HomeMy WebLinkAbout16906-zFORM NO. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Office of the Building Inspector
Town Hall
Southold, N.Y.
CERTIFICATE OF OCCUPANCY
No Z17966 Date MAY 18, 1989
THIS CERTIFIES that the building. INGROUND POOL
Location of Property 2500 ALDRICH LANE LAUREL
House No. Street Hamlet
County T~xMap No. 1000 Section 125 Block 01 Lot 2.24
Subdivision LAUREL EST. EAST Filed Map No. 7870 Lot No. 15
conforms substantially to the Application for Building Permit heretofore
filed in this office dated APRIL 15~ 1988 pursuant to which
Building Permit No. 16906Z dated APRIL 21, 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 POOL WITH FENCE ENCLOSURE AS APPLIED FOR.
The certificate is issued to MITCHELL & KATHLEEN MARKOWSKI
(owner, ~3~)
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A
UNDERWRITERS CERTIFICATE NO.
PLUMBERS CERTIFICATION DATED
Rev. 1/81
N013022 MAY 18~ 1988
~rOB~ NO. ~
TOW'H OF $OUTHOLD
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_o 1 6 ?,'g~ 7
Building inspector.
Fee $..../....c _. ~.~
Rev. 6/30/80
VICTOR LESSARD
EXECUTIVE P~DMINISTRATOR
(516) 765-1802
Town Hall, 53095 Main Road
P.O. Box 1179
Southold, New York 11971
OFFICE OF BUILDING INSPECTOR
TOWN OF SOUTHOLD
October 3, 1988
Mr. & Mrs. Markowski
2500 Aldriah Lane
Laurel, New York 11948
Dear Mr. & Mrs. Markowski:
We have received your application for a building permit
for the accessory building and a deck on the building but we
have not received an application for the deck around the pool.
Please submit an application for the deck along with
construction plans and a survey showing location of pool and
deck.
Very truly yours,
SOUTHOLD TOWN BUILDING D~PT.
Vincent R o Wieczorek
Ordinance Inspector
VRW:gar
TOWN OF SOUTUOLD
BUILDING DEPARTMENT
TOWN EALL
SOUTHOLD, NEW YORK
765 - 1802
11971
APPLICATION FOR CERTIFICATE OF OCCUPANCY
DATE...:'j' .....
NEW CONSTRUCTION ....... OLD OR PRE-EXISTING BUILDING ...... VACANT LAND ........
......... : ~--~. ~c~z,,~ (.I
ItOUSE NO. STREET HAMLET
. owner or Owners oX Propert~ .... /~.~'~.~...~..~.~. ..... //.~^~.~,~.. ....
Subdivision... ~..~.~.~.~ ........ Filed Map ........ Lot ..........
Permit No ........ Date o£ P~mi~ .......... Applican~ .................
Health Dept Approval .....
' ' ................. Underwriters Approval ..............
Planning Board Approval ................
Request for Temporary Certificate ....... Final Certificate ................
Fee Submitted: $ ....................
rev. I(}/14188
i,~,~,~! THE NEW YORK BOARD OF FIRE UNDERWRITERS
BUREAU OF ELECTRICITY
85 JOHN BTREET, NEW YORK. NEW YORK 10038
~ ~pplicati~ No. on file
TMIS CE~I~IE~ THAT
~ examin~ on and found to be in co~npliance with the r~uiremen~s of th~ ~.
RXTUIIE RXTUI~$ RANG~ OVENS DISH WASH4R$ FANS
FUIINACE MOTORS IqJTOl~ AFf~AN~ NI~RS
S E R V I ¢
OF CC. COND.
1,1
Per
[his cedificate must not be altered in any manner; return re, the office my be identified by their
COr-f FOR BUILDING DEPARTMENT. THIS COPY OF CERTIFICATE MIJST NOT BE ALTERED IN ANY MANNER.
OUNDATION (1st)
3UNDATION ( 2nd )
DUGH FRAME &
.PLUMBING
~SULATION PER N. Y.
STATE ENERGY
CODE
FINAL
DDITIONA'L COMMENTS:
SOU 4,,
BOARD OF HEALTH ......
3 SETS OF PLANS .......
FORM NO. I SURVEY ..........
TOWN OF SOUTHOLD CHECK -~....a..q ?~.._~., .,~3a¢ /...~-' .2-
BUILDING DEPARTMENT SEPTIC FORM ............. :
TOWN HALL
NOTIFY
$OUTHOLD, N.Y. 11971
CALL ................
TEL.: 765-1803
Examined .. ~.~.,,~7-'/ ........ , 19 .~4~.
Approved . ~.~.~. ....... , 19 ,~, ,~Permit No./~. ?.~, ,~.. ,~,
Disapproved a/c .....................................
................................
APPLICATION FOR BUILDING PERMIT
INSTRUCTIONS
MAIL TO:
: ~4 ~:D~ATELY"
;C~MPLETION
Date .... .~/ff.. ......... 19 .~.
a. This application must be completely filled in by typewriter or in ink and submitted to the Building Inspector, with 3
sets oft?lens, accurate plot plan to scale. Fee according to schedule.
13. ':*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 Bulld[~gJv3sl~r,..v~ill i~ued a Building Permit to the applicant. Such permit
shall be kept on the premises available for iri~ec, hg.2~rougho t~t, q ~prk.
. e. No building shail__b~e oc_,q~p~md or used m, ~h01ex~r i.~ p~( ~r ~iny purpose whatever until a Cemficate of Occupancy
shall have timllll~ _~dmg Inspector. ,, ~ . ~ · ,.j
APPLICATIOI~ISWIEREBY MADE to the Building Department for the issuance of a Building Permit pursuant to t e
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 r,eg ,ulafions, and to
admit authorized inspectors on premises and in building for necessary inspections. ~_.~ p , ~,~ ~!~ :' ,. ~
~ '~ V ~,' ~ (S~gnature of ~4~'~jan~,~?rm~me' ~f a corporation)
~.~)~)~t,f~l~ ." . ....... ~, ,-z~ev:"~' 'z , ...... : ......
.m . ./('e:. .4,e?. . . .~. .q /. .~.,~.z-/zz~. .~.-. i,. /.~?,~.~. . .
........t'& .~i~,1 ~;~^q]q~*~ ...... :¥I~ ........ ~t,3~L~'"""' ,,~rt~ ~,,~ (Mailing address of applicant)
State whether applicant ~(A~J~tr(~fll~:~la~e~/t~i~chit¢ct, engineer, genera[ contractor, electrician, plumber or builder.
............ CA.~~9~~ ,. '.,'.~ .................. , .... .nn.~)~e'-~.~ ~ -~.
Name of owner of premises ..... ~~. · ,~. · · ~/~ ~ ~,:; ~~ ~ ....
T~:~) ~O)~'"}u~ ~'' ~, )') ~': y '~ 6 (as on the tax roil.or latest deed)
Plumber's License No .........................
Electrician's LicenseNo .......................
Other Trade's License No ......................
'OCCUPANCY OR
USE IS UNLAWFUL
WITHOUT CERTIFICATE
OF OCCUPANCY
1. Location of land on which proposed work will be done: ...~.~ .~...~.g.cf.~....~..~..~(.~.~... ~ ~..
. ............... ........... L .............
House Number Street Hamlet
County Tax Map No. 1000 Section .... 1.'~ ......... Block / Lot. d,~
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 ....................................................................
b. Intended use and occupancy ~&~ r ~F/~& ~ 2 ~ ~OOL ' "
3. Nature of work (check which applicable): New Building ' .. Addition .......... Alteration ..........
Repair .............. RemovAl .............. Demolition .............. Other
f/~ ~ (Description)
4. Estimate Cost ......... ~. ................... Fee ........................... . ...........
~ ~' (to be paid on filing this application)
5. If dwelling, number of dwelling ufiits .............. Number of dwelling units on each floor ...............
If garage number of cars
6. If business, commercial or mixed bccupancy, specffy nature and extent of each type of use .....................
7. Dimensions of existing structures,!if any: Front ............... Rear .............. Depth ...............
Height ............... Number of Stories ........................................................
Dimensions'of same structure witfi alterations or additions: Front ................. Rear ..................
Depth ..................... i' Height ...................... Number of Stories ......................
"8 Dhnensions of entire new construction: Front .... '. · · D pth
......... Rear ............... e ...............
Height ..: ............ Number of Stones ........................................................
9. Size of lot: Front ~i ......... Rear ...................... Depth ......................
10. Date of Purchase ............ i ................. Name.of Former Owner . ............................
1 1. Zone or use district in which premises are situated 21~/
12. Does proposed construction violate any zoning law, ordinance or regulation: ............................
............. Wall excess fill be removed from premises:
13. Wall lot be regraded i./~/(~ Yes
14. Name of Owner of premises .... ] ................ Address ................... Phone No ................
Name of Architect ......... I . Address
Name of Contractor . ~&?¢i i i i i. Address ' i~.~.~.~-)~ .... Phone No.
15. Is th±$ propert:y located w~th±n 300 feet of a t±dal wetland? *Yes ..... No .....
· If yes, Southold Town Trustees Perm±t maybe required.
i PLO'T DIAGRAM
Locate clearly and distinctly ~/1 buildings, whether existing or proposed, and. indicate all set-back dimensions from
property lines. Give street and block nhmber or description according to deed, and show street names and indicate whether
interior
or corner lot.
U;'oNCL°SE POOL TO COi~' --
"IMMEDIATELY,,
ENCLOSE ~00~ TO CODE
UPON COMPLETION
BEFORE "WATER"
OCCUPANCY OR
USE l# UNLAWFUL
WITHOUT iCERTIFICATE
o[r occuP^ Cy
STAVE OF i~E~ YORK,
COUNTY OF
8. INSULA'nON/~
4. FINAL CONSTRUCTION MU~T
BE ~M~ FOR CO.
ALL CONST~N 8~ ME~
THE REQUIR~ M ~ m,~
STATE ~Ne~ i ~V
CODES. N~ ~N~ ~
$.8
................................................. being duly sworn, deposes and says that he is the applicant
(Name of individual signihg contract)
above named.
He is the '.
(Contractor, agent, corporate officer, etc.)
of said owner or own6~s, 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 manne~ set forth in the application filed therewith.
Sworn to before me this
Notary Public ........
HEL~ K DE VOE " ......
NOTARY PUBLIC, Sta~ of New York ' (S~a~'t'~ of apphcant)
.
lerm Expires March 30, ~8.,..i~'
~ ~Z° ~'3o"l,V
CedlfJc,~je~, i,~diented hereon shall run only
porsoe for ~.,hom ~ = ·
bdm[f to t'~e, ti~e company
m~ le~di~g i~stitnt o~ )ist~ ~e~om a~d to
ass,shoes of the lencfl;}g ms~tiiufio~. C~rfific. a~on
not t~ansferable to addi[mnal
subsequent owners. ,
Unauthonze~ a~terat}on or addifioh o[ ttds sorvey
a wotation of Section 7209 of the New York Stat~
Education Law.
Copies of this survey ~ap not bearing ~he
Surve~rs inked sea~ or embossed seg shall not be
cousidered to be a valid true copy..
POSE AND US~ A,v~ H;~.~,~E
THE E~C~ION OF;~
TANNING ~ALLS, POOLS
P~NTING AREAS, ADDIT
~NST~UCTION,
J :,.,, :'.'