HomeMy WebLinkAbout43115-Z D�SUFF04CpG Town of Southold 12/6/2019
P.O.Box 1179
IC,
53095 Main Rd
Southold,New York 11971
CERTIFICATE OF OCCUPANCY
No: 40896 Date: 12/6/2019
THIS CERTIFIES that the building IN GROUND POOL
Location of Property: 800 Private Rd#21, Southold
SCTM#: 473889 Sec/Block/Lot: 78.-9-35
Subdivision: Filed Map No. Lot No.
conforms substantially to the Application for Building Permit heretofore filed in this office dated
10/1/2018 pursuant to which Building Permit No. 43115 dated 10/9/2018
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 Schauer,Bruce&Denise
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL
ELECTRICAL CERTIFICATE NO. 43115 01-10-2019
PLUMBERS CERTIFICATION DATED
ut io ' e Signature
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
s TOWN CLERK'S OFFICE
oy . SOUTHOLD, NY
poi � dao
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#: 43115 Date: 10/9/2018
Permission is hereby granted to:
Schauer, Bruce
1200 Meissen Ct
Ambler, PA 19002
To: construct accessory in-ground swimming pool as applied for.
At premises located at:
800 Private Rd #21, Southold
SCTM #473889
Sec/Block/Lot# 78.-9-35
Pursuant to application dated 10/1/2018 and approved by the Building Inspector.
To expire on 4/9/2020.
Fees:
SWIMMING POOLS -IN-GROUND WITH FENCE ENCLOSURE $250.00
CO - SWIMMING POOL $50.00
Total: $300.00
Bu din nspector
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. '5 pZ,-hX60L 2(-7 2z"Is
New Construction: Old or Pre-existing Building: (check one)
A Location of Property: 800 f 4i wmi c �hJ 21
House No. Street Hamlet
X Owner or Owners of Property: UVC IF- X �DL n14 SC SC 14AV t'I2
x Suffolk County Tax Map No 1000, Section 19 Block 01 Lot 15.E
Subdivision Filed Map. Lot:
Permit No. 15 Date of Permit. Applicant:
Health Dept.Approval: Underwriters Approval:
Planning Board Approval:
Request for: Temporary Certificate Final Certificate: (check one)
Fee Submitted: $
Applicant
SOUP®�®
Town Hall Annex Telephone(631)765-1802
54375 Main Road c� Fax(631)765-9502
P.O.Box 117
Southold,NY 119711-0959 ® y®� roper.richert(cD-town.southold.ny.us
��cOU�TY9��
BUILDING DEPARTMENT
TOWN OF SOUTHOLD
CERTIFICATE OF ELECTRICIAL COMPLIANCE
SITE LOCATION
Issued To: Bruce Schauer
Address: 800 Private Road#21 City- Southold St: New York Zip: 11971
Building Permit#. 43115 Section 78 Block: 9 Lot. 35
WAS EXAMINED AND FOUND TO BE IN COMPLIANCE WITH THE NATIONAL ELECTRIC CODE
Contractor: DBA: REP Electric License No: 46288-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 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 1 Recessed Fixtures CO Detectors
Sub Panel A/C Blower Range Recpt Fluorescent Fixture Pumps
Transformer Appliances Dryer Recpt Emergency FixtureTime Clocks 1
Disconnect Switches Twist Lock Exit Fixtures TVSS
Other Equipment. In ground swimming pool to include, bonding, control panel, 1-GFCI circuit breaker
1-pump motor,gas pool heater, low voltage pool lights
Notes,
Inspector Signature: Date: January 10 2019
81-Cert Electrical Compliance Form xis
�o��oe souryO�
# # TOWN OF SOUTHOLD BUILDING DEPT.
°`ycourm a�' 765-1802
INSP TION
FOUNDATION 1 S404 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:
U�✓ ! o
DATE l�' INSPECTOR
So
o�aOE UTyO -
# TOWN OF SOUTHOLD BUILDING DEPT. "
cou765-1802
INSPECTION
[ ] FOUNDATION 1ST f ] ROUGH PLRG.
[ ]FOUNDATION-2ND [ ] SULATIO CAULKING
[ ] FRAMING /STRAPPING [ ] FINAL
[ " ] 6vf---
FIREPLACE& CHIMNEY [ ] FIRE SAFETY INSPECTION
[ ] °FIRE RESISTANT CONSTRUCTION [ ] -FIRE RESISTANT PENETRATION
[ ] ELECTRICAL (ROUGH) [ ] ELECTRICAL (FINAL-)
[ ] CODE VIOLATION [ ] PRE C/O
REMARK4t ,z--_
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DATE INSPECTOR
of SOUK,°<o
TOWN OF SOUTHOLD BUILDING DEPT.
Cour, 765-1802
J
INSPECTION 4- 1
[ ] FOUNDATION 1ST [ ] ROUGH PLBG.
[ ] FOUNDATION 2ND [ ] INSULATION
[ ] FRAMING /STRAPPING [ ] FINAL
[ ] FIREPLACE & CHIMNEY [ ] FIRE SAFETY INSPECTION
[ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRATION
[ ] ELECTRICAL (ROUGH) [A'] ELECTRICAL (FINAL)
[ ] CODE VIOLATION [ ] CAULKING
REMARKS:
y w
J
DATE INSPECTOR i (yC `�
lt� S
O��OF OUTyo
# TOWN OF SOUTHOLD BUILDING DEPT.
�ycOUNn��' 765-1802
F
INSPECTION
[ ] FOUNDATION 1ST [ ] ROUGH PLBG.
[ ] FOUNDATION 2ND." [` ] SULAULKING
[ ] FRAMING /STRAPPING [ )FINAL7,7, ge,
[ ] FIREPLACE & CHIMNEY [ ] FIRE SAFETY INSPECTION
[ ] FIRE RESISTANT CONSTRUCTION- [ ] FIRE RESISTANT PENETRATION
[ ] ELECTRICAL (ROUGH) [ ] ELECTRICAL (FINAL)
[ ] CODE VIOLATION [ ] PRE C/O
REMARKS:
luDATE 114Wq INSPECTOR
FIELD INSEP CTION REPORT I DATE JA COMMS •S c
,01 la 1 b
FOUNDATION(1ST)
------------------------------
'FOUNDATION (2ND) rA
O
ROUGH FRAMING&
PLUMBING y
INSULATION PER N.Y-. y
STATE ENERGY CODE
10
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NA Y
FINAL A
It maW pig
ADDITIONAL COMMENTS
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TOWN OF SOUTHOLD BUILDING PERMIT APPLICATION CHECKLIST
BUILDING DEPARTMENT Do you have or need the following,before applying?
TOWN HALL oard of Health
SOUTHOLD,NY 11971 _0ets of Building Plans
TEL: (631) 765-1802 Planning Board approval
FAX: (631) 765-9502 �QJ 407vey
Southoldtownny.gov PERMIT NO. J Check
Septic Form
N.Y.S.D.E.C.
tees
O. pplication
1hJq Flood Permit
Examined ,20 Single&Separate
Truss Identification Form
Storm-Water Assessment Form
flLOAtC Contact:
Approved ,20 Mail to:C M 4-CIA ?001 Ke&(
Disapproved a/c QE F �b�, r1Vq l �V
Phone: 65' jig--n w
E ' ion=t: ' AI �, .� 2 T
D �"�'. 5 }
w Building Inspector
SEP 2 8 2018
APPLICATION FOR BUILDING PERMIT
� � �. -. ;i`'•' ;*.D Date Sc VCMlifiL 2L , 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 SpAe,and regulations, and to admit
authorized inspectors on premises and in building for necessary inspections
(Si ure o pplicant or name, if a corporation)
(Mailing•address of applicant)
State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder
Fn 0L__
Name of owner of premises S(LLkc L !9CRAVt.CV_
(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. q6910-11
Plumbers License No.
Electricians License No.
Other Trade's License No.
1. Location of land on which proposed work will be done:
OOH 6QU77k Piy
House Number Street Hamlet
County Tax Map No. 1000 -Section 7 -Blocic_ y"®, a Lot 3�
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 Prs i'6L'A 0
b. Intended use and occupancy $AMC
3. Nature of work(check which applicable): New Building Addition Alteration
Repair Removal Demolition Other Work 1 r4&.-writ Stems e www a& P,0,esL-
(Description)
Estimated Cost Fee
(To be paid on filing this application)
�If dwelling, number of dwelling units Number of dwelling units on each floor
If garage, number of cars
XIf business, commercial or mixed occupancy, specify nature and extent of each type of use.
Dimensions of existing structures, if any: Front Rear Depth
eight Number of Stories
Dimensions of same structure with alterations or additions: Front " ` Rear '
Depth Height Number of Stories i
Dimensions of entire new construction: Front Rear Depth
Height Number of Stories
Size of lot: Front Rear Depth E= v
lute of Purchase Name of Former Owner
,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 )0 Will excess fill be removed from premises?YES 10 NO
$aUC.0&DENISC foo Qalmrr Rte 24
14.Names of Owner of premises Scl+ t4tiER Address �;Qj'WkLA Phone No: Al. y9/4070
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 50
* IF YES, SOUTHOLD TOWN TRUSTEES &D.E.C. PERMITS MAY BE REQUIRED.
b. Is this property within 300 feet of a tidal wetland? * YES NOS
* 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 IV
* IF YES, PROVIDE A COPY.
STATE OF NEW YORK)
SS:
COUNTY OFSU�)
Cs being duly sworn, deposes and says that(s)he is the applicant
(Name of individua ii��gning contract) above named,
(S)He is the l d A I gIt-—iOi-
(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 _
day of 20
75 '51P
Nota Pub PORIS E. Signature
o
Notary c Notary Public,State Of New Y6rk g
No. 01 S P6069527
Clualified In Suffolk County '
Commission Expires Febtuary 4.':�0?-�—
Scott A. Russell ,�
SUPERVISOR
-z IM[A\NA\ GrIENt)EN'7C'
SOUTHOLD TOWN HALL-P.O.Box 1179
53095 Main Road-SOUTHOLD,NEW YORK 11971 'ffj�O Town of Southold
CHAPTER 236 - STORMWATER MANAGEMENT WORK SHEET
( TO BE COMPLETED BY THE APPLICANT )
DOES THIS PROJECT INVOLVE ANY OF THE (FOLLOWING:
t Yes No (CHECK ALL THAT APPLY) 1
❑® A. Clearing, grubbing, grading or stripping of land which affects more r
than 5,000 square feet of ground surface. '
1
❑[3 B. 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.
❑[A D. Site preparation within 100 feet of wetlands, beach, bluff or coastal
f
erosion hazard area.
❑ E_ Site preparation within the one-hundred-year floodplain as depicted
on FIRM Map of any watercourse.
e
❑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 Nu 36 does not apply to your project.
If you answered YES to one or more of the above, pleases Two copies of a water Management Control Plan
and a completed Check List Form to the Building Department it Application.
APPLICANT: (Property Owner,Design Professional,Agent,Co�F ctor,Other) -
S.C.T.M. �`: 1000 Date..
District
>vA> � �� �� ® -7 S D4 3 " q j z� a
J/. w.."o Section Block Lot
FOR BUILDING DL•PARTNIENT USE ONL
Contact
.7cicplqrc�LmOcn
Reviewed By:
— — — — — — — — — — — — — — — — — —
Date:
Property Address/ Location of Construction Work: — — — — — — — — — — — — — — — — — _
❑ Approved for processing Building Permit.
900 ?214acr` IZOA-N 21
Stormwater Management Control Plan Not Required.
- �)Q"700" , A)y I K-7-7 ❑ Stormwater Management Control Plan is Required
(Forward to Engineering Department for Review.)
FOR SMCP-TOS MAY 2014
G ---
g1gFFat A- BUILDING DEPARTMENT - Electrical Inspector
�O
TOWN OF SOUTHOLD
Town Hall Annex - 54375 Main Road - PO Box 1179
Southold, New York 11971-0959
ray • � Telephone (631) 765-1802 - FAX (631) 765-9502
mal , c
roger.richert(a town.southold.ny.us
APPLICATION FOR ELECTRICAL INSPECTION
--- - - - - --- - -
Date: - -
'EQl7ESTED-BY' - -
Company Name: � �-
Name: o
License No.: email: — — �e
Address: o
6
Phone No.: �.J 7�
JOB SITE INFORMATION: (All Information Required)
Name:
Address: I J l
Cross Street:
Phone No.:
BIdg.Permit#: email:
Tax Map District: 1000 Section:1-7Block: Lot: 3
r
BRIEF DESCRIPTION OF WORK (Please Print Clearly)
Circle All That Apply:
Is job ready for inspection?: YES�0
Rough [n FinaC'
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
Additional'Information:
e a
PAYMENT DUE WITH APPLICATION p
Request for Inspection Focm.xls
1
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SURVEY OF PROPERTY �I�
SITUATED AT
BAYVIEW
TOWN OF SOUTHOLD
SUFFOLK COUNTY, NEW YORK
S.C. TAX No. 1000-78-09-35
SCALE 1"=30' /
JULY 24, 19SB
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PHONE(316)737-2090 Gv.(616)7T]-SP7]
DTT LOWED AT Y4PG'100
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AP RR VED AS NOTED
DATE: g.p4RN
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RETAIN STORM WATER RUNOFF
FEE: m- D BY: PURSUANT TO CHAPTER 236
NOTIFY BUILDING DEPT AT OFTHE TOWN CODE.
765-1802 8 AM TO 4 PM FOR THE
FOLLOWING INSPECTIONS:
I. FOUNDATION - TWO REQUIRED
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. ENCLOSE POOL TO CODE
"UPON COMPLETION
BEFORE "WATER"
COMPLY WITH ALL CODES OF
NEW YORK STATE & TOWN CODES
AS REQUIRED AND CONDITIONS OF
Q() cp '„
S -
SN TI RQSUP ELECTRICAL
INSPECTION REQUIRED
OCCUPANCY OR
USE IS UNLAWFUL
WITHOUT CERTIFICATE
OF OCCUPANCY
SECTION G106
a4RAPl41T PROf=ION REIQUIRED POOL AND PROPERTY TO OCNFORM 70 N-Y. smas RESIDENTIAL
S&!:FION G107 OCOE APPENDIX G 2000' EDITION , !�
PObL ALARM REQUIRED -PSL TO aa*qiN Tl? ANSI/NSPI SMUDARDS AG.103.1
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