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Home My WebLink About10762-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. Certificate Of Occupancy No..Z. 1..2 .99.9. ......... Date ............ .O.c~.qb..o.r..2. 2. ......... 19 8..4. THIS CERTIFIES that the building ...I..ng.r.o.u..n.d. ?.99.1, .s...~.e.n.q¢ .................... Location of Property ....1.5.6. .0..M.~.i..1 .~?..R., 9...~.: ~ !3.5.D.0..~.r..P.a..t.h ....... .~:.t~_.~.~.k ...... House No. Street Hamlet County Tax Map No. 1000 Section . . .1.0.6 ....... Block .. 3:..0 ........... Lot ....0 .2.8... 2. ........ Subdivision ........ X. ...................... Filed Map No ......... Lot No .............. conforms substantially to the Application for Building Permit heretofore filed in this office dated ·...O..u.n..o ..... .2 .3 .......19.8. 0. pursuant to which Building Permit No ..... :[ O 7 .6.2.g. .......... 84 dated.... ....... July ....1 .... ..... .... 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 ......... Inground ~.w.i..rnflg..i.n.~ Pool And Fence The certificate is issued to STANLEY & JEAN KOROLES, KI (owner, fe~Ee'1~ TeTl~Tfi[') of the aforesaid building. Suffolk County Department of Health Approval .... I~../.~ . . ................. N41~6317 UNDERWRITERS CERTIFICATE NO ................................................ Building Inspector Rev. 1/81 FORM NO. 2 TOWN OF $OUTHOLD BUILDING DEPARTJ~AENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) Ne 10762 Z Date .................................................... , 19. Permission is hereby granted, to: ~¢~/A-/' /~Z'~ "~0/~.~' ..... ...... ~..C ~.~.~,~.~ .............................................................. ~.....~ .......................... ~ ............. . / ~ ,//~ . ,~ ~ ~,..~ ..... ~ p,em,~e~ ~o~a,~d ~ ...~ ...... .~ ......... ~.....~ ...................... ~ ........ ........................................... ~zZ.z/~c~:.. ~. ~r~.~., ~o a~,c~,~o, d.,~d ...... ~.~...~ ................. , ~,.~O, ~d ~p,,o,ed by Building Inspector. Building ~nspector FORM NO. 6 TOWN OF SOUTHOLD Building Department Town Hall ,<]outhold, N.Y. 11971 APPLICATION FOR CERTIFICATE OF OCCUPANCY Instructions This application must be filled in Wpewriter OR ink, and submitte~pi[cct= 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 applicab[e. For existing buildings (prior to April 1957), Non-conforming uses, or buildings and "pm-existing" land uses: 1. Accurate survey of peoperty showing al~ property lines, streets, buildings and unusual natura~ or topographic featu res. 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: ~ I. Certificate of occupancy ~$5.0U~) / 2. Certificate of occupancy on prying dwelling / land use 3, Copy of certificate of occupancy $1.00 ~ --Pre-Existing C.O. $15.00 Vacant land C.O. $ 5.00 New Building .. ~ ...... Old or Pre-existing Building ............ Vacant Land ............. Location of Property ......................... ~.~... I~.~"~ ........ ~1~[~-~ House No. Street Ham/et Owner or Owners of Property ..... .~ ~[ ~q~. ~.......~..~....~.~.~.~....PI...... ~ c.~..~. [..~j ....... County lax Map No. 1000 Section . . .[.tO...(:>. ........ Block .. J.C) .......... Lot. ~ .~.'..~ ........ Subdivision ................................. Filed Map No ........... Lot No .............. ~..O ~(~_~ ~ Date of Permit .~.~/.1/.~.. Permit No ............ 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 codes and regulations. (,,~_~ r~.~ I Applicant ..................................... ~ Rev. 10-10-7S ~,, THE NEW YORK BOARD OF FIRE UNDERWRITERS I, BUREAU OF ELECTRICITY L, [~! 85 JOHN STREET, NEW YORK, NEW YORK 10038 '" n,,,,, July 17, 1980 .~..I;..,~,., ~o...,/u,. 080414 "' N 486317 [,, THIS CERTIFIES THAT ,,, Yom~s Po~t Estates,S/E Corner Deer Park Path & Millers Rb~d, ~' ~ttituck, N.Y.' ' '. , ~' , ti", .,..,f,,u,.,,,,,~,..a,,.~ [I. ............ ~ [1 ~.,E~. l] ~,,,~ ~,'~. outside ~,., ~' ""'"'"'"'"'"~"" J~ly 14, 1980 DRYERS FURNACE MOEORS FUTURE APPUAI~IYE FEEDERS SERVICE DISCONNECT H P GAS 1 GFC[ H S R V ( Sw~mting Pool) 'lltis certificate covers compliance at the date of ~,t.~;pection (~nly. Because of unu. sual enviromnents it is advisable to have frequent test and/or repairs made by a qualified person. I '*, ' GKNERAL ~ANA~R ' ~ Lic: #il01 , ',, , 7 "~' /'er 11 It.~ ~erl f cate must not bo altered in a.y mQnner~ rofurrl to the of ce of the Board f n ' P~il C~)rdon 12 Dean Street Port Jefferson Station, N.Y. 11776 FIELD INSPECTION ~ COMMENTS FOUNOATION (~s_%! FOUNDATION 2. ROUGH FRAME & PLUMBING INSULATION PER N.Y. STATE ENERGY FINAL ADDITIONAL COMMENTS: 7GS.180,~ BUILDING DEPT, I ,~ ~ - ~ N NSPECTIO [ ] FOUNDATION '~ST [ ] ROUGH PLkG. [ ] FOUNDATI~)N ;ZND [ ] INSULATIO~'* [ ] FRAMING INAL ': .i REMARKS: DATE ~/9/~F INSPECTOR rq ~TRACTO~, 4IM-KING POOLS, INC. ~UTE 25A ~CKY POINT, NEW YORK CONCf~ETE BLOCK / / Right of W~y S, B5 3~ 50 E ~ROVAL. TO CgNSTRUCT SURVEY FOR STANLEY KOROLE$'KI ~ JEAN A. KOROLESKI TOWN OF SOUTHOLD SUFF'OLK COUNTY, NEW YORK A:vN 4, 19,90 dAN 4, SCALE /": ~0 N~ , 7~ '- 445 FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N.Y. 11971 TEL.: 765-180:3 Examined ..... Approved Z/. ... Disapproved a/c . . / Application No ................. APPLICATION FOR BUILDING PERMIT Date ~ ~ .~..-~..~..e...{2~..., 19 ~. 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 g/ving 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 herein 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. )/-~ .... ~.~. "-- '~g4~r'~ of applic, gnt, or name, if a corporatmn) - ..... , ~ (~ailing address.of applicant) State whether applicant is owner, lessee, agent, architect, engineer, getleral contractor,- etectrician, ptumoer or o ilder. Name of owner of premises .~. '.,~./1~¢~.~....~/."~ . .~..~ .~4~.. ....... ./.. .................... (as on the tax roll or '. If applicant is a corporation, signature of duly authorized officer. (Name and title of corporate officer) Builder's License No ....... ~ / Plumber's License No ...... ~.~. ~. i i. i Electrician's License No .... //~..~/. ~ ......... Other Trade's License No ............... 1. Location of land on which proposed work will be done .................................................. House Number Street Hamlet County Tax Map No. 1000 Section .... ./~..~. ........ Block ..... ./..d? ........ Lot.. ~..~.*~...~.. ...... Subdivision .................................... Filed Map No ............... Lot ............... (Name) 2. State exisfing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy ...~..4/..~......~./..~..../~?../,,~..~,~.~q~' .... ,. ....................... b. Intended use and occupancy ~~<~.: ~ 3. Nature of work (check which applicable): New Building .......... Addition....~. ·... Alteration .......... Repair .............. Removal .............. Demolition .............. Other Work ............... 4. Estimated Cost ......................... Fee ................................... (to be paid on filing this application) 5. If dwelling, number of dwelling iunits ............... 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 structurgs, ifany: Front ............... Rear .............. Depth ............... Iteight ............... Number of Stories ........................................................ Dimansions of same structure ~;ith alterations or additions: Front ................. Rear .................. Depth ...................... Height ...................... Number of Stones ...................... 8. Dimensions of entire new constrUction: Front ............... Rear ............... Depth ............... Height ............... Number of Stories ........................................................ 9. Sizeoflot: Front .......... i ........... Rear ...................... Depth ...................... 10 Date of Purcha ' Name ol~ Former Owner 11 Z ne or use d'strict ~n whi h prom' 'tuated 12. Does proposed construction violate any zoning law, ordinance or regulation: .... .~..~ ....................... 13. Will lot be regraded .... ~'~-j~, ~ ................... Will excess fill he remo.v..ed from. .premises: t~)_ No Name ;of Architect ....... ,~//r~ ................ Address ................... Phone No... ~j..~.,~, ....... PLOT DIAGRAM Locate clearly and distinctly ali buildings, whether existing or proposed, and, indicate all set-back dimensions from number or description according to deed, and show street names and indicate whether property lioes. Give street and blocl~ interior or corner lot. coumY .... S.S .... ~.'.'.~.~.. ~ ~.~.."~"'f~-.. ............... being duly sworn, deposes and says that he is the applicant (Name of individual sigpmg contract) above named. He is the ' t'~...."~.. (Contractor, agent, corporate officer, etc.) of said owner or owners, and is d~ly 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 m the manner set forth in the application filed therewith. Sworn to before me this ...... ~......~...a'..~....day ~f...C~.tJ~/~. ........... ,1 .¢~.. Notary Public, . ........... ~.>~../.~.,. ......... Coun Qualified in Suffolk County ~r// ' , ........ ~j~ ~x~... ~1,~ 1~ ~.$ ~-~. (Signature of applicant)