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Home My WebLink About6553-zFOH~ NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Town Clerk's Office Southold, N. Y. Certificate Of Occupancy No. ~ ~6..'J } ....... Date Oct 29 10 .~3. THIS CERTIFIES that the building located atR e(~ ~'.,..-...I{.~. ~f.a.~l~. B~ad.. Street Map No..X?4 ........ Block No...X~ ..... Lot No. xxx 0ri~nt lq,¥o conforms substantially to the Application for Building Permit heretofore fried in this office dated ........... Ap~'~l,1.. ].1., 19. ?3. pursuant to which Building Permit No. ~3.~ .. dated .......... l~I~y .... ~ ....., 19~., was issued, and conforms to all of the require- ments of the applicable provisions of the law. The occupancy for which this certificate is issued is Friv~%e s~l~u~ing Pool The certificate is issued to . . ~.~V. !':~.~.~ ...... .(~..~? .............................. (owner, lessee or tenant) of the aforesaid building. Suffolk County Department of Health Approval 1~.,.~.~ ............................... UNDERWRITERS CERTIFICATE No...~/..1.]:D.O.~6 ..... A.~g. 3.0. ~i~.~3 ............... HOUSE NUMBER ... ~].~ ..... Street Main Road, 01'tent · ............ Building Inspect~ TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PP, EMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) , N? 6553 Z Permission is hereby gmnfed to: .... ~.*..~.?..~... ......................................... ; ....... ~. .... Build new private sw~ming pool .............................. r. at I~remises located at ........ ,.~..e..O...~..~..?......?..~...~....~.../..~......~.....:~......~...O.,~..~.. ....................................................... ............................................ ,~.,e.~.~ ............ ~.:.~.: ................................................................................ pursuant to application dated ......................... ..J~.~.~.~? ..... ~.~,...~ .......... , 19,.~.3.., and approved by the L3uiJding Inspector. i Fe; $...~...~.R~ .......... Building Inspecto/ , FORM NO. 6 TOWN OF SOUTHOLD Building Department Town C~¢rks Office $ou~ho:~l, iq. ¥. 1197~ APPLiCATIGN FGR CI~RTIFICATE GF OCCUPANCY Instructions This apphcahon must be filled ~n typewriter OR ~nk, and submitted ~n DUPLICATE to the Building Inspector w~th the following; for new buildings or new use: 1 Final survey of property w~th accurate location of all buildings, property hnes, streets, ann unusual natural or topographic features 2Final approval of Health Dept of water supply and sewerage d~sposal--(S-9 form or equal) 3.Approval of electrical ~nstallat~on from Board of Fire Underwriters 4 Commercial buildings, Industrial buildings, Multiple Residences and s~milor buildings and mstallohons, a cerhficate of Code comphcnce from the Architect or Engineer responsible for the building 5Submit Planning Board approval of completed s~te plan requirements where applicable [ For ex~shng buildings (prior to Aprd 1957), Nor,~conforming uses, or buildings and "pre-existing" ~ond uses Accurate survey of property showing all property hnes, streets, buildings and unusual natural or topographic features. 2Sworn statement of owner or ~rewous owner as to use, occupancy and condmon of bu~Idmgs 3 Date of any housing code or safety ~nspect~on of buildings or premises, or other perhnent in- formation required to prepare a certificate C Fees- 1. Certificate of occupancy $5 00 2 Certificate of occupancy on pre-existing dweIl~ng or land use $5.00 3 Copy of certificat..~ of occupancy $1.00 ~ ~ __ I~J~'~ ~ Date ..U..~....~.. ....... "~....?,~. i',lew Building ..g...~ ....... Add~hon ................ Old or Pre-existing Building ................ Vacant Land .............. Locat,on Of Property ~..~..~,/ ..... "¢,~_~)....~.~...-'7 ...... ~~-.~...(~:.~ .............. Owner Or Owners Of Property .... ~.~ ........ i_~ .~./~/~.~,~..~..:~ ~ ...................................... Subdtwsion .................................................... Lot No ...... .~.~... Block No .......... House No ............ Perm,t No ............ Date Of Perm,t ............... Applicant ,,~J~,,'.~kJ~....~.~f~ ....... ! .~.I~.~L~J.S...-~..... Health Dept. Approval ......... ~ '..~. .................... Labor Dept. Approval"' ~' ..................... !..~..*..!..~ ............... tJnderwr,ters Approval ..~....~ .j/~J'. /.!...~...0..~'...~...Planning Board Approval I~..:.. ~ .............. Request For Temporary Cemficate ................................... Final Certificate ...~i/~...~ ......................... above~' descr,bed ~~ ~ ~ de] Fee Submitted $ ................................. on building ~nd~r~,t meet//)all icabl~ co and regulations Construction Apph ca nt ... ~. -~L.J~.. I~....~.]-. ~_~.~.k-,~.../_., ..~. ................................ ~worn to before me this (stamp or seal) THE NEW YORK BOARD OF FIRE UNDERWRITERS ~ BUREAU OF ELECTRICITY " ~ ~-' 85 JOHN STREET, NEW YORK, NEW YoRK 10038 TH~ O~IFI~ THAT o~y t~ e~t~ ~u~nt ~ ~d~ ~ ~ int~ by t~ ~l~nt ~ on t~ a~ ~n numar in t~ ~m~s of ~a~cu~ Pu~. ~d. n/~ ~te.~ Or~ent~ 5.~. in th~ following ~atton; ~ B~ement ~ 1st FL ~ 2nd FL o~t S ~ ~Q ~ction Bilk ~t w~exami~on ~ ~7~ ~7~ andfou~tobein~mplianc~withtherequire~ntsof~B~rd. fiXTURE RXTURES RANGES OVENS DISH WASHERS EXHAUST FANS OUTLETS SWITCHES FLUOf~ESCENT 1 1 2 ] DRYERS FURNACE MC)TOES TiME CLOCKS MULTI~)UT~T DIMMERS SYSTEMS Ne. OF FEET SERVICE DISCONNECT S E R V I C E OTHER APPARATUS: (Swimmin~ Pool) This certificate covers compliance at the date OF inspection only. Because of unusual environments it ~ advisable to have frequent test and/or repairs made by a qualified person. Robert A. Goodale 525 Orchard Street ;aw Suffold, ~.Y. 11956 Per COPY FOR BUILDING THIS Disapproved a/c .................... ~ ~ ~,'~.~ :~ ~ INSTRUCTIONS f' e. This~n~i~ion must be completal¥ filled in by typewriter or in ink end submitted in triplicate to the Building Inspector, with 3 sets of plans, accurate plot plan to scale. Fee according to schedule. b. Plot plan d~Owing location of lot and of building~ on premise~, relationship to adjoining premises or public streets or areas, an~ giving a detailed description of layout of property must be drawn on diagram which is pert of this application. .~ c. The work covered by this application may not be commenced before issuanca of Building Permit. t~ d. Upon approval of' this application, the Building. InlpIctor will issue a Building Permit to the applicant. Such permit.shall be kept dn- the premises available for inspection throughout the work. e. No building shell be occupied or used in whole or in part for any purpose whatever until a Certificate of Occupancy shall have been granted by the Building Inspector. 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 Suuthold, Suffolk County, New York, and other applicable Laws, Ordinances or Regulations, for the ~Onetruction of buildings, additions or alterations, or for removal or demelition, as herein described. The a{~:)licant agrees to comply with all aPPlicable law~ ordinances, building code, housing code, and regulations, and to admit authorized inspectors on premises and in buildings for neca~ary inspections. (Signature of applicant, or name, iT a corporation! (Address of applicant) State whether applicant is owner, lessee, agent, amhitact, engineer, general contractor, electrician, plumber or builder. Name of owner of premises ...~..~.~.~ ................................................................................................ If applicant is a corporate, signature of duly authorized officer. Builder's License No .......................................................... Plumber's License No ......................................................... Electrician's License No ..................................................... Other Trade's License No ................................................... 1. Location of land on which proposed work will_be done. Map No .............. = .............................. Lot No ......................... Street and Number ...A~..~..J~.........~......~".~.~..~J~d~..../~.-~-,~... ................................................. Municipality 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: occupancy .,.,/.~.~.~~.,,~: ......... ~ .~ -~ ............................................................... a. Existing Use and b. Intended use and occupancy ~.ff[,~ ............................................................... 3. ~ Nature of work (check which applicable): New Building ....................... Addition ..................... Alteration; ........ .~ .... Repair ......................... Remova~ ......................... Demolition ........................ Other Work {Descripti°r~/ _ -, '4. Estimated Cost ....... ~.~.~ .......................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, commemial or mixed occuoanc~, 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 ..../.~ ........................ He'ght .............. ~- n-- ,-~,~ ? Number of Stor'es,[~r~l_,es~.., ......................... - ;;;;;,~ "~ 7'~" "~r =: ................. Size o,,ot: Front ..... ............. ................... Depth ............ Date of Pumhase ..................................... Name of Former Owner ............................................................................ Zone or use district in which .premises ere situated ..................................................................................................... Does proposed construction violate any zoning law, ordinance or regu at on .~......__...._ ....... ......__ ............ 13. /. L~JYes [].o 14. Name of ownerof pre~ .~s~ ..~e~,,,¢c.~,..,v~,~~.....~f.h~.....x~a~. .................................................... ............................ t × . ., . _ . _ - . ..'~"'. .o . ~,ngaressl .~ / ./ _.(Phope ~Jo,) Name ..... ~ ' (Address) /' (Phone No.~' · PLOT DIAGRAM Locate clearlY and. ~ly all buildinl~, .wh?_er existing or proposed, and indicate all set-back dimensions from property lines. GIv~ ~,met and block number or d~cnpflon according to deed, and show street names and indicate wheth- er Interior or corner lot, 10. 11. · 12. STATE OF NEW YORK. _ COUNTY OF ..~.~.~..~C~,X,,\,~ .................. ) .......... · '~'~'*~. ,,~,~-~:~ ................ being duly sworn, deposes and says that he is the applicant above named. (N'db~ of' individual signing contrac'~') ......... He is the ............... ~-.,C,~.~-'~..~,~[~..~-~(;3.~,~ ............................................................................. (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; end that the work will be performed in the manner set forth in tfte application filed therewith. ,, ~ TERRI LEE ~ \\ - , ~,~ c-'~c~ ~,k IIOI'JUIY PUBLIC, State"~l~w Yofl~ .................... ~..~..~c:~.....oa¥ o.T ....?...~.~..~....? ................ Id~..5~-Ilt68Z.?~ ....... \ % ~ ~ ~'~ · (~lalilisd in Suffolk County Notary Public ~.~~~n [xp res March 30, · , ........................... ~ .......... County ..... : ......... .~...~ ............. ~ ...................................... · x~Stgnature of applicant} ' t / //, t ' ,, '/ I / '0, SURVEY FOR LEON MARCUS AT ORIENT TOWN OF $OUTHOLD SUFFOLK COUNTY, N.Y. SCALE: I =50' DEC. 9, 1972 LAND SURVEYOR N.Y.S, LIC, NO. 28 '72,~ RIVERREAD~ N.Y*