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HomeMy WebLinkAbout18152-z J ~ 1 FORM N0. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No Z-19594 Date DECEMBER 19, 1990 THIS CERTIFIES that the building ACCESSORY Location of Property 25825 MAIN ROAD ORIENT, NEW YORK House No. Street Hamlet County Tax Map No. 1000 Section 18 Block 3 Lot 15 Subdivision Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated MAY 22, 1989 pursuant to which Building Permit No. 18152-Z dated MAY 31, 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 DETACHED ACCESSORY DECK & INGROUND SWIMMING POOL & FENCE The certificate is issued to DONALD BRINKMAN (owner) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A UNDERWRITERS CERTIFICATE NO. N-093827 - SEPTEMBER 28, 1989 PLUMBERS CERTIFICATION DATED N/A uil ing Inspector Rev. 1/81 r~oaas 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) ~ ~ ~ ~ ~ Z Dote ~ 19. Permission is hereby granted to: . at premises located at ~.t!.L........ ` ...............................................~G~ S~ G~11~~.................................................................................. ..........................................................................p..................................................................................... County Tax Map No. 1000 Section Block Lot No......lv~.~....... pursuant to opplication doted : S/.~-...-....../ 19.~~, and approved by the Building Inspector. ~~G 'S/2 ~ / Fee $...i~..;:.,~~.'.°1...,~4,^ /O/ .Soo / .i, ,,,,,~~~.~„"-7~.~....... B dingtor Rev. 6/30/80 Y Form No. 6 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL 765-1802 APPLICATION FOR CERTII'ICATE 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 coith 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~~$1I15.00, Coommercial $15.00 Date . /~iC~Ci. ~~,.~.19.~ New Construction..~~~,~ Old Or Pre-existing Bui-lpding..... ~b0(/„ Location of Property...........~1lk.LYJ..~::....~.~.1'~[E~ House No. 'I, Street Hamlet Onwer or Owners of Property..~~[~,!pp~~(~y,~(~,~~,,,~Q(\,~~p„g~(~t{~/q,,~_,,,,,,,,, County Tax Map No 1000, Section..~~Fl.......Block..~............Lot.~.~ Subdivision ....................................Filed Map............Lot...................... Permit No v „Date Of Permit ................Applicant............................. Health Dept. Approval ..........................Underwriters Approval..V~................... Planning Board Approval Request for: Tempora-~ry~Certificate........... Final Certicate.... Fee Submitted: $...LlJ4~/50~ Q C 6 ~ t ~S 9 ~ APPLICANT . ' I ~ THE NEW YORK BOARD OF FIRE UNDERWRITERS ~ 119511? fT~1vT~ t i ~ BUREAU OF ELECTRICITY 85 JOHN STREET, NEW YC?RK, NEW YORK 10038 Bate sr~hr>>;r~~r;x 2t3,l~1&N ~~~~a.3s~ls~ ~ 09.~~~~ Application No. on file THIS CERTIFIES THAT ~ only the electrical equipment as described below and introduced 6y the applicant named on the above application number in the premises of i)AV317 Al2.CNKN1A1v/ht. ?~tFLNRQM, Ti?S~t~7 Hh~, 1,IS,Ct1~-:l97, nRT:1~19T, ta,Y. in thefoflowinq lacati~n~ ~ Bas ent ? /st FL ? 2nd FT. lll'1T ,Section Block Lot waa examined on ondfound to be in compliance with the requirements q(this Roard. FIXTURE ECEPTACL65 SWITCHES FIXTURES RANGES COOKING DECKS OVENS DISH WASHERS EXHAUST FANS OUTLETS INCANDESCENT FIUORESCENi OTHER AMT. K.W. AMT K.W. AMi KW, qmi. K W, q,Mi. N.P. ~ > z 1 DRYERS FURNACE MOTORS FUTURE APPLIANCE FEEDERS SPECIAL REC'PT TIME CLOCKS EELL UNIT NEATERS MULTI-OUTLET DIMMERS AMi. K. W. Oll H. P. GA$ H. P AMT. NO. A. W. G. AMi. AMP. AMi. AMPS. TRANS. AMi H. P SYSTEMS AMi. WAIIS NO.OF FEET SERVICE DISCONNECT NO.OF S E R V I C E AMi. AMp. LYPE METER 1 q 1W I ,6' JW 3 A ~W 3,e' 4W NO. OF CG COND A. W G EQUIP. PER 9 OF CC COND NO OF NI-LEG OF NI ~IEG NO.Of NEUTRALS OF NEU1RAl OTHER LAPPARATUS: t9~d'~. 1: `.f x(STX~15?RTP7G k't~t7TlA Phis aerti~fi~;-"rJ~C3 ctavF:rs ctTtuplilnrn at i.he d~P¢> oA iDSp~cClr~n, e+nlY. }l~ravlse; s7f az~ttt;u~l env.i.,rtJnluenfi.s i,l :i,s ~aclv:isal/7~ to hav>, krngit~tti: ~k;est an<tlnr ra>1?nYr.H ride by a +~Ika-IiPi~i# }~~r;~on, SAGS & 1rADk~MAi9Y1 T'NC. T,:C<`.~~63S-E ~ P.f9.6t>X .271;8 sc~~rrxf>(~nr ~Y; a1~7~ GENERAL MANAGER 1. J. Per This certificate must not be altered in any manner; return to the office of the Board if incorrect. Inspectors may be identified by their credentials. COPY FOR BUILDING DEPARTMENT. THIS COPY OF CERTIFICATE MUST NOT BE ALTERED IN ANY MANNER. ~~FF~~kC ~ TEL.7G5-1802 O t , OG~; TOWN OI' SOUTIIOLl7 w~ ~ 0I~[~iCE OP BUILDING INSPECTOR u°~ Jr., rxn P.O. BOY 728 cs? vti~ ~ TO1VN HALL yf/O! ~ SOUTfIOLD, N.Y. 11971 To 69hom This May Concern, ` We are unable to complete your Certificate of Occupancy because of the following reasons. nn application for Certificate of Occupancy i:; not on Lile. ~~2c-e?d~e~.-. No Underwriters Certificate on file. The check is- /not on file.) ~d5`. as No tlcalth Dept. Approval on file. N~ final i.ns,pection has been made. Please contact our office on this matter. Thank you for your cooperation. ~~.~p Buildin~t Permit 1 ~ ~ S ~ Z 7'Y/an.~ I3u.ilding Dept. No Plumber Solder Certificate on file. ( all pcrmit-s involving plumbing being issued after April 1,1984 ) b m a \ i ~ G~ _ _ y ~,1 ourJDaTlorr , c 1st) ~ ~I JUNDATION m (2nd) - - - Z 0 OUGH FRAME & ~ CCC>~P, PLUMBING y ~ \!S [T] ' rJSULATIGrt PER N. Y. y STATE ENERGY \ CODE Q.. ~ H dk~ ~ O lI FI,JAL ` ~ ADDITIGPIAL COMMENTS: x . ~ ~ ~ o _ a i7 0 ~ x ~ H \ O d m a ' r \ S • _ y 1 b m ,v y a ~~~~ti 765-1802 BUILDING DEPT. INSPECTION [ ]FOUNDATION 1ST [ ] ROUGH PLBG. [ ]FOUNDATION 2ND [ ]INSULATION [ ]FRAMING [~NAL REMARKS: DATE ~ PJ INSPECTO ~ ~ 765-1802 BUILDING DEPT. INSPECTION [ ]FOUNDATION i5T [ ] ROUGH PLBG. ]FOUNDATION 2ND [ ]INSULATION [ ]FRAMING [ INAL REMARKS: d ~r L7 DATE ~a 7 U INSPECTOR 1~~~~~ 765-1802 BUILDING DEPT. i NSPECTION [ ]FOUNDATION 1ST [ ]ROUGH PLBG. ~ FOUNDATION 2ND [ ] INSULATION [ ]FRAMING [ ~NAL REMARKS:~~®~-`~ i ~ PaAL r~~~ ~u.v5-; >,t~'"i c;l~ C1 of Fr,~l~~' ~C1~~ C='fLAwt C~;~vrvlj AI~~ ~ S 5 i'ta2s~t~G ~L2 ~t2rA~t~kC~ Tc~ i' g t o ~"t~ wt , DATE ~ ~ _INSPECTOR~`" . _ , _.........a.~..........,. . ~ ~ • • ERE aqx Sf~m~ ~,g"'i 4. Ji ,p. qqg ~ _ ( ~.~c~ 3y03 5$~3 6uP~ ~ ~ ~ ~ f,f c~~ Y °u7x E Nn Q (1 i ~ U~ fi ~]E ~ m_v~ m5.'i x ~ X11 ,,1` m Y' S ~ ~a_ w w;',~ \ ~,9~~'$®jy' to r I ~ v~ ~ ?ih'~ • ` `Q ynnyl, (j{ ~ ' J . ~~.1y ~ i 1 -7 r p, 4 s . ~ ~i i p r t, row ' , « ~ ~ ~ ~ ~ ~ ~ ~ zG1 I p ~.<.Y.dp, ~ - ~ ~ - ~ ~ ~ _ `fI ~ O _ ~ ~ . ~ q acv . • .t y. t x,. .2 .G `ti ~ ~fi 0.A 2 ' j ~ i I ~ ~ C s Cr-nss Section Deck Cnnstruction~ , Fi c~t7- l Y.ic~rr' 2"X 4" OR 2'X 6' CEbAR DECKING C 2'X 6' DECK JOIST "'Y..,, 24' ON CTR I 2'X 8' GIRDERS 7'00' ON CTR. 4'X 4' CCA POST T00" ON CTR. TYp. _ 000000 0000000 0000000 00n0000 , 0000000 CONCRETE PILLAR 4' BELOW GRADE 0000000 000 O 0 000 ~~O Oq 0p00 ~.~1C1'_ B VJ{~ f}. C . l 2'X 8" CCA GIRDER 7'.00' ON CENTER TYp, A r 4'X 4' CCA POSj 7'.00" ON CENTER TYp. ' CONCRETE PIER c 4".00" BELOW GRADE TYP. BOARD OF HEALTH . D ~ a ~ 3 SETS OF. PLANS•:;:::::::::: FORM N0. 1 SURVEY qq TOWN OF SOUTHOLD CHECK ~~6~ BUILDING DEPARTMENT SEPTIC FORM TOWN HALL gLpt-,,pEpL SDUTHOLD, N.Y. 11971 NOTIFY TOVIINOFS2OUTHOLDG TEL.: 765-1802 CALL Examined ~/t~?~`.~.. 0.~,,, ]9,., MAIL TO:~ Approved ~!/.~J,/d'f 19 Permit No. ~~:J~?~`~ ~~~~i Vl ~©ol Disapproved a/c I~~- md~~k ~J ` ,,('Building pector) '~IMIlIIEI~IA7ELY APPLICATION FOR BUILDING PERMIT ENCLOSE POOLTO CODE ' UPON COMPLETION m~~• • - .BEFORE "WATER" Date 15~g INSTRUCTIONS , ° a;;gauilt.;H E.IltFalt4< • bYe~?. his; it1;O43'r!9fil`E ~C3B ' ~ f fj7 di i-` i 5 F a. This application must be completely filled in by typewriter or in'in d C'~~~m~ e,~ ~dl~~d1~~~~ Inspector, with 3 - sets of plans, accurate plot plan to scale. Fee according to schedule. '°~`f`8"` I'` ` t~a F t b. Plot plan showing location of lot and of buildings on premis0s,,relpti~ris~ti~ T~ ~l mg piernlSles or public streets or areas, and giving a detailed description of layout of property must be'" drawn' on ~t~~ i gz htc s part of this appli- cation. . t.tF,c,~~3trwt:P.t~a,~, c. The work covered by this application may not be commenced;be'~ "'f f" u}{~~'e ,,.'1 ~ a. p pproval of this a lication the Buildin Ins ector will issu~~~~~i~~~ d. U on a pp g p €~:~~a ~ ~'~~t" •~flie~ap~plicant. Such permit shall be kept on the premises available for inspection throughout the ~'orrk'. e. No buildin shall be occu ied or used in whole or in art fora `'Ria1~31Oy~ ~ ~ ~ E~D g P P z+~)'4~~J~~~.pk~'~~~Cvll a ertt tcate of Occupancy shall have been granted by the Building Inspector. '•;a;, I'~ ~ 8 ~~L APPLICATION IS HEREBY MADE to the Building Departmentpfd~i~~ ` ''.Merit pursuant to the Building Zone Ordinance of the Town of Southold, Suffolk County~~ew York, and or applicable Laws, Ordinances or Regulations, for the construction of buIldings, additions or alteratioy&„SZr"Ybf"I~iPi~'0~1$i~t~e"tt~oh to as herein described. The applicant agrees to comply with all applicable laws, ordinances, b ' dm~ ~}g~~l~o e, and regulations, and to admit authorized inspectors on premises and in building for necessary in ectri~s'}P°j~~" ~ ~ ~ ~b ~(vuih lee/9~EAJIA I ~LYrs (ignatu e of applicator me, if a corporation) ENCLOSE PDOL TO CODE !~'~`1 ...rn,l~'! Y! •...V.~.C'~'`'I..I_.. )v; UPON COMPLETION (Mailing address of applicant) ~ ~ cj -BEFORE "WATER" State whether applicant is own ,lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. Name of owner of premises J .~,1,~12; ~ e I Yl ti-Kitl~• . (as on the tax roll or latest deed) If applicant is a corporation, signature of duly authorized officer. ButiderrsaLtcensde Nole of co orate ~ficer) it 1d 1 0.d Plumber's License No . Electrician's License No . Other Trade's License No . . 1. Location of land on which proposed work will be done. . ~~?'T~..~.t~,~', , 0 "j" ~ to-u~'(~ ~,4'-1;3s`"............Y.YID;.~....~~~ ~I~e~.,.l`......................... House Number Street Hamlet i County Tax Map No. 1000 Section ©~4? Block Lot ~S....... ~~Subdivision Filed t.tap No. . , , , (Name) Lot 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy ~ 1/Z. • ! • . ~y !fie r( II ~ I~ tl... .....U t.vVr b. Intended use and occ~up nc~~. JU~•~O• • • •`~"~l~~t't~~ ~q ~ 't7~ ~~E~ iQ-~.l> '~~n~O>C . 1\1C> ~~;~'1: clec~v~G 3. Nature of work (check which applicable): New Building ~ Alteratio Removal p.......... Repair ~c~~~ I~OD~ ~ BECK-~ ~'ene Demolition Add~t:o Other 1Vork ..~L"~:Q-$~o2e , e.. (p~00. • • • (Descripu 4. Estimated Cost , ....:~Oa:~ Fee I . be paid on filing this application) 5. If dwelling, number of dwelling units . Number of dwclling',units on each floor . If garage, number of cars . . 6. If business, commercial or mixed occu anc ' ' ' p y,spectfy nature and extent of each • tvpe of use . 7, Dimensions of existing stn~ctures, if any: Froth , . , , , • , , , , , , Rear - ~i..:•, . , Depth e-: , ; _ • ; , , , Heigftt Number of Stories . Dimensions of same structure with alterations or additions: Front , Rear , epth Ileight t of Stories . umbc Rear..... ' 8. Dimensions of entire new construction: Front ~ ~ ~ ~ ~ ~ • ~ ' ' Height Depth Number of Stories . ~ 9. Size of lot: Front . , .It.~. ~3; Rear , ~9,7. 0......... l ..Depth . . . 10. Date of Purchase . . . . ,Name of Former Ownei p Q Zone or use district in which remises are sttuated ...i ~ ' 12. Does proposed construction violate any zoning law, ordinance or re ulation: 13. Will lot be regraded n0.. , , , g ~ ' " " " " " " " " ..Will excess fill be rem?Sv from premi$~s: Yes No 14. Name of Owner of premises Ma;R.R2. W.~{v}!c?o,i~, , ,Address ~:~.`'~S' XyfY}jn i ,phone No.31-3;x',7 Name of Architect .Address , .Phone No. Name of Contractor ,i;C~;'I~ui,ri , , , (~~1 S ,Address ~ Zz' :~•~L"~",~~~ .Phone No. Z•~&.:33?,&,^; IS.Is this property located within 300 feet of a tidal~'wet•land? *YES....NO.~.rl *If yes, Southold Town Trustees Permit may be requir~d- PLOT DIAGRAM Locate clearly and distinctly all buildings, whether existing or proposed, andl',indicate all set-back dimensions from property lines. Give street and block number or description according to deed, and stow street names and indicate whether interior or corner lot. _ /-D~ .fir ~~9~ fir. ~ AP ~b AS NdTEO DATEk-~d.RN / ~Jr~. NOTIFY - 786-1802 IF AM I11'f 4/1111 hOq THE FOLLOWING 1N8 1. FOUNDATION~~ T~WOSR~QIMRID FOR POUREb ~OMGREIE 2. RQUGH - FRI~MING i 1M.UM9INA 3. INSULATION Q. FINAL - CONSTRUCTION MUST SE COMPLETE FOR C.O. ~ ALL CONSTRUC710N SHAH MEET 7HE REQUIREMENTS OF THE N.Y. STATE• CONSTRl~CT10N 8 ~NERtlY. - ' CODES. NOT ESPON818 FOR DESIGN OR CONSTRUCTION ERRORS STATE OF N~~V YORK, ;',,;i,.~ S S COUNTY OF.......... , . ~ /7~2/~0.• ~r{~~~~ ~T d contract) ~ ~ ~ ' ' ' • being duly sworn, deposes and says that he is the applicant (Name of individual si~nim~ i above named. He is the .....................~'V1C$wVl2 R--........... (Contractor, agent, corporate officer, etch.... • . ~ of said owner or owners, and is duly authorized to perform or have performed the ~'~said work and to make and file this application; that all statements contained in t}tis application are true to the best of Itis knowledge and belief; and that the work will be performed in the manner set forth in the application filed therewith. , I Sworn to before me'this ",8t L~C~Q kHt711i• yda ~ of ~`.~li~;`f,~ 1 ...e ~ Not bl' ~~2 ~.~~rf{~N~ :County ~ ~I • R6'bva~c /Nova-RY }~,,,13Li c ~ st~rE op- N.~(. Y ~ l5 15 p gu•~~~ C o ! (Signature of applicant) ~ a,.. ~ , _ } zx~ ~t ~ ~ i i . t . 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