HomeMy WebLinkAbout12413-zFORM NO. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
office of the Building Inspector
Town Hall
Southold, N.Y.
CERTIFICATE OF OCCUPANCY
No Z17803
Date FEB. 27, 1989
THIS CERTIFIES that the building.
Location of Property 2670 BOISSEAU AVE.
House No.
County Tax Map No. 1000 Section 055
Subdivision
SWIMMING POOL
Block 06
Filed Map No.
Street
Lot 11
Lot No.
Hamlet
conforms substantially to the Application for Building Permit heretofore
filed in this office dated JUNE 6~ 1983 pursuant to which
Building Permit No. 12413Z dated JULY 11~ 1983
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 INGROUND SWIMMING POOL AND FENCE TO CODE.
The certificate is issued to
CHESTER P. & HELEN T. FIN-NE
(owner,
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL
UNDERWRITERS CERTIFICATE NO. N607118 6/23/83
PLUMBERS CERTIFICATION DATED
Rev. 1/81
FOEM NO. ~
TOWN OF $OUTHOLD
BUILDING DEPARTMENT
TOWN HALL
SOUTHOLD, N. Y.
BUILDING PERMIT
(THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL
COMPLETION OF THE WORK AUTHORIZED)
N? 12413 Z
Permission is hereby granted to~-)/
..... ..................................
...... ~~/........~..~.~..,..... ~..,~-.. ..........
,o ....... ~..*:~...~:....~~.<~.~....~~....~....~ ../... .................
.............. ...~.~ ..................... ~,~.~....~ ......... ....~..~ ........................................................
et premises located o, .......~....~....~.. ......... ff~.~...,~.~.X~-~-.....~..~~. ....................................
......................................................................................................................... ~.~.~.~,.,~..
County Tax Map No. 1000 Section ..~..~..~: ....... Block ...~..~ ..........Lot No..~.,/../.. ...........
pursuant to application dated ........................................................ , 19 ........ , and approved by the
Building inspector.
Fee *../..~: ....
Building Inspector
Rev. 6/30/80
TOWN OF SOUTNOLD
BUILDING DEPARTMENT
TOWN HALL
SOUTHOLD, NEW YORK
765 - 1802
11971
APPLICATION FOR CERTIFICATE OF
NEW CONSTRUCTION ....... OLD OR PRE-EXISTING
OCCUPANCY
BUILDING ...... VACANT LANH ........
HOUSE NO. STREET HAMLET
Ovner or Ovners of Property ..........................
County Tax Nap No. 1000 Section ..... Block ..... Lot ........
Subdivision ....................... Filed Map ........ Lot ..........
Permit No .... Hate of Permit ..Applicant ...................
Health Dept. Approval .................. Underwriters Approval ..............
Planning Board Approval ................
Request for Temporary Certificate ....... Final Certificate
..... ,
Fee Snbmitted: ~....?..~../.~..c ,
APPLICANT...~. ................ ~ ...........
rev. IO/It~/gg
~ ' COMMENTS
FIELD INSPECTION
FOUNDATION (l~t__)
FOUNDATION
{2nd)
ROUGH FRAME &
PLUMBING
INSULATION PER N.
STATE ENERGY
q~DE
FINAL
ADDITIONAL COMMENTS:
.1ooo344 THE NEW YORK BOARD OF FIRE UNDERWRITERS
BUREAU OF ELECTRICITY
THiS ~ERTIFIE5 THAT
only the el~t~cal equipment ~ described below and i~troduced by ~ appHcan~ named on ~he above application number in the premises of
in ~he followi.g locatio.~ ~ B~sement ~ ~ Ft, ~ 2.d FL Section Block Lo~
was exami~d on ~ ~0 ~ 1~ and yound ~o be in compliance wish the r~qulre,nents of rhis Board,
FIXTURE
OUTLETS
DRYERS
JE~PTACLES
SWITCHES
1
FIXTURES RANGES ~OOKING DECKS OVENS DISH WASHERS EXHAUST FANS
SYSTE~AS
E R V I C E
OTHEE APPARATUS:
1-G.F.C.Io
~._~Sw~mi.r~ ~1) This certtfic~te coVer~ c~lie~uce at the date of ~tion o~y.
~-~us~ env~mts it is m~e~le to have fr~nt gest ~/or ~irs
~e ~ a qu~ific~
OF NEUTRAL
Phil Cordon
1~ Dean ~reet
Port Jel'~er~on Station, N.Y. 11776
I.A,o. 110
This certificate must not be altered in any manner; return to the office of the Board if incorrect. Inspectdrs may be
their credentials.
COPY FOB pUILD(NG DEPARTMENT. THIS COey OF, I MANNER.
76S-1802
BUILDING DEPT.
INSPECTION
FOUNDATION ~LST [ ] ROUGH PLBG.
FOUNDATION 2ND [ ] INSULATION
FRAMING )[' ~FI'NAL
REMARKS:
FORM NO. 1
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN HALL
SOUTHOLD, N,Y. 11971
TEL.: 765-1802
..... ,
Approved ...... l . me- it
(~uiidin~ [~specto~)
APPLICATIO~ FOR ~UILDI~G PER~IT
Application No.~..~./.-~.~. ........
Date .... lurta .6 ......... 19.83
INSTRUCTIONS
a. This application must be completely filled in by typewriter or in ink and submitted 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
or areas, and giving a detailed description of layout of property 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 Building Permit.
d. Upon approval of this application, the Building 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 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 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 all applicable laws, ordinances, building code, housing code, and regulations, and to
admit authorized inspectors on premises and in building for necessary inspections.
...... S.w. $.m..K.t, .rig..P.o. 91.s .......................
(Signature of applicant, or name, if a corporation)
(Mailing address of applicant)
State whether applicant is owner, lessee, agent, architect, en~neer, general contractor, electrician, plumber or builder.
...................................... A.g .e .n.t .....................................................
Name of owner of premises ............ .C.h.e.s.t..eT..F..! .n.h.e ...............................................
(as on the tax roll or latest deed)
If applicant is a corporation, signature of duly authorized officer.
(Name and title of corporate officer)
Builder's License No .... .6.1. ...................
Plumber's License No....N/.A. ..................
Electrician's License No..1.%0]~.-g ..............
Other Trade's License No. N./.A ..................
1. Loca~on which proposed work will be done .... E./. ~. B.o.i~e&t! .~.v~ ............ .~ ................
~x.-+ ?.,../.. Boiss.e.o¢. Av.e., ................. Soul;lie. id ..... ' ..................
I~;~~~t~ .... Street Hamlet
County Tax Map~/--No. 1000 Section .... ~ ......... Block '~ Lot.., {/~
Subdivision ..................................... Filed Map No ............... Lot ............... (Name)
State existing use and occupancy of premises and intended use and occupancy of proposed construction:
a. Existing use and occupancy .......... ire s £ d.e.nce ................................................
b. Intended use and occupancy 16×32. irtgr ouru:l, swimming..pooi, f..wit;.h .4.'..fence..lzo. oode, ......
3. Nature ofwork (check which applicable): New Building .......... Addition .... XX .... Alteration ..........
Repair .............. Removal .............. Demolition .............. Other Work ...............
. (Description)
5000
4. Lstimated Cost ........... . ...00 Fee .... ' ..................................
(to be paid on filing this application)
5. If dwelling, number of dwelling iunits ............... Number of dwelling units on each floor ................
If garage, number of cars .... i ...................................................................
6. If business, commercial or mixed occupancy, 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 ................... q.. Height ...................... Number of Stories ......................
8. I)imensions of entire new construction: Front ............... Rear ............... Depth ....... ' ........
Height ............... Number of Stories ........................................................
9. Sizeoflot: Front .......... i ........... Rear ...................... Depth ......................
10. Date of Purchase ............................. Name of Former Owner .............................
11. Zone or use district.in which premises are situated .....................................................
12. Does proposed construction vic!ate any zoning law, ordinance or regulation: ........... I,IO ...................
13. Will lot be regraded ............. ye 8 ............ Will excess fill be removed from premises: Yes No
14. Name of Owner of premises .l$~e~.t;er. F.£nne .... Address Bo. is s eau. Ave. ..... Phone No.. 765.~ 278.9. ....
Name of Architect ......... ~ ....hl ] A .......... Address ................... Phone No ................
Name of Contractor .Swim .King .PooJ-.a ....... Address g.t.e. ~ 25A ~..Rg.c.k.Y.. Phone No.. 755.-.8.1.99. ....
Poine
PLOT DIAGRAM
Locate clearly and distinctly alli buildings, whether existing or proposed, and, indicate all set-back dimensions from
property lines. Give street and block inumber or description according to deed, and show street names and indicate whether
interior or corner lot.
See attached survey
STATE OF NEW YORK,
COUNTY OF .. SJaf folk !S.S
........... M£che.l,e. Sm£t:h ....................... being duly sworn, deposes and says that he is the applicant
(Name of individual signing contract)
above named.
He is the ...................... i ......... Agen¢ ....................................................
I (Contractor, agent, corporate officer, etc.)
of said owner or owners, and is dul~ 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 manne~ set forth in the application filed therewith.
Sworn to before me this :
. ......