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HomeMy WebLinkAbout11131-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. Certificate Of Occupancy No. Z1053~ Date June aa .,19 ~1 THIS CERTIFIES that the building ................................................ Location of Property 1330 Bay .A.y?.n. qe.~ ........ Maggibuck, New Yopk County Tax Map No. 1000 Section 143 .... Block 03 .Lot 021 Subdivision ............................... Filed Map No ......... Lot No .............. conforms substantially to the Application for Building Permit heretofore filed in this office dated .H..~1¥. ,1 ............... , 19,8,1. pursuant to which Building Permit No ..... 111 31 Z dated ...... .H.a. It. ~ ................ 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 ......... Inground S,~in~ming Pool with Fence ' e The certificate is issued to . . (~.o.~g.. SrlSdel~ (owner, [$~ee or ~nan~ of the aforesaid building. N/R Suffolk County Department of Health Approval .......................................... UNDERWRITERS CERTIFICATE NO ...... R ~ 23 ~ ~ 9 / ....... Building Inspector Rev, 1/81 FOTM ~NO. 2 TOWN OF ;DUTH~!4D~ TOWN HAI.L SOUTHOLD, N!. ¥, BUILDING' PER~iT BE KEPT ON THE PREMISES UNTIL,~ULL (THIS PERMIT MUST COMPLETION OF THE woRK AUTHORIZED) N©. 11131 Z ~>ate ..... ~/~. ....... , ........................... ¢ormission is heroby Or~nted to: ...... ....... Z~& .~.~.....~.~ ~)....: ......... ...... ~.~.~... ~ ../~. ......... / ~ ~-, ~ ~', ~ ~ ...... , to...~.¢.~ c.~.~Z ....... ~.~./.~.~.~¢ .....~x~.¢~.~.~.~....x~,.*.& ............ / Co,~, ,~ ~,p ~o. ~000 s,~t~o~ ..... .d.~.~T.....~. ~o~k ;....~.., .......... ~t ~o....0 .............. pursuant to opplicotion~d~t~d ......... ~..~ ................... }....., 19.~n., ~nd ~pproved by the Building Inspector. Fee $ ................ Rev. 6~30/80 FORM NO. 6 TOWN OF $OUTHOLD Building Department Town Hall Southold, N.Y. 11971 APPLICATION FOR CERTIFICATE OF OCCUPANCY Instructions 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: I. 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 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 peoperty showing all property lines, streets, buildings and unusual natural or topographic featu res. 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 or land use 3. Copy of certificate of occupancy $1.00 New Building ............. Old or Pre-existing Building ............ Vacant Land ............. Location of Property. ,~ .~..~..O....~. ~.J .... ~ .U.~../1..M...~. ............... ,~.~ ./.~.~ ¢'.~.~. ...... House No. Street Ham/et Owner or Owners of Property ~..e~...r.<.~. ~.. ~..~{t.~ t' .~.,~../~'. ............... County Tax Map No. 1000 Section /~'/~ Block ~. .... Lot .... .~/. Subdivision ................................. Filed Map No ........... Lot No .............. Permit No. ~.J. ( .~.J....~. Date of Permit ~./.5~/~'./..Applicant ~..~.1.~... ~,.~. Health Dept. Approval ........................ Labor Dept. Approval ........................ Unde~riters Approval ........................ Planning Board Approval ......... Request for Temporary Certificate ......... ' ............ Final Certificate .... Construction on abova describod buildin~ and ~ormit m,ets all a~licablo ~os and ro~ulations. THE NEW YORK BOARD OF FIRE UNDERWRITERS BUREAU OF ELECTRICITY 85 JOHN STREET, NEW YORK, NEW YORK 10038 THIS CERTIFIES THAT ,gt thefollo~viag ~ocat~o~; []~ /Jase,nent [~ /st ~'l. [~ 2nd FI. ~l~t~i~ Sectio,t ~lock Lot was ex.mined on &~e ~ ~ ~ ~}%Jl sad found to be in comphance with th. requirements of this Board. FtXTURE FIXTURES RANGES KINGDECKS OVENS DISH WASHERS EXHAUST EANS OUTLETS SWITCHES ~HCANOE$CENT FLUORESCE~¥ DRYERS S E R I C E NO O~ CC COND A W G NO OF HI LEG A W G NO OFNEUTRAL,5 A W O OF H~-LEO OF NEUTRAL t 4 2?7 E. Brookwmter PaL Mattit~k., No 'L 11952 Li~ ~529 This certificate must not be altered in any manner, return to the off,ce of the may be COPY FOR BUILDING, DEPARirMENT.. THIS CO~Y OF IN ANY MANNER. FIELD INS6~Ci'IQN FOUNDATION (~l~t~ , , FOUNDATION (Und) ~OUGH FBA~E & MBING INSULATION ER N. Y. STATE ENERGY ~.- -~ .~_~..' ~f~ __ TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. ................ _ Approved .... ~.~ ................ , 19¢':.~./... Permit No../._../.~___...._ ............ / Disapproved o/c ..................................... .j~.~, ................... ;./Z. ................... "7 ..... ¢'"'"'""'""'"' ................................ APPLICATION FOR BUILDING PERMIT Date INSTRUCTIONS Application No. ,../,,/,,.~.~.~./.,, ............. 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 o 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 necessary inspections. ......... tute ~¢~f opl:~'~n,, ~'r name, if o corpora ia ) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. ......... ................................ : ..................................................................................................... If applicant is a corporate, signature of duly authorized officer. (Nome and title of corporate officer) Builder's L,cense No ................... ..~..,L ........................... Plumber's license No ......................................... Electrician's License No .... /L..~.J...~.. ....................... Other Zrade's License No ............ ~../~. ....................... Location of land on whi,ch proposed work will be done. Map No.: ........................................ Lot No ......................... Street and Number ........ : .............. ~.....~.....~..-~.-: ............................................................................................... / Municipality State existing use and occupancy of premises and mtended use and occupancy of proposed construction: a Exisiting use and occupancy .......... L..,~.,.~ ;.J,,~. ...... · .~. · · .~. · · ~//. 1.:~--~.~ ........................................................... · U ' ~ b. Intended use ond ~ccup~ncy~..~...~/~..~..~...~..~j.~/~/~.~./~/'~7.~J..~./~./~d~:t~...~.~.~.~z. .. 3. Nature of work (check which applicable): New Building.. ................. Addition ....... Alteration ................ Repair .................. Removal .................. Demolihon .................... Other Work ................................................... (to be paid on filing this application) 5. [f 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 ................................ Depth .................... Height ........................ Number of Stories ................................................................................................................. D~mensions of same structure with alterahons or additions: Front .................................... Rear ........................... Depth ................................ Height ............................ Number of Stories ................................ 8 Dimensions of entire new construction: Front .................................... Rear ............................ Depth ........................ Height .................... Number 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 .................................................................................................. ]2, Does proposed construction violate any zoning law, ordinance or regulation: ....... ~...~. .......................................... I3. Will lot be regraded .....~'..~-~.~., ............. Will excess fill be removed from premises'. ( '"~Yes ( ) No Nome of Architect .......... /W.,,4 ./LC..: ....................................... Address ................................ Phone No ....................... PLOT DIAGRAM Locate cleaHy and distinctly ali buddings, whether ex~stJng or proposed, and indicate all set-back dimensions from property lines. Give street end block number or description according to deed, and show street names and indicate ~vhether interior ar co~ner STATE OF NEW )~ORI(, . , I c S COUNTY OF ...,,5'n-~.. ~./../~-...f~' .............. ~/..I..C~.~.~/~T......4~I::...-,~,~],~,, ,,~,,,,' ...................... be,rig' duly sworn, deposes and says that he is the appl.conl i(Name of individual signing controcf) above named. He is the (_J (Contractor, agent, corporate officer, etc.) of said owner or owners, and is daly 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 fha manner set forth in the application filed therewith. Sworn to before me this 4_sC- . ......... l .............. day ........................ , /, Notary Public,. ............. ~ ........ County ~~/. · .~=. · · .~-~.. · ;.. · ..l~..~J. I.. ~ .............. ~ ~4.~--~- ~'/~ ' / /(tSJgnatClre of'applicant) // / ~ ir- NORDEN L HAGER tr ~-~ Notary Public, ~t~teHAofGNER~ Yetk No, 52-45264331 , Ouelffied in Suffolk Cc~unW _ , Commmslon Expires March 30, , , ' APl'ROVeD AS I IOTED NOTIP,"'BUILD~NG ~AR~MEF~T AT 765-1~02 9 AM ~O 4 PM FOR THE FOLLD~U~NG INSPECTIONS: l. FOUNDATION - TWO REQUIRED FOR POUR~O CONCRETE 2. ROUGN - FRAMING & PLUMBING 4. FINAl_ - CONSwRUCTION MUST BE COMPLETE FOR C O, ALL CONSTRUCTION SHALL 'MEET THE REQUIREMENTS OF THE N. Y, STATE CONSTRUCTION & ENERGY CODES, NOT RESPONSIBLE FOR DESIGN OR CONS! il, d~ ','. ~,}? ~ [, LNORb. .J ' o. IM-KING POOLS, INC. HOUTE 25A ItOCKY POINT, NEW YORK C) 0 Z