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HomeMy WebLinkAbout18238-z r FORM NO. 4 ~4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No Z-19425 Date 6CTOBER 9, 1990 THIS CERTIFIES that the building ADDITION Location of Property 1245 OAK DRIVE SOUTHOLD, NEW YORK House No. Street Hamlet County Tax Map No. 1000 Section 80 Block Z Lot 40 Subdivision Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated NNE 5, 1989 pursuant to which Building Permit No. 18238-Z dated JUNE 20 1989 was issued, and conforms to all of the requirements of the applicable grovisions of the law. The occupancy for which this certificate is issued is ALTERATION TO 2ND STORY OF EXISTING ONE FAMILY DWELLING. The certificate is issued to FRED & FRANCES SCHAEFFLER (owners) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A UNDERWRITERS CERTIFICATE NO. H-018372 - SEPT. 28 1990 PLUMBERS CERTIFICATION DATED OCT. 9, 1990-HENRY J. SMITH PLUMBING ~ ~ , , - ilding~Inspector Rev. 1/81 Fosat xa s TOWN OP 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) G PJ ~ ~ g Z Dote ~ .f+.t~!:S.R.....~~ 19.. Permission is hereby granted to: . ~.~:~s......~~...~.>; cl~,,z... ~ ~ at premises located at ~:.T.S......°..::`:4...~ n County Tax Map No. 1000 Section ........~.Q........, Block .....d.~........... Lot No......~~ pursuant to application doted .........~.,rlrt.erm..~...~1, 19.4.., and approved by the Building Inspector. Fee 5..~.~: ~?.D..... B ding Inspector Rev. 6/30/80 Form No. 6 ~t TOWN OF SOUTHOLD ' Y BUILDING DEPARTMENT TOWN HALL 4 Q~,~ - 9 765-1802 . BLC3G. l~~s~'~. APPLICATION FOR CERTIFICAT) OF OCCU WN C7F ~!~?C.''~'~L,f? 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. 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 ....,October 9=.1990 New Construction........... Old Or Pre-existing Building Location of Property..., 245 OAK DRIVE SOUTHOLD, WEW YORK House No. Street Hamlet Onwer or Owners of Property....F~D 4 FRANCES.SCDAEFFLER County Tax Map No 1000, Section....g~........B1ock...1............Lot.,,40 Subdivision ....................................Filed Map............Lot...................... Permit No.~,~.~4.~~G~.~ .Date Of Permit ................Applicant............................. Health Dept. Approval ..........................Underwriters Approval...,..................... Planning Board Approval Request for: Temporary Certificate........... Final Certicate.. Ors Fee Submitted: $...°1-~'~ Q,~, yd 6~A .......FRED 6 FRANCES SCHAEFFLER . . . . • , ~ ~ ~ q 4 APPLICANT HENRY J. SMITH & SON, Inc. PLUMBING, HEATING & FUEL OIL 2 MAIN ROAD ~ ~ L5 SOUTHOLD, N.Y. 11971 ~ ~ a 1 ~ (518) 765-3690 4~ OCT 4 O Ig90 ~ g 7 ' J ~ i~~ta,a ~~,~?`al~~~~ far-,~~te~-<vC~t,~ C_E_R_T_I_F_I_C_A_T_I_0_N_ . . D a t.e O c t_ 9s_~ 990 Building Permit No,18238Z Owner Fred 5chaeffler Plumber Henry_J__Smith_&_Soni_Inc_ I certify that the solder used in the water supply ' system contains less than 2/10 of 17 lead. w Henry P. Smith Sworn to before me this _ 9th_day of October_____r ~ o 19_QQ_• i~~N~ r Public Notary Public, Suffolk County BERNADETTE L. TAN.IN NOTARY PUBLIC X4844893 State of New York Residin¢ in Suttdk CoulAy Commission E%pires Sept. 30, 19.x. R' C*`~ 1.,~'~~'.~rr~i ~ / goy} how - - ~ ~ - ~ + i i ~ ~ r Y I ~ ~ _ _ Iwo ~ ' ~ f i / ~ ~ ~ V `r P 1 1 ~ O~~a ~ j\ a o ~ '1 rFa ~ 1 ~ /l ~ y___ _ 0 / 5 ~Krr~~ wkc L ' Ree f W ~taPDW ~R~a Se~+,e~-~tG R stc. ~ e ~,y~ Qalr D+~~vG ~GOn/A ~-LoaR acaclt..~ Sava/icGD, n/~/. Lo%~ C. THE NEW YORK BOARD OF FIRE UNDERWRITERS rv~ce r RO1 ` ~ 'I~ BUREAU OF ELECTRICITY 83 JOHN STREET. NEW YORK, NEW YORK 10038 Date JP:!"TfM8Ef2 28„1990 AppNcotionNo.onfile f'-`'1~13708'3i89 H 01Ri7,> THIS CERTIFIES THAT only the electrical puipment ae described below and introduced 6y the applicant nomad on the above application number in tks promlue of P'firdl 5 FkAN1,ES 5CNRE:fp"t.E:R, It'!i5 DAM. DNrV!"., P171.1-. N10, `i?UTHDI_i!, N. Y'. in thefo!lowinq location; ? Basement ? lxt F!. ? 2nd Fl. SertiorrH 11 Bloel~ Lot 11Q woe a:amin. ~ on tT E' P t F' M P. k R 21') . 19'11 and found to 6e in compliance with the reyuirernentK of this Baord. N%7URE e~FPTACIES SWITCHES RXTURES RANGES COOKING D[CKS OVENS DISH WASHERS EXHAUST FANS OUi1EtS 1 INUNDESCENT F1U011ESCENi OTHER AMi. K. W. AMi. K. W. AMT. K.W. AMT. K. W. NAT. N. P. 7 , 4 a .1 (1 r DRYERS FURNACE MOTORS WTURE APPDANC! FE[DlRS SPKIAL RECIT TIME CIOCKS RRL UNIT NlAilRS MIILT40UillT DIMMERS AMi. K. W. ql R. P. GAS N. I. AMT. NO. A. W. G. AMT. AMI. AMT. AMTS. TRANS. AMT. N. P. ~ tK F)~t AMi. WAITS SERVIQ DISCONNECT NO.OF 5 E R V I C E NAT. AMP. TYPE ~ M. 1 / eW 1 / JW 3 H SV/ 3 / AW PER 4COND. OP CC. COND. OP NI.IEG a'HI'~ NO. OP NFUTKAlS p NtVTGMAI OTHER APPARATUS: Qrli r'r hl li YO(t ',tf UND fl.. ~l tltC. kDi1M NFATEkti:2..1 K.NI.,I-i K.W.,:.i,'i k_ld. E{ .fr~ PRkD sf: FiAEFF!.ftN 1.245 GAB. PRIVF - 70111HOLD, NY', 1.719! ~ OEIMlAL MANAOR ar. 1 This certificate must not be altered in any manner; return to the office of the EoordiF incorrect. Inspectors may be ideMilied by their crodeliYwls. COPY FOR BUILDING DEPARTMENT. THIS COPY OF CERTIFIGTE MUST 0E ALTERlD IN ANY MANNER. B0.\RD OF HEALTH FORM17 N0.1 3 SETS OF PL.\NS SURVEY TOWN OF SOUTHOLD CHECK ~ !1f7. , • • , , , • , • ~ • BUILDING DEPARTMENT SEPTIC POR:1 . TOWN HALL EOUTHOLD,N.Y.11~J71 NOTIFY TEL.:~7G5-1802 CALL Examined . ~:w!^.~ ,1.e. , , 19 ~.l MAIL T0: • \pprovcd 20 . „ 19b'Q. Permit No. 1 82~7"~ Disapproved ale r.. , ?f n - p ~~.~V ~ '?~`(Buildin Inspector) APPLICATION FO;R [3UILDING PERMIT ' r - S Date 15... `INSTRUCTIONS a. Tltis application must be completely filled in by typewriter or in ink and submitted to the Building Inspector, with 3 gets of plans accurate plot plan to scale. Fee according to schedule. b. Plot plan showing location of lot and of buildings on premises, relationshils to adjoining premises' or public streets ar areas, and giving a detailed description of-layout of property must be drawn on the diagram which is part pf this appli- =ation. 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 shall be occupied or used in whole grin part for any purpose whatever until a Certificate of Occupancy shall have been granted by the Building Inspector. , APPLICATION IS HEREBY bfADE to the Building Department for the issuance'of a Building Permit pursuant to the 3uilding Zone Ordinance of the Town of SoutholU, Suffolk County, New York, and other applicable Laws, Ordinances or Regulations, for the construction of buIldings, additions or alterations, or for removal' or demolitibn, as herein described. Tite applicant agrees to comply with all applicable laws, ordinances, building code, housingcode; and regulations,, and to _dmit authorized inspectors on premises and in building for necessary inspections. • (Signature o applicant, or ria e if a corporanon)~ • .l~y~ v~r, l~~ri~~'"~S'c~~~rolatd~ yVY ~r ~ (Mailing address of applican ) State whether applicant i owner lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. ...............................Q (~!l~b.~'................................ .Name of owner of premises ~~k~-~...:•~.~`ir~!'4,~ei!%!`;G` (as on the tax roll or latest deed) 'f applicant is a corporation, signature of duly authorized officer. (Name and title of corporatelo7fficer) Builder's License No. ..........C1.uli.(.~~.... • Plumber's Liccnsc No. a"~. ~ 7 . Electrician's License No. ~ w~~.... . OtlterTradc's License No . Location of land on which proposed work will be done. ' /~~~f,6..... U:4~..~R,tVic',_ ............:S~iY.!/~riL~l... ~ ........~~~~!ry.f~i~anF-~" House Number Street. " " • • • • • • • , Hamlet County Tax ~1fap No. 1000 Section Block , , , , , , , , , Lot , , , • , Subdivision Filed ;11ap No. Lot . . ~(N~me) State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy cS:v./~C~• • ~ /a~.~~ _ ~ • ~ ............~,E?!Z L~ /UCH .p. ~~;t/=Pl~!VU 1 r 0~ b. Intended use and occupancy _`f`iA!{.f/`f. • d f • • .~y/<<' . B UQ-,QGLr/,fdt•j' !~/~J~.-• • r 3• Repair of work (check which applicable): New Building ' Rcrnoval Addition .Utcration ..{Y.. Demolition .Other t5'ork.`. ~ 4. Estimated Cost O~d ¢ih+f Jd'~ F. l~:scnp i'~o j • Fee..... (to be paid on filing this application) 5. If dwelling, number oC dwelling units . If garage, number of cars . ~ • ~ • " " " NLimber of dwelling units on each Moor........ • , , , • • • 6. If business, commercial or mixed occupancy, specify nature and c~tent of caclt.[ype of use . • 7. Dimensions o! existing structures, if any: Front , • • - Huight . Nurjtber of Stories , • • • • Rear Depth • • . • . Dimensions of same structure with alterations or additions• Front . • • • • • • - Dapth. Height. Rear.................. ' 8. Dimensions of entire new construction: Front . • • • Number o(Stories . • • Hcigltt Nu~ribcr of Rear Depth............... . 9. Size of lot: Front Stories • • . • . • • • . . 10. Date of Purchase Rear Depth . . 11. Zone or use district in which premises arc situated , ~ 'Name of Pormcr Owner • ~ • ~ ' ' ' ' ' 17.. Does proposed construction violate any zoning law, ordinance or regulation: . . ' l3. 1Villlotberegraded 14. Name of Owner of premises • , , • ~ ~ • • • ~ • ' ' ' ' • • • tiVill excess fill be removed from premises: ~ Yes • No Name of Architect • .............Address , .............Phone No. . Name of Contractor • ..................Address ...................Phony, No.. ' . IS.Is this property loca~ed with•in~~•"Address.......... Phone No..•.•....••••... *If yes, Southold Town', Trustees POrmit may bearequircdetland? *YES....NO....•• PLOT DIAGRAM Locate clearly and distinctly all buildings, whether existing or proposed, and. indicate ail setback dimensions from ~ property (roes. Give street and block number or description according to decd, and show street names and indicate whether interior or comer lot. • • • • ~I . .T.ATE OF \E~4' YORK, -OUNTY OF . . . S.S', • • • • • • • • •(\amc of individual sip • • e ~ ~ ~ • • • • ~ ' ' ' ' ' ' ' • being duly sworn, deposes and says that ha is the a rove named. ,nim• Contract) pplican[ is the , (Contractor, agent, corporate officer, ctc.)• • • • • " " " " • • • • • - said owner or owners, and is duly authorized to pcr(orm or have performed the said work and to make and Mle this placation; that al! statements contained) in this application arc true to the best oClt]s knowledge and 6clicf;and that the ,'rk will be performed in the manner set forth in the application Mled therewith. om to before me this ............~~../~.~.~dayo~f/..r~.J 19~~• ;ar; Public, ~.`K'f-t`:'~..~1.r..N,.4-.V.~°:.. County NOTARY PUB M ~ New yak . t No.4707878,Su0otk0au~Myy~ • • (Signa[ur (applicant)