HomeMy WebLinkAbout35605-ZTown of Southold Annex
54375 Main Road
Southold, New York 11971
CERTIFICATE OF OCCUPANCY
6/29/2011
No: 35033
Date: 6/29/2011
Location of Property:
SCTM #: 473889
Subdivision:
THIS CERTIFIES that the building iN GROUND POOL
1370 Light House Rd, Southold,
Sec/Block/Lot: 50.-5-8
Filed Map No.
conforms substantially to the Application for Building Permit heretofore
5/25/2010 pursuant to which Building Permit No.
Lot No.
filed in this officed dated
35605 dated 6/9/2010
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 ~round swimming pool with fence to code as applied for.
The certificate is issued to
Mastorakis, Dimitrios & Laskaris, Theodora
(OWNER)
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL
ELECTRICAL CERTIFICATE NO.
PLUMBERS CERTIFICATION DATED
35605 5/27/11
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)
PERi, IT NO. 35605 Z Date JUNE 9, 2010
Permission is hereby granted to:
D MASTORAKIS
1370 LIGHTHOUSE RD
SOUTHOLD,NY 11971
for :
CONSTRUCTION OF AN INGROUND SWIMMING POOL, FENCED TO CODE AS
APPLIED FOR
at premises located at 1370 LIGHT HOUSE RD
County Tax Map No. 473889 Section 050 Block
pursuant to application dated MAY 25, 2010
Building Inspector to expire on DECEMBER 9,
SOUTHOLD
0005 Lot No. 008
and approved by the
2011.
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 the Building Department with the following:
A. For new building or new use: 1. Final survey of property with accurate 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 of electrical installation from Board of Fire Underwritem.
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 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. Ce[tificate 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, Commemial $15.00
New Construction:
Location of Property:x'50 ! ~ q O House No.
Owner or Owners of Property:''''x3
Suffolk County Tax Map No 1000, Section
Subdivision
Old or Pre:existing Building: (check one)
m house cl, ,g- o-]4n c kt, V
Street Hamlet
PermitNo. CZO~-~)~ DateofPermit.
Health Dept. Approval:
Planning Board Approval:
Request for: Temporary Certificate
Foe Submitted: $ '~-i~) . ---
Filed Map. Lot:
Applicant:
Underwriters Approval:
Final Certificate: ~ (check one)
Applicant Signature
Town Hall Annex
54375 Main Road
P.O. Box 1179
Southold, New York 11971-0959
Telephone (631) 765 1802
Fax (631 ) 765-9502
ro.qer, richert~town southo d ny us
BUILDING DEPARTMENT
TOWN OF SOUTHOLD
CERTIFICATE OF ELECTRICIAL COMPLIANCE
SITE LOCATION
Issued To: Dimitri Mastorakis
Address: 1310 Lighthouse Road City: Southold St: NY Zip: 11971
Building Permit #: 35605 Section: 50 Block: 5 Lot:
WAS EXAMINED AND FOUND TO BE IN COMPLIANCE WITH THE NATIONAL ELECTRIC CODE
Contractor: DBA: Stasi/Dallas Electrical ContLicense No: 4679-me
SITE DETAILS
Office Use Only
Residential ~ Indoor ~] Basement ~ Service Only [~1
Commerical Outdoor 1st Floor Pool
New Renovation 2nd Floor Hot Tub
Addition Survey Attic Garage
INVENTORY
Service 3 ph Hot Water GFCl Recpt
Main Panel NC Condenser Single Recpt
Sub Panel NC Blower Range Recpt
Transformer Appliances Dryer Recpt
Disconnect Switches Twist Lock
Other Equipment:
Ceiling Fixtures ~J~[~ HID Fixtures
Wall Fixtures I I Smoke Detectors
Recessed Fixtures CO Detectors
Fluorescent Fixtur(~ Pumps
Emergency Fixture Time Clocks
Exit Fixtures I I TVSS
inground swimming pool and accent lighting, to include bonding, 2-pool lights
gas heater, l-time clock, l-pool pump, I-GFCl
Notes:
Inspector Signature:
Date: Ma)/27 2011
81-Cert Electrical Compliance Form
TOWN OF SOUTHOLD BUILDING DEPT.
765-1802
INSPECTION
[ ] ROUGH PLBG.
[ ] INS~ULATION
[~AL
[ ] FIRE SAFETY INSPECTION
FOUNDATION 1ST
FOUNDATION 2ND
FRAMING / STRAPPING
FIREPLACE & CHIMNEY
DATE
INSPECTOR-~~
TOWN OF SOUTHOLD BUILDING DEPT.
765-1802
INSPECTION
[ ]FOUNDATION 1ST
[ ]FOUNDATION 2ND
[ ]FRAMING / STRAPPING
[ ]FIREPLACE & CHIMNEY
ROUGH PLBG.
~I~AL
[ ] FIRE SAFETY INSPECTION
INSPECTOR
~TOWN OF SOUTHOLD BUILDING DEPT.
765-1802
INSPECTION
[ ] FOUNDATION 1ST [ ] ROUGH PLBG.
[ ] FOUNDATION 2ND [ ] INSULATION
[ ] FRAMING / STRAPPING [ ] FINAL
[ ] FIREPLACE & CHIMNEY [ ] FIRE SAFETY INSPECTION
[ ] RRB RESISTANT CONSTRUCTION [ ] FIRE RESISTAI~n' PENETRATION
[ ] ELECTRICAL (ROUGH) [~ELECTRICAL (FINAL)
' ~.
REMARKS:
DATE ~ INSPECTOR ~"
TOWN OF SOUTHOLD BUILDING DEPT.
765-1802
INSPECTION
[ ] FOUNDATION 1ST [ ] ROUGH PLBG.
[ ] FOUNDATION 2ND [ ] INS~LATION
[ ] FRAMING / STRAPPING [//]'FINAL
[ ] FIREPLACE & CHIMNEY [ ] FIRE SAFETY INSPECTIOH
[ ]FIRERESISTANTCOliSTRUCTK~ [ ]FIRERESISTANTFENETRATION
REMARKS:
~/ / /
/
TOWN OF SOUTHOLD
BUILDING DEPARTMEN~
TOWN HALL
SOUTHOLD, NY 11971
TEL: (631) 765-1802
FAX: (631) 765-9502
SoutholdTown.NorthFork.net
PERMIT NO.
Examined
Approved
Disapproved a/c
6/9 , 20 /~
Expiration
2010
BLDG. DEP[
TOWN OF SOUTHOLD
Building Inspector
BUILDING PERMIT APPLICATION CHECKLIST
Do you have or need the following, belbre applying'?
Board of Health
4 sets of Building Plans
Planning Board approval
Survey
Check
Septic Form
N.Y.S.D.E.C.
Trustees
Flood Permit
Storm-Water Assessment Form
Contact:
mhT~} ) ~L~.._.~ I/~_..~
LICATION FOR BUILDING PERMIT
INSTRUCTIONS Date ~//
765-1802 8 AM TO 4 PM FOR THE
FOLLOWING INSPECTIONS:
1. FOUNDATION - TWO REQUIRED
FOR POURED CONCRETE
Builders License No. L'~ q/ ~ / 2. ROuOdd-FRAMING, PLUMBING,
Plumbers License No.
~ ........ ~"..,',',' .... on^.. STRAPPING, ELECTRICAL g CAULKING
Electnctans License No SU
Other Trade's License No. ' wazc, ,nc n:uu,n:~4ENTS OF TH~ Dh~/')'~S*~!JCT*ON & ELECTRICAL
CODES OF NEW YORK STATE.-- N~'SVtSET~MFLETE FOR CO
~L CO¥S rRUCTION SHALL MEET THE
I. Location of land on which proposed work wi~be done~ · - REQ~RE~,-'~TS ~F THE,C~nF NEW
House Number ~ Str~et - ' ' b~ c0NSl;RUCTIO~ ERRORS.
County Tax Map No. 1000
Subdivision
Section
Block C)~ RETAIN STnraa¥1~.E~n~ONOfl.
Filed Map N~U,8~~}a 28~
OF mE DWN COOE
(Name and title of corporate officer)
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
issues a Certificate of Occupancy.
f. Every building permit shall expire if the work authorized has not commenced within 12 months after the date
k;:~uancc or has not been completed within 18 months from such date. !fno zoning amendments or other regulations affecting thc
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, Suftblk 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.
/ kl t UPON cOM~.~'~ l~ /-4uL;l (~.~- 1( l [F~"f~'-tz.,~.x._....,t_t...,--. (Mailing address ofapplicantA
o t~ta'~X'--'hethflEFO'RE''WATE~'"'',/..{ lW£~ ~,~a\C ~( r¢.~/Ll-Jr,5.~kJI/}z
M,,,,/
app,cam o general contr*tor, elect ici < plumber or builder
0 ' APPROVED AS NOTED
Nameofownerofpremises , . _ ('~}/tb~ ~ DATE B.P.#
( A ~ ° ~'-t he t a'hX~rc;l 1-° r ~:'~ ?~ B y/~ff,_
If applicant is a coporation, signature of duly a~~}[,¢4, ' '
NOTIFY ~UILDING DEPARTMENT AT
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_
Repair Removal Demolition
4. Estimated Cost Fee
5. If dwelling, number of dwelling units
If garage, number of cars
Y¢cna' r -r
Addition Alteration
Other Work i-'):::::~:~J [ I/I ~ ~
[ ' (l~e~p~o~)'
(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.
Dimensions of existing structures, if any: Front
Height Number of Stories
Rear Depth
Rear
Number Of Sto~io8 . , '-'t ~
Rear I Depth
Depth
Dimensions of same structure with alterations or additions: Front
Depth Height.
Dimensions of entire new construction: Front
Height Number of Stories
Size of lot: Front Rear
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 __ NO
l 4. Names o f Owner o f,premise~)~~d~ress~o~o, t~Q¢--~'~¢ O-__~
Name of Architect~'"~a::>kq~c,q-~v'k , Address ne No.2;~l
Name of Contracto~lf~/'3- ~C:r~F ~rp tJfddress~I ,~P,ho..ne No.~
15 a. Is this property wlth~n 100/eet ora tidal ;etl~an~or a fresh~wat~a d.~*YE~S }l N'~O.~ ''
* 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 distances to property lines.
17. If elevation at any point on property is at 10 feet or below must provide topograpltic.~ data,on ~upcey.
18. Are there any covenants and restrictions with respect to this property? * YES
· IF YES, PROVIDE A COPY.
STATE OF NEW YORK)
SS,:~
COUNTY O F~..~
~>~ ~~L'~ S beihg duly S~vorn, deposes and says that (s)he is the applicant
(Name;of individual signing eontract~ abe'ce named,
(S)He is the
.[. ::! ._ ,.,(,Contrg~:tor,~Agent,:. . Corporate Officer, etc.)
of said owner or owners, and ~s duly authorized ro perform ~hal/e performed the said work and to make and file this application;
that all statements ~ntained in this application are true to the be~t 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
/ 8-¢ day.,gf ~r)Q~AAJ,, 20
~ ~ [1 elNa M. SCACCIO/
'N~.tary.Public : ' No. 01SC6217947 \
Qualified in King County
: i' Commission Expires 02/22/2014
Signature of Applicant
Town of Southold
Erosion, Sedimentation & Storm-Water Run-off ASSESSMENT FORM
PROPERTY LOCATION: S.C.T.M. #:
District Section Block Lot
THE FOLLOWING ACTIONS MAY REQUIRE THE SUBMISSION OF A
STORM-WATER, GRADING, DRAINAGE AND EROSION CONTROL PLAN
CERTIFIED BY A DESIGN PROFESSIONAL IN THE STATE OF NEW YORK.
Item Number:
1
2
3
4
(NOTE: A Check Mark (~) for each Question is Required for a Complete Application)
Will this Project Retain All Storm-Water Run-Off Generated by a Two (2") Inch Rainfall on Site?
(This item will include all run-off created by site clearing and/or construction activities as well as all Site
Improvements and the permanent creatiD~,O[ ir0pervio~.sprfaces.)
Does the Site Plan and/or Survey Show All Pr'6p~6;sed D~Air~ge Structures Indicating Size & Location?
This item shall include ali Proposed Grad~-Ct, hah~les-~Slopes Controlhng Surface WaterFIow!
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?
wil[ this Application Require Land Disturbing Activities Encompassing an Area in Excess of
Five Thousand (5,000) Square Feet of Ground Surface?
5
6
Is there a Natural Water Course Running through the Site?
Is this Project within the Trustees jurisdiction or within One Hundred (1 Off) feet of a Wetland or Beach?
Will there be Site preparation on Existing Grade Slopes which Exceed Fifteen (15) feet of Vertical Rise to
One Hundred (100') of Horizontal Distance?
7
Will Driveways, Parking Areas or other Impervious Surfaces be Sloped to Direct Storm-Water Run-Off
into and/or in the direction of a Town right-of-way?
8
9
Will this Project 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?
(This item will NOT include the Installation of Driveway Aprons.)
Will this Project Require Site Preparation within the One Hundred (100) Year Floodplain of any Watercourse?
Yes No
NOTE: If Any Answer to Questions One through h'ine is Answered with a Check Mark in the Box, a Storm-Water, Grading,
Drainage & Erosion Control Plan is Required and Must be Submit[ed for Review Prior to Issuance of Any Bui!ding Permit!
EXEMPTION; Yes
Does this project meet the minimum standards for classiflcatien as an Agricultural Project?
Note: If You Answered Yes to this Question, a Storm-Water, Grading, Drainage & Erosion Control Plan is NOT Requiredl __
No
STATE OF NEW YORK, :
, co Nw .....................
SS
~}1~{ I, . . . }.~ . . . , l~}.~.~~ ..................... being dt,:5 sworn deposes ~ad says fllat he/she is ~e applic~t ,hr Pemlit,
(Name of individual signin9 Document)
And fl~at be/she is dm ........................ ~.~ ......................................................................................................................
(~er, Con~ctor. Agent. Co~orate Officer. etc)
O~mer and/or representative of fl~e O~er of O~er's, and ~s duly au~orized to perform or have performed fl~e smd work ;md to
make ~md file fl~is application; that ~dl statements contained in ~is application are tree to tim best of bis ~owledge and belief; ~md
fl~at fl~e work will be performed in the manner set forfl~ in fle application filed bere~fla.
Sworn to before me tiffs;
........................... !~ d5 o~ ......................... 20.J.D
...... ~ ~ () GI~M.S~CClO , / ~ ~ -- --
~ Qualifi~ in ~ng C~n~
TOWN OF SOUTHOLD PROPERTY R.~ORD CARD r,'t- ~/_.,
OWNER ;TREET /~ 7~ VILLAGE DIST. SUB. LOT
_~cO~ER OWUER .' .... N E
RES. ~J O ~S~S. VL. , FARM CO~. ' CB. MICS. Mkt. Value
~ND IMP. TOTAL / DATE REMARKS
/ ~ ~ ~ /
s~ ~oo ~0o "/~/e7 ~/~G~
/ -
I FRONTAGE ON WATER
Till°ble
W~lond FRONTAGE ON ROAD ~ '
Meadowland DEPTH
I BULKH~D
House Plot
Total
COLOR ~/~-'~ TRIM
Extension
Extension
Porch
Porch
Breezeway
Garage
Patio
Oo B.
Total
:oundation
Basement
Ext. Wails
Fire Place
Type Roof
Recreation Room
Dormer
Bath
FlOOrs
Interior Finish
Heat
Rooms 1st Floor
Rooms 2n~ Floor
Driveway
Dinette
Town Hall Annex
54375 Main Road
P.O. Box 1179
Southold, New York I 1971-0959
Telephone {631) 765-1802
Fax (631) 765 9502
BUILDING DEPARTMENT
TOWN OF SOUTHOLD
June 16, 2011
Dimitrios Mastorakis
262 90th St
Brooklyn. NY 11209
RE: 1370 Light House Rd, Southold
TWO WHOM IT MAY CONCERN:
The Following Items Are Needed To Complete Your Certificate of Occupancy:
'x,q Application for Certificate of Occupancy. (Enclosed)
C~ Electrical Underwriters Certificate.
x,,,1 A fee of 50.00.
__ Final Health Department Approval.
__ Plumbers Solder Certificate. (tUl permits involving plumbing after 4/1/84)
__ Trustees Certificate of Compliance. (Town Trustees #765-1892)
__ Final Planning Board Approval.
__ Final Fire Inspection from Fire Marshall.
Final Landmark Preservation approval.
BUILDING PERMIT: 35605-Z swimming pool
,guf£olJc Co~ty. Executive'S Of~'ce. ....
DATE ISS~D:
,... _ . "._ .' .." ,." · ' .~ ~:,~DD~G~-~C.'..'"'"'.'-' ' '." ."m .
' ~e~a re.la&om of~e Coun~ of ~uff6m,'St~te.o[~'e~:Zork;is'hera~ 'licenged:t6. co~Guct bu~mgss as a
Thle cer~e~ that the
hearer ~s du~y It~ensed
by the County of Suffolk
RANDY 'T RODECKER
214~2-H 06/0~11992
This certifies that the
bearer is duly licensed
by the County of Suffolk
COMMISSIONER
SUFFOLK COUNTY DEPARTMENT
OF CONSUMER AFFAIRS
MASTER
ELECTRICIAN
NAME
RAYMOND T DALY
5141-ME
EXPIRATION DATE
IDate Issued
08/13/2001
08/01/2011
BUSINESS NAME
RAYMOND ELECTRICAL CONTRACTING
'!
AREA
= 2'~ztlO sq./L
CERTIFIED TO'
FIRST METROPOLITAN ABSTRACT CORP,
DIMITRIO$ IViASTORAKI$
THEODORA [v~4$TORAKI$
G.F.I. MORT6AEE 8ANKERS, INC.
OLD REPUBLIC NATIONAL TITLE INSURANCE COMPANY
TITLE~,'NO; ;4' 31.~EE'-$-1£65
SURVEY OF PROPERTY
AT
SOUTHOLD
TO WN OF SOUTHOLD
SUFFOLK COUNTY, IV.. Y.
1000 - 50 - 05 - 08
Scale~ 1" = 30'
May 7, 2009
SOUTHOLD, IV.
LIe. NO, 49618
765 - 1797
S TREE T
, ~' , 7' ~ 20' /
¢ CHECKVALVE~
P~N ~. ~,,~. PLUMBING SCHEMATIC
LINE ~
~O~Ep CONe S~PS ~ NOTES
~2"~o ~" SANP BOSOM ING~UNDSWIMMINGPOO~FO~AWPEIIPOOL.
GROUND WATER TASLE IS A MINIMUM OF 4 '-8" ~ELOW ~E PROPOSED FINISHED G~DE
COPING AND WALKWAY ~ 3. BACKFILL WITH CL~N ~RTH, FREE OF ROO~ AND DEBR[S. DO NOT ALLOW THE HEIGHT
{BY OTHEr) OF BACKFILL TO ~CEED THE HEIGHT OF THE WATER IN THE POOL BY MORE THAN
SECTION A ~,~ ,L ~ ~ ~ ~
~ ~.~__~ ~ & ANDP~CE CONCR~E ON SAN DY TO LOAM SOil COMPACT CLaN BACKFILL, REMOVE ANY C~Y DEPOSIT
Scale: ~/~" = J'-O" k ~ 5, WAL~ TO ~E SMOOt, NON SKID WPE, SLOPED AWAY FROM POOL
LINERANDROLLED FOAMcoNc[~EB~EEN ~ ~ [~4~/~ 6. WATERLO~L REGU~TIONSDISPOSAL 5HALL ge LIMITED TO OWNE~ PROPERW IN ACCORDANCE
b ~ ~ ZE VINYL LINER ~ ~ COMMENCEMENT OF CONSTRU~ION.
I ' ~ ' 10. THIS POOL SHALL BE EQUIPPED WITH AN APPROVED POOLA~ ~HICH 15 C~S5IFIED
~'///~//fi'//&//&//fi~//fi~//~/~///~//&//~ 11. A TEMPO~RY ENCLOSURE, OR 4 ~ FENCE SHALL BE INSTALLED AND ~E~[N IN
SECTION B WALL SECTION
s~le: ~/8": Y-O"