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Home My WebLink About13639-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No Z-23017 Date MAY 25, 1994 THIS CERTIFIES that the building Location of Property EAST END AVENUE House No. County Tax Map NO. 1000 Section 4 Subdivision INGROUND POOL FISHERS ISLAND, N.Y. Street Hamlet Block 4 Lot 9 Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated OCTOBER 31, 1984 ~ursuant to which Building Permit No. 13639-z dated DECEMBER 18, 1994 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 BWIHEING POOL The certificate is issued to {owner) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL UNDERWRITERS CERTIFICATE NO. PLUMEERS CERTIFICATION DATED Rev. 1/81 JOHN W. HYLAND, N/A N-754339 - JL~NE 13, 1986 J ~ ~ ~ull~ Inspector Form No. 6 IOWN OF SOUTIIOLD BUILDING DEPARTMMNT TOWN ~%LL 765-1802 AFPL!CATION FOR C~RTI?ICATE OF OCCUPANCY \. This applicStion muse be filled in by typ~.ri~er OR ink and submitted to the buildi~8 inspector with the following: for new building or new use: 1, Final survey of proper~y with accurate location of all buildings, property tines, streets, and unusual natural or topographic features, 2, Final Approval from Health Dept. of water supply and sewerage-disposal(S-9 formS. Approval of electrical i~stallation fro~ Board cf Fire Underwriters. Sworn statement from plumber certifying ~hat the solder used in $ystcTn contains, less than 2/10 of 1% lead. 5. Commercial buildisg, industrial building, multiple residences and similar buildings and ~nstallations, a certificate of Code Compliance fro~ architect or engineer responsible f~r the build~n$. 6. Submit Planning Board Approval of completed site plan requirements. ~or existin$ buildings (prior to April 9~ t957) non-co~formlng uses, or buildings amd "pr~-exl~iog~' land uses: i. Accurate survey Of property showing si1 property lines, street.s, building and unusual natural cr topographic features. 2. A properly completed applicatien and a consent to inspect sisned by thc applicant° If a Certificate of Occupancy i~ denied, the Building Inspector shall state the xeasons therefor in writiug ~o the applicant. Fees !. Certificate of Occupancy - New dwelli~%g $25.00, Additions to dwellin~ $25.00, Al~era~zons to dwellin~ $25.00, Swimming pool $25.00, Accessory bu/ld~ng $25.00. Additions to z%~cessory building $25.00. Businesses S50.00, J. Certificate of Occupancy on Pre-existing guildzng - $100.00 ~. Copy of Certificate of Occupancy - ~5.00 over 5 years - .. Updated Certificate of Occupancy - ,. Temporary Certificate of Occupancy - Residential $15.00~ Co~e~cial $15.00 // .... ............. .un~UC~ion ........... Old Or Pre-exis=ing Building..~ House No, Street Ha~et ,ubd~v ~sion .................................... Filed Map ............ Log .............. · cq.m~,t for: Tempora£y Cer~ificat~ ........... Final Certicate ........... FIELD INSPEC~I'ON FOUNDATION (1st) FOUNDATION (2nd) ROUGH FRAME & FLUMBING COMMENTS INSULATION PER N. STATE ENERGY ?DE FINAL ADDITIONAL COMMENTS: ,Mr, Jo.h_n__W. H._y~a.n,d, Jr. . ihe unr. cr.~gned, That the undershot, ed (~s) (are) the o~vn~r(s) of t~c pre~i~e~ ~n the Totem ,~f So~thold lcccted at East End Avenue, Fishers Island, ~ 06390 Ccu:-) :mx m~ aa Di~tr~ct I000. 5,~c~cn 004.09 Blnck 04.00, L~009.00Q Tha~ tn~ under3Dfne~ /has) thave) fi]ed, cr caused ~o b~ filed, ~n applica~ Swimming pool of the Town of Southol(~ :e eu(er upon the above aeser:bed proper~y, ~Ilclud~nf ~nd r(vul,lt:ons of ~he Town o£ Southold, Daled:__April 6, 1994 State of New York) County of New YOrk) ._John W. Hyl~a_nd, Jr. Sworn to before me this 6th day of April 1994. .. FORM NO. 1 TOWN OF SOUTHOLO BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N.Y. 11971 TEL.: 765-1802 Disapproved a/c ..................................... Received ........... ,19.. (Building Inspector) APPLICATION FOR BUILDING PERMIT % ........ 19 INSTRUCTIONS a. Tiffs application must be completely filled in by typewriter or in ink and submitted to the Building Insj~ector, with 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 street or areas, and giving a detailed 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 issued a Buildlng?ermit to the applicant. Such permi 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 whatex)er until a Certificate of Occupanc' 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 th, Building Zone Ordinance of the Town of Southold, Suffolk County, New York, and other applicable Laws, Ordinances o 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 admit authorized inspectors on premises and in building for necessary inspections. ...... .~.o..¢..4 ~..~..e.....~..o. ~ .c~.. ! ~..q, ..... (Signature of applicant, or name, if a corporation) / ~,~,~z ,(Maili,ng adgll~esT_9_ f applic.a.nt), State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. .. 5 ~ t .~...m. ,{ ~ .~...~.q 9.¢...Qc. ~?.~_~ .c.~...2_.. ................... A~. l'a~7~. ~S. ~*o¥~t~ ........... Name of owner or prem~ses ~O~....,.7 ......... .-JT..., ................... ..:., ......... '!. 7 ........ ffapplicant is a corporation, s~m?,tum of duly authorized o£ficar. 765-h302 9 AM TO /, P,~A FOR ....... ,]/d-.'.'~-."fi.,.. l. FOUNDATI~j'.J _ TV¢O R,-QUIRE.~ (Natne and title of corporate officer) FOR POUR?D CONCRETE r ~ ?, Builder's License No ....... .q..~. ~/ 2. ROUGH - FRAMING °. pi 17MBiNG .............. 3. INSULAT~\t ~ - ...... , '~N MUST Plumber's License No ......................... BE CC?PI c-r? r-r,2 :-. O. .. . ALL CONS'rR~C'!q.r3~! $'~ALL Electrc an s L~ccnse No ....................... THE REOI ~ror',~c~,,,,rc, ~,r, '?F!~ ~,t '5 -- STATE CON?'TRUCTION ,~, ~'~, Other Trade's License No ...................... CODES. NOT RESPOh'?'~, ...... i. Locatio, or land on w~,cl, proposed ,,,ark wi, be done ...... ~t~.t ~ .... :..~.~..:f~.. P.,,....~.~. ...... .................... ~. .......... ,.~k:.. tlouse Nmnber Street Hamlet r'o,,,,>, T~ m~,p ~o. ~000 S~,io,, .. 8..g .......... ~o~k .. ~..¢: .......... [o, .... ~'e' 7 ....... Subdivision .............................. ....... Fibril Map No ............... Lot ............... (Name) 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. [xlsting use and occupancy ................ b. ~m~d~d ~¢ ~a o~p:m~v ... ,.~v:~.~...).~ffP¢.~.9...~.p~ 5...(~s .... ~O~ ........... 3. Nature of work (check which applicable): New Building ...x,~ ..... Addition .. ........ Alteration ........ '.. Repair .............. Removal .............. Demolition ......... . ....Other Work ............... ' (Description) 4 EstimatedCost.....~ ~ffog 000,~ ~' (to b~ 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 ...... i ........ Depth .............. Height ............... Number of Stories~. .......................... [ ............................ f with It ' dd'' ' Re Dimensions o same structure a eratlons or a ltlons: Front ........... ~ ...... ar ................. Depth., ..................... Hei ~ ' ght ............. t ......... Number of Stones ..................... 8. Dimensmns of entire new c.onstruction: Front ..... q~. ...... Rear ...,~iO.t Depth ...o°...r ... Height ............... Number of Stories ........................... i ............................. 9 Size of lot: Front Rear i Depth 10 Date of Purchase Name of Former Owner 11 Zone or use district in which premises are situated ' 12. Does proposed construction violate any zoning law, ordinance or regulation: ...i.~'4'.(.~ ........................ 13. Will lot be regraded ..... ./M..O. ...... ., ........... Will execs fill be remoV~ed from premises: (5~) No 14. Name of Owner of premises .-4"'O~ ~) .~.t/.{-~ .t99. 2E'¢ Address . Name of Architect Gs~b.'{~. ~ .... Address PLOT DIAGRAM Locate clearly and distinctly all buildings, whether existing or proposed, and. indlcate all set-back dimensions from property lines. Give street and block number or description according to deed, and sh6w street names and indicate whether interior or corner lot. STATE OF NEW YORK, COUNTY OF ................. S.S ....... t.C.[ · k9. , .~ : ............... bcing duly sworn, deposes and says that he is the applicant (Name of individual signing, contract) ~ above named. ~ tie is the . , (Contractor, agent, corporate officer, etd.) of said owner or owners, and is duty authorized to perform or have performed theisaid work and to make and file this application; that all statements contained ha this application are trne 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 ............ /..f..~:.. ..... day of 5,../~) .,~--v.. ............ , 19 !y ~"~. 4707878. St~ft0lk County ~. ~, "(Signature of applicant)