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Home My WebLink About20004-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No Z-20076 Date JULY 15~ 1991 THIS CERTIFIES that the building Location of Property 500 SUNNYSIDE ROAD House No. County Tax Map No. 1000 Section 63 Subdivision ACCESSORY Street Block 01 Filed Map No. SOUTHOLD~ N.Y. ~ Hamlet Lot 3.2 Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated JULY 2, 1991 pursuant to which Building Permit No. 20004-Z dated J-0LY 9, 1991 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 N/A UNDERWRITERS CERTIFICATE NO. PLUMBERS CERTIFICATION DATED COLEEN GRATTAN-ARNOFF N-699484 - JULY 11~ 1985 Building Inspector Rev. 1/81 · 0~ NO. ~ TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N. ¥. BUILDING PERMIT (THIS PEPu~AIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) Ne 20004 Z Permission is hereby granted to: ...~. ....... ~.,~,..~ ................. ..~~...~.:~.:....,..,..~..~..~ ........... ~ ,o....~~.........~.....~ ........ ~...~ ......... ;.~..~ ........................... -"V'~" ...... P" ........................... <S" ........ ;"-;." ....... _""; ......... q-~"'"~-;;";'"' ............. at premises located at .....~..~...~.........~.~..,..~ ......... ~~.... ...... County Tax Map No. 1000 Section ..... .(~..~....~ .... Block .......~.} .......... Lot No....~..:...~... ......... pursuant to application dated ....... ...~...~.....~. ...................... , 19.~..'.., and approved by the // Building Inspector. Rev. 6/30/80 Form No. 6 TOWN OF SOUTIIOLD BUILDING DEPARTMENT TOWN I~LL 765-1802 APPLICATION FOR CERTIFICATE OFi?CCUPANCY 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 locution of all buildings, property lines. streets, and Unusual natural or topOgraphic featuros. 2. Final Approval from Health Dept. of Water supply and sewerage-disposal(S_9 form). 3. Approval of electrical instal,lation 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 C~pliance from archiuect 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: i. 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 Euild~ng - $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 Date .......... ew Construction. ~ , ' '~ ............................. House No. Street ............................ ,un~y Ta~ Map No 1000, Section ..... .~.~.B...Block ...... o.J ....... Lot ..... ~.,.~.. ........... bdivision .......................... Filed .......... Map ............ Lot .................. rmit No , ........ Date Of Permit ........... Applicant ........................... ulth Dept Approval ' ............ ~ ...... Underwriters Approval ~nning Board Approval ;ues~ for: Temporary Certificate ........... ~ Fi~al Corticate .......... ~ Submitted: $ ........................... FOUNDATION ~ . (ls.t) COM~gNT~ FOUNDATION (2nd) 2. ROUGH FRAME & .PLUMBING INSULATION PER N. Y. STATE ENERGY CODE FINAL ADDITIONA'5 COMMENTS.. lOc . /c'/d-Z D A/OW o/? FOA'MERL Y £O/YICA Y BROS. NO~)FV ~)LDI~G OEPART~qNT AT T~ -- ,, 2. RO' GH~FRAMING & PLUM~ING The sev.,a~e disposal aod ~ac~lltie~ for t~!s ]on2t~.on have bee~. FIN ~L - CONSTRUCTION~UST inspected by t,h~.s d~p~t~ent a;~dIou~ ~ B~$MPLETE FO~ C.Q ~' ~'~'~ ~' ~E'REQUIREMENTS OF THE N.~ CbOe% o% ~one~aL ~n~nee~n~TATE CONSTRUCTION & ENERGY Services CODES. N~ RESPONSIBLE FOR ', DESIGN OR CONSTRUCTION ERRORS rile OFFSetS (OR Df'/eN$!C:ISI OUARANTEES mmc~T[~ hL:,C,a JOE5 NO. 78',¢80 FILE NO. $03F FROM SKY ELECTRIC D-RP. THE NEW YORK BOARD OF FIRE UNDERWRITERS r BUREAU OF ELECTRICITY , ( e~ JO~N sZ~T. N~w yo~, N~W YO~ ~ooae ,,. IllX fU!~E DRY'ERS '.i +', ',i O?fllR A~PA~AIU~I AND/OR RE~AIR MADE 00~ OOMPLIANCE A~ TH~ DATE OF INSP~ION ~LI~!~ P~RSON, Sky Electric Corp ~ Rt 104/Lewie ad. ; "' ' ', i.:.~.~,.,,..~..:, E. Qtx~o, N Y 11942 Lie 893 E FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT ' TOWN HALL SOUTHOLD, N.Y. 11971 TEL.: 765-1802 Examined .... .~... ~..c~., 19~..~. Approved . .'~4J. ~., 19 .~). Permit No. ' Disapproved a/c ..................................... - . ........ (Building Inspector) APPLICATION FOR BUILDING PERMIT gOARD OF 'HEALTH ......... 3 SETS OF PLANS .......... SURVEY ................... CIIECK .................... SEPTIC PORH .............. NOTI PY ~ CALL ................... HAIL TO: Date ......... ~ ......... , 19... INSTRUCTIONS a. This 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 cbmmenced 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 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 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 regulations, and to admit authorized inspectors on premises and in building for necessary inspections.,, -- (Signature of applicant, or name, 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 ...... & .~.~..~..~f~z.. ..... .~...,~...'?.~...~'.f~.~ .,~../'.,~.~%~.. ............................ (as on the t,a~x 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 ...................... 1. Location of land on which proposed work will be done .................................................. .......... .......... House NumBer Street Hamlet County Tax Map No. 1000 Section ......... 9. i~..~.... Block ........ ~ ) ....... Lot .... .~. :.~..- ......... Subdivision ..................................... Filed Map No ............... Lot ............... (Name) State existing use and occupancy of premises and intended use and occup~,ncy of proposed construction: a Existing use and occupancy ..... . .~..~.....~..~..~.~..'./~....~....?'?~.- .4~..~, .... ~ ...................... b Intended use and · occupancy ....................................... Y4~ ~ ~;i~ ,t~,~ .................... Locate clearly and distinctly all property lines. Give street and block interior or corner lot. 3. Nature of work (check which ' ' ap.phcable): New Building .......... Addition .......... Alterati.o.n ...... i.~/' Repair ..............Rem6val .... Demolition Other Work..ff4a../..~. ~..~t.. · ---- I ........................ /-~ ~- ' ' (Descrii~tion) 4. Estimated Cost..~.~X .°..t~....[ ......................... Fee ...................................... ! (to be paid on filing this application) 5. If dwelling, number of dwelling ~nits ............... Number of dwelling units on each floor ................ · If garage, number of cars ..... , ................................................................... 6. If business, commercial or mixe~ occupancy, specify nature and extent of each type of use ..................... 7. Dimensions of existing structures, ifgny: Front ............... Rear ...... .' .' ......Depth ............... Height ............... Number of Stories ..................................... ". .................. Dimensions of same structure wiih alterations or additions: Front ................. Rear .................. Depth .................... i. · Height ...................... Number of Stories ...................... 8. Dimensions of entire new constr~ction: Front ................ Rear ............... Depth ............... Height ............... Number of Stories ......... ] ............ , ................................. 9. Size of lot: Front ........... i ........... Rear ...................... Depth ...................... 10. Date of Purchase ........... i ......... ......... Name of Former Owner ............................. 11. Zone or use district in which premises are situated ..................................................... 12. Does proposed construction viol~te any zoning law, ordinance or regulation: .... , ........................... 13. Will lot be regraded ......... ! ................... Will excess fill be removed from premises:' Yes No 14. Name of Owner of premises ... i ................ Address ................... Phone No ................. Name of Architect .......... ] ................ Address ................... Phone No ................ Name of Contractor ......... ! ................ Address ................... Phone No ................ 15. Is this property within 3'00 feet of a tidal wetland? *Yes ........ No ......... · If yes, Southold Tiown Trustees Permit may be required. PLOT DIAGRAM buildings, whether existing or proposed, and, indicate all set-back dimensions from ~umber or descriptioh according to deed, and show street names and indicate whether STATE OF NEW Y~RJF~,/¢.~ SiS COUNTY .... · ~e_~c~.r-.~.-. ...,-~:. :,..v::. 'i .....: ' '/'~' ........ being duly sworn, deposes and says that he is the applicant (Name of individual signing contrac0 above named. He is the, (Contractor, agent, corporate officer,~ etc ) of said owner or owners, and is duly iauthorized to perform or have performed the said work and to make and file this application; that all statements contairted in this application are true to the best of his knowledge and belief; and that the work will be perfdrmed in the manner get forth in the application filed therewith. Sworn to before me this ....................... day of/.. ......... County~ CO/~A Y FIW'ZDS ~J OCCUPANCY OR USE IS UNLAWFUL WITHOUT CERTIFICATE OF OCCUPANCY ~<~ NO~ Om Fo~m~Y ~ , APPROVED AS NOTE~ NO~IFY ~ILDING DEPART~N~ S~FO~ COUNTY H~TH D~P~T FOLLY( WI~ INSPECT(~S. ......... ~:-- ]L~ IND~ION - T~REO( IHED F 2. RC ~GH~RAMING & PLUA lING The sewage disposal and wgtev sttp~lF 3. {Nf J~N facilities for this ior:n'~3, on have bee~. FINAL CONSTRUCTION ~UST inspected by this department and'~oa~, 8E~MPLETE FOR C.O, ~'" ' ~HE REQUIREMENTS OF THE Chief of General Engfnee~in~TATE CONSTRUCTION & ENERGY Services CODES. N~ RESPONSIBLE FOR DESIGN OR CONSTRU~ION E~RORS ~UARANTEED ONLY TO ~OOT/-/O/.D SAVIAIG$ ~AAIK 7-//E'OZ)OR--c' ~ CO,4/.~EAI ~dRo Y. . o. ROLD F. TRANCHON JR. PENN. LIC. NO. IJOB NO, 78-580 FILE NO. SURVEYED ~OR T'/'/ffODORE 4 CO/ZEE/V SITUATED AT TOWN OF .~OUT/'-/O/..D- ,~UF~O~IK COOIVT~ Al ISCALE 1" = .~0' DATE I/-/..q-/97~ FILED MAP NO. DATE ~OOK NO. ' PAGE HAROLD E TRANCHON JR. P,C. LAND SURVEYOR SUCCESSOR~ TO WILLIAM G. MEIER NORTH COUNTRY ROAD- WADING RIVER NEW YORK 1 1792 (516)(329` 46(35 ALT. 473-3626