HomeMy WebLinkAbout34930-Z FORM NO. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Office of the Building Inspector
Town Hall
Southold, N.Y.
CERTIFICATE OF OCCUPANCY
No: Z-34525 Date: 08/25/10
THIS CERTIFIES that the building SWIMMING POOL
Location of Property: 1075 NEW SUFFOLK RD CUTCHOGUE
(HOUSE NO. ) (STREET) (HAMLET)
County Tax Map No. 473889 Section 109 Block 7 Lot 5.1
Subdivision Filed Map No_ Lot No_
conforms substantially to the Application for Building Permit heretofore
filed in this office dated AUGUST 13, 2009 pursuant to which
Building Permit No. 34930-Z dated AUGUST 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 LYNNE & MARK V RICKABAUGH
(OWNER)
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A
ELECTRICAL CERTIFICATE NO. 102225 08/21/6.2
PLUMBERS CERTIFICATION DATED N/A
a
Aut1grized 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. 31933 Z Date APRIL 24, 2006
Permission is hereby granted to :
M RICKABAUGH
1075 NEW SUFFOLK AVE
CUTCHOGUE,NY 11935
for
CONSTRUCTION OF AN INGROUND SWIMMING POOL IN THE REQUIRED REAR
YARD, FENCED TO CODE
at premises located at 1075 NEW SUFFOLK RD CUTCHOGUE
County Tax Map No. 473889 Section 109 Block 0007 Lot No. 005 . 001
pursuant to application dated APRIL 20, 2006 and approved by the
Building Inspector to expire on OCTOBER 24, 2007 .
Fee $ 150 . 00
Authorized Signature
ORIGINAL
Rev. 5/8/02
L
.- " Foam No.6
® ECE0 � �
TOWN OF SOUTHOLD
BUILDING DEPARTMENT AUG Z 2010
TOWN HALL
765-1802
BLDG,DEPT,
APPLICATION FOR CERTIFICATE OF OCCUPANC TOWN OF SOUTHOLD
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.bf water supply and sewerage-disposal(S-9.form).
3. Approval of electrical irnstallation'from Board of Fire Underwriters.
4. Sworn statement from.plumber certifying that the solder used in system contains less than 2110 of 16/o 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�oinpleted site plan requirements.
B. -For existing.buildings-�prlor to April 9,1957)non-conforming uses,or buildings and.1`pre-existing"laud 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-blew 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 can 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. j C7
New Construction:' Old or Pre-existing Building: (check one) '
Location.of Property:
House No. Street Hamlet
rVL � L Owner or Owners of Property:._ •. ���� �, ��.pr����E .. . ' • .
Suffolk County Tax Map No 1000, Sectiom Block_.E)0C!5`� Lot
Subdivision Filed Map. Wit;
Permit No. 3 3 -Date of Permit. Applicant: BIZ-1—
HealthDept.Approval: Underwriters Approval:_
Planning Board Approval:
Request for: .Temporary Certificate Certificate: V (check one
Fee Submitted: $
D
Applicant Si titre
[J�[J�[J�[J�rJ�r�rJr�[P[J�[J�[J'i].J'[n[1�[1E1��[J�[1[1[J�ct[1�[.I�[J�[n 211 n[JEn[J'[1r�[J�[n[1�J'[1'[nL3rL3r n[1�[.I�r�r�rJ�r�rJ�rJ��Pr�r�rJ�� El
5 /dg• 7 BY THIS CERTIFICATE OF COMPLIANCE THE
5 NEW YORK BOARD OF FIRE UNDERWRITERS T
BUREAU OF ELECTRICITY
5
5 -
5 Y 5
5 40 FULTON STREET — NEW YORK, NY 10038 C�
5 CERTIFIES THAT 5
5 5
5 Upon the application of upon premises owned by
5 5
5 DOROSKI ELEC. INC MARK RICKABAUGH 5
Cj P.O. BOX 781 1075 NEW SUFFOLK ROAD 5
5 CUTCHOGUE, N.Y. 11935, CUTCHOGUE, NY 11935 5
5 5
5 Located at 1075 NEW SUFFOLK ROAD CUTCHOGUE, NY 11935 5
Application Number: 2102225 Certificate Number: 2102225 5
5 ns11 5 Section: Block: Lot: Building Permit: BDC: c5
5 Described as a Residential 0-599 square ft. occupancy, wherein the premises electrical system consisting of 5
5 electrical devices and wiring, described below, located in/on the premises at: 5
Outside,Pool/Spa, 5
5 5
5 A visual inspection of the premises electrical system, limited to electrical devices and wiring to the extent detailed 5
Sherein, was conducted in accordance with the requirements of the applicable code and/or standard
5 promulgated by the State of New York, Department of State Code Enforcement and Administration, or other 5
5 authority having jurisdiction, and found to be in compliance therewith on the 21st Day of August,2006.
5 Name QTY Rate Ratine Circuit Type
5 Appliances and Accessories 5
5 Pool/Spa Bonding 1 0 5
5 Time Clock/Switch 1 0
Pool Heater 1 0 5
5 Panels
5 1 60 3 5
5 Wiring and Devices
5 5 Fixture 4 0 Pool/Spa 5
Switch 2 0 General Purpose
5 Receptacle 1 0 20 amp Pool/Spa 5
S Receptacle 2 0 GFCI 5
5 GFCI Circuit Breaker 1 0 20 amp Pool/Spa 5
5 GFCI Circuit Breaker 1 0 50 amp Pool/Spa 5
5 (Swimming Pool):This certificate covers compliance at the date of inspection only. Because of unusual environments it is advisable to have 5
frequent test and/or repairs made by a qualified person.
5 5
5 seal 5
5 I
of
1 5
5 5
5 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.
5 S
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pF SOUlyOlo
31 733Z-
coutom,
TOWN OF SOUTHOLD BUILDING DEPT.
765-1802
INSPECTION
[ ] FOUNDATION 1ST [ ] ROUGH PL13G.
[ ] FOUNDATION 2ND [ ] INSULATION
[ ] FRAMING /STRAPPING [ ] FINAL
[ ] FIREPLACE A CHIMNEY [ ] FIRE SAFETY INSPECTION
[ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRATION
REMARKS:
62 —
v
DATE J ��� '0 r INSPECTOR
ho��yOF SO//T�o�
9 .3
cou►m,�
TOWN OF SOUTHOLD BUILDING DEPT.
765-1802
INSPECTION
[ ] FOUNDATION 1ST [ ] ROUGH PL13G.
[ ] FOUNDATION 2ND [ ] INSULATION
[ ] FRAMING / STRAPPING FINAL
[ ] FIREPLACE & CHIMNEY [ ] FIRE SAFETY INSPECTION
[ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRATION
REMARKS:
op
40
DATE INSPECTOR
SOON,°lo
34730
courm
TOWN OF SOUTHOLD BUILDING DEPT.
765-1802
INSPECTION
[ ] FOUNDATION 1 ST [ ] ROUGH PLOD.
[ ] FOUNDATION 2ND [ ] INSULATION
[ ] FRAMING / STRAPPING t4FINAL A-,
[ ] FIREPLACE A CHIMNEY [ ] FIRE SAFETY INSPECTION
[ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRATION
REMARKS:
r
1 J
DATE —� INSPECTOR {
FIELD INSPECTION REPORT DATE COMMENTS
b
FOUNDATION(IST)
------------------------------------
d
FOUNDATION (2ND) � .
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ROUGH FRAMING&
PLUMBING
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INSULATION PER N.Y.
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STATE ENERGY CODE
FINAL
ADDITIONAL COMMENTS
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TOWN OF SOUTHOLD BUILDING PERMIT APPLICATION CHECKLIST
BUILDING DEPARTMENT Do you have or need the following,before applying?
TOWN HALL I Board of Health
SOUTHOLD, NW 11971 3 sets of Building Plans
TEL: (631) 765-1802 Planning Board approval
FAX: (631) 765-9502 Survey
www. northfork.net/Southold/ PERMIT NO. 3�/C�3 Check
Septic Form
N.Y.S.D.E.C.
Trustees
Examined ,20 D Contact:
Approved ,20 0-6 Mail
Disapproved a/c /,/)Y-l�<S , letI/
Phone: W L-7,5 z(x 3
Expiration O 1i ,20j
Building Inspector
APPLICATION FOR BUILDING PERMIT
Date , 20 4ig
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 adj oining 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 co e, and rAgulations, and to admit
authorized,b @r g VeVaid in building for necessary inspections.
ENCLOSECE PJJOOLJO CODE OCCUPANCY OR
UPON COMPLETION
� Cigna e o applic r name, a corporation)
BEFORE"WATER"
USE .IS:.;U�LAWFUL
WITHOUT .CERTIF1 . J
(Mailing adclress of applicant)
OF OCCUPANCY lumber or builder
State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician,p
APP Q) IUD AS
,� DATE:
Name of owner of premises dw, - 1C �� �� BY -
Qll or lat UILDING UE 'F•i's,P,IEI�
IiH LL TO 4
If applicant is a corporation, signature .-M FOP, THE
q 765_1Sp2 8 AM
N NTS OF THE FOLLOWING INSPECTI()"S
qRDES OF TATE: TVJO REGUIRED
(Name and title of corporate offic 1 FOUNDATION -CON(JRETL-
FOR POURED
Builders License No. �6 l f?�NpERWRITERS CERTIFICATE 2. ROUGHT10 Ah+ZINC' �` P'-UP�ti�it.G
3.'INSULA rTIc�N MUST
Plumbers License No. - KOUIRED 4 FINAL - CONSTRU.
Electricians License No. BE COMPLETE FOR C.D.
Other Trade's License No. ALL CONSTRUCTION SHALL MEET
OF NEW
REQUIREMENTS OF TH .nnn-cBLF FOR
1. Location of land on w�,h}}�ch pro ose :'�k w'll be orb �( R TA �6NSTf L ERRORS.
��.T?� � �(/
ouse Number Street Hamlet
County Tax Map No. 1000 Section Block I07 Lot �l
Subdivision
lrairTAIAa STn VYH fti ! t. r+url:".^a
(Name) PURSUANT TO SECTION 45-1 OC t;: .`". ':c .'•"�
OF,.THE TOWN CODE. �;
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 Alteration
Repair Removal Demolition Other WorkZ(JL �r,�
4. Estimated Cost Fee (Desc 'potion)
(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
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 I. 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
n ,, �/ c c%
14. Names of Owner of premises I�l �-1`' 4- dress l6 7�/��cl-ScI�C�Phone No.
Name of Architect ddress Phone No
Name of Contractor S �✓/�//� G Address�� 5r�ci //� Phone No. 7 27—6 2
5 a. Is this property within 100 feet of a tidal wetland or a freshwater wetland? *YES.
* IF YES, SOUTHOLD TOWN TRUSTEES & D.E.C. PE1zN1ITS''l Y B r r
b. Is t ; . . : . yE'R.EQj.JIIRED. . .
his property within 300 feet of a tidal wetland? * YES, �N1J
* IF YES, D.E.C. PERMITS MAY BE REQUIRED. x i`-aw.- (.;, •��"-=�.:9 -"
16. Provide survey, to scale, with accurate foundation'lh'A'anidld stances to.`'do e t. . fines.
a jFf, ,�r r P F Y y
vl
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 OOF/+ ,
v v`� G'� � beingdulyswori;de,'oses' nd says that she 's 1?, .,,. y ( ) i the applicant
(Name of individual si 'ng contract) above named ;-;, ; .- ,-AC- • -
�L— � ,IQ ,.1:. 7ic' if
(S)He is the 66-� , ii `. diJ ... �^.
(Contractor, Agent, Corporate Officer, etc.)
of said owner or owners, and is duly authorized to perform or hqgtp 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 thn Q
day ofQ 20D�__ f
Notary Public S' ature of A licant
CYNTHIA A GALLO
NOTARY PUBLIC, State of New llbfR ,i, x
No. 01 GA6046451 .�. 11,1,A l_� I n i_t .t
Qualified In Suffolk County
Commission Expires August 14, _, ' 1 V,
t•'r r' J l ...if!
pF SO�Tyolo
Town Hall Annex Telephone(631)765-1902
54375 Main Road Fax(631)765-9502
P.O.Box 1179
Southold,New York 11971-0959
yC4UNT`I,Nc�
BUILDING DEPARTMENT
TOWN OF SOUTHOLD
April 8t", 2009 FIRST NOTICE
Lynne & Mark Rickabaugh
67 Pinckney Street
Boston, Ma 02114
RE: 1075 New Suffolk Road (In-Ground Swimming Pool)
SCTM: # 1000-109.-7-5.1
Dear Mr. & Mrs. Rickabaugh,
Please be advised that your Building Permit # 31933 issued April 24th, 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 $250.00: 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 So�ryol
� o
Town Hall Annex Telephone(631)765-1802
54375 Main Road N 41C Fax(631)765-9502
P.O.Box 1179 G O
Southold,New York 11971-0959
coUNT`I,Nct�
BUILDING DEPARTMENT
TOWN OF SOUTHOLD
July 21", 2009
Lynne & Mark Rickabaugh
67 Pickney Street
Boston, MA 02114
Re: 1075 New Suffolk Rd. / Violation
SCTM# 1000-109.-7-5.1
To Whom This May Concern:
Your BUILDING PERMIT # 31933 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 m.PLEASE SEE ENCLOSED DOCUMENT REGARDING SWIMMING
P CODES.
Respectfully r ,
Damon Rallis, Zoning Inspector 7009 0820 0001 7822 0626
Southold Building Department
-, COPY
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SURVEY FOR
MARK RICKABAUGH
AREA = 24,000 sq.ft. AT CUTCHOGUE
TOWN OF SOUTHOLD
SUFFOLK COUNTY, N. Y.
1090 - 109 - 07- 51
Scale: 1" = 30"
June 15, 1992
�� \S OF NFh')'
T.MFr�cp��
old .
.Y. . v_ , 0. l8 =for
in accordance with the minimum
title surveys as established
P •CONIC u �y y. �. by the L.I.A.L.S and approved and adopted
( l6) 765 - 5020 s�c� 9GA8p for such use by The New York Stale Land
P. O. BOX 909 44Np SU Title Assoclalion.
MAIN ROAD
\SOUTHOLD,, N.Y. 11971
92-178
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