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HomeMy WebLinkAbout18373-z 3 FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No Z-19159 Date JUNE 20, 1990 THIS CERTIFIES that the building ACCESSORY Location of Property 2530 OLD COVE ROAD CUTCHOGUE N.Y~ House No. Street Hamlet County Tax Map No. 1000 Section 111 Block OS Lot 03 Subdivision Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated AUGUST 3, 1989 pursuant to which Building Permit No. 18373-Z dated AUGUST 11, 1989 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 ACCESSORY INGROUND SWIMMING POOL & FENCE AS APPLIED FOR. The certificate is issued to WILLIAM & ADELE MOLLER (owners) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A UNDERWRITERS CERTIFICATE N0. N-100693 - NOVEMBER 2, 19$9 PLUMBERS CERTIFICATION DATED N/A Building Inspector Rev. 1/81 l08~i NO. D TOWN OF SOUTNOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N. Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) N 1, ~3 3 7 3 Z Date .......~~....LL 19.~.l. Permission is hereby granted to: QQ s~R~:~:.....a? a c~.:..~;~;uo..4;tn.~ . ...~1.da..... ~ y~ .......................o.:,~..,..lu.:~.:....~ ~ , to .~•1~..!.T1.-M. 1.~:!3:f.~.....4k».....f~ . ....~.~..~.~..~...-sr!.>:f..r.....Sh.~~.....R~l~r..~:-t.>!... JJat premises located at .aS a~.....~a....1.~':"?..1.1W............~, .s~i~A.-.~!~4R~ County Tax Map No. 1000 Sectio Block ......Q..~~....... Lot No...Q..~~i pursuant to application doted 19..9., and approved by the Building Inspectar. Fee S..L.~e~.:.~... . Bu ding Inspector Rev. 6/30/80 l • 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 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 a 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 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. 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 C~tificate of Occupancy - Residen/ti~al $15.00, Commercial $15.00 Date ,Y,~~?~~-~~• . New Construction......... Old Or Pre-existing Building. Location of Property...~.~.~C~..........Y~~~~/•Ut1l~..,l~~~......4.-VC~I••`'',~Q,C-•~•C~~.. House No. Street Hamld~ ~ • Onwer or Owners of Property,.~~j//~,,,~~f„ _ • / /'P County Tax Map No 1000, Secti.on....~~,1.,,,,,,B1ock...~.....,.,Lot.: • Subdivision ...Filed Ma .a „Lat. ~7 p........ Permit No.~ ~ ~,7,~,,,,,,,Date Of Permit. ~ „ ~ . /.....Applicant ;~s42r~ . Health Dept. Approval ........Underwriters Approval Planning Board Approval „ , Request for: Temporary Certificate........... Final Certicate........... Fee Submitted: $ „p,`5,,,,,,,,,,,,, /'s r~-~_ - - ~.3qg a~ APPLICANT ~ THE NEW YORK BOARD OF FIRE UNDERWRITERS PaGE 1000965 BUREAU OF ELECTRICITY _ BS JOHN STREET. NEW YORK. NEW YORK 10038 Dare NOVEPIB:R 07.,1989 gpplicatianNo.unfile 65728189/89 N 100693 THIS CERTIFIES THAT only the electrical equipment as described below and introdnced by the applicant homed on the a(wve application number in the premiaea of 2~OLLER, 2530 VAI'dSTON Rll., CUTCHOGUE, N.Y. in lhefollowing location; ? Basement ? /st Ff. ? 2nd FL CiAR/OUT .Serlion Block Lot uns examined un OCTOBER 20,1989 andfound to be in cornplianre with the reryuirenten FS ~(this /loard. iIXTURE ECEPTAClES SWITCHES FIXTURES RANGES COOKING DECKS OVENS DISH WASHERS EXHAUST FANS OUTLETS INCANGEJCENi FLUORESCENT OTHEfl AMi. K W. AMT, N. W AMi. KW AMi. K.W AMi H.P 2 1 l 2 DRYERS FURNACE MOTORS FUTURE APPLIANCE FEEDERS SPECIAL REC'PT TIME CLOCKS RELL UNIT HEATERS MULTI-OUTLET DIMMERS AMi. K. W Oll N. P. Gqa H. P. PMT. NO. A. W G AMT. AMp. AMi gMpJ. TRANS. AMT. N. P. SYSTEMS AMi WATiS NO.OF FEET 1 20 1 r;0 SERVICE DISCONNECT NO.OF S E R V 1 C ~ E AMi. AMP. TYPE METER NO OF CG COND. q W p - ~ q W G~ C,OUIP• ,9' ]W 1 R JW 3,e 3w 3,e" 4W PER .a' OF CC. LONG NO OF HI-LEG OF H LEG NO OF NEUTRALS ~ OF NEUTRAL OTHER APPARATUS: PANELBOARDS:1-2 CIR. 60 G.r.C.I:-1 *(STdIMMING POOL) This certificate covers compliance at the date of inspection only. Because of unusual environments it i.s advisable to have frequent test and/or repairs made by a qualified person. L~~~E~~-J - G!~%~~'~ JAMES T. RTDGE & SOP75 INC LIC.#1895E 39A DOYLE CT RAl MANAGER E. NORTHPORT NY, 11731 " Pe "I This certificate must not be altered in any manner; return To the office of the Board if intorrecf. Inspectors may b identified by their credentials. j rss-1802 BUILDING DEPT. INSPECTION [ )FOUNDATION 1ST ( } ROUGH PLBG. [ ]FOUNDATION 2ND [)INSULATION [)FRAMING FINAL REMARKS: ~ ~ DATE ~ INSPECTOR i~ I~LD i:..C.. G .11:: I~:in.[. I~ i.v:YM(:NY~ __Il _ y .J cOUNDAT20;J~ (1st) I H ~ ?OUtJDATIOJJ ( 2nd ) - - I zo ~ ROUGH FRAME & ~ h a 0 PLUMJ3INc Q n. 3. y m INSULATIOtI PER N. Y. _ y STATE EPJERGY CODE -r-- 4 . _ ._J y FIiJAL I ` .T • . / ~3 . AD TIOtlAL COMMEPJTS: x Q - 3 ra ' x ro~ r /-i _ p H ~ H O m - ~ H • O m -o H ~Z1 iI u _ ~1 1 ~~rr V . a ~ ~ ~ i~~ u~ •Io . Ufa ~ ~ ~ a. ~ ~~I~' CIS, s~~ ~__ir ~ fl ~r?`O• rt ,C ~ ~ ~ ~ :C ~ ~1'll i ~ ~ ~ J ~ d ~ ~ 1nl~y1' o ~ M ~ 1 ~~~3~~~a~~~~~ ~~x~~~ b~`i~ tie S + / t0 j r ~ , ~ d ~ I r t~ • ~ 'r. ~ ~ '11 ~ ~U6 - 3 1989 ~ v ` , ~ f+ • , ~ A~ a ~i ' y ` 3~lfiiN t7K svuTH~o7 S y }g~ ~7. 0~ e~• 2 Q7 ~11 ~ ~ ~ ~ ,g a• Q u t7 u I ~ ~ I n. ~ b- ~ ~~a uz x ^t ~~S , U 1 ? •ti ~ ~ U ~ . 1 ~ T• 1. V 3. Wj~ • ~ , , ~ • ~ r . • ;N • a~ii ~ ' . .,..t N N ~ ~ 10 . ~ l~j~ t ~ ~Y { ~ ' ~ ~ ? r ~ o i 9. .~S ~ i ~ b ~ ! ~ v. ~ r ~ ~ P ~ ~ i l) v ~ ~ ' 1? is ' .r 11 ~ nr ~ C ~ fr ~ N . r ~ (pl ~ - tv { ~ rt; ,~f rt• 'z,. f, into LLL ~ ,r - T,., ~ • ~ ~'~,i 8 61 £ _ ~ s ~ B end ~ ~ ~ ~ ~ 's ~ ' ' X211 ~9 p ~ j• ~3 ~ (N~ ~ N -l.q, s SF { i! i N , V . ~i . , N.r 3 ' ,g tl~ S`, Vii. C~ ~ ~ i~ ~ ~ Q ~ "fi G / ; THE NEW YORK BOARD OF FIRE UNDERWRITERS PAGE 1000965 BUREAU OF ELECTRICITY 85 JOHN STREET. NEW YORK, NEW YORK 10038 page NOVEPSB',z.R 02,1989 Application No. an Jile 65728189/89 N 100693 THIS CERTIFIES THAT only the dectrkd equipment w described 6eloYa and introduced by the applicant named on the oboes application number in the premises of HOLLER, 2530 VANSTON RD., CUTCHOGUE, N.Y. in tkefdloarnp location; ? Bmement ? rst Fl. ? 2nd F1, GAR/OUT Section Bloek Wt um eaomined an OCTOBER 20,1989 andfoundta be in compliance with the requirements uJ this Huard. RXTURE RXTURES RANGES COOKING DECKS OVENS qSN WASNlRS EXNAUST FANS OUTIRTS ECNTACDiS SWITCHES INCANDESCENT FLUORESCENT OTHER AMT. K. W. AMT. K. W. AMT. K.W. AMT. K. W. AMi. M. P. 2 1l 2 DRYERS FURNACE MOTORS RITURE APRUANCE RIDERS SROAL REC?T TIME CLOCKS Yll UNIT NEATElS MtHi40UilR gMMERS AMT. K. W. dl K P. GAS N. P. AMT. NO. A. w. c. AMT. AMP. AMT. AMPS. iEANS. AMT. N. P. SYSTEMS AMT. WARS NO.OF RET 1 2U 1 4'0 5lRVICE DISCONN[CT NO.OF 5 E R V 1 C E AMT. AAN. TYPE EOU Y• 1 / TV 1 / ]W 3 / TY ] / AW NO, d CC. COND. A. W. G. NO, d HFU?G A, w. G. NO. d NEUUAlS A. W. G. PER / Of CC. COND. OP Nl1EG d NEUiMI OTNER AMARATUS: PANELBOARDS:1-2 CIR. 60 G.F.C.I:-1 *(SWIMMING POOL) This certificate covers compliance at the date of inspection only. Because of unusual environments it is advisable to Crave frequent test and/or repairs made ny a qualified person. JAMES T. RIDGE & SONS INC LIC.#1895E 39A DOYLE CT MANAGER E. NORTHPORT NY, 11731 Pr This certificate must not be ohered in any manner; return to the office of tM Board if incorrect. Inspectors may sntifisd by tMir cndenfials. New York State Department of Environmental Conservatio Building 40-SO/NY, Stony Brook, New York 11794 fl ~L-6L.- ~ ~ ~ry..~~ DATE: f% / ~ /A~ Ig 'iyt~yrr.G / 70'71 ,t„e.~,Gr.1 Re : /Cl "~(f ~ DEPr. 'i>~.~~~ N ORSOUTHOLp / / ~ / Commissioner 9 Dear ~ S ~ ` A review has been made of your proposal to• <:AJL~~~ck ~-2~e~t Based on the information you have submitted, the New York State Department of Environmental Conservation has determined that the parcel ~~project is: Greater than 300' from inventoried tidal wetlands. Landward of a substantial man-made structure greater than 100' in length which was constructed prior to 9/20/77. 1~ Landward of the 10' above mean sea level elevation contour n a gradua~ nay tural slope. {c.~~a2.2, q~c..rf~ ,4sa~-r--~cy ~-r~~Ya~n, ~'u .~L.e,.~ d' a~a p~/fg°. ~a Landward of the topog aphic crest of a bluff, cliff or dune which is greater than 10' in elevation above mean sea level. Therefore, no permit is required under the Tidal Wetlands Act (Article 25 of the Environmental Conservation Law). Please be advised, however, that no construction, sedimentation or disturbance of any kind may take place seaward of the 10' contour or topographic crest without a permit. It is your responsibility to ensure that all necessary precautions are taken to prevent any sedimentation or other alteration or disturbance to the ground surface or vegetation in this area as a result of your project. Such precautions may include providing adequate work area between the 10' contour or topographic crest and the project (i.e. a 15' to 20' wide construction area) or erection of a temporary fence, barrier, or hay bale berm. Please note that any additional work, or modification to the project as described, may require authorization by this Department. Please contact this office if such are contemplated. Please be further advised that this letter does not reliede you of the responsibility of obtaining any necessary permits or approvals from other agencies. Very truly yours, Deputy Regional Pe it Administrator 1~~~ THE STATE INSURANCE FUND 199 CHURCH STREET NEW YORK, N.Y. 10007 (212) 312-7616 CERTIFICATE OF WORKERS' COMPENSATION INSURANCE i' I, I , AUG - 3 ~ggg I~ ~ POLICY NUMBER SEABIRD SWIM ACCESSORIES CORP 700 JERICHO TURNPIKE 868 146-2 DATE .UNTINGTON NY 11743 jOW~N 0 SOU MOLp 5/01/69 CERTIFICATE NUMBER 322-120 PERIOD COVERED BY THIS CERTIFICATE 5/01/87 TO 5/01/90 POLICYHOLDER CERITFICATE HOLDER - ~ SEABIRD SWIM ACCESSORIES CORP TOWN OF SOUTHHAMPTON 1700 JERICHO TURNPIKE 116 HAMPTON ROAD HUNTINGTON NY 11743 SOUTHHAMPTON NY 11968 THIS ZS TO CERTIFY THAT THE POLICYHOLDER NAMED ABOVE IS INSURED WITH THE STATE INSURANCE FUND UNDER POLICY NO. 868 146-2 UNTIL 5/01/90 , COVERING THE ENTIRE OBLIGATION OF THIS POLICYHOLDER FOR WORKERS' COMPENSATION UNDER THE NEW YORK WORK- ERS' COMPENSATION LAW WITH RESPECT TO ALL OPERATIONS IN THE STATE OF NEW YORK. IF SAID POLICY IS CANCELLED, OR CHANGED PRIOR TO 5/01/90 IN SUCH MANNER AS TO AFFECT THIS CERTIFICATE, 30 DAYS WRITTEN NOTICE OF SUCH CANCELLATION WILL BE GIVEN TO THE CERTIFICATE HOLDER ABOVE. NOTICE BY REGULAR MAIL SO ADDRESSED SHALL BE SUFFICIENT COMPLIANCE WITH THIS PROVISION. THE STATE INSURANCE FUND HERBERT JACOBS r,uzv_c'futt, Irsul ~-IC.: rurlu ur~or. R~;dnl nrl~:.~ ~ ! K BOARD OF HEALTH 3 SETS OF PLANS FORM N0. 1 SURVEY ~ r~..... . TOWN OFSOUTHOLD CHECK .J~~1R~ BUILDING DEPARTMENT SEPTIC FoRPI TOWN HALL SOUTHOLD, N.Y. 11~J71 NOTIFY TEL.:765-1802 CALL Examin ..:~P„I,I, , 19`?,~g9, fA I L T 0 - . . Approve MeQ ..<<, . „ 19 P.1. Permit No. I- , Disapproved a/c ~ ~ ~ Il ~ L AU6 - 3 1989 C $J9 (Building Inspector) fsP.t~;; tstsa's. APPLICATION FOR BUILDING PERMIT Date 19 . INSTRUCTIONS a`. a. Tltis application must be completely filled in by typewriter or in ink and submitted to the Building Inspector, 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 parz of this appli- 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 permit shall be kept on the premises available for inspection throu¢hout 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 Re,ulations, for the construction of buildings, additions or alterations, or for removal or demolition, as heie~if escribed. The applicant agrees to comply with all applicable laws, ordinances, building code, ~ousing eo'de~ a ` re'ou1' io s~ and to admit authorized inspectors on premises and in building for necessary inspectipns.,-. 1 'r ~ (Signature of applicant, or na e, if a c' .pozauon) t i (Mailing address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. Name of owner of premises . , ~>.~~4.1.~,~. V`z'``~ - V,{., (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 . - Plumber's License No . . Electrician's License No. Other Ttade's License No . . a . I, Location of land on which proposed work will bed , , ( Il Rouse Number Street, A~ - ` . ~ ~,~h,;~.':~............ Hamlet County Tax hiap No. 1000 Section ~ Block t: } , , , , , , , , , , , , Lot , , , , , Subdivision Filed ~fap No. (Name) Lot............... State existing use and occupancy ofpremises and intended use and occupancy of proposed construction: a. Existing use and occupancy ....~:,,v;:.'y ~ . b. Intended use and occupancy ,t , , , . . , . • • . • • • • • • • . is _ 3. Nature of work (check which applicable): New I3uildinS • • • • Addition . Alteration Re air P Renjoval D•molition .Other 1Vork . ,5„1!r.. 7i^.,i At`;)l,t t°^~''ar•^~-~..~~.i.~i~4i t.l~, ..t'~•~,~''v",,.~~,~1l lt`•7,{ '~Jt~+T.~~.... (Dd5Cr1p40n) 4. Estimated Cost ~ •1#..~~ . i~'ee . 5. If dtvellin~ number of dwelling ~ (to be paid on filing this application) units , , , , , Number of dwelling units on each floor . If gara;c, number of cars • • ' • • • • ' • " " " 6. If business, commercial or mixed occupancy, specify n lure and extent of each type of use G; 7. Dimensions of existing structures, if any: Front ;y;, , , , , , Rcar . . Depth Height ...............NurnberofStorics...., Dimensions of same structure with alterations or additions: Front e'~.i~• ('t ; Rcar . Depth Height . .Number of $torics . 8, Dimensions of entire new construction: Front , . , , , , , , , Rcar ..:~t,,,J, Depth t.,~1 , ~ • Height .'?;°f;~t;-;~ t+`~a€~Y' Nw~t a of Stories 9. Size of lot: Front ( .:}1~~ Rear . . •t............ Depth 10. Date of Purchase t~ . : . . .Name of Former Owner , , 1 1. Zone or use district in which pr 12. Does proposed construction vtocmises are situated , , , , , , , , , , , , , , , , , , • , , , , • . ' late any zoning law, ordinance or regulation: 13. Hill lot be regraded K.`~ : . . . Nill excess fill be removed from r miles: Ye ~ ~o 14. Name of Owner of pre~ises 11, t, . ~ d'- ,c., p3•~ ,a\~:. atw... .Address ti:{.%., ~ v~G.~ tone a~ ~ ~ , Name of Archi[ectV-?. t~${Jnl ;~t`1t~1, , , , , , , , , , ,Address !0 t Ny~~~ ~~~,w.1~~':~ ~ •ss. ^i~~~' . o , No. Name of Contractor :-{5~~14t~, ,;a,~,,, ; s :~:1 Address t : j;,~.t;). C'..sd.~~.~,,c,,,~k'P'ho~tte lib°. " ~w: ,4~ .~j 15.Is this property located with in~00 feet o~ a tidal wetland? *YES~.~SNO~•~:k *If yes, Southold TowtF 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',number or description according to deed, and show street names and indicate whether interior or corner lot. t' j , ~I STATE OF NEN YORE, COUNTY OF,.. ,i.. , t##~/,,~S S t# • . • • k..t4~. being duly sworn, deposes and says that he is t}te applicant (Name of individual signing contract) about named. b , . fie is the . r k`'~: i~;? ` I (Contractor, agent, corppjate officer, etc.) 1f said owner or owners, and is duly) authorized to perform or )rave performed the said work and to make and file this application; that all statements contained in this application are true to the best of his knowledge and belief; and that the vork will be performed in the manner set Forth in the application filed therewith. "vom t, o bg;(ore me this ' i„.~.. .....day of 19 , votary Public~5.. ~rka'1,:~; i .~«9,.a...' .lam"`` ~ ~ ~ ,4;). County r~ P!otnry Public State ~F Nav~York ($ignatuIe Of applicant) No. 62.48611028 Clualitiod In SuNolk County Cnmmesston Exptrae March 30, 1k I i 0.n ice. R U ~ q ~ , ~ ` ~ Imo. ~~.'~\~i> ~(z>'~~. t1S. ~ t 4.. t~ ~ ~ F ~ 6 .c i i C . ~ ~ ~ ~ ob 1 ter. ~ ' I1S \ 7, ' f~ 0~ \ ! W T 2 v P 1 _ ~ ~ 2 .IA ~ ~ ~ 1 r.~ ~ I u~• `•1 . t i~ i % In ~r4 ~r" ht 1~1 ' ' ~L~i. I~~ZO"~ ~o ~ ~ q. ,S, s ~ t ~ ; 4 @`f ) f j ~ ~ ~ ~ fl ~ t(t ~ ?a. ir', ~ ~I ~ ~ ~ i 0~?Q ' f I spa ~ k a ~0 ~ Op »3 ~ SUS o n ~ a 'tV { G nr ~...,:,.'a..~ C 2 n a.8 m 3 i i p w t~:tcMO A m C~`a orq x.» 8~~ ~4,~ r t T+_ O ~ .1> pig ~ n c r ]IIf t n a i' ~ ~ ~I~ IW x n s , . ~ I~~ ~