HomeMy WebLinkAbout30242-Z FORM NO. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Office of the Building Inspector
Town Hall
Southold, N.Y.
CERTIFICATE OF OCCUPANCY
No: Z-30250 Date: 06/22/04
THIS CERTIFIES that the building ACCESSORY
Location of Property: 2275 DEEP HOLE DR MATTITUCK
(HOUSE NO.) (STREET) (HAMLET)
County Tax Map No. 473889 Section 115 Block 14 Lot 14
Subdivision Filed Map No. Lot No.
conforms substantially to the Application for Building Permit heretofore
filed in this office dated APRIL 13, 2004 pursuant to which
Building Permit No. 30242-Z dated APRIL 19, 2004
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 ABOVE GROUND SWIMMING POOL WITH FENCE TO CODE AS APPLIED FOR.
The certificate is issued to PHILIP & DONNA DILEO
(OWNER)
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A
ELECTRICAL CERTIFICATE NO. 2003359 05/27/04
PLUMBERS CERTIFICATION DATED N/A
",4 /- /"�
ho zed 6ignature
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. 30242 Z Date APRIL 19, 2004
Permission is hereby granted to:
PHILIP & DONNA DILEO
2275 DEEP HOLE DRIVE
MATTITUCK,NY 11952
for
CONSTRUCTION OF AN ABOVE GROUND SWIMMING POOL IN THE REQUIRED REAR
YARD, FENCED TO CODE PER APPENDIX G 105 . 2 (10 . 1 OR 10 . 2)
at premises located at 2275 DEEP HOLE DR MATTITUCK
County Tax Map No. 473889 Section 115 Block 0014 Lot No. 014
pursuant to application dated APRIL 13 , 2004 and approved by the
Building Inspector to expire on OCTOBER 19, 2005 .
Fee $ 150 . 00
Authorized Signature
ORIGINAL
Rev. 5/8/02
Form No.6
TOWN OF SOUTHOLD
BUILDING DEPARTMENT /
TOWN HALL ✓(��
765-1802 /
r,. S
APPLICATION FOR CERTIFICATE OF OCCUPANCY
This application must be filled in by typewriter or ink and submitted to the Building Department with the follb,�Ving:
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.
A. Sworn statement from plumber certifying that the solder used in system contains less than 2/10 of 1%lead.
S. 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$15.00
Date. fl
New Construction: l/ Old or Pre-existing Building: (check one)
Location of Property: 4Z 75.-DlW `P //0 A.e 3R, A-4–T 7;T U C K
House No. Stre-ett Hamlet
Owner or Owners of Property: l`iyi,c��� r Jo,��,s _ /; �"r 0
Suffolk County Tax Map No 1000, Section //$` Block O I AI Lot 01,41
Subdivision -Duee?/7011W CR A!," roes ; s Filed Map. 1,Z-5-6 Lot:
Permit No. 30,7,V,? 2r- Date of Permit. % 9 0 Applicant:_ 9/;/n
Health Dept.Approval: Underwriters Approval: J�—
Planning Board Approval:
Request for: Temporary Certificate Final Certificate: (check one)
Fee Subn-i`tted: $ t5_, O}0
� 3voi �
C L(3p3 Appli t Signature
a r��c�cnclr�c ncl�rJ�rJr PrJ'rJ'� r.! cls c.nctr nrJ'cPc--cPrJ'c.--cJ'r.11 � M
5 BY THIS CERTIFICATE OF COMPLIANCE THE S
5 NEW YORK BOARD OF FIRE UNDERWRITERS 5
5 5
5 BUREAU OF ELECTRICITY 5
5 40 FULTON STREET — NEW YORK, NY 10038
SCERTIFIES THAT 5
S S
5 Upon the application of upon premises owned by
5 55
SBLUE ROAM CONTR. LLC PHILLIP DILEO 5
5 22 THUNDER RD. 2275 DEEPHOLE DR.
5 MILLAR PLACE, NY 11764, MATTITUCK, NY 11952 c5
c5 Located at 2275 DEEPHOLE DR. MATTITUCK, NY 11952 c5
5 SAPPlication Number: 2003359 Certificate Number: 2003359 5
S
5 Section: Block: Lot: Building Permit: 30242 BDC: ns11 5
5 5
5 Described as a Residential 0-599 square ft. occupancy, wherein the premises electrical system consisting of
5 electrical devices and wiring, described below, located in/on the premises at: 5
5 Basement,Outside,
5 5
5�j A visual inspection of the premises electrical system, limited to electrical devices and wiring to the extent detailed
herein, was conducted in accordance with the requirements of the applicable code and/or standard
5 promulgated by the State of New York, Department of State Code Enforcement and Administration, or other
5 authority having jurisdiction, and found to be in compliance therewith on the 27th Day of May,2004. 5
5 Name OTTY Rate Rating Circuit T Re 5
5 Appliances and Accessories 5
SPool/Spa Bonding 0 0 5
Wiring and Devices 5
5 Outlet 3 0 General Purpose S
5 Receptacle 1 0 20 amp Pool/Spa
5 Receptacle 1 0 GFCI 5
5 Switch 1 0 General Purpose 5
Outlet 1 0 Fixture 5
SFixture 1 0 Incandescent
S (Swimming Pool):This certificate covers compliance at the date of inspection only. Because of unusual environments it is advisable to have 5
5 frequent test and/or repairs made by a qualified person. [5
5 Defects previously reported,as items of non-compliance,have been corrected. A visual inspection made of the exposed electrical equipment in7cJ'
5 the premises indicated found no obvious unsatisfactory condition. 5
5 5
5 5
5 seal
5
5 1 of I5
5 This certificate may not be altered in any way and is validated only by the presence of a raised seal at the location indicated.
5 5
S S
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71,
MAP OF DEEP HOLE CREEK ESTATES
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DEEP HOLE DRIVE
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rAs. SITUATED AT M AT T1 TUCK
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TOWN OF SOU T HOL D , SUFFOLK COUNTY .N Y
'IOlATiO4� O' SfCRGI.1 J r :;t�.ri a.<`S DATE
8 - 29 -2000
A N SCALE = 30
Y.[ W109K 7Ar. •{ 1,;.• ,�� .� ,� U �;i11
ATE
cu on MAP NO. - - _-
BY THIS NOTICE OF DEFECT THE
MAY 2 X111 YORK BOARD OF FIRE UNDERWRITERS
BUREAU OF ELECTRICITY
-40 FULTON STREET - NEW YORK, NY 10038
on the application of upon premises of
BLUE ROAM CONTR. LLC PHILLIP DILEO
22 THUNDER RD. 2275 DEEPHOLE DR.
MILLAR PLACE,NY 11764 MATTITUCK, NY 11952
Application Number: 2003359
Located at 2275 DEEPHOLE DR.
MATTITUCK,NY 11952
Section: Block: Lot: Building Permit Number: 30242
Regrets to advise that the electrical installation of the stated premises is not in compliance with requirements of
the reference standard as set forth below:
Item Location Description Reference Std.
pool recpticle Pool/Spa switch & recpticle within 5 ft of pool 680-6 (A)(1)
This notice of defect is issued by: ROGER RICHERT on the 21st day of May, 2004.
ns11
SOUTHOLD,TN
TOWN OF SOUTHOLD
P.O.BOX 1179
SOUTHOLD,NY 11971
Paae 1 of 1
Dee-Jo's 04!15104 02:22pm P. 007
APP.-15-2004 11:37 RECREATIONAL PRODUCT`, 3.30 225 1745 P.06/07
1 .75" D-I 'RAIL
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MATERIAL' r/aucru/wrKa: Doh" By' J~ DATE: 1;'->::,. ,
illlf NI/tIMG IS TM(�Ap(fTT EF gECAf/fl01Mt
F 1 N 1 S H. "ons l Am A"LL of of 014. /1/tiosfo ���chnmv,pol(LN IVB
SCALE: p' iEip�uL"r°ilolu fcr'ic°D �r f APPROVED 81: DATE: poorRglW M04
gWtWIMKEGolMfrsloNE UNLESS SPECIFIED ALL DIMENSIONS IN IIICNES TITLE: EASY ACCESS STEP WITn ENCLOSURE
its*.AasAA<ilors*.al THIRD ANGLE PROJECTIONzL '"c'"Ir"'""
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TOWN OF SOUTHOLD PROPERTY RECORD CARD
OWNER STREET VILLAGE DIST. SUB. LOT
it 1
42
FQJZMER OWNERS NE�` /� ND E'S ACR.
I W TYPE OF BUILDING
RES2/0 S. VL. FARM COMM. CB. MICS. Mkt. Value
LAND -IMP. TOTAL DATE REMARKS ti7�j
_ 3 cs-o to q7 09 Z-
700 ze z� G6
9(0— Merr9et-,01 . —
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AGE BUILDING CONDITION
NEW NORMAL BELOW ABOVE
FARM .Acre Value Per Value
Acre
Tillable FRONTAGE ON WATER
Woodland FRONTAGE ON ROAD
Meadowland DEPTH "' J
House Plot BULKHEAD
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302-41-�
765-1802
BUILDING DEPT.
INSPECTION
[ ] FOUNDATION 1ST [ ] ROUGH PLBG.
[ ] FOUNDATION 2ND [ ] INSULATION
[ ] FRAMING [ JNAL
[ ] FIREPLACE & CHIMNEY [ ] FIRE SAFETY INSPECTION
REMARKS:
J_r
DATE � INSPECTOR
A
t
FIELD INSPECTION REPORT DATE
COMMENTS
� b
FOUNDATION(1ST)
----------------------------------- — —
FOUNDATION(2ND)
z
J
ROUGH FRAMING& 7y
PLUMBING
4
i
INSULATION PER N.Y. t�
STATE ENERGY CODE
H
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FINAL
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ADDITIONAL COMMENTS
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TOWN OF SOV-THOLP BUILDING PERMIT APPLICATION CHECKLIST
BUILDING DEPARTMENTR 3 � Do you have or need the following,before applying?
TOWN HALL Board of Health
SOUTHOLD,NY 1197 jl . _ t 3 sets of Building Plans
TEL: (631) 765-1802 , ? Planning Board approval
FAX: (631) 765-9502 ,..... Survey
www. northfork.net/Southold/ PERMIT NO. o a f Check
Septic Form
N.Y.S.D.E.C.
Trustees
Examined 20r)�s- Contact:
Approved / 200S- Mail to:
Disapproved a/c
Phone: ,12 19 F-,5 O c3
Expiration /011(o ,200
Building Inspector
i. 4
5 APPLICATION FOR BUILDING PERMIT
�i
Date , 20
INSTRUCTIONS
a. This application MUST be completely filled in by typew_~iter 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 inspections.
IMMEDIATELY�� OCCUPANCY OR (Sign a of applicant or name,if a corporation)
ENCLOSE POOL TO CODE
UPON COMPLETION \
BEFORE -WATER'
U5E IS UNLAWFUL
INDERWRITERS-CERTIFICATE WITHOUT CERTIFICATE (Mailing addresspfapplicant
State wheBgWicant is owner,0Fc0 NRA 'Tengineer, general contractor, electrician, plumber or builder
APPROVED AS LNOTED
Name of owner of premisesJoy O ; Thr FEE: BY-
(As on the tax roll or latestNM" BUILDING DEPARTMENT AT
If applicant is a corporation, signature of du1e� f ce 765-1802 8 AM TO 4 PM FOR THE
ALL ���UC�I&N§HALL FOLLOWING INSPECTIONS:
(Name and title of corporate oREQUIREMENTS OF THE 1. FOUNDATION , TW9 PEOUIRED
DES OF NEW YOR�TATE. FOR POURED CONpi ETE
Builders License No. DIX i 2. ROUGH - FRAMING & M.UMBING
3. INSULATION
Plumbers License No. 4. FINAL - CONSTRUCTION MUST
Electricians License No. BE COMPLETE FOR C.O.
Other Trade's License No. ALL CONSTRUCTION SHALL MEET THE
REQUIREMENTS OF THE CODES OF NEW
1. Location of land on which proposed work will be done: YORK STATE. NOT RESPONSIBLE FOR
// /t,� DEIGN R CONSTRUCTION ERRORS.
House Number Street Hamlet
County Tax Map No. 1000 Section // 5- Block 0141 Lot 0/-1/
Subdivision 2)zg.P //atiti$ Cbe're- ks7�9r);es Filed Map No. V,IS&l Lot 41
(Name)
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
3. Nature of work(check which applicable): New Building Addition /^ Alteration 9
Repair Removal DenicYltion Other Work ,�3av�c� 64-Roo,4o Sw„yr�,MG /p0%
\` (Description)
4. Estimated Cost ?�3 500. 0 o Fee
(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 //6' ' Rear �'/. V 7Depth /S/
10. Date of Purchase Name of Former Owner
11. Zone or use'district in which premises are situated � s r D,NN 7/9),
12. Does proposed construction violate any zoning law, ordinance or regulation? YES NO
13. Will lot be re-graded? YES NOW Will excess fill be removed from premises? YES NO
14. Names of Owner of premises Address Phone No.
Name of Architect Address Phone No
Name of Contractor Address Phone No.
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. xg'iq ,Xd prdpe &ljnes.
17. If elevation at any point on property is at 10 feet or,bela ;;mu £ ovld�torp graphical date�fi
`fid,».
STATE O��YpRK
COUNTY OF
/�✓•�.� //, '' -, being duly sworn,deposes and says that(s)he is the applicant
(Nameofindividual signing contract),above named,
(S)He is the t�t✓�/t��✓Z r'` ” '
(Contractor,Age oi'poi✓ati±'�lffder, etc.)
Wri.-ti A
1 10
of said odWtlers and ={'
is.duly autboi3zed to perform or have performed the said work and to make and file this application;
that all statq t p�{�tained ua`tbi's`app lication are true to the best of his knowledge and belief; and that the work will be
performed in 'ee manner set forth in'the application filed therewith.
s..
Swoito beforra this rt ,
of. 20V
otary Public Signature of Applicant
JOYCE M.WILKINS
Notary Public,State of New York
No.4952246,Suffolk County
Term Fmires June 12, oZ CC)
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MAP OF DEEP HOLE CREEK ESTATES
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tixArt�s. _ 30 DATE 8 - 29 -2 0 00
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