HomeMy WebLinkAbout29388-Z FORM NO. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Office of the Building Inspector
Town Hall
Southold, N.Y.
CERTIFICATE OF OCCUPANCY
NO: Z-30431 Date: 09/16/04
THIS CERTIFIES that the building ACCESSORY
-Location of Property: 255 WEST COVE RD CUTCHOGUE
(HOUSE NO.) (STREET) (HAMLET)
County Tax Map No_ 473889 Section 111 Block 3 Lot 3
Subdivision Filed Map No. Lot No_
conforms substantially to the Application for Building Permit heretofore
filed in this office dated MAY 14, 2003 pursuant to which
Building Permit No. 29388-Z dated MAY 19, 2003
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 IN THE REQUIRED
REAR YARD AS APPLIED FOR.
The certificate is issued to RANIERO & LYDIA D'AVERSA
(OWNER)
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A
ELECTRICAL CERTIFICATE NO_ 76770C 12/16/03
PLUMBERS CERTIFICATION DATED N/A
tk1 [M � C✓l'.�ri
Authorized Signature
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_ 29388 Z Date MAY 19, 2003
Permission is hereby granted to :
F HELLERMAN TRUST
255 WEST COVED RD
CUTCHOGUE,NY 11935
for
CONSTRUCTION OF AN INGROUND SWIMMING POOL WITH FENCE TO CODE IN
THE REQUIRED REAR YARD
at premises located at 255 WEST COVE RD CUTCHOGUE
County Tax Map No. 473889 Section 111 Block 0003 Lot No. 003
pursuant to application dated MAY 14 , 2003 and approved by the
Building Inspector to expire on NOVEMBER 19, 2004 .
Fee $ 150 . 00
Authorized Signature
ORIGINAL
Rev. 5/8/02
r m
Form No.6
TOWN OF SOUTHOLD A
BUILDING DEPARTMENT '4
!' sr_p I 0 2011
TORN HALL
765-1802
APPLICATION FOR CERTIFICATE OF OCCUPANC r �i�`d 3 t `u
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 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 10ib Iead.
5. Commercial building, industrial building, multiple residences and similar buildings and installations, a certificate
of Codi;,C61ripliance from architect or engineer responsible for the building.
6. Submit Planning Board Approoal 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, Addi6ns 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 $1.5.00, Commercial$15.00
Date.
New Constructionn� Old or Pre-existing Building: (check one)
Location of Property: Lr,r 5 W= Cvjr-,= 126po �lJ
House No. .�j Street Hamlet
Owner or Owners of Property: meo A L YCI P 01 44aasA4.
Suffolk County Tar;Map No 1000, Section It ( Block Zj Lot__3
A
Subdivision � op w mn*m mlap Filed Map. 763 Lot: i's
Permit No. Z 1 'lj B _Date of Permit. Plk`1 l Q t 2yb 3Applicant:
Health Dept. Approval: Underwriters approval:
Planning Board Approval:
Request for: Temporary Certificate Final Certificate: (check one)
Fee Submitted: $ 2�7
r� App is t Signature
0" 6�rSV3
Q0Z30V31
u' a
T '
cal Ins- on Certificate
Issue Date �'F cal Inspill Service,Inc. Application {
t2'17N3i ,.F-- 375 Dunton Avenue 7577CC
East Patchogue, Hev.'r'ork 11772
1631)=82-E'rtI
A
issued To: Raniero & Lith' Daversa
Street: 255 Nest CovT I
Village: Nassau Point i Zip: 11935 Town: Scuti
Section: 10007111 5111¢cic:3-3 Lot: 15 �
3
Contra�tor_iCee E{426
oration _ Lie.# 2239-E
Was eYBrnine .aW be In cemplionce With the National Electrical Code.
❑ commercial ❑ NV Dsleets ® Pool ® Ist Floor ❑ Indoor ❑ Basement ❑ Hot Tub >Sj
Residential ❑ Dnt. Garage i Attic .L 2nd Floor ❑,Outdoor ❑ Addition ❑ Survey III r
{{Pt i Switches Receptacles ..' 'Fixtures GFl Heaters AIC Fans
50 65 89 1;
Dishwasher WasherlAmps Dryer/Ampa Over RangaiAmps Microwaves -
1-20A 1 20 '-. 1 30 1 50
Furnace Oil Gash Circulators Smoke Detector Bell Transformer
x 9 I ;z
voter Amps Phase UG/0H Jacuzzi Television CO Detector
1 200 , _. z
Bldg, Permit: ` ;: `
v= row: I
Other Equipment
�C-AIC Comp 40A
1-200A Panel Hugo S. S4sr�!
1-80A Sub Panel f i :.,
1-60A'Sub Panel-Pool Presldent
-40AAir Haitdlers r
11-30A Range
'i-30A Rec
Rough Inspection: 0WIV2003
1-20A R8C Inspector Eddie Rodriguez ,
1-Hydro Mesa Oe _ `ie
1-House Lift Motor Chandeliere. Final Inspection: 1211rY1005
^ff ! Inspector: Sean P.HightoNer
This,wrtfica a trust not be-el in any.manner. InspecLcrs may be identifled by thea credentials.
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CARD
TOWN OF SOUTHOLD PROPERTY R'SCOR-b
OWNER STREET VILLAGE ILO
DISTRICT SUB. T -,;0
Syr
/C 6 vv
FORMER OWNER N E ACREAGE
Q..r r)haxr-, Coop"— S11 W TYPE OF BUILDING
RES. SEAS. VL. FARM comm. IND. CB. misc. Est. Mkt. Value
LAND IMP.
TOTAL DATE REMARKS
"P
V4 sle ,�Itlz 2�e," r v�w�f
a70 4o (!o�p
AGE BUILDING CONDITION
NEW NORMAL BELOW ABOVE FRONTAGE ON WATER
Form Acre Value Per Acre Value FRONTAGE ON ROAD
Tillable I BULKHEAD
Tillable 2
Tillable 3
Woodland
Swampland
Brushland
House Plot z
Toto I
BUTT-EqNazBIMIEUENUE -IJECIK-LISJ
Applicant/ Dale.
.�
Owners Name: Hz ��n.r Jn - Reviewed:
Architect/ Date
Engineer-- _ Submitted: .S /
SCTM N:
Disirice 1.000 Section: � _ Block: 3 Loc .
Project ^ ' t - Subdivisions
Location: �.�lw�� LCu-Z /� -_ Name_
Single S separalc Required
certi ticaiion: (Yes /No) f- _
/_oni,c lliana: ILc[si:c. .Annal' x.303. I Ilnl curcr3gc 'ropascJ�dhj/,r�l
R. q F
_ 9 Reg �
[Prom Yard Crcp3sed: Side 'ard �jl'-rorused_ 2L_I [R�r Yard
(7 VI
Project Description: / S P
AGENCl'PB�ERMITS Permit .
REQUIRED FOR RE,VIEW N.A. NO YES Number
Suffolk County Health Dept. ✓
New York State D. E- C- v�
Town Trustees
Town Zoning Board approval: _
Town Planning Board approval:
Flood Plane Elevation???
Flood Zone: �x-
/6 _
otes:
i
1
i
76S-1802
BUILDING DEPT.
INSPECTION
[ ] FOUNDATION 1 ST [ ] ROUGH PLBG.
j [ } FOUNDATION 2ND [ ] JWSULAT1,0N
[ ] FRAMING ] FINAL
I
FIREPLACE & CHIMNEY [ ] FIRE SAFETY INSPECTION
i
REMARKS:
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DATE 1-7 INSPECTO
FIELD INSPECTION REPORT DATE COlYIMENTS
v
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FOUNDATION(1ST) y
-------------------------------------
FOUNDATION(2ND)
Z
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(J'q
ROUGH FRAMING 8 m
H
PLUMBING
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INSULATION PER N.F.
STATE ENERGY"CODE
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FINAL.
ADDITIONAL CONBIENTS
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TOWN OF SOUTHOLD BUILDING PERINIIT APPLICATION CHECKLIST
BUILDIT&DEPARTNI.ENT Do youhave or need the follow ng,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 7 Suney
wwvv. northfork.net/Southold/ PERMIT NO. Check
Septic Form
N.Y.S.D.E_C.
Trustees
Examined 20'_0 D a Contact: T,,
,approved � J�j ,_'003 Mail to: DON Lt—,,L
x 60q
.Disapproved a'c � r��+1- 16011 I
�t s2 �}?)ScTT1 lyCV--
Phone:
Expiration �% ,20 D
Building Inspector
~ .APPLICATION FOR BUILDING PERMIT
Date M 200-3
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 pemtit
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.
aPPL1CATION IS HEREBY DL SDE 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 lacus, ordinances, building code,housing code, and regulations, and to admit
authorized inspectors on premises and in building for necessary inspections.
V
"M MEDIATELY" OCCUPANCY OR (Stgnatureof ppl cant or name, if a corporation)
ENCLOSE.UPON COMPLETION
USE IS UNLAWFUL �K Ii7g2 ►^'1+�MTVekI
BEFOREVATER' WITHOUT CER?IF Gly (XfailinPaddress ofapplicant)
State whether applicant is owner, lessee, fit, Y general contractor, electrician,'plumber or builder
DE ITERS CERTIFICATE
I T REQUIRED Annorpr
Name of owner of premises N 1 tnp-n -A L vo1A- De s e Lg.p„y_
(As on the tax roll or latestd)
: 1�U BY:
If applicant is a corporation, signature of duly authorized officer kNOTIFY BUILDIN_G DEPARTMENT AT
765.18112 B AM TO 4 PM FOR THE
(Name and title of corporate officer) FOLLOWING INSPECTIONS:
1. FOUNDATION - TWO REQUIRED
Builders License No. 'lb FOR POURED CONCRETE
Plumbers License No. 2. ROUGH - FRAMING & PLUMBING
Electricians License No. 3. INSULATION
4. FINAL - CONN:UJ iON MUST
Other Trade's License No. BE COMPL - rOR C.O.
ALL CONSTRUCTION SHALL MEET THE
1. Location of land on which proposed work will be done: �p�QUI�EMEIYT$ OF THE CODES OF NEW
-10AD �'V T° S 3Ulf NOT RESPONSIBLE FOR
i
House Number Street HanDESIGN OR CONSTRUCTION ERRORS.
County Tax Map No. 1000 Section 11 Block 3 Lot '3
Subdivision P Lo N Z ZZeR-S;- Y lmJIS-f Filed Map No_ 7 6 3 Lot Irj
(Name)
^
2. State existing use and occupancy of premises and intended use and occupancy of proposed construction
a. Existing use and occupancy V 4L_GAnI T-
b
b. Intended use and occupancy 516 G 1.V rpen/W 0VV-FLw rl C-
3. Nature of work(check which applicable): New Building Addition Alteration
Repair Remo-vql Demolition Other Work -5 v7 M j/-C6 Poo
(Description)
4. Estimated Cost_ �c� gaz) Fee
(To be paid on filing this application)
S. 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 3 oo-j� Name of Former Owner
11. Zone or use district in which premises are situated �y
12. Does proposed construction violate any zoning law, ordinance or regulation? YES NO X
13- Will lot be re-graded? YES k NO—Will excess fill be removed from premises? YES NO x
14- Names of Owner of premises Address (Cosi.y n1 N t' Phone No.S I( - 71-1 - 65"
NameofArchitect DONDwO F��I L..» Address rnA-ITt70ctL- Phone No 2-`f6- SZSy
Name of Contractor Address Phone No.
15 a- Is this property within 100 feet of a tidal wetland or a freshwater wetland? *YES NO X
* IF YES, SOUTHOLD TOWN TRUSTEES & D.E.C. PERMITS MAY BE REQUIRED.
b. Is this property within 300 feet of a tidal wetland? 4: YES NO X
* IF YES, D.E.C- PERMITS MAY RE REQUIRED-
•
16. Provide survey, to scale, with accurate foundation pl ai`and dik@lces fia_property lues:; `' a
1 If elevation at any point on property is at 10 feet or below, must-ptovtde'topographical data on sun'ec
STATE OF NEW YORK)
SS:
COUNTY-OF ) _. -- -
1/io'Yt beim didy sworn, deposes and says that (s)he is the applicant
(Name of individual signing contract) above med,
(S)Heisthe
(Contractor, .agent, Corporate Officer. etc.)
of said owner or ovners,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 faith in the application filed therewith.
Sworn to before i}re this
,dati of
:m t'Y t• `i loFs? SigoriatAejf Applicant
JOYCE M.WILKI !S
{rotary Puttiie,State of New York
No.4952246,Suffolk CogyM
-arm Ex„iras June 12, v4003
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K,3
S.C.T.M. N0. DISTRICT; 7000 SECTION: 111 BLOCK; 3 LOT(S):3 y
+1
R
(
HAYWATER ROAD P,
58
55
LOT 14 54
52
a 50 20 ,00
DWELL LL
ry
0
/ E
n
c�g3.14�50,
NO WELLS o LOT 12 .
/ IN THIS AREA 'w.
o L T 15 S
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m
49.4 70,9' j0. 2k p OPOSEO
3,10 12 EL 49.9 g 36 P7
OOL U!
49.5 INGROUNO 9,
DRIVEWAYm
N N n mo EL 59.1
LILR12 , 010 o y�
r mO KO S \
Q
120.2
Q � Q PROPOSED WATER SERVICE �� �
190
� O T� O
Ou Ba , 2018
I 2e`
) 00
W Q 41 EU 530 USE 1''TANK�
SEPI IG �p OT 16
1N O
THE
LOC
1 s ANL
\ h
I �GCIC i ,
�LY AR A: 2•5,032.9 S.F. OR 0.53 ACRES ELEVA
U AUTHORIZED ALTERATION OR ADDITION TO THIS SURVEY IS A VIOLA ON OF SECTION 7209 OF THE NEW YORK
MAP NOT REARING THE LAND SURVEYORS EMBOSSED SEAL SHALL NOT BE CONSIDERED TO BE A VALID TRUE CE
_.J NLY TO THE PERSON FOR WHOM THE SURVEY IS PREPARED AND ON HIS BEHALF TO THE TITLE COMPANY, GOVL
/LISTED HFREON, AND TO THE ASSIGNEES OF THE LENDING INSTITUTION, GUARANTEES ARE NOT TRANSFERABLE.
VACANT /THE OFFSETS OR DIMENSIONS SHOWN HEREON FROM THE PROPERTY LINES TO THE STRUCTURES ARE FORA sPF!
SC.T.M. NO. DISTRICT: 1000 SECTION: 111 BLOCK: 3 LOT(S):3
#R10-02-0237
HAYWATER ROAD
EO 06"0
LOT 14 09C ELM 53.0
2g2.00! OR BROWN
DWELL SANDY LOAM �.
c BROWN
/ 0"B V3 SILTY SAND 3.5'
NO WELLS
Sg�14'5
/ IN THIS AREALOT
15 J LOT 12 PALE
/ J G BRO
FINEN
v
N EL 50•Z r FENCE .i TO
g•
o io oNt 3 2 MEDIUM
SAND
Q 40.4 ELEC. EL 40.3 31.4 0. AD. .0• t 40.0' Cr7
0 6 �
c OE Nil
0 0
� wni�. >' svnu 22.5+ y
uU1� VES Z N EL 50.1
/ GRA FINEWpY �' S . ''- N
kp
Ci 16 4' g• FENCE NO WATER 17.
54' 48' rn tJ EL 54"1
V 69' c t-3�,pAtER 5 31.4. N 291.85 11-27-02
L.P.
Q d L.P. S.T. 24��
�Q 53.8 LOT 16
/S
41.5• CT
�ir'ry O 60'
�$•1�=''l O THE WATER SUPPLY, WELLS AND CESSPOOL
I o �g�04`30~v DAOR DATA OBTAINED NEDOWV ARE f FROMOM FIELD
OTHERSSERVAIION
I ,. AREA: 23,032.9 S.F. OR 0.53 ACRES ELEVATION DATUM: --_ D________________
UNAUTHORIZED AL7ERA770N OR ADDITION TO THIS SURVEY IS A 140LA7701V OF SECTON 7209 O' THE NEW YORK STATE EDUCA7701V LAW. COPIES OF THIS SURVEY
MAP NOT BEARING THE LAND SURVEYORS EMBOSSED SEAL SHALL NOT BE CONSIDERED TO BE A VALID TRUE COPY. GUARANTEES INDICATED HEREON SHALL RUN
ONLY TO THE PERSON FOR Nt/OM THE SURVEY IS PREPARED AND ON HIS BEHALF TO THE ARE COMPANY, GOVERNMENTAL.AGENCY AND LENDING INS777U7701V
VACANT LISTED HEREON, AND TO THE ASSIGNEES OF THE LENDING /NSATUAOIN, GUARANTEES ARE NOT TRANSFERABLE.
THE OFFSETS OR DIMENSIONS SHOWN HEREON FROM THE PROPERTY LINES TO THE STRUCTURES ARE FOR A SPECIFIC PURPOSE AND USE THEREFORE THEY ARE
95' NOT INTENDED TO MONUMENT THE PROPERTY LINES OR TO GUIDE THE ERECAON OF FENCES, ADDIAONAL STRUCTURES OR AND OTHER IMPROVEMENTS EASEMENTS
AND/OR SUBSURFACE STRUCRJRES RECORDED OR UNRECORDED ARE NOT GUARANTEED UNLESS PHYSICALLY E14DENT ON THE PREMISES AT THE AME OF SURVEY
SURVEY OF: LOT 15 CERTIFIED TO: DAVERSA;
MAP OF: ALONZO JERSEY REVISED
FILED: MAY 9, 1923 AS #763
ADD SWIMMING POOL 08-22-04 SITUATED AT: NASSAU POINT
FINAL SURVEY 09-26-03 TOwN OF: SOUTHOLD KENNETH M. WOYCHUK L.S.
FOUNDATION LOCATION 06-10-03 SUFFOLK COUNTY, NEW YORK Land Surveying and Design
I "'* P.O. Boz 3, Mattituck. New York 11952
FILE E SCALE: ' DATE: �f PH01ile (631) 888-15M FAX (801) 808-1508
22-1 Q9 1 =3O NOV. 2O, 2002 N. Y. S LIC NO. 50227 maintaining the records of Robert J. Hennessy
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amloirAL bibia.