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Home My WebLink About34442-ZFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No: Z-33919 Date: 08/24/09 T~IS u~TIFIES that the building INGROUND SWIMMING POOL Location of Property: 2105 MILL RD (HOUSE NO.) (STREET) County Tax Map No. 473889 Section 100 Block 3 subdivision Filed Map NO. __ Lot No. __ MATTITUCK Lot 13 (HAMLET) conforms substantially to the Application for Building Permit heretofore filed in this office dated FEBRUARY 17, 2009 pursuant to which Building permit No. 34442-Z dated FEBRUARY 19, 2009 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. Ge certificate is issued to MICHAEL & MARIA GAYDOSIK (OWNER) of the aforesaid building. Si/FFOi~COi~Fi~fDEPART~TOF~F~%L~"~APPROV~J~ N/A EL~t-£KICAL CERTIFICATE NO. 10055 03/21/09 pLiERS c~TIFICATION DA'r~ N/A Authorized Signature Rev. 1/81 Form No. 6 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL 765-1802 APPLICATION FOR CERTIFICATE OF OCCUP, AUG 4 200g BLDG. DEPT. TOWN OF SOUTHOLD 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 (8-9 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: t. 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 New Construction: Location of Property: Old or Pre-existing Building: Al,/L (check one) House No. Street Owner or Owners ofProperty: /Tll I'VE- 4- Suffolk County Tax Map No 1000, Section Subdivision PermitNo. 3L~¢d'J ~.~-'~ DateofPermit. Health Dept. Approval: Planning Board Approval: Hamlet Block Filed Map. Applicant: Lot Lot: 15 Underwriters Approval: Request for: Temporary Certificate Fee Submitted: $ Final Certificate: (check2 / Applicant Sig~ure + SUFFOLK BUREAU o~ ELECTRICAL iNSPECTORS, inc. 40 Nottingham Drive, 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.: Raymond Electrical Hatch 21,2009 10055 Certificate No.: Final inspection Date: Building Permit No.: 10055 Harch 21,2009 34442 Suffolk County Tax Map No.: 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: Haria and Hike Gaydosik Site Location: 2105 East Hill Rd., Hattituck, NY 11952 Owner's Address (if different): [] Residential [] Indoor [] Basement [] Service [] Shed [] Commercial [] Outdoor [] First Floor [] Pool ~,Hottub [] New [] Renovation [] Second Floor [] Attic [] Garage [] Addition [] Survey Other: INVENTORY Single Phase Heat Gas Duplex Recpt Ceiling Fixture HID FLxtures Other Equipment: Chlodne Generator 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: Raymond Electrical Inspected By: Gene Surdi S!gnature: ~~ License No.: 5141ME Date Of Certificate: Apr 03,2009 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. 34442 Z Date FEBRUARY 19, 2009 Permission is hereby granted to: MICHAEL & MARIA GAYDOSIK 2105 MILL RD MATTITUCK,NY 11952 for : CONSTRUCTION OF INGROUND SWIMMING POOL IN REQUIRED REAR YARD AS APPLIED FOR. at premises located at County Tax Map No. 473889 Section 100 pursuant to application dated FEBRUARY Building Inspector to expire on AUGUST 2105 MILL RD MATTITUCK Block 0003 Lot No. 013 17, 2009 and approved by the 19, 2010. Fee $ 250.00 Authorized Signature COPY Rev. 5/8/02 TOWN OF SOUTHOLD BUILDING DEPT. 765-1802 INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ]INSULATION [ ] FRAMING / STRAPPING [~ FINAL ~', [ ] FIREPLACE & CHIMNEY [ ] FIRE SAFETY INSPECTION [ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRATION REMARKS:~ DATE ~-/~ '- o ~ TOWN OF SOUTHOLD BUILDING DEPT. 765-1802 INSPECTION [ ]FOUNDATION 1ST [ ]FOUNDATION 2ND [ ]FRAMING / STRAPPING [ ]FIREPLACE & CHIMNEY [ ]FIRE RESISTANT CONSTRUCTION [ ] ROUGH PLBG. [ ] INSULATION ~]~FINAL ] FIRE SAFETY INSPECTION ] FIRE RESISTANT PENETRATION REMARKS: DATE ~7'"~/~ ~a ~ iNSPECTOR~Z~ ~ FOUNDATION OSX) ...................................... FOUNDATION (2ND) '-~ ROUGH FRAMING & PLU~G ~SULATION PER N. Y. STATE ENERGY CODE F~ ~DITION~ CO~ENTS TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, NY 11971 TEL: (631) 765-1802 FAX: (631) 765-9502 www. northfork.net/Southold/ Examined ,20 Approved ,20 Disapproved a/c Expiration 20__ BUILDING PERMIT APPLICATION CHECKLIST Do you have or need the following, before applying? PERMIT NO. Board of Health 4 sets of Building Plans Planning Board approval Survey Check Septic Form N.Y.S.D.E.C. Trustees ~ OF $OUll~B et: Phone: -Iqq - <g lot) Building Inspector APPLICATION FOR BUILDING PERMIT Date INSTRUCTIONS al,71oq,20__ a. This 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 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 fssuance 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, housing code, and regulations, and to admit authorized inspectors on premises and in building for necessary inspections5/,,) / t (Stgnatu/e of apphcant or name, if a corporation) (Mailing address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder Name of owner of premises & (As on the tax roll or latest deed) If applicant is a corporation, signature of duly authorized officer (Name and title of corporate officer) Builders License No. c,~ Iql oq, Iq Plumbers License No. Electricians License No. ~"tq'[ g; Other Trade's License No. Location of land on which proposed,.,wgrk will be done: House Number Street d-; Jru cie Hamlet County Tax Map No. 1000 Section I00 Block : : ~ , Subdivision Filed 'Map No. (Name) Lot i ~ Lot 2. State existing use and occupancy of premises and/~tended use and occupancy of proposed construction: a. Existing use and occupancy ~m6~l~ ,.4~m~lut ('I~td6r)~ b. Intended use and occupancy ~3,J~ 3. Nature of work (check which applicable): New Bxffl~ng_ Repair Removal Demolition Addition Alteration Other Work (Description) 4. Estimated Cost ......... h'-;--, ,-7- ~e'~,- I'" ,' ,',! ,'~ ~! ~ .. ~ "~!..ii (To be pmd on fihng this application) 5. If dwelling, number of dwelling units, i ...... Number of~Welling units on each floor If garage, number of cars 6. If business, commercial or mixed o~cup cal2.qy_a,E~e~cifj/na.t~Illt ext[nt ..... ! ~. t~/~!~: ~ ,:'~ _ ! 7. D~mens~ons ofemst~ng stmct~es, ~t ............. m~ar Height Number of Stories of each type of use. 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 from premises? YES__ NO 14. Names of Owner of premises~l~ql~l 0¢[Lld 0%ig. Address,-~ 105 mill ~ flh4~e~one No. NameofArchitectIm)&Msaoo~.~ Address ~15 l~[;~-g~rvl/~lg(~PhoneNo Address q'31 t2~¢ Z_~ PhoneNo. Name of Contractm: ~OJl~(d 't 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 ) CtI-L/[ ~)0 6~t~C~ being duly sworn, deposes and says that (s)he is the applicant (Name of individual signing contract) above named, (S)He is the ~ 0~&£4'-0 ~ (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. Swom to before/me thj,~ ') /, ' ~ignature of Applicant 5~' " TOWN OF SOUTHOLD PROPERTY RECORD CARD OWNER STREET '~, ] ~)~ VILLAGE DIST. SUB. FORMER dWNER N ~ a~ 14~ ~ E~., ~////~/,//,~ ACR; ~ ~~0~ . S ' W RES. ~ ~ S~S. VL. FARM CO~. CB. MICS. Mkt. Value ~ND IMP. TOTAL / DATE R~RKS /o - ~ ~ ~ ' - NEW NOR~L BELOW ABOVE FARM Acre Velue Per Velue Acre ~/~-L ) )~?~ Tillable F~ONTAGE ON W~TE~ - W~land FRONTAGE ON ROAD Me~dowl~d DEPTH House Plot BULKH~D Total ~ ~ ~ ~ DOCK ' 100.-3-13 3/06 'Bldg. · ~on Oo S. 5 Foundation Ext. Walls Fire Place Both Floors Interior Finish Heat Rooms 1st Floor :reation Room Rooms 2nd Floor ~' ~0 COLOR TRIM Extension _Erosion, Sedimentation and Storm-water Run-off Contro. I Plan ASSESSMENT FORM Yes [% .EXE1YIPTIONS: A. Does this project meet the minimum standards for classification as an Agricultural Project. Note: If you answered Yes to any of the above, a Storm-water, Grading, Drainage & Erosion Control Plan la not required. ACTIONS REQUIRII~G THE SUBMISSION OF k STORM;WATER, GRADING, DRAINAGE & EROSION CONTROL PLAN CERTIFIED BY A DESIGN. PROFESSIONAL IN THE STATE OF NEW YOllK. Item Number: (A Check IV[ark (,/) for each questiou is required for complete application) Will this project retain all Storm-Water Run-off generated on Site? (This will include all run-off created by site clemmg and/or coristruction activities as well as all Site Improvements and the permaneut creation of impervious surfaces.) Will this project require any land filling, grading or excavation whe~ e there is a change to tire natural existing grade involving more than 200 cubic yards of material within any parcel? x~.;es 3. Will this application require land disturbing actix4ties encompassmg an area of five thousand (5,000) square feet of ground si]race el more? 4. Is there a Natural Water course miring through the silo o] is this pI OieCl withm One hundred (100) feet of wetlands or a beach? 5. Will ~ere be site preparation on slopes which exceed fifteen (15) feet of radical dsc to One hundred (100) feet of horizontal distance? 6. Will driveways, par~g areas or other impewious suraces direct Sto]m-Water Run-off into anWor in the direOion of a To~ ~ght-of-Way? 7. Will this application require' the placement of material, removal of vegetation and/or the cons~ction of any item within he Tox~m ~ght-oLWay or toad sbouldei area? (This gem does not include the installation of driveway aprons.) Note: there be site preparation within the oue hundred (100) year floodplaio of any wate~cour'se? If any answer to questions ~)ne through eight is answered with a check mark in the Box, a Storm.water, Grading, Drainage & Erosion Control Plan ia required and must be submiffed for review prior to issuance of any building permit. STATE OF NEW YORK, COUNTY OF SS ....... /~ . sworn, deposes and says thai he/she is Ihe applicanl fm Parodi, ~ame of ind~vidua~ si~ing Decumen0 ~d that He/She is the O~el an~or representative of the Oxm~er or Ox~er's, and is duly aulhoriz~d to pe¢om] or have perforated d~e said wmk and lo and file this application; that all statements contained b~ this application a~e I~e lo the best oebis ~]owledge and belier; nnd thee work sill be performed b] the mam~e[ set [mlh b~ ti~e application filed h,~ewilh t9 0 "W. RoAD MILL Unoulhorlzed allerolion or addition to lhis survey is o vlolollon of seciion 7209 of the New York Slato Education Law. Cop~es of Ihls survey map n¢~ bcar[n~ th: I:nd surveyor's inked SURVEY FOR SUSAN J~NET G~YDOSIK AT MATTITUCK TOWN OF: $OUTHOLD SUFFOLK COUNTY, N.Y. SCALE: 1% 40' AUGUST 14,1968 IVOV, 19, 197~ GUARANTEED TO: / SECURITY TfTLE AND e~ SUSAN JANETGAYDOI · SOUTHOLD SAVlNG~,B~i N.Y.S. LIC. NO. 28725 RIVERHEAD~' N. Y, "IMMEDIATELY" ENCLOSE POOL TO CODE UPON COMPLETION BEFORE "WATER" 2. ROUGH - FRA~ .oo 1-6' 7' 7'-6' 3. ;NSULATiOH ~EQUI~EMENT8 OF THE CODE~ OF HTW YORK STATE. NOT hESFONSqLE FOR DESIGN OR CONS[RUCtiON ERRO~{S. SEE DETAIL 2" to 4" 5A N P BOUFOM FORMED CONCRETE STEPS SECTION A SCALE: 1/8~ ~ 1'-O" 10" TOP OF WALL ~. "'WATER LINE STORM WATER RUNOFF r TO CHAPTER236 NOTES iF THE TOWN CODE. SECTION B FROM SKIMMER FIL PLUMBING SCHEMATIC RODS TYP 20" WHITE RUBBER FULCRUM PAD STN STL TUBE (4' WIDE MIN.) DIVING BOARD DETAIL ROLLED FOAM BETWEEN ~ . ; '~.~/~.~ LINER AND CONCRETE FORM TIES ~ 4 ~ : I~/~..~,'~ 3~0 PSI POURED CONC. ~ : WALL SECTION 1. STRUCTURE IS DESIGNED FOR USE BELOW GRADE AND ONLY IN AREAS WHERE THE GROUND WATER TABLE IS A MINIMUM OF 4'-8" BELOW THE PROPOSED FINISHED GRADE. 2, BACKFILL WITH CLEAN EARTH, FREE OF ROOTS AND DEBRIS. DO NOT ALLOW THE HEIGHT OF BACKFILL TO EXCEED THE HEIGHT OF THE WATER IN THE POOL BY MORE THAN 8", OR THE WATER TO EXCEED BACKFILL BY MORE THAN 8". 3. PLACE CONCRETE ON SANDY TO LOAM SOIL. REMOVE ANY CLAY DEPOSIT AND COMPACT C~.EAN BACKFILL. 4. WALKS TO BE SMOOTH, NON SKID TYPE, SLOPED AWAY FROM POOL 5. WATER DISPOSAL SHALL BE LIMITED TO OWNERS PROPERTY TO SUIT LOCAL REGULATION~ 6. DIVING BOARD AND INSTALLATION TO CONFORM WITH ANSl/NSPI-5 1995 STANDARDs FOR RESIDENTIAL INGROUND SWIMMING POOLS FOR A TYPE II POOL. A) FRAMES ARE MACE OF 1.90" O.D. x .065 WALL. ALL BENDS ARE 6" RADIUS. FRAMES ARE DRILLED 10 ACCOMMODATE 3~8"~ REINF. RODS. REAR STAND HAS 2) 9/16" HOLES DRILLED ON 12' cENTERS FOR D.B. ANCHORING. B) COMPRESSIVE STRENGTH OF CONCRETE SLAB FOR DIVING BOARD TO BE 3.500 pSI OR GREATER. 7. PROPERTy OWNER IS RESPONSIBLE TO INSTALL FENCE AROUND POOL IN ACCORDANCE WITH THE NYS BUILDING CODE, APPENDIX G, SECTION AG105. COPING & PATIO DONE BY OTHERS MIN. DIM. SECTION MIN. DIM. SECTION L, / MIN. DIM. SECTION O_Z ~,,"¢, -> O ~ zF-5~~, ~<~ 4-11-O7