HomeMy WebLinkAbout51002-Z TOWN OF SOUTHOLD
} BUILDING DEPARTMENT
TOWN CLERK'S OFFICE
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 #: 51002 Date: 7/30/2024
Permission is hereby granted to:
Rooney, John
PO BOX 1622
Southold, NY 11971
To: Construct an inground swimming pool accessory to an existing single-family dwelling
as applied for. Pool and pool equipment must maintain a mininum side and rear yard
setback of 5 feet.
At premises located at:
425 Maple Ln, Southold
SCTM #473889
Sec/Block/Lot# 64.-1-25
Pursuant to application dated 6/14/2024 and approved by the Building Inspector.
To expire on 1/29/2026.
Fees:
SWIMMING POOLS -IN-GROUND WITH FENCE ENCLOSURE $300.00
CO- SWIMMING POOL $100.00
Total: $400.00
Building Inspector
TOWN OF SOUTHOLD-BUILDING DEPARTMENT
Town Hall Annex 54375 Main Road P. O. Box 1179 Southold,NY 11971-0959
Telephone (631) 765-1802 Fax (631) 765-9502 hqp . w`w-v .southoldtownnv. ov
Date Received
APPLICATION FOR BUILDING PERMIT E C E 0 W E
For Office Use Only
2024
PERMIT NO. I DD C� Building Inspector:
Applications and forms must be filled out in their entirety.Incomplete Building Department
applications will n6t be accepted. Where the Applicant is not the owner,an Town of Southold
Owner's Authorization form(Page 2)shall be completed.
Date:
OWNER(S)OF PROPERTY:
Name; SCTM # 1000- — — ...
Project Address: 7 ✓�
Phone#: Email: 7/�„�/c� G�aO. C'ovM
Mailing Address:
CONTACT PERSON:
Name: f�•Lv(�2 iftJ��
Mailing Address: ,0 , �36Y g
Phone#: 6,31 Email: c�c-k;f,)K,-D o4l en I: ne- f,E�r
DESIGN PROFESSIONAL INFORMATION:
Name:
Mailing Address:
Phone#. 1:Email:
CONTRACTOR INFORMATION:'
Name: OJ,)lc � nc JS L+,� .
Mailing Address�--�,0 vv Cry k1-,oa,, y /l 9 3-
Phone#: �y�1_�3'�-7laG� Email: ��'� E�Kv��fc�n l'� ne- ne4
DESCRIPTION OF PROPOSED CONSTRUCTION
❑New Structure ❑Addition ❑Alteration ❑Repair ❑Demolition Estimated Cost of Project:
Will the lot be re-graded? des El No Will excess fill be removed from premises? [Wes ❑No
1
PROPERTY INFORMATION
Existing use of property: ��.,,� �r�J / Intended use f prop Z ' #/
Zone or use district in which premises is situated: Are there any covenants and restrictions with respect to
in�n�l this property? Dyes' o IF YES, PROVIDE A COPY.
Check Box After Reading. The owner/contractor/design professional is responsible for all drainage and storm water issues as provided by
Chapter 236 of the Town Code. 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,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(s)for necessary inspections.False statements made herein are
punishable as a Class A misdemeanor pursuant to Section 210.45 of the New York State Penal Law.
Application Submitted By(print ame): '� c)�Cp►uthorized Agent ❑Owner
Signature of Applicant: Date: &113)-2y
CONNIC D.BUNCH
STATE OF NEW YORK) Notary Public.State of NeW York
SS: No,01BU6185050
Qualified in Suffolk County
COUNTY OF } commission Expires April 14,
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/her knowledge and belief; and
that the work will be performed in the manner set forth in the application file therewith.
Sworn before me this
1 4 mday of ✓ y�f -�_ 20 a 4 j8cta �
Notary Public
PROPERTY OWNER AUTHORIZATION
(Where the applicant is not the owner)
residing at �. � � L ' 4 �__ L-d
do hereby authorize to apply on
my behalf to the Town of SouthoN Building Department for approval as described herein.
Owner's nature Date
Print Owner's Name
2
01
TOWN OF SOUTHOLD—BUILDING DEPARTMENT
Town Hall Annex 54375 Main Road P. O. Box 1179 Southold,NY 11971-0959
Telephone (631) 765-1802 Fax (631) 765-9502 hqpL-.//-vvww.southoldtoNvnny.aov
BUILDING PERMIT APPLICATION INSTRUCTIONS& CHECKLIST
• Applications and forms must be filled out in their entirety. Incomplete applications will not be
accepted.
• The work covered by this application, including land clearing/site work, may not be commenced before
issuance of a building permit.
• No building shall be occupied or used in whole or in part for any purpose whatsoever until the Building
Inspector issues a Certificate of Occupancy.
• Every building permit shall expire if the work authorized has not commenced within twelve (12)
months after the date of issuance or has not been completed within eighteen (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 additional
6 months. Thereafter, a new permit shall be required.
ALL APPLICATIONS MUST BE SUBMITTED WITH THE FOLLOWING MATERIALS:
ilding Permit Application: Complete, signed and notarized.
A survey/site plan, drawn to scale at original size, showing the location of lot and of buildings on
pre ises, relationship to adjoining premises or public streets or areas and waterways.
Four O sets of plans bearing the signature and original seal of a NYS licensed professional engineer
or architect illustrating compliance with the Building Codes of New York State.
ontractor's proof of insurance and Suffolk County license:
• Certificate of Workers' Compensation Insurance (C105.2 or U26.3) AND a Certificate of
Disability Benefits Compensation Insurance (DB120.1)
• Certificate of Liability Insurance
"Note: Final Fees will be calculated by the Building Department using the fee schedule. Fees will be
collected after the permit is written"
ADDITIONAL DOCUMENTATION MAY BE REQUIRED AS IDENTIFIED BELOW:
❑Suffolk County Department of Health Services Approval (original copy)
❑Approval of the Zoning Board of Appeals, Planning Board, and/or Historic Preservation Commission
(if applicable)
❑Electrical Permit Application (FILED SEPERATELY): Electrician must have an active license with Suffolk
County
❑Flood Plain Development Permit Application (if applicable)
❑Southold Town Trustees Permits may be required: If any work will be done within 100' of a tidal or
fresh water wetland.
❑NYS D.E.C. Permits may be required: If any work will be done within 300' of a tidal wetland or 100' of
a fresh water wetland
❑1 copy of ComCheck/ ResCheck (if applicable)
❑1 copy of Manual J, Manual D and Manual S (if applicable)
El Utilization of truss/ re-engineered wood/timber construction form (if applicable)
❑Single and separate title search (if applicable)
❑C b cut permit (NYS or Suffolk County form 23 F) (if applicable)
ginal signed Owners Authorization: if applicant is other than owner.
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APPROVED,AS NOTED
NOTES:
DATE:�-�2i B.P.#
1, DIVING BOARD TO CONFORM WITH ANSI/APSPACC-5 SEC 6 FEtj_bD_'bO BY:
2. NO SOIL DISCHARGE PERMITTED WITHIN 4 FEET OF EXCAVATION
31 POOL MUST BE SURROUNDED BY A CONTINUOUS BARRIER CONSTRUCTED IAW RED.OF SEC 326.4.2.1-R326.4.2.6 OF THE NYS RESIDENTIAL CODE(2020)AND ALL SECTIONS OF THE SOUTHOLD CODE NOTIFY BUILDING DEPARTMENT AT
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 631-765-1802 8AM TO 4PM FbR THE
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 FOLLOWING INSPECTIONS: "
TO OPEN AWAY FROM THE POOL AREA. FOUNDATION-TWO REQUIRED
6. DURING CONSTRUCTION THE CONTRACTOR SHALL ERECT A TEMPORARY BARRIER AROUND THE EXCAVATION IAW CODE OF THE TOWN OF SOUTHOLD. FOR POURED CONCRETE
0 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 ROUGH-FRAMING&PLUMBING
7. POOL MUST BE EQUIPED WITH AN APPROVE SPECIFICATION FOR POOL ALARMS".THE
DWELLING.THE ALARM MUST BE INSTALLED,MAINTAINED AND USED IN ACCORDANCE WITH TEH MAUFAGTURERS INSTRUCTIONS.THE ALARM MUST MEET ASTM F2208"STANDARD SP INSULATION
DEVICE MUST OPERATE INDEPENDENT(NOT ATTACHED TO OR DEPENDENT ON)OF PERSONS FINAL-CONSTRUCTION MUST
8. POOL SUCTION FITTINGS(EXCEPT FOR SURFACE SKIIMERS)MUST BE PROVIDED WITH A COVER THAT CONFORMS TO ASME/ANSI At 12.19,8M OR A MINIMUM 18"X23"DRAIN GRATE OR A CHANNEL DRAIN SYSTEM.POOL BE COMPLETE FOR C.O.
CIRCULATION SYSTEM MUST BE EQUIPTED WITH ATMOSPHERIC VACUUM RELEIF.SUCH VACUUM RELIEF SYSTEMS SHALL CONFORM WITH ASME At 12,19.17 OR BE A GRAVITY SYSTEM APPROVED BY THE TOWN OF
SOUTHOLD.POOL$ALL BE PROVIDED WITH A MINIMUM OF 2 SUCTION FITTINGS OF THE ABOVE MENTIONED TYPE.THE SUCTION FITTINGS SHALL BE SEPARATED BY A MINIMUM OF 3'AND MUST BE PIPED SUCH THAT WATER ALL CONSTRUCTION SHALL MEET THE
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 REQUIREMENTS OF THE CODES OF NEW
NO GREATER THAN 12"BELOW THE MINIMUM OPERATIONAL WATER LEVEL OR BE AN ATTACHMENT TO THE SKIMMERfSKIMERS,A REQUIRED POOL ATMOSPHERIC VACUUM RELEIF SYSTEM SHALL BE INSTALLED AS PER YORK STATE NOT RESPONSIBLE FOR
NYS RESIDENTIAL CODE R326.6.3(2020)AND IN ACCORDANCE TO TOW CODE DESIGN OR CONSTRUCTION ERRORS
9, ALL ELECTRICAL WORK SHALL COMPLY WITH THE REQUIREMENTS OF NFPA 70(NEC),PRINCIPALLY ARTICLE 680 AND THE NY$RESIDENTIAL CODE SECTION 4102 THROUGH 4106.ALL ELECTRICAL DEVICES MUST BE
APPROVED BY UNDERWRITERS LABORATORIES AND BE PROTECTED BY A GOUND FAULT CURRENT INTERRUPER GFCI)CURRENT CARRYING ELECTRICAL CONDUCTORS EXCEPT FOR THOSE PROVDING POWER TO P
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 THATI MAY BECOME OOL
ELECTRICALLY CHARGED DUE TO CONTACT WITH AN ELECTRICAL CIRCUIT SHALL BE EFFECTIVELY GROUNDED. COMPLY WITH ALL CODES OF
NEW YORK STATE&TOWN CODES
10. WATER SOURCE FILLING THE POOL SHALL BE EQUIPPPED WITH A BACKFLOW PROTECTION DEVICE IAW NYS PLUMBING CODE 608. A�REQUIRED AND CONDITIONS 01
11, ALL PIPING IS DIAGRAMMATIC UNLESS OTHERWISE STATED. SWMTMZM
12. WALKS,IF PROVIDED SHALL BE NONSLIP AND SLOPE AWAY FROM THE POOL EDGE. SWTWTNNRMNlNG8W
13. A MEANS OF EGRESS FROM DEEP AND SHALLOW ENDS MUST BE PROVIDED IAW ANSUNSPI-5 SECTION 6. RMOLDTOWNTUTES
14. CONTRACTOR TO PLACE THE POOL IAW TOWN OF SOUTHOLD CODE SETBACKS. N,YSDM
15, ALL DRAINAGE FROM THE POOL SHALL BE MAINTAINED ON THE SUBJECT PROPERTY. EXISTS WITHIN 60"FROM GRADE,DEWATERING FACILITIES WILL BE SOUTODW
16 THE DESIGN IS BASED ON AI DRAINAGE SOIL WITH 10%SILT.GROUND WATER SHALL NOT EXIST WITHIN THE EXCAVATION.IF GROUND WATERW ANSI
REQUIRED. z
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 IA
Z21.56 AND SHALL BE INSTALLED IAW MANUFACTURERS SPECIFICATIONS.OIL FIRED POOL HEATERS SHALL BE TESTED LAW UL726.POOL HEATERS SHALL BE LOCATED OR GUARDED TO PROTECT AGAINST ACCIDENTAL
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
FLOW THROUGH THE HATER.POOL HEATERS SHALL BE PROVIDED WITH THE FOLLOWING ENERGY CONSERVATION MEASURES: OF THE HEATER WITHOUT ADJUSTING THE THERMOSTAT SETTING AND TO ELECTRICAL
17.1 ALL POOL HEATERS SHALL BE EQUIPPED WITH AN ON-OFF SWITCH MOUNTED FOR EASY ACCESS TO ALLOW SHUTTING OFF THE OPERATIONR.(exempt INSPECTION REQUIRED
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 COVE
FROM THIS ARE OUTDOOR POOLD)DERIVING M 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 RETAIN STORM WATER RUNOFF
CLEAN AND SANITORY CONDITION JAW APPLCIABLE SANITORY CODE OF NEW YORK STATE. PURSUANTO CHAPTER 236
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 OF THE TOWN CODE
REPLACED WITH SANDY LOAM.
19 THERE ARE MAIN DRAINS IN THIS POOL.THERE ARE TWO APPROVED SUCTION OUTLETS WITH A MINIMUM OF TOF SEPARATION.THE SUCTION OUTLETS ARE PIPED SO THAT WATER IS —
DRAWN THROUGH THEM SIMULTANEOUSLY THROUGH A VACUUM-RELEIF-PROTECTED LINE TO THE PUMP.COMP(7ltkWITH ENTRAPMENT PROTEcTiot
20 THE POOL WAS DESIGNED REFERENCES AS THE FOLLOWING: of EW),o,
20.2
20.1 THE RESIDENTIAL BUILDING CODE OF NEW YORK STATE(2020)SEC R326 D E
THE ENERGY CONSERVATION CONSTRUCTION CODE OF NEW YORK STATE(2020)SEC R403.10 42e. 0
THE FUEL GAS CODE OF NEW YORK STATE(2020) uJ
20.4 THE NEW YORK STATE SANITORY CODE. POOL NOTES SCALE:999 NT$
20.5 ANSI/APSP/ICC-5 STANDARD FOR RESIDENTIAL IN-GROUND SWIMMING POOLS.
01 JAMES DEERKOSKI,P.E. DATE: 101212020
20.6 BOCA CODE SECTION 421. 1~ESs1260 DEER DRIVE
20.7 CODE OF THE TOWN OF SOUTHOLD MATTITUK,NEW YORK 11952 DRAWING NUMBER
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