HomeMy WebLinkAbout19319-z FORM NO. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Office of the Building Inspector
Town Hall
Southold, N.Y.
CERTIFICATE OF OCCUPANCY
No Z-19314 Date AUGUST 23, 1990
THIS CERTIFIES that the building ACCESSORY
Location of Property 2345 ACKERLY POND LANE SOUTHOLD, NEW YORK
House No. Street Hamlet
County Tax Map No. 1000 Section 69 Block 5 Lot 2
Subdivision Filed Map No. Lot No.
conforms substantially to the Application for Building Permit heretofore
filed in this office dated AUGUST 10, 1990 pursuant to which
Building Permit No. 19319-Z dated AUGUST 13, 1990
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 ENCLOSURES
(AS BUILT)
The certificate is issued to FREDERICK PFIFFERLING
(owner)
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A
UNDERWRITERS CERTIFICATE NO. N-144639 - AUGUST 7, 1990
PLUMBERS CERTIFICATION DATED N/A
~ ~
Buildi g Inspector
Rev. 1/81
I ,
tOB:ffi NO. f
TOWN OF SOUTHOLD
8111LdING DEPARTMENT
TOWN HALL
SOUTHOLO, N. Y.
9UILDING PERMIT
(THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL
COMPLETION OF THE WORK AUTHORIZED)
N°_ ; 31 Z Date ...~~/..3 Ig~~
Permission is hereby gr nted to•
,
<s~~.~~........~,..
ro .4n?""'y'?(e'~"~"""" P... fed... ~r~/y~
I at premises located at ...~,aT...~.~
i
County Tax Map No. 1000 Section Block Lot No..........
f pursuant to application dated ....C~~.(.~ 19~~., and approved by the
i
~ Building Inspector.
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G Fee S.~~A .
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4 ` j B ding I for
Rev. 6/30/80
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~ Form No. 6
TOWN OF SOUTHOLD D
BUILDING DEPARTMENT - A'~
TOWN HALL tM1t1:7 2 2
765-1802
BLDG. DEPT.
WN OF SOUTHOLD
• APPLICATION FOR CERTIFICATE OF OCC
.1. 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-4 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:
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.
C. Fees
1. Certificate of Occupancy-Nec,~ dwelling $25.00, Additions to dwelling $25.DD,
Alterations Co dwelling $25.0 Swimming pool $25.00, Accessory building $25.00,
Additions to accessory hui ding $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
k. UpuatCd Certificate of Uccupancy - $50.00
5. Temporary Certificate of Occupancy - Residential $15.00, CGGommercial $15.00
Date ........•.....o.~.~a..~~
:;ew Construction........... Old Or Fre-existing Building
Location of Property
House No. StJ~reeC~ / hamlet
Onwer oY Owners of Property.......~e~~~~°'~lC~•..~.•~::1•~•:~G!/~~j
County Tax Map No 1000, Section...~.F:~ •••••Dlock...~.........Lot..:~' •
Subdivision ....................................Filed Map......... ...Lot.•...........:._......
Permit No ................Date Of Permie................Applicant....................._.......
Health Dept. Approval ..........................Underwriters Approval......................
•
Planning Board Approval
r/~
Request for: Temporary Certificate........... Final Cert ate......
SOY/
Fee Submitted: $..~G?
~O ANY APPLICANT .
765-1802
BUILDING DEPT.
INSPECTft~N
[ ]FOUNDATION 1ST ( ] ROUGH PLBG.
FOUNDATION 2ND [ ]INSULATION
[ ]FRAMING [ ]FINAL
REMARKS. t~ , ~~r
DATE 2' J INSPECTOR
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FDRiot ND. 1 D
Q "'''^t. TOWN OF u~Ot)T'HOLD ~
BUILDING DEPARTMENT'
TOWN HALL ~ Q~
Q~ EOUTHOLD, IJ.Y. 11tJ71
TEL..:765~"Iti02 F3LDG.DEr'i. w
sI.DG. Derr. ' rowN of souTftn~_n
owe of so~>•tiotD ~ .__...a..~m. ~w.
Exar i I-9... eceive , , 1 9.. .
Approved .~/,1~~~......., 19 Permit No.~ye~~~
Disapproved a/c
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(Boil rg Hrspeotorl
APPLICATIO FOR BUILDING PERPAIT pp
Date 19/..v
INS l'12UCT'IONS
a. "This application must be completely filled in by typewriter or in ink and submitted to the Building Inspector, with 3
sets of plans, accurate plot plan to scale. Fee according to schedule. ~ , r:e;,,,Ge~•, r,saCa,,,~~
b. PIoC plan showing location of lot and of buildings on premises, relations}tip.;tn;~~j~~(i1T@I'pr~mises or public streets
or areas, and giving a detailed description of layout of property must bg dxawn_ot~ ~tltert,gfl4rt>hMdl9iiCheis part of this appli-
r9
cation. n~s'11i." O~ llfE
e. The work covered by this application may not be commenced befcoge~;issuance$.cst`tBuJtttldtrigiPe~°ihEta
d. Upon approval of this application, the Building h)speator will issuedca=.Iuilding Pcrr61'Ittto the applicant. Such permit
shall be kept on tha premises available for inspection throughout the work.. :~s'ra,.~§+,c;n ust -i:1
e. No building shall be occupied or used in whole or in part for any purp~oserwhatever until a Certificate of Occupancy '
shall have been granted by il)e Building Inspector. ~ - ~ ~ ~a ~ k6YV§s;bdt;
APPLICATION IS IIERIiBY MADE to the Pudding Department for.y],e;iss4tance of ~.~pj~{1~~,n)it pursuatxt to the
Building Zone Ordinance of the 'Town of Southold, Suffolk Couuty, New, Xo ~ and~pthe~.;~plicable Laws, Ordinances or
Regulations, for the ronstaugtion,,of buildings, additions er alferations,~ n-F r, „l~v) t4lfs herein described.
The applicant agrees o a'attpply ivath•al1 aJ)plicable laws, oa~dinancrs ~b}~i ir~~ .acid g,' ,~gtje~ ~fregtdations, and to
admit authorized insp '1F~7s`,il~pd~frkrses ar)~~,in building for nccessatytlu ectt ft5
p~,,, ~`~rK •
!t ~ ~~R (Signature,~~ ~I!c~.,tt~~, a me, if a corporation)
~ t~ 4~ ii~~~~~
54075 Main Road, Southold New York
(me' I of applicant)
State whether appliauri is owner, lessee, agent, architect, engineer, general ~rlurnber or builder. I
a*_torney for owner I
Name of owner of premises ~".E~~'~l~lC ..../~7, 1',"7,P,G[;/,/~ ,
(as on the tax roll o latest deed)
If applicant is a corporation, signahrre of duly authorized officer.
~N~,,;t ar;d r,t~~ ~f ~~rh~rlt~ ofriceL;.... OCCllPA~C`Y®®OR
Builder's License No . USE U~Lf7~~~~
Pltnnbe:r's License No . ~VIT~OUT CER~'1FICATE
lacer,;<:ian's Licence No . 4F OCCUPANCY ,
Other "T'rade's License No . .
I. Location of Isuul on which proposed work will be done .
....2345 ..............ACker.ly.J?.ctnd..T,ane.....Sout_ho1d..........
Ilousc Nmnber Street Ilantlet
Couuty Tax Ivlap No. 1000 Section h.9......... Block 5 Lot .......2 .
Subdivision Filed blap No. Lot .
(Name)
2. State existing use tool oa;npancy of premises and intenrle;t use and orcug~ancy of proposed constructiorc
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b. Intended usa and occupancy ...same „ea/c:~J. ,!~r90!/~ , 9~a~~1~. ~$'C~f/~ . ~(jO
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~fE NSW Y BflARD Of FIRE UNDERWRITERS rACE i
10ASOhT ,rr ~s-i`
. UREAU OF ELECTRICITY
BfT J ET, NEW YORK. NEW YORK 10038
Dete AUGtl9T O)g199~1 ~ t.zyionNo.onfife ULt42?$9Q/90 N Jdti639 =
THIS CERTIFIES THAT ~ -
only-the alec t as dsscrihed 6ekrm Fhe mxlicewt nRmed en the ahooe epp/icetion numher in the premtan of -
MR. T, PFIfP~~t„iMG, 25,5 ACK~RLY ~ ~-Pt71.E#8, SOU7HOl.b, N.Y.
in thefdlotcing location; ®fhmement ~ Is~ ~rY. OUT Section Bleek Lot
rasa e:amine/FRrI AUfi U 5 7 U 2 490 to 6e in rnmpliaare with the rrquiremend of this Board.
ACIES SWITCIIB ~ ~ COOIIIPIO DECKS DgfI WASNRRS BKIIAIKT TANS a
OUTLETS INCANaltflMT n DYNE R. W. AMT. E. W.. Aen. E.W. AMT. E. W. NAT. M. P.
DRYERS R1NiY1CE MOTORS lUTURi ANUANEE K TUIE ClOGIB ~ I<ATYS MUtTI.OUTIET OMSMNS
AMT. E. w. ai x. r. oAS a. r. AMr. no. A. w. a.. :Wr. AMT. AMPS. iRAItS. - AMt. N. r. p
~ AMT. wAliE
fMVK! DISCONNECT NO.Of S R V 7 C E
NAT. AMr. TrPF R I / rw I / tw t r tw t / Aw rq.OP . o. no. a MF1EG A.nw. o. rto. a rRUmNS p
OISIN AMARA7Uf: .
ANO VISUAL [z E.i:ECIS; "An e7ecirir.~,1
survey hms been made or Chr. espoar,d -
electr•ir.e1 equipment in hhe - - _
premises indicwted." "No obvious
unaNtig}nr..tohv condit;7e~n aws found,
W _ Q
r
tiENE HEAC(If:K fa,f:. CON1R. L'f(:,lt943fi
;515 l".€IiAN REACH RGAp
5011THghp, NY, 7).971 OMfOI MARA9! -
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This. arfificaM mutt not be alMred in any monnsn return to fM office of the Bomd If iRaorrrxt. ~ M iderMified by tbrir crrtclenlialt.
COPY FOR BUILDING DEPARTMENT. THIS COPY OF CERTIFICATE NR~IT IN ANY AMIf~R.