HomeMy WebLinkAbout35459-ZTown of Southold Annex
54375 Main Road
Southold, New York 11971
9/28/2011
CERTIFICATE OF OCCUPANCY
No: 35251 Date: 9/28/2011
THIS CERTIFIES that the building 1N GROUND POOL
Location of Property: 1305 CROWN LAND LA CUTCItOGUE,
SCTM #: 473889 Sec/Block/Lot: 102.-7-2
Subdivision: Fried Map No. Lot No.
conforms substantially to the Application for Building Permit heretofore filed in this ofliced dated
3/29/2010 pursuant to which Building Permit No. 35459 dated 4/9/2010
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
Gambaiani, Scott & Gambaiani, Lauren
(OWNER)
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL
ELECTRICAL CERTIFICATE NO.
PLUMBERS CERTIFICATION DATED
35459 7/28/11
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)
PERMIT NO. 35459 Z Date APRIL 9, 2010
Permission is hereby granted to:
SCOTT & LAUREN GAMBAIANI
1305 CROWN LAND LANE
CUTCHOGUE,NY 11935
for :
CONSTRUCTION OF AN INGROUND SWIMMING POOL, FENCED TO CODE AS
APPLIED FOR
at premises located at 1305
County Tax Map No. 473889 Section 102
pursuant to application dated MARCH
Building Inspector to expire on OCTOBER
CROWN LAND LA CUTCHOGUE
Block 0007 Lot No. 002
29, 2010 and approved by the
9, 2011.
Fee $ 250.00
//~rized Signature
ORIGINAL
Rev. 5/8/02
Form No. 6
TOWN OF SOUTItOLD
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 D~pt. ofwator supply and sewerage-disposal (8-9 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 thaa 2/10 of t% lead..
5. Commercial building, industrial building, mttltiple residences and similar buildings and installations, a certificate
of Code ComplianccTrom 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) ~ion-conforming uses, or buildings and "pre~existing" land uses:
1. Accurate survey of property showing all property lines, streets, building and unusual natum~ or topographic
features.
2. A properly eo0mpleted 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,.
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
Date.
New Construction:
Location of Property: J30S
House No.
Owner or Owners of Property: ~c~
Suffolk County Tax Map No 1000, Section
Subdivision
Old or Pre-existing Building:
Street
;cheek one)
Date of Permit.
Health Dept. Approval:
Planning Board Approval:
Filed Map.
Applicant:.
Underwriters Approval:
Request for: Temporary Certificate
Foe Submitted: $ ~ ~. '~
Final' Certificate:
(check one)
137.5 Main Road
P.(). Box 117!t
l'clcl)honc
Fax ({;31 )
ro.qe r. richert(~,town, so uthold, ny. us
BUII,I)IN(; 1)I~;I~ARTMI';NT
TOWN OF $OUTHOLD
CERTIFICATE OF ELECTRICIAL COMPLIANCE
SITE LOCATION
ssued To: Scott Gambaiani
Address: 1305 Crown Land Lane City: Cutchogue St: NY Zip: 11935
]uilding Permit #: 35459 Section: 102 Block: 7 Lot:
WAS EXAMINED AND FOUND TO BE IN COMPLIANCE WITH THE NATIONAL ELECTRIC CODE
3ontractor: FrankZambriski DBA: Elec Tec Inc License No: 4814-me
SITE DETAILS
Office Use Only
Residential ~ Indoor ~ Basement ~ Service Only ~
Corn meric, al Outdoor 1st Floor Pool
New Renovation 2nd Floor Hot Tub
Addition Survey Attic Garage
INVENTORY
Service 3 ph Hot Water GFCI Recpt
Main Panel A/C Condenser Single Recpt
Sub Panel NC Blower Range Recpt
Transformer Appliances Dryer 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, includes bonding, 2 GFCI circuit breakers, 1 pool light
Notes:
Inspector Signature:
Date: July 28 2010
81-Ced Electrical Compliance Form
TOWN OF SOUTHOLD BUILDING DEPT.
765-1802
INSPECTION
[ ]FOUNDATION 1ST [ ] ROUGH PLBG.
[ ]FOUNDATION 2ND [ ] I~-~ON
[ ]FRAMING/STRAPPING [y']"FINAL
[ ] FIREPLACE & CHIMNEY [ ] FIRE SAFETY INSPECTION
[ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRATION
[ I ELECTRICAL (ROUGH) [ ]~ ELECTRICAL (FINAL)
REMAR~
DATE
INSPECTOR ~ ~~.
/
TOWN OF SOUTHOLD BUILDING DEPT.
765-1802
INSPECTION
[ ] FOUNDATION 1ST [ ] ROUGH PLBG.
[ ] FOUNDATION 2ND [ ] INSULATION
[ ] FRAMING / STRAPPING [ ] FINAL
[ ] FIREPLACE & CHIMNEY [ ] FIRE SAFETY INSPECTION
[ ] FIRE RESISTANT CONSTRUCTION[ ,] FIRE RESISTANT PENETRATION
[ ] ELECTRICAL (ROUGH) ~"~ELECTRICAL (FINAL)
DATE ~-~-.--- INSPECTO~
TOWN OF SOUTHOLD BUILDING DEPT.
765-1802
INSPECTION
[ ] FOUNDATION 1ST [ ] ROUGH,/~G.
[ ] FOUNDATION 2ND [ ]~JL"ATION
[ ] FRAMING / STRAPPING [/,,,]'FINAL
[ ] FIREPLACE & CHIMNEY [ ] FIRE SAFETY INSPECTION
[ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRATION
[ ] ELECTRIC~L,(ROUGH) [ ] ELECTRICAL (FINAL)/--,
REMARKS:~
INSPECTOR
TOWN OF SOUTHOLD
BUILDING DiStORTMENT
TOWN ItAL. L
SOUTItOLD, NY 11971
TEL: (631) 765-1802
FAX: (631) 765-9502
www. northfork.net/Southold/
Examined ,20
Approved .20
Disapproved aYc ~./
Expiration
,20
2 9 2010
BLDG. DEPT.
L TOWN OF SOUTHOtD
m,M,T No. 35
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:
Phone:
Building Inspector
,PPLICATION FOR BUILDING PERMIT
Date
INSTRUCTIONS
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 hnd 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 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.
ALL CONSTRUCT'ON SHALL
CODES OF NEW YORK STATE. uPo:'i
BEFORE
~J'//7-Ul'/ ~LE)L3 Z ~
(Signature of applicant or name, if a corporation)
(Mailing address, of applicant)
State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder
[~.)4 Jz/?Ac/'o/Z Ai'v riOVED AS NOTED
DATE:~ ~.P.~ ~ r?~
Nameofownerofpremises 3~ *~.~ ~W~//~. ~, aY: /~
(As on the tax roll or latest~: ~UILDING ~- ~' ' '
Dzr,.nTdENT AT
If applicant is a co~o~tiog, si~ature of duly authorized officer
~am~d title~f co¢orate office.,, ~,, O)' ,e-,/OR
Builders License No.
Plumbers LicenseNo.
Electricians LicenseNo.
Other Trade's License No.
WITHOUT CERTIFICATE
Location of land on which proposed work will be done:
/ ff~ ~o~v ~.~=z4_~_~_' ......
House Number Street or~.nnnl~=no bl:/ll II'lb,q I L
I~POUI~ED
County Tax Map No. 1000 Section /m~_
Subdivision --~o~?
(Name) /40/~z.,~ ~2~.,~-~
765-1802 8AM TO 4PM FOR THE
FOLLOWING INSPECTIONS:
1. FOUNDATION - TWO REQUIRED
FC~ POURED COv. cRETE
2. Ru.:5!! - [-'ST-.! :,? C
3.
4. FINAL- COL[5[?Ut. Ti N MUST
BE COMPLEi2 ;:Oq C.O.
ALL CONSTRUCTION SMALL MEET THE
REQUIREMENTS OF THE CODES OF NEW
YORK STATE. NOT RESPONSIBLE FOR
~4.y~~ CONSTPUOTION ERRORS.
HamletRETAIN STORM WATER RUNOFF
PURSUANT TO CHAPTER
Block ~ 7 t~r., ,dq~hu
Ma No - ~, ,,,~ ,~,,;~vu~,' -
Filed p .. ~/v 7~ ot
2. State existing use and occupancy of premises and intended use and occupancy of proposed cons~tion:
a. Existing use and occupancy Z .5:~o~2P'' z--.,ov/~ ,~'~/'4r,-4~- ~)~2~
b. Intended use and occupancy
Nature of work (check which applicable): New Building
Repair Removal Demolition
Estimated Cost ~',/.~,tgoo,oO Fee
If dwelling, number of dwelling units
If garage, number of cars
~. _cl_diiiog 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 (_~d,, y/ Rear O6,, q" Depth
Height. ~' Number of Stories ~-
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 oflot: Front ~dg-)t Rear ~r..O
Rear Depth
Depth Z 60 '
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 X NO__
14. Names of Owner of premises Oeo>';' d,~,,Y~,,*/,~,vl Address 47v3~ ~zao,,~,~,~o z,~d~hone No. 7_5 Y'-
Name of Architect Address ~,-~,o,~ Phone No
Name of Contractor ~w~,,ut ~a~.~ ~ ~ Address ~o {3~x ,] ~,~,,~-~ Phone No. ?_.q,/-
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 of a tidal wetland? * YES__ NO x'
* IF YES, D.E.C. PERMITS MAY BE REQUIRED.
NO X/
16. Provide survey, to scale, with accurate foundation plan ah,O. ~ .ay!c_ es to l~r~[~.~y lines.
17. If elevation at any point on prope~y is at 10 feet or below ~0wde topo~aph~cal data on su~ey.
STATE OF N,~,W YORK)
SS:
COUNTY C~/]~)
~'~:-~/dff-,/~74J~'- ,"?.,tgi 7C/1[ being duly sworn, deposes and says that (s)he is the applicant
(Nam~ of'individual signing contract) above named,
(S)He is the
(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 applicalion;
that all statements contained in this application are tree 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.
S w °~. t65/°~°r;a~: ;his~
Claire C. Blew
Nota~-Public, State of New York
No. 01'GL487~1505
Qualified i'n Suffolk County '
Commission E~pires Dec. 8.~,,g' I
- · Signature of Apphcant
Town of Southold
Erosion, Sedimentation & Storm-Water Run-off ASSESSMENT FORM
PROPERTY LOCATION: $.C.T.M. ·
Diet,ct ~'tlon Block Lc~
THE FOLLOWING ACTIONS MAY REQUIRE THE SUBMISSION OF A
8TORM-WA¥~.k~ GRADING! DRAINAGE AND EROSION CONTROL PLAN
G~R'iirII:U BY A DESIGN PROFESSIONAL IN THE STATE OF NEW YORK.
Item Number: (NOTE: A Check Mark (~) for each Queston is Required for a Complete Apptcation)
Ye~s N_.,.~o
1 Will this Projecl Retain Ati Sterm-Water Run-Off Generated by a Two (2') Inch Rainfall on Site? v// r~
(This item will include all mn-off created by site clearing and/or construction actvites as well as all Site
Improvements and the permanent crea~on of impervious surfaces.)
2 sees the Site Plan and/or Survey Show All Proposed Drainage Sbuctures Indicating Size & Location?
Tills Item shall include all Proposed Grade Changes and Slopes Controlling Surface WatenClow!
3 Will this Project Require any Land Filling, Grading or Excavation where them is a change to the Natural
Existing Grade Involving more than 200 Cubic Yards of Material within any Palce~? ~L,TJ
4 Will this Application Require Land Disturbing Activities Encompassing an Area in Excess of r~ ./~
Five Thousand (5,000) Square Feet of Ground Surface? ~ --
5 Is there a Natural Water Course Running through the Site? r~
is this Project within the Trustees jurisdiction or within One Hundred (100') feet of a Wetland or Beach?
6 Will there be Site preparation on Existing Grade Slopes which Exceed Fifteen (15) feet of Vedical Rise to r~
one Hundred (100') of Horizontal Distance? I~ __v
7 Will Driveways, Parking Areas or other Impervious Surfaces be Sloped to Direct Sterm-Water Run-Off
into and/or in the direction of a Town fight-ofqvay?
8 Will this Project Require the Placement of Material, Removal of Vegetation and/or the Consbllction of r~
any Item Within the Town Right-of-Way or Road Shoulder Area?
{This item will NOT Include the Installation of DHveway Aprons.)
9 Will this Project Require Site Preparation within the One Hundred (100) Year Floodplain of any Watercourse? r~ ..~
NOTE: If Any Answer to Questtans One through Nine is Answered with a Check Mark In the Box, a Storm-Water, Grading,
Drainage & Erosion Control Plan la Required and Must be Submitted for Review PHor to Issuance of Any Building Permltl
EXEMPTION: Yes N~o
Does this project meet the minimum standards for classification as an Agricultural Project?
Note: If You Answered Yes to this Question, a Storm-Water, Grading, Drainage & Erosion Control Plan is NOT Requiredl __ _~
~er ~or ~presen~five of ~e ~er of O~er's, ~d is duly au~or~ed to ~fform or have performed ~e s~d work ~d to
n~e md file ~s applic~on; ~at MI smtemenU con~ed in ~is appli~fion ~e ~e to ~e ~st ofhs ~owle~e ~d ~hef; ~d
· at ~e work wiB be ~ffom~ed in ~e m~ner set for~ M ~e application fded here~.
. ......~ .......... ~.....~...~ ............... ~ .............
~l~c State of New Y~ (S~na~re~t)
FORM - 06/07 - '~ suffolk Coun~ -
~ Expires Oec, 8, ~[ ~
KAL OSKI (OPEN
N 47' 26' 10" Ht
$ ~2' AVG. £NCROACHI~£NT O~ PLOH~D FIELD
WELL
STORY WOOD FRAM~ R~SID~NC~
GARAGE
~ CESSPOOL
200. O'
7
CESSPOOL
FINISHED GRADE
'I3T
JO0 S.F. .
SIDE WALL
A REA
LEACHING
POOL
TYPICAL CESSPOOL SYC liCM
N.~S
TYPICAL 5EP T'C T4NK
SUFFOLK CO HEAt fH [,/-pr AP,o~f)',...iZ
H ~. MO
S 1-4 1-EMEN T O? IN TEN f
rile WATER ~UPPL Y AND ~FWACE
POOL DIMENSIONS
TYP. PANEL STIFFNER
TYPICAL WALL SECTION AT 'A' FRAME
POOL PLAN
CORNER CONNECTION DETAIL
~ MIN. 2' THICK VERMICULITE
AGGREGATE TAMPEREO
A2 B2 C2 D2
SECTION , ,P~,-*-.~,~;~....~.¢.,,.
\
J REV.
SCALE N.T.$.
JAMES DEERKOSKI, P.E. DATE
260 DEER PATH DRAWING NUMBER
MATTITUCK, NEW YORK 11952 OF