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Home My WebLink About28796-ZFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No: Z-31052 Date: 07/20/05 THIS CERTIFIES that the building INGROUND SWIMMING POOL Location of Property: 4725 NEW SUFFOLK AVE MATTITUCK (HOUSE NO.) (STREET) (HAMLET) County Tax Map No. 473889 Section 115 Block 4 Lot 8.4 Su]mdivision Filed Map No. __ Lot No. __ conforms substantially to the Application for Building Permit heretofore filed in this office dated SEPTEMBER 27, 2002 pursuant to which Building permit No. 28796-Z dated OCTOBER 1, 2002 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 INGROUI~D SWIMMING POOL IN THE REQUIRED REAR YARD WITH FENCE TO CODE AS APPLIED FOR. The certificate is issued to FRANK & DENISE DELLAQUILA (OWNER) of the aforesaid building. SUFFOLK COUNSel DEPARTMENT OF HEALTH APPROVAL N/A ELECTRICAL CERTIFICATE NO. 3263 10/24/02 PLUMBERS CERTIFICATION DA'~u N/A Authorized Signature Rev. 1/81 Form No. 6 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL 765-1802 APPLICATION FOR CERTIFICATE OF OCCUP:~NCY 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, aud 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 UndeBvfiters. 4. Sworn statement from plumber certifying that the solder used in system contains less than 2/10 of 1% lead. 5. Conm~ercial building, industrial building, multiple residences and sirailar buildings and iustallations, 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 liues, streets, building and mmsual natural or topo~aphic features. 2. A properly completed application and consent to respect sibmed 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 l. Certificate of Occupancy - New dwelling $25.00, Additions to dwelling $25.00, Alterations to dwelling $25.00, Swimming pool $25.00, Accesso~' building $25.00, Additioas 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. TemporaD'Certificate of Occupancy - Residential $t5.00, Commercial $15.00 ,ate. New Construction: Old or Pre-existing Building: (check one) LocationofProperty: Z/Tt25- P~C-~.~' ..q,)~O~Ot-d: ~ ~T~ ~ ~ /]~ House No. Street Owner or Owners of Propeny: ~/f ~ /3CI~IJC: /3CLL~ot;'~ Hamlet Suffolk County Tax Map No 1000, Section Subdivision PermitNo. 77 -7 DateofPernfit. Health Dept. Approval: Planning Board Approval: Request for: TempormT Certificate Fee Submitted: $ a2.5~ 0(~) Co- 3105 B loc k ~'/,5-,~ - OQ:::~.. ~i/l-ot Filed Map. Lot: Applicant: [¢~pr ~ ["3C-lq! ~ UndeBvriters Approval: Final Certificate: ~ (check one) '~&pp[ic~nt ~i~atu~e 765-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] INSULATION [ ]FRAMING ~.~FINAL /~. REMARKS: [ ] FIREPLACE & CHIMNEY [ ] FIRE SAFETY INSPECTION /~ o/~ 765-1802 BUILDING DEPT. INSPECTION [ ]FRAMING ~FINAL ~/~o~Z..~ FIREPLACE & CHIMNEY [ ] FIRE SAFETY INSPECTION DATE ~ ~-- ~ '~' O~ INSPECTOR 765-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLBG. [ I FOUNDATION2ND [ ]INSULATION [ ] FRAMING [c~]~NAL [ ] FIREPLACE & CHIMNEY DATE ~//~/~ INSPECTOR~~~,~ Nassau Suffolk Electrical Inspections. Inc. 5A ('anal Street · ('enter Moriches. Ney, York 11034 * Tel 631-878-3500 ® Fax 6_I 1-878-3764 Application No; 3263 Date:10i24'02 Issued to: Dellaquila Address:.4725 New Suffiok Ave Village: Mat/truck Zip: 11952 Introduced By: Bethel Ek:ctric Liccnsc¢:2880-E was examined and found to be ,allic 1st Basenent 2nd flea' tn compliance with the National Electrical Code Corrrasrdal ~ Tub Pdrltion Receptacles F~xtures G F I M~crowave Wh~dpool 2 1-500 Watt 2 Oven Carbon D~shwasher Washer/Amps Dryer/Amps ~angelAmps Monox~ae Smoke Bell OII G~S Circulators Detectors Transformers Meter Amps Phase Motors IOther Eqmpment: 1-20A Timeclock Oul,Res Permit/I:28796 Fhis certificate must not bc ahcred in any manner 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. 28796 Z Date OCTOBER 1, 2002 Permission is hereby granted to: FRANK & DENISE DELI=AQUILA 4725 NEW SUFFOLK AVE MATTITUCK,NY 11952 for : CONSTRUCTION OF AN ACCESSORY INGROUND SWIMMING POOL IN THE REAR YARD AS APPLIED FOR at premises located at 4725 NEW SUFFOLK AVE MATTITUCK County Tax Map No. 473889 Section 115 Block 0004 Lot No. 008.004 pursuant to application dated SEPTEMBER 27, 2002 and approved by the Building Inspector to expire on APRIL 1, 2004. Fee $ 150.00 Authorized Signature ORIGINAL Rev. 5/8/02 ~00~- I IT -4-~ ,4 ] TOWN OF SOUTHOLD PROPERTY RECORD CARD STREET 4q~ VILLAGE DIST.SUB. LOT =..4FOR ME_R OVa, ER ^ · N E -ACR. '~O ~'~ M*') ~ S W TYPE OF BUILDING, RES. ~.!'~'~ SEAS. VL. ~ FARM COMM. LAND IMP. '~TOTAL DATE REMARKS FRONTAGE ON WATER TILLABLE O, ¢~ ~ ~'~ FRONTAGE ON ROAD WOODLAND DEPTH MEADOWLAND BULKHEAD HOUSE/LOT~% TOTAL COLOR TRIM M. Bldg, Extension Extension Extension Patio Porch Deck Breezewa Garage Poo | ~ 2/-/~' Foundation Basement Ext, Walls Fire Place ...~._. Dormer FULL Vo Bath Floors Interior Finish Heat Woodstove Dinette Kit. BR. ~1 ~eA~- Fin. B. / 5.0 Attic Rooms 1st Floor 1 4' q.2'~°° Driveway Rooms 2nd Floor FIELD INSPECTION'REPORT I DATE COMMENTS~ FOUNDATION (1S~ FOUNDATION (2ND) ROUGH FRA_M~G & PLUM~I~G I~SULATION PERN. Y. STATE ENERGY CODE ADDmONAL COMi~_,NT$ TOWN'OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, NY 11971 TEL: (631) 765-1802 FAX: (631) 765-9502 Examined Approved Disapproved a c /0/0 t' . 20 I0/0/ , 20 0,:.~ Expiration ,20 or/ PERMIT NO. 'Bhilding Inspector BUILDING PERMIT APPLICATION CHECKLIST Do you have or need the following, before applying'? Board of Health 3 sets of Building Plans Planning Board approval Survey_ Check Septic Form N.Y.S.D.E.C. Trustees Contact: Mail to: 5Lk3 Wn API~,LICATION FOR BUILDING PERMIT "- - .... i Date · 2 ~ ,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 the Building Inspector issues a Certificate of Occupancy. fi Ex'eD' 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 intehm, 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, Ordinam:es 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. · (SignatUre ofa~plicant or name, ifa corporatign (Mailing address of applicant) ItTt, ht State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder 0.o n 4o--04 t Xalneofownerofpremises Fro-nK -~ b~nl~)C b~l I~ {~_ t_l (As on the tax roll or latest deed) a corporation, signature of duly authorized officer (Name and title of corporate officer) Builders License No.'"'~[,~ I ''1 g ] ' ~,4 ~ Plumbers License No. Electricians License No. Other Trade's License No. 1. Location of land on which proposed xvork wiJ1 b.e do/kc: -- House Number Street CountyTax Map No. 1000 Section Subdivision (Namel~/ ~ Hamlet 115 Bloc~ q Lot '~. Filed Map No. '}4t,.!.~ Lot State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy ~I~XC6C~ ~C~r'-(~ / b. Intended use and occupancy ~ y q. O l FI ~ ~(__j C4~ ~ ~ L Iq~ t~L,~ POr~ Nature of work (check which applicable): New Building Repair Removal Demolition Addition Other Work 20 x/qO 4. Estimated Cost C~ t ~ ~ ' O O 5. If dwelling, number of dwelling units If garage, number of cars Alteration _ (l~scription) Fee (To be paid on filing this application) Number of dwelling units on each floor 6. If business, commercial or mixed occupancy, specify nature and extent of each type of use. 7. Dimensions of existing structures, if any: Front Height Number of Stories Rear .Depth Dimensions of same structure with alterations or additions: Front Depth Height. Number of Stories Rear 8. Dimensions of entire new construction: Front Height Number of Stories Rear .Depth 9. Sizeoflot: Front Rear .Depth ,/ 10. Date of Purchase Name of Former Owner 11. Zone or use district in which premises are situated 12. Does proposed construction violate any zoning law, ordinance or regulation? YES NO ~ 13. Will lot be re-graded? YES ~ NO_ .Will excess fill be removed fi.om premises? YES NO 14. Names of Owner of premises ~[ .I(~UA I[*~ Address ~72~1q15~u'9o'lJ~ g .2~ Name of Architect Address Phone No Name of Contractor 5~tmTffc_Jq Address qt,3 ffhtlc~ 19Ir-tr._Phone No. c~ \£ 15 a. Is this propcay within 100 feet ora tidal wetland or a keshwater wetland? *YES__NO * IF YES, SOUTHOLD TO~ TRUSTEES & D.E.C. PERMITS MAY BE REQUIRED. b. Is this prope~ within 300 feet of a tidal wetland? * YES NO * IF YES, D.E.C. PE~ITS MAY BE REQU~ED. 16. Provide survey, to scale, with accurate foundation plan and distances to property 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) COUNTY OF 1~/~ I E ~/5 t'! L ~D [t~ '~.~'r~ ~_ being duly sworn, deposes and says that (s)he is the applicant (Name of individual signing contract) above named, (S)ne is the (Contractor, Agent, Corporate Officer, etc.) of said owner or owners, 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 tree to the best of his knowledge and belief; and that the work will be performed in the manner set forth in the application filed therewith. Sworn to before me thi~, Jr 2% day of ~22~) ~ 20 o~2 Notary Public Signature of Applicant TINA M. WOOD Notary Public - State of New York No. 01WO5077029 Qualified in Suffolk County~ MyComrnission Expires ~-~[~'~7//6 '~?f~l~'.V V~~' :" ' · ..,~.., ....... q.~ o,~=~,~..,,~ ~ / ~ . ~ -...~ ~: ~ , ~ .- . / / R II I z , X I ~ N.~z"~'~"w ~'~.~ ~ / / x ~ II I ' / I X I I I ' . I~1~,~ ~ / ~ ~ ~. / / = =II...~,,~../ ~ ~_~I' . =~ ,~f / I / I. , / ~. ~ ~~ / ,, I ll I ~ ~~f~;;,~:~ .,', :' ~,' .. iI I 18 ~ ~ I ~ ,.. ~ ~~-,..' II i I I /~ -.'~' ';:.:':', '.'.,.,":'. '' I i I I/. · " I ' ~ ',I1~ '1 - . ~ ..... ~- ~o' ~ ~ - ' ~ S.88~22 ~6 W. I~.~ /..~ sx' _ ~'~ . J SURLY FOR J THOMAS D. GOELLER & SHARON W. GOELLER OCT. 51~ 1994 APR 7,i994 Z9, 1995 HEALTH DEPARTMENT -DATA FOR APPROVAL TO CONSTRUCT N ~uFF co. tV~x~M e m:l-'~oq SECTION I ~ .~K ~ ,.cOt .!.I. O~H[. ~HAH THOll tHOWN Hi.iO~. NOTE; ·; STAKE FOUND RE ~ LOT i , MINOR SUBDIVISION FOR"SET -OFF : JOHN J, MISKA" ~ OR DATA OJTN~D F~ OTHERI AT MATTITUCK TOWN OF $OUTHOLD SUFFOLK COUNTY, NEW YORK DATE: DEC. SCALE: I "= 50' NO. 93 - 0977 CERTIFIED TO' THOMAS O. GOELLER SHARON W, GOELLER GREEN POINT SAVINGS BANK,ITS SUCCESSORS ANO/OR ASSIGNS NATIONS TITLE INSURANCEOF NEW YORK, INC. YOUNG & YOUNG 4000$TRANDER AVENUE RIVERHEAD, NEW YORK ALDEN W.YOUNG, PROFESSIONAL ENGINEER AND LAND SURVEYOR N.Y.S. UCENSE NO. 1284S HOWARO W. YOUNG, LANO SURVEYOR N.Y.S. LICENSE N0.45893