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Home My WebLink About29746-Z FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No: Z-30653 Date: 12/28/04 THIS CERTIFIES that the building ACCESSORY Location of Property: 4410 OLD NORTH RD SOUTHOLD (HOUSE NO.) (STREET) (HAMLET) County Tax Map No. 473889 Section 55 Block 2 Lot 8.10 Subdivision Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated SEPTEMBER 16, 2003 pursuant to which Building Permit No. 29746-Z dated SEPTEMBER 18, 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 STEPHEN BERTSCHI & VIRGINIA GILMORE (OWNER) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A ELECTRICAL CERTIFICATE NO. 81277C 10/14/03 PLUMBERS CERTIFICATION DATED N/A A horized 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. 29746 Z Date SEPTEMBER 18 , 2003 Permission is hereby granted to: STEPHEN BERTSCHI 4410 OLD NORTH ROAD SOUTHOLD,NY 11971 for CONSTRUCTION OF AN INGROUND SWIMMING POOL IN THE REQUIRED REAR YARD FENCED TO CODE at premises located at 4410 OLD NORTH RD SOUTHOLD County Tax Map No. 473889 Section 055 Block 0002 Lot No. 008 . 010 pursuant to application dated SEPTEMBER 16, 2003 and approved by the Building Inspector to expire on MARCH 18 , 2005 . Fee $ 150 . 00 Authorized Signature ORIGINAL Rev. 5/8/02 r Form No.6 -- TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL 765-1802 APPLICATION FOR CERTIFICATE OF OCCUPANCY - ( 6 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. New Construction: Old or Pre-existing Building: (check one) Location of Property: ' �/ bG� �yp�f� �Cy 5'� �� House No. Street Hamlet Owner or Owners of Property: ,f r .��✓ j /� jrj� �,.If ��113D.�•f? Suffolk County Tax Map No 1000, Section 5✓� Block 92— Lot Subdivision fz Filed Map. Lot: Permit No. `1 7 6 Date of Permit. Applicant: 5 �/�, /�jL A&/7 WL Health Dept. Approval: Underwriters Approval: _ Planning Board Approval: Request for: Temporary Certificate Final Certificate: _ (check one) Fee Submitted: $ a �,s ,r pplicant ignature 6Z6� ► 7 C,O -1?5 3 0 45 Electrical Inspection Certificate Issue Date Electrical Inspection Service, Inc. Application Number 10/15/03 375 Dunton Avenue 81277C East Patchogue, New York 11772 (631)286-6642 Issued To: Steve Bertschi Street: 4410 North Road Village: Southold Zip: 11971 Town: Southold Section: 55 Block: 02 Lot: 8.10 Contractor: Hank*s Electric Inc. (L) Lic. # 2675-E Was examined and found to be in compliance with the National Electrical Code. ❑ Commercial ❑ NV Defects 0 Pool ❑ 1st Floor ❑ Indoor ❑ Basement ❑ Hot Tub X❑ Residential ❑ Det.Garage ❑ Attic ❑ 2nd Floor FRI Outdoor ❑ Addition ❑ Survey Switches Receptacles Fixtures GFI Heaters A/C Fans 1 1 1 1 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 Clock 1-20A Spec Rec 1-Mineral Springs System Hugo S. Surdi President Rough Inspection: 10/14/2003 Inspector: Sean P.Hightower Final Inspection: 10/14/2003 Inspector: Sean P.Hightower This certificate must not be altered in any manner. Inspectors may be identified by their credentials. Applicant/ Date, Owners Name: CL £ G;10tov" 'Reviewed: 3 Architect/ Date Eagineer: Submitted: 9 1G SCTM #: Distrim 00 Section: NS Ijlock: �_ Lot: 10 Project Subdivision Location: Single 8 separate Required n- eertification: (Yes/Nal /J/`- Req. Itcy /_oningDisvid:'C. (I.o(siLe: � �.AcWaI: �•/5� 7 [IAI WVorage !Wllcgmed 1�cy. Req. Rcq. f 11-roM Ward Proposed: ( [Side I roposcd ( (Rear Yard 117, Proposed Project Description: � � AGENCWERMITS Permit REQUIRED FOR REVIEW N.A. NO YES Numb( i Suffolk County Health Dept. _� I New York State D. E. C. l Town Trustees Town Zoning Board approval: _ Town Muming Board approval: Flood Plane Elevation??? y Flood Zone: zV. oto e ' t 1 765-1 802 BUILDING DEPT. INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] INSULATION [ FRAMING FINAL [ ] FIREPLACE & CHIMNEY [ ] FIRE SAFETY INSPECTION R ARKS: DATE �a- r/ � � INSPECTOR _ • � s F LD&MMON REPORT DATE CONIlVV em . Md J � FOUNDATION(1ST) �c ' � C FOUNDATION(ZND) rA � j G ROUGH FRAN NG& P'I•U�7G ,.3 J INSULATION PER N.Y. STATE ENE34Gy CODE MAL ADDITIONAL CoAnUENTS S z1 b O z. r 4 y� ti y� . 4rV 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy nI rU 6LE F&MI Ly -pw L_O.> 6 b. Intended use and occupancy_ 60 tmM1 A3 L, 900L_ 3. Nature of work (check which applicable): New Building Addition Alteration Repair Removal Demolition Other Work 1AU - yRDuA_\6 F (Description) 4. Estimated Cost /d 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: Rear Depth Height Number of Stories 9. Size of lot: Front Rear Depth 10. Date of Purchase Name of Former Owner 11. Zone or use district in which premises are situated r 12. Does proposed construction violate any zoning law, ordinance or regulation? YES NO 13. Will lot be re-graded? YES NO 1/Will excess fill be removed from premises? YES v", NO 6T6PAFN V0,r6ft sau rHoi t> 14. Names of Owner of premises Vl"jA)jA L ILMaZ Address tjOo &h Amerg /ZV Phone No. &51- 75-9/,y-t Name of Architect ,O J Address Phone No &31-fa,7-oll L) Name of Contractor EAkbV_r, 9hPP_(Lg;e_ Address T hone No. WI- 7 V y-O-My I/U eh 3 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 i ' � :' IF YES, D.E.C. PERMITS MAY BE REQUIRED. ��d }/{ V , J 11WAJilU 8138U 16. Provide survey, to scale, with accurate foundation pjan and. '��to�x��,k�� 17. If elevation at any point on property is at 10 feet or below, m t cEt a a data on surve �}V' a Y STATE OF NEW YORK) SS: COUNTY OF • w. 4LE being duly sworn, deposes and says that (s)he is the applicant (Name df individ af sing contract)above named, (S)He is thT;.. .'e Cc�ntrator}agent, corporate Ufticer, etc.) of said owner or ov�-pO , a d�i�dul itAq�zed to perform or have performed the said work and to make and file this application; that all state M clltamed.i this`a"�� hcataon are true to the best of his knowledge and belief, and that the work will be performed int a manner set forth:ixl.tf libation filed therewith. Sworn tobef r�,.; ore me this . ignaq&ie of Applicant NOREEN L HAM _._`�I NOTARY PUBLIC.STATE O1 MWIM , U ALIFIF0 IN SUFFOLK COUNly REG.NO.01HA4 COMMISSION EXPIRES TOWN OtO-SOUTHOLD BUILDING PERMIT APPLICAyi ION CHECKLIST BUILDING DEPARTMENT Do you have or need the following,before applying? a TOWN HALL 60' ' i Board of Health SOUTHOLD, NY 11971 i ,3 sets of Building Plans TEL: (631) 765-1802 E , ':._J Planning Board approval FAX: (631) 765-9502 Survey www. northfork.net/Southold/ PERMIT NO. check Septic Form N.Y.S.D.E.C. Trustees Examined 208 Contact: Approved 20 03 Mail to:3-oyw �1 Disapproved a/c , oZ Phone:foa l-7 7_9106 0 778 Expiration--_31f g ,20 0,6 Building Inspector APPLICATION FOR BUILDING PERMIT Date -14 /'a 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 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,housin code, and regulations, and to admit au4*00ELPVAiises and in building for necessary inspections. ENCLOSE POOL TO CODE OCCUPANCY OR UPON COMPLETION Wv BEFORE"WATER" USE IS UNLAWFUL (Sig afar f applicant or name, if a corporation) UNDERWRITERS CERTIFICATE WITHOUT CERTIFICATE ,- REQUIRfD OF OCCUPANCY (Mai in address of ap icant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder 7-16 e.oN Name of owner of premises _ C /f 3 74/6 (As on the tax roll or latest dee If applicant is a corporation, signature of duly authorized officer FEE:. - ZJ-V._ BY: NOTIFY BUILDING DEPARTMENT AT (Name and title of corporate officer) 765.1802 SAM TO 4 PM FOR THE FOLLOWING INSPECTIONS: Builders License No. /V 1. FOUNDATION - TWO REQUIRED Plumbers License No. FOR POURED CONCRETE 2. ROUGH - FRAMING & PLUMBING Electricians License No. a,(�r�,5�� 3. INSULATION Other Trade's License No. 4. FWAL - CONSTRUCTION MUST BE COMPLETE FOR C.O, 1. Location of land on which proposed work will be done: ALL CONSTRUCTION SHALL MEET THE q y/D /2 LZ A)JX-T-9 gd .REQUIREMENTS OF THE CODES OF NEW ' RR- LTENOT House Number Street R RPnNcmLE FORHVEMN OR CONSTRUCTION ERRORS. County Tax Map No. 1000 Section ``f „ , Subdivision O -- � Lot ` r , � � tle Lot (Name) 1 " OLD NoRT,B jtoA& Y SURVEY OF PROPERTY r v7aJI7S REF 7r- Iry- of 007V A T . SO UTNOLD 7 TOWN OF SO UTHOLD SUFFOLK COUNTY, NE yfj YORK 1000-55-x02--8.10 0 ' SCALE: 1"=50' FEB. 21. 2001 CP. MARCH 27, 2001 ( cerli(icallon I May 18, 2001 (re vlslon) J ; N�D�F VI£D£RAMN & GIU7 OFT-14, 2001 (prop. bse. I (DV£LLING) SKI et, al, Apr# ll, 2002 Uoundallonl STAKE Fro NOV. 1, 2002 f 17174/ 1 0'" 84°06'40'.£ + 7Ye�f borr� + 360,37' 4 p Sa .1so a � 1E' 4E11p �� + -'�'---- � g ��• v d+ set 1 J f o o „ CLE q„ y TEST BORWG °. Brown sett ~ OL a1?77C 1.5' Brown L"my CERTIFIED TO, W sys Jr ' 4 SillSand S nd S TEPHEN BERTSCH/ v / �\ `�` 2 = Gravel SW VIRGINIA M. GILMORE } � � 1 a 2 W ALT LAND TITLE � � COMMON E H � � � 3� Q 4' INSURANCE COMPANY BANK OF SMITHTOWN O cz+ 4 Palo grown lorown Z _ / ,�„ SIM/ Coarse Send / ` /n C�ve/6� l wah 10% Q !U/ Gravel SW j 6� Q O -- O Nl .ti y 1 aCu. 375,1(3' N❑TES: z �P�EOF Nf�r I ar) f omilior with the STANDARDS FOR APPROVAL S �N T.MSIj O,p AND C❑NSTRUCTI❑N OF SUBSURFACE SEWAGE 1 S '" 79°02'10' DISP❑SAL SYSTEMS FOP SINGLE FAMILY RESIDENCES SPS EL AO. 0� F BAR * ' and will abide by the conoitioris set f'ortl tf ere+n and or-, the permit to Corstru,=t A N 1967 T �1 e �y0 The location of wells aril cesspool; shown r,ereor, r;re t D or, field observations and or data obtained +ror, others. "`1`I fF �D 618- " .ANY ALTEkAT , OR ADDITION TO THIS SURVEY IS A VA iCTIrN PECONIC S -EKORS, P,_ Ele:-ations a -e r of erence l to an assur�eG OF SECT,Onf =..4 OF THE NEW YORi: STATE EDUCAT mow' (6319 76� - s0 F r r r r dc.tum .)LTJ AXE(6 31% 765-1797 EXCEPT AS P SECTION .'209-SUBDIVISION 2 ALL�rIFICATIONS P D. BMX 909 HEREON AkE `LID FOR THIS MAP AND COPIES THCRE'0F ONL Y IF 1230 TPA VEL ER STREET t, SAID MAP OR 7 IE.S BEAR THE IMPRESSED SEAL OF rHE SURVEYOR D " = AREA=2.1532 ACRES WHOSE SIGN RE APPEARS HEREON. SOUTHGLD, N.Y 11971 !f CO Ya FUUMPFIM FROM 5wife fo WA51E fo MV045 -A; 44, !0" PLUMBING SCHEMATIC m7 I n b b i 11 ;1 1 7' 19, Ccam It llvptL5 10" PLAN r I fiATEPLU qaLEPPOAMMMEN 0 FOVAP COWAT 5TR MD-5— M (GW-M-lt 0 3� ' T MIER L a , a- F U Lj 0 V) t 7, ?Cem 11E5 .,1) 0- 5500 P151 PoLap Cowillfr -D 211 to 4" 5AM2[,Of fOAAcr- RM LUR 2"TO 4"54V SECTION A I .,j _ J v, Lo CL WALL SECTION C-1 CL Li (Jl < SECTION B NOTES I. 5`ql a 15 PE54-NEP POP L15E DELON 6M MV OILY iU i,TA5 WVT It WAV fAME 15 A MINIMUM Of A. -8,. it"OP05EP F�Nl9ft?WAVE. 2. DXW LL WIN CLEAN WlH.ME Of ROOr5 MP PED05. r/0NOf ALLOW fW Waf Y 3ACKFLL TO MEW ilt H%iif Of Tit MTV Vit POOL 3Y MO.-,T IMAM 5. WALK5'ODE 5MOOM.MON W?IM.5LOPEI?AWAY N 01-A-0a. y A. WAT?1215rO5AL 9iAL L 5E L IMI'V2 fO GVAE6 P?OPE in TO 50 A U LOCAL cow1rON5. V