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HomeMy WebLinkAbout12247-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall $outhold, N.Y. Certificate Of Occupancy No ........ ~5.'13.~.5~... Date .......... g...u~.u.~.~. 9 ............. ,19 .~. THIS CERTIFIES that the building ...... ~o..o.l.. .................................... Location of Property ...7.65 .............. .~.a. 2r.'p.e.~.~..7..R.d.: ............. .O.u.~.c..hg~.u.e' ... House No. Street H~mlet County Tax Map No. 1000 Section ....'1.'!. ']. ..... Block ........ .~ 9. .... Lot ....... 2./.©. .'[. ~... Subdivision ............... X .............. Filed Map No....x. .... Lot No ..... .x ........ conforms substantially to the Application for Building Permit heretofore ~ed in this office dated ~ 38 og ...... ..... g.~.ril..'1 ......... 19~5. pursuant to which Building Permit No ....... } ........ dated ............................April 5 19~. ?. , was issued, andconformstoalloftherequirements of the applicable provisions of the law. The occupancy for which this certificate is issued is ......... Inground pool & fence. The certificate is issued to ........... gZxl~I-[0NY. &, .PAT~I~.~J~-. ~.AG.O.~.Q .................. of the aforesaid building. I~/.~ Suffolk County Department of Health Approval .......................................... N6900~ UNDERWRITERS CERTIFICATE NO .................................................. Building Inspector Rev. 1/81 TOWN 0 $O~THO~D ~ BUILDING D£P~RTMI~NT TOWN~,HALL ' BUILDING, PERMIT (THIS PER~IT MUST BE KEPT ON THE PRE/~I! COMPLETION OF THE WORK ~UTHOP, IZED) Permissi°n is hereby granted to: tO at p~mise~ T~x Map No. pumJant Building I~spect~r. Fe~ $...~.~.~ .......... ..... Section IV No. ......... ~pproved bY the TOWN OF $OUTHOLD OFFICE OF BUILDING INSPECTOR P.O. BOX 728 TOWN HALL SOUTHOLD, N.Y. 11971 TEL. 765-1802 DATE: July /~, 1986 Dear: While reviewing ~our files I find that your expired pool permit l~q~ 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, Executive Adminstrator OCCUPANCY OR , WITHOUT C~TIFICATE ~ ~ ~'~?~:::~-~%~: OF OCCUPANCY ~,~.o.,~..~,~.~ R & H DRAFTING CORP. 2900 Hemp, Turnpike, #110 · Levittown, New York Phone 516-796-6336 SUBJECT FOBM NO. 1 ~ TOWN OF SOUTHOLD BUILDING DEPARTMENT ' TOWN CLERK'S OFFICE SOUTHOLD, N. Y. E×omined ................... 19 ........ Approved .................. iii:.~9'.':iiii:::. 19..~... Permit No. /~ L//'7 Disapproved a/c .................... i..."~~ .................................. j ...... Application No..../..?...?......~...Z.,~ ..... lilding APPLIGATIO~I FOR PERMIT ........ D..:2,..~ ........................... ,1 ~..~._~ .... a. This application must be completely filled Inspector, with 3 sets of plans, accurate plot b. Plot plan showing location of lot and of bui areas, and giving a detailed description of layout c c. The work covered by this application d. Upon approval of this app[ication, the shall be kept on the premises available for e. No building shall be shall have been granted by the APPLICATION IS HEREBY Building Zone Ordinance of Regulations, for the The applicant agrees admit authorized the Buildir of Southold, ~ildings, additions with ~licable laws, in, buildings f oe in ink submitted in triplicate to the Building tar will [p to adjoining premises or public streets o~ diagram which is part of this application. issuance of Building Permit. a Building Permit to the applicant. Such permit purpose whatever until o Certificate of Occupancy the issuance of a Building Permit pursuant to the unty, New York, and other applicable Laws, Ordinances or or for removal or demolition, as herein described. code, code, and regulations, and to (Address of applicant) State whether applicant is owner, lessee, Name of owner of premises If applicant is a corporate, signature of duly authorized officer. ................ ~'"" '~'"'(Name an~le ........ "/~"'"'~'""~"'of corporate ~/f~ ..................... cer) Builder's License No....~.J~..L~..~..~~.(~ architect, engineer, general contractor, electrician, plumber or builder. Plumber's License No ................................................. Electrician's License No ............................................. Other 'rrade's License No ............................................... Locetion of Iond on which preposeg wor~ will be done. ~P ~o.: ........................................ Lot No ......................... sf~t ~.a ~.~b.~q~c~...~..~...~~..~.u~...~ ................ ~:....:.:....:::.. ........ State existing us~dn~ occupanc~o~ premises and intended use and occupancy or proposea construchon: ~. [~i~i~i,~ u~ ,.d o~p~,w ..... .a~.~g~.~..ca%~ ................................................................ b. ~.t~.de~ .~...d oc~.p..cv ..... ~...-..--.----.~ ....... ............ ........................................ 3. Natur work (check which applicable): New Building'. ................. Addition .......... ..~..~.A, Iferation ........... : ..... (to be paid on fil ng this applicat on) 5. If dw~lling, number of dwelHn~ 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 ............ --Z. ............... 7. Dimensions of existing structures, if any: Front ..... .~..~,:...O.. .......... Rear ..... .~..~;~,,.O. .............. Depth .~..q~.~l. ........ Height ...2 .................. Numbgr of Stories ............... /, ................................................................................................ Dimensions of same structure with alterations or additions: Front ....................................Rear ............................ Depth ................................ Height ............................ Number of Stories ..,.., .......................... 8. Dimensions of entire new construction: Front ........ ~.C) ..................... Rear .....~..O. ................. Depth ....~.~. ............ Height .-~..~t~lK ......... Number of Stories ..... ..z~..~..~ ................................................................................................... Date of Purchase ................... i .................................... Name of Former Owner ........................................................ Zone or use district Jn which premises are situated ..................................................................................................... Does proposed construction violate any zoning law, ordinance or regulation: ...... ~ ........................................... Will lot be regraded' .~.~.~..... Will excess fill be removed from premises: ( ) Yes (X) , Name of Owner of premises J~Q~k~.:.~Q~. .............. Address .~.~l'b~..(C~Jl.:.., Phone No....:.' ................. Name of Architect ........ .O~./7)~. ......................................... Address ................................ Phone No ....................... Locate clearly and dfstinctly all;buildings, whether existing or proposed, and indicate all set-back dimensions fram property lines. Give street and block number or description according to deed, and show street names and indicate whether interior or corner lot. ~ 12~ -11. 12, 13. 14. STATE OF ,NEW YORK, I, c c COUNTY OF ...t~C~.~.f~...~.. .......... .... ; ............. i..~'~....:.~C~Ct.L~.Q...i.',..?...~... ......................... being duly sworn, deposes and says that he is the opplicam (Name of individual signing contract0 above n~med. He is the . 0-O~E~r- ...~..~..~...-- ...................................................... .................... : ......... '.. ~ (Contractor, agent, corporate officer, etc.) of,said owner or owners, and is du!y authorized to perform or have performed the said work and to make and file this application; that all stetement~ contained in this application are true to the best of his knowledge and belief; and tha~ the work will*,be performed in tBe manner set forth in the application filed therewith. Sworn to beta'Fa' me this Notary Public,. ....... t~.~ ....................... Co~inty .... .~...4~....~/J" ..................................... x / ' ature of opp,cent, '1 : Jl x~o,c~ oc~c~¢ c~hi~ obOE Oh xc~