The URL can be used to link to this page

Home My WebLink About34659-ZTown of Southold Annex 54375 Main Road Southold, New York 11971 6/7/2011 CERTIFICATE OF OCCUPANCY No: 34998 Date: 6/7/2011 THIS CERTIFIES that the building 1N GROUND POOL Location of Property: 1165 THERESA DR MATTITUCK, SCTM #: 473889 Sec/Block/Lot: 115.-15-11 Subdivision: Filed Map No. conforms substantially to the Application for Building Permit heretofore 5/5/2009 pursuant to which Building Permit No. 34659 was issued, and conforms to all of the requirements of the applicable provisions of the law. The occupancy for which this c~rtificate is issued is: accessory in ground swimming pool with fence to code as applied for. Lot No. filed in this ofliced dated dated 5/7/2009 The certificate is issued to Berliner, Donald & Berliner, Sandra (OWNER) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL ELECTRICAL CERTIFICATE NO. PLUMBERS CERTIFICATION DATED 34659 5/26/11 ignature~~-''~ 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) PEI~MIT NO. 34659 Z Date MAY 7, 2009 Permission is hereby granted to: D & S BERLINER 1165 THERESA DRIVE MATTITUCK,NY 11952 for : CONSTRUCTION OF AN INGROUND SWIMMING POOL IN THE REAR YARD, FENCED TO CODE at premises located at County Tax Map No. 473889 Section 115 pursuant to application dated MAY Building Inspector to expire on NOVEMBER 1165 THERESA DR MATTITUCK Block 0015 Lot No. 011 5, 2009 and approved by the 7, 2010. Fee $ 250.00 ! Authorized Signature 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 thc Building Department with ti A. For new building or new use: 1. Final survey of property with accurate location of all buildings, property lines, streets, and unu: topographic features. 2. Final Approval from Health Dept. of water supply and sewerage-disposal (S-9 form). 3. Apprnval of electrical installation from Board of Fire Underwriters. 4. Sworn statement from phimber certifying that the solder used in system contains less than 2/10 of 1% lead. 5. Commcroial building, industrial building, multiple residences and similar buildings and installations, a certificate of Code Compliance frnm architect or engineer responsible for the building~ 6. Submit Planning Board Approval of completed site plan requirements. For existing buildings (prior to April 9, 1957) non-conforming uses, or buildings and "pre-existing" laud uses: 1. Accurate survey of property showing all property lines, streets, building and unusual naturai 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 I. 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 dig New Construction: Location of erope~y~: t4~se, No. Street Owner or Owners of Property¥ Suffolk County Tax Map No 1000, Section Old or Pre-existing,~,t~ ~Building: ~,~'~ 0~._ (check one)~ ~,'/~d~'~ - ' ~/1~[ Hamlet Filed Map. Lot: Subdivision P*cmit'~ ._~. (9~ Health Dept. Approval: Date of Permit. Applicant: Underwriters Approval: Planning Board Approval: Request for: Temporary Certificate Fee Submitted: $ ~ . ~ ~ Final Certificate: (check one) Applicant Signature Tmxn tfall AllllCX ,5 t375 Main Road P.O. Box 117!) Soulh~ld, NY 11!)71-09.59 Telephone ((iS I) 76,5-1802 l:ax (63 I) 763-9,502 ro.qor r chert~,,town southold.n¥.us BI IIlJ)ING DEPARTMENT TOWN OF SOUTHOLD CERTIFICATE OF ELECTRICIAL COMPLIANCE SITE LOCATION ssued To: Don Berliner ~,ddress: 1165Theresa Drive City: Mattituck St: NY Zip: 11955 5uildingPermit#: ~'~L.[[,ao~'q 3465gSection: Ilt,~~' Block: t~" Lot: I/ WAS EXAMINED AND FOUND TO BE IN COMPLIANCE WITH THE NATIONAL ELECTRIC CODE 3ontractor: as built DBA: License No: SITE DETAILS Office Use Only Residential [~ Ind°°r ~ Basement I~ Service Only Commefical Outdoor 1st Floor Pool New Renovation 2nd Floor Hot Tub Addition Survey Attic Garage Service 1 ph Service 3 ph Main Panel Sub Panel Transformer Disconnect Other Equipment: INVENTORY HotHeatwater ~ Duplec Recpt ~ Ceiling Fixtures ~ HID Fixtures GFCl Recptr--1~ Wall Fixtures Smoke Detectors NC Condenser Single Recpt Recessed Fixtures CO Detectors NC Blower Range Recpt Fluorescent Fixture I I Pumps Appliances Dryer Recpt Emergency Fixtures~ I Time Clocks Switches Twist Lock Exit Fixtures L...J TVSS swimming pool to include, pool bonding, time clock, 2 pumps, 1 pool light I switch, 1 gfci circuit breaker Notes: Inspector Signature: Date: May 26 2010 81-Cart Electrical Compliance Form TOWN OF SOUTHOLD BUILDING DEPT. 765-1802 INSPECTION [ ] FOUNDATION 15T [ ] ROUGH PLBG, [ ] FOUNDATION 2ND [ ]INSULATION [ ] FRAMING / STRAPPING ~ FINAL ~-~ / [ ] FIREPLACE & CHIMNEY [ ] FIRE SAr.., ,( INSPECTION [ REMARKS: /~"~ DATE '~ - //c:, --I( INSPECTOR TOWN OF SOUTHOLD BUILDING DEPT. 765-1802 INSPECTION [ ]FOUNDATION 1ST [ ]FOUNDATION 2ND [ ]FRAMING / STRAPPING [ ]FIREPLACE & CHIMNEY [ ] ROUGH PLBG. [ ] INSULATION [~]~FINAL ] FIRE SAFETY INSPECTION [ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRATION REMARKS: DATE INSPECTOR__~, /~-~ TOWN OF SOUTHOLD BUILDING DEPT. 765-1802 INSPECTION [ ] FOUNDATION l ST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] INSULATION [ ] FRAMING / STRAPPING [ ] FINAL [ ] FIREPLACE & CHIMNEY [ ] FIRE SAFETY INSPECTION [ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRATION [ ] ELECTRICAL(ROUGH) ~ [ ]ELECTRICAL(FINAL~ REMARKS: DATE INSPECTOR FOUNDATION (1ST) ~.~ ~ FOUNDATION (2ND) '~ ROUGH FRAMING & 'x~ ,-.X ~ PLUMBING INSULATION' ~ER N. Y. STATE E~R~ CODE ~ ~o~ com~s ~ TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, NY 11971 TEL: (631) 765-1802 FAX: (631) 765-9502 www. northfork.net/Southold/ Examined Approved Disapproved a/c ~? ,20 ~fl q7 ,20 o~ Expiration //7 , 20/O IIA¥ 5 2009 BLIP. DEPT. TOWN OF SOUTHOtD PERMIT NO. 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: Mail to: ! Buil-ding Inspector APPLICATION FOR BUILDING PERMIT Date INSTRUCTIONS o'-'//"/,/~: p= ,20d)~ 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 is'sues a Certificate of Occupancy. f. Every building permit shall expire if the work authorized has not commenced within 12 months aRer 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. · ,lu~,~, A LY" ALL CONSTRUCTION SHALL CL08~ ~O0~TO COOt UPON CO~,LrI'~ON MEET THE REQUIREMENTS OF THE BEFORE "WATER' CODES OF NEW YORK STATE. applicant is owner, lessee, agent, architect, engineer, general contractor, I State whether Name of owner ofpremises~-'-D o,/O ----~c-:-rz Z "~/C-')~ DATE: ff/'t (Signature of applicant or name, if a corporation) (Mailing address of applicant) ~~uilder ,VED AS NOTED' (As on the tax roll or latestEEE~~ BY: .,ff.~_____ If applicant is a corpor_gtipn, s~gnal~re of duly authorized officer NOTIFY BUILDING DEPARTMENT AT "'-~ - (~aTn~e and title of corporate offico)cCUPANCY OR Builders License No. ,/fi/d-?-/-/USg: IR I INI AWFUL Plumbers License No. ....... Electricians License No. VVllrlLJU ICERTIFICATE Other Trade's License No. OF ~1 ID A 1. Location of land on which proposed work will be done: ?/~-5~ ~',~z--~ House Nmnber Street County Tax Map No. 1000 Section // Subdivision%De-g-p ~ ~,zt~wg (Name) -Do.,,,. 765-1802 8AM TO 4PM FOR THE FOLLOWING INSPECTIONS: 1. FOUNDATION - TWO REQUIRED FOR POURED CONCRETE 2. ROUGH - FRAMING & PLUMBLUG · .,~ x,~...,iK STAIE. NCT RESPONS!L~LE FOR PURSUANT TQ HAPT 236 Block /~ OF T~O~OODE Filed Map No. ~ZfF, ~t , ~(~ 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existinguseandoccupancy Z ~,/z ~' ,~'~, ,,~x~c zo~;c,/ ">~7.~,q~-~ ~ m.4m e,.~,~,~ zc b. Intended use and occupancy 3. Nature of work (check which applicable): New Building Repair Removal Demolition 4. Estimated Cost J/'~, <,Da , ~o 5. If dwelling, number of dwelling units If garage, number of cars Fee Addition Alteration (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_ .5-c~ _' .Rear ~-~ ' .r-wry_._ ~---~ ........ · ' ' '~'~' Height ~' ~Number of Stones ~ Dimensions of same structure with alterations or additions: Front }~ [l't~ Rear Depth Height. Number of StS~~~ ~ ~ f 8. Dimensions of entire new cons~ction: Front Rear Height Number of Stories 9. Size of lot: Front ./~'~',_~3 ' Rear r~5. ~? ' Depth /gP' ' 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 JO' NO__ 14. Names of Owner of premisesp~o Name of Architect Name of Contractor Address//~,~-~.~rv'z~ z>r~. Phone No. ~.~:- .~z/? Address ~"~'"'~ Phone No Address~o:~,- 9 ~,~,~,~ve- PhoneNo, ?.x?- 2&~.~- 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 ora tidal wetland? * YES__ NO -~' * IF YES, D.E.C. PERMITS MAY BE REQUIRED. NO~' 16. Provide survey, to scale, with accurate foundation plan and distances to property lines. 17. If elevation at any point on prop~y is at 10 feet or below, must promde topo~aphzcal data on s~y ,. STATE O~O~}~ CO~TY ~~ ~~ ~/~ being duly sworn, deposes ~d says t~t (s)he is the applic~t (Name of individual si~ng contract) above named, (s)m i~ the ~~ ~ ~ (Contractor, Agent, Co~omte Office, etc.) of smd owner or owners, ~d ~s duly authorized to peffo~ o~ave pe~o~d the.smd work ~d to m~e ~d file ~s apphcat~on; that all statements contained ~ t~s application are tree t~ ~0J~l~l~d belief; and that the work will be perfomed in the m~er set fo~h in ~e application file~ i~}~:., .v ~ }, Swomdo,beforemethis/1 ] ~ , day< Notary Public . Signature of Applican~f , , C s re'= L. Glew Ndf~Cy'J~{)li¢ St~le 0fNew York Qualified inSuffolk Coun~ Commission Expires Dec. 8, ~ Town of $outhold Erosion, Sedimentation & Storm.Water Run-off A88ESSMENT FORM PROPERTY LOCATION: ~C.T.M,d~ THE FOLLOWIN~ A~ION8 MAY REQUIRE THE 8UBM!_-~__~_~ OF A Item Numbec. (NOTE: A Chec~ Mark (~) for eash Ouesiton Is Required for a Complete Appticedon) yes N._~o 1 W'dl this Project Retain All Sten~-Weter Run-Off Generated by a Two (2') Indn Ralofati on Site? /~ r'~ (This item will Include all run-off created by site clearing and/or conalmction ac6vffias as well as all Site Improvements and the pmmanent cma#on of ir~ surfa~.) 2 Does file Site Plan and/or Survey Show All Proposed Drainage Sb~ures Indicating Size & Lasafion? r~ This Item shell include all Propped Grade Changes and Slopes Contra#lng Sorfase Wale~Fk)wi 3 Will this Project Require any Land Riling, Grading or Excavation where ~ is a change to the Natural Existing Grade Involving more than 200 Cubic Yards of Material within any Parcel? -- 4 Will this Apfllluait~l Require Land Distud~ Activities Encompassing an Area in Excess of r~ Five Thousand (5,000) Square Feet of Gr~md Surface? 5 Is there a Natural Water Course Running through the Site? r"""l is this Project within the Trustees jurisdiction or within One Hundred (100') feet of a Wetland or Beach? 6 W'dl there be Site pmpareiton on Existing Grade Slopes whgh Exceed Filtmm (15) feet of Vertical Rise [o r~ one Hundred (100') of Horizontal Distance? 7 Will Dlivewaya, Pafldng Areas or olher Impervious Surfaces be Sloped to Direc~ Storm-Water Run-Off r~ into and/or in the dimcllon of e Town fight-of-way? 8 Will this Project Requiro the Pla~emeof of Malerial, Removal of Vegetation and/o~ f~e ConetnJCflon of r~ any Item v~rflflin the Town Right-of-Way or Rnsd Shoulder Ama? (This Item will NOT Include the Installation of DHuaway Aprons.) 9 Will this P~oject Require Site Preparation within the One Hundred (100) Year Floodplain of any Watercourse? NOTE: If Any Armwer to Questions One through Nine is Answered wllh · Check Mark In the Box, a E4orm-Water, Grading, _ _ _ _o~ _,~.. & ~ronlon Control monta ~q. lrnd end Munt be Submllted for K~v Pr~r t= r. uanc* of Any '~.lld~n. EXEMPTION: Yes N._.~o Does this pmjeot meet the minimum standards for classifluaiton as an Ag~ullural Project? Note: If You Answered Yes to this Question, a Storm-Water, Grading, Drainage & Erosion Control Plan is NOT Requlredl -- _~/ COtrST~ O~ .~..~.{..y~.~ ............ ss T~t I ...~.~ ~ ~/~ bein~ d~v s~m de~ ............ ............... -- - , ~d ~ h~she is ~e ~ ~~ ~er ~or ~prcscn~c of~c ~cr of ~c~s, ~c ~d file ~s appU~on; ~ ~1 s~m~ con~ed in ~t ~e ~rk ~ ~ ~o~ed h ~e ~er set fo~ Sworn to ~fo~ me ~; Oualifle0 m ~ui{ulk ~ORM - 06/0~ commisaion Expires Dec. 8, Town Hall Annex 54375 Main Road P.O. Box 1179 Southold, NY 11971-0959 Tuesday, May 17, 2011 Donald & Sandra Berliner 1165 THERESA DRIVE MATTITUC, NY 11952 BUILDING DEPARTMENT TOWN OF SO[JTHOLD Telephone (631)765-1802 Fax (631) 765-9502 RE: 1165 THERESA DR 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 $50.00 Final Health Department Approval. Plumbers Solder Certificate. (All permits involving plumbing after 411184) Trustees Certificate of Compliance. (Town Trustees #765-1892) Final Planning Board Approval. Final Fire Inspection from Fire Marshall. Final Landmark Preservation approval. Certifications - See Enclosed Ticket. Building Permit: 34659 CONSTRUCTION OF AN INGROUND SWIMMING POOL IN THE REAR YARD, FENCED TO CODE ~ES..~d~O LAND Tillable 1 tillable 2 tillable 3 ~/oodland iwampland ~rushland 4ouse Plot SEAS. IMP. NORMAL Acre TOTAL FARM DATE ,.-.o -~,:, ,, '~a]~e- P;r "~/9~t~e~' Ac re PROPERTY E W COMM. CB. MISC. RECORD CARD FRONTAGE ON WATER FRONTAGE ON ROAD DEPTH BULKHEAD DOCK ~, u L COLOR ~rch ~arage Patio I).. X 3,1'- ~?;. III /~ × it'.~l ? (, Foundation ~Basement Walls Fire Place Type Roof Recreation Roan Dormer Driveway Bath Floors Interior Finish Heat Rooms 1st Floor Rooms 2nd Floo Dinette .K. LR. DR. BR. FIN. B. Total COLOR Foundation Bath FlOOrs Ext. Walls Interior Finish Town Hall Annex 54375 Main Road P.O. Box 1179 Southold, NY 11971-0959 Telephone (631) 765-1802 ax (631) 76 5 ro.qe r. richert('djown so~ut~5o(~.n¥.us BUILDING DEPARTMENT TOWN OF $OI.TTI-IOI.,D APPLICATION FOR ELECTRICAL INSPECTION REQUESTED BY: Company Name: Date: Name: License No.: Address: Phone No.: *Name: *Address: *Cross Street: *Phone No.: Permit No.: Tax Map District: JOBSITE INFORMATION: (*Indicates required information) 1000 Section: ~ \ '-~"" Block: Lot: *BRIEF DESCRIPTION OF WORK (Please Print Clearly) (Please Circle All That Apply) *Is job ready for inspection: *Do you need a Temp Certificate: N° Rough In Temp Information (If needed] *Service Size: 1 Phase 3Phase 100 150 200 300 350 400 Other *New Service: Re-connect Underground Number of Meters Change of Service Overhead Additional Information: PAYMENT DUE WITH APPLICATION 82-Request for Inspection Form Lo; $0 L°t ~,.~ REVIGIONG YOUNG & YOUNG SURVEY FOR: ' ' B~N ~4ENDOZZA LOT ~ $~" OEEP HOLE. CR~K ESTATES SOUTH~ ~r/r~ · ~- ,.~o' I°~*~· ,~,,."~' I"°', POOL DIMENSIONS TYP. PANEL STIFFNER TYPICAL WALL SECTION AT 'A' FRAME ~-- DIVII IG EOARD I I Al POOL PLAN B2 !~ MIN. 2' THICK VERMICULITE AGGREGATE TAMPERED C2 D2 N.T.S. SECTION CORNER CONNECTION DETAIL POOL COMPUES WITH ANSI 5t4, APWNDIX G DESIGN 18 ACCEPTABLE~FOR ALL COMMON SOIL CONDITIONS POOL TYPE: RECTAGLE" i REV. JAMES DEERKOSKI, P,E, 260 DEER PATH MATTITUCK, NEW YORK 11952 I Sl.;ALE N.T.S. DATE DRAWING NUMBER OF