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HomeMy WebLinkAbout13872-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. Certificate Of Occupancy No Z14073 December 11 85 .................. Date ................................. 19,.. THIS CERTIFIES that the building ..... Qn..e..f.a.m..i.ly.. d..w.e.l. 1, $.n.g ..................... Location of Property ... 8..2 .(3..B.r..a y..A. y .e .n.u.e. ........ L a u r e 1 House No. Street Hem/et County Tax Map No. 1000 S~ction ...1.2..~ ...... Block ...... .~ ........Lot...I.~ ............ · 84-688 30 Subdivision?.E.O... I TUTHILL SEC. J ..... FiledMap~o ......... LotNo. conforms substantially to the Application for Building Permit heretofore filed in this office dated ·...~/?.5.1.. J.5 .......... 19 .8.5. pursuant to which Building Permit No. 13872 Z dated ...bP?.%!. J .6 ................ 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 ......... ... 9.n.c...f.a~.~.~. y, .~.~.e.~..z).n.g.r' ?j.~.h...a.~.~.a..c.h.e.~...d.e.qk.: ............................. The certificate is issued to BARBARA & GERARD GOEHRINGER ..................... ?o¥,'o;, 'ria~ ~if~,~'~' f .................... of the aforesaid building. Suffolk County Department of Health Approval . .8.5. = .S .0.-.~. ! ............................... UNDERWRITERS CERTIFICATE NO .... #? 184 ] ] Building Inspector Rev. 1/81 FO~ NO. ~ TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N. Yo BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) N9 13872 Z Permission is hereby granted to: .....'E~..o....x...~.~..~ ................................................. ~~..~..; .......................................... n~ ................. ._..~ ............................................. County Tax Map No. 1000 Section .;....!....~'....~. ....... Block ......... .~ ........... Lot No ....... k..~ ............ pursuant to application dated ...... ~ ....... t..~.. .................... 19.g.~.., 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 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 featu res. 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 "pm-existing" land uses: 1. Accurate survey of property showing all property lines, streets, buildings and unusual natural or topographic featu res. 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. Fees: 1. Certificate of occupancy $5.00 2. Certificate of occupancy on pre-existing dwelling 3. Copy of certificate of occupancy $1.00 4.Vacant Land C.O. $5.00 $15.00 New Building .. ~ ........ Old or Pre-existing Building ............ Vacant Land ............. Location of Property.. fi~ ...... /3.'~. ~'/'~.~. ............................ ..~. ~.~.. House No, / Street/~ Ham/et Owner or Owners of Property ...~.'~.c~...,'¢~../~...~ ~..~.-..~..~?.., ./~. ~/',~'~.~.~.~.-~'¢~. · ................ County Tax Map No. 1000 Sectio/n .../., .2ff..~ ....... Block .... ./. ........ ~. Lot.../'.~. .......... Subdivision,. ~.....~.~.'~z'. ~'.~. ~.~.~ ............... Filed Map No..~, ........ Lot No...~. ~ ........ Permit No../~.~/3.~2~Date of Permit. ~..~Applicant.. J)~., .¢!~.,. / Health Dept. Approval ........................ Labor Dept. Approval ........................ Underwriters Approval ............. Planning Board Approval ...................... Request for Temporary Cer'tificate ..................... Final Certificate ................... FeeSubmitted$.j~...~), ..................... Construction on above described building and permi~eets all,al~l~k;ablej~e'des~nd regulations. Appbca¢ -. .... ...... .................... Rev. 10-10-78 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 ~, (please~p~rint) %/ (pl~ase ~in~ I certify that the solder used in the water supply system contains less than 2/10 of 1% lead. Sworn to before me this 19 f~ . Notary Public, ~~~ County (plumber '~ si.~ure) No~2 Public; Sgate of New Yo~k No. 482', 557 Qualified in Suffolk County Com~ssion ~xp~es M~reh 80, FIELD INSPECTION FOUNDATION FOUNDATION Z. ROUGH FRAME & 1st) COMMENTS 2nd) PLUMBING INSULATION PER N. Y. STATE ENERGY ?DE FINAL ADDITIONAL COMMENTS: looov. 4 THE NEW YORK BOARD OF FIRE UNDERWRITERS BUREAU OF ELECTRICITY ~- 0]- 85 JOHN STREET, NEW YORK, NEW YORK 100:38 ~ate NOV~b~¢ 20 ~ 1985 355817/85 THIS GERTIFIES THAT only the electrical equipment as described belo~ and introduc~ by the applicant na~ed on the ab~e application number in tits premises of i. the following location; ~ Baseme.t ~ let FI. ~ 2nd Fl. Sectio. Block Lot wasex.~.i.edo. 19ov~r~r. 15,, 1985 FIXTURE OUTLETS DRYERS {ECEPTACLES g6 SWITCHES FIXTURES FLUORESCENT and found to be in compliance with the requirements of this Board. RANGES OVENS DISH WASHERS EXHAUST FAN FUTURE APRLIANCE FEEDERS TIME CLOCKS LINIT HEATERS MULTI-OUTLET DIMMERS SYSTEMS NO. OF FEET SERV CE D SCONNECT OTHER APPARATUS: S E R V I ii A' W, G NO, OF HI-LEG NO ERCC~COND. OF CC COND, C OF HI-LEG NO. OF NEUTRALS A, WG OF NEUTRAL )~ubard Box 372 Laur:~l, N Y !i948 2148 This certificate must not be altered in any manner; return to the office of the Board if incorrect. InspectoFs GENEI~AL ,MANAGER ~ may be identified by their credentials. IN ANY MANNER, 'FORM NO, 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL ~OUTHOLD, N.Y. 11971 TEL.: 765-1803 xaminey ... !.t, .., Approved~. }.{P..., 197.~. Permit So. /..~..~.~..~..~ Disapproved a/c ..................................... (Building Inspector) APPLICATION FOR BUILDING PERMIT APR 151985 II BLDG. DEFf. TOWN OF $OUTHOLD Received ........... ,19.. · Date ....... /x~.r. ~. .]_. .1. 5. ,, 19.8..5 IN STRUCTIONS 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 a dm it aut horiz ed in specto rs on premi scs and in building for necessaw~., .~~~~' '~ (Signature of applicant, or name, ~Fa corporation) Box 812 Mattituck, NY 11952 (Mailing address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. .Qwner ..................................... Name of owner of premises . BarJ~ara..anO..Gergtr.d...GQg.h.r..i.nge. r. ...................................... (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 .......................... Plumber's License No ......................... Electrician's License No ....................... Other Trade's License No ...................... 1. Location of land on which proposed work will be done...lot. 30. ot5..Geor.ge. T.u, thi;1-.1..$¢b.d.J,v.i.s.i, qn. .... ........... .......... ........................... ...................... House Number Street Hamlet County Tax Map No. 1000 Section ... 2.26 ........... Block ...1 ............... Lot...1.6 ............... Subdivision ..... .GeorcJ.e.I.T.uthiJ-.ih. S¢.o..:1, ..... Filed Map No..8 .47.6. 8..8 ....... Lot . .3.0. ........... (Name) State existing use and occupancy of premises and hitended use and occupancy of proposed construction: a. Existing use and occupancy ..................................................................... b. Intended use and occupancy ... r~e.w..9.n.% .~..a.m.i.l. zz..d.w.q i..1.i.n.q. ..................................... 3. Nature of work (check which ~pplicable): New Building ,. X..' ..... Addition .......... Alteration .......... Repair ............. .. Removal .............. Demolition .............. Other Work ............... C i (Description) 4 Estimated Cost 4.0.,.Q 00 ' Fee "' (to be paid on filing this application) 5. If dwelling, number of dwelling units..c~r~e .......... Number of dwelling 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. Dimensions of existing structm'es, if any: Front ............... Rear .............. Depth ............... Height ............... Number of Stories ........................................................ Dnnens~ons of same structure With alterations or additions: Front ................. Rear .................. Depth ................... ,... Hei~at ...................... Number of Stories ...................... 8. Dimensions of entire new construction: Front .24 ............ Rear . 2A ............ Depth . .36 ........... Height ..... 3-.6 ....... Number of Stories . .1 ..................................................... 9. Size of lot: Front .. BO ...... !.~_ .......... Rear..50. ................. Depth .~.5.0 .................. 10. Date of Purchase . . 4r.22~85 .~ .......... Name of Former Owner .S.a.m.u..e~..p..o~.l.~.q .r.:i..n.o. ........ 11. Zone or use district in which piemises are situated res 12. Does proposed construction violate any zoning law, ordinance or regulation: .no ............................. 13. Will lot be regraded . .~o~ 'i" ................... Will excess fill be removed' from premises: ~ No 14. Name of Owner of premises .~arae .............. Address . ~tgl~ ............. Phone No..2. .9.87-.9.1.7 .6 ..... Name of Architect ....... ~ .................. Address ................... Phone No ................ Name of Contractor ...... s.~r~ .............. Address ................... Phone No ................ PLOT DIAGRAM Locate clearly and distinctly all buildings, whether existing or proposed, and, indicate all set-back dimensions from property lines. Give street and block number or description according to deed, and show street names and indicate whether interior or corner lot. STATE OF NEW YORK · .~ .rgb. .... . .F..,...~.~..~-=Q. · ?.~.O.~..~,.~. ............being duly sworn, deposes and says that he is the applicant (Name of individual sighing contract) above named. He is the ' i (Contractor, agent, corporate officer, etc.) of said owner or owners, and is drily authorized to perform or have performed the said work and to make and file this applicatiofi; 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 manfier set forth in the application filed therewith. Sworn to before me this ' iLINDA F, KO\¥ALSI([ i No. 52'4524711 ' ' ~ ............ ', I ~ualil,ed in Suff01kCounty ' /(Signature of applicant) . Cornrpissio~ Expires March 30, 198,~ ~UFFOLK COUNTY ~EPA~TMENT OF HEALTH S~RVICE5 , ~ ,,~ ~,~ ................ FOR., APPROVAL~ CONSTRUCTION ONLY "~N ~ SOUTHOLD SCALE: 1", ~O' ~ ~ ~~ N~UTH~IZED ALT[RATION ORADOITION m roms GUARANTEED TO: - / ' ~ J~/~/~ ~ ~ ~ SURVEY~VI~ATION ~SECTmN 7209~THE E~UITYAB~T~A~ HEAL~ DEPARTMENT-DATAF~APP~' ~'~-J~ C~ST~UCI ~ 1.¢1 l~(~:l~ BE~H~ET~IT~L~O~N~ / '~)~ ~UC~T. /~ P~PERTY LINES OR FOR THE ERECTION ~ FENCES ~, w~//;~ ~./~'. w/-x~7~ I YOUNG ~ YOUNG .,v~.~..~ ~O.K NOTE: ~ = STAKE ~= PiPE ALDEN W.~UNG~ PROFESSIONAL ENGINEER SUBDIVISION MAP FILED IN THE OFFICE OFT~ CLERK OF AND LAND SURVEYOR N.Y.S. UCENSE NO. 1~845 SUFFOLK COUNTY ON JAN, 15~ 19Z9 AS FILE NO, 861 HOWARD W, YOUNG, LAND SURVEYOR M~ L~ ~ ~k(w),~lC TANKJ~TJICE~OL$(~) ~N ~E~ N.~S. LICENSE N0.45893 BRANDIS & SONS INC. 1046 SURVEY FOR GERARD P. GOEHRINGER 6, BARBARA GOEHRINGER ,SUFFOLK COUNTY DEPARTMENT OF HEALTH SERVICES LOT NO. 30~'GEORGE I TUTHILL,SECT. I" AT LAUREL DATE: MAy 3, 1984 FOR AppRoV.&L Cc C©NSTRUCTION ONLY TOWN OF SOUTHOLD SCALE: ~": 20' SUFFOLK COUNTY, NEW YORK NO. 85-407' OATE H5 RLF. N UN~UTHO~IZEO Al. TItiVATION OR ADDITION TO THIS GUARANTEED TO: SURVEY ~ A VIOI.&TION O~ SEC[CON 7209 OF THE EQUITY ABSTRACT! INC. OTHER THAH THOSE SHOWN H~REON, OWNERS / NTHEWATERSU~Y~SE~GE ~AL SYST~ISR~IDE~ ~DISTANCES SHOWN HEREON FRO~ PR~ERTY LINES ~[4~/~'~ ~ ~.~. ~ , ~ ~ , ........ ~J -,. I I ) V~H~l~ ~ V~l I~1~ ~ER AVE~E ALDEN W. YOUNG~ PROFESSIONAL ENGINE ER SUFFOLK COUNTY ON dAN. 15,1929 AS FILE NO. 861~ ~JJ HOWARD W. YOUHG~ LAND SURVEYOR M~L~T~L(W),~ICTANK(ST)~CE~OLS(~)~N~E~ _ T ~) N.Y,S. LICENSE N0.4589~ ~E ~ FIE~ ~TI~S ~ OR OATA OITM~O F~ OTHERE DRANDIS & SONS INC* 1046 ~UFFOLK COL,'~Z. I~L~H D~FARI'ME]~ SURVEY FOR GERARD P. GOEHRINGER & BARBARA GOEHRINGER OCT 25, 1985 ~ ~EC O~ ~g~' E. D. ~. ~~/ LOT NO. 30;'GEORGE I TUTHILL,SECT. I" MAY 24,1985 AT LAUREL DATE: MAT 3, ~985 faorli~ for this loc~t~ o~ have been ~N ~ SOUTHOLD SCALE: I"= 20' tnspeeted by this department ~ ~ound $UFFO~ COUNTY, NEW ~K NO. 85-407' USLIFE HE~ DEPARTMENT-DATA F~ A~R~ TO C~STRUCT AND m ,IS M~LF ~ THE ~TLE  ~ ~ ~NDER AVEWE NOT~: ~ = STAK~ 0 = PIP~ ALDEN W.~NG~ PROFESSIONAL ENGINEER SUBDIVISION MAP FILED IN THE OFFICE OFT~ CLERK OF ANO ~D SURVEYOR N.Y.S, UCENSE NO, 12845 SUFFOLK CO~TY ON JAN. 15,1929 AS FILE NO. 861 HOWARD W. YOUNG, LAND SURVEYOR M ~ L~ ~ ~L(W),~IC TA~(~B CE~(~) ~N ~E~ N.~ S, LICENSE NO. 45893 h -t T t If copper tubing is used for water distributing system; piping shall be o1: types K or L onJy SOLDER USED IN WATER SUPPLY SYSTEM CANNOT EXCEED 2/10 of 1% LEAD. USR B llAVVFUI OF Oi3gU?A I3Y 765-18P'~ 9' A/b~ )-CJ ~ ~ ~O~ 1. FOUt4mATfOF~ - TWO R~QUfRED FOR P~UP~D ~O~C'~ETE 2. ROUC;~ FRAMf~E & 3 IN~U' A~fnh.r ALL CC~I~T~'D~TiO~ CHALL MEET THE Rr,~','~:¢,X~FFT~ OF tHE N.Y. ~TAT~ CONCT~UCTION & [NERGY COD~S. NO~ ~ESPONSIBL[ FOR D~I6N O~ 60NCT~UCTION E~RORS. 'Free (-! I Phone477-0400 ~ Main Road GREENPOR r, N.Y. 11944 I Pllone 477-0400 ..,t,, ~ ad 1 I;)d 4 NOTIFY BUILDING ,~,EFART,,/,ENT 755-]802 ~ AM TO ,~ PM FO~ THE ~. FOUN~AT~h~ - ,~7:v'O REQUIRED FOR =~ ~ ._D CONCRETE 2. RO~ - FRA,~fN¢ & PLUMBING ,-- - ~ ....... :CN MUST BE C~,'.'PL~-E FCR C.O. ALL CuN5 .... . .~,~ S~A_L THE R:~,:~=,r,.~k, IS CF T~E N.Y. STATE CONSTRUCTION & ENERGY CODES. NOT RESPONSIBLE FOR DESIGN OR CONSTRUCTION ERRORS. i' , r APPROVED AS NOT£D , D^TE:~._B.P. '~ ~_....--/ ~.,._....--- 765-1802 9 AAA TO 4 PM FOR THE FOLLOWIN~ I~HC'?ECT ONS: , ], FOUNnATiON ' TWO', REQUIRED FOR pOIJRED CONCR~E ROUGH - FRAMING ~, pLUMB~ 2. [NS(jLAT ON : ' 3. 4. FIN~L ,Cmk,~TplICTIQN MUST, nE .C-x ~ ~ rTE ~:OR ,C: O. THE REO~URnMEN~S OF THE N. Y;?