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Home My WebLink About14846-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No Z17818 Date MARCH 7, 1989 THIS CERTIFIES that the buildin~ Location of Propert~ 2510 EDWARDS LANE House No. County Tax Map No. 1000 Section 018 INGROUND POOL ORIENT Street Hamlet Block 03 Lot 6.11 Subdivision HALE Filed Map No. 2370-2 Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated JUNE 30, 1986 pursuant to which Building Permit No. 14846Z dated JULY 9, 1986 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 & ACCESBORY PUMP SHED. The certificate is issued to ROBERT F. & ~r~NORE M. KULPA (owner, }DO~) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A UNDERWRITERS CERTIFICATE NO. PLUMBERS CERTIFICATION DATED N834832 SEPT. 29, 1987 Building Inspector Rev. 1/81 ~ORM NO, 0 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N. Y. BUILDING PERNIIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) 14846 Z Permission is hereby granted tog. L, ~~....~.: ...... ~~ ............ ...~.~.~ ...... ~....~ ................. .....0.~ ....... ..~....~..:.....U...~.~:3 .............. ot premises Iocoted at ,.~...~../...~. ......... ..~..-~ ............. .~ ........................ County To× Map No. ~000 Sec,~on ...... ~J..~ ....... BIo~k ..... ..~....~ ...... Lot NO...~...~., I/ pursuant to ~ppJicotion dated ...... ...~.,.~...~.~. .................. , 19,~.../~e., and approved by the BuiJdlng Inspector. Fee $.~/..7..~ .... Building Inspector Rev. 6/30/80 FORM NO. 6 TOWN OF SOUTHOLD Building Department Town Hail Southold, N.Y. 11971 765- 1802 APPLICATION FOR CERTIFICATE OF OCCUPANCY,.~ TOWN ()[- SOUTHOLD Instructions A. This application must be filled in typewriter OR ink, and submitted ~ ~ 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 pzX)perty 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 buildingm 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 $25.00, Accessory '$~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 $10.00 4.Vacant Land C.O. $ 20.00 5.Updated C.O. $ 50.00 Date .......................... NewCons truc t ion Old or Pre-existing Building Vacant Land House No. Street Ham/et County Tax Map No. 1000 Section ,. ,~./~. f ....... Block .~)~'~.-. ......... Lot...~..?.'//. '"~Health'Oept Approval Labor Dept Approval Request for Temporary Certificate ..................... Final Certificate ..................... Fee Submitted $ ............................. Constructmn on above descmbed budd,ng and perm,t m.eCfs ~pti~:~ble codes and regulations. Applicant .. ~,,q' ..~ ~ / ~/_ ~ / ' ......................... .. OUNDATION (1st) OUNDATION ( 2nd ) ',OUGH FRAME & ?LUMB, ING 'iNSULATION PER N, STATE ENERGY CODE FINAL ADDITfONAL COMMENTS: ..__ {.000620 THE NEW YORK BOARD OF F{RE UNDERWRITERS ~ept:ember 29,1987 BUREAU OF ELECTRICITY THIS CERTiFiES THAT~ . only the electrlcal.eqalpmen~'~ ~scrib~ be~w a~ i~t~daced by t~ applicant ~d o~ the a~pe application number m the prem~es of Robert: Kul~ ~ F~wa~d~ Lane,Eas t o~ Dfederick~ Road ~Orient ~s ex~mt~d o~ and found to be in compliance u'itb the require.tents of this Board. FIXTURE FIXTURES RANGES :~KING DECKS OVENS DISH WASHERS OUT~S SWITCHES FLU~ESCENT DRYERS SYSTEMS E R V I HO, OF CC. COND~ A, w. O ~0 OF NEUTRALS A. W G PER ,0' OF CC COND, - NO, OF HI-lEG OF NEUTRAL OTHER APPARATUS: (~wimming Pool) This Certificate co.ers compliance a~ ~h; d~e O~ inspec~ion only. Because o~ unusual environments i~ i~ advisable to have ~equen~ ~eet/an~ or ~epair~ ~.de by a qualified person. ,1/I COPY FO~ BUILDING DEPARTMENT. THIS COPY OF~CERTIFICATE ~UST~OT'BE ALTERED INANY MANNER FORM NO. 6 TOWN OF SOUTHOLD Building Department Town Hall Southold, N,Y. 11971 765 - 1802 APPLICATION FOR CERTIFICATE OF OCCUPANC' TOWN OF $OUTHOLD 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 featu res. 2.Final approvaJ 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 p~operty 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 requ ired to prepare a certificate. C. Fees: Additions $25.00 POOLS $25.00 ALTERATION $25.00 1. Certificate of occupancy New Dwelling $25.00, Accessory '$~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 $10.00 4.Vacant Land C.O. $ 20.00 5 Updated C O $ 50 00 Date' NewC°nsbructi°n ..... · Old or Pre-ex Jsting 8u ilding ............ Vacant Land ....... Owner or Owners of Property County Tax Map No. 1000 Section .. ~./~. f ....... Block .~),4~.q ......... Lot ....... '.. Subdivision J{C..J~.L./~, .................... Filed Map 0 .... ? .... ?~L. ot NO... ~ .... ~?teofPermit.,~.~/~.~,~,,.~.Applicant /~:~',~.T- %~.~-~.z~.~.~.x~. ........... Unde r ters Approval ............. P ann ng Board Approva ...................... Request for Temporary Certificate ..................... Final Certificate ....................... Fee Submitted $ ............................. Construction on above described building and permit m ¢ pli hble codes and regulations. Applicant ...... %~~ ....... ,.v.,o.,o.,, ...... ................... (- ~ ~o ,. ~ ...-%, ~ , / Ed z /7z/f TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL ~°OUTHOLD, N.Y. 11971 . , · TEL 765,1803 , . TOWN OF SOUTHOLD ~ ' ': 0., ',,~,..~ r, ~R.e~c:eived. .......... ,19 Disapproved a/c ...................................... ....... fLI/' (Building Inspector) APPLICATION FOR BUILDING PERMIT 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 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~code, and regulations, and to admit authorized inspectors on premises and in building for necessary inspection/ (Sign~~a'~t/;;~ame, if a corporation) .... (mailin~ addre~ of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. ................. . ...... .............. Name of owner of premises .. ~...d~.. ..... ! ...... : ~"'" ................ ;w'' ~_{ ' '-~" ' · ~,;G'~ ~, '~;/,'; .... / (as on the tax roll or NOTIFY BUILDING DEPARTMENT AT If applicant is a corporation, signature of duly authorized officer. Builder'si~~g-- ' ~ ............. Plumber s License ~ ......................... Electrician's License No ....................... 766-1802 9 A~ TO 4 ~ FOR THE FOLLOWING INSPECTIONS:' 1 FOUNOA~ON TWO ~q~QUIRED ~ ROUGt~ ~RAMING & PLUMBING ~. INSULATIO~'~ 4, FINAL 8~ COMPL~T[ ~OR C 0 ALI CONS3'~UCTION ~HAL[ f~EET THE NEQUI~MENTS OF ~i N.Y ~A~ CONSTRUCTION & ~N~GY Other Trade's License No .......... ......... .... Location of land on which proposed work will be done. ., · ·.. House Number Street Hamlet County Tax Map No. I000 Section ...~../..~. .......... Block .... .~.. ..... i'. .... Lof'i....~.*.~ .......... ' Subdivision .... .~.~/~ ......................... Filed Map No. ~...~. ?..d~. :..~..... Lot .... ~ ..~../. (Name) State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy P~J C,~ ~ ~/~ ~z/TP~F ~ 7" ................................ ! )t i i 6,;i ............................ .IT.~. ....................... ~ ............ ,.,: . . f, . b. Intended use and occupancy ..... ~ .~ r,.~ ,- ..~ , rs~: .,., .~ ~ .................... 3. ~t~.D'~/'~I}~[4~ pplicable): New Building .......... g~dditio ~oval .............. Demolition ........ 4. E~t~mated,.Cost· ~ . .,. ~,:.O.t..,,;,;.3~.,2 ~ ~'~' ~ .......................... Fee . ~(t( ~' .......... Alteration .......... .... Other Work ............... (Description) be paid on filing this application) 5. If dwelling, number of~_~ ..... Number of dwelling units on each floor .............. If garage, number of ca~.~ ..... 6. If business, commercia ' ' e and extent of eac type of use .................. 7. Dimensions of existing ~11~e~i~a~'~'*' ~* -'-'_:'.'.:.;~k',~, Rear ...q .......... Depth ............... Height... ~ ~.~e~l~tT, o~ ~J~ El~j~ !~,l~ ......... I .............................. Dimensions ~ ~l~'s .................. Rear ................ ........... ............. ................. 8. Dimensions of enti pth re ......... Rear ................ e ............. u~,, tories ........................ 9 Size of lot: Front .' Rear Depth 10 Date of Purchase Name of Former Own 11. Zone or use district in whick premises are situated .................................................. 12. Does proposed construction violate any zoning law, ordinance or regulation: .............................. 13. Will lot be regraded ...... .,,~.., .................. Will excess fill.be r~r oved from ~oJ;eJni~es: Yes , No 14. Name of Owner of premises .~/f.~X~.~'..~/~..~. .... Address ~l.q~.../Q(.//.~., .e'..g.~..t~-~i~o..~.~. ,",~', ??,~',' .... NameName of ArchiteCtof Contractor ....... ~¢..~..~?. ~ ~'~4~ .~. ·~'~.:~ ................. .................. AddressAddress ,ff~.~. .......... ' '~' · '~? !~" "'~' i ~°tn~e~: 15. Is this property locate~ withinl.00, feet of a tida.1 wetland * Yes ..... No ~.. · If yes, Southold Town Trustees Permit may be required. , PLOT DIAGRAM Locate clearly and d~stmctly all buildings, whether existing o~[ proposed, an. ,indicate all set-back dimensions from property lines. Give street and block number or description agqordin~ to deed, and ;how street names and indicate whether interior or corner lot. ~ "',, I! i'6 S.S STATE OF NEW YORK, COUNTY OF ................ ........................... being duly sworn, leposes and says that he: s the applicant (Name of individual signing contract) above named. He m the ...................... ~ ................................................. ......... , ......... (Contractor, agent, corporate officer, ,~tc.) of said owner or owners, and is dhly authorized to perform or have performed l he said work and to make and file this fhis knowledge-and belief; and that the' 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 ' ...... . .: . . . .~..~. ........ day '°f.. ~ ............ 192,~. (Signature of applicant)