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Home My WebLink About23069-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office cf the Building Inspector Town Hall Southold, N.Y. C~TIFICATE OF OC~umANCY No Z-24474 Date JULY ir 1996 THIS CERTIFIES that the buildin~ Location of Property 400 SHORT ROAD House No. County Tax Map NO. 1000 Section 116 Subdivision A~CESSORY UuTU~{O~E~ N.Y. Street Hamlet Block 2 Lot 9 Filed Map No. Lot No. conforms substantially to the Application for Building permit heretofore filed in this office dated OCTOBER 4~ 1995 pursuant to which Building Permit No. 23069-Z dated O~TOHER 16~ 1995 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 WITH FENCE EN(ILOSUREAS APPLIED FOR. The certificate is issued to MARY D. HOLLAND (owner) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL UNDERWRITERS CERTIFICATE NO. PLUMBERS CERTIFICATION DATED N/A N-368776 - NOVEMbeR 2~ 1995 Rev. 1/81 )40.3 TOWN OF SOUTHOLD BU]LDtNG D;PARTMENT TOWN HALL $OU~HOLD, N.Y. N? BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE '¢~RK A~HORIZED) Oo,e ........ Z~l&... ...................................... 23069 Z / Permission is hereby granted lo: ~ .....~m.~......~...~.....L/.~.~ .......... ,~ .:~~ ......... ~ ....... ~.~ ...... :~ ........ ~:~? ..................................... .~.~ ............ ~: ........ ~ .......... ~.., ................................................... o, ...... ...................................................................... Counh/Tox Mop No, IOC)O Sectlon,...L/..~.. .......... Block....(~,..¢2'.. .............. LotNo ...... .,~,..~. .............. pursuon, ,o oppllcoflon doted ............ .~/...~./,.~... ............................. ] 9.....?..,~/...., ond opproved by,he Building Inspector. ~ ,../~.o..:..~... Rev, 6/30/80 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 wish accurate locatiom 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 for~). 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/i0 of i% 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 completed 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. If a Certificate of Occupancy is denied, the Building Inspector shall state the reasons therefor in writing to the applicant. C. Fees I. Certificate of Occupancy - New dwelling $25.00, Additions to dweltiug $25.00, Alterations to dwelling $25.00, Sw4mming pool $25.00, Accessory buiiding $25.00, Additions to accessory building $25.00. Businesses $50.00. 2. Certificate of Occupancy on Pre-~xistLnR Buildinm - $100.OO 3. Copy of Certificate of Occupancy - ~ .~5¢. 4. Updated Certificate of Occupancy - $50.00 5. Temporary Certificate of Occupancy - Residential $i5.00, Com~erciai $15.00 ~ew onstruct on ~. , ~ate .~.:.~J:.f/'. .................... i ..... ~ C i .......... Olt Or Pre-existing Building ................. Locatio~ of ~roperty. . . ~ O.O. ........ JA~ .~ .... Z ~ ., ............ J. .~.'I~6 ~ 4. ~ .... ll~,3f House Mo. Street Ha~fet Onwer or O~mers of Property.'..~.?/~..~..,.%~..,...~0..(~.~..6~ ............ ' · Subdivision .......................... ~. ......... Filed ~ap.>-.~,.~. ..... Lot ............. · ......... [ealth Dept. Approval .......................... ~nde~citers Approval .... ~ ................... Planning Board Approval ........................ Request for: Temporary Certificate ........... Final Certicate ?. q,...~ ................ Fee Submitted: · ........... THE NEW YORK BOARD OF FIRE UNDERWRITERS [[~J~(~)[ BUREAU OF ELECTRICITy ~ ~ 85 JOHN STREET, NEW YORK, NEW YORK 10038 ~O~ER ~2,1995 ~pl~e~o. ~o.o. fi~e ~O521895/95 N 368776 THIS ~RTIFIES THAT ~s examined on OC~SER 26 ~ 1995 and found to be in compliance with the NaMon~ Efect~c~ Code. SWIHHING POOL- l TIME CI~3CK$ 40 AHF-1 G.F.C.I.-1 * ~SW199iING POO~} This certifi¢~ate cove~S eom?tiance at the date of inspection only. Because of unusual ~environments it is advisable to have frequent test/and or rely, airs made by a qualified peri,on. <<< C~RtiF~ued on Page O~NERAt /~NAGBR This cedificate must not be ottered 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 IN ANY MANNER. THE NEW YORK BOARD OF FIRE UNDERWRITERS BUREAU OF ELECTRICITY .~ 85 JOHN STREET, NEW YORK, NEW YORK 10038 Date ~(~'~:~'~'~ (~ ~ [9~ ~pplication ~o. o,f,~ ~ ~521895/95 ~ ~68776 HARY D. HOLL~3~D, 4~ SHORT ROAD, POLE 3, CUTCHOGUE ~ N, Y, ~. ,~e/o~ow~.~,,~.,~o.; ~ a~,~.., ~ ~., ~. ~ ~.d ~. OUT ,~,~0. m~ ~ exe,,ined OR ~TOBER 26 ~ 1995 andfou~ to be in compliance with the No,anal ~ect~cal Code. Lot OTHER APPARATUS: ~HREfi "C" ELECTRIC RT, #1; BOX SOUND AVENUE RIVEP~EAD~ NY, 11901 LIC, #.3327-E GENEItA[ MANAGER Per . 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 BUfLDJNG DEPARTMENT. THIS COPY OF CERTIFICATE MUST NOT BE ALTERED iN ANY MANNER. FAX:PHONE #: 516-283-8515 ' TH~NKYOU" . I* 1 510 SUMPTER ORIVE FURT WAYNE, INOI.~ 48604, O.S.A. STL-O00 J /4' RADIUS, BUILDING DEPT. iNSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLBG. FOUNDATION 2ND FRAMING [ ] INSULATION [ ] FIREPLACE & CHIMNEY DATE INSPECTOR 765-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] FRAMING [ I INS~ON [//~INAL [ ] FIREPLACE & CHIMNEY R£MARKS: //~/~/'~ DATE INSPECTOR FO,rIM NO, 1 TOWN OF SOUTtlOLD BUll_DING DEPARTMENT; TOWN IIALL SOUTIfOLD, N.Y. 11971 TEl_.: 765-1802 I!xanlined .... Z~. ~. ~ ., 1 9 .~.'~ I)iS,plUOVed a/c ................................ ; .... BOARD OF IlEAl. TH ..... 3 SETS OF ?LAN$ SURVEY .............. C H E C.I,~ ............... SEVTIC I' (} I~.~ l ......... APPLICATION FOIl BUILDING PERMIT INSTI(UCTIONS a. This application must be complelely filled in by lypewHler or iii ink and submilted ti) Ibe Buikting h~speclor, ~ sels of pbms, acculale plot plait to scale. Fee according lo scbedulm b. Plot plan showing location of lot and of buildings on premises, ~ehdionship to adjoining premises or public s areas, and giving a detailed descdplion of laym]l of property must be drawn on the diagram which is part of this calion. c. The wink covered by this appliealion may not be eommencgd before issuance ~f Building Permil. d. Upon approval of this application, the Buildittg Inspector wilt i~sued a Building Permit to the applicant. Such p shall be kepi on {be premises available for inspeelion throughoul the work. e. No building shall be occupied or used in whole or in prat for any propose whatever until n Cetlificatc of OcctU shall bare been g~anted by the lhdkling Inspector. APPLICATION IS IIEREF, Y blADE to lhe Buihib~g I)epartment for the issuance of a Buildb~g Permit pursuant t Ihiilding Zone Ordinance of tl~e Tow. of Soutbokl, Suffolk ComHy. New York, and other applicable Laws, Oldinam Regtdations, for the construction of buildings, additim~s or alterations, or for removal or demolilion, as herein desto The applicant agrees to comply with all applicable laws, mdinances, building code, housing code, anti ~egnlations, a admit authorized inspectms on premises and. in buihling for necessaw inspections. (Signatm9 of applicnnl, or name, if a corpo~atimO (Mailing address o/appdcant) State whedmr applicant is owner, lessee a~chilect, engineer, general conhactor, electrician, 14umbe~ m bui r.tL , , , . Builde~ s l.ice ns~ No.N~~ .B~i~I~.~~.~T ]Hech icia,'s License ~O.~R~UR~R~ 4 FINAL CONSTRU~ION ~. ~. ~,~ ', ~ ~;..~ .. ~hid,~,~~:~.O.,a_~ ...................... ALL CONSTR~ION SHALL · ',: ....... ........................................... I S I[er CODES. NOT RESPO~~E FOR Ilamlet ~, ............. Block ..... Lot ........ Subdivision ..................................... Filed Map No ............... I.ol ........... (Name) ' ' Stale exisling use:ami occul:'allcy,of ~remises al~d inlell(]ed use and occupancy of )to )osed constmctitm: a. Exisli,,g use and occul,a,,cy · ]~g~.~R~... P~W..~..~c~$ ................. 3. Nature t~l' work (check which applicable): New Building .......... Addition .......... AlteratLon ...... · .... icl; r . . Remov ........ De no it ox .... ;... Other Wok ~ Estimaled Cost {. Fee ...................................... (to be paid m~ ~ing this applicatio~O 5. If dwelling, mm~be~ oCdwelling mdts ............... Number o{ dwelling traits on each lloor ................ . [{' garage, n[tnlber of cars ........................................................................ 6. If business, commercial or mixed occupancy, specify nature and cxle~lt of each lype of use ..................... 7. Dimensions of existing structures, if any: Front ............... Rear .............. Deplh ............... lleight ............... Number of Stories Dimeusions of same structure with aHe:alions o~ additimls: F[ont ................. Rea¥ .................. Depth ...................... lleigbt ...... x ............ ;.. Number of Stories ...................... 8. Dimensions of entire new cpnslmc{ion: Front ............... Rear ............... Depth ............... Ileight ............... Number of Stories Si~e of lot: Front ......... , ....... ~. ..... Rear .,. ,. .................. Depth ...................... Date of Purchase ............ ~.:e~ :'. '.3 ~._4,. q.'. ~: , . Name of FoHBel Owner .................... :: ....... Zone or use district in which premises are situaled: .... · ................................................ Does proposed construction violate any zoning ~a;v} ordinance or regulatio;~: ................................ Will tot 6e ;egraded ............. ( . ..: ,d'-7.3 .': 2.; .Will excess fill be removed Crom p~etnises: Yes No Name oF Owner of premises ......... ?. ,2 . . ~.'.;?k '... ~ddiess ................... Phone No ................ Name of Architect .......................... Address ................... Phone No ................ Name of Cm t actor . .................. d.~ .... Address ................... Phone No ................ fa this pt:operky within 300 ,[eer.~p¢¢'e'~g[ wetland'? ~Yes ........ No town lrusteeu PekTti}t may be required. ~[f yes, SouCbol. d ..... '~: PLOT DIAGKAM Locate cleady aud disthxctly all buildings, wbetlmr enisting or proposed, and. hulicatgal[ set-back d[mensioas property lines. Give street and block numbe~' or desc~iplion according {o deed, and show street names aml indicate intedor or corner lot. .....~J~.~..~.~.t.~.cc~'~ .... J.~.,..~.. being duly sworn, deposes and says lhat he is the applicant IName of individmd signing ~ h (Cont,'actor, agent, cmpo,'ate officer~ etc.) ' said owner or owners, and is duly' authorized' to perfom~ or have performed the said work and to make and File this ~plicatiou; that all statemenls contained M [bis application are lrue to the best ofhis knowledge and belief; and that the t)l[: will be perfo~med in the manner set forth in the application filed tl~mewith. .yom Io he{ore me .............. ..... ~otaW public, $tato of 'ff~ork (Signatme of applicator) No B2-B12BBBO, S~olk Cou~/ · 'ho ,~