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Home My WebLink About9971-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. Certificate Of Occupancy January 23, 1987 No. Z- ~ 5220 Date ................ INGROUND SWIMMING POOL WITH FENCE THIS CERTIFIES that thc building ................................................ 535 Bay Home Road Southold, New York Location of Property/:/~s~ Ho: ......... Street Hamlet County Tax Map No. i000 Section 56 ..... Block 5 .Lot . 23 Subdivision ............................... Filed Map No ......... Lot No .............. conforms substantially to the Application for Building Permit heretofore filed in this office dated October I0, 1978 9971 Z ......................... pursuant to which Building Permit No ...................... dated.........0ct°bet ...... 10, I.............978 .,wasissued, and conforms to all of the requirements of the applicable provisions of the law. The occupancy for which this certificate is issued is ......... INGROUND SWIMMING POOL WITH FENCE ENCLOSURE JOSEPH MAGAGNIN The certificate is issued to ........................................................... (owner, of the aforesaid building. N/A Suffolk County Department of Health Approval .......................................... N4 12226 UNDERWRITERS CERTIFICATE NO .................................................. N/A PLUMBERS CERTIFICATION DATED: Building Inspector Rev. 1/81 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERICS OFFICE SOUTHOLD, N~ Y. N.o BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) g971 Z Dote ....... Permission is hereby granted to: ~. , ~_, . · .........~ -~ - ~~z:~.~..~ .............. ..~......./.......~ ....... ..u./.....~..~i.~ ........ .'.../. .......... 2 ........................ :, ~:, ~6~ tO~op~l~eo~ign do~ ......... ~,...,.: ......... , 19.. ~nd ~pprov~ b~ th~ ~: (::( FORM NO, 6 TOWN OF $OUTHOLD 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 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 featu res. 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. 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 natural 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. C. Fees: 1, 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 Date ..... .O.c~ ~. ~9.,.. ~9.?~. ..... New Building ...~.O;~ ...... Cid or Pre-existing Building .... ~, ....... Vacant Land ............. Location of Property .... ,~.~...~.~..q...~.o~.e. ?..~....~o..u.~.~.o.].. ~.,. ?.t..~..'. ........................ House No, Street Hamlet Owner or Owners of Property .~.o..~..~.~. ~. ~.o.~.e..p.~..~.s.g.a[~.~.~. ............................ County Tax Map No. 1000 Section ...~.~.J~ ..... Block ............... Lot...2.~. ........... Subdivision ................................. Filed Map No ........... Lot No .............. Permit No...~.~7~ .... Date of Permit ~L.0~.],Q/'.7.~.Applicant ...~.o.~. g~.h..~.a~.~ .~.~. ............. Health Dept. Approval ........................ Labor Dept. Approval ........................ Underwriters Approval ..... ~J~3. 22.2~ ........... Planning Board Approval ...................... Request for Temporary Certificate ......... ~. ........... Final Certificate ....................... Fee Submitted $ ............................. Construction on above described building and I~ermit meets all applicable codes and regulations. '-~ '~' -o~ ~ Applicant .... . .~.~.~.~.~..~..~. ~-~- .... ...................... Rev. 10-10-78 H NEW 'YORK BOARD' OF FIRE' R : ,,. , . yORK !,OO38~ RANGES TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. Disapproved o/c ................................ ~] :::::::::::~:.~ ..... APPUCATION FOR BUILDING PERMIT /,'~ ~f~ a. This application must be completely filled in by typewriter or 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 Jot 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 o 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, sas 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 i~ buildings for necessary inspections. ................ .......................... (Sig~atu~ or%applicant, or~ if a corporotio~'i ..... ......... ...... address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. applicant is a corporate, signature of duly authorized officer. Builder's License No ..........~.~..Z,.....~... ...................... Plumber's License No. ~j~.....~ ........ ~ Electrician's License No. ~....,~,~..,~f~..~. ' Li ense . . --" ~ ~ Other Trade s c No ............................................. /~_ -/~ _ Location of land on which proposed work will be done. Mop No.~/..*': .Z/./..~...'~........~..z...'.~..~.,. Lot No ..... ..~...../. ............ Street and Number .~...~.~.......~i,.~l ......... ....~...1~)..~ ...... ..~..?~. ........................................ ..~t.~..~.[~'~ .................. ~ Municipality 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 ..... ,~.~. ,~.~...... ]..t~..~....~. ....... Z'..~.~.~. ~ ,~..'~.. · . ./~.. ........... / 3. Nature of work (check which applicable): New Building'. ................. Addition .................. Alteration ................. ~ __~ . ~ ~ (Description) (to be paid on filing this application) 5. If dwelling, number of dwelling units ............ .~ ............. Number of dwelling units on each floor ............................ If gar~ge~ number of cors .............................. ~ ............................................................................................................. 6. If business, commercial or mixed occupancy, specify nature and extent of each ~pe of use ............................ 7. Dimensions of existing structures, if any: Front .,.~.*. .................. Rear ...... 7.~..~. .................. Depth ...~.~..~ ......... Height .....~.~.~. ............ Number of Stories ................................................................................................................. Dimensions of same structure with alterations or additions: Front .............. ~.~..~... Rear ............................ Dept~ ................................Height ............................Number of Stories ................................ 8. Dimensions of entire new construction: Front .................... · ............... Rear ............................ Depth ........................ Height .................... Number of Stories ..................................................................................................................... 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: ........................................................ ~3. Will lot be regraded. ...... .~.~ ............. Will excess fill be removed from premises: ( ) Yes (~) No Name of Architect .............................................................. Address ................................ Phone No ....................... Name of Contractor ............................................................ Address ................................ Phone No ....................... PLOT DIAGRAM Locate clearly and distinctly all buildings, whether existing or proposed, and indicate all set-~ck dimensions from property lines. Give street and block number or description according to deed, and sh~ s~reet names and indicate whether interior or corner lot. STATE OF NEW Y,,(~<,, , · [ S S COUNTY OF,,~¢,~.. ,~:~-----/~,~' ' .................... ~..~-~..¢'~....~..~...~:..~ ........ being duly sworn, deposes and says that he is the applicam /,~ame ~ indiwd' ual sig~'ng ,,d6nt racf) above na~ed. He 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 and 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 manner set fo~h in the application filed therewith. Sworn to before me this . ~ ........ ......... of ..................... , ........... Co,, ...... ......................................... "~ '~ ..... ' ~'""~'~'")'~ ". ~ ~ ~ (Signot~e ~applicant) NOTARY PUBLIC, State of Ne~ N~. 52-4522026 - Suffolk