HomeMy WebLinkAbout32862-Z
FORM NO. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Office of the Building Inspector
Town Hall
Southold, N.Y.
CERTIFICATE OF OCCUPANCY
No: Z-33190
Date: 08/04/08
mIS CERTIFIES that the building INGROUND SWIMMING POOL
Location of Property: 800 CROWN
(HOUSE NO.)
County Tax Map No. 473889 Section 109
LAND LA
(STREET)
Block 2
CUTCHOGUE
(HAMLET)
Lot 12.6
subdivision
Filed Map No.
Lot No.
conforms substantially to the Application for Building Permit heretofore
filed in this office dated
MARCH 21, 2007 pursuant to which
Building Permit No. 32862-Z
dated
MARCH 29, 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 WITH FENCE TO CODE AS APPLIED FOR.
The certificate is issued to THOMAS MCADAM
(OWNER)
of the aforesaid building.
N/A
SUFFOLK COOHTY DEPAR'l'MENT OF HBALm APPROVAL
ELECTRICAL CERTIFICATE RO.
7060
05/05/07
N/A
PLUMBERS CERTIFICATIOlII DATED
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Rev. 1/81
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Form No.6
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN HALL
765-1802
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.:IHI'IL2--!<\PPLICATlON FOR CERTlFICATE OF OCCUPANCY
This application must be filled in by typewriter or if!!<: and submitted to the Building Department with the following:
A. For new building or new use:
I. Final survey of propeliy 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 buildings (prior to April 9, 1957) non-conforming IIses, 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 tnerefor 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 ofOceupancy on Pre-existing Building - $100.00
3. Copy of Certificate of Occupancy - $.25
4. Updated Cel1ificate of Occupancy - $50.00
5. Temporary Ce,1ificate of Occupancy - Residential $15.00, Conunercial $15.00
Date. J I - J S-" 07
New Construction.
Old or Pre-existing Building:
Location of Property.
800
C!. f2..1[) (JJ vJ
t-A-NI:>
LA
(check one)
C-u..7c..Ho6 u. E
Hamlet
House No.
Owner or Owners of Property: II40lU.Jr""'-
Street
Suffolk County Tax Map No 1000, Section
~ 13AI1.j,A/tf. Me" AbAItI] .
Block").- Lot
~'-
101
f)'-Cp
Subdivision .._____~_ Filed Map. Lot: ____
Pennit No 31-& 10 ).-J---:.._ Date of Pen nit. '?::>1"7-<j It:> 7 Applicant:J~lt-1kS_14 cA ~!"L"""
/()( tJ
Health Depl. Approval
Underwriters Approva I:
f";-07
Planning Board Approval:
Request for:
Temporary Celiificate
Final Certificate:
(check one)
...."
Fee Submitted $ ~ -'
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C. 0, 2- 3319D
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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.
32862 Z
Date MARCH
29, 2007
permission is hereby granted to:
THOMAS MCADAM
PO BOX 528
CUTCHOGUE,NY 11935
for :
CONSTRUCTION OF AN INGROUND SWIMMING POOL AS APPLIED FOR FENCED
TO CODE
at premises located at
800 CROWN LAND LA
CUTCHOGUE
County Tax Map No. 473889 Section 109
Block 0002
Lot No. 012.006
pursuant to application dated MARCH
21, 2007 and approved by the
Building Inspector to expire on SEPTEMBER 29, 2008.
Fee $
250.00
L~
/ Authorized Signature
ORIGINAL
Rev. 5/8/02
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BUILDING DEPARTMENT
TOWN HALL
SOUTHOLD, NY 11971
TEL: (631) 765-1802
FAX: (631) 765-9502
www.northfork.net/Southold/
PERMIT NO.))9.b;y(3:
Do you have or need the following, hefore applying?
Board of Health _
4 sets of Building Plans ../
Planning B~ approval
Survey ,/
Check -;It:
Septic Form
N.Y.S.D.E.C.
Trustees
Contact:
MaillO SO.:)I(Y"l \('0:~ roots
L-\ll ~e..25A (5~ p-\-
Phone:,Lll\.- 'is lClU N-{ tn?€'
Examined
??~o/I,20N
~r'120~
Approved
Disapproved ale
Expiration_ ~~, 20~
f C-/J--
I Building Inspector
! I
MIll. 20QT
APPLICATION FOR BUILDING PERMIT
Date (Y\M"ch f;tO
,20~
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INSTRUCTIONS
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 pennit
shall b~ 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 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 admit
authorized inspectors on premises and in building for necessary inspections.
"1M MEDIA TEL y"I4DERWRfTERS CE QTjflcff!; o..l
ENCLOSE POOL TO CODE REOUtRED ()
UPON COMPLETION '-f,t 14-e.. 261'\- \(.oc.(e,y t:L-i+ N'f l1118
BEFORE "WATER" (Mailing address ofapplicant)
S I h I., I ALL CONSTRUCTION SHALL I "At" ~ b 'Id
tate w let er app Icant IS owner, ess~E~ewt~~~b~wa contraAt'0r':l';.ert:IYt,~g, p':;;-i:;l)r or Ul er
t)LP'f\ev- CODESOFNE~YORKSTATE. DATE:_.4i:: B.P.I,' '3~ ~b;)e
FEE:
Name of owner of premises /!OM nlcACkUr"l NOTiFY BUILD::';:; ~;~;~/,RTMFNT AT
(As on the tax roll or Il~l €l&d~ P.M TO 4 PM FOR THE
If applicant is a corporation, signature of du6)@0t!lAAN6VrOR FOLLOW:NG INSPECTIO~S:
. ", 1. FOUNDATION - TWO RE'OUIRCD
'~^/FUL FOR POURED CO""'"'":';
(Name and title of corporate officer) UiJC Iv VI'\IL/"\ VV 2. ROUGH _ FRill ::1 (;'- "1; r.u"~ ro
WITHOUT CERTIFICA11ffi;uLATION 'q,., ~ LJ""~b
OF OCCHe-Ml.ICY 4. FINAL. CONSTRUCTION MUST
V 11'\1'\1 BE COMPLETE FOF, C.O.
ALL CONST:~f': ", >'/.' , 'C~T THE
REQUIREMEI if c ; "'I dE CCk:i OF NEW
YORK STATE. NOT fiESPONSIBLE FOR
DESIGN OR CONSTRUCTION ERRORS
1. Location of land on which proposed work will be done: /1. , " .
600 Crown 10.-1'\ A. l-A. ~O~t.l(' U-1 II t16 '5
House Number Street Hamlet
Builders License No. ~14-I,;l"U
Plumbers License No.
Electricians License No, 61..... I e
Other Trade's License No.
County Tax Map No. 1000 Section I {J q ,'., ,Illpck d...
Subdivision l....w.l\'S. z;,d. 'So..., tV w.-th,f1t'u'("'i.f,il~d Map No,
(N ame) c.J .'U," ."0'.
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Lot
Lot
I~- ("
2. State existing use and occupancy of premises and intended use and occupancy of proposed construction:
a. Existing use and occupancy s IY\~\{ ~ii "1 a 'E>1tte.nu
d.. I ..QO'\LO'tU' 0.-1-
b. Intended use and occupancy \f\ s-\-AJ I If'\~YO\.ln roo ~GI
3. Nature of work (check which applicable): New Building
Repair Removal Demolition
4. Estimated Cos~\5'ooO....
Addition
Other Work
Alteration
(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
Depth Height Number of Stories
\,1..
Rear
8. Dimensions of entire new construction: Front
Height Number of Stories
Rear
Depth
9. Size oflot: Front
Rear
Depth
] O. Date of Purchase
Name of Former Owner
II. Zone or use district in which premises are situated
12. Does proposed construction violate any zoning law, ordinance or regulation? YES_NO ,/'
] 3. Will lot be re-graded? YES / NO_Will excess fill be removed from premises? YES_NO ./
14. Names of Owner of premiseS"!om f{\.tAiAtl.1I'\ Addressf:looCroWflIGl.1\/l. L"'" Phone No. 13L.\-5"ia..?-
Name of Architect ~jonn&o" Address W5 Llbu~t"~~~Phone No 33\-,:I..IU5
Name of Contractor rttl{-rRct;.ttlC-W" Address lfJl 4~~' Phone No. 144- <;/'00
(. iLo-tN
15 a. Is this property within 100 feet of a tidal wetland or a freshwater wetland? *YES _NO ...............
* IF YES, SOUTHOLD TOWN TRUSTEES & D.E.C. PERMITS MAY 2QUIRED.
b. Is this property within 300 feet ofa tidal wetland? * YES_:rsro~!J
* IF YES, D.E.C. PERMITS MAY BE REQUIRED.
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16. Provide survey, to scale, with accurate foundation plan and distances to property lines.
17. If elevation at any point on property is at 10 feet or beJ,oy,r, must provide topographical data on survey.
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.:.,
ST ATE OF NEW YORK)
SS:
COUNTY OF )
~andL1 1" l(od.tc!Lev being dul:t'~W6I11, 'd'eposes and says that (s)he is the applicant
(Name of individual signing contract) above named, . . I .
, II!,~ I
-, ,4' .
COl"\<h'.w\v""'-
(Contractor, Agent; Corporate <'lfficer,: etc.)
(S)He is the
('" -
of said owner or owners, and is duly authorized to perform or h~~e 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
performed in the manner set forth in the application filed therewith.
Sworn to before me this
~O d'YOf~61
. . .' . - ~? 8,udw...
Notary Pu hc ~ . . '" , Signature of Applicant
I'<A THLEEN QUIQi.EY
NO rARY PUBLIC, SlItle 01 NlIw YOlk
No. 01Q~U4 ,
Qualjfledin~~
Commission E~.pa.'20~
,
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TOWN OF SOUTHOLD BUILDING DEPT.
765.1802
INSPECTION
] FOUNDATION 1 ST [ ] ROUGH PLBG.
] FOUNDATION 2ND [ ] INSULATION
] FRAMING I STRAPPING UfINAL)!i :
] FIREPLACE & CHIMNEY [] FIRE SAFETY INSPECTION
] FIRE RESISTANT CONSTRUC'nON [ ] FIRE RESISTANT PENETRAnON
REMARKS. /.-.! ~:~
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DATE
"1,..-? 0 - 0 g INSPECTOR.A- ~
3 'J-Y fo ')- 2-
TOWN OF SOUTHOLD BUILDING DEPT.
765.1802
INSPECTION
[ ] FOUNDATION 1 ST
[ ] FOUNDATION 2ND
[ ] FRAMING I STRAPPING
[ ] FIREPLACE & CHIMNEY
[ ] RRE RESISTANT CONSTRUCTION
~
[ ] ROUGH PLBG.
[ ] INSULATION
~ FINAL
[ ] FIRE SAFETY INSPECTION
[ ] FIRE RESISTANT PENETMnON
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DATE 11- ~ '-1J7
INSPECTOR ~PL.
FIELD INSPECTION REPORT DATE COMMENTS ., U)
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FOUNDATION (lSn 6'-
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FOUNDATION (2ND) ~~
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ROUGH FRAMING & O~
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PLUMBING '"'
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INSULATION PER N. Y. " ""
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STATE ENERGY CODE
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FINAL ..,-30 r<nt~ ok. ~'tt"-'h,'~ J
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, . ADDmONAL COMMENTS ::;?
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SUFFOl'+.
BUREAU".
ELECTR CAi~
INSPLCIORS,'flC
40 Nottingham Drive, Middle Island, NY 11953
Telephone: 631 4958136 . Fax: 631 9806455 . E-Mail: SBEIGS@gmail.com
CERTIFICATE OF ELECTRICAL COMPLIANCE
Applicant:
Rough In Inspection Date:
Application No.:
Raymond Electrical
May 5 ,2007
7060
Certificate No.:
Final Inspection Date:
Building Permit No. :
7060
May 5 ,2007
Suffolk County Tax Map No.: 1000 109 2 12.6
This Certificate of Electrical Compliance is limited to the inspection and compliance of electrical equipment and/or
work described below, installed by the applicant named above, located at the premise of and not after the final
inspection date above:
Owner: Tom Me Adam
Site Location: 800 Crown Land Lane, Cutehogue, NY 11935
Owner's Address (if different):
~ Residential D Indoor D Basement D Service
D Commercial ~ Outdoor D First Floor ~Pool
DNew D Renovation D Second Floor DAttic
D Addition D Survey Other:
INVENTORY
Single Phase Heat Duplex Recpt Ceiling Fixture
Three Phase Hot Water GFCIRecpt Wall Fixture
Main Panel AC Gond SingfeRecpt Recessed Fixture
Sub Panel SCkt AC Blower Range Recpt fJourescent
Transformer App'iances Cryer Recpt Emergency
Disconnect Switches 2 Twist Lock Exit Fixtures
GFCI Breaker Heat Pump E1ecbic Heat Pool Luminaire
Other Equipment:
D Shed
D Hottub
D Garage
HID Fixtures
Smoke
co Detect
Pumps
Time Clock
lVSS
Exhaust Fan
electrical work andlor equipment described above were inspected and appear to be in compliance
with local, state and national electrical code requirements and this office,
Applicant: Raymond Electrical
Inspected By: Gene Su .
License No.: 5141ME
Date Of Certificate: May 16 .2007
I.
Signature:
- -
.--
/'1 - /"/
,,-,.
/000 - /0 '1 -) - /:J..t.
OWNER
Jut. me. it
FORMER OWNER
TOWN OF SOUTHOLD PROPERTY RECORD CARD
STREET
/)n
.' (.....I
VILLAGE
DIST.
SUB.
LOT / b
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9
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Lr Eo/Chill
CffOWN
RES.
S
W
ACR.
, 'd!
TYPE OF BUILDING
A'1....'
LAND
VL. 't
TOTAL
Coo
FARM
COMM. CB.
MICS.
Mkt. Value
I'1$"' Q' ~.~.
.... y ... '.. --
GOO
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I ~OO ~~(
I z...........
7200~ B700
DATE
REMARKS
Tillable
FRONTAGE ON WATER
FRONTAGE ON ROAD
1'/
I
Woodland
Meadowland
House Plot
,hi
l~
147.4 2
DEPTH
BULKHEAD
A-v
<9. 'i.$'
I
Total
:2~Bldg.
Extension
\~
Extension
Extension
/l.\'\',
Porch
Porch ~
Breezeway
Go rage
Patio
O. B.
Total
~
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2~,/:'$t\ ~
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\O~ ,4' '''10 l 500
\O~~' 1"6~..l
2. ~ q , l-a
10 'I- '04 ~ 7.04
22.'(..'22" 4~'\-
COLOR
,
_. --.+- -f-.
<O3l4
lSoO
"is- Foundation
Basement
10 ') Ext. Walls
Fi re Place
~S' Type Roof
Recreation Room
.
86/,pc# Dormer
\~(P
7 '2.0.1';> ~4-
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P,c. Bath .3 "t.. Dinette
~\I Floors \-\vJ K. ./
V"'~LC"'O Interior Finish -..e... LR. 1-.1
2(:"\=> Heat \\vJ 0.\ ""~ DR. ../
Rooms 1 st Floor BR. (C~~...."'"
Rooms 2nd Floor ~P..~ 3'i:<1~'- . FIN. B
Driveway T I
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FORM NO. 4
COpy FOR YOUR
INFORMATION
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Office of the Building Inspector
Town Hall
Southold, N.Y.
CERTIFICATE OF OCCUPANCY
No
Z-22580
Date
SEPTEMBER 10, 1993
THIS CERTIFIES that the building
NEW DWELLING
Location of Property 800 CROWN LAND LANE CUTCHOGUE, N. Y .
House No. Street Hamlet
County Tax Map No. 1000 Section 109
Block 2
Lot 12.6
Subdivision
Filed Map No.
Lot No.
conforms substantially to the Application for Building Permit heretofore
filed in this office dated MARCH 2. 1993
pursuant to which
Building Permit No. 21255-Z
dated MARCH 4, 1993
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 ONE FAMILY DWELLING WITH AN ATTACHED GARAGE & OPEN PORCH
AS APPLIED FOR.
The certificate is issued to
LEWIS EDSON
(owner)
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL 93-S0-04-AUG. 25. 1993
UNDERWRITERS CERTIFICATE NO. PENDING - SEPTEMBER 3, 1993
PLUMBERS CERTIFICATION DATED AUGUST 26, 1993-LISO PLUMB & HEAT.
ALA;' k
.- / tf!Uild!ng Inspector
Rev. l/al
1'0" Mo. .
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)
N!N'1 21255 Z
Date .~/i........................................... 19.5.?2
Permission Is he~d~. _ 4L
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..es?~.....&~......'1.f..:?!!1.................................
....~ . ...~...7.24(...,...!..!..f::I. 7 -/ ~
to~~B:....G.fe''''';';''''::''~7'~ - ...~~...~d
~.....~. ........~....d1:J:.... ..~F........................
at premises located at..... ..el2..~...~.. ......:{~............................................
..........................................................q~{MC.....................................................................
..................................................................................................................................................................
County Tax Map No. 1000 Section ......./.,e.t..... Block .........2:...... Lot No. .../..4P..dp.........
pursuont to application dated ...~?:::...................................... 19.&;.r... ond approved by the
Building InspectDr.
Fee $...7.o.tJ/f;1
~...~.if~../l..~......................
./ ~d'ng Inspector
Rev. 6130/80
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Chief f I!lufft!Hl at WMlIIwm MlIn~
AMENDED MAI2.3!.!993,AP~ IS, 1993
"~..JULY28;1993; .'\0,,1. 9, !9'j'3.
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PS SI]R~JEYE-D DEe. 10 '90'2.-
RODERICK VAN TUYL. PJ(C'
1'2. V~-:r~il
LICENSED LAND SURVEYORS
,GRE:E<<~':r~> :.~~}f:(JRt<
SUFFOLK CO. HEALTH DEPT. APPROV I
H.S, NO,'J3'.sO'04
I 3
--'---
ST ATEMENT OF INT~T
THE WA'i-ERSUPPL Y AND SEWAGEDISPC
SYSTEMS FOR THIS RESIDENCE,' ~
CONFORM TO THE STANDARDS OF
SUFFOLK CO. DEPT. OF HEALTH SERVi
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APPLICANT
SUFFOLK COUNTY
SERVICES - FOR.
CONSTRUCTION ONLY
DATE:
H. S. REF. NO.: 93.-:3.Q, 04
APPROVED:
DEPT. OF HEll
APPROV AL
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