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HomeMy WebLinkAbout10695-z FORM NO.4 TOWN OF SOUTH OLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall South old, N.Y. Certificate Of Occupancy No ,n099.., ...... . Date . . . . . . . . . . . . . . . . 2.0, ,J)l.ly. . . . . . . . ., 19 .8,2. TIIIS CERTIFIES that the buildmg . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Location of Property .. 31>0. j?yt.. It3". Sp)ltnp).p.,. NY. ),.19.7.1. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . House No. Street Hamlet County Tax Map No. 1000 Section .....070... .Block ., of>. . . . . . . . . . .Lot . .0.0.4. .. " . . . . . .. . SubdIvision. . . . . . . . . . . . . . , . . . . . . . , . . . . . . . .Filed Map No. ....... .Lot No. ............. conforms substantially to the Application for Building Permit heretofore filed in this office dated ! . ., .. . , . . . Hay, 23. . . . . , 19 .110 pursuant to which Building Permit No. . .1Pf>9;;... ....... . .. .. dated .. May. 30, . . . . . . . . . . . , . . . . . . 19 .I1Q , 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 . . . . . . . . . . ., Construct. addition. to. existing. dwelling. . ..... ... .... .. . . . .. ... .., .., . .. ..... The certificate is issued to .. Howard. Bue;rkle. . . . .. .....,.......,.....,................ (owner,lessee or tenant; of the aforesaId building. Suffolk County Department of Health Approval .. N! A. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . UNDERWRITERS CERTIFICATE NO. . , . Ni>8.768l. . . . . . . . . . . . . . . . . . . . . . . . . . ., . . . . .. . . .. . }~(}~- ..... ..:.... .....-.""':"'~~~" Rev 1/81 j . 1 JI. . . '-" o~ L L ;.,,,,, , ,; " \)y FORM NO. 2 TOWN OF SOUTH OLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. y, BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) N? 10695 Z U.?, >Jb Date ....... ~r...../()....""'" '......... ,.., 19. .. . Permission IS hereby granted to: _ ......Jt/d....I:I..~~.r:?A,f:'/cy, .... , .. . , '''7~.,.,~......t.pcKTf.;<..i/J~...., .. ,...., ....~.dQ~.~..N...y"..,.......... ..", ~ ~ -, Z ~ I to .. . .I.C,d/: :tC.U.C.I.....AJL2/.U.. ./.r:J.iU,..../..(J.. ..$i)1'.(.S'T/.'v7.... '51!'/'t0t::r" .. .............................................................................. ............................. ................................................... at premises located at.3~Q........2T....-;/I.3.................:5b<.lT#ot..tY-..."'N..Y.......'" ............................................................................ ".. ......................................................................... ., ......................................................................... .... ..... ............................................................................ r. pursuant to opplicatian dated ...UA.Y...Z 3 ..'....'..,........,.., 1zrQ". and approved by the Building Inspector. Fee $/~..~......... 0.4-:............. Inspector j, " - FORM NO.6 TOWN OF SOUTHOLD Building Department Town Hall Sauthald, N. Y. 11971 APPLICATION FOR CERTIFICATE OF OCCUPANCY Instructians 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, praperty 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 af 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 topagraphic features. 2. Sworn statement of owner or previous owner as to use, occupancy and conditian of buildings. 3. Date of any housing code or safety inspection of buildings ar premises, or other pertinent informa- tion 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 (o(t~1 ?:2 Date. . . . New Building "AdJ...... Old or Pre.existing Building(X) . .. .__ . > 'Vacant Land ............ Location of Property . ..~3 !.tf) . . . _'. _ . . . . . . . . . Pv:r.. .lid '. <!. . -c? . . . . . . . . . .S~;ji:;d.c;f House No. Street Hamlet Owner or Owners of Property ........,. ......,. .- .. ... ........... .......... ..... ". County Tax Map No. 1000 Section ..,.,.......... Block............... Lot................ Subdivision. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .Filed Map No. . . . . .. . . . .Lot No. ............. Permit No. .......... Date of Permit ......... .Applicant . . . . . . . . , . . . . . . . . . . . . . . . . , . . . , , . . , Health Dept. Approval . . . . . . . . , . . . . . . . . , . . . . . . Labor Dept. Approval ...........0 ,.... .... .,., Underwriters Approval. . . . . . . . . . . . . . . . . . . . . . . ,Planning Board Approval ..............,.... ' ., Request for Temporary Certificate. . . . . . . . . . . . . . . . . . . . .Final Certificate. . . , . . . .'. . . . . . . . . - '. :),00 I Fee Submitted $ . . , . . . . .. ../,.. .............. Construction on above described bUil~tmeets~~ an~lations. 34-0 p (/h.Q IV ec. 1. ;eel. , . ~v, . -"- ?/~ ( P oj' y... '!If- 3) 0-(6" Applicant. , .....y.-.... ...... ..........:,..~..._................... Rev, 10.10.78 C. C ' 't. (1(. q f S(Q.Q 'ii, ~cP N V J I CI '7 I R.l,('. ,<;4.. ;:;>0 '3 ~- ~, , / >iJ (Hew 7/,,,(57 , @ ,"n ~ , . . . . . j ,,',~ ;~ ;":t .,. iL ~ ..' 1:1 THE NEW YORK BOARD OF FIRE UNDERWRITERS BUREAU OF ELECTRICITV r- 85 JOHN STREET. NEW VORK, NEW :YORK 10038 July "9 1980 Application No. onj,le 079434 Date ih :;I N 487681 THIS CERTIFIES THAT only the electrical equipment as described below and introduced by the applicaJtt num-cd on the above application number in the premises of H,}\))I:u:d Buerkle> }'iM Neck Rd, @ Oak lawn , Southold,N.Y, in theJollowmg locatwR; 0 Il<<sement [J 1st Fl. o 2nd Fl. Section Block Lot , .I. "4 1980 wusexa,nfnedon ,JU Y ,z. :I) , . andfound to be in compliance with the "equirement~ of this Board. FIXTURE I FIXTURES RANGES COQKING DECKS ' OVENS DISH WASHERS EXHAUST FANS OUTLETS RE'CEPT ACLES SWITCHES INCANDESCENT fLUORESCENT M$fRW AMT 'W AMT 'W AMT 'W AMT 'W AMT H' " 11 'j 5 1 1..2 1 f " DRYERS FURNACE MOTORS FUTURE APPLIANCE FEEDERS SPECIAL REC'PT tiME CLOCKS BELL UNIT HEA1'ERS MULTI-OUTlET DIMMERS SYSTEMS AMT 'W OIL H' GAS H' AMT ND AWG AMT AM' AMT AMPS TRANS, AMT H' NO. OF FEET AMT WATTS J 3 SERVICE DISCONNECT NO. OF S E R V I C E METER NO OF CC COND AWG AWG AWG AMT AM' TYPE EQUIP lft2W IH3W 3H3W 3H4W PER~ OF CC COND NO OF HHEG OF HI lEG NO OF NEUTRALS OF NEUTRAL OTHER APPARATUS 1 tjn\okC:J d<~ t.1~~C t OT - .ifn1Jl }\ru:os ~~-( i ('C-r;WI^~ Hl~rbor Lm1tZ ld,~ ',:wlct,N,y'. U.9/.l 11c. 282E GENERAL MANAGER 11. Pc< This certifICate must not be altered in any manner; return to the offIce of the Board if l(Jcortect. Inspector~ may be IdentifIed by theIr credentials. I COPYJOR BUI~DING DIPART~INT. THIS COPY )OF CP~!FI9~'it\~ "I'rtf?! 'li~~n/l,E!! IN ANY MANNER. TEL. 765-1802 TOWN OF SOUTHOLD OFFICE OF BUILDING INSPECTOR P.O. BOX 728 TOWN HALL SOUTHOLD, N.Y. 11971 17 June 1982 Mr'. Jlm McGar>r>y - Applicant 7~0 Liber>tv Lane ~nl,thnl Ii , 'TV 11971 Dear> Mr RI1AY'lrJA : This is to advise you tha t the job under> Buildlng Permlt No. 10695 issued to Jim McGar>r>y on 5-30-80 for addltlon is completed and a final lnspection has tL7 has notD been done. In or>der> to complete thls file, it is necessar>y that a Cer>tificate of Occupancy be issued. Please fill out the enclosed for>m(s), r>etur>n same to the above office with a check for> $5.00 payable to the Town of Southold. Please indicate to whom the Cer>tlflcate of Occupancy is to be malled, and ar>r>ange with this office for> an inspectlon date. Thank you for> your> pr>ompt attention. Ver>y trulY yours, , (A' ctL<.- ctQ.A) (G.JL Victor Lessar>d Administrator VL:ec Enclosur>es . I : ,,1 ~ ".i"j,. FIELD INSpECTION DATE COMMENTS _. . _ 'Lf 1. ~... !;;1i;:-. _ l---- ~ I::> ,.__w. ___~_E~-------- ~~ JOUNDA_~IQr-T _ -11sj;,) is c; ,~ ''# cI _ /!" A/'I ,:./ /f W . N c7 I I FOUNDATION (2nd) - ~ _ m - , - - - I 2. - GJ,,~ Pi - , ,/ A='-;?' ~ ROUGH FRAME & ~ ~ . ~ PLUMBING I/IJtJ _ I? /J L..: ............, _ !/L..-2f _-r-] // ~ --# t 3. /.h" _ J/A_~J /100,....." ~~ _ ., -7 /J#.'7:: . m . ,fbM-.A.. m-\.1 INSULATION PER N.Y. c+ c: STATE ENERGY COOE . ~ ~ ~ ~ 4, ~/tL ~L A , /~ L ... l' .. ~ ~ -f-' -J pI ! m "- __ ~ c+'" FINAL - - .. ADDI1'IONAL CO""","S, . r ~ ... ....________ ' 1, ... '" , ~ D f-'. 'i 111 c+ f-'. o -. ::! f- ';:r: m I 111 I-' c+ i3' , t:J ~ c+ . . ; J ' ." ~ , .1 o.l ) ,r-,' ------*----- -~::;--..~---*., ~~-.--..-. ---~.--- -.-- --.,..,--...... -- ----...---._-,-~-.--~ .. ,. " , ., .. .. . ~ . , j ! ',f /./~' iN -' .---~ :J _/< ~ {>- --< z -- , - 'J./ k~ _'( 0<(- , Se.~.4~~ ! > .~. ;; ,<3> <> ~~.e.\ ! <( \ 0- '"\ ,7 I \ ~. ~\' \ \2-,0 ~_. 0-..... . ~ .. I . -'- .~ ~~ .-- --- -- ~ )- ! .. ,;.-~t;Q i \ .;.~ " '0 <t '7 --}"~ i .l.- I ' "'_' '--1,.It I . ~t'~. riJ j. ",.w-"-- - "to "}o '(1 I . ? ".::. f"''tIO. 0- ~ I ') , c.. 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' , 1/ i i /' tY I , II I , ~.- I . I ,.,J HI.- , I, , J ,I~" . '.- ...1 - FORM NO.1 TOWN OF SOUTHOLD BUilDING DEPARTMENT TOWN HALL SOUTHOLD, N.Y. 11971 TEl.: 765-1802 Examined/{-o/ ' ~q . :, 19 J!? Application No.I06?1~ . . . . . ctY,..,' '<', cY9 1&695-2 Approve . ., y. .e:),Cl. . . ., 19 .. Permit No. ...........- Disapproved a/c .~- - ---- '" ......,..... ..": ......... ...... APPLICATION FOR BUILDING PERMIT Date .l71Ql.:2.. 3.., 192P INSTRUCTIONS 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 ta 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 befpre issuance of Building Permit. 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 shan 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 an applicable laws, ordinances, building code, housing code, and regular and to admit authorized inspectors on premises and in buildings for necessary inSpeCti~ . ./ ( ~/~( // . .. . . .. . .. .. ';::.. .ff.~?V... . ..... &U..vt::r.. .. . (Signature applicant, or name, i a corpo tion) . .7$9. -::~6'60e./. f' ~t1!6. .;;J;1111101.+/ N. f (Mailing address of applicant) / /CJ7( State whether applIcant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. , , . . .. . . .. . .. .. . .. . ~ /,(",/.70/::'-:. , .. . . . . .. . .. . .. , .. .. .. . . .. .. . .. . .. . . . . .. . .. . . . . .. . . , . .. . .. . .. . Nameofownerofpremises ... /1!.<<f(~1.~"c:!.ff 6a('("~~1............,........,.............. ~~ (as on the tax ron or latest deed) If apPIi(~ corp()ration: S%?Jd ly authorized officer. .. '~~~:7:d~~~~~~~~:)"""'" B 'Id ' L' N # ~a:;' UI er s lcense 0.......'.............,...,. Plumber's License No. . ~I if. ./Sc. . :fi.-/~J5:::.0 I I I E1 .., L' N . I, b ectnclan s Icense 0, ...........,.,..,.'... Other Trade's License No. .....,.............,. ~ / 4 /1 1. Location of land on whichPro~t work will be done. .:~.... .r/jC!-1q,. .".1'..... .B.?r::. .~c4:. ~. ~C(P. . " . .. . . . .. .. ~,. ,e, :~,$. . " . . , .. ..........,...,'............,..,.,.,..,.., House Number Street Hamlet County Tax Map No. 1000 Section .. Q.7.d. . . . . . . .. Block.. (J.t:. . . . . . . . . . " Lot.. fJ?<;;.1-:. . . . . . . . . , Subdivision. . . . . . . . . . , . . . . . . . . . , . . . . . . . . . . . . . . . . Filed Map Np. ... . , . . .., ., .. Lot. . . . . . . .. ., . . .. (Name) 2. State existing use and occupancy of premises anAded use and o&cy of proposed construction: a. Existing use and occupancy.... .9!r::<:... .2?.,pPc/ t/.... .'G!:".?:;:.~........................... . ~ ~ ~ "M/'- f. --- b. Intended and occupancy ................. :.'<1.J::.1..... . . .-:<IoPe? J.~................. j _ ~ ,i .,:' ,~ - .' / - - , ~ , , 3. Nature of work (check whicb applica~le): New Building. . . . . . . . . . Addition. . . . . . . . " Alteration .......... Repair .............. Removal .r. . . . . . : . . . . .. Demolition .............. Other Work. . . . . . . . . . . . . . . ~ i 600, 00 . , l'/f. -~ (Description) 4. Estimated Cost. . . . . . . . . . . . . . . . (- . . . . . . . . . . , . . . . . . ", . Fee . :I.~ . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . , '/ (to be paid an filing this applicatian) 5. If dweIJing1 number of dwelling unit~ . . . . . . . . . . . . . .. Number of dwelling units on each floor. . /. . . . . . . . . . . . If garage, number of cars ........ i. Q. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . , . . . . , . . , . . . . . . . . . . . . . . . . . . . . . . 6. If business, commereial or mixed oc~upancy, specify natug and extent of each typ.e of use . . . . . .~ . . . . . . . . . . . 7. Dimensions of existing structures, if!any: Front. . . . .-P.. . . .. . . . Rear ....~ g,. . . . . . Depth. ., ~ . . . . . ., . . . Height ...... (,?-. . . . . Number!of Stories. . . . . . . ~. . . . . . . . . . . . . . . .. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Dimfmsions of same structure with ilterations or additions: Front ...... .4?1P. . . . . .. Rear... 3/ . . . . . . . . . . . Depth. . . . . . . ~P. . . . . . . . . . . tIeight . . . . . !: ?-: . . . . . . . . . . . . Number of Stories. . . !. . . . . . . . . . . . . . . . . . 8. Dimensions of entire new construction: Front. . . . . .~. . . . . .. Rear........!? /. . . . . . Depth .. . 8:'. . . . . . . . . . . ~eight . .:.... /.~..". NU~hJ~ofStOries.........I.""" 'eJ""............. .r/J/iS"""....... 9. Size of lot. Front.. . . . ., . .7.. ',Jd " ., ... Rear.......... 9.. . .. .., ... Depth //.<v,r:... .. . ..... ., .., 10. Date of Purchase ......... .t?o.(C? . . . . . . . . . . , . . NameJ!f Former Owner ............................. 11. Zone or use district in which premi~es are situated. . . . . . . .~(lI./7//c?4C? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 12. Does proposed construction viola~J.;ny zoning law, ordinance or regulation: ................................ 13. Will lot be regraded ....... ./Z);;~. . . .~ . . . . . . . . Will excess fill be removed from premises: Yes No 14. Name of Owner of premises .... ..wof('.. .&'.v.e#~ddress .. .,:;;"'U'?'/!.o-h4.... Phone No. :7aa?$'..... Name of Architect ............!............... Address . . . . . . . . . . . . . . . . . . . Phone No. .. . . . . . . . . . . . . . Name of Contractor . . . . .~m:. t'l,1:1?4r.r): . . . Address. . .~kf.7.-7'~~~. . . . . Phone No. . ,7.t;c:~?.p.,'X. . . PLOT DIAGRAM i LocElte clearly and distinctly all b,lIildings, whether existing or propased, and, indicate all set-back dimensions from property lines. Give street and block nu.m ber or description according to deed, and show street names and indicate whether interior or comer lot. i , I i , '! ---- , , , if 3) i / ) it' g ----., !/1L ,11-1 f3J T- l~,LI~ ' I ,of (;Jet y i I ~ , STATEOFNEW~O K, i S.S COUNTY OF . . . . . . . . . . . . . I , i . . . . . . . . . . . . . .. ./.v.v.). .m.\ t;;;/rr:j.. . . . . . . . . . . . .. being duly sworn, depases and says that he is the applieant (Name of individual signing contract) above named. ! He is the. . . . . . . . . . . . .'13<< < I,..,,pf'(?:. . . . . . . . . . . . . . . .. . . . . . . . . . . . . . . . . . .. . . . . . . . . . . . . . .. . . . . . . " . . . . (Contractor, agent, corporate officer, etc.) of said owner or owners, and is ~uly authorized to perform or have performed the said work and to make and file this application; that all statements cobtained in this application are true to the best of his knowledge and belief; and that the , work wi\1,be performed in the manper set forth in the application filed therewith. Sworn to before me this i ... .... . ..d .l1:!:. . . .. ..day!of.. ." ~. . .. .., 19..R? , t7 /J.:.J/ ~~ Notary PUblic~'--1 r.......:<~. County JUDITH T. TERRV I ~ , Notaty Publi~\ State of New Yorrt . i . . f" . ". .. . .. , No. 62.0a4'ltl63 SuffOlk' counNn5/ tu,e 0 appbcant Oommlsslon Iixpjr8$ Marchi 30, ltJ;l: I /