The URL can be used to link to this page

Home My WebLink About13997-zFORM NO, 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N,Y, Certificate Of Occupancy No. Z14808 Aug 19 Date ...... ust 15 86 CERTIFIES t tl b ildi Pool . THIS tha ~e u ng ................................................. Location of Property 3.~.0 .L[U.T..H.E.R.S. RD. (BREAKWATER RD.) MATTITUCK ~ouse No. Street County Tax Map No. 1000 Section 113 .Block 03 ..... Lot 7..5 Subdivision ............................... Filed Map No ......... Lot No .............. conforms substantially to the Application for Building Permit heretofore filed in this office dated 5/15/85 1.3997 .Z ..................... , 19... pursuant to which Building Permit No .................... dated ....... .6./. 3. ./.8.5 .............. 19... , 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 ......... with f..e.n.c.i.n..g.. Accessory in, gr.ound pool & deck HENRY HAAN The certificate is issued to ........................................................... (owner, of the aforesaid building. Suffolk County Department of Health Approval ............. N./..A .......................... UNDERWRITERS CERTIFICATE NO ................... N, 7 ~.5.8.2, 2, ..................... Rev. 1/81 FOR~ NO. 0 TOI~VN 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) NB 13997 Z Permission is hereby granted to: ..~.~~...~....~.~.: ........ J..~.~..~. ...... ..~.~...~, .................. .~.~.£......~.:~.:....J..~..~..z/. ......... ,o ..~~.....~~...~.~~....£ ...~.......~.~.,...~...~ ~.....~ ............... ~.~ .......... ~. ...... ~ ......... .:~. ...... ~.::.~.:.~ .............. o~t premises Iocoted at ....~..:..~..:..~...~..o....~..~.:~.~......~...q..:......v.~.~.~ ............ County Tox Mop No. 1000 Section Il '~ Block ~:~ Lot No. ~ .~.:..~..~.. pursuont to oppllcotion doted ......... .~.~..(~..~....'~... ................... , 19..~....~.., ond opproved by the Building Inspector. Fee t Building Inspector Rev. 6/30/80 FORM NO. 6 TOWN OF SOUTHOLD Building Department Town Hall Southold, N.Y. 11971 765 - 1802 APPLICATION FOR CERTIFICATE OF OCCUPANCY Instructions A. This application must be filled in typewriter OR ink, and submitted m mmmmma 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 Amhitect or Engineer responsible for the building. B. 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 property 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: 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 5.updated C'O--4~f'j4 $15.00 Date .......................... NewCons tr~c t ion ...... Old or Pre-existing Build'~ng ............ Vacant Land ............. Location of Property , ~ .~. ~.e., ,~...2~..~..~., ,0,~. ~.~',~",,,~, ~ .~..~,~., .~., .~.~ ............... flou~e No. Street Ham/et Owner or Owners of Property. ./T.~..~..hv~. . ~z/'~.~ ~.,., ...................................... County Tax Map No. 1000 Section .. ,~, ,/. ,~. ....... Block ... ~[~ .......... Lot.... ,'~",. ~"' · Subdivision .......................... Filed Map No ....... Lot No, Permit No. ~,~..1~.~.?,~. Date of Permit ,~./.$/.~..~'..Applicant .................................. Health Dept. Approval ........................ Labor Dept. Approval ........................ Underwriters Approval ........................ Planning Board Approval ...................... Request for Temporary Certificate ..................... Final Certificate ....................... Fee Submitted $ ............................. Construction on above described building and p Rev. 10-10-78 i d regulations. Applicant ............................. F1ELD INSI~ECTION COMMENTS FOUNDATION (~st) FOUNDAT%ON (2nd~ 2. ROUGH FRAME & PLUMBING INSULATION PER N. STATE ENERGY qODE FINAL ADDITIONAL COMMENTS: THE NEW YORK BOARD OF FIRE UNDERWRITERS BUREAU OF ~L~CTRICITy 85 JOHN STREET, NEW YORK, NEW yORK 1003~.~ THIS CERTIFIES THAT only the electrlca~ ~uipmenZ ~ ~scrlbed below and int~uced by t~ applicant ~med on the a~ve app.cation nu ~ber in the prembes of Henry tIann, ~reakwater Rd. ~ Ma~ti~uck~ N.Y. in thefotlowJnglocation; ~ ~.~,.e.t ~ ~*t ~. ~ 2.d ~. outside s.oa,,, m~ rot ~,as exatnlned on .~e ]. 0 , '~ 9 ~ ~ and fou,td to be in compliance u'ith the reqa~rements of this I~oard. DISH WASHERS EXHAUST FANS DRYERS FURHACE MOTORS FUTURE APPLIANCE FEEDERS TIME CLOCKS MULTI-OUTLET SYSTEMS NO. OF FSET DIMMERS SERVICE DISCONNECT S E R I C (Swimming Pool)This certificate covers compliance at the da'to of inspection only. Because o~~ unusual environments it is advisable to have frequent ~est and/or repairs made by ~ qualified person. (No Visual Defects) "An electrical survey has been made of the exposed electrical equipment in the premises indicated. "No obvious unsatisfactory condion was found -Smoke Petector-~ Henry Haan Breakwater Rd.P.O.Box 1229 Mattituck, N.Y,, 11.952 This certificate must not be altered in any manner; return to the office of the Bqord if inco,(rect. Inspectors may be identified by their BUiLDIHG· DEPARTMENT. THIS COPY~ O~ RED IN~NY~ ~ MANNER. BUILDING DEPT, INSPECTION FOUNDATION ',ST [ ] ROUGH pL~BG. [] FOUNDATION 2ND [ .] INACTION ~ ~ FRAMING ~/.~FINAL REMARKS: ~//~'-~ , Examined ~.,~..'.~. .... Approved .?. · .t't~A4. · . .~.... FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N.Y. 11971 TEL.: 765-180:2 ., 19~..~. Permit No./.~..! .~.'7. ·~. Disapproved a/c ..................................... APPLICATION FOR BUILDING PERMIT Received .......... ,19. · · INSTRUCTIONS a. Tiffs application must be completely filled in by Wpewriter 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 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 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 Re~dations, 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 in_~ec~ ~ · ..... ......... ............... (Signature of applicant, or name, if a corporation) ·../.~. ~....&~.K~ .~'.~... {5~.. ~.,.,~. .......... (Mailing address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. ....... ........................................................................... Name of owner of premises . PJ~ .~-~.~. ~ .... [~;~ ............................................... (as on the tax roll or latest deed) If a~orpo~on, :1.~ f duly authorized officer. (I~ame and title of c~9¥ate officer) Builder's License No....~.[ .~-. ................. Plumber's License No ......................... Electncmn s L~cense o. Other Trade's License No. 7 .................... 1. Location of land on which proposed work will be done ....... , ~...~.t ...................................... .~ ~, ~.~,, . o~ . . 3'to ~ ~xo,~ , ~. ...:,~ .~ ~.~.,,:..%l.~. .~ ..~,. T:r-:.r.~. . . ~.~ ............. LO ~.~., i~c ..... ~... ~/ ............ House Number~~. Street Hamlet County Tax Map No.~1000 Section ...... ~ ........ Block ..... ~ .......... Lot .... ~ 7, ~ Subdwision ................. .~ ................. Filed Map No ............... Lot . . . ~ .......... (Name) 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: ~lO~ t~ ~ , ~, Existin~ use and occupancy .................................................................... b. Intended use and occupancy ........................... 3. Nature ofwor..k.(check which applicable): New Building .......... Addition .......... Alteration ........... Re~l~[ ~.~.~[~ ....... RemOval .............. Demolition .............. Other Work. i , ~..~- ~r ~ (Description) 4. Estimated Cost ......... ./(. 0~/.O~ ................... Fee ...................................... i (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 ............... Nurh bet of Stories ........................................................ Dimensions of same structure with alterations or additions: Front ................. Rear .................. Depth ' Height Number of Stories n ~ · pth 8. Dime sions of entire new construction: Front ......... , ..... Rear ............... De ............... Height ............... Number of Stories .......................................................... 9 Size of lot: Front . ! R D pth .......... : ............ ear ...................... e ......... . ............. 10. Date of Purchase .......... ! ................... Name of Former Owner ............................. 11. Zone or use district in which premises are situated ..................................................... 12. Does proposed construction viglate any zoning law, ordinance or regulation: ................................ 13. Will lot be regraded ..... .Z?~ .................... Will excess fill be removed from premises: ~ No 14. Name of Owner of premises . .(.42~ ..~.. (. pIA.~.*.~.... Address ................... Phone No ................ Nmne of Architect ......... Name of Contractor . .~.~4) Locate clearly and distinctly al 'property lines. Give street and blocl~ interior or corner lot. .... Address ................... Phone No ................ .... Address ... ~.T,.b.~.,. .~.. ..... Phone No.. ~..~:~!~'7.~ 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.~O,R.K, . /j S S COUNTY 07~... '' ................................ · ~ ......... being duly sworn, deposes and says that he is the applicant (Name of individual si~ning contract) above named. (Contractor, agent, corporate officer, etc.) of said owner or owners, and is d01y 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 dALL SECTION ~ '~' FRAME STI~ENE£ r4-: c.-~ PLAN VIeW OF POOL LONGITUDINAL SECTION MATERIALS LIST q' LATIcY-. f£,oc~ OCC ? EY OR APPROVED AS NOTED DATE: ~._~(_B.P. ~ J B~/qg ~ NOTIFY BUILDING DEPARTMENT AT 765~180~ 9 AM TO 4 PM FOR THE FOLLOWING INSPECTIONS: 1. FOUNDATION - TWO REQUIRED FOR POURED CONCRETE 2. ROUGH - FRAMING & PLUMBING 3. INSULA~ ION 4. FINAl. - COF¢STRUCTION MUST BE cOMPLFTE FOR C.O. ALL CONSTRUCTION SHALL MEET THE RF~IIREMUNTS OF THE N.Y. STATE CONSTRUCTION & ENERGY CODES. NOT RESPONSIBLE FOR DESIGN OR ~ONSTRUCTION , iI