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Home My WebLink About34853-Z FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No: Z-33991 Date: 10/06/09 THIS CERTIFIES that the building SWIMMING POOL Location of Property: 465 BURGUNDY CT SOUTHOLD (HOUSE NO. ) (STREET) (HAMLET) County Tax Map No_ 473889 Section 51 Block 3 Lot 3.14 Subdivision Filed Map No_ Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated JULY 13, 2009 pursuant to which Building Permit No_ 34853-Z dated JULY 13, 2009 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 LISA M PATERN (OWNER) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A ELECTRICAL CERTIFICATE NO_ N 508669 12/06/99 PLUMBERS CERTIFICATION DATED N/A thor' Zed Signature Rev. 1/81 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 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. B. For existing buildings(prior to April 9, 1957) non-conforming uses,or buildings and",pre-ex stin " Ian uses i. Accurate survey of property showing all property lines, streets,building and unusual natural o topo rap'li -features. c--) .2. A properly completed application and consent to inspect signed by'the applicant. If a Certifica 041ccupancy i denied, the Building Inspector shall state the reasons therefor in writing to the applicant. o o C. Fees o 1. Certificate of Occupancy-New dwelling$25.00,Additions to dwelling$25.00, Alterations to dwe ling$25.00, Swimming pool$25,00, Accessory building$25.00,.Additions to accessory building$25.00, usin 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. Vo New Construction: Old or Pre-existing Building: (check one) Location of Property: v House No. Street Hamlet Owner or Owners of Property: L[ S 6, K paf. e r Suffolk County Tax Map No 1000, Section 7 7 3 $`� B-j Block n, d p p j Lot 003,014 Subdivision 1�,� i� � N�r-L Filed Map. Lot: LLff �i 0%jh l; Permit No. ��T a�J 3—Z Date of Permit. 1 Applicant: LJSC,- Health Dept.Approval: Underwriters Approval: Planning Board Approval: .Request for: Temporary Certificate Final Certificate: (check one) Fee Submitted: $ Applicant Signature THE NEW YORK BOARD , OF FIRE '- UNDERWRITERS PAGE ' 11850',7 BUREAU OF ELECTRICITY F 40 FULTON STREET, NEW YORK, NY 10038 Date Application No. on file LECEMBER 06.,1999 1.9464899/99 N 508669 THIS CERTIFIES THAT only the electrical equipment as described below and introduced by the applicant named on the above application: number is in the premises of DON PATERN, 465 BURGUNDY COURT, SOUTMOLD, NY in the following ollowin location NOVEI�Ra29 eiQQ 0 Ist Fl. El FLOUT Section Block Lot was examined on and found to be in compliance with the National Electrical Code.- FIXTURE RECEPTACLES SWITCHES FIXTURES RANGES COOKING DECKS OVENS DISH WASHERS EXHAUST FANS OUTLETS INCANDESCENTI FLUORESCENT I OTHER AMT. I K.W. AMT. I K.W. I AMT. I K.W. AMT. K.W. AMT. H.P. 2 2 2 DRYERS FURNACE MOTORS FUTURE APPLIANCE FEEDERS SPECIAL RECTPT. 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 1 20 1 40 SERVICE DISCONNECT NO.OF S E R V. I C E METER AMT. AMP. TYPE EQUIP. 1 0 2W 1 0 3W 3 0 3W 3 0 4W NO.OF CC COND. A.W.1G. .' NO.OF HI-LEG A.W'G. NO.OF NEUTRALS A.W.G. PER 0 OF CC.COND. OF HI-LEG OF NEUTRAL OTHER APPARATUS: POOL-1 G.F.C.r:-2 (SWIMING POOL) This certificate covers comuliance 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. �«< Continued on Page 2 >>> � tea, GEN.ERAL MANAGER 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. THE NEW YORK BOARD OF FIRE UNDERWRITERS PAGE 2 1185077 BUREAU OF ELECTRICITY F 40 FULTON STREET, NEW YORK, NY 1003B Date DECEP-IBER 06,1999 Application No. on file 19464399/99 N 568669 THIS CERTIFIES THAT only the electrical equipment as described below and introduced by the applicant named on the above application number is in the premises of DON PATERN, 465 BURGUNDY COURT, SOUTHHOLD, NY in the following location• ❑ Basement ❑ Ist Fl. ❑ 2nd Fl. OUT Section Block Lot was examined on NO'VEMBER 29,1999 and found to be in compliance with the National Electrical Code. FIXTURE RECEPTACLES SWITCHES FIXTURES RANGES COOKING DECKS OVENS DISH WASHERS EXHAUST FANS OUTLETS -INCANDESCENT1 FLUORESCENT OTHER AMT. K.W. AMT.. 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. AMI.F H.P. NO.OF FEET AMT. WATTS SERVICE DISCONNECT NO.OF S E R V I ; C E METER NO.OF CC COND. A.W.G. A.W.G. A.W.G. AMT. AMP. TYPE EQUIP. 1 0 2W 1 0 3W 3 0 3W 3 0 4W PER 0 OF CC.COND. NO.OF HI-LEG OF HI-LEG NO.OF NEUTRALS OF NEUTRAL OTHER APPARATUS: R05LAK ELECTRIC LIC.nt3677E L L P.O.BOX 164 CUTCHOGUE, NY, 11935-2453 GENERAL MANAGER Per 11 �� 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. 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_ 34853 Z Date JULY 13 , 2009 Permission is hereby granted to: LISA M PATERN 465 BURGUNDY CT SOUTHOLD,NY 11971 for CONSTRUCTION OF AN ACCESSORY IN-GROUND SWIMMING POOL FENCED TO CODE AS APPLIED FOR. REPLACES EXPIRED BP # 32898 at premises located at 465 BURGUNDY CT SOUTHOLD County Tax Map No. 473889 Section 051 Block 0003 Lot No. 003 . 014 pursuant to application dated JULY 13 , 2009 and approved by the Building Inspector to expire on JANUARY 13, 2011 . Fee $ 250 . 00 Authorized 5ignature ORIGINAL Rev. 5/8/02 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. 32898 Z Date APRIL 9, 2007 Permission is hereby granted to: •4)G D—" LISA M PATERN 465 BURGUNDY CT SOUTHOLD,NY 11971 for CONSTRUCTION OF AN ACCESSORY IN-GROUND POOL W/ FENCE TO CODE AS APPLIED FOR.THIS PERMIT REPLACES BP # 26003 at premises located at 465 BURGUNDY CT SOUTHOLD County Tax Map No. 473889 Section 051 Block 0003 Lot No. 003 . 014 pursuant to application dated APRIL 9, 2007 and approved by the Building Inspector to expire on. 00TOBER 9, 2008 . Fee $ 150 . 00 Authoriz igna ure ORIGINAL Rev. 5/8/02 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. 26003 Z Date SEPTEMBER 21, 1999 Permission is hereby granted to: DONALD & LI.SA M PATERN 465 BURGUNDY CT SOUTHOLD,NY 11971 for CONSTRUCTION OF AN ACCESSORY. INGROUND SWIMMING POOL WITH FENCE TO CODE AS APPLIED FOR. at premises located at 465 BURGUNDY CT SOUTHOLD County Tax Map No. 473889 Section 051 Block 0003 Lot No. 003 . 014 pursuant to application dated SEPTEMBER 15 1999 and approved by the Building Inspector. Fee $ 150 . 00 Autho ' z Signature ORIGINAL Rev. 2/19/98 3 �o�,�,oF so�ryolo TOWN OF SOUTHOLD BUILDING DEPT. 765-1802 INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] I�- ATION [ ] FRAMING / STRAPPING [ FINAL [ ] FIREPLACE & CHIMNEY [ ] FIRE SAFETY INSPECTION [ ] FIRE RESISTANT CONSTRUCTION [ FIRE RESISTANT PENETRATION REMARKS: c DATE INSPECTOR FIELD 1'NSYECTION REPORT DATE COMMENTS -----_------- ------------------------- II it 0 bj II II H "1 1I H FOUNDATION ( 1ST) FOUNDATION (2ND) Irr ___________________ ________ _______________________________________________________ r II ROUGH FRAME & tr — u PLUMBING ii ii �l I� II II II �I II jj II jj � I if INSULATION PER N. Y. H STATE ENERGY ,I CODE II II �� I H II ji � it FINAL IIif I ADDITIONAL COMMENTS: 71 6,4j " w H O I - z ro nri L5 N,�� T�...I,� BOARD OF HEALTH �c.•� FORM NO. 1 3 SETS PLANS . . . . . . . . ... . . . . . t ,��Q� TOWN OF SOUTHOLD SURVEY Ti SF s BUILDING DEPARTMENT CHECK �.f�. . . . . . . ... . . . . . . TOWN HALL SEPTIC FORM . . . . . . . . . . .. .. . . . . . 6LDG. DEPT. SOUTHOLD, N.Y. 11971 TOWN FSGUTHGLD Y , TEL: 765-1802 NOTIFY: . . . . . . ,'. . .. . . . , . Examined.................. 19.... MAIL TO: . . . . . . . . . . . . . . Approved...... 20...., 19.'-� Permit No. ...... .................................... Disapproveda/c .................................. .................................... - ......... _ ....Gilding.... .oTj........ APPLICATION FOR BUILDING PERMIT q c� Date. . . 9��y . . . . . . . 19 /. INSTRUCTIONS a. This application mist be completely filled in by typewriter or in ink and submitted to the Building Inspector wi 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 application. 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 permit shall be.kept on the premises available for inspection throggiout 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. APPLICATICN IS HERM 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, 'addiFTontAdr'Td1- etat Ws, or for removal or demolition, as herein described. The applicant agrees to comply with al i e acs, 9,Vinances, building code, housing code, and regulations, and;to .admit authorized inspectors onl ,§ SC. d n,tpilding for necessary inspections. (Signature of applicant, or name, if a corporation) (Mailing address of applicant) „....., 'agplieant riswnet;.'`le State whether ssee,.,-agent;.architect erig3neer,'general contractor, electrician, plumber or builder < .-°`` Nare of owner of premises°:lU. lq ....��1' 4j!�!v............................................................ . �.: r' '(as on the tax ra17�or,latest;oee )9; nisi+may P6"rr_A)u: 135�� If appl-icant-i74"a-corporation gna y ,.,.', r, si tore of dul authors officer. ....... .CSi�W.......... (Namur and title of corporate officer) Builders License No. � ..��7: :z....... Plumbers License No. ......................... Electricians License No. ..................... Other Trade's License No. .................... 1. Location of land on which proposed work will /�be done.............................................................. ................................�o . r-%%ut c�....4 :........................ . House Number Streetl Haslet County Tax Map No. 1000 . Section ....... Block .. .......... Lot ..�F:/l/...... J - Subdivision 0 N Vl?r.yn k....Z ...... Filed Map.No. .W,.0...... Lot ...%�...... (Name) 2. State existing use and occupancy ofof premises and intended use and occupancy of proposed.codstruction:. a. Existing use and occupancy ,7.. .. ...7A. ................. .......... .. b. Intended use and occupancy. ..` :C7.�........... ,..,.;- -X.A,.,.Lg .......... ekuui ....... Alteration Repair ............ Removal ............. Demolition .......... tluer Wo ..�a�cm (Description 4. Estimated Cost .Jt?.Ocx)...:............ fee ................................. (to be paid on filing this application) 5. If duelling, number of dwelling units ............ Number of dwelling units on each floor ................ Ifgarage, cumber of cars ...................................... 6. If business, commercial or mixed occupancy, specify nature and extent of each type of use...................... .�2G 7. Dimensions of existing structures, if any- PYont.,l�,0.,,.,..... Rear �4'.......... Deptic Height ..cS.................. 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 ..................... 1-1 9. Size of lot: Front .y9co?.3.......... Rear ..�f.�j:.�7....... ... .e]:5 ,,�... . Depth .... 10. Date of Purchase ..................... Name of Former Owner ........................................ 11. Zone or use district in which premises are situated �oif�erl��.............................................. 12. Does proposed construction violate any zoning law, ordinance or regulation: ................. 13. Will lot be regraded .Y- .�.............. Will excess fill be removed from premises: ND 14. Names of Amer of premises .rx-JL--A ---qr!a.......... Address j�S: r:gv. .f�:4Av-ii... Phone No. Name of Architect .................................... Address .............................. Phone No. ............. Name of Contractor ram....... .. Address' tom.::emu.,9,. ..... 7 . �-�h��.,�,. ..Phone No..7.��!:-;.C�.4� 15. Is this property within 300 feet of a tidal wetland? * YES .......... NO ..-K...... *IF YES, SOUITUD MM TRUSIFLtS PERMIT HAY BE RFgUIM. 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. "IMMEDIATELY" APP 1 O ED AS NOTED N UPON COMPLIn DATE: Z-o B.P. # BEFORS"11VPItF3C' v FEE: BY• NOTIFY BUILDING FAR ENT AT 765-1802 9 AM TO 4 PM FOR THE OCCUPANCY OR FOLLOWING INSPECTIONS: USE IS UNLAWFUL 1 FOUNDATION - TWO REQUIRED FOR POURED CONCRETE WITHOUT CERTIFICATE 3. INSULATIONRAMINC & PLUMBING OF OCCUPANCY 4 BE COMPLETE FOR C O�ON MUST ALL CONSTRUCTION SHALL MEET UNDERWRtTERSCERTIFlCATE THE REQUIREMENTS OF THE N.Y. STATE CONSTRUCTION & ENERGY REQUIRED CODES. NOT RESPONSIBLE FOR srnir, or raga DESIGN OR CONSTRUCTION ERRORS S.S C"IY Or. .. .. r' --`�-' �it/�''••• •. 1.�U ................being duly sworn, deposes and says that he is the applicant (Name of individual signing contract) above named, Heis the ......(2.,,o / ............................... _ _ (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 this1 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 befgr5 ire this . ....... S.—.�[. •day of .... .. 19..�..!. Notary lic ...... ��.-�4,,e�—s-..C�v`��:•...., - A1RELGLEW (Signature of Applicant) i -• Notary b'% State of New York No.OIGLM79505 Qualified in Suffolk Co Commission Expires Dec.8, i oM;27Y L ice" CO I , , i I - , cJ/�i'�. la�U�-� �/�7 _,wic.c ��c•D. - �- - -�t;�'•--_3.?,_vC.�v- -��L�-civ5._ '�F _.i.�,�� - - - - , , 7G-5 Z Survey No.:89— 070 D P E N SPACE pardorrrrsp OoohB N00°50130'!✓ 415.44 at r Wrpcy N .1 Fled September 2a 1989 as Map No. 8822 414 t�d �D o2oX//o /iU t�uv (�1 Swy Mi-f,�ue ,Zb I x 45 x 0A 311"F1s�M 7ZEy2 uF p.t��P>y L„v� (�y/ V j V-- Story Franetn ————_ 45A 'Y 6 FT* 50.5 I I OV �fr Il2 0 .240, kb1 /J •05 53 'I x 46.5 FinaI Location 09/17/94 Urauttgrtted alteration or addition to o map bearing o PrateselonaI / / 0• 0 - Lond Surveyors Seal m a violation of Sedion 7209. Suo—Seetbn 2. of the Now York State Education Low. Right&—of—way or eaeemente of record not shown on this map are ��`�� not certified. J C,rUfimtions indicated hereon sanity that fife survey roe prepared in accordance with the ssistlnq Codeof practice* tar Land Surveys adopLd by the 'New York State Association of Professional Land to the the My Sal, prepared. and ondihl runbehalonlf. to the p U e company far , UFF'OLK COUNT Y DEP G o . '�iT OF H..aL .i.. v �;e"am not tr sf�and itiio"I institutlioons or s;bs�t SINGLE FRl/t+�ILY DWELLING ONLY o.ners J of Cc Coale from the OMGINAL, of this FAm��..00ti � inked R'1�. ~ � 4s ' with on ORiMNAL' of the Land Surveyor sad shall not be conddemd to be o vdld true copy. } �X.C. FW. �lI .`� -77 caked W / 8t$•1'3` � SL•3 t2as,11 Iti^. ^r[8d PS9Ql�f� 4 f ceridW by this Depa"mant OF,L)8 oltr_r ager:cies �~ and fOUr1d to be$RgSiEaM. I hereby certify that this reap wo, rnade from an actual q� survey txmpleted by me on 07/30/90 for Chardonnay Esta t . lj$ g OiBce o, e:e:aid WBsfismr ttage:nsrtf Edward A. Bullock, Jr. e w Praf...lm L Surveyor FJngb>K 4 Miller tillttr Avenue e Port Jefferson Station NY 11776 ` 516-473-5332 N.Y.S P.LS. No. 49214 k N.YS P.E. No. 63675 Scale: 1' 50' Tax Map No.:100� 51 — 3 —3.14 17—91 -14 e TOWN OF SOUTHOLD PROPERTY RECORD CARD --- -- - — - OWNER STREET VILLAGE DIST-� SUB. LOT u 0 ACR. REMARI(S TYPE OF BLD. 1 122 3 -FKI's&� PROP. CLASS zt 114 e- Cr4),57L cD Y),!� - L/ Jl LAND TOTAL DATE IMP. 4 - 176-2 c) (0 2qi Q P -7400 I -2- 074?01 7 2 FRONTAGE ON WATER TILLABLE FRONTAGE ON ROAD WOODLAND DEPTH MEADOWLAND BULKHEAD HOUSE/LOT TOTAL ------------------ i , - 41 ■NO■N■E■ME■■EM■NEME■ ■■■■IN■EENNN■IIM■■■■■■ ■■■■INE■EME■E■■ENEMO■ ■■■■L■■■■■■■■■■■■■ ■■■■OMENMM■■O■■■■■�� ■■■■■■■■■■■■■■■ ON Foundation mm Basement • ��1 - Interior DOE Fire Place MINE ... . -EIEIIECIE®® .. . SEEM � . ®® INE FIE Rooms 1st Floor Driveway Rooms 2nd Floor --ME I _.- INE . : MINE 0101 �� 01100101 Building. Permit/C.O. Checklist Procedure Approved by:Signature Date Application Received / Complete V-1S Plan Review / OK for Permit qy enclose worksheet ) Permit Issued Plan Amendment ( if applicable) Final Inspection Complete / OK for C.O. (enclose inspection report sheet) C.O. Issued Comments: