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HomeMy WebLinkAbout14653-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. Certificate Of Occupancy No. Z15677 Date .~ P.r.i~...2.2.,. 1..987 THIS CERTIFIES that the building ....A.d.d./. ~. ~9.n. ................................... Location of Property 3245 WELLS ROAD PECONIC h~s'e ~iol ....................... 's'de~i ....................... County Tax Map No. 1000 Section . 0.8.6. ....... Block ....0.:} ......... Lot ....7 ............. Subdivision ............................... Filed Map No ......... Lot No .............. conforms substantially to the Application for Building Permit heretofore filed in this office dated ..... .M.a.r.c..h..5. ,...1.9.8.6. pursuant to which Building Permit No .... 1. ~..6.5.3. Z. ........... dated . Mar cb.. 1.4 o..1.9.~ .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 ......... ..... .~.4 ~..~ .hi.o.~...ho..~..~ ~.~.~. ~..~ ~..o.~..e..f.,.m~ .~.~ y..d. ¥?.~.! ~..~.~.. .......................... The certificate is issued to GUSTAVE AND MARGARET WEIDMANN ..................... ?oYn'e'r, ~'Y-._lC4Jk'x' ................... of the aforesaid building. Suffolk County Department of Health Approval ....... [q/A ............................... UNDERWRITERS CERTIFICATE NO. lq 803894 PLUMBERS CERTIFICATION DATED: April 2, 1987 Rev. 1/81 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N. Y. BUILDING PER~IT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL CQMPLETION OF THE WORK AUTHORIZED) 14653 Permission is hereby granted to: .....~.~.~..~.~ .................................................. ~..~:~.....~.:~.: ....... !.!.5~ .............. - ....... .................................................................................. at premises located at ..,'.~...'~..,~..~. ....... ~.~,.,~........,~,~.. .......... .~......,~'..~'~..~,.~ .............................. County Tax Map No. 1000 Section ........ ..(~....~,..~ ...... Block ...... ..~....~m.. ....... Lot No ..... ~ ................ pursuant to (3pp,t¢otion dated .... ......~......~..~......~. ..................... , 19..~...{~., and approved by the Building Inspector. Building Inspector 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 ~ ~ 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-iS-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 "pm-existing" land uses: 1. Accurate survey of p~perty 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 bui{dings or premises, or other pertinent informa- tion required to prepare a certificate. C. Fees: Additions $25.00 1. Certificate of occupancy New Dwelling $25.00, Accessory I$10.00 Business $50.00 2. Certificate of occupancy on pre-existing dwelling $ 50.00 3. Copy of certificate of occupancy $ ,5.00, over 5 years $10.00 4.Vacant Land C.O. $ 20.00 5.Updated C.O. $ 50.00 Date ...... re-existing Building . .;~ ....... Vacant Land ..; .......... House No, ~ ~ Street ~ I~' [ Hamlet Owner or Owners of Property. ~.~.. ~. I...~.~.. ~. ~:!.. ~.~. ~.~.e.X.. CountyTa×Map~o. 1000~ect,on ..... ~.~ .... B,oc~ ..... --"-~:.... ~ot ..... ~-'~..~ ........ Subdivision ................................. Filed Map No ........... Lot No .............. Health Dept. Approval ........................ Labor Dept. Approval ...................... . . Underwriters Approval ........................ Planning Board Approval ...................... Request for Temporary Certificate ..................... Final Certificate ....................... Fee Submitted $.... ,~.:..(~. (~-~ ................ Construction on above described building and permit mee.ts all~pplie~ble c_?des and regulations. ................ Rev, I0-10-78 THE ~m April THIS CERTIFIES THAT NEW YORK BOARD OF FIRE UNDERWRITERS BUREAU OF ELECTRICITY 85 JOHN STREET, NEW YORK, NEW YORK 10038 15, 198'7 .~p,.l,,~a,,on~o.o..f... 4'08412-86 N 803894 only the electrical ecl~ipm, ent as describ, e~d below and introduced bX the applicant named on the above application nu tuber in the premises of ~UStave Wezdmann~ wells Rd., Rt. 25, Peconic, N.Y. in the follow, lng location; · [] Bas,ment ~s~xo,.i.edo,, Aprzl 6, 1987 ~ lst FI. [] 2nd ~7. Section Block and found to be in compliance u'ith the reqttlre.tents of this Board OUTLET ECEPTACLES SWITCHES D ' FUR IC~ DI O CT O OF RANGES SPECIAL REC'PT S R METER EQUIP. ~w , ~ 3w 3 ~' 3w 3~ 4w NO. O~.CC~CONO A, W G NO, OF HI-LEG O~ CC, COND ;~ ~O~T AMP TYP~ OTHER APPARATUS: LJNIT HEATERS MULTI-OUTLET SYSTEMS NO. OF FEET C Lot EXHAUST FANS DIMMERS 1-G.F.C.I. 275 Town Harbor Lane Southold, N.Y~ 11971 Lic. 282 GENERAL ~ANA~I~R '"" This certificate must not be attered in any manner; return to the office of the Board if incorrect Inspectors may be identified by'their credentials. TOWN OF $OUTHOLD OFFICE OF BUILDING INSPECTOR P.O. BOX 728 TOWN HALL SOUTHOLD, N.Y. 11971 TEL. 765-1802 CERTIFICATION (please print) ~(pleas~, 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,.)~J~,~ l .~ ~ County (plumber's signature) Notar~ Public UNDA J. COOPER Notar~ Publl~, State of N~/~ - No. 4822563, Suff~dk Cou _nty mrm E~ires December 31, 1~ FiELD.INSPeCTION FOUNDATION FOUNDATION (2nd) 2. ROUGH FRAME & ?LUMBING COMMENTS INSULATION PER N. Y. STATE ENERGY CODE FINAL ADDITIONAL COMMENTS: 95-20-6a (9/851 ADDITIONAL GENERAL CONDITIONS FOR ARTICLES lS (Title S), 24, 25, 34 and 36 ( 10. That if future operations by the State of New York require an al- 14 Any material dredged in the prosecution of the work herein permitted 11 12. 13 teration in the position of the structure or work herein autl~brized, or if, in the opinion of the Department of Environmental Conservation ~t shall cause unreasonable obstruction to the free navigation of said waters or flood flows or endanger the health, safety or welfare of the people of the State, or cause loss or destruction of the natural resources of the State, the owner may be ordered by the Department to remove or alter the structural work, obstructions, or hazards caused thereby without expense to the State, and if, upon the expiration or revocation of this permit, the structure, fill, excavation, or other modification of the watercourse hereby authorized shall ~ot be com- pleted, the owners, shall, without expense to the State, and to such extent and in such time and manner as the Department of Environmental Conservation may require, remove alt or any portion of the uncompleted structure or fdl and restore to its former condition the navigable and flood capacity of the watercourse. No claim shall be made against the State of New York on account of any such removal or alteration. That the State of New York shall in no case be liable for any damage or iniury to the structure or work herein authorized whi~:h may be caused by or result from future operations undertaken by the State for the conservation or improvement of navigation, or for other purposes, and no claim or right to compensation shall accrue from any such damage. That if the display of lights and signals on any work hereby authorized is not otherwise provided for by law, such lights and si8nals as may be prescribed by the United States Coast Cuard shall be installed and maintained. All necessary precautions shall be taken to preclude cqntaminaflon of any wetland or waterway by suspended solids, sediments, fuels, solvents, lubricants, epoxy coatings, paints, concrete, Jeachate or any other environmentally deleterious materiats associated w~th the project. shall be removed evenly, without leaving large refuse piles, ridges across the ~ed of a waterway or f(oodplain or deep holes that may have a tendency to cause damage to navigable channels or to the banks of a waterway. 15 If any material is to be deposited or dumped under this permit, either An the waterway or on shore above high-water mark, it shall be deposited or dumped at the locality shown on the drawing hereto attached, and, if so prescribed thereon, within or behind a good and substantial bulkhead or bulkheads, such as will prevent escape of the material into the waterway. 16. There shall be no unreasonable interference with navigation by the work herein authorized. 17 If granted under Articles 24 or 25. and if upon the expiration or re- vocation of this permit, modification of the wetland hereby authorized has not been completed, the applicant shall, without expense to the State, and to such extent and in such time and manner as the Department of Environmental Conservation may require, remove a{I or any portion of the uncompleted structure or fill and restore the site to its former condition. No claim shall be made against the State of New York on account of any such removal or alteration. 16. If g~anted under Article 36, this permit does not signify in any way that the project will be free from flooding. 19, All activities authorized by this permit must be in strict conformance with the approved plans submitted by the applicant or his agent as part of the permit application. Such approved plans were prepared by Bobette Suter on 1Q/25/85 , SPECIAL CONDITIONS Supplementary Special Conditions fA) through (J) attached. N~A Page ..,2 of 3 DEC PERMIT NUMBER 10-85-1344 FACILITY PROGRAM NUMBER(s) I~/~ NEW YORK STATE DEPARTMENT OF ENVIRONMENTAL CONSERVATION PERMIT Under the Environmental Conservation Law EFFECTIVE DATE 1/1-~/86 EXPIRATION DATE(s) 12/31/87 ~-IArticle 15, Title 5: Protection of Water ~-~Article 15, 'Title 15: Water Supply r-lArticle 15, Title 15: Water Transport r-]Article 15, Title 15: Long Island Wells I-I^rticle 15, Title 27: Wild, Scenic and Recreational Rivers E~]6N~'CRR 608; Water Quality Certification [~]Article 17, Titles 7, 8: SPDES __ I-]Article 19: Air Pollution Control r-]Article 23, Title 27: Mined Land Reclamation [~Article 24: Freshwater Wetlands [~Article 25: Tidal Wetlands N--New, R--Renewal, M--Modification r-~Article 27, Title 7: Solid Waste Management [~]Article 27, Title 9: Hazardous Waste Management {~ Article 34: Coastal Erosion Management [-]Article 36: Floodplain Management [~Articles 1, 3, 37; 6NYCRR 380; Radiation Control C--Construction, O--Operation, (if Applicable) PERMIT ISSUED TO Peggy Weidmann ADDRESS OF PERMITTEE P.O. Box 221, Wells Rd.r Peconic, N. Y. 1~5~ AGENT FOR PERMITTEE/CONTACT PERSON gutter &Suter, 51 Woodlawn Ave,,E.Moriches.NY 1L~40 NAME AND ADDRESS OF FACILITY (If different from PermitteeJ ": ~ , '' ~: ' :' N/A LOCATION DE PROIECT Richmond ~COUNTY J TOWH/CJTYW..LAC;E ;reek,between lands of Ho ~O~ Suffolk. Sou~o~d DESCRIPTIONOEPROIECT/FACILITY & Schultze,PEconic Construct a 24' l~n~ addition onto east .~d~_ nF h.n,~.~ !~, of house and 21' TELEPHONE NUMBER 878-46(]2 JUTMCOORDINATES wide off side wide at the northeast corner of garage a minimum of 75' landward of mhw. GENERAL CONDITIONS By acceptance of this permit, the permlttee agrees that/he permit im coeti,a~ent upo~ ~rict c~mp|iance with the ECl., all applicable tegulatlom and the conditions specified herein or attached hereto. ~. Thepermitteesha~f~einthe~ffice~ftheappr~priatere8i~na~permitadministrater'~r~ther~fficedesignatedinthespecIalc~nditi~ns~anot~ce~fintenti~ntoc~mmence work at least 48 hours in advance of the time of commencement and shall also notify him/her'promptly ~n writins of the completion of the work. 2 The permitted work ~hall be sublect to inspecbon by an authorized representative of the Department of Environmenta~ Conservation which m~y ocde~ the work suspended if the public interest so requires. 3 The perminee has accepted expressly, by the execution of the application, the full legal responsibility for all damages, direct or indirect, of whatever nature, and by whomever suffered, arising out of the project described herein and has agreed to indemnify and save harmless the State from suits, actions, damages and costs of every name and descnp- hen resulting from the said p[oject 4 The Department reserves the right to modify, suspead ot ~evoke this po~rnit at ~,ny time after due notice, and, if requested, hold a hearing when: a) the scope of the project is exceeded or a violation of any condition of the permit or provisions of the ECL and pertinent regulations are found; or b) the permit was obtained by misrepresentation or failure to disclose relevent facts; or c) newly discovered information or significant physical changes are discovered since the permit was issued. 5 The permittee is responsible for keeping the permit active by submitting a renewal application, including any forms, fees or supplemental information which may be required by the Department, ,~o Jate~ tha~ 30 days (1~0 days fo~ SPDES ot SoB~ o1 Hazar~uous Waste Manaaement permits) prior to the expiration date 6 This permit shall not be construed as conveying to the applicant any right to trespass upon the tands or interfere with the riparian ri8hts of others in order to perform the permitted work or as authorizing the impairment of any riBhts, title or interest in real or personal property held or vested in a person not a party to the permit, 7 The perminee is respens~ble for obtainins any other permits, approvals, lands, easements and rights-of way which may be required for this project, 8 Issuance of this permit by the D~partment does not, unless expressly provided for. modify, supersede or resciod a~ order o~ consent or dute~minat~on by the Commissloner issued heretofore by the Department or any of the terms, conditions, or requirements contained in such order or determination Any modification of this permit gran~t%d ,by the Oepa. nment_m_ust .be in writing and attached hereto, PERMIT JSSUANCE DATE '~A~I~'~]~I~A'~/O~D'a/ J ^DDRESSBldG.40, SUNY, Room 219 1/13/86 I Charles T.~amilton j Stony Brookr NY 11794 AUTHORIZEx ~ t ,,,SI ATURE ,~ JPage 1 of 3 76.5-1802 BUILDING DEPT, INSPECTION FOUNDATION 1ST [ ] ROUGH PLBG. FOUNDATION 2ND [ ] INSULATION FRAMING [ ] FINAL DATE: INSPECTOR.~,, ~' ~,*~:i:f , ~ FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N.Y. 11971 TEL.: 765-1803 Approved...~. O4>.c~. ! ~.., 19~¢.. Permit No. [ .Q. ~..,~..~...Tq. Disapproved ale ..................................... (Building Inspector) APPLICATION FOR BUILDING PERMIT BLDG. DEPT. TOWN OF SOUTHOLD Received ........... ,19... Date ' ., 19 .?.~ INSTRUCTIONS a. This applicgtion 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. IJpon 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, plmnber or builder. Nameofowner ofpremises ~e~/'~-~ld-~lq'~.~l)f)~ ~;k.)~ IC,~V4~' C ~ .~. .................... (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.. Plmnber's License No ............ ] Electrician's,License No .......... {~/ ........... Other Trade s License No ........ ¥.~. ........... Locatiqn o_f land o,n which proposed work will be done, ' ~~ ~. -'%-~'g;:~f.-~.. ~.~.w3..4. ................... .......... ................ ,.. House Number Street Hamlet County Tax Map No. 1000 Seciion ...C~..~.[4>. ........ Block ...... ~ .......... Lot .... ~ ............ Subdivision ..................................... Filed I~lap No. . .~...r::~...C.~. ..... Lot ............... (Name) State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy . . ~ 1. t-,,J. C~.~...~,,...¢?.~.t'~, ~,L, .x.l....f~,.~.\.%r4~.~,.-r>kB-.k bNt,.., ................ b. I!atended use and occupancy .... .i~. ~.b~_~../~'7.... ~..~..~. ~ ......................... 3. Nature of work (che'~k whiehiapplicable): Repair .............. RemOval... 4. stimated Cost ........ ';'i ......... N B ildi ' Additi ~.. Alt ati r/~ ew u ng .......... on ....... er on ..... ........ Demolition ........ Other Work ............... (Description) ~ ~' (to be paid on filing this application) 5. If dfvelling, ntimber of dwelling units ...o~1~ ....... Number of dwelling units on each floor ................. Ii'garage number of cars .~¢.~>4ff--~.~ .~¥-) .~.?. ).~.~ 6. If business, commercial or mixed occupancy, specify natu,re and extent c~f each tyl?e of use ..................... 7. Dimensions of existing structure!s, if any: Front...ko.~.. .......... Rear . Co.~'~ ..... Depth .~.c:¢..~ .'..c~." ..... Height .... L,-~.~.' ........ Number of Stories..c;~M~-,.. ................................................. Dimensions of same structure wtth alterations or additions: Front ... ~.' ......... Rear...U?.~..' ........... ~'~ ' ' Height ~' Number of Stories Depth .......................................................... 8. Dimensions of entire new construction: Front ............... Rear ...~.c?.'.z .~.'~... Depth ... ' ~ ~ ' Number of Stories ~ ~ Ilaight ................................................................. 9. Size of lot: Front ...... ~..c?.c:?.' .......... Rear ..... ¥ .~ .CC..' ............ Depth .. [ .~C>.'. .............. 10 Date of Purchase k .c3.(o~B. Name of Former Owner 11 " · or use district in which pr~mises are situated . Zont ...................................................... 12. Does proposed construction violate any zoning law, ordinance or regulation: .. ,t,4 Cb ......................... 13. Will lot be r~graded ....... ~,~ ................. Will excess fill be removed fro~ ~:~e~2.mises: ~ No 14. Nmne 0f O~¥[6~r no¥[~r~e~l~[f~,~_ .~,.~:¢~..~.. Address'~..;>.,fg~>~ .~_,.';.\. ~'~h-~ No.."~..~q_~,',',',',',',',','~?.-: Name of Architect ff:,~,.>. --r~&~.....--~....~ ........ Addres~ .o.,.~;;q::~e,¥~, .~on~o..'~D..'~..%t~.~'Z,... Name of Contractor Address ' Phone No PLOT DIAGRAM Locate clearly and distinctly ali buildings, whether existing or proposed, and, indicate all set-back dimensions from property lines. Give street and blocklnumber or description according to deed, and shvw street names and indicate whether interior or corner lot. STATE OF NEW YORK, COUNTY OF t~.. ~?..~?.:~:, ..... S.S ~ (Name of individual sigoing contracO above named. ...... being duly sworu, deposes and says that he is the applicant He is the ........ c~.'>~,, ..> ~9,=,_~-~,I ......... . .... (Contract~rl ;~;~t', ;;;~;[a't; ~fbi;;;,'dt;.~ ............................ of said owner or owne~, ~d is duly authorized to perfom or have perfomed the said work and to m~e and file this application; that all statements contained ~ this application are true to the best of his Biowledge and belief; and that the work will be performed in the m~ner set forth in the application filed therewith. Sworn to before me this .. 4 .......................... y Public, State of New ~ork ~ .~ · · · ~ ........... No. 4~2180 ~ ~- ~ C~ (Signature of applicant) ~lified in ~uffol~ County. ~sion Ex~tres ~eh 30, 19g '7 OCCUPANCY OR USE ,IS uN~WFUL WITHOUt' CERTIFICATE OF OCCU?~NC¥ NOTI~' ~L~IL~!NG DEPART~4ENT AT II ~0 ~o~ MU'ST BE PROSECT',,,, ~ :-"