HomeMy WebLinkAbout18083-z FORM N0. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Office of the Building Inspector
Town Hall
Southold, N.Y.
CERTIFICATE OF OCCUPANCY
No 218649 Date DEC. 18, 1989
THIS CERTIFIES that the building INGROUND POOL
Location of Properly 54375 MAIN ROAD CUTCHOGCTE
House No. Street Hamlet
County Tax Map No. 1000 Section 102 Block 02 Lot 18
Subdivision Filed Map No. Lot No.
conforms substantially to the Application for Building Permit heretofore
filed in this office dated APRIL 27, 1989 pursuant to which
Building Permit No. 180832 dated APRIL 28, 1989
was issued, and conforms to all of the requirements of the applicable
provisions of the Iaw. The occupancy for which this certificate is
issued 15 INGROUND POOL AND FENCE.
The certificate is issued to ESMOND & LILLTAN HAMID
(owner, xxxxxxxxxxxxxxxx~
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A
UNDERWRITERS CERTIFICATE N0. N089093 AUG. 10, 1989
PLUMBERS CERTIFICATION DATED N/A
uilding Inspector
Rev. 1/81
r~os~s xo. s
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN HALL
SOUTHOLD, N. Y.
6UILDING PERMIT
(THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL
COMPLETION OF THE WORK AUTHORIZED)
N 8 0 8 3 Z Date 19.8.8
Permission is hereby granted to:
r0 ...4,r!:?:4:!"~:^^.:!r~..... ..C?-n...h~:~:~cQ:.. ~~..~:...4T.rti!nCC:.... °!'?....q,/~,/,~.)LCA;:G~
at premises located at ..5..`~.~.~.a~
..............[.sl.~'^~t.. ~ :...........~.Std.Sir!T!~!.:4~r.:-..................
. . . . .
........................................ll.................................
. ...s.....
~.Sr.
y!-°.:~ d-.....fa~ 4~... h:1..:.!~ :
.
County Tox Map No 1000 Section Block Lot No.. 1.
pursuant to opplicat~on dated ~y1:Gfe4:tJ: 19.A. and approved by the
Building Inspector. Y
Fee S.L.'~.~.:
.4r' .d'.'L.
Building inspector
Rev 6/30/80
TOWN OF SOUTHOLU
EUILDING DEPARTt[L:NT
TOW N HALL r
SOUTIIOLD, NEW YOi1K 11971
765 - 1802 i;'
DEC 1 ~ ty8g
4 .
APPLICATION FOR CERTIFICATE OF OCCUPANCY TO~,~, «c',',•
D E . ~O? . /.Z..~
NEW CONSTRUCTION .......OLD OR PRE-E%ISTING BUILD I,N~,Ggp~` ._VACANT LAND.....__.
Location of Property ....................„~~~ri~-r+'+r'===-/-------•--...._.._..
HOUSE NO~c /ST~R~C~E~T~ ,~~/J HAMLCT
Owner or Owners of Property.:-":'`i'..O.t~~-fc!?~_:'../.:~~~
County Taz Map No. 1000 Sectioa Block Lot
Subdivision Filed Map ........Lot.,
Permit No.~pv_~ ?!...Date of Permit ........._Applicant
Health Deng C. Approval Undcrvri[crs Approval.__...____....
PLanning Board Approval
RequesC for Temporary Gertifica[e Final Certificate
Fee Submitted: $.a~:Q~ ,
l
APPLICANT. _ .J `:~"^:~:C~7~Y}:. _ ,
3 ~ ~s"G
C Q z / k6
rev. 10/14/88
L
M FORM N0. 6
' ~ TOWN OF SOUTBOLD
BIIILDING DEPARTMENT
TOWN AALL
765 - 1802
APPLIGATION FOR CERTIFICATE OF OCCUPANCY INSTRUCTIONS
A. This application must be filed in typewriter OR ink and submitted to the Building
Inspector with the following; for new buildings or new use:
I. Final survey of property with accurate location of all buildings, property lines,
streets, and unusual natural or topographic features.
2. Final approval of 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 solder used in system contains less
than 2/10 of ix lead.
5. Commercial buildings, industrial buildings, multiple residences and similar
buildings and installations, a certificate of code compliance from the Architect
or Engineer responsible for the building.
6. Submit Planning Board Approval of completed site plan requirements.
B_ For existing buildings ~Prl.Or to April 9, 1957 non-conforming uses, or buildings
and "pre-existing" land uses:
I. Accurate survey of property showing all property lines, streets, buildings and
unusual natural or topographic features.
2. A properly completed application, a consent to inspect signed by the applicant
and a certified abstract of title issued by a title company which shall
show single and separate ownership of the entire lot prior to April 4, ]957.
If a Certificate of Occupancy is denied, the Building Inspector shall state the
reasons therefor in writing Co the applicant.
3. Date of any housing code or safety inspection of buildings or premises, or other
pertinent information required to prepare a certificate_
C. For Vacant Land Certificate of Occupancy:
1_ An application for vacant land Certificate of Occupancy shall be submitted,
and a certified abstract of title issued by a title company showing single and
separate ownership of the entire lot prior to April 9, 1957 shall also accompany
the application. If a Certificate of Occupancy is denied, the Building Inspector
shall state the reasons therefor in writing to the applicant.
D_ FEES:
1. CERTIFICATE OF OCCUPANCY - New Dwelling $25.00, Additions to Dwelling $25.00,
Alteration to Dwelling $25.00, Swimming Pool, $25.00. Accessory building $25.00
Addition to Accessory buildings, $25.00 - Businesses $50.00.
2, Certificate of Occupancy on pre-existing dwelling - $100.00.
3. Copy of Certificate of Occupancy - $5.00 ' over 5 years - $10_00
4. Vacant Land Certificate of Occupancy - $20.00
5. Dpdated Certificate of Occupancy - $50.00
6. Temporary Certificate of Occupancy - $25.00 Residential
$50.00 Commercial
reo. t0/]4J88
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BOARD OF HEALTH
3 SETS OFiPLANS
FORM NO 1 SURVEY t/
TOWN OF SOUTHOLD CHECK • • ~ 8.`101.x-
BUILDING DEPARTMENT SEPTIC FORA
TOWN HALL NOTIFY
~OUTHOLD, N Y 11971
TEL.: 765-1802 CALL
MAIL T0. ~~cn.urw.~~~yq
Examined . , 194`1 _ ~l ~l t'kt`~SN lQarnv}"'Je
~ 1177:
Q,~Q i
Approved . U , 19'9 Permit No ~ 3 3~-~.
Disapproved a/c 2 7 i
' ~r
~ a.c d
FS~
(Build mg Inspector)
APPLICATION FOR BUILDING PERMIT '
Date ~~zy/........., 1`
INSTRUCTIONS
' a. This application must be completely filled in by typewriter or m ink and submitted to the Building Inspector, w
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 s.
or areas, and giving a detuled description of layout of property must be drawn on the diagram which is part of this .
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 p
shall be kept on the premises available for inspection throughout the work.
e. No building shall be occupied or used m whole or m pazt for any purpose whatever until a Certificate of Occur.
shall have been granted by the Bufldmg Inspector
APPLICATION IS HEREBY MADE to the Building Depaztment for the issuance of a Bwlding Permit pursuant t
Building Zone Ordinance of the Town of Southold, Suffolk County, New York, and other applicable Laws, Ordinan~
Regulations, for the construction of buildings, additions or alterations, or for removal or demolition, as herein desc.
The applicant agrees to comply with all applicable laws, ordinances, building code, housing code, and regulations, a.
admit authorized inspectors on premises and in building for necessary mspec(jhy~on,,~s~,
(Signature
o" f a~i~pl
c or n corporation;
Y?/ ,(~f 2Sf~ . ~Qo~ky ~vr~f dvr . ~/7
(Mailing address of applicant)
State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or bu
/717~Pr? ~ .
Name of owner of premises Esmar~G~ f~~/r/i~ /~.D' - . , - - . - - .
(as on the tax roll or latest deed)
If applicant is a corporation, signature of duly authorized offcer.
-
(Name and title of corporate officer)
ALL CONTRACTOR'S MUST BE UFFOLK COUNTY LICENSED
Builder's License No ~v.Q~' NL
Plumber's License No. N///~ -
EIectncian's License No ~ ~P ~5,
y~ ~
Other Trade's License No N~/! - .
1 Location of land on whuh proposed work will be done - .
5v~~5 /Yl~~~ ~d. CGf~hoyv~.
House Number Street Hamlet
County Tax hiap No 1000 Section ~OZ Block 2 Lot . .
Subdivision - Filed Map No Lot ' . . .
(Name)
2 State existing use and occupancy of premises andrinv~tended use aDnd occupancy of proposed constructon
a Existing use and occupancy ~ ~Q/~~~/~. ~\~f/~.~h~~ .L.J. ..,o.
b Intended use and occupancy 'Y3'Z- L /~9rGU~~ . ~F'vi~?/J1/,([~ /~07J~ 7 ~1(/7CF.,~.~G
3 Nature of work (check which applicable) New 13uilding Addition Alteration
Repazr Removal , . Demohuon Other Rork Sovmiss•~ Poq ~
(Desc pSion)
4 Esttmated Cost 'ji • .Fee .
` (to be paid on Ghng this application)
5. If dwelling, number of dwelling amts 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 Stones .
Dunensions of same s'[ructure with alterations or additions Front .Rear
Depth Hetght Number of Stones .
8 Dimensions of entire new construction• Front Rear . Depth .
Ha,oht ,Number ~f Stnnae r
9 Stze of lot Front X77 .`f Rear ..../.~Q V~.. Deptlt .z•~.3 :~P .
] 0 Date of Purchase Name of Former Owner . .
11 Zone or use distract m which premises are situated . .
12 Does proposed construction violate any 7omng law, ordinance or regulation ....N.V .
13 Will lot be regraded ~fs . Nill excess fill be removed fawn p,~mises•
14. Name of Owner of premises Esmend (/p~nia',/hD Address 5, y3~;i iJYoi{r, .P~. phone No. 73Y S G/J.
Name of Architect . N./ff , .Address . .Phone No.
.
Name of Contractor ~N,i!Y/..Fi~J .P°df . , .Address .y Qt .....Phone No ? ~y.-f1L!v . .
15. Is this property located within 300 feetyof a tgidal wetland? *Yes No
*If yes, Southold Town Trustees PermitPLO"1' DIAGIZAMed.
Locate clearly and distinctly all buildings, whether existing or proposed, and indicate all set-back dunensions fn
property lines. Give street and block number or descnphon according to deed, and show street names and indicate whet;
intenor or corner lot
STATE OF NE\V YORK, S S
COUNTY OF
~o~^C-C~.14~. being duly sworn, deposes and says that he is the apphc
~ (Name of individual signing contract)
above named
He is the ff 9~~~
(Contractor, agent, corporate officer, etc.)
of said owner or owners, and is duly authonzed to perform or have performed the said work and to make and file ~
application, that all statements contained in this application are true to the best of hzs knowledge and belief, and that
work will be performed in the manner set forth in the application filed therewith.
Sworn to before ni~evthis r~
GZ< ....d(na~y of ..//,~°!?l...... 14
Notary Public, J~ /1.C:. .County
ORCEN L Hi4GER `1
N to o,Siate ewyf ~`~~,,,,ly~p,U..V.~~
No 52-4526433 " " " ' ~ " " " " '
Qusbfied m Suffolk County (Signature of apphc;
Commisswn Expiresa~a$/9 /