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HomeMy WebLinkAbout16350-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. Certificate Of Occupancy No. Z16643 Date February ]l, 1988 THIS CERTIFIES that the building .... .I,n.Rr.o..u.n.d. pool 3485 (R.O.W.) Peconic Bay Blvd Laurel Location of Property ............................ House NO. ' ' County Tax Map No. 1000 Section 128 .Block 03 .Lot 2 I . 1 Subdivision ............................... Filed Map No ......... Lot No .............. conforms substantially to the Application for Building Permit heretofore filed in this office dated A u g · 13, 19 8 7 pursuant to which Building Permit No. .16 3 5 0 z dated .. Au. .g :..2. ! ,...1.9.8..7 ........... was issued, and conforms to all of the requirements of the applicable provisions of the law. The occupancy for which tiffs certificate is issued is ......... Inground pool and fence as applied for. The certificate isissued to J. MYRON YOUNG JOAN B. YOUNG ..................... ...................... of the aforesaid building. Suffolk County Department of Health Approval ...... N../.A ................................. UNDERWRITERS CERTIFICATE NO ....... P. e..n.d.i.n. $..2./.4./..8 .8 ........................... PLUMBERS CERTIFICATION DATED: N/A ! ............. l qgding'I } ;c't;; ............. Rev. 1/81 FOIIM NO. lB TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N. Y. NO_ BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION QF THE WORK AUTHORIZED) ' ' 6 3 5 0 Z Dote ..... ~~......~...~ .......... , Permission is hereby granted to: ... :. ...... .~...:. ....... ..~~...-.~:...~..'...~.~:.~... ,~ ~o.~~.....~...~.~........~ .......... ~....~.~........o...o¥~..~ at premises located at ...'~..~...~.....~.....~.~.:?..:.~...'.~....~....e,.-fh~.~...~~.:....":~.~..L... ..... ............................................................................... ....... County Tox /~p No. I000 Sectio~n ...... .L.~....~.. ........ Block ...... ..~....~ ..... Lot No......~....~..:.1. ......... pursuant to oppllcation dated ~..~...~......t...~. ........... 19..~..~., and approved by the Building Inspector. ll-ullding 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 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 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 instaila~ 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 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 $25.00, Accessory '$I0.00 Business $50.00 2. Certificate of occupancy on pre-existing dwelling $ 5 0.0 0 3. Copy of certificate of occupancy $ 5.00, over 5 years $10.00 5.Updal:ed C.O. $ 50,00 Date ........... NewC°n=truc~i°~ ...... Old or Pre-existing Building ............ Vacant Land ............. Location of Property . ~ow~c . ~.? ...................... House No. Street /-/am/et Owner or Owners of Property r~" ~ .... .... ..... ..................... County Tax Map No. 1000 Section .../..O~..~ ........ Block ,. ,~ ~ ......... Lot. ~/'. ,~. ......... Subdivision ................................. Filed Map No ........... Lot No .............. Permit No. /.~.~.~.0..~. Date of Permit ~,-,~lw ~.App,icant .~,..~.~. ?..d~¢~.)./~.~. ........... Health Dept. Approval ........................ Labor Dept. Approval ........................ Underwriters Approval ........................ Planning Board Approval ...................... Request for Temporary Certificate ..................... Final Certificate ....................... Fee Submitted $ .~.~...6~'.. .................... Construction on above described building and permit meets all applicable codes and regulations. A p p, ica n t ~..~/f~-47, .~. ...... ~..~ .................. TOWN OF SOUTHOLD OFFICE OF BUILDING INSPECTOR P.O. BOX 728 TOWN HALL SOUTHOLD, N.Y. 11971 TEL. 765-1802 Feb. 1, 1988 To Whom This May Concern, We are unable to complete your Certificate of Occupancy because .of the following reasons. ~_--~ An application is not on file. ENCLOSED ~_--~ NO Underwriters Certificate on file. ~ The check is(outdated/not on file.) /~/ No Health Dept. Approval on file. /~/ No final inspection has been made. for Certificate of Occupancy Contact your electrician. Please contact our office on Thank you for your cooperation. Building Permit # ] 6 3 5 0 Z Building Dept. this matter. No Plumber solder Certificate on file. ( all permits involving plumbing being issued after April 1,1984 ) SENT TO: MYRON YOUNG 3485 R.O.W. off Pec. Laurel, N.Y. 1948 Bay Blvd. UNDATIO.~ ( ls t) UNDATION (2nd) UGH FRAME & PLUMBING SULATION PER N. Y. STATE ENERGY CODE FINAL . ADDITIONAL COMMENTS: s u ~R v ['Y J. MYRON ,Y.,OUNG LAURELJ~? ;'. , TOWN"OF SOUTHOLD~ :;~JULY 24,. 19 AND LAND SURVEYOR, N.Y.$.LIC. NO. · RIVI~R HE n I~ ,~,y, ,~- FORM NO. 1 , TOWN OF SOUTHOLD ,, , , BUILDING DEPARTMENT TOWN HALL , ,?,oOUTHOLD, N.Y. 11971 " TEL.: 765-1803 Examined _{~,~O~. ,.&..I.., 19 ~.~. , , ApPro ' ' D r edisappov-~ a/c "' Received ........... ,19... (Building Inspector) APPLICATION FOR BUILDING PERMIT 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 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.. ,, :;,i~,,e~b, ','- ,: ,'' ...... : : c., The work c var y this application may not be commenced before issaance 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 g Certificate of Occupancy shall have been granted by the Building Inspector. APPLICATION IS HEREBY MA~E to;fh'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 corpo_ration) . ' . or - ........ . (mailing address or app State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. Name of owner of premises .~.. }~.__~ .~. -P- ,q'-D ~-~J ~{~ Z~,,~ft~;,3',z*BO~ ~}~ ag (as on the tax roll or lateptrd~eed) $~at/~ ~/ if am~a~ is a corporation, s}~nat)~r,,e of duly authorized officer· F~' / ~ ~ ~ BY' . ~ 3~~'fi[' /// ~etq~ l/I)/ ................ .. ' . · "'* ............ ,,~ ~-~,~ ,9 A~ 1FI,~ ~l ~'~'¢1 FOR T?I,E ilder's License No /"~,~-"~ , ~O~J,~t~r,-qOe4 't~'O Plumber's License No ......................... & iN${ILA!'I('}/r/' Electrician's License No....~.~f/~. .. .~..&~ ,T~.'~ C., 4 ~;~i~,~.. CO~W~[~C(~iSTRocr~ONFO{~ C~O. Other Trade s License No .................. r . .: ..... ~,_~, ,. ~NEF~z~y · ion of land on which roposed work will be done.. 8..~. ........... ~i~'~a+t,,~,~' ,:, r,~ House Number ~ :.', '.' '. ',~ : Street . Hamlet County Tax ~ap No, ]000 Sectio~ ............. Block ............ Lot;, , ~ .......... Subai~isio~ ..................................... Filed ~ap No ............... Lot ............... 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: .' ......... a. Existing use and occupancy .................................. b,I ded scan occu y ......... ' ......................... 3. Nature of work (check which alpplicable): New Building .......... Addition .......... Alteration ....... Repair .............. Removal .............. Demolition .............. Oth~r Work ....... ~ ....... ~' (Description) 4. Esthnated Cost ......... f.~.. 0.'..C~...' ............... 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 ' ' ~ specify nature and extent of each type of use · , commercial or m~xed occupancy, .................... 7. Dimensions of existing structures, if any: Front ....... ' ...... Rear .............. Depth .............. Height ............... Nubaber of Stories ....................................................... Dimensions ~f same structure with alterations or additions: Front ................. Rear'. ................ Depth · .~ t · .'i ..... .: .. Height ...................... Number of Stories .................... 8. Dimensions of entire new construction: Front ............... Rear ............... Depth .............. Height ............... Nu~nber of Stories ....................................................... 9 Size of lot: Front : Rear Depth 10 Date of Purchase Name of Former Owner 11. Zone or use district in which p~emises are situated .................................................... 12. Does proposed construction vio. late any zoning law, ordinance or regulation: ................................ 13. Will lot be regraded ....... ~.O .................. Will excess fill be removed from premises: ~ No 14. Name f Owner of premmes . .~.. ~.t~l.q ffi Gr. ....... Address ................... Phone No...;...' ......... Name of Architect.. .~. .... ~. ~_~_j~.. ~.: .... .................... Address .................. Phone No. Name of Contractor .. : ~../7/3~d~..-(. .. Address .. J'~.. ~.. ~.. (.,~C/~ Phone No .... 15. Is this property located~ within.l.00 feet of a tidal wetland? * Yes ..... No .~. · If yes, Southold Town Trustees Permit may be required. i PLOT DIAGRAM Lodate clearly and distinctly all 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. couEr ' oF.. .s , .... ~0 . .C~/Z.~ .... ~{. / ......... ~,..'. being duly sworn, deposes and says that he is the applicant (Name of individual si~ning contract) above named. I th ..... .~* .~.~.~. .................................................. Heis e ............. , ' (Contractor, nt, r ~ age c0 porate officer, e'tc.) of said owner or owners, ~d is dhly authorized to perform or have performed the said work and to m~e and file this application; that ail statements coBtained ~ this application are true to the best of his knowledge and belief; and that the work wU1 be perfo~ed in the m~oer set forth in the application filed therewith. Sworn to before me this ............. ....