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33481-Z
FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No: Z-33234 Date: 09/19/08 THIS CHRTIFIHS that the building INGROUND SWIMMING POOL Location Of Property: 725 WHITE EAGLE DR LAUREL (HOUSE NO.) (STREET) (HAMLET) County Tax Map No. 473889 Section 127 Block 9 Lot 24 Subdivision Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated OCTOBER 1, 2007 pursuant to which Building Permit NO. 33481-Z dated OCTOBER 19, 2007 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 JOHN & TARA SEIFERT of the aforesaid building. (OWNER) SIIFFOLR CODNTY DHPARTM@TT OF HHALTH APPROVAL N/A HLHCTRICAL CHRTIFICATH NO. 3064621 07/03/06 PLDMBSRS CERTIFICATION DATHD Aut orized Signature Rev. 1/81 _ Form No.6 ~~~1 w ~,/;r'r TOWN OF SOUTHOLD ~t„+~~ BUILDING DEPARTMENT TOWN HALL ~ "" 765-1802 ~ ~ C ~!i is ~ ~ APPLICATION FOR CERTIFICATE OF OCCUPANCY /f rr> This application must be filled in by typewriter or ink and submitted to the Building Departure t wi i N F ry, D 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 plmnber 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 far the building. 6. Submit Planning Board Approval of completed site plan requirements. B. For ezistiug buildings (prior to April 9, 1957) uou-conforming uses, or buildings and "pre-existing" land uses: 1. Accurate Burney oCproperlti showing all propert~~ lines. streets, building and unusual natural or topographic. features. 2. A properly completed application and consent to inspect signed by the applicant [f a Certificate of Occupancy is denied, the Building Inspector shall state the reasons therefor in writing to the applicant. C. Fees L Certificate of Occupancy -New dwelling $25.0(?, Additions [n dwelling $25.00, Alterations to dwelling $21.00. S~~~inuning pool $25.00, Accessory building $2S_00. ydditions to accessory building $25.00, Liusinesses $?O.OU- 2. Certificate of Occupancy on Pre-existing Building- ~h100.00 3. Copy of Certificate of Occupancy - $25 4. Updated Certificate of Occupance $50.00 5- 'temporary Certificate oCOccupanc}' -Residential $15.00, Commercial $1/5.00 Date. 17(/c~ ~Q ZOO ~ ~ -~ ~ 77 New Constm~tion: ~Sy~ Old or Pre-existing Building: (check one) Location of Property: 7 ~,~ _ ~{~ h f L E4 ~ __ ~~ LQ ~~.~ House No- ~ Street Hanilet Owner or Owners of Property: ,/0~~____~_ _/[7/q __ sei~i~" - - Suffolk Comity Tax Map No 1000, Section ~~ Block ~ Lot -- - ----- Subdivision Filed Map. L,ot: _ PenniiNo.~~ ~ Date ofPem~it. Q 'l,3 d Applicant: JLh~ S((F/'t' Health Dept. Approval _ _ Underwriters-Approval: ~~ ~~~~ ~ ~. ~ ~~ Planning Board Approval: Request for: Temporary Certificate _ Final Certificate: ~ (check one) Fee Submitted: $ ~5, o a U . Z 3-~A23% a Applicant S' azure /~~C x / YOU ~? 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. 33481 Z Date OCTOBER 19, 2007 Permission is hereby granted to: JOHN & TARA SEIFERT 725 WHITE EAGLE DR LAUREL,NY 11948 for CONSTRUCTION OF AN INGROUND SWIMMING POOL IN THE REAR YARD, FENCED TO CODE AS APPLIED FOR at premises located at 725 WHITE EAGLE DR LAUREL County Tax Map No. 473889 Section 127 Block 0009 Lot No. 024 pursuant to application dated OCTOBER 1, 2007 and approved by the Building Inspector to expire on APRIL 19, 2009. Fee $ 250.00 T° Authorized Signature ORIGINAL Rev. 5/8/02 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, NY 11971 TEL: (631) 765-1802 FAX: (631) 765-9502 www. northfork.net/Southold/ Examined~,20~ Approved f~ 20~ Disapproved a/c // . •` BUILDING PERMIT APPLICATION CHECKLIST Do you have or need the following, before applying? Board of Health _ 4 sets of Building Plans_ Planning Board approval PERMIT NO. 'h3~ ~l ~i Expiration , 20~ r _ _ ~ I~ ~ r'- % ~ r L- - c.~u,. CE?" --T..,.e,rl~__.c ~n~_THOLD INSTRUCTIONS a. This application MUST be completely filled in by typewriter or in ink and submitted to the Building Inspector with 4 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 code, and regulations, and to admit authorized inspectors on premises and in building for necessary inspections. ~~IMMEDIATELY~~ OCCUPANCY OR ~Signature~ applican~ name, if a corporation) ENCLOSE POOL,TO CODE USE LS UNLAWFUL UPON COMPLETION Q [ (C:t.( I~ 1171 BEFORE "WATER' WITHOUT CERTIFICA`~+ ~~ ~ Mailing address ofapphcant> Cr OCC` ' I'',NCY State whether applicant is owner, lessee, agent, architect, engineer, general contr~~~~}4~i~~~~t~er or builder UNDERN'FIIt PS CERTIFICJ4TE DATE: Name of owner of premises If applicant is a corporation, signature (Name and title of corporate officer) Builders License No. ~ I ~ I ~ I~ Plumbers License No. Electricians License No. I y 1 ~ Other Trade's License No. 1. Location of land on which proposed work will be done: ~~5 ~nl+~~tc~lc ~>~ ,~,~,,.. House Number Street '`"' -. County Tax Map No. 1000 Section l'~~ 'Block Septic F. N.Y.S.D Trustees Contact: Mail to:J~''m K"nc ~}, t (zkz 'L5r'i 11~ Pt ~~ Phone:l~y-Nj10Q 1177 r VL_waiNG li ~. ~ :..dS: t. FOUi;oHT!ON - "~1,~ REQUIRED FOR FOUR- :~`dCRETE 2. ROUGH - FS;,~,:ddG 8 PLUMBING 3. INSULATION 4. FINAL -CONSTRUCTION MUST BE COMPLFT~ FOR C.O. ALL CONSTi., ,,;td SI-!aLL MEET THE REQUIREMENTS OF THE CODES OF NEW YORK STATE. NOT RESPONSIBLE FOR DESIGN OR CONSTRUCTION ERRORS. Hamlet Lot Subdivision Filed Map N L~ u fc' APPLICATION FOR BUILDING PERMIT Date ol}t~la-~ ~ , 20 03 Building Inspector Lot (Name) 2. State existing use and occupancy of premises v a. Existing use and occupancy S%rt~~l( Intended use and occupancy S. P«,l 3. Nature of work (check which applicable): New Hnileiirtg Z.y~y4 Addition Repair Removal Demolition Other Work_ 4. Estimated Cost-`I(15,CCt0' Fee use and occupancy of proposed construction: (Description) (To be paid on filing this application) If dwelling, number of dwelling units Number of dwelling units on each 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 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_ NO / 13. Will lot be re-graded? YES / NO_Will excess fill be removed from premises? YES_ NO 14. Names of Name of Name of No 'i3~ 2rc~~ No. 7114 - ~ rC U 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? *YES NO ,/ * IF YES, D.E.C. PERMITS MAY BE REQUIRED. 16. Provide survey, to scale, with accurate foundation plan and distaia(ces k9+p~~erty lines. ...4 _ ,~ ...~ t.~.' 17. If elevation at any point on property is at 10 feet or belotv'; "most prb~topographical data o>A surv~sy '. ~~:: `3'- STATE OF NEW YORK) SS: COUNTY OF I__) -'~ '~~ ~~~';C11~c~laT~c~PCk-~ being duly sworn, deposes and says that (s)he is the applicant (Nam o~ f i-residual signing contract) above named, i (S)He is the 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 mariner set forth in the application filed therewith. Swom [o b~tb~re Y e thy; da of /~ 20 Notary nG~ Alteration ~o~apF SOOTyo~ 33 y--g I ~ ~,Q~~ TOWN OF SOUTHOLD BUILDING DEPT. 765.1802 1 NSPECTION [ ]FOUNDATION 1ST [ ]ROUGH PLBG. [ ]FOUNDATION 2ND [ ]INSULATION [ ]FRAMING /STRAPPING FINAL [ ]FIREPLACE 8~ CHIMNEY [ ]FIRE SAFETY INSPECTION [ ] FlRE RESISTANT CO,NQST~R,,UQCTION Q[ ]-FIRE RESISTANT PENETRATION REMARKS: y U ~' ` ~a"''~''~ Z'~- ©~ ' DATE S ~ ~ T ~ O ~ INSPECTOR ~ "~ ~~ FIELD INS,pECTi N REPORT DATE ~ COMMENTS r `\ ~/" ~~ FOUNDATION (1ST) ~ y ~ ---------------- - ~ - ------------------ FOUNDATION 2ND ( ) z ~~ V\ ~ ROUGH FRAMING & PLUMBING y T rn ------- ------- x -- v~ - -- ~ H INSULATION PER N. Y. STATE ENERGY CODE LQ. ,~_ 3 ' FINAL ADDITIONAL COMMENTS .'~- ~ LI Z m ~~ ~ - ~ ; . ~ y .. G o Z n r~ l x x d b y rl2 t•J'rJ•3cPrJ'3rJ•3c.f3 c.f3r~ rJ'3cPrJ'rJ•AJ•3rJ'cPcP rJ~ r~rl3r~rlr~rl3rJ'3r~rJ'rJ•3cPcPrJ'rJ'rJ•3rJ'3rJ•3cJ•3rJ•3cPrJ•3rJ'3rJ@1'r.1~r.Pr.PrJ~r~rJr~r~c.ncPrJ'2 O 5 BY THIS CERTIFICATE OF COMPLIANCE THE ~~ ~ ~ P ~ ' S 5 S NEW YORK BOARD OF FIRE UNDERWRITERS S S BUREAU OF ELECTRICITY ? C5 55 40 FULTON STREET - NEW YORK, NY 10038 Cc5 5 CERTIFIES THAT Upon the application of upon premises owned by 5 G & S ELECTRICAL CONTR. JOHN SIEFERT S 5 P.O. BOX 215 725 WHITE EAGLE DRIVE 5 55 SOUTHOLD, NY 11971, LAUREL, NY 11948 5 nCC7 Located at 725 WHITE EAGLE DRIVE LAUREL, NY 11948 '~~ Application Number: 3064621 Certificate Number: 3064821 J Section: Block: Lot: Building Permit: 0 BDC: ns11 e5 5 Described as a Residential occupancy, wherein the premises electrical system consisting of S 5 electrical devices and wiring, described below, located in/on the premises at: 5 ~~~~ pool house,0utside, PooVSpa, e5 cam, A visual inspection of the premises electrical system, limited to electrical devices and wiring to the extent detailed ~j5 ~ herein, was conducted in accordance with the requirements of the applicable code and/or standard 5 promulgated by the State of New York, Department of State Code Enforcement and Administration, or other 5 authority having jurisdiction, and found to be in compliance therewith on the 3'd Day of ~°ly~ ~• Name 9TY Rate Ratine 'r i Tvce L'~, 5 AdditiooalCharges 5 5 pool and pool house 5 5 Appliances and Accessories 5 Pool /Spa Bonding 1 07 Time Clock Switch 1 0 S Panels 5 1 100 8 Wiring Aad Devices 5 Fixture 2 0 pool Incandescent 5 Fixture 9 0 Incentlescent 5 5 GFCI Circuit Breaker 2 0 pool 5 Paddle Fan 1 0 5 Receptade 1 0 Gen, Purpose 5 Receptade 2 0 GFCI 5 5 Receptacle 2 0 20a pool Spedal I twist lock C Switch , 0 Gen, Purpose C 7 Switch 6 0 Gen, Puryose7 5 5 seat Continued on Next Page 1 of 2 5 5 S 5 Thls 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 o ~~~ ~~~~~~~ ~~~~ ~ sss~~~~~~~~~ ~~ v BY 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 G & S ELECTRICAL CONTR. P.O. BOX 215 SOUTHOLD, NY 11971, Located at 725 WHITE EAGLE DRIVE LAUREL, NY 11948 JOHN SIEFERT 725 WHITE EAGLE DRIVE LAUREL, NY 11948 Application Number: 3064627 Certificate Number: 3064627 Section: Block: Lot: Building Permit: 0 BDC: ns11 Described as a Residential occupancy, wherein the premises electrical system consisting of electrical devices and wiring, described below, located in/on the premises at: pool house,0utside, Pool/Spa, 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 be in compliance therewith on the 3id Day of July, z00e. rn 2T_Y Rate Ratine S~iis ~i TypF (Swimming Pool): This certificace covers compliance at We dace of inspection only. Because of wusual enviromnrnts it is advisable ce have frequent cest and/or n;pairs made by a qualified person. 2 of 2 seal This certificate may not be altered in any way and is validated only by the presence of a raised seal at the location indicated. • ~~ ~r .a. TOWN OF SOUTHOLD PROPERTY RECORD CARD OWNER STREET ~ ~`" VILLAGE DIST. SUB. LOT -a ~ ~ . FORMER OWNER N E ACR. ... r'CU~CE=S 1•-: ~DvCO ~~~tll~i. S W TYPE OF BUILDI NG y ~y~~ RES. z,o SEAS. VL. FARM COMM. CB. MICS. Mkt. Value LAND IMP. TOTAL DATE REMARKS - ( ~ ~[.' 1 'r.- l ~a A" ~ ~ ~G~ ~ a ' I I ~ ~ ~ ~ ~~ ~( ~~ ~. ~ r 1 ('~1 ~~)~~ V ~ ~ : ti ~ v^ ~ `.fir ~ ~ ~ L--' ~_'- ~i:_:t:: ! d S l u S- 4 /8 ' L I 1111 J C ° ~D ~C_fi -IO ~ vs ~ }_ Gd - S . OC3D ~ oo ~ 50~~' leooo ~G z.~oZ 3 ~ ?; _~,, ~ % r~- ~:=~r~ l~_ ~c !, - ~ 5 ~~ 8 u 13 Sob ~ n 2~3 l - n ~! - ~ ~ ~ ~_ ~ o 0 2O ~ C:t'~ ~~ ~ So Tillable ~'_; ,.::' ~.?,1r ,..,. ~ ` ' FRONTAGE ON WATER Woodland FRONTAGE ON ROAD Meadowkxid DEPTH House Plot iq2 ~ I laoo Fj~} ~ y BULKHEAD Total t._'/tcaZ. _. tai vu~1,~.Y~e , ~ ,.~. ~X4 ~ ....._ ~.._. ~. ~z ~ z..~ ~~, ~Sy ~ 3S 1 a, -. 127-9-24 3/03 V 0. ~~ V ls~{ ~{ ~ - $ 8 Foundation G Bath a Z ii~c n i z `~i 375 q~ Basement ~~~ Floors ^ :xtension Fxt. Walls cta bcb,.'+9, Interior. Finish ~ :xtension Fire Place ~C 2~ Heat ~ 'orch '~ 33 ~ ~ ~, t'T -Pool Attic leck Patio Rooms 1st Floor I'e' ~"'~` Ei +~" reezeway Driveway Rooms 2nd Floor ~ Z Sara ~ 8Z~ 3TS 324D 1 NC~..swD kss ~T ~ l - ~ 5 31 Erosion, Sedimentation and Storm-water Run-off Control Plan ASSESSMENT FORM Yes No EXEMPTIONS:. A. Does this project meet the minimum standards for classification as an Agricultural Project. ,G _ Note: If you. answered Yes. to any of the above, a Storm•water, Grading, Drainage 8 Erosion Control. Plan is not required. ------------------------------------------------------------------- ACTIONS. REOUIRINGTHE SUBMISSION OF A STORM-WATER GRADING DRAINAGE & EROSION CONTROL. PLAN. CERTIFIED BY A DESIGN PROFESSIONAL IN THE STATE OF NEW YORK. Item Number:. (A Check Mark (/) for each question is required for complete application) Yes No 1. Will this. project retain all Storm-Water Run-off generated on Site? (This: will include all run-off created by site. clearing and/or construction activities. as well as all Site Improvements and the permanent creation of impervious surfaces.) 2. Will this project require any land filling, grading or excavation where there is a change to the natural existing grade involving more than 200 cubic yards of material within any parcel? ^ .~ 3. Will this application require land disturbing activities. encompassing an area of five thousand (5,000) square feet of ground surface or more? ^ 4. Is there a Natural Water course running through the. site or is this project within One hundred (100) feet of wetlands or a beach? 5. Will there be site preparation on slopes which exceed fifteen (15) feet of vertical rise to ^ - One hundred (100) feet of horizontal distance? 6. Will driveways,. pazking azeas or other impervious surfaces direct Storm-Water Run-off into and/or in the direction of a Town Right-of--Way? ^ ,r 7. Will this application require the placement of material, removal of vegetation and/or the construction of any item within the Town Right-of--Way or road shoulder area? y (This item does not Include the installation of driveway aprons.) 8. Will there be site re aration within the one hundred 100 9 ^ ~ p p ( )year floodplain of any watercourse. Note: If any. answer to questions one through eight is answered. with a check mark in the Box, aStorm-water, Grading, Drainage 8 Erosion Control Plan is required and must be submitted for review prior to issuance. of any building. permit. STATE OF NEW YORK, COUNTY OF..~`°:~.~t IK... _.. ......._. ss That I, ._':!1~L1~{.~.T....~(i(~QC,)~i'.~ .................... being duly sworn, deposes and says that he/she is the applicant for Peanit, (iJame of individual signing Docum``'ent) And that He/She is the ..........~1r~ L1.~~:~ (Owner, Conhactor, Agent, Corporate OCticer, etc.) Owner and/or representative of the Owner or Owners, and is duly authorized [o perforrrr 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 belier; and that the work sill be performed in the manner set forth in the application filed herewith. Sworn to before me this; / ~y~~~ q 1, 7 Notary Public /!titAl.~<il... ~4_~~........... KATfItEEN QUIGLEY ~ / ~ C,~d........ ~'.. ' NOTARY PI.~LIC, SUps or New Vwk (Signature of pplicant) ~osrnnswrt 8 2 1.T J- ~, PLAN ~~ SE£ TYPICAL wA ll 5 E GT10 N '8 GRADE Z. 4• SA ,~CC3-3/8~ BAAS - FORM TIES ~~ ~ 'a FROM SKIMMERS FIL7ERonA PUMP O FROM TO RETURNS ~SOOIb TO WASTE • ~ •: ~ ~4 POURED GONCRE7E ARRANGEMEI' . .. , . ~~ PIPING ~ ~ °: .; p A .. •t s. _ ~ .P :O,' I rC// /1 / KOG• ~ ~ ~ ! it ~ [O~ r • SECTION ~ . -•' - ~-- r FIgER~ ~~ FORM TIE ~ -~- -~ MOU L[ v 1 PtEI n N 4" MAX= 3/8' gARS I - _ - PLAN OPTTYPE` ~.gTEP CONTRACTOR: R SWIM KING POOLS ROUTE 25A, ROCKY POINT, NY ~ ~ ~ IllOODSIDE LANE E L m m ,A M' r m A m s ~' m ~rn ~~~ 0 ~Iz A b n Z v w v E _ ~ m ~ f Seifert House POOL HOUSE Mark K. $dwarfz, Al,9 ~• ~ '~ ~ ,^~ ~ Architect, PLLC ~ A• ~1~~/~ ~ i o V ~ 725 White Eogle Drive r.o. n~, sin / • m - 0 3 Laurel, NY SITE PLAN c~emnynr rrr. ns.3.c /~' ~~~ , -_- nx~~.~ievnna<ses r~,nu~3aauo ~. i -_-_- _. ., m A A i~ ~; t, A ~iH 0 z I ~