HomeMy WebLinkAbout47807-Z t TOWN OF SOUTHOLD
., BUILDING DEPARTMENT
IN
TOWN CLERK'S OFFICE
V o-5 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#: 47807 Date: 5/11/2022
Permission is hereby granted to:
Orsini .».Mark............._._........................_.-.........w.. .____. w—.
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550 W 45thStApt 1807 ww
__w..... ......
New..... 036..........................._ _ www_www._._._. ..........................._ ._...._ _____wwwwww.............................................................................................__.......................................................
To: Install in ground vinyl swimming pool at existing single family dwelling as applied for.
Must maintain minimum 110 feet from edge of pond to pool or Trustee approval will be
required.
Minimum 10 foot setback from property lines to pool and / or pool equipment.
At premises located at:
580 Gin Ln., Southold
SCTM # 473889
Sec/Block/Lot# 88.-3-8.1
Pursuant to application dated 4/12/2022 and approved by the Building Inspector.
To expire on 11/10/2023.
Fees:
SWIMMING POOLS -IN-GROUND WITH FENCE ENCLOSURE $250.00
CO- SWIMMING POOL $50.00
Total: _.__.-.................
.._«........$300.00
Building Inspector
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
Southoldtownny.gov PERMIT NO. sly Check______.._
Septic Form—..........
N.Y.S.D.E.C.
Trustees---
C.O.Application
Flood Permit
Examined 20
Single&Separate
CE V FEE Truss identification Form—....—
Storni-Water Assessment Form—
Approved___.. 20 2 2092 Contact: N
BUILDNG DEPT Mail to:—A)-L,.vN I t
Disapproved a/c kD, a&a
TOWN OF SOUP40
......... ....... Phone:
Expiraliou---............--,20
Building Inspector
APPLICATION FOR BUILDING PERMIT
Date 1. -Z
20
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.
CA---
re f
(Signature or name,if a corporation)
(Mailing address of applicant)
State whether applicant is owner,lessee,agent,architect,engineer,general contractor,electrician,plumber or builder
Name of owner of premises -11 v l C-41-
15-1tI2._w w _w
(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. 57
Plumbers License NO.
Electricians License No.
Other Trade's License No.
1. Location 9f land on whichoposed wok will be don
Ct
House Number Street Hamlet
County Tax Map No. 1000 Section— Block Lot-15-1
subdivision--..------ Filed Map No.- Lot
2. State existing use and occupancy of premiss and intended use and occupancy of proposed construction:
a. Existing use and occupancy
b. Intended use and occupancy,.....AI
3. Nature of work(check which applicable):New Building-__ Addition Alteration
Repair Removal Demolition µ Other Work
4. Estimated Cost '50 qqo Fee
5. If dwelling,number of dwelling units (To be paid on filing this application)
If garage, number of cars of dwelling units on each floor-,.--—.--
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 Z 3 '-X-'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?YES_NO—,\--
13.Will lot be re-graded?YES_NOZ�Will excess fill be removed from premises?YE�NO
14.Names of Owner of premises Z4adc- 05�w: Address5ii o cz- A— _Pi QrNo) -2,'5 L
Name of ArchitectAddressUc, c
Name of Contractor 1-1- X01 Address iik/ye-k_1±—�- Phone No
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.
18.Are there any covenants and restrictions with respect to this property?*YES—NO-
*IF YES,PROVIDE A COPY.
STATE OF NEW YORK)
SS:
COUNTY
0 being duly sworn,deposes and says that(s)he is the applicant
(Name of individual signing contract)above named,
(S)He is the OU-t- L-, -e f,
(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 Girt 20
N-o-taiyVulbric Signature of Applicant
CONSENT TO INSPECTION
JACV C-5 the undersigned,do(es)hereby state:
Owner(s)Name
That the undersi!�tied(is)(are)the owner(s)of the premises in the Town of
Southold,located at
which isd designated on the Suffolk County Tax Map as District 1000,
Section tVBlock !> ,Lot 16�— -
That the undersigned(has)(have)filed,or cause to be filed,an application in the
Southold Town Building Inspector's Office for the following:
y- A
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:
9 (Signature)
(Print Name)
GREGORY PINTO
NOTARY PUBLIC.STATE OF NEW YORK
NO.01-PI6090453 (Signature)
OUALIFIED IN SUFFOLK COUNTY
W COMMISSION EXPIRES APRIL 14, Z 3 (Print Name)
04
CC,VI LA
PA I
Buildinp,I)epartment Application
AUTHORIZATION
(Where the Applicant is not the Owner)
...........-residing at
(Print property owner's name) (Mailing Address)
do hereby authorize
(Agent)
to apply on my behalf to the
Southold Building Department.
(Owner's Signature) (Date)
(Print Owner's Name)
Wnw.uMdY I X .n
Form No.6
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN HAIL
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 electrickl ic)stallatiun from Board of Fire Underwriters.
4. Sworn statement from plutnbt r certifying that the solder used in system contains less than 2/10 of 1%lead.
5. Commercial buildi "industrial building,multiple residences and similar buildings and installations,a certificate
of Code Compliance cdi ffirchitect of dngincer responsible for the building.
6. Submit Planning Board Approval of comp`lete�lasSte 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$50.00,Additions to dwelling$50.00,Alterations to dwelling$50.00,
Swimming pool$50.00,Accessory building$50.00,Additions to accessory building$50.00,Businesses$50.00.
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$15.00
Date.
New Construction: \// VOo^ ( Old or Pre-existing Building: (check one) _
Location of Property: J 6 111 Z, So U-1-"
House No. Street Hamlet
I r w;
.�y!C�)wner or Owners of Property: /�av -5;
Si I iffolk County Tax Map No 1000,Section _ _Block Lot J
Subidivision Filed Map. Lot:
Permit No. _Date of Permit._ µ Applicant:
Health Dept.Approval: Underwriters Approval:
Planning Board Approval:
Request for: Temporary Certificate __......__-.Final Certificate: (check one)
Fee Submitted:$ _
�A ant� lnrature
Jaa ( `
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Suffolk County Department of Labor, Licensing & ;
Consumer Affai
rs
VETERANS MEMORIAL HIGHWAY * HAUPPAUGE, NEW YORK 11788 ;
' ,
' I
DATE ISSUED: 3/1/1977
P , No. 3585-K Ell
SUFFOLK COUNTY
Home Improvement Contractor License Maw,
This is to certify that
Ii fig: �� doing business as T BAR
15WUI\ EIN _ ACT NG CORPMA,
having furnished the requirements set forth in accordance with acid subject to the provisions of a licable laws rules
� •
and regulations of the County of Suffolk" State of New York is hereby licensed to conduct business as a HOME Ica
�
IMPROVEMENT CONTRACTOR, in the County of Suffolk.
i
License Category
0111 U
_ ri-ss Pools/Spas
Suffolk County ept..of x
Labor,Lieens€ng. -Consul or_ ffairs DUNRITE POOLS
�� � WQM�ITNPROVEfulRf�ti'l;1CRNs`E
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irne A
KENNEFti JBARTHMAN �2I�GlGGI�
- tas iiQss:N' a
Commissioner
Bearer is duly.lt wd DUNRITEit4ANOMACTURING CORP-DBA t
)y the County o s ffif�
License Number, - 58
Rosale'Draga Issued: 01/0-1-11977al-
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70M-1�OF SOURHOLD
DUNRITE POOLS, INC,
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S.C.T,M. N0, DISTRICT: 1000 SECTION:88 BLOCK:3 LOT(S):8.1
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BUILDING DEPT
'DOWN OF SOIJTI-tl01-1 b
THE WATER SUPPLY, WELLS DRYWEGLS AND CESSPOOL
LOCATIONS SHOWN ARE FROM FIELD OBSERVATIONS
AND OR DATA OBTAINED FROM OTHERS.
AREA:28,615.65 SQ.FT, or 0.66 ACRES ELEVA77ON DATUM: -------------------------
UNAUTHORIZED ALTERATION OR ADD177ON TO THIS SURVEY IS A VIOLATION OF SECTION 7209 OF THE NEW YORK STATE EDUCATION LAW. COPIES OF THIS SURVEY
MAP NOT BEARING THE LAND SURVEYOR'S EMBOSSED SEAL SHALL NOT BE CONSIDERED TO BE A VALID TRUE COPY. GUARANTEES INDICATED HEREON SHALL RUN
ONLY TO THE PERSON FOR WHOM THE SURVEY IS PREPARED AND ON HIS BEHALF TO THE TITLE COMPANY, GOVERNMENTAL AGENCY AND LENDING INSTITUTION
LISTED HEREON, AND TO THE ASSIGNEES OF THE LENDING INSTITUTION, GUARANTEES ARE NOT TRANSFERABLE:
THE OFFSETS OR DIMENSIONS SHOWN HEREON FROM THE PROPERTY LINES TO THE STRUCTURES ARE FOR A SPECIFIC PURPOSE AND USE THEREFORE THEY ARE
NOT INTENDED TO MONUMENr THE PROPERTY LINES OR TO GUIDE THE ERECTION OFFENCES ADDITIONAL STRUCTURES OR AND OTHER IMPROVEMENTS, EASEMENTS
AND/OR SUBSURFACE STRUCTURES RECORDED OR UNRECORDED ARE NOT GUARANTEED UNLESS PHYSICALLY EVIDENT ON THE PREMISES AT THE TIME OF SURVEY
SURVEY OF: P/0 LOT 2 & LOT 3 INCL. CERTIFIED T0:ARTHUR 0. WELLS;
MAP OF:BAY HAVEN ROSE M. WELLS;
FILED:JAN. 22, 1959 No.2910 FIDELITY NATIONAL TITLE INSURANCE
SITUATED AT:SOUTHOLDSERVICES, LLC;
TOWN OF:SOUTHOLD - KENNE"TH_M WOYCHUK LAND SURVEYING, PLLC
SUFFOLK COUNTY, NEW YORK Professional Lend Surveying and Design
A 41vr P.O. Box 153 Aquebogue, New York 11931
FILE p 16-69-1 SCALE:1"=40' DATE:JUNE 5. 2016 LL ___w PHONE(831)298-1588 FAX (831) 298-1588