HomeMy WebLinkAbout43501-Z o�OSUFFo4 G`� Town of Southold 3/17/2020
a y�� P.O.Box 1179
C=
_ 53095 Main Rd
ti o� Southold,New York 11971
CERTIFICATE OF OCCUPANCY
No: 41152 Date: 3/17/2020
THIS CERTIFIES that the building IN GROUND POOL
Location of Property: 435 Willow Pond Ln., Southold
SCTM#: 473889 Sec/Block/Lot: 78.-1-45
Subdivision: Filed Map No. Lot No.
conforms substantially to the Application for Building Permit heretofore filed in this office dated
2/14/2019 pursuant to which Building Permit No. 43501 dated 2/21/2019
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 to a single family dwelling as applied for.
The certificate is issued to Mark Vonasek&Todd Richardson
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL
ELECTRICAL CERTIFICATE NO. 43501 01/23/2020
PLUMBERS CERTIFICATION DATED
t iz d Signature
°SSUt'r�oTOWN 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#: 43501 Date: 2/21/2019
Permission is hereby granted to:
Vonasek, Mark
435 Willow Pond Ln
Southold, NY 11971
To: construct accessoryinround swimming-g g pool as applied for. (must maintain 15' side
and rear yard setbacks)
At premises located at:
435 Willow Pond Ln., Southold
SCTM # 473889
Sec/Block/Lot# 78.-1-45
Pursuant to application dated 2/14/2019 and approved by the Building Inspector.
To expire on 8/22/2020.
Fees:
SWIMMING POOLS -IN-GROUND WITH FENCE ENCLOSURE $250.00
CO - SWIMMING POOL $50.00
Total: $300.00
Bu pector
Form No.6
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
a TOWN BALL
` 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¢featu res.
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 siatement 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 i
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 Certil'icafe-of Occupancy= 23' -
4. Updated Certificate of Occupancy- $50.00
5. Temporary Certificate of Occupancy-Residential$15.00, Commercial$15.00
` Date. (� /�- +q
�iJ�c�J ti.►CJ s�'�M 1y�J� ,
New Construction. U 3c, Old or Pre-existing Building: (check one)
Location of Property: d��J (,tJe I LDN� Irl
House No. Street I/ Hamlet
Owner or Owners of Property: J"�0 r.K Zr.j
Suffolk County Tax Map No 1000, Section `�� Block Lot ° Jr
Subdivision 2 Filed Map. Lot:
Permit No. J Date of Permit. Applicant:
Health Dept. Approval: Underwriters Approval:
Planning Board Approval:
Request for: Temporary Certificate Final Certificate: (check one)
Fee Submitted: $ ��
OnIJ�
Applicant S gnature
i
®��pE SOV��®l
Town Hall Annex ® Telephone(631)765-1802
54375 Main Road Fax(631)765-9502
P.O.Box 117
Southold,NY 11971-0959 ® @ sean.devlin(cD-town.southold.ny.us
�` �
®l�COUNIy,�
BUILDING DEPARTMENT
TOWN OF SOUTHOLD
CERTIFICATE OF ELECTRICAL COMPLIANCE
SITE LOCATION
Issued To: Mark Vonasek
Address: 435 Willow Pond Ln City.Southold st: NY zip: 11971
Budding Permit#: 43501 section: 78 Block: 1 Lot- 45
WAS EXAMINED AND FOUND TO BE IN COMPLIANCE WITH THE NATIONAL ELECTRIC CODE
Contractor: DBA: North Fork Pool Care License No. 4483-ME
SITE DETAILS
Office Use Only
Residential X Indoor Basement Service Only
Commerical Outdoor X 1 st Floor Pool X
New X Renovation 2nd Floor Hot Tub
Addition Survey Attic Garage
INVENTORY
Service 1 ph X Heat Duplec Recpt Ceding Fixtures HID Fixtures
Service 3 ph Hot Water GFCI Recpt 1 Wall Fixtures Smoke Detectors
Main Panel A/C Condenser Single Recpt Recessed Fixtures CO Detectors
Sub Panel 1 A/C Blower Range Recpt Fluorescent Fixture Pumps 1
Transformer Appliances Dryer Recpt Emergency Fixtures Time Clocks 1
Disconnect Switches 1 Twist Lock Exit Fixtures Combo SD/CO
Other Equipment* Salt Generator, Heater, Pump, Lights w/ Push Button Switch, Intermatic Pool Panel,
Timeclock, 220 GFI Breaker for Pump and 120 Breaker for GFI
Notes. Pool
Inspector Signature: Date: January 23, 2020
S. Devlin-Cert Electrical Compliance Form As
q�fot
# * .TOWN 'OF SOUTHOLD BUILDING*.DEPT.
765-1802
INSPECTION .
[ ] FOUNDATION 1ST [ ] ROUGH PLBG.
[ ] FOUNDATION 2ND [ ] INSULATION/CAULKING
[ ] FRAMING /STRAPPING 1VFINALAe6____
[ ] FIREPLACE & CHIMNEY [ ] FIRE SAFETY INSPECTION
[ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRATION
[ ] ELECTRICAL (ROUGH) [ ] ELECTRICAL (FINAL)-
[ ] CODE VIOLATION [ ] PRE C/O
REMARKS: _
tvii., jibir Y,
vJki \ • t__ \ r
A.
DATE INSPECTOR
SOUTyOIo
f # TOWN OF SOUTHOLD BUILDING DEPT.
765-1802
= INSPECT-ION =
[
] --FOUNDATION 1ST [ ] ROUGH PLBG.
[ ] 'FOUNDATION,2ND - ' [ ] INSULATIOWCAULKING
[ ] FRAMING /STRAPPING [ ] FINAL
[ ] FIREPLACE-& CHIMNEY [ "] FIRE SAFETY INSPECTION
[ ] FIRE RESISTANT CONSTRUCTION ["' ] FIRE RESISTANT PENETRATION
[ ] ELECTRICAL (ROUGH) ELECTRICAL-(FINAL)�7
[ ] CODE VIOLATION [ ] PRE C/O
REMARKS:
DATE 1 lq_-,3/ezo INSPECTOR
FIELD INSPECTION REPORT DATE COMMENTS
FOUNDATION (1ST)
H •
...................................
'FOUNDATION (2ND.)
z
o
ROUGH FRAMING&
PLUMBING y
fiINSULATION PER N.Y-.
STATE ENERGY CODE
c RObat 6
ene, Z` A Af^e
FINAL
ADDITIONAL COMMENTS
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TOW *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 Builditig Plans
TEL: (631)765-1802 Planning Board approval
FAX: (631)765-9502 Survey
Southoldtownny.gov PERMIT NO. Check
�� Septic Form
C�Tn� N.Y.S.D.E.C.
®
DD Trustees
C.O.Application
F E B 1 4 2019 Flood Permit
Examined 20 Single&Separate
Truss Identification Form
Storm-Water Assessment Form
TOWN OF
S®U,���D
Contact:
Approved O1 20)a Mail to: 0050 J pekszs
Disapproved a/c &)04k 6A OD( Ca1-L
/, Phone:
Expiration 20 (�
BuiWi&4nirector
APPLICATION FOR BUILDING PERMIT
Date ® I 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.
Jr)rk rDr K Po LCnr-c,
(Signature of applicant or name,if a corporation)
9770® P-Ya,,] Rd L�4pA
(Mailing address of applicant)
State whether applicant is owner, les ee, agent, architect, engineer, general contractor,electrician,plumber or builder
Name of owner of premises 1r� 91. a6e
(As on the tax roll or latest deed)
If applican a corporati , si ature of-duly authori4ed officer
(N e and title of corporate officer)
Builders License No.
Plumbers License No.
Electricians License No.
Other Trade's License No.
s
1. Location of land on which propose work will be done:
(�e I�oL e o/(�
135
House Number Street Hamlet
County Tax Map No. 1000 Section Block Lot ��j
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 n Alteration
Repair Removal Demolition ther Wor Mull 65,,,,t�.,I&
(Description
4. Estimated Cost Fee
(To be paid on filing 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 I lD I Rear 3Q '
Depth
Height Q Number of Stories 491
Dimensions of same structure with alterations or additions: Front Rear
Depth Height Number of Stories
8. Dimensions of entire new construction: Front ( Rear 30 Depth
Height ®y Number of Stories =-
9. Size of lot: Front Rear Depth
10.Date of Purchase Name of Former Owner
11. Zone or use district in which premises are situated I 0j2 �?
12. Does proposed construction violate any zoning law, ordinance or regulation?YES NO�—
13. Will lot be re-graded?YES NO X Will excess fill be d from pr
removee ises?YESX NO
-- - yS5 c,,,��tw �,d/,-Jnn
14.Names of Owner of premised QfK � Akddress 66A%�► Phone No. go -
Name of Architect Address Phone No
Name of Contractor 1`16 fir Address YJM 14021jPhone No. (09/-o;M - ®l
C o4l�-c M o
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 MAYREQUIRED.
b. 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-A-L
*IF YES,PROVIDE A COPY.
STATE OF NEW YORK)
COUNTY OF 5U
JAND ] R&CS being duly sworn,deposes and says that(s)he is the applicant
(Name of individual signing contract)above named,
(S)He is the l'G — l e
,,�V
(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.
Swom t9 before me this
ll--�� day of 20
0,
Im aau X ';)nA, t9AI)
Notary Public Signature of Applicant
TRACEY L. DWYER
NOTARY PUBLIC,STATE OF NEW YORK
NO.o1DW6306900
QUALIFIED IN SUFFOLK COUNTY
COMMISSION EXPIRES JUNE 30,202--
Scott A. Russell _ �`]F01�I�� WA\T]E1K
SUPERVISOR MANAGEMENT
a
SOUTHOLD TOWN HALL-P.O.Box 1179 p m
53095 Main Road-SOUTHOLD,NEW YORK 11971 Town of Southold
CHAPTER 236 - STORMWATER MANAGEMENT WORK SHEET
( TO BE COMPLETED BY THE APPLICANT )
DOES 'I')iIIS PROJECT INVOLVE ANY OF 'I'I-3[]E FOLLOWING:
Yes No (CHECK ALL THAT APPLY)
❑ 0 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.
❑0 C. Site preparation on slopes which exceed 10 feet vertical rise to
100 feet of horizontal distance.
❑[X D. Site preparation within 100 feet of wetlands, beach, bluff or coastal
erosion hazard area.
p[�E. 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.C.T.M. #: 1000 Date-
APPLICANT (Property Owner,Design Professional,Agent,Contractor,Other) District
NAME
„no Section Block Lot
W
//^^,,��"S^
' °'°" Ii "`:: OF; BUILDING DEPAI?'I'1�'tEN'I l:SE ONLY 4
Contact information. `,1_Q l 8_'qyl q
Reviewed By.
— — — — — — — — — — — — — — —
Date: � - � —
Property Address / Location of Construction Work: —
[O/Approved
— — — — — — — — — — — — — —
J for processing Building Permit.
jt� �C�t'(�1�2. - - Stormwater Management Control Plan Not Required.
r' e)And �" l 1197L- ❑ Stormwater Management Control Plan ib Required.
(Forward to Engineering Department for Review.)
FORM * SMCP-TOS MAY 2014
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54375 a F 6 2 5 201° ' J Telephone(631)765-1802
P.O.Box 1179 n;t^ G Q roger.dchert adtoi soutnOl6.nV.us
Southold,NY 11971-095OF
9
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BURDING DEPARTMENT
TOWN OF SOUMOLD
APPLICATION FOR ELECTRICAL INSPECTION
REQUESTED BY: N o orK OpL Date:
Company Name: E(�c
JName: . 066 C e
License No.:
Address: Q l-7
Phone No.: 6 51 _ `7
JOBSITE INFORMATION: (*Indicates required information)
*Name: O °
*Address: 1
*Cross Street:
*Phone No.: C)12 '7 9 •
Permit No.: !f 2s Sc)
Tax-Map District: 1000 Section: Block:�_ Lot:
*BRIEF DESCRIPTION OF WORK (Please Print Clearly) y�
(Please 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
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APPROVED AS NOTED
DATE: a B.P.# J�J`'l�
SSD �01� RETAIN STORM WATER RUNOFF
FEE: BY: PURSUANT TO CHAPTER 236
NOTIFY BUILDING DEPARTM TAT 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. INSULATION
4. FINAL - CONSTRUCTION MUST
BE COMPLETE FOR CO.
ALL CONSTRUCTION SHALL MEET THE
REQUIREMENTS OF THE CODES OF NEW
YORK STATE. NOT RESPONSIBLE FOR ELEC'T'RICAL
DESIGN OR CONSTRUCTION ERRORS. INSPECTION REQUIRED
COMPLY WITH ALL CODES OF
NEW YORE( STATE & TOWN CODES
AS REQUIRED AND CCNDIT!ONS OF
se 19�e-rs+ A� °°9 AT LY1e
'ENCLOSE POOL TO CODE
60AQLD 19N1�J ISG BOARD ';UPON COMPLETION
ZJIQ TRUSTEES 'B FORE°WAT R�
OCCUPANCY OR
USE IS UNLAWFUL sido- QAr yard
WITHOUT CERTIFICATE:. S-e-Aae,kr
OF OCCUPANCY
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FLOOR PATTERN: _._.
CORNERS:
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DEPTH:....,6 / _...
HUNG OVERLAP (tom ON) .
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