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HomeMy WebLinkAbout20181-z FORM N0. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Ha11 Southold, N.Y. CERTIFICATE OF OCCUPANCY No Z-20939 Date AUGUST 12, 1992 THIS CERTIFIES that the building ADDITION & ALTERATION Location of Property 3689 PINE NECK ROAD SOUTHOLD N.Y. House No. Street Hamlet County Tax Map No. 1000 Section 70 Black 6 Lot 24 Subdivision Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated SEPTEMBER 19 1991 pursuant to which ' Building Permit No. 20181-Z dated OCTOBER 2, 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 & ADDITIONS TO AN EXISTING ONE FAMILY DWELLING The certificate is issued to LUDWIG E. BECKER (owner) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A UNDERWRITERS CERTIFICATE NO. N-245433 - AUGUST 4 1992 PLUMBERS CERTIFICATION DATED NLY 30, 1992 - MARK BAXTER ilding Inspector Rev. 1/81 lOBM NO. f TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL 50UTHOLD, N. Y. BUILDING PERMIT 1THiS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) N o 2 0181 Z Date ../.~.,1.? 19g Permission is hereby grfa~n to: 'G~~""r. L.dltri of premises located at .s~~~...1~~....~ .........1.....t....................................................... ~ County Tax Map No. 1000 Section .........7D........ Block .............fem...... /Lot No.........~~.... pursuant to application doted .~l/..~cl 19.1.., and approved by the ' Building Inspector. urn Fee S..~L~.... ...........:.............1 a~ B ing inspec/~ Rev. 6/30/80 Forin No. fi ' TO[SN OF SOUTIIOLD BUILDING DEPARTPIENT zowN HALL .!(l!_ ~ i~?t~~3 765-1802 - ~ APPLICATION FOR CERTIFICATE OP OCCUPANCY A. This application must be filled in by typewriter OF, ink and submitted to Che 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 £rom plumber certifying that the solder used in system contains less than 2J10 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 Platning 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 by 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 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-existing Building - $100.00 3. Copy of Certificate of Occupancy - $5.00 over 5 years - $10.00 4. Updated Certificate of Occupancy - $50.00 5. Temporary Certificate of Occupancy - Residential x~$[[15.00, Co/mmercia~lJ~$r15+~.00 Date .~.T.....~`r!l.Y.. ~1../„4c............ New Construction........... Old Or Prc-existing Building.. / Location of Property.•3.~t:~~I.........~/.+!/.4.kB'oral!...~~1:,......4J.Ol~Tff0,4q~.~: j,,.. . House No. Street Hamlet Onwer or Owners of P operty. ...[~.V.d7,aJ1/, , , , ..~~CK,B, fQ, , S~iv~,T; 'f73889~7?0// Svc: l Ct•S,'•2/0// •%S~iS'B~'••:G2 County Tax Map No 1000, Section.. ..Blo c. .(,..,,,......LOt........... O FG %~I ~,Lr .VQCk ~y . • Subdivision ....................................Filed Map........./..LoC.............. Permit NoA~OL~/:...,,,,Date OC Permit ................Applicant.~lt4.[~!tl:....~...~~Crto-2 Health,Dcpt. Approval ..........................Underwriters Approval......................... Planning Board Approval Request for: Temporar~~y77 Certificate........... PinallCerticate Fce Submitted: p(~~ Q Q ~y5 . co ~-ao939 PLICANT ~2o/~/-Z THE NEW YORK BOARD OF FIRE UNDERWRITERS P11GE J. 10N7.071 BUREAU OF ELECTRICITY 85 JOHN STREET. NEW YORK, NEW YORK 10038 Date rTUGiIST 0~a,7.9N? AppNoationNo.anfile 't.ri913892/92 N ?.9."t4;33 THIS CERTIFIES THAT only the electrical equipment as described belota and introduced by the ppplicpnt named on the above application number in the premises of L41D4fiG G, f3CvCKIti'C2, PJ:NE Pdf;CK R©APtr 90ItTHOL6i N,Y. in the fpllouinq lacation; ®Bpaement lst Fl. ? 2nd P'l. f){7 3ertion Block Lot u~as examined on '7011Y 30 r 194? and found to be in compliance uith the requirements o/this Board. FI%TURE ECEPTACLE$ SWITCHES FIXTURES RANGES COOKING DECKS OVENS DISHWASHERS EXHAUST FANS OUTLETS INCANDESCENT fIUORE$CENi OTHER pMT. K W. AMT. K.W PMT KW AMt. K.W. AMT. H P. 5% tilt 59. 56 1 1 k' DRYERS FURNACE MOTORS FUTURE APPLIANCE FEEDERS SPECIAL REC'PT TIME CLOCKS ggLL UNIT HEATERS MULTI.OUTLET DIMMERS AMi K. W. Oll H. P GAS H. P AMi. NO A. W. G. AMi AMP AMT AMPS TRANS. AMT. H P SYSTEMS AMT. WATTS NO.OF FEET 2 20 7. ~ fi0@ SERVICE DISCONNECT NO.OF S 'E R V 1 C E AMi. AMP. TYPE METER 1 ]W 1 q 3W J.6' 3W 3,e' AW NO. OF CC. COND A W. G. NO Of HI-LEG A W NO.Of NEUTRALS A. W G EQUIP. PER H OF CC COND. OF HFLEG Of NEUTRAL J. X00 CCi 1 M 1 9(@ 1 2/0 OTHER APPARATUS: J14CtSZ7,Y. •1 ti0T0l29T2-P H.P. PANF,G4i01HD4o1-17. f;C~Ct, 1N0 G. F.C.xs-7 SHf)K~S D(iTF;CTQtti-2 -t'~ ~ G & 5 CONSftAC~'f!N GTC.A97f1-f; C/~~~ !3D% 2ta 5f)IITHGGO, NYr 11971 GENERAL MANAOlR Per11 ~ ~ This certificate must not 6e altered in any manner; return to the office of the Board if incorrect. Inspectors may be identified by their credentials. COPY FOR BUILDING DEPARTMENT. THIS COPY OF CERTIFICATE MUST NOT BE ALTERED IN ANY MANNER. c,U~F~1~'c TEL. 7~s-z soz ~a To~~r or sou~~o~.~ • ' ~ OFFICE QF I3UILDII~IG 1N^ p u-~ ~ ~ ~~,F~i~, ~ BOX 7 aPECT R t T~~ ~~L~e_~°yiK~lk ~~b~ ~ r . p~ ens : Tp~VN I~i~~LL '~~l ~~O SOUTHULD, N.Y. 1 1971 ~ , {/w~,q~y+~yp. ~ ' r ~ ~ : ~ ~ WiB$„• ' "r n r,~ ~.,7i u'iji~ ~x1 N"' ~J§e_y #•&~,B`s~~ Y • ~ n+b.aWa:., >~x_ae t ._.ix.:.a ..s ?::MX<k :.ii C E R T~ F I C A T T O N oats d $uiiding permit No . p~ Owner ~ ~ {p].c~as prznt} . z ~ ~ ' {P-~•case prznt} .I ccrtzfy that the saldez• used i~ the water su oon~ain5 less than 2/~0 of zo Lead. pply system ' • {pl.umt~c 's signature} Swa.rn to beF~re 1. ~~C/~9 day o f ~ ~ ' ' No a z-y I' 4 )J Z z c ~-G~~`' t,otarl I'ubLic ~ L r Gc- r~ C.t.-~i ~ COL321 ~ ~ . Ndta P~iib~ 3~ o ~~nr Yor{c , Na 4952248, Suffolk Cawnty rem, ~xptres June t2, 79~a,~ INSPECTORS Victor Lessard c~UFFO(~ Principal Building Inspector 'J~4 .~x, CC Curtis Horton .v`~ ~ SCOTT L. HARRIS, Supervisor Senior Building Inspector ~ i{~~ ~r' Thomas Fisher 1'+ ' z Southold Town Hall P.O. Box 1179, 53095 Main Road Building Inspector d Gary Fish ~~C~ Southold, New York 11971 Building Inspector 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 JOLY 15, 1992 LIIDWIG BBCRER P. 0. BO% 1011 SOUTHOLD, NY 11971 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) ~ No Underwriters Certificate on file. %%x The check is not on file.)$25.00 No Health Department Approval on file. No final inspection has been made. No Plumber Solder Certificate on file. (All permits involving plumbing being issued after April 1, 1984). BUILDING PERMIT # 20181-Z Please contact our office on this matter. Thank you for cooperation. SOUTHOLD TOWN BUILDING DEPT. 'ti1Ll.J T::.~',. L .:J:i ~IUn: j (t~1LNI.^. i . C/ - Q ' I H 'OUJIDATION (1st) 'OUNDATION (2nd) C z 1 0 LOUGH FRAidE & PLUMBING 1s ?J H m :IJSULATI0;1 PER N. Y. ~ "3 STATE EPJERGY I CODs . } H FI;lAL - I o ADDITIONAL COMMEIJ . ~ ~ x ~,c~ H 1" H F~ O ~ _ ~ ' r ~ ~ z v i m . H _ a i 765-1802 BUILDING DEPT. INSPECTION [ ]FOUNDATION 1ST [ ] ROUGH PLBG. [ ]FOUNDATION 2ND [ ] INSULATI N [ ]FRAMING NAL GD ~Glif-~ ~c,~ REMARKS: DATE ZINSPECTOR 765-1802 BUILDING DEPT. f NSPECTION [ ]FOUNDATION i5T [ ]ROUGH PLBG. [ ]FOUNDATION 2ND [~ULATION [ ]FRAMING [ ]FINAL REMARKS: ~E~~ z~~, G I ~f i~ i 't i DATE y~ Y INSPECTOR i U f 765-1802 BUILDING DEPT. INSPECTION C FOUNDATION iST [ )ROUGH PLBG. C ]FOUNDATION 2ND [)INSULATION C ]FRAMING C ]FINAL REMARKS: ~~~~~i ~ r~- ~~c..~; E f { g r~ DATE ~ l fNSPECTOR l ~aj~/ 765-1802 BUILDING DEPT. 1 NSPECTION [ ]FOUNDATION 1ST [~]'°~tOUGH PLBG. [ ]FOUNDATION 2ND [ ] INSULATION [~MING [ ] FfNAL REMARKS: r f i DATE ~ ~ L°' INSPECTOR i _ ,.~r.~ .,,w..~:a..,:. New York State Depar#menf of ~~s~~irv,?°ier~i~ ~~cns~rvat;~srr ~ ,r~; Building 40-SUNY, Stony Brook, Ne~,v York I j;gn_~~~b i ~z.,r, X516) 751-1389 Tlla CflBS C. ,I a;lt f.' Cammsaianer ~I -.,?CJ~.~°_`O~~' AFFAIRS VISITING .F3OURS AND CALLING HCC S cO?? GR'NERSL INPO~'?~F?TIOtd ANO INQUIRIES TO THE ANP.LYS^ CV DF~'_ ;~°J_Y AtiALYST) ONLY. ^TST':'I'~ FfOLTRS - Noon Monday - i,~~ae_,c..~.> - Friday ONLY . C<-' - [CURS - coon - 3:00 P.bi. Mo day - A'ec.-:~~s::ay - Friday ONLY . Appointments are required if rcee~ wit': a speci_`_.. .nayst cr to discuss a specific pro;tct.~ ::apo_r.t^er.ts may be :,ace by,cailing t'r-e analyst you wish to meet with c_ ~cty Analyst. Due to t_^:e large volume of applications we muse _~..r''e, ~e must keep ;need^gs ar,d telephone conversations as ~<<e= zs ~aossible. We sincerely regret any inconve^~ence t:-~ese requirements mzy cause you,- but they are essential' if we are tc provide the best possible service to you and all other applicants. We appreciate your patience aac un&arstar:ding. Robert A. Greene =regional Perm~.t Admin~strztcr ,~j J~ ?.zgion 1 9V / / L~ C'<~i PY~~ q v ~c / it ~I ` / / 1 ,,tee ~,-~2 ~'rcJ 0~, ~~C~ c o ~P~ ~~~-E~._e___._ it i ~ I i ~ ~ ~ ~ ~ j ~ ~ BOARD O F B E A L T N . U~V~1;sr~`~: FORMN0.1 3 SETS OF PL\NS t}~ TOWN OFSOUTHOLD SURVEY ~'j,10l991 (~y'.' BUILDING DEPARTMENT C11CC1; Er~ TOWN HALL serTlc roar[ . . . ,,s SOUTHOLD, N.Y. 11971 / r ~ ' ' i TO TEL.: 765-1802 ttp'^-FY; fiS0U7HCPLb i CALL Examined .I~ Z 9/ ~~~,~19... r IL T0: Approved . /d./. ,Permit No. ~ . . Disapproved a/c C~ ....!"a. (Bu' ding I ector) APPLICATION FO BUILDING PERMIT q Date ...7..~r.:........, 19 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 rr 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 ,[tall 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. rite applicant agrees to comply with all applicable laws, ordinances, building cow; using cod ,and regulations, and to rdmit authorized inspectors on premises and in building for necessary inspectia .....o...:..~.. ? - (Signature °k pplicant, or name, if a corporation) Pa, i~a~ ~a ~e~rQ . r.... (Mailing address of applicant) State wltetlter applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. \`ame of owner of premises ~,~~l~l~ . CJ,~G.~i ~1z- (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. . C/f~^'!!''.?~~ Plumber's License No . . Electrician's License No . . Otttcr Trade's License No . . I . LocationDof land~on which proposed work will be done . . house Number Street Hamlet County Tax Map No. ]000 Section 7Q......... Block Lot . . Subdivision 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 ~~~%~.Y.Ul° .i:•:"."`s._s ~ a:r:.:"~ . / " " ;3 a ~s~'gea~ilb$ b. Intended use and occupancy ~PS ! `1.7e~r?°... '"'~'.c2:°'~ edPt r".>:•~y « n=7 b5s.1,_~ ails{.~y . s 3. Nature of work (check whiRemol'~licable): N w $uilding / g • • , Addition . Alteration ~ . Repair wal , Demolition Other Work . ~ , t~ (Description) 4. Estimated Cost ..o~a.~--, . Fee . , . • 5. If dwellin number of dwellih~ ~ (to be paid on filing this application) g> o µnits l • , , , , , . Number of welling units on each floor . If garage, number of cazs , , 6. If business, commercial or mixed) occupancy, specify natUiC and eXtCn of each type of use Dimensions of existing structure ff / S ' g ~ if any: Front ~ Re r ` ~1~' ~I `l,...... Depth .~S~,tO...... . Hei ht ~..,,,,,,NUm De th , ..'ra.~ , her of Stories G.• l ~ . Dimensions of sa elstructure wi~h alterations or a~itio~s: Front . , . ,~-1 , , , , , • • , , Rea ~ ~ p . • Height `~','a, , , , , , , , , , Nu be Stories . , `M ~~nn 8. Dimension Aff ire new construction: Front . `r ~ ' ' ' t' ' ' ' ' ' ' Height "IQ.. Rea ..~.7 . . Depth , . • . Number of Stories . 9. Size of lot: Front.,(,y/n„ f 0. Date of Purchase . , , ~ Rear l a ' ~gpt1~2 . `"1 i • • • • • • • • • ........Name of Form r Owner .~!~l: s'2.:.4-''E. . 1 1. Zone or use district in which premises are situated , , , ~Q, • , , , , , , • ~ ~ • • ' ' ' ' ' ' ' 1?. Does proposed construction violate any zoning taw, ordinance or regal tion: , ,/Yd,,, . . 13, Will lot be regraded J , .Will exces fil be remove fr m premises: Yes No 14. Name of Owner of premises ~:°,r~~ t~ . ; ~et/~e R. , , ,Address , . ~px, /a ~ ,,feu , Pho e No..~~,~:S,~9f, , , , Name of Architect ?°T(?.K S.v~,~ . , , • , , .Address ~rl?'~L. ~r ti'~r ~ /'~°~p(rz~~~S ' ame of Contractor , ; 15. Is thislfroeSrtSouthold T • • • • • • • . ~ ~ ~ "'Address , .Phone No....... . ' 00 feet of a tidal wetland? ? " " " " * Yes..... No......... ' Y bwn Trustees permit may be re aired, PLOT DIAGRAM Locate clearly and distinctly all buildings, whether existing or propo ed, and, indicate all set-back dimensions from property lines. Give street and block n~mber or description according to deed, and show street names and indicate whether interior or corner lot. I ICI I I~ I i !i 'OUNTY OFE~~•~. S'~ ~~j ~ mg duly s orn, deposes and says that he is the applicant (Name of individual sig~r Ing~,contract) hove named. fe is the ' (Contractor, agent, corporate off cer, etc,) • ~ ~ ~ • ~ • • ' • ' ' f said owner or owners, and is duly authorized to perform or have perfo ed the said work and to make and file this ~plication; that all statements containe',d in this application are true to the est of his knowledge and belief; and that the ork will be performed in the manner seit forth in the application filed therew th. worn to before me this~f~, . 4 : `day of . 19~.~. otary Public, ....QC~,,(,1,~,QV,~„, , , ounty / Ct•AIAff L b~ " Nt>faty Phd~go. State of NeW Yolk . No.4S78606 ~mmt~uat ~laia~a~>u°.~y~gq~,,,,' , (Signature of applicant) x~, t.. , " r t' ~ `'r ` 'r 9 y a ',~t'a` ~'I~ 41.r .t. ? tu, ~l ~a ~ ~ . 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