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HomeMy WebLinkAbout35506-ZFORM NO. 4 TO,tN OF SOUTHOLD BUILDING DEP~TMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No: Z-34807 Date: 01/19/11 THIS u~KTIFIES that the building SWIMMING POOL Location of Property: 625 DEAN DR CUTCHOGUE (HOUSE NO.) (STREET) (HAMLET) County Tax Map No. 473889 Section 116 Block 5 Lot 7 subdivision Filed Map No. -- LOt No. __ conforms substantially to the Application for Building Permit heretofore filed in this office dated APRIL 23, 2010 purs,,a-t to which Building Petit No. 35506-Z dated APRIL 26, 2010 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 BRIAN SULLIVAN & MARJORIE ADAMS (OWNER) of the aforesaid building. SUFFOI~( COI~TI"fDNPART~ENT OF ~ALTHAPPRO%rAL N/A ELEt-r~ICAL CERTIFICATE NO. 35506 09/01/10 pLD]4BERS CERTIFICATION DA'r~u N/A Rev. 1/81 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. 35506 Z Date APRIL 26, 2010 Permission is hereby granted to: BRIAN SULLIVAN 253 W 73RD ST APT 16D NEW YORK, NY 10023 for : CONSTRUCTION OF AN INGROUND SWIMMING POOL, FENCED TO CODE AS APPLIED FOR at premises located at 625 DEAN DR County Tax Map No. 473889 Section 116 pursuant to application dated APRIL Building Inspector to expire on OCTOBER CUTCHOGUE Block 0005 Lot No. 007 23, 2010 and approved by the 26, 2011. Fee $ 250.00 Authorized Signature ORIGINAL Rev. 5/8/02 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, p[operty 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 PI.arming 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. Accui:ate survey °f pr0perty 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~L..~..-- denied, the Building Inspector shall state the reasons therefor in writing to the applicant~ 1. sC;~ificate of Occupancy - New dwelling $50.00, Additions to dwelling $50 00, Alter S imming po~ccessory building $50.00, Additions to accessory building ~ ~~s~$~SV6.~. 2. Certificate of 0ccupancy on Pre-existing Building - $100.00 · 3. Copy 0fCertifiCateofOccupancy- $.25 4. Updated Certificate of Occupancy - $50 00 [;k0~. ~5 ' - 5. Temporary Certificate of Occupancy - Residential $15.00, Commercial $15.00 New Construction: Location of ProPerty: House No. Date. Old or Pre-existing Building: Vt Owner or Owners of Property: Su o co n,T xMapNol000, tion ! S divi ion ?ermit No. ~ 0~O-'~ Date of Permit. Health Dept. Approval: (check one) 'Planning Board Approval: Request for: Temporary Certificate Fee Submitted: $ Street Hamlet Block ~ Lot 7 Filed Map. Applicant: Underwriters Approval: (check one) Final Certificate: Applicant Signatt~re Tovm [ fall Ampex ,5 t;~75 Main P, oad P.(). Box 117!) Soulhold, NY 11971-09,59 Telcph.nc (631) 765-1802 Fax (631) 71i,54)502 ro,qer, richert~town.southold.ny.us BI ;II,DIN(; 1)EI~ARTM I'2NT TOWN OF SOUTHOLD CERTIFICATE OF ELECTRICIAL COMPLIANCE SITE LOCATION ssued To: Sullivan Address: 625 Dean St City: Cutchogue St: NY Zip: 11935 3uilding Permit #: 35506 Section: 1 16 Block: 5 Lot: WAS EXAMINED AND FOUND TO BE IN COMPLIANCE WITH THE NATIONAL ELECTRIC CODE Contractor: DBA: Elite Electric License No: 37079-me SITE DETAILS Office Use Only Residential R Ind°°r ~ Basement ~ Service Only~ Commedcal Outdoor 1st Floor Pool New Renovation 2nd Floor Hot Tub Addition Survey Attic Garage INVENTORY Servicelph ~ Heat ~ DuplecRecpt ~ Ceiling Fixtures .,s~ HID Fixtures~walIFixtures Service 3 ph Hot Water GFCI Recpt Smoke Detectors Main Panel NC Condenser Single Recpt Recessed Fixtures CO Detectors Sub Panel NC Blower Range Recpt Fluorescent Fixture Pumps Transformer Appliances Dryer Recpt Emergency Fixture Time Clocks Disconnect Switches Twist Lock Exit Fixtures ~ TVSS Other Equipment: bonding, 2 pool lights, 3 GFCI circuit breakers, I control panel, I heat pump 2-pool pumps Notes: Inspector Signature: Date: Sept 1 2010 81-Cert Electrical Compliance Form TOWN OF SOUTHOLD BUILDING DEPT. 765-1802 INSPECTION ~ ~.__[/~OU NDATION 1ST [ ]ROUGH PLBG. '~/ [ ] FOUNDATION 2ND [ ]INSULATION [ ] FRAMING / STRAPPING [ ]FINAL [ ] FIREPLACE & CHIMNEY [ ]FIRE SAFETY INSPECTION [ ] FIRE RESISTANT CONSTRUCTION [ ]FIRE RESISTANT PENETRATION REMARKS: DATE INSPECT INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] INSULATION [ ] FRAMING / STRAPPING [ ] FINAL [ ] FIREPLACE & CHIMNEY [ ] FIRE SAFETY INSPECTION [ ] RRE RESISTANT CO#S1RUCTION [ ] RRE RESISTANT PENETRATION ~LECTRICAL (ROUGH) [ ] ELECTRICAL (FINAL) REMARKS: DATE INSPECTOR TOWN OF SOUTHOLD BUILDING DEPT. 765-1802 INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLBG. [ ]FOUNDATION 2ND [ ]INSU~.A~ON [ ] FRAMING / STRAPPING [~'~FINAL [ ] FIREPLACE & CHIMNEY [ I FIRE SAFETY INSPECTION [ ] RRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRATION REMARKS: .~ ~C,~ ~/~_/Z~ ,~/~/~_~ r~.~/C,' _ DATE INSPECTOR TOWN OF SOUTHOLD BUILDING DEPT. 765-1802 INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] INSULATION [ ] FRAMING / STRAPPING .~]~FINAL [ ] FIREPLACE&CHIMNEY [ ] FIRE SA,-,- , '( INSPECTION DATE l l~/t)~lO iNSPECTOR__--~, ~~-'- TOWN OF SOUTHOLD PROPERTY RECORD CARD :OWNER STREET ~__2 ~ ,~'" VILLAGE DTST. SUB. LOT FORME~ OWNER N E ' ACR._ En~-/~ ~,~,-,~, ~ ~. s . w . · :.,. '- -'~,~, O~~ --- .1_ __ .' REs'.~,,,'i SEAS. VL. " FARM COM~M. CB. MICS. Mkf. Value ' ,- AGE BUILDING CONDITION NEW NOR~L BELOW ABOVE FA~ Acre Value Per Value . . . Acre Tillable FRONTAGE ON WATER .. W~land FRONTAGE oN Meadowl~d DEPTH Ho~ Plot BULKH~D Total D~K Exteneion Extension Extension !Porch Porch Breezeway Garage Patio Oo Bo Total 2z coLo~ N~ f. ~ ~ 1 Woo; Foundation Basement Ext. Walls Fire Place rype Roof P. ecreation Room Dormer Bath Floors Interior Finish Heat Rooms 1st Floor Rooms 2nd Floor Driveway Dinette Ko LR. DR. BR. FIN. B TOWN OF SOUTHOLD ' 'BUILDING DEPARTMENT TOWN HALL SOUTHOLD, NY 11971 TEL: (631) 765-1802 FAX: (631) 765-9502 SoutholdTown. NorthFork. net Approved Disapproved PERMIT NO. uilding Inspector 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 Forra Trustees Fload Permit Storm-Water Assessment Form Contact: Mail to: APPLICATION FOR BUILDING PERMIT INSTRUCTIONS Date ,20 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 re'cas, 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 atler the date of issuance or has not been completed within 18 months from such date. If no zoning amendments or other regulations affecting the proper~ have been enacted in the interim, the Building Inspector may authorize, in writing, the extension of the permit for an addition six months. Therealler, a new peimit shall be required. APPLICATION IS HEREBY MADE to the Building Department for the issuance of a Building Pen/fit pursuant to the Building Zone Ordinance of the Town of Southold, Suffolk County, New York, and other applicable Laws, Ordinances or Regulations, for the coma,action 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. '' (Sign~ur~ oiSapp[fe/u~t~r hame, ifacorporation) ,e_z). ' · (Mailing address o~applicant) State whether applicant is owner, lessee, agent, architect, engi~er,,general contractor, electrician, plumber ~uildar~ Name of owner of premises __~?//~q./ (As on ~e t~ roll or latest dee If ~plic~ is a co~oration, ~gnatore of duly authorized officer ' "~% ~tl?of ~rporate officer) BuildersLicenseNo. ~/~' h, ,, Plumbers Lice~e No. Electrici~s License No. O~ar Trade's License No. 1. Locatio, n of land on which proposed ~o~rk will be done: House Number Street Hmlet ~ Coun~T~MapNo. 1000 Section i/~ Block ~ Lot Subdivision Filed Map No. Lot State existing use and occupancy of premises and intended use and occupancy of proposed construction: a~ Existing use and occupancy b. Intended use and occupancy --~.~OI]/A/l~//1/~ /9~5~/~- I'~'1'~. 3. Natureofwork(checkwhichapplicable):NewBuilding_" Addition Alteration Repair Removal Demolition O~er Work st~.~ (Description) 4. Estimated Co ./'~0 t~ Fee /q. (To be paid on filing this ap~plication) 5. If dwelling, number of dwelling units Number of dwelling units on each floor If garage, number of ears 6. If business, commercial or mixed occupancy, specify nature and extent of each type of use. t~//~ 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 Numbe[ of Stories 8. Dimensions of enfire new construcfion: Front .Reaj _ Depth Height Number of Stories 9. Size of lot: Front Rear Depth 10. Date of Purchase . Name &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 ii 13. Will lot be re-graded? YES ' NO [/Will excess fill be removed from premises? YES__ NO 14. Names of Owner of premises~Address ~~o~; No. Name of Architect ~k/21~[_ 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 · IF YES, SOUTHOLD TOWN TRUSTEES & D.E.C. PERMITS MAY BE REQUIRED. b. ls this property within 300 feet of a tidal wetland? * YES NO_ ~5 ~_ · 1F YES, D.E.C. PERMITS MAY BE REQUIRED. 16. Provide survey, to scale, with accurate foundation plan and distances to property lines. 17. If elevafion at any point on property is at 10 feet or below,must provide topographical data on survey. 18. Are there any covenants and restrictions with respect to this property? * YES~ NO i// · IF YES, PROVIDE A COPY. STATE OF NEW YORK) SS: COUNTY OF ~0][] ~tt~.]~ ~ being duly swom, deposes and says that (s)he is the applicant (Name of individual szgning Contract) above named, (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 tree 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. SwglTa to I~efore me this 1 ~ dayof j~r_.~',I, 20J~_ No, 0~ST~03~196 Qualified ~n Su~c,~ County Commission Expires December 27, ~S]gnamr~ e'~ ~pplicant 06-23-10;18:05 ; 5828145 ; # 1/ .5437,5 M:.;. Road P.O. Box 1179 Southold, NY 11971 '£eleph¢,m (631} 7&%1802 . , ,,,g, ax (6al} 76~-~5q2, . ~oaer. rlcnenca~lown.soulnola .ny. us BUILDINO DF, PARTMI~NT TOWN OF SOUTHOLD APPLICATION FOR ELECTRICAL INSPECTION REQUESTED BY: Date: JOBSITE INFORMATION: ('Indicates required information) *Na~me: *Address: *Cross Street: 'Phone No,: Permit No.: Tax Map District: 1000 Section: *BRIEF DESCRIPTION OF WORK (Please Print Clearly) Block: _'~ Lot: (Please Cirole All That Apply) *Is job ready for inspection: 'Do you need a Tamp Certificate: YES I NO Rough In YES / NO Temp Information (If needed] *Service Size: 1 Phase 3Phase 100 150 200 300 350 400 *New Service: Re-connect Underground Number of Meters Change of Service Additional Information: PAYMENT DUE WITH APPLICATION Final Other Overhead 82-Request for Inspe~'tion Form owen of Southold Erosion, SedEmentatlon & Storm-Water Run-off ASSESSMENT FORM PROPERTY LOCATION: $.C.T.M. ~. THE FOLLOWING ACTIONS MAY REQUIRE THE 8UBMISSION OF A i[~) ~' "~ STORM-WATER, GRADING, DRAINAGE AND EROSION CONTROL PLAN D]stflct Se©rich Block Lot C~I{TIFIED BY A DESIGN PROFESSIONAL IN THE STATE OF NEW YORK. Item Number: (NOTE: A Check Mark (~) for each Question is Required for a Complete Applicatior,) Ye__s N._~o 1 Will this Project Retain All Storm-Water Run-Off Generated by a Two (2") Inch Rainfall on Site? i/ I ! (This item will include all mn-off created by site cleadng and/or construction activities as well as all Site Improvements and the permanent creation of impervious surfaces.) 2 Does the Site Plan and/or Survey Show All Proposed Drainage Structures Indicating Size & Location? This Item shall include all Proposed Grade Changes and Slopes Controlling Surface WaterFIowl 3 Wi,, this Project Require any Land Filling. Groding or ExcavatiOn where there isa change to the Natural Existing Grade Involving moro than 200 Cubic Yards of Matedal within any Pamel? ¥- 4 Will this Application Require Land Disturbing Activities Encompassing an Area in Excess of Five Thousand (5.000) Square Feet of Ground Sulfaca? 5 Is there a Natural Water Courae Running through the Site? s th s Project w th n the Trustees Judsd ct on or w thin One Hundrod (100') feet of a Wetland or Beach'~ 6 oneWill there be Site preparation on Existing Grode Slopes which Exceed Fiftaen (15) feet of Vertical Rise tOHundred (100')of Horizontal Distance? 7 Will Ddveways, Parking Areas or other Impervious Surfaces be Sloped to Diroct Storm-Water Ron-Off D ~/~ into and/or in the direction cfa Town right-of--way? 8 Wi,, this Project Require the Placement of Material, Removal of Vegetation and/or the Construction of r'-"l ,/ any Item Within the Town Right-of-Way or Road Shoulder Area? (This item will NOT Include the Installation of Driveway Aprons.) 9 Will this Project Requiro Sita Preparotion within the One Hundred (100) Year Floodplain of any Watercoume? NOTE: if Any Answer to Questions One through Nine Is Answered with a Check Mark in the Box. a Storm-Water. Grading, Drainage & Erosion Control Plan Is Required and Must be Submitted for Review Prior to Issuance of Any Building Permitl EXEMPTION: Yes No Does this project meet the minimum standards for ciassi§ca~ion as an Agricultural Project? Note: If You Answered Yes to this Question, a Storm-Water, Grading, Drainage & Erosion Control Plan is NOT Requiredl __ ,~ STATE OF NEW YORK,~. ~lJ/". CC That I ................................................................................. being duly sworn, deposes and says that he/she is the applicant for Permit, (Name of individual algni~g Document) Owner and/or representative of the Owner of Owner's, and is duly authorized to perform or have performed the said work and to make and file dais 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 herewith. Sworn to before me this; Notary Public: ~~J..,,~ ....................................................... FORM-06/07 c Tow~ H~dl A~mex 54375 Main Road P.O. Box 1179 Southold, NY 11971-0959 Telephone (631) 765-1802 Fax (631) 765-9502 November 16, 2010 BUILDING DEPARTMENT TOWN OF SOUTHOLD Brian Sullivan A ' 253 W 73~d St, ~'~_~ NewYork, NY 1 RE: 625 Dean Drive, Cutchogue TO WHOM IT MAY CONCERN: The Following Items Are Needed To Complete Your Certificate of Occupancy .. Application of Certificate of Occupancy. (Enclosed) Electrical Underwriters Certificate. A fee of $50.00 __ Final Health Department approval. Plumbers Solder Certificate. (All permits involving plumbing after 4/1/84) __ Trustees Certificate of Compliance. (Town Trustees #765-1892) __ Final Planning Board approval. __ Final Fire Inspection from Fire Marshal. __ Final Inspection from the Building Dept. __ Final Landmark Preservation approval. Building Permit: 35506-Z swimming pool S uffo lk County Executive's OffiCe-Of Consumer Affairs VETERANS MEMORIAL HIGHWAY ~ HAUPPAUGE~ NEW YORK .11788 DATE ISSUED: 4/1/1983 No. 8391-H SUFFOLK COUNTY Home Improvement:COntractor License This is to ceftin that RON A GIBBONS doing business as ' ' GIBBONS POOLS having furnished the requirements set forth in accordance with and subject to the provisions of applicable laws, rules and regulations of the County of Suffolk, State Of New York is hereby licensed to conduct business as a HOME IMPROVEMENT CONTRACTOR, in the County of Suffolk, Additional Businesses NOT VALID WITHOUT DEPARTMENTAL SEAL AND A CURRENT CONSUMER AFFAIRS ID CARD Director This certifies that the bearer is duly licensed by the County of Suffolk SUFFOLK COUNTY EXECUTIVE'S OFFICE OF CONSUMER AFFAIRS HOME IMPROVEMENT CONTRACTOR LICENSE RON A GIBBONS RON GIBBONS SWIMMIMG POOLS INC DBA 8391-H 04/01/1983 ~,..^.o. ,~ 04/0112011