The URL can be used to link to this page

Home My WebLink About14179-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. Certificate Of Occupancy No ....Z..'1.~.8.q. 5. ....... Date September 3 19 85 THIS CERTIFIES that the building swimming pool. Location of Property .. ................. : ....... fioutho~d t~ouse No. Street * Ham/et County Tax Map No. 1000 Section ..... .~.~. .... Block 9 .Lot 1 2&~ 3 Subdivision.. X .Filed Map No. X .Lot No. X conforms substantially to the Application for Building Permit heretofore filed in this office dated .... ~u..1Z .'1.~. .......... 19~.5.. pursuant to which Building Permit No. 'ltM 79Z dated ....g..u. 3:y. ~.'1. ................19 .~.~., 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 ......... ..... Ja~gr.q .u~..d..s.w..i.m.m.i.n.g.p. qg.l: ................................................ The certificate is issued to WI .L~. IAM JAROSZ .................... idd, n'd"~ ..................... of the aforesaid building. Suffolk County Department of Health Approval ............... I~../.~. ....................... UNDERWRITERS CERTIFICATE NO ................... .N.7.Q .2.~?.Q ...................... Building Inspector TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N. Y, BUILDING PERJ~IT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) 14179 Z Permission ts hereby granted t~ // _ ~ ~ ,o ........ ....... .............. ..................................................................................... i.~.2...]~.~.a;.....~. .................................. at premises located at ........~..~..~..~, ....... ,~.~..*f~..~....~..., ........................................................... ................................................................................................................ ,~.~:~.a~....,,~.,..~.. pursuont to applicotion doted ....... . .,~.~.~...c~.. ........ ./....?.. ................. , 19~ and opproved by the Building Inspector. Building Inspector Rev. 6/30/80 THE NEW YORK BOARD OF FIRE UNDERWRITERS ~.000344 BUREAU OF ELECTRICITY ~L~ 8S JOHN STREET, NEW YORK, NEW YORK 10038 v,.,,, {~ul¥ 30, 1985 ~p~.~,~o-~.~.,/"~ 345~27/85 N 702670 THIS CERTIFIES THAT only the electrical equipment os described below and int~duced by t~ oppltca~t named o~ t~ a~ appiic~tlon numb~ in the premises of ~. $~ g~z~ 7930 ~ A~~ ~.Y. in ~he/ollowing location; ~ Basemen~ ~ Is~ FL ~ 2nd FI. ~$~e Section Block Lot was examined on J~ 2~1 ~ and found ~o be in compliance with ~hc re~luireme~ts of this Board. FIXTURE ~ SWITCHES OUTLETS FLUORESCENT 1 1 2 1 DRYERS FURNACE MOTORS FUTURE APPLIANCE FEEDERS TIME CLOCKS UNIT HEATERS MULTI-OUTLET DIMMERS SYSTEMS NO. OF FEET FIXTURES RANGES OWENS DISH WASHERS EXHAUST FANS SERVICE DISCONNECT S E R C NO, OF HILEG A,W G, NO OF NEUTRALS A,W G OF HI LEG OF NEUTRAL 1-G.F.C.I. pa~elhoar~e: 1-2cir. 125amps. (~]~go_l_)_ This certificate covers co~01i~nce at the date of /nsgection only. B~O~se of ~n~m/al env~ts it is advisable to ha~e frequent test and/or repairs made by a q~%lified person. phil Gordon 600 H No. Flcyele Path port Jefferson Station, N.Y. 11776 Lic. llO1E must not be altered in any manner; return to the office of the Board if incorrect. Inspectors may be COPY FOR BI.~ LO NG DEPARTMEN¥ TH S COPY, OF CERTIFJCA?= FIELD INSPECTION FOUNDATION (~st) FOUNDATION ( 2nd ) ROUGH FRAME & PLUMBING iNSULATION PER N. STATE ENERGY C,ODE FINAL COMMENTS ADDITIONAL COMMENTS: Examined.. ~.~[.ct. 5..t .... , 19 ~..~.'~ [pproved..4.~./.9.. ~ ./ ..... FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N.Y. 11971 TEL.: 765-1801~ .11.181t85 BLDG. D£PT. TOWN OF $OUTHOLO Application No .................. )isapproved a/c ......... .~. .... 5~. ...... '"t~ ......... ..................... APPLICATION FOR BUILDING PERMIT INSTRUCTIONS a. This application must be completely filled in by typewriter or in ink and submitted in triplicate 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 puDlic streets Or areas, and giving a detailed description of layout of property must be drawn on the diagram which is part of this appli~ ation. 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 hall 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 hall 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 luilding Zone Ordinance of the Town of Southold, Suffolk County, New York, and other applicable Laws, Ordinances or [egulafions, for the construction of buildings, additions or alterations, or for removal or demolition, as herein described. 'he applicant agrees to comply with all applicable laws, ordinances, building code, housing code, and regulations, and to dmit authorized inspectors on premises and in buildings for necessary inspections. · ·. .... (Signature o"f&pplicant, or name, ' a o pra ' ) (Mailing address of applicant) .tate whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. .... ...................................... ~ame of owner of premises .. ~( .~.~-,4 . . .~.,~..~. a.m.. 2~. .................................................. (as on the tax roll or latest deed) applicant is a corporation, signature of duly authorized officer. (Name and title of corporate officer) Builder's License No. :~ 4~ ~ Plumber's License No ......................... Electrician's License No ....................... Other Trade's License No ...................... Location of land on ~,hich proposed work will be done .................................................. ...... '7. . ......... w: , .................. .o. /. ...................... House Number Street Hamlet County Tax Map No. 1000 Section ....~..~..3..~..~. ...... Block ...... .~. .......... Lot.../..~..~../.~. ........ 2J Subdi¥ision ..................................... 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 ... dP.'q. ¢...2,P<-2-~)[.,~...ff. qo~ (~.e~ c; ~ ................................. b. Intended use and occupancy . :~nr/~z.~.. ~of&Y.~. (~ K ~ ~ .... 3. Nature of work (check which applicable): New Building .......... Ad{ Rep~.8.[ .,~ ...... Remo*al,. .............. Demolition .... 4.' Estima st. .... .~ .~..~.~. · i ........................ Fee .. 5. If dwelling, number of dwelling dnits ............... Number of dw ition .......... Alteration .......... ......... Other Work .,/ff.~?& . ~ ~ ' r~es~r°i~~on) (to be paid on filing this application) ling units on each floor ................ If garage, number of cars ' 6. If business', commercial or mixed occupancy, specify nature and extent of each type of use ..................... 7. Dimensions of ex~sting structurea, if any: Front ............... Rear ............. Depth ............... Height ............... Number of Stories ........................................................ Dimensions of same structure wilh alterations or additions: Front ................. Rear .................. Depth .................... ~. Height ...................... Nu tuber of Stories ...................... 8. Dimensions of entire new constr0ction: Front ............... Rear ............... Depth ............... Height . .............. Number of Stories ......................................................... 9. Size of lot: Front ............ .......... Rear ....................... Depth ...................... 10. Date of Purchase ..... I .... Name of Former ~wner 11. Zone or use district in which pre~nises are situated 12. Does proposed construction violate any zoning law, ordinance or regulati* m:~ ................................ 13. Will lot be regraded I .................. Will excess fill b. ~ removed from premises: Yes No 14. Name of Owner of premises ... i ................. Address .................... Phone No ................ Name of Architect ....... : · · i ...... , .......... Address ..... . ..... Phone No ................ Name qf Contractor ~. ?.'.~. ~??~¥.~,J~....~-~ .... Address "~'~"~ ~'*~' ' I u ,~ .~.~.~rx~ ~ ~, ~t5 .Ih~.~.. Phone No.(~o).q.q.~. :r]~.~.~. .... PLOT DIAGRAM Locate clearly and distinctly all ibuildings, whether existing or propose{ property lines. Give street and block number or description according to deed, interior or corner lot. , ~ i STATE OF NEW YORK, COUNTY OF IS.S ....... ~Z) ~.'O~q ?... ~-.'~.... ~'~. ((J&tt~q ................ being duly (Name of individual signing contract) above named. , and, indicate all set-back dimensions from and show street names and indicate whether )rn, deposes and says that he is the applicant icer, etc.) ' ced the said work and to make and file this ~est of his knowledge and belief; and that the ith. (Contractor, agent, corporate of: of said owner or owners, and is du!y authorized to perform or have perfon application;, that all statements contOined in this application are true to the work will be performed in the manner set forth in the application filed therea Sworn to before me this ~ .............. ! .~.~. ..... day oI. .~ ........ 19~ .~'- ~o~ety ~oblt¢, 8t.te of New York No, 47~565~ Ouallfled in S~ffolk {~o~n/~l, He is the ' C:IERTIF. .' ao~,~mcleV.,~.,N';¥Oy~ p. c. '! PLAN ~OLLED bgRLL FoRr4 ~-S1' 6¢9c-,R~ TE OF CON/',RETE I]LOC~ V/ALL PIPING ARRANGEMENT ~'3AND- J-~-- ~2" --~j POURED CONCRETE FOOTING SECTION B-B ,, i GRADE~ TYPICAL WALL S E CTION SECTION A-A S~INI'dlNG 8Y ARTHUR IZ HUNTER AVE. NILLER PLACE N.Y. POOLS EDWARDS OWNER