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Home My WebLink About18937-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No Z19768 Date MARCH 4, 1991 THIS CERTIFIES that the building Location of Property 850 TRACK AVE. House No. County Tax Map No. 1000 Section 103 Subdivision INGROUND POOL Block 12 Filed Map No. CUTCHOGUE Street Hamlet Lot 05 Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated APRIL 4, 1990 pursuant to which Building Permit No. 18937Z dated APRIL 6, 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 INGROUND POOL~ FENCE AND DECK. The certificate is issued to of the aforesaid building. DOROTHY MARA (owner) SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A UNDERWRITERS CERTIFICATE NO. N129317 MAY 17~ 1990 PLUMBERS CERTIFICATION DATED N/A ~~ ~B~j ]~ding~o~ Rev. 1/81 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N. Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL CONIPLETION OF THE WORK AUTHORIZED) NE 18937 Z Permission is hereby granted to: ..... .......... ..~.~.~..~..~ ................................................... ..~.~....~..,.~ ......... u..~..~.~ ...... ,o.~.~......~.'ii~~....£~...~.~.,.....~..&.& ...... ~ .... at premises located at .. ..~...~..'~. .... .. ... .~..~.~... .. ~ ....... ~.~.~ ............ County Tax Map No. 1000 Section ...... I...°....~. ........ Block. ....... J....~.. ........ Lot No ..... .~.~'. .......... pursuant to application dated .... ...~.......~. ......................... , 19.~..0.., and approved by the Building Inspector. Fee $.~ .............. Rev. 6/30/80 Form No. 6 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL 765-1802 APPLICATION FOR CERTIFICATE OF OCCUPANCY A. This application must be filled in by typewriter OR ink and submitted to the building ~inspector kith the following: for new buildin~ o~ new 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). Approval of electrical installation from Board of Fire Underwriters. 4. Sworn statement fro~'plumber certffying that the solder used in system contains less than 2/10 of 1% lead. 5. Commercial building, industrial building, multiple residences and similar buildings end installations, a certificate of Code Compliance from architect or engineer responsible for the boilding. 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. u. Fees 1. Certificate of Occupancy - New dwelling $25.00, Additiohs to dwelling $25.00, Alterations to dwelling $25.00, Swi,~ing 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 pf Certificate of Occupancy - $5.00 over 5 years - $i0.00 4.Updated Certificate of Occupancy - $50.00 5.Temporary Certificate of Occupancy - Residential $15.00, Commercial $15.00 /' Date ..... .ew Construction ........ Old Or Pre-existing Building. . . ,ocation of Property ............ ~j~ ~.~J~_~. .~ .~. House No. Street Hamlet ' ounty Tax Map No 1000, Section .... ~.~. ..... Block ........ /.~. ..Lot. ~bdivision .................................... Filed Map ............ Lot ......... ................. Date Of Permit ................ Applicant .......... ~alth Dept. Approval ........................ ' - Underwriters Approval ..... ..................... .arming Board Approval ............ quest for: Temporary Certificate ........... Final Certicate Submitted: $ ......... FOU~IDATION FOU:IDATIO:! (2nd) ROUGH FRAME & .PLUMBING I~SULATION PER N. STATE ENERGY CODE Fi::AL ADDITIONA'L COMMENTS: THE NEW YORK BOARD OF FIRE UNDERWRITERS BUREAU OF ELECTRICITY ~- 85 JOHN STREET, NEW NEW YORK 10038 YORK, Date ~pplication No. on file THIS CERTIFIES THAT only the electrical equipment ~ ~scrJbed below a~ int~duced by the ap~icant ~med on the above application number in ~he premises of in thefollowlng Ioca~l~ ,.~- Basement, ~ P ~ Ist FI. ~ 2nd FI. f~l~T Section Bilk Lot FIXTURE FIXTURES RANGES COOKING DECKS OVENS EXHAUST FANS OUTLETS SWITCHES DRYERS SYSTEMS NO. OF FEET OTHER APPARATUS: E R V I C NO OF CC. COND PER ,e' AWG, OF CC COND NO. OF HI-LEG AWG OF HI-LEO NO O~NEUTRA[$ OF NEUTRAL GE~ NEI~AL MANAGER per't1 ..'~ This certificate must not be altered in any manner; return to the office of the Board if incorrect. Inspectors may be~'-'i~ntified by their credentials. COPY FOR BUILDING DEPARTMENT. THIS COPY OF CERTIFICATE MUST HOT BE ALTERED IN ANY MANHER. 765-1802 BUILDING DEPT. INSPECTION FOUNDATION 1ST [ ] ROUGH PLBG. FOUNDATION 2ND [ ] INSULATION [ ] FRAMING [/~INAL DATE BOARD OF HEALTH ...... 3 SETS OF PLANS ....... FORMNO. 1 SURVEY ..,~0%~.~.. · TOWN OF SOUTHOLD CHECK · BUILDING DEPARTMENT SEPTIC FORM ............. : TOWN HALL $OUTHOLD, N,Y. 11971 NOTIFY TEL.: 765-1802 GALL ;0-..~.,~.~7~..~. MAIL Approved ? i=it No. ' · (Buiiding Inspector) APPLICATION FOR BUILDING PERMIT Date .... ~././ ......... 19...t~ INSTRUCTIONS a. This application must be completely filled in by typewriter or in ink and submitted to the Building hi'spector, with 3 sets of plans, accurate plot plan to scale. Fee according to schedule. b. Plot plan showing location of lot and of buildings on premises, relationship to adjoining premises or public streets or areas, and giving a detailed description of layout of property must be drawn on the diagram which is part of this appli- cation. ¢. The work covered by this application may not be commenced before issuance of Building Permit. d. Upon approval of this application, the Building Inspector will issued a Building Permit to the applicant. Such permit shall be kept on the premises available for inspection throughout the work. e. No building shall be occupied or used in whole or in part for any purpose whatever until a Certificate of Occupancy shall have been granted by the Building Inspector. APPLICATION IS HEREBY MADE to the Building Department for the issuance of a Building Permit pursuant to the Building Zone Ordinance of the Town of Southold, Suffolk County, New York, and other applicable Laws, Ordinances or Regulations, for the construction of buildings, additions or alterations, or for removal or demolition, as herein described. The applicant agrees to comply with all applicable laws, ordinances, building code, housing code, and regulations, and to admit authorized inspectors on premises and in building for necessary inspections. ·/9.: ./Z~7.t..t.L ~.. ~o.,v.$... ~ r,, ......... (Signature of applicant, or name, if a corporation) P. . : o. : . . . ez, . . .m . (Mailing address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. .................... .~..z~..~..-~. ~.6....c.o,v.,.-~. ~.~.~..~ ........................................... ofpremises ...... ~.te]/~... Z49/~. qt,~t$/.--'~ ,/ ~'C7/~- ~.O~t"~t~./q~.~· ('~.t~._C~~ Name of owner .......... ., ....................... ~ ............ (as on the ~'ax roll or latest deed) ~0~4t~t~ )/~f~-oze:e_{'~ If app[ie'f~t.J¢ a corporation, signature_of duly authorized officer. · .......... ALL CONTRACTOR'S MUST ~BE SUFFOLK~COUNTY LICENSED Plumber's License No ......................... Electrician's License No. ,F/ZOF~,,W/-,O/...~..~...L-~. J~. t C Other Trade's License No .................. Location of land on which proposed work wil[b.~ done .... ~ .~...C~/..~../~.. G~,~.- ...... ~.y..O. ............... ... ~.~ .......... C ~.zT.~.z~.¢. ¢~.~....,ff..~... House Number Street Hamlet ..... County Tax Map No. 1000 Section ....... ./.~..~- ...... Block ....... /~. ........ Lot ...... '" .......... .......... ....... Subd v, on ...... ,ed Map No. Lot State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy ....... ~ . ./~...d:~...../~. .... b Intended ,~.. tT~.//"~-.'.~. ~ · < ~.~_ · use and occupancy ~ ' Repair ...... ' "Rem°v... .- ~I ......... ..... Demolition ............. Other Work ,~,~.~, ~ ......... 4. ~stim~tcd Cost ......... , E ~ Fee .......... ~ (to be paid on filing this applicatioo) . 5 If dwelling number of dwelling units Number of dwelling units on each floor If garage number of c~s ' 6. If business, commercial or mixed 6ccupancy, specify nature and extent of each type 'of use ~..: ....... 7 Dimensions of existing stmctures,,if any: Front Rear Depth Height Number of Sto~es ' D~ensions'of same structure witt~ alterations or additions: Front ................. Rear ................ Dep~ ..................... ~ HeiSt ...................... Number o[ Stories ................ .... 8 D~ensions of entire new construction: Front ' Rear Depth Height Numbdr of Sto~es 9. Size of lot: Front ............ ~ ......... Rear ............... , ....... Depth ...................... 10. Date of Purchase ............. ................ Name of Foyer Owner ............................. I 1, Zone or use district in which premjses are situated ...... ~.4~/~ .................... 12. Does proposed construction violat~ anv zonin- aw orm~-- ..... ~nIntl~n' :3. Will lot be regraded ........ ~ ..... ~ ....... Will excess fill be removed from prem scs' No ., , ' N~e of Owner of. premises . 4[~.~ i~.~ddress .. ~~.~-7.. Phon~ No ........... N~e of Architect .......... ; · -~ ............. Address ................... Phone No. :5. Is th~s property ioca~ed wfthin~ 300 feet of a ~idal wetland? *Yes ..... No . · If yes, Southold To~ T~ust~ees Parent may be reoufred. PLOT DIAG~M Locate cte~ly ~d distinctly ~1 ~' ' buildings, whether existing or proposed, and. indicate El set-back d~ensions from ~rope~y ~ne$. Give street ~d block number or description accord~g to deed, ~d show street n~es and indicate whether ntefior or comer lot, TATE OF NEW Y.~RK,..~ -- . (Name ofindMdual signin'g zontract) )ovc ' the said owner or owners, ~d is duly 'plication: that all statements contaim ork will be perfo~ed, in the m=ner .yom to before me this ......... ~ ....... day of .................... 19 ~t bi c ....... , .............. County being duly sworn, deposes and says that he is the applicant . (Contractor, agent, corporate officer, etc.) uthorized to perform or have performed the said work and to make and file this d in this application are true to the best of his knowledge and belief; and that the : forth in the application filed therewith. D Z · 'fi3