HomeMy WebLinkAbout12433-zFORM NO. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Office of the Building Inspector
Town Hall
Southold, N.Y.
Certificate Of Occupancy
No. Z16936 Date October Et ...
................................................. ,19 86
THIS CERTIFIES that the building ...... I.n.g.Co.u.n..d' .B.E 5:..m.m.5.n. 5. p.o.o. 1. ................
Location of Property ....................... Cutohogue, N.Y.
7.00 Glen Court ~ .......................................
House No. 0 8 3 0 ~treet Hamlet
County Tax Map No. 1000 Section ............ Block ............... Lot 0. ! ? & 017 · 1
Subdivision..H./.q..V.~.s.~.a...B.l.u.~ .f ............ Filed Map No..5.0.6.0....Lot No. ll & p/o. 12
conforms substantially to the Application for Building Permit heretofore fried in this office dated
ku.n..% .1.3. ~ ............ ,19 .8.3. pursuant to which Building Permit No ....... Z
12433 ...............
dated . .d...u .ly..2.0. ~ ................. 19..8.3, 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
The certificate is issued to Alfred Magill
(owner, I~,~yT~t
of the aforesaid building.
N/A
Suffolk County Department of Health Approval ........... ; ..... ' .........................
N608823
UNDERWRITERS CERTIFICATE NO ..................................................
Rev, 1/81
Ispector....
l~Ou~ NO. ~
TOWN OF $OUTNOLD
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? 12433 Z
Permission is hereby granted to:
...... ~.~,~.....~.,..~:...~o~../.~ .............
....... ~~ ........ ~.k.~ .............................
....... ;~.,%.~.,..~z..t...~...~..~:......z,z z~
,o ......... C.c/.z~.~:.~..c~... ...... ./.~.~..z~..~.~. ....... ...~, .....................
................................................................................ ~.../.~..~......Z~...~.~:~.~ ......... : ........
at premises located at ...~.~.C2.....~../~'.......~..~'.~,....'~.,2, ................. ~'~ '~Z~"'~'/~~'2' ''~'' ~7'
...... ~/~.?...~...~,~....~.~... ......... ~..~..~. ............ ~..~.z......~.¥...~.~..~,z
County Tax Map No. i000 Section ..~.....~....~.. ....... Block....~./,.......... LotNo.~../.~.....~..~../~'-/
pursuant to application dated .,...~.~'~'~:..,.~..~... ........................ , 19~ and approved by the
Building Inspector,
Building Inspector
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
Instructions
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 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 property showing all 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.
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.. ?:.//. :.~ ~.. ..............
NewConstruction ...... Old or Pre-existing Building ............ Vacant Land .............
Location of Property .~. Q p..~./~..~...~.0~/'¢..~.' ............... ~ .................... ~z..~ ~/~.
House No. ~- ~ .. S.~,~It
Owner or Owners of Property ./~.~.~..~. . .~...~'~7,z~.~..~..~-../~. .... .~..~..~./../r./_. .................
County Tax Map No. 1000 Section 2:~, 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 Certificate ..................... Final Certificate .......................
Fee Submitted $ .~..~0.0 ........................
Construction on above described building and permit meets all applicable codes and regulations.
Applicent ...............................
Rev, 10-10-78
6oq A
co% ;qq3&
~L~m~ THE NEW YORK BOARD OF FIRE UNDERWRITERS
BUREAU OF ELECTRICITY . ·
~g 8,5 JOHN STREET~ NEW YORK, NEW YORK 10038
THIS CERTIFIES THAT
only the e~trlcol equ~pmeng as described belo~ and introduced by t~ applicant Rained on the above appl~cat~o~ ~ber [n t~ pretenses of
in tbe /ottowing location; ~ Basement ~ 1st FI. ~ 2nd ri. ~l~ Section Block tot
and~ound to be in compliance with the requirements of this Board.
was examined on J~o ~
FIXTURE
OUTLETS
FIXTURES
RECEPTACLES SWITCHES
FURNACE MOTORS
RANGES/ KING DECKS OVENS DISH WASHERS EXHAUST FANS
DRYERS MULTI-OUTLET
SYSTEMS
NO. OF FEET
S E R 'V
1
OF CC COND,
C
~d
FaaaniL~vitle, N.Y.
117;38 LiC#I$M~
This certificate must not be altered in any manner; return to the office of the Board
COPY FOR. ~U!~OItN~G DEpARTMEnT.
may be
by their credentials.
TOWN OF
OFFICE OF BUILDING INSPECTOR
P.O. BOXY328
TOWN H~LL
SOUTHOLD, N.Y. 11971
TEL. 765-1802
To Whom This May Concern,
Please .complete the enclosed application for
Certificate of Occupancy and enclose a check for
$5.00 (%he-fee for the C.O.)'and I will be able to
complete the Certificate of Occupancy.
Thank you so much for your cooperation in this
matter.
FOUNDATION (ls%)
FOUNDATION (2nd)
ROUGH FRAME &
PLUMBING
INSULATION PER N. Y.
STATE ENERGY
qonE
~FINA~
COMMENTS
ADDITIONAL COMMENTS:
765-t802
BUILDING DEPT.
INSPECTION
[ ] FOUNDATION zST [ ] ROUGH PLBG.
[ ] FRAMING ~] FINAL
RI'MARKS: ,(~ ~ ........
FORM NO. 1
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN HALL
SOUTHOLD, N.Y. 11971
TEL.: 765-180:3
Approved ..... l . ..mermitmo. .....
Disapproved a/c .....................................
APPLICATION FOR BUILDING PERIVlIT
Application No./(..~. ~.~T.~. ......
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, a~t regulations, and to
admit authorized inspectors on premises and in building for neces~ry i,j~ections. .//' ~ ,f
· ......
, ~,t~, .of applicant, or name, if a corporation)
go..u.t.e, .2. .56.,..go..c.ky., ?.o.Ln.t.,..~X. t..~ 7.7.8. .......
(Mailing address o f applicant) 744-8100
State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder.
...................................... Age .n.~ ..............................................
Name of owner of premises . . .A.l..~.r.e..d. Hagill ...........................................
(as on the tax roll or latest deed)
If applicant is a corporation, signature of duly authorized officer.
........... ~1/^ ...............................
(Name and title of corporate officer)
Builder's License No .... 15.1 ....................
Plumber's License No... R/.A ..................
Electrician's License No. 1.101E ................
Other Trade's License No ...... R/.A ............
1. Location of land on which proposed work will be done. S./.s].de..Glen..Ct:,..7.6
....ZOO.. GLen. Caurt .......... Cut.chog~te ...................................................
House Number Street Hamlet
County Tax Map No. 1000 Section .... ()..~5..~. ....... Block ..... ~."). [ ......... Lot .... Q. [ ~.. ~/. ~f.'../
Subdivision..H..ap..of...V.i.s.[a...B.l..u.~.~ .............. Filed Map No...5.0.6.0. ........ Lot .... .1.~.. :-..(.~..CD
(Name)
State existing use and occupancy of premises and intended use and occupancy of proposed construction:
a. Existing use and occupancy ....... .o.n.e.. ~.a.m.~l..y. ?.e.s..~.d.e.n.c, .e ......................................
b. Intended use and occupancy . 2.QX40..txreg. utar..~.ngrr>und, s.wimmi.ng, pool .....................
~, Nature of~ork (cheek which applicabl~): New Building .......... Addition., ,)[ ...... Alteration ..........
Repair .............. Removal .............. Demolition .............. Other Work ...............
(]Description)
........... ........................ Fee .............................
(to be paid on filing this application)
$. If dwelling, numbar of dwelling iunits ............... Numbar o f 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 .....................
?, Dimensions of existing structures, if any: Front ............... Rear .............. Depth, ..............
}{eight ............... 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 ...............
}{eight ............... Number of Stories .................................... , ...........
9. Sizeoflot:Front... ~17' ,: Rear .~O6..~2' ..... .... Depth ....~)iE'.S..~
10. Date o£Purchase .......... ( .................. Name of Former Owner .............................
11. Zone or use district in which pr~mises are situated .....................................................
12. ; no
Does proposed construction violate any zoning law, ordinance or regulation: ................................
13. Will lot be regraded ....... ""'i ;y.e.~ .............. Will excess fill be removed from premises: X Yes No
14. Name of Owner of premises .6z..r r.e.d...M,g~,l~]. .... Address . .7.0.0. G~[.eB. Cg ...... Phone No
Name of Architect ........ 1~./..A ................ Address ................... Phone No ................
Name of Contractor . .S..~.J..m..K.t.n.g..P. 99.1.s. ...... Address .Rg.u.r.e.. 7.5.6 ........ Phone No...7.4.a. nS. !9.0. ....
Rocky potnt, NY 11778
PLOT DIAGRAM
'Locate clearly and distinctly alll buildings, whether existing or proposed, and, indicate all set-back dimensions from
property lines. Give street and block ~umber or description according to deed, and show street names and indicate whether
interior or corner lot.
STATE OF NEW YORK,
COUNTY OF...S..u.Ce.q~..k ...... :S.S
Marga.rel: Fros$ .
.................................. - ........ being duly sworn, deposes and says that he is the applicant
(Name of individual signing contract)
above named.
He is the A.g.e.n.~ '
(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 m the application filed therewith.
Sworn to before me this
Notary Public,. ..... '..(~.~.. ~. ........ , ...... County~ ~/n //
lq ~,, ',~'2.~}5'6433 '~ ~// (Signature of applicant)
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