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HomeMy WebLinkAbout19138-z \ r i FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Ha11 Southold, N.Y. CERTIFICATE OF OCCUPANCY No Z-19412 Date OCTOBER 3, 1990 THTS CERTIFIES that the building ADDITION & ALTERATION Location of Property 640 STROHSON ROAD CUTCHOGUE NEW YORK House No. Street Hamlet County Tax Map No. 1000 Section 103 Block 10 Lot 22.1 Subdivision Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated JUNE 14, 1990 pursuant to which Building Permit No. 19138-Z dated JUNE 21, 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 & ALTERATION TO EXISTING ONE FAMILY DWELLING The certificate is issued to WILLIAM & CHARLOTTE DROEGER (owners) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A UNDERWRITERS CERTIFTCATE NO. N-152064 - SEPTEMBER 27, 1990 PLUMBERS CERTIFICATION DATED OCT. 3 1990 - HENRY J. SMITH & SON INC. Building Inspector Rev. 1/81 / ~I roses xo. s i TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN iIALL ~ SOUTHOLD, N. Y. BUILDING PERMIT i' (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL I COMPLETION OF THE WORK AUTHORIZED) ~ ~ ~ ~ Z _ ` ; , Dote .....~Q~?r.:~ 1R~~ Permission is hereby ranted to: ra Gam?-.,~f.~r,~~..~.... ...G..'~~~~,.~t~,~...~~~=:... ,G~irf~.... ,I~....~fitj. emu....... ~ - of premises located at .....~.~~L7..~.~.,~o?•~ ..........•~.••Rr~ G""'~"s:~lll... y~f ~ County Tox Map No. 1000 Section Block ........:~.~r.....~.yLot No........2..Z pursuant to application dated ~ 19../...Q, and approved by the Building Inspector. Fee S..c.1~..~~. g Bui in I for Rev. 6/30/80 - .s. F r 4 2~ ~.rr.~r t~ fl . - ~.s-,..-,-W'9 • 1 FORM NO. 6 f 11 i ' " LLLJJJIIId.1~ UGl - 5 TOWN OF SOUTHOLD • . Building Department Town Hall BLDG. DEP1: Southold, N.Y. 11971 T~NN OF SOUSHOLD 765 - 1802 APPLICATION FOR CERTIFICATE OF OCCUPANCY Instructions A. This application must be filled in typewriter OR ink, and submitted v anonaa to the Building Inspec• for with the following; for new buildings 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 of Health Dept. of water supply and sewerage disposal-(S-9 form or equal). 3. Approval of electrical installation from Board of Fire Underwriters. 4. Commercial buildings, Industrial buildings, Multiple Residences and similar buildings and installa- tions, acertificate of Code compliance from the Architect or Engineer responsible for the, building. 5. Submit Planning Board approval of completed site plan requirements where applicable. B. For existing buildings (prior to April 1957), Non-conforming uses, or buildings and "pre-existing" land uses: 1. Accurate survey of property showing all property lines, streets, buildings and unusual natural or topographic features. 2. Sworn statement of owner or previous owner as to use, occupancy and condition of buildings. 3. Date of any housing code or safety inspection of buildings or premises, or other pertinent informa- tion required to prepare a certificate. C. Fees: 1. Certificate of occupancy New' Dwelling $25.00, Accessory 10.00 Business $50.00 2. Certificate of occupancy on pre-existing dwelling $ 50.00 ' 3. Copy of certificate of occupancy $ 5.00, over 5 years $]0.00 4.Vacant Land C.O. $ 20.00 a 5. Updated C.O. / $ 50.00 pate ..~~~<1.~.(~.v. NewConstruction„~/„Old orPre-existing//B~~u..,,itdinppg V/a/cantLan~d~. Location of Property ..14.~Q ............3SG?K7?LQ~:t?.. .~4-~Y.... ~d;GK4'~T.4~~C.tlL2 House No. "D Street U Ham/et Owner or Owners of Property lGJ..•G:~P-~RR:l.~:. G7/l{,cf~. ,G , ,K~Gfs(S!~12~ , , , , , , , , , , County Tax Map No. 1000 Section 1~3....... Block Lot . Subdivision .................................Filed Map No. ..........Lot No. . Permit No. F g/.,3.Q.~. Date of Permit ..`D./~~g4Applicant ,~9A,c~, „~L,~ed?~vs Health Dept. Approval ....:U~~ ...............Labor Dept, Approval . Underwriters Approval ~?~0.~}...........Planning Board Approval N~A/ . Request for Temporary Certificate .....................Final Certificate Y . Fee Submitted$...:~,a~.!~ Construction on above described building and permit m/~eet_sgall applicable codes and regulations. Applicant...-~w.9CLQ~lYl/~?... aDJv~~ Rev. 10.10.78 v// ~ Co~l9yl~2 _ - C _ TWE NEW YORK BOARD OF FIRE UNDERWRITERS PauF 1(11,11Q?1 BUREAU OF ELECTRICITY $~'f'1 ~.fj 85 JOHN STREET. NEW YORK, NEW YORK 1003!! 5yPTF%HFR 27,19917 APPliration No. on file 7b08679C1/9(1 N ]511164 - THIS CERTIFIES THAT ~ only the e/ectrica! equipment as deecri6ed irebw and introduced 6y the appNcant named on the o6ooe sppliation number in thepromleee of (e 40 ' L.DRGGF.R, El° STROHS(rN RU., CUICH(7GUf. N. Y. in thefo(louing hwotion; ? Basement ® Ist Fl. ? Ynd FL C)11T Sertiun Block Lot was examined on SF P T F. %F3 F.R 1 7 ~ 19911 and found to he in romplianrr Leith the reyuirements of thu Bwrd. NXTWIE RX RANOEE COOIIIND DECKS OVENS BISN EXHAUST FANS r OUTIETS ACIES S~TCIMK INCANDFSCEM F1D011ESWM GTHEN AMT. K. W. AMi. K. W. AMT. K.W. AMT. t. W. AMT. M. P. . 12 3 3 12 9'l.0 1 1.2 1 P ORYERS RIRNACE A10TOE5 wiUM AMIANCK IEEDMS xEautlK'R ittAE CIOCRf pLL DINT HEATERS MNLTFOYp/T EMIM!!S i AMT. K. W. al N. P. GAS H. I. AMT. NO. A. W. G. AMT. NN. AMT. AMPA TEAKS. AMT. N. P. ~ T NAT. WATTt 6tfD - SERVICE pSCONNlCT NO, OF S E R V I C ANT. AA1P. TYPE ~ 1 X t`M 1 A TV S / JW 3 / AW ~CeCOND. CC ~ Na. P NI.IEG Oi ~ W IEG NO. OF NEUTtAIE OF ~r EU~AL orNRR ANmRATUS WIRING FOR ADGSfIUN UNI.Y-?. TPA(K LTIiHI"1NG:-1h i .e+o~ G 6 S CGNT RAC Tf1R ITC. g57$E ROX .'.15 - - 'iOUfHOL6). NY. 11911 ~ O~lAtlNANMER Ir Psr `~l Thit certificate matt rwt b ahered in any manner; return te the office of 1fLe Eoord if iLKOrreN. Intpeclon b identified by tbir credmtialt. F BUILDING DE AL MI ANY f ~ I ~ ~ 765-1802 BUILDING DEPT. INSPECTION [ ]FOUNDATION 1ST [ ] ROUGH PLBG. [ ]FOUNDATION 2ND [ INSULATION [)FRAMING [ ]FINAL REMARKS: DATE ~ INSPECTOR ~'C~' ~ 765-1802 ! BUILDING DEPT. INSPECTION [ ]FOUNDATION 1ST [ ROUGH PLBG. [ ] FOUNDATION 2ND [ ]INSULATION [)FRAMING PQ [ ] FI fNQAL REMARKS: ~ DATE ~ INSPECTOR HENRY J. SMITH & SON, Inc, PLUNGING, HEATING & FUEL OIL MAIN ROAD SOUTHOLD, N.Y. 11971 (576) I65-3690 C_E_R_T_I_F I C A T I O N ~ Date Oct. 3, 1990 Building Permit No. 191382 Owner_____ William and Charlotte Droeger Plumber__Henry_J__Smith & Soni_Inc~ ' I certify that the solder used in the water supply i system contains less than 2/10 of 17 lead. - enry P. Smith Sworn to before me this _3rd _day of Oct________,1990 ~ , Notary Public Notary Public, Suffolk County 8ERN0.0ETTEL.TAPLIN NOTARY PUBLIC tlgSA4893 State of Now York Residing in Sotldk CaudY amm~ssion Ezpres Sept. 30, 19~.. c'1FL~ ICS: n :1U:i ~(Jni. Cva'~t~1ENT° _ ro~ r-+ \1 / H FOUIIDATION (1 ~ - 0 NDATIOtd (2~ _ F U ) 2. ~ ~ z / o P,OUGH FRA['IE PLUMBING H 3. ~ ~ y I2ISULATIOP! PER N. Y. STATE ENERGY ` ~ CODE m 4. H FI;IAL I - v ' ~ o~ as ADDITIOPfAL COMMENTS: x _~~~7~ ~ Lam,'. x~ b H x 9 O~ • ~ A a C^ '-3 O m ro H I - 4~ 3~- a0 ~ SS/~ ~oS~FFOlK~01 G~ ~.n~~ TRUSTEES ~ ^x' SCOTT L. HARRIS John M. Bredemeyer, lIl, President ~'0 ® Supervisor HenrYP_Smith, Vice President ~'y ~O Il, S309S Main Roar O. Box 1179 1, New York 11971 7~-1802 (516) 765-1823 me (Si6) 765-1800 BUILDING DEPT. INSPECTIQN [ OUNDATION 1ST ~ ] ROUGH PLBG. [FOUNDATION 2ND [ ]INSULATION [~RAMING [ ]FINAL during REMARKS: _ to John .ocated ~ on the eject. ~'J / DATE / ( INSPECTOR ~;e. D B0,1RD OF HE.\LTH • . • • • . • • • • . • 3 SETS OF PL.1:JS d~ FORPdN0.1 SURVEY TOWN OF SOUTHOLD C1iEC1. • • • - • • . EIUILDING DEPARTMENT SEPTIC FORC! . BLDG. DEPT. TOWN HALL TOWN OFSOUTHOLO $OUTIIOLD.N.Y.1t971 NOTIFY y~~_/~--q,/ TEL.:7G5~tII42 CALL i ~ • l9 ~I9 PIAIL T0: Examined ..~a./ / 7 . APProvcd ~'~.7C......., 198 Permit No. ~~~?~..~5~ . Duapprovedalc (Build' g insp • • or) APPLtCATlO FOR BUILDING PERPAIT ~I-I- , Date J. ~ y.... 15Q.~~. - INSTRUCTIONS )1, a. Tltis application must be completely filled in by typewriter or in ink and submitted to the Buiiditr; 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 io adjoining premises or public streets or areas, and giving a detailed description of layout of property must be drativn 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 Buildin; Inspector will issued a Building Permit to the appGcmt. Such permit shat[ 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 Buildin; Inspector. APPLICATION IS HEREBY hfADE 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 Rc~ulations, for the construction of buildings, additions or alterations, or for removal or demolition, as her:in described. The applicant agcees to comply with all applicable laws, ordinances, building code, housing code, and reorriations, and to admit authorized inspectors on premises and in building For necessary .inspections. (Signa[ure of applicant, or name, if a corporaxwn) • . . f3ao• . m.~K°~::v~v.~• , ~a~rv~, .t..S'®ur~c_o. t1?7/ (Mailing address of applicant) . State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. Name of owner of Premises .......~!//ff?M../(/:.~ GN/ei?~Co7Tr~,'...~'•.. ~j~o~~~.~'..... . (as on the tax roll or latest deed) - If applicant is a c/o~rpor~at~io-/n~, signature of duly authorized ofFcer. ' (Name and title of corporate o Fccr) Builder's Liccnsc No.....~.?-.`ZP9.. f~x • • • • • • • • • _ Plumber's Liccnsc No. ../?`~F.!~.tf.'. Electrician's License No. .~~~'u~: • • • • • J Oti~crTradc's Liccnsc No . 1. Location of land on which proposed work wit! be done; GvUI~N~U~ - C~2i vsn )-cS, ~ ....................~.`.~:~..,~.TSP.f,(~'gal..~~v.AR................./s~`~....:`~`~!? Elouse Number ~ Street. Hamlet County Tax Map No. 1000 Section lB.~•"`• • . • Block .........L4 ; Lo[ a~'. .,iµ... , Subdivision F.ilcd t`tap No. Lot , ..((.juucl • State existing use and occupancy of premises and intended use and occupancy of proposed construction: ` - a. Exis[ing use and occupancy t~+~J;'19l~ .Q~1`.t~(<~ . : . b. Intended use and occupancy ~~.~....¢~'~?rF .~t:`:~~;L . ;,p ;",;4?,,~<~;; .,a~s,'r;; . • E.ti7~~Y.~di I Vii. 3. Nature of work (caeck which aPPlicable): New Building Addition ~ t ron ~ Repair RCmova!' Demolition •S ..~n~ 1..{,`4•,••• Tennis Court~~........ Acdessory Building......... ,Fence .......Ochec lJOrtt. r.. yd. Estimated Cost `~C'~.Q"Q:Z?.... Fce . (to be paid on filing this application) S, IC dwelling, number of dwelling units • Number of dwelling units on each (laor • ICgara^c.numbcrofcars 6. If bunncss, commercial or mixed occupancy, specify nature and extent of each type of use r 7. Dimensions of existin„g,~r}tctures, if any: Front y Rear .....~'.T~: • • • • Depth . _...:5~(....... . Hci~_ht ....~~....:'T...Number,ofStorics.......~~t~...... f y... Dimensions of same structure with alterations or a +tions: Front G ~ • • • • • • • • • Rcar . ~a,(o . . Depth ,5'f$?~:~........ , IIcight ..~?~'~25 Number of Stones r~:~~. . S. Dimensions of entirc~.t~tiv constntct~on: Front ,rl~. ~ Rear .....l/`:~~. • • • • • Depth . _.,~'~,~C?~ . Height ~8...... Numb~r'of Stories ~ ; ~ . 9. Size of lot: Front Rear .:~s~s~' DcPth ~?2.:-.~~ '7....... . 10, Date of Purchase • , • ,/fj•~??~y4,Y,?-~f 1~~~ • , .Name of Pacmcr Owner . , t 1. Zone or use district in wlticlt premises arc situated . . l Does proposed construction violate ,any zoning law, ordinance or regulation: . 13. tiVill lot be regraded ,~Q , , , ....1Vill excess fill be removed from premises: .Yes , Naa. 14, Name of Owner of premises ~[74~G. .~?~€~fan • .Address ...................Phone No............... , . Name of Architect , • • ,Address • -Phony No. • Name of Contractor !a~??.~.~(, ~~f?~~~:. Address /"1R? ©•~fFL~Phona No..71~P~ , . l5.Is this property located within 100 feet of a.t~"~etland? ^YCS.oI..KO. • *If yes, Southold Town T'rusrees Permit may be required. PLOT DIAGRAh1 Locate clearly and distinctly all buildings, whether existing or proposed, and. indicate all set-back d'unensions from property lines. Cive street and block number or description according to deed, and show street names and indigte whether interior or comer lot. ~ • , it ~ , I _ STATE OF \E1V }~QRI:,_, S.SII COUNTY O/F e~~~:cl•~... J~ICIC~Gti-. ~~/:~f2 ! I being duly sworn, deposes and says that he is the applicant (Name of individual signingContracC) above named~/. IIc is tltc .C..~.Qnj%'?~ .3.. Q~.'.PIG+~.1.- (Contractor, al;ent, corporate officer, etc.) of said owner or owners, and is duly at~thorizcd to pcr(orm or have performed the said work and to make and file this application; that all statements contaiucd in this applicytion arc true to tl+e best of his knowledge and belie[; and that the +vork will be perfomtcd in the manner suN, forth in thu application filed lltcrewith. ,ti'' Swom to before me this I, • °y Notary Pu61ic, ounty yp~ .~~4 ::~1:. ~/L~.:.........' 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