HomeMy WebLinkAbout16070-zFORM NO. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Office of the Building Inspector
Town Hall
Southold, N.Y.
CERTIFICATE OF OCCUPANCY
No Z19227 Date JULY 20, 1990
THIS CERTIFIES that the buildin9 POOL
Location of Property 2920 BAYSHORE ROAD GREENPORT
House No. Street Hamlet
County Tax Map No. 1000 Section 53 Block 06 Lot 41
AMENDED MAP A 125/126
Subdivision PECONIC BAY EST. Filed Map No. 1124 Lot No. 127
conforms substantially to the Application for Building Permit heretofore
filed in this office dated MAY 22, 1987 pursuant to which
Building Permit No. 16070Z dated JUNE 14, 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 & FENCE.
The certificate is issued to WILLIAM LORENZO
(owner)
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A
UNDERWRITERS CERTIFICATE NO. NB20436 JULY 20~ 1987
PLUMBERS CERTIFICATION DATED N/A
Rev. 1/81
/ Building Inspector
FORM NO. ~
TOWN OP SOUI'HOLD
BUILDING DEPARTMENT
TOWN HALL
SOUTHOLD, N. ¥,
BUILDING PERMIT
(THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL
COMPLETION OF THE WORK AUTHORIZED)
Nfl 16070 z
Date ! /./L 19.~,~ ....
Permission is hereby granted to: ~ C~"' ~
~ ~. . I1~
......... ~.~.., .......... ~ .............. ~..~ ~
...... .......
of ~rem~ses J~$ed ........ a.=._.=~..~ ........... % ....... ~~ .....................
['~. ........ .5~i[~ S~"" ''': ............................................................................................................................. 7~~
co~. · ~'"'~ ................................ '7 ........................... ~"; ................
~ cx Mop No. 1000 Section ...... .~.~..~ ..... 5J~k ..... ~.~. ....... kof No ......... ~. .............
pursuant to application dated ......
Building Inspector.
and approved by the
Building Inspector
Rev. 6/30/80
BLDG, DEPT.
TOWN OF SOU ,'['H,OLD
Form No. 6
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN HALL
765-1802
~PLICATION 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.
B. For existing buildings (prior to April 9, 1957) non-conforming uses, or buildings and
"pre-existing" land uses:
~ i. Accurate survey of property showing all property lines, streets, building amd
unusual natural or topographic features. ' °.°
2. A properly completed application and a consent to inspect signed by the applicant.
If a Certificate o£ Occupancy is denied, the Building Inspector shall state the
reasons therefor in writing to the applicant.
C. Fees
I. Certificate of Occupancy - New dwelling $25.00, Additions to dwelling $25.00,
Alterations to dwelling $25.00, Swimming pool $25.00, Accessory building $25.00,
Additions to accessory building $25.00. Businesse~ $50.00.
2.Certificate of Occupancy on Pre-existing Building - $100.00
3.Copy of Certificate of Occupancy - $5.00 over 5 years - $i0.00
Updaged Cernificate of Occupancy - $50.00
5.Temporary Certificate of Occupancy - Residential $15.00, Commercial $15.00
Date
· ,ew Construction ........... Old Or Pre-exi~ting Building .........
· ..........
Location of Property... .~.~ ..... . ..............................
House No. Street Hamlet
Onwer or Owners of Property.. ~id/~.~/~.~.. ~/~a~/d.~/d?.~.4~ ......................................
County Tax Map No 1000, Section.~.~. ......... Block..d ........... Lot..~./ ................
.......... e Map ............ Lot ............ .
Permit No.../~.~.~.~. .... Date Of Permit..~./~2 ...... Applicant..~.q/~.~{~.~.~;¥.~.'?./.~.~.~....
[Iealth Dept Approval
Underwriters Approval ,,
PI nning Board Approval :i '"
Request for: .Temp°rary Certificate ........... Final Certicate ...........
Fee Submitted: $ .....................
""
OUNDATIO:~ { 1st)
OUNDATION ( 2nd )
OUGH FRAME &
~LUMBING
i~:SULATION FERN. Y.
STATE ENERGY
CODE
ADDITIO~IA~L MME~TS:
THE NEW YORK BOARD OF FIRE UNDERWRITERS
1025023
EIUREAU OF ELECTRICITY
~ 85 JOHN STREET, NEW YORK, NEW YORK 1OO3S
Oat~ July 20,1987 ,4p,,ti,.a,lo, No.,,nflo 485316/87 N
THIS CERTIFIES THAT
only the electrical equipment tr~ described below and introduced by the applicant named on the above application number in the premises of
Lorenzo, 674 Bayshore Rd., Green Port,
in thefollo~i,~ l,,e, tlon~ [] Rase,,e,~ [] I~, ~'l. [] 2,,d ri. OUtS ide .%~tl,m Rt~ Lot
~sexa,ninedon June 29, 1987 andfoundtohelncotnpllan,.eu,ith thoreq.lrement~ofthlsBoard.
fIXT*dEE ~ FIX'i~RES RANGES OVEN~ DISH WASHERS FANS
OUTLETS SWITCHES
E{UORESCENT
1 2
DRYERS
SYSTEMS
E R V I C
HO OF HI-LEG
NO OF CC COND A. W G A W. O NO, OF NEUTRALS
PER ~' OF CC, CONO OF HI-LEO
OTHER APPARATUS: '
G.F.C~I.-1
(Swimming Pool)This certificate covers compliance at the date of inspection
only. Because of unusual environments it is advisable to have frequent test
and/or repairs made by a qualified person.
Henry Bo~n
121 Sheep Pas~Ure~Rd.
Setauket, N.Y., 11733
li0.$2675E
GENERAL MANAGER
This certificate must ~at be altered in any manner; return to the office of the Board if incorrect. Inspectors may be identified by their credentials.
VICTOR LESSARD
PRINCIPAL BUILDING INSPECTOR
(516) 765-1802
FAX (516) 765-1823
Town Hall, 53095 Main Road
P.O. Box 1179
Southold, New York 11971
OFFICE OF BUILDING INSPECTOR
TOWN OF SOUTHOLD
May 2, 1990
William Lorenzo
2920 Bayshore Rd.
Greenport, N.Y. 11944
B.P. %16070Z Inground pool & fence.
Dear Mr. Lorenzo:
I am writing to you regarding the above Building Permit.
The permit has expired and you have not obtained a Certificate
of Occupancy. This is a violation of the Code o~ the Town of
Southold.
I am enclosing a copy of the inspection report from 9/24/87.
Please contact our office immediately to resolve this permit.
Thank you for your attention to this matter.
eno.
Yours truly,
Secretary
765-~1e2
BUILDING DEFT.
INSPECTleN
FOUNDATION 1ST ~ ] ROUGH PLBG.
FOUNDATION 2ND [ ] INSULATION
FRAMING , [~L
765-1802
UILDING DEPT.
INSPECTION
[ ] FOUNDATION 1ST [ ] ROUGH PLBG.
FOUNDATION 2ND £ ] ~SULATION
/
FRAMING ~/J FINAL
REMARKS:
DATE
INSPECTOR ~ ~/~/~
765-1802
BUILDING DEPT.
INSPECTION
FOUNDATION 1ST [ ] ROUGH PLBG.
[ ] FOUNDATION ZND [ ] IN.S/ULATION
[ ] FRAMING
DATE
INSPECTOR
V
J ~
z
'FORM NO, 1
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN HALL
SOUTHOLD, N.Y. 11971
TEL.: 765-1802
Examined...~. ,.~. IH.., 19~. 7.
· . .........
.~.~rCr~../...q.., 199.7 ?ermit No. /
Approved
Disapproved a/c .....................................
(Building Inspector)
APPLICATION FOR BUILDING PERMIT
OI.D(Z DEPL
Received ........... ,19...
Date .................. ,19...
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
~shal[ 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 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 authorized inspectors on premises and in building for necessary inspections.
.::~a~na...%~c5. .9.~x.~ .....................
(Signature of applicant, or name, if a corporation)
5~ ~...~.k¢..~.-.6.. ~o.c.4<.%. ~% :o.~....~Y...
(Mailing address of applicant) \ ~.~ ~
If applicant is a corporation, signature of duly authorized officer.
......
(Name and title of corporate officer) .
Oq-
Builder's License NO ..... ~2 .......... ~.~ ........
Plumber's License No .........................
Electrician's License No... cr~;~..-~ .~ ...........
State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder.
.. ................................................................................
Name of owner of premises ~x~.~,~.¥.X .Q'X..C2~ ..... ¥.-.C~?'..~_.~..~,~3. ........................................
(as on the tax roll or latest deed)~
~OT~
Other Trade's License No.
1. Lo~ of land on whicL proposed work will be done'. .....................
House Number Street ..........
County Tax Map No. 1000 Section .................. Block ................ Lot ..................
........... (h'a~e) "
2. State existing use and occupancy of premises and intended use and occupancy of proposed construction:
' ~ (T~ k : ,: .;:.., ............:~,~,,~.
a. EXisting ~Se a~d occupancy ~ . -
3, Nature of work (check which applicable): New Building ..... ' ..... Addition..i. ,~f~.. · . . , Alteration ..........
Repair .............. Removal ..... , ........ Demolition .............. Other Work ...............
4 Estimated Cost .~ ~);OO,: ~ O) o5~ (Description)
..... ' ................................ 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 ogcupancy, specify nature and e~xtent of each type of use ....................
7. Dimensions of existing structures, ffany: Front...~.'~..: .... . Rear .. ~. ~ ........ Depth ..............
Height Number of Stories \
D~menmons'of same structure with alteratmns or addmons: Front Rear
Depth ..................... !Height ..................... Num~e/r bf Stories ............ / ........
8. Dimensions of entire new construct:ion'. Front ..... ,..
Height ............ '.. Number of Stories ..................................................
9. Size of lot: Front ............. ~ ........ Rear ...................... Depth ......................
10, Date &Purchase ............................. Name of Former Owner .............................
1 I. Zone o~r use district in which premises are situated.., b~..Q ..............................................
12. Does proposed construction violatelany zoning law, ordinance or regulation: . .~9..C>. ...........................
13. Will lot be regraded ........... ; ...... ' .......... Will excess fill be removed from premises: Yes No
14. Name of Owner of premises .cQt,\.\.~ ~ .c~.. ,%~(-G..qgO. Address/~,'2~...~ sc¢~c~e. Phone No..q.~).D. 7. ~-.\q,. (e...
Name of Architect ............ ~ .............. Address .~.' .?~. ~.~.a ..... Phone No ................
Name of Contractor ~.~..on. '~c~'c~ g?o_o\~ .. Address~ .~.~ '~5~... Phone No..~..~. T..~.\O. 9...
.... ~ '~ ........... ~c~ ' ' ~tt:~ex ·
15. Is thia property located within 300 feet of a tidal' we~n~?
· 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 dimensions from
property lines. Give street and block number or description according to deed, and show street names and indicate whether
!nterior or corner lot.
;TATE OF NEW YO,-R,K, , ~ '
:OUNTY OF .... s.s
...................... being duly sworn, deposes and says that he is the applicant
(Name of individual signinglcontract)
hove named,
te is the .~(-~.~..0. ?. ............ i ................................................................
i (Contractor, agent, corporate officer, etc.)
,f 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 knowledge and belief; and that the
/ork will be performed in the manner s~t forth in the application filed therewith.
worn to before me this .
.. .......... ......
~otary Public,' . .... . '
, · NO~.Eh~.. ~-A~.~.[~ ./.... ..... County
No, 52.4526433 ................
Qualified in Suffolk C, gu~W ,... ,.. (Signature of applicant)
Commission Expires ~]~L~' I r~