HomeMy WebLinkAbout19719-z FORM NO, 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Office of the Building Inspector
Town Hall
Southold, N.Y.
CERTIFICATE OF OCCUPANCY
No Z-20110 Date JULY 25i 1991
THIS CERTIFIES that the building ADDLTIONS
Location of Property 1459 GOOSE CREEK LANE SOUTHOLD N.Y.
House No. Street Hamlet
County Tax Map No. 1000 Section 77 Block 3 Lot 17
Subdivision Filed Map No. Lot No.
conforms substantially to the Application for Building Permit heretofore
filed in this office dated MARCH 18, 1991 pursuant to which
Building Permit No. 19719-Z dated MARCH 15 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 & DECK ADDITION TO AN EXISTING
ONE FAMILY DWELLING AS APPLIED FOR.
The certificate is issued to EDWARD R. & EILEEN E. DEUTSCH
(owners)
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A
UNDERWRITERS CERTIFICATE NO. N-196228 - JULY 15 1991
PLUMBERS CERTIFICATION DATED N/A
~i I
Building Inspector
Rev. 1/81
f'Of:IL N0. f
TOWN OF SOUTHOLD
6UILDING DEPARTMENT
TOWN HALL
SOUTHOLD, N. Y.
BUILDING PERMIT
(THlS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL
COMPLETION OF THE WORK AUTHORIZED)
N _ Z Date
19 719 ~........l..S 19..4..1.
Permission is hereby grontad to: ,
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sro~ ...`.:.°.`.^:tii:!n:!4:S~..skm.....A!!;.~,~;edQn;~'\,..~'~!~~.~.~.P+..k.C.S.....`~'^~~....`.t°..~..Qe4l~M
.1..?....~?;::1... ~~//~:!4,.~.....a!^^^^xS!.i...!.(.~~5.2.49... ..:~°..J4~..~.A"~'y~' /B9~SL~
at premises located at ~..`.t..~
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County Tox Mop No. 1000 Section~,.~../.~.Q~11~.]...... Block .....Q.x~,....... Lot No...~...1
pursuant to appNcatlon doted ......1./..1.k4:kS:r.:'~....~g 199...., and approved by the
Building InspecTOr. \1
3a'].
Fee j
Ildinp inspector
Rev. 6/30/80
Form iJO. G
TOWN OF SOUTIIOLD
BUILDI2IC DEPARTPIGNT '
TO[JN kL'1LL
,U~1 2 8 1991 765-1802
PLICATION FOR CERTIFICATE OP OCCUP:\NCY '
This application must be filled in by typewriter OP, ink and submi[ted 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 insCallation from Board of Firc Underwriters.
4. Sworn statement from plumber certifying that the solder used in system contains
less than 2/10 of 17 lead.
S. Commercial building, industrial building, multiple residences and similar buildings
and installations, a certificate of Code C~~npliance from archi~:zct 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 an~i 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.
r
Fees
. 1. Certificate of Occupancy - New dwelling j25.00, :\dditions to d~+elling $25.00,
Alterations to dwelling $25.00, Swimming pool $25.00, <\ccessorc 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 $15.00, Commercial >15.00
ew Construc[ion......``,,...qq.. Old((,,~!`~QQr Pre-eri~Cing uilding.....`~l....... J
ocation of Property.l.l5.1.....4_?CGSC .~rc.~"~. ~CN,~:;~SP,-...........
House No, Street Hanff ~t
~ '
~twer or Owners of Property. ~W.0.'~'~ `.,~~~5 C~\
,unCy Tax Pfap No 1000, Section.... ~.......B1UCk.... 3..........Lct..l.~,'':~
:bdivision Filed P1:~I~............Lot.........
• ~ ~O ~ ~l CI. I.....Applicant~~G~c.IScO ~~f~ c•.
•rmit No .............Datz Of Pcrmi.t....r.
alth Dept. Approval ..........................Underwriters Approval.........................
ginning Board Approval
nucst for: Temporary Certificate........... F('ial Curticate.,.
Submitted: / .
flt,f.i,~ } S
- I~~V~LICANT
eo~d~lio ~
THE NEW YORK BOARD OF FIRE UNDERWRITERS SAC:~~ l
1195:155 BUREAU OF ELECTRICITY
85 JOHN STREET, NEW YORK, NEW YORK 10038
Date JULY ?.5,1991 AppliratianNu.onfile 7337.8'797./97 'i9N22k
THIS CERTIFIES THAT
only the electrical equipment os described below and introduced 6y the applicant named an the above application number in the premises of
~iR.SCIOTTA, GOOSE CREEK LANE, SOIi?'HOLD, N.],
in thefolfowinq [ocation> ? Basement ? lsl F!. ? 2nd Fl. OIPi Section Block Lot
was examined on JUNE 03 , 1991 and found to be in cuneplimu•e a•i Nr [hr regairrrrtenL<qf this Board.
FlKTURE FIXTURES RANGES COOKING DECKS OVENS DISH WASHERS EXHAUST FANS
OUTLETS ECEPTACLE$ SWRCHE$ INCANDESCENT ftUORESCENi OTHEn PMi K W. AMi K W qMi KW AMi K W AMT. M P.
1 1
DRYERS FURNACE MOTORS FUTURE APPl1ANCE FEEDERS SPECIAL REC'PT TIME CLOCKS gELI UNIT HEATERS MULTI-OUTLET DIMMERS
AMi K W OIL H. P. GAS H P. AMT. NO. A W. G AMT. AMP. AMT AMPS TRANS, qMi. H. p SYSTEMS AMT. WAiiS
NO. OF FEET
1
SERVICE DISCONNECT NO.OF $ E R V I C E
AMT, AMP TYPE METER I PW i ~ ~W 3 ~ DW 3 dW NO OF CC COND A W G NO Of MI-lEG A W C'' NO OF NEUiRA15 A W G
EQUIP. PER % Of CC COND Of HI-LEG OF NEUTRAL
OTHER APPARATUS:
SWII4MIP7G PpOL-1
PANELBOARDS;1-4 CIR. 100
S. SANTO LIC,#10%7 ~i~%~~
16 :;ICHA L PLACE
NESCONSET, NY, 1176% GENERAL MANAGER
J1.
Per '
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.
c1ELD II:SPc.C71UIJ ~~ll6:n ~ COMMENT°
i _ ~ ~
1 . E• v
H ~
_ _ H 4O
FOUIJDAT20N , (1st) R
FOUNDATIOJJ ( 2nd ) _ _
2.
o ~
•
P,OUGH FRAME & •+C
-PLUMBING
N
H
3. ~
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IIJSULATIOII PER N. Y. • •
STATE ENERGY ~ Pic
CODE
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ADDITIOPJAL COMMENTS: ~
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~ ~ ~ BOAFD OF HEALTH
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1~~`-_~n,,~,,I-1_Wr FORM NO. 1 3 SETS OF PLdNS.... • • • • • . .
TOWN OFSOUTHOLD SURVEY
H ~99~ BUILDING DEPARTMENT CHECE
: . . . .
3 TOWN HALL SEPTIC r• aRrl _ , ,
L.
.'r fi SOUTHOLD, N.Y. 11971
BL6~~~ril-.~~7..~ ~
TOVVf~ta€~rc~!a'o~a~~s; TEL.: 765-1802 r:aTIFY~'r, ~-~C"~ °
1,~,~ ,,.~.,......._...,...,.ub CALL Zf; ,S, : ~i ;1 ;1 Co .
Examined .I/J.?~~. ,'I ,g..., 199 I . MA I TO
A raved / 0.~..~ g 9~!°~~ •~d.~JC~(..~?°'1J
pp , 19~ ~ .Permit No. }
,..)s9N~~c.~d,~yw-y; f1,~1,7r'
Disapproved a/c 7
(Building Inspector)
APPLICATION FOR BUILDING PERI411T
Date I~/.`l= ~~6......, 19~
! " INSTRUCTIONS
,1 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-
bation.
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 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 alteratio , or for removal or demolition, as herein described.
The applicant agrees to comply with all applicable laws, ordinances uilding code, housing code, nd regulations, and to
admit authorized inspectors on premises and in building for necessa i spections. _
:~~.-:~,C.......~
( ~nature~f-dpplicant, or}~ame, if corporation
O. ~ 119 7t
I......
(Mailing address of applicant)
State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder.
Name of owner of premises Gv' ~ Je-`1`~'c-l/~.
(as on the tax roll or latest deed)
Kapp 'cant is a orporation, ignat e of duly authorized officer.
(Name and ti~. rpora icer)_
Builder's License No.~ . . .
Plumber's License No . .
Electrician's License No . .
Other Trade's License No . .
f. Location of land on which propose work will be one. . .
11 .
..).`'151:... ~~c~sc......~:~~-~~.....°:.,... ~cv~~~,o~~...~...r...11.57.1
House Number Street Hamlet
County Tax Map No. 1000 Section ~ .7 Block Lot 7 .
Subdivision Filed Map No. Lot , .
(Name)
State existing use and occupancy o(f~pr~emises and inte ded use and occupancy of proposed construction:
a. Existing use and occupancy ~4~?~.~.,~~.... ~~'."'.H-:~~, ),N,~, , " , , , ,
b. Intended use and occupancy-~:~~~??~:~~..SW~~"i"'`~'ti~,(~~~~,~ ~C~ ~ o~~c'e~~~lV1~~}~H?A~~
,
m
C Y^ e 4h
. .e.~. , v >~Cx . _6 ai ~J -,aan ri.~i'sT.Fd~~S.v,?~av«x4~s3-,va3~~is'3es~i?~ _
( PPII
3. Retu~re of work check which a icable): New Building Addition Alte ion .
~1 ~
p Remov .Other W
C) u I Demolition or~w\w~~•y~'~ n, o u
1 ~ ,(Deslriptl3n~
4. Estimated Cost~~.).~.d....'
. Fee . ,
(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 .
g ,
if any: Front ...............Rear Depth...............
•S Numb
7 Dimensions of samel tructureuwitljr of Stories . , . , , , , , , , , ,
alterations or additions: Front . Rear .
Depth ~ Height ......................Number of Stories .
g tion: Front...,........... Rear............... Depth
pr of Stories
Heiuhtslons o entire ne acoOu be Rear `.CSC?............ Depth ...3?. Q .
9. Size of lot: Front .
10. Date of Purchase . . . . . . . ..pT~me of Former Owner
11. Zone or use distract in which premises are situated s . . . .
12. Does proposed construction violat~ any zoning law, ordinance or regulation: .
.......................i.
13. Will lot be regraded ~ , .i ` Will excess fill~2e remove} fr premises: Yes
14. Name of Owner of premises~4-W~;~•t•. , ~ti'~SC~; Address .1 ~.'.1~~i, S~9~sc: , `hone No. •7Ca.~: . ~
Name of Architect ............................Address ....Phone No. ~
ame of Contractor .
15. Is this property within 30 " " '••Address ...................Phone No. t
Q feet of a tidal wetland? *yes........ No..•.
*If yes, Southold Town Trustees Permit may be required.
PLOT DIAGRAM
Locate clearly and distinctly all b~lildings, whether existing or proposed, and. indicate all set-back dimensions from
property lines. Give street and block nu~rlber or description according to deed, and show street names and indicate whether
interior or corner lot.
~I
II ~ •
I
STATE OF NEW YORK, S.S'
:OUNTY OF .
' • • • • • • • g g+ • • • • • • • • • • • being duly sworn, deposes and says that he is the applicant
(Name of individual si rain ''contract)
bove named. I
le is the .
(Contractor, agent, corporate officer, etc.) • • • • • • ~ • •
f said owner or owners, and is duly authorized to perform or have performed the said work and to make and file this
pplication; that all statements contained in this application are true to the best of his knowledge and belief; and that the
cork will be performed in the manner set forth in the application filed therewith.
worn to before me this
......dayof.. ~.~'L...... 1 1. -
fotary Public, . ~'~:KQ-w . ,~J:. , ,n!~, , , , , . Count ~
- HELf:N-K.OEVOE r ~ ~
NOTARYPUetIC3tateofNew~'ork ~ , r a.,Fp~
No A7018>S SuffolkCaun
7srm E7:pires Mar¢h 30, LS~` i (Signature Of a~pllCant) ~
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AFFRf3VEIJ A,^a NOTED
DATE, 14 -8.P H ~ 9
FEE.~a?stia _ev _ ~ °PPRDVED AS NDTED
NOTIFY SL1ILOINC DEPAAT4NEI+T r+l -
765-1802 9 AM TO q FJ!°~ FOR l'HE _9'RS
FOLLOWING INbFEf,.TICi^I4 ~L F; _gY;
~ I FOR POUREO CONC ETE clll null QCC+ AN1c.AWf w! DEPARTMENT A7
4 PM FOR THE
2. ROUGH - FRAMING R PLIJM8ING u$E $PON t1E~ AtE F:. -'NS: -
c
" 4. FINAL AT'O CONSTRUCTION MU57 ~ W1tH~U
C
uPANCV ` - 7 "1 REQUIRED , ~
gE COMPLETE FOR C.O QF O ~ p i; ' IMBING '
ALL CONSTRUCTION SHALL MEET ~ t - y0''
4 FI: 'MIST
THE REQUIREMENTS OF THE N.Y. 3 ita
STATE CONSTRUCTION & ENERGY ~ RE ,
- CODES. NOT RESPONSIBLE FOR ALL C'OI~„~ T ~ ~ '
DESIGN OR CONSTRUCTION ERRORS THE REOUIRFnm -
A "
STATE CONSTHUC7i~~
COOES. NOT RESP:~r~
DESIGN OR CONSTRUCTIOi.~ ~
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