HomeMy WebLinkAbout33248-ZFORM NO. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
office of the Building Inspector
Town Hall
Southold, N.Y.
CERTIFICATE OF OCCUPANCY
No: Z-33753 Date: 06/03/09
THIS c~KTIFIES that the building INGROUND SWIPING POOL
Location of property: 3750 BRIDGE LA CUTCHOGUE
(HOUSE NO.) (STREET) (HAMLET)
County Tax Map No. 473889 Section 84 Block 5 Lot 10
Subdivision Filed Map No. __ Lot No. __
conforms substantially to the Application for Building Permit heretofore
filed in this office dated JULY 9, 2007 pursuant to which
Building Petit No. 33248-Z dated JULY 17, 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 POOL WITH FENCE TO CODE AS APPLIED FOR.
The certificate is issued to RICHARD E BOZSNYAK JR & LAURA
(OWNER)
of the aforesaid building.
SiiFi~)i~(CO~I-/DEp;[~OF~THAPPRO%r~J~ N/A
~-rKICAL U~a{'rIFICATH NO. 4029119 05/14/09
I~L~EP~ UF~('rIFIC_ATION DA'r~u3 N/A
/~~ori z~e
Rev. 1/81
Form No. 6
TOW OF
BU D G DEP TMENT II - - IIII
TO~ H~L Il ~11 Ill II
76511802 lUUl ooo
~PLICATION FOR CERTIFICATE OF OCC~CY / ]
I ~ ~PI.
~s app]ioatien m~t ~ fill~ in by ~ew~ter or ~ ~d sub~tted to ~e Building D~ m~m wla~ am ~ll~.ms:
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 s~lder used in system contains less than 2/I0 of 1% 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 Planuing 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 applieation and cousent to iuspect 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 dweiling $25.00, Alteratious 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 Certifieate of Occupancy - Residential $15.00, Commercial $15.00
New Construction:
Location of Property: 3 q50
HOUSe No.
Owner or Owners of Prope~ty:"~ i r.hard
Suffolk County Tax Map No 1000, Section
Subdivision
Pennit No. :3 5 ~,~ q c~
Health Dept. Approval:
Planning Board Approval:
Date.
Old or Pre-existing Building:
/~r/doe
d Street
Date of Permit.
5- ~ -t
(check one)
Filed Map.
Applicant: '~iC~f~trc~
Lot / cD
Lot:
Underwriters Approval:
Request for: Temporary Certificate
Fee Submitted:~ c,~ o~o
Final Certificate: / (check one)
-- Applican~ ~l~atuh- -Q~
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. 33248 Z Date JULY 17, 2007
Permission is hereby granted to:
R BOZSNYAK
PO BOX 31
CUTCHOGUE,NY 11935
for :
CONSTRUCTION OF AN INGROUND SWIMMING POOL IN THE REQUIRED REAR
YARD AS APPLIED FOR
at premises located at
County Tax Map No. 473889 Section 084
pursuant to application dated JULY
Building Inspector to expire on JANUARY
3750 BRIDGE LA CUTCHOGUE
Block 0005 Lot No. 010
9, 2007 and approved by the
17, 2009.
Fee $ 250.00
/ Authorized Signature
ORIGINAL
Rev. 5/8/02
CERTIFICATE OF COMPLIANCE THE
BY
THIS
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
REP ELECTRIC RICHARD BOZSNYAK
PO BOX 635 3750 BRIDGE LANE
MA~-ITUCK, NY 11952, CUTCHOG U E, NY 11935
Located at 3750 BRIDGE LANE CUTCHOGUE, NY 11935
Application Number: 4029119 Certificate Number: 4029119
Section: Block: Lot: Building Permit: * BDC: ns11
Described as a Swimming Pool 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 14th Day of Ma),, 2009.
Name QTY Rate Rating Circuits Type
Appliances and Accessories
Pool / Spa Bonding 1 0
Time Clock Switch 2 0
Wiring And Devices
Fixture I 0 pool Incandescent
Receptacle 1 0 pool Gert, Purpose
Receptacle 1 0 pool GFCI
Receptacle 1 0 20a-pool Special / twist lock
Switch 1 0 pool Gen, Purpose
(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 l
This certificate may not be altered in any way and is validated only by the presence of a raised seal at the location indicated.
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
C01VEVIENTS
FrEI,D INSPECTION REPORT
FO~DATION (2ND)
PL~G
LNS~ATION PER N. Y.
STATE ENERGY CODE
~DITION~ COUNTS
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN HALL
SOUTHOLD, NY 11971
TEL: (631) 765-1802
FAX: (631) 765-9502
www. northfork.net/Southold/
Examined 7/7 ,20 ~7
Approved 1//? ,:o O ?
Disapproved a/c
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_ f
Check ~
Septic Form
N.Y.S.D.E.C.
Trustees
Contact:
Mail to:
Expiration /// 7,20 ~ /Q
-"-~'- ~ n ~ IV i'~.' t Bh~lding Inspector
~~_ ~~~ ,~''LICATION FOR 'UILDI~ 'ER'IT
~._~. -- INSTRUCTIONS
a. This application MUST be completely filled in by t~ewriter or in ink and submitted to thc Building Inspector with 4
sets of plans, accurate plot plan to scale. Fec according to schedule.
b. Plot plan showing location oflot and of buildings on premises, relationship to adjoining premises or public streets or
areas, and wate~ays.
c. The work covered by this application may not be commenced before issu~ce of Building Pe~it.
d. Upon approval of this application, the Building Inspector will issue a Building Pe~it to the applicant. Such a permit
shall be kept on the premises available for inspection t~oughout the work.
e. No building shall be occupied or used in whole or in pan for any pu~ose what so ever until the Building Inspector
issues a Ceaificatc of Occup~cy.
f. Eve~ building pe~it shaIl expire igthe work authorized has not commenced within 12 months aker thc date of
issuance or has not been completed within 18 months kom such date. If no zoning amendments or other re~lations affecting the
propeay have been enacted in the interim, the Building Inspector may authorize, in writing, the extension of the pe~it for an
addition six months. ~erea~er, a new pe~it shall be required.
~PLICATION IS HE,BY M~E to the Building Depaament for the issuance o~ a Building Permit pursuant to the
Building Zone Ordin~ce of thc Town og Southold, Suffolk County, New York, and other applicable Laws, Ordinances or
Regulations, for the const~ction of buildings, additions, or alte~tions 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 ~d in building gor ncccss~ inspections.
,20_o_2_
"IMMEDIATELY ' UNOERWRITERS CERTIFICATE (Signature of applicant or name, ifa corporation)
ENCLOSE POOL,TOCoL: REQUIRED '-'?o ~ox ? ~.~g.,~.~,~'; ~/y'//?~'
UPON COMPLL~riON ALL CONSTRUCTION SHALL (Mailing address of applicant)
BEFORE "WATER' ME~ THE REQU;REMENTS OF THE
State whether applicant is owner, les~{~E~i~, N~E~., general contractor, electrician, plumber or builder
~,.~_,~,.,~x~., ,_APFROVED AS h~OTED
DATE:~ B.P. #
Name of owner of premises "~ IF<~./~I~ ~'~OZ~/~ ~? -~5~_E: ~ ~1). / ~: ~
(As on the tax roll o~d~tN~ 937),ST~lEST Al
If applic~t is a co~oetio~,~ignature of duly authorized officer 765-1802 8 A~ %~ 4 7~f FOR IHE
(~me ~d t]t]e of co.orate officer) 1. FO~ ;NDATION - t'., 3 REQUIRED
FC,:~; POURED CC~'CRETE
CUPANCY
Builders License No. /~/~ ~_ OR 2. ROUGH - Fc,~,,,,. PLUMBING
P umU , Uc ns USE IS UNLAWFUL
4. FINAL - CO~'17T~:U :N MUST
Electricians License No. ~ ~ ~ m~m~ ~ mF BE COMPLE: ¥ ,:_ , J.O.
Other Trade's License No. V~I I ~U~ I ¢~ I Ir I~gl~ ALL CONSTRUCt' 3'; SHALL MEEt THE
OF OCCUPANCY .mU .S S TS O* COa[S O, .[W
1. Location ofl~d on which propose¢¢ r~---- '-----o will be done: YORK STATE. NOT RESPONSIBLE FOR
~7~ ~/~ ~ DE~~CTION ERRORS.
Ho~ ~umb~ S~cct Hamlet
County Tax Map No. 1000 Section ~,/ Block o~' Lot /,4
Subdivision'~,c~2)> ~z.~,~K -x~. Fi[ed Map No. _~'77- Lot /~
(Name) '
Town of Southold
Erosion, Sedimentation & Storm-Water Run-off ASSESSMENT FORM
PROPERTY LOCATION: S.C.T.M. #:
Olstflct Section Block Lot
THE FOLLOWING ACTIONS MAY REQUIRE THE SUBMISSION OF A
8TORM-WATER~ GRADINGI DRAINAGE AND EROSION CONTROL PLAN
CK~rlFIBD BY A DESIGN PROFESSIONAL IN THE STATE OF NEW YORK.
Item Number. (NOTE: A Check Ida~ (~) for each Ouesfion is Requirad for a Complete Application)
1
Will this Project Retain All Slorm-Water Run. Off Generated by a Two (2') Inch Rainfall on Site?
Yes No
(This item will include all mn-off created by site clearing and/or constmciton activities as we~l as all Site
Improvements and the permanent creation of impavious surfaces.)
2 Does the Site Plan and/or Survey Show All Pmpeeed Drainage Structures Indicating Size & Location?
This Item shall include all Proposed Grade Changes and Slopes Conbolling Sudace WaterFIowl
3 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?
4 W{II this Application Require Land Disturbing Activities Encompassing an Area in Excess of
Five Thousand (5,000) Square Feet of Ground Surface?
5 Is there a Natural Water Coume Running through the Site?
Is this Project within the Trustees jurisdiction or with n One Hundred (100') feet of a Wetland or Beach?
any item Within the Town Right-of-Way or Road Shoulder Area?
(This item will NOT Include tho Installation of Drfveway Aprons.)
9
Will this Project Require Site Preparation within the One Hundred (t00) Year Floodplain of any Watemoume?
NOTE: If Any Answer to Questions One through Nine is Answered with a Check Mark In the Box, a Storm-Water, Grading,
Drainage & Erosion Control Plan la Required and Must be Submitted for Review Prier to Issuance of Any Building Parmiti
EXEMPTION: Yes No
Does this project meet the minimum standards for classification as an Agricultural Project? J
Note: If You Answered Yes to this Question, a Storm-Water, Grading, Drainage & Erosion Control Plan Is NOT Requiredl __
STATE OF NEW YORK,
COUNTY OF ........................................... SS
T ?' '
hat 1, ..~'~..ff-7,~.......?~:~Z-~- ....................... being duly sworn, deposes and says that he/she is thc applicant for Permit,
(Name of individual si~liflg Document)
And that he/she is the .................... ~.r(2...~/..~...F~. ....................................................................................
(Owner, Contractor, Agent, Corporate Officer, ete.)
Owner and/or representative of the Owner of Owner's, and is duly authorized to perform or have perfommd the said work and to
make and file ~his application; that all statements contained in this application are true to the best of his knowledge and belief; and
that the work will be perl'ommd in [he manner set forth in the application filed herewith.
Sworn to before me this;
................... .......
No y enblic: .....................
~ /! u ~ Muemraoln~urrolkCou~lty
TOWN OF SOUTHOLD PROPERTY RECORD CARD
W ~PE OF BUILDING
FR~TAGE ON WATER '( ~) ~
FRONTAGE ON ROAD / ~
BULKH~D
q
ERtCK VAN TUYL, P.C.
LIC£NS~D CAND SU~y-O~s
GREJENPORT NEW YORK
S~FOLK CO. I~EAI:TI~I D~PT. H.S. NO.
STATEMENT OF INTENT
THE WATER SUPPLY AND SEWAC~E DISPO
SYSTEMS FOR THIS RESIDENCE
CONFORM TO THE STANDARDS OF
SUFFOLK CO. DEPT. OF HEALTH SERVI,
(si
APPLICANT
SUFFOLK COUNTY DEPT. OF HEA
SERVICES -- FOR APPROVAL
CONSTRUCTION ONLY
DATE:
H. S. REF. NO.: 87-~0'
APPROVED:
SUFFOLK CO. TAX MAP DESIG~NATI(~N
DIST. SECT. BLOCK
/~0OO ~',-sc
OWNERS ADDRESS:
DEED: L. ~1~ P.
TE~ HOLE STAMP
to additional in.it utiegm or rubs,
8' q 8'
8 8' h
TOPAZ STERLING STONETITE
(0560S1 103,205l 103-305)
NON DIVING UNERS
H-6 (03-643)I-8 (03-243) S-14 {03-343)
'Oiogemls given to 90° Imint of caners.
8' Steel Ste~ {side) Ilenxwe
2~108,009) 8' panek ins~
I-(o&3Ol } 81 stag dep,
1-(08,013)7 pa~ I-(08-167)
45'x1' h'lle panel end
1-(08-168) 4' lu~ panel
141&083) sled s~K, coping
set and 1-(10-085) coping
cm'ne~ sol required. See Imge 1.
8' Sle~ Step (oM1 Remove
2-(08-009) O' panels and
1-(08-016) 4' panel. Ir, se1
I-(08-301) e' ~?p,
2-(08-16714,5 x I fille~'~enels,
2-(08,015) 5 pand.,ond
2-(08-210) e~onomy b~o~e~.
I-(1,0083) steel step c~n9 set
o,d 2-(10,085) copiq (oi'ner
sets lequired. See pge I.
FRN-OO5
MAY J'"" 20' X 40'
1995 J RECTANGLE 6' RADIUS
IN-GROUND SWIMMING POOL WILL BE CONSTRUCTED OF STEEL WALLS SUPPORTING A
VINYL LINER THAT WILL HOLD APPROXIMATLY 35,000 GALLONS OF WATER.
FENCE WILL BE CHAIN LINK CONSTRUCTION, 4' HIGH WITH SELF CLOSING GATES THAT
WILL MEET TOWN CODES.