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HomeMy WebLinkAbout15025-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. Certificate Of Occupancy Z-15366 March 18, 1987 No .................. Date ................................ · INGROUND POOL & PENCE THIS CERTIFIES that the building ................................................ 2540 Bridge Lane Cutchogue, New Yo~k Location of Property ...................................................... Hous~ No. Str~r .... h~/e~ County Tax Map No. 1000 Section . 085 .Block 02 ...... Lot 23 Subdivision ............................... Filed Map No ......... Lot No .............. conforms substantially to the Application for Building Permit heretofore fried in this office dated J u n e 1 6, 1 9 8 6 pursuant to which Building Permit No. 1 5 0 1 5 Z June 26, 1986 dated .............................. 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 The certificate is issued to STEPHEN & BEVERLY SPIELMAN ..................... ..................... of the aforesaid building. Suffolk County Department of Health Approval ........ N / A UNDERWRITERS CERTIFICATE NO. N 7 6 1 8 5 2 N/A PLUMBERS CERTIFICATION DATED: Building Inspector Rev. 1/81 zroR~r NO. ~ TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N. Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) No. ~5025 Z Dote / Permission is hereby gronted to: ...,~...~..* .~..**;i';2~.,.....,t....~.~... ...~.~.~...~......~..-..~.~ ..... .~, . ,o at prem,ses Iocoted at ...~.. ............................................................................. County -re× Mop So. ~000 Se~t~o~, ....... .0...~...~...... ~o~k ...... .~.~. ...... Lot No....&..~ ............. Oursuont to opplicotion dotc~:t .... ...~.~...~...~. ..................... , 19.~..~.., end oppro¥od by the ! Building Inspector. Fee $ ........................ Rev. 6/30/80 FORM NO. 6 TOWN OF SOUTHOLD Building Department Tow..a, Southold, N.Y. 11971 765- 1802 APPLICATION FOR CERTIFICATE OF OCCUPANCY~ Instructions This application must be filled in typewriter OR ink, and submitted ~a~ to the Building Inspec- tor with the following; for new buildings or new use: I. 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 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. Fees: 1. Certificate of occupancy $5.00 2. Certificate of occupancy on pre-existing dwelling 3. Copy of certificate of occupancy $1.00 4.Vacant Land C.O. $5.00 5. updated C.O. $15o00 Date ................ New Cons tz~t~c t;ion ...... Old or Pre-existing Building ............ Vacant Land ............. Location of Property.. ¢~.~.~.~..~.'..~ ~ ~-_~ .~.~.~ .~ Hamlet House No. Street Owner or Owners of Property '''S'~"~'"'~"~'~'~""~)'~''~''~"~O_ ....................... -~2, County Tax Map No. 1000 Section .... O..~*. ...... Block....~..~-. ........ Lot.. ~.~. ........ ...I B .' .2 .......... Subdivision ...... .~,.. q.~.~('~.'.Zt .......... Filed Map .o... ~...~.-..Lot .o. Health Dept. Approval ....................... Labor Dept. Approval ........................ Request for Temporary Certificate ..................... Final Certificate ....................... Fee Submitted $. '.'~.. ~-~ ...................... THE NEW YORK BOARD OF FIRE UNDERWRITERS 1000218 BUREAU OF ELECTRICITY J~JT 8S JOHN STREET, NEW YORK, NEW YORK 10038 D. te Jt~ly 31~ 1986 414266/86 'pp'ica,'a. No. a. N7GI852 THIS CERTIFIES THAT only the electrical equipment as described below and introduced by the applicant named on the above application nu tuber in the premises of S~ielman, 2540 Bridge La~e, C~tcho~ue,N.Y in the followi~g location; [] Base:nent ~t~s examined on Jl/ly 28, 1986 FIXTURE OUTLETS ~ECEPTACtES SWITCHES [] Ist FI. ~ 2nd ~7. outside Sectian Block and found to be in compliance with the require.tent,~ o,f th s Board FIXTURES RANGES :OOKING DECK OVENS FLUORESCENT Lot DRYERS FURNACE h FUTURE APPLIANCE FEEDERS TIME CLOCKS MULTI-OUTLET DIMMERS SYSTEMS NO. OF FEET SERVICE DISCONNECT S E R V I C z. !Swimming 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 q~alified person. Raynor Electric 11 ~urleigh Drive I{olbrook,N.y. 11741 /%~M~AZ MA~A~E~ Thi~ certificate mu~t no~ be altered in ~ny mo~ner; return fo ~he office o~ fhe Board i( incorrect Inspedors m~F be identified by fheir credentials, COPY FOR BUILDING DEPARTM~'NT. THIS COPY OF CERTIFICATE MUST NOT BE ALTERED IN ANY ~NNER. FIELD INSFECTION FOUNDATION (1st} COMi~JTS FOUNDATION (2nd) ROUGH FRAME & PLUMBING INSULATION PER N. Y. STATE ENERGY CODE FINAL ADDITIONAL COMMENTS: 765-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] INSULATION [ ] FRAMING ~ ~ ] FINAL REMARKS: / DATE FO]I~M ~qO. 1 TOWN O~ $OUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. ~" .................. ~ .~, . , 19.~...~.. Permit No ..................................... / ~)~ ~' Approved Disapproved a/c ............................................................................................ (Building Inspector) ..~., ~W~ ~'~ ~ ~ APPLICATION FOR BUILDING PERMIT Date ........................................ , 19 ............ INSTRUCTIONS a. This application must be completely filled in by typewriter o~ in ink and submitted in triplicate 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 o~ areas, and giving a detailed description of layout ofproperty must be drawn on the diagram which is part of this application. 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 issue 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 hove been granted by the Building Inspector. APPLICATION IS HEREBY MADE to the Building Department for the issuance of o 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 a~terations, or for removal or demolition, as herein described. The appiicant agrees to comply with all applicable laws, ordinances, building code, housing code, and regulations, and to admit authorized inspectors on premises and in buildings for necessar,~/~spections. ae. 4GSae3S '~ ~'~ State whet~¢'~¢~~ssee, agent, architect, eng near, ~~d~'>[ectr c an, plumber or builder. Name of owner of premises ................. ~ ................................ ~ ........ t~ ......................... If applicant is a car e, signature of duly authorized officer. ........................... ........................................... (Name and tire of corporate ofhcer) . Builder's License No .... ~..0. ~.~ ..... /~ Plumber's License No ................................................. Electrician's License No ............................................. Other Trode's License No ............................................... 1. Location of land on which proposed work will be done. Map No.: .....~..~_.:....~....~...'~...~ ........Lot No Street and Number .~....~......~..~....~...~..~..~.~.,.,~....~.." .-. ~ (<~..7~'..~/~.o..~. ~ .................... i .... ...................... ....... 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: b.a' Intended use and occupancyEXisiting use and occupancy ............................................................................................................................Z~ ?..~ ' '~ . .~.......0~. ~i ...... ...... ......... ..................... 3. JXlatu~e' o.f',~ofk"~(]qh,e, ck, w,M,cJ;1 app cable) New Building.. ................. Addition .............. ~. A~ferohon ..~ .............. ~,~i'F' 'Z'.'.'::.!:.:..:....~,.~Removal., ................. Demolitior, .................... Other Work .¢....~.~./4../.x..~...~.~./.~t~'.. f t ! [ ~;.'".. ~ ' (Description) 4. , !i .~ .c~.~ ........................... Fee ............ ~..~...~ ................. : ......................... J ................ ' (fo be paid on filing this application) 5. If dwe lng, nu'~l~r ~)f dwelling units ...~ .................... Number of ~dweIling 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 ............................ Rear ................................ Depth .................... Height ........................ Number of Stories ....................................................................................... Dimensions of same structure with alterations or additions: Front ....................................Rear ............................ Depth ................................ H~ight ............................ Number' of Stories ................................ 8. Dimensions of entire new construction: Front .................................... Rear ............................ 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 ..................................................................................................... 12. Does proposed construction violate any zoning law, ordinance or regulation: ........................................................ 13. Will lot be regraded' . .............. i ............ Will excess fill be removed from premises: ( ) Yes ( ) No 1 4. Name of Owner of premls~t~u:~/l='Tf.~. .~ilr,~lb',~..~.lD&i,.~l,J.. Addr ...,~.~......~... Phone No ....................... Name of Architect ................ ! .............................................. Address ................................ Phone No ....................... Nome of ContractO'~,~.i..l~¥~,~....~ ............... Addre~(~.~..~Hi.'lH'q~U,~.... Phone PLOT DIAGRAM Locate clearly and distinctly all buildings, whether existing or proposed, and indicate all set-back dimensions frorn property lines. Give street and blo~k number or description according to deed, and show street names and indicate whether interior or corner (NTAJPANCY OR USE I$ UNLAWFUL WffH01 CERIIRCATE DATE: FEE: ......... BY: ........ 'NOTIFY BUILDING OEPAFITMF:~T AT 766-1802 9 AM TO 4 PM FOR THE FOLLOWING INSPECTIONS: 1 FOUN~A''rlDN TWO REQUIRED ALi CONSTRUCTIOFI SHALL ME~ THE REQUIREMEN~S OF THE N.Y ~ATE C'ONSTRU~ION & EN~GY CODES, NOT RESPONSIBLE FOR STATE OF NEW YORK, I'c'c r~ESIGN OR C~NSTRUCTION ERRORS. COUNTY©F~_~ .....................// ."' ~ , ~ 'x~ ........ ~"'~ , - ' ........... /u [N~e of in~'ividual'~ ~i~i~g ~on¢rac~) ~ ' ' ~' ' abow~ na~ed. He is the ~ ......... : .................................................................................................................................. ~ [, (Contractor, agent, corporate officer, etc.) of said owner or owners, and is dqly authorized to perform or have performed the said work and to make and file this application; that ali statemeDfs cgntained in this application are t~ue to the best of his knowledge and belief; and tha~ the work will be perform~d'in'th~ manner set fodh in the a~plicatioh'..{iled therewith. Swo~efore::..~ ~.. t:~ ~~ ......... 19~ ~ 4 ........ ..... y ....................... ,., NAHCY ANNE LU~ Nota~ PuC'lc, State of ~