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Home My WebLink About13877-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. Certificate Of Occupancy No. Z14600 Date Ju.ly 3 198.6.. THIS CERTIFIES that the building ...... .o.n.e.~ .f .a.m.i. 1. ¥..d.w.e..1,1.i.n. ~ :. . Location of Property ..... 1.0. 6. .01 .............L.e.e..w.a?.d...D ?.. .............S. o..u.t.h.q 1..d ...... House No. Street Hamlet' County Tax Map No. 1000 Section .... .7.9 ...... Block ..... .7 ......... Lot ..... ).0..~ ........ Subdivision..L.e..e y.a.p.d...A.c.~, e..s ..............Filed Map No... 5. .5.9.9. .Lot No ...... 5. .2 ...... conforms substantially to the Application for Building Permit heretofore filed in this office dated · .. AP. r..i.1..1. 7. ........ , 19.8.5. pursuant to which Building Permit No .... ).3.8. 7. .7.Z ........... dated ......... .g.p.r.i..1..1.7. .........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 ig ......... One-family dwelling. ....ri,... The certificate is issued to .... JOHN E. & SHARON G. RUM?LER (owner~Y~l ~t]~bl~ of the aforesaid building. Suffolk County Department of Health Approval ................. .8.5.-~S. 9.-.~.9. ............... UNDERWRITERS CERTIFICATE NO ......................... .N.7.5.0..6 9.6 ................. Building Inspector Rev. 1/81 TO~'N OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N. Y. BUILDING PERMIT (THIS PER~IT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) NB 13877 Z Permission is hereby granted to: ...~....g..~..~ ............................................ ~~~..... ~..~..~/~q~.. . ~ ................................... :...~ ......... ~.~. ................ .~. ...... ~ .............................................. .: ...... , es ~ e ~ ~, ~~.._./_~r~.. ..d.,~ County Tax Map No. 1000 Section .... .~...~....el ........ Block .......~.....-] ........ Lot No.....~...~...;./~l~,~. pursuant to application dated ........ ~.....(.2 ..................... , 19..~...~.~.., and approved by the Building Inspector. Rev. 6/30/80 FORM NO. 6 TOWN OF $OUTHOLD 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- tot 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. Su bm it Planning Board approval of completed site plan requirements where applicable. B. For existing buildings (prior to April 1957), Non-conforming uses, or buildings and "pre-existing" land uses: 1. Accurate survey of p~operty showing ail 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 nforma- tion requ ired to prepare a certificate. C. Fees: 1. Certificate of occupancy $5.00 2. Certificate of occupancy on pre-existing dwelling $15.00 3. Copy of certificate of occupancy $1.00 4.Vacant Land C.O. $5.00 ~//J'~/"/,~/~..~. 5.Updated C.O. $15.00 Date ............. New Building ...~.~..'~, ..... Old or Pre-existing Building ............ Vacant Land ............. Location of Property .~..~)?..~. .... .~.~.~'~/~.~.'~.~.....~.~. ....... ~.~..~..T~..I,~..G~. .................. House No. Street Hamlet Owner or Owners of Property ....~.~.~(,/h'.../~.~ .... ~...~.. ~)~l~tP/hf....~. :... [.~/~ .~.~..~.... County Tax Map No. 1000 Section ...7..c/ .......... Block ..... ~. ........ Lot...~.qt3. ......... Subdivision ,z~.~q~/.~. [~j3.,. ~/~ [~.)~ ~ .............. Filed Map No ........... Lot No.....~...Z- ....... Permit No. ]..~.~../7.~.. ~. Date of Permit .~/~'.~.~'..Applicant.. TO.~{.t~...~.~. .... '.~./.J,~P.~h'-/~..'.~."'~'... 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 meets all applicable codes and regulations. TOWN OF SOUTHOLD OFFICE OF BUILDING INSPECTOR P.O. BOX 728 TOWN HALL SOUTHOLD, N.Y. 1 t971 TEL. 765-1802 CERTIFICATION Building Permit No. I~ ~77 (please print) (please print) I certify that the solder used. in the water supply system contains less than 2/10 of 1% ]ead. Sworn to before me this Notary Public, ~, ._County (plumber s signature) Oualifled In S~ ~ ~m~ ~M~mh ~, 1~/ ~otary~ Pu~ic ' FIELD I N S~ E C 1~'~ 0 N FOUNDATION (1st) COMMENTS FOUNDATION 2. (2nd) ROUGH FRAME & FLUMBING INSULATION FERN. STATE ENERGY qODE FINAL ADDITIONAL COMMENTS: 76S-1802 BUILDING .DEPT. INSPECTION [] FOUNDATION 1ST [ ] ROUGH P£BG, FOUNDATION 2ND [ ] INsuLATiON FRAMING I' ] FINAL iNSPEcToR...: 765-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH 'PLBG, FOUNDATION ZND ~ INSULATION FINAL [ ] FRAMING REMARKS: BUILDING DEPT. INSPECTION FOUNDATION 15T [ ] ROUGH PLBG. FOUNDATION ZND [] INS~U, ATION INSPOR THE NEW YORK BOARD OF FIRE UNDERWRITERS 1000~78 BUREAU OF ELECTRICITY ~[ 8S ,JOHN STREET, NEW YORK, NEW YORK '10038 THIS CERTIFIES THAT only the elect~cal equipment as described below and introduced by the applicant named on the above application nu tuber in the premises of John Eo Ru~o,p]e~III~ 1060 Leeward Dr, ~ Sou~hold~ N.Y. in the following location; ~ Basement ~ 1st FI. ~ 2nd FI. Section Block Lot was exa~nined on ~' 1 ~ ~ ~ 98 ~ and Jound to be in compliance with the requiremengs of this Board. FIXTURE ~JXTURES RANGES OVENS EXHAUST FANS OUTLETS SWITCHES 43 FLUORESCENT SYSTEMS OTHER APPARATUS: G.F,C.I. Smoke Ootoctors E R V I C , A.W,G NO. OF HI-LEG A,W G NO OFpE COND. OF CC, COND. OF HI-lEG 2/0 NO OF NEUTRALS OF NEUTRAL Charles N', Hall Elec., P. O, Box 1268 Southold, N.Y., 11971 lic.#3494;E This certificate must not be altered in any manner; return to the office of the Board if incorrect. Inspectors GENEI~AL MANAGER may be identified by their creaenhals. COPY FOR BUll JNANyMANNER 'FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL ~OUTHOLD, N.Y. 11971 TEL.: 765-1802 Examined ' l']., 19 ~.~./ Disapproved a/c ..................................... Received ........... ,19... (Building Inspector) APPLICATION FOR BUILDING PERMIT INSTRUCTIONS 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 E[EREBY 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, j)nspgctiog,y. ,~ ~ er77~ .. ................. / (Signatur~ of atpplic~/nt, or name, if a corporation) p....0... B.ox ,3.9.2.,..G.r.e.e.n. pp.r.t.,...Ny..1.1.97.4 ............ (Mailing address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. Name of owner of premises ...... .Jp.h.n..E...ap.cl..S.h.a. rp.n' 9....R.u.rap. l.e.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 ...................... Location of land on which proposed work will be done .................................................. ............... /.d~.(/. . Leet~ard. Dr;Lye .......................................................... House Number Street Hamlet County Tax Map No. 1000 Section ...... 7.9. .......... Block ...... 7. ........... Lot .... 4.0. ............. Subdivision ...... Leeward..A~r.~. .................. Filed Map No ....... 5.5.9.9 ....Lot . 52. ........... (Name) 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy ......... ~nimB~qv.~4 .................................................. Single Family Residence b. Intended use and occupancy .................................................................... 3. Natur of work check which a: ~cable: New Building .. ... . Addition .......... Alteration ....,,... Repair Removal Demolition Other Work ~v ~.~. O.O~.. ' (Description) 4, Estimated Cost ~ ..... ~OO Fee ................................ , ~" (to be Paid on filing this application) 5. If dwelling, number of dwelling iunits .3..(pp.e) ...... Number of dwelling units on each floor..1..(.o.n.e.) ........ If garage, number of cars .... ~.(.t.w9) ............................................................. 6. If business, commercial or mixed occupancy, specify nature and extent of each type of use ................... 7 ..... if any Front Rear Depth ~ . I)lmenstons of exmtmg structures,, ......................................... Height ............... Nurn bet o f Stories ............................................. Dimensions of same structure with alterations or additions: Front ' Rear Depth ., .i,. Height Number of Stories ' ' 2" 5.4.'. 8" pth .6.2.'. 0"' ....... 8. Dimensions of entire new construchon: Front 58' Rear ·.... De ....... Height 22.' .... Number of Stories 1. (9.n.e) 9. Size of lot: Front ....1.2.5.' .... ! ........... Reari ... )).5.' ............. De th .... 30.6.' ........ ' ~ild ed 'Farddl'n;dff 10. Date of Purchase ........... , .............. · ·. , Name of Former Owner . , r 11. Zone or use district in which pr~mises are situated .................................................... 12. Does proposed construction violate any zoning law, ordinance or regulation: ............................... 13. Will lot be regraded No i Will excess fill be removed ............................ from premises: Yes ( No ) 14. Name of Owner of premises Jetta..K.. Ru,mpJ,e,r..I.I.I. Addressr. O.B.o.x, .3.9.2.,..qp.c...,..I,~/. Phone No.5.1.6. .4.7.7. .2.8.2.6. Name of Architect . ,Jm0,e,s, ILL.¢ja..I.I.I ............ Address S.o.u.t:.h,o,l.d.,...lq2/' ....... Phone No. 5.1.6. .7.6,5, .2,5.5,2.... Nmne of Contractor i Address Phone No PLOT DIAGRAM Locate clearly and distinctly alii buildings, whether existing or proposed, and. indicate all set-back dimensions from property lines. Give street and bloc[ ~number or description according to deed, and show street names and indidate whether interior or corner lot. SEE ATTACHED STATE OF NEW S'dfffbl k COUNTY OF .......... ' ....... John E. Rumpler III ............................. j .................... being duly sworn, deposes and says that he is the applicant (Name of individual sigmng contract) above named. ; He is the .................. , Cgn.tr.act°r [ ................................................................... (Contractor, agent, corporate officer, etc.) of said owner or owners, and is dul~' 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 m the manne~ set forth in the application filed 'therewith. Sworn to before me this ~ Sixteenth ~ .... ~ April (Signature of applicant) - lb0' 0" \ LICENSED LAND SURVEYORS GREENPORT NEW YORK SUFFOLK CO HEALTH DEPT APPROVAL H $ NO STATEMENT Of INTENT THE WATER SUPPLY AND SEWAGE DISPOSAL SYSTEMS FOR THIS RESIDENCE WILL CONFORM TO THE STANDARDS OF THE SUFFOLK CO, DEPT. OF HEALTH SERVICES. (si APPLICANT SUFFOLK COUNTY DEPT. OF HEALTH SERVICES -- FOR APPROVAL OF CONSTRUCTION ONLY t DATE: H. S. REF. NO., APPROVED' ' ~UFF'OL.K CO TAX MAp sT. CT, eLOC OWNERS ADDRE~: ~3o.9 NO~W~ 20A:~ ' DEED: L. ~//(~ P. I VA~. faoi!itie~ For this looatlo~h~ve~e~ inspected by this department and\~eEu~d Chief of Oe~ersl~tnee~i~~ Services RODERICK VAN TUYL, P.C, l LICENSED LAND SURVEYORS GREENPORT NEW YORK j ,, SUFFOLK CO. HEALTH DEPT, APPROVAL No. SUFFOU( ' , ~,' uv 11901 RIVER~ ~:~u' .... STATEMENT OF INTENT THE WATER SUPPLY AND SEWAGE DISPOSAL SYSTEMS For THIS RESIDENCE WILL CONFORM TO THE STANDARDS OF THE SUFFOLK CO. DEPT. OF HEALTH SERVICES. (S} APPLICANT ~SUFFOLK COUNTY DEPT, OF HEALT~-~ , SERVICES - FOR APPROVAL OFt CONSTRUCTION ONLY DATE APPROVED I I 'SUFFOLK CO TAX MAP DESIGNATION: DIST, SECT BLOCK eCL. [oo0 '~9 7 OWNERS ADDRESS: DEED: L. ,r..q,/~, TEST HOLE STAMP SECL If cOpPer tubing is used for Water distributing sYStem; piping shall be of types K or L only CERTI~]CAT~ OP" OCCUPANCy ~OL.;sl~ US~,/D IN WATER SUPPLY SYSTEM CANNOT · EXCEED 2/10 o] 1% L~D, .: OCCUP, ]CY 3 ~S ~OTED NOTIFY BUILL:Imm 765-1802 9 AM TO 4 PM FOR THE FOLLOWING INSPECTIONS- 1. FouNDATiON - TWO REQUIRED FOR ~OURED cONCRETE DESIGN OR CONSTRUCTION ERRORS' L r /~'r 3" ill h~ r JL -I