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HomeMy WebLinkAbout33488-ZFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No: Z-34035 Rte: 10/27/09 T~IS ~RTIFIES that the building SWIMMING POOL Location of Property: 650 THREE WATERS LA (HOUSE NO.) County Tax Map No. 473889 Section 15 Subdivision ORIENT (STREET) (HAMLET) Block 6 Lot 24 Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office ~ted OCTOBER 16, 2007 purs~u~t to which Building Pe~it No. 33488-Z dated OCTOBER 23, 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 GARY & JOANNA CAMPO (OWNER) of the aforesaid building. SI/FFOLK CO~DEPART?~E~¥~ OF H~kLR"~API~ROIL~L N/A ELEC~RICAL ~KTIFIC3%TE NO. 130828C 10/23/08 PLI~B~ c~TIFIC~%TION ~r~v N/A /yho~ ed Signature Rev. 1/81 Form No. 6 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL 765-1802 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 susvey of property with accurate location of all buildings, property lines, sweets, and unusual uatural 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, sweets, 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 app C. Fees 1. Certificate of Occupancy - New dwelling $25.00, Additions to dwelling $25.00, A Swimming pool $25.00, Accessory building $25.00, Additions to accessory buildi~ 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. Tcmporary Ccrtificate of Occupancy- Rcsidential $15.00, Commercial $15.00 00,~Busines~es' BLDG, DEPT. TO)NN OF SOUTHOLD New Construction: Location of Property: House No Owner or Owners of Property: Suffolk County Tax Map No 1000, Section Subdivision Permit No. ~ ~//5~ - 7_~ Date of Permit. · Health Dept. Approval: Planning Board Approval: · Request for: Temporary Certificate Old or Pre-existing Building: Date. Street Block Filed Map. Applicant: Underwriters Approval: Final Certificate: (check one) Hamlet Lot Lot: (check one) Fee Submitted: $ - ~licant-Sig~ure Electrical Inspection Certificate El~ct~c~l I~mpeef~on Sm. vi~e, In~ Applk~tlon Number 375 ll~ Avemm t30828C Em~tP~ch~gue, ~yorK 11772 Is~tled To; Joana & Gray Campo SUeet: 650 T~e W~em Ed~ ~e: O~nt Zip: 11~7 ~ ~1 ~ ~ ~ ,~1 ~nl I. J tM ~ [~ ~or I..I ~ I i H~ Tub I_! o~.Gor*a~ :.l Att~ rl zn~to~r U ou~eor - ' ~uon LI ~r~e~ 1 w~t~Amps aq~An~ Own ~ ttemwawes Meter Amps pllm UG/OH J~clraz~ relevlafOn CO Detegler / Other Equipment. . I-3o amp RainUght Gbb~psn~;I/1-~me Ck~kJ I-:20 amp Gpec_ OuUeU 1-Pool U Hugo & Surdi P~sident 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) PE~d~IT NO. 33488 Z Date OCTOBER 23, 2007 Permission is hereby granted to: GARY & JOANNA CAMPO 650 THREE WATERS LANE ORIENT,NY 11957 for : CONSTRUCTION OF AN IN-GROUND SWIMMING POOL IN THE REQUIRED REAR YARD AS APPLIED FOR at premises located at County Tax Map No. 473889 Section 015 pursuant to application dated OCTOBER Building Inspector to expire on APRIL Fee $ 250.00 650 THREE WATERS LA ORIENT Block 0006 Lot No. 024 16, 2007 and approved by the 23, 2009. ORIGINAL Rev. 5/8/02 TOWN OF SOUTHOLD BUILDING DEPT. 765-1802 INSPECTION [ ] FOUNDATION t ST [ ] FOUNDATION 2ND [ ] FRAMING / STRAPPING [ I FIREPLACE & CHIMNEY [ ] RRE RESISTANT CONSTRUCTION REMARKS: [ ] ROUGH PLBG. [ ] INSU.~U~-ATION [,'"~NAL [ ] FIRE SAFETY INSPECTION [ ] FIRE RESISTANT PEk,- ~ ~,ATION INSPECTOR~ DATE TOWN OF SOUTHOLD BUILDING DEPT. 765-1802 INSPECTION [ ]FOUNDATION 1ST [ ] ROUG~ [ ]FOUNDATION2ND [ ] [ ]FRAMING/STRAPPING [~]"FINAI~,, [ ]FIREPLACE & CHIMNEY [ ] FIRE S~CTION [ ]RRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRATION DATE INSPECTOR FIELD INSPECTION REPORT I DATE [ COMMENTS FOUNDATION (1ST) FOUNDATION (2ND) ROUGH F~G & PL~G .... ~S~ATION PER N. Y. STATE ENERGY CODE ~DITION~ COUNTS LOT AREA 12 500 SQ F T LOT NUMBER 12 · Irome driveway shed 3,3' N, S.8~5oB7' 40"E . 'EST HOLE 7-6~01 by McDONALD GEOSCIENCE O~ 6" :dark brown loam O.L brown loomy slit ML 3 brown silty sand with h¢o,uy 7 grove ~ S M pole brown tine to coarse sand SW 17 J Ld ° ~Y o :: Z asphalt driveway 35.5' 2.0' gor. 27.1: ' 2 STY. FR. DWELL 0 z <~ J 0 ~. BB~ 57'40"W. LOT NUMBER 10 PARK Vll:W ) R:110.00' '--'' / L: 172,79' LANE / ~ . ~,~oT¢ - ' · ' ~ aT YWayS ~?' ~ ""' '~' '"~"'"'*' of record, if any, not show,~ u~,~ ,, -~ ~, 2-,-2002 shew proposed porch I-9-~002 FOUNDATION LOCATION I2-3-200~ REVISED 7-10-2001 ADDED TEST ~OLE 125,00' metaIj shed: NOTE: CESSPOOL. SEPTIC TANK AND WELL LOCATION BY OTHERS. $-14-2003 LOCATE'D DRIVEWAY ond FINAL SURVEY ON GARAGE 2-5~003 GAR. FOUNDATION LOCATION 7-9-2002 PROPOSED GARAGE FINAL SURVEY 6-14-~'002 SHOW PROP. WD. DECK 8, PROP. BALCONY 03-62 03 -21 GUARANTEED ONLY TO ULSTER SAV~GS BANK / GARY ~ JOANNA CAMPO FIRST AMERICAN TITLEINSURANCE COMPANY OF NEW YORK JOBNO. 0"-14~, FILENO.O~IENT BY THE SURVEYED FOR GARY 8, JOANNA CAMPO LOT NUMBER ' 1 tvlAP OF ORIENT BY THE SEA SITUATEDAT ORIENT POINT TOWN OF SOUTH OLD SUFFOLK SCALE 1' 3 O' DATE FILED MAP NO. 27 77 DATE TAX MAP NO.1000 -1 .~- 6- 2 4 SEA COUNTY NY 6 - B - 2001 11-21-1957 (ELF. ONLY) DISK HAROLD F. TRANCHON JR.P.C. LAND SURVEYOR 1866 WADING RIVER-MANOR RD. WADING RIVER,' NEW YORK, 11792 TOWN OF SOUTHOLD BUILDIN .G DEPARTMENT TOWN HALL SOUTHOLD, NY 11971 TEL: (631) 765-1802 FAX: (631) 765-9502 www. northfork.net/Southold/ PERMIT NO;~ ?~' ~'~ Examined Approved ,20 Disapproved a/c Expiration ,20__ 7 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. ~ .~ Tmstees Contact: ~ctor ~ APPLICATION FOR BUILDING PERMIT Date INSTRUCTIONS ,20~?' a. This.appl-idation 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 pa~ 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. 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 inspections. (Signature of applicant or name, ifa corporation) (Mailing address of applicant) / 1~ 0 State whethe~ applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder Nameofownerofpremises ~/~C( d-'-'~t~r~,fif ~' /k/~q{)O (As on the tax roll o} 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. Location of land on which proposed work will be done: House Number Street County Tax Map No. 1000 Section Subdivision (Name) Hamlet Block (~ Filed Map No. 2. State existing use and occupancy of premises and intended use and occupancy of proposed constractior~; 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 Fee Addition Other Work Alteration ud~--/,,~t r~.~F'_ ~- (Descr(ption) (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 Rear 8. Dimensions of entire new construction: Front 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 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 t. Yk NO__ 14. Names of Owner of premises Name of Architect Name of Contractor,~J'~/~q 15 a. Is this property within 100 feet of a tidal wetland or a freshwater wetland? *YES__ * 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. Will excess fill be removed from premises? YES )~ NO__ Address ~'0 7-,oz~t"~Tx2~,/-e',eZl~rone No. ~2-3 Address Phone No Address/,A~PT, ~/,4~/~ ~ S Phone No. NO 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 ) '~O/4g~) ~'~ ~ ~(.:C 7_~/+ ~ C~ ' being duly sworn, deposes and says that (s)he is the applicant (Name of indivi&{al signing contract) above named, (S)He is the C~/L~J[~lfi e %~t (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 tru6 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 I ~-~b,. day of Not'~firy Pubic VALERIE UNDQUIST Nola~y Public State Of New Yod{ No. 01LI6051821 Qualified In 8uffolk County tn Commlssiofl Expires Deo 4, ~ 200---I ignatu Erosion, Sedimentation and Storm-water Run-off Control Plan ASSESSMENT FORM .EXEMPTIONS: A. Does this project meet tho 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 NEW YORK. Item Number: (A Check Mark (,/) for each question 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 clearing 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? Is there a Natural Water course running through the site or is this project within One hundred (100) feet of wetlands or a beach? Note: Yes No Will there be site preparation on slopes which exceed fifteen (15) feet of verticai rise to One hundr¢d (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 .constraction of any item within the Town Right-of-Way or road shoulder area? (This 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 Sox, 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 ss That I, ..._......_.....: [O~.~.Cff~.- ......................... being duly sworn, deposes and says that he/she is the applicant for perrmt, (Name of individual signing Document) And that He/She is the .... (~ Q ~"d~.~7~! ~ (Owner, (ontractor, Agent, Coq)o:ate Officer, elc) 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 maturer set forth in the application filed herewith. Sworn to before me this; ................ L.~~'~ dayof q~'"7~~'~ 200~'~ Notary Public: ~ ~~ .................... YAI,,ERIE tlNl~i~' '['~ ................. ~luallfled in Suffolk Oounty iQ TYPICAL POOL PLAN TYPICAt CROSS SECTION ISLANDIA POOLS 108 FISHEL AVENUE, RI¥£RNEAD, NEW YORK 11901 (516)727-6312 OWNER: ApPR, OVED AS NOTED' DATE:~B-P.#~ NOTIF-ff BUILDING O??¢~f"4ENT AT 765-1802 8 AM TO 4 ?i./,, FOFI THE FOLLOWING iNSPECTIONS: 1. FOUNDATION - i'"',O REQUIRED FOR POURED 2. ROUGH - FRNJ,,;: & ?LgMSING 4. FINAL - C ,, MUST BE COMPLE-i: j: ; ,,_3. ALL CONSTRL;' ;'~ON St,,< - ,,~ET THE REGLI!RE;'aEi~TS oFTHE C©DESOFNEW YORK Si'ATE. NOT RESF©NSIBLE FOR DESIGN OR COfqSTRUCTiON ERRORS. OCCUPANCY ,-,, USE iS UNLF'/'/:,:'-.~, WITHOUT ~ ""' ' OF OCCUr/~N~ ¢ OPTIONAL STEP "IMMEDiA TEL y,, ENcLosE P©CL T U~PONc ,.~ Oco ,~ t~EFoR~,,~LETioN D_ WATER. HOTES: