Loading...
HomeMy WebLinkAbout35567-ZFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No: Z-34380 Date: 05/28/10 THIS CERTIFIES that the building HOT TUB & WOOD PLATFORM Location of Property: 840 CLEARVIEW AVE SOUTHOLD (HOUSE NO.} (STREET) {HAMLET} County Tax ~ap NO. 473889 Section 70 Block 9 Lot 60 Subdivision Filed Map NO. __ Lot No. __ conforms substantially to the Application for Building Permit heretofore filed in this office dated MAY 7, 2010 pursuant to which Building Permit No. 35567-Z dated MAY 18, 2010 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 "AS BUILT" ACCESSORY HOT TUB ON WOOD PLATFORM AS APPLIED FOR. The certificate is issued to DARRIN & DONNA M SKREZEC ( OWNER ) of the aforesaid building. S~FOLK CO~ DEPAR~T~ENT OF }~gALTH APPROVAL ELEC~fRICAL C~KTIFICATE NO. pL~EP~ u~TIFIC~%TION DA'£~3 N/A 12766 04/13/10 N/A ~~~tho'r~nature Rev. 1/81 Form No. 6 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL 765-1802 APPLICATION FOR CERTIFICATE OF OCCUPANC MAY - 7 2010 BLDG. DEPT. TOWN OF SOUTHOLD This application must be filled in by typewriter or ink and submitted to the Building Department with the following: 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 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 cettificate of Code Compliance from architect or engineer responsible for the building. 6. Submit Planning Board Approval of completed site plan requirements. 1. Accurate survey of property 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, the Building Inspector shall state the reasons therefor in writing to the applicant. C. Fees 1. Cettificate of Occupancy - New dwelling $25.00, Additions to dwelling $25.00, Alterations 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 Certificate of Occupancy - Residential $15.00, Commercial $15.00 New Construction: Location of Property: Date. Old or Pre-existing House No. Street Owner or Owners of Property: Suffolk County Tax Map No 1000, Section Subdivision parmit No.~3 ~-~'-~'~'] Date of Permit. Health Dept. Approval: __ Planning Board Approval: Request for: Temporary Certificate _ Fee Submitted: $ Block Filed Map. Applicant: Underwriters Approvah (c eh~ck one) Hamlet Lot Lot: Final Certificate: (check one) FORM NO. 3 TOWN OF SOUTHOLD BUILDING DEPARTMENT Town Hall Southold, N.Y. (THIS BUILDING PERMIT PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) PERMIT NO. 35567 Z Date MAY 18, 2010 Permission is hereby granted to: DARRIN & DONNA M SKREZEC 840 CLEARVIEW AVENUE SOUTHOLD,NY 11971 for : "AS BUILT" HOT TUB, ENCLOSED TO CODE at premises County Tax Map No. 473889 Section 070 pursuant to application dated MAY Building Inspector to expire on NOVEMBER located at 840 CLEARVIEW AVE SOUTHOLD Block 0009 Lot No. 060 7, 2010 and approved by the 18, 2011. Fee $ 500.00 Authorized Signature ORIGINAL Rev. 5/8/02 S U F F 0 I K+~"~ BURFAU .~ 40 Nottingham Drive, Middle Island, NY 11953 Telephone: 631 495 8136 · Fax: 631 9806455 · E-Mail: SBEIGS@gmail.com CERTIFICATE OF ELECTRICAL COMPLIANCE Applicant: Rough In Inspection Date: Application No,: County Tax Map No.: qC Electric [nc Certificate No.: 12766 Final Inspection Date: Apr 13~ 2010 12766 Building Permit No.: Fi'ds 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: Darrin Skrezec Site Location: 840 Clearview Ave, Southold, NY 11971 Owner's Address (if different): ~ Residential Indoor I !Basement L Service · Shed Commercial ~ Outdoor r; ~ .Pool First Floor ~ Hottub New [ i Renovation Second Floor ~ ] Attic ~- Garage I Addition I~ilJ Survey Other: INVENTORY Single Phase Heat Duptex Recpt Ceiling Fixture HID Fixtures Three Phase Hot Water GFCI Recpt Wall Fixture Smoke Main Panel AC Cond Single Recpt Recessed Fixture CO Detect Sutl Panel AC Blower Range Recpt Flourescent Smoke CO Combo transforrne,' Appliances Dp/er Recpt Emergei~cy Time Ciock Disconnect 1 Switches Twist Lock Exit Fixtures Pumps GFCI Breaker Heat Pump Electric Heat Pool Luminaire Exhaust Fan Other Equipment: supply GFCI protected power to self contained hot tub 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. License No.: 3823-ME Date Of Certificate: Apr 23,2010 Applicant: QC Electric Inc Inspected By: Roger Richert ~i~BROBERT O'BRIEN RE. CONSULTING ENGINEERING SERVICES 2074 MAIN ROAD. P.O. BOX 456. LAUREL. NY 11648 May 27, 2010 Southold Building Department Southold, New York Skrezec Residence 840 Clearview Avenue Southold, NY Permit No. 35567 With reference to the hot tub at the above-captioned residence, please be ad- vised of the following: I inspected the wood plank support platform for the hot tub on May 27, 2010, and it appears to be in good condition and structurally sound. Very truly yours, TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, NY 11971 TEL: (631) 765-1802 FAX: (631) 765-9502 SoutholdTown.NorthFork.net Examined pl)~/ , 20 [o Approved ~l[ t~ 20 fid Disapproved a/c Expiration I ~][ ~', 20 I / a. Th MAY - 7 2010AP BLDG. DEPI. TOWN OF SOUTHOLO application MUST be completeb PERMIT NO. 3cc 7 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 Flood Permit Storm-Water Assessment Form Contact: Mail to: Phone: ~ Building Inspector ~.TION FOR BUILDING PERMIT Date ,,~7,~ ,_~ ,20/o INSTRUCTIONS 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. 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 the Building Inspector issues a Certificate of Occupancy. f. Every building perr[)!t shall expire if the work authorized has not commenced within 12 months after the date of issuance or has not been completed within 18 months from such date. If no 'zoning ~tme.ndments or other regulations affecting the property have been enacted in the inte[im, the Building Inspector may authorize,'in"writing, the extension of~he 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 heroin described. The applicant agrees to comply with all applicable laws, ordinances, building code, housing co--admit authorized inspectors on premises and in building for necessary inspections. ,' ' ' · ,~ g F-:.~ _ .[ll. il]ll.~_l~mA,,m.~.= ... ~ature o a'Fi~cant or name, ifa corporatiop) ; ' ~ ~ , ~/~|'TJ~NCLOSE POOL TO c~r~E ' - ~ ' ' UPON CO'.,~ = I '~'" ~,,'¢-z-,,,~R~ ,,~. . · - ..... . ..... TON . . Wi- L_: , BEF©~Z ' q- (Mathng,~ddressofapplicant) State whether applicant is owner, lessee, a~;ent, architect engineer general contract~~[~r builder JN'DERWR TEES CERT F CATE ,//'.-.-~',.-..,~,~-,~ REQUIRED DATE: (As on the tax ron or tatesr0;le¢¢j If applicant is a co~oration, signature of duly authorized officer (Name and title of corporate office" ALL CONS] r' ~ :, ?", }~ET THE REQU; · Builders License No. C,.-,DES OF NE:v',., Plumbers License No. Electr/cians License No. Other Trade's License No. Location of land on which proposed work will be done: House Number Street County Tax Map No. 1000 Section 7~7 Block fi' Subdivision Filed Map No. STRAPPING ELECTkiCA~. & CAULKING 3. INSULATION 4. FINAL ¢ CONSTRUCTION & ELECTRICAL MUST BE COMPLETE FOR C.O. ALL CONSTRUCTION SHALL Mr=Er ~E REQUIREMENTS OF THE C00ES OF NEW YORK STATE NOTRESPONsi[~LE FOR DESIGN OR CONSTrUe'- ~ ~ ~,, ~S Hamlet Y' "Lot ~"'o ' ~ ~ ~ · ~ Lot ~ 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy ~..r,..~.,,"--~ ~ 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 Fee Other Work Alteration (Description) (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. Dimensions of existing structures, if any: Front Height Number of Stories Rear _Depth Dimensions of same structure with alterations or additions: Front Depth Height Number of Stories Dimensions of entire new construction: Front Height Number of Stories Rear Depth 9. Size of lot: Front Rear Depth 10. Date of Purchase ~/~/~ Name of Former Owner ./~,,~ ~" 7/ [:~ar 11. Zone or use district in which premises are situated 12. Does proposed construction violate any zoning law, ordinance or regulation? YES__ NO l 3. Will lot be re-graded? YES NO__Will excess fill be removed from premises? YES NO 14. Names of, g)wner of prem~ses~Address~ -- -- --a-Ph°ne N°' _ Nameof'~5~---,."'/~,,O',,e.,t/'~' ,~:~,g/.~'~" Address. go;/,,, .,~_..f-,~ .,fto.,~- Phone No ,2. ~$:; Name of Contractor Address ~.- ,-r,-,,,,, · ,~, Phone.No. 15 a. Is this property within 100 feet of a tidal wetland or a freshwater ~vetland? *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__ * IF YES, D.E.C. PERMITS MAY BE REQUIRED. 16. Provide survey, to scale, with accurate foundation ~an~and chst~roperty lines. 17. If elevation at any point on property is at 10 feet or below, must provide topographical data on survey. 1 $. Are there anvcovenanl.s.a, ud.r,l~atrictions with respect to this property? * YES__ NO / · IF YES, flt~J~I~J~l~-~IA COUNTY OF (Name of individual signing contract) above named, being duly sworn, deposes and says that ts)he is the applicant tS)He is the ~(Cor~ty~9[gr. Agent, Corporate Officer, etc.) of said o~)ne~' or owners,, and t~,d/uly!tttlthonzed to perform or have performed the said work and to make and file this application; that all statenl{~t~'4vJ~flBlff/i~ttP~i?~tl~m are true to the best of his knowledge and belief; and that the work will be perform~:~ l~[~e~l'~l~li~i~lt¥o~[~t'~t/fll~rt~ati°n filed therewith. Sworn to before me this _ ~ dayof /'14o---~_ 20 lo Corn Oualified in Suffo k County mission Expires January 19, 20 - = S%~'gnature of Applicant