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Home My WebLink About27301-ZFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No: Z-28582 Date: 07/11/02 T~IS CERTIFIES that the building ACCESSORY Location of Property: 1940 DUCK POND RD (HOUSE NO.) (STREET) Cotunty Tax Map No. 473889 Section 83 Block 4 CUTCHOGUE (HAMLET) Lot 4 Subdivision Filed Map No. __ Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated MAY 7, 2001 pursuant to which Building Permit No. 27301-Z dated MAY 10, 2001 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 INGROtrND SWIMMING POOL WITH FENCE TO CODE AS APPLIED FOR. Tg~e certificate is issued to CATHERINE & WILLIAM A MULP~AIN JR ( OWNER ) of the aforesaid building. SUFFOLK COUqqTY DEPARTMENT OF ~rF~LT~ AI~PROVAL ELEC'~RICAL CERTIFICATE NO. PLt~4BERS CERTIFICATION DAT~U Rev. 1/81 N/A 53238 06/26/01 N/A //~i Zed~ignature FORM NO. 3 TOWN OF SOUTHOLD BUILDING DEPARTMENT Town Hall Southold, N.Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) PERMIT NO. 27301 Z Date MAY 10, 2001 Permission is hereby granted to: WILLIAM A MULRAIN, JR. 1940 DUCK POND RD CUTCHOGUE,NY 11935 for : CONSTRUCT ACCESSORY INGROUND SWIMMING POOL WITH FENCE TO CODE AS APPLIED FOR. at pren%ises located at 1940 County Tax Map No. 473889 Section 083 pursuant to application dated MAY Building Inspector. DUCK POND RD CUTCHOGUE Block 0004 Lot No. 004 7, 2001 and approved by the Fee $ 150.00 Rev. 2/19/98 Form No. 6 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL ..... ¥' APPLICATION FOR CERTIFICATE OF OCCUPANC ~ ~ This application must be filled in by typewriter or ink and submitted to the Building Dep~tme~with !he A. For new building or new use: ~-'""~'~ .k~'.i~.~.~ 1. Final survey of property with accurate location of all buildings, property lines, streets, and unusual natural 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 dweliing $25.00, Additions to dwelling $25.00, Alterations to dwelling $25.00, Swimming pool $25.00, Accessory building $25.00, Additions to accessory building $25.00, Businesses $50.00. 2. Certificate of Occupancy on Pre-existing Building - $100.00 3. Copy of Certificate of Occupancy- $25.00 4. Updated Certificate of Occupancy - $50.00 5. Temporary Certificate of Occupancy - Residential $15.00, Commercial $15.00 New Construction: Location of Property: Date. House No. Old or Pre-existing Building: Street Block Owner or Owners of Property: Suffolk County Tax Map No 1000, Section Subdivision ! (check one) Permit No. =,qT-~o / ~ Date of Permit. Health Dept. Approval: Planning Board Approval: Request for: Temporary Certificate Fee Submitted: $ c~ ~.o-~ Lot Filed Map. Lot: /Applicant: Underwriters Approval: Final Certificate: (check one) Applicant SignatUre Electrical Inspection Service, Inc. 375 Dunton Avenue East Patchogue, New York 11772 (631) 286-6642 Date: 6/26/01 Application No.: 53238 Issued to: Mulrain Street: 1940 Duck Pond Road Village: Cutchogue Section: Block: Zip: 11935 Lot: Town: Southold Introduced by: Richard Kleinfeldt Lic.# 665-E wes exemined and fou~ to be/# compliance with the Notional Elect~'ical Code [] Commercial F~NV Defects [] Pool [] fst FIoor I~lndoor [~Basement [] Hot Tub [] Residential [] Det. Garage [~Attic [~2nd FIoor ~]Outdoor [] Addition [~Survey Switches Receptacles Fixtures GFI Heaters 1 I 1 1 Dishwasher Washer/Amp Dryer/Amp Oven Range/Amp Furnace Oil Gas Circulator Smoke Detector Meter Amps Phase UG/OH Telephone Television [] / [] Other Equipment: pool panell timer Building Permit No. Rnal Inspection: 6/26/01 Rough Inspection: A/C Fans Garbage Disposal Bell Transformer Carbon Monoxide President This certificate must not be altered in any manner Inspectors may be identified by their credentials Inspector: Quentin Reynolds JAMES K. MORROW, JR., P.E. DESIGN PERMITS INSPECTIONS 2066 BEDFORD AVE. · NO. BELLMORE, NY 11710 · (516) 785-8032 March 17, 2001 Town of Southold Department of Buildings Re' New Inground Swimming Pool Drainage Facilities 1940 Duck Pond Rd. Cutchogue, NY 11935 Dear Sir or Madam: The new inground swimming pool for the above referenced premises will not require permanent drainage facilities because the pool is constructed with a vinyl liner. The pool water will be continuously recirculated through the filter and will be reused from year to year. The drainage from the filter backwash is nominal and will not interfere with public highways, public water supply, existing sanitary facilities or neighboring properties. Sincerely, J tar~t~K. IV~orroV~, Jr., P. ,1~./ STATE OF NEW YO~K ,. WORKERS' COMPENSATION BOARD EMPLOYER'S APPLICATION FOR CERTIFICATE OF COMPLIANCE WITH DISABILITY BENEFITS LAW INSTRUCTIONS TO EMPLOYER: Complete PART I ONLY and have your Disability Benefits Insurance Carrier complete PART II. PART I. TO BE COMPLETED BY EMPLOYER a~oYn's ~E ~ ^~ss (.o~., ,,. o~,): LOCATION OF OPERATIONS: PREMIER POOL CONST. {T & R SWIMMING POOL SERVICE INC/DBA) 401 BROADWAY PORT JEFFERSON STATION NY. 11776 NAME UNDF_~ WHICH BUSINESS IS CONDUCTED, IF DIFFERENT FROM ABOVE: . ' .~ ~,- ~/ ~ ~1-' $i.q~aal~e of owner. Per. er or authorized* Officer PART II. TO BE COMPLETED BY. DISABIUTY BENEFITS CARPJER CERTIFICATE OF COMPLIANCE WITH DISABIUTY BENEFITS LAW This is to certify that the above-named employer is insured with NATIONAL BENEFIT UFE INSURANCE CO. (IVarne of Carrier] _Policy # $-910-0155552; and that the policy issued to the EMPLOYER covers: *a. X ALL of the EMPLOYER'S employees eligible under the New York Disability Benefits Law. 'b. ONLY the following ~lass or classes of the EMPLOYER'S employees: Date Signed, July 13r 1999 Telephone No. 212-615-7497 3-~e VICE PRESIDENT *IMPORTANT: If BOX "a" is CHECKED, this certificate is COMPLETE. Mail it directly to the employer. If BOX "b" is CHECKED, this certificate is NOT COMPLETE for purposes, of Section 220, subd. 8 of the Disability Benefits Law. It must be mailed for completion to the Workers' Compensation Board, Disability Benefits Bureau, 180 Livingston Street, Brooklyn, New York 11248-0005. PART i11. TO BE COMPLETED BY WORKERS' COMPENSATION BOARD (Only If Box 'b" of Part !1 has been checked) State of New York WORKERS' COMPENSATION BOARD There is on file with the Workers' Compensation Board, Certificates of Insurance indicating that the above-namec~employer has complied with the Disability Benefits Law with respect to all of his/her employees. bISABILITY BENEFITS BUREAU Date By. Telephone No. T'rUe THE WORKERS' DISCRIMINATION DB-120.1 (10-94) COMPENSATION BOARD EMPLOYS AND SERVES PEOPLE WITH DISABILITIES ~/ITHOUT 0~/29/200~ 07~52 7573~88363 r~u~ n,...~ ×.:~: ............................. <': ................ - ' THIS CERTIFICATE, IS ISSUED AB A MAWR OF INFORMATION p~OOUCE. ONLY AND CONFERB NO RIGHTS uPON THE CERTIFICATE NATIONAL HOUSE OF INSURANCE, INC. HOLDER. THIS cEF~TIFICATE DOES NOT AMEND, EXTEND OR 1505 CAPE ANN WAY ALTER THE COVEIRAeE AFFORDED BY THE pOLICIES BELOW. SUITE 1007 COMPANIEs AFFORDING COVERAGE.. VIRGINIA BEACH VA 23456- A SCOTTSDALE INSURANCE CO. (757) 368-B585 ( ) - IN~URED CI~%IPAN¥ S TIC INSURANCE CO. T&R SWIMMING POOLS INC., ]BA PREMIER POOLS c NY STATE INSURANCE PUND 4 01 BROADWAY PORT JEFFERSON ~ 11776- COMPANY D FIRST RE~IABILITATION INS. CO. THIS IS TO CERTIFY THAT THE pot~CIE6 OF ~N~URANCE LISTED BELOW HAVE BEEN I~U~ TO THE: INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NO~NITHBTANDING ANY REQUIREMENT, TE~:~M OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY P~RTAIN, THE INSURANCE AFFORDED ~Y THE POUCIIE~ D~$CRI~ED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS ANO CONDiTION6 OF suCH POLIClF.~ LIMITS SHOWN MAY HAVE BEEN REDUC~r~ BY PAID CLAIMS, ¢ ~..: ~,. ,.c,c-~z,~'~ si MILLION a ,~.~L X CO.aE~S.N~LL~aUW CLS0518761 04/18/00 04/18/01 m~uC~.CC~,~3~- ~1 MILLION ~pSON~^~V~JU~ el MILLION ":' qc~i~DE [~occu. ~::;~OCCUm'~c~ $1 MILLION___ OW~ER~&CON~'~O~'S~O~ ~E~M~'"") $ 50, 00U ^.¥,.To / / / t HIRED AUTO~ ~er~¥ ' NONOWNED AUTO~ AUT~ ONLY, ~% ACC]DENT I _ ,.,..u~..,u~.~uw 1112 017-? 0~/15/00 0,[/15/03. ELF-.~,H~..C~0ENT ~100~000 THEpROPRIE"fOR/ F~ INCL ELDi~EAgE.POLICYUMIT $50,0~, 000 pARTNERS~EX~CUTIVE ~LOI~EA~-EAEMPLOYEE 1100 000 D o~,m NY STATE DBL 1518870-2 05/07/00 05/07/01 CONTINUOUS COVERAGE SINCE 1995 SWIMMIN~ POOL SALES & SERVICE. TOWN OF SOUTAOLD oF ~ KINI~ THE COMP ,Im &GI[~ OR R~d'REeE#TATIYEB. SOTJTHOLD NY 11971 / 765-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLBG. [ ] FRAMING [~/~]' FINAL [ ] FIREPLACE & CHIMNEY DATE 765-~.802 BUILDING DEPT. INSPECTION [ ] FOUNDATION 1ST [] ROUGH PLBG. [ ] FOUNDATION 2ND [] I~~ATION [ ] FRAMING [~ FINAL [ ] FIREPLACE & CHIMNEY REMARKS: c~~ / / DATE INSPEL~I'OR FIELD INSPECTION I~PORT ' DATE ii II Il :: Il Il FO~ATION ( I ST) Il l: Il Il Il Il Il Il " i: Il : Il F~O~I~ll)AT I ON (2ND) ,~ ~ .... ~ II II II II il ii II Il i lI II INSULATION PER N. Y · II Il II ~ ~ = ................ ~i !~ FORM NO. 1 i ~ ! TOWN OF SOUTHOLD : J~[}l~ ~flfll BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N.Y. 11971 TEL.: 765.1802 Examined ................ , 19.. o pproved .. 5 .'1.. ..... : roved a/c APPLICATION FOR BUILDING PERMIT §OAR§ 0P ~tEAL~=it 3 SETS OF PLAN'S -~URV r_y CHECK SEPTIC FOR,'[ ..... ' ......... hO~ ~ py: CAL~ ;g ................. : ' : INSTRUCTIONS a. This applieati0n must be completely filled in by typewriter or in ink and submitted to the BUilding Inspector, with 3 ts 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 ' ai'cas, and giving a detailed description of layout of property must be drawn on the diagram which is part of this appli- ~tion. ~ ,c. Tile work covered by this' application may not'be cbmmenced iSefore issuance of Building Permit. ~ d. Upon approval of this application' the Building Inspector will issued a Building permit to the applicant. all be kept on the premises available for inspection throughout the work. Such permit e. No building shall be occupied or used in whole or in part for a~y purpose whatever until a Certificate of Occupancy all llave been granted by the Building Inspector. APPLICATION IS HEREBY MADE to the Building Department for the issuance of a Building Permit pursuant to the lilding ~one Ordinance of the Town of Southold, Suffolk County, New York, and other applicable Laws, Ordinancas or -'gulations, for the construction of buildings, additions or alterations, or for removal or demolition, as herein described. le applicant agrees to comply with al/ applicable laws, ordinances, building code, housing code, and regulations, and to mit authorized inspectors on premises and in building for necessary inspecti~)s._ (Si=nature of applicant, or name, ff a corporatmn) lailirdg address of applicant) ate whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. .......................... 0 co .oc c ............................... .. m'eorownerorpremises ....... .il i0m . ....................... · (as on the tax roll or latest deed) ' · applicant is a corporation, signature of duly authorized officer. (Name and] title o'~ corporate officer) Builder's License No..LS.i..-I.k 7. ~"~ ........... Plumber's License No ........ ,. ................ Electrician's License No..~l~tl.~.'. ~ ............ Other Trade's License'No.., ....... . . Location of land on which proposed work will be done... ........................ HamlqY ............... State existing use and occupancy of premise, s and intended use and occupancy of proposed construction: · §. i'~ahii:~ 0t:~Ork (chec~r.which applicable): New Building ........ Addition Repair .............. Rem,,,,.,i .... '' · ......... ~teration ...... .................. .............. 4. Estimated Cost .~.~s ~ ......................... Fee ~ (Description) [ / ~ ~ ~,~ br e~fof~ (to be paid on filing this application) 5. el~ng, umts ..... ~ ....~ ..... Number of dwelling units on each floor.. ~ ..... .6. If business, commercial or mixed occupancy, specify nature and extent of each type of use ...................... 7. Dimensions of existing st~ctures, if any: Front ............... Rear Depth Height ............... Number of Stories ..................................................... D~ensions of same structure with alterations or additions F ~- , : 'Fo~t ~ ''' ~eptn .............. ]lo;-~t ................. Rear .......... 8. ' .............................. Number of Stones ...................... Dm~enmons of entir~ new construction: Front ........... Rear Depth Height ............... Number of Stories ...... ~, Sizeoflot: Front ...[~,~ ........... Rear.'~[~~ ........ ............................ 10. Date of Purchase ......... Depth ...~ ~.{ ....... ' ........................ ' ..... Name of Foyer Owner ' I I. Zone or use district in which premises are situated .............. ~ ............................. 1 2. Does proposed construct~o~ violate any zoning law, ordinance or regulation· . ...... 13. Will lot be regraded . ~ X~ W"' ' ' '~ ..................... ' '' ' ' ' ..................... m excess fill be removed " : 14. ~ o~ ?w~ o~p~e~s ~ ~.~ ~(,. Addressl~~~ fr°~2~_mX~,,~ N° N~e of Contractor~-~ aZid ............ ?uures~~4~. ~hone N~ s ...... ~.~ ...... Addres~~ ~.~ .... t~ ........ ''' 15. Is th~s property within 300 feet of a tidal wetland? ~s' ~,n~.~non~O~:t~... · If yes, Southold Town Trustees Pemit ma~ be required. .... PLOT DIAG~ Locate clearly and distinctly MI bulldogs, whether existing or proposed, ~d. indicate M1 set-back'd~ensions from pr°pe~y Hnes. Give street ~d block number or descdplioh accord~g to deed, and show street nines and indicate w~hether intehor or comer lot TATE OF NEW YOIqK, ., OV.'aTV OF ..... S:S ......... ....... o duly sworn, acposes anu says that lie is the applicant (Name ofindMdual signing contract) named. -' is the ........... .C~O~..a,~.-~..C.~' .Qeff~.c}(.Cxj~.. (2~_~ ~' ' (Contractor, agent, corporate officer, etc.) ' ............ said owner or owners, and is duly authorized to perform or have ILer[onned the said work ~nd to m plication; that all statements contained in this application arc true ~.t '~ ' ~e and file this ,rk will be pcrfo~ed in the m~ner set forth in the application filed tl~re~itll. '~ and that the 'om to before me this l{-~bes~f Ins knowledge and belief; ............ /. 6. ~...day or..~~ .......... ~.~/ ~u:l~'~c.~ ir, at'"c.,; ~ c~:~'4 ~ .... ~/~nat~/e'of applicant) ~to. 01BO6005~, LOT AREA = 40,004 Sq. FT. Ld S. 39* 00'00" E. / 160.55' ~ 39,r N39° 00'00" W ---- 55.r 135.55 DUCK POND ROAD NOTED NOT'IF:I '! ~>!~','~ Dr ~.~T AT 765-1~: ~ ',~ '"~ , %1 FOR THE FOLLC 1. FOE FOI 2. ROI 3. INS 4. FIN BE ALL THE STAT LLI CODE g DESlG I F: UL~/ AL ,ONST ,EQUH:: CON~ ~. NOT OR CO REQUIRED 3MBING /; UST 9-10-1999 REVISE DISTANCES TO SEPTIC 8-6-1999 FINAL SURVEY 5-:~7-1999 FOUNDATION LOCATION i-:~G- 9 0 PP. op D~ E~._ ~ ItLR~d ONLY TO ~ ~ THE ~l~l ~ T~ L~I~ INSTITUTI~. ~UARANTEES ARE IN~TITUTION~ OR ~ THE LA~ 5UR~YOa'S ~ ~T M ~S~ TO ~ GUARANTEED ONLY TO WILLIAM A. MULRAIN, JR. /,/~'~~'~ CATHERINE SMITH MULRAIN / BNY M~TGAGE CO. LLC / "IMMEDIATELY" ENCLOSE POOL TO CODE UPON COMPLETION BEFORE "WATER" NOTE: CESSPOOL, SEPTIC TANK AND WELL LOCATION BY OTHERS. JOB NO. 97-269 FILE NO. WOODBI NE SURVEYED FOR LOT NO. 4 MAP OF WOODBINE MANOR SITUATED AT CUTCHOGUE TOWN OF SOUTHOL D - - - SCALE 1" = 50' FILED MAP NO. 8239 TAX-MAP NO. 1000-83 - 4 - 4 MANOR SUFFOLK COUNTY NY DATE 7-- 23 --1997 DATE 12-- 15 -- 19~56 (REF. ONLY) DISK 17( HAROLD F. TRANCHON ~R P.C. LAND SURVEYOR 1866 WADING RIVER-MANOR RD. WADING RIVER, NEW YORK, 11792 --~ 516-929-4695 t