HomeMy WebLinkAbout21544-zFORM NO. 4
TOWN OF BOUTHOLD
BUILDING DEPARTMENT
Office of the Building Inspector
Town Hall
Southold, N.Y.
CERTIFICATE OF OCCUPANCY
No Z-23260 Date
OCTOBER 4, 1994
THIS CERTIFIES that the buildin~ ACCESSORY
Location of Property~ 570 HORSESHOE DRI~-E CUTCHOGUE, N.Y.
House No. Street Hamlet
County Tax Map No. 1000 Section 95 Block 4 Lot 18.20
Subdivision Filed Map No. Lot No.
conforms substantially to the Application for Building Permit heretofore
filed in this office dated JULy 7, 1993 pursuant to which
Building Permit No. 21544-Z dated JULY 16, 1993
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 ENCLOSURE AS APPLIED FOR
The certificate is issued to
(owners)
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL
UNDERWRITERS CERTIFICATE NO.
PLUMBERS CERTIFICATION DATED
LAWRENCE & ANN EKSTER
N/A
N-284068 - JULY 26, 1993
N/A
]~ing Inspector
Rev. 1/81
FORM NO.3
TOWN Of: $OUTHOI.D
BUILDING D~PARTM~NT
TOWN HAJ.L
SOUTHOLD, N.Y.
No 21544 Z
BUILDING PERMIT
(THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL
COMPLETION OF THE WORK AUTHORIZED]
Permission Is hereby granted to:
..................
pursuant to al~llcaflon dated ......?./~. .......................................... 19...~....-~... ..... and apDroved by ff~
Building Inspector.
Rev. 6/30/80
Form No. 6
TOWN OF SOUTHOLD ~'~ m ® ~ I ~ ,J~
BUILDING DEPARTMENT ::!*~F .................... ~i~
TOWN HALL
APPLICATION FOR CERTIFICATE OF gOOUDA~iov ~ ,, ,~.OG, DEP~
v~o~o~ ~ ~OWN OF $OUTHO~ D
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:
t. ~inal survey of property with accurate location o~ all bu±ldings, property lines,
2. Final Approval from Health Dept. o£ 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 lg lead.
5. Commerc±al building, industrial building, multiple residences and s±milar buildings
and installations, a certificate of Code Compliance from architect or engineer
responsible for the building.
6. Submit Planning Board Approval et compZeted 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, bu±lding and
unusual natural or topographic features.
2. A properly completed application and a consent to inspect signed by the applicanb.
If a Certificate of Occupancy is denied~ the Building Inspector shall state the
reasons therefor in writing to the applicant.
:. Fees
1. Certificate of Occupancy - New dwelling $25.00, Additions to dwelling $25.00,
Alterations to dwelling $25.00, Swinaning pool $25.00, Accessory building $25.00,
Additions to accessory building $25.00. Businesses $50.00.
2. Certificate of Occupancy on Pre-existing Buildin~ - $i00.00
3. Copy of Certificate of Occupancy - $20.00
4. Updated Certificate of Occupancy - $50.00
5. Temporary Certificate of Occupancy - Residential $15.00, Comercial $15.00
Date . ..~..~..~....
ew Construction .......... Old Or Pre-existing Building
ocation of Property..~."~......... /~.o.~S~.~. p~. ~ C~TC~.~)..~2. 0
House No. Street Hamlet
ewer or Owners of Proper ...... ; ...................................................
ounty Tax Map No i000, Section...'~.~.~.. ..... Block ..... .~.. ........ Lot...~..~.,...~.~. ..........
bdi ~'~..~. .... Fil .... '.'-;~.
u vision ................. - ~ ... ...... ed Map .... Lot..
,rmit No. Of Pe it...7/ +/Y.3..Appl cant.
~alth Dept. Approval ............. .. ...... .. . .. Underwriters Approval..~/. ................. ... . .
harming Board Approval ..........
equest for: Temporary Certificate ........... Final Certicate...~.'~ ......
ee Submitted: $....~.~.~..~ .~ .. .
Ygs / ......... · ..................
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
September 26, 1994
Larry & Ann Ekser
570 Horseshoe Drive
Cutchogue, N.Y. 11935
To Whom This May Concern:
We are unable to complete your Certificate of
because of the following reasons:
XX
Occupancy
An application for Certificate of Occupancy is
not on file. (Enclosed)
No Underwriters Certificate on file.
XX The check is not on file. $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 # 21544-Z
Please contact our office on this matter.
cooperation.
Thank you for
SOUTHOLD TOWN BUILDING DEPT.
~OU~DATIO:! {2nd)
,~UGH FRAME &
.PLUMBING
~!SULATION PER,N. Y.
STATE E~iERGY
CODE
FI;;AL
ADDITIONA'L COMMENTS..
~UILDIN~ D~T.
INSPECTION
c ~ ~)x~oN ,ST ~ ~ ~U~. PL~.
[ ] FOWIJ)J),TION mD [ ]INSULATION
THE NEW YORK BOARD OF FIRE UNDERWRITERS
[0(} [093 BUREAU OF ELECTRICITY
~-- 85 JOHN STREET, NEW YORK, NEW YORK 10038
Oai& JULY' 26,1993 Application No. onfile 04781193/93 H 284068
THIS CERTIFIES THAT
o~y the electrical ~uipment ~ ~sc~bed be~w a~ int~uc~ by t~ applicant ~m~ on the a~ appl~ation number in the p~m~s of
i. thefollowi.g loca~io.~ ~ Bas~men~ ~ I~t FL ~ 2nd ~. 0~ Section Bilk Lot
~s examined on J ~ h ~ 2 ~ ~ ~ 9 9 3 and found to be in compliance with the NaMonal Elect~cal Code.
DRYERS FURNACE MOTORS FUTURE APPLIANCE FEEDERS
RANGES
;PECIAL REC'PT
SERVICE DISCONNECT
OTHER APPARATUS:
R
qO* OF
METER
COOKING DECKS OVENS DISH WASHERS
V I C E
No. o~e~c~co.o, A.W 0
OF CC, COND
NO. 0F HI*LEG
A.W G. NO. OFNEUTRA
OF HI-LEG
EXHAUST FANS
DIMMERS
OF NEUTRAL
made by a qualified per,on.
DOR08~ HI, gO. INC,
425 MONS~LL LANE
CO~CHOGUE, NY, 11935
GENERAL 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 BUILDING DEPARTMENT, THIS COPY OF CERTIFICATE MUST:.NOT BE, A~ER~ED IN ANY MANNER.
THE NEW YORK BOARD OF FIRE UNDERWRITERS
~001~93
BUREAU OF ELECTRICITY
~" 85 JOHN STREET. NEW YORK. NEW YORK 10038
Date O[lh¥ 26~93 ApplicationNo. onfile ~'~[~3/9~ ~ ~05~
THIS CE~IFIE5 THAT
o~y the zl~trical ~uipment ~ ~scrib~ be~w and intr~uced by t~ applicant Mmed on the a~ve ap~ication nu tuber in t~ prem~es of
the following locaeion; ~ B~sement ~ let Fl. ~ 2nd FI. 0~ S~tlon Bl~k Lot
examined on ~ ~ h ~ ~ 1 r ~. 9 ~ ~ and found to be in compliance with the Na~onal ElectOral Code.
1 2 1
DRYERS
SYSTEMS
NO. OF FEET
E R V I C
Ho. oE CONg. O~ ~:C. CONO
OTHER AP~RATUS:
~gINM~N~ POOL-i
TIMg
G,F,C,I-I
ROTOR8:{-1,§
*(HglMMIN$ POOh) ~hi~ certificate
covers compliance ut the date of
inspection oaly, Because of umusaal
environ~ents Jt is advisable to
have frequen~ test/and or ~epai~s
<<< Cont. tr~ued on Page
A. WG
OF HI-LEG
NO. 05c NEUTRALS
A. WG
OF NEUTRAL
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 BO~ ILDING DEPARTMENT. THIS COPY OF CERTIROATE MUsT~No~LTBE~A[T~E~RED~iN A~Y MANNER
~ITER~
REQUIRED
,/
Examined .~ .~..~ .......... 19~
Approved ...... I ermit No. ~ .....
FORM NO. 1
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN HALL
SOUTHOLD, N.Y. 11971
TEL.: 765-1802
Disapproved a/c .....................................
APPLICATION' FOR BUILDING PERMIT
BOARD OF HEALTH .........
3 SETS OF PLANS .........
SURVEY ..................
CIIECK ...................
INSTRUCTIONS
a. This application must be completely filled in by typewriter or in ink and submitted to the Building Inspector, with 3
~ets of plans, accurate plot plan to scale. Fee according to schedule.
b. Plot plan showing location of ~ot and of buildings on premises, relationship to adjoining premises or public st?eets
br 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 commenced before issuance of Building Permit.
d. Upon approval of this appl/cation, the Building Inspector will issued a Buildhng 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 purpos~ whatever until a Certificate of Occupancy
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 describbd.
The applicant agrees to comply with all apphcable laws, ordinances, building code, housing code, and regulations, and to
admit authorized inspectors on premises and in building for necessary inspecfi,,~s. ~ ~ .. . .
-- (Signature of applicant, or name, if a corporation)
(Mailing addrass'of applicant)
State whether applicant is owner, lessee, 'agent, architect, engineer, generai ·contractor, electrician, plumber or builder.
' ' owner .. ~J~- U .~./~..~..~.~~
Name of of premises i~-, ,,~-,-.~.. ?
(as on the tax roll or latest deed)
If applicant is a corporation, signature of duly authorized officer.'
Builder's License No .... ~..M4...n..e. ~ ..........
Plumber's License No ....... · ......... . ......... ·
Electrician's License No .......................
Other Trade's License No ......................
Loc tio ofl d hichp d ork ill be 'do ' :
a n an onw ropose w w ne. ..~ ..............................................
. 57'_ . .'. i : .... .i.N. .e. . .e: ..... .e. , ............... ' ' e u -,-c . .C. .........................
House Number Street Hamlet
Couhty Tax Map No. I000 Section ...C].~.... ......... Block ............... Lot...'./.~...~) .......
Subdivision .... '. Filed Map No Lot ·
(Name)
State existing use and occupancy of premises and intended use and occupancy of proposed constructiom
/
........ .. .... ..................
a. Existing use and occupancy ....... ' , It4 .... t"~[d ..-.
.... .... ,,
b. Intended use and occupancy ~...c~!...r~. ¢1..~,~ ~¢~ .-..~.i .... .~,;~'~ hr".4~.~ .......... ' .......
' J · ..'- Cl ,I~'o~ ~ ~ ·
3. Nature of work (check which applicable): New Building . ~ ......
Repair .............. Rem?al ....... Demolition'' Addition ........... Alteration/j..,. ........
.... : ......... Other Work ........
'..~. ~] ' (D ipti )
4. Estimated Cost .O. ~. ~ .Qi 9. ............. Fee .........................
~ (to be paid on filing this application)
5. If dwelling, number of dwelling ~nits ............... Number of dwelling units on each floor
· If garage numberofcars .................
6 ' If butane'ss .........................................................................
· xed occupancy specify nature and extent of
· , commercial or mi. , .each type o£use
7 Dimensions of existing structure~ if any: Front Rear .....................
Height Num;er of Stories ............... .............................
. Depth
Dimensions of shine structure with alterations or additions: Front
.................. Rear ..................
Depth ' Height
Number of Stories ' '
8 Dimensions of entire new construction Front ................
· ' Rear Depth
Height ~. .............. Number of Stories ............
~. Si~e Of,oh Front ........... i .... :.. Rear ...... i ........... ' ................... :" ........
............... Depth ...................
I0. Date of Purchase ......... i. i ........ ' ......... Name of Former Owner ...................
I 1. Zone or use district in which oremises are sitnated ......... ' ': ......
12 Does proposed construction violate any zoning law ordinance or regulation: ' '
13. Will lot be regraded ....... '. · · .................. Will excess fill be removed from premises: Yes No
14 Name of Owner of premises Address
........... ; ........................... Phone No ................
Name of Architect
......................... Address ................... Phone No .................
Name of Contractor Address
' Phone No
15. Is this property within 300 feet of a tidal wetland? *Yes ........ No ........
· If yes,~ Southold Tbwn Trustees Permit may be required. ' · '
PLOT DIAGRAM
Locate clearly and distinctly all buildings, whether existing or proposed, and. indicate all set-back dimensions frown
property lines. Give street and block number or description according to deed, and show street names and indicate whether
interior or corner lot.
APPROVED AS ~JOTED
DA'~E: -------------B.R #
~EE', ..... BY: ,-.----
NOTIFY BUILDING DEPARTME'N~"AT
71;:;5.1802 9 AM TO 4. PM .FOR THE
FO[LOW~NG ~NSPECTIONS:
. % FO,UNDATR)N - TWO REQUIRED
FOR POURED CONCRETE
~, ROUGH ~ F~A~NG 8~ PLUMBING
3, iNSULATION
,~, FINAL CONSTRUCTION MiIST
B5 COMPLETE ~::OF{
ALL CONSTRUCTION SHALL MEET
TNE REQUIREMENTS OF THE
S~;~Tt~ CON~T~UC~]ON & ENERGY
CODES· N(~r RESPONSIBL~ FOR
DESIGN OR CONSTRUCTION ERRORS
STATE OF NEW Ye P,,K-.
couwrv OF...~.~ .E~.~.. s.s:
........ Ft.ro.¥...~. ~..w,m~ ............. . ........
(Name of individual signing ~ontract)
above named.
being duly sworn, deposes and says that he is the applicant
~Ile is the ..... . .................. ~x~.... .................................... .
(Contractor agent corporate officer etc ) ..................
of said owner or owners, and is duly adthorized to perform or have performed the said work and to make and file this
application: that ail statements contained in this'application are true to the best of his knowledge and. belief; and that the
~VwOrk will be performed in.J~e manner seti forth in the application filed therewith. '
orn to before me th~)
........ ~..~.~... ~.,~. ,.~..daff'0~../]... ~G... '.~-.X' . .~. i, lo~
. o'ta- Pub,' . ........
., ,y c, .~.?/.. ~_.~.~:~...~.. County . ·
' '($ignatureof p .cant)
· . · . ,. . er,, ~ir~mya~, m ~. .