HomeMy WebLinkAbout6588-zFORM NO. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Office of the Building Inspector
Town Hall
Southold, N.Y.
~ERTIFICATE OF O~CUPAN~Y
No Z-25079 Date JUNE 10, 1997
THIS CERTIFIES that the building ACCESSORY
Location of Property 2150 ANCHOR LA.& 845 WINDJA~ER
House No. Street
County Tax Map No. 1000 Section 79 Block
Subdivision Filed Map No.
DR. SOuT~OLD, N.Y.
Hamlet
Lot 34
Lot No.
conforms substantially to the Application for Building Permit heretofore
filed in this office dated MAX 22, 1973 .pursuant to which
Building Permit No. 6588-Z dated MAY 22, 1973
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 ING~O~ND BWI~ING POOL WITH FENCE AS APPLIED FOR.
The certificate is issued to JOAN M. DAVIS
(owner)
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL
UNDERWRITERS CERTIFICATE NO.
PLUMBERS CERTIFICATION DATED
Rev. 1/81
N/A
H-055476 - MAY 30, 1997
N/A
Building ~ nspe/r
FO~ NO. 2
TOWN OF $OUTHOLD
BUILDING DEPARTMENT
TOWN CLERK'S OFFIGE
SOUTHOLD, N~ Y.
BUILDING PERMIT
(THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL
COMPLETION OF THE WORK AUTHORIZED)
N? 6588
Permission is hereby granted to:
Orient tmteking& ConSt~* A/C JaIeS Da~s
O~ent
blzlld new private swimming pool With fence ere
Anon, or La & Wi~Jamme~ Southol~
pursuant to application dated ..................... ...]~..~. ......... ..~,~. ............ , 19..~.~.., ond approved by the
Building Inspector.
Fee $~..~..e...0~.. ............
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
inspector with the following: 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 a 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 $25.00, Additions to dwelling $25.00,
Alterations to dwelling $25.00, Swimming pool $25.00, Accessory building $25.00,
Additions to accessory building $25.00. Businesses $50.00.
2'. Certificate of Occupancy on Pre-existinK Buildin~ - $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 .................
Location of Property.. ~/.~] .O... ~../~.~.~.~...~.~.~. ~ .................. . .~.~ ~...~. F. ~.~.. .........
House No. Street Hamlet
Onwer or Owners of Property ..................................................................
County Tax Map No I000, Section .............. Block ................ Lot ...............
Subdivision ............ ...... ............. . .... Filed Map .......... .. Lot ................. i ....
Permit No.~~'~'~ ..Date Of Permit...~ /~/ ~'7 .Applicant.
Health Dept. Approval .......................... Underwriters Approval .........................
Planning Board Approval .....
Request for: Temporary Certificate ........... Final Certicate ...........
Submitted: $ ..... ...............
......... ............
~.r~.5~OOI ~/ APPLICANT
THE NEW YORK BOARD OF FIRE UNDERWR~RS
!
~6~21(:~ BUREAU OF ELECTRICITY
~-- 85 JOHN STREET, NEW YORK, NY 10038
Date ~'~Y -~ 1997 ~pplication No. on/ilo ~ 3970397/97 ~ ~- ~7~5 ~
THIS CE~IFIES THAT
~y t~ ~tr~d ~u~nt ~ ~d~ ~ ~ int~ ~ t~ ~t ~ ~ the a~ ~at~ numar in t~ p~m~s of
in t~ followiflg hwation; ~ B~nt ~ Ist FI. ~ 2nd FI. ~ ~ ,~tlo~ Bilk ~' ~t
~ exemi.~o. ~Y 2 3,1997
and found to be in compliance with the National Electrical Code.
V I C
A. W.O. I~O. O~ HI-LEG A. W, G,
COOKING DL~CKS OVENS DISH WASHE8
AMT. K, W. AMT. K.W. k~T. 1~ K. W.
I
MULT~-O~LJ
SYSTEMS
EXHAUST FANS
DIMMERS
~NII~{ING PCOL- 1
* {SWD~HIN,3 P~?~L) This certificate
,:~ v~s compl.[ance at the dire of
ii}Sl~ection only. Because of unusual
environments it is advi?;abte
made by a ,~lified per.on.
<<< Continued ,~n Faqe 2 >>>
This ce~i~ m~t not ~ alte~ in any manner; ~turn to the office of the ~ard if incorre~. Ins~ors may ~ identified by their credentials.
COPY FOR BUILDING DEPARTMENT, THIS COPY OF CERTIFICATE MUST NOT BE ALTERED IN ANY MANNER.
THE NEW YORK BOARD OF FIRE UNDERWRITERS ~,.~_c~ :~
~_~(~]0 BUREAU OF ELECTRICITY
85 JOHN STREET, NEW YORK, NY 10038
~ lL~ ?O,1C) 97 ~pplicationNo. on/ile 139703'37/q7 H 055476
THIS CE~IFIES THAT
o~y t~ ~t~M ~u~ment ~ ~ ~ ~ int~ by t~ ~nt ~ on ~he g~ ~t~n numar in t~e p~m~s o/
Lot
~IS
R v I C
Mi~C~pI' i~'zw I.i'3w 3.e'3w 3.~4w $NO, Of~CC~¢ONO.
A. W- O. NO.(~ HI-LEG A.W.G.
Of CC. COND. O~ HI-LEG
EXHAUST FANS
DIMMERS
2150 ANCHOR I~IE
SOUTIfOLD, NY~ 11971 ~ ~t~l~l
11
This certificate must not be altered in any manner; return to the office of the Board if incorrect. Inspectors may be identified by their credentials.
COPY FOR BUILDING DEPARTMENT. THIS COPY OF CERTIFICATE MUST NOT BE ALTERED IN ANY HANNER.
765-1802
BUILDING DEPT.
INSPECTI
[ ] FOUNDATION 1ST [ ] IGH PLBG.
[ ] FOUNDATION2ND [ ) JLArlON
[ I FRAMING [ ] FINAL
[ I FI~EPLA¢~IMNEY
REMAR~
DATE ~~/ INSPECTO~
765-1802
BUILDING DEPT.
INSPECTION
[ ]FOUNDATION 1ST [ ] RO/~GH PLBG.
i ]] ~ORAU~iDNA~ION 2ND i ~FiNAULLATION
[ ]FIREPLACE & CHIMNEY
REMARKS:
76S~.802 *
~BUILDING DEPT.
INSPECTION
[ ] FOUNDATION 1ST []~/UGH PLBG,
i i ~ORAUMNiDNA~ION 2ND i~/] IFNiNSAU~ATION
[R£]MFIREPiACE &~HIMNEY ~
DATE
INSPECT~
APPLICATION FOR BUILDING PERMIT
Date
INSTRUCTIONS
El.
This
completely filled in by typewriter or in ink and submitted in triplicate to the Building Inspector, ~ith~J
3 sets of I~lm, 4Ccur~e plot plan to scale. Fee aCCOrding to schedule.
b, p!pt_jllJl) ~ location of lot and of buildings on premises relationship to adjoining premises or pub c strew? or areas,~nd
giving a detailed dl~eription of layout of property mu~ be drawn on diagram which is pert of this application.
c. The wo~ coy~Ked by this application may not be commenced before issuance of Building Permit.
d. Upon ~ of this al~olication, the Building Inspector will issue a Building Permit to the applicant. Such permit shall be kept on
the premises a~eilable for inspection throughout the work. '
e. No building Ihall be occupied or used in whole or in pert for any purlxrse whatever until a Ce.rtificate 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 Southold, Suffolk County, New York; am:J'other applicable Laws. Ordinances or Regulations, for the construction of
buildings, additions or alterations, o~ for removal or demolition, as herein described. The applicant agrees to comply with all al~olicable laws.
ordinances, building ~qhousing co~Je, and regulations, and tO admi~'~0th6fi~edi~JPectors oh la'd~rs~s and in buildings for uecassery inspections.
(Signature of applican'C or name, if a corporation)
Orient
(Address of applicant)
State whether applicant is oWner, lessee, agent, architect, engineer, general contractor, electrician, plumber or b~Jilder.
Contractor
Name of owner of premises ..... ~.~$.$.~..~.~.V~ ............................................................................................ ~ ....................
If applicant is a corporate, signature of duJ~ authorized officer.
(Name and title of corporate'officer)
Builder's License ~0 .......................................... ' ................ ,
Plumber's License No ....... ~.~..~[ ........................................
Electrician's License No ........ ~u~],o,J'~ ............................
Other Trede's License No ...................................................
1. Location of land on which proposed work will be done. Map No ........... ..~..a..r...b..°...r....L..~J~.~..~....Lot No. ~'
Street and Number .....,....Jl[~J~...m~..~iZ'...~,....Al:t(tj3,0~..~.~_~_~ ........... ~g.~J:tCtl rl ....................................................
Municipality
2.State existing use and occupancy of premises and intended use and occupancy of proposed construction:
a. Existing use and occupancy ....J~all] '14 nc, .....
· b. Intended use and occupancy ...........,sa~e...wl~b...p=l,z~t,e...sv~ ~m!~..pc~o/. .......... ' ...................................
3. Nature of work (cheek which applicable): New Building ....................... Addition ..................... Alteration .......... ; ....
Repair ......................... Removal ................. Demolition ........................ Other Work ,,.,~..o.p.~, ......................
(Description)
L~' 000 + Fee ....... ~ ~.,.Q.Q. ..............................................................................
4. Estimated Cost ....................... · ............ w. ........ (to be paid on filing this application)
5. If dwelling, number of dwelling units ......0. .......... 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 dY same structure with alterations or additions: Front .......................... Rear .........................................
Depth .......................... ... .. .... .... ...... Height ......................................... Number of Stories ........................................
8. Dimensions of entire new construction: Front ........... ;,~ ......... Rear ....... -1~ ................ Depth .....~ .......................
Height ................................................. Number of Stories...... .......................................................... ....... ............ ......
9. Size of lot: Front ............... , ...................... Rear .......................................... Depth ..................................................
10. Date of Purchase ..................................... Name of Former Owner ............................................................................
~i 1. Zone or ,,se district in which premises are s~tuated ...... ~.....~,~,A~ ............................................................... .
'12. Does proposed construction violate any zoning law, ordinance or regulation: ....... 31o. ...............................................
13. Will lot be regraded ..... ~r~,~ .................. Will excess fill be mmoved from premises: [X] Yes [ ] No
14. Name of Owner of premises 'Tames & .Toan Davis (Address) (Phone No.)
Name of Architect ...; ............................................
(Address) (Phone No.) .
Name of Contractor ......O;~le~lL..t~lz:tg.,&..cap.~l~z%ta:l;l~ .......... ; ...........................................................
(AddreSS) (Phone No.)
PLOT DIAGRAM
Locate clee4~/an~ distinctly all buildings, whether existing or proposed, and indicate all set-back dimensions from'
property lines. Give~stre~ and block numbe.r or deacription according to deed, and show street names and indicate wheth-
er interior or cornellot.I '
//
STATE OF NEW YORK ) ,,~
COUNTY OF ............... ~.~.~ ~.O11c ................... )
.............................. ~.O]D~,Z'.~..~.O.11g].~S,~ ................................... being duly sworn, deposes and says that he is the applicant above named.
(Name of individual signing contract)
He is the ................................................... .O...q.~..~.~.~..~.~.O..~'. ..................................................................................................................................
..' (Contractor, agent, corporate officer, etc.}
of said owner or owners, and is duly ,a~orized to perform or have performed the said work and to make and file this application; that all
statements contained in this applica.t, idn are true to the best of hi~ knowledge and belief; and that the work will be performed in the manner
set forth in the application filed therewith.
...........................