HomeMy WebLinkAbout33688-ZFORM NO. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
office of the Building Inspector
Town Hall
Southold, N.Y.
CERTIFICATE OF OCCUPANCY
No: Z-45080 Date: 09/27/10
THIS C~KTIFIES that the building SWIMMING POOL
Location of Property: 1060 JASMINE LA SOUTHOLD
(HOUSE NO.) (STREET) (HAMLET)
County Tax Map NO. 473889 Section 69 Block 3 Lot 24.14
Subdivision Filed Map NO. __ LOt No. __
conforms substantially to the Application for Building Permit heretofore
filed in this office dated FEBRUARY 7, 2008 purs,,a-t to which
Building Permit No. 33688-Z dated FEBRUARY 13, 2008
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 MICHAEL C & LYNN A EC~DT
( OWNER )
of the aforesaid building.
S~3FE~)~ C~)[~fYDBPART~T OF ~]~ALTHAPPRO~FAL N/A
BLRCTRIC3%L ~K~TIFICATE NO. 4001413 06/02/08
PLiErS ~KTIFICATION DA'£~u N/A
.... 7~holi ze~ignature
Rev. 1/81
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. 33688 Z Date FEBRUARY 13, 2008
Permission is hereby granted to:
MICHAEL C ECKHARDT
1060 JASMINE LANE
SOUTHOLD,NY 11971
for :
CONSTRUCTION OF AN ACCESSORY INGROUND SWIMMING POOL, FENCED TO
CODE AS APPLIED FOR
at premises located at 1060
County Tax ~4ap No. 473889 Section 069
pursuant to application dated FEBRUARY
Building Inspector to explre on AUGUST
JASMINE LA SOUTH~-
Block 0003 ~ot No. 024.014
7, 2008 a~d approved by the
13, 2009.
Fee $ 250.00
Authorized Signature
ORIGINAL
Rev. 5/8/02
Form No. 6
TOWN OF SOUTHOLD ·
BUILDING DEPARTMENT
TOWN HALL
765-1802
Co
APPLICATION FOR CERTIFICATE OF OCCUPAN(
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, 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 tess than 2/t0 of 1% lead.
5. Commexcial building, indus~al building, multiple residences and ~imilar buildings and installations, a certifieate
of Code Compliance from architeet or engineer responsible for the building.
'6. Submit PLanning Board Approval ol~'dompleted site plan requirements.
.For existing.buildings(prior to April 9, 1957) non-conforming uses~ or buildings and ~'pre-exisflng" Land uses:
1. Accurate survey °f Pmpertyshowing all property lines, streets, building and unusual nataral or topographic
features. ' '
2. A properly completed application and censent to inspect signed by the applicant. Ifa Certificate of Occupancy is
denied, the Building Inspector shall state thc reasons therefor in writing to the applicant.
Fees
1. Certi~cate ~f Occupancy - New dwe~ing $25~ Additi~ns t~ dwe~ing $25~ A~terati~ns t~ dwe~ing $2~
Swimming pool $25.00, Acccssory-building $25.00, Additions to accessory building ~25.00, Businesses $50.00.
2. Certificate ofOccupaneyon Pre~existiag Building- $100.00
3. Copy 0fCertificate of Occupancy: $.25
4. Updated Certificate of Occupancy - $50.00
5. Temporary Certificate of Occupancy - Residential $15.00, Commercial $15.00
Date.
Ncw Construction:
Location of Property:
Old or Pre-existing Building:
I-Iouse No. Street
OWner or'Owners of property: } '/~t ;~/. ~. / ¢ Z 3' ~ ~ ~ HA
' sutT°lk county Tax Map No 1000, Section )/p ~'
Subdiv/sion
PermitNo. '7)3~I~' ' DateofPermit.
(check one)
Health Dept. Approval: .
Planning Board Approval:
Request for: Temporary Certificate
Fee Submitted: $ r~/
1 6 2010
· BLDG. OEP)'.
(check one
Applicant Signature
Underwriters Approval:,
Final Certificate: _. ~
Filed Map. Lot:.
APPl~cant: M,~J~4e/ Ft/d~,~rd7c-'
BY THIS CERTIFICATE OF COMPLIANCE THE
NEW YORK BOARD Of FIRE UNDERWRITERS
BUREAU OF ELECTRICITY
40 FULTON STREET ~ NEW YORK, NY 10038
CERTIFIES THAT
Upon the application of upon premises owned by
LYNN ECKHARDT 1060 JASMINE LANE LYNN ECKHARDT
SOUTHOLD, NY 11971 1060 JASMINE LANE
SOUTHOLD, NY 11971
Located at 1060 JASMINE LANE SOUTHOLD, NY 11971
Application Number: 4001413 Certificate N 001413
Section: Block: Lot: Building Permi BDC: ns11
as a Swimming Pool occupancy, wherein the premises electrical system consisting of
Described
electrical devices and wiring, described below, located in/on the premises at:
Outside, Pool/Spa,
A visual inspection of the premises electrical system, limited to electrical 'devices and wiring to the extent detailed
herein, was conducted in accordance with the requirements of the applicable code and/or standard
promulgated by the State of New York, Department of State Code Enforcement and Administration, or other
authority having jurisdiction, and found to be in compliance therewith on the 2od Day of Juoe, 2008.
Name QTY Rate Rating Circuits Tvoe
Appliances and Accessories
Pool / Spa Bonding 1 0
Time Clock Switch 1 0
Panels
1 40 2
Wiring And Devices
Fixture I 0 pool Incandescent
GFCl Circuit Breaker 1 0 pool-15a
GFCl Cimuit Breaker 1 0 pool-20a
Receptacle I 0 pool-20a Gen, Purpose
(Swimming Pool): This certificate covers compliance at the date of inspection only. Because of unusual environments it is advisable to have fi'equent test
md/or repaim made by a qualified pemon.
seal
1 of l
This certificate may not be altered in any way and is validated only by the presence of a raised seal at the location indicated.
TOWN OF SOUTHOLD BUILDING DEPT.
765-1802
INSPECTION
[ ]FOUNDATION 1ST
[ ]FOUNDATION 2ND
[ ]FRAMING / STRAPPING
[ ]FIREPLACE & CHIMNEY
[ ] ROUGH PLBG.
[ ~/J~ FINAL
[ ] FIRE SAFETY INSPECTION
[ ] FIRE R~ CONSTRUCTION [ ] FIRE RESISTANT PENETRATION
REMARKS: ~~ ~L~ /~ ~'~
DATE ~)//? /~
-/
INSPECTOR
TOWN OF SOUTHOLD BUILDING DEPT.
765-1802
INSPECTION
[ ] FOUNDATION 1ST
[ ] ROUGH PLBG.
] FOUNDATION 2ND
] FRAMING / STRAPPING
[ ] ~ULATION
[ ,*']'FINAL
[ ] FIREPLACE & CHIMNEY [ ] FIRE SAFETY INSPECTION
[ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRATION
REMARKS:
DATE
INSPECTOR/~/~~
vn~D ~sv~c~o~ v~vO~T
FO~DATION (1ST)
FOI~DATION (2ND)
ROUGH F~G &
PL~G
~S~ATION PER N. Y.
STATE ENERGY CODE
~,
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN HALL ~
SOUTHOLD, NY 11971
TEL: (631) 765-1802
FAX: (631) 765-9502
SoutholdTown.NorthFork.net
Exmnined ,20
Approved ,20.__
Disapproved Wc
Expiration
2O
PERMIT NO.
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
Storm-Water Assessment Form
Mail to:
Phone:
/~g Inspector
...... ~,PPLICATION FOR BUILDING PERMIT
Date
INSTRUCTIONS
,20
a. This application MUST be completely filled in by typew~er 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 permit 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 amendments or other regulations affecting the
property have been enacted in the interi~n, thc Building Inspectc, 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 cfa 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.
"IMMEDIATELY" 7'rft~ gJ. O.
ENCLOSEupoN COMPLETIoNPOOLTO CODE OCCUPANC .) 2,. (Signature of applicant or name, ifa corporation)
8EFO"E"W^TE"' USE IS UNLAWFUL /0Or
(Mailing address of applicant)
WITHOUT C ' TIFICATE
State whether applicant is owner, le~,.s~e.~, ~l~l~rfl, hi.tect, ~n~gineer, general contractor, electrician, plumber or builder
A??POV[D AS I'{OTED
BATE:~
(As on the tax roll or [~¢
If applicant is a corporation, signature of duly authorized officer 765-1502 8
ALL C' ~' )i,,i SHALL
(Name and title of corporate
C(';
Builders License No.
Plumbers License No.
Electricians License No.
Other Trade's License No.
;:t,:r OF THE
';FATE.
RETAIN STORM WA~ER RUNOFF
pU.n.$tlANT TO CHAPTER 236
OF THE TOWN CODE.
Location of land on which proposed work w_jJ1 be done:
I (~1, o ~-~s~i,,~ Ls,.,,~ UNDERWRtTER$CERTIFICATE
House Number Street REOUIRED
County Tax Map No. 1000
Subdivision
(Name)
FOLLOW;NG INSi;~5 ,'k-iS:
1. FOU',qDATION - 5W,D REQIJIRED
FOR FOURED CC ,~./;ETE
2. ROUG,H - FRAIJ,;NG & PLUMBING
3. INSULAT!ON
4. FINAL - CO;'-' : .':'EC'N MIJST
BECOMPL2rE; ,:;C.O.
ALL CONSTRUC~,!ON SHALL MEET THE
REQUIREMENTS OFTHE CODES OF NEW
YORK STA~E. NOT RESPONSIBLE FOR
~I~E~IEIN~CI~ CONSTRUCTION ERRORS.
Hamlet
Section (~97
State existing use and occupancy of premises and intended use and occupancy of proposed construction:
a. Existing use and occupancy 4
b. Intended useand occupancy
Nature of work (check which applicable): New Building
Repair Removal Demolition
Estimated Cost
If dwelling, number of dwelling units
If garage, number of cars
Addition Alteration
Other Work
(D~scripflon~ -
Fee
(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
Height Number of Stories
Rear Depth
Height Number of Stories
9. Size of lot: Front ~5'5G Rear qO'Oq' Depth
10. Date of Purchase 5'/ /~g' Name of Former Owner
Dimensions of same structure with alterations or additions: Front Rear
Depth Height Number of Stories
Dimensions of entire new construction: Front ~} ~ Fl" Rear ~ ~$/~1"~ Depth ~
11. Zone or use district in which premises are situated
12. Does proposed construction violate any zoning law, ordinance or regulation? YES NO ))<7
13. Will lot be re-graded? YES__ NO X Will excess fill be removed from premises? YES__ NO__
14. Names of Owner of premises
Name of Architect
Name of Contractor
Address Phone No.
Address Phone No
Address 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__
* IF YES, D.E.C. PERMITS MAY BE REQUIRED.
NO ,X
16. Provide survey, to scale, with accurate foundation plan and distanc/es to property lines.
17. If elevation at any point on property is at 10 feet or below, must prt/vide topographical data on surves;.-"
18. Are there any covenants and restrictions with respect to this property? * YES NOt/~
· IF YES, PROVIDE A COPY.
STATE OF NEW YORK)
SS:
COUNTY OF )
(N~ '~&~, f~ being duly sworn, deposes and says that (s)he is the applicant
ame 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 perf, or~ ar ht~vc~ffermed the said work and to make and file this application;
that all statements contmned tn this apphcatzon are true to t[~ ~o~ o~J~,lmowledge.and behef; and that the work wall be
performed in the manner set forth in the application filed therewzt'h. ;' ' '
Sworn to before me this ... ~
~)'~' day of ~Z:~_q4,~,M~, 20 O,~' '
' / I~otal~ m~bl}c--- ~L~ ~
Signature
of
Applicant
OWNER ~T-REET t O(p~ --~IL~AGE DiST~ SUB. L~)¥ 14
F~ONTAGE O~ WATE~ TILLABLE
F~ONTAGE ON ~OAD WOODLAND
DEPTH ~EADOWLAND
BUL~HEAD HOUSE/LOT
TOTAL
~ ~.-,,.~- ~ // ~ Foundation Bath Dinette
FULUL~
Extension Basement c~wc Floors Kit.
Extension Ext, Walls ~: .~ ? Interior Finish ~'I' .'~.-~' L,R,
Extension Fire Place ~ Heat ~.~ D.R.
Patio Woodstove BR.
Porch Dormer Fin. B.
n~u~ .~ ,~L ~ ~ ~ ~ ~ Attic
Breezeway Rooms 1st Floor
Garage ~~~ ~ I~ [0~0 Driveway Rooms2ndFIoor
O.B.
Pool
407.
APPROVED
CERTIFIED TO'
EON F. BAKER
SHEILA L. ELLISTON
THE LONG ISLAND SAVINGS BANK
SUPERIOR ABSTRACT
SURVEY OF
.LOT14
A T SOUTHOLD
TOWN OF SOUTHOLD
SUFFOLK COUNTY, N Y.
1000 ? 70 ' O!, PlO 6
Scale: 1'= 40'
Nov. 19, 1993(final) I
SUFFOLK COUN'ff DEPARTMENT OF II~LTH SERVICES
Approval of Conshucled Works
H.D. Rel. No.~
The sewage disposal and water supply facilities at this location
hays bean aat~slactorily mapecled by this Deportment and oi'e
III complJa,c.e, w~th tlmse as.built plafla
DArE -r- CHIEF OF GENER)~L
ENGINEERING SERVICF~
shown hereon ore from IleM observolions
and or from dais ob/a/ned tram olhers.
AREA = 29,626 sq. ft.
Prepared In accordance with /he m/n/mum
standards for lille surveys ns eslab//shed
~y Ihe L.I.A.L.& and approve~ and adopled ~.~~ ~
IorTllleSUChAssOclation.Use by The New Yor~ elsie Land ~'~D,~-
..~ ~o rne w,ana~dw of The SWIoI* Co~
SUFFOLKCO~TYDEPARTM.T~HEALTHSERVICESFOR A~ROVAL ~ C~T~CTI. ~y DeparlmenlolHeallhServges.
~~N.Y.&LIC. NO. 496/e
C'~516) ~ ~50EO
P.
P.O. BOX 909
~LEVA T/~S AR& R~FEa~NC~ MAIN ROAD
TO AN A$E~ED DA T~.
'. SOUT~LD~ N.Y. 119~1