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Home My WebLink About34492-ZFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUP~/~CY No: Z-34177 Date: 01/26/10 THIS CERTIFIES that the building IN GROUND SWIMMING POOL Location of Property: 2190 LONG CREEK DR SOUTHOLD (HOUSE NO.) (STREET) (HAMLET) County Tax~4ap No. 473889 Section 55 Block 7 ~ot 6 Subdivision Filed~4ap No. __ Lot No. __ conforms substantially to the Application for Building Permit heretofore filed in this office dated MARCH 5, 2009 pur~,ant to which Building Permit No. 34492-Z dated MARCH 10, 2009 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 IN GROUND SWIMMING POOL WITH FENCE TO CODE AS APPLIED FOR. The certificate is issued to ALLAN & KELLY ROSENBLOOM (OWNER) of the aforesaid building. SUFFOLK COI~ryDEPART~ENTOF ~F~LTH~PROVAL N/A BI~t-£KICAL CERTIFICA~ NO. 128047C 07/22/09 CERTIFICATION DA'£~43 N/A Rev. 1/81 Form No. 6 TOWN OF SOUTHOLD BUILDING DEPARTMENT 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 wi' A. For new building or new use: 1. Final survey of property with accurate location of all buildings, property lines, streets, and ~ 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. 5. Sworn statement from plumber certifying that the solder used in system contains less than 2/10 of 1% lead. Con~nercial building, industrial building, multiple residences and similar buildings and installations, a certificate of Code Compliance from architect or engineer responsible for the building. 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 properly 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 New Construction: Location of Property: Date. Old or Pre-existing Building: ~ (check one) House No. Owner or Owners of Property: Suffolk County Tax Map No 1000, Section Street Hamlet ..~ Block ESP ;~- Lot O~ Filed Map. Lot: ~ { l( [ (')~_ Applicant: '~'J-. ~/W--4~I~L/~_ -~{ /~f~]~I" ~[~ Underwriters Approval: Subdivision Pe tNo. _ /r4 Z Health Dept. Approval: Date of Permit. Planning Board Approval: Request for: Temporary Certificate Fee Submitted: $ Final Certificate: (check one) /~-PA p~gnature Issue Date 7/22/2009 Electrical Inspection Certificate Electrical Inspection Service, Inc. Application Number 375 Dunton Avenue 128047C East Patchogue, NewYork 1'1772 (631) 286-6642 Issued To: Allan Rosenbloom Street: 2190 Longcreek Drive Village: Southold Zip: 11971 Section: 055 Block: 0007 Lot: 006 Town: Southold Contractor: Ridge Electrical Contracting Services Inc. Lic. # 44248-ME Was examined and found to be in compliance with the National Electrical Code. Commercial bJ NVDefects JXj Pool J~ 'lstFIoor I ]indoor ~ Basement ~HotTub Residential J~ Det. Garage I I Attic ~ 2nd Floor IX l Outdoor !9 Addition i : Survey Switches Receptacles Fixtures GFI Heaters I 2 Dishwasher Washer/Amps Dryer/Amps Oven Range/Amps Furnace Oil Gas Circulators Smoke Detector Meter Amps Phase UG/OH Jacuzzi Television / Bldg. Permit: 34492Z A/C Fans Microwaves Bell Transformer CO Detector Other Equipment ~l-Aqualink DiscJ 1-50 amp Heater Disc./1-20 ~arnp Spec. Recept./1-Pool Cover Motor Disc./ V-Pool Lts Hugo S. Surdi President Rough Inspection: 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. 34492 Z Date MARCH 10, 2009 Permission is hereby granted to: ALLAN & KELLY ROSENBLOOM 333 E. 45TH ST. APT. 27B NEW YORK,NY 10017 for : INSTALLATION OF IN GROUND SWIMMING POOL WITH FENCE TO CODE IN REQ REAR YARD PER PLAN AS APPLIED FPR. at premises located at 2190 LONG CREEK DR County Tax Map NO. 473889 Section 055 Block pursuant to application dated MARCH 5, 2009 Building Inspector to expire on SEPTEMBER 10, SOUTHOLD 0007 Lot No. 006 and approved by the 2010. Fee $ 250.00 Authorized Signature Rev. 5/8/02 ORIGINAL TOWN OF SOUTHOLD BUILDING DEPT. 765-1802 INSPECTION [ ]FOUNDATION 1ST [ ] ROUGH PLBG. [ ]FOUNDATION 2ND [ ] INSULATION [ ]FRAMING / STRAPPING ~FINAL [ ] FIREPLACE & CHIMNEY [ ] FIRE SAFETY INSPECTION [ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PEN ~L=~,ATION DATE TOWN OF SOUTHOLD BUILDING DEPT. 765-1802 INSPECTION [ ] FRAMING / STRAPPING [ ] FIREPLACE & CHIMNEY [ ] FIRE SA~ ~ ~ INSPECTION RE.ARKS.:- DATE INSPECTOR ~~/ '/~ TOWN OF SOUTHOLD BUILDING DEPT. 765-1802 INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLBG. [ ]FOUNDATION 2ND [ ]I~LA~ [ ] FRAMING/STRAPPING [P~] FINA~ ~// [ ] FIREPLACE & CHIMNEY [ ] FIRE SAFETY INSPECTION REMARKS: ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRATION DATE INSPECTOR FIELD INSPECTION REPORT'1 DATEii COMMENTS FOUNDATION (IST) FOUNDATION (2ND) ROUGH F~G & PL~G INS~ATION PER N. Y. STATE ENERGY CODE ~TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN H~,LL SOUTHOLD, NY 11971 TEL: (631) 765-1802 FAX: (631) 765-9502 www. northfork, net/Southold/ Examined Approved Disapproved Expiration c~[ ~\(~ ,20 (f'i PERMIT NO. BUILDING PERMIT APPLICATION CHECKLIST Do you have or need the following, before applying? Board of Health 4 sets of Building Plans Planning Board approval Survey Check Septic Form N.Y.S.D.E.C. Trustees Contact: Mail to: Phone: . ~ ~ ~'~~ ,- ' Building Inspector 10~t~i0~l~0t0 _ [ INSTRUCTIONS ~s application MUST be completely filled in by typewriter or in ink and submiRed to the Building Inspector with 3 Ekl - 5 200co 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. fi 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,..hm~g cod,~, anslaFgulations, and to admit authorized inspectors on premises and in building for necessary insp~~~/ ~""~ *(~l~nature of applicant or name, if a corporation) (Mailing address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder Name of owner of premises (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. ,,~7 I '7 ~ Plumbers License No. Electricians License No. Other Trade's License No. Location of land on which proposed work will be done:__ House Number ' ,S,.9/e e t County Tax Map No. 1000 Section '~'~ Block Subdivision Hamlet Filed Map No. (Name) Lot Lot 2. State existing use and occupancy of premises,and intended use ~lnd occupancy of proposed construction: a. Existing use and occupancy /'c' ~ r,-{~e ,~. ~L~-~f b. Intended use and occupancy /--~ 3. Nature of work (check which applicable): New Building Repair Removal ' Demolition 4. Estimated Cost /"o/Df'°~) 5. If dwelling, number of dwelling units If garage, number of cars Fee Addition Other Work Alteration (Description) (To be paid on filing this application) Number of dwelling units on each floor 6. If business, commercial or mixed occupancy, specify nature and extent of each type of use. 7. Dimensions of existing structures, if any: Front Height Number of Stories Rear Depth Dimensions of same structure with alterations or additions: Front Depth Height. Number of Stories Rear 8. Dimensions of entire new construction: Front Height Number of Stories Rear Depth 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 A 14. Names of Owner of~remises fd, oSe~]~ Ioo WI Address So o'/'/t o I ~ Phone No. Name of Architect rra,& Yt./[etvda ~Z Address ~opo~ ~ PhoneNo 477~ Name of Con~actor ~7~ P~v~ N Address~ [~l~fl' PhoneNo. 7qq-2,1/0 15 a. Is this prope~ within 100 feet of a tidal wetl~d or a freshwater wetl~d? *YES NO * IF YES, SOUTHOLD TO~ TRUSTEES & D.E.C. PE~ITS MAY BE REQUI~D. b. Is this prope~ within 300 feet of a tidal wetland? * YES NO ~ * IF YES, D.E.C. PE~ITS MAY BE REQUI~D. 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 NEW YORK) SS: COUNTY OF ~.,~ff'o t k ) ~-~ i('~ri'YX. [b ~ V[ ~1 g4~ being duly sworn, deposes and says that (s)he is the applicant (Name of individual signing contract) above named, (S)He is the (''dO '~ {~ C d VI'-~7'c ~ (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 7~4a.cc4~_ 20~ N~ary PublfJc DOROTNY S Comm~ssmn %xplre~,ug!lst 31, ~-?o_zb 02-12-09;17:11 ; 97493529 ; # 1/ 1 Town o_ f Southold _Erosion, Sedan &. I~ and 3 4 $ 6 7 8 9 WUI Ihls Pr0Je~'t Require any Land Fllff~g, Grading ~ EXCavation whom Ihe~e is a change t~ the Nal~ml E3~Ur~ Grade Invo~ng rno~ than 200 Cubic Yards of Marshal u~lhln any Pan,el? Will 6ds Apl~caf~o~ Require Land DlstuWing A~vi~s En~OfT~Oassth9 an ~ in E~nes~ o~ Flys Thousand ($,000) Square Feet o(Gmund ~u~a~e? I$ the~e a Natural Wa~e¢ Coume R~ ~mugh the ~? .15 ~s P~e~ ~ln ~e T~ JuH$d~ ~ w~n One H~dmd (1 ~') ~eat ~ a ~Ua~ ~ ~ch? ~1 ~em be SKe pmp~ o~ ~ G~ 8~ ~ ~ Fi~n (15) feet of Ved~ ~ Hund~ (1003 ~ Ho~ ~n~? Wl~ D~e~ys, P~ ~ ~ a~ Impe~ 8utfa~ be Sl~ ~ D~ Sto~W~r ~N ' in~ ~d/ot in ~e ~n ora T~ Wl~ ~ ~Je~ R~m ~e Pl~e~it of Mated~. Re~ ~ Ve~ion a~/~ ~y I~ ~ln ~e T~ ~ff-W~ or R~d ~ou~r ~? ~ls ~ ~11 fl~ I~Jude ~e lns~llaUen ~ DrY. ay Aprons.I ~ ~is 'PmJe~ ~q~m ~te. Pm~fl~ wi~in .t~ O~ Hu~md (1 ~) Year ~od~in NOTE: If Any Answer to Questions One ~hrough Nine Is A~awemd with a Check Ma~( In ~o Box, D~lo~ & ~1~ C~nlml Plan Is ~eqolmd ~nd Mu~ b~ ~ml~.~ Revl=w P~or ~ ~a~nne N~; ~ o~ ~ YO~, .............. [, ~d $~ ~/she ~ $c · ~om to ~o~ mc ~., DOROTHY S OG~R No 52'~?'':(32~ ~' Suffolk Counly~ ' Commission Expires AuguSt 31, Feb 12 OS Ol:31p Bri~otti & Silkeorth B31-7~9-4152 R.1 ACORDr. CERTIFICATE OF LIABILITY INSURANCE PRODUCER Brisot~J & 8400 ~&in P. O. Box 1448 i~SUR~O ~t~der pools Inc. THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW, / INSURERS AFFORDING COVERAGE /NAIC# iNSURER A: ~A~T~'O~D F~RE ~N~U~NCE CO.~ PO Box 1~60 I~SURER B: w COVERAGES 'HE POLICIES OF INSURANCE LISTED BELOW HAVE SEEN ISSUED TO THE iNSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED, NOTWITHSTANDING ANY REOUIRE~V~ENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE iSSUED DR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRISED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. AGO REGA'I'E LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. tNs~ M)D'~ POLICY NURSER ~ ~ ~__T.A..~__~ 05/10/2008 05/I0/200,q EACH OCCURRENCE $ 1000000 X COM~ ERCIAL O E~ ERAL LIABILITY 2000000 ~ occur ~ CLAIMSMADE AGGREGAT~ ' CERTIFICATE HOLDER CANCELLATION Tow~ of $outholE P.O. ~ox 1179 $outhold, ~Y 11971 ACORD Z5 (2OO9/08) e ACORD CORPORATION 1988 mNi:)E~ POOL~, INO. POOL COPING 14" X 36" PAVERS MORTAR 6" TILE BAND MARBLE Pt./ST #3 & #4 STEEL REBAIC tO" O.C.~UGHOLIT VERTICALS, 5"0,C, WI-IE~ WATE.R DEPTH EXCEEDS 5'. IKadiue variee from 12" to 36" £00/C00,6c~ ~d'gG:oz oo/g;/;; q= 6ZG;-6~L-;£9 0'4 mo=~ ~ . _,, _ -,~-, UC£RWRITERS CERTIFICA~ ~ ~~ '. ' -~.~ .... ..,. - ~ ~ ~ SOUTHOLD, NY ~' ~ ~C; ~ J ~ ~ ~TH: 3,5' TO 6' ~ ; ~ ~ ARCHITECT REFUSE' SH~ G~ ~ = = exCg D~K ~ ,~ DINING ROOM --- , _ ~' . = ~ ~--- ~ J ~ ~ ~K UE~EN~ P.O.~X ~1~ ~GE ~ ~ ~,~,,u, J w ~' ~L: 212-490-2252 2~m-~ -- ~NG R~M ~ ' ~_~~ -~ -- F~ ~ , ~~x; ---;~ ~ /~ PURSUANT TO C~PTEB 23~ L ....... L~LL .... LLL L_ FOR POU __~LLLL~__=L=L-PATH - CONCRDE PA~RS ....... L. GH ~LLLx~ ~" ~- ~ co~,z~T~ ,o~.~=~?~.o~,~ STE PLAN · ,~u~ ~SPONSIBLE FOR DESIGN OR CONSTRucTION ~ ~SITE P~N ~ PROP~,~ L,N[ ~O~s. LONG CREEK DRIVE ~' A-~ ga ~.NO pREPARED IN ACCORDANCE WITH THE MINIMUM oF NEW CERT£FIED ALAN KELLY SURVEY OF LOT 11 MAP OF LONG POND ESTATES SECTION ONE FILE No. 8037 FILED DECEMBER 27, 1985 SITUATE SOUTHOLD TOWN OF SOUTHOLD SUFFOLK COUNTY, NEW YORK S.C. TAX No. 1000-,55-07-06 SCALE 1":$0' JUNE 27, 2000 JULY 9, 2000 PLOT PLAN DECEMBER 12, 2000 FOUNDATION LOCATION JANUARY 10, 2002 FINAL SURVEY DECEMBER 6, 2005 ADDED PROPOSED POOL NOVEMBER 12, 2008 UPDATE SURVEY AREA = 42,571 sq. ff. 0.977 ac. TO: ROSENBLOOM FLEISCH MANN-ROSENBLOOM THE EXISTENCE OF RIGHTS OF WAY AND/OR [ASEM£NTS OF RECORD, IF ANY~ NOT SHOWN ARE NOT GUARANTEED, Nathan Taft Corw~n III Land Surveyor PHONE (631)727-2090 Fox (651)727-1727 28-34