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HomeMy WebLinkAbout41921-Z �Q�SUFRAI Town of Southold 4/9/2018 o - P.O.Box 1179 o _ 53095 Main Rd yjj�l �ao� Southold,New York 11971 CERTIFICATE OF OCCUPANCY No: 39585 Date: 4/9/2018 THIS CERTIFIES that the building IN GROUND POOL Location of Property: 4297 Wells Rd.,Peconic SCTM#: 473889 Sec/Block/Lot: 86.4-9.5 Subdivision: Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated 8/28/2017 pursuant to which Building Permit No. 41921 dated 8/28/2017 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, PER ZBA DECISION#6783,DATED 09-18-2014, AS APPLIED FOR The certificate is issued to van Adelsberg,Janet of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL ELECTRICAL CERTIFICATE NO. 41921 02-22-2018 PLUMBERS CERTIFICATION DATED uth ' ed Signature 1 o�SOtrotX�o TOWN OF SOUTHOLD BUILDING DEPARTMENT y TOWN CLERK'S OFFICE co • 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#: 41921 Date: 8/28/2017 Permission is hereby granted to: van Adelsberg, Janet 420 Riverside Dr Apt 5B New York, NY 10025 To: Construct an ISP per ZBA approval #6783, fenced to code. Replaces BP# 39262 At premises located at: 4297 Wells Rd., Peconic SCTM # 473889 Sec/Block/Lot# 86.-1-9.5 Pursuant to application dated 8/28/2017 and approved by the Building Inspector. To expire on 2/27/2019. Fees: PERMIT RENEWAL $125.00 Total: $125.00 Bui � nspector o�S�FFQIxco TOWN OF SOUTHOLD BUILDING DEPARTMENT y a 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#: 39262 Date: 10/9/2014 Permission is hereby granted to: van Adelsberg, Janet 420 Riverside Dr Apt 5B New York, NY 10025 To: construct an ISP per ZBA approval #6783, fenced to code At premises located at: 4297 Wells Road, Peconic SCTM # 473889 Sec/Block/Lot# 86.-1-9.5 Pursuant to application dated 7/8/2014 and approved by the Building Inspector. To expire on 4/9/2016. Fees: SWINVIMING POOLS -IN-GROUND WITH FENCE ENCLOSURE $250.00 CO - SWIMMING POOL $50.00 Total: $300.00 �X� 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 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 1 Date. q— � " New Construction: �� + 1 Old or Pre-existing Building: (check one) Location of Property: `��1 t��<<S _+P�C�YL;C_ House No. Street Hamlet Owner or Owners of Property: - e,,,Ae - Uez,,g &0_(5624 Suffolk County Tax Map No 1000, Section Block Lot Subdivision Filed Map. Lot: Permit No. Date of Permit. 0 Applicant: Health Dept. Approval: Underwriters Approval: Planning Board Approval: Request for: Temporary Certificate Final Certificate: (check o Fee Submitted: $ 'Appscant SiVatue,� pF SU��®� Town Hall Annex Telephone(631)765-1802 54375 Main Road roa Fax(631)765-9502 P.O.Box 1179 ® a� roger.richert(aD-town.southold.ny.us Southold,NY 11971-0959 c®U BUILDING DEPARTMENT TOWN OF SOUTHOLD CERTIFICATE OF ELECTRICIAL COMPLIANCE SITE LOCATION Issued To: Van Adelsberg Address: 4297 Wells Road city,Peconic st: New York zip: 11958 Building Permit#: 41921 Section- '86 Block: 1 Lot. 9.5 WAS EXAMINED AND FOUND TO BE IN COMPLIANCE WITH THE NATIONAL ELECTRIC CODE Contractor: DBA: Platinum East Electric License No: 34091-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 Ceding Fixtures HID Fixtures Service 3 ph Hot Water GFCI Recpt Wall Fixtures Smoke Detectors Main Panel AJC Condenser Single Recpt Recessed Fixtures CO Detectors Sub Panel A/C Blower Range Recpt Fluorescent Fixture Pumps 3 Transformer Appliances Dryer Recpt Emergency FixtureTime Clocks Disconnect Switches Twist Lock Exit Fixtures 9 TVSS 171 Other Equipment: Inground Swimming Pool to Include: Bonding, Pool Lights, Spa Blower, Control Panel, 2- Gas Pool Heaters, 2- Chlorine Generators, 6- GFCI Circuit Breakers. Notes: Inspector Signature: Date: February 22, 2018 0-Cert Electrical Compliance Form As SOUlyo N O i TOWN OF SOUTHOLD BUILDING DEPT. 765-18®2 INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLEIG. [ ] FOUNDATION 2ND [ ymSULA O [ ] FRAMING / STRAPPING [ FINAL [ ] FIREPLACE & CHIMNEY [ ] FIRE SAFETY INSPECTION [ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRATION [ ] ELECTRICAL (ROUGH) [ ] ELECTRICAL (FINAL) REMARKS: l IV °(i '�✓ � `9.4, erlsvi DATE INSPECTOR r. 1 • g1 1-ay • � tt � - 1: 1 u irism,ATioN STATE ENERGY • r © ' ` 2 � Ir • r tt - 1 10 r-A,M. MAMMA -�a i TOWN Or SOUTHOLD B�JILDING 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 j 1 I a Planning Board approval FAX: (631) 765-9502 Survey SoutholdTown.NorthFork.net PERMIT NO. Check Septic Form N.Y.S.D.E C. Trustees - - - C.O. Application Flood Permit Examined �� 201* Single&Separate Storm-Water Assessment Form '4 SEP 2 9 2014 , act: Approved © - ,,201 Mail to: Orea ve EnvironmentalDesign Disapproved a/c SDG DEP PO Box 160 _------ Phone- ]Peconic,NY 11958 Expiration 20J(_0 F � ' ---�ittding Inspector`__ =BLDCHP_T" APPLICATION FOR BUILDING PERMIT Date — 7 20t4 INSTRUCTIONS TOWPI OF SOUTHOLD 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 wort: 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�ttildnrb`adel o%o l iwa i %s e ,�,l.emoval or demolition as herein described. The applicant agrees to comply with all of '61ible•I Mas, ordinances, buildiing code, housing code, and regulations, and to admit authorized,' t s "In building E CLOSE P,-b041'O CODS {��p�a� '' h i� �C 5e Y haY n « � e o licant or nai if a;cor oration Blslr4R ,'GNAT � NIL FU ����'�ve���►ironmenta�e. esignp ) q - �1 Y :; PO Dox 160 4 . iT UT CERTI TE a> in g'a ress p licant) — — — N OCCUPANCa.: : ;. .. APPROVED AS )40i'E17 State whether applicant is owner, le ee, agent,,,ahhitecx,eatiF �L� £ -'contractor, electr ci n plumber o builder C ATE A) s B P #. : n � l-Y BI;I�JINv '`JAI ,�tri ILiLI�i Name of owner of premises Gea(t1� ��jL� to rtt 8 AM TO 4 PM FOR THE (As on the ax roll or latest deEOLOWING INSPECTIONS: I'f.applicant is a corporation, signature of duly authorized officer 1. FOUNDATION-TWO REQUIRED FOR POURED CONCRETE 2 ROUGH-FRAMING,PLUMBING, (Name and title of corporate officer) STRAPPING, ELECTRICAL&CAULKING Builders License No. 3 INSULATION Plumbers License No. �^ r„�. FINAL-CONSTRUCTION &ELECTRICAL �L MUST BE COMPLETE FOR C.0 Electricians License d L CONSTRUCTION SHALL MEET THE Other Trade's Licens�;N �`�' ON, "�y i � QUIREMENTS OF THE CODES OF NEW RK STATE NOT-RESPONSIBLE FOR 1. Location of land on which proposed work will be done. SIGRORCONSTRUCTION ERRORS , - �12.�1� RETAIN STORM 1AIAT,�,_RiUNOFF House Number Street t Hamlet PURSUANT TO CHAPTER 236 OF TKfgN CODE.. County Tax Map No. 1000 Section �� Block Lot ,___/Subdivision Filed Map No. Lot ti 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy 9\�� ° Aev-,k"oO b. Intended use and occupancy `,A,0�;A_ 3. Nature of work (check which applicable): N,ew,BLiQdiilg :. Addition Alteration�� Repair Removal Dembli�t oii; Other Work 4-r —LIA: _ _ - ( (_Description - —_ 4. Estimated Cost Fee s(1 o-be paid onWiling 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 J " 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 VINO 13. Will lot be re-graded? YES NO Will excess fill be removed from.premises? YES NOLO 14. Names of Owner of premisesIK 6W Address Phone No.ga- Name of Architect \1 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 t7 IF YES, SOUTHOLD TOWN TRUSTEES & D.E.C."PERMITS MAYBE REQUIRED. b. Is this property within 300 feet of a tidal wetland? -* YES NO IF YES, D.E.C. PERMITS MAY BE REQUIRED. lipf� l(l��e`' r ..F 16. Provide survey, to scale, with accurate foundation plan and distances to property lin'a" 17. If elevation at any point on property is at 10 feet or below, must provide topographical data �1wuiZv,ey. 18. Are there any covenants and restrictions with respect to this property? YES -�N®8 * IF YES, PROVIDE A COPY. ' ' h r 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, C®NNIE U.BUNCH Notary Public,State of New York (S)He is the No.01BU6185050 ty Cf5l' C'iUm Expiresgent, Corporate Officer, etc.) ualitl n ed in lk C un i'_1 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 20t�_ Notary Public Signature of Applicant BOARD MEMBERS Southold Town Hall Leslie KaneslWeisman,Chairperson \®F SO(�r53095 Main Road-P.O.Box 1179 Southold,NY 11971-0959 Eric Dantes Office Location: Gerard P.Goehringer Town Annex/First Floor,Capital One Bank George Horning �Q 54375 Main Road(at Youngs Avenue) Kenneth Schneider �lij'COU Southold,NY 11971 http://southoldtown.northfork.net E CU�T i u U ZONING BOARD OF APPEALS TOWN OF SOUTHOLD u2014 Tel.(631)765-1809-Fax(631)765-9064 SEP BLDG DEPT TOWN OF SOUTHOID FINDINGS,DELIBERATIONS AND DETERMINATION MEETING OF SEPTEMBER 18,2014 ZBA FILE# 6783 NAME OF APPLICANT: Janet van Adelsberg SCTM#1000-86-1-9.5 PROPERTY LOCATION: 4297 Wells Road(adj.to Richmond Creek)Peconic,NY SEQRA DETERMINATION: The Zoning Board of Appeals has visited the property under consideration in this application and determines that this review falls under the Type II category of the State's List of Actions, without further steps under SEQRA. SUFFOLK COUNTY ADMINISTRATIVE CODE: This application was referred as required under the Suffolk County Administrative Code Sections A 14-14 to 23, and the Suffolk County Department of Planning issued its reply dated August 19, 2014 stating that this application is considered a matter for local determination as there appears to be no significant county-wide or inter-community impact. LWRP DETERMINATION: This application was referred for review under Chapter 268, Waterfront Consistency review of the Town of Southold Town Code and the Local Waterfront Revitalization Program (LWRP) Policy Standards. The LWRP Coordinator issued a recommendation dated August 21, 2014. Based upon the information provided on the LWRP Consistency Assessment Form submitted to this department, as well as the records available to us, it is our recommendation that the proposed action is CONSISTENT with LWRP policy standards and therefore is CONSISTENT with the LWRP. PROPERTY FACTS/DESCRIPTION: The property is a code conforming 2.6229 acre waterfront parcel located in an R-80 zone district. The parcel has 393.04 feet of frontage on Richmond Creek. The parcel runs 325.19 feet on the North side, 368.66 feet on the East side, and 380.07 feet on the South side. The parcel is a flag lot. The property is accessed by a gravel driveway which leads to Wells Road. The property is a developed parcel with a 2 story frame residence, an accessory frame garage, and a wood dock. A large section of the property is a wooded area. All is shown on a survey by Frank Barylski,L.L.S. dated September 10, 2013, last revised 9-10-2014. BASIS OF APPLICATION: Request for Variances from Article III Section 280-15 and the Building Inspector's July 16, 2014 Notice of Disapproval based on an application for building permit to construct accessory shed and in- ground swimming pool, at; 1)proposed location other than the code required rear yard. RELIEF REQUESTED: The applicant requests a variance to construct a swimming pool partially in the side yard and to construct a storage shed in a side yard. Code requires that accessory buildings and structures or other accessory uses shall be located in the required rear yard or in the case of water front properties a front yard location meeting the principal setback. Page 2 of 3—September 18,2014 ZBA File 6783—vanAdelsberg SCTM#1000-86-1`9.§ ADDITIONAL INFORMATION: A site inspection showed that the land east of the applicant is a farm. The applicant only has one neighbor on Southern side. FINDINGS OF FACT/REASONS FOR BOARD ACTION: The Zoning Board of Appeals held a public hearing on this application on September 4, 2014 at which time written and oral evidence were presented. Based upon all testimony, documentation, personal inspection of the property and surrounding neighborhood, and other evidence,the Zoning Board finds the following facts to be true and relevant and makes the following findings: 1. Town Law X267-b(3)(b)(1). Grant of the variance will not produce an undesirable change in the character of the neighborhood or a detriment to nearby properties. The lot is a flag lot which is not visible from any public road. The neighbor to the South has plantings which provide screening between the properties. 2. Town Law §267-b(3)(b)(2). The benefit sought by the applicant can be achieved by some method, feasible for the applicant to pursue, other than an area variance. The applicant could build the swimming pool and the shed into code conforming rear yard or front yard locations. However, if the applicant moved the pool and shed to a code conforming rear yard location, the pool and shed would be closer to the wetlands than its proposed location. If the pool and shed were moved to a code conforming front yard location it would require a 60 foot front yard setback which would place them 10 feet from the dwelling and in the area of the existing septic system or driveway. 3. Town Law 4267-b(3)(b)(3). The variances granted herein are mathematically substantial, representing 100% relief from the code. However, the proposed pool and accessory shed are located as far away from the wetlands as is practicable. 4. Town Law §267-b(3)(b)(4) No evidence has been submitted to suggest that a variance in this residential community will have an adverse impact on the physical or environmental conditions in the neighborhood. The applicant must comply with Chapter 236 of the Town's Storm Water Management Code. 5. Town Law 4267-b(3)(b)(5). The difficulty has been self-created. The applicant purchased the parcel after the Zoning Code was in effect and it is presumed that the applicant had actual or constructive knowledge of the limitations on the use of the parcel under the Zoning Code in effect prior to or at the time of purchase. 6. Town Law §267-b. Grant of the requested relief is the minimum action necessary and adequate to enable the applicant to enjoy the benefit of a swimming pool and shed while preserving and protecting the character of the neighborhood and the health, safety and welfare of the community. RESOLUTION OF THE BOARD: In considering all of the above factors-and applying the balancing test under New York Town Law 267-13, motion was offered by Member Dantes, seconded by Member Goehringer, and duly carried, to GRANT, the variances as applied for, and shown on the survey by Frank Barylski, L.L.S. dated September 10, 2013 and last revised September 10, 2014, and the 14' X 20' shed plans four pages date stamped received by ZBA on Sept. 4, 2014. Subject to the following conditions; CONDITIONS: 1. Pool mechanicals shall be placed in a sound deadening enclosure. 2. Drywell for pool de-watering shall be installed. That the above conditions be written into the Building Inspector's Certificate of Occupancy, when issued. Page 3 of 3—September 18,2014 ZBA File 6783—vanAdelsberg SCTNINJ000-8b-1'9.5 a Any deviation from the survey, site plan and/or architectural drawings cited in this decision will result in delays and/or a possible denial by the Building Department of a building permit, and may require a new application and public hearing before the Zoning Board of Appeals. Any deviation from the variances)granted herein as shown on the architectural drawings, site plan and/or survey cited above, such as alterations, extensions, or demolitions, are not authorized under this application when involving nonconformities under the zoning code. This action does not authorize or condone any current or future use, setback or other feature of the subject property that may violate the Zoning Code, other than such uses, setbacks and other features as are expressly addressed in this action. The Board reserves the right to substitute a similar design that is de minimis in nature for an alteration that does not increase the degree of nonconformity. Vote of the Board- Ayes Members Schneider, Goehringer, Dantes. Nay: Member Horning. Absent was: Member Weisman (Chairperson). This Resolu ' as d ly adopted(3-1). e neth Schneider,Acting Chairperson Approved for filing /Z 0,/2014 Scott A. Russell �®�u �� STO)]KMWA\T]EIK SUPERVISOR MA A G IEMIEN T SOUTHOLD TOWN HALL-P.O.Box 1179 53095 Main Road-SOUTHOLD,NEW YORK 11971 , Town of Southold CHASTER 236 - ST®RMWATER MANAGEMENT WORK SHEET ( TO BE COMPLETED BY THE APPLICANT) DOES 'SIS ]PROJECT INVOLVE ANY OF THE FOLLOWING Yes No (CHECK ALL THAT APPLY) ®�A. Clearing, grubbing, grading or stripping of land which affects more than 5,000 square feet of ground surface. B. Excavation or filling involving more than 200 cubic yards of material within any parcel or any contiguous area. ®ffC. 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. ®[4 E. Site preparation within the one-hundred-year f loodplain 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 Check List Form to the Building Department with your Building Permit Application. APPLICANT. (Pt erty Owner es�;p Professional,r��tt,Cpntractor,Other) S.C.T.M. 1000 Dat- iL:l�$t1Ve nVlMnMental ff6Slgn Distract NAME: PO Box 160 t q•J 7-7­c�o1Gl Pej&ic,NY 11958 Section Block Lot mgt-3 *`FOR BUILDING DEPARTMENT USE ONLY Contact Information 1�wy'L (_2Ze_'"rpW,L� h \ dCa4,'l/rlV�Lfr1 rI'elephoue Numbed Reviewed By: r-144 — — — — — — — — — — — — — — — — Property Address/Location of Construction WorkDate: — '� : — — — — — — — — a — — — — — — — r�a�� r p� 115 Approved for processing Building Permit. l t�-11 Stormwater Management Control Plan Not Required. Stormwater Management Control Plan is Required. (Forward to Engineering Department for Review.) FORM * SMCP-TOS MAY 2014 SO(/p�o� , � o Town Hall Annex T enhone(631)765-1802 54375 Main Road y� (631)765- 'P.O.Box 11790 �� ro er.richert t sou cLn .us Ll Southold,NY 11971-0959 MAY 2 7 2015 j t BUILDING DEPARTMENT TONT OF SOUTHOlLD "PT TG'' J `GL' HGCD APPLICATION FOR ELECTRICAL INSPECTION REQUESTED BY: kfoyp Date: S-,2 4 I C Company Name: „�u,,� E-As— C 7 f Name: -- -- - - -:-c t- - ---- -- - - - _ - -- - - - --- -- --�--- ------- - License No.: 3 Ya Address: K&=A-vLAlS f SUS-(If0Lo IU _ Phone No.: (� - JOBSITE INFORMATION: (*indicates required information) *Name: N 1,91Z()SjA), *Address: W&tCS q -o,YW,c,© IPCTA,,c `Cross Street:, - M,V,N 1Z!0 *Phone No.: 7657- ,4 Permit No.: 3 Tax Map District: 1000 Section: Block: Lot: , *BRIEF DESCRIPTION OF WORK(Please Print Clearly) (0-0 (Please Circle All That Apply) *Is job ready for inspection: YES / NO Rough In Final *Do 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 • 82-Request for lnspecUonForm �'j� Southold Town Building Department guGFQI,���o� P.O.Box 1179 oG. Permit#: 39262 53095 Main Rd ` Southold,New York 11971 Permit Date: 10/9/2014 (631)765-1802 Expiration Date: 4/9/2016 Parcel)D: 86.-1-9.5 BUILDING PERMIT RENEWAL LETTER Dated: 8/16/2017 Applicant: Creative Environmental Design(Jill) Location: 4297 Wells Road, Peconic Work Description: IN GROUND POOL construct an ISP per ZBA approval#6783, fenced to code A FEE OF $125.00 IS REQUIRED TO RENEW THIS BUILDING PERMIT. Owner: van Adelsberg, Janet Address: 420 Riverside Dr Apt 513 New York,NY 10025 The permit listed above has expired. No work is permitted or authorized beyond the expiration date. Please submit the above fee made payable to the Town of Southold. Mail to the Town of Southold Building Department, P.O. Box 1179, Southold, New York 11971 THANK YOU, SOUTHOLD TOWN BUILDING DEPT. 4297 Welis,Rtl R\ � t �r - � Google Earth Google 00 r SURVEYED FOR: JANET VAN ADELSBERG PROPERTY LOCATED AT PECONIC LOT No. 2 AS SHOWN ON CONIC. MAP OF RICHMOND CREEK FARMS: SECTION 2 MON. LAND N/F FILED: MAY 16, 1999: FILE No. 10262 S PELLEGRINI TOWN OF SOUTHOLD LOT 3 OGRATE 151, PECONIC LLC. SUFFOLK COUNTY, NEW YORK 193• S.C.T.M. "# 1000-66-1-9.5 Zg1g, 6� @M.H.C• \� _ AREA = 2.6229 ACRES \ SCALE: 1"=60' °�g+01 �ti \ 36+8 NOTE: THE EXISTENCE OF RIGHT OF WAYS, WETLANDS AND/OR EASEMENTS OF RECORD 61 IF ANY. NOT SHOWN ARE NOT GUARANTEED. ro Se� 3js Rp F�pRtPEW,IY �<O m 2 F98T0 !SO FRAME \ GARAGE N GRATESTAKE ry 3 RFS ry 0 0 V� lS61 B2 2S,2 GRAVEL ry1�0r UTIL c�0 ti v DRIVEWAY y!u/ BOX (/�O !S? ° 1S 0 TREES /I/ Sc T T o 160 WOODED AREA \ g� N f( �f EDGE OF PROPOSED 4eSTpHF EQUIP PROPOSED POOL ,61; , LAWN SPA B' X 8' 0 STORAGE SHED 3, if/ Sse m / RAD = 485.00'. PROPOSED gNF pF \\ LEN = 184.49' 20.0 X 55.8 R Y\ �( 4,g \ ulC�° ARE NOT TO CO EOF SR O A D MAIN ,T3 37 n °� ^ sso.o SF. RAD = 470.00' \ (N•y•S. RTE 26) `? i9; LEN = 178.78' o, 6, / cb TREES 75' WETLANDS 15"/W SETBACK S .34055'31"E EDGE OF ^ 5 5.3 5' LAWN DN 34°55'31"W 4468.99 ° LOT 1 RICHMOND � 55.35' CREEK -" -" " " - - - S 55004'29"W / 15.00' WETLAND FLAGS y ^ V� BY SHAWN BARRON 9-18-2013 , of: N N► O UNAUTHORIZED ALTERATION OR AODITIN TO THIS SURVEY IS A VIOLATION SD° OF SECTION 72(79 OF THE NEW YORK STATE EDUCATION LAW. COPIES OF THIS SURVEY MAP NOT BEARING THE LAND SURVEYORS INKED 7 J, y r� OR EMBOSSED SEAL SHALL NOT BE CONSIDERED TO BE A VALID TRUE COPY. 66' JS,� t GUARANTEES OR CERTIFICATIONS INDICATED HEREON SHALL RUN ONLY TO •S8, *':J ;:+> THE PERSON FOR WHOM THE SURVEY IS PREPARED,AND ON HIS BEHALF TO THE TITLE COMPANY.GOVERNMENTAL AGENCY AND LENDING INSTITUTION °< ` �,i; SURVEYED B Y: LISTED EON.AND TO THE ASGGUARANTEEEES OR CERTIFICATIONSSIGNEES ME NOT TRANSFERABLE TO AADOF THE LENDING DITIOONN& FRANK B A R Y L S K I LAND SURVEYING INSTITUTIONS OR SUBSEQUENT OWNERS. \ �/lj 44 22 A R I V E R H E A D, NY 11901 CERTIFIED TO: LAAO PHONE 631-727-1730 JANET VAN ADELSBERG FAX 631-284-3697 CHICAGO TITLE INSURANCE SERVICES, TITLE No. C13-7474-14716-SUFF SEPTEMBER 10. 2013 FB 1158-P 9-10-2014: PROPOSED POOL SHED L J r - � SURVEYED FOR: JANET VAN ADELSBERG PROPERTY LOCATED AT PECONIC LOT No. 2 AS SHOWN ON CONC. MAP OF RICHMOND CREEK FARMS: SECTION 2 MON. LAND N/F FILED: MAY 18, 1999: FILE No. 10282 S` PELLEGRINI TOWN OF SOUTHOLD LOT 3 OGRATE \ SSA PECONIC LLC. SUFFOLK COUNTY, NEW YORK �3• S.C.T.M. # 1000-66-1-9.5 Z�j1g' o� Op M.H.C. \� AREA = 2.6229 ACRES \ SCALE: 1"=60' ti °Dcg�o� gory \ 368 WETLANDS EXISTENCE OF RIGHT OF WAYS, S AND/OR EASEMENTS OF RECORD rot IF ANY, NOT SHOWN ARE NOT GUARANTEED. ti @e�i 3 BpRp f�ORrvFW^Y F< p pRSTORY rs6 FRAME GARAGE " GRATE STAKE - !@@`ry 3B2 2S2 N GRAVEL r�l0r` UTIL Cv0 N P DRIVEWAY WBOX IN Sp O 'Sp TREES �/ Sc°1' T ���EIV WOODED AREA \ e4/F9 �3 F� SEP 112014- EDGE OF PROPOSED "OHF EQUIP PROPOSED ,618 LAWN SPA 8' X e' s .0 STORAGE SHED 3, 11i cp �C\ BOARD OF APPEALS Se m / - oaf RAD = 485.00 ., PROPOSED RFq�F p �F�� \\ LEN = 184.49' Z 20.0X55.8 - RY\ AREA OF POOL VD. OrC/ NOT TO CODE \ MAIN ROAD 'To \ oy ^ 330.0 SF. RAD = 470.00' �N,y,S, RTE 26) LQ LEN = 178.78' 00 \ j TREES !� 75' WETLANDS SETBACK S 34055'31"E 55.35' - �' fEDGE OF ^ LAWN ,4* _ °ate LOT 1 N 34°55'31"W 4468.99' RICHMOND : D 55.35' -- - - - M � S 55004'29"W CREEK 15.00' WETLAND FLAGS v� BY SHAWN BARRON _ Qo 9-IB-2013 i'�C � O UNAUTHORIZED ALTERATION OR ADDITION TO THIS SURVEY IS A VIOLATION OF SECTION 7205 OF THE NEW YORK STATE EDUCATION LAW. O°� SURVEYCOPIES OF THIS O BEARING N OR EMBOSSED SEAL SHALL NOT BE CONSIDERED TO BE AA VALIDRINKED , TRUECOPY. ,6� ;s. GUARANTEES OR CERTIFICATIONS INDICATED HEREON SHALL RUN ONLY TO •�` �J r .s THE PERSON FOR WHOM THE SURVEY IS PREPARED.AND ON HIS BEHALF TO THE TITLE COMPANY.GOVERNMENTAL AGENCY AND LENDING INSTITUTION v M.,r% SURVEYED B Y: LISTED HEREON.AND TO THE ASSIGNEES OF THE LENDING INSTITUTION. � FRANK B A R Y L S K I LAND SURVEYING GUARANTEES CERTIFICATIONS NOT TRANSFERABLE TO ADDITIONAL Cpi�, 4-22 ORSUBEOUENTJk �CV RIVERHEAD. NY 11901 CERTIFIED T0: \ `` o LRD PHONE 631-727-130 JANET VAN ADELSBERG ` `" FAX 631-284-3697 CHICAGO TITLE INSURANCE SERVICES, TITLE No. C13-7474-147 16-SUFE SEPTEMBER 10, 2013 FB 1158-P 9-10-2014: PROPOSED POOL & SHED L 1 We make it strong.We make it easy.- OVER ® �qfqal Coverstar Automatic Covers and UL/ASTM standard F 1346-91 All Coverstar cover systems including the Eclipse(CS 1800 SS),CS 1800(CS 1800),Leading Edge (CS1800 LE),CS1800 SwimWise(CS1800 SW),Omega(CS 1800),CS3000(CS 1800)are UL listed (UL certification listing is shown in parenthesis). All meet the ASTM standard for safety covers as specified in ASTM standard F 1346-91 when they are installed and maintained properly according to the installation and homeowner instructions which have been provided by Coverstar. On several different occasions,the Coverstar covers,both automatic and manual have been tested by independent testing laboratories and have always been found to be in compliance with all the ASTM requirements for safety covers. Our covers are also listed by UL(File E164833)and classified by UL as a power safety cover in accordance with ASTM F 1346-91 If you wish to verify either of the UL certifications,take the following steps: Go to www.ul.com Once there click on Search UL.com Click on Online Certifications Directory. Under General Search click on UL File Number Type in E164833 and hit enter You should now see Coverstar's listings. If you have problems,you can also search by company or by Automatic Pool Covers If more information is required about ASTM and its standards,you can go to their website at www.astm.org. Shown below is the UL authorized label that is attached to the automatic cover system that we ship which shows both UL certification and compliance with ASTM F 1346-91.A label is also placed on the front of every cover stating that we meet the ASTM safety standards. POWERED SAFETY COVER e _ Safety Pool C U` us Cover Operrtor' LISTED 98 RJ ALSO CLASSIFIED .. POWER SAFETY COVER z in accordance with ASTM F 1346-91 RIECOFAV97) st 200 North, Lindon,UT 840421 Phone 800-617-7283 Fax 801-373-5095 www.coverstar.com MAR 3 0 2018 TOWN OF SOUTHOLD E C #3 REBAR F� m SEP 3 0 2014 BLDG DEPT TOWS l OF SOUTHOLD J CERAMIC TILE m - - - - - - - - i > Q 3"CLR z III a ED o z #3 @ 120 O.C. VERT. 0 III _ lu I I I O 3' CLR � III --------�------ I � I 6° #3 @ 6"O.C. VERT. 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