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Home My WebLink About13392-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall 5outhold, N.Y. Certificate Of Occupancy No..Z.1.3.3.8..1 .......... Date ...... g.p..v.t.Z.. 1. .9 .................. 19.8.5. THIS CERTIFIES that the building [ngvound pool and fence Location of Property ..... .3.5.5.. ? p.~.q o....D.v. ~ y .e ............... H a t t ± t u e k House/Vo. Street Hamlet County Tax Map No. 1000 Section q q 5 .Block q 6 .... Lot 3 Subdivision ............................... Filed Map No ......... Lot No .............. conforms substantially to the Application for Building Permit heretofore filed in this office dated ·.. &v,g,. 2.8 .......... , 19 .8.6. pursuant to which Building Permit No .... .1.3.3. 9. .2.Z ........... dated .... .g.u,g,..2.8. ............... 19 .8.4., 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 pool, and fence· The certificate is issued to .......... .a.~.~.q~..z 9.S.. s..~Y.q~, o..ub.qs. .......................... {owner,/~.~ ~t}J, Zo~[ X X X of the aforesaid building. Suffolk County Department of Health Approval N / A UNDERWRITERS CERTIFICATE NO .............. .N.6. ~ .2.4.4.q ........................... Building Inspector Rev. 1/81 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, iq. Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) N? 13392 Z Permission is hereby granted~......~ et premises Iocoted et ..1~w~..~..~...,.......~..~.~....~.~ ........ ...~.~ ...... County Tax Mop No. 1000 Section ........ if./...~'.. ..... Block ....... /.~.. ....... Lot No ......... .~ ............ ..~i.~'d..~.......'~....~.. ............ , 19.~...L[.., and approved by the pursuant to application dated Building Inspector. Building Inspector Rev. 6/30/80 FORM 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 featu res. 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. 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 alt 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. C. Fees: 1. Certificate of occupancy $5.00 2. Certificate of occupancy on pre-existing dwelling $ 3.5 o 00 3. Copy of certificate of occupancy $1.00 4.Vacant Land C.O. $5.00 Date... 3 .~-.. 2..~..T.'~..~...~...'~.. New Building ....~ ........ Old or Pre-existing Building ............ Vacant Land ............. Location of Property ........................................ House No. Street Hamlet Owner or Owners of Property . .A~.~d~Y~..~.&¢~ ..... ~ ................ County Tax Map No. 1000 Section .... //, ,,~'~, ..... Block ...... /,~. ..... Lot .... '.~ .......... Subdivision ................................. Filed Map No ........... Lot No .............. Permit No. l~ ~,.[... Date of Permit .~,:~¢. ,Applicant..~.~?,~. Health Dept. Approval ........................ Labor Dept. Approval ........................ Unde~riters Approval .~..~. ~.~.9 .......... Planning Board Approval ...................... Request for Temporary Certificate ..................... Final Certificate ....................... Fee Submitted $ .'~. ,~-~ ......................... Construction on above described building and permit meets all applicable codes and regulations. Applicant. ~-~..~-,~;¥~...~,.~, ~ .d~4t~._,~¢,~. ................ Rev, 10-10-78 i~Ji~i THE NEW YORK BOARD OF FIRE UNDERWRITERS BUREAU OF ELECTRICITY ~-J~.' 85 JOHN STREET. NEW YORK, NEW YORK 10038 o. te Ootober 'i, 19D~ AppI,c.tionNo. onJile ~9i~/~ N662440 was examined on ~ ~r ~7 ~ ~.9~ and found to be in compliance with the requirements of this Board, FIXTURE BXTUEES RANGES OVENS OUTLETS SWITCHES FLUORESCENT DRYERS DISH WASHERS EXHAUST FANS OTHER APPARATUS: S E R OF CC. COND C OF HI-LEG NO OF NEUTRALS1 ma~e pya qua~ltT~ person. OF NEUTRAL Jody Pumillo Pat Lane ~ttitL~k, N.Y. 11952 ]Aa. This certificate must not be altered ~n any manner; return to the office of the Board if incoFrect. Inspecto(s may be identified by their credentials. COpY?OR B~U~JLD N~ DEPA,'TMrENT, TH $ COPY O~ CER~ F[CATE ~U~T ~T ~E/~L'rERED !N ANY MANNER... FIELD INSi)ECTiON FOUNDATION (1st) COMMENTS FOUNDATION (2nd) ROUGH FRAME & PLUMBING INSULATION PER N. STATE ENERGY ~ODE FINAL ADDITIONAL COMMENTS: 'FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL ~OUTHOLD, N.Y, 11971 TEL.: 765-1802 ~xamine .......... ~..'~.., 19 ~pprove~~'T..&.~..',~. 19~.~. Permit No. ~ ~'~.~ .~ .~, · Disapproved a/c ..................................... Received ........... ,19... (Building Inspector) APPLICATION FOR BUILDING PERMIT Date ............ 19 INSTRUCTIONS a. This application must be completely filled in by Wpewriter or in ink and submitted to the Building Inspector, with 3 ets 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 ir areas, and giving a detailed description of layout of property must be drawn on the diagram which is part of this appli- 'ation. 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 Building Permit to the applicant. Such permit ;hall be kept on the premises available tbr 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 :hall have been granted by the Building Inspector. APPLICATION IS HEREBY MADE to the Building Department for the issuance of a Building Permit pu~rsuant to the nmilding Zone Ordinance of the Town of Southold, Suffolk County, New York, and other applicable Laws, Ordinances or ~egulations, for the construction of buildings, additions or alterations, or for removal or demolition, as herein described. I'he applicant agrees to comply with all applicable laws, ordinances, building code, housing code, and regulations, and to ldmit auth°rized inspect°rs °n premises and in building f°r necessar~J~Sl/~,n..~*"t~-'*;' ~ .... - '- : ' ~'.~'"~ -':~' .'. " : ~ ........... 'ti,id .... (Signature of applicant, or nam.~,~a corpora ) . .... (Mailing address of applicant) /W.7 State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. ............................................. Name of owner of premises 1~..~..Z..0..~. ( .0..~. ....... .~.O..~.0..~..{.,,,1~ .... .~.. ~.. ..... .~..~...L~. .......... (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 .... .'(~.~..~O. T. H--~ .... Plumber's License No ......................... Electrician's License No ....................... Other Trade's LJ,:;";~nsell No ...................... 1. Location" of land ~ which proposed work will be done .................................................. 3to [ ........... .... .k.-. ...... ..... House Number Street Hamlet County Tax Map No. 1000 Section ..... / j .~. ....... Block ...... / & ........ Lot...3 .............. Subdivision ..................................... Filed Map No ............... Lot ............... (Nmne) 2. State existing use and occupancy of~mises and intended use and occupancy of proposed construction: a. Existing use and occupancy .... '4~,.~..~ [~~...~... ....... t ................................... b. Intended use and o~c~upancy. ~.~::~. [ ~.. .~.-~.'-~. F .... . .~.~. . ~.. .6~. [.l~,l?~l .~.~. . . ~. ~-, ....... . 3. Nature of work (check which applicable): New Building .......... Addition .......... Alte~tion .......... Repair .............. Removal .............. Demolition ............. Other 4. Estimhted C0~t ..... , ................... 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 . ' . . . ' ' i . . specify natt? an~ extent of each typic of tt~e · If business commercial or mixed occupancy, ........... ,. · .t ...... 7 Dlmenslonsofexlstmgstructurpsifany Front t~'O !!; Rear ~:t'~ Height ............... Number of Stories .... " .............. .. .............. Dimensions of same structure With alterations or additions: Front ................. Rear .... Depth ................... I' · ' Height ...................... Number of Stories ........ Dimensions of entire new construction Front ............... Rear ............... Depth Height ............... Nun3ber°fSt°ries Rear ..... {.//.,5....' ......... Depth ~..~.r~.~ Size of lot: Front .... ~ ~>. i ........... ' ............. ' '~''" ....................... Date of Purchase .~..'~/. J O. ] ].~.'~ .~ ....... Name of Former Owner ....... 11'. Zone or use district in which premises are situated ...................................... 12. Does proposed construction vi~late any zoning law, ordinance or regulation ' ~.~.. 13. Will lot be regrari?d ........ ~ .................... Will excess fill be removed from premises: 14. Name of Owner ~f premises · ... . . .. Address ................... Phone No.. Name of Archite~t ......... ' .................. Address .................. Phone No.. Name of Contradict ........ ~ .................. Address .................. Phone No.. Yes No PLOT DIAGRAM Locate clearly and distinctly all buildings, whether existing or proposed, and. indicate all set-back dimensions from property lines. Give street and bloc} number or description according to deed, and show street names and indicate whether interior el; Corner lot. ]TATE OF NEW YORK, S ;OUNTY OF S. · being duly sworn, deposes and says that he is the applicant County, ' .' ~"~' ' '~ (Signature of applicant) (Name of individual siglq'ing contract) .bove named, i leis the, , ' (Contractor, agent, corporate officer, eic ) ff said owner or owners, and is duiy anthorized to perform or have performed the said work and to make and' file this ~pplication; that all stat.ements contained in th!s applicati.on .are true to the .best of his knowledge and belief; and that the },ork will be performed in the manner set forth m the application filed therewith· ,worn to before me this