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HomeMy WebLinkAbout46374-Z Of so(/ryo`o Town of Southold P.O. Box 1179 �0 53095 Main Rd 4�COUNV.a Southold, New York 11971 CERTIFICATE OF OCCUPANCY No: 45791 Date: 11/24/2024 THIS CERTIFIES that the building IN GROUND POOL Location of Property: 305 Bay Haven Ln Southold,NY 1.1971 Sec/Block/Lot: 88.4-29 Conforms substantially to the Application for Building Permit heretofore, filed in this office dated: 05/17/2021 Pursuant to which Building Permit No. 46374 and dated: 06/07/2021 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: Madhu Southworth,Devaraj Southworth Of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL: ELECTRICAL CERTIFICATE: 46374 08/20/2021 PLUMBERS CERTIFICATION: Auth r' ed ignature �ApF30GryO TOWN OF SOUTHOLD BUILDING DEPARTMENT `� • TOWN CLERK'S OFFICE SOUTHOLD, NY BUILDING PERMIT RENEWED (THIS PERMIT MUST BE KEPT ON THE PREMISES WITH ONE SET OF APPROVED PLANS AND SPECIFICATIONS UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) Permit#: 46374 Date: 06/07/2021 Permission is hereby granted to: Renewal Date: 11/19/2024 Madhu G Southworth 305 Bay Haven Ln Southold, NY 11971 To: construct accessory in-ground swimming pool as applied for. Premises Located at: 305 Bay Haven Ln, Southold, NY 11971 SCTM#88.-4-29 Pursuant to application dated 05/17/2021 and approved by the Building Inspector. To expire on 11/19/2026. Contractors: Fees: Renewal Fee $200.00 Total 200 Building Inspector o�SOFFo TOWN OF SOUTHOLD a oy� BUILDING DEPARTMENT y TOWN CLERK'S OFFICE "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#: 46374 Date: 6/7/202.1 Permission is hereby granted to: Southworth, Madhu 305 Bay Haven Ln Southold, NY 11971 To: construct accessory in-ground swimming pool as applied for. At premises located at: 305 Bay Haven Lane, Southold SCTM #473889 Sec/Block/Lot# 88.4-29 Pursuant to application dated 5/17/2021 and approved by the Building Inspector. To expire on 12/7/2022. Fees: SWIMMING POOLS -IN-GROUND WITH FENCE ENCLOSURE $250.00 CO- SWIMMING POOL $50.00 Total: $300.00 6uffid"'ing spector SO(/j�o Town Hall Annex ~O l0 Telephone(631)765-1802 54375 Main Road Fax(631)765-9502 P.O.Box 1179 Q sean.devlinl-town.southold.n .us Southold,NY 11971-0959 Own y Ow +a BUILDING DEPARTMENT TOWN OF SOUTHOLD CERTIFICATE OF ELECTRICAL COMPLIANCE SITE LOCATION Issued To: Madhu Southworth Address: 305 Bay Haven Ln city:Southold st: NY zip: 11971 Building Permit#: Section: 88 Block: 4 Lot: 29 WAS EXAMINED AND FOUND TO BE IN COMPLIANCE WITH THE NATIONAL ELECTRIC CODE . Contractor: DBA: PSR Electric License No: 4802ME 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 X 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 Ceiling Fan Combo Smoke/CO Transformer UC Lights Dryer Recpt Emergency Fixture Time Clocks Disconnect Switches 4'LED Exit Fixtures Pump 1 Other Equipment: Intermatic Pool Panel 8 Circuit/ 5 Used, Heater, Timeclock, Salt Generator, Pool Lux 60W Tranny, Pump 220GFI Notes: Pool Inspector Signature: Date: August 20, 2021 S.Devlin-Cert Electrical Compliance Form pf SOUIyOlo U 'A 6 L-- f # TOWN O S UTHOLD BUILDING DEPT. 765-1802 INSPECTION [ ] FOUNDATION 1 ST [ ] ROUGH PL13G. [ ] FOUNDATION 2ND [ ] INSULATIOWCAULKING [ ] FRAMING /STRAPPING [ ] FINAL [ ] FIREPLACE &-CHIMNEY [ ] FIRE SAFETY INSPECTION [ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRATION [ ] ELECTRICAL (ROUGH) [ ] ELECTRICAL (FINAL) [ ] CODE VIOLATION [ ] PRE C/O REMARKS: s DATE s-0 INSPECTOR 1� 3-7 �OF SOUIy � O # # TOWN OF SOUTHOLD BUILDING DEPT. 765-1802 INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLBG. [` ] FOUNDATION 2ND [ rULATIOWCAULKING FRAMING/STRAPPING [ AL P�v [ ] -FIREPLACE & CHIMNEY - [' ] FIRE SAFETY INSPECTION [ ] FIRE-RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRATION [ ] ELECTRICAL (ROUGH) [ ] ELECTRICAL (FINAL) [ ] CODE VIOLATION [ ] PRE C/O REMARKS: 1� 1 Ion n-kWtw� _ h,2 �r mddW u ioiw to DATE INSPECTOR oe souryO� 1 # # TOWN OF SOUTHOLD BUILDING DEPT. couMv, 631-765-1802 INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] INSULATION/CAULKING [ ] FRAMING /STRAPPING l v/ FINAI—pwf [ ] FIREPLACE & CHIMNEY [ ] FIRE SAFETY INSPECTION [ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRATION [ ] ELECTRICAL (ROUGH) [ ] ELECTRICAL (FINAL) [ ] CODE VIOLATION [ ] PRE C/O [ ] RENTAL REM KS: 7� D4ww\- DATE �' 20LZ/ INSPECTOR 1 *OF SOUIyOIo # TOWN 'OF'SOUTHOLD BUILDING DEPT.- coorm��' 631-765-1802 INSPECTION ' [ ] FOUNDATION.IST/ REBAR [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] .I SULAtTIOWCAULKING [ ] FRAMING /STRAPPING [ FINAL [ ] FIREPLACE'&-CHIMNEY [ ] FIRE SAFETY INSPECTION [ ] FIRE RESISTANT CONSTRUCTION . [ ]. FIRE RESISTANT PENETRATION [ ] ELECTRICAL (ROUGH) [ ] ELECTRICAL (FINAL) [ ] CODE VIOLATION [ ] PRE C/O [ ] RENTAL REMARKS: Rom— 6 1jV6 gtAA DATE INSPECTOR VA/4 4 1 � Tr oolguard wort sh,r i ,,. .. t7ClOOtr� eft � IYrr s t - s Pool Alar Model PGRM-2 Made in the U.S. - rASTM �°IYw.M.nWr INedw+ F z208 egMRnti ,r FIELD INSPECTION REPORT DATE COMMENTS, ro FOUNDATION(1ST) - H ---------------------------------- FOUNDATION(2ND) � � O d . ROUGH FRAMING.& H PLUMBING (`A 1 4 _ t - r INSULATION PER N.Y. y STATE ENERGY CODE t 1 2f 1 ,� �-• N bur. FINAL, 3Al ��� - w i n�L+�S rzr•�ST3� Cif ADDITIONAL COMMENTS . 006 • � o IU _ H INFA — O(�A• - � d b H StffO�,t : �ao�° goy 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 https://www.southoldtownny.gov Date Received APPLICATION FOR BUILDING P MIT For Office Use Only PERMIT NO. Building Inspector: 7 ,t �r 4J MAY. 1 7 2021 ` - 2'.',A� �;i a•21i.14 , }e 1 ,� {�'� �tt"{5`rr^w � •y "'4 ��k„i x a���'l{�,,x.x >App�icat�o�nsk,�an�Jorrr�s4must be felled out in}t�elr entlrety��lncomp(�ete�k•�,�'r��=. �..�`•: ,:ai-`%.�.ry`�,., � ,�' tsc�"�'3€.!r�.�� �''�*'''��.d,�4`r.�y��F ��+."','i^�. •�ti•a�d ��t 3�rb,� -�X .� appllcatlons5w1117nbt be accepted; Where the Apphcant3is not the owner,5art' g s;s- r:' S'�" �kC`,+c�Fm..�,.b'}/��';FnKi,k�4.-r""�'#c,•✓.�#� �'Syr' QRia.�,•.`t=r1,a"•(Fri.tt^�45�`Fx..��.._ isrfk'35`- 't`�°f:iv.�}�r��iy�+���,9ri�'�.r,�r�T�i?� �,3, .�V... itiW >P�Y yYyk 4•nf.� I-T. u4F.7S�Y�.Fc�i.�f' i��vRi � �41 Y`]� ��y LJR"Yk �� il' Date: Mom 4- �r:t'•t.`ra;,rd(,t.;Y:1.�-�;, .�«;�:'raur,`�+ �-.-t;. r 't..;�3x y w rr#i,vu .� ;� �'; � r �ir:t +F OWNER Fss3 h P....R O. :nE.wR.,:T;__Y.a�_.slr'��5`,r'�r?r._..._,-_kt k�>r�'t+z?`;•r=� s=1P' l:r:!�Y:is*�`+�`b-sl.,GaFt? `4•r'.1+-+Fr,.;w.w...4�..+-v-:x�t a., 4.rf.�,.a.Stg+`aDw �ts3 ,* n ,.� s,dz ^�^,.�•;sF�,t ti.;.<:3"tT r ,•r"t Name ProjectiAddress: In s- -rCy.✓-.._...._. _..._._ .._ ..- __.._._ ._......_. 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RQJ _. - El Phone# dd / b�1 �� 'I� � Email sj y,clr•(a'sa �vh� S __..,,..G•k us, 1i .k3�ttiE try-'l�, s-.sr:f .,'J2-h. i4.1_ SY - •c•C g ,,{ rQBYi� F !-. t t4„ �•-G4./ S }F.S t.r.n- i� a• b .,er• + uFr•`e P Cv rt t ..y3 4'r f'� ifs xi FL., 'i fy _ IDES'GNTI'aOFESSIONAI�INFORMATION'�.;¢26 ,�.ik.?�,��, ;�..r,�r���* 4�..�•��'�',.�`;:� ����`.�,�r '�� ��+�t',..�r .,�'��''} �.�, �r;�' r1�,�,�. s,��: ^Gt<ns��,Y��.ai:,�1:Ca_�.i'�tr_.....>,_._.:•::;,:s.+, _as.�i,.�.3n.�c:�.,..�� �S�.�.:s+-v_,rr>:.�C+:-„�l?�f._�.:.�,e;�rt�:�,�frF fi.aE�.U,:..._.YS�'��'_,�.*r.�.�::ate s�S�t�r �.'i,�f�„7-�k•;�6��'fA'=<��,G�'�j F - Name: C Mailing Address: Phone#: -- Email: �i"?,�rr'id.>>ar$grI-,,i:.-F.ZS�'"�:.f:?5:;>�•D.i.a:.�fx'rt=,ixh kri�52i,�'t7+.i t ..}kr '-t.1k�t.._.riE r. :v.:y1 i r'a y.at1 '`xu�.uv 'z, ,rpt:k° °:y L 4 i� � n e,:�i5" i -..;�`l 't ii;1- rt__:�jy..,; ,t�,.,i '•�ti �. CONT, /1CTORIfFORMi4TION: r �`+, j �irrA� ^� r. .rz s � ,4crk' ,:,tc�F;: rs €� - �3 L F z,, tk;� 't.' .Y Mailing Address: Phone#: _ _ --_ — Email: `` _ I - "�-ems,..o."Es, .' (+gzy; 4-•s -r,:iv��:'i'S.` -¢aai+;rw°. Sr')n.o.r. "�..r�:�' ,�.,aT .fy `SJ�f.'F:' uy *�'.,•r._ t. i Bt 1� �t r¢, f E>..r., r. ''� 43 ,1'%! C IPTIO^„1 OF;PRGPOSED CQNSTRUCT�O zi t> 5 {� , H t s ariu3ss� ' �y'�, � a'�i'�z�2 ❑New Structure ❑Addition ❑Alteration []Repair ❑Demolition a Estimat d C t of Project: - ther W $ Will.the lot be re-graded? EKY12s El No Will excess fill b remov from premises? ❑Yes No K q0 f ro r OD LA.) 5'" FY'�r k[-:� 2 w v�Y f c v7 `:� �lvt 1 F.. i = � �r.' it . -}_-n�- <'.3.:.,RS�, X�r r Y•` "�' w'gr 1- r d 3 �:JI -z - '� -� ;... �, PROPERTY INFORMATION Existing use of property: ntended use of property: Zone or use district in which premises is situated: Are there any co emints and restrictions with respect to this property? ❑Yes IF YES, PROVIDE A COPY. rs — - -- ."� krr.S A 5£ f 4 sajl,s�j id, C eck Box�After Reading iu7 a owHer/conteac o��ilesi`'. 'ofes§ioriel s'es oris � r `�� '3 ; - , ha• t / grl Pf i r p ib(e for all dr nage.and storm water_lssues as provided by,!, f-4� `Cha er236o tieTo"Coiie,JAPR IC..h Na irtiC.,'}G._�,s r* � "tNr•,c . x.. ..,a7.s, .y :r>t y+n G AT(O IS�1EREBYMADE to t}11e d,ng Department for fte iss ante of a BuildingkP.eroiit p rsua io the euildm 'Zone`Fi +ae:•.:. u., .1 f. a;•„-;;�n'{,�'x, viI> Ili h. X �..,- e',i' �.y rdinarlce of the�Tow�ofSoutho�d,,SuffolktCounty��NewYork apd.othenapplgable Laws,Ordinances or�RegulatJo s• forthe'constructio"of biiildin s i c,'�ti�ei,� yaddttioris,,<alterat(o":s'.orfor;�e"oval ory emolition as e�ein desL�b- ��"',�����}��`4r w""�'n ?`.�N"'"4��'��'�''�'�F `""�`n '�'��Y^�'"'s�3i"'•�'x`""`�'t"`'�'`�`•{"'8g�j`Y"}'�x 7 �i y:t,,c_,,,�,�;.� �t2 ,,_�F,k s`.�r .i�d V.�.* k� .,�M��,:edtzThe applicant agrees to comply�w,th all appl(cahle aws,ord(nances,,qullimg code;'.-��; .+.... .,h., [ _ ,*• -"�,i+a:r]33:.uT�.{, 51:.,ree'P[�^.y,+:Y-�•°a:1`rsd.•:Yi-�+,•?s4'a'T53a tii:c`�{a+!�i�M*e�ir,<t�3,�'jg<Shousingtode,and regulations ant(to admit authoryzed Inspectors on premises and ir1 by Itl ng(s� or ecessa si 's ctlo s..False S ate r., tR,` r..4�,t-ta.-r�•v',3'Yy"l.zi4';xr h' 1r'Ku:ss4va'*C«..`;.gl., t.ax.-rw'L ,«e•-fig a x.:.- ..hicY 4..aetaa :. '•.,..,e .:,+ ,t+rP - .iv:c s ..,.. r �' � ,�:,.,r.!�„-',.�:�, �:�,r. �• � a ry h Pe P t mentsmade herein are�, 'punishable as a Class�1lnisdemeanor pursuan�to Section 210 45 of the New York State Penal Law������ ��Wy�`n�,,�''z a;`��"`s t� ��{3` � •�`����� ._.,•:: 1•_�t-ri,.i�,�.L.......-tf...:.-.u.-:...n«....._F..� .n..R:,.l ._....v-.F..'� .v' ...-..a.:.z......L:t:..1 t.. a�N Application Submitted By(prin name): n I ❑Authorized A ent /Owner gSignature of A Si n C Q� `^ _.�...._.Y...�._._.wpplicant:..w.__._.....w_.__.... _ `_ __ f�f.�4'�_•.......__...___.. Date: .�..A�.��[?i1_..._._._,._.....__-.....� STATE OF NEW YORK) SS: COUNTY OF ) 4 4n J)worn,deposes and says that(s)he is the applicant (Name of in ividual 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\ffii8'hV1iqtion file therewith. Sworn before me this ����Q':ospRY 65�'•• S'\ day of w iN oN3 �� .•S�Fo or o �.z No ry Public ii�4 STATE OF PROPERTY OWNE�R�MTH\ORIZATION (Where the applicant is not the owner) residing atU do hereby authorize �W 11N\, c to apply on my behalf to the To n of Southold Building Department for approval as described herein. wner's Signature Date A S cA W v Print Owners Name 2 gEEd�,p BUILDING DEPARTMENT-Electrical Inspector TOWN OF SOUTHOLD Town Hall Annex-54375 Main Road - PO Box 1179 Southold, New York 11971-0959 Telephone (631) 765-1802 - FAX(631) 765-9502 roper.richertOtcwn.southold.ny.us APPLICATION FOR ELECTRICAL INSPECTION REQUESTED BY: Dater Company Name: Name: License No.: q? email: oo Address: o v Phone No.: JOB SITE INFORMATION: (All Information Required) Name: Address: 2,9 a v- l Cross Street: Phone No.: - BIdg.Permit#: 1A 2 3— 7 email: Tax Map District: 1000 Section: Block:.. Lot: BRIEF DESCRIPTION OF WORK(Please Print Clearly) Circle All That Apply: Is job ready for inspection?: �YE;)l NO Rough In Final Do you need a Temp Certificate?: YES/ NO Issued On Temp Information: (All information required) Service Size 1 Ph 3 Ph Size: A #Meters Old Meter# New Service- Fire Reconnect-Flood Reconnect-Service Reconnected -Underground-Overhead #Underground Laterals 1 2 H Frame Pole Work done on.Service?- Y N Additional Information: - PAYMENT t3UE WITH APPLICATION C 82-Request for Inspection Form.xls �� �� Fx - BUILDING DEPARTMENT-Electrical Inspector a` TOWN OF SOUTHOLD Town Hall Annex- 54375 Main Road - PO Box 1179 Southold, New York 11971-0959 Telephone (631) 765-1802 - FAX(631) 765-9502 roger.richert[atown.southold.ny.us. APPLLCATION FOR ELECTRICAL INSPECTION REQUESTED BY: Date: Company Name: Name: License.No.: email: Address: AL Phone No.: dad 15LIZ JOB SITE INFORMATION: (All information Required) Name: Address © o l Cross Street: `` Phone No:: Bldg.Permit#: ,�,D 3 Z L email: ... Tax&4!p District: 1000 Section: Block: Lot: BRIEF DESCRIPTION OF WORK(Please Print Clearly). ,ll ? Circle All That Apply: Is job ready for inspection?: YE / NO Rough In Final Do you need a Temp Certifcate?: YES/ NO Issued On Temp Information: (A11 information required) Service Size 1 .Ph 3 Ph- Size: A #Meters Old Meterf# New-Service- Fire Reconnect=Flood'Reconnect-Service Reconnected -Underground,Oyothead Underground Laterals 1. 2 H Frame Pole Work done on Service Y Additional Information: PA1(MENT DUE WITH APPLICATtC71v! 0, Z O 82-Request for Inspection Form.xls �� � � PERMIT# Address: Switches Outlets GFI's Surface Sconces H H's UC Lts Fans Fridge HW Exhaust Oven W/D Smokes DW . Mini Carbon Micro.: . G.enen or . Combo Coo:ktop Trarisfer AC AH Ho:od Service Amps Have.' Used: . Special: Comments: U 2� rV bow SYMBOL LEGEND • [3 NONJAIENT FNC 0 NAVNpLE 4b TEST HOLE 0 LP./I.B.FND M-A--INLET g INEE 1y1 I.P./I.B.SET M'9'-WLET 0 911UB SPOT ELEYAlI0N5 I]YARD IVLET • BO LARD rQ' URLTY POLE 0 YARD IVLET A W_iLAND FLAG >- CUY WIRE UJ ELECTRIC METER CANT.CANTILEVER o•.� UTILITY POLE W/UGiT I]CAS METER FE.FENCE LIGHT POLE O WATER METER MAS.MASUNRY SIGN A GAS VALVE PLAT.P:IrORM —a— PVC FENCE(PVC) rl WATER VALVE —DON WE- STOCKADE FENCE(STK) B/W BAY WIN00'N —K— CHAIN LINK FENCE(CLF)O/H OI-lHANG C/E CELLAR ENTRANCE —— WIRE FENCE R/C ROOF OVER A/C UNIT FIRE HYDRANT D.C.DEPRESSED CURB RpAD 7�T 13 q r W MA11` AyV E 1 R AD E ass• y I I N FM LOT 39 TAX LOT 28 3 ) sl c un/rn( sTK FENTL S52°05'S0" 125.00' t a—uETAL—FN PS IE FIND P,.E9Nrt N17ER0Rm N I ' I ASPHALT I O \4W/e.B.WNNe I \9 A��1 SJORY` {(• �2 C�I 5) FM LOT 24 '� I IFi srDRr`. , TAX LOT 64 W I 1^\ ,. W q C.C. AMBIENCE\ M LOT 4 y AX LOT 2 1SI c F K B fxT l 7 me,',' I 1 I I /1 FM LOT 72 I }N I £ O TAX LOT 53 M I J I ° I ZI IM I ' (n y—V'` �� Q E N52°05'50—"W— 125.00' I I FM LOT 41 TAX LOT 30 LOT AREA �_ 15,625.00 S.F. GRAPHIC SCALE 0.35 AC. 30 0 1s 30 GUARANTEED TO: MADHU SOUTHWORTH AND DEVARAJ SOUTHWORTH ZENITH ABSTRACT.LLC. ZA-8245-20 ( IN FEET ) FIRST AMERICAN TITLE I inch = 30 ft. CITIZENS BANK,N.A..ISAOA ATIMA ��pFNEWr �' SCALICE SURVEY OF PROPERTY LOT 40 MAP OF -9�_ BAY HAVEN * {p land surveying FILE DATE: 01/22/1959 MAP NO. 2910 SITUATE mjslandsurve .com P:631-957-2400 SOUTHOLD !/C�'YS'NOS 05088a,�Y�� DR.:MC CREW.:JM SCALE: 1° = 30' SUFFOLK TAX MAP N0. TOWN OF SOUTHOLD F�LAND DATE SURVEYED:10/26/2020 JOB No.S20—2235 1000-088.00-04.00-029.000 SUFFOLK COUNTY, NEW YORK in Nw„..�zn„Ln..,,�a.m..d,,"„m w....",.N."W,.a.r,..w:.....° `:a<o'm c,'.i.�°v6a a''wm�.cn m"���'.;':°"`2��r v,.�«,.,r avhm�c�,.TM.�."°`Gnmd.,.°•,.,c��`�m.��:a��a"."`n.w'.m n o>mT.�.I W�a>.°.....+.Y W.K„Y,w,,M .0,,,>,..,n.v<�,`,.a:`�:,:�%'":i M,n..•u.°o-+..a.„re,°,,,,.°,.��,»,„<��,::°°n."w��N«,:���'w°";��„.a,�i�,�,�m�,�°a�M�'�.�°>�'�..a.,•K�,.�,. M,°s.o.,,,..�or.�w..a„�..•°,e,K�.�N� w.F'..In,�o:..I Koh„al�a.,°..c.,.,<.wE :,.w<rol ni°a,�;v<.s..°,rs o:"....wiw w.wm>.amp s.,,c m,��e w:awwrtm. °«+°v- Scott A. Russell �� STO]ELI�MIWA\T]E]k SUPERVISOR MA\N A\cGl]ENIIENT SOUTHOLD TOWN HALL-P.O.Box 1179 0 53095 Main Road-SOUTHOLD,NEW YORK 11971O� Town of Southold CHAPTER 236 - STORMWATER MANAGEMENT WORK SHEET ( TO BE COMPLETED BY THE APPLICANT ) DOES THIS PROJECT INVOLVE ANY OF THE (FOLLOWING: Yes No (CHECK ALL THAT APPLY) ❑ A. Clearing, grubbing, grading or stripping of land which affects more than 5,000 square feet of ground surface. ❑0 B. Excavation or filling involving more than 200 cubic yards of material within any parcel or any contiguous area. ❑0 C. Site preparation on slopes which exceed 10 feet vertical rise to 100 feet of horizontal distance. FloD. Site preparation within 100 feet of wetlands, beach, bluff or coastal erosion hazard area. ❑q E. Site preparation within the one_hundred-year f loodplain as depicted on FIRM Map of any watercourse. EIRF. Installation 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 Department with your Building Permit Application. APPLICANT: (Property Owner,Design Professional,Agent,Contractor,Other) S.C.T.M. 1000 Dale: #: NAME: iN+t i.Y1,V1 l!1 UQv Sfl wiRYVOl+h 4:�� _T 5�W:21 TTI N y M Section Block Lot 01Mq�W&�L j � '� **** FOR BUILDING DEPARTMENT USE ONLY**** Contact Information:oInformation: L Reviewed By: - - - - - - - - Date Property Address/ Location of Construction Work: — — — — — _ — _ ` � I .r A ❑ Approved for processing Building Permit. Stormwater Management Control Plan Not Required. CS) Stormwater Management Control Plan is Required (Forward to Engineering Department for Review.) FORM # SMCP-TOS MAY 2014 SYMBOL LEGEND 0 MONUMENT FND 0 MANHOLE 'Q� TEST HOLE 0 I.P. /I.B. FND 9M "A"-INLET TREE Q I.P. /I.B. SET "B"-INLET a SHRUB *10,55' SPOT ELEVATIONS M YARD INLET • BOLLARD cob UTILITY POLE 0 YARD INLET & WETLAND FLAG 1 GUY WIRE ® ELECTRIC METER CANT. CANTILEVER' o7 UTILITY POLE W/LIGHT © GAS METER FE.FENCE ' LIGHT POLE I@ WATER METER MAS.MASONRY -� SIGN pQ GAS VALVE PLAT.PLATFORM — PVC FENCE (PVC) WY W.W.WINDOW WELL �-- STOCKADE'FENCE (STK) �4 WATER VALVE B/W BAY WINDOW —X— CHAIN LINK FENCE (CLF)O/H OVERHANG C/E CELLAR ENTRANCE WIRE FENCE R/O ROOF OVER FIRE HYDRANT D.C. DEPRESSED CURB A/C UNIT ROAD VIES MAINBAY ROAD HAYVIEw (66 �o FM LOT 39 I TAX LOT 28 ILL Q —� MTL I m MTL/FEN N I STK N I PFND PE i S52°05'50"E 125.00I FEN a 4'METAL FEN. �1.9, 2.0'} X — FND 4 N PIPE GENERATOR z ASPHALT ' \%W/B.B.WAY CURB ''•.. w..41.2' Shy I 0 ITY ~ C" • 1, •. 1'�aTORY u' 1 11 `.• FM LOT 24 w Iol 2•.,$TbRY d 1 TAX LOT 54 L FRAME''•., Q CONC. " 1'eo. RESIDENCE`••., ti, I l a••, 3 M LOT 9 m �ITAX LOTD 2 N. / � a 0 I c�i 4'2 10l •''•.. .� ri I ILo 31, I 39.7' rl - FM LOT 72 l!y TAX LOT 53 ICo "' N to co FND ca IJLPIPE N52005'50"W 125.00' I i I I FM LOT 41 TAX LOT 30 LOT AREA GRAPHIC SCALE 15,0.360AC. 30 0 15 30 GUARANTEED TO: MADHU SOUTHWORTH AND DEVARAJ SOUTHWORTH ZENITH ABSTRACT, LLC. ( IN FEET ) ZA-8245-20 1 inch = 30 ft. FIRST AMERICAN TITLE CITIZENS BANK, N.A., ISAOA ATIMA pF NEbyy SURVEY OF PROPERTY 0 LOT 40 J. SC �� s MAP OF BAY HAVEN * I a n d surveying FILE DATE: 01/22/1959 MAP NO. 2910 mjslandsurvey.com P: 631 -957-2400 SITUATE �0,050$$bK9 DR.:MC CREW.:JM SCALE: 1" = 30' SOUTHOLD SF� LANO'S SUFFOLK TAX MAP NO. TOWN OF SOUTHOLD DATE SURVEYED:10/26/2020 JOB No.S20-2238 1000-088.00-04.00-029.000 SUFFOLK COUNTY, NEW YORK ((1jj UNAUTHORIZED ALTERATION OR ADDITION TO THIS SURVEY MAP BEARING A LICENSED LAND SURVEYOR'S SFAL IS A VIOLATION OF SECTION 7209.SUB-OMSION 2,OF NEW YORK STATE EDUCATION LAW.(2)ONLY BOUNDARY SURVEY MAPS WITH THE SURVEYOR'S EMBOSSED SETL ARE GENUINE TRUE AND CORRECT COPIES OF THE SURVEYOR'S ORIGINAL WORK AND OPINION. (0)CERTWICKTIONS ON THIS BOUNDARY SURVEY,M AR AP SIGNIFY THAT THE M WAS PREPARED IN ACCORDANCE WITH THE CURRENT EXISTING CODE OF PRACTICE FOR LAND SURVEYS ADOPTED BY THE NEW YORK STATE ASSOCIATION OF PROFESSIONAL LAND SURVEYORS,INC.THE CERTIFICATION IS LIMITED TO PERSONS FOR WHOM THE BOUNDARY SURVEY MAP IS PREPARED,TO THE TITLE COMPANY,TO THE GOVERNMENTAL AGENCY,AND TO THE LENDING INSTITUTION LISTED ON THIS BOUNDARY SURVEY MAP.(4)THE CERTIFICATIONS HEREIN ARE NOT TRANSFERABLE.(S)THE LOCATION OF UNDERGROUND IMPROVEMENTS OR ENCROACHMENTS ARE NOT ALWAYS KNOWN AND OFTEN MUST BE ESTIMATED.IF ANY UNDERGROUND IMPROVEMENTS OR ENCROACHMENTS EXIST OR ARE SHOWN,THE IMPROVEMENTS OR ENCROACHMENTS ARE NOT COVERED BY THIS SURVEY.(B)THE OFFSET(OR DIMENSIONS)SHOWN HEREON FROM THE STRUCTURES TO THE PROPERTY LINES ARE FOR A SPECIFIC PURPOSE AND USE AND THEREFORE ARE NOT INTENDED TO GUIDE THE ERECTION OF FENCES,RETAINING WALLS,POOLS,PATIOS PLANTING AREAS,ADDITIONS TO BUILDINGS.AND ANY OTHER TYPE OF CONSTRUCTION.(7)PROPERTY BY MONUMENTS WERE NOT SET AS PART OF THIS SURVEY.(B)THIS SURVEY WAS PERFORMED WITH A SPECTRA FOCUS OD ROBOTIC'TOTAL STATION. (9)THE EXISTENCE OF RIGHTS OF WAY AND/OR EASEMENTS OF RECORD IF ANY,NOT SHOWN ARE NOT GUARANTEED. (10)SURVEY IS SUBJECT TO ANY STATE OF FACTS WHICH AN UP-TO-GATE TITLE EXAMINATION NAM DISCLOSE ' - � . . ENCLOSE POOL TQ.CQDE,. n . 1P0lV.COJViPLE fIOfV 6ad BFORE"WgTR"_t NOTES 10, 40' 10° 1. NO SOIL SURCHARGE PERMITTED WITHIN 4FEET OF EXCAVATION AT THE SHALLOW END,OR 6 FEET OF EXCAVATION AT THE DEEP END. O 0 2. THIS POOL MEETS THE REQUIREMENTS OF AN5I/AP5P/ICC-5"AMERICAN NATIONAL STANDARD FOR RESIDENTIAL INCROUND SWIMMING Q � `- POOLS"AND 1996 BOCA CODE-SECTION 421.DIVING EQUIPMENT IS NOTALLOWED. p, d 3. SWIMMING POOL SHALL IE COMPLETELY AND CONTINUOUSLY SURROUNDED WITH ABARRIERCOINSGRUCTEDIAWP-EQUIREMENTSOF ICJ 41 SECTION R326.4.2.1 THROJGH R326.4.2.6 OFTHE NEW YORK STATE RESIDENTIAL(CODE(2020)AND IN CONFORMITY WITH ALL SECTIONS OF THE SOUTHOLD TOWN CODE.DWELLING WALL(S)MAY 5ELVE AS PART OF THE POOL BARRIERA5 PER SECTION R326.4.2.8AND ...I CONDITION 0)ARE MET.OPERABLE WINDOWS IN THE WALLIS)USED ASA BARRIER SHALL HAVE SELF LATCHING DEVICE.ACCE55 GATES O PPR ,VED AS NO ED s'-o° SHALL COMPLY WITH SECTION R326.5.2 OF THE NYS RESIDENTIAL CODE(2020)AND BE SELF CLOSING,SELF LATCHING AND BE SECURELY O CO H2O - o H2o A LOCKED WHEN POOL IS NOT IN USE OR SUPERVISED.ALL GATES ARE TO OPEN AINAY FROM THE POOL AREA. y0 cl- DATE: B.P.# "�� 4. 1)URING CON STRUCTIONTHE CON TRACTOK5 HALL ERECTATEMPORARYBARRIERAROUNDTHEE7(CAVATION LAW TfHE CODE OFTHE fj 3 TOWN OF SOUTHOLD. Z Z FEE: - " -� SV: 5. POOL MUST BE EQUIPPED WITH AN APPROVED POOL ALARM CAPABLE OF DETECTING ENTRY INTO THE WATER AND SOUNDING AN N a AUDIBLEALARMUPONDETECTIONTHAT15AUDIBLEATPOOLSIDEANDINSIDETHEDWELLING. THE ALARM MUST BE INSTALLED, v•- NOTIF :BUILDING C:: .ARTMENT AT - MAINTAINED AND USED IN ACCORDANCE WITH THE MANUFACTURERS INSTRUCTIONS.THE ALARM MUST MEETA5•TMF2208 � mc� 765-18 2 8'AM TO 4 ;'t.A FOR THE ' s "STANDARDSPECIFICATIONFORPOOLALARM5. THEDEVICEMUSTOPERATEINDEPENDENT(NOTATTACHEDTOORDEPENDENTON)OF 0 V PERSONS. FOLLC AIING INSPECTIONS: Es 6. POOLSUCTION FIT-nNGS.'EXCEPTFOP SURFACE SKIMMERS)ML/ST BE PROVIDED WITH A COVER THAT CON FORMS TO A5ME/AN51 '4C.� 1. FOL NDATION - TWO REQUIRED PLAN A112.19.8MORA MINIMUM 18'x23"DRAINGRATEORA CHANNEL DRAIN SYSTEM. POOL CIRCULATION SYSTEM MUST BE EQUIPPED W17H FO POURED CONCRETE ATMOSPHERIC VACUUM RELIEF IN THE EVENT THE GRATE COVERS LOCATED WITHIN THE POOL BECOME M155ING OR.BROKEN.SUCH N.T.S. VACUUM RELIEF SYSTEMS SHALL CONFORM WITH A5ME A112.'9.17 OR BE A GRAVITY SYSTEM APPROVED BY THE TOWN OF SOUTHOLD. 2. RO GH - FRAMING & PLUMBING POOL SHALL BE PROVIDED WITH A MINIMUM OF2 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 15 DRAWN THROUGH THEM 51MULTANEOLJSLY THROUGH A 1 INS ILATION. VACUUM RELIEF-PROTECTED LINE TO THE PUMP(OR PUMPS) VACUUM/PRESSURE CLEANING FITTINGS SHALL BE IN AN ACCE551BLE 18'VINYL COVERED STEPS POSITION,MINIMUM OF 6"AN1)NO GREATER THAN 12'BELON THE MINIMUM OPERATIONAL WATER LEVEL OR BEAN ATTACHMENT70 v 4. FINA L CONSTRUC"ION MUST THE SKIMMER/SKIMMERS A REQUIRED POOL ATMOSPHERIC VACUUM RELI EF SYS TEM SHALL BE INSTALLED AS PER NY5 RESIDENTIALCODE V BE OMPLETE FOt v.n. R326.6.3(2020)AND IN ACCORDANCE WITH TOWN CODE. c qj ALL ClNSTRUCTICI,,, SHALL MEET THE " 7. ALL ELECTRICAL WORK SHALL COMPLY WITH THE REQUIREMENTS OFNFPA70(INEC)PRINCIPALLY•ARTICLE680 AND THE NYS CS RESIDENTIAL CODE SECTIONS 4201 T POUGIH 4206.ALL ELECTRICAL DEVICES MUST BE APPROVED BY UNDERWRITERS LABORATORIE5AND _ REQU! 1EMENTS OF THE CODES OF NEW 2To4$ANDBOTiOMY O BE PROTECTED BYAGROVNDFAULTCURRENT INTERRUPTER(GFC0 CURRENT CARRYING ELECTRICAL CONDUCTORS IEXCEPTFORTH05E ,Lv/ YORK STATE. NOT RESPONSIBLE FOR METAL POWER TO POOL LIGHTING ANJ POOL EQUIPMENT5HALL MEET THE SEPARATION REQUIREMENTS OF TABLE E4203.5.ALL METAL ENCLOSURES,FENCES OR �RAILINGS IJEAR OR ADJACENTTO THE SWIMMING POOLTHATMAY BECOME ELECTRICALLY CHARGED, -- DESIG OR CONSTRUCTION ERRORS. DUE TO CONTACT WITH AN ELECTRICAL CILCUIT5HALLBE EFFECTIVELY GROUNIDED. SECTION A 8. WATER SOURCE FILLING-HE POOL SHALL BE EQUIPPED WITH A BACKFLOW PROTECTION DEVICE IAW NYS PLUMBING CODE608. `p 3 S Cot IPLY WITH ALL CODES OF N.T.5. 9. ALL PIPING 15 DIAGRAMMATIC UNLESS OTHERWISE STATED. 0 j } ty v Z NEW. ORK STATE & TOWN CODES WATERLINE TOP OF WALL 10. WALKSIFPROVIDEDSHALLBENON5LIPANDSLOPEAWAYFROMPOOLEDGE. v O AS R E U I R ED AND CONDITIONS O F i 4' 1O' 4' ! 11. A MEANS OF EGRESS FOR DEEP AND SHALLOW ENDS MUST BE(PROVIDED IAW AN51/AP5P/ICC-5 SECTION 6. v 0 v m 2 C2 p 0 SOUTHOLD TOWN ZBA 12. CONTRACTOR TO PLACE THE POOL LAW TOWN OF SOUTHOLD CODE SETBACKS. d d M 13, ALL DRAINAGE FROM THE POOL SHALL BE MAINTAINED ON THE 5UBJECTPROPERTY. _<:9QUTH9L______G BOARC 15. THE DESIGN 15 BASED ON A DRAINAGE SOIL WITH,10%SILT. GROUND WATER SHALL NOT EXIST WITHIN THE EXCAVATION. IF GROUND WATER EXISTS WITHIN 6'-0-FROM GRADE,)EWATERING FACILITIES WILL BE REQUIRED. N TEES SECTION B 16. ALL GAS AND OIL HEATERS(IF INSTALLED)FOR THE INGROUND SWIMMING POOLSHALL BE NATIONAL APPLIANCE ENERGY CONSERVATION ACT(NAECA)COMPLIANT. POOL HEATERS SHALL BE TESTED LAW ANSI 221.56 AND SHALL BE INSTALLED LAW Ln N.T.S. MANUFACTURERS SPECIFICATIONS. OIL FIRED POOL HEATER55HALL BETESTED IAW UL726. POOL[HEATERS SHALL BE:LOCATED OR GUARDED TOPROTECTAGAINST ACCIDENTAL CONTACT OF HOT SURFACES BYPERSONS. POOL HEATERS SHALL BE PROVIDED WITH TEMPERATURE AND PRESURE-RELIEF VAL4E5. FOR HEATERS VOT PROVIDED WITH AN INTEGRAL BYPASS SYSTEM.A BYPA55 LINE SHALL BE U INSTALLED FROM INLET TO OUTLET TO ADJUST WATER FLOW THROUGH THE HEATER. POOL HEATERS SHALL BE PROVIDED WITH THE 2'-2' FOLLOWING ENERGY CONSERVATION MEASURES: 00 py CHECK VALVE COPING AND WALKWAY 10° W (8Y OTHERS) 16.1 AT LEAST ONE THERMOS-AT SHALL BE PRO'11DED FOR EACH HIEATING SYSTEM. lU PUMP FROM SKIMMER t GRADE 16.2 ALL POOL HEATERS SHALL BE EQUIPPED WITH AN ON-OFF SWITCH MOUNTED FOR EASY ACCESS TO ALLOW 5H Urn NIG OFF THE (- WATERLINE ,� OPERATION OF THE HEATER WITHOVTAP)U5TJ NG THE THERMOSTAT SETTING AND TO ALLOW RE STARTING WITHOUT RELIGHTING THE z s PILOT LIGHT. y TO DISP05AU _ 16.3 HEATED SWIMMING POOPS SHALL BE EQUIPPED WITH A POOLCOVER(EXEMPTED FROM THIS REQUAREMENTARE OUTDOOR POOLSA. W DRVWELL VND15TURBEDEARTH DERIVING 20%OF THE ENERGY FOR HEATIN'GFROM RENEWABLE SOURCES AS COMPUTED OVERANOPERATINGSEASON) 'I�rN dp r-7 0 16.4 TIME CLOCKS SHALL BE INSTALLED 50 THE PUMP CAN BE SETTO RUN DURING OFF-PEAK ELECTRICAL DEMAND PERIODS AND CAN BESET W Q r «3500 PSI POURED CONC. a e N TO RUN THEMINIMVMTIMENECESSARYTOMAINTAINTHEFOOLWATERINACLFANANDSANITARYCONDITIONIAWAPPLICABLE e co VALVETER�O 3/8°REBAR.2)TYR . _ SANITARYCODE OF NEWYORKSTATE. UI 3 �f-� 3 c� VINYL LINER n 17. THIS DRAWING 15 FOR SnUCTURAL SHELL ONLY.ALL ACCE550PIES AND APPURTENANCES ARE DEFINED BYOTHERS. IIL� = p�mrpM� 2•TO 4•SAND W n C`- -�d " FILTER - 18. BACKFILL WITH CLEAN EARTH,FREE OF ROOTS AND DEBRIS. DO NOT ALLOW THE HEIGHTOF BACKFILL TO EXCEED TTHE HEIGHT OF THE N p •• iz .0 WATER IN THE POOL BY MORE THAN 8", OR THE WATER TO EXCEED BACKFILL BY MORE THAN 8" C w 19. PLACE CONCRETE ON SANDY TO LOAM SOIL. REMOVE ANY CAY DEPOSITAND REPLACE W/COMPACTED CLEAN BACKFILL. W ►a .0 Q; a OCC PANCY ORCHECKV4LVEJ TORETVRNs VeaT7cAL3/e REBAR©3OC. 20. THERE IS NO MAIN DRAIN INTH15 POOL.SU'CTIONFOP,POOL WATER CIRCULATION 15 PROVIDED BWTHE SKIMMERS O�NLY.THIS MEETS y REQUI REMENT5 OF THE NY5 RESI DENTIAL CODE-SECTION R326.5 FOR ENTRAPMENT PROTECTION. PLUMBING SCHEMATIC (NOTSHOWN) 21. THE POOL WAS DESIGNED IAW THE FOLLONJING: O USE UNLAWFUL R N.T.S. WALL SECTION 21.1. THE NEW YORK STATE RE5IDENTIALCODE-SECTION P326(2020) 21.2. THE NEW YORK STATE ENERGY CONSERVATION CONSTRUCTION CODE-SECTIO N R403.10(2020) WIT UT CE RTI FI CA71 N.T.S. 21.3. THE NEW YORK STATE FUEL GA5 CODE(2020) 21.4. THE NEW YORK STATE SANITARY CODE. ' OF-O GUPANC`� ELECTRICAL 21.6. BOCACODE-SECTIONNDARDFOR RESIDENTIAL IN-GROUND SWIMMING POOLS. f C) r r I111 21.6. BOCACODEA-SECTION 421. ' INSPECTION REQUIRED 21.7. CODE OF THE TOWN OF SOUTHOLD. m V f• i1 m L s 22. ALL BACKWASH TO BE SELF-CONTAINED ON-SITE. RETAIN STORM WATER RUNOFF PURSUANT TO CHAPTER 236 8847 �F8847Essl XAP� OF THE TOWN CODE.