The URL can be used to link to this page

Home My WebLink About35652-ZTown of Southold Annex 54375 Main Road Southol~ New York 11971 CERTIFICATE OF OCCUPANCY 12/13/2011 No: 35340 Date: 12/13/2011 THIS CERTIFIES that the building IN GROUND POOL Location of Property: 305 OLE JULE LA MATTITUCK, SCTM #: 473889 Sec/Block/Lot: 114.-12-14.2 Subdivision: Filed Map No. conforms substantially to the Application for Building Permit heretofore 6/10/2010 pursuant to which Building Permit No. Lot No. filed in this ofliced dated 35652 dated 6/16/2010 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: in ground swimming pool with fence to code as applied for. The certificate is issued to Perkins, Richard & Perkins, Betsy (OWNER) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL ELECTRICAL CERTIFICATE NO. PLUMBERS CERTIFICATION DATED 9025 7/7/10 $i~a(ure/ FORM NO. 3 TOWN OF SOUTHOLD BUILDING DEPARTMENT Town Hall Southold, N.Y. BUII~)ING PEI~MIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) PERMIT NO. 35652 Z Date JUNE 16, 2010 Permission is hereby granted to: RICHARD & BETSY PERKINS 305 OLE JULE LA MATTITUCK,NY 11952 for : CONSTRUCTION OF A/q INGROUND SWIMMING POOL, FENCED TO CODE AS APPLIED FOR at premises located at 305 OLE JULE LA MATTITUCK County Tax Map No. 473889 Section 114 Block 0012 Lot No. 014.002 pursuant to appiication dated JUNE 10, 2010 and approved by the Building Inspector to expire on DECEMBER 16, 2011. Fee $ 250.00 Authorized Signature ORIGINAL Rev. 5/8/02 ~ ' ...... PLIC^TION FOR ~ERTIFIC~TE OF Form No. 6 TOWN OF' $OUTHOLD. BUILDING DEPARTMENT TOWN HALL 765-1802 occm' cY 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 accUratei°cati°n °f all buildings, ProPerty lines, streets' and unusual natural °r topograplfic featur6s. 2. Final Approval from Health D~pt. of water supply and sewerage-disposal (S-9 form). 3.. Approval of electrical installation from Board 6fFire Underwriters. 4. 'aw.om ~tatement from plumber certifying that the solder used in system contains less than 2/10 of 1% lead.. 5. Com-~miat 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 09mpleted 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. Certificaie of Occupancy - New dwelling $50.00, Additions to dwelling $50.00, Alterations to dwelling $50.0(1, Swimming pool $50.00, Accessory building $50.00, Additions to accessory building $50.00, Businesses $50.015. ~. Certificate of Occupancy on Pre-existing Building - $100.00 3. Copy of Certificate of. Occupancy - · 4. Updated Certificate of Occupancy - $50_00 5. Temporary Certificate of Occupancy - Residential $15.00, Commercial $15.00 New Construction: Location of Property: Owner or Owners o£ Property.: Suffolk ~y T~ Map No 1000, S~tion Su~sion Pl~n~ Bca~ ~pmval: R~a for: T~ Certificate Old or Pre-existing Building: br", Honse; No. Street (check one) ¢/',, T-r m,'.c Hamlet Block ' i' / Fried Map. Dat¢ofPcrmit. (¢~¢//~. //OApplicant:. Undetwtiters Approval: Final Certificate: (check one) Nassau Suffolk Electrical Inspections,Inc. P.O. Box 549, Aquebogue, New York + 11931 Tel: 631-591-3097 Fax: 631-591-3098 Application: Isstted to: Address: ~, illage: 9025 Date: 7/7/10 Perkins 305 Old Jule Lane Introduced By: Bethel Electric Mattituck License#: 2880-ME Residential [] Commercial The following was examined and approved up to the above date and found to be in compliance with the NEC: Sxx itches Receptacle Fixtures G.F[. Salt Generator l'ime Clock t in/hod hlsp IJ Final hlsp Meter Amps Phase Motors II 7/7/10 I In Ground Pool Permit#: 114 Block: 12 Lot: This certificate must not be altered in any manner 14.6 TOWN OF SOUTHOLD BUILDING DEPT. 765-1802 INSPECTION I ] FOUNDATION 1ST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] IN.~L~TIoN [ ] FRAMING/STRAPPING [~]'I~INAL I ] FIREPLACE & CHIMNEY [ ] FIRE SAFETY INSPECTION [ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRATION [ ] ELECTRICAL (ROUGH) [ ] ELECTRICAL (FINAL) 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 ~/J~O, 20/0 Approved ~/I ~, 20/9 Disapproved a/c Exp2afion /7.//6,20 // 2010 BLDG. DEPT. TOWN OF SOUTHOLI) 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: Building Inspector Phone: PLICATION FOR BUILDING PERMIT Date INSTRUCTIONS b - a',20/0 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. Pict 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 Pemfit 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 Luspecter 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, an~d regulations, and to admit authorized inspectors on premises and in building for necessary inspections. OCCUPANCY OR ALL CONSTRUCTION SHALL ///.¢ h.: lenM,AWFUL ....... e'r^'v=(S,gnat eofapp'-ffcantorname,,facorporation) ,/',.)L. I0 Ul~ll.=F"t U, UL/~-~ UI' I~t'¥¥ lk./ iA /" 'F~ ~ O (Mailing address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contr~]~~er or builder ENCLOSE POOl,TO CODE /~t~p/../ F_.ICtx,~ /.S T-f"[ ~'- ~oO C ,~ 0,1/...,0£,/~.. UPONCOMPLETION Xameofownerofpremises -e Be% Perkins (As on the tax roll or latest deedt Pi~'A if apl~cant is a comor~iion, signature of duly authorized officer~// _/' ROVED AS NOTED /(/ohsrd' 6'h /6 poboma r V~'~ DATE (~CA BP#~ (Name and title of corporate officer) ~ ' ' Builders License No. Plumbers License No. Electricians License No. Other Trade's License No. Location of land on which proposed work will be done: 305 Oh4. Toot¢ House Number Street County Tax Map No. 1000 Section Subdivision I/~IA 0 (Name) BE COMPLETE FOR C.O. ALL CONSTRUCTION ~I~I.L ~ THE Block___[ 2~ REQUIREMEt~(~$ OF ~'h~GO~-.S OF NEW .. ~ NOT..~IES PO NSIR~J:I.OR Filed tvtap No. · ,t:__ -,~ ~ State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Exisfing use and occupancy [ }~[~mlg~ b. Intended use and occupancy ~B1, ( 3. Nature of work (check which applicable): New Building Repair Removal Demolition 4. Estimated Cost ~q~ 00~) 5. If dwelling, number of dwelling units ~ / ~r If garage, number of cars Fee Addition Alteration Other Work ~l,Olffi~'Hl)6 ~)O01-,~ (Description) (To be paid on filing this application) Number of dwelling units on each floor If business, commercial or mixed occupancy, specify nature and extent of each type of use. Dimensions of ¢~isting structures, if any: Front Rear Height~/~r' Number of Stories Dimensions of r:~ame structure with alterations or additions: Front Depth~}~r Height 8. Dimensions [0]~ Number o~Stories of entire new construction: Front Height 9. Size oflot: Front lq0t Rear tqo' Number of Stories Rear ~ Depth Rear Depth Depth 10. Date of Purchase Name of Former Owner 11. Zone or use district in which premises are situated q O 12. Does proposed construction violate any zoning law, ordinance or regulation? YES__ NO 13. Will lot be re-graded? YES __ NO v'~Vill excess fill be removed from premises? YES ~'"NO__ 14. Names of Owner of premises ~lt~4~B De~g.t~SAddress ~ OCO ~t.fl '"'Phone No. Name of Arckitect Address Phone No Name of Contractor ~V-P~0 S~4~ Address 7~'/I 5~q~lkamx ~ Phone No. 15 a. Is this property within 100 feet ora 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. 2.q 8-:5'i60 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. (Name of individual signing contract) above named, He is the being duly sworn, deposes and says that ~is the applicant ......... ~. h (Contractor, Agent, Corporate Officer, etc.) of said owne~.~aar~s;.'~ad4 .c,?d ,u~?uthor/zed to perform or have performed the said work and to make and file this application; that all st~eQll/'/~sr~iffnt~e~i)~n~hi? .~l~cat/-6n are tree to the best of his knowledge and belief; and that the work will be performC4~lt~ul~'~'~[, }~!~1 .~a, ~:~i~}~.lSi~'~ation filed therewith. Signature of Applicant Town Hall Annex 54375 Main Road P.O. Box 1179 Southold, NY 11971-0959 Telephone (631) 765-1802 Fax (631) 765-9502 BUILDING DEPARTMENT TOWN OF SOUTHOLD October 11, 2011 Richard & Betsy Perkins 305 Ole Jule Lane Mattituck, NY 11952 TO WHOM IT MAY CONCERN: The Following Item(s) Are Needed To Complete Your Certificate of Occupancy: __ Application for Certificate of Occupancy. (Enclosed) ~Electrical Underwriters Certificate. ~(~/' A fee of $50.00. Final Health Department Approval. Plumbers Solder Certificate. (All permits involving plumbing after 4/1/84) __ Trustees Certificate of Compliance. (Town Trustees #765-1892) __ Final Planning Board Approval. __ Final Fire Inspection from Fire Marshall. - Bob Fisher __ Final Landmark Preservation approval. BUILDING PERMIT: 35652 - In Ground Swimming Pool CORPORATE AND SALES OFFICE 271 Smithtown Blvd. · Nesconset, NY 11767 RETAIL STORE_ 127-17 Smith, t0w~n l~lvd. · Nesconset, NY 11767 f In. Legal Name & Address of Insured (Use street address only} Swim Clean Pool Services Inc. 271 Smithtown Blvd. Nesconset, NY 11767 STATE OF NEW YORK WORKERS' COMPENSATION BOARD CERTIFICATE OF NY$ WORKERS' COMPENSATION INSURANCE COVERAGE lb. Business Telephone Humber of Insured 631-737-9600 ' lc. lOftS Unemployment Insurance l~.mpinyer Registration Number of Insured Work Locution of Insured (Onlyrequtted lindted to certain locations in Ntnv York State, L~, a Wrap. Up Policy) 2, Name and Address of the Entity Requesting Proof of Coverage (Entity Being Listed ns the Certificate Holder} Town of Sou~hold Main Road Southold, NY 11971 ld. Federnl Employer Identification Number of Insured or Social Security Number 112788598 3n. Name of Insurance Carrier Hartford Insurance Company 3b. Policy Number of entity listed In box "la" 12WECLR4709 3c. Policy effective period 11/1/~nnq to 11/1/201(3 3& The Proprietor, Partners or Executive Officers are [] included. (Onlycheckbozifallpartner~omce~sJndu~ed) [] nH exduded or certain partners/officers excluded. 'l'~is certifies that tho immence canter indicated above in box "3" insures the business referenced above in box "la" for workers' compcnsetlon undcr thc New York State Workers' CompensafionLaw. (To use this fo tm, New York (NY) must be listed under Item 3A o u the INFOKMATIONPAGE o f the we rkers' cumpensntten insn rencu pollcy). The Insurance Cnn'l~ or it~ licen.~ed a~cnt will scud this Certificate ot'Irmmmcn to thc entity listed abovo as thc cmlLficate holder in box"2". The Insurance Carrier wtll also notiff~ the abo~ certificate homer within l 0 days IF a policy is canceled due to nonpayment of pronittm~ or ]~ithln 30 day~ IF there are rea~om other than nonpayment of ~remlurf~ that cancel the policy or eliminata the inrur~d fram th~ cowra~ indicated on this Certificate. fflte$e notices may he sent by r~ntlar mail..) Othern~o, thts CetfIflcttte ts ~alidfor onepear ~fler ts apprm,cd by the Insurance carrier or tt~ licensed agent, or until thc pollcy ex~lralion dat~ lhtod in box ~$e ", ~l,ldohemr ts enrli~. Pleaae Hole: Upon tho cuncuIlatinn of tho wa rkers' compensation polity indicated on this form, if lhe bnsineaa continues to be named on a permit, license or contract issued by a certificate holder, the business must provide that certificate holder with n new Certificate of Workers' Compenaaflon Coverag~ or other authorized proof fhat the business Is complying with the mandote~ coverage requirements of tho New York State Workers' Compensation Law. Under penalty of perjury, I certify that I am an authorized representeflve or lirenled agent of the insucuocu carrier reteroucod above end that the named insured has the coverage es depicted on tltb form. Approved by: ~Clt'[' Treiber ~/(SiSaatu~) '(Dhc) Title: Area President Telepbono Number of author[zed represmtatlve or licensed agent ofi~uamcu aa'tier: ~l~c lVot~: Only in. mrance cnn'Jars and their licensed oxents ~ u~t~oriz~d to issue Fon~ C-~05,~. Insurance ~ral~rs ~ NOF ourhadz~d to i~¢ it, C-I05.2 (9-07) www.w~b.sta~.~y.u~ Town of Southold Erosion, Sedimentation & Storm-Water Run-off ASSESSMENT FORM PROPERTY LOCATION: S.C.T.M, S: THE FOLLOWING ACTIONS MAY REQUIRE THE SUBMISSION OF A Di~lct SecUoh BlOCk Lot C~'KTifiI:~ BY A RESIGN PROFESSIONAL IN THE STATE OF NEW YORK. SCOPEOFWORK - PROPOSED CONSTRUCTION ITEM# / WORKASSESSMENT [ Yes No a. What is the Total Ama of the Project Parcels? (Include Total Area of all Parcels located within ~ Will this Project Retain AIl Ston~-Water Run-Oil the Scope of Work for Proposed Construction) Genera ed by a Two (2') Inch Rainfall on Site? b. What is the Totel Ama of Land Cleadng (S.F, I At. si (This item will include all run-off created by site vl_l cleadng and/or construction activities as well as all and/or Ground Disturbance for the pmpceed ~(~ ~ ~ Site Improvements and the permanent creation of construction activity? impervious surfaces.) (s.F.l~,,) 2 Does the Site Plan and/or Survey Show Ail pmpesed PROVIDE BRIEF PROJECT DF~CEIlq3ON (P.~d, ~,~ ~. ~ Drainage SthJctums Indicating Size & Location? This Item shall include all Proposed Grade Changes and -I-I /J0S~'-~{~.J~ ~(..~X: L/O /(/- ~'~U iUI~ Slopes Controlling Surface Water Flow. V*I ~(~ ~ P(~) ~"] 3 D°es the Stte Plan and/°r Survey describe tho er°si°n and sediment control practices that will be used to control site erosion and storm water discharges. This IA.J/ I~'~ Y)CP '-iLO CO~:~ item must be maintained throughout the Entire / Construction Peded. 4 Will this Project Require any Land Filling, Grading or Excavation where there is a change to the Natural r'~ v Existing Grade Involving mom than 200 Cubic Yards~ __ of Material within any Parcel? S Will this ApPlication Require Land Disturbing Activities r'~ Encompassing an Area in Excess of Five Thousand (5,000 S.F.) Square Feet of Ground Surface?L=~J -- 6 Is there a Natural Water Course Running through the Site? Is this Project within the Trustees jurisdiction General DEC SWppP Requirements: or within One Hundred (100') feet of a Wetland or~ -- Sut~misslon of a SWPPP is required for all Construction activities involving soi~ Beach? disturbances of one (1) or more acres; including disturbances of less than one acre that 7 Will there be Site preparation on Existing Grade Slopes are part of a larger common pbln that win ultimathly disturb one or more ac~es of lend; which Exceed Fifteen (t 5) feet of Vertical Rise to r~ including Construction activities invctving soil disturbances of 16ss than one (1) acre where One Hundred (100') of Horizontal Distance?I~1 -- 2. T~e SWPPP shall de$c~be the erosion and sediment control prac6css end where 9 Will this Project Require the Placement of Material, STATE OF NEW YORK, ~ ' N0tary CONNl£Public ~ateD' BUNCH cou n ............ ss And that he/sbe is the ............................................ ('~;.'~;~aa;~a~'~;/~a'~ ~;,'~'t~;i ................................................................ Owner and/or representative of the Owner or Owners, and is duly authorized to perform or have performed the said work and to make and file this application; that aB statemenLs conlained in this application are true to the best of his knowledse and belief; and that the work will be performed in the manner set forth in the application filed herewith. Sworn to before me this; ............ 1...~....~ ............. day of..~'!......~(,J~ .................... ~0/...~~...~.~..~ ~ ~ o ?ubl c: ...... ........................ ....... FORM - 061t0 NEW SUFFOLK AVE. S 82' ~7; 20"E STAK~ LOT I RES. 74. 9' GARAGE SUR VE Y OF LOT 2 MAP OF HENRY APPEL MA TTITUCK, TOWN OF SOUTHOLD SUFFOLK COUNTY, N.Y. SURVEYED FOR RICHARD PERKINS BETSY A. PERKINS 225.00' SURVEYED $0 DEC., 1999 SCALE ZONED ELEVA DONS ARE IN ASUMED DATUM "OPEN SPACE" VACANT LAND 82' 27' 20"W LOT 3 22400' RETAIN STORM WATER RUNOFF PURSUANT TO CHAPTER 236 OF THE TOWN CODE. GUARANTEED TO RICHARD PERKINS BETSY A. PERKINS SLIRVEYED BY STANLEY ~) ISAR$'EN, JR. P.O. 80~/294 NEW SO~-OL.~_NY 6Jl~ L~NSED ~AND ~YS LIC 99C860 PLAN VIE~/' OIT. POOL L.,I_ RIM LOCI( COPING Perkins 305 Old -'