HomeMy WebLinkAbout12573-zFORM NO. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Office of the Building Inspector
Town Hall
Southold, N.Y.
Certificate O[ Occupancy
No. z-16162 Date September 14, 1987
THIS CERTIFIES that the building INGROUNB SWIMMING POOL & FENCE
Location of Property 48650 Main Road Southold, New York
Ifl~/~S~ 'Al'o: ............................................. Street Ham/et
County Tax Map No. 1000 Section 70 .Block 7 ..... Lot 12
Subdivision ............................... Filed Map No ......... Lot No ..............
conforms substantially to the Application for Building Permit heretofore filed in this office dated
August 23, 1983 pursuant to whieh Building Permit No. 12573 z
dated .... Septembe'r..... ...... 4,. ....... 1983 . ..... wasissued, and conforms to all of the requirements
of the applicable provisions of the law. The occupancy for which this certificate is issued is .........
INGR'OUND SWIMMING POOL & FENCE
The certificate is issued to EDMUND E. & JACQUELINE J. ZENESKI
..................... ?oWn'e;,'i~)~f~ ......................
of the aforesaid building.
Suffolk County Department of Health Approval N/A
UNDERWRITERS CERTIFICATE NO... N 6 2 1 9 6 6
PLUMBERS CERTIFICATION DATED: N/A
Building Inspector
Rev. 1/81
TOV(N 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)
12573 Z
Permission is hereby granted ~0o:
......
,.~L~...o..~....!.5..~..-I. ..........................................
...............
)
at premises located at ....~....~...~....~..'~ .......... ~,.1.(,~:~.~....~..:...,.';;~,~...~;~'....~ ................
County Tax Map No. 1000 Secti~k.~......~......~..~ .~...._ ....... Block ........ i..~.. ......... ~,~L°t No ........~..~,.;
pursuant to application dated ..~..~...~........~...~.. .......... , 19...~....~. ond approved by the
Building inspector.
Fee 3 ......... : ..............
Building Inspector
Rev. 6/30/80
TOWN OF $OUTHOLD
OFFICE OF BUILDING INSPI~CToR
P.O. BOX 728
TOWN HALL
$OUTHOLD, N.Y. 11971
TEL. 765-1802
This in to advise you that the job under building
permit no, 12573Z issued to .Edmund Zeneski Jr
on 9/4/83 for 'Accesso3~ 'i's completed and
;, final inspection ha~; [ ) has not ( X ) been done.
in order to complete this file, it is necessary that
a Certificate of Occupancy be issued. Please fill out tbs
enclosed form, return same to the above office with a check
for $]O.OOpayable to the Town of Southold. Please indicate
to Whom the Certificate of Occupancy ts to be mailed, amd
;~rrange w~th this office for an inspec~io~ date
Occupnncy or use ia unlawful without a Certificate of
Occup.uncy. Please. help ns to clear up this matter so that
{egal action does not have to be taken, t'
Thank you for your prompt attenClon.
Very truly ;~,
Victor Lessard
Executive Administrator
VL:gar
encl.
,FIE~D INSPECTION
FOUNDATION
(lst)
COMMENTS
FOUNDATION (2nd)
ROUGH FRAME &
PLUMBING
INSULATION PER N.
STATE ENERGY
qODE
ADDITIONAL COMMENTS:
765-1802
BUILDING DEPT.
INSPECTION
FOUNDATION ZST [ ] ROUGH PLBG.
FOUNDATION 2ND [ ]INSULATION
FRAMING ~._ , !~- -
REMARKS
DATE
INSPECTOR:
765-1802
BUILDING DEPT.
INSPECTION
[ ] FOUNDATION 1ST [ ] ROUGH PLBG.
FOUNDATION 2ND [ ~SULATION
FRAMING [//] FINAL
REMARKS:
DATE
THE NEW YORK .BOARD OF FiR~
, UNDERWRITERS
BUREAU OF ELECTRI~IT~
l~O~'¢iil~Ot~Z' ~-, ~ 85 JOHN STREET, NEW YORK NEW
THIS CERTIFIES THAT
FIXTURE
OUTLETS
DRYERS
rECEPTACLES SWITCHES
FIXTURES RANGES OVENS DISH WASHERS EXHAUST FANS
NCANDESCENT FLUORESCENT
FURNACE MOTORS FUTURE APPLIANCE FEEDERS
UNIT HEATERS MULTI-OUTLET
SYSTEMS
NO. OF FEET
DIMMERS
SERVICE DISCONNECT
OTHER APPARATUS:
S E R V
NO OF CC COND,
This certificate r0ust not be altered in any manner; return to the office of
GENERAl. MANAGER
identified by their credentials.
i COL Y MANNER,
FORM NO, 1
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN HALL
SOUTHOLD, N.Y. 11971
TEL.: 765-1803
-~-"---~T~ ?] I ~'~ .~, Permit No
Approved .... ~-~.. .... ..........
Disapproved a/c .....................................
(Building Inspector)
APPLICATION FOR BUILDING PERMIT
Received .......... ~19...
Date .................. , . · ·
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 befor~ 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 regu. l_atiqn~, and to
admit authorized inspectom on premises and in building for necessary inspections. __ , ~ ~ ,
..... .q~c~.~. :. .¢~. ~l.<. ' . .
(Signatur~/~f appli~)ant, or name, if a corporation) .
....... £: :...
(Mailing address of applicant) ~X)-Ci_~6
State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder.
Name of owner of premises...~..~.. ~..~ · .~.'...J.('. }..~.~ ~...~...~'. '~'.. '~- .'~' '~ ................. (as on the tax roll or latest deed)
If applicant is a corporation, signature o[ duly authorized officer.
(,Name and title of co~te~f~c~
Builder s License No ....... ~ ~.-h ........
Plumber s License No .............
Electrician's License No...,...'7...~..~.: :~...
Other Trade's License No ......................
1, Lo~ation of land on which proposed work will be done ..................................................
.V. ?. ........... .,.. .......
House Number Street Hamlet
County Tax Map No. 1000 Section ..... '~..~. ........ Block ....... 7 ......... Lot .... /.. ...-YQ~... ........
Subdivision ..................................... Filed Map NO ............... Lot ...............
(Name)
2, State existing use and occupancy of premises and intended use and occupancy of proposed construction:
a. Existing use and occupancy ...!>.~, - . ..~..~.
(~ Natt re Building . .. Addition .......... ~ '_' '/9 .....
of
work
(check
which
applicable)'
New
Alteration
Re air R ~ .......
.p ' . .............. emoyal .............. Demolition .............. Other Work....~.~ .....
i (Description)
~ Estimated Cost ........ 4 ........................................................
, (to be paid on filing this application)
5. If dwelling, number of dwelling ~4nits ............... Number of dwelling units on each floor ................
hum her of cars
If garage ........................................................................
6. If business, commercial or mixed, occupancy, specify nature and extent of each type of use ................
7. Dimensions of existing structure~, if any: Front ............... Rear .............. Depth ...............
Height ............... Number of Stories ........................................................
Dimensions of same structure width alterations or additions: Front ................. Rear ..................
~-~ Depth .................... i' · Hmght ...................... Number of Stories ....................
Dimensions of entire new construction: Front · o~.Oi ~. O t
· ....... Rear ..... o2. ....... Depth ..
~ Number of Stories
Height .......................................................................
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 ....................................... . . ... . .. ... . ..
Do~s proposed construction violate any zoning law, ordinance or regulation: ...............................
'D
Will lot be regraded ....... ~ ....... ~ ......... Will excess fill be xemoved from l~emises Yes
Name of Owner of premises ~f¢~/~oJ,. : . :..J tess . ./.~ 'd.,~ .~
Name of Architect .......... l ................ ~. Address ............... ' ....Phone No. :~i~:
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
property lines. Give street and block humber or description according to deed, and show street names and indicate whether
interior or corner lot.
..... being duly sworn, deposes and says that he is the applicant
?te is the .................. ~ agent
, corporate officer, etc.. )
of said owner or owners, and is ddly authorized to perform or have performed the said work and to make and file this
application; that all statements coniained in this application are true to the.best of his knowledge and belief; and that thc
work will be performed in the manner set forth in the application flied therewith.
Sworn to before me this
........... ..~~day
N Public .............. i County ' '
6/ ~- ~m, st.m .o!. ~_~ ~b ......... '/' F ....................... "~ .... ' []
! _~, ~_.I~I.~.0., S.~I~ ~/__. ~ / (Signature of applicanti
!
FORM NO. 6
TOWN OF SOUTHOLD
Bu ilding Department
Town Hall
Southold, N.Y. 11971
765- 1802
APPLICATION FOR CERTIFICATE OF OCCUPANCY
Instructions
A. 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 Under~Hters.
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 s|te plan requir, ements where applicable.
B. For existing buildings (prior to Aprit 1957), Non-conforming uses, or buildings and "pre-existing"
land uses:
1. Accurate survey of p~operty showing all property lines, streets, buildings and unusua~ 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. Fees:
New Dwelling.S25.00, 'Accessory '$10.00 Business $50.00
1. Certificate of occupancy
2. Certificate of occupancy on pre-existing dwelling $ 50.00
4.Vacant3'C°py°fcertificate°f°ccupancYLand C.O. $ 20.0055.00, over 5 years $'0.00 ./
5.Uodated C.O. $ 50.00 Date .......... ~'/' "1' .....
6. Alteration $25.00
New C on s t t- u c t i on ...... Old or Pre-existing Building ............ Vacant Land .............
Location of Property ..................................
House No. Street Hamlet
Owner or Owners of Property .,,,,~{,{?.~),I,'~L~.. j?, tit-' ~j~ ,
County Tax Map No. 1000 Section ...,V., ,?~,,, .... Block ..... .~7. ....... Lot ..... /,. ,~', ......
Subdivision ................................. Filed Map No ........... Lot No ..............
Permk No. t, ,~',, .?..~, Date ofPormi, .--, , .Applicant..~J. ,~,~-,~.
Health Dept. Approval ........................ Labor Dept. Approval ., ." . ....................
Underwriters Approval ........................ Planning Beard Approval
Rev. 10-10-78
10,wc., $3 174,
Request for Temporary Certificate Final Certificate · · ·
FeeSu m,tted* .... ......
Construction on above described building and permit meets all applicable codes and regulations.
Applicant ...............