIi-f4.4dl-
Suffolk County Tax Map No 1000, Section 10 (J
~,D/
Block 9'
Lot
s/.~~
Request for:
Temporary Certificate
Filed Map. Lot:
1- !t10 3> Applicant: ~/h 7vc.4 _ A.o Ls
/ nderwriters Approval: /
Final Certificate: / (check one)
,
Subdivision
Permit No. t3P ZII z '1'1 Date of Permit.
Health Dept. Approval:
Planning Board Approval:
-
Fee Submitted: $ 2;;-.
G1.o i!; 33 n I
\0c 1'16l~
---
Nassau Suffolk Electrical Inspections, Inc.
5A Canal Street + Center Moriches, New York 11934 + Tel: 631-878-3500 + Fax: 631-878-3764
Application: 3483
Date:
5/20/03
Issued to: Schmidt
Address:. 63 Swnmerfield Dr
Village: Mattituck
Introduced By: A vey Electric East
Lic#:5720-E
was examined and approved up to the above date and was in compliance with the NEC
Jlttic
IEsidertia liD
Olt~
RxlIIiD
I-ti T I.b
1st Fkxr
2rd ftoa"
Co III Clc:iBI
Pdition
~ICI"
Switches Receptacles Fixtures G.F.1. Timeclock Whirlpool
2 2
Fans Dishwasher Washer/Amps Dryer/Amp. Oven Carbon
Range/Amps Monoxide
Furnace Oil Ga. HealZones Smoke Bell
Detectors Transformers
Meter Amp. Phase Motors
ther Equipment:
Inground Pool
ut,Res
7 J~alJ/
This certificate must not be altered
in any manner
Permit # 292972
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)
15, 2003
PERMIT NO.
29297 Z
Date APRIL
permission is hereby granted to:
MICHAEL J SCHMIDT
MATTITUCK,NY 11952
for :
CONSTRUCTION OF AN INGROUND SWIMMING POOL IN THE REQUIRED REAR
YARD AS APPLIED FOR
at premises located at
195 SELAH LA
MATTI TUCK
County Tax Map No. 473889 Section 106
Block 0009
Lot No. 004.005
pursuant to application dated APRIL 11, 2003 and approved by the
Building Inspector to expire on OCTOBER 15, 2004.
Fee $
150.00
~~ G#~
I Authorize Signature
ORIGINAL
Rev. 5/8/02
II"'"
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765.1802
BUILDING DEPT.
INSPECTION
[ ] FOUNDATION 1 ST [
[ ] FOUNDATION 2ND [
[ ] FRAMING [
[ ] FIREPLACE & CHIMNEY [
] ROUGH PLBG.
] INSU TION
INAL
] FIRE SAFETY INSPECTION
REMARKS:
(
DATE
i1tJr
INSPECTOR
?
. ... -- ..'
FlELDlNSPECTION REPORT DATE . COMMENTS '- . .,....... . ~.
. ~ ~.
FOUNDATION (1ST)
~.- ~ *
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FOUNDATION (2ND) ~ ~
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ROUGH FRAMING &
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PLUMBING Ib
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INSULATION PER N. Y.
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STATE ENERGY CODE -
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ADDmONALCOMMEN'l'S
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TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN HALL , 1 ~
SOUTHOLD, NY 11971
TEL: (631) 765-1802
FAX: (631) 765-9502
www.northfork.net/Southold/ PERMIT NO.
(:;}(I.;Lrf 70
BUILDING PERMIT APPLICATION CHECKLIST
Do you have or need the following, before applying?
Board of Health
3 sets of Building Plans V
Planning Board approval
Survey V
Check ./
Septic Form
N.Y.S.D.E.C.
Trustees
Contact:
Examined
1.lJf ' 20 ():3
'1'7/ .'l, 20-03
Mail to:
Approved
Disapproved ale
Expiration
70/;<) ,20 C>.L
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ICJ~
, Building Inspector
APPLICATION FOR BUILDING PERMIT
Date
-Y//O
,2003
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 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.
UNDERWRITERS CERTIFICATE
REQUIRED "IMMEDIATELY"
ENCLOSE POOL TO CODE , L-
UPON COMPLETION "'?u ~~ 9. t"'Jkh",,-.,,-,,- A-// //93'5"
BEFORE -WATER- (Mailing addres.s of'apphcant)
State whether applicant is owner, lessee, age_nt~&~1!i\U~~~m 99.1ltractor, electrician, plumber or builder
MEcl THE RcQUIREMMs'OF'TH~ PROVED AS NOTED
~o.v7'/2A~~SOFNEWYOAKSTATE. AP I ~ ~f~~7c-r
DATE: tH/j/~ B.P.' ~
...., d
Name of oWner of premises M\~t-\AGL :5 I~ \ -r r/
(As on the tax roll or lates ~ DEPART. i:r.rr AT
If applicant is a corporation, si ature oj duly authorized officer 765-1802 . AM TO 4 PM FOR THE
_ ('7"KE'S FOLLOWING INSPECTIONS:
ame and title of corporate GaUp ANCY OR 1. FOUNDATION -lWO REQUIRED
FOR POUREO CONCRETO
Builders License No. /,9. /t'd 7-~E IS UNLA WEUL 2. ROUGH . FlWAlNG & PLuMBING
PI b L. N 3. INSULATION
urn .ers Ic~nse o. CATE 4. FINAL. ~TRUCTION MUST
Electnclans LIcense No. BE COMPLETE FOR C.O
Other Trade's License No. OF C'Cc.up A~'CY ALL CONSTRUCTION SHALL MEET THE
REQUIREMENTS OF THE CODES OF NEW
YORK STATE. NOT RES JNSIBLE FOR
HA7m:~ CONSTRUC-,ION ERRORS.
Hamlet
c:5;1/7UK ~5 ,L.,7/:).
(Signature of applicant or name, if a corporation)
.
1. Location ofland On which proposed work will be done:
/9<' 5ELA-I LAAlE
House Number Street
County Tax Map No. 1000 Section //J /.
Subdivision Hte.t.l-AeL ""5/!#H/D:r
(Name)
Block ~
Filed Map No. 9"J:?"l
Lot //. <'
Lot :3
2. State existing use and occupancy of premises and intended use and occupancy of proposed construction:
a. Existing use and occupancy .:J 6--;'v12 yo '2/31 PEA-'" ,~
b. Intended use and occupancy"p. -:S"aTl'1" 72e5'/A::7VCG
t.017H /,v-6;7<J<-KJr> ~IN"""v4 ,?"",
3. Nature of work (check which applicable): New Building
Repair Removal Demolition
~~/A}_~2,,~~1t:::i:~'-V"7
. (DescnptJon)
Fee Jl'P;l).oo
(To be paid on filing this application)
Number of dwelling units on each floor
7.::i-nL
4. Estimated Cost $ /-tl. tJOU. pO
5. If dwelling, number of dwelling units
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 ~(;'
Height -2:5' Number of Stories ~
Rear ..,/ /
Depth d2c.. '
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 oflot: Front
/f'O'
Rear //.?J, /5
Depth .,tl /6
10. Date of Purchase
Name of Former Owner
II. Zone or use district in which premises are situated qe~/7)eA.J7, AL
12. Does proposed construction violate any zoning law, ordinance or regulation? YES_NO X
13. Will lot be re-graded? YES ~ NO_Will excess fill be removed from premises? YES k NO_
14. Names of Owner of premises N't"JJ4Ez
Name of Architect
Name of Contractor
-<e (lH,n-r Address/>'s" .5~<'.,4d L,4I"1E
Add ~A77.
ress
Address
Phone No. ..2% - /,(,/9
Phone No
Phone No.
15 a. Is this property within 100 feet ofa 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.
16. Provide survey, to scale, with accurate foundation plan ant dtsi!mdes to property lines.
17. If elevation at any point on property is at 10 feet or below, must provide topographical data on survey.
STATE OF NEW YORK)
r'!/.elf'J~3voa,., 3,., ,;'..: '3J.Vj
COUNTYaE.::i( ( (~12"" nGA .3TAT;;~PC ;'d~1 ~O E,OO;)
/.::::-~;;~' :.dj;;'/;;IY" being duly sworn, deposes and says that (s)he is the applicant
(Nam,e of mdlvlfl'~t s~~e~~t) ~bove named,
(S)He is the' '~.' '~' Z:rdK
'lW' . ":;,,(,~trll~tbr! Agent, Corporate Officer, etc.)
'F '!~:"X (--:jM' Ice . --\.__
of said ow:ll.er or own..~rsl,aP4 :i~d~>>;. (,a~.r.' ~ed to perform orhf1~e peiformed the said work and to make and file thi.s application;
that all stat~ments contamed I~~~. ,a~p1i.cation are true to the bestm. 1:i1~knowledge ~ndbehef; and that the work Will be
performed In the m>UJllerseti<l\'1h \n f>>.\l:~p~lcatlOn~~t~f~~~': J :'
..j :,:; jJ'"ip'!;;; -jq-' '.
Swo TOberoreme~s -,";:"~~~G"
. . day C?f(,{ (
V
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Signature of Applicant
ClJl<IRE L GLEW
Notary Public. State of New York
No, 01 GL4879S05
9-ualifj~d in Sl!H?;k rCIJ~t9~ b
Commission eXlJlre:; O<;.:r..;. 3,
LOT AREA = 37,304 SQ, FT,
GREEK CHURCH
WELL
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CESSPOOL, SEPTIC
LOCATIONS BY OTH
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JOB NO, 98 -297 FILE NO, WEST MILL
SURVEYED FOR
LOT NO, 3
MAP OF WEST MILL SUBDIVISION
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DATE 6,17-1998
7 - 20- 1994
(REF, ONLY) DISK 180
LAND SURVEYOR
1866 WADING RIVER-MANOR RD, WADING
NEW YORK, 11792
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4'
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2. ~cJ pool Of _ 6" oec- -.-nd"'9
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LEL.,J .~H~.-JJL
SIZE A . C 0 E , G H J K L
11' x36' II' )6' .' J'.- 12' 10' 5'" 4". 4"" f' 4""
1ISft""o._~ II' )6' 5'" YO' 12' 10' 5'" 4''' 4''' f' 2'r
-.... .....
8'
11-8' Plain Panek (08-009)
2-5' Plain Panek (08-1>1 5)
2-4' Plain Ponek (08-1>161
1-2' Plain PoneI (08-1>18)
)-900 Corner SelI08-020)
12-Economy 81lK1S (08-210)
1-SteoI ","dwar. Kit 108-204)
1-18136 Straight Coping Sel6' RoG'" (10-1)02)
1-900 Coping Comer Sel (10-0041
l-V'lII!lliler (... options below)
8'
8
6' St.,. Remon H08-00918' panels llI1d
1-(08-1)1812' panel_ lmat 1-101-006) 6' rt.p
llI1d H08-01416' panels.
S' S,.,. R.move 2-(08-009) 8' panels ond
'-(08-018) 2' panel. Insert 1-(01-00218' step
llI1d 2-(08-0151 5' panek.
STEEL PANEL OPTIONS , "
RepIcK. 4-8' plain panek 108-009) with:
1-8' llcm- panel (08-011)
2-8' inlet panek (08-1>10)
1-8'lightpanelI08.jJ12)
5'
H-6: (03-604.CS),(03-604-LSl.(03-604-RS)
1-8: (03-204-CS),(03-204-LS),(03-204-RS)
1-14: (03-304-CSl.(03-304.LS),103-304-RSI
NSPI TYPE II
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6'
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2.108-0Il911'panelsand
1-108-0ISI2'poneI.l_
1-(08-30I)S'Ilep,2-(OS.161)
Wxl'liIIorpanekand
2-(08-1>161 0' panek.
1-(10-0831 5l1li Ilepcapingset
and W0-0851 coping co....
set r"*,,,_ lee pago I.
l'Ilool~lsido)-..
H08-OIl9I I' panek. 1_
H08-30I)S'5IIIIs1ep,
H08-013)l'ponel,I-(08-167)
Wxl'liIIorpaneland
H08-16!10'paneI.
Ht0-0831511111lep coping '"
eocIl-(10-0851 coping ,.....
"'....ed. leepago 1.
~o.aler. hil-,-rrespontibi~tylo_tf.lOt"'"",,,~proo;cWbyFWPjlcl.l~1g
pooI_ondlhol"'NOOMNG~'l'l9lrXo.1lore~lnsIaIiid.
3&cCMJhonIl>olIb.Zlorgetthonpoololloround
F,~ -.oodr. urde< bo;,w 01 ponekOtKJ Iomp......n
4_&odJ;I....ltInon-~",...ioI
n,.. dig ditnenlions comply with It.,. NaIiQnoI Spo and j'ool
Inlhlulel:"99'"r.dn'Hnimumllorldorchfor,residerlllolpoo/1
ItdMngbOOrdsor,Jidetor.lDbe.....dWlltlltlesepoolsP'<<!"
consultihe~lin~,anclIheNotional~l)&PooI
~""'" mooimvm Ibldord, prior 10 inPolling d;.;ng boo_-ds ,,..
slides.,., '-pool.. Fot-inftinootianconc..."ingNSl'l m"""'~m
Wndardt."""..: NotionaI5DO&Poollns~IuIe,2111 E,,,,nn.,..
A__.Al.xandriQ, VA 21~IA. 7OJ/8J8.008J
n<<s DOCIJMfNT 1$ FOR UUSTlATM PUtPOSES <:N.Y,
FWPmabson/oytho.. .......bIion......od.(n... in ifo__
warronty-AltyOlhw~.,...........or_.....;.
by....~hontroclorlg....""""""-~"liI....,..-;..l.
pooduc.:lbyfWP<n"*'butobl.lO....-../conIradoronly Th.
dealeroro;on/rodDr...+.oMIIlorj'lIlD1ll)'1X11'PGoIi.gn~
o:onln;Jdorr;wld,.lIOlan~or~oIfWP TheCgnolrurtlon
~oIWrot.d""',"IUpIIion._ondopplyor>lylg"Ol'1l'Kll
grwndcondmon. n..."IOJ'b.oddIlionaI~ond/or
~oI0:0nllnlchcn_ n.~....~.
IN-GROUND SWIMMING POOL WILL BE CONSTRUCTED
OF STEEL WALLS SUPPORTING A VINYL LINER THAT
WILL HOLD APPROXIMA TL Y 27,500 GALLONS OF WATER.
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FENCE WILL BE AT LEAST 4' lllGH WITH SELF CLOSING
GATES THAT WILL MEET TOWN CODES.
POOL PA no WILL BE CONSTRUCTED OF BRICK PAVERS
SURROUNDING SWIMMING POOL WlllCH WILL BE LEVEL
WITH SURROUNDING GRADE
FRQNTI:R
POOLS"
fOIl' WI_ POOtSe.1IC.. 510 SUMrTD Dim.
"WA__46I04 USA (21t)4SH7JI
.......-
OAn mu
MAY
1995
FRN-G04
18' 136'
RECTANGLE 6- RADIUS
Corl"-" ,.., 'O.Y WAYN' I'OOI~, 'Ne
.