HomeMy WebLinkAbout29627-Z FORM NO. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Office of the Building Inspector
Town Hall
Southold, N.Y.
CERTIFICATE OF OCCUPANCY
NO: Z-29854 Date: 11/19/03
THIS CERTIFIES that the building ACCESSORY
Location of Property: 1275 ESPLANADE SOUTHOLD
(HOUSE NO. ) (STREET) (HAMLET)
County Tax Map No. 473869 Section 88 Block 6 Lot 13 .41
Subdivision Filed Map No. Lot No.
conforms substantially to the Application for Building Permit heretofore
filed in this office dated JULY 31, 2003 pursuant to which
Building Permit No. 29627-Z dated AUGUST 5, 2003
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 DANIEL H & JOANN K BROOKS
(OWNER)
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A
ELECTRICAL CERTIFICATE NO. 1167601 11/10/03
PLUMBERS CERTIFICATION DATED N/A
Authorized Si ture
Rev. 1/61
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. 29627 Z Date AUGUST 5 , 2003
Permission is hereby granted to:
DANIEL H & JOANN K BROOKS
1275 THE ESPLANADE
SOUTHOLD,NY 11971
for
CONSTRUCTION OF AN ACCESSORY IN GROUND SWIMMING POOL IN THE
REQUIRED REAR YARD WITH FENCE TO CODE AS APPLIED FOR
at premises located at 1275 ESPLANADE SOUTHOLD
County Tax Map No. 473889 Section 088 Block 0006 Lot No. 013 . 041
pursuant to application dated JULY 31, 2003 and approved by the
Building Inspector to expire on FEBRUARY 5 , 2
Fee $ 150 . 00
or' zed ignatu
ORIGINAL
Rev. 5/8/02
Form No.6
TORN OF SOUTHOLD
BUILDING DEPARTMENT (1
TOWN HALL
765-1802
APPLICATION FOR CERTIFICATE OF OCCUPANCY
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
n I Date. 1/- / �--
New Construction: Ol��dor Pre-existing Building: /�(check one)
Location of Property: /Q( 12 5 [Yl Y'25,01& e S'nit /!'b/d M,C/' I 1 0l
House No. Street Hamlet
Owner or Owners of Property: --�19v1 Fl R12c'e,kS
Suffolk County Tax Map No 1000, Section V,6 Block l[J Lot
Subdivision Filed Map. Lot: 43
//t: i
Permit No. _ a z Date of Permit. -i-D Applicant: Al IE J (tom L20C 2ICs
Health Dept. Approval: Underwriters Approval: �—
Planning Board Approval:
it
Request for: Temporary Certificate Final Certificate: Q ��' (check one)
Fee Submitted: $
(c C-11,6 A00,vup
S r Applicant Signature
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5 BY THIS CERTIFICATE OF COMPLIANCE THE 5
5 NEW YORK BOARD OF FIRE UNDERWRITERS 5
5 BUREAU OF ELECTRICITY 5
fCj 40 FULTON STREET — NEW YORK, NY 10038 rj
S CERTIFIES THAT
Upon the application of upon premises owned by 5
u5
5 BRIAN BROOKS ELEC. INC. DANIEL BROOKS 5
5 BOX 1001, 455 BEEBE DR. 1275 THE ESPLANADE 5
C5 CUTCHOGUE, NY 11935, SOUTHOLD, NY 11971 5
Located at 1275 THE ESPLANADE SOUTHOLD, NY 11971
C5 Application Number: 1167601 Certificate Number: 1167601 5
5 Section: Block: Lot: Building Permit:29627 Z BDC NS11
Described as a Residential occupancy, wherein the premises electrical system consisting of
5 electrical devices and wiring, described below, located in/on the premises at: 5
5 POOL &SHED,Outside, Pool/Spa, 5
5 5
5 was inspected in accordance with the National Electrical Code and the detail of the installation, as set forth below, was 5
rj found to be in compliance therewith on the 10th Day of November,2003. 5
5 5 Name OTY Rate Rating Circuit Tyne
Appliances and Accessories �5
5 Pool,Spa Bonding 1 0 5
tj Pool/Spa Circulator PurnpiAlotor 2 0 1.5 H.P. C5
5 Time Clock/Switch l 0 5
5 Panels C5
5 1 106 9 5
5 Wiring and Devices 5
5 GFCI Circuit Breaker l 0 20 amp Pool/Spa 5
5 Fixture 2 0 Pool/Spa 5
5 Receptacle 2 0 GFCI �5
5 Fixture 3 0 Incandescent rrr5
5 Switch 2 0 General Purpose
5 5 (Swimming Pool):This certificate covers compliance at the date of inspection only. Because of unusual environments it is sovisable to hace �5
frequent test and,or repairs made by a qualified person. 5
5 5
seal
55
5 1 of I 5
This certificate may not be altered in any way and is validated only by the presence of a raised seal at the location indicated. 5
5 5
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13_Lll TOWN OF SOUTHOLD PROPERTY RECORD CARD
OWNER STREET VILLAGE DIST SUB. LOT SCI
( J✓/)��� �S' �-iLY}C��.{� r ' / IC1. _� ' 1� ✓�' IC��E � �1JS�' I�_
ACR. REMARKS
TYPE OF BLD.
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LAND IMP. TOTAL DATE g r / ��-L� _ r by,` r�yyfS 1 1J�5 us(.co
VA
cn. 600 0 � clil q, &0
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FRONTAGE ON WATER TILLABLE
FRONTAGE ON ROAD WOODLAND
DEPTH MEADOWLAND `
BULKHEAD HOUSE/LOT
TOTAL
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M-1802
BUILDING DEPT.
INSPECTION
[ ] FOUNDATION IST [ ] ROU PLBG.
[ ] FOUNDATION 2ND [ ) 1 ULATION
[ ] FRAMING FINAL
[ ]
FIREPLACm & CHIMNEY f —
REM,ARKS:
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DATE INSPECT
FIELD INSPECTION REPORT DATE COMMENTS
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FOUNDATION(2ND)
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INSULATION PER N.Y. _1
STATE ENERGY CODE
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FINAL
ADDITIONAL COMMENTS
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TOWN OF SOUTHOLD BUILDING PERNIIT APPLICATION CHECKLIST
BUILDING DEPARTMENT Do you hace 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
ww-*v. northfork.net/Southold/ PERMIT NQS;0�(7 Check
Septic Form
NX.S.D.E.C.
Trustees
Examined , 10 ontact:
Approved '20 AV barrL
Disapproved a c Englinspector q_ot
Phone:�364� '4-?��=>ExpirationoBu
jUL 320 1APPLICATION FOR BUILDING PERMIT
`.' Date `� I Z�, '003
1 INSTRUCTIONS
a. Thus application MUST be completely tilled in b}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 conurnenced before issuance of Building Permit.
d. Upon approval of this application, the Building Inspector will issue a Building Permit to the applicant. Such a perm t
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 ev er until the Building Inspector
issues a Certificate of Occupancy.
f. Every building permit shall expire if the work authorized has not conmtenced 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 NIADE 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.
Peffl w(--e Rol �cn�tTt 1( Fi
(Signature of applicant or name, if a corporation)
401 1&md ywo Lck e rr O imp
p
(NAuting address of applicant)
State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder
Name of owner of premises (1\(?I N ��oAnrl K Yoc� S
(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.
Plumbers License No.
Electricians License No.
Other Trade's License No.
1. Location of land on which proposed work will be done:
ATI S F�oarncAe, �1 old
House Number treet Hamlet
County Tax Nlap No. 1000 Section—S5-13 lock[p _Lot IJ, 11
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 Coe -Gain cS
b. Intended use and occupancy OrW_ t-QY)1t� 4 �wP�( I Y Tl��
3. Nature of work(check which applicable): New Building_ Addition_ _Alteration
Repair Removal Demolition Other Work vwoM Pc0)
(Description)
4. Estimated Cost 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, specitV 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 �_5�� Rear �2D .6 �J Depth -�01
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? FES_NO
13. Will lot be re-graded? YES_NO K Will excess fill be removed from premises' YES _NO
14. Names of Owner of premises 6rY %6 tz)Am?) coYsAddress I'21r) Phone No. 7(6.36'13
Name of Architect,dam S 1�.M rr �. Address�n d_PndCo 9 N' 'I i�he N05i lc-�I85-��,
Name of ContractorP(emwreP oo 1 s Address 461 ra dw�y. Phone No._4TK- 332
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? * FES NO_V__
* 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 NFA FORK)
SS:
COUNTY OF S
AYy�tlot» being duly sworn, deposes and says that (s)he is the applicant
(Name of individual sigrilng contract) above named.
(S)He is the l r r — eA p -
(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 Jul �O d ,3
Nota Publi SigXatdre Applicant
Arlene D.Bo lino
Notary Public New York State
Suffolk County#01808005207
Commission kes04/0M Lm�o
DESIGN
PERMITS
JAMES K. MORROW, JR., P.E. INSPECTIONS
2066 BEDFORD AVE. . NO.BELLMORE, NY 11710 . (516)785.8032
COMPLY WITH ALL CODES OF
NEW YORK STATE & TOWN CODES July 23, 21 PR VED AS NOTED
ASR UI E AND CONDITIONS OF
11 SOUTHOLD TOWN ZBA DATE: 5 B.P. ibc
wn l IN01-5 TOWN PLANNING BOARD FEE: BYapi? _
NOTI BUILDING DEPARTMENT AT
SOUTHOLD TOWN TRUSTEES 765.1802 SAM TO 4 PM FOR THE
N.Y.S.DEC FOLLOWING INSPECTIONS:
1. FOUNDATION - TWO REQUIRED
Re: ew Inground SwimmingFOR POURED CONCRETE
Pool 2, ROUGH - FRAMING & PLUMBING
Drainage Facilities 3 INSULATION
1275 The Esplanade 4. FINAL • CONSTRUCTION MUST
Southold, NY 11971 BE COMPLETE FOR C.O.
UNGERWRITERS CERTIFICATE ALL CONSTRUCTION SHALL MEET THE
REQUIREMENTS OF THE CODES OF NEW
REQUIRED YORK STATE. NOT RESPONSIBLE FOR
Dear Sir or Madam: DESIGN OR CONSTRUCTION ERRORS.
The new inground swimming pool for the above referenced premises will not require
permanent drainage facilities. The pool water will be continuously recirculated through
the filter and will be reused from year to year. The drainage from the filter backwash is
nominal and will not interfere with public highways, public wat UR"Y OR
sanitary facilities-Or neighbori gproperties. USE IS UNLAWFUL
/ Sincerely, WITHOUT CERTIFICATE
FLOOD ZONE �
COMPLY WITH CHAP ER"460 OF OCCUPANCY
FLOOD DAMAGE PREVENTION
SOUTHOLD TOWN CODE.
Jar2s9. Morrow,
JKMamk,O f Ne, �e
ALL CONSTRUCTION SHALL
s�e�'•°�aN MD'9 '� . .
24 . MEET THE REQUIREMENTS OF THE
, W CODES OF NEW YORK STATE.
°.0 070522••P(�Z�����
ssloNp .���° "IMMEDIATELY"
ENCLOSE POOL TO CODE
UPON COMPLETION
BEFORE"WATER"
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NOTES: 3/1o: I'
GUNITE POOL DETAILS
I. Pool design is based free draining granular soil .t itlt less than 10% silt.
'_. If ground water is encountered during construction, a tem orary dewaterim S.stent shall be constructed. Flog. fn,i, APPRov ED Br:
c P c• SCALE: AS SHORN CR<.ev E" J6M
the temporary dewatering system shall be discharged on the premises in a tempor.try recharge basin. enTE: � -1 og REv,5E9
3. No spoil surcharge permitted within 4 feet of the excavation.
4. Pneumatically applied concrete shall be a 4 to I mix with a maximum of 3.5 ,gallons of t.atcr per sack of cement. PREPARED FOR: I Z-16 TRE ESP�aara 7�
All reinforcement shall be d ¢bars, grade 40 minimum. SoUTaolP I a`( I l9'11
6. All reinforcement splices shall be 30 bar diameters minimum.
PREPARED B\': James K.Morrow,Jr.,P.E. oR>n.r,e N,_ ,PER
3066 BEDFORD AN E. i � Kc� - I
\O. BELLMORE,NY 11710 I
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