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HomeMy WebLinkAbout39309-Z F0j/( Gam, Town of Southold 9/1/2016 o - P.O.Box 1179 co � 53095 Main Rd Southold,New York 11971 CERTIFICATE OF OCCUPANCY No: 38490 Date: 9/1/2016 THIS CERTIFIES that the building IN GROUND POOL Location of Property: 295 Shore Ln, Peconic SCTM#: 473889 Sec/Block/Lot: 86.4-4.19 Subdivision: Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated 10/8/2014 pursuant to which Building Permit No. 39309 dated 10/24/2014 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: ACCESSORY IN-GROUND SWIMMING POOL, FENCED TO CODE, AS APPLIED FOR The certificate is issued to Friedberg,Michael&Friedberg,Adena of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL ELECTRICAL CERTIFICATE NO. 39309 08-23-2016 PLUMBERS CERTIFICATION DATED Autho ed Signat re saFFo�K TOWN OF SOUTHOLD BUILDING DEPARTMENT y z TOWN CLERK'S OFFICE o • 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#: 39309 Date: 10/24/2014 Permission is hereby granted to: Friedberg, Michael & Friedberg, Adena 1 Shore Ln Apt 2001 Jersey City, NJ 07310 To: construct an accessory inground swimming pool fenced to code At premises located at: 295 Shore Ln, Peconic SCTM # 473889 Sec/Block/Lot# 86.-1-4.19 Pursuant to application dated 10/8/2014 and approved by the Building Inspector. To expire on 4/24/2016. Fees: SWIMMING POOLS -IN-GROUND WITH FENCE ENCLOSURE $250.00 CO - SWIMMING POOL $50.00 Total: $300.00 L r- Building Inspector Form No.6 $OWN 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 7110 of 1% lead. - 5. Commercial building,industrial building,multiple residences and similar buildings and installations,a certificate of Code Compliaince-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. Certificaie 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$50.0&- 2. Certifeeate of Occupancy on Pre-existing Building- S 100.00 3. Copy of Certificate of.Oecupancy-$_25 4. Updated Certificate of Occupancy- $50.00 5. Temporary Certificate of Occupancy -Residential $1.5.00,Commercial$15.00 Date. )7// aei' New Construction: Old or Pre--existing Building: (check one) Location of Property: �Cl �/�D/� lobJe House No. Street Hamlet Owner or Owners of Property: 1'/I Lllwd L Suffolk County Tax Map No 1000,Section CD Block O/ Lot Subdivision Filed Map. Lot: Permit No. Date of Permit. Applicant: /vi Health Dept.Approval: Underwriters Approval: Planning Board Approval: Request for: Temporary Certificate Final Certificate: (check one) Fee Submitted: $ Applicant Signature SOIp��®l Town Hall Annex ® Telephone(631)765-1802 54375 Main Road Fax(631)765-9502 P.O.Box 1179 ® roger.riche rta-town.so Litho Id.ny.us Southold,NY 11971-0959 C®Ui1�,� BUILDING DEPARTMENT TOWN OF SOUTHOLD CERTIFICATE OF ELECTRICIAL COMPLIANCE SITE LOCATION Issued To: Friedberg Address: 295 Shore Lane City: Peconic St: New York Zip: 11958 Building Permit#: 39309 Section. 86 Block: 1 Lot: 4.19 WAS EXAMINED AND FOUND TO BE IN COMPLIANCE WITH THE NATIONAL ELECTRIC CODE Contractor: HOME OWNER 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 Ceding 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 A/C Blower Range Recpt Fluorescent Fixture Pumps Transformer Appliances Dryer Recpt Emergency Fixtures Time Clocks Ij Disconnect Switches 1 Twist Lock Exit Fixtures TVSS Other Equipment: Inground Swimming Pool to Include; Bonding, Control Panel, 1- GFCI Circuit BreakE Salt Generator,Gas Pool Heater,2-Pool Lights. Notes: Inspector Signature: Date: August 23, 2016 OOElectrical 81 Compliance Form.xls 9 cou TOWN OF SOUTHOLD BUILDING DEPT. 7654802 INSPECTION ' I FOUNDATION IST ROUGHPLUMBING FOUNDATION 2ND INSULATION FRAMING / STRAPPING �FINAL FIREPLACE & CHIMNEY FIRE SAFETY INSPECTION FIRE RESISTANT CONSTRUCTION FIRE RESISTANT PENETRATION ELECTRICAL (ROUGH) ELECTRICAL (FINAL) CODE VIO CAULKING RE71CS:_L7.0',�a.A DATE -- INSPECTOR eou TOWN OF SOUTHOLD-BUILDING DEPT. 765-1802 INSPECTI N ' !G pH;r 0 P FOUNDATION IST IRO HP ING FOUNDATION 2ND I SU L FRAMING / STRAPPING FIN L FIREPLACE & CHIMNEY FIRE.; INSPECTION FIRE RESISTANT CONSTRUCTION FIRE RESISTANT PENETRATION ELECTRICAL (ROUGH) ELECTRICAL (FINAL) CODE V?�ATION CAULKIN REMARKtit_�/&//,- —nl k, ny,405- G v DATE INSPECTOR '77pl �oF souTyol TOWN OF SOUTHOLD BUILDING DEPT. 765-1802 INSPECTION - - I FOUNDATION 1ST [ ] ROUGH PLUMBING [ ] FOUNDATION 2ND [ ] 1 LATION [ ] FRAMING / STRAPPING [V FINAL [ ] FIREPLACE & CHIMNEY [ ] FIRE SAFETY INSPECTION [ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRATION [ ] ELECTRICAL (ROUGH) [ ] ELECTRICAL (FINAL) [ ] CODE VIOLATION [ ] CAULKING REMARKS: �• O DATE �'�� �� INSPECTOR OF SO(/T�o� b * courm TOWN OF SOUTHOLD BUILDING DEPT. 765-1802 INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLEIG. [ ] FOUNDATION 2ND [ ] INSULATION [ ] FRAMING / STRAPPING [ ] FINAL [ ] FIREPLACE & CHIMNEY [ ] FIRE SAFETY INSPECTION [ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRATION [ ] ELECTRICAL (ROUGH) ELECTRICAL (FINAL) REMARKS: DATE Z C INSPECTOR G t � - ..qolyzi.M � u IMUL ATION PER N.Y. sTATE ENERGY I� 11 � 11 1' 1 t ,' i ��:��it_� _ "�/►a� iw _;ic'.��/ J EMT �1 • 1 TOWN OF SOUTHOLD BUILDING PERMIT APPLICATION CHECKLIST BUILDING DEPARTMENT' :'Do.you have'or need the.followhig,'before applying? TOWN HALL Board•of Health--,. SOUTHOLD, NY 11971 4 sets of Building Plans TEL: (631) 765-1802 ;P.lanning Hoard'approval FAX: (631) 765-9502 Survey SoutholdTowmNorthFork.net PERMIT_NO. ifs_ (_n - i :`° 'Check Septic Form N.Y.S.D.E.C. Trustees Flood Permit - Examined7 � ' Storm-Water Assessment sment Form _ .. .r_ �e•s r,rS 'li. ,.`j'„ ° Cont'ir - act: Approved 10/ifpo ...Mail to: Disapproved a/c , 'n o i Phone: Expiration 20 :a E' E V ,E :iBufldiXrg,Inspector, - PLICATION•FOR BUILDING PERMIT OCT- 8.''2014 _ . Date `1' -7 , 20' 11V BLDG DEPT INSTRUCTIONS T V4N OF soUTHOLD q his ap on ST 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'lo(cation 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 coininericed before issuance of Building PPermit.' 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 inspe6ti6 'througfioli t-"tlie'work: '{ ' e.No building shall be occupied or used in whole or impart 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_amen-..dments4or�other regulations affecting'the property have been enacted in.the.iriterim,the Building Inspectormay authorize,in writing,the extension ofthe'permit'for,an" addition six months. Thereafter,,a new permit shall be required,-: _ -1 •3t ;• APPLICATION IS HEREB'''MADE to the_Building Department for the,issuance-of a Building•Permit pursuant to the Building Zone Ordinancetof the Town pf Southold, Suffolk,Couty, e�w,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 1`aws„o'r�inances,-building_code,housing.coce, and�regulations, and to admit authorized inspectors on premises and in building for necessary mspections:, , . .. 0-CCUPAN"Y OR i.73 r .f .- - � t - � D'•IATE „Y!' '9 @ @'E#' 3' � ”" ",Sign`af&&,6f 4glicani'or name,-if a'corporation) ENCLOSE POOL TO CODE l9 11! 'U,P�ON COMPLETION F C"�$0 ����Y���,,�, (Mailing address of applicant) ,.' State whether applicant is owner, lessee, agent, architect, engineer, general conteactor,-el'ectrician;`plurrLber or uild`e Name of owner of premisesi (As on the tax roll or latest`de I LU-16 ;302 Affil TO 4 PM FOR THE If applica a co ation, signature du'r�authorized officer ' GLOWING INSPECTIONS: , F'✓� r I FOUNDATION-TWO REQUIRED (Name and title of corporate of ce � FOR POURED CONCRETE CAL ROUGH-,FRAMING,PLUMBING, Builders License No. NahvpnWR STRAPPING, ELECTRICAL&CAULKING Plumbers.License No. i vt ; ,r,I ; INSULATION Electricians'License No.' -INAL-`CONSTRUCTI'ON•&ELECTRICAL '`'' ` 1' "f4U'ST•BE COMPLETE FOR C,O. Other Trade's License No. �Z_,'&.A+ tONSTRUCTION SHALL,MEET THE )UIREMENTS OF THE CODES OF NEW :K STATE. NOT RESPONSIBLE FOR 1. Location of land on whic proposed work will be done: �, N 0 C STRUCTI0N ERRORS o�C,.! 5�� 4 4v� 'Pl� �mf - House Number Street Hamlet County Tax Map No. 1000 Section �(� Block Q Lot +� Subdivision Filed Map No. Lot 2. ,.,State existing use and occupancy of,premises and intended use and occupancy of proposed construction: h - a. Existing use and occupancy b. Intended use sand 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 X Rear Depth 3� id Height Number of Stories Dimensions of same structure with alterations•or additions: Front Rear Depth Height Number of Stories .r y, 8. Dimensions of entire new construction: Front Rear Depth r Height Number of Stories 9. Size of lot: Front Rear Depth 10. Date of Purchase Name of Forme"r'Owner ' .F :r, ' r .1 a f• f 11. Zone or use district in which premises are situated 12. Does proposed construction violate any zoriiiig law,'brdin'ance'or`regulafion?YES , NO ;t 13. Will lot be re-graded? YES J NO Will excess fill be removed from premises?YES . , ' NO 14. Names of,Ownerof premises..�'y1iC&. 81, wrte.` '�'Address, -*F.•S164� � r'Phone No. S/,�- ' Name of Architect +: ;,: f{,4v, ;T ,i Address,-Ira,,, :., ' +:Phone No i Name of Contractor /09 lbo( C41E Address -Phone-No. A8—Cla/l 15 a. Is this'property withi&100 feet of-a tidal wetland'or"d'fresliwater wetland?'*YES" ', ''NO N�T * IF YES, SOUTHOLD TOWRU :PE STEES''& D:8"CRMITS MAYBE REQ4UIRED.' b. Is this property within 3`00 feet of atidal wetland? * YES" 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'ari 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 ,p (Name of individual signing contract) above named, CONNIE D. BUNCH Notary Public,State of New York (S)He is the No.01 BU6185050 (Contractor,Agent, Corporate Officer, etc.) Qualified in Suffolk County 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 to before me thJ°s _( day of V 20±9_ Notary Public Signature of Applicant Scott A. Russell ���°su` '��� `]F01KMWA\`]FlE1K SUPERVISOR z MA A\(G IEMENT SOUTHOLD TOWN HALL-P.O.Boz 1179 53095 Main Road-SOUTHOLD,NEW YORK 11971Town 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) ❑dA. 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. ❑13/C. Site preparation on slopes which exceed 10 feet vertical rise to 100 feet of horizontal distance. [:]12(D. Site preparation within 100 feet of wetlands, beach, bluff or coastal [][2( erosion hazard area. E. Site preparation within the one-hundred-year floodplain as depicted 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. �PLICANT: (Property Owner,Design Professional,Agent,Contractor,Other) S.C.T.M. #: 1000 Date: p District NAME: IV.I O� G4✓(� Ct'`6/Ykrt ����%n.E/ 6 .0/ 'C/J/ i rnu Y Section Block Lot i i FOR BUILDING DEPARTMENT USE ONLY* ** Contact Information (/0 n rrel,*ft Number) L — — — — — — Reviewed By: Date: �® Property Address/Location of Construction Work: — — — — — — — — — — — — — — — — � -e i a� S 6,, tAX)e Approved for processing Building Permit. t� Stormwater Management Control Plan Not Required. �C-N��`P_• ,d; j5 Stormwater Management Control Plan is Required. (Forward to Engineering Department for Review.) FORM * SMCP-TOS MAY 2014 oF so�,jyo{ 0 Town Hall Annex � � Telephone(631)765-1802 54375 Main Road y bw (631)765 5 P.O.Box 1179 G Q r0 er.richert 'o`wn.soutfiiolL .us Southold,NY 11971-0959 ! BUaDING DEPARTMENT TOWN OF SOUTHOLD APPLICATION FOR ELECTRICAL INSPECTION REQUESTEDBY: ' . Company Name: Date: Name: License No.: �. Address: Phone No.: JOBSITE INFORMATION: (*Indicates required information) *Name: : F-K;e-A G ' *Address: ilo *Cross Street: ):OL4 ylecl� R _ *Phone No.: _ _ 3 Permit No.: -53 ! Tax-Map District: 1000 Section: Block: ,I _q Lot: *BRIEF DESCRIPTION OF WORK(Please Print Clearly) v ,F_U (Please Circle Alf That Apply) Is job ready for inspection: DESNO Rough In Final Vo-you need a Temp Certificate: YES/q 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 fM- i �� �� Additional Information: PAYMENT DUE WITH APPL TION D AUG - 6 2016 82-Request for Inspection Form TOWN OF SOUTE106 TOWN OF SOUTHOLD PROPERTY RECORD CARD OWNER STREETS VILLAGE DIST.1 SUB. LOT ` i >.{.�%1 �°�'�.r-' "`��;-�.�Y�Cr4.�.., G•�,��, �ii��'�- �..1��. f- t✓Gf.'��"� ��. � I��i -9�e"�t�P�.� P`i?"'=_�'".� tag~� Y�r`-^c'"G+fP"�1 F RMER OWNER vJ,XO-� N E ACR. t'1GC c"� ,i/rtNr-y i'tLs S W TYPE OF BUILDING RES. to SEAS. VL._-� FARM COMM. CB. MICS. Mkt. Value LAND IMP. TOTAL DATE REMARKS ��V-c)-(j-o r,/0, llql�I- �D Al AtWlr9- `c "�� ��iw'a �� t7a-'.� .otl at q,-, = ��Ytbr I-iAes� 40 Tillable FRONTAGE ON WATER Woodland FRONTAGE ON ROAD Meadowland DEPTH House Plot BULKHEAD Total all �- . : - ��.,,�... . i,� � ■■■■■■■■■■I■�1��!®I NOON ■ NOON■■■ ■■■■■■■■■I■iIORol NONE■■■■■■■■■■ f:.�_ , .• '',r b, .,�.—- . , + ��■■■■■■■N��■■O®■1■■■■■■ NOON■ ■■■■N!■Ori■■ti■i�©fit■■■■■■■■■N■■MEN f, ' . • .,:. .:. . `. .!, - . . • NOON■■■0■■�■lI���IGJ Fire Place Rooms I st Floor Recreation Room Rooms 2nd Floor 10 : .. _ ,; • ■■Ne■■■■■■■ ■����■■■■■ NOON■■■ ■■■■■■■■■■■■■■■■■■■■■■■■■■■■■ _ � . � , ■■■■■■■■■■■■■■■■■����®�®NOON■■ `i • � T SO(/j,�®l Town Hall Annex ® Telephone(631)765-1802 54375 Main Road Fax(631)765-9502 P.O.Box 1179ell Southold,NY 1 June Ol� aQ LU COu ,`` BUILDING DEPARTMENT Michael & Adena FriedbergTOWN OF SOUTHOLD 1 Shore Lane, Apt 2001 Jersey City,t' Y 7310 Re: 295 Shore Lane, Peconic 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. l n5 A fee of$50.00. Final Health Department Approval. Plumbers Solder Certificate. (All permits involving plumbing after 411184) Trustees Certificate of Compliance. (Town Trustees#765-1892) Final Planning Board Approval. (Planning#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 - 39309 — Swimming Pool SURVEY OF MAP OF41 1 RICHMOND SHORES AT PEMMIC 10, 66) 0. nLE M3 6an rMID NOVEWBER 20.1979 CZ) .SITUATED AT -Z. PECONIC' J ,4 6 TOWN OF SOUTHOLD 1 < lwooe SUFFOLK COUNTY, NEW YORK S S.C. TAX No. 1000-86-01-4.19PV� - SCALE 1"=40' ;z JUNE 24. 1999 •2,1 KIM[,—FOMI V-OJSF 4. Y»f 1 1 MWW4 M&Tl^ rli+111 IS M,2 F AREA 21,6191.50 sq•ff. gyplz I 0.498 cc. fu" 2 0 6630 00- lam d ID 00. JoseP6 A. Ingegno Land Surveyor 00 S..1331 .4 t' PATE. SIZE, J 0 p p� C&��p���a p�a.5� A&�, ERN" q��� pp��pq ! �V tlC3'�6 9 4 A�� B Fra��_� WALL PAS PLOOR PATTER WNER& DEPT M-.— HUN( OVERLAP (drivis one) 20 GAUGE 27 0 UGE Ord@ cirm) aid' a � < Tit Ty f els? C��a ep.L #--r S 7-IX lVl4,VS ►► LL O �C� �1 P� r� �a r �