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HomeMy WebLinkAbout37816-Z Town of Southold Annex 6/3/2014 P.O.Box 1179 r 54375 Main Road R Southold,New York 11971 CERTIFICATE OF OCCUPANCY No: 36951 Date: 6/3/2014 THIS CERTIFIES that the building IN GROUND POOL Location of Property: 795 Westwood Ln, Greenport, SCTM#: 473889 Sec/Block/Lot: 33.-2-7 Subdivision: Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this officed dated 2/14/2013 pursuant to which Building Permit No. 37816 dated 2/15/2013 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 Georgaklis,George&Georgaklis,Evangela (OWNER) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL ELECTRICAL CERTIFICATE NO. 37816 5/7/13 PLUMBERS CERTIFICATION DATED )4"Orizk Signature rr TOWN OF SOUTHOLD � x BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, NY �x 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 #: 37816 Date: 2/15/2013 Permission is hereby granted to: Georgaklis, George & Georgaklis, Evangela 449 84th St _ Brooklyn, NY 112094711 To: Construction of an in-ground swimming pool as applied for. At premises located at: 795 Westwood Ln, Greenport SCTM # 473889 Sec/Block/Lot# 33.-2-7 Pursuant to application dated 2/14/2013 and approved by the Building Inspector. To expire on 8/17/2014. Fees: SWIMMING POOLS -IN-GROUND WITH FENCE ENCLOSURE $250.00 CO - SWIMMING POOL $50.00 o . $300.00 Bui Inspector n \Y Form No.6 � Cj TOWN OF SOUTHOLD. �\ BUILDING DEPARTMENT TOWN HALL VI 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 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 2110 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 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. 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. vc- la-13 New Construction: Old or Pre-existing Building: (check one) Location of Property: r7gS W&TWOJn �AW'e &anaxj- House No. Street U Hamlet Owner or Owners of Property: &SQL G e JR G A ti-I 5 Suffolk County Tax Map No 1000, Section 33 Block .�2 Lot Subdivision Filed Map. Lot: Permit No. }J �� Date of Permit. 5,_ (12D Applicant:_ Ad-k� Cwt(,c:ac.�,5 Health Dept.Approval: Underwriters Approval: Planning Board Approval: Request for: Temporary Certificate Final Certificate: xj (chec on ) Fee Submitted: $ ���:d ppli tt S� ature sig F9 �r Town Hall Annex p� �a' Telephone(631)765-1802 54375 Main Road � Fax (631) 765-9502 P.O. Box 1179 w�, "► Southold, NY 11971-0959 �41►� .�0< roper.richertCc�town.southold.n BUILDING DEPARTMENT TOWN OF SOUTHOLD CERTIFICATE OF ELECTRICIAL COMPLIANCE SITE LOCATION Issued To: George Georgaklis Address: 795 Westwood Lane City: Greenport St: NY Zip: 11944 Building Permit#: 37816 Section: 33 Block: 2 Lot: 7 WAS EXAMINED AND FOUND TO BE IN COMPLIANCE WITH THE NATIONAL ELECTRIC CODE Contractor: DBA: USI Electric License No: 2740-me SITE DETAILS Office Use Only Residential X Indoor Basement Service Only Commerical Outdoor x 1st Floor Pool X New Renovation 2nd Floor Hot Tub Addition Survey Attic Garage INVENTORY Service 1 ph Heat gas Duplec Recpt Ceiling Fixtures HID Fixtures Service 3 ph Hot Water GFCI Recpt 1 Wall Fixtures Smoke Detectors Main Panel A/C Condenser Single Recpt Recessed Fixtures CO Detectors Sub Panel 1 A/C Blower Range Recpt Fluorescent Fixture Pumps 2 Transformer Appliances Dryer Recpt Emergency Fixtures Time Clocks 1 Disconnect 11 Switches Twist Lock Exit Fixtures TVSS Other Equipment: in ground swimming pool to include, bonding, 1-pool light, 2-GFCI circuit breakers 1-sale generator,1-pool cover circuit Notes: Inspector Signature: Date: May 7 2013 Electrical Certificate.xls �� � � �� �o��►�F SO//ry�6 TOWN OF SOUTHOLD BUILDING DEPT. 765-1802 INSPECTION FOUNDATION IST [ ] ROUGH PLBG. [ FOUNDATION 2ND [ ] INSULATION FRAMING/STRAPPING [ J FINAL [ ] FIREPLACE A CHIMNEY [ ] FIRE SAFETY INSPECTION [ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRATION [ ] ELECTRICAL (ROUGH) [ ] ELE "-(F AL) REMARKS: �� - DATE 4�11 INSPECTOR i' �o0pf sNq ,< TOWN OF SOUTHOLD BUILDING 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) ELECTRICAL (FINAL) REMARKS: DATE S l3 INSPECTOIV�Z TOWN OF SOUTiIOLD BUILDING DEPT. 765.1802 INSPECTION [ ] FOUNDATION 1ST [ ] ROUG BG. [ ] FOUNDATION 2ND [ ] I CATION [ ] FRAMING/STRAPPING FINAL [ ] FIREPLACE & CHIMNEY [ ] FIRE SAFETY INSPECTION [ J FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRATION [ ] ELECTRICAL (ROUGH) [ ] ELECTRICAL (FINAL) REMARKS: DATE INSPECTOR TOWN OF SOUTFIOLD BUILDING DEPT. 765.1802 INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND INSAATION [ FRAMING /STRAPPING FINAL [ ] FIREPLACE & CHIMNEY [ ] FIRE SAFETY INSPECTION [ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRATION [ ] ELECTRICAL (ROUGH) [ ] ELECTRICAL (FINAL) REMARKS: DATE 2LInIZ3INSPECTOR -7 P-1 TOWN OF SOUTHOLD BUILDING DEPT. 765-1802 INSPECTION [ ] FOUNDATION IST [ ] RO H PLBG. [ ] FOUNDATION 2ND [ ] SUL [ ] FRAMING /STRAPPING FIN L [ ] FIREPLACE & CHIMNEY [ ] FIRE TY INSPECTION [ J FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRATION [ ] ELECTRICAL(ROUGH) [ ] ELECTRICAL (FINAL) REMARKS: ursl/��S DATE � �� r3 INSPECTOR �j FIELD INSPT=gN REPORT DATE NTS FOUNDATION(1sT) — FOUNDATION(2ND) 7 z 1 y ROUGH FRAAONG& y PLUAMING l� INSULATION PER N.Y. STATE ENERGY CODE t� 00 FINAL ADDITIONAL COMMENTS nl y � z rn v 0 b t� -4w TOWN 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 3 sets of Building Plans TEL: 765-1802 / Survey PERMIT NO. b _ Check Septic Form N.Y.S.D.E.C. Trustees Examined ,20 Contact: Approved _,2076 Mail to: Disapproved a/c Phone: I '7 Building Inspe for FEB 13 2013 PPLICATION FOR BUILDING PERMIT 7t.,7,L roe,^iN ur ,n�, �io�o Date o2�a , 20 13 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 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 a Certificate of Occupancy is.issued by the Building Inspector. 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, regulations,and to admit authorized inspectors on premises and in building for necessary inspections. (Signatureof applic t r name,if a corporation) 2�4 Mifiv_ P*e l"c 11761 (Mailing address of applicant) State whether applicant is owner,lessee, agent, architect, engineer, general contractor, electrician,plumber or builder Name of owner of premises 6,C CAN -�5 (as on the tax roll or latest deed) If applicant is a corporation, signature of duly authorized officer (Name and title of corporate officer) Builders License No. 3�0- Z' 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 County Tax Map No. 1000 Section • 33 Block Lot Subdivision Filed Map No. -Lot,' ` ` 1 (Name) 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy tCSYNC'�Q _ b. Intended use and occupancy QP,S��rjTk_ Sr�rnn�irra,_ Pool 3. Nature of work(check which applicable): New Building Addition Alteration Repair Removal Demolition Other"Work�� (Description) 4. Estimated-Cost 14 COD- 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 Rear 5�` Depth jt�2) Height Number of;Stories I Dimensions of same structure with alterations or additions: Front Rear Depth Height Number of Stories 8. Dimensions of entire new construction: Front old ' )(40' Rear Depth Height Number of Stories _ 9. Size of lot: Front Rear U-0 Depth S u 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: No 13. Will lot be re-graded Ao Ont- Will excess fill be removed from premises: YES NO 7 i S- We&T" LJ 14. Names of Owner of premises 6 x t_is Address (ik&AFj,,_t Phone No. 417- - ✓D qt_ Name of Architect`Ti om& is QeA PC- Address ).N i-,J S"I"wPhone.No 72-4-7&P Name of Contractor waft.\ &5 Address Q2q 6 14,tkc. Phone No. 7�4- '716'�_ � 15. Is this property within /100 feet of a tidal wetland? *YES NO V • IF YES, SOUTHOLD TOWN TRUSTEES 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. STATE OF NEW YORK) SS: COUNTY OF �JG;XIL ) OA-*05 Pi� being duly sworn, deposes and says that(s)he is the applicant (Name of individual signing contract)above named, (S)He is the (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 before me this day of �;h•'JA'Y-� 2013 Notary Pliblic Signature OlApplicant MARGARET A. KIDNEY Notary Public-State-of New York No. 01 K16021 1 1 1 Qualified in Suffolk County My Commission Expires March 8,20,sZ r� Town of Southold - Chapter 236 - Stormwater Management N � x g SWPPP - Storm Water Pollution Prevention Plan Assessment Form GENERAL INFORMATION: (All Requested Information is Required for a Complete Application) APPUr NAME: ner- t-Consultant-Contractor or Other(Circle On Property OWNER:(N Different than Applicant) i LIS Address: -1 1n1bfi KWO Lam. fe/1 t f p Address: Telep ne Fax : Telephone Fax It E-Mark E-Mail t i fie `'99S hemwap 4%fi[T Brief Description of Construction Activity,Proposed Strucdttal BMPs,Soil S.MT.M.A, 1000 _ �- Stabaliation BMPs,Project Scope amUor Sequence of Construction Activity Y-T eedton sleek Lot (Pro"Adel Papa as Needed) Name of Contractor andior Contact Pers"Responsible for Implementation of SWPPP: QQ p iL 4.4j1 N jjM EoAtp 6)5 ------ - ------- --- ---------- In >�;mnljnf� rens: g2o1 f2 r zsA M t 1 -ec gee P4' 1! rn Y �{? Te phone% b3►-� -71$� Fax#• 1031- -+-"-Q�-- "^F(-it-" -- ---- E-Mail: f�ite t't�112•PJOfs.e�tm ----- _ U t Name of Persons Responsible for lnslelletiondl IntenanceofErosion Control F;a ce: -----' -_ hllvA--------------------------- imwcCit)WkwS 7 teas: 4-2A 20V Mine, v, I"/ -11'W t Telephone#/_2,' `1`7Fax# -------------- E_Mail: ofnce Ae4bxs.e3m Total Area of AN (�(�/1 Total Area of Land Clearkv Qp� •--------------------- ---- .._--------------- Profs Parte: §(J and/or Ground DisNrbance: e v Project Duration: IStar, End _______...________.. (Anticipated) .Date: 71 //3 Date: / /3 ...-_ .- ___._.:,._..._....._.__._,._.___..._ INwnbaacaendar Dan) •'TTT/// .__-_---------.__------ Will this Project Disturbelive(5)or More Acres at '' _____________________,_________ Any One Time During the Proposed Development? Yes ---------------------------__-_----_ - ---^ - If YES:Please Answer theFollowin9l __-,..._.___--_.-_-_--_-_-__--_-____,.____..____________ i a. Does the Applicant have a Qualified Inspector On Staff To Conduct the 13squired Inspections? Yes No b. Does the SWPPP Indicate How Frequently the Site = = List the NAMES or description*fall Potentially Impacted Waterbodtes andlor Wetlands: Inspections will Occur and for What Period of Time? Yes No ------ -- ------------------------ c. Does the SWPPP Adequately Identify AN Temporary ------------- (J and/or Permanent Soil Stabalization Measures? Yes No •"------------ - d. Does the SWPPP Adequately Identify a Complete Project Phasing Plan? Yes No, Status of Impacted Walerbody:(eg:TMDL,303(d)Listed,Impaired .._) e. Does the SWPPP Indicate Additional Site Specific [� C Practices that Will be Utilized to Protect Water Quality? Yes No f. Has the Applicant Submitted a Completed DEC Notice Of Intent and SWPPP Acceptance Form for Review Type of Impacted Waterbody:leg.Lake,Creek,Say,Pond,Sound,Freshwater Wetland- [� by the Town of Southold? Yes No --------------- ---- -- ------ --------- i S7 AIT..OF NFW YORK, I COU 'Y OF............... r4:................SS That I..................... K:z1-!u� t✓D►JA�IJS........... I Name of IrKU zeal s ooairrientj being duly sworn,deposes and says that he/she is the applicant for Permit, And that he/she is the .................................. t (Owner,Contracbr,Agent,Corporate Officer ele) i. Owner and/or representative of the Owner or Owners,and is duly authorized to perform or have performed the said work and to I make and file this application;that all statements contained in this application are true to the best of his knowledge and belief;and i that the work will be 91 that in the manner set forth in the application filed herewith. t Sworn to before me s; I 71" l day of. --.....,20.3 ..................... .......... - Notary Public ............. .............................. ................ .(Signature ....._........_..._..._...._.... SWPPP Assessment FORM: 03-12 f OWY Public State-of New York a No. 01K160211 11 Oualiified in Suffolk County My Commission Expires March 8,201f T.G.S. "SWPPP" Preparation - Chapter 236 For Department Use Only; S.C.T.M.M. Property Address: Storm Water Pollution Prevention Plan Review Checklist Checklist # '1 ' -- REQUIRED PLAN INFO TION AND IM PL MENTATION DETAILS: i , i i Plan Sheet Does tris SWPPP Ade to Provide for and/or Irtdicatb the FolloWin r YES, NO i N.A.r EXpWnatl4h for NO or EA. �) r r Location(pg.ft) 1. Dranap-- -------------=-- a--- -----omen-_--Ino---RainfallOn-Site, ._.i r r �.--------------------- 2. Construdlon PhBal Plan IndicatL 9equertce of Pro-posed Construction Activities, - Q ] �_vcst-' pRlattge Sita Plan Drawnto Scale at Sbd�y(60'j feet to the Inch or lamer Indicating the Following i Q i r©a4oIftlor.�A�3SFlptlonofPriRIIY$9lmdarlBS; i©i��i©�- -------------- -------------------- r�- ___---------------------____.___- c_ All EAstin.Natural and/or Man Made Features on and within 50'of the Property Boundary ' ------------------------ d Test Hole Data Indicating_Soil Characteristics&Deth to Seasonal High Water Table: r=r Qt ' ------------------- ----------------------- e Contours India Prop"EtevationsSMln.2 L____ -_-- _._. O Q r__ _ _ _ --------- ------ f. Spot Grad"o&-Fin Fjoorr EleWaiils for lNang and Proposed Structures; �' -- --- - ------------------- - hLooat7on o�Wdbai& treas ll oleald•Trees wiUt a Mlnlmum bTr sfon orf 1p Diameter '=-=1=1 9• ------------------------- ----- - -a r i +-------___ ----------------------- -SOTI-G`�Onserv8�fOn1�Ts�rie�'3`OIfS`utvsy. --iC�i©i�r-------------------- -------- ----__. _. 5 Background Infomlation about the Scope of ith-eWqfeeC Location&DewAption of the Site, Q 0 Q {' ' / Proposed Changes to the Site and All Existing Development an the site Irrcluding the Follow,ng.-� r L-_ Irl 5tn/i►XiM Wj (WL d._All.la'tpmemorA If 1f"kni-T9t.AE9t Q b. All Excavation,Filling,Stripping&Grading Proposed and Identlfied-as to depth.Volume Q _ __$ $ � �_v_CtY ;----- -------------------- ---_.._ - iQi i i------------------------------- ------._ d. All Areas Where Topsoil Is to•be Removed.StocWled and where Topsoil will ukimately - be placed• e. All Temporar�r&Permanent VeggMa to be Placed ori Site;---- ---- ----- _ Q i L]r ~ f. All &Penpairent 8tonn Water Runoff, trot M —" ' r--------------------------------------- u ..._._... _.....-- � -------- -------------- eastiresProposed:--._..--i --- g_ The A1lticlpated Patt9rrt of Surface Dralnape Dud Periods of Peak RunofF ------- ---- -------- h. The j.OCailor10f811�FO8os,Dtiv6W8�is,Slaewa7ks.__ osStructures,Otliitles8_Qth_er ---------------------------------------- ImprovemertFs,fncruarniTimporary Awes�'ConsEGa6n gteging Areas; _ ..I:-T5 i 9aa�i"rtg'SAU7nfu-Winaar$poll:,avadonsoft64ii15Y_________.__.-.__. ..._.'�;Q;1�----------------------- 6. A Schedule of the Sequence for the Itlatatlatlon bf All Planned Soll Erosion,Setlimentation r , r r --------________________.... &Stormwater Runoff Control Measures 7. Description of Pollution Prevention Measures that will be Implemented __;Q i Q i __ _ _ - ----- --------------- -------------- �----------------------- - - ---------- 8. A Description of the Minimum Eroslon&Sediment Control Practices to be Installed and/or Q Im�lamettted for Each Cjonstructlon ACtfvhXftt will result in Soil Disturbance. r r r ---- -----------___ , , , r-�------------------------------------- g. Pq;-0ptlorLgjConstrygtblL&WasternatertalsExpectedtotieS_toredOn�Site.------------ ;-------------------------------------- -- f 0. Temporary&Perinan6nt Soil$t Ilzetlon Plan that meets the Current Version of the - _New York State Stomp Water Desl$n Mama lLTschnlcal Standard. Q -------- -- - -i i i r 11. Genaral3UePbuiand_ConstructionDrawings1brtheLftL!ct --------------- „_�C�tC7rQr �-------------- ---- -------- - _.., ._ 12._Dimensions.Material$EsCtt[catlons&tnstaUatlon Details for At Erosion&Sediment Control Practices ;Q i Q i�J r _ ----------------- U 13. Tem_-----ratslceath_atwlll_beCorniertedtoPecma_rierrtcontrolMeasures_.'____ _Qi©i[ - ------ `__. . 14. I mplemet $tlorf-8c}tedttle for8taging Tompota►y Erosion t_or►Vol PraGlce_or BMP. Q' ' - __ - _.-..._..� r..--s-- _- ---__ __-_--______-f 1 1 1-_ _ _ __..___-.._-_..__- -__ 15. Maintenance Sdt<edute to Ensure Continuous&Effective Operation of Erosion& Sediment_C_ontrolP_ractltss._ -------- __ _ Names ofPotentlalSurfaceWaters' Ti.-hi tateofNewWWiridlorM 4thatma be -i r ,I.7�7.,,C r-------------'------ -----� 'Impacted by Development. -- - - ;.= 11 -------------------------------------- -- r r r r 17._DallneatiQnofStorm Control Plan lrnplementatl------------ ---------------------- ---------- o_----onstblltUesfo_�F�_chp'artofthe _-_- r ~�,_____ __ r , r Project - - ---- ,�rQr ~- -- -------------------- ---� _ _ r r r r _ 18. All other�ds_ting Data tl18t DeaCtlbos Storm Water F�unoff and/or Natural DralriW%wRlee. __.,(� Q =r_ Jjsyjp- _ _-- _-- _ __ - f s.'I�entMlcatiDrt of Ali CortffadorFs)/Sub-Contractors) Responsibls.for Installing,constructing, �� i Q r � AY �il7c Repairing,Re and Maln tha Erosion&Sediment Control Practices. l Storm Water'lf umMement Control Plan Checklist#1 : 03-12 �. DEC "SWPPP" Preparation - Chapter 236-19 For Department Use Only. KStorStorm Water Pollution Prevention Plan s•C•T•M.f/: PropertyAddress: m Review Checklist Checklist # 2 1oo0 33 A t (Additional Items to be included'with Checklist 41 when Article III is trtgered.') ° "�'°" B10 REQUIRED PLAN INFORMATION AND IMPLEMENTATION DETAILS: I i I t Plan Sheet Does the SWPPP Ad 'uate Provide for andfor indicate the Following:) 1 YES, NO ,N.A. Explanation for NO or NA.Must be Approved by SMO , .. I Location(pg.#) oes e n Indicateandlor show all Iterns-Required_y_____ st___y n this Packet 2. Does the Plan Indicate andfor Showa Descrlptton of Each Post-Construction Stom�water _ . r _.Mag-ement Practice 7 - -------------------------------------- - _, 1 I ___ _ _---------------------- 3. Does the Site PhWConstruction Drawing(s)Indicate and/or Show the Location&Size of Each Post-Cortetruc#gg St"-water M ement PracUca 7 4. Does the Site Plsn/Conakuction Drewing(s)Indicate and/or Show Hydrologic&Hydraulic Analysis; [�, For All Structural Components of the Stormwater Management SZr I rn for Applicable Storms 7 Q Q 1 5. Does the Site Ai Consbvction Drawings)Indicate and/or Provide a Comparison of-50 it. Development Stormwater Runoff Conditions with Pre-Davelopment Conditions 7 -------------- --------- ---------------- -------------- 6. Does the Site PIan/Construction Drewingirs)Indicate and/or Show All Dimensions,Material ' ' ' ------- Specifications&Installation Details for Each Post-Construction Stormwater Practice? p Q� _.. oesth------------------------------------------------ -- --- - 1 I 1 ------_-_----------------------_-- __..... ... 7. Does the Site PlanfConstructlon Grawing(s)indicate a Maintenance Schedule Provided by � 1 1 the Constractor(s)to Ensure Continuous&Effective Operation of Each Post-Construction Stormwater Management Practice? 8. Does the Site Plan/Construction Drawing(a)Indicate and/or Show Maintenance Easements to Ensure Access to AN Stormwater Management Practices at the Site for the Purpose of Inspection Q l� -- and Repair7----------------------------------------- --_ -- =� r----------- ---------- 9. Does the 31te A;W( :TRWction Drawing(s)Indicate and/or Sltow Inspection and Maintenance Agreements) that are Binding nn Ali Subsequent Landowners 7 .__.._._-.__--------------- --------------_-•• ._.. I L---__-___--__-.----_-_ 10. For A Activities meeting the Threshold in 238,1 g(B)(1),the SWPPP shall be Prepared&Slgned By a Professional In the Principles end Practices of.Stormweter Management&Treatment Who ___ Who Shall Certffy_thud he Design Moats the Requirements of Chapter 236_____________ _ i i i I 1 1 CZ A4Does tete 15W Indicate and/or Identl�y All Potential Sources of Pollution which may affect the , , , , Qualltyr oT aWmW stet Dh-d-W-jas 1 ' Does the Plan Provide Documentation Supporting the Determination of Approval with Regard ------------------------------------------- U.- to Historic Places or Archeological Resources that Includes the Following•.______________ Q i i ------------- --- i i --------------------------------------------- Information whether the stormwater discharge or land development activities would have -''--' an effect on a property that is listed or eligible for listing or eligible for listing on theftM The Results isterofWlgforicreenL� - -- --- e- -d4 •j--+Q�Q ------------- _ Plac b. The Results of H Resources Screenin Determinations that have ben Con vied I i I ----- ------ -------- --------•-------- -- --� I I ---------------------------------------------- ------- ----c. Dasc9Kc7n Of Measurers Necessary to Avoid or Minimize Adverse Impacts on Places Listed, or EU,glble for LlaNrtg�on the State or National Register of Historic Places;and________-i i i i`------'`------- -�-_ft,_S ------------------------- .- d. Where Adverao Effects May Ocair,My Written Agreements in Piave with the NYS Office of Parks,Recreation and Historic Places(OPRHP)or other Govemmental Agency to Q Q ] Mlysate Those Effects. ---ADptl --- ---- --------- W.-------------------------------- , 1 I r--------------------- A Descxiption of tete SoN(s)Present at the Site,Indudtng an Identification of the ,�Q,�, Hydreullc Soil-t3Youp. I I I I -- -------------------------------------------- - , 1 1 � --------- 14. IdenUflcstlon of My Elements of the Design that are not in Conformance with the '------- Design manual,Including Reasons for the Deviation or.Alternative Design and a Description of the Egulvslenty Witt1-todutical Standards.---_ i 15. A Hydrologic and Hydraulic Analysis for All Structural Components of the ' ' r-------------------------'----- Stormwater ManagementControl System_ _ _ - ---___-_' ' ' ' ______-__------------------ '16. A Detailiad-3Untrnary,war Cetcul ys__,of the Sizing Criterls that was Used to Oesign 1 Q1 1=1 i All Post-Constructlon8Eoq terManaQementPnadtoss. -- --_--------- I I ---------------------- --------- - - 1 1 1 1 17. �irt Opsraat>Tona and iNakttertance PIaul�hat . e; lespection and Aylaintenanca - ' ' r- ___ ------ Schedules and Action Jo Ensure Continuous and Effective Operation of Each Post-Consbuctton Storm Water management Practice. ' Storm.Watler Managesnont Control Plan Chealdlst#2: 03-12 Town Hall Annex 54375 Main Road Telephone())631)78g65--11802 P.O.Box 117roger.richertt tOWHN 76..tfi% .Southold,NY 11971-0959 � l� ny Us BUILDING DEPARTMENT TOWN OF SOUTHOLD APPLICATION FOR ELECTRICAL INSPECTION REQUESTED BY. Date: Company Name: �,5 .�T. E I-earn Ic Name: EA kIk11, License No.: 2 q4j 14e Address: Phone No.: &31- 5*-Oyoo JOBSITE INFORMATION: (*Indicates required information) *Name: °! �Q61e0(C 14KU 5 *Address: 11 S �*Siwjm *Cross Street: Qenr�J Le '2 I�Q *Phone No.: 8 Permit No.: 1 Tax Map District: 1000 Section. 33 Block. Lot: r *BRIEF DESCRIPTION OF WORK(Please Print Clearly) VSw„M,Ng P, (Please Circle All That Apply) � *Is.job ready for inspection: YES NO To you need a Temp Certificate: Rough In Final YES/ NO Temp'Information (If needed) i *Service Size: 1 Phase 3Phase 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 82-Request for Inspection Form -,� - TOWN OF SOUTHOLD PROPERTY RECORD CARD - OWNER STREET —7 VILLAGE DIST. SUB. LOTZI or �-���✓a ela��o� kl� s �s Twp 1� L � ,�� �l_ i :� f �� ,�� � � �F �,O ME OWN R N E E ACR. `1 S W TYPE OF BUILDING RES. C SEAS. VL. FARM COMM. CB. MICS. Mkt. Value LAND IMP. TOTAL DATE REMARKS / /1° �� ..- a /9SC -31 I12 t: rLIZO AGE BUILDING CONDITION NEW NORMAL BELOW ABOVE FARM Acre Value Per Value Acre Tillable FRONTAGE ON WATER Woodland FRONTAGE ON ROAD Meadowland DEPTH House Plot BULKHEAD Total ^ i i DOCK COLOR TRIM M-9- 9E-� X Al 13 Extension Extension if �i■■�■ ■■■■ ■moi■■■■■■■■ • ■ ■■■■■ r.�■e■■■■■■■■■■ Extension Foundation Bath �■ Basement .. Porch Ext. WallsK.V ■ Fire Place Rooms Ist Floor •. . . . cre ation .. . .. 0. B. �Dor Driveway - Total �� i ��•��p� COMPLY WITH ALL CODES OF OG NEW YORK STATE & TOWN CODES 00 AS" AS REQUIRED AND CONDITIONS OF `*OS GO ;,�a �` SOUTHOLD TO'v"dN SEA O SOUTHOLD TOWN PLANNING BOARD SOU T HOLD TOWN TRUSTEES N ( N.Y.S.DEC • 3,� -1..—r�o ,to Femu 'LECTRICAL 5 z�. PkJ�Y D X Q 00t N • � cl G1B.Za l" �Lo.'T U� d Q 0 U( --'70 OCCU 1ANCY OR USE 1S UNLMNFUL APPROVrM A9 NOTED VV!TH0UT C E F":..l..MFli` ; DATE: / ez �0���6�A���.`F, _l� NOTIFY BUit G 'i'u MF-NT AT 765-1802 8 AMI "Il h OR THE � � K � FOLLOWING I^�'SP���;�iu`?�� cq U �N 1. FOUNDATION' l4`;�� ti�::�;�UiF;ED Q� FOR POURED ROU H - FR, I'.`li l�� '* ► :'.�►0 ��� L I I0f J M1!ST LAW "�i"`r • BE COMPLETE --r• 4=0=2 jr CONSTRUL.T ION SHALL MF THE R QUIREMENTS OF Tk=* . NOT RESPONSIBLE FOR 1.J��C►L..�y,�. Crr�. -- r.gg ►V.OR CONS GEoCsa.carc.i.t�e ..�.c+n-.1G�� GEoczG.a.rGL..LS oc�. ,v•�s�a,�•s � .�'...��� ,..r� "'� t�"JQ' Y.-.lam•/ � ppip�C��"1!� — r��/� ,o. �Ca-sC L193 .._�r-�o G.�1,.._I.�Q-s-r� �-.-►.-•/ . °.�y04- S�'.Sn �G JkMf+F �y'�` r•.:�f ���� �—\ �' Jf•' ..a IV4{fJi. Nth��pp�.��•i 6 eitl�.��.,.I� J..;?��ttC.��rl'y 5.4ky. ♦ \ Jt �!// l�K k'. . �£,ti. 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Suffolk County Executives Office of Consumer Affairs VETERANS MEMORIAL HIGHWAY * HAUPPAUGE, NEW YORK 11788 -F . h DATE ISSUED: 5/1/80 No. 2740-ME SUFFOLK COUNTY f Master Electrician License -- This is to certify that EDWARD S REIFF l doing business as UNDERGROUND SPECIALTIES INC having given satisfactory evidence of competency, is hereby licensed as MASTER ELECTRICIAN in ON accordance with and subject to the provisions of applicable laws, rules and regulations of .Y the County of Suffolk, State of New York. 4' SUFFOLK 0"4�DEPARTMENT I F CON kf;F Additional Businesses MASTER El ECS -RV' is Cbl{�xG�?sCtA�._`l �:.:%►+� � �j'-}! cm�Of Suftik: 2 '40- 1 5 X i 2 $uwewrNwr d t+ raIgrr# 1120 i+4 ti..r f 1 ..�\ r �`. r� > t<ft`\�r�,�ry�a:�. � }'�}.Pm s ! 4,}���r'u4aa�p/'�tq;� �+ f` .,fin :r'� s,', % lL ,_ � �'& t,••� �e '3'�L i�, At—M-11 AM Suffolk County Executive s Office of Consumer Affairs VETERANS MEMORIAL HIGHWAY * HAUPPAUGE, NEW YORK 11788 DATE ISSUED: 7/1/78 No. 4436-H SUFFOLK COUNTY s HOD 2t3 hnprove-inept Contractor License This is to certify that ARTHUR J EDWARDS _ doing business as ARTHUR EDWARDS MASON CONTRACTING INC ` La\l lz ffinlishe'4 +tee I-ec vzi-cements set:l'oi•t'i in accordance Witt, and subject to the provisions of applicable laws, rzlcs axe ig r. tiolls of the County of Suf{alk, State of New York is hereby licensed to conduct business as a HOME IMPROVEMENT CONTRACTOR, in the County of Suffolk. SUFFOLK COUNTY DEPARTMENT Additional Businesses . s OF CONSUMER AFFAIRS HOMEIMPROVEMENT CONTRACTOR LICENSE ; :....., NAME ". ARTHUR J EDWARDS This certifies that the 9UBNE3BNAME ARTHUR EDWARDMASON bearer IS duly CONTRACTING INC DBA # . licensed by the County of Suffolk --- -------- ,---~ —-------� 4436-H 07/01/1978 Director `s c. i..mmm I exnnAnaN ogre 07/01/2014 i 'QFyrr4��.��v�h'r�M«� � ,,,,� '�r� r a�. ' : � �'do v, �� x`�b�r � " �°, ":.� e. ;;�'a •SyyA '�s ��f�� � 'i J�emw,. �. ,N .'�,r � F�� , a'fit �`• <�,�.`�' ��. s3- �;� '�!� A Rau I> BC DE F B F To FlRer nftr dc" <—/ To Wt. —To Rb.. Oky"OOL-4 RoN�d WaN Fam Plan A Piping Arrangement SOCUM /µRtbm 42" r. Section B—B r PJU Car"•b x 10" Section A-A Typical Wall Section SIZE A B C D E F G H AREA CAP. FEET FT. FT. FT. FT. FT. FT. FT. FT. SQJ7. GAL. 16X32' 16' 32' 8' 14' 6' 4' 4' 8' 512 19,000 16'X.34' 16' 34' 10' 14' 6' 4' 4' 8' 576 21,600 LPOOL SL SPA CENTRE Oddi°°' PERMACRETE WALL SYSTEM sesta 18'X36' 18' 36' 12' 14' 6' 4' 5' 8' 648 24,300 929 Route 25A Miller Place NY 11764 ( ) 20'X40' 20' 40' 16' 14' 6' 4' 6' 8' 800 30,000 (631) 744-7185 FAX (631) 744-0174 Pbme 9X44' 24' 44' 18' 14' 6' 4' 6' 10' 7% 30,000 Suffolk License #4436—M 24'X48' 24' 4 20' 16' 6' 4' 6' 10' 900 30,000 Nassau License #HI7445OOOO