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Home My WebLink About41639-Z a ��Q�guFFQIK�pp� Town of Southold 10/6/2017 0 P.O.Box 1179 53095 Main Rd Southold,New York 11971 CERTIFICATE OF OCCUPANCY No: 39271 Date: 10/6/2017 THIS CERTIFIES that the building IN GROUND POOL Location of Property: 1100 Youngs Rd., Orient SCTM#: 473889 Sec/Block/Lot: 18.-2-11.1 Subdivision: Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated 5/8/2017 pursuant to which Building Permit No. 41639 dated 5/16/2017 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 DiSimone,Harry of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL ELECTRICAL CERTIFICATE NO. 41639 9/27/2017 PLUMBERS CERTIFICATION DATED A- t h d Signature �gaFFot�.. TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, NY dol � .ta 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#: 41639 Date: 5/16/2017 Permission is hereby granted to: DiSimone, Harry 18 Hickory Dr Old Brookville, NY 11545 To: construct an inground swimming pool as applied for. At premises located at: 1100 Youngs Rd., Orient SCTM # 473889 Sec/Block/Lot# 18.-2-11.1 Pursuant to application dated 5/8/2017 and approved by the Building Inspector. To expire on 11/15/2018. Fees: SWIMMING POOLS -IN-GROUND WITH FENCE ENCLOSURE $250.00 CO - SW G POOL $50.00 Total: $300.00 Building Inspector Form 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, 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 I% 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$15.00 U 0 (� 7NewDate. J — r17- New Construction: Old or Pre-existing Building: V/ (check one) Location of Property: (�yp0n c op-l" 11 House No. Street Hamlet Owner or Owners of Property: EI IZAWA , is. �, set„ Lo Suffolk County Tax Map No 1000, Section / g Block o;? —Lot—//, , Subdivision ',11 Filed Map. Lot: Permit No. `f l03 Date of Permit. Applicant: Health Dept. Approval: Underwriters Approval: Planning Board Approval: Request for: Temporary Certificate Final Certificate: (check one) Fee Submitted:$ 5-0 ",/Z/ Applicant Signat e pF SO!/r�Ql 0 Town Hall Annex Telephone(631)765-1802 54375 Main Road Fax(631)765-9502 P.O.Box 1179 G aQ roger.richert(a)-town.southold.ny.us Southold,NY 11971-0959 C®U '�,��` BUILDING DEPARTMENT TOWN OF SOUTHOLD CERTIFICATE OF ELECTRICIAL COMPLIANCE SITE LOCATION Issued To: DlSlmone Address: 1100 Youngs Road city-Orient st: New York zip: 11957 Building Permit#: 41639 Section: 18 Block: 2 Lot: 11.1 WAS EXAMINED AND FOUND TO BE IN COMPLIANCE WITH THE NATIONAL ELECTRIC CODE Contractor: DBA: MRJ Industries License No: 41853-ME SITE DETAILS Office Use Only Residential X Indoor Basement Service Only Commerical Outdoor X 1st Floor Pool 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 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 1 Transformer Appliances Dryer Recpt Emergency FixtureTime Clocks 1 Disconnect Switches Twist Lock Exit Fixtures 9 TVSs Other Equipment: Inground Swimming Pool to Include: Bonding, 1- Pool Light, Control Panel, Cover Motor, Gas Pool Heater, 2- GFCI Circuit Breakers. Notes: Inspector Signature: Date: September 27, 2017 0-Cert Electrical Compliance Formas SOF SOUTy �'�OOUHi`I,a� TOWN OF SOUTHOLD BUILDING DEPT. 765-1802 INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLEIG. [ ] FOUNDATION 2ND [ ] INSULATI N [ ] FRAMING / STRAPPING [ FINAL [ ] FIREPLACE & CHIMNEY [ ] FIRE SAFETY INSPECTION [ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRATION [ ] ELECTRICAL (ROUGH) [ ] ELECTRICAL (FINAL) REMARKS- OtJWL.- Q' + lk) loqwY4 • z 'Q.�/ ri +1 DATE INSPECTOR SOUly�l � o TOWN OF SOUTHOLD BUILDING DEPT. 765-1802 INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLSG. [ ] FOUNDATION 2ND [ ],!YtULATJON [ ] FRAMING / STRAPPING [ FINAL [ ] FIREPLACE & CHIMNEY [ ] FIRE SAFETY INSPECTION [ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRATION [ ] ELECTRICAL (ROUGH) [ ] ELECTRICA (FINAL) REMARKS: Qv) DATE INSPECTOR r r • r r � -es_, s: its STATE ENBROY rs =1 XF MM III MMCWM� Ar MOW 0 ,� n 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 11971 4 sets of Building Plans TEL: (631) 765-1802 Planning Board approval FAX: (631) 765-9502 / 9Survey SoutholdTown.NorthFork.net PERMIT NO. l Check Septic Form N.Y.S.D.E.C. Trustees C.O.Application Flood Permit Examined ;20 ;D [ECENR Single&Separate DStorm-Water Assessment Form 16 ,20 �' MAY - 8 Contact. Approved i� - To 0—Zr-:A,�_ Disapproved a/c BjJjj,A�GD y TO ®TSO LD Phone: (! , Expiration ,20 u specto APPLICATION FOR BUILDIN T Date �q t/ � _, 20� INSTRUCTIONS a. This 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 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,houycodend regulations,and to admit authorized inspectors on premises and in building for necessary inspections. (S' nature of ap llicanJt/o name,if a corporation) �Dx l D;� A,- !fes z�( �/_ JJ (Mailing address of applicant) /1196cl State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder Name of owner of premises lj Aae. t, n n L, (As on the tax roll or latest deed) If applicant is a corporatiop;Lsignature�of duly authorized officer 0 (Name and title"To rate'o_fficel;), Builders License No.z Plumbers License No. Electricians License No. Other Trade's License No. 1. Location of land on which proposed work will be done: House Number Street Hamlet County Tax Map No. 1000 Section 1 S Block Lot L , 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 �� \� e'. V-e _R-2 S- -S' b. Intended use and occupancy R�-(A'( 3. Nature of work(check which applicable):New Building Addition Alteration Repair Removal Demolition Other Work /( ` )3 a ' (Description) 4. Estimated Cost &-o-'000 . 00 _ �. ee,M.-§ —� ,• (�T�Ujbp paid on filing this application) 5. If dwelling, number of dwelling units I J , Number of dwelling un is on each floor If garage, number of cars �' ,.l : l rj 6. If business, commercial or mixed occupancy, specify nature and extent of each type of use. 7. Dimensions of existing structures, if any: Front �.Pk.;.,, ,�-,,• �� Zear Depth Height Number of Stories`" s + 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 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 13. Will lot be re-graded? YES NO Will excess fill be removed from premises?YES NO 14.Names of Owner of premises Address Phone No. Name of Architect Address Phone No Name of Contractor, Address Phone No. l 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, NIE OU NOM Id f+1OM Notary Pi 0r,, State of Now WORD- (S)He is the No.01 BU6188060 (Contrack�V orporate Officer, etc.) Qualiff®d in Suffolk County Commission Expires April 14, 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 efore me th' � e. j�7 L day of V� 20 + Notary Public Signature of Applicant " 5 Scott A. Russell SUPERVISOR .9 AW A�N A�(�j>_)EAWIE��C' SOLITHOLD TOWN BALL-P_O.Box 1179 53095 Main Road-SOUrxOLD,NEW YORK 11971 'ff�O Town of 1So u th o l d CF,kPTER 236 - STORMWATER MANAGEMENT WORK SHEET (TO BE COMPLETED BY THE APPLICANT) , Y3olS�-TIS---pRo-j ECT-I VO F-"TEFOLLOWING------=---- -._ Yes No (CHECK ALL THAT APPLY) - 1 ffl A. CIearing, grubbing, grading or stripping of land Which affects more than 5,000 square feet of ground surface. ®M B_ Excavation or-filling involving more than 200 cubic yards of material within any parcel or any contiguous area- El rea❑® C. 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_ t ❑ 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 Cbeck list Form to the Building DepartmpuL-iA lLyour Building Permit Application. APPLICANT. (Property Owner,Design Professional,Agent,Contractor,Other) S.0-T Nl. 'r_ 1000 Date District NAME n �,n•, Section Block Lot �, u•., _ FO al B A,LDING DLP R'FN-1 N r LCL O,,L; Confaet Wormallorr �! Reviewed By_ D.AA Date 5—(f— " Properly Address / Location of Conslruction work — — — — — — — — — — — — — — — — — a Approved for processing Building Permit — — Stormwater Management Control Plan Not Required a i-7rcnt �,,r`-� &/� � � Stcrm.�ater i'hanagen�ei�: ` ral .� ,,,,•re;, L-1 (Forward to E.ig.neent;g Deparmaa for Re .e v) FORM SMCP - TOS MAY 2014 �,W aF S�fjr Town Hall Annex Telephone(631)765-1802 54375 Main Road �gp� P.O.Box 1179 • rover dche Own S0 0IQ.rI�(.LlS Southold,NY 11971.0959 Bual)ING DEPARTMENT TOWN OF SOUTHOLD i APPLICATION FOR ELECTRICAL INSPECTION REQUESTED BY: C�r�ri G � Date: �Y Company Name: Name: _�JO_A VIC Fc a- • az ;- License No.: l✓ t 2 !53— /L4 Address: `oZ`� �a i I_ e �,„ d Phone No.: 5'/� 8,85 o JOBSITE INFORMATION: (*Indicates required information) *Name: T�� O W�U�t *Address: i f OD cuckick? rg Fe n *Cross Street: DD *Phone No.: X51 z , Permit No.: z/4.3UV 2017 Tax-Map District: 1000 Section:V- Block: ` Lot: fly *BRIEF DESCRIPTION OF WORK(Please Print Cleariy) 13t�DEPT. 'TOWN OF SOU.THOLD Ale QD� (Please Circle All That Apply) Is job ready for inspection: YE / Rough in Final *Do-you need a Temp Certificate: YES nNO Temp Infonmation(If needed) *Service Size: 1 Phase 3Phase 100 200 300 350 400 Other *New Service: Re-connect round Number of Meters Change of Service Overhead Additional Information: PAYME T DUE WITH APPLICATION wo B241equest for Inspection Form SURVEY Of" P R 0 1 E I T N" 0,R f ENT vw-1 T MP�N Or TO LD I V- SUVFOLK COUNTY, NEW YORK S.C. TAX No. 10,00 SCA Lt I "!�f 20' t A I, gg MAY 17 X0'05 t. _w_l, 24, wc .44, Lol T_ TMI X Ir O'EA 14�2'33,75 M . Am 4. cic tj Yo ELEVATIONS ARE REFERVAGED TO, AN ASSU IWFD DATUm _UU EXIISUNG ELEVATIONS ARE SWAN THUS, all U ,Ul ULI Val- U U U L 1-.-bzm lUUU. u U U U L UU U U ULl L#010VJ L 4; :lo N U LOT COVEP-AGI UATA 011. -1 .1 --, N , u u?�� - - - __ U U U Q u u u 2�1 U UUUU j LI L I U DESC-RTTION 'EJ,IUUI.J LIU' '25 U U L,U U U U U U, U U H�b V�S E UjU''Lju "A00H F i t�449 0 t,ev -t tm-.4 vq_a-_-t-IA th I I ___ -_— ZZ1.1t; rk j 02ECK A A I—& pr u 3-7 wm_ 0 --- ----- -----ii. A TO W"74Z L d TOTAL ov G H P O 26010 taft 11 Dd -4 K:Ji _-_ZE�gbl E �To Ll CA ss 19!50 VONA '—A TD TFIS f9R',T7T S-A WA's Cl i. ---s Am I', X111 L(J Jolse Am o I % "Fan, D urvley,or L -ONTYWES F";Ym sKrza. Cis FK lmn� P_ go F�T .-a, Vxm TP.K, CTapFr T15 mc P-EW-04 ffA rJt 'AiWilm ", ,q rs �Wwpkpm. IfIT"o T-L 14-7-rQTUA L b krF2V,_-.L mi'j U:. H F uE T 0,1 S IU GN L i @IA 11 1�;A("T j_I y��g SURVEY OF PROPERTY AT ORIENT TOWN OF SO UTOLD SUFFOLK COUNTY, N. Y. 1000-18-02-11.1 SCALE.• 1'— 30' AUGUST 03, 2017 1 PNK (�1P N�LL1 � F vpY 00.0d cry o g�5,p"E �w,�N �i►x �� 8 ria� o� - out �71 e 1t 1 5 Wkpp P051 f� S,ATi1GE � A pl L Z I �� DIGS '� rn rn ow r FR. vii 5E j �S POOL�6'�0 1 �Cjno eool- vw. w 30 Wilk &hit oad ro5t 1 �Sn� �� FE ® 5-r IGE FEN« FR FIREPI-AC•E o 6K,,r`,Td-x op SRA 1 /. I / I �ILInJ� P� I ® O DD a AUG - 72017 BUMDING Dom. TOWN OF SOUTHOLD ' ■ = MONUMENT MAIN ROAD � . AREA = 28,417 SOTT. ANY ALTERATION OR ADDITION TO TH15 SURVEY 15 A , VIOLATION OF 5EGT ION 72090E THE NEW YORK STATE EDUGAT I ON LAW. EXCEPT A5 PER 5EGT ION 7209—5UDD I V I510N 2. (6 5 FAX (631) 765—1797 ALL CERTIFICATIONS HEREON ARE VALID FOR TH15 MAP AND P.O. DOX 909 1230 GOPIE5 THEREOF ONLY IF SAID MAP OR GOPIE5 DEAR THE TRAVELER STREET IMPRESSED SEAL OF THE SURVEYOR 5OUTHOLD, N.Y. 11971 17-042 1 1 ' CO PLY VVI-I H ALL CODES OF APPROVED AS NOTED NEVA YORK STATE & TOWN CODES DATE: � 0�' 6 B.P.# .o n AS REQUIRED pF FEE: . ,.- BY:- /�--- NOTIFY BUILDIING DEr +-MAENT AT 765-1802 8 AM TO 4 PM FOR THE FOLLOWING INSPECTIONS: S017107. SES 1. FOUNDATION - TWO REQUIRED FOR POURED CONCRETE 2. ROUGH - FRAMING & PLUMBING 3. INSULATION 4. FINAL - CONSTRUCTION MUST '� POR BE COMPLETE FOR C.O. I ICY ALL CONSTRUCTION SHALL MEET THE USE IS UNLAWFUL REQUIREMENTS r NOT R SPONS BLUFF NEW YORKSTATE. FOR WITHOUT CERTIFICATE DESIGN OR CONSTRUCTION ERRORS. OF OCCUPANCY EL C 7FRI M L VTO D1ATELY" ENCLOSE POOL TO CODE UPON COMPLETION BEFORE,"WATER';+, Mom— I , azw if M- --, — - _ f � AL omllo j' �fii7d7J'cpMan --- 19 - -_ Git � Wit MOM NVIVAPP" _ UBNAALLS 19N d xn 34 G , p z k} Z6 MAN wm 10 aw - --- — --- --- ,, s ��1� i