HomeMy WebLinkAbout15213-zFORM NO. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Office of the Budding Inspector
Town Hall
Southold, N.Y
Certificate O[ Occupancy
No Z-16872 Date May 16, 1988
THIS CERTIFIES that the budding A.D..D.I.T.~. O..~ ......................
Location of Property 65,0 Spt.lng Lane Peconzc, N.Y.
House No .... 'S't/e~[ ........... Harnie~
County Tax Map No I000 Section 086 . . Block .0.5 ........ Lot .06. ........
Subdivision ..
........... Filed Map No ..... Lot No .......
conforms substantially to the Application for Building Pemut heretofore filed in this office dated
·..Apg. us t 12. t..1.98. 6 pursuant to which Building Pemut No .1 .5.213. .2; ........
dated .Au. au. pt .2.9, .198.6 ..
was lssned, and conforms to all of the requirements
of the applicable provisions of the law The occupancy for wtuch this certificate is issued is .
ADD.T~.I6.~ .~.q [.X. IST.I:.N.G..Op.E..FA.IyI.IL.Y..pW?.hL..IN.~ 4.8 A?.P. LI.E.D.FO~R. ......
The certificate is msued to
of the aforesaid budding.
· VERNON &
DO~QTHY. LUECKO~F ...
~wner,
Suffolk County Department of Health Approval . NJ~ ....................
UNDERWRITERS CERTIFICATE NO N785426 - December 23, 1986
PLUMBERS CERTIFICATION DATED: Aprzl 4, 1988 - John E. Walters Plumbzng & Heat
7Bt~uldm~g ~nsp~ctor
Rev 1/81
FO~Var NO. ·
TOWN OF $O~THOI. D
BUILDING D£PARTMENT
TOWN HALL
SOUTHOLD, N. Y.
BUILDIHG PEPJAIT
(THIS PERA41T MUST BE KEPT ON THE PREMISES UNTIL FULL
COMPLETION OF THE WORK AUTHORIZED)
N°. 15213
Z
cou~ To× Mo~ ~o ,0oo s~ .m ~...~.
pursuont to opphcation doted .'~.~'f~'~''
Budding Inspector
, 19~.~, and approved by the
Building Inspector
Rev ~f30f80
FORM NO 6
TOWN OF SOUTHOLD
Buddmg Department
Town Hall
Southold, N,Y. 11971
765 - 1802
ATION FOR CERTIFICATE OF OCCUPANCY
Instructions
A
Th~s apphcat]on must be filled ~n typewmter OR ink, and submitted m~ to the Budding Inspec-
tor with the followmg, for new buddmgs or new use'
1 F~nal survey of property w~th accurate location of all bufldmgs, property hnes, streets, and unusual
natural or topoqraph~c features.
2 Flna~ approval of Health Dept. of water supply and sewerage dmposal-(S-9 form or equal).
3 Approval of electrical mstallatton from Board of F~re Underwmters
4 Commercial buddm§s, Industrial buddings, Multiple Residences and simdar bullrings and mstalla-
[tons, a certff~cato of Code comphance from the Architect or Engineer responsible for the bullring.
5 Submit Planmng 8oard approval of completed rote plan requirements where apphcabie.
B For ex~snng bufldmgs (pmor to Aprd 1957), Non-conformmg uses, or buddings and "pre.existmg"
land uses
1. Accurate survey of p~operty showmg all property hnes, streets, buildm§s 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 houmng code or safety mspect~on of buddmgs or premises, or other pertinent reforma-
tion required to prepare a certificate
C Fees Addzt~ons $25.00 POOLS $25.00
1 Certff~cate of occupancy New Dwellzng $25.00, Accessory ,$10.00 Buszness $50.00
2 Certificate of occupancy on pre-existing dwelhng $ 50.00
3 Copy of certlflcate of occupancy $ 5 00, over 5 years $10 00
4.Vacant Land C.O. $ 20 00
5.Updated C.O. $ 50.00 Date ...................
NewCo'-:~trucb,on Old orPre-exlst,ngBu,ld,ng~)D[ZION.. Vacant Land .........
Locat,on of ProperLy ~(~'~. ........... ~-~,~./ ............ At~- ~'--- f ........ .~.~.' .~./~/C', ...........
House No Srreet Nam/et
Owner or Owners of Property ~/~/'¢¢t/e;~.A/ . f--~. ¢~'Z~,"~. ~...~., .~...~--~_. ~ ~ ..........
County Tax Map No 1000 Section ......... Block . .~..~. ......... Lot .~. ...........
Subd,vls~on .. . Filed Map No ..... Lot No ............
PermitNo:~=' ' ~'-~'lAtfofPermlt ¢~/~/~Apphcant
Health Dept Approval
..... Labor Dept. Approval ...................
Underwriters Approval ........
Request for Temporary Certificate
.... Planmng Board Approval ......
Fmal Certificate ......
Construction on above described budding and~~s
Apphcant~~ ...............
e~v 10 10 78
TOWN OF SOUTHOLD
OFFICE OF BUILDING INSPECTOR
P.O BOX 728
TOWN HALL
SOUTHOLD, N.Y. 11971
TEL. 765-1802
CERTIFICATION
Date Aft,/
Buildmng Permit No.
Owner
(please prmnt)
Plumber ~o~73 ~' ~-)6tl--Cf~
(p~ease print)
I certify that the solder used in the water supply system
contains less than 2/10 of 1% lead.
Sworn to before me this
Notary Public ,~County
'(plumber's smgnature)
· Notary Pu~lzc
IJNDA j. COOPER
Term Expires Dec~mber 31,
TOWN OF SOUTIIOLD
OFFICE OF BUILDING INSPECTOR
P.O. BOX 728
TOWN IIALL
SOUTIIOLD, N.Y. 11971
TEL. 765-1
To Whom This May Concern,
We are unable to complete your Certificate
of Occupancy because of the follo%~lng reasons.
~not on
/_~// The check is(outdated/not on file.
/-_/ No Health Dept. Approua! on file.
/_~/ No final inspection has been made.
Please contact our office on this matter.
Thank you for your cooperation.
Building Permit tl [ .~'-~ / 3 Z
Building Dept.
~**/~ Ho Plumber~ile.
~~~ .ng.~pl_?~!ng being
FOUNDATION
(1st)
FOUNDATION
2.
(2nd)
ROUGH FRAME &
?LUMBING
3.
INSULATIO~I FERN.
STATE ENERGY
CODE
FiNA~//
ADDITIONAL COMMENTS:
HENRY P.
JOHN M. BREDEMEYER, Vice-Pres.
PHILLIP ]. GOUBEAUD
ALBERT KRUPSKI, JR.
ELLEN M. LARSEN
BOARD OF TOWN TRUSTEES
TOWN OF $OUTHOLD
Town Hall, 53095 Mare Road
P.O. Box 728
Southold, New York 11971
TELEPHONE
(516) 765-1892
June 4, 1986
Mr. Robert H. Lehmann
Contractor
P. O. Box 774
Greenport, New York 11944
RE: Luke & Dot Lueckoff
Spring Lane, Peconic, New York 11935
Dear Mr. Lehmann:
Pursuant to your request for a determination on the
need of a Wetland Permit for premises above captioned,
please be advised that the Bay Constable has conducted
an on site inspection and has determined that no permit
is requlred, as the work proposed was not within the
wetland area.
If this plan for construction changes, and becomes
closer to the wetland area you will be required to return
to the Trustee office for an application. Please keep all
construction material out of ~he 75' area, and after the
work is completed please vegetate to stabilize the soil.
Thank you for your cooperation in regard to this matter.
Very truly yours,
Henry P. Smith, President
Board of Town Trust.ees
Ilene Pfifferling, Clerk
HPS:ip
cc: Bldg. Dept.
Trustees
file
7GS-X80~
BUILDING DEPT.
INSPECTION
[ ] FOUNDATION XST [ ] ROUGH PLBG.
[ ] F~~DATION 2ND [ ] INSULATION
lNG
· [ ] FINAL
76S-'~802
BUILDING DEPT.
INSPECTION
FOUNDATION IST [ ~'~ROUGH PLBG.
FOUNDATION ZND [ ~/~NSULATION
[~/FRAMINO
FINAL
7GS-~.802
BUILDING DEPT.
INSPECTION
FOUNDATION ;LST [ ] ROUGH PLBG.
FOUNDATION 2ND [ ] INSULATION
[ ] FRAMING
REMARKS:
FINAL
DATE ,/~//~-~ ~/~,/~-~ INSPECTOR *~ ~"~/'~
FIXTURE
OUTLETS
~ FIXTURES ' RANGES~COOKING DECKS ~ OVEN~ISHI WASHERS
SW TC.ES ~T ~T ~v,u¢~~¥ A~ ,[ T ' K W I ~ KW ~T I K~
1
FUTURE~v4T APPUANCENo ~-w~F~ED~RS IS~CIAL REC'PT~ TIME CLOCKS~ ~ ~sps t TRANE ~BEtL UNIT HEATERS
DRYERS { FURNACE MOTORS
SERVICE DISCONNECT ~ NO OF ~ $ E R
OTHEE
EXHAUST FANS
DIMMERS
E
Paul D~r~s
2~5 Town ILqrl~or Lane
~outhold~ N.Y. 11971
[dc. 2~E
GENERAL MANAGER
Thru cerhflcate must not be altered m any manner, return to the office of the ~oard d incorrect Inspectors may be ,denflfled by their ~redenf~aJs
COPY FOR BUILDING DEPARTMENT THIS COPY OF CERTIFICATE MUST NOT BE ALTERED IN ANY MANHER
Z
~;ugv£vgO
EDWARD ,Fx ~UTH ~. GILLIE
Examm~ ~
Ap pro~~l~7.
Dtsapproved a/c
'FORM NO. 1
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN HALL
°~OUTHOLD, N Y. 11971
TEL.: 765-1802
~°t, 19~
Recexved ........... ,19..
' '/9'
APPLICATION FOR BUILDING PERMIT
'tOWN OF SOUTHOLD
Date ,~uLn,~g il · ,198~
INSTRUCTIONS
a. 'Tins a~6h~ation must be completely filled m by typewriter or in ink and submitted to the Building Inspector, with
sets of plans, accurate plot plan to scale. Fee according to schedule
b. Plot plan showing location of lot and of buddings on premises, relationship to adjoining premises or public stre¢
or areas, and g~vmg a detmled description of layout of property must be drawn on the diagram whlch is part of this app
cation.
c. The work covered by tins application may not be commenced before issuance of Building Permit.
d. Upon approval of this apphcahon, the Building Inspector wrll issued a Bufldmg Penmt to the apphcant Such peru
shall be kept on the premises avadable for mspechon throughout the work.
e. No budding shall be occupied or used in whole or in part for any purpose whatever until a Certificate of Occupan.
shall have been granted by the Buddmg Inspector
APPLICATION IS HEREBY MADE to the Budding Department for the issuance of a Bmldmg Permit pursuant to
Budding Zone Ordinance of the Town of Southold, Suffolk County, New York, and other applicable Laws, Ordinances.
Regulations, for the construction of buddings, additions or alterations, or for removal or demolition, as herem descnbc
The applicant agrees to comply w~th all apphcable laws, ordmances, budding code, housing code, and regulations, and
admit authorized inspectors on premises and in budding for necessary m~o ~ectlons
y_~ ~,'v ~ ~.~.,. .. :. -. f< ....
(Signature of apphfant, or name, ~f a corpbratlon)
.P0 .Box. 2.11, ,%prxmF Lame~.Po¢onio
(Mmlmg address of appbcant)N . y. 119 5~
State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electnczan, plumber or bufld~
Own. e r
Nameofownerofprem~ses Mr~ 7~rno~ Luecko£f..w~.fe Do~athy
(as on the tax roi1 or latest deed)
If apphcant is a corporahon, mgnature of duly authomzed officer
(Name and btle of corporate officer)
Budder'sLlcense No '~3~. ~-n,z~C - (~.,~)e~,cc~.
Plumber's License No
Electncmn's License No ....... :
Other Trade's License No
1. Locahon ofland on winch proposed work wfil be done S~rzn~; Lane, Peconx¢, N.Y.. .-
House Number Street
County Tax Map No 1000 Section 86 ... Block
Subdivision .... Filed Map No
(Name)
Pe¢on~c, N. Y.
Hamlet
5 .......... Lot. 6
..... Lot
State existing use and occupancy of premmes and ~ntended use and occupancy of proposed construchon
a Exmbng use and occupancy .Mairr .3es~e}ence
b. Intended use and occupancy .~x.gons~on oa exza~ng 'K&g'e'~gt':~2 ~' ':, ...........
3. Nature of work (check which applicable). New Building .... ' ..... Addition X ...... Alteration ......
Repair .... Removal ........... Demolition ........ Other Work ...........
(Description)
4. EstLmated Cost. .$8 ~ 000 ~00 ................ Fee .................................
~ (to be paid on f'fling this apphcatlon)
5. If dwelling, number of dwelhng units.. J~ .......... Number of dwelhng 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. Dnnensions of existing structures, if any. Front . .09.' ........ Rear 69.* ....... 'D;~t'h' i ~"i i ' .
Height ........... Number of Stones .Z.~ ....
Dmaensions of same structure with alterations or additions Front .6.?,~ ........ Rear . .26: .........
Depth. ~[~ ...... Height...l,.,~;O,r..7~ ....... Number of Stones .................
8 Dimenslon~o~ ciliate new construction Front . 1.7 ' .... Rear .......... Depth 18.* ..........
14o~Eht , Number c~f qtc~fioe ~
9 Size of lot Front~9,%4 .. 246 ! ...... Rear 24 5: .......... Depth Z6.6 ? ..........
10 Date of Purchase ' 'd~a~Z Z~b ~D. fi9 ...... Name of Former Owner . k ¢lw~.r. 4. ~J.J.~ie .........
11. Zone or use district in which premises are situated.. ~e~z~t,a.~J.a1 .........................
12. Does proposed construction violate any zomng law, ordinance or regulation ...NO ......................
13. W~I1 lot be regraded ..................... Will excess ~l be removed from premises Yes
14 Name of Owner of premises .¥ernoa .Sue.cX~££.. Address .,Spr~ng -r,.~ ...... Phone No. ?~/[..7559 ....
Name of Architect . . . . .. ...... Address .............. Phone No ...........
Name of ContractorI'hlKh. ~'~..~q ........... AddressRe¢On~. Bay. Biv*i.. Phone No722~5637.
~ouebogue, N. Y,
PLOT DIAGRAM
Locate clearly and dlstmctly all buildings, whether existing or proposed, and.indicate all set-back dnnenslons fro
property lines. Give street and block number or description according to deed, and show street names and indicate wheth
interior or comer lot
STATE OF NEW YORK, S S
COUNTY OF .Suffo.Lk...
....... ~ ........... being duly sworn, deposes and says that he is the apphca~
(Name of individual signing contract) ~ -x
above named /' . / /~ / ~ J
Hemthe .. ,¢:.~.~.~ ..Y/.~L~J~/.~..0.~ ......................................
x ./~ (Contra~j6fl,~orate officer, etc )
of said owner or owners, and ~ duly authorized tog.~r.,form or have performed the said work and to make and file
apphcatlon; that all statements contmned m this application are true to the best oflus knowledge and belief; and that tl
work will be performed m the manner set forth m the application filed therewith
Sworn to before me this
........ /~ . . .day of ..... ~ ..... ,19~J~
4. F~NAL cO~STRUCT~N MUST
ALL CONSTRUCTION SHALL
THE REQUIREMENTS ~ THE N.Y