HomeMy WebLinkAbout28192-Z FORM NO. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Office of the Building Inspector
Town Hall
Southold, N.Y.
CERTIFICATE OF OCCUPANCY
No: Z-28999 Date: 10/21/02
THIS CERTIFIES that the building ACCESSORY
Location of Property: 1660 INDIAN NECK LA PECONIC
(HOUSE NO. ) (STREET) (HAMLET)
County Tax Map No. 473889 Section 86 Block 4 Lot 6.1
Subdivision Filed Map No. Lot No.
conforms substantially to the Application for Building Permit heretofore
filed in this office dated MARCH 19, 2002 pursuant to which
Building Permit No. 28192-Z dated MARCH 19, 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.
The certificate is issued to C. ROBERTSON & J. ZINGER
(OWNER)
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A
ELECTRICAL CERTIFICATE NO. 1063223 07/05/02
PLUMBERS CERTIFICATION DATED N/A
ut orizeAf Signature
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. 28192 Z Date MARCH 19, 2002
Permission is hereby granted to:
CHRISTIAN ROBERTSON
1660 INDIAN NECK LA
PECONIC,NY 11958
for .
CONSTRUCTION OF AN INGROUND SWIMMING POOL WITH FENCE TO CODE IN
THE REQUIRED REAR YARD AS APPLIED FOR
at premises located at 1660 INDIAN NECK LA PECONIC
County Tax Map No. 473889 Section 086 Block 0004 Lot No. 006 . 001
pursuant to application dated MARCH 19, 2002 and approved by the
Building Inspector.
Fee $ 150 . 00
Authorized Signature
COPY
Rev. 2/19/98
7
T� 3f X371
Form No.
6 ��TT)( ��� r2 o,2 - S� y.
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$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 n�
Date. 0CJ�Cn 9 E 2x02
New Construction: Old or Pre-existing
CGrBuilding:
�/ V/ (check one)
Location of Property: 1�,o(op "LN AA ;[e.,,,� A�.c`�.���
House No.r- Street ,Hamlet
Owner or Owners of Property:
Suffolk County Tax Map No 1000, SectionG Block L( Lot '
Subdivision Filed Map. Lot:
r7p
Permit No. G� '12� Date of Permit. �� V`'t 07- Applicant:
Health Dept. Approval: Underwriters Approval:
Planning Board Approval> /
Request for: Temporary Certificate Final Certificate: �/ heck one)
Fee Submitted: $ 2�' 00 �I�,
O
Applicant Signature
co
D cnrJ�rJ�rJ�rJ�r�rJ�cP�IrJ�c ncPr�cnr�rJr1rJ�rJ�rJ�rlrJ�r J��l�l�Ir�rJrJ�cnrJ�r nrJ�rJ�rJ�rJ�rJ�rJ�rJ�rJ�rJ�rJ�rJ�rJ�rJ�rJ��Prn�PrJr�r��Prlr�r�r1rJ�rJ�cPrJ�rJ�rJ o
5 5
5 BY THIS CERTIFICATE OF COMPLIANCE THE \ 5
5 NEW YORK BOARD OF FIRE UNDERWRITERS 5
5 BUREAU OF ELECTRICITY 5
�j 40 FULTON STREET -- NEW YORK, NY 10038 rj
5 THAT
CERTIFIES 5
5 � 5
5 Upon the application of upon premises owned by 5
5 7 ,
5 C-CAT CO. CHRIS ROBERTSON9280 5
5 SOUND MATTITUCK, NYE 1952, PECON C. 1660 AN NECK NE
NY 1958 5
5 Located at 1660 INDIAN NECK LANE PECONIC, NY 11958 5
5 Application Number: 1063223 Certificate Number: 1063223 5
5 55
Section: Block: Lot: Building Permit: BDC: NS11 cC5
Described as a Residential occupancy, wherein the premises electrical system consisting of
5 electrical devices and wiring, described below, located in/on the premises at: 5
5 Basement,Outside,Pool/Spa,
5 5
5 was inspected in accordance with the National Electrical Code and the detail of the installation, as set forth below, was S
5 found to be in compliance therewith on the 5th Day of July,2002. 5
5 5 Name QTY Rate Rating Circuit Type ,5
Appliances and Accessories
5 Pool/Spa Bonding 1 0 5
5 Time Clock/Switch 1 0
5 Wiring and Devices 5
CSCj Receptacle 2 0 20 amp Pool/Spa 5
J Switch 2 0 General Purpose 5
5 5 Receptacle 1 0 GFCI 5
Fixture 2 0 Pool/Spa S
5 (Swimming Pool):This certificate covers compliance at the date of inspection only. Because of unusual environments it is advisable to have
frequent test and/or repairs made by a qualified person. 5
5 5
5 5
5 5
5 seal 5
5 I of 1 5
5 This certificate may not be altered in any way and is validated only by the presence of a raised seal at the location indicated.
5 5
a ��������1II I���������L��Lp� o
Applicant/ Date
Owners Name: 2&! �, if r 7Lnf.L'.fReviewed: 3 a�-
Architect/ Date
Engineer: �— Submitted: Sf 4?-
SCTM #:
District: 1.000 Sec�on: Q Block: �_ LoC
Project /�GO � , - Subdivision
Location: C N( _� -� _ Name:
Sin&le & separate Required
certification: (Yes/No)
(f�
Zaiing 1)istrice_;�.�_ (Loi size: /v �Y/�"
yqlu31: 1 (I of coverage 4Req. - Req. I Req. ���Y�(Front Yard Proposed: I (CI -O�
ide Ya Proposed: J (Rear Yard , &I_ t'roposedI
Project Description: �SP,
AGENC=ERMITS Permit .
REQUIRED FOR REVIEW N.A. NO YES Number
Suffolk County Health Dept.
New York State D. E. C.
Town Trustees
Town Zoning Board approval:
Town Planning Board approval:
Flood Plane Elevation???
Flood Zone: >C
Dotes:
M-1802
BUILDING DEPT.
INSPECTION
[ ] FOUNDATION IST [ ) ROUGH PLBG.
[ ] FOUNDATION 2ND [ ] INS ON
[ ] FRAMING [ INAL
[ ]
FIREPLACE & CHIMNEY
REMARKS:
S 70
ro
DATE / INSPECTOR
FIELD INSPECTION REPORT DATE COMMENTS
gub
t7
FOUNDATION(IST) ^3
x
------------------------------------
rcrc
FOUNDATION(2ND)
� z
0
H
ROUGH FRAMING&
PLUMBING
r
x
r
INSULATION PER N.Y. �
a
STATE ENERGY CODE
FINAL
r
ZZ
ADDITIONAL COMMENTS
S O
z
C� �
S
F
5
_ b
6 �
z
x
l �
x
e
b
TOWN OF SOUTHOLD BUILDING PERMIT APPLICATION CHECKLIS
BUILDING DEPARTMENT Do you have or need the following,before applying
TOWN-HALL Board of Heahh
SOUTHOLD,NY 11971 3 sets of Building Plans
TEL: 765-1802 Survey
PERNIIT NO. 02 8 r g a Check
Septic Form
N.Y,S.D.E.C.
Trustees
Exa, ;,ed �. 1 20�a Contact:.
Approved 3 20�� MaiI to:TH pEKt A� �on� 1 E
Disapproved a/c 3a wood\¢uvJ Fht+- p (E
NY
Phone: Ldp D4/-�073
r �
1 BuildinFma.,.. ,
j
;J
APPLICATION FOR BUILDING PERMIT
Date a/ l9 20 0 2-
If
[BAR 9 INSTRUCTIONS
_a.Tbzs app]a�MU T be completely filled in by typewriter or in ink and submitted to the Building Inspector with 3
is of1, Ot plan o scale.Fee according to schedule.
ation 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 a Certificate of Occupant
is issued by the Building Inspector,
APPLICATION IS BI REBY 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.
IM1VirL-'DlP,,.HELY OCCUPANCY OR ,
ENCLOSE PO01-TO CODE (Signahme of apphem or name,if a corporation)
UPON Can: -:�£nON USE IS UNLAWFUL
BEFORE •.',:.TATER'• WITHOUT CERTIFICATE 3a wQcA�o„ ak."-61
UNDO WRITERs'MMFICATE OF OCCUPANCY (Mailing address of applicant)
REQUIRED
State whether applicant is.owner, lessee,agent, architect, engineer, general contractor, electnm plumber or uildef
}
apt 0
Name of owner of premises 1.4-• (' k r o�ri ser R 1110:1)
(as on the tax roll or latest
�c /soav, 4
If applicant is a corporation, signature of duly authorized officer NOTIFY BUILDING DEPARTMy,FIT AT
765.1802 9 AM TO 4 PM FOR,-THE
(Name and title of corporate officer) FOLLOWING INSPECTIONS.
IL FOUNDATION - TWO REQUIRED
FORPOUREDCONCRETE
Builders License No.SwFir-D i K 1 8 a - N Z = ROUGH e FRAMING A PLUMBING
X INSULATION
Plumbers License No.^ N11: , 4 FINAL CONSTRUCTION MUST
BE COMPLETE FOR C.O.
Electricians License No. �y owe a2 _ ALL CONSTRUCTION SHALL MEET
THE REQUIREMENTS OF THE N.Y.
Other Trade's License No, tJ STATE CONSTRUCTION A ENERGY
CODES. NOT RESPONSIBLE FOR
DESI1. Location of land on which proposed work will be done: � OR CONSTRUCTI� S
1 �Qs�
House Number Street Hamlet
County Tax Map No: 1000 Section 31`P` Block b 4 Lot � f
Subdivision i L 0 O R T S Filed Map No. / 0 O O Lot• /
(Name)
2: State existing use and,oecapancy ofpremises and intended use and occupancy of proposed constraction:
a. Existing use aad occupancy
b. Intended Use and occupancy. _:Yv..
3. Nature of work.(check which applicable):New Building AdditionI6)<qD Alteration
Repair Removal Demolition Other Work S w oA 9,00 k Vo y g o
(Description)
4. Estimated Cost 30 o. • o 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 Depth
Height Number of Stories
Di .ensions of same structure with alterations or additions: Front Rear
Depth '—might Number of Stories
8. Dimensions of entire new construction: Front Depth
Height Number of Stories I x y O
9. Size of lot: Front RearDepth
10. Date of Purchase blame of Former Owner
11. Zone or use district in-which premises are situated
12. Does proposed construction violate any zoning law, ordinance or regulation: tJ� .
13. Will lot be re-graded NoeN*u .
s ' gl�vak�on Wi71 excess fill be renloved.from premises: NO
14. Names of Owner of es_a►�r,51��„ 3W pae k- ft 8�
premia moi,. d se^Address r�v . ,�y. �uu �2_ Phone No.%-1- -7u5- 06 L(o 6w
Name,of Architect Address No
Name of Contractordress 3a woadlawy mk phone No: 63r ayy-11 —r3
oakdah,uy �r�bq
15- Is this property within 100 feet of a tidal wetland? *YES NO
• IF YES, SOUTHOLD TOWN TRUSTEES PERMITS MAY BE REQUIRED
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.
')TATE OF NPWXpw•
• d being duly sworn deposes and says that(s)he is the applicant
(1`� iA��d��cia�slt�c ovenamed,
".;� aril •r;�
S)Re is the a'
ent, Corporate Officer etc.)
f said owner or owners,and Vekily.1ttfbariged to perform or have performed the said work and to make and file this application;
I a11~sai'e}n1' s'F s
�bn are true to the best of his knowledge and belief;and that the work will be
erformed in thenhcation filed therewith.
V ;H 3MT .
qT
r
Otary putlic
Signature of Applicant
JOHN Q SWEDBORG
NO"Public,State cf New York
NO.52ASo39P` „u My
JOHN C.SWEDBORG
Notary Public,State of New York
No.624603958,Suffolk County
Term Expires March 3o,19_
-- q
�` — i U ►4
I
GENERAL NOl"ES - FILTER. -
niEDc71YM1)Sg1io 0►+AovLIA4t Wt. o " 0OTA L,LTC►
(AGOMD W1Rt:t 4C11A-L way EF1ST a1TNlw THi►IMITS of THC S1t1MNE11
t7t AVAATION IF(,LOO MO.+AT[A CJ••LTS l/1T1,IN Y- O bC.Ow LLLARI`i ' I►.J(.[T • ••'I�GI�,,�••'�� 1. -•I1Y �(•n6 1
Oi(PC IA,I p[rATW11GCMll,t1Q•+IIA.IE A[>N IOtb ►. Tet IuLCT CoMYI•JATION Sr-ltihil. l
OIS 001 wL,54NRGD t� OWMEN /A/►EATY co.+�wwcTst vf�ll) �wa0:0. L,wE \�. TILE Fwc,uJ. wnTl.i .i.+t
J ACW"
.KO S-JRC AXt4.t AlLO•h.P O IT'MIM }-O+ OI S KAIA.OI tIA0 ANO S'tErS • tl ;;' �.
6 •0' or oil; vp 1
+ f
AEN+JVM ATICAILT ADDLICO Co NCRET'[ (-UMITY)SHwil !]E A
{= L 1411, tiaIT rI A M FAM LMA OT 3"h C.ALLOMS Or -*Wm 1. Pit e I • .� = ,
S�tK of CEMtwT �l 3 �3BAAl> •_` ,1• .- 0
. Rli u.r oRcuN.STtt L SAAL. 8i 4.p"c at L L E T
ITE_EL WIT% A KIMIMVM IA► oT* 30 biA D,AMrT[aS - ('TIA►DLG
r00%- wATYa y+►Ol), eT t,.r..00.5 fPADt N ,+Ds a FOOL To Ai
HA,N S%ILTION I AI,. AIIU•�NO X
KEPT FULL WRAAK•sort(LN1. dE•Thct P,,, PCAPAC,TY To IiYTA2t`%CH lC WS• 1
T 1CS `.2 OC pW,SM
gc SVf►1lLlf NT TO caRY POOL W LA wooA,S WuyC AtTJ - '
G ML'PMwb SA a'A^W I DI A1d Ju„nkTIG UML[SS OT Ni r,wya' CC- ?VA GLd, - - .-1
..'KOt[D TltlfA4 SMAI.L.bE PDLETrACIcw[ I 13 ED (� I I •.. I - -.
TO%E MCN SND TO •Dt P•~ }QOti
Me DIy IN b_•O�AD SHALL Oc SLI TS ALL-cD uULt SS FOOL, Il RADWS •'1 4ADw! v r�<ti[d
Amob+JktoCourocHTO LAtcn MJ►J STAADAC+ > Or- I,''Tu'A SnA,%.6ato.
40 O V
tiAT{paLl. 7,✓I IMw NIr PeOL I MST•T vT Q -",I• 9 CS'•L•M r
T11E
- 11 `
LOePt.lo.•+ atprenNCAo •rIlCjTO K[tT IIEG�•A[Ms•+TS eF -
• #"ew.4D ae t nE w•Jtecw►Ir r Ls• 'NAL L
.trjs:.Du,urlNo .Pa sTlucTW 1M[LL ONLY SSC--'ION f
-.
I
_ .A000iSoE/tS f klPwlStuti.a:S SNML tjE Ai z � � `•• �`( Iv ..•••};t;,. _ .
OTT-4GR.b AAA- OAA%K G%kL&- Ca,•1/04yToTIAIT �L
LAT[1TSiAAwAATS OF.TL1lnUlRowlS✓IMM,uI PLAil
j OC L,•SM"TVTI /II'AD LD C,..I.COD fS
Fly♦SPNT• TJ 6.I A•IR 4;sr �• 1•A...pw�•`
F\L.L Stti:T C PIR GAP SCi rA.� +«T"14^+
CF Pc L- _ a / 0 ETA, _
_ PQi cAL� ;.00Me •i Teo I. L ,
TILE
I 3G'Er APDoft �S\.IhMER IML�T
Y I
Ofi
T„wwu .. �.
•
F ILTEtt I
'�- U rDt lv AT fl U 4 KT
pump 1 At LINT l I (Or TIouN)
11Ai1 11
WMD[A�+AT[
SWArCL LIN•: — �O►1t6uALl
�' t-1 Tos-c
•
A D ZAI.J
i
S-tCTION El
c
SCHEMATIC PIPING AQRANGE-HENT GUNITE SWIMMING POOL DETAIL FOR:
_ '`rl�v� P�1 �3 StiiL [i1 Mf'o tCCD .
' s �
IMPERIAL GUNITE CORP Gn/]ri l`I an /2o�erfson ' pt.T� �° ->° - °'
3 Z Woo AVENUI M011t I o L
\ 1 , 00 J A 1 -I lk V E RT l i' o C L�94L
~: OAMAIE, NY. 11769 1600 gnd an NreC'z .�oaa ° J econrc, Mery y r�Z �`t '
FLOW L'�•: lwAWn• Da
SURVEY OF
LOT 1
art" MAJOR SUBDIVISION MAP OF
WILD OATS
/ v ~� \• PILE No. 9331 FILED MARCH 9, 1993
y-'A SITUATED AT
a3
0 . PECONIC
p n TOWN OF SOUTHOLD
y
' \a• 'f SUFFOLK COUNTY, NEW YORK
S-C. TAX No. 1000-86-04-6.1 1
\ FEBRUARY 7, 1996
\ OCTOBER 30, 1997 FINAL SURVEY
JUNE 23, 2001 ADDED W000 DECK
I
\ AREA = 39,999 76,sq. H
\ \- 0.913
\\ r / \: \ CERTIFIED TO
\ JOSEPH MUNAFO
so E •r; / \\ , COMMONWEALTH LAND TITLE INSURANCE COMPAN
° +
LOT // \ .' .VOTE
S C D.H S REFERENCE No R 10-96-0030
y� eC
� ha.C'hmsr.,Pc?i
°`/ y
t� �' �, d' vc s "?�\ 0"�-" i X6 se°cvou im`""s c ri+[CN A s
"` ��, ct [^ \ '3 •• / s v, .�
FEATTIES THIS SUNT " NOT Xr
TMnnuiOScossm NOT SEAL
u.
6THAI ` \' In XE rmmmmNY
ivONHIS,, xm
:i"." HE
mn[ FuOFtt[ em-
pNOT ,vmrwc
iss APs 4A" '� E EXISTENCE of RIGHTS OF IVT
�,c
THE X' /, nx0/ox usHCNN Or oc o.
\ \\�. '. J, nx Y, . 5H
XTE uc u 1 cunFwlLm
THE
. /
°f0 „z
TOTE .
J
\ Y
/
CST
p0 I
.Joseph A. Ingeg
Land Surveyor
Rh so,.�... - seg IF, - COFmomo
PHONE (63:)72T-2090 Fx[ (631)727-1
4`, OiFK'ES LOUTED AT "A , ACON,