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Home My WebLink About12479-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. Certificate Of Occupancy No ....... .Z.1.5.9..0.1..'.. Date July 1, 1987 THIS CERTIFIES that the building . inground pool and fence. Location of Property 1355 Tuckers Lane Southold hi,~s'~ hid ....................... 's'&~i ....................... ~'~,~/e:~ County Tax Map No. 1000 Section .... .5.9 ...... Block . 10 .Lot 10 Subdivision ..... X Filed Map No. X .Lot No. X conforms substantially to the Application for Building Permit heretofore filed in this office dated ·.. A~lg¢~.% .~1 ,..1.9.~. pursuant to which Building Permit No. 12479Z 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. JUDITH FALKOWSKI The certificate is issued to ..................... [o~,,ie'r,~/~(~,$~,q~ ..................... of the aforesaid building. Suffolk County Department of Health Approval .................... N./..A ................... UNDERWRITERS CERTIFICATE NO ........... .N.6.1.3.8..2.2. ?...N5.9.0.3. 9.3 .......... PLUMBERS CERTIFICATION DATED: N/A Buikling inspector Rev. 1/81 FOF,~ NO. ~ TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N. Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL cOMPLETION OF THE WORK AUTHORIZED) Permission is Hereby gront..e..~,.:.~~...;~.,......~,.,~ ...... ~.....~..o.:... · .C~...~.~..¢..~.~.''~~_. _ _ "! .............................................. ....~.~..¢~L...~:.~.; ..................... m .......... ~...¢ ..~.~;.m...~.~.~.;:.~..~.~ ........................................................................... County Tax~'.Map No. lO00 Section .......... ..~.....C~. ..... Block ...... .~....0.. ........ Lot No ........ ./....0.. .......... and opproved by the Building Inspector. Fee $../.~'~...! .............. Building Inspector Rev. 6/30/80 TOWN OF $OUTHOLD Building Department Town Hall Southold, N.Y. 11971 765- 1802 Bt.DG. DEFT, TOWN OF SOUTH_. _ OLI3,, APPLICATION FOR CERTIFICATE OF OCCUPANCY Instructions A. This application must be filled in typewriter OR ink, and submitted ~a ~ 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. 2o 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 responslble 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 features. 2. Sworn statement of owner or previous owner es 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 New Dwelllng,$25.00, Accessory ,.$10.00 Business $50.00 2. Certificate of occupancy on pre-existing dwelling $ 5 0.0 0 3. Copy of certificate of occupancy $ 5.00, over 5 years $10.00 4.Vacant Land C.O. $ 20,00 5.Uodated C.O. $ 50.00 Date ,,.~...~.', 6. Alteration 925.00 NewCons tt~uc% ion..~,~.. Old or Pre-existing Building ............ Vacant Land ............. Location of Property ': '~¢ ...... House No. Street Hamlet Owner or Owners of Property County Tax Map No. 1000 Section .... . .'~..~. ......Block ............... Lot ..............., Subdivision ................................. FiJed 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 $ .ddt, .", ,?~,. ¢,:~, 1'''~' ~,0 Construction on above described building and permit meets all applicable codes and regulations. ' .i .......................... Rev. 10-10-78 THE NEW YORK BOARD OF FIRE UNDERWRITERS 1000~.{~3 BUREAU OF ELECTRICITY 4(} 85 JOHN STREET, NEW YORK NEW yORK 1OO3~ Date A~ ~, 1~83 Appl'cation No. on file 229~43/83 N6 1 3 THIS CERTIFIES THAT only the electrical equipment ~ describ~ below and introduc~ by t~ applicant na~ed on the able application nu tuber in the premises of in the foliowl.g location;[] Baseme.t [] ~st ri. [] 2nd ri. Outside Section mock rot was examined on and found to be in cornpliance with the r~quirements of this Board. &utmst 19~3 FIXTURE RANGES OVENS EXHAUST OUTLETS SWITCHES 1 2 DRYERS SYSTEMS NO. OF FEEt S E R I C W G NO, OF HI-LEG A W.G. NO, OF NEUTRALS A W~G NO Oi~ERCC~.COND OF/~C COND. OF HI-LEG OF NEUTRAL OT t . p..fys=. S~lmmin~ Pool: This certifieate covers compliance ~t the d~te of ~:inspecti~. Because of unustml environments it is advisable to have frequent test and/°r repairs made by a. qu~lified person. Per ~;~ _,, ~e~,~ ~ ~ e~d ~./~.~,~ j ~ v . un ~u.tu.~ ucC~n~lVlCl; i. ~.10 UUYY UP UbHIIF CATE-MUST NO~ BE ALTER;D THE NEW YORK BOARD OF FIRE UNDERWRITERS 100077~. BUREAU OF ELECTRICITY ~ 85 JOHN STREET, NEW YORK, NEW YORK 10038 /).t~ January 19, ..llc.tio. No.o,,/ll. N 590303 THIS CERTIFIES THAT in the following location; [] Basement [] 1st FI. Jaumry 13, 1983 FIXTURE FIXTURES OUTLETS FLUORESCENT [] 2,~d rt. at~d fou,td to be in co,vtpliance with the r~quirements of this Board RANGES OVENS DISH WASHERS EXHAUST FANS DRYERS S E R I C E NO. O~E~COND, A W.g. A. W O NO OF NEUTRALS 'A, W G OF CC. COND, OF HI4EG OF NEUTRAL OTHER APPARATUS: 1-O.F.I. (~.mtn_~ ~Oo%)Thi~ certificate covers cca~li~nc~ a~ the date O~ in~pe~ion oaly. ~ of uaUsual environments it is advisable to have freq~ea~ te~t and/or l~pairs made by a qualified person, Ruland Electric Oo. P.O. Bo~ 143 Nattituck, N,Y. 11952 GENE"AL Per _ This certificate must not be altered i. any manner; return to the office of the Board if incorrect. Inspectors may be identified by their credentials· · x ~u~ r~ ~ud:D~m~ DEPARTMENT. THIS COPT OF ~E~T~I~AT= ~U~ ~'~ -- ~; ...... ~- ' ' . , , ~ ~ .,~ ~ ~'U= ~eR. eD ~!~ ANY MANNER. TOWN OF SOUTHOLD OFFICE OF BUILDING INSPECTOR P.O. BOX 728 TOWN HALL SOUTHOLD, N,¥, 11971 TEL. 765-1802 Thls is to advise you that the job under building perrait no, ~247q~, issued to ,Judith Fa~kowski on ~./.~/~3 ...... for _Acq~.~.M_QiLZ is completed a fir}al znspection has ( ) has not ( X ) 'been done. and in nrder to complete this file, it ia necessary that a Certificate of Occupaucy be issued. Please fill out the enclosed form, return same to the above office with a chock for $10.00 payable to the Town of Southold. Please indicate to Whom the Certificate of Occupancy is to be mailed, and arrange with this office for an inspection date Occupancy or usc is unlawful without a Certificate of Occupancy. Please help us to clear up thi~ matter so that legal action does not I~ave to be taken. Thank you for yo.r prompt attention. Very truly Victor Lessard Executive Administrator VL:gar enc] . ~'i£~ INSPECTION FOUNDATION (1st) FOUNDATION (2nd) ROUGH FRAME & FLUMBING INSULATION PER N. STATE ENERGY qODE FINAL ADDITIONAL COMMENTS 765-1802 BUILDING DEPT. INSPECTION~ FOUNDATION lST [ ] ROUGH PLBG. FOUNDATION ZND ~ ~ INS~JLATION FRAMING ~]~FINAL FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N.Y. 11971 TEL.: 765-1802 Approved .~ .~'-~.~...~.., 19... Permit No. }. '.~.'J.?.~. '.~.. Disapproved a/c ........... ."~. · . .~'~.~. · · .............. ................................ ..... (Building Inspector) APPLICATION FOR BUILDING PERMIT Received ......... ,19. INSTRUCTIONS a. Tkis 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 i~ust 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 appl/cable laws, ordinances, building code, housing code, and regulations, and to admit authorized inspectors on premises and in building for necessary insoections. ..... ./~/.. ~d( ./~:.~: .Y...~. :. ?>,..:~..~.c.'. ........ (Signature of applicant, or name, if a corporation) ..p.:z....q~.q..~. f_~n~z-//~et," ,~./.. i~' .................... r:. ,. x¥ (Mailing address of applicant) State whether applicant is owner, lessee, agent, architect, eno~neer, general contractor, electrician, plumber or builder. .......... ~o/,.;:l~. ~.c. ; ~.LL. ...................................................................... Name of owner of premises ...... ':.~{{ ~.C( !/. ....../)~.q i/ot,!~lt i .................................... (as on the tax roll or latest deed) If appl'~c~aFt~i~ a---~F/corpor~/~jon,f~i/g~C]~'~e/f duly authorized officer. ....... / :3. ~ ~. .~!',: v.~: . f:>. ~: ~# ...... i,:.: e. : ...... / (Na~me and title of co~)'~ate officer) Builder's License No ....... ~.:. ?7.' f77..( .(? ..... Plumber's License No ......................... Electrician's License No. 0 ~ F-'~ 6 ~'~ ~Y Other Trade's License No ...................... 1. Location of land on which proposed work will be done .............................................. ¢. · .. 1,~3.'5'. ................. )7~.~.c.Y.-~'~.~: ../.~/.:.zi-. ............... f~.~d/./~.x,~. . . N., f , ............ House Number Street Hamlet County Tax Map No. 1000 S¢ction ....... ~,.~. ...... Block ..... /.0 . Lot Subdivision .................. ./~ Filed Map'$o.' i i ~.[[[[[[... (Name) 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy ..................................................................... b. Intended use and occupancy -z.f/~/f/YC)&/~i) .... ~C'.(?d.r:'y~ ~:~.li t.I./,~.., j~ .c[/:-.... '~ Z ./..'7.~.C.~ ...... 3. Nature of work (check which applicable): New Building .......... Addition .......... Alteration .......... Repair .............. Removal .............. Demolition .............. Other Work ............... 4. Estimated Cost ............................... Fee .... ' ................................. (to be paid on filing this application) $. If' dwelling, number of dwelling ~nits ............... 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 structure~, if any: Front ............... Rear .............. Depth ............... Height ............... Numlber of Stories ........................................................ Dimensions of same structure with alterations or additions: Front ................. Rear .................. Depth .................... i. · Height ...................... Number of Stories ...................... 8. Dimensions of entire new construction: Front ......... , ..... Rear ............... Depth ............... Height ............... ~um'ber of Stories ............... , ...................... e · · .............. 9. Size oflot: Front ....................... 10. Date of Purchase ........... .................. Name of Former Owner ............................. 11. Zone or use district in which pr~mises are situated ..................................................... 12. Does p~oposed construction vi,o. late any zoning law, ordinance or regulation:- ...... ............... v---x~ ..... 13. Will lot be regraded ........ ~'~. ................. Will excess fill be remove,d from premises: (~e_s~] No 14. Name of Owner of premises . '~?~. "/!/../~l.t.~(J?~).tf./Address i'~f.%q~f..~fl/~.%J~¢'//.~.~hone No ....... .~ ....... Name of Architect .......... i ................. Address ................ o" · Phone No ................ 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 Rumber or description according to deed, and show street names and indicate whether interior or corner lot. STATE OF NE~ YO~,.K , S S COUNTYr ~ O F ~" 'C/;~" '~f3~"' 'W-'7 ., .fiCt~ffi¢/¢/¢ ....~..¢.]J..t..~..,,~.~'¢~.: ............. ........ being duly sworn, deposes and says that he is the applicant (Name of indivillual signing contract) above named. He is the ..................... i ................................................................... "~k ' ' (C ' ce~ ) ',,, (' : V'," ,, ontractor, agent; Corporate'offl ,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, a, I1 statements contained in this application are trusto the best of his knowledge and belief; and that the work will be perfoianed in the mann?r se:t'forth in the application filea therewith. Sworn to befor~e this, .... day of. ~:t<t¢'~ j Notary Pub!i -J~ ...... ~. -Ch:mm'F- NOTARY ~UBLIC, State of New , , N~ 52,4524~71 .., ................... ' ~ ' ' ' Qualified in ~d~i~lk C0uhtv! ' ,/ - ' of applicant) Gommi~sion Expires March 30, ,