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33473-Z
Town of Southold Annex 54375 Main Road Southold, New York 11971 6/6/2011 CERTIFICATE OF OCCUPANCY No: 34981 THIS CERTIFIES that the building Location of Property: Date: IN GROUND POOL 6/6/2011 500 FOX HOLLOW RD MATTITUCK, SCTM #: 473889 Sec/Block/Lot: 113.-6-19 Subdivision: Filed Map No. conforms substantially to the Application for Building Permit heretofore 9/28/2007 pursuant to which Building Permit No. 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. Lot No. filed in this ofliced dated 33473 dated 10/12/2007 The certificate is issued to Priolo, Frank (OWNER) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL ELECTRICAL CERTIFICATE NO. PLUMBERS CERTIFICATION DATED 8086 1/12/08 Signature FORM NO. 3 TOWN OF SOUTHOLD BUILDING DEP~RTMENT Town Hall Southold, N.Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) PERMIT NO. 33473 Z Date OCTOBER 12, 2007 Permission is hereby granted to: FRANK PRIOLO PO BOX 473 MATTITUCK,NY 11952 for : CONSTRUCTION OF AN INGROUND SWIMMING POOL AS APPLIED FOR, FENCED TO CODE at pr-m{ses located at 500 FOX HOLLOW RD MATTITUCK County Tax Map No. 473889 Section 113 Block 0006 Lot No. 019 pursuant to application dated SEPTEMBER 28, 2007 and approved by the Building Inspector to expire on APRIL 12, 2009. Fee $ 250.00 //~~u't hori~ g~at ur e ORIGINAL Rev. 5/8/02 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 t A. For new building or new use: 1. Final survey of property with accurate location of all buildings, property lines, streets, and 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. un B. For existing buildings (prior to April 9, 1957) non-conforming uses, or buildings and "pre-existing" land uses: 1. Accurate surveyor 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 $50.00, Additions to dwelling $50.00, Alterations to dwelling $50.00, Swimming pool $50.00, Accessory building $50.00, Additions to accessory building $50.00, 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: Old or Pre-existing Building: (check one) L°cati°n°fPr°pertyx'9' ~_(~'~ ~'_Cgt, h01~{~bt~ ~tr~d ~{'1'~ Jrllf_~_ ~!_~]. []q~o~ House No. ' ~treet ......... Hamlet Owner or Owners of Property'.' V~(~.C~.k ~i-l'O~l l'~ Suffolk County Tax Map No 1000, Section I[~b~l C~ Block Subdivision ~ [ I Filed Map. Permit'~ '2/~'O~ '~)~ Date of Permit. Applicant: Health Dept. Approval: Underwriters Approval: Planning Board Approval: Lot Lot: Request for: Temporary Certificate Fee Submitted: $ ~ , ~) ~'~ Final Certificate: (check one) Applicant Signature SUFFOLK BUREAUo( ~. Applicant: Rough ~n Inspection Date: Application Ne,: Su~lk County Tax Map No.: 40 Nottingham Drive, Mlcidle Island, Ny 11953 Telephone:6314958136 · Fax:6319806455 · E-Mail:$BEIG${~0rnatl.oorn CERTIFICATE OF ELECTRICAL COMPLIANCE Raymond El~;cal January 12,2008 8086 Certificate No.: Final Inspection Date: Building Permit No.: 8086 January22,2008 33473Z 1000 113 5 lg This Certificate of Electrical Compliance is limited to the inspection and compliance Of electrlca[ 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: Frankie and Michelle priolo Site location: SO0 Fox Hollow rd; Mattituck, NY 11952 · Owner's Address (if different): [] Residential ~ Indoor ~ Basement : [] Commercial [] Outdoor [] First Floor ~_~ New [] Renovation [] Second Floor i ~ Addition []Survey Other; , INVENTORY .. Single P~ase Heat 1-gas Duplex Re~t ~_~$e~ice []Shed r~Pool ~jHoflub I--)A~ic []Garage Calling F{x~ure HID Fixtures Wall Fixture ~moke Floumscem Purn~ 1 The electrical work and/or equipment described above were inspected and appear to be in compliance with local, state and nationa~ electrical code requirements and this office, Applicant: Raymond Electrical / License No.: 5141hie Signature; _~-~ ~ '~ ~.~"' TOWN OF SOUTHOLD BUILDING DEPT. 765-1802 INSPECTION FOUNDATION 1ST [ ] ROUGH PLBG. FOUNDATION 2ND [ ] INSULATION FRAMING / STRAPPING ~r/FINAL [ ] FIREPLACE & CHIMNEY [ ] FIRE SAFETY INSPECTION ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRATION REMARKS: ~ ~f~'~ ~ ~-~ TOWN OF SOUTHOLD BUILDING DEPT. 765-1802 INSPECTION [ ] FOUNDATION ¶ST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] INSULATION [ ] FRAMING / STRAPPING [~/FINAL [ ] FIREPLACE & CHIMNEY [ ] FIRE SAFETY INSPECTION [ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRATION REMARKS: DATE TOWN OF SOUTHOLD BUILDING DEPT. 765-1802 INSPECTION [ ]FOUNDATION 1ST [ ]FOUNDATION 2ND [ ]FRAMING / STRAPPING [ ]FIREPLACE & CHIMNEY [ ]RRE RESISTANT CONSTRUCTION REMARKS: [ ] ROUGH PLBG. [ ] INSULATION [~FINAL ,~ ,* ] FIRE SAFETY INSPECTION ] FIRE RESISTANT PENETRATION DATE FW.I,D INSPECTION REPORT I DATE ] COM~-~TS ~ ~ FO~ATION (1ST) ~ ~ FO~ATION (2ND) ~ ROUGH ~G & PL~G ~ ~S~ATION PER N.Y. ~ STA~ E~RGY CODE ~D~ION~ CO~TS ~ TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL ° SOUTHOLD, NY 11971 TEL: (631) 765-1802 FAX: (631) 765-9502 www. nor thfork.net/Southold/ PERMIT NO. ~-~ Examined Approved ! ~! \ ,);'20 (~ Mail to: Disapproved a/c Phone: 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: Expiration /~ Building Inspector ~) ;- ' : il APPLICATION FOR BUILDING PERMIT Date q'2q'0~ ,20 i [ , ~ L~P,': _ INSTRUCTIONS a~ ~'~atToff~~mpletely filled in by t~ewnter or in ~ and submitted to the Building ~spector with 4 sets of plus, accurate plot plan to scale. Fee according to schedule. b. Plot plan showing location of lot and of buildings on promises, relationshp to adjoining premises or public streets or areas, and wate~ays. c. ~e work covered by this application may not be commenced before issuance of Building Pemit. d. Upon approval of~is application, the Building kspector will issue a Building Pe~it to the applic~t. Such a pe~it shall be kept on the premises available for inspection ~oughout the work. e. No building shall be occupied or used in whole or in pa~ for any pu¢ose what so ever until the Building Inspector issues a Ce~ificate of Occupancy. 5 Eve~ building pe~it shall expire if the work authorized has not co~enced within 12 months a~er the date of issuance or has not been completed within 18 months from such date. If no zoning amendments or other re~lations affecting the prope~y have been enacted in ~e interim, the Building ~spector may authorize, in whting, the extension of the pe~it for an addition six months. Therea~er, a new pemit shall be required. ~PLICATION IS HE,BY M~E to the Building Department for the issuance of a Building Pemit pursuant to the Building Zone Ordinance of the Town of Sou~old, Suffolk County, New York, and other applicable Laws, Ordin~ces or Regulations, for the cons~ction 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, ~d regulations, and to admit authorized inspectors on premises ~d in building for necessa~ inspections. ~ ~~CY OR (Signature of applicant or name, ifa corporation) ~ ~TION CERTIFICATE (Mailing address o~applicant) State whether applicant is own~[~~t, engineer, general contr~~~e, or builder 0¢0~ DATE: N~e of owner of premises ~ ~'oJ0 HOT!FY g'% : ~:~,'A,qT;,:~rqT AT (As on the tax roll or l[~e~Ar ., ~.':.A FOR THE If applicant is a corporation, signature/Jkt-c~lP~TlJtIUfitttilN)~aL '~EE~r TIlE REQUIREMENTS OF THE (Name and title of corporate ~OF NEW YORK STATE. Builders License No. ~,~l~l Plumbers License No. Electricians License No. Other Trade's License No. IIN?_RWRITERS CERTIFICATe. 1. Location of. land on whicll, pro. posed work will ~,e,done: House Number Street FOLLOWING IW, ;;CTiOi'JS: 1. FOUNDATION - T~ 0 RECUTRED FOR POURE3 ('.,-';CRETE 2. ROUGH - F ,A!..~,G & PLUMBING 3. INSULATIC:q 4. FINAL - CO:;Y~;%r3TION MUST BE COMPLET£ F?2 C.O. ALL CONSTRd'~.ON SHALL MEET THE REQUIR_:MEr,:i'S OF THE CODES OF NEW YORK STATE. NOT RESPONSIBLE FOR DESIGN OR CONSTRUCTION ERRORS. Hamlet County Tax Map_No. 1000 Section Subdivision lct~Gh~ltt~Ot2~ (Name) Block Filed Map No. Lot Lot 2. State existing use and occupancy of premises andti~tended use and occupancy of proposed construction: a. Existinguseandoccupancy ~:a rc,_--b e ,Jj~m; lu, (~_sa t~ r~co , b. Intended use and occupancy I rl6,)c~l ~¢t ~(* a.~dL "p O0 I I~ '¢ ~q5 3. Nature of work (check which applicable): New Building Repair Removal Demolition 4. Estimated Cost <~\6~{)0b~ Fee 5. If dwelling, number of dwelling units If garage, number of cars Addition Alteration Other Work (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 Rear Dimensions of entire new construction: Front Height Number of Stories Rear .Deptk. 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__ 14. Names of Owner ofpremise~ Name of Architect Name of Contractor Address Address Address Phone No.~-~t~' -'15/o 0 Phone No B~-.P40 ~5 Phone No. '"~-~'~O ¢ 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 di~tances.t~ ~ml~e-rty lines. ' "' ilTAIO MMI" I ?. ~f elevation at any point on property is at 10 feet or be/ow must prq¥.id~.topoj~raphicaI STATE OF NEW YORK) ~ :~ ' ,, SS: COUNTY OF (Name of individual signing contract) above named, (Sine the Ccm a · :' ..... Agent, Co~,porate,Officer, o~.~,. .... ]N ~ : (Contractor, ' .... '" :* c, . ~ ~"* :j: :~.'!: .,-, '/v:~ 4.0 of s~id owner or owners, and is duly authorized to perform or have perfo ea the said work and to rake and file this application; that all statements contained in t~s application are Line to the best ofbJs knowledge and belief; and that the work will be performed in the manner set forth in the application filed therewith. Sworn to before me thi~ -- ¢t/Q"~ day of~ Notary Public 09-~7-~007 09:06 SOUTHOLD BUILDINg DEPT 16317G5950~ Eastern Permits DEPARTMENT OF THE ARMY NEw YORK DISTRICT~ CORPS OF ENGINEERS; JACOe K~ JAVIT$ FEDERAL BUILDING NEW YORK, N,Y. 10278-0090 Section J~ne 13, 2001 SUBJECT: Joint Application .with New York State Department Environmental Conservation 'Frank Priolo . , P.O. Box 194 Souund Beach, NY 11789 Dear Mr. Priolo: PRGE1 of We have recently received a copy of bhe Joint Application for permit you filed with the New York State Department of ~nvironmentat Conservation (NYSDEC). Please be advised we have reviewed the copy of the Joint Application sent to this office 'by NYSDEC. Based solely upon the information provided, it appears £hat a Department of the Army permit is not required for your proposal. The Department of the Army regulates constructi6~ activities in navigable waterways and discharges of dredged or fill material into waters of the United States, including inland and coastal wetlands. If your proposal would involve such work, and has not been portrayed as such in your Joint Application, you should contact this office immediately so that a project-specific determination can be made as to whether a Department of the Army permit will be required.. Any inquiries can be directed to this office at (212) 264-' 6731. ~iRcerely, ',~ ief, Eastern Permits Section 09-27-2007 09:06 SOUTHOLD BUILDING DEPT 16317659502 PRGE2 New York State Department of Environmental Conservation Division of Environmental Permits, Region One Building 40 - SUNY, Stony Brook, New York 11790-2356 Phone: (631) 444-0365 · FAX: (631) 444-0360 Webslte: www.dec.state,ny.us LETTER OF NON JURISDICTION-TIDAL WETLANDS Erin M. Crotty Commissioner July 11, 2001 Mr. Frank Priolo P. O, Box 194 Sound Beach, New York 11789 Re: Application #1-4738-02882/00001 Property, 500 Fox Hollow Road (SCTM# 1000-113-6-19) Mattituck, New Yo~'k 11952 Dear Mr Priolo.: Based on the information you have submitted, this Department has determined that: The portion of property located landward of the 20' contour on a gradual natural slope is beyond the jurisdiction of Article 25 (Tidal Wetlands) as shown on the survey by John McWilliams dated April 14, 2001. Therefore, in.accordance with the current Tidal Wetlands Regulations (6NYCRR Part 661) no permit is required. Please be advised, however, that no construction, sedimentation, or disturbance of any kind may take place seaward of the tidal Wetlands jurisdictional boundary, as indicated above, without a permit. It is your responsibility to ensure that all precautions are taken to prevent any sedimentation or other alteration or disturbance to the ground surface or vegetation within Tidal Wetlands jurisdiction which may result from your project. Such precautions may include maintaining adequate work area between the tidal wetland jurisdictional boundary and your project (i.e. a 15'to 20' wide construction area) or erecting a temporary fence, barrier, or hale bay berm. Please be further advised that this letter does not relieve you of the responsibility of obtaining any necessary permits or approvals from other agencies, cc: .:. BMHP ' · file Very truly yours, : ~ator Erosion, Sedimentation and Storm-water Run-off Control Plan ASSESSMENT FORM Yes l~o 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 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 mn-off 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? Is there a Natural Water course mrming through the site or is this project within One hundred (100) feet of wetlands or a beach? Yes Will there be site preparation on slopes which exceed fifteen (15) feet of vertical 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? 7. 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? ~'~ orris item does not include the installation of driveway aprons.) 8. . Will there be site preparation within the one hundred (100) year floodplain of any watercourse? r~ Note: 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, "~ /-/~ ~-~ ss COUNTY OF...~[ .............. That I, ... ~~ ......................... being duly sworn, ~eposes and says that he/she is the applicant for Permit, (Name of individual signing Document) And that He/She is the (Owner, Contractor, 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 tree to the best of his knowledge and belier; and that the work sill be performed in the manner set foah in the application filed herewith. Sworn to before me this; .................... ..... i ..... NOTARY !~lle~ ~ Yolk .......... ) ~) 0 Q~~~.. (Signature of Applicant) ~ Corn mission I[,~lreo ~k~l,l128~' ~0__ TOWN OF SOUTHOLD PROPERTY' RECORD CARD OWNER STREET ~'0~'~ VILLAGE DIST. ~ O,g~ ~'*~1 ~Pl~o +~ 's w WPE OF BUILDING ~ES. ~O s~s' ' VL -- r FA~ COM~. CB. MISC. Mkt. Value ./ AGE BUILDING CONDITION N~ NOeL BELOW ABOVE FA~ Acre Volue Per Value I I Acre 'illoble 1 'illeble 2 illoble 3 /°~l°nd ~omplond FRONTAGE ON WATER r~hlond ! FRONTAGE ON ROAD ouse Plot DEPTH BULKH~D )~1 ~ ~ D~K COLOR ~. BI Exten= Ex'ten Exter Porct Pard Bre Pot O, To~ Foundation ~ement h Walls 'e Place pe Roof Jcreation Room ~rmer Jriveway j~u L£ Bath Floors !nterior Finish Heat Rooms 1st Floor Rooms 2nd Floo~ Dinette DR. BR. FIN. B. 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 ISOUTHOLD September 25, 2009 Frank Pdolo 4000 Middle Country Road Calverton, NY 11933 RE: 500 Fox Hollow Road, Mattituck 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. A fee of $25.00 Final Health Department approval. Plumbers solder certificate (all permits involving plumbing after 4/1/84.) 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: 33473-Z swimming pool 'l'.~n 1 fall Atm~'x ,5{375 Main 1'.(). Box 1179 Tclephlmt~ (631) 763-1802 Fax (631) 76.;-9302 BUII~I)IN(; I)I~;PAIlTMENT TOWN OF $OUTHOLD May 2, 2011 Frank Pdolo 4000 Middle Country Road Calverton, NY 11933 TVVO WHOM IT MAY CONCERN: The Following items Are Needed To Complete Your Ce~ificate of Occupancy: ~ Application for Certificate of Occupancy. (Enclosed) ~ Electrical Underwriters Certificate. '"'""4 A fee of 50.00. __ Final Health Department Approval. __ Plumbers Solder Certificate. (~JI permits involving plumbing after 4/1184) __ Trustees Certificate of Compliance. (Town Trustees #765-1892) __ Final Planning Board Approval. __ Final Fire Inspection from Fire Marshall. __ Final Landmark Preservation approval. BUILDING PERMIT: 33473-Z swimming pool DISTRICT YOO0 SECTION ~$ BLOCK G LOT ~9 PROPERTY SITUATE AT FOX HOLLOW ROAD, ,MATTITUCK, TOWN OF SOUTHOLD, COUNTY OF SUFFOLK, STATE OF NEW YORK. FOX HOLLOW ROAD S 18'07'30" E (24' WIDE) 12.00' ~ S 71'52'50"_ -- W 1_12.50' EDGE OF ROAD mim FOU.D. W 112J CONC, MON, ASS ~LL 0 PROPOSED ADDlllON AC. 0 20.5' 26.0' GARAGE · ~ 2 sw. F~^.E w/ u~.G I ~. SPACE ABOVE DWELUNG WOOD I 7.6'FOUND CONC. NMON- BULKHEAD SCALE ! "---$0' 9.0' s GUARANTEES INDICATED HEREON SHALL RUN ONLy TO THE PERSON FOR WHOM THE SURVEY IS PREPARED, AND ON HIS BEHALF TO THE CO.,GOVERMENTAL AG[NCY AND LENDING 112.72' BULKHEAD 9.4' S WOOD DOCK 71.1' S MATTITUCK CREEK N 18'07'30" W 12.00' P.O.B. BRICK WALL 0.$' E: ,/ ,9C' ,/ ,/ / PLUF4BI(~G SCH~aA¥~C SE,CT~O~q B SECT'~OIF4 A 9' IQ' SECT~O~ B fOl~ TI~5 ~¢00 F¢t ?OLI~P CONCRl¢.11¢ WALL SECT~OIN B©TES