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Home My WebLink About34886-ZFORM NO. 3 TOWN OF SOUTHOLD BUILDING DEPARTMENT Town Hall $outhold, N.Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) PERMIT NO. 34886 Z Date JULY 23, 2009 Permission is hereby granted to: STANLEY ANDREOU 5255 ROCKY POT RD E MARION,NY for : INSTALLATION OF AN ABOVE GROUND SWIMMING POOL, FENCED TO CODE at premises located at County Tax Map No. 473889 Section 021 pursuant to application dated JULY Building Inspector to expire on JANUARY 5255 ROCKY POINT RD EAST MARION Block 0001 Lot No. 008 13, 2009 and approved by the 23 2011. Fee $ 250.00 Authorized Signature ORIGINAL Rev. 5/8/02 ~-u~ msp~Cn/oN ~EPO~T DA~I, Co~rs ~ FOUNDATION (1ST) ~ ~ FO~ATION (2~) ~ . ROUGH ~G & ~ PL~G 0 STATE E~R~ CODE ~DITION~ COUNTS > Z > TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, NY 11971 TEL: (631) 765-1802 FAX: (631) 765-9502 SoutholdTown. NorthFork.net Examined :)/~ Jt 20 GCY Approved Disapproved a/c 2,/~%, 20 07 Expiration JUL 1 3 2009 BLDG. TOWN OF SOUTNOLD PERMIT NO. r~t~BUiL~RMiT APPLICATION CHECKLIST Do you have or need the following, before applying'? Board of Health 4 sets of Building Plans Planning Board approval Survey Check ~,~o.O~ Septic Form N.Y.S.D.E.C. T~stees Flood Pe~it gtco-Water Assessment Fom~ Contact: Building Inspector APPLICATION FOR BUILDING PERMIT Date INSTRUCTIONS ,20 0} 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 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 la~vs, ordinances, building code, housing code, and regulations, and to admit authorized inspectors on premises and in building for necessary inspections. "IMM lr ELY" ENCLOSE POOL TO CODE UPON COMPLETION BEFORE "WATER" "(Signature of applicant or name, if a corporation) ALL CONSTP! 'r'T~n~,l SHALL MEE'! T' ,~ ....... :. ~:~TSOFTHE CODES OF NEW YORK STATE. (Mailing address of applicant) State whether applicant is owner, lessee, agent, ar~l~q~l contractor,~t~r~?~tO~TFl/l~builder Name of owner of premises If applicant is a corporation, signature of duly authorized officer OCCU?ANCY OR FOUNDATION . TWO REQUIRED (Name and title of corporate office~JsE IS UNLAWFUL Builders License No. WITHOUT CERTIFICATE Plumbers License No. Electricians License No. OF OOOU~ANC~y FOR POURED COb~CRETE 2. ROUGH - FRAMING & PLUMBING 3. INSULATION 4. FINAL - CONSTR',fCTfON MUST BE COMPL~ ~E FOR ,.;,,3. ALL CON£(P,I,':.;'(iC:I :;N;'.L MEET THE Other Trade's License No. L°cati°n °£ land on whic .h. sr°p°sed w°rk wAll/be dBne: 5,955 ,50 House N~mber - ~reet ' / ..... County Tax Map No. 1000 Section ~ [ Block Subdivision REQUIR J. ,;,. S ,qF TqE t., .~r--, OF NEW YORK ~iT.:'fE. Nor [~E~?Lh,~£1;~,LE FOR DESIGI,: ~ COI,Sf~UOTION ERRORS. ./ 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 b. Intended use and occupancy Nature of work (check which applicable): New Building. Repair Removal Demolition Estimated Cost ~ If dwelling, number of dwelling units If garage, number of cars Fee Addition ~ ~klteration Other Work (~D0db//A/OJf{ (Desc~bt[(~n)' (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 Rear Height. Number of Stories Dimensions of same structure with alterations or additions: Front Rear Depth Height Number of Stones 8. Dimensions of entire new construction: Front Rear Height Number of Stories Rear Name of Former Owner 9. Sizeoflot: Front 10. Date of Purchase .Depth 11. Zone or use district in which premises are situated Depth J!lll, , ! 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 __ 14. Names of Owner of premises Name of Architect Name of Contractor Address Phone No. Address Phone No Address Phone No. 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__ * IF YES, D.E.C. PERMITS MAY BE REQUIRED. NoW 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 topographical data on survey. 18. Are there any covenants and restrictions with respect to this pl~o,p~rty? * YES NO __ · IF YES, PROVIDE A COPY. STATE OF NEW YORK) ~ SS: COUNTY OF ~X~, ~q CJ~L ~'-Y'h~ ("-0,][A . being duly deposes and says that (s)he is the applicant "i~qame of ~n&wdual s~gmng 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 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. Sworn to before me this lB dayof ~' LJ '[--.x~ 20Oc~ ! Notar~ e6~blic- j KHALID M CHALIDHABY Notary pubhc. State of ~]ew York No 010~ 16164382 //] - Signature ~ A~plicant 'OWN OF SOUTHOLD ;UILDING DEPARTMENT 'OWN HALL OUTHOLD, NY 11971 'EL: (631) 765-1802 'AX: (631) 765-9502 outholdTown.NorthFork.net ixamined 9/~ ,~ 20 Oq tpproved )isapproved a/c !xpiration ,~/"k~ , 20 /[ JUL 1 3 2009 BLDG. TI3NN OF SOUTHOLO PERMIT NO. BUILDING P~RMIT APPLICATION CHECKLIST Do you have or need the following, before applying Bo~d of Health 4 sets of Building Pl~s Pla~ing Board approval Su~ey Check ~o Septic Fora N.Y.S.D.E.C. Trustees Flood Pemt Store-Water Assessment Fora ~ff~ C°~tact:Mail t°:~ ~ ~ Building Inspector APPLICATION FOR BUILDING PERMIT Date INSTRUCTIONS ,20 a. This application MUST be completely filled in by typewriter or in ink and submitted to the Building Inspector with 4 ;ets 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 adjdining premises or public streets or ~reas, 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. (Signature of applicant or name, ff a corporation) "IMMEDIATELY" ALL CONSTRUCTION SHALL ENCLOSE POOL TO CODE MEE~ Tr';::. REGuJ. ,~:~,v-NTS OF THE UPON COMPLETION CODES OF.NEW YORK STATE. (Mailing address of applicant) B~EFORE "~A~TE R" State whether applicant is owner, leasee, agent, ar~~l contractor,~~~uilder ~!~.,: '.~.~---t--- ' · ,/~,/,~ a Fh, ~ /'~ ~.' ? . FEE~ dlC~. ~ . Name ofowner of remises ( flOC" J enn P , ' , · ' - u2 ..8 AI~ ~ 9 4 PM FOR TI ;7- - / ' As° thetaxr°l '°rlates A k, G If applicant is a corporation, signature of dtl,[y_authorized officer OCCUPANCY OR ~. ~ou~o^TION ~ TWO REOmED (Name and title of corporate of.c sE IS UNLAWFUL Bu, ders Lioense ~o. WITHOUT CERTIFICATE Plumbers License No. ~ r- Electricians License No. L/l'OCCUPANCY Other Trade's License No. Location o~JSl.,an..d.Qn which,~ropoSed~work w~ll/be d~ne: House N'~mb~r '- ~reet County Tax Map No. 1000 Section t>~ [ Block Subdivision FOR POURED CONCRETE 2. ROUGH FRAMING & PLUMBiNG 3. INSULATION 4. FINAL - CONSTRUCTION MUST BE COMP ..: ~ t: FOR ,.;/3. ALL CON£TP, L':;~'iCH -3H~,'.L MEET THE REQUIREk~,':J,SfS I3F THE ~..,..,~k8 OF NEW YORK ,~T;:fE. Nor RIE~,"?~ I..I, LE FOR _.~ DESIGH ",~: COhSrAUCTION ERRORS. Lot J;v ./ Filed Map No. Lot 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 Nature of work (check which applicable): New Building. Repair Removal Demolition 4. Estimated Cost 5. If dwelling, number of dwelling units If garage, number of cars Fee Addition /~lteration Otl~er Work f~g'~OV~o[t~j (Desc$i~tion) (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 Dimensions of same structure with alterations or additions: Front Depth Height "~ ' Rear Number of St0, - f, g .Depth 8. Dimensions of entire new construction: Front Height Number of Stories 9. Size of lot: Front Rear 10. Date ofeurchase Cfl]~9 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__ 14. Names of Owner of premises Iqame of Architect Name of Contractor Address Phone No. Address Phone No Address Phone No. 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 * 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 topographical d~tta.on Survey. 18. Are there any covenants and restrictions with respect to thi~ ~rogertv?. * YES NO · IF YES, PROVIDE A COPY. ~ ...... ~ STATE OF NEW YORK) ~ SS: co. UNTY OF ~ ,'~, .IY)~ ~./'~ f'"Ot~I~A, beingduly sworn, deposes and says that (s)heisthe applicant -(-Name ofin~li~,idual si~nifig'co~tra~t~'~'b;v~named, C; , ;, (S)He is the ~ V ~" (Contractor, Agent, Corpora~Off~rer ~t¢~) ~M ~ of said owner or owners, and is duly authorized to perform or have P[rformed it}e ~s~ii~ work and to make and file this application; that all statements eontained in/his 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. Sworn to before me this . 20 / Notar~ P6blic- ~ KHALID M. CHAUDHARY Notary public, State o[ New York NO. 01 GH6164382 ,,/7 Qualified in Suffolk county -- - S~g~ature cffA~plicant ' Repair ~"L~:~ ............. Demolition .............Otb. or Work. (Description) }. .o..o ..................... .......................... 4. (to be paid on Fflin~ ~ application) $. If dwethn ~llh~glu~flts ............... Number of dwcliin~ units on oach fl°°r ................ §~ number of dw . . .............................. If bushless, comme~lai or rm~=~ v,~,.~ ~' Rear .............. Dopth ............... ~. Dimensionsofextstin~stmctures, d y. Front ............... r of Stofie~ ..................................... Nun}be .... Rear .................. Height ............... om or additions: Front ............... . ..... Dimensions 0~same structure w~th alterati Number pf Stories ........ X;,~ i,'~ ' ~p~...t~. ............. .:.. n0~h~t ..:...,*~, .......... ~...t f-.'. ........ ~P~ · ~' *'* .... :"* ensio~s of enl}.,~ew conshlu, orion: ~ron~. · ~ .... ~, ....... . ............. ~..:~.~- · ~ · - ' 8, ~Do~i~o~t l'5 ~J[,,~:- .l~qlmr of Stories ....... ' '.'hi' bY .......... Depth 19.S:.l,O., ] .~.V?..* .'~.~ ... ---~ '.r ' - "'k'-', . . P.~..~.~.'~ ........... " 9. Size of lot: Front .... ~"~ .......... 10 Dah~ of Purchase ~:. · ~...* .,,. '~. ~.:' ~'"- "-'-~'~ .... . 7~ .~ .'. · .'. ;; · '~' ....... ~ .......... 12. VoesprOp°sod¢.°~nstruc~l°n~,a ...:.W.diex,~c~ss~,_fi~..~ll~n~o~'~o.~~t~k~r~, .~..~'1 ~. w~ot~r~o~ ......:_~.',','~.{"~.~r, e0~Ad~-~.~-~ r,,.. ~....._ .. · ." 14 Name of Owner ol premises -~ ?~ .... AddZess . . ........... pllone rio ................ Name of Arctfltect ......... .; ................. Address ............... ;... Phon~ lqo ................ Name of Contzactor ........ ~ ................. i PLOT DIAGRAM ' , . d andi~dicaj-t~t'back dimensions from · - ~ ~:-.~-,-~l,, all{ butldin~s, whether cx/sttnS or pro.po~l ,..~ [~ ~e,~t nsme~ and indicate whether interior or oomer lot. .i ' ' ~' tt°'sl~ ..../ i too .o STATE OF NEW yORK ~SS CO'~v-Ol~ ............. ~ .... ~/1~/~ e~. ~ ~,&' ......... being duly ~ ~m, d~poses and says that he ~s the aPplicant ~lame of in~Idual si~n[ng contr He is the ...................... : ..... ~Contractor, agent, oolpot'at6 oflicar. application; that all statomemts cont~e~. ,_l~l_,~u~:s.. ~t~-t[ application fled therewith. work will be performed ih tho manne,r sot tot uL ...... · ~wom to befor~ me this , i ~ ........... 42' LOT- 4 ..-{ O AND LOAN ASSOCIATION VA N w ~ JY~_. a SON TO TNE SUFFOLK COUNTY F~]DE2.AL ~/Iodel M ! Filter Pu~'7 INSTRUCTIOF~ ~'~ ~ INSTRUCTION VIDEO '~ .Enghsh lI. Fran~als Ill. Espafio! · EASY SET~ POOL Model M ! Filter Pump ~ Q READY FOR WATER IN MINUTES SET. UP AS EASY AS !. 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