HomeMy WebLinkAbout17275-z FORM N0. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Office of the Building Inspector
Town Ha11
Southold, N.Y.
CERTIFICATE OF OCCUPANCY
No 218728 Date JANUARY 19, 1990
THIS CERTIFIES that the building POOL AND FENCE
Location of Property 350 SALTAIRE WAY MATTITUCK
House No. Street Hamlet
County Sax Map No. 1000 Section 100 Block 001 Lot 038
Subdivision SALTAIRE ESTATES Filed Map No. 4682 Lot No. 35
conforms substantially to the Application for Building Permit heretofore
filed in this office dated JULY 22, 1988 pursuant to which
Building Permit No. 172752 dated JULY 28, 1988
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 POOL WITH FENCE ENCLOSURE.
The certificate is issued to JAMES & ELLEN LEMONDA
(owner, )
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A
UNDERWRITERS CERTIFICATE NO. N029501 AUGUST 23, 1985
PLUMBERS CERTIFICATION DATED N/A
0~.(,.
Bu' ng Inspector
Rev. 1/81
r~osas xo. a
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN HALL
SOUTHOLD, N. Y.
BUILDING PERMIT
(THIS PERMIT MU5T BE KEPT ON THE PREMISES UNTIL FULL
COMPLETION OF THE WORK AUTHORIZED)
N0 ~172~5 ~ Date ....t~`~..~ 19.l1.G~
Permission i~ereby grant o:~ ~ ~Q~
eoG~J /I~G. QG .PsQ~ ~L'~f~ ~-eiilL
to
®........CC......................:............................................................................
ct premises located at ...~.a~..^.........~.1.... ..(~-111.~...~.-
County Tox Map No. 1000 Section ......1~®......... Block ~ Lot No.......3.
pursuant to application dated ..............,7..:....~.~:......................, 19.Q~ and approved by the
Building Inspector.
Fee $../,.tea ...y.:,4^.
~
ildin for
Rev. 6/30/80
=1ELD "li:SPECiIU27 ~(llA_ TE~ i:OMMENT° ~
V
1. ~
~
. y
cOUNDATION (1st)
~O
FOUNDATIOtJ ( 2nd ) _ - ~ ty ~
2.
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0
ROUGH FRAME & Q0,~1
PLUMBING "a
y
H
3. x'
c~N -
~\\v~'
IIJSULATIOP! PER N. Y, y
STATE ENERGY `
CODE
x
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FIiJAL~ ~
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ADDITIONAL COMMENTS: x~
L.(~neQ.flllwAk.~,7L_~
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'~UCIV~~~~~ to
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TOS1N OP SOUTIIOLD ~
8~ BUILDI27G DEPART2IENT 3 S ~ ~oo-p~~ ~~/cu~
TOL7N DALL
TOWN OFSOUINOLD SOUTIIOLD, NEN YORK 11971 .
765 - lII02
,i
APPLICATION FOR CERTIFICATE OF OCCUPAt7CY p
' / ~J`._ DATE _ ~..`O : .
HEH CONSTRUCTION .......OLD OR PRE-E$ISTIttG BUZLDING......VACA2iT LAND....
Location of Propcrty..:~~ ,....:(~4~,1~~rl~,~1.CQ"lnj A i...._~~~~../„ is ~'`r.. .
llOUSE NO_ ~ STREET ~7?C:.4
UAMLET
Owner or Ovncrs of Propcrty.._..J~~C~, ~•~~~•_~j~~~r~j/, __.s__.
County Taz Hap No_ 1000 Section IIlock .PL.
Lot'
Subdivision..
Filed Map .._.....Lot_....._...
PcrmiC No. `7;b7f~",.,,Date of PcrmiC
.._...._._APPlicant
8ea1Ch Dept. Approval "
" Underwriters Approval..___•..
Planning Board Approval
Request for Temporary Certificate
Final Certificate
Pee Submitted: $,•,,,,-,_„_me
APPLICANT.. ~~-rC.YI-0~ ..~~.-e,~,YIC~:~ICI~
/n~ ~
ICec, 3 b'8 7 7
Ca zi~)~~
rey• 10/14/88
.
~4 ~w.O
' FORM N0. 6
TOWN OF SOUTIIOLD
BIIILDING DEPARTMENT
TOWN NALL
765 - 1802 •
APPLICATION FOR CERTIFICATE OF OCCUPANCY INSTRUCTIONS
A. 'Phis application must be' filed in typewriter OR ink and submitted to the Building
Inspector with the follokting; for new buildings 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 of IIealth Dept, of water supply and sewerage-disposal(S-9 form).
• 3. Approval of clectric~l installation from Board of Fire Underwriters.
~4. Sworn statement from ''plumber certifying that solder used in system contains less'
• than 2/10 of 1Z lead:
5. Commercial buildings; industrial buildings, multiple residences and similar,
buildings and installations, a certificate of code compliance from the Architect
or Engineer responsi4le far the building.
6. Submit Planning Board Approval of completed site plan requirements.
B. For eaisting buildings SPrior to April 9, 1957] non-conforming uses, or buildings
and "pre-existing" land ';uses:
1. Accurate survey of property showing all property lines, streets, buildings and
. unusual natural or tgpographic features.
2. A properly completed ',application, a consent to inspect signed by the applicant
and a certified abstXact of title issued by a title company which shall
show single and sepa;ate ownership of the entire lot prior to April 9, 1957.
If a Certificate of Occupancy is denied, the Building Inspector shall state the
reasons therefor in writing to the applicant.
3. Date of any housing ode or safety inspection of buildings or premises, or other
pertinent information required to prepare a certificate.
C. For Vacant Land Certificate of Occupancy:
1. Aa 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 o€~the entire lot prior to April 9, 1957 shall also accompany
the application. If'ia 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 Certific'a[c of Occupancy - $5.00 - over 5 years - $10.00 .
4. Vacant Land Certificate of Occupancy - $20.00
Dpdated Certific~aCe of Occupancy - $50.00
6. Temporary Certificate of Occupancy - $15.Q0 Residential
• Commercial
i
.P' ~
Y
• eo; 10 /h4 /58
i~ a~5~
THE NEW YORK BOARD OF FIRE UNDERWRITERS PAC>:; '
lpQ1.38t
BUREAU OF ELECTRICITY
SS JOHN STREET, NEW YORK, NgW YORK 10038
Attt=tJST ?.3,1.988 55793?.88!88 N t7?,9501
Dote App(icotion No. on file
THIS CERTIFIES THAT
only tAe electrteo/ equipment v dsecrihed beblo and tneneducd 6y .the oppNcent nomd on [he shove opplicetton numher in the premises of
JAMF,S J,EMnNDA, 350 SAi,TAIRE NAY, /Pti7,R A3, MATT"i'fUl:[C, N.Y.
otJ'r
in thefoBotrtnp kPCak~~Us,.~gor~e~t ? (Pe Fl. ? Ynd Fl. .Sertian Black Lot
uws e:emind on and found to 6e in cornplianrr uifh the reyuiremenM of this Board.
gXTUE! RXTURK NOES COOKRNi DICKS OVENS Dlfl1 WA lXNAUST FANS
OUTLETS @TACLES SWITClNS INUNDESCENT FIUGtE3CENT v AMT. K. W. AMT. K. W. AMt. K.W. AMi. K. W. AMi. H. P.
1 ? 7
DRYERS FURNAC! MOTORS tVTURE ANUANCE INDERS fMOAI RECIT TIME CIOCKS .RILL UNR NEATEK ANAT40UTIET DIMMERS
AMT. K. W. Oll N. P. GAS N. P. AMT. NO. A. W.O. AMi. NM. NAT. AMPS. TRANS. AMT. M. F. ~
«
~T NAT. WATn
I 30 1 4,Q -
SlRVtC! DISCONNECT tMD.Oe S E R V 1 C E -
AMT. NM. TYPE ~ 1 / tV/ I R SW S 13W 3 / AW NO. D~RCACOND. OF CC ~ OI,P. NO. OF M4lEG NO.OF NEUTtA15 OF 'P,lVTRAI t~
t•
OTMR AHARATUS:
c.F.c.x:-t
*(SIiTMMTNG P061,) '.Ihi.s certi.ficatE•
cnverq compliance at the date of
inr~pect~ion rlnly. Aeeatese of unueaal
environments i.i: i,s advisable to
have frequent tent/anti nr re~DaiTS =
made by a qual..fied pc~rsnn.
- ~
1i C~~ n ~
JL117Y PttM CId,O
PAT LANE;
MAT'ITTUCK, NY, 1.1.952 OPAL
1 t.
LLCENSF; Nf). 210(7 F; ptr ~ S
it nrtificale mutt not be altered in any manner; return to tM offin rd if incomcf. InapMOrt be idsnfifNd by their crsdsmiolt.
Cgl!Y FOR WILDING DEPAQTMWT, TENS COPY OF CERTMICATG IINIST NOT. iE ALTlREQ INANY MAt1NER. -
1~~~~
765-1802
BUILDING DEPT.
INSPECTION
[ ]FOUNDATION 1ST [ ) ROUGH PLBG.
[ ]FOUNDATION 2ND [)INSULATION
[ 7 FRAMING ( INAL
REMARKS: Q~ ~
.lr.~"'~"'"
~ ~
g
DATE 1 INSPECTOR
`
i,s L~.d1~ (yC rJl~f.'}p l.C j
` r~
N. ' 99 « Od + .SG7'" E: .2 CJ C
Q
~ ~,'~E, ~ ```''~E+lib~t~LQQy''.~~,.~i,' aya'. ~ ~Yx~n~c. ~ ~ ~.z^~.~
~ ~ tom r o ~
:6 ~„..~.,y.,,, r, }-fro, a .(1_ S~ "ii"
/ /
~.E ,
` g'~` ~ "IMMEDIATELY..
~ ~ ~ 9 ENCLOSE POOL TO CODE
j ~....__.:.._._~._.___UPON COMPLETION
BEFORE. "WATER"
~A v;~"G s7 E'S 7" ~G. ANe~" . c..~Ar'i/t~".
~
.a
„ :
,
r''}I'e""CX r
/t~e~c . ~.o~ nt.~yn~cr stirra~~: t°+c trrr ~~."14'l~p
o~ `~.Jb~`J'v,"w•'c~w Qf u`%~~r+re ~s~.-x~"cri~:; fir'/ec~
J'vr ~lic ,~rr¢'~Fn!k` ~OCr?T'~f G~o'r~c'.x ~?f'•~i~'t' ~,s
Millt~ Nunt6Gr''#58.~~
v
1
BOARD OF HEALTH
3 SETS OF PLANS
FORM NO. 1 SURVEY .
TOWN OFSOUTHOLD CHECx
BUILDING DEPARTMENT SEPTIC FORM
TOWN HALL NOTIFY
SOUTHOLD, N.Y. 11971 CALL
TEL.: 765-1802
MAIL UTO:
Examined 19~~ j ~r h ~/~~`P~'
Approved . 19~~ Permit No..... .D ~~"v
Disapproved a/c
..b...p
(Bur din Ins ector)
IjiMMEDiATELY~~ A PLICATION FOR BUILDING PERMIT ,
ENCLOSE POOL TO CODE Date ~ 19
UPON COMPLETION
BEFOflE "WATER" INSTRUCTIONS
~ a. This application must be completely filled in by typewriter or in ink and submitted to the Building Inspector, with 3
f ,
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
' Regulations, for the construction of buildings, additions or alterations, or for removal or demolition, as herein described.
The applicant agrees to comply with all applicable laws, ordinances, building code, housing code, and regulations, and to
admit authorized inspectors on premises and in building for necessary inspections.
f~(Signature of applicant, ory~ngame-~i^f~a corporatio)/n)
.1~t3....,,. 7
t&
tM~,ll1't~VdMi3t~ O~?~ .tits{a r • ~ ~ ' (Ivlaslirig addtess of aPPlicant) ~
1l:~•If ilt,1~ t/~ l~ OY 4;<<d t? t;3t3r
State whether applicat3YGRasG'90wrt@r,?glagsegrAger}t, azchitect, engineer, general contractor, electrician, plumber or builder.
r' 4 t sdt~' ~aea°,.,
s~~~~/`f-C/~
~tO? C3 t7~~.......... ~ . .
D1fiIEE&N1,PR1 #1 i!~@M R'I ~'t'#!'%)z?
Name of owner of premises . t ,w sT.. • ..~z. i~~.....~'~ ° .
T8'}11ts1 s+1C4P1 ;ttrt€'C%'~~~~~ ~ ~ a.. (as on the tax roll or latest deed)
(3,'1 f'?ti"1' ~r n
If applicant ~rsq~~r~~~~,~~pry~slpnatur-e of duly authorized officer.
Y~7N'3YP~" : N14)I s'S='~I`f F t%{•". a. r t` .
(fie ~~~4~~+~'~~
~~ra~e officer), ~ ~A~ 0.7~'6~~
ALL CO IGA~{T ,,}~ap~6,pMU; B,-$. SUFFOLK COUNTY LICENSED
Builder's License No. 29.1, .
Plumber's License No .
Electrician's License No. .~b~G:~!"'"... ~~~C~~ ~ ~~,dI~
Other Trade's License No . .
1. Location of land on which proposed work will be done. ..~7 ~G~:~/2e... , ..~:~l.r`. /.~Sl~ .~C•./. ,
~Y . 1. .
.~~U
...............:SST.~T,~'IxLL"...~?J9'Y......... ~!1?!4"T.~.~`.C~C.....`.. • ~l,J..Z-....
House Number ~~9Street / Hamlet ~~JJ
County Tax Map No. 1000 Section .....~t/.~ Block Lot ......~Y........ .
Subdivision Filed Map No. Lot...............
(Name) ,
2. State existing use and occupancy of premises and i/n~tended use and occupancy of proposed construction:
a. Existing use and occupancy .......'.......l!~+`~'~~.~~7.~/r'7Z~ . .
b. Intended use and occupancy .............fit-~~ ~ !„7~?~16~T-....+^!:l,T~, , ,}~UCJ,C,, , , , , , , , , , , , , , , , ,
Swrvr.•wi~6 Vase
l~uu--
3. Nature of work (check which applicable): New Building Addition , Alteration .
Repair Removal Demolition ..............Other Work .
/~y'')/))7~ (Description)
4. Estimated Cost .......LlY. VO Fee , .
' (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 occt)pane~!, specify..n~ture and extent of each type of use . .
7. Dimensions of existing structure ;-s~ y t~,s} Rear . . Depth , .
~.~n.... , _ , e..... .
Height ...............Num'rl( ones......:..,~;:;.,1...........................................
Dunensions'of same structure wi a1~er ~ on~:~Ftront Rear .
Depth ~igl~...~..~.tri ; ......Number of Stories .
8. Dimensions of entire new const s"~ Depth
t Rear .
Height :..............Num 'erof a
9. Size of lot: Front Depth
] 0. Date of Purchase .............................Name of F~ormer Owner .
11. Zone or use district in which premises are situated /.4/,-: ~L~.~'~!T~'.% 4...... , ..v.._....,,t,,....... .
g e any zoning law, ordinance or regulation: o .
13. Will lot be re raded
p Will excess f71 be removed from one' Nb . .
14. Name
of Ow er of s remises V1 G~ C~~/~71?...... Address ~/Jtq,Z-~;7 ~~,(`ph rer'siises'~ ' Yes
Name of Architect ~ ~ ..Address Pfione No... .
Name of Contractor ~ ~ ~~'f
.4 t......... Address .../,/h ~}'T. ~~~4. Phone No... 7 4 ~.,1~
15. Is this property located within 300 feetppof a t__gqidal wetlandY *Yes No ,
*If yes, Southold Town Trustees PermitPLO'f DIAGRAM ed.
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.
I
h A~ INI~i0 ~
"IMMEDIATELY„ DATE: ~ ~.RN
ENCLOStr POOL TO CODE FEE: cd
UPON', COMPLETION NOTIFY
BEFORE "WATER'. 786-18D2 9 AM "Iq.A IINI TN@
FOLLOWINQ 1NSPEGflOMB:
1. FOUNQATION TiNORECAINI~
FOR MULLED
2. ROU011 - FRAMING ~ li{IFALIIk1
9. IN8ULATION
4. FINAL - CONBTRUCTION MUST
y ' BE COMPLETE FOR C.Q.
ALL CONSTRUCTION BMIAW. MEET
THE REQUIREMBNTA fSi -TNi N,Y.
s STATE CONSTRUCTION i ~1t11iiY
CODER. NOT i~SPONfllllf.~
DESIGN OR CONSTRUCTR7N ERRORII
- STATE O'F NEW YORK, 5i S
COtiNTY OF .
(Name of individual signi' • • • " - " " ' ' ~ - • being duly sworn, deposes and says that he is the applicant
ng contract)
above named.
He is the
(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 this
application; that all statements conta;ned in this application are true to the best of his knowledge and belief; and that the
work will be performed in the manner;, set forth in the application filed therewith.
Sworn to before me this I `
. ; ...day of l 19 .
Notary Public, ~ N.
<L:.. d?!, , County
HELEN K DE 1roE ~ .
NOTApY PUBLIC, State of L ~ .
No. 4707878,Suffotk~~untyY~~r (Si re of applicant)
Term Expires Merch 30,18...e,[
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