HomeMy WebLinkAbout28283-Z FORM NO. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Office of the Building Inspector
Town Hall
Southold, N.Y.
CERTIFICATE OF OCCUPANCY
No: Z-30189 Date: 05/11/04
THIS CERTIFIES that the building ACCESSORY
Location of Property: 80 WATERS EDGE WAY SOUTHOLD
(HOUSE NO. ) (STREET) (HAMLET)
County Tax Map No. 473889 Section 88 Block 5 Lot 54
Subdivision Filed Map No. Lot No.
conforms substantially to the Application for Building Permit heretofore
filed in this office dated APRIL 16, 2002 pursuant to which
Building Permit No. 28283-Z dated APRIL 17, 2002
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 INGROUND SWIMMING POOL WITH FENCE TO CODE AS APPLIED FOR.
The certificate is issued to E SCOTT & BRIDGET WALTER
(OWNER)
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A
ELECTRICAL CERTIFICATE NO. 2697 06/14/02
PLUMBERS CERTIFICATION DATED N/A
Authorized Signature
Rev. 1/81
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. 28283 Z Date APRIL 17, 2002
Permission is hereby granted to:
E SCOTT & BRIDGET WALTER
80 WATERS EDGE WAY
SOUTHOLD,NY 11971
for
CONSTRUCTION OF AN IN-GROUND SWIMMING POOL AS APPLIED FOR
at premises located at 80 WATERS EDGE WAY SOUTHOLD
County Tax Map No. 473889 Section 088 Block 0005 Lot No. 054
pursuant to application dated APRIL 16, 2002 and approved by the
Building Inspector.
Fee $ 150 . 00
w
Authorized Signature
ORIGINAL
Rev. 2/19/98
r ,
TOWN OF SOUTHOLD
h UILDINC DEPARTMENT
TOWN HALF
765-1802
APl?LICAMN FOR CERTIFICATE OF OCCUPANCY
This application must be filled in by typewriter or ink and submitted to the Building IX-partment with the following
Ar For new building or new use:
1. Final survey of property with accurate location of all buildings,property lines,streets,and unusual natural t
topographic features.
2. Final Approval from health Dept of water supply and scwcrage-disposal(S-9 farm).
3. Approval of electrical imallation from Bow-d ofl ire Undemriten.
4. Sworn statement ftxem plumber certifying that the solder used in system contains less than 2110 of I%lead.
5. Commercial building,industrial building„multiple residences and similar buildings and installations,a certi
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 4, 1957)non-conforming,uses,or buildings and"pre-existing"land
1. Accurate survey of property showing all property fines,streets,building and unusual natural or topographic
features.
2. A properly completed application and a consent to inspect signed by tic applicant, (fa Certificate ofOccup
is denied,the Building Inspector shall state the reasons therefor in writing to the applicant.
C- Fees
I. Certificate of Occupancy-New dwelling 525.00,Additions to dwelling$25.00, Alterations to dwelling S2:
Swimming pool 525.00,Accessory building 525.00,Additions to accessory building S25.00,Businesses S5
2. Certificate of Occupancy on Pre-existing Building- S 100.00
3. Copy of Ca6fwate of Occupancy -S25d10
4. Updated Certificate of Occupancy- $50.00
5. T,emMMY CeMfir ce of Occupancy- Residential S 15.04 Conmercial 5 15.00
Date. January 25, 2002
Now Construction:_______ __ Old or Fre-existing Building: (check one)
Location of Property: 80 Watersedge Way Southold
House No. Street Ha:ndet
Owner or Owners of Property: E. Scott and Bridget A.Walter
Suffolk County Tax Map No 1000,Section 088.00 Block 05.00 Lot 054.000
Subdivision Terry haters filed Map. 2901
Lot:
ftmiit No. BP# 28283-2 tae ofpemit. April 17, 2002 AppJieant. E. Scott and Bridget A.Walter
Health Dept.Approval: Underwriters Approval: 2697
Planning Board Approval:
Request for: Tempter},Certificate Fina!Certif cafe: X (Check OW)
Fee Submitted: $ $25.00
Nassau Suffolk Electrical Inspections, Inc.
5A Canal Street• Center Moriches,New York 11934 • Tel:631-878-3500 • Fax: 631-878-3764
Application No: 2697 Date:6/14/02
Issued to: Walter,E. Scott
Address:80 Waters Edge Way
Village : Southold Zip: 11971 Township:Southold
Introduced By: Bethel Electric License#:2880-E
was examined and found to be in compliance with the National Electrical Code
Mc 1st Floor Residertial O Rool D W.Garage
Basement 2A floor Gotrrrwdat F#TUb W Defects
Switches Receptacles Fixtures G.F.I. Microwave Whirlpool
2 3 1-500Watt 2
Fans Dishwasher Washer/Amps Dryer/Amps Oven Carbon
Range/Amps Monoxide
Furnace Oil Gas Circulators Smoke Bell
Detectors Transformers
Other Meter Amps Phase Motors
Equipment
Pool 1-3/4,11/2 H
O ut,Res
This certificate must not be altered
in any manner
Section: 088 Block: 5 Lot:55
E. Scott and Bridget Walter
80 Watersedge Way
Southold, New York 11971
February 3, 2003
631-756-9480
FE:
Town of Southold
Building Department
Town Hall
Southold,New York11971
Dear Gentlemen:
I hereby request a six (6) month extension on Building Permit
# 28283-Z. The permit, for a swimming pool, was originally applied
for on April 2, 2002 and issued on April 17, 2002. An inspection was
performed on January 27, 2003. A few adjustments need to be made
and at this time the inspector advised me to apply for this extension.
Thank you for you time and help in this matter.
Sincerely,
Bridget A. Walter
BUILDING PERMIT EXAMINER CHECK LIST
DATE ISSUED: —/—/02
DATE REVIEWED: -i /�/02
APPLICANT: 6A �j. (a�a��Q DAT6SUBMITTED: y /1&/02
SCTM# DISTRICT: 1,000, SECTION: J!% , BLOCK: t , LOT:
STREET ADDRESS: 9�0 QAT CITY:�`oTf
�. u't�-toLA SUBDIVISION:
PROJECT DESCRIPTION:,=
ESTIMATED PROJECT COST: 4 O-OK ARCHITECT/ENGINEER: N/,A FAST TRACK? -6
SINGLE & SEPARATE CERTIFICATION-REQUIRED? 1Vcp NOTES:
LOTS 40,000SF-100-24.Lot recognition.(CREATED before June 30, 1983),UNDERSIZED LOTS FROM JAN.1997 100-25.Merger.(A nonconforming at any time after 7/1/8.
ZONING DISTRICT: R_qo CONFORMING? ko
REQ. LOT SIZE: yo,.,, ACT. LOT SIZE:igew REQ. LOT COV. 2o�e ACT. LOT COV. -i j'3,4j„
REQ. FRONT im 3' PROP. FRONT ✓ REQ SIDE 3lh ACT. SIDE
REQ. REAR 31 PROP. REAR
WATER FRONT? Mo Cl DESCRIPTION:
PANEL #: 166, FLOOD ZONE:,
APPROVALS REQUIRED
SUFFOLK COUNTY HEALTH DEPT: YES oi(D (BED#): DTE:_/_/_ PERMIT#:R10-
TOWN SEPTIC RECEIPT: Y or®
NEW YORK STATE DEC: PRE-DEC 9/1/75 YES or
SOUTHOLD TOWN TRUSTEES: YES ori
TOWN ZONING BOARD APPROVAL: YES or(OD
TOWN PLAN. BOARD APPROVAL: YES or 0
TOWN HISTORICAL PRE (SPLIA): YES or(q
NYS ENERGY: YES OR QD :
EGRESS (18 H min.? 4 sq total)_V/k VENT (SQ. FT. x4%)_ 144 LIGHT (SQ. FT. x 8%) N/
BUILDING PERMITS OPEN/EXPIRED: BP 20 q 9 -Z/C/0 Z-,Qa9q 1 N 1 D
HAVE PRE CO'S : Y OR® BP -Z/C/o Z- ,
NOTES:
FEE STRUCTURE: FOUNDATION: SF
FIRST FLOOR: SF
SECOND FLOOR: SF
OTHER: SF INIIT OTHER TOTAL
TOTAL: SF FEE FEE F
1. ( SF)- ( SF)= SFX $ =$ +$ +$ _ $ 150
2. ( SF)- ( SF)-- SFX$ =$ +$ +$ = $
765-1802
BUILDING DEPT.
INSPECTION
[ ] FOUNDATION IST [ ] ROUGH PLBG.
[ ] FOUNDATION 2ND [ ] INSULATION
[ ] FRAMING FINAL -7:7CS
[ ] FIREPLACE A CHIMNEY
n=
REMARKS:
J f;
=�� ..�„i'.r!�w c �j.J �'°f�C�' "Nils -r+— .[���2u'.i` ✓
i�
/lam to �.�r-a�1.:=��-�-��► �[, r"""u J1_rr�� r
DATE ' '7 a INSPECTOR '
suaoINa DEPT.
INSPECTION
[ ] FOUNDATION IST [ ] ROUGH PLBG.
[ ] FOUNDATION 2ND [ ] 1 CATION
[ ] FRAMING [ FINAL
[ ]
FIREPLACE & CFIIMNEY
REMA KS•
DATE 1,7,,3 INSPECTOR
7
765-1802
BUILDING DEPT.
INSPECTION
[ ] FOUNDATION 1ST [ ] ROU PLBG.
[ ] FOUNDATION 2ND 1 ULATION
[ ] FRAMING [ ] FINAL
[ ] FIREPLACE�IMNEY [ ] FIRE SAFETY INSPECTION
REMARKS:
9�-
DATE /� INSPECT
765-1802
BUILDING DEPT.
INSPECTION
[ ] FOUNDATION iST [ ] ROUGH PLBG.
[ ] FOUNDATION 2ND [ ] I ULATION
[ ] FRAMING FINAL
[ ] FIREPLACE 8 CHIMNEY [ ] FIRE SAFETY INSPECTION
REMARKS• /�z -1gl. (2�) ?
DATE _ /b � INSP jw�
FIELD INSPECTION REPORT DATE COMMENTS
FOUNDATION(IST)
y
-------------------------------------
I H- 15
FOUNDATION(2ND)
z
0
y
ROUGH FRAMING& tTl
PLUMBING
4
x
INSULATION PER N.Y. y
STATE ENERGY CODE
3
FINAL
DPTIONAL O
n3 'v�
LI' 0
Z
� m
7-77�2
�d =
Zz
NJ
N�
1 y
, Op
x
I �
x
d
o
TOWN OF SOUT �� �_ BUILDING PERMIT APPLICATION CHECKLIST
BUILDING DEPA ENT Do you have or need the following,before applying?
TOWN HALL R 116 2002 i: Board of Health
SOUTHOLD,NY 1 i 3 sets of Building Plans
TEL: (631) 765-18 2 BLDG. DEP.-T--_J Planning Board approval
FAX: (631) 765-95 "VOF a.C" rt opo Survey
PERMIT NO. Check
Septic Form
N.Y.S.D.E.C.
Trustees
Examined 120 Contact:
Approved ,20 Mail to:
Disapproved a/c
Phone: 2P-7 -G312-
Expiration
G3/ ZExpiration ,20
Building Inspector
APPLICATION FOR BUILDING PERMIT
Date L2__, 20& Z—
INSTRUCTIONS
a. This application MUST be completely filled in by typewriter or in ink and submitted to the Building Inspector with 3
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.
(Signa of applic torn e,if a corporation)
(Mailing address of applicant)
State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician,plumber or builder
a VA F_ YL.-
Name of owner of premises o+l
(As on the tax roll or latest deed)
If applicant is a corporation, signature of duly authorized officer
(Name and title of corporate officer)
Builders License No. / �, , 6 q l l- 7�
Plumbers License No.
Electricians License No.
Other Trade's License No.
1. Location d on which proposedwill be done [ /
A pul 9 L 11L w0 �o o f a t-C3
House Num er Street Hamlet
County Tax Map No. 100 SeAcOon U �,O Block 0 S -O v Lot O G D
Subdivision -Pg-tZ r Orr reaS Filed Map No. a 41 Lot
(Name)
2. State existing use and occupancy of premises and intended use and occupancy of proposed construction:
a. Existing use and occupancy
b. Intended use and occupancy. 5W
3. Nature of work(check which applicable): New Building Addition Alter
Repair Removal Demolition Other Work �1 wt vw-1 a `
(De 'ption)
4. Estimated Cost U D 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 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 NOA-
13. Will lot be re-graded? YES NO Will excess fill be removed from premises? YES )C NO
14. Names of Owner of premises Se df-T/N►rLMAddress90 li/ <5130-f Phone No.-ZL S—- 0
Name of Architect Address Phone No
Name of Contractor7'SOkIn�g i�mL� Address&8'f i N e d Phone No. 7P-7- 6-37 -a-
15
15 a. Is this property within 100 feet of a tidal wetland or a freshwater wetland? *YES NO
* 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
* 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.
STATE OF NEW YORK)
SS:
COUNTY OF ' )
OGZ�vilS� (� being duly sworn, deposes and says that(s)he is the applicant
(Name of individual Isigning contract) above named,
(S)He is the CG�/ C -�(Df
(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 04x 20-0,P-
Notary
00,P-Notary Public Signa of A licant
NotaJOYCE bllic,St Vt lI ofNew York
No.4952246,Suffolk County
Term Expires June 12, a bU3
H. S. NO. `
STATEMENT OF INTENT
VAS=AN'i ` THE WATER SUPPLY AND SEWAGE DISPOSAL
50 _f SYSTEMS FOR THIS RESIDENCE WILL
~
MAI`
'q n t _ _} -�`-, ,r CONFORM TO THE STANDARDS OF THE
I " i A i, OF P t C O t' F- 12 ( Y SUFFOLK CO. DEPT. OF HEALTH SERVICES.
.a - S.6022' !4 E. tb.68 +�' ;t�`��t=T cr�. F vt1_
) +� + APPLICANT
ry Jst �^ G'PO LS, N1 P
}�/�}�J� (+J-/7 ~ LJ�� 1!j SUFFOLK COUNTY DEPT. OF HEALTH
i SERVICES — FOR APPROVAL O F
2GP(�55T CONSTRUCTION ONLY
DATE:
POC1l_W-� ` ur tz� h�.'�. 1 H. S. REF. NO. yam, 50 d t .
-��� C.`�,%ttN ✓�` .a .�U��i°-��i.-�, ��`r`� ��SM�i�. APPROVED:
SUFFOLK CO. TAX MAP DESIGNATION:
DIST. SECT. BLOCK PCL.
54
Q ! OWNERS ADDRESS:
Lu tT TACOM L AAN4:.
r 1 y SY05'5gco
, t`e". t k
i
516-496-4996.
DEED: L. NJ P.
TEST HOLE STAMP
�' ZT •�°ti.. p
SCALE_ _A t C a a. un3 ;roniod zdtA-••
�— 1 '•^'eyuar-_�:nu Uoo
�+ n 72,':,q Cf 6he Nevi yult Sao
.3
-El- O !`' T - SuR� notes
Ya a
1 SCaL. FT a a b�aaO�IdMrQ
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o !�f`�t �I G_ GE�__�_l io, {`�8 s Fear ed "'�►
co' Lu�\/�DA-rUMF`::42 Ef �,RSUunen wed hereon and
�HSSV E mEA+l1i ZeA t..E:-ti,'EE r-- ;y aur;c c or a�e�� w had.
SUFF=. CC_ 0, �'._��lAr��l'AL. 5UfZ\/EY. r'� 45 ,-A . 94 � w
LlS
p1 E C4-EN PLOGS ZCiiNIE !iJ
SEAL
'7 - CO. TAX MAP t� ►A, : !_�-.)O 088 s s .•€.�f Y�I�
_ __.. `r ' RODERICK VAN TUYL,
IT `i'i� . QEFE_k T_G_'MAP OF 7ErerzY \, AT-E IZ ` F,i-& Nt 17-i LICENSED LAND SUR. aRS CA.NO
;UF=', `CJ t�ERWS OF Ff'�E Fig' )`'E't,A► f�J+t�,'S'�I, GREENPORT NEW YORK
_
I S LAN D IA POOLS BY JOHN J. WYSOCZANSKI j OWNER:
108 FISHEL AVENUE, RIVERHEAD, NEW YORK 11901 (516)727-6312
3-CPE JNE — RIM CCK CR BCXED DYTRUSION
T
c I
i
RIM LOCK COPING
GRADE
POLY FZAM BACKING WOLMANIZED 2�XE TOP PLATE
i I NOTE: FOR DIMENSIONS SEE
i I
TABLE BELOW I AMYL LINER SKIMMERS RETURNS !
MONOLITHIC POURED �
i
1 fY STEEL. RODS CONCRETE WALL
i
1�� 0�
LADDER SAND BASE T%N
BOTTOM
TYPICAL POOL PLAN
UNDISTURBED I I �p`��
EARTH P JMF
'IMMEDIATELY"
WATERLINE ENCLOSE POOL TO CODE
UPON COMPLETION
BEFORE "WATER"
�^ NOTE: FOR DIMENSIONS SEE
TABLE BELOW OCCUPANCY OR
USE IS UNLAWFU
io
i L T
'ANY` LINER WITHOUT CERTIf[C^TE �°
~ I _
J
�-- OF OCCUPANCY
\. 1'-2' TAMPED SAND BOTTOM m 3r
..... ......................_...__ ...............
FIBERGLASS MOLDED 1 PIECE
zL828s
� P'TIONAL STEP
Fri sr.
r 1 �cEEMMENT IN NOTIFY BUILDING AT
TYPICAL CROSS SECTION 13 cu.
L t.\ 765-1802 ! AN TO 8 PE � TW
FOLLOWING 81SPECTpNS�
c — A 1. FOUNDATION - TWO REOUMEO
FOR POURED ATE
2 ROUGH - FRAYING A PLIIYOINO
N.S.P.I. TABLE OF DIMENSIONS 6' DIVING BOARD-A=4-C B-1 Ir S INSULATION
a' DIVING BOARD-A=4.e B=18' t FINAL - CONSTI*@f�� _
J!2E A A ; C E F G H g0- CAPACITY 10' DIVING BOARD-A=44'8=18'
BE COMPLETE ___ C.
r i?2 ?2 8-E z-6 E 4 8 5!2 17,65C SAL. C=22' FOR C.& ?. _I c LLNCRErE T� EE ���"
6X36 c" 36 2- 3-0 6 4 8 576 '3.15^ GAL. ALL CONSTRUCTION i �NJv rcl R.
t���; Y IJrCSAL BE LIMITEi TL vWNE R2
8X36 8 36 ,C-c 3-_ 8 4 4 1 J 641~ 2^_,4"JO ^AL.
THE REQUIREMENTS 0!I � -C ;_;IT' CAL RE�'_!LAT C
n 20C "'C GA's
2JX4C 2� 4 ?2-c '3-6 _ 4 4 2 25, 0 STATE CON8TRUCTiON NNEilO+Eol SHALL N;,T BE EMF-'EL-.
CODES. NOT RESPOfiS K&VWC Tv aE PRESSURE !MPPE:NA-E_
ESM OR COI_IjL4CT= IIF ESERVA7VE.
�. .� 0 BE SMOOTH NON-SK,D I-y,
SLOPED AWAY FROM THE PCCL.
UNDERWRITERS CERTIFICATE
REQUIRED