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HomeMy WebLinkAbout13713-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT office of the Building Inspector Town Hall Southcld, N.Y. ~PDAT~D CERTIFICATE OF OCCUPANCY No Z-26729 Date OCTOBER 6, 1999 THIS CERTIFIES that the building Location of Property 10450 SOUND AVE. House NO. County Tax Map No. 1000 Section 122 Subdivision Filed Map No. ACCESSORY MATTITUCK, N.Y- Street Hamlet Block 2 Lot 14 Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated JANUARY 25, 1985 pursuant to which Building Permit No. 13713-Z dated MARCH 1, ~985 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 ACCESSORY INOROUND SWTM~TNG POOL AS APPLIED FOR. * GEP, ALDINE B. WORTHINGTON The certificate is issued to (owne~) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A UNDERWRITERS CERTIFICATE NO. AUG. 16, 1985 -N-?05168 PLUMBERS CERTIFICATION DATED N/A *THIS UPDATES CO Z-14768 DATED AUG. 6, 1986. . Rev. 1/81 ~OBM NO. ~ TOWN O~ $OUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N. Y. BUILDING PERMIT trillS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) 13713 Z Permission is hereby gronted to: .~ ....... ..... ..... zd.,,?z....~.~...~. /~4 ........................ . ......,Z~.,~~...~.:~.....z~..~ .............. A-~,.:,...: ............ /...~...~~ ....................... i ...................................... /....o....~;.Z....o.. co..,~ To~ Map No. ,000 S~,,o....Z.~..~ ....... B,o~ .....0..~ .......... Lo, No......0../..~. ......... pursuant ,o application dated ..~....~,,~.., ........... 192..~,~ and approved by the // ' Building Inspector. Rev. 6/30/80 : FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. Certificate Of Occupancy No. z14768 Date August 6, 9.8.6 THIS CERTIFIES that the building..I.'x3g.r, qu..n,d. .~.w. $.m.m.i.n.g..P.o.o..l .................... 10380 Sound Ave., Mattituck, N.Y. Location of Property ~sb ~oi ....................... ~r'e~' ....................... /~r~/'e~ County Tax Map No. 1000 Section 1 22 .Block 02 .Lot 01/4 Subdivision ............................... Filed Map No ......... Lot No .............. conforms substantially to the Application for Building Permit heretofore flied in this office dated J a n u a r y 2 5 , , 19 .8.Spursuant to which Building Permit No. 1 3 7 1 3 Z March 1 , 85 dated ............................ 19..., was issued, and conforms to all of the requirements of the applicable provisions of the law. The occupancy for which this certificate is issued is ......... Inground. Swimming Pool The certificate is issued to Geraldine Worthington (owner, ~e~l~Y: of the aforesaid building. N/A Suffolk County Department of Health Approval .......................................... UNDERWRITERS CERTIFICATE NO. N 7 0 5 1 6 8 Rev. 1/81 J;orm No. 6 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL 765-1802 APPLICATION FOR CERTIFICATE OF OCCUPANCY This application must be filled in by typewriter OR ink and submitted to the building inspector with the following: for new building or new use: 1. Final survey of property with accurate location of all buildings, property lines, streets, and unusual natural or topographic features. 2. Final Approval from Health Dept. of water supply and sewerage-disposal(S-? form). 3. Approval of electrical installation from Board of Fire Underwriters. Sworn statement from plumber certifying that the solder used in system contains less than 2/10 of I% lead. 5. Commercial building, industrial building, multiple residences and similar building and installations, a certificate of Code Compliance from architect or engineer responsible for the building. 6. Submit Planning Board Approval of completed site plan requirements. For existing buildings (prior to April 9, 1957) non-confo~_$ing uses, or buildings and "pre-existing" land uses: 1. Accurate survey of property showing all property lines, streets, building and unusual natural or topographic features. 2. A properly completed application and a consent to inspect signed by the applicant. If a Certificate of Occupancy is denied, the Building Inspector shall state the reasons therefor in writing to the applicant. C. Fees 1. Certificate of Occupancy - New dwelling $25.00, Additions to dwelling $25.00, Alterations to dwelling $25.00, Swimming pool $25.00, Accessory building $25.00, Additions to accessory building $25.00. Businesses $50.00. 2. Certificate of Occupancy on Pre-existing Building - $I00.00 3. Copy of Certificate of Occupancy - . .25~ 4. Updated Certificate of Occupancy - $50.00 5. Temporary Certificate of Occupancy - Residential $15.00, Commercial $15.00 October 5, ~99~ Date ....................................... New Construction ........... Old Or Pre-existing Building.~ ......... ~0450 Sound Avenue Mattituck, N.Y. Location of Property ....................................................................... House No. Street Hamlet GERALDINE B. WORTHINGTON Onwer or Owners of Property ................................................................ County Tax Map No 1000, Section ..... ~22 ..... Block... 2. .Lot...14 Subdivision .................................... Filed Map ............ Lot .................... Permit No. 1~713-Z ..... Date Of Permit. 3[J[~85 ..... Applicant. Health Dept. Approval .......................... Underwriters Approval ....................... Planning Board Approval ........................ Request for: Temporary Certificate ........ ~ert~Cert~ Fee Submitted: $ ...... P?.'PP ............... 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 mm.mrna 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 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 premiss, or other pertinent informa- tion required to prepare a certificate. Fees: ~ 1. Certificate of occupancy $5.00 2. Certificate of occupancy on pre-existing dwelling $15.00 3. Copy of certificate of occupancy $1.00 4.Vacant Land C.O. $5.00 5.Updated C.O. $15.00 Date ................ NewCons tr'uc%ion ...... Old or Pre-existing Buildir;g ............. Vacant Land ............. Location of Property ................. ~~./.~? ~... ~ ~. ~ ....... Hou~ No. Street Ham/et ~r ~r O~n~r~ ~i Pm~ .... ~ ~. ............................ County Tax Map No. 1000 Section ~'~ ~4~... Block Lot Subd vision ......................... Filed Map Permit No, ~Date of Permit .......... Applicant ,,, ~~. Health Dept. Approval ........................ Labor Dept. Approval ........................ Underwriters Approval ........................ Planning Board Approval ...................... Request for Temporary Certificate ..................... Final Certificate ....................... Construction on above described building and permit r~eei~s all applicable codes and regulations. Applicant ................. Rev. 10-10-78 Co FIELD INSPECTIO~ FOUHDATIOM FOUNDATION 2. (2nd) ROUGH FRAME & PLUMBING INSULATION PER N. Y. STATE ENERGY cpo~ FINAL ADDITIONAL COMMENTS: THE NEW YORK BOARD OF FIRE UNDERWRITERS (~ 85 JOHN STREET, NEW YORK, NEW YORK 10038 ~,.,e Au~t re, ~m~ ~ppl,ca.onNo. o./.e :m773/~' N 705168 THIS CERTIFIES THAT only the e~c trical equipment ~ described be~w and introduced by t~ applicant ~med on t~ able applicatlon number in the premises of ~bt. ~v~ 8/S ~d Ave~ ~attit,~ck~ N ~ in tke/ollowlng location; ~ Basement ~ 1st FI. ~ 2nd FI. Section Block Lot was examined on ~ ~ ~ ~ ~ and /ound ~o be in compllance wlth the requirements of this Board. FIXTURE FIXTURES RANGES ~OOKING DECKS OUTLETS SWITCHES FLUORESCENT 2 2 DISH WASHERS EXHAUST FANS OTHER APPARATUS: E NO, O~E~C~COND. R V I C A W, G, NO. OF HI-LEG[ A. W G, OF CC COND. I OF HI-LEG NO, OF NEUTRALS .. er" This certificate must not be altered in any manner return to t ,,~ ~..,.~ u. ~' O~ .FOR ILDINGDEPAR~MENT. TH! COPYO ~, -~, 'FORM NO. 1 · r TOWN OF SOUTHOLD " BUILDING DEPARTMENT TOWN HALL sOUTHOLD, N.Y. 11971 TEL.: 765-1803 Approved ./. . . ., 19?k;ermit No.l ......... Disapprove a c . . .--~-. .................... APPLICATION FO~ BOIkDI~G PEBMIT Received ........... ,19... Date ...... ~. .... 19 e~.~ .- 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 insp,~ctions. · ............. (Signature of applicant, or name, if a corporation) .:,. X..,¢,. . . (Mailing address of applicant) I//~f fl State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. Name of owner of premises ~(;~'~'~.7-,..>'~..~'-f..' · ..... b..~.~..&..~.~..~..~,..q.\,Qa., o~..,~ ~ .[,V ~_ .... (as on the tax roll or latest deed) If applicant is a corporation, signature of duly authorized officer. (Name and title of corporate officer) ' Builder's License No. , . :~..'ff..?. ................ Plumber's License No ......................... Electrician's License No ....................... Other Trade's License No ...................... Location of land on which proposed work will be done .................................................. .... to. .Q ............ .&. .,4. . . hm ............. ....................... House Number Street Hamlet County Tax Map No. 1000 Section . . .. , I . .~..~:x.. ....... Block ~ Lot 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 ...~/~.//~)~.. :.~,Z~, .......................................... 3. Nature of work (check which applicable): New Building ........ Addition ......... Alteration .......... Repair .............. Removal .............. Demolition .............. Other Work ............... ~, f.~.o~ , (Description) 4.' Estimated Cost .. ~' .,2"'~fl.- ~ F -. ~' (to bel paid on filing this application) 5. If dwelling, number of dwelling units... / Number of dwelling units on each floor. ~ . If garage, number of cars ........................................... t ............................ 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 ...... i ....... 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 . ./Z.-.~.~.. i .......Depth ............... Height . .f.. .....~: ...... Number of Stones ........................... , ............................ 9. Size of lot: Front ...................... Rear ...................... i Depth ...................... 10. Date of Purchase ............................ ~Name of Former Owner ~ ............................ 11. Zone or use district in which premises are situated., f. zf.~.//.).£.~2T.q.~.z-. ........ i ............................ 12. Does proposed construction violate any zoning law, ordinance or regulation: . ./b(~P ........................... 13. Will lot be regraded .... ~..~. ..................... Will excess fill be removed from premises: ~ _No 14. Name of Owner of premises ~.o.~T../~..z~../.~ ..... Address~v.~.~. ~7~///~Z~'¢~. Phone No ,~'f~'~.? .~'~f... Name of Architect ........................... Address .............. i .... Phone No ..... ~.. ......... Name of Contractor ff'~. .Z-~. f~. z. ld'~.-~, f. ~. .. ........ Address/d~//~,(./T/fZ~/~.-,s~4~z//,~Phone No. ~F..~..-?.~.~.~.. PLOT DIAGRAM Locate clearly and distinctly all buildings, whether existing or proposed, and. i~dicate 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. '1-~ ~-o ~ -j STATE OF NEW YORK, COUNTY OF .......... S.S ...... .~.~..~...~.~.z.c~. t.~./: .~ .......................... being duly sworn, deposes and says that he is the applicant (Name of individual signing contract) above named. He is the .................................................................... (Contractor, agent, corporate officer, etc.) of said owner or owners, and is duly authorized to perform or have performed the iaid 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 : · ..~ .............. day of. · .~'ktqX,N,~)D.~ .., 19~/~ Notary ~ublic, ..................... .~~o~unty ~~'~ // ~') ,__, tx .... NO I-£ ~ '~ " MOAIUM~NT SOUND Al. S5°&G'00''£' ,, YOUNG & YOUNG 400 OSTRANDER AVENUE, RIVERHEAD, NEW YORK SURVEY FOR: , Wh_L. IAM E. WORTHINGTON & GE ~THINGTON !~' AT ^ 't- ' UAJ ANT ' ~'~' ' I ~uA~ ~:[~ ~; ~l~,~ o~ SOL TH OLD J ~ ~NS~ ~N~CO. ........... /~ _%~ SUFF0~< CO, N.Y aY - ..... : .... · ' L,,.~ ~m~ ...... , =-!~.~] _.. qcT, ~,, ,~.:~. ? EB B D~AM~T~RS, t~: ~ ~ K[~ r~L au~G ~Kt~zl~a ~A~R . ~e,~ , SCHEMATIC PIPING ARRANG~ENT , I ~MP CkP~l~ TO ~SUttiCi~ TO ~P~ P~ · ~ S~L~OW END .... ' ] ! ~ z~ ~s. J~' ~.~,~. ~ , , ~ ,,,, .....