HomeMy WebLinkAbout13821-zFORM NO. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Office of the Building Inspector
Town Hall
Southold, N.Y.
Certificate Of Occupancy
No ..... .Z.-.1.6..6.1.6 ..... Date January 27, 1988
THIS CERTIFIES that the building . .C.o..n.s.t.r.u..c.t..~,n. g.r.o.u.n..d..p.o. ?.1. ?...f.e.n.c.e. .........
Location of Property 4545 Pecons-c Bay Blvd. Laurel, N.Y.
- - h35s'o~id ....................... 's'do3i ....................... h3~,idt
County Tax Map No. 1000 Section128 .Block .3 ......... Lot 19
Subdivision ............................... Filed Map No ......... Lot No ..............
conforms substantially to the Application for Building Permit heretofore filed in this office dated
March 29, 1985 13821 Z
..................... pursuant to which Building Permit No.
dated .....A. p .............. r 5_ 1 ~, 198 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 .........
INGROUND SWIMMING POOL & FENCE AS APPLIED FOR
The certificate is issued to F L 0 Y D & L 0 T T I E J 0 N E S
..................... ?o;;,.'o;, 'ri~'~t~'~' × ....................
of the aforesaid building.
Suffolk County Department of Health Approval ............ .N/.A. ..........................
UNDERWRITERS CERTIFICATE NO.. N 6 9 I 5 34
PLUMBERS CERTIFICATION DATED: N/A
Building Inspector
Rev. 1/81
FORM NO. It
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)
NO
13821 Z Date. ~ ......
Permission is hereby granted to: ~
..Q...~...~.~2~....~.~ ...................
~.~...~:.,~...,~. .............................. ::. ........
~~ .~........u.:~.:....!./..~.~..~.
,o...~~.~~ .i.~.~~..~......~..~......~......~~..
~ ......................... :':"':';'"z'~ ......... ~' .... ~: ....... '~ ......... ":"~ .... ~ ..................
~ p,em~ses located ~.~.?..~ ..... ~.~...~.~...~....~....c~L.,....~..~ ...... ~ ..........
County Tax Mop No. 1000 Section ..... .,/.,.~...~.. ......... Block ....... ,~ ............ Lot No .....................
pursuant ,o application dated .... .....~,~.......~...~. ................ , 19~.~..,'~., and approved by the
I~uildlng Inspector.
Building Inspector
Rev. 6/30/80
FORM NO. 6
TOWN OF SOUTHOLD
Bu ildlng Department
Town Hall
Southold, N.Y. 11971
765- 1802
APPLICATION FOR CERTIFICATE OF OCCUP
BLDG. OEPT,
Instructions
A. This application must be filled in typewriter OR ink, and submitted m ~ to the Building tnsoec-
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 topograph c 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 p:Coperty 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: Additions $25.00 FOOLS $25.00
1. Certificate of occupancy New Dwelling $25.00, Accessory ,$]0.00 8uslness $50.00
2. Certificate of occupancy on pre-existing dwelling $ 50.00
3. Copy of certificate of occupancy $ 5.00, over 5 yeats $10.00
4.Vacant Land C.O. $ 20.00
5.Updated C.O. $ 50.00 Date .,.J.a.n.:.,23, 1988
New C on s l;t~ u c t, i on....x.. Old or Pre-existing Building ............ Vacant Land .............
Location of Property 4545 Peconic Bay Boulevard Laurel, N.Y.
House No, Street Ham/et
FLOYD & LOTTIE JONES
Owner or Owners of Property ............................................................
]28 3 ]9
County Tax Map No. 1000 Section ............... B~ock ............... Lot ................
Subdivision ................................. Filed Map No ........... Lot No ..............
PermitNo. 13821 Z Date of Permit 4/I/85.Applicant A. Rei11¥ & Sons, Inc.
Health Dept. Approval ' Labor Dept Approval
Underwriters Approval . . .N. 6. 9..l .5.3.4 .............. Planning Board Approval ......................
Request for Temporary Certificate ..................... Final Certificate .......................
Fee Submitted $ 25.00
Construction on above described building and permit meets all applicable codes and regulations.
Applicant FLOYD JONES
Rev. lO-10-7a
FIELD INSPECTION
FOUNDATION
(1st)
FOUNDATION (2nd)
ROUGH FRAME &
FLUMBING
INSULATION PER N.
STATE ENERGY
ODE
FINAL
COMMENTS
ADDITIONAL COMMENTS:
TOWN OF $OUTHOLD
OFFICE OF BUILDING INSPECTOR
P.O. BOX 728
TOWN HALL
$OUTHOLD, N.Y. 11971
TEL. 765-1802
January 4, 1987
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. ENCLOSED
/~ No Underwriters Certificate on file.
The check is(outdated/not on file.) $25.00
/5/ No Health Dept. Approval on file.
/5/ No final inspection has been made.
Please contact our office on this matter.
Thank you for your cooperation.
~uilding Permit ~ A 3 ~ 8~. 2 ! Z
Building Dept.
***/5/ No Plumber Solder Certificate on file.
( all permits involving plumbing being
issued after April 1,1984 )
SENT TO: FLOYD & LOTTIE 30NES
4545 Peconic Bay Boulevard
Mattituck, N.Y. 11952
USE OF THIS POOL WITHOUT A CERTIFICATE OF OCCUPANCY IS
ILLEGAL. Please comply by filling out this application
and returning it with your check to avoid legal action.
Thank you.
THE NEW YORK BOARD OF FIRE UNDERWRITERS
100].38l
BUREAU OF ELECTRICITY
~k~. SS JOHN STREET, NEW YORK, NEW YORK 1OO3e
Date ~ay 14,1985 331140/85
A,~.l,cat,~.. N.. on f,,~ N 691534
THIS CERTIFIES THAT
outside
in the followlng location; ~ Basement ~ 1st FI. ~ 2nd FI. Settle. Block Lot
~,,~.~.~do. Mey 6,1985
FIXTURE
OUTLETS
DRYERS
~ECEPTACLES
FIXTURES RANGES OVENS DISH WASHERS EXHAUST FAN
SWITCHES
FtUORE$CENT
SYSTEMS
OTHE AE AR U '.
~.~.~.~.
(Swimming ~ool )
E R
NO O E COND' OF %C CONO
V I C
NO OF HI.LEG
OF HI-LEG
NO. OF NEUTRALS
AW, G
OF NEUTRAL
This certificate covers compliance at the date of insp
only because of unusual environments it is advisable to have frequent test
and/or repairs made by a ~ualified person.
Jody Pumillo
Pat Lane, P. O. Box 182A
Mattltuck~ N.Y,,~ '[1952
FORM NO. 1
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN HALL
~OUTHOLD, N.Y. 11971
TEL.: 765-1802
Examined ~...[ ..... , 19 .?~./
Approved ../. ...., 19 .g ?. Permit No. I .~. ?.~../..~..
Disapproved a/c .....................................
BLDG. DEPT.
TOWN OF SOUTHOLD
Received ........... ,19...
(Building Inspector)
APPLICATION FOR BUILDING
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, bu~td}ij~g code, housing cod%. and regulations, and to
admit authorized inspectors on premises and in building for necessary i.. P.n~..~_._~...~;~q....~..]~....~...~.
'" i~]i~r'e';[ applicantl ;; 'n/r~,,i~o~g;a'tid~) ....
· tip. ~. .... q..Jq..,..-c(~ve~-:..rIeg~r.. ~.,qz27~¢.(<.
(Mailing address of applicant)
State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder.
........... .C.~..~...~. ~..~. iq ....................................................................
Name of owner of premises .... /t-L.O..~.. ~'~.. :/:. .... 4 .o. ;r-Z/. &7....~. .... arO .~./r'72~ ............................
(as on the tax roll or latest deed)
If ap~at.~;t. 7° f duly auth°rized °fficer'
"'/' -" i~aMd ~-fi 'tiii~ ;~ ~r'aig ;}~i~r') .........
Builder's License No ......... ./0 ...............
Plumber's License No .........................
Electrician's License No..[~/~..ff..l~. ~.L.~//.~.q~Ig
Other Trade's License No ......................
Location of land on which proposed work will be done ....... .L..~. % .~...k~-....'.~...~. .........................
.../gf·//5'.i .... P.z~zo.:¢ .... t3~ r .... /J.~ v.o ......... .t. a~r.z~z. .... t .. z : . /o'.~. .~/ ................
House Number Street Hamlet
County Tax Map No. 1000 Section ..... \..>~. ......... Block .... ~ ........... Lot...\.~. ..............
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~3'./. ~.~4.&: ..........................................
b. Intended use and occupancy ...................................................................
3. Nature of work (check which ~pplicable): New Building ..... ' ..... Addition Alteration
Repair .............. Removal .............. Demolition .............. Other Work ......
~., ~ i (Description)
· ~4. Estimated Cost..., .,...~..5~..O...~ ............... Fee ......................................
~ ~ .... .' f ~ i ~" (to be paid on filing this application)
~T~. II'dwelling, number of~welhng units ..... ................ Number of dwelling units on each fioor ..........
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 viblate any zoning law, ordinance or regulation: ................................
13. Will lot be regraded ....... /~q) .................. Will excess fill be removed from premises: ~'Oj27~.? No
14. Name of Owner of premises ./~O)'~J. ~..6o. T2'.'.l.~:Z.O:8~Address . ~ ~.-6:~. ::/?~/t~..~r~hone No.. ¢./~...
Name of Architect ........ i .................. Address ................... Phone No ................
Name of Contractor . ~: .~ /77.. /.. ./fit. ~.. ~..2r~g.~ .~:. Address/JO*. P~q~. J~/477'/./'P~..'ii. Phone No. ~-~.'~'.~.~.-q.2 ....
Locate clearly and distinctly all
property lines. Give street and bloc
interior or corner lot.
k
PLOT DIAGRAM
buildings, whether existing or proposed, and, indicate all set-back dimensions from
number or description according to deed, and show street names and indicate whether
STATE OF NEW YORK,
COUNTY OF ... J'.(.//~ .6,((... S.S
...... ~.0./~/'1/I~¥... ~: ..~ ¢~.. ~ ............ being duly sworn, deposes and says that he is the applicant
(Name of individual s: ~ning contract)
above named.
He is the . ..... ~ ~.~ ~ ...................................................................
~ (Contractor, agent, corporate officer, etc.)
of said owner or owners, and is dgly authorized to perform or have perfomed the said work and to m~e and file this
application; that ail statements co0tained ~ this application are true to the best of his knowledge and belief; and that the
work will be perfomed in the m~ner set forth in the application filed therewith.
Sworn to before me this
.............. .......
Nota~ Public, ~~:~:~~. County ~ '
I
Nature of work (check which applicable). New Bud g ....... .~. o}/'~/~,= c:,/5r/4~
· . Rnmnval ... Demolition ................. Other Work~..~A'[.~,~~.~-.X ..........
Repair \~cr pt on
~ ' -- ~- Fee ......................... :.,x.,m: .............. ; ..............................................
Estimated Cost ............. ;'~':~" · .................... (to be paid on filing this application)
If dwelling, number of dwelling units .................Number of dwelling units on each floor .........................................
If garage, number of cars ......................... ' , -
If business, commercial or mixed occupancy, specify nature and extent of each type of use .....................................
Dimensions of existing structures, if any: . .~...~..... Rear ,..../~,.~.,.,~,,..~, ....... Depth ..~...-~....~..'. .................
/~ ~-~.
Height ............. =; .........
Dimensions of same structure wil
Depth .............
Dimensions of entire
Height ...
Size of lot: Front
Height ........................................
I~ate of Purchase ......... /..~' '~'/' .....
Number of Stories .............................
Rear . ..~ ..... Depth .................................
, ./.~..O...~.~.ff.~ ........ Depth ......... -~ ...........................
Stories ......................................................................
, of Former Owner ..~..x~.:..·.~.;;..~-*~..~.- '~"~'~' ........................
I, Zone or use__di~str~jc~ in which premises e situated ,~r.;.,.,, ...........................
L Does proposed construction violate any zoning law, ordinance or regmaz~on .......... 7f .......................................
Will lot be regraded .......... ...~...-.~.. ..... W excess fill be removed from premiX. ]~ Y~ .[ ] ~ . /
,. . . .......
~. Name of Owner of premises ,~,.~,t~.,,~.,/:,~'~X~'~" '/';' '~'~'¢~'"/7['" ) /y/~/'rC~?~,, ~/Phone Nmi
· . ~ .............. ,,..,~...; ................. ~i...it~?:~...:~.., ....... :.,: .............. . ....... ~...:
Name of Architect ........................................ , (Ad~lressl t '2 '~, '~, '~ (Phone No
PLOT DIAGRAM
Locate clearly and distinctly all buildings, whether existing or proposed, and indicate all set-back dimensions from
,roperty lines. Give street and block number or description according to deed, and show street names and indicate wheth-
r interior or corner lot. ' 4