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Home My WebLink About24282-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No: Z-25462 Date: 12/30/97 THIS CERTIFIES that the building ACCESSORY Location of Property: 680 DONNA DR (HOUSE NO.) (STREET) (HAMLET) County Tax Map No. 473889 Section 115 Block 15 Lot 20 Subdivision Filed Map No. __ Lot No. __ conforms substantially to the Application for Building Permit heretofore filed in this office dated JUNE 30, 1997 pursuant to which Building Permit No. 24282-z dated JULY 31, 1997 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 INGROUND SWIMMING POOL WITH FENCE TO CODE AS APPLIED FOR. The certificate is issued to JOHN & JANET M JEROME (OWNER) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A ELECTRICAL CERTIFICATE NO. N-43100 09/16/97 PLUMBERS CERTIFICATION DATED N/A 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) N.° 24282 Z Da,e ~/ ,~ Permission is hereby granted to: ot premises County Tox Mop No. lO00 Section ...... /./...,~....... Block ......... ./..~ ....Lot No....~,.,q .............. pursuant to application dated ................ ....~..~. ....... , 19..~, and approved by the Fee $.../~.~. ,.~ Building Inspector~ Rev. 6/30/80 Ao TOWN OF SOUTHOLD BUILDING DEPARTF!E~NT TOWN HALL 765-1802 PPLICATION 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-9 form)° 3. Approval of electrical installation from Board of Fire Underwriters. 4. Sworn statement from plumber certifying that the solder used in system contains less than 2/10 of 1% lead. 5. Commercial building, industrial building, multiple residences and similar buildings and installations, a certificate of Code Compliance from architect or engineer responsible for the building. 6. Submit Planning Board Approval of c6mpleted site plan requirements. For existing buildings (prior to April 9, 1957) non-conforming 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. tf 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 dwel~lJ~g_~5.00, Additions to dwelling $25.00, CAitera~ ~ $25.00, $~mmi~g-pooi ~2~ccessory building $25.00, Additions to accessory building 2.Certificate of Occupancy on Pre-existing Buildinm - $t00.00 3.Copy of Certificate of Occupancy - , 4.Updated Certificate of Occupancy - $50.00 5.Temporary Certificate of Occupancy - Residential $15.00~ Commercial $15.00 Date ~ew Co~s~ua~Lo~ .... ~ OZa O~e-~s~Zn8 ~Zd~8 .......... : ~ .... ~. ~o~o~ o~ ~o~=~ ...... ~ .... ~..~n .... D .... .a./.~ ........... ~ ................... House No. S~reet Ha~et o~w~ o~ o~=~ o~ ~o~=~...~.~o4.~z ..................................... ~o=~ ~= ~ ,o ~0oo, ~,~o~ .... ZL5 .... ~oc~ .... ~ ......... :o~...4.~ .............. Subdivision .................................... Filed Map ............ Lot ...................... .~e~i~ ~o...a.~..e.~.:ZDate of ~ermit.7./.'.~.l../?...,pplicant..7'...qk~..b-..~:~.m.~ ....... Health Dept. Approval .......................... Underwriters Approval ...................... Planning Board Approval ........................ ~k/ Request for: Temporary Certificate ........... Final Certicate ...... ~. ~ee Submitted: ~..2~;oo ~~ HAR-31 BAh'STATE NY P. 765-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH pLBG. [ ] FOUNDATION2ND [ ] IN~JL/ATION [ ] FRAMING [ ~]~ FINAL [ ] FIREPLACE & CHIMNEY REMARKS: DATE //h~/~ INSPECTOR~~~ THE NEW YORK BOARD ,OF FIRE UNDERWRITERS ~c~ ~ :L~85~'/7..U.E,,,U~OF E-Ec'r. c,'r¥ J~ ' ' ' 85 JOHN STREET, NEW'YORK, NY 10038 THIS ~ERTIFIES THAT o~y the e~ric~ ~uipment ~ ~scd~ be~w a~ in~uc~ by t~ apricot ~m~ on the a~ve application number in the prem~es of JO}tN JEROH~, 68~3 DONNA DRIVE, [~'YI'ITUCK, NY i~ the following Iocation~ [] B~,~ment [] Ist FI. [] 2nd FL OUT Section Block ~s exatnined on ~PT~]~ {~:3E~ ~ [ ~ ~.99'/ and found to be in compliance with the National Electrical Code. SERVIC~ DISCONNECT NO. OF ~ S R OTHER APPARATUS: Lot COOKING DECKS OVENS DISH WASHERS ,'O~'r. AMpS TRANS.~ NSo.~So~FEMFi~T V I C E NO. OF CC COND I A,W O, I NO. OF HI.LEG OF CC, COND. EXHAUST FANS DtMME~RS ROSLAK ELECTRIC P~O.BOX 164 CUTCHOGUE, NY, 11935~2453 LIC, #3677 GENERAL MANAGER This certificate must not be altered in any manner; return to the office of the Board if incorrect, Inspectors may be identified by their credentials. COPY FOR BUILDING DEPARTMENT. THIS COPY OF CERTIFICATE MUST NOT BE ALTERED 1N ANY MANNER. 'It~INNyH ,LNV NI (l~]lt]il.L-I~ ~a .tON .LSnH ]LLVDI4I/~D 40 Ad03 SIbLL 'J. NqlgI~Vd'ZlG ONIall[18 1:104 Ad03 '~lO!luepe~ ~!aq~ Xq payNuap, eq Xotu s~o~,:edsuI 'loea~o~u! f! p~oog eq,~ ~0 e~!~o etl~ ol. uJnl. e~ ;Jauuotu Xuo u! p.~.llo .q ~ou lsntu eio~y!iaa:~ J.¥Hi $~ldl/)4q~ SIH.L $1:I3118MI:I3aNrl :1813 dO Ol:JVO8 )II:IOA M3N, 3H14 L ' m DONNA DRIVE 616.09',;~ FORH It{). 'I'O~IN OF SOUTIIOI.I) 'I'O~H II^I,L 8OUTI1OLD, 11.¥. 11971 TEl.: 765- Ig()2 BOARD OF IIEAL'rlt ............... 3 ,qE'r~ OF PLANS SURVEY ........................ CIIEC, K ......................... SEPTIC FORH .................... NO'I'I FY: .... HAI 1, TO: .................... a. 'lhla a~llcoki~ ~amt I~ co~t~letely [ill~I i. by tyl~rlter or in ink m~l safl~.itt.~ to the Ik~ildlu8 lnSl~Ckor whl~ sets o[ plans, ~eurake plol: plan to scale. F~ accordD~ to sd~tule. b. Plak plan ~ing l~ati¢~ of lot a~,l o~ l~ildi~s ~ pr~ises, relationship to ~ljoiuln8 pr~nlsea or la,bile ntr~ts or areas, a~l givi~ a (~tail~l t~scrlptks, of labatt of prolmrty nllst I~ drmm ~ the dlagran ~dch is l~qrt of d. Ulxm aH~al of this al~llcatioa, the l~j[ldlng lnslector ~J]l is~ a ~ildt~g Pe~mit to the a~illcant. ~ch ~n(:r~l~. 'Hm .pplican~ ages Io co;~ly wJl. h all a~l~cable l~s, ord~m~es, Is'tildi~ ,,:ate ~t~mr ,~ls)hcant ts ¢~r, lessee, ogel)l, artllltect, engn~er, gestural con:racier, electrteiau, l)l~tmr or Is~dder. .......................... ....................................................... ~,~ o~ ,~,~ or ~,,-~.~. ........... ~.~ ...... ~ ......~.~ ...................................... ~ . · (as (~l the tax n)ll or Iai:est: de~l) lot ............... ......................................... (cJm(:k whlcJI lq~pl .Imf ()f (k~dl ~[aI'IOR ~Lrt~:LtJp ........... III:ii, iL cica' it', s,4)Jl:h pi, mtt~ are 81'tljzjte:d .............................................................. ~C ........ ~t~..~ . R~...~,.~,~ ........ ,,,,,, ~ ............... .................... t~lre~. .............................. 1t~o~ ~ .............. :~W~. ~,,..~r~l~ .... ~.,.i~,.~ m .............. ~ llll}llT ~Y I~i l~lll~il). PI,OT .I di.~lr~l.l~ nil I}llldh~g~ M~lher ~.lm:in~ or prol~m~d "IMMEDIATELY" ,{ , OCCUP,ANCy OR WITHOUT CERTIFICATE occuPAncy DATE: NOTIFY BUILDING ~ 765:1802 9 AM TO 4 PM FOR THE FOLLOWING INSPECTIONS: ~, 1. FOUNDATION . TWO REQUIRED FOR POURED CONCRETE 2. ROUGH - FI~,MING & PLUMBING 3. :NSULATION 4, FINAL CONSTRUCTION MUST BE COMPLETE FOR Al.I, CONSTRUCTION SHALL MEET THE REQUIREMENTS OF THE N,Y, S%ATE CONSTRUCTION & ENERGY CODES. NOT RESPONSIBLE FOR DF~SIGN OR CONSTRUCTION ERRORS · ,lx~.hql duly o~)ru) ()elXme~t m.I 8tiy,~l (Imf: he ia the ~Jl)l)lle~J.I J~)lll JO I~f()l(l li~ IhJ~l ' ' ~ .... ~ ......... '~,"'~r .... '-'