HomeMy WebLinkAbout43424-Z o,,pS�EFnt,�coG Town of Southold 5/15/2019
P.O.Box 1179
o -
�' ? 53095 Main Rd
Southold,New York 11971
CERTIFICATE OF OCCUPANCY
No: 40382 Date: 5/15/2019
THIS CERTIFIES that the building HOT TUB
Location of Property: 1410 Kimberly Ln., Southold
SCTM#: 473889 Sec/Block/Lot: 70.-13-20.11
Subdivision: Filed Map No. Lot No.
conforms substantially to the Application for Building Permit heretofore filed in this office dated
1/23/2019 pursuant to which Building Permit No. 43424 dated 1/28/2019
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:
"AS BUILT"HOT TUB AS APPLIED FOR
l
The certificate is issued to Zeifnan,Danielle&Ross
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL
ELECTRICAL CERTIFICATE NO. 43424 04-26-2019
PLUMBERS CERTIFICATION DATED
outhid Signature
SOFEnt TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN CLERK'S OFFICE
oy.,• o� 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#: 43424 Date: 1/28/2019
Permission is hereby granted to:
Zeifman, Danielle
736 W 187th St Apt 305
New York, NY 10033
To: legalize an "as built" hot tub as applied for.
At premises located at:
1410 Kimberly Ln., Southold
SCTM #473889
Sec/Block/Lot# 70.-13-20.11
Pursuant to application dated 1/23/2019 and approved by the Building 'Inspector.
To expire on 7/29/2020.
Fees:
CO - SWIMMING POOL $50.00
SWIMMING POOLS -ABOVE-GROUND WITH REQUIRED FENCING $500.00
Total: $550.00
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$15.0/0 +�
Date. 0/—G3 " Iq
New Construction: Old or Pre-existing Building: Ase (check one)
Location of Property: k 0 je�^e, S 0__tl�
House No. l Street\ Hamlet
Owner or Owners of Property:
Suffolk County Tax Map No 1000, Section 7 Q Block `) Lot XCC)
Subdivision Filed Map. Lot:
�
Permit No. 7 z Date of Permit. Applicant: n\czffm
Health Dept.Approval: Underwriters Approval:
Planning Board Approval:
Request for: Temporary Certificate Final Certificate: (check one)
Fee Submitted: $ cU
plicant Signatur
Town Hall Annex Telephone(631)765-1802
54375 Main Road CP- Fax(631)765-9502
P.O.Box 117
Southold,NY 119711-0959 ® �o roger.riche rt(ED-town.south old.ny.us
Comm
BUILDING DEPARTMENT
TOWN OF SOUMOLD
CERTIFICATE OF ELECTRICIAL COMPLIANCE
SITE LOCATION
Issued To: Danielle Zeifman
Address: 1410 Kimberly Ln City- Southold St: New york Zip: 11971
Building Permit#: 43424 Section 70 Block. 13 Lot 2011
WAS EXAMINED AND FOUND TO BE IN COMPLIANCE WITH THE NATIONAL ELECTRIC CODE
Contractor: AS BUILT DBA: License No:
SITE DETAILS
Office Use Only
Residential X Indoor Basement Service Only
Commerical Outdoor X 1st Floor Pool
New Renovation 2nd Floor Hot Tub X
Addition Survey X Attic Garage
INVENTORY
Service 1 ph Heat Duplec Recpt Ceiling Fixtures HID Fixtures
Service 3 ph Hot Water GFCI Recpt Wall Fixtures Smoke Detectors
Main Panel A/C Condenser Single Recpt Recessed Fixtures CO Detectors
Sub Panel A/C Blower Range Recpt Fluorescent Fixture Pumps
Transformer Appliances Dryer Recpt Emergency Fixtures Time Clocks
Disconnect Switches Twist Lock Exit Fixtures TVSS
Other Equipment: "HOT TUB"---"AS BUILT"---"ELECTRICAL SURVEY"---"NO VISUAL DEFECTS"
Notes: GFCI protected disconnected for self contained hot tub
Inspector Signature: — ^~ Date: April 26 2019
81-Cert Electrical Compliance Form As
soil
# # TOWN OF SOUTHOLD BUILDING DEPT.
�ycoum e765-1802
INSPECTION
[ ] FOUNDATION 1ST [ ] ROUGH PLBG.
[ ] FOUNDATION 2ND [ ] SULATION
[ ] FRAMING /STRAPPING [ FINAL W7
[ ] FIREPLACE & CHIMNEY [ ] FIRE SAFETY INSPECTION
[ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRATION
[ ] ELECTRICAL (ROUGH) [ ] ELECTRICAL (FINAL)
[ ] CODE VIOLATION [ ] CAULKING
REMARKS:
v u p ( --j d-A )
DATE INSPECTOR
i
FIELD INSPECTION REPORT DATE COMMENTS
FOUNDATION(1ST)
--------------------------------
'FOUNDATION
------------------------------'FOUNDATION (2ND)
Z
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-ate
ROUGE FRAMING&
PLUMBING y 1
r
INSULATION PER N.Y:
STATE ENERGY CODE
q i
FINAL
ADDITIONAL COMMENTS
q fc, D61. rJ1 0,37c5a 5q J3
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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 4 sets of Building Plans
TEL: (631) 765-1802 Planning Board approval
FAX: (631) 765-9502 ` �+ Survey
Southoldtownny.gov PERMIT NO. �� 2� i Check Da
Septic Form /pb ;
N.Y.S.D.E.C.-
Trustees
C.O.Application
Flood Permit
Examined ,20 Single&Separate
Truss Identification Form
( 0�� Storm-Water Assessment Form
it D Contact:
�S �
Approved 20 JAN 23 2019 Na w- �� Jo: 1 c
Disapproved a/c // �/ Q
• r..; • �- �-=�=.�.: Phone• .-
Expiration ,20 1'T OF 8® ^�
Building Inspector
APPLICATION FOR BUILDING PERMIT
Date , 20
INSTRUCTIONS
a. This application MUST be completely filled in by typewriter or in ink and submitted to the Building Inspector with 4
sets of plans, accurate plot plan to scale. Fee according to schedule.
b. Plot plan showing location of lot 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, anew,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.
Lo n% -Y-s kn-pA, 0_aa Q9
(Signature of applicant or name,if a corporation)
6v oc)&
(Mailing address of applicant)
State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder
Name of owner of premisesQ
(As on the tax roll or latest deed)
If applicant is a corporation, si nature of duly authorize officer
_6_A0 \ IAOA�lC
(Name and title of corporate officer)
Builders License No. ,-4'-(y 1 —
Plumbers License No.
Electricians License No.
Other Trade's License No.
1. Location of land on which roposed wor will be done: P ,
House Number Street Hamlet
CountyTax Ma No. 1000 Section ° i
p ``7 �� Block �� Lot \1
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
b. Intended use and occupancy
3. Nature of work (check which applicable): New Building Addition Alteration
Repair Removal Demolition Other Work bu 800? 0.6+�J6
(Description)
4. Estimated Cost o(�o 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.
5 m
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 of lot: Front Rear Depth
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 NOK-
13. Will lot be re-graded? YES NO Will excess fill be removed from premises? YES NO
14. Names of Owner of premises Ju�1 �� `tt� Qess \.4tO ho e No.
Name of Architect Address Phone No
Name of Contractor 6 vAddress EiW.U-Q2NVT Phone No. G C-!D
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.G. 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 data on survey.
18. Are there any covenants and restrictions with respect to this property? * YES NO
* IF YES, PROVIDE A COPY.
STATE OF NEW YORK)
,, SS:
COUNTY OF g
o being duly sworn, deposes and says that(s)he is the applicant
(Name of individual signing contr ct)above named,
(S)He is the (��-rac
(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
o�Jt/d day OUG—mum1 20� `
�J TRACEY L. DWYER
NOTARY PUBLIC,STATE OF NEW YORK �
Notary Pub 1 DW6306900
QUALIFIED IN SUFFOLK COUNTY S1 ature of App a t
COMMISSION EXPIRES JUNE 30,2-0-LI,
t,Scott A. Russell °Su Ir STO]KN[WA\T]E K
SUPERVISOR MA NA\(Gr]EI�WIENT
SOUTHOLD TOWN HALL-P.O.Box 1179
53095 Main Road-SOUTHOLD,NEW YORK 11971 � � Town of Southold
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)
❑ A. Clearing, grubbing, grading or stripping of land which affects more
than 5,000 square feet of ground surface.
❑ & Excavation or filling involving more than 200 cubic yards of material .
within any parcel or any contiguous area.
❑[ C. Site preparation on slopes which exceed 10 feet vertical rise to
❑� 100 feet of horizontal distance.
D. Site preparation within 100 feet of wetlands, beach, bluff or coastal
erosion hazard area.
❑� E. Site preparation within the one-hundred-year floodplain 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-
rict
NAME- � ( Ji
A 3—
'P.' Section Block Lot
S'8"°`°") " `k`FOR BUILDING DEPARTMENT USF ONLY
I '**`
Contact Information- �?-
rriePhonr Nomha
Reviewed By: 0�1 uu=�A
— — — — — — — — — — — — — — — — — — 2j r
Property Address / Location of Construction Work: Date.
— — — — — — — — — — — — — — — —
Approved for processing Building Permit.
�® lam. Stormwater Management Control Plan Not Required.
��t"V�U l �l� ❑ Stormwater Management Control Plan is Required
(Forward to Engineering Department for Review.)
FORM # SMCP-TOS MAY 2014
p c � BUILDING DEPARTMENT- Electrical Inspector
Q� a 219 TOWN OF SOUTHOLD
a TQWn Hall Annex -
54375 Main Road PO Box 1179
� oDix�v� � D • ' Southold, New York 11971-0959
! ' Pov$0 Telephone (631) 765-1802 - FAX (631) 765-9502
160 roger.richert(cD-town.southold.ny.us
APPLICATION FOR ELECTRICAL INSPECTION
REQUESTED BY: Date:
Company Name:
Name: k'Z� 0
License No.: 5-5 toy� —K email: l CC),C-' r-O k
Address: C) i n kct tt
Phone No.: a—
JOB SITE INFORMATION: -(All Information Required)
Name:
Address: �d-
Cross Street:
Phone No.: _ 571(o Q$ 1�-7 to$
Bldg.Permit#: email:
Tax Map District: 1000 Section: Block: Lot:
BRIEF DESCRIPTION OF WORK(Please Print Clearly)
Circle All That Apply:
Is job ready for inspection?: ES NO Rough In Final
Do you need a Temp Certificate?: YES NO Issued On
Temp Information: (Ali information required)
Service Size 1 Ph 3 Ph Size: A #Meters Old Meter#
New Service - Fire Reconnect- Flood Reconnect-Service Reconnected - Underground - Overhead
# Underground Laterals 1 2 H Frame Pole Work done or Service? Y N
Additional Information:
_PAYMENT DUE WITH APPLICATION
QJ '00
82-Request for Inspection FormAs 01/ �� \�
GUARANTEED
ROSS ZEIFMAN
DANIELLE ZFJFMAN
A_ WELLS FARGO BANK
STEWART TITLE INSURANCE COMPANY
FILE MAP LOT NUMBER(MAP OF PARADISE BAY)
-UN,WTHDROED ALTERATION OR ADDITION TO A SURVEY MAP PREPARED AND SEALm BY A UCENSED LAND
Cl SURVEYOR IS A VIOLATION OF SECOON 7709 OF THE NEW YORK STATE EDUCATION LAW.-
'COPIES FROM THE ORIGINAL OF THIS SURVEY MAP NOT MARKED WITH AN ORIGINAL OF THE LAND SURVEYOR'S
INKED SEAL OR HIS EMBOSSED SEAL SHALL NOT BE CONSIDERED A VALID TRUE COPS-"•CEROFICATION
Q Q, INDICATED HEREON SIGNIFY THAT THIS SURVEY WAS PREPARED IN AD
CORdWCE WTTH THE IXISIING CODE OF
�'- - < '9,O PRACTICE FOR UND SURVEYS ADOPTED BY THE NEW YORK STATE ASSOCIATION OF PROFESSIONAL LAND
' rCY\,� k AND ON HIS BEHALF TO nTHE770 LE SHALL RUN ONLY To THE�RNYENTAL PERSON
AND LENDING INSTITUTION.URVEY PREPARED.
9� gs( CERTIFICATIONS ARE NOT TRANSFERABLE TO ADDIOONAL INSTITUTIONS OR SUBSEQUENT OWNERS.'
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CCF F1LON N,TAp PARADISE BY THE BAY,FILE No 6463,111411976 DL57 1000 SEG 70 BLK- 13 LOT 2011
NO A
REV DATE.NOV 25.2018 REV DATE FEB 7,201
DATE FEBRUARY 2,2018 SCALE 1'=40' SHEET.1 OF 1
(ADD POOL PATIO,ETC) (EASEMENT INFO)
V r
APPROVED AS NOTED
DAT :&—li B.P.# ��?-`i E COMPLY WITH ALL CODES OF
' NEW YORK STATE & TOWN CODES
FEC BY. _ AS REQUIRED
NOTI� Y BUILDII,." D`PARTMENT AT
765 1 02 6 AM T 0 4 PM FOR THE SOUTHQT�W►�7R_�
FOLLOWING INSPECTIONS: SO
1. FOUNDATION - 1WO REQUIRED
FOR POURED CONCRETE S(1LL O DTOWNTRUSTEES
2. ROUGH - FRAMING & PLUMBING N.Yl[g
3. INSULATION
4. FINAL - CONSTRUCTION MUST
BE COMPLETE FOR C.O.
ALL CONSTRUCTION SHALL MEET THE w � w
REQUIREMENTS OF THE CODES OF NEW -E��nsb� E °0 Y OR
YORK STATE. NOT RESPONSIBLE FOR USE IS UNLAWFUL
DESIGN OR CONSTRUCTION ERRORS.
MTHOUT CERTIFICATE
OF OCCUPANCY
"IMMMIA 1TC GL!~
ENCLOSE POOL Td'CODE
UPON COMPLETION ;;ETNN STORM WATER RUNOFF
BEFOR5"WATER_" D01 SUANT TO CHAPTER 236
Gr THE TOWN CODE.
ELECTRICAL INSPECTION REQUIRED
Limelight' Collection
rULSE
Seating Capacity 7 adults
T Dimensions 7'5"x 7'5"x 38"/2.26m x 2 26m x 0.97m
''a m ; """ ��' \ ' { Water Capacity 445 gallons/1,655 titers
Weight 1,015 lbs/460 kg dry;5,950 lbs/2,700 kg filled'
i I Spa Shell Colors Alpine White,Ice Gray,Platinum,Tuscan Sun or Desert
C 't , , _ _ _: _ `•� ( Cabinet Finishes Coastal Gray,Espresso or Sable
Jets-49 1 XL Dual Rotary jet
(w/Brushed Stainless 1 XL Single Rotary jet
i j4 Steel Trim) 2 XL Directional lets
d
4StandardSingleRotaryjets
1 � _� ; j 2 Standard Directional jets
i = 4 Rotary Precision jets
35 Directional Precision jets
Water Feature Vidro®backlit ribbon waterfall
Water Care System FreshWater®Salt System
(Optional)
Jet Pump 1 Wavemaster®9200 Two-Speed 2.5 HP,
continuous duty 5.2 HP,breakdown torque
- Jet Pump 2 Wavemaster°9000 One-Speed 2.5 HP,
Pulse shown with Alpine White shell continuous duty 5 2 HP,breakdown torque
Circulation Pump SilentFlo 5000®for quiet,continuous filtration
Effective Filtration Area 100 sq.ft.,top-loading filters
Control System 10 2020°with LCD control panel 230v/50amp,601lz
"i - Includes G.F.C.I,protected sub-panel.
-� G U " Lighting System Raio°multicolor interior points of Light(32)
Exterior multi-color lighting with timer
• ��-,�___ �. "�--'j Heater No-Fault,4,000w/230v
Energy Efficiency FiberCor'insulation;Certified to the APSP 14
s - l National Standard and the California Energy
f Commission(CEC)in accordance with California Law
Vinyl Cover 3.5"to 2.5"tapered,2 lb.density foam core,with
hinge seal in Caramel,Chestnut or Slate
Cover Lifter(Optional) CoverCradle®,CoverCradle II,Lift'n Gtide"or UpRite°
Steps(Optional) Everwood°or PoLynlei
i
Entertainment System Wireless Entertainment
(Optional)
Pulse shown with Alpine White shell& 'Includes water and 7 adults weighing 175 lbs each
Coastal Gray cabinet Export models available in 240v,50Hz,1500w heater
HotSpring @
Every day made better®
0 2018 Watkins Wellness ®Rev R