HomeMy WebLinkAbout9596-zFORM NO. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Office of the Building Inspector
Town Hall
5outhold, N.Y,
Certificate Of Occupancy
No...Z;1, g3~9. fi ........ Date ........ March 29 98.3
THIS CERTIFIES that the ~ffiFd-m-g £nground pool
Location of Property ...6.9.0. .................. Q .u??.n. street Creenport
House No. Street Hamlet
County Tax Map No. 1000 Section .,. 9.4.q ..... Block ....0.3 .......... Lot .... 9.°.5. .........
Subdivision ..... .X. ........................ Filed Map No .... .X....Lot No...X. ..........
conforms substantially to the Application for Building Permit heretofore filed in this office dated
December 16 19 7. .7 pursuant to which Building Permit No. 9596 Z
· dated ..... D.c..c?.m.b.e..r..1.9. ..........197.7. ., 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 .........
an ingraund swimming pool with fence.
The certificate isissued to EASTERN LONG ISLAND KAMPGROUNDS, INC.
(owner,
of the aforesaid building.
Suffolk County Department of Health Approval .... ,N./.g: ..................................
UNDERWRITERS CERTIFICATE NO N 384579
Bud mg Inspec or
Rev. 1/81
TOWN i' OFFICE
SOUTI'fOLD, N.. Y.
BUILDI~IG FER~tT
(THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL ~ULL'
COMPLETION OF THE WORK AUTHORIZED)
9596 Z
~o ~...~..s ...................... ~. ............................. .¢ .......... .(. ..................... ~ ..........
at premises located at .~..~......~.~ ...................................................
~r~ont to opp,~ca,on dated ......................... ~..~ ........ ./...~ ...... , ~7..Z, a~d oppro~ed b~ the
Building Inspector.
FORM NO. 6
TOWN OF $OUTHOLD
Building Department
Town Hall
,~outhold, 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 Inspec-
tor with the following; for new buildings 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 of Health Dept. of water supply and sewerage disposal-(S-9 form or equal).
3. Approval of electrical installation from Board of Fire Underwriters.
4. Commercial buildings, Industrial buildings, Multiple Residences and similar buildings and installa-
tions, a certificate of Code compliance from the Architect or Engineer responsible for the building.
5. Submit Planning Board approval of completed site plan requirements where applicable.
For existing buildings (prior to April 1957), Non-conforming uses, or buildings and "pre-existing"
land uses:
1, Accurate survey of peoperty showing ail property lines, streets, buildings and unusual natural or
topographic featu res.
2. Sworn statement of owner or previous owner as to use, occupancy and condition of buildings.
3. Date of any housing code or safety inspection of buildings or premises, or other pertinent informa-
tion required to prepare a certificate.
C. Fees:
1. Certificate of occupancy $5.00 /
2. Certificate of occupancy on pre-existing dwelling/ land
3. Copy of certificate of occupancy $1.00
use --Pre-Existing C.O. $15.00
Vacant land C.O. $ 5.00
Date ...rd..¢.~V~..~ ... ~ ~...
N~ .... .~x. ...... Old or Pre-existing Building ............ Vacant Land .............
Location of Property G ~ O ~ O i~ ~, ~ ~ ~ ~c~ ~'.
Hou~ No. Street Hamlet
Owner or Owners of Property . .~".~: ./.:., .g.~ ~ 3~o.q ~...).V.~., ..................
co..tv T.~ ~.p No. ~000 S.otio. .... ~ ~.q ..... mook ..... ~ ......... Lot.. :~. ..........
Subdivision ................................. Filed Map No..Lot No ..............
Permit No..c].~.-.c]. ~. ~,. Date of Permit !.~ I.b..-I.-j..Applicant .... ,.~.[~.~..~,..Lj~. ,. ~T~ tO ....
Health Dept. Approval /~¢~.:-Iu~ I~1 ~1 '~'~ .Labor Dept. Approval
/~j ,~LJ~'7 ~ Pta ingBoadApproval
Underwriters Approval . nn r ..............
Request for Temporary Certificate ..................... Final Certificate .......................
Fee Submitted $ .............................
Construction on above described building an~,j~ermit meets all applicable codes and regulations.
~C) '~:~- ( -~)_~c~ (..p Applicant. ,/.,.~"~.. ?..~...(': .~. · . .~. .... ~ .....................
~,,c~ vr~oK BOARD OF FIRE UNDERWRITERS /~ :I-:~
THE ,,~-,, .---,., ~ '~' ..
~ Lon~ Island KOA; Queen St. Norgh gd.~ G~eenport~ ~.I~ ~ ., ?. ,:.
A~ ' 9~ '3Q~ ~,: ~ hndfoundtobe~ncomphancew~thth~requ~remet~tsoJ,~h~sooar~. ,I..q~-:, ,
' '', ~' ~ EXHAUST FANS
Motor~ s: ~.~ap
Bwimmin~ Pool)'T~la C~tificate co~vers.c°mpZi.aac.e_at. the~ d. at?~o_f-,
~nspecti~nOnly~ BeCa~s~of unusual' environments ~i~e~aV~
to have frequent ~e~t ¢~d/or repairs, made by a ,qu
'
S%~ffolk Co~u%ty Department of Healbh Services
General Engineering Services
CERTIFICATE OF APPROVAL
OF PLANS FOR THE CC~.S ..... TIOJ CR C}~NGE OF
AN ARTIFIC~IAL S?fi~'E~ING POOL
Application having been duly made to the Suffolk County Department of Health
Services, as provided ~nder Chapter l, Part 6, of the New York State Sanitary Code~
· S~zmmzng Pool outdoor',
for the approval of plans for _ East6r~ L.I. Kamp,~roand,I, ,na.~ " ' ~ _
are granted to Eu~ne i. Fut~erman
subject to the follow,lng conditions:
I. THAT the proposed artificial swim~_.~ng pool and treatment equipment
sho.~.TM. on the p!anc and specifications approved this day s~ll be
fully constructed and installed in complete conformity with such
plans and specifications or apprcwed amendments thereto.
II. THAT the engineer of record shall inform the Department h8 hours
in Advance for the purposes of r~ing a joint, as built~ pipe in-
spection.
III. T~L~T the engineer of record shall inform the Department h8 hours
in advance for the purposes of na~ng a joint, final inspection
to ascertain conformmnce to the approved plans.
IV. THAT the owner or operator will not open the m~mming pool ~ntil
a certificate of co~.pliance has been received.
V$
THAT the swiwming pool shall be operated at all times to conform
with the requirements of Part 6 and the criteria'for operation
of a swimming pool and to the satisfaction of the permit issuing
officer.
VI.~THAT if any interruptians in treatment or other conditions occur
which may affect the sanitary quality of the water in the pool,
the pool shmll be promptly closed ~ud not reopened until authori~
....... zation.~s,~received~ from the permit issuing official.
EaSt~ L.I. Kamp~roand Inc.
Glenn Apt'/
COUNTY Of SUFFOLK
DEPARTMENT OF HEALTH SErViCES
DAVID HAI~RIS. M.D.. M.P.H.
May 23, 1978
Eugene L. Fut~'~an, Arch~eet
Mad~o~ S.~eet
Sag Harbor, New York 11963
Re: East~n L.I. K~mpground Swimming
Pool, IT} Southold
Dea~. Mr. Fu~te~an:
The above refere~eed swimming pool w~ .Uuspe~ted by a represent~Lve
of t~ office on May 18, 1978. It ~ found that the pool was substant~-
ly co~mo£ed accord~g to the approved plans.
It ~, therefore, the det~ination of th~s office that the above ref-
~enced s~u~?~ing pool be approved.
V~ry tr~y yours,
R~J: cab
ce: Ea6tern L.I. K~mpground Inc.
Enchanted PooZ~ of Suffolk In~.
Sm~hold Town Bldg. Dept. ~
Robert w. Jewetl, P.E.
Assisl~nt Pub~Le H~al~h Engine~
~en~al Engine~d~g Services
FO~ NO. I
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN CLERK'S OFFICE
SOUTHOLD, N. Y.
E×om,ned ......... ........... ,
A~proved ............. ~.l ........ .[..:[ ........... , I9.[./... Permit No ...... ./.~..~...(_..~.~.....~..~.:: ....
Application No .................
Disapproved ...... a/c~ .............................................. j~]~_./
....................... ....... .........
(Building ~nspector~
APPLICATION FOR BUILDING PERMIT
INSTRUCTIONS
a. This application must be completely filled in by typewriter o¢ in ink and submitted in triplicate to the Building~
Inspector, with 3 sets of plans, accurate plot plan to scale. Fee according to schedule,. '
b. Plot plan showing locationZ of lot and of buildings on premises, relationship to adjoining premises or public streets
areas, and giving a detailed description of layout ofproperty must be drawn on the diagram which is part of this application, fid
c. The,,wprk 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 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 ~own of Southold, Suffolk County, New York, and Other applicable Laws, Ordinances or .
Regulations, for the constru~ion 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 buildings for n~essa~ inspections.
~ (Signature of ~plicant,~a~, if a corporatio~)~
......
(A~ress of applicant) /
State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder.
....... .......................................................................................................................................................
Name of owner of premises~Z~:~ ....... ~h..~.....Z~.I~.~.~[~.~..~..Z~.i. ............................................
If applicant is a corporate, signature of duly authorized officer.
................... ....................
(Name and title of corporate officer)
Builder's License No ....................................................
, .
Plumbers L~cense No .... /..L ........................................
' ' ' L' nse L ~~'
Electnc~an s ice No ..... .~.. ...................................
Other Trade's License No .................................... : .......... ~/~ ?'
1. Location of land on which proposed work will be done. Map No.: ............... .~...x~ ............. .'. Lot No. -./..4..-.' ............
Street and Number ......... ..~..!/.~ .~,..~..~.7....J~.~ .............. '~.~..~.'~??/~..~/~.....',, ........
Municipality
2. State existing use and occupancy of premises and intended use and occupancy of proposed construction:
a. Exisiting use and occupancy ................................................................................................................................
b. intended use and occupancy ~.(~.~L~...~..~.a~..w~../~..~.~........~./...~..J.~..~.~.~/~..~.~/../..~..~...t.`:~ ...................................
P
3. Nature of work (check which applicable): ixtew muildJng, .......~:.. ........ Addition .................. Alteration ................
Repair .................. Removal .................. Demolitior; .................... Other Work ....................................................
(Description)
4. Estimated Cost .../..l'7/./...~...O..~t.....~.... ............................. Fee .....~...~..~..~.~ .............................................................
/(to be paid on filing this application)
5. If dwelling, number of dwelling units ....... 7. ................... 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 .(1~t~..~....~..'...'. ....
7. Dimensions of existing structures, if ~ro~,t~...,~.~.....~....~..-~..!.?/.~.. Rear ................................ Depth ....................
Height ........................ Number of Stories ...............................................................................................................
Dimensions of same structure with alterations or additions: Front .................................... Rear ............................
Depth ................................Height ............................ lqu.-~ber of Stories ................................
....... ,~,.~ .................... Rear ..... ..~....~. ................ Depth ~..,~ / ..........
8. Dimensions of entire ~ front ............
Height~..Zt~/~,D.~...~.~... Number of Stories ...... ~....-,.'~ ..............................................................................................
9. Size of lot: Front .-'~......~.....~... ......................................... I,'car ./.'~.~,J....~..J~.. ....................... Depth ~....~.(?..I.....~.. ...........
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 regraded . ........................... Will excess fill be removed from premises: ( ) Yes ( ~
14. Name of Owner of premises .¢J~.I.('.~ct~.D.......~..I..~..P.,..~..'.: .......... Address ~.d~.~-~./~J~.l~...'J~TT... ..... Phone No .......................
Name of Architect ........................................................... Address ................................Phone No .......................
Nome of Contractor .~.~<'..~./~.,~..][-~'~-/2.....J~..~..~..fv.~-~: ............... Address,~.'~/,¢..C.~."Jx~.r~.~.~...~. 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 YORK,
COUNTY OF..~ ..............................
......... ~...'....(,t~..~../~.-~-..,~'...~....../~r..~.~ ................................. being duly sworn, deposes and says that he is the appllcan,
(Name of individual signing contract)
above named.
Fie is the ..... ~~.~..~..~., ...............................................................................................................................
(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 ~nd 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 m~et fo~h in the application filed therewith.
Sworn to before me this
......... ............................
~E~ ~DB~E~ t~gnaTure of ap~icant)
~ ~ ~te d Now York
~fl~ I~ Suffolk Coun~
Term Expires March 3~,
TO
LONG ISLAND, I,<AMPGROUND,_,,
G ¢__E IE:: N P O ¢.L'T'