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HomeMy WebLinkAbout18981-z FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No Z-19593 Date DECEMBER 19, 1990 THIS CERTIFIES that the building ALTERATION Location of Property 25825 MAIN RD. & 50 EDWARDS LA. ORIENT, N.Y. House No. Street Hamlet County Tax Map No. 1000 Section 18 Block 3 Lot I5 Subdivision Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated APRIL 19 1990 ursuant to which Building Permit No. 18981-Z dated APRIL 24, 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 ALTERATION TO EXISTING ONE FAMILY DWEhLING AS APPLIED FOR. The certificate is issued to DONALD BRINKMAN (owner) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A UNDERWRITERS CERTIFICATE NO. N-164769 - DECEMBER 11, 1990 PLUMBERS CERTIFICATION DATED NOVEMBER 23, 1990 - THOMAS McSHANE B ilding Inspector Rev. 1/81 poaas xo. s TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N. Y. BU14.DlNG PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) N O ~ ~ ~ ~ ~ Z Date ....`/.~,~a.,`,~ 19..10 Permission is hereby gronted/~ / ,/~4~ gG ~I~~~ ~f~,j//J 33 ~ a-~ ~Or..,~....~ ..s.~.. //9~3 S to ~r~r.~. ..~~r~..~. , ~ 1 ct premises located at ~ ~'....v~........l ,f,,.lt(!~ ~/.......r~'.t.~..'V.:....?~d ..~ca.~i~~~ ..................................................G'~. ...........................................................................vv.................................................................................... County Tox Map No. 1000 Section/'..//...../~.R........ Block ........~......QQLot Na .............l.:s pursuant to application dated ......T~9 19./..x, and approved by the Building Inspector. / Fee j.•~.e2... . . i~~' B ing Inspector Rev. 6/30/80 4 Form No. 6 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL 765-1802 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 caith 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 1~ 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 New Construction. Old Or Pre-existing Building....? Location of Property.... ~:Y House No. ~~pp .pSt~reet/ Hamlett, . \ Onwer or Owners of Property..M/'}AK ...l,~F.t.N..:f~P.7? /..'p4h.~~A.tj,~.:BRtti.?~K~!~4!l~ County Tax Map No 1000, Section....Q~ Q .....Block../..~.........Lot....~.`t~ Subdivision ....................................Filed Map..........11.Jl.Lot..,.,.1.................. Permit No..l.~~.~g.~.....Date Of Permit ................Applicant..T1!kR~h~..QX+l~O.l•M....... Health Dept. Approval ..........................Underwriters Approval.`.'.~..................... Planning Board Approval Request for: Temporary Certificate........... Final Certicate..~...... Fee Submitted: $.....~.,ti~.t•.°.~~14Q ~ CQ~ ~95gv1 - APPLICANT TEL. 7G5-1802 ~,~FFOL/, Cp Town or< so~T~O]L~ ~~f' lac OFFICE OF ?UILDI23G INSPECI"OR F? ~ . P.O. BOX 728 T01VN HALL ~O ~ ~ Z- SOUTHOLD, N.Y. 11971 C E R T I F I C A T I O N Date /i .73 9f~ _ Building Permit No. ~ ~ 1 owner_}/?r~RK~n11'=\NtZU~7 /i~otUr~i_L~ 3F-~11'UKt~'1~t~9 (please prints Plumber •"'(~F-IOM/+~ i'`'1~`~l~~~tri3'C--~ (please print) I certify that the solder used in the water supply system Contains less than 2/10 of 1~ lead. , ~ ~ " iplumber's siynaturc) Sworn to befor_`e me thiis~ • day of (V ©y~v?1 !?G~" 19 40 . N terry Public Notary Public,~~~tK COllnty •JAME$J, CORCORAN NOTARY PUBLIC, State of NewYOrk No. 62.4896p89 C3ualiftetl in Suffolk Coun, Commiaaion ExpiresAfe~3C, ~g~ . s__-- n J~ ~ C C ~ ~ ~ ~ m I ~ G> ~r ~ v 'Z > a s ~ 3 s N N v .°3 4 ~ O ~ cv ,n .y'-- r.i ~ K 2 .mot s K~ v - 47 Gl O W w 'O 4 ,.d ~ ~ Z x-~ 1D L C`.' ; ~ ~NQ ~ W E ~ V Y. Y. Z N ~ m g ~ W 3i r ; r z~ Gf~ v i ~ y o c 7 Y° ~ T o , i _ z s N a y r _ o Y.: W let ~ .G Y 3Y N u Y b V O O~ u ~ U` y % ~ ~ } W fL ~ K y zp f ~ `5J ~ tf1 d cN ..y V o- l o ~ a LLp N ~ v U 6~ NNW ~n u ~ m V 111 +~9 C ~ W uai o la O ~L. [L Y ,y ~ 'U a z a o r O W~ o ~ w e ~ 3 0 .-i 5 s ~ z m n e0 ~ R p ~ cs. Si a m ~ m ~ M+ t0 ~Y H a ~ ^ H i o a y s ~ ~ ~ m >c ~ ~ o i ~ ,9 ~ ® O a ~ O "m ~ i ~ R~' _ n ~ m m d r+ ~ ~ Fc ca a W w ~ Woo W ~ N~~ r a x cnw~ m ~ ( Gn m F+ V ~ ~ z V ~ N W.~~++ W ~ 0. O W w ~ N ~ 'c Y A C up Q b ~ 0 6 ~ M~ ~ w ~ P ~ ~ y6; ~ ~ ~ 4 ~ ~ a U ~ 'S C v+ Y ae O ~ ~ a _ ~ G V G w rX~ M C1 5a _ ~ ~ ~ ~ .C ~ S~i -i _ ~ ~ T65-1802 BUILDING DEPT. INSPECTION [ ]FOUNDATION 1ST [ ]ROUGH PLBG. [ ]FOUNDATION 2ND [ ]INSULATION [ ]FRAMING [ FINAL REMARKS: DATE ~ ~ ~ INSPECTOR ~~j I ~ 765-1802 l BUILDING DEPT. INSPECTION [?f OUNDATION i5T f l TROUGH PLBG. [ FOUNDATION 2ND [ ]INSULATION [ ]FRAMING [ ]FINAL REMARKS: ~~-~z-F~- i a ._.~~(6SG__ ~ w a- DATE ~ INSPECTOR 4 Court uT~ zB.t,D xtd5{~~7~otJ Ilpi~T~ it h ~ ~ ~ OUt1DTTI0:3 i~'~, _ _ c co 'OU!lDATIO!I (2ria' ~ cz~ 2 . _ N ROUGH FRk'r1E & PLUMBI;IG • cn w H m 3. It3SULRTIO:! PER N. Y• $T i.T E EiIERGY ` o CODE ~ 1 J~~ ~,--~rr.2 U .__s_.1 y a _ ~ _ F2;3AL o~ m x~ ADDITTOtIAL CO:•?MEidTS: ' ' ~ • x . 'v 4 H 1\1 ~ ~ ~V 9 H H O \ r m a • r . ~ M .y a • :ti ~ iui•' ~ t l ' ~ ~ `~w ; to ''1 ' { j , .F ~.x`~~ ~ ~ 'a~. c~x j _s ~t ~ 't ~ r ~ ~ 3 _ 1 ° ~ ~t I ~ ~ ,1 ~ ~ Q ` ~ ~ - . - .b ~ ~ . ~ ~ ~ n ~ t~ } } ~ ~ ~ i o .o ^,2: fit. C 1.14 ~ _ fit, ~s t, ~ ' ~ ~ ' ' ~a L ~ ~ , }}cS y ~,J i ~a ~i~ ~,i. ~~y ~ stn z ~ 4 ',`ta ~ ~ t , ' y , U ~ ,J c ~ ~ ~ ~ 1 ~ ~ .900 !j - ...1 t(+ ~ ~ ~ 1.. V 4 yy E 1 ~ e n,~ ~ °yN, } fr ~ ~ ~ -'~t~-` , rn. ~ ~ y w'y i •.4L~ti.~. P Y c ~~t; Cy~"° mac ~ ~ . Yp t Mr ~ 4 1' C o Q ~ l~ ~~r+Cj ~i 2 y~'i~ Ap~ 9 8Ki y 7~'~ TT A~~ ` ~ Yp. is w ro uo°~~Ur9$Y ~~t^ _ W 4s ~ ~<~_~P° u~ ("1 ~ ~ V • O V + .T ~ r M j g~~«. 765-1802 BUILDING DEPT. INSPECTION [ ]FOUNDATION 1ST [ ] ROUGH PLBG. [ ]FOUNDATION 2ND [ ]INSULATION [ ]FRAMING [c~]~FINAL REMARKS: ~0 1 D.~-~~ l~ Yl~ l DATE ~ ~ ~ INSPECTOR ' BOARD OF HEALTH ..y......... + ~ 3 SETS OF/ PL.\N . FOHM NO. 1 SURVEY ? . TOWN OF SOUTHOLD CHECK .:-~1.5~ . BUILDING DEPARTMENT SEPTIC FORhI TOWN HALL $OUTHOLD, N.Y. 11~J71 NOTIFY ; r~ Q TEL.:7G5-1802 CnLL . Examined ~,,~~TC.e....., 19 / d c MAIL T0: ' Approved ....7:,1.!:.7......, 19 ~~Pcrmit No..:~0 .9~ . Disapproved a/c (Bui ing In ctor) APPLICATION FOR BUILDING PERPalIT n~ Date fib: ~-~':A-. q „ IS~L'7. INSTRUCTIONS a. Tlris application must be completely filled 4n by typewriter or;n ink and submitted to the Building inspector, with 3 sets of plans, accurate piot 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 Bui]ding Permit. d. Upan approvai 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 Permii 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 alf applicable laws, ordinances, building code, housing code, and regulations, and to admit authorized inspectors on premises and in building for necessary inspections. _ p (Signature of applicant, or name, if a corporation) OXNvi,,~~1.~~ ,~,rr~e~'!'I`Gc.'...?O...ti3c'a~ a3a,.S~..?ei~-r2;i~?rJ;.~Y ' ~ (Mailing address of applicant) ~ 1 I ~ 3 } State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. Name of owneroCpremises .•D;7Nr~~.~RIK?~l~~fYR..~1~A'aQ,K.~.~l?U.Et.(7,b,~,,,,,,,,,,,,,,,,,,,,,,,,,, (as on the tax roll or latest deed) iCapplicant is a corporation, signature of duly authorized officer. (Name and title of corporate officer) ~ C3`~ ,4~~tL _ \9yo , J t?.i t LU Sv c.Y Builder's License No. .:lrlya.,1~~~17-.~~...... Plwnber's License No.o~~M~ ~~~YVY~..... Electrician's License No. S~~.~~`!~. ~?~'7~ . , , ' Otlicr Trade's License No . . Location of land on which proposed \vork \vill bu done; • - i(ouse Number Street. ~"a >=DwA92~ Hamlet ~ ~ County Tax tap No. 1000 Section ....U. L ~2 Blvck Lot • ° , , Subdivision Filed !\lap No. Lot (Name),. , State existing use and occupancy of premises and intended use and occupancy of proposed construction: 0 a. Existing use ~~S D~.113.~w?. , 'fit" 3~T ..P ~#itA+~ and occupancy l ..btu t~S~ x;-~ rt b. Intended ~ use and occupancy tg,.t^e'g~:~5t1~r~irkiG~.;Yiirtnr~ . ~.t~3'l' ;S ,xt;r A., ~Tu3ua'.f cai..r~s~ita41.. . 3. Nature of work (check which applicable): New Uuilding Addition Alteration ' . Repair R~maval Demolition .......Swimming pool.... , . Tennis Court Accessory Building..........Fe~ce .......Other Work:........... i. Estimated Cost .x'0110.. Fee ..S~•............................ (to be paid on filing this application) 5, If dwelling, number oC dwelling units t Number of dwelling units on each floor , . . If garage.numbcrofcars S• iC business, commercial or mixed occupancy, specify nature and extent of each type of use . . 7, Dimensions of existing structures, if any: Front . Rear Depth , • , , , , , . . Hcialtt Number of Stories . . Dimensions of same structure with alterations or additions: Front Rear . . Depth . . Iicigttt Nurrtbcr of Stories 8. Dimensions of entire new constntction: Front . Rcar Depth . Height . Numbce of Stories , , . 9. Size of lot: Front . . . Rcar Depth , . (J. Date of Purc;tase ...................:.........Name of Ponncr Owner . , Zone or use district in whirlr premises arc situated . • r, Does proposed constructa.on viofatcany zoning law, ordinance or regulation: • -~D• • • • 3. iVi!I lot be regraded Nill excess Gil be removed from premises: ,Yes Na 4, Name of Owner of premises ....................Address . Phone No.............,. . Name of Architect ...........................Address .............:.....Phone No............. Name of Contractor ~ . ...Address ..Phone No..... . 15.Is this property located within l00 £eer. of a tidal wetland? *ytiS._.: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 )roperty Gnes. Give street and block number or description according to deed, and show street names and indicate whether nterior or corner lot. - L^ / ~p ~j'/ oh STATE OFNE~RK~' l~ 5,3 COUNTY OF ...--.~~.'1~~8 v~ K!~4'R~YJ , ©X~D J.;TI , , , , , , , , , , , , , , • , , , being duly sworn, deposes and says that he is the applicant • (Name of individual signing contract) above named. He is fire • • • • • • ' ' • ~ Contract , agen corporate officer, ete.)~ ~ • ~ • • , • • ~ ~ - • ' • ~ • ~ ~ ~ ~ ~ ~ ~ • -oC said owner or owners, and is duly autltorizcd to perform or have performed the said work and to make and Gle this application; that all statements contained in this application arc true to the best of his knowledge and belief; and that the work will be perforntcd in the manner tot forth in the application filed tltcrcwith. Swom to bciorc me th~ 1. .1 .dayof.. ~ ` 19 Notary Public, , . . , County N,n,y ~ ¢of NawYak / l U 1. ~ . ~~MSuffBd~06n~~~~U (Si;tuture of applicant) i - .~rn:zr~ti TEL. 765.1 E01. J~`'`~~ ~~F('Ck~ ~ ~C. ~~(~~~rrr c.~r sovauo~.~ ' `r ~~~~"~~E. ~~i~~ pfS'iCl: OF i3UiLll1NG ITJSPECTOR x +;A <<~,:ill~. , it 7 ~ r " p.0. (1pX 728 11 ~ ''{~j~,!'•t• 'I'pi, iJ t 1 A LL t1 c1,~ SOCJI'lIOLi), N.`:. l 197i 1 -d vr•:L'~ December 13, 1990 ' RAREN 0%HOLM P.O. BO% 133 EAST MARION, N.Y. 11939 RE: DONALD BRINKMAN ~ MARK WEINROD To Whim This May Concern, Pic aze unable co complete your Certificate ' of~Occupancy becau~c' of the following masons. /-i// nn application for Cr;~tificate of Occunanc;~ 15 nat On fi1C. (ENCLOSED) Vo th:der.:ariters Certificate on file. / / 'C'he chec}: is (1§75%StBi~;f$/not nn file.) 525.00 / / t:o health Dept. Approval on file. % / t:o final inspection ha> been made. Pease contar_t our office on this matter. Thank yo:.: foz your cooperation.' c3uildi.nc; Permit II ~ 8 9 8 ~ Z IIuilclir.~I Ucpt. dbh/" tto plumber Solder Certificate on file. ( all permits involving plumbing being .i~rued after April 1,1909 ) - - x