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HomeMy WebLinkAbout13675-z FORM NO.4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. Certificate Of Occupancy 214055 December. .5 85 No. . . . . . . . . . . . . . . . . . Date . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ., 19 . . . THIS CERTIFIES that the building . . . . . .adaition.. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1305 , . , , , . , . . , , Bayview Ave. Mattituck Location of Property . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . aml. . House No. Street Hamlet County Tax Map No. 1000 Section . . . .106. . . . .Block . . . . . . . .6. . . . . . .Lot . . . . . . . . . . . . Subdivision . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .Filed Map No. . . . . . . . .Lot No. . . . . . . . . . . . . . conforms substantially to the Application for Building Permit heretofore filed in this office dated �.Anvdxy. . ?. . . . . . 19135. pursuant to which Building Permit No. , , ,136752 dated . . . . January 15 , . , . . . . . . . 1985. ,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 . . . . . . . . . Addition to existing dwelling. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . The certificate is issued toBARBARA D. & GEARD P. GOEHRINGER . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . (owne of the aforesaid building. Suffolk County Department of Health Approval . . . . . . . . . . . . . . . . .NlA . . . . . . . . . . . . . . . . . . . . . UNDERWRITERS CERTIFICATE NO. . . . . . . . . . . . . . . . . . . . . . N685.335. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Building Inspector Rev. 1/81 FORM NO. $ TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N. Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) .............. Date rtr !:!MN4 ............ 19 N� 13675 Z y t S .??s' Permission is hereby granted to: .a� .. .. -.............................................. to ....1t1!.!..".01�. �!... ..5�?�....�!�.A�ln...�0..... .ItN7��^f. . .. ...0 ,..n.4lf......d.. ....... ............ \........... ........................ premises remises located at ...(.. ..... .�'1�.... .�........ ..... �....... ................................................................................ ................................................................................ .................................................................................................................................................................. County Tax Map No. 1000 Section ...1 C? �......... Block 4� Lot No. —" ....... .......... ........ .... .. .:............ pursuant to application dated .. -"$460 .... . ..;4"....................... 19P and approved by the Building Inspector. i ' 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 A. This application must be filled in typewriter OR ink, and submitted nmm 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. B. For existing buildings (prior to April 1957), Non-conforming uses, or buildings and "pre-existing" land uses: 1. Accurate survey of property 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 . 00 3. Copy of certificate of occupancy $1.00 4 .Vacant Land C.O. $5. 00 /r G,/ �f� / Date . . . . . . . . . . . . . . . . . New Building . . . . . . . . . . . . . Old or Pre-existing Building . . ./.` . . . . . . . Vacant Land . . . . . . . . . . . . . Location of Property .� �� . ./.✓!�;.1✓(�"� . . . . . . . . . . . . . . . . . ..4 f?/ House No. / Street Hamlet Owner or Owners of Property �? ����. ( !�' h` rot . County Tax Map No. 1000 Section . . . . . . . . . . . . . . . Block . . . . . . . . . . . . . . . . . . . . . . . . . . . . Subdivision . �e . . . . . . . . . . . . . . . .Filed Map No. . . . . . . . . . .Lot No. . . . . . . . . . . . . . Permit No. .'. . Date of Permit . . . . . . . . . .Applicant . -1a"l el. . . . . . . . . . . . . . . . . . . . . . . . . f3� 7 f Health Dept. Approval . . . . . . . . . . . . . . . . . . . . . . . .Labor Dept. Approval . . . . . . . . . . . . . . . . . . . . . . . . Underwriters Approval . . . . . . . . . . . . . . . . . . . . . . . .Planning Board Approval . . . . . . . . . . . . . . . . . . . . . . Request for Temporary C.errtificatre�. . . . . . . . . . . . . . . . . . . . .Final Certificate . . . . . . . . . . . . . . . . . . . . . Fee Submitted $ R. . . . . . . . Construction on above described building and permit meets al �ppisdes and regulations. 1 Rev.10-10-78 YA 100044 THE NEW YORK BOARD OF FIRE UNDERWRITERS BUREAU OF ELECTRICITY 85 JOHN STREET, NEW YORK, NEW YORK 10038 April 02, 1985 319026/85 Date Application No.on file + Q THIS CERTIFIES THAT 8 � 5335 only the electrical equipment as described below and introduced by the applicant"tried on the above application number in the premises of Gerard Goehringer, Jr., Bayview Avenue, Mattitnck, NY in the following location; ❑ Basement 1� 1st Ft. ❑ 2nd Fl. Section Block Lot was examined on March 28, 1985 and found to be in compliance with the requirements of this Board. FIXTURE FIXTURES RANGES COOKING DECKS OVENS DISH WASHERS EXHAUST FANS OUTLETS RECEPTACLES SWITCHES INCANDESCENT FLUORESCENT MEAN v vnFOA AMT K W AMi K.W. AMT K.W. AMT K.W AMT H P 4 3 4 1 :- DRYERS FURNACE MOTORS FUTURE APPLIANCE FEEDERS SPECIAL RECTT TIME CLOCKS BELL UNIT HEATERS MULTI.OUTLET DIMMERS AMi SYSTEMS K W. OIL H , GAS H.P. AMT. NO. A.W.G AMT. AMP AMi AMPS TRANS.; AMT, H P NO.OF FEET AMT. WATTS SERVICE DISCONNECT NO.OF S E R V I C E AMT. AMP. TYPE METER I,,tW I 0 3W 3%3W 3 4W NO OF C< COND. A W.G AWG. A.W.G EQUIP. PfR% OF CC.COND NO.OF H4LEG OF HbLEG NO.OF NEUTRALS OF NEUTRAL _ OTHER APPARATUS: Track lighting: 4 feet 2 Lites Richard Rejcyer P.O. Box 37272 . Laurel, NY 11946 LiO#214SE GENEYtAI MANAGER Per— This certificate must not be altered in any manner; return to the office of the Board if incorrect. Inspectors may be identified by their credentials. COPY FOR BUILDING DEPARTMENT,THIS COPY OF CERTIFICATE U t NOt BE g41EttED IN ANY MANNER. IN _ . FM€# are, soa rr >. _ rro'w+4sr � Y 5 . f� Area 30, 4 19 6 \ I o 42 ��03r-5 W AVCNUF EW p 13A y Fl LU4#p.S2ECTION — DATE COMMENTS . ro H FOUNDATION ( 1st ) FOUNDATION ( 2nd ) 2 . W a ROUGH FRAME & u1 PLUMBING p� • S H 3 . INSULATION PER N . Y. STATE ENERGY CODE13 a 4 . t� FINAL 0 z ADDITIONAL COMMENTS : � J ro � v H 000 z c- 1 x m rz He w. x� CT] ro H 41 40 7-- -------7:f 1-7 x•«461P4-Pin t>o,-- Iii 1:7A I-Wz'I vp LI-0,4 wr 765-1802 BUILDING DEPT. INSPECTION' ', t [ ] FOUNDATION IST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] INSULATION [ ] FRAMING FINAL REMARKS: DATE (� V INSPECTOR FORM NO. t TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N.Y. 11971 TEL.: 765.1802 a i Examined .`. ^�°�^�. �, , ., 19��. Received . . . . . . . . . . . , 19 , . . 4 Approved 19� S. Permit No. .I. ; . I�. . . Oisapproveda c . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . (Building Inspector) APPLICATION FOR BUILDING PERMIT Date . . . . . . . . . . INSTRUCTIONS a. This application must be completely filled in by typewriter or in ink and submitted to the Building Inspector, with 3 ets 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 ,r areas, and giving a detailed description of layout of property must be drawn on the diagram which is part of this appli- ation. 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 hall 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 hall 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 3uilding Zone Ordinance of the Town of Southold, Suffolk County, New York, and other applicable Laws,Ordinances or tegulations, for the construction of buildings, additions or alterations, or for removal or demolition, as herein described. Ahe applicant agrees to comply with all applicable laws, ordinances, building code, housing code, and regulations, and to Amit authorized inspectors on premises and in building for necessary inspec s. Sne, (Signature of applicant, or if a co poration) (Mailing address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. Name of owner of premises . . /J<1�t �fLJ' ?/ �f ✓! ✓ . . . . . . . . . . . . . . . . . . . . . . . . (as on the tax r �I r latest deed) if applicant is a corporation, signature of duly authorized officer. . . . . . . . . . . . . . . . . . . . . . . . . . . . . I . . . . . . . . . . . . . . . . . (Name and title of corporate officer) Builder's License No. . . . . . . . . . . . . . . . . . . . . . . . . . Plumber's LicensN,No. . . . . . . . . . . . . . . . . . . . . . . . . Electrician's LiceIse No. . . . . . . . . . . . . . . . . . . . . . . Other Trade's License No. . . . . . . . . . . . . . . . . . . . . . 1. Location of land on which proposed work will be done. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . House Number treet Hamlet County Tax Map No. 1 //1n000 ction . . . . l .� . . . . . . . Block . . . . (moi. . . . . . . . . . . . Lot . . . J .r✓'. . - . . . . . Subdivision . . . . '4�0,0�w• . • . • • . • . . Filed Map No. Lot . . . . . . . . . . . . . . . (Name) ?. State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy . . . �3laYG'17f%�/L. . �(7.e: .��P/1/�C . . . . . . . . . . . . . . . . . . . . . . . . . . . . . b. Intended use and occupancy . !ifa � rIR� , . CSe�//% , , , . , . , , , 3. Nature of work (check which applicable): New Building . . . . ... . . . . Addition . , . . . . . . . . Alteration . . . . . . . . . . Repair .. . . . . . . . . . . . . . Removal . . . . . . . . . . . . . . Demolition . . . . . . . . . . : . . . Other Work . . . . . . . . . . . . . . . (Description) 4. Estimated Cost . .Aw . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Fee . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . (to be paid on filing this application) 5. If dwelling,number of dwelling units . . . . . . . . . . . . . . . Number of dwelling units on each floor . . . . . . . . . . . . . . . . Ifgarage,number of cars . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6. If business, commercial or mixed occupancy, specfy r1qa�ture and extent of each type of use . . . . . . . . . . . . . . . . . . . . . 7. Dimensions of existing structures,if any: Front Rear ./R . t . . . . . . . Depth . . . . . . . . . . . Height Number of Stories . . / . . . . . . . . . . . . . . . . . . . . . . . . . . Dimensiops of same structure with alterations o'rpdditipns: Front . . .XAVec. . Rear .fo"14:. . . . . . . . . . Depth . J4vg14 . . . . . . . . . . . . . . Height /. Vdc! 1.� . . . . . . . Number of Stories . . . . . . . . . . . . . . . . . . . . . . 8. Dimensions of entire new construction: Front . . . . . . . . . . . . . . . Rear . . . . . . . . . . . . . . . Depth . . . . . . . . . . . . . . . Height . . . . . . . Number of Stories . . . . . . . . . . . . . . . . . .'. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 9. Size of lot: Fronw 3.?" Rear . .'/.'7 . . . . . . . De th *Z�0 . 10. Date of Purchase . . /.9. 1�. . . . . . . . . . . . . . . . . . . .,)Name of Former Owner . . . . . . . . . . . 11. Zone or use distri t in which premises are situated . .14 •. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 12. Does proposed cc struction violate any zoning law, ordinance or regulation: A10 :. . . . . . . . . . . . . . . I . . . . . . . . . . . ig . . . . . . . . . . . . . . . . . . . . . . . d from premises: Yes No 14. Name ofOwner of remises . . . ,S' ,d:. . . . . . . Address . . . fill . .remove phone No. . . . . . . . . . . . . . . . Name of Contractor . . . . . . . . . iL. Address . . . . . . . . . . . . . . • • • • Phone No. . . . . . . . . . . . . . . . . . . . . . . . . . . . . Phone No. . . . . . . . . . . . . . . . PLOT DIAGRAM Locate clearly and distinctly all buildings, whether existing or proposed, and,indicate all set-back dimensions from :>roperty lines. Give street and block number or description according to deed, and show street names and indicate whether nterior or corner lot. M )TATE OF NEW YORK� K S.S 'OUN Y OF 'c4P 'f . . . .(i*�rFtbeing duly sworn, deposes and says that he is the applicant (Name of individual ing contract) bove named. fe is the . . . . { .Q1?c/v�!/pG!firerr!i!. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . (Contractor, agent,.corporate officer, etc.) ,f said owner or owners, and is duly authorized to perform or have performed the said work and to make and file this pplication; that all statements contained in this application are true to the best of his knowledge and belief;and that the 7ork will be performed in the manner set forth in the application filed therewith. ;worn to before ane this rid ....�� . . . . . . . . . . . . . . . . . . . . .day of. \7al 4 d f.. . . . . . . . .. 19 r lotary Public,C✓ . LINDA F. KOWALSKI _ NDTARY PUBLIC, State of New York . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . No. 524524771 gnature of applicant) Qualified in Suftolk County Commission Expires March 30, 198�p 7P [ OR amok �+ ■E [� ( j r r� _ T uccuv MCI a - - APPROVED AS NOTED � F DATE: 1 /S° 8S' B P. - FEE: cS 6" : Y. NOTIFYY-BUILDIN DEPARTMENT AT -r y 765-1802- 9 AM 170 4 PM FOR THE FOLLOWING INSPECTIONS:- 1. FOUNDATION - TWO REQUIRED FOR ", RFD CONCRETE 2. ROUGH '- . !NG -& PLUMBING 3. INSULAT11M - 4. FINAL_ "- C4?P's U tf01 MW t BE C"'llm FTE 'FOR C.O.. � ALL CONST6R4,. . 031 LL MEET- THE RF(WIJPrIkA90S OF THE KY. STATE CMTMUMCIH & ENERGY COMS NOT, BLE FOR � [f{ l M zap — f lik .axt :. j i i M f i f f J a E i I w i g k Y 1 11 fu's 1.G.�... -.,r• �1 �� ) 1 ' T. moi._ I ��S �lI„���041�C"�//✓�A����•�� CGF���'�v�.cy. - ~s k,G - ZM"UIS. _ _ - —_ �.�` f C5'-�=.' /u' v � r'r.,�� �^�(�� �Ok./d�✓J�G✓�I7/'. P�NND S�EP��1 1�1 di" I r-4-