HomeMy WebLinkAbout39098-Z �p�OSUffOtt Town of Southold 11/13/2020
y� P.O.Box 1179
CO
o • 53095 Main Rd
Southold,New York 11971
CERTIFICATE OF OCCUPANCY
No: 41598 Date: 11/13/2020
THIS CERTIFIES that the building POOL HOUSE
Location of Property: 1340 Duck Pond Rd, Cutchogue
SCTM#: 473889 Sec/Block/Lot: 83.-4-9
Subdivision: Filed Map No. Lot No.
conforms substantially to the Application for Building Permit heretofore filed in this office dated
7/28/2014 pursuant to which Building Permit No. 39098 dated 8/11/2014
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 pool house as applied for.
The certificate is issued to Birkmier,William&Ellen
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL
ELECTRICAL CERTIFICATE NO. 39098 09/22/2014
PLUMBERS CERTIFICATION DATED
uto z Signa '
I
�gUFEnt,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#: 39098 Date: 8/11/2014
Permission is hereby granted to:
Birkmier, William & Birkmier, Ellen
1340 Duck Pond Rd
Cutchogue, NY 11935
To: construct a 16' X 24' accessory Pool House as applied for
At premises located at:
1340 Duck Pond Rd, Cutchogue
SCTM # 473889
Sec/Block/Lot# 83.4-9
Pursuant to application dated 7/28/2014 and approved by the Building Inspector.
To expire on 2/11/2016.
Fees:
ACCESSORY $253.60
CO -ACCESSORY BUILDING $50.00
Total: $303.60
A
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 I%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 Building: (check one)
Location of Property:
House No. Street Ha et
Owner or Owners of Property:
Suffolk County Tax Map No 1000, Section 3 Block Lot /
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: $
Applicant Signature
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Town Hall Annex Telephone(631)765-1802
54375 Main Road Fax(631)765-9502
CP
P.O.Box 1179 ® �Q roger.riche rt(aD-town.southold.ny.us
Southold,NY 11971-0959
01
yc®UNT`1,��
BUILDING DEPARTMENT
TOWN OF SOUTHOLD
CERTIFICATE OF ELECTRICIAL COMPLIANCE
SITE LOCATION
Issued To: Birkmier
Address: 1340 Duck Pond Rd City: Cutchogue St: NY Zip: 11935
Building Permit#: 39098 Section: 83 Block: 4 Lot: 9
WAS EXAMINED AND FOUND TO BE IN COMPLIANCE WITH THE NATIONAL ELECTRIC CODE
Contractor: DBA: License No:
SITE DETAILS
Office Use Only
Residential X Indoor Basement Service Only
Commerical Outdoor 1st Floor Pool
New Renovation 2nd Floor Hot Tub
Addition Survey Attic Garage
INVENTORY
Service 1 ph Heat Duplec Recpt 2 Ceiling Fixtures HID Fixtures
Service 3 ph Hot Water GFCI Recpt 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 1 Pumps
Transformer Appliances Dryer Recpt Emergency FixturesTime Clocks
Disconnect Switches 1 Twist Lock El Exit Fixtures TVSS
Other Equipment: POOL HOUSE
Notes:
Inspector Signature: Date: Sept 22 2014
81-Cert Electrical Compliance Form.xls
OE SOpr�olo
cOUNi`I,N
TOWN OF SOUTHOLD BUILDING DEPT.
765-1802
INSPECTION -`
[ ] FOUNDATION IST [ ] ROUGH PLUMBING
[ ] FOUNDATION 2ND [ 1!lpsaLATION
[ ]
FRAMING / STRAPPING [AlFINAL
[ ] FIREPLACE A CHIMNEY [ ] FIRE SAFETY INSPECTION
[ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRATION
[ ] ELECTRICAL (ROUGH) [ ] ELECTRICAL (FINAL)
[ ] CODE VIOLATION [ ] CAULKING
REMARKS: -
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DATE ` INSPECTOR
i
OF SOUTyOIo.
cou
L TOWN OF SOUTHOLD BUILDING- DEPT.
765-1802
INSPECTION
[ ] FOUNDATION IST [ ] ROUGH PLUMBING
[ ] FOUNDATION 2ND [ ] INSULATION ,
[ ]
FRAMING / STRAPPING [ ] FINAL
[ ] FIREPLACE & CHIMNEY [_ ] FIRE SAFETY INSPECTION
[ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRATION
[ ] ELECTRICAL (ROUGH) ) ELECTRICAL (FINAL)
[ ] CODE -VIOLATION [ ] CAULKING
REMARKS:
DATE INSPECTOR
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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
FAX: (631) 765-9502 Survey
South oldTown.NorthFork.net PERMIT NO. oQ Check
Septic Form
N.Y.S.D.E.C.
Trustees
C.O.Application
a Flood Permit
Examined p 1 S ,20 Single&Separate
Storm-Water Assessment Form
JUL 2 8214 Contact:
Approved I 120 Mail to:
Disapproved a/c
BLDG DEPT
TOWPI OF SOUTHOLD Phone:
Expiration ,20_1(0_
Building Inspector
APPLICATION FOR BUILDING PERMIT r/
Date d , 20 f 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
shal I 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.
( ignature of applicant or name,if a corporation)
O
(Mailing address of applicant)
State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder
5!:�e
Name of owner of premises
(As on the tax roll or latest deed)
If applicant ' orpor on„signature of duly authorized officer
J
ame and title of corporate officer)
Builders License No.
Plumbers License No.
Electricians License No.
Other Trade's License No.
1. Location f land o�1)
which propos d ork wil e done: r
�3
House Number Street ,,rr�� Hamlet
County Tax Map No. 1000 Section O�3 Block 4 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 (7 K ?.�
b. Intended use and occupancy 7voc do"S6
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
114<to
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 ��/ Rear l / Depth 02
HeightNumberNumber of Stories
9. Size of lot: Front Rear Depth 4;2 �®
10. Date of Purchase J '7 Name of Former Owner M P,`r,�.
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 LY;Ai t4l AY4� Address /3/0 DLII- k) t Phone No. lo,3�) T -
Name of Architect Address C � `" Phone No
Name of Contractor N•,V, 700—( CjA16 Address Z3.22 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 NO vo"
* 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 OF �/�
being duly sworn, deposes and says that(s)he is the applicant
(Name of individual signing contract)above named,
(S)He is the ��fl� ��'� A& ew��
(Contractor, gent, 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 t
day ofhis 20J
CONNIE D. BUNCH
,, +P-blic,State of r
Notary Public No.OIBU6185050 Signature of Applicant
Qualified in Suffolk County
Commission Expires April 14,2Q1
Scott A. Russell ,��°SU Ir ST01KMWATEIK
SUPERVISOR ��][A\lam�,A\(G]EIS LENT
_
SOUTHOL
53095ain Road-OSOUTHOLD,NEW YORK 911971 ti Town of So u th o l d
CHAPTER 236 - STORMWATER MANAGEMENT WORK SHEET
( TO BE COMPLETED BY THE APPLICANT )
DOES THIS PROJECT INVOLVE ANY OF THE FOII.®WbNG: ;
r
Yes No (CHECK ALL THAT APPLY)
i
[] A. Clearing, grubbing, grading or stripping of land which affects more
than 5,000 square feet of ground surface. ;
i
�] B. Excavation or f illing involving more than 200 cubic yards of material
❑Ewithin any parcel or any contiguous area.
C. Site preparation on slopes which exceed 10 feet vertical rise to
.
❑ud100 feet of horizontal distance.
D. Site preparation within 100 feet of wetlands, beach, bluff or coastal
erosion hazard area. t
ty❑
Site preparation re aration within the one-hundred-year floodplain as depicted� • �
on FIRM Map of any watercourse.
Ell 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 Cbeck List Form to the Building Department with your Building Permit Application.
S.GT.M. 1000 Dat
APPLICANT: (Property Owner,Design Professional,Agent,Contractor,Other) #: e
District
NAME
i . Section Ik Lot
FOR BUILDING DEPARTMENT USE ONEY"
Contact information:
(rdcPuau Numbed
Reviewed By:
— — — — — — — — — — — — — — — — — —
Date-
Property
ate:Pro ert Address/ Location of Construction Work: — — — — — — — — — — — — — — — — —
' ❑ Approved for processing Building Permit.
Stormwater Management Control Plan Not Required-
d
ElStormwater Management Control Plan is Required.
(Forward to Engineering Department for Review-)
FORM SMCP-TOS MAY 2014
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Town-Hall Annex O Telephone(631)765-1802
r� 1543,T5 Main Ry I
�` (631)765- 5Q2 f
_P.Q?_B z 1179 G roger.richertt tOwn.sobf95 l.ny.us i
Southold,NY 11971-0959 I �' • �0 !
�► 13� �l,Y 4UN1`I,
1 SEP 1 8 2014 I C
i
BUILDING DEPARTMENT
BLDG DFPT TOWN OF SOi<77[' OLD
TOVIN OF SOI)T HO)-D
APPS[CAT ON FOR ELECTRICAL INSPECTION
REQUESTED BY- l c`/� �Q� Date:
Company Name:
Name: ?
License No.:
Address:
Phone No.:
JOBSITE INFORMATION: (*Indicates required information)
*Name: x
*Address:
i
*Cross Street:
*Phone No.:
Permit No.: � �a�l
Tax-Map District: 10,60" Section: 3 Block: L/ Lot: I
*BRIEF DESCRIPTION OF WORK(Please Print Clearly) �1�� , D& Ili
(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 needed)
*Service Size: 1 Phase 313hase 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 ��
S.C. TAX MAP NO. DIST, 1000 SECT. 083 BLOCK 4 LOT 9 IILE NO. � ��S PROJECT NO. 9X485
LOT #6 VERTICAL
DWELLING SAND DRAIN
S 39'00'00" E 150.00'
MON MON
O 20' DRAINAGE EASEMENT O
O O
R a`
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12,7 WELL
F
a
LOT #8 \ LOT #10
VACANT \� VACANT
w o \ p a
NomHwEST END Or HOUSE b 21.7
4 b
LLj 1'L 727 t0 S,1 2E .�111.9tl
7.6'
2 sToar
Z LO' s 1 ►BALED 1l1
4 b b DtrtunlC
�..1 41 y CMAC
IE
Yi � ST. 23' 1�.1'� 11.7,
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21.7' iso'—�'
C.P.A 1'b
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,1=25.00' �n —�--- ---J to
L=39.27' Z 20'DRAINAGE EASEMENT to
MON MON
275.00' N 39'00'00" W 150.00' Fm wu
DUCK POND ROAD (49,51)-
0 MYT
49.5')ONYT 20 ON'!T so
SHED
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Unauthorized alteration or addition to this document is a violation of SscUon 7209 PROJECT: FINAL SURVEY OF
i of the New Yak State Education tow. - 1 nT 20
91-011 151-011
I I
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