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HomeMy WebLinkAbout45728-Z �S�EFOLKcoG Town of Southold 7/13/2023 P.O.Box 1179 o - W 53095 Main Rd oy o� Southold,New York 11971 CERTIFICATE OF OCCUPANCY No: 44274 Date: 7/13/2023 THIS CERTIFIES that the building IN GROUND POOL Location of Property: 530 Orchard St.,Orient SCTM#: 473889 Sec/Block/Lot: 25.-4-7 Subdivision: Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated 10/24/2018 pursuant to which Building Permit No. 45728 dated 1/26/2021 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 Bagan,Joanne of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL ELECTRICAL CERTIFICATE NO. 43199 6/7/2019 PLUMBERS CERTIFICATION DATED Au o ized Signature Y TOWN OF SOUTHOLD ' o�sufFot,��o �� Gy BUILDING DEPARTMENT H z TOWN CLERK'S OFFICE woy�o ao��r 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#: 45728 Date: 1/26/2021 Permission is hereby granted to: Hoblock, J Courtney 530 Orchard St Orient, NY 11957 To: Construct accessoryinround swimming-g g pool as applied for. Replaces BP# 43199 At premises located at: 530 Orchard St., Orient SCTM #473889 Sec/Block/Lot# 25.-4-7 Pursuant to application dated 1/26/2021 and approved by the Building Inspector. To expire on 7/28/2022. Fees: PERMIT RENEWAL $150.00 Total: $150.00 Build g-Irstfector ��SUFFut,r�oTOWN OF SOUTHOLD BUILDING DEPARTMENT y TOWN CLERK'S OFFICE oA • 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#: 43199 Date: 11/7/2018 Permission is hereby granted to: Hoblock, J Courtney 530 Orchard St Orient, NY 11957 To: construct accessory in-ground swimming pool as applied for. At premises located at: 530 Orchard St., Orient SCTM # 473889 Sec/Block/Lot# 25.-4-7 Pursuant to application dated 10/24/2018 and approved by the Building Inspector. To expire on 5/8/2020. Fees: SWIMMING POOLS -IN-GROUND WITH FENCE ENCLOSURE $250.00 CO - SWIMMING POOL $50.00 Total: $300.00 Bu 'ng Inspector R 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, dditions to dwelling$50 00, Iterations 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 Buildin check one) ) Location of Property; O r E*- b r e ^� House No et * lZ/✓ LHamlet Owner or Owners of Property: 44 Suffolk County Tax Map No 1000,Section tSotr 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: $ 4Aplican Signature pF SO!/ryOlo Town Hall Annex Telephone(631)765-1802 54375 Main Road N Fax(631)765-9502 P.O.Box 1179 �Q roger.richert(a7town.southold.ny.us Southold,NY 11971-0959 Q �yCOUNT`1,� BUILDING DEPARTMENT TOWN OF SOUTHOLD CERTIFICATE OF ELECTRICIAL COMPLIANCE SITE LOCATION Issued To: Courtney Hoblock Address: 530 Orchard St City: Orient St: New York Zip: 11957 Building Permit#: 43199 Section: 25 Block: 4 Lot: 7 WAS EXAMINED AND FOUND TO BE IN COMPLIANCE WITH THE NATIONAL ELECTRIC CODE Contractor: DBA: Bethel Electric License No: 40557-ME SITE DETAILS Office Use Only Residential X Indoor Basement Service Only 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 HID Fixtures Service 3 ph Hot Water GFCI Recpt 1 Wall Fixtures Smoke Detectors Main Panel A/C Condenser Single Recpt Recessed Fixtures CO Detectors Sub Panel A/C Blower Range Recpt Fluorescent Fixture Pumps 1 Transformer Appliances Dryer Recpt Emergency Fixtures Time Clocks 1 Disconnect Switches 1 Twist Lock Exit Fixtures TVSS Other Equipment: In ground swimming pool to include, bonding, control panel, 1-switch, 1-time clock 1-GFCI circuit breaker, 1-GFCI recpticle, 1-pool pump,pool heat pump,salt generator,low voltage pool lights,1-light control Notes: Inspector Signature: Date: June 7 2019 81-Cert Electrical Compliance Form.xls OP SOUTyo<o # TOWN OF SOUTHOLD BUILDING DEPT. oouuv��'' 765-1802 INSPECTION ' 4� fjf [ ] FOUNDATION 1ST [ ] ROUGH PLBG. [ ] 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: cad� DATE 7 INSPECTOR i Lf���J� �o��OF SOUIyOIo v* # TOWN- OF SOUTHOLD BUILDING DEPT. .- courm ' 765-1802 INSPECTION - I FOUNDATION 1ST [ ] ROUGH PL13G. [ ] FOUNDATION 2ND [ ] SULATION/CAULKING [ ] FRAMING /STRAPPING [vi FINAL 46� [ ] FIREPLACE &CHIMNEY [ ] FIRE SAFETY.INSPECTION ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRATION- [ ] ELECTRICAL (ROUGH) [. ] ELECTRICAL (FINAL) [ ] CODE VIOLATION [ ] PRE C/O REMARK i v� WdftVFA RMWe 5 DATE INSPECTOR / SOUTyo _ f #4 TOWN OF SOUTHOLD BUILDING DEPT. `ycoutov, 631-765-1802 INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND ffSULArN/ HULKING [ ] FRAMING/STRAPPING [ FINAL [ ] FIREPLACE & CHIMNEY [ ] FIRE SAFETY INSPECTION [ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRATION [ ] ELECTRICAL (ROUGH) [ ] ELECTRICAL (FINAL) [ ] CODE VIOLATION [ ] PRE C/O [ ]-- 1RENTAL « � W REMARKS:( (h A , DATE INSPECTOR :'t.`..,�1, �. _ ..� 71+11 • :, - r r.,Ini� 1i it 1,11ye'`,,.• T r�llw NE N _ '-` .— ! (,�- ^ .+•say i l i OA ✓. i I •ice, e* - .~• r • 1 11r%. Z{f r �' 1� 14 lo On ry- Mot IMIRV IN fes ► ( •'�y. ► �, v�:�f, r ,F d ,: ; i N4 Y9G ii(i Y .y •� .�...� � yrs. t ► � .. �_.`:P. � +�'"�. Jam, �'���►v � '• �y � '\- �yti � f^_'ate '� 1 `• -- � - ;,\ ay 3 ~ � 1 ,. � Ili=�•1#•♦ � �1 � •�� _ � SS��i'� Oji � "oa ♦ , ♦ � �'1 4V I • fir_' � s. •i '� -�- �-y I INK Ao 94 VWX lop "21 Lv PPA k TilA IF NO t Vul a IF ,;^,: > ,�y; - �4 � ���;�« J r:� ,r��'•¢I�r�d�rp�°�r'�r�`Y'9¢a'�•16°If vL aPr� ._.#- ;* �W"AM v{;{+�3D$i�b�1e�►� ��jis' '"�r:<�j' `°I��'��'.,i`�'�:ifalljs,!�r�{�v�o Uw Ng NN xx 51 A low IN AAM ♦Ss 0�III' Eelam. 6 � -` �� .0s SIMON P. Ogg W*Ml �_ ►ee ►1♦ IN �' ' ►eeiel� � R ,r ,► 'VAR _.:. r FIELD INSPECTION REPORT DATE COMMENTS FOUNDATION (IST) t ------------------------------------ 'FOUNDATION (2ND) ROUGH FRAMING PLUMBING INSULATION PER N.Y. • H STATE ENERGY CODE Y V51 vzvi 6 0 wt i S A FINAL, ( y m - ADDITIONAL.COMMS TS -t y- nAAASOLl 5 ' d ` b - H TOWN NG'DEPARTMENT SCS JTH BUILDING PERMIT APPLICATION CHECKLIST BUILDING- TO"HALL Do you have or need the following,before applying? SOUTHOLD,NY 11971 Board of Health TEL: (631)765-1802 4,sets of Building Plans FAX: (631)765-9502 Planning Board approval Southoldtownny.gov PERMIT NO. 3Survey Check Septic Form N.Y.S.D.E.C. Trustees C.O.Application Examined /6 D QM� Flood Permit 20—td— y Single&Separate D Truss Identification Form OCT 2 4 2018 Storm-Water Assessment Form Contact: Approved20 BUILDING DEFT. Mail tos6)I m J24. Disapprov*a/c TOWN OF SO OLD Lr? ?I `T r Phone: Expiration 20 i Buil g pector APPLICATION FOR BUILDING PERMIT DateV4bJKZ , 20 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. t (S"ature licant or nan. ,' a co poration) �I>�v� h (Mailing address of applicant) State whether applicant is own Wesee gent, architect, engineer, general contractor, electrician,plumber or builder Name of owner of premises= `i ce G p� IV-3 � (As on the tax rol#rate' stdeed) If applicant is a corporation, signature of duly authorized officer J, (Name and title of corporate offi r) Builders License No. ; Plumbers License No. Electricians License No. Other Trade's License No. 1. Location of land on which proposed work will be don House Tumber Street Ha et County Tax Map No. 1000 Section Block _Lot f Subdivisions Filed Map No. Lot 2. State existing use and occupancy of premis nt nded u a d oc upanc f rop sed consA4 aw truction: a. Existing use and occupancy U' V ; �'° b. Intended use and occupancy 3. Nature of work(check which applicable): New Building Addition Repair Alterati�on) P Removal Demolition Other Work4�a(Desc 4. Estimated Cost , �� Fee 5. If dwelling,number off dwellingunits (To be paid on filing this application) 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 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 Rear Depth 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_,)�NQ 13. Will lot be re-graded? YE NO Will excess fill be removed from premises?YES NOX 14.Names of Owner oqre Tk- - dress Phone No. Name of Architectl. Ad ess Phone No Name of Contractoddress Phone No. 15 a. Is this property within 100 feet of a tidal wetland or a freshwater wetland? *YES N * IF YES, SOUTHOLD TOWN TRUSTEES &D.E.C. PERMITS MA REQUIRED. b. Is this property within 300 feet of a tidal wetland? *YES N * 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: COUNTX_OF ) C ,440bl 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. Swo fore me thi ay of Z) 201w—_ EVE 4�IILINER Notary Pu lic NO ARY PUBLIC STATE OF NEW Y" SUFFOLK COUNTY SiNA �gnal- -A f Applic LIC.# 16231 COMM.D(P. Town Hall Annex Telephone(631)765-1802 54375 Main Road (631)765-gg5p P.O.Box 1179 roper.richertfr .ex(681) 6.ny.us Southold,NY 11971-0959 Q��COU0,�\,�a� • BUILDING DEPARTMENT TOWN OF SOUTHOLD APPLICATION FOR ELECTRICAL INSPECTION QUESTED BY: Mo rm m\ (ItrC e 0C Date: ;, I )mpany Name: r Mme: 2 VA r ,i pvo ,ense No.: idress: 1�7�7�' b\/\co y--, Ave, nd roo: ) 174-- ione )� QSITE INFORMATION: (*Indicates required information) lame: zIdress: Chi\T\ Sfiymi ` -M doss Street: \J'\ hone No.: q15 Ce, 1 . 3 . 81�Jq :rmit No.. L4 3 1 9 X-Map District: 1000 Section: Block:�_ Lot:. RIFF DESCRIPTION OF WORK (Please Print Clearly) p� r lease Circle All That Apply) job ready for inspection: YES NO. Rough In Ffnal o-you need a Temp Certificate: YES QNP mp Information (If,needed) arvice Size: 1 Phase 3Phase 100 150 200 300 350 400 Other ew'Service: Re-eonneot Underground Number of Meters Change of Service Overhead ditionaf Information: PAYMENT DUE WITH APPLICATION 0 t'�'�ce w i CC41 . H0M-e,JVJJAQ_1- —D.(C e S * - Lob— .82-Request for Inspectlon Form r i Scott .A. R. s•'ell. ° r SUPEPV1. 80R' UTHOLU3bWNHAL'L-P:( .Bqg��79 .1\UN A1VfEN4.•JEN 59095 MOin Road-30VTHOLD;NEW-YogK 11Y1i M. 4 ' :Taws:. -of SoW��iold CHAPTER.236 - STORMWATER.MAIVAGEMEN"T'Wo ST ET .( TO-BE COM.PLETED:BYTyE APPLICANT) DOES' 'THIS• PROJECT INVOLVE—ANY. of TM FOLWWIN(G: Yes fNo -CHE01f ALL•THAT APPLY) t#.A. Clearing, 'grubbing, grading or strippfng.of land which -affects.more .than.5;000-stluare feet Of'ground surface., Q� B. Excavation.or filftng involving more:than.200 Cubic yards'of�ma r' within an: to 1a'1 Y par.61 or any corltiVous .area. 0 C. .Srte preparation on $lopes.wl ich exceed. 1,.0.feet Vertical Tice to. 10.0 feet of'�hori�zontal.distance, 0 D: Site preparation within 100 feet of wet.1ands beach, bluff or coastal erosion .hazard area. E. Site preparation within the one-hundred-y.ear floodplain.-as depicted on FIRM Map-of any watercourse.. F. Installation .of new or resurfaced Impervious surfaces Of' 1,000 square feet or,more, 'u:n.less prior approval -of•a-Storm.water Mgem anaent Control Plan was :received by the Town 'and the proposal includes in-kind replace rnen.t of '.impervious surfaces.. If you answered,NO to-all bf the questions above;•STOP! -Ctimplete•the Applicant Signature •section below vrltii.yqur'Name,,.contact.Informatfony Date & Cauhty.Tux.MAap:Number 1 'Chapter 23.6 does not apply to your,project. If•you.answered"•YES tb one-or more of the above, please submit Two coples•of a 5tbrmwater Management•Contrbf Plan and a completed:Check List Form to,the Building..Department wltg'—your Bulldlog Permit Application. I p LICA. (Pro rt — — -ICtT.M. 1.000 Date: R?_..Y.a�ter,'.Desige pr Jexslbrml,Aglrit,�ontladtot,ether) i_k NAME: G 5!'ogon Lot Contact InrormattotL *** FOR BUILDING DEPARTMENT-USE ONLY**** RelepMne Nnmheri I' - - - - - - - - - - - Reviewed.By: i - - - `" — I [_MEg_ty Address/Lo ation.of Constrl icti 'n Work: _ _ _ Date: IL Approved•for.processing Building Permit: I I :St�ormu>ater.Mana emerit — — — •— — — 8 — Contt•ol•Plan.NntRequired. Stvrmwatdf ftnageinent:Conthol:P,lan'isReq u:ifed.: (Forwatd to Engineering Depattment for Review.) FORM * SMCR-Tos M AY 2014 -- � VAI FORM NO. 3 n 6-� � TOWN OF SOUTHOLD Pee- H/L_ BUILDING DEPARTMENT SOUTHOLD,N.Y. NOTICE OF DISAPPROVAL DATE: October 31, 2018 TO: Courtne Hoblock 530 Orchar Street Orient,NY 1 57 i' Please take notice that you application dated October 24, 2018: /' For permit to construct accesso in-ground swimming pool at: Location of property: 530 Orchard eet Orient NY County Tax Map No. 1000—Section 2 Bl k 4 Lot 7 Is returned herewith and disapproved on th f Y owing grounds: The proposed construction on this non-c for in 18,100 s uare foot lot in the Residential R-40 District is not permitted without revie and apAroval bv the Southold Town Landmarks Preservation Commission because t V e propejjy is isted on either the Southold Town New York State and/or the National Re ister of Historic plach and requires review by the Southold Town Landmarks Preservation Comm' sion. If the requirements of the to/n code ertaining to Land rks Local Law No.22 are met a Certificate of AppropriatWess C of A will be issued. Thk of A is required before a Building Permit will be a rove . Information about the re uirementsora 1 in for a C of A is available at the inform.ation counter in the Building De artmen . /further Signature Note ant: Any change or deviation to the above referenced application may, requirreview by the Southold Town Building Department. CC: file,Landmark SURVEY OF PROPER7 N A T ORIENT ORCHARD STREET - (501), TOWN OF SOUTHOLE SUFFOLK COUNTY, X EDGE OF PAVEMENT 1000-25-04-0 �- OHOH OH OH m�P SCALE.• V--20 OH UP off N8740'40"E JULY 9, 2018 CMF SW 19'00"E 91.20' 30.90' CMF ' ®WELL GUYWIRE ,. Wm W C7 1 r J •f � N ZOLu B' GATE j a 23.41 a, PICKET FE. O FE.COR. DEER FENCE t - m N 1.1'w 28.T J m FF-POR. 2 STY ' FR. i 1 STY. N/0/F WD.F OR/I AC +� HOU E EUGENE MOTSA 2°,� 25 B' wooD FE SUSAN MOTSA - ( �j WY.COR. • o, COVERED DECK WALK 4.1'E LOT COVERAGE - --- 2E'4 37.4• g FUND N 0 F V 24.2' OE 3.o'E EXISTING: LAURA OWENS HOUSE & DECK 1709 sq.ft N CHIM. GARAGE & SHED 1108 sq.ft 1 STY. FR. A ND . 2M sq. GARAGE o DECK ft 2817/18100 = 15.69 Ld 9.5' STOP E PROPOSED: w r _ 1 s.2' FUND Ld HOUSE & DECK 1709 sq.ft �` 3.o'E GARAGE & SHED 1108 sq.ft o w El o POOL 450 sq.ft o _ _ OUT SHOWER OT ' 3N, sq ft 3 + ON DECK 11.7' TUB �1..5W 3267/18100 = 18.09J DECK WY.COR. O � 4.5'E KEY o l o Q = REBAR O , ® = WELL CP COVER 8.5' 5.1' A = STAKE BLDG. 2 SHED �o OF NEiv r 3.0'w i o). ��P T 0 = TEST HOLE SF �f- • = PIPES, 19.0'^ * �� ■ = MONUMENT I PROPOSED POOL b 0 ' = WEMAND FLAG CMF 5.0'-� c-QL, = UTILITY POLE FE 2.3'w Mo.q�ya N.Y.S LIC. NO. FUND N8749'00"W DEER FENCE FECOR. CMF MORS, P.C. = HYDRANT 1.2'S 122.10 c N/O/F 0•7'S (6 —5020 FAX (631) 765— ANY ALTERATION OR ADD177ON TO THIS SURVEY IS A WOLA77ON OF SECTION 7209OF I CHRISTINE MORTON P.O. BOX 909 7HE NEW.:YORK STA7E EDUCATION LAW. EXCEPT AS PER SECTION 7209—SUBDIVISION 11971 SOUTHOLD, 2. ALL ONLY IFS 7lF7CID AP OR COPIES BEAR 7HEALI�MPRESSED SEAL OF 7HFOR THIS MAP AND �SURVEYORIES OINHOSE AREA= 18,100 SO. FT. 1230 TRAVELER STREET 18-1 N.Y. ^'^"IA n iQP' APPEARS HEREON. SURVEY OF PROPERTY N AT ORIENT ORCHARD STREET - (50 ) TOWN OF SOUTHOLD SUFFOLK COUNTY, N. Y. m EDGE OF PAVEMENT _ 1000-25-04-07 `�— OH off off rn�P SCALE: 1'—�20 CMF OH uP OH OH N8740'40"E JULY 9, 2018 S86'19'00"E 91.20• 30.90' CMF ®WELL GUYWIRE W rw�T' m W �\ z $ w o � N W � B' GATE 23.4' OO FE.COR. DEER FENCE � PICKET FE.--,, NO 1.1'W 26.7' //�"I rq Z FE.0' o.5W o 2 STY. FR. i 1 STY. N � N/0/F WD.FE.COR./I AC HOUSE EUGENE MOISA 2.0'W 25.8 WOOD FE. SUSAN MOISA COVERED DECK WALK WY.COR. bo 4.1'E LOT COVERAGE 37.4' s FUND EXISTING. N/O/F 3.O'E cE HOUSE & DECK 1709 sq.ft LAURA OWENS _ CHIM. GARAGE & SHED 1108 sq.ft. 1 STY. FR. ? NO FLR. 287 sq.ft. GARAGE 4 DECK 2817/18100 = 15.6% w STOCKADE z 9.5' FEN. PROPOSED: LLJ 16.2' FUND HOUSE & DECK 1709 sq.ft. w 3.o'E GARAGE & SHED 1108 sq.ft. p w o POOL 450 sq.ft. J 3A7 sq. h. OUT SHOWER OT FF-COR ON DECK 11.7' TUB 1.5'W 3267/18100 = 18.0`Y. DECK \ WY.COR. Ln KEY o 4.5'E 0 0 Q = REBAR ODo ® = WELL CP COVER B.S. A = STAKE G. SHED 9 = TEST HOLE 3.0'w 20), �A��4F HE�rQ �*.MET�C �{- �-p • = PIPE 45� 19.0' �F ■ = MONUMENT PROPOSED POOL o o = WETLAND FLAGCD CMF 5.0'-14 = UTILITY POLE FE. 2.3'W CMF '� �• 60 N.Y.S. LIC. NO. 49618 No' HYDRANT 1.2S FE. N8T49 00"w N/O/F DEER FENCE 122.10' 0.7'S MORS, P.C. ' ANY ALTERATION OR ADDITION TO THIS SURVEY IS A VIOLATION OF SECTION 7209OF CHRISTINE MORTON (6`.S9) 7 -5020 FAX (631) 765-1797 THE NEW. .YORK STATE EDUCATION LAW. EXCEPT AS PER SECTION 7209—SUBDIVISION P.O. BOX 909 2. ALL CERTIFICATIONS HEREON ARE VAUD FOR THIS MAP AND COPIES 'THEREOF �, 1230 TRAVELER STREET ONLY IF SAID MAP OR COPIES BEAR THE IMPRESSED SEAL OF THE SURVEYOR WHOSE A1r,A= 18,100 SO. FT. SOUTHOLD, N.Y. 11971 118-1341 SIGNA7URE APPEARS HEREON. Suffolk County Dept of Labor, Licensing&Consumer Affairs HOME IMPROVEMENT LICENSE Name RANDY RODECKER Business Name ,x FENCE KING OF ROCKY POINT INC This certifies that the bearer is duly licensed License Number H-21412 by the County of Suffolk Issued: 06/01/1992 Commissioner Expires: 06101/2020 I rj Y RK Workers' CERTIFICATE OF STATE Compematlon NYS WORKERS' COMPENSATION INSURANCE COVERAGE Board 1 a.Legal Name&Address of Insured(use street address only) 1 b.Business Telephone Number of Insured Fence King of Rocky Point,Inc. 631-744-8100 DBA Swim Kings Pools&Patios 471 Route 25A Rocky Point,NY 11778 1 c.NYS Unemployment Insurance Employer Registration Number of Insured Work Location of Insured(Only required if coverage is specifically limited to 1d.Federal Employer Identification Number of Insured or Social Security certain locations in New York State,i.e.,a Wrap-Up Policy) Number 11-3008276 2.Name and Address of Entity Requesting Proof of Coverage 3a.Name of Insurance Carrier (Entity Being Listed as the Certificate Holder) Sentinel Insurance Company Town of Southold 53095 Rt.25 3b.Policy Number of Entity Listed in Box"1 a" PO Box 1179 12WEOJ2677 Southold,NY 11971 3c.Policy effective period 09/01!2018 to 09/01/2019 3d.The Proprietor,Partners or Executive Officers are QX included.(Only check box If all partners/officers Included) all excluded or certain partners/officers excluded. This certifies that the insurance carrier indicated above in box"3"insures the business referenced above in box"1 a"for workers' compensation under the New York State Workers'Compensation Law.(To use this form,New York(NY)must be listed under Item 3A on the INFORMATION PAGE of the workers'compensation insurance policy). The Insurance Carrier or its licensed agent will send this Certificate of Insurance to the entity listed above as the certificate holder in box 7'. The insurance carrier must notify the above certificate holder and the Workers'Compensation Board within 10 days IF a policy is canceled due to nonpayment of premiums or within 30 days IF there are reasons other than nonpayment of premiums that cancel the policy or eliminate the insured from the coverage indicated on this Certificate.(These notices may be sent by regular mail.)Otherwise,this Certificate is valid for one year after this form Is approved by the insurance carrier or its licensed agent,or until the policy expiration date listed in box"3c",whichever is earlier. This certificate is issued as a matter of information only and confers no rights upon the certificate holder.This certificate does not amend, extend or alter the coverage afforded by the policy listed,nor does it confer any rights or responsibilities beyond those contained in the referenced policy. This certificate may be used as evidence of a Workers'Compensation contract of insurance only while the underlying policy is in effect. Please Note:Upon cancellation of the workers'compensation policy indicated on this form,if the business continues to be named on a permit,license or contract issued by a certificate holder,the business must provide that certificate holder with a new Certificate of Workers'Compensation Coverage or other authorized proof that the business Is complying with the mandatory coverage requirements of the New York State Workers'Compensation Law. Under penalty of perjury,l certify that I am an authorized representative or licensed agent of the Insurance carrier referenced above and that the named insured has the coverage as depicted on this form. Approved by: Bethany Frabizio (Print name of authorized representative or licensed agent of insurance carrier) Approved by: ( nature) (Date) Trifle:Account Executive Telephone Number of authorized representative or licensed agent of insurance carrier. 631-465-4000 Please Note:Only insurance carriers and their licensed agents are authorized to issue Form C-105.2.Insurance brokers areIj•OT authorized to issue it C-105.2(9-17) www.wcb.ny.gov r,�YTARK TE Compensation N workers' CERTIFICATE OF INSURANCE COVERAGE Board DISABILITY AND PAID FAMILY LEAVE BENEFITS LAW PART 1.To be completed by Disability and Paid Family Leave Benefits Carrier or Licensed Insurance Agent of that Carrier la.Legal Name&Address of Insured(use street address only) 1 b.Business Telephone Number of Insured FENCE KING OF ROCKY POINT INC.DBA SWIM KING POOLS&PATIOS 471 ROUTE 25A ROCKY POINT,NY 11778 1c.Federal Employer Identification Number of Insured Work Location of Insured(Only required if coverage is specifically limited to or Social Security Number certain locations in New York State,i.e.,Wrap-Up Policy) 113008276 2.Name and Address of Entity Requesting Proof of Coverage 3a.Name of Insurance Carrier (Entity Being Listed as the Certificate Holder) ShelterPoint Life Insurance Company Town of Southold 3b.Policy Number of Entity Listed in Box"l a" 53095 Route 25 DBL37154 P.O. Box 1179 3c.Policy effective period Southold, NY 11971-0000 02/01/2018 to 01/31/2019 4. Policy provides the following benefits: © A.Both disability and paid family leave benefits. F] B.Disability benefits only. ❑ C.Paid family leave benefits only. 5. Policy covers: © A.All of the employer's employees eligible under the NYS Disability and Paid Family Leave Benefits Law. B.Only the following class or classes of employer's employees: Under penalty of perjury,I certify that I am an authorized representative or licensed agent of the insurance carrier referenced above and that the named insured has NYS Disability and/or Paid Family Leave Benefits insurance coverage as described above . Date Signed 2/2/2018 By Will (Signature of insurance carrier's authorized representative or NYS Licensed Insurance Agent of that insurance carrier) Telephone Number 516-829-8100 Name and Title Richard White, Chief Executive Officer IMPORTANT: If Boxes 4A and 5A are checked,and this form is signed by the insurance carrier's authorized representative or NYS Licensed Insurance Agent of that carrier,this certificate is COMPLETE. Mail it directly to the certificate holder. If Box 4B,4C or 5B is checked,this certificate is NOT COMPLETE for purposes of Section 220,Subd.8 of the NYS Disability and Paid Family Leave Benefits Law. It must be mailed for completion to the Workers'Compensation Board, Plans Acceptance Unit,PO Box 5200,Binghamton, NY 13902-5200. PART 2.To be completed by the NYS Workers'Compensation Board (only if Box 4C or 513 of Part 1 has been checked) State of New York Workers' Compensation Board According to information maintained by the NYS Workers'Compensation Board,the above-named employer has complied with the NYS Disability and Paid Family Leave Benefits Law with respect to all of his/her employees. Date Signed By (Signature of Authorized NYS Workers'compensation Board Employee) Telephone Number Name and Title Please Note:Only insurance carriers licensed to write NYS disability and paid family leave benefits insurance policies and NYS licensed insurance agents of those insurance carriers are authorized to issue Form DB-120.1.Insurance brokers are NOT authorized to issue this form. DB-120.1 (10-17) 1111111 i�iiiuiii�iiiiu�iiiiiiiu�iiiIIIII APR VED AS NOTED ELECTRICAL INSPECTION REQUIRED DATE: B.P.-l" FEE: 11b0 BY: NOTIFY BUILDING DEPATIrENT AT . 765-1802 8 AM TO 4 PM FOR THE FOLLOWING INSPECTIONS: 1.. FOUNDATION - TWO REQUIRED a . .FOR POURED CONCRETE 2. ROUGH FRAMING & PLUMBING !"RETAIN STORM WATER RUNOFF 3. INSULATION PURSUANT TO CHAPTER 236 4. FINAL - CONSTRUCTION MUST OF THE TOWN CODE. 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. ; r--�3 S33 "JW J EMM 1-F-i.Y' ;ELOSEP . OOL TO CODE NC UPON COMPLETION !BEFORE"WATER" d0 SNOWON00 ONd 0381n03E1 SV S3003 NMOi T 31d1S N80,k M3N d0 S3000 JIV H11M AldW00 OCCUPANCY OF USE IS UNLAWF?-" WITHOUT CERTIFi-�-'r''` - OF OCCUPANCY NOTES 10" 45' 10" l/1 1. NO SOIL SURCHARGE PERMITTED WITHIN 4 FEET OF EXCAVATION AT THE SHALLOW END,OR6 FEET OF EXCAVATION ATTHE DEEP END. O 0 2• THIS POOL MEETS THE REQUIREMENTS OFANSI/NSPI-5 "AMERICAN NATIONAL STANDARD FOR RESIDENTIAL INGROUND SWIMMING POOLS'AND 1996 BOCA CODE-SECTION 421. DIVING EQUIPMENT 15 NOTALLOWED. < X�3 3. SWIMMING POOL SHALL BE COMPLETELYAND CONTINUOUSLY SURROUNDED WITH A BARRIER CONSTRUCTED LAW REQUIREMENTS OF o� H2O b SECTION R326.5.3OFTHE INTERNATIONAL RESIDENTIAL CODE(2016)AND IN CON FORMITY WITH ALL SECTIONS OFTHE SOUTHOLD 5'-O 00 TOWN CODE.ACCESS GATES SHALL COMPLY WITH SECTION R326.5.20FTHE IRCAND BE SELF CLOSING,SELF LATCHING AND BE SECURELY LOCKED WHEN POOL 15 NOT IN USE OR SUPERVISED.ALL GATES ARE TO OPEN AWAY FROM THE POOL AREA. Q n 0 4. DURING CONSTRUCTION THE CONTRACTOR 5HALL ERECTA TEMPORARY BARRIERAROUND THE EXCAVATION LAW THE CODE OF THE O TOWN OFSOUTHOLD. V 3 PLAN5. POOL MUST BE EQUIP PEI)WITH AN AP PROVED POOL AIA RM CAPABLE OF DETECTING ACHILE)ENTERING THE WATER ANDSOUNDING QZ AN AUDIBLE ALARM WHEN DETECTED THAT 15 AUDIBLE AT POOL51PE ANDATANOTHER LOCATION ON THE PREMISES WHERE THE POOL ZLn I5 LOCATED. THE ALARM MUST BE INSTALLED,MAINTAINED AND USED IN ACCORDANCE WITH THE MANUFACTURERS INSTRUCTIONS. Y N c THE ALARM MUST MEETASTM F2208 "STANDARD SPECIFICATION FOR POOL ALARMS. THE DEVICE MUST OPERATE INDEPENDENT(NOT C 3� ATTACHED TO OR DEPENDENTON)OF PERSONS. < 3�� 6. POOL SUCTION FITTINGS(EXCEPT FOR SURFACE SKIMMERS)MUST BE PROVIDED WITH A COVER THAT CONFORMS TO A5ME/ANSI A112.19.8M OR A MINIMUM 18"x 23"DRAIN GRATE ORA CHANNEL DRAIN SYSTEM. POOL CIRCULATION SYSTEM MUST BE EQUIPPED WITH ATMOSPHERIC VACUUM RELIEF IN THE EVENT THE GRATE COVERS LOCATED WITHIN THE POOL BECOMEM155ING OR BROKEN. SUCH Y VINYL COVERED VACUUM RELIEF SYSTEMS SHALL CON FORM WITH A5ME A112.19.17 OR BE A GRAVITY SYSTEM APPROVED BY THE TOWN OF 5OUTHOLD. CONCRETE END STEP POOL SHALL BE PROVIDED WITH A MIN IMUM OF 2 SUCTION FITTINGS OF TH E ABOVE MENTIONED TYPE. TH E SUCTION FITTINGS SHALL BE SEPARATED BY MINIMUM 0F3'AND MUST BE PIPED SUCH THAT WATER 15 DRAWN THROUGH THEM 51MULTAN EOVSLY TH ROUGH A 3'-6" VACUUM RELIEF-PROTECTED LINE TO THE PUMP(OR PUMPS) VACUUM/PRE55URE CLEANING FITTINGS SHALL BE IN AN ACCE551BLE POSITION,MINIMUM OF 6-AND NO GREATER THAN 12"BELOW THE MINIMUM OPERATIONAL WATER LEVEL OR BEAN ATTACHM ENT TO THE SKIMMER/SKIMMERS. n QJ rn 2-to 4-SAND BOTTOM 7. ALL ELECTRICAL WORK SHALL COMPLY WITH THE REQUIREMENTS OF NFPA 70 CNEC)PRINCIPALLY ARTICLE 660 AND THE IRC SECTIONS j., SECTION A 4201 THROUGH 4206. ALL ELECTRICAL DEVICES MUST BE APPROVED BY UNDERWRITERS LABORATORIES AND BE PROTECTED BY Ql Z GROUND FAULT CURRENT INTERRUPTER(GFCI) CUR?ENT CARRYINGELECTRICAL CON DUCTORSEXCEPT FOP,TH05EPROVIDING POWER "CT TO POOL LIGHTING AND POOL EQVIPMENT 5HALL MEET THE SEPARATION REQUIREMENTS OF TABLE E4203.5.ALL METAL ENCLOSURES, O FENCES OR RAILINGS NEAR ORAD)ACENTTO THE SWIMMING POOL THAT MAY BECOME ELECTRICALLY CHARGED DUE TO CONTACT WITH AN ELECTRICAL CIRCUITS HALL BE EFFECTIVELY GROUNDED, B. WATEK 50VRCE FILLING THE POOL SHALL BE EQUIPPED WITH A BACKFLOW PROTECTION DEVICE IAW NY5 PLUMBING CODE 608. �20 O v 9. ALL PIPING 15 DIAGRAMMATIC UNLESS OTHERWISESTATED. 0 O s TOP OF WALL WATER LINE 10. WALKS IF PROVIDED SHALL BE NONSLIP AND SLOPE AWAY FROM POOL EDGE. 0 O vQj 'n 2' 6' 2' 11, A MEANS OF EGRESS FOR DEEP AND SHALLOW ENDS MVST BE PROVIDED IAW ANSI/NSPI-5 SECTION 6. S+ oq 12. CONTRACTOR TO PLACE THE POOL LAW TOWN OF SOVTHOLD CODE SETBACKS. n '9 13. ALL DRAINAGE FROM THE POOL SHALL BE MAINTAINED ON THE SUBJECT PROPERTY. m 15. THE DESIGN 15 BASED ON A DRAINAGE 501L WITH(10%SILT. GROUND WATER SHALL NOT EXIST WITHIN THE EXCAVATION. IFGROVND SECTION B WATER EXISTS WITHIN 6'-O"FROM GRADE,DEWATERING FACILITIES WILL BE REQUIRED. 0 16. ALL GAS AND OIL HEATERS(IF INSTALLED)FOR THE INGROVND SWIMMING POOL SHALL BE NATIONAL APPLIANCE ENERGY - CONSERVATION ACT(NAECA)COMPLIANT. POOL HFATER5 SHALL BE TESTED IAW ANSI 221.56 AND SHALL BE INSTALLED LAW MAN VFACTVRERS SPECIFICATIONS. OIL FIRED POOL HEATERS SHALL BE TESTED IAW UL726• POOL HEATERS SHALL BE LOCATED OR GUARDED TO PROTECT AGAINST ACCI DENTAL CONTACT OF HOT SURFACES BY PERSONS. POOL HEATER5 SHALL BE PROVIDED WITH f� TEMPERATVREAND PRE55URE-RELIEF VALVES. FOR HEATERS NOT PROVIDED WITH AN INTEGRAL BYPA55 SYSTEM. A BYPASS LINE SHALL �; W) CHECK VALVE 2'-2" BE INSTALLED FROM INLET TO OUTLET TO ADJVST WATER FLOW THROUGH THE HEATER. POOL HEATERS SHALL BE PROVIDED WITH THE a FROM SKIMMER COPING AND WALKWAY 00 PUMP FOLLOWING ENERGY CONSERVATION MEASURES: 00 10 00 MOTHERS) GRADE 16.1 AT LEAST ONE THERMOSTAT5HALL BE PROVIDEDFOR EACH HEATING5Y5TEM. Z y +_ WATER LINE E. 16.2 ALL POOL HEATERS SHALL BE EQUIPPED WITH AN ON-OFF SWITCH MOUNTED FOR EASYACCE55 TO ALLOW SHUTTING OFF THE OP ERATION OF TH E H EATER WITHOUT A P)USTI NG TH E TH ERMOSTAT SETTI NG AN P TO ALLOW RESTARTING WITHOUT RELIGHTING TH E PILOT LIGHT. W d h a-eV ro DlscosAv VNDISNRBED EARTH y� 16.3 HEATED SWIMMING POOLS SHALL BE EQUIPPED WITH A POOL COVER(EXEMPTED FROM THIS REQUIREMENTARE OUTDOOR POOLS W Q r o0 co q DRYWELL 3500 PSI POVRED CONC. •d - DERIVING 20%OFTHE ENERGY FOR HEATING FROM RENEWABLE SOURCES AS COMPUTED OVERAN OPERATING SEASON) "� VIy / v 16.4 TIME CLOCKS SHALL BE INSTALLED 50 THE PUMP CAN BE 5ET TO RUN DURING OFF-PEAK ELECTRICAL DEMAND PERIODS AND CAN BESET " -Z J/ 3ie°REBAR.2)TVP. ° TO RUN THE MINIMUM TME NECESSARY TO MAINTAIN THE POOL WATER IN A CLEAN AND SANITARY CONDITION IAW APPLICABLE (y� ; �o c~o co p ,j VALVE O VINYL LINER '.•d \ SANITARY CODE OF NEW YORK STATE. WL' = o ff 2'TO415AND W A C` er �"""�"'d O 17. TH15DRAWING15FORSTRUCTURALSHELLONLY. ALLACCE550RIE5ANDAPPURTENANCESAREDEFINEDBYOTHERS. N 0 FILTER `�••�F / r 18. BACKFILL WITH CLEAN EARTH,FREE OF ROOTS AND DEBRIS. DO NOTALLOW THE HEIGHT OF BACKFILL TO EXCEED THE HEIGHT OF THE O h°'ILL.a WATER IN THE POOL BY MORE THAN 8",OR THE WATER TO EXCEED BACKFILL BY MORE THAN 8" •19. PLACE CONCRETE ON SANDY TO LOAM SOIL. REMOVE ANY CLAY DEPOSIT AND REPLACE W/COMPACTED CLEAN BACKFILL. ��OF NE I (NOT N TVERTISHOWN)REBAR®3'O.G 20. THERE 15 NO MAIN DRAIN IN THIS POOL. SUCTION FOR POOL WATER CIRCULATION 15 PROVIDED BY THE SKIMMERS ONLY. THIS MEETS P NER Ty0 .p REQUIREMENTS OF THE IRC-SECTION R326.6 FOR ENTRAPMENT PROTECTION. Z-111 WALL SECTION 21. THE POOL WAS DESIGNED IAW THE FOLLOWING: L r- r 21.1. TH 42(2016) V"` TO RENRNS N.T.S. ('7 U a .( fi u° b 211. THE INTERNATIONAL ENERGY CONSERVATION CONSTRUCTION CODE-SECTION 8403.10(2015) CHECK VALVE ;.- "'j•r, (V 21.3. TH E I NTERNATIONAL FUEL GAS CODE(2015) � •-•+-. .-% I(I�r, 21.4. THE NEW YORK STATE CODE SVPPLEMENT-SECTIONR326 (20 7) 21.5. TH E N EW YORK STATE SANITARY CODE. 21.6. ANSI/N5PI-5 STANDARD FOR RESIDENTIAL IN-GROUND SWIMMING POOLS. A ��84721.7. BOCA CODE-5ECTION 421. 5 ' 21.8. CODE OF THE TOWN OF SOUTHOLD. �OFCSSI0\ PLUMBING SCHEMATIC 22. 'ALL BACKWASH TOBESELF-CONTAINED ON-SITE. N.T.5.