HomeMy WebLinkAbout35179-ZFORM NO. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Office of the Building Inspector
Town Hall
Southold, N.Y.
CERTIFICATE OF OCCUPANCY
No: Z-34189
~te: 02/11/10
THIS ~KTIFIES that the building SWIMMING POOL
Location of Property: 2225 KENNYS RD SOUTHOLD
(HOUSE NO.) (STREET) (FLAMLET)
County Tax Map NO. 473889 Section 59 Block 7 Lot 8
Subdivision Filed Map NO. __ Lot No. __
conforms substantially to the Application for Building Permit heretofore
filed in this office dated NOVEMBER 25, 2009 pursku~nt to wb/ch
Building Permit NO. 35179-Z dated NOVEMBER 25, 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 ABOVE GROUND SWIMMING POOL WITH FENCE TO CODE AS APPLIED FOR.
The certificate is issued to RICHARD A GRIGONIS
(OWNER)
of the aforesaid building.
SUP~)LK C~)U1FI"IDBPAR~glqTOF[{E;KLTHAPI~RO~-AL N/A
ELECTRICAL U~a(TIFICATE NO. 11837 12/11/09
PLIERS C~I~TIFICATION DA'i'~,]3 N/A
'~t ~ri~e/Si~ature
Rev. 1/81
F~rm No. 6
TOWN OF $OUTHOLD
BUILDING DEPARTMENT
TOWN HALL
765-1802
AppLIcATION'FOR CERTHIICATE OF OCCU~Ab
This application must be filled'in by typewriter or ink and submitted to the Building D~
· A. For new building or new use:
1. Final survey of property with aCcurate location Of all buildings, pwPen'y lines, streets, and unusual nalurai or
· topographic feature.
2. F/hal Approval from Health Dept. of wa{er supply and sewerage-disposal (S-9 form).
· (~3 Approval 0felectfical'/ustallation from Board of Fi~e Underwriters.
4. Sw0m statement from plumbor certifying that the solder us~ in system contains less than 2/10 of 1% lead.
- 5. Commereial building, industrial building, multiple reddeaces'and similar buildings and installations, a certificate
· Of Code·Compliance.from architect.0~- engineer responsible for the building.
. 6. Submit Planniug Board Approvai.ofoomPleted site plan requirements.
'B. For existing buildings (prior to AprU 9,. 1957) non. conforming naes, Or buildings and ,pre.exfsting,, land uses:
· 1. ~Accuratq survey of property showing all property lines~ streets, building and unusual natural o~' topographic
· .features. '. ' ·. · ·
2. A properiy completed application and c0naent 'to inspect signed bythe applicant, if a Certificate ofoecUpancy is.
denied, the Builaing Inspector shal! state the reasons therefor in writing to the applicant.
· C. Fees
· 1. CcHificate ~f Occupancy - New dwelling $25.00, Additions to'dwelling $25.00 Alterations to dwelling $25 00,
Swimming P0ol $25,00 Aeces~ory building $25.00, Additions to accessory buiiding $25.00, Businesses $50.00.
:. 2. Certificate o£O~cupancy on Pr~-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
DEC 1'5 2n99
BLDG. DEPT.
, . ~W//
Date.
New Construction: ':
Old or Pre-existing Building: (cheek one)
tio o Fiop : · .
· . . . Hons¢ No. ~2 . Street (,,t , '
mO~ ~W T~ MaP N° 1000' 8~0n ~9" ''. BG ~
8u~ion 'Fil~ M~,
P~tNo. %~[ ~q Date0fPo~t. ~pli~t:
H~ Dept. ~pmval:
· Hamlet
Lot:
Planning Board ApproVal:
Underwriters Appmvai:
[tenluest for: Temporary Certificate
?ee Submitted: $ ~ ~. Q%0
Final Certificate: (check one)
Applicant Signature
· +
SUFFOLK
BUREAUot
ELECTRICAL
IN$,P~CTORS, inc.
40 Nottingham Ddve, Middle Island, NY 11953
Telephone: 631 495 8136 · Fax: 631 980 6455 · E-Mail: SBEIGS@gmail.com
CERTIFICATE OF ELECTRICAL COMPLIANCE
Applicant:
Rough In Inspection Date:
Application No.:
Richard Grlgoni$
December 11,2009
11837
Certificate No.:
Final Inspection Date:
Building Permit No.:
11837
December 11,2009
County Tax Map No.:
This Certificate of Electrical Compliance is limited to the inspection and compliance of electrical equipment and/or
work described below, installed by the applicant named above, located at the premise of and not after the final
: inspection date above:
Owner: Richard Grigonis
Site Location: 2225 Kennys road, Southold, NY 11971
Owner's Address (if different):
[] Residential [] Indoor
[] Commercial [] Outdoor
[] New [] Renovation
[] Addition [] Survey
Single Phase
Three Phase
Main Panel
Sub Panel
Transformer
Disconnect
OFCl Breaker 1
Other Equipment: pool bonding
Heat
Hot Water
AC Cond
AC Blower
Appliances
Switches
Heat Pump
[] Basement [] Service [] Shed
[] First Floor [] Pool [] Hottub
[] Second Floor [] Attic [] Garage
Other:
INVENTORY
Duplex Recpt Ceiling Fixture HID Fixtures
GFCl Recpt Wall Fixture Smoke
Single Recpt 1-20a Recessed Fixture CO Detect
Range Recpt Flourescent Pumps 1-poo
Dryer Recpt Emergency Time Clock
Twist Lock Exit Fixtures TVSS
Electric Heat Pool Luminaire Exhaust Fan
The electrical work and/or equipment described above were inspected and appear to be in compliance
with local, state and national electrical code requirements and this office.
Applicant: Richard Grigonis
Inspected By: Roger Richert
License No.: Homeowner
Date Of Certificate: Dec 11,2009
Signature:
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. 35179 Z Date NOVEMBER 25, 2009
Permission is hereby granted to:
RICHARD & JUDITH GRIGONIS
2225 KENNEYS ROAD
SOUTHOLD,NY 11971
for :
CONSTRUCT AN ABOVE GROUND SWIMMING POOL W/ FENCE ENCLOSURE AS
APPLIED FOR. THIS PERMIT REPLACES EXPIRED BP # 20164
at premises located at
County Tax Map No. 473889 Section 059
pursuant to application dated NOVEMBER
Building Inspector to expire on MAY
2225 KENNYS RD SOUTHOLD
Block 0007 Lot No. 008
25, 2009 and approved by the
25, 2011.
Fee $ 150.00
Authorized Signature
Rev. 5/8/02
ORIGINAL
iPomuf No. I
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)
No- 201 ~4 Z
Permission is hereby granted to: ~ .
~..~..~~...~: .........
.... .~..~..~.~...~~~....~..
. , ...........................
7.-,r.,.-. ~-..T?.-.,._...~...~: ........ ;:~ ................... ;~:; ..................................................
at premises located at .....~.....?.. .................. ~..~.~....~.~. .........................................
County Tox Map No. 1000 Section ....... ~ ....... Block ...... 2. ............ Lot No ........ ~.. ............
pursuant to application dated ....... .~.,~.~ ...................................... , 19..~./.., and approved by the
Building Inspector.
Rev. 6/30/80
~OUNDATION (1st)
'OUNDATIO~ (2nd)
:OUGH FRAME &
-PLUMBING
]NSULATI0~! PER N.
STATE ENERGY
CODE
FINAL
ADDITIO~;A'L COMMENTS:
FORM NO. 1
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN HALL
SOUTHOLD, N.Y. 11971
765-1802
Disapproved a/c .....................................
. (Boil~ ~e&~)
APPLICATION FOR BUILDING PERMIT
gOARD OF HEALTH .........
3 SETS OF PLANS ..........
SURVEY ...................
CIIECK ....................
SEPTIC FORH ..............
CALL ...................
HAIL TO:
INSTRUCTIONS
a. This application must be completely filled in by typewriter or in ink and submitted to the Building Inspector, with 3
;e~ts 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
)r areas, and giving a detailed description of layout of property must be drawn on the diagram which is part of this appli-
:ation.
e. The work covered by this application may not be cbmmenced before issuance of Building Permit.
d. Upon approval of this application, the Building Inspector will issued a Building Permit to the applicant. Such permit
;hall 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 whatever until a Certificate of Occupancy
;ball have been granted by the Building Inspector.
APPLICATION IS HEREBY MADE to the Building Department for the issuance of a Building Permit pursuant to the
luilding Zone Ordinance of the Town of Southold, Suffolk County, New York, and other applicable Laws, Ordinances or
~egulations, for the construction of buildings, additions or alterations, or for removal or demolition, as herein described.
fhe applicant agrees to comply with ail applicable laws, ordinances, building code, housing c~gde, and regulations, and to
Mmit authorized inspectors on premises and in building for necessary ~3~Spections ? i
· ~ ~ ,
· ...........
(Stgnature of applicfint, or ff'.~, ~ezsif a c~rl2oration)
(Mai~/g address bf applicant)
State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder.
........ ' . ....... . ........................
Xame of owner of premises .~.,¢L~Txg ~?~ 8. ~}; .~.~. ¢.f .G nO'.l.~...~..~[.4-~. Jh: .(--¢.(~ J ~oAl ~ .................
(as on the tarx roll or latest deed)
If applica~)i.s~ coV~po~ti7, signature of duly authorized officer.
( me and title 0fcorporate officer)
Builder's License No ..........................
Plum ber's License No .........................
E cctrician's Liccnse No .......................
Other Trade's License No ......................
Location of land on which proposed work will be done ..................................................
(¢.(, .4 ..................... kd .......................
I louse Number Street Hamlet
County Tax Map No. 1000 Section ...... :~..~.ff ...... Block ...... 7 ........... Lot...~. ..............
Subdivision ..................................... Filed Map No ............... Lot ...............
(Name)
· State existing use and occupancy of premises and intended use and occupancy of proposed construction:
a. Existing use and occupancy [ .~RV31[~. &toe LL
b. Intended use and occupancy .... ~2xta~.~..qcx Ox, ~ ~(~)e:,.c~ '
Nature of work (check which applicable): New
3. Building .......... Addition .......... Alteration ..........
Repair .............. Removal .............. Demolition .............. Other Work ...............
.. ~ ~ (Description)
4. Estimated Cost ''' t ..... ' .......................... 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 t~e ......................
7. Dimensions of existing structures, if any: Front ............... Rear .............. Depth ...............
Height ............... Number of Stories ...................
Dimensions of same structure with alterations or additions: Front .....................................
Depth ...... · ................ Rear ..................
................ Height ...................... Number of Stories ......................
8. Dimensions of entire new construction: Front ............... Rear ............... De ....
Height ........... Number of Stories ..... pth ...........
9. Size of lot: Front ........... Rear ......... ' .........
10. Date of Purchase ................................. Depth ......................
.................... ......... Name of Former Owner
11. Zone or use district in which premises are situated ...................... ' ........... ' .................
1 2. Does proposed construction violate any zoning law, ordinance or regulation.
13. Will lot be regraded Wi .... ' ................ ~ ...............
............................ u excess tm oe removed from premises: Yes No
14. Name of Owner of premises .................... Address ................... Phone No ................
Name of Architect ........................... Address ................... Phone No .................
Name of Contractor .......................... Address ................... Phone No.
15. Is this property within 300 feet of a tidal wetland? *Yes ........ No .........
· If yes, South01d Town Trustees Permit may be required.
.. PLOT DIAGRAM
Locate clearly and distinctly all buildings, whether existing or proposed, and, indicate all set-back dimensions from
property lines. Give street and block number or descriptioh according to deed, and show street names and indicate whether
interior or comer lot.
AI~PROVED AS NOTED ~ ,'~
~.~-1802 9 AM TO 4 PM FOR THE
F:)LA [)WING iNSPECTiONS:
t. FOUNDATION '~0 REQUIRED
FOR POURED CONCRETE
2 ROUGH - FRAMING & PLUMBING
3. INSU~TION
4, FINAL CONSTRUCTION
BE COMPL~E FOR C.O.
ALL CON~TRU~ION ~LL ME~
T~ REQUIREMEN~ OF ~E N,Y.
STATE CON~U~ON ~ ENERGY
CODE~. N~ RE~N~IB~ FOR
DESIGN OR C~STRU~ON ERROR~
;TATE OF NE~-YO_I~K
......................................... being duly sworn, deposes and says that he is the applicant
(Name of individual signing contract)
bore named.
le is the .........................................................................................
(Contractor, agent, corporate officer, etc.)
f said owner or owners, and is duly authorized to perform or have performed the said work and to make and file this
;~plication; that all statements contained in this application are true to the best of his knowledge and belief; and that the
'ork will be performed in the manner set forth in the application filed therewith.
worn to before~me this
No. 52-;~625897
Qualified in Suffolk Co~u~nty,~ i ~/~
Commission Expires t,~rcL ..... ~./~L~ y ~
County
(Sig/fature of applicant)
/~--~7-?-~ TOWN OF SOUTHOLD PROPERTY RECORD CARD. ~<~'~7 ,
OWNER ^ STREET i VILLAGE DIST. SUB. LOT~. ~"..'~ ~, /4_
FORMER OWNER ~' N ~'
,S
W
FARM COMM. CB. MISC. Mkt. Value
: ',
I TOTAL DATE j REMARKS
ACR; ~/33 ; ~
WPE OF BU~LD,NG I 0~ Or4Z~,~L~
x"-~LAND ~ IMP.
NEW
FARM
AGE
Tillable 1
Tillable 2
Tillable
3
Woodland
Swampland
Brushland
House Plot
NORMAL
Acre
BUiLDiNG CONDiTiON
BELOW ABOVE
Value Per
Acre
Value
FRONTAGE ON WATER
FRONTAGE ON ROAD
DEPTH
BULKHEAD
DOCK
M. Bldg.
Extension
Extension
COLOR
TRIM
Foupdotion
Basement
illll,lil]il ! III[
II[[J~(;~[ll lliliJilifJ[JIl
Both
Floors
Interior Finish
Ext. Walls
Extension Fire Place Heat
Type Roof C ~ Rooms 1st Floor
Porch Recreation Roorr Rooms 2nd Floo
Porch Dormer
Driveway
j Breezeway
~ Garage
Total
Dinette , r
K.
LR.
DR.
BR.
FIN. B
MAP OF LAND'
RICHARD A. 4: P-..ITA M. GP..IGONIS
AT
$OUTHOL
· ' TOWN OF' .~OUTHOLD,
$CALI[: 40% I"
· - l~On pip~ ' .,.. ....