HomeMy WebLinkAbout28912-Z FORM NO. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Office of the Building Inspector
Town Hall
Southold, N.Y.
CERTIFICATE OF OCCUPANCY
No: Z-29613 Date: 07/31/03
THIS CERTIFIES that the building ACCESSORY
Location of Property: 270 NORTH SEA DR SOUTHOLD
(HOUSE NO.) (STREET) (HAMLET)
County Tax Map No_ 473889 Section 54 Block 5 Lot 50
Subdivision Filed Map No. Lot No.
conforms substantially to the Application for Building Permit heretofore
filed in this office dated NOVEMBER 12, 2002 pursuant to which
Building Permit No. 28912-Z dated NOVEMBER 12, 2002
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 INGROUND SWIMMING POOL WITH FENCE TO CODE AS APPLIED FOR.
The certificate is issued to PAUL & MARY STETZ
(OWNER)
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A
ELECTRICAL CERTIFICATE NO. 3632 04/20/03
PLUMBERS CERTIFICATION DATED N/A
Authorized Sign re
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. 28912 Z Date NOVEMBER 12 , 2002
Permission is hereby granted to :
PAUL & MARY STETZ
21 MAGNOLIA AVE
LARCHMONT,NY 10538
for
CONSTRUCTION OF AN IN-GROUND SWIMMING POOL IN THE REQUIRED REAR
YARD AS APPLIED FOR
at premises located at 270 NORTH SEA DR SOUTHOLD
County Tax Map No. 473889 Section 054 Block 0005 Lot No. 050
pursuant to application dated NOVEMBER 12, 2002 and approved by the
Building Inspector to expire on MAY 12, 2004 .
Fee $ 150 . 00
ut i e Signature
COPY
Rev. 5/8/02
Form No.6
TOWN OF SOUTHOLD t
BUILDING DEPARTMENT
TOWN HALL
765-1802 JUN 2 5 2003
APPLICATION FOR CERTIFICATE OF OCCUPANCY
This application must be filled in by typewriter or ink and submitted to the Building Department wv 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 electrical installation from Board of Fire Underwriters.
4. Sworn statement from plumber certifying that the solder used in system contains less than 2/10 of 1% 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 completed site 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$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 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: Old or Pre-existing Building: (check one)
Location of Property: A?J Ald�T7/ .SE d Sa U Iu/OJ N•�
House No. Street Hamlet
Owner or Owners of Property: o-
Suffolk County Tax Map No 1000, Section Block _ Lot Oi5-O
Subdivision Filed Map. Lot:
Permit No. `�'� 2. Date of Permit. ZVe I/ /c� o7au_z Applicant ,4 v r A/R} G�o-re__
Health D . Approva • Underwriters Approval:
Planning Boar pproval:
Request for: Temporary Certificate Final Certificate: �� (chec one)
Fee Submitted: $ og'(—,.i�
OA o--?— `12—q(,I (__�) 2?Ak1_
C (_0 `l
( Q 0 0 Appficdnf Sign e
Nassau Suffolk Electrical Inspections, Inc.
5A Canal Street • Center Moriches,New York 11934 • Tel: 631-878-3500 • Fax: 631-878-3764
Application: 3632 Date: 4/20/03
Issued to: Stetz
Address:. 270 N.Sea Dr
Village: Southold Introduced By: Bethel Electric Lic#:2880-ME
was examined and approved up to the above date and was in compliance with the NEC
Attic 1st Floor F2eaderltial 1] Pod❑x Det Geragge
Basmiat 2nd floor Camerdal Hot Tub A dMon
Switches Receptacles Fixtures G.F.I. Timeclock Whirlpool
1 2 1 2 1
Fans Dishwasher Washer/Amps Dryer/Amps Oven Carbon
Range/Amps Monoxide
Furnace Oil Gas Heat Zones Smoke Bell
Detectors Transformers
Rough Insp4/17/03 Meter Amps Phase Motors
Final Insp: 4/20/03
Other Equipment:
Inground Pool
ut,Res
-�O)U ov
This certificate must not be altered
in any manner
Permit#:
Section: Block: Lot:
BUILDING PERMIT EXAMINER CHECK LIST
DATE REVIEWED: /]_L/02
APPLICANT: I o �� 2Y DATE SUBMITTED: 11 / lZ/02
SCTM# DISTRICT: 100, SECTION: �� , BLOCK: -�, LOT: h�(�
STREET ADDRESS: gip V, Sc f Jleiyg- CITY: l&wTHctdj SUBDIVISION: —
PROJECT DESCRIPTION: ��� r„ v
ESTIMATED PROJECT COST: ARCHI T/ENGINEER: N 4 FAST TRACK-
SINGLE & SEPARATE CERTIFICATION-REQUIRED '* NOTES:
LOTS 40,000SF-100-24. Lot rccogninon.(CREATED before June 30,1983),UNDERSIZED LOTS FROM JAN.1997 100-25.Met ger.(A nonconforming at any time after 7/1/83:
ZONING DISTRICT: Q-yo CONFORMING? Ah' IK
REQ. LOT SIZE:/ r o oo ACT. LOT SIZE: -elk oov�REQ. LOT COV. �o� ACT. LOT COV. O �
REQ. FRONT 31 PROP. FRONT /REQ SIDE/ � ' ACT. SIDE
REQ. REAR PROP. REAR / REQ. EIGHT PROP. HEIGHT
WATER FRONT? DESCRIPTION:
PANEL #: FLOOD ZONE: , COMPLIANCE:
APPROVALS REOUIRED
SUFFOLK COUNTY HEALTH T: YES or O, ED #): DTE:—/ / PERMIT #:RIO-
TOWN SEPTIC RECEIPT: Y o N
NEW YORK STATE DEC: Pe - 9/1/75 YES o
SOUTHOLD TOWN TRUSTEES: YES or
TOWN ZONING BOARD APPROVAL: YES or
TOWN PLAN. BOARD APPROVAL: YES o
TOWN HISTORICAL PRE (SPLIA): YES O
NYS ENERGY: YES ORO A/ w
EGRESS (18 H min.? 4 s al) VENT(SQ. FT. x 4%) �° o LIGHT (SQ. FT. x 8%)
BUILDING PERMITS OPEN/Elx D: BP -Z/C/0 Z-
HAVE PRE CO'S : Y OR N BP -Z/C/o Z__
NOTES:
FEE STRUCTURE: FOUNDATION: SF
FIRST FLOOR: SF
SECOND FLOOR: SF
OTHER: SF INIT OTHER TOTAL
TOTAL: SF FEE FEE
1. ( SF)- (SF)= SF X
2. ( SF)- ( SF)= SF X $ _$ +$ +$ _$
qq f
M-1802
BUILDING DEPT.
INSPECTION
[ ] FOUNDATION IST [ ] ROUGH PLBG.
[ ] FOUNDATION 2ND [ ) I CATION
[ ] FRAMING [ FINAL
[ ] FIREPLACE & CHIMNEY
REMARKS:
i4V-4 �
41
CT
DATE a��—INSPE
765-1802
BUILDING DEPT.
INSPECTION
[ ] FOUNDATION IST [ ] ROUGH PLBG.
[ ] FOUNDATION 2ND �7 [ ] INSULATI
[ ] FRAMING AL
[ ] FIREPLACE CHIMNEY
REMARKS: �-
DATE /)oINSPE
FIELD INSPECTION REPORT DATE COMIUNTS
ro
9
FOUNDATION(1ST) y
i ac
--------------------------------- J C
2A
FOUNDATION(2ND)
_ � O
Q '
y
ROUGH FRAMING& y
PLUMBING
7 �
INSULATION PER N.Y. H
STATE ENERGY CODE
Ae
c
FINAL
ADDITIONAL COMMENTS r
O
z
Z
M
z
Li
----------------
y
x z
x
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e
TOWN OF SOtiTHOLD BUILDING PERMIT APPLICATION CHECKLIST
r'
BUILDING DEPARTMENT Do you have or need the following,before applying?
TOWN HALL Board of Health
SOUTHOLD, NY 11971 3 sets of Building Plans
TEL: (631) 765-1802 Planning Board approval
FAX: (631) 765-9502 Survey
PERMIT NO. Check
Septic Form
N.Y.S.D.E.C.
*,"
Trustees
ExamiContaekApproMail to:�)t'�!J
Disap /�Phone: ���� CExpira
4Buildg Inspector
it
2 LUOZ J APPLICATION FOR BUILDING PERMIT
dL
� Date 20
o 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 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 inspec
a(si to a of applic t or na e,if a corporation)
'( L N 4) rte 9c)
(Mailing address of applicant)
State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician,plumber or builder
Name of owner of premises 74-11 U d M fta ST 9pf-?
(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.
Other Trade's License No.
1. Location of land on which propos d worwill be do
House Number Street Hamlet
County Tax Map No. 1000 Section 5—`1j Block 0 ,t,d wsAfl 'A nnTCts
Subdivision Filed Map No._� ' f ;;,°.. �
(Name) loan dt)iupuA m rc iw "�1
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 S(>J1 v.rl M t o2: o L
3. Nature of work(check which applicable): New Building Addition Alterario
Repair Removal Demolition Other Work St.t ,vv� v•
p (Descri tion)
4. Estimated Cost (�J Fee
--T (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
11. Zone or use district in which premises are situated
12. Does proposed construction violate any zoning law, ordinance or regulation? YES NOX,
13. Will lot be re-graded? YES-K_NO—Will excess fill be removed from premises? YES NO
14. Names of Owner of premises1&G -MMR-y S-f efz-Addresso2'70 WALA S4'�ht2 Phone No. ?0,5-
Name of Architect Address Phone No
Name of Contractor�R�n1 Address /D 8 �rS� d(& Phone No. 2�- �i 2
eY.f"3
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.
STATE OF NEW YORK)
SS:
COUNTY OF )
T e)t 41 1�"SOC-11-A!t 4-1 being duly sworn, deposes and says that (s)he is the applicant
(Name of individual signing contract) above named,
(S)He is the Co n1' R4'h--A
(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.
Swo o-pe�(,f,o__rre�e me this
Tday of ,r20 09-
%t*� Q b,C�
N6tiiyAlblic Signat t7
plicant
A. GAUO
NOTARY PC U8 C Stme of New Y49k
No. 01QAW4601
OnIffled In
ftwnlle E*ku Augt 1�
OWNER:
ISLANDIA POOLS BY JOHN J. WYSOCZANSKI STS t2Rw tncx aR eDxm utRuslDN 108 FISHEL AVENUE, RIVERHEAD. NEW YORK 11901 (516)727-6312
UN6EftVI"Rlil:ii5 CEt; itlbwlE
REQUIRED
wu laat rawNc
cnrnE
v Y FD 6..0 W rauuwan rxt ro mm
vNr��+ ° sxxtMFrs t¢RwFs
MONORM PDURED
t/r mLRODS" � CONfJIlIE YINL
IADDDt ��
SAND SSE � � �
TYPICAL POOL PLAN it nm �
NIM uo6ltt�m tarot a
AS NI I W FArtIK i
T'a nacpe'i 02-z
EP T
b NOTE: FOR#LL4W
4_PM FOR THE �}-
TABIONS:
TWO REQUIRED
2 ROUGH - FRAMING & PLU NG T
A INSULATION 4
A FINAL - CONSTRUCTION MUST
LETS FOR C.O. FtmtaAa MD t PIECE
ALL CONSTRUCTION SHALL MEET
TYPICAL CROSS SECTION THE REQUIREMENTS OF THE N.Y. OPTIONAL STEP
iTATE CONSTRUCTION Ilk ENE
CODES. NOT RESPONSIBLE FOR
N.S.P.I. TABLE OF DIMENSIONS OEM OR CON8TRUCTION ERRORS
SIZE A B C D E F G H OAPACITY
16%32 16 32 8-6 13-6 8 4 ♦ B 512 17,650 GAL. dulxG Ntw��at�tC NOTES:
16X36 16 36 12-6 13-6 6 4 4 8 576 18,150 CAL � ��e0aw-A-ate-tt
tP DIMAi BD.gD-ro.ate-tC 1. 3.500 LB. TEST CONCRETE TO BE USED
16X38 16 36 10-6 13-6 B 4 ♦ 10 B{B 20,400 GAL, O-�
4 12 25,000 GAL IN CONTINUOUS POUR.
2. WATER DISPOSAL TO BE LIMITED TO OWNERS
Izn2v IZZY zY - "IMMEDIATELY3. ,HIS POOL SHALL NOT LOCAL EMPTIED.
\ __l II PROPERTY SH SURTBERE-TIED. )NS.
ENCLOSE POOL TO CODE 4. ALL
��BEP ESSURE IMPREGNATED
UPON COMPLETION 5. WICKS TO BE SMOOTH NON-SKID TYPE,
BEFORE "WATER" SLOPED AWAY FROM THE POOL.
I �� t
?�
o
SURVE OF PROPERTY
•° .s - TUA TED AT
S°. -0 SOUTHOLD
a . s°° \ �� 41 TOWN OF SOUTHOLD
�9 sod SUFFOLK COUNTY, NEW YORK
\ � �
Q S.C. TAX No. 1000-54-05-50
a �' • "`ta � 20• �c�mo
\ \
�° \ �o SCALE 1 "=20'
ti ti / P
p/ OCTOBER 28, 2002
NOVEMBER 4, 2002 ADDED PROPOSED POOL
4 \ of NOVEMBER 12, 2002 REVISED PROPOSED POOL
AREA = 12,500.00 sq. ft.
0.287 ac.
O _ G�PP� WELL k SEPTIC LOCATIONS AS SHOWN ON PREVIOUS SURVEY.
3 �• - a ,a. \
S°3 '�° ,\
s /
�\
�'J PREPARED IN ACCORDANCE WITH THE MINIMUM
„S7' �i�� STANDARDS FOR TITLE SURVEYS AS ESTABLISHED
> F BY THE L.IAL.S. AND APPROVED AND ADOPTED
FOR SUCH USE BY THE NEW YORK STATE LAND
TITLE SOCIATIDN.
4pry
G3�
Y ren ° _ss qy� o S .� ° �'Y,��'� N.Y.S. Lic. No. 49668
UNAUTHORIZED ALTERATION OR ADDITION
TO
72009FSMENN WT YORK STATEJ seph A. Ingegno
EDUCATION LAW.
�O V O
COPIES
LAND OF
SU VEYOft�NKMAP D SEAL OR OT ANG and Surveyor
°• EMBOSSED SEAL SHALL NOT BE CONSIDERED
TO BE A VALID TRUE COPY.
CERTIFICATIONS INDICATED HEREON SHALL RUN
ONLY O THEED, PEANDSON HIS W140MBEHALTHE THEY Title Surveys - Subdivisions - Site Plans - Construction Layout
IS A/Epi f� TITLE COMPANY, GOVERNMENTAL AGENCY AND
a'9 S'sJ'rN LENDING INSTITUTION LISTED HEREON, AND PHONE (631)727-2090 Fax (631)727-1727
TO THE ASSIGNEES OF THE LENDING INSTI-
'�'.ft/ /9 G TUTION. CERTIFICATIONS ARE NOT TRANSFERABLE.
q .(. OFFICES LOCATED AT MAILING ADDRESS
1� 0( THE EXISTENCE OF RIGHTS OF WAY 380 ROPNOKE AVENUE P.O. Box 1931
y� G AND/OR EASEMENTS OF RECORD, IF RIVERHEAD, New York 11901 Riverhead, New York 11901-0965
G ANY, NOT SHOWN ARE NOT GUARANTEED.