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HomeMy WebLinkAbout10569-z FORM NO.4 JIiU..&,,,..> TOWN OF SOUTHOlD , - . BUILDING DEPARTMENT Town Clerk's Office Southold, N.Y. Certificate Of Occupancy 210029 Date. . . .. . . . ,J:14y. ;1,4.. . . . . .. . . . . .. ., 19 .?O No...............,. . THIS CERTIFIES that the building. . . . . . . . . . , . , . , . . . . . . , . , . . . . . , . . . . , . . . . . . . . . . . . , 865 North Sea Drive, Orient Location of Property ..... "..,.....,....,......,...........................,...... House No, Street Hamlet County Tax Map No, 1000 Section .....,..... .Block .......... . . . . .Lot . . . . . .~6. . . . . . . . . Subdivisionq~~~p:~ . ~r. .~l?-~. ~.e~ . ~.e.c: ~ . ? . .Filed Map No. ~~~ . . .Lot No. . .~~ . . . . ..". . . ..1," ., conforms substantially to the Application for Building Permit heretofore filed in this office dated . .~:~:. .~~. ' ,.. ,..... 19~0 pursuant to which Building permi(No. . ;t.q~~~~, , . '. . .. . .. . . dated ... .~'~~.', .2! p. . , , . . . . . . . . . . . 19 .~~, was issued, and co:~orms to all of the requirements of the applicable provisions of the law. The occupancy for which this certificate is issued is . ' , . , . . . . Inground Pool with fence ....... ..... ....................................,.................. ,.... ,.,..,.. The certificate is issued to ...... Ch8:r:J,eS.,~. ~p..~~~. ~~~~~r.'o/. . . . . , . . . . . . . . . . . . . . . . (owner, :<;#~~yt!"'(1r*'ttmmTt) of the aforesaid building. Suffolk County Department of Health Approval ...........,...... . . . . . . . . ' . . , . , . . . . . . . . . . N474868 UNDERWRITERS CERTIFICATE NO. . . . . . , . . . . . . . . . . . . . . . . . . . , . . . . . . . . . . . . . . , . . . . . . . . .C.~....?/~....... Building Inspector Rev4n9 , I I ~. :,l. < J ",.~ ,,-1,,-;1; fie, i", , ". FORM NO. 2 TOWN OF SOUTH OLD BUILDING DEPARTMENT TOWN C.LERK'S OFFIC.E SOUTH OLD, N. Y. BUILDING PERMIT (THIS PERM\T MUST BE KEPT ON THE PT\EMISES UNTIL FULL COMPLETION OF THE WORK AUTrlORIZED) N~ 10569 Z Date6i?<<:Ct'lPk7......Z..(.." ........, 19/Q.. Permission IS hereby granted to: .....c'lldIC(~...Z;./49'9,~, 26.;) ~ - ....., .. ........., M.r.r::rll.--."C./Q ., , < .....Qf.~!..~(0.:'(....tY:..:1, . .....// f $j7 to ...Co..A!..5.7tCQ .c?.......I.N.9..<<.OU./...I.O=;;:;bo~. ,...W/.T#...F"s:i".<:;.E:.." . ..#.;.I0..C.i...O.s:.?:<..K.t::.................. ........... . ........"........,....,....,..,....,... ............ . .........."....,......,.., at premises located at J!6.5:......t./Q./.C.7l:f."SE6J,..,.kkr...([),IC~.;::r.0.N~y. ....... ............................................................... " ............ ... ..................................................... ............. b ~ <<?:::.~~:,;,;r.::~":::;~~~i.j................JJb....:~c:'!1t.;", Budding Inspector. Fee $.I~c:..~....... I -' ..",.!.J ii!". [ FORM NO.6 TOWN OF SOUTHOI,.D Building Department Town Hall Sauthold, N.Y. 11971 APPLICATION FOR CERTIFICATE OF OCCUPANCY Instructions A. This applicatian must be filled in typewriter OR ink, and submitted in duplicate to the Building Inspec- tor with the following; for new buildings ar new use: 1. Final survey of property with accurate location of all buildings, praperty lines, streets, and unusual natural or topographic features. ' 2. Final approval of Health Dept. of water supply and sewerage dispasal-(S-9 form ar equal). 3. Approval of electrical installatian from Board of Fire Underwriters. 4. Commercial buildings, Industrial buildings, Multiple Residences'and similar buildings and installa- tions, a certificate of Cade compliance fram the Architect 'or Engineer respansible for the building. 5. Submit Planning Baard appraval af completed site plan requirements where applicable. B. Far existing buildings (prior to April 1957). Nan-canforming uses, or buildings and "pre-existing" land uses: 1. Accurate survey of peoperty showing all property lines, streets, buildings and unusual natural or topograph ic features. 2. Swam statement af awner or previous owner as to use, occupancy and conditian af buildings. 3. Date of any hausing code or safety inspection af buildings or premises, ar other pertinent informa- tion required to prepare a certificate. C. Fees: 1. Certificate af accupancy $5.00 2. Certificate af accupancy an pre-existing dwelling or land use $5.00 3. Copy of certificate of occupancy $1.00 Date .. .r(r/~~.. ............. New ~Uilding ......... 'f~.;ld ar Pre-existing BUild;Vo..0~ ::t~~'~~f::nt ~:~f;.;" .. . ... ... Location of Property ................................71..............,................... House No. -!l;/t Hamlet Owner or Owners of Property Gf~~!~<;..<:f. F.'!P;~~. . .. .fI:~.~~ 1j. . . . . . . . .. . . . . . . . .. . . . County Tax Map No. 1000 Section ............... Black............... Lot... ~~ . . . . . . . . . . Subdivlsian ~.'~0y.'RI:'7. $~':I-.,. ~~~.?-:-. .Filed Map No. ?.'!-.~~... .LO~ .~C:.......... Permit No. (t?$.fq.? ? Date of Permit fir.o.. .Applicant . ~ !~t.. . .0.. ~'?7j..... Health Dept. Approval . . . . . . . . . . . . . . . . . . . . . . . . Labor Dept. Approval ...........,............ Underwriters Approval. . .~. ~7.~~~~. . . . . . . . . . . .Planning Baard Approval ........ . . . . . . . . . . . . . . Request for Temporary Certificate. . . . . . . . . . . . . . . . . . . . .Final Certificate. . . ~. . . . . . . . . . . . . . . . 50" Fee Submitted $ . . . . .77. . . . . . . . . . . . . . . . . . . . . . Construction an above described building and p'ermit meet~Plicable codes and regulatians. Appl'~' .~V.. u99~u U.. u.... U U.. U U. Rev. 10.10.78 ;y1 G 1r I~ :r ~ /ftM<"t ad <&<oA /& ~J/ '" dl",~ ""/"""'7 ~:l<\\~ ~ i ~,' .!t ,.,,,,-,,..1 "J, ,i,,:!i. b!., .L . -- ,/ THE NEW YORK BOARD OF FIR(: UNDERWRITERS I pm BUREAU OF ELECTRIC IT): , 85 JOHN STREET. NEW YORK, NEW YORK 1003$ Date April 16, 1980 Application No. on file 068104 N 4'711868 THIS CERTIFIES THAT only the electrical equipment as described below and introduced by the applicant named on the above application number in the premises oj IY1U. .. hrs. Haggerty. 136;' North Sea. Br., OrientJ?oint, N.Y. rn the following location; D Basement D ],t Fl. D 2nd Fl, o\1teide Section Block Lot was examined on Apt' J..1 14, 19130 and found to be m compliance with the require~nents oj this Board. fiXTURE A SWIT HE FIXTURES RANGES COqt(ING DECKS OVENS DISH WASHERS EXHAUST FANS OUTLETS RECEPT CLES C S INCANDESCENT flUORESCENT MERCURY AM' KW AM' KW AM' KW AM' KW AM' H P VAPOR 1 1 2. 1 DRYERS FURNACE MOTORS FUTURE APPLIANCE fEEDERS SPECIALREC'PT TIME~LOCKS BELL' UNIT HEATERS MULTI-OUTLET DIMMERS I SYSTEMS AM' KW OIL H P GAS HP AMT NO A W G AMY AMP AMY AMPS TRANS. AMT H P NO. OF FEET AM' WATTS 1 20 SERVICE DISCONNECT NO. OF S E R 'V I C E METER 1.J!2W Ijf3W 3jf3W 3jf4W NO O~E~:e.-COND A W G, AWG AWG AM' AMP TYPE EQUIP NO OF HI-LEG NO OF NEUTRALS OF CC COND OF HI lEG OF NEUTRAl OTHER APPARATUS' l"G, F. 1. (Swimrulng Pool) This certificate covers compl:l,ance .at the date of inspect;lon0111y. Beca.use of unusual environments it is a.dvisable to have frequent t:est and/or repairs made by Ii. qualified person. - Ph :J.l Gordon ~~-( 12 Dean St. Port J'.Ifferson. Stat;wu. N.Y. U176 Lie .1101 E GENE'rl MANAGER This certificate must not be altered in any manneri return to the office COpy fOR B ILDING DEPA 1M N1. 1HIS COPy 0 ' ., , l.v .J ~ "J :,_ )"" FIELb IN5PECTION DATE COMMENTS t , \ 'd a 1. ~ HI 11'1 -.. t-3 ~ -"-"--- ---.-----.- .. FOUNDATION (1st) z -- ~---'-~-~ 0 . N FOUNDATION (2nd) ~~ IJ),~ .. Till> () 2. " ROUGH FRAME & ~~ PLUMBING ~ 3. ~~ Ii - [~ . INSULATION PER N.Y. . STATE ENERGY CO:QE 6 ~ 4. , ~~ ~'I - "1l'-!l. /fjrfl - /J /~.( ./..-.. ~a; /' u "oo ,. " P FINAL , /L ,0' .If ,/.'> ,. - ./ - ... 7 t?' / ~? Q ~~ ::s'" - - <D . ADDITIONAL COMMEIifTS: >-j ~ -_.._~ 1t ~ ~ - , ~~ ~.~ ~'" (+~ b'~ - ::s' ; -- , "" - <D .. P> J--' . ~ \ ill ti:! IT . i i, '*' , ,- "j'< )". ;. .I'l!. ~% (, ,1 .... 1.: ~_ ...,I...: ., - , ? 4' _-!,.r ~ ~ ".3 00 ~ . 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'" '" 0':.. cnJ -- ,,' -1 1..>< '> ':;; i~ '....,. - '/~~ ,..,. ";.; IJ) c;'I;tj :..., 4 . co :J ..y( i (",1) ... 0 -1"'1 --t -/'/ (~.1J - '0 '"T1::oiu I it, lJr<! "' I "-0 oO!11 n 7<1 -t 00 0:::::.0 ^ G)l' Oc 7.:fTI(.) VI I' --t.JJ o,r . C)-i ,- ZfT1 ;;o",~O::.o ~,rHRACTOR '0 00 rT10..~ J> () , -f to fTI 0 0 SWIM-KING POOLS, INC.Z g :~gB; "'~; Z r m (') (1 HOUTE 25A ~ ~~~ ~ ;., ROCKY POINT, NEW YORK ~ ,,~o.z ).Jo." G). , "I _I I=-~ '. 1 '_' "\ 1.! .'.1 t . -,,--- J., A', t. ~.~,,__ ".>. ,_"'..t..~ii,.",;I .".,'. '" , ',ffl ,,~., ~ FORM NO.1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N.Y. 11971 TEL.: 765.1802 Examined h. I?: ,k? .., 19d8 Application No. l Q ~"!:;.9. .... . ct& 6 tfe)p 'Q S( '1 ~ Approve . ."7'.l;..7_ ...., 19. ermit No. /. ...... . Disapproved a/c . , . , . ,- .-. . . ,~. , . . . . . . . . . . . . . . . . . . . . . . ----r-. . . .~.--....-..---. . . . . . . . . . . . ,/ APPLICATION FOR BUILDING PERMIT Date. . . . .2/2.1/89, . . . . . ., 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 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 applic,ation, 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 i 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 "'mt< w"",n.,d ""'~'on 00 p~;,,' md m bWldm,. fO<n~.",", m~ ~ ~ . . . . . . . . . . . . (Signature of app' nt, or e, if corporation) 865. .~~r:~h. .~.8: pr.i.v. . . .~:z:i.e.D:t.,. . . . . ,~~5.7. . . . . . . . . . . . (Mailing address of applicant) , i State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. owner ............. ..............,...... ,...... ,................ ,.............................,..,..,. Name of owner of premises ..,..,.. .c.h;8:r:1~s. .~8:~~~X:~~ . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ' . , . . , . . . . . . . . . , . (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. .. .~IJ:t::t:<?J,~ .q<?IJI!~Y. .X!~~E! .~lI!prQvelllenti /I609HI Southald #61 Plumber's License No. ..,.. N/f!>.. ............. . Electrician's License No. ..p.Q:!J!..........,.... Other Trade's License No. .. N/A................ I. LocatIOn of land on which proposed work will be done. ...........".,.,................,..........,. . . ..~q5..~q~~q.~~.~~~~~, .q~~~~~, .~~~ .~q~~.....,....... ,..., . ,-.... .........................., House Number Street Hamlet . 8~ ' -&- !;"' County Tax Map No. 1000 Section ....... r ....... Block..O .. . . .. . .. ... Lot........ 00 ..;... Subdivision . l!;It~r. . t;Z' .'T#:. . : . F."~. '. . . . Filed Map No. .............. Lot ,l!6. . , . . , . . . . . (' ame) 2. State existing use and occupancy of premises and in tended use and occupancy of proposed construction: a. Existing use and occupancy . . . . . . . ~~ f:':!-~~J?"~ . . . . . . . . . . . , . . . . . . . . . . . ./. :...:...: . . . . . . . . . . . . . . . . . , . . . . b. Intended use and occupancy ,.. fl!.~. ~I!. :j.P. gr?J.1p9-. !!1":j.~:j.pg. P99;1.,..:~ .. /:7'''''./:-.C:~. .~1-;~Cl.~~If:~.. i J., ~ ,. ili J,j 1> , ,L,_', 1,.1 , ; I 3. Nature of work (check which applicable): New BuIlding. . . . . . . . . . Addition. . . . . . . . .. Alteration .... ';E" . . Repair .............. Removal.............. Demolition .............. OtherWork..~C;...... 1 #; 20 x 40 in ~~J1f!.~) 4. ' 5""0-0 Estimated Cost. . . . '$6000 ;09 . . . . . . . . . . . . . . . . . . . . . . . . . Fee . . .I. . (t~ 'be' ;~d' ~~ fiii~~' thi~ ~~~Ii~~ti~~)' . . . . 5. If dw~lling, number of dwellinglunits . . . . . . . . . . , . . ., Number of dwelling units on,each floor. . . . . .'. . . . . . . . . . If garage, number of cars ....,................................................................... 6. If business, commercial or mixed oecupancy, specify nature and extent of each type of use . . . . . . . . . . . . . . . . . . . . . 7. Dimensions of existing structures, if any: Front. . . . . . . . . . . . . . . Rear .............. Depth . . . . . . . . . . . . . . . Height ............... Nurj1ber 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 ',' . . . . . . . . . . . . . Height ............... Nu1bber of Stories. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 9. Size of lot: Front .. . . . . . . . . I. . . . . . . . . . .. Rear...................... Depth ...................... 10. Date of Purchase .......... '. . . . . . . . . . . . . . . . . . . Name of Former Owner ............................. II. Zone or use district in which piemises are situated. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 12. Does proposed-construction violate any zoning law, ordinance or regulation: ................................ 13. WIll lot be regraded .. '" ... . . . . . . . . . . . . . . . . . . . Will excess fill be removed from premises: Yes No 14. Name of Owner of premises .. . . . . . . . . . . . . . . . . . Address . . . . . . . . . . . . . . . . . . . Phone No. .. . . . . . . . . . . . . . Name:of Architect. . . . . . . . . . . . . . . . . . . . . . . . . . Address . . . . . . . . . . . . . . . . . . . Phone No. . . . . . . . . . . . . . . . Name of Contractor . . . . . . . . '. . . . . . . . . . . . . . . . . . Address .. . . . . . . . . . . . . . . . . . Phone No. .. . . . . . . . . . . . . . charles J. HasgeWyDIAGRAM 865 N. Sea Dr. 323~2689 Locate clearly and distinet1yN.a~ buIldings, whether existing or proposed, and, indicate ail set-back dimensions from prop~'rty lines. Give street and~oc1{dumb~r of desfA~tion according to dee~n~~:Wc s~ep~ames and indi~4~l(J8er mtenor or eorner lot. 1m ng 00 s. n. . . 00 . , r " " ) ,)(1,) ',', "' 'd' [ J, 1 r; \ PETliR (I. WlLlS1II!IN) , , ' , r, Notary Public. Stata of New Vork , No. 52-4612312 , Qualiflad In Suffolk C n'rg?7' STATE OF NEW YORK, I CommiS81 xplr s Mar ,- I S.S COUNTY OF . . . . . . . . . . . . . . . . . ' r [[ . . . . . . . . . . . . . . . . . . . . . . . . . . . .. . . . . . . . . . . . . . . . . . . .. being duly sworn, deposes and says that he is the applicant (~OlX1dividual sig~ing contract) above name<katbxSxxWtilIlteb: i Charles J, Haggerty He is the. . . . . . . . . . . . . . . . . . . . .,. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . (Contractor, agent, corpd/ate offic&f;'etd.'} ,'J .1'1, owner ' of said owner or owners, and is dilly authorized to perform or have performed the said work and to make and file this applicatiolj; that all statements con~ained 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 ........ . 1ft. ~........ .day ~f. Hr..............., 19 ~ I Nm~"b1l"HH:~~~;HH C'~W ~~ 4, Notary P~~~lg.AJ~t"2~1 ~~w York I . ,. . . . .. ....... .......... ~ig~' u;e' ~i ~~~Ii~~~t) Qualified in Suffolk coun~ <;r C~&2~dV~~ ~-