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Home My WebLink About20840-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No Z-21007 Date SEPTEMBER 11~ 1992 THIS CERTIFIES that the building. ACCESSORY Location of Property 160 SEBASTIAN COVE ROAD' MATTITUCK~ N.Y. House No. Street Hamlet County Tax Map No. 1000 Section 107 Block I Lot 24 subdivision Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated JULY 14~ 1992 pursuant to which Building Permit No. 20840-Z dated JULY 20, 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 ABOVE GROUND SWIMMING POOL WITH FENCE ENCLOSURE The certificate is issued to IN REAR YARD AS APPLIED FOR. LEON & PAULINE KREMENTZ (owners) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HF2kLTH APPROVAL N/A UNDERWRITERS CERTIFICATE NO. H-030450 - AUGUST 12~ 1992 PLUMBERS CERTIFICATION DATED N/A Rev. 1/81 IPORM NO. O TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N. Y. BUILDING PERMIT (THIS PEPu~AIT MUST BE I(EPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORI~ ^UTHOP, IZED) NgN? 205~0Z Permission is hereby granted to: ~ . ~'~.~~ ..~..~ ~ ........ ~i~....~..~..~..~ .................. ~ ...... ~.~;~ ........ ~;./...;. ....... ./../.F.~ ....... ~o ....~~.,.r.. ........ b. .......... t.~..'.....~.:~~.....~.~..C ........ ~.~...~.......-f~ ..... £~./~.~. ...... /.~...~ ........ ~....~....~ ....... ~/./.~.,.~......~...~ .... · i ......... ;x~..?~ ~/~;~"~ ....~.~ X~a( ............ at prem,ses ocated at ....................... ~..~..~.. ........................................................... : ...................... .............................................. .~: ........... /77./..~.... ....... ~, ....... ././...w.~..4. .......................... .............................................. · ........................................................................... -- Co..tv To~ Mop No. ~000 Sect~o. ...... /.~.7.. ....... BIo~ ...... ~../. ......... Lot No ........ ~ .......... pursuant to application dated ................... ~.~...~... ....................... , 19..~...'~., and approved by the Building Inspector. Building In.~tor Rev. 6130/80 TOW~ 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 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. B. 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. -. Fees I. 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 - $i0.00 4.Updated Certificate of Occupancy - $50.00 5.Temporary Certificate of Occupancy - Residential $15.00, Commercial $15.00 Date ............ ew Construction.~.¢~.. Old Or Pre-existing Building ................. ocation of Property.~.Q ....... Nouse No. Street Hamlet ............. )wer or Owners of Property.~=~. ~unty Tax Map No i000, Section..~f~. ....... Block ..... ~ .......... Lot..~.~. ....... :bdivision .................................. Filed Map ................... ' ' Lot alth Dept. Approval .......................... Underwriters Approval ......................... arming Board Approval ..................... q~cst for: Temporary Certificate ........... Final Certicate.. ~ Ssbmitted: $ THE NEW YORK BOARD OF FIRE UNDERWRITERS ~ ~ ~(~' BUREAU OF ELECTRICITY ~ BS JOHN STREET, NEW YORK, NEW YORK 10038 in thefollowlngh,catlon; ~ Basement ~ Ist Fl. ~ 2nd FL OtlT ~ctlonI~7 ~. Lo, 2~ FIXTURE SWITCHES OUT'TS ORYERS FIXTURES RANGES OVENS DISH WASHERS EXHAUST FANS NCANDE$CENT FLUORESCENT OTHER SYSTEMS NO. OF FEET E R V I C NO OF CC COND. A W, G, HO OF Hi-LEG A.W. G PER ~' O; CC. COND OF Hi-LEG OTHER APPARATUS: *(SWD[f~ING POOL) YhJl~ certificate made by a qualifieg BO~ 207 E FNO OF NEUTRALS GENERAL MANAGER This certificate must not be attered 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. 765-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLBG. [ .]FOUNDATION 2ND [ ] INSULATION [ ] FRAMING // ,~A~L 765-1802 BUILDING DEPT. INSPECTION [ .] FOU~ATION~ 1ST [ ] ROUGH PLBG. [/~J,~OUNDATION ZND [ ] INSULATION FRAMING [ ] FINAL FOUNDA'TION (lst) FOUNDATION 2. (2nd) ROUGH FRAME & -PLUMBING II~SULATION PER N. STATE ENERGY CODE FI:IAL ~DDITIONAL COMMENTS: FORM NO, 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT · TOWN HALL SOUTHOLD, N.Y. 11971 TEL.: 765-1803 ............................... ., ~ildi~g Inspector) APPLICATION FOR BUILDING PERMIT BOARD OF HEALTII IIECK .............. SEPTIC FOR~! .............. q~ ...~.7~r..~.~-.q.-/~... HAIL TO: Date ................... 19... · J INSTRUCTIONS a. Tkis application must be completely filled in by typewriter orin 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 3r ~reas, and giving a detailed description of layout of property must be drawn'on the diagram which is part of this appli- :gtion. ¢. The work covered by this application may not be commenced before issuance if Bui/ding Permit· d. Upon approval of this application, the Building Inspector will issued a Building Permit to the applicant. Such permit ;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 ,hall 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 ~uilding Zone Ordinance of the Town of Southold, Suffolk County, New York, and other applicable Laws, Ordinances or ~.egulations, for the construction of buildings, additions or alterations, or for removal or demolition, as herein described·' ?he applicant agrees to comply with ail appl/cable laws, ordinances, building code, housing code, and regulations, and to .dmit authorized inspectors on premises and in building for necessary j, nspections., ,.,~ ~. ( '? 't~re ;f'applicant, ~m'e] ]~ ~ ~;;3;;a'ti'o'n') .... (M~ailing address of applicant) fi,/. ~tate whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, pl9mber or builder. ..... ¢..;~.~ .~.., ................... ~'ame of owner of premises . .¢ ~,5 .. ~O · · · ~ ..... ¢,~,. et~ ...... N0~[[[~ ...... · , (as on the tax roll or latest ~k ~/~'~/?'~'B.P. # fapplicant is a corporation, signature of duly auth..orized officer. FEE: ~/0~'~'~,, , BY:-,''fi' ......................... f ' ' OR NOTIFY BUILDING DEPARTMENT AT · (Name aud tit'o of co ;o;a ; ,.-.BO, S A., .0.. P,, ,0. T.E Bui,der's License No ............ USE.[$.UF b WFUL ' ' CERTIFICATE Electric, Jan's License No. ~'.i~ f~'~ ~'~'D~j~'~c~V ....... &'~:. ~O ~ Other Trade's License No ........ FOLLOWING INSPECTIONS: 1, FOUNDATION - TWO REQUIRED FOR POURED CONCRETE 2. ROUGH - FRAMING & PLUMBING 3. INSULATION 4· FINAL CONSTRUCTION MUST BE COMPLETE FORC.O. ALL CONSTRUCTION SHALL MEET THE REQUIREMENTS OF THE N.Y. STATE CONSTRUCTION & ENERGY Location,of land on which proposed work will be'done. CODES. NOT RESPONSIBLE FOR ..................... b~§i~ ~FI House Number Street Hamlet County Tax MapNo. lOOOSection ../OX ........... Block .... Z ............. Lot...~ ......... Subdivision ..................................... Filed Map No. L (Name) .............. ot ............... State existing use and occupancy of premises and inlended Use an~ occupancy of proposed construction: ~. E~,,~,~ an~ o~,,~,~..&.'~... $~ ............................. ,. . b. Intended use and occupancy ~' ~ ~: *Z, -~ :~ ' ':J~ ' ' ' ;' ........ 3. Nature of work (cheek which ~pplicable): New Building .......... Addition .......... Alteration ......... Repair .............. Removal .............. Demolition .............. Other Work. lA }. , '" /asa/. ~',s~ (Description). 4 Estimated Cost /~ ~.~. r~ ~ ' Fee ~ (to be paid on filing this application) 5. Ifdweliing, number ol'dwellin units · If garage, number of cars . '.' ............. Number of dwelling units on each floor ................ 6 If business commercial or mix~d specifynat~re'a'ndJxt'e~'ofeachty;~'of't~s'e'iii~i~ · " occupancy ............ 7 Dimensions of existing structuOs if any: Fr{;nt Height Numl~er of Stories ............................. Depth ............... . Rear Dimensions 7f same structure ?th alterations or additions: Front Rear Depth Height ' 't 8 Dimensions of entire new constrUction: ................. RearNUmber of Stories Front ........... " ' Height ' Number of Stones ............... Depth 9. Size of lot: Fr6nt . ,- ....... , .......... Rear... 10. Date of Purchase ~.~..~ ~ .~ ,.o~ -, · .................. .Depth .................... 11. zone or use restrict in w,dcn promises are situated i~..e.r.l, deo 12. Does proposed construction rioi ''' ' ....' .................... ii ........... ate any zoning law, ordinance or regulation...A& ........................ 13. Will lot be regraded ./V~ .... ! .......... : .......... Will excess fill be removed fi:om remises: '~' ' ' Name of Architect i · . .. ...... · ....i ................. Address .......... ' ......... Phone No ................ Name of Contractor ......... ~ ................. Address ............... ;. · · Phone No ................ 15. Is this property within 300 feet of a tidal wetland? *Yes ........ No...~. .... · If yes, Southold Town Trustees Permit may be required. .... PLOT DIAG RAM' Locate clearly and distinctly all buildings, whether existing or proposed, and, indicate all set-back dimensions from property lines. Give street and block mmber or description according to deed, and show street names and indicate whether interior or corner lot. rATE OF N -F_AC~,ORK% ..... . . . · (Name of individual signingi contract) ~' ........ ,ore named. 78~q- being duly sworn, 'deposes and says that he is the applicant i (Coutractor agent corporate .... 'e't~') ............................ , , dm°e/, . i . said owner or owners, and is duly authorized to perform or have performed the said work and to make and file this plication; that all statements contaln{d in this application are true to the best of his knowledge and belief; and that the ~rk will be performed in the manner selt forth in the application filed therewith. 'om to before me this , .......... y ......... · .... o. ~798~. . ~Signature of applicant)