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HomeMy WebLinkAbout14273-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. Certificate Of Occupancy Plumbers Certification dated N°---'Z3.4.9.0.-9 ........ Date September 24, ,19 86 THIS CERTIFIES that the building One family dwelling Location of Property . .7.2.5...L.a.n.d.s...E.n.d...R.o.a.d. ................... Orient, New .Y. ork House No. Street .............. ~l~l'e~ County Tax Map No. 1000 Section 0 15 . .Block 0 9 .Lot 1.16 S ..... M/o Lands End 5909 16 uoe~wsmn ............................... Filed Map No ......... Lot No .............. conforms substantially to the Application for Building Permit heretofore tided in this office dated ?.u.g..u.s.~..26 ....... ,19..8.Spursuant to which Building Permit No. 14273Z dated . .S.e.p..~.e.m.b.e..~..1.2. ,. ........... 19..8 .5, 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 ......... One family dwelling The certificate is issued toKurt & Mary Ellen Werber ..................... .................... of the aforesaid building. Suffolk County Department of Health Approval 85 - S O- 150 UNDERWRITERS CERTIFICATE NO .... N 735643 September 23~ 1986 Rev. 1/81 FOP. Mr NO. 9 TOW'N OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, H. Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) 14273 Z Permission is hereby granted to: ,e . .~.~..~......~ ................................................. ........... . ,o ot premises located at ....~......~. .... ..~.......~... ..................... .~-.~ .................... · ~ o .~ Cou.tv To,~ Map ~o. 7000 Sect,%.: ........... (..~.. ..... B~ock .......... ..5 ......... Lot No ...... ~. ................ pursuant to application d~ ..~.~...~.~ ................ , 19~.~.~, and opprov~ by the Building Insp~tor. Fee $ ........................ 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-(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: I. Accurate survey of p~operty 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 buildings or premises, or other pertinent informa- tion required to prepare a certificate. C. Fees: 1. Certificate of occupancy $5.00 2. Certificate of occupancy on pre-existing dwelling $15.0 0 3. Copy of certificate of occupancy $1.00 4.Vacant Land C.O. $5.00 5.Updated C.O./ $15.00 Date ~.~.~'...~..~.~..~. ?..~. ..... NewConstruction .V'. .... Old or Pre-existing Building ............ Vacant Land ............. Location of Property . ~.3.-'...~..~( .~..o?..'.~.' .~...~.j~.. ......... .~..~. ~..~...~. ~.~. .... ~.; .~./. ........ House No. Street Hamlet Owner or Owners of Property c, .~ County Tax Map No. 1000 Section . .~. z. ,~'. ....... Block ...?..~. ........ Lot../... Subdivision .~..~..~..~..~../~.~.~.~.~ $.. -~4~. ~'....Filed Map No..~.~i'.~..q .... Lot No. ~.~. ......... Permit No. ZZ/~?.~.~. Date of Permit ~'..~.~"./?~./?J~p~licant .L .[. ~ ¢.. ~, ~. ~ ~.~.'..~'.~.(~.~.; .... Health Dept. Approval -J¢ .['.~ ~.~ i.~g'.~ .Labor Dept Approval /t'. Underwriters ~pprova[ ......... Planning Board Approval ~ .................... Request for Temporary Certificate ............... Final Certificate .................. Fee Submitted $ ..... ~-.~. ................... Construction on above described building a~_~it meets all applicable codes and regulations. Applicant .~.~..~ ................. Rev. 10-10-78 [ISO CONSTRUCTION CORP. Main Rd,, P. (~ Box 439 30S$7 Jomesport, N. ¥. 11947 THE NEW YORK BOARD OF FIRE UNDERWRITERS ~~l~d j~9/:/~5 JOHN BUREAU OF ELECTRICITY STREET, NEW YORK, NEW YORK 10038 THIS ~ERTIFIES TNAT ordy the electrical equipment as ~scrlbed bel~ and introduced by t~ applicant rmm~ on tke ab~ application number in the premises of Section Block Lot ~as examined on ~ ~ 0~ ~ ~ and ~ound to be in compliance with the requirements of this Board. FIXTURE OUTLETS RECEPTACLES 44 SWITCHES FIXTURES RANGES ~ COOKING DECKS OVENS DISH WASHERS EXHAUST INCANDESCENT FLUORESCENT 42 32 DRYERS FURNACE MOTORS FUTURE APPLIANCE FEEDERS TIME CLOCKS MULTI-OUTLET DIMMERS SYSTEMS NO. OF FEET SERVICE DISCONNECT' OTHER APPARATUS: S E NO, OF CC, COND, PER ~ R V I C A. W, G NO, OF HI.LEG OF CC COND 4/0 OF HI-LEG NO, OF~UTRAL$ A'WO, OF NEUTRAL ' 11901 Lio$33~TE /'GENErAl. JM~,NAGER must not be altered in any manner; return to the office of the Board if incorrect. Inspectors may be'identified by/their credentials. TOWN OF SOUTHOLD OFFICE OF BUILDING INSPECTOR P.O. BOX 728 TOWN HALL SOUTItOLD, N.Y. 119'/1 TEL. 765-1802 CERTIFICATION Date Building Permit No. Owner ~ ~'~ (please print) (please print) I certify that the. solder used in the water supply contains less than 2/10 of 1% lead. system Sworn to before me this 19 · Notary Public, ~/~~ ~lpl~m~r s signature) IBARBARA STEPNOWSKI Notary Public, State of New York No. 4844752 Oualifiecl in Suffolk County ~ C~misston ~ires Mar~ ~, 1~ - Notary P~--ubl--c ' County 7GS-~,802 BUILDING DEPT. INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLBG. FOUNDATION ZND [ ] INSULATION [ ] FRAMING [ ] FINAL REMARKS: ~ .... DATE FOUND i DATE INSPECTOR 765-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION IST [ ] RouGH PLBG. FOUNDATION 2ND~ INSULATION FRAMING [ ] FINAL :DATE., :1///4~-~-' BUILDING DEPT. INSPECTION [ ] FOUNDATION 1ST ~ ROUGH PLBG. [ ] FOUNDATION 2ND [ ] INSULATION ~ FRAMING [] FINAL REMARKS: DATE INSPECTOR ,, , ~ ~ ,'IELD iN~J'ECTION :'OUNDA~_TION ( 1 st ) :OUNDATION (2nd) OUGH FRAME & PLUMBING COMMENTS ;NsULATION PER N. Y. STATE ENERGY CODE FINAL ADDITIONAL COMMENTS: TOWN OF SOUTHOLD OFFICE OF BUILDING INSPECTOR P.O. BOX 728 TOWN HALL SOUTHOLD, N.Y. 119?l CERTIFICATION TEL. 765-1 $02 ~uiidin9 Permit No. Owner (,,~% (please print) (please print) certify that the solder used in the water supply system con%ains less than 2/10 of 1% lead. (plum~r ' s signature) -- Sworn to before me this ~ ~*~day of ~ u ~ 19_~_~. Notary Public~/~ County u~e! fled n Suffolk Corem ss on Expires March 3~ FORM NO. 6 TOWN OF SOUTHOLD Building Department Town Hall Southold, N.Y. 11971 APPLICATION FOR CERTIFICATE OF OCCUPANCY Instructions A. This application must be filled in typewriter OR ink, and submitted in duplicate 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 of 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 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 buildings or premises, or other pertinent informa- tion required to prepare a certificate. C. Fees: 1. Certificate of occupancy $5.00 ~ 5-/$ 2. Certificate of occupancy on pre-existing dwelling land use 3/ 5.00 3. Copy of certificate of occupancy $1.00 Date...~.V ~ .~/~...,~..~ .~ ~. .... New Building ,,, ~ ...... Old or Pre-existing Building ............ Vacant Land ............. Location of Property RO-. ...... 0'/Z .'y' ...... House No. Street Hamlet Owner or Owners of Property .~..~..~.~....~/4. ,,'F~ J~....~-- P' ..................................... County Tax Map No. 1000 Section .... 4~..I.L~'. ......Block . ~..~. .......... LOt, ,~,,1~ .......... Subdivisio~'~.l;~?... ¢F.~"...(,~. ~.*.-~..~ .~:l~..) .... F lied Map No..~.~..~..~.... Lot No../.~. .......... Permit No. ~ Date of Permit-~..~...~'..Applicant . .~ p...~.'?..~..~.~.;..~..o?..~.o ........ Health Dept. Approval .~.¥'~.. ~.~. ~..~..4, ........ Labor Dept. Approval ........................ Underwriters Approval ~. oG, j .t.~ ~. ~. Planning Board Approval Request for Temporary Certificate.... .............. ~ .~..~.'I.~. .~)..~ ..... Final Certificate .................. Fee Submitted $ ..... ~.~..O ........... Construction on above described building a, nd permit meets all applicable codes and regulations. ~'~t~ ~de P.' O. Box 439 '~'~amesperb H. Y. 11947 FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N.Y. 11971 TEL,: 765-1803 Disapproved a/c ..................................... (Building Inspector) APPLICATION FOR BUILDING PERMIT INSTRUCTIONS a. This application must be completely filled in by typewriter or in ink and submitted.~;:!k-~m 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 issue 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 buildings for necessary inspections. ..... ~k.~. ~ .0....~.~...~. ~.'?c.... ~.e..~.e ......... (Signature of applicant, or name, if a corporation) / .P..o...~?..~...~.~.~....~..~.,~.~.~?..~.-T...~.~...~[.... (Mailing address of applicant) ~ ~ °e~/ . State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. C~ ~,~.~, ...~,~...~.-T..~..~?.~.~..~..-,. ................................... Name of owner of premises '~ .'~.~.. ~.-'.~ .~...~1. ~ .1~.~(...~-~k .~.('~fk...~ ~..A.~...~: ........... (as on the tax roll or latest deed) If applicant is a corporation, signature of duly authorized officer. ....'k ~..~...~..v~.. ~ ~...k,.~.~.o., .&..~.: .P~,~.~... (Name and title of corporate officer) Builder's License No. '~ .'"~',~..~..q .G,.. Plumber's License No... Electrician's License No, . .~.~..~ .":1~ ........... Other Trade's License No ...................... , ---, .~ Iq~ oi:: 1. Location of land on which proposed work will be done.'~./~..-~..~te. ~..~h..t~ R~.~.~ ./~ ~.*~.~ .~..h ... ..... ................ ..... House Number Street Hamlet County Tax Map No. 1000 Section . .O. [ ~ ........... Block .~ ~ ............. Lot. ~rZ~ ............. SubdNision~ ~ ~ P.~..C.~.~..~ ~ .......... Filed Map No. ~.9.~ ....... Lot. J.~ ........... (Name) State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy ... ~.G ',lg ~ ......................................................... b. Intended use and occupm~cy O~- ~.,~,,k,'-~ ~>~,~,k. ti-q~at, v~m~ .................................. g/~ ~'~ :~ .~:'~ ~ ................. 3. Nature of work (check whichl applicable): New Building ..... Addition ........... Alteration . ........ Repair . .. ': st. ~ ~ Remo~at · i. Demolition Other Work ...... ~ (D ipti ) . .~..OF.6.0,I O. ,~' escr on 4. Estimated Cost .. . O....o ..... ; ............. Fee ...................................... I '~ (to be paid on filing this apl~l'cafion) _ 5. If dwelling, number of dwelling ~nits .... .~e ........ Number of dwelling units on each floor. ~ ............. If garage, number of cars . ... ................................................................. 6. If basiness, commercial or mixedloccupancy, specify nature and extent of each type of use ................... 7. Dimensions of existing structure~, if any: Front ............... Rear .............. Depth ............. Height ............... Number of Stories ...................................................... Dimensions of ~ame structure wi[h alterations or additions: Front ................. Rear ................ Depth . ..... : ............. i · Height ........... ~ .......... Number of Stories ............... ,, .... Dimensions~,f entire new construction: Front .~.q'l,q' . , Rear ~. ~ ! O ~.~ Depth /.~F'./.~. '~.. 9. Size of lot: Front .../... ?. ;. i .......... Rear, .2,3. ¢~ ............. ~Depth .,~g,~-. ~ .............. 10. Date of Purchase . ./.*~.~..~.. i ................. Name of Former Owner ........................... 11. Zone or use district in which preinises are situated ............................................... 12. Does proposed constructmn wg~te any zomng law, ordinance or regulatmn: ............................ ~'~ 13. Will lot be regraded ..... Pi'.., ................... Will excess fill be remaved from premises: Yes ('N~) 14. NameofOwnerofpremises~..~..~gi~.~.,C,.~'..~ .... Address .~.~qm~'~g~t.~.PhoneNo.,-~./.~.:4~.~.~."~.~.~' Name of Architect ~. ~1~-~. ~..~..~.t,~..~.?,~/..~. Address .... ~ ........... Phone No. -77. ............. Nmne of Contractor [~.~. $ t~. ¢.~ t'~ .~: .~-. ,o .g,.O.. Address ~.~ l~.o.g'.t4r/~ .q ..... Phone No. ~ ? .~. I~. ~../. PLOT DIAGRAM Locate clearly and distinctly all ibufldings, whether existing or proposed, and, indicate all set-back dimensions from property linbs. Give street and block fiumber or description according to deed, and show street names and indicate whether interior or corner lot. STATE OF NEW YORK, COUNTY OF .......... iS.S ~ being duly sworn deposes and says that he is the applicant (Name of individual sigging contract) above, named. He is the ..................... i ................................................................... , (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 contained in this application are true to the best of his knowledge and belief; and that the work will be performed in the manner set forth in the application filed therewith. Sworn to before me this ............ 4.¢ ......... dayof ..... ......... .... Noting'Public, ..~...~', ..~.~.U..~. .... .~.. County' - ..... ..... (Signaturo of applicant) ~ ~ '~ ~' 5 t;'1 ~ I 0 I SINGLE FAMILY DWELLING ONLY SURLY FOR KURT WERBER & MARY ELLEN WERBER , ~,U,~[I CF;~ARI~hll OF HEALTH SERVICE5 LOT 16 "MAP OF LAND'S END" JULY ~3, 1985 AT ORIENT POINT OAT[: JULY II, 1985 ' ~ AP~OV'AL OF CONSTRUCTION ONLY .~N ~ SOUTHOLD SCALE: 1"=50' HEAL~ ---'--""-' - ''OEPA~iM~/-DAI~ F~ APPRO~ AND ~ HIS BEHALF ~ THE TITLE C~P~Y, GOV~N- ~-~- ~~ YOUNG ~ YOUNG RIVER<AD, NEWYO"K NOTES: ~=MONUMENT AR~A=55~4~gs.F~J ALDEN W. YOUNG~PROFESSIONAL ENGINEER SUBDIVISION M~P FILED IN THE OFFICE OF THE CLERK OF ANO LAND SURVEYOR N.Y.S, UCENS[ NO. IZB45 SUFFOLK COUNTY ON MAY 3~197~ AS FILE N0,5909 HOWARD W. YOUNG~ LAND SURVEYOR ~ L~L~W),~IC TANK(~TIICE~S(~) ~H ~E~ N.~S. LICENSE N0.45893 / '5,,. '~ 0 = 0 o~ z' ' // - SUFFOLK COUNTY HEAL rH DEPA~ ~'~ or ~ FAMILY DW ,:LLING O~Y~ O~ ~of~er o DATE ,,,, , _ , ................... i ~ J THE SEWAGE DI3POSAL AND WATER ~UPPt. YTHisFACtLITtESDEPARTMENTFOR AND ~ ~ LOCATION HAVE EEEN INSPECTED BY FOUND TO BE ~A'rlSFACTORY.' · - Cfiikf 0f Was~kwate('Management section' " . S~? FO~ KURT WERBER ~ MARY ELLEN WERBER LOT 16 "MAP OF LAND'S END" MAY 14, 1986 J~Y ~3~ 1985 AT ORIENT POINT DATE: dULY II, m985 .~N ~ SOUTHOLD SCALE= I" =50' SUFFO~ COUNTY, NEW ~RK NO. 85-559 . ~UT.~ZZO ~trn*t~o. .OT .[ co. sm[~o TO HE~ DEPARTMENT-DATA F~ APPR~ TO C~STRUCT ~ ~R~ Fo~ WHOM THE SU~EY tS PR[eAReD ~. ~~ ~ ~ OS~NDER AVE~E NOTES: ~=MoNUMENT AR~A= ~5~4~9 S.8 SUBDIVISION MAP FILED IN THE OFFICE ~ THE CLERK OF ALDEN W. YOUNG~ PROFESSIONAL ENGINEER SUFFOLK COUNTY ON MAY 3~ 1973 AS FILE N0.5909 AND ~ND SURVEYOR N.Y.S. UCENSE N0.12845 HOWARD W. YOUNG, LAND SURVEYOR ~ ~ L~ ~ ~L(Wl, ~PTIC TA~II~a C(~S{~) ~ ~ . N.~ S. LICENSE N0,4589~ ~ ~ ~E~ ~T~S ~ O. DATA OeTm~O F~ Mtk.~ YL dirge K m.L only · ,~O~D~*R I,I.~ED ~ WA}ER 3glPPLY ~I"&'TEM CANNOT EXCEED 2'70 ef l~ LEAD. PLUMBER CERTIFICATION ON I.F. AD CONTENT BEFORE CERTIFICATE OF OCCUPANCY OCCUPANCY OR USE IS UNLAWFUL WITHOUT CERTIFICATE OF OCCUPANCY APPROV~-'D AS NOTED NOTI~ BUILDING DEPAR~T AT 765-1802 9 AM TO 4 ~ ~R THE FOLLOWING INSPE~IONS: 1 FOUNDA~ON ~ REQUIRED FOR PO~ED CONniE 2 ROUGH FRAMING & ~UMBING ¢, FINAL CONST~ON MU~ e~ COMP~E ~R C.O. ~L[ ~NSTRUCTION ~ALL ME~ tHE REQUI~MENTS OF ~E N.Y ~TATE CON~RU~ON & ENERGY ~S. NOT ~S~SI~E ~R ~ ~ CO~I.~O~, ~RRORS, ( -~ F~.©I',~' ~ E~ L- ~ ",,/,z~'--r- ~ 0 t'-.J LOCATION O,XT* ~ ,, , 't t- OWNER F-o LOCATION ~ DATE OWNER sec. LOCATION ,42-1 V E,N'T' P~P GENERAL NOTES: 1--,4" x 8" HEADERS OVERALL OPENINGS UNLESS' 2--ALL STRUCTURAL LUMBER TO BE MIN. 1200 p.$,L DOUGLAS FiR OR ~--,.ALL FOOTINGS TO BEAR ON VIRGIN OR UNDIS CAPACITY. 4~DONTRACTOR TO VERIFY ALL DIMENSIONS AND CONDITiONr5 AT THE BUILDING, 5 ALL ELECTf~iC WORK ACCORDING TO CODE. 6---OOUBLE JOISTS UNDER ALL BEARING PARTI- LOOAT~N I' WER ~..1 I LOCATION I ~T£ GENERAL NOTES: 1--~" x 8" HEADERS OVERALL OPENINGS UNLES~ OTHERWISE 5PECG~EO. 2--ALL STRUCTURAL LUMBER TO BE MIN. 1200 P.S,L DOUGLAS FIR OR EQ, C~DITIOHS AT THE ~UiLDING. ~LL ELECTRIC WORK ACCORDING TO CODE, ~OUBLE JOISTS UNOER ALL B~RING PART~, MERRICK DRAFTING SERVICE 310 /~ER.R~CK AVL~E GENERAL NOTES: [, 4" x 8" HEADERS OVERALL OPENING5 UNLESS OTHERWISE SPECtFIEO. 2.~-ALL STRUCTURAL LUMBER TO BE MIN. [200 P.S.L DOUGLAS FiR OR EQ, ~ 3~-ALL FOOTINGS TO SEAR ON VIRGIN OR UNDIS. TURBED 5OIL OF ~I/VO TONS PER SQ. Fl, BEARING CAPACR'Y, " ¢-~CONTRACTOR TO VERIFY ALL DIMENSIONS AND CONDITIONS AT THE BUILDING. ' 5--ALL ELECTRIC WORK ACCORDING TO CODE. 6---DOUBLE JOISTS UNDER ALL BEARING PARTI- TIONS, "J~--NOTED DIMENSIONS TO TAKE PRECEDENT OVER SCALE. 4-" blA, iTL, APPIZo X ~RADr~ WA'T- c:i::L F:=~JD. N ,"(. -STA,T'E. ~ Cf:: LLA.~ ,4--" OWNER ~-.LJ~.'Z' .WE~::'~':~E~ I~ ' MERRICK DRYING ~RVICE ADDRESS' ' ~S ~N~ 310 M~RIC~V~E ~mCK, N~ YORK ~EC, BLK. LOT . T~ ]516) 868-~I0 ; lmoATION DA~ ' -