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Home My WebLink About16211-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall 8outhold, N.Y. CERTIFICATE OF OCCUPANCY No Z17086 Date JULY 14~ 1988 THIS CERTIFIES that the buildin~ Location of Propert~ 1405 NOKOMIS ROAD House No. County T~x Map No. 1000 Section 078 Subdivision POOL SOUTHOLD Street Hamlet BlockO3 Lot 30.2 Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated JUNE 26, 1987 pursuant to which Building Permit No. 16211Z dated JULY 12, 1987 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 ACCESSORY ABOVE GROUND POOL AND DECKING AS APPLIED FOR. The certificate is issued to ELLIS, KERRY AND MAGDA (owner, of the aforesaid building. Suffolk County Department of Health Approval N/A UNDERWRITERS CERTIFICATE NO. N021396 7/12/88 PLUMBERS CERTIFICATE NO. Building Inspector Rev. 6/88 FOBBS NO, ~B TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N. Y. BUILDING PEIU~IT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) Date Permission is hereby granted to: ...~..~...-..~T.I ............................................... ~.,.~.**..~..,. ....... ~.L~.~ ........... · to ~~ .~ ~, ~,~, ~,~ ~ ...... ~....~ ..................................... ~ ......... ~.....~ ............ County Tax Map No. 1000 Section ...... ,,,C~.~.~ ...... Block .......~...."~... ...... Lot No...~:k.O...%...~:'.. ..... pursuant to application dated ........ ~.~,...~.~ ............... , 19.~.3., and opprov~ by the Building Inspector. Building Inspector Rev. 6/30/80 FORM NO. 6 TOWN OF SOUTHOLD Building Department Town Hall Southold, N.Y. 11971 765 - 1802 APPLICATION FOR CERTIFICATE OF OCCUPAN Instructions 8LDG, DEPT. TOWN OF SOUTHOLO A. This application must be filled in typewriter OR ink, and submitted ,-~ 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~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 prepare a certificate, C. Fees: Additions $25.00 POOLS $25.00 ALTERATION $25.00 1. Certificate of occupancy New Dwelling $25.0.0, Accessory,$10.00 Business $50.00 2. Certificate of occupancy on pre-existing dwelling $ 50.00 3. Copy of certificate of occupancy $ 5,00, over 5 years $.1.~.0~ 4.Vacant Land C.O. $ 20.00 5.Updated C.O. $ 50.00 Date ..................... NewC°ns %r uc ti°nty/~7L'¢ Y ...... Old or Pre-existing Buildiog . ,~,~. ~(~YY~'-~ ''~, ,'~'~., (~ ' '" ' '' '' Vacant La%d0 ~L' ' 7 ~' ' ~ ~/.~ .0/(~ ........... Location of Proper ............................................................ Owner or Owners of Property ..... .~..~ County Tax Map No. 1000 Section ............... Block ............... Lot ................ Subdivisioni,~iiii ......................... FiledMapNo ........... LotNo. , ............. Permit No. .. Date of Permit .......... Applicant .... f~. ?..~,~...~..///./,~. ............ Health Dept. Approval ........................ Labor Dept. Approval ...................... Underwriters Approval ........................ Planning Board Approval ...~ ............ Request for Temporary Certificate ..................... Final Certificate ........................ Construction on above described buiJdin~and pe~ets all a~Je code~ ~nd regu~ns~ App cant ~~ .~ .............. 765-1802 BUILDING DEPT. INSPECTION FOUNDATION 1ST [ ] ROUGH PLBG. FOUNDATION 2ND [ ] I/NSULATION / FRAMING [ ~ FINAL 765-1802 BUILDING DEPT. INSPECTION ]FOUNDATION 1ST ~ ~ ROUGH PLBG. j FOUNDATION 2ND [J/INSULATION ~ FRAMING 765-1802 BUILDING DEPT. INSPECTION [ '] FOUNDATION 1ST [ ] ROUGH PLBG. FOUNDATION 2ND [ ] INSULATION FRAMING [~/]'~INAL REMARKS: I ..~..., 19~..-I. Permit No. ! .~..~. ! ! .~... 0~.~ Sf.g~lg7 Approved Disapproved a/c ..................................... (Building Inspector) APPLICATION FOR BUILDING PERMIT TOWN OF SOUTHOLD CHECK BUILDING DEPARTMENT SEPTIC FORH TOWN HALL $OUTHOLD, N.Y. 11971 TEL.: 765-1802 CALL · BLDG. DEPT. TOWN OF SOUTHOLD INSTRUCTIONS a. This application must be completely filled in by typewriter or in ink and submitted to the Building Inspector, with 3 sehs 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 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 qther applicable Laws, Ordinances or Regulations, for the construction of buildings, additions or alterations, or for removaJe or demolition, as herein described. The applicant agrees to comply with all applicable laws, ordinances, building code, blbusing cod,~d,]~d regulations, and to admit authorized inspectors on premises and in building for necessary inspections. ,~/ . l~/[/. ? ; (~ignature r name, ~ a cgrporation) ?L Woods;cie. State whether applicant is owner, lessee, agent, architect, en~neer, general contractor, electrician, plumber or builder. (as on the tax roll or latest deed)c) If applicant is a corporation, signature of duly authorized officer. (Name and title of corporate officer) . ALL CONTRACTOR'S ~IUST BE SUFFOLK COUNTY LICENSED Builder's License No ...... .o/3MtA~....O,, .~3~<... ....... '~ [3~7'3" Plumber's License No ......................... Electrician's LicenseNo ....................... Other Trade's License No ...................... 1. Location of land on which proposed work will b,e done ............ .,...., ................................. House Number Street Hamlet County Tax Map No. 1000 Section ....... 7.~.. ...... Block .... 3 ............ Lot · · . . .~...~..: . ·~. ....... Subdivision ..................................... Filed Map No ............... Lot ............... (Name) State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occueancv .~../qo ~ ~+ a[ .... ~ - ' ' ...... : ..... i .................... : ', :,',': ": !"i .... , .......... : 3. Nature of work (check which applicable): New Building ..... ' ..... Addition .. ........ Alteration i Repair .............. Removal .............. Demolition .............. Other Work ............... ' i' escr on (D ip.ti ) 4. Estimated Cost ................................ Fee ...................................... *' (to be paid on filing this application) 5. If dwelling, number of dwelling un!ts ............... Number of dweliing 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.... i ...... ' ........ 7. Dimensions of existing strUctures, i any: Front .'..':-~-~.. ...... ..,.. Rear ......... . ..... l~epth; .............. Height ............... Numbe of Stories ........................................................ Dimensions of same structure with alterations or additions: Front ................. Rear .................. ~Depth ....... ~4~! ~ .... , Height ..................... Number of Stories ...................... 8. iaimensions of entire new construction: Front ............... Rear 3~ 3... ~.1;¢ .... Depth ............... ~ H~ight 3!~ .+..~.~.~4o.~--.. Numbe!' of Stories. :~; :'. .................................................. 9. Size ofloti Front .......... : ........... Redr ...................... Depth ...................... 10. Date of Purchase ............. ~ ............... Name of Former Owner ............................. ~ 1 1.Zone or use district in which prem] ~es are situated ..................................................... !12. Does proposed construction violate anyzoninglaw, ordinance or regulation: ................................ 13. Will lot be regraded ........... , ................. Will excess tilt be removed from premises: Yes No ;14. Name of Owner of premises ..... . ............... Address ................... Phone No ................ Name of Architect ........................... Address ................... Phone No ................ Name of Contractor ........... . ............... Address .... : .............. Phone No ................ ~ 15. Is this property located within 300 feet of a tidal wetland? *Yes ..... No ..... *If yes, Southold Town Trustlees Permit maybe required. PLOW DIAGRAM Locate clearly and distinctly ali b~ildings, whether existing or proposed, and. indicate all set-back dimensions from property lines. Give street and block nuinber or description according to deed, and show street names and indicate whether tntenor or corner lot. ~ sTATE OF NEW Y~K, ~_ //~,~; COUNTY OF .~a'7 I~....i' being duly sworn, deposes and says that he is the applicant (~" '~o ~ i'v'~l'si~i;gm ' ' ' ' ' ' contract) above named. I ae is the ........................ ! ................................................................. ' (Contractor, agent, corporate officer, etc.) *f said owner or owners, ~d is duly authorized to perform or have performed the said work and to m~e and file t~s .~pplieation; that all statements contained ~ this application are true to the best of his knowledge and belief; and that the ~ork will be perfo~ed in the m~ner sbt forth ~ the application filed therewith. 1'6" 17' APPROVIEDJ