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HomeMy WebLinkAbout21278-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. OERTIFICATE OF OCCUPANCY No Z-23312 Date OCTOBER 28, 1994 THIS CERTIFIES that the buildin~ Location of Property 13451 ORE~ON ROAD House No. County Tax Map NO. 1000 Section 83 Subdivision ACCESSORY CUTCHOGUE, N~W YORK Street Hamlet Block 2 Lot 10.6 Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated MARCH 12, 1993 pursuant to which Building Permit No. 21278-Z dated MARCH 23, 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 SWIPING POOL WITH FENCE ~NCLOSURE 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 LOUIS C. & LUBA CORSO N/A N-284150 - JULY 27, 1993 Rev. 1/81 lvOB,H NO. fl TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, H. Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) N~N? 21278Z Permission is hereby granted to: ~ 'Z'~.)' ......... ~ ........... .~ .......... :. ........................... . t -/ , - ~..~.~.~....~ ........................... . ... ~". ......... ~ .~ ................... ~ .......... i..~ ......................................... · ................................................... at premises located at ..,.S.~....~.~...Z......~........~,...~... ........................................................ County Tax Map No. 1000 Section .......... ?.....'~.. ...... Block .......... :~. ....... Lot No ..... ././~.~....~.. ...... pursuant to application doted ..... ..~.,~ ................................. , 19..~....'~,., and approved by the Building Inspector. Fee $...../....~..~.....~. Rev. 6/30/80 Form No. 6 TOWN OF SOUTHOLD 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 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. B. For existing buildings (prior to April 9, 1957) non-conforming uses, or buildings and "pre-existing" land uses: i. 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-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, Commercial $15.00 NewConstruction .... .~. .... OldOrPre_existingD~lj~jji~!./'t~'.~!i'~.'i'il ...... Location of Property ...... /..~.~.~%1 ........ ¢~..~.~..~..g[..i ..... [~5~.~';~--~.'i.'.'i'''.''' House No. Street Hamlet Onwer er Owners of Propert ........ L l. o County Tax Map No 1000, Section .....~.~ ..... Block...~ ........... Lot...~g.~ .......... Subdivision ..................... · Filed Map Lot Permit No..~.~.~.~.~....Date Of Pernlit ....... Applicant.. · ~, Health Dept. Approval .................... Underwriters Approval .................. Planning Board Approval .................... Request for: Temporary Certificate .......... Final Certicate ..........~~ ... . ................. THE NEW YORK BOARD OF FIRE UNDERWRITERS 100012]. BUREAU OF ELECTRICITY ~ 85 JOHN STREET, NEW YORK, NEW YORK 10038 THIS CERTIFIES THAT o~y the electrical equipment ~ ~scribed ~low a~ intr~uc~ by t~ applicant ~ on the o~ve application number in t~ prem~es of in the fol~o~in~ locat~on~ ~ a~,oment ~ Ist n. ~ 2nd FI. 0 ~ Soetlon Bilk Lot ~s examined ofl J~ 23,~993 and found to be in comp[~nce ~ith the NaHonal Elect~cal Code. FIXTURE FIXTURES RANGES OVENS OUTLETS SWITCHES FtU~ESCENT OTHEfi E R V f C NO. OF CC. COND PER ~' AW, G, OF CC. CON~, NO OF HI-lEG A. WG OF HI,LEG qO OF NEUTRA OF NEUTRAL OTHER APPARATUS: cove'cs compliauce at, the datxe of; ln~.~psc, tion only. Because of unusual envSroameuts i,t, i~ advisable have freclueut, t, est,/and or repairs made tW a quallLied person~ 11971 GENERAL MANAGER This certificate must not be altered i~ any member; return to the office of the Board if incorrect. Inspectors may be identified by their credentials. THE NEW YORK BOARD OF FIRE UNDERWRITERS 10~O121 BUREAU OF ELECTRICITY -- 85 JOHN STREET, NEW YORK. NEW YORK 10038 THIS CERTIFIES THAT o~y ~he electrical equipment ~ ~scrlbed below a~ intr~uc~ by t~ applicant ~med on the a~ appl~atlon ~u~ber in the p~m~es of in the yoJlow~ng locatlon; ~ Basement ~ Ist ri. ~ 2nd FL OUT Section Bl~k Lot ~sexaminedon J [I[~Y 23~1993 and found W be in compliance with the Na~nal Elect~cal Code. FIXTURE FIXTURES RANGES COOKINGDECKE OVENS DISH WASHERS EXHAUST FANS OUTLETE EWITCHEE 3 3 DRYERS OTHER OTHER APPARATUE: ~ffI~MIlqG POOl,~'1 HOT TUB., 1 MOTORB~2-F H,P~3'[,5 H,P~ ~N~]LBO~ROS;I-'~J CIR, lOO,l~3 CIR. 100 G,F.C.i: -I *(SWIMHING POOh) l'hl~ certificate <<< eont, lnued or) Pacje 2 >>> E R V I C E OF CC, COND. NO OF HI.LEG A. W. G NO GE NEUTRAtS A, W G. OF HI-LEG OF NEUTRAL GENERAL MANAGER i Per ' · ' ~' ificate must not be altered in any manner; return to the office of the Board if incorrect. Inspectors may be identified by their credentials. '=~OPY FOR BUILDING DEPARTMENT. THIS COPY OF CERTIFICATE MUS.T 5NOT BE ALT_ERED IN ANY MANNER. - - PRODUCER The Burr Agency, Inc, 1 Ray place Northport~ N.Y. 11768 CODE SUB-CODE 3111193 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW COMPANIES AFFORDING COVERAGE COMPANY LETTER A CNA Insurance Company INsuRED Luces Swimmin~ Pool Service ~nc. 2 Ursular Court Smithtown, N.Y. 11787 COMPANY LETTER LETTER C LETrEN O ii [',IAR I 2 199 THIS IS TO CERTIFY THAT THE POLICIES OF iNSURANCE LISTED BELOW HAVE BEEN iSSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD ~NO(CATED, NOTWiTHSTANDiNG ANY REQUIREMENT, TERM OR COHD~TtON OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THiS CERTIFICATE MAY BE iSSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES, LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS, D POLICY EFFECT VE POL CY EXP RAT ON ~.TR TYPE OF iNSURANCE POLICY NUMBER DATE (MM/DD/YY) DATE (MMIDD/YY) ALL LIMITS IN THOUSANDS GENERAL AGGREGATE i $ ~0 ' G~=RA[ LIABILITY .... ~ ~ .... ~ .... A X' COMMERCIAL GENERAL LIABILITY {~ ~-~R~'~'~;6~'~'~''~'**''''~ ~ C~A,~S~A~ XJ OCCUR.; 0 06607899 2/1/93 2/1/94 '~6~[~ib~i~i~J~'~'~ "'500 MEDICAL EXPENSE (Any one person) ~ $ ~ ~ AUTOMOBILE LIABILITY ~ COMBINED : SINGLE $ [ , iNJURY ~ $ ~ HIRED AUTOS BODILY J 'DAMAGE ~$ A AN~ 1 21001293 ~/1/93 2/1/94 ~ 100 (~Ac, Acc~,~) $ ~ 500 (D~SEASE--POLICY LIMIT) OTHEH } Proof of insurance Town of Southold P.O. Box 1179~ Main Road Southold, N.Y. 11971 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES ~BE CANCELLED BEFORE THE EXPIRA,~T[,ON DATE THEREOF, THE ISSUING QOMBANY WILL ENDEAVOR TO MAILJ.,7 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEET, BUT FAILURE TO MAIL SUCB NOTICE SHALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE COMPANY, ITS AGENTS OR REPRESENTATIVES ! ~ ~ .................. ' FORM NO, 1 '~ TOWN OF SOUTHOLD ' ',',' '4AR I 2 1993' ··BUILDING DEPARTMENT i , TOWN HALL $OUTHOLD, N.Y. 11971 Examined ., 19 Disapproved a/c ' d APPLICATION FOR BUILDING PERMIT BOARD OF HEALTH ......... 3 SETS OF PLANS .......... SURVEY ................... ClIECK .................... SEPTIC FORH .............. ..... M^[L TO: INSTRUCTIONS : a. ,This application must be completely filled in by typewriter or in ink and submitted to the B~ilding Inspector, with 3 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 streets or areas, and giving a detailed description of layout of property must be drawn on the diagram which is part of this appli- cation. ¢. The work covered by this application may not be commenced before issuance of Building Permit. d. Upon approval of this application, the Building Inspector will issued a Building Permit to the applicant. Such permit s,hall 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 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 appllcable Laws, Ordinances or Regulations, for the construction of buildings, additions or alterations, or for removal or demolition, as herein described. The applicant agrees ~t~cgmp~ly/~f, th~ll applicable laws, ordinances, building code, housing code, and regulations, and to admit authorized inspecto,rs on premises and in building for necessary inspections. - . .' ......... t~ ." . ...... "; ' ". ' .~..~.c~....(~/.~.~.~ ..... ~.,~¢, ......... --' . ' (Signature of applicant, ~br name, if a corporation) £ · (Mailing address of applicant) -- State whether applicant is owner, lessee, agent, architect, engineer, ,l~a~l'contractor electrician, plumber or builder. · ~ame o~ owner orprcmises ,.Z'~;~-:~.. C~ ¢"~,,;'¢~'~ ~. ,Z, .~,F..~... ~.~.~. ~ .......................... (as on the tax roll or latest deed) If applicant is a ~orporation,,signature of duly authorized officer. (Name and title of corporate officer) JBuilder's License No. ~..~. 7.~....ff..: ./.'/ ........... Plumber's License No ......................... Electrician's License No ....................... Other Trade's License No ...................... 1. Locatio9 of land on which proposed work will be'done ................... .~.'.-~. ........................ House Number / Street Hamlet ' County Tax Mal, No. I000 Section .... ~.8.~ ......... Block ...0.~. ' Lot ..... ~.O!.~.. ........ ! .l?l. I..~l..~ . . .~J~...~.~..~..~. ! ........... Filed Map No ............ Lot.. ~ .......... Subdivision ..... ... (Name) 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy .................................................... : ............... b. Intended use and ofcupancy ...... h appli ng...' ........ .3. Nature of work (check whic cable): New Buildi Addition .......... Alteration ..... '.. Repair ... ........... Re,oval .............. Demolition .... ..' .... Other im'at ' (Description 4. Est ed Cos .... ~ .... Fee ............................. (to be paid on filing this application) 5 If dwelling number of dwe ling units ' NUmber · ' ........... of dwelling units on each floor If garage number of cars i ; ................ 6 ' If bus,nc'ss .... ' ................................................... commercial or mi,.xdd occupancy specify nature and extent of each type of use ................. 7 Dimensions ofexistingstructur if any: Front. ...................... · ~s, . Rear Depth Height Nun bet of Stories ' '" ............................. Dimensi~ ............. ' ....................................................... of s:ime structure w ith alterations or additions Front Rear Depth ' Height .................................... ' Number of Stories ' Dimensions of entire new eonst~ uction: Front ............... · ' Rear Depth Height Nun her of Stories ............... ' " ............................. 9 raze ofl i: ............. ' ....................................................... Front ' Rear I0' Date of Purchase .......... ·~ ................................. Depth ...................... · · .......... '. ' Name of Forfner Owner 11. Z .... one or use dmtnct xn whmh premises are situated..~ -.~ ........... 12. Does proposed construcl~ion violate any zonim, law ~rfiin~ce',-'f~-' ; *" .... ...................... 15. Is thzs property within 300 feet of a tidal wet~'~~ -.--~'~ .... rnone?o, rli~"Y. ~.~..... · ~zr yes, Southoid Town Trustees Permit may be required. ' ........ PLOT DIAGRAM Locate clearly and distinctly ~11~ - ' ' [buildings, whether existing or proposed, and. indicate all set-back dimensions from property lines. Give street and block fiumber or description according to deed, and show street names and indicate! whethe interior or corner lot. APP/ROYED AS NOT£ , DATE~ ~B.R # ~ ':~ FEE:~BY:~ NOTIFY $1:llLt~llS' OEPARTM~ablT'~RT 76§-1802 9 AM TO 4 PM FOR THEi FOLLOWING INSPECTIONS: 1. FOUNDATION - TWO REOUIREDi FOR PO~EO CONCRETE 2, ROUGH - FRAMING & PLUMISINGI 3. INSULATION : 4. FINAL CONSTRUCTION MUST: ~ BE COMPLETE FOR C.O. ALL CONSTRUCTION SHALL MEETI THE REQUIREMENTS OF THE N.Y.i STATE CONSTRUCTION & ENERGYi CODES. NOT RESPONSIBLE FOR DESIGN OR CONSTRUCTION ERRORS .;TATE OF NEW ¥-61RK ,, (Name of individual signing contract) bore"named. being duly sworn, deposes and says that he is the applicant Notary Publiei S1 (Signature of app · No. 52-8125850 ;uffolkCountv/ Term Exp res October 31, 19 ~/~-- ~ of New York ~/ icant) le is the ' ~'~;;t'racto'r,~gent, corporate officer etc t.?oWn?~a(~ra ce. and. ~le this · ork will be performed m the manner se! forth in the application filed therewith. ~, ann that the worn to before me this LONG ! : : :"_:::~,~ . ~ ~ UND 17,O' ~ ~ IS NOT SHOWN HEREON. SU~Y FOR LOUIS C. ~RSO 6 LUBA CORSO~ov. ~5,1992 NOV. 17~ 1992 NOV. I 3, L992 OCT, Z5 1992 AT CUTCHOGUE DATE: SEPT. 2], 992 ~WN ~ SOUTHOLD SCALE: I" = I00' SUFFOLK COUNTYi NEW ~RK ~0. ~ut~tZ~o &LTE~TtO~ O~oomo. m HEAL~ DEPARtMENT-DATA F~ APPRO~ TO C~STRUC T A.O ~ HiS ~HALF ~ THE TITLE C~P~Y, GOV~N- " ' ' i I '~1~ I V~I~ RIVER~AD, NEW ~RK ~E: ~ =STAKE ARE~ ~589~;E 0 ~ LATH . RE: L~ NO. 4 MINOR 8u~tVtaON NINA STEVENS A[DENW.~UNG, PROFE~IONAL ENGINEER . AND ~ND suRVEYOR N:Y.S. UCENSE NO. i28a5 ELEVATIONS SHOWN THUS~ cs~o) ARE REFERENCED TO NGVD( MSL 1929). HOWAR~ ~. YoUNG~ LAND sURVEYOR M~ ~aT~ ~LIW),~IC TAK(~ICl~(~I ~. eE~ : N.~S~LICENSE NO~45893 r '