HomeMy WebLinkAbout44971-Z �o�QSUFFOitx• Town of Southold 4/10/2023
P.O.Box 1179
o • .� 53095 Main Rd
Southold,New York 11971
CERTIFICATE OF OCCUPANCY
No: 42013 Date: 5/7/2021
THIS CERTIFIES that the building IN GROUND POOL
Location of Property: 585 Donna Dr.,Mattituck
SCTM#: 473889 Sec/Block/Lot: 115.-16-5
Subdivision: Filed Map No. Lot No.
conforms substantially to the Application for Building Permit heretofore filed in this office dated
6/29/2020 pursuant to which Building Permit No. 44971 dated 7/10/2020
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 fenced to code as applied for.
The certificate is issued to Oliver,Michael&Kristin
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL
ELECTRICAL CERTIFICATE NO. 44971 9/28/2020
PLUMBERS CERTIFICATION DATED
0 v
Au o ized ig tore
TOWN OF SOUTHOLD
FF01,�coGy BUILDING DEPARTMENT
C* TOWN CLERK'S OFFICE
"o • �,' SOUTHOLD, NY
BUILDING PERMIT
(THIS PERMIT MUST BE KEPT ON THE PREMISES
WITH ONE SET OF APPROVED PLANS AND SPECIFICATIONS
UNTIL FULL COMPLETION OF THE WORK AUTHORIZED)
Permit#: 44971 Date: 7/10/2020
Permission is hereby granted to:
Oliver, Michael
585 Donna Dr
Mattituck, NY 11952
To: construct an in-ground swimming pool as applied for.
At premises located at:
585 Donna Dr., Mattituck
SCTM #473889
Sec/Block/Lot# 115.-16-5
Pursuant to application dated 6/29/2020 and approved by the Building Inspector.
To expire on 1/9/2022.
Fees:
SWIMMING POOLS -IN-GROUND WITH FENCE ENCLOSURE $250.00
CO- SWIMMING POOL $50.00
Total: $300.00
Building Inspector
CONSENT TO INSPECTION
0�`v* r , the undersigned, do(es)hereby state:
Owner(s)Name(s)
That the undersi d(is) ( e) the owner(s) of the premis s in the Town of
Southold, located at �j Hv►cr r �/r� l �/C ,
which is shown and designated on the Suffolk County Tax Map as District 1000,
Section 1 ) Z�, Block 16 Lot 057
That the undersigned (has) (have) filed, or cause to be filed, an application in the
Southold Town Building Inspector's Office for the following:
That the undersigned do(es) hereby give consent to the Building Inspectors of the
Town of Southold to enter upon the above described property, including any and all
buildings located thereon, to conduct such inspections as they may deem necessary with
respect to the aforesaid application, including inspections to determine that said premises
comply with all of the laws, ordinances,rules and regulations of the Town of Southold.
The undersigned, in consenting to such inspections, do(es) so with the knowledge
and understanding that any information obtained in the conduct of such inspections may
be used in subsequent prosecutions for violations of the laws, ordinances, rules or
regulations of the Town of Southold.
Dated: �O Z-Z12,
/(Signature)
-��!�t-7rf�/ G I�c•�r �
(Print Name)
(Signature)
(Print Name)
OF SO!/P�,®l
Town Hall Annex ~ ® Telephone(631)765-1802
54375 Main Road Fax(631)765-9502
P.O.Box 1179 G sean.devlin(cD-town.southold.ny.us
Southold,NY 11971-0959 • y®
BUILDING DEPARTMENT
TOWN OF SOUTHOLD
CERTIFICATE OF ELECTRICAL COMPLIANCE
SITE LOCATION
Issued To: Michael Oliver
Address: 585 Donna Dr city.Mattituck st: NY zip: 11952
Budding Permit#: 44971 Section: 115 Block. 16 Lot- 5
WAS EXAMINED AND FOUND TO BE IN COMPLIANCE WITH THE NATIONAL ELECTRIC CODE
Contractor: DBA: Bethel Electrical License No: 40557ME
SITE DETAILS
Office Use Only
Residential X Indoor Basement Service
Commerical Outdoor X 1st Floor Pool X
New X Renovation 2nd Floor Hot Tub
Addition Survey Attic Garage
INVENTORY
Service 1 ph Heat Duplec Recpt Ceiling Fixtures Bath Exhaust Fan
Service 3 ph Hot Water GFCI Recpt 1 Wall Fixtures 1 Smoke Detectors
Main Panel A/C Condenser Single Recpt Recessed Fixtures CO2 Detectors
Sub Panel X A/C Blower Range Recpt Ceiling Fan Combo Smoke/CO
Transformer UC Lights Dryer Recpt Emergency Fixtures Time Clocks 1
Disconnect Switches 4'LED Exit Fixtures Pump 1
Other Equipment: Intermatic Pool Panel, Pump on 220GFI, Salt Generator
Notes,
Date: September 28, 2020
Inspector Signature:
S Devlin-Cert Electrical Compliance Form.xls
1� o�Oof SOUI�o
# # TOWN OF SOUTHOLD BUILDING DEPT.
��`y�ourrn 765-1802
INSPECTION '
I FOUNDATION 1ST [ ] ROUGH PLBG.
[ ] FOUNDATION 2ND - [ ] INSULATIOWCAULKING
[ ] FRAMING/STRAPPING [ ] FINAL
[` ] FIREPLACE & CHIMNEY [ ] FIRE SAFETY INSPECTION
[ ]' FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRATION
[ ] ELECTRICAL (ROUGH) [ ] ELECTRICAL ( INAL)
[ ] CODE VIOLATION [ ] PRE C/O
REM K e___
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DATE fTi7vv 7-v INSPECTOR
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TOWN OF SOUTHOLD.BUILDING DEPT. '
co 765-1802
INSPECTION
FOUNDATION 1ST- ROUGH PL13G.
FOUNDATION 2ND rULATIOWCAULKING
FRAMING /STRAPPING IV FINAI_fjvz�
f-FIREPLACE & CHIMNEY FIRE SAFETY'INSPECTION
FIRE--RESISTANT-CONSTRUCTION FIRE RESISTANT PENETRATION
ELECTRICAL (ROUGH) ELECTRICAL (FINAL)
CODE VIOLATION PRE C/O
REMARKS:
T_;4t
DATE INSPECTOR
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TOWN OF SOUTHOLD BUILDING DEPT.'"
`ycou765.1802
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INSPECTION
[ ] FOUNDATION 1ST [ ] ROUGH PLBG.
[ ] FOUNDATION2ND [ ] NSULATION/CAULKING
[ ] FRAMING /STRAPPING [ FINAL �ajt-�
[ ] FIREPLACE & CHIMNEY [ ] FIRE SAFETY INSPECTION
[ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRATION
[ ] ELECTRICAL (ROUGH) [ ] ELECTRICAL (FINAL)
[ ] CODE VIOLATION [ ] PRE C/O
REMARKS: Aaw\
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DATE .INSPECTOR
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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 4 sets of Building Plans
TEL: (631) 765-1802 Planning Board approval
FAX: (631) 765-9502 Survey
Southoldtownny.gov PERMIT NO. Check
Septic Form
N.Y.S.D.E.C.
Trustees
C.O.Application
Flood Permit
Examined ,20 Single&Separate
Truss Identification Form
� m Storm-Water Assessment Form
d 4 Contact:
Approved ,20 Mail to:
bvllif.le-
Disapproved a/c �L k6 41:!"t ��✓��► r.,
Phone: 171 Co
Expiration ,20
Lr JJL—LS
C DuildingLInspp
juN 2 9 2020APPLICATION FOR BUILDING PERMIT
1 7 ,�'.� "'' Date C� , 20 '2c
--C INSTRUCTIONS
a.This application MUST be completely filled in by typewriter or in ink and submitted to the Building Inspector with 4
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.
(Signature of ap licant or name,if a corporation)
(Mailing address of applicant)
State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician,plumber or builder
6 "her
Name of owner of premises C,bq,z� 0l1'Ler—
(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.
Plumbers License No.
Electricians License No. q&5 r-7—
Other Trade's License No.
1. Location of land on whi proposed w k will be done:
House Number Street j Hamlet
County Tax Map No. 1000 Section 11�5 Block / 6 Lot 0 ,57
�OS�fFOL,t,`O BUILDING DEPARTMENT- Electrical Inspector
0�0 Gym TOWN OF SOUTHOLD
Town Hall Annex - 54375 Main Road - PO Box 1179
u' - Southold, New York 11971-0959
y p�� Telephone (631) 765-1802 - FAX (631) 765-9502
��l rogerr(aDsoutholdtownny.gov - sea nd(a),southoldtownny.aov
APPLICATION FOR ELECTRICAL INSPECTION
ELECTRICIAN INFORMATION (Ail information Required) - Date: 2-a Z&-
Company Name: 9VT"C-L nL-F—C--M- CAL CONT-RACTI N& L'TV
Name: �:TC—Afz.-9, i U
License No.: QQ� -� -. Nt , email: -P-L 0 IV/\ AeT,
;Address: = L1\A'Co1,,r,, v�mg— 74-1
Phone No.:
JOB SITE INFORMATION (All Information Required) -
Name: m
Address: �5
Cross Street: 1-
Phone No.: _7
-�BIdg:Permit#: �_1.�,Q � email:
Tax Map District: 1000 : Section: 1 Block: - -)(a Lot: jg-
BRIEF DESCRIPTION OF WORK (Please Print Clearly)
POO 11`;
Circle All That Apply:
Is job ready for inspection?: YES NO Rough In Final
Do,you need a Temp Certificate?: YES NO Issued On
Temp Information: (All information required)
Service Size 1 Ph 3 Ph Size: A # Meters Old Meter#
New Service - Fire Reconnect - Flood Reconnect - Service Reconnected - Underground - Overhead
# Underground Laterals 1 2 H Frame Pole Work done on Service? Y N
A-dditionaldnformation: -
Vas Z� Ca r, �R(L wi AA
R a1N o r CCS.
PAYMENT DUE WITH APPLICATION ,Q
C�
Request for Inspection Form.xls d
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SURVEY OF SURVEYED: 12 MARCH 2008
LOT 68 SCALE 1"=30'
I IN AREA= 20,020 SF
MAP OF DEEP HOLE ESTATES O
0,459ACRES
SI TUA TE
MA TTI TUCK, TOWN OF SOU THOLD
SUFFOLK COUNTY, N. Y.
SURVEYED FOR MARK PALLADINI
EVEL YN PALLADINI
TM 1000-115-16-05
FM#4256 SURVEYED
FILED JAN. 28, 1965
GUARANTEES INDICATED HERE ON SHALL RUN
ONLY TO THE PERSON FOR WHOM THE SURVEY STANLEY J. I SAKSEN, JR.
IS PREPARED, AND ON HIS BEHALF TO THE
TITLE COMPANY, GOVERNMENTAL AGENCY, P.0. BOX 294
LENDING INSTITUTION, IF LISTED HEREON, AND
TO THE ASSIGNEES OF THE LENDING INSTITUTION. NEW FFOLK, NY 56
GUARANTEES ARE NOT TRANSFERABLE TO 516- 34- 8
ADDITIONAL INSTITUTIONS OR SUBSEQUENT OWNERS.
UNAU7HORIZED ALTERATION OR ADD177ON TO THIS
GUARANTEED TO SURVEY IS A VIOLATION OF SECPON 7209 OF LI ENS LAND UR VE
THE NEW YORK STATE EDUCATION LAW
YS LIC. NO. 4 273 '
MARK PALLADINI
EVELYN PALLADINI COPIES OF THIS SURVEY MAP NOT BEARING
THE LAND SURVEYORS EMBOSSED SEAL SHALL
NOT.BE CONSIDERED TO BE A VALID TRUE OBR 1666
COPY
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