HomeMy WebLinkAbout33188-ZFORM NO. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Office of the Building Inspector
Town Hall
Southold, N.Y.
CERTIFICATE OF OCCUPANCY
No: Z-34377
Date: 05/26/10
THIS CERTIFIES that the building SWIMMING POOL
Location of Property: 4225 BRIDGE
(HOUSE NO.) (STREET)
Coullty Ta~ Map No. 473889 Section 84 Block 4
Subdivision
Filed Map No. __ Lot No. __
CUTCHOGUE
( HAMLET )
LOt 11.3
conforms substantially to the Application for Building Permit heretofore
filed in this office dated JI/NE 21, 2007 pursuant to which
Building Permit No. 33188-Z dated JUNE 29, 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 WILLIAM W & TERRI L pARK
( OWNER )
of the aforesaid building.
SIIFP~)LKC~DL~I"fDEPAR1T~ENT OF }~LTHAPPRO~-~J~ N/A
ELECTRICAL CERTIFICATE NO. 119259C 09/28/07
PLIERS CERTIFICATION DATED N/A
Rev. 1/81
d
Form No. 6
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
. . TOWN HALL
765-1802
APPLICATION FOR CERTIFICATE OF OCCUPANC
This application must be filled in by typewriter or ink and submitted to the Building Depar
L~ MAY 24 2010
ntlwithth,
TOWN OF SOUTHOLD
A. Fol' uew hnilding or new nse: 1. Final survey of property with accurate location of all buildings, property lines, streets, and unusual natural or
topographic features.
2. Final Approval from lfealth 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. 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 Plmming Board Approval of completed site plan requirements.
B. Fol' existing buildings (prior to April 9, 1957) non-conforming uses, or buildings and "pre-existing" land uses:
1. Accurate survey of properly 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, tile Building luspector 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,
New (~OllStlllClion:
Location of Property:
Swi~mning pool $25.00, Accessory building $25.00, Additions to accessory building $25.00, Businesses $50.00.
Certificate of Occupancy on Pre-existing Building - $100.00
Copy of Certificate of Occupancy - $.25
Updated CerTificate of Occupancy - $50.00
Temporary Certificate of Occupancy - Residential $15.00, Commercial $15.00
~52C:t2,\ ~/ Old or Pre-existing Building: (check one)
House No. Street Hamlet
Ox,,, e ' or ()w ~e's of Prol)eny:
Suf£olk County Tax Map No 1000, Section
Subdivision
Block (.~ ~q
Filed Map.
Applicant:
Umlerxvriters Approval:
Permil NOI ~__~ Date of Permit. (~01 ~=1 \ t"3"'l
Health I)cpt. Apl)roval:
Lot:
Planning Board Appllox al:
Request i'or: ]'elnpoil]Uly Certificate
Fee Subnfitted: $ ~
Final Certificate: V/ (check one)
Applicant Sign~t~rre
lesue D~
9/28/07
Electrical Inspection Certificate
Electrical Inspection Service, Inc. Application
375 Dunton Avenue 119259C
East Patchogue, New York 11772
(6.1t) 286.6642
Issued To: Mr. William Park
Street: 4225 Bridge Lane
Village: Cuthogue Zip: 11935
Section: 84 Block: 04 Lot: 11.3
Town: $outhold
Contractor: Elec-Tec Electrical Contracting Lic. # 4814-E
Was examined and found to be in compliance with the National Electrical Code.
[] Commemlal [] NVDefects [] Pool [] tetFIoor [] Indoor [] Basement []HotTub
[] Residential [] Der. Garage [] Attic [] 2nd Floor [] Outdoor [] Addition [] Survey
Switches Receptacles Fixtures GFI Heaters A/C Fans
2 1
Dishwasher Washer/Amps Dryer/Amps Oven Range/Amps Microwaves
Furnace Oil Gas Circulators Smoke Detector Bell Transformer
Meter Amps Phase UG/OH Jacuzzi Television CO Detector
/
Bldg. Permit: 33188
Other Equipment
l-Time Clock/1-20 amp Spec. OutletJ 1-Pool
Light
Hugo S. S/drdi
President
Rough Inspection:
Inspec~r:
Rnal InsiPidlY:m: 09/26/2007
Inspector: John Mc Mahon III
This certificate must not be altered in any manner. Inspectors may be identified by their credentials.
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. 33188 Z Date JUNE 29, 2007
Permission is hereby granted to:
WILLIAM W & TERRI L PARK
4225 BRIDGE IJ~NE
CUTCHOGUE,NY 11935
for :
CONSTRUCTION OF A/~ IN-GROUND SWIMMING POOL AS APPLIED FOR
at premises located at 4225 BRIDGE LA CUTCHOGUE
County Tax Map No. 473889 Section 084 Block 0004 Lot No. 011.003
pursuant to application dated JUNE 21, 2007 and approved by the
Building Inspector to expire on DECEMBER 29, 2008. / ~
ORIGINAL
Rev. 5/8/02
INSPECTION
[ ]FOUNDATION 1ST
[ ]FOUNDATION 2ND
[ ]FRAMING / STRAPPING
[ ]FIREPLACE & CHIMNEY
[ ]FIRE RESISTANT CONSTRUCTION
[ ] ROUGH PLBG.
[ ] ~U~,ATION
[,,,,,]"FINAL
] FIRE SAFETY INSPECTION
[ ] FIRE RESISTANT PENETRATION
REMARKS: ~'//~
DATE /~/~~~ INSPECTOR~~~
FIELD INSPECTION REPORT
FOUNDATION (2ND)
PLUM~ING
~S~ATION PER N.Y. /
STATE ENERGY CODE
~DITION~ COUNTS
SOUTHOLD, NY 11971
~ Ou~C. D~P..
TEL: (631) 765-1802
FAX: (631)765-9502
~w. northfork.neffSoutholW PERMIT
Examined
I/1.. ,20 _
Approved >o [ J~ ,20-~/~
Disapproved a/c
Expiration ,20
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
Contact:
Mail to:
__ ~ Phone:
APPLICATION FOR BUILDING PERMIT
INSTRUCTIONS
Date /~,/~r) ,20 O ?
a. This application MUST be completely filled in by typewriter or in ink and submitted to the Building Inspector with 4
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.
~. 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 I2 months after 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.
(Signature of applicant or name, ifa corporation)
(Mailing address of applicant)
State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder
Name of owner of premises ~-~//L/~,~.Q/ + ~'~-'~7~/ '5~/~;~(
(As on the tax roll or latest deed)
If applicant is a corporatjo~),~ sig~atu~ of duly anth~orized officer
~?ard~ a-n~n'tI~ of corporate officer)
Builders License No. /~.//~
Plumbers License No.
Electricians License No.
Other Trade's License No.
Location of land on which proposed work will be done:
House Number Street
Hamlet
County Tax Map No. 1000 Section
Subdivision /x~t~ ~-~
(Name)
Block tO .4/
Filed Map No.
Lot 2/, _~
Lot
2. State existing use and occupancy of premises and intended use and occupancy of proposed construction:
a. Existing use and occupancy .? ~ -~z~Z ~' F,Z ;~eS~a-~e~
b. Intended use and occupancy /
3. Nature of work (check which applicable): New Building
Repair Removal Demolition
4. Estimated Cost
5. If dwelling, number of dwelling units
If garage, number of cars
Addition Alteration
(~th'~r Wor~/,--~,~o..,-~ ~s,.~ .,-,.,~.~ ~.
-~-z (Description)
Fee 27_~-'0, O0
(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 c/,,~,
Height ~ff5~' Number of Stories
Rear (/~ '
Depth. ? D
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 oflot: Front ..29/~,$D' Rear ..ff~'~,?d' Depth .2~5'5'-/
10. Date of Purchase
Name of Former Owner
11. Zone or use district in which premises are situated /52/_~/~-x.~,,4 ~
12. Does proposed construction violate any zoning law, ordinance or regulation? YES__
NO 5'
13. Will lot be re-graded? YES ,&' NO__ Will excess fill be removed from premises? YES__ NO X'
14. Names of Owner of premises/,o,, ·,~*r ~,~z~g
Name of Architect
Name of Contractor/3/4~/~
Address .~/zz,¢ 35~,~6~5 z.6t PhoneNo.
Address e,o,a,,~-,~ Phone No
Address'~,~ -~o~ ?. ~.~.~,~-Phone No. ~'~/-
15 a. Is this property within 100 feet of a tidal wetland or a freshwater wetland? *YES * 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 ~k/
* IF YES, D.E.C. PERMITS MAY BE REQUIRED.
NO.,~'
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 )
:5~-i/f.~_,~-.4.~ _,,'~/~7'0// being duly swom, deposes and says that (s)he is the applicant
(Name of individual signing contract) above named,
(S)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 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/m-'~his
2tST ~ayo~/ 3'9-~.q # 200'7
~ ~ ~" Si~ture of Appli&t
Town Hall, 53095 Main Road
P.O. Box 1179
Southold, New York 11971-0959
Fax (631) 765-9502
Telephone (631) 765-1802
BUILDING DEPARTMENT
TOWN OF SOUTHOLD
DEC.26,2007
WM. & TERRI PARK
4225 BRIDGE LANE
CUTCHOGUE, N.Y. 11935
To Whom It May Concern:
We are unable to complete your Certificate of Occupancy because of the following
reasons:
An application for Certificate of Occupancy is not on file. (Enclosed)
No Electrical Certificate on file.
The Check is not on file - $25.00
No Health Department Approval on file.
No final inspection has been made.
No Plumber Solder Certificate on file. (All permits involving plumbing being
issued after April 1, 1984) )
Certificate of Compliance from Southold Town Trustees.
Approval of the Zoning Board of Appeals
Final Planning Board Approval.
BP #33188-Z (INGROUND SWIMMING POOL)
Town Hall Annex
54375 Main Road
P.O. Box 1179
Southold~ New York 11971-0959
Telephone (631 ) 765-1802
Fax (631) 765-9502
BUILDING DEPARTMENT
TOWN OF SOUTHOLD
2nd Notice
November 25, 2008
Occupancy or use is unlawful without a Certificate of Occupancy
Mr.&Mrs. W.Park
4225 Bridge Lane
Cutchogue N.Y. 11935
To Whom It May Concern:
It has come to the attention of the Southold Town Building Department that a Certificate
of Occupancy has never been issued for Building Permit # 33188 issued on June 29,2007
for an lnground Swimming Pool. In order to rectify this situation please submit the
following to this office so that a C.O. may be issued.
~An application for Certificate of Occupancy is not on file.(Enclosed)
c~No Electrical Certificate on file.
r~'~The Check is not on file -$ 25.00
No Final Health Department Approval on file.
No final inspection has been made.
No Plumber Solder Certificate on file. (All permits involving plumbing being
issued after April 1, 1984)
Certificate of Compliance fi.om Southold Town Trustees.
Approval of the Zoning Board of Appeals*
Final Planning Board Approval.
TOWN OF SOUTHOLD PROPERTY RECORD CARD
OWNER
STREET../'"'/"~""~'~ ..VILLAGE ~ST.
ACR, '~ REMARKS
TYPE OF BLD.
PROP. CLASS
LAND IMP. TOTAL DATE
SUB. LOT ~
FRONTAGE ON WATER TILLABLE
FRONTAGE ON ROAD WOODLAND
MEADOWLAND
DEPTH
BULKHEAD
HOUSE/LOT
TOTAL
COLOR
Bldg
Extension
Extension
Extension
Patio
Porch
Deck
Breezeway
Garage 2~'-'~ 22 .~ '700
O.B. ~ '-~- o,,~..~__~
Pool ~-/'~0
Foundation
Basement
Ext. Walls
Fire Place
Dormer
TRIM
c.B Bath 2 ~ Dinette
FULL
SLABCRAWL Floors Kit. v/
Interior Finish ER. V/
Heat
Woodstove
Attic
Rooms 1st Floor
Driveway Rooms 2nd Floor
BR.
Fin. B.
SAB I, g4P OR CORE'S ~4R THE IId~ED SEAL OF THE. SURVEYOR
ADL~ITION4LL Y TO COM~ Y I~7'H.SAIO LAF/ ~ ~:.1~1 'AL TE~ED BY'
I, tUST BE (,I~2) BY ANY AND ,4I.~ ~I.~/EYORS UTL1Z~E A COPY
I am femSIm' wllh the STANDARDS FOR APPROVAL
AND CONSTRUCTION OF SUBSURFACE SEWAGE
DISPOSAL SYSTEMS FOR SINGLE FAMILY RESIDENCES
and will ebfde I~ fhe condfllons set forfh lherefn end on Ihe
permit lo conslrucf.
The locations of wells an.d cesspools
shown hereon ore from field observofions
ond or from dole obf;Jned from others.
'" ' ' SURVEY OF
LOT 3
'" '-' ' ¢ FROM MINOR VlSI~ MAP
"SHA L VE Y PROPER TIES"
F~ED ~L Y 16, 1990 FILE NO. 8975
A T CUTCHOGUE
TOWN OF SOUTHOLD
SUFFOLK C~NT~ N
~RT~D TO~ S · = ' '
~ CALE I 50
[L~M W. PARK
LAKE SHORE ~8STRACT, INC. Apr,716~ 1997 (SCDHS INFO) r
~FFOLK COUNTY N~ T/ON~L BANK Ocl 10,1997 (/ound~lion)
CONTOUR LINES ARE REFERENCED TO
~ - 1,41
:l'o__w n o_ f Southol__d
Erosion, Sedlmentat,on & Storm-Water Run-off ASSESSMENT FORM
PROPERTY LOCATION: S.C.T.M.#: THE FOLLOWING ACTIONS MAY REQUIRE THE SUBMISSION OF A
,~ [~ I I I, ~ STORM-WATER, GRADING; DRAINAGE AND EROSION CONTROL PLAN
--CERTIFIED BY A DESIGN PROFESSIONAL IN THE STATE OF NEVi YORK.
District Section Block Lot
Item Number: (NOTE: A Check Mark (~) for each Question is Required for a Complete Application)
Ye__s N__o
I Will this Project Retain All Storm-Water Run-Off Generated by a Two (2")Inch Rainfall on Site?
(This item will include all run-off created by site cleadng and/or construction activihes as well as all Site
Improvements and the permanent creation of impervious surfaces.)
2 Does the Site Plan and/or Survey Show All Proposed Drainage Structures Indicating Size & Location?
This Item shall include all Proposed Grade Changes and Slopes Controlling Surface WaterFtow!
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 Matedal within any Pamel?
4 Will 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 Course Running threugh the St/e?
Is this Project within the Trustees jurisdiction or within One Hundred (100') feet of a Wetland or Beach?
One Hundred (100') of Horizontal Distance?
7 intoWill Driveways, Parking Araas or other Impervious Surfaces be Sloped to Direct Storm-Water Run-Offand/or in the direction ora Town right-of-way?
8 Will this, reject 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?
(This item will NOT include the Installation of Driveway Aprons.)
9 Will this Project Require Site Praeparation within the One Hundred (100) Year Floodplain of any Watercoume?
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 is Required and Must be Submitted for Review Prior to Issuance of Any Building Pennitl
EXEMPTION: Ye._.~s
Does this project meet the minimum standards for classification as an Agricultural Project?
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
That I, ..~...~.~.~.....~.~...F......~.. ...................... being duly sworn, deposes and says that he/she is the applicant for Permit,
And that he/she is the ................. ~~E~'"/"E .......................................................................................................
Owner and/or representative of the Owner of Owner's, 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 pefforn~ed in the manner set forth in the application filed herewith.
Sworn to before me this; ~
................. JO: ................... f ~..~,t:¢ ........................... 20.0.7
Notary Public: ..... ~~~. l....,~lffiTl;, o vt. ....
/ / ~.~otar~'Pubr, c, State of New York (Signature of Ap¢cant) --
FORM - 06/0'~ // .o. m sc4725os_.9 -.-
Term Expires May 31. ~
8' b 8' b 8' b 8- b 8'
TOPAZ STERLING STONETff£
{03-~osI {03
NON DIY1NG LIN[~S
H4 103-~43} I-8 {03-243~ ~14
'""' MAY I"m ~0
APRROV~ED AS NOTED
°ATE: #
NOTIFY BUILDING ;:SPARTMENT AT
765-1802 8AM TO 4PM FOR THE
FOLLOWING INSPECTIONS:
1. FOUNDATION - TWO REQUIRED
FOR POURED CONCRETE
2. ROUGH - FRAMING & PLUMBING
3. INSULATION
4. FINAL - CONSTRUCTION MUST
BE COMPLETE FOR C.O.
ALL CONSTRUCTION SHALL MI~ET THE
REQUIREMENTS OF THE CODES OF NEW
YORK STATE. NOT RESPONSIBLE FOR
DESIGN OR CONSTRUCTION ERRORS.
ALL CONSTRUCTION SHALL
MEET THE REQUIREMENTS OF THE
Cr':-)~g OF ;,:F: '.; ':-: F' L':',:~TE.
OCCUPANCY OR
USEIS UNLAWFUL
W!THOUTCERTIFICATE
QFQCCU?ANCY
IN-GROL,'ND SWIIMM~NG POOL WILL BE CONSTRUCTED OF STEEL WALLS SUPPORTING A
VINYL LINER THAT ~,qLL HOLD APPROXIMATLY 35,000 GALLONS OF WATER.
FENCE WILL BE CHAIN LINK CONSTRUCTION, 4' HIGH V,'ITH SELF CLOSING GATES THAT
~,ILL MEET TOWN' CODES.