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Home My WebLink About16646-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No Z19773 Date MARCH 6, 1991 THIS CERTIFIES that the building ADDITION Location of Property 225 FRANKLINVILLE ROAD House No. Street County Tax Map No. 1000 Section 125 Block Subdivision Filed Map No. I~%UREL Hamlet Lot 03 Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated NOV. 23, 1987 pursuant to which Building Permit No. i6646Z dated NOV. 23~ 1987 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 ADDITION TO AN EXISTING ONE FAMILY DWELLING. The certificate is issued to (owners) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL UNDERWRITERS CERTIFICATE NO. H020440 FEB. 12, 1991 PLUMBERS CERTIFICATION DATED ROBERT H. GERDTS 2/26/91 Rev. 1/81 ROBERT H. & KATHLEEN K. GERDTS ~~; B'i~ding Inspector l~lltM NO. B TCYW'N 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) N]1~646 Z Permission is hereby granted to: ........ ....'~.~.~ ...... 1..3..~ .............................................. ......... ................... at premises located at ...... .~...~. ......... ..~.',~....~...~.~-,]/-J~....~.., ......... ~J.~ ................. County Tax Map No. 1000 Section ..... !....~....~. ........ Block ...... ..~.~, ......... Lot No ..... .(~..~;~ .......... pursuant to application doted ...J~.~~....e~...~.. ........... , 19..~.~.., and approved by the Building Inspector. Fee $..~..~....: ....../.. .... Rev. 6/30/80 BUILDING DEPARTMENT APPLICATION FOR CERTIFICATE OF OCCUPANCY ~. /~ A. This application must be fillgd in by typewriter OR ink and submitted to the bniidingf~uc~ '~pector ~ith the following: for new building o~ new h~se] //~ ~ .Tr. Final survey of property with accurate location of all buildings, property lines, streets, and unusual natural or topographic features. Final Approval from Health Dept. of water supply and sewerage-disposal(S-9 form). Approval of electrical installation from Board of Fire Underwriters. : Sworn statement frog"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 gnd installations, a certificate of Code Compliance from architect or engineer responsible for the beilding. ~. 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: i. Accurate survey of property showing all property lines, Streets, building and unusual natural or topographic features. 2. A properly completed application and a consent to inspect signed by the applicant. If a Certificate of Occupancy is denied, the Building Inspector shall state the reasons therefor in writing to the applicant. Fees Certificate of Occupancy - New dwelling $25.00, Additio'ns to dwelling~ Alterations to dwelling $25.00, Swimming pool $25.00, Accessory buiid~00, Additions to accessory building $25.00. Businesses $50.00. 2. Certificate of Occupancy on Pre-existing Building - $100.00 3. Copy 9f Certificate of Occupancy - $5.00 over 5 years - $i0.00 ~ 4. Updated Certificate of Occupancy - $50.00 5. Temporary Certificate of Occupancy - Residential $15.00, Commercial $15.00 Date ........ ~.'~ ! .c:~.. ~.~. l .~,~ .................... .... .... ................. ii Location of Property.~..~...~....~[..~V{L~J~ '_'~0/'~ LaU~-~J-- Hamlet 'nwe~ or Owners of Property...~O~.~.1~..-~..~. ~ ~fi~-~..~..A~..~. .~..~.'.~..~. :ounty Tax Map No 1000, Section...)~.$. ..... Block ....... ~ ......... Log ...... i~.. ........ ubdivision ................... ' · ......... Filed Map ............ Lot ................. e mit of .K aalth Dept A royal..k)ll~ ' ~ ' ' ~'~ · PP .... ~ ................... Underwriters Approval.~.~. [arming Board Approvai.~jJ .................. ~quest for: Temporary Certificate ........... Final CerCicate ........... ,e Submitted: $ -~..~.;..--7 da z / f?7~ APPLICANT TOWN OF SOUTHOLD OFFICE OF BUILDING INSPECTOR P.O..BOX 728 TOWN HALL SOUTHOLD, N.Y. 11971 TEL. 765-1802 CERTIFICATION Building Permit No.~ Owner~:~- ~ ~]5-~ (please print) Plumber ~4~q~__ (please print) I certify that the solder used contains less than 2/10 of 1% lead. in the water supply system Sworn to before me tkis ~'~, da~ of ,4-/d- ,' ~IOtary Public,.. ~~ County (plumber's signature) Notary Public FOUN DA.T~ FOUNDATION ( 2nd ) ROUGH FRAME & PLUMBING INSULATION PER N. STATE ENERGY CODE FINAL ADDITIO~A'L COMMENTS: 765-1802 BUILDING DEPT. INSPECTION [ ] /FOUNDATION 1ST [ ]/~OUGH PLBG. FO/UNDATION 2ND [~]' INSULATION / [~FRAMING [ ] FINAL THE NEW YORK BOARD OF FIRE UNDERWRITERS ~02~6(1~, BUREAU OF ELECTRICITY ~ 85 JOHN STREET, NEW YORK, NEW YORK 1003S Date FEBRUARY 12,3.991 Appllc~tlonNo. onfite 596066~8/8~ ~ 020/~0 THIS CERTIFIES THAT only the electrical equipment ~ ~scrlbed below a~ int~duced by t~ applicant ~med on the a~ve applicat~n number in the premises of in thefollowlng Iocatlon; [] B~se.~e*tt [~ Ist FL was exa,nined on FEBRUARY 04,1991 FIXTURES fiXTURE SWITCHES 5 6 [] 2~d Fi. OUT Section Block Lot artd found ~o be {n co~*tp~nce u, lth the reqttirements o~ th~s Board. R~GES OVENS DISH WA~HERS EXHAUST FANS OTHER OEYSRS OTHER APPARATUS: ADDITIONAL ff~(NG ONT.,Y'~I ND. OF CC, COND pER~ OF CC. COHD ROBERT ~. GERDIe FRANKLINVILLE ROAD LAUREL, NY, 11948 A W, G. NO, OF HI-L~G FEE PAID A. MOONT ~LEASE REMIT SY ~HECK OR MONEY ~ORDER TO THE ORDER OF THE NEW YORK ~OARD OF FiRE UNDERWRITERS AS CASH SENT BY MAIL WILL BE AT RISK OF SENDER. 11 THIS IS YOUR BILL FOR SERVICE RENDERED AND tS NOT A CERTIFICATE OF COMPLIANCE, THIS BILL PAYABLE AT I~HR NEW YORK OFFICE, 85 JOHN STREET, INEW YORK, N. Y. 10038 'FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL P, OUTHOLD, N.Y. 11971 , TEL.: 765-1802 Examined . {Q 0-7%-~ .~....&.~., 19 ;~. . 7. Approved .PQ.~..~q...&. '~, 19~.D. · Permit No./..~..q..~.7. ·~. BOARD OF HEALTH ...... 3 SETS OF PLANS ....... SURVEY .......... CHECK .......... SEPTIC FORM ............. : NOTIFY CALL ................ MAIL TO: Disapproved a/c ..................................... ....... · (Building Inspector) APPLICATION FOR BUILDING PERMIT Date },[O~.C=_f0.. ~...~.. ~)~,O.., 19 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 necessary inspections. (Signature of applicant, or name, if a corporation) (Mailing address of applicant) State whether applicant is_owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. .......... OW . t4E..f- ............................................................................ Name of owner of premises . .~.~.~. 1~... ~,..~...~..~.~.~.L...~.1~.. ~.....~.~-~.'t$..-5-w--~ ................... (as on the tax roll or latest deed) If applicant is a corporation, signature of duly authorized officer. (Name and title of co~orate officer) . ALL CONTRACTOR'S MUST BE SUFFOLK COUNTY LICENSED Builder's License No ........ O.t4~9 ~ ~Z ......... Plumber's License No ...... .~. IJC. t~4~3.~-. ......... Electrician's License No ..... .O.t~..~..ff~.. ........ Other Trade's License No .... O. UO..~-. ........ 1. Location of land on which proposed work will be done[ ................................................. ............. c.. .. ., .................. .L. .......... : ............. House Number Street Hamlet County Tax Map No. 1000 Section .... ~..~'.~ ......... Block ~ 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 .......... ~5 .K).~.... ?..Fi ..D~. I 1-:.~.....~. ~..~..I .~..l~J~.J~ ................. b. Intended use and occupancy ......... .C~..1~..[~.....~. {q[ ~1.~/.....~..~..~.. [ .'~...F~.I~- ................. 3. Nature of work (check which applicable): New Building ..... ' ..... Addition .... ~. .... Alteration .. ,. ....... Repair .............. Removal .............. Demolition .............. Other Work ............ :.. , (Descrip~tion) 4. Estimated Cost ....~..~..~...'~..1:{.~.~....~.[.O.,.C71~. ........ Fee ...................................... · (to be paid on filing this application) 5. If dwelling, number of dwellin~ units ....... .~. ...... Number of dwelling units on each floor ................ If garage, number of cars ..................................................... ; .................. If business, commercial or mixed occupancy, specify nature and extent of each type of use .: .................. Dimensions of existing structures, if any: Front... firOo ."~. ..... Rear . ...~.O.o..'~. .... Depth . . . ~ ........ Height ...~. (O ..~. ..... Number of Stories ........... ~. .......................................... Dimensions of same structure with alterations or additions: Front .....,~O.~r. ....... Rear ....~(~)~ .~. ........ Depth ..... ~.'~ ........... i... Height ..... ~.(P..-~. ........... Number of Stories ...... ~- .............. Dimensions of entire new consiruction: Front .... .,~..I ~.. Rear ..... ~.~. ....... Depth .... .~. ......... Height ...c~:P..~. ...... Number of Stories ....... '~. .............................................. 9. Size of,lot: Front ....... I.ql! ............. Rear: .... [LO~) ........... c:~.[.~ ........ 10. Date of Purchase ...... .q.[?g:>.~{5 .............. Name of Former O~vn;r' Depth... OD..~ .~.~/. ..... 1 1. Zone or use district in which premises are situated ..... ~.].~ .................... · · · · · .'~'"I> .~ .wT~......--......'F~'M'..... ..... 12. Does proposed construction vi61ate any zoning law, ordinance or regulation: ..... ~ ........................ 13. Will tot be regraded ....... ./~O .................. Will excess fill be removed from premises: Yes ~ 14. Name of Owner of premises ~.OiEI~::IF.~...~.~>.'~ Address"TOl~,l.~r~ ~./~I~..~-,J~L.. Phone No. o~,q/::l .-'::~l~r'/ .... Name of Architect ....... C~A.~J~lg, ............ Address ................... Phone No ................ Name of Contractor ...... O.c9. M .~.E.'/ ........... Address ... : ........... Phone No ........ 15. Is this property locatediw±th±n 300 feet of a t±dal wetland? ~¥es ..... No .'~Y~.i .... · If yes, Southold Town Trhstees Permit maybe required. PLOW DIAGRAM Locate clearly and distinctly all buildings, whether existing or proposed, and~ indicate all set-back dimensions from : number or description according to deed, and show street names and indicate whether property lines. Give street and bloc] interior or corner lot. STATE OF NEW YORK, S.S COUNTY OF .................. ......... .~. I~.C~T~... ~.. ~.lg~..-~. '. ............... being duly sworn, deposes and says that he is the applicant (Name of individual sigfiing contract) above named. He is the ........ ~)l~..~.~-4~..'7'.. ~O.../~'E'...~..~..~..'-~:D....~-..' .............................................. (Contractor, agent, corporate officer, etc.) of said owner or owners, ~d is duly authohzed to perform or have performed the said work and to m~e and file this application; that all statements con*ained ~ this application are true to the best of his knowledge and belief; and that the work will be perfomed in the m~n~r set forth in the application filed therewith. Sworn to before me this ............. ~ ~ ....... day o~ .... ~-~ .... / ..... 19 .~ Notary Public ......... ~'. ~..~untyf ~A~ PUB[IC. ~ate 0f ~o~ Y~ (Signature of applicant) ~. 4707878, Suffolk C0un~ Tern hpir~s M~rch 30, 19~