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HomeMy WebLinkAbout12886-zFORM NO. 4 TOWN OF $OUTHOLD BUILDING DEPARTMENT Office of the Buildin§ Inspector Town Hail 5outhold, N,Y. Certificate Of Occupancy THIS CERTIFIES that the building Addition Location of Property 920 R. O. ~. -Youngs Rd. Orient House No. Street Hamlet County Tax Map No. 1000 Section . .0.1..8 ....... Block 02 .Lot 016,16 Subdivision X ...Filed Map No. .Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated Feb. 8 19 .8 4. pursuant to which Building Pemfit No. 12 8 8 6 Z dated .... .F.e.b.: ..... 2. .3 ............ 19 .8.4., was issued, and conforms to all of the requirements of the applicable provisions of the law. The occupancy for which this certificate is issued is ......... .... .c.o.n..s.t.r.u.c..t. A44.i.t.i.o.n...t9..a..n..E.x.$.s.t.i.n.~. p.w.~..Z.Z.i.n.~ ......................... The certificate isissued to ........ KENNETH & JERIE NEWMAN ............. ?o¥,'0;, ¥;~,oYVr&/,;,'O' ..................... of the aforesaid building. Suffolk County Department of Health Approval .......... N../.A ............................. N679762 UNDERWRITERS CERTIFICATE NO .................................................. Building Inspector Rev. 1/81 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) 12886 Z Permission is hereby granted to: ..~ .o=~.... Z~..~,~../.~.~.~,~./..,,~..., ...~~....~.~.~. ....... ~z.~.z~. .... ,o ......... ~~...~.z~....~....~...~2z~..~n~ .~... ....... ~.~. ........... ~~....~....~~...~....~..__.__. ............................. County Tax Map No. 1000 Section ..... . .~..d .~.. ...... Block ...~..~, .......... Lot No. ~., .~g.'~.t(.~. .... pursuant to application dated ....... ~.~.~./~...'.~.....~....~...., 1~..~....~'., and approved by the Building Inspector. Fee $..~.. ............. Building Inspector Rev. 6/30/80 FORM NO. 6 TOWN OF $OUTHOLD Building Department Town Hall ~,~uthold, N.Y. 11971 APPLICATION FOR CERTIFICATE OF OCCUPANC~ Instructions This application must be filled in typewriter OR ink, and submitte~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. 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 ie 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. Fees: 1. Certificate of occupancy $5.00 / 2. Certificate of occupancy on pre-existing dwelling/ land use 3. Copy of certificate of occupancy $1.00 --Pre-Exist±ng C,O. $15.00 Vacant land C.O. $ 5.00 Date .......................... New Building .~.~.~.~.~..~.~.. Old or Pre-existing Building .' ...... .~ .... Vacant Land ............. Location of Property....~.~,, .... ~..~. ) ..... ~,, ,~:~.. ~,~ ,r....~, ~. ................ ,0,~, ~,~, ,N. ~,,.. Owner or Owners o f pHr;;~rtNyO...~.~.~.~...~....~.~..~.S, treet~..~..~:~.V~. ..... H~mlet County Tax Map No. 1000 Section ..... /.~. ....... Block . .~., .......... Lot .... ~/.~;.~.~. .... Subdivision ................................. Filed Map No ........... Lot No .............. Permit No; I..~..~'.~..~.'~.--Date of Permit ~/. ~..~...Applicant..~-'~...~.~.~L .................. Health Dept. Approval ........................ Labor Dept. Approval .... ~ ;':' .-7. ............ Underwriters Approval Planning Board Approval ~ ' Request for Temporary Certificate ~ Final Certificate Fee Submitted $ ~.. ......................... / above described building and ~'r~it ~neets all applicable codes and regulations. Construction ~.~n _ j Applicant .... ... J./.../~..~.~.. ............. / looo3o7 THE NEW YORK BOARD OF FIRE UNDERWRITERS BUREAU OF ELECTR C 'I~Y 85 JOHN STREET, NEW YORK, NEW YORK 1003~ Date ~k~/ 22~ ~ N 679762 THIS CERTIFIES THAT only the electrical equipment as described belo~ a~ int~duced by t~ applicant named on the able application number in the premises of ~enne~ K. ~e~n, ~oungA ~ane(~vt. in the followlng locatlo,,; ~ Basement ~ 1st FI. ~ 2nd Ft. Section Block Lot was examined on F~ ~4 t ~9~ attd found to be in cornpliance with the requirements of this Board. FIXTURE OUTLETS RECEPTACLES FIXTURES SWITCHES RANGES OVENS DISH WASHERS EXHAUST FLUORESCENT VAPOR 21 18 14 21 DRYERS FURNACE APPLIANCE TIME dLOCKS UNIT HEATERS MULTI-OUTLE SYSTEMS NO, OF FEET DIMMERS SERVICE DISCONNECT OTHER APPARATUS: Re~laced sub panel in basement S E OF CC COND. NO. OF HI-LEGi~ J oFA' Hi. LEGW G. NO OF NEUTRAl OF NEUTRAL Joseph J. Fronnhoefer Box 817 Route 25 Southold, NY 11971 This certificate must not be altered in any manner; return to the office L1¢%962 [f inco~rect. (flspector may be by their credentials. COPY THR COPY OF Cl= FIELD INSPECTI~ DATE COMMENTS FOUNDATION (Ist) 2.FOUNDATION (2nd) ---- - ~ '° o ROUGH FRAME & FLUMBING INSULATION FER N. Y. STATE ENERGY , -- qpDE "' FINAL ADDITIONAL COMMENTS: Mrs. Helen DeVoe Building Inspectors TOWN 0F SOUTHOLD Office TO Euston Road Garden City, N.Y. January 20, 1985 Box 728, Southold, New York 119~1 Dear Mrs. DeVoe: Thank you for your note regarding our C.©. Frohnhoefer Electric Co., Inc. was' the electrician on the job. We have spoken to him about getting the Underwriters Cert[ificate. He assured us he would get it done. I have jwst written him a?le~ter~e~inding him. The Mrs. Newman on Oysterpond Lane is my mother-in-law. I am glad to hear she has hers. Thank you for your note. ~l~e erel~1 Juts, i~ R k' Ngw~an FORMNO. 3 TOWN OF SOUTHOLD BUILDgNG DEPARTMENT TOWN CLERK'S OFFICE SOUT}IOLD, N.Y. NOTICE OF DISAPPROVAL Date ~...~, ................ , File No ........................... ~ · · · . ~...~,~,'.~g ........... .......... PLEASE TAKE NOTICE that your applicatfon d~ted . ~[5~J~.~d.. ~ ..... 19 ~(. for pe~nit to const~ct ~ff~/(~ at - h3bse ~o~ .............. d / Streot ~ Ham/et Cotmty Tax Map No. 1OO0 Section ...(~[~ ..... Block .. Z~ ....... Lot ~.-: /~ .... Subdivision .... 2'.~7~. ....... Filed Map No. .~ .... Lot No .................. is returned herewith and disapproved on the Ibllow~g grounds . ~~...~d~Z..~'?[.. · , . ~.t:..- ................... Building Inspector RV 1/80 · FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N.Y. 11971 TEL.: 765-1802 xamined Approved 2 .... l ermit Disapproved a/c .... =-,-: ~-...., .-------T .................. ................................ tit ( Buird '~ng Inspector) APPLICATION FOR BUILDING PERMIT INSTRUCTIONS Rece~ived ......... , I 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 necessary inspections. .©~q .~..~.4~. ( .~.. ¥./~.~ :-/.re,f f? .~f~ .,-~..r?-./~ 9 .... (Signature of applicant, or name, if a corporation) ·/~.4/.~.. fid/. g / ~. ~. . £.~, . . . ~.o .~. V~/ i o. q ~. .) . ./4. ?, . . (Mailing address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder· ..... ~'.(,.¢,~,f.,f..c ..... ¢#.,,/T.,c~ .e.zA,q ................................................................. Name of owner of premises ....~.~.O...,~. ~.~.. ~..~;/Fd~;¢~. F.//.....,'~.... ?....~.'/f/~ ............................ (as on the tax roll or latest deed) If applicant is a.qcoJ'poration, sigrt~ture of duly authorized officer. ......... ...... ....... ) .... (Name and title of corporate officer) Builder's License No....~..~.~. ................. Plumber s L~cense No ......................... Electrician's License No ..... /.~./}..~-...~-.C.~.¢:.T.~.(C.... Other Trade's License No ...................... Locationoflandonwlfichproposedworkwillbedone....['~ffll2,drE If[J, o F,c /vo ~'°~'3 ,~d~ flouse Nmnber Street Hamlet County Tax Map No. 1000 Section .../.~. ............ Block ....~. ............. Lot.../(.' ./.~. ........... Subdivision ..................................... Filed Map No ............... Lot ............... (Naine) State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy ZTA/£C~ t ,dj:' . ................... b. Intended use and occupancy 3. Nature of work (check which al,plicable): New Building .......... Addition .......... Alteration ........... Repair .............. Rem )val .............. Demolition .............. Other Work ................ '/ ~ c,~ (Description) 4. Estimated Cost ......... ~.~ 0~,~-'~_,,,~.,~h ~/~fT_ '~--- 'i ..... ~V~ .......... Fee .rYe..(4 .~ ............................... i ; o ~/~ (to be paid on filing this application) 5. If dwelling, number of dwellin ;i units ..... .O..,. ..... Number of dwelling units on eac, h floor ................ If garage, number of cars .......................................................... 6. If business, commercial or mixed occupancy, specify nature and extent of each type of use .\. .................. 7. D~mensmns ofex~mng structures, ffany Front ~q ........ Rear . .~.o. ......... Depth . ~-':.~.-'/ ,~(~. Nur0ber of Stories 0.~..~. Height ." Dimensionsgf same structure With alterations or additions: Front .../.~.: ........... Rear .g. ~.' ............ Depth... ~'.4./'. ........... i'" Height .../..~'.' ................ Number of Stories.. ?.~.~ ............ 8. Dimensions ofeptire new constpaction: Front . .. 1~. fl ...... Rear ... ~ .~..~.~../... Depth . .~.t ..... 2 .... Height .../.~./. ........ Number of Stories ..... O. ~ ~,~ .................................. 9. Sizeoflot: Front .. [ '~/.,/.d ........... Rear ¢l/.~'~ ..... Det~th /~'°~ ...... 10. Date of Purchase ..... /?.7..f. .................. Name of Former O~v~['...~..~i .F.~.~..~.. i.. ii. 11. Zone or use district in which p~emises are situated ..... ~.~/.~.~.,~.'.r2.~.c. .......................... ;. ......... 12. Does proposed construction viOlate any zoning law, ordinance or regulation: ....,~.q .......................... 13. Will lot be regraded .... .A~.0.. ! ................. ;,. ~,~Will excess fill be removed from premises: Yes t 4. Name :of Owner of premises . ~.g??.~.~:. ~.*.,~Yf?.g..~'.~.'~ddress ................... Phone No ................ Name of Architect ......... , .................. Address ................... Phone No ................ Name of Contractor . .~.q~'....(,~.~.¢% ......... Address r.~.4.~Y. ~d.~.g/¢.~.tY.~,,... Phone No...'.,TA~.'.".~.?,~..~.. PLOT DIAGRAM Locate clearly and distinctly al1 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. i NOTARY PUBLIC, State of New !York No. 4728113 QualJ[ied ir~ Suffolk County: j Commh$ion E~pire$ March 30° (Signature of applicant) STATE OF NEW YORK, [S.S COUNTY,~/,/]r~]~,~LFf/,~->~,' ' "'/'f~ ..... i' , .................... being duly sworn, deposes and says that he is the applicant (Name of individual signing contract) above named. He is the ,.....~.o..~ff. 0..~,~.'~, .o. ~:?.(e..~.,g' ............................................................. (Contractor, agent, corporate officer, etc.) of said owner or owners, and is du y 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 manndr set forth in the application filed therewith. Sworn to before me this .............. ....... day ......... 19 Notary Public ..... ounty ['EGGY' jr, WHITE i