HomeMy WebLinkAbout13331-zFORM NO. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Office of the Building Inspector
Town Hall
Southold, N.Y.
Certificate Of Occupancy
No Z15568
Date AP. r..i 3..2 :..198. 7..
THIS CERTIFIES that the building ...... I..n g.r.q u..n.d..p.o. 9 .~..q n..d..I.e.n..c .e ...............
Location of Property 1125 Inlet Pond Road Greenport
House No, Street Hem/et
033 2 30
County Tax Map No. 1000 Section ............ Block ............... Lot .................
Subdivision ............................... Filed Map No ......... Lot No ..............
conforms substantially to the Application for Building Permit heretofore filed in this office dated
A u g u s t I, 1984 ,., pursuant to which Building Permit No. 1333. 1 Z
dated........................Au gu s t ?, 1984 .... , ,. 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 .........
....I.n.g.r,.o.u.n.d.pool and fence.
The certificate is issued to Donna and Harry Mulhal 1
..................... ?o¥,,'o'r, dhi x' ....................
of the aforesaid building.
Suffolk County Department of Health Approval tq /A
UNDERWRITERS CERTIFICATE NO. lq 6606 18 9 / 18 / 84
PLUMBERS CERTIFICATION DATED:
N/A
Building Inspector
Rev. 1/81
]gO~ NO. ~
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN HALL
$OUTHOLD, N. Y.
BUILDING FEIU~IT
(THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL
COMPLETION OF THE WORK AUTHORIZED)
N? 13331 Z
L...~....~........~.~ ..............................................
.....
at premises located at 1./... ,-~. ...................................................
County Tax Map No. 1000 Sectior~w~,,,~..,,~,,..~3. ..... Block ........ ,.,~,.. ........ Lot No .......~.,..~., ............
pursuant to application dated .... O-- *":~,~.,:~..~.....I .................. , 19X..~.,,~*" and approved by the
Building Inspector.
Fee $,.J, ....................
t'Bt~dlng Inspector
Rev. 6/30/80
FORM NO. 6
TOWN OF $OUTHOLD
l~uilding Depmtmont
Town Hall
$outhold, N.Y. 11071
765- 1802
APPLICATION FOR CERTIFICATE OF OCCUPANCY
Instructions
A. This application must bo filled in typewriter OR ink, and submitted ta a=a=~a=m to the Building Inqoec-
tar with the following; for new buildings or new uso:
1. Final survey of property with Occurate location of all buildings, property lines, streets, and unu~al
natural or topographic features.
2, Final approval of Health Dept. of water supply and sewerage disposal-iS-9 form or equal).
3. Approval of electrical installation from Board of Fire Underwriters.
r, .......=~l k-;Idlnns Industrial buildines, Multtplo Res;dances and simdar buildings and inmalla-
t OhS .a cart f?ato of Code comphanco from the Arclmoct ~r Engineer responsible for the building.
5. Submit Planmng Board approval of completed site plan requ rements where applicable.
~. For existing buildings (prior to April 1957). Non.conforming uses, or buildings and "pre-existing"
land rises:
1. Accurate ~ey of p~perty showing all property lines, streets, buildings and unu~a~ 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 pe~inent informa-
tmn reqmred to prepare ~ certdicato.
C. Fees: . ' '
1.Certiticateofoccupan~ ~e~ Owe[l~n~.$25.OO. Accessory ..~10.00 Bua~tte~n
2. Certificate ~f occupancy on pre-existing dwelling S 50.00
3. Copy of certificate of occupancy $ 5.'00, ove~ 5 yearn $10.0~0
4.Vacant Land C.O. $ 20.00 3/j~2'J~
5.Updated C.O. $ 50.00 Dote ...................... ~
6. hlteration $25.00
%ruc ~on Old or Pre ex~sting Bu~ld'ng Vacant Land
NewtOns ...... ..........................
Location of Property .' .................................... ~ ..........................
House No. Street Hamlet
Ownar or Owaer~ ot ~oDarty ......... .p .......................................
County Tax Map No. 1000 Section ~ ~ ~ ......... ~.~' ........
............... Block .......... Lot
Subdivision ............................
Permit No]A~', 3. J~.--.. Date of Perml~ .....
Health Dept. Approval ...................
.... Filed Map No ........... Lot No ..............
· ,~,,.'Applicant ..................................
.... Labor Dept. ApproVal ........................
Planning Board Approval
Underwriters Approval ·
Request for Temporary Certificate .................... Final Certificate .......................
Fee Submitted $ ............................
Construction on above described buildin~ permit meats all applicable codes and regulations.
,~.v. ~o.~o 7e ~
FIELD INSPECTION COMMENTS
_ F OU__.N D A_.T I O_.N -.-
FOUNDATION
2.
(2nd)
ROUGH FRAME &
PLUMBING
INSULATION PER N.
STATE ENERGY
ODE
FINAL
COMMENTS:
TOWN OF SOUTHOLD
OFFICE OF BUILDING INSPECTOR
P.O. BOX 728
TOWN HALL
SOUTHOLD, N.Y. 11971
TEL. 765-1802
This is to advise you that the job under the
building permit no. 13331Z for a.pool
is completed. A final inspection made on 8/25/8.6
showed that the . qate needed__a self-closinq spri~q and
the lock must be brouqht up to 40"~from qrade
Since you building permit expired on 2/7/84' it is
necessary that you obtain your CO. If the problem has
been'corrected, please contact this office to set up a
time for re-inspection.
We are returning your check because it is out-
dated. Kindly forward us a new check in the:~amount~ Of
$~25.00 for the Certificate of Occupancy.
Occupancy or use is unlawful without a Certificate
of Occupancy. Please help us to clear up this.matter
so ~hat legal action does not have to be taken.
Thank you for your prompt attentiQn.
Very truly yours,
Victor Lessard
Executive Administrator
VL:lmr
BUILDING DEPT.
INSPECTION
[ ] FOUNDATION ZST [ ] ROUGH PLBG.
[] FOUNDATION 2ND [/~.ULATION
[ ] FRAMING [~'] FINAL
REMARKS: ,
DATE
INSPECTOR
THE NEW YORK BOARD OF FIRE UNDERWRITERS
~.~ BUREAU OF ELECTRICITY
000~:~3 8,5 JOHN STREET. NEW YORK. NEW YORK 10038
~,~te ~,.,c.tio.. No. o./il¢ N 660418
Only the electrical equipment ~ described below and interlaced b~ t~ applicant ~med on the able appJlcat~on number in the premises of
i. th~o~o~i,~ ~o~.~io.; ~ ~.~.,,,~,~ ~ ~ r~, ~ ~.d r~. Outside s~o. ~oc~
tvas exantlned o~t ~r ~ ~4 and found to be in compliance with the requirements of this Board.
FIX/ORE FIXTURES RANGES COOKING DECKS OVENS DiSH WASHERS EXHAUST FANS
OUTLETS ~ FLUORESCENT
1
DRYERS
SYSTEMS
NO. OF FEET
R V I
OTHER APPARATUS:
.{.SL_~w~_~.n~_~Po~_~l~) This certificate covea's co~plt~nce at tP~ date o~ ink. orion only.
Eecau~e of t~uU~al environments it is advisable to have frequent test and/or rexwair~
made by ~[ qualified person.
OF NEUTRAL
Glenn Bradley
IIorton Avenue
~ T~is ce~ificote must not be Gltered in any manner; return to the office o~ the Boar~ if incorrect, inspector~ may ~e ~der~tifie~ 6y their
COPY FOR BUILDING DEPARTMENT, THIS COPY OF CERTJFICAT~ MU~T N~E ~R~D IN ANY MANNER.
FORM NO. 1
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN HALL
,~OUTHOLD, N.Y. 11971
TEL.: 765-1802
Examined~.~.~N...~. .... , 19 ~tJ.
.dX~.~.. 3. .... 197.% Permit No. !.~3~t 3..
Approve
Disapproved a/c .....................................
(Building Inspector)
APPLICATION FOR BUILDING PERMIT
INSTRUCTIONS
(
Received ........... ,19...
Date .... .fi//. .......... 19 7./-(.
a. Tkis 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 lo ~ of buildings on premises, relationship to adjoining premises or public streets
or areas, and giving a detailed descr, i~til ~'ltllda3( ~ of probity must be drawn on the diagram which is part of this appli-
cation.
c. The work covered 1~:~ ~th~ .~i~.~ ~o~ ~t~%~ced before issuance of Building Permit. Such ermlt
d. Upon approval of~t~ .~.~% %'~ ~q~L~or will issued a Building Permit to the applicant, p '
shall bekept on the pre,~! ~ ~]~q~ ~t~'~r%~ghout the work.
e. No building~l~lb~C~l~J , ,.t~'~; ~ ~c~/~[ or in part for any purpose whatever until a Certificate of Occupancy
shall have been gra~'~ll 4[~jl~tie~l~ii
AP PLIC' A TI;N~~_~ ~ ~ ~ ~. ~p4~tO~4 ~g ~Department for the issuance of a Bml&ng' ' Permit' pursuant to the
Building Zone Ordinai~O~'~[~ ~ ~ u~_.,7~ffolk County, New York, and other applicable Laws, Ordinances or
Regulations, for the cs)tl~t~l~ .~.~'~ ~, ttditions or alterations, or for removal or demolition, as herein described.
The applicant agrees to cl~[~ ~ ~[~l~cable laws, ordinances, building code, housing code, and regulaJ;i,~ns, and~
l~n~ ~d in building for necessary inspections. /~/ /~ ~///~/'
admit authorized inspectors
"
(Mailing address of applicant)
State whether applicant is owner, lessee, agent, architect, engineer, general' contractor, electrician, plumber or builder.
Name of owner of premises ... ~.~.~.. ~... ~-~ - · · ~ %.~ ~ ~. .......
(as on the tax roll or lat~P~[~ 'AS' ~Og~ ' ' j.' ......
If ~o~uly authorized officer. DATE: ~B'P' '~ ] ~')~
' ' ~'~Zf~-~r~ ......... NOTIFY BUlhDING DEPARTMkN' ~'
Builder's License No .......... .a~../.~. ...........
Plumber's License No .........................
Electrician's License No .... ~. ~Z-~. ....~.~.~. · ~/~ ~ ?
Other Trade's License No ......................
765-1802 9 AM TO 4 PM FOR THE
FOLLOWING iNSPECTIONS:
1. FouNDATION TWO REQUIRED'
FOR POURED cONCRETE
2. ROUGH - FRAMING & PLUMBING
3. iNSIJLATION
4. FINAL - CoN'STRUCTION /'ZUS~'~; '
BE cQMP!_ETE FOR C.O.
ALL CONSTRUCTION SHALL MEET
THE REOtJIREMENTS OF THE N.Y.
l. Location of land on which proposed work will be done ............... STA'r'~ .EONS.T.I~tJCTIO~I..&- I~bI.E.R?~.Y~ ....
/~ ~ ~ ~c~ES~ ~ RESPONSIBLE kU~
...... ...... .... ......... ....
House Number Street
,o00 S ,ion ...... ........ ..... 2 ..... ' ...... .... ...........
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 .....................................................................
. b Intended use and occupancy s~r-j~.~..o..~../g ~.~t). ~..~..~..t..t~. .~..g~.. ~7..'./'~L-sT~¢~ .....
3. Nature of work (check whtch applicable): New Building .......... Addition .......... Alteration ..........
Repair .............. Removal ........ Demolition ............ Other Work ..............
4. Estimated Cost ....................... 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. If business, commercial or mix6d 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 additions: Front ................. Rear ..................
Depth ...................... Height ...................... Number of Stories ......................
8. Dimensions of entire new construction: Front ............... Rear ............... Depth ...............
Nuraber of Stories
.- Height .....................................................................
9 Size of lot: Front" Rear Depth
10 Date of Purchase ~ Name of Former Owner
1 1. Zone or use district in which premises are situated .....................................................
12. Does proposed construction vi01ate any zoning law, ordinance or regulation: .....
13. Will lot be regraded ........ ] .................... Will excess fill be removed from premises: Yes No
14. Name of Owner of premises //~gg.~ t-..l~.a..//(~.~t~. Address ~r~.t~K. ?.~.~...t'~. Phone No ................
Name of Architect ' Address Phone No
Name of Contractor ' Address Phone No
PLOT DIAGRAM
Locate'clearly and distinctly alt buildings, whether existing or proposed, and. indicate all set-back dimensions from
property lines. Give street and block number or description according to deed, and show street names and indicate whether
interior or corner lot.
STATE OF NEW YORK, 'S.S '..,
COUNTY OF
i ....... being duly sworn, deposes and says that he is the applicant
(Name of individual sig~ing contract)
above named. :
He is the ...................... i ...................................................................
i (Contractor, agent, corporate officer, etc.)
of said owner or owners, and is duiy 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 manner set forth in the application filed therewith.
Sworn to before me this
~0IAR~/~C, Stal~ oJL}lew York ' ?ertr~ E~oes ~lorc~ 30, ~9~-~