HomeMy WebLinkAbout12534-zFORM NO. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Office of the Building Inspector
Town Hall
Southold, N.Y.
Certificate Of Occupancy
No...Z.lt~??0 Date August 12, 19.86.
THIS CERTIFIES that the building , I..n~.~.o.u..n.d..S.¥.~.m,m. 5:.n..g. ,p,o..o.l,,.&.. D..e.c,k. ............
Location of Pronertv 1350 Woodcliff Drive Ma.t. tituck, N..Y..
House No. Street Hamlet
County Tax Map No. ]000 Section . 1 0 ? ..... Block 8 . .Lot 1
Subdivision ............................... Filed Map No ......... Lot No ..............
conforms substantially to the Application for Building Permit heretofore filed in this office dated
.J.u.l.y..8.,. .3. 12.53) z.
............. 19 .8 pursuant to which Building Permit No ...................
dated d?ly .30 ,, 83
...... · ~ r ................. 19..., 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 Fool & Deck
Robert & Jeanann Ferretti
The certificate is issued to ...........................................................
(owner, t&~ve~X
of the aforesaid building.
Suffolk County Department of Health Approval ........... ~ ./.~ ...........................
N611516
UN~)ERWRITERS CERTIFICATE NO ............................................... . ..
Rev. 1/81
Building Inspector
l~O~ NO. ~
TOWN O~ $OUTHO~D
BUILDING DEPARTMENT
TOWN HALL
SOUTHOLD, N. Y.
BUILDING PERMIT
(THIS PERMIT MUST BE KEPT ON THE PREMIS£S UNTIL FULL
COMPLETION OF THE WORK AUTHORIZED)
12534 Z
Permission is hereby granted to: ~ , · , / ~
A /~.,..~ ~. .~
....... "'"'"""':','~":;'"'~t ................... ~' ':'
.... ...~.~L.......~?.~..~ ..................
,o..~~.~:..~~-~...~.~.:~.~....~.~..~ ....
~ ...... ~ ..~....~..L~..~.,~............' ................................................... ~. .................. ,..............' .....
0, pre~,$e, ,=.d a, ....!..~.~.....~.~.~'.~.-...,.~..~.........'..~.~~.~.
County Tox Map No, 1000 Section,. ...... ,k,O,.,.~, ...... Block ...... ,,~ ............ Lot No ........ l ................
Building Inspector.
Building Inspector
Rev. 6/30/80
FORM NO. 6
TOWN OF SOUTHOI. D
Building Department
Town Hall
Southold, N.Y. 11971
765 - 1802
APPLICATION FOR CERTIFICATE OF
TOWN
Instructions
A, This application must be filled in typewriter OR ink, and submitted .~ ~ to the Building Inspec-
tor with the following; far 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.
B, For existing buildings (prior to April 1957), Non-conforming uses, or buildings and "pre~existing"
land uses:
1. Accurate survey of p~operty 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:
I. 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
NewCons%ruction ...... Old or Pre-existing Building
Date...~ .~..~../~..~.~-....
............ Vacant Land .............
~ ........... Hamlet
House No. -- ~re/et ~
Owner or Owners of Property ~.d. ~.~..~..~../~.~..,~. ,/~.. , .A/, .,~d. .... '.~T,/~. ,~,~ ,' ............
County Tax Map No. 1000 Section ............... 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 .................
.Final Certificate .......................
Request for Temporary~C,ertif~c,a;~e .....
Construction on above described building and,p~rmit meets all appli~aj~le codes and regulations.
Applicant . .. ~..~..4~/.?-~..~ ..................
Rev, 10-10-78
IqTqD
FIELD INSPECTION
FOUNDATION (1st)
COMMENTS
FOUNDATION ( 2nd )
ROUGH FRAME &
FLUMBING
INSULATION PER N. Y.
STATE ENERGY
C,ODE
'7 FINAL
ADDITIONAL COMMENTS:
APPLICANT:
TOV~N OF SOUTHOLD
OFFICE OF BUILDING INSPECTOR
P.O. BOX 728
TOWN HALL
SOUTHOLD, N.Y. 11971
DATE: July /q, 1986
Dear:
While reviewing our files I find that your expired
pool permit I~%q~has never been finalized. Kindly return
the enclosed application with a check for $5.00. 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.
~0~ .~,~. ~ ~.~ ~J Yours Truly,
~ Victor Lessard
~ ~~ ~ ~ · Executive Adminstrator
OCCUPANCY OR
USE IS UNLAWFUL
WITHOUT CERTIFICATE
OF OCCUPANCY
"IMMEDIATELY,,
I~NCLOSE POOL TO CODE
UPON CO.M, PLE'rlON
e~FORE WATr_-R" .
765-1802
BUILDING DEPT.
INSPECTION
FOUNDATION 1ST [ ] ROUGH *~PLBG.
FOUNDATION 2ND [/] I~LATIGN
FRAMING ~] FINAL
REMARKS: ~/~
THE NEW YORK BOARD OF Fl!RE UNDERWRITERS
BUREAU OF ELECTRICITY/ .,; ~ ·
J~ 85 ,.JOHN STREET, NEW YORK, NE~ ~RK~IOO3S ~ ~ -~ ~ ;
THIS CERTIFIES THAT
only the el~t~cal equipment ~ described belo~ and introduc~ by t~ applicant ~a~d on the abobe application number iR the preraises of
~t Ferretti, W~cllf~ ~ive, ~ Aven~ W~tvi~ ~ve, ~titu~,
i.*h~/o.ow~Sloo, t~o~i [] B.sement [] 1st ri. [] '.d ri.Outside , s~o. .to~ ro~
was examined on J~ ~ ~ ~9~ and ~ound ~o be in complla~ce with the requlre~nen~s of this Board.
FIXTURE FIXTURES RANGES EXHAUST FANS
OUTLETS SWITCHES FLUORESCENT
1 2
DRYERS
SYSTEMS
NO. OF FEET
OTHER APPARATUS:
1-G.F.I.
(AvAmuLng Pool)
~c-ml~e oi' ~mu~x,.ml envtron~ments it is ~vis~ble to have
made by ~ quad±~±ed person.
E R ~V I , C
OF Hi-LEG
NO. OF NEUTRAl
This certificate covers ~liance at ~the d~te of~ insp~tion onJly.
~requent test a~t/or rep'air~
A. WG
OF NEUTRAL
Glenn R. Ltr~Jley
Horton Avenue RFD 169
Mattituck, N.Y. 11~2
in an' manner; return to the office of
' MANNER.
FORM NO. 1
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN HALL
SOUTHOLD, N.Y. 11971
TEL.: 76§-1802
Examined
Approved .... ~4r~..~..D., 19~.~ · Permit No.I. .~X.~.. 3- - -~. -
Disapproved a/c .....................................
(Building Inspector)
APPLICATION FOR BUILDING PERMIT
IN STRUCTION S
Application No...J..~-..~. ~.. !*t ....
Date ................ .~//~(' 19 g3
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.
· -' "' ""' "' . z.x.: ¢. .......
(Signature of applicant, or name, if a corporation)
· .,,x.x ...................... ......
(Mailing address of applicant)
State whether applicant is owner, lessee, agent, architect, eno~neer, general contractor, electrician, plumber or builder.
Name orowner of premises /(O~.<t~77.. ~ ...... .f~..~..~ff~e.~. ~. f .....................
(as on the tax roll or latest deed)
If applicant is a corporation, signature of duly authorized officer.
(Name and title of corporate office~
Builder's License No ...... ~ .................
Plumber's License No .........................
Electrician's License No .......................
Other Trade's License No ......................
1. Location of land on which proposed work will be done·t5/5" .W.O 9.P..Q .t,. ( F. ?....O..~.t. ~c~ ............. 2,,,/
House Nnmber Street Hamlet
County Tax Map No. 1000 Section .... J.(~.'~] ......... Block ..... .~. ........... Lot .... /...: ..... .~.,...
(Name)
2. State existing use and occupancy of premises and intended use and occupancy of proposed construction:
property lines. Give street and block
interior or corner lot.
3. Nature of work (che6k which applicable): New Building .......... Addition .......... Alteration--?: .~.~.
Repair .............. Rembval .............. Demolition Other Work ...........
i . (Description)
4. Estimated Cost ............ i · · :.o..? ........ Fee ......................................
I (to be paid on filing this application)
5. I f dwelhng, number of dwelhngiumts ............... Number o f 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. Dtmens~ons ofemst~ng structures if any: Front Rear Depth
Heighi ............... Number 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 ............... Number of Stories.
9 Size of lot: Front i Rear Depth
10. Date of Purchase .......... i .................. Name of Former Owner .............................
11. Zone or use district in which pr~mises are situated .....................................................
12~ Does proposed construction vioiate any zoning law, ordinance or regulation: ................................
131 Will tot be regraded ........ , ................... Will excess fill be removed from premises: Yes No
14. Name of Owner of premises .. i ................. Address ................... Phone No ................
Name of Architect ......... i ................. Address ................... Phone No ................
Name of Contractor
........ , ................. Address ................... Phone No ................
PLOT DIAGRAM
Locate ~clearly and distinctly all buildings, whether existing or proposed, and. indicate all set-back dimensions from
number or description according to deed, and show street names and indicate whether
STATE OF N,E(gr~R~(...Q/fi( S S
COUNTY OF,~ .... i' '
" ~'l~f~.i~vi~t~?. ' '~ ~' r' (- .C .~. being duly sworn, deposes and says that he is the applicant
above named.
He is the ....................................................................................
(Contractor, agent, corporate officer, etc.)
of sakl owner or owners, ~d is duly authorized to perform or have performed the said work and to m~e and file this
application; that all statements cont6ined ~ this application are true to the best of his knowledge and belief; and that the
work will be perfomed in the m~ner set forth in the application filed therewith.
Sworn to before me this
'
__ ....... ........ ..........
No. ~2-8125850, Suffolk Co~7
~urm £:~ires March 30, 1
(Signafur~ of applicant)