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HomeMy WebLinkAbout12458-z FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No Z17982 Date APRIL 28, 1989 THIS CERTIFIES that the building ADDITION i Location of Property 2405 PVT. RD. #7 DIEDRICKS RD. ORIENT House No. Street Hamlet County Tax Map No. 1000 Section 018 Block 03 Lot 027 Subdivision Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated JULY 11, 1983 pursuant to which Building Permit No. 12458Z dated AUGUST 1, 1983 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 DECK ADDITION TO EXISTING DWELLING. The certificate is issued to MR. & MRS. ARTHUR TRUCKENBRODT (owner, ) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A - UNDERWRITERS CERTIFICATE NO. N/A PLUMBERS CERTIFICATION DATED N/A Building Inspector Rev. 1/81 FORM NO. 2 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) N° 12458 Z Date ......... �1 ........../.................. Permission is hereby granted to: ................ ..:.... :............................... l NV... ....ti...`s:....... to ........ .0........CdaQ, .7��..C,s.ZG....... ..... 1 e`2Q�.(71.. 1�-?.... c fS .✓ .......... K. :..........K7 at premises located at ... y zo..�...........K..Y. ....................................................................................................................... r.�.�..��....:`.�Y ( ................................................................................................................................................................. County Tax Map No. 1000 Section p ..... Block ...� .7.� .......... Lot No. .��.�.7 .....Q.l.C3••• ......... pursuant to application dated ..........:7-rjA(....... .................. 14?. , and approved by the Building Inspector. do Fee $.. ..6.....- .. C . ....... . ..... uil ing Inspector Rev. 6/30/80 FORM NO.6 TOWN OF SOUTHOLD Building Department Town Hall Southold, N.Y. 11971 APPLICATION FOR CERTIFICATE OF OCCUPANCY Instructions A. This application must be filled in typewriter OR ink, and submitted in duplicate 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 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, 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 peoperty 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: 1. Certificate of occupancy $5.00 /�r 2. Certificate of occupancy on pre-existing dwelling ! land use,$ 5.00 3. Copy of certificate of occupancy $1.00 1111 (\�' Date . . S . . .` t. . . . �q New Building . . . . . . . . . . . . . Old orPre-existing Building . ... . . . . . . Vacant Land . . . . . . . . . . . . . Location of Property 9AP:$. . . . . . . .i�r.�k:. � .#7 . . . . . . . . . . . . . . . J. rI. . .14 . . . . . . . .' House No. Street r I y,,, Ham/et 4 Owner or Owners of Property . . 1' . �-VA . .A . t:r. , 1iS�th, kv4�,'-Ol County Tax Map No. 1000 Sect/ion . . . . .12 . . . . . . . Block . . . . 3. . . . . . . . Lot . . .�z 7. . . . . . . . . Subdivision . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .Filed Map No. . . . . . . . . . .Lot No. . . . . . . . . . . . . . Permit No. Date of Permit . . . . . . . . . .Applicant . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Health Dept. Approval . . . . . . . . . . . . . . . . . . . . . . . .Labor Dept. Approval . . . . . . . . . . . . . . . . . . . . . . . . Underwriters Approval . . . .i . . . . . . . . . . . . . . . . . . .Planning Board Approval . . . . . . . . . . . . . . . . . . . . . . Request for Temporary Certificate Final Certificate . . , . . .V, , , , , , , , , , , , , , r/ Fee Submitted $ . . . .�(/.�. . . . . . . q. . . .?al . . . . . . Construction on above described building an p rmit*ea.l. plic ble codes and regulations. Applicant . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Rev.10-10-78 --7 G 0 z i79�2 VICTOR LESSARD Town Hall, 53095 Main Road PRINCIPAL BUILDING INSPECTOR ^~ P.O. Box 1 179 (516)765a902 ,' Southold, New York 11971 FAX(5 16) 765-1823 OFFICE OF BUILDING INSPECTOR TOWN OF SOUTHOLD �Ol�t C�bw U ll2u e� I Idt �n DATE: NAME: ARTHU'P-a I ZUC,-E1 -IZ4b7 ADDRESS : RE: BUILDING PERMIT # SEC . It BLOCK_3 _LOT 17 This Building Permit has expired. You are now in violation of the Town of Southold Zoning Code . Please contact our office, this matter must be corrected. Yours truly, Victor G. Lessard Principal Inspector 4 Tp. d j( LM1:P Y� FIET.D INSPECTION DATE COMMENTS s to H — FOUNDATION .— ( 1st ) V FOUNDATION ( 2nd ) 2 . o� ROUGH FRAME & tn, PLUMBING ` 3 . 13 INSULATION PER N . Y. H STATE ENERGY nu BODE x a 4 . ax- H FINAL o �1 z ADDITIONAL COMMENTS : ' x ro �H a o 1 ' x a r H x ra ro H �& r HORTON CONSTRUCTION CO. INC. CONTRACTORS & BUILDERS P.O. BOX 1442 Q L5 (@ MATTITUCK, N.Y. 11952 PHONE (516) 298-5531 r®1Aeft, vcP`T�N j{ Town of Southold Office of Building Inspector P. O. Box 1179 Town Hall Southold , NY 11971 To Whom This May Concern April 26 , 1989 Please find the enclosed check #4921 this is for Arthur Truckenbrodt . Please mail the C . O. to us and we will get it to the job site of Truckenbrodt . Thank you for your understanding . i--nc ereIy , µAnne M. Hubbard Secretary/Bkkp . Enc . amh �zrlr'I J` TEL. 765-1 SD' TOWN Or SOUTHOLD Oi f'ICI' OF BUILDING INSPECTOR v t q z 1).0. BOX 1 1 79 -7;F TOWN HALL SOlJ7'I10I.D, N.Y. 11971 To Whom This, May Concern, We are unable to complete your Certificate of Occupancy becaus. of the following reasons . An application for Certificate of Occupancy is not on file . No Underwriters Certificate on file . /✓ The check .i:_ (Out.dated/not on file . ) Shce ad I_1 No Health Dept . Approval on file . No final inspection has been made . Please contact our office on this matter. Thank you for your cooperation. BnLldir.q PcrmA I! / oZ / S Z r�2 Building Dept. tic) Plumber Solder Certificate on file . ( all permits involving plumbing being issued after April 1 , 1984 ) �6. ol- ,y s y Ro Whom This May Concern, we are unable to complete your Certificate of Occupancy because of the following reasons. 1) The check is out dated. 2) No final inspection has been made. Please contact our office on this matter. Thank you for your cooperation. 11 Building Permit #12458Z for Truckenbrodt. f Please find check #1727 for $5.00 enclosed. C�VFFO(k TL'L. 765.1802 TOWN OF SUUTIIOLD OFFICE OF BUILDING INSPECTOR P.O. BOX 728 Ln TOWN If ALL SOUTHOLD, N.X. 11971 This is Lo advise you that the job under building Permit no . 12458Z , issued to Arthur Truckenbrodt on 8/1/83__ for Addition is completed and a final inspection has ( ) has not X been done . In order to complete this file , it is necessary that a Certificate of Occupancy be issued . Please fill out the enclosed form , return same to the above office with a check for $25 . 00 payable to the Town of Southold . Please indicate to Whom the Certificate of Occupancy is to be mailed , and arrange with this office for an inspection date . Occupancy or use is unlawful without a Certificate of Occupancy . Please help us to clear up thin matter so that Legal action does not have to be taken . Thank you for your prompt attention . Very truly yours , Victor Lessard Executive Administrator VL : gar encl . M-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION 1ST [ I ROUGH PLBG. [ ] FOUNDATION 2ND [ ] INSULATION [ ] FRAMING [ NAL REMARKS: 0 C _ DATE - INSPECTOR � Kr i FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N.Y. 11971 TEL.: 765-1802 Examined • �!C . . . . ., 19©.� Application No. .���l.J�.Q • • . . . Approved . . . ... .' . ., 19:yPermit No.xa&-- .6z Disapproved a/c . . . ./. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . (Buildi g Inspector) APPLICATION FOR BUILDING PERMIT Date :-Q: . . . .1 �. . . . . . . .. lq K-3 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 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 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' code, housing c de, and regulations, and to admit authorized inspectors on premises and in building for necessary insp o s. (Signature o lic nt, or na , if a corporation). . . . (Mailing address of a icant) State whether whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. . . L. .�. . . . . . . . . . . . .y.�. . . .f . . . . . . . . . . . . . . . . . . . .((. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Name of owner of premises . . .f .�U/Y . . . .Y( �'N.KJ\C1 (t . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . (as on the tax roll or latest deed) If applicant is a corporation, signature of duly authorized officer. . . . . . . . . . . . . . . . I . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . (Name and title of corporate officer) Builder's License No. ! P. . . N.3Y , , . . . Plumber's License No. . . . . . :':": . . . . . . . . . Electrician's License No. . . . .. -- . . . . . Other Trade's License No, I. Location of land on which proposed work'will be done. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .9� tree . . . . . . . . . . . . . . . . . . . .Q� . . �d . . . . . . . . . . . . . . . . . . . . . . . . . . . . House Number Street Hamlet 7 County Tax Map No. 1000 Section . . . . .�. . . . . . . . . . . Block 3 Lot . . . .2. l. . . . . Y . . ./.. . . . . . . . . . . . . ✓/ 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 . . . .� !`I:v . : . . �L1. .� . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . b. Intended use and occupancy . . . . . .cS r2 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3. Nature of work (check which applicable): New Building . . . . . . . . . . Addition Alteration . . . . . . . . . . Repair . . . . . . . . . . . . . . Removal . . . . . , . . . . . . . . Demolition . . . , . . . . . . . . . . Other Work . . . . . . . . . . . . . . . (Description) 4. Estimated Cost j . . . . . . . . , ' . . . . . . . . . . . . . . . . . . . . Fee . . (to be paid on filing this application) 5. If dwelling,number of dwelling units . . . . . . . . . . . . . . . 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 . . . . . . . . . . . . . . . Rear . . . . . . . . . . . . . . Depth . . . . . . . . . . . . . . . Height . . . . . . . . . . . . . . . Number of Stories . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Dimensions of same structure with alterations or additions: Front . . . . . . . . . . . . . . . . . Rear . . . . . . . . . . . . . . . . . . Depth . . . . . . . . . . . . . . . . . . . . '. . Height . . . . . . . . . . . . . . . . . . . . . . Number of Stories . . . . . . . . . . . . . . . . . . . . . . 8. Dimensions f entire new construction: Front . . . . J.. . . . . . . Rear . 3. l � . . . . . . . . . . Depth ,R T . . . . . . . . Height f. . P� . . . . . . . . . Number of Stories . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 9. Sizeoflot: 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: . . I . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 13. Will lot be regraded . . . . . . . . . . . . . . . . . . . . . . . . . . . . Will excess fill be removed from premises: Yes No 14. Name of Owner of premises . . . . . . . . . . . . . . . . . . . . Address . . . . . . . . . . . . . . . . . . . Phone No. . . . . . . . . . . . . . . . Nameof Architect . . . . . . . . . . . . . . . . . . . . . . . . . . . Address . . . . . . , . . . . . . . . . . . . Phone No. . . . . . . . . . . . . . . . Name of Contractor . . . . . . . . .'. . . . . . . . . . . . . . . . . Address . . . . . . . . . . . . . . . . . . . Phone No. . . . . . . . . . . . . . . . PLOT DIAGRAM Locate clearly and distinctly all j 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. S'(2 e_ S�izV STATE OF NE R S.S COUNT -- rx-a..oc . • . • • . . . . . . . being duly sworn, deposes and says that he is the applicant (Name of individual signing contract) above named. Heis the . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . (Contract r, agent, corporate officer, etc.) of said owner or owners, and is d ly authorized to perform or have performed the said work and to make and file this application; that all statements cont ined 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 e this . . . . . . . . . . . . . . . .day of. . . . . . . . . . . ., 19 Notary Public. . . . . . . County I`1MNEILLB SuffofVNyaYDrM olkCwtpNOAR [UEIC, e e - (Signature Of applicant)ND, 9E12585 Torm Expires Merch 30, 1