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Home My WebLink About14239-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. Certificate Of Occupancy No ......... g.l.q 5.6.1.. Date .......... .g.u.n.e...2.0 ............... 19 .8.6. THIS CERTIFIES that the building ....... ~_lag.~.o..u[~.ct..P. 993 ........................ Location of Property ...3913. ~t.ejn.~.y ~ I~a..n.e. ?econJ_c House No. ' ............. Street ............... ~iei County Tax Map No. ] 000 Section ...... 7./~ .... Block ........ .2. .....Lot ...... .3 .4 ......... Subdivision.. -P.e c o n.Lc. ~?~m~ ~. ~,e.q,..1 ..... Filed Map No .... 4. 1. .~.1 ,Lot No....3.3 ......... conforms substantially to the Application for Building Permit heretofore filed in this office dated ·.. g~ue g. ~5. ........ , 19 ~5. pursuant to which Building Permit No ..... .1.6.2.3. 9..Z .......... dated ........ ~ ~ p.l:.e.n~ lp ? r..5 ....... 19 ~3 ~., 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 ......... Ingz'ound pool. The certificate is issued to MARGARET & JOHN SKABRY ..................... ...................... of the aforesaid building. Suffolk County Department of Health Approval N / A . UNDERWRITERS CERTIFICATE NO. P g N D Z N O Building Inspector Rev. 1/81 FO~ NO, ~ TOWN O~ $OUT~OLD BUILDING DEPARTMEN'r TOWN HALL $OUTHOLD, N. Yo BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) N~ 14239 Z Permission is hereby granted~to~ ,~ ,//, __ ...~......~...q...~.~.~ ............................................... ' ~ '~. ,.1l &"~.--~ ~~ .................................... ~; ....... : .................. ~ ....... ~ .............. .~. ........ ~.....:..; ........................ at premises located at ,....~.~ .......... ..~...~.....~.....~ ...... .~-~..~ ...~.-. ..................... 'V~. .~,~-~:. ~.~.~ ...................................................... ............ ~'"'~ ........... ~ ........... ~" ............................ ~' ",~i i County Tax Map No. 1000 5ection~ ............... ..~ ...... Block ..... ..~....~.... ...... ot No ....... J. .......... pursuant to application dated .. .d~9...~.......~.~ ................... , 19.?...at.., and approved by the Building Inspector. Building Inspector Rev. 6/30/80 FORM NO. 6 TOWN OF $OUTHOLD Building Department Town Hall Southold, N.Y. 11971 765- 1802 APPLICATION FOR CERTIFICATE OF OCCUPANCY Instructions BLDG. DEPT. TOWN OF SOUTHOLD This application must be filled in typewriter OR ink, and submitted ~ 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~2operty 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. Fees: 1. Certificate of occupancy $5.00 2. Certificate of occupancy on pre-existing dwelling 3. Copy of certificate of occupancy $1.00 4.Vacant Land C.O. $5.00 5. Updated C.O. $15.00 $15.00 Date .......................... New Building ............. Old or Pre-existing Building ............ Vacant Land ............. Location of Property .................................................................. House No. Street Ham/et Owner or Owners of Property "~'O/.~,/J ~ ~~ ~', County Tax Map No. 1000 Section 7~ Block ~.. Lot.. ~ Subdivision ~)~ ..~ ......... Filed Map No. ~ / .LotNo .............. Permit No. /.~.~ ¢.. Date of Permit ~.~ ~Applicant .~.,.~.~.&~ ~ ~.~ .~[ .... Health Dept. Approval ........................ Labor Dept. Approval ........................ Underwriters Approval ........................ Planning Board Approval ...................... Request for Temporary Certificate ..................... Final Certificate ... ~... ................ Fee Submitted $..d..~... ?/.~...?..~J. ?...~. ..... Constru,c, tion on gbove ,de, scribed bu ilding and peri, it meets ,a~/~pplicable codes and regulations. Rev. 10-10-78 FIXTURE . .. I FIXTURES RANGES FCOOKINODECKS ~ OVENS DISH WASHERS (Swimming Pool)This certificate covers compliance at the date only. Because of unusual environments it is advisable to have and/or repairs made by a qualified person. DIMMERS A. WG OF NEUTRAL of inspection frequent test John Skabry certificate must notbe altered in any manner return to the office of the Board if incorrect. Ins ectors ma be identfe ! .~ ~,~.~z~,,.,,.,~,~m~w~,~.~,~w~ ~e~,-.A,~.T,,-,~,.iti~,....,~c~.~ors~m,~aY~be~,~d~ d by their credentials. [ CO~Y FOR B~ILDING DEPARTMENT TH S COPY OF CERTIFICA~EMUS~ ~oT BE xL~:~n ~ * ............ 765-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLBG. [] FOUNDATION 2ND [/]~JJ~ATION [ ] FRAMING [/-~FINAL REMARKS: I~ ¢ ~'~ ;-- INSPECTOR FIELD INSPECTION DATE COMMENTS 1. FOUNDATION (1st) FOUNDATION ___J(2nd) ROUGH FRAME & PLUMBING 3. INSULATION PER N. Y. C,ODE FINAL )ITIONAL COMMENTS: ~,OGGUPANGY OR 'FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL 8OUTHOLD, N.Y. 11971 TEL.: 765-1803 ~LDG. DEPT TOWN OF SOUTHOL q ,pprove~_~.~..&~...~....~.., 19 ~..~. Permit No. / ~/.&..~.q..~:.. 3isapproved a/c ..................................... t~ ~ ~'o ~ ............................... ..... (Building Inspector) APPLICATION FOR BUILDING PERMIT INSTRUCTIONS Received ........... ,19... a. Tlds application must be completely filled in by typewriter or in ink and submitted to the Building Inspector, with 3 a~ets 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 '· ~r areas, and giving a detailed description of layout of property must be drawn on the diagram which is part of this appli- ~ dation. 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 ~hail be kept on the premises available for inspection throughout the work, i e. No building shall be occupied or used in whole or in part for any purpose whatever until a Certificate of Occupancy · s~all 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 · l~uilding Zone Ordinance of the Town of Southold, Suffolk County, New York, and other applicable Laws, Ordinances or ~hegulations, for the construction of buildings, additions or alterations, or for removal or demolition, as herein described. e applicant agrees to comply with all applicable laws, ordinances, building code, housing code, and regulations, and to ,~ ~dmit authorized inspectors on premises and in building for necessary inspections· ...~.:..££/.~.z-.~.. ~. . .J.o. v.~.,. .~zF £ : ......... (Signature of applicant, or name, if a corporation) ~..~×. ~. ¢./..Y~r.~./..z~.../c...~...::/¢..~. l/M> (Mailing address of applicant) tate whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. .¢.~ .~2. dc....c~..~ .,.~.~..~.~...~o. ~ .................................................. ~qame or owner of premises ...~.~.~..~.~.~../~. · ~.0~ ..... '20~.~/5/ ...... ~·~./4~.,~..'~. ~. ...................... ~ (as on the tax roll or latest deed) if a~'~ is a corpql;atiop,Aign~t~ure of duly authorized officer. · ~;/) ......... Builder's License No ......... /.t? .............. Plumber's License No ......................... Electrician's License No...}~..o.~..~7~...~.... {q~. ~.~,~.~ t C Other Trade's License No ...................... Location of land on which proposed work will be done ..... .~..'~:~. .... ,,:-: ........... .... ~ ~.q ...... //.~.-/,(~. ~..~ .... .z:~.~.~ ..... £z> :,,,r:./.~..~, ~.....c..-~.....,,V.-.../: ..... ./.~' ?..?..~ .......... House Number Street Hamlet .,c - County Tax Map No. 1000 Section ...... '?.~. ..... .,·. Block .... .~. ............ Lot ..... 9~. ......... Subdivision.. P~. (,to .,10. ~,...k/-& .¢~.gf,.~' ............... 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 .................................................................... b. Intended use and occupancy ................ ~' .~/./?..~.~.. ,...~.~... ~~ ......... ' .... 10. 11. IZ l~. re~flaw~or.k ~lsck h ~ ng ..... ' ' Natu whie pplicable): New Buildi ; .... Addition .......... Alteration .......... Repai/~., ?.,. ~ .... Removal .............. Demolition .............. Other Work ._.~.~.. ........... ,' S~,~,~. ~oC (Description) Est~ated Cost .......... ~ ................... Fee .; .................................. ,~ ~ (to bo paid on filing this ap3 dication) If dwelling ' ' ' Number et dwelling units on ~ach floor , number of dw~mg umts .............................. If garage, number of cars ... ~ .................................................................... If business, commerci~ or mix,ed occupancy, specify nature and extent of each type of use ..................... 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 conitmction: Front ....... ~ ........ Rear ............... Depth .............. Height N~ber of Stores Size of lot: Front Re~ Depth Date of Purchase ~ Name of Foyer Owner Zone' or use district in which premises are situated ..................................................... Does~proposed construction viblate any zo~ng law, ordinance or re~lation: .......... Will lot be regraded ....... ~ ................ Will excess fill be removed from premises: Yes Nme of Architect ........ ~ .................. Address ................... Phone No ................ N~e of Contractor ~: ~k7 ~& Y. ~..~. ~. Address flq~. ~P/, .~Phone No..~c~o~.. PLOT DIAG~ Locate cle~ly ~d dist~ctly ~1 burden, whether existing or proposed, ~d. indicate ~1 set-back d~ensions from' property lines. Give street and bloc interior or corner lot. number or description according to deed, and show street names and indicate whether STATE OF NEW YORK, ~ S.S COUNTY OF ................. (Name of individual signing contract) above named. being duly sworn, deposes and says that he is the applicant He is the ..................... . .................................................................... ~ (Contractor, agent, corporate officer, etc.) of said owner or owners, and is dgly authorized to perform or have performed the said work and to make and firg'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 p'erformed in the man~er set f6rth in the application filed therewith. Sworn to before me this Notary Public ..... ~.: .~.4..~..0~. ..... ,.. County of apphcant)