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Home My WebLink About36531-ZTown of Southold Annex 54375 Main Road Southold, New York 11971 2/9/2012 CERTIFICATE OF OCCUPANCY No: 35436 Date: 2/9/2012 THIS CERTIFIES that the building Location of Property: SCTM #: 473889 Subdivision: IN GROUND POOL 1255 Woo&lift Dr, Mattituck, Sec/Block/Lot: 107.-6-18 Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this officed dated 6/23/20 ! 1 pursuant to which Building Permit No. 36531 dated 6/30/2011 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 Hinden, Peri (OWNER) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL ELECTRICAL CERTIFICATE NO. PLUMBERS CERTIFICATION DATED 36531 2/3/12 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, NY BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES WITH ONE SET OF APPROVED PLANS AND SPECIFICATIONS UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) Permit #: 36531 Date: 6/30/2011 Permission is hereby granted to: Hinden, Peri 2883 Bay Dr Merrick, NY 11566 mo~ construct an In-ground swimming pool, fenced to code At premises located at: 1255 Woodcliff Dr, Mattituck SCTM # 473889 Sec/Block/Lot # 107.-6-18 Pursuant to application dated 6/23/2011 and approved by the Building Inspector. To expire on 1212912012. Fees: SWIMMiNG POOLS - IN-GROUND WITH FENCE ENCLOSURE $250.00 CO - SWIMMING POOL $50.00 To~l: $300.00 Building Inspector Town Hall Annex 54375 Main Road P.O. Box 1179 Southold, NY 11971-0959 Telephone (631) 765-1802 Fax (631) 765-9502 m.qer, richertC,,town.so uthold, ny. us BUILDING DEPARTMENT TOWN OF SOUTI-IOLD CERTIFICATE OF ELECTRICIAL COMPLIANCE SITE LOCATION Issued To: Randy & Perri Hinden Address: 1255 Wooddiff Dr City: Mattituck St: NY Zip: 11952 Building Permit #: 36531 Section: 107 Block: 6 Lot: 18 WAS EXAMINED AND FOUND TO BE IN COMPLIANCE WITH THE NATIONAL ELECTRIC CODE Contractor: DBA: Raymond Electrical Cont License No: 5141-me SITE DETAILS Office Use Only Residential ~ Indoor ~ Basement ~ Service Only ~ Corn merical Outdoor 1st Floor Pool New Renovation 2nd Floor Hot Tub Addition Survey Attic Garage INVENTORY Servicelph ~ Heat ~ DuplecRecpt ~ Service 3 ph Hot Water GFCI Recpt Main Panel A/C Condenser Single Recpt Sub Panel A/C Blower Range Recpt Transformer Appliances Dryer Recpt Disconnect Switches Twist Lock Other Equipment: Ceiling Fixtures ~ HID Fixtures Wall Fixtures I I Smoke Detectors Recessed Fixtures[~ CO Detectors Fluorescent Fixture ~ Pumps Emergency Fixture!.__~ Time Clocks Exit Fixtures [__~ TVSS swimming pool and patio lighting, pool bonding, l-pool pump, I pool light I control panel,2-GFCI circuit breakers, 5-patio lights Notes: Inspector Signature: Date: Feb 3 2012 81-Cert Electrical Compliance Form.xls 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 Healtb Dept. of water supply and sewerage-disposal (S-9 form). 3. Approval of'electrical iustallation from Board of Fire Underwriters. 4. Sworn statement from plumber certifying that tile solder used in system contains less tbao 2/10 of I% lead. 5. Commercial building, industrial building, multiple residences and similar buildings and installations, a certificate of Code Compliance from architect or engineer respousible 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: 1. Accurate survey of property showing all properly 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 [nspec}tgr shall state the reasons therefor in writing to the applicant. C. Fees I. Certificate of Occupancy - New dwelling $50.00, Additions to dwelliug $50.00, Alterations to dwelling $50.00, Swimming pool $50.00, Accessory building $50.00, Additions to accessory building $50.00, Businesses $50.00. 2. Certificate of Occupancy oil Pre-existing Building- $100.00 3. Copy of Certificate o£Occupancy- $.25 -' 4. Updated Certificate of Occupancy- $50.00 5. Temporary Certificate o£Occupancy Residential $15.00, Commercial $15.00 Date. New Construction: Locatiou of Property: House No. Owner or Owners of Property: Suffolk County Tax Map No 1000, Section SulJdivision Permit No. Health Dept. Approval: Old or Pre-existing Building: / Street Date of Permit. Filed Map. (check one) Ham let Applicam: Underwriters Approval: Planning Board Approval: Lot Lot: Request for: Temporary Certificate Fee Submitted: $ ~. Final Certificate: (check one) Applicant Signature TOWN OF SOUTHOLD BUILDING DEPT. 765-t 802 INSPECTION [ ] FOUNDATION 1ST [ ] ROUG~.BG. [ ] FOUNDATION 2ND [ ]~,~JJ. ATION [ ] FRAMING/STRAPPING [/~FINAL [ ] FIREPLACE & CHIMNEY [ ] FIRE SAFETY INSPECTION [ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRATION [ ) ELECTRI~L IROUGH) [ ) ELECTRICAL IFINAL) REMARKS..~/~/~--/~ C/-~O~.~ ~.,~_.~ ~ DATE INSPECTOR TOWN OF SOUTHOLD BUILDING DEPT. 765-1802 INSPECTION FOUNDATION 1ST [ ] ROUGH PLBG. FOUNDATION 2ND [ ] I~LATION FRAMING/STRAPPING [~] FINAL [ ] FIREPLACE & CHIMNEY [ ] FIRE SAFETY INSPECTION [ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRATION [ ] ELECTRICAL (ROUGH) [ ] ELECTRICAL (FINAL) REMARKS: DATE ~ INSPECTOR ~~, r~/~ BUILDING DEPARTMENT TOWN HALL SOUTHOLD, NY 11971 TEL: (631) 765-1802 FAX: (631) 765-9502 www. northfork.net/Southold/ Examined ~/~rO ,20 {[ Approved ;_~,/~?j/),l~ 20 [[ Disapproved a/c Expiration //?/0, 20 ].~-'-, PERMIT NO. 3~::~ 5J/ I Buiiding Inspector Do you have or need the following, before applying'? Board of Health 3 sets of Building Plans Planning Board approval Survey Check Septic Form N.Y.S.D.E.C. Trustees Contact: Phone: Swim King Pools 471 Route 25A Rocky Point, NY 11778 631-744-8100 ~pLICATION FOR BUILDING PERMIT INSTRUCTIONS ,20/_5_ 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" OCCUPANCY OR ENCLOSE POOL TO ~O~ ,ICl- IO I lkll ^U~lr'l I1 / ( 'g ~/ /~ p~icantorname~'-i{%corporation) UPONCO~PLSTION UOr- IO L/I'~L/'~V¥~t- / I.~'"-) , '~ ~' . ~ ,/') . . 'BEFORE WATER" ~^IITI-IPhl ITn RTIFICATE/' 1 "rsT?' ¥ ~ f/I IXd~/ '~.~1,. ~' (Mailing address of applicant)/') t- J State whether ap pl icant is ow~l ~29a~n ,~a~r c~i~ct, engineer, gener~c~,~e[~ plumber~or buff der Name of owner of premises 1 (As on the tax ~&~I~CTIONS: If applicant is a co¢oration, signature of duly authohzed officer ~. FOR ~URED CO~RETE (Nm~c and title of co~oratc officer) 2. R~H. F~. ~UM~Nfi, i]ders t Plumbers License No. 4. FINAL. CONSTRUCTION l ELECTRICAL aUST ~ C~ ~m CO. ~]ecthci~sUccnseNo. ~l~l ~?~!Cl[ mC~m~LL~E*~E REQUIRE~NT8 m ~E CODES OF NEW Other Trades ~icense ~o. ;NSP=CTICN ~QU!RED v~ ~. m,RES~NSIBLE FOR 1. Location ofl~d on whichoroposed wor~will be done: ~~S~TION [REORS. House N~ber Street Hainlet County Tax Map No. 1000 Subdivision ~ame) State existing use and occupancy of premises and intended use and occupancy of p~bpose4 construction: a. Existing use and occupancY .,_~4r3F/La,_ 4~J~A~. £,~,~t('~g.~ b. Intended use and occupancY ~ ~ ch::' ~ O V~="~l wl -~-'{"~ Nature of work (check which applicable): New Building Addition Alteration Repair Removal Demolition Other Work /[')~"=' I I (Description) Estimated Cost Fee (To be paid on filing this application) If dwelling, number of dwelling units Number of dwelling units on each floor If garage, number of cars If business, commercial or mixed occupancy, specify nature and extent of each type 0fuse. 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 Height Number of Stories Rear Depth Size of lot: Front Rear Depth I 0. 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 14. Names of owner o~fpremises~(}~ 1~41~)Addres~t~?~t~aO/'O~c~~ J~Pl~°ne N°'~ 1~ Name of Architec~/.~ ~.~ mr~5 -_--L,"~_ Address bo4-q Phone Name of Contractor~ mo I~..o'~q (2~,~ tX Address °r~ I ZF~2-~, Phone 15 a. Is this property within 100 feet of a tidal wetland or a freshwater wetland? *YES * IF YES, SOUTHOLD TOWN TRUSTEES &.D.E.C. PERMITS MAY BE REQUIRED. b. Is this property within 300 feet of a tidal wetland? * YES xq~NO * IF YES, D.E.C. PERMITS MAY BE REQUIRED. 16. Provide survey, to seat~,,,vith;gCF,t}~]fol~dation plan and distances to property lines. 17. If elevation at any poinLon propert.y..isat40 feet or below, must provide topographical data on survey. STATE OF NEW YORK) ,"-',i'.' :v~:~ i,~ ~'7-.,; SS: ~.,,:. . '~,z,. ~ 'd' ~:' COUNTY OF ) :,~ ~ ;: , * ;t;' · '~.~ being duly sworn, deposes and says that (s)he is the applicant (Name of i d~lvidual signing',tm~radty aBo,v, e;narfled, (S)He is the ~2:P ~(7,- ~7,,~,,~. ;, _k77: ,''7 ~ ; · .: (~6ntra~t0r; Agen~ Corporate Officer, etc.) of said owner or owners, and is:duly ~thofiz~t~l*e.r,f0rrn or have performed the said work and to make and file this application; that all statements contained in this applicati~n,a~l';tr~,to the best of his knowledge and belief; and that the work will be performed in the manner set forth in theapplicafi0rt~filed therewith. Town ~ Anm. v 54375 Main itoad P.O. B~ 1179 Sou~m~i, NY !1971-0959 Tdephom (631) 76~-180Z ro~er, rich~.~.nv, i ,.. BUILDING DEPARTMENT TOWN OF $OUTHO~Xt APPLICATION FOR _FLI=CTRICAL INSPECTION JOBSITE INFORMATION: (*Indicates required information) *Name: *Address: *Cross Street: ~l~one No.: Permit No.: Tax Map District: 1000 Sec~k~i,: / 0 -7 *BRIEF DESCRIPTION OF WORK (Please Print Clearly) (~ C~mk~ N~ That *Is job ready for inspection: *Do you r. ccda Temp Certificate: BIock:..,.~ ~ Lot: Rough In Final ~! NO YES/~ Temp.lnformation (If r.:=ded) * ~ Size: 1 Pha~e 3Phass 100 150 200 300 350 400 Other · New Service:. Re'c°nn~t Underground Number of Meters Change of 8en4ce Overhead Additional Information: PAYMENT DUE WITH APPLICATION Town Hall Annex 54375 Main Road P.O. Box 1179 Southold, NY 11971-0959 Telephone (631 ) 765-1802 Fax (631) 765-9502 January 27 2012 BUILDING DEPARTMENT TOWN OF SOUTHOLD Peri Hinden 2883 Bay Dr Merrick, NY 11566 Re: 1255 Woodcliff Dr., Mattituck 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: 36531 - In Ground Swimming Pool STATE Of NEW YORK WORKER'S COMPENSATION BOARD CERTIFICATE OF INSURANCE COVERAGE UNDER THE NYS DISABILITY BENEFITS LAW PART 1.To be completed by Disability Benefits Carrier or Licensed Insurance Agent of that Carrier 1 a. Legal Name and Address of Insured (Use street address only) RANDY T. RODECKER, INC. DBA SWIM KING POOLS 471 ROUTE 25A ROCKY POINT, NY 11778 lb. Business Telephone Number of Insured lc. NYS Unemployment Insurance Employer Registration Number of Insured 8561753 ld. Federal Employer Identification Number of Insured or Social Security Number 113092960 2. Name and Address of the Entity requesting Proof of Coverage 3a, Name of Insurance Carrier (Entity being listed as the Certificate Holder) Town of Southold 53095 Route 25 PO Box 1179 Southold NY 11971 The First Rehabilitation Life Insurance Company of America 3b. Policy Number of Entity listed in box "la": DBL37154 3c. Poi icy effective period: 02/01/2011 to 01/31/2012 4, Policy covers: a. [] All of the employer's employees eligible under the New York Disability Benefits Law b. [] Only the followingclassorclassesoftheemployer'semployees: Under penalty of perjury, I certify that I am an authorized representative or licensed agent of the insurance carrier referenced above and that the named insured has NYS Disability Benefits insurance coverage as described above. (Signature of insurance carrier's authorized representative or NYS Licensed Insurance Agent of that insurance carrier) Telephone Number 516-829-81 O0 Title. Chief Executive Officer IMPORTANT: If box "4a" is checked, and this form is signed by the insurance carrier's authorized representative or NYS Licensed Insurance Agent of that carrier, th is certificate is COMPLETE, Mail it directly to the certificate holder. If box "4b" is checked, this certificate is NOT COMPLETE for the purposes of Section 220, Subd. 8 of the Disability Benefits Law It must be mailed for completion to the Worker's Compensation Board, DB Plans Acceptance Unit, 20 Park Street, Albany, NY 12207. PART 2, To be completed by NYS Worker's Compensation Board (Only if box "4b" of Part 1 has been checked) State of New York Worker's Compensation Board According to information maintained by the NYS Worker's Compensation Board, the above-named employer has complied with the NYS Disability Benefits Law with respect to all of his/her employees. Date Signed By Telephone Number Title (Signature of NYS Worker's Compensation Board Employee) Please Note: Only insurance carriers licensed to write NYS Disability Benefits insurance policies and NYS Licensed Insurance Agents of those insurance carriers are authorized to issue Form DB-120,1, insurance brokers are NOT authorized to issue this form. DB-120.1 (5-06) PLAN 20 x 40 Rectangle WATER LINE ~ I~ ~' ~L ~, YORK STATE- 2010 AND THE ANSI/NSPI-5~)3 STANDARDS FOR RESIDENTIAL INGROUND SWIMMING POOLS FOR A TYPE II POOL. 2. STRUCTURE IS DESIGNED FOR USE BELOW GRADE AND ONLY IN AREAS WHERE THE GROUND WATER TABLE IS A MINIMUM OF 4'~" BELOW THE PROPOSED FINISHED GRADE. COPING AND WALK, NAY 3. BACKFILL WITH CLEAN EARTH, FREE OF ROOTS AND DEBRIS. DO NOT ALLOW THE HEIGHT (BY OTHERS) - ~ .- OF BACKFILL TO EXCEED THE HEIGHT OF THE WATER IN THE POOL BY MORE THAN e", OR THE . WATER TO EXCEED BACKFILL BY MORE THAN 8" SECTIONscALE: ,,." = ,'-0"AWATER L,.E ~ ~_~___¢L : GR~ .DECLEAN"' PLACE CONCRETE ON RA.DY TO LOAM SO,L.RACKF,L,. REMOVE ^~ CLAY DEPOS,T ANC COMPACT -- 5. WALKS TO BE SMOOTH, NON SKID TYPE, SLOPED AWAY FROM POOL. TOP OF WALL ~ ~ WATER LINE 6. WATER DISPOSAL SHALL BE LIMITED TO OWNERS PROPERTY IN ACCORDANCE WITH LOCAL REGULATIONS. Li 3500 PSI POURED CONC.- -- 7. PROPERTY OWNER IS RESPONSIBLE TO INSTALL PERMANENT FENCE AROUND POOL IN . [ 2" RETURN LINE ~ ~ V,NYL INER 2"T04 SAN 4' 12' 4' ACCORDANCE WITH THE NYS BUILDING CODE, APPENDIX G, SECTION AG105. PERMANENT ENCLOSURE MUST BE COMPLETED WITHIN NINETY DAYS AFTER THE DATE OF COMMENCEMENT OF CONSTRUCTION. 8. THERE IS NO MAIN DRAIN IN THIS POOL, SUCTION FOR POOL WATER CIRCULATION IS i PROVIDED BY THE SKIMMERS ONLY. THiS MEETS REQUIREMENTS OF RC- SECTION AGIO6 FOR ENTRAPMENT PROTECTION. 9. THIS POOL SHALL BE EQUIPPED WITH AN APPROVED POOL ALARM WHICH IS CLASSIFIED SECTION B BY UNDERWITERS LABORATORY, INC TO REFERENCE STANDARD ASTM 2208 ENTITLED ! "STANDARD SPECIFICATION FOR POOL ALARF~S," AS ADOPTEDIN 2008. SCALE: 1/8" = 1'~" 10. A TEMPORARY ENCLOSURE, OR 4 FT FENCE SHALL BE INSTALLED AND REMAIN IN PLACE THROUGHOUT THE PERIOD OF CONSTRUCTION OF THE SWIMMING POOL, OR UNTrL THE c~ COMPLETION OF A PERMANENT ENCLOSURE. WALL SECTION 6-12-11 t SURVEY OF PROPERTY SITUATE MATTITUCK TOWN OF $OUTHOLD SUFFOLK COUNTY, NEW YORK S.C. TAX No. 1000-1'07-06-18 SCALE 1"=20' MARCH 15, 2007 JULY 24, 2007 ADDFD PROPOSED ADDITIONS NOVEMBER 26, 2007 ADDED PROPOSED DOCK APRIL 8, 2005 ADDED SEPTIC SYSTEM ELEVATION APRIL 7, 2008 REVISED NOTES DECEMBER 10, 2008 FINAL SURVEY ON ADDITIONS AREA = I02,174 sq. ff. 2.346 ac. CERTIFIED TO: CONTINENTAL ABSTRACT Corp. TITLE No, 550475 FIRST AMERICAN TITLE INSURANCE COMPANY OF PERI HINDEN RANDALL HINDEN NEW YORK N 83'17'20" W TEST HOLE DATA ZONE AE (EL 11) ZONE X* 245.53' N 74.44,40,' ~lO ~ ' ~ ~oo~Oy~ ~°cIdrZo~, IzVC SEPTIC SYSTEM TIE DISTANCES COVER HOUSE CORNER"A" HOUSE CORNER"B" SEPTIC TANK 51.5' OUTLET COVER -"~' ,~--~l CESSPOOL COVER 1 65.5' 50' CESSPOOL COVER 2 69.5' 40' iI, 240.00, / N.Y.S, L~c No 50467 Nathan Taft Corw n III Land Surveyor PHONE (651)727-2090 Fox (631)727 1727 THE EXISTENCE OF RIGHT OF WAYS NOTES: 1. FLOOD ZONE INFORMATION TAKEN FROM: FLOOD INSURANCE RATE MAP No. 56105C0143 G ZONE AE. BASE FLOOD ELEVATIONS DETERMINED ZONE X*: AREAS OF 500-YEARI FLOOD; AREAS OF 100-YEAR FLOOD WITH AVERAGE DEPTH OF LESS THAN 1 FOOT OR WITH DRAINAGE AREAS LESS THAN 1 SQUARE MILE; AND, AREAS PROTECTED BY LEVEES FROM IO0-YEAR FLOOD. ZONE X: AREAS DETERMINED TO BE OUTSIDE 500-YEAR FLOODPLAIN, 27-060C