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HomeMy WebLinkAbout20019-z FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Ha11 Southold, N.Y. CERTIFICATE OF OCCUPANCY No Z-21002 Date SEPTEMBER 10, 1992 THIS CERTIFIES that the building NEW DWELLING Location of Property 1205 TUTHILL ROAD EXT. SOUTHOLD N.Y. House No. Street Hamlet County Tax Map No. 1000 Section 55 Block 6 Lot 15.52 Subdivision Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated JULY 12, 1991 pursuant to which Building Permit No. 20019-Z dated JULY 17, 1991 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 (FIRST FLOOR ONLY) WITH ATTACHED GARAGE The certificate is issued to JOSEPH & SANDRA KOLLEN JR. (owners) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL 91-SO-46-DEC. 3, 1991 UNDERWRITERS CERTIFICATE N0. H-027657 - MARCH 18, 1992 FLUMBERS CERTIFICATION DATED AUG. 19 1992 - JOSEPH H. KOLLEN JR L~ Q. Bu' ing Ins ector Rev. 1/81 1'OBdI[ N0. t 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) N° 2 0 019 Z Date t..7..........., 19..9.1. Permission is hereby granted to: I~ s~ ~k... 3 ...............................................VVV..... ...........Xa.... 7..1.. at premises i~......lerl'R.rSi .....~:4siAr11~:!s1,e1X.....14.~.. County Tox Mop No. 1000 Seetlon ....O.~S...... Bloek Lot No...~.a~..e. S.:?-... pursuant to opplieation doted ......~..........1..a.- 19.9..x.., and approved by the Building Inspector. Fee S..P?.~~! ~ St.. . . . ~ : S r~ ~ : . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Buil ng Inspector Rev. 6/30/80 _ . . Form No. 6 ` " s TOWN OF SOUTIIOLD ; ~,f ~ t ~ . BUILDING DEPARTMENT Z ~90~~ TOWN HALL 765-1802 APPLICATION POR CERTIFICATE OF OCCUPANCY A• This application must be filled in by typewriter OF, ink and submitted to the building inspector with the following: for new building or new use: 1. Final survey of property with accurate location of all buildings, property lines, Final Ap rovalnfromlHealthaDeot topographic features Su.Q?dy R~~e'N P of water supply and sewerage-disposCal(S-9 fo m~R 3• pproval of e ectrical installation from Board of Fire Underwriters. v" 4. Sworn statement from plumber certifying Chat the solder used in system contains t~~.D less than 2/10 of 17 lead. • 5. Commercial building, industrial building, multiple residences and similar buildings and installations, a certificate of Code Compliance from architect or engineer responsible for the building. 6• Submit Planning Board Approval of completed site plan requirements. 8• For existing buildings (prior to April 9, 1957) non-conforming uses, or buildings and "pre-existing" land uses: t 1. Accurate survey of property showing all property lines, streets, building and unusual natural or topographic features. „ 2. A properly completed application and a consent to inspect signed by the applicant. If a Certificate of Occupancy is denied, the Building Inspector shall state the reasons therefor in writing to the applicant. Fees 1. Certificate of Occupancy - New dwelling $25.00, Additions to dwelling $25.00, Alterations to dwelling $25.00, Swimming pool $25.00, Accessory building $25.00, Additions to accessory building $25.Op, Businesses $50.00. 2. Certificate of Occupancy on Pre-existing Building - $100.00 3. Cony of Certificate of Occupancy - $5.00 over 5 years - $10.00 4• Updated Certificate of Occupancy - $50.00 5. Temporary Certificate of Occupancy - Residential $15.00, Commercial $15.00 7~a3 Date ew Construction...,, Old Or Pre-existing Btu/i~lding. •fl~ ocation of Property..../.~.~ ....~~rl( ~..~~P SD ,J,yJ/+J IIouse No. Street V7~1 I Hamlet ewer or Owners of Property.. , , • .s~~~ L4d~le,J aunty Tax Map No 1000, Section... •~•-5. • • • • • • • • . • • • . . ff~~ ff~~ ....Block. .~.....LOt...... ~6vs Z- bdivision...~T1.~.`7 pet~~... ~NOtJS .Filed Map............Lot...~p„ rmit No.•~~.~~.~.`~.,~Date Of'Permit•.~f:•~ '-y- ,~i,~,~~ ~t~LJ _~py~.•..... ~~y 11" a// .Applicant.. V'~ alth Dept. APPr~"°1........ ~ '•••••••••.......•.Underwriters Approval........... inning Board Approval iuest for: Temporary Certificate..... Final Ccrticatc., Submitted: ~ o eo al© 2. ' THE NEW YORK BOARD OF FIRE' UNDERWRITERS p~c~ ~ L'9'T,E55[i BUREAU OF ELECTRICITY ~ ~ 88 JOHN STREET. NEW YORK, NEW YORK 70038 - Date NARC}1 1•~e~~~2 Application No. on file 1b`~17,4I97.I y:d 7d $~~~x)i " THIS CERTIFIES THAT i'P[11~7. 5' NQ. 7~.1~7.gZ only the electrical equipment as described below and introduced 6y the applicant named on the above application number in the premises of JUSfillii [d, 7iU[,Lk;N, i.?W5 fIITNTLL Rf}. r :7UIfT71UL[F, 1d.`{. in the following location; 0 Basement ® lst Fl. ? 2nd Fl. ~~[y if}`I'T;CG ([Id7:C Sertion$~J Block~6 Lot ~i1 u'as examined un Ndi12 Id ~ ~ + i g y ~ and fourzd to be in cmnplionee with the requiremea is of this /foard. " FI%TURE FIXTURES RANGES COOKING DECKS OVENS DISHWASHERS EXHAUST FANS OUTLETS ECEPTAClES SWITCHES INCANDESCENT FLUORESCENT OTHEH bNT K W AMi K W AMi K.W, qmi K.W AMT. H P 3ti 92 ~i:t 7. ~ i~ - DRYERS FURNACE MOTORS FUTURE APPLIANCE FEEDERS SPECIAL REC'PT TIME CLOCKS BELL UNIT HEATERS MULTI-OUTLET DIMMERS AMi K. W. Oll H P GAS H. P. AMT. NO A. W. G AMT. AMP AMT: AMPS TRANS. AMT H, p SYSTEMS qMT. WAiiS NO.OF FEET 3 F 1 SERVICE DISCONNECT NO.OF S E R V _I C E AMT. AMP TYPE 1~4W I,B'3W JA'~JW ].e'4W NO.OpERCgCOND. OF CC.COND NO. Of HbIEG Of~H lEG NO OF NEUTRAR OF NEUTRAL OTHER APPARATUS: s ~ BLN9~. ROUdI kitdA'7'[dRSt1.-1.1 7t.W. - C.R.C.II-6 - BMURIi 77IST$L'TUR t - 1. *'NUi'Nt TI>is i:l a Itarr,fa7„ DoL ti cotaQlote [;Qrtificctrs. anu~eN N. K~>r.LLt1N ' e.o..d~ox a~a SGU'd NOLIi, NY+ 1b979, GENERAL MANAGER Y 1 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. o COPY FOR BUILDING DEPARTMENT. THIS COPY OF CERTIFICATE MUST NOT.,BE ALTERED IN ANY MANNER. OSUFF~(~f~~O. TORN Or' TEL.7G5-1802 f~" ~`u??'t" OFFICE OF IIUILDII~IG INSPECTOR cn %T P.O. BOX 728 T0IVNHALL ~'~yu' '-~,',t' x ~b0~' SOUTHOLD, N.Y. 11971 ~I~(i 2 I l~.a~~ C E R T I F I C A T I O N Date ~ l Building Permit Nop. ~A Owner n,n (-CL S t)O ~r~D~~ Ic,a l le ~Jr. (please pr/~int) h (please- print) I certify that the solder used in the water supply system contains less than 2/10 of 1; lead. ~i lG~ • (plumbcr''s signature) Sworn to beforo me this ~9YY~~ -L=-d a Y o f ~ ~ - - - 19 ~ ~ tiotary Public Not y Public ' County ' ' .~r~-=° y q°T tt 5~ :~sr?-n'i~~l:~_ 1~1111~0~~~f _ f i • ' _ - 1c:LD i1:S:'EO::Ui! ~IUni ~ i:OMMGNT° M v ~ ~O d y ~0 FOUIJDATION (1st) - - FOUNDATIOiJ ( 2nd ) m 2. - - - b D N't dn,.:o z P,000H FRAME & h ~ .i PLUMBING 9 v , 9 P y 3 . ~3 ItJSULATI0P1 PER N. Y, ~ , , y STATE ENERGY CODE x~ a 2 4 . 7 °1. Z ~ . FI;JAL ' ~ ' ' ~ _ ADDITIONAL COMMENTS: p p x ~IAMr-A:~1 0`n ~ ~~.d.Ci ~e~~i I qJ ~ '~co. t ' - P • t~ ' x .a • H 9 •J y H O ~ 2 Z ~ ' ~ ~ > ~ _ r ' x G v - b.~ ' .r7 H - ~ .f.. _.,.,......_.._,......,~~r, ~~~FFa~K~oa JAMES C. McMAHON t~ ~ SCOTT L. HARRIS Administrator =o rxn Supervisor tr ~ Telephone (5l6) 765-1892 ~ 0~' Town Hall, 53095 Main Road ~'y01 ~ P.O. Box 1179 Southold, New York 11971 Fax (516) 765-1823 TOWN OF SOUTHOLD COMMUNITY DEVELOPMENT AGENCY TO: VICTOR LESSARD, PRINCIPAL BUILDING INSPECTOR FROM: JIM MCMAHON, DIRECTOR, COMMUNITY DEVELOPMENT SUBJECT: CERTIFICATE OF OCCUPANCY - AFFORDABLE HOUSING PROGRAM DATE: August S, 1991 I hereby certify that Joseph Kollen has been issued a valid Certificate of Eligibility for the Town of Southold's Affordable Housing Program and the issuance of a Certificate of Occupancy to Joseph Kollen will not permit a use, occupancy, sale or lease of a dwelling unit or unimproved lot in violation of the provisions of the Southold Town Affordable Housing Code. James C. c ahon Director, Community Development it 765-1802 BUILDING DEPT. INSPECTI~1~1 ] .FOUNDATION 1ST [ j ROUGH PLBG. ] FOUNDATION 2ND [ ]INSULATION ~ [ ] .FRAMING [ ] FINAL 'REMARKS: ~.~.L ~ i ~ ~p r f f E DATE 9Z INSPECTOR ~ ~ L - - - 4,. ~e _ _ ~ ~ 765-1802 BUILDING DEPT. 1 NSPECTION [ ]FOUNDATION 1ST [ ]ROUGH PLBG. FOU ATION 2ND [ ]INSULATION [ FRAMING [)FINAL REMARKS: J I I - k t DATE ~ INSPECTOR ~G~ 765-1802 BUILDING DEPT. INSPECTION [ ]FOUNDATION i5T [ ] RO PLBG. [ }FOUNDATION 2ND [ INSULATION [ ]FRAMING [ }FINAL REMARKS: `4 , k f k E t €4 k f t ~ DATE ~ INSPECTOR _ ~ J 8 r rss-isos BUILDING DEPT. INSPECTION [ ]FOUNDATION 1ST [ UGH PLBG. [ ] F UNDATION 2ND [ ]INSULATION [ FRAMING [ ]FINAL REMARKS: i~ ~ DATE d © INSPECTOR I. 765-1802 BUILDING DEPT. MNSPECTION [ FOUNDATION i5T [ ] ROUGH PLBG. [ ]FOUNDATION 2ND [ ]INSULATION [ ]FRAMING [ ] //FINAL REMARKS: '7~ ` ~ _s~~. DATE INSPECTORr f {if{ E . _ - J J W J a J I W ~ a ~3 ~ O JLL Jin y O U in a a vi Eo^ i.°. °;.o {O ~JYL BtiS~~ Q Z ~ W p 2 > 2 r. f 4; t, o F'A G € e e ~ = x s' ? ~N o~1 x r O O l7 (n, Q-€, ~~8 eiY~a~ 'Fw a w>P ~s z d ~3O~Q d ~V 1~/1 ai'- ~c>~OyEY?'N5 NLLYp~,.~f,~,+d.^mJl . Z w VY ~~~~1y,~ O Q - N~ Z 2 2 Q p 0l0 )'I o~' 2;.~^o i;co~co~ ~'b O~i.~+'!ao'~O LL a W d 01 _~FT ;"C'"a aNOaaA ~b Qb a ~ Z I w ~ J X In: 1 y _ b., 3;A z.€~N 55` = Z W d F- W Z Z O O H~ VI XiU SuEo _ «E~ a p00D U O ~ Z Ovi a~~ y F' H O aJ O~~ O u p~~ w j N W V LL W V 2 0 Y D r J ~ n ¢ f ~ .Yi a -Y' ~ ¢ w > ~ pp ~ ~ _ , dVW 03'713 335-'d O37J 10n! N I Y 0 7 j w Z¢ N a ~n o- Z .r0 w F vi U~ W U pV O I a ~ p ' q~- J I U-\I W W ' i« i ~ 'Z ! N ~ Id= F N N' ~ W °d ~ ~ o J IN ~ C7 I ~ k- a W > f~ UI ¢ L•7 4 w ~ F Z ~ v) ~ g ~ LLIU> ~ k a ~zalW zZ C1. fj p A~ ti E~ w~ w~o~ W w ~ lLl d~ 2 nl ' ~ a f- \ Q. Z~ ' a. ~-I _ L~ 5~1ti~~ i~ a _ ~ ~I~~" 01 I J a a z u, ~ a iu ~ ~ ~ ~ o vim} ~ ~ ~ i O ~ Q S~ ~ ui ~ i I ~ d~~I ~~W lr~ ~ i i , I I W I ~ t~ mi _ ~ QI w O I rnl $ ~ ? ~ ~ ~ ~ ~ ~ d; I N ~ xd.._ ' l? I !I ~ ~ IwA' IW ~ Fr`" Z V i~ V U 1 y0 ~ lU1 £ yI~+4 ~ ~ u ~u, ~ ~ W ~{I ~ ~ ~ Q NN W ~ (!J 5? i. ~ (1 I'6L~ _ 'xa~ arm ~ ~ i { ' ~ 00'86 rn OY £G,Y6~N 1 I „I D NOf5N31X3 r~,4V071 "7~IHJ.f71 e, s, Y _ c 'F, 1 +s, k J - - N o0 m~ 1 B D s.>-_ ~~~ti ~ D 60ARD OF HEALTt{ FORMNO.1 3 SETS OF PL1:iS • TOWN OF SOUTHOLD SURVEY . . x,~ BUILDING DEPARTMENT CULC1: • • • • • • • - - • _ . ` ~ ` TOWN HALL SEPTIC FOR:I _ SOUTHOLD, N.Y. 11971 BLDG DEF7~ • • . TOWN OF SO THOLD TEL.: 765-7802 Y.OT I F'f ; CALL . 7 : J • Examined 199.( . n rtnlL ro: :approved . ~ ..~.7.., 199.1. Permit No.e~.Q?? ~ q,~ . Disapproved a/c . _ . (Buil mg Inspector) APPLICATION FOR BUILDING PERMIT ''''7 ~f Date ~.Cct..., ]9.! / INSTRUCTIONS a. This application must be completely filled in by typewriter or in ink and submitted to the Building Inspector, with 3 its of plans, accurate plot plan to scale. Fee according to schedule. -r b. Plot plan showing location of lot and of buildings on premises, relations}tip to adjoining premises or public streets u 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 call 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 call 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 uilding Zone Ordinance of the Town of Southold, Suffolk County, New York, and other applicable Laws, Ordinances or egulations, for the construction of buildings, additions or alterations, or for removal or demolition, as herein described. he applicant agrees to comply with all applicable laws, ordinances, ilding code, housing code, and regulations, and to jmit authorized inspectors on premises and in building for necessary ' echo s. 1 ~ L~ ~ ( 'gnature of applicant, or name, if a corporation) (Mailing addre~s of applicant) tate whether applicant is owner lessee, agent, architect, engineer, general contractor, electrician, plt(mber or builder. ~.....:.....~....C-0 ~~2r-~ ame of owner of premises ~0.Y?QI Y;G--.. , (,O,S 1/ (as on the task roll or latest deed) ' 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 . . r Other Trade's License No . . . . Location of land on which proposed work wil~~d"oK. . , .~~',7!!! , House Number Street ' ' ' ' ' ' ' ' ' ' ' ' Hamlet County Tax Map No. 1000 Section Block ....6 ~ f~ 1 ,t~ ~ J Lot..... ~ . Subdivision . ! '~FJ, ,~QI ~,1, /•~Q~(~,Dv!S , , , , , Filed Map No. p ~ ..(Name) ~ 6 . 1~,....... Lot ;Tl~ . State existing use and occupancy of premi/ses and intended ise and ciccupancy of proposed construction: a. Existing use and occupancy ~-.CGLIl....... (1 a:~ c I ~ .~t',1~I~~^t,.r~c ' b. Intended use and occupancy .........1 ~Q'M.t.!~/ .....~~JQ~~u'~s y ~Jl}fdNYRA*F~ . 3. A'ature of work (check which apl ' `7 . ~licable): New Building Addition Alteration` c~, J # Repau Removal , , Demolition Other Work .........F~. • . 4. Estimated Cost , ~ ~ 0 ~d pr (EA ptign) (to be paid on filing this application) s t! 5. If dwelling, number of dwellin nits , , , Number of dwelling units on each floor , . • If garage, number of cars • • . . 6. If business, commercial or mixed) occupancy, specify nat r and extent of each type of use NIe¢,,,,,,, , , , , , , , 7. Dimensions of existing structures, if any: Front Nr~, , , , , ,Rear , , Height ...............NumberofStorics............,........ Depth............... Dimensions of same structure with alterations or additions: Front Depth 1 „ Rear 8. Dimensions of entire new constrUCtion~ Front S rr • • • • • • • Number of Stori~ s , , Rcar.,..°?e~."~t....Depth .c~(a~-D~r..••• Height um erofStories......a;,,,,,,,• 9. Size of lot: Front 0 10. Date of Purchase Rear...,.,II,~,,~(.~~~••••~~~•De th••••••,••OC~ p t'.95n! '''~•~•y~•~~•••••••'•••••••..NameofFormerOwner ...G~s3.r+?...1,0;,,•..•.. 1 1. Zone or use district in which prcr~tises are situated . . • • • ' • oes ro osc construction vtola ' p p ~ to any zoning (aw, ordinance ar regulation: ~ d , . 13. Will lot be regraded ,Will exce s fill be removed from premises: Yes No 14. Name of Owner of premises . tJ,O,.f$e1o!1 ,J~,'a r"cL ~i 3Y3, - hone No..7.4~J.:/ 7~/7. , ~r Address G, • , i , , , Name of Architect ,~/~n S~~'a~~' r,•'~,• • • • • • Address Phone No, . . , Name of Contractor . , ~ :.h, n»QT, , . , , , , , , , ,Address . . ~Q u,Yh p,~c?, , , , ,Phone No...~lo,~'~, ; f~33b L5. Is thi~ property within 3Q If yes, Southold Too feet of a tidal wetland? ~yeS,,,,,,,, No wn Trustees Permit may be required, r, i, PLOT DIAGRAM s Locate clearly and distinctly al] 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. I I~ N LATE OF NEW Y , I -AUNTY OF . , ,~V, e~,~, , S.Sj I/ ` . • • ' ' ' ' ' ' ' ' ' ' ~a • ~ s rg ~\P v~1 being duly sworn, deposes and says that Ire is the applicant (Name of individual si nin contract) ove named. his the 04~~.,~,,~- 'f'.i~;'c. (Con tractor, agent, corporate officer, cte.) ~ ~ ~ ~ ~ ' ' ' ' ' ' ' ' ' ' said owner or owners, and is drily atfthorized to perform or have performed the said work and to make and file this alication; that all statements containe(1 in this application are true to the best of his knowledge and belief; and that the irk will be performed in th anner seG forth in the application filed therewith. orn to before me this .........~z~ ay r. ...~~.V y. 19~! Lary Public, , , . ~ County ~ ~`.V}~.. . ~I . . 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