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HomeMy WebLinkAbout12959-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. Certificate Of Occupancy No. Z13794 Date August= 23 .................................................. 19 8-5. THIS CERTIFIES that the buildfl~g swimming pool. Location of Property 800 Albo Dr. Laurel House No. Street Hamlet County Tax Map No. 1000 Section 126 ,Block 3 .Lot 9 Subdivision X .Filed Map No. X .Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated March 22 198..~ pursuant to which Building Permit No. 12959Z dated ....... ,~.a,r, c. ,h, ,3. 0. ........... 198. .4., was issued, and conforms to all of the requirements of the applicable provisions of the law. Tt~e occupancy ~r which tls certificate is issued is ......... ...... 7.q~9~q~.p~.n~.~q pool. The certificate isissued to PATRICIA & JOHN CLARK (owner; ~t~a~i~ of the aforesaid building. Suffolk County Department of Health Approval .................. N../.A ..................... UNDERWRITERS CERTIFICATE NO ...................... .N,6,5.0..6 .1.3. ................... Building Inspector Rev, 1/~11 ~O~M NO. 2 TOWN OF $OUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N. Y. N? BUILDING FER~IT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) ~ z ~o,e ..... ..~..~'. ...... ~ ............. ,,,.~.~ Permission is hereby granted to: ~ , __ -- ..j.....).~.~.~..~...~.~....~..~. .......... ,...~...~.~...~.~..ff. ................................................. ,o ....~~..~.~.~~.....~.L.~.2~ ..................... ~ /~ ,,'1 I ~ ............... ~~'"~ ...... ×"~'~ ........ : ........... ~ .......... : ....................... i .... at premises located at .....,~..~¢~:L....,~,,~,,,. .......... .,,J~..~....~..~,~,,.,~- ....................... Counh/ Tax Map No. 1000 Section ....... /..~.~.. ...... Block ....... ~ ........... Lot No......Cj. ................. pursuant ,o application dated ...... .~.~...:~...."~... .................. , 19..~.~.., and approved by the Building Inspector. Building Inspector Rev. 6/30/80 1 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 i~ IIiEIaIIB~I 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. B, For existing buildings (prior to April 1957), Non-conforming uses, or buildings and "pre-existing" land uses: 1. Accurate survey of p~perty 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 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 $15.00 3, Copy of certificate of occupancy $1.00 4.Vacant: Land../C'O' $5.00 Date .~./~ New Building ............. Old or Pre-existing Building ............ Vacant Land ............. House No, Street Ham/et Owner or Owners of Property ' l~./// '~ 5. County Tax Map No, 1000 Section ............ Block ............. Lot Subdivision .................................. Filed Map o ........... Lot No ..... '...' ...... Permit No ...... Date of Permit pp,icant ..... ~?~-.. ,~.-~..,.,. , Health Dept. Approval ........................ Labor Dept, Approval ........................ Underwriters Approval ........................ Planning Board Approval ...................... Request for Temporary Certificate ................. Final Certificate ...... ................... Fee Submitted $ Construction on above described building and perm t'meets a I ap~i~ca~le cj:~des and regulations ~, ~, ,~ %~q Applicant...:~~~ Rev. 10~10-78 lo~oee3 THE NEW YORK BOARD OF FIRE UNDERWRITERS BUREAU OF ELECTRICITY ~ 85 JOHN STREET, NEW YORK, NETM YORK 1003B ~.~e ~, l~ ~pp"ca,o.~o. on~,~ ~S~W~ N 650613 THIS CERTIFIES THAT only the electrical equipment as described below and introduced by the applicant framed on the abdve application number in the premises of John Cl~rk, Al~ Drive, O£f Bray Aven~e, Mattituak, in the followlng location; [] Basement [] 1st FI. was examlned on d'tm¢ 28~ 1884 [] 2nd FI. Outs±dye Section Block Lot and found to be in compliance with the requirements of this Board. FIXTURE FIXTURES RANGES OVENS FAille; OUTLETS SWITCHES NCANDE$CE NT FLUORESCENTVAPOR 1 1 ~ 1 DRYERS FURNACE FUTURE APPLIANCE FEEDERS TIME CLOCKS UNIT HEATERS MULTI-OUTLET SYSTEMS NO, OF FEET DIMMERS SERVICE DISCONNECT OTHER APPARATUS: 1--G.F.I. S E R V NO O~EI~COND A W. ~. NO OF OF CC COND, OF HI-LEG NO. OF NEUTRAL l~S~_.~zln._~_Pop__l_) This certificate covers compliance at the date of inspection only. Because of unu~u~l environments it is a~vi~ble to h~ve frequent test and/or r~l~airs made by a qv~,lified t~rson. AW, G OF NEUTRAL Glenn R. Bradley Hot toa Av~me Mattituck~ N,Y. 11952 Lic..1227 This certificate must not be altered in any manner; return to the office of the Board if incorrect. Inspectors IILDING DEPARTMENT. THI may be identified by their IN ANY MANNER. FIELD iNS~PECTION COMMENTS FOUNDATION (1st) FOUNDATION 2. ROUGH FRAME & PLUMBING (2nd) INSULATION PER N. STATE ENERGY C,ODE Y D FINAL ADDITIONAL COMMENTS: 765-1802 BUILDING DEPT. INSPECTION FOUNDATION 1ST [ ] ROUGH pLBG. FOUNDATION ZND [ ] INsuLATION [,-~F~MING [ ] FINAL REMARKS: FORM NO. Approved..5.~.C4&.c~...2~...., 19~!. Pentfit No. Disapproved a/c .............................. (Building Inspector) APPLICATION FOR BUILDING PERMIT INSTRUCTIONS a. Tiffs application must be completely filled in by typewriter or in ink and submitted 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 buildh~gs on premises, relationship to adjoining premises or public streets 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 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 building for necessary in~,oections. .........//'.~..,f..e. .4'./5.4--_.2'...?..Z~...~ ::..../.~..<., ..... (Signature of applicant, or name, if a corporation) ..../&<...~.¥ ~'....,~.../¢.:../5c.....®~....././.~s7 (Mailing address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor. .e~e,~triqi~an_Number or builder. AI~PR©'~'LD AS NOTED ............................ .~.. g X4. e S2~ .................... ~ar~: .X~l~?p..~.,-~ ~5 .SS .~... Name or owner of premises . .~ .~. ~ v IILD NG DEPA2TMENT AT ' ' ' (as on the ;ax roll ;r l~l~ee~- 765-1802 9 AM TO 4 PM FOR THE If applicant is a corporation, signature o f duly authorized officer. ~OL [Dx.'VING INS':' i CTiONS: .....~ ~ .~ . ~ 1. FOUNDA'I ION - 'FV/O REQUIRED .~~~ ?.. ~FOR PDURnD CONCRFT~5 (Name and title of co~ora~ officer) 2. ROUdU{ - FR/,,M~'~ ~, PLUMBING Builder's License No .... ~.~ .................. 4. FIN.~4 , c~m,,', .... * "N MUST Plumber's License No ......................... ALL CO"":TR; C'~q~~ 5' 'At.I M[ET Electrician's License No. .~*~,s~ ......... ~TgT~ C"NSrRLICT!ON fd"-I- RESPON5~[~[ r- FOR Other Trade's License No ...................... DESIGN OR CONSTRUCTION ERRORS. [. Location of [and on which proposed work will be done. ~5... ~.~ · · 0 ~ } M~. ........................ House Number Street Hamlet ~o~,,~ ~x ~ap ~o. ,000 Sec,~on ...... ~ .~.¢ ..... ,,ock ...... ~ .......... lot .... ~ ............. Subdivision ..................................... Filed Map No ............... Lot ............... (Name) 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy ~..~.~.'~../~.. (.t':I ~../r.~.~../.-.~../..,~'.~.., ... b. lntended use and occupancy J./~..~..~'..O.O.,?.~... 3. Nature of work (check which api'plicable): New Building .......... Addition .......... Alteration .......... Repair .............. RemOval ............. Demolition .............. Other Work ~'~/,~/~'1. ~ _J~ (Description) d Fee 4. Estimated Cost ............. ~.. ~ s ............................................ (to be paid on filing this application) 5. If dwelling, number of dwelling ~nits ............... 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 ..... if any: Front Rear Depth . r)tmensmns of ex~st~ng structures, ............................................ Number of Stories Height ............... . ...................................... Dimensions of same structure with alterations 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 ' pth ........... : ........... Rear ...................... De ...................... 10. Date of Purchase ........... .................. Name of Former Owner ............................. 11. Zone qr use district in which pr~mises are situated ..................................................... 12. Does proposed construction vioiate any zoning law, ordinance or regulation: ................................ 13. Will lot be regraded ..... /k/.O.'. .................. Will excess fill be removed from premises: Yes 14. Name of Owner of premises ~.C..6.,4 ~ ~. ....... Address . ~.,~ ~'/~. ~ ...... Phone No ................ Name of Architect .......... . ................. Address ................... Phone No ................ Nmne of Contractor ~..~c: ./.~...~,fi(....l,g'-J,",o/r/);.. Address ~, ,~. ,F'~.~,,. ,~,,~. FZ-.: Phone No..a?ff. ~. ~-.a°..~ PLOT DIAGRAM Locate :clearly and distinctly alii buildings, whether existing or proposed, and, indicate all set-back dimensions from property lines. Give street and blocklnumber or description according to deed, and show street names and indicate whether interior or corner lot. STATE OF NEW Y,,OR~,, ,~ ~ 'S S COUNTY OF ~.,. i ' .... :~.0.¥~...,~..~l. ,~. .....~.' · · ~'"~' .~. Z.~..~,.~. .........being duly sworn, deposes and says that he is the applicant (Name of individual signing contract) above named. He is the ............ /..~. .G(. /. ,~. ~..~..,~'.. .............................................................. ~ (Contractor, agent, corporate officer, etc.) of said owner or owners, and is duly 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 the mann{r set forth in the application filed therewith. Sworn to before me this Notary Public,~~...~--~/.... ~ I ~._~z.'~?l~_. ~1 Suffolk Countyflt..-.-- (Sighature 6f applicant) THle No. 07-72325 NOTE= qLSo m=MONUMENT FOUND O= PIPE FOUND REVISIONS MAY 11,1973 MAR. 4, 1974 SEPT. 9, 1974 ALDEN W. YOUNG · SURVEY FOR: JOHN E. CLARK ~ PATRICIA~A. CLARK AT LAUREL ~AN~,~D 'to: ~ PATRICtA A. CLARK DIVISION OF OF' INSURANCE CO. SOUTHOLD CeRH EAO SAVINGS BANK SUFFOLK CO., SCALE:'. i i, :,40, MAY 2, ~973 73-279