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19951-z
~ FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Ha11 Southold, N.Y. CERTIFICATE OF OCCUPANCY No Z-20663 Date APRIL 21, 1992 THIS CERTIFIES that the building ADDITION Location of Property 730 ROBINSON LANE PECONIC N.Y. House No. Street Hamlet County Tax Map No. 1000 Section 98 Block 4 Lot 34 SubdivisS.on Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated JUNE 11, 1991 pursuant to which Building Permit No. 19951-Z dated JUNE 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 ADDITION WITH PART ENCLOSED AND SCREENED TO EXISTING ONE FAMILY DWELLING AS APPLIED FOR. The certificate is issued to CRAIG & FENNYANN VON BARGEN (owners) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A UNDERWRITERS CERTIFICATE NO. PENDING - APRIL 10 1992 PLUMBERS CERTIFICATION DATED N/A B il-~nspector Rev. 1/81 108M NO. f TOWN OF SOUTHOLD BUfLDING DEPARTMENT TOWN HALL SOUTHOLD, N. Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) N°- 19 9 51 Z Date ....~.~..T 19~ Permission is hereby granted to: ......1~~:....~~.. `~..r.~...e L D . ~ ..~.~-..~...,~...~.1.-~. ~.........rl9.r~ to .~~>~~:.~....r~~ ...~'...~...c~..~~r~~.... ~i ? . . at Premises located ot ....~J..:~G.........4R.r.~.T!C.l~~.~.T.7........f~~!fteeer ~~a .~.7.)..~ County Tox Map No. 1000 Section ......../..;..,~A..... Block ..........el..~.......~. ~L/ot No...~..e~ pursuant to application doted ........~G./,l.,l 19..'./..., and approved by the Building Inspector. Oa Fee S.sl....~..~X~. ~ rr uildi i for Rev. 6/30/80 C , Form No. 6 y~~(~" ~ TO[JPI OF SOUTI[OLD BUILDING DCPARTMENT TO[JN HALL 765-1802 APPLICATION POR C>:RTIFICATE OP OCCUPANCY A. This application must be filled in by typewriter OR 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 19 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. 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 $15.00,/Commercial $15.00 / Date ......~'~-6 /•~JZ';..... IJew Construction....V Old Or Pre-existing Building........... Location of Property....73~,,...,,~a~~iUSd;U,,,,L-/4 .•.••~~C~,YUrU House•No.' Street , Hamlet Onwer or Owners of Property..... ~l~U ~jo¢l/L,~,(~ County Tax Map No 1000, Section.... ~ „',,,,,B1ock.,.....1..........Lot.,,J o Subdivision.q. ..............................Filed M:ip............Lot.. Permit No,~~ qS 1........Date OC Permit ................Applicant............................. Ilcaltti Dept. Approval ..........................Underwriters Approval........................, Planning Board Approval Request for: Temporary Certificate........... final Cer icate........... I'ee Submitted: ; C O ~QV~~.,? APPLICANT..•....•• _S~ THE YORK BOARD OF FIRE UNDERWRITERS rnG~ z pG3i4$9 BUREAU OF ELECTRICITY 85 JOHN STREET, NEW YORK, NEW YORK 10038 Date AI.'TiTtt 22,7.442 APplic¢tionNo.onfile 76479792142 1t G283T3 THIS CERTIFIES THAT only the electrical equipment as described below and introduced 6y the applic¢nt named on the Above opplication number in the premises of CRATG Yt)N NARfiBN r 784] R<)RT.NSt1N CIANr7 T PNCfINTC r N. Y. in the fallowing locotion; ? B¢sement ® l.at Fl. ? 2nd F'l. GAR/a17~ Sertion Block Lot wos examined mt AhR7. )a 76 L 149 2 and found to be in c¢rnplianre u•itii the rwlu irernen tx q( then Board. FI%TURE ECEPTACIE$ SWITCHES FIXTURES RANGES COOKING DECKS OVENS DISHWASHERS EXHAUST FANS OUTLETS INCANDESCENT fIUORESCENT OTHER AMi K.W. AMi K.W. PMi KW. AMi K W AMT. H P E fl R f; x DRYERS FURNACE MOTORS FUTURE APPLIANCE FEEDERS SPECIAL REC'PT TIME CLOCKS BELL UNIT HEATERS MULTI-OUTLET DIMMERS AMi K. W. Oll H P GAS M. P AMi N0. A. W. G. AMi. AMP AMT. AMPS ~ TRANS. AMT H p SYSTEMS AMi WATi$ NO.OF FEET 7 2® 3 fiN~? ~ m SERVICE DISCONNECT NO.OF S E R V I C E ~ AMT. AMP. TYPE METER I EW I A3W 3,a 9W 3,e' 4W NO. OF CC. COND A. W G NO OF HbIEG A G NO OF NfUTRAlS A' W' G' EQUIP. PER b' Of CC. COND OF H4LFG OF NEUTRAL OTHER APPARATUS: z i CRACG ~fON D71RG(7N G/~~~ T3N ROATN:it1N 7,ANE L ~Ge1NIC, P1Yf 77.958 6ENERAI MANAGER 19' i Y 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. COPY FOR BUILDING DEPARTMENT. THIS COPY OF CERTIFICATE MUST NOT BE ALTERED IN ANY MANNER. :'1:LD i::S: c~:lU;i ~~Unii ~vcKMtNT~ ~ _ \ 'o 7. 7 / ~ ~ °7 ~ ` ~ U FOUIJDATTON ~ 1st) ~ ~ ~ _ c FOUNDATIOid ) _ m \ 2. ~ s e O ROUGH FRAME & /D ~ - „~-dC V PLUMBING ~ ~ y H b 3. ~ cn H I2ISULATION PER N. Y. STATE ENERGY CODE x a ~ ~ r FIidAL o AD TIOIIAL COMMENTS: x 7 - 5 ~kl' ~ ~ ~y ~ rzr b 5 ~ to ~ ? U/2u/, ro H . r ~1 z x rn A \1 H . - x hL d m ^o H l 765-1802 BUILDING DEPT. INSPECTION [ ] FO ATION i5T f ] ROUGH PLBG. [ FOUNDATION 2ND [ ]INSULATION [ ]FRAMING [ ]FINAL REMARKS: ~Gti i DATE ~ INSPECTOR ~ ~ 1 K ~~~s~~ 765-1802 BUILDING DEPT. INSPECTION [FOUNDATION 1ST [ ] ROUGH PLBG. FOUNDATION 2ND [ ]INSULATION [ ]FRAMING [ ]FINAL REMARKS: U r ~ , / ' DATE ~3 /9. ~ INSPECTOR t~~ i ` 765-1802 BUILDING DEPT. INSPECTION [ ]FOUNDATION 1ST [ ] ROUGH PLBG. [)FOUNDATION 2ND [ ]INSULATION [~RAMING OFINAL REMARKS: ' .r DATE ~ INSPECTOR i C~k 765-1802 BUILDING DEPT. INSPECTIaN [ ]FOUNDATION i5T [ ] ROUGH PLBti. [ ]FOUNDATION 2ND [ ]INSULATION [ ]FRAMING [ J FINAL REMARKS: DATE ~ ZJ d/' INSPECTOR ~ ` ~ r~ T6S-1802 BUILDING DEPT. INSPECTION [ ]FOUNDATION iST [ ]ROUGH PLBG. [)FOUNDATION 2ND INSU TION FRAMINGi FINAL [ REM RKS: - r DATE G~ INSPECTOR r T65•i802 BUILDING DEPT'. INSPECTIt'~N [ ]FOUNDATION 1ST ( ] ROUGH PLBG. F DATION 2ND [ ]INSULATION [ FRAMING [ ] FINAL'` REMA KS: ~ ~ ~1 .5" DATE ~ t' ~ INSPECTOR e ~a,.,...~~---»~~-.~q BO,1FD OF HE.\Lrlt p' g FORM N0. 1 3 SETS OF PL,1;JS , . . ,IUN ~ ~ 1991 I qq TOWN OF SOUTHOLD SUI;vEY . . S BUILDING DEPARTMENT CIICCI: ~ ~ ' ' - _ _ . f~f./ ~ 1~~~.,..,...A,,,._._,,,._,,,,,.,.~.~.w. TOWN HALL SEPTIC COIt:t _ FsLt7U. t7kP"~f. - - - • • . 7iJV'~iV CF F.t'a?1~P-"„f C? ~ SOUTHOLD, N. Y. 11071 _ ~ TEL.: 765-1302 J70TIF'!: xamined .ln.~ 'y... 19 CALL ~7~!~v_ / ~ ~ NAIL TO: ~ PProved ...O~//, 191/ Permit No. ~ isapprovcd a/c _ (B ing Insp tor) 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 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 areas, and giving a detailed description of layout of property must be drawn on the diagram which is part of this appli- ion. 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 ttte applicant. Such permit Il 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 II 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 lding Zone Ordinance of the Town of Southold, Suffolk County, New York, and other applicable Laws, Ordinances or ~ulaYions, for the construction of buildings, additions or alterations, or r removal or demolition, as herein described. applicant agrees, to comply with all applicable laws, ordinances, bui 'n code, housing code, and regulations, and to tit authorized inspectors on premises and in building for necessary i pect r)s. o . (Sin ur f applicant, or name, if a corporation) , tailing address of applicant) :e whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. /1 rtn.. p to of owner of premises .....(..~n.l`"t,~ . , . ¢ , ? c (rriv ~ ~J\f ~jf}~.(S~'/~/ . (as on the tqt roll or latest deed) 'tplicant is a corporation, signature of duly authorized officer. (Name and title of corporate officer) Builder's License No..Q,~,;v~,, : , , . Plumber's License No . . Electrician's License No . . Other Trade's License No . . . ocation of land on which proposed work will be done. , . . ~7.3..C7 o3.~n! St~n6...L~ , ...........::P~co~o.i~~ . ouse Number Street Elamlet xlnty Tax i`fap No. 1000 Section Block . Y Lot..>.~f~,............. bdivision . Piled hlap No. (Nantc) Lot............... tte existing use and occupancy of premises and intended use and occupancy of proposed construction: Existing use and occupancy , , , , , , , , , , , , , , 1iI#.f#`J.,E~l1P~.f~ and pane S'c,~ t t~A/~-D ~ ~ ~'c~G~ , ...Y,i~+av4t.• ~»st~,~''t tar~.+4~+tnN. Intended use • . • • • • • • • • • ~~as~t3.~,~~z~ia4iil'~~d~nute~nltlntl~' ,4w8P , 3. \ature of work (check which a li Reparr cable): Ncw Budding Addition Alteration, . • • emova pp 1 Dcrnolition Other Work , r'.... . d. Estimated Cost , l16®~ prv (Description) Fcc 5, If dwellin„ (to be paid on filing [his application) e uni, o, number of dwelling' • • is • • , , • • , , , , , , • Number of dwelling units on each floor . If garage, number of cars , , , • G. If business, commercial or mixed o~cupancy, specify nature and extent of each type of use • • • • • Herightsions of existing stru Nun ben any: Front Rear . Depth . p ofStorics uncnsions of same structure with Iterations or additions: Front , De tlt Height........... Rear.................. 8. Dimensions of entire new constructilon: Front ...2.~; r • • ' ' ' Nu°~~of Stories . , , , , , , , • ,r _ • • . • . Height .........Rear . . Depth um Berl of Stories......, 9. Size of lot: Front • • • • . 0. Date of Purchase Rear Depth . I. Zone or use district in which premises are situated , , _ :Name of Former Owner . . . . ar 3, 1Vi11 lot be rem aded y~nY zoning law, ordinance or regulation: r ose construction violate Address Phone N ' Name of Owner of remises ' ' Will excess fd! be removed from premises: Yes No Name of Architect , o . Name of Contractor , , , , • • ' ' • ' ' 'Address ...................Phone No.............. . i. Is this property within 300 jfeet of a tidaldwetland? ~ • ~ • • • • • Pltone No. * Yes........ No...... If yes, Southold Town, Trustees Permit may be required. " ' PLOT DIAGRAM Locate clearly and distinctly all buildings, whether existing or proposed, and. indicate all set-back dimensions from -operty lines. Give street and block number or description according to deed, and show street names and indicate whether tcrior or corner lat. I I !I ri:oFNe oR INTY S.S . • • • ' a'( g ' /g~ ~ • ~n• • • • • bcin dul sworn ~ ~ g Y ,deposes and says that he is the a (Narnc eYindividual si nin coot t) pplicant c named. the .Q ,(Contractor, agent, corporate officer, etc.) ~ • • " • • ' ' " • • • • id owner or owners, and is duly authorized to perform or have performed the said work and to make and file this ration; that all statements contained in!this application are true to the best of his knowledge and belief; and that the will be performed in the manner set for4h in the application filed therewith. n to before me this f ~ I ..G. l...d~y of.. . ~ 19~~ Y Public, . . • ~ .County ~v ~`sof~~bWMo~kl 'I' l~lnro ~IHlsdin$u dkCqu I~ji--~ ~ (Signature of applicant) ~~""a i~~_ ti. - . f h ~ t"1 ~s mss 1~#~~ir~ ~i ,7 ) f„"t ~'~r{..~. y}, ~l 1 34 t~i _a ~ T` , . _ ~ ~rnc~m~- - ~s ~ ~ ~ ~'o,,.. ~ , r.~ ~ y ~ « t y i t ~ • ~ r~~atV~3~U92Y > ~ t,, x. tt _ ~ ~ ' ~ ~ _ ~ _ ~ ~ I . y~h~, ~ . i , ~ , ~ ~ ; ~ r^ r ~ y t f.. m ~ z ~v~ ~~n~~m~ ~ z~m ~ M ~ ' l A'1 ~ G a ~m ~ .l7 'tl 'ri 'p -i ~ _:.-E~.. ~'{~.:F..R t?IR'~"~ "i r. lt1 N ,i ~ ~Q m ~ C Or N ~ ~ ~ T+ '!t =O ~ ,~ffN O ~'T~ n m ~ ~Nm 4 i~ ~ m ~ n „ II-Ni m A ~ Q ~ r Q O O~ID A , i~,„,1 m~ m 0 z c ~ o xtcn' I[~ O ~ r ~ • 3 ~ y ~ r'~` r',st ~ l w'I c < `x ~ k ~ `r`: rW ~ ~ ~ '+1 ~ Z~ P1. ~ Ifl j U~j ti"~i \ n ° ~ u n a y}v~~4r~ 'il P7 /~f ~ Uf ~~iRs~o~ « ° ~ , ~ ~r 2rn w~ l„~~, _ 4 f p ~ ~ ~ ~ y " m ~ ~ - ~ ~j ~ ~ ~ d y©. ,x~ p m G1 -i~ th. 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