HomeMy WebLinkAbout47746-Z �TSUFFOLk�
Town of Southold 12/6/2022
P.O.Box 1179
o _ 53095 Main Rd
1'✓�j o�+aSouthold,New York 11971
CERTIFICATE OF OCCUPANCY
No: 43658 Date: 12/6/2022
THIS CERTIFIES that the building IN GROUND POOL
Location of Property: 850 E. Gillette Dr., East Marion
SCTM#: 473889 Sec/Block/Lot: 38.-3-9.3
Subdivision: Filed Map No. Lot No.
conforms substantially to the Application for Building Permit heretofore filed in this office dated
3/24/2022 pursuant to which Building Permit No. 47746 dated 4/27/2022
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 Tsatsos Theodora Liv Trt
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL
ELECTRICAL CERTIFICATE NO. 47746 8/29/2022
PLUMBERS CERTIFICATION DATED
\4�v� \4,
Autri d S' tore
o�SUEFe��co TOWN OF SOUTHOLD
oy BUILDING DEPARTMENT
C* z TOWN CLERK'S OFFICE
SOUTHOLD, NY
�Ol ao�'S
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#: 47746 Date: 4/27/2022
Permission is hereby granted to:
Tsatsos Theodora Liv Trt
6331 W Estes Ave
Chicago, IL 60646
To: construct accessory in-ground swimming pool as applied for.
At premises located at:
-*W Gillette Dr., East Marion AdjkAt,QA J-t3—
SCTM #473889
Sec/Block/Lot# 38.-3-9.3
Pursuant to application dated 3/24/2022 and approved by the Building Inspector.
To expire on 1012712023.
Fees:
SWIMMING POOLS -IN-GROUND WITH FENCE ENCLOSURE $250.00
CO- SWIMMING POOL $50.00
Total: $300.00
Building Inspector
pF SOUjyol
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Town Hall Annex Telephone(631)765-1802
54375 Main Road
P.O.Box 1179 �Q roger.riche rta-town.south old.ny.us
Southold,NY 11971-0959 Q�yCOUN'i`1,��
BUILDING DEPARTMENT
TOWN OF SOUTHOLD
CERTIFICATE OF ELECTRICIAL COMPLIANCE
SITE LOCATION
Issued To: Theodora Tsatsos Lic Trt
Address: 850 E Gillette Dr City: East Marion St: New York Zip: 11939
Building Permit#: 47746 Section: 3$ Block: 3 Lot: 9.3
WAS EXAMINED AND FOUND TO BE IN COMPLIANCE WITH THE NATIONAL ELECTRIC CODE
Contractor: homeowner DBA: License No:
SITE DETAILS
Office Use Only
Residential X Indoor Basement Service Only
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 HID Fixtures
Service 3 ph Hot Water GFCI Recpt Wall Fixtures Smoke Detectors
Main Panel A/C Condenser Single Recpt Recessed Fixtures CO Detectors
Sub Panel 1 A/C Blower Range Recpt Fluorescent Fixture Pumps
Transformer Appliances Dryer Recpt Emergency FixturesTime Clocks
Disconnect Switches Twist Lock Exit Fixtures TVSS
Other Equipment: In ground swimming pool to include, bonding, gas pool heater, salt generator,
1-pool filter pump,4-GFCI circuit breakers, low voltage pool lights.
Notes:
Inspector Signature: Date: August 29 2022
81-Cert Electrical Compliance FormAs
*oe souryolo
# TOWN OF SOUTHOLD BUILDING DEPT.
cou631-765-1802
INSPECTION
[ ] FOUNDATION 1ST [ ] ROUGH PLBG.
[ ] FOUNDATION 2ND [ ] ULATIO CAULKING
[ ] FRAMING /STRAPPING [ I FINAL
[ ] FIREPLACE & CHIMNEY [ ] FIRE SAFETY INSPECTION
[ ] FIRE-RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRATION
[ ] ELECTRICAL (ROUGH) [ ] ELECTRICAL (FINAL)
[ ] CODE VIOLATION [ ] PRE C/O [ ] RENTAL
REMARKS:
DATE ► 60,2e,- INSPECTOR
FIELD INSPECTION REPORT DATE COMMENTS ,
--C
FOUNDATION(1ST) G� y
------------------------------------
FOUNDATION (2ND) �?
00
LA O CA
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W
ROUGH FRAMING& G p y
PLUMBING
INSULATION PER N.Y. y
STATE ENERGY CODE
(y 'y
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FINAL
ADDITIONAL COMMENTS
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BUILDING DEPARTMENT- Electrical Inspector
TOWN OF SOUTHOLD
AUG 2." 202-ow I Annex - 54375 Main Road - PO Box 11.79
w �. BUiLLAvu utpi Southold, New York 1197.1-0959
Towry OF souTMOL-,elephone (631) 765-1802 - FAX (631) 765-9502
rogerro(�southoldtownny.gov - sea nd(a.southoldtownny.gov-
APPLICATION FOR ELECTRICAL INSPECTION
ELECTRICIAN INFOMATION (All Information Required) Date:
Company Name: �.�ocI,�
Electrician's Name:
License No.: Elec. email:
Elec. Phone No: ❑1 request an email copy of Certificate of Compliance
Elec. Address.:
JOB SITE INFORMATION (All Information'Required)
Name: Co
Address: CIZ-cer7e P,L
Cross Street:
Phone No.:
Bldg.Permit#: 1/ -7 7 `f,6 email:
Tax Map District: 1000 Section: -3Y Block: 3 Lot: q, 3
BRIEF DESCRIPTION,OF WORK, INCLUDE SQUARE FOOTAGE (Please Print Clearly):
Square Footage:
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 1-11 PhF—]3 Ph Size: A # Meters Old Meter#
❑New Service❑Fire Reconnect[]Flood Reconnect❑Service Reconnect❑Underground❑Overhead
# Underground Laterals 1 2 F1 H Frame Pole Work done on Service? Y FIN
Additional Information:
PAYMENT DUE WITH APPLICATION ���
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��o�og�FFDtK�oGy` TOWN OF SOUTHOLD—BUILDING DEPARTMENT
y z Town Hall Annex 54375 Main Road P. O. Box 1179 Southold,NY 11971-0959
Telephone(631) 765-1802 Fax(631) 765-9502 https://www.southoldtownny.gov
Date Received
APPLICATION FOR BUILDING PERMIT
For Office Use Only ® C E W
�6PERMIT NO.JL1Building Inspector: MAR 2 4 2022
Applications and forms_must be filled-out,in their entirety._,incomplete• .. :. BUILDING DEPT.
applications will noi,be�accepted.. Where'the Applicant is not the owner,an TOWN OF SOUTHOLD
Owner's Authorization form-(Page 2)shall be completed.
Date: ��y/aa
OWNER(S),OF°PROPERTY:
Name: �Q�,01Z�,-_ � Q� SCTM#1000- _ -.�._.-_./__•
,..Project Address: Gil -_: --�- -_-_-_-•-_.�:- ------ =-_--__-- _-
Phone#: 3j��cU��_S/"7� Email:
Mailing Address:
CONTACT PERSON:
Name:�"COTT / D .
Mailing Address: 4�
Phone#: Email:
sca
DESIGN PROFESSIONAL INFORMATION
Name:
Mailing Address:
Phone#: Email:
CONTRACTOR INFORMATION:°
Name:
Mailing Address: /,VV
Phone#: �6�� Email:, '`�/���y�/�
DESCRIPTION OF.PROPOSED CONSTRUCTION =
❑New Structure ❑Addition ❑Alteration ❑Repair ❑Demolition Estimated Cost of Project:
Other POO f_- $
Will the lot be re-graded? ❑Yes*Alo Will excess fill be removed from premises? ❑Yes {Vo
1
PROPERTY'INFORMATION .
Existing use of property: Co
Intended use of property: A f
Zone or use district in which premises is situated: Are there any covenants and restrictions with respect to
this property? ❑Yes NNo IF YES, PROVIDE A COPY.
Check Box After Reading: The owner/contractor/design professional is responsible for all drainage and storm water issues as provided by
Chapter 2t&of the.TownCode. APPLICATION IS.HEREBY.MADE to the Building Department for the issuance ofa 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,alterations orlor.removal,or demolition:as herein described.The applicant agrees to comply with,all appl,icable.laws„ordinances,building code;`,
housing code and regulations and to-admit authorized inspectors on premises and in building(s)for necessary'inspgctions.false statements made herein are
punishable as a Class.A-misdemeanor,pursuant to Section,210A5 of the New,York State Penal Law:;,'
Application Submitted By(pri name): Authorized Agent ❑Owner
Signature of Applicant: Date:
STATE OF NEW YORK)
SS:
COUNTY OF SU4 )
SOS 9 being duly sworn, deposes and says that(s)he is the applicant
(Name of individual signing contract)above named,
(S)he is the C A17-1Z4C7_,Q1r
(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/her knowledge and belief; and
that the work will be performed in the manner set forth in the application file therewith.
Sworn before me this
'WnMarch
lay ay of .20 2%Zq11dX1U /9 1 TIt A JAA
-
Notary Public
TRACEY L. DWYER
NOTARY PUBLIC,STATE OF NEW YORK
6900
PROPERTY OWNER AUTHORIZATION IED IN SUFFOLK
QUALIFIED IN SUFFOLK COUNTY
(Where the applicant is not the owner) COMMISSION EXPIRES JUNE 30,20”
I, residing at
do hereby authorize to apply on
my behalf to the Town of Southold Building Department for approval as described herein.
Owner's Signature Date
Print Owner's Name
2
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DWELLING
:T: 1000 SECTION: 38BLOCK: 3 LOT(S): 9.3 W/PUBLIC WATER I r.
•I 00'
VACANT I
100'
EL 19.6 5 64051 r 10'r W149 ,3 c5 r EL 18.0 EL 16.3
EL 18.4 i
-o
SILT FENCE '-� '
DRYS
Z WELL/ I
z
U, PROPOSED DRIVEWAY
� o
o CONCRETE WASH our AREA
(O
ZR
IN BED OF PROPOSED DRIVEWAY.
— EL 17.8 � I
p Iv
DRY WELL DRYS} %10'MIN
8'DIAx4'DEEP \ WELL/ 5 w d
tq _ MIN. O
66.1' �
r� (18.5) M IO
TI I
10
GARAGE ::;: z
CD ;.: GF(19.0):;: QO z Cri
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D ~ OUT rrl I~
4 BEDROOM SYSTEM �
m : PROPOS D :. :::;:;::;: 1250 GAL S.T. Z
y�` :'12 STY M: :::: . :;'. (1)10'DIAxIO'DEEP L.P. u-, —I
Fri : :.DWELLIN (A z
BEDR OMS .,,:::•:oLd
PROPOSED SOIL : FFL 21. I
STOCK PILE AREA ( N :.;.;::: ( ): : '.,:'::';:.:':" -
L_Lj IT PROP. WATER LINE 4
p OF CLEARING & :360';.';::.: (17.5) p
DISTURBANCE (17.5) . 37.4' _p I
O 14,200 S.F. DRY WELL p
SILT FENCE W WINDOW (/DRY } 8'DIAx4'DEEP P
-WELL WELL
EL 14.
EL 14.5 EL 15.8 S 6405 Ir rr10 W 1511 .93' EL 16.2 I
DWELLINGS 411
r I W/PUBLIC WATER �`
25' TOTAL 150' ELEV. 1
Z OL DR BR(
i, DRYWELLS AND CESSPOOL ANDY l
OM FIELD OBSERVA70NSBONROM OTHERS MIDLAND
PLACE
Sm S .
or 0.35 ACRES ELEVATION DATUM: NAVD88 SANT
TYPICAL CLEAN OUT eRo�n
ADDl710N TO THIS SURVEY IS A UlOLA7/ON OF SEC770N 7209 OF THE NEWYORK STATE EDUCATION LAVY. COPIES_OF THIS SURREY
O
APPROVED AS NOTED
DATE: a P.#
FEE: BY: RETAIN STORM WATER RUNOFF
NOTIFY BUILDING DEPARTMENT AT PURSUANT 70 CHAPTER 236
765-1802 8 AM TO 4 PM FOR THE OF THE TOWN CODE.
FOLLOWING INSPECTIONS:
I. FOUNDATION - TWO REQUIRED
FOR POURED CONCRETE
2. ROUGH - FRAMING & PLUMBING
3. INSULATION
4. FINAL - CONSTRUCTION MUST
BE COMPLETE FOR C.O.
ALL CONSTRUCTION SHALL MEET THE
REQUIREMENTS OF THE CODES OF NEW
YORK STATE. NOT RESPONSIBLE FOR ELECTRICAL
DESIGN OR CONSTRUCTION ERRORS. NSPEC°TION REQUIRED
COMPLY WITH ALL CODES OF
NEW YORK STATE & TOWN CODES
AS REQUIRED AND CONDITIONS OF
S0R 10�0 TGYrN P! PJGMRD
S ES ENCLOSE PORT -:'' ,,
UPON COMPLC -TIOW
'BEFORE"WATERS';'
OCCUPANCY OR
USE IS UNLAWFU:L
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'JIIITHOUT CERTIFICA I
)F OCCUPANCY /YIGcS-� �� � �� yin ��'►
��4er
E - MVE
MAR. '4 2022
Z
BUILDING DEPT.
TOWN OF SOUTHOLD
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40
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