HomeMy WebLinkAbout15018-zFORM NO. 4
TOWN OF $OUTHOLD
BUILDING DEPARTMENT
Office of the Building Inspector
Town Hall
Southold, N.Y.
Certificate O[ Occupancy
No. Z- 16527 Date December 22, 1987
THIS CERTIFIES that the building . .C.o.n.s..t.r.u.c.t.. Inground Swimming Pool & fence
Location of Property .... 4.9..5. Eugenes Road Cutchogue, New York
Houso No. ' ................ 'S't/e~i .................. h;d~iol
County Tax Map No. 1000 Section 97 .Block 2 ..... Lot I 6.3
Subdivision ............................... Filed Map No ......... Lot No ..............
conforms substantially to the Application for Building Permit heretofore filed in this office dated
June 13, 1986 15018 Z
....................... pursuant to which Building Permit No ......................
dated ...J.u.n..e..2.4. ,...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 SWIMMING POOL & FENCE
The certificate is issued to FREDERIC B. & NANCY F. ENDEMANN
..................... ? oYn' ;, 'lt i,V 'Z; × ....................
of the aforesaid building.
Suffolk County Department of Health Approval N/A
UNDERWRITERS CERTIFICATE NO... N 775014
PLUMBERS CERTIFICATION DATED: N/A
....... q~'~' 'l~ilding In~ic't;~ .............
Rev. 1/81
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN HALL
SOUTHOLD, N. Y.
N?
BUILDIHG PER~?,IT
(THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL
COMPLETION OF THE WORK AUTHORIZED)
Date --~- ~ 4-
1501~ Z ...Zu..~.t,~ ................................. , ~.~
Permission is hereby granted to:
......
~a ........ . .C.~..~.,.5~.~..[L~..~...... ,t ~.C,,~.~..~ .T~ ....... .~.UV~./~.~ ~.~,~.~.~ ~..~---...
......... ~.';[Z~ ................ '~..~_/,x..-~. ~....~.... ~. Z:~.~ .C.v:.~......~.':D:~.. i.~ ~.(~ ./;::..~.
ot premises located o, ....... ...~. ,.'~, ....... ,~.(.~.C'~:::~./T~..I..'....~.......,.L~.. 0~,~'~, .....................
.................................................................................................... .................
County Tax Map No, ]000 Section ...~...9..,,,~-.... Block .... ,(~...~,, ...... Lot No...,~).~.!-(~,.,"..,~,, ......
pursuant tO application dated ...~[.~..~.L~ ....... I...~. .................... , 19.~ and approved by the
Building Inspector.
Fee $...~---~...'.~......~...'~.~.
=bilding Inspector
Rev. 6/30/80
FORM NO. 6
TOWN OF $OUTHOLD
Building Department
Town Hall
Southold, N.Y. 11971
765 - 1802
APPLICATION FOR CERTIFICATE OF OCCUPANC'
Instructions
This application must be filled in typewriter OR ink, and submitted m ammmmma 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 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. ~
C. Fees: Additions $25.00
1. Certificate of occupancy New Dwelling $25.00, Business $50.00
2. Certificate of occupanc,y, 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 .... ~O.~,..l.-?~.(.~.?.7. ....
NewCons truction Old or Pre-existing Building
Location of Property ....~...
/louse No. Street
Owner or Owners of Property ...... ~../~...~. ....
County Tax Map No. 1000 Section .... .~ .'7 ....
.... Vacant Land .............
......... ......
Natant
... Block ..... ........ Lot.../~. .......
Subdivision ................................. Filed Map No ........... Lot No ..............
Permit No./.~'.O, .l~..~.. Date of Permit &¥~'.../~.~.~..Applicant ...hJ.q~ ."1.. P,~.4t~.~... ~9.°.t-/', .........
Health Dept. Approval ........................ Labor Dept. Approval ........................
Underwriters Approval ........................ Planning Board Approval ......................
Request for Temporary Certificate ..................... Final Certificate .......................
35. ou
Fee Submitted $ ........... . ..................
Construction on above described building and permit meets all applicable codes and regulations.
Applicant ....... y~. ~... ~ ................
Rev. 10-10-78
76,5-t802
BUILDING DEPT.
INSPECTION
[ ] FOUNDATION 1ST [ ] ROUGH PLBG.
FOUNDATION 2ND [ ] INSULATION
FRAMING [~FINAL
REMARKS:
DATE ///~/////~7
THE NEW ,YORK BOARD OF FIRE UNDERWRITERS
~L201381 I t3UREAU OF ELECTRICITY
I ~,5 JOHN STREET. NEW YORK, NEW YORK 10038
D.,. October 17~ 1986 .4ppi,,'a,ionNo. o.f,t,~ 416152/86 N775014
THIS CERTIFIES THAT / '
Frederic Ende~ann, 495 Eugenes Road, C~tchog~e, N.Y
in ~h. follo~n~ h,c.~ion: ~ Ba.,e,nent ~ Is~ ?'l. ~ ~nd FI. outside Section Bilk ~t
EIXTURE I T~
OUTLETS ECEP CLE$
1
DRYERS
SWITCHES
2
FIXTURES RANGES OVENS DISH WASHERS
SYSTEMS
NO. OF FEET
E
OF CC COND
OTHER APPARATUS:
1-G.F.C.I.
(Swirmning Pool) This certificate covers compliance at the date of inspection only.
Because of unusual environments it is advisable to have frequent test and/or repairs
made by a qualified person.
Jody Pumillo
Pat Lane
Mattituck, N.Y 11952
GENERAL MANAGER
L±C#2300E
ll
This certificate must not be aJtered in any manner; return to the office of the Board if incorrect. Inspectors may be identified by their credentials.
FIELD INSP~CTIO~ !DATE COMMENTS
FOUNDATION (1sC)
FOUNDATION (2nd)
ROUGH FRAME &
PLUMBING
3.
INSULATION PER N. Y.
STATE ENERGY
ADDITIONAL COMMENTS
TOWN OF SOUTHOLD
OFFICE OF BUILDING INSPECTOR
P.O. BOX 798
TOWN HALL
SOUTHOLD, N.Y. 11971
DATE: October 6 1987
TEL. 765-1802
Applicant: Edward & Nancy Endemann
495 Euqenes Road
Cutchoque, N. Y. 11935
Dear: Mr. & Mrs. Endemann
While reviewing our files I find that your expired
permit 15018Z has never been finalized. Kindly return
the enclosed application with a check for $25.0~ Also,
please call and arrange for a final inspection so that
we may issue a Certificate of Occupancy on the above
property and complete this outstanding file.
Yours truly,
Victor Lessard
Executive-Administrator
TOWN OF SOUTHOLD
OFFICE OF BUILDING INSPECTOR
P.O. BOX 728
TOWN HALL
SOUTHOLD, N.Y. ~ 197!
TEL. 765-1802
To Whom This May Concern,
We are unable to complete your Certificate
of Occupancy because .of the following reasons.
/5/ An application for Certificate of Occupancy
is not on file.
~ -No Underwriters Certificate on file.
/5/ The check is(outdated/not on file.)
/5/ No Health Dept. Approval on file.
No final inspection has'been made.
Please contact our office on this matter.
Thank you for your cooperation.
Building Permit # / ~ ~ / _~ Z
Building Dept.
***/5/ No Plumber Solder Certificate on file.
all permits involving plumbing being
issued after April 1,1984 )
· ~-~ MONUMENt
YOUNG.& YOUNG
40~ OSTRANDER AVENUE, RIVERHE,~D, NEW YORK
SURVEY FOR: : ~
FREDERIC~ ~
~ow~ ov SOUTHO~ ~r~
SUFFOLK CO.. N.Y..': - ~' ~, ~
FORM NO. 1
TOWN OF SOUTHOLD
BUiLDiNG DEPARTMENT
TOWN HALL
[OUTHOLD, N.Y. 11971
TEL.: 765-1803
, .(~ DEPT.
't'OV~q~ OF '.50UTHOLD
Examined~.~,~, Z~...., 19~
Disapproved a/c .... ~'i...-~¥. ·..~. · · · ...........
· · (Building Inspector)
APPLICATION FOR BUILDING PERMIT
_ /
,Date ....~.../[.~ .......
/
INSTRUCTIONS
Received ........... ,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 thc Town of Southold, Sltffolk 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 in{!hections. ,-
· . .... //. :..~.F../4¢..~. ~....3.~..,'¢..x..,,..~...0....
(Signature of applicant, or name, if a corporation)
... 3.0..a.. ff.3.?,r. .~.~.E.../~c. ~.~.y. .....
.... ~ili~tg address of applicant)
State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder.
..G'..A~.~..~'~.. ~o.~. ~/-_¢/~.'.:vo.~ .............................................
Name of owner of premises ....h~../4J~ .~.0...~.,..~r~.~..G.~. .... ~/~..~...~r~ ~.~..~. .........................
(as on the tax roll or latest deed)
If a~pt~zant is a corporatiql~, si, gn~ature 9f duly authorized officer.
.........
Builder's License No ....... /. 0 ................
Plumber's License No .........................
Electrician's License No. ~ .olgkgg/a)....~.~ ~
Other Trade's License No ......................
I. Location of land on which proposed work will be done .... ~...-q~Z,-O:t).t;~. .... ./~../~t4~' .t .... .~. k~.77-..~./~.0. ------------------¢~d~. ~ ~
qqs' ~.~.cx~.~. .eo~.~.. C..~.T.c.z.¥o. ~. ~..~. ..........
House Number Street Hamlet
County Tax Map No. 1000 Section ....... .~., ./.~' ...... Block ~-- Lot..
I~,.5
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 ........ fi-..~.,.,.,.J, ( ?...~. ?-..t.~. ~ .... ~..~1~..~.----/'q,~.~.~.ur~. ..................
b. Intended use and occupancy ~q~. · ~. ~g.//~ Z4ff77./. ~. ~-. · &~
3. Nature of work (check which aPPlicable): New Building .......... Addition .......... Alteration ..........
'rl~lDl,.~... ~:~ ~]j.~Rem6val ........ Demolition ............. Other Work ...............
Repro ' ' :' ..... ~ ...... (Description)
4.i stimatedCost .... ....................... Fee
(to be paid on filing this application)
5. If dwelling, number of dweiling units ............... Number of dwelling units on each floor ................
If garage, number of cars ..... ~ ...................................................................
6. If business, commercial or mixe~ occupancy, specify nature and extant of each type of use .....................
7. r)imensions 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 ......................
8. Dimensions of entire new constrUction: Front ............... Rear ............... Depth ...............
Height ............... Nun~ber of Stones .............
9. Size of lot: Front .......... I ........... Rear ...................... Depth ......................
10. Date of Purchase .......... 2 .................. Name of Former Owner .............................
11. Zone or use &strict ~n which prCrmses are s tuated ................ ............. .~j~ ....................
12. Does proposed construction violate any zoning law, ordinance or regulation: ........ rr.r .................
13. Will lot be regraded ..... AA).. ................... Will excess fill be removed from premises: Yes
14. Name of Owner of premises~.AJ~...~)/~P//~.. · Address/~ .~)r~ ...... Phone No ................
Name :of Architect .......... i_ ............. Address ................... Phone No ....... .......
Name of Contractor .~.;/~.&?A ..~' .~. ~. .......
15. Is this property locatediwithinli00 feet of a tidal wetland? * Yes ..... No .~..
· If yes, Southold Town Tr6stees Permit may be required.
i PLOT DIAGRAM
Locate clearly and distinctly eli buildings, whether existing or proposed, and, indicate all set-back dimensions from
number or description according to deed, and show street names and indicate whether
property lines. Give street and bloct
interior or corner lot.
STATE OF NEW YORK, i S.S
COUNTY OF ........... . ..... ~
....... ; ................... ................. : .... being duly swc~rn, 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 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 manner set forth in the application file~l therewith.
Sworn to before me this
19~
.............. p/~ ....... day!of ...... ~ ..... ,
Notary Public,. .... ~ .'..~.-...~...~...~//.~.. ~2~t..y '~ (~' fi/~ ~0 / '
HFI~N K. ~ W)[ ..................
I~..t~/~l~St/C ~teot ~ ' 'ff' ~ ;-' '" "~-~' "~' re of applieant~
Ter~.~7.,OZS_;7.8., Sqifolk Co~l~tyy~ ~ /' '-~e'