HomeMy WebLinkAbout13482-zFORM NO. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Office of the Building Inspector
Town Hall
$outhold, N.Y.
Certificate Of Occupancy
No. Z.l.Z~ ~ .66. ......... Date ...... 4¢~a.u,~¥..1.0 ............... 1986.
THIS CERTIFIES that the building .... Q~.~..f..~m3.2ky. ¢~¢.e.~ ~. $~.g .....................
Location of Property ...... 6.~5..0.],ct. ¥.~.v.m. ~{.q~ ¢ .......................... o.v.~on.t. ....
House No. Street Hamlet
County Tax Map No. 1000 Section ... ~5 ....... Block ..... 5 ......... Lot .... .7 ............
Subdivision .... l~.a.y.¥$..e~..F..~.v.m. ............Filed Map No. 7..0(L5 .... Lot No.. fi. 5. .........
conforms substantially to the Application for Building Permit heretofore filed in this office dated
.... S~p.¢....a6 ......... 195~. pursuant to which Building Permit No...L3.6.~3~.Z .............
dated ...0.c.'~,. ~.2, ................. 198.6. ., 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 .........
.... On e..£am ;~ 2.y.. ¢ ~.e.~, ~. ~. ~.g: ......................................................
The certificate is issued to .49.h.n.M. Bredem~er III or Beverly A Bredemeyer
......... ......................
of the aforesaid building.
Suffolk County Department of Health Approval ...... 1. 6. 7 .S.O.-: ~..9 ~ ..........................
UNDERWRITERS CERTIFICATE NO.., ............ Eev~l.~.qg ............................
Plumbers Certificate Dec. 27, 1985
Rev. 1/81
Building Inspector
FO~M bO. ~
TOWN OF $OUTNOLD
BUILDING DEPARTMENT
TOWN HALL
$OUTHOLD, N. Y.
BUILDING F'ERMIT
(THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL
COMPLETION OF THE WORK AUTHORIZED)
N? 13482 Z
Permission is hereby granted to'~ ~
...... ..'.J..~...~:.....~.~r..~ar/~'~...~
......... .................................
~o ..... ~.Q~.,2~..,,,~.~....~..,r~......~.(.~.~....gb.,r~..~....~..: ..............................
at pr~mises ,=ated et ....~.~.~...'.....Q./..~2.....~.~/~.....~,~2~....., ...... ...(~... ............................
County Tox Mop No. 1000 Section ..~..~.... Block ..~....~..... ..... Lot No. ~...~.. .........
pursuant to application dated .,,~~(.~(~...~-,..~..., 19~..~.., and approved by the
Building Inspector.
Fee ,./..~Z.. ........
Rev. 6/30/80
FORM NO. 6
TOWN OF SOUTHOLD
Building Department
Town Hall
Southold, N.Y. 11971
765- 1802
APPLICATION FOR CERTIFICATE OF OCCUPANCY
Instructions
A. This application must be filled in typewriter OR ink, and submitted J ~ 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 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 $5.00
2. Certificate of occupancy on pre-existing dwelling
3. Copy of certificate of occupancy $1.00
4.Vacant Land C.O. $5.00
New Building ~'.~, ...... Old or Pre-existing Building
$15.00
Date
. ./¥,(C) ....... Vacant Land ~.~ .........
Location of Property .. ,/-v/.,~:(~'...~.,~,z~....~..~./~..~,:.. ,~.O,,Z/~. ................... ~.~/~.
House No. Street Ham/et
Owner or Owners of Property .<~/~ ~,. ~~.~, ~Q ,~ ~. ~., .~~
County Tax Map No. 1000 Section "~ ~ Block .... ~J.,. Lot...
Subdivision ..... ~ ............................ Filed Map No. ~.~'...Lot No ..............
Permit No. ~'~ .~ Date of Permit ~7~..Applicant, ~c~..~7.,.. ~~'~.
Health Dept. Approval . ] ~' ~O-~ ~. ~ ,Labor Dept. Approval ~ '
b . S~//~/.q-~
nae~riters Approval ........................ Planning Board Approval /~, ~ ~ ...............
Request for Temporary Certificate,..,.........,....~- ...Final Cert~f*cate~'' -~- ...................
Fee Submitted $ ~ .~ .........................
Construction -
on above described building and permit meets all applicable codes and regulations.
Applicant~...%"~.~...~.-. · .~.'.'. ,~/h~...~/C,~.~z' ........
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, Fina~ survey ot property with accurate location of all bui)dings, property lines, streets, and unusua)
natural or topographic features.
2, Final approval of Health Dept. of water supply and sewerage disposal-(S-9 form or equal).
3. Approval of e{ectricat 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 naturat or
topographic 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
3. Copy of certificate of occupancy $1.00
×X
New Building ............. Old or Pre-existing Building ............ Vacant Land .............
Location of Property .............. z'//~5"
Old
Farm
Road
Orient
House No. Street Ham/et
Owner or Owners of Property Peter Blank, Jr. and Mary Louise Blank
County Tax Map No. 1000 Section 025 Block 05 Lot. 007
Subdivision 'Map of Bayview Farm .Filed Map No. 7045 .Lot No. 15
Permit No ........... Date of Permit .......... Applicant ..................................
Health Dept. Approval ........................ Labor Dept. Approval ........................
Underwriters Approval ........................ Planning Board Approval ......................
Request for Temporary Certificate ..................... Final Certificate
Fee Submitted $ 5.00
Constructiononabovede~ribedbuiidingandperm~m.~e~'~ica~~io_~_as.
Applicant,.,~ .......
Wi~~.ri'o~,~ff. ~rney/Agent for
Ray. lO-lO-TS Peter Blank, Jr. and Mary Louise Blank
HENRY J. SMITH & SON,
PLUMBING, HEATING & FUEL OIL
MAIN ROAD
SOUTHOLD, N.Y. 11971
(516) 765--3690
Inc,
CERTIFICATION
D a t e __D_e_c _e _mb_e r _2_7~_1985
Building Permit No._!~A~Z~ .......
Owner Mr & Mrs John Bredemff~E___
Plumber__~Z_~_~_~£~_!~
I certify that the solder
system contains less than 2/10
used in the water supply
of 1% lead.
Sworn to before me this
27thday of Decemb~x__,
19_~i_.
Notary Public, Suffolk County,
State of New York, Commission
Expires March 30, 1986
FIELD INSPECTION ~ DATE COMMENTS
FOUNDATION (1st) ~
STATE ENERGY ~
FINAL
,,
ADDITIONAL COMMENTS:
To: Building Department :~ ~ ~ :f,-< J~n~uary,2, 1986
RE:~ Bredemeyer Job - 425' 01d Farm Road~ ~- ~.ead~ fqr reiBspection.
~. House has R-19 insulation b~tW~en ~i~S~~ ~Jd s~eond .~toor,. i
beldame your Department ~nspec~e~.i~
2.1 ~ 2 ~oa.. n outside of.fo~nd~ien~D~b~ ~be:i[bw grade.
~ Bac~ steps 'p~gvided per you¢ o~d~r. ' ~ ' ~'~ ~'
¢,~ 1~0~ smoke 'alarm IS a~rp~5~ag~5~:~'~ '}f~p~: ~fir~<f!o0'i° bedroom
' ~ by garage/basement door~ I hawe~,~ao~ ~¢~-~Bit~:riEhb:, outside
:. b~d~Oom'd0or t0 supplemenb It a~nd' te,~ ~e~r~kn~ When my ~steaks
~ , ~are done~ ~ , . ~ ~ ~ , ~ ~ ~ : ~ ~ ' :,
Ms. Elizabeth Thompson
Architect
316 Mort Street
New York,' NY 10012
guty 9, 1985
Mr. Walter Corwin
Building Inspector
Town of Southold
Southold, NY 11971
Dear
On behalf of Mr. John Bredemeyer, I have made a site visit to his
new residence at 425 01d Farm Road, Orient. Upon close inspection,
I deem the roof framing over the garage area sufficient to support
all the anticipated loads. The existing roof framing over the main
house also will be adequate once two minor additions are made.
These are designed in th~inheeesg of preserving access to attic
storage space and are as follows:
To prevent ridge beam deflection over the 30 foot span, a
double 2 X 4 post should act as a vertical bracing member
from the ridge beam to the ceiling joist below at a point that
coincides with the bedroom ~2 partition below.
To prevent roof rafter deflection over the 16 foot span, 2 X 6
vertical supports should be added at 32" intervals, 6' inside
both the east and west walls. This will tie the second floor
ceiling Joists to the roof rafters.
Once these modifications are complete, then I am in agreement that
the residence is of sound structure. Please call me %see enclosed
card) if you have any further questions.
Sincere~y~ a A~ /
Elizabeth Thompson, AIA, N.C.A.R.B.
Reg. Architect in New York & Maryland
THE NEW YORK BOARD OF FIRE UNDERWRITERS
BUREAU OF ELECTRICITY
85 JOHN STREET, NEW YORK, NEW YORK 10038~
THAT
wasexa~ninedon~D,~ ~e~.~ andfoundtobeincoo~pliancewithther~quirementsofthisBoard.
DRYERS FURNACE MOTORS
T ME CLOCKS JNIT HEATERS MULTI.OUTLET DIMMERS
SYSTEMS
NO. OF FEET
SERVICE DISCONNECT S E R V I C
OTHER APPARATUS:
l~..oto~~
NO, Oi~E~C,~CON D.j A W(~ NO. OF HI-LE~ A.W.G NO. O~ NEUTRALS A W.G.
OF CC, COND OF H~-L~G O~ NEUTRAL
3/0 J
Dickm.~*.~on CiL ec ,.
GENEI~AL MANAGER
Per % A "
This certificate naust not be a[l'ered in any manner; return fo the office of the 8oard if. inco?mct. Inspedoes may be {dentified by thei?
, CORY FOR~UII.DING DEPARTMENT. THIS COPY O~ CERIjFJCA'I[~ ~S!.NO~ ~LTERE~ IN ANY MANNER;
0
v)
I
0
BUILDING DEPT,
INSPECTION
[ ] FOUNDATION IST [ ] ROUGH PLBQ.
IgC/FOUNDATION 2ND [ ] INSULATION
[ ] FRAMING
REMARKS:
[ ] FINAL
o ~ +o, ~c/<-F-,',,l/,
INSPECTOR ~, _.
'FORM NO. 1
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN HALL
,, ~OUTHOLD, N.Y. 11971
TEL.: 765-1803
Approved~.~27...~'. ~ .'~-. .... ', 19~. Permit No. ~u2~.. ~.~..
Disapproveda/c ........... ~.;..--~..........~.~
(Building Inspector)
APPLICATION FOR BUILDING PERMIT
Date...~ ............ /..,
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, building code, housing code, and regulations, and to
admit authorized inspectors on premises and in building for necessar~ inspegdions. ~--~-D --
.. .....
~Signature of applicfint, or name, if a corporation)
(Mailing address of applicant)
State whether applicant is owner, lessee, agent, architect, en~neer, general contractor, electrician, plumber or builder.
Nmne of owner of premises ....~.".~..'~?~:... ~./7.Q/eft.. .Ac/. · · · ~.~..'. · ~./~gfi~'7. '/'~. .~L' '~' '~%~' · ' - ..~.i ..... (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 ...................... ~Z~_.~
Location of land on which proposed work will be done... ~-.... ~...~...~9~.- .'~ ~.~ ~.~
House Number Street Hamlet
County Ex Map No. 1000 Section .................. Block .................. Lot ...................
Subdivision... ............. So.. ...... ot.. / 5'
(Name)
State existing use and occupancy of premises and intended use and occupancy of proposed construction:
/
a. ~xisting us~ and occupancy ..................................... '. · >', ...........
b. Intended use and occupancy .. ~ ...............................................................
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