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Home My WebLink About9933-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. Certificate Of Occupancy No. ~. .I .1.2. 7.8. .......... Date Daco,.b~r 20 19 82 THIS CERTIFIES that the'b'n2dri~g'., p.o.q 1. ......................................... Location of Property .3.1.2.5. ............... qr..a.n.d..~..~.o.n.u.e. ........ Hat~ti~;uck House No. Street ................ h~r~/ei County Tax Map No. 1000 Section J.0.7. ........ Block . 9.1 ............ Lot .. ,0.2. 1. ........... Subdivision ..... X. ......................... Filed Map No...X. ..... Lot No. X. ............ conforms substantially to the Application for Building Permit heretofore filed in this office dated ... $.u.g.~s..t,..2.~ ........ 19 7.8. pursuant to which Building Permit No, , .9..9.3.3, .7., ............ dated .... '.d.e.p.'c.~ [ap.e.r.. ) '.2 .......... 19 ?.8. , 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 tngrourid swimming pool., The certificate is issued to .... qu..d~.t;.h...IJ~.~e..r ......................................... {owner, I~e-e'b~' FeYtgi517 of the aforesaid building. Suffolk County Department of Health Approval .... n./..a ................................... UNDERWRITERS CERTIFICATE NO ............ ~..4 9.3.5.4. .2 ............................. Building Inspector Rev. 1/81 FOI~ NO. ~ TOWI~ OF $OUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N~ Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PP, EMISES UNTIL FULL CQMPLETION OF THE WORK AUTHORIZED) 9933 Z Date ~'J~ ~D7 Ia 19.Z..~.. Permission is hereby granted to: .... ..d...~:.j~.!..z!f. ...... ..u...~L~ ............ ................ .- at Premises'located at ........ ,~..L ~,,~., ........ ~,~P~.,W.I~.,..,.,..~. ~, ~'..k?. ........ ~,,_ ~ :.....: ......................... .....,: .............................. lx!l/.~...-~.~...-r.:~,.c~.~'..,! ................................ [ ....................... ]9:...~..~.,'and opproved by the FORM NO. 6 TOWN OF SOUTHOLD Building Department Town Hall Southold, N.Y, 11971 APPLICATION FOR CERTIFICATE OF OCCUPANCY Instructions A. This application must be filled in typewriter OR ink, and subr~itted 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 approve{ of Hea~th Dept. of water supply and sewerage disposaI-(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. B. For existing buildings (prior to April 1957), Non-conforming uses, or buildings and "pre-existing" land uses: 1. Accurate survey of peoperty showing all property lines, streets, buildings and unusual natura~ or topographic features. 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. Fees: 1. Certificate of occupancy $5.00 2, Certificate of occupancy on pre-existing dwelling or land use 3. Copy of certificate of occupancy $1.00 $5.00 Date ..... New Building ............. Old or Pre-e~y~isting Building(X) ......... .~/Vacant Land ............ Locat on of Property ...... - ................................. ~.. ......... Hous~IVo. .~ .~. ~..,.~,..~-, Street. Hamlet Owner or Owners of Property ............................................ County Tax Map No. 1000 Section ............... Block ............... Lot ................ Subdivision ........ ~ ................ , ...... Filed Map No~ .......... Lot)No.~.. ......... .... Permit No. (~..~.,~5... Date ofPermit .?/".~.7~.Applican~ ..~... ,. Health Dept. Approval ........................ Labor Dept, Approval ...................... ,.. Unde~riters Approve . .~ .... Planning Board Approval .................. Request for Temporary Certificate ..................... Final Certificate ................. Fee ~ubmitted $...~'...~ ............ on- .... ....... ................ Skinn~ ~Dip 'Pools Inc. A HALLMARK DISTRIBUTOR Westphalia Road, Mattituck 298-5010 ~- 2984445 Vic, Chuck Stabile, Dawn Drive East Marrion is sending in under seperate cover the applicat~n for C.O. enclosed is the Underwriters certificate needed to complete same. Art TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. C/r 7f ? ..... ........................ Examined .................. .~,,~....~,~... ....... , 19 ........ ~'3 Application No..¢....~. ~.... . Approved .................. ~ ....... , 19 ........ Permit No. Disapproved a/c ~ ~ ...................................................... (Building Inspector) 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 location of lot and of buildings on premises, relationship to adjoining premises or public streets o~ areas, and giving a detailed description of layout ofproperty must be drawn on the diagram which is part of this application. 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 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. xis"~ce ofa Building Permit pursuant to the Building Zone Ordinance of the Town of Southold, Suffolk County, N~ York/and oth, u¢ applicable Laws, Ordinances or Regulations, for the construction of buildings, additions or alterations/or for F~moval ~/derr)61ition, as herein described. The applicant agrees to comply with all applicable laws, ordinances/building/code, h~'u~ ng~ode, and regulations, and to admit authorized inspectors on premises and in .......................~~~,or/~~/'name, if a~oration, ............................. ( ddress ay app icant} State whether applicant is owner, lessee, agent, architect, enginee~~lectrician, plumber or builder. I' applicon[ iq~~gnot~ of duly a~thorized off'c . ................. (Nome and tit e o corporate o ~c~r) Builder's Lic~se Plumber's License No .......................................... .....~-- ~..~,--,_--~.. Other Trade's License No ............................................. Location of land on which proposed work will be done. Map No.: ........................................ Lot No ......................... Street and Number ....................................... ~..~...~.-.~..~-. .................................... ~.k. .............. ~ ..................... Municipality State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Exisiting use and occupancy ......... I.q.~...: ............................................................................................................ b. Intended use and occupancy ................................................................................................................................ 3. Nature of work (check which applicable): New Building.. ................. Addition, ....(~) ......... Alterotio~ .....',9";u~ ' Repair .................. Removal .................. Demolitior: .................... Other Work ....~,._ .~...!]:.f.,..~......~._~¢...~C~. (Oescription) 4. Estimated Cost ...........~..~ .................................. Fee .......................................................................................... (to be paid on tiling this application) 5. If dwelling, number of dwelling units ............................ Number of dwelling units on each floor ............................ If garage, number of cars .........J ................................................................................................................................... 6. If business, commercial or mixed occupano/, 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 ........................ Height .................... Number of Stories ..................................................................................................................... 9. Size of tot' Front ...L...C).. ~ ..................................... Rear ........................................ Depth. J.] ............... 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 frp, m premises: ( ) Yes (~No , . ' Ju u 14. Name of Owner of premlses ................ Name of Architect ...(r~.r~ ................. z'~ ................................ Address ................................ Phone No ....................... Name of Contractor .......................... Address ~..~. ......... Phone N .6~.~..~..~.~.?..~..?...~. PLOT DIAGRAM Locate clearly and distinctly all buildings, whether existing or proposed, and indicate all set-back dimensions from property lines. Give street and block number or description according to deed, and show street names and indicate whether interior or corner lot. COUNTY OF......~,.~,Z..~../~ ,._L.M ,/ (-)! ~ ~,.~f~' '~.../0 0 ' ~ (Name of individual signing contract) / // above named. / Fie is the ............................ 4:;~..Z.l~.~....q'.~..., .~... ........................ / ............. l ...................................................................... (Contractor, agent, corpora/'e office_r, letc.)_J~ f of said owner or owners, and is duly authorized to perform or h/ave perforJ~ed the sa/la work and to make and this application; that all statements contained in this applicatio~ are tru~l.tJ~ the best dp( his knowledge and belief; and thor the work will be performed in the manner set forth in the appJlication /Jle~d therewit~.l Sworn to before me this --~ [ I I I. / I /' ...... ~}.'~¢'~ ....... day of ..~.~.~'~..¢...~...~...~'..~......., 19~.. ~ /J ~J/l~ ~// I ~ ~ otery Pub,,c,. ............... Cou, ....... ............. ~-.'"'y .~ . /d c~ /,, / /~ ".~ J '.~ /'/ ~./ (~ignat~gre ~f epplicant) Term Expires ~rc~ ~0,