HomeMy WebLinkAbout19916-z FORM N0. 4
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TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Office of the Building Inspector
Town Hall
Southold, N.Y.
CERTIFICATE OF OCCUPANCY
No Z-20242 Date SEPTEMBER 25, 1991
THIS CERTIFIES that the building ACCESSORY
Location of Property 270 BOISSEAU AVENUE SOUTHOLD, N.Y.
House No. Street Hamlet
County Tax Map No. 1000 Section 63 Block 3 Lot 6
Subdivision Filed Map No. Lot No.
conforms substantially to the Application for Building Permit heretofore
filed in this office dated JUNE 4 1991 pursuant to which
Building Permit No. 19916-Z dated JUNE 4 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 INGROUND SWIMMING POOL FENCE & DECKING AS APPLIED FOR.
The certificate is issued to CARLISLE E. & JEAN W. COCHRAN
(owners)
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A
UNDERWRITERS CERTIFICATE NO. N-198680 - AUGUST 2 1991
PLUMBERS CERTIFICATION DATED N A
~
B i ing Inspector
Rev. 1/81
I
roast xa •
TOWN OP SOUTHOLD
BUILDING DEPARTMENT
TOWN HALL
SOUTHOLD, N. Y.
BUILDING PERMIT
(THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL
COMPLETION OF THE WORK AUTHORIZED)
N~ 19 91 ~ Z Dare .........`.f:............., 19.`1::.(
Permission is hereby granted to:
pJ ~ :R .
of premises I«ated at ....~.J..G?....1 .
County Tax Mop No. 1000 Section ...o~~:......... BI«k ....Q.~........ Lot No...~...`.P
pursuant to appiicotion dated .....~.4r:M~..~ 19.x.)..., and approved by the
Building Inspector.
Fee Sc~:~.....
Bu ing Inspector
Rev. 6/30/80
Form No. 6
J .
. TOWN OF SOUT110LD
BUILDING DEPARTMENT
TOWN HALL
765-1802
APPLICATION FOR CERTII'ICATE 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 17 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.
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
S. Temporary Certificate of Occupancy - Residential $15.00, Commercial $15.00
Date
New Construction........... Old Or Pre-existingpB,u~i~lding..
Location of Property..~?~......~~L~ra:~'SdcA,..`.lV~.~v1tiA........ SOU~:R9~\...N.~..........
House No. Street Hamlet
Onwer or Owners of Property.... h Q C,, ;P;C;~,,,,,,,,,,
County Tax Map No 1000, Section ..............Block................Lot......................
Subdivision ....................................Filed Map ............Lot..........
Permit No. .I. ~~,9~ jo.~-....,Date Of Permit ................Applicant.. ~ri~Y'.~. ~
kiealth-Dept. Approval ..........................Underwriters Approval.........................
Llanning Board Approval
Request for: Temporary Certificate........... Final Certicate...g.~,......
Fee Submitted: QLS,,,,,,,,,,,,,,,,,,,,
Q ~~t.~2 APPLICANT
'f"H~ ME'W YORK BC#;R~~ Qf R tE vA+,r; 1
1.0?.5023 ' ~
StMRtAU OF BLEGTMNG/7'Y m
N4 JOltl't STRSlT. 1r~W YORK, tr~lYY YbRK tOO:ls
0.G AUGUST 02,199.1 ,lpptleetton No. on file 7 1890491/91 N 1.986x0
THIS Gt#tftlgl3s TF6lT
' MI1' ttN e6ete/ed egtn M tleoetNeoJ tNN~ew aewl intreeAwed Ay LFe epptteent Mes1~ M tAe ebwe ~ elew~eetll tb tNe~~e of
gCHRAN, E/S 270 BOIS5EAU AVr:Nt(r;, SOUTHO[,D, N.Y.
Ll tksfeSswinR tocettow ~e meat ? tee Fl. ? Ywd Ft. f)(iT - Sertton 1Mek Lot
wee etantMedun JI11'~ 1.991. .naDfoena to be in eoelptunre Kith. eke.eysircmenie of t~.lle..d.
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SPINNING POOL-1
RF:GF;F1'ACLES-1.IG.Y,C_I.-7-2 -
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HANK'S FLr1C'1'RIC I, IX:. X2675 ~ `
t21 SHF.F.F PASTURE RD A~%
SFtiTAUKF,T, NY, 7.1.733 t~MNNM
1 ) 11~,.
Per ~
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!INSPECTORS
Victor Lessard g~FFO(,(-
Principal Building Inspector OHO CGG
Curtis Horton o0 y~ SCOTT L. HARRIS, Supervisor
Senior Building Inspector y x Southold Town Hall
W ~
Thomas Fisher P.O. Box 1179, 53095 Main Road
Building Inspector O • ~
y O! Southold, New York 11971
Building Inspector ~ ~'a Fax (516) 765-1823
Vincent R. Wieczorek Telephone (516) 765-1800
Ordinance Inspector
Robert Fisher
Assistant Fire Inspectrn OFFICE OF BUILDING INSPECTOR
Telephone (516) 765-1802 TOWN OF SOUTHOLD
September 6, 1991
Carlis~ & Jean Cochran
270 Boisseau Avenue
Southold, N.Y. 11971
To Whom This May Concern:
We are unable to complete your Certificate of Occupancy
because of the following reasons:
XX An application for Certificate of Occupancy is
not on file. (Enclosed)
XX No Underwriters Certificate on file.
XX The check is (not on file) $25.00
No Health Department Approval on file.
No final inspection has been made.
No Plumber Solder Certificate on file.
(All permits involving plumbing being
issued after April 1, 1984).
BUILDING PERMIT # 19916-Z
Please contact our office on this matter. Thank you for
cooperation.
SOUTHOLD TOWN BUILDING DEPT.
r1EwD II:S:~?CiIU;) II~h+~ I i;OMMEN7°
i
1~: ~.9
_ _ H '6"
FOUIJDATION (1st)
c 5
FOUNDATIOIJ (2nd) _
m
2.
z
oN
P,OUGH FRAME $ v
0
PLUMBING
b
3. y
IIJSULATION PER N. Y. m
. y
STATE ENERGY
CODE
x
a
4 . 9 I ~
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G
FZiJAL _
z
ADDITIOPJAL COMMENTS: ~
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BOAKD OF HEALTH
3 SETS OF PLANS
FORM N0. 1 SURVEY .
TOWN OFSOUTHOLD CHECK
BUILDING DEPARTMENT SEPTIC FORM
TOWN HALL NOTIFY
SOUTHOLD, N.Y. 11971 CALL
TEL.: 765.1802 MAIL T0:
Examined . 19~
Approved AF!r1a...T..., 19q~ .Permit No. ~ ~~.L~.~2.•. ~q yry^ ,~-I._, .yyry
Disapproved a/c f ! I.,,~, .,rz? t,;~',.~ . `-`j I
6t ' i' ,
~ ,r ,Alhl•4t99( '
. , ~
(Building Inspector) TC+Is!'d ;
~^;x
APPLICATION FOR BUILDING PERMIT /
Date 199.
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 street:
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 permi°
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 Occupanc}
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 o:
Regulations, for the construction of buildings, additions or alterations, or for removal or demeli±ior., as herein described
The applicant °agke~~.'~d'epr~iy with ail applicable laws, ordinances, building code, housing code, and regulations, and tc
admit autJtiorjzed inspeC~gi5.,4,cjpremises and in building for necessary ins tions. \/lam
_ ! . (Sign ture of applicant, or name, if a corporation)
:.a , iii ....0?`10. ~O~.S;~.u...V!~!.e:...~,,o. y`~~o.~.~.,,1J~
(Mailing address of applicant)
State whether applicant is- owner, lessee, agent, azchitect, engineer, general contractor, electrician, plumber or builder.
~,~h.~ ~.r
Name of owner of remises ~ ~
(as on the tax roll or latest deed)
If applicant is a corporation, signature of duly authorized officer.
(Name and title of corporate officer)
ALL CONTRACTOR'S MUST BE SUFFOLK COUNTY LICENSED
. Builder's License No. ........10.4
Plumbet's License No, l1~ .}.p......... .
/ Electrician's License No. ,et(P.n..~ E..... .
Ot ense No. ~ ~ , .
1. Location o a which proposed work will be done . . . . .
House Number Street H let /r__
County Tax Map No. 1000 Section ~3....... Block ~ Lot ...W .
Subdivision Filed Map No. Lot...............
(Name)
2. State existing use and occupancy of premises and intended use,and occupancy of,proposed construction:
a. Existing use and occupancy , :e ....~.m.l. r'?S.l. ~-2 iZ C ~ .
b. Intended use and occupancy ~ ~ r ~.~'n ~ ....[~4 d. ~ : , , . , U~?,(~?-~.Y,'; , ~;i2 c, ~G..-... .
~ o u1~21" c~ .e c IG , y ~ ~-,p' vlc~ ~o Co r~-2 4
f
3. Nature of work (check which applicable): New Building . , . , , Addition , Alteration .
Repair Removal ; . , Demolition ......Other Work .1BX,~(a. ,Ifl .
~raund Sairmrn~n Descriplion)
4. Estimated Cost . Fee ld)c~dc~..~l:S -,~(!;{;Ptk
` (to be paid on filing this application)
5. If dwelling, number of dwelling t+nits . . Number of dwelling units on each floor .
If garage, number of cars .....r
6. If business, commercial or mixed) occupancy, specify nature and extent of each type of use .
7. Dimensions of existing structure, if any: Front . . .....Rear . , , Depth , , , .
Height Number of Stories , . .
Dimensions'of same structure with alterations or additions: Front Rear .
Depth . .Height , . , . Number of Stories , , .
8. Dimensions of entire new construction: Front . . . . . Rear , ............Depth , , .
Height ...............NumperofStories.........,,........,,......
9. Size of lot: Front Rear Depth
]0. Date of Purchase , b . . . .Name of Former Owner .
11. 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 ....................Will excess fill be removed from premises: Yes No
14. Name of Owner of premises . . . . . .....Address , , ...Phone No, , , , . .
Name of Architect , ' ...............Address ~ ...Phone No....... , .
Name of Contractor , j . .Address , ..Phone No... , , .
, . .
15. Is this property located within 300 feet of a tyyiuudal wetlandY *Yes No
*If yes, Southold Town Tru'atees PermitPLO~ DIAGKAMed.
Locate clearly and distinctly all ~ buildings, whether existing or'proposed, and, indicate all setback dimensions from
property lines. Give street and block ~tumber or description according to deed, and show street names and indicate whether
interior or corner lot. O'~~
M cdch ran !s
!I ~i~~~u.- Sk2fcti q-ffaelte~.
I f ~ 3(0
~i ~ro~ X01 ,
OCCUPANCY OR
USE IS UNLAWFUL
WITHOUT CERTIFICATE
~ ~xx ~z~'` x ~
}loose. OF OCCUPANCY
o -
i ~ ~.ar APP 011r;D A5 NQTED
A ~ ~ DATE: (o ~ R.P N / 9 /
s ~ 30, Y' .L.
NC771FY BL.IIL.DINC; 04rPARTMENT AT
~e~ i ~ 7G6-1$02 ~J AN; 'ffa Pry FOR THE
~ ~ FOLLOWING INsi'Ff;l IONS.
t. FCx1NDATION rwo REC2UIRED
FOR POURED CONCRETE
2. ROUGH • FRAMING tk PLUMBING
0 3, INSULATION
4•. FINAL - CONSTRUCTION MUST
~0 / S S PR C(,, BE COMPLETE FOR C.O.
ALL CONSTRUCTION SHALL MEET
THE REQUIREMENTS OF THE N.Y.
STATE OF NEW YORK, STATE CONSTRUCTION & ENERGY
~ COUNTY OF ~ S'S CODES. Nt7T RESPON5tBLE FOR
• ~ ~ g y SIC~1~~~1 CON~TRtl~CT10NhERRORS
. , , bein dui sworn d~~bse says a e is t e appltcan4
(Na of individual si ring contract) '
above named. i ~
He is the ................C~CA.)fl.-Q.ll-..
(Contractor, agent, corporate officer, etc.)`
of said owner or owners, and is duly authorized to perform or have performed the said work and to make and Ella this
application; that all statements contained in this application are true to the best of his knowledge and belief; and that the
work will be performed in the mann~r set forth in the application filed therewith.
Swom to before me this
, , . , .....day o~f .l•~(1:~ 19q.
A'otary Public, . , , , County
NORF.EN L. HAGER ~ ~
" , , l Notary raubhc, State of New York V . , (-l~
' ' w"""--, Na 67.'•4826A33.... , i ~ , . .
Quahtiad ui Suffolk Coun ~.l (Signature of applicant)
. Commiss;on Expires ~ I~~~
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