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HomeMy WebLinkAbout19505-z FORM NO. 4 t TOWN OF SOUTHOLD BUILBING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No Z-20357 Date NOVEMBER 19, 1991 THIS CERTIFIES that the building ADDITION Location of Property 46925 MAIN ROAD SOUTHOLD NEW YORK House No. Street Hamlet County Tax Map No. 1000 Section 69 Block 5 Lot 16 Subdivision Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated NOVEMBER 1, 1990 pursuant to which Building Permit No. 19505-Z dated NOVEMBER 7, 1990 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 HENRY FAUCON (owner) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A UNDERWRITERS CERTTFICATE NO. N-204888 - SEPTEMBER 24 1991 PLUMBERS CERTIFICATION DATED N/A >2' uildinq Inspector Rev. 1/81 >losai xa a TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N. Y. BUILDING PERMIT ffHIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) No 19 5 0 5 Z Date 19.~~.a Perm Sion is reby grant ~ t~`" ~p of premises located of ....7.:~..... ~~~r~... . County Tax Map No. 1000 Section Block Lot No. l...h~ pursuont to oppileation doted 19~~, and approved by the Building Inspector. ~ 9~ Fee S~ •~j uildl Inspector I \ Rev. 6/30/80 ~ Form No. 6 ' E ~ 4=''t' ~ ` ' TOWN OF SOUTHOLD J~ ~~,1~~" BUILDING DEPARTMENT I~~~ ~ ~ 6~I ! ~ ~ TOWN HALL ~ ~ Ilia 76s-laoz g,~~sti 1198' _ _ , , APPLICATION FOR CERTIFICATE OF 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. 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. i 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 proper t}' 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 i. 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-exilsting 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, Commer~cjial $15.00 Date ~~~~~~......6~ I New'Construction........... Old Or Pre- i tingG$,~ildin Location of Property.........,.: `O.,(~. /..~.~:.d :9 ~ 1~..... yyx House No. _ Street N/ Hamlet r Onwer or Owners of Property....~~..~... County Tax Map No 1000, Section ..............Block................Lot...................... Subdivision ....................................Filed Map............Lot...................... Cy Cam' tr Permit No. J f .-1..~..1.. ~ .Date Of Permit.. IJ. ~7 .~:~...Applicant......~.) . Health Dept. Approval ..........................Underwriters Approval......................... Planning Board Approval Request for: Temporary Certificate........... Final Certicate........... Fee Submitted: $ Q.~, ua 96~ . C O D~~ ~ APPLICANT j I 7~•1~ NYIt~iMA ~tPT. e INSPfC~'ION [ ] PnUNDATfON 1ST [ ] RQUQM PL66. [ ] ROUNDATION 2ND [ ] i ULATION [ ] F'RAMINQ FINAL I~ 1li,MARKS: r f PATE INfP'NC'TOR E PAt+X7 1 - ,pu~a~1 THE NEW YC1Rl( Bt? Of I~tttE U1M~Ei1RN~E1lS _ su~ISwu e~~Ituart~t~l~ ,~A:,, . s'~7PTFMHi~;p' ta: 3`$91""" s1R. ear roc. ° 7~ v~:h1~S38 I~ zgaaas Data Applie.rion No. ow file THIS C[iRlf[ES THAT only the slecteicd Nwipment aR dRwcri6eJ6dom nRd iwwrrwd 6Y tA. RrhtNaiit n....d.w r/u sbsw y~Ne~as wwRwM In Gb pnMRi+n of H.k. E'AIICGN, HAI'.N~[K~gpAD~, SO(PfH~~+,~,, N.Y. in thefoUoTeInR loea~,I,~F~'fk/9~ Ixt fl. ? !nd fl. .Sertian Mdek Lot rr uNU exomined on Rwdfuwndtu 6e in centplLnn riM.the reyuirentewu ~/tAUfrrd. pU(iW! ~f AGK SWITCIRS M OTIITi11 AMT. K. AMi. R.W. AMT. R.W. M11Y. 'KM. AMT. N. r. ~j ~Y~ NOIAMN, Mf.'w ~ z AMT. R. W. Ql M. r. tMS N. 1. AMT. M. A. W.O. MM. AW. AID. NMI. 1WK. M2 M I. AMi. WAlT3 _ :y g i; 5.^. t~RVla~ f E A V 1 C i AMT. MM: >sR Titw ~/aw fwtw twar :a rq.aNFMC tao:breuwAts ~•t'~,' Ollll~ A/IiMAW°: e T! G & S CONTRAC'Cgft 1.'[<'.#5'iAF, HqX ?.1.5 r SOifTNQt~D, MY, 1.1977. ~ ~ f1~?IIIMi(Y~! t 1 ltes.._ 7- Tlut ari4d ~ yM.aM~tw1~t!..?p~'. saMws rMum hl:,zLM.~ Vf: ~'I~IJIYBIdR,~teri~ s... cnd~ntiuk...;! 765-1802 BUILDING DEPT. 'INSPECTION [ ]FOUNDATION i5T [ ]ROUGH PLBG. [ ]FOUNDATION 2ND INSULATION [ ]FRAMING [ ]FINAL REMARKcS~ ~ -~~v~-~ DATE ~ ~ ~ ~ INSPECTOR ~ ~ J l~J:,: I~ ~"v:"fi4LNi~ ~ z Qvl ~ r., ~ UtIDATION ~ 1s ~i ~ I I c m IUNDATIO,( ~ ) L L HUGH FRki~(E & I b -PLUMBING 1 n ~ '1lSULATIO;I PER N. Y. STATE ENERGY I CODE I r r. ' FIilAL I . I o r ADDITIOPIAL COMMEPITS: . x ro • ~ v H _ ` O r x m a r H S - m~ .9 _ H a i ! ~ 5~~ 765-1802 BUILDING DEPT. INSPECTION [FOUNDATION 1ST [ ]ROUGH PLBG. L,D [~FO NDATION 2ND [ ]INSULATION [ ]FRAMING [ ]FINAL REMARKS: ~ i l~ , DATE ~ b -INSPECTOR _ PETER DOHRMAN LEOJENDRAL 734-5467 399-5266 NORTH FORK HOME IMPROVEMENT RFD 3, 1150 Smith Road Peconic,N.Y.11958 ((,~~~~~~~~,--s~(~~~~k _alll .a f OCT 3 11990 ~ r , <<~ i 4{=,:=~ 5 0. (.s CiLGG. t7ci~T. w.~,~ October 31, 1990 ' To Whom It May Concern: In regard to the building application for H.B. Faucon, I have measured the front setback as shown on the plot survey and found it to be 28`. Thank you. Peter Dohrman 11~~I9o HEIEH K DE VOE NOTARY PUBLIC, State o1 Hew Ywk Pb. 47O7B%9, SuflolkCountfr,„ Taem Expires PAarch 80,19 = r FORM NO. 3 M TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE STN ~ SOUTHOLD, N.Y. NOTICE OF DISAPPROVAL n ~ Date ..O c-~!"",'.`"... ~.d......., 19 .9 ~ . PLEASE TAKE NOTTICE that your application dated ...~A+~!~~~!-;.~~.~....., 194 ~ . . for permit to Q~.4r...dp:+:~..d: ~4 .~Gt~,~..1 at Location of Property ~ / ~ ~.Q.!-n..(~:d ........000.. l~ . n . House No. Street w~. Hamlet County Tax Map No. 1000 Section ~ ~?`.~1..... Block Q,`~~...... Lot ja . Subdivision Filed Map No. , Lot No. . is-~retu~rn~ed herewith and disapproved ion the following gyro-u~nds . ?d~! .p~.~ `.3Z- .1~'W:~..~4~~-?. pr..Q:"~.~...i!?OA.!!. wc°~?uoY!~. a .~.~4-!i-'~C~. ~!~!a. ~~R. u ~1~ n ~j,(~„ +:K-en~.~~:t:a.tF.•,~'..'~-t-~.e~. ~:0~-..~w.a~"-.Kl-01~~.4?..Q ~""'...~9:~```~I,.``~' O r~'#.. .~~~sf i ~ ~!1;~:..4 . C Building Inspector RV 1(SO s ~ „E 00~ 70. N.53' /0 30 Err-"__--._~--- srK FND BROKEN _ MON. m UD ~ 'a m ~ $ a FENCE w~' AO ,WIPE ~ W V ~ Sh CH ~ ABOVE O FR GROUND ' ~ ~ m SNEO /E.6 ~ s ~ p00L \ T m m N h~ O F r o m ~ ti ~ ~ -c C n 2s.T' w ® ry b ly n_ 65'~ Z Z 2 w BTY Ner o m / ~i s a n, ~ w FR RE ~ n nl a ~ O T w 79~ F pyER (L~,3 i /~i CONG ROTN%N - Op m p~ ~ 2~ / $ 6 tD ~ Qty, ~ S.^ ~ J ~ ~ Et` OEF. 0 SET STK~ t,Q ~ E1.5/~ i FND. MON o/5'SOaw r0.00 FNO. MON. S. 53 RO~ l~ ~ S.R. 25~ MAIN MAP OF- _ , _ _CERTJF/ED TOE 7NE NORTH FORK BAiVK JA rRUSI' CO. DESCR/BEl~ PROPERTY carcASO rircE /NSURANCE Co. AT SOUTHOL O HENRY BREWSTER FAUCON TOWN OF SOUTHOLD ~ DOROTHY FYELLS FAUCON SUFFOLK CO. , N. Y. ~P~~ OF NEw yO L c ^ `A 5 o~~W DpN~~'P,j. UWBIY V~ QSJOCi~®16S * Q~ P'' N 3l3 west main street ~ ~ riverhead, new York 11901 `'oF, ao 3 0~' 4516)369-1717 (212)746-3020 AREA ~ /3,J95 ~ ' 2S~o tarvo s~~`,~~ July 22,1983 ,Job Nf 83-296 0.3029 ACRES 1000-069-05-17 Scol~~l°=30~ ~D ~ ~ ~ C h Jet, LJ s _ TgUV~ CtF 5t?!~F6V3i_t7.. 70.00' xa a... ~ NA3!l0'30 E• Er s rx. FNO. 6RO~N NON• m Vf ~ a, O ~ W~AE z~ V e ,C ~ V Y ~ ~ 5 iA. ABGRO NO m SNlD 12.6 Z pOOL \ ~ "1 m ~ • = ro !n b ti r • T i ~ ro \ m n ~ n ~ ES.r' n O r a 85~A Z Z : , p, = liK STT ~ ~ n ~ aj' ~ m P ~ FR. RES~ ~ n m o - - ~ n 3.l'S.4 45 ~i /4A ~ ~ ~ ~ ~ e ~ ~ ~ ~(G 1 ~0 ~ ~ i Cp m 2,/3~~-' ao e ~ ~9' co Gte . • STK• OE£O SET LO ~ 5/.5/' ~ iNO. MON. . 70.00 iNO.MON. 5.53°/5 50~~N! /70A D (S•R• 25 I . ~yglN MAP O F CERT/F/ED TO / D ES CR/BED PROPERTY 7HE NORTH FORK BANK & TRUST CO. CH/CAGO T/TLE /NSURANCE Gb AT SOUTHOL D HENRY BREWSTER FAUCON TOWN OF SOUTHOLD Q DOROTHY WELLS FAUCON SUFFOLK CO., N. Y. tP~~ of New yo . 5 O~~W ~~n'q 9~ donack associates * Q oN 313 west main street riverhetyd, new york 11901 . AREA ~ /3 /95 Q ' `'~F'ls, ~O. 89263 d~-,O~ (516)369-1717 (212)746-3020 0.3029 ACRES NANO SJ~ July 22,1983 Job N- 83-296 1000-068-05-I7 Scal• ~ I =30 D ~ BOARD OF HEl,LTH J ~ 3 SETS OF PLANS FORM NO. 1 SURVEY SEP ~ 8 ~ ~ TOWN OF SOUTHOLD HECK .AS~k: tf-'j i5,a , ~O r( tl BUILDINGDEPARTMENT SEPTIC FORM I~R{M:^:•o:-~.-....... ~~~t 3 TOWN HALL i_, tSr...., if l , ,~',~.i.•' ~rF~ Uh't~'_r"""""'"' I ~ $OUTHOLD, N.Y. 11971 NOTI Y c t r/ ,,:3,ir~tt_;(yCs G ~ TEL.: 765.1802 CALL .~7:~ G,.... MAIL T0: Examined . ~/~7........, 19~d. . Approved ~l1•' • 19 90 Permit No.!~.~?j, d J~6 CQtiCC~-~FyG . Syr Disapproved a/c uitdi nspector) APPLICATION POR BUILDING PERMIT Date 15... + INSTRUCTIONS <j a. Tltis application must be completely filled in by typewriter or jn ink and submitted to the Building Inspector, with ~ . 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 or areas, and giving a detailed description of layout of property must be drawn on the diagram which is part of this appli- cation. 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 shall 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 - shall 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 Building 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 ousin^ code, and regulations, and to admit authorized inspectors on premises and in building for necessary ins ctions. ( ~nat i applicar name, icon) ....c(~o.S.~t,s.~t...~~?~~G.N.~. (Mailing address of applicant) ' State wh11ether applicant is owner, lessee agent, architect, engineer, general contractor, electrician, plumber or builder. Name of owner of premises ...:.l. ! . rJ. ,r.. ,t~.a ~J.~O!~ . (as on the tax roll or latest deed) IC applicant is a corporation, signature of duly authorized officer. (Name and title of corporate officer) Builder's License No. , r~ • • Plumber's License No . . Electrician's License No . . Other Trade's License No . . 1. Location of land on which proposed work will b' done; - Elouse Number / S~tjreet. Hamlet / County Tax i\tap No. 1000 Section L? • ! • • • • • • • • • Block ~~,J~'. Lot ..~G~ , , Subdivision Filed Map No. Lot . . •(Namej . 2. State existing use and occupancy of~p~reomises and intended use and occupancy of proposed construction: a. Existing use and occupancy • ~G?.~?P..~~..-~` • • • • • • • • • . b. Intended „r^1~,~r~Qp,t!G:(;.... i' use and occupancy 3. Nature of work (check which appliG able): New Building Addition Alteration . Repair Removal . . Demolition ..............Swimming pool , . Tennis Court Accessory Building........,.Fehce .......Other W~rk:.., 4. Estimated Cost ~ ~ D4").~.... ~ Fce ~ (to be paid on filing this application) 5. If dwelling, number of dwelling units Number of dwelling units on each floor If garage,numbcrofcars 6. If business, commercial or mixed occupancy, specify nature and extent of each type of use , 7. Dimensions of existing structures, if any: Front , Rear . , Depth (a, , , 3. , , , , Height ..?i,~C , Numbci of Stories , , , , , , Dimensions of same structure with] alterations or addition ~ Front Rear ,iZ,~,~ , , , , Depth ~ }Z Height Num~cr of Stories 8. Dimensions of enttre new construction: Front Rear Depth ,~Q, , Height (Dumber of Stories ' , 9. Size of lot: Front ~ Rear ,'~Q Depth ~~~s'. q.~,t , , , , , . 10'. Date of Purchase : -Name of Former Owner i 1. Tone or use district in which premises are situated . 12, Does proposed construction violate any zoning law, ordinance or regulation: . p, . 13. Will lot be regraded , , , , , , , , , , , \Vill excess fill be re oved from premises; Yes No . . 14. Name of Owner of premises . , ~N,~p,R/,', , , ,Address ..1~!(6(/,v,,q~....... Phone No.T(W.~. g!~ , Name of Architect ) ,Address . ..Phone No. ~p / : . Name of Contractor , , (,i£"~~?~~; ;I, , , , , , , ,Address .4f,- !GNeS. .Phone No. ~.~~'.`i. ~Q~ . IS.Is this property locat,'ed within 100 feeC of a tidal wetland? *YBS....NOe%• . *If yes, Southold-TowniTrustees 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. a~,e~ ~ ~ 3a~ ~ ~ ,~u~ G~~~.d~/'~1 ~'7 ~ ,l ~ ~ STATE OF NE1V YORK, ' S S COUNTY OF . . • • • • • • • • • • • • • • • • . • • • being duly sworn, deposes and says that he is the applicant • (Name of individual signing contract) above named. licisthe (Contractor, agent, corporate officer, etc.) ~ • • • • • of said owner or owners, and is'duly authorized to perform or have performed die said work and to make and file this application; that all statements con}aincd in this application are true to the best of his knowledge and belief; and that the work will be performed in the manner set forth in the application Gicd therewith. ' Sworn to before me this ~ .....day of 19`~'C. ~ ,rJ Notary Public, , , ,~~~°~t,?~, ~..~..2. (,~!S~°.'~.-_. County v/ NtiIEN K QE VO New Yak . . ~!1 . ~1U787& Sd~Nolk • . . (Signature of applicant) T9~ Expile3 Meroh 30.19 r;; , _ _ - _ I, f ® I ' ' 1 ® R VEO ~S 4~OTEp 1 ( ' ~l 1 ri#UTd3~4` t3 IL. ~NE; Y3kT~ART TAT sG~~~~ ~aa~ ~ ~ ~ Bt~S~-~SOl. E .Put Tp ~ PM OR TWE 1 ~ /"]©B? 1 ~ F6J~d.t~Va13N~ 4N§~EG~tC1flSS: lDf ~'j ~c~U~c~ATlor~ rwre~~EeaUdRED ~ ~ CGS 1 } FpR~~a~R~tzGCSNCREr~ 2. ROUGW -FRAMING PLUMAING i I S e~ lob ~1~+~ I`` i dNSUL~TtpN rre-t ~ ~ ~ ~ 1 I ~ RE CpMPLETE FOR C OTION MUST I%~L~~f~G,-.:~Z I y Ai.L CONSTRUCTION SHALL MEET ~I ~~O 3G TWE REQUIREMENTS OF THE N.Y. STATE CONSTRUCTION & ENERGY t CQOES. NOT RESPONSIBLE FOR _,~~,__.,.~..e r / 9 OESIGN OR CONSTRUCTION ERRORS vN B v- ( S~~ a~ I ~ ` I G ` ~ ~ ~ T wits zx~f t6 Cc~~~N ~X~ 16 n~G q CjfG'rar, ~taf7r~~ ~pv'J'(~ ify~0~i' - d/ ~ l~y~.Byro ~,?Kl,. ~t j~ie~ f/ ~5~~~"~~~~o 17~ 4 ~ ~ ~ '~'K ~2t~r5~r~ F i~ ~f~~ _ _ _ I ~pP~ Ep AS NdOTED ~ ~ ~Toa~ z ~r s~~~~~ ~oa~ t ' ~ pry ~y f~'l'.f ~ I 48.1: 4I_-/r I I ~ err . BY: iS/`~ CC!* { j ~3139i.~!M13~ DEPd~R AT t / ~=1,2 ~ ,~.E'I+ TO ~ PM FOR THE ~ I +rr-t/rte S~~r~~1 fE~tr~+.. t I ~rtr;,ut;?EVSS~TeTtt)NS: I ~~Z'l~o~fir-~LG ~GG'l_.~ °p~I~.~.~ ~ i ,,;,'tnaFEttit~ - 't1n10 REf2UiRED _ _ at~L7RED CONCRETE ;tie-JC>~ - FF7AiV19NC ~S PLUMBING .-.I d~~ 36 `-,t.rt;(. CONSTRUCTION MUST ~iF {>OtU'iPi ETE FOR C.O. ~ / ~ ~ ~;~1Li. 1`rONSTRUCTION SHQ,LL MEET 7 ~jH[ 6iE0U1REMENTS OF THE N.Y. O ~ ~ , w t / c P/ ~T'~"s z: C01~3TRUCTtON & ENERGY 0 vN~/' A i ~ S vt~095C~i. NOT RESPONSIBLE FOR ~~ESts:SN OR CONSTRUCTION ERRORS ~ llNbERWR~fR5 CERTtf'~ATE r ~ 1 a. I titi~ .Z.4~~'f~°'d ~ , a . ~ ~ ~ ~ i j ~ '3Q c~ ~ i`. ~ a, ~/P / ~ w`v.lls zX~ tb rroG tz- ~7 y ri ~ n 3l ~ r l~ /~~J-4-i~ ~j~ec~n ,wry 1/,Z 1 r G~K ~~r s r Ba t ~ ~°C~C . ~ [dJS~0.NC2 ~a~~ y tK~s~~~ ? ~