The URL can be used to link to this page

Home My WebLink About16268-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No Z-17388 Date OCTOBER 6, 1988 THIS CERTIFIES that the building Location of Property 930 OLE JULE IJ~NE House No. Street County Tax Map No. 1000 Section 114 Block 12 Subdivision Filed Map No. MATTITUCK{ N.Y. Hamlet Lot 13.4 ACCESSORY Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated JULY 22~ 1987 pursuant to which Buildinq Permit No. 16268-Z dated JULY 23~ 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 INGROUND SWIMMING POOL & FENCE AS APPLIED FOR The certificate is issued to JOHN & LINDA KOWALSKI (owner, ~) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A UNDERWRITERS CERTIFICATE NO. PLUMBERS CERTIFICATION DATED Rev. 1/81 N003540 - JANUD~R¥ 29~ 1988 N/A ~VJBuil~d~r.~Inspector TOWN 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) Permission is hereby granted to: __ ~--~ , ...,~.....~..~. .................. ~ ............... ~.~.'J~.~ ................................... ::: ............ ~~....~.~.~.:~:.:....!..,..~..~..~ .... . ,o ..~....~....~~......~. ......................................... .~~ ~. .......................... ~.;. ....... ~....~.....~.....~: ........ ~;;...~ .................. at premises located at .... ~ .......... .~J~:~....~ ........................................ .... ~'i'~TZi¥..'~"~.'~i~'; .............. i'ii ........... ZZ ............... ii .............. County Tax Map No. 1000 Section ...... .J../.~.. ......... Block ......?. .............. Lot No...)...~[.:.."./.. ......... pursuant to application dated ..... ...~.....~....~'.. .................... , 19.~..."/., and approved by the Building Inspector. Fee $.L~*~...*, ............ Building Insl:~ctor Rev. 6/30/80 FORM NO. 6 TOWN OF SOUTHOLD Building Department Town Hall Southold, N.Y. 11971 765- 1802 APPLICATION FOR CERTIFICATE OF OCCUPANCY Instructions A. This application must be filled in typewriter OR ink, and submitted m ~ 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 property showing all propertv lines, streets, buildings and unusual natural or topographic featu res. 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 $25.Q0, Accessoryi$~0.O0 Business $50.00 2. Certificate of occupancy on pre-existing dwelling $ IO0. O0 3. Copy of certificate of occupancy $ 5.00, over 5 years $10.00 4.Vacant Land C.O. $ 20.OO 5. Updated C.O. 50.00 Date . .9/.3.0./..8.8. Pool w/ Fence Enclosure,$ etc. NewConStruction .~ .... Old or Pre-existing Building ............ Vacant Land Location of Property ... 9.3.0... 0.I.e.. 0 U .] .e.. ~ ~ J%e. ,. I~ ~.t.1; i ~.Q.c.k,. [~.Y. ........................ House No. Street Ham/et Owner or Owners of Property ..... 0. q b ~1. ,P., . ~ jq.d.. [. ] .n.d. { . [~p~/.~ ] . .k.1, . County Tax Map No. 1000 Section .... .~ Subdivision 0ohn KoW~Tski ..... Filedl~a. pB~lo ..... LotNo. P..B 3/2~83 App~ Permit No/~ .~. °c>.~.. Date of Permit .Applicant .~.~ .... Health Dept. Approval ........................ Labor Dept. Approval ........................ Underwriters Approval ........................ Planning Board Approval ...~/. 7/B.3. ( Re.-,S u bd.tv i s $ 0 n Request for Temporary Certificate ..................... Final Certificate . PO.Q ]. w,/., F.. ~ j3.c.e,. I~ tlc.].o s u r e Fee Submitted $ ............................. Construction on above described building and permit meets all applicable codes and regulations. Applicant .... ...................... Rev. 10-10-78 C 0 ~ I UNDATION (1st) UNDATION (2nd) UGH FRAME & FLUMBING SULATION PER N. Y. STATE ENERGY CODE FINAL ADDITIONAL COMMENTS: 765-1802 BUILDING DEPT. INSPECTION FOUNDATION 1ST [ ] ROUGH PLBG. FOUNDATION ZND [ ] INSULATION [ ~l~L [ ] FRAMING REMARKS: DATE D 6! t~, 19,~ FO~ ALL GO~T~UCT~ON ~TE CON~TRuC~ ~/7~t~bi°~ ~ Off COr~SI'RUCT.()h EF~ROR~, Disapproved a/e .................................... · FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL ' COUTHOLD, N.Y. 11971 TEL.: 765-1802 (Building Inspector) APPLICATION FOR BUILDING PERMIT INSTRUCTIONS Received ......... ,19... Date ."; ............. 19 a.' This applicati0nmust be completely filled in by typewriter or in ink and submitted tothe Buildinglnspector, with3 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 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- , ~ c..~ The. Work covered by this application may not be commenced before msuance of Building Permtt. . 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. ¢~, No building shall be occupied or used in whole or in part for any purpose whatever until ~ Certificate of Occupancy shall have been granted by tho Building Inspector. · APPLICATION IS HEREBY M~DE to?th'e 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 inspections. .... ..... (Signature of applicant, or name, if a corporation) ' ..... ........... (mailing address of app±icant) 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 latest deed) If aPP__, s~Tuth°rized °fficer' -- Builder's License No ...... ; ...... Plumber's License No ......................... Electrician's License No..~,P~.Z.'~.~... Other Trade's License No ...................... ' I. Location of land on which proposed work will be done .................................... .. '~ House Number ..... ,' . , . Street Hamlet C; ;tyT M pN; I O00S u ax a . ection ................. ck ............. Lot ............. Subdivision ..................................... Filed Map No ............... Lot ............... trqame) 2.State existing use and ~ccupancy ~f premises and intended use and ~ccupancy ~f pr~p~sed c~nstru~ti~n: a. Existing use and occupancy ................................................................... b intended use and occupancy ............................ 3. Nature of~lq (~laee~which applicable): New Building ..... i .... Addition .......... Alteration .......... Repair. ~;p. ?.u~.. . Remqval ............Demolition ............ .. Oth~r Work ................ ' (Description) 4 Estimated Cost 2(~..0 ".~'' ' (to be paid on filing this application) 5. If dwelling, number of dwelling hnits ............... 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 Dimensions of 'sting tru tur~s if any Front ...". Rear Depth Height ............... NunJber 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 ............... Height ............... Nun)ber of Stories ........................................................ 9. Size of lot: Front .......... i ........... Rear ...................... Depth ...................... 10. Date of Purchase .......... i ' '. ................ Name of F. gnner Owner ........................... 11. Zone or use district in which prgmmes are situated .......... [~,~/~.~. 77/.~.. ......................... 12, Does proposed construction violate any zoning law, ordinance or regulation: ....... ./~..O. ..................... 13. Will lot be regraded ........ ,~,,O. ................. Will excess fill be removed from premises: _Yes 14. Name of Owner of premises ../~??..~ .~,1~ ...... Address ................... Phone No .... Name of Architect .... ~ ....... ~, .~.,~..j .... Address ................... Phone No ......... ~ ...... 15. Is this property locatedlwithin 1.00 feet of a tidal wetland? * Yes ..... No ~.., · If yes, Southold Town Tr0stees Permit may be required. PLOT DIAGRAM Loc'ate clearly and distinctly al buildings, whether existing or proposed, and, indicate all set-back dimensions from property lines. Give street and blocl~ number or description according to deed, and show street names and indicate whether interior or corner lot. STATE OF NEW YORK, COUNTY OF ................ S.S (Name of ~n&vidual mgmng contract) above named. being duly sworn, deposes and says that he is the applicant He is the .................... l ..................................................................... " I (Contractor, agent, corporate officer, etc.) of said owner or owners, and is duly authorized to perform 6r have performed the said work and to make and file this apphcat!on that all statements contained m this application are true to the best of his knowledge and belief; and that the work will be performed in the manher set forth in the application filed therewith. Sworn to before me this ~ .... ~" '""7. ' ~' ~e'of applicant~