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Home My WebLink About22734-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No Z-23834 Date AUGUST 24, 1995 THIS CERTIFIES that the building ADDITION Location of Property 3895 p~%DISE POINT RD. House No. Street County Tax Map No. 1000 Section 81 Block 1 subdivision Filed Map No. SOUTHOLD, N.Y. Hamlet Lot 8 Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated MAY 5, 1995 ~ursuant to which Building Permit No. 22734-Z dated MAY 5, 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 INGHOUND SWIPING POOL WITH FENCE ENCLOSURE & DECK ADDITION TO EXISTING OWE FAMILY DWELLING AS APPLIED FOR. The certificate is issued to ANNE MAZZ~TW.A (owner) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL UNDERWRITERS CERTIFICATE NO. PLUMBERS CERTIFICATION DATED N/A N-356688 - JUNE 29, 1995 Rev. 1/81 FORM NO.3 TOWN OF $OUTHOLD BUILDING DEPARTMENT TOWN HAU. SOUTHOLD, N.Y. N£ BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) Date ......... ~./.../.....~. ....................................... 22734 Z at premises located at ........... ~..~....~..~_...........~..-~-~. ,~./. ~.;../-..'...... ~'..'~. ~'.'~........~.....~;..' ..................... ooun~a×Map~o. ~oo0 sec,on...~/ ............. ~ec~ .......... /... ........... [ot~o. ~ ................. pursuant to application dated ............................ 19 ........ and approved by the Building Inspector. ................... ~'~ii~'ng Insp ct r Rev. 6/30/80 Form No. 6 TOWN OF SOUTtIOLD BUILDING DEPARTMENT TOWN HALL 765-~802 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-9 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 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 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 ' 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-existin~ Buildin~ - $100.00 3. Copy of Certificate of Occupancy - $20.00 4. Updated Certificate of Occupancy - $50.00 5. Temporary Certificate of Occupancy - Residential $15.00-, Commercial $15.00 .......... .................. New Construction ..... ~. .... Old Or Pre-existing Building ................. Locatiou of Property ..... ~.~O~. ........ .~.~..~.~.<~'~.. ~.~{..~.....~.'..~. ......... ~...~.'/.'~...~.~. House No. Street tlamtet Onwer or Owners of Property./~..~.~, Subdivision .................................... Fi lcd Mop ............ Lot ...................... 0ealth Dept. Approval .......................... Underwriters Approval ......................... 'lanl~ing Board Approvul ........................ Request for: Temporary Certificate ........... Finul Certicate .... ~ .... ?ee Submitted: $~p,~,~O~/q ............................ i ..~...~.~/ ¢o ........ .......... : ......... . 765-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] INSU~.A.T4GN [ ] FRAMING [ ,~'FINAL [ ] FIREPLACE & CHIMNEY REMARKS: ,INSPECTOR/~~ '-'~'~/~ I~LI) 'I~SPECTION REPORT FOUNDATION ' (]ST) II I, ,, II FOUNDATION (2ND} Il- II ROUGH FRAME & PLUMBING INSULATION PER N. Y. STATE ENERG]I' CODE FINAL Diagonals given to 90° point of corners, SET ET 'OF 2 lNG {NER SET, , ,* ~,4 eACXRL(. SHOUt. O~,FfOT I~XCeED WATER' ~IEOHT .~ ,/~;', ~' , I 51o SUMPTER DRIVE FORT WAYNE. INDIANA, ' - ' x " ,~ ·~, 46804, U.S.A. 219.432-8731 YPE Trr, RS (SET OF 2)',, "', '" ' ' "" ': :" I RECTANGLE .,,., , ~ & Pool Institute, 2111 Eisenhower Avenue, Alexandria, VA 22314 · 703/838-0083 THE NEW YORK BOARD OF FIRE UNDERWRITERS ~.18§077 BUREAU OF ELECTRICITY ~ ~'~ B5 JOHN STREET, NEW YORK, NEW YORK 10038 Da{ ' ~ 29~1995 dpplicationN~.onfile 07337895/95 N 356688 THIS C~TIFIES THAT o~y t~ electrical equipment ~ ~scribed be~w a~ int~uc~ by t~ applicant ~m~ on the a~e applicat~n number in the p~m~es of in the fotWwlng location; ~ Bt~ement ~ Ist FI. ~ 2nd ~, O~ Section Bilk Lot t~s examlned on ~ 26,~995 and found to be in compliance ~ith the Na~onaI Elect~caI Code. OTHER APPARATUS: SWIMMING POOL- 1 TIME CLOCKS 40 AMP-I G.F.C.I.-! * (SWI~4ING POOL) This certificate covers compliance at the date of inspection only. Because of unusual ~nv~ronments it is advisable to have frequent test/and or repairs made by a qualified person. <<< Continued on Page 2 >>> 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 DEPARTiVIENT. THIS COPY OF CERT!F CATE MUST NOT I~E ALTERED IN ANY MANNER. THE NEW YORK BOARD OF FIRE UNDERWRITERS · P o8 ! 185077 N 356688 THI~ C IFIES / o~dy the electdctd ~uipme~ ~ ~sedbed be~ a~ (~t~uc~ by ~ ~ppl~t ~e~ o~ the a~:e appJicatio~ ~mber in the presses of ~ZZE~, 3895 P~ISE POIHT RO~, SOU~O~D, N* Y. in the followln~ location; ~ B~sement ~ Ist FL ~ 2nd ~]. OUT Section Bilk Lot ~s examined on ~ 26 ~ ~99~ and found to b~ in compliance with the N~onal Electrical Code. BUREAU OF ELECTRICITY 85 JOHN STREET, NEW YORK, NEW YORK 10038 JUN8 29,1995 Appllc. tlo. No. o./i~e 07337895/95 THAT FIXTURE LECEPTACLES EWlT FIXTURES / DRYERS [ FURNACE MOTORS FUTURE APPLIANCE FEEDERS S RANGES E TIME CLOCKS ~Ekk UNIT HEATIERS MULTI-OUTLET A,~T. ~p$. TRANS. NO. OF FEET NO. OF CC. COND A W G. PER ,f/ OE CC, COND, NO. OF HI.LEG OF HI-LEG EXHAUST FANS DIMMERS NO, OF NEUTRALS A, W G, OF NEUTRAL SERVICE DISCONNECT I NO. OF METER ROSLAK ~L~CTRIC P.O.BOX 164 CUTCHOGUE, NY, 11935 LIC.#3677-E MANAGER Thls 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 IN ANY MANNER. FORM NO, 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL $OUTHOLD, N.Y. 11971 TEL.: 765-1802 Approved ....... 197.~. Permit No ~l.,,~ ~.~ .~.'~. ................ Disapproved a/c ................................ ~ .... . (~tu~ding Inspector) APPLICATION FOR BUILDING PERMIT INSTRUCTIONS B~ARD OF HEALTH .... 3 SETS OF PLANS ........ SURVEY ................. CIIECK .................. SEPTIC FORkl ............ CALL ... HAIL TO; Date ................... a. Tiffs application must be completely filled in by typewriter or in ink and submitted to the Building Inspector, with 2 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 sfi-eet'. 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 commencefl 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 Occupan% 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 appli, cable 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 inspections. (Signature of applicant, or name, if a corpo~-ation) (Mailing address of applicant) State whether applicant is owner, lessee, 'agent, architect, engineer, generai contractor, electrician, plumber or builder. (as on the tax roll or latest deed) If a nt is a cor >oration, sign tnre of duly authorized officer· (Name and titlq~ ~orporate officer) lumber s L cense No ......................... Electrician's License No .... ~..O..S.~.,~.l~.....~?..~.~..~(C_. OCCUPANCY OR USE IS UNLAWFUL , WITHOUT CERTIFICATE OF OCCUPANCY Other Trade License No 1. Location of land on which proposed work will be done. ~' ~ : .... .... ........... House Number Street ttamlet ........ ConntyTax MapNo. 1000 Section .... '...~.t ........ Block ..... / ........ :... Lot ..... ~ ........... Subdivision .... ~11~-7. ff~:~ ..... Filed Map No. ~ ~ Lot (Name) ............................ 2. State existing use and occupaucy of prennses and intended use and occupancy of proposed construction: a. Existing use anti occupancy .......... ~ (~~' ' ..... ?~ ~. ~ ,~.~. 3 ........ b. Intended use and occupancy .. .~,..~ [.~. '.' . ~r'?'~'~*~':8 ............ '3. Nature of work (check which applicable): New Budding .......... Addition ..... ~'~"?°~ ' ..... Alteration/Z .' ..... ~. P, epair .............. Removal .............. Demolition . ' Other Workc ..... ~000!' .QqD.. (Description) 4. Estimated Cost ......... . ......... Fee ............. ~ (to be paid oil filing this application) 5. If dwelling, number of dwellinglunits ............... Number of dwelling units on each floor ......... If garage, number of cars .... i ' · ...... 6 Ifbu i d .................... : ........................... i I i P Y st ify~ d xtentof I tyl fus '' ' ' · S IICSS, conlmerc a or lB.xe occu ant , )cc lature an e ,eac 1 ~e o e 7 Di nsi ofexisti truct ' ifa F ' ' ' .................... · me OhS ngs ures, ny: ront ..... , ........ Rear ............ De)>th ... II ight Nu nb fSto ' ' ' ' e ............... I er o nes ............ mensonso s estmcturew ia era onsorat OhS: ront Depth ~ ................ .. Height ................. Rear .................. ' Number of Stories ~"2' .'. 8. D nrensions of entire new construction: Front a~7 Rear o~..~ ............ Height Numlber of Stories .......... : ' ............. Depth .. . .. 9. Size of lot: Front ......... ..., ........ ~.. Rear .' . ..... ~..~ ........ i ... Depth ..... 11. Zone or use district in xvhich premises are situated. Does proposed construction violhte any zoning law ordinahce or regular on' .... . Will 16t be re reded . ' · ' ........................... 13. ,, g · .. .....~.~.? ................ Will excess fill be removed from premises: lf~ No 14. l~mne of Owner of premises .. (14~q,.~..t~. [dl ....... Address .. ~.4~,t.2~.'.~j~. 2t,7,,'2 ...... Phone No .......... :. . Name of Architect .... j ..... ' ............ i .... Address ................... Phone No ................ Name of Contractor .~...~.. 67/~,¥..p:-.$ .4v:%8. ........ Address .. ,K~.,Y'FTT.Z/~ .... Phone No. ,. ~}~ .,~.'o.'~ [5. Ig ~:h±s property w±th±n 300 ~eet of a t:±dal wetland? eyes...~-;~... No ......... ' ...... elf yes, Southold T:own Trust:ees Perm±t may be requ±red. PLOT DIAGRAM Locate clearly ,'md distinctly all ibuildings, Wlieth~r existing or proposed, and, indicate all set-back dLmensions from property lines, Give street and block ]lumber or description according to deed, and show street names and indicate whether interior or corner lot. (Name of individual signin~ contra~t) (Contractor, agent, corporate officer, etc.) said owner or owners, ~d is duly utl~orized to perform or have performed the said work and to make and file this plication; that all statements contain6d ~ this'application are true to the best of his knowledge and belief; and that the ~rk wHl be perfommd in the manner s6t forth in the application filed therewith. ,'om to before ~ne tt~. , uallf~ed m Suffolk g00n~ ~ [~ ' .~' " ' gnature ofappbcant) ~mm~0n Exp,res ~cem~r 8, 19~ , ~S/gna