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Home My WebLink About41108-Z o�g�FFOI,fCpG Town of Southold 7/24/2017 y� P.O.Box 1179 0 53095 Main Rd �y�►a� ��o`" Southold,New York 11971 CERTIFICATE OF OCCUPANCY No: 39074 Date: 7/24/2017 THIS CERTIFIES that the building IN GROUND POOL Location of Property: 455 Three Waters Ln, Orient SCTM#: 473889 Sec/Block/Lot: 15.-7-11 Subdivision: Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated 10/17/2016 pursuant to which Building Permit No. 41108 dated 10/25/2016 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: ACCESSORY IN-GROUND SWIMMING POOL,FENCED TO CODE,AS APPLIED FOR The certificate is issued to Raphael,Frank of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL ELECTRICAL CERTIFICATE NO. 17-44403 06-28-2017 PLUMBERS CERTIFICATION DATED t o ' ed Signature o�guF�ot�� TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE oy SOUTHOLD, NY dol � ,dao 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#: 41108 Date: 10/25/2016 Permission is hereby granted to: Raphael, Frank 243 River Rd Nyack, NY 10960 To: construct accessory in-ground swimming pool fenced to Code as applied for. At premises located at: 455 Three Waters Ln SCTM # 473889 Sec/Block/Lot# 15.-7-11 Pursuant to application dated 10/17/2016 and approved by the Building Inspector. To expire on 4/26/2018. Fees: SWIA4MING POOLS -IN-GROUND WITH FENCE ENCLOSURE $250.00 CO - SWIMMING POOL $50.00 Total: $300.00 Buildin erector Q � p `AP (10 Form No.6 u (Q 31 ,-7 71-q V Z 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 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. //A New Construction: '706 L Old or Pre-existing Building: (check one) Location of Property: YS� %�ti? Gv'--m s L iy T/Z°=.V-r PC/•,- House No. Street Hamlet Owner or Owners of Property: R Suffolk County Tax Map No 1000, Section /S Block 7 Lot Subdivision a xi crrr i3 y • 7,� gay ?wa, Filed Map. s' Lot: Permit No. Date of Permit. Applicant:_ r✓i� pva C �,✓L Health Dept.Approval: Underwriters Approval: Planning Board Approval: Request for: Temporary Certificate Final Certificate: (check one) Fee Submitted: $ - E711i'can ignature Certificate of Compliance' ..........................................................................................................i.......................................................................................... CERTIFIED ELECTRICAL INSPECTIONS, INC. 188 PARK AVENUE AMITYVILLE, NY 11701 P: (631) 598-5610 ................................................................................................................................................................................................... CERTIFIES THAT Upon the application'ofl� Upon premises owned by All Wright Electric Frank Raphael 1290 Flanders Road 455 Three Waters Road Flanders, NY 11901 Orient, NY 11957 Located at:'455 Three Waters Road, Orient,'NY 11957 Application Number#: 17-44403 Certificate MI 17-44403 Electrical License M 43457ME Section: Block: Lot: Building Permit#: 41108 Name QTY LV Transformer- 15/2 Amp, 120/14V 1 Pool Receptacle -20 Amp, 240V 2 Electrical Inspector: Anthony Giordano VaCAL % Z-S. APPROVED 0 This certificate is not valid unless raised seal is present. Certificate of Compliance ............................ ...............................................................................................I........................................................... CERTIFIED ELECTRICAL INSPECTIONS, INC.' 188 PARK AVENUE AMITYVILLE, NY 11701 P: (631),598-5610 ................................................................................................................................................................................................. CERTIFIES THAT Upon the application,of Upon,premises owned by All Wright Electric Frank Raphael 1290 Flanders Road 455 Three Waters Road Flanders, NY 11901 Orient, NY 11957 Located at: 455 Three Waters Road, Orient, NY 11957 'Application Number'#: 17-44403 Certificate#: 17-44403 Electrical License M 43457ME Section: Block: Lot: Building Permit#: 41108 Described as a Residential occupancy, wherein the premises-electrical system consisting of electrical devices and wiring, described below, located in/on the premises at: Swimming Pool A visual inspection of the premises electrical system, limited to electrical devices:and wiring to the extent detailed herein, was conducted in accordance with the requirements of thb.applicab,le code/or standard promulgated by the State of New York, Department of State Code Enforcement and Administration, or other authority having jurisdiction, and found to be in compliance therewith on the 28th day of June 2017 Name QTY LED LV Light Fixture 2 Pool Panel -60 Amp, 240V 1, GFI Circuit Breaker-20 Amp, 220V 1 Pump Motor Circuit-20 Amp, 220V 1 Pool Switch - 15 Amp, 120V 1 Time Clock-40 Amp, 220V 1 GFI Receptacle- 15 Amp, 120 V 2 Swimming Pool Bonding 1 GFI Circuit Breaker- 15 Amp, 220V 1 Electrical Inspector: Anthony Giordano I fit S 19iAPPROVEDo . .. ........ This certificate is not valid unless raised seal is present. �pF S0111,�, TOWN OF SOUTHOLD BUILDING DEPT. 765-1802 INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLEIG. [ ] FOUNDATION 2ND [,?WSULA70 �� N [ ] FRAMING / STRAPPING [ INAL [ ] FIREPLACE & CHIMNEY [ ] FIRE SAFETY INSPECTION [ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRATION [ ] ELECTRICAL (ROUGH) [ ] ELECTRICAL Zvi REMARKS: - t f� �. Pi�i4 • DATE INSPECTOR ` R MAS ® ® SHERMAN ENGINEERING &CONSULTING C F 70 MAGNOLIA DUNES CIRCLE ST AUGUSTINE,FL 32080 S E 631.831.3872 June 17,"2017 Building Department ' Town of Southold 53095 Route 25 Southold, NY 11971 Re: Pool steel inspection; Permit#41108; 455 Three Waters Ln SCTM 473889; 15-7-11 Building/Zoning Official, This certification is for the foundation steel installed at the above referenced property on or about May 29, 2017. The rebar was installed in substantial compliance with the approved design with #4 bars at 10" each way throughout the bottom and*4 bars at 10" horizontal and 5" vertical in the walls. All steel was spaced to be in the middle of the 8" concrete shell with appropriate laps and intersections tied in accordance with acceptable building practices. This certification is limited to the installed structures and does not include nor does it address plumbing, electrical, site placement, or any other aspect of construction. Please contact me if you have questions or require clarification for this certification. Very trul yo Sher ngin ring & Consulting, P.A. Matthew Sherman, P.E. OT � JaA D � 7 F S ) �1:,� ; 1(,`i JUN 21 2017 DEPT• �GsF�1,083,C',k DING �._ TOWN OF SOUTSOLD �'� S s 10c�WV TO CnnL ENGINEERING DESIGN SITE PLANNING PERMr"ING FIELD INSPECTION REPORT DATE COMMENTS �✓ �K � .Qe� Q rJ � � FOUNDATION(1ST) r7l -------------------------------------- FOUNDATION (2ND) O ROUGH FRAMING& PLUMBING INSULATION PER N.Y-. STATE ENERGY CODE FINAL ADDITIONAL COMMENTS Q t to � *-+ -. o K z • rn o. d 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 119171 4 set of Building Plans TEL: (631) 765-1802 ; Planning Board approval FAX: (631) 765-9502 Pu ySoutholdTown.NorthVork.net PERMIT NO. i Septic Form N.Y.S.D.E.C. Trustees I C.O.Application Flood Permit Examined ` ,20 Single&Separate w Storm-Water Assessment Form Contact: Approved �j ,20110 _Mail-tea> J LAD Disapproved a/c Phone: 031-1- -9V Z 9 (c- Expiration ,20 (� Bui mg nspector i PPLICATION FOR BUILDING PERMIT OCT 1 7 ,2016 Date r� // , 20� INSTRUCTIONS BUILDING DEPT. • TOWN 0 a. I his app kation e 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,re,lationship+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 Perinif'tb 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 of applicant or name,if a corporation) (Mailing address of applicant) !i y4 Y 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 applicant is a corporation, signature of duly authorized officer �Grr• n ��`I�c�er � ��vl.e�.e.�' Taa�S, � Nc - �,wv�e.-r (Name and title!of corporate officer) Builders License No. 3—] �—► q� Plumbers License No. Electricians License No. Other Trade's License No. 1. Location of land ons which proposed work will be done: House Number Street Hamlet County Tax Map No. 1000 Section / :5— Block 7 Lot �� Subdivision "g2icyr Ay rxa 1;61" Sec. �wz Filed Map No. 3,15"y Lot Ss/ 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 A-dditti Alteration Repair Removal Demolition her Wor — J (Description) 4. Estimated Cost 4 y7(,o® as Fee (To be paid on filing this application) 5. If dwelling, nu er of dwelling units Number of dwelling units o each floor If garage, numberof cars 6. If business, commercia\rh,- ed occupancy, specify nature and ex t of each type of use. 7. Dimensions of existing structures, if Front Rear Depth Height Numf 6r of tories Dimensions of same structure with.alteratistxs or dditions: Front Rear _ Depth Height / \ Number of S bF1 �` —VEL s 8. Dimensions of entire new constr�tro- : Front Rea Depth Height / Number of Stories 9. Size of lot: Front /� Rear Depth 17 PIR OV121-IM"MOU319 10. Date of Purchase 9/� //3 Name of Former Owner 11. Zone or use district in which premises are situated 12. Does proposed construction violate any zoping 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 Frank?,,nhn.�Address RD Phone No. 8YS- SFS'- 00e7 ,,tame Of A-..6R44Address- 1v/,4----k,1vy lo9&0 Phone No Name of Contractor Address' 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 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 being duly sworn, deposes and 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 this�,� day of UC''4620/(, Notary Public SHARON O.JACOBSS' 4 r of pplicant Notary PubNo. Notary JA50811ate 68 w York Qualified in Suffolk Counl�_ Commission Expires June 30, U�-1ti�15�11:41 : 2593445 (,A 6 4� ovk"R�Tcwm HWI Ann=SW,$Mak Diffid fo1ffthP.O.Box1179 Southold.NY 119740959 , BUIMANG DEPARThfWr 'OWN OF SOUTHOLD AP-E!uc TION FFR Et gMQ&L IN EczION REQUESTED BY: - Date: Company Name: All V-� 1- Co Name: c4841 On License No.: 3 sq- Address. Phone No.: 6 V 1 )-3SS J013SITE INFORMATION: (*Indicates required information) *Name: -- 01rJ K )2a ) _ *Gross Street. Phone No.: } Pemlt No.: liog, Tax Map District 100o Section: Block:� Lai "ERIEF DESCRIPTION OF WORK(Please Print CIeW — Poo 90,w Gimle All That Apply) *Is jab ready for inspedion: YES/ NO Rough In F'Irtsl .*Do you need a Tamp Cerf ftcats: YES/ NO 'Camp Infiannatlon(ff neeftd) *Service Wei 1 Pha:3e Whas 100 150 200 300 350 400 Older *Mew SerAce: Re-conned Undereround Numbw of Maters Change of Serfte QvvefluW AddMonal Information: pAYAAENX a� W! APPLICATION / cK KAaI le oviS l-7, tap . - -will CgE w�er ve0cl rov7 k- o j B�Requeot!ar Inapadion Form '—s , s Scott A. Russell ��-� �� ST0][ZNIWA IER SUPEI2VIS0R c NIANA(G!JENUEN T y SOUTHOLD TOWN HALL-P.O.Box 1179 p 53095 Main Road-SOUTHOLD,NEIN 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 THE 1F®1L.IL®VaN G: Yes No (CHECK ALL THAT APPLY) ❑U3'4A. Clearing, grubbing, grading or stripping of land which affects more ��than 5,000 square feet of ground surface. ElU B Excavation or filling involving more than 200 cubic yards of material within any parcel or any contiguous area. ®12(C. Site preparation on slopes which exceed 10 feet vertical rise to 100 feet of horizontal distance. ❑E✓(D. Site preparation within 100 feet of wetlands, beach, bluff or coastal erosion hazard area. ❑[(E. Site preparation within the one-hundred-year floodplain as depicted on FIRM Map of any watercourse. ❑[j"`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.Contractor,Other) S.C.T.M. #• 1000 Date- NAME: 47,(A,-A5-f2_ jDy c LS 7J✓C— 15 Section Block Lot _!d fSisNmm kti..- ..cs "'01"i BU11 ING DEPAPTNIENT L.ZE ONLY Contact Information, _j'JV Co—,. 6,31- 7 5/9- 2-1,(o Reviewed By — — — — — — — — — — — — — — — — — — / Property Address / Location of Construction Work: Date. — — — — — — — — — — — — — — — — Approved for processing Building Permit. 7�i 1�✓97 /ZS G�✓r/ Stormwater, Management Control Plan Not Required ��/EN! ❑ Stormwater Managcrricit Control Plan i�,Required (Forward to Engineeiing Department for Review) FORM � SMCP-TOS MAY 2014 OI FE. I' w. N01°02'20"E 100.00' o .— m I B Its B I B 00 D V L� D [ oxo o ,x'01 v MAY 1 6 2017 0 v m __ �3 BUILDING DEPT. A B TOWN OF SOUTHOLD C —_— GONG. b PATIO rn 1O lo' I to e_ r►a' 2 STORY STUCCO HOUSE AND GARAGE fv w N Ila, ti Lu to ~ 20.1' I6' STONE DRIVEWAY \�. o �� F•+ � B � 1 � o a� t 1 � � i 110.00 S01002'20"W 100.00' mss' Thrcc Watcro La n P 2 NP AC L goo- AP ROVED AS NOTED DATE: B.P.g FEE: BY: COMPLY WITH ALL CODES OF OCCUPANCY OR NOTIFY BUILDING DE:PARTiA T A. NEW YORK STATE & TOWN CODE 765-1802 8 AM TO 4 PM FOR THE AS REQUIRED AND CONDITIONS O USE IS UNLAWFUL FOLLOWING INSPECTIONS: 1. FOL),ZATION - TWO REQUIRED WITHOUT CERTIFIC� - FOR POURED COINCRE T r 2. ROUGH - FRAMING & PLUMBING OF OCCUPANCY 3. INSULATION s 4. FINAL - CONSTRUCTION MUST BE COMPLETE FOR C.O. filft.DEC ALL CONSTRUCTION SHALL MEET THE REQUIREMENTS OF THE CODES OF NEW �$ '?� �` ELY'„Y'' YORK STATE. NOT RESPONSIBLE FOR � �"� �� 5,� ENGLOSE,f ooL TO COU'-- DESIGN OR CONSTRUCTION ERRORS. RETAIN STORM WATER RUNOFF UPON CO�APLETION PURSUANT TO CHAPTER 236 ',B,EFORE"WATERS OF THE TOWN CODE. ELECTRICAL INSPECTION REQUIRED h r ,Q 5UFZ1(E't' O>r 1.01' # 41 ---- ;Uhl Lane Extension N IIORIEKT—BYNTHE— ° SECTION ONE 'FILED N01/ RZ�, Ig3'1 SITUAT'Ei OR 'POINT s TOM, SWTHOLD VirrOLr..OWN'ry, NY ILOr s PWI �AYIID.O021.a0,T 0N 03.26-04 LI-p60 .C4 05, 04.03 S88057140"E 125.00' SUFFOLK COUNTY TAX 1I I 1000-13•1-II Q „_mow wsraR eDlanee W— CERTIFIED T0+ j �7p �. YT �' ,YL• - PATRICIA E.KREN C ELLEN B,KREN DIS' PETER w,KREN FC7n ��•' ' � ' FIDELITY NATIONAL TITLEcp< ST , � ,u �• � .� � � IDD' I 4, ' +t,� � 'r ." ;i i S" +IFN• `it 61 r -70 Od m I 4 of XD J - ft' N$8057'40"W 125.00' NOTES rwx.•..••�•-...wH�•...M 0 PIPs AREA a 12 OO F OR 0,29 ACRES 1 fLOT 42 •p:r"wTi ELEVATIONS ARE FROM PILED MAP1ry�:�+�^'�,«,,��,+^,,,., � SEPTIC t HELL LOCATIONS ARL'FROM I'` p/� �"��- • FIELD 068ERVATION5� INPORMATION PROVIDED BY OTNERS M L�{1 I 1 ` r O Law202 I6 A69 15 e1 S P, 1 �1� S �,r(� JOHN C.EHLERS LAND SURVEYOR AVAILABLE 3fa»JAfU rOOTA6E 09 5,F �. i 1;J (�1� BEASTMR EMIN 61R81P N.Y.9.LIC.N0.A031 RIVBRIIBAD,N.Y•11901 RBF;11Hp Dan'Dt1.12000 pcw120-317.in aRAPHIG SCALE 1"a 369-8288 Pelt 369-8287 _ _ i 10.5" 12" Coping Pavers Mortar ::1 4 Compacted Sand 6" Tile 12" Bond Beam " Marble Dust Concrete #4 rebar (4) #4 rebor 10" o.c. throughoutcont. through verticals 5" o.c. where �" bond beam water depth exceeds 5' O O 12" TO 36" Radius Compacted Soil O rlJA 4" min. thick C-2 " Gravel base t �© 3554 =MOM At1ER1TidVf OR ADD=M IMS ORATING AND RI1AifD OXWO 6 A HMO OF SEI~7209 OF ltlt'KYS MOM LAW �SS1�F � R �- binaa ATE: 02.28.16 Typ Pool 5a R� SHERMAN ENGINEERING AFAS NOTED &CONSULTING P.A. Cross Section � 70 MAGNOLIA DUNES CIRCLE DRAWMG NUMBER r S E C : ST AUGUSTINE FL 32080 S► r 631.831.3872 1 2 skimmers 12" bluestone coping 36 ft. LO 18"x18" Corner seat X10 ft. 10 ft. . 16 ft. 3'x2' platform 3 LED lights (4)3'x1'steps 3 returns 10'x36' Gunite Pool 4.5-6 Feet deep Binder Pools, Inc. Phone: 631-749-2110 Designed by: SCALE: 1/8" = 1' PO Box 1960 Judy Card Designed RAPHAEL Shelter Island NY 11964 Fax: 631-749-3529 10/12/2016 for: 12"x2" pool 18"x 18"corner seat coping 3'x2platform latform pool tiles With (4)3'x1'stairs 2 skimmers 36 ft. 10 ft. loft. 16 ft. 8"Gunite shell 2 main drains 10' x 36' Gunite Pool Side view Binder Pools, Inc. phone: 631-749-2110 Designed by: SCALE: 1/8" = 1' RO Box 1960 Judy Card Designed RApHAEL Fax: 631-749-3529 Shelter Island .NY 11964 10/12/2016 for: