HomeMy WebLinkAbout29240-Z FORM NO. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Office of the Building Inspector
Town Hall
Southold, N.Y.
CERTIFICATE OF OCCUPANCY
No: Z-30663 Date: 12/29/04
THIS CERTIFIES that the building ACCESSORY
Location of Property: 90 LONG CREEK DR SOUTHOLD
(HOUSE NO. ) (STREET) (HAMLET)
County Tax Map No. 473889 Section 55 Block 4 Lot 4
Subdivision Filed Map No. Lot No.
conforms substantially to the Application for Building Permit heretofore
filed in this office dated MARCH 19, 2003 pursuant to which
Building Permit No. 29240-Z dated MARCH 25, 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 JOHN & CAREN MAIETTA
(OWNER)
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A
ELECTRICAL CERTIFICATE NO. 1157463 08/12/03
PLUMBERS CERTIFICATION DATED N/A
'Ztni �—z-cz
A or' ed S'gnature
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. 29240 Z Date MARCH 25, 2003
Permission is hereby granted to:
J & C MAIETTA
130 LONG CREEK DRIVE
SOUTHOLD,NY 11971
for
INSTALLATION OF AN INGROUND SWIMMING POOL IN THE REQUIRED REAR
YARD AS APPLIED FOR
at premises located at 90 LONG CREEK DR SOUTHOLD
County Tax Map No. 473889 Section 055 Block 0004 Lot No. 004
pursuant to application dated MARCH 19, 2003 and approved by the
Building Inspector to expire on SEPTEMBER 25, 2004 .
Fee $ 150 . 00
Authorized Signature
ORIGINAL
Rev. 5/8/02
Form No.6
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
28 �
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 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. a� '^Z-L
New Construction: Old or Pre-existing Building: (check one)
Location of Property: I Z2 O Lo✓1c� �-P-2 l�r v e , 5 Qu ( to 1)
House No. U Street Hamlet
Owner or Owners of Property: J ay-)n 4 CA2 E_t,1 yy) f�-" G i 7A
Suffolk County Tax Map No 1000, Section Block .4 Lot 4
Subdivision I E,; noca-C-07 7 �,v �K Filed Map. `� $ Lot:
Permit No. a q Q 1}Q_-_b Date of Permit. 3 1°1 jo3 Applicant:
Health Dept. Approval: Underwriters Approval:
Planning Board Approval:
Request for: Temporary Certificate Final Certificate: (check one)
Fee Submitted: $ a sJ
App1ic gAature
CC)-q_- 30G �3
BY THIS CERTIFICATE OF COMPLIANCE THE
NEW YORK BOARD OF FIRE UNDERWRITERS
BUREAU OF ELECTRICITY
l 40 FULTON STREET — NEW YORK, NY 10038
I
CERTIFIES THAT
5 Upon the application of upon premises owned by
5
PECONIC ELECTRIC CORP JOHN/CAREN MAIETTA
2195 STANLEY ROAD 130 LONG CREEK DR
MATTITUCK, NY 11952, SOUTHOLD, NY 41971
Located at 130 LONG CREEK DR SECTION#473889-055 SOUTHOLD, NY 11971
vj-
Application Number. 1157463 Certificate Number. 1157463
Section: Block: 0004 Lot: 004 Building P it: BDC: NS11
29240
Described as a Residential occupancy,wherein the premises a ectrical system consisting of
electrical devices and wiring,described below, located in/on the premises at:
Outside,Pool/Spa,
was inspected in accordance with the National Electrical Code and the detail of the installation,as set forth below,was
S found to be in compliance therewith on the 12th Day of August,2003.
Nam� QTY Rate Ratin Circuit TWe
Appoances and Accessories
i..
Tirne Clock/Switch 1 0
PooL Spa Bonding 1 0 a"'t
Furn tce 1 0 Gas
Pun s
1 40 2
Wiring and Devices
GFCI Circuit Breaker 1 0 20 amp
Receptacle 1 0 20 amp Pool/Spa
Fixture 1 0 Pool/Spa
Switch 1 0 General Purpose
Receptacle 1 0 GFCI
(Swimming Pool):This certificate covers compliance at the date of inspection only. Because of unusual environments it is advisable to Have
frequent test and/or repairs made by a qualified person.
seal
1 of 1
This!,certificate may not be altered in any way and is validated only by the presence of a raised seal at the location indicated.
F li
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1 l
� TT �T�T .
HU LZT1 I��T E T7T —11 11
Applicant/ Date.
��
Owners Name: 1 ��Vl, -1 � Reviewed:
Architect/ Date
Engineer: Submitted:
SCTM #:
Dis(rict: 1,000 Section: JCtT 131ock: _ Lol:
Project // Subdivisioii
Location: l3 D �c� rVV el— r S - ._ Nanie:
�----
Sin�le& separate Required
eel ltfica(ioil: (Yes!No) kj/t+ _
Y Req. rn Req. 7
Zoning District: (I of 'ze �_ �� Acwal: o 7� 7 l (Lot coverage wl'ropnzcd I
Req. /v Req. / / Req. /
(J'-'ront Yard Proposed J [Side Yard J Proposed: b J [Rear Yard Proposed
Project Description:
AGENCYJERMITS Permit
REQUIRED FOR REVIEW N.A. NO YES Number
Suffolk County Health Dept.
New York State D. E. C.
Town Trustees
Town Zoning Board approval: ✓
Town Planning Board approval: d�
Flood Plane Elevation???
Flood Zone: fir
Notes:
765.1802
BUILDING DEPT.
INSPECTION
[ ] FOUNDATION 1ST [ ] ROUGH PLBG.
[ ] FOUNDATION 2ND [ ] INSULATION
[ ] FRAMING [ FINAL
[ ] FIREPLACE & CHIMNEY [ ] FIRE SAFETY INSPECTION
RE : G"- � �
qAR�KS
DATE jl/;- /oINSPECTOR
Z
765.1802
BUILDING DEPT.
INSPECTION
[ ] FOUNDATION 1ST [ ] ROUGH PLBG.
[ ] FOUNDATION 2ND [ ] INSULATION
[ ] FRAMING [FINAL Cf6oL)
[ ] FIREPLACE & CFIIMNEY [ ] FIRE SAFETY INSPECTION
REMARKS: �� �n/9✓ �"Q�`�`�""
J�
C64
iova4it-- D,/-,
N
DATE ��l� � � � INSPECTOR
„►
FIELD INSPECTION REPORT DATE COMMENTS
�J �J
FOUNDATION(1ST)
0 �
--------------------------------------
ON
----------------------------------- O C
FOUNDATION(2ND) a
� O
O
r �
0
ROUGH FRAMING& Z
PLUMBING
p
L
r
INSULATION PER N.Y. y
STATE ENERGY CODE
O
FINAL 3 �j
ITIONAL COMMENTS
H
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m
14 X
9/
Q
x
E�
y
x
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b
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TOWN Or SOUTHOLD ' BUILDING PERMIT APPLICATION CHECKLIST
BUILDING DEPARTMENT R t) 'N'^? Do you have or need the following,before applying?
TOWN HALL Board of Health
SOUTHOLD, NY 11971 3 sets of Building Plans
TEL: 765-1802 --- --_ -_ __ ' Survey
PERMIT NO. R,2 gyp— Check
Septic Form
N.Y.S.D.E.C.
Trustees
Examined ,2003 Contact:
Approved 120 Mail to:
Disapproved a/c
?�0�2 - Q /-)- Phone:
—r Building Inspector
APPLICATION FOR BUILDING PERMIT
Date �{ � , 20�_
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 a Certificate of Occupancy
is issued by the Building Inspector.
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.
°WEDIATELY" CCC II
NCY 0
ENCLOSE POOL TO CODE (Sig re of applicant or name,if a corporation)
UPON CONVILETIO N USE IS UNLAWFUL
BEFORE "WATER" WITHOUT CERTIFICATE (�2q �t O' r-nA I�,l� 1170
UNDERWRITERS CERTIFICATESP
REQUIRED . OF OCCUPANCY (Mailing address of applicant)
State whether applicant is owner, lessee, argent, architect, engineer, general contractor, electrician,plumber or builder
1.�r11�lC71J12. ,
Name of owner of premises p CO&M PA IeTTA- APPR VED AS NOTED
(as on the tax roll or ates
FM By:
If applicant is a corporation, signature of duly authorized officer NOTIFY BUILDING DEPARTMENT AT
765-1802 9 AM TO 4 PM FOR THE
FOLLOWING INSPECTIONS:
(Name and title of corporate officer) 1. FOUNDATION - TWO REQUIRED
FOR POURED CONCRETE
Builders License No. 443 j- H i 2 ROUGH - FRAMING & PLUMBING
& INSULATION
Plumbers License No. L FINAL - CONSTRUCTION MUST
BE COMPLETE FOR C.O.
Electricians License No. 0390 M ALL CONSTRUCTION SHALL MEET
THE REQUIREMENTS OF THE N.Y.
Other Trade's License No. STATE CONSTRUCTION & ENERGY
CODES. NOT RESPONSIBLE FOR
1. Location of land on which proposed w rk will be done: DESIGN OR CONSTRUCTION ERRORS
130 Mm Wer t o SOUThOLo
House Number Street 14amlet
County Tax Map No. 1000 S�ction rj�, Block -- Lot `f
Subdivision�RVIAFCQ T MURK Filed Map No. r7 Lot 2
(Name)
2. State existing use and occupancy of premises and intended use and occupancy of proposed construction:,
a. Existing use and occupancy Ken jw ee `
b. Intended use and occupancy C ►perJ7Qe. A, ��.
3. Nature of work(check which applicable): New Building Addition Alteration
Repair Removal Demolition Other Work��1/gapd1yO POOL.
(Description)
4. Estimated Cost 12,000— 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 3' i �3 ' Height Number of Stories
8. Dimensions of entire new construction: Front Rear Depth
Height Number of Stories }
9. Size of lot: Front Rear c9134 _ Depth !CJ
10. Date of Purchase Name of Former Owner C—&gQrz
11. Zone or use district in which premises are situated
12. Does proposed construction violate any zoning law, ordinance or regulation: Y�
13. Will lot be re-graded &LAM 0ALq Will excess fill be removed from premises: 6ES NO
14. Names of Owner of premises 16 e (lQten1 Qoai" Address 130 iQnq OfeeK U. Phone No. 'AS-NVQ`
Name of Architect e.l%oufts.b i e►llu PC Address 4 kpc Ln) W►t. Phone No 70Y-7M
Name of Contractor &MZ X GM,* o 4PdJ)s Address q20, f t J"- Phone No. `14'1-7/ff
ti V4
s .
15. Is this property within 100 feet of a tidal wetland? *YES NO u, "
• IF YES, SOUTHOLD TOWN TRUSTEES PERMITS MAY BE REQUIRED
16. Provide survey, to scale, with accurate foundation plan and distanIqes to prpperty lines:
17. If elevation at any point on property is at 10 feet or below, must provide topographical data on survey.
STATE OF NEW YORK) tt
COUNTY OF 04 A
'B AQ
yJ being duly sworn,deposes and says that(s)he is the applicant
(Name of individual sign rig.7ov, amed,
(S)He is the � -
(Contractor,Agent, Corporate Officer, etc.)
I
of said owner or owners, and is duly authoriz4to perform or have performed the said work and to make and file this application;
that all statements contained in this applrqtion'' rt true to the best of his knowledge and belief; and that the work will be
performed in the thriner set forth in the 313
ci n filed therewith.
Sworn to before meahis 7-, T
z
day of
3
Notary Public S' ature o Applicant
MARGARET A. BANNWARTH
NotaryNob101,BA6021111 w York
Qualified in Suffolk County
commission Expires March 8.�Q
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FM FT. FT. FT. FT. FT. FT. FT. FT. SQ.FT. GAL. POOL & SPA CEVM
16x32' 16' 32' 8' 14' 8' 4' 4' 8' 512 19,000 "dramPERMACRETE WALL SYSTEM
16'x36' 16' 36' 12' 14' 8' 4' 4' 8' 576 21,600 929 Route 25A Miller Place NY 11764 city state
18'x36' 18' 36' 12' 14' 6' 4' 5' 8' 648 24,300 (631) 744-7185 FAX (631) 744-0174 ( )
Suffolk License #4436—HI Phone
20'x40' 20' 40' 14' 14' 8' 4' 6' 8' 800 30,000 Nassau License #HI7445OOOO