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Home My WebLink About10707-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Town Clerk's Office Southold, N.Y. Certificate Of Occupancy No. ZqO0?7 Date August 15, 19 80 THIS CERTIFIES that the building ................................................ Locat~on of Property 38350 Main Road, Peconic, New York County Tax Map No. 1000 Section ...0.8..5 ...... Block 02 .Lot Subdivision ............................... Filed Map No ......... Lot No~ ....... conforms substantially to the Application for Building Permit heretofore Fried in this office dated ....M.~y..?._ .8 ........... , 19..8.0pursuant to which Building Permit No .... 19797..z. .......... 80 dated 0'uno /* 19..., 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 ......... Ingrounfl Pool with fence enclosure. The certificate is issued to ......???.e.~.., .L.e.n..~ ........................................ (owner, I~)~z.l~iiffi~ Of the aforesaid building. Suffolk County Department of Health Approval N/R UNDERWRITERS CERTIFICATE NO ............ .N.../*7.9.3.5..5 ............................ ...... ~.~: ....... Building Inspector R~ 4/70 FOI~i~ NO. 2 TOWN OF SOUTHOLD BUILDING DEPAP. TMENT TOWN CLERK'S OFFICE SOUTH'OLD, N. Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PkEMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) N? 10707 Z Permission is hereby granted to: ........ ..~,.~..~ ...... ~/~,.. ~ .~ ...... at promises located ~;~:'~ ...... Building Inspector. Fee $./~.. ~.:~ ..... 196~.~)., and approved by the / :// FORM NO. 6 TOWN OF $OUTHOLD Building Department Town Hall Southold, N.Y. 11971 APPLICATION FOR CERTIFICATE OF OCCUPANCY Instructions 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 w~th accurate location of all buildings, property lines, streets, and unusual natura~ or topographic features, 2. Final approval of Health Dept. of water supply and sewerage disposal-(S-9 form or equal). 3. Approval of electrical installatmn 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. Fees: 1. Certificate of occupancy $5.00 2. Certificate of occupancy on pre-existing dwelling or land use 3. Copy of certifmate of occupancy $I .00 $5.00 Date ..... .~.. ;..~.~..; . .~.L? ....... New Building ............. Old or Pre-existing Building ............ Vacant Land ............. Location of Property ~1~1 ~,~.: ..... ~-~ (- ~) ~/~ 1c House No. Street .~, , )~/~ b Ham/et Owner or Owners of Property .... .~..C~...~..'.~.L,'.C~...~.'..~. ~..~.. ............................. 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 ...................... Request for Temporary Certificate ..................... Final Certificate ....................... Fee Submitted $ ............................. Construction on above described building and permit meets all applicable cgdes and regulations. App cant....~.~..p.O../~,...0..,...'t ........ · ..... FIELD INSPECTION 1. COMMENTS FOUNOAr~ON (lst) FOUNDATION (2nd) ROUGH FRAME & PLUMBING INSULATION PER N.Y. STATE ENERGY cope FINAL ADDITIONAL COMMENTS: THE NEW YORK BOARD OF FIRE UNDERWRITERS ~)Lf[BUREAU OF ELECTRICITY ~- S5 JOHN STREET. NEW YORK, NEW YORK 1OOSB THIS CERTIFIES THAT Pea;er Len~ai~ t~d., exactly 1~. e/o CO~ La~e,[~in I%d, ;L~ R.~ 25, was examined on ~ lay 1. ~, ], 9 8ti a~tdfound to be in compliance with the requirements of this Board. FIXTURE FIXTURES RANGES OVENS DISH WASHERS EXHAUST OUTLETS SWITCHES DRYERS OTHER APPARATUS $ E AWG OF CC COND C ($v~inmaiag Pool) This certificate covers compliance at the date of inspectiononly. Bacaus~ of unusual environrae~s i~ is a~visable James T, kidg~ & Sons 315 Veg~ tlwy. Commacg, N,Y. 11725 Li¢o238 1~ Ii Per_ _~ This cerhftc~te must not be altered m any manner return ia the off,ce of the Board if incorrect Inspectors may be Identified by their Examined ~/~2.~....~. ...... 19 5~ Approved .~.QL?~...~. ....... 19&. Permit Disapproved a/c ..................... ............ ~ ..~..: .~ .................. FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N,Y. 11971 TEL.: 765-180'~ APPLICATION FOR BUILDING PERMIT 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 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 heroin described. The applicant agrees to comply with all applicable laws, ordinances, build~n~coCe~ hous~g code, and regulations, and to admit authorized inspectors on premises and in buildings for necessary i. ns2~ (Signature of applicant, or name, if a corporation) (Mailing address of applicant) State whether applicant is owner, lessee~chitect, engineer, general contractor, electrician, plumber or builder. Name of owner of premises ...f.l~..~..<.~-.fl,. .... .[w'..L7'7'~. ~..'~.. ............................................. (as on the tax roll or latest deed) If applicant is a corporation, signature of duly authorized officer. (Name and title of corporate officer) Builder's License No ......... J.~..~ .............. Plumber's License No ............... ~ ...... Electrician's License No.. ~.~.....~.'. Other Trade's License No ...................... , 1. Location of land on which proposed work will be done ..... .~.]..~..../~...~./.{~.....~. ?.~. ..... .~.~.O...O....~7. ..... ,-,, 5 :7-: ..... House Number Street Hamlet' .... .o.&... Lot...O/.7. County Tax Map No. 1000 Section . . .O.t~. ........... Block ...... Subdivision.. ~..~,~.~.cr.~..~..%-0, .................... Filed Map No ............... Lot ............... (Name) 2. 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 ....... ~..%4 ~..~,~'x& O. C,.. ~O..% .... [{~. Y.~.~. ..................... I0. 11. 12. 13, 14. Nature of work (check which applicablf): New Building . .~..~..~..~.. Addition .......... Alteration .......... Repair .............. Removal .............. Demolition .............. Other Work ............... (Description) Estimated Cost .... ~ ............................... Fee .............................. (to be paid on filing this application) If dwelling, number of dwelling units i Number of dwelling units on each floor '. If garage, number of cars .......... I .............................................................. If business, commercial or mixed occupancy, specify nature and extent of each type of use ..................... Dimen,sions of existing structures, if any: Front .... .~c~ .... Rear .... .q=~. ...... Depth ...~/-.O. ......... Height . .~.~ .......... Number of Stories . Dimensions of same structure with alterations or additions: Front ................. Rear .................. Depth ...................... H~ight ...................... Number of Stories ...................... Dimensions of entire new constmctioh: Front ...... ~ .~ ..... Rear ..... /..C. ....... Depth ...O~.ak ........ Height .............. Number of Stories ' . ..................................... Size of lot: Front ...~.~'.'.~. ...... , ....... Rear... ~ .~...~ .............. Depth .'3.0.~.~ .............. Date of Purchase .............................. Name of Former Owner ............................. Zone or use district in which premise~ are situated ....... .&'/~...'~. ....................................... Does proposed construction violate any zoning law, ordinance or regulation: ...... .~..~ ...................... Will lot be regraded ....... /~..Q..: ............... Will excess fill be removed from premises: Yes Name of O~ner of premises O¢17.=fi~.. ~.~ ~- Address ~.~ ~t ttO .. Phone No. Name of Architect ............. i ............. Address ................... Phone 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 YO~ COUNTY OF...~..~..E..o..~.k. .... .S ......... .~..~..~.O.[.&: ..... .0~...~7~..~5....~7~.. ........... being duly sworn, deposes and says that he is the applicant (Name of individual signihg contract) above named. , :.Pt ................... He is the.. t ................... .............................................. ' ~ (Contractor, agent, corporate officer, etc.) of s~d owner or owners, ~d is dul~ authorized to perfo~ or have perfo~ed the said work and to m~e and file ~is app~cation; that all statements contained ~ this application are true to the best of~is ~owledge and belief; ~d that the work w~l be performed in the m~ne~ set forth in the application filed therewith. Sworn to before me this .......... .~.~..~.day o{ ~.~. · ·; ....... 19~ ~01~RY PU~LIt, ~t~te of ,ew Y0~ ...... '~~(Signature of applicant) 4