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HomeMy WebLinkAbout20146-z r S FORM N0. 4 TOWN OF SOUTfiOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No Z-20480 Date JANUARY 15, 1992 THIS CERTIFIES that the building ALTERATION Location of Property 1250 BRIDGE LANE CUTCHOGUE, NEW YORK House No. Street Hamlet County Tax Map No. 1000 Section 118 Block 1 Lot 6.1 Subdivision Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated SEPTEMBER 9, 1991 pursuant to which Building Permit No. 20146-Z dated SEPTEMBER 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 ALTERATIONS TO EXISTING ONE FAMILY DWELLING AS APPLIED FOR. The certificate is issued to BETTY M. KUNKEL (owner) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A UNDERWRITERS CERTIFICATE N0. N-219620 - JANUARY 8 1992 PLUMBERS CERTIFICATION DATED DEC. 11 1991 - PERFECTION PLUMBING & HEAT ~ _ Bui ding Inspector Rev. 1/81 maas xo. a TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N. Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON 7HE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) N°- 20146 Z Date ....~~~.I~:xak1~+.......~..7........, i9.4.I.. Permission is hereby granted to: .....1. ,~......kY1.........~.,s.!.:~~..~ .....~:1'.aa.?c.....9..~.~r fo ...~IELA^^:t~9.....:(.?.4»rl~.drL~W.. j.....4.N..Stan.dGt3.~.f.7....~,~!:~c:v1A....Sa,4.Sr..... ~ of p~ at~t ..~.:z ...'........Ro......)(~krut.................... Counfy Tax Mop No. 1000 Section .....p./,.,~...~........ Block ........4.r'........ Lot No......~.:..~......... pursuant to application doted ....~..I..H.^.^:.~...9 19.9...., and approved by the Building Inspector. U fee $...r~2.a...~..... Bui ding Inspector Rev. 6/30/80 i ~,.~`~~~i_'~~~'"~ .;~'1~;~~{ Form P;O. h [r ~yCp~ h j}~d TO[JN OP SOUTIIOLD WGV ~ ~~J~~ BUILDING DGPARTMCNT TOWN HALL ~ ~ ~ 765-1802 `~,iE`.., _ , APPLICATION POR CBRTIPICATI': OF OCCUPANCY Tttis application must be filled in by typecariter 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-O 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 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. ~,j. For existing buildings (prior to April 9, 1957) non-conforming uses, or buildings and "pre-existing land uses: 1. ,lc curate survey of property showing all property lines, streets, building and unusual natural or topographic features. 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 $25.00. Businesses $50.00. 2. Certificate of Occupancy on Pre-existinfi Building - $100.00 J. Copy of Certificate of Occupancy - $5.00 over 5 years - $10.00 4, Updated Certificate of Occupancy - $50.00 S. Temporary Certificate of Occupancy - Residential $,1u5.00, Commercci7al $15.00 Date .~~,.1 / 1 ':ew Construction........... Old Or Pre-existing Building............. • Lucac ion of Property.. ,~5~~..7 1-~ ~,,2,L~1.~:., . ~;~~-,l"6.-~ House No.~~^~;y- //L~/-~ Street • • Hamlet %nucr or Owners of Property/;~+1-J4:-rf.-~- . .Q,?„(...f~,~ry;~G . %:Juncy Ta:t Map No 1000, Section..fl..~~„ ,,,,Block....c,/.~,,,,,,,Lot.,.:./ ut~dtvlsiun Fi ed M:tp............Lot....... crmlt :;o~C/. ./„"j ,(q „~{ja to Of Permit..~~~~~ 1, , ,Apltl icant l/c<'•('.,~~ ~/j ;~G ~-~PJI 'icalch Dept. Approval ..........................Underwriters Approval.. •':.uuiinl; I:oard Approval •~equest for: Temporary Certificate........... Final Certicate,,;`,,,,,,,, _ dv "cc'Submitted: $~.~..~~J ©7 ~~j ~ ~ APPLL~T ~ THE NEW YORK BOARD OF FIRE UNDERWRITERS :'~r;~; Lfo~.fl r~l. BUREAU OF ELECTRICITY BB JOHN STREET. NEW YORK, NEW YORK 10038 s ,;I1~'td14Ad`w OR,.1Ci?1;; `3Fi;.2`I;TCI'} i`Yi P~l ;}1})ti)U paw Appficatlon No. on file THIS CERTIFIES THAT .a only the e[ectricol equipment as described below and introduced 6y the opplicont named on the above application number in the premises of x 1f.~wl}1jtfEll,, tsRT.l{l3i", Ili7d'c,~ 'Lu't' l)l4 C+'i ftt~FlR,~f(t1711 ~t?.'~(,~~, illJ't',£fOr;f}t~l, ~!.F. in the follouinR loca,Eign; ~ B¢~s m n ? lat Fl. ? 2nd Fl. Section Block Lot - was examined on ~ andfound to be in complianre with the requirements q(this Buard. FIXTURE ECEPTACLES SWI7CNE5 FIXTURES RANGES COOKING DECKS OVENS DISHWASHERS EXHAUST FANS _ OUTLETS 1 INCANDESCENT FIUORESCENi OTHER AMT. K W. AMi K W PMT K.W AMi K W PMT. H P - {I rl 41 DRYERS FURNACE MOTORS FUTURE APPLIANCE FEEDERS SPECIAL REC'PT TIME CLOCKS BELL UNIT HEATERS MULTI-OUTLET DIMMERS PMT K. W. 01l H. P. GAS H P AMT. NO. A. W G AMi AMP PMT. AMDS TRANS. AMT N P. SYSTEMS AMT WAITS NO. OF FEET t~ L` SERVICE DISCONNECT NO.OF S E R V I C E AMi. AMP TYPE EQU~V 1,e' ZW 1,a 7W 3,6 3W J,F' dW NO.OpERCaCOND. OF CC COND. NO OF H4tEG OF IILLEG NO OF NEUTRALS OF HEUTPAL ? OTHER APPARATUS: IiANA;i,HC)AitD;;t1.°-$ t`I(t, l.(10 x ~~~~.I~:%ucz.i -c~c~ tY x 6 ti'flgp`i'YtDt"(.'1?dt I','f:{',~57ati"2; - i3p7f ?15 = S<ltl'YI{i}I,1i, li1Y, li-9'(;l, GENERAL MANAGER Per 9 j ~l 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. 1 COPY FOR BUILDING DEPARTMENT. THIS COPY OF CERTIFICATE hWST NOT BE ALTERED IN ANY MANNER. c~~FFQ(~~C' TEL. 7G5-1802 o~~/'-v ~l? TOTY~N Or SOtJTB[Ob.ID • ~ OFFICE OF BUILDII•IG INSPECTOR ~ E P.O. BOX 728 ~ e?~i TOWN HALL %o`,~,Q~' SOUTIiOLD, N.Y. 11971 C E R T I F I C A T I O N Date 1 lll~ Building Permit No.~p/_ c~_ Owner ~~y lie /~Zease print) Plur„ber 1Cf-1~..~'~o,~ ~(Vm to d ~'~tv~v) v (please print) I certify that the solder used in the water supply system contains less than 2/10 of to lead. a'- ~,7j Za7- ~~5~~~~ `fie GU,9-Ter h ea.7'e f~P,h g To i~ V + ~'~S~- (plumber's signature) S~w~oCrjn~ to befar~ j~~,,this _t_L__ da Y o f ~ 19 Notary Public notary Public, ~~County Notary Puti alit cR 3t&te ofwNe~r York No.487850b v • Qualified in Suftolk County 9q ' Commission Expires December 8,18E INSPECTORS Victor Lessard ~I,~ „ , Principal Building Inspector %~~~b' ' i 3.~ Curtis Horton ',r r", 'a SCOTT L. HARRIS, Supervisor Senior Building Inspector i{ 2~ ~ Thomas Fisher vi e r:'; ~ Southold Town Hall Building Inspector via , . ~ , s~~ , * P.O. Box 1179, 53095 Main Road m , ~'.-~`r ~ Southold, New York 11971 Gary Fish - Fax (516) 765-1823 Building Inspector ~ s Vincent R. Wieczorek ^~-uu~~ Telephone (516) 765-1800 Ordinance Inspector Robert Fisher Assistant Fire Inspector OFFICE OF BUILDING INSPECTOR Telephone (516) 765-1802 TOWN OF SOUTHOLD DECE[~IBER 6, 1991 BETTY M. KUNREL BOR 936 CUTCUOGUE, NY 11935 To Whom This May Concern: We are unable to complete your Certificate of Occupancy because of the-following reasons: xxI[ An application for Certificate of Occupancy is not on file. (Enclosed) Xxlt No Underwriters Certificate on file. x1[1[ The check is (>~It~/not on file. )$25.00 No Health Department Approval on file. No final inspection has been made. xxx No Plumber Solder Certificate on file. V (All permits involving plumbing being issued after April 1, 1984). BUILDING PERMIT # 20146-Z Please contact our office on this matter. Thank, you for cooperation. SOUTHOLD TOWN BUILDING DEPT., _ ~-UI ~ ~ 765-1802 BUILDING DEPT. tNSPECTtON [ ]FOUNDATION 1ST [ ]ROUGH PLBG. [ ]FOUNDATION 2ND [ ]INSULATION [ ]FRAMING [ FINAL i REMARKS: --,~~7~-- i AA DATE ~ ~ ` INSPECTOR ~1~ Fl£LD IJ:S:'cC.lU:J ~IJr.:~ ~ ~ONMGNT° J;t. 1. m0 ' ~ ,,j 6' FOUIJDATION-_.. (1st) _ _ _ ' ~ :,ti c ~p."} FOUNDATIOtd (2nd) 2. _ c~ o P,OUGH FRAME & . a PLUMBING ti r 3 . -3 It1SULATIOPi PER N. Y. ~ ~ ~ y . n STATE ENERGY j CODE p~ . ~ f 4 . Ji .--I ~ a H v FI;JAL ' I o ADDITIOPIAL COMMENTS: x~ x ro ' H 9 • . H H O Z w i4 } ' ~ ' ~ ' H r,' V~ V ~ BOAFD OF HEALTH ~ FORM N0. 1 3 ,SETS O~LA:1S . , , - ~ TOWN OF SOUTHOLD SUavEY SEP 91991 ~f1E~1: .zt.a~321._......... BUILDING DEPARTMENT ~ ~y, TOWN HALL sErTlc r•oarf . i>r• CSEPT. SOUTHOLD, N.Y. 11971 YC)bJ~d i?r'""t+.JThIOLp TEL.: 765.1802 t70~ I FY ~ C/ PP c~ CALL ./~J:'l0.7_~:J.'.. Examined .V~.1p~•hY~?4•,.~,~,, 19~.~. hfAIL T0: Approved ~D?~J nl ~`!a.. ~ ~ 19°1 J .Permit No ~4 ~ 7 ~°.Z1.. . Disapproved a/c . . AC~dU. GL;1,6~.-;........ (Bui ding Inspector) APPLICATION FOR BUILDING PERMIT Date 19 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 ~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 pazt 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 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 tdmit authorized inspectors on premises and in building for necessary ections. ' " (Signature f applicant, or name, if a corporation) (Mailing addre~s of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. ~ur~ , ,s~~...././ vameofownerofpremises ..~~.T~./'.......?..".'.../.`~.~~.~~,~,,.. (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. .~.~.I. ~.~.~.r. Plumber's License No . . Electrician's License No . . Other Trade's License No . . 1. Location of land on which proposed work will be done..~~~~~'~ Nt/~?.~?~/'r?/~`/~2~~I!J •W,4!~'~J.~G~o~7'!~ Elouse Number Street / Hamlet County Tax Map No. 1000 Section ~l~ Block f............ Lot ~ , Subdivision .................r................... 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 ~a~~~~~~, , ~~6~/~ ~ , ' b. Intended use and occupancy ..~~.~~-~~'R.11'~'. . L,S~,/~~7,C.~ , , ,~,~~./.LI~, , i , , . ( pi' • . 3. Nature of work check which a ~licable): New Building , Addition Alteration Repair .Removal , . Demolition ~ ' iQ.6/~f%,~,~X/S"~irv~' ~®~/~.~,g~~~,,~~S~~It-~- .r?~'ir? 'f'czr2.IlJ~~°o k: ~ ~a• • • . ~~rr ''(description) 4. Estimated Cos~".~~dJ tom.. Fee . s.:: . g g (to be paid on filing this application) 5. If dweilin number of dwellin units Number of dwelling units on each floor If garage, number of cars , ~ ~ ~ ' ' ' ' ' ' 6, If business, commercial or mixes( occupancy, specify nature and extent of each type of use 7, Dimensions of existingg structure if any: Front , F~>~.T, :Rear 3!1. ~n a -F~~ °L~'3 F1=E j ts~ 1 T.... Depth Height Number of Stories 1................................................. . Dimensions of same structure with alterations or additions: Front .S.C.v, , F~:~T; , , Rear , c37, ,FF-E,'r.... , P _ . Height ....,'Z~,. F~E'f Number of Stories 8, Dimensions of entire new construction: Front Rear Depth Height Number of Stories . . 9. Size of lot: Front ~°l.d.. ~ L-= Rear ..~,7~? : , , ,„1~~~"J' , , , , , Depth J ~ F~1=.T. . ] 0. Date of Purchase ~ ; ~ , , , , , , , , , , , 'Name of Former Owner ~h 1) ((ev,,bq C , , , , , , 11. Zone or use district in which re 12. Does proposed construction v~la uses are situated .....~c.: ; , ~ Q , , , , , , , , , , to any zoning law, ordinance or regulation: ,!L~c~, 13, Will lot be regraded /.v~ Will excess fill be removed from premises: Yes No . l4. Name of Owner of premises :~~T,/, , 17~ K!/;t?r~~ddress 6?•. !~%X.. ~c3~, Phone No..~'r1~ . ~~`):'.~(a~c? Name of Architect S'fl!y11/,~,1~~ 37~Ziay~.J. , , Address Z52~~. N1All~~,4t~ phone No.~~~. °1~ ~ Name of ContractoY~ra/,! .[a C~ ,(fie, ~;~';j-~~ddress/8.a.~YQ~1n!t1pf~J, ,Phone Nom/Fx-,~.~~f: ~'.a/9 , 15. Is this property wi in 3 ~ y 1~ b0 feet of a tid wetland? eyes„~„ No If es, Southold Tpwn Trustees Permit may be required. PLOT DIAGRAM Locate clearly and distinctly all ~uildings, 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. ~T7i5~'~Fi~~ ~ ~ , tt i a I~ iTATE OF NEW YOKK, I ~ S S 'OUNTYOFsI)E~a••••••••• ................f.~~~......;....,... ~ • being duly sworn, deposes and says that he is the applicant (Name of individual signing contract) bove named. i lc is the ..:.......OI;J/JE,Ie-.,6T,. .1~~.~'c . . . . . (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 ork will be performed in the manner set forth in the application filed therewith. wom tp before me this ~,a` rotary Public, ..S,'v.~tQ~-(C-, , . , , County No,dA95f2~ (l . Qds6Rcd It 5ut16k I (Signature of applicant) Comml~ron ~ltg'