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Home My WebLink About34643-ZFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No: Z-33983 Date: 09/30/09 THIS c~KTIFIBS that the building SWIMMING POOL Location of Property: 31605 CR 48 PECONIC (HOUSE NO.) (STREET) (HAMLET) Co~ty Tax Map NO. 473889 Section 74 Block 1 Lot 23 Subdivision Filed Map NO. __ Lot NO. __ conforms substantially to the Application for Building Permit heretofore filed in this office dated APRIL 17, 2009 pursuant to which Building Per, nit No. 34643-Z dated APRIL 30, 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. The certificate is issued to ANDREW & VERA ANSELMO (OWNER) of the aforesaid building. SOFi~OI~( C~)I]~Fl-fDEPART~gTOF~ALTHAI~PR0%5%L N/A ELECTRIC3%L CERTIFICA~q~ NO. 129217C 08/21/09 PLBMBE~S c~KTIFICATION DA'r~o N/A ~~/ori~re Rev. 1/81 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 Prcperty with accusate 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 o f electrical iustallation 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 o f 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 - $I00.00 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 Old or Pre-existing Building:_ / Street New Construction: ro tionofProper / F House No. Owner or Owners of Property.y.y.~ (check one) Hamlet Suffolk CountyTax Map No 1000, Section Subdivision Permit N~--...3 y,~ q ~ Health Dept. Approval: Date of Permit. Block I Lot Filed Map. Lot: Applicant: Underwriters Approval: Planning Board Approval: Request for: Temporary Certificate Fee Submitted: $ ~ ~ , (~ C) oo Final Certificate: (check one) Issue Date 812112009 Electrical Inspection Certificate Electrical Inspection Service, Inc. Application Number 375 Dunton Avenue 129217C East Patchogue, NewYork 11772 (631) 286-6642 Issued To: Andrew & Vera Anselmo Street: 31605 Sound Avenue Village: Peconic Zip: Section: . Block: Lot: Contractor: North Eastern Electric (L) 11958 Town: Southold Lic. # 4658-E Was examined and found to be in compliance with the National Electrical Code. ~ Commercial [] NVDefects [] Pool [] lstFIoor [] Indoor [~ Basement ~HotTub [] Residential ~ Det. Garage [~ Attic [] 2nd Floor [] Outdoor [] Addition [] Survey Switches Receptacles Fixtures GFI Heaters A/C Fans 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 2-Pool Lts/1-Raintight Subpanel/1-50 amp Heat Pump Disc./1-20 amp Spec. Outlet/ 1-T me Cock Hugo S. Surdi President Rough Inspector: ; Mahon III 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. 34643 Z Date APRIL 30, 2009 Permission is hereby granted to: ANDREW & VERA ANSELMO 31605 NORTH RD PECONIC,NY 11958 for : INSTALLATION OF IN GROUND SWIMMING POOL WITH FENCE TO CODE IN THE REQUIRED REAR YARD AS APPLIED FOR. at premises located at 31605 CR 48 County Tax Map No. 473889 Section 074 pursuant to application dated APRIL Building Inspector to expire on OCTOBER PECONIC Block 0001 Lot No. 023 17, 2009 and approved by the 30, 2010. Fee $ 250.00 Authorized Signature ORIGINAL Rev. 5/8/02 TOWN OF SOUTHOLD BUILDING DEPT. 765-t802 INSPECTION [ ] FOUNDATION 1ST [ ] ROUG~ PLBG. [ ] FOUNDATION 2ND [ ] INFLATION [ ] FRAMING / STRAPPING [(,/]~FINAL [ ] FIREPLACE & CHIMNEY [ ] FIRE SAFETY INSPECTION [ ] FIRE RESISTANT CONSTRUCTION//[ ] FIRE RESISTANT PENETRATION REMARK~~ DATE INSPECTOR 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 PE#,-iIMTION REMARKS: /~ + ~ ~,~'/~-* DATE '"~----'~'~ '~ ~ ~ INSPECTOR FIELD ]INSpECTIoN REPORT I DATE I COMMENTS FOUNDATION (2~) ROUGH F~G & PL~G STATE E~RGY CODE ~DITION~ COUNTS 4/29/2009 11:29 AM FROM: Lupton and Lute Ins. Lupton _Luce, Ins. TO: +1 (631) 727 8419 PAGE: 002 OF 003 ACORD. CERTIFICATE OF LIABILITY INSURANCE I ~O~CE. (631)'727-4114 ff~: (631)727-7138 ~IS CERTIF~ATE ~ ISSUED AS A MA~ER OF INF~TI~ ~LY AND CONF~ NO R~S UPON THE CE~IF~ATE ~he~ ~ 11901 INSURER~ ~FORDING COVE~ NA~ ~=~ ~ 11901 ~E ~ClES ~ I~U~E USeD BELOW ~VE B~N ISSUED TO THE INSURED ~ED ~E F~ ~E ~LICY PERI~ INDI~mD. ~IT~T~ ~Y REQUIR~E~, ~RM OR C~Dm~ ~ A~ C~CT ~ OTHER ~M~T ~TH RESPECT TO ~ICH ~lS CERTIFI~ ~Y BE tSSUED ~ ~Y ~RTAIN A I ~MS~ ~ ~UR ~539747 S/~/200e 5/~/200~ ~D~/~one~ 5,00~ OFFIC~M~ ~CLU~D~ ~9495619 4/25/2009 4/25Z2010 E L DI~ - ~ E~OYEE :ERI1FiCATE HOLDER CANCELLATION ACORD 25 (2001106) e ACORD CORPORATION 1988 IN8025 (olo~) O~a Page 1 d 2 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOW~ HALL SOUTHOLD, NY 11971 TEL: (631) 765-1802 FAX: (631) 765-9502 www. northfork.net/Southold/ PERM Examined ~,, 20 ~'~ ~t/ Approved -/ t ~/,20~',,/ Disapproved a/c Expiration_ BUILDING PERMIT APPLICATION CHECKLIST Do you have or need the following, before applying? Board of Health 4 sets of Building Plans~ APR l BLDG. DEPT. Phon, TOWN OF $OUTHOLD Building Inspector APPLICATION FOR BUILDING PERMIT // Date//J~ ,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 tnt and of buildings on premises, relationship to adjoining premises or public sheets or areas, and waterways. c. The work covered by this application may not be conma~nced before issuance of Building Permit. d. Upon approval of this application, the Building Inspector will issue a Building P~nnit to the applicant. Such a permit shall be kept on the promises available for inspection throughout the work. e. No building shall I~ 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 pennit 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 proper~ have he~n enacted in the interim, the Building Inspector may authorize, in writing, the extension of the permit for an addition six months. Thereafrer, a new pemfit shall be requfr~d. APPLICATION IS HEREBY MADE to the Building Department for the issuance cfa 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 constmcfion &buildings, additions, or ~teratioas or for removal or d~molition as herein des~tthed. The applicant ag~es to comply with all applicable laws, ordinances, building code, housing code, and re,tala, fians, and to admit authorized inspectors on premises and in building for necessary inspections_ ..... (Mailing address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, elec~ician, plumber or builder Nameofownerofpremises/iW~)t~.LoLJe_ ~.]y~,~/~t /~//V~ c~:~ L.~ got (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. /~ Plumbers License No. Electricians License No. Other Trade's License No. 1. Lanatio~ of laud on which plO~osqd,w, ork will be donc:r~ House Number Street Hamlet County Tax Map No. 1000 Section ~ L~ Block 0 / Subdivision Filed Map'~o. (Name) Lot Lot 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_~ Addition Alteration Repair Removal DemOlition ' ~er Work ~.~ ~. ~ (Description) 4. Estimated Cost 'l/~-Jt. ~ t:9 Fee ' (To be paid on filing this application) 5. 1 f dwelling, number o f dwelling units Number of dwelling units on each floor If garage, numbor of can} ~ : 6. lfbusiness, commercialor ixedoccupancy, specif'yn~.~a~ extanlofeanhtypeofuse. 7. Dimansions of existing structures, if any: Fmnt .... R~ff Depth Height. Number of Stories Dimensions of same structure with alterations or additions: Front Depth Height. Number of Stories Rear 8. Dimensions of entire new construction: Froat Height Number of Stories Rear .Depth 9. Size of lot: Front Rear .Depth 10. Date of Purchase Name of Former Owner 11. Zone or use dis~ct 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/~]lJ ~.~L !~~ Address ~/~rO~) ~_~ ~/~ Phone No. ?/~f ~ ~t~/ /~.~fi7 Name of Architect Address Phone No Name of Contractor ~7~/-~.q/~/,*- j'~/~ Address./6~t~'ts,~'t- /~/J~ Phone No. t~°'~ - ?~L~7-~' ~'J~?--- 15 a. Is this pmperty within 100 feet of a tidal wetland or a freshwater w~tland? *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.X. * IF YES, D.E.C. PERM1TS MAY BE REQUIRED. 16. Provide survey, to scale, with aceura~ foundation plan and distances to property lines. 17. If elevation at any point on properly is at 10 feet or below, must provide topographical data on survey. STATE OF NEW YORK) ~j0t~,q'/ ~ ~S~'C~z/'~'I& b~ingdulyswom, deposcs and says that (s)he is the applicam ~e of in~vidu~ sing con~) ~ove n~ed, (Con,actor, AgenL Co~mte Offi~r, etc.) of said owner or ovmers, and is duly authorized to perform or have performed the said work and to make and file this application; that all statements contained ia this application are tree to file best of his knowledge and belie~, and that the work will be performed in the manner set forth in the application filed therewith. Sworn to before me thitrx D - ~' Notar~ Public CYNTHIA A. GALLO NOTARY PUBLIC, State of New Yo~ No. 01GA6046451 Ouahfied in,Suffolk Count~ ,x Commission Exp'~es Auguat 16t ~ 10 Erosion, Sedimentation and Storm-water Run-off Control Plan ASSESSMENT FORM Yes No EXEMPTIONS: 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 Is not required. ACTIONS REQUIRING THE SUBMISSION OF A STORM:WATER~ GRADING, DRAINAGE & EROSION CONTROL PLAN CERTIFIED BY A DESIGN PROFESSIONAL IN THE STATE OF NEV¢ YORK. Item Number: (A Check Mark (4) for each question is required for complete application) Will this project retain all Storm-Water Run-off generated on Site? (This will include all nm-elf created by site cleating and/or construction activities as well as all Site Improvements and the permanent creation of impervious surfaces.) Will this project require any land filling, grading or excavation where there is a change to the natural existing grade involving more than 200 cubic yards of material within any parcel? Will this application require land disturbing activities encompassing an area of five thousand (5,000) square feet of ground surface or more? Note: Yes No Is there a Natural Water course running through the site or is this project within One hundred (100)feet of wetlands or a beach? Will there be site preparation on slopes which exceed fifteen (15 ) feet of vertical rise to One hundred (100) feet of horizontal distance? Will driveways, parking areas or other impervious surfaces direct Storm-Water Run-off into and/or in the direction of a Town Right-of-Way? Will this application require the placement of material, removal of vegetation and/or the .construction of any item within the Town Right-of-Way or road shoulder area? ('rhis item does not include the installation of driveway aprons.) Will there be site preparation within the one hundred (100) year floodplain of any watercourse? 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 is required and must be submitted for review prior to issuance of any building permit. STATE OF NEW YORK, COUNTY OF...~ ~..~.).g..~.~ ........... SS That I ................. ~'~.Q~...~....~ ..... S..Q.~.~-..~...tTC. ~d~.. being duly sworn, ~ieposes and says that he/she is the applicant for Penn/t, (Name of individual signing Doct/ment) And that He/She is the (~ (Owner, ContTactor, Agent, Corporate Officer, etc.) Owner and/or representative of the Owner or Owner's, 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 belier; and that the work sill be performed in the manner set forth in the application filed herewith. Sworn to before me tiffs; .......... !.~:}....,c~ ......... :.d~ay of...~Ja~.~ [..[ ~, ...... ~ ..... Notary Public:...(~.~{(~'~(~-~.. · .(~. :'.. 6.~-~C) ............... CYNTHIA A. GALLO NOTARY PUBLIC, State of New York No. 01GA6046451 Qu..Ihfied in,Suffolk County Corr,mission Exp"es August 14, 20~ lO lephone (631 ) 765-1802 Fax (631) 765-9502 uo-~ I t-"~o~ ~ ~t~¢ ~4oyizl~C[kL-DINQDEPARTIviENT · 4MEDIATELY" "IMMEDIATELY" ~ ~ TO COr''': ENCLOSE POOL TO CODE W ~LF'" UPON COMPLETION 'E ~. )UGH 3. .4. :[NAL - IRUCTION MUST 70~ C.O. ALL CONSTRUCTION SH REQUIREMENTS OF THE CODES OF NEW YORK STATE. NOT RESPONSIBLE FOR DESIGN 0 TRU ON R RS. UNi~ERWRI~F-RS CERTIFiCA POOL ~ pI~)PERT~ ~ID C~ TO N.Y. STATE RE~IOfR~TLAL ODOE APPEndiX G 2007 EDITION I~DOL ~ ~ TO ANSI/NSPI ~ /x~.~103.1 AnseL¢a 316050.Sound Ave Peconic, NY 11958 RETAIN STORM WATER RUNOFF PURSUANT TO CHAPTER 236 /-~o~..,, OF THE TOWN CODE ' II b i ~z. 1¢~. REVISED 5/06 H. ROY JAFFE, P.E. SURVEY OF PROPERTY SITUATE PECONIC TOWN OF SOUTHOLD SUFFOLK COUNTY, NEW YORK S.C. TAX No. 1000-74-01-23 SCALE 1"=40' APRIL 19, 2006 ADDED PROPOSED SANITARY SYSTEM APRIL 17, 2008 RELOCATED BUILDING MAY 16, 2008 FOUNDATION LOCATION AREA = 48,183 sq. ff. 1.106 ac. TEST SOLE DATA (TEST HOLE OUG BY M~OONALD GEOSCIENCF ON JANUARY 19 2006) ~a orwin m .. ~,..,.~ ~o.~.. ~,w Land Surveyor ./ SURVEY OF PROPERTY SITUATE PECONIC TOWN OF SOUTHOLD SUFFOLK COUNTY, NEW YORK S.C. TAX No. 1000-74-01-25 SCALE 1 "=40' FEBRUARY 8,, 2006 APRIL 19, 2006 ADDED PROPOSED SANITARY SYSTEM APRIL 17, 2008 RELOCATED BUILDING MAY 16, 2008 FOUNDATION LOCATION NOVEM6ER 17, 2OOF~ FINAL SURVEY APRIL 14 2009 ADDED PROPOSED POOL MAY 21, 2009 LOCATE POOL UNDER CONSTRUCTION AREA = 48,185 sq. ff. 1.106 ac. MAY 91 2OO9 BLDG DEPT. (TEST HOLE DUO BY McDONALD GEOSCIFNCE ON JANUARY 19, 2006) ' Nathan Taft Corwm Ill " ...,,,o~..[... Land Surveyor,