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HomeMy WebLinkAbout33383-ZFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEP~TMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No: Z-34491 Date: 08/03/10 THIS CERTIFIES that the building SWIMMING POOL W/DECK Location of Property: 205 NORTH SEA DR SOUTHOLD (HOUSE NO.) (STREET) (HAMLET) County Tax [qap NO. 473889 Section 54 Block 4 Lot 4 Subdivision Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated SEPTEMBER 12, 2007 pursuant to which Building Permit No. 33383-Z dated SEPTEMBER 12, 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 SWIMMING POOL WITH DECK SURROUND AS APPLIED FOR. The certificate is issued to DONINICK MAVELLIA (OWNER) of the aforesaid building. S~FOLKCO~SFI"fDEPAI~ OF IIF~kLTHAPPRO~rAL N/A ~.~CTRICAL CERTIFICATE NO. 07-7408 09/27/07 i~LU[~IEP~ U~I(TIFICATION DA'r~ N/A ~zed~ 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. 33383 Z Date SEPTEMBER 12, 2007 Permission is hereby granted to: AILEEN PASKOFF 7 PARK AVENUE - APT #15-G NEW YORK,NY 10016 for : CONSTRUCTION OF AN ACCESSORY IN-GROUND POOL & DECK INDEPENDENT OF THE EXISTING DWELLING AS APPLIED.W/FLOOD PERMIT.REPLACES BP # 31067 at premises located at 205 NORTH SEA DR County Ta~ Map No. 473889 Section 054 Block pursuant to application dated SEPTEMBER 12, 2007 SOUTHOLD 0004 Lot No. 004 and approved by the A~h~r i~n a t~ ORIGINAL Rev. 5/8/02 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. 31067 Z Date APRIL 20, 2005 Permission is hereby granted to: AILEEN PASKOFF 7 PARK AVENUE - APT #15-G NEW YORK,NY 10016 for : CONSTRUCTION OF AI~ ACCESSORY INGROUND POOL & DECK INDEPENDENT OF THE EXISTING DWEIJ,ING AS APPLIED FOR WITH FLOOD PERMIT. REPLACES PERMIT #29793Z at premises located at 205 NORTH SEA DR SOUTHOLD County Tax Map No. 473889 Section 054 Block 0004 Lot No. 004 pursuant to application dated OCTOBER 9, 2003 and approved by the Building Inspector to exlDire on OCTOBER 20, 2006. Fee $ 400.00 Auth~ ~ giqDature Rev. 5/8/02 ORIGINAL 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) PERMIT NO. 29793 Z Date OCTOBER 9, 2003 Permission is hereby granted to: AILEEN PASKOFF 7 PARK AVENUE - APT #15-G NEW YORK,NY 10016 for : CONSTRUCTION OF AN ACCESSORY IN-GROUND SWIMMING POOL AND DECK INDEPENDENT OF THE EXISTING DWELLING AS APPLIED FOR WITH FLOOD PERMIT at premises located at 205 NORTH SEA DR County Tax Map No. 473889 Section 054 Block pursuant to application dated SEPTEMBER 19, 2003 Building Inspector to exqDire on APRIL ~2~05,_-- ~.~ Fees 400.00 !~~ ~ ~/~~ ~iz~d Signatur~ SOUTHOLD 0004 Lot No. 004 and approved by the ORIGINAL Rev. 5/8/02 Form Ho. 6 TOWN OF SOUTttOLD BUILDING DEPARTMENT TOWN HALL 765-1802 APPLICATION FOR CERTIFICATE OF OCCUPA APR 3 0 2OO9 rcY E~LDG. DEPT. TOWN OF $OUTHOLO This application must be £flled in by typewriter or ink and submitted to the Building Department with the following: For new building or new use: 1. Final survey of prope~ with accurate location of all buildings, property lines, streets, and unusual natural or topographic fcanues. 2. FinAl Approval from Health Dept. of?ater 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 sYstean cont~in~ less than 2/10 of 1% lead. 5. C~mmer~ia~ bui~d[mg~ industria~ bui~ding~ mu~tip~e resid¢n~es and simi~ar bui~dings and insta~~ati~us~ a certi~cate of Code Compliance fi-oin architect or engineer respousible for the building. 6. Submit Planning Board Approval of completed site plan reqnirements. B. For existing buildings (prior to April 9, 1957) non-conforming uses, or buildings and "pre-existing" land uses: 1. Accurate stU'vey of property showing all property lines, street& building andunusual 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 3. 4. 5. 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 buildiag $25.00, Businesses $50.00. New Construction: Old or Pm-existing Building: nocatio~ of Property: & 0 _~ ~,~C~' ~ '~ ~,xt ~. House No, Street Owner or Owners of Property: ~) ~NAJ'~ ~,t~,~(~ Suffolk County Tax Map No 1000, Section ~.'~ :~ g ~' ~- OS~lock., Subdivision Filed Map. Permit No. ~ Date of Permit. Applicant: Health Dept. Approval: Underwriters Approval: Certificate of Occupancy on Pre-existing Building - $100.00 Copy of Certificate of Occupancy d $.25 Updated Certificate of Occupancy - $50.00 Temporary Certificate of Occupancy - Residential $15.00, Commercial $15.00 Date. ~ (check one) Planning Board Approval: Hamlet Lot Lot: Request for: Temporary Certificate Fee Submitted: $ Final Certificate: (check one) Electrical Inspectors, Inc. 308 East Meadow Avenue East Meadow, NY 11554 Office: (516) 794-0400 (63 I)396-7474 Fax: (516) 794-5854 Website: www.elech5 catinspectors.com Emil: in fo~eleclxicalin spector s .eom Mail To: ADB And Son Elech'ic, Inc. Arthur Babcock 266 Jericho Turpike LL3 Floral Park, NY 11001 Licenseg: 4402E Certificate Number: 07-7408 MunicipaliO~: Southold, Town Of Inspector: 124 Issue Date: 9/27/2007 Property Address: Dominick Mavellia 205 North Sea Drive Southold, NY 11971 ELECTRICAL APPROVAL CERTIFICATE AREAS LISTED BELOW ARE APPROVED BY INSPECTION AND FOUND TO BE IN COMPLIANCE WITH THE NATIONAL ELECTRIC CODE No visual defects were found for the electrical inspection provided. No obvious unsatisfactory conditions were found in the areas herein below only. Residential Inspection Above Ground Pool l- Motor, I- Gas Heater, 1- Time Clock, 2- Pool Lights, 1- 40Amp Sub Panel/8Ckts/5 Used.* This Pool meets Article 680 of the National Electdc Code 1999 Edition. Each year prior to the use of this pool/spa an inspection should be made by a qualified person or company to vedfy for safe use and operations of associated equipment. GFI protection should be tested regularly as directed by the manufacturer, and integrity of all bonded metal parts, Richard M. Bivone President Philip F. Ooehring Chief Electrical Inspector Not valid unless signed by an authorized EH Agent TOWN OF SOUTHOLD BUILDING DEPT. 765-1802 INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ]INSULATION [ ] FRAMING / STRAPPING [/~ FINAL /~ [ ] FIREPLACE & CHIMNEY [ ] FIRE SAFETY INSPECTION [ ] FIRE RESISTANTCONSTRUCTION [ ] FIRE RESISTANYPENETRATION REMARKS:` /~ DATE TOWN OF SOUTHOLD BUILDING DEPT. 765-1802 INSPECTION [ [ [ [ REMARKS: ]FOUNDATION 1ST [ ] ROUGH PLBG. ]FOUNDATION 2ND [ ] INSULATION ]FRAMING/STRAPPING [ ] FINAL ]FIREPLACE & CHIMNEY [ ] FIRE SAFETY INSPECTION DATE INSPECTOR ~2~_~, ~ TOWN OF SOUTHOLD BUILDING DEPT. 765-1802 INSPECTION [ ] FOUNDATION 1ST [ [ ] FOUNDATION 2ND [ [ ] FRAMING / STRAPPING [ ] ROUGH PLBG. ] INSULATION ] FINAL [ ] FIREPLACE & CHIMNEY [ ] FIRE SAFETY INSPECTION REMARKS: ~~_~ _. ~ DATE INSPECTOR 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 I) ~ b'~ 0 ~'~ USE ~O, STI~ET HAMLET ~ OWNER I Ii TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL ' 9 ?~ SOUTHOLD, NY 11971 TEL: (6-31) 765-1802 -' _ .j FAX: (6.31) 765-9502~___~L ...... - ' www. northfork.net/Southold/ PERMIT NO. Examined i~J~ ,20. Approved lo [~1 ,20. Disapproved We Expiration qffl ,20 5' BUILDING PERMIT APPLICATION CHECKLIST Do you have or need the following, before applying? Board of Health 3 sets of Building Plans Planning Board approval Survey Septic Form N.Y.S.D.E.C. Trustees - Builc~ng Inspector APPLICATION FOR BUILDING PERMIT Date ~//0 INSTRUCTIONS ,20a~ a. This application MUST be"completely f'flled in by typewriter or in ink and submitted to the Building Inspoctor with 3 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 pr6mises 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 applicanL 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 propose what so ever until the Building Inspector issues a Certificate of Occupancy. f. Evexy 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 desert%ed. 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. 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. Plumbers License No. Electricians License No. Other Trade's License No. Location of land on which proposed work will be done: House Number Street County Tax Map No. 1000 Section Subdivision (Name) Block ' Filed MaP NO. Hamlet 2. State existing use and occupancy of promises and inten~ted us,e and occupangy of proposed construction: a. Existing usc and occupancy I b. Intended use and occupancy ~/~ ~ 3. Nature of work (check which applicable): New Building Repair Removal Demolition 4. Estimated Cost ~:~'O~ ooa Fee 5. If dwelling, number of dwelling units If garage, number of cars Addition Alteration Other Work eZff-ff-? ~ ff-t. ff. ffe~ (Description) (To be paid on filing this application) Number of dwelling units on each floor 6. If business, commemial or mixed occupancy, specify nature and extent of each type of use. Dimensions of existing stmcture~, if any: Front ~5-Ir Rear 5"-~' Depth .5"7 Height ~.~ff Number of Stories l !/~- ' Dimensions of same structure with alterations or additions: Front 5" Depth 5- 7 Height. ~ Number of Stodes / 8. Dimensions of entire new construction: Front Rear Depth Height Number of Stories 9. Size of lot: Front /OO Rear /o / 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 exeess fill be removed from premises? YES__ 14. Names of Owncrofpremises /%5/ear'S' Name of Architect ,q~,b~r'/'/~r~.e'~ Name of Contractor l)t~rt~n~t, I~l[~t,.~ Address .rtl ~ ff-VL tOtnlagPhone No..S/a Address 005- ~f ,,ew.. Phone No ~'77-- Address ~~.z~_Phone No. g'?tf'- 15 a. Is this property within 100 feet of a tidal wetland or a freshwater wetland? *YES ~ NO * IF YES, SOUTHOLD TOWN TRUSTEES & DE,C,. PERMITS !~Y BE REQUIRED. b. Is this property within 300 feet ora tidal wetland ? * YES v~ 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_~ ~ /90~O~tq,*"! a) being duly sworn, deposes and says (Name of indi~,idual signin~g contract) above named, that (s)he is the applicant (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 applicatioh; 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 fried therewith. Sworn to.before me this / , . II ~y of~~l~_ 200) /t Public N0. 4875122 O~A[IFIED }N SUFFOLK C0UN~ _ ~ COMMISSION ~PIRES NOVEMBER 3, 20~ Signature of Applicant James F. King, President Jill M. Doherty, Vice-President Peggy A. Dickerson Dave Bergen Bob Ghosio, Jr. Town Hall Annex 54375 Main Road P.O. Box 1179 Southold, New York 11971-0959 Telephone (631) 765-1892 Fax (631) 765-6641 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD CERTIFICATE OF COMPLIANCE Date June 19, 2009 · THIS CERTIFIES that the single-family dwellin~, and vool At 205 North Sea Dr... Southold Suffolk County Tax Map 054-4-4 Conforms to the application for a Trustees Permit heretofore filed in this office dated 1 i/27/01 pursuant to which Trustees Wetland & Coastal Erosion Permits //5462 Dated 12/19/01were Issued and conforms to all of the requirements and conditions of the applicable, provisions of law. The project for which this certificate is being issued is for the sinp_le-familv dwellion and vool. The certificate is issued to DQMINICK MAVEI~LIA owner of the aforesaid property. Authorized Signature BLDG. DEPT. TOWN OF SOUi'HOLD Albert J. Krupski, President James King, Vice-President Henry Smith Attic Foster Ken Poliwoda BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD Town Hall 53095 Route 25 P.O. Box 1179 Southold, New York 11971-0959 Telephone (631) 765-1892 Fax (631) 765-1366 COASTAL EROSION MANAGEMENT PERMIT Permit #5462 Date: December 21, 2001 SCTM#54-4-4 Name of Applicant/Agent: Amy Martin/Fairweather-Brown Name of Permittee: Aileen Paskoff Address of Pcrmittce: 21 West Street, NY, NY 10006 Property Located: 205 North Sea Dr., Southold DESCRIPTION OF ACTIVITY: Replace the burned-out structure with a new single-family residence with pool, as depicted on site plan dated December 13, 2001. SPECIAL CONDITIONS: (apply if marked) __ Bluff restoration through a re-vegetation plan is a necessary special condition of this permit. __ A relocation agreement is attached hereto and is a necessary special condition of this permit. A maintenance agreement is attached with application and is a necessary special condition of this permit. Albert J. Krupski, Jr. President, Board of Trustees AJK/lms Board Of $outhold Town Trustees SOUTHOLD, NEW YORK Dec. 2]., zoo]_ PERMIT NO ......... DATE: ....................... AILEEN PASKOFF ISSUED TO ........................................................................................................................... Pursuant to the provisions of C:hapter 6lEi of the Laws of the State of New York, 1893; and Chapter 404 of the Laws of the State of New York 1952: and the Southeld ToWn Ordinance en- titled ."REGULATING AND THE PLACING OF OBSTRUOTIONS IN AND ON TOWN WATERS AND PUBLIO LANDS and the REMOVAL OF SAND, GRAVEL OR OTHER MATERIALS FROM LANDS UNDER TOWN WATERS;~. and in accordance with the Resolution of The B~ard adopted at a meeting held on ..Pe%.-.~.c~ ..... 2001 and in consideration of the sum of $,.....~.~,g:.g~ ..... i~id by Fairweather-Brown for AILEEN PASKOFF · Greenport I,J y. and subject to the Terms end Cond,hons ,sted on the reverse side hereof, of Southold Town Trustees authorizes and permits the followlng: Wetland Permit to replace the bur.ned-out structure with a new single-family residence and pool, as depicted on the site plan dated December 13, 2001. ell' in accordance with the detailed specifications as presented in the orlglnatlng application. IN WITNESS WHEREOF, The said Board of Trustees here- by causes its Corporate S.e. al t.o be aff. lxed, and these p.resents to be subscribed by a'major,ty ot the se,d Board as of th~s dat~. NEW YORK STATE DEPARTMENT OF ENVIRONMENTAL CONSERVATION DEC PERMIT NL~4BER 1-4738-02951/00001 FACILITY/PROGRAM NL~4BER(S) PERMIT Under the Environmental Conservation Law EFFECTIVE DATE January 31, 2002 EXPIRATION DATE(S) January 30, 2007 I TYPE OF PERMIT · New [] Article 15, Title 5: Pro- tection of Waters [] Article 15, Title 15: Water Supply [] Article 15, Title 15: Water Transport [] Article 15, Title 15: Long Island Wells [] Article 15, Title 27: Wild, Scenic and Recreational Rivers [] Modification [] Renewal [] Permit to Construct [] 6NYCRR 608: Water Quality Certification [] Article 17, Titles 7, 8: SPDES [] Article 19: Air Pollution Control [] Article 23, Title 27: Mined Land Reclamation [] Article 24: Freshwater Wetlands · Article 25: Tidal Wetlands [] Permit to Operate [] Article 27, Title 7; 6NYCRR 360: Solid Waste Management [] Article 27, Title 9; 6NYCRR 373: Hazardous Waste Management [] Article 34: Coastal Ero- sion Management [] Article 36: Floodplain Management [] Articles 1, 3, 17, 19, 27, 37; 6NYCRR 380: Radiation Control PERMIT ISSUED TO TELEPHONE AUJMBER Aileen Paskoff (212) 217-2967 ADDRESS OF PERMITTEE 21 West Street, New York NY 10006 CONTACT PERSON FOR PERMITTED WORK Fairweather-Brown Design Associates, P.O.Box 521, Greenport NY 11944 NAME A~D ADDRESS OF PROJECT/FACILITY Paskoff Property, North Sea Drive, Southold NY TELEPHONE NI~BER (631) 477-9752 LOCATION OF PROJECT/FACILITY SCTM #1000-54-4-4 COUNTY I TOWN Suffolk Southold Description of Authorized Activity WATERCOURSE I NYTM COORDINATES Long Island Sound I E:713.8 N:4549.9 Remove the existing single family dwelling and construct a new single family dwelling, swimming pool, deck, wood walk, sanitary system, and pervious driveway extension. Ail work shall be performed in accordance with the plans stamped NYSDEC approved on 1/31/02. By acceptance of this permit, the permittee agrees that the permit is contingent upon strict compliance with the ECL, all applicable regulations, the General Conditions specified (see page 2 a 3) and any Special Conditions included as part of this permit. I Joh~A~Wieland (MRP} ~ / AU~Z~ SIG~TUR~~// DATE Page 1 of 4 January 31, 2002 RES. LAND Fo rm Tilloble. 1 Tillable 2 Tillable 3 Waodland Swampland BruslC'~'t~ House Plot Total s~s.~ da IMP. / Ac re VL. FARM I COM~. TOTAL DATE/ REMARKS I IND.V RECORD CARD DISTRICT SUB. ACREAGE TYPE OF BUILDING CB. I MISC. kC,...,' 10/00 Extension Extension Breezewa Garage , · J Foundation Basement Ext. Walls Fire Place Porch Porch Bath Floors Interior Finish Hec~t Attic Rooms 1st Floor Patio Rooms 2nd Flaar '~Driveway COLOR TRIM P c Bath ~ Dinette M. Bldg. ~ 7' ~ -- ~ULL Extension I . . EXten{i°n Extension ~ ~ ~ g~ ~,0~ ~0~ FirePlace ~0 Heat D.R Patio W°°dst°ve BR. Porch Dormer Fin. B 13 Y~ ~ Rooms 1st Floor ~ tS~ /~ A7o~ Garage Driveway Rooms 2nd Floor O.B. Pool T 0 V, flY CLEI~K OFFICE OF THE TOWN CLERK TOWN OF SOUTHOLD THIS IS TO CERTIFY THAT THE FOLLOWING RESOLUTION WAS ADOPTED BY THE SOUTHOLD TOWN BOARD AT A REGULAR MEETING HELD ON AUGUST 211, 1993: of the Code of the Town of Southold: Application" [FDP(93)], and "Certificate Special Flood Hazard Area [C/C(93)]. RESOLVED that the Town Board of the Town of Southold hereby adopts two (2) new forms to be used under tlite Flood Oamage Prevent regulations "Floodplain Oevelopmen.t Permit of Compliance for Development in BLDG. DEFT.. TOWN OF $O',J~'~OLD__j T. T~rry Fy Southotd Town Cleck August 25, 1993 APPLICATION # TOWN OF SOUTHOLD FLOODPLAIN DEWELOPMENT PERMIT APPLICATION This form is to be filled out in duplicate. SECTIQN I: GENERAL PROVISIONS fAPPLICANrT to mad and sign): 1. No work may start until a permit is issued. 2. Thc permit may be revoked it' any falxe statements are made herein. 3. If revoked, all work must cease until permit ix re-ixsued. 4. Development shall not be used or occupied until a Certilicate of Compliance is i~ued. 5. The permit will exph-e il ~,o work is commenced within Six months of bsuance. 6. Applicant ix hereby informed that other permits may be required to full',ll local, state a~ud federal regulatory 7. Applicant hereby giv~ consent to thc Lo~ Administrator or bix/her rcpr~cntativ~ to make ieasonablc insp~cfion.q required to vcrlf7 compliance. 8. I, THE APPLIC,~qT. CERTIFY THAT ALL STATISMEHTS HEREIN AND [iq ATIACHME~NrI'S TO AND ^CCURATI~. (APPLIC. AN'r's SIGNATURE) C.//'TL.//F/~._ u/r"-ta~ v'- '~--~ SECTIQN 2: PROPOSED DEYCELOPMENT (To be completed by APPLICAN~CI NAME ADDRESS ENGINEER TELEPHONE 9774-7s . {~ROJECT LOCATION: To avoid delay in proce~ing the apptlcatJoa, please provide euough informatioa to e.~ily idcutily the project location. Provide the ~treet addrex~ lot number or legal dexcription (attach) and, outside urban areas, the distance to the uearest intersecting road or wcll-knowu {~,:tm:~crlc A sketch attached to this appEcation showing thc projccl location would be helpkd FOP(s3) APPLICATION PA©E 2 OF a DESCRIPTION OF WORK (Check ~] applicable boxes): A STRUCTURAL DEVELOPMENT A (22'TI VI-F Y O New Structu-r¢ ~d~don [] .~Jtcr~tion [] Relocation IZl Dcm01itlon ' El Replacement ..qTRUCTURE TYPE ESTIMATED COST OF PROJECT ~sidenaal (1-4 Family) 121 Residential (More than 4 Family) [] Nou-rcsidenfal (Floodproofmg? [] Yes) [] Combined Use 0/.esidential & Commercial) El Manufactured (Mobile) Home (In Manu- factured Home Park? [] Ye~) B. OTHER DEVELOPMENT ACTIVITIES: [] F'dl ID Mining El Drilling [] Grading [] Excavation (Except for Structural Development Checked Above) -- - [] Watercourse Altexation (Inducting Dredging and Channel Modifications) ID Drainage lmpcovcment.q (Including Culvert Work) [3 Road, Street or Bridge Construction [] Subd~vixion (New or Expansion) {2] Individual Water or Sawer System ID Other (Please Specify) At'tot completing SECTION 2. APPLICANT should submit form to Local Admix~trator for re¼e~'. ~;ECTION 3: FLOODPLAIN DETERMINATION {'Fo be completed by LOCAL ADMINISTRATOR) The proposed development is located on FTI:LM Panel No. , Dated The Proposed Development: [] Ix NOT located in a Spedal Flood H~,?ard Area (NoLify the applicant that tho application review ix complete and NO FLOODPI..aklN DEVELOPMENT pERld]T IS REQUIIZED). ID Ix located in a Spedal lq. ood Hazard Area. FIRM zone designation ix 100-Yea~ flo<xt elevation at thc site i~: Ft. HGVD (MSL) [] U uavailablc ID Thc proposed development is located in a floodway. FBFM Panel No, Dated {2] Sec Section 4 (o~ additional instructions SIGNED DATE__ APPLICATION PAGE 3 OF 4 SECTION_~: ADDfTIO/qAL INFORJvlATION REQUIRED (To hc co~mpleted by b~kL ADMINISTRATOR} Thc app[ic?mt must submit the documents checked below before thc. applJca0on can bc processed: [] A site pla~ showing thc location of all cx~Lmg struct~cs, water bodies, adiaccm roads, dimensions and proposed development. El Development plans, drawn to scale, and spcdfications, including where applicable: details for anchoring structures, proposed elevation o£ lowest floor (includhag basemen0, types of water resista.nt materials used below the Ftrst floor, details of floodproofmg of uGlities located below thc lust floor and details o( enclosures below thc Fu-st floor. Also, CI Subcfls-Lsion or other dcvclopmcut plans (If thc subdivision or other development exceeds 50 lots or 5 acres, whichever is the lesser, the appEcem must provide L00-year flood clevatiohs if they are not otherwise available). rl Plans showing the extent of watercourse relocation a.nd/?r landform altecation~. El Top of new ifil elevation Ft. NGVD (MSL). 121 FloodprooEmg protection level (non-residential oDly) Ft.' bIGVD (MSL). For floodproofed structures, appEcant m~t attach certification from registered engineer or [] Certification from a registered engineer that the proposed activity in a regulatory floodway will not result in ~ increase in the height of the lO0-year flood. A copy of all data and calculations supporting this Finding must also be submitted. [] Other: ~EqTTIQ~ 5: PERMIT DETERMINATION (To be completed bY LO~CAL ADMIN. b5~TRATO-~ I have determined that the proposed activity:. A. [] Ix B. [] Is not in conformance with provislon~ of Local Law ~ , 19 . The permit is issued subject to the conditions attached to and made part of this permit. SIGNED , DATE fL(_B~X A iS checked, the Local Administrator may Lssue a Development Permit upon payment of designated LfBQX I3 i; checked, thc Local Administrator wall provide a written summary of deficienciC-S. Applicant may revise and resubmil an apptication to Iht Local Administrator or may request a hearing from the Board of Appeals. APPEAL& Appealed to Bo~d of Appeals? [] Ycs [] No Hearing date: Appeals Board Decbioa --- Approved? [] Yes Coaditioas C] No APPLICATION PAGE 4 OF 4 ~ECTION 6: A~.nUILT ELEVATIONS (To be submitted by APPLICANT before Certificate of Compliance is issued) The folJowlng iMormatJoa must be provided for proiect structures. This section must be completed bY a registered professional engineer or a ficeused land surveyor (or attach a cer6fication to this application). Complete I or 2 below. 1. Actual (As-Built) Elevation of the top of ~hc lowest floor, including basement (in Coastal Hieh Hazard ' Areas, bottom of lowest s~uctttral member of thc lowest floor, exdudlng piling and colttmns) i~: v'r. t4Gvt) (MSL). Actual (As-Built) Elevation of floodproo/'mg prote~ion is FT. NOVD (~SL). NOTE: Any work performed prior to submittal of the above baformatioa i~ at thc risk of the Applicant. ~ECTION 7: COMPLIANCE ACTION (To be completed bv LQCAId ADMINISTRATOR) Thc LOCAL ADMINISTRATOR wifl complete thJ~ section as applicable based oa inspection of the project to ensure compliance with the community's local law for flood damage prevention. INSPIECTIONS: DATE BY DEFICIENCIES? 0 YES [] NO DATE BY DEFICIENCFES? C] YES [] NO DATE BY DEFICIENCIES? E] YES [] NO SECTION 8: CERTIFICATE OF COMPLIANCE(To be comoleted by LOCAL ADMINI:!iTRATQR~ Certificate of Compliance issued: DATE: BY: Attachment B SAMPLE CERTIFICATE OF COMPLIANCE for Development in a Special Flood Hazard Area TOWN OF SOUTHOLD CERTIFICATE OF COMPLIANCE FOR DEVELOPMENT IN A SPECLa. L FLOOD I4AZAP. D 3A:CEA (OVVNER MUST RETAIN THIS CERTIFICATE) PI:LEMISES LOCATED AT: PERMIT NO. PERMIT DATE OWNERS NAME AND ADDRESS: CHECK ONE: rn NEW BUILDING [] EXISTING BUILDING [] VACANT LAND THE LOCAL ADMINISTRATOR IS TO COMPLETE A. OR B. BELOW: COMPLIANCE IS HEREBY CERTIFIED WITH THE REQUIREMENTS OF LOCAL LAW # , 19 SIGNED: DATED: COMPLIANCE IS HEREBY CERTIFIED WITH THE REQUIREMENTS LOCAL LAW #__, 19__, AS MODIFIED BY VARIANCE # DATED SIGNED: DATED: OF C/C(sB) Town Hall Annex 54375 Main Road P.O. Box 1179 Southold, New York 11971-0959 Telephone (631) 765-1802 Fax (631) 765-9502 BUILDING DEPARTMENT TOWN OF SOUTHOLD April 30, 2009 Dominick Mavellia 71 N 1st Street Deer Park, NY 11729 RE: 205 North Sea Drive, Southold TO WHOM IT MAY CONCERN: The following items are needed to complete your Certificate of Occupancy: ~ Application for Certificate of Occupancy. (Enclosed) Electrical Underwriters Certificate. '""'J A fee of $25.00 Final Health Department approval. Plumbers solder certificate (all permits involving plumbing after 4/1/84.) "x,..3 ~- 3"'Trustees Certificate of Compliance. Final Planning Board Approval. Final Fire Inspection from Fire Marshal. Final inspection from the Building Department. Final Landmark Preservation approval. Building Permit: 33383-Z deck and swimming pool DOMINICK MAVELLIA 71 NORTH 1 sr STREET DEER PARK, NY 11729 Phone: 516-527-8071 Fax: 631-586-0580 October 12, 2006 Town of Southold Building Department Southold, NY 11971 Re: Building permits # 31067 & 31068 Premises: 205 North Sea Drive, Southold, NY Section 054, Block 0004, Lot 004 Dear Sir/Madam: Regarding the above-referenced matter, I am now requesting a six month extension to allow for the full completion of the work authorized by the town for both permits. I am enclosing copies of the original permits for your convenience. In addition, I would appreciate it if you would change the grantee and the address on the permits to reflect the new ownership of Dominick Mavellia. Please send all tax bills and mailings to my office at 71 N. 1st St., Deer Park, NY 11729 Thank you for your assistance in this matter. If you require any additional information, please do not hesitate to call me. DOMINICK MAVELLIA DM.'jj Enclosures BUILDING PERMIT EXAMINER CHECKLIST APPLICANT: DATE REVIEWED: DATE SUBMITTED: /03 SCTM# DISTRICT: 1,000, SECTION: ~'4- _, BLOCK: . ADDRESS:oq06- t4.~e-m -I~0. CITY: ~o~oc~ , LOT~ 4 SUBDIVISION: ZONING DISTRICT:"~/~ CONFORMING? BUILDING PERMITS OPEN/EXPIRED: PRE CO: Y OR N BPoq~(::~'~-Z/C/OZ-~ ,INFO f~o0~, /BP BP -Z / C/0 Z- , INFO / BP -Z / C/0 Z- 1NFO -Z / C/0 Z- 1NFO SINGLE & SEPARATE CERTIFICATION-REQUIRED NOTES: LOTS 40,000SF -100-24. Lot recognition.(CIkEATED before June 30, 1983), UNDERSIZED LOTS FROM JAN.1997 100-25. Merger.(A nonconforming at any time after 7/1/83 REQ. LOT SIZE: '3~.-O ACT. LOT SIZE: 4ao_~0 REQ. LOT COV.~ACT. LOT C0¥. REQ. FRONT ~> PROP. FRONT~/~./P./EQ SIDE [TDI~--~_~ ACT. SIDE REQ. REAR ~ PROP. REAR J REQ. HEIGHT PRO~.. HEIGHT PROJECT DESCRIPTION: {>ox_! beoJt ~ ~, ,x, ESTIMATED PROJECT COST: ~D-1)~-- WATERFRONT? ~ DESCRIPTION: t__om~ '~%1o~ ~PANEL# -- FLOODZONE~>~ APPROVALS REQUIRED SUFFOLK COUNTY HEALTH D~P~T: YES ~BED #): DTE: / / PERMIT #: TOWN SEPTIC RECEIPT: Y ogN / '~ NEW YORK STATE DEC: ;~,*~_.~0r NO -// DTE: _~_/5/ /~ SOUTHOLD TOWN TRUSTEES: , .~E~ ~r NO '/ DTE: kg, ~91 k~ TOWN ZONING BOARD APPROVAL: '~ or/~ DTE: / / TOWN PLAN. BOARD APPROVsA~.: YES or~ DTE: / / TOWN HISTORICAL PRE (SPLIA). YES o~.~) __ PERMIT #: I-q~-Clk?ft PERMIT #:~o~ PERMIT #: PERMIT #: NEW YORK STATE CODE COMPLIANCE (S.~~ NO FEE STRUCTURE: FOUNDATION: FIRST FLOOR: SECOND FLOOR: OTHER: TOTAL: SF SF SF SF SF 1. ( SF)- ( SF)= SF X $ 2. ( SF)- ( _SF)= SF X $ =$ +$ INIT FEE OTHER TOTAL FEE FEE +$ =$ =$ +$ +$ 3. ( SF)- ( _SF): SF X $__ =$ +$ +$ = $ ,o, FINAL TOTAL: · 'Vj/~r Frost Depth: 36" ./ Termite: M-H Decay: S-M ~gn Te~.' 11 ~ X~hield ~S Flood Hazards: TYPE S: Y/N WALL Y/N GIRDERS: Y/N ROOF RAFTERS: Y/N Y/N YfN SNOW: Y/N SEISMIC: Y/N WIND: Y/N WINDOW AND DOOR SCHEDULE: MISSLE TEST REQUIREMENTS: Y/N EGRESS 5. SCHEDULE: Y~ EGRESS: Y/N (' OF~IRE PRO~-IDN EQUIPMENT: Y/N ENERGY CALCS: Y/N TOTAL COMPLIENCE? Y/N (RETURN TO PAGE ONE) 6314770973 FAIRWEATHER BROWN PAGE 02 PASK, OPP P-,E,..51DENCE POOL ¢ DECK` 5L~T. 2~, 2005 2, THE t"I~IGHT Of' TI'fib 5~CTU~J: A.5 DEP'IN~:D DY Ti-IE I~J'gDIDENTIAL CODE NL%'V YOlk. STATE 15 J ,5, J ,'~L'~'r TO UNDER.51D~ Of' HOI~JZONTAL 5TR. UCTuP. E. TIlE I"LOOP~ AP, gA 15 I 50~, 5.1~. 3. THE ~ (:~ CON.~TRJJCrlON 1.5, T'r~l~ v ~), 4. THE D~IGN ~T~A I~ ~C~ (UN~ ~HE~5~ INOICAT~D), IN ~T~ AN~I / AP ~ PA ~FM-J ~5. 5. F~MING E~MENT~: A. A~ F~MING LUM~ER 5H~L ~E G~DE ~TAM~D D~ FIE- ~KCH ~T~U~L ~E NO,2 ~ O~EE ~U~ T~TED) D~B~ F~ING ~ND A~ OPENING5 ~ ~ N~D ~ D~N~. C, D~D~ UP E~MING UNDE~ A~ F~ AND ~ NOrD D. ALL ~SH W~D CONNE~ ~H~L DE F~NED ~ ~D D~tGN LO~ C~CU~TI~ A~ B~ED ~: O~D LO~: ~LCU~D ~ ~R ~01.3 R~. 5N~ LO~: 45 PSI GROUND 5N~ L~D (~ PER fiG. R301.2(5) RCN~, ~E~MIC D~IGN ~TA~Y B. ~ND UPU~ AND ~U~ ~TA~ ~', ~ J 20 MFH 3 ~E~ND GUST, T. L~ FA~5 ~ I~DI~D BYSE~ SEP 2 g 2003 ,FL I/ MONUMENT ~ITE PLAN 7 8 SCALE?' ) "=20' ~ON,SET NOTE~ Tlfll5 AND 5URY, OUNDING P-,ESIOENCE5 AP~ SUPPLIED BY PUDLIC WATEF~ f5 C.W.A.) NOTE: EXISTING LOT COVEt~AGE 2,~09 DRAIN LOC~N6 C.I, , COVER TO G.4' I/4"/h-T, DP. OP 4"~ CA~T IRON DP. AIN TO 5~PTIC TANK I18'VFT,, DROP 4'!¢ PvC CF'.055 5ECTI. ON OF ?RO?OSED SE?TIC, OCCUPANCY OR USE IS UNLAWFUL WITHOUT CERTIFIOATEi ,OF OCCUPANCY FILL TO COVER SEPTIC OYSTEM / PIN GR.~gE MtN, 7,~ ~t~TING coMELY WiTH A; ~S OF NE-V~Y~RK STATE & '~OWN CODES AS REQUIRED AND CONDITIONS OF N~P~OVED A~ ~OTED DATE: ' ~T[Fy BUILDING DEPA~ AT 7~54802 8AM 4. ~NAL~ ~E COMPLETE FO~ C,O. AL~ ~ONST~UCTIOH SH~ UE~ ~E ~EQUI~EMENTS OF TNE YO~K ~TATE, NOT ~E~PON~IBLE FO~ i'T lB I ~J~WI STEP5 D ETAI L ISSUES / RE~I~ ' :, OOMPLy WITH Cv~APTER"'46,". FLOO[~'OAMAGF IpRIEv EN-FiON, ~OUTHOLD TOWN (;ODE. AU. CONStrUCTION SHALL ~DERWR~ER&CE~FICAW~J REQUIRED "IMMEDIATELY" ENCLOSE pOOL TO CODE , UPQN COMPLETION BEFORE "WATER" ALL ~I~ P-,ESE~VED CLIENT / OWNER' A. PA5 F-,O~.l= R:ESIDI~NCE NORTH SEA DP-.. 50UTHOLD,' N.Y. N~W CONSTP-,UCTtON, DRAWING TITLE PLAN DAI~ SEP - 5, ~083 ISSU~E DRA~ING NO. ' 'oo37 I 2 3 4 5 co '/ 8 cD I0 II IP 13 14 15 ISSUES / RE~SIONS OCT 07,2005 02003 PASKOPF RESIDENCE POOL ,~ DECK PLAN : A J i i, K J H G F E SECTION A TYPICAL EDGE OF DECK '1 SECTION C DETAIL AT EXISTING DECK POOL PILING ¢ BEAM W/DECK SUPPORT SECTION B [ GP. ADE BEAM SCALE 1/2"= I '0" CLIENT / OWNER t, 3 na~:, ~2"o c _e"_ A. PADKOFF RESIDENCE NOF. TH SEA DP-. SOUTHOLD, N.Y. POOL CONSTRUCTION DRAWING TITLE POOL BEAM ?LAN ¢ DETAIL5 ~T DATE SCALE OCT 07,2003 LAW FOR ANY PIERSON, DES~RI.m IH ACCOR~I REF* NO. w,m. ~E ~w. 0 O 3 7 D C 15 A