HomeMy WebLinkAbout22484-zFORM NO. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Office of the Building Inspector
Town Hall
Southold, N.Y.
CERTIFICATE OF OCCUPANCy
No: Z-25780
Date: 06/18/98
THIS CERTIFIES that the building ACCESSORY
Location of Property: 2345 PLUM ISLAND LA ORIENT
(HOUSE NO.) (STREET) (HAMLET)
County Tax Map No. 473889 Section 15 Block 5 Lot 24.3
Subdivision Filed Map No. __ Lot No. __
conforms substantially to the Application for Building Permit heretofore
filed in this office dated NOVEMBER 14, 1994 pursuant to which
Building Permit No. 22484-Z dated NOVEMBER 21, 1994
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 & FENCE ENCLOSURE AS APPLIED FOR.
The certificate is issued to PATRICIA LOLLOT
(OWNER)
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A
ELECTRICAL CERTIFICATE NO. 18469 12/05/94
PLUMBERS CERTIFICATION DATED N/A
Buil/n~g/'In~
Rev. 1/81
FORM Ne.2
TOWN OF $OUTHOLO
BUILDING DEPARTMENT
ToWN HALL
SOUTHOLD, N.Y.
N_o 22484 Z
BUll. DING PERMIT
(THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL
COMPLETION OF THE WORK AUTHORIZED)
Permission Is hereby granted to: ~ . ,- . . ~
~.....x...:...b...~.~.~..~:..x/-/~, ~ ~,~,
.~.'l........~...,x., ......... ....~ .........................................
,-, -'~ ~~~ ~.~ ......... ~ ..........
..... ,~'.~,~. ............ ~ ............ ~..~<~ ......... ~...~..x......~ .................
.... ~ .......... ,~...~.....x'..~..., ...........................................................................................
Z',',',',',',',',',',',',',',',',',',',',',',',','.','.',',',',','.','.',i ',i Z',i] Z]',i'. ~' ..~~............................................................~....Z............. i'.iiiii',ii ',',
atpr~,s~s,~at~a~ .............. ...X.'..~..~.....~~ ........... ...~..: ......................
CounlyTax Map No. lO00 Sectlon.......~..~ .......... Block ......... ~ ...... LotNo ........~......~..'....~,.,, ......
pursuant to application dated ................................... ~. .......................... .~ .....
Building Inspector.
Fee ~....L...~.....:..~...
and approved bythe
Rev. 6~30~80
Form No. 6
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN HALL
765-1802
?LICATION 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 ail buildings, property lines,
streets, and unusual natural or topographic features.
2. ~Finai 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.
For existing buildings (prior to April 9, 1957) non-conforming uses, or buildings and
Upre-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.
Fees
i. Certificate of Occupancy - New dwelling $25.00, Additions to dwelling $25.00,
Alterations to dwelling $25.00, Sw~ming pool $25.00, Accessory building $25.00,
Additions to accessory building $25.00. Businesses $50.00.
2. Certificate of Occupancy on Pre-existing Buildin~ - $100.00
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 Construction ........... ~Old Or Pre-e~istingvl~..~. )~.~..Building.Q~... ] ......... O~l~
bocation of Property .... · ................
House No. Street Hamlet
9nwer or Owners of Property ..... - .....
0ounry 1000, ection .... !.5 ....... .... ........ ..
Bubdivision............- .......... · .......... .. Filed Map ............ Lot ......................
Permit No.~..~.~.~..~....Date Of Permit ........... .~....Applicant .............................
Realth Dept. Approval... ................ ... . .. . Underwriters Approval .........................
Planning Board Approval ........................
Request for: Temporary Certificate ........... Final Certicate ...........
9.9. .......
Fee Submitted: $ .......... ' ............
~.~ ' ~ (1 ~/b ~ APPLICANT ...............
¢ 2 gO
1-11/2 hp motor
40 ~Imp timed ,nOtch
:POOL'
NO VISUAL DEFECTS
BUILDING PF.P,3,11T No.
ORIO~/AL YELLOW C~PY
HUGO $, St/ItDI
pIh~IDE}VT
idL, t~I4p
~.
'OCCUI
USE IS
wI;rHOI
OF
REQUIRED
S CERTIFICATE
REQUIRED
~NCY
iDIATELY'"
CODE'
3LATIO.~I PER'N. Y.
STATE
CODE
COt~M£NTf.
J~
~DDITIOtlA'L C0:-~IEIITS:
./
.", P?I
RI.DG
TO
Swim~#ing
f.,~G' Pools
Route 25A Rocky Point, New York 1'] 778
(516) 744-8100
FAX {516) 744-8292
765-1802
BUILDING DEPT.
INSPECTION
[ ] FOUNDATION 15T [ ] ROUGHPLBG.
[ ] FOUNDATION2ND [ ] IN.>~ULATION
[ ] FRAMING [~NAL ~J~
[ ] FIREPLACE &.~NIMNEY
INSPECTOR
765-1802
BUILDING DEPT.
INSPECTION
[ ] FOUNDATIONIST [ ] ROUGHPLBG.
[ ] FOUNDATION2ND [ ] I~LATION
[ ] FRAMING [~' FINAL
[ ] FIREPLACE & CHIMNEY
DATE
INSPECTOR
' ;,i
Examined ...
Approved . . .//.//~./..
...... , 19 .~/~ermit
FORM NO. 1
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN HALL
$OUTHOLD, N.Y. 11971
TEL.: 765-1802
Disapproved a/c .....................................
BOARD OF HEALTH ............
3 SETS OF PLANS ............
SURVEY .....................
CHECK
SEPTIC FORM ..... ' ''
NOTIFY
CALL .....................
MAIL TO:
Inspector)
APPLICATION FOR BUILDING PERMIT
INSTRUCTIONS
a. This application must be completely filled in by typewriter or in ink and submitted to the Building Inspector, with.3
sets of plans, accgrat,e plot plan to scale. Fee according to schedule.
, b. Plotlpla~' sligwinj l~cation of 16f and of buildings on premises, relationshi to adjoini~g premises or public streets
or areas an.d,.gxvm$ a .detmled descnptron of layout of property must be drawn on the diagram which is part of this appli-
cation. '
c. The:work.¢oYered by this. a, ppli, dhtion may not be commenced befdr6 issuance of Building Permit.
d. Upon apprqyal Of this apl~lication, the Building Inspector will issued a Building Permit to the applicant. Such permit
shall be kept on the premises avaihble for inspection throughout the work.
e. No3building 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 !S, HEREBY MADE to the Building Department for~the issuance of a Building Permit pursuant to the
Building Zone Ordnance of th, e, Town of Southold, Suffolk County, New York, and other applicable Laws, Ordinances or
Regulations, for the~ construction of buildings, a.d. ditions 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 authbrize~ in~pe,k, tors on pr~r0is?s and in building for necessary inspections.
State whether applicant is owner, lessee, agent, architect, engineer, g~neral contractor, electrician, plumber or builder.
....................... e.q ..... ..........................
Name of owner of premises ...r~.~..%_y:.~.+ .q .~.....~...~..47..L~A?..v~. ..... ~. ~.1.[.0 .~. ........................ .
(as on the tax roll or latest deed)
If applicant is/ja, corporhtion, siynature, of duly authorized officer.
, tr~ame ana(t e of corporate officer) ' ~-
Builder's License No ......... .~. ~..q. 3.'&..~..~....
Plumber's License No ......... I~) ]~. ...........
Electrician's License No ..... .~g,.'"[~.. ~-- ....... '
Other Trade s Ltcense No .................
1. Location of land on which proposed work will be done..~, .~..~.~.. .d?[0,:,~....~'7~(~.~. d..~.qo..-~...
....... ~.35/S-. ....... ~:o.... ,-n. ..r~.~ ..............
House Number Street Hamlet
County Tax Map No. lO00 Section .... rS..I.~.~ ....... Block ..... ~.. .......... Lot...o~ .~.,..~' .........
~l'a?~?'..-iTl:t?.....~'.o._.Filed Map No....~./.O.Q .... Lot .... I .~7..'TL
Subdivision .... Ch F) .-4? ~/'a..°17..( .....
2. State existing use and occupancy of premises and intemled use and occupancy of proposed constrnction:
a. E'ist'n use and occupancy ....... .... 7.
b. lntended use and occupancy .J-(P.-~.-.~.'~....I-~..'.~.J~ FI~. ~.'~C~']'i ........ i ......
......... .... ................
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