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HomeMy WebLinkAbout14088-z 765-1802 BUILDING DEPT. INSPECTION [ ]' FOUNDATION 1ST [ ] ROUGH PLBG. FOUNDATION 2ND [ ]INSULATION FRAMING [//~1NAL /o FORM NO. 6 TOWN OF SOUTHOLD Building Department Town Hall Southcld, N.Y. 11971 765- 1802 APPLICATION FOR CERTIFICATE OF Instructions A. 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 Archite~t 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: Addieions $25.00 POOLS $25.00 ALTERATION $25.00 1. Certificate of occupancy New Dwelling,S25.(10, Accessory ,,$10.00 Business $50.00 2. Certificate of occupancy on pre-existing dwelling $1~0.00 3. Copy of certificate of occupancy $ 5.00, over 5 years $10.00 4.Vacant Land C.O. $ 20.00 o.oo ..... 7..-/. NewCOnStrucgion...~... Old or Ftc-existing Building ............ Vacant Land ............. Location ofProperty ./.~'~'~.. ~ t 6,d~u'7-/ /J d, . .. ~ l V~ House No. Street Ham/et Owner or Owners of Property .. County Tax Map No. 1000 Section ..... .O.'~'.~...... Block ..~.?.......... Lot.,.~.~ ..... .... Subdivision ..... ~,~-/~. ,,~.~...Lj. ~z7-~, .......... Filed Map No...,.5'/.~.~., .Lot No. PermitNo. ~/Y0¢-¢~ Date of Permit '7.///~-.5- .......... · ^pplicant .~.: ~, /,~ .3..~:u.~,. .... . .. . .... ?..~ ~.~.~.~..-. .... Health Dept, Approval ...................... · · Labor Dept, Approval ........ Underwriters Approval ........................ Planning Board Approval ............ Request for Temporary Certificate ..................... Final Certificate ....................... Construction on above described building and permit meets all applicable codes and regulations. ........................... Rev, lO-lO-7a TERS 1985 fixTUREs RANGES OVENS , 1 1 2 DRYERS FURNACE MOTORS, IIME CLOCKS MULTI-OUTLET ' · SYSTEMS OTHER APPARATUS: : ' : ~ ~ ~ 'J ';i' ' ? ] ;: ? ' '.' ~G.P.C.I.. ? (swIMMING POOL}THIS CERTIFICATE 'COvERS COMPLIANCE ~iAT' ~HE DATE OF IIqSPECTIONO~LY. ~ZCA~SE31r ::'OE UNusuAL ,TT IS ADVISABLE TEST AND/OR REPAIRS MADE Pat Lane : must not' b6'alfered 765-~8~2 BUILDING DEPT. INSPECTION FOUNDATION 1ST [ ] ROUGH PLBG. FOUNDATION 2ND [ ] INSULATION FRAMING ]~FINAL BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD Town Hall, 53095 Main Road P.O. Box 728 Southold, New York 11971 June 21, 1985 TELEPHONE (5 ~.6) 765-1892 A. Reilly ~ Sons, Inc. Builders Box 434 Mattituck, New York 11952 Re: Thomas P. & Annette Jordan Pool Construction Dear Mr. Reilly: As per your request for a determination on the need of a Wetland Permit, regarding the above referenced matter, please be advised that the Trustees have reviewed your plan on June 20, 1985. The Board determined that no permit will be necessary subject to the adoption of a resolution on June 26, 1985 with the following provisions: 1. During excavation the fill must be contained so that it does not wash into the creek. 2. No backwash from the pool is to be discharged into the creek. 3. immediatel~following construction, all areas of exposed soil shall be properly protected with suitable erosion control devices and/or vegetated to prevent entry of eroded soil into the nearby waters. If you have any questions, or need additional information, please do not hesitate calling this office at the number listed above. Very truly yours, Henry P. Smith, President Board of Town Trustees HPS:ip cc: Trustees Building Dept ?iELD INSI'ECTION FOUNDATION__ ?OUNDATION (2nd) 2. ~OUGH FRAME & PLUMBING INSULATION ?ER N. Y. STATE ENERGY CODE FINAL ADDITIONAL COMMENTS: 'FORM NO. 1 .... TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N.Y. 11971 TEL.: 765-1802 ~,pproved .t .... 19~.~. Permit No.. ! .~..O.~.~..~. )isapproved a/c'. .................................... (Building Inspector) APPLICATION FOR BUILDING PERMIT INSTRUCTIONS JUN iT 1985 Received ........... ,19... Date a, This application must be completely filled in by typewriter or in ink and submitted to the Building Inspector, with 3 .ts 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- ~tion. 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 mil be kept on the premises available for inspection throughout the work. e. No building shall be occupied or used in whole or tn part for any purpose whatever until a Certificate of Occupancy mil 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 uilding Zone Ordinance of the Town of Southold, Suffolk County, New York, and other applicable Laws, Ordinances or egulations, 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 trait authorized inspectors on premises and in building for necessary inslzgeAiqns.__ ~ ................ (Signature of al~licant, or na,me, if a corporation) .... ............. (Mailing address of applicant) ,tate whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. lame of owner of premises .... i [~. .O.. .P.~. .~5. . ff....fir:...., f). .~..W. ~.T. d-~7 .... '~C.~Z,~ D dq A/.. ................... (as on the tax roll or latest deed) t' 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... ~.'~.~9. L:~.... ~Z.. L-.c [7[t CL Other Trade's License No ...................... .. . · Location of land on which proposed work will be done.. ./t3//.~'y.(( .v.~,.~ ......................... ........... /?. 5'/.o. ........ .... .......... 3'(> ................. House Number Street Hamlet County Tax Map No. 1OOO Section ...... ~..~. ........ Block ...... V .......... Lot... c:~..~: ........... Subdivision ...................... : .............. 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 ........... .~. ~5'./ff. ~-.-7~...7-~ .~.~ ........................................ b. Intended use and occupancy ....... ~C~../. O k~./..L-/~.(. ........................................... 3. Nature.of work, (check which applicable): New Building Addition .......... Alteration ...t./:....:'- ~-( / Repair .............. Removal .............. Demolition Other Work 4. E~timated Cost /(~ CV~)(_~ @~ (Description) · t .... / ....................... Fee ..................................... (to be paid on filing this application) 5. If dwelling, number of dwelling units ............... Number of dwelling 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 existing structures, if any: Front ......... : ..... Rear .............. Depth .............. Height Number of Stories Dimensions of same structure with alterations or additions: Front ................. Rear ................. Depth ...................... Height ...................... Number of Stories ..................... 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 ............................ 1 1. 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 ........ . .................... Will excess fill be removed from premises: Yes Nc 14. Name of Owner of premises '~,a.~. r./~.~I[~-~.~'Y'/~:. .~.~g.~Address . .-~t ~. ~//.qq(9o ~/.~.f.. Phone No ............... Name of Architect ............. ~ ............. Address '. .................. Phone No ..... ~; ......... Name of Contractor ../{: ~.ff/{~i ~ ~_ q"c~q' Address .~4'~Y.../q.~[~.~,/.¢/(~, .?.~'~¢~hone No. -~"xc/5'' ~/' ' ' 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 number or description according to deed, and show street names and indicate whether interior or corner lot. STATE OF NEW YORK, COUNTY OF ................. S.S ........... ~.~. · ~../~.. · ~..~.....~..'..: .'~.. ~ ./..~..47..~... being duly sworn, deposes and says that he is the applicant (Name of individual signing contract) above named. tie is the ........ ~..(_./. ?..~-....g~..4~. ?..~ ' i6[ [ ir'a' id, rl 'a'g;;,i, 'o'fh'c'd., Yt'c.') ............................ 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 manner set forth in the application filed therewith. Sworn to before me this NoCry Public, ~: ............ ~--4~g ' ..... County NOTARY PUBUC, State of New Y~k No. 4822563, Suffolk Term Expires Merch 30, 19 ~' ~:' NOTIFY BUll -"qG DEPARTMENT AT 765-1802 9 / ~'~ TO 4 PM FOR TPIF-~ Ix. FOLLOWING C, PECTIONS: JX, x'x,I' 1. FOUNDA=' ~,N - TWO REQUIRED '~ FOR P,GU" -r~ CONCRETE 2.ROUGH - ':-~AMING & PLUMBING 3.INSUI.-AT!~'" 4.FINAl_ - r"X~qTPUCTION MUST BE C'~M? "FPR C.O. x/oALL CONS]" 'c'-,-I©N SHALL MEET HE REOUII' '-~TS OF THE N.Y. STA~,~. CON '°,!,'CTION & ENERGY '~O' CODES. i',' '~- RESPONSIBLE FOR ', DESIGN OR CONST~.UCTION ERRORS, HEALTH DEPARTMENT-DATA FOR APPROVAL. TO CONSTRUCT STAKE 0 -" P/PE SUBD/VISION MAP FILED 141 THE OFFICE OF OF.$UFFO£K COUNTY ON AUG. Y~ 1968 AS FII ~ NO. ~1~7. # ~ LOCATION OF ~ILL(W), I[PTIC TANK(ST)& CE~OL$(Oe) ~NOWN HEREON SURVEY FOR MAy THOMAS /~ JORDAN ~ ANNETTE JORDAN ~vov. LOT NO. 55, "HARBOR LIGHTS ESTATES, SECT/ON THREE ~WN ~ SOUTHOLD SCALE: SUFFOLK COUNTY, NEW ~RK No, II YOUNG YOUNg ALOEN W. YOUNG~ PROFESSIONAL ENGINEER AND LAND SURVEYOR N.Y.S. UCENSE NO. 12:84.5 HOWARD ~YOUNG, LAND SURVEYOR N.~ S. LICENSE N0.45893 400 OSTRANDER AVENUE RIVERHEAD~ NEW YORK