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34398-Z
FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPA/~CY No: Z-34185 Date: 12/10/09 THIS C~KTIFIES that the building ABOVE GROUND POOL Location of Property: 350 OAK CT HAST MARION (EOUSE NO.) (STREET) (HAMLET) County Tax Map NO. 473889 Section 31 Block 3 Lot 11.11 Sul~ivision Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated JANUARY 22, 2009 pursuant to which Building Per. nit No. 34398-Z dated J~N/IARY 22, 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 ABOVE GROUND SWIMMING POOL WITH FENCE TO CODE AS APPLIED FOR. The certificate is issued to CHERYL L BONDARCHUK (OWNER) of the aforesaid building. S[]FFOLKCOI]N~"fDEPART~TOFHF~%LTHAP~OIrAL N/A ~L~-r~ICAL c~TIFICATE NO. 11896 12/10/09 PLIERS u~KTIFICATION DA'r~u 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 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: 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 1. Certific~o~ - New dwelling $25.00, Additions to dwelling $25.00, Alterations to dwelling $25.00, ~wimnfmg pool $2gA)~,~ccessory building $25.00, Additions to accessory building $25.00, Businesses $50.00. 2. e ~ ~ca e o ncy 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 ate. oa. New Construction: Old or Pre-existing Building: LocationofProperty: ,~5~ OOJ(- Q,~, ~O~.~)f ~C~Ot~ House No. Street OwnerorOwnersofProperty: ~htll~ ~X)~C[tLiffC~UC[K~ Suffolk County Tax Map No 1000, Section "~ '! Block Subdivision Permit No. Date of Permit. Health Dept. Approval: (check one) Hamlet Filed Map. Lot: ///2-- ,g-/O ? Applicant: Underwriters Approval: ~ ' Planning Board Approval: Request for: Temporary Certificate Fee Submitted: $ ~x~,()(3 Final Certificate: (check one) ~'li~ant Signature SUFFOLK BUREAUof Et. ECTRICAI INSP~CTORS,~nc. 40 Nottingham Drive, Middle Island, NY 11953 Telephone: 631 495 8136 · Fax: 631 980 6455 · E-Maih SBEIGS@gmail.com CERTIFICATE OF ELECTRICAL COMPLIANCE Applicant: Rough In Inspection Date: Application No.: Cheryl Bondarchuk December 10,2009 11896 Certificate No.: Final ]nspection Date: Building Permit No.: 11896 December 10~2009 34398Z County Tax Map No.: This Certificate of Electrical Compliance is limited to the inspection and compliance of electrical equipment and/or work described below, installed by the applicant named above, located at the premise of and not after the final inspection date above: Owner: Cheryl Bondarchuk Site Location: 350 Oak Court, East l, larion, NY 11939 Owner's Address if different): [] Residential [] Indoor [] Basement [] Service [] Shed [] Commercial [] Outdoor [] First Floor [] Pool [] Hottub [] New [] Renovation [] Second Floor [] Attic [] Garage [] Addition [] Survey Other: Single Phase Three Phase Main Panel Sub Panel Disconnect GFCI Breaker 17® Other Equipment: pool bonding INVENTORY Heat Duplex Recpt Ceiling Fixture HID Fixtures Hot Water GFCl Recpt VVall Fixture Smoke AC Cond Single Recpt i-20a Recessed Fixture CO Detect AC Blower Range Recpt FI0urescent Pumps 1-p°° AppJian~es D~yer Recpt Emergency Time Clock 1-poo Switches 1-poo Twist Lock Exit Fixtures TVSS Heat Pump Electric Heat Pool Luminaire Exhaust Fan The electrical work and/or equipment described above were inspected and appear to be in compliance with local, state and national electrical code requirements and this office. Applicant: Cheryl Bondarchuk Inspected By: *Roger Richert License No.: Homeowner Date Of Certificate: Jan 05. 2010 Signature: 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. 34398 Z Date JAI~-UARY 22, 2009 Permission is hereby granted to: CHERYL L BONDARCHUK 350 OAK CT EAST MARION,NY 11939 for : CONSTRUCTION OF AN ABOVE GROUND SWIMMING POOL IN THE REQUIRED REAR REAR YARD,FENCED TO CODE, THIS REPLACES BP# 30273 at premises located at County Tax Map No. 473889 Section 031 pursuant to application dated JANUARY Building Inspector to expire on JULY 350 OAK CT EAST MARION Block 0003 Lot No. 011.011 22, 2009 and approved by the 22, 2010. Fee $ 150.00 Authorized Signature ORIGINAL Rev. 5/8/02 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. 30273 Z Date APRIL 30, 2004 Permission is hereby granted to: CHERYL L BONDARCHUK 350 OAK CT EAST MARION,NY 11939 for : CONSTRUCTION OF AN ABOVE GROUND SWIMMING POOL IN THE REQUIRED REAR YARD, FENCED TO CODE at pre,rises located at County Tax Map No. 473889 Section 031 pursuant to application dated APRIL Building Inspector to expire on OCTOBER 350 OAK CT EAST MARION Block 0003 Lot No. 011.011 19, 2004 and approved by the 30, 2005. Fee $ 150.00 Authorized ~i~hature ORIGINAL Rev. 5/8/02 TOWN OF SOUTHOLD BUILDING DEPT. 765-1802 INSPECTION [ ]FOUNDATION 1ST [ ]FOUNDATION 2ND [ ]FRAMING / STRAPPING [ ]FIREPLACE & CHIMNEY [ ] ROUGH PLBG. [ ]~N [ ,,,~-'FINAL [ ] FIRE SAFETY INSPECTION [ ] RRE RESISTANT CONSTRUCTIOfl [ ] FIRE RESISTANT PENETRATION REMARKS: ..(~~ ? / DATE INSPECTOR TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, NY 11971 TEL: (631) 765-1802 FAX: (631) 765-9502 www. northfork.net/Southold/ Examined Approved Disapproved a/c 20 Expiration ~/~:~'O , 20 ~;~ ~ PERMIT NO. -,,?,,.9~,~f'3 ~ *ILDING PERMIT APPLICATION CHECKLIST Do you have or need the following, before applying? Board of Health ~- 3 sets of Building Plans Planning Bo~approval Survey ~ Check '~ Septic Form N.Y.S.D.E.C. Trustees Contact: Mail to: Building Inspector APPLICATION FOR BUILDING PERMIT Date INSTRUCTIONS ., 20 ' 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 code, and regulations, and to admit authorized inspectors on premises and in building for necessary inspections. "IMMEDIATELY" ENCLOSE POOL TO CODE UPON COMPLETION BEFORE "WATER" t~Slgflature of apphcant or name, ~f a corporataon) ALL CONSTRUCTIONSHALL ,3,~) I lqS7 ONDERWRIERS CERqFICA ME~ TH E REQUIREMENTS OF THE - (Mail~g ad~s of ~ppli~t) REQUIRED ~ES OF NEW.YORK STATE. State wheth~ applic~t is owner, lessee, ag~t, ~ch~tect, en~neer, general ~n~actor, elec~ci~, pl~ber or build~ ', . APPROVED AS NOTED (As on the tax roll o~'P2t~~-' ..r. If applicant isa corporation, ~im~gq ~t/0[~¢tl~q~i~ed officer V~E:/ N©TIP-'Y BUILDING DEPARTMENT AT (Name and title of c ol~e ~i~ LAW F U L Builders License No. WITHOUT CERTIFICATF Plumbers License No. f'hl: t'ht~l ID ^ ~ lr~x/ Electricians License No. v, ~v~l m~l Oth~ Trade's License No. Location of land on which proposed work will be done: House Number Street County Tax Map No. 1000 Section Subdivision (Name) 765-1802 8AM TO 41~{ FOR THE g.3L~.GWit,,al 1. FOUflDATDN - ~ REQUIRED FO~ POURED ~R~E 2. ROUGH - FR~ & PLUMBING 3. INS~JLATION 4. F,',~ - CONSTRUCTION MUST ~F COMPL~ FOR C.O. AL~ CONSTRUCTION SH~L REQUIREMENTS OFTHE CODESOFN~ YO ...... TE. NOT RESPOii$i~LE FOR D~]~'~]~t~ CONSTRUCTIO~I ~ Block ~ Lot /J, ,// Filed Map No. Lot 2. State existing use and occupancy ofprem~ises and intended use and occupancy of proposed construction: a. Existing use and occupancy b. Intended use and occupancy4~L'(4,((01Lq~ ~0C~: ~Tflhl~'L~l (~f,~Wr~'D[',~ Nature of work (check which applicable): New Building. Addition Repair Removal Demolition Other Work Estimated Cost Fee If dwelling, number of dwelling units If garage, number of cars 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 Rear Depth Height. Number of Stories Dimensions of same structure with alterations or additions: Front Depth. Height Number of Stodes 8. Dimensions of entire new construction: Front Height Number of Stories Rear 9. Size of lot: Front Rear Depth 10. Date of Purchase Name of Former Owner Depth 11. Zone or use district in which premises are situated 12. Does proposed construction violate any zoning law, ordinance or regulation? YES NO v/ 13. Will lot be re-graded? YES__ NO ~/Will excess fill be removed from premises? YES . NO 14. Names of Owner of premises~At~L..~_~2r~Lht~__.a~_._tAddress 3q6 c~{~o~ ~2 ~-00 Phone No. 427 ~o 19 ¢~ 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 NO v/ * ~F?E.S, SOUTHOLD TOWN TRUSTEES & D.E.C. PERMITS MAY BE, REQUIRED4 ~ o. ts this property within 300 feet of a tidal wetland? * YES .NO ~/ .... ~ :~ ~[.~V * IF YES, D.E.C. PERMITS MAY BE REQUIRED. 16. Provide survey, to scale, with accurate foundation plan and distanc~es to prope~y lines. 17. If elevation at any point on property is at 10 feet :~'r below, must provide topograp~fi~cal data on survey. "a STATE OF NEW YORK) SS: COUNTY OF~ t "" OCI"": ~7/::~:~¢ ~., V(/,4~. -: being duly sworn, deposes and says that (s,he is the applicant t,~ame of'individual si ,g~n~ g c6fiir-~i~-fibove named, (Contractor, Agent, Corporate Officer, etc.) ' ~ ~..,[J of said owner or owners,:.~fi'i~ d~uly authorized to perform or have performed the said work and~ make and file this application; that all statements conta~l. ~[fi'~.'S application are true to the best of his knowledge and beliefi aitd that the work will be performed in the manner'sift f6~th;in the application filed therewith. "J Sworn to before me this '~' d / Sign~tu/e of Applicant ~ TOWN OF SOUTHOLD PROPERTY RECORD CARD IOOO- BI-~- (S, ~ I h/lo ~ ~54- R~.~iO S~S. ' VL.~_ FARM) CO~. CB. MICS. Mkt. Value ~ND IMP. TOTAL DATE R~RKS ~ ~o~~ ~ ~ 'J/~/~ ~l,s/~ U~a~- Tillable O,e~ ~~ / ~O~ FRONTAGE ON WAlK W~la~ I~eO / ~ ~ FRONTAGE ON ROAD ~ ~' ~ · ~ ~ DEPTH H~ P~ BULKH~D To~I Extension Extension Extension Porch (~ ~ '~(~ '= ~---t (z Deck Breezeway Garage Foundation Basement Ext. Walls Fire Place Poo I Patio Driveway Bath Floors Interior Finish Heat Attic Rooms 1st Floor Rooms 2nd Floor 4 2- POOL PLAN SECTION A-A (TYPICAL) SECTION B-B (TYPICAL) TABULATED DATA WALL MAXIMUM 1~o ANO BOl'rdM R~ %_ s .../__j 'lOP AND BO'19'{1~4 14_A'ES TOP COVERS MATERIAL: ALUMII~M 6063-1'5 BUT'IRESE~ PO~TS AgO BRACES MATERIAL: STEEL H~ I 'S1RAP$ SWIM 'N PLAY INC. FUTURA CONSUL'tiNG ~ NO. SNP--OO2V i I ~" o