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Home My WebLink About36480-ZTown of Southold Annex 54375 Main Road Southold, New York 11971 8/22/2011 CERTIFICATE OF OCCUPANCY No: 35158 Date: 8/22/2011 THIS CERTIFIES that the building 1N GROUND POOL Location of Property: 1430 Clearview Ave, Southold, SCTM #: 473889 Sec/Block/Lot: 70.-9-54 Subdivision: Filed Map No. conforms substantially to the Application for Building Permit heretofore Lot No. filed in this officed dated 6/15/2011 pursuant to which Building Permit No. 36480 dated 6/15/2011 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 eyound swimming pool with fence to code as applied for. The certificate is issued to Caiola, Gene & Caiola, Shari (OWNER) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL ELECTRICAL CERTIFICATE NO. PLUMBERS CERTIFICATION DATED 36480 8/1/01 Town of Southold Annex 54375 Main Road Southold, New York 11971 CERTIFICATE OF OCCUPANCY 8/22/2011 No: 35159 Date: 8/22/2011 THIS CERTIFIES that the building OTHER 1430 Clearview Ave, Southold, Location of Property: SCTM #: 473889 Subdivision: Sec/Block/Lot: 70.-9-54 Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this officed dated 6/15/2011 pursuant to which Building Permit No. 36480 dated 6/15/2011 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 hot tub with deck as applied for. The certificate is issued to Caiola, Gene & Caiola, Shari (OWNER) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL ELECTRICAL CERTIFICATE NO. PLUMBERS CERTIFICATION DATED 36480 8/1/11 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, NY BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES WITH ONE SET OF APPROVED PLANS AND SPECIFICATIONS UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) Permit If: 36480 Permission is hereby granted to: Caiola, Gene & Caiola, Shad Date: 6/15/2011 27 S Pentaquit Ave Bay S_h~._re, NY 11706 To: inground swimming pool & accessory spa with deck, fenced to code At premises located at: 1430 Clearview Ave SCTM # 473889 Sec/Block/Lot # 70.-9-54 Pursuant to application dated To expire on 12/14/2012. Fees: 6/15/2011 and approved by the Building Inspector. SWIMMING POOLS - 1N-GROUND WITH FENCE ENCLOSURE CO - SWIMMiNG POOL CO - SW1MMiNG POOL~ Total: $658.80 $50.00 $50.00 $758.80 Building Inspector Form No. 6 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL 765-1802 APPLICATION FOR CERTIFICATE OF OCCIJ-PAI~cy This application must be fdled 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 flora Board 0f Fire Underwriters. 4. Sworn statement from plumber certifying that the solder used in system contains less than 2/10 of 1% lead. 5. Commen~ial building, industrial building, mfiltiple 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, 1957J non~conforming uses, or buildings and "pre-existing" land uses: 1. Accurate survey of property showing all property lines, streets, building and:unusual natumi or topographic features. 2. A properly completed application and consent to inspect signed by the applicant. If a Certificate of Occupancy is denied, the Building Inspector shall state the reasons therefor in writing to the app icant 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 2. Certificate of Occupancy on Pre-existing Building- $100.00 ' ' 3. Copy of Certificate of Occupancy - $ 25 4. Updated Certificat~ of Occupancy - $50.00 ' 5. Temporary Certificate 0fOecupancy - Residential $15.00, Commercial $15.00 New Construction: Location of Property: Date· House No. Own6r or Owners of Property:. Suffolk .County Tax Map No 10fi0, Section :--~ ~ Subdivisibn Street Old or Pre.existing Building: (check one) Health Dept. A.ppmval: Planning Board Approval: Request for: Temporary Certificate Fec Submitted: $ ~) 10/4 ~ Block Filed Map... Applicant: Und~vriters Approval: Hamlet · Date of Peamit. Final Certificate: (check one) Aoolicanl Sivnatnre Form No. 6 TOWN OF SOL~rHOLD BUILDING DEPARTMENT 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 feature~. 2. Final Approval fr°m Health Dept. of water supply and sewerage_disposal (S_9 form). Approval of electrical installation from Board 6f Fire Undenvriters. 4.Sworn statement from plumber certifying that the solder used in system contains less than 2/I 0 of 1% lead. 5. C0mmereial building, indus~al building, m~ltiple 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. F~rexis~ngbuildings(pri~rt~April9~957)n~n-c~nf~rminguses~rbui~dingsand"pre-existing~landuses: 1. Accurate survey of property showing all property linea,'streets, building and: unusual naturai or topographic features. 2. A properly completed apphcation and consent to inspect signed by the applicant. If a Certificate o£ 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, Aceessory building $50.00, Additions to accessory building $50.00, Businesses $50.00: 2. Ceytificate of Occupancy on Pre-existing Building - St00.00 3. Copy of Certificate of Occupancy - $.25 zl. Updated Certificate o£Occupancy - $50.00 ' 5. Temporary Certificate o£Occupancy - Residential $15.00, Commercial $15.00 New Construction: Location of Property: · Owndr or Owners of Property:. ~% C V'~t 'Suffolk .County Tax Map No I000, section. Sulxlivision H~alth Dept. Approval: Planning Board Approval: Request for: Temporary Certificate Date. Old or Pre--exist~g Building: . (check one) se rqo. - Street ' Hamlet - Filed Map... Lot: . Applicant: Underwritem Approval: _ Final Certificate: (check one) Town Hall Annex 543?5 Main Road P.O. Box 1179 $outhold~ 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: Caiola Address: 1430 Clearview Ave City: Southold St: NY Zip: 11071 Building Permit #: 36480 Section: 70 Block: 9 Lot: 54 WAS EXAMINED AND FOUND TO BE IN COMPLIANCE WITH THE NATIONAL ELECTRIC CODE Contractor: as built DBA: License No: SITE DETAILS office Use Only Residential ~ Indoor ~ Basement ~ Service Only ~ Commerical Outdoor 1st Floor Pool New Renovation 2nd Floor Hot Tub Addition Survey Attic Garage INVENTORY Servicelph ~ Heat ~ DuplecRecpt ~ Service 3 ph Hot Water GFCI Recpt Main Panel A/C Condenser Single Recpt Sub Panel NC Blower Range Recpt Transformer Appliances Dr~er Recpt Disconnect Switches Twist Lock Other Equipment: Ceiling Fixtures [~ HID Fixtures Wall Fixtures [~ Smoke Detectors Recessed Fixtures ~ CO Detectors Fluorescent Fixture [~ Pumps Emergency Fixtures[~ Time Clocks Exit Fixtures ~ TVSS in ground swimming pool, self contained hot tub, patio with BBQ, to consist of, 1 control panel, 1 pool light, 1 pump, I GFCl circuit breaker, GFCI protected disconnect for self contained hot tub, GFI' for BBQ deck Notes: Inspector Signature: Date: Aug 1 2011 81-Cert Electrical Compliance Form TOWN OF SOUTHOLD BUILDING DEPT. 765-1802 INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] INS~A~ON [ ] FRAMING/STRAPPING [//3~:INAL [ ] FIREPLACE & CHIMNEY [ ] FIRE SAFETY INSPECTION [ ] FIRE RESISTANT CONSTRU~I'ION [ ] FIRE RESISTANT PENETRATION [ ] ELECTRICAL (ROUGH) [ ] ELECTRICAL (FINAL) REMARKS: ~q-~ ~) TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, NY 11971 TEL: (631) 765-1802 FAX: (631) 765-9502 SouthoidTown. North Fork.net PERMIT NO. BU1LDING PERMIT APPLICATION CHECKLIST I)o you have or need the following, belbre applying? Board of Health 4 sets of Building Plans Planning Board approval Surx ev Septic Form _ '-~ ~ ~ ~ ~ I ~"~' N.Y,S.D.E.C. D ~ I1 _ Fmstees - ~ 2011o '~[[ Flood Permit I~xamined .... ~ ]1~,20'{ ~ Contact: Stornl-Wa*er Assessment Fornl Approved ~flJ 5 . 20 ~ Mail to: Disapproved a/c TOWN O~ SOuT~LO t ~' ' ,~ ~ ~ ~ , ~il~nginspector q~OX APPLICATION FOR BUILDING PERMIT ~ dtJU - O 2011 Date ,20 BP6, I)[}'1. INSTRUCTIONS TOWN OF SOUTHOLO a. This applicatioa MUST be completely filled in by typewriter or m ink and submitted to the Building lnspcctor 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 pretnises or public streets or areas, and waterways. c. The work covered by this application may not be commenced bcIbrc issnancc of Building Permit. d. Upon approval of this application, the Building Inspector will issne a Building Permit to the applicant. Snch a pemfit shall be kept on the premises available tbr inspection throughout thc work. e. No building shall be occupied or used in whole or in pan lbr any purpose what so ever until the Building Inspector ~ssucs a Ce~ificate of Occupancy. f. Every building permit shall expire if the work anthorized has not commenced within 12 months after the date of issuance or has not been completed within l 8 months lkom such date. If no zoning amendments or other regulations aftbcling thc property have been enaclcd in the interim, the Building inspector may anthorize, in writing, the extension of the permit tbr an addition six months. Thereafter, a new permit shall be required, APPLICATION IS HEREBY MADE to the Building Department lbr the issuance cfa Building Permit pursuant to thc Building Zone Ordinance of the Town of Southold, Suflblk County, New York, and other applicable Laws, Ordinances or Regulations, fbr the construction of buildings, additions, or alterations or Ibr 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 authorize~e~r~n ~em.s~a~ i~u~ding lbr necessa~ inspect'o ~s. ~ OCCUPANCY OR ,,iMMEDiAT (~4~ / PO~ TO USE IS UNLAWFUL ..cms ~eSigIlatL're of applicant or name, ifa corporation) UPON CO~L~ WITHOUT CERTIFICATE aEFORE"Wa~f0 W M It971 (Mai ing address of applicant) ' OCCUPANCY co :5, tate whether applicant is owner, lessee, agent, architect, engineer, general cont,-act~0V[D~$1~T~,r builder Nameofownerofpremises ~; ~g Ge~ ~k~ E'J~Lg~N: =E~ (As on the tax roll or late~8~ 8 ~ TO I PM FOR THE FOLLO~NO INSPECTIONS: If applicant is a corporation, signature of duly authorized officer (Name and title of corporate officer) Builders License No.-d~rS/5't./'~0 "' ~ Plurnbers License No. 1. FOUNOATION- TWO REOUfRED FOR POURED CONCRETE 2. ROUGH- F~,I~tUM61NG, STRAPPING, ELECTRICAL & CAULKING 3. INSULATION 4 FINAL. CONSTRUCTION 8, ELECTPICAL MUST BI:: COMP: r~ -OR C C ALL CONSTRUCTION ~A!.L ME:. T 'HE REQUIREMENTS OF THE C~' ~FS OF NEW Electricians License No. ,... I~mmAeRIAl I Other Trade's License No. RESPONSIBLE FOR DEIGN C~STR~TION ERROR / ~o~s~ N~m~r Stm~t ~ Hamlet PURSUANT TO C~P. TER 23~ ~o~ntyTax~ap~o. 1OOO Section ~ Block ~ ~ 0FTHET0W~.Lot Subdivision Filed Map No. Lot 2. state existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy ~'5 l 0~/ ~ b. Intended use and occupancy ~ 1 ~ ~ 3. Nature of work (check which applicable): New Building ~ Addition Repair Removal Demolition Other. Work 4. Estimated Cost ~ ~5~[t ' gl~O Fee ~t ...... ~ (To be paid on filing this application) 5. If dwelling, number of dwelling units ~ Smhg~r gfdw'& lh g units on each floor If garage, number of cars 6. If business, commercial or mixed occupancy, specif~ nature and ext~nt of each type of use. 7. Dimensions of existing structures, if any: Front ~ Rear Height Number of Stories - Alteratig, n (Description) Dimensions of same structure with alterations or additions: Front Depth Height. Number of Stories 8. Dimensions of entire new construction: Front Height Number of Stories 9. Size of lot: Front /tO O Real' [ O O Depth Rear Rear Depth I O. Date of Purchase Name et' Former Owner 1 1. Zone or use district ill which prelnises are situated 12. Does proposed construction violate any zoning law, ordinance or ,'egulation? YES NO ~ 13. Will lot be re-graded? YES NO ~Will excess till be removed from premises? YES NO 14. Haines of Owl'le~ ol-~.l~relllises Name of Architect C--M4-"t Name of Contractor Address Address Address Phone No. Phone Nc~$( '/g-'{' O~O Phone No. 15 a. Is this property within 100 feet cfa tidal wetland or a freshwater wetland? *YES / NO * IF YES, SOUTHOLD TOWN TRUSTEES & D.E.C. PERMITS/MAY BE REQUIRED. b. ls 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 fSUgdafio'n plan and distances to property lines. 17. If elevation at any point on property is at 10 t~'et or'below, must provide topographical data on su~ey. 18. Are there any co,v.eaaBts and restrictions with respect to this property? * YES__ · [F YES, PROVIDE A.COpY. SI'ATE OF NEW'YORk) ., :S~: ,. . COUNTY OF ) . ~~ being duly sworn, deposes and says that (s)he is the applicant abo,¢ aa,a d, '- '? ~, ~1~¢ ..... C~NIE D. BUNCH , ,,,, ,:, O~ ~,:¥:: , ,,~ · ,, Nota~ P~, ~e of New Yo~ (S)tle is [h9 : , .: -.% ? .~¢,~ ~,, ,', ~. 01BU61~ ¢~ontr~tor, A~eat, Corporate Officer, etc.) Oual~ In of said o~w~er or owners, and is duly authorizcd lo perlbrm or have performed the said work and to make and file this application; that all statements contained in this application are true to the best of his ~owledge and belief; and that the work will peHbrmed in the manner set fo~h in the application filed lherewith. S~vora to before ~ne tliis 20,, Notary Public x Signature of Applicant 86/88/2811 87:34 7656641 Jill M~ Doh~rty, President Bob Ghesio, Jr., Vice-President Jmnes F. ~Jng John Bredemeyer BOARD OF TRUSTEES P~GE Town Hall Annex 54375 Main P, oad P.O. Box 1179 Sou~hold, New York 11971-0959 Tel~phone (631) 765-1892 Fax (631) 765-6641 01 June 7,2011 BOARD OF TOWN TRUSTEES TOWN OF $OUTHOLD Mr. Chuck PHncio~a Ca~le Quali~ Homes, inc. 22 Sandra Ddve Hauppauge, NY 11788 RE: GENE & SHARI CAIOLA 1430 CLEARVIEW AVE., SOUTHOLD SCTM#70-9-54 Dear Mr. Princiotta: The Board of Trustees reviewed the survey prepared by John T. Metzger last dated May 6, 201 t and determined the proposed construction of an in-ground swimming pool and spa area with deck to be out of the Wetland jurisdiction under Chapter 275 of the Town Wettand Code and Chapter 111 of the Town Code. Therefore, in accordance with the current Wetlands Code (Chapter 275) and the Coastal Erosion Hazard Area (Chapter 111) no permit is required. Please be advised, however, that no construction, sedimentation, or d!sturbence of any kind may take place seaward of the tidal and/or freshwater wetlands jurisdictional boundary or seaward of the coastal erosion hazard ama as indicated above, or within 100' landward from the top of the bluff and/or wetlands jurisdictional boundary, without further authorization from the Southold Town Board of Trustees pursuant to Chapter 275 and/or Chapter 111 of the Town Code. It ia your responsibility to ensure that all necessary best management practices am taken to prevent any sedimentation or other alteration or disturbance to the ground surface or vegetelJon within Tidal Wetlands jurisdiction and Coastal Erosion Hazard Ama, which may result from your project. This determination is not a determination from any other agency. If you have any further questions, please do not hesitate to call. Jill M.{l;~oherty, President Board 'of Trustees JMD:lms New York State Department of Environmental Conservation Division of Environmental Permits, Region 1 SUNY @ Stony Brook 50 Circle Road, Stony Brook, NY 11790-3409 Phone: (631) 444-0365 · Fax: (631) 444-0360 Website: www.dec.ny.~ov PERMIT MODIFICATION May 27, 2011 Gene and Shari Caiola 27 S Penataquit Avenue Bay Shore, NY 11706 Re: Permit # 1-4738-03804/00001 Caiola Property, 1430 Clearview Avenue, Southold De. ar Mr. and Mrs. Caiola: The Department of Environmental Conservation (DEC) has reviewed your request to modify the above referenced permit in accordance with the Uniform Procedures Regulations (6NYCRR Part 621). It has been determined that the proposed modifications will not substantially change the scope of the permitted actions or the existing permit conditions. Therefore, the permit is hereby modified to authorize: Revised configuration of pool and construction of spa and deck, as shown on the plans prepared by John T. Metzger, last revised 5/6/11, and stamped NYSDEC approved on 5/27/11. This letter is a modification to the original permit and must be available at the job site whenever authorized work is in progress. All Other terms and conditions remain as written in the original permit. CC: C. Princiotta BOH-TW File Sincerely, Mark Carrara Permit Administrator S ) Town of Southold Erosion, Sedimentation & Storm-Water Run-off ASSESSMENT FORM PROPERTY~,,~OO~ION: i~C.T.~ THE FOLLOWING ACTIONS MAYREQUIRETHESUBMISSIONOFA STORM-WATER~ GRADING~ DRAINAGE AND EROSION CONTROL PLAN o~ct Se~on Stuck ~ , C"k~iriED BY A D"~i~, PROFESSIONAL IN THE STATE OF NEW YORK. SCOPE OF WORK - PROPOSED CONSTRUCTION ITEM# / WORK.ASSESSMENT ] Yes No a. Wbet is the Total ^.e of the Project Parcels? 5F !^~c~s"~'r-- 1 VVitl this Project Retain All Stmre-Watar Run-Off (Include Total Area of all Parcels located within ~ Generated by a Two (2') Inch Rainfall on Site? the Scope of Work for Proposed Construction) (~.~ (This item will include all run-off created by site b. What is the Total Area of Land Cleedng ~ v) ~O~ cleedng and/or construction activities as wall as all sad/or Ground Distulbance for the proposed ~[/OA/.~' ~_~OZ) ) Site Improvements and the permanent creation of constrection ectivily? impervious surfaces.) tS.F.,,~.) 2 Does the Site Plan and/or Survey Show Att Proposed PROVIDE BRIEF PROJECT DESCRIFTION iP,o,,a. Addl0o~al pages as N~ Drainage Structures Indicating Size & Location? This ,~ n item shall include all Proposed Grade Changes and 'St~~ //~ ~'/~....." Slopes Controlling Surface Water Flow. /6, x'/~0 ..~-~ ~7 ~C~J/) /~ ~ 3 Does the Site Plan and/or Survey describe the erosion and sediment control practices that will be used to control site erosion and storm water discharges. This -- item must be maintained throughout the Entire Construction Peded. 4 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 YardsI~l -- of Material within any Parcel? 5 Will this Application Require Land Disturbing Activities rii Encompassing an Area in Excess of Five Thousand (5,000 S.F.) Square Feet of Ground Surface? 6 is there a Natural Water Course Running through the Site? Is this Project within the Trustaes jedsdiction General DEC SWPpp Requirements: or within One Hundred (100') feet of a Wetland or Submission of a SWPPP is rsquired for all Conslmction actNities involving soil Beach? disturbances of one (1) or more ecrus; including disturbances of less than one acre that 7Will there be Site preparation on Existing Grade Slopes ~ am part of a isrger common plan thai will ultimately disturb one or more acres of land; which Exceed Fifteen (15) feet of Vertical Rise to I I im~uding Construction activities involving soil disturbances of less than one (1) acm where One Hundred (100') of Horizontal Distance9 I~l the DEC has determined that a SPDES permil is required for slo~n water discharges. SWPPP's Shall meet the Minimum Requirements of the SPDES General Permit 8 Will Driveways, Parking A~eas or other Impervious f~r storm Water Di$charaes from Construction activity - Permit No. GP-0-10-001.) Surfaces be Sloped to Direct Sthm~-Water Run-Off~ 1. Tee SWPPP shall be prepared pber to the submi~al of the NOL The NOI shall be into and/or in the direction of a Town right-of-way? STATE OF NEW YORK, Notary Public, State of New York COUNTY OF ........................................... SS No. 01BU61850~0 ^ Qualified in Suffolk County says that he/she isthe appficant for e~t, And that he/she is the Omler and/or representative of the Ovmer or Owners, and is duly authorized to perform or have performed the said work and to make and file this application; that all statements contained in this application are t~ue to the best of his knowledge and belief; and that the work will be performed in the manner set forth in the application filed herewith. Sworn to before me this; FORM - 06/10 Town Hall Annex 54375 Main Road P.O. Box 1179 $outhold, NY 11971-0959 Telephone (631) 765-1802 ro,q e r. riche rtd$~n3.ts)o7 u~'l~5o(~(~ .ny.us BUII,r)ING DEPARTMENT TOWN OF SOUTHOI.D APPLICATION FOR ELECTRICAL INSPECTION ~ompany Name: Name: License No.: Add~ess: Phone No.: JOBSITE INFORMATION: (*Indicates required information) *Name: ~--~/~' I OL. ,X~ *Address: *Cross Street: *Phone No.: Permit No.: ~(~ ~/~'O Tax Map District: 1000 Section: *BRIEF DESCRIPTION OF WORK (Please Pdnt Clearly) Block: Lot: · (Please Circle All That Apply) *Is job ready for inspection: *Do you need a Temp Certificate: Temp Information (If neededl *Service Size: 1 Phase *New Service: Re-connect Additional Information: YES/NO Rough In Final YES / NO 3Phase 100 150 200 300 350 400 Other Underground Number of Meters Change of Service Overhead PAYMENT DUE WITH APPLICATION 82~Request for Inspection Form 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 August 16, 2011 Gene & Shari Caiola 27 S. Pentaquit Ave Bay Shore, NY 11706 TO WHOM IT MAY CONCERN: The Following Item(s) Are Needed To Complete Your Certificate of Occupancy: _~^pplication 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 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: 36480 - In-ground Pool and Spa 04,/21/2011 12:05 FAX 651 351 1700 BORG & BORG STATE OF NEW YORK WORKERS' COMENSATION BOARD CERTIFICATE OF INSURANCE UNDER NYS DISABILITY BENEFITS LAW ~001 =ART 1. To be compleX, by Disability Benefits Carrier or Licensed Insurance Agent or that Carrier $ a. Legal Name and Address of Insured (Use street ~ddress only) ~estle Quality Homes Inc. 22 Sandra DHve ~mithtown, NY t t788 ~.. Name and Address of Enffiy Requesting Proof o1 Coverage iEntity Being Listed as Certificate Holder) I'own of Southhold ~uilding Department ~outhhold, NY 11971 Policy Covers: a. b. C. lb. Business Telephone Number of Insured (631)883-1182 1¢. NYS Unemployment Insurance Employer Registration Number of Insured ld. Federal Employer Identification Number or Social Security Number 11.-3609074 3a. Name of Insurance Carder Fimt Rehabilitation Ins. Co. 3b. Policy Number of entity listed in box "la': 227246 3c. Policy effective period: 01/07/0501/07/12 [ AII for the employer's employees eligible under the New York Disability Law Only the following class or ¢'Jesses of employer's employees: Jnder penalty of perjury, I cen~y that I am an authorized representative or licensed agent of the insurance cartier ~eferenced above and that the named insured has NYS._lDisability Benefits insurance ~(e')age as described above. MPORTANT: If b~x 4a is che~knd, end this fomq is signed by the insurance ca~ier's authorized ra~resanta0~'e or NY$ Licensed InsuranCe Agent of Hat career, his cerlffmath is COMPLETE. Mail it directly to the ~e~tir~e holder. f Ixlx '4b' b {~le~ed. this certificate is NOT COMPLEi t: for the purposes of .~,ction 220, Subd. 8 of Ihs Disability Benefi~ Law. It mu~ be maae<l for oompletJon o the Workem' Compensation BoanJ, DB Plans Acceptance Unit, 20 Pan~ S~ee[, Albany, New York 12207 ]ART 2. To be completed by the NY$ Workers' CompenasUon Board (Only if box "4b" of Part t has been checked) State of New York Workers' Compensation Board ~ccording to information maintained by the NYS Workers' Compen,~aUon Board, the above-named4nsured employer has coml~ied with the NYS )isability Benefits Law with eeapect to all or ht~/her employees. )ate Signed .By: I-ete~hone No. (siSnstum ef NYS Wedmrs' Compe~r~fion 6ea~ Employee) =ISSSS Notre Only insurance ceniem licert~ed to ~ NY$ disability ben~ite Inaumnee poli~iss and NYS lieerme irmurance agents of hose insurance r. awiem am authorized to issued Form D~.120.1. Issuranse Brokem em not authorized to i~ue this feint. )B120.1 (5-06) 04/08/2011 08:17 FAX 18314211852 RSF [NS. / RTL ~014/022 ~ .3G,~u,~ 'mm -,.~-~_~ ,,.=..,_.~ EXECUTIVE .c:UPER--'~ 91580 27,800.00 ~ ~ ~ ~ ~ ~ GO~T OF SUB8 91583 S0,000.OO VACANT BUILDINGS ~ ZSO0 SQF"I SEE ATTACH VACANT BUILDINGS 68606 ~500 8QF'T SEE ATTACH VACANT LAND 470~1 SEE A'CrACH ~ (EXI~dn aH "Yin" m~n~m~Bt New York State Insurance Fund Workers' C-~ ~ens~ & DisObey B en~J~ ~cialists Since 1914 8 CORPORATE CENTER DR, 3RD FUR, MELVILLE, NEW YORK 11747-3129 Phone: (631) 756~300 CERTIFICATE OF WORKERS' COMPENSATION INSURANCE AAAA 113604074 CASTLE QUALITY HOMES INC 22 SANDRA DRIVE SMITHTOWN NY 11787 POLICYHOLDER CASTLE QUALITY HOMES INC 22 SANDRA DRIVE SMITHTOWN NY 11787 CERTIFICATE HOLDER TOWN OF SOUTHOLD BUILDING DEPARTMENT SOUTHOLD NY 11971 I POLICY~IMBER .... ,~ CERTIFIcA~ENuMBER~ PERIOD COVERED BY THIS CERTIFICATE 1327_ ~7'5 ~ 570751 L 04/19/2011 TO04/19/2_012 _ ~4/21~011_ THIS IS TO CERTIFY THAT THE POLICYHOLDER NAMED ABOVE IS INSURED WITH THE NEW YORK STATE INSURANCE FUND UNDER POLICY NO. 1322337-5 UNTIL 04/19/2012, COVERING THE ENTIRE OBLIGATION OF THIS POLICYHOLDER FOR WORKERS' COMPENSATION UNDER THE NEW YORK WORKERS' COMPENSATION LAW WITH RESPECT TO ALL OPERATIONS IN THE STATE OF NEW YORK, EXCEPT AS INDICATED BELOW. IF SAID POLICY IS CANCELLED, OR CHANGED PRIOR TO 04/19/2012 IN SUCH MANNER AS TO AFFECT THIS CERTIFICATE, 30 DAYS WRITTEN NOTICE OF SUCH CANCELLATION WILL BE GIVEN TO THE CERTIFICATE HOLDER ABOVE. NOTICE BY REGULAR MAIL SO ADDRESSED SHALL BE SUFFICIENT COMPLIANCE WITH THIS PROVISION. THIS POLICY DOES NOT COVER CLAIMS OR SUITS THAT ARISE FROM BODILY INJURY SUFFERED BY THE OFFICERS OF THE INSURED CORPORATION. CHARLES PRINClOTTA (PRES) OF A ONE PERSON CORPORATION HAS ELECTED TO BE EXCLUDED FROM THE POLICY OF CASTLE QUALITY HOMES INC THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLYANDCONFERS NO RIGHTS NOR INSURANCE COVERAGE UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICY. NEW YORK STATE INSURANCE FUNn DIRECTOR,INSURANCE FUND UNDERWRITING This certificate can be validated on our web site at https~N~w, nysif.com/cerl/certval.asp or by calling (888) 875-5790 VALIDATION NUMBER: 659952113 N S.C.D.H.S. REF. NUMBER R-10090056 LOT COVERAGE EXISTING - 4090 sq. lL 4090/23600 ~n~ = 17% AT COMPLETION OF IMPROVEMENTS 4592 s~fh 4592/25600= 19.4% ? / ? ? '~ ELEVA TIO~.S ABE REFERENCE'D TO THE FIVE EASTERN TOWNS TOPOeRAPH1C IV~J~$ (N~VDI LOCA T/ON OF SEPTIC SYSTEM FROM OTHERS. m=MONUMENT LOT NUMBERE REFER TO '"SUBDIVISION MAP SMITHFIELD PARK" FILED IN THE SUFFOLK COUNTY CLERK'S OFFICE ON DECEMBEQ 27, 1966 AS FILE NO. 4770, ANY ALTERATION OR ADDITION TO THIS SURlilY IS A VIOLATION OF SECTION 72090F THE NEW YORK STATE EDUCATION LAW. EXCEPT AS PER SECTION 7209-SUBDIVISION 2. ALL CERTIFICATIONS HEREON ARE VAUD FOR THIS MAP AND COPIES THEREOF G~IL Y IF SAID MAP OR COPIES BEAR THE IMPRESSED SEAL OF THE SURVEYOR iM"COSE SIGNATURE APPEARS HEREON. SURVEY OF PROPERTY A T SOUTHOLD TOWN OF SOUTHOLD SUFFOLK COUNTY, N.Y. 1000-70-09-54 SCALE: 1%30' DECEMBER 5, 2006 APRIL 3, 2007 (PROP. ADDItiONS) FEB. l, 2008 (WETI_AND FLAGS) ~ARC>/ ~0, 2OO8 (LOT COVERA~) JUNE 27, 2008 (REWSIONS) JULY 28, 2009 (ADDITIONS) DECEMBER 29, 2010 (FINAL.) MAY 6, ZOll L&DOITION$I NYSDEC APPROVED AS PER AND CONDITIONS OF (*("C;: )0 (~sO 7~5-50:~-r-ca~(630 7~5-~7~7 P.O. BOX 909 12~0 ~A ~LER S~EET ~ sOUrHO~O, N. : .~7~I 06-253 Technical Specifications - Ra inier Privacy Fence With Lattice 6'~all x 8' Or 6' Wide Sections 95.75' 1.5' x 5,5" x 95-75' 5 1/2" 48 112" I/2' A Vinyl Fenc¢&De. ckWholesaler 8' CURVED PLASTIC STEP 1'~6 7/8" R6'-6" ~'-6 ~/4" y I'-6, 7/8'' 5 -1 '-3" R 2'--0 R6'-6" 6'-0 1/ 6~ 6'-3" 6'-3' 30' NOTE: THIS IS -I 27'-11 5/4" VIEW ACROSS HOPPER CENTERLINE NON DIVING POOL TE- ~HE IN~ERIOR DIG SPECIRCAI~ONS ILLUS~TEO ON AREA = 385.8 SO. Fi'. PERIMETER = 78'-7 ~" CARDINAL SYSTI o~'~ 4/9/10 ~ 15' X ~ "- 1' KlOi~ 3/16- n ~ ~ LR ~ ~ ' dE ~S ~0' [¥ '¢15021 I/¢"-- ILo" APP. ROVED AS NOTED OCCUPANOY OR FE~ .¢_~4--.~, ~¢ NO.rIFy BUILDING DEPARTME~ ~-~ USE ,e 765 1802 8 AM fo 4 PM FOR ~,:' UNLAWFUL ~ou~o~.~ ~s~c~o~. OF (., '~(.,'L , l u~L,~ 8TRAPP NG ELEC,rRICAL & CAULv,~,,S ~ .~, ........ 4 FINAL'CONSTRUCTION&ELECTRiCqL "'.,. ',.,, -',: ,'.LY"MUSTBE COMPLETE FOR C O ENCLOSE POCL 70 CODEALL CONSTRUC,rfON SNALL MEET THE UPON COMPLETION ~EQUIREMEN'rs OF 'rile CODES OF N£W 'BEFORE"WATER. YORK STATE ~T RESPONSIBLE FOR