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HomeMy WebLinkAbout12485-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. Certificate Of Occupancy THIS CERTIFIES that the building Inground Poe]. w±th Dock Location of Property . .17.0.0. ................... .O?.e..5..u.~.e...h.a.n.o. ........ ~.a.~.~..i.t.u.c.k.... House No. Street Hamlet County Tax Map No. 1000 Section 122 .Block 04 . .Lot 004 Subdivision .......... .X .................... Filed Map No ......... Lot No .............. conforms substantially to the Application for Building Permit heretofore filed in this office dated ·..~.u.g .u.a.L.....5 ........ 19 .8.3. pursuant to which Building Permit No. 12 4 8 5 g dated ..... ~.u. $.u.s.t...~.1 ............. 19..., was issued, and conforms to all of the requirements of the applicable provisions of the law. The occupancy for whiclx this certificate is issued is ......... ...... Construct In,round Swimming Pool & Deck ...... The certificate is issued to DAVIS, CLAUDE E. , JR. (owner,:~ff~.~:~r~) of the aforesaid building. Suffolk County Department of Health Approval tq/A UNDERWRITERS CERTIFICATE NO .... N 7 4 412 9 Building Inspector Rev. 1/81 l~'OB~ NO. ~ TO~VN 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) 12485 Z Permission is hereby granted to: .......... C'~.~.~...~..~...~c.~... ........ ~..~.~?..~.~/~..x...~/,: ...... : ........ x.~..?~ . ,/.....~....~.~.~e....~-~Z..,..,.~.~ ................................................... ....../... ........................ at premises located at .../....~...(~....~.. ............... ./.~...~.~.. ...... · .,~.../.~-....d .~../~'~,~ .............................. ............................................................................................................... ~/~.,e. ..~.zTo.~..::~..~.Y Coun~ Tox Map No. 1000 Section ..... /.z~.~. ....... Block ..... ~....~... ...... Lot No...~....~...,,~... ....... pursuant ,o application dated ..,.././.~'~...~..~........~.... ............ , 19 .~.~., and approved by the Building Inspector. /~. Fee $.; ............... : ...... Rev. 6/30/80 FORM NO. 6 TOWN OF SOUTHOLD Building Department Town Hall Southold, N.Y. 11971 APPLICATION FOR CERTIFICATE OF OCCUPANCY Instructions This application must be filled in typewriter OR ink, and submitted ia~ 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 p:Coperty 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. C. Fees: 1. Certificate of occupancy $5.00 2. Certificate of occupancy on pre-existing dwelling $15.0 0 3. Copy of certificate of occupancy $1.00 / / 4.Vacant Land C.O. $5.00 - New Building ,,; .......... Old or Pre-existing Building ............ Vacant Land ............. Location of Property ":..?.:'J o-. ' House No. t Street ~ Ham/et Owner or Owners of Prope .. ............ ....... County Tax Map No. 1000 Section ,.../, .~ ........ Block ...... ,~. ....... Lot ........ Subdivision ......................... .t .,, .... Filed Map No .... ....... Lot No ............... Permit No/~,.~/.~. ,~. ,~, Date of Permit .~1/,//. ?.-?.Applicantj / .,~,~'.~.',~...~, 1'¢~.~-.~, l;~~ ...... Health Dept. Approval ........................ Labor Dept. Approval ........................ Underwriters Approval ........................ Planning Board Approval ...................... Request for Temporary Certificate Final Certificate Fee Submitted $ .... ~., 8, ¢ .... ., ,~,..4~, 1 ....... Construction on above described building and perm[t meets ~Fa~-~-[cable codes and regulations. cc~C~_.~ ,-~%,~%~--tq '~(e~ ' Applica ~. ................. Rev. 10-10-78 PERMIT NO. NEW YORK STATE DEPARTMENT OF ENVIRONMENTAl- CONSERVATION '10--83--O923 PERMIT UNDER THE ENVIRONMENTAL CONSERVATION LAW E ARTICLE 15, (Protection of Water) [] ARTICLE 25, (Tidal Wetlands) ARTICLE 24, (Freshwater Wetlands) ~L~I ARTICLE 36t (Construction in Flood Hazard Areas) PERMIT ISSUED TO Claude E. Davis, Jr. ADDRESS OF PERMITTEE Box 17, Ole Jule Lane, Mattituck, NY 11952 LOCATION OF PROJECT (Sechon of stream, tidal wetland, dam, braiding) James Creek, west side of Ole Jule Lane, south of lands now or formerly Cabave' DESCRIPTIONOFPROJECT~nd north oF~land~ now or Tormerly Siemerling Construct 16'x32' swimming pool with long side 5' from back of house~ and 3' -wid~g~pool~ COMMUNITY NAME (C~ty, Town, Vdlage) TOWN Mattituck Southold COUNTY F~ COMMUNITY NO. DAM NO. Suffolk GENERAL CONDITIONS 1, The permittee shall Die In tile office of the appropriate Regional Permit Administrator, a notice of intention to commence work at feast 48 hours in advance of the time of commencement and shall also notify him promptly in writing of the completio*r of the work. 2. The permitted work shall be subject to inspection by an authorized representative of tile Department of EnvironmentaJ Conservation who may order the work suspended if the public interest so requires. 3. AS a condition of the ~ssuance of this permit, the applicant has ac- cepted expressly, by the execution of the application, the full legal respon- sibility for all damages, d~rect or indirect, of whatever nature, and by whom- ever suffered, arising out of the project described herein and has agreed to shall be removed evenly, without leaving large refuse piles, ridges across the bed of the waterway or flood plato or deep holes that may have a tendency to S. Any material to be deposited or dumped under th~s permit, either in at the locality shown on the drawing hereto attached, and, if so prescribed thereon, within or behind a good and substantial bulkhead or bulkheads, such 6. There shall be no unreasonable interference with navigahon by the work herein authorized. Jn the posit~on of the structure or work herein authorized, or if, in the opinion of the Department of Environmenlal Conservation it shall cause unreasonaNe condihon the navigable and flood capacity of the watercourse. No claim shall PERMIT EXPIRATION DATE Sept. 30, 3-983 8. That the State of New York shall in no case be liable for any damage or injury to the structure or work herein authorized which may be caused by or result from future operations undertaken by the State for the conservation or improvement of navigation, or for other purposes, and no claim or right to compensation shall accrue from any such damage. 9. That if the display of lights and signals on any work hereby authorized is not otherwise provided for by Jaw, such lights and signals as may be pre° scribed by the Umted States Coast Guard shall be mstalled and maintained by and at the expense of the owner. 10. All work camed out under this permit shall be performed in accor- dance with established en§meenng practice and m a workmanlike manner. il. If granted under Articles 24 or 25, the Department reserves the right to reconsider this approval at any time and after due notice and hearing to continue, rescind or modify this permit in such a manner as may be found to be just and equitable, if upon the expiration or revocation of th~s permit, the modification of the wetland hereby authorized has not been completed, the applicant shall, without expense to the State, and to such extent and m such time and manner as the Department of Environmental Conservation may require, remove all or any pomon of the uncompleted structure or DII and restore the s~te to its former conditron. No claim shall be made against the State of New York on account of any such removal or alteration. 12. This permit shall not be construed as conveying to the apphcant any nglrt to trespass upon the lands or interfere with the riparian rights of others to perform the permitted work or as authorizing the ~mpairment of any rights, title or interest in real or personal property held or vested in a person not a party to the permit. 13. The permittee is responsible for obtaining any other permits, ap- provals, lands, easements and rights-of-way which may be required for this pro)ecl~. 14. If granted under Article 36, this permit is granted solely on the basis of the requirements of Article 36 of the Environmental Conservation Law and Part 500 of 6 NYCRR (Construction m Flood Plain Areas having Special Flood Hazards - Building Permits) and in no way signifies that the project will be free from flooding. 15. By acceptance of th~s permit the permittee agrees that the permit is contingent upon strict compliance with the special conditions on the reverse s~de. 95-20~4 (9/75) SPECIAL CONDITIONS 1. There is to be no disturbance to vegetation or topography within 50' of mean high water by ~onstruction, excavation, filling, grading, clearcuttin temporary or pennanentlplacement of construction materials or debris. See additional conditions A-J PERMIT ISSUE DATE July 29, 1983 cc: U~ACE '/~) "~ ~ ~ %~ '~'~ ADDRESS J PERM T ADMINISTRATOR ,/ ~ ~/ ~/~ ~ t Danie!' J. Lark%~J~%%~/~'~"'~J~SDEC Bldg ~0 SU~ Stony Brook TOWN OF $OUTHOLD OFFICE OF BUILDING INSPECTOR P.O. BOX 728 TOWN HALL 5OUTHOLD, N.Y. 11971 TEL. 765-1802 October 22,1985 To Whom This May Concern, We are unable to complete your Certificate of Occupancy because ,of the following reasons. /~ An application for Certificate of Occupancy is not on file. /~ ~The check i~--ouLd~ted. /~ No final inspection has been made. Please contact our office on this matter. Thank you for your cooperation. Building Permit # Expiration Date ~~ Building Dept. Sincerely your~s, Dorothy~.~Mi_dgley(~ Bldg. De~t.' Sec. FIELD ~NS?~TION COMMENTS FOUNDATION (1st) FOUNDATION 2nd) 2. ROUGH FRAME & PLUMBING INSULATION PER N. Y. STATE ENERGY C~gDE FINAL ADDITIONAL COMMENTS: .ooo a THE NEW YORK BOARD OF FIRE UNDERWRITERS BUREAU OF ELECTRICITY ~ . ~ ,,*~'~g ~5 JOHN STREET, NEW YORK, NEW YORK 10038 ivas examined on ~ ~ ~ ~ &~k~5 and found to be in compliance with the requirements of this Board. FIXTURE FIXTURES RANGES OVENS DISH WASHERS EXHAUST OUTLETS SWITCHES FLUORESCENT J ~ DRYERS SYSTEMS NO. OF FEET E R V I C NO, OF CC COND. PER ~' AWG. OF CC, COND. NO. OF Hi-LEG AW, G OF HI LEG NO OF NEUTRALS AWG. OF NEUTRAL OTHER APPARATUS: t-G, 1,'o ~ t~;f ~ envlro~nt;~ il; ~.; [~vl~bte to ~ve fr~en~ test ~/or repai~.'~ Glenn R. Br. wtley Horton Ave. RFD Nattituck, N.Y. Lic. 1327 Per This certificate must not,be altered in any manner return to the office of the Board if incdrrect, Inspect s m~y. be ident f ed by the r credent COPY FOR ~U LD[NG DEPARTMENT TH S COPY OF CERT FICATE ~'US~ N~T BE ALTE~E~ N ANY MANNER FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N.Y. 11971 TEL.: 765-1803 ^pp oved ..... ,l ..4ee itNo. Application No,../.~...~..~.~: ...... Disapproved a/c ........ i ........................... APPL,CAT,ON FOR BU,'D,N PERM,TDate ...... SJ 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. (Signature of applicant, or name, if a corporation) (Mailing address of applicant) State whether applicant i~lessee, agent, architect, engineer, genera contractor, electrician, plumber or builder. ....................... i '.O:/.d.O. '.P. ..... F .... '0. i ....... i ............................ Name of owner of premises . .X:~ 4, ......................... ~lv~- ............................. (as on the tax roll or Pfitest 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 ....................... House Number Street Hamlet County Tax Map No. 1000 Section .... .]?..~ ......... Block...Z~. .............. Lot ................... Subdivision ................ ('~a'n~) ................ Filed Map No...~.. Lot i.~.. .~. 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy ...... ~.4 .......................................... b. Intended use and occupancy .... f...t?~.../. ..... ~.. ~.. ~..~...~...-~. ................. 9. 13. 14. Nature of work (check which applicable): New Building .......... Addition ......... Alteration .......... Repair .............. Removal .............. Demolition .............. Other Work ............... F fimated Cost F ; (to be paid on filing this application) If dwelling, number of dwellingiunits ..... / ......... Number of dwelling units on each floor.....~. .......... If garage, number of cars .... i ..... { .................................................. - ............ If business, commercial or mixe'd occupancy, specify nature and extent of each type of use . .-7. .................. Dimensions of existing structures, if any: Front... ~..'.'~...: . . . Rear ...~7-..-~. ...... Depth ~..7.. ........ Height ..... ~ ....... Number of Stories ..................................................... g i Dimensions of same structure with alterations or additions: Front ' -- Rear "--"-- Depth ................... i · ' Height ...................... Number of Stories ...................... Dimensions of entire new construction: Front ,. ~ ...... Rear ~ Depth Height ......... .c'7'...~ Nmmber of Stories .... . .-.':-~-7..-. ............................................... o,ze of lot. rent . .... ~'C~., ........... Rear ~ ~ De~th .~f.~.'. ........... Zone or use district in which premises are situated.. ~,~ .~..~..'T-. ................................ .'Tr. ....... Does proposed construction viohte any zoning law, ordinance or regulation: . .~...iQ. .................... Will lot be regraded ....... ._~ .,.~. ...... ~ .~ .... ... Will excess fill be removed from premises: _ Yes Name of Owner of premises . ~[..~.0.~t~...]?tr~et.~. Address 0]~'.. ~.a].~;. ~1~..~.~.. Phone No..~..cji.. 7. Name of Architect ..... i~i~12 1 ~. i ~.' i i i i i i i i i 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 blocklnumber or description according to deed, and show street names and indicate whether interior or corner lot. STATE OF NEW~OR~:$_ I 7/ COUNTY OF...O'?..~...c~ .... t' .......... ,j.,. '. ....... being d ly sworn, deposes and says that he is the applicant (Name of individual signing contracll/ above named. He is the ...................... (Contractor, orpora .) 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, t,his application are true to the best of his knowledge and belief; and that the work will be performed in the manner set fj~ffth~in the application filed therewith. Sworn to before meAh_is [ / ........... · .~..'. <Y~. ...... day off. ~. ~, 19 .~.O~'''