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Home My WebLink About14030-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. Certificate Of Occupancy No. Z13749 Date August 12 ., 1~5. THIS CERTIFIES that the building ..... i..n.g.r.o.u.n..d..s.w. '.:.r~..i.n.g...p.o.o..1: ................ Location of Property 490 Northfield Lane Southold House No. Street Hain/et County Tax Map No. 1000 Section 79 .Block 3 . .Lot 4.2 Subdivision x .Filed Map No. x .Lot No. x conforms substantially to the Application for Building Permit heretofore filed in this office dated June 6 .8.5. 14030Z ...................... 19 pursuant to which Building Permit No ...................... dated ........ J..u.n.e.. 1..0 ............ 19 .8.5. , was issued, and conforms to all of the requirements of the applicable provisions of the law. 2~e occupancy for which this certificate is issued is ......... ..... Ir~g~cp.u.n..d..s.w.i..m.u~..i.n.g.p.o. ql., .&..f.e..n.c.e... ...................................... The certificate is issued to .............. P.I, ,N.A..~.9 .CF?.qR..D..(.~E..C.~.B.E.). ................... of the aforesaid building. Suffolk County Department of Health Approval ................ N../.~. ...................... UNDERWRITERS CERTIFICATE NO .... PENDING Building Inspector Rev. 1]81 FORM NO. 0 TOr~VN OF SOUTHOLD RUILDING DEPARTMENT TOWN HALL SOUTHOLD, N. Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) No 14030 Z ,~, County Tax Map No. 1000 Section ..... ..C~..~...~. ....... Block ...... ..~..~. ..... Lot No...,..L.~ ................. pursuant to application dated ..~...~.....~.. ........................... , 19..~.~., and approved by the / Building Inspector. Fee ';;'"-;"" 'Building Inspector Rev. 6/30/80 FORM NO. 6 TOWN OF SOUTHOLD Building Department Town Hall Southold, N.Y. 11971 APPLICATION FOR CERTIFICATE OF OCCUPANCY Instructions This application must be filled in typewriter OR ink, and submitted ia ~1~111~ 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 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 $[ 5.00 3. Copy of certificate of occupancy $1.00 4.Vacant Land C.O. $5.00 Date New Building ............. Old or Pre-existing Building ...-. ,_ · Vacant Land ............. Nam/et Owner or Owners of Property ...... ~ ?,~ ,~,- ,'~¢', ................ County Tax Map No. 1000 Section .. ,0, ,~, ,% ....... Block ...Q. ~<a?, ........ Lot..Q,O,~.~, , ,~-,, .... Subdivision ................................. Filed Map No ........... Lot No .............. Permit No. l .~..~..~..~.. Date of Permit · .~-~)~, ~ .Applicant .~. !\,~..~....~..~..c..~,. ................ Health Dept Approval ~'~ / ~ ....... Labor De royal ........... ................. pt. App ............. Underwriters Approval ~/~...c~..V~.% ............ Planning Board Approval ...................... Request for Temporary Certificate ..................... Final Certificate .... ~ ............... Fee Submitted $ ..~.. ......................... Construction on above described building and ~,~rmit meets all applicable codes and regulations. Rev. 10-10-78 ~ FOUNDATION (1St) FOUNDATION 2. ROUGH FRAME & (2nd) PLUMBING INSULATION PER N. STATE ENERGY ?DE FINAL ADDITIONAL COMMENTS: THE NEW YORK BOARD OF FIRE UNDERWRITERS 1025023 BUREAU OF ELECTRICITY , ~ 85 JOHN STREET, NEW YORK, NEW YORK 10038 . ~ ~ ~ THIS CERTIFIES THAT only the electrlc~d equipment as described below and introduced by the applicant r~med on the above application number in the premises of MeCabe, 490 Northfi~ld Lane, Southotd, New York wasexamlnedonJUly 15,1985 andfoundtobeincornpliancewiththerequire.te,;tsofthlsBoard. FIXTURE OUTLETS DRYERS 1 I FIXTURES RANGES OVENS DISH WASHERS EXHAUST FANS TIME CLOCKS MULi;I-OUTLET DIMMERS SYSTEMS NO. OF FERT OTHER APPARATUS: G.F.C.I.- i S E R V I C E and/or repairs made by a qualified person. (~imming Pool) This certificate covers compliance at the ~ate of inspection only. Because of ~n=s=al environments it is advisable to have frequent test Henry Bohn 121 Sheep Pasture Rd. Setauket, N.Y., 11733 This certificate must not be altered in any manner; return to the office of the Board if incorred. Inspedors may be identified by their credentials· COPY FOR BUILDING DEPARTMENT. THIS COPY OF CERTIFICATE MUST NOT SE ALTERED IN ANY MANNER. LJILDER'$ lOB NO, TITLE NO. .... FEE: - ,' 765 [~ EXISTENCE OF RIGHT OF WAY~ AND OR/EASEMENTS OF RECORD, ~ ANY, NOT SHOWN ARE NOT GUARANTEED. , B.P. '~ ~ TO A ~hA FOR PF. cTIONS: _ zYVO REQUIRED coNCRETE ~ FRAMING ?~ pLUMBiNG , ~- FOR C.O. )~q-~' cqION sHALL MEET R~:AEH~S OF ~HE N.Y. .CONSTRUCTION & E~ERGY RESpoNSIBLE FOR iON ERRORS- DATE: BLOCK ;UFFOLK COUNTY TAX MAP iAP NO. OTB LOT--~4~ HAND FIBERGLASS MOULO~O I PIECE OPTIONAL TYPE I. STEP NO','ES .... ,',A,..KS 're BE SMOOT.- NON SK,D TYPE. SLOPED AWAY FROM POOL WATER DISPOSAL SHALL BE LIMITED TO OWNER*S PROPERTY TO, SUIT LOCAL REGULATION.S- ~SEE TYPICAL L SECTION VINYL SECTION ---z~'~'.,*~ ......... ~ .,., n ,.,~ r- COPING ST~:PS OPT,ONAL P L A N BLOCK CONCRETE GRADE ROLLED FOAM BETWEEN LINER end*BLOC BOND" VINYL 2"- 4' SAND THICK 'OWENS CORNIN6 FIBERGLAS'BLOC BOND' TROWELED ON EACH OF CONCRETE BLOCK WA TY PICA L ,-1 0 0 ,~__ SK!MMERS t~' ._~,.~ POURED CONCRETE ] FOOTING; WALL $_E~CT_. 0 RETURN~'~ ~TO FILTER ~ FROM FI L'T~. TO RETURNS PIPING ARRANGEMENT 'FORM NO, 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL ~OUTHOLD, N,Y. 11971 TEL.: 765-1803 Examined ~1 O ,19~.~.: Approved i]..~..~ill;i i, 19~..~.PermitNo..}.~?..~..~..~. Disapproved a/c ..................................... (Building Inspector) APPLICATION FOR BUILDING PERMIT Date 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 per,)it 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 Regulations, for the constxuction of buildings, additions or alterations, or for removal or demolition, as herein described. The applicant agrees to comply with all applicable laws, ordinances, building co~%housing co<~and regtflations, and to admit authorized inspectors on premises and in building for necessary ............ in spection~/(..~..~..~L~ .Q~.~. ,O~~ .......... ~'~ (Signature of applicant, or name, if a cor)poration) .. , , . . . . , .:. , . (Mailing address of applicant) fl77c9 State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. ...~...~...r.....~..~. ..... ~..o4./..~.....~. <.~..~... ~¢.0: .&.~ ........................................... Name of owner of premises . . .~J../.~.g:./.../7_._._._._._._._~9. .... ./~...~..d:..~.~...~_,. .............................................. (as on the tax roll or latest deed) 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. '~t-~L {~ .'~.~ r Trade's License No... I.T ...... ., :1. ........ Location of land on which proposed work will be done. ~..Q%r.~..0..~. /tJOET~t leC. O ~. q*O. e/.o .~?.¥.ro..~..~, .... ~. .q. 9 ........ ~o. ~ T ~.~.t.~. ¢ ~. . . >. . .~. .~. ............... ,~.. o.c2.7:~.~. > ~ ......... ?. ~.~ ' .. House Number Street Hamlet /0 County Tax Map No. 1000 Section .0 ?.~. ............. Block . ..C~. .............. Lot.. P/.~.~Z. .......... ~.~.~ ~cD p N Subdivision ......... ~. { .......................... Filed Ma o ............... Lot ............... (Name) State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy ~9M¢..F..~.~2../.c.~...~..~q..(.~.~.~.c;.E~, .......................................... b. Intended use and occupancy ~..~.~/.D.~../~.-.~....¢/.~2(c~..,~.../.~..~.s~. ?..~.~...d'..O~,/../~?.x~././J.~.-......../~oC .,~./.~..~.~ 3. Nature of we k (check which apphcable): New Building .......... Addition .......... Alteratip0 ....... Repair ............. Remov~al ............ Demolition .............. Other Work..~..d}02L~.... '~' (D ipti n) 4. Estimated Cost ......................... Fee .................... ~" (to be paid on filing this application) 5. If dwelling, number of dwelling ugits ............. Number of dwelling units on each floor ............... If garage, number of cars ...... ,~ ................................................................. 6. If business, commercial or mixed Occupancy, specify nat~:re and extent of each type of use ..................... 7. Dimensions of existing structures,lif any: Front ............... Rear .............. Depth ............. . Height ............... Number of Stories.. ....................................................... Dfinensions of same structure with alterations or additions: Front Rear Depth ..................... ,1. Height ...................... Number of Stories ...................... 8 Dimensions of entire new constru.ction: Front Rear Depth Height ............... Number of Stories ........................................................ 9 Size of IOt: Front I Rear Depth · 10. Date of Purchase ............ i ................. 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 14. Name of Owner of premises txNr ~.....~77 ~.~.... Address ..~.qO. ~,o..~T~..~.c.~.~. .~. Phone No ................ Name of Architect . .~., ......... , ................ Address ................... Phone No ................ Name of Contractor ~f.(-x2/..r~. ?. ,/.Z?.67.../c..~0~,g' .. Address ,5(9./..t~.F..~.x..rp: ...... Phone No...75<.ff. ?. (?P... PLOT DIAGRAM Locate clearly and distinctly all buildings, whether existing or proposed, and, indicate all set-back dimensions from property lines. Give street and block n~umber or description according to deed, and show street names and indicate whether interior or corner lot. ,. STATF. OF NEW YORK, COUNTY oF ....... S.S ~ ~,~o~ ~ .~..~TZ..<~...~...z_.o. i being duly sworn, deposes and says that he is the applicant (Name of individual signing contract) above named. He is the...~...~.~ .7'. ....... (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 manne~r set forth in the application filed therewith. Swom to before me this .................... day of .............. ,19 Notary Public, . .......... .~..~.7~..~(/.~. .............. County Commigsion ~,xpi~,~,$ garch 30. 18~ Mi}nature of applicant)