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Home My WebLink About14673-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. Certificate Of Occupancy No. Z14354 Date April 22 .8.6 THIS CERTIFIES that the building ...... .A.c..c.e.s.s.9 .r.Y ............................... Location of Property 265 Rochelle Place (AKA--Salt Marsh Ln.) Mattituck h~s'~ ~io: ....................... 'S't/e~i ....................... h~r~iel County Tax Map No. 1000 Section ...1.4.4. ...... Block .....0.4. ........ Lot ..... 0.0..9 ......... Subdivision X, .Filed Map No. .Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated March 12 ..... 19 8..6pursuant to which Building Permit No. 14673 .Z dated ..... M..a .r.c.h. ..... 1.9. .......... 19.8..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 ......... .... Accessory swimraing Pool w/ Fence ..... The certificate is issued to BRUGGEMAN, CHARLES A. & Wf. ..................... ...................... of the aforesaid building. Suffolk County Department of Health Approval N/A UNDERWRITERS CERTIFICATE NO. N7 416 7 4 Building Inspector Rev. 1/81 FO~M NO. 0 TO~N OF $O~'~IOI. D BUILDING DEPARTJ~AENT TOWH HALL SOUTHOLD, Ho Y. BUILDING PER~IT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) N? 14673 Z Permission is hereb/granted to: .....3~.~.~_...~..:~.,....u.~...,-..~ ,o.~~........~......~ ...... ~~....~.~.....~..~.....~-~..~ ~......~~...~..~.~..~~,~.~ .............. ~ ................ : ......... ; ......... ~t premises located ot ........................ ~:~..~....C~CI,~.~-~Ie~.~,......~.~..C~--.-~...L/, BuildinD 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 This application must be filled in typewriter OR ink, and submitted m ~ 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-iS-9 form or equal). 3. Approval of electrical installation from Board of Fire Underwriters, 4. Commercial buildings, Industrial buildings, Multiple Residences and simiiar 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 p~operty showing all property lines, streets, buildings and unusual natural or topographic features. 2. Sworn statement of owner or previous 6~ner as to use, occupancy and condition of buildings. 3. Date of any housing code or safety inspebtion of buildings or premises, or other pertinent informa- tion requ ired to prepare a certificate. C. Fees: 1. Certificate of occupancy $5.00 2. Certificate of occupancy on pre-existing dwelling $1 5.0 0 3. Copy of certificate of occupancy $1.00 4.Vacant Land C.O. $5.00 5.Updated C.O. $15.00 Date'~-~--/~.~./~../¥. ;/.¢...~.~ ...... New Building ............. Old or Pre-existing Building ............ Vacant Land ............. Owner or Owners of Property .....~...~. q .'~'~X....(~-~....~...,' ."~.,.~..X~. ~..~....~... ~.~.., .~.....t.~/~ ~ County Tax Map No, 1000 Section ,../..vt..~. ....... Block ..... ~ ........ Lot...~. ........... Subd~ws on ................................. Fdee Map No ............ Lot No ....... ~_ ....... Applican~ Permit No ........... Date of Permit .......... . .~//?~.. ,:22¢.Z'. (~..~/~) .... Health Dept. Approval ..... /¥~,.,. .............. Labor Dept. APproval ..... /¥.)~. ! ............. Onderwriters Approval ..... ~... ' ............. P~anning Board Approva ............... Request for Temporary Certificate ..................... Final Certificate ....................... Fee Submitted $. ~?0.,.~¢--~. Construction on above described building and permit meets all applicable codes and regulations. (~' ~ ~ '~ -- Applicant... /~-./~z..--.,~....~-¢%~. ~¢,~., '~'~ '~'. ~..~.. ¢jb ................ . . THE NEW YORK BOARD OF FIRE UNDERWRITERS BUREAU OF ELECTRICITY 65 JOHN STREET, NEW YORK, NEW YORK 10038 ~g ~a~eh ;?~, 19~ 322426/26 THIS CERTIFIES THAT only the e/~trlca/e~uipment ~ described below and introduced by the applicant named on the above application i~ m~r in the premises of ~, th~ yo~o~g ~o~o~; ~ ~,~m~,~ ~ ~,t r~. ~ ~,,d r~. Outside P~. s~o,, ~to~ ~o~ w~ examined on ~ ~h ~ ~ ].~1 aad fou~ to be i~ compliance with the requirements of this Board. FIXTURE SWITCHES OUTLETS FIXTURES RANGES OVENS DiSH WASHERS EXHAUST FANS DRYERS R V I C made of the ext~ electrical ~9 Fm..lc lane MAN~R This certificate must not be oltered in any manner; return to the offke of the Board if incorrect. Inspectors may be identified by their credentials. COPY F0R BUILDING DEPARTMENT. THIS COPY OF CERTIFICATE MU~T NOT ~E ALTERED IN ANYMANNER. FIELD INSPECTION 1. FOUNDATION (1st) FOUNDATION (2nd) 2. ROUGH FRAME & PLUMBINO 3. INSULATION PER N. Y. STATE ENERGY CODE 4. ADDITIONAL COMMENTS: From the Desk o! THOMAS J, ZIMMERMAN THE NEW YORK BOARD OF FIRE UNDERWRITERS BUREAU OF ELECTRICITY 85 JOHN STREET, NEW YORK, NEW YORK THIS CERTIFIES THAT only the electrical equipment as described beJow and ~ntroduced by the applicar~t named on the above appllcot~on number ~n t~ premises of in the followlng location; ~ Basement ~ 1st FL ~ 2nd FI. ~Si~ Section B~k Lot was exa~n~ned on and foand to be in compliance with the requirements off this Board. FIXTURE FIXTURES RANGES OVENS DISH WASHERS EXHAUST FANS OUTLETS SWITCHES FLUORESCENT 1 1 DRYERS SYSTEMS NO. OF FEET R V I C i~Al~u~d Slec~ric Co. P.o. ~ l*J Lio#~Z This certificate must not be altered in any manner; return to the office of the Board if incorrect. PeK may be identified by cred,.entials. COPY FOR BU LO NG DEPARTMENT TH S COPY',OF CERT F CATE MUST NOTJ~E~ALTERED IN ANy MANNER. ;xamined ............. ~pproved . ·/. ·cl. . r ~ ~ 'FORM NO. 1 · ~ .';', TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N.Y. 11971 TEL.: 765-1803 ., 19 g.~. ., 19~..~. Permit No..).~ .~ .~.a .'~ 0isapproved a/c ..................................... (Building Inspector) APPLICATION FOR BUILDING PERMIT Date .................. , 19... INSTRUCTIONS a. This application must be completely filled in by typewriter or in ink and submitted to the Building Inspector, with 3 · ts 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 ~ areas, and giving a detailed description of layout of property ~nust be drawn on the diagram which is part of this appli- ~tion. 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 roll 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 ~all 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 ailding Zone Ordinance of the Town of Southold, Suffolk County, New York, and other applicable Laws, Ordinances or egulations, for the construction of buildings, additions or alterations, or for removal or demolition, as heroin described. he applicant agrees to comply with all applicable laws, ordinances, building code, housing code, and regulations, and to hnit authorized inspectors on premises and in building for necessary i~, .ections.. (Signature of applicant, or nar0e, if a corporation) (Mailing address of a~oplicant) //~7,5'~ rate whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. ame of owner of premises .... .~/~.~--./.~...g'...d/?~..~.~.¢ .F~. ,.t~..~. .................................... · [a~ on the tax roll or latest deed) ' ' ' 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 ...................... Location of land ~ which prooosed work will be done ........................... d~,s ffo;d~_.g_~ f/~e_ c,q~)_~nt--r- .c.~t~k2 "c.~4 ................ ................. ~;~' -~_~ Z,~_,L~.. ............. /~,~. ~r-/:t:. ~x.~/~/,,.~.,..../l~ .~.~. ..... Ilouse Num bet Street Hamlet County Tax Map No. 1000 Section . ./~.z/ ........... Block . .z-/. .............. Lot.. ~. ............... Subdivision ..................................... Filed Map No ............... Lot ............... (Name) State existing nsc and occupancy of premises and intended use and occupancy of proposed construction: .use and occupancy .... .~.~k:. "¢~' · '(~· .................................................. a. Existing b. Intended use and occupancy ......... . ,~5<....X',f,~.`` .~'5 . .o~. !. ,?..C)~..\ ...................................... iS. 0. 1. 2. 3. 4. Repair .............. Removal ..' ............ Demolition ....... i. · Other Work.~.\/.q~.~C.q-. (Description) · Estimated Cost ....'~..../V o(2 ............................................................. 4 ..... Fee (to be paid on filing this application) 5. If dwelling, number of dwelling units ............... Number of dwelling uniis on each floor ................. If garage, number of cars ............................................ i ............................ 6. If business, commercial or mixed occupancy, specify nature and extent of each ty~e of use ..................... 7. Dimensions of existing structures, if any: Front ............... Rear ....... ....... Depth ............... Height ............... Number of Stories ............................ , ............................ Dimensions of same structure with alterations or additions: Front ................. Rear .................. Depth ...................... Height ...................... Num b~zfo fl Stories ...................... D/anensions &entire new construction Front . .. Rear .~ ...... Depth ~,. Height 7..~. Number of Stories ii . iiiii ii ..... i.. i... i ..... . ....~.'7~/~i/*~.'~.'; Size of lot: Front ...................... Rear ...................... iDepth ...................... Date of Purchase ............................. Name of Former Owner .! ............................ Zone or use district in which premises are situated ......................... ................... 2 ........ Does proposed construction violate any zoning law, ordinance or regulation: .... ! ............................ Will lot be regraded ............................ Will excess fill be removed from premises: Yes No Name of Owner of premises .................... Address ................... Phone No ................ Name of Architect ........................... Address ............... i ....Phone No ................ Nmne of Contractor .......................... Address ............... .... Phone No ................ PLOT DIAGRAM i Locate clearly and distinctly all buildings, whether existing or proposed, and, indicate all set-baak dimensions from roperty lines. Give street and block number or description according to deed, and show street names and indicate whether ~terior or corner lot. CATE OF NEW YORK, 3UNTY OF ......... S.S (Name of individual signing contract) eve named. .... being duly sworn, deposes and says that he is the applicant ~ is the , , (Contractor, agent, corporate officer, etc.) '. said owner or owners, and is duly authorized to perform or have performed the s plication; that all statements contained in this application are true to the best of hi~ )rk will be performed in the manner set forth in the application filed therewith. torn to before me this ......... /. ............ day of ........... , ,ta~y Public,.. ~t~_f~....j~...~.~...~/...~.~.~.~.~.~.~.~.~. ...... County fid work and to make and file this knowledge and belief; and that the ~*rm ~x~r~ ~.~h 30, lg_M.F : ' ~ (SignatUre of apphcant)