HomeMy WebLinkAbout42996-Z z•�'�'"�-tom
�guFFOI cp Town of Southold 8/12/2020
k
=o Gyp P.O.Box 1179
C" x 53095 Main Rd
y�01 dao Southold,New York 11971
CERTIFICATE OF OCCUPANCY
No: 41261 Date: 7/18/2020
THIS CERTIFIES that the building IN GROUND POOL
Location of Property: 175 Goose Creek Lane Ext, Southold
SCTM#: 473889 Sec/Block/Lot: 78.-8-14
Subdivision: Filed Map No. Lot No.
conforms substantially to the Application for Building Permit heretofore filed in this office dated
8/27/2018 pursuant to which Building Permit No. 42996 dated 9/5/2018
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 Schuch,John&Orlick,Rebecca
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL
ELECTRICAL CERTIFICATE NO. 52996 7/10/2020
PLUMBERS CERTIFICATION DATED
Au o ze S nature
�gU ��o TOWN OF SOUTHOLD \
BUILDING DEPARTMENT
y TOWN CLERK'S OFFICE
SOUTHOLD, NY
�Ol � 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#: 42996 Date: 9/5/2018
Permission is hereby granted to:
Schuch, John & Orlick, Rebeccah
1 John St Apt 5C
Brooklyn, NY 12201
To: construct accessory in-ground swimming pool as applied for.
At premises located at:
175 Goose Creek Lane Ext, Southold
SCTM # 473889
Sec/Block/Lot# 78.-8-14
Pursuant to application dated 8/27/2018 and approved by the Building Inspector.
To expire on 3/6/2020.
Fees:
SWIMMING POOLS -IN-GROUND WITH FENCE ENCLOSURE $250.00
CO - SWIMMING POOL $50.00
(h Total: $300.00
Buil ector
Form No. 6
TOWN OF SOUTHOLD
BUILDING DEPARTMEN"C
TOWN HALL
a ` 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"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 Certicafe'of Occupancy= 25' . .. .
4. Updated Certificate of Occupancy- $50.00
5. Temporary Certificate of Occupancy-Residential$15.00, Commercial$15.00
`� Date.
New Construction: d
Old or Pre-existing Building: (check one)
Location of Property: CIS G o k. 1�cite W . O 61� ray
House No. f I Str„eett� Hamlet
Owner or Owners of Property:
Suffolk County Tax Map No 1000, Section -7 o Block, Lot /,A4
Subdivision Filed Map. Lot:
Permit No. Date of Permit. Applicant:
Health Dept. Approval: Underwriters Approval:
Planning Board Approval: /
Request for: Temporary Certificate Final Certificate: F/ (check one)
Fee Submitted:
Applicant ignature
pF SOU��,®l
Town Hall Annex JIL I ® Telephone(631)765-1802
54375 Main Road Fax(631)765-9502
P.O.Box 1179
Southold,NY 11971-0959 � sean.devlinl'cD-town.southold.ny.us
BUILDING DEPARTMENT
TOWN OF SOUTHOLD
CERTIFICATE OF ELECTRICAL COMPLIANCE
SITE LOCATION
Issued To: John Schuch
Address: 175 Goose Creek Lane Ext city,Southold st: NY zip: 11971
Building Permit#: a q% Section: Block 1� Lot: l
WAS EXAMINED AND FOUND TO BE IN COMPLIANCE WITH THE NATIONAL ELECTRIC CODE
Contractor: DBA: JES Electrical Contracting License No: 4483ME
SITE DETAILS
Office Use Only
Residential X Indoor Basement Service
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 X A/C Blower Range Recpt Ceiling Fan Combo Smoke/CO
Transformer UC Lights Dryer Recpt Emergency Fixtures Time Clocks X
Disconnect [E] Switches 4'LED Exit Fixtures Pump
Other Equipment Salt Generator, Pump on 220GFCI Breaker, Pool Heater, Pool Cover w/ Keypad,
Pool Light w/ Push Button
Notes* Pool
Inspector Signature:
Date: July 10, 2020
S.Devlin-Cert Electrical Compliance Form.xls
l� 1� �o�aOP SOUIyOIo
* # TOWN OF SOUTHOLD BUILDING DEPT.
co 765-1802
INSPECTION
[ ] FOUNDATION 1ST [ ] ROUGH PL13G.
[ ] FOUNDATION 2ND [ ] SULATION/CAULKING
[ ] FRAMING /STRAPPING [Z- FINAL p �
[ ] FIREPLACE & CHIMNEY [' ] FIRE SAFETY INSPECTION
[ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRATION
[ ] ELECTRICAL'(ROUGH) [ ] ELECTRICAL (FINAL)
[ ] CODE VIOLATION [ ] PRE C/O
REMA_RKS:
VOW FX/ f L r6--,7
DATE INSPECTOR
L apE SOUI --
how 'yob
* # TOWN OF SOUTHOLD BUILDING DEPT.
coQ 765-1802
INSPECTION
[ ] FOUNDATION 1ST - [ -] ROUGH PLBG.
[ ] FOUNDATION 2ND,- j ] I ULATIOWCAULKING'
[ ] FRAMING /STRAPPING [ FINAL 4e,1", ge
[ ] FIREPLACE & CHIMNEY [ ] FIRE SAFETY-INSPECTION
[ ] FIRE RESISTANT CONSTRUCTION [ ] -FIRE RESISTANT PENETRATION
[ ] ELECTRICAL (ROUGH) [ ] ELECTRICAL (FINAL)
[ ] CODE VIOLATION [ ] PRE C/O
REMARKS:
C/v)
_ n
DATE INSPECTOR
] =--_
OF SOUTyO(o
# # TOWN OF SOUTHOLD BUILDING DEPT.
`ycourm,�F`` 765-1802
INSPECTION
[ ] 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) ,--"a�
[ ] CODE VIOLATION [ ] PRE C/O
REMARKS:
u S'�' _ � •o.� � ►mac.
aor
DATE ?� INSPECTOR
I / J
FIELD INSPECTION REPORT DATE COMMENTS
�J
FOUNDATION (1ST)
H
------------------------------------
'FOUNDATION (2ND)
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ROUGH FRAMING&
y 1
PLUMBING
INSULATION PER N.Y-. y
STATE ENERGY CODE
l�rp
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FINAL 1
'� UD
DI IONAL 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 Board of Health
SOUTHOLD, NY 11971 4 sets of Building Plans
TEL: (631) 765-1802 Planning Board approval
SAX: (631) 765-9502 / Survey
Southoldtownny.gov PERMIT NO. ( Check
Septic Form
N.Y.S:D.E.C.-
Trustees•
/ C.O.Application
Examined
G✓-, Flood Permit
,20 Single&Separate
Truss Identification Form
Storm-Water Assessment Form
Contact:
Approved 20
Mail'to:
Disapproved a/c -7al). Nal�j
-41 Phone: &3( ®Q,91%�— IC)14 -
Expiration 20 �t `
Dector
APPLIC
AUG 2 7 2018 ATION FOR BUILDING PERNUT
BM,LDING DEPT- Date ALk, o10 , 20_8__INSTRUCTIONS
VQ `71D
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
3hal l be kept on the premises available for,inspection throughoufi 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 commencedwithin 12 months after the date of
issuance or has not been completed within'1,8 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,Buil4ing:D,epartment 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`andjn building for necessary inspections.
IQDC CA)-c
(Signature of applicant or name,if a corporation)
Q7 08 M61►,k-j R� Oaek �Jy
(Mailing address of applicant)
State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder
..��;-�. IOL
Name of owner of premises„
(As on the tax rol r latest deed)
If applica t is a corpora o ' ''signature of duly authorized officer
- :)Moj`1 4 ( 1'. P.
(Name and title of corporate officer)
Builders License No.
Plumbers License No.
Electricians License No.
Other Trade's License No. =
1. Location of land on which proposed worX will be done:
House umber Street Hamlet
County Tax Map No. 1000 Section �� Block Lot ��'
I
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
(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 6ccupancy, 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 Gl�P Rear 3(a Depth
—�
Height � ' Number of Sforios,
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 N0)—(
13. Will lot be re-graded? YES NO Y Will excess fill be removed-from. premise ? YES JNO
• 1"�� C--t,i��1- Com•
14. Names of Owner of premises: 6A.) 7 Aur Address `fin �� )JY No.
Name of Architect Address' Phone No
Name of Contractor d,@r-44.a r, PnL a ddress C3 Phone No.
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 REQUIRED.
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)
COUNTY OF 5U PF0
9
r;0NN1E D.13U
Pu 1
Jp�� �� � being duly sworn, deposes and sW9f9i nt
(Name of individual signing contract)above named, QuEjoed in Suffolk n
1110
n a � Com ission Expires April 14, -
(S)He is the �C�rt_® rK f✓f�. VIC
(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 thi � � ��.,, pp
l day of N� 2
6AK Wk"k
Notary Public Signature of Applicant
Scott A. Russell STORMMAT E]K
SUPERVISOR �T ( �T
Z1��1C�A\lam A\G]EI��1[]E1�'7C'
SOUTHOLD TOWN HALL-P.O.Box 1179
53095 Main Road-SOUTHOLD,NEW YORK 11971 Al Town of So u th o l d
01 y,
CHAPTER 236 - STORMWATER MANAGEMENT WORK SHEET
( TO BE COMPLETED BY THE APPLICANT )
DOLES THIS PROJECT INVOLVE ANY OF THE FOLLOWING:
LOWING:
Yes No (CHECK ALL THAT APPLY)
❑p 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.
❑ 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.
❑[ E. Site preparation within the one-hundred-year f loodplain as depicted
on FIRM Map of any watercourse.
EINI 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
Distrac
O - -^//p
NAME —[ -a-
(P-1) Section Block
S°'°"i `"` 1-Mi RUILDIING DEPAI7TNIEN'I- LSE ONLY •"r
Contact Information &3
1" l9 a
recd m e-Nmnxr C6
Reviewed By: y,�..��......-���/
Date:
Property Address / Location of Construction Work: — — — — — — — — — — — — — — — — —
Approved for processing Building Permit.
• Stormwater Management Control Plan Not Required.
50 41�616 9 Stormwater Management Control Plan is Required.
(Forward to Engineering Department for Review)
FORM 11 SMCP-TOS MAY 2014
�A SDpZ
Town Hall Annex
54375 MdnRoad ; a,>
Telephone(hal)763-1802 I
p:0:sox!!79 G'', %8c (G3l)7br 5pg
Southold,NY 11971-0959 �O �? _ �Q r�er.richerta t0{Nf31)7M� C11Cl.nV.US 1
BUf WING DEPARTMENT
APPLICATION FOR ELECTRI.CAL_INSPECTIOIV
REQUESTED BY: ' (7c4, �c�� 1L v0� l -G
Company Name:� Date: j ZZ ZD24
'Name:
License No.: �3 F
Address: Z (� a r 1G
'Phone No..: 3 l AA
JOBSITE INFORMATION: ( Indicates required inform,,
atfon)
*Name:
*Address: + �
*Cross Street:
`'Phone No,:
Permit No.: _ z
Tax•Map Dlstrict: 11 00 Section:
Block: Lot:
*BRIEF D>"SCRiPTION OF WORK(Please PnIntCleady)
(Please Circle All That Apply)
*Is job ready for inspection:
*®o•you need a Temp Cartifrcate: YES/ NO Rough in Flnal
YES I NO
Temp Information(if.needed) +
*Service Size: 1 Phase 3Phase 100 160 200 3
00 3
*New Service; .50 Re-connect. Underground Number of Meters Chan a of S 400 Other
Additional information: 9 ervlce Overhead
PAYMENT DUE WITH APNLICA',T'ION
82-Request1orfnspecoon Form
G2li�g- L�
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BREAKER HANDLE
INDICATES BREAKER NH R MID-PpS1TloN
RESTORE SERVICE; FIRSTj TRIPPED, TO
OFF POSITION ,A, THEN ST « VE HANDLE To
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ELECTRICAL
INSPECTION REQUIRED
A R VEl AS NOT d
DATE: xx B.P.
FEE: f6U BY:
NOTIFY BUILDING DEPARTWT AT
765-1802 8 AM TO 4 PM FOR THE
FOLLOWING INSPECTIONS:
1. FOUNDATION -
WT REQUIRED RETAIN STORM WATER RUNOFF
FOR POURED CONCRETE PURSUANT TO CHAPTER 236
2. ROUGH = FRAMING & PLUMBING OF THE TOWN CODE.
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.
COMPLY WITH ALL CODES OF I*ELY °
NEW YORK STATE & TOWN CODES ENCLOSE POOL TO CODE
AS REQUIRED AND CONDITIONS OF .UPON.COMPLETION
SOUTHOLD TOWN ZBA '.BqFpRE
SOUTHOLD TOWN PLANNING BOARD
SOUTHOLD TOWN TRUSTEES
N.Y.S.DEC
OCCUPANCY OR
USE IS UNLAWFUL
WITHOUT CERTIFICATE
OF OCCUPANCY
Poi Cf0-C.
�.O 1 NAME- ( Jr'�h,f.� L)CL
MATE:
- - size
swaps: R u
BMDEA PATTERN:
WALL pA'I`TEpt�
. FLOOR PATTERN:
0ORNERs:
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DEPTH:.. - IR - - _...
HUNG OVERLAP (dr* one)
20 GAUGE 27 GAUGE (cards on)
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