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HomeMy WebLinkAbout20133-z R FORM No. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Ha11 Southold, N.Y. CERTIFICATE OF OCCUPANCY No Z-20404 Date DECEMBER 11, 1991 THIS CERTIFIES that the building ADDITION Location of Property 1172 BAILIE BEACH ROAD MATTITUCK N.Y. House No. Street Hamlet County Tax Map No. 1000 Section 99 Block 3 Lot II.2 Subdivision Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated SEPTEMBER 4, 1991 pursuant to which Building Permit No. 20133-Z dated SEPTEMBER 10 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 ADDITION TO EXISTING ONE FAMILY DWELLING AS APPLIED FOR. The certificate is issued to SOHN WOHLFARTH (owner) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A UNDERWRITERS CERTIFICATE NO. N-215212 - DECEMBER 3, 1991 PLUMBERS CERTIFICATION DATED OCT. 23 1991 - MATHEW SCHIBI Building Inspector Rev. 1/81 B'OBM N0. fl 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"_ 20133 Z Data 19. Permission is hereby granted ~ R..G.~....../~..~;: `mil "U6~+~ " to ~9:rocs;rJ...`.....ext......~~~...~~.%,~.....~..,~....~...~~~ti.~~,,~......... ................................................................o........,........................... at premises located at ....~1.7~:......~f~t/ 1, .R~rj.L~.:....~.. ~,rtl . ...................................................................p............................................................................................ County Tox Map No. 1000 Section Block Lot No.....1~.~...... pursuant to application doted 19.l~., and approved by the Building Inspector. Fee S••`,--/•••v r/ ~ ..:a...' . g... hS~C 6 In I for Rev. 6/30/80 TEA ~,ge.ce~P.a.~ U-on..~Q~, e~""" Form No. 6 Wn- IX.aAY~ ~y. ~ (7f0~ TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL 765-1802 APPLICATION FOR CERTIFICATE OF OCCUPANCY A. This application must be filled in by typewriter OP, 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, streets, and unusual natural or topographic features. 2. Final Approval from Health Dept. of water supply and sewerage-disposal (S-9 form). 3. Approval of electrical installation from Board of Fire Underwriters. 4. Sworn statement from plumber certifying that the solder used in system contains less than 2/10 of 1~ lead. S. 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. B. For existing buildings (prior to April 9, 1957) non-conforming uses, or buildings and "pre-existing" land uses: 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 ~y the applicant. If a Certificate of Occupancy is denied, the Building Inspector shall state the reasons therefor in writing to the applicant. , C. Fees , . 1. Certificate of Occupancy - New dwelling $25.00, Additions to dwelling $25.00, Alterations to dwellin g $25.00, Swimming pool $25.00, Accessory building $25.00, Additions to accessory building $25.00. Businesses $50.00. 2. Certificate of Occupancy on Pre-existing Building - $100.00 3. Copy 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,,C/ommercial $15.00 Date ,/r, , ; New Construction...../... Old Or Pre-existing Building...~.~:n?~~.~!~ ~ ~XdlT7a19 ~vitJi,~~ Location of Property... t"~j5„r> ................~'./}~L14 . ~F.7JG~i~,.~./~,..~~~`'/,~Y';/J'~/~......... House No. Street Hamlet Onwer or Owners of Property...~P.:~K...!'Tl~~z Zr.rd.~.7~,P County Tax Map No 1000, Section...~.y.~......B1ock....~.~.........Lot..~,(,~ ~ % Zr„ Subdivision ....................................Filed Map............Lot.....d................ Permit No ................Date Of Permit................Applicant............................. health Dept. Approval ..........................Underwriters Approval......................... Planning Board Approval Request for: Temporary Certificate........... Final Certicate........... Fee Submitted: $ c~,~e. `130 ~.s e o n ao y n y APPLICANT THE NEW YORK BOARD OF FIRE UNDERWRITERS k'"`'`" E4UREAU OF ELECTRICITY 85 JOHN STREET, NEW YORK, NEW YORK 10038 - 1')b;t'I'NIM23f~~H 03 , ~ 39 t Q?, i>: 4 S rf:t /y'S is ~ 5i` Data Application No. on file Y~ THIS CERTIFIES THAT 9 only the alectrIcol equipment os described below and introduced by the applicant Homed on the above application number in the premises of ?CtfT111 fd<~fJi, P'1:R9'Hr 17"Tl Est`1l'i11'$ fif4kli`,li Cil'1., Tl:Cil,hO3,.~1'Lr MA°P'C'C`i'iJ("R, 1V.1', q p p~I~,,n,~, t1S19" in the following lnc LltfO~j~~h,Ip P!' 8~~ ~~(7 j ~ tat F't. ? 2nd Fl. Section Block Lot u~as exmnined on NNN !ll,,, artd fourzd to 6e in compliance with the requirernenbq u(this Board. FIXTURE ECEPTAClE3 SWITCHES FIXTURES RANGES COOKING DECKS OVENS D15H WASHERS EXNAUST FANS ODUTLETS INCANDESCENT fIUORESCENi OTHER AMi K W. AMi K.W AMi K.W PMi K W PMT H P ` { ~ ~ ~ ! r f ~ DRYERS FURNACE MOTORS FUTURE APPl1ANCE FEEDERS SPECIAL REC'PT TIME CLOCKS BELL UNIT HEATERS MULTI-OUTLET DIMMERS AMi K. W Oll H. P. GAS H. P AMi. NO A. W. G AMi AMP. AMi. AMPS TRANS. AMi, y p SYSTEMS pMi. WAIIS NO.OF FEET 1 3 4~ C)l~ SERVICE DISCONNECT NO.OF S E R V 1 C E AMi AMP. TypE METER l A. EW 1 q 3W 3.e 3W S,e dW NO. OF CC COND A W G. NO Of HbLEG A W C'' NO. OF NEUTRALS A. W G EQUIP. PER Of CC COND. Of HbIEG Of NEUTRAL OTNER APPARATUS: f?(lF;f, P!(lghi fi'(~;tl"1"P~Ki;;i-.?~5 K.;f,; i,-~1.;?", H.W. ~A}.C., 4d71'Phlh ~FSf~,A'1'T~;N3:;}-„~-5 R.W. Li,n .f,f~C'-~ ,709H;fIH '[~bLt1 3r'#C~(~7""s31.-c 519 Esi~o4l,N,; ~Nl"ILt11 ~ S,AK.R R©MR(It~R(7~fAr NX, "f:t"3'!9 GENERAL MANAGER F I'y Per 's ( 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 MUST NOT BE ALTERED IN ANY MANNER. ~ SVF~DL~,COIs TEL. 765.1802 TORN OIL' SOYJ7CB[OLD ,,ti c OFFICE OF DUILDIt1G 1NSPECTOf~ a ~ P.O. I30X 728 `r' -c TOWN HALL wO',~ SOUTHULD, N.Y. 1 t 971 1 Y+ C E It T I F I C A T I O N Date- --/0/z~~i'/ Building Permit No. ~ fJ 1 Owner f y,+{ ~ohf~ ~Rt'F/ ~~(p,~l~e~~a~se print) ' Plumber r_~ l~~)`~')~~ ~~t~l (pl asease print) I certify that e solder used in the water supply system contains less than 2%20 of 1~ lead. ` ( e siynaturel Swozn to be£orc ma this ~R~day of Cl i r' 19~. ~~`y~~NOta b~...._ Notary Public, a _COUnty /pANK PACIELLA ' ~~f pD~ ~taf~e of New YoIK t • OOIne~MYa~Fjp111~yiVfd - r . T:. OF OAKDALE INC. HOME IMPROVEMENTS Phone: 516-567-6443 91 Vanderbilt Blvd. Fax: 516-589-1737 Oakdale, N.Y. 11769 ~ z~~~r/ l ~7~ ~ ~ti ~~-~~ti~~ UIGJ//~f f' 'i~G .S o,,r - , ~ ~ ~ ~,r ,ti., ~ 4/ ~'N DEC 1 0 I~,;~I :.1 I TEL. 7G5.1803 5JFF0(kl'`~ ~py~ TOWN OF SOUTIIOLD _ •i~ ~^.ti,t ~ UI~[ ICL' Or BUILDING INSPECTOR ~ ?:f ; <'d~j~ny?- n I'.O. BOX 728 ~ u.. p's ~ TOiVN IfALL ~,°f/Ol ~ ~~Q~' SOUTIfOLD, N.Y. 11971 November 27, 1991 Mr. john Wohlfarth 162 North Lee Avenue _ Rockville Centre, N. Y. 11500 To t9hom This May Concern, - We are unable to complete your Certificate of Occupancy because ,of the following reasons. An application for Certificate of Occupancy i : not on Lile. /Xx/ No Underwriters Certificate on file. The check is (~cxtd~~ri/not on file.) $25.00 No Ilcalt-h Dept. 1lpproval on L-ilc. Nu final inspection has been made. Please contact our office on this matter. Thank you for your cooperation. I3uildi.n~l Permit If 2 0 1 3 3 Z Building Dcpt. No Plumber Solder Ccrt-ificate on file. ( all permits involving plumbing being .issued afCcr npril 1,19II4 ) ~ - 765-1802 BUILDING DEPT. INSPECTION [ ]FOUNDATION i5T [ ROUGH PLBG. ]FOUNDATION 2ND [ INSULATION [ ]FRAMING [ FINAL ~c~-- r REMARKS: ~ DATE ~ INSPECTOR }.LLU `lu*J. ~...V.1 11.~h. 1' vl::~JVJ tU r.. . ~ ~ t --.1 H `FOUtJDATION (1st } r c ti FOUNDATIOtJ (2nd} ~ ~ 2 . ..rJ { o\ P,000H FRAME & .PLUMBING H 3 . m cn IASULATIO,! PER N. Y. • • STATE EPJERGY CODE I _ 4 . ~ ~ ~ FZ;JAL - I p ADDITIOPJAL COMMEPJTS: x 0 C' r - ~ ~ ' rn ~ - x ~ H ~a o "s m • ~ ' ' ~ `1 S O F-~- m H - - ~ a 1 O a ovoer Hsv~e .~~~itre o~ ~ ~ pm o~ i 1 o ~ ' } ~ A ~ .u• 4 ~ ~ 4 h ~y,aa•N ~ v Qo, ~ a~ oot ~ 8 pi4.r N I ~ i f g a a . I d~ ~ ~ai t ~ ~ ~ 9,p1~ `ap0 0 R rAoM 1~ lysll! ~3,oi si.~i'f 1`~'''~1pp 9tA pDOr ~ -~-m. TO ~ pa~MaS ~ paeMaS Z89i 99G 9T9 $ Z\0T 8Zi90 I8. Otr08+ NaD'.~9 .77/79 S ' s s ~ ~r ~ p ~ ~ ~ m s @n ~ $ ~ $ ~ ^ ~ 1 Q~~~~~yZ N ~ ~~a01 w Y~ b bI~ yy VV~!N rn A ~ M{ in ~ ~ t ° ' J~p~DO~t~~ N 7~ 1 b Ap _ C~ 8 ~ $ ~ ~ pYl ~ F9py r• o a ~ y y g1 6y J !r 91 ( ~ Y N W ~ ~S; I 0~ ~ 1pp0 ~ ~p ~ M,ol,s_~ s N py?~vy Q p~~ t• r pQ'Oi ra I0 f~} IiaeM2s ~ p.~ema,~ Z69i 99L 9I5 Zt~~Oi 6ZiS0 i6. a~ Id~~i~ ~ ~ p~ ~MY~~~ Fi~~~~ u W !r n^y~~~~ CCOy Q^+e~npp~ S$L' ~y ~Hu^~i xm~s r o 7S N'i ti T ~ A • ~ q~ 'dry ~ ~ '------ti.... r~ ~ A ~ r OY it ~ q n, ~ 0 _ _ O'~ x pp Ro AAM /o a~ ~ ~ r ----r., ~r ~ m •s ar. ~.t*_ S i ~ r•~la+~wY+. 45 r r ~ a a. A Alaro,+d itiMYei • ~ r N.N ~ yq xrppr$.MN ,NW ~ ~ ~iq q~ pp +A ~ iI~$"~. a ~ r rti~ ~ ~ye1N $ ,~C$AI peak ~ 1?NV B 'Y /NPAY to i/ll/y IR1~7 B A9A~ Z0 1$I p,~t~Mes ~ paerte5 Z85I 99L 9T9 $ £0~0T 8Z~90 IB, Oi~'.O yyiSt Fyl/2h^2 h% E11 ,TI ~ dBa8 mlYi*ymi°m `tiA°K Ki ~ ~ -rya` ~~{~T-/ ~xN>N~°xrx A~~GN Q x p" 1 ym-1'l. -I IwiAW Nx rZ~w ~~m®i N1lNN yP E<•M ^ T y e~mn T npwy ~>P~~Alimlmwmga d N C 1'~ A Y'~ DY J' noex w~a°as ~~~r <p iron x ^I ',u~i~ Oo -1 i~mA ~Twmnwem~~7ok ~ = Q y m 4 ~owm ppN~'ommmfizzuX•f p f'?p Y ~wpi tp~, i.~yA[m On.mF ~ Q ~~n' ~6 ~f ~ tummy o'^u01 ry-z~?em~_o T ~ N~ ~O ~ ~n4~ wO TKm~N~N,y a'/ Q G L jC-1 y _]f y9N..., T •i m~ •°yo m?m~bprm y ~ ~9 ~ °um~ c°il'p i1nCm~I OZ 7C A' p' A wy~x R`wm4~lx Sim' ~'d ~W~d HA~r~A°~ShD HO .Km ~ ~rnA ss.wimcr=- ~ T,i 1qq t~ C ~ l w C f" ~ S~~~nywrMww/rrr N w m C V C r ,l A m ~ { O ~ C w 4H y~S~ O mm ~ l ?~m hq h~ x oc:, ~ < T~~ m ~ ~ t ,T Np a~waair * ~^3 v y m o ~p x$ ~ m $ ,ft 1. m v,a u~ d ~ O ua C,:.~ O r ~ n- ~ ry ,pOfN ~ii.i VyV~ ~O i y~ ~ J N t~ q• r 20 ar o mm +NO a ; ~ ~ $URYEYU ~ iD ~ jq 7~cm n ~i± _ m ~ ~ h f ~ oF~~' p ~ peFF ~h ~ TM~ ~ ~ a~ I~4~iI#AW.J ti ~y q ~ V ~ ~ H =~1 '7~ A ~ ~ pstaUl6 ~rulW.U ~ m pr9io/d t iFlt h ~ p,,,pp,rdipN 1 ~ ti_8.'4.t_~--~ y-" H _ app p~ a ~ ~ AoM _ a. ~d..r'8 tr rIr ~ O $ $ ~o'JOF paaN 'T .s,Up B Y 1~.0~ d A r- $ ~ .rury arrw7 a r~pr ~N Z6 ~1 p.~eMeS ~ p~EpMeS Z95T 99L 9I5.Bn £0~©T 67,i5'C~ T6, ~ ~ <-.BOAFD OF HEALTH ' FORMN0.1 ~'J SETS OF PL.\NS TOWN OFSOUTHOLD'SURVEY ~r.:'~•--.....,...... BUILDING DEPARTMENT C11ECt: . . . . TOWN HALL -SEPTIC 1"ORPI SOUTHOLD, N.Y. 11971 TEL.: 765-1802 t:oTIFY; CALL Examined ~ 19~~ PIA I L TO _ _ _ . Approved ~P•OF.d./f/~J~GG,',/~; . 19~/• Permit No.®~, ,~:3 . . Disapproved a/c J. P. OF OAKDALE INC. • HOME IMREdQt9E;~,P,ENTS 91 Vand~arbilt Blvu, C\ 1 Oakdale, N.Y. 11763 Q (Bu' ing I e r) ~p APPLICATI N FOR BUILDING PERMIT SG- - 41991 y~ Date 19 . t3L43ti~'T• INSTRUCTIONS TOWN C)r 50tJTH(y81 a. lus application must be completely filled in by typewriter or in ink and submitted to the Building Inspector, with 3 ats 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 Fall 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 Halt leave been granted by the Building Inspector. APPLICATION IS HEREBY MADE to the Building Department for the issuance of a Building Permit pursuant to the tuilding Zone Ordinance of the Town of Southold, Suffolk County, New York, and other applicable Laws, Ordinances or legulations, for the construction of buildings, additions or alterations, or for removal or demolition, as herein described. i he applicant agrees to comply with all applicable laws, ordinances, building code, housing code, and regulations, and to dmit authorized inspectors on premises and in building for necessary inspec ons. Hor~~ sFt~~ov~~~ (Signature of applicant, or name, if a corporation) (Mailing address of applicant) 7 (y~ Mate whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. Vame of owner of premises .:~®~!t~... r~~~.T.'< (as on the tax roll or latest deed) i applicant is a corporation, signa/tJu/rye of duly au/~thorized officer. ' (Name and title of corporate officer) Builder'sLicense~~Klo. ~,~,.~~:x~...~:~: 3~~.. Plumber's License No. . Electrician's License No . . Other Trade's, License No . . Location of land on which proposed work will be done . . (louse Number Streeti Hamlet County Tax Map No. 1000 Section . ~ Block Lot .Q. ~?.O.J. . Subdivision Filed Map No. Lot (Name) Stale existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existin use and occu one ~ ~r b. Intended use and occupancy J. ~ ~ . 3. Nap~T of work check whiRem Iplicable): New $uilding ( p • • • Addition Alteration . Re oval . Demolition Other Work . (Description) 4. Estimated Cost ,0,'~`d 8 Fee , . g ' (to be paid on filing this application) 5. If dwelling, number of dwellin (,nits , Number of dwelling units on each floor ,1, , , , , If garage, number of cazs , i.... . G. If business commercial or mixe Hei ht , , • Num occupanc ,specify nature and extent of each t pe of use .,.Pi.J,9.... , . 7. Dimensions of existing structure, if any: Front ~ ~ , Rear Depth . g ~ per of Stories . 8. Dimensions of e ~ 6 r ~h alterations or additions: Front , . , . Rear .,,?t?. . Depth • • • • ' ' • ntire nt~w co stru Height 1~ . Number of Stories ~ me s u wi' ction: Front Rear ...............Depth . Height : her of Stories . , , . 9. Size of lot: Front } , . , , , , Rear . Depth (0. Date of Purchase , .Name of Former Owner ` il. Zone or use district in which pre misesaresituated 13. Will lot be re raded to any zoning law, ordinance or regulation: .,fig. , , ...;~~,~c~,. ~ tt y..... r;....... . p p g •r~•~= • • • • • ........Will excess fil be removed from premises: Yes 14. Name of Owner of remises ~Kd. !R!G.6/~ fTy,/GYJf , • • /b Z rt~CE1r Name of Archrtecnp ruoh~ viol L A.ddress , ,/?,•~r .Phone No..~~. 3 2 z t ,t3iV~/.t'k?.. 1~4..~'. .......Address .5.•`li/.zlCl9, ..........Phone No. ?:~l.~s~¢r:~.... Name of Contractor (^.'Rtr4',~.~~~lr~~~, , , , , , , , ,Address ~'IIQIN~Ji`n~4r,1'1,L4,fS phone No. 6 z/{/,~ , , Is thi* property within 3 If yes, Southold T00 feet of a tidal wetland? dyes,,,,,,, No. pwn Trustees Permit may be required. 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. ry l iTATE OF NEW YORK, ~I :OUNTY OF S'~ (N me of~di~dual signing • • ~ • ' ' ' ' ' • • • • being duly sworn, deposes and says that he is the applicant • • • • • I • contract) hove named. le is the ~.QCYTh. 19C7.'D.''~: ~ . (Contractor, agent, corporate officer, etcJ f said owner or owners, and is duly authorized to perform or have performed the said work and to make and file this nplication; that all statements contain@d in this application are true to the best of his knowledge and belief; and that the cork will be performed in the manner s~t forth in the application filed therewith. worn to before me this ~r rotary Public~~~,t-,c.r~~cO.,~,G/~N, IIurr~~nty HELENE D, I~ORNE • _ • •l• •i~~~~~'0*~'~ . . Notary Public, Stat$ of New 1'r ' No.495t~3fi4 Qualified in Suffn~x r~,,, (Signature of applicant) Commission Exnirea n` , -a. ,_.-F _ .,r- 765-1802 UILDING DEPT. INSPECTION [~UNDATION 1ST [ ) ROUGH PLBG. FOUNDATION 2ND [ ]INSULATION [ ]FRAMING [ ]FINAL R MARKS: J ~7 DATE INSPECTOR i. i eU~ INSPECTORS Principal Building Inspector O~QSUff~(~-COG Curtis Horton =y' 9~ SCOTT L. HARRIS, Supervisar Senior Building Inspector H x Southold Town Hall Thomas Fisher P.O. Box 1179, 53095 Main Road Building Inspector ~ • ~ ~y O~ Southold, New York 11971 Gary Fish '~Oj ~ ~0 Fax (516) 765-1823 Building Inspector Telephone (516) 765-1800 Vincent R. Wiecmrek Ordinance Inspector Robert Fisher Assistant Fire Inspector OFFICE OF BUILDING INSPECTOR Telephone (516) 765-1802 TOWN OF SOUTHOLD October 11, 1991 Mr. John Wohlfarth, Jr. 162 North Lee Avenue Rockville Centre, N.Y. 11500 Re: Premises 1172 Bailie Beach Road, Mattituck, N.Y. Suff. Ca. Tax Map #1000-99-3-11.2 Dear Mr. Wohlfarth: A deck addition and accessary shed at the above property location apparently was constructed without a building permit. According to Article XXVIII Chap. 100-281 of the Code of the Town of Southold, a building permit is required for a deck addition and accessory shed, and an inspection and Certificate of Occupancy is also required. Please contact me as soon as possible so that we may resolve this matter. Thank you for your cooperation in this matter. Very truly yours, SOUTHOLD TOWN BUILDING DEPT. Gary J. Fish, Building Inspector GJF:gar