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HomeMy WebLinkAbout20939-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUP~J~CY No Z-22665 Date OCTOBER 20~ 1993 THIS CERTIFIES that the buildin~ Location of Property 20075 ~IN ROAD House No. County Tax Map No. 1000 Section 17 Subdivision ACCESSORY Street Block 3 Filed Map No. ORIENT~ N.Y. Hamlet Lot 6.1 Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated SEPTEMBER 3, 1992 pursuant to which Building Permit No. 20939-Z dated SEPTEMBER 3, 1992 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 & FENCE AS APPLIED FOR. The certificate is issued to (owners) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HF~kLTH APPROVAL UNDERWRITERS CERTIFICATE NO. PLUMBERS CERTIFICATION DATED THOMAS & URSULA MURRAY N-291219 - OCTOBER ir 1993 Rev. 1/81 ~o~,~ NO. ~ TO~N O~ $OUT~OLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N. Y. BUILDING PERMIT CrHIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) N~To. 20935Z Permission is hereby granted to: ,o. ....o~. .. ~ .o~..~ ~. ....... at premises located at ...~..~:~...~....~.~...~.: ........ .~..~....,......~...'.~.: ............................... Cou.w Tax Mop No. ~ooo Sectio. ...... .C>.1.~ ....... mock ....... ~.~ ...... Lot No....Le.:...~. ............ pursuant to application dat~ .... ~..~....~-- .......... , 19.~.~ and approv~ 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 buflding inspector with the following: for new building or new use: i. Final survey of ~roperty 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 ~sed 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 "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 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, Coramercial $15.00 Date ......................................... New Construction...........~ Old Or Pre-existing Building ............ .. ... Location of Property ................................ . · House No. Street Hamlet 0nwer or Owners of Property ..... (~-~.~.~...~ ~ ~ ~A~ zTf~ ~ County Tax Map No 1000 Section ~] Block ~. TO~ ~o / Subdivision ~ · 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: $ ~...~.. ' THE NEW YORK BOARD OF FIRE UNDERWRITERS [~0129~ BUREAU OF ELECTRICITY ~'- 85 JOHN STREET, NEW YORK, NEW YORK 10038 Date OC~J~O~R (;) [ ~ ].993 Application No. onfile ~4 ~0B8~9 ~ / 9 ~t THIS CERTIFIES THAT only the electrical equipment as d~scrlbed below and introduced by the applicant named on the above application number in the premises of in the following b,cation; [] Basement [] Ist Fi. [] 2nd ~7. Ot]T Section Block Lot ~s examined on ~ ~] I~ ~{~ ~R 16~I99~ and found to be in compliance with the National Electrlcal Code. FIXTURE FIXTURES RANGES COOKINGDECK~ OVENS ~)ISH WASHERS EXHAUST FANS SERVIC~ OISCONNECT NO. OF S E R V I C E covers co~upliauce at the date of iflSpection oily Because of u;lusua] e~vlroumeuts it is advisable to made t)~ a qualified <<< Co~t, lnu.d on Page 2 GENEIIAL I~tNASER 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~OT~ ~E .... ALTERED~ IN ANY MANNER THE NEW YORK BOARD OF FIRE UNDERWRITERS [~)C,',)[ 290 BUREAU OF ELECTRICITY ~'- 85 JOHN STREET. NEW YORK, NEW YORK 10038 Date Of'dJ~()~[/ ~l~ [9~3 Application No. onfile ~8~e93/~3 ~ ~9:[?~9 THIS CERTIFIES THAT o~y the e~ thee] equipment ~ ~scri~ below and int~uced by t~ applicant ~med on the a~e application number ~n the premiss of Lot FIXTURE OUTLETS IECEPTACLES SWITCHES FIXTURES RANGES OVENS DISH WASHERS EXHAUST FANS DRYERS SYSTEMS NO. OF FEET OTHER APPARATUS: S R V I C NO, OF CC. COND, PER ~' AWG OF CC. COND NO. O,; HI-tEG OF HI-LEG NO. OF NEUYRAI.$ A, WG OF NEUTRAL 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 ALTERED IN ANY MANNER. INSPECTORS Victor Lessard Principal Building Inspector Curtis Horton Senior Building I~pector Thomas Fisher Building Inspector Gary Fish Building Inspector Vincent R. Wieczorek Ordinance Inspector Robert Fisher Assistant Fire Inspector Telephone (516) 765-1802 OFFICE OF BUILDING INSPECTOR TOWN OF SOUTHOLD Sept. 9, 1993 SCOTT L. HARRIS, Super~iso~ Southold Town Hall P.O. Box 1179, 53095 Main Road Southold, New York 11971 Fax (516) 765-1823 Telephone (516) 765-1800 Mr. Thomas Murray 20075 Main Road Box 2032 Orient, N.Y. 11957 To Whom This May Concern: We are unable to complete your Certificate of Occupancy because of the following reasons: An application for Certificate of Occupancy is not on file. (Enclosed) XX No Underwriters Certificate on file. The check is on file. $25.00 No Health Department Approval on file. No final inspection has been made. No Pl~unber Solder Certificate on file. (All permits involving plumbing being issued after April 1, 1984). BUILDING PERMIT ~ 20939 Z (POOL & FENCE) Please contact our office on this matter. cooperation. Thank you for SOUTHOLD TOWN BUILDING DEPT. 765-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLBG. FOUNDATION 2ND [ ] INS~.ATION FRAMING [l/]' FINAL DATE INSPECTOR 765-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLBG. ] FOUNDATION 2ND [ ]INSULATION ]FRAMING ~"AL REMARKS: / ///' INSPECTOR~..~ OUNDATION (1st) OUNDATION (~nd) !. :OUGH FRAME & -PLUMBING iNSULATION PER N. STATE ENERGY CODE Fi:;AL Ye ADDITIONA'L COMME~;TS: , : FORM NO, 1 ' i':: S.Ft0 -- 3 '"'>~ TOWN OF SOUTHOLD ~. ,,,, BUILDING DEPARTMENT ~ TOWN HALL ~ " SOUTHOLD, N.Y, 11971 )isapproved a/c .... . .............................. ./~ . -- .. (Building Inspector) APPLIC,&TION FOP, BUILDING PERMIT gOARO OF HEALTIt ......... 3 SETS OF PLA;{S .......... SURVEY ................... ClIECK .......... HAIL TO: Date ' 19 INSTRUCTIONS a. Tiffs application must be completely filled in by typewriter or in ink and submitted to the Building Inspector, with 3 ts 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 ' areas, and giving a detailed description of layout of property must be drawn on the diagram which is part of this appli- tion. c. The work covered by this application may no~ 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 all be'kept on the premises available for inspection throughout the w6rk. e. No building shall be occupied or. used in whole or in part for any purpose whatever until a Certificate of Occupancy all 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 dlding Zone Ordinance of the Town of Southold, Suffolk County, New York, and other applicable Laws, Ordinances or :gulations, for the construction of buildings, additions or alterations, or for removal or demolition, as herein described. ~e applicant agrees to comply with all applicable laws, ordinances, building code, housing code, and regulations, and to mit authorized inspectors on premises and in building for necessa.po inspections. /4, ,~ (Signature of at~pLicafit, or name, if a corporation) (Mailing address of applicant) . ate whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. ~me of owner o f premises ....T~..g,g3.~...~C..X~ ,~. .... ~..~..~~..~.C4, .......................... (as on the tax roil[Dr latest deed) applicant is a cbrporation, signature of duly authorized officer. (Name and title of corporate officer) Builder's License No .... Plumber's License No ......................... Electrician's License Nb ....................... Other Trade's License No ...................... Location of land oh which proposed work will be'done, e,~ O ~) ~ ! ................ ': ................. · .................. ·· llouse Nmuber Street' l~i ........... Co,,nty Tax Map No. ,000 Section ........ /.7.. Block3 Lot ./. .... Subdivision Filed Map No Lot ' (Name) State existing use and occupancy of premises and intended use and occupancy of proposed construction: '. Existing use and occupancy ...... .O.%-~t~.....~. 'At" .%~k. Vy., .~'-~....t~... ~ '. Intended use and occupancy ~..M~.\ .X'j%....'3'XA.\~.Q:.' .~..~. ~... 3. Nature orwork (check which a~plieable): New Building .......... Addition Alterati~'n .... Repair ..... ~ ...... Removal .............. Demolition .... i' ~ih'e} Work ,' ..... $. If ' . ' i (to be paid on filing this application) dwelling, number of dwelling! units If garage, number of cars .... ~ ............... Number of dw lling unit,s on each floor.... ............. 6. If business, commercial or mixed occupancy, specify nature and extent of each type of use ...... 7. Dimensions et existing structur s, if any: F~-ont .............. '. Rear .............. Depth ............. Hight ~b fSt ' e ............... _.N?' u er o ones ........... Di i f with dditi ............................................. mens oas o same structure alterations or a oas: Front Depth 4 Height .......... ' ..... ·· Rear .................. 8 .......................................... Number of Stories ........... Dimensions of entire new const~ction': Front Rear Height Nun~ber of Stories .............................. Depth ............... Front ' ' 9 Size orl;i: ............. ' ....................................................... 10' Date of Purchase ........... i ........... Rear ...................... Depth ...................... · -, .... ' Name of Former Owner I 1. Zone or use district in which pr~mises are situated .......................... · Does proposed construction violate ~ ........................... 12 Will lot be regraded .... ' ..... ny zoning law, ordinance or regulation: ................ . ............ · ' i ............... Will excess fill be removed from prem scs ~ No 14. Name of Owner of premises ...~ .................. Address ................. Phone No ............. Name of Architect ....... i 15. Is this property x,,ithin ~00 feet of a tidal wetland.'? *Yes. ' Trustees Perrait may be required· · 1'£ yes, Soul:hold ~own ....... No ......... PLOT DIAGRAM Locate clearly and distinctly all [buildings, whether existing or proposed, and. indicate ail 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 comer lot. STATE OF NEW YORK COUNTY OF ' S. .......... ' ....................................... being duly sworn, deposes and says that he is the a cant (N ig t) ppli amc of individuals nih contrac :bore named· {e is ihe ........................ ' (Contractor agent corporate officer crc ) ................... £ said owner or owners, and is duly a,uthonzed to perform or have performed thc said work had to make and file this d in this application are trne to the best of his knowledge and belief; and that the I Forth in the a, pplication filed therewith. pplication; that all statements contain( 'ork will be performed Jn the mannersc worn to before me this ~' r-q 50.9( -- I_T-O.O c) rm > ~ THE NEW YORK BOARD OF FIRE UNDERWRITERS [~0129~ BUREAU OF ELECTRICITY ~'- 85 JOHN STREET, NEW YORK, NEW YORK 10038 Date OC~J~O~R (;) [ ~ ].993 Application No. onfile ~4 ~0B8~9 ~ / 9 ~t THIS CERTIFIES THAT only the electrical equipment as d~scrlbed below and introduced by the applicant named on the above application number in the premises of in the following b,cation; [] Basement [] Ist Fi. [] 2nd ~7. Ot]T Section Block Lot ~s examined on ~ ~] I~ ~{~ ~R 16~I99~ and found to be in compliance with the National Electrlcal Code. FIXTURE FIXTURES RANGES COOKINGDECK~ OVENS ~)ISH WASHERS EXHAUST FANS SERVIC~ OISCONNECT NO. OF S E R V I C E covers co~upliauce at the date of iflSpection oily Because of u;lusua] e~vlroumeuts it is advisable to made t)~ a qualified <<< Co~t, lnu.d on Page 2 GENEIIAL I~tNASER 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~OT~ ~E .... ALTERED~ IN ANY MANNER THE NEW YORK BOARD OF FIRE UNDERWRITERS [~)C,',)[ 290 BUREAU OF ELECTRICITY ~'- 85 JOHN STREET. NEW YORK, NEW YORK 10038 Date Of'dJ~()~[/ ~l~ [9~3 Application No. onfile ~8~e93/~3 ~ ~9:[?~9 THIS CERTIFIES THAT o~y the e~ thee] equipment ~ ~scri~ below and int~uced by t~ applicant ~med on the a~e application number ~n the premiss of Lot FIXTURE OUTLETS IECEPTACLES SWITCHES FIXTURES RANGES OVENS DISH WASHERS EXHAUST FANS DRYERS SYSTEMS NO. OF FEET OTHER APPARATUS: S R V I C NO, OF CC. COND, PER ~' AWG OF CC. COND NO. O,; HI-tEG OF HI-LEG NO. OF NEUYRAI.$ A, WG OF NEUTRAL 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 ALTERED IN ANY MANNER.