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HomeMy WebLinkAbout33034-ZFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPDRTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY NO: Z-33719 Date: 05/18/09 THIS U~'TIFIES that the building ACCESSORY Location of Property: 260 HALLS CREEK DR MATTITUCK (HOUSE NO.) (STREET) (HAMLET) County Tax Map NO. 473889 Section 115 Block 17 Lot 17.28 Subdivision Filed Map No. __ Lot NO. conforms substantially to the Application for Building Permit heretofore filed in this office dated MAY 3, 2007 pursuant to which Building Pez~t No. 33034-Z dated MAY 15, 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 IN GROUND SWIMMING FOOL WITH FENCE TO CODE AS APPLIED FOR. The certificate is issued to SCOTT & KATHLEEN HYGOM (OWNER) of the aforesaid building. SIIF~I~K CO~/Q~"fDEPAR~TOFHF~k~THAPPROI~kL N/A ELECII~IC3%L £1~RTIFICATH NO. 3036088 06/25/07 PLK~ERS CERTIFICATION DA'I'~D N/A Rev. 1/81 Form No. 6 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL 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: A. For new' building or new use: 1. 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 1% lead. 5. Connnercial 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 Plarming 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: 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 therefor in writing to the applicant. C. Fees 1. 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 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. ~-~- /..~'~0~ New Construction: Location of Property: C~GC) House No. Owner or Owners of Property: Suffolk County Tax Map No 1000, Section Subdivision Permit No...~Cb3 q Health Dept. Approval: Old or Pre-existing Building: c,,'-cc\c Street (check one) Filed Map. Hamlet Underwriters Approval: Lot ~_~,q. 0 ~:,'~ ~' Lot: Planning Board Approval: Request for: Temporary Certificate Fee Submitted: $ ~-~,~'. ( ")O Final Certificate: (check one) Applicant Signature BY THIS CERTIFICATE OF COMPLIANCE THE NEW YOrk BOARD Of FIRE UNDERWRITERS BUREAU OF ELECTRICITY 40 FULTON STREET ~ NEW YORK, NY 10038 CERTIFIES THAT Upon the application of upon premises owned by SCOTT HYGOM SCOTT HYGOM 260 HALL'S CREEK DR. 260 HALL'S CREEK DR. MATTITUCK, NY 11952 MATTITUCK, NY 11952 260 HALL'S CREEK DR. MATTITUCK, NY 11952 Located at Application Number: 3036088 Certificate Number: 3036088 Section: Block: Lot: Building Permit: BDC: ns11 Described as a occupancy, wherein the premises electrical system consisting of electrical devices and wiring, described below, located in/on the premises at: Outside, Pool/Spa, A visual inspection of the premises electrical system, limited to electrical devices and wiring to the extent detailed herein, was conducted in accordance with the requirements of the applicable code and/or standard promulgated by the State of New York, Department of State Code Enforcement and Administration, or other authority having jurisdiction, and found to be in compliance therewith on the 25th Day of June, 2007. Name QTY Rate Ratin~ Circuit Type Appliances and Accessories Pool/SpaBonding 1 0 Time Clock/Switch 1 0 Panels 1 80 3 Wiring and Devices Fixture 2 0 Pool/Spa Receptacle I 0 20a Pool/Spa Receptacle 1 0 GFCI Receptacle 1 0 General Purpose GFCI Circuit Breaker 3 0 20a Pool/Spa (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 made by a qualified person. seal I of 1 This certificate may not be altered in any way and is validated only by the presence of a raised seal at the location indicated. 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. 33034 Z Date MAY 15, 2007 Permission is hereby granted to: SCOTT & KATHLEEN HYGOM 260 HALLS CREEK DR MATTITUCK,NY 11952 for : CONSTRUCTION OF AN IN-GROUND SWIMMING POOL IN THE REQUIRED REAR YARD AS APPLIED FOR at premises located at 260 HALLS CREEK DR County Tax Map No. 473889 Section 115 Block pursuant to application dated MAY 3, 2007 MATTITUCK 0017 Lot No. 017.028 and approved by the Building Inspector to expire on NOVEMBER 15, 20~.~"~ ' ~ Fee S 250.00 ~~/ Authorized Sig~ 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: f~ ,~ DATE FIELD INSPECTION REPORT ] DATE [ COMMENTS FOUNDATION (2ND) -- ROUGH FRAMING & PLUMBING STATE ENERGY CODE ADDITIONAL COMMENTS TOWN OF SOUTHOLD BUILDING DEPA~RTMENT TOWN SOUTHOLD, .NY 11971 TEL: (631) 765-1802 FAX: (631) 765-9502 www. northfork.net/Southold/ Examined ,20 Approved ~F//r'- ,20 ~ Disapproved a/c Expiration ,20 PERMIT NO. BUILDING PERMIT APPLICATION CHECKLIST Do you have or need the following, before applying'? Board of Health 4 sets of Building Plans Planning Board approval Survey Check Septic Form N.Y.S.D.E.C. Trustees C°ntact:Mail to: ~ ~L~,trr~ ~ tr'l ~ ~00} ~ ~ctor ~_ APPLICATION FOR BUILDING PERMIT Date INSTRUCTIONS a. T~his application MUST be c~mpletely filled in by typewriter or in ink and submitted to the Building Inspector with 4 sets of plan~Va'~¢~ate 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 m2er 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~77) k.~ (Signa~re~f-applicant or name, if a corporation) (Mailing address bf applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder Nmneofownerofpremises ..~e0{t' {Af~0ffh (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. &).lq I ~- H Plumbers License No. Electricians License No. ~ ~ q- [ ~ Other Trade's License No. 1. Location of land o,n which proposed work will be done: , . House Number Street Hamlet County Tax Map~No. 1000 Section Subdivision ~a/y)O~9~eo9 MI -- (Name) II ~ Block ' I-/ '.~.tlddnq~c-K. Filbd Map NO.` Lot 17 :,gJB Lot ~q 2. State existing use and occupancy of premises and i~ended use and occupancy of proposed cons?ruc¢.~llf: a. Existing use and occupancy b. lntended use and occupancy ~_~,q_~eg~',lc{ (6~d.O~lO.~ oD! iFI~CooJ't~ 000] 3. Nature of~vork (check which applicable): New Building Addition Alteration Repair Removal Demolition Other Work Estimated Cost~[~, 009 -' 5. If dwelling, number of dwelling units If garage, number of cars Fee (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 Depth Dimensions of same structure with alterations or additions: Front Depth Height Number of Stories Rear 8. Dimensions of entire new construction: Front Height Number of Stories Rear Depth 9. Size of lot: Front Rear Depth 10. Date of Purchase Name of Former Owner 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 re-graded? YES__ ¢'' NO Will excess fill be removed fi.om premises? YES.__ NO 14. Names of Owner ofpremises~ CoPx ~ ¥ ct0r¢ Address oqbO NameofArchitect ~,,k~3 ,j0hrk, fqa to Address t\~dge4t44)OC4 l~'honeNo Name of Contractor ~-~?ndl('f k/od(£X,,,./ Address q-~t g-4f_ 2~'4' 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. PhoneNo. 55-.q55Bq ~ 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 ) %oLf ~(~ i i%u(~ being duly sworn, deposes and says that (s)he is the applicant (Name of. x,. .individual signing contract) above named, (S)He is the (Contractor, A~e~t, 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 belief; and that the work will be performed in the manner set forth in the application filed therewith. Sworn to before me this f 007 KATHLEEN QUIGLEY NOTARY PUBLIC, State o~ Y~ NO. 01Q~24124 Q~lifi~ in Suffolk Co~ ~n Expires ~125 20~ ¢" / Signature of Applicant Erosion, Sedimentation and Storm-water Run-off Control Plah A SESSMENT FORM Yes 1~o EXEMPTIONS: A. Does this project meet the minimum standards for classification as an Agricultural Project. \J' .Note: If you answered Yes to any of the above, a Storm-water, Grading, Drainage & Erosion Control Plan is not required. .ACTIONS REQUIRING THE SUBMISSION OF A STORM:WATER~ GRADING~ DRAINAGE & EROSION ,,CONTROL PLAN CERTIFIED BY A DESIGN PROFESSIONAL IN THE STATE OF NEW YORK. Item Number: (A Check Mark (4) for each question is required for complete application) Will this project retain all Storm-Water Run-off generated on Site? (This will include all run-off created by site cleating and/or construction activities as well as all Site Improvements and the permanent creation of impervious surfaces.) Will this project require any land filling, grading or excavation where there is a change to the natural existing grade involving more than 200 cubic yards of material within any parcel? Will this application require land disturbing activities encompassing an area of five thousand (5,000) square feet of ground surface or more? Is there a Natural Water course running through the site or is this project within One hundred (100) feet of wetlands or a beach? Will there be site preparation on slopes which exceed fifteen (1 $) feet of verticaI rise to One hundred (100) feet of horizontal distance? Will driveways, parking areas or other impervious surfaces direct Storm-Water Run-off into and/or in the direction of a Town Right-of-Way? Will this application require the placement of material, removal of vegetation and/or the .construction of any item within the Town Right-of-Way or road shoulder area? 0'his Rem does not include the installation of driveway aprons.) Yes 1~o 8. . Will there be site preparation within the one hundred (100) year floodplain of any watercourse? Note: If any answer to questions ~)ne through eight is answered with a check mark in the Box, a Storm-water, Grading, Drainage & Erosion Control Plan is required and must be submitted for review prior to issuance of any building permit. A ST TE OF NEW YORK, COUNTY OF ........ ~.~ ~'!.~/~P~' f (~ SS That I, .}~.k'lr~'~.... (~ii..~\~ ............ being duly sworn, ~ieposes and says that he/she is the applicant for Permit, (Name of individual signing Documen'0 And that He/She is the ..... (Owner, Contractor, Agent, Cot~oiate Officer, otc) Owner and/or representative of the Owner or Owner's, and is duly anthorlzed to perfom~ or have performed the said work and to make and file fl~is application; that all statements contained in tiffs application are irne to the best of his knowledge and belier; and that the work sill be performed in the manner set forth in the application filed herewith. Sworn to before me/tis; ............ ~_~..~... d~,4o~ /~D I~ i~ Notary Pub~na~ .}a.en~n~,.d..~.. I. ~ . ~ a',' NOTARYJ~2C~ m,~-'~ ~ , ,1 ( Signa tut ¢~.,f/Ap~l~ ant9 Lo~ 40 S. 84© Lot ,58 Lof ,54 Areo= 4289.6 s.f Lot 37 Lot `55 -A= STAKE FOL~D NOTE: 'm = MONUMENT FOUND SUBBVISION MAP FILED IN THE OFFICE OF THE CLERKOF SUFFOLK COUNTY ON AUG.21, 1987 AS FILE NO 8;3T7 Lot 33 ~2. 256 Young & young, Land Surveyors 400 Ostrander Avenue, Riverhead, Ne~v York 11901 516-727-2303 Thow~as C. Folper~, Profess~enal E~q~eer Kenneth F. Abrazzo, Land SUFFOLK COUNTY DEPARTMENT OF HEALTH SERVICES CERTIFICATION '1 AM PAMIUAR Wil~l THE STANDARDS FOR APPROVAL AND CONSTRUCTION OF SUB~LIJ~FAOE SURVEY FOR: JAMES SCOTT HYGOMI& KATHLEEN D. HYGOM LOT NO. 34, "HARBOR VIEW AT MATTITUCK" At.: MATTITUCK Town of: SOUTHOLD Suffolk County, New York Surf. Co. Tax Mop: ~1000 Digtrfct I 115 ~ 17 I 1~28 Section Block Lot CERTIFIED TO: JAMES SCOTT NYGOM KATHLEEN D. HYGOM FIDELITY NATIONAL TITLE ULSTER SA~INGS BANK FEB. 21, 1997 MAR. I I, 1996 JAN 29 1996 DEC. ;3, 1995 OCT. IT, 1995 DATE :APR. 8, 199-3 SCALE : 1"= 40' JOB NO, : 93- O259 SHEET NO. :l OF 1 ,50' "IMMEDIATELY" ENCLOSE POOL TO CODE UPON COMPLETION BEFORE 'WATER' UNDERWRITERS CERTIFICATE 14' / APPROVED AS NOTED DATE: '.¢"//5'"/~ B.P.# FEE~ E'~ NOTIFY BUILDING DEPARTMENT AT 4 PM FOR THE TWO REQUIRED CONCRETE v~ING & PLUMBING FRUCTION MUST FOR C.O. ION SHALL MEET THE i CODES OF NEW RESPONSIBLE FOR STRUCTION ERRORS. COMPLY WITH ALL CODES OF NEW YORK STATE & TOWN CODES AS REQUIRED AND CONDITIONS OF SOUT~SLD TO~¢', 25A SOS-2.-.: T?,% F~,qN',NG BOARD N.Y,S. DE'3 fO f]Lf~E PEOM f ILTCE ALL CONSTRUCTION SHALL MEET THE REQUIREMENTS OF THE CODES OF NEV',/YORK STATE. SECT~OB A SECTION B WATfR LIN[~ ROLL~P FOAM D~IWC~N LINER R, IP C0kE:1~11¢ PO~ 11E5 ~500 P51POt~P Vli~,~ LIN~ 1'0 4" 5AHP -- WALL SECT~:OB NOTES m~ 05-22-05