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44261-Z
�o�SU F COG , Town of Southold 8/11/2020 P.O.Box 1179 * { 53095 Main Rd Southold,New York 11971 Ol •� � CERTIFICATE OF OCCUPANCY No: `41345 Date: 8/11/2020 THIS CERTIFIES that the building IN GROUND POOL Location of Property: 230 Lesters Rd., Mattituck SCTM#: 473889 Sec/Block/Lot: 114.-7-5.1 Subdivision: Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated 9/30/2019 pursuant to which Building Permit No. 44261 dated 10/7/2019 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 White,Jarrett&Warren,Emily of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL ELECTRICAL CERTIFICATE NO. 44261 7/21/2020 PLUMBERS CERTIFICATION DATED A tho ' d ignature r � TOWN OF SOUTHOLD BUILDING DEPARTMENT 0 ' TOWN CLERK'S OFFICE 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#: 44261 Date: 10/7/2019 Permission is hereby granted to: Melan LLC 97 Goose Hill Rd Cold Spring Harbor, NY 11724 To: construct accessory in-ground swimming pool as applied for. At premises located at: 230 Lesters Rd., Mattituck SCTM # 473889 Sec/Block/Lot# 114.-7-5.1 Pursuant to application dated 9/30/2019 and approved by the Building Inspector. To expire on 4/7/2021. Fees: SWIMMING POOLS -IN-GROUND WITH FENCE ENCLOSURE $250.00 CO - SWIMMING POOL $50.00 Total: $300.00 Bui ng Ins or" Form No.6 TOWN OF SOUTHOLD BUILDING DEPARTMEN"C 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 topographic4features. 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$50.0,Accessory building$50.00,Additions to accessory building$50.00,Businesses$50.00. 2. Certificate of Occupancy on Pre-existing Building- $100.00 3. Copyof'Certificafe'ofUccupancy=$25" _. ._..._ 4. Updated Certificate of Occupancy- $50.00 5. Temporary Certificate of Occupancy-Residential$15.00, Commercial$15.00 Date. 9�� ! New Construction: Old or Pre-exis1•ting Building: (check one) Location of Property: L&i Az House No. Street Hamlet Owner or Owners of Property: �0:?—' („ kfNII , - Suffolk County Tax Map No 1000, Section Ei i�_ Block. `7 Lot Subdivision Filed Map. Lot: Permit No.��Q ( Date of Permit. Applicant: Health Dept. Approval: Underwriters Approval: Planning Board Approval: - Request for: Temporary Certificate Final Certificate: (check one) Fee Submitted: $ oft Applicant Signature Building Department Application AUTHORIZATION (Where the Applicant is not the Owner) residing at (printroperty owner's name) (Mailing Address) do hereby authorize /`I Gm 9AX Pad " -11el (Agent) to apply on my behalf to the Southold Building Department. ( er' afore) (D te) -�� 0 AYI (Print Owner's Name) Town Hall Annex Telephone(631)765-1802 54375 Main Road Fax(631)765-9502 P.O.Box 1179sean.devlinO-town.southold.n Southold,NY 119711-0959 � � y•us BUILDING DEPARTMENT TOWN OF SOUTHOLD CERTIFICATE OF ELECTRICAL COMPLIANCE SITE LOCATION Issued To: Jarrett White Address: 230 Lesters Rd city:Mattituck st: NY zip: 11952 Building Permit#: 44261 Section: 114 Block- 7 Lot 5.1 WAS EXAMINED AND FOUND TO BE IN COMPLIANCE WITH THE NATIONAL ELECTRIC CODE Contractor: DBA: JES Electrical Contr. License No: 4483ME SITE DETAILS Office Use Only Residential X Indoor Basement Service Commerical Outdoor X 1 st Floor Pool X New X Renovation 2nd Floor Hot Tub Addition Survey Attic Garage INVENTORY Service 1 ph Heat Duplec Recpt Ceiling Fixtures Bath Exhaust Fan Service 3 ph Hot Water GFCI Recpt 2 Wall Fixtures Smoke Detectors Main Panel A/C Condenser Single Recpt 1 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 Switches 2 4'LED Exit Fixtures Pump 1 Other Equipment: Salt Generator on 220 GFCI Breaker, Pool Light w/ Push Button Switch, Pool Cover w/ Keypad Control, Pump on 220GFCI Breaker Notes: Pool Inspector Signature: Date: July 21, 2020 S Devlin-Cert Electrical Compliance Form.xls SOOT,yo� # # TOWN- OF SOUTHOLD BUILDING DEPT. `ycourm eF'` 765-1802 INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] INSULAT ON/CAULKING [ `] FRAMING/STRAPPING [�] FINAL P4 [ ] FIREPLACE-& CHIMNEY [ ] FIRE SAFETY INSPECTION [ ] FIRE RESISTANT,CONSTRUCTION [ ] FIRE RESISTANT PENETRATION [ ] ELECTRICAL (ROUGH) [ ] ELECTRICAL (FINAL) [ ] CODE VIOLATION_5 M RKS: iJ ov Go fit' DATE INSPECTOR qf so L4 l000t L� OF SOUTHOLD BUILDING DEPT. TOW 76S-1802 INSPECTION : I 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) Pool/ CODE VIOLATION PRE C/O REMARKS: 1�11V*tn ge4!�C4174t C-41t—_ 1AIS DATE -7 2,1 INSPECTOR r ��1 OF 50Ujyo� TOWN OF SOUTHOLD-BUILDING DEPT. �o • �o `yco 765-1802 INSPECTION- I , ] FOUNDATION IST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] SULATION/CAULKING [ ] FRAMING /STRAPPING [ FINAL �� [ ] FIREPLACE & CHIMNEY [ ] FIRE SAFETY INSPECTION [" ] FIRE RESISTANT CONSTRUCTION- [ ] FIRE RESISTANT PENETRATION [ ] ELECTRICAL (ROUGH) [ ] ELECTRICAL (FINAL) [ ] CODE VIOLATION [ ] PRE C/O REMARKS: C3 DATE INSPECTOR � r E I E 1 � r 14 !'y,.� '/ •7�i'• i � ' 40 slow 1 h FIELD INSPECTION REPORT DATE COMMENTS b C=i FOUNDATION (1ST) ------------------------------------ C FOUNDATION (2ND) t4 z o H ROUGH FRAMING& a PLUMBING H r INSULATION PER N.Y. y STATE ENERGY CODE KOT Wk leojp CA Q • 7'V)iAob4%,#V ` FINAL r IJ401 r- ADDITIONAL CO C� b °z H d tro�7 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) 765-9502 Survey Southoldtownny.gov PERMIT NO. Check Septic Form N.Y.S.D.E.C. Trustees C.O.Application Flood Permit Examined 20 �..,` Single&Separate , �,- �`;'?`�..; ,• Truss Identification Form 1�_ # Storm-Water Assessment Form �Ep 3 0 2019 Contact: Approved ,20 Mail to: Disapproved a/c \\ /��f {(�J�/// : -529~V\9 76 Phone• kyG) - Expiration ,20 r— Bui in ector APPLICATION FOR BUILDING PERMIT Date a , 20_6_ 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. Qor-4) L� A,%(_. Cry . (Signature of applicant o name,if a corporation) 97760 H o �J &A Hc�� (Mailing address of applicant) State whether applicant is ow er, les ee, agent, architect, engineer, general contractor, electrician, plumber or builder de- Name of owner of premises �, c—iAL—, L (As on the tax roll or latest deed) If applican is a c rporatio i nature of ly authorizeoi fficer ok P (NamYse n title of corporate officer) Builders Lic No. Plumbers License No. Electricians License No. Other Trade's License No. 1. Location ofland on hich propos d work will be done: Qsn z Q ,a*AjoK House Number Street Hamlet County Tax Map No. 1000 Section 1 144 Block 7 Lot 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 -15�� (Description) 4. Estimated Cost Fee (To be paid on filing this application) 5. If dwelling, number of dwelling units Number of dwelling units onach 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 I Rear A0 Depth 401 Height Number of Stories 9. Size of lot: Front �� � Rear /0(0 /Depth (©�.,: 10. Date of Purchase Name of Former Owner I 11. Zone or use district in which premises are situated K c-51 r)e Q�G 12. Does proposed construction violate any zoning law, ordinance or regulation?YES NOZ 13. Will lot be re-graded? YES NO ✓Will excess fill be removed from premises?YES 1/ NO II q ?� Q d 14.Names of Owner of premise� aKM� L =4L- -e Address 4 Phone No. Name of Architect Address Phone No Name of Contractor �n 1 r—nr 115(5(' itblddress 7DD- Wt oA N 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 BE REQUIRED. b. Is this property within 300 feet of a tidal wetland? * YES NO3/_ * 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 V * IF YES, PROVIDE A COPY. STATE OF NEW YORK) S: COUNTY OF"IVF being duly sworn,deposes and says that(s)he is the applicant (Name of individual signing contract)above named, ae(S)He is the o � u I eIJ (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 -0 day of njiga 20jq_ aacw dt I Notary Public TRACEY L. DWYERYOignatu pplicant NOTARY PUBLIC,STATE OF NE RK NO 01 DW630E900 QUALIFIED IN SUFFOLK COUNTY COMMISSION EXPIRES JUNE 30,26.X Scott A. Russell ,��°suF'r S'7C'0]kMWA\TIE]k SUPERVISOR 2 MANAGEMENT SOUTHOLD TOWN HALL-P.O.Box 1179 SMS Main Road-SOUTHOLD,NEW YORK 11971 Town of Southold CHAPTER 236 - STORMWATER MANAGEMENT WORK SHEET ( TO BE COMPLETED BY THE APPLICANT ) DOES TMS PROJECT INVOLVE ANY OF THE FOLLOWING: Yes No (CHECK ALL THAT APPLY) []6"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. ❑[0"b. Site preparation within 100 feet of wetlands, beach, bluff or coastal erosion hazard area. ❑OYE. Site preparation within the one-hundred-year floodplain as depicted on FIRM Map of any watercourse: ❑[v"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: District NAME: 1 �Dl, 7 5 t aJ Section Block Lot �qq �� ****FOR BUILDING DEPARTMENT USE ONLY **** Contact Information: . �' (rekpWw N whorl Reviewed By: Property Date: Address/Location of onstruction Work: — — — — — — — — — — -- — — — -Sz L Approved for processing Building Permit. ll ��' �� JStormwater Management Control Plan Not Required. L y I L Stormwater Management Control Plan is Required (Forward to Engineering Department for Review.) FORM # SMCP-TOS MAY 2014 oF so�pyo�p Town 4Aj 0 2020 Telephone(681)765-1802 54375 Main Road P.O.Box 1179 G, Q roger.riche rtd?oL wn.sou�fh�a�d.q�us Southold,1,Y 11971-0959 i BUILDING DEPARTMENT TOWN OF SOUTHOLD J APPLICATION FOR ELECTRICAL INSPECTION REQUESTED BY: Ifn f C1Oct cot(' Date_ Company Name: Name: 1: License No.: q g,3 Address: _ •ZCo`--E �a�c�- �l-e. �a�/� �% I I�f�Z Phone No.: Ca JOBSITE INFORMATION: (*Indicates required information) *Name: ; �'J-L la✓1 LL, 'Address: Z:© L-e-5+eP9 — *Cross Street: LTJ i c��.� V-k'A-4-- _ *Phone No.: (cJ J 0'-450 -cl n Permit No.: ` LPZG I Tax-Map District: 1000 • Section: W1, Block: Lot: 5' 1 'BRIEF DESCRIPTION OF WORK(Please Print Clearly) �� ���Q � (Please Circle All That Apply) *Is job ready for inspection: t�O/ NO Rough in Flnal *Do-you need a Temp Certificate: YES/ NO ' Temp Information (If•n ded) *Service Size: 1 Phas 3Phase 100 150 200 300 350 400 Other *New Service: Re-connect. Underground Number of Meters Change of Service Overhead Additional Information: PAYMENT DUE NINTH APPLICA'T'ION 82-Request for Inspection Form I . 0SDSyo Town HIST hne 2020 a ( Telephone(681)765-1802 54375 Main Road (G31)76�• 5o2 P.O.Box 1179 • , roger.richert[ t0 n.sC5 o hV.,Us F Southold;i4Y IiWT 959 Qf� /I' -ro mli 4 - BUILDING DEPARTMENT TOWN OF SOUTHOLD APPLICATION FOR ELECTRICAL INSPECTION REQUESTED BY: f e ,Pate:, 1 ig Z_0, Company'Name: 73-5S I / (' - Name: License No.: Address: Z_G`f 62arw__ �1-e, Q�r(oyl i 1/770Z Z Phone No.: (..;-9 ( -:F$Gf Z p JOBSITE INFORMATION: (*Indicates required information) '"Name: � �iY••�� �G►r�-� V' r G3,Yl L � *Address: Z Z O L-e, 4*Ar-S Tzd - — *Cross Street: *Phone No.: 1-7)L4570 - r Permit No.: gLP2-G r —7 ' Tax Map District: 4000 Section: t Block: Lot: *BRIEF DESCRIPTION OF WORK(Please Print Clearly) - (Please Circle All That Apply) *Is Job ready for inspection: NO Rough In Final *Do.you need a Temp Certificate: YES/ NO Temp Information(If n ded) *Service Size: 1 Phas 3Phase 100 450 200 300 350 400 Other S *New Service: Re-connect. Underground Number of Meters Change of Service Overhead Additional Information: PAYMENT DUE WITH APPLICATION .Poo 82-Request for Inspection Form 0' a�7 � Z7� �GI nenY2 � w• e I��; �� on I Zee 6Ge�� ve v reA CIO S� Sa, l � 7-18063 DIST: /OQO SECTION: I l4 BLOCK: 7 TAX LOT: 5, / a NSIONS SHOWN HEREON p VES TO THE STRUCTURES. RF 0 PURPOSE AND USE O:2O NOT INTENDED TO 11. kt tY LINES OR TO GUIDE THE / -9 t ADDITIONAL STRUCTURES �`� O. N p PH Y 'J S/Cq ONC/NF 4 QN POSSESS%OV / 1 Al lJ oO// m R ASPygLT _l1 Q1 FF o:3� °RJvtw,4f- GARAGE n TIMBER 00 TAX LOT 5.1 O � 0 �, n� O ✓ v ctttM. � b � Q � 0 7 co® FF oc In V 6ax �1 (� ST RA FEN ° PL( - +1 NO PHYSICAL POSSESSION m �( O ASPHALT 0 N 54 O 1 '20" V V 109. 16 1e7 f DRIVEWAY3 O O 1 tx (11 oV n' ' TAX LOT G 00 VINYL FENCE `V 96.03' o N 5401 1 '20" W 4 � m U> TAX LOT 5.2 ,I;' � II Komi APP 0 ED AS NOTED +" RETAIN ANOTO CHARM WATER P ER 236RUNOFF DATE: B.P.# PURSU FEE: BY: OF THE TOWN CODE. NOTIFY BUILDING DEPAR AT 765-1802 8 AM TO 4 PM FOR THE FOLLOWING INSPECTIONS: 1. FOUNDATION - TWO REQUIRED FOR POURED CONCRETE 2. ROUGH - FRAMING & PLUMBING 3. INSULATION 4. FINAL - CONSTRUCTION MUST BE COMPLETE FOR C.O. ELECTRICAL ALL CONSTRUCTION SHALL MEET THE INSPECTION REQUIRED OF THE CODES OF NEW YORK STATE. NOT RESPONSIBLE FOR DESIGN OR CONSTRUCTION ERRORS. COMPLY WITH ALL CODES OF ae �,$ dsyf�`L .�ora NEW YORK STATE & TOWN CODES ENC_ LOSE POOL TO CODE AS REQUIRED AND CONDITIONS OF " jp COMPLEI'i`ON —� HOLD TOWN ZBA SOLITHOLD TOWN PLANNING BOARD SO TRUST OCCUPANCY OR USE IS UNLAWFUL WITHOUT CERTIFICATE OF OCCUPANCY g7a0 P-401rJ RJ 43o Lids rid H a4f4j Ck JQ� t(q!s a jail pDU * 3 r�e6� /s placej ►��ip�c P1 , Yo ® qtr fC L -fop C' 1:704 o)-f o F- PL-e uerhcA 1'Y ec-e7 Four- cod �44D,Hp,,,,L F'foc�r-- -e 6 o P O • e 8 ` SHAM WALL PA FLOOR M oEPf :.___. HU NG OVERLAP (drds am) 1 jt iwew• JIo� �� � - j���fV O� �cjvcks