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HomeMy WebLinkAbout14871-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. Certificate Of Occupancy Z14793 October 15 No. Date .............. '. ................ THIS CERTIFIES that the building Inground Swimming ?oo]- & fence 405 Mayflower Rd.~ MaLtituck, N.Y. Location of Property ~ ~ ~ ......................................................... ~ounty Tsx Map No. 100O S~cHon . .. ~ ~ ~ ...... Blo~k 08 .Lot 21 Subdivision ............................... Filed Map No ......... Lot No .............. conforms substantially to the Application for Building Permit heretofore fried in this office dated ?..ay. 7, ...... 19 $6 pursuant to which Building Permit No' 1~87q Z dated .... May 12, 86 ........................ 19..., 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 ......... Ingr. ound Swimmin~ ?ool & fence The certificate is issued to George & Diane Lessard (owner, of the aforesaid building. Suffolk County Department of Health Approval .......................................... N753961 UNDERWRITERS CERTIFICATE NO .................................................. Rev. 1/81 ''~''"~ng Inspector TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N. Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLIZT'ION OF THE WORK AUTHORIZED) 1~o. 14871 Z Permission is hereb/granted to: ................. ....%....o...~..q....~...~. .............................................. ..~.~....~.:.~..:..!.!..t ~:~ ........ ,o ..~...~.....~........~...~..~...~..~...~..~.....~.....~......~~ County Tax Mop No. 1000 Section .... J..~....'~ ........... Block ...... .(~...~. ........ Lot No ..... ~..J. ............. pursuant to application dated ...... ~.~r~.....~ ........................ , 19..~...~., and approved by the Building Inspector. Fee $,.¢~ ................... Building 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 featu res. 2. Final approval of Health Dept. of water supply and sewerage disposal-IS~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 featu res. 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. Fees: 1. Certificate of occupancy $5.00 2. Certificate of occupancy on pre-existing dwelling 3. Copy of certificate of occupancy $1.00 $15.00 4.Vacant Land C.O. $5.00 5. Updated C.O. $15.00 Date .................. NewC°nstvucti°n ...... Old or Pre-existing Building .......... Vacant Land ............. Location of P rope rty ...~z.,...~....~..,~;/.~,/,;.,~ ~, ~....~..j.,~i~l~ ......... Z~..'9. ~4'~:.t ................ House No. Street · ' ~' , '~, /d~', ~ Ham/et Owner or Owners of Pro ' ~"~-'~'~' 3 i -' ' '~ - ~ perry ... ~ ...... ~ ..... ,~-~ ~. - ' ~7 - Y'"~' '-~ ......... County Tax Map No 1000 Section /O [ Bock ~, - - '~ ) ...................... LOt.. ~ ./.. . Subdivisio~ .-~..fP. WC.' .r>[.. ~.'~q¢~:.[: .........Filed Map No ........... Lot No.* Perm't No./..~/.~..~./..Z. Date of Perm,t .~..~/].~,/?..~.Apphcent Health Dept. Approval ........................ Labor Dept· Approval ........................ Underwriters Approval / Planning Board Approval ..... Request for Temporary Certificate ..................... Final Certificate ....................... Fee Submitted $....~'...%.. ................... Construction on above described building and p~mit meets a}~_~pplicable codes and regulations. App cant t.~:.~<'/~,,~.' I~?.f~Z/.~. ;~....~'~--~,.. ....................... R~. 10-I0-78 ~ ~ 0530 FIELD INS[~ECTION FOUNDATION (1st) COMMENTS FOUNDATION 2. {2nd) ROUGH FRAME & PLUMBING INSULATION PER N. Y. STATE ENERGY CODE FINAL ADDITIONAL COMMENTS: lOOl~,~l THE NEW YORK BOARD OF FIRE UNDERWRITERS k~ BUREAU OF ELECTRICITY ..t~ ~p.l,c.,io. No. o.~.e N 75396:[ THIS CERTIFIES THAT only the elec trical equipment ~ described belo~ and introduced by t~ appJica~ n~med on the above application number ~n the premises of George Le~sard J'r., 405 ~.{ayflower R~,,, MattitUc[~ N,Y. in the following ]ocaHon~ ~ Basement ~ 1st FI. ~ 2nd FI. Section Block Lo~ was ex,~,ined on J~n O .~ ~ ~ 9 ~ ~ and found ~o be in compl~ance ~th tt~ re~,~reme~ts of thls Bo,rd. FIXTURE FIXTURES RANGES OVENS DISH WASHERS EXHAUST FANS DRYERS SYSTEMS NO. OF FEET E R V I C OTHER APPARATUS: (Swimminv Pool%This cerlti£icate cow, rs comp.~ian.ce at tho date of inspection only. Because o:~- unnsual environments it ~s advisable to have l:reqtlen~; t~st and/er repairs made by' a qualified person. Jody Pumillo Pat Lane Mattituck, N.Y,~ 119~2 GENEI~AL MANAGER This certificate must not be altered in any manner; return to the office of the Board ~f incorrect. Inspectors may be identified by their credentials. COPY FORiBUILDING DEPARTMENT. THIS COPY OF CER? FIXATE MUsT NO~ BE ALTERED N ANYMANNER '~ ~"' '" ;~,I~ORM NO. 1 {~"~'~ ~ ;:' *~0WN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL ~OUTHOLD, N.Y. 11971 TEL.: 765-1802 Approved .' .~ i%1 i;, 197¢. Permit No. ~.~. .~. .'7./. .~. · Disapproved a/c ..................................... ................................ ........ (Building Inspector) APPLICATION FOR BUILDING PERt¥]IT INSTRUCTIONS BLDG, DEPT. TOWN OF $OUTHOLD Received ............ 19... 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, 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. .... ~.,. ~.~.: .~. r..~... ,~.x~...x~....~, ...... (Signature of applicant, or name, if a corporation) · . 5;, '2.'~f- ~a.¢ .~.~....~.~..q../...~.. ...... A~..~. .... ~ ..~.4..r.~/...z:~..~(...c.':~7.:.~...V. .... /.(.?.o~ · ' iraa±i±ng address of appi±¢anl:) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. .......... ~.~...~...n.+ .... C.o..~.~.~..w..~...~.. ..................................................... Name of owner of premises ...... .~..~.O.f~.. ?~.....~....D../../?.~..~'~. ...... O..67~.. ~'..~.k~...~. ........................ (as on the tax roll or latest deed) If ap~?tf~nt is a corporation, signature of duly authorized officer. ced Builder's License No .......... /..O. ............ Plumber's License No ......................... Electrician's License No....~..~..O...~....~... ~-?".?.~.~F~'pg t~,~ Other Trade's License No ...................... 1. Location of land on which proposed work will be done ...... ~..~. ~. [~../...~..e. (~- ......................... .... ~0..~ ............. O..n.y./?.~.0. ?.~..~. ...... /~ .o.ooo.., ........ . .~.~..r77. ?. ,-~.< ........... House Number Street Hamlet County Tax Map No. 1000 Section ...... /0.2 ....... Block ...... ~. .......... Lot ...... ~../ ........ Subdivision ..................................... Filed Map No ............... Lot ............... (Name) 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy .......... t~,.~/.~..~¢~. ~--/,~ C ......... b. Intended use and occupancy ............ .~..~'a.~../.~. · .~...7-'./- ~..~../..~..a?.~.. ?..~...~L~-.. ................... 3. Nature of work (check which applicable): New Building .......... 3,ddition .......... Alteration ..... Repair .............. Removal ....... ; ...... Demolition .......' ' i .. Other Work ..... ,<. ........ (Description) ' Fee 4. Estimated Cost ........................................... : ............................. (to b9 paid on filing this application) 5. If dweiling, number of dweiling units ............... Number o f dwelling units on each floor ................ If garage, number of cars ........................................... : ............................. 6. If business, commarcial or mixed occupancy, specify nature and extent of each type of use ........... . .......... 7. Dimensions of existing structures, if any: Front ............... Rear ..... ~ ........ Depth ............... Height ............... Number of Stories .......................... i ............................. Dimensions of same structure with alterations or additions: Front .......... ~ ...... Rear .................. Depth ...................... Height ...................... Number 0f Stories ...................... 8. Dimensions of entire new construction: Front ............... Rear ...... i ........ Depth ............... Height Number of Stories 9 Size of lot: Front Rear ~ Depth 10. Date of Purchase ............................. Name of Former Owner ! ............................. 11. Zone or use district in which premises are situated ......... ~..r./~.. &-~...T./.~/~.L 12. Does proposed construction rig,late any zoning law, ordinance or regulation: .. i ~.~ ..... ~ .......... ~ ....... 13. Will lot be regraded ...... .~/?. ,, .................. Will excess fill be removed from premises: ('i~s}_ No 14. Name of Owner of premises ..'.(~'~.. ~. ~Address .. v/~.d~,~7'~.2e~-~.. Phone No.. o~. ~.~?.~... Name of Architect ........................... Address ............. ~ ..... Phone No ................ Name of Contractor ./ti../~..~..g. (~.~..~..,~..$ .... Address .... .~4..~. ~'~..//.--~:, .c.~.~.. Phone No.. ~.~ .~..~.d'.~ 15. Is this property located w~thin 1.00 feet of a tidal wetland*. ~ Yes ..... No .~.. * If yes, Southold Town Trustees Permit may be 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 shlow street names and indicate whether interior or corner lot. STATE OF NEW YORK, S.S COUNTY OF ................. ...... /~.Q .~..~.../fl~.... ~.:.. ~./~'} .~.L..~....~7~. ..... being duly sworn, deposes and says that he is the applicant (Name of individual signing contract) above named. He is the ...................................................................... (Contractor, agent, corporate officer, etc.) of said owner or owners, and is duly authorized to perform or have performed thi 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 manner set forth in the application filed therewith. Sworn to before me this ......... ~ .......... d f...~/~..a~, ............ , 19 ~.. Notary Public,... ~...a~.°-.. 8~. 0~.. .....