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44292-Z
zr-TZI Town of Southold 3/13/2020 P.O.Box 1179 53095 Main Rd �A10Southold,New York 11971 CERTIFICATE OF OCCUPANCY No: 41146 Date: 3/13/2020 THIS CERTIFIES that the building IN GROUND POOL Location of Property: 1830 Boisseau Ave., Southold §CTM#: 473889 Sec/Block/Lot: 55.-6-18 Subdivision: Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated 10/7/2019 pursuant to which Building Permit No. 44292 dated 10/15/2019 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 DeJesus,Liza&Kersamt,Reginald of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL ELECTRICAL CERTIFICATE NO. 44292 02-03-2020 PLUMBERS CERTIFICATION DATED ut o ' e Signature TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE o� • 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#: 44292 Date: 10/15/2019 Permission is hereby granted to: DeJesus, Liza 35-24 214th PI Flushing, NY 11361 � 1 To: construct accessory in-ground swimming pool as applied for. At premises located at: 1830 Boisseau Ave., Southold SCTM # 473889 Sec/Block/Lot# 55.-6-18 Pursuant to application dated 10/7/2019 and approved by the Building Inspector. To expire on 4/15/2021. Fees: SWIMMING POOLS -IN-GROUND WITH FENCE ENCLOSURE $250.00 CO - SWIMMING POOL $50.00 Total: $300.00 Buil ector Form No.6 "roNvN OF SOUTHOLD BUILDING DEPARTMENT 6 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.aew use: 1. Final survey.of property with accurate location of all buildings, property lines, streets, and unusual natural or topographic 4features. 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- $100.00 3. Copy oCerti$cafe ofUicupancy-$2'S�' '' _. ._..._ 4. Updated Certificate of Occupancy- $50.00 5. Temporgry Certificate of Occupancy-Residential$15.00, Commercial$15.00 Date. ru New Construction: / Old or Pre-existing Building: (check one) Location of Property: ]� � (jpl.55PaU House No. Street Hamlet Owner or Owners of Property: Suffolk County Tax Map No 1000, Section S!S Block, ( Lot Subdivision Filed Map. Lot: Permit No. qygv— Date of Permit. Applicant: Health Dept. Approval: Underwriters Approval: Planning Board Approval: - Request for: Temporary Certificate Final Certificate: (check one) Fee Submitted: $, 'Applidant Sig ure BuRding Department Anolication - AUTHORIZATION (Where the Applicant is not the Owner) I, C 17.x' ���t.SK 5 residing at =$ (Print property owner's name) (Mailing Address) `17 do hereby authorize TT ' (Agent) 1 to apply on my behalf to the Southold Building Department. (owners signature,) (nate) IZA P��g75as (print Owner's Name) rjv so Town Hall Annex ® Telephone(631)765-1802 54375 Main Road Fax(631)765-9502 P.O.Box 1179 ® Q sean.devlin('D-town.southold.ny.us Southold,NY 11971-0959 BUILDING DEPARTMENT TOWN OF SOUTHOLD CERTIFICATE OF ELECTRICAL COMPLIANCE SITE LOCATION Issued To: Liza DeJesus Address: 1830 Boisseau Ave city Southold st: NY zip: 11971 Building Permit# 44292 Section: 55 Block 6 Lot 18 WAS EXAMINED AND FOUND TO BE IN COMPLIANCE WITH THE NATIONAL ELECTRIC CODE Contractor: DBA: JES Electrical Contracting License No: 4483-ME SITE DETAILS Office Use Only Residential X Indoor Basement Service Only Commerical Outdoor X 1st Floor Pool X New X Renovation 2nd Floor Hot Tub Addition Survey Attic Garage INVENTORY Service 1 ph X Heat Duplec Recpt Ceding Fixtures Bath Exhaust Fan Service 3 ph Hot Water GFCI Recpt 2 Wall Fixtures Smoke Detectors Main Panel A/C Condenser Single Recpt Recessed Fixtures CO2 Detectors Sub Panel A/C Blower Range Recpt Ceiling Fan Combo Smoke/CO Transformer UC Lights Dryer Recpt Emergency Fixtures Time Clocks 1 Disconnect LEI Switches 4'LED Exit Fixtures Pump 1 Other Equipment: Pool Cover w/ Keypad, Pump on a 220GFI Breaker, Salt Generator, Heater, Lights on a Button Switch, Intermatic Pool Panel- 8 Circuits Used Notes: Pool Inspector Signature: Date: February 3, 2020 S Devlin-Cert Electrical Compliance Form.xls *oF souryolo (�"l (2 1 f�)V 13 # TOWN OF SOUTHOLD BUILDING DEPT. ycou765-1802 INSPECTION [ ] FOUNDATION 1 ST [ ] ROUGH PLBG. [. ] FOUNDATION 2ND [ ] INSULATIOWCAULKING [ ] FRAMING /STRAPPING [ ] FINAL [ ] -FIREPLACE & CHIMNEY [ ] FIRE SAFETY INSPECTION [ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRATION- �� [ ] ELECTRICAL (ROUGH) ' ELECTRICAL (FINAL) [ ] CODE VIOLATION [ ] PRE C/O REMARKS: _ . DATE Z INSPECTOR { 1 �rsf SOy _ f # TOWN OF SOUTHOLD BUILDING DEPT. Comm' ' 765.1802 [ ] FOUNDATION 1ST [ ] ROUGH PLBG. [ ° ] FOUNDATION 2ND [ INSULATIOWCA�ULKING [ ] FRAMING /STRAPPING [ ] FINAL [ ] FIREPLACE & CHIMNEY- a [ ] FIRE SAFETY-INSPECTION [ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRATION [ ] ELECTRICAL (ROUGH) [ ] ELECTRICAL (FINAL) [ ] CODE VIOLATION [ ] PRE C/O REMARKS: _ c ` DATE -INSPECTOR FIELD INSPECTION REPORT DATE COMMENTS 41, FOUNDATION (15T) y ------------------------------------ C DO FOUNDATION (2ND) t� z � o cy u ROUGH FRAMING& � PLUMBING � Q r r INSULATION PER N.Y. STATE ENERGY CODE rw &Avil Wk NAM,,, FINAL i ADDITIONAL COMMENTS m ZINP 4� O �. y 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 Southoldtownny.gov PERMIT NO. Check Septic Form N.Y.S.D.E.C. Trustees C.O.Application Flood Permit Examined 20 !• ; + ; ; , Single&Separate m 4._.... Truss Identification Form OCT 7 2019 Storm-Water Assessment Form �} I Contact: Approved t/ `� ,20J BITH`�° 1`Dlj�' � Mail to: 00 p a 10 P .. Disapproved a/c 0A �Jy Phone: Expiration ,20 Built Spector APPLICATION FOR BUILDING PERMIT Date , 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. Ork a2(, CAS (Signature of applicant or name,if a corporation) M C,1.o Lq-cj )4 k(� _ (Mailing address of applicant) State whether applicant is owner lessee, agent, architect, engineer, general contractor, electrician, plumber or builder rlinAef-- Name ofontis of premises �2� A -eLIL(. As on the tax roll or latest deed) -r J0 If appliccorpo 'gnature f auth9rized officer ( dense and title of corporate officer) Builders No. Plumbers License No. Electricians License No. Other Trade's License No. 1. Location of land on which proposed work will be done: J L '1� 38 (�►�J V�. LsUj6a House Number Street Hamlet County Tax Map No. 1000 Section 155 Block (p Lot /18 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 b. Intended use and occupancy 3. Nature of work(check which applicable):New Building Addition Alteration Repair Removal Demolition Other Work (Description) 4. Estimated Cost Fee 1 ( �o be paid on filing this application) 5. If dwelling,number of dwelling units Number of,dwelling' nits 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 Number of Stories 8. Dimensions of entire new construction: Front ! Rear /o 6 Depth 01/0 Height rr�� ,, Number of Stories 9. Size of lot: Front qui . 07 Rear gr83 Depth 10. Date of Purchase Name of Former Owner 11. Zone or use district in which premises are situated C�ZsickA o I 12. Does proposed construction violate any zoning law, ordinance or regulation?YES NO 13. Will lot be re-graded? YES NO /" Will excess fill be removed from premises?YES t", NO "-LA jVs_s'-c D1Jcs4 /00 (N5�- u i o 14. Names of Owner of premises Address 680 kA Phone No. (D'-1(o-' Name of Architect Address Phone No Name of Contractor oL I"IRr3-tAddress 7DO e A Phone No. 5qy— U� H Owd< 15 a. Is this property within 100 feet of a tidal wetland or a freshwater wetland? *YES NO. 1/ * 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_Xeo!!� * 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 uTol - JAS oO 4� efS being duly sworn, deposes and says that(s)he is the applicant (Name of individual signing contract)above named, 1�1 � (S)He is the 06 &d--K POO(- C'Iq m, cant (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 tgbefore me this day of 20101JA oa� 74 Notary PublicTRACEY L. DWYER /6ignature'of pplicant NOTARY PUBLIC,STATE OF NEW YORK NO.01 DW6306900 QUALIFIED IN SUFFOLK COUNTY COMMISSION EXPIRES JUNE 30,2ffA;I- Scott A. Russell ,� DSUIFQ r STO]KIMWA\TIE]k SUPERVISOR ' MA\1�A\�G�]El��l[]E1�'7C' SOUTHOLDTOWN HALL-P.O.Boz 1179 0 z 53095 Main Road-SOUTHOLD,NEW YORK 11971 Town of Southold CHAPTER 236 - STORMWATER MANAGEMENT WORK SHEET ( TO BE COMPLETED BY THE APPLICANT ) DOES PIIS 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. ❑El'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. ❑EfD. Site preparation within 100 feet of wetlands, beach, bluff or coastal erosion hazard area. ❑[3*E. Site preparation within the one-hundred-year f loodplain 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. APPLICANT (Property Owner,Design Professional,Agent,Contractor,Other) S.C.T.M. #: 1000 Date (Int) District J Q NAME. 1�C � L mow) Section Block Lot lSymturtl ****FOR BUILDING PARTMENT USE ONLY n � **** Contact Information. ,,59� ,29 qs Mkpbme Number) Reviewed By: h Vk)4tA )C - - - - - - - - - - - - - - Date: Property Address/Location of Construction Work: — _ _ _ _ _ _ ' _ /Z� e!JI`SSPGU �J 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 ��UTyo�o Town Hall Annex J A N 3 0 2020 Telephone(6a1)765-1802 54375 Main Road ( 1)7 P.O.Box 1179 roaer.richertownS0GM 0QQ& nV us Southold,NY 11971 - 4 BUILDING DEPARTMENT TOWN OF SOLrrHOLD APPLICATION FOR ELECTRICAL INSPECTION 1' f REQUESTED BY: �0'rt rock. Pool Core, Date: / Z z© Company Name: �r��,�, f a✓i cacArh Name: I: License No.: Po V� r Address: 2(0 Pork- five, ffaAy,®', /)V //7oz Phone-No.: Z qo-�_ JOBSITE INFORMATION: (*Indicates required information) *Name: - - —&ScL �S *Address: l�3 go,SSeao lqve, Y 1 *Cross Street: *Phone No.: tpq(o - 3317 -3035 Permit No.: ggzq 2 Tax-Map District: 1000 Section: SY, Block: G Lot: I g *BRIEF DESCRIPTION OF WORK(Please forint Clearly) nti(4 k-)�'�id (Please Circle All That Apply) Is job ready for inspection: �/ NO Rough In Final *Do•you need a Temp Certificate: YES/,NO Temp Information (If• ded) *Service Size: Pha 3Phase 100 150 200 300 350 400 Other d *New Service: Re-connect, Underground Number of Meters Change of Service Overhead Additional Information: PAYMENT DUE WITH APPLICATION 82-Request for Inspection Form I t (SIG) . _ ME �PUIz WSALTr-E ! ► AT�"� t f rt? �8 �1 TF�O LJ his p ) ��� 5►0Y/ °rO`.VN oi- T,,)Un•IOLD ICY. boc Era 25 � L��Xlfxr� d i e � t1D P6pryA E91dPft 11C1,Q®a®Ot10 �p� ml))All•ha.)1 GAR. r�Jc13T/ �tttal���taw vwx)Idm lu but arp,�Iwr oVasroeZ1r �e Mctd� m u A 941 vae� asmAs r es�slowl Q < _0 FQ.mcL c�S CAd�7�/i AJ-�- ® .i�Moro watal tlra�aur t!(i c-u fo n o 36bABWaQNPAt !•q� � ��$ � a6P1t4tf�1:SI�Gi.e.�o 45[8 k� -%T Lima TMMT�Yeae r�lsanua oo 9 eur 940.00- D.FOSTE P. UA&NTECQ__—TQ 71IF1lCdlGU T!'E iLE.( ,UPµtyCE Ct a� AND TD 7 l E sC.0,'HO Ll,SyM,/�+i�2 BAN V _.._. uac6 stJCL9.' C0 _ • '`• � EYJU�JF 19�197Z VAN TUYLJF c-,ION SCALE- L A eras oa4 elm ly 5,4 �l4 POfa.1', 1. - . 4 1 a ^ Hal APP 0 ED AS NOTED DATE: B.P.# o� FEE: D BY. 'RETAIN STORM WATER RUNOFF NOTIFY BUILDING DEPAP,Tt AT PURSUANT TO CHAPTER 236 765-1802 8 AM TO 4 PM FOR THE OF THE TOWN CODE. FOLLOWING INSPEC--!c„dS: 1. FOUNDATION -- TVK' REQUIRED FOR POURED CONCRETE 2. ROUGH - FRAMING & PLUMPING 3. INSULATION 4. FINAL - CONSTR"^7111•,- MUST BE COMPLETE F;, 0 ALL CONSTRUCT N 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 S9k�H91-8�9�A'�1.Z� sOtTtt9 , 1 ING BOARD - _ STEES `ENG OSE POOL TO CODE. I, N COMPLETION BEF®RE:"WATER",u, OCCUPANCY O USE IS UNLAWFUL WITHOUT CERTIFICATE OF OCCUPANCY At P.O.lI! 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