HomeMy WebLinkAbout16059-zFORM NO. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Office of the Building Inspector
Town Hall
Southold, N.Y.
CERTIFICATE OF OCCUPANCY
No Z-17871 Date MARCH 22~ 1989
THIS CERTIFIES that the building. INGROUND SWIMMING POOL
Location of Property 1525 ALDRICH LANE
House No.
LAUREL~ NEW YORK
Street Hamlet
County Tax Map No. 1000 Section 125 Block 2 Lot 1.11
Subdivision Piled Map No. Lot No.
conforms substantially to the Application for Building Permit heretofore
filed in this office dated MAY 1, 1987 pursuant to which
Building Permit No. 16059-Z dated JUNE 12, 1987
was issued, and conforms to all of the requirements of the applicable
previsions of the law. The occupancy for which this certificate is
issued is INGROUND SWIMMING POOL & FENCE AS APPLIED FOR
The certificate is issued to
(owners)
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A
UNDERWRITERS CERTIFICATE NO. N-819531-JULY 14~ 1987
PLUMBERS CERTIFICATION DATED N/A
NORMAN & CAROLE PALEY
Rev. 1/81
' Building Inspector
· OEM NO. ~
TO~N O~ $OUTSOLD
BUILDING D£PARTMENT
TOWN HALL
SOUTHOLD, N. Yo
BUILDING FERMIT
CT'HIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL
COMPLETION OF THE WORK AUTHORIZED)
N9 16059 z
Permission is hereby granted to: ,
;;;~" ~ ............. !'?~5 .......... ' ,~,
a remises I~ate t../~ ~..
......... ~ .......... ~. ....~..............t p da
County Tax Mop No. I000 Section ........ /~....~...... Block .......... ...~.. ....... Lot No. /' //
pursuant to application dated ............. .g~././. ............................... , 19~**~..., and approved by the
Building Inspector.
Fee $../.....~..~
/ I~ilding 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 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 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.
1. Certificate of occupancy $25.00 -- BUSINESS $50.00 ACCESSORY $10.00
2. ~rtificate of occupancy on pre:~xisdfl-~'dwelling $ 50.00
3. Copy of certificate of occupancy $ 5.'00, over 5 years $10.00
5.Updated C.O. $ 50.00 Date .............
NewConstruction ...... Old or Pre-existing Building ............ Vacant Land .............
Location of Property ..................................
House No. Street Ham/et
Owner or Owners of Property ....................................................
County Tax Map No, 1000 Section .../~ .~. ...... Block ..... 2 ........ Lot..././. Z/ .......
Subdivision ................................. Filed Map No ........... Lot No ..............
Permit No..../; .~.D~..~.. Date of Permit . (././2./~. ~,Applicant..... . . .~.--~-~ /~(~'7~./~' .&~?£/~' '
Health Dept. Approval ........................ Labor Dept. Approval ........................
Underwriters Approval ...................... Planning Board Approval ......................
Request for Temporary Certificate ..................... Final Ccrtifi_cate .,. Z ................
Construction on above described building andpermit mee,ts all appli~&ble codes and regulations,
App cant .
Rev. 10-10-78
THE NEW YORK BOARD OF FIRE UNDERWRITERS
10003~2
BUREAU OF ELECTRICITY
~I'T 8.5 ,JOHN STREET, NEW YORK, NEW YORK 10038
THIS CERTIFIES THAT
only the electrlcal equipment as described below and introduced by the applicant named on the above application nu tuber in the premises of
Nozmlan Paley, 1525 Aldrige Lane~ Laurels N.Y.
tt~es examined o. O'U~le ~.~ 7 and fou,d to be i. compllanee .'i~h the r,qolre.zentz ,f this Board
FIXTURE
OUTLETS
2
1ECEPTACLES
SWITCHES FIXTURES RANGES .'OOKINGDECKS OVENS DISH WASHERS EXHAUST FANS
2
FLUORESCENT
DRYERS
FUTURE APPLIANCE FEEDERS
TIME CLOCK~ UNIT HEATER
MULTI-OUTLET DIMMERS
SYSTEMS
NO. OF FEET
SERVIC~ DISCONNECT S E R V I C E
(Sw~miug Pool) This certificate covers compliance at the dat~ of inspec-~
tion only. Because of unusual environments it, is advisable %:o have frequen(
test and/or r~pairs nlad,~ by a qualified
&
Weslay To J[a=~is
P~D 1, Box A3 Reeves Park
Lic $377E
GENERAL MANAGER
This certificate must not be altered in any manner; return to the office of the Board if incorrect, inspectors rma¥ be identified by their credentials.
(~0PY FOR BUILDING DEPARTMENT TH S COPY OF CERT F CATE MUST NOT BE ALTERED N ANY MANNER.
"IMMEDIATELY"
ENCLOSE POOL TO CODE
· .t UPON COMPLETION
BEFORE "WATER"
j 8~ ¢li/'°l)°f~ Id.
Fro~¢is '
~urP~y
TEST
0.0
LOAM
$.0
~"~OVFA) AS NOT~
9 AU TO ~ PI~ FOR
-INSPECTIONS:
FOUNDATION TWO
POUFIED CONCF~EY!~
ELD I~S~~ECTION
UND~TION (1st)
UNDATION (2nd)
UGH FRAME &
PLUMBING
SULATION PER N. Y.
STATE ENERGY
CODE
ADDITIONAL COMMENTS
OUNDATIO:; ( 1st)
OUNDATION ( 2nd )
OUGH FRAME &
'~!SULATION
PLUMBING
PER N. Y.
STATE ENERGY
CODE
. ADDITIONA'L COMME~TS:
765-1802
BUILDING DEPT.
INSPECTION
[]FOUNDATION 1ST [ ] ROUGH PLBG.
[]FOUNDATION 2ND [ ] I/~ULATION
/
[]FRAMING [~]'~L
REMARKS:
DATE
INSPECTOR ~_~
765-1802
BUILDING DEPT.
INSPECTION
FOUNDATION 1ST [ ]
FOUNDATION ZND
FRAMING
REMARKS:
ROUGH PLBG.
INSULATION
[~NAL
DATE /'~ //"~ / ~'~ INSPECTOR ~ ~'~*~
BUILDING DEPT.
~ INSPECTION
FOUNDATION 1ST
FOUNDATION 2ND
[ ] FRAMING
REMARKS: ,~/~)
ROUGH PLBG.
INSULATION
FINAL
//~ ~ ~
765-1802
BUILDING DEPT.
INSPECTION
FOUNDATION 1ST [ ] ROUGH PLBG.
FOUNDATION 2ND [ ] INSULATION
[ ] FRAMING ~J/FINAL~
DATE
INSPECTOR
Memorandum from ....
BUILDING INSPECTOR'S OFFICE
TOWN OF ~OUTHOLD
Tow~ [~ALL, ,~OUTHOLD, N. Y 11971
765-1802
October 19, 1987
Neptune Pools & Construction Co. Inc.
47 D Jayue Blvd
Port JefFerson, New York 11776
Gentlemen:
.'~.~U~nt to OUr telephone conversation o~
tOdmy~ '~'.~uyn herewith your check #1029 in the
amount Of $160.00 for swimming pool permit
#~6059Z for Norman & Carole Paley.
~Ki"~!y',send us a new check in the amount
of. $..{50,~0,'a~d we will release the permit to
~oU.
: Thank you.
SOUTHOLD TOWN BLDG. DEP'['.
Georgia Rudder, SecrcCa~Y
BOARD OF HEALTH ......
~.' SETS OF PLANS .......
'FORM NO. I SURVE~Y ..........
TOWN OF SOUTHOLD CHECK ..........
BUILDING DEPARTMENT SEPTIC FORM .............
TOWN HALL
SOUTHOLD, N.Y. 11971
TEL.: 765-1802
Examined..~/./..Zr ......... , 19
Approve{ . .~././~. ........ , 19~. Permit No../~.~..~..~....~..~
Disapproved a/c .....................................
................................ ~~.~ .~ii~i~ ......
APPLICATION FOR BUILDING PERMIT
NOTIFY
MAIL TO:
Poi PcF~'~+~ Plo~,:rF~C,
Date .... .~.¥ ./. ........ , 19 .~.7
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·
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 ~ 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 authorlzed inspectors on premises and in building for necessarY/inspectiqns;/-'/~
(Signa~ff6 of applicant,/or name, if a corporation)
State whether applicant is_ owner, lessee, agent, ar'eh~/;~i~;~;~al~*~entractor, electrician, plumber
Nameofownerofpremises .~f?~o~.TP~..XJ...~..~.~ .~...~/2. ~geg~· ~ ~..~.
· ' '('a; on the tax roll or latest' d;id')' '? ' ..................
If applicant is a corporation, signature of duly authorized officer·
(Name and title of corporate officer) -
ALL CONTRACTOR'S MUST BE SUFFOLK COUNTY LICENSED
Plumber's License No ....... ./~./~. .............
Electrician's License No ..... /.c~./z¢ ..............
Other Trade's License No ..... ./~/.~.. .............
I Location of land on which proposed work will be done. ~-;~.~. 7;-...~,< ~-...~..F~-....~f..D...,~/.c/,~... ·.........~ ~,w ~ ...
House Number Street
County Tax Map No. 1000 Section .../.<~:..~...-~. ........ Block ..... ......... ~ .... Lot. ...../' .//..
Subdivision ..................................... Filed Map No ............... Lot ...............
(Name)
2. State existing use and occupancy of premises and intended use and occnpancy of proposed construction:
a. Existing use and occupancy . . .~..~.~.....~F42.~..~. /.~....~-~'~r...c.~.~. ..............................
/
3. Nature of work (check which applicable): New Building ..... ' .....~....~.~??..C.. Alteration ..........
Repair .............. Removal .............. Demolition .............. Other Work ...............
e/o ~' (DescriPtion)
4. Estimated Cost..Z ~..o.c? ............................ Fee ./.~.-'O...~...~-../..~.. 7;../~Q.,.o.? ............
(to be p~id on filing this application)
5. If dwelling, number of dwelling units .... .xff,/.,~ ........ 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 ....~/,,fe? .............
7. Dimensions of existing structures, if any: Front. ,..~.~. { . Rear ...~5/ I ..... Depth .. ~>,~( ......
Height ....~-. ~. ........ Number of Stories ... ~..~.q ..............
Dimensions'of same structure with alterations or additions: Front . ~."7..'~..~. ........ Rear . ..-7 ..............
Depth ........ .-w-. ..... '. ...... Height ..... ~ .............. Number of Stories ..... .77. ...............
8. Dimensions of entire ne~v constmctiou: Front ...... .~..o. ..... Rear .... ~.~.. J ..... Depth .. ~.O...; ......
'Height i./t4Q.Ro..~.~.~ Number of Stories ./'.x~..~,-zo 0,02>
9, Size of lot: Front ..... ~,~,,,~,./. ......... Rear ..... .O. ?-~..~/7t. ..........Depth ... ~-~.~..t ............
i0 Ddt of P ch .,~f..,~. N eofF rmerOwn ' 42~j.~
· e ur ass .......................... am o er ........................
I 1. Zone or wse-dis~ricMn4vhi~h-p~;omise~ are~tua~ed~. ............. ~...;; ....... :: .........................
i2. Does proposed construction violate any zoning law, ordinance or regulation: .4,(.0..I ................... - .......
13. Will lot be regraded .. 4'('( .~'./...z~.,~../-''. . ....,~: ~ ....... Will ex'ess fill be removed from premises: Yes
-- Name of Arclutect ....... /df ................. Address., ....... ~ ........ Phone No ................
NameofContractor.,~.~7.~..P...~-fl.~4,,s . Address~'7~.-7-2~-~',~ /~Lv_O. Pb,~n,~No ~?~-
15. Is th±s property located ~ithin 300 feet o~'°a~-'t~'i~'ffi~-w~-~cl~'an~e~s :.x~,~.. ~--,~...
*If yes, Southold Town Trustees Permit maybe required.
PLOT DIAGRAM
Locate clearly and distinctly all buildings, whether existing or proposed, and. indicate all set-back dinrensions from
3roperty lines. Give street and block number or desctiption according to deed, and show street names and indicate whether
.nterior or corner lot.
"IMMEDIATELY"
ENCLOSE P(X)L113 CODE
UPON COMPt. ETION
BEFORE "WATER"
STATE OF NEW YORK,
:OUNTY S.S
............ .....
(Name of individual signing contract)
tbove named.
....... ~.being duly sworn, deposes and says that he is the applicant
lworn to before me this
........ /f..~..~. · ........ day of .~ .......... , 19 .~'.~.
MARY tOO REILLY
, NOTARy PU..BLIC, State of New York
no, 4805679
~uall[~ in Nassau County
Comrai~on Expires September 30, 19~/
(Signature of applicant)
is the '
(Contractor, agent, corporate officer, etc.) ~
said owner or owners, and is duly authorized to perform or have performed the said work and to make and file this
:pplication; that all statements contained in this application are true to the best of his l~nowledge and belief; and that the
york will be performed in the manner set forth in the application filed therewith..