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Home My WebLink About11065-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. Certificate Of Occupancy No..Z.q.4fi.].2. Date December 20 19~.5. THIS CERTIFIES that the building...~,n,g ,v pM, ri, cl.. pp. q3:...a.n.d.. ,~?.n.c.? .................. 1435 EDWARDS LANE (PVT. RD. #8) ORIENT Location of Property/-1[~6s'o County Tax Map No. 1000 Section . ,0. q..8 ....... Block ...0. 3. .......... Lot 01 8 Subdivision ............................... Filed Map No ......... Lot No .............. conforms substantially to the Application for Building Permit heretofore filed in this office dated ·..PI.a.v.q h...1.2. ......... ,19 .8.1. pursuant to which Building Permit No .... .1.1.q § 5 .~ ........... dated .... ~.a.v.c. ~. ,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 ......... ·. ~B.g~. 9.u.n.d' . p p.ql...a.n.d., f..e.n.qe.: ................................................. The certificate is issued to JAY GOLD (owner, I~y~J~ ~tX~tt~t~ X X of the aforesaid building, Suffolk County Department of Health Approval ...... N/A UNDERWRITERS CERTIFICATE NO ................ #. ~ ~,q.9.2. .8.6 ......................... Building Inspector Rev. 1/81 TOWN OF $0UTH~LD BUILDING Di~'.,~.'rMEN'r TOWN HALL SOUTHOLD, N~ Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PP, EMIS~S COMPLETION OF THE WORK AUTHORIZED) UNT L FULL N9 1-1095 Z o=~e ..... ~.~c~/....~.~ ................. Permission is hereby granted to: . .~.? ............. ....... ~. ...... ~. .......... .~ ..................... ,~ ................. ~o .......... G~.&-~.ZZ~.ggE: . z~.~.z.g~.~.&e......~....~..-.~w~.~= .................. ~c g~ ......................................................... x. ........ ...~...~ ........ ~ ................. .~ .. . ..................................................................................................... ~ ............... n~ ...... ~. .. ........................ 0 ~ lot ~o....~....~. ......... Coun~ T~x ~p ~o. 1000 Soctio~ 0 [~ ' BI~ ;....} ................ pursuon~ to ~ppficot[on d*t~d .... ~~...~..~:: .......... ~....., 19~, ~nd ~pprovod by the Building Inspector. Fee $ ....... :......T. ........ Building ~lnspector Re¥. 6/30/80 FORN~ 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 instalJation 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. Accurate survey of peoperty showing all property lines, streets, buildings and unusua~ 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 inspecti,,on of buildings or premises, 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 Date ..... New Building ............. Old or Pre-existing Building(:~) ........ ~/Vacant Land ............ Location of Property .... House No. Street Hamlet Owner or Owners of Property . .'].~L¢4~:.. . ~1~.~¢ ,~.. .................................. County Tax Map No. 1000 Section ............... Block ............... Lot ................ Subdiwsion ................................. Filed Map No ........... Lot No .............. Permit No.,, 0.~e.~.... Dateof Permit */;~]~"]..Applica., .~. , . , .~:~. ~. ~.~,~.¥~.-'. ,~...~1~ Health Dept, Approval ........................ Labor Dept. Approval ...................... ,,, Unde~riters Approval .................... Planning Board Approval .............. ' ....~ ,., Request for Temporary Certificate ..................... Final Certificate ........ Fee Submitted $~ ~ Construction on above described building and permit'meets all appl~cable~co,des and regulations. I~;Zo/¢~~ ~,O,~* I~l/I,.~, Applicant., ..... . ........ ~ ~. FORM NO. 6 TOWN OF SOUTHOLD i3uilding Department Town Hall Southold, N.Y. 11971 765 - 1802 APPLICATION FOR CERTIFICATE OF OCCUPANCY Instructions This application must be filled in typewriter OR ink, and submitted ,., ~ to the Building Inspec- tor w~th the following; for new buildings or new use: 1. F~nal survey of property with accurate location of all buildings, property lines, streets, and unusual natural or topographic features. 2. F~nal 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. Commercm~ 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. For existing buildings (prior to April 1957), Non-conforming uses, or buildings and "pre-existing" land uses: 1. Accurate survey of p~operty 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 prepare 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.C. $5.00 $15.00 Date .......................... New Building X Old or Pre-existing Building Vacant Land Location of Propertv 1435 Hales Road Orient Houee No. Street Ham/et Owner or Owners of Property JAY GOLD County Tax Map No. 1000 Section ..... ]:.8. ........ Block .... ,3 .......... Lot.. ,~.8 ............ Subdivision ................................. Filed Map No ........... Lot No .............. Permit No ........... Date of Permit .......... Applicant .................................. Health Dept. Approval ........................ Labor Dept. Approval ........................ Underwriters Approval ........................ Planning Board Approval ...................... Request for Temporary Certificate ..................... Final Certificate X Fee Submitted $ . , .5.: .0,0 ...................... Construction on above described building an/I p/rmi,l~~,cable codes and regulations./'/ Applicant~~. t~....4:~...~...~.. .... December 19, 1985 Building Department Town Hall Southold, NY 11971 Att: Ms. DeVoe Re: C.O. - Gold Swimming Pool Dear I~s. DeVoe: Pursuant to our recent telephone conversations, enclosed is an application for C.O. and our check in the amount of $5.00 to cover the fee. I greatly appreciate the cheerful cooperation which you have extended, and send my best wishes for a very happy holiday. Thank you. HKP / ip Eric 1 s. TOWN OF SOUTHOLD OFFICE OF BUILDING INSPECTOR P.O. BOX 728 TOWN HALL SOUTHOLD, N.Y. 11971 TEL. 765-I 802 - Applicant This is to advise you that the job under Building Permit No. on ~/a~]~ for~~ ~oo~ ~ ~.~ is completed ~nd a fl'naI inspection h&s~ ~as not~ been done. In order to complete thms file, it is necessary that a Cert~fmcate of Occupancy be mssued. Please f~ll out the enclosed form(s/, return same to the above office with a check for $5.00 payable to the Town of Southold. Please indicate to whom the Certificate of Occupancy is to be and arrange wmth this office for an inspection date. Thank you for your prompt attention. Very truly yours, Victor Lessard Administrator VL:oc Enclosures ma~led~ THE NEW YORK BOARD OF FIRE UNDERWRITERS BUREAU OF ELECTRICITY 85 JOHN STREET, NEW YORK, NEW YORK 100:38 THIS CERTIFIES THAT otdy the electrical equipment as described below and introduced by the applicant named on the above application number in t~ premises of ~n tke following location; ~ Basement ~ 1st Fl. ~ 2nd Fl. Sectiott Block Lot FIXTURE FIXTURES RANGES OVENS EXHAUST FANS t 1 ~4 1 DRYERS FURNACE MOTORS FUTURE APPUANCE FEEDERS TIME CLOCKS UNIT HEATERS MULTI-OUTLET DIMMERS SYSTEMS NO OF FEET SERVICE DISCONNECT S E R V I C NO O~ERC~.COND OF ~cWc~)ND NO OF HI LEG OFA Hi. LEGW O NO O~ NEUTRALS (~mm~g Pool~) ~'~s c~ific~ cov~'~ c~1.~ ~ ~ ~e of ~c~i~n only, AWG OF NEUTRAL GENEI~AL MANAGER ~Per Th,s cerhflcate must not be altered m any manner; return to the office of the Board tf incqrrect. Inspectors may be ident*fled by the,r credenhals COpY FOR BUILDING DEPARTMENT. IHIS COPY NO~ BE ALTERED IN ANY MANNER. FIELD INSPECTION 1. FOUNDATION FOUNDATION (2nd) 2. ROUGH FRAME & PLUMBING INSULATION PER N.Y. STATE ENERGY CODE COMMENTS FINAL ~DITIONAL COMMENTS: ,.4 FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N.Y, 11971 TEL.: 765-1802~ Examined ~-f~h~.4/...d~ ~, 19 .?~/ Application No./...d',O?d~ .......... Disapproved a/c .......................... ~ ......... APPLICATION FOR BUILDING PER~IT Oat~ .. ~.~.~, 1,~. ., ]9 ~ { 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 detaded 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 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, builtl~ng code, housing code, and regulations, and to admit auth°rized inspect°rs °n premises and in buildings f°r necessi~ i.n~..~ .......... (Signatur.e of applicant, or name, if a corporation) ,q. .t¢..o. . .... .m. .o... !c. o. ..... (Mailing address of applicant) State whether applicant is owner, lesse~rchitect, engineer, general contractor, electrician, plumber or builder. Name of owner of premises ...~..A...~...~...O.~.~'> ......................................... (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 ..... ~."~ .8 ..... .~.: .}q .~.~. ~T- ::~ 2d~ Plumber's License No ......................... Electrician's License No ............. · ......... Other Trade's License NO ...................... ~'/~/~' (//~/7 ,'~ ~d¢ 1. Locationoflandonwhichproposedworkwillbedone... ~../~' t~),~O~-~,~D~q I- ,~ II~o w. . . .7. . ............ o. . .rL.te. . T ...................................... House Number Street Hamlet County Tax Map No. 1000 Section ... ?..d..,~. ......... Block .... ~:?.~.. .......... Lot..O.f?~ ............ Subdivision .... ~)..~.~...%..~.\ .f~..~.~. ~. ............... Filed Map No ............... Lot ............... (Name) 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy ...... ~...~. ~. ........................................................ b. Intended use and occupancy ...... ~...0~..t.~..~tf../~. ~. ..... .~.00..t~. ................................... 3. Nature 0fwork (check which applicable): New Building .......... Addition .......... Alteration . .,..' ..... : Repair .............. Removal .............. Demolition .............. Other Work .~.?./.~,~. ~. ?.~.. (Description) 4. Estimated Cost ..... .~.~..'~..Q ......................... Fee . [.>.~..-] .............................. (to be paid on filing this application) 5. If dwelling, number of dwelling units ............... Number of dwelling units on each floor ............... If garage, number of 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 .... ~ .O. ...... Depth... ~ .o. ....... Height ....... /. ~. .....Number 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 ....,~..o. ........ Depth ....."'~-O ...... Height ............... Number of Stories .... ~, y..~. ,,~.~ :t..: .~..~.-~..,,~.. ....................... i .... 9. Size of lot: Front .............. ?/:.~..~... Rear .... .~..~..o. ........... Depth . ."'~..O..~, ...... 2... 10. Date of Purchase ............................. Name of Former Owner ..................... ' ....... 11. Zone or use district in which premises are situated ........ ~r.~, .~ ...................................... 12. Does proposed-constrnction violate any zoning law, ordinance or regulation: ............................... 13. Will lot be regraded .................... I~r,O .... Will excess fill be removed from premises: ~ No 14. Nmne of Owner of premises .,~ ,~. ¥..C~O.% .~. ...... Address . I~ ~.a~..tt-.~.D.~../~. ? ~. Phone No. ~ .g 3...~...~..~.. Nmne of Architect ........................... Address ............. .oPho?~ No ................ Nmne of Contractor . .~.o..c:.tp~/~. ~.o,o,~,~>., .~.O. ~.~. Address ............. ',~ ~i~lC~o rr~l¢, ...... C, rnone~¢-~¢ ethane... PLOT DIAGRAM Locate clearly and distinctly all buildings, whether existing or proposed, and, indicate all set-back dimensions from property lines. Give street and block number or description according to deed, and show street names and indicate whether interior or corner lot. ' O STATE Ol~ NEW Y Ri{, COUNTY OF...~..~.[~.C'~I..%~... S.S ....... ~7)~, .~. ~ .~....~f[.~.~ 5 ~ .~.tO ............... being duly sworn, deposes and says that he is the applicant (Name of individual signing contract) above nam0d. ., (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 all statements contained 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 ' ........... ........ , /q ,