HomeMy WebLinkAbout30027-Z FORM NO. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Office of the Building Inspector
Town Hall
Southold, N.Y.
CERTIFICATE OF OCCUPANCY
NO: Z-30459 Date: 09/22/04
THIS CERTIFIES that the building ACCESSORY
-Location of Property: 8440 MAIN RD EAST MARION
(HOUSE NO.) (STREET) (HAMLET)
County Tax Map No. 473889 Section 31 Block 7 Lot 3
Subdivision Filed Map No. Lot No.
conforms substantially to the Application for Building Permit heretofore
filed in this office dated JANUARY 26, 2004 pursuant to which
Building Permit No. 30027-Z dated JANUARY 27, 2004
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 IN THE REQUIRED
REAR YARD AS APPLIED FOR.
The certificate is issued to FRANCINE LEVINE REVOC. TRUST.
(OWNER)
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF BEALTH APPROVAL N/A
ELECTRICAL CERTIFICATE NO. 2006621 06/09/04
PLUMBERS CERTIFICATION DATED N/A
f
- f
th ize Signature
I
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. 30027 Z Date JANUARY 27 , 2004
Permission is hereby granted to :
F LEVINE (REMIERE POOLS)
401 BROADWAY
PORT JEFFERSON,NY 11776
for
INSTALLATION OF AN INGROUND SWIMMING POOL IN THE REQUIRED REAR
YARD FENCED TO CODE
at premises located at 8440 MAIN RD EAST MARION
County Tax Map No. 473889 Section 031 Block 0007 Lot No. 003
pursuant to application dated JANUARY 26, 2004 and approved by the
Building Inspector to expire on JULY 27, 2005 .
Fee $ 150 . 00
% Authorized Signature
ORIGINAL
Rev. 5/8/02
Form No.6
TOWN OF SOUTHOLD
BUILDING DEPARTMENT -- --:
TOWN HALL3
765-1$03
APPLICATION FOR CERTIFICATE OF OCCUPANCY $E0 2 1 2U04
This application must be filled in by typewriter or ink and submitted to the Building Dep'rtrneu� v.wtfierf 6flawing_
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 2110 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 buRdings(prior to April 9, 1957)non-conforming uses,or buildngs and"pee-exisfine land uses:
1. Aecuratesurvey o€property showing all property lines,streets,building and unusual natural or topographiic
feat azm
2. A properly completed;application and consent to inspect signed by the applicant.If a Certificate of Occupancy is
denied,the Huihiing,lospectorshall state the reasons therefor in writing to the applicant.
C. Fees
I. Certificate of Occupancy-New dwelling$25.00,Additions to dwelling$25-00,Alterations to dwc1hng-$25.00,
Rwirnmingpoo1S25.00 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
4. Updated Certi5cateofOecupaney- $50110
5. Temporary Certificate of Occupancy-Residential$15.00, Commercial $15.00
Date- Oxq - i 57, dm-�
New Construction_ V Old or Pre-existing Building. (check one)
location-of Property- ?4 () l%ql hi kaAAND e if f Cre7
e
House No. Street Hamlet
Owner or Owners of Property. ! f.C5 C^t' c'Z t �l�J E r
Suffolk County Tax Map No 1000, Section Block 0-7 Lot D
Subdivision Filed Map. Lot:
Permit No. Bate of Penn it. y (c Lt Applicant: Let)!r f
Health Dept.Approval: Underwriters Approval:
Planning Board Approvat.
Request for. Temporary-Certificate Final Certificate_ {check one)
Fee Submitted:$ 0o
Applicant Signature
r�7Cfr7k7R c13i7!-rJlM lr7rr3rlr.fd fr][e�7�171�,7C_I7rsrar_�ar�rtr�G.ir'�snrar��rarr - r r7 r7r7fr7
�lBY THIS CERTIFICATE OF COMPLIANCE THE
NEW YORK BOARD OF FIRE UNDERWRITERS
BUREAU OF ELECTRICITY
40 FULTON STREET — NEW YORK, NY 10038
CERTIFIES THAT
Upon the application of upon premises owned by
BRIAN BROOKS ELEC. INC. ELLIOT LEVINE
BOX 1001,455 BEEBE DR. 8440 ROUTE 25
CUTCHOGUE, NY 11935, EAST MARION, NY 11939
Located at 8440 ROUTE 25 EAST MARION, NY 11939
2006621
Application Number: Certificate Number: 2006621
Section: Block: Lot: Building Permit: BDC: nsll
c Described as a Residential occupancy, wherein the premises electrical system consisting of
eiectrica! devices and wiring, described below, located in/on the premises at:
Detached Garage,
A visual inspection of the premises electrical system, limited to electrical devices and wiring to the extent detailed
herein, was conducted In accordance with the requirements of the applicable code and/or standard
promulgated by the State of New York, Department of State Code Enforcement and Administration; or other
authority having jurisdiction, and found to he in compliance therewith on the 9th Day of June, 2004-
Name QTY Rate Ratios Circuit Type
Wrtscellaneous
install sub panel in garage
Panels
1 100 4
seal
I of I
This certificate may not be altered in any way and is validated only by the presence of a raised seat at the location indicated_
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I Electrical Inspection Certificate 1�=
Issue Date Electrical Inspection Service,Inc. Application
7/16/04 375 Dunton Avenue 89835C
East Patchogue,New York 11772
(631)286-6642 :>�
_ _ 3
Issued To: Mr. Levine -
Street: 8440 Main Rd.
Village: East Marion Zip: Town: Southold
Section: Block: Lot:
= Contractor: Richard Kleinfeldt Lic. # 665-E _
Was examined and found to be in compliance with the National Electrical Code-
❑ Commercial ❑ NV Defects ❑x Pool ❑ list Floor ❑ Indoor ❑ Basement ❑ Hot Tub
x Residential ❑ Det.Garage ❑ Attic ❑ 2nd Floor FXJ Outdoor ❑ Addition ❑ Survey
Switches Receptacles Fixtures GR Heaters AIC Fane
< _ 3 1 2 �9
t•w___ Dishwasher Washer/Amps Dryer/Amps Oven Range/Amps Microwaves -- --
= Furnace oil Gas Circulators Smoke Detector Bell Transformer
Meter Amps Phase UGIOH Jacuzzi Television CO Defector -
Bldg_ Permit
IJ
Other Equipment a B'�
11 pool light/bonding o.k. /1 time clock 11
�Oamp 220V speciality outlet/ 1 151220V
�= peciality outlet/ 1 501220V rain tight disc for Hugo S.Surdi
eater 11 40/220V rain tight sub panel President `
Rough Inspection: 07/152004
Inspector. John Mc Mahon IN
Final Inspection: 071152004 — -
_ _ Inspector: John McMahon III _
rR This certificate must not be altered in any manner. Inspectors may be identified by their credentials.
^ � �k - ---'11 � Cit' r1¢.. P�r1-J 1• j! 4 11ft 1 ���•r
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�- •7/Y}/•. .�"S ..Y. , :.'•T'' •.-`Jy�in�i7a#��eb� _.•- s._::$".`.,Y eb.'..•.�,'�!• .:.. ,r• �'$�i Y_.! t•: '4. •.,r• >,
TOWN OF SOUTHOLD PROPERTY V-10 D CARD
OWNER 4STET ,"� ,, VILLAGE DIST. SUB. LOT
I ,, p�
fir_.
$ M"n .S
wo
FORNIER�WNERS E -� ACR
' ( �. r c_I l L/I t �i r( rIa)'vS W TYPI:OP BUJLDING �
RES. ll'I p SEAS. VL. FARM COMM. CB. MICS, c Mktg Value. •T _
LAND IMP, TOTAL DATE REMARKS
� � 1�� � /�, .. ul�^ l'.f'GL 1� Ft✓ j I' ! A) (_
pp .d7 J (�.) /� u: ty r... s.�; �1, �'J _ 'y.
G /pJ l„Y 1C>c." C r. c.. r „ .., F�rqx( i.,o.,Y f �.' ✓.•. �.
oo
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4 cao �F4 a
:- a -`o b,2, CC7a)ndc;a
9or) Mon S` Td�(1 (I �(� Irk 5��',-� .. � M�c�� al: C' r)ms.4 YA . m i�ii7 3(r��,I31r`s
-fz) Ott M ck(ct7c
Lov,ner�sl �.�,�
� Rria l7
Tillable FRONTAGE ON WATER
Woodland FRONTAGE ON ROAD1
ri� Y,
Meadowland DEPTH
House Plot BULKHEAD
Total
1y
..,.., COLORAw
Id f A TRIM '.x1 ;\� .t, +
1
v -- -
n( �x
Y'
y
M. Bldg. Y G x e r g - .' S 1'
i
.v
Extension 8 i y = !? d
Extension x a s r. �y J,
X g- C w
w ,.
Bath
Extension � �� 1, <;� s �s' o_ >"� � Dinette.
� I r+, Foundation < I^
�xci4 yeF z$O % Basement y} Floors ( K.
Po qI&/ —
Ext.'tNa�ls Interior Finish LR.
Porch s` A. d � G a / 7 n ,a r,
y 1
Fire Place ` Heat DR.
` Rooms 1st Floor BR
P eRoo .
Ion j f _
P c>n Recreation Room Rooms 2nd Floor FIN. B
O. B• qZ Z� 4�
Dormer Dnyewoy..,
Total
fv'
_ E'Iz �445a
Gl^127-dsl 2 6.'" ��"R � �'� pdid .�. �.� / Y ' �1 H ?�
9 V// A7 T
le
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Applicant/ Date
Owners Name: . C"r_,"L�I��e,✓c� ��"^-34--- Reviewed: _ f &7
Architect/ _ Date D t
Engineer: �7� r 7 Submitted: )/,;.6R
SCTM
District: 1000 Section: 3f woc[: 7 _ Lot. 3
Project ' 1 Subdivision
Location:
(
Single &, separale Required
cernficatiou: (Yes/ No)
Rcq. _ lacy: _
Zonine I7islnu. L"L if.olsiu M�.� Ae¢nl:,2jSi J?�,? I (Loi eovcragc_, -rroposcd
I Rcq. Req.
[[Trani Yard _Proposed. ry/�sdc Yard ------ ---�s1'mNsed: to J [Rear Yard _ 11mposed' � I
Project Description: -4 YV— J� n�
AGENCif.,BERMITS Permit
REOUIRED FOR REVIEW N.A. NO YES Number
Suffolk County Health Dept.
New York State D. E. C.
Town Trustees
Town Zoning Board approval: _
Town Planning Board approval:
Flood Plane Elevation ??? [�
Flood Zone: 2' ti K,
Notes:
I` 765-1802
BUILDING DEPT.
INSPECTION
[ ] FOUNDATION IST [ ] ROUGH PLBG.
[ ] FOUNDATION 2ND [ ] INSULATION
[ ] FRAMING [ /FINAL
[ ] FIREPLACE & CHIMNEY
REMARKS: cP �,s L�✓s J .ice
DATE�� U `( INSPECTOR _�
FIELD INSPECTION REPORT DATE CONITNIENTS
n
C �
FOUNDATION(1ST)
--------------------------------------
�f
FOUNDATION(?ND) — p
7
C
t -r
m
ROUGH FRAMING& cn
PLUMBING
.r
a
3
r
INSULATION PER N.Y_
STATE ENERGY CODE
rj SNC;(cls,, C:i— ---
FINAL.
ADDITIONAL,COMMENTS
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TON'('. OF SOUTHOLD BUILDING PERMIT APPLICATION CHECKLIST
BUILDING DEPARTMIENT bo you have or need the following,before applying?
TO'"'N$aLL Board of Health
SOUTHOLD,NY 11971 3 sets of Building Plans
TEL: (631) 765-1802 Planning Board approval
FAX: (631) 765=9502 Survey
N"vw. northforlk.net(Southold/ PERMIT NO. 3 O C',7 Check_
Septic Form
N.Y.S.D.E.C.
a
Trustees
Examined / PooContact: 4I &(�
Contact-
Approved j ,2004 �7Mail to: urjt Y____�
Disapproved a'c
Expiration 17 , "0 015—�
Building Inspector
APPLICATION FOR BUILDING PERMHT
JAN 2 6 N4
Date 1 20L;�—
INSTRUCTIONS
a. -Phis-app!ic tion bIUST be 'om letel filled ' b typewriter r ' ands tte the t x'
a Q p m y o m ink submitted to h Building Inspector with 3
sets of llaans ia_c-uratirg}ot-pla ftifse�ie.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 13 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 NL-.DE to the Building Department for the issuance of a Btulding 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 e)itolition as her described.The
i applicant agrees to comply with all applicable laws, ordinances, building code, ho mg code, and regal ton-•and to admit
authorized inspectors on premises and in building for necessary inspections.
UNDERWRITERS CERTIFICATE
C CUPANOY OR REQUIRED
(Signature of app lican or name,if a corporation)
VSE IS UNLAWFUL 4)69k�A 14
i I ROUT CERTIFICATftWneer,
:Mailing address of applicant)
( E(Z(',{�I_I�#AI('Yto ra tt is oec-nneer, general contractor, electrici2n, plumber or builder
own
ArrpOVEDAS NOTED
Vame of orvner of premises oji D-o DATE: -400-) ;7-&
(As on the tax roll or late�e BY.L4
If applicant is a corporation, signature of duly authorized officer NOTIFY BUILDII'.G ^—°:9TN, AT
;S5-i&02 B AM TO 4 PM FOR THE
(Name and title of corporate officer, FOLLOWING INSPECTIONS:
1. FOUNDATION - TWO,REQUIRED
Builders License No. 15I`) I - I [T FOR POURED CONCRETE
Plumbers License No. 2. ROUGH - FRAMING 8 PLUMBING
Electricians License No. 3. INSULATION
Dther Trade's License No. 4. FINAL - CONSTRUCTION MUST
BE COMPLETE FOR CO.
I. Location of land on cchich roposed work will be done: ALL CONSTRUCTION SHALL MEET THE
EQUIREMENT,S:OF THE CODES OF NEW
'34J� N1atn O _ �1 R ATE_ NOT RESPONSIBLE FOR
House Number Street \ H029M OR CONSTRUCTION ERRORS.
County Tat Map No. 1000 Section j' j Block D- Lot 03
Subdivision Filed Map No. Lot
(Name)
2. Stateexisting usc`and occupancy of premises &nd intended use and occupancy of proposed cpnstrucijon:
a. Existing use and occupancy (Y)`p fY1 t IU dW-P��1
b. Intended use and occupancy d k(►�Y11�� 1.l 111 1.�� \fyu j AM. .(;Ww
3- Nature of work(check which applicable):New Building Addition Alteration
Repair Removal Demolition Other Worl��f10.t tf - tY i
(Desen on)
4. Estimated Cost Fee
(To be paid on filing this application)
5. If dwelling, number of dwelling units O_Number of dwelling units on each floor_ {(
If garage, number of cars N R
6. If business, commercial or mixed occupancy, specify nature and extent of each type of use.
7. Dimensions of existing structures, if anv: 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 neve construction: Front 15' Rear Depth`
Height Number of Stories
9. Size of lot: Front 1M. q I Rear CA,og t Depth 15.( o-V
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 lain, ordinance or regulation": YES_NO V,
13. W,ill lot be re-graded? YES X NO Will excess fill be removed from premises? YES P NO
��[(,@3 Norwood Ave.
14. Names of Owner of premises Lp ift l Address FkUVetne .NSI I i51P5 Phone No.,�Lyg S'n- [0
r„� Address PQ1 d�� r 4. Phone
Name of Architect �ty5 � _,_-
Name of Contractor Qrer�fPfQ �\ Address Ao i R"�4Phone No. (431--411-3333
PorF l2F��nrs m,Ny IMC,
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? * 'i'ES = " NO
* IF YES, D.E.C. PERMITS MAY BE REQUIRED.
y .
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 topogra�hical data on suxvgv.
STATE OF NEW YORK)
SS:
COUNTY OFc% ^ z r n-
being duly sworn, deposes and says that (s)he is the applicant
(Name of indixidual signing contract) abate named,
(S 11 e is the,
_(ContraPtor,.Agent, Corporate Officer, etc.)
of said owner or of4atn-21d ' duly a4th6rized to perform or have performed the said work and to make and file this application;
that all statements coe. ix}t�4' application are true to the best of his knowledge and belief; and that the work will be
performed in tlie`` ` er se[forth p5,fi application filed therewith.
Sworn to before me thi` % �
"'q� gyPf yul
SionatureofApplicant
Arlene D.@ogiino
Notary Public New York.restate
SWOR COMAY#61B0i3 05-x7
Commission ires 04T6120 069
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EAQT11 ""..III =III elll - PAWEAAA'nC.A�_L-(
- III_111=III=111=111_III APPLlEn e.OrJ CRETE.
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NOTES
1. Pool design is based on free draining granular soil with less than
10/R/B silt,
?I. Pneumatically applied concrete shall be a 4 to 1 mix with a
-----� maximum of 3.5 gallons of water per sack of cement.
3. If ground water is encountered during construction, a temporary
dewatering system shall be constructed. The system shall have a
PLAA1 minimum of two 11/2-inch diameter weep lines. Flow from the
weep lines shall be discharged on the premises in a temporary
0
recharge basin. I
4; No spoil surcharge permitted within 4 feet of excavation. I
5. Finished grade shall slope away from the pool a minimum of V4-inch "
per foot.
& All reinforcement shall be#4 bars,grade 40 minimum. All
reinforcement splices shall be 30 bar diameters minimum.
D E(nI d, ES )ULE,
Poet L31 , 31
bEPT'H
VERT, 12!' 0.6, o,C.
FLooE it' O.C,. oR I ALL P>4e5 SMALL
MPSII t4„I\I. Pyr- # 4 ysPSE� y
rat CTUUITE_ PodL 9l,-AA $. IJE.TAtLS
3 _r
Fb 'W SCALE; AS SIYOWN APPROVED BY: DRAWN BV dlCt.{
X0529 �2� DATE: 12J2�D�
JFESSIONP� MLPI- 6D '�Y : JAegeS K,, n4o¢,u�ll .f¢-.1 r'F_
IDG4 t�FMIO e.Jz.
♦ Id. ALLUAo _- Wf a-Io (.516)'1455.8032
r R.EnARer) FofL: 6 4J Me.W ROAi7 ORAWINO NUMBER
EAST MARIo At' 11939 I_EVInll_ - I
N
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P 0� r o
100
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PmOPER T Y "
A T EAST MARION
TOWN OF SOUTHOLD
SUFFOLK COUNTY, N. Y° #0 it
1000 - 31 - 07 - 03
Scale 1" = 30' �► g
Dec. 17, 2003
AREA - 25,820 sq. ft. 4Ltr# NEW y
moo' t. mEpp P,f.
AMY AL MU TION OR AQpTIM TO TIN SLOWY IS A VIOLA TW
VAIMM
TAaN T2O!AF Tl STATEfDIAAC�A�TIgN LAM.9 AAD S TwDfFOF OAALYY rSt QR COTES eeAR SEAL OF ME SURVEYOR
�raaE srAw rt�tE AARs ALN.Y.S. LIC. NO. 49618
Arro oarrLr wnrl sAo1 r, rrew• TEc er .
c+r ANVE'NY a°AAA Ttrws sua+•urr w A CuiAADY MORS, P.C.
ro -OA AAE Aar Av c�OrrLaNL1E r► T►E uw. p�,311 765 - 5020 FAX !6311 765 - 1797
f�! O. BOX 909
.1230 TRAVELER STREET
f
SOUTHOLD, N.Y. 119,1
90 - 291