HomeMy WebLinkAbout10233-zFORM NO, 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Town Clerk's Office
Southold, N.Y.
Certificate Of Occupancy
No. Z9716
Date October 18 19 79
THIS CERTIFIES that the building ................................................
Location of Property 130 Tasker Lane . Oreenport ...
House No. ' ............... 'S'tt:e~i ...................... I21~mlet
County Tax Map No. 1000 Section 53 .Block /t- .Lot
Subdivision...ty.a.a.~.e..r.n. ~B...o.r.o.8. ........... Filed Map No, ~Q .2.'1 .... Lot No ..... ~..~ .......
conforms substantially to the Application for Building Permit heretofore filed in this office dated
May 21 197.9.. pursuant to which Building Permit No .... J.Q2.~. ~.z. ..........
dated Ma.y...2..2 ................ '.. 19 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 and Fenge . .
Thc certificate is issued to Kenneth J.. Rishe. ..........
of the aforesaid building.
Suffolk County Department of Health Approval ...................... ,ff ...............
UNDERWRITERS CERTIFICATE NO ................................ : ..................
/
Building Inspector
Rev 4/79
FORM NO. 2
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN CLERK'S OFFICE
SOUTHOLD, N. Y.
BUILDING PERMIT
(THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL
COMPLETION OF THE WORK AUTHORIZED)
10233 Z
Permission is hereby granted to:
.... !..<.E~.~.~ ....... ..v..:.....~.!~..C¥......~.~:~
............................ ~_~.~?~..T.. ...... .~:...~. / ~/
~IL · I~ ~U~ _~ /~/~ p~o~ ~D I=~~
~o ..... ~_....~ ...... ~ .............................................................................................................................
at premises located at ................ ./....~..~ ...... .,,~/-~ ._¢..../~...~..7~... ........ ..~...~...,~..~ ..............................................
...................................................................... ~ ~.~.~.~.~'.~z.,....~('....':d ...................................
Building Inspector.
Fee $ ........................
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 Wpewriter 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 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 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.
Fees:
1. Certificate of occupancy $5.00
2. Certificate of occupancy on pre-existing dwelling or land use
3. Copy of certificate of,occupancy $1.00
$5.00
Date .....................
New Building ............. Old or Pre-existing Building ... ,~ ...... Vacant Land .............
Location of Property /.~..~. · ./~. k¢.~ · · · ~. z/~-.~. .d~. ................ .~?. ?'..~;~..~1 )~.~ ?.. -
House No, Hamlet
Owner or Owners of Property ~.'.d.-~,q~..~..~.. ................................
County Tax Map No. 1000 Section ... ~'~.~ ........ Block .... /. ........ Lot ..... /1/..~. · .....
Subdivision .~.??. :'~.1%/'/....?~. ?.?'.d.~: ......... Map No .... -~.~..~../ ..... Lot No .... .~. · ...~ ....
Permit No//4~.~.~ :~..~. Date of Permit ..~...~.~:,9...~..Applicant .~.~..~ ....
Health Dept. Approval ........................ Labor Dept. Approval ........................
Underwriters Approval/~J .~..~..~..~'. x///. ........... Planning Board Approval ....................
Request for Tempora~ertificate ..................... Final Certificate .....................
Fee Submitted $ .............................
Construction on above described building and permit meets all applicable cg~]es ar)~ regu lations. App,icant ..~~--,..~........~..'~ ...............
,.,. ,o.,o.,a /
FORM NO. 1
TOWN OF $OUTHOLD
BUILDING DEPARTMENT
TOWN HALL
SOUTHOLD, N.Y. 11971
TEL.: 765-1803
Disapproved a/c ..... ~'.~':~.~: .~... ~ .....................
.......................................... ....
(Building Inspector)
APPLICATION FOR BUILDING PERMIT
Application No. ('. i:...: .......
/f~./~q/ · 19.?/~/
Date. . .:;~/ ....,
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, ~ccurate 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 ~nust 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 perm~
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 Occupanc'~
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,.bt~ilding code, housing code, and regulations, and to
admit authorized inspectors on premises and in buildings for necessary inspections.
.>,.L.
.......... ,> ~ ~,,,... ../. · .~,,,.: ........
(Signat,gg~of applicant, or nhn4e ~1~ a corporation)
(Mailing address of applicant)
State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder.
ownel~
Kenneth J. ~i~ha
Name of owner of promises ..........................................................................
(as on the tax roll or latest deed)
If applicant is a corporation, signature of duly authorized officer.
........ iName and title of corporate officer)
Builder's License No. #61
I~/A
Plumber's License No .........................
1101 g
Electrician's License No .......................
Other Trade's License No ......................
Eaet ;>~t~e Tasked' Lane
Location of land on which proposed work will be done ..................................................
33 Tasked' Lane O~,eanpel,~
House NumBer Street Hamlet
County Tax Map No. 1000 Section .................. Block .,. ............... Lot ...................
Subdivision l~ap o£ ~ss~x'n Shox'~8 Filed Map No. [lOal Lot 33
(Name)
State existing use and occupancy of premises and intended use and occupancy of proposed construction:
a. Existing use and occupancy .....................................................................
b. Intended use and occupancy ............................... ' ..............................
3. ]Nature of work (check which applicable): New Building .......... Addition .......... Alteration ..........
Repair .............. Removal .............. Demolition .............. Other Work ...............
(Description)
4. Estimated Cost ...................................... Fee ......................................
(to be paid on filing this application)
5. If dwelling, number of dwelling units ............... Number of dwelling units on each floor ................
If garage, number of cars ........................................................................
6. If business, commercial or mixed occupancy, specify nature and extent of each type of use .....................
7. Dimensions of existing structures, if any: Front ............... Rear .............. Depth ...............
Height ............... Number of Stories ........................................................
Dimensions of same structure with alterations or additions: Front ................. Rear ..................
Depth ...................... HeiSt ...................... Number of Stories ......................
8. Dimensions of entire new construction: Front ............... Rear ............... Depth ...............
Height ............... I~umber of Stories
9. Size of lot: Front .... !9.0............... '~;~i iiiiii i~0.~?iiiiiiiiiii'~)~i~'iiil)~.°.'!iiiiiiiiill J J
10. Date of Purchase ............................. Name of Former Owner .............................
11. Zone or use district in which premises are situated .....................................................
12. Does proposed constructio~olate any zoning law, ordinance or regulation: ....... .n.o .......................
13. Will lot be regraded ............................ Will excess fill be removed from premises: Yes ~
14. Name of Owner of premises . .K. $~1~.$1~1. ~8195... Address J~..~88~.~.~.. bt~l$.. Phone No..1~77.-.1006 .....
Name of Architect ..... .N~A. .................. Address ................... Phone No.
Name of Contractor .87..~.ra.- .K.~ .rig..P.o. 97..~ ........ Address .R.o.~.~...~.A. ........ Phone mo~ i'~41'.'.~.'~ ~)~)i i i i i
Rooky Potni;~ N,Yo 11776
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 number or description according to deed, and show street names and indicate whether
interior or corner lot.
STATE OF NEW YORK,
COUNTY OF..Suf£o.lk ....... s.s
Kenneth Rishe
................................................. being duly sworn, deposes and says that he is the applicant
(Name of individual signing contract)
above named.
He is the
(Contractor, agent, corporate officer, etc.)
of said owner or owners, and is duly authorized to perform or have performed the said work and to make and file this
application; that all statements contained in this application are true to the best of his knowledge and belief; and that the
work will be performed in the manner set forth in the application filed therewith.
Sworn to before ~ this
197.¢.... /7 d of
//, _. .
."7. .,.G..,i,~.% ~". s..o,, c,~.~, g'/ --
(Signature of applicant)
b.I 0
· t · . 5<
.~-.
CAST
COPtNG
E.=Z_-.,
SECTION B'B
LNOT E S....
WALKS TO SE SMOOTH- NON SKID TYPE, SLOPED
AWAy FROM POOL
WATER DISPOSAL SHALL BE LIMITED TO OWNERS
PROPERTY TO SUIT LOCAL REGULATIONS
SIZE A B C O E F G ARE/ CAP
16',~ $2' I6 32 8 8 12 4
I '
GRA3E
. I f~, If~,k,-~'.~4' ' ..~T[' -',-~ORED TO CONCRETE
8'- J ~'~ BLOCK
SECTION ~-A "
RETURN ~ o
~OL~D FOAM
~TO FILTER BETWEEN
-''AL ~FROM SKiMMER~
-- SEE TY~ ~ .....
WALL SECTION ~
~ / ~ FILTERend PUMP
TO RETURNS F~M FILER
TO WASTE ·
.... :~PIPING ARRANGEMENT ~'~ s~.~ ~":" ~'~
........ ~t.~
E C~,ST CONCRETE
COPING
GRADE
THICK 'OWENS CORNIN
FIBERGLAS' BLJ3C BOND'
TROWELED ON EACH
OF CONCRETE BLOCK V
POURED CONCRETE
FOOTING
FIBERGLA~
MOULDED
I PIECE
OPTIONAL STEP
TYPE I.
T__Y=PIC'AL WALL SECTION
0 C'