HomeMy WebLinkAbout42554-Z r1FFOl,fc Town of Southold
a•A "m ®�; 5/10/2018
P.O.Box 1179
o ! 53095 Main Rd
t ►pl ��0�' Southold,New York 11971
CERTIFICATE OF OCCUPANCY
No: 39638 Date: 5/10/2018
THIS CERTIFIES that the building ACCESSORY ALTERATION
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
4/4/2018 pursuant to which Building Permit No. 42554 dated 4/10/2018
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:
EXISTING ACCESSORY BUILDING ALTERED TO UNHEATED POOL HOUSE WITH STORAGE ABOVE
AND ATTACHED "AS BUILT"PERGOLA AS APPLIED FOR
The certificate is issued to DiSimone,Harry&Elizabeth
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL
ELECTRICAL CERTIFICATE NO. 42554 05/01/2018
PLUMBERS CERTIFICATION DATED Jim
0 Ohood Signature
SUFFn��. TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN CLERK'S OFFICE
o� SOUTHOLD, NY
Q� ��.
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#: .42554 Date: 4/10/2018
Permission is hereby granted to:
DiSimone, Harry
18 Hickory Dr
Old Brookville, NY 11545
To: alter existing accessorybuildin to a pool house with an "as built"
pergola as applied
for per ZBA approval. Additional certification will be required.
At premises located at:
1100 Youngs Rd, Orient
SCTM # 473889
Sec/Block/Lot# 18.-2-11.1
Pursuant to application dated 4/4/2018 and approved by the Building Inspector.
To expire on 10/10/2019.
Fees:
ACCESSORY $252.00
AS BUILT-ACCESSORY $115.20
CO -ACCESSORY BUILDING $50.00
Total: $417.20
Bu Spector
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
Date.
New Construction: Old or Pre-existing Building: C (check one)
Location of Property: '
p rty:
House No. Street Hamlet
t
Owner or Owners of Property: \� � cL ��v S4 4A 004 �
Suffolk County Tax Map No 1000, Section J Block 0_11 Lot
Subdivision e Filed Map. Lot:
Permit No. 2 J� Date of Permit. Applicant:
Health Dept. Approval: Underwriters Approval:
Planning Board Approval:
Request for: Temporary Certificate Final Certificate: (check one)
Fee Submitted: $ I_� a
Applicant Signature
rjv so
Town Hall Annex Telephone(631)765-1802
54375 Main Road Fax(631)765-9502
P.O.Box 1179 �� roper.richert@town.southold.nv.us
Southold,NY 11971-0959 `r®
MUM
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
Budding Permit P 42554 Section: 18 Block 2 Lot: 11.1
WAS EXAMINED AND FOUND TO BE IN COMPLIANCE WITH THE NATIONAL ELECTRIC CODE
Contractor: DBA: Garnett Electric License No: 34073-ME
SITE DETAILS
Office Use Only
Residential X Indoor X Basement Service Only
Commerical Outdoor X 1st Floor X Pool
New Renovation 2nd Floor X Hot Tub
Addition Survey Attic Garage
INVENTORY
Service 1 ph Heat Duplec Recpt 10 Ceiling Fixtures HID Fixtures
Service 3 ph' Hot Water GFCI Recpt 2 Wall Fixtures 10 Smoke Detectors
Main Panel A/C Condenser Single Recpt Recessed Fixtures 4 CO Detectors
Sub Panel A/C Blower Range Recpt Fluorescent Fixture Pumps
Transformer Appliances Dryer Recpt Emergency Fixture Time Clocks
Disconnect Switches 5 Twist Lock Exit Fixtures TVSS
Other Equipment: "pool House"
Notes: 1- Combination Smoke/ CO Detector, 1- Exhaust Fan,
13- Combination ARC/ GFCI Circuit Breakers.
r
Inspector Signature: Date: May 1, 2018
0-Cert Electrical Compliance Form.xis
ho��pF SO(/ry�lo
000MV 0c�
TOWWOF 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 1 1 INSPECTOR
F SOUIyOIo
TOWN OF SOUTHOLD BUILDING DEPT.
765-1602
INSPECTION
[ ] FOUNDATION 1ST [ ] ROUGH PLSG.
[ ] FOUNDATION 2ND [ ] ISOLATIION
[ ] FRAMING /STRAPPING [ FINAL dd 6 b a
[ ] FIREPLACE & CHIMNEY [ ] FIRE SAFETY INSPECTION
[ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRATION
[ ] ELECTRICAL (ROUGH) [ ] ELECTRICAL (FINAL)
[ ] CODE VIOLATION [ ] CAULKING
'REMARKS:
A4k a(�,-
con (nD !� S
y G�L
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DATE INSPECTOR
JOE READ CONSTRUCTION MANAGEMENT
P.O.Box 1031,29 Lakeview Drive,Shelter Island,New York 11964
631-749-1616 cell 631-252-8578
joereadsi@gmail.com
May 4, 2018
CERTIFICATE OF COMPLETION:
Subject: D
Dry pool house D
1100 Youngs Road MAY - 7 2018
Orient, New York
PT
SC TAX MAP NUMBER: 18-2-11.1 «aNG D.'' •
TOWN OF SOUTHOLD
This is to certify that the trellis/arbor, built at the above location, meets all New York
Building Code standards.
Joseph Read, Contractor
E OF NFiy
4
John Barylski P.E.
��FSS10NAL�N
FIELD INSPECTION REPORT DATE COMMENTS
t�FOUNDATION(1ST) H
-------------------------------
FOUNDATION (2ND)
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ROUGH FRAMING& t�
PLUMBING
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INSULATION PER N.Y:
STATE ENERGY CODE
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FINAL t
4
ADDITIONAL OMMENTS
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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
SOUTHOLD, NY 11971 4 sets of Building Plans
TEL: (631) 765-1802 Planning Board approval
FAX: (631) 765-9502 Survey
S-outholdtownny.gov PERMIT NO. Check
Septic Form
N.Y.S.D.E.C.•
Trustees.
C.O.Application
Flood Permit
Examined ,200 Single&Separate
Truss Identification Form
Storm-Water Assessment Form
r) c Contact:
Approved 20� Maim: � ��
Disapproved a/c
Phone: (DZ l 3623 - R57-79'
Expiration b 20
D 0f!�=Y PV
nspector
D
APR ® 4 2010P'DATION FOR BUILDING PERMIT
GAY
Date*n I , 20
Buf u�,m �DIEM INSTRUCTIONS..,,,,, ,._.
TOWN OF SOUTHOLD u"s
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,housing,code, and regulations, and to admit
authorized inspectors on premises and in building for necessary inspections.
y�ignature�of applicant or name,if a corporation)
(Mailing address of applicant) 11,96
State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or,-builder•
Name of owner of premises l �- � �� YC)VIP
(As on the tax roll or latest deed)
If applicant is a corporation, signature of duly authorized officer
(Name and title of corporate officer)
Builders License No.
Plumbers License No.
Electricians License No.
Other Trade's License No.
1. Location of land on which proposed work will be done:
/00 yM1i :S r � 0 —a
House Number Sal Street Hamlet
County Tax Map No. 1000 Section Block Lot �,
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 < A �
3. Nature of work (check which applicable):New Building Addition Alteration X
Repair Removal Demolition Other Work D�,eo
r� 'Poo I kovbd - (D b'1 tion)s��
4. Estimated Cost /�5 fes'. o� 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 Num ��ofStoriosa ,.4 -
8. Dimensions of entire new construction: Front Rear s Depth
Height Number of Stories 'I— ; .. .;
4 L -
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 :K'e)e-7ZL A-a Address, Phone No.6.31-0,4'9-S,S'7�?
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.G. 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,
CONNIE D.BUNCH
Pulicof
(S)He is the Notary Nob 01BUt6185050w ®
rk
(Contractor, Agent, Corporate Officer, etc.) Qualified in Suffolk Ceunty
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.
Sw rn o before me
g�day of ` 20
Notary Public Signature of Appli ant
Scott A. Russell �01°s� � � STO>[ZI��1 WAXIE)E,
SUPERVISOR M[ANAG]EM MEDT
SOUTHOLD TOWN HALL-P.O.Box 1179
53095 Main Road-SOUTHOLD,NEW YORK 11971 �� �- Town of So u t O
ld
CHAPTER 236 - STORMWATER MANAGEMENT WORK SHEET
( TO BE COMPLETED BY THE APPLICANT )
`7[ ORD --'I' IS---PIE OJ EC T—"IINVO LVIE—ANY—'OF- d']Cl[lE—F'®l LOWING:�
Yes No (CHECK ALL THAT APPLY)
❑59 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.
E1% 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.
❑ E. Site preparation within the one-hundred-year floodplain as depicted
on FIRM Map of any watercourse.
❑W 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.
�C 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:
District I'
NAME- t _a,_
Section Block Lot
Ss�amra .F�:��e FORBUILDING 1)E:' j�11{"I' -L'�`(- Lia:
Contac['Informatiori
ri,iao,v„�o,r
Reviewed By:
Date.
Property Address / Location of Construction Work: — — — — — — — — — — — — — — —
[ Approv'd for processing Building Permit
/ Stormwater Management Control Plan Not Required
❑ Stormwater Management Control Plan is Required
(Forward to Engineering Department for Review)
FORM # SMCP-TOS MAY 2014
FFOL/r BUILDING DEPARTMENT- Electrical Inspector
TOWN OF SOUTHOLD
Town Hall Annex - 54375 Main Road - PO Box 1179
"' Southold, New York 11971-0959
� a� Telephone (631) 765-1802 - FAX (631) 765-9502
roger.richertRtown.southold.ny.us
APPLICATION FOR ELECTRICAL INSPECTION
- --- ---- -- Date:- e
REQUESTED BY.--
Company Name: Q Z1✓C j
Name: C/ ! S ti
License No.: 3 7 3 email:
Address: 4;�;, vZF-' S,9 9Z
Phone No.: l
JOB SITE INFORMATION: (All Information Required)
Name: /"62/./C C--
Address:
Address: 4.5) e.-D U /l16S I:F-y7-
Cross Street:
Phone No.: /2,6 5' /
Bldg.Permit#: y y �S email:
Tax Map District: 1000 Section: / r3 Block: 2 Lot:
BRIEF DESCRIPTION OF WORK (Please Print Clearly)
Circle All That Apply:
Is job ready for inspection?: YES 9 NO Rough In Final
Do you need a Temp Certificate?: YES /(�O Issued On
Temp Information: (All information required)
Service Size 1 Ph 3 Ph Size: A # Meters Old Meter#
New Service - Fire Reconnect - Flood Reconnect - Service Reconnected - Underground - Overhead
# Underground Laterals 1 2 H Frame Pole Work done on Service? Y N
Additional Information:
PAYMENT DUE WITH APPLICATION
Request for Inspection FormAs ��r�
SURVEY OF PROPERTY
AT ORIENT
TOWN OF SOUTOLD
SUFFOLK COUNTY, N. Y.
1000-18-02-11.1
SCALE. 1'= 30'
AUGUST 03, 2017 �uM
SEPTEMBER 14, 2017 (LOT COVERAGE) N/O/F L� 0,_0,_20„
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ANY ALTERATION OR ADDITION TO TH I5 SURVEY 15 A .5. L I C. NO. 18
VIOLATION OF SECTION 7209OF THE NEW YORK STATE PLE.ONIG 5UKVEYOK5, P.G.
EDUCATION LAW. EXCEPT A5 PER SECT ION 7209-5Uff)D I V 151 ON 2. 76 —5020 FAX (631) 765 -1797
ALL CEKTIFICATION5 HEREON ARE VALID FOR THI5 MAP AND P. OX `10`1 1230
COPIES THEREOF ONLY IF SAID MAP OR COPIES DEAR THE TRAVELER STREET
IMPRESSED SEAL OF THE SURVEYOR 5OUTHOLD, N.Y. 11971 17-042
CONT RIDGE VENT n
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