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Home My WebLink About14636-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. Certificate Of, Occupancy No... Z-]5671 Date ....Ap.r.i. 1,..2.1. ,...I .9.8. 7. ............. THIS CERTIFIES that the building., r..n gy.qu..n.d..S.~ .i.m.m,i. n. g. ?.o..o .1..~..f .e.n.c.e. .......... Location of Property . ...2.4.5.. ~.a,p. 1..e. Av.e..n.u.e ........... ~a..~ .~.i.t.u.c..k.,..N.e..w..Y.q .r.k ....... House No. Street Ham/et County Tax Map No. 1000 Section . . .1.0.7 ....... Block . ...2 ........... Lot ...... 1.0. ......... Subdivision ............................... Filed Map No ......... Lot No .............. conforms substantially to the Application for Building Permit heretofore filed in this office dated .F.e.b.r.u..a.ry..2..8~..1.9..8.6. ~ pnrsuant to which Building Permit No...I.4.6.3..6.Z ............. dated Mar ch 8, 1 9 8 6 was issued, and conforms to all of the reu.uirements 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 ... ~A..g~. p...B.E.V.E.R.L..Y..R.O.L..L.I.N.S. ............................. of the aforesaid building. Suffolk County Department of Health Approval ......... .N/.A. ............................. N752656 UNDERWRITERS CERTIFICATE NO .................................................. N/A PLUMBERS CERTIFICATION DATED: Building Inspector Rev. 1/81 I~ORM NO. ~ 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) ~T.o li636 z Permission is hereby gronted to: ~ , . ~ , ~ / ........ ....~X....~.~..~. ........................................ ...%~..~.~.....~..:~.;..././...~..~...~...~ . ............ ~ .............................. /.~:...~. ................ ~ ....... /,~ ............ %...._., ...... ~ ...... ./ ................. ot pre,,i~,oco,ed ot..~.~ ....... ...~....~ ...... ~.: ........ ....~.....~.C~ .............. County Tax Mop No. 1000 Section ...... 1...0...?. ......... Block ......... .?. .......... Lot No ....... /...,b,. ........... pursuant to opplicatJon dot~:J ...~.~...,~..~ ......... , 19..~...~.., ond approved by the Building Inspector. Building Inspector Rev. 6/30/80 FORM NO. 6 II I TOWN OF SOUTHOLD i~j~! ~ "2 ~ Building DepartmentTown Hail , ~BLD~ ~E~. JL.~ Southold, N.Y. 11971 765 - 1802 I .'~OF~O~OL~ APPLICATION FOR CERTIFICATE OF OCCUPANCY Instructions A. 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 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. 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 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: Additions $25.00 1. Certificate of occupancy New Dwelling,S25.00, Accessory ,~$10.00 Business $50.00 2. Certificate of occupancy on pre-existing dwelling $ 50.00 3. Copv of certificate of occupancy $ 5.00, over 5 years $)0.00 4.Vacant Land C.O. $ 20.00 5.Updated C.O.n I~t¢'~.~' ~ 50.00 .~.,-~-- oC~7 $ Date ....................... NewC°nstz~ucti°n......t~l~\?~torPreexistin- gBuilding ............ Vacant Land ............. Locat on of Property . ~>~.~/~"~ , '~/~ ~ ..~..~ · .................. .... ; .............. Owner or Owners of Property . . .~ . .'~...~..~/~l~u~ 'No. .... 'H~rnlet County Tax Map No. 1000 Section ..... .... Block ....... ~ ..... Lot ..... /, ,C/. ...... Subdivision ................................. Filed Map No ........... Lot No .............. PermitNo. /Y.~..~.~..~. Date of Perm t .~./o~ZaAoo cant ...,~).',~. ?..~ ~ -- -- ............ ' 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 a~applicable codes and regulat OhS. Rev. 10-10-78 C o 15C7 THE NEW YORK BOARD OF FIRE UNDERWRITERS ,~ BUREAU OF ELECTRICITY J~ne U3, ,1985 85 JOHN STREET, NEW YORK, NEW YORK 10038 D. te 2pplic.tion ~o. o.~il~ 4(~950/~6 THIS CERT,FIES THAT N 7 in the following location; [] Basement wasexaminedon ~y ~ ~[j~ FIXTURE OUTLETS RECEPTACLES SWITCHES DRYERS FURNACE MOTORS ~ 2nd FI. Section Block and found to be in compliance with the requirements of this Board. Lot FIXTURES FLUORESCENT VApOR RANGES OVENS DISH WASHERS EXHAUST FANS FUTURE APPLIANCE FEEDERS TIME CLOCKS UNIT HEATER MULTI-OUTLET DIMMERS SYSTEMS NO. OF FEET SERVICE DISCONNECT OTHER APPARATUS: i-G .F.C; o L S E R V I C E NO O ~E{~C,~CO N DOF Acc.W'coNDG' NO OF HI4EG cFA HI-LEGW' G NO, OF NEUTRALS AW.G. OF NEUTRAL l~a~gigu~k, NY l195g Lic#~300g GENEral. MANAGER This certificate m~sl nol b~ ~[tered in any manner: relvrn lo the office of the Boord ff incorrech Inspectors moy be ,denhfled by lhelr credentials, COPY FOR BUILDII ~ COPY OF~ ) IN ANY . ~R, TOWN OF SOUTHOLD OFFICE OF BUILDING INSPECTOR P.O. BOX 728 TOWN HALL SOUTHOLD, N.Y. 11971 TEL. 765-lS02 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. /5/ No final inspection has been made. Please contact our office on this matter. Thank you for your cooperation. _Building Permit # ; ~ ~ ...~ & uilaing ept. /6-09 Z- ***/~/ No Plumber Solder Certificate on file. ( all permits involving plumbing being issued after April 1,1984 ) TOWN OF $OUTHOLD OFFICE OF BUILDING INSPECTOR P.O. BOX 728 TOWN HALL $OUTHOLD, N.Y. 11971 TEL. 765~1802 To Whom This May Concern, We are unable to complete your Certificate of Occupancy because,of the following reasons. /Z/ An application for Certificate of Occupancy is not on file. /Z~. No Underwriters Certificate on file. /Z/ The check is(outdated/not on file.) /Z/ 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 # ; 4 ~ ~ ~, Building Dept. /j~ C/ ~ ~__ Z ***/Z/ No Plumber Solder Certificate on file. ( all permits involving plumbing being issued after April 1,1984 ) TOWN OF SOUTHOLD OFFICE OF BUILDING INSPECTOR P.O. BOX 728 TOWN HALL $OUTHOLD, N.Y. 11971 TEL. 765-1802 To Whom This May Concern, We are unable to complete your Certificate of Occupancy because,of the following reasons. /~/ An application for Certifi%ate of Occupancy - is not on file 23 /5~ NO Underwriters Certificate on file. /7 The check is{~d/not on file.)~?~,~O /5/ No Health Dept. Approval on file. /5/ No final inspection has been made. Please contact our office on this matter. Tkank you for your cooperation. Building Permit # Building Dept. ***/5/ No Plumber Solder Certificate on file. ( all permits involving plumbing being issued after April 1,1984 ) FIELD INSPECTIQN 1. FOUNDATION (1st) COMMENTS FOUNDATION 2. (2nd) ROUGH FRAME & PLUMBING INSULATION PER N. STATE ENERGY CODE FINAL ADDITIONAL COMMENTS: BUILDING DEPT. INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ~, IN~LATION]~ ~, , , . 'FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N.Y. 11971 TEL.: 765-1802 Examined...~..OM~..~..~..., 19 Y.~ Approved..~.Q¢. :~..~...., 19~b. Pe~it No.~ ~.~.~ ItLDG, DEPT, TOWN OF SOUTHO[,D Received ........... ,19... Disapproved a/c ..................................... (Building Inspector) APPLICATION FOR BUILDING PERMIT Date ................... 19 . INSTRUCTIONS 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 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 Reeulations, 'for tl~e'~o~stmc~icm, ol; h~aildings, additions or alterations, or for removal or demolition, as herein described. Th~ applicar[t ~re~kg~l¥~f~ra~ll;[appl/cable laws, ordinances, building code, housing code, and regulations, and to admit authorized in~p~.c,t;~ ~pr~e~n~s~e~a~d in building for necessary inspectiop.?~. · . , ..... '[ ~ ~ ~'~ ~" ..... ,, (Sigi~nfe o~ ~pplicmi~, or)name,~f a corporation) ' v,~ ..~,. ;~ ~ ~; , t .... (Mailing address Of~pplicant) State whether applicant is owner, lesse'e, agent, architect, engineer, general contractor, electrician, plumber or builder. ~m~ o~ o~ o~r~ ...~..~ .... .~ .... B ~. ~... ~.~.~.~ ..................... (as on ~he ~ax roll or latest deed) If a~ is a ~rporafion, s~nat~re of ~uiy authorized Builder's License No ....... ~ ~ ................ Plumber's License No ......................... Electrician's License No...~.O.j~,-~... Other Trade's License No ...................... 1. Location of land on which proposed work will be done ..... ~7;. ............. .O. ...................... .... House Number Street Hamlet County Tax Map No. 1000 Section ..... ./.O..~7 ........ Block ...... ~. ......... Lot ..... ~.O. ........... Subdivision ..................................... Filed Map No ............... Lot ............... (Name) State existing nsc and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy ......... ~..~. ~../.~..~.~/.77.~...~ .......................................... b. Intended use and occupancy ............. ~..~( ~....~t~. {.~.~. .......... ~.~...rd2T . ~.,,~_< 3. Nature of work (check which applicable): New Building .......... Addition.. ........ Alteration .......... Repair .............. Removal .............. Demolition .... : ...... ... Other Work ............... ,~[~G/f, OtO00 ~!w~ ~ ~/,,v C, (Description) 4. Estimated Cost ~.(~.Q0 ~'- Fee /~Oz~t, ~- .~.~..'~. C_~"' ~ (to be paid on filing this application) 5. If dwelling, number of dwelling units ............... Number o f dwelling unitls on each floor ................ If garage, number of cars ............................................ ! ............................ 6. If business, commercial or mixed occupancy, specify nature and extant of each type of use ..................... 7. Dimensions of existing structures, if any: Front ............... Rear ....... i .......' Depth ............... Height ............... Number of Stories ............................ ! ............................ Dimensions of same structure with alterations or additions: Front ............ i.:. · · Rear .................. Depth ...................... Height ...................... Number of iStories ...................... 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 .../~Ls3'¢~..//'Ag.~ ................... 12. Does proposed construction ,v. iolate any zoning law, ordinance or regulation: .... .../~.'i~. iii... 13. Will lot be regraded ..... ~.o. ................... Will excess fill be removed from premises: 14. Name of Owner of premises-/~/~g[, t,../~6~..~/,?,r .... Address ~/~.//O/.~..fO. Jrt~40hone No ..... ~ ...... Name of Architect ........................... Address ............... ~... Phone No ................ Name of Contractor ~-. l'~G-/{g.~..-~..~.~..'~.../~q~. Address /~Ot. .q.J~.. I~'/a .f~/.~t. Phone No. ~': PLOT DIAGRAM Locate clearly and distinctly all buildings, whether existing or proposed, an&indicate all set-back 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. OCCUPANCY OR USEJS WITHOUT CERTI C T OF OCCUPANCY APPROVED AS NOTED NOTIFY BUILDING DEPARTMENT j AT 765-1802 9 ,At~/t TO '~ PM FOR THE FOL[ Ow~f~ INSPECT]oNS: 1FOUNDA'rlO~ '~%~O REQUIRED FOR POU~D CONCRETE ALL {;~",'.,~, :~dC"f~L?h~ ~HALL MEET CODES ~(Tf H~;~ONS?~L~ FOR ~ ~StGN O ~ CONSTRUCTION E~RORS, STATE OF N~W YORK, COU~Y O~ ................. ................................................. being duly sworn, deposes and says that he Js the applicant (Name of indMdual siguin~ co~t~act) 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 s~id 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 perforn~ed in the manner set forth in the application filed therewith. Sworn to before me this ........................ day of .................... Notary Public, ....~.~....~.. ~..~... County ~ . ~. 4707878, S~dk Cou~. ~i~nature of applicant) ~erm Explre~ March ~0,