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HomeMy WebLinkAbout23448-z FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No: Z-25420 Date: 12/12/97 THIS CERTIFIES that the building ACCESSORY Location of Property: 1365 PARK AVE MATTITUCK (HOUSE NO. ) (STREET) (HAMLET) County Tax Map No. 473889 Section 123 Block 2 Lot 29 Subdivision Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated MAY 2, 1996 pursuant to which Building Permit No. 23448-Z dated MAY 15, 1996 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 STORAGE SHED IN REAR YARD AS APPLIED FOR. The certificate is issued to HAROLD F & IRENE SHIELDS (OWNER) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A ELECTRICAL CERTIFICATE NO. N/A PLUMBERS CERTIFICATION DATED N/A � i vzo'e� Buil ng inspeoeor Rev. 1/81 FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No: Z-25419 Date: 12/12/97 THIS CERTIFIES that the building ACCESSORY Location of Property: 1365 PARK AVE MATTITUCK (HOUSE NO. ) (STREET) (HAMLET) County Tax Map No. 473889 Section 123 Block 2 Lot 29 Subdivision Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated MAY 2, 1996 pursuant to which Building Permit No. 23448-Z dated MAY 15, 1996 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 INGROUND SWIMMING POOL WITH FENCE TO CODE IN REAR YARD AS APPLIED FOR. The certificate is issued to HAROLD F & IRENE SHIELDS (OWNER) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A ELECTRICAL CERTIFICATE NO. N-391780 07/19/96 PLUMBERS CERTIFICATION DATED N/A Buigeing Inspec r Rev. 1/81 1 FORM NO.3 TOWN OF SOUTHOLD BUILDING DEPARTMENT 1OWNHALL SOUTHOLD,N.Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) Date ............. .1r..................... NP 23448 Z Permission Is hereby granted to: . .y,( .. c2,4sr4 ,>�c /.'... 1�..............L./� ................................ to. >.....:^ �..��?.....1 .... GCJe .......... .. �........ ..... . .. . . ,.., -. ... ...... ..................... aelt..... ..................... . at premises located at.......%J?.416.: ....... ........ ..`evco-""_.......................................... .............................. County Tax Map No. 1000 Section ......./P..3.... Block......r.���............//Lot No. R?................. pursuant to application dated ...................... ...r .... 19.... (Q., and approved by the Building Inspector. Fee$.(.. i .... ./..... .......... Bdin uilg Inspec r Rev. 6130180 Form No. 6 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL 765-1802 APPLICATION FOR CERTIFICATE OF OCCUPANCY A. This application must be filled in by typewriter OR ink and submitted to the building inspector with the following: 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 17 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 a 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 525.00, Additions to dwelling 525.00, Alterations to dwelling 525.00, w�mminpoo X25. ccessory building $75 UP 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 - .25e. 4. Updated Certificate of Occupancy - $50.00 5. Temporary Certificate of Occupancy - Residential $15.00, Commercial $15.00 Date . . . . . .. 13k# 7. . . . . . . . . . . . . . . . . . . . . . . New Construction. . . . . . . . . . . Old Or P e-existing Building. . . . . . . . . . . . . . . . . Location of Property. . . 0.�. . . . . . . A.✓g. . . . . .. . ./YI !` Tv % '!C . . . . . . . . . . . . . . House No. Street Hamlet Onwer or Owners of Property. ev�Q. b 1.. '`. . . .. . . .5�/i°���0, ) . . . . . . . . . . . . . . . . . . . i County Tax Map No 1000, Section. . 3. . . . . .Block. . �-.. . . . . . . . . .Lot. 5 . . . . . . . . . . . . . . . . . . Subdivision. . . . .'. . . . . . . . .. . .. . . . . . . . . . . . . . . . .. .Filed 'Map. . . . . . . . . . . .Lot. . . . . . . . . . . . . . . . . . . . . . i Permit No.a 3 yy�. . . . . .Date Of Permit. f, . . 3�4. .Applicant. . . . . . . . . . . . . . . . . . . . . . . . . . . . . Health Dept. Approval. . . . . . . . . . . . . . . . . . . . . . .. . .Underwriters Approval. . :'. . . . . . . . . . . . . . . . . . . . . . Planning Board Approval. . . . . . . . . . . . . . . . . . . . . . . . \l Request for: Temporary Certificate. . . . . . . . . . . Final Certicate. . . . . . Com/ Fee Submitted: 5. . . . . . • . . . . . . . . . . . . . . . . . . . . . . 37�s s� Form No. 6 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL 765-1802 APPLICATION FOR CERTIFICATE OF OCCUPANCY A. This application must be filled in by typewriter OR ink and submitted to the building inspector with the following: 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 a 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 425.00, Additions to dwelling $25.00, Alterations to dwelling 425.00, wimming poo 425. ccessory ui ing Additions to accessory building 425.00. Businesses 4500. 2. Certificate of Occupancy on Pre-existing Building - 4100.00 3. Copy of Certificate of Occupancy - .25e. 4. , Updated Certificate of Occupancy - 450.00 5. Temporary Certificate of Occupancy - Residential 415.00, Commercial 415.00 Date . . . . . . . I. :li,/fir. 7. . . . . . . . . . . . . . . . . . . . . . . New Construction. . . . . . . . . . . Old Or P e-existing Building. . . . . . . . . . . . . . . . . Location of Property. . . '3.1 . . . . . . AY�$. . . . . . . . /)l . . . . . . . . . . . . . . House No. Street Hamlet Onwer or Owners of Property.l.l. . e ��. . . �� !� . . . . . . . . ..!�1 ��,�. . . . . . . . . . . . . . . . . . County Tax Map No 1000, Section. . 3. . . . . .B1ock. . ;�-. . . . . . . . . . .Lot. a. J. . . . . . . . . . . . . . . . . Subdivision. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. .Filed Map. . . . . . . . . . . .Lot. . . . . . . . . . . . . . . . . . . . . . Permit No.5� 3 yyX. . . . . .Date Of Permit. !-A . . • . .. Applicant. . . . . . . . . . . . . . . . . . . . . . . . . . . . . J Health Dept. Approval. . . . . . . .. . . . . . . . . . . . . . .. . .Underwriters Approval. ::.Y. . . . . . . . . . . . . . . . . . . . Planning Board Approval. . . . . . . . . . . . . . . . . . . . . . . . \\ Request for: Temporary Certificate. . . . . . . . . . . Final Certicate.f C� Fee Submitted: $. . . . . . . . . . . . . . . . . . . . . . . • • • • • • a C. 0. - �1� - . . . . .� . . . . . . . . . . S31)aSk� AP LICANT 0v�- 2Sy,y 2. —2 239.4 THE NEW YORK BOARD OF FIRE UNDERWRITERS PAGE 1 1001290 BUREAU OF ELECTRICITY F 85 JOHN STREET, NEW YORK, NY 10038 Date JUI,Y 19,1996 Application No.on file 12078196/96 N 391780 THIS CERTIFIES THAT only the electrical equipment as described below and introduced by the applicant named on the above application number in the premises of FUMY SHIELDS, 1:365 PARK ROAD, MATTITUCK, N.Y. in thefollowinq location; ❑ Rosemont ❑ Ise Fl. .❑ 2nd Ft. OUT Section Block Lot was examined on JULY 16 F 1996 and found to be in compliance with the National Electrical Code. FIXTUREFIXTURES RANGES COOKING DECKS . OVENS DISHWASHERS EXHAUST FANS OUTLETS ECEPTACIES SWITCHES INCANDESCENT.FLUORESCENT OTHER I NAT. I K.W. I AMT. K.W.. AMT I K,W. AMT. I K.W. AMT, H.P. DRYERS FURNACE MOTORS FUTURE APPLIANCE FEEDERS SPECIALREVPT TIMECLOCKS I RILL UNITHEATERS MULTI-OUTLET DIMMER,0,,,: !! SYSTEMS AMT. K.W. OIL N.P. GAS H.P. MST. N0. A.W.G. AMT. AMP. AMi, MApS. TRANS. AM i H.P. NO.OF FEET AML. 'WATTS ! 20 SERVICE DISCONNECT NO.OF S E R V 1 C E AMT. AMP. OPE METER I A, $SW 'A,SW S�,AW NO.OF CC.GOND. A.W.G. NO.OF MIdEG A'M'�+ NO.OF NEUTRALS A'W'G' EQUIP. PER A' OF CC.COND. OF HbIEG OF NEUTRAL OTHER APPARATUS: SWIMMING POOL-1 TIME CLOCKS-AMP AO-1 G.F X.I-1 *(SWIMMING POOL) This certificate covers compliance at the date of inspection only, Because of unusual environments it is advisable to have frequent or repairs L made by a qualifiedified pe person. ;r . a <<< Continued on Page 2 >>a GENERAL MANAGER S5 Per «...: This certificate must not be altered in any manner; return to the office of the Board if incorrect. Inspectors may be identified by their'credentials. COPY FOR BUI'LDING DEPARTMENT. THIS COPY OF CERTIFICATE M,UjST NOT BE ALTERED I,N ANY MANNER. _ THE NEW YORK ,BOARD OF FIRE UNDERWRITERS PAGE 2 r1001290 BUREAU OF ELECTRICITY 85 JOHN STREET, NEW YORK, NY 10038 Date JULY 19,'19% Application No.on filo 120713196796 N 3917530 THIS CERTIFIES THAT only the electrical equipment as described below and introduced by the applicant named on the above application number in the premises of HARRY SHIELDS, 1.365 PARK ROAD, RATTITUCK, N.Y. inthefollowinglocationl ❑ Basement ❑ 1st Fl. ❑ 2nd Ft. OUT .Sertion Block Lot was examined on JULY 16,1996 and found to be in compliance with the National Electrical Code. FIXTURE RXTURES RANGES COOKING DECKS OVENS DISH WASHERS EXHAUST FANS OUTLETS ECEPTACLES SWITCHES WCANDEScENT1 fLUCRESCENT I OTHER MT I K.W. AMT 9.W. T. K.W. "T I K.W AMT I H.P DRYERS FURNACE MOTORS FUTURE AWLIANCE REDERS ISPICIAL ItEC'PTj TIME CLOCKS I BELL I UNIT HEATERS MULTI-OUTLET DIMMERS AMT. K.W. OIL H.P. GAS H.P. AMT. NO. A.W.G. AMT. AMP MAT. AMPS TRANS. AMT. H.P. SYSTEMS AMT. WAiiS NO,01 FEET I SERVICE DISCONNECT NO.OF S E R V I C E AMT, AMP. TYPE METER 1 q'2W 1 0 3W 3 a 3W 3,e IW NO.OF CC GOND. A.W.G. NO.OF HI-LEG A�`'G. NO.Of NEUTRALS A.W.G. EQUIP. PER,O' Of CC.COND OF HbIEG OF NFVG. i OTHER APPARATUS: t TED CHESHIRE JR. CO. LIC.#953—E L L P.O. BOL{ 255A 9280 SOUND AVE. GENERAL MANAGER HATTITUCK, NY, 11952 11 a5 Per \1 certificate must not be altered in any manner; return to the office of the Board if incorrect. Inspectors may be identified by their credentials. COPY FOR BUILDING DEPARTMENT. THIS COPY OF CERTIFICATE MUST NOT BE.ALTERED IN ANY MANNER. 111':1,11 Illiil'I',1.11 U11 Ill;1'11111 UAII. � I I III IIIIIA 11011 I� ll � I ------ --- O w .,,,...:,.oma.,..e.,,.m,.....,.m.,.�..,,,m., ,. _ z.• ,•.n.,,.�.,.-•.,.,:,�.,.,,..,,,�•.,,,,,,,,,.�,,,,,,,,,,,,,,,,,,,.•.e•,...,o.�,..,•,.,...,.,.,,.,�.,•,.,, 111!i lll.n 1 Illll 1'I,it If I .ilnlli I(IIIiN(;Y ---------- -� CUI11! __. ( AM)I IIU nI. ..�uSnlS • - u , h - - ---- . II i NORTH FORK WOOD DESIGN PAUL'S LANE & RT. 48 • PECONIC, NY 11958 PHONE: (516) 765-3090 FAX: (516) 765-0013 r / To �i r(1 (L.% f ,r — Date 1> ' 1�a: 'y� d f 9 C ;J / � o Addresses_/� - �11. fi t. .3 ( ) /)1' ' Phone # H � f� ("'' city )�' I �Z1P �<.- State-1) Z)p ? (W)U -)C:;1i ' ource Load Truck { 1 Description f13 lore---- f �Q 0 a Watt�. -_�1_)' y 'A A14 ;� Trim- 1+-}� , Special Instructions: ,.. PRICE AMOUNT — NOTICE— Options: TO ALL CUSTOMERS BEFORE YOU MAKE YOUR PURCHASE! •If site is not prepared properly and driver must prepare site,there Will be an additional charge. •If site is inaccessible to our truck and we must return with shipment, .1- up to 10%transportation cost will be charged. •Can we drive directly to the location you've chosen for your shipment? •Are there any overhead obstructions lower than 12'? •You the customer are responsible for any building permits and boundary lines! TOTAL _ •We're going into your yard at your request,therefore we do not accept any responsibility for damages which occur! --- •Placement of Shed. Our drivers must assume whatever instructions Tax given by person(s)present,in accordance with the buyers wishes or Subtotal d C in event no one is present,we do not assume responsibility whatso- I f . ever for misplacement of shed. Any relocation will be done at the buyer's expense. Deposit •Wood.when it is exposed to the elements has a tendency to shrink ` and expand. Because of this,we cannot accept responsibility for BALANCE DUE chipping,cracking,minor warping,etc. If there is a problem,please let us know. Signature 'r�aue 4 71tce Daryl , e , M-1842 BUILDING DEPT. INSPECTION [ ] FOUNDATION IST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] INS ATION [ ] FRAMING [ FINAL [ ] FIREPLACE A CHIMNEY REMARKS: DATE / INSPECTOR 2�""-"' raAgerolb B He%en: 2 71-chard O'60r0Ora - Froncd3Borlolll . I ) MolhewS. I - °' ' i, , Y ! '•j� AC86'5TE'� {00001 • ♦.J w `r 0C. ♦ 1 f '1 I Itgdy R I: fy4 ). • I Pf��,�9 N I^k i - 1,rS4 p I. 13 I1YIME bIATEtY A . I 1 ` • 3 i �' W eVl I 1t�.tLC,J ) of 4 1 CLOSE,p�p LTOCO `�'; L '� ` rr UPON COMPLETION , A BEFORE FNWATR" •j .._xj •• O � ••ry � £�Gfet 3 } ii 1•R 1 4 O OWLKINe Jp�T r ♦ u ,r�. 4 �•" a' P6A• 5�lSFv I09 . � � . ° Ii �� I °o ewcLuxR }„ .1 , `� •T[sT NOL-1O`�JL-L�Ls.b' P ' I I',�..... /, • • `'�__oa i f ,' L rT�rerAv= • C� :% _ �•i __. - - AASO I .., 2FdaN; ♦A ..- - ----��" . 'K86°5TE '18500' •,+y SBG•57W IDOAO , 4:9 PARK TEST HDL[ TeP MIY A ►AHO A " rY, 4 Av[�I d w - t IHHt EYY / a ros+, AL OwcVS.wA �J V �SANG P '.`+'• - � ' SURVEY FOR Na - NOV. 7 1978 1978 THOMAS A. KEW/N Q LE/LA M. KEW/N• OCT,, 11, 66*17 76,1976 AT MATT/TUCK .? '• DATE I AUG,4, 1978 TOWN OF SOUTHOLD'- SCALE / ° c40 ' `aI SUFFOLK COUNTY' `NEW ORK N0. , 78-471 4UNAVTNORIItO ALT&ATIDN OR ADDITION 10 . TNI! ' -GUARANTEEb Tb 3URV1T ISA VIOL At10q Of SECTION T;DI Of rN[ NEW YORK[TAf[EDOCATIONLAW , I R/VERN£Ab JPdJr��9Y CoP,Es Of THIS SUAVCY NOT TEAM,1d VNf LAND SURVEYOR'S INKEC SEAL OA TMSO![ED'Irt"!ALL✓ AMER/CA A yv Co NOT St CONSIDERED t0 OE A VALID IMUC COPY VLP' , ` 4r NOVAAANTEEf 1NOICAEtO MCRCON SN.LL RUN ONLY TO O O ' * HEALTH DEPARTMENT•IDATA FOR APPROVAL TO CONSTRUCT TNT rCASON FOR*"ON THE SURVEY 19 PRtYAACD� $ •t•. •�l:;tl. 5 r �J , AND ON Nn[TNAV to IN(Ttflt COMPANY,DOVCRN- ��(A�,, 9 A D+ M NEAREST WA![RMAIN 1.I H:COVRSt OF WATER.MIVAT[YWEER!— MENTAL AGENCY AND L(NOINC IHSIltVVION LIS ITO ri r[ NSUA.CO.TAM MAP DIE . ILCTION 1�y7,7 OLOCK 2 LD!�j�� N L A EON.AN O,f 0 TMt AS OONC[!Of ML L[N DING„ r11��r5�; IT MTN[fl[ Afl[MO OW WITHIN IC[T OI TIiIA PROPERLYINlONTIDH,OWAANTI(1 ME NOT TAANSIMNI[' OTHER THAN THOSE[NOW 1 NCR[ON. 10 ADDITIONAL INSTITUTIONS ON SUOSEOUENT *THE WATER SUPPLVAND S WAG[DISPOSALSYST[N IORIHIS Rtl10[NC[ OWNERS - h0. WILL CONFORM TO TNL♦T HOARDS OF THE SUFFOLK COUNTY OtPAATMENT POISTANCES SHOWN M(Nto*FROM PNOP[ATr UN[! 9 A9"+ to tx.t. ft.cruntS ARE FOR A SPECIFIC . H Of HEALTH SLRVICT!• — PUN POSE AND ARE HOT TO It VSCO TO CITAPLISH J S OT AIPLICANTI !• ^A MOPLPtY LIN[!OR FOR THE ERECTION 01 fLMC[t - fJ/I ADDRE[f, ,' . . TEL•, Y t 400 OSTRANDER AVENUE f Y..O,�• NG $YOUNG ,RIVERHEAD,NEWYORK a, more, A�LOEN'WYbUT1 P'PROF' CliDfNPER j ht + •MONOMEYTFOUNp AND LAND BVRYIYDRjY,SINCEN5ENoRo40 • I•J - '�NOWARD W YQUNO,LAND IWNVEVDR *THE LOCATgNWW[LLIWI,lEPTIC 7ANN1l T)RCEtSPOd.l ICPISMOWH N[R[ON ''N.Y.$ 410ENSE,flO(}3093 ?I ARE FROM FIELD RVAT N H RDATA ODTAI LO FROM O R r_ .. OWNER: -- ISLANDIA POOLS BY JOHN J. WYSOCZANSKI 106 EISHEL AVENUE, RIVERHEAD. NEW YORK 11901 (516)727-6312 NOTE: FOR 91YENSKINS SEE TABLE BELOW RW ILtic mrfn cIMDE ' PSY EON b0]K 'YIXMN!®rI 1CP mm 1 SOIAIXS RflUW15 t/T SIm AMS KWfltD 1z nw TYPICAL POOL PLAN =p k tN06TABFD PWP NAIEPIINE E.V(Rt N NOTE: FOR DIMENSIONS SEE TABLE BELOW NM:IFhT f-Y SNCED yND.ORO" © { T TYPICAL CROSS SECTION is l ' m� iL9EA01A55 MgLFD t hECE OPTIONAL STEP T ,� � TYPICAL SIDE SECTION NOTES: 1. 3,500 LB. TEST CONCRETE TO BE USED IN COM1RiNUOUS POUR. x omxD apwD--u'e-t E- 2. WATER DISPOSAL TO BE LIMITED TO OWNERS I tv omxc eoARD-a-u e_tx PROPERTY TO SUR LOCAL REGULATIONS N.S.P.I. TABLE OF DIMENSIONS D�tY 3. THIS POOL SHALL NOT BE EMPTIED. - ---"----'—-- 4. ALL WOOD TO BE PRESSORE IMPREGtNTgD SIZE A *C D T F LE—G� 'H� WITH PRESERVATIVE. 280X40 180 30 i 5 jt0 `'8 i20I03a0 5 SLLKS TO BE OPED AWAY SMOOTH NON EROL/ i41E POOL ttF'E. ! I ., Richard B Borom o :.� •• .,,BoriofJi 1 Mofhews .'J�. 1 �/ 1; I;.�� 'J.•' � YDP Y,yq°tI��I'tii -DIATE� lot I J' � LOS P00 0 " '�n,,l w :'•'r"'i; ENC N CflNIFLEnON w� :,.:. rm'. ; UPO I'' '' BEFORE A •.� � �' n � m t 'qk - ° .t Lf' •t C' . it's, a+tr Ft �!'TC1T NOLL.11'A1f�l..le.0 L• 1 04 "AlB6°57'1. 185.001 L S.BG'57 W." /00.00 ? .. L •IP•T AVENUE PARK s; l',1�:' TEST MOLL, :ale 64N4 t ' ,' ...: LOANS ! ..(„! ., •:(;�/: '. 1. LONE ELLY A.L III Ne OLAVLL 1 I I• .• ItO 1 1 SURVEY FOR, a NOViI,OCT,190 ;,, THOMAS A. KEWJN d LE/LA M. KEW/N• 16 66az95,1916 'I" AUG.9,/978, AT MArrfrUCK DATE 1 AUG.4, 19r8 •• TOWN OF SOUTHOLO' • SCALE- J ,1 = 40 1 SUFFOLK COUNTY, NEW TORK NO. - 78-47/ UNAUIH00Itt0 ALt ERATON On A001tION t0 THIS SUR' ['M A VIOLATION of StONDN 1109 of INt GUARANrEEO F Ht.TORR furl EDUCAIIONLAW. . R/VERNEAG efN/Msv .. ICONtS o1 THIS SUAVE V Not.BEARING TNS LAND y SVAVt1OA'5 MACO SEAL 04[MPOSS0 SEAL SHALL AMER/CA At Ut' CO. not OF COHSIOEACO 109t A VALID IRU[COPY VL J• T,I ' 0OVARANtttl INOICAtLD HEREON$HALL RUN ONLYIO HEALTH DEPARTMENT-DATA FOR APPROVAL TO CONSTRUCT IHt r["loN Aon *Ham SHE SURVEY It PREPARED, .Yt Q� •tl4tt� 015 A NO OR HIS/1NALf To IN[-ITL[COMPANY,OOYERN• (1A yy M"SANEST WAX[RMAIN 1.1 IL,SOVRSE OF WATER. VATS "'Onley 01"'AL AOtNCY AND LCMOINO InillivbO"LISTED J fT 41 N SUFF.CO.TAX MAP DIST.jQ $%CTIOH��}�.1�DLDM 2 LOT HCREON•RNO IO THC AE/-ONCE/D/IN[ 11010110 f}}'' :f rTNtRR AMC NO DWELL WITHIN Iba'rE Ct OFT FRO IY -NSTITUTON.OUARANlltI AAt NOF IAANII[RA9Lf `•'I OTHER THAN TNO/E SHOW I AER[ON. t0 ADDIIIONAI INITIIUT10NS On SVD It DVINI •1 M TIL WATER SURLY AND S WAOC DISPOSALSYATAM FORtHM RtSHERCC OWHt AS RL H WILL CONFORM TO TNLSTHOARDS OFT"E SUFFOLK COUNTY D[PMtMLNT 0OISIANCtS SHOWN"EPSON tAOM PA009RIT LIHCS I 'J\. a•R 093 W HEALTH SERVICES, tO t"ITINO SIAOCTURCS ARE FORA SPECIFIC p APPLICANT,. i. I _ PURIOS[ AND Apt HOT TO 9t USED ID LLTAIII9HA/ S 1� .VAOPtOTY LINt9 ON FOR THE[RECTION of f[NCt C. ADOglf E, !/LV lt�t 400 OSTRANDER AVENUE T"' YOUNG'.8�<'YOUNQ_..,,aiveaHEao,NEw YORK 'Yore, O 1?..:, ,,'4dte("�': f'.-.ayw. ,i 11 - �.fl r F Atoy(IIENr fGUNp ALOE"W.YOUNO,PkOrE5510NAL ENGINEER AND LAND IURYEYOR NX10CEN09 N019040 i• NOWARO A YOUNG.LA NO WAVA YOM NTIIE LACATgN DPW[LL(WI,DLPTIC SPAIN )aSPWL!(CFHHOWH"CRCON ICES.LICENSE NO 893 :�'iARE FROM FIELD RVA- Nt N RD AEA D tTAIHCD FROM O 1 RE 771 Mp[1K �eoDL FM IGC[aB mm oDILURON - ISLANDIA POOLS BY JOHN J. iVYSOCZANSKI SIWNEH: 106 FISHES AVENUE, RIVERHEAD, NEW YORK 11901 (516)727-6312 NOTE: FOR DIMENSIONS SEE TABLE BELOW G/DE P1Y FOW 6VS]N6 WCIYVYIID rw IOP PATE Yv1YL IllkT1 0' SKAAEQS REIUKKS l� ,n sm ecus ET1 m,cPET` T^- ,Z BAR j TYPICAL POOL PLAN 80101 ODER. IAIDaTucxn mam xATERNNE �M NOTE: FOR DIMENSIONS SEE TABU BELOW VIIM IaYY v ---------------- . .1_Z SWGFO 541J BOf10M I- D —I { T TYPICAL CROSS SECTION ,. 1 m3 Fl$CG(A55 MOILED 1 PIECE &T OPTIONAL STEP� ENDABFD M I I-Y TAVPED YHD BTTCY �---C T�I.� TYPICAL SIDE SECTION NOTES: 1. 5,500 L& TEST CONCRETE TO BE USED IN CONTINUOUS POUR. s AMNO BowD--KB-IC 2. WATER DISPOSAL TO BE UMITED TO OWNERS a GMNG BX4D--V'B�IS Id Dmxc wu+n-A-u e_tet PROPERTY TO SUR LOCAL REGULATIONS j N.S.P.I. TABLE OF DIMENSIONS _ _ o_2r a. 'Nls Pool sNALL NOT BE EMPneo. SIZE A B C D E F G B 4. ALL WOOD TO BE PRESSURE mPREGLNTEJ L WITH PRESERVATIVE 20X40 10 30 5 10 2C FAG 5. WALKS TO BE SMOOTH NON-SKID TYPE. I 18X361 8 5 ,9 1s SLOPED AWAY FROM THE POOL 60,11D OF HEALTH . . . . . . . . FORM NO* 1 3 SETS OF PLANS . . . . . . . . . . TOWN OF SOUTHOLD SURVEY -- ZW BUILDING DEPARTMENT CHECK . . . . . . . . . . . . . . . . . . . . TOWN HALL SEPTIC FORM . . . . . . . . . . . . . . BLOG.DEPT SOUTHOLD, N.Y. 11971 ir- k LDTEL.: 765-1802 NOT I FY ., 19 CALLMAIL LQ,; ., 19 �Permit No. ved a/c . . . . . . . . . . . . . . . . . . . . gr F. fIPG ), d . . . �P4C r7�� Building Inspector APPLI TION FOR BUILDING PERMIT ,- Date . . .'L:. . . . . . . .. 19 J� INSTRUCTIONS a. • This application must be completely filled in by typewriter or in ink and submitted to the Building Inspector, with 3 is 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 areas, and giving a.detailed description of layout of property must be drawn on the diagram which is part of this app .tion. 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 issued a Building Permit to the applicant. Such permit all be'kept on the p;em,ses-available for inspection throughout the work. e. No builtlina shall„be.occupied or.used in whole or in part for any purpose whatever until a Certificate of Occupancy all have been granted'by the Building Inspector. APPLICATION IS HEREBY MADE to the Building Department for the issuance of a Building Permit pursuant to the ,ildin; Zone Ordinance of the Town of Southold, Suffolk County, New York, and other applicable Laws, Ordinances or ;ulations, for the construction of buildings, additions-or a e a i or for re novaI o demolition, as herein described. ie applicant agrees to comply with all applicable laws, or inances, b g c 'e hou ng code, and regulations, and to mit authorized inspectors on premises and in building for n essary i tion . (Sig-liatur f applican or na e, if a corporation) . la. . .F-6� P . . . J. . . . . . ����� � � h1g16611 ailing address of applicant) ate whether applicant is owner, lessee, agent, architect, engineer,,generihcontractor, electrician, plumber or builder. imc of owner of premises �. . . . .Ii (as on the tax roll or latest deed) applicant is a corporation, signature of duly authorized officer. . . . . . . . . :. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . (Name and title of corporate officer) Builder's License No. . , ,6TE . , . , , Plumber's License No. . . . . . . . . . . . . . . . . . . . . . . . . Electrician's License No. . . . . . . . . . . . . . . . . . . . . . . Other Trade's License No. . . . . . . . . . . . . . . . . . . . . . Location of land on which proposed work will be done. . . . . . . . . . . . . 13 6 . . .\. ACL (� . . . � . . . . . . . 1/I/�A?-r -4 Hamlet-oC IL House Number Street . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . a . . . . . . . . . . . . . . . . . . . . . . . .. e County Tax Map No. 1000 Section . . . . .'.2 3. . . . . . . Block . . . .0.. . . . . . . . . . . Lot . . . . .. . . . . . . . . . Subdivision . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Filed Map No. Lot . . . . . . . . . . . . . . . (Name) 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 . . . . . . . . . e, � � Repair 3. Nature of work check which a'pplicable): New Building . . . . . . Addition . . . . +� 666 tdaa7 �. : P Rc oval . . . . . . . . . . . . . . Demolition . . Other Work . . . . . ... . V D Ct (Descrip 4. Estimated Cost . . . . . . . . . . . . . . . . . . . . . . . . . . . Fee . . . . . . . . . . . . .' (to be paid on }f t t Ij," plication If garage, number of cars g'units . . . . . . . . . . . . . . . Number of dwcllin units on cif B 40 f 5. If dwelling number of dwellin gfah » or S f g o r 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 P Height . Rear . Depth . . . . . . . . . . t . . . . . . . . . . . . . . . . . . . . . . Number of Stories . . ... . . . . . . . . . . . 8, Dimensions of entire new construction: Front Depth Height . . . . . . . Nunjber of Stories .( 1t11 P?JtV. 4r�(, • „ �Q. . . . 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: . 13. Will lot be regraded Will excess fill berem from premises: l4. Name of Owner ofpremises ����?��„ 51%%ew T/LAddress . .434�S �i1?{C G`F112 (� No Name of Architect . Phone No. . . . Address . . Phone No. Name of Contractor 15. s this roert with 5to4?ni<?I, irLs LTi Address /OB Sf!?� U}t/e f2/11 Phone No. .7-R * P yes, y 00 feet of a •tidal wetland?* Yes. . . . , . If es Southold Town Trustees Permit may be required. . . . . . • • • . 3 PLOT DIAGRAM Locate clearly and distinctly all 'ibuildings, whether existing or proposed, and,indicate all set-back dimensions from property lines. Give street and block number or description according to deed, and show street names and indicate whether interior or corner lot. UNDERWRITERS CERTIFICATE REQUIRED ii''�t`a� 9'66 �°a �. } hi, 1g np ROD AS*POR � ? t DATE: �f B.P. A � EJ FEE: , 81^ t NOTIFY BUILDING DE u u� u �'Wh � ,�- T �� E 7135-1802 8 AM TD 4E f ER -- ,.• ti, L.,, FOLLOWING INSPECTIONS: 1. FOUNDATION - TWOREQUIRED Ali FOR POURED CONCRETE 2, ROUGH - FRAMING & PLUMBING 3. INSULATION 4• FINAL - CONSTRUCTION MUST BE COMPLETE FOR C,O. IMMEDIATELY" ALL CONSTRUCTION SHALL MEET ENCLOSE POOL TO CODE THE REQUIREMENTS OF THE N.Y.. UPON COMPLETION STATE CONSTRUCTION & ENERGY BEFORE "WATER" ;ODES. NOT RESPONSIBLE FOR DESIGN OR CONSTRUCTION BRRQRS iTATE OF NEW YORK, Ss -OUNTY OF . . . . . . . . . . . G. . 010 ,v9h� /f • • • • • • • • , . . • . . . . . being duly sworn, deposes and says that he is the applicant (Name of individual signing,contract) bove named. 77 le is the . . . . UI9Cf.w�:., . . . . . . . (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 pplication; that all statements contained in this application are true to the best of his knowledge and belief; and that the ork will be performed in the manner set forth in the application filed therewith. worn to be or me this . . . . . . . . , . of. . . i119 . ota Public, : . . . . . . . . . . unty r DIANE M,K090LESKI Nota rY Public,State of New Yor1 • No.4891900 (Signature of applicant) Qualified in Suff014 County Commission Expires June 8, 19� BO,\1;0 OF HEALTH t! �, 1 FORM NO. 1 3 SETS OF PL.1,*1S . . . . . . . . . . SURVEY . . . . . . . . . . . . . . . . . . . FMAY _ 2CHECKTOWN OF SOUTHOLD, BUILDING DEPARTMENT CHECK . . • • • . . . . . . . . . ! TOWN HALL SEPTIC rORN SOUTHOLD, N.Y. 11971 T BLDG. E!'1G TEL.: 765-1802 ttoT I F'f ; CALL :xamined . ,�,1. , . 19 HA I L ,TQ,,: \pprovcd . . . . . lXPermit No.(;, 3 W / . . .. . c . Asapproved a/c . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 0em t1P� r� �A-14 ./leio/ . . Building, Inspector APPLI TION FOR BUILDING PERMIT Date . . . . . ... : . . . . . . . .. 19l.� INSTRUCTIONS a. This application must be completely filled in by typewriter or in ink and submitted to the Building Inspector, with 3 is 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 - areas, and giving a detailed description of layout of property must be drawn on the diagram which is part of this appli- .tion. 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 issued a Building Permit to the applicant. Such permit all be'kept on the prem* ave for inspection throughout the work. e. No buiAfiii'shall be occupied or.used in whole or in part for any purpose whatever until a Certificate of Occupancy all have been grantedby the Building Inspector. APPLICATION IS HEREBY MADE to the Building Department for the issuance of a Building Permit pursuant to the ,ilding Zone Ordinance of the Town of Southold, Suffolk County, New York, and other applicable Laws, Ordinances or =;ulations, for the construction of buildings, additions orrinancels, a , or for re oval o demolition, as herein described. ie applicant agrees to comply with all applicable laws, or b g c e,iho�: ng code, and regulations, and to mit authorized inspectors on premises and in building for n essary i tiona'. . . . . . . . . . . .. . _ . , . . . . ,/ (Signature applican or na e, if a corporation) . . .-�-°. . . . .? .. . . . . . .... . . . . . . � . . ... .�. ailing address of applicant) ate whether applicant is owner, lessee, agent, architect, enZineer„ general-Amntractor, electrician, plumber or builder. re-)o fiAc' L- VD 'ime of owner of premises.. . . . .. . . . .��. 5�. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . (as on the tax roll or latest deed) applicant is a corporation,signature of duly authorized officer. (Name and title of corporate officer) . Builder's License No. 6,E . . . . . Plumber's License No. . . . . . . . . . . . . . . . . . . . . . . . Electrician's License No. . . . . . . . . . . . . . . . . . . . . . . Other Trade's License No. . . . . . . . . . . . . . . . . . . . . . Location of land on which proposed work will be done. . ... . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . House Number Street Hamlet County Tax Map No. 1000 Section . . . . .� �.�. . . . . . . . Block . . . . . . . . . . . . . . Lot . . . . V. . . . . . . . . . . Subdivision . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Filed Map No. . . . . . . . . . . . . . . Lot . . . . . . . . . . . . . . . (Name) 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 . . . . . . . . .2? .. ... . . .. . . . .lam. 3. Nature of work (check which applicable): New Building . . . . . . . . . . Addition . . . = - Repair . . . . . . . . . . . . . . Removal . . . . . . . . . . . . . . Demolition . . . . . . . . . . . . . '':Other Work . . . . I . . . . . . . . . . " (Description) 4. Estimated Cost . . . . . . . .�O. V O.�. . . . . . . . . . . . . . . . . . . Fee . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ,.:., (to be pai on plication) �0 S. If dwelling,number of dwelling units . . . . . . . . . . . . . . . Number of dwSlling units on'ejdlt . . ... . . . . . . . . . . . . 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 . . . . . . . . . . . . . . . . . . Depth j Height . Number of Stories �.�w 4W1 -,�tV. . d�. . . . �i�. . . . . : . . . . . . . . . . . . . . . . . . . . . . . Depth . 9. Size of lot: Front . . . . . . . . . . . . . . . . . . . . . . Rear . . . . . . . . .� . . . . . . . . . . . . . . . . . . . 10. Date of Purchase . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Name of Former Owner . . . . . . . . . . . . . . . . . . . . . . . . . . . . . H. Zone or use district in which premises are situated . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 12. Does proposed construction violate any zoning law, ordinance or regulation: . . . 13. Will lot be regraded . . . . . . Will excess fill be empve from premises: Q No 14. Name of Owner of premises w 4.A �uIK�.`�Address . .l. la: `. �.Phone No. 1. Name of Architect . . . . . . . . . . . . .Address . Phone No. . Name of Contractor 5 ?�?! •��? . �:i�) • .Address ,/08. �. �1,'7 `� Phone No. .7 ?:.(3�?:, . . . . . 15. Is this property within 300 feet of a tidal wetland? *Yes. . . . . .1CP. . . . . . . . . *If yes, Southold Town Trustees Permit may be required. PLOT DIAGRAM Locate clearly and distinctly all buildings, whether existing or proposed, and.indicate all set-back dimensions from property lines. Give street and block number or description according to deed, and show street names and indicate whether interior or corner lot. • UNDERWRITERS CERTIFICATE REQUIRED "� AP RO D 9 Ncffw e ra DA B.P.# z r Lig U$ e �L _ NOTIFY BUILDING DE E T T 765-1802 9 AM TO 4 P R THE Alt FOLLOWING INSPECTIONS: 1. FOUNDATION - TWO REQUIRED FOR POURED CONCRETE 2. ROUGH - FRAMING & PLUMBING 3. INSULATION 4. FINAL - CONSTRUCTION MUST BE COMPLETE FOR C.O. "IMMEDIATELY" ALL CONSTRUCTION SHALT. MEET ENCLOSE POOL TO CODE THE REQUIREMENTS OF THE N.Y. UPON COMPLETION STATE CONSTRUCTION & ENERGY BEFORE "WATER" f=ES. NOT RESPON818LS FOR DESIGN OR CONSTRUCTION FARORS STATE OF NEW YORK, S.S -OUNTYOF . . • �� ). . . . . • • • .(.1/lf cSo . . . . . '. . . . . . . . . . . . . . . . . being duly sworn, deposes and says that he is the applicant . .(Name of individual signing contract) bove named. reis the .C.! . . .. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . (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 ;)plication; that all statements contained in this application are true to the best of his knowledge and belief;and that the ork will be performed in the manner set forth in the application filed therewith. wom to beforg me this . . . . . . . . . ... . . of. . . . . . , 19 . . . / ota Public, . . . . . . . . . . . . . .: . . . . . . . unty DIANE M.KOKOLESKi .. . . . . . . . . . . . . . . . . . . . Notary Public,State of New Yor (Signature of applicant) No.4691300 Qualified in Suffolk County Commission Expires June 8, 1 t� __