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HomeMy WebLinkAbout35629-ZTown of Southold Annex 54375 Main Road Southoid, New York 11971 CERTIFICATE OF OCCUPANCY 10/6/2011 No: 35267 Date: 10/6/2011 THIS CERTIFIES that the building Location of Property: SCTM #: 473889 Subdivision: 1N GROUND POOL 1100 WESTPHALIA RD MATTITUCK, N.Y. 11952, Sec/Block/Lot: 114.-7-14.1 Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this officed dated 6/9/2010 pursuant to which Building Permit No. 35629 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: "as built" accessory in ground swimming pool with fence to code as applied for. The certificate is issued to Milienos, Savas & Milienos, Joanne (OWNER) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL ELECTRICAL CERTIFICATE NO. PLUMBERS CERTIFICATION DATED 35659 10/5/11 fized Signature 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. 35629 Z Date JUNE 9, 2010 Permission is hereby granted to: SAVAS & JOANNE MILIENOS 118 KNICKERBOCKER ROAD MANHASSETT,NY 11030 for : "AS-BUILT" IN-GROUND SWIMMING POOL IN THE REAR YARD AS APPLIED FOR. REPLACES EXPIRED BP ~ 33750 at premises located at 1100 County Tax Map No. 473889 Section 114 pursuant to application dated JUNE Building Inspector to expire on DECEMBER WESTPHALIA RD MATTITUCK Block 0007 Lot No. 014.001 9, 2010 and approved by the 9, 2011. Fee $ 500.00 Authorized Signature Rev. 5/8/02 ORIGINAL 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 subraitted 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 0fFire Underwriters. 4. Sw. om 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'/ I. Accurate survey of proPerty showing all property lines, streets, building and. unusual natumi or topographic features. 2. A properly c~mpleted 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. Cortiflcaie of Occupancy - New dwelling $50.00, Additions to dwelling $50.00, Alterations to dwelling $50.00, Swimmir~g pool $50.00, Accessory building $50.00, Additions to accessory building $50.00, Businesses $50.00. 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 $ l 5.00 Date. New Construction: Old or Pre-existing Building: (check one) Location of Property: I i (~0 ~/~t~'~-~O--~/iC~, ~%~ House No. Street Hamlet - Owner or Owners of Property: - Suffolk County Tax Map No 1000, Section Subdivision (iq pextnit No. 3~ {9,~ Date of Permit. Health Dept. Approval: __ Planning Board Approval: Request for: Temporary Foe Submitted: $ Block Filed Map., Applicant:. Lot: Underwriters Approval: 2011 BLDG DLP¥ T0¢/~l OF SO[ITFfOLD F icate: (check one) ' ~ Signature Town Hall Annex 54375 Main Road P.O. Box 1179 Southold, NY 11971-0959 Telephone (631 ) 765-1802 Fax (63 I) 765-9502 rofler.dchert~town.southold.nv.us BUILDING DEPARTMENT TOWN OF SOUTHOLD CERTIFICATE OF ELECTRICIAL COMPLIANCE SITE LOCATION issued To: Milienos Address: 1100 Westphalia Rd City: Mattituck St: NY Zip: 11952 3uilding Permit #: 35659 Section: 114 Block: 7 Lot: 14.1 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 Service 3 ph Hot Water GFCI Recpt Main Panel NC Condenser Single Recpt Sub Panel PJC Blower Range Recpt Transformer Appliances Dryer Recpt Disconnect Switches Twist Lock Other Equipment: Ceiling Fixtures [~~~ HID Fixtures Wall Fixtures I I Smoke Detectors Recessed Fixtures CO Detectors Fluorescent Fixture U Pumps Emergency Fixture~ Time Clocks Exit Fixtures TVSS in ground swimming pool to include, bonding, cover motor, pool light, heat pump Notes: Inspector Signature: Date: 81-Cert Electrical Compliance Form TOWN OF SOUTh. MOLD-BUILDING DEPT. INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] INSU~.AI'ION [ ] FRAMING / STRAPPING [ ,~j"FINAL [ ] FIREPLACE&CHIMNEY [ ] FIRE SA,-.. ~ ,f lNSPECTION [ ] FIRE RESISTANT COftS'TRt/CTI~ [ ] FIRE RESISTANT PENETRATION REMARKS://~// ~/~ ~ .~/~'~ DATE TOWN OF SOUTHOLD BUILDING DEPT. 765-1802 INSPECTION ] FOUNDATION 1ST ] FOUNDATION 2ND ] FRAMING / STRAPPING ] FIREPLACE & CHIMNEY [ ] ROUGH PLBG. [ [ ] INSU/U.J-ATION [//]~NAL [ ] FIRE SA,-.., ,ir INSPECTION [ ] FIRE RESISTANT CONSllWCTlON [ ] FIRE RESISTANT PENETRATION REMARKS: I~I2ELD 12NS?ECTION REPORT FO~ATION (1ST) FO~DATION (2ND) ROUGH F~G & I LNSULATION PER STATE ENERGY CODE m 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 ~i~} 20 0~ Approved g ,20 ~)~ Disapproved a/c / Expiration ~1 ~ ~ [~ ~ ~ [~ '-. ~ Building Inspector { ~LD ~. DEPT. TCWN 0F q~"~O' ~ Datc INSTRUCTIONS BUILDING PERMIT APPLICATION CHECKLIST Do you have or need the following, before applying? Board of Health 4 sets ofBuilding Plans // Plarming B.~ard approval Survey ~ Checkz~ Septic Form N.Y.S.D.E.C. Trustees Contact: Mail to: ~'i,,3D ruth ¢f1200 }S Phone?/qq -~ I00 tt~q ~ j~a.l~ /2') ,20 07 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 untii 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 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. ENCL08[ POOLTO CODE ALL CONSTF~U :7: :!i ?~ ' L I.~ON COMP[ETlON MEET THE REQUIRi: ' ' , '~E ~- (Signature offapplicant or name, ifa corporation) BEFORE "WATER" CODES OF NEW ?;: ": · I) IIEIt$ CEP, TIFICATE (Mailing aCdress of applicant) '-REOUIRED bu.[ . State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electnman, plumber or builder ,. ..... .... (As on the tax roll o¢tfife~'dbed)~; If applicant is a corporation, signature c~l~y~[~ ' ! lot" ~t~ ~ ~ ........ 1 "i .......... (Name and title of corporate off~J)k' lO (./I~/L~I~/~-[.![ ' _ WITHO ,- - .,',., · . UTC r' .... Butlders L~censeNo. ,-~-t14 ,9, 4 ~, Plumbers License No. Electricians License No. ~ iq i /~ Other Trade's License No. Location of land on which~ proposed work w_jll be done: I O0 Qh u [4& House Number Street County Tax Map No. i000 Section Subdivision ,e%c[~ (Name) 4. FINAL - COl/$'.; '7: 'O5! "JUST BE CO3/~PcE'iE , 5; ¢ ALL CONS'rRucqfDN S¥%L ;,tEST THE REQUIREMENTS OF T 17 C 5525 c)F NEW YORK STATE. I:0T RLS?ONS~¢LE FOR H~UANT TO CHar/~ 2~ 0F IHE TOWN Filed Map No. ~ q q Lot State existing use and occupancy of premises and inte~:led use and occupancy of proposed construction: a. Existing use and occupancy ~q~¢ ]~'d~ ¢4C~e.~i~ f. b. Intended use and occupancy qlr)c~l{. ~-~Lm~ 3. Nature of work (check which applicable): New Building Repair Removal Demolition Addition Alteration. Other Work (Description) Fee (To be paid on filing this application) Number of dwelling units on each floor 4. Estimated Cost 5. If dwelling, number of dwelling units If garage, number of cars 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 Dimensions of entire new construction: Front Height Number of Stories Rear 9. Size of lot: Front Rear .Depth 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 __ NO Cot 14. NamesofOwnerofpremises~a~tlS [~' li*-n0~-~Address 1100 [,I.)~.~t0~tt PhoneNo. Name of Architect ~0q~ Address I~,~ ~ Phone No Name of Contractor ~d~W ~tc~ Address ~qlX g4< 2~PhoneNo. ngq- ~ ~00 15 a. Is ~is prope~y within 100 feet of a tidal wetl~d or a ~eshwater wetl~d? *YES__NO * IF YES, SOUTHOLD TO~ TRUSTEES & D.E.C. PERMITS MAY BE ~QUIRED. b. Is this prope~y within 300 feet ora tidal wetland? * YES~ NO~ * IF YES, D.E.C. PE~ITS MAY BE REQUIRED. 'h 16. Provide s~ey, to scale, with accurate foundation plan ~d dist~ces t0 g~ope~y lines. 17. If elevation at ~y point on prope~y is at 10 feet or below, must provide topo~aphical data on su~ey. STATE OF NEW YO~) : ~ .: ~ SS: CO~TY OF ) '~ ~ ~K~ being duly sworn, deposes and says that (s)he is the applicant (Name of individual si~ng contract) above named, (S)He is the ~ O ,a~ acW ~ (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 application; that all statements contained in this application are true to the best of his knowledge and belief; and that the work will be performed in the manner set forth in the application filed therewith. ' Nota~ Public ] ~ ~,.,. ,,.~ KATHI.EEN QUIGLEY · NOTARY PL~LIG, Stale of N~w ,~.~0 ~ ~ l~ _ ~0~124124 Signature of Applicant New York State Department of Environmental Conservation Division of Legal Affairs, Region One Building 40 - SUNY, Stony Brook, New York 11790-2356 Phone: (631)444-0260 · FAX: (631)444-0348 Website: www.dec.state.ny.us Alexander B. Grannis Commissioner Mr. Randy Rodecker, Pres. Swim King Pools 471 Route 25A Rocky Point, NY 11778 Re: R1-20071120-327 Dear Mr. Rodecker: December 10, 2007 Enclosed please find a copy of the fully executed Order on Consent and a receipt in the amount of One Thousand ($1,000) Dollars with regard to the civil penalty in the above referenced matter. Sincerely, Carole A. Gajewski Secretary I Legal Affairs /cag enclosure STATE OF NEW YORK DEPARTMENT OF ENVIRONMENTAL CONSERVATION In the Matter of the Violation(s) of Articles 15, and/or 25 and 7i, as indicated below, of the New York State Envh-o~unental Conservation La,v, by: Swim King Pools - Respondent(s) (Suffolk County) ORDER ON CONSENT FILE NO. 1- 7 // io ' of Waters) prohibits conducting any regulated activities in any of the navigable waters or protected streams of the State without the requisite permit, or in noncompliance with the requisite permit; and WHEREAS, Article 25, Title 4, of the New York State Environmental Conservation Law, (Tidal Wetlands Act) prohibits conducting any regulated activities on or adjacent to any tidal wetland without the requisite permit, or in noncompliance with the requisite permit; and WHEREAS, the Department of Environmental Conservation (DEC) has documented a violation of said statutes, specifically Section 25.401.1 , Section , and Section , in that Respondent(s) eansed and/or pertained to be caused, Installation of a svvimmin~ pool in a regulated area adjacent to a tidal wetland at 1100 Westphalia Rd in Mattitu¢l~, on or before 10/22/2007; and WHEREAS, Respondent(s) has/nave affn-rnatively waived his/her/its/their right to a public heating in this matter in the manner provided by law and having consented to the entering and issuing of this Order, agree(s) to be bound by the terms and conditions contained herein. NOW, having considered this matter and being duly advised, it is Page I ORDERED, that wi[~spect to the aforesaid violation(s), there is hereby imposed upon Respondent(s), a penalty in the sum of ( $1 ~250.00 ) Dollars, of which ($1,000.00) ) Dollars shall be made payable by certified check or money order to the NE~S Department of Environmental Conservation upon the siginng of this Order, and the remain/ng ($250.00)'~Dollms to be suspended provided Respondent(s) smctly adhere(s) to the terms and conditions outlined in this Order, including Schedule A, the compliance schedule attached hereto and made part hereof; and it is ORDERED, that this Order shall not become effective until it is executed by the Regional Dkector on behalf of the Coroanissioner, and the date of execution by the Regional Director shall be the date of execution of this Order; and it is further ORDERED, that in those instances in which the Respondent(s) desire(s) that any of the provisions, terms or conditions of this Order be changed, (s)he/it~they shall make written application, setting forth the grounds for the relief sought, to the comrmssioner, c/o Regional Attorney, New York State Department of Environmental Conservation, Building 40, State University Campus, Stony Brook, New York 11790-2356; and it is further ORDERED, that Respondent(s) shall strictly adhere to the terms and conditions outlined in tiffs Order and in Parts I, ii, and/or III of Schedule A, the compliance schedule attached hereto and made a part hereof; and it is further ORDERED, that any change in this Order shall not be made or become effective, except as specifically set forth by written order of the Commissioner, such written order being made either upon written application of the Respondent(s) or upon the Commissioner's own findings; and it is further ORDERED, that this Order shall be deemed binding on the Respondent(s), it/his/her/their successors and assigns and all persons, firms and corporations acting under or for it/him/her/them, including, but not limited to those who may carry on any or all of the operations now being conducted by Respondent(s), whether at the present location or at any other in this State; and it is f~rther ORDERED, that the failure to pay any penalty amounts due under the terms and conditions of this Order may result in a 22% surcharge i~ recovery costs and a potential tax refund offset by the Department of Taxation and Finance, and it is further ORDERED, that a dishonored check fee of Twenty ($20.00) Dollars will be charged for all checks which are returned for insufficient funds. Dated: Stony Brock, New York ~'~re~ ~.-['~'.~ ~. C:' , 2007 Alexander B. Grannis comrmssioner of Environmental Conservation By ~Se~u ly Regional Director To: Kathy Quigley Swim King Pools, Inc. .471 Route 25A Rocky Point, NY 11778 NOV#: 07AF257 Page 2 CONSENT BY RESPON_DENT (Business Entity) Respondent acknowledges . . . . . the authorltv and Jurisdiction of the Commissioner of Environmental Conservation of the State of New York to is~sue the foregoing Order, waives public hearing or other proceeding in this matter, accepts the terms and conditions set forth in the Order and consents to the issuance thereof. Respondent Busi~Entity: By (signature):/~ Q~¢.~/~ y/_, , ~ ! - an individual dually authorized by respondent to sign on behalf of the business entity named herein and Whom may bind respondent to the terms and conditions contained herein. Date: NOTE TO NOTARy: The correct acknowledgment from below MUST be utilized for signing in New York State versus outside New York State. All blanks MUST be completed. ACKNOWLEDGMENT (Signing within New York State) STATE OF NEW YORK ) COUNTY OF-~;CC~&i}d. ) O O n the I/~ day of ~O~'E.~qt)cn,~ ,200 ~ before · ]~'~(Liqd( ~'fY~ E C ~ ~--. me, the undersl ned I~ fYg~ ~C ~ g , personall a say that (s)he resides at '~?l ~'-~ ~ ~ ~',a , p~erso, uaH~ known to me who, beine dun ~w,,.,. -,-~ ~ y ppeared nnpose and Not/dry Public, . ~ACKNOV~LED~MENT (SignJu~ outside New York ) ) On the_ day of ,200._.__._, before me, the undersigned, personally appeared (s)he resides at , personally known t? me who, being duly sworn, did depose and say that ~ of -----___.., that (s)he is the~ ~l-in e of business enti d-'~-Scribed , the herein and which execute~ the above instrument; and that (s)he signed her/his name thereto with fnH authority so to do and that such individual made such appearance before the undersigned in the _* * Notary Public · (Insert the State {& CountyJ, District of Columbia, Territory, Possession or Foreign acknowledgment was taken.) Country the · * (/nsert the city or other political subdivision and the state or COUntry or other place the acknowledge:cut was taken.) · ** (Signature and office ofindivldual taking acknowledgment) Page 3 .SCHEDULE A Compliance Schedule for Article(s) 15 and/or 25 GENERAL REQUIREMENTS: humediately, Respondent (s) shall cease and desist from any and all future violations of the New York State Environmental Conservation Law and the rules and regulations enacted pursuant thereto. Respondent (s) shall submit photographs of the completed work, if any, required under this schedule, to the DeparUnent within five (5) days of its completion. All submittals to the Department required under this Order shall be made by Respondent (s) as follows: 1) One copy to the Legal Affairs Office, Region One, New York State Deparlment of Environmental Conservation, Building 40, S.U.N.Y., Stony Brook, New York 11790-2356; -and- 2) One Copy to Marine Habitat Protection, Region One, New York State Department of Environmental Conservation, Building 40, S.U.N.Y., Stony Brook, New York 11790-2356. II. REMOVAL REQUIREMENTS: Within days fi.om'the date of the execution of this Order, Respondent (s) shall have removed the sUmcUn'es and/or fill which are the subject of this Order as follows: Removal Specifications: none  No Removal Required Page 4 Schedule A (Contd.) III. RESTORATION REQUIREMENTS: Within thirty (30) days from the date of the execution of this Order, Respondent(s) shall submit to file Department, an approvable* restoration plan and time schedule for implementation of said plan. *Approvable in the context of this Order shall mean approvable by the DEC with minimal revision. Minimal revision shall mean th~tt Respondent(s) incorporate(s) the revisions required by the DEC and resubmits the plan for approval within fifteen (15) business (;lays of receipt of the DEC's comments. This plan shall include: r-1 Regrading Plantings in disturbed area Specifications: All pool dischame must be directed into a dry well at least 100' landward of the tidal wetland boundary Other: Upon written approval by the Department, Respondent(s) shall implement the approved restoration plan in accordance with the approved time schedule. Said maintenance shall ensure a success ratio ofnt least 85% for a 5 year time frame from completion of plantings.  No Restoration Required. Page 5 Erosion, Sedimentation and Storm-water Run-off Control Plan ASSESSMENT FORt.'. .EXEMPTIONS: Yes l~o A. Does this project meet the n~nimum standards for classification as a ~ Agricultural Project. ~' Note: f you answered Yes to any of the above, a Storm-water, Grading, Drainage & Erosion Control Plan is not require. ACTIONS REQUIRING THE SUBMISSION OF A STORM~WATER~ GRADING~ DRAINAGE & EROSION CONTROL PLAN CERTIIolED BY A DESIGN PROFESSIONAL IN THE STATE OF NEW YORK. ' !tern Number: (A Check Mark (J) for each question is required for complete application) Yes ]No 1. Will this project retain all Storm-Water Run-off generated on Site? (This will include all m-off created by site clearing and/or construction activities as well as all Site Improvements and the permanent creation of impervious surfaces.) / ~ 2. 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? 3. 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 running through the site or is this project within One hundred (100) feet of wetlands or a beach? Will there be site preparation on slopes which exceed fifteen (15) feet of vertical rise to One hundred (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? (This item does not include the installation of driveway aprons.) one hundred (100) year floodplain of any watercourse? 8. Will there be site preparation within the Note: If any answer to questions ~)ne through eight is answered with a check mark in the BOX, a Storm-water, Orading, Drainage & Erosion Control Plan is required and must be submitted for review prior to issuance of any building permit. STATE OF NEW YORK, COUNTY OF .. . ss l~aat I,~i..}[~a.~'ldq T ~)0C}fihl/-~F'- being ................................................................ duly sworn, deposes and says that he/she is the applicant for Permit, (Name of individual signing Document) And that He/She is the {~ ora {-f~.(4'D ./ (Owner, Contractor, Agent, Cmpontte Olticeh etc/ Owner and/or representative of the Owner or Owner's, and is duly authorized to perfomt or have performed the said work and to make and file this application; that all statements contained in tiffs application are tree to the best of his knowledge and belier; and that the work sill be performed in the manner set forth m rite application filed herewith. Sworn to before me this; ................. ...... :...(..day ............ 20 .U.. r- Notary P u b 1~'6~1[~ .~ ¢L)~..~ KATHi..I~M ~kl!¥ co~mm~ ~ ~ ~, a0_O_ ~ To~ ~ 543?5 bhin Road P.O. Box 1179 ,%uthoki, NY 1 Telephone (631) 765-1800 · 631)7 .5 rog er. nchert~,t~,~, so~ur~So~, nv. us BL~.~ING DEPAIITMENT TOWN OE $OUTHOLD APPLICATION FOR ELECTRICAL INSPECTION REQUESTED BY: Company Name: Name: License No.: Address: Phone No.: Date: JOBSITE IN:FORMATION: (*Indicates required information) *Name: *Address: *Cross Street: *Phone No.: Permit No.: Tax. Map District: 1000 Section: / / 9 Block: ~RIEF DESCRIPTION OF WORK (Please Pgnt CleagyL ' Lot: ' //--/. / (Please Circle All That Apply) *is job ready for inspectiOn: *Do.you need a Temp Certificate: ~)NO YES / NO Rough In Temp Information (ff needed} *Service Size: 1 Phase *New Service: Re-connect Additional Information: 3Phase 100 150 ~)300 350 400 Underground Number of Meters Change of Service PAYMENT DUE WITH APPLICATION /oo. Oo Other Overhead 82q:~quest for Inspection Form · '/o0~-//y-?_,~OWN OF'SOUTHOLD pROpERTY RECORD CARD OWNER STREET ,//?, ?% VILLAGE DIST, SUB. LOT / ti(, .~.~~=~,,O' S~S. VL. FA~ ~M. CB- ~lS~.' .'Mkt. Value ~~," ~ND IMP. TOTAL DATE REMARKS ~o ~ ~ ~ ' ...... "h ' ' ' " ' " " 4 "" '' Tillable 3 Woodland .~~-~' '~' ~~L"/ .~fl~ ~(~' :;- / /~ Swampland FRONTAGE ON WATER Brushland FRONTAGE ON ROAD ,j Mouse Plot DEPTH ~..~ BULKH~D -~. rot~l [ D~K M. Bldg. Extension Extension Extension Porch Porch Breezeway Garage Patio Total o Foundation ~ Both ~asement /~/~ ~//_~ Floors 0/~ ~ Ext. Walls ~.x~..~. Interior Finish Fire Place ;Heat O//~ Type Roof Recreation Roor~ Dormer Driveway Rooms ]st Floor Rooms 2nd Floo: ' ~inette LR. DR. BR. FIN. B. l'ox~n Hall Annex 137,5 M:fin R~ml PAL Box 1179 S~nlll~ld, NY I 1!t71 rl'Clt, l)hollC ((;:11 ) 763-180~2 I~ax (631) 7(;,%51502 IH T]I J)IN(; 1)ICIL,\RTMI~NT TOWN OF SOUTHOLD May 19th, 2008 FIRST NOTICE Savas & ,Toanna Milienos 118 Knickerbocker Road Manhassett, N.Y. 11030 RE: 1100 Westphalia Rd. (AS-BUTLT TN-~qOUND SW~IMMTNG POOL) SCTM: # 1000-15114.-7-14.1 To Whom It May Concern: Please be advised that your Building Permit # 33750 issued March 18th, 2008 has expired. According to the Code of the Town of Southold, a Certificate of Occupancy must be issued before the use of the structure. To renew your Building Permit please submit a fee of $500.00: at that time we can schedule an inspection by one of our Building Inspector's. PLEASE SEE ENCLOSED DOCUMENT REGARDING SWIMMING POOL CODES. If you have any questions, please call us at 765-1802. Respectfully, 50UTHOLD TOWN BUILDTNC_,- DEPT Town Hall Annex 54375 Main Road P.O. Box 1179 Southold, New' York 11971-0959 BUILDING DEPARTMENT TOWN OF SOUTHOLD Telephone (631 ) 765-18(12 Fax (631 ) 765-9502 May 2,2011 Savas & Jeanne Milienos 118 Knickerbocker Road Manhassett, NY 11030 RE: 1100 Westphalia Road, Mattituck TWO WHOM IT MAY CONCERN: ,~llowin9 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 involvin9 plumbin9 after 4/1184) __ Trustees Certificate of Compliance. (Town Trustees #765-1892) Final Plannin[I Board Approval. Final Fire inspection from Fire Marshall. Final Landmark Preservation approval. BUILDING PERMIT: 35659-Z swimming pool Town Hall Annex 54375 Main Road P.O. Box 1179 Southold, NY 11971-0959 Telephone (631 ) 765-1802 Fax 1631) 765 951)2 BUILDING DEPARTMENT TOWN OF SOUTHOLD September 19, 2011 Savas & Joanne Milienos 118 Knickerbocker Rd Manhasset, NY 11030 Re: 1100 Westphalia Rd. 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. (~SfA fee of $50.00. Final Health Department Approval. Plumbers Solder Certificate. (All permits involving plumbing after 4/1/84) Trustees Certificate of Compliance. (Town Trustees #765-1892) Final Planning Board Approval. Final Fire Inspection from Fire Marshall. - Bob Fisher Final Landmark Preservation approval. BUILDING PERMIT: 35659- Swimming Pool 4,5' ,/ 21' 8' / DEEP I .9' DFFP I0' WA~R biNS ~ /Sf, ~fgBb rgA/V~ L H©T~S I, 5~11JH~ 15 O~51HNgD FO~ USC [~LOVV dF~SP- AND Q,%Y IN AR~A5 V~IBI~ 1T~ dROLINP WAI~R lA,LB 15 A MINIMUM Off ~l'-8" pBLO~V 11dg ?F~OFOSgl2 PINISHBP ~, W~K5 ?O PB tMOn, NON ~N ~, ~BP A?,IXf ~EOM POOL [~ 60HPlflON9. 9. fllVlN& PO~ ~q~ IHSP~.bAflON fO CONfirM V~d/,NC/H~l-$ Igg9 ca () ca xx'x"x~x fO Hbll~E / ~i FROM 5~IMM~R PLUMBIM6 SGHEMAiIG WAfgR LINg RObU~P POA~ blNBR ANP CONCI~I~ ~O0 FSi FOU~P CONC~11¢ S 84'57'I0" to~ ® ~ N 84"57'10" W LO~ 234.75' ~ ~ 181.7, SURVEY OF LOT 1 MAP OF SUBDIVISION FOR SIDNY W. OLMSTED, JR. & ROBERT OLMSTED FILE No. 8gg4 FILED AUGUST $0, 1990 SITUATED AT MATTITUCK TOWN OF SOUTHOLD SUFFOLK COUNTY, NEW YORK S.C, TAX No, 1000-114-07-14.1 SCALE 1"=50' AUGUST 8, 2007 AREA = 49,650.75 sq. ff. [TO 31E LINE) 1.1~-0 aC. N.Y,S. Lie, No. 50467 THE EXISTENCE OF RIGHTS OF WAY AND/OR EASEMENTS OF RECORD, IF ANY, NOT SHDWNARE NOT GUARANTEED. Nathan Taft Corwln III Land Surveyor PHONE (631)727-2090 Fax (631)727-1727