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Home My WebLink About14687-ZFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. Certificate Of Occupancy THIS CERTIFIES that the building r ' Inground pool & fence 2155 Jockey Creek Dr. & 2550 0aklawn Ave. Southold Location of Property .. .............................................................. ~ouse No. S~reet Hamlet 070 02 28 County Tax Map No. 1000 Section ............ Block ............... Lot ................. Subdivision ............................... Filed Map No ......... Lot No .............. conforms substantially to the Application for Building Permit heretofore Fried in this office dated February 28, 86 16687z ..................... ,19... pursuant to which Building Permit No ...................... date~ a r c h 2 1 , 19 8 6 , 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 & fence Edwin & Margaret Tonyes The certificate is issued to ........................................................... (owner, Illalee~t ~mml~X x of the aforesaid building. Suffolk County Department of Health Approval N / A N748620 UNDERWRITERS CERTIFICATE NO .................................................. Rev. 1/81 TOWN OF 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) Permission is hereby gronted to: · '"'~' .~..~...~.~ ................................................ ....... County Tox Map No. 1000 Section ...... ..0...']o~. ....... Block ...... ..~.....~.. ....... Lot No ...... ..~'.,..~. ............ aursuant ,o application doted .....~..~~ ..~..~ .............. , 19.~-..~.., or~d approved by the Building Inspector. Fee $..~../..'.~ ..... Building Inspector Rev. 6/30/80 FORM NO. 6 TOWN OF SOUTHOLD Building Department Town Hall Southold, N.Y. 11971 765- 1802 APPLICATION FOR CERTIFICATE OF OCCUPANCY Instructions A. Thisapplicatior[ must be filledinWpewriter OR ink, and submitted mi~m~ tothe Building Inspec- tor with the following; for new buildings or new use: 1. Final survey of property with accurate location of all buildings, property lines, streets, and unusual natura[or topographic features. 2. Final approval of Health Dept. of water supply and sewerage disposal-(S~9 form or equal). 3.1APProval of electrical install~'tion from ,Board of Fire UnderwrFcers. ;4. :C~ommercial~ bUiJdings, IndL[stdal building% Multiple Residences and,$imilar:l~uildings and instella- t~ons; a: certificate Df Code ,COmpliance from the Architect or Engineer responsible f6r the.building. 5. Submit Planning Board aDproval of completed site plan requirements wher~ applicable. B,._ ~,~s~ir!g. b~i~l~qg!.(p~_or to April 1957), Non-conforming uses, or buildings and "pra-e×istin[f' I'"~-Ac~ -c~u-~-t~-~e~"-°~fsP~°perty~upu~..~mm,,~ .==~u,= - ~owing all prope~ lines,~ets'~ buildings and unu~al natural or 2~SWom statement of owner or prewous owner as to u~, ~pancv and cond~t~o~ of buddmgs. 3J~a~e,,~'~y hoas[~g code or saf~ in~ection of buildings or premix, or other pertinent inform~ t~on requiYed to prepare a ce~ificate. C. 1F ees:~ ,;Ce~ificate of occupancy $5.00 2~e~tificate of occupancy on. pre-existing dwelling $15,0 0 3J~C0PY~if certificate of occupancy $1.00 4,,Va~a~!, % Land C.O. $5.00 5~ Upd~%ed C. O. $15.00 Date .......................... NewCO~s tYU~c'tion ...... Old or Pre-existing Building ............ Vacant Land ............. House No, Street Hamlet Owner or Owners of Propa~ ~ .~..e .r~.~.~T...~'....4..~, ~.b. ~:<<<, ..~. ;. ~.~?..., County Tax, Map No. 1000 Section ............... Block ............... Lot ................ Subdivision,..; ............................. Filed Map No ........... Lot No .............. Permit Nejd..~..~.7. Z. Date of Permit .~,'./.~.1:/.~'.~..Applicant .................................. Health Dept Approval Labor Dept Approval Underwriters Approval ........................ Planning Board Approval ...................... Request for Temporary Certificate ..................... Final Certificate ....................... Fee Submitted $ ............................. Construction on above described bu ilding and ~it_ m eets_atl app_p~lilicable cod?~u lations. R~_ ~q c~ q3 ~ co% Iq77~. i ois i THE NEW YORK BOARD OF FIRE' UN p:ERWRITERS BUREAU OF ELECTRICITY · 85 JOHN STREET. NEW YORK. NEW YORK 10038 THIS CERTIFIES THAT only the e~ctde~ equipment ~ describ~ below a~ int~duced by t~ appllcant ~amed on the ab~ app~o~ number ~ t~ ~m~s qf ~n thefollowing locatto.: ~ Bmement ~ Ist Fl, ~ 2.d FI. ~g i~e Secao= Bilk Lot ~.~,.~do. May ~t~ a~.found~bei, complla~cewiththerequlreme~tsofth~Board, FIXTURE fiXtuRES RANGES OUTLETS SWtTCHE~ FLUORESCENT VAP~ EXHAUST FANS TIME CLOCKS DIMMERS SERVICE DISCONNECT S E E NO. O~ CC~ COND. PER ~' APPARATUS: R V I ' C A.W.G, No.O~ HI-LEG ~ A,W.G. GENERAL MANAGER P~ ~/ 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. SPECT ON [~ ~'O~JNDAT~ON ~.ST [ [ ] ;'OUNDATION 2ND [ ] ROUGH PLBG. ] INSULATION DATE INSPECTOR COMMENTS 1. FOUNDA__TI__ON~,u{lst) FOUNDATION (2nd) 2. ,ROUGH FRAME & PLUMBINO INSULATION PER N. STATE ENERGY CODE ADDITIONAL COMMENTS: O~OU?ANC¥ OR USE B UNLAWFUL CERTIFICATE OF "_iMMEDIATELY" UEO_N_ COMm.L~ON BEFORE "WATER" 'FORM'NO. '~ TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL ~OUTHOLD, N.Y. 11971 TEL.: 765-1802 ........ i9.~.G. Permit No. [ .~.~. .~.?..~.. Ro¢oivod ........... ,19... Disapproved a/c ............ : .......... : ............. ............................... (Building Inspectgr) APPLICATION FOR BUILDING PERMIT Date INSTRUCTIONS a. This apphcation 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 ad}oining premises or public streets or areas, and giving a detailed description of layout of property must be drawn on the diagram which is parr 6fthis appli- cation. c. Tlie 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 apphcable Laws, Ordinances or Regulations, for the construcnon 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 admi[ authorized inspectors on premises and in building [or necessary inspections. ..... /9.:. ~:7.(¢ ~...*....J-.~.~s. ~..~.--W..c... ....... (Signature of applicant, or name,if a corporation) ../)~..*... 9~ttz.../'~.~r. z.r'&~ a,:...z.,~Z-/v. ~. (Mailing address of applicant) /r ~j"'L- State whether applicant is owner, lessee, agent, architect, en~Mneer, general ~'ontractor, electrician, plumber or builder. .......... C/r/g..~. ~:...c ¢~../.-w..o..~..~-_~ ........................................................ "~ame of owner of premises . .~..~'.~11~.. ~. ~... Ar. iq/9.. ..... ~1~/{~g/./~.'.'.~. .... ~.,..... :7~.O. A/. ~'.~ ............ (as on the tax roll or latest deed) If app~h~g~t is a corporation, signature 6f duly author/zed officer. ......... Builder's License No ....... ?.(2. ............... Plumber's License No ......................... Electrician's License No.. Other Trade's License No ...................... Location of land on which proposed work will be done ........ ff~)..L~{...'-7~...g: .~..... ~ .'.~. ................... ~ drrx~ .~T.o.~.c.~..&~..C~.e.~q4.._ D~. ~: ........ _C~.~gz'g0.a..~.../t/fi' ·. .~ ~'s~o- ·. ~, ................. House Number Street Hamlet County Tax. Map No. I000 Section .... 7..° .......... Block ....... .~.: ........ Lot .... ~ ............ Subdivision ..................................... Filed Map No ............. Lot ............... (Name) State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy ........ ~...~../.~.~..~rT.~ .~. .......................................... b. Intended use and occupancy ........... .~..~..{.~.~. ~/---..~.~¢'~-~ q- ~ 3. Nature of work (check which applicable): New Building .......... Addition .......... 3dtqu~irm ~P.~.?.~. .... Repair .............. RcmovaI .............. Demolition .............. Other Work ............... ~ (Description) 4. Est~nated Cost ......... ~.~...<~... ~ .............. 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 15usiness. commercial or mixed occupancy, specify nature and extent of each type ofnse .................... 7. Dimensions of existing structures, if any: Front ............... Rear .............. Depth ............... Height ............... Number of Stories ........................................................ Dimensions of same structure with alterations or additions: Front ............. :... Rear .................. Depth ...................... Height ...................... Number of Stories ...................... 8. Dimensions of entire new construction: Front ............... Rear ............... Depth ............. Height ............... Number of Stories ........................................................ 9. Size of lot: Front ...................... Rear ...................... Depth ...................... 10. Date of Purchase ............................ Name of Former Owner ........................... 11. Zone or use district in wkich premises are situated .......... ~f~l~'~--'~-I ,,~t~. ...... . ..................... Does proposed construction viol0t, e any zoning law, ordinance or regulation: ....... t~ ................... ~ 13. Will lot~ be regraded ......... -~.~"~. .............. Will excess fill be removed from premises: Yes ~ Name of Architect ........................... Address .................. Phone No. i~.~i PLOT DIAGRAM Locate clearly and distinctly all buildings, whether existing or proposed, and. indicate all set-back dimensions from property trues' GFce street and block number Or description accord/rig to deed, and show ~treet names and indicate whether interior or corner lot. STATE OF NEW YORK, S.S COUNTY OF ................. ................................................ being duly sworn, deposes and says that he is the applicant (Name of individual signing contract) above named He is the ......................................................................................... (Contractor, agent, corporate officer, etc.) of said owner or owners, and is duly authorized ro 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 .day of. ' ......... 19 . ~ ............. applicant)