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HomeMy WebLinkAbout10265-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Town Clerk's Office Southold, N.Y. Cerlificate Of Occupancy No..7..9.~[5 ........... Date . .Sep:heraber..10 ................. 19 7.9 THIS CERTIFIES that the building ................................................ Location of Property .... (3~.0.... ~D.p.~..n. ~ .P.%V.~ ......................... .GU ¢oko. ffg~e... House No. Street Hamlet County Ta× Map No. 1000 Section ., .1.0.4-. ..... Bloc]( ....o.1 ......... Lot ..... 003 ......... Subdivision..H.i. qk.. 9.vY..A. 9.z'.e.8. .............. Filed Map No.. ~.25..Lot No ..... 5 ........ conforms substantially to the Application for Building permit heretofore filed in this office dated ·...~.ay~ .7.'-l? ........... ,19 "/9. pursuant to which Building Permit No .... '1.02652, ........... dated ...O.:.u.n.~ .'!-~) ................. 1979. , 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 ......... ....... qn..e. ?.~.n%!y..IhC~lling. ,/~wimmi~g. P. ool..and. F. ence. Encloaure ........ The certificate is issued to . .. ,B .~.ian. ,~,,. T.,..&. P,~ne].o.p.e .J,. Z~t.J. tl~ .................. of the aforesaid building. Suffolk County Department of Health Approval UNDERWRITERS CERTIFICATE NO...~JS.t,~.O.9.'! 7 ....................................... Rev 4/79 Building Inspector *I'OWN 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) N? 10265 Z Date /.. 19..7. Permission is hereby granted to: ............ x~.:z~.z4.~... ~.~.../.~N ................ ........ ..................... ....... 6%./...-~.~./..,~¢~.G~....~..~~. .............. to....~.~..4,,.~.~...Z'.'~'.~.c...'/. ......... /,~....~.14.~(_,,c,,~..~..,~ ...... ~...~,,,,'./~.,~.x.4.~'~ ..... ~.,4,,.. ............ ~z,~./. . .. .~. .~ zc,.~. ~, ....... ,~ ,~,~. .C. .. . ~. ~. .,:.c, /z. ~-. . . ................................................... at premises located at ..... ~ ............ pursuant to application dated .............. ~',~2.~...~...~. ............ , 19..7..~., and approved by the Building Inspector. Fee $..Z,~....:::.:: ..... f tSCfiSdtng inspector TOWN OF SOUTHOLD OFFICE OF BUILDING INSPECTOR P.O. BOX 728 TOWN HALL SOUTHOLD, N.Y. 11971 TEL. 765-1802 DATE1 14 July 1982 APPLICANT Mr. Smith 610 Lupen Drive Cutchogue, NY 11935 Dear~ Mr. Smiths It has been reported to me teat you have a swimming pool installed on your property without legal permission. I suggest you come to the Building Department and fill out the necessary paper's to be in compliance ,with the law and avoid legal action. Thanking you in advance, I remain. Victor Lessard Administrator THE NEW YORK BOARD OF FIRE UNDERWRITERS ~:)m BUREAU OF EI. ECTRICITY ~'~ 85 .JOHN STREET, NEW YORK, NEW YORK 10038 o..e July 10, 1979 Applicaao.~oon/UJ}27807 .0/ k~ ~ ~.~, ~ THIS CE~IFIES THAT ~_l only the ~t~ equipm~t ~ ~ ~ ~ int~u~ ~ t~ ~nt ~m~ on t~ ~ ~t~ nu m~r in t~ p~m~es of ~. S~gh, 6XO Lupen Dr., Cu~ehogua, L.I. in the following location; [] Basement [] ;st FI. [] 2nd FI. OUtSide Section Block Lot was examlned on July 6, 1979 andfoundtobeincompliancewiththerequlrementsofthisBoard. AMT. AMP, LTYPE ~J~lpR, lJ'2W 1,~3W 3J'3W 3jr4W NO. OFPERCC. COND.,8, RANGES SPECIAL REC'PT R EXHAUST FANS D~MMERS COOKING DECKS OVENS DISH WASHERS TIMECLOCKS BELLIUNITHEATERSUNITHEATERS MULTI-OUTLET R NS ~ SYSTEMS A. W.O. NO. OF NEUTRALS OF CC. COND. OF NEUTRAL OTHER A~A~TUS: (Swimmin~ Pool) This certificate covers compliance at the da~e o£ inspection only. Because of unusual environments it is advisable to have frequent teat and/or r~palrs made by a qualified person. Phil Gordon 12 Dean St. Port Jefferson Station, N.Y. 11776 Llc.ll01 E Per This certificate must not be altered in any manner; return to the office of the Board if incorrect. Inspectors may be identified by their credentials. 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 fil~ed 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 natural 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 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 Date.. ~.'.~'..7 g, .............. New Building .... ~ ...... Old or Pre-existing Building ............ Vacant Land ............. Location of Property . .~. ~.O. ...................... .L..Cl. ?.~..N.. ~. ~.! ~/.~. ......... ~ .~'.T..~: .~! .O..~. Ci.~' House No. Street Hamlet Owner or Owners of Property .~.~. ! .~.N.. ,~....~. S.lV[..i .T.F~...~...~.E..N'~C..o..~ .~...'.,~....~ i.~ 7'.~/. ...... County Tax Map No. 1000 Section /.~..z~. ......... Block . ~./. .......... Lot...~.~..~'.~. ........ Subdivision ................................. Filed Map No ........... Lot No .............. Permit No./.O, .~.~ .~.... Date of Permit (~: .l.~;7.c~ .Applicant . B.~./?../~.../.~..-~....~./.~. ~.~.~/. ........ Health Dept. Approval ........................ Labor Dept. Approval ........................ Underwriters Approval ........................ Planning Board Approval ...................... Request for Temporary Certificate ..................... Final Certificate ... ~ ................ Fee Submitted $ .~': (~.~.-~ ....................... Construction on above described building and permit meets all applicable codes and regulations. Applicant. ~-O.~.~ ~.. FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N.Y. 11971 TEL,: 765-1803 E amined- :.., Approved . J~z,~...[.~..., 19 7.~. Permit No., .~.O.'..~.'.~/., Disapproved a/c .......................... (Building Inspector) APPLICATION FOR BUILDING PERMIT Application No .................. (Name and title of corporate officer) Builder's License N,o ...... ~Q. J. ................. Plumber's License No ..... ]k'... .............. Electrician's License No... / f.L)./. · .~ ........... Other Trade's License No...~..-: ./~ ............ 1. Location of land on which proposed work will be done . . House Number ~ Street County Tax Map No. 1000 Section .... ~' .~ ....... Block . .~:~ ..... .: ...... Lot.. ~~ ~ ........... Subdivision ~ft~ .t).f.. j¢/.(~}~¢.~/... ~. Filed Map No. (~'2'~ ..... Lot...~ .......... 2. State existing use and ~ccupancy ~f premises and intended use and ~ccu~ancy ~f pr~p~sed c~nstructi~n: b .... Intended use and occupancy (~--~ ...... !f~[~f-/:~O/fO(:l'~' · · ~ '~'~l:~?' '~.]' ..... INSTRUCTIONS a. This application must be completely filled in by typewriter or inink 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, orfor removal or demolition, as herein described. The applicant agrees to comply with all applicable laws, ordinances, building code, housing code, and rqgulat~ns, and to admit authorized inspectors on premises and in buildings for necessary inspections. //~ -- /] '~ /I (Signature of applicant, or name, if ,a ddrporation) (/~ailing address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or buitder.'~ C,.' ,' . L.I · ......................... (as on the tax roll or latest deed) If applicant is a corporation, signature of duly authorized officer. 3. Nature of work (check which appa*aole): New Building .......... Addi .. Alteration .......... Repair .............. Removal .............. Demolition .............. Other Work ............... ,,' (Description) 4. Estimated Cost ?'" / /':' (2 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 ...................... Height ...................... Number of Stories ...................... 8. Dimensions of entire new construction: Front ............... Rear ............... Depth ............... tteight ............... Number of Stories ........................................................ 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 ...................... ~..,.,. .......................... 12. ' .... . i~./ "-/ Does proposed construchon vml~,te~any zoning law, ordinance or regulation.. ..................... ., .. ....... 13. Will lot be regraded ....... ,j.~: ~:b. .... ,~ .......... Will excess fill be removed from premises: ! 4. Name of Owner of premzse, s ,. ~.,.... ,... ~: ..... Address ... ~.., ....... , ...... hone ................ Name of Architect ...~ ....... ..: ...... ~:,....., .... Address .................. P~one No ........ Name of Contractor ...',¢ '."...(;:; ~...r. ,. /~,' .... Address, ..... '? ...... ,..../ .... ~hone 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 number or description according to deed, and show street names and indicate whether interior or corner lot. STATE OF NEW ~ORK, COUNTY OF ...... ,.j.../.,,.%~.. S.S '"~ .'": ".;;'~/ ~ '/", / / / /") being duly sworn, deposes and says that he is the applicant (Name of individual signing contract) above named. He is the ..... ~" ' '(/C ~ (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 me this ....... ..¢....¢... ...... ............. Notary Public, . ...... ~.~..~. ............ County A ~, Nota~ Public, Slate of NowYoI~ /] ~ No. 52-4612312 ,..., .,. (Signature of applicant) / ~ ~ .~ Qualified in Suffolk County ~/" /~~~~s March 30,19-- LUPEN DP. tVR. N,80 12 ~ E. :SCALE- 40': ' ,/ Wt?~ ' ANCHORED COPING GRADE / ' ~ SECTION ~-A ''~ E / SLO~ ~ B . - ~ ~SF~BERGLAS.B~c'OWENS CORNtNG" I { ~ ~ I t ~' ~ TROWELED ON EACH F ~ ', ~ _~__ ~ I ~ ~ ~ OF CONCRETE BLOCK WA ~E~ALL sECT'ON ~ FILTERondPUMP ~ ~t ~ ~ ti ::. L~'.~',~.~ .o~ ~-~i -~ PIPING ARRANO~M~NT_ ¢~'~*~ ~g..' ,,: ~' ~ POu~E~CONCRETE ~ - ~ , FOOTING ~ '~ S ECTI 0 N ;NOT~S... ~ ~ , ,- WALKS TO 9E SMOOTH- NON SKID ~PE, SLOPED ~ ~ ~ ~ STEEL ~PPOeT ~ · ' /3 STEPS PROPERTY TO ..J,, LOCAL REGULATIONS. ~ ~ t~OULD~D ' S~ZE A ~ I c I O E F G ~R CA* '