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HomeMy WebLinkAbout13215-zFORMNO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. Certificate Of Occupancy No. ,Z.1.3, .6.5.0 .......... Date May. 17 1985 THIS CERTIFIES that the building Inground pool and fence. Location of Property .... ..6,0.5.. y?.~.~, .~ 9.g..~..&~.g .............. House/Ye. Street ..................... County Tax Map No. 1000 Section ... 9.2.5 ...... Block .., 2 ..... Lot 20.1 9 Subdivision ............................... Filed Map No ......... Lot No .............. conforms substantially to the Application for Building Permit heretofore filed in this office dated J u n e 1 2 19¢.6. pursuant to which Building Permit No. 132 ~ 5 Z dated ....J.u, rl~..q.~ ................ 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 ......... .... ~.n. gr.o.u.n.d., p.qo..~..a.n.q..r.e.n.c..e.. ................................................ The certificate is issued to ....... ~. A, .I3.0.L.. &...h/,I.L. L, .I .A.lvI., q .~ ,L.L.O. 0..L y ........................ (owner,~;~ of the aforesaid building. Suffolk County Department of Health Approval ,.. N//~ UNDERWRITERS CERTIFICATE NO ~)i~ 6 5 ~ 5 0 Rev. 1/81 Building Inspector IPOB~[ NO, It TO%VN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N. Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) N? 13215 Z Permission is hereby granted to: ..~~..~..~ ................... ~'7 ./, ~..~.E.~ ................. ,o...~~.~...~......~~.4...~..~....~..~ ......... ~ ............ ..~:..~.:. ...... ;...:..~ ....... ~.:...~.~ ................ ~ ............... ~:..,......= .................. at premises located at ,...Lg.....,~,. ........... ,~.~%~,.~.,~...~,,,_C~ .......... ,k~J~ ..................... ................... ...... ...... pursuant to application dated, ..... ~:::~.~...L....:~.. ..................... , 19..~..~.,, Building Inspector, Fee $.1..~..~ ............. approved by th~ Sct~l~' ?//~/~/ BullcJlng Inspector Rev. 6/30/80 FORM NO. 6 TOWN OF SOUTHOLD [~uildlng Department Town Hall ,~,~uouthold, N.Y. 11971 APPLICATION FOR CERTIFICATE OF OCCUPANCY Instructions in duplicate ~- A. This application must be filled in typewriter OR ink, and submitted, , ,V,,, ?co'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 dnes, streets, and unusual natu fa[ 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 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 preoare a certificate. C. Fees: 1. Certificate of occupancy $5.00 3. Copy of certificate of occupancy $1.00 4.Vacant Land C.O. $5.00 Date ~ / New Bu~tdmg ~ ........... Old or Pre-existing Building ............ Vacant Land ...... ~/~6 Ham/et Location of Property . .~..~..~-~, · ............. U[,~,<, .~¢~'-~... ~ ............... ~/ ..... House No. /~tree~t · Owner or Owners of Property ~ ~.<'Y'/.<Z.f-TC..~.... · .~.~.~ ......................... County Tax Map No. 1000 ct on .. .... B,ock .... ...... ./.%. ...... Subdivision ................................. Filed Map No ........... Lot No .............. Permit No ...... ¢...~. Date of Permit ..... ,....Applicant ............ t ..................... Health Dept. Approval ...~. .................. Labor Dept. Approval ........................ Underwriters Approval ..................... Planning Board Approval ................. Request for Temporary Certificate ..................... Final Certificate .¢'...- .................. Fee Submitted $ ............................. reflu lations. Construction on above described building a Applicant. ~f/.. ~/..~.v.~. r~.../~z< ~¢ .,: ./ ..................... THE NEW YORK BOARD OF FIRE UNDERWRITERS 10'~.~l~ BUREAU OP ELI~CTRICiTY ~,~ 85 JOHN STREET, NEW YORK, NEW YORK 10038 THIS CERTIFIES THAT only the electrical equipment ~ described belo~ and introduc~ by the applicant named on the above apphcat~on number m the premtses of Bill Gill~ly, 6~ Vi. ll~ ~ne~ ~i~ N.Y. in the following I~cation; ~ Basement ~ Ist FI. ~ 2nd FI. ~Si~ Section Block Lot was examined on and found to be in compliance with the requirements of this Board. July 0~, FIXTURE FIXTURES RANGES :O~KING DECKS I OVENS DISH WASHERS EXHAUST FAN~ DRYERS FURNACE MOTORS FUTURE APPLIANCE FEEDERS SPEClALREC'PT TIMECLOCKS BELt UNIT HEATERS MULTI-OUTLET DIMMERS SERVICE DISCONNECT NO. OF of ~1 ~m~i~s it q~ified COPY FOR B~ILDING DEPARTMENT. THIS COPY oF CERTIF CAT~J~iU~T NOT BE ALTERED IN ANY MANNER. FIEL~ INS~PECTION FOUNDATION (1st) FOUNDATION 2. (2nd) ROUGH FRAME & PLUMBING COMMENTS 3. INSULATION FERN. STATE ENERGY qODE FINAL ADDITIONAL COMMENTS: 'FORM NO. 1 TOWN OF $OUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N.Y. 11971 TEL.: 765-1803 E,amined..~...~.. ). ~.., 19 ~,~! Approved..~ .cx~.. l . .~:.., 19 ~.~. Pc=it No..).. ~ ~ ? ~'~ Disapproved a/c ..................................... Received ........... ,19... (Building Inspector) APPLICATION FOR BUILDING PERMIT Date .... Q~ II ~/ 19 r¢'c~ INSTRUCTIONS a. This 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 buildings on premises, relationship to adjoiniftg 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 pern?.it shall be kept on the promises 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 heroin 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 inspections.// /'/ ~ , ........... <¢z~../~.<, .~...~...' ~(.~..~..J (Signatur~'of applicant, or name, if a corporation) ........ ~. ........... ~. ......... ./~., ~.fl.. '~Mailing address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. ................................. .~/~.~. ~/,.~ .................................................... Name of owner of premises ... / .~/~.4/.~2C~.... ~.i ~-~ .~-. ~. W ./--~.__-.-~ ......................................... (as on tl~e lax roll or latest deed) If applicant is a corporation, signature of duly authorized officer. (Name and title of corporate officer) Builder's License No ..... .~...~./ .............. Plumber's License No ..... /~/x~-. ................ Electrician's License No..~..//~../.~. ........... Other Trade's License No .......... ,.-. .......... 1. Location of land on which proposed work will be done .................................................. .~~....¥.~ ~... ~2 ./, ~.~....Z.~ ~ ............. /)x.,.~ .~. ~ ................. : .... House Number Street Hamlet County Tax Map No. 1000 Section .... .~..~..~ ........ Block ....... .D-rn.. ........ Lot ~ ......... Subdivision ...................... Filed Map No. Lot 2- O - / !~.~a..~ Name ............. )/a~ 2. State dxisting use and occupancy of premises and intended use and occupancy of proposed construction: °7//~/~b a. Existing use and occupancy .... 0. D.%....~:~t?/~.~.l.~.... f.e¢ '4c~_~c.e._~ . ..................... b. Intended use and occupancy .. O.~.q~...~/~, ~.. AC'..~. ~ .&.e.~ .c.$.. cx)..~(:~... ~. ¢.,.tlO...~ .~ .~..0%.o?..~.~... Repair .............. RemOv~ ~. Estimated Cost ~ ~o) 0~v'.°.©. 5. If dwe!ling, number of dwelling junits ........ N f we k (ch ck whih applic ble) N Building 'Addition Alte ation ·. Demolition .............. Other Work.. ~0~..~w'... ~24&.t/0 .... (Description) *" (to be paid on filing this application) .... Number of dwelling units on each floor ................ If garage, number of ears .... ~ ............. 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 .............. Depth ............... Height ............... Number of Stories.· ....................................................... D~nens~ons of same structure wlth alterations or additions: Front ................. Rear .................. Depth ,' Height Number of Stories 8. Dimensions of entire new construction: Front ............... Rear ............... Depth ............... }}eight ............... Nu~mber of Stories ........................................................ 9 Size of lot: Front I.q. g ' i Rear Depth 10. Date of Purchase ........ :~ . Name of Former Owner 11. Zone or use district in which ~ ' ' premases are s~tuated ..................................................... 12. Does proposed construction vie!ate any zoning law, ordinance or regulation: ... ~.O ............... 13. Will lot be regraded ....... ~ ~.s: ................. Will excess fill be removed from premises "'~'" No 14. Name of Owner of premises L001Lwt-...~.'t&.o0t~... Address l/~[l~e~ ]-A .t. ~¢~..~Phone No. dg.O~.~. ~ ~.ft.q'... Name of Architect ~ Address Phone 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 blocklnumber or description according to deed, and show street names and indicate whether interior or coruer lot. STATE OF NEW Y.O, RI~ ~ COUNTY OF .... ~.'..O.~.'.~c).~..~... S.S ........... ~. e~.~7.. .~..~..i p. ~ ............... being duly sworn, deposes and says that he is the applicant (Name of individual signing contract) above named. He is the ,' ~..~ ~..~. i (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 contgined in this application are true to the best of his knowledge and belief; and that the work will be performed in the manne~ set forth in the application filed therewith. Sworn to before me this ........................ day of ..... QO .-e~ .......... 19 o,,a,,~;o ~,2 ~:i.?.?~:,,,ntv (Signature or applicant) m O0 A A F CONTRACTOR .... SWIM-KING POOLS, INC. ROUTE 25A · 43' 5 COURSES CONCRETE BLOCK '-1