HomeMy WebLinkAbout14269-zFORM NO. 4
TOWN OF SOUTHOLO
BUILDING DEPARTMENT
Office of the Building Inspector
Town Hall
Southold, N,Y.
Certificate Of Occupancy
No. .Z. 15~5.4.3. Date March 25, 1987 THIS CERTIFIES that the building P o o 1
Location of Property 80 Greenway Drive ' Cutchogue
House No. Street Hamlet
County Tax Map No. 1000 Section 109 .... Block 05 .Lot ! 4. 17
Subdivision .............................., FAIRWAY FRARbIS Filed Map No ......... Lot No. 1 ............. 7
conforms substantially to the Application for Building Permit heretofore filed in this office dated
..... 8../.2.2./. 8..5 .......... pursuant to which Building Permit No. 14 269 Z
dated ...... 9. { .1.2./. 8..5 ................ was issued, and conforms to all of the requirements
of the applicable provisions of the law. The occupancy for which this c~rtificate is issued is .........
Inground pool.
The certificate is issued to . ETHEL FRYE
(owner, Xe~Ct~XttOl~Rj(
of the aforesaid building.
Suffolk County Department of Health Approval N/A
UNDERWRITERS CERTIFICATENO... ~..~i.. ~ .5 .~ 7. .5 7.2.6. 5. ............................
PLUMBERS CERTIFICATION DATED:
Building Inspector
Rev. 1/81
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN HALL
SOUTHOLD, N. Y.
BUILDING PERMIT
(THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL
COMPLETION OF THE WORK AUTHORIZED)
14269 Z
Permission is hereby granted to:
........~.~ ............................ .~.~,u ~.1 ~: .................... .....
....... ..................
.......... .g...q.~.~..~,.?:~ ......... ~ ~ ~.,.. .. . ~.! .
to .......................... ~ ...~. ........................................................................
at premises located at .................................................................... .~. ....
County Tax Map No. 1000 Section ......... l..~..7. ....... Block ~'~ Lot No. ~'/Z
pursuant to application dated ................................ **~. ................... , 19 ........ , 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 OCCUI
Instructions
A. This application must be filled in typewriter OR ink, and submitted m~ 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.
B. For existing buildings (prior to April 1957), Non-conforming uses, or buildings and "pre-existing"
land uses:
1, Accurate survey of property showing all property lines, streets, buildings and unusual natural or
topographic featu res.
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-
Lion required to prepare a certificate.
C., Fees:
1. Certificate of occupancy New Dwelling $25.00, Accessory,,$J0.00 Business $50.00
2. Certificate of Occupancy on pre-existing dwelling $ 50,. 00
3. Copy of certificate of occupancy $ 5.00, over 5 years $10.00
4.Vacant Land C.O. $ 20.00
5o/3pdated C.O.,~ $ 50.00 Date ..........................
New C OhS ~ ruc % i on ~,,.,.. Old or Pre-existing Building ............ Vacant Land
/ ,
Location of Property. ,.'~,...~.V ~.~..~..~ ~..~.7,/ /.-.~. ! .~:..~.~.,,, , .~.~ M ~5.~. ....
Hamlet
Owner or Owners of Property /~'--~L h~ / F.v,
County Tax Map No. 1000Section ~./.0..°[... Block 5- Lot. /~"./.?
Subdivision... .~. .... .~..'~..~. .... Filed Map No ........... Lot No. ,/..7. ........
Permit No. ~/~..~.~..~..Z,. Date of Permit ..~/f/~ .z/.f.>.-~ .Applicant ~ ..~.~¢f..
Health Dept. Approval ........................ Labor Dept. Approval ........................
Underwriters Approval ~d_ ¢//~-~ Plannin card roval ......
........................ g B App ................
Request for Temporarv Certificate ..................... Final Certificate .......................
Fee Submitted $.../..~.~..-~. ....................
Construction on above described building and permit meets all applicable codes and regulations
:'..: ·
Applicant ..... ;.4~. ............................
a,,,,.,o-,o.,a
THE NEW YORK BOARD OF FIRE UNDERWRITERS
~.(~0~07~. BUREAU OF ELECTRICITY
~ 85 JOHN STREET. NEW YORK, NEW YORK tOO38
.ate N757265
THIS CERTIFIES THAT
o~y the electrical equipment ~ ~scrlbed belo~ a~ introduced by the appl~ant ~med on the above application number in the premises of
J~e~ ~ye, ~v C/O F~ay ~i~, F~ay ~, ~tc~e, N.Y.
~. meyo~o~i,,g ~,,~.tio~ ~ ~.~.~e.~ ~ ~ ~. ~ ~nd ~'~. ~side s~ti,,~ B~ Lot
was exatnined on ~ ~9 ~ 1~ andfound to be ln co.tpliance with the requirentents of this Board.
FIXTURE FIXTURES RANGES COOKING DECKS OVENS DISH WASHERS EXHAUST FANS
OUTLETS SWITCHES FLUORESCENT
1 2
1
DRYERS MOTORS FUTURE APPLIANCE FEEDERS TIME CLOCKS
NIT HEATERS MULTI.OUTLET
NO. OF FEET
DIMMERS
SERVICE DISCONNECT S E R V I C E
~bS~IM~G_~I~O_L_)~ This oer~ificate covers compliance at the date of inspsction only.
Because o£ unt~ual ~Lvirom~nts it is advisable to have frequent test/and or repairs
made by a qualified pe:m,~on.
8 Electric
215
Southe ld, N.Y.
11,971 L%c. 578E
GENERAL MANAGER /
This certificate must notbe altered in any manner; return to the office of the Board if incorrect. Inspectors m'~y be identified by their
COPY FOR BU~ILD NG DEPARTMENT. THIS COPY OF CERTIFICATE MUST~?OT BE ALTERED IN ANY/~ANNER.
Il. ELD INSFEC~ION
'OUND~TION (1st)
COMMENTS
UNDATION (2nd)
~UGH FRAME &
PLUMBING
ISULATION PER N. Y.
STATE ENERGY
CODE
FINAL
ADDITIONAL COMMENTS:
765-1802
BUILDING DEPT.
INSPECTION
[ ] FOUNDATION 1ST [ ] ROUGH PLBG.
FOUNDATION AND [ ] INSULATION
DATE ' INSPECTOR
TOWN OF SOUTHOLD
OFFICE OF BUILDING INSPECTOR
P.O. BOX 728
TOWN HALL
SOUTHOLD, N.Y. 11971
TEL. 765-1802'
To Whom This May Concern,
We are unable to complete your Certificate
of Occupancy because,of the following reasons.
/_~//'--/ An application for Certificate of Occupancy
is not on file.
/~//, No Underwriters Certificate on file,
/~ The check is(~/not on file.)~/~,O
/~/ No Healtk Dept. Approval on file.
/5/ No final inspection has been made.
Please contact our office on this matter.
Thank you for your cooperation.
-Building Permit # ~_/ ~ ~ ~ ~ Z
Building Dept.
***/5/ No Plumber Solder Certificate on file.
( all permits involving plumbing being
issued after April 1,1984 )
22 ALLEN BOULEVARD
FARMINGDALE, NEW YORK
August 22, 1985
Town of Sonthold
Office of Building Inspector
Town Hall
P. O. Box 728
Southold, NY 11971-0728
Dear Sir:
Enclosed are application for a building permit to construct
a swishing pool for Ethel Frye, Greenway Drive, Cutchogue and a
check for the applicable fee.
Please have the application processed.
Please have the permit sent to our office.
If a.y additional data is required, we would appreciate
you calling us.
Yours truly,
Charles Spallino
CS/mjb
Enclosures
~ FORM NO. '~
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN HALL
,~OUTHOLD, N.Y. 11971
TEL.: 765-180:~
.... .....
Received ........... ,19...
isapproved a/c .....................................
(Building Inspector)
APPLICATION FOR BUILDING PERMIT
~/v. ~X~-
Date .. ~ ...........19...
INSTRUCTIONS
a. Tins api~lication must be completely filled in by typewriter or in ink and submitted to th6 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
: 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 tins 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
tall 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
tall 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 a tees to comply with all applicable laws ordinances, building code, housing code, and regulations, an.d t~
lmit authorize~ inspectors on premises and in buildh'tg for necessary inspections.
Q~ ~,,~ ~.~,g~ .............
(Signature of applid~nt, or name, if a corporation)
(Mailing address of applicant)
tatewhether applicant is owner, lessee, agent, architect, engineer, or~_er.~
general'
contractor,
electrician,
plumber
me of owner of remises ~ ~../f.~.~. .... ].-~f.~./~. .................................................
P (as on the tax roll or latest deed)
~ applicant is a corporation, signature of duly authorized officer.
...... .v.:?: ......
(Name and ~tle 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 will be done ..................................................
.......................... ./. . . b. ?. ! ......... C. ?. .o. F:.4.g ..... ,'/. I,
House Number Street Hamlet
County Tax Map No. 1000 Section .... ~..Q .~. ......... Block .... ~...~. .......... Lo{ .~¢"
/
7
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 .... '?.t~ J.~. /~. .~. .[/~. . ~ ~" ~ t ~} ~ ,~/.C ~ .........
b. Intended use and occupancy ~./.T..,c/~qT~ .~gO/~l't~,~} t./.V..5... ?oC {~-
3. Nature of work (check which applicable): New Bu/Iding .......... Addition .......... Alteration
Repair Removal Demolition Other Work ·
4. Estimated Cost. ,~',. ;L o o o
' ' /.. ~ ............................ Fee ...........................
~ 4, (to be paid on filing this application)
5. If dwelling, number of dwelling traits ............ 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 Dimen'sions of existing structures if any: Front Rear Depth
Height ............... Nurqber of Stories ........................................................
Dimensions of same structure with alterations or additions: Front ................. Rear ..................
Depth ................... i., Height ...................... Number of Stories ......................
8. Dimensions of entire new construction: Front .. 1~' ......... Rear ,. {~q7 ........ Depth ............
Height ............... .Number of Stories ..... i /?~ 'o' )
9. S~ze of lot: Front .... ~. .. Rear ....... Depth ~-.~ ...................
10. Date of Purchase .......... i .................. Name of Former Owner .............................
11. Zone or use district in which pr~mises are situated ....................... x','b ..........................
12.. Does proposed construction vic!ate any zoning law, ordinance or regulation: ../.~. ..........................
' 13. Will lot be regraded ........ i .................. Will excess fill be removed from premises: ~ No
14. NameofOwnerofpremises ]:~ .~_J..~.L:.../.-?~.~.~.. AddressO?eearu~ ~)~, ~rc~¢~'~h '~t~
....... ~. ........... P oneNo ............. ?..
Name of Architect ......... ~ ................. Address ................... Phone No ................
Name of Contractor fJ0Pe~. ~2.~. ,~t.t, qtt, t¢. ~q t.... Address 24 :~./eY fl.~.~.~. ....... Phone No...o~..~..~.: .~.d.~t'. p' ..
PLOT DIAGRAM
Locate clearly and distinctly ali buildings, whether existing or proposed, and, indicate all set-back dimensions from
property lines. Give street and blockinumber or description according to deed, and show street names and indicate whether
interior or corner lot.
STALE OF NEW YORK,
COUNTY OF j .~'..~.g.a". ~. ?..... S.S
,' CWAtt/es
(I~ame of individual sig~ing contract)
above named. I :
being duly sworn, deposes and says that he is the applicant
H th 0_~o tx[ 7'-?~ ~9- C T o t~
els e .... ~ ................ ~ ...................................................................
(Contractor, agent, corporate officer, etc.)
of said owner ;or owners, and is du!y 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 p{rfonned in the mann~ ~r set forth in the application filed therewith.
Sworn to befor, e me this ]
........... ! ...... ]~ .... dayc
Nota!~ Public, i · ~--'QrVA' .....
No. 52-316411~ ~
~a,..a ~. a....~ co..~ (Signature of applicant)
\
\ t
SUFFOLK COUNTY DEPARTMENT OF HEALTH SERVICES
FOR APPROVAL OF CONSTRUCTION ONLY
DATE HS REF. NO.
DEPARTMEnT-DATA FOR APPROVAL TO CONSTRuCT
WAY
1:5.2.
SURVEY FOR
ETHEL FH YE
I..OT NO. 17, "FAIHWAY FA.HMS"
AT CUTCHOGUE
TOWN OF SOUTHOLD
SUFFOLK COUNTY, NEW YORK
DATE: dOZY 20,
SCALE: / "= 40'
NO. ~3- 540
/ :'t' d
.4* I/
YOUNG