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Home My WebLink About21415-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector To~n Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No Z-22346 Date MAY 20~ 1993 THIS CERTIFIES that the building. Location of Property 2005 PI~TT ROAD House No. County Tax Map No. 1000 Section I8 Subdivision ADDITION Street Block 6 Filed Map No. ORIENT~ NEW YORK Hamlet Lot 27 Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated MAY lld 1993 ..pursuant to which Building Permit No. 21415-Z dated MAY 19, 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 DECKS AROUND, FENCE & STORAGE BUILDING ATTACHED TO EXISTING ONE FAMILY DWELLING "AS BUILT" The certificate is issued to (owners) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL UNDERWRITERS CERTIFICATE NO. PLUMBERS CERTIFICATION DATED RALPH & ELLEN PELUSO N-146429 - AUGUST 29~ 1990 Building- inspect-or Rev. 1/81 · OB~J NO. O TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL $OUTHOLD, N. ¥. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLY'ION OF THE WORK AUTHOPJZED) N°-No. 21Jl~Z Permission is hereby granted to: ...A...~..~~.~~ ..... .................. Co~n~, To~ ~op No. ~000 Seat,on ....... ./.~... ....... B~=~ ....... ~ ........... Lot No ...... ~......~....... pursuant to application dated ....... ~.~,~ .......... /..L ...... , 19...~...~, and approved by the Building Inspector. Rev. 6/30/80 Form No. 6 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL 765-1802 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-~isposal(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 '7pre-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. 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 Building - $100.00 3. Copy of Certificate of Occupancy - $5.00 over 5 years - $10.00 4. Updated Certificate of Occupancy - $50.00 5. Temporary Certificate of Occupancy - Residential $15.00, Commercial $15.OO Date .~..-'./.~..'7 ~.~. ... NeC Construction...~.. .... Old Or Pre-existing Building .... ~ ..... . ..... Location of Property. ]]..~.Q.O..5.-~..~/~-f'~F- ~0 .~..~.~ ..~..I....~../.... House No. Street Hamlet Onwer or Owners of Property.~.~..~.~..~...~..~.--~l~..~...~.~..~..~.~~5 ................................. . County Tax Map No 1000, Section. .. /.~ ....... Block.,~ ....... Lot ~p Subdivision..~..~.¥..~../.~..O. bT/.~. 7~ .~.2~.~. .......... Filed Map ............ Lot..: ]..fi; ¢52" ' Permit Xo~l.~../.~.~.._.Date Of Permi~.~.~./~..Xpplicant.~.~....~.~..... iiiii Health Dept Approval .. Underwriters Approval ........... Planning Board Approval ........................ Request for: Temporary Certificate ........... Final Certicate .... .~ ..... THE NEW YORK BOARD OF FIRE UNDERWRITERS JO0oOt*,~ BUREAU OF ELECTRICITY ~'-- 85 JOHN STREET, NEW YORK, NEW YORK 10038 Date ~[]~' ~,9, ] 990 ~pplication No. on file THIS CERTIFIES THAT only the electrical equipment ~ ~scribed below and intr~uced by the applicant ~med on the a~e applicotion number in the premises of in the followlng location; ~ Base~nent ~ Ist ~7. ~ 2nd FL [)[]~J~ Section Bilk Lot ~s examined on t~L*~ ~ ~ ~ ~'~%() and found to be in compliance with the require.tents Qf this Board. flXIUt~E OUTLRTS DRYERS RECEPTACLE~ SWITCHES FIXTURES RANGES OVENS DISH WASHERS EXHAUST FANS FLUORESCENT OTHER SYSTEMS OTHER APPARATUS: 39A 00'~ 1,~, E R V I NO 0 E COND' Of ~C COND NO OF NEUTRALS GENERAL MANAGER Per~ ~{ COPY FOR BUILDING DEPARTMENT. THIS COPY OF CERTIFICATE MUST H~ BE ALTERED tH ANY ~NER [~ ~o o__;D ^zSo.w ( 1 s t ) ~OUGH FRAME & -PLUMBING ~SULATION PER N. STATE ENERGY CODE '' FI;;AL ADDITtONA'L COMMENTS: '3. N o~'k (she'ck which applicable): New Buildin'g.: ........ Ad id~tio~n~~d~eration . .' .. Repmr ....... 2,' ..... Removal .............. Demolition .... :...g ..... Other Work.~.c:./~,i ' ' ~ t9 0 ~' t~escnption) · -~. · .... ' . ~o//,~,~/:tv;6 ~,'. ...... 4. Est m tedOost../.¢...0. ........... ' .................. Fee .,. i y. .q.q/. .. . ' (to be paid oq~ filing this application) ' 5. If dwelling, number of dwelling units ............... Number of dwelling units on each floor ........ · If garage, number of cars ........................ ' ......................... 6. If business, commercial or mixed occupancy specify nature and,extent of each type o ~ ...................... 7. Dimensions of existing structures, f~use'\ ............ if any: Front .... :~ .....: .... Rear .... '..' ........ Depth ...... Height ............... Number of Stories ......... Dimensions of shme structure with. alterations or additions: Front ................. Rear .................. Depth .... ~ .................. Height ...... ,k'.:'," ........ ;.. Number of Stories ............ ~' ......... 8. Dimensions of entire new construction: Front.. ~ ......... Rear .............. Depth ..~.O ........... Height ............... Number of Stories ...; ....... ~_. ..... ~ ..... , ............... 7: '/ .............. 9. Size of lot: Front .'-~.~2: ......... .. Rear... ~.. (~, ~ Denth '.~:.'~ .. ... 10. Date of Purchase /'/t~k, . Name o[~ ..... ': ..... ~t~. ~ ............. ............................ ormer tawner ............................. 11. Zone or use district in which premises are situated..~..P-4 .'t~.&.w.T. ' ' 12. Does proposed construction violate any zonin,, law ordinance',,'f~.;~'~; ................................... 13. Will lot be regraded [qo · Wf' : ........................ · ..... · .......................... 'u excess fill be removed from premises: Yes '14. Name of Owner of premises .[7/%[.L$..~.Q ............ Address~'.2..~ ]~.~.j~..e. {4.,.~... Phone No:T/~'.'.~..~..~'.?.~.q..~: · Name of Architect .............. Add ............. ress ................... Phone No ............... Name of Contractor .......................... Address ................... Phone No. ' .... 15. I.s this property within 300 feet of a tidal wetland? *Yes ........ No ......... · If yes, Southold Town Trustees Permit may be required. PLOT DIAGRAM Locate clearly and distinctly all buildings, Whether existing or proposed, and. indicate all set-back dimensions from property lines. Give street and block number or description according to deed, and show street names and indicate whether interior or corner lot. STATE OF NEW YORK. ~. o o COUNTY OF... 5. .V3.\% ..... °'° (Name of individual signing contract) above named. (Contractor, agent, corporate officer, etc.) of said owner or owners, and is duly authorized to perform or have performed the said work and to make and file this application; that all statements contained in this application are true tO the best of his knowledge and belief; and that the ~VwOrk will be performed in the/mapner set forth in the application filed therewith· ' om to before me this ./ .... \ ~'./'~../[~/3~Yt'6~. · -~}.. ~.' 19 ~'~ ' FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N.Y. 11971 TEL.: 765-1803 Examined ................. 19 Disapproved. a/c ...................................... (Building Inspector) APPLICATION FOR BUILDING PERMIT 3 S'ET$ OF PLANS SURVEY ClIECK ....... hO? z py · CALL MAIL TO: INSTRUCTIONS a. This application must be con pletely filled in by typewriter or in ink an'd submitted to the Building Inspector, with 3 sets of plans, accurate plot plan to sc~.le. Fee according to schedule. ' b. Plot plan showing location o.f lot and of buildings on premises, relationship to adjoining premises or public sti'eets 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 t/tis application may not be commenced before issuance of Buffding Permit. d. Upon approval of this application, the Building Inspector vdll issued a Building Permit to the applicant. Such permit shall be kept on the premises availabl~ for inspection throughout the work. e. No building shaI1 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 M~DE to the Building Department for the issuance of a Building Permit pursuant to the Building Zone Ordinance of the Town of South61d, Suffolk County, New York, and other applicable Laws, Ordinances or Regulations, for the constraction of buildings, additions or alterations, or for removal or demolition, as heroin described. The applicant agrees to comply with all applicable laws, ordinances; building code, ho~ing code, and regulations, and to admit authorized inspectors on premisesj and .in building for necessary insns~~ic~/q~. (Sign;i]~(e'~[ ;~lida'nt, or name, ifa corporatto'n)- . . : ,[. t . . (Mailing address of applicant) State whether applicant is owner, l?see, 'agent, architect, engineer, generai contractor, electrician, plumber or builder. Name of owner of premises .... . .................................................................. : (as on the tax roll or latest deed) If applicant is a corporation, signature of duly authorized officerJ (Name and title of corpor4te officer) Builder's License No.. ~ ' ' Plumber's License No ........ ; ................. Electrician's License No Other Trade's License Nc ..... i ................. Location of land on which proposed work will be done : Ilouse Number Street Hamlet County Tax Map No. 1000Sectioln ...:./..~. .......... Block....~.... ' Lot...~..7 ............. Subdivision ' Filed Map No Lot State existing use and occupancyof" 'premises and intended use and occupancy of proposed ~onstruction: a. Existing use and occ,,~pancy b. Intended use and occupancy . ? ??' ' :'; ""' "~":; ~ '