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Home My WebLink About10350-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. Certificate Of Occupancy THIS CERTIFIES that the building .... .I.n.g.r.o..u.n.d...S .wj.m.m. ~ .n.g..P..o.o.1..&...f.e.n.c.e. ........ Location of Property ....3.4. .5.7.0..N. 9 Y.~.h...R.o.a.d. . P e c o n i c, N e w, ¥ o r k Ho.se No. ' .....'S't/e3i ...................... h3, iel County Tax Map No. 1000 Section 75 .Block 1 ...... Lot I. 2 Subdivision ............................... Filed Map No ......... Lot No .............. conforms substantially to the Application for Building Permit heretofore filed in this office dated .A.u.g.u..s .t..6.:..l .9.7. 9. .......pursuant to which Building Permit No, 10350 Z dated .... A.u..g .u.s.[..7 .,.. 1. 9. .7 .9 ........ 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 AS APPLIED FOR The certificate is issued to JOHN BEDNOSKI ..................... ?o¥,,'o'r, )&vigx .................... of the aforesaid building. Suffolk County Department of Health Approval ... N/A UNDERWRITERS CERTIFICATE NO, N4 4 5 8 7 6 N/A PLUMBERS CERTIFICATION DATED: Building Inspector Rev. 1/81 TOWN OF $OUT~Ot.D BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTH*OLD, N, Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) Permission is hereby granted .... ;..~,~,_.Z/.~.. ~ .. FORM NO. 6 TOWN OF $OUTHOLD Building 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 prol~erty with accurate location of all buildings, property lines, streets, and unusual natural or topogral~hic 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 property 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 $25.00 -- BUSINESS $50.00 ACCESSORY $10.00 2. Certificate of-occupancy on pre-existing dwelling $ 50.00 3. Copy of certificate of occupancy $ 5.00, over 5 years $10.001 4.Vacant Land C.O. $ 20.00 7/~.//...~.. 5.Updated C.O. $ 50.00 Date ............... New C °n s t' z" u c t i °n · .'~.~ · · Old or Pre-exJst~B~/~lding ............ V. acant Land ............. location of Property ...... ~ ............................ Owner or Owners of Property .... ~;~,~..~.,~- ,~" .~',~.f ......// - /f~ .~..u~..//.~.. V.~ ................ 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 ...................... ..................... F Jnal Certificate/~ ..................... Request for Temporary Certificate Fee Submitted $..'2-. ~..'. ~ ................. Construction on above described building and permit meets all applicable codes and regulations. Rev. 10-10-78 76S-1802 BUILDING DEPT. NSPECTION [ ] FOUNDATION 1ST FOUNDATION 2ND [ ] FRAMING [] ROUG#:~~LBG. .... [~/J/FiNAL REMARKS: ,,; , DATE NSPECTiON [ ] FOUNDATION 1ST [ ] 'ROUGH PLBG. [ ] F(J)UNDATION :)ND [ ] IN~ULATI0N [ ] FRAMING [ L DATE INSP OR THE NEW YORK BOARD OF FIRE UNDERWRITERS Ir ~ I , ' BUREAU OF ELECTRICITY (~b ,' '~ 85 JOHN STREET. NEW YORK, NEW YORK 10038 THIS CERTIFIES TNATj ' only the electrical equipment, as,, described below and ~ntroduced by the applicant r~atned on the above applicatiowt number in the pre,hi#es of J. Bednos~i,'. Route 27-A, Peconic, N.Y. RXTU~E RANGES OVENS DISH WASHERS EXHAUST FANS OUTLETS 1 DRYERS SERVICE DISCONNECT V I C E ?anelboards: 1-2c~r,,60amp. (Swimming Pool) T~,,certiCicate covers compliance at thQ ~ate of ~nspection only. Because of unusual environments it is aavlsable ~o have frequent 'test~and/or repairs made by a qualified person. AwG OF NEUTRAL Glenn R~ Bradley RFD'169 Hortona\: Ave. SENBEAI. Mattl~uc~e ~N ;Y. 11952 LIc:1227 11 Ih*s cerhficate must not be altered in any mannerl return to the off,ce of the Board if incorrect. Inspectors may be identified by thelr credentials. ~*0~ ~TO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. ................................... _,/_. .......... Dote ............. , 1 .. INSTRUCTIONS a. This application must be completely filled in by typewriter o~ in ink and submitted in triplicate to the Building Inspector, with~ 3 sere 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 o detailed description of layout ofproperty must be drown on the diagram which is port 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 o 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 -IEREBY MADE to the Building Deportment for the issuan.c,e~ Building Permit pursuant to the Budding Zone Ordina ~c.~e,of~l~,~Tewn of Southold, Suffolk County, New York/and o, fher applicable Laws, Ordinances or !d~~e~'~. ~h~'uc~i~of buildings, additions or alterations, or for/emovgl' or demolition, as herein described. :~ JomJl~ith oil applicable laws, ordinances, buildin~ code~housing c~p, a~ regulations, and ~o ~rj ~ ~s and in buildings for n~essa~ in~ectio~. ~ ~ ' ' [Address o~ opph~ont) Sto~[et~SU~¢~Yless ~rchnect, eng,neer, generalcontractor, electr,oon, plumberorbu, O~he~m~de'~ U~n~.o ............. ~...~. ........................ ~ ~ ~' : S ~ ~ = > 1 Location of land on which p~o~e~rk~ ~ ~w~e do~. M~o ................. ~ .................... ~ Lotto ........................ ~...:Z~...~....~~~....~ ....... ~= ......... '~'"~'i'"'~ii ........... Street Number b. Intondod uso ~nd occupancy ............................................................................................................................... 3 Nature of work check which applicable) New Building'. ................. Addition ...... '/~'"'.1. Alter~on ? ........... ; '(to be paid on filing this apphcatlon) 5. If dwelling, number of dwellm~ units ............................ Number of dwelling units on each floor ........................ If garage, number of cars ........... ~. .............................................. ~ ............................................................................ 6. If business, commercial or m~xed occupancy, specify nature and extent of each type of us~ ........................ 7 Dimensions of existing structure~, if any: Fron~ .....~ ............... Rear .... ~d .................. Depth .~.~ ......... kleight ........................Numbe~ of Stories ........... J ................................................................................................... Dimensions of same structure With alterations or additions: Front .................................... Rear .......................... Depth ............... '.: ............... He ght ...........................Number of Sto~es ................................ B~' Dimensions of entire new construction: Front .................................... Rear ............................ Depth ....................... Height ................... Number of _~to~es ....................................... .~.~. ............ y ................................ ~ ........ ~"7 ..... 10. Date of PurcBase ...~.:~ ...... ~.~..~.~ ............. Name of Former Owner ........................................................ 11. Zone or use distnct in which premises are situated .................................................................................................. 12 Does proposed construction violbte any zoning law, ordinance or regulation: ........................................................ ~3. Wdl Io~ be regraded . ........................... WiI~ excess fill be r~moved fro~premJses: ( ) Yes ( ) No Name, of ' Architect '"'~"I~'"Z ........... ~ ............................ Address .~ .................... Phone No ....................... Name of Contractor ..~..~.....~ ................ Address [~ ..... Phone No.~z.~.~ ~ PLOT DIAGRAM Locate clearly and distinctly all buildings, whether existing or proposed, and red,cate all set-back dimensions from property lines. Gwe street and block number or description according to dee~, and show street names and indicate whether interior or corner lot. ~' J'~~X~Z~ ~'b~ :;o,~'e oses and sas that he ,s the above named. . (Contrac.,,~r, agent, corl~,orate offic~er, etc.) of amd owner or owners and is dul~ authorized to perfbrm oF have ~p~rformed the said work and to make and file this application; that all statements jcontained in this application a~e trde to the best of his knowledge and belief; and that the work wilt be performed in th~ manner set forth in the application filed therewith. Sworn to be~ore me this A~ // ELIZAfETH ANN ~/ILLE ~OTARY PUBL~, State of Hew Yetl~ ' ~1~ §2-8].258,50, SuffOlk I T/~tm Expires March 30, lg,.~,~' The sewage dtsposal and rater supply Pacil,.ttos for this location have been inspected by this depal'tment and found to be sa{l~~ · Services 'to D,0 _..tA`` ro ,sro"] : FOR APPROVAL OF CONS~U~ON ONLY DBNCE Wl~ C~F~M B. REF. NO.: ..... ~AND~D~