HomeMy WebLinkAbout33921-ZFORM NO. 4
TOWN OF SOUTHOLD
BUILDING DEPA=RTMENT
Office of the Building Inspector
Town Hall
Southold, N.Y.
CERTIFICATE OF OCCUPANCY
No: Z-33291
~te: 09/24/08
THIS u~KTIFIES that the building SWIMMING POOL FENCE
Location of Property: 355 WOODCLIFF DR
MATTITUCK
(HOUSE NO.) (STREET)
County Tax Map No. 473889 Section 107 Block 7 Lot 25
Filed Map No. Lot No. __
Subdivision
(HAMLET)
conforms substantially to the Application for Building Permit heretofore
filed in this office dated MAY 14, 2008 pursuant to which
Building Permit No. 33921-Z dated MAY 20, 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 FENCE ENCLOSURE FOR AN EXISTING IN GROUND SWIMMING POOL AS APPLIED FOR.
The certificate is issued to FREDERICK V & BARABAR L HANSEN
(OWNER)
of the aforesaid building.
SUFFOLK COU~FrY DEPART~ENT OF HEALTH APPRO~rAL
ELEC~RICAL c~KTIFICATH NO.
PLU~BERS u~KTIFICATION DA'r~u
N/A
Rev. 1/81
Form No. 6
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TO x~VN HALL
765-1802
APPLICATION FOR CERTIFICATE OF OCCUPANCY ]
This application must be filled in by typewriter or iak and subm/tted to the Buikting Departme'rtt"w~ the-fOllo~ii~i:
A. For new building or new use: 1. Final survey of property with accurate location of ali buildings, p~opm~y lines, streets, and unusual naturalor
topographic features.
2. Final Approval from Health Dept. of water supply and sewerage-disposal (S-9 form).
3. Approval of electrical installation fi-om Board of Fire Underwriters.
4. Sworn statement fl~om plmnber certifying that the solder used in system contains less than 2/10 of 1% lead
5. Co~mnercial building, industrial building, multiple residences and similar buildings and installations, a ce~ificate
of Code Compliance from architect or enginee! responsible for the building.
6. Submit Planning Board Approval of completed site plan requirements.
B. For existing buildings (prio~ to April 9, 1957) uou-conlorming uses, or buildings and "pre-existing" landuses:
1. Accurate supvey of prope~%, showing all properly lines, s(reets, building and unusual natural or topographk
features.
2. A properly completed applicatien and consenl to in, peel signed b3 the applicant If a Ceilificate of Occupancy is
denied, the Building ]nspectol shall slate the zeaso~s l}lelef'oi ill writing to the applicant.
C. Fees
New Construction:
Location of Propmly:
1. CettificateofOccupanc,; Neu. dweiling$25.0(i,,Additionstodwclling$25 00, Alterations to dwellmg $25.00.
Swium~ing pool $25.00, Accessory building 525 00 Additions to accessoty building $25.00, Businesses $50 00
2 CertificateofOccupm~cyonI:qeexistingBtnldin~2 $10000
3 Copy of Ceaificate of Occupancy $25
4 Updated Cel~ificate of C)ccupan%, $5000
5 Temporary Ce~tificalc ofOccupaocy - Residential $15 00. (onunercial $1500
~re ex,sting Building Date. S~¢,
House No. Street I
q,
__ (cheok one) .p
Lot O o~ ~"--
Underwriters ApN oval:
Ow.er Owne,, of Prope,.y:
Sufiblk C6unty Tax Map No !g0O, Sectiou ~ l O ~ Block
Subdivision ~ ~ . Filed Map.
Permit No 33q [ DateofPetmil ~ -al'f0~ Applicant:
Health Dept. Approval: ' '
Plamng Board Approval:
Request for: Temporary Certificate
Fee SuNrdtted: $ c:~ ~, ~ {5
Lot:
Applicant Signature
FORM NO. 3
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Tow~ Hall
Southold, N.Y.
BUILDING PERI, IT
(THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL
COMPLETION OF THE WORK AUTHORIZED)
PERi,IT NO. 33921 Z Date MAY 20, 2008
Permission is hereby granted to:
BARBARA HANSEN
355 WOODCLIFF DRIVE
MATTITUCK,NY 11952
for :
CONSTRUCTION OF A FENCE SURROUNDING AN EXISTING INGROUND SWIMMING
POOL AS APPLIED FOR FENCED TO CODE
at premises located at 355 WOODCLIFF DR
County Tax ~ap No. 473889 Section 107 Block
pursuant to application dated MAY 14, 2008
Building Inspector to explre on NOVEMBER 20,
MATTITUCK
0007 Lot No. 025
and approved by the
2009.
Fee $ 100.00
/ Authorized Signature
ORIGINAL
Rev. 5/8/02
TOWN OF SOUTHOLD BUILDING DEPT.
765-1802
INSPECTION
FOUNDATION 1ST [ ] ROUGH PLBG.
FOUNDATION 2ND [ ] INSULATION
FRAMING / STRAPPING ~.
FINAL
FIREPLACE & CHIMNEY [ ] FIRE SAFETY INSPECTION
FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRATION
TOWN OF SOUTHOLD BUILDING DEPT.
765-1802
INSPECTION
[ ] FOUNDATION 1ST [ ] ROUGH PLBG.
[ ] FOUNDATION 2ND [ ] INSULATION
[ ] FRAMING / STRAPPING [~FINAL
[ ] FIREPLACE & CHIMNEY [ ] FIRE SAFETY INSPECTION
[ ] RRE RESISTANT CONSTRUCTION [ ] FIRER~I~ANT~NETRATION
REMARKS:
DATE
TOWN OF SOUTHOLD BUILDING DEPT.
765-1802
INSPECTION
[ ] FOUNDATION 1ST
[ ] ROUGH PLBG.
[ ]FOUNDATION 2ND
[ ]FRAMING / STRAPPING
[ ]FIREPLACE & CHIMNEY
[ ] INSULATION
XFINAL
[ ] FIRE SAFETY INSPECTION
[ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRATION
REMARKS: ~:~ ~ ~/~~
DATE ~;;~ ~3'~'~ INSPECTOR~~
,5
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN HALL
SOUTHOLD~ NY 1.1971
TEL: (631) 765-1802
FAX: (631) 765,9502q -'
SoutholdTown. NorthFork.net
Examined
/
^.proved 4/ 20
/
Disapproved
Expiration
PERMIT NO.
/ Building Inspector
APPLICATION FOR BUILDING PERMIT
INSTRUCTIONS
BUILDING PERMIT APPLICATION CHECKLIST
Do you have or need the following, I~fore applying?
Board of Health
4 sets of Building Plans
PIanning Board approval
20 0¢
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 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 thc 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 thc permit for an
addition six months. Thereafter, a new permit shall be required.
APPLICATION IS HEREBY MADE to thc Building Department for the issuance ora 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.
(Signatare of applicant or name, if a corporation)
(Mailing address of applicant)
State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder
(As on the tax roll or latest deed)
If applicant is a corporation, signature of duly authorized officer
(Name and title of corporate officer)
Builders License No.
Plumbers License No.
Electricians License No.
Other Trade's License No.__. [C,~]g~ ¥~[ ~ ~0"J~ griLL ~&-:lk)(~_~
/ 1. Location of land on which proposed work willbe done'
House Number Street Hamlet
County Tax Map No. 1000 Section IO'~ Block 7
Subdivision Filed Map No.
"IMMEDIATEI.Y"
ENCLOSE POOL TO CODE
UPON GOMPLETION
BEFORE "WATER"
OCCueANUY OR
USE I,g
WITHOUI Gt::F{TIFIGATE
OF OCGUPANGY
C.q,
DATE:_
NO[,FY E:.'.-;Lc DEPABT~ENT AT
765-1802 8AM TO 4PM FOR THE
FOLLOWING INSPECTIONS:
L FOUNDATION - TWO REQU'.RED
FOR POURED CONCRETE
Z ROUGH - FRAMING & PLUMBING
3. INSULATION
'T THE
: NEW
:~K S'i;,;:. ~':.: .:-F '2hSiaLE FOR
DESIGN OR CONSrRUGTION ERRORS.
2. State existing use and occupancy of premises and intended use and occupancy of proposed construction:
a. Existing use and occupancy
b. Intended use and occupancy.
d 3. Nature of work (check which applicable): New Building Addition Alteration
Repair Removal Demolition OtherWork }D~2X) t:-~lqC~_
(Description)
4. Estimated Cost 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
Height Number of Stories
Rear _Depth
Number of Stories
9. Rear
10. Date of Pumhase Name of Former Owner
Dimensions of same structure with alterations or additions: Front
Depth Height. Number of Stories
Dimensions of entire new construction: Front Rear
Height
Size of lot: Front _Depth
Rear
_Depth
11. Zone or use district in which premises are situated
12. Does proposed construction violate any zoning law, ordinance or regulation? YES__ NO__
13. Will lot be m-graded? YES__ NO__Will excess fill be removed from premises? YES NO
, 5 55
414. Names of Owner of premises Address Phone No.
Name of Amhitect '~ Address -- Phone No
Name of Contractor ~}/~O~J~-. FI L[- 7~1~ c,~:~ddress Phone No.
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 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 and distances to property lines.
17. If elevation at any point on property is at 10 feet or below, must provide topographical data on survey.
18. Are there any covenants and restrictions with respect to this property? * YES __ NO ~'
· IF YES, PROVIDE A COPY.
STATE OF NEW YORK)
SS:
COUNTY OFS~F~L ~4)
~ /~(~ t~ /~ N~/~ ~"-{ being duly swom, deposes and says that (s)he is the applicant
(Name ofindividuaI signing contract) above named,
(S)He is the 0 [,U ~,l ~ ~
(Contractor, Agent, Corporate Officer, etc.)
of said owner or owners, and is duly authorized to perform or have performed the said work and to make and file this application;
that all statements contained in this application are hue 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
I ~ day of /~ /~ ~ 20 (9~
l~r ~i~'~ Notary Public, State of Now York
~ NO. 5003414
~ Qualified in Suffolk County
~ommission Expires ~
TOWN OF SOUTHOLD PROPERTY RECORD CARD ~.
OWNER ISTREET .', ;:, VILLAGE DIST. SUB. LOT
RES. ~'t~,
SEAS.
N ,~ / E
TYPE OF' BUILDING
VL FARM CB. MICS. Value
LAND IMP. TOTAL DATE REMARKS
r,-~-u
AGE BUILDING CONDITION
NEW NORMAL BELOW ABOVE
FARM Acre
Tillable
Woodland
Value Per Vc~lue
Ac re
Meadowland
House Plot
Total
FRONTAGE ON WATER
FRONTAGE ON ROAD
DEPTH
BULKHEAD
DOCK
M. Bldg./
Extens
Extension "~
Extension
Po~ch ?
Porch
Total
TRIM
Foundation
Ext. Walls
TYpe
Roof
Recreation Room
IDormer
Bath
Floors
Interior Finish
Heat
Rooms 1st Floor
Rooms 2nd FIoo~
· DriVeway
/ // 'Dinette
0 ¢._/~' K.
SURVEY OF PROPERTY
~7TUATED AT
MATTITUCK
TOWN OF SOUTHOLD
SUFFOLK COUNTY, NEW YORK
S.C. TAX No. 1OOO-107--O7-25
SCALE 1" =20'
SEPTEMBER 15, 1995
CERTIFIED TO:
CH(CAGO TITLE INSURANCE COMPANY
TITLE No. 9508--04644
BRIDGEHA~PTON NATIONAL I~ANK
AREA = 15,59g.57 sq_ ft.
0,308 ac.
Land
A. Ingegno
Surveyor
%$5.OO'
5.O0'