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Home My WebLink About38433-Z OXEM Town of Southold Annex �iFQ(,f 12/4/2014 P.O.Box 1179 54375 Main Road "8 Southold,New York 11971 CERTIFICATE OF OCCUPANCY No: 37307 Date: 12/4/2014 THIS CERTIFIES that the building IN GROUND POOL Location of Property: 3930 Horton Ln, Southold, SCTM#: 473889 Sec/Block/Lot: 54.-7-23.7 Subdivision: Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated 10/10/2013 pursuant to which Building Permit No. 38433 dated 10/21/2013 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: accessornground swimming pool with fence to code as applied for The certificate is issued to Kosovsky,Jane (OWNER) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL ELECTRICAL CERTIFICATE NO. 38433 5/27/2014 PLUMBERS CERTIFICATION DATED 12 A,�Ilo ed ignature 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#: 38433 Date: 10/21/2013 Permission is hereby granted to: Kosovsky, Jane 276 Riverside Dr New York, NY 10025 To: Construction of an in-ground swimming g pool as applied for. At premises located at: 3930 Horton Ln, Southold SCTM # 473889 Sec/Block/Lot# 54.-7-23.7 Pursuant to application dated 10/10/2013 and approved by the Building Inspector. To expire on 4/22/2015. Fees: SWIMMING POOLS -IN-GROUND WITH FENCE ENCLOSURE $250.00 CO - SWIMMING POOL $50.00 ELECTRIC $100.00 Total: $400.00 irg s ctor Form No.6 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL 765-1802 APPLICATION FOR CERTIFICATE OF OCCUPANCY This application must befilled 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). I Approval ofelectrical 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 fr=architect or engineer responsible for the building. 6. Submit'Planning Board Approval-ofcompleted 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- $100.00 I Copy of Certificate of Occupancy-$.25 4. Updated Certificate of Occupancy- $50.00 .5. Temporary Certificate of Occupancy-Residential $15.00,Commercial $15.00 Date. 0A. k O . 'LO 'D New Construction: Old or Pre-existing Building: (check one) Location of Property: 392-,0 Q_ v`cC House No. Street Hamlet I___, Owner or Owners of Property: -J 1kN oc�oySK� Suffolk County Tax Map No 1000,Section Sq Block d---7 - Lot, D i Subdivision Filed Map. Lot: Permit No. 3 ?�k Date of Permit. Applicant: Health Dept.Approval: Underwriters Approval: Planning Board-Approval: Request for: Temporary Certificate- Final Certificate: (check one Fee Submitted:$ `Q L9n e Applicant Signa r Cc: File, ZBA SO � O Town Hall Annex Telephone(631)765-1802 54375 Main Road N Fax(631)765-9502 P.O.Bax 1179 �� roger.richert(aD-town.southold.ny.us Southold,NY 11971-0959 'OIyCOUNTY,� BUILDING DEPARTMENT TOWN OF SOUTHOLD CERTIFICATE OF ELECTRICIAL COMPLIANCE SITE LOCATION Issued To: Kosovsky Address: 3930 Horton Ln City: Southold St: NY Zip: 11971 Building Permit#: 38433 Section: 54 Block: 7 Lot: 23.7 WAS EXAMINED AND FOUND TO BE IN COMPLIANCE WITH THE NATIONAL ELECTRIC CODE Contractor: DBA: G&S Electric License No: 578-e 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 1 Recessed Fixtures CO Detectors Sub Panel A/C Blower Range Recpt Fluorescent Fixture Pumps 1 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-control panel, 3-GFCI circuit break pool heater Notes: Inspector Signature: Date: May 27 2014 81-Cert Electrical Compliance Form.xls Q��3 :3 Of SO(/l9p WAL 7-0 A TOWN OF SOUTHOLD BUILDING DEPT. c�J 765-1802 INSPECTION [ ] FOUNDATION 1ST [ ] ROU 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- (�,046 (1 L)-X— C;W 4L tom/ dr7,Wt, a>j DATE INSPECTOR 1(3 3 OF SO(/l�,o� N ie i TOWN OF SOUTHOLD BUILDING DEPT. 765-1802 INSPECTION [ ] FOUNDATION 1 ST [ ] ROUGH PLUMBING [ ] FOUNDATION 2ND [ ] IN [ ] FRAMING / STRAPPING [ FINAL [ ] FIREPLACE A CHIMNEY [ ] FIRE SA 1 CTION [ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRATION [ ] ELECTRICAL (ROUGH) [ ] ELECTRICAL (FINAL) [ ] CODE VIOLATION [ ] CAULKING MARKS: S f L f k ` f"g- c,-_'i?�,�� /e*o � ntr-, G-: Gas 7� / 1��6 Ldp ®nom � 4-tl- DATE G INSPECTOR �,33 -i- Of SO(/ TOWN OF SOUTHOLD BUILDING DEPT. 765-1802 INSPECTION [ ] FOUNDATION IST [ ;] R OU PLUMBING FOUNDATION 2ND [ ULATION FRAMING / STRAPPING [ INAL [ ] FIREPLACE A CHIMNEY [ ] FIRE SAFETY INSPECTION [ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRATION [ ] ELECTRICAL (ROUGH) [ ] ELECTRICAL (FINAL) [ ] CODE VIOLATION [ ] CAULKING REMARKS: AI DATE INSPECTOR Robert I. Brown Architect, P.C. with Fairweather Design Associates 205 Bay Avenue,Greenport, NY 11944 fbdainc@optonline.net 631-477-9752 � E August 28, 2014 j SEP -2 2014 Town of Southold Building Department BLDG DEPT. Southold,NY 11971 TOhN of SOU[HOLD Re: Kosovsky Residence Swimming Pool 3930 Horton Lane Southold,NY 11971 B.P. # 38433 To whom it may concern, This letter is to confirm that based on observations and reports from the above referenced project throughout construction to date,and to the best of my knowledge,belief and professional judgment,the steel reinforcing at the above referenced swimming pool has been installed in accordance with the plans and with the Residential Code of New York State. If you have any questions,or require additional information,please feel free to contact me. Thank you for your attention to this matter Sincerely, Robert Brown, A.I.A. A �,♦``� �rrFo q F*", v 1 • a � ;�• �MMA TOWN OF SOUTHOLD BUILDING PERMIT APPLICATION CHECKLIST BUILDING DEPARTMENT Do you have or need the following,before applying? TOWN HAC, Board of Health SOUTHOLD, NY 11971 4 sets of Building Plans TEL: (631) 765-1802 Planning Board approval FAX: (631) 765-9502 C/ Survey SoutholdTown.NorthFork.net PERMIT NO. T 3 Check Septic Form N.Y.S.D.E.C. Trustees C.O.Application / Flood Permit Examined / ( ,20� 3 Single&Separate Storm-Water Assessment Form Contact: Approved 12—t.20 Mail to: Disapproved a/c Phone: Expiration Z z 20 Bui ding Ii pector , T — A N ING PERMIT 1 OCT 10 2013 Date 201 _ INSTRUCTIONS CiEPT. a. t applicant oii b$TTrbe coin let y filled in by typewriter or in ink and submitted to the Building Inspector with 4 sets of plaenrat p o p an 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. (Signature o a icor a nam , if a corporation) (Mailing addres of applicant) State whether applicant is owner, lessee, agent, architect. engineer, general contractor, electrician, plumber or builder �.�ira-c rZ Name of owner of premises —TA-ti 6 V_w bc7vrsY_q (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. Plumbers License No. Electricians License No. Other Trade's License No. 1. Location of land on whichroposed work will be done: 3930 V , [A,ikic I SoaUiL 4 House Number Street Hamlet County Tax Map No. 1000 Section S1q Block (0-7 Lot 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 rRr 5�4 e V" +a-L b. Intended use and occupancy .CN Z h 4--► AA 3. Nature of work (check which applicable): New Building Addition Alteration Repair Removal Demolition Other Work 5w jmmlty r (De cription) 4. Estimated Cost -� 1,() w Ip , c) , Fee (To be paid on filing this tion) 5. if dwelling, number of dwelling units 1�1 Number of dwelling units on each floor/(Ipplica A 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 5S� Rear 6-2- Depth S 3 r 10. Date of Purchase Name of Former Owner 11. Zone or use district in which premises are situated --F'' 70 12. Does proposed construction violate any zoning law, ordinance or regulation? YES NO_ 13. Will lot be re-graded? YES NO Will excess till be removed from premises? YES NO__X Sa �Rnrt-ti`�1d' 14. Names of Owner of premises tf kosoys i�-y Address -3q-3-0 Moat"U. Phone No. (0117)k39-30 73 Name of Architect Address Phone No Name of Contractor ClZt PTiVC E&JO. Addresska IbO , EL0rji_(- rhone No. 73q - 712-3. —� �— . 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 ) 7b 6 CO'KA C being duly sworn says deposes and that she is the p Y applicant (Name of individual signing contract) above named, BONNIE 0. BU,5 H (S)He is the CCM��7 C- Nota=:y Pubh�', State a1 €erv; York 10 (Contractor, Agent, Corporate Officer, etc.) r� " ;feed seri ty tt of said owner or owners, and is duly authorized to perform or have performed the said work and to make and fide 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 tQ,before me this day of 20 Js Notary Public Signatur Appl ant Scott A. Russell ,fid°sI*FQ`r James A. Richter, R.A. SUPERVISORMichael M. Collins P � Z .E. SOUTHOLD TOWN HALL-P.O.Box 1179 53095 Main Road-SOUTHOLD,NEW YORK 11971 Telephone#: (631)-765-1560p Fax#: (631)-765-9015 MICHAEL.COLLINS®'I'OWN.SOUTHOLD.NY.US 11 JAMIE.RICHTEROTOWN.SOUTHO US Office of the Engineer Town of Southold �`�� STORMWATER MANAGEMENT CONTROL PLAN REVIEW AUR S ( TO BE COMPLETED BY THE APPLICANT) TO. ENGINEERING DEPARTMENT PLEASE ATTACH THE AOLL00ZAV' iI,YFI WS or INFIMRNATION.• FROM: BUILDING DEPARTMENT ❑ Copy of completed Application for Building Permit DATE: ❑ Stormwater Management Control Plan APPLICANT:'-�A CC-q-,4,U0wi c'2: ❑ Completed Chapter 236 Stormwater S.C.T.M. *: loo 0 5-1 -(:)7 ---;�3"-) Review Checklist PROPERTY ADDRESS- BRIEF DDRESS BRIEF PROJECT DESCRIPTION: QA ' ;YkC -�csti �., uNDVII)& rnt x 4 Dft—so Le 1 Q W 1 VYj m r Pent- a &D 6a - * FOR EN I G DEPARTMENT USE ONLY''"'°'` Reviewed By: Date: —1-13 Ap 'roved Additional Information Required: Wt DATE: 1-O O I CHAPTER 236 APPLICANT: ph,;� L�," ,,c z 0 Storm�water Review Checklist S.C.T.M.#: ;oma,, _ sy C)-? PHYSICAL ADDRESS: Stormwater Management Control Plan Requirements Yes No NA _ If No or NA,Please Provide Additional Information 1. Plan drawn to scale of not less than 60 feet-to the inch showing: a. location and description of property-boundaries b. total site acreage c. existing and natural and man-made features on and within 500 feet f of the site boundpry as reo uired in§236-17(C)(2). d. test hole data indicating soil characteristics and the depth to water e. proposed limits of clearing and the total area of proposed land disturbance ✓ �'�' "� 3� r �j�� D f. existing and proposed contours of the site(minimum 2' interval) V- g. g. location of all existing and proposed structures,roads, driveways, sidewalks drainage improvements and utilities h. spot grade and finished floor elevations for existing and proposed structures i. location of the swimming pool discharge ring ,./ C�✓L �L u� S S j. location of proposed soil stockpile area(s) k. location of the proposed construction entrance/staging areas ✓ 1. location of the proposed..concrete washout area m. location of all proposed erosion and sediment control measures 2. Plan includes calculations showing that the stormwater improvements are sized to capture, store and infiltrate on-site the runoff from all impervious surfaces generated by a two-inch rainfall 3. Detail drawings(required fo plan anprov D provided for: a. erosion and sediment controls b. construction entrance c. inlet•strucum(e.g.catch basins,trench drains,etc.) d. leaching structures(e.g. infiltration basins,swales,etc.) REVISED 7/24/2013 i OF SO(/p'ol � o Town Hall Annex Telephone(631)765-1802 54375 Main Road zz P.O.sox 1179 G Q roger.richermaNOW�.So�6 ulllpltlppgg nY us 3 Southold,NY 11971-0959 Q �0 ly� � . - I MaDING DEPART WEW TOWN OF SOUTHOLD APPLICATION FOR ELECTRICAL INSPECTION REQUESTED BY: Date: O/ Company Name: 6;Q S Name: License No.: Address: o Lf-> Phone No.: JOBSITE INFORMATION: (*Indicates required information) *Name: koS o � C *Address: %gyp �.Io�Z3N S 9:f_�f, *Cross Street: *Phone No.: Permit No.: 3 3 Tax-Map District: 1000 Secfion: 5 7 Block: Lot *BRIEF DESCRIPTION OF WORK(Please Print Clearly) PC6 L P71 e.2 E,4 Gam ` (Please Circle All That Apply) Is job ready for inspection: E NO Rough In Final *Do-you need a Temp Certificate: YE NO 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 .82-Request for Inspection Form C- � ' � � i #3 REBAR m CERAMIC TILE uj - - - - -T I 3 CLR z I w I Z m I I #3 @ 12'O.C. VERT. II � I I I 3 CLP, I I #3 @ G'O.C. VERT. I 6 RADIU5 VERIE5 FROM 12" @ W DEPTH I I TO 5'=O' @ U-6"DEPTH II - '' II II III III WALL DfTAIL T 19 A VIOLATION TION OF THE LAW FOR ANY PERSON, UNLESS ACTWO UNDER R THE r-sIITECTI TO ALTER ANY `':.V;`YR THIS DRAW-PlI x M 'WVYAY,ANY '1 HORMED 'LTE ATION MUST BE '! ,PEALED,ANDKO!30VSKY RESIDENCE POOL QgZrCE EATIVE ENVIRONMENTAL DESIGN Robert I . brown Architect, P.C. w/ Fairweather e51cjn A5500ate5, Inc. FPti a P05 DA" AVFN jt C J 2012 GR f-NPoI,r, N.Y. 1 1 Q44 r-'� 1 -477-9752 ff;ix) C�.3 1 -477-0973 , T o coag ENCLOSE.P��rt10N UPON GO�ATEF�' BEEOB� i "1711 r x' RETAIN STORM WATER RUNOFFx PURSUANT TO CHAPTER 236 TOWN Of' SOU1111OLD OF THE TOWN CODE. ^ . S.C . IAX No. 1 000 _-_ 4 0 7 23 . OCCUPANCY OR `SC A "1 4 0' A�� C0^,?F 's �'I T H ALL CODES OF OSE IS UNLAWFUL �,0 �� TOWN CODES � �, _ NEW Y----)RK STA E WITHOUT CERTIFICATE ° AND CONDITIONS OF 4r V x ��O t ,..: AS REQUIRED h , OF OCCUPANCY SOUTHOLD TOWN ZSA T HOLO T SOU OWN PLANNING BOARD ------------ SOU'i HOLD TOWN TRUSTEES •. ARE Sw5. x N,Y.S.DEC2,9 r - two - - - f APP V D AS NOTED `. "t I O T '' N l DATE: B.P. ' `�` JANE MclN(,RNf, l FF. BY: W T R BANK NC'P N t,UILDING DEPARTMENT AT 05 �IO2 A>� TO a PM FOR THE ; _ �"IS�� [ (�":�"�t4 T I T[ l C"#M�_'�'��'�"l �`a�,l�(�WIN�i INSPEC'f90�!S: JANE Ko5ov5KY 1. FOUNDAnON - TWO REQUIRED FOR POURED CONCRETE � ... x. J0 ,�-IORTONS LANE Sy MF. ROUGH FRAMING & PLUMBING *" G,� 3, INSULATION :JVUT LD, NY 11971 4, FINAL . CONSTRUCTION MUST �� BE COMPLETE FOR C.O. Ae ALL CONS`RUCTIO SHALL MEET THE , lE1ENTS OF THE CODES OF NEW YORK STATE, NOT RESPONSIBLE FOR � � � , OEM CON'STR hCTION ERRORS. 14 \ : 1` - PROPOSED POOL FENCE pool 18'x 56' � y ' \ 1 ` \` • `1 , y7 "K J r� `l " +' a 1 R a Fr•.. k EC may'1 3 ,' c , 1 41b, wr. ° &*'tu n„ nwe ,.uf.u- .Pw.ac. '_ _