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HomeMy WebLinkAbout37254-Z FG1Town of Southold Annex � � 10/31/2014 P.O.Box 1179 54375 Main Road "+ Southold,New York 11971 CERTIFICATE OF OCCUPANCY No: 37246 Date: 10/31/2014 THIS CERTIFIES that the building IN GROUND POOL Location of Property: 4583 Wickham Ave, Mattituck, SCTM#: 473889 Sec/Block/Lot: 107.4-6 Subdivision: Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this officed dated 5/18/2012 pursuant to which Building Permit No. 37254 dated 5/29/2012 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 SWIMMING POOL FENCED TO CODE AS APPLIED FOR The certificate is issued to Tchebotarev I Supp Needs Trt (OWNER) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL ELECTRICAL CERTIFICATE NO. 37254 10-27-2014 PLUMBERS CERTIFICATION DATED A riz Signature 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 #: 37254 Date: 5/29/2012 Permission is hereby granted to: Tchebotarev I Supp Needs Trt 4583 Wickham Ave Mattituck, NY 11952 To: construct an inground swimming pool, fenced to code as applied for At premises located at: 4583 Wickham Ave, Mattituck SCTM # 473889 Sec/Block/Lot# 107.-4-6 Pursuant to application dated 5/18/2012 and approved by the Building Inspector. To expire on 11/28/2013. Fees: SWIMMING POOLS - IN-GROUND WITH FENCE ENCLOSURE $250.00 CO - SWIMMING POOL $50.00 Total: $300.00 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 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$25.00,Additions to dwelling$25.00,Alterations to dwelling$25.00, Swimming pool$25.00,Accessory building$25.00,Additions to accessory building$25.00,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$15.00 Date. New Construction: Old or Pre-existing Building: (check one) [�� Location of Property: k (f(�,( A,� Mall HUL" House No. Street Hamlet Owner or Owners of Property: Suffolk County Tax Map No 1000,Section 117_7 Block '� Lot Subdivision Filed Map. Lot: Permit No. Date of Permit. Applicant: Health Dept.Approval: Underwriters Approval: Planning Board Approval: Request for: Temporary Certificate Final Certificate: (check one) Fee Submitted:$ Applicant S' ature *pF SO!/ryolo Town Hall Annex Telephone(631)765-1802 54375 Main Road Fax(631)765-9502 P.O.Box 1179 G roger.riche rt(D-town.southoId.ny.us Southold,NY 11971-0959 '00UNTY,� BUILDING DEPARTMENT TOWN OF SOUTHOLD CERTIFICATE OF ELECTRICIAL COMPLIANCE SITE LOCATION Issued To: Tchebotarev Address: 4583 Wickham Ave City: Mattituck St: NY Zip: 11952 Building Permit#: 37254 Section: 107 Block: 4 Lot: 6 WAS EXAMINED AND FOUND TO BE IN COMPLIANCE WITH THE NATIONAL ELECTRIC CODE Contractor: as built DBA: Lunas Electric 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 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 1 Transformer Appliances Dryer Recpt Emergency FixtureSH Time Clocks Disconnect Switches 1 Twist Lock Exit Fixtures TVSS Other Equipment: in ground swimming pool to include, bonding, 2-pool lights, 1-chlorine generator, 1-GFCI circuit breaker Notes: Inspector Signature: Date: Oct 27 2014 81-Cert Electrical Compliance Form.xls i ho��OF SOUry�lo TOWN OF SOUTHOLD BUILDING DEPT. 765-1802 INSPECTIO" [ ] FOUNDATION IST [ ] ROU PLUMBING [ ] FOUNDATION 2ND [ ] 1 ULATION [ ] FRAMING / STRAPPING [ FINAL [ ] FIREPLACE & CHIMNEY [ ] FIRE SAFETY INSPECTION [ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRATION [ ] ELECTRICAL (ROUGH) [ ] ELECTRICAL (FINAL) [ ] CODE VIOLATION [ ] CAULKING REMARKS: DATE INSPECTOR i SOF SOUlyo TOWN OF SOUTHOLD BUILDING DEPT. 765-1802 INSPECTION [ ] FOUNDATION 1ST [ ] R UGH PLUMBING [ ] FOUNDATION 2ND [ ] SULATION [ ] FRAMING / STRAPPING ] FINAL [ ] FIREPLACE A CHIMNEY [ ] FIRE SAFETY INSPECTION [ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRATION [ ] ELECTRICAL (ROUGH) [ ] ELECTRICAL (FINAL) [ ] CODE VIOLATION [ ] CAULKING REMARKS: DATE INSPECTOR i SOUjy�lo ewp, ` V Uc TOWN OF SOUTHOLD BUILDING DEPT 765-1802 1li� INSPECTION [ ] FOUNDATION 1 ST [ ] ROUGH PLUMBING [ ] FOUNDATION 2ND [ ] INSULATION [ ] FRAMING /STRAPPING [ ] FINAL [ ] FIREPLACE A CHIMNEY [ ] FIRE SAFETY INSPECTION [ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRATION [ ] ELECTRICAL (ROUGH) ELECTRICAL (FINAL) [ ] CODE VIOLATION [ ] CAULKING �I REMARKS: DATE d' Z' INSPECTOR FIELD REPORT DATE COmmpI TS � t•� FOUNDATION(1ST) FOUNDATION(2ND) rA z ROUGH FRANDNQ& PLUMBING t-. INSULATION PER N.Y. STATE ENERGY CODE 4 \« R FINAL ADDITIONAL COMMENTS ( t1 r _ c-' � y b TOWN OF 56UTHOLD 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 SeuthvWTown.NorthFork.net PERMIT NO. Check Septic Form N.Y.S.D.E.C. Trustees (� Flood Permit EExamined 20 �� D E LS Storm-Water Assessment Form Contact: Approved 20J� M�� $ ?Q�2 Mail to: Disapproved a/c BLDG.DEPT. Phone: ,- )1 TOWN OF SOUTHOLD Expiration 20­15 Building Inspector APPLICATION FOR BUILDING PERMIT Date , 20 INSTRUCTIONS 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. ANC AU hp. rl-IJAQ-) it 'S U N LAS+ Signature of a icant or n ,i a o tion) 'IAIl IEDIATELY"P ENCLOSE POOL TO CODE UPON COMPLETION '1T �' L� �P�►\/1 Q . l�S14 M i G LQ BEFORE VATS . '� (Mailing address of applicant) rf. .� � .. ! GCUA ,�C �P � ice , tiCi tot State whether applicant is owner, lessee, agent, architect, engineer, general con r or builder (i IS 2- Z A s Name of owner of premisesAJrK&rJe-j2Q /FEE:- J jV BY (As on the tax roll or W WDING DEPARTMENT AT If applicant is a corpora�iq signature of dul authorized officer 765-1802 8 AM TO 4 PM FOR THE II�`JJ �EC'�"���/,�� FOLLOWING INSPECTIONS: 1. FOUNDATION-TIM REQUIRED (Name and title of corporat4kSRK ION REQ( ED FOR POURED CONCRETE 2. ROUGH-FRAMING,PLUMBING, Builders License No. Tb) STRAPPING,ELECTRICAL 8 CAULKING Plumbers License No. TZ b 3. INSULATION 4. FINAL-CONSTRUCTION 8 ELECTRICAL Electricians License No. - 61) MUST BE COMPLETE FOR C.O. Other Trade's License No. ALL CONSTRUCTION SWILL MEET THE REQUIREMENTS OF THE CODES OF NEW 1. Locaji§r of land on w 'ch proposed wor will be done: YORK STATE. NOT RESPO"SWLE FOR ,� � l04 Lv- Mk ffim"Tr!TT EIIOR$. House Number Street �Hamlet County Tax Map No. 1000 Section (p-7 Block `-1 Lot i t 2. State existing use and occupancy of premises and ' nded use and occupancy of proposed construction: a. Existing use and occupancy t_q b. Intended use and_gecupancy h�c� 0 B 1 P La 1k-��T V1, 11'L�1�Oi YN� L 3. Nature-of work(check which applicable):New Building Addition Alteration Repair Removal Demolition Other Work�y 2p�(_ (Description) 4. Estimated Cost Fee c')b,y p (To be paid on filing this application) 5. If dwelling,number of dwelling units JU c,- Number of dwelling units on each floor C�-- If garage, number of cars JL ) cam___ 6. If business,commercial or mixed occupancy, specify nature and extent of each type of use. Yl —_ 7. Dimensions of existing structures, if any: Front f Lo Rear Len Depth 52 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 1�1D, bQ Depth 073,7S 10. Date of Purchase Name of Former Owner 11. Zone or use district in which premises are situated 12. Does pronosed construction violate qny zoning law, ordinance or regulation?YES NO ✓ C 6u d` 1266C- CA- \l 13. Will lot re-graded? YES NO "Will excess fill be removed from preses?YES NO w"/t/el(andre. WP(NaJ-►tuck,7u-( 1 i R sZ 14.Names of Owner of premises TC}}cbnrA0Ey Address451dM Phone No. - -/ o Name of Architect Address 2 k.)inAyja-.e 4 L Phone No Loa -'S Name of Contractor il, Tbb Address ` hone 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�p 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 IQ(% )`{6)' SS: COUNTY S- OF ___j ac.� c� c-ot ✓cz being duly sworn,deposes and says that(s)he is the applicant (Name of individual signing contract)abave named, (S)He is the -Ae— mk Q. (Contractor,Agent,Corporate Officer,etc.) ����e111111/B��i of said owner or owners,and is duly authorized to per*N qr hate v the said work and to make and file this application; that all statements contained in this application are t>� a best of his�t�dge and belief;and that the work will be performed in the manner set forth in the applicatioW therew' Sworn to before me this day of 1 201 'OUB00 N Publ�%At)4 -,O j- COU ` Signature of plicant ,00ArS 0AJ V. Town of Southold - Chapter 236 - Stormwater Management SWPPP - Storm Water Pollution Prevention Plan Assessment Form GENERAL INFO ON: (All Requested Information is Required for a Complete Application) APPLICANT MAME: osmr Agent ultard-contractor or ower(CIS on•) Propnly OWMER:pF DEfin d than Applles" T e R-- I ras: Terphon•Ee��_ _ Fasfk (l reefs Faxfk i . E-NoM Properly Address: `eydilim --e Brief Daervuon of Cwstrocuon Achway,Proposed structural BMP+,Soil f S C T M.m 1900 SMbaliabon BMPe,Prmed Scope and/or Sequence of Conetruchon Aarv3q, trrra a.e�Ym �ieai tee '�"1 I (WAddend Pap..se l l h4nr•of Conbodor andbr Contact Person Responsble for Imprrrwltaaon of SWPPP: drs•e: l.Y�,A..L43---P1dJ...._�����Y_1_ c�Ql.�3;!??�l.I i. orphan. a#: E-Mali: P Nuns d Pom ReepooWbb for rstdraon&Mpintarrnce dr,gd, Cannot ARMAGs Tbb AdWon, ---�04t_•--------------------------- F=* --------------------------- asm _------ ! E-MNI: Told Area of a ��/d 1 Total Area of Land C loodng ProlectParodx endforGfouodDiMutmnee P-------_--- (eF.llmaa) (SAIAa ) ProAetCuradon: R V rata +-----_ - ---__ (Alttlep rd) �� [&L - Wig this PmJect Disturbs We(5)or Mom Acres at Q Any One Time During the Proposed Dwdognent? Yes No �j�� - ---'e-\ -----/-�f-C----+----' - NYIW Prsee Anter me Foaoodnal Y ds- 4b 13-1-OL _! a. Does the Applicant have a QualMed Inspector On Q 2: LAAr Staff To Conduct the Requited kleperdions? Q No b. Does the SWPPP Indicate How Frequently the Site Q I.tet the``wWEs or eaatpson of ell P•anady lnpoeed warrbodra amtlar w�esnds Inspections will Occur and for What Period of Time? Yes No _1l/ Q_ _IDI------------------ c. ; c. Does the SWPPP Adequately Identify All Temporary Q [� --------- -------�-- - and/or PermalterltSON Sfeb�[zatortMeas>rres? Yes o _____________________________.._..____..__..._.___..__ d. Does the SWPPP Adequately Identify a Complete Q � ----------- ! Project Phasing Plan? Yes No e. of kr*ocbd (re TOOL.>Osld►tmd,Impend ) e. Does the SWPPP Indl ate Addidwal Site Spedec Q Practices that Will beUtWzedtoProtect Water Quality? Yes Non--------.--_--._._.._...----.--___---- f. Has the Applicant Submitted a Completed DEC Notice ,ype repeetad wwruody Tea Laic.,creek cry.Pond.sound Fr•dreste.tfr sold_) Of Intent and SWPPP Acceptance Form for Review Q j by the Town ofSouthold T Yes No STAIT OF rfNV-YeW, 1,(b COUN'T'Y OF..... .ar►p..N. SS Tliat T, cll..�... Q�4AL I ang dt)y sworn,deposes and says that he/she is the applicant for Permit, of IndMdual a....g am) ..�.! . And that he/she is the ................... { ✓.. e— v .... ........................................................................................................ (Owrar.C:oneador,Agent,Corporate O(Ilcer,etc) Owner and/or representative of the Owner or Uff" yl authorized to perform or have performed the said work and to make and file this application;that all statem lication are true to the best of his knowledge and belief;and that the work will be performed in the ` in the filed herewith. j Sworn to before me this; ........................... .................day of.... ... ...a Notary Public: ........ ..r... ... = . ... .. ... .... it�L lfw ......... fsigneturea► ) SWPPP Assessment F : 03-1 ` r��',Co U N.T.( � I For Department Use Only: T.O.S. "SWPPP" Preparation - Chapter 236 S.C.T.M.* PmportyMdrs.: 5� Storm Water Pollution Prevention Plan Review Checklist Checklist # 1 1000 -&-wro-n eWZLm REQUIRED PLAN INFORMA110M AND IMPLEMENTATION DETAILS: , s i Pan Shoot YES, NO ,N.A.,Explanation for NO or N.A. Location(pg. Does the SWPPP Ad Uatel Provide for and/or indicate the Followin : , to conte a Two MW ite. ` 2 Construction PhasingPlan Indicating Se erf P Construdlon Activities �'Q' ' _........._._..._...._ _ - _.._.__._... ._._........_._..,ng As ence _....roposed des._._.._....._....._. Q� 3. General Location M 4. Dralange Site Plan brawn to Scats,at.Sixty.(601).t eetta the„Inch or larg-er Indicating the FoNorw. , _. __._ a. Location tlasori on Boundaries ®,� _.site Existin Nato and/or Man Made Features on and wNhln^50'of the P..., V Bounds , c. All IL-•--rel a roP�Y..__. ..ry;......�Com,r-71 0 h_..... d. Test Hole Data Irxflcatinp SoJI Characterlatics&Depth to Seasonal Hlgh Water 7abls 0 s 0 _.-....____. ,___.._ _._._._.._.__. e. Contours Indicator Pro Elevations Min.2'; iCM f. Spot Grade&Finish Floor Elevations for Existing and Proposed Strictures. .. u Cooatiori of WeiodedAreas S Isolated gees writ a Minimm GGtieirslon of iB Diameter; _ ..._ . ._ ... 5. Background information about the Serape eti the Project,Location&Description of the Site, 0 Proposed Changes to the Site and All Existing--�._Development...pment,on the site Including the Fdl.. i. . ��3 o s Q i _. - ..__... . .v. . _... ._ _a. All Excavation. .Fi ling,Stripping �Grading l aRS posed a n Identilled sSIRQ..hrspth,.... i�ice';m'>.E`:c`0.�(��D.� ZOK QO f�Gctil_ _ b. All Excavation,Flfftng,Stripping&Grading Proposed and Itlentifled as to depth,Volume C. AN.Areas R ulrt,_ Ciearin .andlor G..bbtn9a.... _ _......_-.---..__.__.._...,.................. &_Nature of.Mate ._..jnXQM._....... _. .........._..... _..._...-_......___ �,�� eq ng.. _ _.9 _.. _ nZ_ _-..._...._.....����ui� d. All Areas Where Topsoil is to be Removed,Stockpiled and where Topsoil will ultimately - bee! ,...-- ._ ... -_ -- . .. .... ---- ���� rel�►r�ur1S on.�k� nR� to�c.�i- to re�l� e. All Temporary&Permi nerrt Vegstatiai to be Placed on Site, 0 0 .-__ __ _....__._._._. ____.... . ._ ___.. . ........ _.._-.1 s f. All Tem &Permanent Storm Water Runoff BMP Control Measures P r , g. The Anticipated Pettem of Surface brainags During Periods of Peak Runoff; h. The Location of all Roads.Driveways,Skiswalks,patios,Structures,UtWlea Ulfier '__ ..., i _- _..-....,........_. ' -lmprosiemenfs;Yni�u�rig'�emporary/Cdese�Corisbuc�ion Sarg�rig Ar"eaat., _..__._.y.._ .._� �©��;_ . . - ....._.._-- ..... _.... C Tfis F�ls�irig�,'Firia7'Coniours and or SpatCevatrarts of tf»aNe:__ .__...... _ s ,Q,0, __ .._.. B. A Schedule of the Sequence for the Installation of All Planned Soil Erosion,Sedimentat �, r &Stormwater Runoff Control Measures. i i i I 6 �cj 7. Deson-'on Pollution Prevention Measures that will be Im lamented. `�'�'®^ S. A Description of the Minimum Erosion&Sediment Control Practices to be Installed and/or : s-11 s , Im mite ed for Each Construction Activity+that will result in Soll Disturbance-______............._, i 0 i�; �!) � �? . _.___.... ___ ... ` 9, Description of Constuctlon&Waste materials Famed to be Steed On-SHe.. 10.-Temporary-&Permanent Sal StebgttiaBon Plan that meets the Current Version of the New York State Storm Water Design Manual Technical Standard. ' +�(1✓P i(,�_ Q•„. Q. Q, Q.(�. _.M... 11. General Stte Plan end Constnsction Drawin s for the -- 12. Dimensions,,Material Specifications&Installation Details for Al Erosion&Sediment Control Practices,., ,r1 F ,___-_ Practices that will be Converted to Permanerrt control Measures. w�Firm i�� QrS-e - ..--- ------_-«_ ----------•-_,_.. - 14._Impj mentation Schedule for Staring Tamporery�F_rosion Practice or BMP._ 1S. MalntenanceSchedule to Ensure Continuous&Effective Opardon of Erosion& Sediment Control Practices. ia [ ! ., !....( USI P_.. i6.R•Names of Potential Surface Waters of the State or New Ycrk ii r MS4 that may_b-e--------i i i i • - ' ImQacedbyDevebpmenL _ ---___.___. ._ u_..n.mk �� _..,...,_,........... 17. Delineation of Storni Water Control Plan Im tementedlon Res hies for Foch of the -_._----_--_--- -__-.,2_ _ �____...._._P�,.___.__.;��0��;__ laOt��E _.i?Lll�'It�.� __........_....•....,,........_.._...._.__....._.................._... Prole!q-onstructlonSite. _ 18. AI I other Existin Datathat Describes Storm Water Runoff andlor Natural Drains Swales. __......,.. _---_-• .--_,.JIot.., E?. ...«,Q.....« .._..................................._..�.._..._._....._ 31�J����>,.__.�.UI-`fM..... .<•ktL�•=•_b7c^. .... 19. Identification of All Co;n s /Sub-Con a Responsible for Installing,Cons I_, m_-....,..,-..•.••_.__._._..._.........,..,_._._ fr'aCtor( ) tactor( ) ResPonsl g fructing, Repairing, acro Ins and Maintaining the Erosion&Sediment Control Practices. Storm Water Management Control Plan ChecNW 4 1 1 03-12 - i SD�jjdolIO ' Town Han Annex I ph eleone(631)765-1802 CO254375 Main Road T ,,aaxx i> P.O.Box 1179 er rog .richerrt(G iOwn SO6595,71 i Southold,Nal 11971"0959 ny us� � �� BUILDING DEPARTMENT i TOWN OF SOUTHOLD APPLICATION FOR ELECTRICAL INSPECTION REQUESTED BY: I Date: Company Name: Name: E License No.: Address: - i Phone No.: JOBSITE INFORMATION: (*Indicates required information) �= `� �t= ? *Nam 3 *Address tc/ il *Cross Street: l fit S L *Phone Noy 2rd 2,0 I Permit No.: Tax Map District: 1000 Section: - Block: �._ Lot: *BRIEF ESCRWTION OF WORK(Please Print Clearly) (Please Circle Ail That Apply) C - � *Is job ready for inspection: YES/ NO Rough In Final *Do-you need a Temp Certificate. YES/ NO i Temp Information(If needed) Sl'✓n 3 3 f If *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 p1 I ` 8Mequestfor inspection Form b Long Island Permit Service 1814 Middle Country Road Suite D Ridge,NY 11961 Phone 631-345-6820 Fax 631-345-9429 Date: 5/17/12 To: Town of Southold From: Sandra Savage Building Department Town Hall Southold,NY 11952 Via: Overnight Mail Re: 4583 Wilickham Avenue,Mattituck,NY 11952 We are submitting to you the following documents: No. Date Documents being sent to you 2 Building Permit Application 4 Sets of pool plans- 4 Surveys 1 Application for Certificate of Occupancy 1 Tax Bill 1 Check#198 in the amount of$300.00 1 Electrical Inspection Certificate 1 SWPPPS *pF SO(/T- Town Hall Annex Telephone(631)765-1802 54375 Main Road Fax(631)765-9502 P.O.Box 1179 • Southold,NY 11971-0959 'Q 1��4UNTY August 6, 2014 BUILDING DEPARTMENT TOWN OF SOUTHOLD Tchebotarev 4583 Wickham Ave Mattituck, NY 11952 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. 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. (Punning#765-1938) Final Fire Inspection from Fire Marshall. Final Landmark Preservation approval. Final inspection by Building Dept. Final Storm Water Runoff Approval from Town Engineer BUILDING PERMIT — 37254— In-Ground Pool Subdi vision c--) r' Suffolk OP "Wolf CI' f p ., Co �t ,� � un tY file pond E tj ;50 w If Pnow or forrher no, 896 sfptes„ R" <n it AS Iy 3 Sociote Lot 12 s S84-35,00. I e= 84 35,00. I Il now EIO1 n e r form er) 00 146'�2' - - eened/ct FES, 23aJo. I j °�5E �� 2 R) li p 0. ��- j, °fie• ,/ � o .� o 0 co ` +!- � ��\ . .'12.5 •�^ n ��Oa *a e a o i o / e9 9Gi_ t • 0. N 1 / 06 gam. G \ U% / a. to. W 0% GP o O, 0. GP CP O � GP d�P 0 •g3 row Of z F��F Ro�ph V� x \ '0 e tL \T��O, w o \ . 0- JUN 29, 2007 FINAL SURVEY JAN. 1;8, 2006 UNDERCONSTRUCTION SURVEY \ AUG. 9, 2005 ADDED CERTIFICATION JULY 18, 2005 REVISED LOCATION OF HOUSE \ MAR. 02, 2005 STK. FOR DEC Survey for. FEB. 14, 2005 DEC AMENDMENTS y DEC. 10, 2004 BUILDING PERMIT IVAN TCHEBOTAREV DATE: N2004--7622 SUPPLEMENTAL �2`� JOB N0:20 NEEDS TRUST \ ��aoy CERTIFIED T0: IVAN TCHEBOTAREV At \ \ SUPPLEMENTAL NEEDS TRUST COMMONWEALTH LAND TITLE_ Mattituck INSURANCE COMPANY Town of Southold Suffolk County, New York S.C.T.M.: 1000-107.00-04.00-006.000 \ � a ao o ao cr I_ \ SCALE:1"=40' �� DAVID H. FOX, L.S. P.C. N.Y.S.L.S. #50234 NOTES: FOX LAND SURVEYING 1. AREA = 43,241 S.F. \ 64 SUNSET AVENUE ADJACENT AREA = 11,075 S.F. WESTHAMPTON BEACH, N.Y. 11978 2. ■ = MONUMENT FOUND, O = PIPE FOUND, (631) 288-0022 3. REFERENCE DEED L. 7046 P. 188. UNAUTHORIZED UNAUTHORIZED ALTERATION OR ADDITION TO THIS SURVEY 4. THIS PARCEL IS WITHIN THE AE FIRM ZONE E A VIOLATION DCOPIE GO 7THI OF HE NEW YORK STATE p/� H EDUCATION LAW. COPIES OF THIS SURVEY MAP NOT BEARING (EL 11) AS SHOWN ON FIRM BOUNDARY MAP / '� A THE LAND SURVEYORS REDO SEAL OR EMBOSSED SEAL V,` SHALL NOT BE CONSIDERED TO BE A VALID TRUE COPY. PANEL NO. 36103CO143 G LAST DATED p CERTIFICATION INDICATED HEREON SHALL RUN ONLY TO THE MAY 04, 1998. PERSON FOR WHOM THE SURVEY IS PREPARED AND ON HIS BEHALF TO THE TITLE COMPANY. GOVERNMENTAL AGENCY AND LENDING INSTITUTION LISTED HEREON , AND TO THE ASSIGNEES OF THE LENDING INSTITUTION. CERTIFICATIONS ARE NOT TRANSFERABLE TO ADDITIONAL INSTITUTIONS OR SUBSEQUENT OWNERS. DWG: 2004-762 L AN corm iP32 x-WaFgtLL Imm WA XD ®IS 6C ONC�p'1� WxL@10 (BY a4WSLO0 M OAWlTUBW� D) �-51UMMER-W4XIiT MiI*AWW UNDER —1Mmw UNDERVDM L. AFMAW BMW MX16xtpou' NUT,.x%WWWi ' dlmK'86YAK9 i STWLL WAIL PAW Af)mwm BA - =IT) A-MAMOft HAy}BOTIq( 1 co EAAM WxWY BN7H MORT T{1R IM 40xp{TBW.1� ANW9 IOW �1�0 � xaae w RETURN RL+711RN RErtJAN RETURN REYUfU� . TYP. WALL SECTION AT A-FMg PROPOSED POOL FLOOR PLAN N.T.S. SCALE:t/S-y,OP D NOTES: �C LONGITUDINA,L SECTION ,o• NOTE: 1 0� SCALE:UB"=1'-0" 6'.r WAW IOQLeIOWL F N� '" IN'��N TCHEB©TARE 1 RESIDENCE KERI KARL ARCHITECT P.C. DATE;APRIL 4" 2012 . .,. . . 21�VIl�ibEWRE COURT, ,.,.++... ++.,h+.n.�w•w+�. A 3483 WICKHAM AVENUE, SPEONKP NY 11972 SCALE: 1r8°=1P.SII MATTITUCK,NY 11953 PFIONE:631.874.2425 FAX:631x874-7377 URI@KERIKA2EL.COM DRAWN BY:KAK