HomeMy WebLinkAbout41096-Z Town of Southold 5/18/2017
0
y P.O.Box 1179
53095 Main Rd
�4,1 ��0� Southold,New York 11971
CERTIFICATE OF OCCUPANCY
No: 38955 Date: 5/18/2017
THIS CERTIFIES that the building IN GROUND POOL
Location of Property: 1090 Laurelwood Dr., Laurel
SCTM#: 473889 Sec/Block/Lot: 127.-7-9
Subdivision: Filed Map No. Lot No.
conforms substantially to the Application for Building Permit heretofore filed in this office dated
10/13/2016 pursuant to which Building Permit No. 41096 dated 10/19/2016
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:
IN-GROUND SWIMMING POOL,FENCED TO CODE, AS APPLIED FOR
The certificate is issued to Harned,Richard
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL
ELECTRICAL CERTIFICATE NO. 41096 12-14-2016
PLUMBERS CERTIFICATION DATED
ut o ed Signature
�o�guFFotK�oTOWN OF SOUTHOLD
BUILDING DEPARTMENT
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#: 41096 Date: 10/19/2016
Permission is hereby granted to:
Harried, Richard
PO BOX 212
Laurel, NY 11948
To: construct an in-ground swimming pool as applied for.
At premises located at:
1090 Laurelwood Dr., Laurel
SCTM # 473889
Sec/Block/Lot# 127.-7-9
Pursuant to application dated 10/13/2016 and approved by the Building Inspector.
To expire on 4/20/2018.
Fees:
SWIMMING POOLS -IN-GROUND WITH FENCE ENCLOSURE $250.00
CO - SWIMMING POOL $50.00
Tot 1: $300.00
Li
LBuildi4 Inspector
Form No.6
TOWN OF SOUT14OLD
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$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
Date. /Q` l 3—`�,
New Construction: Old or Pre-existing Building: (check one)
Location of Property: /D op -;>Zi u6� L A u?EL
House No. Street Hamlet
Owner or Owners of Property:
Suffolk County Tax Map No 1000, Section 17-7 Block Lot f
Subdivision Filed Map. Lot:
Permit No. Date of Permit. Applicant:
Health Dept. Approval: Underwriters Approval:
Planning Board Approval:
Request for: Temporary CA ficate Final Certificate: !/ (check one)
Fee Submitted: $
Applicant Signature
pF SO!/�y®lo
Town Hall Annex Telephone(631)765-1802
54375 Main Road y Fax(631)765-9502
Asc
P.O.Box 1179 �Q roger.riche rt(a-town.southoId.ny.Lis
Southold,NY 11971-0959
®um,�
BUILDING DEPARTMENT
TOWN OF SOUTHOLD
CERTIFICATE OF ELECTRICIAL COMPLIANCE
SITE LOCATION
Issued To: Harried
Address: 1090 Laurelwood Drive City: Laurel St: New York Zip: 11948
Building Permit#: 41096 Section: 127 Block: 7 Lot: 9
WAS EXAMINED AND FOUND TO BE IN COMPLIANCE WITH THE NATIONAL ELECTRIC CODE
Contractor: DBA: Electric Tec Inc. License No: 4814-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 1 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 1 A/C Blower Range Recpt Fluorescent Fixture Pumps 1
Transformer Appliances Dryer Recpt Emergency Fixtures Time Clocks 1
Disconnect Switches F1 Twist Lock Exit Fixtures TVSS
Other Equipment: Inground Swimming Pool to Include, Bonding, Salt Generator, 1- Pool Light,
2- GFCI Circuit Breakers.
Notes:
Inspector Signature: Date: December 14, 2016
0-Cert Electrical Compliance FormAs
SOUThOIo
�yUOUNiV,��
TOWN OF SOUTHOLD BUILDING DEPT.
765-1802
INSPECTION
[ ] FOUNDATION 1ST [ ] ROUGH PLEIG.
[ ] FOUNDATION 2ND [ ] rULAY40N
[ ] FRAMING / STRAPPING [X FINA r
V)
[ ] FIREPLACE & CHIMNEY [ ] FIRE SAFETY INSPECTION
[ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRATION
[ ] ELECTRICAL (ROUGH) [ ] ELECTRICAL (FINAL)
REMARK
�00 I -
r
DATE lY INSPECTOR
I�9_ l� q SObTyo!
TOWN OF SOUTHOLD BUILDING DEPT.
765-1802
INSPECTION
[ ] FOUNDATION 1ST [ ] ROUGH PLEIG.
[ ] FOUNDATION 2ND [ ] SULATION
[ ] FRAMING / STRAPPING [Vf FINAL P06
[ ] FIREPLACE & CHIMNEY [ ] FIRE SAFETY INSPECTION
[ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRATION
[ ] ELECTRICAL (ROUGH) [ ] ELECTRICAL (FINAL)
REMARKS: ^ � �
vG 0
DATES I INSPECTOR
FIELD INSPECTION REPORT7DATE COMMENTS
FOUNDATION (1ST)
----------------=--------------- LN
----
C
FOUNDATION (2ND) N
z ®
o
ROUGH FRAMING&
PLUMBING H
4 '
INSULATION PER N.Y.
STATE ENERGY CODE
I I�- G& WC& 'Cd S i
lb �� 0
oey
FINAL
ADDITIONAL COMMENTS
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TOWN OF SObTHOLD 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) 7654802 Planning Board approval
.FAX: (631) ,765-9502 - . Survey .
SoutholdTown.NorthFork.net PERMIT NO. q(0!1 QZ Check
Septic Form
N.Y.S.D.E.C.:
Trustees
C.O.Application
D
1E, E
� n� Flood Permit
Examined 20a�V/! Single&Separate
DD
OCTtact:
T 1 3 2016 Storm-Water Assessment Form./
t✓
� �-� -
Approved ,20 Mail to: Ch i luk Rod /s
Disapproved a/c gjJjL jNGDEM
�O F Ph�n .,/ Z� 'lo&S'
Expiration 120
Building Inspector `
APPLICATION FOR BUILDING PERMIT
Date �1,� f/ 20le�q
INSTRUCTIONS
a. Thi's 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 of 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 Dave 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.
f�I7rJK 7201&5 L
(Signature of applicant or name,if a corporation)
(Mailing address'of applicant)
State whether applicant is owner, lessee, agent, architect, engineer, general contractor,electrician, plumber or builder
Name of owner of premises
(As on the tax'roll or latest deed):
If applic t is a co r ion, si nature 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 which proposed work will be done:
,,LLQ `D2,/ LAu2EL
House Number Street vlkiolll N'i`"M ti A- t
County Tax Map No. 1000 Section xt" ^?''� '�`E�os't{�'�'
fZ7 Block . 4.1i n i.bl.�;��oex Lot
Subdivision Filed Map No. 3315'5- Lotzv
.
2. State existing use and occupancy of premises and intended use and occupancy of proposed construction:
.a. Existing use and occupancy /-X 5iT,4: LG6
b. Intended use and occupancw»14
3. Nature of work(check which applicable):New Building Addition Alteration
Repair Removal, Demolition ther Wo 1;AO-C720"0D
-- (Description)
4. Estimated Cost '1101.57 ovv,veer W4,
-bopaid on filing this application)
5. If dwelling, number of dwelling units I Number of dwelling wits on each floor
If garage, number of cars9� /{ i
6. If business, commercial or mixed occupancy, specify nature and extent of each type of use.
7. Dimensions of existing structures, if any: Front 7 f Reay, 7y Depth 93.5��
Height -25-' Number of Stories- Z" ;
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 /fid Rear ZS Depth 0270
10. Date of Purchase Name of Former'Owner
11. Zone or use district in which premises are situated �CSmotn,ia�
12. Does,proposed construction violate any zoning law, ordinance or regulation? YES NO
13. Will lot be re-graded? YES„ X NO ; Will excess fill be removed from premises? YES X NO
14. Names of Owner of premises tic, 'b 14AR�ve�> Address z , Phone No.&31-z9S--&&y6
Name of Architect Address «` 'Ny"9 Phone No
Name of Contractor 0-4i,-une 4--". Address-?O"aox 9 cum c�Phone No. G3���y-7G�S
,-)93, -
15 a. Is this property within 100 feet of a tidal wetland or a freshwater wetland?,*YES NO X
* IF YES, SOUTHOLD TOWN TRUSTEES & D.E.C. PERMITS MAY BE EQUIRED.
b. Is this property within 300 feet of a tidal wetland? * YES NO x' '
* 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 DC.
* IF YES, PROVIDE A COPY.
STATE OF NEW YORK)
1 SS:
COUNTY OF 6I
elyloa� being duly sworn, deposes land says that(s)he is the applicant
(Name of individual signing contract) above named,
(S)He is the
(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.
Sworn to before me thi _
day of � 20 _ -
' SABRINA M BORN
Notary Public, State of New York
01 6317038
Notary Public, Cualifie in Suffolk county - Signature of Applicant
Commission Expires Dec.22,2018
Scott A. Russell
�� STO]KI��1 WA\T]EIK
SUPERVISOR co 0M[A\� ,G�]ENHENT
SOUTHOLD TOWN HALL-P.O.Box 1179 m
53095 Main Road-SOUTHOLD,NEW YORK 11971 Town of So u th o l d
CHAPTER 236 - STORMWATER MANAGEMENT WORK SHEET
( TO BE COMPLETED BY THE APPLICANT )
DOES THIS PROJECT INVOLVE ANY OF T1I-IlE FOLLOWING:
Yes No (CHECK ALL THAT APPLY)
❑ffA. Clearing, grubbing, grading or stripping of land which affects more
than 5,000 square feet of ground surf ace.
❑E]'/B. Excavation or filling involving more than 200 cubic yards of material
within any parcel or any contiguous area.
❑Q/C. Site preparation on slopes which exceed 10 feet vertical rise to
,_,/ 100 feet of horizontal distance.
E][3 'D. Site preparation within 100 feet of wetlands, beach, bluff or coastal
erosion hazard area.
❑Ef/E. Site preparation within the one-hundred-year floodplain as depicted
,.....,� -on-FIRM-M- ap-of any water-cou-r--se: - - --
❑L" r . 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 Contractor,Other) S.C.T.M. #: 1000 Date.
Disttrju L�
NAME: GN/'U� f'�iL�S 6 97.1 l Z? /
i� Section Block Lot
FOR BUILDING DEPARTMENT [,SE. ONLY
Contact Information
Reviewed By:
— — — — — — — — — — — — — — — — — — CmIS"
Date- 16—/3/�0
Property Address / Location of Construction Work: 1�m
— — — — — — — — — — — — — — — —
Approved for processing Building Permit
/09U GiQy/Z.�.LGyyy7� 'D�- Stormwater Management Control Plan Not Required
— — — — — — — — — — — — — — — — —
4-t44)X=4-, .t11/lf`/6 ® Stormwater Management Control Plan i�Required.
(Forward to Engineering Department for Review)
FORM I" SMCP-TOS MAY 2014
0f SOUr I :
Town Hall Annex Telephone(631)765-1802
54375 Main Road QQ2
P.O.Box 1179 G roper d hertCa-own sOU OItl ny us
Southold,W 11971-0959 ` a�
�4UNt'h D
D
BUILDING DEPARTMENT N O V 2 9 2016
TOWN OF SOU I OLD
APP'LICATION FOR ELECTRICAL INSPECTION
BUILDING DEPT.
' LD
REQUESTED BY: ZCj Date: _
Company Name: ( .
Name: �, m
License No.-. I
Address: q3 Ave, �Zkv-�P r (1 1 `C('® l _
Phone No.: rr��� ee 1 2J ®I c
JOBSITE INFORMATION: (*Indicates required information)
—`Name:------ -- -----._ - . -- ---- - :_ ----
*Address: �-� L y ,
*Cross-Street:
*Phone No.:
Permit No.:
Tax Map District: 1000 Section: ( Block: _ Lot:
*BRIEF DESCRIPTION OF WORK(Please Print Clearly) fl n�
(Please Circle All That Apply) -
*Isjob ready for inspection: PE6, / NO Rough In Final
*Do you need a Temp Certificate: YE ! O
Temp Information (If needed} -
*Service Size: 1 Phase Whase 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 -` b
i• r!J � �
TOWN OF SOUTHOLD PROPERTY -.. ORD CARD
r�OWNER STREET 6) VILLAGE DIST. ! SUB. LOT
La. v4-e-1 b f-jec Za u.. Y e:-L_. (zct- re.L o e d rs -s
9FMER OW ER !, N E ACR.
SW TYPE OF BUILDING
RES SEAS. VL. FARM COMM. CB. MICS. Mkt. Value
LAND IMP. TOTAL DATE REMARKS — 36
/10
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a Q K o o ; 2-1-1612003
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FRONTAGE ON WATER
Noodland FRONTAGE ON ROAD
Aeadowkxld DEPTH
iouse Plot BULKHEAD
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7
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porch o4, 2S Ext. Walls on�� �j `q•Interior Finish
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YAV-111 �9�4.5�..SURVEY 8- 12'-77
'SUF'FOLK,,,C'O,UfVTY THE WATER SUPPLY S. SEWAGE NAME
r; `DEPAR:TA�I HE-ALtHl 'DISPOSAL FOR THIS RESIDENCE
'S'ER-VI"CE•S`,FOR APPROVAL WILL CONFORM TO THE STAND- ADDR;ES'S
`Q' ,,'C4�,'I1 6�U.CLT'ION' ONLY ARDS OF THE' SUF{�OLK COUNTY
DATE �` 'H'S:REF NO, DEPT. OF HEALTH SERVICES.
APfR;C7"V,ED TELE •
PHONE
O „ N :1'O� 'NO. 77=- 303 Ff'L E NO 'LAUR1wLWD ESTE.
f' THE' '•OFFSETS (OR -DIMENSIONS) GUARANTEES ;INDICATED HEREON
SHOWN, HERGON; FtR 0'M T H E" SHALL RUN ONLY TO THE PERSON, - - • -
1 ' S,IT,RUCTURES TO, THE 1 PROPERTY FOR'Y/HOPS .THE SURVEY IS PRE- S U F V E Y E D• ',FOR'
r LIINES,:ARE,FOR,•A ,SP,ECIFIC'P¢R- PARED, AND ON -RIS BEHALF TO
PQSE.°AND,'USE'.'AW7� r4E?EFORE T(IE•'T!TLE COMPANv GOVERNMEN.
•" 1 ARE NOT;,I NTENDED,TO''.GIIIixEiAiE' T'V AGENry A,•!n ipiDING INsn• LOT NUM'I�ER •2'1 '
' �ERtCTION OF•,FEld'";RETAINING TOrDN IIS"cam HERFO'I, AND TO -
!; WALLS:'POOLS. .PATIOS. 'P "PITfnar ; T": ASSIr"EE_S OF THC LENDING
.AREAS;,''AOD'IJ,IC(I ;Tb 'RI!!IDIPIGS IN''- imlfj GUARANTEES ARE MAP O LAU-RE,LW'OOD ESTATES
OR✓ANY,OTHER.CONSTP.UCTION. liar TR+ASFFR.431 E TO ADDITIONAL •; ,
~ ! INSTITUTIONS OR SUBSEQUENT SITUATED AT L A U R E L-
-f ,•'UNUTHOAIZSD:�„'ALTERATION ' ORS OWNERS - ` ,
"'ADDITTONI T0'THIS^,SURVEY-,IS_, A •
( V16 ATISN OP-SECTION;7209,.OF COPIES OF THIS SURVEY MAP NOT TOWN OF S O U-T RO L'D-� SUFFOLK C'O'UNTY N.`Y:
'41 1 THIt-NEW,Y9RK_ST.�1TE';EDUCATION BEARING THE LAND SURVEYOR'S
- LAW. I, - ; n, .-; INKED SEAL OR EMBOSSED SEAL SdA L E 1 r 5O^ - ,:DATE ' -6,-'17-'19-77
SHALL NOT BE CONSIDERED TO BE ,
A VALID.T
r r:, RUE COPY. FILED MAP 'Nb..
N' •55:�;5 DATE;, 5 ,'l 7- 1'977”
F' GUi R,A_NTE,ED ".OiJ�Y TO' BOOK NO: LOOSE`L'EAF PAGE
" 'v"E'RHE''A'D,SA;VINGS. BANK' HAROLD' F" 'TRANCFIO,
N J R .-P'C.
T'',y'EL7lTLE>>"•'GUAf�A,taTEE CO. L'A'N'D ` SURVEYO_R'
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NORTH COUNTRY, !ROAD 11VA'D1fd'G, R=IVR:
J 'HA'R4LI� t`; TRd►'N'CHON JR._ N'
Y. LIC. ,NO. 048992 NEW Y.OR:K_ 11,792
PENN. LIG NO.21.175- E (5.1,f�)9'29-45`9`5 Ak,'T, '4'•73=,.'3 2,5';
APPROVED AS NOTED
DATE.O• &P.# L0CO11riPL``( WITH ALL CODES OF
FEE: B :® NEW YORK STATE & TOWN CODES
NOTIFY BUILDING D TMENT 'AT AS REQUIRED
765-1802 '8'AM TO 4 PM. FOR THE S I
FOLLOWING INSPECTIONS:,
1. FOUNDATION - TWO.REQUIRED , S^'I�Tia^ =R bAiMNG BARD
FOR,POURED CONCRETE -r) n T IN TRi iSTEES
2. ROUGH -'FRAMING '& ,PLUMBING - -
3. INSULATION
4: FINAL CONSTRUCTION. MUST �g ®
BE COMPLETE FOR C:O,
ALL CONSTRUCTION' SHALL MEET THE OCCUPANCY OR
REQUIREMENTS OF THE CODES OF NEW
YORK STATE. NOT ,RESPONSIBLE FOR USE IS UNLAWFUL
DESIGN OR CONSTRUCTION ERRORS. WITHOUT CERTIFICATE
--;; MPAE
®� iT �Y��'}-} OF OCCUPANCY
ENCLOSE POOL TO CODE, {
UPON COMPLETION
,BEFORE°WATefr , { ELECTRICAL
INSPECTION REGLARED
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