HomeMy WebLinkAbout22267-z FORM NO. 4
TOWN OF 'SOUTHOLD
BUILDING DEPARTMENT
Office of the Building Inspector
Town Hall
Southold, N.Y.
CERTIFICATE OF OCCUPANCY
No Z-23251 Date SEPTEMBER 28, 1994
THIS CERTIFIES that the building ACCESSORY
Location of Property 1602 YOUNGS ROAD ORIENT, NEW YORK
House No. Street Hamlet
County Tax Map No. 1000 Section 18 Block 2 Lot 38
Subdivision Filed Map No. Lot No.
conforms substantially to the Application for Building Permit heretofore
filed in this office dated AUGUST 2, 1994 pursuant to which
Building Permit No. 22267-Z dated AUGUST 15, 1994
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 INGROUND SWIMMING POOL WITH DECK & FENCE ENCLOSURE "AS BUILT"
The certificate is issued to DANIEL & PATRICIA LATHAM
(owners)
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A
UNDERWRITERS CERTIFICATE NO. N-326782 - SEPTEMBER 13, 1994
PLUMBERS CERTIFICATION DATED N/A
lding Ins ec or
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)
0
Date
u`" � ................ 19.....�.
............................... . .... ...
f�� 22267 Z
Permission is hereby granted to;
A. REILLY & SONS, INC. a/c DANIEL LATHAM
..........................................................................................
P.O. BOX 98
..........................................................................................
MATTITUCK, .N.Y. 11952
..........................................................................................
to ,....INSTALL INGROUND SWIMMING POOL WITH FENCE ENCLOSURE & DECK
.....................................................................................................................................
"AS BUILT"
..................................................................................................................................................................
..................................................................................................................................................................
..................................................................................................................................................................
DANIEL & PATRICIA LATHAM
..................................................................................................................................................................
at premises located at......,,,I602 YOUNGS ROAD.................................ORIENT, N.Y.
................... .............................................
................................................................................................................................................................
County Tax Map No. 1000 Section ...........1.8............ Block........2................ Lot No. .......3g.................
pursuant to application dated ..........AUGUST 2, 1994 pp y
..................................... 19................ and approved b the
Building Inspector.
Fee$ ,7..?,,.�......
Building Insp for
Rev. 6/30/80
. �'r,,` �:�_cN__i_s+,•- .. ,^ �; Form No. 6
e
TOWN OF SOUTHOLD
tf S� 2 8 BUILDING DEPARTMENT
TOWN HALL
i
�- - -� 765-1802
'Ft3VVN OF SOUTHOLD
APPLICATION FOR.CERTIFICATE OF OCCUPANCY
1. This application must be filled in by typewriter OR ink and submitted to the building
inspector with the following: 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 a 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.
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 - $20.00
4. Updated Certificate of Occupancy - $50.00
5. Temporary Certificate of Occupancy - Residential $15.00,gCommercial $15.00
Date . . . . . . . . . . . . . ! a . . . . . . . . . . . . . . . . . .
ew Construction. . . . . . . . / Old Or Pre-existing Building. .
ocation of Property. . . . C. '0 .L. . . . . . .(/�.`'.'�V6.y . . ,n;Cf . . . . . . . . . . . ... . . . . . . . . . . . . . . .
House No. Street Hamlet
nwer or Owners of Property. . . . . . . ���:. . . . � ��Gt�9 . . . L ?111 . . . . . . . . . . . . . . . . . .
ounty Tax Map No 1000, Section. . . . . . . . . . . .Block. . . . . . . . . . . . .Lot. . . . . . . �. . . . . . . . . . . .
ubdivision. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .Filed Map. . . . . . . . . . . .Lot. . . . . . . . . . . . . . . . . . . . . .
ermit No. . . z?Z:G 9 2 .Date Of Permit. . . .. 2/4r . 5 `� .Applicant. . .
aalth Dept. Approval. . . . . . . . . . . . . . . . . . . . . . . . . .Underwriters Approval. . . . . . . . . . . . . . . . . . . . . . . . .
lanning Board Approval. . . . . . . . . . . . . . . . . . . . . . . .equest for: Temporary Certificate.'. . . . . . . . . . Final Certicate. . ./\, . . . . . .
ee Submitted: $. . . . . �
. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
APPLICANT
o�a3 �f
FO(��00
y<
Town Hall,53095 Main Road y 2 Fax(516)765-1823
P. 0. Box 1179 0 Telephone (516)765-1802
Southold, New York 11971
OFFICE OF THE BUILDING INSPECTOR
TOWN OF SOUTHOLD
August 23, 1994
A. Reilly & Sons, Inc.
P.O. Box 98
Mattituck, NY 11952
Re: Daniel & Patricia Latham
To Whom This May Concern:
We are unable to complete your Certificate of Occupancy
because of the following reasons:
xx An application for Certificate of Occupancy is
not on file. (Enclosed)
xx No Underwriters Certificate on file.
xx The check is not on file. $25.00
No Health Department Approval on file.
No final inspection has been made.
No Plumber Solder Certificate on file.
(All permits involving plumbing being
issued after April 1, 1984) .
BUILDING PERMIT # 22267-Z
Please contact our office on this matter. Thank you for
cooperation.
SOUTHOLD TOWN BUILDING DEPT.
I q,-I �91 4 -_?,_
THE NEW YORK BOARD OF FIRE UNDERWRITERS PAGE 1
1185077 BUREAU OF ELECTRICITY
F_ 85 JOHN STREET, NEW YORK. NEW YORK 10038
Date SEPTEMBER 13,1994 Application No.on file 06390894/94 N 326782
THIS CERTIFIES THAT
only the electrical equipment as described below and introduced by the applicant named on the above application number in the premises of
DANIEL T.LATHAM, 1500 YOUNGS ROAD, ORIENT, N.Y.
in thefollowing location; K Basement ❑ lst Fl. ❑ 2nd Fl. BUT Section Block Lot
was examined on SEPTEMBER 07,1994 and found to be in compliance with the National Electrical Code.
FIXTURE ECEPTAClES SWITCHES FIXTURES RANGES COOKING DECKS OVENS DISH WASHERS EXHAUST FANS
OUTLETS INCANDESCENT I.FLUORESCENT OTHER AMT. K.W. T. K.W. AMT. K.W. AMT. K.W. AMT. H.P.
DRYERS FURNACE MOTORS FUTURE APPLIANCE FEEDERS SPECIAL REC'PT TIME CLOCKS BELL UNIT HEATERS MULTI-OUTLET DIMMERS
SYSTEMS
AMT. K.W. OIL H.P. GAS H.P. AMT. NO. A.W.G. AMT. AMP. AMT. AMPS, TRANS. AMT. H.P. NO.OF FEET AMT. WATTS
SERVICE DISCONNECT NO.OF S E R V I C E
AMT AMP TYPE METER 1.02W 1,0'3W 3,0'3W 3 0/W NO.OF CC.COND. A.W.G. NO.OF HI-LEG A.W.G. NO.OF NEUTRALS A.W.G.
EQUIP. PER AY OF CC.COND. OF HI-LEG OF NEUTRAL
OTHER APPARATUS:
SWIMMING POOL-1
*NO VISUAL DEFECTS- "All electrical
survey has been made of the exposed
electrical equipment in the
premises indicated." "No obvious
unsatisfactory condition was found.
ROSLAK ELECTRIC LIC.#3677-E
P.O.BOX 164
CUTCHOGUE, NY, 11935 GENERAL MANAGER
11 Per
This certificate must not be altered in any manner; return to the office of the Board if incorrect. Inspectors may be identified by their credentials.
COPY FOR BUILDING DEPARTMENT.THIS COPY OF CERTIFICATE MUST NOT BE ALTERED IN ANY MANNER.
1ELD I::SL'FCT1ON "0JjbATE
• H
F OUIJDATION ( 1st)
FOUNDATION ( 2nd )
2 .
' z
o �-
6�
ROUGH FRAME &
-PLUMBING
v,
H
3 ' r�
IIJSULATIOPI PER N. Y.
STATE ENERGY
CODE
x
• a
4 . ►�
Chi
FINAL
I o
ADDITIONAL COMMENTS : x
a �1
H
z
rn
' a `
a
i7 4i_
-_ H
D BOARD OF HEALTH . .
rr FORM NO. 1 3 SETS OF PLANS . . . . . . . . -
AUG� ZI TOWN OF SOUTHOLD SURVEY . . . . . _ _ . . . . . . . . . . . .
BUILDING DEPARTMENT CIIECi: • • • • • . . . . . . . . . . . . .
i TOWN HALL SEPTIC FORM . . . . . . . . . . . . . .
s r. SOUTHOLD, N.Y. 11971
TEL.: 765-1802 NU ;FY
0� CALL . . . .2.g
Examined . . ., 19 . MAIL TO :
Approved /1 19�. Permit No.�Z?. . . . . . . . _ . . . . . . . . . . . .
Disapproved a/c . . . . . . . . . . . . . . . . . . . . $(Building
. . . . . . . . . . _ . . . . . . . . . . . . .
Inspector)
R BUILDING PERMIT p
Date . . . . . . . . . .`. . . . . 19 .!:Y
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 giving a detailed description of layout of property must be drawn on the diagram which is part of this appli-
cation.
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 issued a Building Permit to the applicant. Such 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 whatever until a Certificate of Occupancy
shall have been granted by the Building Inspector.
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.
aF
(Signature of applicant, or name, if a corporation)
Al
(Mailing address of applicant)
State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder.
Name of owner;of premises . . . . . . 1-2
/./✓v/.�`L. ,l. . . . . . . . .�/�"(/? C/. /! �!yl
(as on the tax roll or latest deed)
If appl• an ' a corporatio ig ture of duly authorized officer.
(Name and title of c o to officer)
Builder's License No.
Plumber's License No. . . . . . . . . . . .
Electrician's License No.
Other Trade's License No. . . . . . . . . . . . . . . . . . . . . .
1. Location of land on which proposed work will be done. Gt /�/� S. , •` �. . /rl . .
��. . ... . . . . . . . . . . .Y.��.WG�. . . . . ., : . . . . . . . . a � . . . . . .. . . . . . . . . . . . . . . .
House Number / Street Hamlet c�
County Tax Map No. 1000 Section . . . . . /. . ... . . . . . . Block . . . . . . . . . . . . . . . Lot . . . . .J.7. . . . . . . . . .
Subdivision . . . . . . . . . . . . . . . . . . . .
Filed Map No. . . . . . . . . . . . . . Lot . . . . . . . . . . . . .
(Name)
2. State existing use and occupancy of premises and intended use and,occupancy of proposed construction:
a. Existing use and occupancy .:. . . . . !���. ' '�f�. • . • • • • , • • , , • • , • •� r r� A L
s
b. Intended use and occupancy . . . . . . . . . . .C`:�. . r� '?�� :. . .�! /j �U,z� e;e . . . .
_
• �s 1
3. Nature of work (check which applicable): New Building . . . . . . . . . . Addition . . . . 1�. iation . `. . . . .
Repair . . . . . . . . . . . . . . Removal . . . . . . . . . . . . . . Demolition . . . . . . . . . . . . Othez Work . . . ./K. . . . . .
(Description)
4. Estimated Cost . . . . . : : . Q�o:d. . . . . . . . . . . . . . . . . Fee . . . . . . . . . . . ., . . ._
(to be paid.,onif`�l%tg is a gl afion)
S. If dwelling,number of dwelling units . . . . . . . . . . . . . . . Number of dwelling units on each floor . . ... . . . . . . . . . . . .
Ifgarage,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 . . . . . . . . . . . . . . . . . . . . .
Dimensions of same structure with alterations or additions: Front . . . . Rear •
Depth . . . . . . . . . . . .. . . . . . . . . . . Height . . . . .. . . Number of Stories . . . . . . . . . . . . . . . . . . . . . .
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:
13. Will lot be regraded • . • • • • , • . • •Will excess fill be removed from premises: . es No
14. Name of Owner of premises . . . . a . . . . Address . . . . . . . . . . . . . . . . . . . Phone No. .
Name of Architect . .Address . . . . . . . . . . . . . . Phone No. . . . .
Name of Contractor .A. : 6?.44�C�`.J ? . • . . • Address . .e? IPItL.11_C • .Phone No. . .
15. Is this property within 300 feet of a tidal wetland? *Yes. . . . . . . . No.-,<. . . . . .
If yes, Southold Town Trustees Permit may be required.
PLOT DIAGRAM
Locate clearly and distinctly all buildings, whether existing or proposed, and,indicate all set-back dimensions from
property lines. Give street and block number or description according to deed, and show street names and indicate whether
interior or corner lot.
..........
STATE OF NEW YQRK
COUNTY OF . . .,U4. . . .�. . . S.S
• • • •/.. . . .. . . . . . . . .L!LG�(• being duly sworn, deposes and says that he is the applicant
(Name of individual signing contract)
above named.
Heis 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.
Sworn to before me this (�
. . . . . . . . . . . . .day of. . .�. ., 19 .(.
Notary Public, . . . . . . ... . . . . . . . . . . County
MARE L.GLEW
Notary Public,State of New York . . . . . .
No.4879505 (Signatur • f a hcant
Qualified in Suffolk County
p )
Commission Expires Decembar 8,19
�9 r/r•r r/ '
OCCUPANCY OR
USE IS UNLAWFUL
WITHOUT OF Q
CERTIFICATE,, ;1
f/,Mp�
Y
o ' ME®LATEL ,v
ENCLOSE
UPON COMP E
BEFORE
t"ERWRITERS CERTIFICATE
J /:,, REQUIRED —
`r
lr
io
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_ ~col r• 'emu `_. {/ N1 1
G va A r. ..'r� �1
�� 011 D AS NOTED
FEE: 6Y:
NOTI>=, SE.UILDING DEBAR ENT AT
765-1502 9 AM TO 4 PM .FQR THE
FOLLOWING INSPECTIONS:
1, FOUNDATION TWO REQUIRED
FOR POURED CGttNNCRETE
`� 1,., rn•i �� `E', it t-i F4' ;P:,'!'�iy, ?, PLUMBING
r ' ,t" ItytCcst ;
i4 "tf 3l� NIUS7
ALL
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41I9:(UfYlq�lTtl1 AU-+ Oit J1n•t1,vn
[O THIS SUAVF! IS I.VIC+,6rl';ri'r..+1
35?'T:ON 7109 or TY!4 Y.9iYr .:'.K .:.V: r.
3.AUtATIO11 LAW. C_+L' / 4:'• .J.�. .a(.. ._ / 1 t Y t ..._ ..1.
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{ OCCUPgNcy f
t USE I ORrP
,l S UNLAWFUL1 -t
WITHOUT CERTOF OCCUpANCyIFICATE ��
MMEDIATELy:
° ENCLOSE POOL
BEFORE
r, ; IINIIIPINRITERS CERTIFICATE
REQUIRED
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1= APPROV D AS NOTED
1�,�Y DATE: B.P.It C?L
_r FEE: BY:
NOTIFY BUILDING DEPAR ENT AT
1 765-1802 9 AM TO 4 PM FOR THE
' FOLLOWING INSPECTIONS:
�'• 1, FOUNDATION TWO REQUIRED
FOR POUTED rr N(-RETE
7. FC . CH .11
` "' MA (7) ,I`
altMBING3, INS01
tt� 1_fl{�' —s' t FINA[, i TI
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ALL CONd STkI,li'T11}N SNAIL MEET
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to THIS SUKYL'T Is A.V1l•!drl•::l Or
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a,ir, Thu n,anufacturar makes only those reprosentations which are staled in
�g -its Vuitton Warranty.Any other representations,slatements,or contracts
E.i,:S il� �, r- -R {)E t9` i, , �f,r , , mr..ua by the cec;ior and or the contractor to the customer regarding any
A F1{A C r-,� A'1—L' C t'�i�L�{'" rnalrrials produced by the manufacturer are attributable to the dealer andf
Fa oar 1+, or the coollaclor only.1lte dealer or contractor who sells or installs your
pool is an independent contrtjclar and not an agent or srnployaa of the
manufacturer.The construction methods illustrated are suC n-sVons and
apply only to normal ground conditions.There may be,additional precau-
(ions and/or methods of construction.The responsibility is the contreMors.
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;ja<`.k f'i1Ql iiiSlti'': `(i rpLiiinum SlUrJatrds iiiior to histRINIO diving boards or Spites
.,p&1'snl ttcs3ltat°i,'M 1 1--.. ralexaiulria,VIA 22314 o 710'51-3O-0033 � .
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IWS BnOCHUAE 18 FOR ILLUSTRATIVE PURPOSES ONLY
Th, manufacturer makes only those representations which are stated in
its writlen warranty.Any other representations,statements,or contracts
A�E E ��'}��(J,�i, �.V���( mi-oo by the dealer and or the contractor to the customer regarding any
j A H R A G 1: ,Q,L I— CORNER ma•r,rials produced by the manufacturer are attributable to the dealer and/
AR E t' X g' or the contractor only.The dealer or contractor who sells or instant your
pool is an independent contractor and not an agent or employee of the
manufacturer.The construction methods illustrated are suggestions and
apply only to normal ground conditions.There may be additional precau•
tions and/or methods of construction.The responsibility is the contractors.
irinim;I'm stan't-1q for residential pools. if diving boards or slides are to be used
,a & Void irsli : minimum standards prior to installing divingg boards or slides
'`oa&Pool ln,iituts,2111 Eisenhower a,.hn,+� Alexandria,VA 22314.70838.8R@3