The URL can be used to link to this page

Home My WebLink About8059-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Town Clerk's Office Southold, N. Y. Certificate Of Occupancy No. Z~.36.2 ....... Date ............ ~IOV ....8 ....... , 19 7..(~. THIS CERTIFIES that the building located at .-Gl*a~e. Road ............. Street Map NoS ,. Hal~bo~... Block No ........... Lot No..i.3 ..... flougho].~l...I~ ,Y.o ......... conforms substantially to the Application for Building Permit heretofore filed in this office dated ............ Ju3,y.. 7..., 19.7.~. pursuant to which Building Permit No..8.0~9.Z.. dated ............ ,y~t~....7.., 197.~.., 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 . Pr:~vata..swi~r~l~g .poo3, .wi~h. fence. & .Ac~s~or.y.~ ................. The certificate is issued to .J ,. E,. ¥~15orl~m ..... ~,e~*. .......................... (owner, lessee or tenant) of the aforesaid building. Suffolk County Department of Health Approval NoR, .......... ~ .................... UNDERWRITERS CERTIFICATE No. N300.~69 ..... At~g..2~.. 3.976 ................. HOUSE NUMBER ..... ~.~.~ ..... Street ..... GI'~ge. P~ad .... ~o,~.~hold ........... Building Inspectbr FOI~i~ NO. 2 TOWN OF $OUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, bi. Y. BUILDING PERh~iT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) N? 8059 Z Permission is hereby gronted to: J. ,E. ,~/an..:~ ork~u~ ............................................... ........... ao~.thalcl ................................................. ~o .,e r.e c.t ..new...p~.i.v~.t~... awi~m f ng..p.o ol.. ~.. ac~e -~ s o~¥~ ................................................ at premises [ocoted ct .~.$....~ ......... J~OLll;~l..~l~_Eb.O.~..~OllteZl ....................................................... ........................................................... 9~.a..n..~,..~,.o.a,..4 .......... ~..o. ~,.t..h .o. ~.~.....~.:.T..,. ................................ pursuont to opplicotion doted ..................... ~..ll~. ....... ~. ............... , 19..~'..~.., ond opproved by the Building Inspector. ]QOTE$ Need underwriters certificate for electric connections and grounding tO 6et certificate of occupancy Fee $! ~-,.QQ ............ ,.. ..Y}V..~i. .................... Building Inspector ( FORM NO. 8 TOWN OF $OUTHOLD , Building Department Town Clerks Office Southold, N. Y. 11971 APPLICATION FOR CERTIFICATE OF OCCUPANCY Instructions A. This application must be filled in typewriter OR ink, and submitted in DUPLICATE to the Building Inspector with the following; for new buildings or new use: 1. Final survey of property with accurate location of oil buildings, property lines, streets, end unusual natural or topographic features. 2. Final approval of Health Dept. of water supply and sewerage disposol--(S-9 form or equal). 3. Approval of electrical installation from Board of Fire Underwriters. 4. Commercial buildings, Industrial buildings, Multiple Residences end similar buildings and installations, o certificate of Code compliance from the Architect or Engineer responsible for the building. 5. Submit Planning Board approval of completed site plan requirements where opplioable. B. For existing buildings (prior to April 1957), Non-conforming uses, or buildings end "pre-existing" land uses: 1. Accurate survey.of property showing all property lines, streets, buildings and unusual natural or topographic features. 2. Sworn statement of owner or previous owner as fo use, occupancy and condition of buildings. 3. Date of any housing code or safety inspection of buildings or premises, or other pertinent formation required to prepare a certificate. C'. Fees: J. Certificate of occupancy $5.00 2. Certificate of occupancy on pre-existing dwelling or land use $5.00 3. Copy of certificate of occupancy $1.00 New BLdlding ................ Addition ....~... ........ Old or Pre-existing Building ................ Vacant Land .............. Location Of Property ~ ~ ................................... ..../c... ................. Owner Or Owners Of Property ....... ................... ../.. ....................... Subdivision ~.~../T./.,~2.~.Z~...~x~.~.~.. ....... Lot No./..~....... Block No ............. House No .~.~S~-..~.., Permit No..~...~...~....,~., Dote Of Permit ?.Z~./Z.'?.r. Applioant .~.../.....;...~.~.,......~.j. ~ ,4,/ ~,,(~/c (./.......~... ............. Heo,,h Dap,. Approve, ........ .................... Lobar bp,. Approve, ........ ............................. Underwriters Approval ...~.......?...O....~.....~....~_.~.. ............. Planning Board Approval ...~'~. '~..~..--~... Request For Temporary Certificate ........................................ / Fined Certificate Fee Submitted $ ~.....-~.. ................... Construction on above described building and p,p,p,p,p,p,p,p,p,~it meets all applicable c~les en~ regulations. Applicant/· g¢¢......~.(~r~.... ~~ ...................... ................ day of ............................................ (stama or seol~'--~/~' ~/ Notary Public .................................... County - '~-~?~'//~ JOHN V. N, KLEIN SUFFOLK COUNTY DEPARTMENT OF CONSUMER AFFAIRS SUFFOLK COUNTY CENTER P/AUPPAUGE, NEW YORK 11787 516 979-3100 Date: Complaint Investigator: subject: May 4 1976 036-1611-76-4953 C Papsco American Pool Town of Southold Building Dept. Main Road Southold, N.Y. 11791 Att: Mr. Howard M. Terry Dear Sir: We are in receipt of'the above complaint. Since the matter appears to be within the jurisdiction of your agency, we are forwarding the description to you. Please be advised that our jurisdiction is based on the residence address of the individual filing the complaint, and not the business address of the subject. In order to keep our records current, I would appre- ciate your keeping us informed concerning this par- ticular matter. JJL :BH 203 Thank you for your cooperation. Very truly yours, JAMES J. LACK COMM~ S S I ONE R cc: American Pool John Van Workun SUFFOLK COUNTY DEPARTMENT OF CONSUMER AFFAIRS SUFFOLK COUNTY CENTER HAUPPAUGE, NEW YORK 11787 516 979-3100 JOHN V. N, KLEIN JAMES Jo LACK Transferred To: Complaint No. Transfer of Investigation Licensing Division Date ,~/~/~ Complainant: ..,Jo~/--,,~/ V',,~,a) ~,/o,~c:4.,'a.J Tel No. Address: Vendor: Address: Brief Description of Complaint Tel No. 225 "DESIGNERS AND BUILDERS OF UNIQUE FIREPLACES FOR THE HOME" FIREPLACES by 543 Middle Country Road, Coram, N,Y. 11727 · (516)698-8688 . 876E Jericho Tpk., Huntington, N.Y. 11743 November 20, 1975 ,,,rs. VanWorkum 855 Grange Road Southold, New York 11971 Dear Mrs. VanWorkum, After several attempts to reach you by telephone in the last few days, we thought we would a&vise you in writing as to the . decision we have ma~e after our inspection of your liner. The pool liner does need replacing. We are writing to you so that you can make a decision as to if you want us to take a chance with replacing it now or would you rather wait until the spring. In the spring we are saluted of resulting in a better Job. This letter will be your guarantee that the liner will be replaced as soon as possible in the spring. Please advise if the above does not meet with your approval. Jd/nf Yours truly, A~E~ ICAN INDUSTRIES AF NASSAU TRUST cOMPANY 9-13 GLEN STREET, GLEN COVE, N.Y. 11542 (516) 676-8400 jtl ~....~. 5L 1975 ' Date: ............. vanWorkum johannef E. & jozefima HuyLs 855 Grange Road SoubhOld, NY 11971 your Retail Instalment obli§ation dated __-- SUBJECT TO: 1) indenture _ to finance 197~5 __ ~-------~- your property modernization will be assigned to this bank. The Retail Instalment Obligation to be assigned ~ m the net amount of $ 1700 · 00 ~ to be 60 -- equal InstalmentS of $ 42.08 ....~. per month. repaid in__ ~ It is our intention to disburse the funds to the below named dealer when all necessary documents are received in proper order. ' If you have any questions regarding this transaction, or if we can be helpful in any way, kindly let us hear from you. D E A L E "L the dartmouth plan inc. 1 old country road carle place, new york 11514 (§16) 742-2300 Instalment trem (Name auver's Residence SELLER SeJ~er hereby sells and Buyer ("Buyer" r'heans each of the Buyers',' if mor~ than one, jo*ntIy and severally) hereby purchases the goods and/or services described here*n or on the Seller's work order annexed hereto and incorporated herein, subject to the terms and conditions on the face and the reverse hereof. DESCRIPTION OF GOODS AND/OR SERVICES As per attached work order dated PROPERTY TO BE IMPROVED: ....................................... FINANCE CHARGE will begin to accrue upon completion of the work which is est4mated to be MO. .Day 19 . Buyer agrees to pay Seller, ~ts successors and/or assigns, The TOTAL OF PAYMENTS (item 7) in equal monthly instalments of $ each, the f~rst instalment being payable sixty days efter the date upon which the work is com- -pleted and the finance charge actually accrues, and all subsequent instalments on the same day or each consecutive m~nth until pa id in full at the address of the Seller or at such other ptace as may be designated m writing by the Seller, Itssuccessors and/or assigns, if any instalment is m default for a permd of more than ten days, ~er a~rees to pay as hqu~dated dama,~es occasioned by the delay in mai ng pay- ments~ in addmon to other amounts due~ a delinquency ch_ar~e in an amount equal to five percent of such ~nstalment or five dollars, which ever ~s less. P----roper ty Insurance ~s required and may be obtained by Buyer through any a~;~:ept- NOTICE TO THE BUYER 1. DO NOT SIGN THIS AGREEMENT BEFORE YOU READ IT OR IF IT CONTAINS ANY BLANK SPACE. 2. YOU ARE ENTITLED TO A COMPLETELY FILLED IN COPY OF THIS AGREEMENT. 3. UNDER THE LAW, YOU HAVE . THE RIGHT TO PAY OFF IN ADVANCE THE FULL AMOUNT DUE AND UNDER CERTAIN CONDITIONS TO OBTAIN A PARTIAL REFUND OF THE., CREDIT SERVICE CHARGE (FINANCE CHARGE). RETAIL INSTALMENT OBLIGATION . Seller Buyer Buyer (DO NOT DETACH) City or Town 1. CASH PRICE LESS CASH AND TOTAL DOWN PAYMENT' ' 3. UNPAID BALANCE OF CASH PRICE 4. OTHE R'CHARGES State Describe, If Any .................... a C~EDIT LIFE INS. $ .............. AND AMOUNT $ ..... FINANCED (3+ 4) ' ...... 6. FINANCE CHARGE $.,.~ .....'.. ,, .... 7. TOTAL OF pAYMENTS (3 + 4 + B)~ $ ......... · 8. DEFERRED PAYMENT ' pRICE (1 +4 + 6) ' $ .......... ~... 9. ANNUAL PERCENTAGE RATE ................... SECURITY INTERESt:: Seller may acquire a mechanic's lien, and in connecuon with any assignment. A, ssignee may require a mod- gage upon Buyer s residence and/or property 'to be.improved, as shown above. In the event sucl~ mortgage be required by Assignee, the face amount shall hot be in excess of the Total of Payments (Item 7) hereunder· All e~<penses incident to the preparation a~d cording of said mortgage will be borne by the Seller. REBATE OF U'NEARNED CREDIT SER- ,VICE CHARGE ~FINANCE CHARGE) IS CALCULATED BY THE 78the METHOD. IN WITNESS WHEREOF, the Buyer and Seller have hereunto set their hands m tr;plicate as of the date first above written. BUYER ACKNOWLEDGES RECEIPT OF AN EXECUTED, TRUE AND COM- PLETED COPY OF THIS OBLIGATION. -SEE REVERSE SIDE FOR ADDITIONAL COVENANTS AND CONDITIONS TO WHICH THIS AGREEMENT IS SUBJECT. CREDIT APPLICATION Date , lB $ Net . Tybe of .,.,o., "[ (We) hereby authorize Seller and/or ~t's a~igns to mvesUgate my (our) credit ~ckground as it applies to the loan applied for in th~s app]icatmn." TDP 109 Rev. 4/75 .DESIGNERS AND BUILDERS OF UNIQUE SWIMMING POOLS FOR THE HOME", POOLS by 543 Middle Country Road, Corarn 11727 698-8688 NAME ADDRESS TOWN _ " ' DATE OF SALE ~. DATE OF JOB ,. I SALESMAN _ PHONE Deliver and install: -' / ~- Including: 1. 3/4 H.P. Perflex Filter ,- ' 2. In-wail Haywood skimmer 3. Commercial vacuum set weighted 4. s/s chemical kit ,. 5, 20 guage winterized liner 6. In pool ladder- alum[], s/s[] 7. OTHER EXTRAS''~-~: C. Installation includes: pool base, assembly of pool, deck, filter, etc., with 2 year guarantee on parts and ~abor, D. Other Information: Payment Schedule GOOD FAITH BINDER ... $. DEP( ON DELIVERY.., ON EXCAVATION .......... $ ~ ' ON LINER iNSTAL. ., r- -' ON COMPLETION ........... S-- TOTAL "~ · Mosaic Liners optional ,,~-~:'lnstallation includes assemb y of poe .f ter sk mmer,,~deck. ,,ng only,~,~. ,,m~,*-~ ~_~ ~,,~ ,, ,,~,~,,~.~,~,,,,,, . .... , , ~.~ ~ ,.,~,~,,,~,, ,. -~,.,~'~,,~':~:, ¢,~ · Decks and patios unstained unless stated on contract· · There will be an additional charge if the ground level is more than 5" off level, · Any dirt or grass removed from pool area to make ground level will not be removed from 10 feet of pool area unless otherwise specified. · Pools installed shall be reasonably level and approximately 4' deep. · Customer assumes all responsibility for damage to property as a result of machinery working, entering or leaving premises. · In the event a fence section must be removed to gain access to property the customer is responsible for re- moving and reinstalling the section. ,,~ ANY PAYMENTS AFTER THE DEPOSIT MUST BE CASH OR CERTIFIED 'CHECK. · All New Deck.Pools have a 6" Baked Enamel "Top Coping instead of Wood." · All deep ends, or middies, must have hopper pleats· " ' ' ' DATE '" CUSTOMER SIGNATURE ' the dartmouth plan, inc. _______ one old country road, carle place, new york11514 (516) 742-2300 · (212) 347-3400 Mr. & Mrs. Johannef VanWorkum . 855 Granqe Road Southold, NY 11971 .... Ret Pools by American industries Enclosed is a completion certificate which requires your signatures when the work you contracted for is com- pleted. READ IT CAi{EFULLY AND UPON COMPLETION OF THE WORK~ PLEASE DATE AND SIGN, THEN GIVE IT TO YOUR CONTRACTOR. This certificate will indicate to us that the job has been completed in accordance with terms of your con- tract or sales agreement. Please feel free to call us if you have any questions, or if we can be of assistance to you at any time. Thank you for financing your home improvement through The Dartmouth Plan. ~ July 17, 1975 Date of Mailing "1 (We} he~ebv auTh'or~Te ~eHer and/or its a~gn to H~vest,gate mv (our) credit ~ckground as ~t apphes to the loan applied for in th~s applicatmn." TDP 109 Rev. 4/75 ....... O0 -4I 9u -¢ ~oq prov d ....... ....... .?....., Disapproved a/c . INSTRUCTIONS o. This application must be completely filled in by typewriter or. in ink and submitted in triplicate to the Building-~ 3 sets of plans, accurate plot plan to scale. Fee according to schedule. Inspector, with b. Plot plan showing location of lot end of buildings on premises, relationship to adjoining premises or public streets areas, end giving o detailed description of layout ofproperty must be drown on the diagram which is pert of this application, c. The wore 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 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 whatever until a Certificate of Occupancy shall hove 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, 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 oil applicable laws, ordinances, building code, housing code, and regulations, and to admit authorized inspectors on premises and in buildings for necessary inspections. ......... i~[~'~t'~';~"~ ~'~'l~¥i'~rl or I~'~e, if ~"~rporatio~ ' (Address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. Name of owner of premises ... ~ ............. ~.... .............................................................................................. If applicant is a corporate, si~ture of duly authorized officer. (Name and title of corporate officer) Builder's License No ..................................................... Plumber's License No ................................................. Electrician's License No ............................................. Other Trade's License No ......... "-" '1 / // Locotion oflandonwhich E ~i:~';'"'""l~'e".~i~.M~P N~°''' "~~"~'"'c~"~L°t No L..-~., ........... Street and Number ~ ..~....~ i i.....~~ ........................ i ........... ........ Municipa ity State existing use and occupancy of p~mises a/~ intended use and occupancy of proposed construction: a. Exisiting use and occupancy '"'~"~'~'¥t' ........... '-'~'-~¢ .................. *-~ ............................... ~ ................... Intended use and occu one b. p y ..................................../._..~ ................................. .( ............ of work (check which applicable): New Building. ................. Addition .................. Alteration ............... Repoir .................. Removol .................. Demolitior. .................... Other We r k 6rr~.,..q ~.~}...~..q~..~'~ ................... (Description) 4. Estimated Cost ...................... .~...~....~.....O~.. ................ Fee //~ 'T' (to be paid on filing this application) 5. If dwelling, number of dwelling units ~ Number of dweIling units on each floor if garage, number of cars ............................................................................................................................................. 6. If business, commercial or mixed occupancy, specify nature end 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 ..... ~.,.~...'...~....~...O...- ........ Rear ............................ Depth ........................ Height .................... Number of Stories ..................................................................................................................... 9. Size of lot: Front ........................................................ Rear .......................................... Depth ................................ 10. Date of Purchase ...................................................... ¢,Naml~ of F, ormer Owner ........................................................ 11. Zone or use district in which premises are situated ....,Cc5....~ ............................................................................... 12. Does proposed construction violate any zoning law, ordinance or regulation: .... ~ ............................................. 13, Will lot be regraded , ............. ., ............ Will excess fill be removed from premistefr:' (,~)"~ ( ) No 14. Name of Owner of premises ..~.....~........~...~..~g/E~,~ Address .....~,~)~...~.. ..... Phone No ....................... Name of Architect ............................................................ Address ................................ Phone No ....................... Name of Contractor .~.h....c:~......~ ................ Address ........ ~.c.~ ...... Phone No ....................... PLOT DIAGRAM Locate clearly and distinctly all buildings, whether existing or proposed, and indicate all set-back dimensions frorn property lines. Give street and block number or description according to deed, and show street names and indicate whether interior or corner lot. STATE OF NEW~"O[~', J~,# IS S COUNTY QF-~..,..~U'~.Z1L'?~......~........~ ' ~ .................... ~~C.:..~...~.~ ........... being duly sworn, deposes and says that he is the applicam (Nam~ 6f individual signing contract) above named[ He is the .......................................................................................................................................................... en[,"~;rporate officer, etcl) ......... 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 th, ar the work will be performed i~ the manner set fo~h in the application filed therewith. Sworn to before me this r ~ . ,~ :....: ....... i~ma~ ~ubhc, . .................... ~ ~/~-...F ~ounw .................... ~ ................................................................... ' ~ I /// ~ (Signature of applicant)