HomeMy WebLinkAbout41090-Z �o�SUFFUt,��G_ Town of Southold 11/28/2017
g P.O.Box 1179
53095 Main Rd
py!pQ! �o� Southold,New York 11971
CERTIFICATE OF OCCUPANCY
No: 39363 Date: 11/28/2017
THIS CERTIFIES that the building IN GROUND POOL
Location of Property: 11365 Sound Ave, Mattituck
SCTM#: 473889 Sec/Block/Lot: 141.-3-6.2
Subdivision: Filed Map No. Lot No.
conforms substantially to the Application for Building Permit heretofore filed in this office dated
10/11/2016 pursuant to which Building Permit No. 41090 dated 10/17/2016
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 Velasquez,Felicia
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL
ELECTRICAL CERTIFICATE NO. 41090 10-10-2017
PLUMBERS CERTIFICATION DATED
ut o e Signature
TOWN OF SOUTHOLD
ao�gUo�,��oa BUILDING DEPARTMENT
y TOWN CLERKS 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#: 41090 Date: 10/17/2016
Permission is hereby granted to:
Velasquez, Felicia
15 Abingdon Sq Apt 53
New York, NY 10014
To: construct accessory in-ground swimming pool as applied for. Maintain proper
setbacks.
At premises located at:
11365 Sound Ave, Mattituck
SCTM # 473889
Sec/Block/Lot# 141.-3-6.2
Pursuant to application dated 10/11/2016 and approved by the Building Inspector.
To expire on 4/18/2018.
Fees:
SWIMMING POOLS -IN-GROUND WITH FENCE ENCLOSURE $250.00
CO - SWIMMING POOL $50.00
Total: $300.00
IN
B ' din I pector
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
Date. 6/)
New Construction. v Old or Pre-existing Building: (check one)
Location of Property: ff.z�� 04/., SGl d,� j /1 // l
House No. yStreet Hamlet
Owner or Owners of Property:
Suffolk County Tax Map No 1000, Section � Block 31 Lot - 2
Subdivision Filed Map. Lot:
Permit No. 0 Date of Permit. Applicant:
Health Dept. Approval: Underwriters Approval:
Planning Board Approval: /
Request for: Temporary Certificate Final Certificate: ✓ (check on
�VFee Submitted: $
A Wicant ign ture
i
Vol SO(/r�®lo
Town Hall Annex Telephone(631)765-1802
54375 Main Road en Fax(631)765-9502
P.O.Box 1179 ® aQ ro-ger.richerKD-town.Southold.ny.us
Southold,NY 11971-0959 ®lyc®U '�„�\
BUILDING DEPARTMENT
TOWN OF SOUTHOLD
CERTIFICATE OF ELECTRICIAL COMPLIANCE
SITE LOCATION
Issued To: Velasquez
Address: 11365 Sound Avenue city,Mattituck st: New York zip: 11952
Building Permit#: 41090 Section: 141 Block: 3 Lot: 6.2
WAS EXAMINED AND FOUND TO BE IN COMPLIANCE WITH THE NATIONAL ELECTRIC CODE
Contractor: DBA: MRJ Inductries 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 Ceiling Fixtures HID Fixtures
4
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 1,
Transformer Appliances Dryer Recpt Emergency Fixture Time Clocks
Disconnect Switches Twist Lock Exit Fixtures �] TVSS
Other Equipment: Inground Swimming Pool to Include: Bonding, 60A Pool Panel, 2-GFCI Circuit
Breakers, Heat Pump, 2- Pool Lights.
Notes:
Inspector Signature: Date: October 10, 2017
0-Cert Electrical Compliance Form.xls
--- — - _OF SO(/ly -
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��y�OUNi'I,a�
TOWN OF. SOUTHOLD BUILDING DEPT.
765-1802
ANSPECTION '
[ ] FOUNDATION 1ST [ ] ROUGH PLBG.
[ ] FOUNDATION 2ND [ ] SULATION
[ ] FRAMING /STRAPPING [ FINAL ?wo-
FIREPLACE &
CHIMNEY [ ] FIRE SAFETY INSPECTION
[ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRATION
[ ] ELECTRICAL (ROUGH) [ ] ELECTRICAL (FINAL)
REMARKS: Vi v
Y -66,z -PrJ -kc PCZ)
DATE INSPECTOR
IN
OF SObjyolo
0
UNTI,�
TOWN OF SOUTHOLD BUILDING DEPT.
765-1802
INSPECTION
[ ] FOUNDATION 1ST [ ] ROUGH PLEIG.
[ ] FOUNDATION 2ND [ ] SULAT ON
[ ] FRAMING / STRAPPING [ FINAL �
[ ] FIREPLACE & CHIMNEY [ ] FIRE SAFETY INSPECTION
[ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRATION
[ ] ELECTRICAL (ROUGH) [ ] ELECTRICAL(FINAL)
REMARKS:
DATE D INSPECTOR Vt
- - - - --- --- — /----- --- - -ho��OF so�Tyolo
f In�L N 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 J 6 I INSPECTOIRjq;gZ:�
FIELD INSPECTION REPORT I DATE COMMENTS
FOUNDATION(IST)
------------------------------f--- C
FOUNDATION (2ND)
co
ROUGH FRAMING&
PLUMBING
6
INSULATION PER N.Y. `
STATE ENERGY CODE f
iJ4 6&4A
Peets;i Y 3
FINAL
C-\n tell
Ll 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 Board of Health l
SOUTHOLD, NY 11971 4 sets of Building Plans
TEL: (631) 765-1802 Planning Board approval
FAX: (631) 765-9502 L416q Survey e!/
South oldTown.NorthFork.net PERMIT NO. Check
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_L� Mail to sL SG N�/� �C��S 7-1
Disapproved a/c M is oet 11-cle V(fJcwNe,}O v W
Phone:G��r�r�-7'nc,5/2,
Expiration Lf I ly 20
Build Ins or
D PLICATION FOR BUILDING PERMIT
OCT 1 1 2016 Date , 20�
INSTRUCTIONS
a. Tl-#UN2VGbM be completely filled in by typewriter or in ink and submitted to the Building Inspector with 4
sets of pla1r0 g (Wle. 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,housing code,and regulations,an to admit
authorized inspectors on premises and in building for necessary inspections.
P
of app 'c nt o ame,if torpor 'on)
(Mailing address of applica t)
State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder
/M, l l 4-,-q e—
Name of owner of premises /%��/� ` — Z-Syl �
(As on the tax roll or latest deed) j
If applicant is a corporation, signature of duly authorized officer
(Name and title of corporal e�.o�p�r�_�
Builders License No.
Plumbers License No.
Electricians License No.
Other Trade's License No.
1. Location ond on which prODosed w�wiJ�bye: j�/ �
6)64v
ouse Number Street Hamlet
County Tax Map No. 1000 Section h t/ Block Lot , 2
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 /
b. Intended use and occupancy
3. Nature of work(check which applicable):New Building Addition Alteration
Repair Removal Demolition Other Work S6t�/l/r2 f D�
_ (Descriptio
4. Estimated CostV/1;7/ �b� 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 Rear Depth
Height Number of Stories
Dimensions of same structure with alterations or additions: Front Rear
Depth Height Number offStones_
8. Dimensions of entire new construction: Front Rear + 3 1 ' D`eptli
Height Number of Stories 1.
9. Size of lot: Front Rear Depth
10. Date of Purchase Name of Former Owner ;717'71
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 ANO Will excess fill be removed from premises? YES z, NO
'/ Ade 4 _
14.Names of Owner of premises V67„L/;2,aE_-,,-Address/,/365 eco Svo--�,o Phone No.
Name of Architect Address 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
BGG.
being duly sworn, deposes and says that(s)he is the applicant
(Name of individu4 signing contract)above named,
(S)He is the (��✓�1,1to 4�L
(Contractor,Agent, Corporate Officer, etc.)
of said owner or owners, an 's duly authorized to perform or have performed the said work and to make and file this application;
that all statements containe i this application are true to the best of his knowledge and belief; and that the work will be
performed in the manner s f rth in the application filed therewith. DAVID FREEBORN
otary Public,State of New York
Sworn to before me thi No.OIFR6137963 ,
day of j� //� 20,/P— Com�sslon
Qualified in
Dec 05,t20�
No ry P bli Cg ature of licant
Scott A. Russell
°SUFFQIr STO]KI��l WATJE][,
SUPERVISORI�V][A\1�A�G 1EAM[]EN`]F
SOUTHOLD TOWN HALL-P.O.Box 1179
53095 Main Road-SOUTHOLD,NEW YORK 11971Town 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 `I'lH[lE FOLLOWING:
Yes No (CHECK ALL THAT APPLY)
❑ Clearing, grubbing, grading or stripping of land which affects more
than 5,000 square feet of ground surface.
❑0-1. Excavation or filling involving more than 200 cubic yards of material
Rhin any parcel or any contiguous area.
❑ C. Site preparation on slopes which exceed 10 feet vertical rise to
feet of horizontal distance.
❑ Site preparation within 100 feet of wetlands, beach, bluff or coastal
osion hazard area.
❑ E. Site preparation within the one-hundred-year floodplain as depicted
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.
APPLICANT (Property Owner,Design Professional,Agent.Contractor,Other) S.C.T.M. #: 1000 Date.
�i��' District
NAME L_/tivlJo 1 JL5 LY// ✓a�t�,� sc� 1 1—A
anwi 'V'� Section Block Lot
""- 1-0�113t-iit_I)I\G 1�Ef'f11 "1'411 "! t t: 0' L'I
Contact Inf mation r l z—
rriynor�„ c.r 1 V
• Reviewed By:
— — — — — — — — — — — — — —
Date. 10 - 11 -10
Property Address / Location of Construction Work- — — — — — — — — — — — — — — — — —
Approved for processing Building Permit.
�� ((��C•/�LJ�� /yam'�' Stormwater Management Control Plan Not Required
�� // ❑
Stormwater Management Controi Plan n,Required
(Forward to Engineering Department for Review.)
FORM 4
SMCP-TOS MAY 2014
i n-5P w Od-- IDA
Town Hall Annex Telephone(631)765-1802
54375 Main Road (fi3I)7 goj
P.O.Box 1179 • O _%ner.richertfilown.$ODU10[ .ny.us
Southold,NX 11971-0959 Q�y �
ti
I
BURDING DEPARTMENT
TOWN OF SOUTHOLD
APPUCATION FOR ELECTRICAL INSPECTION
G'
- REQUESTED BY: (,�y,e/Z ��c 7`r7(C Date: �/ 7
/7 i
Company Name: 2 J �(�s 7`��t5 �)-O•
Name:
License No.: B S3
Address:
Phone No.: i
JOBSITE INFORMATION: (*Indicates required information)
*Name: '�—
*Address: l
*Cross Street: o r_ 41
*Phone No.:
Permit No.: IA-1 01510
Tax-Map District: 1000 Section: 1 A� Block: Lot:
*BRIEF DESCRIPTION /OF WORK(Please Print Clearly)
I
(Please Circle All That Apply) Sr� `
*Is job ready for Inspection: YES 1 NO—
Rough In Final
*Do-you need a Temp Certificate: -YM'- NO
Temp Information (if needed)
*Service Size: 1 Phase 3Phase 450 200 300 350 400 Other
*New Service: Re-connec nderground Number of Meters Change of Service Overhead
Additional Information PAYMENT DUE WITH APPLICATION
c �c c / J
82-Request for Inspection Form I�V
i
1
rMC IVO 7308.03497
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APPROVED AS NOTED
DATE: �.P.#-4
FEE: 2 BY: ELECTRICAL
NOTIFY BUILDING DEPARTIVI ' ' "T INSPECTION REQUIRED
765-1602 8 AM TO 4 PM FOR THE
FOL-OWING INSPECTIONS:
1, F )UNDATION - TWO REQUIRED
FOR POURED CONCRETE
2. ROUGH - FRAMING & PLUMBING
3. INSULATION RETAIN STORM WATER RUNOFF 4. FINAL - CONSTRUCTION MUST PURSUANT TO CHAPTER 236
BE COMPLETE FCR C.O. OF THE TOWN CODE.
ALL CONSTRUCTION SHALL MEET THE
REQUIREMENTS OF THE CODES OF NEW
YORK STATE. NOT RESPONSIBLE FOR
DESIGN OR CONSTRUCTION ERRORS. —
'aa�BM E
IATELY,�
1 1/2" TO WASTE
FILTER PUMP HAIR & LINT STRAINER
SUCTION SKIMMER PUMP '
FILTER AUTO SKIMMER
a _ .
4 POOL MAIN DRAINS WITH
BACKTO HYDROSTATIC VALVE
• POOL AND COLLECTOR TUBE
SUCTION IN GRAVEL BASE
(OPTIONAL)
a
5' SCHEMATIC PIPING ARRANGEMENT
a
NOT TO SCALE
2" X 6" CCA
PRESSURE
VINYL LINER TREATED WOOD
RETURN I8.5" (MIN.)
FOAM PADDING3,500 PSI CONCRETE
d ' n f
32'
POOL PLAN &4 BOTTOM REARTOP a 42"
SCALE: N.T.S.
°
a ,
3.5'
°
7. d
NOTE
1. POOL AND PROPERTY TO CONFORM TO 2015 IBC do
2" COMPACTED SAND 322016 UNIFORM CODE SUPPLEMENT SECTION
6 I•— 125"
2. POOL SHALL CONFORM TO ANSI/ NSPI STANDARDS
R326.3.1. TYPICAL WALL DETAIL
UNDISTURBED EARTH 3. SECTION R326.7 POOL ALARM REQUIRED.
SCALE: 3/4" = l'-0"
POOL PROFIT -
SCALE: N.T.S.
NEW YORK STATE EDUCATION LAW NOTE: DATE: ' 10104/16
UNDER N.Y.S. EDUCATION LAW SECTION 7209, SUBSECTION 2, IT IS ILLEGAL FOR ANY PERSON, PREPARED FOR: HM ENGINEERING P.C.
UNLESS ACTING UNDER THE DIRECTION OF A LICENSED PROFESSIONAL ENGINEER, TO ALTER ANY VELASQUEZ SCALE: AS SHOWN
IT,SM ON THIS MATERIAL IN ANY WAY. IF AN ITEM IS SO ALTERED, THE PROFESSIONAL ENGINEER 3 CHERRYWOOD DR.
WHO SO ALTERS OR WHO DIRECTS ANOTHER TO SO ALTER, SHALL AFFIX TO THE ITEMS HIS SEAL 11365 OLD SOUND AVENUE E
SOE. NORTHPORT, NY 11731 RESIDENTIAL
AND THE NOTATION "ALTERED BY" FOLLOWED BY HIS SIGNATURE, THE DATE OF THE ALTERATION MATTITUCK, NY _ CONCRETE POOL PLAN
AND A SPECIFIC DESCRIPTION OF THE ALTERATION. 516.476.5392 FAX: 631.980.7671