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Home My WebLink About39497-ZW r tS� Town of Southold Annex P.O. Box 1179 54375 Main Road Southold, New York 11971 CERTIFICATE OF OCCUPANCY 1/29/2015 No: 37401 Date: 1/29/2015 THIS CERTIFIES that the building IN GROUND POOL Location of Property: 49700 CR 48, Southold, SCTM #: 473889 Sec/Block/Lot: 55.-3-4.4 Subdivision: Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated 1/20/2015 pursuant to which Building Permit No. 39497 dated 1/20/2015 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" in ground swimming pool with fence to code as applied for. The certificate is issued to Kerbs, Jon & Kerbs, Janis (OWNER) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL ELECTRICAL CERTIFICATE NO. PLUMBERS CERTIFICATION DATED s ut riz Si ature TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, NY rk,�t-Y�2 BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES WITH ONE SET OF APPROVED PLANS AND SPECIFICATIONS UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) Permit #: 39497 Date: 1/20/2015 Permission is hereby granted to: Kerbs, Jon & Kerbs, Janis 430 Riley Ave Mattituck, NY 11952 To: ,as built" in ground swimming pool with fence to code as applied for. At premises located at: 49700 CR 48, Southold SCTM # 473889 Sec/Block/Lot # 55.-3-4.4 Pursuant to application dated To expire on 7/21/2016. Fees: 1/20/2015 and approved by the Building Inspector. AS BUILT - ACCESSORY CO - ACCESSORY BUILDING Tntn 1 $500.00 $50.00 TSSn nn Building Inspector Form No. 6 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL 765-1802 APPLICATION FOR CERTIFICATE OF OCCUPANCY 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 I% 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 Planning Board Approval of completed site plan requirements. B. For existing buildings (prior to April 9, 1957) non -conforming uses, or buildings and "pre-existing" land uses: 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. Certificate of Occupancy - New dwelling $50.00, Additions to dwelling $50.00, Alterations to dwelling $50.00, Swimming pool $50.00, Accessory building $50.00, Additions to accessory building $50.00, 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 Date. % New Construction: Location of Property 9,6 v Old or Pre-existing Building: (check one) C_ e_ Ct 9" G3ACI W House No. Street Owner or Owners of Property: 30 Suffolk County Tax Map No 1000, Section Subdivision Permit No. Date of Permit. Health Dept. Approval: Planning Board Approval: Request for: Temporary Certificate Fee Submitted: $ ss - Date S Block Lot Filed Map. Applicant: Underwriters Approval: Lot: Final Certificate: (check one) Ap licant Signature Hamlet FIELD lXSP9C=QN epi FOUNDATION (1ST) ........... ....w........ FOUNDATION' (ZND) ROUGH FRAN=Q & PLUMBING INSULATION PER N. Y. STATE ENERGY CbDZ FINAL TOWN OF SOUTHOLD BUILDING DEPARTMENT BUILDING PERMIT APPLICATION CHECKLIST TOWN HALL SOUTHOLD, NY 11971 TEL: (631) 765-1802 FAX: (631) 765-9502 SoutholdTown.NorthFork.net PERMIT NO. l C Examined Approved Disapproved a/c INSTRUCTIONS 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 C.O. Application Flood Permit Single & Separate Storm -Water Assessment Form Mail to: Date , 20 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. 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 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, if a corporation) (Mailing address of applicant) State whether applicant is ow'per, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder 30"..'_ Name of owner of premises (As on the tax roll or latest deed) If applicant is a corporation, signature of duly authorized officer (Name and title of corporate officer) Builders License No. Plumbers License No. Electricians License No. Other Trade's License No. 1. Location of4and on whic roposedwork=OX House Num�JJber Street Hamlet County Tax Map No. 1000 Section Block Subdivision Filed Map No. Lot State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy b. Intended use and occupancy 3. Nature of work (check which applicable): New Building Addition _ Alteration Repair Removal Demolition Other Work 26 1 LDISQ) (Des& iption) / 4. Estimated Cost 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 use. 7 Dimensions of existing structures, if any: Front Rear Height Number of Stories Dimensions of same structure with alterations or additions: Front Depth Height Number of Stories Depth 8. Dimensions of entire new construction: Front Rear Depth Height Number of Stories 9. Size of lot: Front Rear 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? YES NO 13. Will lot be re -graded? YES NO Will excess fill be removed from premises? YES_ 14. Names of Owner of premises Address Phone No. Name, of Architect Address Phone No_ Name of Contractor Address Phone No 15FIs this property within 100 feet of a tidal wetland or a freshwater wetland? *YES NO 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 plan and distances to property lines. Rear NO 17. If elevation at any point on property is at 10 feet or below, must provide topographical data on survey. 18. Are there any covenants and restrictions with respect to this property? * YES NO * IF YES, PROVIDE A COPY. STATE OF NEW YORK) SS: COUNTY OF ) being duly sworn, 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 true 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. Swornt o before me this day of 7rt5tA,kk fA rQ MIS: "&Lei Notary Pub1i�oNmE D. BUNCH Now ptm' ft" d New Yak MAIMW o AMed I &9h* ►,a z: oomml� �-4CSigtnature4of Applicant STOIKIMMA Scott A. Russell. SUPERVISOR 2 1��1[A�1�A�(G!1EM[)E1�T SOUTHOLDTOWN HALL -P.O_Box 1179 O Town of Southold 53095 Main Road - SOUTHOLD, NEW YORK 11971 `� & ✓ '"1'3 -0 CHAPTER 236 - STORMWATER MANAGEMENT WORK SHEET ( TO BE COMPLETED BY THE APPLICANT) DoEs T -His PRomcr INVOLVE ANY OF THE FOLLOWING: (CHECK ALL THAT APPLY) A. Clearing, grubbing, grading or stripping of land which affects more than 5,000 square feet of ground surface. B. Excavation or filling involving more than 200 cubic yards of material within any parcel or any contiguous area. 100 feet of horizontal distance. ❑ D. Site preparation within 100 feet of wetlands, beach, bluff or coastal erosion hazard area. El B. Site preparation within the one -hundred -year floodplain as depicted on FIRM Map of any watercourse. F. Installation of new or resurfaced impervious surfaces of 1,000 square feet or more, unless prior approval of a Stormwater Management Control Plan was received by the Town and the proposal includes in-kind replacement of impervious surfaces. If you answered NO to all of the questions above, STOP! Complete the Applicant section below with your Name, _ Signature, Contact Information, Date & County Tax Map Number! Chapter 236 does not apply to your project. If you answered YES to one or more of the above, please submit Two copies of a Stormwater Management Control Plan and a completed Check List Form to the Building Department with your Building Permit Application. APPLICANT: (Pr ope y Owner, Design Prof tonal Ageecnt, Contractor, Other) r7AME: _ AA --C .0 — f�u:,rwm/rd �l Contact Informalion: . ,�.... ?!.., l..V..—S47-........ ,.....Y14 (- ...L ................................ ... _ _ .:ikP`+cr '.rix Pro[xn-tv Address / Location of Construction Work, ` yew 6.R. ..... __ �..... _ S.C.T.M. 100017— .. Disu ict ............._ ........_..._,. _ Section Block Lot RevwNved By, __..__.. Approved for processi mB.l i ing Permit. it. Stormwalc.r lvla .. na-c.ni,.n.'..O.,irul Plat' Nlu'i 1 t.,;irA .`.>toII tiattrN9 € ;cllt.11`. rtr0t '1 r Itetcirt_rt o, ti:,,rd' # t o TOWNOF SOUTHOLD PROPERTY. RECORD CARD OWNER STREET'7 DIST. SUB. LOT C-7.'"^Y'�S c e0 y r 4VI�+AGE `J iFORMER OWNER N ACR. Ji S rYw TYPE OF BUILDING RES. j ,% SEAS. VL. J� FARM COMM. CB. MICS. Mkt. Value LAND IMP. TOTAL DATE REMARKS ' 7.. _ +� a d z./.;x -716 g c--- ts 17act 81 a --7 —L 17.1522 D 515- Ker6:5 on J..3 f hYl M M l� e Al 46 rb . in ✓44 _) 1) BUILDING CONDITION AGE NEW NORMAL BELOW ABOVE FARM Acre Value Per Acre Value < . Tillable FRONTAGE ON WATER FRONTAGE ON ROAD Woodland Meadowland DEPTH House Plot BULKHEAD DOCK Total -earth feet 1200 metersr, 90