HomeMy WebLinkAbout12546-zFORM NO. 4
TOWN OF $OUTHOLD
BUILDING DEPARTMENT
Office of the Building Inspector
Town Hall
Southold, N.Y.
Certificate Of Occupancy
No. z-15295 Date February 24,-- ,19 87
THIS CERTIFIES that the building Inground Pool & fence
4200 Young Avenue Southold, New York ---
Location of Property ...............................................................
House NO. Streat Ham/et
55 2 I3
County Tax Map No. 1000 Section ............ Block ............... Lot .......... ;- ......
Subdivision ............................... Filed Map No ......... Lot No ..............
conforms substantially to the Application for Building Permit heretofore filed in this office dated
July 10, ~ 83 12546 z
...................... 19... pursuant to which Building Permit No ......................
dated ..... .A.u.g..u.s.t.. 6.., ............ 19..8.3, 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 & FENCE
ROBERT & ELIZABETH KRAUS
The certificate is issued to ...........................................................
of the aforesaid building.
Suffolk County Department of Health Approval ..........................................
UNDERWRITERS CERTIFICATE NO .... N 6 I 5317
Rev. 1/81
FO~ NO. 2
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)
~25~e z Oote ....... ..~.~...~. ............ , i,~.~
Permission is hereby granted to:
'~..1..~ ....... ~l.~....r.~.. .....................................
County Tax Map No. 1000 Section ..~.....~...~ ........ Block ...... & .......... Lot No ..... /......~. .........
the
Building Inspector.
Building Inspector
Rev. 6/30/80
FORM NO. 6
TOWN OF SOUTHOLD
Building Department
Town Hall
Southold, N.Y. 11971
765 - 1802
APPLICATION FOR CERTIFICATE OF OCCUPANCY
Instructions
This application must be filled in typewriter OR ink, and submitted m~ 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~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.
Fees:
1. 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
$15. O0
Date
New C on s t ruc t i on ...... Old or Pre-existing Building ............ Vacant Land .............
Location of Property ............ ; .I ...... '..// ....... -,-~'..-- ..........
House No, I ~/ , Street Hamlet
Owner or Owners of Property .....(~..~-~ .~..?..~.~..~. ~.";~. ..... ,~./.~. ?r-~.~. .................
County Tax Map No. 1000 Section ............... Block ............ Lot ................
Subdivision ~ .Filed Map No ......... Lot No.
Permit No. ~2~..~.~/...~.~Date of Permit ~.';~.: ?.?...Applicant...~...)~.b),~v~ ~ ...~...~. ...........
Health Dept. Approval ........................ Labor Dept. Approval ......................
Underwriters Approval ........................ Planning Board Approval ....................
m ~.o~.. ,e.,~, for T n ,,_em~orar~ Certificate... ~ ................ Find Certificate .......................
Fee Submitted $ .... .~.....'~....~ .(~...~..~.? ....... ~ ,
Construction on above described building and,,g~m~s~~ and regu lations.
Applicant.' .~ .~_~.~~,,2. ~ .... .. ..............
TOWN OF SOUTHOLD
OFFICE OF BUILDING INSPECTOR
P.O. BOX 728
TOWN HALL
SOUTHOLD, N.Y. 11971
TEL. 765-t 802
October 3 1986
ROBERT KRAUS
95 KENILWORTH DR.
STAMFORD, CT. 06902
Dear Mr. Kraus:
Thank you for your check for the C.O. for
your pool.
I haven't been able to locate an underwriter
certificate for the pool. If you have one
please send'us a copy. If not contact the
electrician who did the work, and have him
send it to us. Thank you°
Yours truly,
Secretary
FIELD INSPECTION COMMENTS
FOUNDATION ' (1st)
FOUNDATION (2nd)
ROUGH FRAME &
PLUMBING
INSULATION PER N.
STATE ENERGY
C,ODE
FINAL
ADDITIONAL COMMENTS
APPLICANT:
TOWN OF SOUTHOLD
OFFICE OF BUILDING INSPECTOR
P.O. BOX 728
TOWN HALL
SOUTHOLD, N.Y. 11971
TEL. 765-1802
DATE: July Iq, 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,
Victor Lessard
Executive Adminstrator
OCCUPANCY OR
USE IS UNLAWFUL
WITHOUT CERTIFICATE
OF OCCUPANCY
"IMMEDIATELY"
ENCLOSE FOOL TO CODE
UPON COMFt.E'TION
BEFORE "WATER"
765-1802
BUILDING DEPT.
INSPECTIO
[ ]FOUNDATION XST [ ] ROU6H
[ ] FOUNDATION: 2ND [ ] INSU~TIO.
[ ] F~MING [ ] FINAL
REMARKS: ' :
DATE INSPE~OR
765-1802
BUILDING DEPT.
INSPECTION
[ ] FOUNDATION 1ST [ ] ROUGH PLBG.
FOUNDATION 2ND [ ] INSULATION
[ ] FRAMING [ ] FINAL
THE NEW YORK BOARD OF FiRE UNDERWRITERS
lo0o~3 .UREAU OF E--EC'rRI¢~T~ ~,: ~ ,'
~ 85 JOHN STREET NEW YORK NEW ~ORK 10038 ~
THIS CERTIFIES THAT ;;
on'y the electrica~ eq~ipment as descrlbed belo~v and ~trod~ced y the appllcartt ~atr~ed on the above appllcatlon number i~ the preo~ises of
in the following location; ~ Basement [] 1st FI. [] 2nd FI. (..)t,~.i~ ,Section Block Lot
was examlndd on
and found to be in compliahce with the r~quirements of this Board·
FIXTURE FIXTURES RANGES OVENS DISH WASHERS EXHAUST
OUTLETS
DRYERS
FURNACE FUTURE APPLIANCE FEEDER~
UNIT HEATERS MULFI-OUTLE1
SYSTEMS
NO. OF FEET
DIMMERS
SERVICE DISCONNECT S E R, V I C
OTHER APPARATUS:
~ of ~t~ual env~t~,; it xs ~vl~le to ~V6 ;f~q~nt t~t;t ~d/o~ repaiI's
OF NEUTRAL
i~orCon Av~uue -i~D
This certificate must not be in , manner; return to the office
~ DEPARYMIE
GENERAL MANAGER
Per-- ~ /
may b~ identified by their cr~dentio~s.
f MANNER,
FORM NO. 1
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN HALL
SOUTHOLD, N.Y. 11971
TEL.: 765-1803
Examined .~u~..x~....~.., 19~..~
Approved ........ .h~?iy.. ~.., 19~.'.~. Permit No.
Disapproved a/c .....................................
Application No,. !..~. .~..¢.¢ ......
(Building Inspector)
APPLICATION FOR BUILDING PERMIT
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, t tg c_ode,~and regulations, and to
admit auth°rized inspect°rs °n premises and in building f°r necessary inspe6ti°ns' / ~...O~..~..~'..~...~''~ .~
.... ........ .............
(Signature of ~[ppl ~t, or name, if a corporation)
(Mailing address of applicant)
State whether applicant is owner, les g chitect, engmeer, general contractor, electrician, plumber or builder.
(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..1.2-.~..~....& .......
Other Trade's License No....~ ~. .............
1. Locationoflandonwhichproposedworkwillbedone....~.~.~....'~..~.~ .....................
...¢. ................................. ' ........ .-. ..........
House Number Street Hamlet
County Tax Map No. 1000 Section .....c.,~..~.~. .......... Block c~ Lot .... /.~.
Subdivision ................. .~ .................. Filed Map No. . ..~ .......... Lot ....~. .........
(Name)
2. State existing use and occupancy of pre~eslr~ ,]and intended use and occupancy of proposed construction:
a. Existing use and occupancy ...... ~ .~ 4.~..~...~--~...q....~_~ .......................................
b. Intended use and occupancy ............. 'p~.?--/. J..~.. ~...-~...-3: '~'~'' .........................
3. Nature of work (check which applicable): New Building .......... Addition .......... Alteration ..........
Repair ........... 2~' Removal .............. Demolition ............... Other Work ...............
4. Estimated Cost ....... t...'~7.kd. ~ ...................... Fee ......................................
: ~ (to be paid on filing this application)
5. If dwelling, number of dwelling u3~ts ............./. Number of dwelling units on each floor ................
If garage, number of cars ..... ! .' .~'r. ...............................................................
6. If business, commercial or mixed occupancy, specify nature and extent of each type of use ...' ..................
7. Dimensions of e~,isting structurels, if any: Front ............... Rear .............. Depth ...............
Height ...... ~;{ 0 ...... Num. ber of Stories .... ~:~. .................................................
Dimensions of same structure wlth alterations or additions: Front /. ~..~.~.~...-~.. .... Rear ..................
Depth , Height Number of Stories
8. Dimensions of entire new construction: Front ......... , ..... Rear ............... Depth ...............
Height .............. hlltmber of Stories ........... ~ ...........................................
9. Sizeoflot: Front .... [..,~.._.~?~.. ....... Rear .... /~....~'~.. ......... Dep, t.~h . ./' ~".V ..............
10. Date of Purchase .... /. ~..oC~. .................. Name of Former Owner .. ~./y~O. M ................
11. Zone or use district in which pr?mises are situated .......................... ,h'~ · I'~ .....................
12. D~es pioposed construcj~o~ ~llate any zoning law, ordinance or regulation: .... .Lk~....'~ ..................
13. Will lot be regraded . .r..'ff.. . ; .................. Will exce3s fill be ren;,oved from premises: Yes
14. Name of Owner of premises ~.~.X../~tg~... Address .,~'.9~r~. ~'.~0.'. . .~.o.. ..... Phone No.~..~./~.¢~....'~.
Name of Architect ._.~. .... ~.i.. F~..I. · · c~ ...... Address [. ................. Phone No ..........
Name of Contractor~J~F.<~ .0J;f2. ~(q~/~ G.&~2~3~.~.. Address~.~d~.'.~ ( t~..tC&.~4 Phone Noc~ .q ~..'2~.. ~5
PLOT DIAGRAM
Locate clearly and distinctly all! buildings, whether existing or proposed, and, indicate all set-back dimensions from
property lines. Give street and block ~umber or description according to deed, and show street names and indicate whether
interior or corner lot.
STATE OF NFfi~RK.
COUNTY OF.~-~r'~f~-?~. ...... ,!a'a
..........~n~~' . ......... being duly sworn, deposes and says that he is the applicant
above named.
He is the ....................................
--g/ Q~ (Contra~r, agent, corporate officer, etc.)
of said owner or owners, ~d is duly~ perform or have perfomed the said work and to m~e and file this
application; that all statements contained ~ this application are true to the best of his knowledge and belief; and that the
work w~l be perfomed in the m~ner set forth in the application filed therewith.
Sworn to before me this
.......... ....
v - ....
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