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Home My WebLink About15942-zFORM NO. 4 TOWN OF 5OUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. Certificate Of Occupancy No. ZZI6~p6 Date January 7 , I 988 THIS CERTIFIES that the braiding . Co. nstruct. ORe .F. am.i.l.y..Dw.e, ll. in~ wz. th .a. tt. ache. d ~a. rage tocatlon of Property . I800 Country Club Drtve Cutchogue, New York House 'IVo ....... '8't~e~f ................ ~lamlet County Tax Map No I000 Section 109 .. Block 3 .Lot 2. l 8 Subdivision ~/o Country Club Estates .Fried Map No 6736 . .Lot No. 17 conforms substantially to the Application for Building Permit heretofore filed in this office dated .A.prxl 17, 1987 pursuant to wtuch Bmlding Permit No 15942 g dated Ap.r 5. 1 2.8: I 9.87 ..... was issued, and conforms to all of the requirements of the applicable prowsions of the law Tile occupancy for whsch flus certificate is issued is ..... ONE FAMILY DWELLING WITH ATTACHED GARAGE The certificate is issued to ROBERT & NANCY BERTORELLO of the aforesaid buridmg Suffolk County Department of Health Approval UNDERWRITERS CERTIFICATE NO ......... PLUMBERS CERTIF'ICATION DATED: 86-S0-222 PENDING - I2/I0/87 BERTSAND PLUMBING & HEATING - 11/30/87 Building Inspector Rev 1/81 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) Permission is hereby granted to: ~-' --~ . ..~..~.~. ~...../...~...~~... , ...~.?..~...!..,.~.,~'t..J ............................................ , ......'r:q.~.~,.....~.....v.,.....c.,r.~.~'...~ ..... , ~ ,o at premises located at ..TL.~..o~. .......... ~ .......... A~ _ County Tax Map No 1000 Sect,on .... L..°o.e:] ....... Block ......~....~ ........ Lot No......~.., I...~' ...... pursuant to application, dated .,~......,L.'~ ............... , 10.~...7.., and opproved by the Building Inspector. Fee $. ~/...~...~....~..*..~..~). Building Inspector Rev 6/30/80 FORM NO 6 TOWN OF SOUTHOLD Building Department Town Hall Southold, N.Y. 11971 765- 1802 APPLICATION FOR CERTIFICATE OF OCCUPANCY A instructions Th~s apphcat~on must be hlled in typewmter OR ink, and submitted m IIm, l,a,~ to the Budding Inspec- tor w~th the following, for new buddings or new use: 1 F~nal survey of property w~th accurate location of all buddings, property hnes, streets, and unusual natural or topographic features 2. F~nal approval of Health Dept, of water supply and sewerage disposal-(S-9 form or equal) 3 Approval of electmcal mstailaUon from Board of F~re Underwmters. 4 Commercial buddings, Industrml buildings, Multiple Residences and similar buddings and installa- tions, a certificate of Code comphance from the ArcMtect or Engineer responmble for the budding. 5 Submit Planning Board approval of completed s~te plan requirements where apphcable. For exmting buildings (pmor to Aprd 1957), Non-conforming uses, or buddings and "pre-exmtmg" land uses' 1. Accurate survey of property showing ail property hnes, streets, buddings and unusual natural or topographic features. 2.Sworn statement of owner or prewous owner as to use, occupancy and condition of buildings 3 Date of any housing code or safety mspecnon of buddings or premmes, or other pertinent mforma- t~on required to prep,are a certificate. Fees. ^ddzt~ons $25.00 ?OOLS $25.00 1.CerhflcateofoccupancV Nee Dwellzng $25.00, Accessory ,$]0.00 Business $50.00 2 Certificate of occupa'ncy on pre-ex.sUng dwelhng $ 50.00 3. Copy of cert~f~cate of occupancy $ 5 00, over 5 years 510 00 4.Vacant Land C~O. $ 20.00 5.Updated C.O. $ 50.00 Date J t,~,l)~ ........ NewConstructton , ,, Old or Pre-existing Budding .... Vacant Land .......... House No Street OwnerorOwnersofProperty'~Of~Li ~ k.~t~3~ County Tax Map No. 1000Section Io~.~o ,... Block .~...~?. .... Lot Subdwm~on ~ ¢gM~* Q ~ ~$T~-~$ , . .Lot No . ,~ ...... FfledMapNo ~-.~.. Perm,t NO~.~c~ ¥~ Health Dept Approval . Underwriters Approval Request for Temporary Certificate Date of Permit ......... ~. ............... ........ Labor Dept Approval .................. ..... Planning Board Approval .............. . , Final Certificate ............. Fee Subrmtted $ ... ConstrucUon on above described budding and permit meets all applicable codes and regulations App,,cant. ..................... Rev 10 10-78 Co TOWN OF SOIJTltOI.,D OFFICE OF BUILDING INSPECTOR P O. BOX 728 TOWN HALL SOUTHOLD, N.Y. 11971 TEL. 765-1802 CERTIFICATION Date Building Permit No. (pleas~ pri~) (please print) I certify that the solder used in the water supply system contains less th~n 2/10 of 1% lead. Sworn to before me th~s .~0~ da~ of ~~_~ , 19 E7 Notary Public, '~ ~=,< County Notary Publzc OUNDATION OUNDATION (2nd) OUGH FRAME & PLUMBING :;SULATION PER N. Y. STATE ENERGY CODE FINAL ADDITIONAL COMME~:TS: THE NEW YORK BOARD OF FIRE UNDERWRITERS BUREAU OF ELECTRICITY 85 JOHN STREET, NEW YORK, NEW YORK 10038 bob & ~anc7 ~rto~ello, W/~ 18~0 Cou~t~ ~lub Drive, Cutc~o~, ~.Y in the following hwat,on, [] Basement [] let FI was exummed on December 10, ]987 MUlTI-OUTLET~DIMMERS FIXTURE FIXTURES !l I LOS [13 108 DRYERS FURNACE MOTORS FUTURE APmA.CE r~E~)RRS .~RVICE DISCONNECT S E R OTHSR APPARATUS Motors. 2-1 Jacuzzi Pmnelboer~s: 1- 29c£r. 150amps 1-Smok~ Detector b Alarm System, ~-6~ ~team ~it, NO OF CC COND A W G PER ~'~ OF CC COb~D 1/0 C NO OF HI LEG AWG OF HI {EG E 2 1-5 Ton A/C Units, 1-2% Ton A/C Unit Cell Electrical Lighting Inc. 211Riverhead Road Westhamp~on Beach~ N.Y. 11978 Lic. 1022E Thru certd:~¢ate must not be altered m any manner, return to the offsce of the Board ~f incorrect Inspectors may be ~dent,f~ed by their credenhals COPY FOR BUtLDING DEPARTMEHT THIS COPY OF CERTIFICATE MUST NOT BE ALTERED IN ANY MANNER 765-1802 BUILDING DEPT. INSPECTION FOUNDATION 1ST [ ] ROUGH PLBG. [¢~UNDATION 2ND [ ] INSULATION { ] FRAMING FINAL REMARKS: 765-1802 BUILDING DEPT. INSPECTION FOUNDATION 1ST FOUNDATION FRAMING [ ] ROUGH PLBG. 2ND [ ] INSULATION £ ] FINAL REMARKS: ,NSP£CTO~~ .'/~ 765-1802 BUILDING DEPT. INSPECTION [ F~OUNDATION 1ST [ ] ROUGH PLBG. FOUNDATION 2ND[ ]INSULATION FRAMING [] FINAL DATE 765-180Z BUILDING DEPT. INSPECTION FOUNDATION 1ST [ ]ROUGH PLBG. FOUNDATION 2ND [ ]INSULATION FRAMING [ ]FINAL DATE 7GS.'1802 BUILDING DEPT. INSPECTION [ ] FRAMING REMARKS: FOUNDATION SST [ ] ROUGH PLBG. FOUNDATION ;ZND [ ] INSULATION [ ] FINAL 765-1802 BUILDING DEPT. INSPECTION FOUNDATION 1ST [~RROUGH PLBG. FOUNDATION 2ND [ ] INSULATION [~I=~MING [ ] FINAL REMARKS: INSPECTOR ~T,,.O2' > [OUTHOLD Avprove~ . ~ ~. , 19~]. Pe~,t No. 1 ~a ~ Disapproved a/c .................... ............ , ............. (Budding Inspector) APPLICATIO~ FOB BUILDING PEB~IT 'FORM NO 1 TOWN OF SOUTHOLD UILDING DEPARTMENT TOWN HALL BOUTHOLD, N Y. 11971 TEL.. 765-1802 3 sera o F s SURVEY. CHECK ..... ~. SEPTIC FORM ..~,~,. ....... : CALL MAIL TO: Date A.prxl 9.,. 1.9.8.7. ,19. INSTRUCTIONS a. Tins application must be completely filled m by typewriter or in ink and submitted to the Buddmg Inspector, wit sets of plans, accurate plot plan to scale Fee according to schedule b. Plot plan showmg location of lot and of bmldings on premises, relationship to adjommg premises or pubhc str~ or areas, and glvmg a detaded descnphon of layout of property must be drawn on the diagram which is part of this ay cation. c The work covered by tins apphcat~on may not be commenced before issuance of Buddmg Permit d. Upon approval of this apphcat]on, the Building Inspector wall issued a Buddmg Permit to the apphcant Such pet shall be kept on the premises available for aspect]on throughout the work e. No buddmg shall be occupied or used m whole or in part for any purpose whatever unt~l a Certificate of Occupa shall have been granted by the Bmldmg Inspector APPLICATION IS HEREBy MADE to the Building Department for the issuance of a Budding Permit pursuant to Building Zone Ordinance of the Town of Southold, Suffolk County, New York, and other applicable Laws, Ordmance Regulations, for the construction of bmldmgs, additions or alterations, or for removal or demolition, as herein descnl The applicant agrees to comply with all applicable laws, ordmances.~ buddmg code, housmg code, and regulations, an, admit authorized inspectors on premises and m bufldmg for necessar~J/inspectio, rr~ / ..------z-. . x ............. (Signal/ute of applicant, or name, if a corporation) P.O...I30.X..1.451t..Ma. ttzt. uc.k 11952 (Marling address of applicant) State whether applicant is owner, lessee, agent, architect, eno~neer, general contractor, electrician, plumber or bml, Owner, 9e.n.era. 1 .coD..traqt. o.r ............. Name of owner of premises R..OBERT..& N.A..N.CY .B.ERTORELLO ................. (as on the tax roll or latest deed) If apphcant is a corporatmn, signature of duly authorized officer (Name and title of corporate officer) ALL CONTRACTOR'S MgST BE SUFFOLK COUNTY LICENSED - ~' ltfil~a6P~'Li~i{~ ,"%7 .......... ~ ~-~'-~ -~'~' ............................................. Plumber's License No .i1 ~1~77 .... Electnman's L~cense No .... Other Trade's License No ...... 1 Location of land on which proposed work will be done. 17oo ~ COUNTRY CLU~. ~QgIVE House Number Street 109.00 County Tax Map No 1000 Section . Block Subdivision Country Club Estates. . FdedMapNo 6736 (Name) 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction a Existmg use and occupancy vacant. .land. construct b Intended use and occupancy CUTCHOGUM . . llamlet 03.00 . Lot 002.018 Lot 17 2 story frame dwelling, swimming pool, hot 3. Nature of work (check which applicable) New Building . :~:X Addition ..... Alteration .. Repair ....... Removal ...... Demohtlon .... Other Work .......... 4~ (Description) 4 Estimated Cost. t ~O, b.o0 ,..: ............... Fee . .~ fi~:["~./,o., ~ O ................... (to be paid on fihng this apphcabon) 5. If dwelling, number of dwelhng,umts . i. .... Number of dwethng units on each floor ..... If garage, nmnber of cars . 3 6 If business, commercial or mxxed occupancy, specify nature and extent of each type of use ........... 7 D~menslons of existing structures, if any Front Rear ............ Depth ....... Height .. Number of Stories ............................ Dm~enslons of same structure with alterations or addmons Front ............... Rear ............ Depth ......... Height .......... Number of Stones .......... 8. Dunensmns of entire new constructmn Front Rear .......... Depth ...... Height ........ Number of Stones ~ ' 401' 487' 1-Jonth 33Q' 9 Slzeoflot Front ~i)t:... 3,: 19~6 .... Rear ................ ,- .................. 10 Date of Purchase ................ Name of Former Owner . .Gu.n.~.er..lVlo..rc.h.e. 1 ....... 11. Zone or use district m--wtuch-pr~rms*s a~e situated.; ---....-= ................................ 12. Does proposed construction wolate any zo, nmg law, ordinance or regulation . 13. Will lot be regraded ~o. .......... .,~L~. ......... Will excess fill be removed from, p. rremises: Yes (_N~ - Name of Architect .O'.a.me.$ D.e,Luc.c.a. .... Addressl.2 .L;t.n. da.. :hA., t!]~qtl)l{<6~q~(~...727.-1.6,'L1 ... Name of Contractor ~ Address Phone No. 15. Is this property located w~_thin 300 feet ot5 a tidal wetland.9 *Yes ..... No ..... *If yes, Southold Town Trustees Permit maybe required. PLOW DI AG P.u~.M Locate clearly and distinctly ail, bu~!dmgs, whether existing or proposed, and indicate all set-back dimensions from oroperty hnes Give street and block number or descnption according to deed, and show street names and indicate whether ,ntenor or corner lot 3TATE OF NEW YORK, S S ..... ?.9 ,b e. r J..~.~. ,e 7.~. ,?.4' ~.~_ ~. ........... being duly sworn, deposes and says that he is the applicant (Name of md~wdual signing contract) xbove named te is the . . ~.C ~L ~c~, c.g o r- (Contractor, agent, corporate officer, etc.) )f said owner or owners, and is duly authorized to perform or have performed the said work and to make and file this tppllcation, that all statements contained m this apphcation are true to the best of his knowledge and belief, and that the york will be performed in the manne~' set forth m the apphcation filed therewith. 3worn to before me this ...... //<.fa ..... dayof... ~/~..' ...... 19~'?. qotary Public, . ....... {~ . .,..~ ............ 10-87-0104 FAC~LITYIPROGRAM NUMRE R(s) t~/A PERMIT Unde~ Ihe Enwronmental Conse~vahon Law 4/7/87 ~/50/92 Article 15, T~t[e 3, 6NYCRR 327, 328, 329 Aquabc Peslm~des Article 15, T~tle 5 Protechoe 0~ Water Article 15, Title 15 Water Supply Article 15, T}tle 15 Water Transport -- Article 15, T~tle 15 __ Long Isiand Wells ~-~ Article 15, T~tle 27 Wdd, Scenic and Recreational R~vers ~"~ 6NYCRR 608 Water Ouahty Certdmatmn F-~'~ Amcle 17, T~tles 7, 8 SPOES [~--] Artmle 19 A~r Pollutmn Control* [---~ Arhcle 23, Title 27' Mined Land Reclamation ~-'~ Article 24 Freshwater Wetlands N--New, R--Renewal, M--Modffmatmn, C-Construct (*only), O-Operate (*only) Article 25 N T~dal Wetlands Arhcle 27, Title 7, 6NYCRR 360 Sol~d Waste Management* -- Article 27, T~tle 9, 6NYCRR 373 __ Hazardous Waste Management Article 34' Coastal Erosmn Management Article 36, Floodplain Management Articles 1, 3, 17, 19, 27, 37, 6NYCRR 380 Radmt~on Control Robert J. Bertorello _9_.25 Theresa Dr., I~atti~:uck, NY 11952 Downs Creek Cutchogue ~ Suffolk DLSCRIPTION OF AUTHORIZED ACTIVITY TELEPHONE NUMBER Southqld Constznict a sinmle family dwellinm, swimminE ~ool. docks, hot tub. sanftarv system and driveway. Ail work shall be in conformance with the NYSDEC aomroved plan attached. GENERAL CONDITIONS By acceptance ot th~s permit, the perm~ttee asree~ that the permat is conhnGent upon strict compb- ance w,th the ECL, ail applicable regulations and the cond~tmns specdled hereto or attached hereto Any m~,f,cat~on o~ Ih~s ~rm,t 8rant~ ,~y ?~.O~rt~e~t_~u~ ~ ~n writing and at~ached hereto 4/7/87 A~fred T. Kellar Bldg. 40 S~ ~. 219 Stony Brook~ ~ 117 4 cc: C.T. Hamilton New York State Department of Environmental Conservation NOTICE The Department of Environmental Conservation (DEC) has issued permit(s) pursuant to the Environmental Conservation Law for work being conducted on this site. For further informa- tion regarding the nature and extent of work approved and any Departmental conditions on it, contact the Regional Permit Administrator listed below. Please refer to the permit number shown when contacting the DEC. Permit No. ~ Expiration Date 95-20-1 (11~2) NOTE: This notice is not a permit -Regk~na,' Permit Administrator- ADDITIONAL GENERAL CONDITIONS FOR ARTICLES 15 (T~tle 5), 24, 25, 34, 36 and 6 NYCRR Part 608 ( 10,oTh~t ~f'juture operabons by the State oi New York require an al ~t shall cause unreasonable obstruction to the free nav~aat*on of sa~d the people of the State, or cause Io~,~ or destruction of the natural thereby w~thout expense to the State. and if. upon the expiration or pleted, the owners, shall w~thout expense to the State, and to such other enwronmenta[lv deleter~ou~ matema[s assoc*ated wath the proiect Any mater~al dredged m the prosecution of the work heres perm*tted shall be removed evenly, w~thout leawng large refuse pdes, r~dges across the bed of a waterway or floodplam or deep holes that may have a tendency to cause damage to nawgable channels or ~.o the banks of a waterway There shall be no unreasonable interference with navigation by the work to ~ts former condmon No clmm shall be made against :he State of that the prolect will be free from f[oodmg If granted under b NYCRR Part ~O&, the NY$ Department of Environ mental Conservation hereby certd~es that the sublect prolect w~ll not Sections 301,302, 303, 306 and 307 of the Clean Water Act of 1977 (PL 95 217J provided that all of the condmons hsted heres are met All act~vmes authorized by thru permit rnusl be ~n stmct conformance w~th the approved plans submitted by the apphcant or h~s agent as part Such approved plans were prepared by SPECIAL CONDITIONS Sanitary system must be located a minimum of 2' above seasonally high ground water and between the h~use and the road. T~ere shall be no disturbance to naturally o~curing vegetation or topography from a point 105' w/o the proposed pool and running west to the tidal wetland. Excavated materlalmay be used to raise existing grade around house only and not placed anywhere else on property. Any additional fill or construction of decks, etc. will require additional NYSDEC approval. Supplementary Special Conditions (A) through (J) attached 10-87-0104 PROGRAM/FACILITY NUMBER J N/A , Page 2 of ~ ' LINTY DEPARTMENT OF HEALTH SERVICES "rPROVAL DE CONSTRUCTION ONLY cqNrb-' CUr ~EYORS 5 1--7~5 -5020 BOX 909 N ROAD JTHOLD , N Y 11971 ,N Y S LIC MARSH AREA ~ 89'39'40"E 195 O0 ' 75' LOT. F'ROF~O~ ~o~ S, 82° 53'40"W' N/O/F NO 49668 ENGINEERS, P C NORTH LOT 18 EASEMENT 25 O0 CLly8 DR. 40/ 53' a.s~ FOR K 406 63' Prepared h accordance wit~ he minlmu ~0 T I 6 m aards for tit e supers os estabhshed by the t; A L S c ~ ~u~o~ed and adopted for ~ch ~ a c~ ~ ' ~-~ ~cr~ ~ta'o Land 487 25 · & ~,,~x~ ~4~:~lIti' CERTIFIED TO CHICAGO TITLE INSURANCE COMPANY ROBERT J. BERTORELLO NANCY J BERTORELLO ~.= 4~O~ AREA = 145 , 161 SC). FT OR 3. 33 ACRES L SURVEY OF LOT' 17 MAP OF' COUNTRY CLUB ESTATES FILED OCT 17,f978 FILE NO. 6736 AT CUTCHOGUE TOWN OF SOUTHOLD SUFFOLK COUNTY, N.Y. I000 109 - 03 2 lB SCALE I "= I00' JULY 14, 1986 PO B /V/AIN RO SOUTHOLD , Prepared in accordance with the m|mmum standards for tille su~eys as estabhshed by the L I A. LS. and approved and adopte= for such use by The New York State Land Tdle Association. M A R S H SUFFOLK COUN~ The sew3 o[her Chief ~If Bureau N Y 11971 AREA LOT .lNG ONLY NO ;upply facd~tms for this Management S LIC NO. 49668 ENGINEERS , P C EASEl LOT 18 40f 53' 467 25' .,-~.,v "~ C LU B, FORK C OUh"~ n' CERTIFI ED TO CHICAGO TITLE INSURANCE COMPANY ROBERT J. BERTORELLO NANCY J. BERTORELLO NORTH FORK BANK ~ TRUST CO. ~,AREA = 145,161 OR $. :53 °% oo: 25 O0 SQ FT ACRES SURVEY OF LOT 17 ' MAP OF COUNTRY CLUB ESTATES " F/LED 'OCT. 17,1978 FILE NO 6736 ,AT CUTCHOGUE TOWN OF SOUTHOLD SUFFOLK COUNTY, N.Y. I*OOO - IO9 O3 2 18 SCALE I"= I00' ,JULY 14,19~6 MAY 14~ 1987 NOV 2~it987[FINAL} 86 - 376 CC t'~3TFL'CT,C N CNLY ~0 SINGLE F,~MILY DW~LuL:O R=~60 oo: ~.= 25 O0 MARSH AREA I LOT S 89°39'40"E The wcler supply & sewage disposal sys- lem$ for Ibis residence w,ll conform to the stan<~ds of.,~,~yffolk Cj~unty Depart- g ro ~ 03 Pre ar~ in accord~n ~'- -~ 8z° 53'4o w, SURVEY 0F for suc~ use by T~e New York State Land, ~ ~ O~ L~CA FILED OCT. 1?,1978 FILE NO. 6736 ~~~ cmcAso T~TL~ mSU~C~ COM~A~ TOW g ~UU U //.f~"-~e~?~X~ v ~ , ,~ ....... ~oe~T J BE~TOR~LLO SUFFOLK COUNTY, N.Y. PEJF~N/~EY~J~ a ENGINEERS, P C SCALE I"= I00' ~ 0''~ ~ 909 /-+# · JULY 14, 1986 Mfll~~u~ ' OR 3 33 ACRES 86 - 376 R=I60 00' BLDG DFPT TOWN OF SOU £HOLD 0 S MARSH AREA I LOT 18 S 89°39'40"E 195 O0 ' o O 75' 8~ 53'40 N/O/F EASEMENT 4ol 53' ~"'~ 0 53,37' ' ~OT ,7~~~~~ ~6 487 :>5 NORTH FoRK C oUl%~r~ y ' cLUB, oo' OLUO DR. SURVEY OF LOT 17 AT CUTCHOGUE NYS )RS NO. 49668 ENGINEERS , P C CERTIFIED TO CHICAGO TITLE INSURANCE COMPANY ROBERT d BERTORELLO NANCY d BERTORELLO )20 prepared in om:::ordan,'~ wfth Ihe mlnimmm dandarcb for title marve,~ m established by A R E A = 14.5 , 161 SO FT TOWN OF SOUTHOLD SUFFOLK COUNTY, N.Y. fO00 109 05 2 18 SCALE I" = I00' JULY 14, 1986 MAY 14~ I.,°87 the LI.A. LS. and approval and adopted OR 3 33 ACRES N Y 11971 {-or *uch u~e by The N, ew York State Lano T~tle As~ciation. 86 - 376 OCCUPANcy OR USE IS UNLAWFUL WITHOUT CERTIFICATE OF OCCUPANCY SOl. DER USED IN WA rER SUPPLY ~I~?EM CANNOt EXCEED 2/I0 of I% rEAD. pz u ae~a cE, riFic, q rio~v : ,:ON/~.EAD CONTENT BEFORE ICERT'IFICAT'E OF OCCuPA/VCY I I I II I I i vF-.~'r To r~ - X N ~4 5~ cT ~s4 ] ..... 1 tO'-G # ,/ I I I I J REAR EI. EV, I FRONT IE,LEV, II · I I I Jr ti -~1- t SIDE EI-EV, ELEV, ?. x-~o R ~' iF.,," o.(-. ~ > SECTION A-A r