HomeMy WebLinkAbout19778-zFORM NO. 4
TO~N OF SOUTHOLD
BUILDING DEPARTMENT
Office of the Building Inspector
Town Hall
Southold, N.Y.
CERTIFICATE OF OCCUPANCY
No Z-20524 Date
FEBRUARY 11~ 1992
THIS CERTIFIES that the buildinq
Location of Property 1700 ALDRICH LARE
House No.
County Tax Map No. 1000 Section 125
Subdivision
ACCESSORY
LAUREL, NEW YORK
Street Hamlet
Block 1 Lot 2.16
Filed Map No. Lot No.
conforms substantially to the Application for Building Permit heretofore
filed in this office dated APRIL 10, 1991 pursuant to which
Building Permit No. 19778-Z dated APRIL 16, 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 ABOVE GROUND SWIHMING POOL & FENCING AS APPLIED FOR.
The certificate is issued to
(owners)
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL
UNDERWRITERS CERTIFICATE NO.
PLUMBERS CERTIFICATION DATED
KEVIN & CATHERINE STAKEY
N-185481 - MAY 1, 1991
N/A
~uilding Inspector
Rev. 1/81
I~OBM NO. ~
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOV,' H HALl.
SOUTHOLD, No Y.
BUILDING PERMIT
(THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL
COMPLETION OF THE WORK AUTHORIZED)
N~- 19778 Z
ig..~..[
Date
Permission is hereby granted to:
..... ...... .~..~ ~.~.....~:/',:/, .............................
..... ....~....~.....~..~..l .......................... : ................
.~. I17~/ ~
,o
at prem,sesvu' located a6/ t ...... , .~. ............. c~ ~'.~........~..~.$. .......... ~.~ ....................
County Tax Map No. 1000 Section ..... J...~....~... ....... Block ........ .Cj~...~. ...... Lot No ...... .~...;.!...~. ......
pursuont to application doted ....... ~ ....... ~....~.. ............... , ]9.~./..., ond
Building Inspector.
Fee ,..../..~..:..~
approved by the
Rev. 6/30/80
Form No. 6
TOWN OF SOUTIIOLD
BUILDING D EPAllTMENT
TOWN NALL
765-1802
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: '
l. 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 I% 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.
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
]. 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 $15.00
Date ...... ,~.~ ..............................
...
..ew Cunstruction ........... Old Or Pre-existing Building..~ ...........
!.oea~£on of P[operty..%.~.(~...~. .... ..~.~ ~..~.~ ~..~.~.~.~.
H6use No. Street Hamlet
.hlwer or Owners of Property.. .~ .......... ~.~ ..................
:uunty Tax 000, .... .......... ...........
..... h,p ........... ..-] .......
!!e.~ ~ Dept. ~proval .......................... Uuderwritcrs Approval ........
· '!.m, ing Board Approval ....................
eques~ for: Temporary Certificate ........... Fioal Certicate ...........
APPLICANT
., THE NEW YORK BOARD OF FIRE UNDERWRITERS 1
1000418 BUREAU OF ELECTRICITY
~-- 85 JOHN STREET. NEW YORK, NEW YORK 10038
D,,e MAY 01,1991 Applica,i,, No. o, file 73063391/91 N 1~5451
THIS CERTIFIES THAT
only the electrical equipment as described below and in,rod,iced by the applicant named on th~ above application .umber in the premises of
KEVIN STAKEY, 1700 ALDRICH LANE, LAUREL, N.Y.
in dteyotio,ci,,g/.cation: [] nas,~..,,~t [] t.~t V'I. [~ 2nd ri. OUT s~,~tio. Bto~t~ Lot 7
was exarnlned o~l APRIL 25,1991 ,,nd found to be in co npl at 'e ti, tit the reqt ire. entn qf this #oard.
FIXTURE
OUTLETS
DRYERS
SWITCHES
FIXTURES RANGES OVENS DISH WASHERS
NCANDE$CENT FLUORESCENT OTHER
E R V I C E
NO OF CC COND.
PER ~'
SWIMMING POOL-1
G.F.CoI:-i
*(S~IMMING POOL) This certificate
covers compliance at the date of
inspection only. Because o~ unusual
environments it is advisaLle to
h~ve frequent test and/or repairs
made 5y a qualified person.
ALEXANDER G. HUBBARD
BOX 222
AQUEBOGUE L.I., NY, 11931
LIC.~304-E
A. WO
OF CC COND
GENERAL MANAGER
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,
INSPECTORS
Victor Lessard
Principal Building Inspector
Curtis Herren
Senior Building I~pector
Thomas Fisher
Buikting Inspector
Gary Fish
Building Inspector
Vincent R. Wieczorek
Ordinance Inspector
Robert Fisher
Assistant Fire Inspector
Telephone ( 516 ) 765-1802
SCOTT L. HARRIS, Supervisor
Southold Town Hall
P.O. Box 1179, 53095 Main Road
Southold, New York 11971
Fax (516) 765-1823
Telephone (516) 765-1800
OFFICE OF BUILDING INSPECTOR
TOWN OF SOUTHOLD
FEBRUARY 5, 1992
KEVIN STAKEY'
BOX 23 I
LAUREL, NY 11948
To Whom This May Concern:
We are unable to complete your Certificate of Occupancy
because of the following reasons:
An application for Certificate of Occupancy is
not on file. (Enclosed)
No Underwriters Certificate on file.
The check is ~s~%~d~XX~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 ~ 19778-Z
Please contact our office on this matter.
cooperation.
Thank you for
SOUTHOLD TOWN BUILDING DEPT.
765-1802
BUILDING DEPT.
INSPECTION
FOUNDATION 1ST [ ] ROUGH PLBG.
FOUNDATION 2ND [ ] INSULATION
FRAMING [ ~FINAL
DATE
FOU~DATION (1st)
FOUNDATION
2.
ROUGH FRAME &
CO~£~T~
.PLUMBING
(2nd)
INSULATION PER N.
STATE ENERGY
CODE
FINAL
ADDITIONA'L COMMENTS:
TOWN OF
' /
Examined . ~ .... ~.., 19~J .I.
Approved .C~ ....
Disapproved a/c .... . ..............................
(Building Inspector)
APPLICATION FOR BUILDING PERMIT
FORM NO. 1
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN HALL
SOUTHOLD, N.Y. 11971
TEL.: 765-1802
BOAgD OF HEALTH .........
~ s~rs or..e~-a.s ..........
SURVEY
SEPTIC FORH ..............
Date .................. , 19...
INSTRUCTIONS
a. T,his 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 c~mmenced 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 gran.~l~~pector.
APPLICATION IS HEi~*~III~ADE 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 ail 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)
~lt'JBT/~la~¢ress of applicant) --
State whether applicant is owner, lessee, agent, architect, engineer, ~ electrician, plumber or builder.
Name of owner of premises g.~t~0..%...~ .~:.&%.~.~. ..............................................
(as on the t~r~ roll or latest deed)
If applicant is a corporation, signature of duly authorized officer.
(Name and title of corporate officer)
Builder's License No.. D,Cv: .w5~..: ..............
Plumber's License No .........................
Electrician's License No. ~ ...........
Other Trade's License No ......................
1. Location of land on which proposed work will be done ..................................................
........... .... L. ....... .....................
House Number Street
County Tax Map No. 1000 Section ..I.'~5 .......... Block....~..[
Subdivision..L~..[~-~L_..~r.~.<~?.(~ .~..~.~..V~J~.5"~ .... Filed Map No.
(Name)
Hamlet
........... Lot..~.,1 .~ ...........
· ~.~.-.).q..~.. Lot ...~7 ...........
State existing use and occupancy of premises and intended use and occupancy of proposed construction:
a. Existing use and occupancy S ~ ~. ~/~. ~.(~..~.~-~.... ~'~..~./~[ ~3. ~ ..........................
b. Intended use and occupancy ................................... ~ .~5~. %~. ~.
property lines. Give street and block
interior or coruer lot.
3. Nature of. work (check which applicable): New Building .......... Addition .......... Alterati~ ..........
Repair ............. RemoVal .............. Demolition ............. Other Work.., [~).~.
4. Estimated Cost ........ , . ,~. . Fee f , ~, . ' ~
i (to be paid on filing this application)
5 Ifdw lling number of dwell'rig u~its Numb r ofdw lling nits each floor
· e , 1 ............... e e u on .............
If garage, number of cars '
6. If business, commercial or mixed becupancy, specify nature and extent of each type of use .....................
7 Dimensions ' ' ' i if any: Front Rear Depth
· of existing structures, ............................................
Height Num b~r o f Stories
Dimensions of same structure with alterations or additions: Front ......... Rear
Depth ..................... I' Height ...................... Number of Stories ......................
8. Dimensions of entire new construction: Front Rear
.............................. Depth ...............
Height ............... Number of ~tories .........................
9. Size of lot: Front . . ~q~l~)/.i 7 ~D~pt~h . lj.~(~ ~
10. Date of Purchase ..... .~.O).~.2-~ii i ..... Name of Former Owner'..~.~x~.'. i~ !~..~. ~
1 1. Zone or use ......
district in whzch premises are situated .....................................................
12. D ' · ' ·
Des proposed construchon violate any zoning law ordinance or regulation' . . .
13. Will lot be regraded ~ .... · .............................
...... "' "i ........ -:2 ....Will excess fill be removed from premises: Yes
14. Name of Owner of premises ~qJ.~. ,t~.~.~!.~_.~?.. Address .~. ?.~..~).~.a, Phone No..~qZ:'z~.~ ....
Name of Architect ........... ............... Address ................... Phone No ................
Name of Contractor .......... [ ............... Address .................. Phone No ............ x ....
Is this property within 300 feet of a tidal wetland? '*Yes ........ No.~ ....
·If yes, Southold To~n Trustees Permit may be required.
PLOT DIAGRAM
Locate clearly and distinctly all buildings, whether existing or proposed, and, indicate all set-back dimensions from
tuber or descriptio~ according to deed, and show street names and indicate whether
"II '4MEDIATELY'
OCCUPANCy
USE IS
WITHOUT
OF OCCUPANCY
APPROVED AS NOTED
NOTIFY BUILDING DEPARTMENT AT
76§-~802 9 AM TO 4 PM FOR TH~
FOLLOWING INSPECTIONS;
1, FOUNDATION TWO REQUIRED
FOR POURED CONCRETE
2. ROUGH . FRAMING & PLUMBING
3, tNSULATION
4. FINAL CONSTRUCTION MUST
BE COMPLETE FOR
ALL CONSTI:{~CTION SHALL MEET
THE REQUIREMENTS OF THE
STATE CONSTRUCTION 84 ENERGY
CODES. NOT RESPONSISLE FOR
DESIGN OR CONSTRUCTION ERRORS
STATE OF NEW YORK,
'~OUNTy OF S.~
. ....
(Name of individual signingicontract)
lbove named.
being duly sworn, deposes and says that he is the applicant
is the .............
................... .... .......................
[ (Co~tra;t;r~ ag;nt, co;poia~e ;~ic;; .
said owner or owners, ~d is duly ahthofiz~d to perform or have perfomed the said work and to m~e ~d file this
tpplication; that all statements contained ~ this application are true to the best of his knowledge and belief; and that the
york will be perfo~ed in the m~ner se't forth in the application filed therewith·
lwom to before me this
.................
.