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Home My WebLink About18955-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No Z-21089 Date OCTOBER 14~ 1992 THIS CERTIFIES that the building Location of Property 975 ANDERSON ROAD House No. County Tax Map No. 1000 Section 50 Block 1 Subdivision Filed Map No. ADDITION SOUTHOLD, NEW YORK Street Hamlet Lot Lot No. I5 conforms substantially to the Application for Building Permit heretofore filed in this office dated APRIL 16, 1990 pursuant to which Building Permit No. I8955-Z dated APRIL 16~ 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 EXISTING ONE FAMILY DWELLING AS APPLIED FOR The certificate is issued to (owners) of the aforesaid building. SUFFOLK COUNTY DEPARI~ENT OF HEALTH APPROVAL N/A UNDERWRITERS CERTIFICATE NO. N/A PLUMBERS CERTIFICATION DATED N/A JOHN & PHYLLIS MACK Rev. 1/81 FORM NO. 4 TOWN OF SOUTHOLD BUILOING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No Z-21090 Date OCTOBER 14~ 1992 THIS CERTIFIES that the building Location of Property 975 ANDERSON ROAD House No. County Tax Map No. 1000 Section 50 Subdivision ADDITION SOUTHOLD~ NEW YORK Street Hamlet Block 1 Lot i5 Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated APRIL 16, 1990 pursuant to which Building Permit No. I8955-Z dated APRIL 16, 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 POOL ADDITION WITH FENCE TO EXISTING ONE FAMILY DWELLING AS APPLIED FOR. The certificate is issued to JOHN & PHYLLIS MACK (owners) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH ~iPPROVAL UNDERWRITERS CERTIFICATE NO. N-032407 PLUMBERS CERTIFICATION DATED /~ '~ding Inspector Rev. 1/81 FORM NO. O TO~N OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N. Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) 18955 Z pursuant to application f ./t.e~. ""~'~,~ .............. Building Inspector. Fee $..~...~ ond approved by the 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 with the following: for new building or new use: 1. Final survey of property with accurate location of ail 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 f~om Board of Fire Underwriters. 4. Sworn statement from plumber certifying that the solder Dsed in system contains less than 2/10 of i% lead. 5. Commercial building, industrial b~ilding, multiple residences an~ 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.' 3. For existing buildings (prior to April 9, 1957) non-conforming uses, or buildings and '.'pre-existing" land uses: 1. .Accurate survey of property showing ali property lines, streets, building and unusual natural or topographic features. 2. A properly completed application an~'~ 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 appiicant. 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. Cer~tificate 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. Tgmporary Certificate of Occupancy - Residential $15.00, Commercial $15.00 Date ...October"l, 1992 aw Construction . 01~ Or ........... Pre-existing Building ................. ~ca~ion of Propertyl ..... ~ .A.~..ERSON ROAD - SOUTHOLD, NEW YORK · '" House No. Street ...... ~ ................... Hamlet 0 of Property JOHN & PHYLLIS MACK ' unty Tax Map No 1000, Section.. 50 I 15 ............ Block ................ Lot ................ ................. Filed Map ............ Lot. ~mit No.. I8955 Z(DECK)n ' ' ................. - 4/16/90 ''' ............... ate Of Permit .... ............ Applicant. JOHN B. MACK, JR. ~lth Dept Approval ' ' · ' ......................... Underwriters Approval ......................... ,nfng Board Approval .......... uest for: Temporary Certificate ........... Final Certicate ........... Submitted: $.. -25.00 Form No. 6 TOWN OF SOUTtlOLD 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 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 psed in system contains less than 2/10 of 1% lead. 5. Commercial building, industrial b~ilding, multiple residences an~ similar buildings andinstallations, a certificate of Code Compliance from architect or engineer responsible for the building. 6. Submit Planning Board Approval of completed site plan requirements.· 3. 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~'~ 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. Cer.tificate 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. T~mporary Certificate of Occupancy - Residential $15.00, Commercial $15.00 Date October.'l 1992 ~w Con ruc on ........... 0id Or Pre-existing Building ................. )cation of Propert ....... , SO~THOLD, NEW YORK Street ............. Hamlet JOHN& PHYLLIS MACK ' wet or Owners of Property ......... 5O unty Tax Map No 1000, Section .............. Block ..... !.. bdiviaion ' ~mlt N~ 18955~Z ..Dat~ Of Permit ................ Applicant. JOHN.B. MACK, JR. ............... 4/~6/9o ~lth Dept Approval · · ' ......................... Underwriters Approval ........................ mning Eoard Approval ........................ uest for: Temporary Certificate ........... Final Certicate ........... Submitted: $ ..... %25.00 APPLICANT INSPECTORS (516) 765-1802 VICTOR LESSARD, Principal CURTIS HORTON, Senior VINCENT R. W1ECZOREK, Ordinance ROBERT FISHER, Assistant Fire Building Inspectors THOMAS FISHER GARY FISH OFFICE OF BUILDING INSPECTOR TOWN OF SOUTHOLD February 27, 1992 SECOND NOTIFICATION John B. & Phyllis Mack Box 1837 Southold, New York 11971 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 To Whom This May Concern: We are unable to complete your Certificate of Occupancy because of the following reasons: X.X An application for Certificate of Occupancy is not on file. (Enclosed) No Underwriters Certificate on file. The check is not on file. $25.00 No Health Department Approval on file. No final inspection has been made. No Plumber Solder Certificate on file. (Ail permits involving plumbing being issued after April l, 1984). BUILDING PERMIT $ 18954-Z ACCY SHED * Please contact our office on this matter. Thank you for cooperation. SOUTHOLD TOWN BUILDING DEPT. *NOTE: ACCORDING TO THE CODE OF T~_E TOW~ OF SOUTHOLD, IT IS UNLAWFUL TO OCCUPY OR USE SAID ACCESSORY WITHOUT A CERTIFICATE OF OCCUPANCY. PLEASE SUBMIT APPLICATION AND CHECK IN THE AMOUNTOF $25.00 SO THAT CO CAN BE ISSUED. THE ABOVE BUILDING PERMIT HAS EXPIRED. TOWN OF SOUTHOLD OF[:ICIi OF BUILDING INSPECTOR ILO. BOX '1179 TOWN ItALL SOUTIIOLD, N.Y. 11971 June 28, 1990 JOHN B. & PHYLIS HACK, JR. BOX 1837 SOUTHOLD , N.Y. 11971 To Whom This May Concern, TEL. 765-1802 We are unable r.o coalptete your Certificate of Occupancy because ,of the following reasons. / /--//An_ application for Certificate of Occupancy _/is not on file. (ENCLOSED) . /k///.,~;,o__,f ,, Underwr'iters Certificate on file. /._~f qhe check i:;(c~t~Lxkx~r~k/not on file.) $25.00 /~/ No Health Dept. Approval on file. /--/ No final inspection has been made. Please contact ()ur office Thank you for your cooperation. lh~ildir:g Pcrmi_t t~ I 8 9 5 5 Building Dept. on this matter. rio Plumber Solder Certificate on file. ( all permits involving plumbing being issued after AprJ. 1 1,1984 INSPECTORS (516) 765-1802 VICTOR LESSARD, Principal CURTIS HORTON, Senior VINCENT R. WIECZOREK, Ordinance ROBERT FISHER, Assistant Fire Building Inspectors THOMAS FISHER GARY FISH 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 27, 1992 SECOND NOTIFICATION John & Phyllis Mack Box 1837 Southold, N.Y. 11971 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. XX The check is not on file. $50.00 (2 CO'S REQUIRED) No Health Department Approval on file. No final inspection has been made. No Plumber Solder Certificate on file. (Ail permits involving plumbing being issued after April 1, 1984). BUILDING PERMIT # 18955-Z (POOL & DECK) Please contact our office on this matter. Thank you for cooperation. SOUTHOLD TOWN BUILDING DEPT. *NOTE: ACCORDING TO THE CODE OF THE TOWN OF SOUT~OLD, IT IS UNLAWFUL TO OCCUPY OR USE SAID SWIPING POOL & DECK WITHOUT A CERTIFICATE OF OCCUPANCY. PLEASE SUBMIT APPLICATIONS AN~ C~ECK IN THE AMOUNT OF $50.00 SO THAT THE CO CAM BE ISSUED. THE ABOVE BUILDING PERMIT HAS EXPIRED. TOWN OF $OUTHOLD OFFICE OF BUILDING INSPECTOR P.O. BOX 1179 TOWN IIALL $OUTIIOLD, N.Y. 11971 June 28, 1990 TEL. 765-1802 JOHN B. & PHYLIS MACK, JR. BOX 1837 SOUTHOLD, N.Y. 11971 To Whom ' ' 5hxs' 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) /~_~,,I,o Underwriters Certificate on f/lc. /.~/ qhe check .i:;(~mtxk~tx~k/not ou file.) $25.00 /_-/ No Health Dept. Approval on file. /-~/ No final inspection has been made. Please contact ()ur office on Thank you for your cooperation. lh~ilding Permit t! I 8 9 5 5 Building Dept. * * this matter. Z No Plumber .Uoldcr Certificate on file. ( all permits involving plumbing being issued after April 1,1984 ) · OU~TIOJ { ~ FOU:~DATIO:~ ( 2nd ~OUGH FRAME & -PLUMBING !~SULLTION FERN. STATE E~ERGY CODE ~DDITIO~IAL COMMEI,;TS: FORM NO. 3 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N.Y. NOTICE OF DISAPPROVAL . Date.,. ,~..."~.. ................ , 19 .~. ,4~.. To ~ ~.,..~r~...~/...~..~~ ~ PLEASE TAKE NOTICE that your application dated ~ 1~ ~ ~ ~ ~ ~ / "5 ....... ~ ............. ' ..... . for pe~it to ~~~..~~~.. at Lo~o~ o~ ~o~ .. ~.. ~~..~ ............. a~~ Hous~ ~o. v Street ...... ~ ' ~/~ County Tax Map No. 1000 Seztion .... ~ ...... Block ....... ~, ..... Lot .... J~ ..... Subdivision ................. Filed Map No. r ............... Lot No .................. ~,~ ~ anO ~a~o~O on ~ ~o~low~n~o~nOs .~.. ~._~... ~~~. ~....~..~....~~..~ ..... ~..~...~,.. . ..~ ....... ~ ~-~ .~ .--_ ...... ~ .... ~ .... ~ .......... ~ ........... . ........... ~ ..... ~ ~. . . . .~ ' ~ ~ ~ ~ .................... ,_ .-,. ................... .................. ~. . ~ .... ~ ,. . . ~-~~ . ........... ::::::::::::::::::::::::::::::::::::::::::: RV 1/80 ,1 ¢ ( ( ( ( ( £ £ (_ 765-1802 BUILDING DEPT. INSPECTION [ ]FOUNDATION 1ST ~ I ROUGH PLBG. [ J FOUNDATION ZND [ ] iNSULATION [~F'RAMING ,r ] FINAL ~ FORM NO. ] TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL ~OUTHOLD, N.Y. 11971 / TEL.; 765-180:2 Examined P/.~"/ . . ,19 .~. .. ,.... . . . .................... ...... ...................... Disapproved a/d . ~, BOARD OF HEALTH ............ 3 SETS OF PLANS ............ SURVEY ..................... CtlECK SEPTIC FORH NOTIFY: CALL ..................... blAIL TO: ' '~ ~L~.~'"'~\\II1 t~uildi,~= Insp~tor) .... ~ ATION FOR BUILDING PERMIT . ',~ ~A~ ~ ~ ........ ' %~.~&. ~45~~ ~ - ' .... , X?~,~5~~'~ instructioNs Tlfis applic~i['n mast be completely filled in by m.-~ d,~ · - - ' '> ' . .~ ~ ....... r or In mr and submitted to the Building sets of plans, accurate plot plan to scale. Fee according to schedule. b. Plot pl~ showing location of lot and of build~gs on premises, relationship to adjoining premises or public streets or areas, and givNg a det~led description of layout of property must be drawn on the diagram which is pag of t~s app~- e. The work covered by tNs application may not be commenced before issuance of Bu~ding Permit. d. Upon approval of this application, the Building Inspector will issued a Build no shall be ~ ~i~[~ .......... Pe~it to the app~c~t. Such pe~it .,-~ Z~-i-~,~ ~ tu~ ~nspecrion mrou~out the work. ~, . ~-~. ~ ~ .~,~ :. _ e. mq~~t;~95~.~d or used in whole or in part for any purpose whatever unt~l~a C~ificato 0f:0ccup~cy shall have ~~9.>~e~,0ild~g Inspector. ' ,:.. , .. ~ , .. APPLICATION~I~HE~E~ MADE to the Building Depmment for the issuance of a ~lding }e~it pursuant'to the Building Zone Ordinanc~ of the Town of Sbuthold Suffol'- ~ .............. ~e=umtions, for the construction of bufldln.¢ nadirs.. ~ ,- ., ~ . pp le ~ws, Ord~oes or The apphcant agrees to comply w~th all applicable Fa'{vs, ordinances, bufld~g code, housihg code, an~ s admit authorized ~spectom on premisds and~ bulldog for necessa~nsvoctions~ . ~ ~ "IMMEDIATELY" '~ ' - //{~gnature or applicant, or name,/ - ~ ~' ~,=o~ ,oo~ ,o ~o~ 4./~. ~. ~7.. ~~/.',. a ¢ n q. z/ ..... u~o. cO?L~T~ (~ ~d~e~, or~i~;) "' Stat~ whether applicant is owner, lessee, agent, ~chiteet, engineer, general contractor, electrician, plumber or builder. Name of owner of remises ~. . .~ ~. ~/ . ~ ~ // ~ ......... / ........ , · · · ~.. ~r ~4 ~[ ~/~' ~ ' (as on the tax(~ll or latest deed) , If applicant is a corporation, signature of duly authorized officer. (Name and title of corporate Builder's License No ........................... Plumber's License No ......................... Electrician's License No ....................... Other Trade's License No ...................... 1. Location of land on which proposed work will be done: ' · ·. · ~t cO.O. '. House Number ' '1 Street ~" ~ ................................ Hamlet · Block Lo~ Subdjvisio~ ..................................... ~iled Map No. Lo~ (Name) ..................... - S1*~e existing use and oooupanoy of pr~mises aqd in t~nded us~ ~( occupancy o~ propqsed construction' ..... .... ......... Swimrain=~terati°n--"~'"'~- ' ,/2"~'Ml~'" ) 5/' 3. Nature of work (check which appl!cable): New Building .......... Addltlo · Repot ....... Rbmoval ............ Demolition .............. pool.~.g... Zennls Court ......... accessory Buildlng.~,C~Y~.. Vence ....... Other Work.~ ..... 4 Estimated Cost ~ (~'I~ Fee .............. '' ' (to be paid on filing this application) 5, If dwelling, number of dwelling u~its ............... Number of dwelling units on each floor ........... Ir garage number of cars ~ ..... 6. If business, commercial or mixed ¢ccupancy, specify nature and extent or each type of uso .. ..... ~ ·., ......... {if any: Front Rear ~ 7 Dimensions of existing st~ctures · · ' ...... wit ' ............ '" ~ ' ':~ t ............ Depth ..................... ~. HeiSt .................... :. Number of Stohes .... '''.. ' ' 8 Dimensions of entire new construction: Front Rear Depth ... Height ~umb~r of Stories ' - .... 9. Size of lot: Front ............ _-_~- ~ ~-~ .......... Rear ..... ................. DeR[h .~,,...~..., ............ 1 I. Zone or use dmtnct ~n which premises are mtuated .... ~~ ...... ~ ....... ~ .................. 12. Does proposed construction violate any zoning taw, ordinance or regulation: ~; ?~. ;"...- .~'~* .............. ~- · ~ '~ 13. W~I lot be regraded . ' ........ .~; ~._..i, ......... ~... Will excess fill be~ ,~..,~remove~ from ~remiseS:No. ~ P.~Y~s~.~ ~.{2~' .., ~ .~ 14. N~e of Owner of premises ~m Address ~g ~'~//~.~}h~t,ghone N~e of Architect ....... ~...~ ................ Address ............. ~. ~..t. ~hone No .................. Nme o~ Contractor .......... ...............' .Address ............ ; ...... . ~Ph°ne.~, ~N° ..... ~'.....~/ .... 15.I~ th~s propert7 !ocat~ed within 100 fe~t of a tidal wetl,,n ..... S .... NO..~ · If yes, Southold Town]Trustees Permit may be required. ~ PLOT DIAG~M Locate ele~ly ~d dist~ctly fll buHdMgs, whether existing or proposed, ~d. indieate M1 set-back d~ensions from prope~y Hnes. Giw street ~d block ~umber or desc~ption aecord~g to deed, ~d show street n~es and ~dieat~ whether interior or corner lot. "IMMEDIATELY" ENCLOSE POOL TO CODE~.~ UPON COMPLETION BEFORE"WATER" STATE OF NEW YORK, COUNTY OF ................. "IMMEDIATELY" ENCLOSE POOL TO CODa BEFORE *'WATER" ' being duly sxvorn deposes and says that he is the applicant (Name of individual signing contract) above nam'~d. He is the i ' ' ] (Contractor, agent, corporate officer, etc.) of said 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 contfiined in this application are true to the best of his knowledge and belief; and that the Work will be performed in the manne'r~ set forth in thc application filed therewith. Sworn to before me this i ' ' ~ day Oi ~ .~...<~ 19 .~. Notary Public, NOTARY PUI~LIC, State et New york Ne, 4707~BT'& Su~tk C~unfLl~ , Term Expires Mereh (Signature of applicant) /r ? '0 0