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HomeMy WebLinkAbout11140-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. Certificate Of Occupancy No .... ZJ~[5 ....... July .19. 198,4. Date ............................... THIS CERTIFIES that the building ........ 5,n g r p.u,v. ~. p.q Q 3. ......................... 300 Oakwood Dr. Southold Location of Property ............................................................... House No. Street Ham/et County Tax Map No. 1000 Section 0.70. ..... Block 1 2 . .Lot 020 x x x Subdivision ............................... Fried Map No ......... Lot No .............. conforms substantially to the Application for Building Permit heretofore fried in this office dated April 20 l~.l . pursuant to which Building Permit No. .JllqgZ. dated May 8 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 swimming pool w/fence enclosure KATHLEEN VACCARIELLO The certificate is issued to .......................................................... [owner, of the aforesaid building. Suffolk County Department of Health Approval .......................................... N523120 UNDERWRIIERS CERTIFICATE NO .................................................. Building Inspector Rev. 1/81 FOI~M NO. ~ TOWN OF~ ~UTH~L~I~ BUILDING D~'AR~M~NT TOWN HALL SOUTH:OLD, N~ Y~ BUILDING PE~IT (THIS PERMIT MUST BE KEPT ON THE PP, EiMIS~ UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) N©. 11140 Z Dote ..... Permission is hereby granted to: /-,~ ¢ c_/,,/',~ ~..~,.~ ~. .... ~...~.~..z~.~,;} ................ ~o ...... ~.~..~Z~.c~ ....... z~..~..xc~.~......~~.....~.~ ............... ~ prom,so~ Ioc*t*d ot ...... ~O ........ ~;'""~'~'~'"'~ '~'~7~ ................................... ................................................................................................ :....~. ............. Co~ ,~ ~p uo. ~00 s,~t~o~ ...... ~..7~...~. ~ ;....~.~ ........ ~cot ~o ..... o.~.o ....... Boildlng Inspector· Building i lnspector Rev. 6/30/80 FORM NO. 6 TOWN OF SOUTHOLD Building Department Town Hall ~uthold, N,Y, 11971 APPLICATION FOR CERTIFICATE OF OCCUPANCY Instructions This application must be filled in typewriter OR ink, and submitte .'.~. _J~Hcct= 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 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 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 3remises, 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/ land use 3. Copy of certificate of occupancy $1,00 --Pre-Existing C.O. $15.00 Vacant land C.O. $ 5.00 Date ...................... New Building .... .~.~¢.) .I... Old or Prmexisting Building ............ Vacant Land ............. Location of Property ,~ .~..-~,J.,., ~.'~. ...... f~¢./~ ............ *. ~/~ ......... Owner or Owners of Property .... ~;'~. · · ~~ cou.w T.~ M.. No. ~000 S~o~o.....g~ ...... ,~o.k ...... ~ ~ ...... Lo~ .... ~2 ~.~ ..... Subdiwsion ................. ~ ............... Filed Map No .... ~ ..... Lot No...~ ......... Permit No, .~, ~ ,~,~,~[ ~Date of Permit. ~ / ~.J..Applicant.. ,~.~ ~ ~,~,..~ ~ ~/~ Health Dept. Approval ...... ~ ............. Labor Dept. Approval ....................... Unde~riters Approval..~'~ ~ .~,~,~ ......... Planning Board Approval ..................... Request for Temporary Certificate ..................... Final Certificate .... ~ ................ F.~ Sub~i~t~ ~..~, ~ ................ ~. ~ ~ Construction on above described bu lid lng an,d:~it ~t~;~le codes and r~s. THE NEW YORK BOARD OF FIRE UNDERWRITERS BUREAU OF ELECTRICITY ~[ 85 JOHN STREET, NEW YORK, NEw ~ORK 10038 ..t;, Jn~e % 1.9~] ~a~.~o~..o.~a~ 123030-81 N in tke follo~ng location; ~ Baseme,tt ~ 1st FI, ~ 2nd FL OUe~ Section Block ~ot was examlrte~ on JL~3;~ ~ , ][98~. attd found to be in compliaace wltk the requirements of tkis Board. EXHAUST FANS DRYERS FURNACE MOTORS FUTURE APPLIANCE FEEDERS TIME (~LOCKS MULTI-OUTLET DIMMERS SYSTEMS NO OF FEET SERVICE DISCONNECT OTHER APPARATUS, S E R V I C E A W G NO OF HI-LEG [ A W G NO OF NEUTRAL~ A W G OF CC COND [ OF HI LEO OF NEUTRAL Lie:#l!O1 GENEI~AL MANAGER li ~ Th,s cerhflcate must not be altered n any manner; return to the off,ce of the Board If !ncoirect. Inspectors may be ,dentifled by their credenhaJs COP~ FOR B~ILDING DEPAR blENT. THIS ,COPy OF- C}~IFICATK, U' T ~OT BE~ALTERED IN ANY MANNER FI~LD 1N ~ ~'Ls U'I' 1ON b',~lvlivl ~ 1'~ I ~ ~ ~-~ FOUNDATION (1st) FOUNDATION 2. (2nd) ROUGH FRAME & PLUMBING INSULATION PER N. Y. STATE ENERGY CODE FINAL ADDITIONAL lENTS: FORM NO. 3 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N.Y. NOTICE OF DISAPPROVAL File No ............................... . dX..-/,'.4~/. ..... Date . ~Z ~-~ ,~O 19. ·/..<71./.~..¥?~:...,,5.~.c..~ .~. .~.//4,?~.~. ?. ... for permit to construct../~..~.~.Q ?...A~.?.....~.~. ?...(-~x.....~..~...d: (Z...~/.o.~...c:~.. ~../.~. ?.z/4 at Location of Property ...~.,..~2...(./~..~..~.2~..~.CL~....~/f-,~/.c/.4~..T ..... .~.~.~././._/.q.&..~.:...~.(.~k~. .ouse ivo. b'treet Hamlet// County Tax Map No. 1000 Section .............. Block .............. Lot .............. Subdivision ....... ~?-. 7..~ ..... Filed Map No ...... /...~.... .... Lot No...O:~.~. ........... is returned herewith and disapp~oYed on the £ol]owin~ ~rounds... ~ ......... Inspector RV 1/80 ' BUILDING DEPT. INSPECTI!ON [ ] FOUNDATION 1ST [ ] ROUGH P~BG. I* '] FOUNDATION 2ND [ ] INSULATION [ ] FRAMING [ ] FINAL DATE INSPECTOR FOBI~ NO. TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFIC:E SOUTNOLD, N. Y. Examined .... .~...~. ~.....C/ .............. , 1 . Approved ...~.~......~ ............ , 19~.. ~erm,t ~o....~.~.~.~r~.~ ........ O~sopproved o/c ...................................... ~ ........................ ..~ ................. (Building Inspectod Application No ...... , ......... : ................. APPLICATION FOR BUILDING PERMIT ......... ........... , I NS'I'RUCTIONS 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 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 a~terations, 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. . ............................... (SignaYure of applicant, or name, if a corporation), ' State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. Nome of owner of prem ses ..~../~_.A..[-~...L...~.~....~.........~..8..~..~....~....~..../...~...~ ....................................................................... if apphcant is a corporate, signature of duly authorized officer. (Name and title of corporate officer) Builder's License No ..............~.../. ................................... Plumber's License No ......... ..~./~.. ............................. Electrician's License No .... /../...O../....~.. ......................... Other Trade's License No ..........~/.~.. ............................. 1. Location of land on which proposed work will be tJone. Mop No ...................................... Lot No ...................... Street and Number ..~.0~.......O.~.~,~.~...Q..o...~......~..(~..~..~ ...................................................................................... Municipality 2 State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Exisiting use and occupancy /..~...,~..~.../~ use and occupancy Q4...0.~.~.0.....(~.~I~.I!..~....~..~......!.(.L~I'Z0..~...~....c~.....~b~.l.~.~.....Z~.~4 ............... b. Intended 3. Nature of work (check which!applicable): New Building, · ................. Addition .....~ ...... Alteration ............... Repair .................. Removal ,. ................. Demolition .................... Other Work ................................................. .., ..~..6. ~ (Description) 4. Estimated Cost .~...~....~.: .................................... Fee ..../..~T...~ ........................................................................... (to be paid on filing this application) 5. If dwelling, number of dwellihg 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 ................................................................................................................. Dimensions of same structure, with alterations or addmons: Front .................................... Rear ............................ Depth ................................ Height ........................... Number of Stories ................................ 8. D~mensions of entire new construction: Front .................................... Rear ............................ Depth ........................ Height .................... Number' of Stories ..................................................................................................................... 9. Size of lot: Front .................1 ...................................... Rear .......................................... Depth ................................ 10. Date of Purchase ........................................................ Name of Former Owner ........................................................ 11. Zone or use district in which premises are situated ..................................................................................................... 12. Does proposed construction viblate any zoning law, ordinance or regulation: ........................................................ 13. Will lot be regraded' ....V..~.-S ................... Will excess fill be removed from premises: ( ( ) es No 14. Name of Owner of premises ..(~...BD~..J.E-,~,...?...~..~..~.¢./)~.!~./.!~... Addres~;~R..~..~..c?...~?.~..~..~.. Phone No ....................... Name of Architect ..... ..~/.Z..~..i .............................................. Address ................................ Phone No ....................... Name of Contractolr~.,f~.D3~ .~./.jD.9.....j~/..~../.S..r-, ---, ...................... Address .~.~..~2./~l ................. Phone No.'7...~.~.:T..~./.(.~. ...... p,o, D ^GRAM Locate clearly and distinctly all buildings, whether existing or proposed, and indicate all set-back dimensions from property lines. Give street and bldck number or description according to deed, and show street names and indicate whether interior or corner Io1 STATE OF NEW,,~'O__RL(,., ~ c c ........ J'~ ....~b~- J.f~'./~...k%~'~.L.~ ..................................... be.ng' duly sworn, deposes and says that he is the applicam (Name of individual signing contracl0 above named. He is the ~ (Contractor, agent, corporate officer, etc.) of said owner or owners, and is dul,y 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 tha~ the work will be performed in the manner set fo~h in~lication filed therewith. ~ Sworn to before me this ,] , ~. ) / - { ~ ~~N ~.~ '/ /(SignatUre of~pHcant)/ 2 12 .