HomeMy WebLinkAbout37046-Z
Town of Southold Annex 4/3/2014
P.O. Box 1179
54375 Main Road
6 ~ Southold, New York 11971
l}
CERTIFICATE OF OCCUPANCY
No: 36841 Date: 4/3/2014
THIS CERTIFIES that the building IN GROUND POOL
Location of Property: 4600 Oaklawn Ave, Southold,
SCTM 473889 See/Block/Lot: 70.-9-48
Subdivision: Filed Map No. Lot No.
conforms substantially to the Application for Building Permit heretofore filed in this officed dated
3/2/2012 pursuant to which Building Permit No. 37046 dated 3/7/2012
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 swimmininool with fence per New York State Petition #2014-0035.
The certificate is issued to Gros, Alfred & Gros, Christine
(OWNER)
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL
ELECTRICAL CERTIFICATE NO. 37046 6/25/12
PLUMBERS CERTIFICATION DATED
thorized ignatur"e
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 37046 Date: 3/7/2012
Permission is hereby granted to:
Gros, Alfred & Gros, Christine _
17 Gardenia Ln
Levittown, NY 11756
To: construct an accessory InGround Swimming Pool fenced to code as applied for
At premises located at:
4600 Oaklawn Ave, Southold
SCTM # 473889
Sec/Block/Lot # 70.-9-48
Pursuant to application dated 3/2/2012 and approved by the Building Inspector.
To expire on 916/2013.
Fees:
SWIMMING POOLS - IN-GROUND WITH FENCE ENCLOSURE $250.00
CO - SWIMMING POOL $50.00
Total: $300.00
Building Inspector
Form No.6 .1
TOWN OF SOUTHOLD V
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:
I. 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:
1. Accurate survey of property showing all property lines, streets, building and unusual natural or topographic
featu res.
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
I. Certificate of Occupancy - New dwelling $50.00, Additions to dwelling $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 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
/ Date. 3 -7- ) a
New Construction: ? Old or Pre-existing Building: (check one)
Location of Property: `f(p O b YQ aAA2
House No. Street Hamlet
Owner or Owners of Property: ~ oe ~ N ~ M5
Suffolk County Tax Map No 1000, Section % t Block 9 Lot
Subdivision Filed Map. Lot:
Permit No. ~J '?01/60 Date of Permit. - - (L Applicant:
Health Dept. Approval: Underwriters Approval:
Planning Board Approval:
Request for: Temporary Certificate Final Certificate: (check one)
Fee Submitted: $ -5-6 Apph 'ant `igna[ure
SOUTyolo
Town Hall Annex Telephone (631) 765-1802
54375 Main Road 4 Fax (631) 765-9502
P.O. Box 1 179 A Q
Southold,NY 1 1 971-0959 ~Q roger.richert(a) own.southold.nv.us
OOUN i,Nc~
BUILDING DEPARTMENT
TOWN OF SOUTHOLD
CERTIFICATE OF ELECTRICIAL COMPLIANCE
SITE LOCATION
Issued To: A&C Gross
Address: 4600 Oaklawn Ave Ext City: Southold St: NY Zip: 11971
Building Permit 37046 Section: Block: Lot:
WAS EXAMINED AND FOUND TO BE IN COMPLIANCE WITH THE NATIONAL ELECTRIC CODE
Contractor: DBA: Elec-Tec Inc License No: 4814-me
SITE DETAILS
Office Use Only
Residential X Indoor Basement Service Only
Commerical Outdoor 1st Floor Pool X
New Renovation 2nd Floor Hot Tub
Addition Survey X Attic Garage
INVENTORY
Service 1 ph Heat Duplec Recpt 1 Ceiling Fixtures HID Fixtures
Service 3 ph Hot Water GFCI Recpt Wall Fixtures Smoke Detectors
Main Panel A/C Condenser Single Recpt Recessed Fixtures CO Detectors
Sub Panel A/C Blower Range Recpt Fluorescent Fixture Pumps 2
Transformer Appliances Dryer Recpt Emergency Fixture Time Clocks 1
Disconnect Switches 1 Twist Lock Exit Fixtures TVSS
Other Equipment: in ground swimming pool to include, bonding 1-pool light, 2-GFCI circuit breakers
1-salt generator
Notes:
Inspector Signature: Date: June 25 2012
81-Cert Electrical Compliance Form.xls
o~r,OF SOfjT~
TOWN OF SOUTHOLD BUILDING DEPT.
i 765-1802
INSPECTION
[ ] FOUNDATION 1ST [ ] ROUGH PLBG.
[ ] FOUNDATION 2ND [ ] INSULATION
[ ] FRAMING /STRAPPING [ ] FINAL
[ ] FIREPLACE & CHIMNEY [ ] FIRE SAFETY INSPECTION
[ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRATION
`kELECTRICAL (ROUGH) [ ] ELECTRICAL (FINAL)
REMARKS:
DATE INSPECTOR`
i
o soury~
TOWN OF SOUTHOLD BUILDING DEPT.
765.1802
INSPECTION
[ ] FOUNDATION 1 ST [ ] ROUGH PLBG.
[ ] FOUNDATION 2ND [ ] INSULATION
[ ] FRAMING/ STRAPPING [ ] FINAL
[ ] FIREPLACE & CHIMNEY [ ] FIRE SAFETY INSPECTION
[ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRATION
[ ] ELECTRICAL (ROUGH) [ELECTRICAL (FINAL)
REMARKS:
DATE 2 5 INSPECTOR
K67 ~o3aoesWTyO6
TOWN OF SOUTHOLD BUILDING DEPT.
765.1802
INSPECTION
[ ] FOUNDATION 1ST [ ] ROUGH PLBG.
i
[ ] FOUNDATION 2ND [ 11 INSULATION
[ ] FRAMING / STRAPPING [ FINAL
[ ] FIREPLACE & CHIMNEY [ ] FIRE SAFETY INSPECTION
[ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRATION
[ ] ELECTRICAL (ROUGH) [ ] ELECTRICAL (FINAL)
REMARKS
c~J YC~
CA-fA J' L
Z>
DATE ® 11-7 / INSPECTOR
TOWN OF SOUTHOLD BUILDING DEPT.
765-1802
INSPECTION
[ ] FOUNDATION 1ST [ ] ROUGH G.
[ ] FOUNDATION 2ND [ ] I TION
[ ] FRAMING / STRAPPING [ FINAL
[ ] FIREPLACE & CHIMNEY [ ] FIRE SAFETY INSPECTION
[ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRATION
[ ] ELECTRICAL (ROUGH) [ ] ELECTRICAL (FINAL)
REMARKS: Ql(o
DATE 7 INSPECTOR
FIELD N REPORT DATE COMMENTS
J
FOUNDATION (1ST) ' Q
FOUNDATION (2ND) -p M
~
c
a
0
y
ROUGH FRAMING &
PLUMBING
W
INSULATION PER N. Y.
STATE ENERGY CODE
Y
f / G Ldw
L~
A* ei)ot)
e~ 3
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FINAL C~x
LL2
ADDITIONAL COMMENTS
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ACL
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k)14-2035
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*AN OF SOUTHOLD BUILDING PERMIT APPLICATION CHECKLIST
BUILDING DEPARTMENT Do you have or need the following, before applying?
TOWN HALL Board of Health
SOUTHOLD, NY 11971 4 sets of Building Plans ?
TEL: (631) 765-1802 Planning Bo d approval
FAX: (631) 765-9502 Survey
SoutholdTown.NorthFork.net PERMIT NO. 37o V k Check
Septic Form
N.Y.S.D.E.C.
Trustees
C.O. Application
Flood Permit
Examined e3 20 Single & Separate
Stone-Water Assessment Form
Contact:
Approve317,20 Mail to:
Disapproved a/c
Phoney-~(~ ~!J
Expiration , 20
ZTOVVN Building Inspector
ICATION FOR BUILDING PERMIT
2012
Date 20/Z
PLM T. INSTRUCTIONS
HOLD
a. is 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
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. ~1
,611741X i~GUL S 47b
(Signature of applicant or name, if a corporation)
'TO
( ailing address of applicant)
State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder
Name of owner of premises AL Z a 5
1 (As on the tax roll or latest deed)
If applic nt is a cor o do st aturef duly authorized officer
<
(Ma-me`-and title of corporate officer)
Builders License No. IS-,16
Plumbers License No.
Electricians License No.
Other Trade's License No.
1. Location of land on which proposed work will be done:
House Number Street Hamlet
County Tax Map No. 1000 Section_ L) Block ~Lot~
Subdivision ,91_ SoZ~ Filed Map No. Lot _„2 7 .41
2. State existing use and occupancy of premises and intended use and occupancy of proposed construction:
a. Existing use and occupancy / 47~y ;rZ,
b. Intended use and occupancy/ ~v1LY Fig' 7E
3. Nature of work (check which applicable): New Building Addition Alteration
Repair Removal Demolition er Wor Z,&4,-"Az (Description)
4. Estimated Cost-'/ ao Fee
(To be paid on filing this application)
5. If dwelling, number of dwelling units Number of dwelling units on each floor
If garage, number of cars
6. If business, commercial or mixed occupancy, specify nature and extent of each type of use.
7. Dimensions of existing structures, if any: Front (00 d r Rear Q' Depth set)
Height Number of Stories /
Dimensions of same structure with alterations or additions: Front Rear
Depth Height Number of Stories
8. Dimensions of entire new construction: Front Rear Depth
Height Number of Stories
9. Size of lot: Front lUh Rear //5b Depth /SD
10. Date of Purchase Name of Former Owner
11. Zone or use district in which premises are situated '/7-C5i7~~u7i9r_
12. Does proposed construction violate any zoning law, ordinance or regulation? YES NOX
13. Will lot be re-graded? YES X NO Will excess fill be removed from premises? YES NO
14. Names of Owner of premises /14 42i,5 Address ~/lsuU 4,k4,4u-k) Aa.EPhone No. &:57-
Name of Architect Address 1ta01ft4-;7;> Phone No
Name of ContractorG;97,k -Ax t,-p Address Po -2kv 9 e yr,,"i Phone No. 735/- 7G4,5'
15 a. Is this property within 100 feet of a tidal wetland or a freshwater wetland? *YES NO ,y
* 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 o<
* IF YES, D.E.C. PERMITS MAY BE REQUIRED.
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.
18. Are there any covenants and restrictions with respect to this property? * YES NO
* IF YES, PROVIDE A COPY.
STATE OF NEW YORK)
SS:
COUNT,,//Y OF~
z5L4e I,c being duly sworn, deposes and says that (s)he is the applicant
(Name of individual signing contract) above named,
(S)He is the &'(L)7Z17c7dJz
(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 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 therewith.
Sworn to befor e his
k~--j y rcG 20aT I. SCOTT, JR.
Notary Public, State Newr
Q
a~C'c ualified in Suffolk lk Cou Dt ~
Notary o. 1SC47250
7 Term Expires May 31, ~ 8~t Signature of Applicant
n,P 3')
NYS DEPARTMENT OF STATE
DIVISION OF CODE ENFORCEMENT AND ADMINISTRATION
Variance Attest List
Petition No: 2014-0035
The persons below are advised to TAKE NOTICE of the attached document. The attached
document pertains to a petition for relief related to code requirements. If there are any
questions, call (518) 474-4073 and ask for the Variance Unit. Please refer to the petition
number in all related conversations or correspondence with us.
MICHAEL VERITY/
TOWN OF SOUTHOLD BLDG DEPT
54375 MAIN ROAD
SOUTHOLD, NY 11971
AL GROS
4600 OAKLAWN AVENUE
SOUTHOLD, NY 11971
PETE PONTERIO, PRES.
NORTH FORK FENCE
P.O. BOX 1525
MATTITUCK, NY 11952
021112014 Page 1 of 1
0010
APR 2 2014 i' J
STATE OF NEW YORK
DEPARTMENT OF STATE -
ONE COMMERCE PLAZA n
ANDREW M. CUOMO 99 WASHINGTON AVENUE _ CESAR A. PERALES
GOVERNOR ALBANY, NY 12231-0001 SECRETARY OF STATE
In the Matter of the Petition of DECISION
PETE PONTERIO
For a Variance to the New York State PETITION NO. 2014-0035
Uniform Fire Prevention & Building Code
Upon the application of Pete Ponterio, filed pursuant to 19 NYCRR 1205 on January 27, 2013 and
upon all other papers in this matter, the Department makes the following determination:
NATURE OF GRIEVANCE AND RELIEF SOUGHT
The petition pertains to the installation of an in-ground swimming pool for a one-family dwelling,
located at 4600 Oak Lawn Avenue, Southold, Town of Southold, County of Suffolk, State of New York.
Relief is requested from:
19 NYCRR Part 1220, Residential Code of New York State, (2010) Section AG105.3 section 8.2,
which requires, in part, that all gates shall be self latching, with the latch handle located within the pool
enclosure (i.e., on the pool side of the enclosure) and at least 40 inches above grade. In addition if the
latch handle is located less than 54 inches from the bottom of the gate, the latch handle shall be located
at least 3 inches below the top of the gate. [ The Petitioner request permission to permit latch handles for
two pedestrian access gates as a part of a pool enclosure, located 54 inches above the bottom of the
gate, to be located on the outside of the pool enclosure.)
FINDINGS OF FACT
1. An in-ground swimming pool was installed at the subject premises. In doing so an enclosure was
provided around the pool with two pedestrian access gates.
2. The two pedestrian access gates swing outward from the pool and have latch handles that are
located at least 54 inches above the bottom of the gate. However the latch handles have been
located on the outside of the gate.
3. The previous, 2003 and 2007, Residential Codes of New York State allowed the latch handle to be
placed on the outside of the pool enclosure as long as the handle was located a minimum of 54
www.DOS.NY.GOv E-MAIL: INFO@DOS.NY.GOV
Petition No 2014-0035
Page 2
inches above the bottom of the gate. The current 2010 Residential Code of New York State requires
that even if the latch handle is 54 inches above the bottom of the gate that it must be located on the
pool side of the enclosure.
4. The provisions for barriers around swimming pools are to protect young children, less than 5 years
of age, according to the International Residential Code Commentary.
5. The 2006 International Residential Code, on which the 2010 New York State Residential Code is
based, allows a latch that is 54 inches above the bottom of the gate to be located on the outside of
the enclosure.
6. The commentary for the International Codes states that the "54 inch latch height requirement limits
the potential for small children to reach and activate the latch." If the latch is located lower than 54
inches then the Code requires that the latch be located 3 inches below the gate on the inside of the
enclosure.
7. Section 303.2, Part 8 of the current, 2010, Property Maintenance Code of New York State has
retained the language about pool latches that was in the previous Residential Codes of New York
State and still allows a latch that is located 54 inches above the gate to be located on the outside of
the enclosure.
8. Based on the above findings, it is the assumption that the 54 inch height of the latch above the
bottom of the gate is adequate to protect the children that the Code has identified from reaching the
latch and gaining entrance to the swimming pool regardless on which side of the enclosure the latch
is located.
9. On some gate configurations it may be possible to reverse the latch to be in compliance with the
current Code requirements. However in this instance the enclosure and the gates would have to be
completely reconfigured or replaced to reverse the latch. The Petitioner has stated that this would
both physically and financially impractical.
10. The Petitioner has proposed that the pool enclosure and pedestrian gates will be in compliance with
all other applicable provisions of Appendix G of the Residential Code of New York State.
11. The local code enforcement official has been consulted in this matter and does not object to the
granting of a routine variance under the provisions of 19 NYCRR 1205.
oql
Petition No 2014-0035
Page 3
CONCLUSIONS OF LAW
Strict compliance with the provisions of the Uniform Fire Prevention and Building Code would be
unnecessary in light of the fact that the latches as configured will be a minimum of 54 inches above the
bottom of the gate and should be out of reach of the children that the Code provisions are trying to protect
and would ensure the achievement of the Code's intended objectives more efficiently, effectively or
economically such that granting a variance would not substantially adversely affect the Uniform Code's
provision for health, safety and security.
DETERMINATION
WHEREFORE IT IS DETERMINED that the application for a variance from 19 NYCRR Part 1220,
Section AG 105.3 section 8.2, to permit latch handles for two pedestrian access gates as a part of a pool
enclosure, located 54 inches above the bottom of the gates, to be located on the outside of the pool
enclosure; hereby PROPOSED TO BE GRANTED with the following condition:
1. That the latch handles be located a minimum of 54 inches above the bottom of the pedestrian gates.
2. That the pool enclosure and pedestrian gates will be in compliance with all other applicable
provisions of Appendix G of the Residential Code of New York State.
This DECISION is issued under 19 NYCRR 1205.6. Unless objected to by the petitioner in
writing received by the Department, the decision shall become FINAL after fifteen days of receipt of the
decision by the parties.
This decision is limited to the specific building and application before it, as contained within the
petition, and should not be interpreted to give implied approval of any general plans or specifications
presented in support of this application.
Ronald E. Piaster A.I.A , Dirac r
Division of Building Standards d Codes
DATE: 3/a>!/y
RAS: nc
oToVFn of So
uthold
Erosion, Aedimentation & SjormWater Run-off ASSESSMENT FORM
PROPERTY LOCATION: s.GT.ALS: TH8 F LLOWINO ON8 MAY B7,I)ME THE 9UBMISSWN OF A
FFUl YYATM ADMDRA1 D OS CO
S
in t!c -'Cow' B ED UT A 0 V R IO~ IN N THE OF I.V
F
SCOPE OF WORK - PROPOSED CONSTRUCITON rPEM # / WORKASSESSMEN'r Yes No
a. VAd Ib the rotes Area d tAepraw ParZbb? 1 VIA Rtis Plq~ct fatalist AI Sbnn Webr.Run-0fl
Ibe Scope Rialutle Total Area dati Parcels boated tIwithin
on /SAC SF W a 7Wo (2q Ildt RahM on SW a
theofWorkforPlopaeedCorulrxdlal) AAaay MGeraralled ile RemwEIlokldaaArur"Ifcreated bysh
b. Wlatis the Total Area d Lend Cbaling dea ft en for naRan eeftNes eswel as all
mWor Gm WW Diedrbahce (Doha pfopased 8Ra, afrTUle permartent (reetion d
canshudlon whiny? . .
W.IAms) 2 Does the Fie Plan ari Somas am Al Proposed
PROVIDE BRIEF PRCOWr DE4CWMN Potl.AdMrmouRa asm"en Dreklegef icagesindicating8ke8lacadat?This
Mam shell Incklfle of
.1 1 aropopedwaterGrade Cefgestild
Does 9re 8Rs Ften wW& SwM deswft #m wosbn / r1
Su9:.vtr (•~s ~r2x~ eonbot $b , wdr This J { _li
ban r imstitls melotakhed ftvj* Ut the Entire
ConAction period.
4 wEthis ProJedt Require .anyLand Filing.Graftor
Excavation where there Is a charge to the Natural /
. Extatig Grade Involving more than 200 Cubic Yards. .
of Material within any parcel?
5 Will Able Application Require Land Disturbing Act vibes ?
Encompassing an Area in Excess of Five Thousand
(5.000'SF.) Square Feet of Ground Surface?
.6 Is there a Natural Water Course Running through the
- Gtte? Is thisProject whin tha Tnutees J risdodon
G.nuat MC MNPPP Reeuaermnrs : - or within One Hundred (1007 feel of a Wetland or
SuWd.bna. SWPPP is required for err ConsnucUm adivides kwIvIrraa Beach? -
4besbakmaon.(1)wmoresaes:tnrAr rdxrieas also tlian sue aai,110 Wertiara be Site are peraabrierrmmnton plan that will ularnley dloab one a Fees, aces of land: preparatlon on Existing Grade Slopes /
kiatDEO dateronaeavuea sor dbMbenco shoremornone(1)acrewhere which One Hundred Exceed (1001 Fifteen of (16) feel of
Hortrootal Ver6caf Distance? Rise to
F
naot:cit has aebnnarednnre VsPDIES OespenaY[s,eyakedreramrmwarermawyes. .
(BWPP.Ps own pre.Hh• Aunknum tt"u1n eenb or the sPOES Dermal Permit . 6 WE Driveways, parking Areas orother Impervious
for sraFewabr Discharges Arm eonswcnon n4 tp-Punta Nm ar L"O. M.) Surfaces be Sloped to Direct Stom?YVater Run-Off .
. 1.ThesWWties beprspamdWier Ntlresub oflheNOLThe NOINWIpe Into wWorInWedirection. ofaTown FightcLwrey?
suMpged asmpepmbrmM pftlo rb ammenus,maitaaauuWdWpu Gd .
27ha8NPPPshall dewWe IM adsedleent ba pi es andwhwe 9 YVE this Project Require the Plece entofMa(tlld,
rsupnbed, pogoatesuabn elamwNa norrrpemenlpraallas awtwib.wedaMbr RemCVaf of VeoetWn sndlor the Construction ofa
arbhldedbrNMrc. sue pgsMbis, slwmmradbdaepee indbwws - it= Within the Tam-R%hli-ollWay or Reed Wooden
uxmuptisrucsvaln tlirbmraWiendNossasd. peaYL In sddsme,ss sYYPl+p Nan Area?
trahmmwAlsDrbwa.snsgapdonarupwirrApar,1
)derrKr psM~~rses 4tPa~ssrlwNtllrbr ru:aeelabgrMSrgecbdbalfecttls ttW@ aAryASSwabquolbasOrb
que0ydtlarrsnbr alnagq. beams caul tlteppmlrrWen abd blNarsirr 5.000U.&IIA"Iuaa,
3.MaWRrPstlWrdgWSarspwraoiaaudton slam wabrmsnaaanadgaotlce ate.
• # Is tai l¦ into prk4ow orb rescIond Sim" %WW soNaNamd w feravrr P&rtoba Gfft m~iabsimae.
Flora AChKk AC$) wA%rArwmlbrewh% mbRquMbrec=owAp,IWm)
STATE OF NEW YORK,
COUNTY OF SS
That I, ..Cif( C~~/ 77 » being duly sworn, deposes and says that ht hhe is the applicant for Permit,
(Naneo7 d9irMgtioirinrad)
And that he/she is the
»
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 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 er set forth in the application filed herewith.
Swom to before me this;
d G.... .
'Notary Public ~fi 1;..... .:/c............
Irk, ~ ,•••i (5gmbne d Applicant)
Qualified in Suffolk County
FORM - 06/10 °
No.O1SC4725089
Term Expires May 31, .LaaL
ho~~01; SOplyo6
Town Hall Annex J Telephone (6~33y~1) 7y65.1804
54375 Main Road 41
P.O. Box 1179 ~ roomer-richettCai~.
( SODU 16y us
Southold, NY 11971-0959
"WIIII,
BUILDING DEPARTMENT
TOWN OF SOUTHOLD
APPLICATION FOR ELECTRICAL INSPECTION
REQUESTED BY: Date: 5-23
Company Name:
Name:
License No.:
Address: Q e2~~ Q n Q
Phone No.:
JOBSITE INFORMATION: (*Indicates required information)
*Name: -t
*Address: i- 00 tc~yg
F~nl
*Cross Street: ~,~C~~3 c V t J
*Phone No.:
Permit No.: Q
Tax Map District: 1000 Section: p Block: Lot:
*BRIEF DESCRIPTION OF WORK (Please Print Clearly)
(Please Circle All That Apply) C161^ _ ~1
*Is. job ready for inspection: S NO i Roug In Final
*Do you need a Temp Certificate: YES / NO
Temp Information (if needed)
*Service Size: 1 Phase 313hase 100 150 200 300 350 400 Other
*New Service: Re-connect Underground Number of Meters Change of Service Overhead
Additional Information: PAYMENT DUE WITH APPLICATION
C&GS I
82-Request for Inspection Form ~j Z 2
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Town Hall Annex 411 Telephone (631) 765-1802
54375 Main Road 411 Fax (631) 765-9502
P.O. Box 1179 A ~Wc
Southold, NY 11971-0959
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BUILDING DEPARTMENT
TOWN OF SOUTHOLD
February 12, 2014
Alfred & Christine Gros
17 Gardenia Lane
Levittown, New York 11756 nn
4600 Oaklawn Avenue, Southold NQ Gl `~~a~~~
TE: ore the Certificate of Occupancy can be issued, a variance from New York State is
egwred.
TO WHOM IT MAY CONCERN:
The Following Items (if Checked) Are Needed To Complete Your Certificate of Occupancy:
Application for Certificate of Occupancy. (Enclosed)
Electrical Underwriters Certificate. (for the hot tub)
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. (Planning # 765-1938)
Final Fire Inspection from Fire Marshall.
Final Landmark Preservation approval.
Final inspection by Building Dept.
BUILDING PERMIT - 37046-Z swimming pool
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