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Home My WebLink About20784-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No Z-22611 Date SEP~MBER 23~ 1993 THIS CERTIFIES that the buildin~ SWIMMING POOL Location of Property 1145 STILLWATER AVE. CUTCHOGUE, N.Y. House No. Street Hamlet County Tax Map No. 1000 Section 103 Block 1 Lot 16 Subdivision Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated JUNE 29, 1992 pursuant to which Building Permit No. 20784-Z dated JULY 6, 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 S~IMMING POOL & FENCE 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 Rev. 1/81 DOROTHY CHARNEWS & EVERETT GLOVER N-254418 - OCTOBER 22~ 1992 ' // B~ilding Inspector FOBM NO. ~1 TOWN OF SOU'I'HOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N. Y. BUILDING PERMIT ('I'HIS PEP-JvIIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) N~-No. 20784Z Permission is hereby granted to: , (~) . .... ~.~ ...... ~.?~.....,~........,~ ,o ..................... at premises Iocoted at ....J.[.~.~.......~......~ ......... .Q~~.~ ................ County Tax Mop No. 1000 Section ....... J...~...~ ...... Block ........ ..~)..J ....... Lot No ......~..~0. ............ to opplicotion dated ....... 4..~G~,....~.~.~( ................, 19.~..'~, and approved by the pursuant Building Inspector. ...... ;"'""BuJJe~ng 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 accurats 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 1% lead. 5. Con~ercial 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, Commercial $15.00 J. 'R .-B.. ........... New Construction ........... Old Or Pre-existing Building ................. Location of Property.. JJ.~'5 ...... .~'~i'J./.~.~.~..~... ~.~.~. .......... ~ ~[~.~ ,~.~.. House No. Street Hamlet k_/ 0nwer or Owners of Property~~..~.. ~b~[[~.~/~..~...~..~..~...~.l.~ .~.... County Tax Map No 1000, Section..~,~ ...... Block...~..l .......... ~ot...~!~. ............... ......... Filed Map ............ Lot..~ ] .~.~.~ .... Subdivision.~.~.~.~-~.~ .... Permit No..~ .~..~.~..~ ..Date Of Permit.~-[~.].~. ~.j. ! .~Applicant. ~..~.~..~.. ~. l~'.~..... Health Dept. Approval .......................... Underwriters Approval ......................... Planning Board Approval ........................ Request for: Temporary Certificate .......... Final Certica.te ....... Fee Submitted: APPLICANT ~OU~__~DA~ION (lst) :OU~DATIO:.! (2nd) '~OUGH FRAME & .PLUMBING :NSULATION PER N. Y. STATE ENERGY CODE FINAL ADDITIONA'L COMMENTS: 76~-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLBG. FOUNDATION ZND [ ] INSULATION [ ] FRAMING [ ] FINAL DATE_~ INSPECTOR THE NEW YORK BOARD OF FIRE UNDERWRITERS 11~.q077 BUREAU OF ELECTRICITY ~ 85 JOHN STREET, NEW YORK, NEW YORK 10038 Date O(~?O~l~ ~2~'}9~2 /lpplicationNo. onfile ~3695392/92 ~ 2~441~ THIS CERTIFIES THAT o~ly the elect~cal equipment ~ ~scribed be~w and ~ntroducod by t~ appBcant ~med on the a~ve application nu tuber in the p~mises of in thefollowin$ location; ~ Basement ~ Ist FI. ~ 2nd FI. OlJ~ Section BI~k Lot . . 0(~ ~0~ [~ 1 ~ t [ 9 9 ~ and found to be in compliance u'ith the require.tents of th s Board. FIXTURES RANGES OVENS DISH WASHERS FIXTURE SWITCHES OUTLETS FLUORESCENT OTHER DRYERS SYSTEMS NO. OF FEET E E V I C E NO OF HI-LEG OTHER APPARATUE: cove[~ co,pti, atica at the date o[ ~virotme~tts Jt ].s advisable to have freque~t tesg/and or repairs GENIRAL MANAGER This certificate must not be altered in any manner; retorn to the offke of the ~oard if incorrect, inspectors may be identified by their credentials. COPY FOR BUILDING DEPARTMENT. THIS COPY OF CERTIFICATE MUST NOT BE ALTERED IN ANY M~NNER. ~'~' >'THE NEW YORK BOARD OF FIRE UNDERWRITERS ~(m :~ 1,18!J077 BUREAU OF ELECTRICITY [~ 85 JOHN STREET, NEW YORK, NEW YORK ~0038 Date 0C~'0I}]{ll 22~992 Application No. onfile 03695392/92 R 254~DA~ THI~ CERTIFIES THAT only the electrical equipment ~ &sc~bed below and interlaced by the applicant ~med on the a~e appllc~tion number in the prem~es of DOR0~H~ Ctt~[~, 1145 Sl"t][,h~ ~gE~[I~, C~'fC}~0~E, ~Y. in thefollowlng loca~ion~ ~ Basement ~ Ist Fl. ~ 2nd 37, O1J~ Section Bilk Lot ~sexaminedot~ Ol~ ~0~ ~ [~ [~t1'9 {) 2 and found to be i~, co,tpliance u. lththerequirements~fthlsBoard. FIXTURE OUTLETS rECEPTACLES SWITCHES FIXTURES RANGES OVENS DISH WASHERS EXHAUST FANS DRYERS SYSTEMS NO. OF FEET E R V I C OTHER APPARATUS: 164 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 BUILDING DEPARTMENT, TNIS COPY OF CERTIFICATE MUST NOT BE ALTERED Ill ANY MANNER. FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N.Y. 11971 TEL.: 76§-1802 Examined ................. 19 ... Approved ................. 19... Permit No ............ Disapproved a/c ..................................... gOAg'0e OF HEALTH ......... 3 SE~TS OF PLANS .......... SURVEY ................... CIIECK .................... SEPTIC FORH .............. ~'-4; OT I PY ~ HAIL TO: (Building Inspector) APPLICATION FOR BUILDING PERMIT INSTRUCTIONS Date ... ~./,,,~,.~.-'~... a. This application must be completeJy filled in by typewriter or in ink and submitted to the Building 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. c. The work covered by this application may not be c~)mmenced before issuance of Building Permit. d. Upon approval of this application, the Building Inspector will issued a Building 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 purpose whatever until a Certificate of Occupancy shall ~ave 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',~t~,)q, onstruchon of buildings, add~hons or alterations, or for removal or demolition, as herein described. The applicant agi(~0~,'{o comply With all applicable laws, ordinances, building code, housing code, and regulations, and to admit authorized ~spectors on premises and m building for necessary ~nspect~ons. ~ / ,f -- · r · ig4 .... (Mailing address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. ............. .............................................. :-. ....................... Name of owner of premises ~.~74Q .zT*,/?~,. ~.~.14 (3.-g...k)~..~.. ,*..~ .~.~.~. ?..~., .'45...~,~r, JUZ¢,~ .................. (as on the t.a~' roll or latest deed) If applicant is a corporation, signature of duly authorized officer. (Name and title of corporate officer) Builder's License No../~'g.Z'~. ~..~//~. ......... Plumber's License No ....................... .,. Electrician's License No ....................... Other Trade's License No ...................... Location of land on which proposed work will be done .................................................. ./. ........... ............. .................. House Number Street Hamlet County Tax Map No. 1000 Section., ,z/l~*, OO. ........ Block . .~./.,.Q~P ........... Lot. z~/d; ..Z~dP. ........ Subdivision'~.'/...~/~ .~.~..~, .I~.E..~..~..~..'.~.F.~.~.. Filed Map No ............... Lot .rp?~.,.~/r/.'d ...... (Name) State existing use and occupancy of premises and intended use and occupancy of proposed construction: a, Existing Us,,d~nd occupancy ./..,~...,~//.~,,T'... :'~,4~../~.~ .......... ~*~j/~,l.~l~l~,~ ... ........ ~ Intended use and occupancy e'. ~/~4¥/.z-~....:~/.~.,N~t. g..~f4~.,.. ~,).z~. ~~~A-t',ztg~..' .-~...o.~. 3. Nature of work (check which apl[ licable): New Building .......... Additi .......... Alteration .......... .............. Rem, 'si .............. Demolitio, ...... o.n. .... Other Work 4 Est' atedC t -~(~r'-/2d~g) OO I ' Fee (to be paid'on filing this application) 5. If dwelling, number of dwelling ugits ............... Number of dwelling units on each floor ............... . If garage, number of c~s ...... [ ................................................. ................ 6. If business, commercial or mixed ~ccupancy, specify nature and extent of each t e of use ...: ................. 7. Dimensionsof~xistingstmctures if any: Front..~ ......... Rear ......... Depth ~ ....... Height . ~ .......... Number of Stodes ~ .................................. D~ensions of same structure with alterations or additions: Front ................. Rear ................. Depth ..................... ~. HeiSt ...................... Number of Stories ..................... 8. Dimensions of entire new constmStion: Front ............... Rear ............... Depth .............. Hight..............,Numb,~e er of Stofies .............. v ........................................ ........................................ Depth ~.. . ~.. 10. Date of Purchase ............ ~ ................. Name of Fomer Owner ............................. 11. Zone or use district in which premises are situated.. ~F/~ ...................................... 12. Does proposed construction violate any zoning law, ordinance or regulation' 13. Will lot be regraded ~/~g~ . .. Will exc .... ' ' ~; .......................... ' ~Pt~~' ' · ess nn ~e removea xrom premises: ~ No 14. Nme of Owner of premises ~r. ~ .... Address ~/~~. Phone No. Nme of Architect ~ ............... ........... ~ ................ Address ................... Phone No ................ N~e of Contractor ~. ~ ~ Address ~ ~ ~r~ .... Phone No~n~Z2 ....... 15. Is th~s property w~th~n 300 feet of a t~da~ wetland? eyes ........ ~o..~... elf yes, Souehold Tdwn Trustees Permit may be required. PLOT DIAG~ Locate clearly and distinctly fll ~uild~gs, whether existing or proposed, ~d. indicate fll set-back d~ensions from propeRy ~nes. Give street ~d block nCmber or descfiptioh aecord~g to deed, and show street nines and indicate whether integer or comer lot. STATE OF NF:~V'~OR~-.~' fL,--- S $' COUNTY oF~.-F.T&/A.. ', ...... ........... .(Name 0J individual sigmng contract) above named. being duly ~worn, deposes and says that he is the applicant a agJ a'te o'C~io;;, e'tJ.) ........................ uf said owner or owners, and is duly ~uthonz~rd to perf--" 'orm or have performed the said work and to make .and file this application; that all statements containpd in this application are true to the best of his knowledge and belief; and that the ~vork will be performed in the manner s~t forth in the application filed therewith. Sworn to before me this · _. ........... -_ .................... (Signature of applicant) .% 0 Z 0 C C .< Z ..<