HomeMy WebLinkAbout28223-Z FORM NO. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Office of the Building Inspector
Town Hall
Southold, N.Y.
CERTIFICATE OF OCCUPANCY
NO: Z-29208 Date: 01/22/03
THIS CERTIFIES that the building ACCESSORY
Location of Property: 180 MARINA LA EAST MARION
(HOUSE NO. ) (STREET) (HAMLET)
County Tax Map No. 473889 Section 35 Block 8 Lot 5 .12
Subdivision Filed Map No. Lot No.
conforms substantially to the Application for Building Permit heretofore
filed in this office dated MARCH 28, 2002 pursuant to which
Building Permit No. 28223-Z dated MARCH 29, 2002
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 INGROUND SWIMMING POOL WITH FENCE TO CODE AS APPLIED FOR.
The certificate is issued to WILLIAM J & DEBRA M KELLER, SR
(OWNER)
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A
ELECTRICAL CERTIFICATE NO. 62174 05/15/02
PLUMBERS CERTIFICATION DATED N/A
Authorized Signatur
Rev. 1/81
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. 28223 Z Date MARCH 29, 2002
Permission is hereby granted to:
WILLIAM AND DEBRA KELLER
180 MARINA LANE
EAST MARION,NY 11939
for .
CONSTRUCTION OF AN IN-GROUND SWIMMING POOL IN THE REQUIRED REAR
YARD
at premises located at 180 MARINA LA EAST MARION
County Tax Map No. 473889 Section 035 Block 0008 Lot No. 005 . 012
pursuant to application dated MARCH 28, 2002 and approved by the
Building Inspector.
Fee $ 150 . 00
Authors re
COPY
Rev. 2/19/98
Form No.6
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN HALL
765-1802
n erc 1
APPLICATION FOR CERTIFICATE OF OCCUPANCY
This application must be filled in by typewriter or ink and submitted to the Building Department wi Ythe-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$25.00, Additions to dwelling$25.00,Alterations to dwelling$25.00,
Swimming pool $25.00,Accessory building$25.00, Additions to accessory building$25.00,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 $15.00
Date. /�Z6 1Q3
New Construction: )WI Old or Pre-existing Building: (check one)
1
Location of Property: /90 4WlAd? A. AA.S/ &&40
House No. Street / C ,Ham�l�ett
Owner or Owners of Property: W///lA/1�/ ,� ��G LCU_.k J 1`�
Suffolk County Tax Map No 1000, Section 3 Block (b60$ Lot _(poj. ir912'
Subdivision Filed Map. Lot:
Permit No. ZqV 3-Z7 Date of Permit. ct 2 Applicant:
Health Dept. Approval: Underwriters Approval: NAA) Poe, -' 1/4c.
Planning Board Approval:
Request for: Temporary Certificate Final Certificate:_ �� (check one)
'Y
Fee Submitted: $ Z J 06
F � j 1�"� Applicant SigngGre
E/ectrica/ Inspection Certificate
Diu Electrical Inspection Service, Inc. ARnl►cat►on#
05/15/2002 375 Dunton Avenue 62174
East Patchogue, Now York 11772
(631)286.8842
Issued to: Bill& Debbra Keller
Street: 180 Marina Lane
Village: East Marion Z/p:11939 Town:Southold
Section: 35 Block: /8 Lot: 5.12
Introduced by: Merit Electric (L) Lic.# 4289-E
was exaWned orrd fawl<d fo fie/n coNW10 ince wrfh Me Alvt/a w/E/ectiva/Code
0 Commercial ❑NV Defects W[i Pool ❑ist Floor ❑Indoor `,Basement ❑ Not Tub
Wi Residential ❑ Det. Garage ❑Attic LJ 2nd Floor I_IOutdoor ❑ Addition L]Survey
Switches Receptacles Fixtures GFl Heaters A/C Fans
1 2 1 1
Dishwasher Washer/Amp Dryer/Amp Oven Range/Amp Garbage Disposal
Furnace Oil Gas Circulator Smoke Detector Bell Transformer
Meter Amps Phase uG/OH Telephone Television Carbon Monoxide
J ❑
Other Equipment: Building Permit#
?-dmeisjgashealer �--�-�
Hugo S. Surdi
President
Rough Inspection:
Inspector: Ed Scavelli
Final Inspection: 05/14/2002
Inspector: Ed Scavelli
This certificate must not be altered in any manner. Inspectors may be identified by their credentials
TOWN OF SOUTHOLD PROPERTY RECORD CARD
OWNER - STREET I VILLAGE -..
DIST. SUB. LOT
arenaC—as M �rl�r� Z — r �� a4Lc
ACR. ' / 9 RE AR S
TYPE OF BLD. Cd"e a8,a�
ff r PROP. CLAS
I'r1 G f 2 L O
LAND IMP. TOTAL DATE
7 '- ?G7 -
FRONTAGE ON WATER TILLABLE
FRONTAGE ON ROAD WOODLAND
DEPTH MEADOWLAND
BULKHEAD HOUSE/LOT
— - TOTAL
zz
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■■■...�®Na■■■■■■■■■■■■■■■NONE
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■■■■■■■■■■■■■■■■■iE■■EEE■■■
NOON■■■■E■■■■■■■■■■■■■■■O■■
■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■
• ••• • '
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RoornslstFloor • • _
Rooms 2nd Floor
-.. �■� NOON ■�
BUILDING PERMIT EXAMINER CHECKLIST
DATE ISSUED: -1-,"02
DATEREVIEWED: 3 47 /02
APPLICANT: Ula.. e- DAT .SUBMITTED: �/j&:/O2
SCTM# DISTRICT: l,000, SECTION: �, BLOCK: , LOT:
STREET ADDRESS: /Oo kA*eirf4 CITY: j�s- 0*A(6q SUBDIVISION:
PROJECT DESCRIPTION:
ESTIMATED PROJECT COST: 13 S ARCHITECT / ENGINEER: .. FAST TRACK? � /,
SINGLE & SEPARATE CERTIFICATION-REQUIRED? AiNOTES:
LOTS 40,000SF-100-24.Lot recopition.(CREATED before June 30, 1983),UNDERSIZED LOTS FROM JAN.1997 100-25.Merger.(A nonconforming at any time after 7/1/83;
ZONING DISTRICT: e-y1/ CONFORMING? No
REQ. LOT SIZE: o apo ACT. LOT SIZE: 01 REQ. LOT COV.a0l. ACT. LOT COV.
REQ. FRONT ,S' PROP. FRONT REQ SIDE -5-Wr ACT. SIDE
REQ. REAR f PROP. REAR
WATER FRONT? �� 0 DESCRIPTI
PANEL #: _IV FLOOD ZONE:
APPROVALS REQUIRED
SUFFOLK COUNTY HEALTH DAT: YES ofN01(BED#)!� DTE:_/_/_ PERMIT#:RIO-
TOWN SEPTIC RECEIPT: Y or( l (9
NEW YORK STATE DEC: PRE-DEC 9/1/75 YES or
SOUTHOLD TOWN TRUSTEES: YES or
TOWN ZONING BOARD APPROVAL: YES o
TOWN PLAN. BOARD APPROVAL: YES or
TOWN HISTORICAL PRE (SPLIA): YES o O
NYS ENERGY: YES OR �' _
EGRESS (18 H min.? 4 sq otal) - ENT(SQ. FT. x 4%) —LIGHT (S . FT. x( _�
BUILDING PERMITS OPEN/EXy1RED: BP�s�L-Z/C/0 - �Lr/ �`�L l
HAVE PRE CO'S : Y OR N BP -Z/C/o Z__
NOTES:
FEE STRUCTURE: FOUNDATION: SF
FIRST FLOOR: SF
SECOND FLOOR: SF
OTHER: SF INIT OTHER TOTAL
TOTAL: SF FEE FEE FEE
I. ( SF)- ( SF)= SFX $ =$ +$-+$-=$ A_ b
2. ( SF)- ( SF)= SF X $ =$
765-1802
BUILDING DEPT,
INSPECTION
[ ] FOUNDATION IST ( ] ROUGH PLBG.
[ ] FOUNDATION 2ND [ ] IN LATION
[ ] FRAMING [ INAL
[ ] FIREPLACE & CHIMNEY
REMARKS cS 44J
LL �,
r
DATE 2--- SPECTO
01 WW'Le�
765-1802
BUILDING DEPT.
INSPECTION
[ ] FOUNDATION IST [ ] ROUGH P
[ ] FOUNDATION 2ND [ ] IN ATION
[ ] FRAMING [ FINAL
[ ] FIREPLACE & CHIMNE
REMARKS:
DATE/ INSPECTO C
FIELD INSPECTION REPORT I DATE COMMENTS
b
FOUNDATION(1ST) y
------------------------------------
G
FOUNDATION(2ND)
ems.
z
� o
� y
ROUGH FRAMING& y
PLUMBING
A
(`I ax
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INSULATION PER N.Y.
STATE ENERGY CODE j
GS
J
FINAL
ADDITIONAL COMMENTS i
O
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m
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7
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TOWN OF SOUTHOLD BUILDING PERMIT APPLICATION CHECKLIST
BUILDING DEPARTMENT Do you have or need the following,before applying?
TOWN HALL Board of Health
SOUTHOLD, NY 11971 3 sets of Building Plans
TEL: (631) 765-1802 Planning Board approval
FAX: (631) 765-9502 Survey �
PERMIT NO. 0-9J7 _ Check -t l y y va
Septic Form
N.Y.S.D.E.C.
Trustees
Examined `�L1 ,20 Z Contact:
Approved '&I,, 20 Mail to:
Disapproved aic
Phone: Vt— 0!(p(j
Expiration ,20
(f;) lding Inspe r
� :
'LAR 18 �Q2
LJ APPLICATION FOR BUILDING PERMIT
BLDG. DEPT. Date 20
F _nurrsoLD I INSTRUCTIONS
a. This application MUST be completely filled in by typewriter or in ink and submitted to the Building Inspector with 3
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 laws, ordinances,building code,housing code, and regulations,and to admit
authorized inspectors on premises and in building for necessary inspections.
?1-,�o SW•Mry,of\
(Signature of applickit or name,if a corporation)
P,o. 8ox Flo ac,s-+ Mw;Jkes , t)�( t\c�ya
(Mailing address of applicant)
State whether applicant is owner, lessee, agent, arcJJhitect, engineer, general contractor, electrician, plumber or builder
w i,.,... ,� t ?00, Cc V\J t err,r
Name of owner of premises W 11 k�i,w. J- Ke ll2! St . IfWr� �'l• u��`4 r
(As on the tax roll or latest deed)
If applicant is a corpo on si ature of duly authorized officer
T P„A4,Ot�
(Name and title of corporate officer)
Builders License No.
Plumbers License No.
Electricians License No.
Other Trade's License No.
1. Location of land on which proposed work will be done:
180
House Number Street Hamlet
County Tax Map No. 1000 Section 35 Block Lot S• 1
Subdivision S�rv<+. Es 1c�eT SectiL� 1 " Filed Map No. R 4 a_(o Lot S
(Name) a (zzICt3
2. State existing use and occupancy of premises and intended use and occupancy of proposed construction:
a. Existing use and occupancy a 5+or y F=-4.e- N s e- A Gczr4t
b. Intended use and occupanc 'wool
3. Nature of work(check which applicable):New Building Addition Alteration
Repair Removal Demolition Other Work
(De cription)
4. Estimated Cost 13 ,�15 a 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 mixed 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 Number of Stories
8. Dimensions of entire new construction: Front Rear Depth
Height Number of Stories
9. Size oflot: Front 1 to 8. (o-7 Rear 6,6-&' Depth 0645- 3,;C
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
14. Names of Owner of premises Wm. t ae�wr< Kit I ei Address /Yo M4n.,4 C4. C.M4,wPhone No. 4j -7 7- 9,5,5 0
Name of Architect Address Phone No
Name of Contractor R-,cF6 PPact% Address_(o& Ho,,�e,k Ilo+4 Phone No. S'7 k- 7
1,
15 a. Is this property within 100 feet of a tidal wetland or a freshwater wetland? *YES NO ✓
* 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 t/
* 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 data on survey.
STATE OF NEW YORK)
SS:
COUNTY OF )
��w�✓� r' o Tl being duly sworn, deposes and says that ($)he is the applicant
(Name of individual signing contract)above named,
(;)He is the
(Contractor, Agent, Corporate Officer, etc.)
Of said owner or owners, and is duly authorized to perform or have performed the said work and to make and file this application,
that all statements contained in this application are true to the best of his knowledge and belief, and that the work will be
performed in the manner set forth in the application filed therewith.
Swo before me this
day of 1".an J, 200Z—
Notary
00LNotary Public DARLENE M. ROTH Signature o Applicant'
4001*ftY° PUBLIC, State of New %en
No. 4881014
0II41RNt1 In Suffolk Covatp
CI*Mtakn Enplra pae, 49,
-Ag,
Young & Young, Land Surveyors " IV
�'
400 Ostrander Avenue, Riverhead, New York 11901 '3 �a
631-727-2303
s03$
N Howard W. Young, Land Surveyor -qa
Than. C Wolpert, Profession.! Engineer ..Ka
Robert C. Tact, Architect €<e=
Ronald E. Pfuhl, Landscape Architect =
0
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4otDeP°t `rPc5 c �S. 1 mo
o< �e p �o<\` r��� °w r Nd NOTE
poi \c, seo. Pis °o �� AREA = 30,000 SQ. FT.
fiatµ QJb �' , • SUBDIVISION MAP "SUMMIT ESTATES, SECTION 1" FILED IN THE o
�e� �Nti6 +pc ;° Lot 8 d OFFICE OF THE CLERK OF SUFFOLK COUNTY ON NOV. 22, 1993 AS
sc.o..x a MAP N0. 9426
`N�tJ aI '1
de
>e,
29 SURVEYOR'S CERTIFICATIONQy`
• WE HEREBY CERTIFY TO WILLIAM J. KELLER, SR.,
DEBRA M. KELLER, TEACHERS FEDERAL "Om
` A M1M1. r~ CREDIT UNION & ADVANTAGE TITLE AGENCY, G ee
aype INC. THAT THIS SURVEY WAS PREPARED IN ACCORDANCE WITH €�
THE CODE OF PRACTICE FOR LAND SURVEYS ADOPTED BY THE
NEW YORK STATE ASSOCIATION OF PROFESSIONAL LAND
\roe is SURVEYORS.
NEW
sir sG6 `or `yob.
V;1
19
A `C� fYyr✓6'f.p(�,kJ' "/�,�"_"_ �^ * OP' G' * o
9 .`,'gee - r 2
°rPs hti\ CHOWARD W YOUNG, N.Y.S. NO 45893
6
S
45893
SF0 ANDS��
°r, s \S\
r SURVEY FOR
g<Rk
WILLIAM J. KELLER, SR. & DEBRA M. KELLER � €
LOT 8 "SUMMIT ESTATES, SECTION 1 "
At East Marion, Town of Southold mW
Suffolk County, New York ASH
County Tax MOP o..mlI 1000 S-U., 35 B1..F 8 poi 5.12
BOUNDARY SU FRVEY
0
-
GENERAL AMENDMENTS DEC. 70, 200F'oa
MAP PREPARED NOV 27, 20011
SCALE 1" = 40' Bim` S z
G= uax)xexr scs l= MONUMENT rouxo A = surc SET ♦- sru,e rouxo JOB N0. 2001-0448 vJl =Fb
DWG. 2001_0448bs =s��
DETAIL A
I OCCUPANCY OR WALL BRACE ASSEMBLY DETAIL
USE IS UNLAWFUL
GALVANIZED ANGLEI
\1-- - —�(
3 � S� I i WITHOUT CERTIFIC:TE
Of Of d&W—
ar►
NOTIFY B ILDING A I CONCRETE
765-1602 O A PM I = ( 42" FOOTER UNDISTURBED EARTH
FOLLO SPECTIONS: I WALL BRACE ASSEMBLY
1. F D#TION - TWO REOOIRw
OR POURED CONCRETE
----
kji-
2. ROUGH - FRAMING A-PLUNWINO �� ;.,.• ;;;
3 INSULAlllOy,
BE COMPLETE FOR CA. 2- BOTTOM MATERIAL— BEARNG PLATES x 12"
ALL CONSTRUCTION SHALL MEET3/8- REBAR
THE REQUIREMENTS OF THE NX Ll 1/2 x 24• x 14 GA.
STATE CONSTRUCTION t ENERGY GALVANIZED ANGLE
CODES. NOT RESPONSIBLE FOR
DESIGN OR CONSTRUCTION ERRORS NOTE:BACKFILL To GRAVEL,
OR OTHER NONN EXPANSIVE MATERIAL
B DETAIL A A
K
---- ----- ------ C --- ------ -- - -L
C D E- -F H -I- F
—NOTE—
„IMMEDIATELY" ION
THESE DIG DIMENSIONS COMPLY WITH THE NATAL SPA AND POOL INSTITUTE SUGGESTED MINIMUM
STANDARDS FOR RESIDENTIAL POOLS. WARNING - DD NOT DIVE IN THE SHALLOW END. IF DING BOARDS
OR SUM ME TO BE USED WITH THESE POOLS PLEASE CONSULT THE MANUFACTURE'S INSMUC 06
ENCLOSE POOL TO CODE
UPON CONIPLETION BOARDS OR SUDE.S ON THESE POOLS.( MORMAITION MINIMUM
NSM MINIMUM (STANDARDS,DIVING
* NO DNING BOARD ALLOWED BEFORE "WATER" NATIONAL SPA AND POOL INSRR11E, 2111 EISENHaM AVENUE. ALEXANDRIA, VA 22314 (703) Baa-0083
POOL SIZEk20
B C D E F G H J K L
12 x 24 * 24 a 76 s 26 s 2s 36 2610 CARDINAL SYSTEMS
733
14 x 26 * 26 1 o 7 6 6 2'61' 6 2 6 9 3 6 29 6 3 8 Seta V RL e1 (717 3 85 131
16'x32 732'7'74'7'-T''8 --;f''873635'9 1 4 SGnatLaLL ��+ PA (717) 385 1318 FAX
16 x 36 36 12 14 6 4 8 4 8 3 6 39 4 3 4 ��' 4-8-9 �1 6' R, CORNERS
18 'x3 5 36 12 14 6 4 '8 -T--f-0' 36 40 3 SCALE: NON RECTANGLE
20 x 40 40 14 14 s 4 s 4 12 3 s 44 s 5 a 1 DRAWN: KK I"LE NAMe RECT6RC