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HomeMy WebLinkAbout12150-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building inspector Town Hall Southold, N.Y. Certificate Of Occupancy No. z- 15629 Date April 13, 1987 THIS CERTIFIES that the building One Family dwelling 1645 Brigantine Drive Southold, N.Y. Location of Property ...................................................... House No. Street .... County Tax Map No, 1000 Section 79 .Block 4 ...... Lot 58 Subdivision. ,M./.o..H.a.r.b.o,r..L.i.g.h.t.s..S.e,c... //.3 ..... Filed Map No. 5147 .Lot No. 70 conforms substantially to the Application for Building Permit heretofore filed in this office dated January 31, 1983 12150Z ........................ pursuant to which Btdlding Permit No ...................... dated......F e .... b r u, a .... r y . 1 ..... 0, I.......983 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 ......... ONE FAMILY DWELLING The certificate is issucd to ROBERT W. & LOIS A BRANDSTETTER (owner, ~dtoY~ Y~Y~X of the aforesaid building. Suffolk County Department of Health Approval 13 - S O- l 0 N608095 UNDERWRITERS CERTIFICATE NO .................................................. N/A PLUMBERS CERTIFICATION DATED: Rev. 1/81 i2150 ~i~sior~ is her~eby granted to: , T~N !OF BUlLI~iNG (THIS PERMIT MUST BE KE~T ON T"~ COMPLETION OF THE WORK AUTH~RiZED~ rO .,~ ......... J at, p~emlses located at · CoUnty Tc~x Map No. 1000 Section p~s~ant ?o application dated ' B~ilJlng Ibspe~°'~ ~ ~.: ...... ~.~ ............. : PErMiT' INCLUDES APPROVAL ~O REMovE EXCESS FILL ;FROM !ABOVE PREMISES BY · 'DI~J~/!WAY ~:ONrTR, UC'TION --C oOL Co,s, O~H~R : Rev. i6/30/a0 19; .... ~ !rTO ,,, and approved by the ? FORM NO. 6 TOWN OF $OUTHOLD Building Department Town Hall Southold, N.Y. 11971 765- 1802 APPLICATION FOR CERTIFICATE OF OCCUPANCY Instructions 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 features. 2. Final approval of Health Dept. of water supply and sewerage disposel-(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. 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 informa- tion required to prepare a certificate. C, Fees: 1. Certificate of occupancy New Dwelling,$25.O0, Accessory%$]O.00 Business $50.00 2. Certificate of~)ccupancy on pre-existing dwelling $ 50.00 3. Copy of certificate of occupancy $ 5.00, over 5 years $]0.00 4.Vacant Land C.O. $ 20.00 z~./,~./~.Z 5.Updated C.O. $ 50.00 Date .................. NewC°nstruction Old or Pre-existing Building Vacant Land Location of Property ./..~..~..~.. ,~../~0~. ~C/~/~..~g/~., ~./~ ........... Hou~ No. Street ~let Owner or Owners of Property ~.~ ~., .& ./~ ~ .~.~ ~ r~C~ .......... County Tax Map No. 1000 Section l~' .~.T.~.~.. Block ............... Lot ................ Subdvsion~[~, ~ ~ F ed Ma Nb~ 7' LotNo ~m Health ~ept. Approval .~x~.~ [~ ............ labor De~t Approval ........................ Unde~riters ~proval..~.0. ~ ~ ..g~ .......... Plannin~ Board Approval ...................... ~equost for Tomporarg Certificate ..................... Fina~ Certificate ....................... Feo Submittad $ ~ ~ Construction on above described building and permit meets all_applicable codes and regulations. Applicant ,~.../~/..~ .................... Rev. 10-10-78 FIELD I~S?EC~'ION COMMENTS FOUNDATION (1st) FOUNDATION (2nd) ~2. ROUGH FRAME & FLUMBING INSULATION PER N. STATE ENERGY C,ODE FINAL ADDITIONAL COMMENTS: 765:,1802 INSPECTION [ ] FOUNDATION XST [ ] ROUG8 FOUNDATION 2ND [ ] FRAMING REMARKS: THE NEW YORK BOARD OF F[RE UNDERWRITERS Z~ BUREAU OF ELECTRI(~IT~ ~- 85 JOHN STREET, NEW YORK, NE~V ~ORK 10038 THIS CE~IFIE$ THAT ~ ~ only the e~trlcal equipment as described belo~ and introd~ed by the applicant oa~fd on the able application number in the premises of ~ B~tetter, I~ig~ine Dr. N. ~i~ ~ ~c~r, ~t~ld, N.Y. in the followlng location; [] Basement [] 1st Fl. 23 ~ [] 2nd FI. i Section Block Lot and found to be irt compllat~ce with the requirements of this Board. RANGES OVENS DISH WASHERS EXHAUST FANS DRYERS SYSTEMS NO. OF EEET OTHER APPARATUS: 1-4.5 K.W. t~)t Water Heater 1-~Smoke Detector Paul Burns Town H~bor Lane Southold, N.Y., 11971 E R C OF HI-lEG 1 OF NEUTRAL This certificate must not be altered in any man6er; return to the office of the Board, f MANNER. credentio UILDING DEPARTMENT. THIS COPY OF MAP AMEND6D JAM. iT, .~'r?r2C~ surF'ouc co: D~s~, 'o~5 ~,6t:.r~ TOWN OF SOUTHOLD BUILDING DEPARTMENT 'I~OWN CLERK'S OFFICE SOUTHOLD, N. Y. Examined ,...~,.~, ......... Approved ...~..'~.. .......... ./..?.. .......... , 19~..~...: Permit No ..... /.~'~Z~?..~.'.. ...... Disapproved a/c ............................................ ~i' ...................... '~ ..................... × '~' (Building InSpector) Application No../.~.~./...~...~. ............ APPLICATION FOR BUILDING PERMIT Date ,a . /. INSTRUCTIONS a. This application must be completely filled in by typewriter oe in ink and submitted in triplicate to the Building Inspector, with 3 sets of plans, accurate plot pla, 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 oF areas, and g v ng a deto led descr Pt on of layout ofproperty must be drawn on the diagram which is port of this application. c. The work covered by this application relay not be commenced before issuance of Building Permit. dl Upon approval of this appJication, 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 have been granted by the Building Inspector. APPLICAT ON S HEREBY MADE to the Building Department for the issuance of a Building Permit pursuant to the Bud ng Zone Ord nonce of the Town of Sou{hold, Suffolk County, New York, and other applicable Laws, Ordinances or Regu arians, for the construction of buildings, additions or alterations, or for removal or demolition, as herein described. The app leant agrees to comply w th all appli6abl'e laws, ordinances, building code, housing code, and regulations, and to admit authorized inspectors on premises and in buildings for necessary inspections. (Signature of applicant, or name, if a corporation) 3~0 Bo~i~so~ B~]. Green'Oor~, ~. Y. (Address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. ~ .... :~ Leis & Rober% Bra~4s%e%%er Nome of owner u. ~,.~...,o~= .................................. .................................................................................................................. If applicont is a corporate, signature of duly 'authorized officer. (Name and title of corporate officer) Builder's License No. 28 ................ Plumber's License No .... ~.%..c.~.~.?.~: .......................... Electrician's License No .... : ........................................ Other Trade's License No ............................................... 1. Location of land on which ?~ropos~3dr~r~nw~l~ ~b~ d.~e~.~oP No.: ..~,l:~..7...~.~}~z~/.iF.~:.,/;~..~{~oO~ ~o.....7.? ................. Street and Number ./.~.~..~.' .................. J.......J.: ...... : ......................................... ":.'- ........... ': ............................................. Municipality 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Exisiting use and occupancy ................................... ~ ............................................................................................. Resielen trial ~l~].l in g b. Intended use and occuponcy ................................................................................................................................ Nature of work (check which applicable): New Building, .~..?,?- .......... Addition i ................. Alteration .,J ......... ~,., Repair .................. Removal .................. Demolition...: ................ Other WorkI ..................................................... 4. Estimated Cost ............................................................ rea ....~...f. c~ i (Description) (to be paid on! filing this application) 5. If dwelling, number of dwelling units ....?..B.9. ................. Number of dwelling uqits on each floor ..... ~.~ ............... If garage, number of ~rs ..................................................................................... k ....................................................... 6. If business, commercial or mixed occupancy, specify nature and extent of ~ach 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 of entire new construction: Front 44 ~ ~ ~ 28 .................................... Rear ....... ~ .................... Depth ........................ Height .................... Number of Stories ..................................................................................................................... 9. Size of tot: Front 100' 204 ........................................................ Rear 155~ . . Depth ~0. Date of Purchase ........................................................ Name of Former Owner ....................................... 11. Zone or use district in which premises are situated ~es~¢~l 12. Does proposed construction violate any zoning law, ordinance or regulahon 13. Will lot be regraded .....~ ................... Will excess fill be removed from premis~es: ~') Yes ( p .................................................... ~ ............ Fnone ~o ....................... Name of Architect ~¢~0~1 ~s I~c. . . Address ~I~.~.?l Ph ,. 8128830840 Name of Contractor .~.~...~.t...~.~ ...............................Address ................. ~ .............. Phone No ....................... PLOT DIAGRAM ' Locate clearly and distinctly all buildings, whether existing or proposed, and indicate all set-~ck dimensions from prope~y lines. Give street and bh :k number or description according to deed, a~,d show street names and indicate whether interior or corner lot. TATE 0 NEW R [ < ...................... ~. ......................................................................... being duly sworn, deposes end s~ys that he is the epplicom (Neme of individucl signing contrecf) above n~med. (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 conta ned n th s appl cat on are true to the best of h s knowledge and be ief; and that the wark will be performed in the manner set fo~h Jn the application filed therev ith. Sworn to before me this ~OT~RY pUBL O, State of HeW YO~ N~. 52.8125850, Suffolk / SErViCES - F"Or'~ APPP-.OVAL OF I t APP~.OVED~ I / I I · .N:s. ~., ,. t ~loN 7~o~ o~ I '~L~ OF OCCD, C¥ If copper lubing is u.sed [or water distributing sysiern; piping shall be o[ types K or L o.nly I U LI t FEE."~,~ f DY :~ .- NOT~F¥-BUiLr~ING DEPARTMENT AT CODES. NOT RESPONSIBLE FOR DESIGN OR'CONSTI~UCTI©N EI~RORS. I 2:80' ~5~'T H 2_ 8'0 44' X lt77.32 1000o 177.32 0.05 x t77.32 177.32 I77.32 x 0.05 8.866 0 \ .