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HomeMy WebLinkAbout18871-z FORM N0. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No 219815 Date MARCH 26, 1991 THIS CERTIFIES that the building INGROUND POOL Location of Property 480 GRISSOM LANE SOUTHOLD House No. Street Hamlet County Tax Map No. 1000 Section 78 Block O1 Lot 10.3 Subdivision Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated MARCH 6, 1990 pursuant to which Building Permit No. 188712 dated MARCH 14, 1990 was issued, and conforms to all of the requirements of the applicable provisions of the law. The occupancy for which this certificate is INGROUND POOL WITH FENCE AND DECK ADDITION issued is TO EXISTING ONE FAMILY DWELLING. The certificate is issued to ELSIE D. YOUNG (owner) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A UNDERWRITERS CERTIFICATE NO. N129318 MAY 17, 1990 PLOMBERS CERTIFICATION DATED N/A cam? Building Insp for Rev. 1/81 fOSM N0. f TOWN OP 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) 18~~~.. N a Z Date 19.94 Permission is hereby granted to: ~...~~..~.........?1. . .~~~:...~.........1....... at premises located at r.~.Q......~,,,i2r~?Y~A......~ .......................................................................pp.................................................................................... County Tax Map No. 1000 Section x.........~f...0........ Block .............~.....QLot No........lQir...:3.. pursuant to application dated ......5<.~~ 19.?...~, and approved by the Building Inspector. Fee ~ . ...........r...... B ding or Rev. 6/30/BO Form No. 6 rJ TOWN OF SOUTHOLD r fr I ~ ~.,i ..,i ~ BUILDING DEPARTMENT j!. (\~.~1 TOWN HALL 765-1802 ~ ~ ~ 6~ APPLICATION FOR CERTIFICATE OF OCCUPANCY F?E_DrT1;' ,i.;,_. _ 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 17 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: 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 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. Certificate of Occupancy on Pre-existing Euilding - $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 $(/'15. ~0~0y",~{{/C~~ommercital(5yy~$~/1!5.00 Date '.'1 ::1~.~ S • t J 1 . . New Construction..... /L~~. Old ~O`r'ppPTre-existing~~~~B~,u~~ilding.......... c~..... Location of Property......1~~ . l~l~±,S.SGI`1i~ L rll~'C . . . . ~wL~~O~~~, _ . _ , House No. Street Hamlet Onwer or Owners of Property.........~~5~ C „ Nc~,,,,,,,,,,,,,,,,,,,,,,,,,,,, AAppp~ ~ County Tax Map No 1000QQ, Section....J~/~.....Block...~.. .....Lot.....`.~f'.ti7........... Subdivision.. ~~~~"..y u~ ~ .Filed Map.~~ ~l..Lot...~.~.. Permit No. Date Of Permit. Applicant. / t. Health Dept. Approval ..........................Underwriters Approval..~i~ ~ µ~~~~1f~ Planning Board Approval Request for: Temporary Certificate........... Final Certicate..G::...... Fee Submitt~el~d~: ~[$..ca~~~.^ 3/~ /2 / 98! S~ APPLICANT U or1 lWx#T~ i~ CO~t'.~tt.vF.S -o ~tg-~jp 2NSF'~T1 H a ~ 3 ~ FOU;7DATI0;1 (1st) J- c FOU;IDATIO;I (2nd) o 2. h ROUGH FRAc1E & .PLUMBING ~ y c7 ,.3 3. 217SULATIO?] PER N. Y. STnTE ENERGY CODE nn~ k ~ ~ 1 ~ ~ ~ u C, o , F2:7AL r ~ O r y ` tl'. r ADDIT OPIAL CO;dMEplTS: Q ~ . !0 SO ~ - . . 5 saQ~ R ` F, 7 x • ~ c i i :Ci ~ ~ i;: ~~$~t ~ 765.1802 BUILDING DEPT. INSPECTION [ ]FOUNDATION iST f ] ROUGH PLBG. [ ]FOUNDATION 2ND [ ]INSULATION [ ]FRAMING [ FINAL Q(~ , REMARKS: D c ,_~.d1~ ~ Cr`~f' DATE~2~ INSPECTOR t S" S ~ l ~ 765-1802 BUILDING DEPT. INSPECTION [ ]FOUNDATION i5T [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ]/INSULATnION C 7 FRAMING [ Vj FINAL I" ©d C~ s_ REMARKS: ~ . C~ , ~ ~ u Z lJ < ~ !A- i IAA- ~ S i 13 ~ S ~ f% ~ ~7~1s ~.Y-~ ~ C b S ~ S ~ ?2 LO.CC't DATE ~l R C INSPECTOR J u2~~,,, , ~/i `1g~~t -9 ~ T6S-1802 BUILDING DEPT. 1 NSPECTIC?N [ ]FOUNDATION 1ST [ ] ROUGN PLBG. [ ]FOUNDATION 2ND [ ]INSULATION 7 [ ]FRAMING [ti]~FINAL ~G~% c'4~v`'`L' `"'r.,.,ru REMARKS: ~ ~ i~ ~ ~Y Rt 1 ~ DATE 3 6' ~_____INSPECTOR t` ,,1 ~•1,~~ .rl I~ - ~ - ~I)) ~ 1 .11 : f i. y' ~ ~ az 1, ~ ~ ~ p ar 117 p, t. «~11 li' if ~ a I - ~ ~ ~ ul ~ ~ t i h V ~ ~ I V 1• y 1 ~ ~ ~ ~ ~ Ypq~ 1 x_41" _ - ''~,~~r+.l'~.,~ ~°o-~PA~ l~~ll - 1 1. r a 1~ I['_ o~'P R _..117.: v, . ' VY 5V 1.: ll7 1 q ~ K " 1~ 4 Y. ) ~ 11 1 V . f 1 , tl. ~ r" ~ t• ~ t 1L 11 4 - k t1 ~ 1 ~ .II -1 1. ~l~ C J 3Y!?'k O~) 7 111 ~ ` ti~.. l ~ ~ /i I l1 1, 1~ ~ rr,` `mod<`L i 1 . ~ . 1 Y: l 1, .y1 i F { ~_l ~,1 1 ly ~ "Z 1} f ~ 1' 1 i 1 u 1 I l ~ - ~ ~ ~,I ~ ~ ~ l ~ ~ ~~7 V t\. . ~ , _ ,y 1 , II M 1' -7 ~ ~ 3 3 ~1 ~ ~ , ~ 1 ' 1 4. 1 1J`, 1. .1 l1 ,-,1 il',. 1 ~ ~ a, ' . ~i ~;1 ~ I'~• w ~ 1 _ .a; _ ni ~ r ` J r~ ? C THE NEW YORK BOARD OF FIRE UNDERWRITERS PAGE 1 7.0$5023 19UREAU OF ELECTRICITY = 85 JOHN STREET. NEW YORK, NEW YORK 10038 ~ Date NAY 17,1990 gpplicationNo.onfrle 68762590/90 N 17,93].8 - THIS CERTIFIES THAT ~ only tAe aMetrkxl puipment a. described 6slom and tneroduced by the appltcont named on [ke eboro appHcatioxs number in tks promises of YAUNG, N/S 480 GRIS?SON CANE, SOUTHOLD, N.Y. in tkefolloFatnp kreo NAryl 01 r'(Bosemen[ ? Is[FI. ? Ynd Fl. OUT Srrt7on Block Lot outs exgmined on T 9917 and found to 6e in complianre Fritk tke rryutrements of tkb Boord. RXiUp FU(TYRlS RANOlS tbORINa 0ECK5 OVRNf W NAUST FANS tlltTlETE At.7E5 SY/1iC11K INCANDESCENT F1U011ESCEM OTHER NAT. K. W. AMT. K. W. AMT. K.W. AMT. K. W. AMT. N. P. ~ 1 1 a 1 DRYMS RNNACE MOTORS FLTUEE At7UA1KE RtENRS SMOAI EEC'R TIME CIOCRf pA Wai IIEAHRf MWI40YtYT OUIEAERS - AMT. R. W. dl N. 1. CMS N. P. AMT. NO. A. W.O. AMT. AMI. AMT. AMPS. TEAMS.. AMT. M. P. ~E ~ ~t AMT. WATT] ~ 1 20 1 40 SRRVKi RISCONNECT sp.t]F S E R V 1 C G~ E AMT. AAV. TYPE ~ 1 / ]W 1 P ]w ] p 3w ] / ARV NO. pE~ COND. OF CC COND. NO. OP MNEO Oi~ W lLC NO. p NEVIRAlS. Of 1 EUfOMI OTNp AFME11iU5: *{SWINNING POOL) This certi.fi.cate - covera compliance at the date of inspection only. Because of unusual - eAViCOAmentS it iS adViseble tC have frequent test andlcr repairs wr made by a qualified person. HANK'S ELECTRIC LIC..j2675'B 121 SHEEP PASTtIRE RD _ SETAUKET, NY, 11733 O~ERAiREAElAOBR 11 Psr Tlris must not be oMerad in any monnsry Murn b.. the office of 1M Board iF incorrect, c IAeir crINEEliab,~~~ dr`' COPY FOR tlQLDIM6 DEPARTM!lIT. TMIf COPY OF CEItTIFIGA'TE MI`T MOT' M ANY MMM~R. BLDG, DEFT. TOWN ~F SOUTHOLD OCCUPANCY OR USE IS UNLAWFUL WITHOUT CERTIFICATE OF OCCUPANCY i ~ -~y ~ 9 a -c _o a,.~.~. ~ ~ , r ~ ~ r pr~~ ~ ~~o ~ ~ ~ ":°yor ~ ~ m ~ ~ r`1 ~ _ ~ ~~i L G ~ s M- z 3. m p'+aU 0 .~o~ r ~ a O rt ~ ~ t"' 'O d ? ~m m~ r ~ ~ L/~ ~;b ~ A I _ _ W ar. W ~ mpC ~ a W ~ N ~ r 1 - ~ W W a H r W 0. Ve ~r-, ~ a ~ OC I r CV ~ e Q A W O ~ , N ~ ~ r0 ~ : 'Yr ~ ~ N~ w Q oz Z W ~ ~ W a ~ & c.~ ~ a. , ~ ~ Z O G. ~ .ot ~-,ez U N~Zb ~ l~ p tJtW ~ ~ ~ WW LJ V ~ aN p! Zvi 4+ H N~ ~ V 'Y ~ W rr u ? W Z O ~ f ` i e ~ C) ~s Z~o8 cQ ~,N; ~ N, a W~ ' y °a r. ..1 ° r o~la w 3 W z Q~ ! _ ~ O W O J .U 4lW¢¢J J ° ~ W 'K NOOIB 313k1~N 00 J~+O Y Z ' ,9t ;8 i B 63S2Irt00 q ¢ m e > h ,Q ~WY 'f.. V , otJJO U . • ~j .`b ~ ~ i• ~N ~ ~r O i m o O + b CO ~ 9 " ~ q ~ Q N to N .~~3r ~p~ Wu,c~¢ 3dOlS O 3d- OAS ~O~w ~ ~t V OT ) o •o'£ W .N a a W ~ ~ w o ~ i9L• W 2 J ~ i O J _ _ x - Y f. Y ~ D _ S J N u ~ ,i, ~ C • v a, o W ~ a __l_~_ ~ Z Ju ~ I1- I--I_- S I ( I~ z b W ar ~ ty w O I( I ~8 SJ ~ ~ O t~ b b O ~ ~ ~ J + NF , Wcfi~ ~ z N$pO'p~ o'~•'~ ~ C b 4Y p' RU I W Oy m ~ 4 V- •q O~~ el r`1 I M ~ ~ ~r Co O O ~ ~ ~I f ~ ~ I N wa .N aw ~ V _ n i~ NN H 3G Q; d ~ N W ~ M r M m v1 N ~ •R _ _ _ nn~jf~~~~~ ° BOARD OF HEALTH • u`J \I R€ 3 SETS OF PLANS - ~~~f~ ~FORMN0.1 SllRVEY r ~ ~ & ~ i ~ ~4 TOWN OF SOUTHOLD CHECK - • • • • • • • - _'t .III BUILDING DEPARTMENT SEPTIC FORM TOWN HALL SOUTHOLD, N.Y. 11871 NOTIFY BLDG. DEFT. r,` n CALL TOWN Sna.n-F+ 7EL.: 765-1802 . MAIL T0: Examined 19 ~a Approved . 19 ~a. Permit No. ; ~~P~?>1~~ Disapproved a/c l a u' n Inspector "'IMMEDIATE~.Y" APPLICATION FOR BUILDING PERMIT ENCLOSE POOL TO COC1E UPON COMPLETION Date 19; BEFORE T" INSTRUCTIONS a. This application must be completely filled in by typewriter or in ink and submitted to the Building Inspector, wit 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 str._ or azeas, and giving a detailed description of layout of property must be drawn on the diagram which is part of this ap cation. c. 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 per shall be kept on the premises available for inspection throughout the work. e. No building shall be occupied or used in whole or in pazt for any purpose whatever until a Certificate of Occupy 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 Building Zone Ordinance of the Town of Southold, Suffolk County, New York, and other applicable Laws, Ordinance: Regulations, for the construction of buildings, additions or alterations, or for removal or demolition, as herein describ The applicant agrees to comply with all applicable laws, ordinances, building code, housing code, and regulations, and admit authorized inspectors on premises and in building for necessary inspec ' rr ,Ry nn ~®t~~~, OBE (Signature of applica , or name, i coRrporation)~ „ ~NC~N C~N,~ ET RN ....7,l~.Sil ..~}..Y. t Sv~~..~ UO.tJ~O,/L BEFORE ~ (Mailing address of applicant) ~f State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or~build oc~a-er...................................................... . Name of owner of premises ~5/:Pi . y~U1'~ .:..`/~1.1 ..l~Y.~('?. S.. S7.w. rt., ..~t:. s'J[l~tl~~..!J . ~ ~ (as on the tax roll or latest deed) If applicant is a corporation, signature of duly authorized officer. (Name and title of corporate officer) -ALL CONTRACTOR'S MUST BE UFFOLK COUNTY LICENSED Builder's License No. ....fpD.9.((f~//.~z . Plumber's License No. ......~!~f7 . Electrician's License No. ~ 7~.~...... . Other Trade's License No . . 1. Location of land on which proposed work will be done . . House Number Streetp~ ~ .Hamlet County Tax Map No. 1000 Section 7.4 Block ..........ryry.. Lot ~.Q:..3....... . Subdivision Filed Map No. ..~~y0...... Lot t.3.3. (Name) 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy ~P...-~.Q,eXI~ l . ~t?~.~'~~///>- . . . . . . . . . . b. Intended use and occupancy .....p~0:7F. y0.. • ~!7• ~ vt"7..Gy.. ~S„).CLI'~t :Y1,/.'~~?lI. . •~d,0 ` -y~~c..P ~ 7L0 cc n~..o ~ . 3. Nature of work (check which applicable): New Building Addition Alteration' . Repair Removal Demo itio .......Other Worko~C.f~.,t . 9L /r19icrl irl ~sc~~i~oytt J 4. Estimated Cost ~'a0134 Fee . ,~.SS~ ` (to be paid on filing this application) 5. If dwelling, number of dwelling units Number of dwelling units on each floor . If garage, number of cars . 6. If business, commercial or mixed occupancy, specify nature and extent of each type of use . 7. Dimensions of existing structures, if any: Front Rear Depth . Height ...............Number of Stories . Dimensions of same structure with alterations or additions: Front Rear . Depth ......................Height Number of Stories . 8. Dimensions of entire new construction: Front Rear Depth . Height ...............NumberofStories......................................................: 9. Size of lot:Front Rear...................... Depth 10. Date of Purchase .............................Name of Former Owner . 1 I. Zone or use district in which premises are situated . 12. Does proposed construction violate any zoning law, ordinance or regulation : . 13. Will lot be regraded ............................Will excess fill be removed from premises: Yes- . N 14. Name of Owner of premises ....................Address ...................Phone No...........:. ; Name of Architect ...........................Address ...................Phone No.............. , Name of Contractor ..........................Address ....:..............Phone No............. . 15. Is this property located within 300 feet~rof a tiidal wetland? *Yes No *If yes, Southold Town Trustees PermitPLO'I'DIAGKAMed. Locate clearly and distinctly all buildings, whether existing or proposed, and. indicate all set-back dimensions fro. property lines. Give street and block number or description according to deed, and show street names and indicate wheth• interior or corner lot. AP ~RQ~~ED AS NOT~p 7U DATE ~~L B.P. !1 FEE: ~ S BY: NOTIFY B IL ! G DEPART AT 766-18D2 9 AM TO 4 PM THE FOLLOWING INSPECTIONS: 1. FOUNDATION - TWO REQUIRED FOR POURED CONCRETE 2. ROUGhI -FRAMING & PLUMBING 3. INSULATION 4 FINAL - CONSTRUCTION MUST BE COMPLETE fOR C.O. ALL CONSTRUCTION SHALL MEET THE REQUIREMENTS OF THE N.Y. STATE CONSTRUCTION 5 ENERGY CODES. NOT RESPONSIBLE FOR DESyC;N OR CONSTRUCTION ERRORS STATE OF NEW Y S.S COUNTY OF ~ ~K-... . . 6.(1.C/. being duly sworn, deposes and says that he is the applica (Name of individual si ning conRract) above named. Fie is the ..................CJG{~~'e r (Contractor, agent, corporate officer, etc.) of said owner or owners, and is duly authorized to perform or have performed the said work and to make and file ti application; that all statements contained in this application are true to the best of his knowledge and belief; and that t work will be performed in the manner set forth in the application filed therewith. Sworn to before me this ' NOREEN L. HALER Notary Public, State of New York ........................day of . f'l.q 14 .9.b N~. sa•aezsass Qualified in Suffolk County - Notary Public, U'~~.~. County Commission Expires n 1~Y,1(J/ - 1 r~J Y \l~`.,Y`~,R'-J tgnature of applica! _ _ , - T: ~t .5 V ~ ..r , 4 ~ ~ ~ ~ ~'1 q., 5,. l ~ ~ ~ ~ 5 l 1 t., \ ~ r , ~ 7 p. ' . ~ \ 5 ,y' ~ ~ }C~ `1 v „y~. y n ~ t ~ ~ f ~ ~ ~ \ ^1 ~ o U ti t ~L r 11 _ t ~.~N~~ 4 r ~ ~ ~ \ _ v 1 ~ ~ ~v1 A ~ .F-, r,. r -d , \ ~ ~ r ~ ~ ~ 5t + `C> 1, ~r~~. '',t fy~ 'S, t ~ ~r-. ~ _ ~ _ 1,~,(r C ~ Q oa, ~ `z ~4 ~ Cl ~ v ..S 1~ ro ,u- (1 ~i~ R ;ice-~~~ u It'~ U., t. , , ' ~ in l,~ , 5, ~ } ' ` ,y t~;i o ; i~ ~ U U, 1~ S 5