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Home My WebLink About11506-zFORM NO. 4 TOWlq OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUP/LNCY No: Z-11062 Date: 07/02/82 THIS C~MTIFIES that the building ADDITION WITH DECKS Location of Property: 3695 ROW PINE NECK RD (HOUSE NO.) County TaxMap No. 473889 Section 70 SOUTHOLD (STREET) (HAMLET) Block 6 Lot 25 Filed Map NO. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated NOVEMBER 23, 1981 pursuant to which Building Permit No. 11506-Z dated DECEMBER 10, 1981 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 AN ADDITION TO AN EXISTING ONE-FAMILY DWELLING, INCLUDING DECKS AND STAIRS. 4/14/11, UPDATED TO INCLUDE DECKS AND STAIRS. (/LKA 3693 ROW PINE NECK ROAD) The certificate is issued to ANN B BRUER of the aforesaid building. ( OWNER ) SUFFOLK COUNtrY DEPART~ENT OF HEALTH APPRO~%L N/A ~.RCTRICAL u~KTIFICATH NO. N 561214 05/13/82 PLUMBERS c~KTIFICATION DA'r~ N/A Rev. 1/81 FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. Certificate Of Occupancy No. Z11062 Date ....... .,l.u.i.y. 2 19 82 THIS CERTIFIES that the building ................................................ Loca~ionofPro/perty 369~' I~.O.I~, ot'f' P:tne }leek ltd, ~out:ho~.d House IVo. Street Hamlet County Tax Map No. 1000 Section 070 .Block 06 .Lot 025 X Subdivision ............................... Filed Map No ......... Lot No .............. conforms substantially to the Application for Building Permit heretofore filed in this office dated ...bl.o.v.o..m.b.e.v...2.3 ...... ,19 ?,1. pursuant to which Building Permit No....1.1.5.0..6..g. .......... dated December 10 81 ............................ 19..., 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 ......... an add~-t;~.on t~o an ex~.e~;~ng one-fame, iT d~ell:[ng, The certificate is issued to ~,nn B o Bruev (owfler, of the aforesaid building. Suffolk County Department of Health Approval UNDERWRITERS CERTIFICATE NO ..... ~..5.6.1. 2. ? ~. ................................... Building Inspector Rev. 1/81 FOBM NO. ~ TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N~ Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON TH.E PP, EMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) 11506 Z Permission is hereby granted to: ..... ~..~_~.,~..L.~..~.z~..../~. ........ db/.~./~.z_....z~. ............................ ........ ~(~.z.rz.~.~..:..~ ...... /z~Z/ ~o ........................... ~.~., ....... ,...~ ....... z ~.~. ..z...~.....~.z~.~.~.~...~/~ .......... .......................... ~ .............. ~;~.....~,...../~ .............................................................. at premiss I~ated Ct ..... ~"'.~.,..~ ....... ~ ...... ~...~c~..~....f .............. ............................................................................................................ ~.~~..~.~ .... ~un~ Tox Mop No. lO00 Section .... .~.Z~ ........ Bilk ..¢..~. ...........~t No..~ ........ pursuant to o~licotion dated ..~¢.~.....~ ........................... , I~/., and oppr~ by the Building Inspector. Rev. 6/30/80 Form No. 6 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL 765-1802 APPLICATION FOR CERTIFICATE OF OCCUPANCY This application must be filled in by typewriter or ink and submitted to the Building Department with the following: A. For new building 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 from Health Dept. of water supply and sewerage-disposal (S-9 form). 3. Approval of electrical installation from Board of Fire Underwriters. 4. Sworn statement from plumber certifying that the solder used in system contains less than 2/10 of 1% lead. 5. Commercial building, industrial building, multiple residences and similar buildings and installations, a certificate of Code Compliance from architect or engineer responsible for the building. 6. Submit Planning Board Approval of completed site plan requirements. B. For existing buildings (prior to April 9, 1957) non-conforming uses, or buildings and "pre-existing" land uses: 1. Accurate survey of property showing all property lines, streets, building and unusual natural or topographic features. 2. A properly completed application and consent to inspect signed by the applicant. Ifa Certificate of Occupancy is denied, the Building Inspector shall state the reasons therefor in writing to the applicant. C. Fees 1. Certificate of Occupancy - New dwelling $50.00, Additions to dwelling $50.00, Alterations to dwelling $50.00, Swimming pool $50.00, Accessory building $50.00, Additions to accessory building $50.00, Businesses $5000. 2. Certificate of Occupancy on Pre-existing Building - $100.00 3. Copy of Certificate of Occupancy- $.25 4. Updated Certificate of Occupancy- $50.00 5. Temporary Certificate of Occupancy - Residential $15.00, Commercial $15.00 Date. ti New Construction: Location of Property: House No. Street Owner or Owners of Property: ~_'~ ~.~k Suffolk County Tax Map No 1000, Section Subdivision Old or Pre-exis,ting Building: Date of Permit. Permit No. Health Dept. Approval: Planning Board Approval: Request for: Temporary Certificate Fee Snbmitted: $ ~1~ .~ (check one) Hamlet Block ~o Lot ~-~ Filed Map. Lot: Applicant: Underwriters Approval: Final Certificate: ~ (check,one) Applicalff Signature FORM NO. 6 TOWN OF ~OUTHOI~D 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 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 peoperty showing all property lines, streets, buildings and unusual natural or topograph ic featu res. 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 2, Certificate of occupancy on pre-existing dwelling or land use $5.00 3. Copy of certificate of occupancy $1.00 Date . .~.~.~ .~/.~... New Building ..... .~.. .... O[d or Pre-existing Building ...V~... ...... Vacant Land ............. Location of Property ... ~ ~.: ~/: .... Of'~'..../'.~/././:/g'....'(/.,¢~-:. ~' .... ~.o..~..C~ ...... ~'.~ M. ~./~./~.. House No. Street Hamlet Owner or Owners of Property . . . ~.A2.~f,2 .... ~>... ,~.A~C/~Z~ ............................... County Tax Map No. 1000 Section .... ~.7. ~) ..... B lock ....~).~-_c~ ....... Lot...~:~).~-, ~,'~. ...... Subdivision .... ~_. ............................ Filed Map No. .Lot No. Permit No:;~?~.... Date of Permit /.~././.~//.4~/..Applicant.. ,,~.~, ~,~/"'~/.. ~..c~, Health Dept. Approval ...... /~/~,. ............. Labor Dept. Approval ..... x~./g, ............... Underwriters Approval. ~. 5~1 ~, I.~ .......... Planning Board Approval ... v~./~ .............. Request for Temporary Certificate ..................... Fina~ Certificate ...... ,l~... Fee Submitted $...~'. ~..O..O... ~ ................ Construction on above described building and permit meets aH applicable codes and regulations. Applicant ~L .~.. ~ ....................... STATE OF NEW YORK ) COUNTY OF SUFFOLK ) JOHN BERTANI, being duly sworn, deposes and says: THAT he is the President of John Bertani Builders, Inc. That in 1981, he built an addition to premises then known as 3695 ROW offPine Neck Road, Southold, New York (Suffolk County Tax Map Number 1000-070.00-06.00-025.000) The premises were then owned by Ann B. Bmer; THAT he built the addition in accordance with Southold Town Building Permit No. 115506Z, which resulted in Certificate of Occupancy No. Z 11062; THAT the construction included two decks on the North side of the structure, steps on the East side of the structure, including steps offthe Northeasterly wing of the premises. A sketch of the decks and steps are attached hereto. Sworn to before me this Day of ?~{c~ ~J~ ,2011. Notary i=u; c !~ =f New York No. '~ ~ Qua fed in SE'*'" ~'- · Oommiss on Expires November 30, %"1~ Jo~h'Bertani THE NEW YORK BOARD OF FIRE UNDERWRITERS BUREAU OF ELECTR C TY j~;¢, 85 JOHN STREET, NEW YORK, NE~V yORK 1003~ D.te My 13, 198g ~ppacatlon No. on/lie 138013-82 N5 6 1 2 1 4 THIS CERTIFIES THAT only the electrical equipment as described below and introduced by the applicant named on the abo~e application number in the premises of Rudolph ~'uer, Private R~ad (off Pi~e Neck Road), SouChold, N.Y. in thefollowing location; ~ Basement ~ 1st FI. ~ 2nd FI. Section Block Lot w,$ ~,,ni,,ed o,, May 6, 1982 and found to be in complianre with the r~qulrements of this Board. FIXTURE FIXTURES RANGES EXHAUST FANS OUTLETS SWITCHES NCANDESCENT FLUORESCENT 81 66 81 DRYERS SYSTEMS OTHER APPARATUS: 1/2, 2-FHPs E R NO, O C~.COND, OF CC COND. 3/0 C NO OF Hi-LEG J NO OF NEUTRALS A, W G 3/0 G & S Elec, lX~x . . . Per_ , This cerhflcote must not be altered in any manner; return to the office orr the Board if i;nco~rect. Inspectors may be idenfif~ bv theiQ, credentials. o.Y m~ BUI DING DEPARTMENT. THIS ~OPY OF ~ERTI ICATE M ~; ~ ~OT B~D_I~ ANY MANNER. [~ FIEL~INS~ECTION · FOUNDATION (1st) COMMENTS FOUNDATION (2nd) ROUGH FRAME & PLUMBING INSULATION PER N. STATE ENERGY FINAL ADDITIONAL COMMENTS: FORM NO. 3 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N.Y. NOTICE OF DISAPPROVAL File No,~ .............................. /~ Date. :.~-~. ..... .~. ............ 19.~.. .... PLEASE TAKE NOTICE th~ your application dated...~..:.: ........ 19 &.. Location of Property ~'~' ~Z.~.~~ , ~ h3~s; ~d ..... /~ Street / Ha co~ty ~x ~p ~o. ~000 s~tio....~ ...... ~o~k .. ~.~ ......... ~ot . .~5~ ...... Subdivision ...... ~ ........ Filed Map No. ...... ~..... .... . Lot No ................ is return~ herewith and disapproved on the following grounds . · ~~~ ............................ Butld~g Inspector FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N.Y. 11971 TEL.: 765-180;3 Examined .~.C.../..O. ..... 19:~...ff. D~sapproved a/c ............... ......... ~ ......... APPLICATION FOR BUILDING PERMIT Application No. f./..~.~.~..~ ......... Date ...~J. ?.~....~..~ ...... , 19,~.1. 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 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 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. 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, building code, housing code, and regulations, and to admit authorized inspectors on premises and in buildings for necessary inspections· ·..~.~d//4..~,~',,~.. ~o~ .. Mc .......... (Signature of applicant, or name, if a corporation) o.... f-gqco ............ (Mailing address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. ... ................................................................................... Name of owner of premises . . . ~.~ S. · ·:- .~A~. - .~?. . · .J~. ~- .... ~q~?..c~ ................................. (as on the tax roll or latest deed) If applfica~nt 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...~>.~......c~?..~. [,~,/.O... Other Trade's License No ...................... Location of land on which proposed work will be done· . .~r~?~2t~: e..~7..g~2.,~...O~r:.2~.. ~..~'. ................. ............................................... ............. House Number Street Hamlet County Tax Map No. 1000 Section ...... .~7~. ........ Block ...(o .............. 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 .. ~ddcO;.~t~-~t.~a34~ ..................................................... b. Intended use and occupancy .... . .O~..~......~zXt.ff .... ~ ~-Z/~[~/,~ ............................. 3. NatureI of work (check which applicable): New Building .......... Addition ..... .~/... Alteration .~.. ...... Repair' Removal Demolition Other Work (Description) , (to be paid on filing this application) 5. If dwelling, number of dwelling cnits ............... Number of dwelling units on each floor ................ If garage 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 .... ~Sf. ~.: ...... Height .../'~ .......... Number of Stories ..... ~0.,(-,(.,~ ............................................. Dimensions of same structure with alterations or additions: Front .... :~.~. ........ Rear ...~. &'..: ......... Depth '. ....... ~,~ ......... i. · Height . ...~.4f.. 7~.. ~. .......... Number of Stories . . .~'..~'~ 8. Dimensions of entire new construction: Front.. ~. ~. ........ Rear., ~: ........ 'l~epth . .81 ....... 9. Size of lot: Front ..... ~..~. f. ........... Rear ~... ~.~.. ........... Depth . .,~..,~,~t'~'.. ......... ..... 10. Date of Purchase ........... 1 .................. Name of Former Owner ............................. 11. Zone or use district in which pr~mises are situated ..................................................... 12. Does proposed construction wolate any zomng law, ordmance or regulation ... ~ .......................... 13. Will lot be regraded .... ,4~ ..: ................... Will excess fill be removed from premises: Yes ~ No 14. Name of Owner of premises . ./t(.4~...'~..'V.~',. e~.~o'~ddress ................... Phone N0/' · .'---~. ............ Name of Architect . ~.,.. ~¥y'~.¥'. ............. Address ................... Phone No .... ~ .......... PLOT DIAGRAM Locate ~learly 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 c,orner lot. STATE OF .NEW YQRK, ' COUNTY OF. ~..444~,-t.~(,,. 'iS'S · · "~t~' · · ~'-~:a~/' ...... i .................... being duly sworn, deposes and says that he is the applicant (Name of individual signing contract) above named. He is the.. ,..~...~-?q. tPt~., a~.t~.~ ............................................................ (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 that the work will be performed in the manner set forth in the application filed therewith. Sworn to before me this .../~ ...~/~. ......... day of ...... .~..~V ........... , 19~.[ I~to'far~ Public, ................. Qualified m Suffolk County 6omralssion Expires March,:tO, 198~ (Signature of applicant) ~A LT~IZ ~- M t.)DD~ '1 FL-, doi~l% FC:~::>~ N(_3 , J s ~1~ ~A~ ~NGT, WITH ~W F,~, ~ ~. ALL-~LAS~ ~NI~ULATIk~(gOOIF~') L)NLr~.% NC~'TE-~ cxr~t~, loll,, p~AkL LI~Xr~T~ CU,H~AT~.~,. ~ ~IT6HI~N ~-Jj "~i NI N~ J J EJ'4T~.-f I ' ] /' 1 I o to.'¢' g,o. J,q".}. ~.' o ',%" ~,~ _be" L N / (_E.'f,i~,T, -~ , ..... ~ ..... , ~ , _~- ' _ _, .~ .... i~.,,~''~ - ,~ , -,-~.- - ~ ............ A A A ,- / - _ ~ ~,~ r, ~. ~A~EY AI~ / ~, I/~"=l--O'~ I0/ I/~l~ ~V N;~/~I / '0 ~r=C-TIOkl ALTEt~-.ATION TO ~INI ,t~. I~IZUP_..P-.. r--F--..~,~lbF--..N(_.~_.. t='~F--. MF...,~'MF--S_~I2DOI__F'I-I H, ~,~t.J~IZ. AINID[=AMI/.-¥,/F:'INr-- 1512TT~N FOI~- N&'B-. ~ N4.~--$. 1ZUI:NgLPFi H, ~U~--~-.. Ak~b FAMIL'-i"/PINPI NELF--F-- JZD, ) ~--.~,'f'i-~;'f' A~A- / ~.AN-~.: '/.~-~'---I~o'' / Io-I-~l$ Cev. 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