HomeMy WebLinkAbout37429-ZTown of Southold Annex
P.O. Box 1179
54375 Main Road
Southold, New York 11971
6/3/2013
CERTIFICATE OF OCCUPANCY
No: 36277
Date: 6/3/2013
THIS CERTIFIES that the building
Location of Property:
SCTM #: 473889
Subdivision:
IN GROUND POOL
450 Brigantine Dr, Southold,
Sec/Block/Lot: 79.-4-42
Filed Map No.
conforms substantially to the Application for Building Permit heretofore
7/27/2012 pursuant to which Building Permit No.
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 ~-ound swimming pool fenced to code as applied for.
Lot No.
filed in this officed dated
37429 dated 8/7/2012
The certificate is issued to
McKenna, John & McKenna, Ethel
(OWNER)
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL
ELECTRICAL CERTIFICATE NO.
PLUMBERS CERTIFICATION DATED
37429 10/15/12
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 #: 37429
Date: 8/7/2012
Permission is hereby granted to:
McKenna, John & McKenna, Ethel
450 Brigantine Dr
Southold, NY 11971
To:
construct an In-Ground Swimming Pool, fenced to code as applied for
At premises located at:
450 Brigantine Dr, Southold
SCTM # 473889
Sec/Block/Lot # 79.-4-42
Pursuant to application dated
To expire on 2/6/2014.
Fees:
7/27/2012 and approved by the Building Inspector.
SWIMMING POOLS - IN-GROUND WITH FENCE ENCLOSURE
CO - SWIMMING POOL
Total:
$250.00
$50.00
$300.00
Building Inspector
Form No. 6
TOWN OF $OU~UOLD
BUILDING DEPARTMEN'F
TOWN HALL
765-1802
APPLICATION FOR CERTIFICATE OF OCCUPANCY
This applieati0n 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 °f pr°perry 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 0f Fire Underwriters.
4. Sworn statement from plumber certifying that the solder used in system contains less than 2/I 0 of 1% lead.
5. Commercial building, industrial building, multiple residenoes and similar buildings and installations, a certificate
of Code Compliaace 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:
1. Accurate survey °f pr°perrY showing all property lines, streets, building and unnsual 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. Certi~cate ~f ~ccupa~cy - New dwe~~ing $5~.~~~ Additi~ns t~ dwe~~ing $5~.~~~ A~terati~ns t~ dwe~~ing $5~.~0'
Swimming PO01 $50.00, AccesSOry building $50.00, Additions to accessory building $50.00, Businesses $50.00;
2. Ceytificate of Occupancy on Pre-existing Building - $t00.00
3. Copy of Certificate of Occupancy - $.25
4. Updated Certificate of Occupancy- $50.00
· 5. Temporary Certificate of Occupancy - R6sidential $15.00, Commercial $15.00
New Construction:
Old or Pre-existing Building:
Location of Property: J~'~ & [ t~/'[-~ ~
House No. Street
' Owner or Owners of Property: '~]~/~ ~C ~/~[
. Su o k Cowry Tax Map No ,000, s ,io
P~tNo. ~']~ ~Q DateofPemit. g~ ~ I~
Health Dept. Approval:
Planning Board Approval:
Request for: Temporary Certificate
Foe Submitted: $ ~'0, ~"~v/
Date. 7-tq-t2
(check one)
Hamlet
Filed Map.. 2] ~[a2 Lot:
Applicant:
Underwriters Approval:
Final Certificate: t~ (check one)
~plicmlt Signature
Town Hall Annex
54375 Main Road
P.O. Box 1179
Southold, NY 119714)959
Telephone (631 ) 765-1802
Fax (63 l) 765-9502
roqer, dchort~town southo d nv us
BUILDING DEPARTMENT
TOWN O1* SOUTI-IOLD
CERTIFICATE OF ELECTRICIAL COMPLIANCE
SITE LOCATION
ssued To: John McKenna
~,ddress: 450 Brigantine Dr City: Southold St: NY Zip: 11971
3uilding Permit #: 37429 Section: 79 Block: 4 Lot: 42
WAS EXAMINED AND FOUND TO BE IN COMPLIANCE WITH THE NATIONAL ELECTRIC CODE
3ontractor: DBA: Goodale Electrical Cont. License No: 783-e
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
Service 3 ph Hot Water GFCl Recpt
Main Panel NC Condenser Single Recpt
Sub Panel NC Blower Range Recpt
Transformer Appliances Dryer Recpt
Disconnect Switches Twist Lock
Other Equipment:
Ceiling Fixtures ~r~lJ~ HID Fixtures
Wall Fixtures I I Smoke Detectors
Recessed Fixturesl I CO Detectors
Fluorescent Fixture Pumps
Emergency Fixture Time Clocks
Exit Fixtures TVSS
in ground swimming pool to include, bonding, 1-GFCI circuit breaker, 1-pool light
Notes:
Date: Oct 15 2012
81-Ced Electrical Compliance Form.xls
TOWN OF SOUTHOLD BUILDING DEPT.
765- t 802
INSPECTION
FOUNDATION 1ST [ ] ROUGH PLBG.
[ ] INSULATION
[ ] FINAL
[ ] FIRE SAFETY iNSPECTION
[ ] FOUNDATION 2ND
[ ] FRAMING / STRAPPING
[ ] FIREPLACE & CHIMNEY
[ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRATION
[ ] ELECTRICAL (ROUGH) [ ] ELECTRICAL (FINAL)
REMAR~,~,. ~-~--~(~'~ ~
DATE ~ INSPECTOR
:~ TOWN OF SO ILDING DEPT.
765-1802
INSPECTION
FOUNDATION 1ST [ ] ROUGH PLBG.
FOUNDATION 2ND [ ] INSULATION
FRAMING/STRAPPING [ ] FINAL
[ ] FIREPLACE & CHIMNEY [ ] FIRE SAFETY INSPECTION
[ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRATION
[ ] ELECTRICAL (ROUGH) /~LECTRICAL (FINAL)
REMARKS:
DATE ~ ~ INSPECTOR~
TOWN OF SOUTHOLD BUILDING DEPT.
765-1802
INSPECTION
[ ] FOUNDATION 1ST [ ] ROU~PLBG.
[ ] FOUNOATION2ND [ ]//INSULATION
[ ] FRAMING / STRAPPING [I/~J FINAL
[ ] FIREPLACE & CHIMNEY [ ] FIRE SAFETY INSPECTION
[ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRATION
[ ] ELECTRICAL (ROUGH) [ ] ELECTRICAL (FINAL)
REMARKS: ~C./~ /~ C,cr"Y~
DATE
TOWN OF SOUTHOLD BUILDING DEPT.
765-1802
INSPECTION
[ ] FOUNDATION 1ST
[ ] FOUNDATION 2ND
[ ] FRAMING/STRAPPING
[ ] FIREPLACE & CHIMNEY
[ ] ROUGH PLBG.
[/~INAL
[ ] FIRE SAFETY INSPECTION
[
[ ] ELECTRICAL (ROUGH)
] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRATION
[ ] ELECTRICAL (FINAL)
R EMAR KS: ~(~_o ~_~ ("~'~
INSPECTOR
DATE
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN HALL
SOUTHOLD, NY 11971
TEL: 765-1802
Examined
Approved 20 I
Disapproved a/c
JUL 2 7 2012
¢['DG DF_PI.
PERMIT NO.
BUILDING PERMIT APPLICATION CHECKLIST
Do you have or need the following, before applying ?
Board of Health
3 sets of Building Plans
Check
Septic Fornrt
N.Y.S.D.E.C.
Trustees
Contact:
Mail to:
Phone:
Building Inspector
PPLICATION FOR BUILDING PERMIT
Date
INSTRUCTIONS
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 issaance of Building Permit.
d. Upon approval of this application, the Building Inspector will issue a Building Pe,,nit to the applicant. Such a pemxit
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 a Certificate of Occupancy
is issued by the Building Inspector.
APPLICATION IS HEREBY MADE to the Building Department for tile issuance of a Building Permit pursuant to the
Building Zone Ordinance of the Town of Southold, Suffolk County, New York, 9nd 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, a~ regulations, and tO admit
authofizedinspectors on premises and in building fornecessaryfspections.. :" :~., ,,I //m~f/~ra
"lMI011:l~lA?l=/¥" , , ,: (Signa tion)
ENCLOSE POOL TO CODE ',, . O. ,I L-; ~ ,'1 .....
U.ONCOU.L.T ON 9,/iTHOUTCEi::
BEFORE "WATER" (Mailing address of applicant)
,' ;: !3CCI. IPAb:'i
State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder
(as on the tax roll or latest d~ed),,lff
NOTIFY BUILD NG DE'PARTMENT AT
If applicant is a corporation, signature of duly authorized officer 755-1802 8 AM TO 4 PM FOR THE
FOLLOWING INSPECTIONS:
(Name and title of corporate officer) 1. FOUNDATION ~ TVVO REQUIRED
FOR POURED CONCRETE
Builders License No. ,/--/1~(,~ 2, ROUGH. FR/~IING, PLUMBING,
STRAPPING, ELECTRICAL & CAULKING
3. INSULATION
Plumbers License No. 4, FINAL - CONSTRUCTION & ELECTRICAL
Elect,ci s Liee;,se
MUST BE COMPLETE FOR C.C.
Other Trade's License No. REQUIREMENTS OF THE CODES O¢ NEw
¥ORt(STATE NOT RESPONSIBLE FOR
1, Locationoflandonwh, j,chproposcdworkwillbedonc: ~t,q,)37fl~ ' ' ~'~"~ '~ "~¢~"~ AM
House Number Street Hamlet
Coun Ta× a No.;000 Section Vq Bloc ,
Subd ision,
(Nme) ~ INSPECTION REQUIRED PURSUANT TO CHAPTER 236
OF THE TOWN CODE.
' 2. State existing use and occupancy of premises and~tended use and occupancy of proposed censtmction:
a. Existing use and occupancy .Rt%a~J¢0
b. Intended useand occupancy ' ~Sl~,l-p~ ~}Oq~IM'~
3. Nature of work (check which applicable): New Building. Addition
Repair Removal Demolition Other Work
Estimated Cost
If dwelling, number of dwelling units
If garage, number of cars
Fee
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
Rear
Depth. Height.
8. Dimensions of entire new construction: .Front
Height Number of Stories
9. Size of lot: Front 1190' Rear
Number of Stories
Rem'
Depth 2.0C3 ~
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: )~)
13. Will lot be re-graded ~ >~ ~L.~ Will excess fill be removed from premises:(~ NO
14. NamesofOwn~o~p[~ises~ W~M Address ~o PhoneNo. 70~
Nme ofMchitect ~o~ h ee~l~ ~' Address ~ ~t ~ ~hone No VZ¢-7 ?P
N~e ofContractor~ ~m. . .... ~ Address ~~~ ~~ Phone No.
15. Is tNs prop~y wi~in 100 feet of a tidal wetl~d. YES NO ~ ,~
· IF YES, SOUTHOLD TO~ TRUSTEES PERMITS MAY BE R~UIRED ~: '~'
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 )
~7J15~ '~ ~,0}~O~' being duly sworn, deposes and says that (s)be is the applicant
(Name of individual signing contract) above named,
(S)He is t~e '
. :t54~'& (Contractor, Agent, Corporate Officer, etc.)
of said owner o. powners, 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 f6rth ih tl~e application filed therewith.
;.¢: .: '
· Sworn to befgl;e ~dtl~s~ ' . ,~, .
' ~ .... ; , . I, , ,. ,
· ;):' 7: ,; 4'' ' .
KIDNEY
No. 01KI~211ll
~IH~ in S~olk CounW
I own of Southold - Chapter 236 - Stormwater Management
SWPPp. Storm Water Pollution Prevention Plan Assessment Form
GENERAL INEO~ON: (All Requested Information is Requ/red for a
Will this Project Disturbe five ($) or More Acres'at
Any One Time During the Proposed Development ?
a. DoestheAPPlicanthaveaOualifiedlnspectcrt~n
' S~ff To COndUct the F~quited Inspections ?
b. Does tJ~ ~WPPPindi~ale How FrequenUy ~he Site
thspeclfons w~ Occ~ and for What Pedod ~ Time ?
c. Does.me
Yes No
Ye~ No
Yes No
Yes No
~tatcments con.ned in ~ perform~ ~v6r'~ ~d
ofl~ ~o,:/''~ ~;.~
the manner set forth in thc a d
No. 01'KI602 iI I1
Thomas D. Reilly P.E.
Consulting Engineer
'For evePj hoL~e is buiE by someone, but the buiider of all things is God" Hebrews 3:4
4 Bezel Lane Smlthtown, N.Y. 11787
Tel: (~1) 724.78~
Fax: (631) 724-5740
ENGINEERING DEPARTMENT
TOWN OF SOUTOLD
53095 MAIN ROAD
P.O. BOX 1179
SOUTOLD, NY 11971
JULY 19, 2012
TO WHOM IT MAY CONCERN,
RE:
JOHN MCKENNA
450 BRIGANTINE DRIVE
SOUTHOLD, NY 11971
THIS IS TO CERTIFY THAT THE DESIGNED CONSTRUCTION OF A SWIMMING
POOL ON THE SUBJECT PREMISES WILL NOT REQUIRE SPECIAL DRAINAGE
FACILITIES.
THE POOL IS CONSTRUCTED WITH A VINYL LINER AND THE POOL WATER IS
DESIGNED TO BE CONTINUOUSLY RECIRCULATED THROUGH THE FILTER AND
REUSED FROM YE. AR TO YEAR. THE DRAINAGE FROM THE FILTER
BACKWASH IS NOMINAL AND WILL NOT INTERFERE WITH THE PUBLIC WATER
SUPPLY, THE EXISTING SANITARY FACILITIES, NEIGHBORING PROPERTY, OR
PUBLIC HIGHWAYS.
VERY TRULY YOURS,
~HHOMAS D. REILLY, P.E.
T.O'.S. "$Wppp,, Preparation . Chapter236
Storm Water Pollution Prevention Plan
Review Checklist Checklist # I ~ooo .~-~
I YE~ ~ NO, N.A.~ ~taa, n for NO or N.N.N.N.N.N.N.N.N.~
. ~f._P_r~e~ 1~ ~.d~ ~.. ........................... --
_B9 .u n_d~ CZ
Table;
~ZZZTZ:ZZZZZZZZZZZ~ZZZZZZZZZZZ~ZZ~Z~
Locatlor
~T~ ~~. - .....................
;_jI J __
r BMP.
~he State of New Fo-r k- ~'n-dTo~ ~1'~1 -t h-a~ ~n~ ~ ~ ~ ....... ~ , , ~ .....................
p,.~,~,. ,r'm,r-m,r-m, 7~'/..:-..',.. .... ;~ ..... -- .........
~. OEO u~N~PPP"' Pr~.~atlo.. Ch~pter~36.~9 ForDopartmentU.aOnl~'
Sto~ Water Pollution Prevention Plan
~ Renew Chec~lst Checklist ~ 2
(~ ~e ~PP ~ ~e ~t ~or nd~ ~e Following. ' ~ '~ ~ ~a~on ~r NO or N~. Mu~ be ~d by 5MO Plan S~eet
1. Oo~ ~e P~n ,,~g.~e .,~v~ ~ all i~ R~ ~ ~11., ~ 1. in ~ls Pa~et? i~1~,~ , Location (pg. ~)
2. Do~ePlan~orSh~a~p~p~on~to~waer ~~ .................................
3. ~e~ ~ ~~0n Dm~ng($) I~1~ ~Sh~ ~e Loca~on &Stze of , m
E~ ~~ ~ ~t~? ,I hi,
'~. -~?~ ~-~- 7~-~- 5~,~a' -"~ ~' ---"-~ ~ ~;~.igi ~;~i~ ~,~ ;~ ~ ~ ~ ~ ........................................
5, Do~ ~on Dm~g(s) I~or ~de a Comp~f~t;" -'[ ~ ~ ~ ...............................................
. Do" ~ ~l~ ~on~ii/~0Y ~i~ ~F~l~T~ir~i iii&~i f ' ' q ,, }~ .........................................
7. De~Slm~%%~a~i~-~&~aSEgy ...... j ~ ~ ~ ...... = ................................
he O~*) ~ E~um ~nan~us & E~ ~on of ~ Post-Cons~u~on '~ td I~l
8. Doe~ ~e ~ P~ Dm~g(=) Ind~ ~or S~ Ma~' ~ ~0 '" -~ ~ ~ _~ ..........................................
EP~ ~ ~'~ ~er Mana~ment Pm~s at ~e S~e for ~ Pu~ose of Inspection
and Re~ ?
.....................................
g.. Does ~e S~ Pl~_~n Dm~(~) Ind~ an~?g~-I~' ~[~fi~$ -
-1'~: '~ ~ ~ ~-~-~-~ ~- ~ f~)[f~ ~ ~i~g~ri~;~'g ~ ~;~' q : [ ~ ...........................................
By a ~ ~ ~ ~ e~ P~ of.~ ~gement & Treatment Who , ~, ~
~ F. - ~ ~;-~ ~ ~..~' ~rP~.- - ~-~ ~-~TA~A~a ~T - - } ~ ~ ................. = .......... ~ ...............
ti I,~ .......
12. DO~ ~ PI~ ~ ~ Sup~g ~ De~i~ of ~pmval ~ R~ard I ~ ~ ~ s ~ ........................
-- to ~ P~.~ ~1~ R~u~ ~t ~d~ F~Io~ ~1 P~tl ~
a. I~Mon Mot ~ s~ ~ ~ ~ de~m~t a~vi~es woui~ haw ~ [ ~ ~t ...........
an e~ on a ~ ~ Is fl~ or eligible ~r ~ng 0r ~lg~la ~r lls~ng on ~e ~',l 1~[ ~J~ .
...... ~[}[~~_~_~ ....... = ...................... ~ : . :~ .
_ _ _ P= _~_~_~ ~.~%~[~_~j b~[~ ~c:[d~ _ _ ~ ~, ~, ~ r ........................................... : .........
C. O~M~N~AvoidorMi~eme mpac~onPacesL~ed. ~ ~ ~ ........ ~ ............................................
d. ~ ~ ~e ~ May O~ r, :~-~q~ ~1~ ~?~ ~ - - , ~--~ ................................................
of ~, ~ ~d Hl~c PI~ (OP~P} or o~ ~vemmentaJ Agency to ~ ~ ~
MI~ ~ ~. ~
~ - ~-~ ~r~; ~;~4i~ir~ ~i4 T~r~ ~ ~ ~~,~ io, ~ ........... ~, ~,i, ,;~'"~ ...................................... , .......
14. Iden~n of ~y ~ of ~e D~gn ~nt am not Jn Co~ahce with the ......... ~ . ~ ~ ~ ............................................
Design ~ual, I~.d~ng Rmons f~ ~e De~n ~ ~ma~e O~lgn and a Des~ption ii ~[ ~,
.... ~[~.~.~_~ ~.. , ,
~5. ~ H~g~c ~d ~c ~i~t-~ai&~ ~g~g&ai~? r.i ............... ~',~ ..................... - .......................
6. A ~ 'SU~ ~ ~ o~e S~g ~ ~t m Used to Design ,__ ,__, ~, .................................
NIP ' Pmk. H IJ~
.......... .... ~~ ............................... ~ ~ ..........................
, ,, ..............................
P~ ~~~ · t , , , .
Town Hall
54375 ~ Road
P.O. Box 117~
Souli~old, ~ 11971-0959
Tdephone (651) 765-1802
ro,qer, dchertf~ow(~n.tgur~o~.n¥.us
Name:
License No.:
Address:
Phone No.:
sun.nme
TOWN OF SOUTFIOIJ~
APPLICATION FOR ELECTRICAL INSPECTION
REQ~STED BY: · Date:
~mpany Name: ~D~ ~7~r~ ~.~ ./~ ~
*Address: X/'.'~"Z~ 4~',/2/',¢'~ f,,~"z,,'r~
1000 Section: .~-~ o)
*Cross Street:
*Phone No.:
Permit No.:
TaxMap District:
JOBSITE INFORMATION: (*Indicates required information)
Block: ~ Lot: ~ ~.
(Please Circle All Tl~at APply)
*Is job ready for inspection: Rough In Final
*Do.you need a Temp Certificate:
~/NO
YES/~
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
Addltienal Information: PAYMENT DUE WITH APPLICATION
Olher
Overhead
,824~quest for Inspection Form
Towa H~II Annex
54375 Main Road
P.O. Box 1179.
Southold, NY 11971-0959
ephone (631) 765-1802 ~
BUILDING DEPARTMENT
TOWN OF SOUTHOLr~
APPLICATION FOR ELECTRICAE INSPECT..ION
Company Name:
Name:
Date:
No.:
Phone No.:
*Address:
*Cross Street:
*Phone No.:
Permit No.:
Tax Map District:
JOBSITE INFORMATION: (*IndiCates required information)
*Name:
1000 Seotion:.. 7~
*BRIEF DESORIPTION OF WORK (Plesse Print
I , O '
Lot: 42
(Please ~rcle All That Apply)
*Is, job ready for inspection:
~Do you need a Temp Certificate:
Templnformation (If needed} -
*Service size: 1 Phase 3Phase
*New Service: Re-connect
Additional Information:
YES/N{~
Rough In Final
100 150 200 300 350 400 Other
Underground Number of Meters Change of Service Overhead
PAYMENT DUE WITH APPLICATION
82-Request for Inspection Form
Suffolk County Executive's Office of Consumer A_[fairs
VETERANS MEMORIAL HJGtlWAY * HAUPPAUGE, NEW YORK 11788
[)ATE ISSUED: 7/1/78 No. 4436-H
SUFFOLK COUNTY
_Hon,e hn£ro vement Contractor License
This is to certify that ARTHUR J EDWARDS
doing business as ARTHUR EDWARDS MASON CONT1La~CTING INC
I ~, ing fiv__,nd~c,~ e ~ ~-,.~ ~emem2, sc l'o~th in accordance with and subject to the provisions of applicable laws,
~ ,~,c~ and ~ cg'~,, a~m.s ,,~ thc Coung; of Suffolk, State of New York is hereby licensed to conduct business as a
HOME IMPROVEMENT CONTRACTOR, in the County of Suffolk.
SUFFOLK COUNTY DEPARTMENT
OF CONSUMER Al=FAIRS
HOMEIMPROVEMENT
CONTRACTOR
Additional Businesses
This certifies that the
bearer' is duly
licensed by the
County of Suffolk
ARTHUR J EDWARDS
4436.-H 07/0~/1978
[ ~.,~o~ 07/01/2014
Director
SINGLE FAMILY DWELLING ONLY
SUFFOI~ OOUNI"/ f~]STR DEPARTI~E~*~
faoilittes for this lo~ation ..... been
inspected by this department ~d found
SUFFOLK CO. HEALTH DEPT, APPROVAL
H.S. No TAr,.SQ;~7
STA~EME.NT OF INTEN? -
THE WATER SUPPLY AND SEWAGE DISPOSAL
SYSTEMS FOR THIS RESIDENCE WILL
CONFORM TO THE STANDARD~ OF THE
SUFFOLK CO. DEPT. OF HEAIzTH SERVICES.
(S) AP.L'ICANY '
SUFFOLK CO.
DI~T, ~'ECT. BLOCK PCL
..U;X;~ ....... .i~,L~ ................ ~ ........... 4.~
OWNERS
B
_t
Section B-B
B-
Plan
Section A-A
Typical Wall
Piping Ai~rangement
Section
SIZE A B' C D E F G H AREA CAP.
FEET ~T. ~. FT. FT. FT FT. FT. FT. Sq. FT. GA[,.
i5x30' 15' 30' 8' 12' 6' 4' 4' 7' 450 16,000
16'x36' 16' 36' 13' 14' 6' 4' 4' 8' 576 31,600
18'x36" 18' 36' 12' 14' 6' 4' 5' 8' 648 24,300
20'x40' 20' 40' 16' 14' 6' l' 6' 8' 800 30,000
24'x44' 24' 4t' 10' 14' 8' .4' 6' 10' 798 30,000
24'x48' 24' 48' 20' 16' 8' 4'
ARTHUR EDWARDS
pOOL & SPA CENTRE
PERMACRETE WALL SYSTEM
929 Route 25A Miller Place NY 11764
(631) 744-7185 FAX (631)744-0174
Suffolk License #4436-HI
Nassau License #HI74450000