HomeMy WebLinkAbout17047-z FORM NO. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Office of the Building Inspector
Town Ha11
Southold, N.Y.
CERTIFICATE OF OCCUPANCY
No Z-17364 Date SEPTEMBER 28, 1988
THIS CERTIFIES that the building ACCESSORY
Location of Property 16105 MAIN ROAD MATTITUCK, NEW YORK
House No. Street Hamlet
County Tax Map No. 1000 Section 115 Block 1 Lot S
Subdivision Filed Map No. Lot No.
conforms substantially to the Application for Building Permit heretofore
filed in this office dated MAY 11, 1988 pursuant to which
Building Permit No. 170047-Z dated NNE 1, 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 INGROUND SWIMMING POOL & FENCE AS APPLIED FOR
The certificate is issued to JOHN M. & JANET STEWART
(owner, }
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A
UNDERWRITERS CERTIFICATE N0. N027518- AUGUST 12, 1988
PLUMBERS CERTIFICATION DATEIl N/A
Bu' in Inspector
Rev. 1/81
r~oaas xo. s
TOWN OF SOUTHOLD
BUILDING DEPARTMEN4
TOWN HALL
SOUTHOLD, N. Y.
BUILDING PERMIT
(THIS PERMIT MU5T BE KEPT ON THE PREMISES UNTIL FULL
COMPLETION OF THE WORK AUTHORIZED)
N ~ ~ 17 ~ ~ ~ Z Date ...fr.1. 19~g
Permiss~n is reb ranted to: G
.....C.~~~.....~~...~...r...~. .~.......~~,'9~,..~6.Z.
.aQr.......
ct premises located of ......1~~.~~ ~....!~.......~..`.~.......~'r~...'~'1'1.....(?5,,...~
...........................................~~~l~..G.
County Tax Map No. 1000 Section Block ........1.......... Lot No .................0......
pursuant to application dated 19.CF1.l., and approved by the
Building Inspector.
Fee $~SQ..
o?~ 1..7.........~'~~..........
Builds Inspector
Rev. 6/30/80
~ FORM NO. 6
TOWN OF SOUTHOLD
Building Department
Town Hall
Southold, N.Y. 11971
765 - 1802
APPLICATION FOR CERTIFICATE OF OCCUPANCY
Instructions
A. This application must be filled in typewriter OR ink, and submitted ~ s..... to the Building Inspec-
torwith the following; 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 Health Dept. of water supply and sewerage disposal-(S-9 form or equal).
3. Approval of electrical installation from Board of Fire Underwriters.
4. Commercial buildings, Industrial buildings, Multiple Residences and similar buildings and installa-
tions, acertificate of Code compliance from the Architect or`Engineer responsible for the building,
5. Submit Planning Board approval of completed site plan requirements where applicable.
B. For existing buildings (prior to April 1957), Nonconforming uses, or buildings and "pre-existing"
land uses:
1. Accurate survey of property showing all property lines, streets, buildings and unusual natural or
topographic features.
Z. Sworn statement of owner or previous owner as to use, occupancy and condition of buildings.
3. Date of any housing code or safety inspection of buildings or premises, or other pettinent informa-
tion required to prepare a cettificate.
C. Fees: Additions $25.00 POOLS $25.00 ALTERATION $25.00
1. Certificate of occupancy New Dwelling, $25.00, Accessory 10.00 Business $50.00
2. Certificate of occupancy on pre-existing dwelling $ 50.00
3. Copy of certificate of occupancy $ 5.00, over 5 years $ 10.00
. 4.Vacant Land C.O. $ 20.00 p Q
S.Uodated C.O. $ 50.00 Date ....../.~al.~~!~[1........,
NewConstruction,x,,,OldorPre-existin Buildin Vacant Land
9 g
Location of Property ..~~~.w
...........:.........M.A~iJ..~~io~D.......M.R7.rt~+~,K.
House No. Street Hamlet
_
Owner or Owners of Property bHr~ . (}/~Tj, , ; N~T... ,~'~~,~1~~.7 . . . . . . . .
County Tax Map No. 1000 Section , , , , , , , , , , , , , , , Block Lot .
Subdivision .................................Filed Map No. ..........Lot No. , '
Permit No~ . Date of Permit ..........Applicant .r-~,.,T'1~/.~L~, ~.SQ/~S , ._L
n/C
Health Dept. Approval ........................Labor Dept. Approval
Underwriters Approval ........................Planning Board Approval .
Request for Temporary Certificate .....................Final Certificate ....x.
Fee Submitted $ t~., GU .
Construction on above described building and permit mee~all a plicable codes and regulations.
Rev. 10-10-78 lJ
R.e.~. 3.5 g(~-
Cv ~ )~3Gy
,
- ~~1z'l~= TEL. 7G5-1 &OZ
O~ C~' ~ 1'n~t'N t)I' S(~UTLTO~.TI
" `a 1. r.
}
y+='J/'+~+1L~,~~tY~~ Ori'iCfi OT~ I3CJTLDiNG 114SP1?CTOR
4~ w ~ _r: •jt -c. '1'OP1TJ ilALL
``O~. ,u'~sr Cr ~ SOIPi'IfOLi), N.`4. 11971
~'~~i 'try; ~~I I
~~Q,~ `r .'ai~,Nltvd.~'
os~uC~ as - a~,e,ti~.~~,
To 4411UI11 This May Concern,
tTe are unable to complete your Certificate
of Occupancy becau:~e of the following mason;,.
1
/~i// Pn nnplication for Certificate of Occupancy
i s not n n f i 1 c. ~~ir~.~~rna-~L'~
/!o Under:•~riters Certificate on file.
1 / the check .i~
(not on file.) ~'a~,G~77
t:n tlenlth Dept. Approval on file.
L'u final in:;pection hay been made.
P]e.Z:,e contact: our office on this matter.
Thank yo,.: for your. c:ooperation;"
Duilc]inr Permit 1 2 ~ ~ ~ Z
Q~"
Iluildir.q Uept.
iio Plumber Solder Certificate on file.
( all permits .involving plumbing being
i:,:,ued after April 1,19fl~1 )
,~rynl~~%T* TEL. 7G5-1 Fp;?
7 (?+,yC14~,:~ti~r,i Or( iCfi ()1' 13UILUING IiJSPLCTOR
lti„- r~„~•, "PO~VNII:ILL
~=+'."~'3•^~` ~ SOUI'It0!,i), N,Y. t 197i
IGIUS C~~ a5-
To 47hom This I9ay Concern,
t•;e_ are unable to complete your Certificate
of Occupancy becau,c ,of the following reason;,.
/i~n nnplication for Certific;itc of Occupancy
is not nn file,~~~*'%-~-*~>
• ,lo Under•:rriters Certificate on file.
i'hc check i:: (r'••',~not an file.) -~~«~.lh
P:o Health Dept. Approval an file.
/ t;c~ final inspection han been made.
Please contacL• our affice on this matter.
Thank yo,., for your. cooperatian.~
i)Uildinr Permit 11 ~ 2 ~ ~ 2 Z
~tYO~'
Buil<li^-I UepL-,
ito I'ie:mher Solder Certificate on file.
( all pcrrnits involvin~7 plumbinrl bcin~
.L :7UL`<I affCr Aprll 1,19fl9
THE NEW YORK BOARD" OF FIRE UNDERWRITERS pA`,>s
1t7t`I1 t$!
BURIAU OF ELECTRICITY
Afl(..I I,~T • I ~~~5 JOHN STREET, NEW YORK, N~~~',,~~38 N (7~75f K
Date Application No. on fiG
THIS CERTIFIES THAT
only the akxtrled equipment a descrihed 6ekEw and introduced 6Y the applicant Homed on the shoos opplieaNon numher in thepremieee of
JpHN STEYAriT, MALN ROAD; F'<7I,E;~NKTApA, MATTLTt1Cti. N.Y.
n Oil'P
in thefolbwinp kECO~l•Y 7-tk ~pPent ? /xt Fl. ? End FI. Sertinn flock Lot
wee examined on andfound tolEe in compliance with the reyuirernentAOf this Board.
RXTWE MXTURlS RANOlS COOX1116 tMCK5 OVlNS DISH WAfN95 EXNAUSTPANS
OUTIMS ACIiS SYVITGIlS INCANDESCENT FlUGI1ESClNT NAT. K. W. AMT. K. W. AMT K.W. AMT. K. W. AMT. M. P.
DRYNS RMDIAC! MOTORS wTURE APPt1A1KE IRWY6 snuullRC'R Tllel CIOCKS RRtt IBIIT IRiATIRIS ewxTl-0UTIR DGAMERS
AMT. K. W, pl X. P. GAS N. I. AMT. NO. A. W. G. AMT. NM. NAT. AMR. TR71Nf. AMT. N. P. SYSTtYAf AMT. WAITS
NO.OP PNi
SRRVIQ DIfCOTtNECT NO. DF S E R p V 1 C E
AMT. AMP. TM,E ~
P 1 J tW I / ]N' S / TM S/ 1\4 NO. ~f~COND. OF CC
CGND. NO. OF NI.tEG ~~h~~~ NO. Or N[a1RAtt OP
NWEUTGXAI
CTIRR AIKAARATUS
(i. F.C. T:'l.
*(Sk+:tMMTNC FtAOI,} This r:Prii.txt:atr
covers rompiiance aC t;he elate r,>f L
yin.<apection Drily, Amcantse of Tln~lsna1
environments it is advi~:+hlu ro
h>tvw frRgelenT tenfJ;anri or re~a3re
~ IUBKIP, l!Y A t711:2~ 7. t i elf ;)o-?t'li„U .
Ht
i
/~j~
,?nDY rur~ll.t,o ~~~71/~e
r~A'r I,AIdF,
MA7'1'C'fUCt~. NY, 7'4.95
OTI,rRAt MANAGER
Ill t; i~NSr; Nt?. 23Q0 F, Psr
This urfificaPo mutt not be altprid in any manner; return tothe offin of Me Eoard if ineenaq, hTSpectots may be identified b their credentials.
eortr fcR oe~ue~wr. ,mss oorr of a~f~±cn~MtsT~t?#t kcT~.~ inn wu~eit. ~
c'1cLD i;;S:`LS:IU;i ~lliiiE ~ :;OMMENT° V
' r
Y v
,y
H
FOUNDATION (1st)
FOllNDATIOtJ ( 2nd ) _ _ _ ~'~c~
2 . h~+~
o~
ROUGH FRAME &
G1
PLUMBING
cn `~9~
H`_`
3 .
IIJSULATION PER N. Y,
STATE ENERGY
CODE
_ 3 ~
FZNAL
o
ADDITIOPJAL COMMENTS:
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S~Fi'ei~"9C)'w__`"•---.~,.y.~' Licerraerl
JN r~,~ -/-yam 9 C3rrerr~~erf
1 h
BOARD OF HEALTH
3 SETS OF PLANS
FORM NO. 1 SURVEY . .
TOWN OF SOUTHOLD CHECK • •~Q`~
BUILDING DEPARTMENT SEPTIC FORM
TOWN HALL NOTIFY
SOUTHOLD, N.Y. 11971 CALL • -
TEL.:765-1802 P0:
MAIL T0:' ~3c{
Examined 19 0.
po
Approved . 19 a~Permit No. ~ rte. 7 ~ rJ• ~
5
Disapproved a/c
(B'uildin sp ctor)
APPLICATION FOR BUILDING PERMIT
"IMMEDIATELY" Date ,J.. .......,19~~.
.
ENCLOSE POOL YO CODS
UPON COMPLETION INSTRUCTIONS
BEFORE "WATER"
a. This 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 kepton 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 Depaztment 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 Lzws, 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.
S~~!
C~.
~ X , s .
"IMME~"lATELY" ~ (Signature of applicant, or riame, if a corporation)
ENCLOSE POOL TO CODE ~.0. 62j~- l/~>~~~j_~
UPON COMPLETION • • • • • • • • • • •T
1, BEFORE "WATER" (Mailing address of applicant) /i 9J L
State whether :app cant is, owner, lessee,, agent, architect, engineer, general contractor, electrician, plumber or builder.
Name of owner of premises .........I~UNN ~.~.....~W~~...~....5~~~~~.{
(as on the tax roll or latest deed)
If ap 'ant corporation, s~gnat re of duly authorized officer. CCUPNCY
.
(Name and title of corpo e facer) ~ ~ l.q FUL
ALL CONTRACTOR'$,MU T'BE SUFFOLK COUNTY LICENSED US ~ U
B11`fl`t~l'~ts'~I:ice°'s~~i1~1rS=~':'c. ~~L'~..........
IT®UT CERTIFICATE
Plumber's License No . .
Electrician's License No . ~ • O~Y
Other Trade's License No . .
1. Location of land on which proposed work will be done. ~ .
. l . I o .5 .....................n~-..... a.~ ~ erg..
House Number Street Hamlet
~
County Tax Map No. 1000 Section J.~S.......... Block ~ Lot .
Subdivision Filed Map No. Lot...............
(Name)
2. State existing use and occupancy of premises and intended use and occupancy of proposed construction:
a. Existing use and occupancy /2~7!/J.L?vl./!'J.4. • • • • • . • • • • • • .
b. Intended use and occupancy ~~5.~~~??j,/~L . • c.,~ > ~ r6 D C_ , . , , , , . , , , .
SW f ~ H. iNG ~pz14
/~iy''G~
3. :Nature of work (check which applicable): New Building Addition Alteration .
.Repair Removal Demolition ..............Other Work , .
(Description)
' ~ a;. Fee
4. Estimated Cost . .
` (to be paid on filing this application)
5. If dwelling, number of dwelling units Number of dwelling units on each floor . , .
]f 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 ...............NurpberofStories.......................,................................
Dimensions of same structure with alterations or additions: Front Rear .
Depth ' .Height Number of Stories .
Dimensions of entire new constriction: Front . Rear , Depth .
Height NurYiber of Stories .
9. Size of lot: Front Rear Depth .
10. Date of Purchase ..................Name of Former Owner .
11. ,Zone or use district in which premises are situated , ..........f 1Y~~7-!~~ . .
12. Does proposed construction violate any zoning law, ordinance or regulation: ,~„~q~.. r~ a nix • .
13. WHl lot be regraded ; : ~ ...Will excess fill be remod~~fj~ ~ 's Yes
14. Name of Owner of prem~ s .....,.~.~~G'Y19x4'1 Address ....~~~f / ~ '
Name of Architect .....Address ~5&"f ~~~a ;~'tr+";t,l .
• t•
//1~I~~ll2.t,C.K:. P v~;,~Iobfi.;¢ . .
15. IVs
thisConotraer~r locatedi~7~4.`/.~..,(.d??,J..Address honeNo...Z~.d.'':~d.d~.
p p y within 300 feet of a tiqidal wetland? *Yes No .:5,1..
*If yes, Southold Town Trµstees PermitPLO~DIAGKAMed.
Locate clearly amd 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.
"IMMEDIATELY
ENCLOSE POOL TO CODE
UPON COMPLETION
S~~vL BEFORE "WATER"
~ ~
"IMMEDIATELY" ~P ED ASNafED
ENCLOSE POOLTO CODE ~6~^_ r - p,ll-°J
UPON COMPLETION DATE:
BEFORE "WA ER"
J D% ,
NOTIFY B TiEPA T
786-1802 9 AM TD 4 PM F THE
® FOLLAWINGINSPECTIONS:
t, FOUNDATION TWO REQUIRED
FOR POURED CONCRETE
~',®'F~~ 3. NSULATIONAMING 6 PLUMBING
4. FINAL - CONSTRUCTION MUST
~((~T nCET~F~C~TE ALLECONSTRUC11ON SHALL MEET
la,:~ UA Y THE R'EOUIREMENT$ OF THE N.Y.
STATE CONSTRUCTION 8 ENERGY
rr ; ' ^ CODES. NQT RESPONSIBLE FOR
. , . ~ DESIGN OR CONSTRUCTION ERRORS
. , UNDgtINR~
~
ICA1P
STATE OAF, NEW YOR3C, `s ' „ . _ ~
COUNTY OR....~ . 'i~S.5
. . . . . being duly sworn, deposes and says that he is the applicant
(Name of individual sigrjing 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 contained 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
..........c ~ ~ .........day oP .....!'.1.4~-~ . 19 ~8
a
Notary Publi , i..7.~ 4 Lld4, County
HELEN K. DF. VOE , , , , , , , , , ,
NOTARY PU841C, 3tote of New York ~ , .
_ No. 4707878, Su9lolk fuuntY (Si atu of applicant)
i Term Expires MaKch 30,15