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Home My WebLink About11189-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. Certificate Of Occupancy No...z.l.q T 6.0 ......... Date . .A..ug.u.s. ~...5., ..................... 19. THIS CERTIFIES that the building .... ~.n. $ .p.o.u.n.d...a?.5:.m..m.~.n.~. p?.o. 3:...&..f.e.n..c.e ......... 410 Bungalow Lane Mattituck~ N.Y. Location of Property h3~sb 3ioi ....................... 's't/e31 ....................... h3r3ie~ County Tax Map No. 1000 Section ~ 23 .Block Subdivision ............................... Filed Map No ......... Lot No .............. conforms substantially to the Application for Building Permit heretofore filed in this office dated .~..ay..2.6., ............. 19.8.1. pursuant to which Building Permit No..~.3:..~.8.9.z. ............. dated .. d..u.n.e.. ! .6., ................. 19 8...q, 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 ......... lnground swimming pool & fence The certificate is issued to Davzd C. Tuthmll (owner,/~Yo~ of the aforesaid building. Suffolk County Department of Health Approval Iq/A N5242~7 UNDERWRITERS CERTIFICATE NO .................................................. Rev. 1/81 FOI~ Town BUILDING DE~ARTMENT~ TOWN HALL SOUTH'OLD, N,, BUILD~NG PE~I~ (THIS PERMIT MUST BE KEPT ON THE PP, EMISI~ COMPLETION OF THE WORK AUTHORIZED)~ UNTIL F~LL Permission is hereby granted to:~ ~..',,~..,/..¥::~. i ~..,.(.~ ...... ............... ~...~.Z~,. ........... ~.;.~.....?...7:....' at premises located at ...i ....... ..~..../. ................. .~...?.. [ ............................................. County Tax Map No. I 00 Section , , " "~' / ........ , ........... ~. Blocl~ ~....[ .......... ~kot No ......................... 1~,., and approved by the pUrsuan, to a~p,,catJon-~ate, ...................................... ~ ...... ~...., Biiilding Inspector. Rev. 6/30/80 Buildin~ Inspector FORM NO. 6 TOWN OF SOUTHOLD Building Department Town Hall ~outhold, N.Y. 11971 APPLICATION FOR CERTIFICATE OF OCCUPANCY Instructions in duplicate A. This application must be filled in typewriter OR ink, and submitted v ~:~o zhe 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 Undetwrlters. 4. Commercial buildings, Industrial buildings, Multiple Resider~es 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 p~operty showing all property lines, s~reets, 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. C. Fees: I. Certificate of occupancy $5.00 4.Vacant Land C.O. $5.00 $15.00 ,,,, .... ......... New Building,............ Old or Pre-existing Building ............ Vacant Land ............. · oc,t,on of Property... ¥. . ..... ............. l-louse No. ' ..... Street Hamle't Owner or Ownersof Property ....-~.~U. !.~....~................)...-"~'~/a ,'/t ~.~../L~.'.../~ . County Tax Map No. 1000 Section ............... Block ............... Lot ................ ~ ~.Ot NO Subdivision ................................. Filed Map No ......................... Permit No. ,/. ~:-. Date of Permit ...Applicant .... ~ ~ .................. Health Dept. Approval ........................ Labor Dept. Approval ........................ Underwriters Approval..~..~..~.~ ./..~ .......... Planning Board Approval ...................... Request for Temporarv Certificate ..................... Final Certificate ..... .J~. · · .............. Fee Submitted $ ............................. Construction on above described building and permit meets all ~Olicable codes and regulations. Apphcant . ~ ...................... Rev. 10.10-78 THE NEW YORK BOARD OF FIRE UNDERWRITERS BUREAU OF ELEC Y THIS CERTIFIES THAT o~dy the electrical equipment ~s described below and Dttroduced by ~he applicant ~amed o~ the able application r~umber in the preotises of ~. the follow,ng location; ~ Basement ~ 1st FI. ~ 2nd Fl. G~Si~ Section Block Lot was examined on · ~ ~'~)~J~ andf°undt°belnc°mpliancewlthtberequirementsofthisBoard. OUTLETSFIXTURE SWITCHES FIXTURES RANGES OVENS DISH WASHERS EXHAUST FANS FLUORESCENT VAPOR DRYERS FURNACE MOTORS FUTURE APPLIANCE FEEDERS TIME ~LOCKS UNIT HEATERS MULTI-OUTLET SYSTEMS NO OF FEET DIMMERS SERVICE DISCONNECT OTHER APPARATUS AWG OF NEUTRAL Gordon Lic~ #llO1 GENERAL MApMAkER t[ i/I, Th,s cerhf,cate must not be altered In any ~anner; return to the office of the 8oord if incorrect Inspectors may be ~denfifled by their credentials ~G THIS Of IN ANY MANNER. APPLICANT: TOWN OF SOUTHOLD OFFICE OF BUILDING INSPECTOR P.O. BOX 728 TOWN HALL SOUTHOLD, N,Y. 11971 TEL. 765-I 802 DATE: July/5, 1986 Dear: While reviewing our files I find that your expired pool permit ///~ has never been finalized. Kindly return the enclosed application with a check for $5.00. Also, please call and arrange for a final inspection so that we may issue a Certificate of Occupancy on the above pool and complete this outstanding file. Yours Truly, Victor Lessard Executive Adminstrator OCCUPANCY OR USE IS UNLAWFUL WITHOUT CERTIFICATE OF OCCUPANCY "IMMEDIATELY" ENCLOSE POOL TO CODE UPON COMPLETION ~3EFORE "WATER" FOUNDATION (1st) FOUNDATION (2nd) ROUGH FRAME & PLUMBING INSULATION PER N. STATE ENERGY C,ODE FINAL ADDITIONAL COMMENTS: INSPECTION FRAMING [~/] FINAL DATE 1~0~,~ NO. ! ~ TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. pro ed .......... ............ Porn' ................................... D~sapproved ~" (Building Inspector) APPLICATION FOR BUILDING PERMIT Dot ...... ~; ............. , INSTRUCTIONS 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 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, building code, housing code, and regulations, and to admit authorized inspectors on premises and in buildings for necessary inspections. ............................ · j~ignatgfe of applicant,~or name, if a corporation) ............................. (^ddress~of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, eJectrioan, plumber or builder. Name of owner of premises .....~..~..:.Q~..~. ........ J....L;~...?....,~. ?..]. ................................................................................................. if apphcant is a corporate, signature of duly authorized officer. (Nome and title of corporate officer) Builder's License No. ~/ Plumber's License No. /~/J~ .. Electrician's License No.././.~..../...~.~.~ ............................ Other Trade's License No .................................... / ~.~ Location of land on which proposed work will be done. Map No.' ...................................... Lot No ....................... Street and -- ......................................... ........ State existing use and occupancy of premises and intended use on~ occupancy of proposed construction: o Exislting use ond occuponcy ....... ~ ......................................................................................... b ,ntended use and occu~ncv . ~,, ~ ~ / X.~ ~ . ~ I 3. ~Nature of work (check which applicable): New Building .................. Addition ..... ~.. Alteration ................ Repair .................. Removal' Demolition .................... Other Work ~.. . /~.~ I~ (Description) 4. Estimated Cost~--...k~.../..(...)~.. (D; ~ ....................... Fee .......................................................................................... ............. ' ........... (to be p~id 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 an~ extent of each type of use ............................ 7. Dimensions of existing structures, if any: Front ............................ ~ear ................................Depth .................... Height ........................ Number of Stories ................................................................................................................. Dimensions o~ same structure, with alterations or addffions: Front .................................... Rear ............................ Depth ................................Height ...........................Number of Storms ................................ 8. g~mensJons of entire new con'struchon: Front .................................... ~ear ............................ Depth ........................ Height .................... Number of Stories ..................................................................................................................... 9. Size of lot: Front ........................................................ Rear .......................................... Depth ................................ 10, Date of Purchase ................. J ...................................... Name of Former Owner ........................................................ 11. Zone or use district in which premises are situated ................................................................................................... 12 Does proposed construction vJblate any zoning law, ordinance or regulation: ........... ~.~. .................................... 13. Will lot be regraded ...... --~;~ ............. Will excess fill be remav~ fr~ premises: (~Yes ( ) No 14. Name of Owner of premises ~.~.L~....~.~fi.t.6~~ .............. Address Phone No. ~ Address Name of Architect .......... :~:.: ............................................ ................................ Phon~ No.~L .............. Name of Contractor~'~.~.~/.....~q~.~. ............ Address ~L..~x~ ............... Phone No. ~U PLOT DIAGRAM /~Oc~'l~f Ol~J Locate clearly and distinctly all buddings, w~ether ex~sting or proposed, and ~ndJcate all ~et-~ck dimensJon~ from prope~y lines. Give street and bl6ck number or description according to deed, and show street names and indicate whether interior or corner Io~. above named. He is the .................................. ~(Contr*ctor, o~ent, corporoto offlceh etc.) of said owner or owners, and is duly authorized to perform or have performed the said work and to make and fife th s application; that ali statements contained in ~his application are true to the best of his knowledge and belief; and that the work will be performed in ~he manner set fo~h i~licat~n filed therewit~ Swor~to before me this ' , ...... /~lgnature o* appucan7 ~ - / No. 52-4612312 i ..... C~m~ssion Expires March 30, 19~ G) = I/,/¢// Z 0 1 Z 0 0 (~)l Z 'DNI '~qO0~ ONI~-NT~