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HomeMy WebLinkAbout29376-Z FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No: Z-30226 Date: 06/02/04 THIS CERTIFIES that the building ACCESSORY Location of Property: 3800 WELLS AVE SOUTHOLD (HOUSE NO.) (STREET) (HAMLET) County Tax Map No. 473889 Section 70 Block 3 Lot 22 .6 Subdivision Filed Map No. Lot NO. conforms substantially to the Application for Building Permit heretofore filed in this office dated MAY 12, 2003 pursuant to which Building Permit No. 29376-Z dated MAY 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 PAUL R & ELLEN GOMEZ (OWNER) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A ELECTRICAL CERTIFICATE NO. 77548C 07/17/03 PLUMBERS CERTIFICATION DATED N/A Authorized Signa re 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. 29376 Z Date MAY 14, 2003 Permission is hereby granted to: ASSOCIATES INC GENDOT PO BOX 143 WADING RIVER,NY 11792 for CONSTRUCTION OF A 20 X 37 IN-GROUND SWIMMING POOL IN THE REQUIRED REAR YARD WITH FENCE TO CODE AS APPLIED FOR at premises located at 3800 WELLS AVE SOUTHOLD County Tax Map No. 473889 Section 070 Block 0003 Lot No. 022 . 006 pursuant to application dated MAY 12 , 2003 and approved by the Building Inspector to expire on NOVEMBER 14, 2004 . Fee $ 150 . 00 AKoriature ORIGINAL Rev. 5/8/02 ? u 'AcC-t Form No.6 /n} O w 4'`"`"S •U v 14 = TOWN OF SOUTHOLD C�Q Ut �e �O BUILDING DEPARTMENT i TOWN HALL _._. . 765-18021 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,' 'I. 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 p / Date. New Construction: (check g:` (check one) Location of Property: ` ��ne) \ >`I �`'� Doi V , Q House No. Street Hamlet Owner or Owners of Property: �>Wr C,>t Z PJt�, Suffolk County Tax Map No 1000, Section Block 3 Lot Subdivision Filed Map. Lot: Permit No,�� - Date of Permit. 'O '� Applicant: Health Dept. Approval: Underwriters Approval: Planning Board Approval: Request for: Temporary Certificate Final Certificate: (check one) Fee Submitted: $c795=� C, �p �/ Applicant ature 1 I 14 �n04 J I ctrical Inspection Certificate Issue Date Electrical Inspection Service, Inc. Application Number 07/17/2003 375 Dunton Avenue 77548C East Patchogue, New York 11772 (631)286-6642 Issued To: Paul Gomez Street: 3800 Wells Avenue Village: Southold Zip: 11971 Town: Southold Section: 70 Block: 3 Lot: 22.6 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 Q Pool ❑ 1st Floor ❑ Indoor ❑ Basement ❑ Hot Tub X❑ Residential ❑ Det.Garage ❑ Attic ❑ 2nd Floor X❑ Outdoor ❑ Addition ❑ Survey Switches Receptacles Fixtures GFI Heaters A/C Fans 1 2 1 2 1 Dishwasher WasherlAmps DryerJAmps Oven RangeJAmps Microwaves Furnace oil Gas Circulators Smoke Detector Bell Transformer X Meter Amps Phase UG/OH Jacuzzi Television CO Detector Bldg. Permit.- Other ermit:Other Equipment 1-Pump Motor 1-Time Clock 1-Panel 125Amp (60Amp Main 3 Circuits) Hugo S. Sill President Rough Inspection: 07/10/2003 Inspector: Jerome Damico Final Inspection: 07/10/2003 Inspector: Jerome Carrico This certificate must not be altered in any manner. Inspectors may be identified by their credentials. TOWN OF SOUTHOLD PROPERTY RECORD CARD OWNER STREET 3g© VILLAGEv f 1 DIST. SUB. LOT We ( IS �e �OUO ((A5 F,le 4r 1.771 1q-y 71 ACR. qZ REMARKS ZIZ,710/ TYPE OF BLD. Ge rd o 1' sDe �� s IS Q 9p-* a9 PROP. CLASS ZU({l12ClS Getz doi- N C io G1S :LAND f so I►�e. �a a �o a o -� I zz ►1 q�tS- IMP. TOTAL DATE 5 9102 v Rp 1 ?7a v o --- FRONTAGE ON WATER TILLABLE FRONTAGE ON ROAD WOODLAND DEPTH MEADOWLAND 1 BULKHEAD HOUSE/LOT Qz - - TOTAL ■■■■■■■■■■■■■■■■■■■■■■■■■■■ ■■■■■■■I©■■�a1■■■11■iii■■■■■■■■■ ■■■■■■■■■■■■■■■■■■■■■■■■■■■ ■■■■■■■■■■■■■■■■■■■■■■■■■■■ ■■■■■■■■■■■■■■■■■■■■■■■■■■■ ■■■■■■■■■■■■■■■■■■■■■■■■■■■ Basement SLAB® Ext. Walls _ Interior Finish �_® Fire Place -� Floor __ 765.1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION IST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] IN LATION [ ] FRAMING [ INAL [ ] FIREPLACE A C IMNEY [ ] FIRE SAFETY INSPECTION REMARKS: Gc DATE INSPECTO FIELD INSPECTION REPORT DATE COMMENTS' ro FOUNDATION(1ST) � H -------------------------------' C FOUNDATION(2ND) z O ROUGH FRAMING& PLUMBING 3 INSULATION PER N.Y. STATE ENERGY CODE ' Y y FINAL ADDITIO COMMENTS O Z m _ o O x 1 � d c� 'OWN OIC' SOUTHOLD - BUILDING PERMIT APPLICATION CHECKLIST UILDING DEPARTMENT Do you have or need the following,before applying? ,OWN HALL Board of Health OUTHOLD, NY 11971 3 sets of Building Plans 'EL: (631) 765-1802 Planning Board approval 'AX: (631) 765-9502 ./ ` Survey PERMTr NO. 9T 5�LI, Check Septic Form N.Y.S.D.E.C. Trustees xamined '� /y 20 3 Contact: tM q .pproved T q 20_�> _ Mail to: 4t ,isapproved a/c O� - Ll lZ Phone: 44-81 o xpiration is 20_ Building Inspector 1 2 APPLICATION FOR BUILDING PERMIT Date i 2 2003 INSTRUCTIONS a. This application MUST be completely filled in by typewriter or in ink and submitted to the Building Inspector with 3 As of plans, accurate plot plan to scale.Fee according to schedule. b. Plot plan showing location of lot and of buildings onpremises, relationship to adjoining premises or public streets or -eas, 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 tall be kept on the premises available for inspeztion 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 sues a Certificate of Occupancy. f. Every building permit shall expire if the work authorized has not commenced within 12 months after the date of nuance or has not been completed within 18 months from such date.If no zoning amendments or other regulations affecting the operty have been enacted in the'interim,the Building Inspector may authorize, in writing,the extension of the permit for an .dition 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 iilding Zone Ordinance of the Town of Southold, Suffolk County,New York, and other applicable Laws, Ordinances or :gulations, for the construction of buildings, additions, or alterations or for removal or demolition as herein described. The plicant agrees to comply with all applicable laws, ordinances,building code,housing code, and regulations, and to admit thorized inspectors on premises and in building for necessary inspections. (Signature of applicant or%Qne, if a corporation) 336o was AJenuej (Mailing address of applicant) ate whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder I1 ;me of owner of premises Pa-Ld Qnd �I+e0 p fae7 (As on the tax roll or latest deed) applicant is a corporation, signature of duly authorized officer (Name and title of corporate officer) ilders License No. umbers License No. ,ctricians License No. JL4 E er Trade's License No. Location of land on which ropo ed work will be done: ,, a ;�, ; �32oo 1,511 �J�nu� SOl4-hold •y� House Number Street Hamlet County Tax Ma No. 1000 Section �D Block 3 Lot M �o Subdivision xD.Filed Map No. Lot a. Existing use and occupancy '51ode-T�L f2Si der)c2- I j b. Intended use and occupancy a6X 3, mountoui i lgXe. f(oojmJ j(1Q0u r1(J moo l 3. Nature of work (check which applicable): New BMgTMTnp1)00 Addition Alteration Repair Removal Demolition mer Work 0 (Description) 4. Estimated Cost*10.wo-0Fee (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 3. Dimensions of entire new construction: Front Rear Depth Height Number of Stories 9. Size of lot: Front 114,11 Rear. -i- 3 Depth 3bg 73 10. Date of Purchase Name of Former Owner 11.}Lone 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 P 1 tT Address89DO UJellan So ow C( 14. Names of Owner of remises au- oYrtez 1�1� Phone No. Name of Architect eon o S Address VoiwkMdoLOM Phone No moi.$ - 9,4-37 Name of Contractorc Address Phone No.' - ctrl - Fiod 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 MAY BE REQUIRED. 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) SS: COUNTY OF- Ca u F-Can-I SOI \e Z being duly sworn, deposes and says that(s)he is the applicant (Name of individual signing contract) above named, (S)Heisthe atom (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 applicatic that all statements contained in this application are true 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 this -day of 2063 O Notary Public Signature of Applicant MMM L K4= 10+A"Anuo.oras or r aw T= 0"IEO M SUfRX5K�COUNn REG No M Wift"s 14 FROM : GREAT AMERICAN DRYWALL LLC FAX NO. 631-653-7976 May. 09 2003 02:00PM P2 LOT AREA= 40,182 sq. ft. lOT NLWBER 4 ry11 y 04 Q r� f x �7 2 SiYFli.I 2 .a 9TIL OM�LL d z I � 12� Li f I Nl v a7cn CO . a o a CL 0 a � I ay .. m 0 IIs f uaia FD S 73'20'OOV 194.11 ' WELLS ROAD NOTE CESSPOOL, SEPnc TANK & WATER SET PROP. CORNERS & LOCATED FENCE, SERVICE LOCATIONS BY OTHERS. PROPANE TANKS & LAWN 9-19-2002 FINAL SURVEY 8-22-2002 Ike, Wgmw OF Wnm 4V OR sksbom LOCATED FOUNDATION 6-4-2002 a :ISO F!!LR11" B .1 ...%A9WM o., REVLSEO OWpJJNG s.-17-2002. . -- IMOiERis'(o i'ayeweoiq}sllairi iielEaN"Ml*.7W T m 7W K LWO-AW FOR n WMPOW"M4 USE WD o kibhE" MOT JOB No_ 01-617 FILE No. PECONIC DEVEI„ CORP. �n�to auoe THE a►' serreio ws roa�x amoe, SURVEYED FOR PAUL GOMEZ & ELLEN EUROPE-GOMEZ uNkmioFm A)ii3� a wmMla 1W "W-Y rt A upumi W=WN LOT NUMBER 6 .. .. - 770°aP•,rm MEW wm saa¢ 1J L MAP OF PECONIC DEVELOPMENT CORP. AT SOUTHOLD WOW= MOW= MW VVQ NN OKY M nC M74M FOR WOW ne SLTUAI'ED AT SOUTHOLD Amy Is PARD.J"ap ms 9DW-m 1w mu cwwn.01my NGrsY. . naWo UMD.W RitmunoW uslE NMW'AM m We 1®9G 'W THE Aw.moT iwmnww Tb Aar nwA rsm mm TOWN OF SOUTHOLD - SUFFOLK COUNTY N.Y. mrty PIFTNs nmkY wr Mor Rovlon n� uwD wrtwnxCs MIREa.sFiL as SCALE 1" 50' DATE 12-20-2001 s swuuorx'mRdaeRm m,se n'ww'vxc oorr. FILED MAP No. 10723 DATE 12-27-2001 CERTIFIED ONLY TO: TAX MAP Na,(REF ONLY) 1000-JO-3-22.6 DISK 500 PAUL GOMEZ & ELLEN EUROPE-GOMEZ NORTH STAR TITLE AGENCY, INC. (#L253920) HAROLD F. TRANCHON JR. PC COMMONWEALTH LAND T1TL INSURANCE COMPANY LAND ANCHO 5vih��`�a{t -7 w� 1866 WADING RVEEV0KSRzWNOR.R 2LVtAO ER, YPM N. IC.. No 048992 631-- -469%k12 98 ROLD•F. TRANCHON JR. PENN. LIC. Nv. 2115-E COMPLY WITH ALL CODES OF NEW YORK STATE & TOWN CODES EOUIRED AND CONDITIONS OF ALL TRUCTI D AS WO MEET THE REQUIREMENTS OF THE USE IS UNLAWFUL g B.P.R q� _,,F */�l W S01TH0LD TOWN ZBA CODES OF NEW YORK STATE. WITHOUT CERTIFICATE DATE 3 • - SOL7HOLDTOWN PLANNINO OF OCCUPANCY F G DEPAR7IENT AT, _91/4 SOU7HOL6 TOWN TRUSTEES . 4 P MR Te /p AIVC (1(f :e'. a I� � SKIMMERS { INER - ___- 't..�•- ' - RE URNS J 1. CRETE Q� 9' R _- ' ^t. �. 3.�•POURED � & �% 0 R 4'-2 12- ->.- Ft 3-3/g BARS -{ 4. C.O. FORM TIES THE N SF1Atl 11�T 10• R THECODESOFt*W \ `� T RESPONSE MR \ TO FILTER AT . YORK �TpN ERRORS' 8 ; 'a 3FROM SKIMMERS 21' 2 i t j 10' B ROLLED FOAM 0 fiLTERnnd PUMP _tt 0, I BET':wEEN UNER-. ` 4'� 4' I FROM FILTi t � CONCRETE TO RETURNS , 35 O O 16 - TO WASTE --------------,tet 10' R _ - - POURED CONCRETE VINYL LINEA PIPING ARRANGEMENT is'CON SIDE OR END - I �e�« P E STEPS OPTIONAL _ _ 1U" I Tq_ 'ERGLA: tzI c P LAN 2- a _ARIT SECTION SEE TYPICAL WALL SECTION FORM TIE - LDED IECE 24" MAX 3 /8' BARS lO 2 - 4 SAND SOTTO I& 13, 0'" O "IMMEDIATELY" �l ENCLOSE POOL TO CODE P LAN OPTIONAL STEP UPON COMPLETION S E C T I O N B — B BEFORE "WAIEp" TYPE* I. GRADE `I"Y PIC A L WA L L FLOOD7,p1VE COMPLY WITH CHAPTER I FLOOD DAMAGE PREVE UNDERWRiTERS CERTIFICATEp[: NEW' SOUTHOLD TOWN NTION �A�� RECUIRED 5 Re ��yo NOTES: PROPOSED POOL FOR: CONTRACTOR: SECTION A- A * * WALKS TO BE SMOOTH, NON-SKID TYPE SLOPED AWAY FROM POOL. RANDY T. RODECKER, •INC r 1X w WATER C?IEPOSAL SHALL BE LIMITED TO SWIM KING POOLS = OWNERS PROPERTY TO SUIT LOCAL REGULATIONS. 4°• oseJO6 �2' . . ROUTE 25A, 2 O 3 2 °RorEssloN�� .' ROCKY POINT, NY 11778 BUILDING PERMIT EXAMINER CHECK LIST DATE REVIEWED: S-1 f 103 APPLICANT DATE SUBMITTED: 3/0/03 SCTM# DISTRICT: 1,000, SECTION: , BLOCK: J , LOT Vi, SUBDIVISION:�tc. ,� , ADDRESS%%x ( �, CITY: ZONING DISTRICT: _CONFORMING? BUILDING PERMITS OPEN/EXPIRED: BP -Z/C/0 Z- , INFO _/BP -Z/C/0 Z- , INFO BP -Z/C/0 Z- , INFO /13P -Z/C/0 Z- , INFO PRE CO: Y OR N BP -Z/ C/0 Z- , SINGLE & SEPARATE CERTIFICATION-REQUIRED NOTES: LOTS 40,000SF-100-24.Lot recognition.(CREATED before June 30, 1983),UNDERSIZED LOTS FROM JAN.1997 100-25.Merger.(A nonconforming at any time after 7/1/8 REQ. LOT SIZE: ACT. LOT SIZE. ' REQ. LOT COV.c�o ACT. LOT COV. REQ. FRONT B PROP. FRONT Q; E �/ ,- ACT. SIDE REQ. REAR ,,h PROP. REAR HEIGHT PROP. HEIGHT PROJECT DESCRIPTION: ESTIMATED PROJECT COST: ARCHITECT/ENGINEER: tj FAST TRACK WATER FRONT? DESCRIPTION: PANEL #: _FLOOD ZONE: COMPLIANCE: APPROVALS REQUIRED SUFFOLK COUNTY HEALTH DEPT: YES or&(BED #): DTE: / / PERMIT#: TOWN SEPTIC RECEIPT: Y 09) NEW YORK STATE DEC: PRE-DEC 9/1/75 YES O SOUTHOLD TOWN TRUSTEES: YES or TOWN ZONING BOARD APPROVAL: YES or TOWN PLAN. BOARD APPROVAL: YES o TOWN HISTORICAL PRE (SPLIA): YES o / NEW YORK STATE CODE COMPLIANCE (SEE PAGE 2): YES or NO �/ NOTES: FEE STRUCTURE: FOUNDATION: SF FIRST FLOOR: SF SECOND FLOOR: SF OTHER: SF INIT OTHER TOTAL TOTAL: SF FEE FEE FEE 1. ( SF)- (_ SF)= SFX $ -=$-+$-+$-= $ Psz) 2. ( SF)- ( SF)= SFX $ =$ +$ +$ = $ 3. ( SF)- ( SF)= SF X $ -=$-+$-+$-= $ FINAL TOTAL: $_ 45Z� NEW YORK STATE CODE COMPLIANCE CHECKLIST USE/OCCUPANCY CLASSIFICATION: HEIGHT/FIRE AREA: TYPE OF CONSTRUCTION: DESIGN CRITERIA: ENGINEERED/PRESCRIPTIVE FULL FRAMING DESIGN ELEMENTS: - HEADERS: Y/N WALL STUDS: Y/N GIRDERS: Y/N CEILING JOISTS: Y/N FLOOR JOISTS: Y/N ROOF RAFTERS: Y/N LUMBER SPECIES AND GRADE: Y/N DESIGN LOAD CALCULATIONS: Y/N SHOULD INCLUDE LI dE,DEAD,SNOW,SEISMIC AND WIND(INCLUDING UPLIFT AND EXPOSURE) WINDOW AND DOOR SCHEDULE: MISSLE TEST REQUIREMENTS: Y/N EGRESS, LIGHT, VENT: Y/N LOAD PATHS: Y/N ROOF TO FOUNDATION NAILING/CONSTRUCTION SCHEDULE: Y/N MEANS OF EGRESS: Y/N PLUMBING RISER DIAGRAM: Y/N LOCATION OF FIRE PROTECTION EQUIPMENT: Y/N TRUSS DESIGN: Y/N CERTIFICATION: Y/N ENERGY CALLS: Y/N TOTAL COMPLIENCE? Y/N(RETURN TO PAGE ONE)