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HomeMy WebLinkAbout42390-Z Town of Southold ' arA • d�. 3/27/2018 ; P.O.Box 1179 a' 53095 Main Rd 1% f Southold,New York 11971 CERTIFICATE OF OCCUPANCY No: 39571 Date: 3/27/2018 THIS CERTIFIES that the building IN GROUND POOL Location of Property: 830 N Sea Dr., Southold SCTM#: 473889 Sec/Block/Lot: 54.-5-13 Subdivision: Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated 2/16/2018 pursuant to which Building Permit No. 42390 dated 2/16/2018 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 ground swimming pool with fence to code as applied for. The certificate is issued to Granbanana On the Sound LLC of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL ELECTRICAL CERTIFICATE NO. 42390 4/13/2017 PLUMBERS CERTIFICATION DATED t o ' e Signature o�g11PfU�,�loG I Town of Southold 3/27/2018 P.O.Box 1179 0 o s 53095 Main Rd 4N �O�' Southold,New York 11971 CERTIFICATE OF OCCUPANCY No: 39572 Date: 3/27/2018 THIS CERTIFIES that the building OTHER Location of Property: 830 N Sea Dr., Southold SCTM#: 473889 Sec/Block/Lot: 54.-5-13 Subdivision: Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated 2/16/2018 pursuant to which Building Permit No. 42390 dated 2/16/2018 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 outdoor kitchen. The certificate is issued to Granbanana On the Sound LLC of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL ELECTRICAL CERTIFICATE NO. 42390 4/13/2017 , PLUMBERS CERTIFICATION DATED 10/30/2017 evin Brazill A t ed Signature Q�OS�EF0I, �pG Town of Southold 3/27/2018 P.O.Box 1179 0 o _ 53095 Main Rd Southold,New York 11971 CERTIFICATE OF OCCUPANCY No: 39573 Date: 3/27/2018 THIS CERTIFIES that the building ELECTRICAL Location of Property: 830 N Sea Dr., Southold SCTM#: 473889 Sec/Block/Lot: 54.-5-13 Subdivision: Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated 2/16/2018 pursuant to which Building Permit No. 42390 dated 2/16/2018 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: electric for an accessoryag zebo. The certificate is issued to Granbanana On the Sound LLC of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL ELECTRICAL CERTIFICATE NO. 42390 4/13/2017 PLUMBERS CERTIFICATION DATED Authorized Signature �saFEo��- TOWN OF SOUTHOLD BUILDING DEPARTMENT y a 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#: 42390 Date: 2/16/2018 Permission is hereby granted to: Granbanana On the Sound LLC 450 Westbury Ave Carle Place, NY 11514 To: Construction of an in-ground swimming pool as applied for. Replaces BP# 39827 At premises located at: 830 N Sea Dr., Southold SCTM # 473889 Sec/Block/Lot# 54.-5-13 Pursuant to application dated 2/16/2018 and approved by the Building Inspector. To expire on 8/18/2019. Fees: PERMIT RENEWAL $125.00 Total: $125.00 ui ding Ape for TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE oy �, 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) i Permit#: 39827 Date: 6/2/2015 Permission is hereby granted to: Molinari, Michael & Molinari, Paula 830 N Sea Dr Southold, NY 11971 To: Construction of an in-ground swimming pool as applied for. At premises located at: 830 N Sea Dr, Southold SCTM # 473889 Sec/Block/Lot# 54.-5-13 Pursuant to application dated 5/20/2015 and approved by the Building Inspector. To expire on 12/1/2016. Fees: SWIMMING POOLS -IN-GROUND WITH FENCE ENCLOSURE $250.00 CO - SW POO otal: 00.00 Building Inspector 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 Underwriters. 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. 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: Old or Pre/-existing Building: (check one) PLocation of Property: S O /14U�1� Ira & ),J,7-10 LJ� House No. Street Hamlet Owner or Owners of Property: &.111 ¢ �� `j,%��'� D Gf/✓/, ,2/r Suffolk County Tax Map No 1000, Section 4a Block ! 3 Lot / s Subdivision Filed Map. Lot: Permit No. Date of Permit. Applicant: Health Dept. Approval: Underwriters Approval: Planning Board Approval: Request for: Temporary Certificate Final Certificat": (checkFee Submitted: $ ppcantaure OF SOU��®l h O Town Hall Annex Telephone(631)765-1802 54375 Main Road N Fax(631)765-9502 P.O.Box 1179 • �Q roger.richert6&-town.southoId.ny.us Southold,NY 11971-0959 Q l�c®WN,� BUILDING DEPARTMENT TOWN OF SOUTHOLD CERTIFICATE OF ELECTRICIAL COMPLIANCE SITE LOCATION Issued To: Granbanana on The Sound Address: 830 N Sea Drive City: Southold St: New York Zip: 11971 Building Permit#: 4x390 3902.7 Section- 54 Block: 5 Lot- 13 WAS EXAMINED AND FOUND TO BE IN COMPLIANCE WITH THE NATIONAL ELECTRIC CODE Contractor: DBA: Kel-Rob Electric License No: 37725-ME SITE DETAILS Office Use Only Residential X Indoor Basement Service Only Commerical Outdoor X 1st Floor Pool X New Renovation 2nd Floor Hot Tub Addition Survey Attic Garage INVENTORY Service 1 ph Heat Duplec Recpt 5 Ceiling Fixtures HID Fixtures Service 3 ph Hot Water GFCI Recpt 2 Wall Fixtures Smoke Detectors Main Panel A/C Condenser Single Recpt Recessed Fixtures CO Detectors Sub Panel 1 A/C Blower Range Recpt Fluorescent Fixture Pumps 3 Transformer Appliances Dryer Recpt Emergency Fixture Time Clocks Disconnect Switches 1 Twist Lock Exit Fixtures 11 TVSS Other Equipment: Inground Swimming Pool, Outdoor Kitchen (BBQ) & Gazebo. Pool to Include: Bonding, 2- Pumps, 1- Pool Cleaner, Gas Pool Heater, 1- SPA Blower, 1- Control Panel, Notes: Low Voltage Pool Lights, 5- GFI Circuit Breakers. 1- Paddle Fan, 5- Receptacles, 1- Switch, and 1- GFCI Receptacle in Gazebo and BBQ. Inspector Signature: Date: April 13, 2017 0-Cert Electrical Compliance Form.xis f 4 o�of SO(lryol ti o Town Hall Annex Telephone(631)765-1802 54375 Main Road Pax(631)765-9502 P.O.Box 1179 G�` • Q Southold,NY 11971-0959 y BUILDING DEPARTMENT TOWN OF SOUTHOLD j CERTIFICATION Date: Building Permit No. I- ' Owner: R o6e f T (Please print) Plumber: 2 (Please print) I certify that the solder used in the water supply system contains Iess than 2/10 of 1% lead. (P#imbers Signature) Sworn to before me this :�'o�4- day of Dc-To3e(L 20 1-7 ® D NoZryPuLblic,Qkeg'�-'sCounty FEB 1 4 201 , Ralph Tiseo G D ?', Notary Public,State of Nov York: BUILDIV No.O1TI6135121 TOWN OF SoUr-- Qualified in Queens County ; Commission Expires Octcbsr 11,2).?� SOpl�o TOWN OF, SOUTHOLD BUILDING -DEPT. 765-1802 -INSPECTION FOUNDATION, I ST [ ] ROUGH PLUMBING [ ] FOUNDATION 2ND [ ] INSULATION [ ] FRAMING /STRAPPING [ ] FINAL [ ] FIREPLACE & CHIMNEY [ ] FIRE SAFETY INSPECTION [ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRATION [ ] ELECTRICAL (ROUGH) [ ] ELECTRICAL (FINAL) [ ] CODE VIOLA ON [ , CAULKING REMARKS: • Lol DATE d7 �� �� INSPECTOR �ar3F souls° TOWN OF SOUTHOLD BUILDING DEPT, 765-1802 INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLEIG. Zr�,- ( ] FOUNDATION 2ND [ ] INSULATION FRAMING / STRAPPING FINAL [ ] FIREPLACE & CHIMNEY [ ] FIRE SAFETY INS C N [ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENE f N ELECTRICAL (ROUGH) [ ] ELECTRICAL (FINAL) REMARKS: 44 t- `DATE. 'w INSPECTORV, - t t t FSO UTyo N O o�yUOUMV TOWN OF SOUTHOLD BUILDING DEPT. 765-1502 INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLRG. [ ] FOUNDATION 2ND [ ] INSULATION [ ] FRAMING / STRAPPING [ ] FINAL [ ] FIREPLACE & CHIMNEY [ ] FIRE SAFETY INSPECTION [ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRATION [ ] ELECTRICAL (ROUGH) ,[/ ] ELECTRICAL (FINAL) REMARKS: DATE X317 INSPECTOR r. Y 103 �irg SO(/T N O cou TOWN OF SOUTHOLD BUILDING DEPT. 765-1602 INSPECTION — [ ] FOUNDATION 1ST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] I ULAT N [ ] FRAMING / STRAPPING [ FINAL 0, [ ] FIREPLACE & CHIMNEY [ ] FIRE SAFETY INSPECTION [ ] FIRE RESISTANT CONSTRUCTION [ ] -FIRE RESISTANT PENETRATION [ ] ELECTRICAL (ROUGH) [ !] ELECTRICAL (FINAL) REMARKS: �hjh/ ckot � �✓ 1 b, v�r • Y (S r �o✓ ra&o,�4x -AV 6 tj4A 6- 4W 3 - ' DATE OML �' INSPECTOR �•cK_-=>__ _ 32-e-_��! �. � - .—k_.. _ _._,_ _^Y __ _ �.a- .n _.tom _ ._ _ y � water 538 Broad Hollow Road,41"Floor East tel 631.756.8000 Melville,NY 11747 fax 631.694.4122 September 14,2016 Town of Southold Town Hall Annex Building 54375 Route 25 P.G. Box 1179 Southold,NY 11971 Re: KLEBER RESIDENCE POOL 830-N. Sea Drive ' Southold, NY 11971 " Dear Sir: This is to certify that the steel is#4 rebar formed 12"on center In accordance with our drawings . dated 5-23-16 and comply with the structural requirements for the pool at 830 North Sea Drive Southold,NY 11971. l Respa lly submitted: t'JOhQ R. cIlhat 'l j Director o Is and Aq tics 1 Panico P.E. Assigned D Rz.--45 o�c D r F E,B 1 4 2010 BUMDING DEPT. TOWN OF SO 01a www.h?_nixom r 4� " • r • M r i 1 ps KAMMAXI oU.,524 pwtzl �Sq,d-1W2.r mm Wa r r • �_�� R ,� x1;111j ��,r TOWN OF SOUTHOLD BUILDING PERMIT APPLICATION CHECKLIST BUILDING DEPARTMENT Do you have or need the following,before applying? TOWN HALL r,Board of Health SOUTHOLD,NY 11971 w 4 sets of Building Plans )D ` ,'—s TEL: (631) 765-1502 Planning Board approval FAX: (631) 765-9502 ```-- Survey SoutholdTown.NorthFork.net PERMIT N®. Che' ck7 ) t ' s.. Septic,Form N.Y.S.D.E.C. Trustees C.O.Application Flood Permit Examined ,20;, Single,&Separate Storm-Water'Asses'sment Form t. Contact: Approved ,20 Mail to: Disapproved a/c Phone: 76- 101'7 Expiration / 2(L(2 '/I ` r , •, Building spector F�F «. ._i � PPLICATI,ON FOR BU ING PERMIT Y 1� 2015 `�. --- - - - -- :. _ .,• ate--- -� � �! , 205 :INSTRUCTIONS. , �. -- __._ .. _, - ' • a.This app ficatioii 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 Fv tt r/,-,, e R.6 r• d PwsC- b. Intended use and.occupancy 3. Nature of work(check which applicable):New Building Addition Alteration_ Repair Removal ''f, Demolition Other Work 10o o & (Description) 4. Estimated Cost x, ,; Fee (To be paid.on-filing this application), ' 5. If dwelling, number of dwelling•units Number of dwelling units on each floor If garage, number of cars 6. If business, commercial or mike`'d occupancy, specify nature and extent of each type of use. 7. Dimensions of existing structures, if any: Front Rear Depth Height Number of Stories Dimensions of same structure with alterations or--additions:,Front Rear_ Depth Height `' €'°'' '°`' '' l Number of Stories 8. Dimensions of entire new construction:Front"` '; m " ` ` ' >` `Rear' Depth Height Number of Stories 9. Size of lot: Front Rear ;i " xDepth ' i, ; 10. Date of Purchase, Name ofFo'rmer`Owner` 11. Zorie`or USe'di'strict inh which premises'are''sit{1'at`ed_`` 12. Does proposed construction violate any`zoning law,aordinance"or egulatiori?YES.' NO , !',• ,cr };is ;:,=.try•a. :Fi, " ;:','. .°ti , .: r ',rjF , 13. Will lot be're YES.. NO, ;.,W.ill-excessgf l,be:removed from::premises? YES. NO 14. Names of Owner,of premises, Address. :f, r:; ;s 1,Phorie:No.,,, Name-of Architect_ . ,, > .'FAddress " e%Phone`iNo Name of Contractor " ' Addressd' ` ' 'Phone No.-.' .r 15 a. Is this propefty withiin�"100'fee't-ofa�tidal wetlMd'o'r`a freshw'ater`wetlarid`�-`*YES ='? �NO` * IF YES,-SOUTHOLD'TOWN"pRUSTEES 8i''D.E'C'.-PE t1VIITS,NTAY'BE'REQ,UIR-ED: b. Is this proper ty`witliiri'300"feet of a'tidal;wetl'and? *OYES '' " NO''` ' * IF YES, D.E.C': PERMITS MAYBE'REQUIRED c r„ 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 atf&restrictions with respect to this property? * YES NO * IF YES,PROVIDE A COPY. STATE OF NEW YORK) SS: COUNTY OF ) being duly sworn,deposes and-says-that-(s)he is the applicant (Name of individual signing contract)'above named, jl (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_worlc 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 kO� day of 20 Notary Public Si tore of Applicant DOLORES M BETSCH Notary Public,State of New 5830 York Qualified inBSuffo k county commission Expires November I 4: { -I � I n 'n HMI. S 1OyS Alair) FIH T. TERRY ► }— TOWN CLERK �, �' = Suulhold. Nc%%- 1 urk l �� Fax (S 1 h) 765.1 g2:%TR ILEcISAR OF v1TN,STnT'IS-17CS O� T MARRIAOE OFrICI'R - �IcPlicinc (S I(�) 7(�C_ I f RECORDS M/WAOEMENT OITICEII .1 FREEDOM OF INFORMATION OFFICER OFFICE OF THE TOWN CLERIC TOWN OF SOUTHOLD THIS IS TO CERTIFY THAT THE FOLLOWING RESOLUTION WAS ADOPTED BY THE SOUTHOLD TOWN BOARD AT A REGULAR MEETING HELD ON AUGUST 24, 1993 : RESOLVED that the Town Board of the Town of Southold hereby adopts two (2) new forms to be used under tide Flood Damage Prevent regulations of the Code of the Town of Southold: "Floodplain Development Permit Application" (FDP(93) 1 , /nd "Certificate of Compliance for Development in Special Flood Hazard Area (C/C(93)] . 4 ^ l ) • 6i`.�i. G�� TOWN OF SOJ711OLD � T _ Terry Southold Town Clerk August 25 , 1993 APPLICATION PAGE I of 4 TOWN OF SOUTHOL.D FLOODPLAIN DEVELOPMENT PERMIT APPLICATION This form is to be filled out in duplicate. SECTION I GENERAL PROVISIONS (APPLICANT to read and sign): 1. No work may start until a permit is issued. 2 The permit may be revoked if any false statements are made herein- 3. If revoked, all work must cease until permit is re-issucd. 4. Development shall not be used or occupied until a Certificate of Compliance is issued. 5. The permit will expire if oo work is commenced within six months of issuance. 6. Applicant is hereby informed that other permits may be required to fulfill local,state and federal regulatory requirements. 7. Applicant hereby gives consent to the Local Administrator or his/her representative to make reasonable inspections required to verify compliance. 8. I,THE APPLICANT,CERTIFY THAT ALL A MENTS HEREIN AND IN ATTACHMENTS TO _ THIS APPLICATION ARE,TO THE B OF Y KNOWLEDGE,TRUE AND ACCURATE. (APPLICANTS SIGNATURE) DATE "71'2 SECTION 2: PROPOSED DEVELOPMENT o be completed by APPLICA-h S f�' NAME ADDRESS ao —//3 7 TELEPHONE APPLICANT /1ei-e, IT A /�P� BUILDER ENGINEER PROJECT LOCATION- To avoid delay in prooessing the application, please provide enough information to easily identify the project location. Provide the street address, lot number or Icgal description (attach) and, outside urban areas, the distance to the nearest intersecting road or well-known Landmark -A sk-ctcb attached to this application showing the project location would be helpful. OdZZ C Y�� 9 eWAI `Y Qr1/2 O 9 J a FDP(93 ) APPLICATIOK PAGE 2OFa DESCRIPTION OF WORK (Check all applicable boxes): A STRUCTURAL DEVELOPMENT AAC 1VITY STRUCTURE TYPE ❑ New Structure 01,,idential (1-4 Family) C9 Addition ❑ Residential (More than 4 Family) —"-------- --- ❑A11cratioa ---rtT oo-residcnTiat(Ftoodp�oof� —❑�Y�sy- --------- ❑ Relocation ❑ Combined Use (Residential & Commeraal) ❑ Demolition' ❑ Manufactured (Mobile) Home (In Manu- 0 Replacement factured Home Park?- ❑ Yes) ESTIMATED COST OF PROJECTS ao��cc0 B. OTHER DEVELOPMENT ACTIVITIES: ❑ Fill ❑ Mining ❑ Drilling ❑ Grading W,9X'cavation (Except for Structural Development Checked Above) ❑ Watercourse Alteration (Including Dredging and Channcl Modifications) ❑ Drainage Improvements (Including Culvert Work) ❑ Road, Street or Bridge Construction ❑ Subdivision (New or Expansion) ❑ Individual Water or Scwcr System ❑ Other (Please Specify) S!✓�l�,h�/ After completing SECTION 2, APPLICANT should submit form to Local Administrator for review. - SECTION 3: FLOODPLAIN DETERMINATION (To be completed by LOCAL ADRfIMSTRATOk) The proposcd development is located on FIRM Panel No. , Dated The Proposed Development_ ❑ Is NOT located in a Special Flood Hazard Arca (Notify the applicant that the application review is complete and NO FLOODPLAIN DEVELOPMENT PERMIT IS REQUIRED). ❑ Is located in a Spcdal Flood Hazard Arca. FIRM zone designation is 1Q0-Year flood elevation at the slit is: Ft. NGVD (MSI-) ❑ Uaavailablc ❑ The proposcd devclopmcm is located in a floodway. FBFM Pancl No. Datcd O Scc Sccuon 4 (or additional iastrucnoos SIGNED DATE APPLICATION 4 PAGE 3 OF 4 SECTION d ADDITIONAL INFORMATION REQUIRED (To he comnlctcd by LOCAL ADMTNISTRATORI The applicant must submit the documents checked below before the application can be processed: ❑ A site plan shounng the location of all existing structures, water bodies, adjacent roads, lot dimensions and proposed development. ❑Development plans,drawn to scale, and specifications,including where applicable:details for -------------------- -ancboring-4[xurwrrs,-_pmpascd-cl_evalQn o_f lowest floor(including basement), types of water resistant materials used below the first floor, details of floodproofwg of utilities located below the first floor and details of enclosures below the first floor. Also ❑Subdivision or other development plans(If the subdivision or other development exceeds 50 lots or 5 acres,whichever is the lesser, the applicant must provide 100-year flood elevations if they are not otherwise available). ❑ playas showing the extent of watercourse relocation and/or landform alterations_ ❑Top of new fill elevation Ft. NGVD (MSL). O Floodproofmg protection NGVD ion level (non-residential only) (MSL).' For [loodproofed structures, applicant must attach certification from registered engineer or architect. ❑ Certification from a registered engineer tha[ the propc,;:e'd activity in a regulatory floodway will not result in any increase in the height of the 100-year flood. A copy of all data and - calculations-supporting-thi&finding-m-u-5t-also_be submitted. ❑ Other. SECTION 5 PERMIT DETERMINATION (To be completed by LOCAL ADMTNISTRATORI I have determined that the proposed activitT. A. ❑ Is B. C3 Is not . fn conformance with provisions of Local Law if , 1.9 The permit is issued subject to the conditions attached to and made part of this permit. SIGNED DATE If BOX A is checked, the Local Administrator may issue a Dcvelopmeol Permit upon paymcn( of designated fee. If BOX B is checked, (be Local Administrator vnll provide a wriuco summary of deficiencies. Applicant may revise and resubmi( an application to the Local Administrator or may rcqucs( a bearing from the Board of Appeals APPLICATION ry . PAGE 4OF4 APPE-,l.S Appealed to Board of Appeals? O Yes ❑ No Hearing date: Appeals Board Decisioo --- Approved? O Yes ❑ No Conditions SECTION 6• AS-13UILT ELEVATIONS (To be submitted by APPLICANT before Certificate of Compliance is issued The following information must be provided for project structures. This section must be completed by, a registered profcssioga] engineer or a licensed land surveyor (or attach a certification to this application). Complete 1 or 2 below. 1. Actual(As-Built)Elevation of the top of the lowest floor, including basement in Coastal Hieh Hazard Areas• bottom of lowest structural member of the lowest floor, excluding piling and columns) is: FT. NGVD (MSL). L Actual (As-Built) Elevation of floodproofmg protection is FT" NGVD (MSL). NOTE: Any work performed prior to sty miaal of the above information is at the risk of the Applicant- SECTION 7• COMPLIANCE ACTION (To be comvleted by LOCAL ADMINISTRATOR) The LOCAL ADN1INISTRATOR will complete this section as applicable based on inspection of the project to ensure compliance with the community's local law for flood damage prevention. 1NSPP-CTIONS: DATE BY DEFICIENCIES? O YES O NO DATE BY DEFICIENCIES? O YES ❑ NO DATE BY DEFICIENCIES? ❑ YES ❑ NO ,SECTION 8• CERTIFICATE OF GQMPLIANCE(To be completed by LOCAL ADI1TiNISTRATQR) Certificate of Compliance issued: DATE: BY: ---------------------------------- --- 3 Attachment B j SAMPLE CERTIFICATE OF COMPLIANCE i for Development in a Special Flood Hazard Area n I • t a n TOWN OF SOUTHOLD CERURCATE OF COMPLIANCE FOR DEVELOPMENT IN A SPECIAL FLOOD HAZARD AREA (OWNER MUST RETAIN THIS CERTIFICATE) PREMISES LOCATED AT: PERMIT NO. PERMIT DATE OWNERS NAME AND ADDRESS: CHECK ONE: 0 NEW BUILDING O EjGSTING BUILDING --I] VACANT LAND ,s THE LOCAL ADMINISTRATOR IS TO COMPLETE A. OR B. BELOW: A. COMPLIANCE IS HEREBY CERTIFIED WITH THE REQUIREMENTS OF LOCAL LAW # , 19_. SIGNED: DATED: B. COMPLIANCE IS HEREBY CERTIFIED WITH THE REQUIREMEN'T'S OF LOCAL LAW # , 19_, AS MODIFIED BY VARIANCE # DATED SIGNED: DATED: C /C ( 93) �1 r ��SU� ST�O IKMIWAT]EIC, Scott A. Russell SUPERVISOR 0MAN AG IENUENT SOUTHOLD TOWN HALL-P.O.Box 1179 53095 Main Road-SOUTHOLD,NEW YORK 11971 j{{ Town Qf S'o a th o G LL CHAPTER 236 - STORMWATER MANAGEMENT WORK SHEET ( TO BE COMPLETED BY THE APPLICANT ) - -- - - - - - -- - - - -- - --- - - - ----------- DOES THIS PROJECT INVOLVE ANY OF THE FOLLOWING: Yes No . (CHECK ALL THAT APPLY) ❑ffA. Clearing, grubbing, grading or stripping of land which affects more than 5,000 square feet of ground surface. ❑ B. Excavation or filling involving more than 200 cubic yards of material within any parcel or any contiguous area. ❑[3C. Site preparation on slopes which exceed 10 feet vertical rise to ❑E�D. 100 feet of horizontal distance. Site preparation within 100 feet of wetlands, beach, bluff or coastal erosion hazard area. ❑ E. Site preparation within the one-hundred-year f loodplain as depicted on FIRM Map of any watercourse. ❑[]"F. Installation of new or resurfaced impervious surfaces of 1,000 square feet or more, unless prior approval of a Stormwater Management Control Plan was received by the Town and the proposal includes in-kind replacement of impervious surfaces. If you answered NO to all of the questions above, STOP! Complete the Applicant section below with your Name, Signature, Contact Information, Date & County Tax Map Number! Chapter 236 does not apply to your project. If you answered YES to one or more of the above, please submit Two copies of a Stormwater Management Control Plan and a completed Check List Form to the Building Department with your Building Permit Application. APPLICANT- (Property Owner,Design Professional,Agent Contractor,Other) S.C.T.M. #: 1000 Date" District NAME � _S _0 L� l Section Block Lot (Nsn„ur<) /r t"<:<-< FOR B 1LDI.N(.� DEP rMUNIENIT LSE ONLY Contact Information 6� /) rdgnion<w„a, Reviewed B y�%r/ - - - — — — — — — — — — — — — — — — — ., � Property Address / Location of Construction Work. — — — — — — —Date — — — — — — — _ [� Approved for processing Building Permit" n�/ u Stormwater Management Control Plan Not Required. ' d v L d� ❑ Stormwater Management Control Plan is Required (Forward to Engineering Department for Review.) FORM SMCP-TOS MAY 2014 • �0��0�SO�ryo , fo Town Haa Annex Telephone(681)765-1802 54375 Main Road (G$1�76�95gP� P.O.Boat 1179 ` roger.flclt@rt _fowri, dU o .mus SouftW,NY 11971-0959 ��UEIIV,� BURDING DEPARTMENT TOWN OF SOU7H01 n APPLICATION FOR ELECTRICAL INSPECTION rlc� EQUESTED_BY Date:- 111301 ►4 ompany Name: K c I- Rab I EJ�,c Name: g ob License No:: 3-lid Address: 218y Atscros.cl 0--10 Phone No.: JOBSIT'E INFORMATION: (*Indicates required information) *Name:. K I e b el- _ C�ro�f�,L SCA r\ &fPie C�ZU,r\, *'Address: �3 0 . /Jo r�h' S c A ri v t So h al d N U-G� *Cross Street: *Phone No.: G31 aH 1- r PbrMit No.: 9 a Tax Map District: 1000 Section: Block: � Lot: T *BRIEF DESCRIPTION OF WORK(Please'Print Clearly) vwimmirt POO (Please Circle All That Apply) *Is.job ready 1br inspection: • YES/ NO Rough In Final *Do you need a Tem Certificate: y P YES/ O Temp Information (If needed} *Service Size: 1 Phase 312hase 100 150 200 300 3q E fr400 Oth r _.- *New Service: Re-connect Underground Number of Meters Change of=SO Ni66 L=Overlie d, U1 Additional Information: PAYMENT DUE WITH APPLICATION i Vic„« .G,..; 'ojfy'(rPTi'•�Pi ;' �C�J � 82-Request for lnspeollon Form ;`.s `}10 P!,U V UN- ���� 0', Southold Town Building Department g11FFOt�C�� P.O.Box 1179 _ Permit#: 39827 53095 Main Rd a Southold,New York 11971 Permit Date: 6/2/2015 4,1 p`� (631) 765-1802 Expiration Date: 12/1/2016 Parcel ID: 54.-5-13 BUILDING PERMIT RENEWAL LETTER Dated: 1/29/2018 Applicant: Molinari, Michael&Molinari,Paula Location: 830 N Sea Dr, Southold Work Description: IN GROUND POOL Construction of an in-ground swimming pool as applied for. ***Please call to set up a final inspection with the building department. This is our last request for compliance before we send out Code Enforcement to assess the situation. Thank You A FEE OF $125.00 IS REQUIRED TO RENEW THIS BUILDING PERMIT. Owner: Molinari,Michael&Molinari, Paula Address: 830 N Sea Dr Southold,NY 11971 The permit listed above has expired. No work is permitted or authorized beyond the expiration date. Please submit the above fee made payable to the Town of Southold. Mail to the Town of Southold Building Department, P.O. Box 1179, Southold, New York 11971 THANK YOU, SOUTHOLD TOWN BUILDING DEPT. ROBERT & ERLINDA KLEBER 450 WESTBURY AVE. CARLE PLACE, NY 11514 516-326-8700 February 9, 2018 To: Southold Town Building Department Subject: 830 North Sea Drive. PO BOX 1179 Southold 54.-5-13 53095 Main Rd. Permit#39827 Southold, NY 11971 - Building Permit (631) 765-1802 Renewal Letter 1/29/18 Ladies & Gentlemen: The attached Building Dept. renewal letter was forwarded to me by the previous owner who took out the permit for the swimming pool in 2015. I have enclosed the requested$125.00 payment. We have since completed the pool. We have kept your office advised of the ownership change, the construction and completion of the pool. Also attached are copies of the following documentation: • Building Permit 6/2/15 `�• Application of Certification of Occupancy—Kleber D • Rebar Certificate 09/14/2016 D • Survey 08/22/2017 FEB 14 2098 • Final Inspection 09/28/2017 '\i• Lead Solder Certificate 10/30/2017 R1'JII..TDu"G DEPT. • Building Permit Renewal Letter 01/29/2018 TOWNT G. SD1I OLD Check: $125.00 to Southold Town Building Department I am hoping this will satisfy all the Town's requirements. Thank you, Very Turley/You s, Rob . Kleber J NORTH SEA DRIVE POINT OF BEGINNING N 39'24'00" E 1 0.00' ' YONUYEM YONLIYENT ' -983.48' O a �G AV, Z5G Y ;1K%KI OE K 191' 19� ry f `p4 #830 9�" 2 STORY ' 2 9 0'- FRAME oYUOE DECK V F w 167' 19.0• x z w Ym00 < 1 i1 r\ d 0 Ld ^ mo w Of o ;V M z pZ w v CPASS OPASS Ih r Z < Z cD 0 w Go DO op w z M 'M s 0 0 w � `YmN IFK s 0 p V 0�d3 yam z SAND fx.. MCK PATIO Q Z K O p y 0 w W pmUN9 POOL L✓V Z 0 ik:N 2 O f t � 9NCK PAHO (on g W O 1 M GAZMO Z �a D .. zzomw r - M god wx3ovm-i-i o¢¢r0- 3 �$ Sum lO F D 0-0 Z'w WOW 'x FEB 1 4 2018z 1,15 ELI Z�� M M Lo 'An L7SJALDING4 DEM aW OO~ w7 Q r TOWN OF S�+1U OLD z "~ p 0 Ix-alpi7F�1=no p3p ZNWZ- ' WwUfAOI}.� SAIm 3K Q�OF'Q> ' �00w_NpW KK17 woY�ax;...I 0 rL�7�fp6 ZF AREA=37652.64sq.ft. z 3 cn c0O ri uxi 4 ui FINAL SURVEY C PETAL POLE DATE: AUG d, 2017 ENGINEERING AND LAND SURVEYING, P.C. ,100.41' 150-18 HILLSIDE AVENUE 414'30" w HA JAMAICA, N.Y. 11432- S 3 TELEPHONE (718) 657-8444 p� FAX (718) 657-8555 Y.C./J.E YDKUYEKr EMAIL ABLANDSURVEYGGMAIL.COM SURVEY No. 6090 TOWN OF SOUTHOLD Fys, 05p7 ' COUNTY OF SUFFOLK FQ LAND S� STATE OF NEW YORK TITLE No. CERTIFIED T0: TAX MAP FILED MAP DAVID D ARARI, P.E. SECTION 54 SECTION TOWN OF SOUTHOLD NEW YORK LICENSE 06735-1 BLOCK 5 BLOCK PAUL RARYLSKI, L.S. LOT 13 LOT NEW YORK LICENSE 050782 i I NORTH $EA DRIVE APRON N3974'00'E 100.00' v 7 883.48' wEct L WALL WELL 0.8'E o , S�S , 14 v mO� V V 2nd. FUR;DECK OVER ff° fat. FLR DECK PARS 4.}r a� � SURVEY OF PROPERTY ,B.O' 1 N A T SO UTHOLD w 2'Sn 9.3'.N �� 9' TOWN OF SO UTHO D o 6 F FREL 'SE 4 6 �0 ril SUFFOLK COUNTY, N. Y. a 30.01L2�'' 2nd. FLR. DECK 49.9' O 1000-54-05-13 rq SCALE. 1 -30 DECEMBER 22,2004 191 DROYWFLL APRIL 1, 2005 (FLOOD ZONE) L p LP. Lp P FEBRUARY 3, 2011 (UPDATE & PROPOSED ADD/77ONS) LP PR E T K EXISTING SEPTIC SYSTEM a o --- - _ - - -, _ .-- -- - �, -- _- -_ _- - t-- -- - -- - -- - -- -_-- -- - -----D--�------ -CEssPOOLs- -- -- �iLul° g r m f�O D G GAZER 23.8' O Rl �o a p S�10 r6P 0aY1vbiz i r QAO � I O II OD O i I i I OCR i I N ' pOI I METAL POLE • FLOOD ZONE AE (el 11) FIRM J610JC154 G d h � AREA=37 657 SQ. FT. 4 '143S 340W R i ■=MONUMENT SET / .,, N 9 8 •=REBAR SET N101F SMITH PECbNIC SURVefOR,, .;C� a ANY AL7ERA77ON OR ADDI7ION 70 7HIS SURVEY IS A NOLA71 (631) 765-5020 FAX.-(S31r);.7•7fi'S ''1797 OF SEC77ON 7209OF 7HE NEW YORK SZ47E EDUCATION LAW. P.O. BOX 909 EXCEPT AS PER SEC77ON 7209—SUBDINSION 2. ALL CER77RC 770NS HEREON ARE VALID FOR THIS MAP AND COPIES THEREOF ONt Y IF 1230 TRAVELER STREET 04—313 SAID MAP OR COPIES BEAR THE IMPRESSED SEAL OF THE SURVEYOR SOUTHOLD, N. Y. 11971 WHOSE SIGNA7URE APPEARS HEREON. ARTHU-1 OP ID:VM ATECERTIFICATE OF LIABILITY INSURANCE P0112212(MMID01 YY) 01/22/2015 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(les) must be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER CONTACT Bagatta Associates,Inc. PHO Bagatta Associates, Inc. NE 823 W Jericho Turnpike Ste 1A WC.No. •631-864-1111 AJc No. 631-864-8274 Smithtown, NY 11787 ADDRESS: Bagatta Associates,Inc. INSURER(S)AFFORDING COVERAGE NAIC f INSURERA-WorcesterInsuranceCom an 26182 INSURED Arthur J Edwards Mason INSURER B: Contracting,Inc.DBA Arthur J. Edwards Pool& INSURER C' Spa Center INSURER D. 929 Route 25A Miller Place,NY 11764 INSURER E. INSURER F COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN,THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. 1LTRR TYPE OF INSURANCE INSD WVQ POLICY NUMBER MMIDDIY MMIDDIYYYY LIMITS A X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 CLAIMS MADE OCCUR MPA00000038801 H 01101!2015 01!01/2016 PREMISES Ee occurrence $ 100.000 MED EXP(Any one person) $ 5,000 X BLANKET ADDITIONA PERSONAL&ADV INJURY $ 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER GENERAL AGGREGATE $ 2,000,000 POLICY PRO ❑ $ 2,000,000 )ECT LOC PRODUCTS-COMPlOPAGG OTHER $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ Ee ecadent ANY AUTO BODILY INJURY(Per person) S ALL OWNEDSCHEDULED BODILY INJURY(Per accident) $ AUTOS AUTOS NON-OWNED PROPERTY DAMAGE $ HIRED AUTOS AUTOS Pereccldent UMBRELLA LIAB OCCUR EACH OCCURRENCE $ EXCESS LIAB CLAIMS-MADE AGGREGATE $ DED I I RETENTION$ $ WORKERS COMPENSATION - AND EMPLOYERS'LIABILITY YIN STATUTE ER ANY PROPRIETORIPARTNERIEXECUTIVEE L EACH ACCIDENT $ OFFICER/MEMBER EXCLUDED? F-1 N I A (Mandatory In NH) EL DISEASE-EAE PLO EE $ It yes,describe under DESCRIPTION OF OPERATIONS below EL DISEASE-POLICY LIMIT 1$ DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101,Additional Remarks Schedule,maybe attached If more space Is required) CERTIFICATE HOLDER CANCELLATION 0000000 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Town of Southold ACCORDANCE WITH THE POLICY PROVISIONS. Town Hall P.O. BOX 728 AUTHORIZED REPRESENTATIVE Southold, NY 11971 ©1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25(2014101) The ACORD name and logo are registered marks of ACORD A— A PR APPRNOTED COMPLY •r,/ITIA ALL COD F DAT # -2 NEW YORK "`TATE & TOWN COD S • Rotuma r, FE BY. AS REQUIRED NO IFY BUILDI _ EPA TMENT AT � �Tntnl �1 765-1802 8 AM 4 PM FOR THE ,EQA,, ,OWING IN F� B ®c - �3R E F— B 1. FOUNDATIO - TVV'O REQUIRED FOR URED nfFi'LteRETE From Flke 2. ROUG I - FRAMING & jBf4 UMP �' "•� f 3. INSUL TION 4 INAL CON�4 W'6 Pf�h'�D MUST Retume A Rolled Wall Foam-- COMPLETE FOR C.O. Plan ALL 'ON TRUCI� 1M F¢ngement REQUI MENTS OF HEC E �}j Wall Section YORK S TE. NOT RESPONSIBLE FOR �� Vinyl un D SIGN Crpubar UCTION ERROR ° �, " v '� ti;� w Yom 42 �� � .;� 5��•RE/44� -t B2'San 3500-P,S.I. Co O10, 0 JOG OPP - '` Section A—A vP �°ESE"`� ` ypical Wall Section SIZE A B C D E F G H AREA CAP. FEET FT. FT. FT. FT. FT. FT. FT. FT. SQ.FT. GAL. Purchase 16x32' 16' 32' 8' 14' 6' 4' 4' 8' 512 199000 ` 16'x36' 16' rfe �aareaa36' 12' 14' 6' 4' 4' 8' 576 21,600 &SPA CENTRE 18'x36' 18' 36' 12' 14' 6' 4' 5' 8' 648 24,300PERMACRETE WALL SYSTEM gut A&1617-46 Cct Bata /1/,Y 929 Route 25A Miller Place NY 11764 20'x40' 20' 40' 16' 14' 6' 4' 6' 8' 800 30,000 (631) 744-7185 FAX (631) 744-0174 Phone 24'x44' 24' 44' 18' 14' 8' 4' 6' l0' 798 30,000 Suffolk License #4436—HI °°de 24'x48' 24' 48' 20' 16' 8' 4' 6' 10' 900 30,000 Nassau License #HI74450000 1 04- LEGEND PLAN NO COPING THIS SIDE ^r• FOR ROCK ,� ._ A AUTOFlLL •.. � 4�O •\••• J,. Q� CEFJ�NER LINE SIMMER(PLAN) GIBBONS z VVV A V t� t`• Hia b t ® sHOuuER(EEcnoN) POOLS O 0 t (- EEO LIGHT(SECnON) N A 171 BRIDGE ROAD z 0 <---R RETURN ISLANDIA,NY 11749 42'-0'- f 2-0 T ® i TEL(631)B51-3000 TILE BREAK AT 0= SET APT OOL 2 LE�s' FAX(631)851-2107 BOTTOM STEP AND i BENCH ' o O YD%J E1RNN SWIMOUT 3• mx SOE WALL GRAIN (PLAN) REVISIONS ® SOX SDE WALL ORNN 03/14/16 (SECTION) POOL SPA.BEACH REDUCED SF 03)21/16 POOL SHAPED MODWFD SAND8"-0" + 05/16/16 BOULDERS BY AQUA FX BEACH I i POOL EMAROED H TO TRANSITION TILE AT / Tl I ZERO ENTRY %, (STEPS REMOV 1,� FILE: �`� /• FROM SPA) 10'-114 U �r 11'-6" �r REVERSE SHELF •\ H UNDER PATIO l �I KLEBER - 15-4j" RESIDENCE CD 830 N.Sea Drive Southold,NY 11971 12'-7g" 1 ` TOTAL POOL WATER SURFACE AREA:773 SQ.FT. ( F POOL PERIMETER: 132 LF. - DEPTH '"k=' BEACH USABLE AREA:148 SQ. FT. k LAYOUT !� POOL AREA LESS BEACH:625 SQ.FT. � SPA AREA:50 SQ.FT. ') SCALE:3/16"=1' , commodate a diving board now SPA PERIMETER:25 LF. DWNBMADNI I' wing board on this pool is DATE0.Y04/16 a a rovaC s Dates I injury or death. / PP �9nature ��; � �o � r �: C� G, ,1�•-� 7 1 r ` 4��830 N Sea Dr s Go, )Sle leetl 1000 meters 11 LI)3c1- '0 'I 1 i