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HomeMy WebLinkAbout43462-Z F041(4-� Town of Southold 7/6/2020 3 P.O.Boz 1179 0 d' T 53095 Main Rd V,'j%V ��p,�� Southold,New York 11971 CERTIFICATE OF OCCUPANCY No: 41226 Date: 7/6/2020 THIS CERTIFIES that the building IN GROUND POOL Location of Property: 1655 Old Farm Rd., Orient SCTM#: 473889 Sec/Block/Lot: 26.-4-1 Subdivision: Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated 2/4/2019 pursuant to which Building Permit No. 43462 dated 2/11/2019 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 Thompson,Elizabeth&Fahs,Marianne of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL ELECTRICAL CERTIFICATE NO. 43462 7/6/2020 PLUMBERS CERTIFICATION DATED f AuthorW Signatur �SUFFn� TOWN OF SOUTHOLD BUILDING DEPARTMENT o TOWN CLERK'S OFFICE o . Al 4� 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#: 43462 Date: 2/11/2019 Permission is hereby granted to: Thompson, Elizabeth PO BOX 464 Orient, NY 11957 To: construct an in-ground swimming pool as applied for. At premises located at: 1655 Old Farm Rd., Orient SCTM # 473889 Sec/Block/Lot# 26.4-1 Pursuant to application dated 2/4/2019 and approved by the Building Inspector. To expire on 8/12/2020. Fees: SWIMMING POOLS -IN-GROUND WITH FENCE ENCLOSURE $250.00 CO - SWIMMING POOL $50.00 Total: $300.00 LD: 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- $100.00 3. Copy of Certificate of Occupancy-$.25 4. Updated Certificate of Occupancy- $50.00 5. Temporary Certificate of Occupancy-Residential$15.00, Commercial $15.00 Date. New Construction: Old or Pre-existing Buil 'ng: (check one Location of Property: 6 WQ/G /GJl y House No. StreetHamlet Owner or Owners of Property: �/ Gi'/ '/'!'1/ /c��t 4 Suffolk County Tax Map No 1000, Section Block Lot Y 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: $ a2 /AlYplicant Signature Of so Town Hall Annex ® Telephone(631)765-1802 54375 Main Road Fax(631)765-9502 P.O.Box 1179 sean.devlin(a)-town.southold.n us Southold,NY 11971-0959 COW, �® y c0U ,� BUILDING DEPARTMENT TOWN OF SOUTHOLD CERTIFICATE OF ELECTRICAL COMPLIANCE SITE LOCATION Issued To: Elizabeth Thompson Address: 1655 Old Farm Rd city Orient St: Ny zip: 11957 Budding Permit#: 43462 Section 26 Block- 4 Lot. 1 WAS EXAMINED AND FOUND TO BE IN COMPLIANCE WITH THE NATIONAL ELECTRIC CODE Contractor: DBA: East County Electric License No: 1005ME SITE DETAILS Office Use Only Residential X Indoor X Basement Service Commerical Outdoor X 1st Floor Pool X New X Renovation 2nd Floor Hot Tub Addition Survey X Attic Garage INVENTORY Service 1 ph X Heat Duplec Recpt Ceding Fixtures Bath Exhaust Fan Service 3 ph Hot Water GFCI Recpt 1 Wall Fixtures Smoke Detectors Main Panel A/C Condenser Single Recpt 1 Recessed Fixtures CO2 Detectors Sub Panel X A/C Blower Range Recpt Ceiling Fan Combo Smoke/CO Transformer UC Lights Dryer Recpt Emergency Fixtures Time Clocks Disconnect Switches 4'LED Exit Fixtures 11 Pump Other Equipment Salt Generator, LV Tranny, Pump on 220GFCI Breaker, Aqua Solar on 120 GFCI, Pool Cover w/ Keypad on 120GFCI, Pool Lights on 120GFCI Notes. " AS BUILT " " NO VISUAL DEFECTS " Did Not See Bonding Inspector Signature: Z Date: July 6, 2020 S.Devlin-Cert Electrical Compliance Form.xls L OESOUTy how o� # * TOWN OF SOUTHOLD BUILDING DEPT. _ - °`ycourm 765-1802 INSPECTION r [ ] FOUNDATION 1 ST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [4ASLATIOWCAULKING U FRAMING/STRAPPING [ FINAL [ ] "FIREPLACE & CHIMNEY° - " [ - ] FIRE SAFETY INSPECTION [ ] FIRE RESISTANT CONSTRUCTION - [' ]' FIRE RESISTANT PENETRATION [ ] ELECTRICAL (ROUGH) [ ] ELECTRICAL (FINAL) [ ] CODE VIOLATION [ ] PRE C/O . R ARKS: � r DATE 311VI INSPECTOR , O�aOF SOUTyO� Ll 172 1 � � b -Pk eolw # * TOWN OF SOUTHOLD BUILDING DEPT. °`ycourm��' 765-1802 INSPECTION [ ] FOUNDATION 1 ST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] INSULATION/CAULKING [ ] FRAMING /STRAPPING [ ] FINAL [ ] FIREPLACE & CHIMNEY [ ] FIRE SAFETY INSPECTION [ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRATION [ ] ELECTRICAL (ROUGH) 9 4 ELECTRICAL (FINAL) Do/ [ ] CODE VIOLATION [ ] PRE C/O REMARKS: C A e a�r ^0 mAd a DATE v INSPECTOR FIELD INSPECTION REPORT DATE COMMENTS FOUNDATION (1ST) 'FOUNDATION (2ND) � z 0 ROUGH FRAMING& j m PLUMBING y INSULATION PER N.Y: y STATE ENERGY CODE FINAL AMrTIONAL COMMENTS Z ® m z d b H 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) 765-9502Survey ��� Southoldtownny.gov PERMIT NO. Check Septic Form N.Y.S.D.E.C. Trustees C.O.Application Flood Permit Examined ,20Single&Separate DTruss Identification Form C d lip( FEB - 42019 Storm-Water Assessment Form �t: Approved ,20 _ Na maiuo: � � G � S D Disapproved a/c TOWN OF SOU'g'RO� Phone: ��I IV Expiration 920 Building Inspector APPLICATION FOR BUILDING PERMIT Date b , 20 /7 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,housin ode, and regulation a d to admit authorized inspectors on premises and in building for necessary inspections. / V ( ignature of applicant or name,if a corporation) f)41A L ov (M ' g a dress of applicant) Stat whether I applicant il owne lessee, agent, architect, engineer, general contractor, electrician, plumber or builder Name of owner of premises / Z A �� J d"' I �I► '` (As A the tax r ll or latest deed) If applicant is a corporation, signature of duly authorized officer (Name and title of corporate o icer) Builders License No. �71) Plumbers License No. Electricians License No. Other Trade's License No. 1. Location of land o which propd work will be done: oneo House Number ---Street" --Street° - Hamlet County Tax Map No. 1000 Section Block', Lot I = 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 fa be aid on filing this application) t e� ; r t f"1 d -paid g 5. If dwelling, number of dwelling units Nui: e&i ofd we'lling_un>X�ts' each floor If garage, number of cars V� 6. If business, commercial or mixed occupancy,.specify nature and extent of each type of use. 7. Dimensions of existing structures, if any:'Front 'RearDepth Height = Number of Stories "'� ai • Dimensions of same structure with alterations or additions: Front Rear Depth Height Number of Stories 8. Dimensions of entire new construction: Front Rear Depth Height 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 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 NO 14.Names of Owner of premises Address Phone No. 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 NOy * IF YES, SOUTHOLD TOWN TRUSTEES & D.E.C. PERMITS MAY"QUIRED. 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 * IF YES, PROVIDE A COPY. STATE OF NEW YORK) SS: COUNTY OFSW W being duly sworn, deposes and says that(s)he is the applicant (Name of individual,=,s' ning con act)above d, (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 before me this +—h day of 2019 TRACEY L. DWYER NotaryPublic ...'PUBLIC,STATE O-NMI, NO.01 DW6306900 Si ature of Applicant QUALIFIED IN SUFFOLK COUNTY COMMISSION EXPIRES JUNE 30,20AI-1, Scott A. Russell ,��°Su STOIRMWA IEIR.. SUPERVISOR � MANAGIE MEDT SOUTHOLD TOWN HALL-P.O.Box 1179 Town of Southold 53095 Main Road-SOUTHOLD,NEW YORK 11971 CHAPTER 236 - STORMWATER MANAGEMENT WORK SHEET (TO BE COMPLETED BY THE APPLICANT ) DOES TIUS PROJECT INVOLVE ANY OF THE FOLLOWING: (CHECK ALL THAT APPLY) YesNo ❑ 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. ❑VC. Site preparation on slopes which exceed 10 feet vertical rise to 100 feet of horizontal distance. 1:10/6. 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. O r , 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 wif pour Building Permit Application. S.C.T.M. #: 1000 Date APPLICANT: (Pro rty Owner, Professional Contractor.Other) District NAME \ Section Block Lot 7Reviewed OR BUILDING DEPARTMENT USE ONLYContact Information By: - - - - - - - - - - - - - - - - Dae: Property Addre&s/Location of Construction Work: — — — — — — — — — — — — — — — Approved for processing Building Permit. Stormwater Management Control Plan Not Required. ElStormwater Management Control Plan is Required. (Forward to Engineering Department for Review:) FORM " SMCP-TOS MAY 2014 r ' r BUILDING DEPARTMENT- Electrical lnsp icto`r� TOWN OF SOUTHOLD Town Hall Annex- 54375 Main Road - PO Box 1 1A 2 6 2020 Southold, New York 11971-0959 O� Telephone (631) 765-1802 - FAX (631) 765-95,024.. al 'ig ' roger.richertna.town.southold.ny.us ^� APPLICATION FOR ELECTRICAL INSPECTION i=QUESTED BY: -- -- - - - - ----- ----------- --- -- -- -- - ---- - - - Date: - ompany Name: ��Q C6Ca a l 6 4�c r'-iL ame: O T�-( -- �Gense No.: 1©G�5-i-i 5 - email: ddress: J366 61 C.-rA MI• Svi_:--t4nic) �J '/ hone-No.: (e,t 7767- �`l OB SITE INFORMATION: (All information Required) ;ame: bi:i 4 I o salt dress: Ra5-T ® td � rr-' R OSI aT 'rocs Street: 0114 6<_ ,vdv-d hone No.: tdg.Permit �A (p 0Z, email: iax Map District: 1000 Section: Block: Lot: -41 ;RIEF DESCRIPTION OF WORK (Please Print Clearly) �ook :ircle All That Apply: job ready for inspection?: (YES / NO Rough In Final to you need a Temp Certificate?: YES NO Issued On emp Information: (All information required) service Size 1 Ph 3 Ph Size: A # Meters Old Meter# le%v Service- Fire Reconnect- Flood Reconnect-Service Reconnected- Underground-Overhead Underground Laterals 1 2 H Frame Pole Work done on Service? Y N Ldditional Information: PAYMENT DUE WITH APPLICATION Request for Inspection For mxls ` � OF SOUp�®� Town Hall Annex ® Telephone(631)765-1802 54375 Main Road Fax(631)765-9502 P.O.Box 1179 Southold,NY 11971-0959 ® �Q lyCOO,�� BUILDING DEPARTMENT December 30, 2019 TOWN OF SOUTHOLD Elizabeth Thompson P.O. Box 464 Orient, NY 11957 RE: 1655 Old Farm Road, Orient TO WHOM IT MAY CONCERN: The items marked below are required to obtain your Certificate of Occupancy Application for Certificate of Occupancy. (Enclosed) Electrical Underwriters Certificate. --J"n5p 1(1 A fee of$50.00. Final Survey with Health Department Approval. Plumbers Solder Certificate or Pex Affidavit Trustees Certificate of Compliance. (Town Trustees # 765-1892) Final Planning Board Approval. (Planning # 765-1938) Final Fire Inspection from Fire Marshall. (631-765-1802) Final Landmark Preservation approval. Final Elevation Certificate required. Final Storm Water Runoff Approval from Town Engineer Spray Foam Insulation certification from a NYS licensed architect or Engineer BUILDING PERMIT: 43462-Z Swimming Pool t / SUFFOLK CO.H'gA'LTH DEPT. APPROyAt r H. 5_ NO. i ic STATEMENT OF INTENT THE WATER SUPPLY AND SEWAGE DISPOS. •''�� - {�"V- M'R ��� SYSTEMS FOR THIS RESIDENCE WI f'rC� CONFORM TO THE STANDARDS* OF TI 'ujUl/ SUFFOLK CO. DEPT. OF HEALTH SERVICI )IS J APPLICANT :=# ' `- , • '� �� SUFFOLK COUNTY DEPT. OF HEAL' SERVICES - FOR A-PPROVAL < CONSTRUCTION-ONLY DATE: k H. S. REI:. NO.: 1-1- 50* 23J APPROVED: p rr'arzk z••...f� f SUFFOLK CO. TAX MAP DESIGNATION: q DIST. SECT. BLOCK PC-L. OWNERS ADDRESS, <5eof--cycrre =ramal ` ,arc 1. ':j''' DEED: L. P. TEST HOLE STAMP Unx+,tharimd aheratlm or addition tr this survey is a violation of Secum 72208 od the Now York State �- des of this OMWIrAp trot barb the land eurreyara Med seat cc embmsed aaef to be a tratid �bt!aoteatdei r� ��T Guaranteel�h irar'eon sha1P n +only to the Petsan for whom tfis sun PrOPK0 b end on his behalf to the gor�mnental ag"m Iendtae inatituNon amd hereon and um".G imine not trtrthe anskm tO ovvna ftWW(wtudondoraubmW J" Z "l uat�-�zrr+ f fix,- - rt�rcal�l $E-AL, �''•'� �r�-rr�� �:v�r lye�'�@ o�vr�t� �1'rY.�-fes � �Gr.�'.�=�����'�" L1. �, �i •'7"i f�r�':�tx� �orr°r �tt� � `` ' � Rt3 I�R�CK-5110. UY#:r'F►.G, - - ._. :. APPROVI-1.) AS IN, :1 � fi By NOTIFY B 117)II` C._t ,,N,ft�kNT AT 7, I 1765-1802 3 AM TO 4 P,',A FOR THE ' I FOLLOWING INISPECTIONS: `i 1. FOUNDATION - TWO REQUIRED FOR POURED CONCRETE i �2. ROUGH FRAMINGPLUMBING f i 771, r 3. INSULATION -T �)4. FINAL CONSTRUCTION MUST 'k ` �` ��®yi -� �� BE COMPLETE POR C.O. kjA ' ` �'� , )ALL CONSTRUCTION SHALT_ MEET THE �, % REQUIREMENTS OF THE CODES OF NEIN 0,O ` YORK STATE. NOT RESPONSIBLE FOR -DESIGN OR CONSTRUCTION ERRORS, -77 }} COMPLY WITH ALL CODES OF I EW YORK STATE & TOWN CODE - REQUIRED I _ SO 0 = 1 j444 LD TOWN TRUSTEES gra. :, • CUPANCY -IS UNLAWFUL USF WITHOUT CERTIFICATE UF LJUUUR r%H v