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29651-Z
FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No: Z-30536 Date: 11/05/04 THIS CERTIFIES that the building ACCESSORY Location of Property: 345 LLOYDS LA MATTITUCK (HOUSE NO.) (STREET) (HAMLET) County Tax Map No. 473889 Section 99 Block 3 Lot 4 .9 Subdivision Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated AUGUST 13, 2003 pursuant to which Building Permit No. 29651-Z dated AUGUST 14, 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 AS APPLIED FOR. The certificate is issued to FRANKLIN & CAROL ANN GOLD (OWNER) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A ELECTRICAL CERTIFICATE NO. 80688C 10/22/03 PLUMBERS CERTIFICATION DATED N/A 4 Au th r' ed ignat re Rev. 1/81 �1 y'�- ► d R CO no aiw-AL - Form No.6 TOWN OF SOUTHOLD � BUILDING DEPARTMENT S CM i\Q C 12 M 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 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 certifica 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 i 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 foe O cupancy 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$15.00 Date. l o New Construction: Old or Pre-existing Building: (check one) Location of Property:_3,t5- LLOYDS L /:�I\I E N1 T r I TU C V, NY 1 ( moi 52 House No. Street Hamlet Owner or Owners of Property: 1 N �, R 1 CT Suffolk County Tax Map No 1000,Section O cIcl , ©O Blocl000- 00 Lot 004-, 00 q Subdivision �+o N E YS U G-,'I-E F+I L L Filed M • 7109 Lot: 9 Permit No. Z"9 (,5'1 Z Date of Permit._81 141 O 3—Applicant:_C-A 2O L ANN Go Lp Health Dept.Approval: N A Underwriters Approval: S L)R M I T T F r2 Planning Board Approval:_h(A Request for: Temporary Certificate Final Certificate:—A/ one) Fee Submitted:$ 3� 0/1 C, Applicant Signature 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. 29651 Z Date AUGUST 14 , 2003 Permission is hereby granted to: CAROL ANNE GOLD 5815 ROYAL LAKE CIRCLE BOYNTON BEACH FL, 33437 for CONSTRUCTION OF AN INGROUND SWIMMING POOL IN THE REQUIRED REAR YARD FENCED TO CODE at premises located at 345 LLOYDS LA MATTITUCK County Tax Map No. 473889 Section 099 Block 0003 Lot No. 004 . 009 pursuant to application dated AUGUST 13 , 2003 and approved by the Building Inspector to expire on FEBRUARY 14 , 2005 . Fee $ 150 . 00 Authorized Signature ORIGINAL Rev. 5/8/02 'A Electrical Inspection Certificate Issue Date Electrical Inspection Service, Inc. Application 10/22/03 375 Dunton Avenue 80688C East Patchogue, New York 11772 (631)286-6642 Issued To: Carol Ann Gold Street: 345 Lloyds Lane Village: Mattituck Zip: 11952 Town: Southold Section: Block: Lot: Contractor: F. M. Electric (L) Lic. # 4099-E > Was examined and found to be in compliance with the National Electrical Code. Commercial NV Defects 'X' Pool 1st Floor El Indoor J Basement El Hot Tub X Residential ❑ Det. Garage Attic 2nd Floor X❑ Outdoor ! Addition ❑ Survey Switches Receptacles Fixtures GFI Heaters A/C Fans 1 3 2 Dishwasher Washer/Amps Dryer/Amps Oven Range/Amps Microwaves Furnace Oil Gas Circulators Smoke Detector Bell Transformer Meter Amps Phase ' UG/OH Jacuzzi Television CO Detector Bldg. Permit: Other Equipment '1-20A Spec Rec 1-115V Water Neater 11-20A Time Clock Hugb S. Surdi President Rough Inspection: 10/21/2003 Inspector: Sean P.Hightower Final Inspection: 10/21/2003 Inspector: Sean P.Hightower This certificate must not be altered in any manner. Inspectors may be identified by their credentials. TOWN OF SOUTHOLD PROPERTY RECORD CARD OWNER STREET VILLAGE DIST. SUB. LOT G� ( `� ' L W( a `t' c 19 FORMER OWNER N E AGR. S W CODE DATE OF CONSTRUCTION l 2- LAND IMP. TOTAL DATE REMARKS / L 3 d� /uao �/23��L I► ZZ 3 ^' l �' C Lf -RSO �_4 a o 0 61700 Tillable FRONTAGE ON WATER Woodland FRONTAGE ON ROAD fl� Meadowland DEPTH Z4 c5 , House Plot BULKHEAD Total ■■■■■■■■■■■■■■■■■■■■ ■■■■■■■■■■oi■li■■■■■■ a::=Ems R■p■■■■■®:■■■■■ ■■■■■11®■viii■i■G1■ii■■��'!�'1 - ■■■rid■■r�■■■■■■■■■■■■ ., ®� Foundation r ■■■■■■■■■■■■■■■■■■■■ ■■■■■■■■■■■■■■■■■■■■ ■■■■■■■■■MMMMO■■■■■■ ■.MMM=M=�r;:M==M=H■■■■ ■■NM■■■■■■■■■NN11■■■■ ■■■MEMMO■■■■MU■■■■EN FoundationMilk . • Rooms 1st Floor Rooms 2nd Floor i ;, i TOWN OF SOUTHOLD PROPERTY RECORD CARD OWNER STREET Lq VILLAGE DIST. SUB. LOT G, CA'C.iC� �NN �OL.� �...- t 4 d �. �l� �1 CP `C' c 6 I� �t' s FORMER OWNER N E ACR. S W CODE DATE OF CONSTRUCTION 2,10 LAND IMP. TOTAL DATE REMARKS -- `o 4�J �L- 1 1 2Z L µEr � L_f`` � o a o 9"700 q loo s o o a�hajlj 'C Tillable FRONTAGE ON WATER Woodland FRONTAGE ON ROAD ` Q Meadowland DEPTH 245 'ty House Plot BULKHEAD TotoI Applicant/ Date, Owners Name: Reviewed: Architect Date EmIgitieer: Submitted: l 3 3 SCTM #: District: II OOQ Section: 13 lock: Lot: Project — Subdivision I,ocation: � 7U, A _ Name: Single A separate Required certification: (Yes/No) Req. Itcy, l Zoning OisiricC (I,ol zc: T" AmW: ( (Loi coverage _�tl I'rolkrQi Req. Proposed: Req. (��ron� Pard Side Ya Proposed: ( (Rear Yard ,-�' / Proposcd�,/ Project Description: -L6 P. AGENCN'..�ERIYIITS Permi REQUIRED FOR REVIEW N.A. N0 YES Numbc Suffolk County Health Dept. New York State D. E. C. f Town Trustees / Town Zoning Board approval. Town Planning Board approval: Flood Plane Elevation ??? �n Flood Zone: Notes.: 765-1 802 BUILDING DEPT. INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] I ULATION [ ] FRAMING I FINAL [ ] FIREPLACE & CHIMNEY [ ] FIRE SAFETY INSPECTION REMARKS: /Jte�e� DATE aY � INSPECTOR 765-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION IST [ ] ROUGH PLBG. � [ ] FOUNDATION 2ND [ ] INSULATION [ ] FRAMING [ �INAL [ ] FIREPLACE 8 CHIMNEY [ ] FIRE SAFETY INSPECTION REMARKS; DATE �o � INSPECTOR 765.1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] INS ION [ ] FRAMING [ INAL [ ] FIREPLACE & CHIMNEY [ ] FIRE SAFETY INSPECTION REMARKS: Jf DATE � � � /0- 4-,- INSPECTOR- t FJELD•INSPEMONREPORT DATE FOUNDATION(1ST) FOUNDATION(2ND) Dt _ !Z ' O r y ROUGH FRAIVIING& PLUMBING ►3 INSULATION PER N.Y. STATE ENERGY CODE f`. r FINAL ADDITIONAL COMMENTS z- m d • c � O tz M TOWN OF SOUTHOLD BUILDING PERMIT APPLICATION CIfECKLIST BUILDING.]aEPARTMENT 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 www. www.northfork.net/Southold/ PERMIT NO. / 7 Check Septic Form N.Y.S.D.E.C. Trustees Examined dN 20__aContact: Approved 120 t)3 Mail to: G'H'2 D L Disapproved a/c � Phone: (63!) 298 10f6 Expiration q ,20 0 Building Inspector i 13 2om APPLICATION FOR BUILDING PERMIT Date4yGvST /3 , 2003 �-,Lr 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 inspections. Cltlw ,61W 0&wlil/ (Signature of applicant or name,if a corporation) ENCLOSE EPOO TO CODE .34-5" It a yDS -L,,13 AJE 1yA7 _1L_- k UPON COMPLETION UNDERWRITERS CERTIFICATE (Mailing address of applicant) ii 9S2 BEFORE "WATER" REOUIS State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or.builder 0k)A1C-tR- AwwwwVEw AS uwwww Name of owner of premises CR R.O L 4 JV&1 GOL D 9A q/3 a p # -7-f( 57 Z (As on the tax roll or latest deed) If applicant is a corporation, signature of duly authorized officer FEE: f BY: _ NOTIFY BUILDING DEPARTMENT AT (Name and title of corporate766-1802 .SAM TO QPM FOR THE &tUPANCY OR FOLLOWING INSPECTIONS: 1. FOUNDATION - TWOS Builders License No. FOR POURED CONCRETE Plumbers License No. 2. ROUGH=FRAMING i--PLUMIG Electricians License No. WITHOUT GERMCATE 3. INSULATION Other Trade's License No. 4. FINAL - CONSTRUCTION DUST BE COMPLETE FOR C.O. 1. Location of land on which proposed work will be done: ALL CONSTRUCTION SHALL DEET THE Or^345 LLOYDS IANC M 7-r/Ti.1 IV y // y SuFwUIREMENTS OF THE CODES of NEW House Number Street Haml V1RK-STATE NOT RESPONSIBLE OR 4�ESS04 OR NOT ERRORS. County Tax Map No. 1000 Section 0 D Block 3, 0 0 Lot "/, 2 Subdivision ';4oNErsvcxi_E 1-pas *r MArrvrvc,iC'Filed Map No. 7/ 09 Lot "(P9 (Name) 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: .. a. Existing use and occupancy RESl DE_/V CC S'tiVC-L E "/ViLY b. Intended use and occupancy S'WiM M 1V 6- F-001- 18 '9 42 / 3. Nature of work(check which applicable): New Building Addition Alteration Repair Removal Demolition Other Work/POOL 4. Estimated Cost ,�2�v. O©D, Fee (Description) (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 73, 1 , Rear 73./ Depth 3.3 Height 35'(!)GaAveT ';gLNumber of Stories 2 _" - —(SSE s�Qv�y �y7-�.,gc,�,F� Dimensions of same structure with alterations or additions: Front /'!A Rear Depth 66A9 pg J�ha Height Number of Stories 8. Dimensions of entire new construction: Front a, ,4 . Rear Depth Height Number of Stories 9. Size of lot: Front 108, SO ' Rear /0 9,65' Depth E_2'18,(02 ' k1;2#2,92' 10. Date of Purchase I I l z 2 fiTS'3 Name of Former Owner #61-E/1/ y-/;>'/9-('14 1` 11. Zone or use district in which premises are situated /f 0/VE`/SU ck/l f M 1L 4 5 97- MA77-17-U k 12. Does proposed construction violate any zoning law, ordinance or regulation? YES NO_ dNry AO�49N�n Pros. ARtl 13. Will lot be re-graded? YES V'-NO ( Will excess fill be removed from premises? YES _NO , 14. Names of Owner of premises ('AR-0& 6oLD Address 3YS- AoY S �4N45 Phone No.(( 3/)298 /09 Name of Architect Address Phone No Name of Contractor CNARL ES RogI>SE/V/Address 235- LvVds ) A1EPhone No. 163,)298'/22!7 �.l9pRflSt�,.r c J!5rp h mc- !� tI���DEat C� Reg,' 4Nori 15 a. Is this property within f00 feet of a tidal wetland or a freshwater wetland? *YES NO_y * IF YES, SOUTHOLD TOWN TRUSTEES & D.E.C. PERMITS MAY BE REQUIRED. b. Is this property within 300 feet of a tidal wetland? * YES NOS_ * IF YES, D.E.C. PERMITS MAY BE REQUIRED. 16. Provide survey, to scale, with accurate foundation plan and distances to propertla—es. + _ JT T..,+,�.e, t 1°) 1tr, �i 17. If elevation at any point on property is at 10 feetnr b� 16, TM' p-r 'Vide topogr"J' 1','4 ey. (i�AI 'J."r:. STATE OF NEW YORK) SS: COUNT C'q & TSO being duly sworn, deposes and says that(s)he is the applicant (Name of individual sigmng contract)above named, (S)He� ��� ��'' "` �?`- C�1t �tor, Agent, Corporate Officer, etc.) of said oeir an i duly altherized to perform or ha e e fornlgd t e said work and to make and file this application; that all �t {n e tit _'i tFiis applicV.ation are true to th� 11 d:and l elief; and that the work will be perfornfiE 14Y th�rial�il��e lgfi'h'tfi� plication.. tJ e ih, ��3+��,! is Sworn to e or!(yw is 24 r P L,�4i'll LZ WF 10 M Signature 6fApplicant J. MARIE A.WOODS Notary ,Sbft O50318of New York No.OuN fled In SuitoNcCounty My Commission Expires Aug.15,20 SMEMAMNS —DOPING "OOPMIti ' B"TILE BAND;. -I. A& wft and p'sPmal7 placed steel rein. ir p1• �. _= fesws reds. •• y�� 2. Uniform and drib raaforced Buaite walls. BEAM BACK 3/8"ROD 12 O.C. • MB"ROD 12"O.C. 3. 77re suaita wed bails even and of•Kish ROD 24^ Psi.mtias. •o ! 4. Simple. depm&hle. Preeticel fcttinp and a r. egnipeeatt whieh allow for low-cost.woo• t SPRING LINE _: " -` STRING LINE free maiRterlaoce w«: a s"MIN: •e e SHALLOW END-SECTION DEEP END SECTION f► B . MW I V. tb TrrICAI POOL`��ION °`Orr.. •� r . _ - SECTION A SECTION B. POOL DATA RADIUS FLOOR WALLS STEEL SCHEDULE SNM-. dCIIMOEo cCRNeas. MOwaLI►@URFA=asIERO VORTICAL FOR r-r WALLS BERM FLOOR S I r•r MAIOE RAONIs. POOL oDPTN 0 LA TMAM mom Waves LrA L Tor 001"M MMM aaRam cumm-D r NOmmumMAL DICTION, mama w-m rALL ALL WMM SW Roo+r ALL Amaum POOL. A"ftom as••Mas P(01 •ALL-FLOM JUNCTION: KUM To OEM Na OF MO Ma POOL PMONI a. OIL AMT amm"aM.- FUMA UL rr oa.AMr oIROCTroN. OMDM• POOL. Alfa POpI AEIIN M W MM.As Dlr1040M. 's - . EaIAA f ra04 Dam was"+as"POOL amm a nou[ P r-rs A Ealy•saIIMQR 1001M. MINE: MOR*r•r,RYA MAI(aaM LARDER.01AM TO oEMEW oUE VBlrftq•Aa. f110M oD 11OT CUT. . of r-r. fomf flow ANY r-r iLtlrll,loraf O AM MAU am sr ore. rrlru MIM.RADM Mi TO MAoa To IMM GUNrM POOL PLAN MAX.RAaus: VttaTl "air•r or- MDRIaOMrAI aEr'�MPO& s . N .00 jo �' = -')y � •. 'fes'` t6 M Jam"" vas""►�>-� ' .4 _ C4 AU w' WOE WAM UK @) Z v - aVAuc ` p� s ori• Iw SA 'Y 1 - V v,7 wwtt os AN SURVEY OF N� LOT 9 �U d r3 MAP OF cN HONEYSUCKLE HILLS WLI K =R WLI Ll - LL:- >_ ow O'I FILE No. 7019 FILED OCTOBER 16, 1981 t SITUATED AT � N oa • a e ""63 MATTITUCK 1,01(DS ��lv , w py9e o TOWN OF SOUTHOLD os�o G SUFFOLK COUNTY, NEW YORK 1 N S.C. TAX No. 1000-99-03-4.9 j Y moo; d SCALE I"=40' Y WJ o E o G APRIL 14, 7999 6013 \\W \\p $*6.0. o, 1 MAY 14, 1999 UNDER CONSTRUCTION SURVEY - <.. DECEMBER 17, 1999 FINAL SURVEY k 1 _ \ AREA = 26,666.36 sq. ft. 0.613 ac. n S.C.D.H:S.No. R10-96-0151 51pN 1510 CERTIFIED TO 1104 "' O CAROL ANN GOLD 9 4 w \ \p6 EN C" eA SUFFOLK COUNTY DLRAR7'A.w?77 C?l ar TH SERV1CfS / F _ – \ �1011 p / APPtt RVSl7'tiCL<CQ67c��.1:'CCu y F ca! ��r 0 1 2f�Vli1 a F- �--- —ff-- 1 _•. iac .-1 hp.e tppp al gyp, UNAUTIORIZED�&I RAMN DNAEIUMON • �� StCTMNS)2n9 OF THE NEEV YOW-STATE / EpUGTON IrNi. - / COPIES OF TMS'SURAY WW�- NUT, HEARIN,ME VND SURVMWV INIpD°EEA OR EmEcs EO SEA, 6 NOT RE CONSIpERED_ My BE A y O TRUE COP, ERED cERnncKvcm RUN IS yER'PAREO si v ak'MRNEIp@�INf�S1fEl�.nig-, E a/ - w�C NPNSRrt1MN IJSIFG N!]RON, NIR .AAWJS, TO THE ASSW11fE5 tlF'1NEARE'_lEypYp jNSn�� - tutKxl. cERCHlrwnoNs NOF TIIAN9EWAgl[ ��' �• THE EXIRSE�ASOEYEOF AM 1t SOF:WAY' ANNOT-SHOWN'ARC NtlfeCGUAI•IAH}EER. 1 PREPARED IN ACCORDANCE WIM THE NINR,WN ON NERD FOR ITLEND 9URVLYS AS E6TARI,,,, M TIE H USE AND E NEW YD AND ATE UW A . In � no FOR SUCH USE N. THE NEW YORK SPATE LWp Joseph TTpE ASSOCIAtI(IN. - Land surveyo �4 EP .406 0';nC 9m .Tito"S.—ya, Su6didsions - SRe Plows Cal/f/OChoN Cayayl N PHONE (516)727-2990 Fox,(516)723L5093, S;; HO • OFFICES LOCATED AT WING ADDRESS, N.Y.S. Uc. No. 49666 One Union Square - P.Q. Box 1931 `A` w-•v y' Aquebo9ue; New York 11931 Rrverheod; NoW Yat! 1190i