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HomeMy WebLinkAbout16368-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No Z18492 Date OCTOBER 23~ 1989 THIS CERTIFIES that the buildin~ Location of Propert~ 760 RAMBLER ROAD House No. County Tax Map No. 1000 Section 088 Subdivision TERRY WATERS INGROUND POOL AND FENCE SOUTHOLD Street Hamlet Block 05 Lot 20 Filed Map No. 2901 Lot No. 33 conforms substantially to the Application for Building Permit heretofore filed in this office dated AUG. 19~ 1987 pursuant to which Building Permit No. 16368Z dated AUG. 22~ 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 POOL AND FENCE. The certificate is issued to GEORGE ~ PAT HOLLOWAY (owner, of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A UNDERWRITERS CERTIFICATE NO. N092588 SEPT. 19, 1989 PLUMBERS CERTIFICATION DATED N/A Rev. 1/81 B~ilding Inspector FOR~ NO. t TOWN OF $OUTHOLD BUILDING DEPARTMENT TOWN HALL $OUTHOLD, N. Y. No_ BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PP, EMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) 16368 Z ('~.~,.,,~- ~z ~9~.~ Dote .,~.~ ............................... , .... / Permission is hereby granted to: ('~ ~--~ ~ ............................................... County Tox Map No. 1000 Section ...... .0.,.,..~.,. ........ Block ......C~.k .......Lot No. ,.,~.,,..,~.. ............. pursuant to application dated ............................. , Building Inspector. and approved by the Building' Irk~l~ctor Rev. 6/30/80 FIELD INSPECTION FOUNDATION (~st) FOUNDATION (2nd) ROUGH FRAME & PLUMBING INSULATION PER N. Y. STATE ENERGY ~ODE FINAL COFiMEN '1 ~ ADDITIONAL COMMENTS: t3LDC, i, DC' i APPLICATION FOR CERTIFICATE OF OCCUPANCY FORM NO. 6 TOWN OF SOUTHOLD Building Department Town Hall Southold, N.Y. 11971 765- 1802 Instructions A. This application must be filled in typewriter OR ink, and submitted mlmmmmmm 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 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 pZOperty showing all property 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 $25.00, Accessory.i$~0.00 Business $50.00 2. Certificate of occupancy on pre-existing'dwelling $ 50-. 00 3. Copy of certificate of occupancy $ 5.00, over 5 years $]0.00 4.Vacant Land C.O. $ 20.00 5.Updated C.O. $ 50.00 Date .......................... New Cons truct ion .~..~. · . Old or Pre-existing Building ............ Vacant Land ............. GEORGE & PAT ~OLLOWAY Location of Property ................................................................... House No. Street Ham/et Owner or Owners of Property 760 ][~XRAMBLER ROAD SOUTHOLD County Tax Map No. 1000 Section ...... .0.8.8. ..... Block ...0.5 ........... Lot..2?. ............ Subdivision TERRY WATERS .Filed Map No. 290 1 .Lot No. 33 Permit No ........... Date of Permit .......... Applicant .................................. Health Dept. Approval ........................ Labor Dept. Approval ........................ Underwriters Approval ........................ Planning Board Approval ...................... Request for Temporary Certificate ..................... Final Certificate .......... z.~..z .......... Fee Submitted $ ............................. Construction on above described building and~_..,~,__~_ ~~j~d~ regulations. Applicant .. j-... ~ ........... 765-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLBG. FOUNDATION 2ND [ ] INSULATION [] FRAMING [,'~'INAL /~~ DATE ~/~/~,, ~ INSPECTOR.s., ~ THE NEW YORK BOARD OF FIRE UNDERWRITERS ~;~, ~, :[00~l BUREAU OF ELECTRICITY ~- 85 JOHN STREET, NEW YORK, NEW YORK 10038 Date ~,~J>T)~;~ ~ ~ ~ 9~9 ~pplication No. on file 5~4~/~ ]~ 0,, ~5~ THIS CERTIFIES THAT in the followlng Iocation~ ~ B~sentent ~ Ist FI. ~ 2~d FI. S~tlon Bilk Lot DRYERS SYSTEMS NO. OF FEET OTHER APPARATUS: e~vJro~ment~ it .i.~ adv:L~ab'~ to h~ve freq~e~d, ~e~t and/or repairs ~ae by a q~ta]i~ed E R V I C A. WG OF CC, COND NO OF HI-LEG OF HI-LEG NO OF NEUTRALS A, WG OF NEUTRAL This certificate must not be altered in any manner; return to the office of the Board if incorrect. Inspectors may be identified by their credentials. COPY FOR BUILDING DEPARTMENT. THIS COPY OF CERTIFICATE MUST NOT BE ALTERED IN ANY MANNER. USE ~ :,U~LAWFUL ~'8.8 ' .6c~9 /89 o ~1 0 (7 ~'0~, "7 0 ~. ,.~ .~ ,19 '.2 ,,,0£ ,90 o~ £ 'N FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT . , TOWN HALL 8OUTHOLD, N.Y. 11971 TEL.: 765-1802 Received 19 APPLICATION FOR BUILDING PERMIT ? · ' · INSTRUCTIONS a.' This application mbst be completely, filled in by typewriter or in ink and submitted to the Building Inspector, with 3 sets of plan~, accbrate 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 befor& 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 lnspec.tor." ' APPLICATION IS HEREBY MA~DE 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 herein described. The applicant agrees to comply xyith ail applicable laws, ordinances, building code, housing code, and regulations, and to admit authorized inspectors on premises and in building for necessar~ inspe.ctions. ,. ~,../~.4.~...~.,.~. ,-,gw.r.;....~z~..... ............ (Signature of applicant, or name, if a corporation) '' , ~matling address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, generai contractor, electrician, plumber or builder. Name of owner of premises .............................. (as on the tax roll or latest deed) i~ a~sign~re~q f..duiy .... '.. , .... ~ '~'~ ~~ authorized · officer. . . .,., (Name and title of c , ' "' ' Builder's License ftc ....... '; ........... Plumber's License No ......................... , '.. , . ~0.~.~....~.~..w~.fc~ ' Electnman s L~cense No. Other Trade's License No I Location of land on which proposed work will be done .................................................. ... a ........ ................ ,.' ~ House Number i,, ,,. ' ;. ' I,, , Street , . Hamlet . . County Tax Map N~. 1000 Section ............ o ............ Lot ............. · ,x% 3.3 Subdivision ..... .[4). }~-.-.~.'~...~ ........... 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 ................. 3. Nature of work (check which ~pplicable): New Building ..... '. ....~.ddition .......... AIteration--~" ~ "~'..,A..' Repair Removal .............. .............. Demolition .............. ~tqet,. vKork ................ (Description) 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 mixed occupancy, specify nature and extent of each type of use ................ 7. Dimensions of existing structures, if any: Front ............... Rear .............. Depth .......... ' of Stories Height ............... Number ................................................... Dimensions of same structure With alterations or additions: Front Rear' Depth ................... 2 · · · Height ...................... Number of Stories ................. 8 Dimensions of entire new construction: Front Rear ' Depth Height ............... Number of Stories ................................................... · · rent .......... ! ............ 9. S~zeoflot. F Rear ...................... Depth .................. :. 10. Date of Purchase .......... i ................... Name p~f Former Owner ......................... 11. Zone or use district in which p~emises_,., are situated ......... /t.~r$~c~../q. ~ ......................... Does proposed construction viq~.e any zoning law, ordinance or regulation: .... ~ ..................... 12. 13. Will lot be regraded ........" -- ' .~'~J' ................ Will excess fill be removed from premises: Yes ~ 14. Name of Owner of premises ./~.0.~1- .g~,T,)ff ....... Address . .,2.o7t-~.'¥~ ..... Phone No ............... ~,. Name of Contractor JZ)'7.~'.'.'.M/~IZ'L~ r" ~,ox/t' .. Address . .'~..'~?vgT. Z..~...... Phone No. 15. Is this property locate4 withint.00 feet of a tidal wetland? ~ Yes ..... No ~.. · If yes, Southold Town T~ustees Permit may be required. i PLOT DIAGRAM L0chte clearly and distinctly all 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 coruef lot. STATE OF NEW YORK, COUNTY OF ................. S.S ............................ . ..................... being duly sworn, deposes and says that he is the applicant (Name ...... of ~n&wdual sighing contract) above named. He is the j (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 conltained in this application are true to the best of his knowledge and belief; and that the work will be performed in the man~ier set forth in the application filed therewith. Sworn to before me this ............... ?. ....... day of .............. , 19°~/.