HomeMy WebLinkAbout19793-z FORM NO. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Office of the Building Inspector
Town Hall
Southold, N.Y.
CERTIFICATE OF OCCUPANCY
No 220104 Date JULY 23 1991
THIS CERTIFIES that the building ADDITION
Location of Property 800 HALYOAKE AVE ORIENT
House No. Street Hamlet
County Tax Map No. 1000 Section 27 Block 62 Lot 2.9
Subdivision Filed Map No. Lot No.
conforms substantially to the Application for Building Permit heretofore
filed in this office dated APRIL 18, 1991 pursuant to which
Building Permit No. 197932 dated APRIL 22 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 DECK ADDITION TO EXISTING ONE FAMILY DWELLING.
The certificate is issued to INGO SCHARRENBROICH
(owner)
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A
UNDERWRITERS CERTIFICATE N0. N/A
PLUMBERS CERTIFICATION DATED N/A
uilding Inspector
Rev. 1/81
P08M NO. A
TOWN OF SOUTHOLD
~ BUILDING DEPARTMENT
TOWN HALL
SOUTHOLD, N. Y.
BUILDING PERMIT
CfHIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL
COMPLETION OF THE WORK AUTHORIZED)
N 19 7 9 ~ Z Date I9~./..
Permission is hereby granted t
....`1~.~.~c....1...9..a l:
to ..4:o::^~A:`:^:S:~:S.~:...~...k~:4:ClG......~a,kX.C~~,..~:.Gt.....~1~7......~~`~'~!~':<t~,.G{.........
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at premises located at ..!l.D.:i?.....1.11.. 11::4.........~„~t,S.g^Y~+r
1
::::::::RI~.::.:::::~.~.~ ^^~..::.:f
County Tox Map No. 1000 Section .~.~::..I......., Block Lot No. ~ ~ :.g.
pursuant to application dated ....\~~.....~..d 19..1.x..., and approved by the
Building^I9nspector.
Fee 3..J, lJ.....:
Building Inspector
Rev. 6/30/80
\ ~ P
Form No. ~i /-'d-~ S
TOWN OF SOUTIIOLD _
BUILDING DHPARTPIGNT t
TO[JN 1[ALL ~ ~ ~f ~
765-1802 f/~ " `
APPLICATION POR CGRTIFICATL OF~OCCUPANCY
This application must be ~j
inspector with the followinsledfor newtbuildineroOF inlc and submitted to the building
1. Final survey of property with accurate to cationnecJ use:
streets, and unusual natural or topographic featuresll buildings, property lines,
2. Final Approval from Health Dept, of water supply and sewerage-disposal (S-9 form).
3• Approval of electrical insCal-lation 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 C~;mpliance from archi_ect or engineer
rESponsible for the building.
6• Submit Planning Board Approval of completed site plan requirements.
For existing buildings (prior to April 9, 1957) non-conforming uses, or buildings and
'~prc-existing" land uses:
1. Accurate survey of property showin; all property lines, streets, building and
unusual natural or topographic features.
2• A Properly completed application and a consen[ to inspect signed by the applicant.
If a Certificate of Occupancy is denied, the Building Inspector shall state the
reasons therefor in writing co the applicant.
Fees
1. Certificate of Occupancy - New dwelling $25.00, Additions to dwelluio $25.00,
Alterations to dwelling $25.00, Swimming pool $25.00, Accessory building $25.00,
Additions to accessory building $25,pp, 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, Commerrycial 515.00
/ ~ Date ~7
ew Construction.../1{J Old Or Pre-existing Building.,.
ocation of Property.,(? ~O/~i, f•-L,-,}'(9~y(~.~~~. ~ G~~~ ~ • ~ '
Ilousc No• Street •••j•~-f.~.."'•""'•••••
Hamlet
ewer or Owners of Property...../.,~~Q•,•;SCir-/~-?~-~i~/
,unty Tax hfap No 1000, Section. •q~ •
.U.~ ....Block...... ~........Lot.....a,
.bdivision...... ~ " "
~r-77 ......................Filed Plap............Lot..
rmit \'o..{~.~•,'•?•~Datc Of Permi.C..
..............Applic:~nt...........
ulth Dept. Approval.....,
'••••••••••••••.....Undcrwriters Approval
=nning Board Approval......... '
;uest for: Temporary Certificate........... Final Curticate.•
' Submitted:
?jai f C'G z a~ ~ a 7 APrLIC,1~=~:'u`:e~:ti. ct./.~.....
=iELD II:S1`EC:i0t7 ~IUi,:c ~ i:OMMLNT°
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FOUt7DATI0N (1st)
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FOUNDATIOtJ (2nd) _ m~~
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P,OUGH FRAME &
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IIJSULATIOtJ PER N. Y. • •
STATE ENERGY
CODE O
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ADDITIONAL COMMENTS: ~
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r6s-isoz
BUILDING DEPT.
INSPECTION
[ ]FOUNDATION i5T ( ] ROUGH PLBG.
FOUNDATION 2ND [ ] IN CATION
[ ]FRAMING FINAL
REMARKS:
DATE ~ INSPECTOR
765-1802
BUILDING DEPT.
1 NSPECTION
[ ]FOUNDATION 1ST [ )ROUGH PLBG.
[ ]FOUNDATION 2ND [ ]INSULATION
[ ]FRAMING [ ]FINAL
REMARKS: ~ ~
!~L ~
DATE ~ INSPECTO !
TEL. ,765-1802
c~~FF~LX~
~p OG TORN OI' SOUTIIOLD
! ~ OPPiCE Or BUILDING INSPECTOR
o c4 ~y~~ rn ~ P.O. BOX 728
~ ` ~ TOWN HALL
,~Ol ~ ~a~~ SOUTHOLp, N.Y. 11971
July 3, 1991
Angelo Rodriquez
Box 190
Greenport, N.Y. 11944
Re: Scharenbroich
To Whom This May Coltcern,
We are unable to complete your Certificate
of Occupancy because ,of the following reasons.
nn application for Certificate of Occupancy
is not on file. (ENCLOSED)
/_/i No [Inderwriter~ Certificate on file.
The check is( /not on file.) $25.00
/ / No tlcalL-h Dept. P.pproval on file.
No Linal ins.pccCion has been made.
Plea:,e contact our office on this matter.
'1'hattk you for your cooperation.
Bu.i]di.nq Permit II 1 9 9 3 Z
Buildi.ncl Dept.
/ No Plumber Solder Certificate on file. ~ .
( all permit, involving plumbing being
i:,sued after npril 1,19II4 )
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BOAT D OF HEALTII
~~~(~~f1C~{7{--cry-" ~ FORMN0.1 3 SETS OF PLAaS
t- LJ 1J I TOWN OF SOUTHOLD SURVEY
il~ BUILDING DE A CIfCCI: ~ .
P RTMENT
4;f~ 1 18~99~ TOwNHALL serTlc Form
SOUTHOLD, N. Y. 11971
TEL.: 765-1802 t:oTIFY;
' CALL
Examined Z2' 19`x), NAIL T0: • • • • . • • • .
Approved 2.2. 19 q 1. Permit No. ~ 9 9, 3 .
,
Disapproved a/c .
it„ CSI LM.. . ~?!!.~'.cK. ~ .
(Building Inspcctor)
APPLICATION FO.R BUILDING PERMIT c~/
Date~nRlt/.. 19
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.
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
call 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
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
wilding 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 3emolition, as herein described.
'he applicant agrees to comply with all applicable laws, ordinances, building code, housing code, and regulations, and to
unit authorized inspectors on premises and in building for necessary ins ections
(Sign ure of applican r n ~e, if a corporation)
. ~v, r3. / 90 6266.v`d~l~Y ligy~-or9v
.
(Mailing address of applicant)
tate whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder.
. .f?~r~2,'~~e z... C,~~P.~
Lame of owner of premises . ~N.~~.Q... SGl7~~,~1Y/,3/QOlG. N .
(as on the tak roll or latest deed)
'applicant is a corporation, signature of duly authorized officer.
(Name and title of corporate officer)
Builder's License No. . ~ 9 V , N-
Plumber's License No . .
Electrician's License No . .
Other Trade's License No . .
Location of ]and on which proposed work will be done . .
....K ................................r...............................
House Number Street Hamlet
County Tax Map No. 1000 Section ...0.'L: Block Lot t~ ~ .
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 ~''.F~C...~Pf~'! ,~?e ~(~GGy~C-~
tit:t. •
b. Intended use and occupancy j- , , , / ~C.r~ ; ;
_c.,..',' ,'~r.~,' -
3. Nature of work (check which applicable): New Building Addition Alteration
Re air
mo'
• • • • • • • • • • • • • • val . Demolition Other Work ....12CC-('~,... , ,
~•<Fj<Description)
4. Estimated Cost , ~~V~.. I, . Fee t,.~. .
o ~
g, (to be paid on filing this application)
5. If dwellin number of dwelling u
If ara a number of cars nits . . . . Number of dwelling units on each floor , .
g g>
6, If business, commercial or mixed occupancy, specify nature and extent of each type of use . .
Dimensions of exiting structure, if any: Front G,/.:•.:. , .Rear , 6 , , , , • , • , , Depth ...3:~,', , , • , , , ,
Height ....'Z.$. , Nmn¢er of Stories xc .
Dimensions of same structure with alterations or additions: Front .
Depth........... ~ Rear
, .Height ......................Number of Stories .
8. Dimensions of entire new const ction: Front Rear De th
Height . I~mUer of Stories . , , P • • • " " " • "
9. Size of lot: Front .p .3 S ~ Rear . , .d 9 3 Depth •'F~3 ,
Data of Purchase ..,~?!Y, •
P P v P ~ • • • • • • • • • • ...Name of Former Owner .GH'1~'~ f~p.Y, ...i ,
1 1. Zone or use, district in which re
• r~isesaresituated........
12. Does ro osed constructio violate any zoning law, ordinance or regulation: .
14. Nrilllotbereraded D
g
ame of Owner of remises $G,' • • • • ' ' ' ' ' ' • • • Will excess till be remove~}om premises: Yes No
P ~ ~~~R.12~..n Rai~t'. Address ~ 38 w.at~aer` s ~ , , ,Phone No. ~ Y-. r '9 ,7,ay
ame of Architect , •
P P Y ~ ..............Address , . •7
Name of~if treStorSouthold T l(a~•+1r-Cti`r*~ (3~ak(d~ h!~ Phone No.
Address Phone N
15. Is this ro ert within 300 feet of a t dal wetland? syeS•,•,,,,, No
Y wn 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.
i
~@ ~L Y
I~`
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T.
I
TATS OF NEW YCk~.R ,
'OUNTY OAF
t`FP~ `u ~ ~ g g I~ &xl ~ being duly sworn, deposes mid says that he is the applicant
(Naf~ of individual si nm ~ontracta
rove named.
e is the 4 Q.iJ~d-e~O'af........... .
(Contractor, agent, corporate officer, etc.) • ' ' ' '
said owner or owners, and is duly au~,thorized to perform or have performed the said work and to make and file this
~plication; that all statements contained in this application are true to the best of leis knowledge and belief; and that the
ork will be performed in the manner sett forth in the application filed therewith.
vorn to before me this
° °F"' day of . ri~, 19 IQ"
nary Public, , , , . Co t lt~ l .t~
ROBERT I SCOTT, J
NOTARY PUBLIC, Stott t N,Y. ' ' ' ' ' j'~ • • • • • • • • • ,
T
rm Expes'Mey
31,19u~ 'gna of applicant)
I