HomeMy WebLinkAbout10878-zFORM NO. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Office of _the Building Inspector
Town Half
Southold, N.Y.
Certificate
Of Occupancy
Date March fl5 ., 19.8.3.
THIS CERTIFIES that the building ....fi:c.c..e.s.s.a..r.y ..................................
Location 2?60 Little I~eck Rd.
of Property .. . Cutcho ue
House No. 'S'tle3i '' ~ .....
County Tax Map No. 1000 Sechon '103 .Block 0/4 .Lot 0/4-2
Subdivision..B..~...y..~.h..o..~?.~ ................ Filed Map No...3.2.3..5..Lot No... J ~ .........
conforms substanttally to the Application for Building Permit heretofore filed in this office dated
..... .S9~..°.m]:).e.~.. 9..., 19 ~..0. pursuant to which Building Permit No ..... ~..0.~.7.~..g ..........
dated . . .S. ep.~e.m.t?e. T..fl. 9 .......... 19 ..~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 pool & Fence enclosure
Richard Oliver & Wife
The certificate is issued to ..................... [o~n'og'l[~s~ge'dr't3t3a'n'O ......................
of the aforesaid building.
Suffolk County Department of Health Approval N/A
UNDERWRITERS CERTIFICATE NO ....... .~9¢?~.8 ...................................
Building Inspector
Rev 1/81
N? 10878 Z
Date ...... ~....~..~ .............. ? ........................... · ......
Permission is hereby gradted to: ?
......................................... · ' ................ : .............. ;
...............
~ ~., ~.~[~, ~;~,...lJ ~$..~ ..............
~0 ............................................................................ , ............... ~-..~..,. ............. ~ ........................................
Qt premises IOCQTeG aT ................................ ; ......... -~{ ........... ;~;~,.,'~,.~ ......... "*"~ ............ ~ ..........................
..................... ~ ........................................ ~ ........... ..4-;,.~ ................ + ......... ~ ...............................
Coun~ T~x ~ep No ]000 Secton ..... ; ....... BI~E ~ ~ ....... Lot No ............
. ~ 8eptembe~ 11 ;:
pursucnt, to cpp] cet~on ~dctea ................ ; ............. , ............ ;.?.,~ ......~.,,.~.., end cpproved by the
Building Inspector. :~' 2
P~P, MIT INCLUDES A~PROV^L
TO REMovE EXCE~S FILL
FI~OM ABOVE PREMISES BY
REGRADING~, LOT
DRIVEWAY CONSTRUCTIO~
t~4~li~OOL CONSlRUCTIO~ ~
CE~LA'R CONSTRUCTION ~
OTHER ~
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
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.
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 .. ~o~5'I~- ..
New Building . ~... ..... Old or Pre-existing Building[X)., ..... ,~ _,~/Vacant Land
Location of Property . .,22'(~&~, .~.~ .b~ t:.,?c;~..t,ci: .............. ; .~u.~c.h..o.~u.e~ ...................
House No. Street Ham/et
Owner or Owners of Property Rlchard Arle~m 011vet
County Tax Mu No. 1000 Section 1,0~ Block 04 Lot ~j 042
Subdivi~on ...... .S.u.~.qy..S.h.o.?? ............... Filed Map No. ~231 .Lot No.
19
V 9/11/80 . ,. Tetra Pool Corp.
Permit No. 1.0,~.7.~. .....Date of Permit .......... ~.ppHcant ..................................
Health Dept. Approval ........................ Labor Dept. Approval ...................... ~..
Underwriters Approval ,/t.~, , .~'.~..~, .'~, ~.~ ..........Planning Board Approval ..................
Request for Temporary Certificate ..................... Final Certificate ........ - ......... *
Fee Submitted $ .... ~.' ...... V~, ...............
Construction on above described building and permit'meets all app~cable~coc~ anc~regulations.
THE NEW YORK BOARD OF FIRE UNDERWRITERS
~-- BUREAU OF ELECTRICITY~:
8S JOHN STREET, NEW YORK NEW YORK 10038
-.t~ Septm~r ~5, 1,980 ~p~,~o,,~o.o,,~ 091639 N
THIS CERTIFIES THAT
in the /ollowlng location; ~ Basement ~ 1st FI. ~ 2nd Fl ~S~ Section Block Lot
w~ examined on ~p~e~:' ~2, ~950 attd found to be in compliaa,'e with the requirements of this Board.
OTHER APPARATUS.
Panelboard/s; 1~2 ch". 60a~p
1 MCi
$ E
NO O~ERC~COND
R V I C E
A W G NO OF HI-LEG A W G
OF CC COND OF HI
(Sw/~md~g Pool) This cez~ificate covers compli~me at ~he dat:e of
iz~pectiO~ o~Ky. t~ecan~se of ~ual envlror~ent:s i~ is a~lv~sable
to hav~ fzequent ~ests ~a~d/or repair~ a~ade by a qualified peraoa.
NO OF NEUTRALS j
A W G
OF NEUTRAL
Janes T. Ridge & S¢~ Inc.
Th,s certificate must not be altered ~n any manner, return to the office of the Board ~f y be identified
COPY FOR. BUILDING OF ALTERED IN ANY
FZ~LI~U_NSPECTIONV COMMENTS
FOUNDATION
(~se)
FOUNDATION
2.
ROUGH FRAME &
PLUMBING
(2nd)
INSULATION PER N.Y.
STATE ENERGY
CODE
FINAL
TOWN OF SOUTHOLD
OFFICE OF BUILDING INSPECTOR
TOWN HALL
SOUTHOLD, N. ¥. 11971
TEL. 765-1802
November 12, 1980
Richard Oliver
Box 37-F
Little Neck Road
Cutchogue, New York
Dear Sir:
This is to notify you that Building Permit No. 10261Z
issued June 13, 1979 to construct A/G poo~
will expir---~-on De~emb~ 13, '~980 .......
If more time is required to complete the job 'and obtain a
Certificate of Occupancy, you may apply, bY letter, for a
six (6) month e~tension. '
If the work is not completed and the Certificate
not issued after the six (6) month extension period,
than required to apply for a new building permit.
Very truly yours,
GEORGE H. FISHER
Sr. Building Inspector
of Occupancy
you are
Re; Above - As told in ,p,_~ne--~- , _ Nov~. 19, 198~ I
am informing you that t~p?up.under ~uilding Permit
is no lo,er f~ Use. It has~~, d~a~ ~stalled a new
In th~ 9round psol under a n~w Buildi~ Pe~lt. Thankyou
/
~/~W/~/Y~M~. Arleen Oliver.
FORM NO. 1
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN HALL
SOUTHOLD, N.Y. 11971
TEL.: 765~1803
Disapproved a/c ......... ~.. ...... ~ ~.(~. ..........
(Building Inspector)
~PPklC~TIO~ FOB BHILDI~G ~E~IT
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, 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 Sou(hold, 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 heroin described·
The applicant agrees to comply with all applicable laws, ordinances, building code, housing code, and regulations, and to
admit authorized inspectors on premises and in buildings for necessary inspections.
.... ~.'r. ~..0.... ~...c~.. ~..~.~¢. .........
(Signature of applicant, or name, if a corporation)
.7. ?... . .?. ... . ~. .~. ~.o . .~: . ~ ~c~.
(Mailing address of applicant)~/,~.
Stgte whether applicant is.owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder.
~ . ..... ,C.E.~, g ~. .~ .... Co~. .~. P-~. .-. .~g ..............................................
Name of owner of premises ...... .ii.~. !..~-..~..~. ~..~. ...... ~./,~ ].~. · .~. ].~, ...................................
(as on the tax roll or latest deed)
If ~~a~horized officer.~
(Name and~~gr'a~ ;~ic'e'r) ..... ~,.... S .
B~lder'~ License No .... .P.~..~..t>.~.8.~ .......
Plumber's License No .........................
Other Trade's License No ......................
1. Location of land on which proposed work will be done ..................................................
~.~w. ~....x!~.c..~..~,.. W.. ! c. ~t....~..P ...... ~v.W,, .c4~. ,O~O.~ .................
House Number Street Hamlet
County TaxMap No. ,O00Section ..... I.~ ....... Block .......... ~ ...... Lot ....... q.~ .......
Subdivision.. ~O ~. ~..~.~ ~ ........ Filed Map No. ~ ~.~. ~ ..... Lot .... t~ ........
(Name)
2. State existing use and occupancy of premises and intended use and occupancy of proposed construction:
a. Existing use and occupancy .. O~..~.~..~/~/~ .............................
'l~ended use and occupancy . .~~...~..[~ ~...~ff/~.~/~? ~O~..
Nature of work (check which aDplicable): New Building .......... Addition .......... Alteration ..........
Repair .............. Rembval .............. Demolition .............. Other Work
Estimated Cost ...... ,
(to be paid on filing this applica~tion)
If dwelling, number of dwellingiu~ts .... [. ......... Number of dwelling units on each floor ................
If garage, number of cars .... ~ ~ .............................................. ~ .................
If business, commercial or mixed occupancy, specify nature and extent of each~type of use ...'.... ~. ............
Dimensions of existing strnctures, if any: Front ............... Rear .............. Depth ...............
Height ............... Nur0ber of Stories ........................................................
Dimensions of same structure with alterations or additions: Front ............. ' .... Rear ..................
Depth ...................... Height ...................... Number of Stories ......................
Dimensions of entire new construction: Front ............... Rear ............... Depth ...............
Height ............... Number of gtories ...........................................
Size of lot: Front ........... , ........... Rear ...................... Depth ......................
10. Date of Purchase ........... ; .................. Name otaFormer Owner .............................
1 1. Zone or use district in which premises are situated ................................................... .~
12. Does proposed construction violhte any zoning law, ordinance or regulation: ................................
13. Will lot be regraded ......... . .................... Will excess fill be removed~from premises:.,t~.,~.. ~ .~. No
Name of Contractor ........ 0 ........ '.~ ........ Address ~., .~. ~. ~.~.. Phone No..5~.~'. ~.~
PLOT DIAGRAM
Locate clearly and distinctly all .buildings, whether existing or proposed, and. indicate ail set-back dimensions from
~umber or description according to deed, and show street names and indicate whether
property lines. Give street and block
interior or corner lot.
STATE OF NEW'RIO,/ -- : ' t "~ ~ -
COUNTY O~..~'-~~.. S S
......... ~~i~~ being duly sworn, deposes ~d says that he is the applicant
above named.'
He is the .................. ~: ~~ .................................................
(Contractor, agent, corporate officer, etc.)
of said owner or owne~, ~d is duly ~authofized to perform or have perfomed the said work and to m~e ~d file this
application; that ~1 statements contained ~ this application are true to the best of his knowledge and belief; and that the
work will be perfo~ed in the manner ~et forth in the application filed therewith.
Sworn to before me this
.......... ~: ..... day of~~ ....... 19.
Notaw~.~bllc' ................... :.~. Cgunty~
' NOTARY P~BLIC~Ie 0l ~ew
' No: 52,81~5850, Suffolk Cou~
' Term EXptres March 30, 19~' ~ :,