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HomeMy WebLinkAbout18705-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No Z 19434 Date OCTOBER 10, 1990 THIS CERTIFIES that the building ADDITIONS 2040 JACOBS LANE Location of Property 6360 NORTH BAYVIEW ROAD SOUTHOLD House No. Street Hamlet County Tax Map No. 1000 Section 79 Block 7 Lot 1 Subdivision Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated DECEMBER 14, 1989 pursuant to which Building Permit No. 18705 Z dated DECEMBER 22, 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 ADDITIONS TO EXISTING ONE FAMILY DWELLING AS APPLIED FOR The certificate is issued to CARL F. HOLTHAUSEN JR & WF (owner} of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A CERTIFICATE NO. N 122810 APRIL 9, 1990 PLUMBERS CERTIFICATION DATED N/A uilding Inspector Rev. 1/81 goaas xo. s 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) Na x.8705 Z Dare .......~`~~ ~ ..,, 15,~,/~ Permission is hereby granted to: " ' ,~ ~ /~~~~^~ ~'~" ..~.ee~~Q......G........~ ..~ ....... 'f/~'' to .~~.~..... .. ~ .........:°.~~ .....e....~~` .,~ .,. .~,~- yam/ ct premises located at ..~.r,~.`a..~.......~./ ........ ............. .~~'/.r....1.~,.`/..~................,........,........... County Tax Map No. 1000 Section ............ ~%~. .. Block .......r~........... Lot No . .............~....... pursuant to oppllcation doted ....... / ../..~.,~„(..~~ ..... ........................... 19.cF~, and approved by the Building Inspector. i Bp Fee $4%~~ . ......a.. ..., .1~i.L_ ................ Build I ect r Rev. 6/30/80 Jp~. ~ i ~ vs~~ F ~~/ ~{" r°' f ~ i ~dyp-lam ~~ms~ ~ s x d ,- ,~tp ~ 3 G`a5~,:c ~~G~~pdSa /~~yk3 ~ryat- ^~` ~ P ~ `i cn c~. P J .n a , "~ - J te ~ ~ ~ ~ Hl y ~ V '~ lt, "a ~.~ ~ T_ ~ T I ~ Ga m J f~ ~ G ~ M h}M p p e N \.`t ~ d Cn V,+ '~ ~l '`y \\4 ~\ ` \V~ 1' ~~ 0 ~ ~ p ~, ti -'' ~- ~ . J ~ N fd 0. H b 0 ~ ~ Z r.~ h x: N `~ ~ ~ ~~ ~~ ~Q~ryftai,~a n~k-~' f !~ v t ,. asf9o ~~~~Gt~ ~~C7'vrn7~DF~ e e p.~~M '" $¢ss' P 9' N 0 A ~/ .+ ` _: ___ - - ~ ~ a :,~ I ~ ~ +~ rte ~~°~ "` TM ~ . ~ ~ ,~ ~~ v N ~ ~ ~ ~~ °P A A N ~' L m C.a. ~ 1 n ~ ` q \ ~~ 4 h ~ ~ ~ „ ~~ ;a ~ C ;e w p~S r y` , V - ._ ~ r ~^'~ rQ ``(( L ~7 X~ C~ A i • \. b.~ ~ h Q o a ~ b ~~ ~ ~ ~ M # t, ,~ ~ w b °y 4 j (,s `~ J~7os~ z ~. - ~G..91 c:, T ~ ~~ S X '~ 9 d~ ,foN• ~~ ~ ~ A d 3~O ~av~P`r~lma' //97r ~~~ cf0 ~f 3 / e!$Ai2~ ff\ P7 per` \\ f .C o~~~~ a ~~ +t ~~ h THE NEW YORK BOAI~tf3 OF FIRE UN`D~RWRItERS rncr 1 i (11111 / 4 4 BUREAU OF EL,lCTRK:ITY R+6 JOHN STREET. MEW YORK. NEW YORK 10030 Date APNTi. f;9, 199(1 AppUcotienNo.onfiie ('789Y09U/9CI N 12;'RSU TYIIt RYOTIf16G TYaT w only the eketrlcal putpment w deecrf6ed 6sbto and int roduced by the ep'Beatlt named on the a4oes aprBcatian num6sr in the promiwe of Q' ~ CANI HgIIHAUSF:N, NONI'N NAYVCi'.N N11., sgUi'HULp, N. Y. in thefoiloleinR GTCatian; ^ Basement LJ iAt FI. ^ 2nd F1. 9N'Eion Block Lot uw examined un MA12CH 1, ), (4911 ondfound to 6e in compliance TRith the requinatente Of thL Board. tiRTIN! _ TURK QUTIRK ACTRf i~~f INCNIeltClaT nuaxtaur - - Dlgft ~ WASIIKli R1iN;-IIST lA11f OTMlR NAT. R. W. MIT.. R. W. AMT. R.W. AMT. R. W. AMT. 14 r. ~ T(1 3 3 ORYRK R1MUIq MOTOK ttl11NR MlIIAN q RiiNi MCf1 TIMl CkOC1If My MIR:RgTKf MIIlT1.0UT1lI ~ DMIAIRRS AMT. R. W. ql R. r. aAS X. r. AMT. NO. A W. 0. AMT. AMI. NAT. AMrb. TRlltq. AMT. n r. ~ ~ T AMT. WATTS lMVICi OIfCONNRCT NO. tle f ! R V I C ! - iC ~ AMr. AMr. Trrt RO~IN-. 1.! tw ; A tW t.t tW R / Aw n0. a c. Cg10. - ~a, ~ ~ . n0. q RFlto 0i w~ uo. a murRAU p ~r EU1RAt ------ -- ~ - -- - -- - -- - - 16 ~ ~ - - - I I I s WCKTNf, I`UN A11D1iTON i0 1'XT.`il"1NG 1 RTCtiAitl) G. Hf:,4Yi-:A P.U. BUX 372 1_AI1NE1., NY, 1194N _~_ ~~ ~ 1 [I;. g2148••E ~ >v . r r ~,;~f ~ j ~kTlMW11NR 11 - n_ Plx-- RTYA rlw ba ohend in anv 1lwoner, rNwn N, +a Form No. 6 TOWN OF SOUTHOLD ~( /~ Q(~ {' 7/~ _ l~~ J~~ BllILDING DEPARTMENT V4t' Q~""`+ `'llJ~{ (fl // TOWN HALL 765-1802 .,~j~ ~ BLDG. DEPT. ~/~ ~~ ~ YOV~lN Of- S!3tJ"fFaOl.D~~ ' ~ APPLICATION FOR CERTIFICATE OF OCCUPANCY "~"°" '"' .\. This application must be filled 3n by typewriter OR ink and submitted to the building inspector with Che 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. 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. 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 o£ 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 dwellin $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 Updated Certificate oY Uccupancy - $50.00 , 5, Temporary Certificate of Occupancy - Residential $15.00, Commercial $15.00 Date ... ~~.~.'.~.~.. ~~. t. l9 ~'.'~ ................. ::ew Construction....../..... O~l/d Or Pre-exi/s~ting~Building.. .. Location of Property.K~.'~'•~of~/r0.~.~1~/~1.i8.°'!.'~C9.1,~y'k:9'.:QfT~j~/AcoBS~.d,v~ ,.,;.~'F1dTffvt,'a House No. Street Hamlet••~..~ .••••• Onwcr or Owners of Property.~fai?~::~:.~y~R~AL~f1'.~~fr~.~~~:jjftUS.4!1~ ......................... County Tax Map No 1000, Section.... /.~......Block....../..........Lot....l ................ Subdivision ....................................Filed Map........ .Lot... .... .. ':... ... .. ~Mra! .~ 6~~c G ss~.rro.¢'a Permit No.~~~~?..:Z....Date Of Permit.' ...............Applicant.....~°A~f~.'::~!!~4T,f/tdvs~iV ({ealth Dept. Approval ..........................Underwriters Approval....................,. ' Planning Board Approval ........................ Request for: Temporary Certificate........... Final Certicate........... , ~^ ~ Fee Submitted: $,~`a,~-;';,,,,,,,,,,,,, .... ~ ~ , co `~ 1 `+~(3Y L,~f j~ APPLICANT to ~ ... ~~~ °~' ~~-~8®z BUILDING DEPT. INSPECTION [ ]FOUNDATION 1ST ( ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ]INS TION [ ]FRAMING REMARKS: [ fNAL DATE Y ~~3 / 1~ 1 1 ~~~~ 765-1862 u BUILDING DEPT. INSPECTION [ ]FOUNDATION 1ST f ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ]INSULATION [ MIND [ ]FINAL REMARKS: ~~.~...P_ c~' ~---• r DATE ~` CP (, INSPECTOR O ~©~ 765-1802 BUILDING DEPT. 1 NSPECTION [/j OUNDATION i5T [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ]INSULATION DATE ~ INSPECTOR ~'~l [ ]FRAMING [ ]FINAL REMARKS: _~ ~z~~ `~. ' 1:.~.D ,, ..ti .:. .:.~:.• ~f 'Jn. I~ ~.v:YMLNl.:. _\ I a ~ ~r p ~ '~ \ m ~ . R W ' H 'OUt1DATI0:l ( 1st } ___. +~ ~ ~ ~ _ c ~OUtJDATIO;J ( 2nd 1 _ - ~ ~_ o~ ' OUGH FRAM I ~' o . , E & .PLUMBING / y `~ 3 . . I1ISULATIOPI PER N. Y. I ~ ~ STATE ENERGY ~ CODE . ~ y '~ • .~ r M ~ ~ n FZIIAL ' •~ o ADDITIONAL COMME11T5: x~ • m x F •n ' ~ H 9 ~ • 9~ y H ,~ O ~ m • a r e • j H ~'` b ' ' ~-7 a ~~ IQMMOi,~~ M.aNG" I ~`,t~ID/It/¢ ~ ~ C~ ~~ ~ v' ~ © r `~~~~~~ /~9 s z d-- ~!.- Ol ~ T" S~x~ /hlct vas C'~'y`~,nNvY 2v.e -- ~,~\ y VI ~ `_I ,~ O a s~ ~ ~{ w ~ ~ ~1 r ~ i'i ~ C s~., ~~~ D ~ n N `~ z 9 oayX'. q '~. ~ ~ `C" ~ ~ ~ 't ~~ ~ ~ ' ~ ~ S, f lv ~ f ~ ~ r ~~ -- --~ ~ _ ~~/ 0.. 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'_-1 `% ,. `, I !=, -°~ 9 -- ; ---. ,/ I t ~.~~~.n/f~ ~ J 3°I u• ~ L, ~ J i % t ~~~+ C% 1 f/ ii~A) tc-~fy 1 .1 1LsA~ \ t \ ~ ~,[, ^e .J ~~ ~ C r -- ~~x~xz ,~~~_. r-„~~ ~°~ -~~ ao~= v Z~/ k / SAO /j ~_ ~ ~ , t i ,.. -- ;I ~' ;# ,} ~~;1 ~,, ~s '''r ._~__._____. ,1 `~ ~0 ~r ....~...._..._._~ 7 ra ~- - - i ,. :~ x 12 <~ ~- • c rr-' ~ ~~ ,~ s 5 ~~ ' r~ y ~~ ,- ~ rT Ex~s r~~v~ ~"/.~/S~L,.Rf9 ~ !s~nznc~ ~ ,fi~rrerr7oc~¢ - G~enc.' S1 D~ a 'tn/S~t iz ~ nr ~_ ;n. ~~ ~• ~ ~ ~ ~ A ~ ~ CAa ~ ~ H C ~ V % ~ $. ~ ',l ~ ~. ~ a G c ~~ W wQ y~ ~~ ti Ca 8 t, C `1 a ~ c r W r S .~ ~~ i 3 ?~ ~ 1 ? Q~ ' C* s ~ x i ~~ ~a ~ i i x ~ h r .. 3 C7 Yi i 1 't ~ L?rre~~o~th~~~ ' ~ 2' d, i L" L9S ~c.C• 1 s i 1 1' ~. i i~ ~```~ ii i FORM NO. 1 TOWN OF SOUTHOLD BUILDING OEPARTMEN7 TOWN HALL $OUTHOLD, N.Y. 11971 TEL.: 7G 5-1802 Examined .%`~/~~~~......, 19 c~~ Approved ./~.2-~......., 194y Permit No. ~~70 u Disapproved a/c ..................................... BOARD OF HEgLTH ............ 3 SETS OF PLAN.:! :...... SURVEY .......... ........ CHECK .........I~ ......... SEPTIC FORr1 ................ NOTIFY a 7/ J~<~r', CALL .../.`:~ .,,., MAIL T0: .............................. ~~ ~~ ~wr ~u' ng Inspector) tOWN OF SOI~~O! APPLICATION.FOR BUILDING PERMIT Date ...~~: / ~~~..... „ 15d .g INSTRUCTIONS a. Tltis 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 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 shalt 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 iemoval or demolition, as herein described. The applicant agrees to comply with all applicable laws, ordinances, building code, housin; code, an reg ions, and to admit authorized inspectors on premises and in building for necessary ipppec(,ions. h ~: ~ pplicant, or name, if a c~rporauon) (Mailing address of applicant) State whether applicant is owner, lessee, agent, azchitect, engineer, general contractor, electrician, plumber or builder. Ulu--~~2 ..................................~/.............................................................. Name of owner of premises G'R!~~. f..U_.o1-TNft'l-~ sE~ j~ ; _ ..~R2C3/~2/~ .LEE.. , , J~!o1.7NF1~ISL- ~/ .... .............. (as on t e tax roll or latest deed) If applicant is a corporation, signature of duly authorized officer. .............................................. (Name and title of c~o1rporate of/fi/cer) Builder's License No. .~'/.-~'.~...17~~:......... . Plumber's License No. .......' ................ . Electrician's License No . ..................... . Otl~cr Trades License No . .................... . 1. Location of land on which proposed work will be done; ~o't~ p ~u,~, ...........~:-/~,~0........./I/. ~AYteIE!~..o'2~... ....d~~..,:?oyTl-IoJ-L~.......... Ifouse Num bcr Street. ~ ~ " " " "' Hamlet ~/ County Tax Map No. 1000 Section .7 9'. ~ ~ ~:o• ~ • . BI'ock .................. Lot .. f 6 ........ , ` , , Subdivision ............... .............. Filed Afap No. .............. Lot ............. . (Name) ~ ' '-. State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy . Z 1,//:':.~:...Qv/~r~~~2 S . ......................................... b. Intended LI /1 //~ '+?j v ~:~ ~~JE'f use and occupancy ... .... .. ... .... .......................................... 3. Nature of work (check which applicable): New Building ..... , .... Addition . ~...... Alteration .......... . Repair ... ....... R~mova+ .............. Demolition ..............Swimming pool........., , , , Tennis Court .....^~... Accessory Building..........Feilce .......Other Work:........... ~- fi/ 4. Estimated Cost ...... , 17).a 0~ ...................... Fee ..................................... (to be paid on filing this application] 5. if dwelling, number of dwelling units ............... Number of dwelling units on each floor ................ . If garage. number of cars ..... ~ ............................................... . ... . ........... . • 6. If business, commercial or mixed occupancy, specify nature and extent of each type of use ..................... . 7, Dintcnsions of existing structures, ~f any: Front . ........... Rear ............... Depth .............. . . Height^~r„°rs,.,. ,,~pr'I°~'*s",..,rt.;:... Number of Stories ....................................................... . Dimensions of sarri'e structure witl~~ alterations or additions: Front ................. Rear ................. . . Depth . ...... ....... ~ Height ......................Number of Stories ...................... . 8. Dimens~bl~ew constntGtion: Front ........... . ... Rear ...............Depth .............. , , Height ............. '.,~9umber of Stories ........................................................ . 9. Size of lot: Front ............:......... Rear ... .................. Aepth ................. , ... . . W. Date of Purchase ...:.;...... ............... Name of Former Owner ............................. . 1 1. Zone or use district in which pmtt}ises are situated ................................................ . .... . . 12. Does proposed construction violate any zoning ]aw, ordinance or regulation : .............................. . l3. \Vilt lot be regraded .. ~:~~: S...', .................. Will excess fill be removed from premises: Yes ... ; No%~ 14. Name of Owner of premises . , , lii,'~~-?H1 uSt"f.... Address !:~Q~.`~.'~~~:`~!f'r( .....Phone No. ~6~.: y°`~3 , , , o Name of Architect .. ... ' ... ,Address . ... ....Phone No... .. Name of Contractor .J,'7~k'~ !~~,~Si9k'~.: ...Address .~~'.':~~6:: !ayE.. ..Phone No. 369".~`~6 ~ .. IS.Is this property located within 100 feet of a tidal wetland? *Y1:S...~NO~. *If yes, Southold TownTrustees Permit may be required. PLOT DIAGRAM Locate cleazly and distinctly all buildings, whether existing or proposed, and, indicate al! 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 comer lot. ~ ~ 1 ~~~ (~~,/~°~5 ~ Sz112>/E~ • STATH OF N \V YORK, ~ S.S COUNTY O ..... . ......-:. .°.?"~ ,-s~~........... being duly sworn, deposes and says that ha is the applicant /~~~ d' al si ding contract) ., about namdd: (Contractor, agent, corporate officer, ctcJ of said owner or owners, and is dully authorized to perform or application; that atl statements contained in this application arc work will be performed in the manngr set forth in the applicatiat Sworn to bciore meot-his Notary Public, ...... ~~'~-~1?! ./.;~•.. ~~. Y~... HELEN K DE VOE N No~4701819, 3uftulk CduniY~ork~ Term Expires rykrsb 30, t9.-.~•t have performed true to the best filed therewith. ........, 19~/. ... County the said work and to make and file this of his knowledge and belief; and that the (Signature of applicant) O m~ OZ o ~ ~~4~~0~°~~ to Imo- a, ~u ~ Q ,~ U ~" ~; ~ ¢~Y~~O~ ~~m ~ ~'Q~~o Q~ O ~ I l+~ ri `\ O ,,~I. mil ((~~~ `L1 ~ N ~ 4 ran J ~11.A o 8.88=;~ s --=-~-- ~l i~ Y6 ~\ 0 ,~ ~ ~ ~4 ~ ~o $d / r~ ~~ "- "' ~ .rY`l~ ~,..~- ., bra mN', ~~o /~ Z 'y ~oH~s'%N O Gaoo ~a~ "°oa Nb~ ~ J/ .4 L ~~ w - b p, 'n q1C ~~ M~ Ywo Yl' N/ ~~3 ys por 4 .~, j N m j ,_ a ~ ,~ .~* i ~~~ S,b,~ ~`\ ~ ' b 1y~d\ ~o T "'..~ ~''O a ~ a' A Q' ~9`a N v z o q ti i ooh m~aZQ ~_°° ;~ ~"3~'O 2WVZ2 pp ~ Wq2~~~ ti h ~~~~ U~QI~-Ua~q ~~ y .` ti~ a i~ s m°' , ~~ ry~~ rn a d z ci 1 Ci 0. vi v; ~~t 88t a~ N ~ I ~~ g0 ,f h• '~ ~~ ,~ ~~ bry LJ n ?: 2 Q• dD i QO QO ~~ a 00 ey -~ 3 ~ O~ °Q ~~~~ ~~yo~ S~`!oe v~¢ao °a~&.". ~$O O ~Q 4 2! y,~ p `uiC y.~