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HomeMy WebLinkAbout46459-Z �o`osulfOC��pG� Town of Southold 12/9/2021 P.O.Box 1179 cz VIA 53095 Main Rd Southold,New York 11971 CERTIFICATE OF OCCUPANCY No: 42592 Date: 12/9/2021 THIS CERTIFIES that the building IN GROUND POOL Location of Property: 75 Clearview Ave., Southold SCTM#: 473889 Sec/Block/Lot: 70.-8-41 Subdivision: Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated 6/10/2021 pursuant to which Building Permit No. 46459 dated 6/22/2021 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 Zoumas,Ioannis of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL ELECTRICAL CERTIFICATE NO. 46549 11/8/2021 PLUMBERS CERTIFICATION DATED o 0 0 th riz d ignature �gufFDl„z TOWN OF SOUTHOLD o aye BUILDING DEPARTMENT C2 X TOWN CLERK'S OFFICE "may • 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#: 46459 Date: 6/22/2021 Permission is hereby granted to: Zoumas, loannis 2050 N Country Rd Wading River, NY 11792 To: construct accessory in-ground swimming pool as applied for. At premises located at: 75 Clearview Ave., Southold SCTM #473889 Sec/Block/Lot# 70.-8-41 Pursuant to application dated 6/10/2021 and approved by the Building Inspector. To expire on 12/22/2022. Fees: SWIMMING POOLS -IN-GROUND WITH FENCE ENCLOSURE $250.00 CO- SWIMMING POOL $50.00 Total: $300.00 B ' ding 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. se=1. Final survey of property with accurate location ofall 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 Appeoval 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$15.00 ' Date. �onstru :j�y.5c.a.y. -V, Old or Pre-existing Building: (check one) Location of Property: Z5' House No. Street Hamlet Owner or Owners of Property: �,4A).tJiS azwW --oy l A:5 Suffolk County Tax Map No 1000,Section I7D Block S Lot�J Subdivision Filed Map. Lot: Permit No. Date of Permit. Applicant: Health Dept.Approval: Underwriters Approval: Planning Board Approval: Request for. Temporary Certificate Final Certificate: (check one) Fee Submitted:$ npli nt i-gnature Building Department Application AUTHORIZATION (Where the Applicant is not the Owner) L ftNNIS residing ac • (Print property owner's name (Mailing Address- •` G do hereby authorize �t����-) (Agent) to apply on my behalf to the Southold Building Department. - -- 0— (Owner's Signature Datei �'Uf�Nn�iS s, Zyu�--tq4 (Print OtN►ner's Name) oF so�,��®� Town Hall Annex ® Telephone(631)765-1802 54375 Main Road Fax(631)765-9502 P.O.Box 1179 G Q sean.devlin(a)-town.southold.ny.us Southold,NY 11971-0959 ® �® couff N' BUILDING DEPARTMENT TOWN OF SOUTHOLD CERTIFICATE OF ELECTRICAL COMPLIANCE SITE LOCATION Issued To: loannis Zoumas Address: 75 Clearview Ave city,Southold st: NY zip: 11971 Building Permit* 46459 section 70 Block 8 Lot 41 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 Ceiling Fixtures Bath Exhaust Fan 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 Fixture Time Clocks 1 Disconnect Switches 4'LED Exit Fixtures Pump 1 Other Equipment: Intermatic Pool Panel 8 Circuit/4 Used,Pump 220GFI, Salt Generator, 3 Lights on J&J Pool Tranny, Heater Notes Pool Inspector Signature: Date: November 8, 2021 S Devlin-Cert Electrical Compliance Form OF SOUIyO� �� �� c fe,&L�v f ew Ave TOWN OF SOUTHOLD .BUILDING DEPT. cou765-1802 -INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PL13G. [ ] FOUNDATION 2ND [ ] INSULATION/CAULKING [ ] FRAMING /STRAPPING [ ] FINAL [ ] FIREPLACE &-CHIMNEY [ ] FIRE SAFETY INSPECTION [ ] FIRE RESISTANTCONSTRUCTION [ ] FIRE RESISTANT PENETRATION [ELECTRICAL (ROUGH) [ ] ELECTRICAL (FINAL) [ ] CODE VIOLATION [ ] PRE C/O v REMARKS: _ � e� Zvi Ate DATE 6? e7,6 V INSPECTOR - 4 �a 90 F # # TOWN OF SOUTHOLD BUILDING DEPT.- co765-1802 INSPECTION [ ]' FOUNDATION 1 ST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] SULATION/CAULKING ; [ ] FRAMING-/STRAPPING [ FINAL [ ] FIREPLACE & CHIMNEY [ f FIRE SAFETY INSPECTION [ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRATION [ ] ELECTRICAL (ROUGH) [ ] ELECTRICAL (FINAL) [ ] CODE VIOLATION [ ] PRE C/O REMARKS: I V4 DATE V24 34 2-a-2"1 INSPECTOR FIELD INSPECTION REPORT DATE COMMENTS FOUNDATION(IST) H ------------------------------------ �1 ci FOUNDATION(2ND) ROUGH FRAMING& y PLUMBING � . r INSULATION PER N.Y. y STATE ENERGY CODE FINAL N ADDITIONAL COMMENTS W 30CP 5—F2( Z ' �rn N � N y No z x x tC m ►d 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 � �j Survey V11,Southoldtownny.gov PERMIT No. Le Check ✓ Septic Form N.Y.S.D.E.C. - Trustees C.O.Application P/ Flood Permit Examined 20 i Single&Separate JUN 1 0 2021 Truss Identification Form Storm-Water Assessment Form V_ 7F 77 " Contact: .. 1.1 .�. Approved 20__C Mail to: Disapproved a/c ho C'�3l-73Y-7C�G Expiration 20 `/Z'v�6.,_// B • ding I ector APPLICATION FOR BUILDING PERMIT _ Date K0-1,9 , 20 --Y/ 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. `17ux,5 L-7>. (Signature of applicant or name,if a corporation) (Mailing address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician,plumber or builder (_f-t)ti7i2P C-OR Name of owner of premises - dA�J,pJJS `Z0/+q/ Z oul�ar45 (As on the tax roll or latest deed) If appl• nt is a c ati n, gnature of duly authorized officer (Name and title of corporate officer) Builders License No. IkIl JN Plumbers License No. Electricians License No. Other Trade's License No. 1. Location of land on which proposed work will be done: 75- ja211l w House Number Street, Hamlet County Tax Map No. 1000 Section - 'r,,, JIia� Lot 71/ li;telE¢� Subdivision '7r4-17-K Filed Map No. Lot /9 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy—,g­_676x ,' ;r 2z 2E3/7De;,.'CE b. Intended use and occupancy 3. Nature of work(check which applicable): New Building Addition Alteration Repair Removal Demolitioner Wo -" (Description) 4. Estimated Cost ��SUcv 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 structures, if any: Front 2!a,s2 Rear Depth �y ' Height may' Number of Stories -,g 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 div' Rear _ &/.S/' Depth gGo' 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 NO_)( 13. Will lot be re-graded? YES_NO Will excess fill be removed from premises?YES X, NO 14. Names of Owner of premisessU,n,,vwts -N. z,)uHliSAddress,?ost N. ecxv7zS, 'T-P Phone No.,S/lo- 9d3-a91�2 Name of Architect Address ` 1r-Dm4 72'&V-R''"y r"gzPhone No Name of Contractor C*ti7aK Pcrac3 Address a4 eLy 9 hone No. 6.5- 15 S15 a. Is this property within 100 feet of a tidal wetland or a freshwater wetland? *YES NO x * 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 C�' * 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 06jg ) Ems*b-71)E being duly sworn,deposes and says that(s)he is the applicant (Name of individual signing contract) above named, (S)He is the �U X-r- (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 -VO LV p 20-5� N is STEVEN L. Signature of Applicant Notary-Public'Stat e of ew York No.OlhA6071848 Qualified inSuffolk County Commission Expires March 3, Subdivision 7*q ZuieW 'P,R-Ze Filed Map No. .13 8•e- Lot /9 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy 67vxy r,2. -1Ze3.7>evyc6 b. Intended use and occupancy A 67aXy /—_�Z 3. Nature of work(check which applicable): New Building Addition Alteration Repair Removal Demolition er Wo T (Description) 4. Estimated Cost $'2S Fee (To be paid'on filing�this application) 5. If dwelling, number of dwelling units NiI nb'e:q ofVdikelling 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 --lIy ' Height ,�y' -Number of Stories Dimensions of same structure with alterations or ladditio,ns: Front Rear Depth Height ` - Number of Stories 8. Dimensions of entire new construction: Front Rear Depth Height Nuri'iber'of'Stories 9, "Size of lot: Front fia'`k Rear " - lei/,s/' Depth _2eQ` 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 NO_ 13. Will lot be re-graded? YES NO Will excess fill be removed from,premises?YES Al NO 14. Names of Owner of premises,zaAA,ws i. zouH.aSAddresszory1y, Phone No. 74.3-"$$Z Name of Architect - Address` ` '4 '2"f''v'r i%;"-Phone No Name of Contractor Gf/7vK Pcei.a �L>D, Address Tta icy 9, eu�Le Phone No. C�3�-73y 7G G S 15 a. Is this property within 100 feet of a tidal wetland or a freshwater wetland? *YES NO X * IF YES, SOUTHOLD TOWN TRUSTEES &D.E.C. PERMITS MAY BE REQUIRED. b. Is this property within 3`00 feet of a tidal wetland? * YES NO ck' * 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 D( * IF YES, PROVIDE A COPY. 5 STATE OF NEW YORK) SS: COUNTY O11� ) Ec A L7,JC �` 17th2 being,duly sworn,deposes and says that(s)he is the applicant (Name of individual signing contract) above named, (S)He is the 00 N� (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 -4-0 A Nis :STEVEN Signature of Applicant Not ary-Publieltatd of'New York- No.OI 6071848 Qualified inSuffolk County Commission'14ires March 3, TOWN.OF SOUTHOLD BUILDING PERMIT APPLICATION CHECKLIST BUIEDING DEPARTMENT Do you have or need the following,before applying? TOWN HALL Board of Health SOU HOLD, NY 11971 4 sets df'Building Plans TEL: (631) 765-1802, ;, : . Planning'Board'approval ' FAX: (631) 765-9502 Survey_Z Sout oldtownny.gov PERMIT NO: " Check ✓ Septic Form N.Y.S.D:`ir:C: - • Trustees, C.O.Application � u Flood Permit, Exami ed 20 R i r w Single&'Separate- i uss,Identification Form �U Nf� �: 0'��"2021 Tr +�.,_ . . . . , Storm-Water,Assessmerit--Fo-rni�_t✓ T"??y ^, T�,T?,r,,p*T, Contact: APProllIed 20 ` '' • 1 - Mail to: Disapproved a/c Expiration 20 yz B ' df g'Tector APPLICATION FOR BUILDING I'.FR", IT Date 409` INSTRUCTIONS a. This application MUST be completely filled in by typewriter or in ink and submitted to the Building Inspector with 4 sets o plans, accurate plot plan to scale.Fee according to schedule`~,. b. Plot plan showing location of lot and of buildings on premfses,relationship to adjoining premises or public streets or areas, �nd 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 1'Certificate of Gccupancy. f. Every building permit shall expire`if'the work aiithorized,has not commenced within 12 months after the date of issuance or has not been,completed within I8,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-b,e required. APPLICATION IS HEREBY MADE to the Building DEpartment for the issuance.of a Building,Permit pursuant to the Builds g 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,de'scribed.The applicant agrees to comply with all applicable laws,ordinances,building code, housing code,rand regulations, and to admit authorized inspectors on premises and in building for necessary inspections, Gly-!•7c�K �Gcx,S C7�. (Signature of applicant or name,ifa,corporation) ' ��:'.vY' (Mailing addr`essof3applicant)" State hether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder )A-)717AC>y2 Name of owner of premises _7,D,4„/,v15 -Sor-t•,y Z ouM�S (As ori-tlie-tax'roll.or-latest deed) If app i nt is a c ata n, 'gnature of duly authorized officer ' (Name and title of corporate officer) Builders License No. /,5.1-6 / Plumlers License No. Electr clans License No. Other Trade's License No. 1. Location of land on which proposed work will be done! I 7S C[.G��2U�Ecy+ ,.4 d� �Syt���� . A. • , ;r ,,. Hmy'use Number' Stree'f,, HamletJ.033 •'f r - C unty Tax Map No. 1000 Section `i1��St�" 1 > ' 7U;l�lo�' `f,$�k � �,> -,l� Lot 3,1 ytlrr:,',,, �ilalfiu2rts beihii.. . Scott A. Russell •�°Sur-1-�,�� ST(0)]KIA�J WAT)E]R� SUPERVISOR AM[A\N A\cGrIEAM[IEN F SOUTHOLD TOWN HALL-P.O.Box 1179 !� 53095 Main Road-SOUTHOLD,NEW YORK 11971 2�0 - Town of ISO u th o l d CHAPTER 236 - STORMWATER MANAGEMENT WORK SHEET (TO BE COMPLETED BY THE APPLICANT) -- ------- ]li® -TIIS-'-PROJECT—PROJECTF— P�PI�WING: -—--- = ---- --- No (CHECK ALL THAT APPLY) - lii�A. CIearing, grubbing, grading or stripping of land which affects more than 5,000 square feet of ground surface. ❑[3B. Excavation or filling involving more than 200 cubic yards of material within any parcel or any contiguous area. ❑63 C. Site preparation on slopes which exceed 10 feet vertical rise to 100 feet of horizontal distance. - t ❑[3"D. Site preparation within 100 feet of wetlands, beach, bluff or coastal erosion hazard area. t ❑[�E. Site preparation within the one-hundred-year floodplain as depicted �ron FIRM Map of any watercourse. L . I ® nstallation 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 DepartmenLmith-your Building Permit Application. APPLICANT: (Property Owner,Design Professional,Agent.Contractor,Other) - S.C.T.M. -#: 1000 Date: y Datrid p NAME EU�jC/t�L^ �JI/7L �� � /� �� wr.1 t �%�Z%2�/C Section Block Lot FOR BUILDICG DEPARTMENT t.SL ONLY Contact Information Lo 31-73y- 7e,G.S Reviewed By: Date: Property Address / Location of Construction Work: — — — — — — — — — — — — — — — — — 73 ❑ Approved for processing Building Permit Stormwater Management Control Plan Not Required- - — — —C — —plan Rcqu t � Stormwater Manage�„e,it `vlitrvl iJ i�ayuireu- (Forward to Engineering Department for Review) FORM ' SMCP - TOS MAY 2014 r� Frr�' E � V ILDING DEPARTMENT-Electrical Inspector CT 2 2 2021 TOWN OF SOUTHOLD C T all Annex- 54375 Main Road - PO Box 1179 •m- BUILDING DEPT. Southold, New York 11971-0959 WN OF SOUTHOLD Telephone (631) 765-1802 - FAX (631) 765-9502 �J roclerr@southoldtownny.gov— seand@southoldtownny.gov APPLICATION FOR ELECTRICAL INSPECTION ELECTRICIAN INFORMATION (All Information Required) Date: Company Name: Electrician's Name: a vvl (S a License No.: -M E Elec. email: '�ranlF�o Elec. Phone No: I [�]I request an email copy of Certificate o Compliance Elec. Address.: peeves ,Q,� ��\ve v JOB SITE INFORMATION (All Information Required) Name: Z, Address: _ f. Cross Street: Phone No.: Bldg.Permit#: i email: Tax Map District: 1000 Section: Block: Lot: BRIEF DESCRIPTION OF WORK, INCLUDE SQUARE FOOTAGE (Please Print Clearly): vo©1 Square Footage: Circle All That Apply: Is job ready for inspection?: YES ❑NO []Rough In CPg alDo you need a Temp Certificate?: YES NO Issued On Temp Information: (All information required) Service Size F11 Ph R3 Ph Size: A #Meters Old Meter# ❑New Service[]Fire Reconnect[]Flood Reconnect❑Service Reconnect❑Underground❑Overhead # Underground Laterals 1 n2 R H Frame Pole Work done on Service? Y N Additional Information: PAYMENT DUE WITH APPLICATION X14 FO C E UILDING DEPARTMENT- Electrical Inspector TOWN OF SOUTHOLD oCTo� 2 2 2021 To z all Annex- 54375 Main Road - PO Box 1179 o BUILDING DEPT. Southold, New York 11971-0959 WN OF SOUTHOLD Telephone (631) 765-1802 - FAX (631) 765-9502 Ol �� rogerr(@-southoldtownny.gov— seand southoldtownn . ov APPLICATION FOR ELECTRICAL INSPECTION ELECTRICIAN INFORMATION (All Information Required) Date: Company Name: E-1E.C-72C 7:K--�f-�C Electrician's Name: M Z�,r,� �� License No.: EElec. email: FranmG1 10cc rr Elec. Phone No:,5i(,) q I request an email copy of Certificate o Compliance Elec. Address.: y� ?eeve s K\vec G (�Y. \A61 JOB SITE INFORMATION (All Information Required) Name: Z, Address: (� Cross Street: Phone No.: Bldg.Permit#: j email: Tax Map District: 1000 Section: Block: Lot: BRIEF'DESCRIPTION OF WORK, INCLUDE SQUARE FOOTAGE (Please Print Clearly): =-V, (�roor-6 � p0®1 Square Footage: Circle All That Apply: Is job ready for inspection?: LN YES❑NO R Rough In CP Final Do you need a Temp Certificate?: F-1YES�NO Issued On Temp Information: (Alf information required) Service Size❑1 Ph❑3 Ph Size: A #Meters Old Meter# ❑New Service[]Fire Reconnect[]Flood ReconnectOService ReconnectOUnderground DOverhead # Underground Laterals 1 n2 F1 H Frame Pole Work done on Service? 0 Y ON Additional Information: PAYMENT DUE WITH APPLICATION PERMIT# Address: Switches Outl GFI- Surf Sconces , HH' UC Lt's Fans Fr'r'd" �. HW Exhaust Oven W/D Smokes DW Mini { 'Carbon M ` . - 1Vfitro• _.. Generator, Comp.o.�. . . - .- ,._ 'Cooktop - i - Transfer-- -- -- - AC � � .•. ..._--�AH•_�_ -. ..-. _. Hood, ,. ., ,.•..-.. .-... . , ._.. �. . .__.. � Service .. .. . : .._ ._..• _.- ' Amps " Have `Used Special:. .- - Comments- - - . .T-� '• r- ,. � .- -_' _ 12. r - PROPERTY ON THE SUBDIVISION MAP OF b FAIRVIEW PARI, SECTION ONE LOT 19 FILED AUGUST 9, 1961 AS MAP NO. 3388 SITUATE AT PINE NECK TOWN OF SOUTHOLD SUFFOLK COUNTY,NEW YORK LIL 4¢ AREA OF PARCEL = 21,346± SQ.FT. OR 0.490± ACRE _ a N/F I ELIZABETH E. GORDON N/F AND JOSEPH C, GORDON I CUSTER TACKLE INC. LOT 7 'PRa � 20 xSd/ LOT 8 /jl, ,�jWlJ9N�Ny 7 92.0E x1229 . N 89°3345" FEEND E 101. 1' N 03' FE.£ND x 12.13 v R7' 4' STOCKADE FENCE REMAINS MON MON X_ H� 4CL. FE. x1329 F£ COR E 0.4' ❑� x1354 x13.78 NOTES �J �v .1288 x 1 MEASUREMENTS ARE IN ACCORDANCE WITH U S STANDARDS O 2. THE HORIZONTAL DATUM IS IN THE NEW YORK STATE PLANE 0COORDINATE SYSTEM,NAD83(2011),LONG ISLAND ZONE O !v N x1144 sv 3 THE VERTICAL DATUM IS REFERENCED TO NAVD86(GEOID12A) x ,33 x 1268 x 12.35 w O 3 4 UNAUTHORIZED ALTERATION OR ADDITION TO A SURVEY MAP W D� �Z� 4 3 2 BEARING A LICENSED LAND SURVEYOR'S SEAL IS A VIOLATION OF SECTION 7209,SUBDIVISION 2,OF THE NEW YORK STATE EDUCATION LAW 04 O z L q 5. ONLY COPIES FROM THE ORIGINAL OF THIS SURVEY MARKED a " "MapQ WITH AN ORIGINAL OF THE LAND SURVEYOR'S"EMBOSSED"OR r A oI 1AgI-gW I "INKED"SEAL SHALL BE CONSIDERED TO BE VALID TRUE a I CRY COPIES LOT 18 w o Z 6 CERTIFICATIONS INDICATED HEREON SIGNIFY THAT THIS .5 SURVEY WAS PREPARED IN ACCORDANCE WITH THE EXISTING x 1x74 CODE OF PRACTICE FOR LAND SURVEYORS ADOPTED BY THE 'WING 'I G U-) SURVEYORS YORK STATE ASSOCIATION OF PROFESSIONAL LAND TF 1160 -------42 3'-------TF 1160 WALL WA L __17 0� ^� _ SURVEYORS SAID CERTIFICATIONS SHALL RUN ONLY TO THE e op 9i PERSON FOR WHOM THE SURVEY IS PREPARED AND ON HIS x o BEHALF TO THE TITLE COMPANY,GOVERNMENTAL AGENCY (� to O AND LENDING INSTITUTION LISTED HEREON AND TO THE �+ CONCRETE c II ASSIGNEES OF THE LENDING INSTITUTION CERTIFICATIONS FOUNDATION a ARE NOT TRANSFERABLE TO ADDITIONAL INSTITUTIONS OR 4' CL FE. SUBSEQUENT OWNERS 1039 7 RIGHTS-OF-WAY NOT SHOWN ARE NOT CERTIFIED oW TF 1160.3' N 8 4' 4, EED COR rF 1157 8. THE SURVEY CLOSES MATHEMATICALLY 0 0 o N ' - CDNC. CDNC. CONC. 9 UNDERGROUND UTILITIES SHOWN ON THIS SURVEY ARE FROM --16.9 = UTILITY MARKOUT LOCATED ON THE GROUND AND/OR RECORD x994 ITF 11.58 TF 11,591 �y 1 ;a; PLANS BEFORE ANY EXCAVATION IS TO BEGIN,ALL W I x 11,76 I = UNDERGROUND UTILITIES SHOULD BE VERIFIED AS TO THEIR o` I x 1137 i i LOCATION,SIZE AND TYPE BY THE RESPECTIVE UTILITY jn I i 0 COMPANIES. OJ J ` `A C0 I, " x936 oo I LEGEND x9491 1 SLATE VALL i v 02' L7 FIRE HYDRANT 1 I D4 WATER VAL.VE E: CLEARVIEW AVE, x884 1 GARDINERS LN MON ON O WATER WELL LL S 89°33'45" W 110,00' SIGN C,STOP DECIDUOUS TREE 0 CONIFEROUS SHRUB v pd EDGE OF PAVEMENT -' wv UTILITY POLE X900 3 964 x873 x8,77 x928 x 9,43 OVERHEAD WIRES x ❑ BENCHMARK CL EAR VIE W A VENUE ® CONCRETE MONUMENT H t BM=9.46 TF TOP OF FOUNDATION MAG NAIL SET IN POLE n a OH H pH pH OH OH pH OH �- x 1l 37 SPOT ELEVATION �— j LLIL 1 IL 6 4 x M Ln Q O 2.1 O OF Hop ®'�'� a 03/23/2021 D.M. LOCATED FOUNDATION TLS DATE BY DESCRIPTION APPROV. BY a REVISIONS Town of Southold r, Suffolk County, New York 080 2@ �Qy, 75 CLEARVIEW AVENUE yci�ic� SOUTHOLD, NEW YORK FOUNDATION AS—BUILT I hereby certify that this map was made from an actual survey m completed by me on 052312020 and 03/19/2021. L. K. McLEAN ASSOCIATES, P.C. SUFFOLK COUNTY REAL PROPERTY TAX MAP NO. CONSULTING ENGINEERS & LAND SURILI tn DISTRICT 1000 X01 a 437 SO. COUNTRY ROAD, BROOKHAVEN, NE SECTION 070.00 ` Field Survey By JL./C.M. Scale V, = 30' BLOCK 08.00 TAMARA L STILLMAN,P.L S LOT 041.000 NYSPLS No.50528 Office Survey By T.L.S. Date JULY 14, 2020 h Approved By TL.SFile No 20059000 Y NOTES: a>>tIN'MEATLY°t h`49`o%E POOL TO(DDE; - 4�.�,.r ( 1. DIVING BOARD TO CONFORM WITH ANSI/APSP/ICC-5 SEC 6 t�3�---UPQN COMPLETION 2. NO SOIL DISCHARGE PERMITTED WITHIN 4 FEET OF EXCAVATION - i CODE(2020)AND ALL SECTIONS OF THE SOUTHOLD CODE 3. POOL MUST BE SURROUNDED BY A CONTINUOUS BARRIER CONSTRUCTED IAW REQ.OF SEC 326.4.2.1-R326.4.2.6 OF THE NYS RESIDENTIAL r 4. WALLS MAY SERVE AS PART OF THE POOL BARRIER AS PER SEC 326.4 2.8 AND ALL WINDOWS HAVE A SELF LATCHING DEVICE 5. ACESS GATES SHALL COMPLY WITH SEC R326.5.2 OF THE NYS RESIDENTIAL CODE(2020)AND BE SELF CLOSING,SELF LATCHING AND BE SECURELY LOCKED WHEN POOL IS NOT IN USE OR SUPERVISED. ALLL GATES ARE APPROVED AS NO, TO OPEN AWAY FROM THE POOL AREA. J DATE:• -g,p:# 6. DURING CONSTRUCTION THE CONTRACTOR SHALL ERECT A TEMPORARY BARRIER AROUND THE EXCAVATION IAW CODE OF THE TOWN OF SOUTHOLD. FEE:2,_- BY: 7. POOL MUST BE EQUIPED WITH AN APPROVED POOL ALARM CAPABLE OF DETECTING ENTRY INTO THE WATER AND SOUNDING AN AUDIBLE ALARM WHEN DETECTED THAT IS AUDIBLE AT THE POOLSIDE AND INSIDE THE NOTIFY' BUILDING DE?ART TAT DWELLING THE ALARM MUST BE INSTALLED,MAINTAINED AND USED IN ACCORDANCE WITH TEH MAUFACTURERS INSTRUCTIONS.THE ALARM MUST MEET ASTM F2208"STANDARD SPECIFICATION FOR POOL ALARMS".THE DEVICE MUST OPERATE INDEPENDENT(NOT ATTACHED TO OR DEPENDENT ON)OF PERSONS. 765-18OZ-,8 AM TO 4 PM FOR THE FOLLOWING_'INSPECTIONS: 8. POOL SUCTION FITTINGS(EXCEPT FOR SURFACE SKIIMERS)MUST BE PROVIDED WITH A COVER THAT CONFORMS TO ASME/ANSI Al 12.19.8M OR A MINIMUM 18'9(23"DRAIN GRATE ORA CHANNEL DRAIN SYSTEM.POOL 1. FOUNDATION - TWO REQUIRED CIRCULATION SYSTEM MUST BE EQUIPTED WITH ATMOSPHERIC VACUUM RELEIF.SUCH VACUUM RELIEF SYSTEMS SHALL CONFORM WITH ASME Al 12.19.17 OR BE A GRAVITY SYSTEM APPROVED BY THE TOWN OF FOR POURED CONCRETE SOUTHOLD. POOL SALL BE PROVIDED WITH A MINIMUM OF 2 SUCTION FITTINGS OF THE ABOVE MENTIONED TYPE.THE SUCTION FITTINGS SHALL BE SEPARATED BY A MINIMUM OF T AND MUST BE PIPED SUCH THAT WATER -2. ROUGH - FRAMING & PLUMBING IS DRAWN THROUGH THEM SIMULTANEOUSLY THROUGH A VACUUM RELIEF-PROTECTED LINE TO THE PUMP(OR PUMPS).VACUUM/PRESSURE CLEANING FITTINGS SHALL BE IN ACCESSIBLE POSITION,MINIMUM OF 6"AND 31 INSULATION NO GREATER THAN 12"BELOW THE MINIMUM OPERATIONAL WATER LEVEL OR BE AN ATTACHMENT TO THE SKIMMERISKIMMERS. A REQUIRED POOL ATMOSPHERIC VACUUM RELEIF SYSTEM SHALL BE INSTALLED AS PER NYS RESIDENTIAL CODE R326.6.3(2020)AND IN ACCORDANCE TO TOW CODE 4: FINAL - CONSTPl.!,'T!0N MUST 9. ALL ELECTRICAL WORK SHALL COMPLY WITH THE REQUIREMENTS OF NFPA 70(NEC),PRINCIPALLY ARTICLE 680 AND THE NYS RESIDENTIAL CODE SECTION 4102 THROUGH 4106.ALL ELECTRICAL DEVICES MUST BE BE COMPLETE F; O• APPROVED BY UNDERWRITERS LABORATORIES AND BE PROTECTED BY A GOUND FAULT CURRENT INTERRUPER(GFCI).CURRENT CARRYING ELECTRICAL CONDUCTORS EXCEPT FOR THOSE PROVIDING POWER TO POOL ALL CONSTRUCTION SHALL MEET THE LIGHTING AND POOL EQUIPMENT SHALL MEET THE SEPARATION REQUIREMENTS OF TABLE E4203.5. ALL METAL ENCLOSURES,FENCES OR RAILINGS NEAR OR ADJACENT TO THE SWIMMING POOL THAT MAY BECOME REQUIREMENTS OF THE CODES OF NEW ELECTRICALLY CHARGED DUE TO CONTACT WITH AN ELECTRICAL CIRCUIT SHALL BE EFFECTIVELY GROUNDED. YORK STATE. NOT RESPONSIBLE FOR 10. WATER SOURCE FILLING THE POOL SHALL BE EQUIPPPED WITH A BACKFLOW PROTECTION DEVICE IAW NYS PLUMBING CODE 608. - DESIGN OR CONSTRUCTION ERRORS' 11 ALL PIPING IS 61AGRAMMATIC UNLESS OTHERWISE STATED. RMIN STvRiifl WATER RUNOFF ELECTRICAL 12. WALKS,IF PROVIDED SHALL BE NONSLIP AND SLOPE AWAY FROM THE POOL EDGE. PURSUANT TO CHAPTER 23$ INSPECTION REQUIRED COMPLY WITH ALL CODES O 13 A MEANS OF EGRESS FROM DEEP AND SHALLOW ENDS MUST BE PROVIDED IAW ANSI/NSPI-5 SECTION 6. OF THE TONIN CODE. NEW YORK STATE & TOWN,CO ES 1 14. CONTRACTOR TO PLACE THE POOL IAW TOWN OF SOUTHOLD CODE SETBACKS. AS REQUIRED AND CONDITION OF 15. ALL DRAINAGE FROM THE POOL SHALL BE MAINTAINED ON THE SUBJECT PROPERTY. 16 THE DESIGN IS BASED ON A�RAINAGE SOIL WITH<10%SILT.GROUND WATER SHALL NOT EXIST WITHIN THE EXCAVATION.IF GROUND WATER EXISTS WITHIN 6'0"FROM GRADE, DEWATERING FACILITIES WILL BE ZS OtD REQUIRED. ARD 17 ALL GAS AND OIL WATER HEATERS(IF INSTALLED)FOR THE IN-GROUND SWIMMING POOL SHALL BE NATIONAL APPLIANCE ENERGY CONSERVATION ACT(NAECA)COMPLIANT.POOL HEATERS SHALL BE TESTED IAW ANSI 221.56 AND SHALL BE INSTALLED IAW MANUFACTURERS SPECIFICATIONS.OIL FIRED POOL HEATERS SHALL BE TESTED IAW UL726.POOL HEATERS SHALL BE LOCATED OR GUARDED TO PROTECT AGAINST ACCIDENTAL SOUTHOLD TOWN TRUSTEES CONTACT OF HOT SURFACES BY PERSONS.POOL HEATERS SHALL BE PROVIDED WITH TEMPERATURE AND PRESSURE-RELIEF VALVES.A BYPASS LINE SHALL BE INSTALLED FROM THE INLET TO OUTLET TO ADJUST WATER 1 FLOW THROUGH THE HATER.POOL HEATERS SHALL BE PROVIDED WITH THE FOLLOWING ENERGY CONSERVATION MEASURES: 17.1 ALL POOL HEATERS SHALL BE EQUIPPED WITH AN ON-OFF SWITCH MOUNTED FOR EASY ACCESS TO ALLOW SHUTTING OFF THE OPERATION OF THE HEATER WITHOUT ADJUSTING THE THERMOSTAT SETTING AND TO ALLOW RESTARTING WITHOUT RELIGHTING THE PILOT LIGHT. AT LEAST ONE THERMOSTAL MUST BE PROVIDED FOR EACH HEATING SYSTEM.HEATED SWIMMING POOLS SHALL BE EQUIPTED WITH A POOL COVER.(exempt FROM THIS ARE OUTDOOR POOLD)DERIVING 20%OF THE ENERGY FOR HEATING THE POOL FROM RENEWABLE SOURCES OVER AN OPERATING SEASON. 17.2 TIME CLOCKS SHALL BE INSTALLED SO THE PUMP CAN BE SET TO RUN DURING OFF-PEAK ELECTRICAL DEMAND PERIODS,AND CAN BE SET TO RUN THE MINIMUM TIME NECESSARY TO MAINTAIN THE POOL WATER IN A OCCUPANCY OR CLEAN AND SANITORY CONDITION IAW APPLCIABLE SANITORY CODE OF NEW YORK STATE. m IS EICS U N L/Pr WFI 1 L 18 BACKFILL WILL BE DONE WITH CLEAN EARTH FREE OF ROOTS AND DEBRIS. BACKFILL HEIGHT AND WATER LEVEL TO BE WITHIN 8"OF EACH OTHER. PLACE CONCRETE ON SANDY LOAM SOIL. CLAY TO BE REMOVED AND WITHOUT y7 �° /1 y y �J REPLACED WITH SANDY LOAM. YY IT IOU I CFRTI FICATL 19 THERE ARE MAIN DRAINS IN THIS POOL THERE ARE TWO APPROVED SUCTION OUTLETS WITH A MINIMUM OF T OF SEPARATION. THE SUCTION OUTLETS ARE PIPED SO THAT WATER IS DRAWN THROUGH THEM SIMULTANEOUSLY THROUGH A VACUUM-RELEIF-PROTECTED LINE TO THE PUMP_COMP I WITH ENTRAPMENT PROTECTION AS PER CODE. 20 THE POOL WAS DESIGNED REFERENCES AS THE FOLLOWING: 20.1 THE RESIDENTIAL BUILDING CODE OF NEW YORK STATE(2020)SEC R326 OF EW YUQ 20.2 THE ENERGY CONSERVATION CONSTRUCTION CODE OF NEW YORK STATE(2020)SEC R403.10 a�.D fR,r�o .f- _o s 2�,,3 THE FUEL GAS CODE OF NEW YORK STATE(2020) :,. -_ •'� a�.1 20.4 THE NEW YORK STATE SANITORY CODE. 20.5 ANSI/APSP/ICC-5 STANDARD FOR RESIDENTIAL IN-GROUND SWIMMING POOLS. �%� '� �� POOL NOTES SCALE: NTS 20.6 BOCA CODE SECTION 421. u�® Q� , PJAMES DEERKOSKI, P.E. DATE: 10/2/2020 20.7 CODE OF THE TOWN OF SOUTHOLD OFESS 260 DEER DRIVE MATTITUK, NEW YORK 11952 DRAWING-,'NUMBER 2 QF 2 _ POOLSR€ ,wi8lsrep R B C . o E F. G H K '-L 61 . N Gal --- —. 14X30 14X34 14 30, 3'-4° -6'•6' 6 -14 6 4_ '4- 6. .4'-0" T_4° 12900 fmQ&.y •16Y'�2:' 16: •28 3'-4 6'-6°. 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POOL SECTION i Complies With ' 8 ���` i^ 11 r 2020 Code Section 3032-1-3034 Swimming Pools,Spas and Hot Tubs ®��®FFSSio�P� Section R326 of the Residential Code of New York =------------'�$_------------ I 1 Section 3109 of the Building Code of New York i K' Section N7103-12(11403.12)Residential Pools and Permanent Residential Spas ®®� ��.��������� ��° SCALE. ��� Section 31093.12-3109.7.4 Pools and Spas Gates,Barriers Section G106 Entrapment Protection JAMES®EERK®SKf,P.E. - TYPICAL P • EL STIPMER E Section G107 alarms ®ATE: ti Sdcon E4201—E4312 Electrical Connections fot Pools 2�®®���®RIVE I A'ffITUK,NEW YORK 11952 ®RWWIMS NUMBE