HomeMy WebLinkAbout18315-z FORM NO. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Office of the Building Inspector
Town Hall
Southold, N.Y.
CERTIFICATE OF OCCUPANCY
No 219803 Date MARCH 18, 1991
THIS CERTIFIES that the building POOL AND FENCE
Location of Property 1730 COUNTRY CLUB DR. CUTCHOGUE
House No. Street Hamlet
County Tax Map No. 1000 Section 109 Block 03 Lot 2.17
Subdivision COUNTRY CLUB ESTS Filed Map No. 6736 Lot No. I8
conforms substantially to the Application for Building Permit heretofore
filed in this office dated JULY 13, 1989 pursuant to which
Building Permit No. 183152 dated JULY 14, 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 INGROUND POOL AND FENCE AS APPLIED FOR.
The certificate is issued to TERRY & LAURA WOODHULL
(owners)
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N(A
UNDERWRITERS CERTIFICATE N0. N090198-SEPT. 5, 1989
PLUMBERS CERTIFICATION DATED NfA
Building Inspector
Rev. 1/81
rosai xo s
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)
N°- X8315 Z Date ...........~.~c,.kQa.~...1..`~ 19.g.~
Permission is hereby granted to: i
..1 T.... S. .
4.3'x .
at premises located of ..[..7a~!.......~•~:!~'S"'... `~-'~::':.~•~•+........1,.A+-3.~.f.KR~.....~
County Tox Map No. 1000 Section .....1..~.~........pp Block .......1,{.r~....... Lot No......a.:.t'.1......
pursuant to application doted ..L.3 19~~.., and approved by the
Building Inspector.
Fee g. ~..ti4„ k.:...
.
B 'ng.Inspector
Rev. 6/30/80
Form No. 6
TOWN OF SOUTHOLD ~ ~ i it ~,u.I ,i 9 i
BUILDING DEPARTMENT ~ ..I j;+
TOWN HALL ~ ~
76s-lsoz NOV I f990 ;!d
~E ~ ~.m~~~_.w ~na,,~~.~.1'.~~
st_C~,. tt~s>~. t
APPLICATION FOR CERTIPICATl:. OF OCCUPANCY 8 7{3it'J;+t DF 4;r,s "~`;}Cg'e K
4.r........ ..,e...-9.._U.... .r„,,.., ce~
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 ro erl com leted a lication and a consent to ins ect si ned b the a licant.
~ P P Y P PP P g Y PP
' If a Certificate of Occupancy is denied, the Building Inspector shall state the
reasons therefor in writing to the applicant.
Fees
1. Certificate of Occupancy - New dwelling $25.00, Additions to dwelling $25.00,
Alterations to dwelling $25.00, wimming pool $25.0 Accessory building $25.00,
Additions to accessory building $2s.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 $1/s.00, Commercial $15.00
Date ~U/l d``/.~
dew Construction.......... Old Or Pre-existing Building _
.ocation of Property....~.7;~C?........~QUAiT'R CLG/63.,/)~............ CulGI~OGUL-.....
House No. ~ Street / Hamlet
lnwer or Owners of Property.., le!":~'~:. ~duwcr.. ~+.~p~,c~Lv`~
:ounty Tax Map No 1000, Section..... Q.~....Block......~ ........Lot.... +~~p.~1.~...........
~ubdivision..~tL~~'):..~~(t G.../c'.$fi/.~:~~5......Filed Map.. ~ );3~D ...Lot.... J.4.....<..........
'ermit No..~.~.~.~~..~...Date Of Permit....7~1LJ......Applicant...lr.~.~~:~/Y. d-.s~4~~......
'.ealth Dept. Approval ..........................Underwriters Approval......../................
lanning Board Approval
equest for: Temporary Certificate........... Final Certicate...~.
i
ee Submitted: $.....41t~
L' 6 Z/JPO 3 • . • APPLICANT
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iELD i::S: ~ ~~i;;,:.. Ij ~O:KMENTC
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c0U17DATI0;! ~ (1st) F~
?OUI7DATI0;7 (2nd) _I _ F
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.',OUCH FRAME & q1
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PLUMBING
3. a
IIISULATI01! PER N. Y. y
STATE EPIERCY
CODE ~ n
FI;IAL L~ SS
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ADDITIOPIAL C MEP S: m
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THE NEW YORK BOARD OF FIRE UNDERWRITERS frta{,~,
Ytl(i .l '9, .1. BUREAU OF ELECTRICITY
85 JOHN STREET. NEW YORK, NEW YORK 70038
Date `)~~}'h'T:}I}'S+.k i7 T, ft)}i9 APPlication No. on file ~f~~~d'~`f~1 }V ~f~ft.t. `~i+'
THIS CERTIFIES THAT
only the electrical equipment as deacrihed below and introduced 6y the applicant named on Lhe shove application numher in the premises of
1"L:kI4V '~tTO{iDHt37,Lr ~"t`:;f} CO11T?TH~' CT„aJY T)R_, Y~~!Tf",Ef~7t,1,{1(:~r Yd.Y
in thefo/lowinq location; ? Basement ? Ist Fl. ? 2nd Fl. ~;iP .Sertion Block Lot
woo examined an Xl1f(>il i>T 7 r ~~'.')hl) arzdfound to 6e in contpfianre with the requirerneaLs v/this Board.
FIXTURE ECEPTACLES SWITCHES FIXTURES RANGES COOKING DECKS OVENS DISH WASHERS EXHAUST FANS
OUTLETS INC++ANeESCENT PWORERCENi OTHER AMT K W AMT. K W PMi KW. AMi. K W. AMi. H P
1.
DRYERS FURNACE MOTORS FUTURE APPLIANCE FEEDERS SPECIAL REC'PT TIME CLOCKS BELL UNIT HEATERS MULTI.OUTLET DIMMERS
AMi. K. W. Oll H. P GAS H. P. PMT. NO A. W. G. AMT PMP NAi. AMPS TRANS. AMT H P. SYSTEMS AMi. WATiE
NO.OF FEET
SERVICE DISCONNECT NO.OF S E R V 1 C E
AMi. AMP. TYPE EQU~V I.6' RW 1 ,a' 3W ],6' JW 3,a' 4W NO. OF C[ COND A. W G NO. OF MI-LEG A W G NO. OF NEUTAAlS A. W. G
PER .a' OF CC.COND. Of HbIEG OF NEVTRAI
O7NER APPARATUS:
x{5~1~~~F,iNti ASQL) ';°hj~ ttir{'$lT`~t'3}.&
COVG-'3: ft Ct5R1]I}'J. [hTbr~ 277 th.a Q9 iyk l;Q rjQ
LTi~Y~T~i'Y 119YA t,tCt.l~!'« ~L:L'9!°d {tH f7.L i7Di79tkp~
ettvi.roaim~ItS:a ii' a': aaiivis:~ttlcs tr+
h~tTr ~r.I'quenC r,vu•'t. arrC~l~,r x"npaJs-~
made: J7y s~. ga~7t~~i,l~ }TF~~>nn.
~1UDY P(,?f~71~i~f> L%G'.~`?.,tiQt~-~:
/
a'.,T LAN(F.
}5.'9'("PC'1'[f{;K, q}V ~ ~ j rt~lis GENERAL MANAGER
~
Per
This certificate must not be altered in any manner; return to the office of the Board if incorrect. Inspectors may be identified by their credentials.
COPY FOR BUILDING DEPARTMENT. THIS COPY OF CERTIFICATE MUST NOT BE ALTERED IN ANY MANNER.
~ ~ ~ 65-1802
ILDING DEPT.
INSPECTION
[ ]FOUNDATION i5T [ ] ROUGH PLBG.
[ ]FOUNDATION 2ND [ ]INSULATION
[ ]FRAMING [ FINAL p
REMARKS:
LG-~
DATE INSPECTOR
. o~pFFOIKCOG
VICTOR LESSARD ~O~' < Town Hall, s3095 Main Road
PRINCIPAL BUILDING INSPECTOR = z P.O. Box 1179
(s 15) 76s-ISO2 ~ ~ Southold, New York 11971
FAX(s 16) 765-1823 ~Q~~O ~ ~~0~
1
OFFICE OF BUILDING INSPECTOR ~ ~ ~ f ~ , r~
TOWN OF SOUTHOLD { r"p v. ' r'I
i i
~ Z' p
r ^ 11:)t~~
August 21, 1990
Terry Woodhull
1730 Country Club Dr.
Cutchogue, N.Y. 11935
Re: B.P. 183152 Inground pool & fence
Dear Mr. Woodhull:
I am writing to you regarding the above permit which has
expired.
You have not had an inspection and you have never filed for
a Certificate of Occupancy. Please call our office to set up an
inspection. If you pass the inspection please fill out the
enclosed application and return it to us along with your check
for $25.00. We have your underwriters certificate on file.
If you have any questions please call our office.
Thank you.
Yours truly,
~ pR
Secretary
~o5~EE0lKCOGy
VICTOR LESSARD ~O ` Town Hall, 53095 Main Road
PRINCIPAL BUILDING INSPECTOR = z P.O. Box 1179
(516) 765-? 802 ~ ~ Southold, New York 1 1971
FAX (516) 765-1823 yO7~~ ~~0~
7 1
OFFICE OF BUILDING INSPECTOR
TOWN OF 50UTI-TOLD
August 21, 1990
Terry Woodhull
1730 Country Club Dr.
Cutchogue, N.Y. 11935
Re: B.P. 183152 Inground pool & fence
Dear Mr. Woodhull:
I am writing to you regarding the above permit which has
expired.
You have not had an inspection and you have never filed for
a Certificate of Occupancy. Please call our office to set up an
inspection. If you pass the inspection please fill out the
enclosed application and return it to us along with your check
for $25.00. We have your underwriters certificate on file.
If you have any questions please call our office.
Thank you.
Yours truly,
Secretary
E0.\RD OF HE.\LTH
3 SETS OF PL.1NS
FORM NO. 1
SURVEY
TOWN OFSOUTHOLD CHECK
BUILDING DEPARTMENT SEPTIC FOR:f
TOWN HALL
SOUTHOLD, N.Y. 11~J71 NOTIFY
q TEL.:765-1II02 CALL
Examined . / 198.81. MAIL TO
\PProved ..~~J~-{/. I.7..., 19 B. !Permit No. I. ~ '
Disapproved a////c .
.
...•t s;.rl A,ti .
(Buy ing Inspector)
APPLICATION FOR BUILDING PERMIT 11~~
Date 15~/.
INSTRUCTIONS
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 part 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 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
Reculations, for the construction of buildings, additions or alterations, or for removal or demolition, as herein described.
The applicant acrees to comply with all applicable ]aws, ordinances, building code, housing code, and regulations, and to
admit authorized inspectors on premises and in building for,neces ~p J„~cllts.
4,. , ~~~~4 y. f Sc~~s . .
. (Si~~~uti•ite ot~applicant, or nart~~grporauon)
' .(Mailing addres~s~a ic8janf~r
g~ " .a,
State whether applicant is owner, lessee, agent, azchitect, engineer, general contractor, elec ~ ~itber.,or builder.
°.r •
. jg p~~t .
Name of owner of premises .........`7~rn:~ . tic............ .
(as on t deed)
~ 3~
[f app -cart i .a corporation, signature of dt~Ily authorized officer.
(Name aril title' of cotpo- ~ officer)
Builder's License
No.
Plumber's License No . .
Electrician's License No . .
Ot}rer Trade's License No . .
1. Location of land on which proposed work will be done. . S..~I~t;x1.'j7?J' ...~Lu:~, Anl v~' ~~~JfD~
.............1.7,0 ~`c~~,,~I-V.zy.....C~~rq Q~(~~.. C'urc~ .a~ u~'. ,
House Number Streeat. ~ Hamlet /
County Tax Map No. 1000 Section ......1.Q . Block , , , , , , , , , , Lot , /
Subdivision .Dar. „!722:7 C 4~iJ ~l~/~.~... Filed flap No. ~.~~~j..... Lot (.Q......:.
(Name) '
State existing use and occupancy of premises and intended use and occupancy of proposed construction:
a. Existing use and occupancy ~~~~~~~~7~ ~ _
.,,..::~.r,..
b. Intended use and occupancy ........Y~tr7.C ~L~'rl~~; , , ~ 1 , dt) L .?-n
~~1~.~~.~...:......
sGv/N+n~i.vG ?faac
p ' ( R` ~7pplicable): New Building , ~
• • Addition , . Alteration .
Ret air of work check w•hichmoval Demolition ,
• • . , Other Work D~.. ,
4, Estimated Cost ~lJ~~..~Q (Description)..
. Fee .
(to be paid on filing this application)
5 If aara,lennumber of carsvelling units . . . . Number of dwelling units on each floor , .
6. If business, commercial or mix~'ed occupancy, specify nature and extent of each type of use .
7. H`m~ Ysions of existing structures, if any: Front .Rcar , . , .
Nujnber of Stories . Depth .
Dimensions of same structure with alterations or additions: Front • • • • • • ' ' • ' ' ' ' ' ' ' '
Depth..,.... .Height. Rcar...
' ....Number of Stories .
8. Dimensions of entire new construction: Front .
Hcigltt , , , , , , , , Number of Stories , Rcar Depth , , , , , , . • , . • • .
9. Size of lot: Front Rear.........................................,.........
] 0. Date of Purchase , • ~ • • " " " " " " " • • • • • • • Depth
l 1. Zone or use district in which r • • ~ ' ' ' ' ' • • • • Name of Former Owner ,
P
p p emisesaresituated...... S
12. Does ro osed construction violate any zoning law, ordinance or regulation: • ~ ~ ~ • • • ~ • ' • ' '
ill lot be regraded ~~rr//,~b
p ~ • • • • • • • • • • • • • Will excess till be removed from premises: Yes
ame of Owner of remises . .
~1.~..l~Lr Gi•6Dp//.u:eL...Address .x~..%Z,~Q:~4k.~YPhoneNo
Name of Architect
Address ' ' '
Name of Contractor :
/•G, ~,y,y,-, , ,,~'bWt• • Address . ~~,Z ' ' ' • Phone No. Yip p •
IS.Is this property looted within~00 feet of a tida~tland?n*No..a~:/„O,;f,~p(Q~,.
*If yes, Southold 'Town Trustees Permit may be required. YES....NO.,~S1
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.
S~~ Sl>! f2 u
~ ~ ,
OCCUPANCY OR APPROVED A5 NOTED
USE IS !lNLAWFUL oarE~ ~ / e.p ayl
~'~__3~s'_~'
WITHOUT CERTIi1CATE FEE: 1ST . ,
OF ~MUpAN~ NOTIFY BUILDING DEPARTMENT AT
YV 7Fi5 t9f)2 A AM TO 4 PM FOR THE
~ fOt.LOWING INSPECTIONS. •
1. fiUUNDATION TWO REQUIREp
j 6OR POURED CONCRETE
2 ROUGIi FRAMING R PLUMBING
~N~~'~'EI,.'~' 3. INSULATION r
~ 4. FINgt - CONSTRUCTION MUST
UPON ~ 8E COMPLETE FOR C.O.
BEFW41t"Y1MfB1"' ~ ALL CONSTRUCTION SHALL MEET
TFIE REQUIREMENTS OF THE N.Y,
STAB CONSTRUCTION & ENERGY '
CODEZs„ NOT RESPON816LE FOR
DESIGN OR CONSTRUCTION ERRORB
STATE OF NEW ORIw
COUNTY OF . c.li , , , SiS I
i
bein dul
b•~~ ~ • • ~y'-/CL'Y' ' ' g y sworn, deposes and says that he is the a
(Name of individual signing contract) pplicant
above named.
He is the 1!!r~.
Contractor, agent, corporate officer, etc.) ' ' ' ' '
of said owner or owners, and is duly authorized to perform or have performed Cite said work and to make and file this
application; that all statements contairicd in this application arc true to the best of Itis knowledge and belief; and that the
work will be performed in the manner set fprth in the application filed thcrewitft.
Sworn to before me /this
Vote lie, , ,
• .County
Notary Public, ' ' ' • • • •
No. 6Z"81268 ~Suffolke~York
Term ~r (Sign of applicant)
ExplresOc~obar81,18r`.