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Home My WebLink About13791-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. Certificate Of Occupancy No. Zq 3535 Date June q8 198.5. THIS CERTIFIES that the building above-ground ]pool and fence Location of Property 200 Oakwood Drive Southold House No. Street Ham/et County Tax Map bio. 1000 Section ... 70 .Block ~2 . .Lot ~9 . Subdivision ............... .x. .............. Filed Map No. x .Lot No. x conforms substantially to the Application for Building Permit heretofore filed in this office dated .....................~arch ~9, 19~..5. pursuant to which Building Permit No ...................... ~1379~ Z dated ...~.~..~9.h. .2..6 ................ 19~..5. , 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 ......... above-ground swimmin~ ~ool and required fence. The certificate is issued to EDWIN F. &. D52xlYSE C. ~IC32gISSEN (owner, !e°_ree er .... r~O of the aforesaid building. Suffolk County Department of Health Approval ........... ~/.A ........................... UNDERWRITERS CERTIFICATE NO. N6939#6 Building Inspector Rev. 1/81 FOB, M NO. f~ TOWN OF SOUTHOLD BUiLDIHG Di~PAF. TMENT TOWN HALL SOUTHOLD, N. Y. BUILDING PER~IT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) N9 1379i Z Permission is hereby granted to: .......... ........ County Tax Map No. 1000 Section .... .**(~...7~.?.. ....... Block ........ ~...'~.. ...... Lot No. .......C~..!...~ ....... pursuant to application dated ...... .~..~,,C~....J...I~ ................. , 19.~...~.~., and approved by the Building Inspector. Building Inspector Rev. 6/30/80 FORM NO. 6 TOWN OF SOUTHOLD Building Department Town Hall ~outhold, N.Y. 11971 APPLICATION FOR CERTIFICATE OF OCCUPANCY Instructions in duplicate ;- A. This application must be filled in typewriter OR ink, and submitted~ , '~V,, :co'she 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 F~operty showing all property lines, streets, buildings and unusuat 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 preoare a certificate. C. Fees: 1. Certificate of occupancy $5.00 2. Certificate of occupancy on pre-existing dwelling $15.0 0 3. Copy of certificate of occupancy $1.00 4.Vacant Land C.O. $5.00 New Building ... : . · .~. · Id or Pre-existing Building ............ Vacant [.and ............. House No. Street Hamlet County Tax Map No. 1000 Section . .~..~.. (~. ....... Block .../. ~, ......... Lot.. ~...Z'..~ ........ Health Dept. Approval../f//~'../~.,., ............... labor Dept. Approval ...~/,'~, ................. Underwriters Approval~..Planmng Board Approval ...................:~ Request for Temporary Certificate Final Certificate ...L~.... ............... Fee Submitted $ .~ ..................... Construction~on above described building and permit meets all applicable c~odes a~d regulations· FIELD INSPECTION FOUNDATION (1 FOUNDATION ( ROUGH FRAME & PLUMBING 3. INSULATION PER N. STATE ENERGY qODE FINAL ADDITIONAL COMMENTS: THE NEW YORK BOARD OF FIRE UNDERWRITERS 1000121 BUREAU OF ELECTR[CITY: ~ ~ 30, 198.~ 85 JOHN STREET, NEW YORK, NEW'YORK '100$8 331729/85 ..,to ,ppllca.on No. o. file N 693946 THIS CERTIFIES THAT only the electrical equipment as described below and i~ttroduced by the applicant named on the above application nu tuber in the premlsez of Fred E. Flckelssen> 200 Oakwood Drive, Southold~ N.Y. im the follmvi,tg loeb; 2~J~] 4~a~me,,t [] ~st ri. [] ~,d Fl Outside D~ 3.~ D ' 'Section Block Lot was examined on and found to be in compliance with the r~quirements of this Board. FIXTURE FIXTURES RANGES COOKING DECKS OVENS DISH WASHERS EXHAUST FANS OUTLETS SWITCHES FLUORESCENT DRYERS SYSTEMS NO, OF FEET OTHER APPARATUS: Z-G.F.C.I E R V ; C NO OF CC COND, PER AW.G. OF CC. COND NO OF HI-LEG A W.O. NO OF NEUTRALS A.W.G, OF HI-LEG OF NEUTRAL (S~in~Po_p%) ~hls certificate covers compliance at the date of inspection only. Because of unusual environments it is advisable to have frequent ~est and/or repairs made by a qualiDled person. Paul Burns Town Harbor Lane Southold, N.Y. 11971 Lic. 282 This certificate must not be altered in any manner; return to the office of the Board if inco[rect. Inspecto.rs Per ~/', ]''/j may be identified by their credentials. ANY MANNER. Examined..'~t..0~..~. ~.., 19~. 'FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL ~°OUTHOLD, N.Y. 11971 TEL.: 765-1802 Approved . . .~0,4~..~.~.., 19~.. Permit No. l .~ .-1..~.1. Disapproved a/c ..................................... Recelved ........... ,19... (Building Inspector) APPLICATION FOR BUILDING PERMIT 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 authorized inspectors on premises and in building for necessary inspections. J ~ ~,, ~:'¢°'°-~(Sign~ '~' .2d'~at ureof applicant, or n%~~/. (Mailing address of applicant) / State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. Name of owner o remls ............. ax 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 ...................... ~ .~..: ................... 1. Loc~ of land on)~yhich proposed work will be done./~7~.... House Number Hamlet County Tax Map No. I000 Section .,~....O..~.Q ...... Block ..... .~..'"~.. ........ Lot .q .~.~. ............. Subdivision..~. ................ Filed Map No ............... Lot ............... (Name) 2. 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 . ~ ~.~/./5'..~.../.¢./..~..~..,~.' ..... .~..,~..~..~...~..~..~...~(~.~(~.~. 3. Nature of work (check which applicable): New t~ .... ~ .... Addition .......... Alteration ..... j,~... Repair .,,.~ .......... Ren~oval .............. Demolition ............. -- Other Work ?..~?./.'~....,(7.°~.~ - . ~;~' "~i i (Description) 4. Estim ted Cost .... ~ ......................... Fee ...................................... . I *'~ (to be paid on filing this application) 5. If dwelhng, number of dwelting umts ............... Number of dwelling units on each floor ................ If garage, number of cars .... i .................................................................... 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 9vith alterations or additions: Front ................. Rear .................. Depth ................... i\.. Height ...................... Number of Stories ...................... 8. Dimensions of entire new construction: Front ............... Rear ............... Depth ............... Height ............... Nu~nber of Stories ........................................................ 9. Size of lot: Front .... ./..~79....i ............ Rear ....... /. ~.-57. f ......... Depth ... ~d~"~ .t ...... ^ ..... 10. Date of Purchase .... /..P..7~. ................. Name of Former Owner ...~.'. t~?~.~.a/.~.. ~.~.~..i ..... 1 1. Zone or use district in which premises are situated .......................................... 12. Does proposed construcbon vmlate any zomng law, ordinance or regulation: .... .o ....................... 13. ,W, dl lot ~be,,regrade,d ... 44..o:&2,. ',:,z '.'' '--' ':;-: · ' - '. ' ' Will excess fill be ~'emo~d from premises: Yes 1 4. f~alne et owner or premises~.,.~...~..~: 9:..~?~/.J~..e.~. Address .~..,~f.~ .~.. ~.~.'..~..Z'd/~gPhone No. 2~;..'~: ./~'J/a . . .[-r-~.~ Name of Architect ......... i ................. Address ................... Phone No. Name of Contractor...~ .(.,,~Ig.¢ .~.~... Address . Phone No. i ?.' .~.~'~ PLOT DIAG! ~1 Locate clearly and distinctly a~l buildings, whether existing set-back dimensions from property lines. Give street and block number or description accord ~g to deed, and show street ~indicate whether interior or corner lot. STATE OF NEW YORK, COUNTY OF ................ ,EX'/~T, . S.S (Name of individual si above named. ..................... being duly sworn, deposes and says that he is the applicant ning contract) He is the ..................... ~ .................................................................... I (Contractor, agent, corporate officer, etc.) of said owner or owners, and is daly authorized to perform or have performed 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 manner set forth in the application filed therewith. Sworn to before me this · .. ........ ltl/ ....... day df ............ 19ff.fi''. Notary Public ..... NOTARY PiJgLIC, State of New York , . ,-~'-.~ .,,,~,--rl, =-~, *-~ . ,,, .' ...... No, ,/707,878, S'ulfolk C0urlt~..? ~ (Signature of applicant) Term Expires [Brch 30, 19-c'-r