HomeMy WebLinkAbout26919-Z FORM NO. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Office of the Building Inspector
Town Hall
Southold, N.Y.
CERTIFICATE OF OCCUPANCY
No: Z-28390 Date: 05/06/02
THIS CERTIFIES that the building ACCESSORY
Location of Property: 8580 COX LA CUTCHOGUE
(HOUSE NO.) (STREET) (HAMLET)
County Tax Map No. 473889 Section 83 Block 3 Lot 3 .2
Subdivision Filed Map No. Lot No.
conforms substantially to the Application for Building Permit heretofore
filed in this office dated OCTOBER 16, 2000 pursuant to which
Building Permit No. 26919-Z dated NOVEMBER 14, 2000
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 ANTONE E. & GERALDINE BERKOSKI
(OWNER)
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A
ELECTRICAL CERTIFICATE NO. N-564013 07/13/01
PLUMBERS CERTIFICATION DATED N/A
or' ed S' nature
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. 26919 Z Date NOVEMBER 14 , 2000
Permission is hereby granted to:
ANTONE E BERKOSKI
PO BOX 1097
CUTCHOGUE,NY 11935
for
CONSTRUCTION OF AN INGROUND SWIMMING POOL WITH FENCE TO CODE AS
APPLIED FOR.
at premises located at 8580 COX LA CUTCHOGUE
County Tax Map No. 473889 Section 083 Block 0003 Lot No. 003 . 002
pursuant to application dated OCTOBER 16, 2000 and approved by the
Building Inspector.
Fee $ 150 . 00
Authorize ignature
COPY
Rev. 2/19/98
0 g 077
Form No. 6
TOWN OF SOUI'HOLD
BUILDING DEPARTMENT
TOWN HALL
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 fi-om 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 I% lead.
5. Commercial building, industrial building, multiple residences and similar buildings and installations, a certificat
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 Occupanc)
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. Photocopy of Certificate of Occupancy-$0.25
4. Updated Certificate of Occupancy- $50.00
5. Temporary Certificate of Occupancy- Residential$15.00, Commercial$15.00
Date. ZD -0
New Construction: Old or Pre-existing Building: (check one)
Location of Property: (!foX LZL(Af?—
House No. C Stree/t� Ha et
p�Y�
Owner or Owners of Pro6eyo-0 fw - `-1, �1-6�
Suffolk County Tax Map No 1000, Section g 3 Block 3 Lot_5 2-
Subdivisio
-2-
Subdivision q Filed Map. Lot:
Permit No. Date of Permit. (moi-d Applicant:
Health Dept. Approval: Underwriters Approval: !A e `J
Planning Board Approval:
Request for: Temporary Certificate Final Certificate: 1/ (check one)
Fee Submitted: $
Applicantignature
CO2:dU�D
THE NEW YORK BOARD OF FIRE UNDERWRITERS PAGE '
1185@7'7 BUREAU OF ELECTRICITY
40 FULTON STREET, NEW YORK, NY 10038
JULY 13°2001 '.': P=:n N 564013
Date Application No. on file
THIS CERTIFIES THAT a 6q ��-
only the electrical equipment as described below and introduced by the applicant mimed on the above application number is in the premises of
ANTONE BERKOSKI, 8580 COX LANE, CUTCHOGUE, NY
in the following location• ❑ Basement Ellst FL El 2nd Fl. OUT Section Block Lot
was examined on ` 29,2001 and found to be in compliance with the National Electrical Code.
FIXTURE FIXTURES RANGES I COOKING DECKS OVENS DISH WASHERS EXHAUST FANS
OUTLETS RECEPTACLES SWITCHES INCANDESCENJ FLUORESCENT OTHER AMT. K.W. AMT. K.W. AMT. K.W. AMT. K.W. AMT. H.P.
1 1 1
DRYERS FURNACE MOTORS FUTURE APPLIANCE FEEDERS SPECIAL REC,PT.j TIME CLOCKS BELL UNIT HEATERS MULTI-OUTLET DIMMERS
SYSTEMS
AMT. K.W. OIL H.P. GAS H.P. AMT. NO. A.W.G. AMT. AMP. AMT. AMPS. TRANS. AMT. H.P. NO.OF FEET AMT. WATTS
1 20 .
SERVICE DISCONNECT NO.OF S E R V I C E
METER
NO.OF CC COND. A.W.G. A.W.G. A.W.G.
AMT. AMP. TYPE EQUIP. IS 2W 1/3W 1/SW 3/4W PER 0 OF CC.COND. NO.OF HIAEG OF HI-LEG NO.OF NEUTRALS OF NEUTRAL
OTHER APPARATUS:
SWIMMING POOL-1
G.F.C.IT-2
*(SWIMKM POOL) This certificate
covers compliance at the date of 63 f_ 3,2
inspection only. Because of unusual
environments it is advisable to
have frequent test/and or repairs
made by a qualified person.
<<< Continued on Page 2 >>>
GENERAL MANAGER
Per
This certificate must not be altered In any manner;return to the office of the Board it Incorrect.lY be identified by their credentials.
COPY FOR BUILDING DEPARTMENT. THIS COPY OF CERTIFICATE MUST NOT"FRED IN ANY MANNER.
s
THE NEW YORK BOARD OF FIRE' UN�06 RITERS PAGE 2
1185077 BUREAU OF ELECTRICITY
F 40 FULTON STREET, NEW YORK, NY 10038
Date JULY 13,2001 Application No. on file r' }'' "r' ''' N 564013
THIS CERTIFIES THAT
only the electrical equipment as described below and introduced by the applicant named on the above application number is in the premises of
ANTONE BERKOSKI, 8580 COX LANE, CUTCHOGUE, NY
in the following location El Basement ElIst Fl. El 2nd Fl. OUT Section Block Lot
was examined on ' 29,2001 and found to be in compliance with the National Electrical Code.
FIXTURE RECEPTACLES SWITCHES FIXTURES RANGES COOKING DECKS OVENS DISH WASHERS EXHAUST FANS
OUTLETS INCANDESaIkA FLUORESCENT OTHER AMT. K.W. AMT. K.W. AMT. K.W. AMT. K.W. AMT. H.P.
1
DRYERS FURNACE MOTORS FUTURE APPLIANCE FEEDERS SPECIAL REC'PT.j TIME CLOCKS BELL UNIT HEATERS MULTI-OUTLET DIMMERS
AMT. K.W. OIL N.P. GAS H.P. AMT. NO. A.W.G. AMT. AMP. AMT. AMPS. TRANS. AMT. H.P. SYSTEMS AMT. WATTS
NO,OF FEET
SERVICE DISCONNECT NO.OF S E R V I C E
METER NO.OF CC COND. A.W.G. A.W.G.
AMT. AMP. TYPE EQUIP. 102W 1 0 3W 303W $•4W PER 0 OF CC.COND. NO.OF HI-LEG OF HI-LEG NO.OF NEUTRALS A.W.G.
OF NEUTRAL
OTHER APPARATUS:
ROSLAK ELECTRIC LIC.#3677-1 LL
P.O.BOX 164
CUTCHOGUE, NY, 11935-2453 GENERAL M�ANNAUR
11
Per-
This
er This certificate must not be altered In any manner;return to the office of the Board If Incorrect.I " y be identified by their credentials.
COPY FOR BUILDING DEPARTMENT. THIS COPY OF CERTIFICATE U5 N0,T-,jW4LTERED IN ANY MANNER.
Y
suiLuiNc DEPT.
INSPECTION
[ ] FOUNDATION IST [ ] ROUGH PLB6.
[ ] FOUNDATION 2ND [ ] 1N ULATION
[ j FRAMING [ FINAL
[ ] FIREPLACE & CHIMNEY
REMARKS:
0
DATE 8PECTOR
ZLD INSPECTION REPORT DATE COMMENTS 6—
:xssxxaa=====axaaa=eax==�xxzxaa==lt==cxatc=====x=cox=x==oaao=x===vx===ca====xacca=ax=xo=xa ^
)UNDATION OST)
rr �I
I
)UNDATION (2ND) II II ----------------
----- -----------------------------------
-------------
11
IIII p
� N
z OC
1
0
+UGH FRAME &
PLUMBING II ij
I�1
II ij ^
=
r -
i
'i BOARD OF HEALTH . . . . . . . . . . . . . . .
�. FORM NO. 1 3 SETS OF PLANS
j I 62000 iso' TOWN OF SOUTHOLD SURVEY . . . . . . . . . . . . . . .
F BUILDING DEPARTMENT CHECK
TOWN HALL SEPTIC FORM . . . . . . . . . . . . . . . . . . .
/?V"".\6,56UTHOLD SOUTHOLD, N.Y. 11971
TEL: 765-1802 NOTIFY:
. . . . .5 . . . .
Examined........... 20....
2(b.... �.V�. MAIL TO: . . . . . . . . . . . . . . . . . . . .
Approved.....���1'?l Q.P.., Z.?2 Permit No. ..................................
Disapproved a/c .......................... ...
..... ..................................
........................................ ..... .......
i
. ..... . ....................
(Buil Inspector)
APPLICATION FOR BUILDING PERMIT
Date. . . . AYA . . . . . . 20.41v
INSTRUCTIONS
a. This application must be completely filled in by typewriter or in ink and submitted to the Building Inspector w
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 giving a detailed description of layout of property must be drawn on the diagram which is part of
this application.
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
permit shall be kept on the premises available for inspection throughout the work.
e. No building sball be occupied or used in whole or in part for any purpose whatever until a Certificate of
Ocanpancy shall have been granted by the Building Inspector.
APPLICATION IS HEREBY RME to the Building Department for the issuance of a Building Permit pursuant to the
Building Zone Ordinance of the Town of Southold, Suffolk Canty, 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.
................
(Signature of applicant, or name, if a corporation)
••(Mailing address of applicant)
State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builde
..........................�G1�.1.' � l�.k�............................................................................
Name of owner of premises .�r4L�J.tU ...t...!l iU7t►.c �....is fj U5l K 1....
(as on the tax roll or latest deed) ............ .......... .. .
If applicant is a corporation, signature of duly authorized officer.
.�g.k,.�... ........ �f�).............
(Name and title of corporate officer)
Builders License No. .( �llp.7;�fT.........
Plumbers License No. .........................
Electricians License No. .....................
Other Tirade's License No. ....................
1. Location of land on which proposed work will be done..............................................................
... 0..................... .. f�:...................................
House Number Street Hamlet ..................
County Tax Map No. 1000 Section ...40........ Block ...,........... Lot .. .
Subdivision .�i1174s..t� 'KG15�1............. Filed ...
Map No. ........ Lot ...�..........
(Name)
2. State existing use and occupancy of premises and intended use and occupancy of proposed construction:
a. Existing use and occupancy ..�1�.. ?4�e�4y.:..� ...f�J•:................................................
b. intended use and occupancy ,y� ....................GJ,71 rp
t: c .... W
.•' •f p.oil
..........
Repair ............ Removal ............. Demolition ............ them hdc ........ Alteratiah./h?:�?dtuN.P.. ,4!`a"!�!�i..
(Description)
4. Estihmated Cost ../v.y.0................... fee :Ov................................
(to be paid on filing this application)
5. If &A---ling, nUTber of dwelling units ............ Number of dwelling units on each floor ................
Ifgarage, 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: .,;,,,... ,�i,Z'.........
Front.. vet.. Rear Depth
lleight .�................... Number of Stories .. �.. ...............
Dimensions of sane 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: Dont ..3�5t:.7��....... Rear ..` .lr.•.??.*...... Depth .?•2 y.4..........
10. Date of Purchase ..................... Name of Former Owner ........................................
II. Zone or use district in which premises are situated .7 45'.5 P94 Z/A4 ...........................................
12. Does proposed construction violate any zoning law, ordinance or regulation: ..AC 49
13. Will lot be regraded ...yZ:!?' ........... Will excess fill be removed from premises: YES
14. Names of Owner of premises [ .'9..ZeTiS<4 K4..... Address 7?. /.U9.7..�'NT 'liG .. Phone No.
Name of Architect .................................... Address .............................. Phone No. ...........
Name of Contractor GTt+!TpM.�..'Fi:X : ........... Address �.�Ulc.9...C�cR 4,V....Phone No. .7.35!;
15. Is this property within 300 feet of a tidal wetland? * YES .......... ND
*IF YES, SOUIIilgD IUA TRDS ELrS PERMIT MAY BE RTQ M.
PLOT DIAGRAM
Locate clearly and distinctly all buildings, whether existing or proposed, and indicate all set-back dimensiohs
from property lines. Give street and block number or description according to deed, and show street names and indicate
whether interior or corner lot.
_ /N-!'2cwiJD �cviM�-l�.tJf� 700L LA. i�L. 'r3� 00A.Z7ZtC12'D OF -STEEL c Mft-6
U iii 1Z't N!� /4 U/AVy'L 4,J/LL /71Cx,l� h'T✓.2U �U UUO �.9U c' off=
Srn.lr OF NU YOML
SS
.........................bei� dulY sworn, deposes and
says that be is theappl.icamvt
(Name of individual signing contract)
above named, /�
tie is Live .........1-%.0!(J7% .C.f-.7�f ..........................................
(Contractor, agent, corporate officer, etc.) ..•...
of said owner or owners, and is duly authorized to perform or have per.founed 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
�,? .... a
fyi
Notary Public ..... ...... •g
.....,, ...... ............
LYIVDA 11.BONN (Signature of Applicant)
NOWY PUBuc Stars a Nsirn**
&NNW in S Cour
Ybrm Expkes OA"4 2pa
`•__ - - - - _ -s - .r,.�it _ : _.., ....W - ti:r iia_... - - - --y_• _ - __ _'r" _a - -- - .• - +r: -3•.or, ....
,tom :.._:3.: y e�� R. { Anm
'TINOL *4% �AS:.. -.
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< - = .. 386.77 Y. �" a
- ceODUNrr DEPAfl'rMMT OF NEAN
LY DN►E111NG OI�tY -r Y_ _
H.S. REF.NA. 7t?-fin_ ' '�V'�D ,vD N € STATEMENT OF.INTENT
s r
_ O '
ge disposal and water supply facilities for this N THE WATER SUPPLY AND SEWAGE DISPOSAL,
- �sJO(' k:a have been inspected b this De rtm _=` x'42 _ _ '` "`�"'_"*,?LU-
pec Y pa ent"/Or _ _ _ _ _ Z SYSTEMS FOR -THIS RESIDENCE- WILL-
other - - A.,,� 65 -.. . .. . .
•` _ (iw'' .,fi«:-- r _ - , --- -, CONFORM ,TO. THE`�_STANDARDS OF THE:_.
Chef of &ween of Wastexaber Management _ _�_-, -- - i SUFFOLK CO. DEPT.-OF HEALTH SERVICES.
�laL '
APPLICANT
-
_ `� SUFFOLK •� COUNTY::. DEPT. OF HEALTH
{
�.. •� SERVICES ,-_FOR APP'�OVAL.. OF
O a- CONSTRUCTION ONLY
DATE:
_ ;ys_ . SEPnc s - -;4•L� -_ --3 _ _ . 87:50-225
REF;NO-
i LLa O O - APPROYEt?:
a V
'0- P1l11 DINC.I s&fe�Ac,r. IdNb \ V SUFFOLK CO. TAX MAP DESIGNATION:
.�
U o _ GIST.. - SECT. BLOCK PCL.
0 2��� 0 83 3
� •� �. i o0o O 3. 2 �
OWNERS ADDRESS:
-.. .:. ��- . .. __-> a . .. . •' .` ,.
. _ "i= _ .�4-- _ _ '.� _�'}$ -�' -1+J. - . - `_ =- . - 386.'1'1' � . � _ f :�.`�, . �-#�•�
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cr DEED' L. P.
:TEST HOLE STAMP
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SAN D - -....
p.WD I`�; (. � 14 3 MAP AM ELI D�!?.-.00T. 13,19$8_ _ � V
�R... -MAP.241SEAL'
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APPROVED AS NOTE
DATE: 13 a B.P.
` FEE: ��� BY: �
NOTIFY BUILDING D PART T AT
/ 765-1802 9 AM TO 4 PM FOR THE
FOLLOWING INSPECTIONS:
i 1. 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 N.Y.
STATE CONSTRUCTION & ENERGY
CODES. NOT RESPONSIBLE FOR
DESIGN OR CONSTRUCTION ERRORS
"IMMEDIATELY"
ENCLOSE POOL TO CODE
C "`� '° 1 '� �� ` "" UPON COMPLETION
'' •,.. BEFORE "WATER"
t_-
BILL OF _ C
11-8'Plain Pamk(08-009) K 1
2-5'Plain Pa ls(08-01 )
24'Plain Panels(084166)
1-2'Plan Panel(08-018) LIE F G N J K J
40 80
8' p " 1-90'Caner Sol(08-020) SIZE A B C D E F G H J K L
v v 812-Economy Braces(08-210) 181x36' I8' 36' 8' Y4' Ir 14' 5'6' 4'6' 1 4'6' 9' 4'8'
1-Steel Hardwarerd(08-204) , ,>,Pro•,,,,,wva4 . . . . ,
rj 1-18x36 Straight Coping Set 6"Radius(10-002) roasroaorina 18 u S 6 Y4 tY U 5 6 4 6 4'6 9' YY'
8CORN' 1-90a Coping Corner Set(10-004)
ER
1-V'myl Uner(see options below) :•-e•
� * STEP OPTIONS ACRYLIC FIBERGLASS -
8' AO,b 6'Stip-Remove 2408-009)8'panek and "UT
8' 1-(08-018)2'panel. Insert 1401-006)6'step
and 2408-014)6'panels. l
58'Step-Remove 2408-009)8'panels and mow"
2' 1-(08-018)2'panel. Insert 1{01-002)8'step
4' 8' 8' 8 8 and 2-(08-015)5'panels. FILLET . ,
CORNERS rC •'•+:
..•
STEEL PANEL OPTIONS
onrRsslaarTt j
Replace 4-8'plain panels(08-009)with: i 11
1-8'skimmer panel(08-011) PANELS E . ,x s►..c
2-8'inlet panels(08-010) T�"'""' j
1-8'Tight panel(08-012) STEEL STEP OPTIONS COPING LAYOUTSTEEL STEP LINERS i
8'Steel Step(end)Remove
H-6:(03-604-CS),(03-604-LS),(03-604-RS) 2•(08-009)8'panels end]-(08-018)
nd 1
' 1-8:(03-204-CS),(03-204-LS),(03-204-RS) 1-(08-018)1'panel. Insert
8 45oe-30
S-14:(03-304-CS),(03-304-LS),(03-304-RS) �-161)
2408-016)4'panels.
S 5 6 NSPI TYPE II 1410-083)steel stop coping set
OPTIONSVINYL LINER and 2-(10-085)coping corner
set required. See pope 1.
I ob , 8'Steel Step(side)Remove
Allo.. 8 6 i-Toe-00)8' step,
l
1408-013)1'ponel,1408-167)
45'x1'fiber panel and
6 1408-168).4,panel.
5 1410-083)stool stop coM set
and 1-(10-085)coping corner
4 8 8 TOPAZ3-6STEO RUNG ST204) ONE T E set required.See page 1.
NON DIVING UNERS A"*Wlen Dalen It is your responsibility to see AIa dw softly podusp provided by FWP is ddi esed to
H-6(03642) 18(03-242) S-14(03-342) pool° and dxo a"NO DrVM" n'na Iotas one properly msa"ed.
ADDITIONAL NOTES THIS DOCUMENT IS FOR ILLUSTRATIVE PURPOSES ONLY. FORT wAT1E Poolse),wr_$10 SUMPTFR arid;
• o �mAa only s� ��inisde FT VAM 0 4Ne4 ISA (2H14324731
Diagonals given to 90 point of comers. Thea.ala d mansions carlply wiA,A»National Spa and Pool �,Fon ,Ioontaclor to"cusw w reo«d;rg«ry mo"s F P O O L---R euvrf"o swreea
insMute slrggesAd minimum sbrldords for residential pods. Pn' d by FWP an dk&joob6 to dw d"w/con in over only. The
NOTESGENERAL EXCAVATION NOTES If" lsoards«slides are b be wed with Asei•pods pleose dealer«aaneae«wow sells or nsbes y«w pool is on indgx K6,,t FRN-004
conwh the aiarwfadureh instudions and dw hkdioral Spa&Pod ,qn p,and is not an agent«ploy-of FWP.TM—*--Non
LAI"W1'rrerreitlle are frac Tier es•wiw on ON gook. 1.Sort b haw nlinilrerrn beorirp aopoWy of 2000 P.S.F. 3.Escawtian shill be 7 larger Aan and aN'road. Mshme's minunwn sb�dads prior b insbaing divwra boards or ,nyhods iRuseabd hen as sand apply only to normd own mu s s
2.bob bP of pod at Isoo 6'above amramding Fie odds wdr bass of panel and bnP wee. slides on Arose pools. For in$kpromulim carlaan' NSPI minimum 18 X 36
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