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HomeMy WebLinkAbout43052-Z �gilFFO(,f�� Town of Southold 8/8/2019 �O G� P.O.Box 1179 T 53095 Main Rd p��,ti i Southold,New York 11971 j� CERTIFICATE OF OCCUPANCY No: 40607 Date: 8/8/2019 THIS CERTIFIES that the building HOT TUB Location of Property: 825 Kimberly Ln.,Southold SCTM#: 473889 Sec/Block/Lot: 70.43-20.5 Subdivision: Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated 9/14/2018 pursuant to which Building Permit No. 43052 dated 9/19/2018 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: SPA ADDITION TO AN EXISTING POOL AS APPLIED FOR The certificate is issued to Mandelbaum, Jay&Or of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL ELECTRICAL CERTIFICATE NO. 43052 08-01-2019 PLUMBERS CERTIFICATION DATED th d Signature o�goFEotK�oTOWN OF SOUTHOLD BUILDING DEPARTMENT y 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#: 43052 Date: 9/19/2018 Permission is hereby granted to: Mandelbaum, Jay 1107 Fifth Ave Apt 7N New York, NY 10128 To: install accessory hot tub as applied for. At premises located at: 825 Kimberly Ln.,Southold SCTM # 473889 Sec/Block/Lot# 70.-13-20.5 Pursuant to application dated 9/14/2018 and approved by the Building Inspector. To expire on 3/20/2020. Fees: ACCESSORY $250.00 CO - SWIMMING POOL $50.00 Total: $300.00 Buil ing 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 DatV �°�1/ice/I �' New Construction: Old or Pre-existing Buildin �i � (check one) Location of Prope 9�� *W 1 �/ 1 oo( id House No. 9 _ r Street � Hamlet Owner or Owners of Prop I-A y 1 h �-f/1 G aum a4 �L�✓� C�—0 0 Suffolk County Tax Map No 1000, Section? � Block 13 Lot �•S Subdivision 'POL61-Ci k 0y ThAE— L`�`�� Filed Map. A�,, Lot: S Permit No. Date of Permit. Applicant: ��� I�u ooW�"/In Health Dept.Approval: Underwriters Approval: Planning Board Approval: • / Request for: Temporary Certificate Final Certificate: ✓ (check one) Fee Submitted: $ C,(0- Aliplicant Signature pF SOUr�,®l Town Hall Annex ~ ® Telephone(631)765-1802 54375 Main Road Fax(631)765-9502 P.O.Box 1179 G Q roger.richert(cDtown.southold.ny.us Southold,NY 11971-0959 ol�C®UN N BUILDING DEPARTMENT TOWN OF SOUTHOLD CERTIFICATE OF ELECTRICIAL COMPLIANCE SITE LOCATION Issued To. Jay Mandelbaum Address: 825 Kimberly Ln City: Southold St: New York Zip: 11971 Building Permit#: 43052 Section: 70 Block: 13 Lot 20.5 WAS EXAMINED AND FOUND TO BE IN COMPLIANCE WITH THE NATIONAL ELECTRIC CODE Contractor: DBA: Quinlan Electric License No: 4437-ME SITE DETAILS Office Use Only Residential X Indoor Basement Service Only Commerical Outdoor X 1st Floor Pool New X Renovation 2nd Floor Hot Tub X Addition Survey 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 FixtureTime Clocks Disconnect Switches Twist Lock Exit Fixtures 9 TVSS Other Equipment. "NEW SPA, ADDED TO EXISTING POOL", to include, bonding, spa blower, spa jet motor,spa filter pump,gas spa heater,3-GFCI circuit breakers Notes: Inspector Signature: 7aDate: August 1 2019 81-Cert Electrical Compliance Form.xls OF SOGIyO� * # TOWN OF SOUTHOLD BUILDING DEPT. cou765.1602 INSPECTION [ FOUNDATION 1ST [ ] ROUGH PLBG. [ ] 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: MNr DATE O INSPECTOR 1 OE SOUIyo� # TOWN OF SOUTHOLD BUILDING DEPT. `ycourm, 765-1802 INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLEIG. [ ] 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: DATE �� f INSPECTOR �o��,oF soulyolo # TOWN OF SOUTHOLD BUILDING DEPT. cou765-1802 INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] NSULATION [ ] FRAMING /STRAPPING [ FINAL W l I y [ ] FIREPLACE & CHIMNEY [ ] FIRE SAFETY INSPECTION [ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRATION [ ] ELECTRICAL (ROUGH) [ ] ELECTRICAL (FINAL) [ ] CODE VIOLATION [ ] CAULKING REMARKS: o c," t4ve DATE 9/1 INSPECTOR OF SOUlyO� * # TOWN OF SOUTHOLD BUILDING DEPT. `ycou765-1802 INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PI-13G. o--?2- FOUNDATION --?2FOUNDATION 2ND [ ] INSULATION l [ ] FRAMING /STRAPPING [ ] FINAL [ ] FIREPLACE & CHIMNEY - [ ] FIRE SAFETY INSPECTION [ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRATION [ ] ELECTRICAL (ROUGH) ELECTRICAL (FINAL) [ ] CODE VIOLATION /[ ] CAULKING REMARKS: DATE INSPECTOR Bunch, Connie From: Gary Grismer <gary@pelicanpoolsinc.com> Sent: Wednesday, February 20, 2019 6:58 AM To: Bunch, Connie Subject: Mandelbaum 825 Kimberly Lane Southold Hi Connie. Can you please have a steel inspection done for Mandelbaum new Gunite spa at 825 Kimberly Lane Southold and let me know when it has been completed? Thanks so much, Gary r V `3 Gary J Grismer V.P. /Partner Pelican Pools Inc. 516-369-1504 i FIELD INSPECTION PLEPORT DATE CO MENTS J FOUNDATION (IST) ---------------------------------- 'FOUNDATION (2ND) z � o ROUGH FRAMING& PLUMBING H �� INSULATION PER N.Y-. H STATE ENERGY CODE �- ^ V ) JOVI FINAL ADDITIONAL COMMENTS u1 C ° CR - CT CF z • z d H 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: 631 765-95021 L,-2 �1 SurveyCep(�sl Southoldt wnny.gov PERMIT NO. 3D�� Check Septic Form N.Y.S.D.E.C. Trustees C.O.Application r-< � OVIE Flood Permit Examined 20 D Single&Separate Truss Identification Form SEP 1 4 2010 Storm-Water Assessment Form IContact: l Approved '20 L� >l�UMDI?N DER". Pdfail-ta:J&` fth cum-n Z•lYth,' h5+1 p� � �Q� Disapproved a/c �t`� t •:,. .'I� V, _6V_8Wf Phone: Expiration 20 Bu di s e or APPLICATION FOR BUILDING PERMIT L Date—S 6 �y, 20 (Sof 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,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. (Si a re of applicant or name,if a corporation) Nem Yvi 1-, d&AI yLin(c. (oi -I.- (Mailing address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician,plumber or builder 0 WVV ev-' Name of owner of premises Jay 10 c ✓ d ell Avoi a4ot �--ay yre o 6—o✓cto� (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 No. Plumbers License No. Electricians License No. Other Trade's License No. 1. Location of land on which proposed work will be done: ) :9 -x� '✓vibe,- I 1,0tile— -Sou� a CA House Number Street Hamlet County Tax Map No. 1000 Section .Block ; L"ot ® o Subdivision a,-A-Alde i? I te- "Rct Filed Map No. 3 Lot 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy S;+k ig f944A I'( WIAA N01 a4 pbp1 koJ,&e.- b. Intended use and occupancy S 0.Kke, ; �Q�/Yi2sT►► �1�i1yN c�' -"p O d� h c+JV Y wI41A ti v1 $i)(jjq V16 rJ v o 3. Nature of work(check which applicable): New Building Addition Alteration f Repair Removal Demolition Other Wo !Ad h-4::-1V 1�' W t" (Description) awl. 4. Estimated Cost '7'- 'Ofd t7e f 9 (To lie' aid on filing this application) 5. If dwelling, number of dwelling units .Number.of dwelling unitl U each floor If garage, number of cars 6. If business, commercial or mixed occupancy, specifyAkure and extent,of each type of use. 7. Dimensions of existing structures, if any: Fron / Rear a " ( Depth Height ?,<;o ' Number of Stories -2-- Dimensions of same structure with alterations or additions: Front Rear Depth Height Number of Stories 8. Dimensions of entire ne construction: Front I Rear 10 Depth .-3 s ° Height Number of Stories A aJ 1A «s ►si o poa I r �✓� 9. Size of lot: Front Rear 11 I .S�( 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 NO 13. Will lot be re-graded? YES NO V Will excess fill be removed from premises? YES NO �i c'7 (vl n del 6 WA- g, k;r ly L.&kle-- 14. Names of Owner of premises L, s-ul'em 6-vrkA Address ((5W Phone No. Name of Architect Address Phone No Name of Contractor 94M i Govt Po,,s, [vi c.. Address ,mPhone No. 4--S-1 35' I y n 16g' Ob. Is this property within 100 feet of a tidal wetland or a freshwater wetland? *YES NO YES, SOUTHOLD TOWN TRUSTEES &D.E.C. PERMITS MAY B E 13,EQUIRED..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 Von * IF YES,PROVIDE A COPY. STATE OF NEW YORK) SS: � COUNTY 0696-[Lo'C Jdy M c-nJdloau Iq being duly sworn,deposes and says that(s)he is the applicant (Name of individual signing contract) above named, (S)He is the Don-c r_ (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. Swor tp before me this -i day of r 2019 r 44 Ct (:�)UUAA TRACEY L DWYER Notary Public OTARY PUBLIC,STATE OF NEW YO gnature of Applicant NO.01 DW6306900 QUALIFIED IN SUFFOLK COUNTY COMMISSION EXPIRES JUNE 30,21? sum Scott A. Russell ,��° STORIM[WAT EJK SUPERVISOR ( N SOUTHOLD TOWN HALL-P.O.Box 1179 b 53095 Main Road-SOUTHOLD,NEW YORK 11971 Town of So u th o l d CHAPTER 236 - STORIMIWATER MANAGEMENT WORK SHEET ( TO BE COMPLETED BY THE APPLICANT ) --- - - --- --- - --- --- -- - ---------- DOES THIS PROJECT INVOLVE ANY OF ')<'IH(lE FOLLOWING: (CHECK ALL THAT APPLY Yes No E] A. Clearing, grubbing, grading or stripping of land which affects more than 5,000 square feet of ground surface. ❑F2(B. Excavation or f illing involving more than 200 cubic yards of material within any parcel or any contiguous area. ❑LTJ C. Site preparation on slopes which exceed 10 feet vertical rise to ❑[B/ 100 feet of horizontal distance. D. Site preparation within 100 feet of wetlands, beach, bluff or coastal erosion hazard area. ❑ . Site preparation within the one-hundred-year f loodplain as depicted on FIRM Map of any watercourse. ❑[0/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 ' Distrct � NAME: nVV � '&/M 13 iP-0 Section Block Lot FOR BUILDING DEPARTNIENT USE ONLY Contact Information �),j n-I_jA 1 f tl dcplrone\um7crr Reviewed By: ji A Property Address/ Location of Construction Work: — — — — — — Date: -1 '1 Ll— — — — — — — — — Approved for processing Building Permit. Sto—rmwater Management Control Plan Not Required. S�✓ �J, �' �1 ❑ Stormwater Management Control Plan is Required (Forward to Engineering Department for Review.) FORM SMCP-TOS MAY 2014 BUILDING DT WElectrical I N OF SOUTHOLD � DD Town Hall Annex - 54375 Main Road - F ox 1179 Southold, New York 11971-0c, APR 2 9 2019 Telephone (631) 765-1802 - FAX(631) 765-9502 - roaer,richert(Mtown:southold.ny,:us `ie_: TOWN OF SOLIZia0LD A_ PPL_ KATION FOR ELECTRICAL INSPECTION REQUESTED BY: % ae I 41.1 (et 1 _ - Date:, ��a Company Name: Q u% Fa-nI-JA ; G .INS - - - - Name: License No.: Mf. y'3 7 - - - email: Address: Phone No: 13 9 Ya - JOB SITE INFORMATION: (All Information Required) _ Name: -- Address: Cross Street: T _ Phone No.: - - 9'17 6 j.3- 888 - - - - - -- - - - - -- --- Bldg.Permit#: email: _ -- Tax Map District: 1000 Section: --)o Block: L lr3 _Lot: 2©�S BRIEF DESCRIPTION OF WORK(Please Print'Clearly) � a Ake z�, k y p�aL Circle All That Apply: Bo/J� Is job ready for inspection?: YE / NO Stough I Final Do you need a Temp Certificate?: YES NO Issued On Temp Information: (All 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 on Service? Y N Addition al-Information: - - - PAYMENT DUE WITH APPLICATION 82-Request for Inspection Formals " - 6 lz�- I.: .::: . CHAIN LINK FENCE ulz P fLLWAYl 24.8' 7 CL f Or 0. -.n I I . --I — 0 ROOF ,4Y W&L 0 FRAME O.L POOL HOUSE u—' Pro pmcwk- 6,4 4 s;,;k r 24.4' Poo co t 62 Iuj C,4. In. 00 all. 10 Box Zs, 4e 0j Lj fl�u APPROVED AS NOTED DATE: B.P. , 05�2_ RETAIN STORM WATER RUNOFF ebb BY: PURSUANT TO CHAPTER 236 ,NOTIFY BUILDING DEPAhThlErNT AT OF THE TOWN CODE. 765=1802.• 8 AM TO 4 PM FOR THE FOLLOWING INSPECTIONS: 1: FOUNDATION - TWO REQUIRED FOR POURED CONCRETE 2:ROUGH. FRAMING & PLUMBING 3:.iNSULAT ;, 4. FINAL - CONSTRUCTION MUST BE COMPLETE FOR C.O. ELECTRICAL ALL CONSTRUCTION SHALL MEET THE INSPECTION REQUIRED REQUIREMENTS OF THE CODES OF NEW YORK STATE. NOT RESPONSIBLE FOR DESIGN OR CONSTRUCTION ERRORS. COMPLY WITH ALL CODES OF NEW YORK STATE & TOWN CODES AS REQUIRED AND CONDITIONS OF rSB�kIA� RD 7 , EB +i'TEES nm OCCUPANCY OR' USE IS UNLAWFUL WITHOUT CERTIFICATE OF OCCUPANCY N"SOY JAFFE,P.E. $ ® 82EAMCHASE 1. 7N6 DCV1AH H Wtto MI A PWW6'�aL, ►:q1 WOODBURY,NY 11797 < )oyb *T• ArvLNP NAMIN %U IIS vpTr ,s NIi111►t iN�LI►111'y of TIK "CAIMIMA It d ARM so � W►rt� Lxni� blltTrld �O°af,Le�I �IfV�,yrs QL•W'rtMWA fMI.Inf" Nru. Pe 1140111AW, wA1 EP+ vrsrovw 11 unites p woph fives a/ 2. No 4UAatWE AU 04W Nlydw IV Gf 4841-0�" PrP MP frd Of PUP ENP" Toe rNFunAT"*r �ru�v conn lacir+ItE. oAku" pe A 1:1 npc wNH h r1Nrinun of 0)Ye 441,400 of 049A rfA ow Ofafogilt, r piu.VT 4W "I'MA r1W Orl W ff w fRt- M SMrrTA1`art/W . -dA ryaw:Ire��+r A*m"I "rap To or. "fuµ M -tyPICJi rvn®arr 40f9 g TV 6°Mr17 rM Irj CIL— . ��TrrRF15 N�?>`fb Pur+P - IN wM I�x uKr sLAW aatcrt s y4trG---- l�.� p1'ficNAN �Sriarr9irti ' �N M`COOSf� 1:1 soc-T1814 "to r-%, �4°eaue'�'eoN fait 1)IET-s vw�vE ties Go1.�rcros K GRAN F-L PFMIDE 6" MIN. FROST ROOF TILE UNDER COPING PIPING SCHEMATIC • rr t lb EAT SPA DESIGN � C ��ZRE'ryRNS) ! m - ,i � � EI.�VAT10tN • POOL r•= - 12" x 1Z"�CN MAX. SPACING 3/8- DIA. SMEL SM OL POSIDES - 6" x 6° CN�MAX. SPACING POOL INTQtIOR WIRTL LIcRr COIAR MARBLE DUST MINIAAL 6' OOVE RADIUS BEMEM FLOOR AND WALLS Mandelbaum .-�t•,�q T,�a'�� ;��;_, FiYmosrmc VALVES 825 Kimberly Ilan `` -s COLLEMR TUSES Southold, NY cvER GRAVEL EASE I X31 . H. ROY JAFFE, P.E. ' 82 EAGLE CHASE,WOODBURY, N.Y. 11797 516-364-0148 FAX 516-364-0158 June 12, 2013 Village of Southold Dear Sir: This is to certify that the drainage facilities to be used exclusively for the• construction of a _ spa° " -_ _ pool on the premises of: Mandelbaum 825 Kimberly Lane Southold, MY will not require draining because the pool is of gunite construction. The pool water will be continuously recirculated through the filter and will be reused from year to year. The drainage from the filter backwash is nominal and will not interfere with the public water supply, the existing sanitary facilities or public highways,, Very truly yours, H. Roy Jaffe,