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Home My WebLink About28281-Z 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. 28281 Z Date APRIL 16, 2002 Permission is hereby granted to: V v I v ` GEORGE H WILLIAMSON �� PO BOX 813 11 MATTITUCK,NY 11952 fA D V E "or nAS BUILT" HOT TUB AS APPLIED FOR Cfte'v at premises located at 1200 ARBOR LA MATTITUCK County Tax Map No. 473889 Section 121 Block 0001 Lot No. 001 . 009 pursuant to application dated APRIL 15, 2002 and approved by the Building Inspector. Fee $ 300 . 00 a?/ Autho ' zed S NQatu7 ORIGINAL Rev. 2/19/98 FIELD INSPECTION REPORT DATE COMMENTS ro FOUNDATION(1ST) - -------------------------------------- FOUNDATION ---------------------------------FOUNDATION (2ND) - -- -� T z •— o ROUGH FRAMING& PLUMBING ----- -- - --- INSULATION PER N.Y. STATE ENERGY CODE - --- FINAL ADDITIONAL COMMENTS i 2 ---- - - _ - -- O - - - z - � m � C � ro V� O r d ro H TOWN OF SOUTHOLD BUILDING PERMIT APPLICATION CHECKLIS i r ' , BUILDING DEPARTMENT Do you have or need the following;before a 1 PP 3'ing' TOWN HALL Board ofHealth SOUTHOLD,NY 11971 3 sets of Building Plans TEL: 765-1802 Survey PERMIT NO. aB,'�S 4. Check Septic Form N.Y.S.D.E.C. Trustees Examined (� . 20 Z Contact: Approved 20 Mato. Charles R. Cuddy Disapproved a/c PO Box 1547, Riverhead, NY Phone: 631 369-8200 11901 Building or APR 5 2 � APPLICATION FOR BUILDING PERMIT Date O1/03 20 02 INSTRUCTIONS a. This application MUST be completely filled in by typewriter or in ink and submitted to the Building Inspector with 3 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 a Certificate of Occupanc3 is issued by the Building Inspector. 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 ,if a corporation) PO Box 1547, Riverhead, NY 11901 (Mailing address of applicant) State whether, applicant is owner, lessee,agent, architect, engineer, general contractor, electrician,plumber or.builder attorney Name of owner of premises George Mi lei 11 amson (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. N/A Plumbers License No. N/A Electricians License No. Certificate attached Other Trade's License No. N/A I. Location of land on which proposed work will be done: 1200 Arbor Lane, Mattituck _ House Number Street Hamlet County Tax Map No. 1000 Section 121.00 Block 01.00 Lot 001.009 Subdivision Map of Thornton E. Smith Filed Map No. 1006 Lot 4 (Name) 2. State existing use and.occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy existingHk�ng with C0 and hat tub b. Intended use and occupancy 3. Nature of work(check which applicable):New Building Addition Alteration Repair Removal Demolition Other Work (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 . Rear. Depth Height Number of Stories Dimensions of same structure with alterations or additions: Front Rear Depth Height Number of Stories 8. Dimensions of entire new construction: Front Rear Depth Height Number of Stories 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: 13.Will lot be re-graded Will excess fill be removed from premises: YES NO 14.Names of Owner of premises Address Phone No. Name of Architect Address Phone No Name of Contractor Address Phone No: 15. Is this property within 100 feet of a tidal wetland? *YES NO • IF YES, SOUTHOLD TOWN TRUSTEES 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. STATE OF NEW YORK) SS: COUNTY OF S I EEE I ) CHARLES R. CUDDY being duly sworn, deposes and says that(s)he is the applicant (Name of individual signing contract)above named, (S)He is the attorney (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 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 t q before me this IL /1day of V o Public Signature of Applicant' MARY LOUISE SANTACROCE Notarryy P�u�blic,State of New York No.01SA�1325;SuffolkCou Commission Expires Nov.20,20 J FROM OCEAN SPRAY POOLS & SPAS PHONE NO. 516 288 6235 Apr. 08 2002 03:40PM P2 K HLATE `V. REQUIRED APPP VED AS NOTED DATE: � 2 B.P. BY: NOVY BUILDING DEPARTMENT AT .FLy 765-1802 9 AM TO 4 PM FOR THE FOLLOWING INSPECTIONS: 1. FOUNDATION - TWO REQUIRED FOR POURED CONCRETE ROUGH - FRAMING & PLUMBING Sumatran® (Model N) INSULATION FINAL - CONSTRUCTION MUST Dimensions BE COMPLETE FOR C.O. LL CONSTRUCTION SHALL MEET HE REQUIREMENTS OF THE N.Y. TATE CONSTRUCTION & ENERGY E € „ ODES. NOT RESPONSIBLE FOR pont view) IGN OR CONSTRUCTION ERRORS C Y � a OCCUPANCY OR 1 3/4 ELECTFIGA4 CUTOUT 2a 1rj'(62.2 cm) USE IS V NLAVJ U L (t-oconw mcr`•O•r 1/2-) ,91/e (99.4 cm) w{ HouT CERTIFICATE 43 3/e h1u.2 aA) 56;/4'(144.1 cM) of OCCUPANCY µAIN ORAN 9EOOM1OARr pNAIN "IMMEDIATELY" ENCLOSE POOL TO CODE 441/2-010 C-) : UPON COMPLETION • BEFORE "WATER" 0pttom View) Ar • `e A'?.:^ V yµM1 it 3/4•(6?4 Nn) ' •.." 79-(1.96 m) 2�',•;: OOOR 51DL • 15 leveling points (PlOGc shi&ig OPPrOx 15" in (eom e09(t, then centre MiddIC shims) ...;• _ Page 7 • . :•T:i..:'.