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Home My WebLink About14717-zFORM NO. 4 TOWN OF 5OUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. Certificate Of Occupancy Z14804 D August 14 19 86 No ......... -.- ........ ate ................................ ,... THIS CERTIFIES b ildi Pool and fence. . that tbe u ng ................................................. · 535 L'UPTON PT. RD.' M~TTITUCK Location of Property ..... : ......................................................... House/ye. Street Hamle~ Tax Map No 1000 Section 115 Block 11 Lot .2 ' County ........................................... . Subdivision ............................... Filed Map No ......... Lot No .............. conforms substantially to the Application for Building Permit heretofore filed in this office dated ......... ~.a.r.c.h...2.6 .... 19..8.6pursuant to which Building Permit No. 147177, dated .... ~9.r.ch....................31 19 .. .8,6was issued, and conforms to all of the requirements of the applicable provisions et' the law. The occupancy for which tlfis certificate is issued is ......... Inground pool and fence. The certificate is issued to . Henry J. Loeffler [owner, of the aforesaid building. Suffolk County Department of Health Approval ....... ~/.A. .............................. .. UNDERWRrFERS CERTIFICATE NO #N750928 Rev. 1/81 FOEM NO. ~ TO~N OF $OUT~OLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N. Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) N.o lqTl? Z Permission ~s hereb/gronted to: ............................................... . .... ot premises located ot ..~... ..~.. ........... .~ ...................... County Tax Map No. 1000 Section ....... .J./...~-..-. ........ Block ....... J..J. ........... Lot No ......................... pursuant ,o application dated ...... .~.~.(~.....~..J. ................ , 19..~..~.., ond opproved by the Building Inspector. 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 This application must be filled in typewriter OR ink, and submitted I Immm~a 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 featu res. 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 pX~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. C. Fees: 1. Certificate of occupancy $5.00 2. Certificate of occupancy on pre-existing dwelling $15 o 00 3. Copy of certificate of occupancy $1.00 4.wo nt L nd c.o. $ .00 ..7. 5.UpdaLed C.O. $15.00 Date ... .'-....~..~ ........... NewConstruc f, ion. ~... Old or Pre-existing Building ............ Vacant [.and ............. Location of Property . t~--,~,~ ~(.~-'~)'~ ~T '~'~r'e2 ~..~..~.,~l?..q .~./.~ House No, Ham/et Owner or Owners of Property.. ~ ~.~.. ~. >..~ ~.~.t~. ~.~.~ ....................... ~ounty Tax Map No. 1000 Section .... ~ ...... Block ............. Lot ............... Subdivision ................................. Filed Map No ........... Lot No .............. Permit No. f.¥.~. ~/,~...~. Date of Permit .......... Applicant .;/~. ?.~..~..~..;...¥~...~..D.E-..~..{ .~?_...~. Health Dept. Approval ........................ Labor Dept. Approval ........................ Underwriters Approval ........................ Planning Board Approval ...................... Request for Temporary Certificate ..................... Final Certificate ....................... Fee Submitted $ ............................. 765-1~02 BUILDING DEPT. INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLBG. [ ] FOUNDATION :)ND [ ] INSULATION [ ] FRAMING [ ] FINAL REMARKS: DATE /?/~//~/ INSPECTOR ~,~~ THE NEW YORK BOARD OF FIRE UNDERWRITERS 1000344 ~--~'t BUREAU OF ELECTRICITY ~ 8.5 JOHN 'STREET, NEW YORK, NEW YORK 10038 Loe~fler~ llen~, ~35 Lupron ~ ~o~a;-~Cl~uc~, ~x ~ p of in the following location; ~ Basement ~ ~9. 19~ and found to be in co.~pliance with the requirements of this Board, FIXTURE ~EC~P~ACLE~ FIXTURES R~ANGES COOKING DECKS OVENS DISH WASHERS EXHAUST FANS DRYERS FURNACE MOTORS FUTURE APPLIANCE FEEDERS ~PECIAL REC'PT TIME CLOCKS BELL UNIT HEATERS IMULTi.OUTLET DIMMERS NO. OF FGET AMT WATTS SERVICE DISCONNECT NO. OF S E R V I C E METER ~T ~P. TYPE EQUIP. 1~2W 1~3W 3~3W 3~4W NO OFpERCC~CONO OF A, Wcc CoNDG NO. OF~ HI-LEG uFA' W.G.Hi.tEG ~O OF NEUTRALS oFANEuTRALW'G' *8~I~G~.; T~I8 C~TIFICATI CO~ COI~L~NC~ A~ 0F ~U~ ~VIRON~T~ IT IS ADVIl;aLE TO q~I~IlD PER~ON, This certificate must not be oltered in any manner; return to the office of the Board if incorrect. Inspectors may be identified by their credentials. OPY FOR BUILDINa n;oa~T~c~T Tu,o : ' - ........ '~-' "T ......... ,., r,,S COPY OF Ct:N ! Ir;IC~TE M.,~DST NOT BE ALTERED IN ANY MANNER. 'FIELD INSI~ECTION 1. COMMENTS FOUNDATION (1st) FOUNDATION 2. (2nd) ROUGH FRAME & PLUMBING INSULATION PER N. STATE ENERGY CODE FINAL ADDITIONAL COMMENTS: SUFFOLE COUNTY HEALTH DE~AKT~ENT DATE--__ D. BEF ..... Fhe soy, age disposal and ~,ater supply facilities for this lacs%lan have been inspected by this department and found to be satisfactory~~ ~, Chief of General Engineering Services ~ D O~ N I0 1 F v~~ RUE~ND g4. Unaulhorized alteration or addition t,3 this survey Is a violation of s~ctlon 72CR o~: the New York State Education Low. Copies o~ th~s survey mop not bearing the land surveyor*s inked ' FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N.Y. 11971 TEL.: 765-1802 Approved...~..ok%..~... 3. [ .... 19 ~.~.. Permit No, ].~ 2/. ?..~r. Disapproved a/c ..................................... (Building Inspector) APPLICATION FOR BUILDING PERMIT Received ........... ,19... E~ ~/F 3 ~ ?1 INSTRUCTIONS a. Tins 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 ~t Certificate of Occupancy shall have been granted by the Building Inspector. APPLICATION IS HEREBY MADE to the Building Department for the issuan~ ;2 a~':B~i!~g ~ianit pg~suant to the Building Zone Ordinance of the Town of Southold, Suffolk County, New York, arI~ 6~her'ai~plicab[,e'Laws, Qrdinances or Regulations, for the construction of buildings, additions or alterations, or for~01 :or. di~moli~io~, as he3ein described. The applicant agrees to comply with all applicable laws, ordinances, building.[~.~e,~h6usii~g code'; and ~regula'tions, and to admit authorized inspectors on premises and in building for necessary in~pections.~ ...... . ..... ~, "~0,~,' · ': ? /Y-~ _ · ' (Signature of apl~¢icArgi~or ~nam,e, if ~rl~bration) (Mailing address of applicant) State whether applicant is owner, lessee, agent, architect, en~neer, general contractor, electrician, plumber or builder. .............................. .................................................. Nmne of owner of premises ..... ,'~/C.~ ~ .y../~..o..~-.-./'!/<.~ .............................................. (as on the tax roll or l~test d~eed) 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 ....................... Other Trade's License No. /~Z ~ ~ & Location of land on which proposed work will be done .................................................. ·. .................. ............ & .................. House Number Street Hamlet County Tax Map No. 1000 Section .../ff. ,C .......... Block .... /./ ............ Lot ..... ~. ............ Subdivision ..................................... Filed Map No ............... Lot ............... (Name) State existing use and occupancy of premises and intended use and occupancy of proposed construction: ' a. Existing use and occupancy .. ~/.~;.~.. twj ...,v.~.~./~.c~.~.c,. fa. ................................. b. Intended use and occupancy . .~e. Z~ . ~ ~A'~e 5: ~...~(~. 4 t! ~O.~e.d. ~(~/~7<~. 3. Nature of work (check which .qpplicable): New Building ' Addition .......... Alteration .......... Repair ..... .., .,~. Removal .............. Demolition .............. Other Work Jff..;(.~..(~../.0.¥./.~A 4. E~t~ated Cost .... ~' ...... : ........................ Fee .......... ~ : ~' (to be paid on filing this application) 5. If'dwelling, number of dwellin8 units .............. Number of dwelling units on each floor ................ If garage, number of cars .... ~ .................................................................... 6. If business, commercial or mixed occupancy, specify nature ~d extent of each type of use 7. D~ensions of existing structures, if any: Front ............... Rear .............. Depth ............. Height ............... Number of Stories ........................................................ D~ensions of same structure ~ith alterations or additions: Front ................. Rear .................. Depth ................... ~... HeiSt ...................... Number of Stories ...................... Dimensions of entire new construction: Front ............... Rear ............... Depth ............... Height Number of Stode~ 9. Size of lot: Front ......... ~ . Rear ...................... Depth ...................... 10. Date of Purchase ............................. Name of Foyer Owner ............................. 11 Zone or use district in .... . which p~emlses are situated ..................................................... 12. Does proposed constructlon vi01ate any zoning law, ordlnanceorre~lat~on: ..~.C~ ........................... 13. W~I lot be regraded ..... ~. ........ ~ ......... Will excess fill be removed from premises: ~ No Nme of Architect ............ ; .............. Address ................... Phone No ................ PLOT DIAG~M Locate cle~ly ~d dist~ctly ~1 bu~d~gs, whether existing or proposed, ~d, indicate ~1 set-back d~ensions from property ~nes. Give street ~d block number or description according ~o deed, ~d show street n~es and indicate whether interior or corner lot. · 8. OCCUPANCY OR USE IS UNLAWFUL 4tlTHOUT CERTIFICATE CF OCCUPANCY NOTIFY BUILDING DEPARTMENT AT 765-~802 ~ ~ TO 4 PM ~R THE ~ ~:~r,:;c:.~ ..... ~.i,~Ib~G & PLUMBING ~- ~ ~..'~, ' ~,'~"; ~ CTION MUST ~ua. , .~ ~ :- ' '~/C'r*O~l SHALL MEET 1-t,~[: ~:(,}Lh~:t/,f~ENTS O~ THE N.Y [~ rA r~ CONSTRUCrlON b ENERGY CODES NOT RESPONSIBLE FOR r~S~G~ Off ~ON~TflU~TtO.~ ERRORS. STATE OF NEW YORK, COUNTY OF..~.~/**~:/.*~ ...... S.S ....... ~.p~ ~'.~.. ~.....~/~/~.ffd.~ ............... being duly sworn, deposes and says that he is the applicant (Name of individual sig~ing contract) above named. He is the ..................... !..~..~.....~C..~. .................................................... (Contractor, agent, corporate officer, etc.) of said owner or owners, and is drily 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 ~an~er set forth in the application filed therewith. Sworn to before me this : ota Puhc . *~:.~o..%t.c-.. County ~~..,. N ry b' , ...... 'h ....... .......... , ,, . : LORRIE A. Qualified S.uf~o? : Term Expires N~arc~ ,~u, Z W _J