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HomeMy WebLinkAbout32818-Z· FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPkNCY NO: Z-33663 Date: 04/21/09 T~IS CERTIFIES that the building ACCESSORY Location of Property: 125 CAIOLA CT (HOUSE NO.) (STREET) County TaxMap No. 473889 Section 33 Block 3 s~bdivision Filed Map No. __ Lot No. __ GREENPORT (HAMLET) Lot 19.17 conforms substantially to the Application for Building Permit heretofore filed in this Office dated. MARCH 15, 2007 pursuant to which Building Permit NO. 32818-Z dated MARCH 20, 2007 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 IN GROUND SWIMMING POOL WITH FENCE TO CODE AS APPLIED FOR. The certificate is issued to SHEFQUET KOCI & ANO. (OWNER) of the aforesaid building. S~3FFO~ ~L~TYDEPAR~F~TOF~F2%L~{APPRO~-~-L N/A ~.Rt-£KIf2%L ~KTIFICA~ NO. 7152 06/16/07 5~]~B~q~ ~TIFICATION DA'r~ N/A ~A / d/S'~nat~ ure Rev. 1/81 Form No. 6 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL 765-1802 APPLICATION FOR CERTIFICATE OF OC£ This application must be filled in by typewriter or ink and submitted to the Buildff A. For new building or new use: 2 0 2009 1(- / 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. Conunercial building, industrial building, multiple residences and similar buildings and installations, a certificate of Code Compliance from architect or enginccr responsible for thc 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, buildiug 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, Swinnning 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 - Resideotial $15.00, Commercial $15.00 New Construction: Location of Property: f Old or Pre-existing Building: (check one) House No. Street Owner orOwnersofProperty: ~1~ ~Ci ~ Efh Suffolk County Tax Map No 1000, Section 0~. Or) Block Subdivision Date ofPermit. {~/~30/0~ Permit No. !~ Health Dept. Approval: Filed Map. Applicant: Hamlet Lot ol~ , Lot: Underwriters Approval: Planning Board Approval: Request for: Temporary Certificate Fee Submitted: $ Final Certificate: (check one) ./ A~Jicant Signature 40 Nottingham Ddve~ Middle island. NY 11953 Telephone: 631 495 8136 · Fax: 631 980 6455 · E-Mail: SBEIGS@gmail.com CERTIFICATE OF ELECTRICAL COMPLIANCE Applicant: Rough In inspection Date: Application No.: Leos Electric Corp Certificate No.: 7152 3une 16,2007 Final inspection Date: June 16,2007 7152 Building Permit No.: 32818z Suffolk County Tax Map No.: 33 3 19.017 This Certificate of Electrical Compliance is limited to the inspection and compliance of electrical equipment and/or work described below, installed by the applicant named above, located at the premise of and not after the final inspection date above: Owner: Shef Koci Site Location: 125 Caiola Court, Greenport, NY 11944 Owner's Address (if different): Residential Indoor Basement Service Shed Commercial -~ Outdoor First Floo[ - Pool Hottub New Renovation Second Floor Attic Garage Addition Survey Other: INVENTORY Other Equipment: Automahc Chlonnator The electrical work and/or equipment described above were inspected and appear to be in compliance with local, state and national electrical code requirements and this office. Applicant: Leos Electric Corp Signature:?~://,/xJ' '7 v License No.: 2199 Date Of Certificate: Jun 30,2007 FORM NO. 3 TOWN OF SOUTHOLD BUILDING DEPARTMENT Town Hall Southold, N.Y. (THIS BUILDING PERMIT PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) PERbtIT NO. 32818 Z Date MARCH 20, 2007 Permission is hereby granted to: SHEF KOCI 125 CAIOLA CT GREENPORT,NY 11944 for : CONSTRUCTION OF AN INGROUND SWIMMING POOL IN THE REAR YARD, FENCED TO CODE at premises located at 125 CAIOLA CT GREENPORT County Tax Map No. 473889 Section 033 Block 0003 Lot No. 019.017 pursuant to application dated MARCH 15, 2007 and approved by the Building Inspector to expire on SEPTEMBER 20, 2008. Fee $ 250.00 /~C~kut hori zed Signature ORIGINAL Rev. 5/8/02 TOWN OF SOUTHOLD BUILDING DEPT. 765-1802 INSPECTION [ ]FOUNDATION 1ST [ ]FOUNDATION 2ND [ ]FRAMING / STRAPPING [ ]FIREPLACE & CHIMNEY [ ] ROUGH PLBG. [ ].~I~L~TIoN [ ~ FINAL ] FIRE SAFETY INSPECTION [ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRATION REMARKS: ~/~)~/~ DATE INSPECTOR,~~ TOWN OF SOUTHOLD BUILDING DEPT. 765-1802 INSPECTION ] FOUNDATION 1ST [ ] ROUGH PLBG. ] FOUNDATION 2ND ] FRAMING / STRAPPING [ ] I N,.,.,~U LATIO N [~'~INAL [ ] FIREPLACE & CHIMNEY [ ] FIRE SAFETY INSPECTION [ ] FIRE R~j CONS~R~ UCTION [ ] FIRE RESISTANT PENETRATION R E M~.~//4-9~/4~'~ '/~---- ~,-~ ~ DATE INSPECTOR ! i COMMENTS FIELD INSPECTION REPORT i DATE i FOUNDATION (1ST) FOUNDATION (ZND) PLYING ~S~ATION PER N. Y. STATE ENERGY CODE ~DITION~ CO~ENTS J TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, NY 11971 TEL: (631) 765-1802 FAX: (631) 765-9502 www. northfork.net/Southold/ Examined Approved Disapproved a~c Expiration 7/,)'~), 20 08 PERMIT NO. Building Inspector 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: Mail to: Phone: APPLICATION FOR BUILDING PERMIT INSTRUCTIONS ~t. )'his application MUST be completely filled in by typewriter or in ink and submitted to the Building Inspector with 4 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 adjdining 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 o£this application, thc 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 whoIe or in pan for any purpose what so ever until the Building Inspector issues a Certificate of Occupancy. f. Every huilding 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 describod. The applicant agrees to comply with all applicable laws, ordinances, building code, housing c de, and regulations, and to admit anthorized inspectors on premises and in building for necessary inspections. "IMME h TELY" . ENCLOSE 7o or_ 70 CODE UNDERWRITERS CERTIFICAIE (Signature of 3plicant or name, ifa corporation) UP©N CO~ i'LETlOrq REQUIRED ALL CONSTRUCTION SHALL (Mailing address of applicant) State whether applicant is owner, less~, ~, ~r~e~,Fg~rral contractor, electrician, p!,u~,ber or builder /~ .PZJDES OF NEW YOFtK STATE. Name of owner of premises (As on the tax roll or If applicant is a corporation, signature of duly authorized officer Builders License No. Plumbers License No. Electricians License No. Other Trade's License No. (Name and title of corporate officer) mCcur ki,. / OR qF IR UNLAWFUL '-,'- "" 3. INSULATION 4. FINAL- CONS,,; ,,~,1 MUST BE COMPLETE,-- ,, C.O. ALL CONSTRUCTIOd SHALL MEET THE EC U ,EME TS C03 S O "EW , . .F OCCUPANCY STATE. NOT RESPONSIBLE FOR Locationl2.~.of land on wnicn/1./~]QCCrI~roposed worE(~Q wllI be done: L~fE/xl~gq. ~ T/4 .DESIGN OR CON~UOTIO~¢¢¢ORS. House Number Street ' Hamlet County Tax Map No. 1000 Section ~ Block ~ Subdivision Filed Map No. (Name) 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy b. Intended use and occupancy 3. Nature of work (check which applicable): New Building_ Repair Removal Demolition 4. Estimated Cost 5. If dwelling, number of dwelling units If garage, number of cars Addition Alteration Other Work ~}mm~o/ 19~oc_ Fee (Description) (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 8. Dimensions of entire new construction: Front ,7-D' ~ qO' Rear Height Number of Stories 9. Size of lot: Front r]0~ Rear Ir]3~ Depth 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 V 13. Will lot be re-graded7 YES / NO__Will excess fill be removed from premises? YES v/ NO__ 14. Names of Owner of premises ~c I(Oe.'~ Address 125Camco, Ct Phone No. 01'7-[~#~- ~71 Name ofArchitect ~[h~t~ ~3 .~dk/ Address q Name of Contractor ~oem~ ~ ~ao~ms ~zocx Address q2~ 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 ora 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 tgpographical data on survey. STATE OF NEW YORK) ss: COUNTY OF ) ~2J~3 ~)t,l~l. th.~ being duly sworn, deposes and says that (s)he is the applicant (Name of individual signing contract) above named, (S)He is the ~./CrJt~tl6P¢~ (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 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 tp~before me this. I -- IL~ day of I I Notary Public MARGARET A. KIDNEY I~ Pu~ic - State of New York No. 01 KI6021111 Qualified in Suffolk County My Commissio~ Expires I~lar~ 8, 20J~... 200r~ ~f Applicant SuFfolk Countjz Execu~'ve's Office of Consumer A~aZrs VETERANS MEMORLAL HIGHWAY * HAUPPAUGE, N~W YORK 11788 DAT~ ISSUED: 7/1/78 No. 4436-H SUFFOLK COUNTY _.f f o~ ~ e .[~pro p-em en t Con ira ctor License This is to certify that ARTI-IU~ J EDWARDS doing business as A~qTHUR EDWARDS MASON CONT1L~CTING INC _t _.~m,,c .... ~ cci mumen,:., ~c ~o~ u~ n accordance with and subject to the provisions of applicable laws, n,.,c, an~: ~ ~,~t~[~cz~ o£ thc CounE~- of SuffoLk, State of New York is hereby licensed to conduct business as a HOME PM_PROVEMENT CONTRACTOR, in the County of Suffolk. SUFFOLK COUNTY EXECUTIVE*S OFFICE OF CONSUMER AFFAIRS ROME IMPROVEMENT CONTRACTOR ARTHUR EDWARDS LICENSE o7o726.H I 7'1!1978 Additional Bu me es Director ACORD. CERTIFICATE OF LIABILITY INSURANCE OP D DATE.D ) / Ol/O8/O7 PRODUCER THIS CER~FICATE IS ISSUED AS A MATTER OF INFORMA~ON ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE Bagatta Associates, Inc. HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR 823 W Jericho Turnpike Ste lA ALTERTHECOVERAGEAFFORDEDBYTHEPOMClESBELOW. Smithtown NY 11787 Phone: 631-864-1111 Fax: 631-864-8274 : INSURERS AFFORDING COVERAGE NAIC# INSURED Arthur J Edwards DBA: INSURERS: Arthur J. Edwards Pool & Spa' Center Contracting Inc. INBURERC: 929 Route 25A Miller Place NY 11764-2700 INSURERD: COVERAGES THE POLICIES OF iNSURANCE LISTED BELOW HAVE BEEN ISSUEC TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT. TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WFFH RESPECT TO WHICH THIS CERTIFICATE MAY SE ISSUED OR MAY PERTAIN. THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HERE N S SUBJECT TO ALL THE TERMS. EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. G~ERAL LIABILITY EACH OCCURRENCE $ 1 ~ 000 ~ 000 A X COMMERCIALGENERALLL~BILITY l~A8G0912 01/01/07 01/01/08 PREMISEsUAMa~ 'u~=mltU(Ea 0ccurence) $50t000 I CLAIMS MAOE [] OCCUR MEDEXP (Any one p,~) $ 5,000 A X Contractual Liab PERBONAL&ADVINJURY $ if000,000 A X Blanket Addtl Ins GENERALAODREGATE $ 2,000,000 ~ ~OLICY ~ JECT ~--~ LOC PRODUCTS-COMPmPAeO $ 2,000,000 -- COMBINED SINGLE LIMIT , $ ~ OCCUR ~ CLAIMS MADE AGGREGATE $ ANDBMPLO .B,L.B, ITORYLiM'TB I A Property MPA8G0912 01/01/07 01/01/08 Building 919,000 A Inland Marine MPASG0912 01/01/07 01/01/08 Ded 1~ 000 CERTIFICATE HOLDER CANCELLATION 0000000 Town of Southold Town Hall P.O. Box 728 Southold NY 19971 ACORD 25 (2001/08) © ACORD CORPORATION 1988 This certificate is an original. STATE OF NEW YORK WORKERS' COMPENSATION BOARD CERTIFICATE OF PARTICIPATION IN WORKERS' COMPENSATION GROUP SELF-INSURANCE la. Legal Name and Addre~ of Business Participating In Group Self-lnsurance (Use Street Address Onlv) Arthur J. Edwards Mason Contractor, Inc. 929 Route 25 A Miller Place, NY 11764 lb. Effective Date of Membership In the Group 04/24/2002 ld. Business Telephone Number of Business refernced in box "la" 1-631-744-7185 lo. NYS Unemploytment Insurance Employer Registration Number of Business refernced in Box "la". 24108715 Issue Date 6/5/2006 Expiration Date 6/4/2007 included. (Only cbeck box if all partners/oBicers included) 2. Name and Address of the Entity Requesting Proof of Coverage fEntitv Boine Listed as Certifcate Holder] Town of Southold Town Hall PO Box 728 Southold, New York 11971 lf. Federal Employer Identification Number of Business refernced in Box '*la'* 111277925 Name and Address of Group Self-insurer Special Trades, Contracting And Construction Trust 6250 South Bay Road PO Box 3580 Syracuse, NY 13220 Policy: W521504 This certifies that the business referenced above in box "1 a" is complying with the mandatory coverage requirements of the New York State Workers' Compensation Law as a participating member of the Group Self-Insurer listed above in box "3" and Participation in such group self-insurance is still in force. The Group Self-Insurer's Administrator will send this Certificate of Participation to the entity listed above as the certificate holder in box "2". The Group Self-insurer's Administrator will notify the above certificate holder within 10 days IF the membership of the Participant listed in box" la" is terminated. (These notices may be sent by regular mail.) Otherwise, this Certificate is valid for a maximum of one year from the date certified by the group self-insurer. If this certificate is no longer valid according to the above guidelines and the business referenced in box "Ia" continues to be named on a permit, license or contract issued by the certificate holder, the business must provide the certificate holder either with a new certificate or other authorized proof the business is complying with the mandatory coverage requirements of the Certified by: Ce~ified by: Title: TelephoneNumber: David Francey (315) 699-8475 GS-105.2 (2-02) WORKERS' COMPENSATION LAW WORKERS' COMPENSATION LAW Section 57 Restriction on issue of permits and the entering into contracts unless compensation is secured. 1. The head ora state or municipal department, board, commission or office authorized or required by law to issue any permit for or in connection with any work involving the employment of employees in a hazardous employment defined by this chapter, and notwithstanding any general or special statute requiring or authorizing the issue of such permits, shall not issue such permit unless proof duly subscribed by an insurance carrier is produced in a form satisfactory to the chair, that compensation for all employees has been sccared as provided by this chapter. Nothing herein, however, shall be construed as creating any liability on the part of such state or municipal department, board, commission or office to pay any compensation to any such employee if so employed. 2. The head of a state or municipal department, board, commission or office authorized or required by law to enter into any contract for or in connection with any work involving the employment of employees in a hazardous employment defined by this chapter, notwithstanding any general or special statute requiring or authorizing any such contract, shall not enter into any such contract unless proof duly subscribed by an insurance carrier is produced in a form satisfactory to the chair, that compensation for all employees has been Please Note: This Certificate is valid only through the policy dates indicated above, OR a maximum of one year after this form is approved by the authorized representatives of the Group Self-insurer. At the expiration of those dates, if the business continues to be named on a permit or contract issued by the above government entity, the business must provide that government entity with a new Certificate. The business must also provide a new Certificate upon notice of cancellation or change in status of the policy. GS- 105.2 (2-02) Reverse Suffolk County Executive's Office of Consumer Affairs VETERANS MEMORIAL HIGHWAY * HAUPPAUGE, NEW YORK 11788 DATE ISSUED: 5/1/80 No. 2740-ME SUFFOLK COUNTY Master Electrician License This is to certify that EDWARD S REIFF doing business as UNDERGROUND SPEC_ ~!ALTIES INC having given satisfactory evidence of competency, is hereby licensed as MASTER ELECTRICIAN in accordance with and subject to the provisions of applicable laws, rules and regulations of the County of Suffolk, State of New York. SUFFOLK COUNTY EXECUTIVE'S OFFICE OF CONSUMER AFFAIRS Additional Businesses MASTER ELECTRICIAN This cedifies that the bearer is duly licensed by the County of Suffolk EDWARD S REIFF u__ 7~7 2740-ME /1980 05/01/2008 !)irectoi A 13 Plan 2 Section B-B Section A-A -F-- B .P~p~ng Arrangement Typical Wall Section bTZE A B C D E F G H AREACAP. FEET FT. FT. FT. FT. FT. FT. FT. FT. S(t.FT. GAL. 16x32' 16' 32' 8' 14' 6' 4' 4' 8' 512 19,000 16'x36' 16' 36' 12' 14' 6' 4' 4' 8' 576 21,600 i18'x36' 18' 36' 12' 14' 6' 4' 5' 8' 648 24,300 ~'x40' 2,0' 40' 16' 14' 6' 4' 6' 8' 800 30,000 ~'x44' ~4' 44' 18' 14' 8' 4' 6' 10' ~ 30,000 ~'x48' ~4' 48' aO' 18' 8' 4' 6' 10' 900 30,000 & SPA PERMACRETE WAIL SYSTEM 929 Route 25A Miller Place NY 11764 (631) 744-7185 FAX (631) 744-0174 Suffolk License #4436-HI Nassau License #HI74450000 /NI~'I'~OND ~ ~. [amtiiar wffh (h~ ST~DRRDS FOR A~ROVAL '~ ~ c~s~ucno~ ~ su~u~c~.s~ ~ DISPOSAL SYST~S FOR ~LE FA~L Y RES~ENCES ond will e~Ide by ibe co~dlllons sel forth fhe~ ond on Ibe ~ o~4~ permit to conslr~cL ' LOT .NUJtBER$ ARE REFERENCED TO. $UBDI:VIEION "ROC~.~VE ESTATES' FILED IN THE OFFICE OF THE SUFFOLK COUNTY CLERK AS MAP NO. /0637, · ~._ ~ ' · ~. ~ 'f-. ~: Gq' ~q' ' '~,~ 175.! 7' . \ CERTIFIED TO' ETA TE B~NK OF LONG ISLAND ..~..~_ , W. ,ANTHONYNICOLETTI ~ '~,~ z sURVEY OF PROPERTY A T GREENPORT' TOWN OF SOUTHOLD Me locations dwells a~d cesspools ~ewfl hereon are from field obser'vatlon$ and or from data o~ldlfled from olher~. *SUFFOLK 'COUNTY, N. Y. ' 1000 = 33- 03- 19.17 SCALE: 1' = 30' · SEPT. 9,. 2003 OCT. ~9, 2005 ( cerllflcdlon ) Mqrch §~ 2004 (Cerfificolion~~ . 'PECONIC $~,ll~W/gYO'~e.~ ~ (631) 765 - 50gO FA~C~(~ S5 1797 P. O. 80X 909 1230 TRAVELER ~TREET SOUTHOLD~ N.Y. 1197i