HomeMy WebLinkAbout18268-z FORM NO. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Office of the Buildinq Inspector
Town Ha11
Southold, N.Y.
CERTIFICATE OF OCCUPANCY
No 218187 Date JULY 13, 1989
THIS CERTIFIES that the building ADDITION
Location of Property 1225 NORTH SEA DRIVE SOUTHOLD
House No. Street Hamlet
County Tax Map No. 1000 Section 054 Block 04 Lot 14
Subdivision Filed Map No. Lot No.
conforms substantially to the Application for Building Permit heretofore
filed in this office dated JULY 6, 1989 pursuant to which
Building Permit No. 182682 dated JULY 6, 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 DECK ADBITION TO EXISTING DWELLING.
The certificate is issued to KERT & BRETTA LUNBELL
(owner, )
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A
UNDERWRITERS CERTIFICATE NO. NSA
PLUMBERS CERTIFICATION DATED NSA
Building Inspector
Rev. 1/81
n~oaaa xa 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 .18 2 6 8 Z Dare ...........'~...1., 19
Permission is hereby granted to• ~ l
~aas
..~,~:A~.?~~/~~~.~.•~.~.f.~~~-mac :y......l.a.q.~.~............
ro ..~,a.~!.9~.ta..cSt:.....~?r.....(~-?.r:4F-:.~.Ofrawt~....~....JCk,a....!!~~......1.~.~-!?:C~q
. ~ ~
~ ...f.~,4~'.~
at premises located at ...1..•.1:~:,?....~. ...~??:4.-:..!.,d~.V.`4.......... Qr!~4;,i~.~~k....
County Tox Map No. 1000 Section .....f,75..~....../. Block .......5?~........ Lot No...
pursuant to applicotion doted ...........tip 19.~q.., and approved by the
Building Inspector.
Fee $..'o~.~?.
9 c
Buildin I for
Rev. 6/30/80
TOWN OF SOUTDOLU
BUILDING DEPART:ICNT
TOWN HALL
• SOUTUOLD, NEW YORK 11971
765 - 1802
APPLICATION FOR CERTIFICATE OF OCCIIPANCY '
DATE.. June 16,_,1989 .
NEW CONSTRUCTION ._..._.OLD OR PRB-E%ISTING BUILDING...X..VACANT LAND..._
Location of Property..~,125.PJ4xtk1:$Qa Dpi,V~,.~Fa~yX~S.D~caC11.,_3outholcl........,,
llOUSE N0." ----'STR-EET ~ ~ -
HAML'ET
owner or owners of Property. _Kert and Bretta Lundell
County Taa Map No. 1000 Section ..$,4._. Block ._4...,, Lot'..].},,,
Subdivision.,
Filed Map ........Lot...._.....
Permit ;Jo. ......._..Date of Permit
APPLicant Q1C1Yle x'..........
Flcalth DepC. Approval Underwriters Approval..............
Planninn Board Approval '
Request for Temporary Certificate
Final Certificate
Fce Submitted: $,,,,,25;00...._..._.
~ APPLICANT....
KE12T L DELL.•
/~-e~ L3 7 ~
Co z/~/~7
to/14/as
` Y FORM N0. 6 2- J'
_ ' TOWN OF SOUTBOLD
BIIILDING DEPARTMENT
II TOWN DAL:
765 - 1802
APPLICATION FOR FERTIFICATE OF OCCUPANCY INSTRUCTIONS
A. 'This application must bg filed in typewriter OR ink and submitted to he Building
. Inspector with the follbwing; for new buildings or new use:
1. Final survey of property with accurate location of all buildings, roperty lines,
streets, and unusual~~natural or topographic features.
2. Final approval of Heelth Dept. of vater supply and sewerage-dispos 1(S-9 form).
3. Approval of electrical installation from Board of Fire Underwriter .
4. Sworn statement from ',plumber certifying that solder used in system contains less
than 2/10 of ]z lead~i
5. Commercial buildings,' industrial buildings, multiple residences as similar
buildings and instal];ations, a certificate of code compliance from the Architect
' or Engineer responsilile 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, buildings and
unusual natural or topographic features.
2. A.properly completed application, a consent to inspect signed by the applicant
and a certified abstract of title issued by a title company which shall
show single and separ'~ate ownership of the entire lot prior to April 9, 1957.
If a Certificate of Occupancy is denied, the Building Inspector shall state the
reasons therefor in whiting to the applicant.
3. Date of any housing code or safety inspection of buildings or premises, or other
pertinent information'Irequired to prepare a certificate.
C. For Vacant Land Certificate of Occupancy:
1. An application for vacant land Certificate of Occupancy shall be submitted,
and a certified abstr~ct of title issued by a title company showing single and
separate ovnership of the entire lot prior to April 9, 1957 shall also accompany
the application. I£ a Certificate of Occupancy is denied, the Building Inspector
shall state the reasons therefor in writing to the applicant.
D. FEES:
D. CERTIFICATE DF OC~UPANCY - New Dwelling $25.00, Additions to Dwelling $25.00,
Alteration~to Dwelling $25.00, Swimming Pool, $25.00. Accessory building $25.00
Addition to Accessory buildings, $25.00 - Businesses $50.00.
2. Certificate of Occupancy on pre-existing dwelling - $100.00.
3. Copy of Certificate of Occupancy - $5.00 - over 5 years - $10.00
4. Vacant Land Certificate of Occupancy - $20.00
5. IIpdated Certificate of Occupancy - $50.00
6. Temporary Certificate of Occupancy -"$25.00 Residential
$50.00 Commercial
~I
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rev.~l 10/ 14 /S8 '
p
$1. ~pp 765-182 ~
BUILDING DEPT.
INSPECTION
[ ]FOUNDATION 1ST ( ] ROUGH PLBG.
[ ] FOUNDATION 2ND [ ]INSULATION
[ ]FRAMING [ FINAL
REMARKS:
r
DATE ~ INSPECTOR ~j
'1cLD I.:SPEC:iu; IIUniG I~ ~ "UtKMENT°
. 'b ~
1. ~ ~ ro
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H
_ _ _ _ y CG
r0U1JDATION (1st)
?OUNDATIOIJ (pad) m~"'
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ROUGH FRAME &
PLUMBING ~
y
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3. ~ ~('tV/
n
IIJSULATIOPI PER N. Y. y
STATE ENERGY h
CODE
4 . y
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FI;JAL
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ADDITIONAL COMMENTS: ~ ~
x
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cn
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BO.~RD OF HEALTH N/A .
FORM N0.1 3 SETS OF PL.1NS
SURVEY
TOWN OFSOUTHOLD CHECK
BUILDING DEPARTMENT SEPTIC FoRCi ...ICI/,P, , , , , , , , , , .
TOWN HALL
• SOUTHOLD, N.Y. 11071 NOT ~ flans A. van Nes, Esq.
' TEL.: 7051802 CAL ,(914 , 949-1070
ECamincd ......~QQ .s/p lg AfAIL T0: HOLD • • .
Approved ~..iP, 1919, Permit No. 1 ~ ~ `DO NOT MAIL '
Disapproved a/c ,
l f/
D
(Building Inspector)
APPLICATION FOR BUILDING PERMIT
Date .,June•16,...•,,,~ 1589.
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 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
5uilding 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 emolition, a herein described.
Tite applicant aerees to comply with all applicable laws, ordinances, building cod ~ousin code, nd egulations, and to
admit authorized inspectors on premises and in building for necessary inspections. U
(Signature of applican or name, i a corporation)
9,6,Barrow Street, New York, NY 10014
(Mailing address of applicant) •
State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder.
.........................Kert Lundell
Name of owner of premises KBX.t . 13xetta..Ltazld~.1~ , , , , , , , , , , , , , ,
(as on the tax roll or latest deed)
If applicant is a corporation, signature of duly authorized officer.
(Name and title of corporate officer)
Builder's License No. Owner
Plumber's License No . .
Elcctricial~'s License No . .
OtlterTradc's License No .
Location of land on which proposed work will be done. '
1225 North ,Sea, Driye , , , , , ..SOlttl~old~, ,Neva York
House Number Street • • • • • • • • •
Hamlet
County Tax Map No. 1000 Section 5.4 , : Block , 4
Lot...14....
Subdivision Filed l,fap No. • • • . • .
~(N~me) Lot...............
• State existing use and occupancy ofpremises and intended use and occupancy of proposed construction:
a. Existing use and occupancy S?.t}rdle. Family •Resiclestce, , , ,
b. Intended use and Same • • ~ • ~ • • ~ ~ ~ ~
\ occupancy
~
3. lvaturc oCworl. chec}, which
_ ~ p • • - • • : • • . • applicable): New Uuilding Addition , ,Deck • . , ,Utcration
Re air Removal
• • • • • • • • Demolition Other 15'ork .
4. Estimated Cost 1 ~ b00. 00 50 (Description)
Fee.....
:
(to be paid on Cling this application)
5• jf dwelling, number of dwcllin'p units Number oC dwelling units on each floor , .
varagc, num bcr oC cars , , ,
6. If business, commercial or mixl'ed occupancy, specify nature and extent of each type of uses • • •
7. Dimensions of existing structui•cs, if any: rtQ.nL__,_T • • • • • .
- Height =af'Sferres'..~.~:I~'L.
Dimensions of same structure t~ith alterations ~ ~'T' • • ~ " • "
- Depth or additions: Front • , Rcar .
. IIcight . Number oC Stories . • • • • • • ' '
8. Dimensions of entire new construction: Front . • • • • ' ' ' " •
Hcigltt Nwttbcr of Stories • Rear Depth • .
- 9: Sizcoflot:Front
10. Date of Purchase October! 25 : '~J84 ' Rcar Depth • • • ~ , , , • • ~ ~ ~ ~ • • •
~ '••••••••••...NamcofFormcrOwner ,Diana •A.'•Winecoff•'•""'
1. Zone or use district in ~vhiclt r
' cmiscsaresituated. Sing~e,F mil
p
I Does proposed construction vto~late any zoning law, ordinance or regulation: ...IQp• , , , , , , , • , • • • . .
_ 13. Nill lot be regraded • ~iQ, I , , , ,
14. Name of Owner of premises f, ,I,t}r}dell ~ . ' ~ ' ' ' ' ' ~Vdl excess fill be removed from premises: Ycs • No
c , Name of Architect _ - • • • • • Address 96. R.asx'ow..St. ,NXQ>hone No.(21.2),2¢2=,Er491.
.satn~,,,,,,,•,. .Address „
Name of Contractor .Sagt~, • • ' ' ' ' ' ' ' ' • • • • • • • • • • • Phonr. No.... ,
y ...............Address
• ......Phone No... , .
S.Is this property located within X00 feet of a tidal wetland? *YES....NO.X';•••
*Zf es Southold Towq TrusCees Permit may be required.
PLOT DIAGRAM
Locate clearly and distinctly allll buildings, whether existing or proposed, and.oindi cote all set back dim nsions from
property lines. Give street and block inumber or description according to deed, and show street names and indicate whether
interior or corner lot.
ISee survey attached
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TATS OF XE1V YORE.
OUNTY OF .NEW YO~2K S.~
ERT LUN
ELL
• . • • • • ~ • ~ ~ ~ ~ ~ • • ~ ' ' ~ ~ ' ' ' ' ' ' ~ ' ' ' ' ' ' ' ' ' • • • • • • • • . • being duly sworn, deposes and says that he is the applicant
(~amc of individual si nin•i contract)
rove named.
=isdtc ..................Ownerli
Ii (Contractor, agent, corporate officer, etc.)• • ~ • " •
~}(~Q~{Re,{ or owners, and is duly autltarized to perform or have performed the said work and to make and Glc this
phcation; that all statements contain~ld in this application arc true to the best of his knowledge and belief; and that the
uk tvill be perfot7tted in the manner sett forth in the application filed Ihcrcwi[It.
om to bciorc me this I
kh
.day of.. i~ l~rJ;C^, ~
tar)• Public, ~F~~t-l'~............ Count 19~
_ y
J ,NQTAfiV 1 UdLtC, State uf~ New Vo,g ' ' ' ' ' • • • • • • • . .
Quallfled io
Sutfaik4
ounty •
QOmml&SPWt I r (Signature of applicant)
Facptras Marcq,30~ 19,~ I
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~+`~2 ~ Any TO n QM r<OR THE
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- - _ 4 ~~i~~~I- - CONSTRUCTION MUST
_ ECONSTRUCTtON SHAt,~ MEET
- - - - - _ - - - - _ _ Ts-IE REQUIREMENT•6 OF THE N.Y,
- - =>??'(E_CONSTRUCTION 8 Et~ROY
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AREA 26,678 so.Fr. ~ o<, F°" r• ~~J SURVEY OF PROPERTY
fo tie line zf< +
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c'NO ,a~: ~ \~•;3 0 TOWN OF SOUTHOLD
~ a SUFFOLK COUNTY, N. Y.
7( \ 3. !L
~ ° 1000 - 054 - 04 14
2~9ei• y Q- SCALE 1e= 30~
"ti j
JUNE 20,1989
AND ~F
o ~ tN G9~ yet CERTIFIED TO ~ Prepared Iri amordan[6 with the mini~nam ,
1~ ry ,t ~ standards for title survey's as estahlished hf,
i J.~, a s ~ NERT LUN DE LL i6° L.hA. L. S. and approved and adopted
n N.Y. 9. LIC. NO. 49668 R BRETTA LUN DE LL for such use by The Naw York Smta land
O Tdle Asmciati°n.
P s R s , a, c. q0
Is eve. 020
n.o.eox sos
MAIN ROAD
90UTN04D,N.Y. 11971
89 - 300