HomeMy WebLinkAbout32868-Z SdFFGI/r Town of Southold Annex 8/30/2012
=off �Gy� P.O.Box 1179
y 54375 Main Road
oy Southold,New York 11971
CERTIFICATE OF OCCUPANCY
No: 35926 Date: 8/30/2012
THIS CERTIFIES that the building IN GROUND POOL
Location of Property: 2450 LIGHT HOUSE RD SOUTHOLD,
SCTM#: 473889 Sec/Block/Lot: 50.4-10
Subdivision: Filed Map No. Lot No.
conforms substantially to the Application for Building Permit heretofore filed in this officed dated
3/29/2007 pursuant to which Building Permit No. 32868 dated 3/30/2007
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 with fence to code as applied for.
The certificate is issued to George&Pamela Tietjen,III
(OWNER)
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL
ELECTRICAL CERTIFICATE NO. 32868 8/27/12
PLUMBERS CERTIFICATION DATED
Aut rized Signature
FORM NO. 3
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Town Hall
Southold, N.Y.
BUILDING PERMIT
(THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL
COMPLETION OF THE WORK AUTHORIZED)
PERMIT NO. 32868 Z Date MARCH 30, 2007
Permission is hereby granted to:
GEORGE N III TIETJEN
151 BEVERLY AVE
FLORAL PARK,NY 11001
for
CONSTRUCTION OF AN IN-GROUND SWIMMING POOL AS APPLIED FOR IN THE
REQUIRED REAR YARD
at premises located at 2450 LIGHT HOUSE RD SOUTHOLD
County Tax Map No. 473889 Section 050 Block 0004 Lot No. 010
pursuant to application dated MARCH 29, 2007 and approved by the
Building Inspector to expire on SEPTEMBER 30, 2008 .
Fee $ 250 . 00
:- ]zed S n
ORIGINAL
Rev. 5/8/02
Form No.6
TOWN OF SOUTHOLD. 1
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 2110 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 9,190) non-conforming uses,or buildings and "pre-existing"land uses:
l. 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$50.00, Additions to accessory building$S0.00, 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 o Occupancy -Residential $1.5.00,Commercial$15.00
Date. - 2�1 1 Z
New Construction: Old or Pre-existing Building:' (check one)
Location of Property: /5d f 1,WjU
House No. U Street Hamlet
Owner or Owners of Property: (=D�G✓� CIL- e� 7 CA,
Suffolk County Tax Map No 1000, Section Sy Block L Lot
Subdivision Filed Map. Lot:
Permit No. J�tp$ Date of Permit. `� - - (�7 Applicant: '
Health Dept.Approval: Underwriters Approval:
Planning Board Approval:
Request for: Temporary Certificate Final Certificate: ✓ Vo -
J7ee Submitted: $
ppl�tSi ature
SOUryolo
Town Hall Annex Telephone(631)765-1802
54375 Main Road Fax(631)765-9502
P.O.Box 1179 G • Q roger.richert( -town.southold.ny.us
Southold,NY 11971-0959
CoU ,�
BUILDING DEPARTMENT
TOWN OF SOUTHOLD
CERTIFICATE OF ELECTRICIAL COMPLIANCE
SITE LOCATION
Issued To: George Tieden
Address: 2450 Lighthouse Rd City: Southold St: NY Zip: 11971
Building Permit#: 32868 Section: 50 Block: 4 Lot: 10
WAS EXAMINED AND FOUND TO BE IN COMPLIANCE WITH THE NATIONAL ELECTRIC CODE
Contractor: as built DBA: License No:
SITE DETAILS
Office Use Only
Residential X Indoor Basement 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 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 Fixtures Time Clocks 1
Disconnect HSwitches F1 Twist Lock RExit Fixtures TVSS
Other Equipment: In ground pool to include, bonding, 3-GFCI circuit breakers, gas heater,
salt generator, 1-pool light
Notes:
Inspector Signature: Date: Aug 27 2012
81-Cert Electrical Compliance Form.xls
32, �'� O��a SOUTyo!
� o
Courm,��'
TOWN OF SOUTHOLD BUILDING DEPT.
765-1802
INSPECTION
[ ] FOUNDATION 1ST [ ] ROUGH PL13G.
[ ] FOUNDATION 2ND [ ] INSU ION
[ ] FRAMING / STRAPPING [ INAL
[ ] FIREPLACE & CHIMNEY [ ] FIRE SAFETY INSPECTION
[ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRATION
REMARKS:
DATE U INSPECTOR
OF SOpTyOlo
TOWN OF SOUTHOLD BUILDING DEPT.
765-1802
INSPECTION
[ ] FOUNDATION 1ST [ ] ROUGH PL13G.
[ ] FOUNDATION 2ND [ ] INSULATION
[ ] FRAMING / STRAPPING [ f FINAL
[ ] FIREPLACE A CHIMNEY [ ] FIRE SAFETY INSPECTION
[ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRATION
REMARKS:
P
o
J
DATE ��/�' ��' INSPECTOR �,
OF SOpT�olo
4;v
TOWN OF-SOUTHOLD BUILDING DEPT.
765-1802
INSPECTION .
[ ] FOUNDATION 1ST [ ] ROUGH PLBG.
[ ] FOUNDATION 2ND [ ] INSULATION
[ ] FRAMING/STRAPPING [ ] FINAL
[ ] FIREPLACE A CHIMNEY [ ] FIRE SAFETY INSPECTION
[ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRATION
[ ] ELECTRICAL (ROUGH) ] ELECTRICAL (FINAL)
REMARKS:
OK
DATE �� INSPECTOR j
FIELD INSPECTION REPORT DATE COMMENTS
FOUNDATION(1ST) CKN
y
------------------------------------
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FOUNDATION (2ND)
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ROUGH FRAMING&
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PLUMBING
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INSULATION PER N.Y.
STATE ENERGY CODE
02
FINAL.
CA ✓ -
ADDITIONAL COMMENTS
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BUILDING DEPARTMENT Do you have or need the following, before applying'?
TOWN HALL Board of Health
SOUTHOLD, NY W;,971 4 sets of Building Plans
TEL: (631) 765-1802 Planning Board approval
FAX: (631) 765-9502 Survey
www. northfork.net/Southold/ PERMIT NO. Check _
Septic Form
N.Y,S.D.E.C. _
Trustees
Examined /) ,20 Contac • n n
Approved t/ ,20 ! (mil o;Jul i�rYl ���1 Ybc�1.5
Disapproved a/c
Phone:
Expiration 20 47—
Building Inspector
APPLICATION FOR BUILDING PERMIT
- Date mQ r-ch a6! , 20 07
i . 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
0
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.
/L'TC�CP�
(Signature of applicant or name, if a corporation)
2-150 ,
(Mailing address of applicant)
State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder
Name of owner of premises Gaf Ole- e�
(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. Z41 X k4
Plumbers License No.
Electricians License Now�4 I E
Other Trade's License No.
1. Location of land on which proposed work will be done:
A 0 5 0 I---I qhA A0 use- P-J- �o�{-h o t of
House Number Street Hamlet
County Tax Map No. 1000, Section �J,�., .. „Block 04 Lot �
Subdivision ' 1�eS�� zd ,fl , Filed Map No. - 15-;'- Lot
(Name) J.
2. State existing use and occupancy of premises and 'ntended use and occupancy of proposed construction:
a. Existing use and occupancy Stn6l e ;1 e- 1 de."u-
b. Intended use and occupancy vI l� n'►%� ��s►d�rece
�� o ® fd D S-ed -- o
3. Nature of work (check which applicable): New Building Addition Alteration
Repair Removal Demolition Other Work
(Description)
4. Estimated Cost 1Jr, goo- 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 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 premisesgeo ,, ' e4,�Address A46o LigM ouse Phone No.
Name of Architect L-e- 7J oh r',sgn Address 115 U Phone No
Name of Contractor�n&ij ( Coded— Address -7t 9-+e ZSV Phone No.
G�
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.
STATE OF NEW YORK)
SS:
COUNTY OFF
�MIJLJ7 Od66Le-Y" being duly sworn, deposes and says that(s)he is the applicant
(Naive of individual signing contract) above named,
(S)He is the Lo 4-�O-C4-D✓
(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 before me this
day � 20
IDA
&�
N ary Public Signature of Applicant
KATH t9f QUIOIL��(
NOTARY PUBLIC;SffFlo1N`YQf�€.
No.siOfpp�i'6A 41�d
Qualifigd kruUffOk Cow:
Comm;ssi0rr Expires A0A1 g5,'20,O
TOWN OF, SOUTHOLD PROPERTY RECORD CARD
OWNER STREET 2 VILLAGE DIST. SUB. LOT
FOf�MLR OWNER N E ACR.
S W TYPE OF BUILDING
RES: ,r SEAS. VL. FARM COMM. CB. MICS. Mkt. Value
2- 6
LAND . . ,.. . . . .IMP... .. .. .. _..TOTAL DATE REMARKS-...
p
r
.. �b —
..,
bad 'a liet►'Pn z-79,000. .
AGE BUILDING CONDITION
NEW NORMAL BELOW ABOVE
FARM Acre Value Per Value
Acre
Tillable FRONTAGE ON WATER
Woodland FRONTAGE ON ROAD
Meadowland DEPTH
House Plot BULKHEAD
Total __ .� DOCK
.,\�`fit•
NONE ME ■■■
�=.. _.._ _ NOON■■■®■■■■■■■■■■■■■■■■
■■■■■■■■■■■■■■■■■■NON■ ■■NONE
ONE
■■■■■■ERREW ■■ ■■NON■E■■■■■ON
ME IM
ONE
��■■■■■■■■■■■■■■■■NONE EENO
■■■■■■■O■■■■■■■■■■■N■■■■■■■E
- s
Foundation p
Basement
creation Room Rooms 2nd Floor_
Dormer
o
asOLL d
.
.� to
Town Hall Annex 1 Telephone(631)765-1802
W75 Main Road (63 )76�hQ0d.m� WOP.O.Box 1179 ger.rchert nsUgg022ny.us
Southold,NY 11971-0959
eoulm
BUILDING DE'PARThf 1qT
TOWN OF SOI MOLD
APPLICATION FOR ELECTRICAL INSPECTION
` REQUESTED BY: w T1EN/ Date:
Company Name:
Name: : (? -TLe_V)A� I f P A4 f i, �
-License No.:
Address:
Phone No.: Ge j( b� L
JOBSITE INFORMATION: (*In6cates required information)
*Name: 02
*Address:
*Cross Street: N D�\ LLB vi NTH DNS 04WEI
*Phone No-: LoCA�
Permit No.: a T(o $'
Tax-Map District: - 1000 Section:. 51c) . Block: 4 Lot: (gyp
*BRIEF DESCRIPTION OF WORK(Please Print Clearly)
I lease Circle All That Apply)
*Is job ready for inspection: ES NO Rough In Final
*Do-you need a Temp Certificate: YES/ NO
Ternp Information(If-needed)
*Service Size: 1 Phase .313hase 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 Inspection Form
SO(/T�,O
Town Hall Annex l Telephone(631)765-1802
54375 Main Road Fax(631)765-9502
P.O. Box 1179
Southold,New York 11971-0959
BUILDING DEPARTMENT
TOWN OF SOUTHOLD
September 17,2008
Swim King Pools
471 Rte 25A
Rocky Point N.Y. 11778
Re: Tietjen 2450 Lighthouse Rd, Southold
To Whom It May Concern:
We are unable to complete your Certificate of Occupancy because of the following
reasons:
An application for Certificate of Occupancy is not on file. (Enclosed)
No Electrical Certificate on file.
The Check is not on file -$25.00
No Health Department Approval on file.
No final inspection has been made.
No Plumber Solder Certificate on file. (All permits involving plumbing being
issued after April 1, 1984)
Certificate of Compliance from Southold Town Trustees.
Approval of the Zoning Board of Appeals*
Final Planning Board Approval.
B.P.# 32868 Inground Swimming Pool
SOUTyolo
Town Hall Annex Telephone(631)765-1802
54375 Main Road Fax(631)765-9502
P.O.Box 1179
Southold,NY 1 1 97 1-0959
COU
BUILDING DEPARTMENT
TOWN OF SOUTHOLD
November 23, 2011
George n. Tietjen
151 Beverly Ave
Floral Park, NY 11001
Re: 2450 Lighthouse Rd., Southold
TO WHOM IT MAY CONCERN:
The Following Item(s)Are Needed To Complete Your Certificate of Occupancy:
Application for Certificate of Occupancy. (Enclosed)
ZlElectrical Underwriters Certificate.
v A fee of$25.00.
Final Health Department Approval.
Plumbers Solder Certificate. (All permits involving plumbing after 4/1/84)
Trustees Certificate of Compliance. (Town Trustees#765-1892)
Final Planning Board Approval.
Final Fire Inspection from Fire Marshall. — Bob Fisher
Final Landmark Preservation approval.
BUILDING PERMIT: 32868 — In Ground Swimming Pool
*pF SO!/ryo
Town Hall Annex ~� l� Telephone(631)765-1802
54375 Main Road Fax(631)765-9502
P.O.Box 1179
Southold,NY 11971-0959 �l • �O
BUILDING DEPARTMENT
TOWN OF SOUTHOLD
May 7, 2012
George N. Teitjen
151 Beverly Ave
Floral Park, NY 11001
Re: 2450 Lighthouse Rd., Southold
TO WHOM IT MAY CONCERN:
The Following Items Are Needed To Complete Your Certificate of Occupancy:
Application for Certificate of Occupancy. n pp p y. (Enclosed)
/
Electrical Underwriters Certificate. (contact your electrician)'`"
✓A fee of$25.00.
Final Health Department Approval.
Plumbers Solder Certificate. (All permits involving plumbing after 4w84)
Trustees Certificate of Compliance. (Town Trustees#765-1892)
Final Planning Board Approval. (Planning#765-1938)
Final Fire Inspection from Fire Marshall.
Final Landmark Preservation approval:
BUILDING PERMIT : 32868 — In Ground Swimming Pool
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SURVEY OF .PROPERTY
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PRE CAST. SKIMMERS
NOTED
r
COPING t o" a� to i� IPRq
ED A . NOTED
RETURNS
DATE: B.P.,I�ag
L - FEE: B -
''�' y• C� F'Y- I' DING G ,�RTMENT AT
i �
CGO 3735-%02�8AM TO 4PM FOR THE TO FILTER s
I Or', SLDPE O'
B 1 SLOPE Q'� ��\� FOLLOWING INSPECTIONS' FROM SKIMMERS
. �/ 5 g F0..FFM'JITITA` ON - TWO REQUIRED FILTERond PUMP
FOR POURED CONCRETE
E
�vr.CRET�
_�' 2. ROUGH - FR�^.ti;l�!'� & PLUMBING FROM FILTER
h =0 3. INSULATION TO RETURNS
a - 4. FINAL - CON�TRUCTICN MUST TO WASTE
In— Q BE COMPLETE FOR C.O.
ROLLED FOAM 0 .
-�-*' B ETWEEN�LINER: ' ALL CONSTRUCTION' SHALL E� I N G A R RA N G E M EN T.
>< co NCRTE REQUIREMENTS OF THE
VINYL LINER Q YORK STATE. NOT RESPONSIBLE FOR
SIDE o R. END �NpERWRITERS CERTIFICATE a s P @�IraN OR CONSTRUCTION ERR BRS� e'
STEPS OPTIONAL I BLOCK
PiEc.
/eLoc1 PiCRS
IRED t-.�-�: POURED CONCRETE rl � IZ,
P L A N REDU__ _
VINYL L HER ' =� O..R
_
OCCUPANCY
•y- _;� ~�•.% a,�-e�� i' I R�d'�f } L� FIBERGLASS
SEE TYPICAL �/� y�,`v SE IS UlN.mi�$dt11 U Q MOULDED
WALL SECTION 1 PIECE
�- .� , 2_ 4• SAND:= `WITHOUT CE TIFIC' T�
SECTION
0 OCCUPANCY
- - FORM T11: 8'-
2�- 4 SAND BOTTOM Q ZA
-
24 MAX
- - - - - /8 BARS OPTIONAL STEP
... ;o —_— _— — — — s ,• CONSTRUCTION SHALL
-SECTION B- B p : `� ALL CO TYPE 1
MEET THE REQUIREMENT '' ' 8SE�f
GRADE CODES OF NEW YORK STATE. coEi+�` FOpTP GRT IN
- ' 3 STEPS
O s=0' G P LAN • - '
• Ic- - ,
CONc BLOCK O
PIERS. IA '
TY. IP C A L. WA L L ---T- - -
i _ - i 12� I
t2 � I4-0"
SECTION- A- A _ OPTIONAL STEP
IyEI„ y TYPE 2.
SIZE A 8 C D E . 1 F G AREA CAP
FEET FT. FT FT- FT. FT. FT FT 30-FT_ C AL_ :/�4� 1 ` y��-\=�= '
o' .l CONTRACTOR
r NOTES-._.
Ig` 3`` (�' �J' [I I (rL LE lvfrp (4�aCi 3 = 1 '.`l WALKS TO Br SMOOTH - NON SKID TYPE, SLOPED
PROPOSED POOL FOR: I
_ AWAY FROM POOL RANDY T. RODECKER, INC.
i' � ' i
WATER DISPOSAL SHALL BE LIMITED TO OWNERS I
16'z 327 t6 32 8 I e I I2 4 4 15t2 18,500 �y��.1. SWIM KING POOLS
` 1-° ? PROPERTY TO SUIT LOCAL REGULATIONS
,J�'����°
16' z'36' ` t6 136 I 12. �. 8 I 12 I 4 I q 1376 20 ROUTE 2SA
20'i 40 20 140 1 12 I I
10 1778I ,OOo C , I