HomeMy WebLinkAbout39871-Z �o�OS�FFaI�cdG Town of Southold 11/13/2015
0
P.O.Box 1179
a' 53095 Main Rd
Southold,New York 11971
CERTIFICATE OF OCCUPANCY
No: 37900 Date: 11/13/2015
THIS CERTIFIES that the building IN GROUND POOL
Location of Property: 1750 Mt Beulah Ave, Southold
SCTM#: 473889 Sec/Block/Lot: 51 -3-210
Subdivision: Filed Map No. Lot No.
conforms substantially to the Application for Building Permit heretofore filed in this office dated
6/12/2015 pursuant to which Building Permit No. 39871 dated 6/12/2015
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 Sack,Peter&Sack,Danielle
of the aforesaid building
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL
ELECTRICAL CERTIFICATE NO. 36182 06-24-2011
PLUMBERS CERTIFICATION DATED
A o ' ed gnatu e
o�gvF��co TOWN OF SOUTHOLD
BUILDING DEPARTMENT
y TOWN CLERK'S OFFICE
SOUTHOLD, NY
a 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# 39871 Date 6/12/2015
Permission is hereby granted to
Sack, Peter & Sack, Danielle
267 Stewart Ave
Garden City, NY 11530
To INSTALL AN INGROUND SWIMMING POOL ,FENCED TO CODE AS APPLIED FOR.
Replaces BP# 36182
At premises located at
1750 Mt Beulah Ave, Southold
SCTM #473889
Sec/Block/Lot# 51.-3-2.10
Pursuant to application dated 6/12/2015 and approved by the Building Inspector
To expire on 12/11/2016.
Fees
PERMIT RENEWAL $12500
Total $12500
T__��)Buil ing ns a cLr --
®�AspfF04�aTOWN OF SOUTHOLD
BUILDING DEPARTMENT
y z 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 # 36182 Date 2/15/2011
Permission is hereby granted to
Sack, Peter & Sack, Danielle
111 Ridge Rd
Douglaston, NY 11363
To install an inground swimming pool, fenced to code as applied for
At premises located at
1750 Mt Beulah Ave, Southold
SCTM # 473889
Sec/Block/Lot# 51.-3-2.10
Pursuant to application dated 2/15/2011 and approved by the Building Inspector
To expire on 8/16/2012.
Fees
SWIMMING POOLS -IN-GROUND WITH FENCE ENCLOSURE $25000
CO - SWIMMING POOL $5000
Total $30000
Building Inspector
Foi m 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, sti eets, 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 of 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 i easons thei efor 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
r� Date
New Construction 1/ Old or Pre-existing Building / (check one)
Location of Property l � �U&42
/
House No Street/ Hamlet
Owner or Ownei s of Property �� e��f Sc, (
Suffolk County Tax Map No 1000, Section Block 3 Lot
Subdivision d L(f YJ� A-, V/4 Filed Map Lot
Permit No Date of Permit Applicant
Health Dept Approval Underwriters Appi oval
Planning Board Approval
Request for Temporary Certificate Final Certificate (check one)
Fee Submitted $ 1:�-L/
Applicant Signa u
pf SOUr�®l®
Town Hall Annex Telephone(631)765-1802
54375 Main Road Fax(631)765-9502
P O Box 1179
Southold,New York 11971-0959 roger rich ert(a�town Southold ny us
�" UNT`I,�c�
BUILDING DEPARTMENT
TOWN OF SOUTHOLD
CERTIFICATE OF ELECTRICIAL COMPLIANCE
SITE LOCATION
Issued To Peter Sack
Address 1750 Mt Beulah Rd City Southold St NY Zip 11971
Budding Permit# 36182 Section 51 Block 3 Lot 10-Feb
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 1st Floor Pool X
New Renovation 2nd Floor Hot Tub
Addition Survey Attic Garage
INVENTORY
Service 1 ph Heat gas Duplec Recpt Ceding 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 3
Transformer Appliances Dryer Recpt Emergency Fixtures Time Clocks
Disconnect Snatches Twist Lock Exit Fixtures 11 TVSS El
Other Equipment In ground swimming pool to Include, bonding, 2 blower motors, 3 pump motors
1 gas heater,2 GFCI circuit breakers,control panel,and pool lights
Notes
Inspector SignatureJ��QDate June 24 2011
81-Cert Electrical Compliance Form
coum,
T N OF SOUTHOLD BUILDING DEPT.
765-1802
INSPECTION
] FOUNDATION IST ] ROUGH PLI3G.
FOUNDATION 2ND INSULATION
FRAMING / STRAPPING FINAL
] FIREPLACE & CHIMNEY FIRE SAFETY INSPECTION
] FIRE RESISTANT CONSTRUCTION FIRE RESISTANT PENETRATION
A�l ELECTRICAL (ROUGH) ELECTRICAL (FINAL)
REMARKS:
Q/�� -73
DATE . e�A//, I
INSPECTOR!a�--
_I
l ��OE SOUIyo
3j'a
TOWN OF SOUTHOLD BUILDING DEPT.
76S-1802
INSPECTION
[ ] FOUNDATION 1 ST [ ] ROUGH PLUMBING
[ ] FOUNDATION 2ND [ ] IN LATION
[ ]
FRAMING /STRAPPING [ FINAL
[ ] FIREPLACE A CHIMNEY [ ] FIRE SAFETY INSPECTION
[ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRATION
[ ] ELECTRICAL (ROUGH) [ ] ELECTRICAL (FINAL)
[ ] CODE VIOLATION [ ] CAULKING
REMARKS:
&"*� cc
,a A
DATE INSPECTOR
1
rA-
YIELD INSPEC�ON REPORT DATE COMMENTS
L ` v
F03UND,ATION(1ST) �
------------
FOUNDATION(2ND)
r Z
. v 1J
Q C4
72
ROUGH FLING&
PLUMING
r
INSULATION PER N.Y. y
STATE ENERGY CODE
' G �
FINAL
ADDITIONAL COMMENTS
r� tea s ��
' � m
d
i
TONS 6U HOLD � v IS BUILDING PERMIT APPLICATION CHECKLIST
BUILDING DEPARTMENT Do you have or need the following,before applying'?
TOWN HALL j v 4 201 Board of Health
SOUTHOLD,NY 11971 4 sets of Building Plans
TEL: (631) 765-1802 Planning Bard approval
BLDG DEPT
FAX: (631) 765-95021o4gN OF SOUTHOLD Survey
SoutholdTown.Nort or ne T NO. �`��- Check
Septic Form
NYSDEC
Trustees
7Flood Permit
//5-20 Examined 4� Storm-Water Assessment Form
Contact.
Approved 0520_ Mail to 379 /fit,!► 57t-
Disapproved
7t-Disapproved a/c ce,,A-MoT,C 11 a s
Phone (.131-
Expiration 20_L�--
Building Inspector
APPLICATION FOR BUILDING PERMIT
Date 31 , 20 1 1
INSTRUCTIONS
a T'#is 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 monthg'after the date of
a
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 mterun,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 herem described The
applicant agrees to comply with all applicable laws,ordinances,building code,housing code, and regulations,and to admit
authorized inspectors on premis dm uilding for necessary inspections
-jN 'Y OR
USE1 UNLAWFUL I."—(Signa applicant or name,if a corporation)
WITHOUT CERTIFICATE -713 IM&,:n � - N-� I (ct 54
OF ( ,} � , (Mailing address of apphcant)
State whether applicant is owner, lessee, agent, architect, Engineer, general corPM0R0VntA9fl0fWber or builder
BP
!� /.0
Name of owner of premises r �c c�L E _ BY L9FPARTM NT AT
�-�-
(As on the ta)croll or latest deed r,P TO a t, FOR THE
If applicant is corpo tion, signatur of duly authorized officer F JL_,0� ;"UV; INSPECTIONS
�— „'� 1 F OUNDATION-TWO REQUIRED
(Name itle of corporate officer) FOR POURED CONCRETE
2 ROUGH-FRAMING,PLUMBING,
Builders License No_ C��O — STRAPPING,ELECTRICAL 8 CAULv'NG
E. 3 INSULATION
Plumbers License No 4 FINAL-CONSTRUCTION&ELECTRiCAL
Electricians License No 4�6 l-1 _ wl E MUST BE COMPLETE FOR C 0
Other Trade's License No ELECTRI L ALL CONSTRUCTION SHALL MEET THE
EQUIRETHE CODS OF
CTI REOPARIFORK STAITENTS NOTORESPONS BEE FOP EW
1 Location of land on which proposed wor} will be done CONSTRUCTION ERRORS
(7S`0 dam ae.t214 G4 A-vTAIN STnRBj 1A1ATE R11NQW
House Number Street Ha#996UANT TO CHAPTER 236
OF THE TOWN CODE.
County Tax Map No 1000 Section Block —3 Lot �e
r N
2 State existing use and occupancy of premises and intended use and occupancy of proposed construction
a Existing use and occupancy '2 S4 E-e-
b Intended use and occupancy c2 e,c ew s S
3 Nature of work(check which applicable) New Building Addition Alteration
Repair Removal Demolition Other Work Sw,,.,�,•-i,�� ���sTT
(De ription)
4 Estimated Cost— �D , 0 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 nixed 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
Heights Number of Stories
9 Size o'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_j��
13 Will lot be re-graded YES NO ✓Will excess fill be removed from premises?YES -NO
14 Names of Owner of premises to i Se, o-/(- Address /7� 7 t//
h Phone No �l o- �13�-19 Z
Name of Architect Address Phone No
Name of Contractors�6sA Address 37.6 ft-IfPhone No L31 -,9,75-76
cc,4'it n-0�-.ckes/w
15 a Is this property within 100 feet of a tidal wetland or a freshwater wetland9 *YES NO
* IF YES, SOUTHOLD TOWN TRUSTEES &D.E C PERMITS MAY BE REQUIRED
b Is this property within 300 feet of a tidal wetland9 * YES NO
* IF YES,D E C PERMITS MAY BE REQUIRED
16 Provide survey,to scale,with accurate foundation plan and distances to property Imes
17 If elevation at any point on properly is at 10 feet or below,must provide topographical data on survey.
18 Are there any covenants and restrictions with respect to this property9 * YES NO
* IF YES,PROVIDE A COPY
STATE OF NEW YORK)
SS
COUNTY O�
being duly sworn, deposes and says that(s)he 1s the applicant
(Name of Individual signing contract)above named,
(S)He Is the r c�1n. N`c� '. o T'
(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
d
Sworn to before me this
day of 20_1/
F/A �' Y
Not PubNOTA ` PUBLIC,STATE OF NEW YORK S1g atur of Applicant
ALIFIED IN SUFFOLK COUNTY
NO 01SH6083048
MY COMMISSION EXPIRES NOV 12,20
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REQUESTED BY. Date. SF ly //
Company Name S G.
Name: -ra fz2 - G�- --- -
License No.: S 7 ^,E
Address, ', o . Q'0x C;� /S J av-4 o xp /eJ„`l
Phone No.: 7r. S--- 6 �/
JOBSITE INFORMATION: (*Indicates required Information)
*Name. G le_
*Address: S-b +M,1: 3 FjJ U f4 H �•
*Cross Street. 0 5 Py w P J t F__'" -
*Phone No : _ 9i7 (, 4�f6 -- �6
Permit No.: 3l_-1 1 I �L
Tax Map District: 1000 Section: 5 l Block. 3 Lot- to
*BRIEF DESCRIPTION OF WORK (Please Print Clearly)
(Please Circle All That Apply)
*Is job ready for inspection YE / NO Rough I Final
*Do you need a Temp Certificate: YES 40
Temp Information (If needed)
� a
*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
/`o—
Fatq(
Southold Town Building Department
Suac, P.O.Box 1179
$off oG� Permit#: 36182
54375 Main Road
o ' Southold,New York 11971 Permit Date: 2/15/2011
y�ol �ao� (631)765-1802 Expiration Date: 8/16/2012
Parcel ID: 51.-3-2.10
BUILDING PERMIT RENEWAL LETTER
Dated: 11/6/2013
Applicant: PETER&DANIELLE SACK
Location: 1750 MT BEULAH AVE SOUTHOLD
Work Description: IN GROUND POOL
INSTALL AN INGROUND SWIMMING POOL,FENCED TO CODE AS APPLIED FOR
A FEE OF $125.00 IS REQUIRED TO RENEW THIS BUILDING PERMIT.
Owner: PETER&DANIELLE SACK
Address: 111 RIDGE ROAD
DOUGLASTON,NY 11363
The permit listed above has expired. Please contact our office as soon as possible to begin the renewal
process. All work on the project must stop on the expiration date.
No work is permitted or authorized beyond the expiration date.
�- V 5 �
THANK YOU,
�G
SOUTHOLD TOWN BUILDING DEPT.
2396
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YAIxL ANA GOLt-EGA OR
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i POOL P j- .A%N
PA
OCIIERAL NOTES.
..• b \ �� FtW�A WnP
t.THE ocslcll IS tAsao ON A DRAINAGE SOIL WITH<"SILT. _ '• "; G�xv 1Y1 N W(t ct Sn
GROUND WATER SMALL NOT EXIST WffWN THE LIMITS OF THE
EXCAVATION.IF G10U10 WATER EXISTS WITHIN 6--0'BELOW LAIfi•LVNVDEm Mr.
GRADE SPEpAL-OVATERING FACUTIES WILL RE REQUIRED. At"IfOP) '+
TW� nn�
WATER.DMSPO LIMITED TO Owwjts ►ROPERTT. I KI�y
IIS s _
L NO SM6 W ALLOWEO WITHIN4=0-OF WW-LOW ENO A, PR'Ltt1
ANO i�d OF Dttl ENo. '`- y`� �N WMOSTAT<'Ic,
3.THE rwCLuAT1GLL.LY APPLIED CONCRETE(GUNIT E)SMALL b :� , t coLLCCTda Tv8'
K A M4 MIX WITH A MAXIMUM OF 3S2 GALLONS OF s I tK GPAVr=L ZA6t
WATER PER SACK OF CEMENT. �$ �. — —tvAks RHT hGH E MAT!G riuriDING -mfi/4N ism iwi
4. REINFORCING STEEL SHALL 6E INTERMEDIATE GRADE
BILLET STEEL WITH A MINIMUM LAP OF SO MAR '� SMD
DIAMETERS
' Q4 NPON f/MD
Il ►DOL, WATER SUPPLY BY OWNERS GARDEN HOSE. - •� � i, •�+ - ` #3 -4zELp �� I�'r
POOL TO iC KEPT FULL DURING FREEZING WEATHER. YhtV�S (i t7 o, f p{�H �5" � �! �f�
PUMP CAPACITY TO RE SUFFICIENT TO EMPTY POOL jimirwj r "�. HayZ AO 'qs/G �P e�PT R0 s
IN 24 LOURS � t I�G�c L� vcnT.
WALL, -Sf G'r 10 t4 nw?s 17i.1. w wr�t
I161It FM61N'i.gNT - •� `
Peter Sack
175-0 Mount Beulah Ave. REVISED 9/06 H. ROY JAFFE, P. E.
Southold, NY11971 f
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SURVEY OF LOT 7
SUIBDIVHSHON MAP
OF E
SIO ]BE t�C AH ACRES
51TUATE: SOUTHOLD �c
TONN: SOUTHOLD
1
5UFFOLK COUNTY, NY
SUBDIVISION MAP OF MOUNT BEULAH ACRES
FILED IN THE OFFICE OF THE CLERK OF SUFFOLK COUNTY
ON MAY 2q, Ig81 AS MAP FILE NO. bg84
SURVEYED: MARCH 2.3, 2010
SUFFOLK COUNTY TAX #
1000 - 51 - 3 - 2.10
CERTIDFfED TO:
]Peter Sack
Danielle Sack
Chicago Title][n%wmce Company
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STONE BUILDING
RES. LOT 6
of NEW
COP ��r \S'O „na,tM1rrized alteration ar addition to a whey
_� map bed-y,g p hcer�ed land wrvaya^'e seal Is a
vlobtlon of sectbn Y�k w tl EN n 2,of the
York Stats Education
T �; �kI � � 'Only copies frcm the original of lhls swey
ked wIG�m original of u�IoW wrveyors
r *` etonipea seal eholl tx considered to be vand nue
' Q' copies
L r� �� 'GerklFlcatlot�5 Indicated V,ereon siyil }hot this �
\\\���9Y9���"'((��` wrvey was prepared n accoreance wl`'�,tnc ex-
NOES: M - Code of Pracklce for Lord SOf—adcyte l
the New York State A. latim of Professimnl
SFO N •5v �Lmd�eyor=.sold certificatlais shall,�
to the person for whom[he wrvey is prepef,re
and on his lxlwli b the title compoy,qqoovv
bl agency acid IeridFg Iatlfuf lan ilsted hereon,and
to the oulyiees of the ler�dlriy Instk�tlon Certifica- i
tions a^a rot trans{erable to addltbrial Instltutlons
■ MONUMENT FOUND GRAPHIC SCALE 111 30' JOHN C. LE LAND J �� '
Area = 47228 S. F. 6 EAST MAIN STREET N.Y.S.LIC.NO.50202
Area = 1.0842 Acres O 30 h0 q0 RIVERHEAD,N.Y. 11901 369-8288 Fax 369-8287
REF:C:\Documents and Settings\Owner\My Documents\My Dropbox\10\10-114.pro
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SURVEY OF LOT 7
SUBDMSEON MAP
J
OF
MOUNT BEULAH ACRES
51 TUATE: SOUTHOLD
TOM 5OUTHOLD
5UFFOLK COUNTY, NY
SUBDIVISION MAP OF MOUNT EaJLAR AGR -5
FILED IN THE OFFICE OF THE CLERK OF SUFFOLK COUNTY
ON MAY 29, IcIbI A5 MAP FILE NO. 6954
SURVEYED; MARCH 23, 2010
SUFFOLK COUNTY TAX
1000 - 51 - 3 - 2.10
CERT f=TO:
Peter Sack
Danielle Sack
Chicago Title hmmce Company
S87022"30"E
1.62
6
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00
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LOT -7
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HALL L0-0-0—Q-
STONE BUILDING
LOT, C?
of NEW
yomap treartng a licensed land yseal Is a
-
12- 2,of tM
New York State Edreakbn Law'
4.
•Gtily copses from the orlgmol or un survey ,
/y sto,pea seal shall ee consdered to be gaud we
0Yartiflcalkxe tho!this
—y P-P!nd=Z=11
-vS al mg Godo of——for L =.dopt.d
Fp the New Yak StateNOTE5:
NLmd f� tho-Saki urbflcatl 9 1,p—p=
ab on his 4elwli to tM title company,qqao
tat agency od Ixidkig hstitutbn listed hereon and
to the asskrees of the lending Mxtltutbn GerGfKa-
eloin
-tUtI.-
MONUMENT FOUND ORAPHIC, SCALE I
JOHN C. EHLERS LAND SURVEYOR
Area = 41,226 5. F. rm K:Zj� 6 EAST MAIN STREET N.Y.S.LIC.N0.50202
Area = I D542 Ar-res 0 50 60 CIO i RIVERHEAD,N.Y. 11901
369-8288 Fax 369-8287