HomeMy WebLinkAbout15008-zFORM NO. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Office of the Building Inspector
Town Hall
Southold, N.Y.
Certificate Of Occupancy
No. z-15952 Date July 14, 1987
THIS CERTIFIES that the building INGROUND SWIMMING POOL & FENCE
Location of Property ...8.9.5..H.~.g.h.l.a.n.d..R.o.a.d. ........... C.u.t.c.h.o.g.u.e.,..~e.w..Y.o.r.k. .............
House IVo. Street Hamlet
County Tax Map No. 1000 Section I02 ...... Block 08 .Lot 02
Subdivision..~./.o. Hi~t~land Es'cares .... 6357 5
............. : ........... m~ea Map No ......... Lot No ..............
conforms substantially to the Application for Building Permit heretofore Cried in this office dated
June 13, 1986 pursuant to which Building Permit No. 15008z
dated June 20, 1987 was issued, and conforms to all of the requirements
of the applicable provisions of the law. The occu ancy_ for which this c rtificat's is i .
~NOROUND SWIm,NC POOL a PENCE AS AP~D FOR WITH W~NDSWS FR~ H~
POOL AREA BLOCKED NOT TO OPEN MORE THAN 2 INCHES: DOORS FROM HOUSE INTO SOME AREA
~E? 'C~0$ING 'S 'EATCHING .' ........................................................
MARC & BEVERLY LEVEY
The certificate is issued to ..................... [oh;n'o),'/~7,~'J~x .....................
of the aforesaid building.
Suffolk County Department of Health Approval ... N/A
UNDERWRITERS CERTIFICATE NO ..... N761540
N/^
PLUMBERS CERTIFICATION DATED:
Rev. 1/81
lrO~ NO. ~
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN HALL
SOUTHOLD, N. Y.
BUILDiHG PERJ~IT
(THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL
COMPLETION OF THE WORK AUTHORIZED)
15008
Z
Dote ..... ~ ............................... , ......
Permission is hereby granted to:
Q,,~....~ .~..'...~....~..~....~..~ ....
~u..~ ...... ~.....~ ......... ~... ........
~,.."
,o .~.~,,,..~....~.~.~.~.......~...~...~.~ ..........................
...~..~......~......... .............. , ........ .,. .... .: ........... ; ...................... ;...~ ................................
ot premises located ot ....~....~. .......... ~' ~..~....J~- ............ .~g~...~~ .............
.................................................................................. :::: ...................
.......................................... ~ .............. ;. ........................................................ ~...~.~ ....
County Tax Mop No. 1000 Section .... ./.......~'.. ....... Block ..... .(~..~. ......... Lot No ........................
pursuant ,o ~pplicotion doted ..... ....~. ~...L...~.. .................... , 19.~....~.., and approved by the
Building Inspector.
Building Ins4pector
Rev. 6/30/80
~),- BLDG. DEPT.
TOWN OF SOUl,lOLl)
FORM NO. 6
TOWN OF SOUTHOLD
Building Department
Town Hall
Southold, N.Y. 11971
765- 1802
~PLICATION FOR CERTIFICATE OF OCCUPANCY
Instructions
This application must be filled in typewriter OR ink, and submitted m~ to the Building Inspec-
tor with the following; for new buiidings 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.
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 occupancv on pre-existing dwelling
3. Copy of certificate of occupancv $1.00
4.Vacant Land C.O. $5.00
5. Updated C.O. $15.00
$15.00
Date .....................
NewConstruction .. Old or Pre-existing Building Vacant Land
Location of Property ...............................................
House No. Street Ham/et
Owner or Owners of Property . '/~.'P~ ffi ~ ~...~..~T~.L~' ~
County Tax Map No. 1000 Section ,/~9~- Block °°' Lot
Subdivision. .~ .~..z~'A.~..z). · · .~..'~.~.'~.~~.~..'~. .... Filed Map No..~../.~..P'./?-7 .Lot No.
Permit No. ~,5-e~c~ E -2~ 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 and permit meets all applicable codes and regulations.
Applicant ......................................
Rev. 10-10-78
F1EDD i~4~SFECTION
FOUNDATION
(1st)
FOUNDATION
2.
(2nd)
ROUGH FRAME &
PLUMBING
INSULATION FER N. Y.
STATE ENERGY
CODE
C OM~'~ E~'JTS
FINAL ~'r
ADDITIONAL COMMENTS:
765-1802
BUILDING DEPT.
INSPECTION
FOUNDATION ZST [ ] ROUGH PLBG.
FOUNDATION 2ND [ I INSULATION
FRAMING [ !~'iNAL
DAT[ INSPECTOR
THE NEW YORK BOARD OF FIRE UNDERWRITERS
BUREAU OF ELECTRICITY
B5 JOHN STREET. NEW YORK, NEW YORK 10038
THIS CERTIFIES THAT
o~y the electrical ~u ~pment ~ ~scrlbed be~w and introduced by the appllca~t ~m~ on the a~ve application number in the premises of
Levey, w/~ Box 81~ ~ighl~d ~o~, ~/o ~te 25 Cut~ogue,N.Y
DRYERS FURNACE MOTORS FUIURE APPliANCE ,~EDERS TIME CLOCKS
UNIT HEATERS MULTI-OUTLET
SYSTEMS
NO. OF FEET
DIMMERS
SERVICE DISCONNECT S E R I C
~ ~C,e' ~ V~t C,. NO. OF HI-LEG t A W G t40 OF
CT E A~ A T :
(Swi~ng P~i) This certificate covers oomplian~% at ~e da%e of ~$~otion only,
B~ause of ~]usual Enviro~tents i% is advis~le to have fre~ent test and/or
A.W G
OF NEUTRAL
[{enry Sohn
121 Sheep Pasture Road
Setauket,N.Y. 11733
Li¢$2$75E
GENERAL MANAGER
This certJfkcde must not be oJtered in an), manner; return to the office of the Board if incorrect. Inspectors may be identified by the/ir
COPY FOR BUILDING DEPARTMENT. THIS COPY OF CERTIFICATE MUST NOT BE ALTERED IN ANY MANNER.
'FORM NO, 1
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN HALL
$OUTHOLD, N.Y, 11971
TEL.: 76~180~
Ex~mined .... ~O..., 19~.¢. '
Approved.. ~{.i~-...1~.O.., 19~.~. Permit NO. ! .~.-'.O.~ ~ .~,..
Disapproved a/c ....................................
(Building Inspector)
APPLICATION FOR BUILDING PERMIT,
Received ........... , 19..
INSTRUCTIONS
a. Tins application must be completely filled in by typewriter or in ink and submitted to the Building Inspector, with
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 o~ public streeb
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. Tile work covered by tins 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 peri, ix
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 Occupant3
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 ox
Regulations, for the eonstroction 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...~ ~ ~
· ''' i~i~r'e'of applica' ' ' '''' ~; ~ ~am'e~6~C]a't;o'n') ....
:-.
(Mailing address of applicant) ,~.eO~ ~'
., ~/~: /dc/
State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumberl~u~flder.
...... . z7 .............................................................................
xan~e or o~,er or p~e~ises .... ~ x.?.,q.q4 .... .X_.~ .~..<~. ............................................
(as on the tax roll or latest deed
If applicant is a corporation, signature of duly authorized officer.
(Name and title of corporate officer)
Builder's License No ..........................
Plumber's License No .........................
Electrician's License No.. :~?.E..~.~ .............
', Other Trade's License No .......... :-. ..........
House Number Street
County Tax Map No. 1000 Section .... ./. q.'+7 .....
Hamlet
. B~ock .... /. ............ Lot .... ~ ...........
Subdivision../?./.d:.#.~.t~.xg./?... ~ .~.'..~..~.'~ ........ Filed Map No...~./7'.~.C~7 ..... Lot ..... ,.5.~ .......
(Name)
State existing use and occupancy of premises and intended use and occupancy of proposed construction
~. Existing use and occupancy ...............................................
· Intended use and occupancy . .~..W~.../.D.~.~...~../.../.5/...~...
Y3.
4.
5.
6.
7.
lO.
11.
12.
13.
14.
property hnes. Give street and block number or description according to
interior or corner lot.
i '/; !' :.~'~,."~, . f',, ~.,..?3 ! .... . ..
Nature of wor~'~,~app!lcable): New Building .......... Addmon .......... Alteration,,~ .........
Rep~ ...... .... ~l[.~mov~. .......... Demolition · .. O~er wor~.. · - z.~dd~._ .... . ...
st ated cost ....... .............. . . , .... ....................................
~ ~ ~' (to be p~d on filing this application)
If dwolgng, number of dwe~g 'nits Number of dwelling units on each floor
If g~age, number of c~s ..... J. ............................................................. .
If business', commercial or mixedj ~c~upancy, specify nature ~d extent of each type of u~ ...............
D~nsions of existing st~etures, ~f any: Front ............... Rear .............. Depth .........
H~i~t .. .............. Number of St~nas.. .................................................
D~ensxons elsie stmcturo wi~ ~tera~ons or additions: Front ................. Re~ ............
Dop~ ......... . ....... ~ . ~ei~t ..... ~ z . . Number 0f Stories ..... .~_. .........
Dimen~ons of entir~ n~w const~txo~~.~ · · · ~ ....... : .......~e"~ · · r .......
H~i~t . ........... Number of Stories ..................................................
Siz~ of lot: Front .... '. ~ ....... Re~ ...... ~ ...... De . .
Date of Purchase . ,' ..... N~e of Fo~er Owner
Zone or uso d~rict in which pr~misos ~e si~ated ....................... ~ .....................
Do~s proposod const~ction violate any zoning law, ordinance or re~lation: ........................
Will lot be regraded ............................. Will excess fill be removed from promises: Yes b
N~e of ~chitect ...~ ...... ~ ........~... ~ .... Address ................... gnon~ ~o.
r~ /~/~ ~o~ . .~Z/..~ .~.~'~...PhoneNo. ~' ~r~ '
N~e of Contractor ~. · · ~., .............. Address ~oc~ ~ ~o r~ .............
P~T DIAG~
Loeato clo~ly ~d dis~ctly ~ bufld~, wh~er ~xist~g or proposed ~d, indicate. ~1 ~t-back ~mions fro
dooff, ~d ~ow stroet n~os ~d indicate who~
STATE OF NEW YORK ~
' S.S
COUNTY OF.. ..... '.
' ,e_~,/.?, ,T-~D, ~ ,~, ,~. ,~ being duly sworn deposes and says that he is the applica '
(Name of individual signing contract)
above named.
He is the ......... .~./..~_~...7;.
(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 ti:
application; that all statements cbntained in this application are true to the best of his knowledge and belief; and that t
work will be performed in the manner set forth in the application filed therewith.
Sworn to before me this i ' .
Notary
~....; .,.' .... County
Public, ......... ~,,.~ .......... ~"*'?',~ .," '~¢~ :~'~I
'~ I~ Pubti~, ~tate of New yom ~
. '- - ~ N~ ~2-4526433 tq
~ '~tif~ n Sufto klCqUn~ /_ ~
re of applicm
f' ~ /'*~ BLOCK
8' ~ /~BLOCW, ~l~S 3 STE S
~ T' ' co.c ..... : , ,
I
: ~,~:'., OPTIONAL STEP :
m FIBERG~S B~C B~D'
i~ TROWELEO ON EACH FAC:
, ~ ~ ~ OF CONCRETE BLOCK WA~.,
T PE
O PTI ONA L STEP .o~[~.~ To e~ ~.- .o. s~,o ~.~. ~o.~o ~
POOL
AWAY FROM ROL~D FOAM
~tT~ P[ I~ WATER~, OlS~SAL SHALL BE LIMITED TO OWNER'S
..... ~- PROPERTY TO. SUIT LOCAL REGULATION~ B~EEN
SEE TYPICAL end'BLOC
WALL SECTION
2% 4"SAND BOSOM
2: 4' SAND ~"" u
RETURNS~
SECTION B-B ,2- FooTPOUREDIN G CONCRETE
"- PICAL WALL SECTION~
SKIMMERS
SECTION '~ 'A-A:! ~TOFILTER
I
SIZE: A B C O E F O ~ CA~.
FEET FT. I~ FT. rE rt. rE Irt $~J~
16'x ~2' 16 ~2 8 8 12 4 4 51~ I~
16' x 36' 16 56 12 8 12 4 4 576
lSKIMMERS
LTERond PUMP
TO RETURNS
FROM FI L'I'ER t
$1DF OR END
.P. :~/6'o0 ~' G.
Y: V. CL,
G DEPARTMENT AT
TO 4 PM FOP, TH!
~'ECTIONS: ,
- TWO REQUIREC
CONCRETE
'~ I N.":- :~., PLUMBING
iSTRU .TI')N MUST
FOR C.O.
ION SHALL MEET
qTS OF THE N,Y,
CTION & ENERGY
RESPONSIBLE FOR
TRUCTION ERROR5,
OR
;t iFiC TE
eCY
HEALTH DEPARTMENT-DATA FOR APPROVAL TO CONSTRUCT
ADO~LSS
SURVEY FOR
MARC H. LEVEY I~ BEVERLY LEVEY
LOT 5, "HIGHLAND ESTATES"
AT CUTCHOGUE
TOWN OF SOUTHOLD
SUFFOLK COUNTY, NEW YORK
DATE dULY 17,1981
SCALE I"=
. NO 81- 412
GUARANTEED TO:
~OUTHOLD SAVINGS BANK
EQUITY ABSTRACT, INC.
MARC H. LEVEY 8 BEVERLY LEVEY
]ri J_ 1 YOUNG e, YOUNG
.~I~IVFRHEA°) NEW YORK