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HomeMy WebLinkAbout18698-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFTCATE OF OCCUPANCY No 219216 Date JULY 16, 1990 THIS CERTIFIES that the building ONE FAMILY DWELLING Location of Property 425 PRIVATE ROAD #16 ORIENT House No. Street Hamlet County Tax Map No. 1000 Section 15 Block 08 Lot 32 MINOR Subdivision LITTLE BAY EST. Filed Map No. Lot No. 1 conforms substantially to the Application for Building Permit heretofore filed in this office dated DEC. 8, 1989 pursuant to which Building Permit No. 186982 dated DEC. 18, 1989 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 ONE FAMILY DWELLING WITH ATTACHED OPEN PORCH, BREEZEWAY T`he certificate is issued to JEANNE & DAVID BRAWNER (owner) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL 6/28/90--89-SO-111 UNDERWRITERS CERTIFICATE NO. N135021 JUNE 22, 1990 PLUMBERS CERTIFICATION DATED PECONIC PLUMBING MAY 14, 1990 Rev. 1/81 roans xo. s TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N. Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) N a 1 8 6 9 8 Z Date ....1.1..~~ .............<..,............,....,, 9. Permission is her by~g/rant~ed~° //~, to .. ~~........ .....::........ ... .....~. ......... ...., , '~ i~...~-r%. f..~,~~ ....... ............ ,~ ~... . ..:..... J ........ ............................................................................... ct premises ]vcated at .~.~~..:~ ~ ~Z.: .~d'~ ................................................................................................................................................................ Cvunty Tax Map No. 1000 Section .....~5.......... Block .....~............ pLot No.....3~'......... pursuant to application dated .......~..~.~1~ ................................. 19.~!., and approved by the building Inspector. Fee $../••,../..51Y,.-~j i ...~ . ........'........., .-LS.~ ...................... ~~~~~ iding I ctor Rev. 6/80/80 ~,,~ ,, ~'p ~ ~~~ ~/~ p IVU~ a~, a Ssys ~~ Form No. 6 Ol~n.I', ~, t-I , ~IQS? TOWN OF SOUTHOLD u BUILDING DEPARTMENT TOWN HALL 765-1802 ,*, ! 3190 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 17 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. For existing buildings (prior to April 9, 1457) 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. 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 S years - $10.00 4. Updated Certificate of Occupancy - $50.00 5. Temporary Certificate of Occupancy - Residential $15.00, Commercial $15.00 I ' Date ............I. I. ~ .`~. ~ .~.V, ................ . New Construction.... ... Old Or Pre-ex~~ sting Building.... ......... Location of Property.... ~~ .~ ....... 1.~~,~~~."~ . !~/~ ... ~~............~~4~ ~ ~ ...... House No. Street Hamlet lnwer or Owners of Property..~~v ~ Q.. ~.. :~~.~~~.~YG.VS ~:~:L~ ............... lounty Tax Map No 1000, Section...~.~........B1ock........A.......Lot... ~ ~ ............. subdivision ....................................Filed Map............Lot..............._...... 'ermit No.~~.~~.6.~.Date Of Permit ................Applicant.~o?~?~/e:h~s,l-~or; :;;~..Il~.tal rtvc-, lealth Dept. Approval... ...................Underwriters Approval.../..................... - Tanning Board Approval ........................ .equest for: Temporary Certificate........... Final C~tbtt~~......... ee Submitted: $......02..~.' ............... a~ 7 ~(7~ 90 Impron lnc 9aX S2o '/~~~ V ~ . .. . • • (<. LI71~j' 11971 ~ '~.~ ,y . 516.323-3527 f~" .. ...... ....., ...................... V .APPLICANT .• ~ `~:, ~ ~ ~• ~ o~ol ~apt- TOWN OF SOUTIIOLD OFFICE OP BUILDING INSPECTOR r.o. Box 72s TOtVN FiALL SOUTI{OLp, N.Y. 1 1971 May 23, 1990 Robert Reh1 Home Imp. 28545 Main Road Orient, N.Y. 11957 RE: .TEANNE BRAWNER To Whom This May Concern, TEL. 7G5-1802 We arc unable to complete your Certificate oL- Occupancy because of the following reasons. /~ An application for Certificate of Occupancy ~is not On file. (ENCLOSED) f ~// Please contact our office on this matter. Thank you for your cooperation. ~DIo Underwriters Certificate on file. /_/ rlic check is {m>ngl~tx~~~ffiXxiot on file.) S2s.oo //~ No flcalth Dept. l:pproval on file. /_/ No Final inspection has been made. Bui]di.ng Permit 1f 1 8 6 9 S Z Buildi.nq ept. ***/J No Plumber Solder Certificate on file. ( all permita involving plumbing being issued after npril 1,19II4 ) 4 THE NEW YORK BOARD OF FIRE UNDERWRITERS PASE 1 IOOIU'T1 BUREAU OF ELECTRICITY 83 JOHN STREET, NEW YORK, NEW YORK 10038 Date JUNE 12,149CI APPlicationNo.onfile 67867190/90. N 135021 THIS CERTIFIES THAT only the alee[rlcd equipment w dwcrt6ed 6eloto end introduced 6y the epp!lcortt nomad en the e4oos epplicsNon num6sr in thepromiaa of - DAVE BRAUNF.R, 425 PRIVATE ROAO, ORIENT, N. Y. In thefoBouinE locotion; ®Besement ® Ixt FL ®Ynd Fl. 6AR/AT'F .((:/OUT Sertion Black Lot ^ Kees examined on MAY 29, 149D andfound to 6e in compliance with tke reyuirementx of thu Board. HXAAB RX RANOES COOKRi8l1ECK5 OYBif 019H WA lXNAYST FANS OUTLETS AClES SW1T~ NGNaESCEM P1U011ESCMT OTHER AMT. K. W. AMT. K. W. AMT. K.W. M1T. R. W. AMT. X. P. 50 1 66 50 1 M1.8 1 1.2 1(7 F DRYERS RNINACE MOTORS FUTVE! AMLIANCE IEEEEK EreaAt LNCFi TIME CIOCK! Eel WMT WATERS MULTI.OUTIET OIAtALlRf AMT. K. W. OIL N. P. OAS N. P. AMT. NO. A. W.O. AMT. AMI. NAT. AMIt. TEAKS. AMT. N. P. ttO~~T AMT. WA7T5 i 2 F 1 ~ S@V14! DBCpMCT .. NO.Oe S E R V 1 C E wk. AAM. tree ;,e [VI ; f Av a x tw 7/ nv No. wi,,CONO. OP ~c cOi+D. No. oP N4Ita_- _- Os ~ ~I[ao NO.OP teNllAtE a ~~~ ~- 1 200 CB 1 % 1 d/0 1 ?/(t a oTWR ARMRATUS: ~ _ 3 TON. A/C UNITS-2 `s= G. F. C. I.-9 SMOKE DETECTOR:-2 - ~-. ~ _ 'C ~o G k 9 CONTRACTOR I.IC.S51AE 80% 215 _ SOUTHOLD, NY, 11971 'AAiI1NA08! ` 11 d'`;- in am manner; rNwn to the office-of IIrRoard if inwrrM. kK;oectors mtw bs ,= . ~~ ~ 1 ~~Ol \~. , rn TO1~N OF SOYTTIIOd.~ OFFICE OF DUILDII•IG INSPECTOR P.O. IIOX 728 TOWN HALL SOUTHULA, N.Y. ! 1471 TEL. 7G5-i 862 C E R T I F I C A T I O N rr~ Date rr/c~ /9~`~ Building Permit No. /8~6'9~ 2 Owner ~/911~ fJ ~ ~~`ya~rr~ w.RS~ (please print) P1u^..~,er~~rnirii, %/~~.~'i~iinrcr~/~~FN/~/T/rrr~ (please print) I certify that the solder used in the water supply system contains less than 2/10 of 1~ lead. Sworn to befor=2mc this day of /`t,/~,r~.. _~ 19, ycs tlotary hublic,eJi/C~~~~/C County umber's signature) No ary Public CYARBARA Si'FPNtlYJS@fl Notary Public, SteRe of N~a Xotk No.4SA4752 6uafified in Suffolk Couroiy Commtssictc Eupiroe tB.18~/ . .. IfUA: 1{ vv:`tMCNT~ LcLD ~:. . _... _~,. DUIIDATIO`1 (1y~) r`, OUtdDATI0IJ f 2nd 1 TOUGH FRAME & .PLUMBING ~iJSULATIOPI PER N. Y- STATS EPlERCY CODE ~. FI;IAL ~~ m a .. u H r, .. ~ ~~ ~I 1 • ~ -> -~c^ __ff m P ~ H ~. i f 0 Qi m x ~ ADDITIONAL COMME11T5: ~ c» ~ x • ro 1-1 A A O a ` a O d. 9 • b ~`.. ., c :: f~-iN2 suII.DINO D!~'T. INSPECTION [ ] FOUNDATION 18T [ ] ROIJ~iN PLBfi. [-~ FOUNDATION 2ND [ ] INBULATION [ ] FRAMINQ [ F1NAL G ~ ~~ ~ DwTE ~ ~ INS'~cTOI~~ ::_ __. _. i~GfY 765.18®2 BUILDING DEPT. INSPECTION [ ]FOUNDATION 1ST ( ] ROUGH PLBG. [ ] FOUNDATION 2ND [/i]'INSULATION [ ]FRAMING ( ]FINAL REMARKS: ~^-a-~~-~G-r..~.ai?~ c~'~c..... ~I DATE C~ INSPECTO _ ~~, ~: 5 i d ~~ '~: ~, 4~ ~~ 4~ ~. Il~ [:~ J ~ V 4~ 4_ ,Q `` a v .~.. J ; Q d q ~~{ q 4 W ~ . ~../ ri 1> cam.. °"- w wnn A i' ~u~O 4 .--+ ~.,,~-_ 7 N 1- ~ P ~ ~ '~~+ ~p ttW~~77 'rl P ~. '~9 cr ~ ~ ~+ O 4 p ~w ___-- _ ---- J ----' "'_`- ~~- tM I ~ r U~ ~. / ~ e~.$J 1~-! ., 5~' ~ W ~ ~~ ~ I ~I~ ~'~ M ,t II ~i t', 7 l ~Q 1 ~~ o~ r- ~ ~ ~ ~ `~~ 1 ~- _..--- ~d ~ ~ ~ ~ ; ~ ~ ~ ' • ~° H M "`~ N M i-~ Q 4 `a ~M~{ 4 ~ ~ ~~ ~ N+ V V WM.~ .'? J ~ 0° ~ 4 ~ ° ~ Q ~ ~ ~ ~ ~ ~ ~ ~ th~~: N~ ~~ 1t w.` 1111 ~ ~ ~ V 1,` ~ ~ ~ ~ ~ _ _ FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N. Y. 11971 TEL.: 765-1802 d ~?~ ~~ i 1~~ . ne ........, Exam roved ~0 /~ A 19~ Pe it No l~~O I 9~~ . . ......., pp rm .. . Disapproved a/c ................. .................... BOARD OF HEALTH ......~... 3 SETS OF PLANS ,........... SURVEY ..... CHECK ...... ~~~,•.•~ SEPTIC FORM ................ NOTIFY CALL ~J~l~I~ / /~/. //~/~~ ,( l ( ~ ~:~ MAIL T0: (B ding Inspector) APPLICATION FOR BUILDING PERMIT INSTRUCTIONS ~' ~~, ~~\~'j~~ll~, a ~~~~ ,~~i Date ...................15... 1 a. This application must be completely filled in by typewriter or in ink and submitted to the Building 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 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 BuBding 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, housing code, and regulations, and to admit authorized inspectors on premises and in building for necessary inspection~s/. i .... ~0~ ^FHC S l~a~fi //~+®Ro UF.hEw7T /.v(°, (Signature of"applicant, or name, if a corporation) ' (Mailing address ofapplicant) /~9Si State whether applicant is owner, lessee, agent, azchitect, engineer, general contractor, electrician, plumber or builder. ...................................................................................... T1-~l~ltiG~ ' Name of owner of premises ....=E2.... ~./1'h't~rv,Fee ............................................. . (as on the tax roll or latest deed) If applica t is a cot or tion, signature of duly authori ed officer. / / , (Name and tyt " of corporate officer) Builder's License No. ... ~.3 a .7 ~ f'~.L Plumber's License No . ....................... . Electrician's License No . ..................... . Other Trade's License No . ..................... L~ a ~ ~~~ (~ n ~"~ / ~ O~ l 1. Location of land on which proposed work will be done. . ~.°. 7- ~_ ~~ ~'~~©Q~~'-'1~a ~(s/U~~~'°"' rrF ........................................... L,7/ze ~~Y ~aTNTiL'S os~/.~',~'i ..................................................................... House Number Street Hamlet County Tax Map No. 1000 Section ....., .......... Block ....... ~. , , , , , , , Lot ......-. - Subdivision .4 l'!-T.4~....~. f.`3 r.....~ `~~~ 1.~, a .. Filed Map No, , , , , , , , , , , , , , , Lot ...•.-~-:~:..... . (Name) 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existin use and occupancy /////~ L°/~^iT LuT' g ......V ......................................... .......... 1 ....... Intended use and occupancy ........ ~!/~C ~ !'~ ~ AuP/~11~M ...................... ,app....... ....~t,tt+erma6 emal` Nature of work check which a 3 Re air ,, , , , , , , , , , , , , Rempplicable): New Building ..~... Addition .......... Alteration ..... , ... . p ( oval ..... . ........ Demolition .............. Other SVork .............. . ,gY ! (Description) 4. Estimated Cost ..'!. ^.r~. 9_ S ~ boo ....................... Fee ..................................... . ~, (to be paid on filing this application) 5. If dwelling, number of dwelling, units .... A. "•: °~ ..... Number of dwelling units on each floor .. ,vni~ If garage, number of cars ... .................................................................. 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 .............. . Height ............... Nurjtber of Stories ............................................... . ........ De th ... , ith alterations or additions: Front ................. Rear ................. . p ..................height ...................... Number of Stories ..................... . imens~ons o same structure ntction: Front .... ~ ~ ........ Rear .... ~~~....... Depth ..°f,~'~......... . fi, $ Hetghtsions of en tre new c 8urtiber of Stories .... ~ ~S... , ...~ ................... ........... , .... , . , 9. Size of lot: Front.......°~ ........., Rear....3ka .............. Depth .a,(~.:~:!l......... 101. Zone or usecdistrict in which pr ~ ~ • ' ' ' ' ' ' • • • Name of Former Owner ............ . ............... . emises are situated ... ~fS~;OitwTiq ~ ..................................... 12. Does proposed construction violate any zoning law, ordinance or regulation: .../.~!D .......................~ ...... 13. Will lot be regraded .... ~/.~? ; , , . ..........Will excess fill be removed from premises: Yes 14, Name of Owner of premises /J%9.V10 , .~{,+Aa.v,~.e, , ,Address !$A'"'. Ra: , okrs.~r• phone No, $Z3-.?~P~ .. , . Name of Architect ... .Address .... .. , ....Phone No. . Name of Contractor .~Q96.. X~H~ ... . ......... .Address !y:"~!;~.~F'c • a!;rF:W:~. ,Phone No. 3, $ 3, ; 3Sd7 15.Is this property located within 300 feet of a tidal wetland? *YES.~°.a`.NO.l~ *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 property lines. Give street and block,number or, description according to deed, d show street names and indicate whettler interior or corner lot. i ,3~ ®r i , S ~ && ~ t I ~m_~ /~ T ( \ h ~ -----/ ~-~~-_.~_- ~~j aka S 4 G' ,~. _ ~ l~ ( K 1-d a ~d tr i ~ v ,~o , e _,,,.. .Sd ~ GjifyT d~ ls.4y STATE OF NEW YORK, I~S.S COUNTY OF ................. '•••'••••••••••••••••••••••••~••••••••••••........ being duly sworn, deposes and says that he is the applicant (Name of individual signing contract) above named. ~ He is the ..................... I .... ............... (Contractor, agent, corporate officer, etc.) of said owner or owners, and is duly authorized to perform or have performed the said work and to make and file this application; [hat all statements contained 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 filed therewith. Swom to before me this ......................day of ~~r .~-~~C~Ck-Q'.-:--..., 19 .~~ _~~,/ Notary Public, ... ~~~:`':"^.':--,~• , County ~ ~ ~ ~~~,~ . %ti.~~ ~ ~'~` ~, ~', • ~ (Signature of applicant) '~ .NiM 1 F~z ~~4 .~ , .r ~i ~.. .. ~Y4~ y~ .~.~ i' ~. .~ _ ~ ~ r. ~ ~~ ~ avn 7 r:T:rn ~. ~.~ z _: ~• .:~ a l C. .i. ~. L [? 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