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FORM NO.4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Office of the Building Inspector
Town Hall
Southold, N.Y.
CERTIFICATE OF OCCUPANCY
Date: 07/28/06
NO: Z-31712
THIS CERTIFIES that the building INGROUND SWIMMING POOL
Location of Property: 1745 EDWARDS
(HOUSE NO.)
County Tax Map No. 473889 Section 18
LA
(STREET)
Block 3
ORIENT
(HAMLET)
Lot 6. 11
Subdivision
Filed Map No.
Lot No.
conforms substantially to the Application for Building Permit heretofore
filed in this office dated
JUNE 21, 2006 pursuant to which
Building Permit No. 32151-Z
dated
JUNE 22, 2006
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 CHRISTIAN LANGE
(OWNER)
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL
N/A
ELECTRICAL CERTIFICATE NO.
106925C
06/06/06
PLUMBERS CERTIFICATION DATED
N/A
~
~ized Signature
Rev. 1/81
Form No.6
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN HALL
765-1802
;}S,OO
=-----
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:
I. 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 2/1 0 of I % 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:
I. 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
I. 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. / - d I - 0 c:,
New Construction: X
Location of Property:
Old or Pre-existing Building:
t 'I '1 -:; Cd CUCLVd.5
( check one)
L CJvrt.P--, 0 i ,-e rL I;;-
House No.
Street
Hamlet
,
Owner or Owners of Property: C h\""I "S n C0Y'> Lcvrc ~ Go
Suffolk County Tax Map No 1000, Section l8 Block
3
Lot (p-/l
Subdivision
Filed Map.
Lot:
Permit No.
Date of Permit.
Applicant:
Underwriters Approval:
Health Dept. Approval:
Planning Board Approval:
Request for:
Temporary Certificate
Final Certificate: (check one)
~
UpPlicant Signature
Fee Submitted: $
~.7tJ~~7
L<,~3)'7)::l..
Electrical Inspection Certificate
Issue Date
6n12006
Electrical Inspection Service, Inc.
375 Dunton Avenue
East Patchogue, New York 11772
(631) 286-6642
Application
106925C
Issued To:
Street:
Village:
Section:
Mr. & Mrs. Robert Kulpa
1745 Edwards Lane
Orient
18
Block: 3
Zip: 11957
Lot: 6.11
Town: South old
Contractor: Ridge Electric Contracting, LLC Lie. # 1895
Was examined and found to be in compliance with the National Electrical Code.
D Commercial [J(] NV Defects [J(] Pool D 1st Floor D Indoor D Basement D Hot Tub
IX] Residential D Del. Garage D Attic D 2nd Floor IX] Outdoor D Addition [J(] Survey
I Switches Receptacles F;xtures GFI Heaters AlC Fans
1 1 2 1
Dishwasher Washer/Amps Dryer/Amps Oven Range/Amps Microwaves
Furnace Oil Gas C;rculators Smoke Detector Bell Transformer
I Meter Amps Phase UG/OH Jacuzzi Telev;s;on CO Detector
/
Bldg. Permit:
Other Equipment
Pool Panel wI Timer.
f{/f:/J ~\
Hugo S. Surdi
President
Rough Inspection: 03/15/2006
Inspector: Aneal Angelillo
Final Inspection: 06/06/2006
Inspector: Dennis Brandi
This certificate must not be altered in any manner. Inspectors may be identified by their credentials.
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.
32151 Z
Date JUNE
22, 2006
permission is hereby granted to:
CHRISTIAN LANGE
116 EAST 68TH STREET - APT. 6C
NEW YORK,NY 10021
for :
CONSTRUCT AN ACCESSORY INGROUND SWIMMING POOL WITH FENCE TO
CODE AS APPLIED FOR. (THIS REPLACES BP#26362-Z)
at premises located at
1745 EDWARDS LA
ORIENT
County Tax Map No. 473889 Section 018
Block 0003
Lot No. 006.011
pursuant to application dated JUNE 21, 2006 and approved by the
Building Inspector to expire on DECEMBER 6, 2007.
Fee $
150.00
ORIGINAL
Rev. 5/8/02
3~IS I 7-
TOWN OF SOUTHOLD BUILDING DEPT.
765.1802
INSPECTION
[ ] FOUNDATION 1 ST [] ROUGH PLBG.
[ ] FOUNDATION 2ND [] INSULATION
[ ] FRAMING I STRAPPING [X FINAL ., ~J\ ~ \i ..)
[ ] FIREPLACE & CHIMNEY [ ] FIRE SAFETY INSPE~ -
REMARKS:
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DATE
INSPECTOR ~ ~
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ROUGH FRAME & II II
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PLUMBING II II
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INSULATION PER N. Y. II II
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CODE II II
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FORM NO. 1
TOIlH OF SOUTHOLD
BUILDING DEPARTMENT
TOIlH HALL
SOUTHOLD. N.Y. 11971
TEL: 765-1802
BOARD OF HEALTH ...............
3 SETS OF PLANS ...............
SURVEy........................
CHECK .........................
SEPTIC FORM ...................
3J.JSfr::
Exaoined.................. 19.... .:)~J.o:;,(&
Approved.................. 19.... PeIlD1t lb. ................
Disapproved a/c..................................
NOTIFY:
d.'6~-7373
CALL ..................
MAIL TO:....................
............................................................
.-~, ................................ ).
_---- ... '" ., (lUilding Inspector)
r' ;;B\ ~ 1000 . ......"''''U"...''',.. "'"" DO<:.. . ..... . . " .
\ .' . ,j INSTRUCTIONS
a. \n.~.!'<JPlllicatioo DUSt be-coo..letely filled in by typewriter or in ink and subnitted to tbe lUilding Inspector w
3 sets of plans. accurate plot plan to scale. Fee aInlrding to sche<hJle.
b. Plot plan sbowing locatioo of lot and of wildings 00 pranises. relatiooship to adjoining premises or public
streets or areas. and giving a detailed descriptioo of layout of property DUSt be drawn 00 tbe diagrllD ...ich is part of
this applicatioo.
c. The work covered by this <JPlllication "'8'J not be COIIJJeIICed before issuance of lUilding Permit.
d. Upln approval of this application. tbe lUilding Inspector will issue a lUilding Permit to tbe applicant. Such
permit shall be.kept 00 the premises available for inspection througl:lout tbe work.
e. Ib wilding shall be occupied or used in ....,le or in part for any purpose liiIatever until a Certificate of
1r...VUV'Y shall baW! been granted by the JUilding Inspector.
APPLlCATIlB IS JIlIlEBY MAlE to tbe lUilding Department for the issuance of a lUilding Permi t pursuant to the
JUilding Zooe Ordinance of the Town of Southold. &1ffolk frAmty. Hew York. and otber applicable lam. Ordinances.or
Regulations. for tbe construction of wildings. additions or alterations. or for U!ID\1al or dlm>litioo. as herein
described. The applicant agrees to ~ly with all applicable 1""". oi-dinanr:es, building code. housing code, and
regulations. and to acbit oothorized inspectors 00 pranises and in wilding for necessary inspections.
J . .J... ..79.~.;T.p. t..E: /111. SWlfYl/n((),:r. P..4(J.!.s...
(lignsture of applicant. or "'""'. if "ucorporat ion)
17.~. r. .!Jfj.{.!it. .f!.;;AWlf;'j,-. S?v:MR'r.'.b..cl
<Mailing address o{'~icant) /1761'
State liiIether applicant is owiler. lessee.G>.Y? architect. engineer. general contractor. electrician. plumer or wilclf
...........................................................................................................................................
lla1E of CMler of premises ...~9.6iL7...E....'f:~Ef.~.I:-!1~;;..~A.,m.......K ~I/!A.... .... ..... .... .... .......
(as 00 the tax ro'ih arJMW~"'1l .
';' c, ',r ,,).'~' :)'0)'",)(1 /
If applicant is a corporation. signature of Wly aii\lln'i.Ii;ct"ft~:, IV
.3QhM..~.!.<?~7J2!::~{F.r.....l!F..C;f;...:.. . ',,'1
(lla1E and title of corporate officer)
lUilders License lb. .. to.. r. 7.f.C.. If. +;. ..
. d-j'lJ--;1
Plumbers License NO. .........................
Electriciaos License lb. .....................
Other Trade's License lb. ....................
I. Locatioo of land on ~ch proposed work will be done..............................................................
.... .l.J.~2............... .~d.w.tf~;;'.q... f.ftt:.!&........................ .O#(~ 7::.......................
House IbJber Street lIaDlet ~
frAmty Tax Map lb. IlXXl Sectioo ....a/f....... Block .....0........ IDt .....~...3..~
&Jbdivision ..................... ................. Filed Map lb. ...... ......... IDt ...............
(lla1E )
(: ..
" " '...' .~,--. ." '" ~ ' '!
2. State existing use and """'VUV'Y of praoises and intended use and occupancy of ptopOsed constnJctiqn: ( ':11
Exi. and ~~crd-r>.nt'11 wI tJHJ!. v' ..:
a. sung use occupancy ...... ./~Q.. ..'cfI.'.>-W....... f.. 1-... ................................... ..","0:'>
b. Intended use and occupancy ....... .....r~..... ................................................ .....
J. 1....;lUJl~ UI. ",,",0.. \c.:t~ __lUll applJC8IHe): New llJitding .......... Addition ..--!r...... Alteration ..'\,.......
Repair............ Remval............. IJeJmlition ............ Other Work A,('/'lW~ .(.k/S.tVlJ.l/.iP)'(.~ .j.1{J/J. f.... .
(Descripti&,) (lJS-r"il ~)( '10
4. IlstimJ:ed Cost ............~............ fee .............................................. 3\J(\i+e
(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 ......................................
S. If business. COuue,cial or mi:xed occupancy. specify nature and extent of each type of use......................
1. Dimensions of existing structures. if any: Front................ Rear ............... Depth .................
I~i~t ......................... Number of Stories ......................
Dimensions of lllIIle structure with slterations or additions: Front............... Rear...............
Depth .................... ~i~t .................... Number of Stories ...............
~. Dimensions of entire new construction: Front ................ Rear ............... Depth ..............
lIei~t ......................... Number of Stories.....................
j. Size of lot: Front.. . . . . . . . . . . . .. . . . .. Rear .................... Deptb ....................
10. Date of Purcbase ..................... IIan! of Fotlll!r Oimer ........................................
II. Zone or use district in lohicb premises are situated ..............................................................
12. Does proposed construction violate any zoning 1..... ordinance or regulstion: .. .iJa.................
13. Will lot be regraded .......MQ.......... Will excess fill be IeIJJIIed fran premises: mi ~
14.
IIan!s of Oimer of premises ........................... Mdress .............................. l'hone No.
IIan! of Arcbitect .................................... Mdress .............................. l'hone No.
Nane of Contractor................................... Mdress ...............................l'hone No.
15. Is this property within 300 feet of a tidal ""tland? * YES .......... Rl..........
*IF YES. !WI1IID 1tHl 'l1lIlSTEIlS Pmm" Mt\Y IE mpmm.
PLOT DIAGRAM
Locate clearly and distinctly all buildings. .nether existing or proposed. and indicate all set-back dimensions
frau property lines. Give street and block number or description according to deed. and sitoII street DlIIeS and indicate
A1ether interior or comer lot.
~uevt'l- U)C'U K.e;IIf~c! Co(/ry;s~d V/!!Jy//tTOl tJllt ~ cll/~/fe
'rf..e, PM/ uHI h~ WE- StWE- S;Ze.. 1!ftJ:i ;,J 'ilL- S~ f.tJ~,9~
APPROVED AS NOTED
DATE: ~ B.P. # Q~?:Jo.).-z:
FEE' I Sb BY: Q.,~. <7'--
NOTIFY BUilDING D!PART T AT
765-1802 9 AM TO 4 PM FOR THE
FOllOWING INSPECTIONS:
1 FOUNDATION - TWO REQUIRED
FOR POURED CONCRETE
2. ROUGH - FRAMING & PLUM81NG
3 INSULATION
4: FINAL - CONSTRUCTION MUST
BE COMPLETE FOR C.O.
"IMMEDIATELY" ALL CONSTRUCTION SHALL MEET
INCLOSE POOL 10 CODE THE REQUIREMENTS OF THE N.Y.
;fAIE lI' lIo:1l YOOK~ UPON COMPlETION STATE CONSTRUCTION & ENERGY
S; J 1/ s.<; BEFORE 'WATER" CODES. NOT RESPONSIBLE FOR
nJIlrY lI' .......... J:)........ DESIGN OR CONSTRUCTION ERRORS
..... a.(}h.~....l.9gt?.~!(A.....................being duly """ro, deposes and says that be is the applicant
:~~ individual signing contract)
.bove DmI!d.
~ is the....... (t!1~!.~~: ';;';;';';;'~; '~ffi~~: .;~~:)................................................
)f said owner or owners, and is duly authorized to perform or have perfotlll!d tbe said work and to make and file this
'pplication; that all statenents contained in this application are true to the best of his knowledge and belief; and
chat the work will be perfotlll!d in tbe manner set f'01'th in the application filed therewith.
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UNDERWD'F'/S CERTIFICATE
n.~UiHED
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IUT CERTIFV'"'/\
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lwom to before "" this edJ
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Notary Public ~l.. M1..............
SHANON M. CARTER
Notary Public, State of New Volle
No.01CA5086134
Qualified In Suffolk Coun", ~ I
Commission Expires October 6, ~
a' ~JC~
. . . .. ... .....'O ~ . . . .. . ~ . .. . .. .. . .. . . . . . . . . .. . ..
(Si of Applicant)
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TOWN OF SOUTHOLD PROPER~ RECORD CARD
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OWNER
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STREET 1145
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TYPE OF BUILDING
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COMM.
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MICS.
Mkt. Value
IMP.
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1)"..,-0
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TOTAL DATE REMARKS
II.:, OU!//' 0 hi' 2- ~/Ii."I<;:Jz. SPL''';' 'I. Z,,'~1!-2G (If\' 1--i~\LE-~ iu \...'.JLj::,L\ 'WiF L -'1'152... ~_c34
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Tillable
FRONTAGE ON WATER
e5oo. 32.'-' FRONTAGE ON ROAD
DEPTH t.
J f._ ( 400 BULKHEAD
,""(;2. 0
Woodland , {..g
Meadowlcnd
Hause Plot I . iAeo
Total
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POOL WALLS. BOND BEAM. AND FLOOR SHALL BE
STEEL REINFORCED GUNlTE CONCRETE. GUNlTE
CONCRETE SHALL MEET OR EXCEED 4.000 P S.l. (IJ ,
28 DA YS. STEEL REINFORCING BARS SHALL
CONFORM TO ASTM A615. GRADE 60.
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6" X 6" FROSTPROOF CERAMIC TILE
WA TE~ LEVEL (iJ CENTER OF CERAMIC TILE _ /'" 'i:l !:C~;;::'~
IN POOL WALLS 'MTH A WATER DEPTH OF 5'-()" OR
LESS. RE-BARS SHALL BE PLA.CED HORIZONTALLY
AND VERT/CALLY tf!J 12" O.C.
IN POOL WALLS 'MTH A WATER DEPTH GREATER
, THAN 5'-()'~ ADDmONAL VERTICAL BARS SHALL BE
INSERTED TO CREATE VERTICAL BAR SPACING (IJ 6"
D.C. THESE BARS SHALL START FROM THE TOP OF
THE WALL AND SHALL BE BENT A T THE BOTTOM TO
EXTEND 24" HORIZONTALLY INTO THE FLOOR.
THE VER17CAL RE-BARS (IJ 12" D.C. SHALL BE BENT
AS SHOWN IN THE BOND BEAM.
UNLESS OTHERWISE SPECIFIED OR REQUIRED, #3
BARS SHALL BE TYPICAL
NORMAL FLOOR REINFORCING SHALL CONSIST OF
RE-BARS PLACED AT RIGHT ANGLES (9d') TO EACH
OTHER @ 12" D.C.
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MINIMUM SIZE OF COPING STONE SHALL BE 112"
THICK BY 12" WIDE
41' SAND BASE. WHEN NECESSARY TO AID.
DRAINAGE IN SLOWDRAINING SOIL
POOL WALLS AND FLOOR SHALL BE 7" THICK. AND
BOND BEAM SHALL BE 10" WIDE X 12" HIGH.
4 - #4 BARS SHALL BE SPLICED TO FORM
CONTINUOUS REINFORCING 'MTHIN BONO BEAM
INTERIOR FINISH ON GUNITE SHALL BE l2" THICK
TROWELED-DN "MARBLEDUST"
RADIUS A T INTERSECT/ON OF GUNITE WALL AND
FLOOR VARIES.
CRUSHED STONE. WHEN NECESSARY TO AID
DRAINAGE IF GROUND WA TER IS ENCOUNfERED IN
SLOW DRAINING SOIL