HomeMy WebLinkAbout45243-Z Town of Southold 8/19/2021
P.O.Box 1179
53095 Main Rd
Southold,New York 11971
CERTIFICATE OF OCCUPANCY
No: 42253 Date: 8/19/2021
THIS CERTIFIES that the building IN GROUND POOL
Location of Property: 3075 Oregon Rd,Mattituck
SCTM#: 473889 Sec/Block/Lot: 100.-2-7
Subdivision: Filed Map No. Lot No.
conforms substantially to the Application for Building Permit heretofore riled in this office dated
9/16/2020 pursuant to which Building Permit No. 45243 dated 9/24/2020
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 in-ground swimming pool fenced to code as applied for.
The certificate is issued to RPMS Inc LLC
I
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL
ELECTRICAL CERTIFICATE NO. 45243 7/19/2021
PLUMBERS CERTIFICATION DATED
X11tho z
U 9 gignature
o�g�F of t TOWN OF SOUTHOLD
BUILDING DEPARTMENT
c 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#: 45243 Date: 9/24/2020
Permission is hereby granted to:
RPMS Inc LLC
4 Madsen Ct
Mt Sinai, NY 11766
To: construct accessory in-ground swimming pool as applied for.
At premises located at:
3075 Oregon Rd, Mattituck
SCTM # 473889
Sec/Block/Lot# 100.-2-7
Pursuant to application dated 9/16/2020 and approved by the Building Inspector.
To expire on 3/26/2022.
Fees:
SWIMMING POOLS -IN-GROUND WITH FENCE ENCLOSURE $250.00
CO - SWIMMING POOL $50.00
Total: $300.00
lk
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. OW�U
/VEw//VGZUL_/D
New Construction:Yw�.ti„�, ncv� Old or Pre-existing Building: (check one)
Location of Property:�3o;75- oi7_ac4olu 7zb
House No. Street Hamlet
Owner or Owners of Property: `17,,4?NA&z 4- -W�, -B,4-DA61_1,4GcA
Suffolk County Tax Map No 1000, Section /UU Block ,2 Lot 7
Subdivision Filed Map. Lot:
Permit No. 7/�� Date of Permit. Applicant:
Health Dept. Approval: Underwriters Approval:
Planning Board Approval:
Request for: Temporary Certificate Final Certificate: (check one)
Fee Submitted: $
Applicant Signature
Building Department Application
AUTHORIZATION
(Where the Applicant is not the Owner)
(n � fa
residing at U / l
(Pri
nt ntro owner's name) (Mailing Address)
F ,
�U��I.hereby authorize C�� /fit.
(Agent)
to apply on my behalf to the
Southold Building Department.
(Owner Signature) e)
(Print Owner's Nan-A)
Vjf so
Town Hall Annex ® 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
BUILDING DEPARTMENT
TOWN OF SOUTHOLD
CERTIFICATE OF ELECTRICAL COMPLIANCE
SITE LOCATION
Issued To. RPMS Inc LLC
Address: 3075 Oregon Rd City Mattituck st: NY zip: 11952
Building Permit# 45243 Section: 100 Block 2 Lot 7
WAS EXAMINED AND FOUND TO BE IN COMPLIANCE WITH THE NATIONAL ELECTRIC CODE
Contractor: DBA: Elec Tec Inc License No: 4814ME
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 Heat Duplec Recpt, Ceding Fixtures Bath Exhaust Fan
Service 3 ph Hot Water GFCI Recpt 2 Wall Fixtures 2 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 1
Disconnect Switches 4'LED Exit Fixtures 11 Pump 1
Other Equipment. Intermatic Pool Panel - 4 Circuit, Intermatic Pool Tranny - 3 Lightsl20GFI,
Heater, Pump 220GFI, Pool Cover 120GFI w/ Key Locked Switch
Notes Pool
Inspector Signature: Date: July 19, 2021
S.Devlin-Cert Electrical Compliance Form
Of SO//j
# TOWN OF SOUTHOLD BUILDING DEPT.
°`yrourm��' 765-1802
A-INSPECTION
[ ] FOUNDATION 1ST [ ] ROUGH PL13G.
/ [ ] FOUNDATION 2ND [ ] NSULATION/CA'ULKING
/ [ ] FRAMING/STRAPPING [ FINAL pw�o_
[ ] FIREPLACE & CHIMNEY [ ] FIRE SAFETY INSPECTION
[ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRATION
[ ] ELECTRICAL (ROUGH) [ ] ELECTRICAL (FINAL)
[ ] CODE VIOLATION [ ] PRE C/O
REMARKS:
010 f •
v
v �1r1t1�
AVV(.
DATE 2 2O INSPECTOR
J
pE SOUIyO� L-1 73 V l f C 9C.JV v �
# # TOWN OF SOUTHOLD BUILDING DEPT.
765-1802
INSPECTION,
[ ' ] `FOUNDATION 1ST [ ] ROUGH PLBG.
[ ] FOUNDATION 2ND [ ] INSULATIOWCAULKING
[ ] FRAMING /STRAPPING [ ] FINAL
[
] ' FIREPLACE & CHIMNEY [ " ]Y FIRE SAFETY INSPECTION
[ ] FIRE RESISTANT'CONSTRUCTION [ ] FIRE RESISTANT PENETRATION
[ ] ELECTRICAL (ROUGH) ELECTRICAL (FINAL)
[ ] CODE VIOLATION [ ] PRE C/O
REMARKS:
DATE d �� INSPECTOR .
I
40
01
c 1
d�
f
e
i
:-j
° .
I ► it Alf ..
FIELD INSPECTION REPORT DATE CIOMMENTS
FOUNDATION(1ST)
-------------------------------
FOUNDATION(zND) �
LA
ROUGH FRAMING&
PLUMBING
ell
INSULATION PER N.Y.
STATE ENERGY CODE
FINAL
ADD _ I( 1L CI1MNTS
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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 b/
TEL: (631) 765-1802, Planning Board approval
FAX: (631) 765-9502 /��`� Z Survey
Southoldtownny.gov PERMIT NO. Check f
Septic Form
N.Y.S.D.E.C.
Trustees
C.O.Application
)( Flood Permit
Examined 120 AO Single&Separate
Truss Identification Form
Storm-Water Assessment Form_
Contact:
Approved ,20 Mail to:e,g1.7t 7C�yL�i
Disapproved a/c
Phone:
Expiration ,20
® E990VE Building Inspector
SEP 1 6 2020 BPLICATION FOR BUILDING PERMIT
Date �,� 520,16
BUMU DING DEMINSTRUCTIONS
.I aOLD
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.
��7llC �ez5 c��
(Signature of applicant or name,if a corporation)
P®- '3ax 9 941"'C0547 LC/LI;e' //93S
(Mailing address of applicant)
State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder
Name of owner of premises 7,�6/���. 4 zcSD/ 73� �L�.9C�A
(As on the tax roll or latest deed)
If appli aV is a co ti 'gnature of duly authorized officer
C,12/7 es
(Name and title of corporate officer)
Builders License No. 1kZ&7 ,N
Plumbers License No.
Electricians License No.
Other Trade's License No.
1. Location of land on which proposed work will be done:
_O 7�_ 62E(;;,C"AJ
House Number Street Hamlet
County Tax Map No. 100 �'r± 'i`'` ` ' f
� ) . „ > '; ',rs, Lot
0 Section B.lock
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 57-e,y rl? 1/&-;5ngvz.G
b. Intended use and occupancy, 5�r rd)?N IA.,�zcv 4u�a,r.�i.��� 9';-u'L-
3. Nature of work(check which applicable): New Building Addition Alteration
Repair Removal Demolition er Wo 1Aj6mvv%p 5w,.u.Mi 0'"Z-
(Description)
4. Estimated Cost Z.S;�C3ZJo 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 occupancy, specify nature and extent of each type of use.
7. Dimensions of existing strictures, if any: Front 3 / Rear `/ Depth 35
Height_gs 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 Depth
Height Number of Stories
9. Size of lot: Front /vim Rear 6V Depth SWI
10. Date of Purchase Name of Former Owner
11. Zone or use district in which premises are situated '/Zff5>7c-�n//4-C
12. Does proposed construction violate any zoning law, ordinance or regulation? YES NO,X
13. Will lot be re-graded? YES X NO Will excess fill be removed from premises?YES D( NO
14. Names of Owner of premises72,o & �-gym I Address3oz�raxe-vN -zD Phone No.,973-9.S3-07&7
Name of Architect °VU`S C-f- Address /`"-""`ac Phone No
Name of Contractorajt/7U( eintxls cau Address 7o.-.3vx9, Phone No.63�--39,7e-6S
15 a. Is this property within 100 feet of a tidal wetland or a freshwater wetland? *YES NOA"
* 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 �X
* 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 1Y
* IF YES, PROVIDE A COPY.
STATE OF NEW YORK)
SS:
COUNTY OF-52 )
Eu(V e7-1E eknjc ' being duly sworn, deposes and says that(s)he is the applicant
(Name of individual signing contract) above named,
(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
day of 20 ZO
t u lic STEVEN L. HARNED Signature of Applicant
Notary 114wYorkNohA60788
Qualified inSuffolk County
Commission Expires March 3, wo 1/`9-
Scott A. Russell �.�-°Sup �� STcO)IKI�WWA\TIE]EZ
SUPERVISOR � AI-A NAcG IENUENT
SOUTHOLD TOWN HALL-P_O_Box 1779 16
53095 Main Road-SOUTHOLD,NEWYORK 11971 ��O - Town of)Southold
CHAPTER 236 - STORMWATER MANAGEMENT WORK SHEET
(TO BE COMPLETED BY THE APPLICANT)
Yes -No (CHECK ALL THAT APPLY)
- []CB�A. CIearing, grubbing, grading or stripping of land which affects more
than 5,000 square feet of ground surface.
n[]B. Excavation or-filling involving more than 200 cubic yards of material
within any parcel or any contiguous area_
❑Efc- 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. ;
❑[3--E. Site preparation within the one-hundred-year floodplain as depicted
on.,FIRM Map of any watercourse..
[]l� 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 DepartmenLwUh-your Building Permit Application.
APPLICANT._ (Property Owner,Design Professional,Agent,Contractor,Other) S.C_T.M. 1000 Date.District
NAME '7!/K �UUL S L-7-D. I UU 7
Z
� Section Block Lot
-�.�-=FCR1?LiILDI\G DEP.•,f?T�=11=4'I-L� ;: OCL;- - ._
Contact Inrormatlorr 631-73'/-761,6_
:rrnuor t+nom-
Reviewed By:
Date:
Property Address / Location of Construction Work: — — — — — — — — — — — — — — — —
_�U7� Approved for processing Building Permit.
Stormwater Management Control Plan Not Required
Slormwater Managenzen. Control qu,
1_J (Forward to Engineering Department for Review_)
FORM - SMCP- TOS MAY 2014
a _a f
D E i 5 20JILE06W DEPARTMENT-Electrical Inspector
TOWN OF SOUTHOLD
`"� ;:aT wn:Hall Annex-54375vMain Road -PO Box 1179
4-
1,r$outhold, New York 11971-0959
Telephone(631) 765-1802-FAX (631) 765-9502
-
roc err� southoldtQ�rnr�y.�€®�r- sear?d�sor�thoidtovvr:r���.c
APPLICATION FOR ELECTRICAL INSPECTION
ELECTRICIAN INFORMATION (Au information Recluu+ed) Date: kms- 16-ad
Company Name: k -mac "T(n
Name: '
license No.: �ffi l +M E email: ��e�-Fec � m ;
m_
Address: �us�e�
Phone No.: -JOB SITE SITE INFORMATION (Ail information Required)
Name: c� )D e` -k- 7:S2: �a \Q CCG
Address: — Q
Cross Street
Phone No.:
Bidg.Permit#: email:
Tax Map District: 1000 Section: ICp® Block Lot
BRIEF DESCRIPTION OF WORK(Please Print Clearly) f1 !24`cKincl rnrnrr)Q
C)6\
Circle All That Apply:
Is job ready for inspection?: YES NO Rough In Final
Do you need a Temp-Certificate?: YES/ NO Issued On
Temp Information: (Ali information required)
Service Size 1 Ph- 3 Ph Size: A #Meters Old Meter#
New Service-Fire Reconnect-Flood Reconnect-Service Reconnected-Underground-Overhead
#Underground Laterals 1 2 H Frame Pole Work done on Service? Y N
Additional Information:
PAYMENT DUE WITH APPLICATION
Request for inspection Formids / �n
PERMIT## Address:
Switches '1
Outlets '
GFI's l
Surface
Sconces
H H's
LIC Lts
Fans Fridge HW
Exhaust Oven Dryer
Smokes DW Service
Carbon Micro Generator
Combo Cooktop Transfer
AC AH Mini
Special:
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APPROVED AS NOT D
DATE: B.P.# lJ�
FEE: 6- iD6 BY: 6&
NOTIFY BUILDING DEPARTMENT AT
765-1802 8 AM TO 4 PM FOR THE ELECTF -AL
FOLLOWING INSPECTIONS: INSPECTION REQUIRED
1. FOUNDATION - TWO REQUIRED
FOR POURED CONCRETE
2. ROUGH - FRAMING & PLUMBING
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. 5IAT FLY"
E G bsE-ObOL TO CODE
x"``WON COMPLETION
;BEFORE,,WAT�R"
COMPLY WITH ALL CODES OF
NEW YORK STATE & TOWN CODES
AS REQUIRED AND CONDITIONS OF
sGuTi!S 1
S ff ARD
SUU I HC'LyMWff7Rb&TEES RETAIN STORM WATER RUNOFF
PURSUANT TO CHAPTER 236
OF THE TOWN CODE,
OCCUPANCY OR
USE IS UNLAWFUL
WITHOUT CERTIFICATE
OF OCCUPANCY
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POOLSIZE
POOL SIZE IMiH STEP A B C 0 E G• H K L" M N GALLONS D
12X24 12X28 12-0" 24'-0" 3'-0" 6'-0" 6-0° 8'47'19-3 4�0" 4-D' 4 4-D" 6.3.18 9,050
16X24 16X28 16'-0" 24'-0" 3'•6" 7'40" 6'•0° 8'•0" W-V' 4'•0" 4'-g" 8'3" 4'-0" V-3-1B" 13,750
, ■ , n , ■ , , , , w r -
16tt32 16X36 16-0" 32-0" 3-0 8-0" 8.6 13-6 63' 4.0" 4-0" 83' 4-0" 7-0 19,SOD
18X36 18X40 18'-0" 36`-0" 3'-4" 8'-0" 10-6" 13'-V W-T' 4'4r 4'-0" 10'3" 4'-0" T-4" 25,500
20X40 20X44 20'•0" 40' 3'.4" 8'-0" 12-6" 13'•6° 10'.3" 4'-0" 4'40" 121•3" 4'-0" T4" 3Z;000
16X34 18X38 16'-0" 34'-0" 3'-0° 8'-0" 10'-6" 1 '-6° 6-3" 4'-0 4-0" 8'3" 4.0" 7140 20,900 �`""' �„
X50 2SX54 25'-0' 50'-0" 3'-0" 8-6" 20'.6' 13'•6" 12'•3" 4'-0° 4'-0" t7'3" 4'-0" T7-Mn S8,760
30 30X64 30' 60'-0" 3'-0" 9-6" 20'-0" 15'-0" 20'-T 4'-6° 4'-0" ' 4'-6" 8-2318" 79,550
QM9 14X32 14'-0" 28'11" 3`-0" 6'-0" 8'11" 12'-0" 4'3" 4'-0° 4'-0" VLT' 4' 6'3-1116" 12,100
13X26 12X30 13 26 3'-0" 6'-0" 8:-0" 10'-0° 4'3" 4'-0" 4-0" 6'3" 4'-0" 6'•3-1116" 11,600 oN�cc " Q ++�C`� A `
16X38 16X42 16 38 3'-0" 8'•0" 14'-0 14'-0" 6'-0" 4'-0 4'-0" B'3" 4'-0" T-4" 22,OOD
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Complies With:
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41
2016 NYS Uniform Code Supplement Sec 8326 � �Q
R32633 in Ground Pools Shall Be in Conformance with ANSI/NSPI-5 A 07'2
8326.5 Barrier requirements:Temp Pence must be installed at time of RO
Pool construction,and Permanent fencing is the homeowners responsibility ��
R326.6Entrapment Protection Installed
-------------- ''-- — --------- R326.7 Swimming Pool and Spa Alarms must be installed
POOL TYPE:RECTANGLE REV. SCALE: NTS
20151ECC JAMES DEERKOSKI, P.E.
Sec R 403.102 Time switches or other control methods that can run DATE:
TYPICAL PANEL STIFFN ER automatically tum off and on according toa preset schedule sball be 260 DEER DRIVE
installed for heaters and pump motors. Heaters and pump motors that I DRAWING NUMBER
have built in time switches shall be in compliance with Sec R 403.10.2 MATTITUK, NEW YORK 11952
OF 1
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