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HomeMy WebLinkAbout16562-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No Z17213 Date AUGUST 22~ 1988 THIS CERTIFIES that the building Location of Property. 2835 House No. County Tax Map No. 1000 Section 67 Subdivision SWIMMING POOL MILL ROAD PECONIC Street Hamlet Block 4 Lot 21.3 Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated OCTOBER 22r 1987 pursuant to which Building Permit No. 16562Z dated OCTOBER 23, 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 WITH FENCE. The certificate is issued to GEORGE & BERNADETTE ALDCROFT (owner, of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A UNDERWRITERS CERTIFICATE NO. N025069 PLUMBERS CERTIFICATION DATED N/A Building Iq~ector Rev. 1/81 FO~w; NO. ~ TOWN OF $OUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N. Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) No_ 16562 Z Date ...(~ .................... , granted to: ('~ /~ .... .~...g...~..~.'. ............................ : ................. ....~~~...o......~.:.....~...~..~.~.~..~ .~...~ ,/~..~.~ , .... ~ .... uV --'~'*~~ .................. '~'"'"¥-*'~'":'"~ ................ '~'"'"~ ............ ; ...................................... at premises located at .m~..~,~1~. ...... ..~.L,'~......~ ........ 1~..~-..~ ................................... County Tax Map No. 1000 Section ..... ..~..~q. 2 ...... Block .......C~.....~.. ....... Lot No...~..,l.....'~. ........ pursuant to application dated ....... O..~..~.......~t.....~.. ........., 19.-~.-'~.., and approved by tile Building Inspector. Fee $..L~...~../. ....... Building Inspector Rev. 6/30/80 FORM NO. 6 TOWN OF SOUTHOLD Building Department Town Hall Southold, N.Y. 11971 765 - 1802 PPLICATION FOR CERTIFICATE OF OCCUPANCY Instructions A. This application must be filled in wPewriter OR ink, and submitted m ~ to the Building Inspec- tor with the following; for new buildings or new use: I. 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 property showing all property lines, streets, buildings and unusual natural or topographic featu res. 2.Sworn statement of owner or previous owner as to use, occl3pancy 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: Addicions $25.00 ?OOL$ $25.00.~ALTERATION $25.00 1. Certificate of occupancy New Dwelling,$25.O0, A~cessory,$10.00 Business $50.00 2. Certificate of occupancy on pre-existing dwelling $ 50.00 4.Vacant3' Copy of certificate ofoccupanCYLand C.O. $ 20.0055'00' over 5 yearI $ 10.~0 .~..~..~.~/.. ~ 5.Upda%ed C.O. $ 50.00 Date ........ ,~.~.~.;., New C OhS t r' uc t i on ...... Old or Pre-existing Building ............ Vacant Land ............. House No. ~ ~ Street ~ Nam/et Owner or Owners of Property ....~...~-~,..~.... f. ~ .~. ~..F~..... ~...~...~..~'../. ........ County Tax Map No. 1000 Section ............. Block ............... Lot... : ..... Subdivision ................................. Filed Map No ........... Lot No ............. Permit No ........... Date of Permit .......... Applicant ............................. ... . Health Dept. Approval ........................ Labor Dept. Approval ......................, Underwriters Approval ........................ Planning Board Approval ..................... Request for Temporary Certificate ...................... Final Certificate ...................... Fee Submitted $..~. ,~..~..~.....~'~ .~...~9..~...~. Construction on above described building and permit ~ all appl~ co~s an~regu~t~o~s. ...... .... ....... Rev. 10-10-78 COM~gNTS FOUNDATION ( 1st ) FOUNDATION 2. (2nd) ROUGH FRAME & .PLUMBING INSULATION PER N. STATE ENERGY CODE FINAL ADDITIONAL COMMENTS: 57~. / ~/~ / THE NEW YORK BOARD OF FIRE UNDERWRITERS 1001381 BUREAU OF ELECTRICITY I--- 85 .JOHN STREET. NEW YORK. NEW YORK 10038 ' q ~GUST 02,~988 5~288988/88 N 02506. ~ ~pplieation No. on file THIS ~B~IFIE~ THAT GEORGE E. AbDEROFT, Mi~{, L~NE~ POl.~; ~NY54, P~CONI.:, ~Y. JULY 1 ~ ex.min~ ~ and~oufld to be in compliance with fhe ~ui~m.nfs ~ th~ ~. PlXTUIE RXTURE~ RANGES OVENS EXHAUST FANS 3 4 3 SERVICE DISCONNECT S E R V I C IG OTHH AI~ARATUS: PANELBO~RD$:~-5 CIR. 125 (;.~'.C. ~ :--4 *{SWI~ING P~L) Thi~ certJ, ficatc~ cover~ compliance ~t the dale of inspect J. on only. Because of unu~,~al environments i~ is advisable to ~ve irequent test/an4 or repai~ made by a q.a]:if.ied person. JOI)Y PUMI [.bO PAT MA '1 ! ~ULK. NY, CC. COND, This certificate must not be oJtered in any manner; return to theLO~ld~NliJ]~)ari~{~ca~rect. Inspectors m¢~/ be identified by their credentials. COPY FOR BUILDING DEPARTMENT. THIS COPY OF CERTIFICATE MUST NOT BE ALTERED IN ANY MAHHER. 'FORM NO, 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL $OUTHOLD, N,Y, 11971 TEL,: 765-1803 Examined .O..~.. · .*J~A~. · · .&..3., 19 ~.? Approved ~2>.~...~....'~'..'.~.., 19'~... Permit No.l.~..~..'--.'~..I. ~ Received " 19 (Building Inspector) APPLICATION FOR BUILDING PERMIT INSTRUCTIONS Date../.O./~..0 · · ' ...... 19g~... 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 authorized inspectors on premises and in building for necessary inspections. .. ~.:..~.~7.~z..z. k r:. 52¢..~. ?,..~: ........ (Signature of applicant, or name, if a corporation) f..q... ~o.~.. ~¢.z/,.. Z-hn..77:.,, .~..c.¢:..,N.: Z: (Mailing address of applicant) /fq3'~ct~ State whether applicant is_owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. ............ .~.~..~..~. ~c. .... .C.o. ~T~..q.~.'..7~..~ .................................................. Name of owner of premises ..... .~..,~...~ff..~...~... ~..~.~..~..~. ~&.'-.7-.~...../~...~.0.. ~ .~.. 0 .~...~. ............... (as on the tax roll or latest deed) If ~~n~y authorized officer. (Name and title of corp4r, fft~Sfficer) ' Builder's License No .... t;~ .7~..7 .......... Plumber's License No ......................... Electrician s License No .................. Other Trade's License No ...................... 1. Location of land on which proposed work will be done[ ... ....?,.$.'5.~. ............... ,,?/./.4.c .... ./¢.o.~.¢.~ ...... /?4<c..~.,v..r.9 .... .z...z., ~:Z .... /.c.?~sT~ ...... House Number Street Hamlet County Tax Map No. 1000 Section .... d .7 .......... Block.. · .~. · ............ Lot. c~./.,..~. .......... Subdivision ..................................... Filed Map No ............... Lot ............... (Name) 2. State existing nsc and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy ..... ~...~. r/~.~ff'~ b. Intended use and occupancy ........ t . ~ .............. 3, Nature of work (check which applicable): New Building ' Addition .......... Alteration .......... Repair .............. Removal ............ Demolition ............. Other Work ~)C) O-LO (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 gat'age,,[3llraber of cars . ,~ .......... If business commercial or m~xe'd occupancy, specify nature and extent of each type of use ..................... 7. Dimensions of existing structures, if any: Front ................ Rear .............. Depth ............... Height Number of Stories Dimensions of same structure With alterations or additions: Front ................. Rear .................. Depth ' Height Number of Stories Dimensions of entire new construction: Front .......... '... Rear Depth Height ............... Number of Stories ........................................................ Size of lot: FrOnt ~ Rear ............................................ Depth ...................... )ate of Purchase .......... i .................. Name of Former Owner ................. Zone or use district in which nrbmises are situated ~t ~/:'N TT~t, ............ Does proposed construction violate any zoning law, ordinance or regulation: ..................... ; ......... Will lot be'regr/ded ........ /~..O ................ Will exces, s,,fill be removed from premises: Yes (~ Name of Owner 'of premises . ~C~...~.tO.og~?/~Address ..~R~c-~Q.4/(~.. fif.~,.. Phone No ...... Name of ArchiteCt .......... ' ................. Address .................... Phone No. Name of Contractor .~.; ~/.t,.~.~...~'~,~,C,. ,,. ...... Address ~1F~..e./~../~. j~t. Phone No. i~. 2~.'i ~.'d.' .~. 15. Is this property located,'within 300 feet of a tidal wetland? *Yes ..... No ..... *If yes, Southold Town Trustees Permit may be required. PLOT DIAGRAM ..,- Locate clearly and distinctly alll 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 corner lot. 9. 10. 11. 12. 13. 14. NOTIFY ~L,D~NC~ ~'.~ AH~ ~ ~M 1 AT 765-1~2 ~ ,A~ 'cO A p~ ~R THE STATE OF NEW YORK, COUN~£Y OF ................. $.S ..... ~ ...... ./.~ · · ' being duly sworn~,dep0~es and says that he is the applicant (Name of individual signing contract) above named. ~ He is the ...... i ............... : , ' (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 contained in this application are true to the best of his knowledge and belief; and that the work will be performed in the mannerlset forth in the application filed therewith. Sworn to before me this q> ~" .day of .! O. ~...~ Notary Publi~ ..... ~.. t~...i:'' .~..t:,...~...~..... County ~_,..)/~/,)wl ~,r,,'"'D ~; . . ................ ' _N~, 4 PUSLI~ ~b~e of New Yolk an't) . , 707878, SuffolkCeunW.,r,.~~ r ~erm I~ir~ t,~rch 30, l-~ o?