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HomeMy WebLinkAbout37479-Z S�pF�t�'C Town of Southold Annex 7/12/2013 P.O.Box 1179 cm� 54375 Main Road o Southold,New York 11971 CERTIFICATE OF OCCUPANCY No: 36394 Date: 7/12/2013 THIS CERTIFIES that the building IN GROUND POOL Location of Property: 570 Critten Ln, Southold, SCTM#: 473889 Sec/Block/Lot: 70.-12-13 Subdivision: Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this officed dated 8/16/2012 pursuant to which Building Permit No. 37479 dated 8/28/2012 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: IN-GROUND SWIMMING POOL, FENCED TO CODE AS APPLIED FOR The certificate is issued to Leiblein,Gary&Leiblein,Lorraine Beck (OWNER) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL ELECTRICAL CERTIFICATE NO. 37479 05-08-2013 PLUMBERS CERTIFICATION DATED Au th Sign re TOWN OF SOUTHOLD BUILDING DEPARTMENT 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#: 37479 Date: 8/28/2012 Permission is hereby granted to: Leiblein, Gary & Leiblein, Lorraine Beck 570 Crittens Ln Southold, NY 11971 To: construct an In-Ground Swimming Pool, fenced to code At premises located at: 570 Critten Ln, Southold SCTM # 473889 Sec/Block/Lot# 70.-12-13 Pursuant to application dated 8/16/2012 and approved by the Building Inspector. To expire on 2/27/2014. Fees: SWIMMING POOLS -IN-GROUND WITH FENCE ENCLOSURE $250.00 CO - SWIMMING POOL $50.00 Total: $300.00 Building Inspector r Form No.6 TOWN OF SOUTHOLD. BUILDING DEPARTMENT n 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 IWlead. . 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.andunusual 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$5000,:-Businesses$50.00. 2_ Certificate of Occupancy on Pre-existing Building- $100.00 3. Copy of Certificate of Occupancy-$;25' 44. Updated Certificate of Occupancy- $50.00 5. Temporary Certificate of Occupancy-Residential $15.00, Commercial$15.00 I Date. New Construction: Old -or Pre existing Building: ' (check one) Location of Property: '670 6ei-iews LJ .� House No. Street Hamlet Owner or Owners of Property: 1 e .?���l .4161fin Suffolk County.Tax Map No 1000, Section Block IZ Lot Subdivision Filed Map. Lot: Permif No. J�L� Date of Permit.c6'Z9^12_ Applicant: Health Dept. Approval: Underwriters Approval: Planning Board Approval: equest for: Temporary Certificate Final Certificate: (check one) Pee Submitted: $ Applica ignature g�1FFQ(,� Town Hall Annex p� CQ�� Telephone(631) 765-1802 54375 Main Road o Fax (631) 765-9502 P.O. Box 1179 • Southold, NY 11971-0959 �'4j®� �.D4� roper.richertCa)town.southold.ny.us BUILDING DEPARTMENT TOWN OF SOUTHOLD CERTIFICATE OF ELECTRICIAL COMPLIANCE SITE LOCATION Issued To: Leiblein Address: 570 Critten Ln City: Southold St: NY Zip: 11971 Building Permit#: 37479 Section: 70 Block: 12 Lot: 13 WAS EXAMINED AND FOUND TO BE IN COMPLIANCE WITH THE NATIONAL ELECTRIC CODE Contractor: DBA: Laurel Lighting Inc License No:. 4718-me 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 1 Ceiling 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 Transformer Appliances Dryer Recpt Emergency Fixtures Time Clocks Disconnect Switches 1 Twist Lock 2 Exit Fixtures TVSS Other Equipment: in ground swimming poolto include, bonding, 1-control panel, 2-GFCI circuit break Notes: Inspector Signature: w-� Date: May 8 2013 E lectrical_Certificate.xls Of SO(/1,�,010 - - --- col • �Q TOWN OF SOUTHOLD BUILDING DEPT.- 765-1802 INSPECTION [ : FOUNDATION 1 ST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] INSULATION [ ] FRAMING/STRAPPING [ ] FINAL [ ] FIREPLACE & CHIMNEY [ ] FIRE SAFETY INSPECTION [ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRATION [ ] ELECTRICAL (ROUGH) [ ] ELECT (FINAL) REMARKS: DATE INSPECTOR -� Of SO(/r�o� cOUNi`I,N TOWN OF SOUTHOLD BUILDING DEPT. 765-1802 INSPECTION [ ] FOUNDATION 1 ST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] INSULATION. [ ] FRAMING/STRAPPING [X FI NAL. [ ] FIREPLACE & CHIMNEY [ ] FIRE SAFETY INSPECTION [ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRATION [ .] ELECTRICAL-(ROUGH) [ ] ELECTRICAL (FINAL) REMARKS: RIOT --L6- /V y DATE / INSPECTOR oF soulyo�o �o • Q Comm, TOWN OF SOUTHOLD BUILDING DEPT. 765-1802 INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLB [ ] FOUNDATION 2ND [ ] INS TION [ ] FRAMING /STRAPPING [ FINAL [ ] FIREPLACE & CHIMNEY [ ] FIRE SAFETY INSPECTION [ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRATION [ ] ELECTRICAL (ROUGH) [ ] ELECTRICAL (FINAL) REMARKS: d DATE 7//7 "4 INSPECTOR i FIELD IN6Z5�LON REPORT DATE NTS FOUNDATION(IST) -� --- -----• -----.....--.... U FOUNDATION(2ND) O CA cl ROUGH FRAMING& y PLUMBING 57 Cr! INSUL•ATION PER N.Y. STATE ENERGY COVE d d FINAL s 7 W ADDITIONAL COMMENTS ��' �i r �-G�� -�� .� � cam► Z '_ tz 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 3 sets of Building Plans TEL: 765-1802 Survey PERMIT NO. 3 Check C f� j W Septic Form LS lei E U N.Y.S.D.E.C. • Trustees Examined 20 AUG 1 6 Contact: Approved" _- !2ola- 2012 Mail to: Disapproved a/c BLDG.DEPT. TOWN OF SOUTHOLD Phone: Building Inspector APPLICATION FOR BUILDING PERMIT Date_ �O�J �a , 20 INSTRUCTIONS a. This application MUST be completely filled in by typewriter or in ink and submitted to the Building Inspector with 3 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 toahe applicant. Such a permit shall be kept orithe premises available for inspection throughout the work: . e;No:lulding shall be occupied or used.in whole or in part for any purpose what-so-ever:until a Certificate of Occupancy is issued bythe:Building Inspector. APPLICATION IS HEREBY MADE to the Building Department for the issuance of a Buildmg;:P.ermit pursuant to the Building Zone Drdinance 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 de described. The applicant agrees to comply uvith all applicable laws, ordinances;;building code;housing code; and r ations;.and to admit authorized inspectors on premises and in building for necessary;inspections. � � q= USE r� u Q (Signature..of applrcant or n if a corporation) sell 0 )OC 10 POW BEF0i3 � t '� ae r _ I=v �T _ pp (Nlailmg addresS.,of applicant) State whether applieant is owner;lessee, agent, arclutect,f engineer; general contractor; electrician plumber or builder APPROVED AS NOTED VAT`E Name ofowner of premises � Q(��10� l bIIP1A7 (as on the tax roll or lat fdeed�E y N�FY BUILDLNG :D -`�' ERARTMENT AT T£.applicant is a corporation, signature of duly authorized officer �65 1802 8 AM TO 4 PM FOR THE FOLLOWING INSPECTIONS: airie and title of corporate officer 1 FOUNDATION-:TWWO REQUIRED FOR POURED:CONCRETE .2. ROUGH-FRAMING,PLUMEING, Boulders License No: STRAPPING, ELECTRICAL&CAULKING 3. INSULATION ' t Plumbers License No. 4. FINAL..CONSTRUCTION.6 ELECTRICAL MUST BE COMPLETE FOR co Electricians-License No. ALL CONSTRUCTION'S. MEET:THE . REQUIREMENTS OF THE COdES OF NEW Other Trade's License No. PORK STATE. NOT RESPONSIBLE FOR' � - � DESIGN OR CONSTRUCTtON;ERROR$. IN T1 �. � I € 1 Location ofland on which pro osworwill beone: ��Il� aC1�t�+S � �9rrt.�:�'•� .� "��#��9"� �r�4 House Number Street6.'vuHainlets� 1)i County Tax 1ylap No. 1000 Section ''0 Block « Subdivision. FiledrlVlapNo. ��Tnin► eTrAt� rn rr�. iinin�NONF 111V1 (Name) PURSUANT'TO C1-IAPTER.:236 OF THE TOWN 2. State existing use and occupancy of premises and intended u e 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 Alter tion Repair Removal Demolition Other Work i,11t In A1Q Description) 4. Estimated Cost ����J -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 �S Height Number of Stories 111z Dimensions of same structure with alterations or additions: Front Rear. Depth Height Number of Stories 8. Dimensions of entire.new construction: Front I b' Rear 32 t Depth TIL 8° Height Number of Stories 9. Size of lot: Front Rear 0 Depth 351 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: 13.Will lot be re-graded .P& MA QQ ky Will excess fill be removed from premises: YES NO. 14.Names of Owner of premises Le,e'k 11 Address Sr WA AAft5 LIU Phone No. `7V-91790 Name of Architect Address &t4 ne No `72W-78M Name of Contractor Address qM ft--27A Phone No. 31-7,ff-71a— yVl 1124 15. Is this property within 100 feet of a tidal wetland? *YES NO • IF YES, SOUTHOLD TOWN TRUSTEES PERMITS MAY BE RE UIRED. 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) LL- SS:•, COUNTY OF6)PF&rt dJ S being duly sworn, deposes and says that(s)he is the applicant (Naive of ihdiviclual,signing:contract) above named, (S)He is the acto i=.��. rr,Agent, Corporate Officer, etc.) "i:,, l fit _, Ys of said owner or ov¢%riers, ridisi MIX4authprized to perform or have performed the said work and to make and file this application; that all sta eiiieiits coritaiiied ii' h"gppUcatibn`are true to the best of his knowledge and belied and that the work will be performed inahe.:�na ner,s,et_ Qrtli irijthe.oDf cation filed therewith. I f F4 i.J-4-1..� - ;; Sworn to befor,,me'this i 4 a J,; of Public Signature of plicant"= MARGAKE r A. KIDNEY Notary Public State of New York No.-01 K16021111 Qualified in Suffolk County. My commission Expires March S,2�1,. Town of Southold. -' Chapter 236 - Stormwater Management � -SWPP: P Storm Water. Pollution Prevention Plan Assessment Form GENERAL INFORMATION: (All Requested Information is Required for a Complete Application) APPLICANT NAME: Owner-Agent-Consultant-Contractor or Other CWeOne ! t ) Properly OWNER (If Dit. rent than Applicant) ; A Tess Sn I.IKI �enfS L lV Address: j Telephone#: /7�5 p 7.0• Fax# Telephone#: Fax i 0 i E-Mail: E-Mail: Property Address: . Brief Description of Construction Activity,Proposed Structural BMPs,Soil S.C.T.M.#; 1000 ja Stabalization BMPs,Project Scope and/or Sequence of Construction Activity 61 Section frock Lot '' 01mAle Addtional Pages as Needed) Name of Co tractor andlor Contact Pemon'Responsible for hnplementation of SWPPP; � -_ A 32 I -VA p't� f)SkS ee1' ----Sm Address; +. M t 1 17d - Telephone#:((f31 1-877® Fax# --- -- -� -- _ --- i 1 DQ�y. E-Mal: --- dVL1--- --_L_�_&L "•• �,_ ------ --- l ' Name of Persons Responsible for Installation ti M�Inlenance of Erosion Control Practice; ULU � � t ftf � -------------------------------- ----------- Address: I i I Telephone#: Fax# l F E-Mail: Total Arai atAll -----=--------------__.___.__.._______.__ ____ Total Area of land Clearing project Parcels: 5512 and/or Ground Disturbance: . Project Duration: J�� (Anticipated) 0/1��Z (timber°TUB) _--------------- , --._.--..-------•--_------"-_------.-- --------- 1 Will this Ptoject:Disturbe five(5)or More Acres at •. Any OneTirle`During the Proposed Development? Yes o --------------------------•__••-__--__ If YES;PIeaseAnswer the Followingl _,__ ------------ I a Does the Applicant have a Qualified Inspector On Staff To Conduct the f3equired Inspections? Yes No b Does the';SWPPP'Indicate How Frequently-the Site List the NAMES or description of all Potentially Impacted Waterbodles and/or Wetlands: Inspections:Will Occur and for What Period of Time? Yes No c. Does-the SWPPP-Adequately Identify All Temporary ----------- ----- ------ --------------=-- andlorPerminent Soil Stabalization Measures? Yes No ----'•----------------------------- d- Does theSWPPP Adequately Identify a Complete I Project Phasing Plan? Yes No ! ei Does the SVIIPPP Indicate Additional Site Specific Status of Impacted eg Waterbody:( : Impaired TMDL 303(d)Listed, .._) ��. i Practices that.Will be:Utiltzed to Protect Water Quality? 'Yes No f Has the Appbcant Submitted a Completed DEC Notice LTypeofOf intent and:SWP PP Acceptance Form for Review O pacted Waterbody:(eg.Lake,Creek,Bay,Pond,found;Freshwater Wetland_by the Townof.Soutfiold? Yes No ------------_---- S'1 ATF OF NFWYORK, COUNTY OF......... Lie&else That r•••••••••••••• :.being duly swom,deposes and says that he/she is the applicantfor Perini[, (Name of indivIUu81 stgnfng Dowment) '' ,A,/I��--'' And that he/she is the ................................... i (Owner.Contractor,Agent,Corporate Officer etc)•............•.... i• Owner and/or representative of the Owner or Owners,and is duly authorized fo perfoim or have performed thesaid work and to I make and file;thts 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 herewith.I Sworn:to before}ne this; IS -• day of....._A. .._... 2012 Notary..Public: .......:........... ... ( .. >k '._.._.... ......... ........i .. ................ re of Applicant) iW_PPP Assessment FORM: 03-12 Nclfary:Aubfrc=State 6f,New York 1V0:-0I.K1602 f 1 i'1 Oualified in Suffolk'County. My Commission Expires March 8,20il °80F " T.O�S. "5Wl'PP" Preparation - Chapter 236 FcrDepartrhentuseoniy: storm Water PolFwfior `Prev s.c.T.lw,#' Propert Address: ention Plans C2t�te °� X Review Checklisthecicist # 70 ,000 �z 13 ._,._; ,...,:.:. . .. :•:` rct Sa ctlon black Lot D REQUIRED isLAN INFORMgT10N AND IMPLEMENTATION DETAILS: , Does the S,WPPP Adequately Provide for and/or Indicate ttie.Following:) I YES, NO ,N.A.;EXplanation for NCO or =Plaer BMPs Desi ned to conta n a Two InchRainfall On-Site. r ----- 2. Construction Phasin :Plan Indicatin Se uence of Pro osed Construction Activities. (�i i ;"`-- 3. _----____-, � t i-- -- - --- ------------ 4, Dralange Stte Plan Drawn to Scale at S 60' feet to the Inch or lar er indicating the Following__,[�,�, , ``- --- __--------__g _. _..a. caUon attd Descri Uon of P Boundarles - , r- ------- - - SlteAcrea e ___.__....___.._._-_._.___.__..._..-_. r� _ ..._ _ c_ _All Existing,Natural and/or Man Made Features on and within 5_0'of the Property Boundary; ©� __ -------------- d. est Hole Data Indlcatine_So- Characteristics&De th to Seasonal HI h Water Table: a _.. . e. Contcurs Ind!catn ETp erty.Elevations Min.2'; f. Spot Grade&.Finish Floor Elevations for Existing and Proposed gtructures;- `"-___..____ ^ i _____--_--__--_---- ---_--`- ._._..._._____ _ JQI®t� -------- g. LoCatTono °G17oodeditreas&Isolated�reeswithaMfnimui D-ffr sionoff8"Diameter; 1010, L---`-------------------________ h. doll ions---- nl�Ts�rTctSo'tfSurvey:-'-- ------------------ --------- _ , , ,--------------------=------- 5. --------- --- ----- -...--t , , ,----------------------------- --- --____._._......_........._....... ... Background Information about the Scope of the Protect,Locatbn&Description of the Site-, Proposed Changes to the Site and AIL Exlstrtq Develojgn nt on the site InDludin the Following.-J�f Q i i-� 1 c 911.1tnArstvsmQatslrtal�siin9_T9La.Ll�aG�LlanddP� i4WIPIQ 9�ai�lt�Ar� L____._...----a�,C7�C7�-- ----- -`-�r►ln�rhln/�-- _._......_ - y---------- b. All EiccavaUon;Pilling.Stripping&Grading Proposed and Identified'as to depth;.Volume � r , r -----------•__----_.__.__. _ _&_Nature of Materials Involved• ___-•__ _ _ __ - i 0 i�� � c. All Areas Re uirin Clearin -and/or Grubb!" ____ - - -------- --- - q-- g--- -g ---- .gam r--------------------=-------------__.-__.__.. d. All Areas.WltereTopsollisto'be Removed,Stockpiled and where Topsoilwil-ultimately ' - '®�-`--"-'-'---------------- beplacedl__ -- ----------------- ------- ___ e All Temporary&Pel•msnent Ve etaton to be Placed on Site; f M1, li TeineoratY&Permanent Storm Water RunoffBMP Control Measures Pro osetl; y•�, ' ''------------------ - - - - -------- g ------- ---- -p --I TheAritclpatedPattemofSulfaceDralnageDuringPeriodsofPeakRunoff; r----------------------------.________.___._ h The LopUon of all Roads Dnveways Sidewalks Patios,Structures,Utilities&Ottier - i i i i----------- Improvements,(ncluaGg Temporary Access tfiePstTng�PInaUZ`onfoursanaorSpoevatonsoftfiesite-------"--"-"'-- ___-- 6. A Schedule of the"Sequence for th e Installation of All'Planned Soli 8. ADes� aterRunoffControiMeasures I�r�,�, --`-""'--�'-_---•__.__.___ _. _. _..- - 7. Description of Pdhuton Prevention Measures that well 6e Imptem_ented. I -- --------_ __ ....--..._.:_- - ------------- - + I I ption of the Minlmtim Erosion&Sediment Control Practices to be Installed and/or I , , -------- ---- ach --------------- -_ --- Implemented for E Constructior Activity fhat will result in S_oll Disturbance. _ _ _ 0;0;u _9._Description of Construction&Waste materials Expected to be Stored On-Site. -- -- Y '�' r----- _ -------------------------------- emporary&PermanentSgil StabllrzaUon Plan that meets the Version of the } , , , ------------.----_ New York State Storm Water Design Manual.Technical Standar_d._ _ __ 11._General Slte Plan and Cons,ructon Drawin�sforthe Protect - - - ----_ --�- ------------ 12 _D,menslonsiMater181 SeeClfIcafrons&tnstallatton Details for Al Eroslor&Sediment Control Practices. , , . . , ` 13 T,emgoraryPracttG-ethatHriltbeConvertedtoPQrmanentcontroiMeasuros.------------- -- ---^--_-_--_- -_------ r , r---------...--------- ---- 14 Implementation Schedule forSta in --------- -� : - _ _ ______ _-_--_- - g g Temporary Erosion Control Practice 6ri BMP. , tom,L J' -------- _+ I I >___-- 15 Malnterance Schedule to Ensure Continuous&Effective Operation of Erosion& ,0�0, - ----- ---____- Sedlment Control QwacUtes` , , , ------------ ----- _ _ ---- .- __------j � ' amesvof P,otental Su[face Waters of the State of New York a /or MS4 that may be , -------------------------- ----- 17 p eactedib�Devefoemeni ,OIO,� __-- ---- ----- rid _ __ elineaton of Storm'Watt3r'Control Plan Implementation Res�onsibilitles for Each art- the --i i i i------------'--------'------------------ rojectCQnstrueUtnSite ------e- ---------P--- - ------ '-' ----- - --------------------- ------- i8, All other Fadstne Data that Describes Storm Water Runoff and/or Natural Drainage Swales. '�'�'[�'- - -------- 19. IdentificaUonofAll'Contractor(s)/Sub-Contractors) Responsible.foTlnstalling,Const,ucting, -- - -------------------------_-_-_ Repalrin ,Re laein ,Inspecting and'Maintaining the Erosion&Sediment Control Practices, - Storm Water"Management Control Plan Checklist#1 : 03-1.2 denke a Town Hall Annex Telephone(631)765 1802 54375 Main Road �r�x 6�7 -1 P.Q.Box 1179 roger.ddhertji own.southold nV us Southold,NY 11971-0959 BUILDING DEFARTUW TOWN OF SOUTHOLD. APPLICATION FOR ELECTRICAL INSPECTION REQUESTED BY: i0 Date: jG Company Name: r 'Name: . License No.: 9— Address: 7 10f4f�, Phone No.: JOBSITE INFORMATION: (*Indicates.required information) *Name: *Address: ? f *Cross Street: ��j ��� *Phone No.: 5 70 Permit No.: .� 7c{7 Tax-Map District: 000 Section. _ Block: _ Lot: *BRIEF DESCRIPTION OF WORK (Please Print Clearly) (Please Circle All That Apply) *1s 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 Inspection Form 1 y �k (�V Town Hall Annex Telephone(631)765-1802 54375 Main Road wn ` y a (631)76 5Q P.O..Box 1179 G' roger richertdfra n sou�tf9io��tl.ny us Southold,NY 11971-0959 a BUILDING DEPARTMENT TOWN OF SOUTOLD APPLICATION FOR ELECTRICAL INSPECTION REQUESTED BY: Date: Company Name: . C1'YC IC Name: t✓� �►�F License No.: Address: )Z� PUCAS6 AD 4tr s P Phone:;No.: 1�3►- 5�y-Dy00 JOBS;ITE::INFORMATION: (*Indicates. required m'forrnatian) me:' Address: 270 Ciet4e m 'bi �4�► r,x� *CrossStreet: Phone No.: 7.(o5 Wl)0 ' Permit Jo:: -7 q-7 q Tax Map District: 1000 Section:_�ZO Bloch: 1 Lot: *BRIEF DESCRIPTION OF WORK(Please Print Clearly) awl - pjj ffio l��lny,c, �rnmiNg � (#lease QirEle All-That Apply) �`Is fob ready#or inspection: YES / NO Rough In Final *Do you need a Temp Certificate: YES / NO Ter>�p information (If needed} *Service Slze: 1 Phase 3Phase 100 150 200 3U0 350 400 Other *New Service: Re-connect Underground Nurn6 o€Melers Change of'Servlce ::.Overhead Addlflonal Information: PAYMENT QUE WITH APPL1CgTI,ON. K: 82 Request for Inspection Form S.C.T.M. NO. DISTRICT. 1000 SECTION: 70 BLOCK: 12 LOT(S): 13 FE. OA. 1 D b! \ �m �. FD ti • M r z r . . Q FE. /0.01 o� �V x I, _\ LOT 24 4 p -! LOT 23 STOCKADE 0� - FENCE W/ X— �� �Q P`6.,., 1 4P.CAS 16'E 0 le.o' 20.2 O 0.P�x FO. FE:0.6'E EM. TINO•N C`1 % o /. 41 4E !1' assEn LOT 25 v, NON :M FO CV ntt/7 kpi o `�il y I Z Man L� 0FD �4 u CRITTEN CORRECT LOT AREA .07-.16-12 ..ADD -PROPOSED ADDITION 03-17-08 UPDATE SURVEY . 1.1 —19-07 AREA: 34,986.20 SQ.FT. or 0.80 ACRES ELEVATION DATUM: UNAUTHORIZED ALTERATION OR ADDITION.TO THIS SURVEY IS A VIOLATION OF SECTION 7209 OF Tk1E �lEWDRK STATE EDUCATION LAW. COPIES OF THIS SURVEY MAP NOT BEARING THE LAND SURVEYOR'S EMBOSSED SEAL SMALL NOT 8E CONSIDERED r0 BE A u�l" s'q�17L7E COPY. GUARANTEES-INDICATED HEREON SHALL RUN ONLY TO THE PERSON FOR WHOM THE SUR:.VEY /S FREPAREb AN6 xbN HIS BEHALF TO::THE TITLEX'e � �'��frbGERNMENTAL AGENCY AND LENDING INSATUTION LISTED HEREON, AND TO THE ASSIGNEES OF THE LENDING°,INSTCTUTION, G(JARANTEES ARE NOT; TRI � B� THE OFFSETS OR DIMENSIONS. SHOWN HEREON FROM THE�'PRbPERTY LINES TO FHE STRIJGTUR , A E?FOI Jf SPECIFIC PURPOSE AND USE THEREFORE THEY ARE NOT INTENDED TO MONUMENT THE PROPERTY LINES 0'R TQS,GU%bE 'THE ERECTION OF FENCES ADD1Tl �A`L 451'RUGrURES OR AND.OTHER IMPROVEMENTS. EASEMENTS AND/OR SUBSURFACE STRUffURES RECORDED OR UNRECORDED }A{'l E Nbt GUARANTEED:UNLESS"'PH 1, °LILY EVIDENT ON THE PREMISES AT THE TIME OF SURVEY SURVEY OF: LOT 24 j GARY LEIBLEIN; LORI LEIBLEIN,; I fIFIEO TO: MAP OF: SOUTHWOOD n=: xi1DI. LAND ABSTRACT; TITLE MID-07=888S FILED: NOVEMBER 24, 1953 AS #2141 ,.:. ..:.: SITUATED AT: SOUTHOLD TOWN OF: SOUTHOLD L J KENNETH M. WOYCHUK L.S. SUFFOLK COUNTY, NEW YORK Lihd Surveying and Deaign tos .3, Mattituck, New York 11952 FILE 26-1 19 SCALE: 1„=40� DATE: MAY 26 f2`007 PAbNB`..(831) 288-1588 FAX 83 - F Y. S. LIC N0. 50227 w r} ( 1� 298 15 88 w F mil talning the records of Robert J. Hennessy S.C.T.M. NO. DISTRICT: 1000 SECTION: 70 BLOCK: 12 LOT(S): 13 o.L. • O U F< 0.4W ro 0.]W Z Q ro. 0.9W o T pl x tl 2I ' LOT 24 LOT 23 O 0�0� /Q' FENNCCE�. x— Vl� LRGAS PIC l` set Cf-' O L . ,e.o' 20.2' O PIPE ro A: F1600r C FE 1 to c ,,• c R LOT 25 MON FO • ti � �� 3D,�r�� •. �'' xn17 z bl • FDN4 rny6 tea. CRIT EN CORRECT LOT AREA .07-.16-12 ADD` PROPOSED ADDITION 03-17-08 UPDATE SURVEY . 1.1 -19-07 AREA: 34,986.20 SQ.FT. or 0.80 ACRES w. ELEVATION DATUM: ___________________ UNAUTHORIZED ALTERATION OR ADDITION TO THIS SURVEY/S A VIOLATION OF SECTION 7200 OF'T L t.W bPK STATE EDUCATION LAW. COPIES OF THIS SURVEY MAP NOT.BEARING THE LAND SURVEYOR'S EMBOSSED SEAL Sill, NOT DE CONSIDERED: TO BE.,A V J)7 TRUE•&OPY. GUARANTEES INDICATED HEREON SHALL RUN ONLY TO THE PERSON FOR WHOM THE SURVEY /S PREPARED AND TON HIS BEHALF TO THE T1T, E LQ Ar+ [bVERNMENTAL AGENCY AND LENDING INSTITUTION :LISTED:HEREON,AND TO THE ASSIGNEES Of THE L XD/NG INSTITUTION, GUARANTEES ARE NOT tR r INS BL THE OFFSETS OR DIMENSIONS. SHOWN HEREON FROM;-, THE PROP' -Y LINES TO THE STRUCTURES AREi fll'PR SPECIFIC PURPOSE AND USE THEREFORE THEY ARE NOT INTENDED TO MONUMENT -THE PROPER Tj'L/NESOR TD ,GUlD� THE ERECTION OF FENCES A'DDITIO% `� ,1 UGTURES OR AND OTHER IMPROVEMENTS. EASEMENTS AND/OR SUBSURFACE STRUeTURES RECORDED OR UNRECOkDED A'f E N0 GUARANTEED UNLESS fPI�I�>�.1 ,ltY EVIDENT ON THE PREMISES AT THE TIME OF SURVEY y,,..,.... .. �� ggw­ SURVEY OF: LOT 24 " £ ( TIFIED TO: GARY LEIBLEIN; LORI LEIBLEIN; MAP OF: SOUTHWOOD x z ELAND ABSTRACT; TITLE MID-07-888S FILED: NOVEMBER 24, 1953 AS #2141 r SITUATED AT:' SOtJTHOLD 4. rowN OF: SOUl HOLD KENNETH M. 1POYCHUK L.S. a SUFFOLK COUNTY, NEW YORK ;fir Lead Surveying and Design Hos .3. Mattituck, New York 11952 FILE # 26-1 1 9 SCALE: 1„=40' DATE: MAY 26t 2`007n PHCNB:(8$1) 298-1688 FAX (8$1) $98-1588 N Y,-S:'UC N0; tamjntaIning the records of Robert J. Hennessy s:' A ' Skimmers Retume B B /Aluminum _ E F To Filter From ���JJ(Filter de Pump . To Waste.. -To Retume (Dry Well Qptinal) Rolled Wal! Faa A Plan Piping Arrangement Wall Section VW Un /4 Reber 42" Section B—B e son asoo Ps l Concrete ��✓OF NEW} r�'�o�.S Q.Raj`�+�l• H 10" Typical Wall Section � Section A—A i �� 0• 04'359�P�wa SIZE. AA C D E F G H 'AREA CAP. FEET FT. FT. FT. FT. FT. FT. FT. FT. SQ.FT. GAL. abnoe 16x32' 16' 32' 8' 14' 6' 4' 4' 8' ' 512 19,000 p rem 16'x36' 16' 36'. 12' 14' 6' 4' 4' 8' 576 21,600ol&SPA CENTRE PERMACRETE WALL SYSTEM ate 18 g36 18 36 12 14 6 4 5 8 648 24,300 929 Route 25A Miller Place NY 11764 20'Ae -20' 44' 16' 14' 6' 4' 6' 8' 800 30,000 (631) 744-7185 FAX (631) 744-0174 a� e 2A44' 24' 44' 18' 14' 8' 4' 6' 10'• 798 30,060 Suffolk License #4436-111 ' 2A48' 24' 48' 20' 16' .8' 4' 6' 10' 900 30,000 Nassau License #HI74450000