HomeMy WebLinkAbout45151-Z rta�"
roil FFO4caG� Town of Southold 10/24/2020
-
P.O.Box 1179
C,
53095 Main Rd
oy p� Southold,New York 11971
CERTIFICATE OF OCCUPANCY
No: 45151 Date: 10/24/2020
THIS CERTIFIES that the building HOT TUB
Location of Property: 1230 Kimberly Ln., Southold
SCTM#: 473889 Sec/Block/Lot: 70.-13-20.13
Subdivision: Filed Map No. Lot No.
conforms substantially to the Application for Building Permit heretofore filed in this office dated
8/17/2020 pursuant to which Building Permit No. 45151 dated 9/1/2020
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 hot tub as applied for.
The certificate is issued to Friedberg,Michael&Adena
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL
ELECTRICAL CERTIFICATE NO. 45151 10/8/2020
PLUMBERS CERTIFICATION DATED
A tho d Signature
FFo o TOWN OF SOUTHOLD
�� ao BUILDING DEPARTMENT
x 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#: 45151 Date: 9/1/2020
Permission is hereby granted to:
Friedberg,' Michael
1125 Maxwell Ln Apt 925
Hoboken, NJ 07030
To: install a hot tub as applied for.
At premises located at:
1230 Kimberly Ln., Southold
SCTM #473889
Sec/Block/Lot# 70.-13-20.13
Pursuant to application dated 8/17/2020 and approved by the Building Inspector.
To expire on 3/3/2022.
Fees:
SWIMMING POOLS-ABOVE-GROUND WITH REQUIRED FENCING $250.00
CO-ACCESSORY BUILDING $50.00
Total: $300.00
Building Inspector
Form NQ.6
TOWN OF SO'UTHOLD
BUILDING 09PARTM NT
•J.". TOWN HALL
765-1802
APPLICATION FOR CERTI''FICATE OF OCCUPANCY
This application must be tilled in by typewriter or ink and submitted to the Building Department with the follows
A. For flew building or.
new use: ng.
y40f ply wtth•accurate l atioct of all buildings,
topographic featutes. ��FrQPert3'liilefi,suets,and unusual natural or
2. Final Approval from Realth Dept,of water,supply and sewers
3. Approval of elecEn.c4l iAstallatxon from Board of F' ffie-disposal(S-9 form).
4. Sworn statement Fire Uadeiwcfters.
&off-plumb eerdfg lost the solder
S• COMIli Bial buiifftj industr.'-I'buil in
system
cotttatas less than 2/10 of 1%lead.
Of Code Coxnplinac e l m. Iiil�t multiple enoes'acid Similar bu"ldings acrd insWlatiens a certificate
6, Submit r `respotsibte'for the buiidcg. '
laauut Board Appi�ovat of cba#Ieted'"site glad requirements.
B. FgUs"Ar esisgabtddr
1. �„�(Fridx t�AP�•p,19�5�no � •
features.Accurate sns vey of Pte►showing a Property h butler and trap ojs r ting”land uses;
2- A properly so5letd.apg pohtc
ioa apd;,ctonseat
diMied,the Btt ag r' 1 P rigged bar applicaa ,If a Cect%fleate of O
Feces _ s t offi r in writiag to the;appKc�, ocupancY is .
Q:QQ;� O-tw.eliiog9.00M7 Cir ,
3. Cony C — ".'
` - .
Po'
4. Updated ' . .
to=a y. $S01,00
5. Teimpor�iry Cerdficate of QoCnpanr
� Dat6. �S-ZO ZO
New Constcnctioj; Old or Pte:i "Buil
Loc,adon of PMpeLjr r ) (mak one) .
0.
('
a
Owns Or Owa'=Of1i?'La0!ifw r; [ MMr �
l
Suffolk County Tax Map Nti Ion.'.Swoon B .
S =--- `-.�. Lot Zo� •rte
ubdivisioa
1 S! Filed 1lrinp. Lot:
Permit No. Date of Permit. _Applicant:
health Dept.Approval.' .
ITndetwriters Approval:.
Pig Board Approval.
Request for. Tempotwy Cbraftc;atc
FinalCmfMcate::4nt
(check one) .
' igaatere
Building Deioarbment APDHcation
AUTHORIZATION
(Where the Applicant is not the Owner)
f7Pi:� 6 ---residing at(Print Property owner's name) (Mailing Address)
do hereby authorize_ 1UDC-1,Y- /;-1e- �LY
(Agent)
to apply on my behalf to the
Southold Building Department.
Ll Z,CJ
(Owner's Signature} (Date)
(Print Owner's Name)
Town Hall Annex s2�, ® Telephone(631)765-1802
54375 Main Road Fax(631)765-9502
P.O.Box 1179 sean.devlin(a�town.southold.ny.us
Southold,NY 11971-0959 �° �®
C®U9�
BUILDING DEPARTMENT
TOWN OF SOUTHOLD
CERTIFICATE OF ELECTRICAL COMPLIANCE
SITE LOCATION
Issued To Michael Friedberg
Address: 1230 Kimberly Ln city,Southold sr NY zip: 11971
Building Permit#. 45151 Section. 70 Block 13 Lot: 20.13
WAS EXAMINED AND FOUND TO BE IN COMPLIANCE WITH THE NATIONAL ELECTRIC CODE
Contractor: DBA: North Fork Pool Care License No- 4483ME
SITE DETAILS
Office Use Only
Residential X Indoor Basement Service
Commerical Outdoor X 1st Floor Pool
New X Renovation 2nd Floor Hot Tub X
Addition Survey Attic Garage
INVENTORY
Service 1 ph Heat Duplec Recpt Ceding Fixtures Bath Exhaust Fan
+z
Service 3 ph Hot Water GFCI Recpt Wall Fixtures Smoke Detectors
Main Panel A/C Condenser Single Recpt Recessed Fixtures CO2 Detectors
Sub Panel A/C Blower Range Recpt Ceding Fan Combo Smoke/CO
Transformer UC Lights Dryer Recpt Emergency Fixtures Time Clocks
Disconnect 50A Switches 4'LED Exit Fixtures Pump
Other Equipment. Hot Tub w/ 50A GFI Breaker as Disconnect
Notes, Hot Tub
,,,EInspector Signature: I --- Date: October 8, 2020
S.Devlin-Cert Electrical Compliance Form As
�1 OE SOGI�o
* # TOWN OF SOUTHOLD BUILDING DEPT.
�`y�ourm ' 765.1802
INSPECTION
[ ] FOUNDATION 1ST [ ] ROUGH PLBG.
[ ] FOUNDATION 2ND - [� ] SULATION/CAULKING
[ ] FRAMING/STRAPPING [ FINAL imrr -w( p
[ ] FIREPLACE & CHIMNEY [ ] FIRE SAFETY INSPECTION
[ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRATION
[ ] ELECTRICAL (ROUGH) [ ] ELECTRICAL (FINAL)
[ ] CODE VIOLATION [ ] PRE C/O
REMARKS:
Oft 14 A 0 - Z -
DATE INSPECTORY qaO16-
OF souryolo �1 r 2 3 0 1v Z-n
# TOWN OF SOUTHOLD BUILDING DEPT.
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) ELECTRICAL (FINAL)
[ ] CODE VIOLATION [ ] PRE C/O
REMARKS: l
YOUR ?c* L leL,V6 bvd
/ o T",
DATE INSPECTOR r
FIELD INSPECTION REPORT DATE COMMENTS '
FOUNDATION(IST)
FOUNDATION(M)
0
ROUGH FRAMING&
PLUMBING y
INSULATION PER N.Y. y
STATE ENERGY CODE -�-
LIN
FINAL
ADI> ' ICiN G`£�1+=$TS '
C U �
o
1� H
1
TOWN OF SOUTHOLD BUILDING PERMIT APPLICATION CHECKLIST
BUILDING'DEPARTMENT
TOWN.BALL Do you have or need the following,before applying?
SOUTHOLD,NY 11971 Board ofHealth
TEL:(631)765-1802 / 4 sets of Building Plans
FAX:(631)765-9502 Planning Board approval
Southoldtownn . ov Survey
Y g PERMIT NO. Check
1
Septic Form
N.YSDEC.
Trustees
C O Application
Examined 20 Flood Permit
Single&Separate
Truss Identification Form
Approved Storm-Water Assessment Form
Mail to:
20 Contact: �1�7JP a0z
r'
Disapproved a/c
E 20_ Phone:(
Buildin ector
APPLICATION FOR B, DING PERMIT
Date
INSTRUCTIONS 202-0
'�► , Ths`application MUST be completely filled in by typewriter or in ink and submitted to,the Building Inspector with 4
ol,Seta 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 Ins
shall be kept on the premises available for inspector will issue a Building Permit to the applicant.Such a permit
pection 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.builiiing 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 fromsuch,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 ofthe 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 Pe
Building Zone Ordinance of the Town of Southoldrmit pursuant to the
,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. (�
m—of r K �-60L- � >ArIZP
(Signature of applicantor name,if a corporation)
1*1A) R(A -
(Mailing address of applicant)
State whether applicant is own lesC,,agent,architect,-engineer,general contractor,electrician,,plumber or builder
Name of own r of emises f E tscIA , 'z&-g-
(As on the tax roll or latest-deed)
If applicant is ration of duly authorized officer
(Name d title of corporate officer)
Builders Lice se No._ S 4,11 -14
Plumbers License No.
Electricians License No.
Other Trade's,License No.
1. Location of landon which ro o work ill be done:
t7-3D r-1
House Number Str et Hamlet
County Tax Map No. l,000 Section__70 Block/;5 Lot Zee
Subdivision Filed Map No. Lot
2. State existing use and occupancy of premises and intend_ed,usand occupanf proposed construction:
a. Existing use and occupancy l: Y D
b. Intended use and occupancy
3. Nature of work(check which applicable):New Building Addition A4teration
Repair Removal Demolition Other Work
4. Estimated Cost Fee (Description)
5. If dwelli (To bepaid on filing this application)
ng,.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 Rear Depth
Height Number_of,Stories _
Dimensions ofsame structure withEaiterations,or additions.,Front, Rear
Depth. Height Number-df-'Stories.
8. Dimensions of entire new•construction:;Fiont Rear Depth-
Height- Number of Stories '
9. Size of,lot:Front to 8 / Rear 'I�D --
-&,Z,, Depth. 0/Z a 9
10..Date.of,,Purchase Name of Former,Owner,
1'1.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 /_V/^Will excess fill•be removed•from premises?YES_NO
PAddress,IZ50 ljen %lr Phone No.7,r-3�Z�b
,14.Names of Owner of premisesht V-e I'�
Name of Architect Address '�Plione No
Name,of Contractor 0rm �(�rE Address D Phone�No. ,3P cid
15 aAs thisrproperty.within 100 feet of a tidal,wetland or a-freshwater wetland?*YES NO V
*IF YES,SOUTHOL"D TOWN,TRUSTEES,&•I):E:C.VERNIItTS MAY BE REQUIRED.
bAs this,property within 300 feet of aatidalw,etland?*1'ES, NO;
*I'F YES;D.R.C.'PERMITS 1VIAY�BErREQUI,RED.
16.Provide survey,to-scale,with accurate foundation plan,and distances to property.lines.
17.If elevatiomat,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-td�this-property?*YES NO
*-1F'YE%iPROVIDR A COPY.
STATE.OF NEW YORK)
COUNTY OW
DIQ1 �E� being duly sworn,deposes and'says that(s)he is the applicant
(Name of individ Gpsigning coonn'tract),above,named,
(S)He is,the
(Contractor,Agent;Corporate,-Officer,etc.)
of said owner,otowners,and+is duly,authonzedp,perform,oi•have•performed the said work-and to make and file this application;
that all'statements containedtin;tliis.applicatiowarearue to the b6t-of his knowledge and-belief+and'•that the work will be
perforrlied'n the manner'set-forth in the application, led`therewith:
Sw tolbebore•me this
day-of 20 D
otary Public - }�CE� ® �� Signat orApplicant
�O CRY PUBLIC,STATE OF YEW YORK
NO.01DW63W900
QUALIFIED IN SUFFOLK COUNTY
a
COMMISSION EXPIRES JUNE 30,2�_
.bY I
Town Hall Annex
a s
6975 gain Road Telephone(681)765-1802
1'•O.Box 1'179 �' i+e {631176r 5
Southold,NY 11971-0959 �t tom, �� ro er.richert tosol olCl.n us
BUIMINe DE�'�,RTN1I•;IV'I'
W1�I'�F WMTRIOJLD
APPLICATION FOR ELECTRICAL_l SPE TIO_iN
'
1.11companY
PtEQUESTED'gY: e �,.P,� ��r� GO l �Name: +� Date:
ame: eC. (� / oa „
License No.: �3 F
Address: Z ---
'. Phone No. ark. , , / ►-y /U 1176 Z
JOBSITE INFORMATION: (9ndIcates required infor mafifo
"Name: n)
*Address: �nr_
��2L*Craoss Street: b V' 04 a
*Phone No-:
Permit No..: 5
Tax-Map District: 1000 Section:
Block: to#: Zoo 1;
*BRIEF DtSCRIPT ION OF WORK(Please;P int.Cleady)
Pbt--Tn-t L,5_ E PA
QPlease Clrcie All That AppYY) .
*Is job ready for inspection:
*Do-you need a Temp Certificate: YES/ NO Rough In
Final
• YES r No
TOMP InfOr ation (if,needed)
*serAce Size: 1 Phase 3Phase 1.00 160 200
New Service: 300 350 400 Other
Re-connect. Underground Number ofMeters
Additional Information: Change of Service Overhead
PAYMENT DUE WlTN APF .
LICA TION
82=Request forfnspecoon Form e C
643.7,5 a Reed , T*phom- (6812 '2
TOWA mcx 746-180
r+0!. �g 4�r9 roger ri� �i 4�n}s 9 rev
SouMold,NY 189714M
F,QAM
REQ
Name:
License No.: 4 Al
. .
Address:, Up!
Aw
*tom •e: � �L�b-$ : __�_-----_._ ' --
Rft:t>c::
Ts
Lot Zo.
"sm
> 1TCtN 'd` �c( 1 rNrira� fecat�y�) � ? tel'x ;
�PA _
(Pitt- sa Putti,All,Th�r�i a°4"R
*18,job mody for 3 -pa� ,: YS.1 NO Riatigh in F{nei
*Llo YQu nil a' f P Ct iflcata: les/ NO
T-snp[nfo,,,�'Atim°Of'"0 d)
*3 r Ace,ske: 1 Ph,486 3Ph,Ose 100 160' 200 300 3,60! • 4,00
*Now 4erAea: RoommaW. Underground Nvwker of Motu Chi ange of o. Chor umd
Addihonai lnfor-matlan: - PAYMRNjTHVii?-,PLL ATJO,N
or
--- 82,A"uest for inspeWon form I ,�
6,-A
A
PERMIT# Address:
Switches
Outlets`°
GFI's
Surface
Sconces
4IH's
UC Lis
Fans Fridge HW
Exhaust Oven Dryer
Smokes DW Service
Carbon Micro Generator
-__zom-bo---------.------------ -----— -- -------Cookfop------------ ------------- -----;------•-----Tr�r�sf�r-------- -- - -
AC AH Mini
• - J
Special:
Comments —.
�� U
► "foRAM
RAN
""f
RoAp
ORTBA YVt / 150.00 we11
N 05` 3T' 20" wR
to
AC
e l81 W N
• T�!
..a `
S,e
� r N
W'' 3¢9
3 4� H R t
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46
3p4.5ll
1�, 14
�.�y
As, IIKAL3
APO
•
�3 "IMMEDIATELY"
ENCLOSE POOL TO CODE
UPON COMPLETION
BEFORE"WATER"
�, • Al OVED t3 NOTED
I DATE: Zb B.P.#
FEE�+
-� - —
-tomb NO BUILL' °" ;�RTMENT AT
765-1802 8 AU i G 4 PM FOR THE
#0 to ' FOLLOWING INSPE"i!Ow'):
fit AL
46 1. FOUNDATION TWOREQUIRED
> FOR POURED CO+!CRETE
J 2. ROUGH - FRA".'iING & PLUMBING
® r P 3. INSULATION
4. FINAL - CON!STRUCTION !`MUST
BE COMPLETE FOR C.O.
TWILIGHT SERIES 87.3 ALL CONSTRUCTION SHALL MEET THE
REQUIREMENTS OF THE CODES OF NEW
Seating Capacity 5—_ --------------- YORK STATE. NOT RESPONSIBLE FOR
Dimensions 84"x 94"x 38" (214 cm x 239 cm x 97 cm) DESIGN OR CONSTRUCTION ERRORS.
Gallons 310(1173 L)
-- --
-Weight(Dry/Full) — 1.025 lbs(465 kg)/4.540 lbs(2 059 kg) ----
Power Requirement 240 V/50 Amp —
Pumps 3 ----- C(' 4
' 'PLY WITH ALL CODES OF
,!
Number of Jets 49 Jets(2 Master Blasters®) N i_W YORK STATE & TOWN CODES
Water Features 3 —'------
Filtration —"------ AS REQUIRED A ONS OF
Ec PUr-Charge
LED Lighting —prion Light System..---- SOU'HOLD TOW CH
Exclusive Features Master Force'"Bio-Magnetic Therapy System
Noise Reduction System SOUTHOLD T N PLANNING BOARD
Premium options Fusion Air Sound system SOUTH TOWN TRUSTEES
Wi-A Module
QuietFlo Water Care System"' N.Y.,').D C
Mast3rPur-Water Management system
Afterglow Jet Package
Dream Lighting
Vac-formed ABS Pan Bottom
-- --- --- �CUI�ANCY
Listing Number 1450 OR
p i�•�s
1E IS UNLAWFUL
I'ITHOUT CERTIFICATE
OF OCCUPANCY
W@MMAL INSPECno"RMJMED
RETAIN STORM WATER RUNOFF
PURSUANT TO CHAPTER 236
OF THE TOWN CODE.