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HomeMy WebLinkAbout20384-z FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No Z-20982 Date AUGUST 27, 1992 THIS CERTIFIES that the building ADDITION Location of Property 5605 NASSAU POINT ROAD GUTCHOGUE N.Y. House No. Street Hamlet County Tax Map No. 1000 Section 111 Block 13 Lot 02 Subdivision Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated JANUARY 10, 1992 pursuant to which Building Permit No. 20384-Z dated JANUARY 14, 1992 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 ONE FAMILY DWELLING AS APPLIED FOR. The certificate is issued to ROBERT & JOAN LEHNERT (owners) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A ELECTRICAL INSPECTION CERT. #1175 - JULY 14 1992 PLUMBERS CERTIFICATION DATED AUGUST 17 1992-PERFECTION PLUMB.&HEAT. uilding Inspector Rev. 1/81 i 10Bffi NO. • TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N. Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL CQMPLETION OF THE WORK AUTHORIZED) No 203$4 Z Dote ...~.A^':!":°.4s!1s1......j.:~ 19.Q.2r Permission is hereby granted to: ~xanR...... `~.:....1.1.9.~.~.. to ...S.~.rA.~,-4.r~frsM.tN.'......Q...~,:t~?:!~::!.:!`!M...~!i?....,~~{r9!~rq....D.~1:4..,~.P-!^kL~f.,~ ......~...5?~I y.. ....................................1................1.......................................... ' at premises locate at ..~~P.~.S.....!~:'.~4a".a- ~V;, ..M1n-a-,,... County Tox Map No. 1000 Section ......./.I1........... Block ......~..ti'7......... Lot No......©.~-:......... ~ pursuant to application dated .......~°~^~Q:^:`~.......1.~..........., 194:2c:, and approved by the ' Building Inspector. u Fee g.a3$:s.~...... ......~c~a.... wilding Inspector Rev. 6!30/80 c _ - 0 ~ fi y . )~19 ~.S ~~r..yc:':-'w ~'t. ~ FORMN0.6 V ' ~ ~ ~ TOWN OF SOUTHOLD II', ~ Building Department r'~4 n a% ~ 5 1„:9,~ Town Hall Southold, N.Y. 11971 4; ( 13 ta;__ 765 - 1802 ?APPLICATION FOR CERTIFICATE OF OCCUPANCY fu~.~, Instructions A. This application must be filled in typewriter OR ink, and submitted to the Building Inspec- torwith 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 installs- ` lions, 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 inform~- tion required to prepare a certificate. C. Fees: Additions $25.00 POOLS $25.00 ALTERATION $25.00 1. Certificate Of occupancy New Dwelling $25.00, Accessory 10.00 Business $50.00 2. Certificate of occupancy on pre-existing dwelling $ 50.00 3. Copy of certificate of occupancy $ 5.00, over 5 years $10.00 4.Vacant Land C.O. $ 20.00 5.Undated C.O. $ 50.00 Date . .G ..J~~.~ NewConstruction,,,,,.Old or Pre-existing Building Vacant Land Location of Property .~^~.~05...~~S~C-?.;~, , ,~1 v>~.... 1~ /L '-~-~~j ..............~.yl.?......... yause No. Street ~ ~ ~j~ ya Owner or Owners of Property .~G7~`~-1'.1p~ . ~`~J~, , , , , , , , County Tax Map No. 1000 Section ....f i. 1....... Block , , . , , Lot d.°~` . Subdivision .................................Filed Map No. ..........Lot/Nom. . Permit No.°l~ 3,C~,yZ, Date of Permit .~~(`~~?~-:Applicant ~e?Y , ,~?",!~7~U~Y°~'~-~ Health Dept. Approval ........................Labor Dept. Approval Underwriters Approval . . . ......Planning Board Approval . Request for Temporary Certificate .....................Final Certificate . Fee Submitted $ ..c~ s. ~ . Construction on above described building and troll meets all a 55'cable codes and regulations. Applicant . ~~\~~L~ . Rev. 10-10-78 ~O~~F f~~ CO/' TEL. 765-1802 TOWN OF SO~7TIIOd.D ~ ` r ~ OFFICE OF BUILDING INSPECTOR o P.O. BOX 728 u' ~ ~ a~ --"c TOWN HALL /~O~ SOUTHULD, N.Y. 11971 C E R T I F I CAT T O N , Date V f? 7/ Building Permit No. 'pj 03~~ owner ~c~jnc,~T (please print) Plumber~e~acf~p ~~/~7~/~C°F~~rY~ (please print) I certify that the solder used in the water supply system contains less than 2/10 of to lead. (plumber's signature) / f, ~ Sworn to before me this f 7-c~~- day of / 19 t 2 . NotaL~PUtri-ie-- Notary Public, ~U~il~ County - d j~ ROBERT' 1. S~t'T, JR. N0. 4 289 Sutf~o~pt~fAU~~ Term Expires May 31,19~2~ _ a NroBNwo ,y_ x~ rao ~ o N O .,y x [%1 r ~a ~y~q rt uai ~ r'c N ~ rt ~ ~ ~ N H - ~ Q O fC 'x fD W ~ r N M ~ O m y n rt 3 tq co ro C--- r M H~ rn rt p m ~ pin ~ ~ ro~ d ~ M5' ~ Arta H ;t arra HA r ,POr ro o H n ma o ,pam H ~ ~ 0 H d ~ H to ~ roMro ~ $ to ~ !I td C1 H y [ H,-- ~ H H p ~ rt U1 W ~ ~ y N ~ N n n W a aN H fD o - M ~ ~ o N p a ~ ~ a ~ H ~ tn1 ~r+ z ~ G 4 C W C n 4 a r r_. y M W Wirt N~ Drn ~ M o o rt y fn fir. H N a~ E a rt n ~ i~ m T' ~ x~ o ~ ~ocg c7~c~_-i z a r b z c~ Z _ x ~O ~ 5"~ ~ Eno ~ w ~~m 8 n ~ D a; rx+ x - ~ x ~ k ~a a ~l r,,.i y o o w o ~a• a rt ~ < N ' ,d ~ ~ rt rt ~'rt a o ro (7 j' s"i ~ M - - N c ~ m N• ~ a m , v d ro a ~ ~y y n 't ~ y fD wtD o m ~ ~ n K - Jr N• I N n ~ v q ~ ~V't V 7 - Z G' Ffi ~C 'y~ (t ~D 1 _f_ - o ~ a ~z M _ ~ ~ iro~ 1` ~ Ua.. ,.,.a. 1. lwuusaA, cr.,c ~ ~ ~s N ~'Cr: ri ) ~ c'?,.. ~ ...g r, ~i:~ t:...~..;~ Cf:J f; n7 ~ ~C1 4 JY° ~ 5>J' ~ - K INSPECTORS ,~~,Y • Victor Lessard ev~fUj~~~ Principal Building Inspector C© Curtis Horton a~ ~O'"s~ SCOTT L. HARRIS, Supervisor r:~~: ~ . Senior Building Inspector ca Southold Town Hall Thomas Fisher ~ a P.O. Box 1179, 53095 Main Road Building Inspector ayi` Southold, New York 11971 Building Inspector ~®1 Fax (516) 765-1823 Vincent R. Wieczorek Telephone (516) 765-1800 Ordinance Inspector Robert Fisher Assistant Fire Inspector OFFICE OF BUILDING INSPECTOR Telephone (516) 765-1802 TOWN OF SOUTHOLD AUGUST 17, 1992 BURGER CONSTRUCTION, INC. 2515 PINS TREE ROAD CUTCHOGUE, NY 11935 RE: ROBERT ~ JOAN LEHNERT To Whom This May Concern: We are unable to complete your Certificate of Occupancy because of the following reasons: An application for Certificate of Occupancy is not on file. {Enclosed) / xlt% No Underwriters Certificate on file.l The check is (outdated/not on file.)\\\$25.00 No Health Department Approval on file. No fina]_ inspection has been made. No Plumber Solder Certificate on file. ~ (All permits involving plumbing being p~' issued after April 1, 1984). BUILDING PERMIT # 20354-Z Please contact our office on this matter. Thank you for cooperation. SOUTHOLD TOWN BUILDING DEPT. lELD II:S:'~:.;_u:J ~ I IIJn:c I COHi''(ENT° 6 ~ m0 ~W _ H~ FOUtIDATZON (1st) _ -M -pp FOUNDATIOIJ ( 2nd ) ~ p+ m ip P,OUGH FRAME & ~ ~ 0 ry PLUMBING g~ i 3 . ~ d y m IIJSULATIDII PER N. Y. ~ y STATE ENERGY CODE n ~~-.F G~7 ~ y FI;JAL byj~ q~q ' -"'p-' • ~ ~o ~ ~ o ADDITIOIJAL COMh1ENTS: s x . ~ ~ x ..1 ro • ~ ..+F a H ~ • N O Y- Z `m r. • y . m - - ~n ~ , - - 765-1802 BUILDING DEPT. INSPECTION [ ]FOUNDATION 1ST [ ] GH PLBG. [ ]FOUNDATION 2ND [ INSULATION [ ]FRAMING Q [ ]FINAL REMARKS: ~,X ~ l DATE ~ a~ V INSPECTOR U~ I i~~g~~''$C ;1~. ~~_f~~t`<<<-'~~~'~-. BOnFD OF HEALTH 3 SETS OF PL.1NS l~~rfi ,3E r.: PonrnNO.1 SURVEY J~~ ~ Q :'!n~ TOWN OF SOUTHOLD CHECK • • . BUILDING DEPARTMENT SEPTIC FOltrf i'7 TOWN HALL • $OUTHOLD, N.Y. 11971 NOT FY ~ 77 ` TEL.: 7G5~1802 cnLi~ ...l:~.~ Examined . ~aNM'°~. ~ .7.., 199 MAIL T 0 : ' ' ' APProvcd . ~Q:w!^"tiy. ~ y.., 19gZ. Permit No: a~. O.o3.$~. . Disapproved a/c . . (Building Inspector) APPLICATION FOR BUILDING PERPi11T q Date ~Q.~ 15 /c~. INSTRUCTIONS , a. Tl[is application must be completely tilled 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 stree[s or areas, and giving a detailed description of ]ayout of property must be drawn on the diagram which is part of this appL,- 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 Permii 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. TI[e applicant agrees to comply with all applicable laws, ordinances u ding code, ho sink code, and regulations, and to admit authorized inspectors on premises and in building for necessa insp ctions. (Signature o[ applicant, or n if a corporaTwn) ' ' /y ~ (Mailing address of applicant) U State w~(they a_p}p_licant is owner, lessee, agent, azchitect, engineer, general contractor, electrician, plumber or builder. .....lJ\~~ Vll Name of owner of premises 1~~~ ; ` , ~QCt Y1, ~ ~ ~1 ~ (as on the tax roll or latest deed) If applicant is a corporation, signature of duly authorized officer. • . • (Name and titie of corporate officer/) Builder's License No. ~f."~ ~ ~T Plumber's License No. , .4,,,~ 9~ , , , , , , , , ~-r yy---- Electrician's License No. ~ 4~:..... , , OthcrTradc'sLicensc No, I. Location of/land on which proposed work will be done; _ FlouseNuntbcr SS,treet Hamlet County Tax Map No. 1000 Section v~:`.4~:~.. ~ , : BI'uck , , , , , , , f~ Lot......f~' Subdivision Filed !\1ap No. • . . ..(Name] ' Lot 0 State cxistin~ use and occupancy of premises and intended use and occupancy of proposed construction: ~ a. Existi n, use and occupancy t~~J.!~~l , , , , , b. Intended u . , se and occupancy ~~S i,Cir2 vi... ~ . . ~..-.t:-~(?1'le Gl V~ ~l r~ ' ~ Cam' F[p~J Q 'SYO h`/ pot-a-t E-2- 3. Nature of work (check which applicable): New Quilding . - Addition Alteration . Repair RFmoval Demolition ..........Swimming pool............ . Tennis Court Accessory Building.........,Fence .......Other lJork............ 4. Estimated Cost .:~FQ~Q Fee (to be paid on filing this application) 5, If dwelling, number of dwelling units Number of dwelling units on each floor If garage.numbcrofcars 6. If business, commercial or mixed pccupancy, specify nature and extent of each type of use . 7. Dimensions of existing structures; if any: Front , . ~:tl~i....... Rear Depth . . Height Number of Stones . . Dimensions of same structure with alterations or additions: Front ~Sr?~x~•:eR~ Rear TT~...l~~a-,'~:?-c ` , . Depth . . 5-.-......,. Height ....~oi-ri^^-?.r: ........Number of Stones . 8. Dimensions of entire new constn~ption: Front Rear Depth , Hcitht .............1 . Number of Stories . . 9. Size of lot: Front .....I,Q . Rear .......~Q.~.......... , Pepth ~ee?~3 . I0. Date of Purchase b..~ . .Name of Fo cr Owner.. ....[~-l;f~~,-.~~-~~ . . 1 I. Zone or use district in which premises are situated ~[.-F° S.IG.t},°• ~1 >;t .l . • , l2, Does proposed construction tolate any zoning law, ordinance or regulation: . . l3. Hill lot be regraded . Nill excess fill Uc remoxcd from premises: .Yes No . . 14. Name of Owner of premises~~,l!{",t~ll!~Q,w;'~; Addressr.~.:~! l~flt1, 1G~1.... Phone No.2L~v.:Y~•($.r~... • . Name of Architect ~r~ Address ...................Phone No. . i Name of Contractor (~i~~~~ f1S'C'1'•!A(~j(~1~1Address Phone:~+.'.~2.-C~ . . 15.Is this property located within 100 feet of a tidal wetland? *Y ..NO.... *If yes, Southold Town TrusCees Permit roay be required. ? PLOT DIAGRAM Q~,,~--~ p,~~~ 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 comer lot. STATE OF NE1V ORI: S S COUNTY OF . • • • • • • • • • • • • • • • • • • • • • • • • . • • being duly sworn, deposes and says that he is the applicant (Name of individual signutg contract) above named. I,,. , (Contractor, agent, corporate officer, etc.) of said owner or owners, and is duly' authorized to perform or have performed the said work and to make and Gle this application; that all statements contained in this applic~[ion arc trot to the best of his knowledge and belief; and that the work will be perforned in the manner set forth in the application filed therewith. Sworn to bef/ore me thi .........l• • ~ . .......day of . ~ 19%~ Notary Public,®!~;~.~, ;~~;41i, ?u!; .........,,4'~?~~~ounty i Notary Public Sa to ORNE . No. 4961364NaWYO~' (Signat• •ofappiicanU C.ommaiss ~fne@'xr,ires n~lak Count ~ ' v z2,1 ~ p