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Home My WebLink About16040-zFO~ ~0. ~ TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No Z-20323 Date OCTOBER 31e 1991~ THIS CERTIFIES that the building~ Location of Property MANSION HOUSE DR. House No. County Tax Map No. 1000 Section 6 Subdivision SWIMMING POOL FISHERS tSLAND~ N.Y. Street Hamlet Block 6 Lot 18 Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated MAY 13, 1987 pursuant to which Building Permit No. 16040-Z dated JUNE 9, 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 (owner) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL UNDERWRITERS CERTIFICATE NO. PLUMBERS CERTIFICATION DATED R. RICHARD ZANGHETTI N-036383 - SEPT. 28, 1988 ' B~ilding I{spec%o~ ' f3 Rev. 1/81 ~OB~ NO. 0 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) N~ 16040 z Permission is hereby granted to: ..... ~.?,.**x....~ ..................................................... ,o .... County Tax Mop No. 1000 Section ....... .(~..{,~ ...... Block ...... ...~....~. ....... Lot No ....... J...~. ............. to application dated ....... ,~.....~.L..~... ................., 19~.~...,- and approved by the pursuant Building Inspector. Building Inspector Rev. 6/30/80 Form No. 6 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL 765-1802 APPLICATION FOR CERTIFICATE OF OCCUPANCY This application must be filled in by typewriter OR ink and submitted to the building inspector with the following: for new building 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 from Health Dept. of water supply and sewerage-disposal(S-9 form). 3. Approval of electrical installation from Board of Fire Underwriters. 4. Sworn statement from plumber certifying that the solder used in system contains less than 2/10 of 1% lead. 5. Commercial building, industrial building, multiple residences and similar buildings and installations, a certificate of Code Compliance from architect or engineer responsible for the building. 6. Submit Planning Board Approval of completed site plan requirements. For existing buildings (prior to April 9, 1957) non-conforming uses, or buildings and "pre-existing" land uses: 1. Accurate survey of property showing all property lines, streets, building and unusual natural or topographic features. 2. A properly completed application and a consent to inspect signed by the applicant. If a Certificate of Occupancy is denied, the Building Inspector shall state the reasons therefor in writing to the applicant. Fees 1. Certificate of Occupancy - New dwelling $25.00, Additions to dwelling $25.00, 3. 4. 5. Alterations to dwelling $25.00, Swimming pool $25.00, Accessory building $25.00, Additions to accessory building $25.00. Businesses $50.00. Certificate of Occupancy on Pre-existing Building - $100.00 Copy of Certificate of Occupancy - $5.00 over 5 years - $10.00 Updated Certificate of Occupancy - $50.00 Temporary Certificate of Occupancy - Residential $15.00, Commercial $15.00 Date ~. ~... ~.~/..~... ~, .............. . House No. , Stre&t Hamlet Onwer or Owners of Property...~.,....~..~....~.. / ~ ~' ~'~ ................ County Tax Map No 1000, Section ...... '~. ..... Block ..... .~. ......... Lot .... ~...~.. ........... Subdivision .................................... Filed Map ............ Lot ...................... Permit No..l.~.~..~.~.Date Of Permit.~.~....~.'~.~..~.Applicant..~~....~.. Health Dept. Approval ........ '..~.. .............. Underwriters Approval~..~.~.~...~.~ .... Planning Board Approval ........................ Request for: Temporary Certificate ........... Final Certicate.....~.....~ Fee Submitted: $ ....... ~.~J .................. .~..~. ~ , ~--'~'~'' P~'~'~ ........................ OUNDATION ( 1st I OUNDATION (2nd) OUGH FRAME & PLUMBING ~NSULATION PER N. Y. STATE ENERGY CODE FIX;AL , ADDITIONA'L COMMENTS: "IMMEDIATELY" 'FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL $OUTHOLD, N.Y. 11971 TEL.: 765-1803 Examined. · .~,~. ~...., 19 .~.7 Approved . .~.J~..9. ., 19~..7 Permit No. ] .&.O..~.0..% Disapproved a/c ..................................... Received ........... ,19... (Building Inspector) APPLICATION FOR BUILDING PERMIT INSTRUCTIONS Date ~/./~. ........ , 19 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, relgtionsllip t~o~odjojn~n~ premises or public streets or areas, and giving a detailed description of layout of property must be ctr~wn on.}t}~¢j~i~'which is part of this appli: cation. c. The work covered by this apphcat~on may not be commenced before l~s%u~e 'of~[aldiftg Permtt. d. Upon approval of this application, the Building Inspector will issued a Builfii~g ~%ffm~it ~othe 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 puri~o~ }wh*at~ve~ until ~ 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 herein described. The applicant agrees to comply with all applicable laws, ordinances, building code, housing code, and regulations, and to admit author/zed inspectors on premises and in building for necessary inspecti~J~.____ ____~ ~ (SigrI~fire of apt~cant, or name, if a corporation) ............ (Maliing address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. .......... .~.~.~,~..,,-A~..~. ...'--~. ~ ..................... : ........ , ........................................ Name of owner of premises ..... ,r'7)~./.:.'(~ ~"~-' ~YZt,.4~.-.~~~o. ii ~; i~t};t' ~d) ......................... If applicant is a corporation, signature of duly authorized officer. Builder's License No .......................... Plumber s License No ......................... Electrician's License No ....................... Other Trade's License No ...................... ~ . Location of land on which pro posed work will be donee,.. .................. ......... House Number Street Hamlet CountyTaxMapNo. 1000Section ......... ~. ...... Block ...~. ........... Lot.../...~.. ......... Subdivision ..................................... Filed Map No ............... Lot ............... (Name) State existing use and occupancy of pre, nd intended use and occupancy of proposed construction: a. Existing use and occupancy.../... ?~,.~..~(~..~...~'. ........................................... b Intended use and occupancy ~.~.~7~...~..~. ......... ' ................... . .... 3. Nature of work (check which applicable): New Building ..... ' ..... Additic Repair .............. Removal .............. Demolition ....... 4. Estimated Cost (t, 5. If dwelling, number of dwelling units ............... Number of dwellir If garage, number of cars ....................................... 6. If business, commercial or mixed occupancy, specify nature and extent of eac' 7. Dimensions of existing structures, if any: Front ............... Rear ... ......... Alteration ..... >-~.. .... Other Work~: (DesCription) ble paid on filing this application) units on each floor ................ t type of use ..................... ........ Depth ............... Height ............... Number of Stories ....................................................... Dimensions of same structure with alterations or additions: Front .............. Rear .................. Depth ...................... Height ...................... Numb~ r Of Stories ...................... .... 8. Dimensions of entire new construction: Front .......... ' ..... Rear ..... i ........ Depth ............... Height ............... Number of Stories ....................................................... 9. Sizeoflot: Front ...................... Rear .................... ,. i Depth ...................... 10. Date of Purchase ............................ Name of Former Owr r ............................. 11. Zone or use district in which premises are situated ..................... 12. Does proposed construction violate any zoning law, ordinance or regulation: : ............................. 13. Will lot be regraded ............................ Will excess fill be ten ed from premises: Yes No 14. Name of Owner of premises .................... Address .............. i ..... Phone No ................ Name of Aruhitect ........................... Address ............. j ..... Phone No ................ Name of Contractor .......................... Address .... : ....... i... Phone No ................ 15. Is this property located within 300 feet of a tidal wetland~ *~es ii... No ..... *If yes, Southold Town Trustees Permit maybe required, i PLOT DIAGRAM ; Locate clearly and distinctly all buildings, whether existing or proposed, an property lines. Give street and block number or description according to deed, and interior or corner lot. STATE OF NEW YORK, COUNTY OF ................. S.S ................................................. being duly sworn, (Name of individual signing contract) above named. He is the .......................................................... (Contractor, agent, corporate officer, of said owner or owners, and is duly authorized to perform or have performed application; that all statements contained in this application are true to the best, work will be performed in the manner set forth in the application filed therewith. Sworn to before me this. ...: ...... ./.3 ...day of ..... .')~...~.. HELEN It DE VOE ~ PUBLI~ ~ of No, 4707878, Su~lk T~m ~H~ March ~, t. indicate all set-back dimensions from DhOw street names and ~ndlcate whether OCCUPANCY USE IS UNLAWFUL WITHOUT CERTiFICATe. OF oCCUmNCY eposes and says that he is the applicant ( ~) ~' (Signature of applicant) :~eisaid work and to mae and file this This knowledge and belief; and that the