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Home My WebLink About23448-z FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No: Z-25419 Date: 12/12/97 THIS CERTIFIES that the building ACCESSORY Location of Property: 1365 PARK AVE MATTITUCK (HOUSE NO. ) (STREET) (HAMLET) County Tax Map No. 473889 Section 123 Block 2 Lot 29 Subdivision Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in. this office dated MAY 2, .1996 pursuant to which Building Permit No. 23448-Z dated MAY 15, 1996 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 INGROUND SWIMMING POOL WITH FENCE TO CODE IN REAR YARD AS APPLIED FOR. The certificate is issued to HAROLD F & IRENE SHIELDS (OWNER) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A ELECTRICAL CERTIFICATE NO. N-391780 07/19/96 PLUMBERS CERTIFICATION DATED N/A i Bui ing inspectEr Rev. 1/81 FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No: Z-25420 Date: 12/12/97 THIS CERTIFIES that the building ACCESSORY Location of Property: 1365 PARK AVE MATTITUCK (HOUSE NO. ) (STREET) . (HAMLET) County Tax Map No. 473889 Section 123 Block 2 Lot 29 Subdivision Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated MAY 2, 1996 pursuant to which Building Permit No. 23448-Z dated MAY 15, 1996 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 STORAGE SHED IN REAR YARD AS APPLIED FOR. The certificate is issued to HAROLD F & IRENE SHIELDS (OWNER) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A ELECTRICAL CERTIFICATE NO. N/A PLUMBERS CERTIFICATION DATED N/A BuilglIng inspeceor 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) Date ....................... N2 23448 Z ..................... 19. .. Permission Is hereby granted to: �i . ..... .:socz, ds/ G lc G ..c� .. A....................................... ......... f... ..y...� . . T to .................. .... era . .....�. ... . ..... .. .............. ...... ..... ...... . ... ...... .� .. ....... ............... ................. .... .. ..................... ... ........................................................................................ .........................................................`................... . at premises located at....../W—ll.. 7 � �-��............................................. ...... .fir•••••••..................................... ............................................................ .. . . ................................................................ . ........... County Tax Map No. 1000 Section .......1.P.Z ..... Block......6.7.� ............ Lot No. dR....?................. pursuant to application dated ......................L% ..... ..., 19.... ., and approved by the Building Inspector. Fee$.� .... . ........... ........ .../ .... l ............ Building Inspec r Rev. 6/30/80 Form No. 6 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL 765-1802 APPLICATION FOR CERTIFICATE OF OCCUPANCY A. This application must be filled in by typewriter OR ink and submitted to the building inspector with the following: 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 17 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 a 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 525.00, Additions to dwelling 525.00, Alterations to dwelling S25.00, wimming poo �Z5.0. , lccessory uildin� Additions to accessory building S25.00. Businesses $50.-00. 2. Certificate of Occupancy on Pre-existing Building - $100.00 3. Copy of Certificate of Occupancy - •25q. 4. Updated Certificate of Occupancy - $50.00 5. Temporary Certificate of Occupancy - Residential $15.000, Commercial $13.00 Date . . . . . . .!3 ,ll# 7. . . . . . . . . . . . . . . . . . . . . . . New Construction. . . . . . . . . . Old Or P e-existing Building. . . . . . . . . . . . . . . . . Q ✓1 Location of Property. . . 0.6 iz. . . . . . . .. . !�,7-T i i. . . C A� . . . . . . . . . . . . . . House No. Street Hamlet Onwer or Owners of Prop erty. e.v .2 ..�/�. .. . . .Si�e.��, 1 County Tax 'Map No 1000, Section. ./ a 3. . . . . .Block. . Z. . . . . . . . . . .Lot. �5 . . . . . . . . . . . . . . . . Subdivision. . . . .. . . . . . . . . . . . . .. . . .. . . . . . . . . . .. .Filed Map... . . . . . . . . .Lot. . . . . . . . . . . . . . . . . . . . . _ Permit No.a .yy... . . . . .Date Of Permit. .! . . L. •applicant. . . . . . . . . . .. . . . . . . . . . . . . . . . . . . Health Dept. Approval. . . . . . . . . . . . . . . . . . . . . . . . . ..Underwriters Approval. . . . . . . . . . . . . . . . . . . . . Planning Board Approval. . . . . . . . . . . . . . . . . . . . . . \l Request for: Temporary Certificate. . . . . . . . . . . Final Certicate. . . . . . Cam/ Fee Submitted: . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .i,�a�- a . . . . . . . . . . . . . . . . . . . . . . . . . . . . �� APPLICANT Form No. 6 1 TOWN OF SOUTHOLD BUILDING .DEPARTMENT TOWN HALL 765-1802 APPLICATION FOR CERTIFICATE OF OCCUPANCY A. This application must be filled in by typewriter OF, ink and submitted to the building inspector with the following: 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 a 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, wimm—R poo $25.0 , Tccessory building y 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 - .25v,-. 4. 1 Updated Certificate of Occupancy - $50.00 5. Temporary Certificate of Occupancy - Residential $15.00, Commercial $15.00 Date . . . . . . . 7. . . . . . . . . . . . . . . . . . . . . . . New Construction. . . . . . . . . . . Old Or Pe-existing Building. . . . . . . . . . . . . . . . . Location of Property. . . �,3.foS. . . . . . . . . . . . .✓.Yl ►`t_7-Ti i. H C ?(i:� . . . . . . . . . . . . . . House No. / Street Hamlet Onwer or Owners of Property. ~:C?!L:0. . . . . .. . . . • • • • • . . y County Tax Map No 1000, Section. .� . . . . . .Block. .a. . . . . . . . . . .Lot. o. 1, . . . . . . . . . . . . . . . . Subdivision. . . . .. . . . . . . . . . . . . . . . . . . . . . . . . . . . .. .Filed Map. . . . . . . . . . . .Lot. . . . . . . . . . . . . . . . . . . . . . Permit No.5� 3 yy�. . . . . .Date Of Permit. /! . . ?: . . .Applicant. . . . . . . . . . . . . . . . . . . . . . . . . . . . Health Dept. Approval. . . . . . . .. . . . . . . . . . . . . . . . . :Underwriters Approval. .... . . . . . . . . . . . . . . . . . . . . . . . Planning Board Approval. . . . . . . . . .. . . . . . . . . . . . . . Request for: Temporary Certificate. . . . . . . . . . . Final -Certicate. . . . . . C FeeSubmitted: $. . . . . . . . . . . . . . . . . . . . . . . . . . . . . �: C� / � ::`• • . . . . . . . . . . . . . . . . . . �� AP LICADIT cod 1:2_� z --9 23 H THE NEW YORK BOARD OF FIRE UNDERWRITERS ��Ti��lid%Gl BUREAU OF ELECTRICITY F_ 85 JOHN STREET, NEW YORK, NY 10038 Date J'Uj'y 1.9,1996. Application No.on file 120,73'1'-o/9G N 39171Ma THIS CERTIFIES THAT only the electrical equipgmentt as descri1beTd�below and P tintroduced byT N.Y. theapplicant named on the above application number in the premises of d-LC25\.RY a31-11- -DS, 136 5 �ARF ROAD, p`'i[i.1.TI AjUCE, N. 7.�. in thefollowinq location; ❑ Basement ❑ Ist Fl. .❑ 2nd Ft. OUT Section Block Lot was examined on JUI.yT 16,199C and found to be in compliance with the National Electrical Code. FIXTURE FIXTURES RANGES COOKING DECKS OVENS DISH WASHERS EXHAUST FANS OUTLETS RECEPTACLES SWITCHES INCANDESCENT.FLUORESCENT OTHER AMT. K.W. AMT. K.W. AMT. K.W. AMT. K.W. AMT. H.P. DRYERS FURNACE MOTORS FUTURE APPLIANCE FEEDERS SPECIAL REC'PT TIME CLOCKS BELL UNIT HEATERS MULTI-OUTLET DIMMERS SYSTEMS AMT. .K.W. OIL H.P. GAS H.P. AMT. NO. A.W.G. AMT. AMP. AMT. AMPS. TRANS. AMT. H.P. NO.OF FEET AMT. WATTS 1 �+J SERVICE DISCONNECT NO.OF S E R V I C E METER No' CC COND. A.W.G. A.W.G. A.W.G. AMT. AMP. TYPE E,0UIP 1,0 2W 10 3W 3,0'3W 3,U AW PER . OF CC.COND. NO.OF HI-LEG OF WLEG NO.OF NEUTRALS OF NEUTRAL OTHER APPARATUS: SW PIRMING PGOL_.1 ?'IAE CrOCF.;S_T>IiP �zr�•-1 t.f.C'.?--I (SVIDIMING POOL) TIAS cer if:i.cuxte covers <:omr_)Iiance� .it the date of inSpecti'on only. T_-;c?cause oP L1i1L1:3ual envirc)nments it is advisable, to have fr quont test/and or repairs made by a qualified person. <<< Continued on Far -je 2 GENERAL MANAGER Per This certificate must not be altered in any manner; return to the office of the Board if incorrect. Inspectors may be identified by their credentials. COPY FOR BUILDING DEPARTMENT. THIS COPY OF CERTIFICATE MUST NOT BE ALTERED IN ANY MANNER. THE NEW YORK ®BOARD OF FIRE UNDERWRITERS PAGE 2 1001290 BUREAU OF ELECTRICITY F_ 85 JOHN STREET, NEW YORK, NY 10038 Date JULY 19,1996 Application No.on file 12078196/96 N 391780 THIS CERTIFIES THAT only the electrical equipment as described below and introduced by the applicant named on the above application number in the premises of HARRY SHIELDS, 1365 PARR ROAD, MATTITUCK, N.Y. in the following location; ❑ Basement ❑ I st Ff. ❑ 2nd Ff. OUT Section Block Lot was examined on JULY 16,1996 and found to be in compliance with the National Electrical Code. FIXTURE FIXTURES RANGES ICOOKINGDECKS OVENS DISHWASHERS EXHAUST FANS OUTLETS RECEPTACLES SWITCHES INCANDESCENT FLUORESCENT OTHER AMT. K.W. AMT. K.W. AMT. K.W. AMT. K.W. AMT. H.P. DRYERS FURNACE MOTORS FUTURE APPLIANCE FEEDERS SPECIAL RECIPTI TIME CLOCKS BELL UNIT HEATERS MULTI-OUTLET DIMMERS SYSTEMS AMT. K.W. OIL I H.P. GAS H.P. AMT. NO. A.W.G. AMT. AMP. AMT. AMPS. TRANS. AMT. H.P. NO.OF FEET AMT. WATTS SERVICE DISCONNECT NO.OF S E R V I C E AMT. AMP. TYPE METER 1 0 7W 1�3W 3 0 3W 3 0 4W NO.OF CC.COND. A.W.G. NO.OF HI•LEG A.W G. NO.OF NEUTRALS A,W.G. EQUIP. PER 0 OF CC.COND. OF HI-LEG OF NEUTRAL OTHER APPARATUS: TED CHESHIRE JR. CO. LTC.#F953—P L L P.O. BOX 255A 9280 SOUND AVE. GENERAL MANAGER MATTITUCK, NY, 11952 11 _ a5 Per _ \s certificate must not be altered in any manner; return to the office of the Board if incorrect. Inspectors may be identified by their credentials. COPY FOR BUILDING DEPARTMENT. THIS COPY OF CERTIFICATE MUST NOT BE ALTERED IN ANY MANNER. �*^ - ^ / 4- .......... ' c�^� -------~ * \ �~ `. M ------------- - _�_ ---- M -------'-----'-------- i] --�-----------'------_--'_._-__---___---_--__- ''__-----_'_--'----_-----_-_ ----_-_---- �� _-----� � --'--'------------_-_ �--''-' — - .-- '- -- ' - ' �_----- ...... _'__________________ _ _. _._____ __��__`_____ _ \ � . . NORTH FORK WOOD DESIGN PAU US LANE & RT. 48 - PECON IC, NY 11958 PHONE: (516) 765-3090 FAX: (516) 765-0013 C TO J) i e r. Date j Address-J-3-(4, J1 1z Phone# (H) t V City C. — State-1 zip (w)-(I L ou rce Load Truck .Description ..... ..... Of SL C j-1 all— rim VN Special Instructions: rK PRICE AMOUNT NOTICE - TO ALL CUSTOMERS Options: BEFORE YOU MAKE YOURPURCHASE! •If site is not prepared properly and driver must prepare site,there will be an additional charge. •If site is inaccessible to our truck and we must return with shipment, up to 10%transportation cost will be charged. •Can we drive directly to the location you've chosen for your shipment? •Are there any overhead obstructions lower than 12'? •You the customer are responsible for any building permits and boundary lines! TOTAL We're going into your yard at your request,therefore we do not accept any responsibility for damages which occur! Tax•Placement of Shed. Our drivers must assume whatever instructions given by person(s)present,in accordance with the buyers wishes or in event no one is present,we do not assume responsibility whatso- Subtotal ever for misplacement of shed. Any relocation will be done at the buyer's expense. Deposit •Wood.when it is exposed to the elements has a tendency to shrink and expand. Because of this,we cannot accept responsibility for BALANCE DUE or) chipping,cracking,minor warping,etc. If there is a problem,please let us know. Signature 0 (D 0 s BUILDING DEFT. INSPECTION ] FOUNDATION 1ST [ ] ROUGH PLUG. [ ] FOUNDATION 2ND [ ] INS ATION [ ] FRAMING [ FINAL [ ] FIREPLACE & CHIMNEY REMARKS: Lol DATE �' y � 7 INSPECTOR ;r y +:, r r r} .. i s I I �w A erolo B He%n hoed B Bl.ortioro C[%rron 5�$ L 9h oln R/c Fronces11 Boil '::1. I Mathews, I ` � . 1 1 1j. r 1K815'571E" /I - 14'. `�' . % / C;'' ';. O t�I ar ti e I .I ` 1 1 Yhn 4 lti( ` �, ` I 11 '•,1 Y - 5 l � UQ 1 Ly I •.� IMEDIATEtY w� r 1 , rIY , 1f1<i r. '' r G d i ` ENCLOSE POOL:TO CODE : wl �, �r !. :' ;,: UPON C&PLETION BEFORE"WATER" L. .1 I' r n , _, 1. �, n o ,,I ., , p y ",d 1 ` i • ( Q •I ,* 1. fx LLLP irr ♦ !} C(' '4 I. ,'r I _ I. `I :.ID ,. 11 ,g !r r tddr +. .i r'l,�r'i+ ", I�� I 1 t t T I .�i r' ' g I, /4.r s•f � x . ,�I.. ... -,'I I. .- . . . _.1.f- C,I. ..'.. I I - .�Is I ...IA :.%,,�,1-. . � . '� n ;O ,r/ I ` 1 ,n O t ONLLUNta . ' t' I . 1. 0 _ ''f O TEST Not.L tL iDD : ' ,• r.— .._. , _ - ..((L ,' LJ f t�, • 11f86°57E /8500 S86.57 W /0000 • q .i* c.�1at .AVENUE. : } I`PARK t� , ,rf R''^I .. , ... ,. i I ' . . `o �.�.-! - TCaT NoLC •If I oo If4 t f t' LOAM�, �• � 1L.Y r j, f , ,t ` }OML CLAY„ J „} �— I rI. . OW[kLiNQ. t -r• tI t i 11 �' I 17D 1 ?a, i i� r SURVEY.'FOR • NOV'?I 19�9 OCT:. THOMAS A. KEW/N Q LE/LAM KEW/N S£PT?s,i97e p to .4UG.9,/978, =4; AT MATT/TUCK 'DATE I auG.4, /978 .' _ TOWN OF SOUrHQLD SCALE / = 40 ,ia • . .. .. ' SUFFOLK COUNTY4'.,'NEW�..O K ?, :' ' NO. . I 78' 4N .' j ri UNAUINORITED ALIE'RATION OR AOOITION t0 TNu :61/ARAN. r0 . .. •'SURVErq A VIOLATtOM�O/SCC t10N:TtOf 0►INC , NI OP.CS fTT.,S SUOSTIONLAw R/VERNEAD p�/A�9� •COPI(S 01 iN15 SURVCY NOT lCAR1NQ INC LAND lUR vEYOR'S INKED SEAL'OR EYBOS;EO SEAL SHALL AMER/CA dVCO. ,,I ., _ NOT BE.CONSIDERED TO DE A VALID TRUE COPY �r . }• �* •'. •GUARANTEES-INOICAICO NCRCONSHALL RUN ONLYTO O O � ' 1- T.0 PERSON FOR-*HOW INC SURVEY I!PREPARED Q`_ pI G HEALTH.DEPARTMENT-DATA FOR APPROVAL.TO CONSTRUCT �4 ANO ON NISL'f[NALF TO INC TITLE COM►ANY.00V[RN „ A .•2 . M NEAREST WATER MAIN-01.1 M.SOURSE OF WATER.P IVATL XPUBLIC ' , MENIAL,.AOENCT AND LCNOINO INSTITUTION LISFEO f� "r,T fiT %lUFR.CO.TAR MAP DIf T, lLCTION t1 OLOCR Z LOT ' NLREON,AMO,./0 TNEA{110NECf 01 INC-,.LtN01M6 f .K M THERE AMC NO DWELLI G WITHIN 1 0•FEET OF TNIl FRO Y .. INS TITVTION;GUARANI([* AMC NOT:TRANS/E RA11L[ OTHER THAN THOSE SHOW ON.[ON. � ' ;` TO ADDITION AL INS TITU TIONf OR fVB![OULNt p `.:c , M•THE WATCR SUPPLY'AND! WAGE OIS POSAL SYf TEN FOR iHIf RElIOENC[ OWNER! , ,.!. 'r;e ` �. WILL CONFORM TO THE BTJUOARDS OF THE SUFFOLR COONTY O[FMTN[NT RDISTANCES.SHOWN MERLON FROM FRO►ERTY LINES I fir,. �q g93 OF HEALTH SERVICES. I 'PUR OSCTO ING STRUCTURES AND AMC NOT TO fCEU[0 TO ESTABLISH ' yr. �,,; APPLICANT, - ,PROPERTY LINES OR FORTH[[AEC TION 01,FLMCES.. M''''• t S �`I ADORElSI - - �/" ',f tEL,I. YOUNG e�_YOUNG 4000STRANDERAVENUE . _. RIVERHEAO,NEW YORK aorE. .I , a':,t 7 11 - )•:ti� ■ A NOH(/MENT FQbNp ALOEN W YOUNO,PROFESSIONAL�NOINEER J. AND LAND SYRYEYQR NlYSIIIICENSE NO 1�9g0 40WARO W,•YOUNOILANO/URVtTOR. ' r 'wTHELDCATIONOPWELLIWI,3IPTICTANK11T10CESSPDOIBICFglnol7nHEREOH N.Y.S.,LICENSE NO.45893 ;:� ARE FROM FI D SERVAT NS AN OR DATA DETAINED FROM 0 RS ,'-1 f; Co/L tA� LADDER RIM LDCN OR OOIQD,E nRum, - - - OWNER: ISLANDIA-, FOOLS BY JOHN J. WYSOCZANSKI 108 FISHEL AVENUE, RIVERHEAD. NEW YORK 11901 (516)727-6312 NOTE: FOR DIMENSIONS SEE TABLE BELOW ua RIM LOCK COPING GRADE POLY POW BACIGNG wOLMMUIFD?X(r TOP PLATE ;.A S70� RETURNS VINYL LINER Qo 11r Sma ROCS CON wMONOunoc Am L o r SAND BASE 17 FLAIR 0` TYPICAL POOL PLAN BOfTOM FILTER h PUMP UND IRJRBFD PUMP WATERLINE { NOTE: FOR DIMENSIONS SEE TABLE BELOW NNYL LINER l'-Y TAMPED SAND BOTTOM I- G I o T I —�� 1 ry TYPICAL CROSS SECTION m 1 i. FIBERGLASS MOLDED 1 PIECE q7 OPTIONAL STEP CEMENT IN ENf n J eu.R ....:.......:.:..::..:.::..:..:.:......:..._.-----.:.:..::...:::::::....:.:::.... :.:::..:....:.-.::::.............:........_..................... ...... .. ....... PER LEG `-1--Y TAMPED SAND BOTTOM - �C----.�--A� TYPICAL SIDE SECTION NOTES: 1. 3,500 L.B. TEST CONCRETE TO BE USED ; IN CONTINUOUS POUR. I rB DMNG BOARD—A-44'e-16 2. WATER DISPOSAL TO BE LIMITED TO OWNERS I D:DMNG BOARD-A-4A-B-llf N.S.P.I. TABLE OF DIMENSIONS D DmNc B°c4.f ..B ,ErJ 3. THISOPOOOL SHALL NOT E EMPTIED.CAL REGULATIONS. 4. ALL WOOD TO BE PRESSURE IMPREGNATE- SIZE A B C I D E 'F G H WITH PRESERVATIVE. 20X40 10 �j 10 20-'7-0 30 5. WALKS TO BE SMOOTH NON—SKID TYPE, 18X3 8 ` 5 ` 8 '.8�� SLOPED AWAY FROM THE POOL. t I 1 Richord& &OlOu/Umoffiews . I 1 I uN i w I a Bario//i N.86°57E ldo.00r" — �� 1. 4 iI "L� ,i t+ 1 1' ! •i I Df AT�4.�•I OOLTO CODE w .,y i • LOSE.P Bi�CpQN C®Mp1 �W' p� n,, .BEFORE AIy i 4. O p i p ►r Noia,tl.te.e p, rj j.m:— _ _ _ i—F^ `__rr-�.. ..- fir: •�--•__L: 4- '` q Al B6°57�E. ioapo AVENUE PARK ..,. ..'�'.. TCbT MOLL. Tom►AIOIV O-e 0.0 ,i�f ,�,;.�;' i• SOME CLAY SURVEY FOR,'. L NOV. 7 1978 t '` TNOMAS A. KEWIN TQ LEILA M. KEWIN OCT. 11, I9Te SfPr?S,/976 /976., AT MATT/TUCK DATE I AUG.4, I978 f' TOWN OF SO UTHOLD' SCALE l 11 = 40 SUFFOLK COUNTY,'NEW YORK ' NO. 1 78-47/ +' A UNAUTHORITEO ALTf'RATIoN OR ADD,TIoH To TNIII GbARANTEEO TO SURVEY IS A VIOLATION Of SECTION TEOS OF 1N( t NEW YORA STATE EDUCATION LAW.:•,. • R/VERNEAO .. P COPIES OF '"IS SURVEY NOT.11EARINO THE LAND '. _t SURVEYOR'S HIRED SEAL OR EMOOSSEO SELL SMALL AMER/CA /1 � CO. NOT AE CONSIDERED TO It A VALID TRUE COPY yLP I /„ T* A DUAAANIEE9 11101CATED HEREON SMALL RUN ONLY TO HEALTH DEPART MENT-�DATAFOR APPROVAL TOCONSTRUCT T-(PEREDN'tOR*MOM TN( SURVEY IS PREPARED,. �t R .r �;� �G AND OM MIS SENAL/TO THE TITLE COMPANY,OOV(RN• ,Q x NNEAREST WATER MAIN 1.! 11•,SOURSE D►WATERIP IVATIX►VILIC•� M[N1AL .AO(NCY ANO,LCNOINO INSTIf Vf10N LISTED (1 G7 TVSUF'.CO.TA%MAP DIS QQSLCTION��2,1�OLOCit "L LD T-/��e� M(ACOM1,AND TO THE A1110NtLS pl TM(.LENOIMO ((� �•I ,M THE AL AR[NO DWLLL 07 WITHIN IOU"i-LLT OI TNii PROPLRTY INSTIYV TION'.OUARAM IL(S ARl NOT TRANS/[RA SLL \• .' , ' yf OTHER TMAH THOSE SHOW 1 HEREON. TO ADDITIONAL INSTITUTIONS DR SUOSEOUENT +.• *THE WATER SUPPLY AND S WAOE 013POSALSYITEM FORTHIS R(SIOENCE OWNERS WILL CONFORM TO THE STANDARDS Of THE SUF/OLK COUNTY DEPARTMENT R DISTANCES SHOWN N(REON FROM PROPERTY LINE I �¢�, �0•q Og3 Of HEALTH SERVICES. I TO(AISTINO STRUCTURES ARE FOR A SPECIFIC 4 a1 APpIICANT,. I PURPOSE AND ARE NOT TO SE USED TO LSTARLISH prC D� PROPERTY LINES OR FOR THE ERECTION OF FENCES. ADORESSI 400 OSTRANDER AVENUE YOUNG 6„YOUNG ,, RIVERHEAD,NEW YORK NO r4* ■ •NON(/MENT FOUNp A YOUNO,PhOFESSIONAL iNOINEER ;..i.. , AND LAND SURVEYOR NITS,LICENSE N0.121046 ?` HCWARq W.YOUNo,LAN0 runvtroM . L 'NTMELOCATIOHOFWELLIWI,SE►TICTANK(STIOCESSPOOLS(CPISMOWHH(REON N.Y.S.LICENSE NO.L4S 893 N11 ARE FROM FIfl,D OUSE RVATIPNS ANQ OR DATA 03TAINE0 FROM OT RS SLOPE t1@ LADDER RAM LOCX Olt 0016D E1fTRUSION OWNER: - I SLAN,DIA - POOLS BY JOHN J. WYSOCZANSlfl 108 FISHEL AVENUE, RIVERHEAD, NEW YORK 11801 (516)727-6312 NOTE: FOR DIMENSIONS SEE TABLE BELOW 08 RBI LOCK COPING GRADE POLY FOAM BACIONG WOILANRID Y%C TOP PLATE _ . :;•� SlOS0ETt5 RETURNS LINER . 90 MONOLITHIC 1/[SfEEL RODS ,�1 CONCRETE W�� f SAND BASE lY FLAIR TYPICAL POOL PLAN BQfTOY FILTER x UNDISTURBED PUMP WATERLINE EARTH Q NOTE: FOR DIMENSIONS SEE TABLE BELOW .. , VINYL LINER f B, � _ 1'-Y TAMPED SAND BOTTOM o T G ry b I TYPICAL CROSS SECTION m <, 3 .- FiBFS:GLASS MOLDED 1 PIECE OPTIONAL STEP T= d, ENp StT)IN lEG I CEl1E1Tf J eu tt PER ( ) f T 1'-Y TAMPED SAND BOTTOM C I A TYPICAL SIDE SECTION NOTES: 1. 3,500 LB. TEST CONCRETE TO BE USED s'omr NG eoueo-A—u�B—I� IN CONTINUOUS POUR. B:DM BOARD—A-4lB-1� 2. WATER DISPOSAL TO BE LIMITED TO OWNERS 10'GIVING BOARD-A-44"B-16 PROPERTY TO SUIT LOCAL REGULATIONS. N.S.P.I. TABLE OF DIMENSIONS _ C_Z_r 1 3. THIS POOL SHALL NOT BE EMPTIED. 4. ALL WOOD TO BE PRESSURE IMPREC-14 TED SIZE A B C r D E F G H L WITH PRESERVATIVE. 2OX40 10 30 5 10 2C 2U 40 30 5. WALKS TO BE SMOOTH NON-SKID TYPE. 18X3gt 8 `® 5 L{� 14.18 SLOPED AWAY FROM THE POOL. �a [� 80,1RD OF HEALTH �D FORM NO. 1 3 SETS OF PLANS . . . . . . . . . . e� e TOWN OF SOUTHOLD SURVEY . . . . . _ _ _ . . . 11 MAY — G BUILDING DEPARTMENT CIIECK . . . . . . . . . . . . . . . . . . . . .TOWN HALL sErrlc FOR:I f SOUTHOLD, N.Y. 11971 - BLDG.DEFT.T OF SOUt TEL.: 765-1803 t:OT I Fy r ((HO� .-xamined .�✓. . . ., 19 . CALL . . . . . . _ . . . . . . . . . . . . f/�/ NAIL %pproved . . . . . / No. �G�.U, .�1 . . :, 19 Permit ..disapproved a/c �. .. . . �r. . . . . . . . . . . . . . . . . . . . . . . . . . . . . � /ley Building Inspector APPLI TION FOR BUILDING PERMIT Date . . : 19 ;. INSTRUCTIONS a. This application must be completely filled in by typewriter or in ink and submitted to the Building Inspector, with 3 is 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 areas, and giving a.detailed description of layout of property must be drawn on the diagram which is part of this appli- .tion. 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 issued a Building Permit to the applicant. Such permit all 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 whatever until a Certificate of Occupancy all have been granted by the'Building Inspector. APPLICATION IS HEREBY MADE to the Building Department for the issuance of a Building Permit pursuant to the iilding Zone Ordinance of the Town of Southold, Suffolk County, New York, and other applicable Laws, Ordinances or =gulations, for the construction.of buildings, additions or.s `eraiios; or for reptnoval o demolition, as herein described. ie applicant a,grees to comply with all applicable laws, or inances, b ' ' g c e, hog: ng code, and regulations, and to mit authorized L*rspectors on premises and in building for n essary i tion�. (Signature of applican or na e, if a corporation) . . ... . . . . . . . . . . . . .. . . . yG% ailing address of applicant) ate whether applicant is owner, lessee, agent, architect, engineer,—generate contractor, electrician, plumber or builder. . . .... . ; Ac . . . . . ... . . . . . . . . . . . . . . : . . . . . . . . . . . . . . . . . . . . . me of owner- of premises . . . . . . . . . . . . . . . . . . (as on the tax roll or latest deed) applicant is a corporation, signature of duly authorized officer. • . . (Name and title of corporate officer) .. Builder's License No. . . .( . 6. 1, Plumber's License No. . . . . . . . . . . . . . . . . . . . . . . . . . Electrician's License No. Other Trade's License No. . . . . . . . . . . . . . . . .. . . . . . Location of land on which proposed work will be done. 0. . . . . . . . . . . . House Number yy Street . . . . . . . . . . . . . . . . . .Hamlet. . . . County Tax Map No. 1000 Section . . . . .I.Z3„ , , . . Block . . . . Lot . . . . : . . . . . . . . . . ��--� . . . . . . . . . . Subdivision . . . . . . . . . . . ... . . (N ame) . . . . . . . . . . . . . . . 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 . . . . . . . . . C9, �KK. ,vi;, : • c{ . . ,� ..A( . 3. Nature of work (check which applicable): New Building . . . . . . . . . . Addition "N v v- ltt raiio.n :.., Repair . . . . . . . . . . . . . . Removal . . . . . a . . . . . . . . Demolition . . . . . . . . . . . . . I r'Other Work . . . . . . ... . . . . . . . V D 2y Description) 4. Estimated Cost . . . . . f• ��. . . . . . . . . . ... . . . . . . . . . . . . . Fee •r . . . . . . . . (to be paid'on f1109,,11?is„application) 5. If dwelling,number of dwelling units . . . . . . . . . . . . . . . g on - ':Number of dwellin units cach`°fl�$1•":`� " If garage, number of cars . . . . . . . . ' ' ' ' • 6. If business, commercial or mixed occupancy, specify nature and extent of each type of use . • . 7. :Dimensions of existing structures,if any: Front . . Rear Depth . . Height . . . . .,: . . Number of Stories . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Dimensions of same structure with alterations or additions: Front • • . . . . . . . . . . . . . . • Depth . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Rear . . ... . . . . . . . . . . . . . . . Height . . . . . . . . . . . . . . . . . . . Number of Stories . 8. Dimensions of�entire new construction: Front Depth. Height . Number of Stories �l$Q 4W1 - . �n �?�� . �Cr. . . . . . . . . . . . .9. Size of lot:•Front . . . . . . . . . . . . . . . . . . . Rear . • Depth. . . . . . . . . . . 10. Date of Purchase . . . . . . Name of Former Owner I.I. Zone or use district in which premises are.situated . • • ' ' ' • ' ' ' ' ' ' ' ' ' 12. Does proposed construction violate any zoning law, ordinance or.regulation:• • . • • . • •( 13, 'Will lot be regraded Will excess fill be emove • rom premises: • • . 14. Name of Owner of premises �a�?�L4. , •511i1'W�✓ �i Q No • • • • • • . • .Address . ./.3(pS�,�i�?J� G;►•�-e• Phone No. Y9(.0. -5,� Name of Architect . Address . Phone No. Name of Contract orseo9 ?!� ,r�vLs • LT/l • • • , Address' ,/1Jd: s/:'�G�l9ve ✓�� phone No. .��7:.�3/, , 15. Is this property within 300 feet of a tidal wetland? *If yes, Southold Town Trustees Permit may be required. � • � . . A PLOT DIAGRAM Locate clearly and distinctly all buildings, whether existing or proposed, an&indicate all set-back dimensions from property lines. Give street and block number or description according to deed, and show street names and indicate whether interior or corner lot. UNDERWRITERS CERTIFICATE REQUIRED a f �4, ptic ub; AP R� Q AS NOTE # ,r U pyA. A , °� DATE: / B.P. FEE. C, „? `, y M10TIF� BUILDING ®E E T � k Ej F ', �` 755-1802 B AMA 70 4.P J OR TFIE . s u FOLLOWING INSPECTIONS: � . I- FOUNDATION �$ t, U - TWO REQUIRE® ��J FOR POURED CONCRETE 2. ROUGH - FRAMING & PLUMBING 3. INSULATION 4. FINAL - CONSTRUCTION MUST IMMEDIATELY" SE COMPLETE FOR C.Q. ALL CONSTRUCTION SHALL IISIEE'F', LOSE POOL TO CODE THE REQUIREMENTS OF THE Iu.Y.. UPON COMPLETION STATE CONSTRUCTION & ENERGY BEFORE 'WATER" t,ODES. NOT RE; PONSII3LE FOR DO~Sl hl(JR CONSTR�II TIIti1M ERROR STATE OF NEW YO.RK, . :OUNTY OF . . . . . . S.S y • • • • • • • • • • • • • . . . . being duly sworn, deposes and says that lie is the applicant (Name of individual signing contract) bove named. re is the . . . .�.�J. �C 5q 4.. . . . . . . . . . . . . . . . . . ... . . . . . . . . . . . . . . . . . . . . (Contractor, agent, corporate officer, etc.). . . . . . . . . . . _ . . . • . • ' . . f said owner or owners, and is duly authorized to perform or have performed the said work and to make and file this T)plication; that all statements contained in this application are true to the best of his knowledge and belief;and that the, 'ork will be performed in the manner set forth in the application filed therewith. Wom to bef�lme this . . . . . . . . . . . of. : . . . . , ota Public, L/' 1 f DIANE M.KOR00_ESKi Notary Public.State of New Yar � • • • . . . . . . . . . . . ... . : :. . . . . No.48913t10 - . (Signature of applicant) Qualified in Suffolk County Commission Expires.tune 8, 1 S