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HomeMy WebLinkAbout11268-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. Certificate Of Occupancy Z10721 THIS CERTIFIES that the. building ................................................ 345 Youngs Avenue, t4attituck, New York Location of Property ........... House No Street Hamlet County Tax Mai) No. 1000 Section 114 .Block 10 .Lot 029 Sub&vision ............................... Flied Map No, .. - .Lot No .............. cou£onns substantially to the Apphcanon for Bml&ng Permit hei'etofore filed in this office dated July 7 ^ 81 ~ ..................... , j~ ... p~ rsuam to which Building PcrmR No. t. 1.2..6.8..Z. ............. dated . . .g.u.~.7.. ! .3 .................. 19 .8.1. , was issued, and conforms to all of the requirements of the at)phcahlc provtsions of the law. The occupancy for which this certificate is issued is ......... Inground Swimming Pool with Fence The cemficate is issued to . .F.r..a.n.~ .S. ,~.a.r.~o. ? .......................................... (owner, ~J~3'x~:x*~q(~& x of the afmesa~d bmkhng. Suffolk Connty Department of Health Approval ...~ ./.R .................................... UNDERXVRITERS CERTIFICATE NO .... ~5..2.9.~.2.4. ...................................... Braiding Inspector ~'OE~ NO. ~ TOWN OF $OUTHOLD suI,D Ne TOWN HALL SOUTH'OLD, N~ Y. BUILDING I~,ERMIT (THIS PERMIT MUST DE KEPT ON THE PP. EMISES COMPLETION OF THE WORK AUTHORIZED) UNTIL FULL 11268 Z Permission is hereby granted to: ~unty Tax Mop No. I000 '~c~ on ~ ................... Bilk .~....~;, ......... = t ........................ 7 pursuant to app cat on dated ........... ~ ...... ..~. ...................... ?...J~. ..... 19.....~.., appr y Duilding Inspector. } ~i~ing ~ln~ector Rev. 6/30/80 * .-~>~l~ THE NEW YORK BOARD OF FIRE UNDERWRITERS -U.~AU Of E~.ECT.IC,T¥ THIS CERTIFIES THAT only tko electrical equipment as described below artd introduced by the applicant , number in the premises of ~. thefollowing Iocattou; ~ Basemene ~ 1st FI. ~ 2nd Fl. was examined on j~) { ~r /L ~ ~ ~.~.), at~d ~ound to be ln cotnpliance w~ FIXTURE OUTLETS FIXTURES RANGES 2 FURNACE MOTORS FUTURE APPLIANCE FEEDERS SPECIAL REC'PT TIME CLOCKS DRYERS Block Lot DISH WASHERS FANS MULTI-OUTLET DIMMERS SYSTEt~S NO OF FEET SERVICE DISCONNECT S E R V I C E NO OF CC CONO A W G NO OF HI ERG A W G NO OF NEUTRALS A W G OTHER APPARATUS, This certificate must not be altered in any manner; return to t~e office of the Board ff Inspectors may be ~dentlfred b~t~.~crede~ia[s. copY...FOR~ BUILDING DEPARTMENT, ,THIS COPy OF ~_NOT. BE~ALTERE~ IN ANY MANNER. FORM NO. 6 'TOWN OF SOUTHOLD Building Department Town Hall Southold, N.Y. 11971 APPLICATION FOR CERTIFICATE OF OCCUPANCY Instructions Th~s 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 featu res. 2. Final approval of Health Dept. of water supply and sewerage disposal-(S-9 form or equal). 3. Approval of e~ectrica~ 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 s~te plan requirements where applicable. For existing buildings (prior to April 1957), Non-conforming uses, or buildings and "pre-existing" land uses: I. Accurate survey of peoperty showing ail 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 othe,r 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 Date ' . ...... New Building ............. Old or Pre-existing Building ............ Vacant Land ............. oeat,on of Property House No, Street Hamlet Owner or Owners of Property . .~.~ ~,.~.{~ ~ ~. , .~, :.. ~.~.~ ~.~. ......................... County Tax Map No. 1000 Section., .~.~..~. ........ Block .... ~.~) ........ Lot ..... (~..~.~ ...... Subdivision ............................... Filed Map No ........... Lot No .............. Permit No.|~o~ .~ .~.... Date of Permit 1 r.l~.',(~.l, ,Applicant...~k~.~...~'.~1~.~/~' ....... Health Dept. Approval ........................ Labor Dept. Approval ................... Underwriters Approval ........................ Planning Board Approval ............... Request for Temporary Certificate ..................... Final Certificate ........... Fee Submitted $ ...... ~; ~ ................. Construction on above described bu ilding and permit meets all applicable codes and regu lations. Applicant.,..~..~, Rev, 10-10-78 FIELD INSPECTION~ COMMENTS FOUNDATION (1st) FOUNDATION (2nd) 2. ROUGH FRAME & PLUMBING INSULATION PER N. STATE ENERGY Q,ODE FINAL ADDITIONAL COMMENTS: TOWN OF SOUTHOLD OFFICE OF BUILDING INSPECTOR P.O. BOX 728 TOWN HALL SOUTHOLD, N.Y. 11971 TEL. 765-1802 September 29, 1981 Mr. Frank Starzee 345 Youngs Avenue Mattituck, New York 11952 Dear Mr. Starzee: your which is to be completed office with fee of $5.00 close your file. Thank you. Please be advised that a final inspection has been made on Inground Pool Building Permit #11268Z. We are enclosing Application for Certificate of Occupancy in duplicate. Kindly return to this so we may issue your Certificate and Yours truly, GEORGE H. FISHER SR. BUILDING INSPECTOR GHF:jd Enclosure FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N.Y. 11971 TEL,: 765-1802 E,,amined Approvedk~. (-g../.¢.~...I.~. .... 19~../Permit No.. t ]. -~.~. Disapproved a/c ............. -,~-~../ ........ / .................. 77.;-....'...---V .... . ./~ . .I. - (Bffflding Inspector) APPLICATION FOR BUILDING PERMIT Application No..£..~-.~ .(~:~ · .'. INSTRUCTIONS a. This application must 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 diagram which is part of this ap!: 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 pern shall be kept on the premises avatlable for inspection throughout the work. e. No building shall be occnpied 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 bmldings, additions or alterations, or for removal or demolition, as herein describe The applicant agrees to comply witt~ all apl:'.icable laws, ordinances, building code, housing code, and regulations, admit authorized inspectors on premises and in buildings for necessary inspections, .......... ,1.¢/ (Signature of applicant, or name, if a corporation) / 64tMsilino address of applicant) State whether applicant is owner, lessee, agent, ~chitect, en~neer, general contractor, electrician, plumber or buildt N~e of owner of premises. ~/~ ~ ~... c~ ~.~.~5:~,: ........................................... (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 ..... ./~? ./': .............. Electrician's License No ..... .//.~?/.~' ........... Other Trade's License No .................... Location of land on which proposed work will be done... ............ ................... ............ House Number ~} Street Itamlet County Tax Map No. 1000 Section ..... I.c~ ......... Block ..... !.C_). .......... Lot...O..~.~ .......... Subdivision ................ (iq'a}~) ................ Filed Map No ............... Lot .............. State existing use and occupancy of premises and intended use and occupancy of proposed construction: £:.: o-- '-- a. Ex~sting use and occupancy ...... /. .~:-l~'I~.~: ............................................., b. Intended use and occupancy q" -:-.e.,o c~ --->o ~ oc~'~ 3. Nature of work (check which applicable): New Building .... Addition.~.. Alteration : Repair .............. Removal ............. Demolition .............. Other Work ............... o ~,, (Description) t. Estimated Cost *. ........................ Fcc .......................... (to be .paid on fding this application) L If dwelling, number of dwelling units ......... Number of dwelling units on each floor ............... If garage, number of cars ....................................................................... 5. 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 ............................ i ........................... Dimensions of same structure with alterations or additions: Front ................. Rear ................. Depth ...................... Height ...................... Number of Stories ..................... 3. Dimensions of entire new construction: Front ............... Rear ............... Depth ............... Height . ~.~ber of Stories ' ~ Size of lot: Front ~w~/.,~. Rear Depth ' ) Date of Purchase Name of Former Owner district in which premises are situated i ' 1. Zone cruse .................................................... !. Does proposed construction~vi_olate any zoning law, ordina.n, ce or regulation: ... ~ .................. .~...~ ...... L Will lot be regraded ...I/.~_.~. ................... Will excess fill be removed, from premises: ~_-~ ~ No ~. Name of Owner of prem{ses ~.'..~~ ... Address .~05..qtY~J-XI. ~.~./~)~. Phone No. ~l,qot~. Name of Architect... ~./,A~ ........... ~..::... Address . ._~. ..~. ~...~. ...... Phone No.. ~Z-....~ ......... Nmne of Contractor . ~ t~'~,].~l~10.. ~.t~t'~lS.. Address . .... Phone PLOT DIAGRAM Locate clearly and distinctly all buildings, whether existing or proposed, and, i~dicate ail set-back dimensions from :operty lines, Give street and block numbar or description according to deed, and show street names and indicate whether ~terior or corner lot, 'FATE OF NEW YORK,--,- ' ~" ".S ......... ~...................~.. ............. ~. ~ ........ being duly sworn, deposes and says that he is the applicant (Name of individual signing contract) Cove named. e is the .............. ~...~../Q.z~,~ ............................................................... (Contractor, agent, corporate officer, etC.) f said owner or owners, and is duly authorized to perform or have performed thel said work and to make and file this pplication; that all statements contained in this application are true to the best of his kuowledge and belief; and that the ,ork will be performed in the manner set forth in the application filed therewith. worn to before me this ioCry P?lic, . . ~..~...~ ..... ~_~..~-~ ... ~h~d~tt~. County . ~/= ..~ ~OrAI~' P~UO, State of new ¥ k (Signature of applicant) ~0. 52-$125850, Suffolk Coun~ ~ Term Expires March 30, 19st~.s~' ' '~ ® SKtMMERS RETURNS~'< ~TO FILTER 3TES . WALJ(S TO J~E S';C.CTH- NON SKID TYPE, S~OPED'~ AWAy FROM POOL WATER DISPCSA. S~ALL EE LIMITED ~rO OWNER~ I PRCPERTy TO '5~,T LOCA~ ~/GULATION~ ~ FOAM BET/.EEN LINER THICK "OWENS COR~- -'r~J,',E,-EO C", EACH CF CONCRETE BLOCK r~ BERGLAC~: ' ~OULDED , P~ECE ~T_¥=PIC'AL_ y~A LL $ EOT! ON C ONCR~TE - %t '"! FLOT,N$ OCCU?AI~C¥ OR WIT[,~G~JT C[RT[FICATE Ol: OCCU?AHCY~ NOTIFY BUILDING DEPARTMENT AT 765-1802 9 AM TO 4 PM FOR THE FOLLOWING INSPECTIONS: I, FOUNDATION . TWO REQUI]RED FOR P©URED CONCRETE i 2. ROUGH - FRAMING & PLUMB~iNG 3 INSULAT!3N 4. FINAL - COHSTRUCTION M~JST BE COMPEFTE FOR C. O. ALL COi',!S'¢RUCTION SHALL '/V~EET STA~TE~ CONSTRUCTION & ]ENERG'¥' CODES, NOT RESPON~I~EE FOR DESIGN OR CONSTRbCTION ERRqRS, L OCCUPANCY AF:'::~L'Z:3 A'S NOTED 765,1802 9 AM TO ~ PM FOR THE ~ODE$. NOT RESPONSIBLE FOR . , ~I~N OR ~ON$TRUCTION ERRORS. r