HomeMy WebLinkAbout30306-Z FORM NO. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Office of the Building Inspector
Town Hall
Southold, N.Y.
CERTIFICATE OF OCCUPANCY
No: Z-30802 Date: 03/03/05
THIS CERTIFIES that the building INGROUND SWIMMING POOL
Location of Property: 8125 MAIN RD EAST MARION
(HOUSE NO.) (STREET) (HAMLET)
County Tax Map No. 473889 Section 31 Block 2 Lot 30
Subdivision Filed Map No. Lot No.
conforms substantially to the Application for Building Permit heretofore
filed in this office dated MAY 4, 2004 pursuant to which
Building Permit No. 30306-Z dated MAY 11, 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 WILLIAM L & BARBARA CLAYTON
(OWNER)
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A
ELECTRICAL CERTIFICATE NO. 04-9290 11/30/04
PLUMBERS CERTIFICATION DATED N/A
A
Aut o ized Signature
Rev. 1/81
Form No.6
' TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN HALL
765-1802
APPLICATION FOR CERTIFICATE OF OCCUPANCY 18
This application must be filled in by typewriter or ink and submitted to the Building Department with the following:
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 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 dwelling$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
4. Updated Certificate of Occupancy- $50.00
5. Temporary Certificate of Occupancy-Residential$15.00,Commercial$15.00
Date. �L , .S
New Construction: Old or Pre''-existing Building: (check one)
``
Location of Property: 6 S M 0 1 A) R b.
House No. Street Hamlet
Owner or Owners of Property: U I L L► 4 rA RaW A a A C (A Y7'0^)
Suffolk County Tax Map No 1000,Section Block O L Lot O
Subdivision Filed Map. Lot:
Permit No. 3 O O` Date,ofPermit. MAy/1, L-44Y Applicant: LS C A NA i.4 F O OSS , C ."I'd.
4 a t.}YP*6
Health Dept.Approval: 01 ,4 Underwriters Approval:
Planning Board Approval: N 1 A
Request for: Temporary Certificate Final Certificate:_ (check one)
Fee Submitted: $ r.00
Applicant Signature
)zoo
-E3 08 0 2
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. 30306 Z Date MAY 11, 2004
Permission is hereby granted to:
WILLIAM L CLAYTON
8125 MAIN RD
E MARION,NY
for
CONSTRUCTION OF AN INGROUND SWIMMING POOL IN THE REQUIRED REAR
YARD AS APPLIED FOR
at premises located at 8125 MAIN RD EAST MARION
County Tax Map No. 473889 Section 031 Block 0002 Lot No. 030
pursuant to application dated MAY 4, 2004 and approved by the
Building Inspector to expire on NOVEMBER 11, 2005 .
Fee $ 150 . 00
Authorized Signature
ORIGINAL
Rev. 5/8/02
Electrical Inspectors, Inc. Certificate Number: 04-9290
308 East Meadow Avenue
East Meadow,NY 11554 Municipality: Southold,Town Of
Office:(5 16)794-0400(631)396-7474 Inspector: 124
Fax-(516)794-5854
Issue Date:
11/30/2004
Website:www.electricalinspectors.com
Email:info@elcctricalinspectors.com
Mail To: Property Address:
East County Electric,Inc.
William,Oster/Bruce Oster William Clayton
PO Box 2620 8125 Main Road
Aqueboque,NY 11931 East Marion,NY 11939 r.
License#: 1005E
ELECTRICAL APPROVAL CERT ICS
Pertnit#: Application#:
Section: Block: Lot
AREAS LISTED BELOW ARE APPROVED BY INSPECTION
AND FOUND TO BE IN COMPLIANCE WITH THE NATIONAL ELECTRIC CODE
No visual defects were found for the electrical inspection provided.No obvious unsatishetory conditions were found in the arm
herein below only.
sr Residential Inspection
In Ground Pool
100,4 Single Phase Sub Pane1120CW17 Used
InP
]-Single Receptacle,4-Switches, I-GFIReceptacle ]-Incandescent Fixture,I-Time Clack]-Motor*,
Amended CertificaWJR
43
..........
This Pool meets Article 680 of the National Electric Code 1999 Edition.Each year prior to the use of this pool/so an
inspection should be made by a qualified person or company to verify for safe use and operations of associated
equipment.GFI protection should be tested regularly as directed by the manufacturer,and Integrity of alt,booded,iostai
parts.
if
Novvalid unless signed by an
44 au th zed ER,Agent
t9j t"
Richard M.Hivone Philip F.Goehring
President Chief Electrical Inspector
TOWN OF SOUTHOLD PROPERTY RECORD CARD
WN R X,6,1 dgr5LA1 STREET !/, VILLAGE DIST. SUB. LOT
�!j �ct&, Rar ka on AAa'OAMCV -MjLq/f7 Cl&'k?s" eltllj-14�1 .3
FORMER OWNER N , E ACR.
I, Nvahael ,A,A,GP2r--CQ ,6d�.
1J.i t bur. Cook S W TYPE OF BUILDING
f i' (aw
RES. �d SEAS. VL. FARM COMM. CB. MISC. Mkt. Value
LAND IMP. TOTAL DATE REMARKS
S' Z-
Zv L3 n--�� 7 n (200)4::n aA MM r--u2
0 3 G o o �f}/-�v .�` 5�2.�� - 5 N/e
�o Qc� U d og
46Az 5- mnrur Cl -
GE (Q t 0® '�t*/ B I G , " I a K 0�b
NEW NORMAL BELOW ABOVE
FARM Acre Value Per Value C�J
Acre
Tillable 1
Tillable 2
Tillable 3
Woodland
Swampland FRONTAGE ON WATER deed
Brushland FRONTAGE ON ROAD
House Plot DEATH
BULKHEAr
Total DOCK
(3 Gn
,, -, ■■■■tl■■ ■1110■■■■■■■■■■■■■■■• �®�:. ..
30 30��
ass.,sot
BUILDING DEPT.
INSPECTION
[ ] FOUNDATION 1ST [ ] ROUGH PLBG.
[ ] FOUNDATION 2ND [ ] IN CATION
[ ] FRAMING [ FINAL
[ ] FIREPLACE & CHIMNEY [ ] FIRE SAFETY INSPECTION
REMARKS: D� � C. O
DATE D3 a2- — INSPECTOR__���G�
FIELD INSPECTION REPORT DATE COMMENTS
FOUNDATION(1ST)
------------------------------------
_ _ h
FOUNDATION(2ND)
• z
o� o
-9J
.. y
ROUGH FRAMING&
ILI
PLUMBING
y
R
INSULATION PER N.Y.
STATE ENERGY CODE "3
G9L �I
oY
FINAL O ,.
Z .
ADDITIONAL COMMENTS ('
2
3 �
LA O
z
x
_ Ir
x
d
b
y
TOWN OF SOUTHOLD BUILDING PERMIT APPLICATION CHECKLIST
BUILDING DEPARTMENT Do you have or need the following,before applying?
TOWN HALL Board of Health
SOUTHOLD, NY 11971 3 sets of Building Plans
TEL: (631) 765-1802 Planning Board approval
FAX: (631) 765-9502 Survey
www. northfork.net/Southold/ PERMIT NO. Check
Septic Form
N.Y.S.D.E.C.
Trustees
Examined // 20 O�' Contact:
Approved �V11 2001/) Mail toaSLO3W,064 nLS �rr�
Disapproved a/c /(� SiL / � Kt(,l
Phone: Z-
Expiration (/ 20� /
Building Inspector
APPLICATION FOR BUILDING PERMIT
�4t Date 5J C , 20Uc
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 ode, an regulations, and to admit
authorized inspectors on premises and in building for necessary inspectio
1
"IMMEDIATELY"
ENCLOSE POOL TO CODE
OCCUPANCY OR UPON COMPLETION / (Sk f p ant o arae,if a corporation)
BEFORE"WATER" /
USE IS UNLAWFUL UNDERWRITERS CERTIFICATE
WITHOUT CERTIFICATE REQUIRED (Mailing address of applicant)
AMNY owner, lessee, agent, pLLh M contractor, electrician, plumber or builder
OF
c MEET THE REQUIREMENTS OF THE
IL rnnr-S OF W YORK STATE.
RROVEAS NOTED
Name of owner of premises t QL 1 A-An r 6A n, � v D
(As on the tax roll or late
If applicant is a corporation, signature of duly authorized officer FES- A-6 _ BY:
NOTIFY BUILDING DEP RTMENT AT
(Name and title of corporate officer) 765-1802 8 AM TO 4 PM FOR THE
FOLLOWING INSPECTIONS:
Builders License No. A/ 1. FOUNDATION - TWO REQUIRED
Plumbers License No FOR POURED CONCRETE
2. ROUGH • FRAMING & PLUMBW
Electricians License No. 3. INSULATION
Other Trade's License No. 4. FINAL • CONSTRUCTION MUST
BE COMPLgTE FOR C.O.
1. Location of land which proposed work w' done: CONSTRUCTION SMALL INET THE
M P ►U �S� OF THE CODES OF NEW
House Number Street HAW STATE NOT RESPONSIBLE FOR
DESIGN OR CONSTRUCTION ERRORS.
County Tax Map No. 1000 Section C)3 1 Block d) 2- Lot D
Subdivision Filed Map No. 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
3. Nature of work (check which applicable): New Building Addition Alteration
Repair Removal Demolition Other Work
(Description)
4. Estimated Cost e� 6) 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 NOX--
13. Will lot be re-graded? YES X NO Will excess fill be removed from premises? YES A NO
14. Names of Owner of premises LoiLL k9r„f(3, BIW 'Address AX 3ZA&� e Phone No. ?- �3
Name of Architect Address Phone No
Name of Contractor Address Phone No.
15 a. Is this property within 100 feet of a tidal wetland or a freshwater wetland? *YES NOA
* IF YES, SOUTHOLD TOWN TRUSTEES &D.E.C. PERMITS MAY BE REQUIRED.
b. Is this property within 300 feet of a tidal wetland? * YES 4 NO
* IF YES, D.E.C. PERMITS MAY BE REQUIRED.
16. Provide survey, to scale with accurate foundation plan and distances to ro ' }
p p p�tY��nes.
17. If elevation at any point on property is at 10 feet or below, must provide topographij tale
STATE OF NEW YORK)
COUNTY OF )
,-- 0 T!
J3Vgg9A
So Cc--„9 ' being duly sworn, deposes and says that(s)he is the applicant
(Nla�e iyid iat g g ce traa eve named,
(S)He is the .e_
a�
(QQntractor,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 cogtained in thisapplication are true to the best of his knowledge and belief, and that the work will be
performed iigAVqj�Wgr ,+et forthin the _application filed therewith.
Sworn to befo � T, 4
U
ay o
...r
afyPjiblicV 3 1 A 2 ature of t
JOYCE M.WILKINS
Notary Public,State of New York
No.4952246,Suffolk Co my
Term Expires June 12, o o 7
1
SURVEY OF
DESCRIBED PROPERTY
SITUATE LOT SUBDIVISION
FILED Y1gp
EAST MARION, TOWN OF SOUTHOLDI°70155 00,,EFILEgNOL 99135 W
EXLER
FD
SUFFOLK COUNTY, N.Y. FD 5.50'
cn
FENCE
CORNER WOOD FENCE FD
E 0.1 CM
SURVEYED FOR: WILLIAM CLAYTON S 0.3' FENCE CORNER
BARBARA CLAYTON YEN 0.3'
3-CAR WOOD S 0.2'
U cn
FRAME GARAGE IV
(l�
0
i 2.3' 12
1 Fl
2 i
I
1 DRIVEWAY
I
TM# 1000-031-02-30 W / I
O j I
O
GUARANTEED TO: i 0
WILLIAM CLAYTON i
BARBARA CLAYTON 2
j 1 18'X36' o
IN
GROUND rri
�
SURVEYED: 03 APRIL 2003 j POOL
m
1 I
SCALE 1"= 30'
AREA = 22,726.77 S.F. SET
z
0.5O2R ACRES CM 1 r 11 FRAME SHED OVER
N SHED r_v
0.6' N
i SET
0.3' I I CM
1 I WOOD FENCE
i 1
�1 11
06,
1! ! 2
U / W000 U FENCE CORNER
2 I pEOK W W 0.1'
o N
PERCENTAGE OF LOT COVERAGE:
EXISTING HOUSE INCLUDING i 26 NCE
REAR DECK: 1928 S.F IV �l I iENCE Y RE51DE
EXISTING SHED (EAST SIDE) 250 S.F. O �� 2,ST0
R 2
35X42 GARAGE 1470 S.F. WOoD\ \ 1� NU�.
10.3'
TOTAL.......................................... 3648 S.F. A v \ a U
1 o
PERCENTAGE OF LOT COVERAGE 16.19 p \\ � `•\ o_ �
22,4'
FD
CM
20• z (TOP BROKEN)
ti \
SET
Cly
ES 5�.0000
T� �
362 68 M jw
GUARANTEES ONRUN
ONLY TO THE/PERSONOFORRWHOM THELSURVEY SURVEYED BY
IS PREPARED, AND ON HIS BEHALF TO THE STANLEY J. ISAKSEN, JR.
TITLE COMPANY, GOVERNMENTAL AGENCY,
LENDING INSTITUTION, IF LISTED HEREON, AND P.O. BOX 294,
TO THE ASSIGNEES OF THE LENDING INSTITUTION.
GUARANTEES ARE NOT TRANSFERABLE TO NEW SUFFOLK. N.Y. 11956
ADDITIONAL INSTITUTIONS OR SUBSEQUENT OWNERS.
631 -73 —5835
UNAUTHORIZED ALTERATION OR AODIT70N TO THIS
SURVEY IS A VIOLA77ON OF SECTION 7209 OF
THE NEW YORK STATE EDUCATION LAW.
COPIES OF THIS SURVEY MAP NOT BEARING 4. 10 JAN 05 SHOW FENCE RESET, EAST SIDE. LI NSED N YOR
THE LAND SURVEYORS EMBOSSED SEAL SHALL 3. 9 NOV 04 SHOW FENCE.
NOT BE CONSIDERED TO BE A VALID TRUE 2 11 AUG 04 SHOW IG POOL, FRAME GARAGE. YS Lic. o. 492 03R 1222
COPY.
1. 4 FEB 04 SHOW PERCENTAGES OF LOT COVERAGE.
303o6
7ss.,sos
BUILDING DEPT.
INSPECTION
[ ] FOUNDATION IST [ ] ROUGH PLBG.
[ ] FOUNDATION 2ND [ ] INS TION
[ ] FRAMING [ FINAL
[ ] FIREPLACE & CHIMNEY [ ] FIRE SAFETY INSPECTION
REMARKS:�v'"�3�� � ���
DATE INSPECTOR
SIZE( FT) A B C D E -1 F G I AREAl CAP. I
777 5(l 'f SO.FT.1 GAL.
- J DIVING BOARD
A A
INLET �LADOER INLET FITTING
�i AUTOMATIC SKIMMER
UNDERWATER O
_ LIGHT
OB (OPTIONAL) O
G
o
B MAIN DRAIN ----
{ f .
I O
PLAN _
6':6' SECTION A—A
GENERAL,NOTES TILE FACING WIT
I
THE DESIGN IS BASED ON A DRAINAGE SOIL WITH<10%
SILT.GROUND WATER SHALL NOT EXIST WITHIN THE r y ISS WASTE FILTER
LIMITS OF THE EXCAVATION,IF GROUND WATER EXISTSv •` 5 SMP HAIR d LINT
WITHIN 6'-0-BELOW GRADE SPECIAL DEWATERING T f • `" 1r r CATCHER SKIMMER
FACILITIES WILL BE REOUIRED.WATER DISPOSAL ISc+� V* < C --—WATER LINE—--——
LIMITED TO OWNER'S PROPERTY. e• U c
F
2_ NO SURCHARGE ALLOWED WITHIN 4•-0'OF SHALLOW CONT. 3 BA SEAM +a�.�'t, `� {•t i RETURN TO
END AND 6•-0'OF DEEP END. ALL AROUND -a MARBLE
• _.. _. TIES 12"OC
- DUST .X
3. THE PNEUMATICALLY APPLIED CONCRETE(GUNITE) FINISH ,
/MAIN DRAIN
SHALL BE A 1:4 MIX WITH A MAXIMUM OF 3%GALLONS OF jC
WATER PER SACK OF CEMENT. 4-THICK r.
1 SS
4. REINFORCING STEEL SHALL BE INTERMEDIATE GRADE
BILLET STEEL WITH A MINIMUM LAP OF 30 BAR
DIAMETERS. ' RADIUS VARIES -SCHEMATIC PIPING ARRANGEMENT .
5. POOL WATER SUPPLY BY OWNERS GARDEN HOSE POOL V to 24-SHALLOW END
51
TO BE KEPT FL DURING FREEZING WEATHER.PUMP UP ON DEEP END
IL
CAPACITY TO BE SUFFICIENT TO EMPTY POOL IN
24 HOURS_ '3 REINFORCED POOL SPECIFICATION CONTRACTOR:
- DEPTH «3'-0' > -0 Hwe M a typkd Pool sp�lCMkadom
_ WALL SECTION -
— B—B HORIZ. it cc e'
VERT. lrOC a'oC ?c OWNER:
•lam. FLOOR 12-OC EACH WAY O
MESH EOUIVALENT
Applicant/ Date
Owners Name: ' Reviewed:
Architect/
Engineer: �"� Date
Submitted:
SCTM #:
District: 1.000 Section: Block: 2_ Lot: —:-D
Project
Location: Subdivision
!11�S�' Name:
—
Sin&Ie& separate Required
cerl(fica(ion: (Yes/No)
Req. Req.
Zoning Disaric(: � 11,0(size: _ Aqual: l (L
--._
Req. ot coverage,� Irolx)sed C`w
!
(1`ronl Pard Proposed: 1 (Req. Req.
(Side Yard Proposed: _( (Rear Yard
Propose 1
Project Description: /S 1
AGENC'i�►..PER_MITS
REQUIRED FOR E4 VIEWermit
N.A. NO YES Mumber
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: fo