The URL can be used to link to this page

Home My WebLink About11229-zFORM NO, 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. Certificate Of Occupancy z14806 August 15, 86 No .................. Date ................................ ,19... THIS CERTIFIES that tbe building ~.n..g.ro.u.n..d .s.w:L.m.m~.n~ .p.o.o. 1..& fence . fP ty 1600 Track Avenue · Cutchogue New York Location o roper ................................. House No. Street Hamle~ County Tax Map No. I000 Section . 13.7 . ,Block . . . 02 Lot Q0.3 Subdivision..~./.o.H.S. }land S~..c: .t72 .Filed Map No. 1280 .Lot No.53. !. p/o .5.~ conforms substantially to the Application for Building Permit heretofore filed in this office dated .3.u.n.e...1.8., ............ , 19.8. ] pursuant to which Building Permit No.. 1. ! .2.2.9...Z ............ dated July ] , 19 81 ............................... , was issued, and conforms to all of the requirements of the applicable provisions of tile law. Tile occupancy for which this certificate is issued ig ......... Ingroun~ swimming pool & fence John E, & Sandra Simchick The ' ' ' issued to certificate m .................... fownor, of the aforesaid building. N/A Suffolk County Department of Health Approval .......................................... N527645 UNDERWRITERS CERTIFICATE NO .................................................. R~v. 1/81 Inspector' N~ Y~ BUiLDiHG ~P'ERMIT i (THIS PERMIT MUST BE KEPT ON THE P~EMISl COMPLETION oF THE WORK AU~HORIZE~) t! ~[o. 112 2 ~ 2[ 6~te..~ Pei¥~ission~ is hereby granted t~ ~ ~ ~ / , C~u~ty T~× Map No. ]000 Section :...,~..~z. ;.,?;.~:. Bl~ck~ . p~spant ~o applicotion dated ............... '..~.,-.~....~...~ ........ ? approved by the FORM NO. 6 TOWN OF SOUTHOLD Building Department Town Hall ,~Jouthold, N.Y. 11971 APPLICATION FOR CERTIFICATE OF OCCUPANCY Instructions ~u i.,~ duplvicate~o A. This application must be filled in typewriter OR ink, and ~ bmitte ,: ~he 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 ,b. uildings, Industrial buildings, Multiple Residences and similar bull.din, ga a. nd Ins. t,a. lla- tions, a certihcate of Code compliance from the Arch tact or Engineer respon$iole Tor tim ~uilumg. 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. Accurate survev of property 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 preoare a certificate. Fees: 1. Certificate of occupancy $5.00 2. Certificate of occupancy on pre-e×isting dwelling 3. Copy of certificate of occupancy $1.00 $15.00 Date ....... New Building ............. Old or Pre-existing Building ............ vacant Land .......... Location of Property, ,/../.0. ....................... ~ .t,,).~.~., ,, .~ ........... , ............ House No. ~ ~ ~-, Street ~--~ ~,1~ I~a?let Owner or Owners of Property .. o'~..0.~.~, !~.....~...~ ./~...Y~..~. ~..~ .... .~?.'..~..~..C--~...t~..i .~...)~.... County Tax Map No. 1000 Section ..... Subdivision ........................ Permit No ....... .t. Date of Permit . Heakh Dept. ApproYal ............... ...... Block ............... Lot ................ ..... Filed Map No ........... Lot No .............. Applicant ..... Labor Dept. Approval ........................ Underwriters Approval ............... Request for Temporary Certificate... /~. Su m,ttad $ ....... j ..oTi. ,q ....... Planning Board Approval ...................... ............. Final Certificate ....................... Construction on above described building and permit meets a applicab e codes and regulations. Applicant ' Rev. 10.10.78 3ooql co THE NEW YORK BOARD OF FIRE UNDERWRITERS BUREAU OF ELECTRICITY BS JOHN STREET, NEW YORK, NEW Y~ORK 10038 THiS CERTIFIES THAT only the electrical equipment as described below and introduced by t~ applicant named on the above application number in the premises of was examined on ~tt]~y Ba~ser~t nt [] 2nd FI. OL~$iC~2 "~L Section Block and found to be in cotnp;l an¢'e with the requirements of this Board. Lot FIXTURE FIXTURES RANGES EXHAUST FANS OUTLETS SWITCHES i 1 2 1 DRYERS FURNACE MOTORS FUTURE APPLIANCE FEEDERS TI~IE(~LOCKS UNIT HEATERS MULTI-OUTLET SYSTEMS NO. OF FEET DIMMERS SERVICE DISCONNECT S E R iV I ; C NO O~E COND OF CC. COND OTHER APPARATUS: NO OF HI-LEG~ A W.O. NO. OF NEUTRAl A.W G OF HI. LEG OF NEUTRAL ~e of ~1 ~t~nC~ it is a~v~ab~ to ~ :-~eq~l~ ~st ~d/or repairs n~ by a ci~l/ified p~rs~n Gle~ai R. Bradley ~D 16~, ~orton Ave. This certificate must not be altered in any manner; return to the office of th COPY F ii Board if may their cre~gn~als [nspect¢ IN ANY MANNER. 76S.1802 BUILDING DEFT. INSPECTION FOUNDATION 1ST [ ] ROUGH !PLBG. FOUNDATION 2ND [/~0' N FRAMING [/-~ FINAL DATE , INSPECTOR 76S,1802 BUILDING DKPT, INSPECTIO~N i~ [ ] FOUNDATION 1ST [ ] ROUGH P~LBG. [ ] FOUNDATION 2ND [ ] INSULATION [ ] FRAMING REMARKS; [ ] FINAL DATE COMMENTS ~DD~ZO~ ~O~ZS~ ~.~ ,- ~ FIELD ~NS?ECTION 1. FOUNDATION ( FOUNDATION ( 2. ROUGH FRAME & PLUMBING 3. INSULATION PER N STATE ENERGY FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL ' SOUTHOLD, N.Y. 11971 /~ ~ Lv.· TEL.:765-1802 Examined~. ,~A~t...co.../. ...... , Approve(~,...~../..~.., 196~./. Permit No.//.~ .~..?. ~ Disappro¢~d a/c .' ..... ;: . ....'T. ...... _ . .~.. ......... '. (Building Inspector) APPLICATION FOR BUILDING PERMIT Application ............. Date ~. :'; fl. ~. .......... , 19~') INSTRUCTIONS a. This application must be completely filled ii~ 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 drown on the diagram which is part of this apr. 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 isstie a Building Permit to the applicant. Such peru 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 Occupan 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 t Building Zone Ordinance of the Town of Southold, Suffolk County, New York, and other applicable Laws, Ordinances Regulations, for the construction of buildings, additions or alterations, or for removal or demolition, as herein describe The applicant agrees to comply with all applicable laws, ordinances, building code, housing code, and regulations, and admit authorized inspectors on premises and in buildings for necessary inspections. "(Signature of applicant, or name, if a corporation) (Mailing address of al~plicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or build~ Name of owner of premises . ~Y'~',t~,J'be<....2k-, .... ~.. ,f/l:fi,,~.,~.~..4'?-~. ..... ~. ~RY,.:'I ~J.~J/.¢ J~. ......... ~ (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:~.~,-l-"...~ Plumber's License No ......................... Electrician's License No...~'~./~-/~.. /'~./:~5,~. ~% Other Trade's License No../~. ~xk'~..~ .....~./.~ ' ' 1. Location of land on which proposed work will be done ......................................... : ...... House Number Street Hamlet County Tax Map No. 1000 Section ..... [.~.W ........ Block ~ Lot . .~ (Name) ~. State existing use and occupancy of premises and intended use and .ocaupancy of~roposed construction: a. Existing use and occupancy ). 1. 2. 3. Nature of work (check which applicable): New Building .......... Addition ......... Alteration .......... Repair .............. Removal .......... Demolition ............ Other Work... P'~.<,& ....... , ~f/~- ~ (Description) Estimated Cost ....... ~..~, ~ ................ Fee../. ...................... 4.. .......... (to be paid on filing this application) If dwelling, number of dwelling units ............... Nmnber of dwelling units on each floor ................ If garage, number of cars ..... ;.../.'~ .......... ., ................................................. If business, commercial or mixed occupancy, specify fioture and extent of each type of use ................... Dimensions of existing structure~, if any: Front ..... J ......... Rear .............. Depth ............. Height ............... Number of Stories ...................................................... Dimensions of same structure with alterations or additions: Front ................. Rear ................ Depth .................... :.. Height ........ i ............. Number of Stories .................... Dimensions of entire new constrdction: Front ............... Rear ............... Depth ............ Height ............... NumBer of Stories ....................................................... Size of lot: Front ..... ~F~. f.. ! ........... Rear .... .~'ff..~ .............. Depth .. 2.7...~. ~. ............. Date 6fPurchase ........... .................. Name of Former Owner ~T~,ff~4*r.37. ~. ~4Y~..g~-g~/~. ..... Zone or use district in which preinises are situated ................................... '. ................. D.o, es proposed construction violate any zoning law, ordinance or regulation: .... /3(..~. .......... '....~ ..... Will lot be regraded ............................ Will excess fill be re~noved from premises: ~. No Name of Owner of premises /.~.~.)~3~... ff'~',~v~*/t.~_,ff. Address ~ t~.~¢.t~'gJ~..~~. ..... Phone No. Z~/.'::( ~?.~.$..~ Name of Architect .......... i ................. Address ................... Phone No ................ Name of Contractor ~.~)g/~...27~.~:g'O7.. Address 2/t/~./~;r~'t4. ~7-/~.. Phone No. 2~..~q: ~.-r y'~.. q.c¢. PLOT DIAGRAM Locate clearly and distinctly alii buildings, whether existing or proposed, and~ indicate all set-back dimensions from roperty l/nes. Give street and block humber or description according to deed, and show street names and indicate whether ~terior or corner lot. rATE OF NEW k"~K, -- .,,i ~ _ OUNT¥ )ove named. ....... being duly sworn, deposes and says that he is the applicant e is the ................... ~ ............... ~ ......................................... (Contractor, agent, corporate officer, etc.) f said owner or owners, and is duiy authorized to perform or have performed the said &york and to make and file this )plieation; that all statements cont3ined in this application are true to the best of his knewledge and belief; and that the 'ork will b? performed in the mannqr set forth in the application filed therewith. worn to before me this ' ..... oj~rl~tLblic ~,.~/q~.. ex:~.,x~x ..... L.k,~l, County ' NN NEVILLE Now ~,'~' · / N~o. ~_-81~§8S0, Suffolk CoujiI~,~~ ~ I ($~g~aature.of apphcant) : /erm txpires March 30, 19..g;?,;~:~/ 411'