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HomeMy WebLinkAbout39051-Z guffOt� ? Town of Southold Annex 9/15/2014 c P.O.Box 1179 d " 54375 Main Road Southold,New York 11971 CERTIFICATE OF OCCUPANCY No: 37062 Date: 9/15/2014 THIS CERTIFIES that the building IN GROUND POOL Location of Property: 2950 Camp Mineola Rd,Mattituck, SCTM#: 473889 Sec/Block/Lot: 123.-5-5 Subdivision: Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this officed dated 7/15/2014 pursuant to which Building Permit No. 39051 dated 7/24/2014 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: "AS BUILT"IN-GROUND SWIMMING POOL,FENCED TO CODE AS APPLIED FOR The certificate is issued to Laguardia, Susan&others (OWNER) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL ELECTRICAL CERTIFICATE NO. 39051 07-29-2014 PLUMBERS CERTIFICATION DATED Aut ed ignature =f "' TOWN OF SOUTHOLD N BUILDING DEPARTMENT TOWN CLERK'S OFFICE �'� • {.4` 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#: 39051 Date: 7/24/2014 Permission is hereby granted to: Laguardia, Susan & others 2950 Camp Mineola Rd Mattituck, NY 11952 To: construction of an "as built" in round swimming g pool, fenced to code At premises located at: 2950 Camp Mineola Rd, Mattituck SCTM # 473889 Sec/Block/Lot# 123.-5-5 Pursuant to application dated 7/15/2014 and approved by the Building Inspector. To expire on 1/23/2016. Fees: AS BUILT - SWIMMING POOL $500.00 CO - SWIMMING POOL $50.00 ELECTRIC $100.00 Total: $650.00 Building Inspector 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 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 I%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. New Construction: Old or Pre-existing Building: (check one) Location of Property: 0??-1"6 e,4MIO to I /_� . /) %7 11 TICK House No. Street Hamlet Owner or Owners of Property: -'S.&5,+&j 6&4A- 74i"✓d Suffolk County Tax Map No 1000, Section I a 3 Block Lot Subdivision Filed Map. Lot: Permit No. Date of Permit. Applicant: Health Dept.Approval: Underwriters Approval: Planning Board Approval: Request for: Temporary Certificate Final Certificate: (check one) Fee Submitted: $ / Applicant Sign u SOUlyol 0 Town Hall Annex Telephone(631)765-1802 54375 Main Road N Fax(631)765-9502 P.O.Box 1179 G �Q roger.riche rt(cD-town.southoId.ny.us Southold,NY 11971-0959 'OlyCOUNTY,� BUILDING DEPARTMENT TOWN OF SOUTHOLD CERTIFICATE OF ELECTRICIAL COMPLIANCE SITE LOCATION Issued To: Susan LaGuardia Address: 2950 Camp Mineola Rd City: Mattituck St: NY Zip: 11952 Building Permit#: Section: 123 Block: 5 Lot: 5 WAS EXAMINED AND FOUND TO BE IN COMPLIANCE WITH THE NATIONAL ELECTRIC CODE Contractor: as built DBA: License No: 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 Duplec Recpt 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 Transformer Appliances Dryer Recpt Emergency FixtureTime Clocks Disconnect Switches Twist Lock Exit Fixtures TVSS Other Equipment: AS BUILT in ground swimming pool to include, bonding, 1-single use recpticle (pui DEFECTS REMOVED----------re-bonded Notes: Inspector Signature: Date: July 29 2014 81-Cert Electrical Compliance Form.xls SOUTy�� TOWN OF SOUTHOLD BUILDING DEPT. fhbti\ 765-1802 INSPECTION [ ] FOUNDATION 1 ST [ ] ROUGH PLUMBING [ ] FOUNDATION 2ND [ ] INSULATION [ ] FRAMING /STRAPPING [ ] FINAL [ ] FIREPLACE & CHIMNEY [ ] FIRE SAFETY INSPECTION [ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRATION [ ] ELECTRICAL (ROUGH) ELECTRICAL (FINAL) [ ] CODE VIOLATION [ ] CAULKING REMARKS: 14/ `)�) � DATE ? 1 INSPECTOR i TOWN OF SOUTNOLD BUILDING DEPT. 765-1802 INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLUMBING [ ] FOUNDATION 2ND [ ] "ULATION j [ ] FRAMING /STRAPPING [? FINAL P Fu�� .1 [ J FIREPLACE & CHIMNEY [ ] FIRE SAFETY INSPECTION [ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRATION [ ] ELECTRICAL (ROUGH) [ ] ELECTRICAL (FINAL) [ ] CODE VIQ�►T REMARKS:v ION [ ] CAULKING 652� < � zK DATE � INSPECTOR TOWN OF SOUTHOLD BUILDING DEPT. 765-1802 INSPECTI" I FOUNDATION IST R GH PLUMBING FOUNDATION 2ND SULATION FRAMING /STRAPPING FINAL FIREPLACE & CHIMNEY FIRE SAFETY INSPECTION FIRE RESISlANT CONSTRUCTION FIRE RESISTANT PENETRATION ELECTRICAL (ROUGH) ELECTRICAL (FINAL) CODE VIOLATION CAULKING REMARKS: (/0 A DATE INSPECTOR r t i o • " COMEWTS IMULATION PER N.Y. STATE ENERGY br •.��i�rlY�i��iA�ir1ie11e.1�E�li �� ��� lei, i ` .o 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 4 sets of Building Plans TEL: (631) 765-1802 Planning Board approval FAX: (631) 765-9502 Survey SoutholdTown.NorthFork.net PERMIT NO. 3y �s� Check Septic Form N.Y.S.D.E.C. Trustees C.O.Application Flood Permit Examined o� 20 Single&Separate Storm-Water Assessment Form Contact: Approved 20 Mail to: Disapproved a/c Phone29 i_ ��� Expiration � ,20 pil) �7 i� 0 " Building Inspector APPLICATION FOR BUILDING PERMIT tI JUL 14 2014 Date , 20 INSTRUCTIONS Tr! a. This application MUST be completely filled in by typewriter or in ink and submitted to the Building Inspector with 4 sets of plans, accurate plot plan to scale.Fee according to schedule. b. 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. /,Z (Signature of app scant or name,if a corporation) ATELY EN{„-t , = +"'OOL TO CODE i i address of ap If can i i 9s Z ,OMPLETION DIED AS NOTED v ePt1 eRE UYATET State r applicant is owner, lessee, agent, architect, engineer, general contractor elec i ian, plumber or builder DATE ,-- B.P. 4i5.— NOTIFY 1ILDING DEPARTMENT AT Name of owner of premises �a �'btQl d(GL, ot%(BABO91rTTm 4 PM FOR THF (As on the tax roll or lJMltld�MNG INSPECTIONS: If applicant is a corporation, signature of duly authorized officer 1. FOUNDATION-TWO REQUIRED FOR POURED CONCRETE ROUGH-FRAMING,PLUMBING, (Name and title of corporate officer) 2. STRAPPING, ELECTRICAL&CAULKING Builders License No. 3. INSULATION Plumbers License No. 7 - 4. FINAL-CONSTRUCTION &ELECTRICAL Electricians License No. MUST BE COMPLETE FOR C.O. Other Trade's License No. ALL CONSTRUCTION SHALL MEET THE REQUIREMENTS OF THE CODES OF NEW 1. Location of land on which proposed work will be done: YORK STATE. NOT RESPONSIBLE FOR _,,,Zqn-U nom P m fel aOtA Rt T- Tkc I,(—DESIGN OR CONSTRUCTION ERRORS. House Number Street Hamlet County Tax Map No. 1000 Section 3 Block S Lot 5' Subdivision Filed Map No. Lot 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy b. Intended use and occupancy 3. Nature of work(check which applicable): New Building Addition Alteration Repair Removal Demolition Other Work (Description) 4. Estimated Cost 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 Depth 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 Rear 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?YES NO 13. Will lot be re-graded? YES NO Will excess fill be removed from premises?YES NO 14. Names of Owner of premises Address Phone No. Name of Architect Address Phone No Name of Contractor Address Phone No. 15 a. Is this property within 100 feet of a tidal wetland or a freshwater wetland? *YES NO * IF YES, SOUTHOLD TOWN TRUSTEES & D.E.C. PERMITS MAY BE REQUIRED. b. Is this property within 300 feet of a tidal wetland? * YES NO * IF YES, D.E.C. PERMITS MAY BE REQUIRED. 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: COUNTY OF ) being duly sworn,deposes and says that(s)he is the applicant (Name of individual signing contract)above named, CONNIE D.BUNCH (S)He is the Notary Public,State of Ncew York (Contractor,Agent, Corporate Officer, etc.) . #---. Qualified in Suffolk Col 2r,i 1 Commission Expires April J y 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 knowle ge and belief; and that the work will be performed in the manner set forth in the application filed therewith. S orn to before me this day of 20 ` Notary Public Signature of Applicant Scott A. Russell ,�a°� � S�C'0jPLMWA_T1E1K SUPERVISOR MA_NA(G 1E 1EN`]F (x SOUTHOLD TOWN HALL-P.O.Box 1179 `r Town of So u tho l d 53095 Main Road-SOUTHOLD,NEW YORK 11971 CHAPTER 236 - STORMWATER MANAGEMENT-'WORK SHEET ( TO BE COMPLETED BY THE APPLICANT) DOES THIS PROJECT INVOLVE ANY OF THE FOLLOWING: Yes No (CHECK ALL THAT APPLY) F� A. Clearing, grubbing, grading or.tripping of land which affects more than 5,000 square feet of ground surface. F1 B. Excavation or filling involving more than 200 cubic yards of material within any parcel or any contiguous area. D C. Site preparation on slopes which exceed 10 feet vertical rise to { ©Qj100 feet of horizontal distance. D. Site preparation within 100 feet of wetlands, beach, bluff or coastal erosion hazard area. ! 0 E. Site preparation within the •one-hundred-year f loodplain as depicted } j on FIRM Map of any watercourse. ❑0 F. Installation of new -or resurfaced impervious surfaces of 1,000 square t . feet or more, unless prior approval of a Stormwater Management Control Plan was received by the Town and the proposal includes in-kind replacement of impervious surfaces. If you answered NO to all of the questions above, STOP! Complete the Applicant section below with your Name, Signature, Contact Information, Date & County Tax Map Number! Chapter 236 does not apply to your project. If you answered YES to one or more of the above, please submit Two copies of a Stormwater Management Control Plan and a completed Cbeck List Form to the Building"Department with your Building Permit Application. -- _------- _ —----------- --- -- Date APPLICANT: (Property owner,Design Professional,Agent,Contractor,Other) S.C.T.M. District 000 NAME Section Block Lot FOR BUILDING DEPARTINIENT USE ONLY Contact Infornwiion, G �- a 9Jy- rr<Icphw,Numb<d ♦ " —r Reviewed By: Date- Property ateProperty Address/ Location of Construction Work: — — — — — — — — — — — — — — — — ® Approved for processing Building Permit. Stormwater Management Control Plan Not Required. Stormwater Management Control Plan is Required. (Forward to Engineering Department for Review.) FORM ' SMCP-TOS MAY 2014 I of SO{/T�o Town Hall Annex �O �O ! 1rt Telephone(631)765-1802 (> 54375 Main Road y (631)765993UU22 P.O.Box 1179 Q roger.richert 'o`wn.soutllold ny us I Southold,NY 11971-0959 �O BUILDING DEPARTMENT TOWN OF SOUTHOLD i APPLICATION FOR ELECTRICAL INSPECTION REQUESTED BY- � C rot Date: Company Name: ! Name: License No.: Address: Phone No.: JOBSITE INFORMATION: (*Indicates required information) *Name: t . *Address: V *Cross Street: kJ gg Q *Phone No.: Permit No.: Tax-Map District: 1000 Section: t! Block: ' Lot: *BRIEF DESCRIPTION OF WORK(Please Print Clearly) ! (Please Circle All That Apply) Is job ready for inspection: YES NO. Rough In Final *Do-you need a Temp Certificate: YES! NO I Temp Information(if needed) } *Service Size: 1 Phase 3Phase 100 150 200 300 350 400 Other I . *New Service: Re-connect Underground Number of Meters Change of Service Overhead Additional Information: PAYMENT DUE WITH APPLICATION 82-Request for Inspection Form ft q tiD zz AOL- 16e�it'.nOE �� - - -z____ r ��. unnuthoozed alwadon or adddoo to this sumy Is a vtota400 of 0 13f AN Seetbn 7208 d M NOW y0l*She y eaueafa+utw Q togp LAIVO e4 coptas '] of rra suMry tttep^�b+*� P 9 she lewd w+wyon 1 attl a ad6%aiiw _z/ ,� / � .,G emboessd oeel ehd trot bit aorteblrtaa `�i T 1 9 !1n1INNe tndC'abt t1{•t1 t�ftlR S �N ^""`-//�i/ '�`l to the Dam tot rtf+orn tlta strvay N { V4 \� V N ' �( _ �C r ccoa+ed,and on No OMaaM b M uuo=pont goYanMlNrtrl apanoy llAd �1 N ,._. ` to a Aialvo" to wWldwW hack Mor s tawtF �jbcfii9/'e` 3 Q g B, owner, .G//�•3�"'rV C50 • *J` lccriav-�u„� rrry 0WAv a x.v �'o✓�,er��,��,�L (,Z91��.4c'TdBF..2 J Zfa4/ �C�C�'•i"-30' C �Yl��/ODt�'fC� �D -G+ �''�lO.�/G.�14.t/•�AU.L/v