Loading...
HomeMy WebLinkAbout22775-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY NO Z-24123 Date JANUARY 23, 1996 THIS CERTIFIES that the building Location of Property 1780 HENRY'S LANE House No. County Tax Map No. 1000 Section 74 Subdivision ACCESSORY PECONIC NY Street Hamlet Block 2 Lot 4 Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated MAY 1, 1995 .pursuant to which Building Permit No. 22775-Z dated MAY 18, 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 AN INGROUND SWI~H4ING pOOL WITH FENCE ENCLOSURE AS APPLIED FOR The certificate is issued to DONALD & LORRINDA STANON of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL UNDERWRITERS CERTIFICATE NO. N047683 PLUMBERS CERTIFICATION DATED N/A NOVEMBER 8, 1995 N/A Rev. 1/81 /~ iL~in/g~2spector FORM NO.3 TOWN OF $OUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N.Y. N£ BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED] Date,...~ ........................................... 22775 Z CountyTax Mop No. 1000 Section .......... .?..~.... BIoc~. .................. ...~..... Lot No. ... ..~.,.. .................. pursuant to application dated ..~ ............................................ 19 ..~nd approved bythe Building Inspector. Fee ~~ ¢:kg Inspector Rev. 6/30/80 Form No. 6 TOWN OF $OUTHOLD BUILDING DEPARTMENT TOWN HALL 765-1802 APPLICATION FOR CERTIFICATE OF OCCUPANCY A. 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 completed site plan requirements. B. 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 buildihg $25.00. Businesses $50.00. 2. Certificate of Occupancy on Pre-existing Buildin~ - $100.00 3. Copy of Certificate of Occupancy'- $201OO 4. Updated Certificate of Occupancy - $50.00 5. Temporary Certificate of Occupancy - Residential $15.00, Commercial $15.00 .......... ...................... New Construction. Old Or Pre-existing Bu~ld,~ing..;.... ........... Location of Property ..................... 4 ............................................... House No. Street Hamlet f ty .~.~ ~..~ · · ---. · ....................... Onwer or Owners o Proper ............................. .. County Tax Map No 1000, Section... Block ............................ Subdivision.... ~.~.~ .;3.~ .~. .. (.~.~ .~ ~.~... . ....... . . Filed Map..~.'-.~..~./ . .Lot ..................... · Permit No.. .Date Of Permit .... Applicant ....................... Health Dept. Approval .......................... Underwriters Approval ......................... Planning Board Approval.. ...................... Request for: Temporary Certificate ........... Final Certicate...-~-. ..... Fee Submitted: APPLICANT THE NEW YORK BOARD OF FIRE UNDERWRITERS 805'7149 BUREAU OF ELECTRICITY ~-- 85 JOHN STREET, NEW YORK. NEW YORK 10038 THIS CERTIFIES THAT DONALD & IDRRINDA STARON~ 1780 HENRYS t~L~E~ PECONIC, N~Y. in ~hefoliowing location; [] B~sement [] Is~ Ft. ~ 2.d F& OUT ,%~tlo. BIlk ~s examined on OCTOBER 30,1995 ~ and found to be in vomPli~n~e with the NaHOOal Elec~cal Code: . Lot FIXTURE OUTLETS SWITCHES 1 FIXTURES RANGES OVENS DISH WASHERS INCANDESCENT FLUORESCENT OTHER DRYERS FURNACE MOTORS FUTURE TIME CLOCKS MULTI-OUTLET SYSTEMS NO. OF FEET DIMMERS SERVICE DISCONNECT S E R V I C E NO, OSE~C~¢Ot4D OF A.cc.Wco.{),G. NO OF HI-LEO OTHER APPARATUS: SWIMMING POOL- 1 TIM~ CLOCKS-AMP. G,F.C.I-i *(SWI~94ING POOL) This certificate covers compliance at the date of inspection only. Because of unusual ~nvironments it Is a~visable to have frequent 'test/and or repairs made by a qualified person. ~<< Continued A W G. NO OF NEUTRALS A W G OF HbtEG OF NEUTRAL GENERA~LMANAGER 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 BUILDING DEPARTMENT. THIS COPY OF CERTIRCATE MUST NOT BE'ALTERED IN ANY MANNER THE NEW YORK BOARD OF FIRE UNDERWRITERS 8057149 BUREAU OF ELECTRICITY , 85 JOHN STREET, NEW YORK, NEW YORK 10038 Oate ~OV~MBP, R 08,1995 ~pp.c.tlo. No.o.f.e 10531895/95 H 0476B3 THIS CERTIFIES THAT o~y the e~ctrlcai equipme~t ~ ~scrlbed below a~ intr~uc~ by t~ applicant ~ on the a~ application number in the p~m~es of DONALD ~ LORRINDA 8TARON~ 1780 HENRYS LANE, P~CONIC~ in the followlng location; [] Basement [] Ist FI. [] 2nd FI. OLF~ ,Section Block t~S exatnlned on OC~'OE~R 30,1995 * ' ' and found to be tn comph~n~e wtth the Na~onal Electmcal Code. Lot FIXTURE I FIXTURES OUTLETS ECEPTACLES SWITCHES iNCANDESCENT FLUO~E$CENT OTHER DRYERS RJRNACE MOTORS [ FUTURE APPLIANCE FEEDERS SERVICE DISCONNECT )THEE APPARATUS: RANGES SPECIAL EEC'PT E R NO OF CC COND. PER ,g TIME CLOCKS BELL UNIT HEATERS MULTI-OUTLET  SYSTEMS A~T, A,~Aps. TRANS. NO. OF FEET V I C A W G. NO OF HI-LEG A, W, G, OF CC. COND. OF HI-LEG EXHAUST FANS H P. DIMMERS AMT. WATTS P~CONIC, NY, 11958 11 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 SE ALTERED IN ANY MANNER. Town Hall, 53095 Main Road P. O. Box 1179 Southold, NewYork 11971 Fax (516) 765-1823 Telephone (516) 765-1802 OFFICE OF THE BUILDING INSPECTOR TOWN OF SOUTHOLD December 7, 1995 Mr. Donald Staron 1780 Henry's Lane Peconic, NY 11958 To Whom This May Concern: We are unable to complete your Certificate of Occupancy because of the following reasons: xx An application for Certificate of Occupancy is not on file. (Enclosed) No Underwriters Certificate on file. xx The check's are not on file. 2 @$25.00 No Health Department Approval on file. No final inspection has been made. No Plumber Solder Certificate on file. (All permits involving plumbing being issued after April 1, 1984). BUILDING PERMIT # 22775-Z & 15607-Z* Please contact our office on this matter. Thank you for cooperation. SOUTHOLD TOWN BUILDING DEPT. * - AMENDED FEE FOR ACCESSORY BUILDING $14.40 DUE ALSO FOR AN ADDITIONAL 96 SQ. FT. FIELDiINSPECTION REPORT DATE COMMENTS ___ FOUNDATION ( IST) ROUGH FRAME & PLU3M~ING ADDITIONAL COMMENTS: 765-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION 1ST [ ] FOUNDATION 2ND I I FRAMING [ ] FIREPLACE&CHIMNEY REMARKS: _~'~. [ ] ROUGH PLBG. [ ] I.~SULATION [ ~INAL MAY - 3 1995 FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N,Y, 11971 BOARD OF HEALTIt ........ /'3 SETS OF PLANS ........ _~URVEY ................. /CHECK TEL.: 765-1802 ' ' .......... . Approved . .~.. ...... , 19 .~.~Pe;mit No Disapproved a/c ' APPLICATION FOR BUILDING PERM IT CALL . . .... NAIL TO: Date . 'l 19 INSTRUCTIONS This application must be completely filled in by typewriter or in ink and submitted to the Building Inspector, with 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 st?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 tlfis application may not be commenced before issuance of Building Permit. d. Upon approval of this application, the Building Inspector will i~sued a Building Permit to the applicant. Such permil shall be kept ou 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 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, buiIding code, housing code, and regulations, and to admit auth°fized inspect°rs °n premises aud in building f°r neces:~r~.i~:~ti~s'~. ~ ..' ...... -- (Signature of applicant, or name, if a corporation) (Mailing addi'ess 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 applicant is a corporation, signature of duly authorized officer. (Name and title of corporate officer) Builder's License No .......................... Plumber's License No ......................... Electrician's License No ....................... Other Trade's License No ...................... I. Location of land on wliich proposed work will be done .................... ' .... 17Y.8. ............. . ' . /: c' House Number ~ Street llamlet County TaxMapNo. 1000Section ...:..'77..~. ........ Block )- ' Lot .~. ~ .... Subdivision ..... p~,.~.O./~J. I"C. 1.~.. ~ .< ~ ......... '. Filed Map No...5.0.(~.f .... Lot..L'../3 ......... (Nan, e) 2, Slatc existing usc and occupancy of premises and intended nsc and occupancy of proposed construction: a. Existing use and occupancy ......... '~.5 . . . /7..,.5. {. . .~"...O~ ................................... b. Intended use and occupancy ............ /~..~.A/~ . ...e--5,; .... ~o.o..~...~..~....~ ................. .3. Nature of work (check which applicable): New Building .. Repair .............. Rcmbval ............ ........ Addition .......... Alteration Estimated Cost ..... ] ...... ' ........... Demolition .... : ......... a Qther Wqrk ~fo ~f~'~Jl~i~'i · ~ ~f~ %~J ~ ~ (Descript on)/ Fee .... (to be paid on filing this application) 5, If dwelling, nnmber of dwelling iunits .......... Number of dwelling units on each floor ............. Ifg i .... · arage, llUnlber of cars ............... , .............. . . d ify ...... ' .............................. 6. If business, commercial or mixe occupancy, spec nature and extent of.each type of use ... 7. Dhnensioas of existing stmcture~,ifany: rent ...... ' ................. F igl , . · ........ Rear .............. Depth He ~t ............... Numlber of Stories .......... ' ............... Dimeusions of shme st~cture width alterations or additions: Front ...... ' ' . ................ Rear ............... Depth .................... 5. · Height ........... . ........ ,.. Number of Stories .... ' ' ' ' 8. Dimensions of entire new construction: Front ................. He g~t x~ ~ .............. : Rear ............... Depth ......... ............. ~un3per of Stones ....... ~' . . · ..... ....................... 9. Size oflot: Front ..... l~.[ ....... Rear ..... ., Depth ~ff(~g 10. Date of Purchase ......... ~.4]~]. ........... Name of Former O ' .. I 1. ~one or use dmtnct ~n which preOdses are situated .... wner . . ~O.~ ~ .............. 1 2. woes proposed construct/on viola're anu ~m,; ~ ' '~. '" ................. ......................... Will 10t be regraded ...... ' -~ .....ng mw, ormnance or regulation: .... ~. .... 13. ~i~ ................. Will excess fill be removed 14. Name of Owner of premises .I. .... from premises: Yes Name ~- . '' , ....... , ........ auaress . Plo " marcmtect ................. ne ~o , ......................... Address ...... :. ~. · .' .......Phone No ........ N A~ ' am~ of Contractor ..... ~ ~.'~ .... Address '~' , . ~ ~' ~, · [5.' Is this property within 300 feet of ~ ti' ' · '. ............... Phone No .......... ' oa~ wetland? *Yes ........ No..~.. ' ..... · If yes, Southold Tdwn Trustees Permit may be required. '' ' ~ PLOT DIAG~ Locate clearly and distinctly all ~uildings, whether existing or proposed, ~d, indicate ~1 set-back dimensions from property hnes. Give street and block n~mber or description according to deed, and show street names and indicate whether ~tefior or corner lot.~~ NOTIFY BUIL.~N~ .DEPA~NT AT 7B5-1802 9 AM ~ 4 PM FOR THE FOLLOWING iNSPECTIONS: 1. FOUNDATION ~ 'P~O REQUIRED ' 2, ROUGH - FRAMING & PLUMBING ~ I'~./' ' 3. fN~RJLATff)N ~ 4. FINAL CONSTRUCTiON'MUST ~LL CONGTRUCT~ON SHALL ME~ TH~ ~:{EQUIREMENTS OF THE N.Y. .~L~]E CONSTROCTION & ENERGY CCq3FS NOT ~ESPONSIBLE FOR r)F~GkJ OF~ CONSTRUCT ON ERRORS TATE OF NEW YORK, OUNTY OF S.S ....... ' ......... being duly sworn, deposes and says that he is the applicant (Name of individual signing c )ntract) )OVC named, . . (Contractor, agent, corporate officer, etc) ...................... stud owner or owners, ~d is duly at t ~orized to perform or ha"e -~_e.. . J . . ~[[cat)?n; that all s~atyments contained~in this application re tr't~e ~t~l}7~s~ ~7:51 work ~nd to m~ke and filet ~is r}, wd~ be perforned m the man , ~nowledge ant behef, and that the her set ~orth in the application filed t ~0~,, ', ' ' ,'om to before ~ne this i -,~w~,u ........ .... .......... Term ~pir~ June 12, 1~ ' (Signature off applicant)