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Home My WebLink About10349-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No Z17280 Date SEPTEMBER 12, 1988 THIS CERTIFIES that the building Location of Property 11975 House No. County Tax Map No. Subdivision POOL MAIN ROAD MATTITUCK Street 1000 Section 141 Block 4 Lot Filed Map No. Lot No. 38 Hamlet conforms substantially to the Application for Building Permit heretofore filed in this office dated AUGUST 6~ 1979 pursuant to which Building Permit No. 10349Z dated AUGUST 7r 1988 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 W/FENCE. The certificate is issued to DONALD SACKER (owner, of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL UNDERWRITERS CERTIFICATE NO. PLUMBERS CERTIFICATION DATED N445878 Bu~l~ding Inspector Rev. 1/81 FORM NO. ~ TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PP, EMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) Building Inspector. (/ / .ee ,..l~...~... / Building Inspector FORM NO. 6 TOWN OF SOUTHOLD Building Department Town Hall 'Southold, N,Y. 11971 APPLICATION FOR CERTIFICATE OF OCCUPANCY Instructions A. This application must be filled in 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 natu rat or topographic featu res. 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 peoperty 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 or land use $5.00 3. Copy of certificate of occupancy $1.00 /~j~,_ ~,~ ,~,~ Date .~~. · . New Building . ~E~T..~...'... Old or Pre-existing/"~,~)-- ,,~Building ........... ; Vacant Land ............. Location of Property J.J. ~.~. ,-~ .... :., ......... House No. t (! County Tax Map No. 1000 Section ............... Block ............... Lot ................ Subdivision ...Filed Map .............................. No ........... Lo, No .............. Permit No ........... Date of Permit .......... Applicant.. ,'~..../~..]...~.'~..'.'~. ............ Health Dept, Approval ............... ..'~. ......Labor Dept. Approval ........................ Underwriters Approval. ~..'.~....~-'~. .......... Planning Board Approval .~ ............. /I Construction on above described building and p/r~eets a II applies and regulations. Rev, 10-10-78 Harrison Conferenc~ Center/Inn .emge V,Ila~e; ~oathbury, C~nnectlcut 06488 TOWN OF SOUTI{OLD OFFICE OF BUILDING INSPECTOR P.O. BOX 728 TOWN HALL SOUTHOLD, N.Y. 11971 To Whom This May Concern, TEL. 765-I 802 We are unable to complete your Certificate of Occupancy because ,of the following reasons. /5/ An application for Certificate of Occupancy is not on file. / / No Underwriters Certificate on file. /-/ No Health Dept. Approval on file. /? No final inspection has been made. Please contact our office on this matter. Thank you for your cooperation. ~ ~,, ~ Bui]d~.ng Permit It ~ ~ ~ ~ .~ Z Building Dept. ***/~/ No Plumber Solder Certificate on file. ( all permits involving plumbing being issued after April 1,1984 ) OCCUPANCY OR USE IS UNLAWFUL WITHOUT A CERTIFICATE OF OCCUPANCY. CLEAR UP THIS MATTER AS SOON AS POSSIBLE'SO THAT LEGAL ACTION DOES NOT HAVE TO BE TAKEN. Thank you. NSPECTION [ ] FOUNDATION SST ] ROUGH: PLBG. FORM NO, 6 TOWN OF SOUTHOLD Building Department Town Hall Southold, N.Y. 11971 APPLICATION FOR CERTIFICATE OF OCCUPANCY Instructions A. This application must be filled in typewriter OR ink, and subr~itted 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 topographtc features. 2, Final approval of Health Dept. of water supply and sewerage disposa~--(S-9 form or equat). 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 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 building~s, 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 Date.. .. New Building ....... Old or Pre-existing Building(X)., ........ ~ rVacant Land ............. Location of Property .../.~.~~, .'~' ................. / -- . House No, Street Ham/et Owner or Owners of Property County Tax Map No. 1000 Section .............. Block ............... Lot ................ Subdivision ................................. Filed Map No ........... Lot No .............. Permit No/¢. .... ~.... Date of Permit ............................ Health Dept. Approval ........................ Labor Dept. Approval ......................... Underwriters Approval ........................ Planning Board Approval .................. ~ , . ~ Request for Temporary Certificate ..................... Final Certificate ........ - ......... - Fee Submitted $ ............................. Construction on above described building ancl. l~ermit~s all~ and regulations. Applicant.,11,~_..,,~ ~/3,/.,~' ....... '~...,"7,~...~ ..................... o- o.Te , t TOWN OF $OUTHOLD Building Department Town Hall Southold, N.Y, 11971 APPLICATION FOR CERTIFICATE OF OCCUPANCY Instructions This application must be filled in typewriter OR ink, and subr~itted 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 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 certifmate 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 peoperty showing ali 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 buildin§s or premises, or other pertinent informa- tion required to prepare a certificate. Fees: 1. Certificate of occupancy $5.00 2. Certihcate of occupancy on pre-existing dwelling or land use 3. Copy of certificate of occupancy $1.00 $5.00 Date.. ~'/~-'~'/e~'~- New Budd.ng ............. Old or Pre-existing Buildmg(~{) ........ =/Vacant Land ............ Locat,on of Property /~..~. ~-~.....J~...~.?~.. ~..- ..... ~.~'.~...~...~.. ....... . .......... House No, Street Hamlet Owner or Owners of Property .... ~.ff, .~/?) ~'~....~..-.-,'~.. ~;]'~, .~'. ~ .~. ......................... County Tax Map No. 1000 Section .............. Block ............... Lot ................ Subd v sion ................................ Filed Map No ........... Lot No .............. Permit NoJ~.~.f¢ .~,... Date of Permit .~./~Z~.~...Applicant .t~"~/~.~{//~/¢ ,~)~.'~... ,2~..~.~, .~"A/.¢-~ ..... Health Dept. Approval ........................ Labor Dept. ,~,pproval ...................... ,. · Underwriters Approval ........................ Planning Board Approval .................. ~ ,., Request for Temporary Certificate Final Certificate Fee Submitted $....'~.. ~ ..................... Construction on above described building an/~)permlrmeets all ~'c~¢~des and regulations, A icant ~ ~ ~ ~..~'~.-.~ pp ·; ..,..,,' ....... :~ ........ -;/ .......................... , ..... Rev, 10-10-78 FOltM NO, 1 TO~N OP $OUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OPPICE $OUTHOLD, N.Y. //C~ ~ £×am,ned ..~....~ .............. , 19Z~... /0"~ ¢?~--~ Application No.~ ....... Approved .~...Z .............. , 19.Zd?. Permit No. ~ ..... Disapproved alc~.. .................. ~ .............................. .~. .............. APPLICATION FOR BUILDING PERMIT /'~ ,. ~ ,' Date ......................... , 1 \ INSTRUCTIONS a. This application n~ust be completely filled in by typewriter o~ in ink and submitted in triplicate to the Building Inspector, with 3 sets of plans, accurate plot plan to scale. Fee according t¢ schedule. b. Plot plan showing location of lot'and of buildings on premises, relationship to adjoining premises or public streets o~ areas, and giving a detailed description of layout ofproperty must be drawn 6n the diagram which is part of this application. 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 thrcughout the work~ · e. No building shall be occupied or used~in v~hol~ or in part for any purpose whatever until a Certificate of Occupancy shall have been granted by the Building Ibspec'toh ' ' ', APPLICATION IS HEREBY MADF to the BuiJding~D;P~a~'t~nent fort ~ issuaJ3ce of a Bail i Permit pursuant to the Building Zone Ordinance of the Town of Sou(n01d, Suffolk County, Ne v YorkJ and other aF 3hie Laws, Ordinances or Regulations, for the construction of building? additions ar alterations, j ' for r/~moval or de~ ion, as herein d~ribed The applicant agrees to comply with all /applicable laws, ordinances, bql ding l~ode, housing ( ~ and regulatior~,/and to admit auth°rized inspect°rs °n Pr?-n3ises :and in buildings f°r necessal insp~ ,., ....... , ........... (Signature of appl&'cant, or name, if a corporat, i6n'~ (Add'tess o f'~ppl~ca~nt) State ,berber applicbnt is owner, less~ee, agent, architect, engineer, general contractor, electrician, plumber, or builder Na i r . ........................................ ..... ' ~ ' r If a~ ~orcorporate,,~s~nature of d~y authorl~, , ofRce . r (~mk~a~d title at comorate ottme~ I Builder's Lic~se No. Plumber's License No ....... ......... (~t~ ~ ~>o~ ~lectncmn s L~cense Other Trade s L~cense No ............................................... ~. uo~at~o, o~ ~,d o, wH~,~o~o~ed w~r~ w~ do,.. ~:~.~.~.~,~.....~.....~... ~ N~ ~J.....J~ ......... S~ ..a Nu~b.~ ...... /..U..~..~..~ ........ ~.~......~~.~g. ....................................................... ~ ~/~ 7~ Municipali~ 2. State existing use and occupancy o~ premises and ~fended use and occupancy of proposed construction: a Exisiting use and occupancy ...... ~ ................................................................................. ~ ..................... ...... ........... .................... ~ ! ~ /~. ~ (Descr ption) 4 Est.mated Cost ...... ~ .......~,2...~. ....................... F e ......... ~..: .............................................................. (to be paid on filing this application) 5.. If dvfe!ling, numlSer of dwelli0g units ............: ............... Number of dwelling units on each floor .......................... If ga.rage, number of cars ......! ........ I[ .................................................................................................................... 6 If business, commercial or mixed occupancy, specify nature and extent of each type of use ............... ; ......... Dimensions of ~tmg structures, if any: Front .....¢..6.'"~ ........... Rear ......... .~..~.. ............. Depth ....~...~ 7. Height .. Number of Stories ..........~ ........................... D~mens~ons of same structure' with allerations or additions: Front ~ ................ : .................. Rear ..... ~ ............ Depth ......... ~ ................... Height .,?.. .................... Number of Stories 8 Dnm~ns~ons of entire new conlstruction: Front .................................... Rear ............................ Depth ........................ Height .................... Num~be~r. of Stories .................................................................................................. .~, ........ 1 I. Zone or use district in which premises a~e situated ..................................................................................................... 12 Does proposed constructiqn violate any zoning law, ordinance or regulation: ........ .~......~.. ................................ J3 Wdl. I;ot be regraded ......(,¢/. ......... Will excess fill be removed from premises: ('~ Yes ( ) No.. .Name el Architect ...<, ...~.~.f ........... :':) ............................... Address ................................ Phone No ....................... Nome of Contractor .~-~¢~'¢..¢~..~.~.¢~.~?,/~__......~5. .................. Address .............. Phone No. i J PLOT DIAGRAM Locate clearly and distinctly ali buildings, whether existing or ploposed, and indicate all set-back dimensions from property lines. Give street and bl0ck nu ~r or description according to deed, and show street nomes and indicate whether interior or corner lot, ~,~O**/ ~' ~/'J S3'A:'I;E OF:NEW Yj~P,K, ,.. ~ ,I S S ................ ~~..~~ ................. being duly sworn, deposes and says tha¢~ tne applicam ~ame ~vidual signing ¢0ntr~f) .... above named. He m the .......................................................................................................................................... (Contractor, agent, corporate officer, etc.) oF said owner or owners, and is du'y authorized to perfor¢'o~ have p~rformed the sa~d work and to make and file this opplicahon; that oil stotement~ contained in this applicotion,q~.e.true to the best of his knowledge and belief; and thor the work will be perform¢d~n the manner set fo~h in the apphcafi6n filed therewith. Sworn to before me this ~? ] .~,, 765-1802 .... "/' BUILDING DEPT. INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLBG. [ J FOUNDATION 2ND [ ] FRAMING REMARKS: , /~.~ ~ [ ] I~ULATION [~,.,c /~Z/ /?//