HomeMy WebLinkAbout39724-Z ��Q�gUFFOt,� Town of Southold 10/23/2019
3 P.O.Box 1179
a
co _ 53095 Main Rd
Southold,New York 11971
CERTIFICATE OF OCCUPANCY
No: 40797 Date: 10/23/2019
THIS CERTIFIES that the building IN GROUND POOL
Location of Property: 685 Track Ave, Cutchouge
SCTM#: 473889 Sec/Block/Lot: 137.4-22
Subdivision: Filed Map No. Lot No.
conforms substantially to the Application for Building Permit heretofore filed in this office dated
5/1/2015 pursuant to which Building Permit No. 39724 dated 5/1/2015
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 Edgett, Scott
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL
ELECTRICAL CERTIFICATE NO. 3972 08-13-2019
PLUMBERS CERTIFICATION DATED
tho ' Si ature
�SOFFot,r�oTOWN OF SOUTHOLD
a�0, Gy BUILDING DEPARTMENT
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#: 39724 Date: 5/1/2015
Permission is hereby granted to:
Edgett, Scott
685 Track Ave
Cutchogue, NY 11935
To: accessory in ground swimming pool with fence to code as applied for.
At premises located at:
685 Track Ave, Cutchouge
SCTM # 473889
Sec/Block/Lot# 137.-1-22
Pursuant to application dated 5/1/2015 and approved by the Building Inspector.
To expire on 10/30/2016.
Fees:
IN-GROUND SWIMMING POOL $250.00
-ACCESSOR G $50.00
Total: $300.00
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 OccupancZ5 -_-_-_-.--
4. Updated Certificate of Occupancy- $50.00
5---empom y–Certificate_oLOccupanc-y=Residential-$15.00,_Comm-ercial$L5.00
Date. < 271 2.0 IS
New Construction: Old or Pre-existing Building: (check one)
Location of Property: COS5 R kALK- AJle CK;(G1tE)gA A t_-
House No. Street Hamlet
Owner or Owners of Property: S cait ej ce*-
Suffolk County Tax Map No 1000, Section 1'3'7 Block O( Lot 22
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: $
Applicant Signature
Of sOUy�®l
Town Hall Annex ® Telephone(631)765-1802
54375 Main Road Fax(631)765-9502
P.O.Box 1179
Southold,NY 11971-0959 • i� sean.devlin(aD_town.southold.ny.us
l'�C®UNTV,�c�
BUILDING DEPARTMENT
TOWN OF SOUTHOLD
CERTIFICATE OF ELECTRICAL COMPLIANCE
SITE LOCATION
Issued To. Scott Edgett
Address: 685 Track Ave city Cutchogue st: NY zip. 11935
Building Permit#: 39724 Section: 137 Block: 1 Lot: 22
WAS EXAMINED AND FOUND TO BE IN COMPLIANCE WITH THE NATIONAL ELECTRIC CODE
Contractor. DBA: Platinum East Electric License No: 34091-ME
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 X Attic Garage
INVENTORY
Service 1 ph X Heat 60A! Duplec Recpt Ceiling Fixtures HID Fixtures
Service 3 ph Hot Water GFCI Recpt Wall Fixtures Smoke Detectors
Main Panel A/C Condenser Single Recpt 1 Recessed Fixtures CO Detectors
Sub Panel X A/C Blower Range Recpt Fluorescent Fixture Pumps 1
Transformer Appliances Dryer Recpt Emergency Fixture Time Clocks 2
Disconnect Switches 2 Twist Lock Exit Fixtures �] TVSS
Other Equipment: 8 Circuit Pool Panel, Salt Generator, Pump, Pool Heater, Pool Cover, Pool Cover swi-
(KEY), Pool Light Switch, Bonding, 220 GFI Breaker for Pump & Salt Generator, 260 Breaker for
Notes. Heater, 120 Gfi Breaker for Pool Cover and Lights
Inspector Signature: Date: August 13, 2019
S Devlin-Cert Electrical Compliance Form.xls
3 SOF SOUjy
cOUM'1,0c�
TOWN OF SOUTHOLD BUILDING DEPT.
765-1802
INSPECTI N- _
[ ] FOUNDATION. 1 ST [ IRO GH PLUMBING
[ ] FOUNDATION 2ND [ ] SULATION
[ ]
FRAMING /STRAPPING [ ] FINAL
[ ] FIREPLACE &.CHIMNEY [ ] FIRE SAFETY INSPECTION
[ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRATION
[ ] ELECTRICAL (ROUGH) [ ] ELECTRICAL (FINAL)
[ ] CODE VIOLATION [ ] CAULKING
REMARKS:
DATE -7, 3 INSPECTOR
OF SOUIyOIo
# TOWN OF SOUTHOLD BUILDING DEPT.
coulm, 765-1602
INSPECTION
[ ] FOUNDATION 1ST [ ] ROUGH PLEG.
[ ] FOUNDATION 2ND [ ] INSULATION
[ ] FRAMING /STRAPPING [ ] FINAL
[ ] FIREPLACE & CHIMNEY [ ] FIRE SAFETY INSPECTION
[ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRATION
[ ] ELECTRICAL (ROUGH) ELECTRICAL (FINAL) Toe-1
[ ] CODE VIOLATION [ ] CAULKING
REMARKS:
Af
DATE INSPECTOR
�� OF SOU
ryO
# TOWN OF SOUTHOLD BUILDING DEPT.
765-1802
INSPECTION
[ ] FOUNDATION 1 ST [ ] ROUGH PLBG.
[ ] FOUNDATION 2ND [ ] INSULATION
[ ] FRAMING /STRAPPING [ ] FINAL
[ ] FIREPLACE & CHIMNEY [ ] FIRE SAFETY INSPECTION
[ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRATION
[ ] ELECTRICAL (ROUGH) [ ] ELECTRICAL (FINAL)
[ ] CODE VIOL ION [ ] CAULKING
REM RKS: &c-vifi
Com✓ �i tl�
14
DATE 61140INSPECTOR
FIELD XNSPE4=01'?ME110P.T DATE CO�vIl1JT,NTS
FOUNDATION(1ST) co
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FOUNDATION(2ND) trt
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ROUGH FRANMCx& _ H
PLUMBING 1
t�
INSULATION PElk N.Y. H
STATE ENERGY cbm
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FINAL
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TOWN OF SOUTHOLD BUILDING PERMIT APPLICATION CHECKLIST
BUILDING DEPARTMENT Do you have or need the following,before applying?
TOWN HALL i, : ; s, :f;Board of Health
SOUTHOLD NY 11971
:4 sets of Building Plans S.
TEL: (631)765-1802 Planning Board approval
FAX: (631) 765-9502 SuveY.
South oldTown.NortfiFork.net PERMIT NO. �� � �� Check
j, ;i!SeptioFprm
N.Y.S.D.E.C.
fr .•. _i Trustees'
' C.O.Application
_ Flood Permit
Examined / ,20;•r} ',i _•;; ;,1 . Single&Separate
Stbhn-Water_Asses's`mentForm
r / ✓ -Contact:
Approved ,20 Mail,to:
Disapproved a/c
Phone:
''
Expiration ,20 31'
.__B nspTeSC:o, . „
'APLICATONFORBUILDING.PERMITI
-APR 2 2 2015
,
Date hcj L- 22 ' 20 19
INSTRUCTIONS .3
a. Ibis app ication e completely filled in by;typewritep or in ink,and submitted to the Building Inspector with,4
sets of plans,accurate plot plan to scale.Fee according to schedule, w_-
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:beforeissuance of B1, iluilding Pers
mit.
d.Upon approval of this application,the'Bmlding Inspector will issue a Building Perimt'to the applicant. Such'a permit
shall be kept on the premises available for inspection throughout the work.
e.No building shall,be occupiedW`used,in whole o'r in part for.-ariypurpose what so ever'uAtil tlie'Building Inspector
issues a Certificate of Occupancy.
f.Every.building peimit shall expire if the work authorized'has not commenced within X12 months after the date of—
issuance or has not been completed"within 18 months from such date.r`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 Dlepartment�for,the issuance of a Building Permit pursuant to.the
Building Zone Ordinance of the Town of Southold,�Suffolk County,,New,Yori,and other,applicable Laws, Ordinances or
Regulations,for the construction of buildings,additions,or alterationsror for removal or demolition as herein described. The
applicant agrees to comply with all applicable laws,ordinances,building,,00de,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)
(Nlailing'address of applicant)
State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder
-f
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 No.
Plumbers License No.
i +
Electricians License•No.
Other Trade's License No. ti
1. Location of land on which proposed work will be doile:.
60, $5
House Number Street
County Tax Map No. 1000 Section` 13-7 Block - 'v` Th i c a : 'S '°�' Lot Z Z
__- t�•`S� ;Sf t/;, ,<--�.,e. :Ott." - •,:"9'�^s..
Subdivision Filed Map No. Lot
2. State existing;use and cccupancyofpremises and intended use and occupancy of proposed construction:
a. Existing use and,,o'c'cupancy
b. Intended use and.occupancy
3. Nature of work(check which applicable):New Building Addition Alteration
Repair Removal ' Demolition Other Work e,yL.
(Description)
4. Estimated Cost 7� D60 Fee
(To be paid omfiling 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 ;3i-.:> •':'; 1 Number of Stories
8. Dimensions of entire new construction Front°`;'i.V,P %-'= � _'Rear• st �'� Depth •5 �1b��
Height Number of Stories t„
9. Size of lot: Front 101) l Rear :I°&O, `a ;ks T,f r, Depth No
0
10. Date of Purchase
:+' .'a iii. . t• ci ..J..:
r i=t i t r ., :-r f 'Slli�-':• .:s r •i=}jrtr{ it1 I'M ,•, I"} 0%
11. Zone or use'di'strict- 'i-n which premisesy arse'`sittlated'
�t,..�.. •i .o,ii' ' - ){'I .f:'!1 ..1; �"Iiw JTt'7' i Ei i t 'fJ iL! /r.rt .9' �jr
12. Does proposed construction,violate'dhy zoning law,,rordinance oriregulation?YES NO \I�'[�
�'f,}1; ,�;ir/fl�i t`{ t,.?• ,, ;', !'li !,iiilr,i 'tr' ..
13. Will lot be re-graded?YES . NO,.K-Will excesslf�l,•besremoved from.•premises? YES+•X NO
14. Names of Owner ofpremises„S'ltv}4 r;t 1GLe-* •k Address,6Pj5,,.TRP;tk.i&V(F•j!Phone No. (x'31, '2-S'S 40 29
Name-of Architect—. k{'. _ ° k :.,:. (Address C-LdXko JL0_ ,.',�, Phone;No r
Name of Contractor,{ '=,'=Address,>t
15 a. Is this property within l00 feet 6faIM6f wefland'o'r a'freshwate"fwdtlaridd-*YES i '` NO,
* IF YES, SOUTHOLD'TOWN'TRUSTEES&6R.C.-PERMITS MAY"BE`REQUIRED:
b. Is this property witliin'300'fee6of a't�id'al we'tl'aind?*.`YES rN0
* IF TES, D.E.C.-PERMITS MAYBE'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 andrestrictions with respect to this property? * YES NO�
* IF YES, PROVIDE A COPY.
t ' • '{'
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, " ''
(S)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.
Sworn to Pefore me this
2 z1� day of ✓-I 1 20 t,
....wawa 0;BUNCH
Notary PublicNotary Puboo,State of New York Signature of Applicant
- No.01 SU6186060 I '
QWRW in Suffolk County )v
Commisalon Expires A01 14,
1
Scott A. Russell 0°�� '� � STO]KAWWAT]E R,
SUPERVISOR IWANAG]EAMI]ENT
SOUTHOLD TOWN HALL-P.O.Box 1179 >rt
53095 Main Road-SOUTHOLD,NEW YORK 11971 Town of Southold
CHAPTER 236 - STORMWATER MANAGEMENT WORK SHEET
( TO BE COMPLETED BY THE APPLICANT )
- - - - - - - - - - --- - ---- - - - -
- - - -- --- -- -- --- -- -- - - -- - -DOES THS PROJECT ECT INVO LVE ANY OF THE 1F®ILILOWHNC:
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
within any parcel or any contiguous area.
E][A 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 f loodplain as depicted
- --on FIRM Map of any-watercourse - -
❑[P 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. 1'& 7
'�: 1000 Date:
l37 o,StilCt
NAME 01 ZZ- t L LZ. 2D S
,r Section Block Lot
(�/� �( FOR BUILDING [)EP RTNICN"I- (.'SL0NL�' •'`<
Contact Information �P� 7_537- L6 1" t
t I elrvhm �umEcd
Reviewed By:
— — — — — — — — — — — — — — — — —
Date.
Property Address / Location of Construction Work: — — — — — — — — — — — — — — — — —
Approved for processing Building Permit.
Stormwater Management Control Plan Not Required
— — — — — — — — — — — — — — — —
❑ Stormwater Management Control Plan is Required.
(Forward to Engineering Department for Review)
FORM * SMCP-TOS MAY 2014
- pf SO�pyO�
Town Hall Annex 411 Telephone(631)765-1802
54375 Main Road y� ax(631 ` io
C
P.O.Box 1179 ro enrich tewrr
Southold,NY 11971.0959
BUILDING DEPARTMENT
'SOWN OF SOUTHOYD G,,r�u ,�t T
APPLICATION FOR ELECTRICAL INSPEC ION'
REQUESTED BY: 1( -jT(t Date: _5--24-I I"
Company Name: nJvti► � S C c 7c
Name:- --- -- - - 1-- cF -" - - _ - - - - -- -- - - - --- -_ --_------------- - -
License No.: Yrs C1 j ._ tr
Address: 1-32-o K(--2A-V&-11 5 f 0 Sv✓_TffOW /), _
Phone No.: �, _ 1�Y'2- -
JOBSITE INFORMATION: (indicates required information)
`Name: S c o ff (-704 c 7
*Address: &8 !�_ 7-A^C(c +Ve U7c(404 Ue-
*Cross Street: -sTc cL
*Phone No.. 74 5--9 y
Permit No.: 4) "7L
Tax Map District: 1000 Section: 1317 Block: J Lot:
*BRIEF DESCRIPTION OF WORK(Please Print Clearly)
(Phase Circle All That Apply)
*Is job ready for inspection: YES/ NO Rough In Final
*Do you need a Temp Certificate: YES/ NO
Temp Information (If needed)
*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 P � (46 S(o IqL
oF soUry®l
� o
Town Hall Annex 4 Telephone(631)765-1802
54375 Main Road us Alc Fax(631)765-9502
P.O.Box 1179 G • Q
Southold,NY 11971-0959 Q a
Ph
July 21, 2015
BUILDING DEPARTMENT
TOWN OF SOUTHOLD
Scott Edgett
685 Track Ave
Cutchogue NY 11935
TO WHOM IT MAY CONCERN:
The Following Items(if Checked)Are Needed To Complete Your Certificate of Occupancy:
/Application for Certificate of Occupancy. (Enclosed)
Electrical Underwriters Certificate.
A fee of$50.00.
Final Health Department Approval.
Plumbers Solder Certificate. (All permits involving plumbing after 4J1/84)
Trustees Certificate of Compliance. (Town Trustees#765-1892)
Final Planning Board Approval. (Punning#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 — 39724— Swimming Pool
:...:.. . ..., . . . - •" ..: ' WATER RUNOFF
. . .: ... ....� :.' .:-: ,.: :..:. •:�:' _.;.;. ..: . CHAPTER 236
-
:. .. .. . PURSUANT TO
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. :...:- .. . ... - CODE
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