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HomeMy WebLinkAbout14703-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. Certificate Of Occupancy THIS CERTIFIES that the building Add swimming pool Location of Pro-err 9 1 5 LAKESIDE DRIVE SOUTHOLD House No. Street .... ~d~ie~ County Tax Map No. 1000 Section ...0..99 ...... Block 04 .Lot 6 Subdivision ............................... Filed Map No ......... Lot No .............. conforms substantially to the Application for Building Permit heretofore f'ded in this office dated March 20~ 1986 pursuant to which Building Permit No. 14703. Z dated .. ~ .a.r.c.h...2.6 .... ! .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 ......... Enclosed swimming pool addition to existing one family dwelling. The certificate is issued to . .,H~,~bl. & ERNE ST SCHNEIDER .............. x .................... of the aforesaid building. Suffolk County Department of Health Approval ......... N. [ .A .............................. UNDERWRITERS CERTIFICATE NO ................. t~ 7 8.4.8 5 0 ......................... N/A PLUMBERS CERTIFICATION DATED: Rev. 1/81 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N. Y. BUILDING PER~IT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) 14703 Z Permission is hereby granted to: ....... ................ .z~......~i~.~ ~~.. ~~.~..~.+,...s...~ ......... ;.~.z..~ ,o ~~...~...~.~.....~ ~:~...~.~ ~ ~'~. _ ~~~ ~ ~ ~ ..%' .............. ..f..O ~.~ ~ ~~ J ~~ ~ ~J ~ .............. ~ ................ ~"'""~'L"'-I ....................... I' ~"'~'=-'"~h ~.~... ~ x-.~ ....... ~ o~i~, ~t~d ~, ...~.....~....~~ ........ ~~~ ............................ County Tax Map No. 1000 Section ...... .~....1~..~., ....... Block ..... ..C~....~.. ......... Lot No ..... ~ ................ pursuant to application dated ........ ...~..~g~......~..J. ................. , 19.~..~.., and approved by the Building Inspector. Building Inspector Rev. 6/30/80 FORM NO. 6 TOWN OF $OUTHOLD Building Department Town Hall Southold, N.Y. 11971 r765- 1802 APPLICATION FOR CERTIFICATE OF OCCUPANCY Instructions This application must be filled in typewriter OR ink, and submitted i ~ 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. 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 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 . .?/. ,~,. g .~, ,A"'~',~,/,.~,,~..,.~,~.., ,~.,, ....... j,Z~, ,g. ,7'/.),~,~,Z, ..................... House No. Street Ham/et Owner or Owners of Property ~,.&J ~...~.~4~/.~.,5 ?- ~'~/-/xv&[: x',o~5~,_ County Tax Map No. 1000 Section ............... Block ............... Lot ................ Subdivision ................................. Filed Map No ........... Lot No .............. Permit No. /..~. Y?.~, ~ Date of Permit~./-8..(,/~...Applicant .................................. Health Dept. Approval ........................ Labor Dept. Approval ........................ Underwriters Approval ........................ Planning Board Approval ...................... Request for Temporary Certificate ..................... Final Certificate ....................... Fee Submitted $ ............................. Construction on above described bui)ding and permit meets all applicable codes and regulations. App cant .............. ~ ....................... Rev. 10-10-78 ~.6. '2_ IS-I [o~o7o~ THE NEW YORK BOARD OF FIRE UNDERWRITERS BUREAU OF ELECTRICITY S~neider, 915 L~o Side Drive~ ~utl~)ld, N~Y X FIXTURE SWITCHES OUTLETS ll FIXTURES RANGES OVENS 21 Lot EXHAUST FANS DRYERS MULTI.OUTLET SYSTEMS NO. OF FEET pa~lL~rds: l~.Bcir, lO0~rps ~-GoF. C.I. E R V - I C E ~b~i~_~mi~_l~). Tl~s certificate covers ~plia~e ~ the date of i,~ction only. ~c~e of ~1 env~s it is ~sablo to have f~lu~t t~t/%md or ~pai~ m~e by a qualified pe~n. Sal Prato Elc~trician Wlggio3 I.ane Greenport, N.Y. 1[944 Lie. 1049E this certificate must not be altered jn any manner; return to the office of the Board if incorrect. GENERAL MANAGER be identified their credentials. COPY FOR BUI~-OIHG DEPARTMENT. THIS copY OF Cl~RTIFIC~'r~ MUST ~OT BE. ALTFRED IN ANY MANNER. FIELD INSFECTION FOUNDATION ) FOUNDATION (2nd) o ROUGH FRAME & PLUMBING INSULATION PER N. Y. STATE ENERGY CODE C OMMEN TS ADDITIONAL COMMENTS: 7GS-1802 BUILDING DEPT. INSPECTION FOUNDATION 1ST [ ] ROUGH PLBG, FOUNDATION 2ND [ ] INSULATION FRAMING [ ] FINAL REMARKS: .... ~) '~ DATE ///~//op/ INSPECTOR 765-1802 BUILDING DEPT. INSPECTION FOUNDATION 1ST [ ~ROUGH PLBG. /]~0/UNDATION 2ND [ ] INSULATION [~FRAMING [ ] FINAL DATE I .SPECTOR/~'~ 765-1802 BUILDING DEPT. ~~~o.~INSPECTION DATION ~ST [ ] ROUGH PLBG. NDATION 2ND [ ] INSULATION [ ] FRAMING REMARKS: [ ] FINAL DATE ~'~/~/'~ INSPEC'rOR '~~ FOILM~ NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE $OUTHOLD, N. Y. Disapproved a/c ............................................................................................ (Building Inspector) Application No ................................. APPLICATION FOR BUILDING PERMIT Dote tvt ,~ ['~,j,~ ~,CD 19...~..~.... INST~,UCTIONS a. This application must be completely filled in by typewriter o~ in ink and submitted in triplicate to the Building Inspector, with 3 sate 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 m 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 avai able 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 ir~ buildings for necessary inspections. ........ .... ......................... --. ~:2::l~~d~s of applicgnt) _ State whether appJlcant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. ........ ........ : ...................................... Name of owner of premises ...l~l~...~..l~J~.~.....~.~lg~..~.....~..~.t~l.t~.J.%J~ ...... '~c~it~ant is ~°rlate~'~u ~- ~ ~..~ ~,~n~a~re of duly authorized officer. ...~ ........................................................ h.~..~.. ................. (Name and title of corporate officer) Builder's License No ..................................................... Plumber's License No ................................................. Electrician's License No ............................................. Other Trade's License No ............................................... 1. Location of land on which proposed~work w be done. Map No ........... Lot No Street and Number .~../'..~.~ ~..~ Z~ ........................ i ......... Municipality State existing use and occupancy of premises and intended use and occupancy of proposed construction: a: Exisiting use and occupancy ...... ~.,~..~..J ..C?.~. .' b. Intended use and occupancy ....... .[~.,~'-~.l..~.JP~h.)'~.J~h..L~.......~.~ .I.I~.~...L~.......~....~....I~.. 3. JNoture of work (check which applicable): New Building'. ................. Addition ......'~. ....... Alteration ................ Repair .................. Removal .................. Demolition .................... Other Work ..................................................... 4. Estimated Cost ..... ~.~.~.~]7.~2.. ................................. Fee ............................................ ~...~L.~ ......... (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 ~pe of use ............................ H~i~ht .................... Number o~ Storie~ .......... ~. ..................................................................................... ~ ......... 1 ]. Zone or us~ district in ~hich premises ~re situated 12, Does proposed construction violate ~ny zonin~ Name of Contractor ............................................................ Address ................................ Phone No ....................... PLOZ DIAGRAM Locate clearly and distinctly all buildings, whether existing or proposed, and indicate all set-~ck dimensions from property lines. Give street and block number or description according to deed, and show street names and indicate whether interior or corner lot ...... ~q .... ' ..... ~,' ', ~ ~1 ~ II . /RAP 0p STATE OF NEW YORK, . lc S COUNTY OF ................ ; ............... ~' ............ .~.(~...~.~.~ .................................. being duly sworn, ~eposes and says that he is the applicam (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 b~ performed in the manner set fo~h in the application filed therewith. Mot~ Public, . ............. ~ ............... Coun~ ... ................. - ~ ~,~ ~.. APPROVED AS NOTED 7 765-1802 9 AM TO 4 PM~ FOR THE FOLLOWING INSPECTIONS: I. FOUNDATION - ~O REQUIRED FORPOUR~D CONCR~E 2. ROUGH - FRAMING & PLUMBING 3. INSU~TION 4. FINAL - CONSTRUCTION MUST BE COMPLETE FOR C.O. ALL CONSTRUCT[ON' SHALL ME~ THE REQUIREMENT~ OF THE STATE CON~RUCTION & ENER6Y CODES, NOT R[SPONSIBLE FOR P'L H · -r 1- -7 T.) I L ~. C) .: d P LC:C;~ P'LAh"t -"2L 0tI O. H G, pLUl'd DIH© JJ PLoC2~ / ', / \ P_-.L ~VATIOH I ,i _~E::CTtOH . '-_, '! U. J , ZILO~! PIJ, IMBER CERTiFiC~ TIO ~i ' c..~snF~c4rE OF occu~,~,vcr SOLDER USED IN WATER EXCEED 2/'10 of I9~ lEAD. NOTIFY BUILDING DEPARTMENT AT q6B. l~O2 9 AM TO 4 PM ~R THE FOL -OWING IN~PEC,TIONS: . ~ ~U;~A~ION ~O REQUIRED' ~R ~)[~H~O CONCRETE ~ ~O(Jr~ ~'~AI,~rNG & PLUMBING ALL OO~ST~CT~ON ~ M~ ~ REQUIP~M~NTS OF ~E ~. NOT ~ ~ OCCUPANCY OR USE IS UNLAWFUL WITHOUT CERTIFICATE OF OCCUPANCY I I F I, ,2×8:, ~A~r4A ,I, .; 7 J "J."