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Home My WebLink About28270-ZFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPD2qCY No: Z-28645 Date: 08/02/02 T~IS CERTIFIES that the building ACCESSORY Location of Property: 120 LANDS END RD ORIENT (HOUSE NO.) (STREET) (HAMLET) County Tax Map No. 473889 Section 15 Block 9 Lot 1.13 Subdivision Filed Map No. __ Lot No. __ conforms substantially to the Application for Building Permit heretofore filed in this office dated APRIL 11, 2002 pursuant to which Building Permit No. 28270-Z dated APRIL 15, 2002 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 INGROUND SWIMMING POOL WITH FENCE TO CODE AS APPLIED FOR. · ~ne certificate is issued to DANIEL F NICKOLA & ORS (OWNER) of the aforesaid building. SUFFOLK COU/FI"f DEPARTMENT OF ~IE~J~T~ APPROVAL ELECTRICAL CERTIFICATE NO. PLI~BEP. S CERTIFICATION DA'f~3 Rev. 1/81 N/A 1044059 06/10/02 N/A Authorized S~ature 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. 28270 Z Date APRIL 15, 2002 Permission is hereby granted to: DANIEL F NICKOLA 37 NINTH AVE FARMINGDALE,NY 11735 for : CONSTRUCTION OF AN INGROUND SWIMMING POOL IN THE REQUIRED REAR YARD WITH FENCE TO CODE AS APPLIED FOR at premises located at 120 County Tax Map No. 473889 Section 015 p~rsuant to application dated APRIL Building Inspector. LANDS END RD ORIENT Block 0009 Lot No. 001.013 11, 2002 and approved by the Fee $ 150.00 Rev. 2/19/98 COPY Form No. 6 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN 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 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 Planning Board Approval of completed site plan requirements. 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. Ifa Certificate of Occupancy is denied, the Building Inspector shall state the reasons therefor in writing to the applicant. Fees 1. Certificate 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 - $25.00 4. Updated Certificate of Occupancy- $50.00 5. Temporary Certificate of Occupancy - Residential $15.00, Commercial $15.00 Date. / New Construction: Location of Property: /a~ C;> House No. Owner or Owners of Property: ~) ~5-~',~~'' Suffolk County Tax Map No 1000, Section Subdivision d~,~J Permit No. 02~a~ ~ ~ Date of Permit. Health Dept. Approval: Planning Board Approval: Request for: Temporary Certificate Fee Submitted: $ ~ f ;/ Old or Pre-existing Building: (check one) x Street Hamlet Block Lot ~9~/,' /3 Filed Map. Applicant: Lot: Underwriters Approval: Final Certificate: ~ (check one) Applicant Si~ure BY THIS CERTIFICATE OF COMPLIANCE THE NEW YORK BOARD OF FIRE UNDERWRITERS BUREAU Of ELECTRICITY 40 FULTON STREET - NEW YORK, NY 1OO38 CERTIFIES THAT Upon the application of upon premises owned by VORRATH ELECTRIC DAN NICOLA 16 BROMLEY PLACE 120 LANDS END ROAD GREENLAWN, NY 11740, ORIENT, NY 11957 Located at 120 LANDS END ROAD ORIENT, NY 11957 Ap@lication Number: 1044059 Certificate Number: 1044059 Section: Block: Lot: Building Permit: BDC: NS11 Described as a Residential occupancy, wherein the premises electrical system consisting electrical devices and wiring, described below, located in/on the premises at: Second Floor, Outside, was inspected in accordance with the National [lectrical Code and the detail of the installation, as set forth below, was found to be in compliance therewith on the 10th Day of June, 2002. Name QTY Rathe Rating Circuit Type Additional Charges modular house N.Y.State approval # 19-15 nffg Deluxe Homes serial # 15363 Appliances and Accessories Air Conditioner 1 0 30,000 BTU Air Conditioner 1 0 24,000 BTU Wiring and Devices Fixture 4 0 Incandescent Switch 1 0 General Purpose Service 1 Phase 3W Service Rating 200 Amperes Service Discotmect: I 200 cb Meters: 1 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. 765.1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION 1ST [ ] ROU/GH PLBG. / [ ] FOUNDATION2ND [ ] I~ULATION [ ] FRAMING ~ FINAL [ ] FIREPLA(~E & CHIMNEY REMARKS:~ DATE FIELD INSPECTION REPORT ! DATE COMMENTS FOUNDATION (1ST) FOUNDATION (2ND) ROUGH FRAMING & PLUMB~G INSULATION PER N. Y. STATE ENERGY CODE ~DITION~ COMMENTS I. OWN SOUTHOL~f! BUILDING DEPARTM[~.dS~T TOWNUALL SOUTHOLD, NY 11971 TEL: (631) 765-1802 F~: (631) 765-9502 Examined ~Z/~ ~- , 200,,~, Approved Disapproved Expiration /0//'5'-, 20t:~ BUILDING PERMIT APPLICATION CHECKLIS~ Do you have or need the following, before e,pplying Board of Health 3 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 Date INSTRUCTIONS a. This application MUST be completely filled in by typewriter or in ink and submitted to the Building Inspector with 3 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. Uppn 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 Ceriificate of Occupancy. f. Every building pemlit 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 ora 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, al~ regulations, and to admit authonzed ~nspectors on premises and in building for necessary inspections. /,7-N ~///P'- ~ / · ' (Mailing ~d'dress of applie~ant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder Name of owner of premises 53~,,,~_,9 ,,2-~,~4', Z ~_~,~e'--, x, ~e4 ? (As on the ff~x roll or latest deeA) If applicant is a corporation, signature of duly authorized officer (Name and title of corporate officer) ' /') ml~rs License No. 72~ ;2. ~/De ] Plumbers License No. Electricians License No. Other Trade's License N~. Location of land on which proposed work will be done: House Number Street Hamlet CountyTax Map No. 1000 Section Subdivision (Name) Block o?. '~ o Filed Map No. Lot <~o r'. or.7 Lot 2. 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 Repair Removal Demolition Other Work 4. Estimated Cost 3/~ e~q~, o~ 5. If dwelling, number of dwelling units If garage, number of cars Fee 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 o fuse. 7. Dimensions of existing structures, if any: Front Height Number of Stodes Rear Depth 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 9. Size of lot: Front Rear Rear Depth / Depth 10. Date of Purchase Name of Fomier 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 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 B,E.~REQUIRED. b. Is this property within 300 feet of a tidal wetland? * YES NO ,dj * IF YES, D.E.C. PERMITS MAY BE REQUIRED. No-4 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 ) being duly sworn, deposes and says that (s)he is the applicant (Name of individual signing contract) above named, (S)He is the (Contractor, Ag~'llt;-, 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. Sworn to before me this //,-Z::;~C-day of O._.o_.*.~2.tt , 20~ Notary Public HELENE D. HORNE Notary Public. State of New ¥o1~ No, 4951364 Qualified in Suffolk Coullty ....... ~ion Expires May 22, Si'gnattW(o f Applicm~t ~/~/~ · OF SUFFOLE S 02'19'4.0" N 01'02'20" £ 113.76' L= LAND'S END ROAD S 02'1g'4,0' W N 01'02'20" E 113.76' LAND'S END ROAD //,=1