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Home My WebLink About10528-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Town Clerk's Office Southold, N.Y., Certificate Of Occupancy No....zAQJ?3. ....... Date October 2, 19 80 THIS CERTIFIES that the building ................................................ Location of Property . .1675...Jockey. C~el~. I).rg¥.e,.. ~t. ...... .Sp.u.~..hg.l.d.,' . .M...Y.: ..... House No. 070 ~t~e 0']9 Hamlet 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 .D..eg.o.m.t?.e.r' .'I.~. ....... , 19 . 7.gpursuant to which Building Permit No...~.Q~¢.8..Z. ........... dated .... D.e.q o..rg.b.e.~..]-.9 ........... 19.7.~, was issued, and conforms to all of the requirements of the applicable provisions of the law. The occupancy for w~ch tlus certificate is issued is ......... Addition of Roof on Existing Inground Pool Enclosure. The certificate is issued to .......D?. ,...H,o?.~.. e..r.t..S ....A..l~. ............................... (owner, le~ of the aforesaid building. Suffolk County Department of Health Approval - U~DERWmTERS CERnr]FmATE ~O... ~. ?.~. 99.9.5 .................. .~//. ............... // Building Inspector Rev 4/79 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. BUILDING P, ERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) No. 10528 Z Permission is hereby granted to: ~.,~./..~...~./.~z .~z...~..../.4,..~, ...... ........ . ......... ,~..o.~..r.~r...~...=...~.....y.. ................ ~o ...C.u.~..~z~.c~.T... ...... ~oo.~... ....... ol~.....~z~..~'~,~.CT..../-~z~'c~.~.o.Z~o.c- ....... ,~'/.~...C C. o ~ .~<,,c~. ................................................................................................................. pursuant to application dated'--~.~'J...~t./,,~'~.~:....,~...~:~Jl ........ , 19-7..~...., ond approved by the Building Inspector. 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 ~n typewriter OR ink, and submitted in duplicate 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 featu res. 2. Final approval of Health Dept. of water supply and sewerage disposel--(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 er 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 peoperty 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. Fees; 1. Certificate of occupancy $5.00 2. Certificate of occupancy on pre-existing dwelling or land use $5.00 3. Copy of certificate of occupancy $1.00 ..... New Building ............. Old or P~e-existi/gg Bui/~di~g ....... 7~'" V~a/q/an~L~ ............. Location of Property .l~.?..~. ~... ~~.~.~ ........ ~.~' ................ House No. // j I [ ~ I~Street _ ,,~ Ham/et Owner or Owners of Property.../.~...~..'.'~.....~......~....~......~..'....~..~..~.. ........ County Tax Map No. 1000 Section ...~.7.~. ....... Block ..... .0. Z.~., .... Lot ..... .0,/.~. ..... Subdivision ................................ F ded Map No.., ,~z: ....... LotN~o ............. Permit No. Ii~.~.?, .o~..~~. Date of Permit .... ~, .Applicant.. : .... Health Dept. Approval ..... ·.....__..,../~..Labor Dept. Approval ....................... ... Underwriters Approval .... ~. .............. .~..~'~// Planning Board ApprovaJ ...................... Request for Temporary Certificate ..................... Final Certificate ...~ ............... Fee Submitted $,, ,~'. ,~, ,~,, ................. Construction on above described building and-I~ee, ts~codes and regulations. Applicant ... ,~...~.~ ~'. ~.' ../~. ....................... THE NEW YORK BOARD OF FIRE UNDERWRITERS [3[~ BUREAU OF ELECTRICITY ~ 85 JOHN STREET, NEW YORK, NEW Y~0RK 10038 oa,~ J~ 4, 19~0 ~pplic.tlo./~o.o./,l~ 075200 N 480933 THIS CERTIFIES THAT only the electrical equipment as described below and introduced by the qpplicant named on the above app~lication number in the premises of Dr, H. Arm~ Jockey Lk'eek Dr., ~, 25 & 0a[~a~ Ave,, ~ld, N,Y. in the following location; [] Basement ,~..~e~a,,~i.edon J~-~ Z~ 1980 FIXTURE ~ OUT[ETS ~-SWITCHES DRYERS [] 1st FI. FIXTURES [] 2nd Fl. Sectlon Block and found to be in compliance with the requirements of this Board. Lot FANS OT.. ~'.^R^TUS. ¥~or/s: 2-1/2hp SYSTEMS E R I, C E OF CC COND OF HI-LEG AWG OF NEUTRAt Jb~e~,h F~ Froh~afer ~)u~hold, N.L 11971 This certificate must not be oJtered in an COPy FOR BUILDING office o~ Inspector may be identified by IN ANY MANNER, F IEI~_~D ~NSPECTION COMMENTS FOUNDATZON (~s2) FOUNDATION (2nd) '. ROUGH FRAME & PLUMBING INSULATION PER N.Y. STATE ENERGY COpE FINAL ADDITIONAL COMMENTS: FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N.Y. 11971 TEL.: 765-1803 Examined.. .. .?..., Disapproved a/~ ................................. APPLICATION FOR BUILDING PERMIT INSTRUCTIONS a. This application must be completely filled in by typewriter or in ink and submitted in triplicate 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 issue 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, hou~sing code, and regulations, and to admit authorized inspectors on premises and in buildings for necessary insp<~cti~ns. ] /),~ (Signature of applicant, or name, if a corporation) · · .1.67.5. Xocke.y .Cre.ek. Dr....Sou.thold ........ (Mailing address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrici/~n, plumber or builder. .................................... OI~NE.R ...................................................... Name of owner of premises . .HERI~ERT. ~.. · AND .~ERAJ-DItXlE- .AI~i ....................................... (as on the tax roll or latest deed) If applicant is a corporation, signature of duly authorized officer. Plumber's License No ......................... Electrician's License No ....................... Other Trade's License No ...................... 1. Location of land on which proposed work will be done. 1,675 d'ocke~r,~C~'eek D~J,yO~..S. qu. ~.ql.d... House Number Street Hamlet County Tax Map No. t000 Section ..... '~..O. ........ Block ...... .~.. ........ Lot ..... /.¢ ........ 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 .,. O¢.~,d,~oJ7. ~q O]-, .w.J, Sh, .~.tllT~p,gr~cl~.r~g ,v/o,J.~l,~ ........................ b. Intended use and occupancy . .Enclose· .laool..~ith. t~ermanent. ~.oof. as .pe~..plans ............ 3. Nature of work (check which applicable): New Building .......... Addition .......... Alteration Repair'. ............. RemoVal'' .............. Demolition .............. Other Work ...... ~ ..... i ~ ~T~ · .. (Description) En'c~ose roof over pool 4. Estimated Cost ......... $10.-~.2,0O.0. .... .... ~ ......... Fee ................................. , (to be paid on filing this application) 5. If dwelling, number of dwelling qnits "--- "' Number of dwelling units on each floor If garage number of cars ' 6. If business, commercial or mixed! occupancy, specify~a~g~e and extent of each type of uric ......... 7. Dimensions of qx~ing structure~, if any: Front....-J?.. 2 ...... Rear .... .,wr ....... ;,~ ~-'IJepth .............. Height /~'- Number of Stories ........................................... Dimensions of same structure wi~h alterations or additions: Front ................. Rear .................. Depth .................... ~. Height ...................... Number of Stories ...................... 8. Dimensions of entire new construction: Front ............... Rear ............... Depth ............... Height ............... Number of Stories ........................................................ 9. Sizeoflot: Front ...................... Rear ...................... Depth ...................... 10. Date of Purchase ........... : .................. Name of Former Owner ............................. 11. Zone or use district in which premises are situated ..................................................... 12. Does proposed construction violate any zoning law, ordinance or regulation:. ................Ne .. ............ 13. Will lot be regraded ......... ~ ................... Will excess fill be removed from premises: Yes No 14. Name of Owner of premises l,I..&~m .............. Address .167.5..Jocka7 .Ct.,. Phone No. . .7.65. 2995. · · Name of Architect .......... i ................. Address ................... Phone No ............... Name of Contractor ......... ! ................. Address ................... Phone No ............. Climatrol Corporation, Miami, Fla. via Superior Sale's' and Engineering Copr. PLOT DIAGRAM Locate clearly and distinctly all ibuildings, 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. STATE OF NEW Y.~I~J',~,I~. .............. ~.~.~.~.. ~,. ,~,~,~ ' being duly sworn, deposes and says that he is the applic~t (Name of individual signing contract) above named. (Contractor, agent, corporate officer, etc.) of s~d owner or owne~, ~d is dul~ autho~zed to perform or have perfo~ed the said work and to m~e ~d file application;that ~1 statements conthined work will be perfomed in the m~n(r set forth ~ the application filed therewith. Sworn to before me this IbTA~ IUBUC ', .h,, I m Suffoikl Counly ~ (Signature of applic~t)