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HomeMy WebLinkAbout38883-Z t ` "gam Town of Southold Annex 11/14/2014 1� P.O.Box 1179 54375 Main Road Southold,New York 11971 L CERTIFICATE OF OCCUPANCY No: 37273 Date: 11/14/2014 THIS CERTIFIES that the building IN GROUND POOL Location of Property: 95 Shore Ln, Pecomc, SCTM#: 473889 Sec/Block/Lot: 86.-14.17 Subdivision: Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated 5/5/2014 pursuant to which Building Permit No. 38883 dated 5/14/2014 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: ACCESSORY IN-GROUND SWIMMING POOL FENCED TO CODE The certificate is issued to Perez, Jose&Perez,Judith (OWNER) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL ELECTRICAL CERTIFICATE NO. PLUMBERS CERTIFICATION DATED Aut Sigifature r z Or 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#: 38883 Date: 5/14/2014 Permission is hereby granted to: Perez, Jose & Perez, Judith 95 Shore Ln Peconic, NY 11958 To: construct an accessory In-Ground Swimming Pool, fenced to code At premises located at: 95 Shore Ln, Peconic SCTM #473889 Sec/Block/Lot# 86.-1-4.17 Pursuant to application dated 5/5/2014 and approved by the Building Inspector. To expire on 11/13/2015. Fees: SWIMMING POOLS -IN-GROUND WITH FENCE ENCLOSURE $250.00 CO - SWIMMING POOL $50.00 ELECTRIC $100.00 Total: $400.00 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 2110 of 1% lead. 5. Commercial building,industrial building,multiple residences and similar buildings and installations,a certificate of Code Compliauce-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 properlympleted 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. F4tes 1. Certificaie of Occupancy-.New dwelling$50.00,Additio:s to dwelling$50.00,Alterations to dwelling$50.00, Swimming pool$50.00,Accessory building$50.00,Additions to accessory building$50.00,Businesses$50.00. 2. Certificate of Occupancy on Pre-existing Building- S 100.00 3. Copy of Certificate of.Occupancy-$.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: House No. Street Hamlet Owner or Owners of Property: 0 Suffolk County Tax Map No 1000,Section 3?�V __Biock [> Lot / Sabdivision Filed Map. Lot: Permit No. Date of Permit. Applicant: X` P&lle/� Health Dept.Approval: Underwriters Approval: Planning Board Approval: Request for: Temporary Certificate Final Certificate: (check one) Fee Submitted: $ t Applicant Signature o��OF SO�TyQI � o Town Hall Annex Telephone(631)765-1802 54375 Main Road Fax(631)765-9502 P.O.Box 1179 �� roger.riche rt(a_town.southoId.ny.us Southold,NY 11971-0959 Q ���4UNTY,Nc� BUILDING DEPARTMENT TOWN OF SOUTHOLD CERTIFICATE OF ELECTRICIAL COMPLIANCE SITE LOCATION Issued To: Jose Perez Address: 95 Shore Lane City: Peconic St: NY Zip: 11958 Building Permit#: 38883 Section: 86 Block: 1 Lot: 4.17 WAS EXAMINED AND FOUND TO BE IN COMPLIANCE WITH THE NATIONAL ELECTRIC CODE Contractor: DBA: JES Electric License No: 4483-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 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 Transformer Appliances Dryer Recpt Emergency Fixture Time Clocks 1 Disconnect F1 Switches 1 Twist Lock Exit Fixtures f] TVSS Other Equipment: in ground swimming pool to include, bonding, pool light, 1-GFCI circuit breaker, 1-salt generator, 1-heat pump Notes: _s Inspector Signature: Date: Nov 12 2014 81-Cert Electrical Compliance Form.xls i OF SOUr�O �o TOWN OF SOUTHOLD BUILDING DEPT. 765-1802 INSPECTION [ ] FOUNDATION 1 ST [ ] ROUGH PLUMBING [ ] FOUNDATION 2ND [ ] INSU ION [ ] FRAMING / STRAPPING [ NAL [ ] FIREPLACE & CHIMNEY [ ] FIRE SAFETY INSPECTION [ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRATION [ ] ELECTRICAL (ROUGH) [ ] ELECTRICAL (FINAL) [ ) CODE VIOLATION [ ] CAULKING REMARKS: �C 1 Y 1 V -- r C t i DATE d /� INSPECTOR '" i oF soujyo� TOWN OF SOUTHOLD BUILDING DEPT. 765-1802 INSPECTION [ ] FOUNDATION 1 ST [ ] ROUGH PLUMBING 4 [ ] 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 REMARKS: DATE ` f INSPECTOR t FIELD II�TSPE ON 'ORT DATA COMIVIICNTS FOUNDATION(IST) N-) FOUNDATION(SND) rA ROUGH FRAMW Q& H PLUMBING - l INSULATION PER N.Y. � H STATE ENERGY CODE • Y ._— MAL ADbtftbN ' C 10 nrn / O f 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. Check _—� 71 Septic Form N.Y.S.D.E.C. Trustees Flood Permit Examined 20 J !I NIAY - 5 2014 f Storm-Water Assessment Form � �LJ iContact: Approved ,20 Mail to: f �iniD Disapproved a/c _ Phone: Expiration_ 20 Building Inspector APPLICATION FOR BUILDING PERMIT Date��J , 204/ 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 BuildingPermit. 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. 'IMMEDIATELY" '(Signatdre of app licant or name;if a corporation) iCJH �L Cs9✓� ENCLOSE POOL TO CODE UPON COMPLETION BEFORE "WATER` ea".addXe�s:ofapplicant) //js'? State whether applicant is owner, lessee, agent, architect, engineer, general c fgtfactor, electrician,'plumber or builder FFE NOTIFY BUILDiN A.RTMENT 765-1802 8 ANI 1,j a PM FOR TF. Name of owner of premises J (As on the tax roll or latgs ATION-1'Vo'-) REQUIRED If applic is rporation, signature of duly authorized officer FOR POURED CI;NCRETE �2 A2dz% &6,6 t� ���S, JT' 2. ROUGH-FRAMING, F._UMBING, (Name and title of corporate officer) STRAPPING, ELECTRICAL&CAULKING 3. INSULATION 4. FINAL-'CONSTRUCTION&ELECTRICAL Builders License No. MUST BE COMPLETE FOR C.O. Plumbers License No. ALL CONSTRUCTION SHALL MEET THE Electricians License No. REQUIREMENTS OF THE CODES OF NEW ORK STATE. NOT r'FONSIBLE FOR Other Trade's License No. DESIGN OR CONSTRUCTION ERRORS, 1. Location otland on which pro osed ork will be done: RETAIN STORM WATER RUNOFF IliHouse Number Street Ham et '`'". County Tax Map No. 1000 Section w Block Q / Lot 7• -7 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 rontl�o Rear Depth 3- Td (o 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 .j :/--Pt a, Address f r5A6 e1A#oe'tLNwkhone No. �6 31J,6 7-11WP Name of Architect Address, tr, Phone No Name of Contractor rV ��dt� Address J 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 MAYBE IREQUIRED.' b. Is this property within 3400 feet of a`tidal wetland? * S 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 b.BUNCH c Notary Public,8tnte of New York (S)He is the /s ��l Q� ; No.01OU6185060 E)j-GWW in 810*cauft (Contracto Agent,Corporate Officer, etc.) commission Expires APril 14,2 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 tp before me this day of 20 Notary Public Signature of Applicant Scott A. Russell 01- STO)R.lMMA\T]EIK SUPERVISOR AKA\NA\GIEN[1E1��C' SOUTHOLD TOWN HALL-P.O.Box 1179 v' 53095 Main Road-SOUTHOLD,NEW YORK 11971 o - Town of Southold 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) ❑ A. Clearing, grubbing, grading or stripping of land which affects more ❑[ ( than 5,000 square feet of ground surface. B. Excavation or filling involving more than 200 cubic yards of material within any parcel or any contiguous area. ❑ C. Site preparation on slopes which exceed 10 feet vertical rise to 100 feet of horizontal distance. ❑D'D. Site preparation within 100 feet of wetlands, beach, bluff or coastal erosion hazard area. � ❑E E. Sitere aration within the one-hundred-year f loodplain as depicted P P on FIRM Map of any watercourse. ❑ F. Installation of new or resurfaced impervious surfaces of 1,000 square 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 Check List Form to the Building Department with your Building Permit Application. APPLICANT: (Property Owner,Design Professional,Agent, ontrac_ her) S.C.T.M. #: 1000 Date: 1 j Distrito 2 NAME: 4�L3Y�y'>'� �L� C. i�✓� ALL S2L �7 ` Ll wti Section Block Lot FOR BUILDING PEPARTMENT USE ONLY Contact Information: ITekphak Numtierl Reviewed By: t Date: 5151 j`If Property Address/ Location of Construction Work: — !rApproved - - - - - - - - - - - - - —,,// � for processing Building Permit. 95- ,�l� ZAvtJ� tormwater Management Control Plan Not Required. (I` ���`� , �/- /��1�0 ❑ Stormwater Management Control Plan is Required. (Forward to Engineering Department for Review.) FORM # SMCP-TOS MAY 2014 . OF s1jyo Town Hall Annex 54375 Main Road Telephone(631)765-1802 • � ax M1 O� ��0U �P.O.Box 1179 rOger.rChert S nV US Southold,NY 11971-0959 BUILDING DEPARTMENT TOWN OF SOUTHOLD APPLICATION FOR ELECTRICAL INSPECTION REQUESTED BY: Date: Company Name: �G Name: E License No.: Address: � Phone No.: &3 / 7- 7 03 JOBSITE INFORMATION: (*Indicates required information) *Name: *Address: 1.4f 7 *Cross Street: *Phone No.: (�3/ -6-;:? 7_ y�oZ Permit No.: 3 5493 Tax-Map District: 1000 Section.-_VL_ Block: O ! Lot:_—_q- -7 *BRIEF DESCRIPTION OF WORK(Please Print Clearly) (Please Circle All That Apply) *Is job ready for inspection: ES NO Rough In final *Do you need a Temp Certificate: YES NCS Temp Information (If.needed) *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 f 82-Request for Inspection Form I e �j v �`d..w- + ..krd .rax.:,¢ .w� .:.. ,. � v � n: �� �. .,,, ... ..,., ;,•,. ' r G. r x � r w ,�. r f L01© i SURVEY OF LOT 17 At4P OF RICHMOND SHORES AT PECONIC nLE No. 6033 FRED NOVEMBER 20. 1979 SnVATWD AT PECONIC TOWN OF UTHOLD SUFFOLK COUNTY, NEW YORK RE af� S.C. TAX No. 1000-86-01-4.17 r l SCALE t"=34' � „ 0 O `J ajtm 24, Y949 .p0 }l9 ?� 4� Amus.2 o4 PROP NONUW r LY r• •. ` 6� �o -� q •Y JULY 23: W 9f1R11R`Y F'�t h HOT?UB .. r0 AREA = 2 .96 sq. 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