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Home My WebLink About15005-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. Certificate Of Occupancy No. Z16745 Date March 29, 1988 Pool THIS CERTIFIES that the building ................................................ Location of Property 1845 HENRY ' S LANE PECONI C House No. Street Hamlet County Tax Map No. 1000 Section 074 ..... Block 0 I .Lot 0 7 Subdivision ............................... Filed Map No ......... Lot No .............. conforms substantially to the Application for Building Permit heretofore filed in this office dated J u n e 1 2, 1 9 8 6 pursuant to wtfich Building Permit No. 1 5 0 0 5 z dated J u n e 2 0, 1 9 8 6 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 and fence as applied for. The certificate is issued to ANTHONY & FLORENCE BRANDI ..................... ?oY.'o;.~,h'~'~c&~k .................... of the aforesaid building. Suffolk County Department of Health Approval ...... ~/. A. ................................. UNDERWRITERS CERTIFICATE NO .............. N. 7. .5 .7.7.6. 7...J.u.l.y...8.,.. ! .9 .8.6 ............. PLUMBERS CERTIFICATION DATED: N/A Building Inspector Rev. 1/81 ~vOB-M NO. ~ TOWN OF SOUTHOLD BUILDING DEPARTJ~ENT TOWN HALL SOUTHOLD, N. ¥. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPL[~'ION OF THE WORK AUTHORIZED) N°. 15005 Z ,o.~ ~ ~.~~.z...~ ...... ~ ......................... · ~ rs'- ' .............................................. i ....... at premises located at ../. ................................. pursuant to application dated ....... ....~..~.....)....~... ............. , 19...~...~f, 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 ~LDG. DEPT. TOWN OF SOUTHOLD 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-6onfbrming ~ses, or buildings and 'pre-exi~ing' land uses: 1. Accurate survey of p;~operty showing alt 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. C. Fees: Additions $25.00 POOLS ~25.00ALTERATION $25.00 1. Certificate of occupancy New Dwelling $25.00, Accessory rS ~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 $]0.00 0.0o 5.Updated C.O. $ 50.00 Date ...... ~.~. ........ New C on s t r u c t i on ...... Old or Pre-existing Building ............ Vacant Land ............. Location of Property.../.¥, ,,~-~ ..... Owner or Owners of PropertV ....~-.--~,, County Tax Map No. 1000 Section .. ,,0, .~,, ,~ ..... Block .... ,C~,. J ....... Lot...~). ,~, ........ Subdivision ................................. Filed Map No ........... Lot N~ .............. 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 $ ............................. Construction on above described building anlper~it meets all applic~-c.~des~-~regulations, App cant ... , .~-~...~..~.~...~, .(~..~..O,.~..~ ........ THE NEW YORK BOARD OF FIRE UNDERWRITERS BUREAU OF ELECTRICITY 85 JOHN STREET, NEW YORK, NEW YORK 100~8 THIS CERTIFIES THAT in thefottou, lng locatlon; ~ Basement ~ Ist Fl. ~ 2nd ~. ~S~O Section Bl~k Lot u~sexatninedon ~[~0 30, 1~6 attdfoundtobeinco.tplancewiththereqtrementsqfthlsBoard, EIXTURE OUTLETS [ECEPTACLES SWITCHES ] 2 FIXTURES RANGES OVENS DISH WASHERS EXHAUST FANS NCANDESCENT FLUORESCENT 1 DRYERS SYSTEMS NO, OF FEET E R V I C OTHER APPARATUS: (_,~I~_9~]_~_~_.~t~9_iL.)- TBis c~*l~ificate cOVers ~li~ at t~ ~te of i~ction only. ~mse of ~al envim~nts it is ad.sable to have fr~ t~t ~de by a qualifi~ person, ltonry Bohn 121 ~h~ep Pasture Road S~a~et~ N.Y. 11733 ItC. g675E GENERAL ~ANAGER '~ This certificate must not be altered in ~ny m*nner; return to the et{ice of the Board if incorrect. Inspectors roof be identified by their credentials. COPY FOR BUILDING[ DEPARTMENT. 'THIS cOPY OF CERTIFICATE. ~, . ..:MUST NOT: BE ALTERED: IN ANY MANNER, F 1.E L31- ~NS~JECTM FOUNDATION (1st) FOUNDATION (2nd) ROUGH FRAME & PLUMBING 3. INSULATION PER N. Y. STATE ENERGY CODE FINAL ADDITIONAL COMMENTS: 765-1802 BUILDING DEPT. INSPECTION DATE FoRM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N.Y. 11971 TEL.: 765-1802 Examined · .~-~..~.~. .... , 19 .~.~. Approved . .~/ff'A'u~..'~/.g~..o..., 19~.6.. Permit No..~..~.O..0(.~.. Disapproved a/c ..................................... (Building Inspector) APPLICATION FOR BUILDING PERMIT - BLDG. DEPT. , TOWN OF SOUTI..IOLO Received ........... ,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 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, housing code, and regulations, and to admit authorized inspectors on premises and in building for necessary i~spect~ons, t ..... .................. --~ (Signature 9f applicant, or name, if a corporation) /Fqo ............... tO.Y, //?0'a' ............ State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumoer or ouiluer. ..................................................................................... Name of owner of premises ...~.~..~/~.ON~/..~...~:. E/.c~.e~..c.' .~....~.~[ ................................... (as on the tax roll or latest deed) If applicant is a corporation, signature of duly authorized officer. (Name and title of corporate officer) Plumber's License No ......................... Electrician's License No ....................... Other Trade's License No ...................... Location of land on which proposed work will be done...[.~..q.~....~/.~.ro.~.~.~.../~. :....~.~.c.oqq..l'.C .................. House Number Street Hamlet County Tax Map No. 1000 Section..~.~..W.q .... Block ...... } ........... '. Lot.. ~. · ~..'. .... Subdivision g¢'oq]?< (c~oevle$ . Filed Map No. ~.O..Q / . ':~I~..~t.~ ......... ................ ............... 2. State existing use and occupancy of premises and intended use and occupancy of proposed constructi~m: a. Existing use and occupancy ,...~..o.~..~ ........................................................... b. Intended use and occupancy .... Ro~a}~,' -~ ~. .............. Demolition .............. Other Work. .,:~t,~k,~, (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 occupancy, specify nature and extent of each type of use .......... ~ ~ ........ 7. Dimensions of existing structures, if any: Front....q~ Y ........ Rear .. ~. ~.~ ........ Depth .. ~ ............ Height ...................................................................... D~ensions of same structure with alterations or additions: Front ................. Rear .................. 8. Dimensions of entire new construction: Front .... ~ t Rear .. De Height ....... 9. Size of lot: Front .[~.Q.... ............ Rear .. 10. Date of Purchase ( ~ q~ . Name of Foyer Owner . ~, .~(~.~ ........ 11. Zone or use district in which premises are situated ..................................................... 12.~ Does .proposed construction viblate any zoning law, ordinance or regulation: ...... ~. ...................... 13. Will lot be regraded ...... Y~ .................. Will excess fillbe removed from premises: ~ No N~e of Arcintect .......................... Address .................. Phone No ....... ~.. ~ ..... 15. Is this property located, within 1.00 feet of a tidal wetland? * Yes ..... No ~.. · If yes, Southold Tom Tr~ustees Permit may be required. ' , PLOT DIAGR~ . Locate clearly ~d dist~ctly MI bufld~gs, whether existing or proposed, ~d. indicate ~1 set-back d~ensions from property lines. Give street and bloc~ number or description accord~g to deed, ~d show street names and indicate whether interior or corner lot. STATE OF NEW YORK, ....~. [~'d~...~.-....~. ~...~./.[ .................... being duly sworn, deposes and says that he is the applicant (Name of individual signing contract) above named. (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 th-bt the work will be' performed in the manne[ set forth in the application filed therewith. Sworn to before me this ~ J~ re .tt~. ~ (Signatu~ ~applicant)