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HomeMy WebLinkAbout9759-z FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Town Clerk's Office Southold, N. Y. Certificate Of Occupancy No. 2940?. . . . . . Date . . January ?3 . . . . . . . . . . .' 19. . 79 THIS CERTIFIES that the building located at 134 Bayview ktosd Map No. . . . . . . . . . . . . Block No. . . . . . . . . . .Lot No. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . conforms substantially to the Application for Building Permit heretofore filed in this office dated . . . . . .14ay-. . .1 . . . . . . . . .. 19.7.8. pursuant to which Building Permit No. . . .9759.Z dated . . . . . .liay. . .30. . . . . . . . .. 19.7B., was issued, and conforms to all of the require- ments of the applicable provisions of the law. The occupancy for which this certificate is issued is . . . . . . . . . . . . . ?y ��. SwilnminE Pgpo .w.ith. . Fence.. . . . . . . . . . . . . . . . . . . . . . . . . . . . The certificate is issued to . . . . . . Gerhard Goel?ringer (owner, of the aforesaid building. Suffolk County Department of Health Approval . . . . . . . . . . ATI.9. . . . . . . . . . . . . . . . . . . . . . UNDERWRITERS CERTIFICATE No. . . . . . R395P7I . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . HOUSE NUMBER . . .1305 . . . . . . Street . . . . . . . J3. .Rgxc.. . . . . . . . . . . . . . . . . . . . Southold$ New York . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. . . . . . . . . . . . . . . . . . . . . . Building Inspector County Tax Number 1000106.6. 15 & 16 FORM NO. 2 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTH'OLD, N•. Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) N? 9759 Z Date .....NELY.............30.........................., 19.7.8... Permission is hereby granted to: ......t5k1QYy.. ........................ ......a/c.....Gerard..Goebringer..................... ................................................................................ to ........ltd .U..A..I374ti.RlOuU9...P0.01.&..fence............................................................................... ................................................................................................................................................................ 1305 Ba iew Road atpremises located at ................................ .�.................................................................................... ......................................................Nattlt1 kv...NAY........................................................................ .......................................................................I........ ................................................................................ pursuant to application dated ...... ay....... .......I.......................... 19.78.., and approved by the Building Inspector. Fee $.....1.5~00........ ............. ....t zz�.... .... .... . ,... ................... 1000-106-6-15 & 16 Buildin Inspector FORM X0. 6 TOWN OF SOUTHOLD Building Department Town Clerks Office Southold, N. Y. 11971 APPLICATION FOR CERTIFICATE OF OCCUPANCY Instructions A. This application must be filled in typewriter OR ink, and submitted in 46Zto the Building Inspector 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 natural or topographic features. 2. Final approval of Health Dept. of water supply and sewerage disposal—(5-9 form or equal). 3. Approval of electrical installation from Board of Fire Underwriters. 4. Commercial buildings, Industrial buildings, Multiple Residences and similar buildings and installations, a certificate 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), 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 topographic features. 2. 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 pertinent in- formation required to prepare a certificate. C. Fees: 1. Certificate of occupancy $5.00 2. Certificate of occupancy on pre-existing dwelling or land use $5.00 3. Copy of certificate of occupancy $1.00 ,�� f � � Date .. . ........... ./. .. . ..................... New Building Old or Pre-existing Building Vacant Land ......... Location Of Property ..../. d3JG:'.lt 1. e%r. .... 7leLis�ztGj.Ck ................................................... Owner Or Owners Of Property ..1Wtl. �sv ':. 't:b€%Jv�d ..(:ft?r4tY ?vY —:......................................... Subdivision ....................................................................Lot No. ............ Block No. ............ House No............. Permit No. .................... Date Of Permit .://. j{ .......Applicant .....`. tT............................................... Health Dept. Approval ........................../.................Labor Dept. Approval ................................................ Underwriters Approval .............1 .4.x........................Planning Board Approval ........................................ Request For Temporary Certificate ........................................ Final Certificate ......................................... ` Fee Submitted $ ........................ Construction on above described building and perm meets C l es nd regulations. .-'..sel.✓ .............APPlicant ....... ......... `1ECp� fr Sworn to before me this p /� �S 3 11 ,�.. day of ... (✓f"iCi.....1.1. .................. (stamp or seal) ��g /�Cf Notary Public .�� Count STANLCY SL. of New ODZ yd' ....•• Y Notary Public,State of New York No.mmis0s1175 Suffolk County My commission expires Mar.30,19�f? THE NEW YORK BOARD OF FIRE UNDERWRITERS per' BUREAU OF ELECTRICITY 85 JOHN STREET. NEW YORK j YeRK 10038 July .2'7, 197C �3 Date Application No.on file THIS CERTIFIES THAT only the elecericp{�;Ptp4n IHfliL ' number in thepremises of jtWW. E� �a � 1BW "tnm �• L in thefollowing locatioryu�❑ Basemept�� Ist Fl. ❑ 8nd Fl. Section Block Lot was examined on JJ —44 11 and found to be in compliance with the requirements of this Board. FIXTURE RXTURES RANGES COOKING DECKS OVENS DISH WASHRRS EXHAUST FANS OUTLETS ECEPTACIFS SWITCHES INCANDE3CEM�FLUMEX y AMT. K.W. AMT. I K.W. AMT. K.W. AMT. C W. MIT. H.P. DRYERS FURNACE MOTORS FUTURE APPLIANCE FEEDERS SPECIAL REC'"I TIME CLOCKS I BELL UNIT HEATERS MULT14UTIET DIMMERS fMT. K.W. all H.P. GAS H.P. AMT. NO. A.W.G. AMT. NAP. AMT. Mrs. TRANS. AMT. H.P.K. PUT AMT. WAII$ 1 20 SERVICE DISCONNECT I NO-OF I S E R V 1 C E AMT. AMP. 1YPE EQUIP. 1 X tM' 1$3W 3 Ar3W 3 X tW NO.OPER.coND. OF. .OND. NO.OF HIAL0 Of NIW.. NO.OF NEUIMLS OF NEUTRAL OTHER APPARATUS: -c.F.C.I. �(5wimuing Pool) This certificate covers compliance at the date of inspection only. Because of unusual environments it Is advisable to have frequent test and/or repairs made by a qualified person. Richard uelyea j Delmar Dr. P.c7 3 372 Laurel, L.I. 119 Lio.2148 E 11 Per This certificate must not be altered in any manner; return to the office of the Board if incorrect. Inspectors may be identified by t creel Wt. COPY FOR 811LL9N10 o@�TMiNT. TNIS�OPY OF CERTIFICAT®MWST NQT tt ALiERI� IN ANY NIANNIR --,TIAIt'ECTion/s irosai NO. 1 /1�1?#9 ®— 0� ©. TOWN OF SOUTHOLD C_q BUILDING DEPARTMENT J ]� TOWN CLERK'S OFFICE SOUTHOLD, N. Y. Examined ..... ...... ............... 19..E Application No. ......... �............ 0 Approved ..... ......30............... 19..,E Permit No. M. 9Z........................ �— Disapproveda/c ............................................................................................ .......................................................::: ................................................... i '-.................................... .......... ./................�.................. O (Building Inspector) r APPLICATION FOR BUILDING PERMIT f' I i` _ Date ...........r ................................ 19............ v z INSTRUCTIONS r, a. This application must be completely filled in by typewriter or, in ink and submitted in triplicate 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 port of this application. c. The work covered by this application may not be commenced before issuance of Building Permit. Q d. Upon approval of this application, the Building Inspector will issue 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 hove 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, Ne York; and other applicable Laws, Ordinances or Regulations, for the construction of buildings, additions or alterations, r for removal or deyholiti heroin described. — The applicant agrees to comply with all applicable laws, ordinances, b ilding,code,rhousing code, regulations, and to n admit authorized inspectors on premises and in buildings for necesso s�eCtionh. r o ..................................... ...... ........ .... ......... c (Signatyrnerofropp� ant, or name)if a c roti 05— .................................................................//............................ (Address of applicant) State whether applicant is owner, lessee, agent, architect, engin r general controcto , electrician, plumber or builder. .......... ........r , ....... .................. ........................... Name of own er of premises ' .. 'x..� `` .... ...........Q�.�.....��..�`...... If opplicantiis a�c)(, orate, signatua'o'iOly authorized officer. A� 'h'� k' o ..._ ..- /L AILan� �jP�L ..............................:................:.... .................................. (Name and title,of corp oratteer officer) j � ec Q nirrwM9 Builder's License No. ........... 1............................... R/' /3 U -6 RU7.Gr„) Loa�Q..— Plumber's License No. ................................................ 7 _� / LdQ Electrician's License No. .. ....................... �6 /n 14 Other Trade's License No. .................. 1. Location of land on which proposed work will b ne. Map No.: . ...................................... Lot No. ..... Streetand Number ....;E Y. ;. ..........:................ ............................................................ Municipality s 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: o. Exisiting use and occupancy ................................................................................................................................. b. Intended use and occupancy ................................................................................................................................ 3. Nature of work (check which applicable): New Building .................. Addition ........ Alte ion ................ . Repair .......... . Removal .................. Demolitior.................... Other Work ................................................ ..... r / I ,f^ !'"�,' l (Description) 4. Estimated Cost ...`.........................................................Fee .......................................................................................... (to be paid on filing this application) 5. If dwelling, number of dwelling_U2" ,..........................Number of dwelling units on each floor ....-....................... Ifgarage, 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 ........On)......... ¢a; t., y .,Re .... pg i :.a,,,..... Height ........................ Number of Stories .................................................................................................................. Dimensions of some 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 which premises are situated ..................................................................................................... 12. Does proposed construction violate any zoning law, ordinance or regulation: ........................................................ 13. Will lot be regraded ..... y}.(�y.�j J� "'II excess fill beremoved,�� p,mV14044 ) Yes NbBY1Q ✓mak' .3'a.�^ �L"`n�'.......` 14. Name of Owner of premises ........................................ .... Address ................................ Phone No. ..................... Name of Architect l Address Phone No Name of Contractor ......... .... ...k................................ Address ........................... Phone No ...................... 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. r � ff , di r� r t r, iJ F �y i' ell STATE OF NEW R 15 S COUNTY OF . . . . . .. .. f .................................................................................................being duly sworn, deposes and says that he is the applicant (Name of individual signing contract) above named. Heis 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 than the work will be performed in the manner set forth in the application filed therewith. Sworn�to_bbe�re me this .......V..... ay of ........ .... ..........././,! .... ........., 19-7e NotaryPubl,i*5 ..` ` . unty ................... .. ........9........ . ......P....................................... (Si nature of a licant) JuolTlq T. ITR>Y - N,^,t�ry V�::f: ='e of New York No. 5' �� Cart-tis u p;,.;,starch 30, 1 19