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Home My WebLink About34881-Z FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No: Z-34430 Date: 07/06/10 THIS CERTIFIES that the building SWIMMING POOL Location of Property: 605 ORIOLE DR SOUTHOLD (HOUSE NO. ) (STREET) (HAMLET) County Tax Map No. 473889 Section 55 Block 6 Lot 15.29 Subdivision Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated JULY 20, 2009 pursuant to which Building Permit No. 34881-Z dated JULY 20, 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 ROBERT W & JILL A JOHNSON (OWNER) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A ELECTRICAL CERTIFICATE NO_ 78319C 07/30/03 PLUMBERS CERTIFICATION DATED N/A /,�60r ed 'gnature Rev. 1/81 Form No.6 TOWN OF SOUTHOLD (� BUILDING DEPARTMENT 0 TOWN HALL 765-1802 JUG APPLICATION FOR CERTIFICATE OF OCCUP I? 20j0 8 TOwNa°°�oFpj This application must be filled in by typewriter or ink and submitted to the Building Department wi w .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 eieotricai instaiiation 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 engineef 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= $100.Ob 3. Copy of Certificate of Occupancy'*$.25 4. Updated Certificate of Occupancy- $50.40 5. Temporary Certificate.of Occupancy-Residential$15.00, Commercial$15.00 Date. Z / New Construction: Old or Pre-existing Building: (check one Location of Property: 012-o L E- '-64 "Irlla G House No. Street Hamlet ' Owner or Owners of Property:.-` 2r�8 z�. ��C U�,J S o Suffolk County Tax Map No'!600, Section S� Block_ . . ®� Lot J ,. O 2- �I Subdivision Filed Map. Lot: Permit No. aj I 'Date of Permit. Applicant: lealth Dept.Approval: Underwriters Approval: Planning Board Approval: Request for: .Temporary Certificate Final Certificate: L/ (check one) Fee Submitted: $ z CD -2: 0 �`J - Applicant Xiggnature r�•,S?�i4 IRw :� :gg tla.d'•D; ma'","_`S Ts ;:;:'S '.r.z+�. r> �-,% -.• ••.t .� 'i �.%.,3 v`'Z.' G.,.e.'F;gyp•e•'F'�.:'r�"� •'+ Fi :•:•••�"Z`S'•:%.r 3p.'••:-��.�' `:•.r•. �,f•'.- r %S''V 2 •j •:•S F•.i �i•0,.•. N v•C 4'•:%.•r'ir O•.:%. •0. de••�•i�:4 �i•:•'•••i'•• •3 i•. • 4••:•4rta v• ''/ e• . S O•e O• • • O'r4 i•:::�;. 2�%R0 e4 H �,S• �� S� SS r � r'N SS �i � � � � P !,•, �` _. y r� Electricallnspection Certificate ==� Issue Date Electrical Inspection Service,,lnc. Application Number :may Hi 07/30/2003 375 Dunton Avenue 78319C East Patchogue, New York 11772 (631)286-6642 s•C Issued To: Robert W. Johnson =' Street: 605 Oriole Drive Village: Southold Zip: 11971 Town: Southold Section: 055 Block: Lot: 015.029 Contractor: R. C. Electric Corporation Lic. # 1610-F Was examined and found to be in compliance with the National Electrical Code. ❑ Commercial ❑ NV Defects Pool ❑ 1st Floor El Indoor ❑ Basement ❑ Hot Tub . _ X❑ Residential ❑ Det.Garage El Attic ❑ 2nd Floor X❑ Outdoor ❑ Addition El Survey ---=-=-- Switches Receptacles Fixtures GFI Heaters A/C Fans Dishwasher WasherlAmps DryerlAmps Oven Ran ge/Amps Microwaves Furnace Oil Gas Circulators Smoke Detector Bell Transformer 'r == Meter Amps Phase UG/OH Jacuzzi Television CO Detector `==' faw=== Bldg. Permit. _= : r~j Other Equipment 1-Gas Heater +r t 1-Pool Panei 4=: 1-Time Clock Hugo S. Surdiv 1-Motor President Rough Inspection: 07/29/2003 Y+ Inspector: EdScavelli �=y: -=_ Final Inspection: 07/29/2003 Inspector: Ed Scavelli - "'� This certificate must not be altered in any manner. Inspectors may be identified by their credentials. - =" �;r��`« �'dd� ddi' �d0i�„� .�d� � � .SSA,•• .� + �,�"� � � � y-•�''' :. ..•. .•.,.;, .•, • • .� � ••,�. •;:;.�.. :.��y•`•:f: ' �'. . . ..•,.. . •0♦ is ,,Y� •4 pY•.tr `4 u�♦, '•- .•' 4.t• SS••••'• S t ♦' _ �} ✓ •♦:,. J♦ ♦ .�, �• % d �! :.. ''•.. • ..�%i•,. �i.},':'%�•�.ti.:� +�� +%d�i�� a�.ti:;�=+1}Y�f y�S,a:4��y.%��k:�fi� i-v�s.�Naf'� %f,. On;. V�••.f �''•'•. � v. % } v.•,., .• __ z s: a�`:.c � a__ a._��'.a � ,..:3'} �.� � �r�:i ��:�'� ��?' �-�'}x��s�'��` r'��+'`'�ar�_ �.is2..� ..•.-0•f.*iya�.. 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. 34881 Z Date JULY 20, 2009 Permission is hereby granted to: ROBERT & JILL JOHNSON 605 ORIOLE DR SOUTHOLD,NY 11971 for CONSTRUCTION OF ACCESSORY INGROUND SWIMMING POOL IN REQUIRED REAR YARD FENCED TO CODE AS APPLIED FOR.REPLACES EXP. BP # 32051 at premises located at 605 ORIOLE DR SOUTHOLD County Tax Map No. 473889 Section 055 Block 0006 Lot No. 015 . 029 pursuant to application dated JULY 20, 2009 and approved by the Building Inspector to expire on JANUARY 20, 2011 . Fee $ 250 . 00 Authorized Signature ORIGINAL Rev. 5/8/02 FORM NO. 3 TOWN OF SOUTHOLD BUILDING DEPARTMENT �viy I Town Hall 3 Southold, N.Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) PERMIT NO. 32051 Z Date MAY 26, 2006 Permission is hereby granted to: off^ .� � LL ROBERT WILLIAM JOHNSON 605 ORIOLE DR SOUTHOLD,NY 11971 for CONSTRUCTION OF ACCESSORY INGROUND SWIMMING POOL IN REQUIRED REAR YARD FENCED TO CODE AS APPLIED FOR. THIS PERMIT REPLACES BP 29298 . at premises located at 605 ORIOLE DR SOUTHOLD County Tax Map No. 473889 Section 055 Block 0006 Lot No. 015 . 029 pursuant to application dated MAY 26, 2006 and approved by the Building Inspector to expire on NOVEMBER 26, 2007 . Fee $ 150 . 00 A or ' ed i atur 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. 29298 Z Date APRIL 17, 2003 Permission is hereby granted to : ROBERT WILLIAM JOHNSON 605 ORIOLE DR SOUTHOLD,NY 11971 for CONSTRUCTION OF AN IN-GROUND SWIMMING POOL IN THE REQUIRED REAR YARD WITH FENCE TO CODE AS APPLIED FOR at premises located at 605 ORIOLE DR SOUTHOLD County Tax Map No. 473889 Section 055 Block 0006 Lot No. 015 . 029 pursuant to application dated APRIL 14 , 2003 and approved by the Building Inspector to expire on OCTOBER 17, 2004 . 1 Fee $ 150 . 00 A ho ' zed Signature ORIGINAL Rev. 5/8/02 �o��OF SO(/T�olo Comm,�c� TOWN OF SOUTHOLD BUILDING DEPT. 765-1802 INSPECTION [ ] FOUNDATION 1 ST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] INS ATION [ ] FRAMING / STRAPPING [ kTIFINAL [ ] FIREPLACE & CHIMNEY [ ] FIRE SAFETY INSPECTION REMARKS: DATE INSPECTOR .�.J Of SO(/T�o o�yco , TOWN OF SOUTHOLD BUILDING DEPT. 765-1802 INSPECTION [ ] FOUNDATION 1ST [ ] ROUG�-_P_ LB [ ] FOUNDATION 2ND [ ] IN ON [ ] FRAMING /STRAPPING lye FINAL [ ] FIREPLACE A CHIMNEY [ ] FIRE SAFETY INSPECTION [ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRATION REMARKS: 1-7 DATE `� t INSPECTOR FIELD 7NS�ECTION REPORT DATE COhBHNT FOUNDATION(1ST) C FOUNDATION(2ND) M z _ 0 'ROUGH FRAMING& G y PLUMBING INSULATION PER N.Y. y STATE ENERGY CODE 14,245 lee ?.N /� ®_. CD FINAL P C ADDITIONAL CON MENTS S rn y . 'O z Va ��t7 J TOWN OF'SOUTHOLD BUILDING PERMIT APPLICATION CHECKLIST BUILDING DEPARTMENT Do you have or need the following,before applying? TOWN HALL ,. Board of Health SOUTHOLD,NY 11971 J- 3 sets of Building Plans TEL: (631) 765-1802 / Planning Board approval FAX: (631) 765-9502 2 Survey www. northfork.net/Southold/ PERMIT NO. 2-9 2 �7/ Check.' Septic Form. N.Y.S.D.E.C. 2 Trustees Examined ��. ,20 / Contact: Approved 17 20_,� Mail to: Disapproved a/c Phone: Expiration 1.0117 20 Building Inspector - i APPLICATION FOR BUILDING PERMIT APR 0 Date ,,...' , 20 INSTRUCTIONS a. Tlug'application'MUST-b ompletely 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.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. (S naturepplic t or name,if a corporation) aos (Mailing address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder . Name of owner of premises1?6Le p�n �n (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. cjS_ H Plumbers License No. Electricians License No.1610— M E Other Trade's License No. 1. Location of land on which proposed work will be done- -605 r le. a r lsnu+�Ol d House Number Street Hamlet County Tax Map No. 1000 Section_ Block Olp.dp LotaJ5,OQ9 Subdivision -� Filed Map No. Lot CV(O ame) 2. State existing use and occupancy of premis (s and int nded use and occupancy of proposed construction: a. Existing use and occupancy BSI �X� 6L b. Intended use and occupancy) (\ IrYkMI po0 k 32 3. Nature of work (check which applicable): New Building Addition Alteration Repair Removal Demolition Other Work ( �escript�ion) 4. Estimated Cost 5/,'� ()CO 00 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 Dimensions of same structure with alterations or additions: Front Rear Depth Height Number of Stories NFE 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 I L 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 premiseR66d �chnSon Addres�0 Orio�e dr Stu lhone No.7765-1639)5 Name of Architect Address Phone No Name of Contractor ffla&s n Q6 + R)D S Address 5 rn idd(e WPhone No. t04 g-49 3 Comm 15 a. Is this property within 100 feet of a tidal wetland or a freshwater wetland? *YES NO * IF 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. 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 ) 0 ljle 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. Sworn to before me this l day of 206 3 7 Pdblic ' Signature of Applicant ROWRT G.IAo Notary Public,State of New York No.OJRA5076746 QualBted In Sufolk County Commission Explres April 26, E OF SO!/ryDl Town Hall Annex ~ Telephone(631)765-1802 54375 Main Road Fax(631)765-9502 P.O.Box 1179 Southold,New York 11971-0959 yeOUNTY,� BUILDING DEPARTMENT TOWN OF SOUTHOLD April 9t", 2009 FIRST NOTICE Robert & Jill Johnson 605 Oriole Drive Southold, N.Y. 11971 RE: 605 Oriole Dr. (In-Ground Swimming Pool) SCTM: # 1000-55.-6-15.29 Dear Mr. & Mrs. Johnson, Please be advised that your Building Permit # 32051 issued May.26th, 2006 has expired. According to the Code of the Town of Southold, a Certificate of Occupancy must be issued before the use of the structure. To renew your Building Permit, please submit a fee of $150.00: at that time we can schedule an inspection by one of our Building Inspector's. If you have any questions, please call us at 765-1802. Respectfully, SOUTHOLD TOWN BUILDING DEPT �o'of SOUryolo Town Hall Annex l Telephone(631)765-1802 54375 Main Road y Fax(631)765-9502 P.O.Box 1179 • Q Southold,NY 11971-0959 OUNT1,�� BUILDING DEPARTMENT TOWN OF SOUTHOLD June 28, 2010 Robert&Jill Johnson 605 Oriole Drive Southold, NY 11971 TO WHOM IT MAY CONCERN: The following items are needed to complete your Certificate of Occupancy: y Application of Certificate of Occupancy. (Enclosed) Electrical Underwriters Certificate. A fee of $25.00. Final Health Department approval. Plumbers Solder Certificate. (All permits involving plumbing after 4/1/84) Trustees Certificate of Compliance. Final Planning Board approval. Final Fire Inspection from Fire Marshal. Final Inspection from the Building Dept. Final Landmark Preservation approval. Building Permit: 35501-Z swimming pool o�jq"I -lot - CGUANCY3 s FUL SE IS UNLAW NOTED HOOT CERTIFICATE 4YBUILDiNu)' ovE AS NO �` IT Y DAT 0 occUPA _ FEE: V" NOT _.. RTMENT AT S AM 0 4 PM FOR THE FOLLOWIN ECTIONS: 1. FOUNDATION = EQUIRED FOR.POURED. CONCR 2. ROUGH - FRG di.PLUM61 AMIN 021•�� 3. INSULATION t. FINAL - CONSTRUCTION MUST BE COMPLETE, FOR C.O. ` ALL UCTION SHALL MEET THE t - THE CODES OF NEW YO ONSIBLE FOR RE N OR 4STRWT RRORS. o N �,Z,7 ODD ZONE . � o �. -° '�•�' MPIJI, WTH AP ERy„46" Z'�'r 4 FLOOD 6/(MA PREVENTION N SOUTHOLD T WN CODE. 3 7 Ssrcp lf' T__O_�r41 f_L_- r`�Ad w"off �,Y Z'jZ4- °•� rk ' AW FOUNDATION LOCATION REQuI "IMMEDIATELY", ENCLOSE POOL TO CODS UPON COMPLETION BEFORE"WATER" S 6 , �� •t��;. �i�:f'U;��:`:1�Y.i'tTfiE�Z'V�Ci:,� `�e p8 / U ald ' yy }N �� if.i711Y�•rL��u l..t/1 a i�J1lfg14Y+ " Q. '" —.d�.�i,i7 Y,11r((k•} Lb-J1LO dL �,/ �/ �/ `J'h�.S.t1,',,,;ir•cii S(x)5<:)t�tll �1L'tt:)';a1r)p:!i lLc��i'.1~�L'1' 7? r .•.., � 0 Pvd/'1 i I t•�y .e::.:C-.iu•l 7fiit t:UCC:. NEW Y60CE _"�_.._K'6 DES o Z+� As R1�� 13:,�OGINS OF it4Cl'ytl' M:Sr:tY:f#e: )j.Ctit:i:6 °.00 9 THE L�V"f U1�NICONSTRUCTIONS LL K%WESSi-uuL-j ALL '�' S®UNIMONNR RIELD OBSERVA- � HE REQUIREMENTS f THE �� C� ES OF NEW PORK S ATE. N TIONS R DATA OBTAINED FROM Unauthonzed alteration or addition to this document is a violation of Section 7209 SURVEY OF: , l� �- T -t•p of the New York State Education Law. Certifications indicated hereon shall run only to the person for whom it is prepared /� / and on his oahall to the Title Company.Governmental Agency and Lending �1� Of �C�P�ItiT !y 1— PO.A;, 2- Institution listed hereon,and to the assignees of the lending institutions or subse / �'n. quent owners. Copies of this document not bearing the professional's inked seal or embossed seal shaft not be considered a valid true copy. / _ '^ I '/ The offsets(orbe considered shown hereon from structures to the property lines are ow—k� for a specific purpose and use and therefore are not intended to guide the erection of 1 fences,retaining walls,poofs,patios•planting areas,addition to buildings or any other construction. The existence of right of ways and/or easements of record,if any,not shown are not guaranteed. i F DATE: Pj ALE:SC =4 a CERTIFIED ONLY TO: �� y� DES IN G• � DESTIN G.CRA VJiL-L.'A.M _0lt �(.I AMJ T lk,� k4tI TOWN 1,,4 (�: �_ pf3Cuived .r�2 P7A " '� G� LAND ST.TR.VEY• -.,:/�^ouniy .. ` t;<E%7rmk2� A�Tf¢�T, T.,i 000 82 the D N' � � N ROAD DEC 171998 Y DESTIN G. GRAF N.Y.S. LIC No.50067 '° ROCK DINT.NEW YQgK 1078110Zl`t"''f`' �s PHONE(516)821i;j2U('Jiffl=I�IV '�: +lt' TAX I.D. No. Ocx� — 5� D!o — I , o z� SION °. __— ----_ pF SO!/ryol Town Hall Annex Telephone(631)765-1802 54375 Main Road Fax(631)765-9502 P.O.Box 1179 Southold,New York 1 197 1-0959 Irou BUILDING DEPARTMENT TOWN OF SOUTHOLD April 9th; 2009 FIRST NOTICE Robert & Jill Johnson 605 Oriole Drive Southold, N.Y. 11971 RE: 605 Oriole Dr. (In-Ground Swimming Pool) 5CTM: # 1000-55.-6-15.29 Dear Mr. & Mrs. Johnson, Please be advised that your Building Permit # 32051 issued May 26th, 2006 has expired. According to the Code of the Town of Southold, a Certificate of Occupancy . must be issued before the use of the structure. To renew your Building Permit, please submit a fee of $150.0.0: at that time we can schedule an inspection by one of our Building Inspector's. If you have any questions, please call us at 765-1802. Respectfully, SOUTHOLD TOWN BUILDING DEPT oF so�ryolo Town Hall Annex Telephone(631)765-1802 54375 Main Road y Fax(631)765-9502 P.O.Box 1179 G • Southold,New York 11971-0959 'O COUNT`I,N BUILDING DEPARTMENT TOWN OF SOUTHOLD July 61h, 2009 Robert & Jill Johnson 605 Oriole Drive Southold, N.Y. 11971 Re: 605 Oriole Dr. / Violation SCTM# 1000-55.-6-15.29 To Whom This May Concern: Your BUILDING PERMIT # 32051 for construction of an IN-GROUND SWIMMING POOL has been referred to me because you have not responded to requests to obtain your certificate of occupancy as required by Southold Town code. Pursuant to 144-15A, of the Southold Town Code, "No building hereafter erected shall be used or occupied in whole or in part until a certificate of occupancy shall have been issued by the Building Inspector." Therefore, you have ten days from the receipt of this letter to submit a check made out to the Town of Southold in the amount of $250.00: to renew the building permit, or legal action will be taken against you. Should you have any questions, call the building department between the hours of 8:00 a.m. and 4:00 p.m.PLEASE SEE ENCLOSED DOCUMENT REGARDING SWIMMING POOL C -n espectfully Y N ►n co a Ln amon His, Zon' g Insp as Southold B ' g Depart nt a Im ca rA ca a Ca TOWN OF SOUTHOLD PROPERTY RECORD CARD OWNER STREETS VILLAGE DIST. SUB. LOT ,� art vl, ha . ff--1/1 �i�le � ��. r� lc� Ali �- a�n� 1e� a�u�, 'c2 ACR. REMAR S ` G7s 1 I �g 9�-L ��a9/ 9 - l c��o f� o , .� ca TYPE OF BLD. z !. PROP. CLASS ' �� J ` 1�f ,� �la�nde (q_ao -►' �-�D sA� ?�- 3P a � - coy n� ti - -Y, ..�� :�� { ,� . LAND IMP. TOTAL DATE C�C�.-� /J(9Ll� 3-7 LG �j.! G �S 10 a p I oo q &7J 7 n 3 o FRONTAGE ON WATER TILLABLE FRONTAGE ON ROAD WOODLAND DEPTH MEADOWLAND BULKHEAD HOUSE/LOT ' b c �' TOTAL �: • Ilil l°kl'ip]..I ; eq:Yw s+d '` 4 g•=.t u yi -------------- p -mvaj., t"$ro'"w e 3, �� A.si y .A.A °`..._—•- . • ■��■■■■■■■■■■I`■■�■■■■■ ■■■■M■■EMAR_EM■■■■■■ ■■■■■■■■■■EM■■■■■■ ■■■■■■■■■■■■■■■■■■�■ ■■■■■■■■■■■■■■■■■■■■ BUILDING PERMIT EXAMINER CHECK LIST i T DATE REVIEWED: /03 APPLICANT: (�.�(�L�cc1 F V�Q �v�v ®� DATE SUBMITTED: /14 /03 SCTM# �V - DISTRICT: 1,000, SECTION: , BLOCK: Zip , LOT: SUBDIVISION: Kec? cows ADDRESS: �6- O2iocz lie . CITY: ZONING DISTRICT: CONFORMING? BUILDING PERMITS OPEN/EXPIRED: BP-2 H 91'� -Z/C/0 Z-a4 A 1 , INFO —/BP�b6 4 -Z/C/0 Z- or BP -Z/C/0 Z- , INFO /BP -Z/C/0 Z- , INFO PRE CO: Y OR N BP -Z/C/0 Z- , SINGLE & SEPARATE CERTIFICATION-REQUIRED Alo NOTES: LOTS 40,000SF-100-24.Lot recogni ti on.(CREATED before June 30,1983),UNDERSIZED LOTS FROM JAN.1997 100-25.Merger.(A nonconforming at any time after 7/1/83; REQ. LOT SIZE: HO,00a ACT. LOT SIZE:C?b1� REQ.�LOT COV. 2�o ACT. LOT COV. REQ. FRONT PROP. FRONT — REQ SIDE r ACT. SIDE REQ. REAR 'S" PROP. REAR _ REQ. HEIGHT PROP. HEIGHT PROJECT DESCRIPTION: r�� ESTIMATED PROJECT COST: ('S ARCHITECT/ENGINEER: N/� FAST TRACK WATERFRONT? /�c D DESCRIPTION: PANEL #: FLOOD ZONE: COMPLIANCE: APPROVALS REQUIRED SUFFOLK COUNTY HEALTH DEPT: YES orBED#): DTE: _/ / PERMIT#: TOWN SEPTIC RECEIPT: Y dZID NEW YORK STATE DEC: PRE-DEC 9/1/75 YES oL7- SOUTHOLD TOWN TRUSTEES: YES oli TOWN ZONING BOARD APPROVAL: YES or TOWN PLAN. BOARD APPROVAL: YES or EEE�� TOWN HISTORICAL PRE (SPLIA): YES or NEW YORK STATE CODE COMPLIANCE (SEE PAGEd2L(J NO NOTES: FEE STRUCTURE: FOUNDATION: SF FIRST FLOOR: SF SECOND FLOOR: SF OTHER: SF NIT OTHER TOTAL TOTAL: SF FEE FEE FEE 1. ( SF)- NSF)= SF X$ =$ +$ +$ =$ 2. ( SF)- (_ SF)= SF X $ =$ +$ +$ =$ 3. ( SF)- _SF)= SF X$ =$ +$ +$ =$ FINAL TOTAL: $ 115D NEW YORK STATE CODE COMPLIANCE CHECKLIST USE/OCCUPANCY CLASSIFICATION: HEIGHT/FIRE AREA: TYPE OF CONSTRUCTION: DESIGN CRITERIA: ENGINEERED/PRESCRIPTIVE FULL FRAMING DESIGN ELEMENTS: HEADERS: Y/N WALL STUDS: Y/N GIRDERS: Y/N CEILING JOISTS: Y/N FLOOR JOISTS: Y/N ROOF RAFTERS: Y/N LUMBER SPECIES AND GRADE: Y/N DESIGN LOAD CALCULATIONS: Y/N SHOULD INCLUDE LIVE,DEAD,SNOW,SEISMIC AND WIND(INCLUDING UPLIFT AND EXPOSURE) WINDOW AND DOOR SCHEDULE: MISSLE TEST REQUIREMENTS: Y/N EGRESS, LIGHT,.VENT: Y/N LOAD PATHS: Y/N ROOF TO FOUNDATION NAILING/CONSTRUCTION SCHEDULE: Y/N MEANS OF EGRESS: Y/N PLUMBING RISER DIAGRAM: Y/N LOCATION OF FIRE PROTECTION EQUIPMENT: Y/N TRUSS DESIGN: Y/N CERTIFICATION: Y/N ENERGY CALCS: Y/N TOTAL COMPLIANCE?Y/N(RETURN TO PAGE ONE)