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FORM NO. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Office of the Building Inspector
Town Hall
Southold, N.Y.
CERTIFICATE OF OCCUPANCY
Date: 08/03/06
No: Z-31718
THIS CERTIFIES that the building INGROUND SWIMMING POOL
Location of Property: 3615
(HOUSE NO.)
County Tax Map No. 473889 Section 115
DEEP HOLE DR
(STREET)
Block 16
MATTITUCK
(HAMLET)
Lot 19
Subdivision
Filed Map No.
Lot No.
conforms substantially to the Application for Building Permit heretofore
filed in this office dated
MARCH 6, 2006 pursuant to which
Building Permit No. 31826-Z
dated
MARCH 7, 2006
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 NANNETTE FEVOLA
(OWNER)
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL
N/A
ELECTRICAL CERTIFICATE NO.
108976C
05/31/06
PLUMBERS CERTIFICATION DATED
N/A
Rev. 1/81
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J APPLICATION FOR CERTIFICATE OF OCCUPANCY
Form No.6
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN HALL
765-1802
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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:
I. 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 2/1 0 of I % 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:
I. 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.
-,! zS' JOb
f
New Construction: foo I Old or Pre-existing Building:
Location ofproperty: ~0\ 5 Df2.p \..\t:M~Dn \It.-
House No. Street
Owner or Owners of Property: ~G\()nP./lTe- fuvo t::\,-
(check one)
~tbJ\JLL
Hamlet
Suffolk County Tax Map No 1000, Section
Block
Lot
Permit No. 3 \ g 2~
Date of Permit. 3/ <::} { 00
. I
Filed Map. Lot:
Applicant: NOJVte A:l€ "fi1 JvVlq
Subdivision
Health Dept. Approval:
Planning Board Approval:
Underwriters Approval:
Request for: Temporary Certificate
Fee Submitted: $ !)S.W
Final Certificate:
(check one)
~. 70707
Coc3)1(~
----r1mutt Jo;J~ .
Applicant Signature '--'"
Electrical Inspection Certificate
Issue Date
6/1/2006
Electrical Inspection Service, Inc.
375 Dunton Avenue
East Patchogue, New York 11772
(631) 286-6642
Application
108976C
Issued To:
Street:
Village:
Section:
Mr. & Mrs. Fevola
3615 Deep Hole Drive
Mattituck
Block:
Zip: 11952
Lot:
Town: Southold
Contractor: Richard Kleinfeldt
Lie. # 665-E
Was eXAmine(i gnn found to be in compli;:mce with the National Electrical Code.
D Commercial D NV Defects 00 Pool D 1st Floor D Indoor D Basement D Hot Tub
IKJ Residential D Det. Garage D Attic D 2nd Floor IKJ Outdoor D Addition D Survey
Switches Receptacles Fixtures GFI Heaters AlC Fans
1 1 2 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
rime Clock
I
I
f{/f;;/~~~jA\
Hugo S. Surdi
President
Rough Inspection:
Inspector:
Final Inspection: 05/31/2006
Inspector: Dennis Brandi
This certificate must not be altered in any manner. Inspectors may be identified by their credentials.
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.
31826 Z
Date MARCH
7, 2006
permission is hereby granted to:
E ORLOWSKI (FEVOLA)
361S DEEP HOLE
MATTITUCK,NY 119S2
for :
CONSTRUCTION OF AN INGROUND SWIMMING POOL IN THE REQUIRED REAR
YARD AS APPLIED FOR
at premises located at
361S DEEP HOLE DR
MATTI TUCK
County Tax Map No. 473889 Section 11S
Block 0016
Lot No. 019
pursuant to application dated MARCH 6, 2006 and approved by the
Building Inspector to expire on SEPTEMBER 7, 2007.
Fee $
lS0.00
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Authorized
Signature
ORIGINAL
Rev. S/8/02
!/K.M
JAMES K. MORROW, JR., P.E.
DESIGN
PERMITS
INSPECTIONS
2066 BEDFORD AVE. . NO. BELLMORE, NY 11710 . (516) 785-8032
February 23, 2006
Town of Southold
Department of Buildings
Re: New lnground Swimming Pool
Drainage Facilities
3615 Deep Hole Drive
Mattituck, NY 11952
Dear Sir or Madam:
This letter shall certify that the new inground swimming pool for the above referenced premises will
not require permanent drainage facilities because the pool is constructed with a vinyl liner. The
pool water will be continuously recirculated through the filter and will be reused from year to year.
The drainage from the filter backwash is nominal and will not interfere with public highways,
public water supply, existing sanitary facilities or neighboring properties.
Sincerely,
5 I f ),(P 1::
TOWN OF SOUTHOLD BUILDING DEPT.
765.1802
INSPECTION
[ ] FOUNDATION 1 ST [] ROUGH PLBG.
[ ] FOUNDATION 2ND [] INSULATION
[ ] FRAMING I STRAPPING [~
[ ] FIREPLACE & CHIMNEY [ ] FIRE SAFETY INSPECTION
REMARKS:
DATE
.
31 tJ-b ;2-
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TOWN OF SOUTHOLD BUILDING DEPT.
765.1802
INSPECTION
[ ] FOUNDATION 1 ST [] ROUGH PLBG.
[ ] FOUNDATION 2ND [] INSULATION
[ ] FRAMING I STRAPPING [~FINAL ~ ~
[ ] FIREPLACE & CHIMNEY [ ] FIRE SAFETY INSPECTION
-
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DATE /p-;L{, -OC, INSPECTOR ~~
.
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-
FIELD INSPECTION REPORT DATE COMMENTS
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FOUNDATION (1ST) c(\~
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FOUNDATION (2ND) 2r~
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INSULATION PER N. y, L>t"l
STATE ENERGY CODE 7"'\ ..,
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~ITIONAL COMMENTS 1/ {Y /
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'TOWN (')F SOUTHOLD
. .
BUILDING DEPARTMENT
TOWN HALL
SOUTHOLD, NY 11971
TEL: (631) 765-1802
FAX: (631) 765-9502
www.northfork.net/Southold/
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BUILDING PERMIT APPLICATION CHECKLIST
Do you have or need the following, before applying?
Board of Health
4 sets of Building Plans
Planning Board approval
Survey
Check
Septic Form
N.Y.S.D.E.C.
Trustees
Contact: PreM';€{ e.., .\bo \ "> - Dano.....
Mail to: 401 'P,Quac\.u.:x;.., J-
~-\~~s;h N- H'l'l~
Phone: . - 4-~3A3 '>1..'1]\
PERMIT NO.
3 ~~ ,20QL
~/ ,200'"
Examined
Approved
Disapproved ale
Expiration
117 ,20&
I
~--::
.--'
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Name of owner of premises
f::
\' I;ilP:<- - Q'LIJJo., \ INSTRUCTIONS Date .3~\0l0 ,20_
~. Thi$ apPlicatio~~letelY filled in by typewriter or in ink and submitted to the Building Inspector with 4
sets of pl~ns, ac~~ot plan to scale. Fee accordmg to schedule.
b.\Elet1iIan showing location oflot 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.
APPLICA nON IS HEREBY MADE to the Building Department for the issuance of a Building Permit pursuant to the
Building Zone Ordinance of the Town of South old, 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.
"IMMEDIA TEL Y" OCCUPANCY OR jtJwJ;tz ...Ja.J1-0c
EN3~g~Ed'o~~\.~~,g~DE US F I S UN~~fUL (Signature of applicant or name, if a corporation)
BEFORE 'WATER" wn HOUl CERllFICA lEad.":> h>t'f ~~e DR-. lVc>>ri1-\K'~ d N \ \qSd-.
F OCCUPANCY (Mailingaddressofappli ~
State whether applicant is ~~~_~EWmeATEngineer, general contractor, 1f~ll}ci~I~.Q~l;,..~ builder
A . I \ ",,'/ \ ""i..,.D
. REQUIRED DATE' '5/ Zf, R P it 1 f ~::J-f, C-
OO . ~ \ FEE: I " B'-': LCr....L.L-.
(As on the tax roll or latest ~~..~02 ~ i: I.,) , I..~..~. Thi:
If applicant is a corporation, signature of duly authorized officer fJL~' \ ,,; ,;, '[ T,-'~:
APPLICATION FOR BUILDING PERMIT
Builders License No.
Plumbers License No.
Electricians License No.
Other Trade's License No.
loIJf) -[ REi AIN STORM WATER RUNOFF
PURSUANT TO SECTION 45-10C .
OF THE TOWN CODE.
1. Location of land on which proposed ~ork will be done:
3tolS tx'e 0 \\t>\e.. De.\\Je ;
House Number Str~et
1. FOichDATIO" -T, -' L[QUiRED
FOFt POURW CC:-;';'i':TE
2. ROUGH - FRAMI'iG & PLUMBING
3. INSULATION
4. FINAL - CONSTiiUGT!ON MUST
BE COMPLETE FOR C.O.
ALL CONSTRUCTiON SHALL MEET THE
REQUIREMENTS OF THE CODES OF NEW
YORK STATE. NOT RESPONSiBlE FOR
Mx,\\i~SIGN OR CONSTRUCTION ERROR&
cx.
Hamlet
(Name and title of corporate offic~L CONSTRUe T ION .L1ALL
MEEf THE REQUIREMENT.:) OF THE
15\'1 \ - \-II. CODES OF NEW YORK STATE.
County Tax Map No. 1000 Section \ I':)
Subdivision lx><:9 \-\o\e. ex e~'L ~C;;\o.\6
(Name)
Block \(0
Filed Map No. L\di rD
Lot ,q
Lot 5~
,
...
2. State existing use and occupancy of premises and intended use and occupancy of proposed construction:
a. Existing use and occupancy Ol'f:> ~m\ ~hL'e\ lIes
b. Intended use and occupancyLFe ~M'\ \j k\\w:J UJ\ \~()'1(\A ,'il0\mffil~ Gd
3. Nature of work (check which applicable): New Building Addition Alteration
Repair Removal Demolition Other Work \rsrC1Jt'Y\ SJJimml('(] 1fo\
(Descri~
,
4. Estimated Cost
Fee
5. If dwelling, number of dwelling units
If garage, number of cars
(To be paid on filing this application)
Number of dwelling units on each floor
6. Ifbusiness, commercial or mixed occupancy, specify nature and extent of each type of use.
7. Dimensions of existing structures, if any: Front Call. z:) ,
Height Number of Stories On 0
Rear la'-\. \j
Depth d.l.D..S\ ~ '
Dimensions of same structure with alterations or additions: Front Rear
Depth Height Number of Stories
8. Dimensions of entire new construction: Front /lQ 1
Height Number of Stories
,
9. Size oflot: Front \~D .O~ Rear \;),O.CO'
Rear 34 I Depth
,:;J5'
Depth \ C();j, .Od.\
"
10. Date ofPurchase~Dlo
Name of Former Owner ---.Eileen ORIllLVSk\
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 from premises? YES ~ NO_
14. Names of Owner of premises~\\e \=""e,l 0\0... Address~~ Phone No. 51~Ljq, -,?JJdI
Name of Architect, ~~~ ~ ~~ ._____ Address ...... _ .< '\[l\.D.Phone No.6.,(g-'16S -906d..
Name ofContractor~_ _~L~\_ AddJ:ess40~~'1 Phone No. LJ1..l-~3?l~
I'..-hk . CI~\\T14
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_NO ~
* IF YES, D.E.C. PERMITS MAYBE REQUIRED. -. ".'
16. Provide survey, to scale, with accurate foundation plan ~ddr~i~k~:property linbs. -- . '(.
." -- ,~.', ::! "'-"~"'; "i" _" <Or:. ", ::;q.....',-;:3
17. If elevation at any point on property is at 10 feet or below, ~t~~9)jdetopographical data on survey.
i' "..,' ~/', '. ''''I _ .
STATE OF NEW YORK)
SS:
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~.
,
COUNTY OF
NMne.\.\-e r;:vol Cl. being duly sworn, deposes and says that (s)he is the applicant
(Name of individual signing contract) above named,
(S)He is the
(}....J()fl f?
(Contractor, Agent, Corporate Officer, etc}
.~
of said owner or owners, and is duly authorized to perform or have performed the said w'ork and to make and file this application;
that all statements contained in this application are true to the bestof his. knowledge and belief; and that the work will be
performed in the manner set forth in the application filed therewith.
r
Sworn to before me this
.~ day of t1{~ 20 0 ~
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ilfr-gnature of Applican't--"'
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LOT 54
LOT 63
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SURVEY OF
LOT 55
IN
MAP OF DEEP HOLE CREEK ESTATES
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SURVEYED FOR: NANNffiE M. FEVOLA
10.2'
WOOD
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26.5'
0.8'
SITUA TE
MATT/TUCK, TOWN OF SOUTHOLD
SUFFOLK COUNTY, N.Y.
FM# 4265
DATE FILED JANUARY 28, 1965
TM# 1000-115-16-019
GUARANTEED TO:
NANNETTE M. FEVOLA
COMMONWEALTH LAND TITLE INS. CO.
LONG BEACH MORTGAGE CO.
SURVEYED: 19 JANUARY 2006
SCALE 1"= 30'
AREA = 22,045 SF
OR
0.506 ACRES
GUARANTEES INDICATED HERE ON SHALL RUN
ONi Y TO THE PERSON FOR WHOM THE SURVEY
IS PREPARED, AND ON HIS BEHALF TO THE
TfTlECOMPANY. GOVERNMENTALAGENeY, JR.
LENDING INSTITl.IT1ON, IF LISTED HEREON. AND
TO rHE ASSIGNEES OF THE LENDING INSTTTtlTlON.
GlJARANTEEs ARE NOT TRANSFERABLE TO
ADOfT/ONAL INSTTTI./TlONS OR SUBSEQUENT OWNERS. 1 1 9.s 6
UNAUTHORIZED AL TERA T10N OR ADDmON TO THIS
SURVEY IS A VIOLATION OF SECTION l209 OF
THE NEW YORK STATE EDUCATION LAW.
Cq:>fES OF THIS SURVEY MAP NOT BEARiNG
THE LAND SURVEYORS EMBOSSED SEAL SHALL
NOT BE CONSIDERED TO BE A VAUD TRUE >
COPY,
--
PERGOU\ OVER
THIS AREA
;., RAM
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PATI
CELLAR
ENTRANCE
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LOT 56
185.12
THERESA DRIVE
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WA~~J~C; - IT IS A \,]OLATIOI\' OF SECTIO'\' 7209.2 OF THE NEW YORK STATE
EDUCATIO;; LAWFOR A:-;Y PERSO;;, L')>;LESS ACTING UNDER THE D1RECTIO:\ OF
A UCL:\SED PROIESSIONAL ENCiI:\EER. TO ALTER TillS DRAWI:\G 1:\ A:\Y WAY.
T'(f'Ic:AL W~\.\. ~R.A.Ce. ~~t>\."(
(~..')(. ~i>~~\~":: eo')
1--2' 2~
14 c.o.. CAlVANiZEO-
STEEl WALl. PANEl
UNOISTUR&D EIJlTH
1. r,o" .. 4" C.otiil..l1.lOU!>
~o>lc.ll..ne. c.ol.U'o.R.
t '/.,: .. II "'..... u...\..-J. "t1Co.\..~ o~
"Ib" Co."'-" .i'''\i.~'Ot.D lLcO
42"
'2:' B0TTOI.l LL6..TER:Al
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7 1/2 II " '/2 II: t7
&AA1NG PLATE
J/~ REBAR
1 1/1" I: 24" II '" CA.
GAl,VIo).jIZEO ANGLE
NOiL BACKrtll TO BE 5A,'lO, CP,!.\-"E:...
OR OTHER NON EXPA."l$r\l~ U-.t,";"tR;AL
'5(CTlorJ A. A.
/\IT"
:\OTES:
I, :\0 SPOIL SURCHARGE PERMITTED WITHI:" 4 FEET OF EXCAVATION,
2, FI:\ISHED GRADE SHALL SLOPE AWAY FRO~I POOLA MIJ'OIMUM OF 'l\-
I:"CH PER FOOT.
1. THIS POOL MEETS THE REQUIREMENTS OF A:"SI/NSPI-5 "AMERICAN
NATIONAL STANDARD FOR RESIDENTIAL INGROUND SWIMMING POOLS"
A:\D SECTION 421 OF THE BOCA CODE.
,,)0 'P\",.Jc... t-Qu\PM~T f'UM,"1'Tt.T'::>.
ST ANDARD DETAILS - STEEL WALL POOLS
APPROVED BY:
ORAWN BY JK~t
SCALE: NONE
OATE: J. '1.")10'0
PREPARED FOR: _ ~_G,..L? "D~E.P fl..L'-.
_M,l..TTITWc'I'-, ,\'{
REVISED
P'i!.-NE.
II"lc;'L
PREPARED BY: JAMES K. MORROW, JR.. P.E.
2066 BEDFORD AVE, (
NORTH BELLMORE, NY 1\710 'SIlo) 1b<;" bO",>'l...
DRAWING NUMBER
FE..'\I t>LA .. I