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Home My WebLink About10874-zFORM NO. 4 TOWN OF 5OUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. Certificate Of Occupancy No....ZY. lfi. 2..2.9 ....... Date January 29, 1987 THIS CERTIFIES that the building INGROUND SWIMMING POOL & FENCE 3376 Wickham Avenue Mattituck, N Y Location of Property ................................ ' · House No, ''' County Tax Map No. 1000 Section I 07 .Block ,09 .Lot 15 Subdivision. fi.m.d... ?./.o..H.a.C.~.~.t.u.c,k..H.e.J:g.h.~.s....Filed Map No. 1184 .Lot No. 9 & 10 conforms substantially to the Application for Building Permit heretofore filed in this office dated August 22, 1980 pursuant to which Building Permit No. 10874z dated ...S.e.p.t..e .m.b.e.r...1.9. ,.. J .9.8.0. ....., 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 The certificate is issued toFRANK RAYNOR ..................... ?oYn'd , ..................... of the aforesaid building. Suffolk County Department of Health Approval .......... N / A UNDERWRITERS CERTIFICATE NO. N 5 2 0 6 5 3 N/A PLUMBERS CERTIFICATION DATED: '~!ing Inspector Rev. 1/81 FO~EM ~qO,' 2 BUILDING DEPARTM! TOWN HALL SOUTHOLD, N, ¥. BUILDING P, ERMIT~, (TH S PERMIT MUST BE KEPT ON THE PR£M SiS UNTIL ULL COMPLETION OF THE WORK AUTHORIZED) ~..~. ~ .~.,~e ~ N9 ~0~74 Z ~. ,..~ ........... , .......................... , ....... PermiSsion is hereby granted to: ...... : ................................... ,' ........ ~7~'"~'~';"~. ~. o.. ~ .~o8 ........................... : ...................... ~.... ................ BUIAD A SWIPING POOL & F~OE ~0 .............................................................................. ~ .......... "'~'"'?'~ .......... ""~ ........................................ s~ D~em~ses ~oce~ed e~ .........~ ................................. ~,--.{~ ....................................................... ~ ~ o~ ~z~ ~.~ ~3 ~9~ .~ ~ 39. .......... .............................................................................. 107 Building Inspector. 'Building ~lnspector :.. 15.oo Fee 4, ........................ FORM NO. 6 TOWN OF SOUTHOLD Building Department Town Hall $outhold, N.Y. 11971 765- 1802 APPLICATION FOR CERTIFICATE OF OCCUPANCY Instructions A. This application must be filled in typewriter OR ink, and submitted ..~ 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. B. For existing buildings (prior to April 1957), Non-conforming uses, or buildings and "pre-existing" land uses: 1. Accurate survey of p~Coperty showing all propertv 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 $25.00 -- BUSINESS $50.00 2. Certificate of occupancy on pre-existing dwelling $ 50.00 3. Copy of certificate of occupancy $ 5.00, over 5 years $t0.00 4.Vacant Land C.O. $ 20.00 5.Updated C.O. $ 50.00 Date .......................... NewC°nstructi°n ...... Old or Pre-existing Building ............ Vacant Land ............. Location of Prop erty ~...~..?. ~...~...-~/.~.~. ~.~/..~'~.....~..~..L~ .... . ./~/?/~ ~.¢~, ?../.~.. .............. House No. Street Ham/et Owner or Owners of Property , ~'.~.~..~?~.../.~. ................................ County Tax Map No. 1000 Section .............. Block ...~;.~. ....... Lot .............. Subdivision..~. ~.7¢.,./.g/.~..~../..~,.~./.~ .~..~ ....... Filed Map No../'/~...'~.~/~/..Lot No....~.~../?. ..... Permit No./~..d)..~. ?..5~.~. Dat~ 9f Permit .......... Applicant ................ ~/3/7~ .................. Health Dept. Approval ........................ Labor Dept. Approval ........................ Underwriters Approval 3~,~c~ .~..~, ,.~ .Planning Board Approval Request for Temporary Certificate ..................... Final Certificate ....................... Fee Submitted $ .... I.q,..c~. .................... Construction on above described building and permit meets all applicable codes and regulations. Applicant .................................................... Rev. 10-10-7S FORM NO. 6 TOWN OF SOUTHOLD ~uild~ng Department Town Hall Southold, N.Y. 119TI APPLICATION FOR CERTIFICATE OF OCCUPANCY Instructions A Tl~s apphcation must be filled in typewriter OR ink, and submitted in duplicate to the Building inspec- tor with the following, for new buddings or new use; 1 Final ~¥ey of property w~tb accurate location of all buildings, property lines, streets, and unusual natural or topographic features. 2. Final approval of Health Dept. of wa~er supply and sewerage disposal-(S-9 form or equal). 3. Approval of ei¢ctrtcal installation from Board of Fire Unden, vriters. 4. Commermal bmldmfls, Industrial buildings, Multiple Residences and similar buildings and installa- tions, a certificate of Code con]phance from the Archt[ect or Engineer responsible for the building. 5, Submit Planmng Board approval of completed site plan requirements where applicable, B. For exist~f~9 bufid,~gs (prior to April 1957), Non-conforming uses, or buildings and "pre-existing" land uses' 1. Accurate ~Jrvey of peoperty showing ali property lines, streets, buildings and unusual natural or topographic featt res 2.Sworn statement of owne~ or plevious owner as to use, occupancy and condition of buildings. 3. Date of any housing code or safety inspection of buildl)~es or premises, or other pertinent informa- hen requi~ed to prepare a certlf~cate. " C. Fees' 1 Certificate of OCCUpdrtcy $5.00 2. Certificate of occupaney on pre existing dwelhng or land use $5,00/~ 3. Copy of certificate of occ~pancyo~. $1.00 Owner or Owners of ProperW , . . .... County Tax Map No. 1000 Sect,on..'l O..7. (~J~' ..................... Health Dept. Approvat .,~ :':". '.: _ ..~-, ........ Labor Dept. Approval ......... Underwriters qequest for Temporary Cart f c to .................. F ra Cer[f cate .~ .......... Tee Sub,'mtted $ .... ~ ............. /1 ,onstruct,or, on above deso,,bec, build,n, an&~r~et~ a--ppliNe cod~and regulations. FORM NO. 6 TOWN OF $OUTHOLD r3uildi~g Department Town Hall Sou,tbpld, N.Y. 11971 APPLICATION FOR CERTIFICATE OF OCCUPANOY ~nstructions A. This application mus~ be filled in typewriter OR ink, and submitted in duplicate to the Building Inspec- tor w~th the following, for new buddings or new use: 1 Final survey of property w~th 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 dlsposal-(S-9 form or equal). 3.Approval of electrical ~nstaltation from Board of Fire Underwriters. 4.Commercial buddings, industrial buddings, Multiple Residences and similar buildings and dons, a certificate of Code comphance from the A~ch~tect or Engineer Cesponsible for the building. 5. Submit Pl~nrung 8omd approval of completed site plan ~equirements where applicable, B. For existing buddings (prior to Aped 1957), Nomconforming u~s, or buildings and ' pre-ex'st'ng" land uses' 1. Accurate su~ey of peoperty showing all p~operty lines, streets, buildings and unusual natural or topogr~ph c features. 2Sworn statement of owne~ or previous owner as to use, occupancy and condition of buildings. 3. Date of any housing code or safety inspection of buildings o~ premises, or other pertinent informa- l~on rcquired to prepare a certificate, C. Fees: 1. Certificate of occupancy $5.00 ~. Ceruf,cate of occupancy on pre existing dwelling or land use $5,0~ . Copy of~cert~ficate~ of oc~panc~ $? .00 .~J/~' Subd,v,s,o~,~. ~.. ~ F ed Map ~o./ ~'/ P-rmitNojO~.~Z. DateofPerm~./¢..~p~licant ~;;~ /~..., ..... Heath Dept A rova. ' ~ · ~ ~-. .................. Labor Dept Ap~r¢~a(~ .~ .... ? ........ . ~equest for Temporary Certff~3te ..................... Final Certificate .. ~... ..... Fee Submitted S. .~ .: ............... /~. ' ~'~ ,' :onstruction o~ above described bud6mg/~,s,all ap~ole ¢~d rsgulatio~s, '~' THE NEW YORK BOARD OF FI~RE UNDERWRITERS BUREAU OF ELECTRICITY n Bs Jo.. T.EET, HEW ¥OR., THIS CERTIFIES THAT only the electrical equlprnent ~ described belo~ and introduced by tt~ applicant named on the able application number in the premlses of Prauk ,Rayrlor ~ WS~ktm:~:/~Ve, ~:,~76~ l~¢tt~k, was examined ,,n '~V~y-- ~[ q' ' ," ¢"*'X ~al a,td you,td to be in compliance with the requirements ,ff this Board. FIXTURE FIXTURES RANGES COOKING DECKS OVENS DISH WASHERS EXHAUST FANS OUTLETS SWITCHES ~LUO~.SC~NT v~o~ DRYERS FURNACE MOTORS FUTURE APPLIANCE FEEDERS TIMRCLOCKS UNIT HEATERS MULTI-OUTLET DIMMERS SYSTEMS NO OF FEET SERVICE DISCONNECT S E R ' V I C NO O~E(~C~,CONO A W C~ I~O OF MI LEO A W O NO OF NEUTRALS OF CC CONO O~ HI O ER AR RATUS OF NEUTRAL 169 I~:~?:'ton Th~s cerhhcate must not be altered m any manner, return to the ofhce of the Board 1ie~1227 GENEI~At MANkGBR Inspectqrs may be identified by their credentials. COPY FOR BUILDING DEPARTMENT. THIS COPY OF IN ANY MANNER. FI.~LD~ T~NSPECTION FOUNDATIOM COMMENTS FOUNDATION (2nd) ROUGH FRAME & PLUMBING INSULATION PER N.Y. STATE ENERGY CODE FINAL ADDITIONAL COMMENTS: 1~0~ ~0, 1 TOWN OF $OUTHOLD ~ BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. ...... . ~ j /~? ~/~ ~_ Approved ................ ..~...~'/.~.~./.. ~? 1~..~.. Permit No ..................................... D~sapproved a/c (Building Inspector) APPLICATION FOR BUILDING PERMIT ~ INSTRUCTIONS Date ...~........~.....~....[J ............. Application No ................. ./.... .......... a. TMs application must 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 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 ofproperty must be drawn on 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 apphcant. 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 Y.g~k, and other appllcable Laws Ordinances or Regulations, for the construction of buildings, additions or alterations, or,~r lemoval or d~molition, as herein described The apphcant agrees to comply with oil applicable laws, ordinances, buil/fing/code, housir/~co~le, and regulations, and to admit authorized inspectors on premises and in buildings for necesso~i/,~_....,.,,~ .~~ ........ i~i~'~'~ture of '~',"i-f"~"~'o~]~'~i~i~'i ........ Nam/~ of_o,, her of reminds .....~/.U-/~ ......... ~.),J.....o~.. ..................................... : .............................................. ~ra~rporate, signature of duly authorized officer. Builder's License No ..................................................... Plumber's License No ........... ;,~1. .......... "j'"lt ................ E,ectr~c,an's L,cense No ..... ..J~.~.~.L.~..:..--....... Other Trade s License No ....... ~......~.~. .......................... 'jc ono a.do.w ich o o .. or /.. ....... Street and Number ....~.~.../....~.:.J..~../7,~.~t..../~. ....... .~...~....-~.....~~.....~... ........................... Municipality State existing use and occupancy of p~mises and intended use and occupancy of proposed construction: a i~xisit.ng use and occupancy .... ~.~ .~ ..C...~?.~,, ............................................................. b. ntended use and occupancy ....... ..~....O.....C~.~..!.......c~........~..~..~ ................................................... 3. Nature of work (check which,applicable): New Building .................. Addition ................... Alteration ............... Repair ........... Removal .................. Demolition ....... Other Work l.?~...~.(..,.~7........r',..,.-f~..~ .... ........ ',~ . / ~ .~ o (Description) .~MOOO / .......... , ......................... ............ ,..-....,.. ............................................................. (to be p~id on filing this ~pplic~tion) 5. If dwelling, number of dwelHng units ........ ~ ................... Nu'mber of dwelling units on e~ch floor ........................... If g~mge, number of cars ........ ~ ............................................................................................................................. 6, If business, commercial or mixed occupancy, specify n~ture ~nd extent of e~ch ~pe of use .............~ .............. z.~,.~io~ o~,x,~t,~ ~tr=~.~,~. ~ ~: ~o~t~"O ........ ,~,~ ..... ~.Q ................ ~,~ ..~..~.~ Height ,......' ................. Number of Stories .... Dimensions of snme structure with ~ltemtions or ~dditions: Front .................................... Rear ............................ Depth ................................ Height ............................ Number of Stories ................................ 8 Dimensions of entire new construction: Front ....................................Rear ............................ Depth ........................ iht , Numbe~ of Stories ........................................................................................ He g ................... /~' 9. Size of lot: Front ....... ~..~...~ ........ ~ ......................... Rear ........ ............ ~. ............... Depth ....~..~. ........ ]0. ~ ~ of ~r~h~e ..~¢.Z:..:~-- ...... .G..]. ................. --~ of ~.~ Ow~e~ ........................................................ 1 1. Zone or use distr,ct in which ;premises are situated ...... ~ .................................... ~ ...................................... 12. Does proposed construction violate any zoning law, ordinance or regulation: ......... ~..~....~ ................................ 13. Wd[ lot be regraded'. ........................... ~ ~, ~Will excess fill be removed from premises: ~Yes ( ) No 14. Name of Owner of premises .~.~.....~.~:~ ........ Address [~.~.....~ ............. Phone No.~..J.~ Name of Architect ..~ ....... ~ ......... ~.~ ............................. Addre~ ................................ Phone No ....................... of .................... PLOT DIAGRAM Locate clearly and distinctly a I buildings, whether existing or proposed, and indicate all set-~ck dimensions from property lines Gwe street and block number or description according to deed, and show street names and ind cate whether interior or corner Iol Ioo' STATE OF NE~' ¥,~1<,~.~..~ ISS C O U N T T~ .N~_NN.~../F.~6////'~. 2...; f -'.- . being duly sworn, deposes and says that he ~s the applicom above nomed. '---- C~ ._,._~..,~ _ ~- He is the ~ recto parole officer, etc.) of said owner or owners, and is duly authorized to perform or have performed the said work and to make end file this appl cat on that ail statements contained in this application are true to the best 9,f his knowledge end belief; and thor the work will be performed in [the manner set forth in the application filed therewiFo/. Sworn to before me this ~ _4 // ...... o, .............M: Noto~ Public, · .......... ~. Couo~ ~.~~-: ...... it- ......... :'~ ........... ~/ ' ' / ~// ) - ~/~ J~ '. ~ ' ~ / (Signature of applicant; NOTARY PUBLiC,State ?.N~ ...... Nb. 52.B125850, Suborn Term Expires ~arch 30, TITLE NO. 1265161 SUBDIVISION MAP FILED IN THE OFFICE OF THE CL~'RK OF SUFFOLK COUN~ ~ dULY 2~, 1~5~ AS MAP N~ 118~. SURVEY FOR FRANK L. RAYNOR ~ BERTHA E RAYNOR LOTS 9 ~ I0 "AMENDED MA? OF' T4J TFITUCK HEIGHTS" .. MA TTl FUCK TOWN OF SOUTHOLD SUFF, CO, N. ~ GUARANTEED TO' THE TITLE GUARANTEE CO. SCALE. I ''= 40 ' THE UNITED STATES OF A1'ERIC~ FARllERS HOME ADMItIIST~ATION OCT. I7, 19~9 FRANK L. RA YHOR ~ 6ERTHA E. ALDEN ~ ~OW~ PROFESSIOH,4L ENSINEER AND tAND SURV~OR~ N ~S. LI& NO. RIVERII~AO~ N. Y