Loading...
HomeMy WebLinkAbout11927-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. Certificate Of Occupancy No. Z-15718 Date May l, 1987 THIS CERTIFIES that the building . .A.b.o.v.e..C.r.o.u?.d..S.w.i..mm..~.n.g..r.o.o. 1. .................... fPr,~,~,~ ~ 3600 Pequash Avenue Cutchogue, New York Location o .... e~r~y ............................................................... House No. Street Hamlet County Tax Map No. 1000 Section ...1.0.3 ....... Block 14 .Lot 002 Subdivision ............................... Filed Map No ......... Lot No .............. conforms substantially to the Application for Building Permit heretofore filed in this office dated September 15, 1982 11927 Z ...................... pursuant to which Building Permit No ...................... dated .... .S.?,t,e,m?,e.r. ,2.2.,..1.9.8.2 ...... 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 ......... ABOVE GROUND S[4IHHING POOL AS APPLIED FOR The certificate is issued to DAVID R. ROHLEIN & PATRICIA ROIq~LEIN ..................... .................... of the aforesaid building. Suffolk County Department of Health Approval .. ' N/A UNDERWRITERS CERTIFICATE NO. N805763 N/A PLUMBERS CERTIFICATION DATED: Building Inspector Rev. 1/81 N©. 1~1927 Z Permission is hereby granted to: TOWN OF $~)UTBOI~ ii BUILDING DEPARTMENT TOWN HALL SOUTH*OLD, N~¥. BUILDING: pE~IT (THIS PERMIT MUST BE KEPT ON 'I~H,~ PP, E~IS~S UNTIL i ULL COMPLETION OF THE WORK AUTHORIZED) ;, Date < ' ..~ 19. tO ......~i ......... ; .......... ............ ;..;...: ....... :.....=~...~=~._~_~ ~"-'"~":-~-~ ...... ~.. .......... :,...,.....:. ............... at ptemises located at .~.6.~Q ........ ~;~.?~--:~...'~ ~ .......... ,. .......................... ...... '. ......... ~ ........................................... ~ ......... ...~...., ........... ...~...~.~ ~ .~...~.~ '[u~' T~x Ma- ~'o 1000 Secton ~:~ B k :~.2~ ,;.,~;Eot No ~ . purs~uant ~o application dated ~Z ....... ..~..J...~ ...... 19~and;~:9 ',~pprov~ by the Building ~spector. ~ ......-~'~'~ ~", 5 .......... ~ ..~.~ ~.~ ................................. , : :':' Butldtng~l~ector Rev. 6/30/80 FORM NO. 6 TOWN OF $OUTHOLD Building Department Town Hall Southold, N.Y. 11971 765- 1802 APPLICATION FOR CERTIFICATE OF OCCUPANCY 1 2 3 Instructions A. This application must be filled in typewriter OR ink, and submitted m~ 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 p~operty showing all property lines, streets, buildings and unusua! 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. Fees: 1. Certificate of occupancy $5.00 2. Certificate of occupancy on pre-existing dwelling 3. Copy of certificate of occupancy $1,00 4.Vacant Land C.O. $5.00 5. Updated C.O. $15.00 $15.00 Date.. F.~.. ~..~/?.~. ........... New C OhS t~ruc t i on ...... Old or Pre-existing Building ............ Vacant Land ............. Location of Property . .~.O.? ..... .~.~..OxO.'..~...q-..' . .~..~.. ..................... House No. Street Hamlet Owner or Owners of Property . . . . P. h !¢. ......................... County Tax Map No. 1000 Section ............... Block ............... Lot ................ Subdivision ................................. Filed Map No ........... Lot No .............. Permit No ........... Date of Permit .......... Applicant .................................. Health Dept. Approval ........................ Labor Dept, Approval ........................ Underwriters Approval ........................ Planning Board Approval ...................... Request for Temporary Certifi, cate ..................... Final Certificate ...... ~ ............. Construction on above described building,act6,permit~ts all applicable codes and regulations. Applicant~~. :'~ .......................... Rev. 10-10-78 Co& · TOWN OF SOUTHOLD OFFICE OF BUILDING INSPECTOR P.O. BOX 728 TOWN HALL SOUTHOLD, N.Y. 11971 TEL. 765-1802 APPLICANT: DATE: July ]q, 1986 Dear: Whil'e reviewing our files I find that your expired pool permit ~l~_ has never been finalized. Kindly return the enclosed application with a check for $~.00. Also, please call and arrange for a final inspection so that we may issue a Certificate of Occupancy on the above pool and complete this outstanding file. Yours Truly, Victor Lessa~d Executive Adminstrator O~UP^NCY OF~ USE IS UNLAtNFUL WITHOUT CFJtTtFD^TE OF OCCUPANCY ENCLOSE POOL TO CODE UPON .... COM PL,'--1 tON ~SFORE ....... WAT~: R ,~,'i~ v~ ~ ~ T: THE NEW YORK BOARD OF FIRE UNDERWRITERS BUREAU OF ELECTRICITY 85 JOHN STREET, NEW YORK, NEW YORK 1003e o.t~ April 27, 1987 465401/87 . No... s,,e N 805763 THIS CERTIFIES THAT only the electrical equipment a~ described belo~v and introduced by the applicant named on the ob~ve application number in the premises of in the following lo~ion; [] Basement [] Ist FI. [] 2nd FL o~tside .Seotlo. Bto~k Lot t~sexamlnedon ~'i~. ~6~ ~9~7 andfoundtobeinco.~plianceu, iththere¢luiretnentsqfthisBoard' /' PIXTURI~ FIXTURES RANGES OVENS OUTLETS SWITCHES SYSTEMS NO. OF PEET OTHER APPARATUS: 1 GoFoC.-~. E R V I C NO. Olde RCC,~CON D A W G NO OF HI-LEG I A.W. G OF CC, COND I OF HI-tEG E NO OF NEUTRALS A. W G OF NEU'[RAL David R. R~mle~] Cutchcgue, N.¥o 11935 MA ER nm be omtered in ony monner~ return fo ~he office o~ ~e Boor~ i~ in~o?rect inspect rs moy be identi~;~b? their ~redenfio~s. ~~RIMENT. THIS COPY OF qERTIFICA:~E,M~}NQT BE aL~ERED N ANY ~NNER '~J FIELD INSPECTT~ON FOUNDATION ( 2nd ) ROUGH FRAME & PLUMBING INSULATION PER N. STATE ENERGY ~pDE FINAL COMMENTS ADDITIONAL COMMENTS: 765-18~2 BUILDING DEPT. INSPECTION FOUNDATION 1ST [ ] ROUGH PLBG. FOUNDATION 2ND [ ] INSULATION FRAMING ~] FINAL INSPECTOR 765-1802 BUILDING DEPT. INSPECTION FOUNDATION IST [ ] ROUGH PLBG. FOUNDATION 2ND'[ ] INSULATION [ ] FRAMING REMARKS: FINAL DATE ~/'~;/ GL INSPEL'~I'OR FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N.Y. 11971 TEL.: 765-1803 Ex=ined.. .A . ...... Disapproved a/c.. .......... ~ ......... ./~ ....... / / C ,ild g fnspector> APPLICATION FOR BUILDING PERMIT IN'Si, RUCTiONS Date .~'..~..: a. This application must be completely filled in by typewriter or in ink and submitted to the Buildin{ Inspector, with 3 sets of plans, accurate plot plan to scale. Fee acconiia{ to schedule. b. Plot plan showing location of lot and of buil~ on premises, relationship to adjoinin8 preimises or public streets or areas, and giving a detailed description of layout of )/oporty must be drawn on the diagram which is part of this appli- cation. c. The work covered by this application may not be commenced before issuance of ~ Permit. d. Upon approval of this application, the Buildin~ Inspector will issued 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 par~{~ any purpose whatever until a Certificate of Occupancy shall have been granted by the Building Inspector APPLICATION iS HEREBY Mi~E to th~ Building Depathue~t'~loff the iseuance of a Building Permit pu_rm..~t to the ~, .~.. zo~ ~ca~ o~,~ ~o~, ~r-.Sou~o,d. Su~rotk Cou~,~ew York..nd :other apphble ~w., Onman~ or Re~lations, for the cons{Fu~ii0n 'of ~uildtn{s',~sddiltoas or alte~tidhs, or for removal or demolition, as helmi~ d~scribed. The applicant agrees to bbmply wlth.~U uppli~ble lawS;'orai~aes. , b~.~.c.ode~ _housing code, and regulations, amid to a~lmi~ au ,thorized inspeato~s on lmmfl~s and in~buildin~ ,for ne~~~ ' .~ :~ pplicant, or name, if a corporation) · of applicant) * ' , '., (Mailing a~klress / State whether app~li~/mt is owner, lessee, agefit, architectL engineer, ~eneial contractor~ electrician, plumber or builder. ...... ..................... ..,. ............................ ............................ (assort the tax roll or latest deed) If applicant is a corporation, signature of duly authorized officer. (Name and title of corporate officer) Builder's Ltcon' N~.~ J.~i ~'~ ,... Plumber's Licens~ NO ......................... Electrician's License No ....................... Other Trade's License No ................. ..... 1. Location of land on which proposed work will be done .................................................. · 3 ,.oo ..................... ......... ................ House Number Street Hamlet County Tax Map No. 1000 Section .[O.~...O.O. ....... Block . J.~...O.(~. ........ Lot..O..~ .:~ .... Subdivision ....... (Name) Filed Map, No. Lot 2. State existing use and occupancy of premises and intended use and occupancy ot proposed constructiun: a~ Existing use and occupancy ..... ~ ................................ .......................... b. Intended use and °C°Upancy ....~.(~ ..... '. CO ..................... 3. Nature of work (check which applicable): New Building .......... Addition .......... Alteration .......... Repair ' Remo4ai' ... - ' Demolition Other Work i~$(.~..t~. /:tflO0~ ~-~.oo~O />o~t~.' (Description) ' · °° ' · 4. Estimated Cost. · ..... ........... Fee ...................................... (to be paid on filing this application) 5. If dwelling, number of dwelling units ............... 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. Bimensions of existing structures, if any: Front ............... Rear .............. Depth ............... Height ............... Number of Stories ........................................................ Dimensions of same structure w!th alterations or additions: Front ................. Rear .................. Depth ...................... Height ...................... Number of Stories ...................... 8. Bimensions of entire new construction: Front ............... Rear ............... Depth ............... Height ............... Nun~ber of Stories ........................................................ 9. Size of lot: Front .... (O.C~...-/[.~ .......... Rear .... /.Ot~)..7~.~. ......... Depth ../~q'O...~. .......... 10. [)ate of Purchase . ~'td..v]. tg./f gt ............. N,~me of Former Owner ~'¢~..~.q~. 11. Zone or use district in which promises are situated .... K~;5, ............................................ 12. Does proposed constructiqn violate any zoning law, ordinance or regulation: ...AJ..q ........................... 13. Will lot be regraded ..... ~J"O.. i ..................... Will excess fill be removed from premises: Yes ~ No 14. Name of Owner of premi§es ~)$g.!.c[..~. ~.V.a~. !t.t*.~..~9~]~f~ress ~..~.O .*O/-~.~8 ...... Phone No. ~.t/. ~,2,~ ~.. .... Name of Architect .. ?./.Pt ..................... Address ................... Phone No ................ Name Of Contractor ......... ~ ................. Address ................... Phone No ................ PLOT DIAGRAM Locate clearly and distinctly all buildings, whether existing or proposed, and, indicate all set-back dimensions from property lines. Give street and block number or description according to deed, and show street names and indicate whether interior or corner lot. t ! STATE OF NEW YORK, COUNTY OF .~..o,.e f-7..t_~.. ..... S.S ...~....~..t.?... g.- . .~. fi...tt~..L..e-!,,.~' .................. being duly sworn, deposes and says that he is the applicant (Name of individual signing contract) above named. , He is the .... (~. ~...~..../~. ....... ................................................................... · , (Contractor, agent, corporate officer, etc.) of said owner or owners, and is duly authorized to perform or have performed the said work and to make and file this application;~that all statements contained in this application are true to the best of his knowledge and belief; and that the work will be performed in the manner set forth in the application filed therewith. Sworn to before me this ........... )/ ....... y of'~ ./.'-~...: ..... ,19... Nota. Pubii , County ~IOTA~¥ ~PUBLTC, State o~ ~ ~*~ .~c. %x~~, ,~.'. i':;...'7¥,v. ~.. ~ ........ ,.. · . N,. ~2-a$~2;'40 (Sigriatui'e 6f'applicaht) Qualified in Suffolk Cou~ ~:~ ~sssian ~xpire$ Mamh ~0, ~9 ~.,¥;