The URL can be used to link to this page

Home My WebLink About11473-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. Certificate Of Occupancy No..g. 1. .1.1.5.3. ......... Date ..... .R.u~u.s..t;. ?.4. ................. 191~. THIS CERTIFIES that the IRflltlt~... pg.o.l. ........................................ Location of Property ...6.5.0. ............. .E.a.~.~¥.op.d..C..o.u.r.~ ................. ~.a.t.t;.l~.c.k House No. Street Hamlet County Tax Map No. 1000 Section . 1. .1 ~ ........ Block ...07 ........... Lot... p.0?. .......... Subdivision..E..a.s.~.w.o..o.d..M.a..np.r. ............ Filed Map bio. 5..6.0.6 ....Lot No...7. .......... conforms substantially to the Application for Building Permit heretofore f'fled in this office dated November 9 ,198..1. . pursuant to which Building Permit No. 1167.3 Z dated ...N.o.v.e..m.b.ey...2.3 ............. 19.8. 1., 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 ......... an Inground swimming P991.. The certificate is issued to ....... ~.a..m.ep...&..B.e.~ .t ¥..H.e. ? .r,?.c.h..e.f.~. ....................... (owner, I~e'or't~t~tlt) of the aforesaid building. Suffolk County Department of Health Approval ........ n../.a ............................... UNDERWRITERS CERTIFICATE NO ................ ~.. ~.47.8. 3. 7 ......................... Building Inspector Rw.l~l 11473 Z Perh~issio~ is hereby grented to:~.~ BUILDING P, ERM!T r ~ (THIS PERM T MUST BE KEPT oN TH,E PRE/~IS~S UNTIL !ULL COMPLET~ON,O~ THe WOrK ^UTH~RIZ~>) · ' i ; ~a~e,.~.~~.....;..g ........ ,~ No. i~g~...<4.. ......... and bpproved by tbe / Inspector' ~ORM 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 buildi'ngs 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 e×~sting buildings (prior to April 1957}, Non-conforming uses, or buildings and "pre.existing' land uses: 1. Accurate survey of peoperty showing ali 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 prem scs, 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 certificate of occupancy $1.00 $5.00 New Building ............. Old or Pre-existing Building(Z) ........... ~/Vacant Land ~ ............ OwnerorOwnersofProperty ~~2 ~~V H~ ~'~ /.; ~ T' ............... ....[ -..-.. ....... :...,,~.... ,. - //~ '73 . Petrol, No ....... .~.. Date of ,ermit~ .............. 'i ...: ......... Unde~riters Approval... 7F~F~2F ...... ma.ning ~oa~a Approval ......... Request for Temporary Certificate ..................... Final Certificat~ ....... Fee Submitted $ ............................. Construction on above described building and permit'meets all aPpl~cable~codes a /~ ' ~' '"'~' '"'/ 'App cant ~-¢ , " '~0 ~1', ,...,,,o.,~ ~ ~ ,m ~ ~,O, ~. l l t ~~ ~/' "' ..... Memorandum from.... BUILDING INSPECTORS OFFICE TOWN OF SOUTHOLD Tov4~ HALL, SOUTHOLD, N. Y. 11971 765-1802 OCCU?ANCY OR FIELD INSPECTION COMMENTS · FOUNDATION (1st) FOUNDATION (2nd) 2. ROUGH FRAME & PLUMBING INSULATION PER N. Y. STATE ENERGY C,ODE FINAL ADDITIONAL COMMENTS: --1600%44 THE NEW YORK BOARD OF FIRE UNDERWRITERS ~ IBUREAL) OF ELECtRICItY B5 JOHN STREET, NEW YORK, NEW YORK 10038 THIS CERTIFIES THAT only t~e e~ctrlcal equiD,ne~t as ~scribed below and introdu~.~ ~y th, e ap~icant ~m~d. on ~_a~ a~l~tio~ number in ~he premises of l~Sc~t, W/s F~ C~., 325 s/o ~e. ~ ~tt~r;~ ~. in the bllowi.,g Ioca~ou; ~Basement ~ Ist I"L O 2,~d FL Section Block Lot was examined on ~ ~ ~ ~98~ and found to be in compliance with ta. requirements of this FIXTURE FIXTURES RANGES OVENS DISH WASHERS EXHAUST FANS DRYERS FURNACE MOTORS FUTURE A TiME CLOCKS UNIT HEATERS MULTi-OUTLET DIMMERS SYSTEMS NO. OF FEET SERVICE DISCONNECT S E R V I C E NO OF CC COND A, W G NO OF HI-LEG A. W g NO OF NEUTRALS A, W G. (~ Pool) %~ cer~ificate covera o~mpltance aC ~ det~ Of iuspee~ion only. Became of ~usual' envi~om~nts it ia advi~able to have fxequent test a~A/or repairs ma~e by a qualified person. ~hil. Gordon 12 Dcm% Por~ Jefferson SCa., N.Y. 11776 11 .' / ') This certificate must not be altered in any manner; return to the office of the Board if in~dorrect, may be identified by their c?edentJals. FORM NO, 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N.Y. 11971 TEL.: 765-1802 APPLICATION FOR BUILDING PERMIT Application Nd ./.~..~.& ........ INSTRUCTIONS a. This application nmst be completely filled in by typewriter or in ink and submitted in triplicate to the Buildi 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 stre* or areas, and giving a detailed description of layout of property must be drawn on the diagcam which is part of this app cation. c. The work covered by this application may not be commenced before issuance of Building Pe~it. d. Upon appro':al of this application, the Building Inspector will issue a Building Pem~it to the applicant. Such peru shall be kept on the premises available for inspection throughout the work. e. No buikling shall be occupied or used in whole or in pan for any purpose whatever until a Certificate of Occupan sb~l have been granted by the Building Inspector. APPLICATION IS HEREBY MADE to the Building Department for the issuance ora Building Permit pursuant to t Building Zone Ordinance of the Town bf Southold, Suffolk County, New York, and other applicable Laws, Ordinances Regulations, tbr the construction of buildings, additions or alterations, or for removal or demolition, as herein describe The applicant agrees to comply with ~11 applicable laws, ordinances, building code, housing co~d regulations, ~d admit authorized inspectors on premises and in buildings for n~ce~ inspection5. ~ [ (~ailing address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or build, Nmne of owner of premises . x~.~. b~'~...../.-ff. ~./~(t~/~-z~. :./~.. ................................ (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 ..... .~../. ................. Plumber's License No ...... Z~./,'~. ............. ,, ' · ' · El~ctrmlan s License No ......... Other Trade's License No .... ~/~ ............ ]. Location ofla~ on which proposes work win be done..~. ~a*~..~./. ~/ Hamlet County Tax Map No. ~000 Section ...... {(.~7 ....... Block ...... 7. Lot .......... Subdivision ........... Filed Map ......... Lot ........... (Name) 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy ...... /(g21~CE.. ..... . .................................... ~epair .............. ~em~val .............. Demoiitio~ .............. O~he~ Work .............. (to bo paid on/2ting this application) It d~velling number ot dwelling units Number of dwelling units each floor It garage, number of cars ....................................................................... It business, commercial or mixe~ occupancy, specify nature and extent of each type of use ..................... Dimensions of existing stmctures, itany:Front.. ..... ..... . .. Rear . ...... .... ... Depth. ........... ... Height ............... Number ot Stories ........................................................ Dimensions of same structure w~th alterations or additions: Front ................. Rear .................. D ptg ' Hei~ N nb of St rids Dimensions ot entire new const~uction: Front ............... Rear ............... Depth ............... Height Number ot Stories Size o~lot: Front ' ' Rear Depth Date ~f Purchase ~ Name of Former Owner Zone or use district in which premises are situated Does proposed construction violate any zoning law, ordinance or regnlation: ... ~0 ....................... Will lot be regraded .... .~ ~ ~.'. ................. Will excess fill be removed from premises: No NameName of Contracto~l~. ~dS ......... Address .................. Phon~ Locate clearly and distinctly alll roperty lines. Give street and block ,terior or corner lot. PLOT DIAGRAM 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 TATE OF NEWtYxORK__ , ....... H.i..~]~.).~.[~.t .... ~.' · .~.~.S .~ ......... being duly sworn, deposes and says that he is the applicant . (NaMe of indMdual sigr lng contract) ~ove named. (Con~tor, agent, corporate officer, etc.) f said owner or ownem, ~d is duly authorized to perform or have performed the said work and to m~e and file tiffs ~plication; flint all statements cont.ained in this application are true to the best of his knowledge and belief; and that the 'ork will be performed in the manner set forth h~ the application filed therewith. ~om to before me this ~ . , ~ '~~'~g[k, Cl;~ / ~ (Signature of applicant) .~. · ' ~2, ' , ..,.:~ · ~1 ...-:?*' ' .,. ":': :SURVEY' FOR ':' i...JOHN ,:e ....... ~":' '" B SECTION A~'A , (:D ' SKIMMERS ROLLED FOAM MOULDED I PIECE ,,~t.~,~ TO BE SMOOTH- NON SKID WATER DI~SAL SHALL a[ LIMITED OPTIONAL STE, P :' TYPE !. F._ CZST THICK FIBERGLAS TROWELE, OF CONCR~ POURED F~TIHr~