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Home My WebLink About12328-ZFORM NO. 4 TOWN OF SOUTBOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY NO: Z-34115 Date: 12/07/09 THIS c~KTIFIEE that the building ACCESSORIES Location of Property: 625 ARSHAMOMAQUE AVE SOUTHOLD (HOUSE NO.) (STREET) (HAMLET) County Tax Map No. 473889 Section 66 Block 3 Lot 1 subdivision Filed Map No. __ Lot No. __ conforms substantially to the Application for Building Permit heretofore filed in this office dated APRIL 21, 1983 purs~ant to which Building Permit No. 12328-Z dated MAY 16, 1983 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 SWIMMING POOL WITH DECK, NON-HABITABLE & UNHEATED POOL HOUSE WITH SHOWER, SINK ~/qD TOILET. THIS C/O REPLACES COZ12600 ISSUED 7/8/85. The certificate is issued to PAULINE R BAYLIS (OWNER) of the aforesaid building. SuF~OLKCOUNTYDEPARTM~T OF HEALTH APPROVAL N/A ~CTRICAL c~KTIFICATE NO. N 619371 10/11/83 PLIERS ~KTIFICATION DA'r~u N/A Rev. 1/81 It*OR'M NO* 0 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) N? 12328 Permission is hereby granted to: ..... /~....,~.....~,~...~ ............. ....... ~.~......~..~ ....................................... Rev. 6/30/80 November 19, 2009 Town of Southold Building Department Town Hall Southold, New York 11971 Re: 625 Arshamomaque Avenue, Southold, New York BLDG, DEPT. I,OWN OF SOUI'HOLD To whom it May Concern, Attached you will find an application for th..t~e ~pdating of certificate of occu. ancp_.~0_fy~ #Z13600. We are requesting that th('~°l ba~'~~~_i_n~ being added to the certificate of occupancy which is currently stated as: in~'~n~ swimming pool and deck accessory." Attached are also copies of supporting 'documents from your files showing the pool bathhouse was included on the original plans. Please update as requested. Thank you for your help. Pauline R. $outhold, New York 11971 Telephone: 631 765-2742 FORM NO. 4 TOWN OF: 50UTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. Certificate Of Occupancy No. Z'13600 Date Jul~y 8 985 THIS CERTIFIES that the building pool and deck accy. Lc ion of Pro err 535 Arshamomaque Ave. Southold o at P Y h3,~hiol ....................... 's'~/e;i ....................... h~ie~ County Tax Map No. 1000 Section ............ Block ............... Lot ................. Subdivision Be±×edom EBtote8 .Filed Map No. qq-72 .Lot No. 9&qO conforms substantially to the Application for Building Permit heretofore filed in this office dated .... .l~.a..~9.h. ?.~. ........ 19 .~.3. pursuant to which Building Permit No. ~1952SZ dated ....H.a.~..~..G .................. 19 gS..., was issued, and conforms to all of the requirements of the applicable provisionS of the law. The occupancy for which this certificate is issued is ......... ....i~.g~. 9.m~..d...~.~.~.m.m..~.~fi .p99.1..&...d.e.e.k.. ?.e. qe..s.~.o.r..7: .............................. GORDON J. BARES The certificate is issued to ..................... [dv~e'r'~ ..................... of the aforesaid building. Suffolk County Department of Health Approval UNDERWRITERS CERTIFICATE NO ........................ Building Inspector Rev. 1/81 F~rm ~o. 6 TOWN OF SOb~HOLD BUILDING DEPARTMENT TOWN HALL 765-1802 APPLICATION'FOR CERTIFICATE OF OCCUPANCY Thiz appE~gion must be filled'in by typewriter or ink and submitted to the BuiJdln$ Department with the following:. -A. For new building or new use: 1. Final. survey of properly with accurate location Of all bu/ld/ngs, property line~, streets, and unusual natural or · topographic features. 2. Final Approval from Health Dept. of wa{er supply and sewerage-disposal (S-9 form). · 3.Approval 0 f electrical in~allation Ii, om Bo~.d of F'~reUnderwriters' · '4. Swgm statement from plumber certifying that the Solder u~ ia system coataias le~s than 2/10 of 1% lead. - 5. Commercial building, industrial building, multiple reddenc~ sud similar buildings and installations, a certificate ·Of Code. Cempliance-from architect.qr engineer respousible for the building.' . 5. Submit Planning Bogrd Approval.of completed site plan requirements. '.'B. For existing buildings (prior to April 9, 1957) non-conforming uses, 0r buildings and ,pr~g~ had u~. L '_.Accurate surVey of property showing'all Pmp~-~y liaes~ stm~ts, building and un-usual na~al or top~graphic .'. ' · .teaturcs. ~ -. - · ~ . · · ' .2. A properly completed application' and c0ns~nt to iaspect signed by.the applieant, ff a Certificate of ocCUPancy is: denied~ the Building Inspector shall state the reasons.therefor in writing to the applicant. · C. Fees. . . . . 1. Certificate 6f Occupanc)~ - New dw¢lliag $25.00, Additions to'dwelling $25.00, Alterations to dwelling $25.00, Swimming pool $25~00, Acces~qry building $25.00, Additions to accessory building $25.00, Busi~ses $50.00. : :. 2. Certificate o£Occupancy on Pre-existing Building - $I00.00 .. Copy of Certificate of Occupancy ~ $.25 updated Certificate of Occupancy - $50.00' :~ ~ ~ ~ ~ ~) ' · Temporary Certificate of Occupancy - Residential $15.00, Commercial $15 00 Subdivision Permit No. Date of Permit. Applicaat: Health Dept. Approval: Planning Board AppwVah equect for: Tempo? Certificate .~ee Submitted: $ Underwriters Appmvah Final Certificate:' FORM NO. 6 TOWN OF SOUTHOLD Building Department Town Hall Southold, N.Y. 11971 APPLICATION FOR CERTIFICATE OF OCCUPANCY Instructions A. This application must be filled in typewriter OR ink, and submitted in duplicate to the Building Inspec- tor with the following; for new buildings 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 of Health Dept. of water supply and sewerage disposal-(S-9 form or equal). 3. Approval of electrical installation from Board of Fire Underwriters. 4. Commercial buildings, Industrial buildings, Multiple Residences and similar buildings and installa- tions, a certificate of Code compliance from the Architect or Engineer responsible for the building. 5. Submit Planning Board approval of completed site plan requirements where applicable. For existing buildings (prior to April 1957), Non-conforming uses, or buildings and "pre-existing,~_ land uses: 1. Accurate survey of peoperty showing all property lines, streets, buildings and unusual natural or topographic features. 2. Sworn statement of owner or previous owner as to use, occupancy and condition of buildings. 3. Date of any housing code or safety inspection of buildings or premises, or other pertinent informa- tion required to prepare a certificate. C. Fees: ~ 1. Certificate of occupancy / 2. Certificate of occupancy on pre-ex~sting dwelling landuse--?re-E×±st.±ng C.0. $15.00 3. Copy of certificate of occupancy $1.00 Vacant [and ¢.0. $ 5.00 Date ... C~ New Building . ~..~..~. ..... Old or Pre-existing Building ............ Vacant Land ............. Location of ........ ¢... ....... House No. Street ~) Hamlet Owner or Owners of Property ............. .~..C~...~...~.....~..-...~..0,~...~.%~. ................ County Tax Map No. 1000 Section ... ~). ~o. ~ .... Block .... ~ .~ ....... Lot....O..(~. ! ....... Subdivision..~..~..i .~..~. ~.C~..-[~~...Filed Map No..~..z~...--( .~...Lot No...(~..~..l(~.... Permit No. 1..'~.~. ,~.:~Date of Permit .~. l).-/.I.~..Applicant.. ~O~C,, .~, ,C~,, .~.:., ,~..,~, ...... Health Dept. Approval .... , ,V~, ,I (' .Labor Dept. Approval ,~, I ¢ Underwriters Approval. ~.. (Q .~ ?[.. ,~.~ .[ ......... Planning Board Approval ..... ~.1..(~. ............ Request for Temporary Certificate ....... Final Certificate ~ Fee Submitted $...S :..~.? .... .v/....~..~..~.... Construction on above described building and permi~lJ~eets all applicable coc~ and regulations. pp ................... Rev. 10-10-78 FIELD'INSP~CTION 1. FOUNDATION (1st) F~OUNDATION (2nd) 2. ROUGH FRAME & FLUMBING 3. INSULATION PER N. Y. STATE ENERGY ~ODE 4. FINAL 76S..X8e2 BUILDING DEPT. INSPECTION FOUNDATION ZST I' ] ROUGH PLBG. [ ] FOUNDATION 2ND [] INSULATION []FRAMING .[/~ FINAL DATE 7/,.~ ~//'~f'~/,NSPECTOR~~:;~ FOI~M NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. Disapproved a/c ................... :z ....................... ~ .......... ~....,./ ..................... (Building Inspector) Application No. /.~.~...~.....~... ............ APPLICATION FOR BUILDING PERMIT Date ........................ .~./. ~. ........... , 19..~..~,~.,. INSTRUCTIONS a. This application must be completely filled in by typewriter at in ink and submitted in triplicate 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 gi~(ng a detailed description of layout ofproperty must be drawn on the diagram which is part of this application. 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 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 pa rt for any purpose whatever until a Certificate of Occupancy shall have been granted by the Building Inspector.~,~he APPLICATION IS HEREBY MADE to the Building Department for the issuance of a Building Permit pursuant to Building Zone Ordinance of the Town of Southold, Suffolk County, New York, and other applicable Laws, Ordinances aT 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 buildings for necessary inspections. (Sig.~fure of appl~'Eant, or name, if a co~oration) (Address of applicant) State whether ap~cant/ "~is owner· lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. ...................... ......................... , .................................................... Name of owner' ~'~of premises ...... JJ~<.:.....~..:.......~.J~:~...~......:.....~.~..CkY: (~J~..~...'"'~.,...) ............................................. If applicant is a corporate, signature of duly authorized officer. (Name and title of corporate officer) Builder's License No .... L°...7. ....................................... Plumber's License No....~...i...~.....~..~....'..~..~..,~..~''j'~l'~ ~/ - Other Zrade's License No ............................................ "/~''~1 *~ *~ ~ -- / L~at on of an hich proposed work will be don ,Map No.: .~..~...~ Lot No ~ 1. ~ - ~ ~ ........................ Street and Number ~.~.~ ~. ~ ~.~..~ .......................................... ~ ~v~( ~ ¢ ~-z ~ Municipali~ 2. State existing use and occupancy of premises and intended use and occupancy of proposed c~strucbon: a. Exisiting use and occupancy .......... ~ ...... ~.~].~.~. ...... ~~~..~ ............................................... b. Intended use and occupancy .~.~..~.....~., ........ ................ ~..t~.~..: .......... wh~.-ocate clearly and distinctly all buddings, whether existing or proposed, and ~5erty lines. Give street and block number or description according to deed, ~--.~ther interior or corner lot. 3. Nature of work (check which applicable): New Building "X~' ........... Addition Alteration Repair .................. Removal .................. Demolition .................... Other Work ................................................ .... 4. Estimated Cost ....~....c~..,~...c~....g~......c~.. ................................ Fee ~ /,~%,._~p. (Description) (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 ...../.~.......F~... ..... Number of Stories .... ./. ............................................................ Dimensions of same structure with alterations or additions: Front - Rear ......'"-q ..................... Depth ........ ~ ................... Height ............................ Number of Stories '""~*'*.;.l.; ................ 8.Dimensions of entire new construction: Front ..~c....~....~....~.~;~.....~....~...~'~. ~eor ..c~...1.../~........~..~epth ........................ Height .................... Number of Stories .... ~. .............................................................................................................. 9. Size of lot: Front ...'~...,~:...~......~...~...~.. ..................... -R-~ar ........................... i .............. 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 regraded~ ........LA.~ .............. Will excess fill be removed f~o~,,~p~r~es: ( ) Y~/ ~r No 14. Name of Owner of premises .I~/~.,,.~.IM~.~...~:~.~ ........ Address~---c=~.'l':Hr~.~....-. ...... Phone No. ~..~...~7...~....~..c~.~../'~ Name of Architect ...(~..lt/L;.~tz3a4.16~;Ol~4a~ ...................... Address,,.;.._...~;~.;~.~..~. 'e ............... Phone, No.~ Name of Contractor ~-.~..[.~)Jb~......~...(...~...~,~...L~...c~..~ ........... Address:~i~TTl.l..rc,/u:j.tc) ...... Phone No.'Z...2~.....¢3~1~J~ PLOT DIAGRAM all set-back dimensions from show street names and indicate STATE OF NEW YORK, ,~,,/' I. c c COUNTY OF ....................~...1r ....... ........................ ~,,~r ........................... ~ ....................................... Demg duly sworn, deposes and says that he is the applicant (Na~ of individual signing contrac[) above named. 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 a.nd to make and file this application; that all statements contained in this application are true to the best of his knowledge and belief; and thor the work will be performed in the manner set forth in the application filed therewith. Sworn to before me this · - ~ _ // Nota~ Public, ...;....~......~?~, .~ County .~ ...~~,...~f~ ' ...... ......... .............................. ~ / R~ Public, Stat~ 0f New Y0~ ~ .... ; . . ,-,,:~ ~:;:,~ / ~pointed for ~u?? County ~ = Ce~ificate FUod in f:a',v Yo~ Coun~ C ~.~ .~- 0..~',.0 SESAME ~" / lOOO218 THE NEW YORK BOARD OF FIRE UNDERWRITERS ~ BUREAU OF ELECTRICITY ~- 85 JOHN STREET, NEW YORK, NEW YORK 10038 THIS CE;IFIES THAT G. ~, 935 ~~ ~., ~ld, N.Y. in the following ~catlon; ~ B~ement ~ 1st Ft. ~ 2nd Ft. ~Si~ ~ctlon Bt~k w~ exami~d on S~r 26, 1983 and found to be in compliance with the require,nents of this B~rd. FIXTURE FIXTURES RANGES OVENS DISH WASHERS EXHAUST FANS OUTLETS SWITCHES FLUORESCENT 6 4 11 6 DRYERS FURNACSMOTORS FUTURE APPUANCE FEEDERS TIME CLOCKS MULTI-OUTLET DIMMERS SYSTEMS NO. OF F~ET SERVICE DISCONNECT S E R V I C E A. W.G. NO, OF HI-LEG A.W.G. OF CC, COND. O~= NEUTRAL .o. A, W, G. NO. OF NEUTRAI.~ OF HI-LEG K.W. Hot Water Heater 1-G.F.C.I. 11 Burleigh Dr. Holbrook, N.Y., 11741 LIC.~1805 o~. MANAC, H~ /I This certificate must not be altered in any manner; return to the office of the Board if incorrect. Inspectors may be ide ' 'ed y ' ' s. COPY FOR BUILDING DEPARTMENT. THIS COPY OF CERTIFICATE MUST NOT BE ALTERED N ANY MANNER, ST& E BXds. 40, SU~/-"BOOU 219 Stony Brook, NY 11794 (.516) 751-7900. A review has been made of your proposal to: New York State Deoartment of Environ~ental Conservation has found the parcel , ~roJect to be: Crea~er than 300' from inventoried tidal wetlands. ./Landward of a substantial man-made structure ~}~ '~ ~ greater Chart 10J' in lena. Ch constructed prior to September 20, 1947. I~andward of 19' contour elevation above Man sea level on a Eradual, nat- ural ~lope. Landward of tot)ographical crest of bluff, cliff or done in excss~ of l0 feet in elevation above mean sea level. Therefore, .no permit under Article 25 (Tidal WetL~uds of the Env~r~tal COnservation Law) is required at this time since the current proposal is beyond State mandated Jurisdiction pursuant to this act. However, any additional or "~difications to the project m~y require a permit. It is your responsibility to notify this office, in writing, if such additional work of madifications ar~ contemplated. ~ t r~ly ~r~ Daniel ~. Larkin Regional Supervisor of Regulatory Affairs DJL:RI~:cz ~WASTE RETURN LiNE PRE CAST LADDER POOL PLAN WATER LINE .~.q'.'4 · / WN¥..,NER ~.' Ao;::L I., \ ........... ~_T._. ...... ~,:'.'~ t 1"-2" B CENTER SECTION 0o PRE CA~T COPING UNDISTURBED EARTH ~ ~ DETAIL FIBERGLASS MOLDED ONE PIECE OPTIONAl,. STEP GRADE WOLMAN~ZED TOP RAIL A--A 12" FLAIR BO'i-rOM MONOLITHIC POURED (~tESERVATIVIE SALTS. ~. WALKS TO 8E *~*~OOTH*NON SKID T~PE, SLOPED AWAY FROM 34599 TOWN OF SOUTHOLD P~OPERTY RECORD CARD OWNER STREET VILLAGE DISTRICTSUB. LOT ~ 9 ,.. ~ ,, ,:.,./ / IMP. IO,"loo LAND /oSmo TOTAL / &~?O 0 ,/ AGE NEW NOPJC~AL Farm Acre Tillable 1 Tillable 2 Tiitoble 3 Woodland Swampland Brushland House Plot Total DATE BUILDING CONDITION tVol~u_~ Per Acr~e ABOVE Value FRONTAGE ON WATER FRONTAGE ON ROAD M. Bldg. ' Basement Extension ~ 7 ~_L~ _~.~. E~ension ~C % ( j = ~' ./ cxt wans c~,.~' ~ ' ~ nteror rnsn Heat Extension - ~ '~ /77~ ~ -~;~ Porch R~ms ]st FI~. ~ /~-q~ ~ ....... "i ..... ............................... Breezewey : ~ ~ ,d~ ~ j ] Petio ~ ~ Rooms 2nd Floor , _ .r":, j~ ~ f .-. .,., Driveway ~ ~ Dormer Garage xx~c' el: OCCU?~C¥ OR OF 765-3802 9 FOLLOWING 1. FOR POURE 9. 4, FINAL ,ALL C01qC~FFR TH,E STATE CODE~ DESIGN TO d PM FOR THE TWO REQUIRED ~INr', ,8, PLUMBING ,l ~ TO 4 PM FOR THE ,- TWO & FIO~ S~4^LL & , i~OT RESPONSIBLE