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Home My WebLink About11207-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. Certificate Of Occupancy No. z14717 Datc July 29, 1986 ................................. 19... THIS CERTIFIES that tile building ...... S~J-~am~.~g..P.o o~- ........................... Locatlon of Property 3775 Pine Neck Road Southold, N.Y. House No. Street Ham/et County Tax Map No. 1000 Section ...7. .0 ....... Block ...0.6. .......... Lot..0 26 Subdivision ............................... Filed Map No ......... Lot No .............. conforms substantially to thc Application for Building Permit heretofore filed in this office dated June 2, 81 11207z ...................... 19... pursuant to which Building Permit No ...................... June 25 , 86 dated ............................ 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 ......... Swimming pool Betty Mudd The certificate is issued to ........................................................... (owner, of the aforesaid building. N/A Suffolk County Department of Health Approval .......................................... N/A UNDERWRITERS CERTIFICATE NO .................................................. Building Inspector Rev. 1/81 BU (THIS pERMIT MUST BE KEPT COMPLETION OF THE ,No. ~12~17 Permissior located at CoUflty Tax Map No. 1000 Section ..... ~.~,..,_.:.~.,. Blocl~ ~,.. Bb'il~ing I~$pector. ~ P' ! i FORM NO. 6 TOWN OF SOUTHOLD Building Department Town Hall ~outhold, N.Yo 11971 APPLICATION FOR CERTIFICATE OF OCCUPANCY Instruations . in duplicate A. This application must be filled in typewriter OR ink, and suom tted V ~:~:o ~he Building Inspec- tor with the fo lowing; for new buddings r new use: 1. Final survey of property with accurate location of all buildings, property lines, streets, and unusual n.atural or topographic features 2.Final approval of ,Health Dept. of water supply and sewerage d!sposal-(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. Accura[e survey of property showing all property lines, streets, buildings and unusual natural or topograph ic featu res. 2.Sworn statement of owner or previous owner as to use, occupancy and condition of buildings. 3. Date of any housing coda or safety inspection of buildings or premises, or other pertinent reform - tion required to preoare a certificate· Fees: 1, Certificate of occupancy $5,00 2, Certificate of occupancy on pre-existing dwelling 3, Copy of certificate of occupancy $1,00 4.Vacant Land C.O. $5.00 $15.00 Date .......................... New Building ............. Old or Pre-exmt~ng Building.~. f.~. ~..~ ............ Vacant Land~ ..~.~. ~ · ·. ocation of Property. Z Z. :C ........... .......................... Owner or Owners of ProperW ...... - .......................................... County Tax Map No. 1000 Section .... Subdivision ....................... Permit NoJ'/.~.~. .~.../~... Date of Permit Health Dept. Approval .............. .......... Block ............... Lot ................ ......... Filed Map No ........... ~.ot No .............. ......... Applicant ............ ~ ..................... ......... Labor Dept. Approval ........................ Underwriters Approval ....................... Planning Board Approval ...................... Request for Temporary Certificate .................... Final Certificate ....................... Fee Submitted $,...~..d~.v. .................... Construction on above described building andlpermit moats all appl~/olo~codas and.r~gula,tions. /] ~ Applicant ......... Rev. 10.10-78 Co :z~ iq ?/? THE NEW YORK BOARD OF FIRE UNDERWRITERS BUREAU OF ELECTRICITy Date ~pplication No. on file THIS CERTIFIES THAT N only the electrical equipment ~ described below ar~ introduc~ by tile a lice · ~, ~dd q~7~ ~ ~,~ p~l ~[~ ~,n~edontheaboveapphcat,onn..~berinthepren,isesof in the following Ioc~, 1~ ~.ent ~ Ist .. ~ 2nd .. PG~I Section Block Lot was examined on and found to be in corn~liahce with the requirements of this Board. FIXTURE FIXTURES RANGES OUTLETS SWITCHES OVENS DISH WASHERS EXHAUST FLUORESCENT I i z DRYERS i S FUTURE APPLIANCE FEEDERS MULTI-OUTLET DIMMERS SYSTEMS NO. OF FEET SERVICE DISCONNECT OTHER APPARATUS: ~de by a qu~l£fied person, S E R V I : C E PER ~' ~ NO. OF H~-LEG A W. G NO OF NEUTRAL Pool) Thi~ certificat~ covers co~pl~ ~t '~he date of inspeetion oaly. advis~ble, to ha~e £~equant tes~ and/or rep~&r~ OF NEUTRAL Phil C~ordon, Port Je~ffermon Station, N~Y. 11776 this certificate must not be altered in any manner; return to the office of the Board if DEPARTMENT. THIS COP GENERAL MANAQER ~ Per~ · j may be identified by theft: credentials. IN ANY MANNER. 7GS.1802 BUILDING DE~. INSPECTION [ ] FRAMING ~'"] FINAL FOUNDATION (~st) FOUNDATION (2nd) 2. ROUGH FRAME & PLUMBING 3. INSULATION PER N. STATE ENERGY C,ODE 7 ADDITIONAL COMMENTS: TOWN OF $OUTHOLD OFFICE OF BUILDING INSPECTOR P.O. BOX 728 TOWN HALL SOUTHOLD, N,Y. 11971 DATE: TEL. 765-1802 July [5, 1986 Dear: While reviewing our files I find that your expired pool permit 1[~0-'/~ has never been finalized. Kindly return the enclosed application with a check for $~.00. Also, please call and arrange for a final inspection so that we may issue a Certificate of Occupancy on the above pool and complete this outstanding file. Yours Truly, Victor Lessard Executive Adminstrator OCCUPANCY OR USE IS UNLAWFUL WITHOUT CERTiFiCATE" OF OCCUPANCY "iMMEDIATELY" ENCLOSE POOL TO CODE UPON COMPLETION ' ~3EFORE "WATER" FO~ NO. ! TOWN O~ $OUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE / SOUTHOLD, N. Y. Examined .~(-~......?...?..~./ ........., I~.. Application No..~.~ .............. ~proved¢~ ...................... , ,~... Permit No ................ Z ................. ...................... .................. ................................................ .................................................... APPLICATION FOR BUILDING PERMIT INSTRUCTIONS a. This application must be completely filled in by typewriter o¢ 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 o~ areas, and giving a detailed description of layout ofproperty must be drawn on the diagram which is part of this application. 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 necessar~inSpections. ~ _ (Signature of applicant, or nome, if a corporation) ................................. (Address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. ............. ............................................................................... ; ...... ....................................................................... Name of owner of premises ...~.~..U.J..~.....~.......~'L.L~....b ....... .(.. .~...b/. ............. ~ .......................... if applicant is a corporate, signature of duly authorized officer. (Name and title of corporate officer) Builder's License No ................ .~../. .............................. Plumber's License No ......... .J~...~,,~. ............................... Electrician's License No .... ~.J..,~..~..J~ ......................... Other Trade's License No .......... .~../.~, ........................... i. Location of land on,which proposed work will be done. Map No.: ........................................ Lot No ......................... Street and Number ~..~..7...~.....~.~ .~....~....J~.~.~..~.....~..{g..~...~. ....................................................................................... Municipality 2., State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Exisiting use and occupancy ..............'..~.~-..~..~.~.J~.....'~ ....................................................................................... Intended use a nd occupa ncy.i..~.....~...~.../.!.?..~.!.0../~., ....... 0...~...,. ~...... ~...~...~....~.....~....... ~.~..~...~-~.+~ CJ...~ .................... U 070 -- 3. Nature of work (check which applicable): New Building.. ................. Addition .... Alteration ................. Repair .................. Removal: .................. Demalition...L ............... O_thier Work ................................................ . .... · . r ~ ~''~?/' (Description) 4. Estimated Cost ..... ~..(~P..;. ' ....... Fee; ....... .~ ................................................................................ (to be poid on filing this application) 5. If dwelling, number of dwelling units ............................ Number of dwelling units on each floor ............................ If garage, number af cars ...... ........................................................................................................................................ 6. If business, commercial or :mixed occupancy, specify nature and extent of each type of use ............................ 7. Dimensions of existing structures, if any: Front ............................ Rear ............................... Depth .................... Height ........................ Number of Stories ................................................................................................................. Dimensions of same structur~ with alterations or additions: Front ....................................Rear ............................ Depth ................................ Weight ............................ Number of Stories ................................ 8. Dimensions of entire new construction: Front .................................... Rear ............................ Depth ........................ Height .................... Numbe~ of Stories ...................................................................................................................... 9. Size of lot: Front ................~ ....................................... Rear .......................................... Depth ................................ 10. Date of Purchase ................. :....~ .................................. Name of Former Owner ........................................................ 11. Zone or use district in which !premises are situated ..................................................................................................... 12. Does proposed construction violate any zoning law, ordinance or regulation'. .............. ~. ...................................... 13. Will lot be regroded . ........ .~..~....~. ........ Will excess fill be removed from premises: ('~Yes ( ) No Name of Architect ............~/,/~.. ............ ,:. ........................ ,. Address ................ ~ ...............Phone No ....................... PLOT DIAGRAM Locate clearly and distinctly all buildings, whether existing or proposed, and indicate all set-back dimensions frora property lines. Give street and block number or description according to deed, end show street names and indicate whether interior or corner Io1'. STATE OF: NEW~YORK,~ ~,, /% S COUNTY OF ...... ' ....... ~....~.~.i..~....~.'~.~.~~ ~ --- ........... i ....................................... being duly sworn, deposes and ~ays that he is the applicon, (Name of individual sig:ning contractJ) above named. He is the ........................... .~.L/~....~...~...~... ....................................................... ' ...................................................................... i (Contractor, agent, corporate officer, etc.) of said owner or owners, and is duly authorized to perform or have performed the said work and to make and file this application; that ali statements contained in this application are true to the~..best of his knowledge and belief; and that the wbrk will be performed in fha manner set forth in the application filed therew, ith. Sworn ~before me this ' ' '"r'Z~ ...... ' ........... i~i~'~'a'~';; ;~' ;;~'~ii~;~')' ............................. PETER C. WIL,~T~N - Qualified In 8 u.ff.olk 0 0 L) P SLOPE --I 3NZH-KINO PO0~ 'INOo HOUTE ~A HOCKY POINT~ Ng~W YORK