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Home My WebLink About14140-zFORM NO. 4 TQWN OF 80UTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No Z-20975 Date THIS CERTIFIES that the building. Location of Property 1500 HENRY LANE House No. County Tax Map No. 1000 Section 74 AUGUST 27~ 1992 /NGROUND POOL PECONIC¢ N.Y. Street Block 2 Lot 24 Hamlet Subdivision Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated JULY 11, 1985 pursuant to which Building Permit No. I4140-Z dated JULY 17¢ 1985 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 SWIMMING POOL & FENCE AS APPLIED FOR. The certificate is issued to (owner) Qf the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HED_LTHAPPROVAL UNDERWRITERS CERTIFICATE NO. PLUMBERS CERTIFICATION DATED Fa%RIETTA L. SILVESTRE N-706098 - AUGUST 26, 1985 Inspector Rev. 1/81 FOILI~ NO. ~ TOWN OF SOUTHOLI~ BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N. Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) NB 14140 Z · . ~ '...%..3 ....+...~.'.~?~- ~ . ~ ,o~.~ ........... ~~ .... ~ ............................ ¥~...~ at premises located at ..J..-~.. ............................................................................... County Tax Map No. 1000 Section ...... 0.?.....~. ....... Block ......~.....~'... ........ Lot No ........~..~. ........... pursuant ,o application dated ....... ....~...~..~ ...................... , 19.~...~../, and approved by the Building Inspector. Fee $~..: ............. ..... :'"'"'"'""Building Inspector Rev. 6/30/80 Form No. 6 TOkrN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL 765-1802 APPLICATION FOR CERTIFICATE OF OCCUPANCY This application must be filled in by typewriter OR ink and submitted to the building inspector with the following: for new building 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 from Health Dept. of water supply and sewerage-disposal(S-9 form). 3. Approval of electrical installation from Board of Fire Underwriters. 4. Sworn statement from plumber certifying that the solder used in system contains less than 2/10 of 1% lead. 5. Commercial building, industrial building, multiple residences and similar buildings and installations, a certificate of Code Compliance from architect or engineer responsible for the building. 6. Submit Planning Board Approval of completed site plan requirements, For existing buildings (prior to April 9, 1957) non-conforming uses, or buildings and "pre-existing" land uses: 1. Accurate survey of property showing all property lines, streets, building and unusual natural or topographic features. 2. A properly completed applicJtion an~'~ consent to inspect signed by the applicant. If a Certificate of Occupancy is denied~ the Building Inspector shall state the reasons therefor in writing to the applicant. C. Fees 1. Certificate of Occupancy - New dwelling $25.00, Additions to dwelling $25.00, Alterations to dwelling $25.00, Swimming pool $25.00, Accessory building $25.00, Additions to accessory building $25.00. Businesses $50.00. 2. Certificate of Occupancy on Pre-existing Building - $100.00 3. Copy of Certificate of Occupancy - $5.00 over 5 years - $10.00 4. Updated Certificate of Occupancy - $50.00 5. Temporary Certificate of Occupancy - Residential $15..00, Commercial $15.00 / Date ...... New Construction .... ~ .... Old Or Pre-existing Building ....... .~. ....... ~,~ . · /.,~, '-"~ ' 1~ /'" ~"~-J~ ' '.. ~0~,, ~0. ~ .--,~StreetL. ~) ~H~et ........ { .............. .......... 000,.. :. .,. .... ....... -- ........ ...... ap..,......' ' ...Lot .................... '~rmtt No ............ Date 0f Permit .... pplScant .......... [ealth Dept, Approval ........... UnderurSrers Approval ..... 'lann~ng Board Approva~ .............. ~ equ~sr for: Temporary Certificate ........... Final Cert~cate...~ ..... ee Submitted: * .......................... ~.qq~, · . .... THE NEW YORKBURE,,,uBOARDoF ~_ECTR,CIT¥OF FIRE UNDERWRITERS/q/~0~_. ~g~ ~ ~ [~85 85 JOHN STREET, NEW YORK, NEW YORK 100;38 THIS CERTIFIES THAT only the elect~cal equipment ~ ~scribed below and introduced by the applicant nomad on the above ~pl[catlo~ number in the premises in tbe followin8 Ioc.tion; ~ Basement ~ 1st FI. ~ 2nd n. O~=Si~ Section Block ~t was exam~ned on ~ ~9~ ~98~ and found to be in co~npiiance with the requiretnents of this Board. FIXTURE IECEP~ACLE$1 DRYERS FIXTURES RANGES COOKING OECK$ OVENS DISH WASHERS EXHAUST FANS SYSTEtAS NO. OF FEET SERVICE DISCONNECT E R V I C This certificate must not be altered in any manner; return to the office of the Board if incorrect. Inspectors may be identified by~-h"~h'"~CYe/c~entloE. ILD!NG DEPARTMENT, THIS COPY OF CER'I'IFI C,AT~E M U,~"F NOT BE.ALTERED iN ANY MANNER. ELD INSPECTION COMMENTS FOUNDATION (1st) EOUNDATION 2, (2nd) ROUGH FRAME & PLUMBING INSULATION PER N. STATE ENERGY CpDE FINAL ADDITIONAL COMMENTS,:,__ 'FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N.Y. 11971 TEL.: 765-1803 l~xamined..~... ' .~.., 19 .~.~.'~_. .. .. ~pproved ..... l.'~..., 19~..~. Permit No. ( t/ [ .~..~ .~:. ~)isapproved a/c ..................................... (Building Inspector) APPLICATION FOR BUILDING PERMIT eceived ........... ,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 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 auth°rized inspect°rs °n premises and in building f°r necessary ins~tsn~-'-~'Z C~.. ................. (Signature of applicant, or name, if a corporation) *.q.... (Mailing address of applicant) State whether applicant is owner, lessee, agent, architect, en~neer, general contractor, electrician, plumber or builder. .... .7- .z4c.. ............................................................ Nameofownerofpremises .... --.DIt4/ff:G.T7 .~.~. ................................................... (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 ....................... Other Trade's License No ...................... Location of land on which proposed work wilt be done .................................................. · I.d.o ........ .... ............. ................... House Number Street Hamlet County Tax Map No. 1000 Section ....... .~.q ...... Block ...... Subdivision..~.C,~td.i.C-.. ~..~..~.~...~...~.¢: .......... ~ Filed Map No. (Name) State existing use and occupancy~emises and intended use and occupancy of proposed construction: a. Existing use and occupancy . . ]~. ,t~dtC'5~ .......... ../ ................................... b. Intended use and occupancy. ~.~/-~.~:..: ..t~...~. ', .... ~J./~.'.~....~...~..F~g~ ................... .,11. 12. 13. 14. Na~ute of work (check which ~pplicable): New Building ..... ' ..... A Repair .............. Removal .............. Demolition ... Estimated ......................... Fee . If dwelling, number of dwelhng units ............... Number of d If garage number of cars ~ 'If business, commercial or mixbd occupancy, specify nature and extent maenslons of existing structures, if any: Front ...... . ......... Res property lines. Give street and bloc c number or description according to dee interior or corner lot. STATE OF NEW/YO~, , / S S COUNTY OF .ag~q.~;.._ · .......... · ~.O.~.~f( .~.... ?...~/..af.~..(~. .............. being duly s ' (Name of individual signing contract) above named. ddition .......... Altera~on .......... ........... Other Wor~tlq.}g].~.. ?r-x'q~cription ) (to be paid on filing this application) elling units on each floor ................ each type of use ..................... .............. Depth ............... Height ............... Number of Stories ........................................................ Dimensions of same structure With alterations or additions: Front ................. Rear .................. Depth .................. ~... Height ...................... umber of Stories ...................... Dimensions of entire new construction: Front ............... Rear .............. Depth ............... .... ~ht I',umbex o. ~,tones ......... ............... dO3..?./ e 15'l ................................... Size of lot: Front ..... : .. Rear ........ :. . De ........... Date of Purchase .......... ! ..... Name of Former Owner ..................... Zone or use district in which p~emises are situated ..................................................... Does proposed construction viglate any zoning law, ordinance or regula :ion: ................................ Will lot be regraded ........ ' .................... Will excess fill be removed from premises: _Yes No Name of Owner of premises . .~.//-~/ff.~. 7",~2~=: Address ~ ~t~. . ~'~...-xr/~. Phone No. 7. ~..f~ .~..~.~,..g~ Name of Architect . .,e~'3 .... i ................... Address .................. Phone No ....... d ........ Name of Contractor :/~,~.~....~.,. ~"~'~... Address ~,/-i' ~MOIg~;..,4~Phone No.."7~ .~...~B~.~. · ' .. PLOT DIAGRAM Locate clearly and distinctly all buildings, whether existing or proposgd, and, indicate all set-back dimensions from and show street names and indicate whether torn, deposes and says that he is the applicant He is the ................ .~.~ 7~ ~.. ! (Contractor, agent, corporate o 'ficer, etc.) of said owner or owners, and is duly authorized to perform or have perfo ~ned the said work and to make and file this application;that all statements con~ained in this application are true to the best of his knowledge and belief; and that the work will be performed in the man~er set forth in the application filed there' vith. Sworn to before me this : .......... //.. ~A~.. ....... day ~~/f ./. ~. ......... 19 . .f~. Notgry Public, . ............. ~.. County/'~ / / ................. I~orAmt PUBLIC, ~tat~ of n~w York (Signature of applicant) No. 4822563, :Suffolk Coul*,~-: Term Expires March 30, 19 ~.~/~