HomeMy WebLinkAbout43512-Z FatA,�pG� Town of Southold 11/13/2019
P.O.Box 1179
53095 Main Rd
Southold,New York 11971
CERTIFICATE OF OCCUPANCY
No: 40847 Date: 11/13/2019
THIS CERTIFIES that the building IN GROUND POOL
Location of Property: 7380 N Bayview Rd., Southold
SCTM#: 473889 Sec/Block/Lot: 79.-7-10
Subdivision: Filed Map No. Lot No.
conforms substantially to the Application for Building Permit heretofore filed in this office dated
2/21/2019 pursuant to which Building Permit No. 43512 dated 3/1/2019
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:
ACCESSORY IN-GROUND SWIMMING POOL, FENCED TO CODE, AS APPLIED FOR
The certificate is issued to Schaubeck,Patricia&or
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL
ELECTRICAL CERTIFICATE NO. 43512 11-04-2019
PLUMBERS CERTIFICATION DATED
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�SVFFot,r 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#: 43512 Date: 3/1/2019
Permission is hereby granted to:
Schaubeck, Patricia
PO BOX 604
Southold, NY 11971
To: remove existing swimming pool and construct a new accessory swimming pool as
applied for.
At premises located at:
7380 N Bayview Rd., Southold
SCTM # 473889
Sec/Block/Lot# 79.-7-10
,t
Pursuant to application dated 2/21/2019 and approved by the Building Inspector.
To expire on 8/30/2020.
Fees:
SWIMMING POOLS -IN-GROUND WITH FENCE ENCLOSURE $250.00
CO - SWIMMING POOL $50.00
Total: $300.00
Building nspector
Form No. 6
'rO\x/'N OF SOUTHOLD
BUILDING DEPARTMENT
TOWN HALL
d 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
- topograplticpfeatures. -
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 I% 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-C6rti1Fafe ofUiicupancy . .. _
4. Updated Certificate of Occupancy- $50.00
5. Temporary Certificateof Occupancy-Residential$15.00, Commercial$15.00
�( Date. - -- - --- - -- ----
``�u N t�J �I I.fi1-1lV
New Construction: 00(— Old or Pre-existing Building: (check one)
Location of Property: I J
House No. I Street Hamlet
Owner or Owners of Property: �Ht �JV1QtlC�.
Suffolk County Tax Map No 1000, Section, Block Lot
Subdivision y Filed Map. Lot:
Permit No. f/ Date of Permit. Applicant:
Health Dept. Approval: Underwriters Approval:
Planning Board Approval: r�
ora
Request for: Tem Certificate Final Certificate: (check one)
q Temporary
Fee Submitted:
AVplicant Signature
OF SOUPy®l
Town Hall Annex ® Telephone(631)765-1802
54375 Main Road Fax(631)765-9502
P.O.Box 1179 Q sean.deviin(a�town.southold.n us
Southold,NY 11971-0959 .t` • y® y
BUILDING DEPARTMENT
TOWN OF SOUTHOLD
CERTIFICATE OF ELECTRICAL COMPLIANCE
SITE LOCATION
Issued To Patricia Schaubeck
Address: 7380 N Bayview Rd city Southold st: NY zip: 11971
Building Permit#: 43512 Section: 79 Block. 7'Lot 10
WAS EXAMINED AND FOUND TO BE IN COMPLIANCE WITH THE NATIONAL ELECTRIC CODE
Contractor' DBA. Glen's Electric License No: 4770-ME
SITE DETAILS
Office Use Only
Residential X Indoor Basement Service Only
Commerical Outdoor X 1st Floor Pool X
New Renovation 2nd Floor Hot Tub
Addition Survey Attic Garage
INVENTORY
Service 1 ph X 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 1 Recessed Fixtures CO Detectors
Sub Panel A/C Blower Range Recpt Fluorescent Fixture Pumps 1
Transformer 300W Appliances Dryer Recpt Emergency Fixtures Time Clocks 1
Disconnect Switches Twist Lock Exit Fixtures 11 Combo SD/CO
Other Equipment Pump on 220GFI Breaker, (4) Lights on 120 GFI Breaker, Salt Generator,
Pool Heater, Pool Panel 16 Circuit -4 Used,
Notes
Inspector Signature: Date: November 4, 2019
S Devlin-Cert Electrical Compliance Form.xls
OF SOUI �'� 7 S 2 73 N• 13q x�/��� �✓
* # TOWN OF SOUTHOLD BUILDING DEPT.
co765-1802
'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) 1pv d
[ ] CODE VIOLATION [ ] CAULKING
REMARKS:
Al 41--e EtA 4AW CCA L.- IN S.?J-5&n At
DATE j! P INSPECTOR
SJ I a0F SOUTy '----- --- - - - - - - --- --
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# TOWN OF SOUTHOLD BUILDING DEPT.
cou765-1802
a
INSPECTION -
FOUNDATION
1ST [ ] ROUGH PLBG. -
[ ] FOUNDATION 2ND [ 'I ULATION/CAULKING
[ ] FRAMING/STRAPPING [ FINAL
[ ] FIREPLACE & CHIMNEY " [ ] FIRE SAFETY INSPECTION =
[ ,] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRATION
[ ] ELECTRICAL (ROUGH) [ ] ELECTRICAL (FINAL)
[ ] CODE VIOLATION [ ] PRE C/O
REMARKS:
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DATE 11 INSPECTOR
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FIELD INSPECTION REPORT DATE COMMENTS
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FOUNDATION (1ST)
------------------------------------
'FOUNDATION (ZND) 0�
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ROUGH FRAMING&
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PLUMBING
INSULATION PER N.Y: y
STATE ENERGY CODE
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FINAL
ADDITIONAL COMMS S
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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 f Survey
Southoldtownny.gov PERMIT NO. ( Check
Septic Form
N.Y.S.D.E.C.
Trustees
C.O.Application
1 Flood Permit
Examined 20 1 !" Single&Separate
® `• D Truss Identification Form
FEB 2 2019 Storm-Water Assessment Form
2 Contact:
Approved J 20IL ;• Mail to: nr p�, erg
Disapproved a/c t ® D'�,-, v� `>
WN
Phone: (03, —oZ�'cQ` yo/Expiration 20
Buil"kLnjspdor
APPLICATION FOR BUILDING PERMIT
Date/L ,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,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.
off- P-01K 8�C C61y-
(Signature of applicant or name,if a corporation)
(Mailing address of applicant)
State whether applicant is ow , lessee, agent, architect, engineer, general contractor, electrician, plumber or builder
Name of owner of premises VC
(As on the tax roll or latest deed)
If applicanj a corpqLation sigma of duly aut orized officer
f� 2_o .
(Na e and t e of corporate officer)
Builders License No.
Plumbers License No.
Electricians License No.
Other Trade's License No. /— Ft
1. Location of land on which 916\,/ kaeu
oposed work will be done:
73 v N. d , d
House Number Street — Hamlet
County Tax Map No. 1000 Section /q Block -7 Lot /0
Subdivision Filed Map No. Lot
2. State existing use and occupancy of premis and i tend d use and occupancy of proposed construction:
a. Existing use and occupancy Rcsf 0-e I'A,e,
b. Intended use and occupancy_T� 11-►G, '
3. Nature of work(check which applicable):New Building Addition Alteration
Repair Removal Demolition Other Work ZQ-,-j�� r
R LmR t n r
4. Estimated Cost Fee-
(T6,beipaid on filing this application)
5. If dwelling,number of dwelling units ; i Number of dwelling•'units on each floor
If garage, number of cars E ,
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 -LJO Depth �D
Height 4 ' Number of Stories -4;)--
Dimensions of same structure with alterations or additions: Front Rear
Depth Height Number of Stories
8. Dimensions of entire new construction: Front /(0 ' Rear r Depth (e r
Height � ' Number of Stories -42;)-
9. Size of lot: Front ��. -7Rear / q. 7 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-Z\-
13. Will lot be re-graded?YES x NO Will excess fill be removed from premises? SS�NO
�JBd Nor borve'., R
14.Names of Owner of premises C,Y LRC Address Souttvq J Phone No.61(n -310`!�J530
Name of Architect Address Phone No
Name of Contractor Nnrk Fir I'bot- Address X66 al 1� Phone No,631-oQ9�4 -'y8! A
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_X__
* 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-X—
* IF YES,PROVIDE A COPY.
STATE OF NEW YORK)
pAS
:
COUNTY OF�Win►
L/ 50.', r"s being duly sworn,deposes and says that(s)he is the applicant
(Name of individual signing contract)above named,
(S)He is the �J,)r-,Ll o rX A-)( (/q r-, �h'5 Je.Q1-
(Contra or 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 mariner set forth in the application filed therewith.
Sworn tofore me this
1 — day of F b 1(1-4a c 201
otary Public TRACEY L. DWYER Signa re of Applicant
NOTARY PUBLIC,STATE OF NEW YORK
NO.01 D W6306900
QUALIFIED IN SUFFOLK COUNTY
COMMISSION EXPIRES JUNE 30,2L�P,
Scott A. Russell °suFFQI STO]Kl��I WA\T]EIK
SUPERVISOR a IWANAG]EAMI ENT
SOUTHOLD TOWN HALL-P.O.Box 1179 m
53095 Main Road-SOUTHOLD,NEWYORK 11971 Town of Southold
CHAPTER 236 - STORMWATER MANAGEMENT WORK SHEET
( TO BE COMPLETED BY THE APPLICANT )
DOES THIS PROJECT INVOLVE ANY ®1F THE 1F®1L1L®WHNG:
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 B. Excavation or filling involving more than 200 cubic yards of material
within any parcel or any contiguous area.
❑ja 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.
EINE. 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.
S
APPLICANT (Property Owner,Design Professional,Agent Contractor,Other) .C'T .M. #: DOtrl Date
NAME 79 -7 / A 1— /
01
Section Block Lot
1'OR BL11,LD1tiC, DE:P-A, R NIENT bSE ONLY .,r<
Contact Information
,r�lplmnVuinbr, �—
Reviewed By p�
- - - - - - - - - - - - - - - - - -
Date- C�— � � -1 /
Property Address / Location of Construction Wo k. — — — — — — — — — — — — — — —
for processing Building Permit.
0O V /1-f-'^/`j� —[!14Approved
— Stormwater Management Control Plan Not Required
�o�/}`�L7, ►.lY /
/q7 7 ❑ Stormwater Management Control Plan is Required.
(Forward to Engineering Department for Review.)
FORM SMCP-TOS MAY 2014
1 ( BUILDING DEPARTMENT- Electrical Inspector
TOWN OF SOUTHOLD
Town Hall Annex - 54375 Main Road - PO Box 1179
• °� �� Southold, New York 11971-0959
Olephone (631) 765-1802 - FAX (631) 765-9502
oq�e�r(a-southoldtownny.gov - seand(Dsoutholdtownny.gov
APPLICATION FOR ELECTRICAL INSPECTION
ELECTRICIAN INFORMATION (All Information Required) Date:=�a f
Company Name:
Name:
License No.: 1-1'-70 ,M ,F email:--f) ' o'yC,o
Address:
Phone No.:
JOB SITE INFORMATION (All Information Required)
Name: '7S
Address:
Cross Street:
Phone No.:
Bldg.Permit#: X'351 email:
Tax Map District: 1000 Section: Block: Lot:
BRIEF DESCRIPTION OF WORK (Please Print Clearly)
Circle All That Apply: ������ �,o,� �"vim !�`l
Is job ready for inspection?: �O/ NO Rough In Fina
Do you need a Temp Certificate?: YES /0 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
Additional Information:
PAYMENT DUE WITH APPLICATION
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Request for Inspection Form.xls
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SUBDIVISION MAP F/LED/N Tf•/E r
I OF ME CLERK 0F5UFR7LK CQ7k
J f JUNE 4,/9T/ AS RLE NO-5599
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REVISIONS YOUNG & YOUNG
400 OSTRANDER AVENUE, RIVERHEAD, NEW 1
ALDEN W.YOUNG
F{OWA
pROFESSiONAL ENGI1•iBER ANO LAND!
jLANG SURVEVOR,'N.Y.S.LIC.NO,12645 N.Y.S.
UNAUTHORIZED ALTERATION OR ADDITION TO SURVEY FOR:
, �• 1HIS 2.09 OF THE NEW YORK STATE-EDUCATION SURVEY ISA VIOLATION OF SECTION
LAAWGEORGE C, BEAURY B b'EATRICE E, BEA�11R�'
'I L
}I r .LOTIVO. 9, "LEEWARD ACRES AT BA � F
COPIES OF THIS SURVEY MAP NOT BEARING S\�
THE LAND SURVEYOR'S INK90 SEAL OR
( EMBOSSED SEAL SHALL NOT BE CONSIDERED �P,FLD
I t I TO BE A VALJD TRUE COPY AT
W
8.4YVIEGUAR jIT TW
GUARANTEES INOICATED HEREON SHALL RUN G Ys CA. E•4L
'{ ONLT TO THE PERSON FOR WHOM THE• c TOWN!OF ^OU��0�0 Gp
J
go a,
APPR VED AS NOTED
DATE: B.P.
FEE: BY:
NOTIFY BUILDING DEPART T AT
765-1802 8 AM TO 4 PM FOR THE 'RETAIN STORM (NATER RUNOFF
FOLLOWING INSPECTIONS: 'PURSUANT TO CHAPTER 236
I. FOUNDATION - TWO REQUIRED OF THE TOWN CODE.
FOR POURED CONCRETE
2. ROUGH - FRAMING & PLUMBING
3. INSULATION
4. FINAL - CONSTRUCTION MUST
BE COMPLETE FOR C.O.
ALL CONSTRUCTION SHALL MEET THE
REQUIREMENTS OF THE CODES OF NEW
YORK STATE. NOT RESPONSIBLE FOR
DESIGN OR CONSTRUCTION ERRORS. ELECTRICAL
INSPECTION REQUIRED
COMPLY WITH ALL CODES OF
NEW YORK STATE & TOWN CODES
AS REQUIRED AND CONDITIONS OF
��-P�hflPl&60ARD
seg ere�e ISR S S �� NqF-E), A TELYo®
%I SLOSE POOL TO CODE
VPbN'COMPLETIO,N
OCCUPANCY O
USE IS UNLAWFUL
WITHOUT CERTIFICATC
OF OCCUPANCY
POO(- cp�rc . PA�-
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P.0.k 1 NAME:
GATE: SIBS:,
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nSHAPE.,-
OWDER PArrERN:
WALL PAMA
' FLOOR PATTERN:
D4RNERS:
HUNG OVERLAP (cede one)
20 GAUGE 27 GAUGE (drds on)
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