HomeMy WebLinkAbout34597-ZFORM NO. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Office of the Building Inspector
Town Hall
Southold, N.Y.
CERTIFICATE OF OCCUPANCY
No: Z-33685
I~ate: 05/01/09
THIS ~TIFIES that the building ACCESSORY
Location of Property: 6670 SKUNK LA
(HOUSE NO.) (STREET)
County Tax Map No. 473889 Section 104 Block 5
Subdivision
Filed Map No. __ Lot No. __
CUTCHOGUE
Lot 7
( HAMLET )
conforms substantially to the Application for Building Permit heretofore
filed in this office dated APRIL 9, 2009 pursuant to which
Building Pel~nit No. 34597-Z ~ted APRIL 9, 2009
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 BRIAN & ELLEN GALLAGHER
( OWNER )
of the aforesaid building.
SUFFOI~KCO~YDEPARq~T OF ~{F~%LTHAPPRO~-AL N/A
E~.~C~!~RICAL c~TIFICA~ NO. 117902C 07/30/07
PLIERS C~KTIFICATION DA'rF~u N/A
Rev. 1/81
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
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;
For new building or new use:
1. Final survey of property with accurate loc~tion of alii buildings, prOPerty Frees, 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 iustallation fix)m Board of Fire Underwriters.
4. Sworn statement from plumber certifying that the ~older used in system contains less than 2/10 of 1% lead.
5. Commercial building, industrial building, multiple residance~ and similar buildings and installations, a certificate
of Code Compliance from arehitcct or engineer re*pousible for the building.
6. Submit Planning Board Approval of completed site plan requirements.
For existing buildings (prior to April 9, 1957) non-conforming uses, or buddings and "prc-exi
1. Accmate survey of property showing all property line~, streets, building undunusual natural or
features.
2. A properly completed application and consent to inspect signed by the applicant. If a Certificat~
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 d
Swimming pool $25.00, Accessory building $25.00, Additions to accessory building $25.00, Bt
2. Certificate of Ocoupancy on Pm-existing Building - $100.00
3. Copy of Certificate of Occupancy- $.25
Updated Certificate ofOccu, pancy- $50.00
4.5. Tempotm-y Certificate of~ccupancy - Residential $15.00, Commercial $15.00
Date.
New Construction:
House No. ,'x-- ~ Strut . xJ ! '-~lamlet
Owner or Owners of Property: /~~ ~q.~4Od~
' Suffolk County Tax Map No 1000, Section /0'¢ Block ~ Lot--
Subdivision , ~ t Filed Map.
Permit No. ~~Da~f~ermi!. ~ft. q/tff/ Applicant: ,~
?
Final Certificate: ~/ (check one)
Applicant Signature
Request for: Temporary Certificate
Fee Sabmitted:$
ine ....
Issue Date
7/30/07
Electrical Inspection Certificate
Electrical Inspection Service, Inc. Application
375 Dunton Avenue 117902C
East Pstchogue, New York 11772
(631) 286-6642
Issued To: Mr. Brian Gallager
Street: 6670 Bay Avenue
Village: Cutchogue Zip: 11935
Section: 104 Block: 5 Lot: 7
Contractor: Elec Tec Inc.
Town: Southold
Lic.# 4814-E
Was examined and found to be in compliance with the National Electrical Code.
Commercial L~ NV Defects IX~ Pool ~ lstFIoor [Xl Indoor
Residential [] DeL Garage /' Attic [] 2nd Floor [Xj Outdoor ·] Addition
Switches Recep~aclea Fixtures GFI Heaters A/C
2 1
Dishwasher
· Basement [~ Hot Tub
I~il Survey
Fans
Wesher/Amps D~/er/Amps Oven Range/Amps Microwaves
Furnace Oil Gas Circulators Smoke Detector Bell Transformer
Meter Amps Phase UG/OH Jacuzzi
/
Television CO Detector
Bldg. Permit:
Other Equipment
1:Po01 Light/~-SUbpan6i Raintight/2-Time
Clocks/2-20 amp Spec. Outlets/1-15 amp
Heater Disc.
Hugo S. Su/~li
President
Rough Inspecidon:
Inspector:
Rnai InspecUofl: 07/25/2007
Inspector: John Mc Mahon III
This certificate must not be altered in any manner. Inspectom may be identified by their credentials.
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)
PER~IT NO. 34597 Z Date APRIL 9, 2009
Permission is hereby granted to:
BRIAN & ELLEN GALLAGHER
3445 LUFBERRY AVE
WANTAGH,NY 11793
for :
CONSTRUCTION OF AN INGROUND SWIMMING POOL AS APPLIED FOR IN THE
REQUIRED REAR YARD,FENCED TO CODE.
at premises located at 6670
County Tax Map No. 473889 Section 104
pursuant to application dated APRIL
Building Inspector to expire on OCTOBER
SKUNK LA CUTCHOGUE
Block 0005 Lot No. 007
9, 2009 and approved by the
9, 2010.
Fee $ 250.00
Authorized Signature
ORIGINAL
Rev. 5/8/02
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.
32683 Z Date JANUARY 30, 2007
Permission is hereby granted to:
BRIAN & ELLEN GALLAGHER
WANTAGH,NY 1~793 O
for :
CONSTRUCTION OF AN IN-GROUND SWIMMING POOL AS APPLIED FOR IN THE
REQUIRED REAR YARD
at premises located at 6670
County Tax Map No. 473889 Section 104
pursuant to application dated JANUARY
Building Inspector to expire on JULY
Fee $ 250.00
SKUNK LA CUTCHOGUE
Block 0005 Lot No. 007
24, 2007 and approved by the
30, 2008.
zed 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
REMARKS:
DATE /~-17'-a~ iNSPECTOR ~r~-, ~
TOWN OF SOUTHOLD BUILDING DEPT.
765-1802
INSPECTION
[ ]FOUNDATION 1ST
[ ]FOUNDATION 2ND
[ ]FRAMING / STRAPPING
[ ]FIREPLACE & CHIMNEY
[ ]FIRE RESISTANT CONSTRUCTION
[ ] ROUGH PLBG.
[ ]INSULATION
~INAL
[ ] FIRE SAFETY INSPECTION
[ ] FIRE RESISTANT PENETRATION
FW, I,D ll',!SPECTIONREPORT ] DATE I COMMENTS
FOU2NrDATION
(IST)
FOUNDATION (2ND)
ROUGH FRAM3[NG &
PLUMBING
]INSULATION PER N. Y.
STATE ENERGY CODE
FINAL
ADDITIONAL COMMENTS
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN HALL
SOUTHOLD, NY 11971
TEL: (631) 765-1802 ·
FAX: (631) 765-9502
www. northfork.net/Southold/
,/
Examined !'/'es' ,20 ~
Approved / ,20_
Disapproved a/c
Expiration ,20__
PERMIT NO. -~
BUILDING PERMIT APPLICATION CHECKLIST
Do you have or need the following, befbre applying?
Board of Health
4 sets of Building Plans v/'
Planning Board approval
Survey fi/
Check r./
Septic Form
N.Y.S.D.E.C.
Trustees
Contact:
Mail to:
APPLICATION FOR BUILDING PERMIT
Date /,/~Z ,20t97
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, relationslfip 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 prenfises 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
proper~y 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.
(Signature of applicant or name, if a corporation)
(Mailing address of applicant)
State ~vhether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder
Name of owner of premises
(As on the tax roll or latest deed)
If applicant is a corooration, signature of duly authorized officer
'(Name ~md title of corporate officer)
Builders License No.
Plumbers License No.
Electricians License No.
Other Trade's License No.
Location ot~land on
House Number
which proposed work will be done:
Street
Hamlet
County Tax Map No. 1000 Section _/fi)p/
Subdivision "-6,7~,,c)
(Name)
Block ff
Filed Map No.
Lot ,~
Lot
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
3. Nature of work (check which applicable): New Building
Repair Removal Demolition
4. Estimated Cost ~,s~,, ~./)Ot).rv~)
5. If dwelling, number of dwelling units
If garage, number of cars
Fee
Addition Alteration
oL) (Description)
(To be paid on filing this application)
Number of dwelling units on each floor
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 ff~J Depth
Dimensions of same structure with alterations or additions: Front Rear
Depth Height Number of Stodes ~ ~ ~ ~,
8. Dimensions of entire new construction: Front
Height Number of Stories
Rear Depth
9. Size of lot: Front /,9 Z~'oz'~ Rear /d~ 2, e'~-' Depth
10. Date of Purchase
Name of Former Owner
ll. Zone or use district in which premises are situated 72~3/2>~-~-~.-~,,J'a -~'-~'~
12. Does proposed construction violate any zoning law, ordinance or regulation? YES NO ~'
13. Will lot be re-graded? YES & NO__Will excess fill be removed from premises? YES ~( NO
14. Names of Owner of premisesZ;~//~,v z~,~.z,4w~,z Addressd6,,~ *r,~//~-- &,~q;~Phone No. ~
Name of Architect Address Phone No
Name of Contractor d,~,~,~ ~-o~ ~,~ Address ~, ~ . . Phone No. ~'~'e'-
15 a. Is this property within 100 feet of a tidal wetland or a freshwater wetland? *YES
* 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.
NO-k'
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.
STATE OF NEW YORK)
SS:
COUNTY OF ~ ?%k,kC)
~Z2~ --
~' _ ~-Td,~ /'7.,z/'/;~t~" being duly sworn, deposes and says that (s)he is the applicant
(Name of individual sit,ting contract) above named,
(S)He is the
(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 tree to the best of his knowledge and beliefi and that the work will be
performed in the manner set forth in the application filed therewith.
Sworn to before me ~l~ss'///
~'~ day/~' ./"~O/~'~t 20 0 7
/ ~ota~blic x ~
Note~ublic, State of Now York
~s~ified in Suffolk Coun~
~ No. 01SC47250~ ,~
T~rm Expires May 31, ~-
Signature of Applicant
TOWN OF SOUTHOLD PROPERTY RECORD CARD
OWNER
C-~n I Ioa ¼e r'-
FORMER Ow~IER
LAND
VL.
IMP. TOTAL
!
1'4
~oo 3 $ o~ ' oo
~ 1 ~'¢o~'~'~ "~ ~ oO
FARM
DATE
VILLAGE
SUB. LOT
Mkt. Value
AGE BUILDING CONDITION
NEW NORMAL BELOW ABOVE
FARM Acre
Tillable FRONTAGE ON WATER
Woodland FRONTAGE ON ROAD
Meadowla~cl DEPTH
House Plot BULKHEAD
Value Per Value
Acre
DOCK
TRIM
Extension
Extension
Extension
Porch
Breezeway
Garage
Pbtio
Foundation
Ext, Walls
Fire Place
Type Roof
t Recreati__on_ _Room
· . LDormer
Beth
Floors
Interior Finish
Heat ,~
Rooms I st Floor
Rooms 2nd Floor
Driveway
Dinette
LR.
DR.
BR.
FIN. B
104.-5-7 9/06
COLOR
TRIM
I st 2nd
M'BId~+~'~'X~---- /O~C~, ~'..~'0 ~"??D Foundation ~ _ Fin, B, Bath ~ Dinette
Exten{~°3 ~ x13 ~ / ~ ~s° ~.'~ ~0 easement s~ PA"T'AL Floors Kit,
Ext~nsi~: ~g: ~ ~ Ext. Walls L.R.
Extension Fire Place O~ Heat D.R.
Patio Woodstove BR.
~o~ ~ ~o~me~ Ba~h~
Garage ~X~: ~ I,~q ~_d .....
O.B.
Pool
O~WNER STREET VILLAGE
ACR.
TYPE OF BLD.
PROP. CLASS
LAND IMP. TOTAL DATE
REMARKS
FRONTAGE ON ROAD
DEPTH
BULKHEAD
I
SUB. LOT
TILLABLE
WOODLAND
MEADOWLANE)
HOUSE/LOT
TOTAL
WI~t.I.
TOWN OF SOUTHOLD PROPERTY REC
STREET
VILLAGE
ACR.
TYPE OF BLD.
REMARKS
PROP. CLASS
TOTAL DATE
12716223150-2H 2054 2486
COPIES ~. ~T,S C~L 806-421-1030
SUI~N4~¥ OF PP. OPEP-.TT
SITUATE, OUTCHOCUE
TOIAIN, SOUTHOLO
5t)F~OLK COUNTY, NY
SU~VFYtED
SUFFOLK~ COUNT'f' TAX ~
1000-104-5-~
N
E
NOTES:
· I"qONUMENT FOUND
0 PiPE FOUND
· t~.E DA~ FOUND
ELEVATIONS REFERENCE SUFFOLt< COUNTY TOPO f'dAPS
TO~N P~.OPE~.TY ZONE P. 40
AREA = 1~2,121 SF or' 0.~ ACP-.ES
®P. APHIC, SC, ALE I"= 50'
JOHN C. EHLERS LAND SURVEYOR
6 EAST MAIN STREET N.Y.S. LIC. NO. 50202
RIVERHEAD, N.Y. 11901
~'~'r]. 8' n 8' I1 8' n -8'
· 8
5 4 U 8 U 8 U 8' 'U 8' '
24' I'kia I'~mk (01.01 &)
I.~' Cm~' Set
I -l~ (~ir, J (Jrl ~f (I 0-004
bl~e 44' ~ ;~ek (0~.0~9)
I ~' ~lmm~ i)oml (0~.01 i
?4' ~ ~ {OJ-OlO)
SiZE
Il' z 34V
[N-GROL~D SWIMMING POOL ~.'ILL BE CONSTRUCTED
OF STEEL WALLS Sb~I:)C)RTINO A VINYL LINER THAT
'~,' .L HOLD APPROX MATLY 27,500 GALLONS OF WATER..
FENCE WILL BE AT LEAST 4' H]GI! WITH SELF CLOSING
GATES.THAT ~,qLL MEET TOWN CODES.
APPROVED AS NOTED -
DATE: '?,.~__~ B.P. # ~-~ l~)~"'3"~
NOTIFY BUILDING b::~ARTMENT AT
!765-1802 8AM TO 4bM 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.
ALL CONSTRUCTION SHALL MEET THE
REQUIREMENTS OF THE OODES OF NEW
YORK STATE. NOT RESPONSIBLE FOR
DESIGN OR CONSTRUCTION ERRORS.
OCCUPANCY OR
USEISUNLAWFUL
WITHOUTCERTIFICATE
OFOCCUPANCY
UNDERWRITERS CERTIFICA'E
REQUlREO
"IMMEDIATELY"
ENCLOSE POOL TO CODE
UPON COMPLETION
BEFORE "WATER"
ALL CONSTRUCTION SHALL
MEET THE REQUIREMENTS OF THE
CODE8 OF NEW YORK STATE.