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Home My WebLink About19200-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTI~ENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No Z-19261 Date AUGUST 3~ 1990 THIS CERTIFIES that the buildin~ Location of Property 1665 ALBO DRIVE House No. County Tax Map No. 1000 Section 126 Subdivision ADDITION TO AN ACCESSORY Street Block 3 Filed Map No. LAUREL~ N.Y. Hamlet Lot 18 Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated JULY t0, 1990 pursuant to which Building Permit No. 19200-Z dated JULY 17, 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 DECK ADDITION TO AN ACCESSORY INGROUND SWIMMING POOL. The certifica%e is issued to (owners) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL UNDERWRITERS CERTIFICATE NO. PLUMBERS CERTIFICATION DATED Rev. 1/81 KEITH A. & CECELIA A. ROBERTS N/A /Building Inspector I~OIR~ NO, ii T(~/'N OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL $OUTHOLD, N. Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) ~200 Z Dot~ .~.. .......................................... pursuant to application dated ...~././..~'~ ......................................... , 19..~.**~.., and approved by the Building Inspector. Rev. 6/30/80 Form No. 6 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL 765-1802 i ,70WNOFSO~ ION FOR CERTIFICATE 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 conta~s ~ less than 2/10 of 1% lead. 5.. Commercial building, indus, trial 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. ',o 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 Occupamcy -. New dwelling $25.00; Additions t6 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 Temporary Certificate of Occupancy - Residential $15.00, Commercial $15.00 New Construction ' Old Or Pre xisting B ilding House No. Street Hamlet Onwer or Owners of Property... C~ County Tax Map No 1000, Section ..... . ......... Block .............. Lot ..................... SubdiVision' Filed Map Lot permit *O°O...Date of ~ealth Dept Approval Underwriters Approval ,, Planning Board Appro al ? '" 'for: Request .Temporary Certificate ........... Final Certicate ..... ~. ..... Fee Submitted: $ .... ......................... .... FIELD FOU~;DATION FOUND^T!ON _(..2 n d ~. ROUGH FRAME & .PLUMBING INSULATION PER N. STATE ENERGY CODE FI]IAL ADDITIONA'L COMMENTS: 765-1802 BUILDING DEPT. INSPECTION FOUNDATION 1ST [ ] ROUGH PLBG. FOUNDATION ZND [ ] INSULATION FRAMING [~i~AL DATIE-'~/~i~/~ ' **SPECTOR ~ ~ ':JLVOIJiII:I~O. IllOHI~M FORM NO. 1 TOWI~ OF ~:OUTLIOLD BUILDING DEPARTMENT TOWN HALL $OUTHOLD. N,Y, 11971 Exmnincd .., 19... Disapproved ale ... ............................. BOARD OF HEALTH --'-.s..~- ~ . SURVEY .' ........ SEPTIC FORi'! NOTIFY: CALL ............. HAIL TO: 'r~ ...... · LX ' Date..f ................ 19... INSTRUCTIONS a. Tl~is application must be Completely tilled in by typewriter or in ink and submitted to the BuildingI~'Pector, with sets of plans, accurate plot plan to scale. Fee aCCording to schedule. b. Plot plan Showing location of lot and of buildings on premises, relationship to adjoining prcrni.~x or public streets or areas, and giving a detailed description of Dyout of property must be drawn on the diagram which/$part of th.is appll- cation. ¢. The work Covered by this application may not be commenced befor ' .~ ,.d. Upon approval of this application, the Buil~;,,-, ...... e ,ssu~nc.e of Building PermiL - ' sl~all be kept on the premises available fo~; ...... :-~.,[~ msp.ec~or wm ~Ssued a Braiding Permit to the a licant. Su ' - ,,~uu~on mrouo_nout the Work. PP ch permit e. No building shall be occupied or Used in whole or i-n part for a.ny'purpose whatever until a Ce~tifica~ of Occupancy shall have been granted by the Building Inspector. APPILICATIOI~I IS HEREBY MADE to the Building Department for the issuance of a Building Permit pn~u-~t to the Building Zone Ordinance of the Town of Southold, Suffolk County, New Yin-k, and other applicable ~. Ordinances or .~lations, for the const~c ..... . Re- li;~ ..of ~uild~s., ad. dztions or .a. lterations, ?.r for removal or demolition as ~ descri Th~ applicant agrees to ,c~.r~,p~y:. ~V[t~ tilt applicable laws. ordmancs , · bed admit authorized m~pecto~ Bn premises andi/i buil~l~lh- fo ........ .'es.,,_b_u_i/d.m= code, housm~ code, and rcg~tmns, and to pplicant ls ~¢/h~r~ I~F~ agen't,"arch'Jtect, engineer, general contractor, electrician, plumber or builder. tit ~ ~t,,~/iM~14~,,~ . ,~' ~"~ (as on thc tax roll or latest deed (Namcand I of corporate officer) uilde,'s ...... ......... Plumber's License No ..................... Electrician's License No ....................... Olher Tradc'~ Liccnsc No ................ ' ..... Location of land on which proposed work will be done: ·ouse Number ............... Hamlet ............... COunty Tax MapNo: 1000 Section ..... 1.~..~..ii .... ' BlOck .5. Subdivision ............... Lot ................ .............................. ~ .... F, iled Map No. . (Name) .............. Lot ......... a. xislinguscandoccunanev . '~¢E ~ ~/E.a,.~'7'3~'/L~ . · b. Intended u~e and occupancy ....... . ................· ........................... ' Nature of work (check which aplalicable): New Buildin§ .......... Addition .......... Altcrat:on .......... Repair. ........... .. [. R~moval .............. Demolition ............ Swimming poor ..... : ...... EstimatedTenn~s CoUrCcost .... ' '"" ' ;/' ' '~r. ~..~?.~ccess°rY: .... ~u£/.dlng .......... ,- ~'enee ...' .... Other Work.-'~ . . ... ~ ................. ret ! (to be paid on filing this application} If dwelling, number of dwelling t~nits .......... ; .... Number of dwelling units on each floor Il'garage number of cars II'business~ . ¢ommerc'al or mixedioecupancy specify nature and extent of each type of D] ....' if any: Front , ................ Rear ............... Depth. HelL'hr ' ' .5. .... Numt?cr of Stories Dimensions of same, structure wi~h alterations or additions: Front Rear ' Depth ......... .,.,.,~ ...... : Height S. Dimensions ofentire new constniction Front Hot,Itt Nu'n~er of ' i ......................... ~ Stories ' ' ' Rear . Depth ............ 9 .... .............. .................................. ' ' ' ..................... Depth ................ . . I0, Date of Purchase , '- . .. · ' · · ~ ......~ ................ Na. mg_o f Former O,vner ............... any zoning law, regulation: ....~...,.-.~, ............. 13. Willlot be re-.radcd . ...........a.'~'~.':~'J' .~.' .7%· ............. Will excess fill be removed from premises: . Yes ... Name °f Owner °f premises .-r'£41; Address .. Phone No ..... Name'of Architect ' Address Phone No Name of Contractor . ~ . IS. rs this proper't'; ..... : ................ Address ................... Phone...No ..... F...k~ ...... located within I OFF feet of a .tidal wetland? ~YE$ .... NO/~.. ~If yes, Southold TownlTrustees Permit may be required. i ' PLOT DIAGRAM ocate clearly and distinctly all buildings, whether existing or proposed, and indicate all set-back dimensions from proplerty Unes Give street and blocknumbe de ' ' ' - ' ' ' r or scnpt~on accordm,, to deed, and show street names and md:cate whether inte:~or or comer lot. ' FOLLOwIN~ iNSPECTiONS: eu~ POURED CONCR~ 2, ROUGH. FRAMING & ~UMBING 3. E FOR C.O. DESIGN OR ~~N STATE OF NEW YORK, COUNTY OF .......... ~.S · ' ' ~ .........................., .... ' ................. .. being duly sworn, deposes and says that h= i~ the applicant · . (Name of:mhv~dual mgnmg contract) a boyle nam'ed. ~ is; ti e I , (Contractor, agent, corporate officer, etc.) of s~id owner or owners, and is duly] authorized to pe,rform or have performed the said work and to make and file this application: that all statements contalimd in this appticatiou are true to the best of his knowledge and belief; and that the Work; will be pert'om;ed in tile manner;set forth in ti,e application filed thcrewid~. Sworn to before mc this ' i ......... · .. County .~.~. · "e ....~ .... , ' THE OFFSETS (OR DIM£NSIONS) · · ~ ' ~,-~ , :'- ,-, """ ,' ~ SHOWN tlEREON FRONI rile ~,~ 0.[', ,1 ,~ ;.:, ., : LINES ~RE FOR A .~ . ~. .k;~ O~ ' "'''' ' :~. POSE AND USE AND TTI~REtOR~ ': 'f ,~"~":"," ' ' BUILDINGS OR ANY OTH~ DONALD J. TASE, L.S. RICHARD WILHELM AND ASSOCIATES LICENSED ~ND SURVEYORS Ceneer ~orieh~lt ~. Y. 1193~ ' ~re.~odl N.Y. 11717 _.~120 . / ~el. 273-8163