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Home My WebLink About20824-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No Z-22171 Date MARCH 1, 199~ THIS CERTIFIES that the building Location of Property 2875 BAY AVENUE House No. County Tax Map No. 1000 Section 144 Subdivision ACCESSORY MATTITUCK, N.Y. Street Hamlet Block 5 Lot 8 Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated JULY 8, 1992 pursuant to which Building Permit No. 20824-Z dated JULY 13, 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 ACCESSORY INGROUND SWIMMING POOL & FENCE AS APPLIED FOR. The certificate is issued to (owner) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL UNDERWRITERS CERTIFICATE NO. PLUMBERS CERTIFICATION DATED JOSEPH W. MAVELLIA N-245602 - AUGUST 4, 1992 - /~ild~ng Inspector Rev. 1/81 FORM NO. O TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N. ¥. BUILDING PERJ*AIT CrHIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) NO_N? 2082jZ Permission is hereby granted to: f) · ...... ~.~.~......'~..~.~Z~.~ ................... ...... ........................ ......~..~~.,~..a...~.:....~/.~.~.~ ...... · ~ ~. ............. = ............ ~ ............................. = ........... ~:--~ ............. o, p,~,~,~oted o, ..... ~.~.7.~...2L~...~~ ............. ~.~ ............ County Tax Map No. 1000 Section ..................... Block ......(~)...~.. ..... Lot No ....... ..~....~. ......... pursuant to application dated ............ ...~..~.....~>. ............. , 19.~.....~;., and approved by the Building Inspector. Fee $. ~/.~..,....'=~.. ...... Re~ 6/30/80 Form No. 6 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL 765-i802 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-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. Commercial building, industrial building, multiple residences and similar buildings and installations, a certificate of Code Compliance ~rom 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 t'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 - $i00.00 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 New Construction ........... 01d Or Pre-existing Building ................. House No. Street Hamlet On Ow of Prop rty ~. ?~.~,.. ' Subdivision .............................. Filed Map.,..~%~ ..... Lot ...................... Permit No ...... ate Of Permit ...... Applicant ........ Health Dept. Approval .......................... Underwriters Approval ......................... Planning Board Approval ........................ Request for: Temporary Certificate ....... Final Certicate ......... Fee Submitted: $ ............ /G'h~ A .... ,c_....... ............. P, Iss i .................... C0 ~ } q I APPLICANT THE NEW YORK BOARD OF FIRE UNDERWRITERS [ t_ ? §0(93 BUREAU OF ELECTRICITY j--- 85 JOHN STREET, NEW YORK, NEW YORK 10038 Date THIS CE~IFIES THAT o~ly ~he electrical equ~nt ~ ~se~bed be~ end intmd~d by t~ appJlcant ~med on the a~ve application number in the pre~es of in ,hefoHowln8 h,catlon~ ~ B~ement ~ Ist FI. ~ 2nd ~3. 0~ .~eetlon Bilk Lot was examined oa ~ ~ 31. ~ ~ ~ ~ ~ and found to be ~n con~pllance with the req~ire~nents qf this Board. F XTURE ~ECEPTACLE$~ SWITCHES j FIXTURES RANGES J~EC~ OVENS [DISH WASHERS EXHAU$T FANS SEEVI~ OI~ONNEC~ OTHER APPARATUS: PaNgLBOARDS~[-2 CIR. 1_00 t(fiWIHMING POOL) Th.fa cel'tifteate t ' dato~ covers c~pl.,,eace at the inspection only, ~ecause of un~al e~vlroaaents it is advisable toz';. have frequent test/and ox repa.trs~ made by a quali[ied per,on. :~, <<< Contim~ed ou Page 2 >>> GENERAL MANAGER Per /~ ; This certificate must not be altered in any manner; return to the office of the Board if incorrect. Inspectors may be ideofified by their credentials. ~OR BUILDING DEPARTMENT. THI$ C. OPY OF-CERTIFICA TE MUST NOT BE ~E--~E~ ~ THE NEW YORK BOARD OF FIRE UNDERWRITERS ~ ~ SUREAU OF ELECTRICITY 85 ,JOHN STREET, NEW YORK, NEW YORK 1OO38 ~t~ e~,~992 ~pplicationNo. onfile e3~85~9~/~ t~ 2~5~ equipment ~ ~scHb~ be~w and introduced by t~ applicant ~med pn the a~e appllcat~on number in the premises of Iocat~on~ ~ ~e~ent ~ Ist FI. ~ 2nd ~. 0~ S~ctlon Bilk Lot J UI',Y ~, ~ ~9~ andfoundtobeincompllancewiththerequlre~nents~fthlsBoard. FIXTURE OUI'LET$ FIXTURES RANGES OVENS DISH WASHERS EXHAUST FANS DRYERS SYSTEMS NO. OF FEET E E R V I C t~O OF Hi-LEG A.W G. JN~ OF NEUTRALS AW, G, OF NEUTRAL P.O.BOX GENERAL MANAGER ~ This certificate must not be altered in any man,er; return to the office of the Board if incorrect. Inspectors ma), be identified by their credentials. COPY FOR BU'I-~DING DEPARTMENT. THIS COPY OF CERTIFICATE MUST NOT BE ALTERED IN ANY MANNER. THE NEW YORK BOARD OF FIRE UNDERWRITERS ~a~, 1 1~[~(~ BUREAU OF ELECTRICITY ~ B~ JOHN STREET, NEW yORK, NEW YORK 10038 THIS CERTIFIES THAT only ~he electrical ~uipme~t ~ ~scrlb~ be~w and i~troduced ~y t~ oppllca~t ~med on the a~e application number in the prem~es of Lot FIXTURE OUTLETS SWITCHES PIXTURES RANGES OVENS DISH WASHERS EXHAUST FANS DRYERS MOTORS SYSTEMS NO. OF FEET E OTHER APPARATUS: E R V t C NO, OF CC, COND. PER OF CC, CQND OF HI-LEG OF NEUTRAL GENERAL MANAGER Pet: This certificate must not be aitered in any manner; return to the office of the Board if incorrect. Inspectors may be identified by their credentla~s. COPY FOR BUILDING DEPARTMENT. THIS COPY OF CERTIFICATE MUST NOT BE ALTERED IN ANY MANNER. 765-~.802 BUILDING DEPT. INSPECTION FOUNDATION IST [ ] ROUGH PLBG. FOUNDATION 2ND [ ] INSULATION FRAMING [ ~flRAL DATE ~/~ /~ INSPECTOR ?OU~__;D~!ON COMMENTS ~OUNDATIO~! (2nd) IOUGH FRAME & -PLUMBING iNSULATION PER N. Y. STATE ENERGY CODE FI~IAL ADDITIO~A'L 'FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL ~OUTHOLD, N.Y. 11971 TEL.: 765-1803 Examined ...-~?. ].~., 19~..~''' Approved ...~..I. ~., 19~ .~. Permit No. ~'~. · .~...q ~ Disapproved a}c ..................................... (Buddmg Inspector) APPLICATION F, OR BUILDING PERMIT INSTRUCTIONS a. Tins application must be completely 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 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 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 ~ Certificate of Occupancy shall have been granted by the Building Inspector. APPLICATION IS HEREBY MADE t6 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 described. The applicant agrees to comply with all applicable laws, ordinances, building code,~housing code, and regulg~6"~s, and to admit authorized inspectors on premises and in building for necessary inspe, gJtions. J/ . )/// ''' i}~at~'e'oJ'i a~lica~, ;(~;(~e', if a corporation) .... (Mailing address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. Name of owner of premises ~3 ...... ' ..................................... (as on the tax roll or latest deed) If applicant is a corporation, signature of duly authorized officer. (Name and title of corporate officer) Builder's License No .......................... Plumber's License No ......................... Electrician's License No ....................... Other Trade's License No. !q2).'7..3.~..~...~...~. · . 1. Location of land on which proposed work will be done .................................................. ............................ · ............... County Tax Map No. 1000 Section /~OO ..... Block O~OO Lot. Subdivision ..................................... Filed Map No ............... Lot ............... (Name) 2. State existing use and occupancy of premises and intended use and occupancy of proposed const~ction: ~ a. Existing use and occupancy ...... ~.~... ~. .. ;,.; ......... ,. int=a oo m= ................ ......... 3. Nature of work (check which apphcable): New Building .......... 'Addition ........ Alteratio~.. ,, ....... Repair .............. Ren3oval .............. Demolition ............ Other Work../E.o.o..t ....... ~ (Description) 4 Estimated Cost ~._~C?~5> ' ~51t59 Fee i ~ (to be paid On 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 of use ... ..... ~ .............. 7. Dimensions of existing structures, if any Front... ....... '.;.. Rear ............. . Depth ............... Height ............... Number of Stories ........................................................ Dimensions of same structure ~kith alterations or additions: Front ................. Rear .................. Depth i Height Number of Stories ' 8. Dimensions of entire new construction: Front ............... Rear.. ............. Depth ............... Height ................ Nuxnber of Stories ........................................................ 9 Size of lot: Front ~ Rear Depth 10. Date of Purchase .......... [ ................... Name of Former Owner,. ............................. 1 1. Zone or use district in which premises are situated ......... · ............................................ 12. Does proposed construction violate any zoning law, ordinance or regulation' . ...... 13. Will lot be regraded ...... ,~.I .]~ ....... ~ ........,~ .Will excess fill,be removed from premises: Yes Name of Architect ........ I .................. Address ................... Phone No ................ 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 NEgjHORK, COUNTY OF..~ ['~ ~,~ ..... S.S ............ ¥3.~."~ ~ ..... .~., .~ .'4,e .[~ ~, ~ ............being duly sworn, deposes and says that he is the applicant (Name of individual sig~' dng contract) above named. He is the ..................... . ................................................................... (Contractor, agent, corporate officer, etc.) of said owner or owners, and is & :ly authorized to perform or have performed the said work and to make and file this application; that all statements con}ained in this application are true to the best of his knowledge and belief; and that the work will be performed in their set forth in the application filed therewith. Sworn to before me this////~ / I~!.~Z : (Signature of applicant) AT 765-180.~ 9 A~4 ~ ~ P¢~ FOR THE 1, FOUNDA'FK')~,~ [ 'TWO REQUIRED FO~ POURED ~ 2. ROUGH 3. IN~ULATK)N ' 4. FINAL C~ STRUCT~ON MUST ALL CONSTRUCTI SHAL~ ME~ CODES. N~ DESIGN OR CONSTRUCTION ERRORS ~ OF OCCUPANCY