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HomeMy WebLinkAbout18737-z 5 FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No Z-19010 Date MAY 1, 1990 THIS CERTIFIES that the building INGROUND SWIMMING POOL Location of Property 4120 BREAKWATER RD. MATTITUCK, N.Y. House No. Street Hamlet County Tax Map No. 1000 Section 099 Block 5 Lot 5 Subdivision Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated JANUARY 11, 1990 pursuant to which Building Permit No. 18737-Z dated JANUARY 11, 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 INDOOR SWIMMING POOL AS APPLIED FOR. The certificate is issued to GUSTAV BARTRA (owner) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL NIA UNDERWRITERS CERTIFICATE N0. N-123620-APRIL 12, 1990 PLUMBERS CERTIFICATION DATED N/A QO Bu' ding Inspector Rev. 1/81 roses xo. s TOWN 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) Na 8 7 3 7 2 Date 19.90 Permission is hereby gran/te/d to: to at premises located at ~.~l~G~ij.L...a.......................................................................... County Tax Map No. 1000 Section ..........~j~/...... Block Lot No.........~..... pursuant to application dated ................../...,,lJ?..........................., 19.`~.zJ., and approved by the Building Inspector. Fee $..1 uild Inspector Rev. 6/30/80 - ~ ~ V _ ~ _ _ y FOUtIDATIO.""! s t) • d C (n FOUtlDATI011 (2nd) - m~ 2. ~ o ROUCH FRkilE & ~PLUMI3ING ~S to H 3. m t~ IJISULATTOPI PER N. Y. y STATE EiJERGY ~ CODE ' ~ .7. i C~- ~e.~ ~ y 4. FI:JAL ADDITIOPIAL COMMENTS: x • ' ' m ~ x\ ~v H ~ ` 9 O ~ • m • ~ • H d m ~v H ~~rr 4Ca ~ ~ "y Form No. 6 i ~ i,~.., TOWN OF SOUTHOLD ~ ~t BUILDING DEPARTMENT . MAY ~ ~ ~ TOWN HALL 765-1802 ~ _ r~~/,~ s~ P•: ~~rt d APPLICATION FOR CERTIFICATE OF OCCUPANCX 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 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. b. Submit Planning Board Approval of compieted Site piati 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. ~C. Fees 1. Certificate of Oc::~.;pancy - New daclling $25.00, P.dditior.s to dctel7.ing x25.00, 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 5. Temporary Certificate of Occupancy - Residential $15.00, Commercial $15.00 Date ~.Q ~ New Construction........... Old Or Pr/~e-existing Buildin~/g~.. ..~.....~.n.. T,ncn_*_ion of Property..~.~.~~.__..."N~:~'.4i. ~(A~7~~~~.f'SC~~. .f,c ~Lx~~~~.7zd4`.'k House No. Street Hamlet ~ / Onwer or Owners of Property. ~ 4~s.:(:~.V... r~.~"~1`.C,ii,. County Tax Map No 1000, Section..~:I..n~.......Block....:~ ..........Lot...-2~ Subdivision ....................................Filed Map..........~~.11.Lot...................... Permit No.~ g.~.7..3l~.....Date Of Permit. t.1.j.~~~~....Appl3.cant..S~.4G~~p../ ~~r`f:~;-.<~i-.... Health Dept. Approval ..........................Underwriters Approval ...~'f./1.~:~1y ~ Planning Board Approval Request for: Temporary Certificate........... Final Certicate..~....., Fee Submitted: $..~.`~.'.Q ~ Qom, ?,q,~ a` .........~`Q~:`.'r"~ ..~G~.~ APPLICANT C0~ ?q0)6 ~~2Y2A~~,t95ihvo~ce~~~ ~ 765-1802 ~.,J~~ ~ BUILDING DEPT. 'mss f" ~ ~ f NSPECTI®N [ ] UN TI i5T f ] O H P BC. []F DA ION2ND[]1 U ON []F M INA CACtz. REMARKS: ~'io u~ tat A~~~2~U.~„~r-i .-~f~ P~~~'~ Oo~~F io Cr~lut~usrt~t-~S• Atr~2~ ~ ~ mac. ~~-L uo Pr~@u,~ ~ ; , ~~739 0~t7i.t~ Dl~_Pt~JL u.c c i i~ydL t~~oU~itetls, co S To v ai- Y ~ w ~ ~xau,t ~a~c~ Poo _ ~o P~ lac ~ U9 ~+u ut Poo C~ - ~ , ~ ~ ~~1~~~ M~°~'~S P~~~~ s%; r~7.~ ~ ~ /~f , DATE ~2 ~O INSPECTOR !4l~ii , l ~7~ ~ i80Z ILDING DEPT. INSPECTION [ ]FOUNDATION 1ST ( ] ROUGH PLBG. [ ]FOUNDATION 2ND [ ]INSULATION [ ]FRAMING [ ]FINAL REMARK5: ~O ~L~`~-~s DATE C~ INSPECTOR \ M i.. ~'1z'•rn7:;; , TEi. 7C5-1 F,01. ~~~EF()lkC^ , 7~o~~rN or' SoUTUO~,~ . 'l; . fit}~f'~?~f ~~~4 7~ !°ry1~4~:1Ttia(+s _t t OrI 1Ct:01~ I3UILlliNG ItdSPfCTOR v . 5~~;~r~,a t P.o. uax 7~s tti er ~ ~ 1'OlV1J HALL t',~ .a',,^vs~,c1; SOLII'ilOl.I), N.Y. 11971 C r'r .April 30, 1990 GIISTAV BARTRA 4120 BREAKWATER RI). MATTITIICR, N.Y- ]1952 To 47hcm This May Concern, ~ Vic nre unable r_o complete your Certificate of Occupancy becau;c of the following reasons. An a?plication for Certificate of Occunancy ~is not nn file. ENCLOSED) /,~///ao llndr_r•;~ritcrs Certificate on file. /t!/ '1't:c check is(c~~t~CL~not on file.) $25-00 I:o ttc~alth Dept. Approval on file. ?:o final inspection has been made. P]ear;e contact our office on this matter. Thank you foz youz cooperation. c~uildinr, Permit (1 1 8 7 3 7 2 Buildin~I Ucnl. ,t ~hk/'`/ fio plumber Solder Certificate on file. ( all permits involving plumbing being .is:n:ed after April I,19II4 ) . ~ } .i i y / 1 y , VVV 6 4T>+ ~ 4 i ~ ~ 1 L ~ k, ~ / ( `f ~ t i~ S j ~ ~ ~ ~ ~ 3 ~ ~ ~ Q- ~ _ "^~ti~ _ _ r l ~ B0,\FD OF HEALTH 3 SETS OF PLANS FORM NO. 1 SURVEY . . TOWN OF SOUTHOLD CHECK li~.`~b.`~ . BUILDING DEPARTMENT SEPTIC FORrt TOWN HALL $OUTHOLD,N.Y.11~J71 NOTIFY; TEL.:7G5.1802 CALL p PfAIL T0: APprovcd ...~.,1.~~......., 19,l.~Pennit No. l ~ . Disapproved a/c (Boil ing In ector) APPLICATION FOR BUILDING PERPi11T Date ~ 15 ~ j) INSTRUCTIONS ~ - a. Tltis application must be completely filled in by typewriter or in ink and submitted to the Building Inspector, 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 premises or public streets or areas, and giving a detailed description of layout of property must be drawn on the diagram which is pan of this appli- cation. e. The work covered by this application may not be commenced before issuance of Building Permit. d. Upon approval of this application, the Buildin; 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 demotitian, as herein described. The applicant agrees to comply with all applicable laws, ordinances, building code, housin; code, and regulations, and to admit authorized inspectors on premises and in building for necessary inspectio ~r,~ cu ~e (Signatuure f applicant, or nna nme, if a corporatton) ~p (Mailing address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. S~~'!yti~'~.~.'~.'ye.zmc~ 1.~:iJr~~-P~-~" Name of owner of premises ,~US~ 8~1...'~~ R._~?~~ . (as on the tax roll or latest deed) If applicant is a corporation, signature of duly authorized officer. (Name and title of corporate officer) Builder's License No. . ~~:'?':~:1 . ~~.5~`~`l" Plumber's License No. Electrician's License No. Outer Trade's License No. , 1. Locapti~on of land on which proposed work wi~llpbe done; ~~J~,-~],~~•^ House Number Street. Hamlet County Tax \lap No. 1000 Section • • • • • • . Block ........-r'........ Lot ~ • • Subdivision Filed A1ap Ho. Lot . •(Name) ' State existin^ use and occupancy ofpremises and intended use and occupancy of proposed construction: 0 a. Existinguscand occupancy b. Intended use and ....~~w;r;{~;? ::z ~ occupancy I'' • 3. Nature of work (check which appliFable): New Building Addition Alteration . Reparr Rpmova~ . Demolition , .....Swimming pool . Tennis Court Accessory Building..........Fence ..,,,,,Other Work............ 4. Estimated Cost . 25,~23r>. . Fee ~~~•.t~'"o,~.............. (to be paid on tiling this application) ' S, IC dwelling, number of dwelling unfits Number of dwelling units on each poor If garage,numbcrofcars • 6. If business, commercial or mixed occupancy, specify nature and extent of each type o(use . 7. Dimensions of existing structures, if any: Front , Rear Depth . . Height Number of Stories , . . Dimensions of same structure withi alterations or additions: Front Rear , . Depth . Height , Number of Stories . 8. Dimensions of entire new constntc~,tion: Front . . Rear ...............Depth . Height . Number of Stories , . 9. Size of tot: Front , ! , Rca.* . . Depth . . 't), I%ati' of Purchase . ............Name of Former Owner'~?!'~!!r~? :.~P?.~~--; . . p 't. :one or use district in which remises m~e situated . . . . 12. Does proposed construction violate any zoning law, ordinance or regulation : • , , , . ' 1 s. iVill lot be regraded .....Will excess fill be removed from; premises: Yes No . . I4. 'N.'rme of Owner of premises ~ y.v~!,~~, ?}~~#4- Address . f!?~ ~{~-;*~°~r~~. Phone No.~1.~:.~.'`-'~~~~.. , . Nance of Architect ! ,Address ~ .Phone No.. ? . . Name of Contractor ~j,l_r~;f?rc~J , ~?-~.n'."t".~.. Address .:~9!k'?-r!:CT~4!4.. Phone Noi~.~/.~'rii ~'E' 2''• 15,Is this property located within 100 feet of a tidal wetlagd? *Y);5....NO.... ~If yes, Southold Town!Trustees Permit may be required.' PLOT DIAGRAM Locate clearly and distinctly all buildings, whether existing or proposed, and, indicate all set-back dimensions from property lines. Give street and block nµmber or description according to deed, and show street names and indicate whether ~ interior or corner lot. ~ I i Ij STATE OF N S S COUNT OF~~ , .~~.C~~.V.~1.Y......~-t. . being duly sworn, deposes and says that 1te is the applicant (Name of individual sr;nin; contract) „ about named. (Contractor, agent, corporate officer, etc.) of said owner or owners, and is duly authorized to perform or have performed the sail work and to make and file this application; that ati statements contained in this application arc inre to the best of his ~nowledgc and belief; and that the work will be performed in dte manner set forth in the application tiled therewith. ' Sworn to bc(ore me this ; l._, Notary Public, ,Q.. `County r--- CLAIRE ~ye~............ Notary Public, State of ew York (Signature of applicant) Qoall?7ed in Suffook (;oun(y ~ Commission Expires O'ecember 19w 0 LL ONO w~~ ~ a' ~ I ~ ! 2on.l J 14' i l ~ 20 r' ATELY" - ie°r~~°E NATER" I " ~25A, 6 W6LDEft r r n X50• D. 4. 284 ayG 535 d 7'/zOP©SC1~ f1LTE2AT/pN ANTa OrVE' C,~/~ CtFILAL~~-S?O/2.AG°s~' /rUT~1T/pnJ ' SCALE ~~U..c /~-p rr APPROVED BY DRAWN BY e ~T~ B DATE g. 5, P~ REVISED , CTUS U1~tL'7~/Lf} 227', 82~`A,~Lr/~}'T~/L-• (S.• DRAWING NUMBER ~9 rMq'Tri ~ caF _ ~ _ _ _ _ _ _~.w _ ~ ~~r ~ ~ `r If 'I _ - _ - - / ut p/D~' iFS PC2 Hoag ~ O .--T EN OP , s~ irx/ STihJG kl'7cr/~ nJ ~nac~ ~dA ~ 5, n ~ ~ ,,_.S 4.. A C~~CUACY ®R l~S IS ULA°~FUL ~d~~! r r~~, I~OU~T~CERfi1F~CA~'E ,y.o., ' C~ CCU~ACY UPON CO i BEFORE 1d-_..... 13'_ 6k/STi~JGT 1 /Vl~JL7 kM/. ~ ` . - , y A PROVED AS NOTED ' ~ > n bATEay~~~-~=-9.RM /~73? ~ ~ tMMED1ATEL' ~ °O - ENCLOSE POOL TO COY ~ NOTIFY SIlILO! G QEPA ~ UPON COMPLETION 785-180 9 AM TO Q PM FQR THE BEFORE "WATER" FOLLOW NG tNSpECTIONS: FOR P,pURED CONCRETE ~d 2. ROWC?H -FRAMING & Pl[IMBING ~ ~ 3. INSULATION ~ ~ 4. FINA4 CONSTRUCTION MAST BE C(SMPLE7E FOR C.O. ~~~IRE~D tt~~T~ ALL CONSTRUCTION SHALL MEET - o = THE..REQUIREMENTS Of THE' N.Y. " ' STATE ~~ONSTRUCTiON ° ENERGY ~ COQES.~ NOT RESPONSi':;.E, FOR 4 n C?E:SIGNj OR CONSTRuCT10N ERRORS , 6 r. ~ p :1~ . . . i , ~ __.___.___.._~.___.__u__~