HomeMy WebLinkAbout40901-Z gufFBI 4,0oV Town of Southold
9/6/2017
0
P.O.Box 1179
* � 53095 Main Rd
Southold,New York 11971
CERTIFICATE OF OCCUPANCY
No: 39200 Date: 9/6/2017
THIS CERTIFIES that the building IN GROUND POOL
Location of Property: 37900 Route 25, Orient
SCTM#: 473889 Sec/Block/Lot: 20.-3-9.2
Subdivision: Filed Map No. Lot No.
conforms substantially to the Application for Building Permit heretofore filed in this office dated
3/23/2016 pursuant to which Building Permit No. 40901 dated 8/12/2016
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 Nathanson,Peter
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL
ELECTRICAL CERTIFICATE NO. 40901 11-10-2016
PLUMBERS CERTIFICATION DATED
0 V
t o ' ignature
��o�Sv�nc,r�aG TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN CLERK'S OFFICE
oy . 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#: 40901 Date: 8/12/2016
Permission is hereby granted to:
Nathanson, Peter
37900 Route 25
PO BOX 190
Orient, NY 11957
To: construct accessory in-ground swimming pool as applied for per Trustees and DEC
exemption letter.
At premises located at:
37900 Route 25
SCTM # 473889
Sec/Block/Lot# 20.-3-9.2
Pursuant to application dated 3/23/2016 and approved by the Building Inspector.
To expire on 2/11/2018.
Fees:
SWIMMING POOLS -IN-GROUND WITH FENCE ENCLOSURE $250.00
CO - SWIMMING POOL $50.00
Total: $300.00
Bu di Ins ector
Form No.6 r�\a4 do 4-0
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.
New Construction: Old or Pre-existing Building: (check one)
Location of Property: 32 1) / Al"U 57 02r J7
House No. Street Hamlet
Owner or Owners of Property: -__P07,:�577 A'A 7,q,&VSdA)
Suffolk County Tax Map No 1000, Section 0,U Block 0 Lot Z
Subdivision Filed Map. Lot:
Permit No. Date of Permit. Applicant:
Health Dept. Approval: Underwriters Approval:
Planning Board Approval:
Request for: Temporary Certificate Final Certificate: ✓ (check one)
Fee Submitted: $ (�
App scant Signature
pE SO!/T�,®l
0
Town Hall Annex Telephone(631)765-1802
54375 Main Road N Fax(631)765-9502
P.O.Box 1179 ® �� roger.riche rtR)town.southoId.ny.us
Southold,NY 11971-0959
BUILDING DEPARTMENT
TOWN OF SOUTHOLD
CERTIFICATE OF ELECTRICIAL COMPLIANCE
SITE LOCATION
Issued To: Peter Nathanson
Address: 37900 Route 25 City: Orient St: New York Zip: 11957
Building Permit#- 40901 Section: 20 Block: 3 Lot: 9.2
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 X Basement X 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 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 2
Transformer Appliances Dryer Recpt Emergency Fixtures Time Clocks 2
Disconnect Switches 11 Twist Lock Exit Fixtures 11 TVSS
Other Equipment: Inground Swimming Pool to Include; Bonding, 1- Pool Light, Salt Generator,
2- GFCI Circuit Breakers.
Notes:
Inspector Signature: Date: November 10, 2016
0-81-Cert Electrical Compliance Form.xls
OE SOUTyo�
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:
4-7
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DATE 0 �� ��' INSPECTOR j
4`` �O��DE 50Ujyo6
J � �
acOUNiY,a
TOWN OF SOUTHOLD BUILDING DEPT®
765-18®2
[ ] FOUNDATION 1ST [ ] ROUGH PLSG.
[ ] FOUNDATION 2ND [ ] INSULATION
[ ] FRAMING / STRAPPING [ ] FINAL
1�
[ ] FIREPLACE & CHIMNEY [ ] FIRE SAFETY INSPECTION
[ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRATION
ELECTRICAL (ROUGH) [ ] ELECTRICAL (FINAL)
REMARKS:
' ® � Gl pkl� � a,�e
DATE �(� ��' INSPECTOR
�o�aOF SO(/lyo�
�y00UNI'1,��
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:
r,-tlWW-.
DATE f CO INSPECTO1�0JIM;;1-
oFsocou
ur
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a
TOWN--OF SOUTHOLD BUILDING DEPT.
765-1602
INSPECTION
[ ] FOUNDATION 1ST [ ] ROUGH PLBG.
[ ] FOUNDATION 2ND [ ] SULATIION
[ ] FRAMING / STRAPPING [ FINAL /" MZ--
[ ] FIREPLACE & CHIMNEY [ ] FIRE SAFETY INSPECTION
[ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRATION
[ ] ELECTRICAL (ROUGH) [ ] ELECTRICAL (FINAL)
REMARKS: l J 'c .
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DATE 3 INSPECTOR
p I O��pF SOUTyo!
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��y�OUNi'1,a�
TOWN OF SOUTHOLD BUILDING DEPT.
765-1802
INSPECTION
[ ] FOUNDATION 1ST [ ] ROUGH PLEIG.
[ ] FOUNDATION 2ND [ ] SULATION
[ L] FRAMING / STRAPPING [ FINA
[ ] FIREPLACE & CHIMNEY [ ] FIRE SAFETY INSPECTION
[ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRATION
[ ] ELECTRICAL (ROUGH) [ ] ELECTRICAL (FINAL)
REMARKS:
Aft
DATE INSPECTOR
FIELD INSPECTION REPORT DATE COMMENTS
ro
FOUNDATION(1ST)
------------------------------------
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FOUNDATION (2ND) M
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ROUGH FRAMING& y
PLUMBING
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INSULATION PER N.Y.
STATE ENERGY CODE
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Li ADDITIONAL COMMENTS,
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TOWN OF SOUTHOLD BUILDING PERMIT APPLICATION CHECKLIST
BUILDING DEPARTMENT Do you have or need the following,before applying?
TOWN HALL J! Board of Health
SOUTHOLD, NY 11971 4 sets,of Building Plans 9/
TEL: (631) 765-1802 Planning Board approval
FAX: (631) 765-9502Survey Z
South oldTown.NorthFork.net PERMIT NO. J Check ✓
s Septic Form
N.Y.S.D.E.C,
Trustees
C.O.Application
Flood Permit
Examined ,20 Single&Separate
Storm-Water Assessment Form
Contact:
Approved ,20 >1 Mail to:
Disapproved a/c
hone:21
�yGS
Expiration '20 l `
D ���D V Bu ..ing Inspector_
PPLICATION-FOR BUILDING PERMIT
VAN 2 3eS
Date A) Y , 20 15'_
- - INSTRUCTIONS---
• ' ' '
B�I.DII,TG DM.T a ri e completely-filled in by`type`writer br 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 prem ises;: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 Buildin Ins"ector will issue a Buildin "Per' it to thea applicant. Such a permit
p pp Pp g p g pP
shall be kept on the premises available for inspection throughout the,,w,ork. , ,
e,No building shall be occupied'or used in whole or iri'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 authori'zedhas e
not commnced-within-12 months after the date of
issuance or has not been completed.within 18 months from-such-,d'ateAf 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 B,uildipg I),epartment:fgr.the issuance of a Building Permit pursuant to the
Building Zone Ordinance of the Town;of Southold;Suffk County;NewXdrk, and other'applicable Laws,�Ordinances,or
Regulations, for the construction of buildings, additions, or alterations or,fgr removal or demolition'as herein described.,The
applicant agrees to comply with all applicable laws, ordinances,buil�ding,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)
`py —43r�,x c), GC,9e./4-24LIF, N% 1/!F3:5_
(Mailing'address of applicant)
State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder
��Gy72/�c,�oZ
Name of owner of premises
(A•s'on the tax roll or.latest-deed)
If applicant is a co porati , signature of duly authorized officer
(Name and title of corporate officer)
Builders License No. 7/-
Plumbers,License No. -�'
Electricians License'No.
Other Trade's License No.
1, Location of land on which proposed work will be done:
5759o0 1-11,41icJ ZZ"D, !S2/N7y7
House Number Street Hamlet
r "P.08 V1 At/aMm'
County Tax Map No. 1000 Section �,21� Block d 3 ��Yor�c� it Tt`,'�,r�i e,P�ci��
erCS ,SS *E)Q a:iNy'3 noi„eir:moo
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 7
b. Intended use and occupancyy_v-edity 7:12. L
3. Nature of work(check which applicable):New Building- Ad ' ' n Alteration
Repair Removal', Demolition theiu �cn-o✓� v�w�.,
(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.
r
7. Dimensions of existing structures, if any: Front 7Z. 15 Rear 7Z. 3 ' Depth -Yo.3 1
Height ZS' ' Number of Stories Z,
Dimensions of same structure with alterations or additions: Front Rear
Depth Height r ,; . i Number of Stories_--%.A
8. Dimensions of entire new construction:_Front 1 "
,�F" , ,.;:a .,� rRear� �;,.:>;;-.�'�,` � Depth
Height Number of Stories
9. Size of lot: Front /5 Rearf>.-_5� ,•s bAi i )Depth ZOW
10. Date of Purchase Na e b n ,=�„
m f Forftt,,,Owner ' n -_•: 5, } ,^�
11. Zone or use district-iii which premises areaituated:, �5�%»�i ''
12. Does proposed cori'struction"violate any zoning"1"aw,ordiriarfde`or�regulatiori YES ~NO �C
,.
13. Will lot be re-graded?,YES X4 . NO . Will excess fill+be r moyed,from.."premises? YES NO b<
14. Names of Owner-of premises7e7,yz m,7n )Al .Addres,s.3?i'k4. '.Phone No.
Name of Architect : Address p2'`a`' Phorie No
Name of ContractorCyrn)4-prx)LS'+c; r+' Address'�a -Phone No.'735i-�LoG�
15 a. Is this property:within 100 feet of a tidal wetland or&Rf shwdterwetlandT*.YES'X 'NO "
* IF YES, SOUTHOLD TOWN TRUSTEES &D.&G. PERNIITS'MAY"•BE-REQUIRED.
b. Is this property Within'300'feet-of a tidal wetldrid? *'YES"`'' , NO""',
* IF YES, D.E.C. PERMITS MAYBE REQUIRED:''
16. Provide survey, to scale, with accurate foundation plan and distances to property lines.
}_, •
17. If elevation at any point on property'i's-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 OC
IF YES, PROVIDE A COPY.
STATE OF NEW YORK)
SS:
COUNTY OF )
e!!�y�aoi,� �' /i�tJl� I . , ..being,duly swtoi;n, deposes and says that(s)he is the applicant
(Name of individual signing contract) above named;
(S)He is the 7:ZA(f-7U�z
(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 me this ` 6
day of ((�J 20 e
Nod )Mj"M BORN Signature of Applicant
Notary Public,State of NewYotk
No.01806317038
Qualified in Suffolk County
Commission Expires Dec.22,2018
! � ~'C1�'� .'=:.:�C��r•�-" yJ��11�i i•:�. •'• i�\�i 11rr.•-s..- "`:vii•i�'.r� �-���.�•^' _
'ria HP 1°/ oy..'T - �� 11 ellr•J ''G•' _ 11 1//'°•r.. � 1•il 410'15': - NI 1111 � \101 111%'":• - 'e�lilf r0I%%•'•-.- _
,00 11% ^:deli ��:• v`pil I/j �,��1 /I: y� Ij�:. ill 11 ^Y1 /%° �
,,.,_. � o r"t.ase:� ... � :s?`�;n.�� �c �•o� �•a '}///11\� �.tt 4..' � '���' �•;-,i=--�-� 'r�' G�.'J
BOARD OF SOUTHOLDTOWN TRUSTEES R
SOUTHOLD,NEW YORK f1
PERMIT NO. 8714 DATE: DECEMBER 16,2015
r_ ISSUED TO: PETER NATHANSON
i 401•V•f .: .: . �;" - ,. 9'I'i%moi \y�
PROPERTY ADDRESS:;37900 ROUTE 25, ORIENT I
SCTM# 1000-20-3-9.2
;,�{�
_.gar AUTHORIZATION `
Pursuant to the provisions of Chapter 275 of the Town Code of the Town of Southold and,in
_ accordance with the Resolution of the Board of Trustees adopted at the meeting held'ori December 16,2015,
and in consideration of application fee in the sum of$250.00 paid by Peter Nathanson and subject tithe Terms s'
and Conditions as stated in the Resolution,the Southold Town Board of Trustees authorizes and permits the 1;
''`•'''4 following:
`l�'°•° Wetland Permit to install a 16102' in-ground swimming pool; install 3' wide decking
e around pool; install 4.5' high pool enclosure fencing; install a drywell for pool
backwash; and install a line of silt fencing and/or staked hay bales,prior to
construction; with the condition that'the drywell be constructed at'least one to two feet
}� above ambient ground water level; and as depicted on the survey prepared by Young&
Young, received November,17,2015, and stamped approved on December 16,2015. os%
IN WITNESS WHEREOF,the said Board of Trustees hereby causes its Corporate Seal to be affixed,
r and these presents to be subscribed by a majority of the said Board as of this date.
Ja/m�es F. King — Absent
i�� �� �-"�`. `�• g v ,� �`;:�� �V� ��¢^.•,?f'Z .�_ ��3=;+�� •`_� a +-;��`� •`�_.�• l^�r7
— .,,;�11/ 1111.•. - ?- •'.,;del 1N r { IO•e. �1 �• �.-, 1 �1 I{ 1�•. •,`,r.
Michael J.Domino,President ��®F s® �® Town Hall Annex
John M.Bredemeyer III,Vice-President h® �® 54375 Route 25
P.O.Box 1179
Charles J.Sanders
Southold,New York
11971
Glenn Goldsmith G
® ® Telephone(631) 765-1892
A.Nicholas Krupski ® Fax(631) 765-6641
BOARD OF TOWN TRUSTEES
TOWN OF SOUTHOLD
CERTIFICATE OF COMPLIANCE
# 1383C Date: August 28, 2017
THIS CERTIFIES that the installation of a 16'x32' in-ground swimming pool; install 3' wide
decking around pool; install 4.5' high pool enclosure fencing; install a dDmell for pool backwash; and
install a line of silt fencing and/or staked hay bales prior to construction;with the condition that the
dDywell be constructed at least one to two feet above ambient ground water level;
At 37900 Route 25, Orient
Suffolk County Tax Map#1000-20-3-9.2
Conforms to the application for a Trustees Permit heretofore filed in this
office Dated November 17,2015 pursuant to which Trustees Wetland Permit#8714
Dated December 16, 2015,was issued and conforms to all of the
requirements and conditions of the applicable provisions of law. The project
for which this certificate is being issued is for the installation of a 16'x32' in-ground swimming pool;
install 3' wide decking around pool; install 4.5' high pool enclosure fencing; install a drywell for pool
backwash; and install a line of silt fencing and/or staked hay bales prior to construction; with the
condition that the dDmell be constructed at least one to two feet above ambient ground water level.
The certificate is issued to PETER NATHANSON owner of the
aforesaid property.
Authorized Signature
08/06/2016 20:39 6319261898 PETE NATHANSON PAGE 01/01
NEW YORK STATE DEPARTMENT OF ENVIRONMENTAL CONSERVATION
DMeian of Environmental Permits,Region 1
SUNY g Stony Brook.so arch Road,Stony Brook.NY 11790
P•(631)444-03651 R(631)444.0366
www.dec nygov
IM ASL.WETLAND NO PER,1V, I NECESSARY
August 3,2016
Peter Nathanson
PO Box 190
Orient,NY 11957
Rc: UPA#1-4738-04474/000b1
Owner—Peter Nathanson
Facility-37900 Main Road SCTM#1000-20-3-9.2
Dear Mr-Nathanson:
The Department of Environmental Conservation (DEC)has`completed a review of your proposal to construct a '
swimming pool,patio and fence,replace a concrete patio and resurface a driveway at an existing single family
dwelling,as shown on the survey prepared by Howard W.Young last revised 7/12/16.
Based on the information you submitted,DEC has determined that the proposed structures are more than 75 feet
from regulated tidal wetlands and the project is listed in the Vidal Wetlands Land Use Regulations(6NYCRR Part'
661,5#50)as a use not requiring a permit.
Therefore,in accordance with the current Tidal Wetlands Land Use Regulations(6NYCRR Part 661),no permit
is required under the Vidal Wetlands Act(and the$200 permit application fee check is returned to Peter
Nathanson herewith).Please be advised,however,that no construction,sedimentation or disturbance of any kind
may take place seaward of tidal wetland boundaries without a permit.It is your responsibility to ensure that all
necessary precautions are taken to prevent any sedimentation or other alteration or disturbance to the ground
surface or vegetation within wetland jurisdiction which may result from your project. Such precautions may
include maintaining adequate work area between the wetlands and your project(i.e.a•15' to 20'wide construction
area)or erecting`a temporary fence,barrier,or fray bale berm.
Please be further advised that this4att"does-not-relieve you of the responsibility of obtaining any necessary
permit or approvals from other agencies.
Sincerely, l'
lfaura Scov o
Deputy Permit Administrator
cc: P.Moore
BOH-TW
File
NEWYM Departmentof
o MUNM Environmental
Conservation
TOWN OF SOUTHOLD 'PROPERTY .DECOR® CARD -10
OWNER STREET 3+7G} VILLAGE DIST. SUB. LOT
F(ORMERWNER r,} � N E ACR:
S W CODE DATE OF CONSTRUCTION
LAND IMP. TOTAL DATE REMARKS li
G'.
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1 �
Tillable FRONTAGE ON WATER
FRONTAGE ON ROAD
Woodland
Meadowland _ DEPTH
House Plot BULKHEAD
h Total
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Scott A. Russell
SUPERVISOR AM[ANA,G IEN[IE-N F
SOUTHOLD TOWN HALL-P.O.Box 1179 t0 �
53095 Main Road-SOUTHOLD,NEW YORK 11971 y Town of Sou th o l d
CHAPTER 236 - STORMWATER MANAGEMENT WORK SHEET
( TO BE COMPLETED BY THE APPLICANT)
AR 25 2616 = DOES THIS PROJECT INVOLVE ANY OF THE ]FOLLOWING:
Yes No (CHECK ALL THAT APPLY)
❑fA. Clearing, grubbing, grading or stripping of land which affects more
than 5,000 square feet of ground surface.
Elff B. Excavation or filling involving more than 200 cubic yards of material
within any parcel or any contiguous area.
❑Erc. Site preparation on slopes which exceed 10 feet vertical rise to
100 feet of horizontal distance.
❑ D. Site preparation within 100 feet of wetlands, beach, bluff or coastal
erosion hazard area.
El El E. Site preparation,within the one-hundred-year floodplain as depicted
- on FI-RM---M-ap of any watercourse:-
El[3/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. #: 1 000 Date:
District
NAME: C 16 Blur cImnUI"C !✓1 j� �� L� c 6 3
w„�,tSection Block Lot
FOR BUILDING DEPf;R'rNIENT U”'1E 0""L Y
Contact Information
Reviewed By:
— — — — — — — — — - Date-
Property Address /Location of Construction Work: — — — — — — — — — — — — — — — — —
❑ Approved for processing Building Permii-
Stormwater Management Control Plan Noi Required
— — — — — — — — — — — — — — — —
® Stormwater Management Control Plan a Required.
(Forward to Engineering Depariment for Review)
FORM " SMCP- TOS MAY 2014
t
APPLICANT S.C.T.M.#: 1000 StlFF{YI
CHAPTER 236
(Property Owner,Design Professional,Agent,Contractor,Other) 4
zu Stormwater Management Control Plan CHECK LIST
NAME. e`•'t-al-:�,tvl< -Pvv z-'5 Section Block Lot w z S M C P -Plan Requirements: Provide ONE copy of the Building Permit Application.
Date: >k The applicant must provide a Complete Explanation and/or Reason for not providing
P all Information that has been Required by the following Checklist!
X151 al,ul' Tchphone Number
1. A Site Plan drawn to scale Not Less that 60' to the inch MUST If You answered No or NA to any Item, PleasviVON
t0relShow all of the following items: YES NO If you need additional room for explanations, 1� i9f#elFr
a. Location & Description of Property Boundaries 0O UL regi
b. Total Site Acreage.
c. Existing - Natural & Man Made Features within 500 L.F. MAN eQ�
of the Site Boundary as required by §236-17(C)(2).
d. Test Hole Data Indicating Soil Characteristics&Depth to Ground Water. DING DEPM
e. Limits of Clearing & Area of Proposed Land Disturbance. 0ODRAINAGE To
f. Existing & Proposed Contours of the Site (Minimum 2'Intervals) !0 REQUIRED
g. Location of all existing & proposed structures, roads, Contaet:Fes eering at 765-1560 before
Baekfi!Vdriveways, sidewalks, drainage improvements & utilities. vie ngineer's Certific
h. Spot Grades & Finish Floor Elevations for all existing & If
nage as been installed to Corfe
proposed structures,
I. Location of proposed Swimming Pool and discharge ring.
j. Location of proposed Soil Stockpile Area(s), 1
k. Location of proposed Construction Entrance/Staging Area(s).
I. Location of proposed concrete washout area(s). 00Shall inrlude hilt not be limited to-'
in. Location of all proposed erosion&sediment control measures,
2. Stormwater Management Control Plan must include Calculations showing
stabilization &
that the Stormwater improvements are sized to capture,store,and infiltrate '
on-site the run-off from all impervious surfaces generated by a two(2")inch Seeding of exposed ai H74oj h active sails.
�0
rainfall/storm event
3. Details&Sectional Drawings for Stormwater practices are required for approval.
Items requiring details shall include but not be limited to: w_�
a. Erosion & Sediment Controls. 0
b. Construction Entrance & Site Access. 00=
c. Inlet Drainage Structures (e.g.catch basins,trench drains,etc.)
d Leaching Structures (e. . infiltration basins,swales,etc.) EZ1=1=1
I OR I.NGINI_L-;ItI a )EPARTMENT USE ONLY""`
l Additional Information is Required.
Reviewed & l ® Stormwater Management Control Plan is Not Complete.
Approved By: - — — — — — — — — — — — — — — — — — — — — — — — -
1 Stormwater Management Control Plan is Complete.
Date: l ® SMCP has been approved by the Engineering Department.
FORM ' SWCP Check List -TOS MAY 2014
k
*0�s0(/Ty�� QGQ l�' 13 •�'P
Town Hall Annex 1ct Telephone(631)765-1802 1
54375 Main Road v, � ax(o"3t)76x 5 2
P.O.Box 1179 G� Q roger.richert(a fown.so0UR0�d ny us
Southold,NY 11971-0959 �O
ly�0UG1fY,�� I
BUILDING DEPARTMENT
TOWN OF SOUTHOLD ! -
---- — - - --- - --- APPLICATION FOR-ELECTRICAL-INSPECTION - - - -
REQUESTED BY:
Date: i
I
. Company Name:
Name: -
License No.:
Address.-
Phone No.:
JOBSlTE (NFORIVIATION: (Indicates required information) -
*Name:
*Address:
*Cross Street:
*Phone No_: _ )
Permit No.: _ (A p
Tax-Map District: 1000 Section: Block:
*BRIEF DESCRIPTION OF WORK(Please Print Clearly)
I
(Please Circle All That Apply)
Is job ready for inspection: YES/ NO Rough in Final
*Dv-you need a Temp Certificate: YES/ 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
i -
82-Request for Inspection Form
I _
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OVEDBYNov 1 7 2o15
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W �N'ta S•6404640 ho roPsoa
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S. $. 9 i LOAM*
39.90
formerly W Barden GRAVEL
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7 '
WArER
SURVEY FOR
PESTER NATHANSON & SANDRA NATHANSON MAY 1 , 1987
JAN. 9, 1986
AT ORIENT DATE: MAY 2, 1983
TOWN OF SOUTHOLD SCALE; I" a 50'
SUFFOLK COUNTY, NEW YORK NO. 83-204
H UNAUTHORIZED ALTERATION OR ADDITION TO THIS GUARANTEED TO:
SURVEY eS A VIOLATION Of SECTION 7209 OF THE SOUTHOLD SAVINGS BANK
NEW YORK STATE EDUCATION LAW
*COPIES OF THIS SURVEY NOT BEARING THE LAND CHICAG '15, N ANCE COMPANY
SURVEYOR'S INKED SEAL OR EMBOSSED SEAL SHALL l7F 1 $W y
NOT BE CONSIDERED TO BE A VALID TRUE COPY •(�
NGUARANTEES INDICATED HEREON SHALL RUN ONLY TO g4P�tl W
THE PERSON FOR WHOM THE SURVEY IS PREPARED
HEALTH DEPARTMENT-DATA FOR APPROVAL TO CONSTRUCT AND ON HIS BEHALF TO THE TITLE COMPANY,GOVERN-
* NEAREST WATER VAIN—M1,± NSOURCE OF WATERT PRIMLTE_PUBLIC_ MENTAL AGENCY AND LENDING INSTITUTION LISTED f1
M SUFF CO. TAXMAP DIST11Oe SECTION "a BLACK o3 LOT 9•= HEREON,AND TO THE ASSIGNEES OF THE LENDING r.
NTHERC ARE NO DWELLINGS WITHIN 100 FEET OF THIS PROPERTY INSTITUTION. GUARANTEES ARE NOT TRANSFEhABLE
OTHER THAN THOSE SHOWN HEREON. .TO ADDITIONAL INSTITUTIONS OR SUBSEQUENT
OWNERS
N THE WATER SUPPLY AND SEWAGE DISPOSAL SYSTEM FOR THIS RESIDENCE *DISTANCES SHOWN HEREON•FROM PROPERTY LINES
WILL CONFORM TO THE STANDARDS Of THE SUFFOLK COUNTY DEPARTMENT TO EXISTING STRUCTURES ARE FOR A SPECIFIC
OF HEALTH SERVICES, PURPOSE AND ARE NOT TO BE USED TO ESTABLISHs • 129 2$prlb
APPLICANT] PROPERTY LINES OR FOR THE ERECTION OF FENCES
1
ADDRESS
"-c•r
TEL. OSTRANDER YOUNG a YOUNG R�VERHEAD, NEW YORK
E
0-- MONUMENT O=STAKE ALDEN W.YOUNG,PROFESSIONAL ENGINEER
AREA a 41033 S•F AND LAND SURVEYOR N.Y.S.LICENSE NO.12845
HOWARD WYOUNG, LAND SURVEYOR
*TNN LOCATION Of WELL(W),SEPTICTANK(ST)QCESSPOOLS(CP)SHOWN HEREON N.Y.S.LICENSE NO.45893
ARE FROM FIELD OSSERIATIONS AND OR DATA OBTAINED F"M OTHERS
PoAmnlc t QnNC INC IRIR
jcoo-d
*RVED1 AS NOTED
DATE: 6.P.# U6q0j _74— DRAINAGE INSPECTIONS ARE REWIRED
FEE: BY: Contact TOS Engineering at 765-156o before
NOTIFY BUILDING DEPARTME T Backfill,OR Provide Engineer's Certification
765-1802 8 AM TO 4 PM FOR THE that the drainage has been Installed to Code.
FOLLOWING INSPECTIONS:
1. FOUNDATION - TWO REQUIRED
FOR POURED CONCRETE
2. ROUGH - FRAMING & PLUMBING
3. INSULATION
4. FINAL - CONSTRUCTION MUST
BE COMPLETE FOR C.O. ELECTRICAL
ALL CONSTRUCTION SHALL MEET THE INSPECTION REQUIRED
REQUIREMENTS OF THE CODES OF NEW
YORK STATE. NOT RESPONSIBLE FOR
DESIGN OR CONSTRUCTION ERRORS.
!,-I M UU.:U!ATEP:LY"'
ENCLOSE,fOOL TO CODE.-
Q]PON COMPLETION
COMPLY WITH ALL CODES OF tB FF AE,,WATER",
NEW YORK STATE & TOWN CODES
AS REQUIRED AND CONDITIONS OF
SOilt}IOI.D T0Vw TRUSTEES
OCCUPANCY OR
USE IS UNLAWFUL
'WITHOUT CERTIFICATE
CSF OCCUPANCY
—I -
_ POOL DIMENSIONS
09c7S C 24' W L-7
YJf37 K • i'i4 i-9' �
- 79X71_ NI' 314 i
*XLI W-W 94 lo-e 20 O
757"90
i
cuw
I DIVII IG BOARD A
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1•LONO WELDS ONSIOE
YIELOEO77QP&BPOTTAHELiW
ABSMOWNANOGOVER -------------- TT------------- i \
om WE7ASWRN I \
AUANNUM COATING FLTt7t I
sum"
e
I -
POOL PLAN
1_
TC
D
TYP. PANEL STI F FN E R Mw.r.THICK vERMICLiurE ��'
In.+aclWsELFORULslosaaEarsSPACED a Ir CLC. AGGREGATE TAMPERED �•
}f _ :n
CONCRETE ORWOODOM UP TO
Lu
SOPDOAWAYYFFR MFOOF�'PAt8I --�- — — H -V/'
BiFFB�A(BEY01D1 ALUMINUM OOPP16 G F E
- LONOSTFHANGLE - - '�
WrIPPgALSAN MCOAIM SECTIONS ®A
I I O 20 wL VINYL LINER
\ STEEL VYALLPANEL
&W-Ifni•BOLT.NUT.w WASH=
STEEL ANGLE
CR1YE STAN TC`
D
710UPp WRIT. -
CU.FT.CONCRETE r THICK VER7MGuLm AGOREIATE YDt
SHORTSTEEL fNPOIACAR VC3EB7OLTS
ANGLE O HAi�BOTTOM dWASIER A NUTT
CRtB7T
TOP CORNET PAD
81IE�tncAL FALER
0 3W RIMFORC�IG FOO
1-1 K L M
T
+f LONG STEELREIAFORUNO ROD p v
UIC 9U PIDED EARTH I RTO UNDISTURBED EARTH TTiLOUGH TO REUEVE LINER -
HOLES RI BOTTOM OF PANEL
p 11 4 CARRIAGEBOVES Q11t�IG BOARD
T =uil�IaIY I N.T.S.
POOL TYPE: AG- REV. SCALE N.T.S.
TYPICAL WALL SECTION AUX FRAME CORNER CONNEC ON DETAIL POOL WMPUES WITS =�"'PEND°X° JAWA .P.E DATE
DESIGN IS ACC AM FOR ER PATH DRAYVING NUMBER _ALL COMMON SO 'COMMONS
MAT 11952 OF