The URL can be used to link to this page

Home My WebLink About12644-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No Z17416 Date OCTOBER 14~ 1988 THIS CERTIFIES that the buildin~ SWIMMING POOL Location of Property. 1295 ELIJAHS LANE House No. Street County Tax Map No. 1000 Section 108 Bloc~ 04 subdivision ELIJAHS LA EST. Filed Map No. Lot MATTITUCK H~let 7.7 Lot No. 5 conforms substantially to the Application for Building Permit heretofore filed in this office dated SEPT. 29, 1983 pursuant to which Building Permit No. 12644Z dated SEPT. 29~ 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 INGROUMD S%~IMMING POOL. The certificate is issued to PETER & JUDITH VICTORIA (owner, of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL UNDERWRITERS CERTIFICATE NO. N623188 11/11/83 PLUMBERS CERTIFICATION DATED N/A Rev. 1/81 B[~ i 1-di'n~ Inspector FO]B,~ 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) 1~. 12644 Z Permission is hereby granted to: ~..~...A~..~.9 .............................................. .i..,~~..,....~.: ...... u.,.t~.~..~ ~ ,o .,~~..,...~...~~,...~,~;.,~ ........ at premises located at ../.~..~..~. ......... ,~.....c~.,...,~.~ ............. /.~ ............. County Tax Map No. 1000 Section ...... ]...0....'~. ......... Block ........ ..L~. .......... Lot No.....~...:..~. ........... pursuant to application dated ...~.~.....~ .......... , 19.%2.,~, and approved by the Building Inspector. Fee $.1..~.;.~ ..... Building Inspector Rev. 6/30/80 FORM NO. 6 TOWN OF $OUTHOLD Building Department Town Hell $outhold, N.Y. 11971 76.5- 1802 APPLICATION FOR CERTIFICATE OF OCCUPANCY Instructions This application must be filled in typewriter OR ink, and submitted .- ammmm= 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 uncial natural or topographle 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 R. esidences 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 property showing all property lines, streets, buildings and unusual natural or topographic features. 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. C. Foes: New DweLling,S25.00, hcce,~sory ,,$10.00 }3ustne.~ $50.00 1. Certificate of occupancy 2. Certificate of occupancy on pre-existing dwelling $ 50. O0 3. Copy of certiflcate of occupancy $ 5.00, over .5 years $10.00 ,. na c.o. o.oo .... 5.U~dated C.O. $ 50.00 Date ............ 6. hlteration $25.00 New C o n s t. r' u c t. i on Old or Pre-ox isting Building Vacant Land Location of Property .................. House No. Street ~ Hamlet Owner or Owners of Property ...................................................... County Tax Map No. 1000 Section .../.'.d?.~.~ ....... Block ...... .~. ...... Lot ..... ~.t .~.7 ....... Subdivis,o n .~.)..J].~//. .............. .~..~... / ~ ~, 5/c/ of Permi{ Applicant Permit No ........... Date .......................................... Health Dept. Approval ....................... Labor Dept. Approval ........................ Underwriters Approval ....................... Planning Board Approval .................... Request for Temporary Certificate .................... Final Certificate ..................... Fee Submitted $ ............................ Construction on above described building and pe~,r~it meet{~ all applicable codes and regulations. Applicant .../. v: ...... v.- .................................... looo:~o~ THE NEW YORK BOARD OF FIRE UNDERWRITERS ~ ~- 8.5 JOHN STREET, NEW YORK, NEW YORK 10038 ~ THIS CERTIFIES THAT only the electrical equipment ~ ~scribed bel~ and introduced by the applicant ~med on the ab~e application nusnber in the prendses of in the/allowing location; ~ Basement ~ 1st FL ~ 2nd FI. ~1~ Section Block Lot was examlned on ~i' ~ ~ ~ and found to be in compliance with the requirements of this Board. FIXTURE I FIXTURES RANGES OVENS DISH WASHERS OUTLETS ~ECEPTACLES SWITCHES FLUORESCENT I 1 2 SYSTEMS OTHER APPARATUS: E NO, o ~C~.CON D. OF CC. COND C NO OF HI-LEG OF HI-LEG NO, OF NEUTRALS John Iadem~ Harbar Laae Cutcho~e, N,Y. 1i~5 OF NEUTRAL GENERAL MANAGER This certificate must not be altered in any manner; return to the office of the Board if ncorrect. Inspector~ may be dentifJed b their cred -- ~ARTMENT'THISCOP¥OFC~RTIFI,CATEMUST!NO~B~'~LT~En~n m ^m~'aaaa,m=~, ~( ~ I FIELD INSFECTION FOUNDATION FOUNDATION ROUGH FRAME & (1 FLUMBING 3. INSULATION PER N. STATE ENERGY C~E DATE COMMENTS m{ st) ~[ Ind) m 7/. ~ ,. ~/ ~-, I1~.' ~ , FINAL TOWN OF SOUTHOLD OFFICE OF BUILDING INSPECTOR P.O. BOX 728 TOWN ItALL SOUTHOLD, N.Y. 11971 TEL. 765-1802 This is to advlae you that the job under building perrn~t no. 12644Z issued to Peter Victoria on _.3~ ...... for Accessory is completed a final inspection has ( ) has not (' X )'"been done. and In order to complete this file, it'is necessary that a C¢,rtificate of Occupancy be issued. Please fill out the enclosed form, return same to the above office with a check for $10.00 payable to the Town of Southold. Please indicate to Whom the Certificate of Occupancy is to be mailed, and arrange with tills office for an inspection (late Occupancy or nsc ia nnlawful without a Certificate of Occupancy. Please. help tls to clear up thls~ matter so that legal action does not have to be taken, Thank you for your prompt attention. Very truly f~, Victor Leasard Executive Administrator Vl.:gar cnc]. 765-1802 BUILDING DEPT. INSPECTION FOUNDATION 1ST [ ] ROUGH PLBG. FOUNDATION 2ND [ ] INSULATION []FRAMING [~FINAL//~-~____~..~ REMARKS: ~'~.~ ,:;~2,Z~. DATE INSPECTOR _~'~ 765-1802 BUILDING DEPT· INSPECTION [ ]FOUNDATION IST [ ] ROUGH PLBG. [ ] FOUNDATION ZND [ ] INSULATION FRAMING REMARKS:~ ~NAL FORNI NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N.Y. 11971 TEL,: 765-1803 Examined...~?~...°~..cJ.., 19~..~. Approved.... .. i Permit No.. 1. Disapproved a/c ..................................... ................................ .... (Building Inspector) APPLICATION FOR BUILDING PERMIT Received .......... ,19... INSTRUCTIONS a. This application must be completely filled in by Wpewriter 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 Buildhzg 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 insp~tipns. (Signature ot' applicant, or name, if a corporation) ..... /./~. .o. .................... ,,.... ,,. (Mailing address of applicant) ! State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. ............ ........................................................ Name of owner of premises ..... /~.,-f-a~... ~r.... ' ............................................ (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 .... ~.~ .~.~.' ................ Plumber's License No....~. ,/.~. ~..?. ............ Electrician's License No...Z,, ooo ~ Other Trade's License No ...................... 1. Location of land on which proposed work will be done .............................. o .................... ........................ £z. :.5-. .............. ................ House Number Street Hamlet County Tax Map No. 1000 Section . . ./~)~:~ ......... Block ...... ~.. ......... Lot....~'..7. ............ Subdivision .~....~--~'~...~ .... .~.c ,~../... Filed Map No ............... Lot...~...'77. ......... (Name) 2. State existiug use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy ...... ~ ........................................................ Intended use and occupancy .... . .ff .~. t,'~.~,d.~.~/jf .... .~.?.O../. .... ........ r ........................... b. 3. Nature of work (check which applicable): New Building .......... Addition .......... Alteration .......... Repair .............. Removal .............. Demolition .............. Other Work ~/~.~..~...~...g%. : (Description) 4. Estimated Cost ....... ~., O.0. .~. ................ ~ ....... Fee ...................................... : (to be paid on filing this application) 5. If dwelling, number of dwellinglunits ............... 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. Dimensions of existing structures, if any: Front ............... Rear ............ ~.. Depth ............... Height ............... 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 ............... Height ............... Number of Stories .................... ' .................................... 9. Size of lot: Front .......... ~ ........... Rear ...................... Depth ...................... 10. Date of Purchase .......... ; .................. Name of Former Owner ............................. 11. Zone or use district in which premises are situated ..................................................... 12. Dales proposed construction violate any zoning law, ordinance or regulation: ................................ 13. Will lot be regraded ........ ! ................... Will excess fill be removed from premises: Yes No 14. Name of Owner of premises .. i ................. Address ................... Phone No ................ Name of Architect ......... ; ................. Address ................... Phone No ................ Name 'of Contractor ........ ! ................. Address ................... Phone No ................ PLOT DIAGRAM Locate clearly and distinctly al! 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. ATE OF N~E~)RK~'/ /2 Z~ iSS\ · 'r('I~a~'o'f'ifi~;vifi '~_.~fining contract) above named. o / being duly sworn, deposes and says that he is the applicant He is the ................... d~64m~-*~4~. ......................................................... (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 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 ......... .....c~ .~gL~77. 7 :'day o~ :".., 19 .~'.~ ~fOTARY PUBLIC, ~tate o! Rew YOt:K,. , ~ 1/ ,' ~~.~o~/ ' -- (Signature of applicant) i Term Exbires Merch ~. 19,,~/