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Home My WebLink About11953-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y, Certificate Of Occupancy No. Z-16143 Date September 8, 1987 THIS CERTIFIES that the building . .R.e.p..1 .a.c.e...p 9.s.t...&..a.d. d..i .t.lff. n...t.o..b..e .d.r.q o..m ...... Location of Property ...8..0 ...... .R.a.b.b..i.t..L.a. ?.e ......... E..a.s.t..M..a.r.i.o.n.:..N.e.w...Y.o.r.k. ..... House No. Street Hamlet County Tax Map No. I000 Section ,..3, [ ....... Block .... 1.8. ......... Lot .... 3. ............ Subdivision ............................... Filed Map No ......... Lot No .............. conforms substantially to the Application for Building Permit heretofore filed in this office dated Sept. 20, 1982 11953 Z ....................... pursuant to wlfich Building Permit No ...................... dated October 6, 1982 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 ......... REPLACE POST & ADDITION TO BEDROOM TO EXISTING ONE FAMILY DWELLING AS APPLIED FOR The certificate is issued to CHARLES LUSCHER, JR. ..................... /oh;.'e;, ..................... of the aforesaid building. Suffolk County Department of Health Approval N / A UNDERWRITERS CERTIFICATE NO ..... N 5 9 4 8 1 4 PLUMBERS CERTIFICATION DATED: N/A Rev. 1/81 Building Inspector FOIL~ NO. Z TOWN BUll. DING DEPARTM[NT TOWN HALL SOUTHOLD, N~ Y. Fee !$. Rev; 6/30/80 BUILDING P,ERM!Ti (THIS PERMIT MUST BE KEPT ON T~H,E PRE~IS~S UNTIL EULL COMPLETION OF THE WORK AUTHORIZED) L Permission is hereby granted to: .~'~ pursuant :1'o application dated ~ ...... ~:~.. ..... :...:....., l¢~nd ipproYed by th~ Building Ihspector. ' r FORM NO. 6 TOWN OF $OUTHOLD Building Department Town Hall Southotd, N.Y. 11971 765- 1802 ~LDG, DE F'T. TOWN OF SOUTHOLD APPLICATION FOR CERTIFICATE OF OCCUPANCY Instructions A. This application must be filled in typewriter OR ink, and submitted m ~ to the 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 natural or topographic featu res. 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, 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 pZoperty 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 informa- tion required to prepare a certificate. C. Fees: Additions $25.00 1. Certificate of occupancy New Dwelling, $25.0,0, Accessory i$10.O0 Business $50.00 2. Certificate of occupancy on pre-existing dwelling $ 50. O0 3. Copy of certificate of occupancy $ 5.00, over 5 years $]0.00 4.Vacant Land C.O. $ 20.00 O~'~.~. ~...'7.~. 5.Updated C.O. $ 50.00 Date ................ NewConstruc tion ...... Old or Pre-existing Building ............ Vacant Land ............. Location of Property . .' ...................... (. ?-.. .... .~. House No. Street Ham/et L c . ............. Owner or Owners of Property ............ ./~.. . .~ ~.~ ..q..~..3....~...d. County Tax Map No. 1000 Section .'~..~.7 .... .~ ...... Block ............... Lot ................ Subdivision ................................. Filed Map No ........... Lot No .......... Permit No././', ~.'~. ,'-~ Date of Permit ./ .~. ............. Apphcant .: ..... Health Dept. Approval ........................ Labor Dept. Approval ........................ Underwriters ApprovM .~. ~ ~../~.. ?.( .~. ....... Planning Board Approval ...................... Request for Temporary Certificate ..................... Final Certificate ....................... Fee Su bm itted Construction on above d~scribed building and,~ermit meets all applicable codes and regulations. - Applicant, .~..~~ .L,.¢. ............. '.. .... Rev. 10-10~78 ¢oe " 1000378 THE NEW YORK BOARD OF FIRE UNDERWRITERS D,8 BUREAU OF ELECTRICITY [~ 85 JOHN STREET, NEW YORI~ NEW YORK 10038 THIS CERTIFIES THAT Char.Les Luech~. ~bit ~e, ~st M~t~, N.Y. in the followlng location; ~ B,se,ne,~ ~ 1st FI. ~ 2nd Ft. See~io,~ B~oc& Lot FIXTURES RANGES gOOKING DECKS OVENS DISH WASHERS EXHAUST FANS FIXTURE DRYERS OTHER APPARATUS: S E R ' A W G NO OF HI-LEG A W G NO, COND OF CC, COND, OF Hi-LEG · E NO I AWG OF NEUTRALS OF NEUTRAL C~mrles M, Hall Elect. 760 Lmxg Creek Dr. $outhold. N,Y., 11971 Lic. ~657 This certificate must not be altered in any manner; return to the office of the Board if incorrect. Inspecto~rs may be ~edentials. r MANNER. FIELD ~NSPE~TION FOUNDATION (1st) FOUNDATION 2. ROUGH FRAME & PLUMBING {2nd) INSULATION PER N. STATE ENERGY C,ODE Yo COMMENTS ADDITIONAL COMMENTS NEW YORK STATE DEPARTMENT OF ENVIRONMENTAL CONSERVATION Regu£~o~y Aff~s Bldg. 40, SUNY--Room 219 Stony B~ook, NY 11794 (516) 751-7900 A a(,v.~'ew h~ be~m made of you~ paopo~at to: ?0 ?O~K ~~ k~ ~ ~'~ N¢~o York State Dep~u~¢.nt of Env~;tor~:e~l Co~s~.vat~Lon h~ found projee~ to be: Ore~e~ than 300' from invente~d, ed tdZ~ woman.. ~ t~n 100' in l~ngth contoured p~or to Septemb~ 20, 1977. Landward of I0' ¢ontou~ ~.evat~on above mean sea lev~ on a g~adudt, ndZu~al ilslope. ~ Landward of topog~p~e~l ~¢~t of bluff, cliff or d~e in exee~s of 10 feet - in ¢£evatlon abov~ mean sea leve~.. Thcw~efore, ~o per-lt, u~d~ A~.ti~e 25 (Tidal W~ffan~ of the E~vi~onmental ConS~rv~ZJ. on Law is required since the proposal ls beyond State mand~ed ju~x'~~ dd~tion pu~suanZ to t~s aeC. Regional Supervisor of R~gu~or y Af f~,~ DJL:RNT:cz 765-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLBG. FOUNDATION 2ND [ ] IN/SULATION / FRAMING [ ~/FINAL REMARKS: DATE INSPECTO~ .J L;I LJ FORM NO, 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N.Y. 11971 TEL.: 765-1803 Examined .~/'... ~.. ...... , 19./p.~. Approved ~ ....... , l~memlit No../.~ O. Disapproved a/c .............. ..................... ................... '-' ')/' ')' ' '~-- ._~ ..... ~ , . APPLICATION FOR BUILDING PERMIT Application No././. ~..~..--?. ....... INSTRUCTIONS. 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 tlfis 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, build_'mg code,/gous~tng codere}nd regulations, and to admit authorized inspectors on premises and in building for necessa~/~~, (Signature of appl~a~,,or n,~ame, !~a corporation) 7729 State whether applicant is ~ tessr, r.~g ...... ~ ~, e!e~r-buildor, .......... ¢.. 7 b-, 778 D ,r. .. Nameofownerofprffmises.. ~.~.~.~./.~.~ ....... ~..~. ~,~.~ '.t~. .......................... (as on the tax roll or latest deed) If applicant is a corporation, signature of duly authorized officer. (Name and title of corporate officer) Builder's License No .......................... Plumber's License No ......................... Electrician's License No ................. : ..... Other Trade's License No.. ~...'?./. .............. Location of land on which proposed work. will be done.., g.~.~..~. *.'..~...~.~..%'~-....'.-..-.~.. s../...,~..~..%~...~-~,. .... House Number Street Hamlet County Tax Map No. 1000 Section .0'.4 ~: ./.~'. 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 ... b. Intended use and occupancy ..... ,,5~6t/BJl.~....~..~d..'..~'.(.=i.. ~'.~.,~,.~.~...~.. Y..~. '.'.. 3, Nature ofvrk (check which applicable): New Building .......... Add~i.o.n .......... Altera![ion ......... Repair .. z~ .......... Removal .............. Demolition ............ Other Work....~r'~ff. ......... 4. Estimated Cost ............................. Fee ......... , .............................. (to be paid on filing this application) 5. If dwelling, number of dwellinlg, units ..... Z ........ Number of dwelling ~nits on each floor.../.. ............ If garage, number of ~ars . . .~.es..~m,~_.. .............................................................. 6. If business, commercial or mixed occupancy, specify nature and extent of each type of use .../g'.~...~-~m.. ............ 7. Dimensions of existing structure~, if any: Front../.~. '7.g.' .. Rear .eg a ~, ',. . Depth . Height . .I ............. Numbe, r oratories... / ................... ; ............................... Dimensions of same structure with alterations or aclditioI~s: Front .... ,/.~,~. ?, ,' ...... Rear ... tr..~.'T .o..~ ....... Depth ... ,,8-. }r .............. .. Hmght .../~-. ................ Number of Stones../. .................. 8. Dimensions of entire new construction: Front ............... Rear . .' .............. Depth ............... freight ............. ... Number of Stories ........ ; ............................................... 9. Size of:lot: Front ..... ~ff..t, .0-.O. ..........Rear .. ~.' .i,.a..~ ............. Depth . ~ f~.l~. ............. 10. Date of Purchase ........... i .................. 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 .. ~. O. .... Will excess fill he, removed from premises: Yes (/No~ 14. Name of Owner of premises .'~ ~ '~-'~'~ ~; } ~'~' .... .. Address ...... Phone No. 2 .~.. Name of Architect . .), ....... i ................ Address ................... Phone No ................ Name of Contractor f-./.q~.r~,. ~...L~..~ .'~.'.'. ..... Address d{/~'~ ~.. :'.7'?..~ ./~. ...... Phone No,g- ?.~'.'r t~. ~.. ~.... PLOT DIAGRAM Locate clearly and distinctly all i buildings, whether existing or proposed, and,, indicate all set-back dimensions from property lines. Give street and block gumber or description according to deed, and show street names and indicate whether interior or corner lot. ,4Zx,rv,~ _Z,~,~ STATE OF NE~'~RK. ~.~ COUNT¥~ .... '~' .....' ~Tr--~- ~ ;x'~') ---> , ~ . .~. '~l~q~. '. '. '. '..~-~._....~... ~a~ ..... being duly sworn, deposes and says that he is the applicant (Name of iffdividual~igning contract) above named. He is the .......................... ~... % ............................ of said owner or owne~, ~d is duly aUt~m or have perfomed the aid work ~d to m~e ~d file this application; that al statements contained M this application are true to the best of his ~owledge and belief; and that the work will be perfomed in the intoner set forth M the application filed therewith. Sworn to before me this Not~blic, .. --..,...~ ..... : 5. .... ...... ;" ' ' i]CffiPANCY' ~'. USE-IS WITH~OT CERTIFICATE OF OCCUPANCY Ii ~pper Lulling is usecl Mr Water distributing system; piping Shall .be of type.~ K or L only AFFEO~'~ J. FOU~DATtO~ FOR ~OUR~D CONtROl ~. ROUGH - F~gN~ ~ IN~UEAT~O~ 4. FINAL ~ CON~U~ BE COMPL~E FO~ C O. ~LL CqN~UCTION , THE RE~U~E~E~S OF' ~ATE CONSTRUCTION & ~ODES. NOT RESPONd[BEE D~IGN OR 'i ~¢. ,4, 'i