HomeMy WebLinkAbout42402-Z � �0"4'F
Town of Southold 5/31/2019
P.O.Box 1179
o • ph53095 Main Rd
Southold,New York 11971
CERTIFICATE OF OCCUPANCY
No: 40424 Date: 5/31/2019
THIS CERTIFIES that the building IN GROUND POOL
Location of Property: 1625 Chablis Path, Southold
SCTM#: 473889 Sec/Block/Lot: 51.-3-3.6
Subdivision: Filed Map No. Lot No.
conforms substantially to the Application for Building Permit heretofore filed in this office dated
2/21/2018 pursuant to which Building Permit No. 42402 dated 2/21/2018
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, FENCED TO CODE, AS APPLIED FOR
The certificate is issued to Boger, Scott&Gerarda
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL
ELECTRICAL CERTIFICATE NO. 42402 05-28-2019
PLUMBERS CERTIFICATION DATED
4
uth riz d §ignature
s�Frnc� TOWN OF SOUTHOLD
ON
BUILDING DEPARTMENT
TOWN CLERK'S OFFICE
o . SOUTHOLD, NY
ypta1 � �pp�`
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#: 42402 Date: 2/21/2018
Permission is hereby granted to:
Boger, Scott
PO BOX 1603
Southold, NY 11971
To: Construction of an in-ground swimming pool as applied for.
Replaces BP# 39751
At premises located at:
1625 Chablis Path
SCTM # 473889
Sec/Block/Lot# 51.-3-3.6
Pursuant to application dated 2/21/2018 and approved by the Building Inspector.
To expire on 8/23/2019.
Fees:
PERMIT RENEWAL $125.00
Total: $125.00
Building Inspector
S� FF oto TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN CLERK'S OFFICE
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#: 39751 Date: 5/11/2015
Permission is hereby granted to:
Boger, Scott & Boger, Gerarda
PO BOX 1603
Southold, NY 11971
To: Construction of an in-ground swimming pool as applied for.
At premises located at:
1625 Chablis Path, Southold
SCTM # 473889
Sec/Block/Lot# 51.-3-3.6
Pursuant to application dated 5/1/2015 and approved by the Building Inspector.
To expire on 11/9/2016.
Fees:
SWIMMING POOLS -IN-GROUND WITH FENCE ENCLOSURE $250.00
CO - SWIMMING POOL $50.00
tal: $300.00
Buildin s e or--""
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)
Location of Property: /���' eW4A'4f° �. l_xo
House No. ,� Street Hamlet
Owner or Owners of Property: Se-err L�,eIZ41144
Suffolk County Tax Map No 1000, Section Block Lot
Subdivision Filed Map. Lot:
Permit No. Date of Permit. Applicant:
Health Dept.Approval: Underwriters Approval:
Planning Board Approval:
Request for: Temporary Certificate Final Certificate: (check one)
Fee Submitted: $
Ap i t Signature
so
Town Hall Annex Telephone(631)765-1802
54375 Main Road Fax(631)765-9502
P.O.Box 1179
®
Southold,NY 11971-0959 ® ® roger.riche rtAtown.south old.ny.us
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BUILDING DEPARTMENT
TOWN OF SOUTHOLD
CERTIFICATE OF ELECTRICIAL COMPLIANCE
SITE LOCATION
Issued To Scott Boger
Address: 1625 Chablis Path City: Southold St: New York Zip: 11971
Building Permit* 42402 Section: 51 Block- 3 Lot 36
WAS EXAMINED AND FOUND TO BE IN COMPLIANCE WITH THE NATIONAL ELECTRIC CODE
Contractor: HOME OWNER DBA: License No:
SITE DETAILS
Office Use Only
Residential X Indoor Basement Service Only
Commerical Outdoor X 1 st Floor Pool X
New Renovation 2nd Floor Hot Tub
Addition Survey Attic Garage
INVENTORY
Service 1 ph Heat Duplec Recpt Ceiling Fixtures HID Fixtures
Service 3 ph Hot Water GFCI Recpt 1 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 1
Transformer Appliances Dryer Recpt Emergency Fixture Time Clocks 1
Disconnect Switches Twist Lock Exit Fixtures �] TVSS
Other Equipment: In ground swimming pool to include, bonding, control panel, 1-time clock,
1-GFCI circuit breaker,salt generator,gas pool heater, 1-pool pump,2-low voltage pool lights, 1-GFCI recpticble
Notes:
Inspector Signature: Date: May 28 2019
81-Cert Electrical Compliance Form.xls
E
Y � Y
Of so(/Tyo
* # TOWN OF SOUTHOLD BUILDING DEPT.
°ycou765-1802
INSPECTION
[ ] FOUNDATION 1ST [ ] ROUGH PLBG.
[ ] FOUNDATION 2ND [ ] ULA ON
[ ] FRAMING /STRAPPING [ FINALPWL---�
[ ] FIREPLACE & CHIMNEY [ ] FIRE SAFETY INSPECTION
[ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRATION
[ ] ELECTRICAL (ROUGH) [ ] ELECTRICAL (FINAL)
[ ] CODE VIOLATION [ ] CAULKING
REMARKS:
orp1r �n�l'K
DATE INSPECTOR
OF SOUTyo�
* * TOWN OF SOUTHOLD BUILDING DEPT.
°ycou765-1602
INSPECTION
0
[ ] 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)
[ ] CODE VIOLATION [ ] CAULKING
REMARKS:
14" 6y- cac-te�
DATE / / INSPECTO� '
IC 1
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1 ON
STATE ENERGY C
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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
SoutholdTown.NorthFork.net PERMIT NO. �J� -�(� Check
Septic Form
N.Y.S.D.E.C.
Trustees
Examined 120 Storm-Water Assessment Form
1 1 S�_ Contact:
Approved ,20 Mail to:
Disapproved a/c
Phone:
Expiration ,20 1 L
Building Inspector -
rrp I PPLICATION FOR BUILDING PERMIT
1 2015
� Date 20
INSTRUCTIONSa3i�rrMUST- e 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 Biuilding Inspector will issue a Building Permit to the applicant. Such a permit
shall be kept on the premises available for inspection throughout the work.
e.No building shall be occupied or used in whole or in part for any purpose what so ever until the Building Inspector
issues a Certificate of Occupancy.
f. Every building permit shall expire if the work authorized has not commenced within 12 months after the date of
issuance or has not been completed within 18 months from such date. If no zoning amendments or other regulations affecting the
property have been enacted in the interim,the Building Inspector may authorize, in writing,the extension of the permit for an
addition six months.Thereafter, a new permit shall be required.
APPLICATION IS HEREBY MADE to the Building Department for the issuance of a Building Permit pursuant to the
Building Zone Ordinance of the Town of Southold, Suffolk County,New York, and other applicable Laws, Ordinances or
Regulations, for the construction of buildings, additions, or alterations or for removal or demolition as herein described. The
applicant agrees to comply with all applicable laws, ordinances,building code,housing code, and regulations, and to admit
authorized inspectors on premises and in building for necessary inspections.
(Signature of applicant or name,if a corporation)
lMgi SON9700,ky //97/
(Mailing address of applicant)
State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician,plumber or builder
Name of owner of premises
(As on the tax roll or latest deed)
If applicant is a corporation, signature of duly authorized officer
(Name and title of-corporate officer)
Builders License
Plumbers License
Electricians License No.
Other Trade's License No.
1. Location of land on which proposed wo&will be done:
House Number Street Hamlet
County Tax Map No. 1000 Section 5'/ Block 3 Lot
Subdivision &WeWzyt/vi/.Q1Z ylfG+ Filed Map No. Lot
(Name)
`l
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 11000/4-
(Description)
4. Estimated Cost 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 zle' Rear Depth
Height -,2- 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 111a,0:7, Rear /��'6 Depth /?0
10. Date of Purchase Name of Former Owner
11. Zone or use district in which premises are situated 165-145A.1 ",4.4-
12. Does proposed construction violate any zoning law, ordinance or regulation? YES NO X
13. Will lot be re-graded? YES NO Will excess fill be removed from premises? YES NO-X-
14. Names of Owner of premises�W7-9- � Address Phone No. ✓/-�-65--26��
_ Name of Architect Address Phone No
Name of Contractor Address Phone No.
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--�
* 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 )
being duly sworn, deposes and says that(s)he is the applicant
(Name of individual signing contract) above named,
C®tVN1E Q.BUNCH
(S)He is the Notary PW11%State of New York
No 01RU6185M
(Contractor,Agent, Corporate Officer, etc.) oua#W in Suffolk County
Commission Expires April 14,2 a(-
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
day of 20 �
Notary Public Signature of pplicant
Scott A. Russell
o �1F ST�O�][�I�W WA IEIK
SUPERVISOR IM[A,NA,G IEIM11EN'7F
SOUTHOLD TOWN HALL-P.O.Box 1179 c
53095 Main Road-SOUTHOLD,NEW YORK 11971i9i� Town of So u th o l d
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.
❑ B. Excavation or filling involving more than 200 cubic yards of material
❑13/ 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.
❑�. ite preparation within the one-hundred-year floodplain as depicted
on FIRM Map of any watercourse.
101F. 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.
%k 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.
APPLICANTiSe
A'-7
j. Professional,Agent,Contractor,Other) S.C.T.M. #: 1000 Date
istnct
NAME
Section Block Lot
gE26d
CS,Sna,nfe, :" FOR BLiii-I`))i.Nu r)rPAl'TN11-:NT t.tiE t)N1_.T'
Contact Information l✓l.j !/I�� "" 1
'telephone Numbcr
Reviewed By:
— — — — — — — — — — — — — — — — — —
Date �--�l S✓
Property Address / Location of Construction Work: — — — — — — — — — — — — — — — — —
A��,` Approved for processing Building Permit
l� �y ✓T�� Stormwater Management Control Plan Not Required
�V"� ��`9�� ❑ Stormwater Management Control Plan is Required
(Forward to Engineering Department for Review)
FORM * SMCP-TOS MAY 2014
so
O !
Town Hall Annex 1t 1�C Telephone(631)765-1802
54375 Main Road N ,aaxx
(631)765-
P.O.Box 1179 GQ foger.rlChert 1pWrt_SOUt O ad nV us
Southold,NY 11971-0959
BUILDING DEPARTMENT
TOWN OF SOUTHOLD i
APPLICATION FOR ELECTRICAL INSPECTION i
REQUESTED BY: (J (A 9,L Date:
Company Name:
Name:
License No.:
Address--
Phone No.:
JOBSITE (NFORMATION: (*Indicates required information)
*Name:
*Address:
*Cross Street:
`Phone No.: 631
Permit No.: — 361151
-
Tax-Map District: - 1000 Section: 5j Block: Lot:
*BRIEF DES IPTION OF WORK(Please Print Clearly)
(Please Circle All That Apply)
*Is job ready for inspection: YES/ NO Rough In Final C
*Do-you need a Temp Certificate: YES/ NO
Temp Information (if needed)
i
*Service Size: 1 Phase 3Phase 100 150 200 300 350 400 Other
*New'Service: Re-connect Underground Number of Meters Change of Service Overhead,
Additional Information: PAYMENT DUE WITH APPLICATION
82-Request for inspection Form
�y�FFaI�Co BUILDING DEPARTMENT- Electrical Inspector
TOWN OF SOUTHOLD
Town Hall Annex - 54375 Main Road - PO Box 1179
Southold, New York 11971-0959
�'�O� Telephone (631) 765-1802 - FAX (631) 765-9502
roger.richert(a-town.southold.ny.us
APPLICATION FOR ELECTRICAL INSPECTION A
Date: �0_� �-7REQUESTED BY:
Company Name:
Name: 5evri" f�oC�E/L
License No.: email: Sco C r�1•9�G • ��
Address: a
Phone No.: d 3/ - 6r- 7t G3/
JOB SITE INFORMATION: (All Information Required)
Mame:
Address:
Cross Street: 6v.�vv�E�✓
Phone No.: 63/ -7G�'3 y� 63� 6�-26E'S/ •
Bldg.Permit#: 2� o ?� email: �co�r�GGG�2�! remit.�
Tax Map District: 1000 Section: 5-.( Block: 3 Lot: 3. G
BRIEF DESCRIPTION OF WORK(Please Print Clearly)
Circle All That Apply: Inal
y Inspection?:
read for Ins NO Rough In
Is fob P
Do you need a Temp Certificate?: YES t to Issued On
Temp Information: (All information required)
Service Size 1 Ph 3 Ph Size: = # Meters Old Meter#
New Service - Fire Reconnect- Flood Reconnect- Service Reconnected - Underground-Overhead
# Underground Lateral's 1 2 H Frame Pole Work done on Service? Y N
Additional Information:
PAYMENT DUE WITH APPLICATION `S
_ CP� g�5
82-Request for Inspection ForrnAs ��
pr SOUryOlo
Town Hall Annex 4 Telephone(631)765-1802
54375 Main Road Fax(631)765-9502
P.O.Box 1179 G • O
Southold,NY 11971-0959 'Q
14 enu T i
BUELDING DEPARTMENT
TOWN OF SOUTHOLD
May 10, 2019
Scott Boger
PO Box 1603
Southold NY 11971
Re: 1625 Chablis Path, Southold
TO WHOM IT MAY CONCERN:
The Folio 'ng Items(if Checked)Are Needed To Complete Your Certificate of Occupancy:
Electrical Underwriters Certificate 1✓l5P I5 ��,�/��
A fee of$50.00.
Final Health Department Approval.
l
Plumbers Solder Certificate. (All permits involving plumbing after 411/84)
Trustees Certif cate'Of Compliance. (Town Trustees#765-1892)
Final Planning Board Approval. (Planning#765-1938)
Final Fire Inspection from Fire Marshall.
Final Landmark Preservation approval.
Final inspection by Building Dept.
Final Storm Water Runoff Approval from Town Engineer
BUILDING PERMIT —42402 — Swimming Pool
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