HomeMy WebLinkAbout17925-z FORM NO. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Office of the Building Inspector
Town Hall
Southold, N.Y.
CERTIFICATE OF OCCUPANCY
No: Z-25563 Date: 03/02/98
THIS CERTIFIES that the building ACCESSORY
Location of Property: 28545 MAIN ROAD/ROUTE 25
(HOUSE NO.) (STREET) (HAMLET)
County Tax Map No. 473889 Section 18 Block 6 Lot 24.3
Subdivision Filed Map No. Lot No.
conforms substantially to the Application for Building Permit heretofore
filed in this office dated , 19 pursuant to which
Building Permit No. 17925-Z dated MARCH 16, 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 INGROUND SWIMMING POOL & FENCE ENCLOSURE TO CODE AS APPLIED FOR.
The certificate is issued to ROBERT A. & SHELLY G. KEHL
(OWNER)
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A
ELECTRICAL CERTIFICATE NO. N-081492 07/09/89
PLUMBERS CERTIFICATION DATED N/A
Bu' ding Inspector
Rev. 1/81
rosai 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~ 017925 Z Date .........~.w.~s~ 1
..........lP 19...1.
Permission is hereby granted to•
to .C:~~~,~~... P~Q ~-~'..P-~.~......c~..~r.~. .
. . . . . . . . . . . . . . . . . . . . . . . . . . .
,
.
p.. . ..~~..yy b.
. . . . . . . . . . . . . . . . . . . . . . .
ct premises located et ..~..~.5 .4~ 4~?~
.....:.....~..QR-~.... .
Caunh Tax Ma No 1000 Section Lot No
/ P Q.~ Block Q.~t. s~~:
pursuant to application dated 1 19.l.~ and approved by the
Bui ld ing~`--Iy~n~spector.
Fee S•L ~.1V..c....... .
Building Inspector
Rev 6!30/80
Form No. 6 ''^.'-+..,~.,Ty77" `C~-~~
TOWN OF SOUTHOLD r 4..
BUILDING DEPARTMENT
TOWN HALL i ~ 4 ! L, !
765-1802 `cs~~
n~' l
APPLICATION FOR CERTIFICATE OF OCCUPANCY
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, 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 eigned 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,"~ ditions to dwelling $25.00 '
Alterations to dwelling $25.00, Swimming pool $25.00, Accessory bu ing 25.00,
Additions to accessory building $25.00. Businesses $50.00.
2. Certificate of Occupancy on Pre-existing Buildine - $100.00
3. Copy of Certificate of Occupancy - .25r
4. Updated Certificate of Occupancy - $50.00
5. Temporary Certificate of Occupancy - Residential $ 5.00, Commercial $15.00
Date ...:2 Z Y.~.~
onstruction..........C Old Or Pre-existing Building...Q
ion of Property...~.i .'S.~S
................~!f /N.. 4~~.~'~............ ~~~.te"w
House No. Street HCa-~mlet
or Owners of Property.....~:e. ~~5.... ~P,E~T ~ ~J. ~/`~.FCL~)'~.
/ ..A
y Tax Map No 1000, Section.. ~ ......Block.. ~ ~...........Lot
vision .Filed Map..........,~.Lot.....N..../............
t No..~.~:S89.z:..Date Of Permit..l~lp~9~.....Applicant..(T.'.'~e^'t..!r:~&~./.........
h Dept. Approval ..........................Underwriters Approval.........................
ing Board Approval
st for: Temporary Certificate........... Final Certicate...::...... ~
~tS xX
ubmitted: $....OS... ~o c
.
~~-t--' ~fJ ~Q '2!® • .APPLICANT
('cJ a,~5 ~Y
T . ~
a ~
THE NEW YORK BOARD OF FIRE UNDE-RWRITERS PALS 1
1000719 pUREAU OF ELECTRICITY
pb JOHN STREET, NEW YORK, NEW YORK 10038
JULY 18,1989 gpplkotionNo.onfile b2318789/89 N 081492
TMIp CERTIFIEb TXAT
only the ahK:trlcel equipment v dsacrihed 6elotR and Introduced hY ehe opplicant nerved on the abode eppBcetion numher trF thepremleee of
RSHL,ROBSRT i SHSLLSYn, 28545 MAIN ROAD, ORIENT, N.Y.
in thejoNolrvrR loc JUliL 2~r Bategaent ? Iet Fl. ? Ynd Fl. OUT .Seetiun clack Lot b/27
uw examined un 8 7 1989 and found to 6e in compliance reith the reyuirementK of this Board.
IIXTIIRR XTIMK RANOlf COOKaW.DRCKS OVpIf qSN WASMpK XAUST FANS
OUTYTS AGRf SMRTCIIlS INGNDlKlM FlUOtlEClNT OTHER NAT. K. W. NAT. K. W: AMT. K.W. AMT. K. W. AMi. n./.
1 1 1
aRYRRS RIRNACR MOTORS 111TIIRf ARlIA?Ka IMROf fMOA/RRC7T TMIR GOt:.Rf Mil 11111TIpATMi hRllT40af1Ri
AMT. K. W. dl n. 1. OA! N. F. AMT. le). A W.O. AMT. AMR AMT. AMIb. TRANf. AMT. X. 1. ~a t~T AMT. TR
1 20 1 40
SMVICa apW111ilCT NO.OR f ! R V- 1 C
AMr. AMr. Tr1e ~ I t4F l / Av t e ]w t / AW w. anc ~d»+o. ~
~ . Ro. d rx.tlc A: M'• u0. a minKAls OF 'r
eL
~Al
OTIIY ANARATUte
PAMSLBOARD3:1-2 CIR. 80
6.E.C.I:-1
*(3itIMMIE6 POOL) This certificate
covers compliance at the date of
iaspectioa only. Because of uauausl ~
environments it is adviaaDle to
have frequent teat and/or repairs
made by a qualified parson.
R.C. ELECTRIC CORP. LIC.i1610 S
112 KSYLAND COURT oMtAl MANAOmt
BOHEMIA, NY, 11716
Psr 11 _s.-~:_-
Thit u ' ' Molt not ba oNered in Monnar; .enwn ro tM oNip of the Roord i( incorrect. 1 ,May ba idenHfiad by thEir cra~Mia4.
COPY FOR BUILDING DE AR . THIS COFY 1 A
l ~ q~s~
765-iS02
BUILDING DEPT.
iNS~ECTlON
[ ] FOUNDATION 1ST [ ]ROUGH PLBG.
[ ] FOUNDATION 2ND [ ]INSULATION
[ ] FRAMING [ FINAL
{ ] FIREPLACE ~ CHIMNEY
REMARKS: ~22s'v~
Cam. U
DATE 2 /y INSPECTOR
1?~~~-~
765-iS02
BUILDING DEPT.
1 NS~ECTION
[ ]FOUNDATION 1ST [ ]ROUGH PLBG.
[ ] FOUNDATION 2ND [ ] IN ULATION
[ ] FRAMING [ FINAL
[ ] FIREPLACE & CHIMNEY
REMARKS: ~ ~
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D~~f J~ FORM NO t v
~ , ! f+ TOWN OF SOUTHOLD
MAR 14 i~ ; ' ' BUILDING DEPARTMENT
' ~ ~ TOWN HALL
..qi.-.~~ SOUTHOLD,N.Y.11971
FS.f,G
iJr~z~"
TOW\N~gUFSUnil~F?Ct_("i~1 i TEL.: 7651802
1;+~.unmcd . Y.Y1y~~,~-~t~.`~? 19 Application No
Approved 1~,~ 1. t0 19 Permit No 1. 9.a~ ~ ,,6,~G~ •
Disapproved a,~c Ce~-2F
it C/! ax ~ ~ .
(Burldnrg Inspector)
APPLICATION FOR BUILDING PERMIT
Date . , ~ 19
' INSTRUCTIONS
a Thrs apphcathon must be completely filled m by typewnter or in ink and subrurtred m tnphcat: to the Bwid
lnapci tor, wrth 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, relatronshrp to ad~oming premrses cr public strc
or areas, and grvmg a detailed descnption of layout oh property must be drawn on the dragram winch rs part of this ap
patron.
c The work covered by thrs apphcatron may not be comrnemed before rssuance of Building Permrt
d. Upon approval of thrs apphcataon, the Buildurg inspectur will rssue a $uildmg Permit to the apply+;aut Such pen
shall be kept on the premrses available for inspection throughout the work
e No building shall be occupied or used m whole or in part for any purpose whatever until a Certrficate of Occupar
shalt have been granted by the Buridmg Fnspector
APPLICATION IS HEREBY MADE to the Buridmg Department for the issuance of a Building Permit pursuant to
Building Zone Ordinance of the Town of Southoid, Suffolk County, New York, and other apphcable Laws, Ordinances
Regulations, For the constnroUon of buildings, addrtrons or alteratrons, or for removal or denrolrtron, as herein descnb
The apphcant agrees to comply with all apphcable laws, ordinances, building coda, housing code, and regulai~ons, and
admrt authorized inspectors on premrses and m bwldmgs for necessary ~m,(sJq/,gctrons.
(Srgnahue of apphcant, or name, rf a wrporatrun)
(Hurting acY.~ress of apph~ ant} l/7~.~
State whether apphcant rs' owner, lessee agent, architect, engineer, general contracror, clectrru,+n, plumber or buIld
Name of owner of premrses J"1 Fr. ~ > ~ E ,~1c° ~l ~i
fas on the tax roll or latest deed)
ll apphcant rs a corporation, srgnahue of duly authorrzed officer
(Name and trtlc of corporate ofpficeLr,)
Euilder's Lrcense No ~~-~4 . !~I
Plumber's Lrcense No.
Electncran's Lrcense No
Other Trade's Lrcense No.
I Luc atiun of land on whrch proposed work will be done !j')A~ ~ . ~ ~
house Number Stpreet / Hamlet ~St,3
County Tax hlap No 1000 Se~Uon ~.f d, Block d.47 . Lot
Subdrvrsron , Fled Map No , , .Lot
(Name)
Z State exrsUng use and occupancy of pre/mrses and intended rse an/fd occupancy of proposed construction
a Existing use and occupancy ~ ! L S TL',;e~'
....~i;~.L,ll.r.~~ rj ,
S~rl~Lc' -J r-. U
b intended use and occupancy Ct. U .,.~•:~~rP~- ~ .5~:~.r.~?r ~ Ile D~-C ,
J.~?..
3. Nature of work (check which apphcablep New Building Addition . ~ Alteration .
Repair Removal , . Demolition Other W_ ozk .
~ (Descnptron)
4 Estimated Cost . Fez . .
(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. Dunensions of existing structures, if any. Front ~9 .......Rear Depth . .
Height ..Number of Stones 1. J.k'................................ • .
Dimensions of same structure with alterations or additions• Front Rear .
Depth .Height . ......slumber of Stories
8. Dmensions of entire new construction. Front Rear Depth . .
Height Number of Stones .
9. Size of lot Front Rear Depth .t'i'.CJ'....... .
10. Date of Purchase ...................Name of Former Owner .
11 Zone or use district in which premises are situated .
12. Does proposed construction violate any zoning Iaw, ordinance or regulation: , . . .
13 Will lot be regraded _ Will ex ess fill be removed rom premises. Yes N.
14 Name of Owner of premises . ff.L; .y,[., Address ~ds{.I .?~9U!. tC~.. Phone No..~v?7
Name of Architect ....Address Phone No....... .
. ./c . .
Name of Contractor F`o~C'!~?. `(Jr?d,Foir..?'~`........ Address ?'.~C1~~4 0(r~~~.
Phone No.,7„}.
/.-d.-7Jy`!. .
c~',Pe~P?LN~
PLOT DIAGRAM ?~?d3
Locate clearly and distinctly all buildings, whether existrng or proposed, and, indicate all set-back dimensions froi
property fines. Give street and block number or description according to deed, and show street names and indicate whethe
interior or corner lot. •
STATE OF NEW YORK, S S
COUNTY OF
a~G ~ being duty sworn, deposes and says that he is the applica
(Name of mdrvidual signing contract)
above named
He is the ~~~'t-~
. . . .
(Contractor, agent, corporate officer, etc )
of said owner or owners, and is duly authorized to perform or have performed the said v?ork and to make and file t
application, chat all statements contained in this application are true to the best of his knowledge and belief; and that t
work will be performed in the manner set forth in the application filed therewith.
Sworn to before me this c~ 5s
...day of . ..l .l.~~~-~. 19 S~~
n
Notary Pubhc, . , , County
~1~,~^ n ~~~i('~j DONNA TAYLOR ~L~
w, eI' e'l~, `TfVTARY PUBLIC, Stall of NM Ydk. - /c~L:! L+r :4eA-Kra .
No 4891784 .SI attire Of a tIC
QueilBed in Su$olk County ( gn pp a
Term expire June i, 1989
' N/0/F MAY WATSON
PLOT I
• PL OT 3 ~
e
' '25~-R.0 W.
I' Gas
4 PAP
t s7k N. 6°3440°E. ~ ~i' 'I at~l ~ 37156~',.~[~ .
'y I ~ NELILIL• - .m I
I 'lsll ~ N ~ 56
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' 2 ~ I '~3~ ~a om N
ti U, j
rn
- I .5 I .
I
/ P B~'EPB ' ' 1000 . "
' ~Il. 9TEPE
_ / I ~ 1(17.0'
< f~./ a p rvl eronv F?,IYE 3 N/0/F GEORGE L.YOUNG
LP ' LP Fy°•L'WAN h ~ HO(/8[cl ?A?BBE I I
f ~
3
0
?LB• NE? L1G
s ~ e I°,
W1
A'§ / ~ ~ I ~
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11 Q
LIL!1'
~ 1n 11 ^ME~~~~ ~ i d1132P I ' ~
1W' I °
,9 I
L PLOT 2 m °
~ I I i 13
m AREA 1.79 acres e I
`I ~ I N
OCCUpANCY.OR ° i ~ I. '
USE fS UNLAWFUL ° N I I N _
A
WITHOUTCERTIffCATE ~ N ~ ~
OF OCCUPANCY I'
~ I °
0
o~ -
APPNDVED AS NOTED mgn. I ,
' DATE 31b `LB.PN~ sfk. s/k. ,
I
' FEE GY Ci 4' ni`N 5.79°2840°W NE?,L,L alo 227. 81~ X78°34~40~~W. '
NOTIFY GUILD NL. DEPARTMENT AT o3'e. zolh* 56:05'
r
765 7R07 9 AIA TO '1 PM FOR THE / r
FOLLOWING INSF ECt I;.'aS
1. FOUNDATION - two REQUIRED ~ '
FOR POURED CONCRETE MAIN ROAD ( ~ Y S ROUTE 2 5)
2. ROUGH ~ FRAMING t4 PLUMBING '
a.lNSUUnon~ SURVEY OF PROPERTY
4. FINAL - :ONSTRUCTION MUST I
SE COMPLETE FOR C O, A T ORIENT
" ALL CONSTRUCTION' SHALL MEET
THE REQUIREMENTS OF THE N.v. TOWN OF SOUTHOLD
STATE CONSTRUCTION S ENERGY '
cones. Not aesRONSISLe FoR cERrIFl6rD1 SUFFOLK COUNTY N. Y.
DESIGN OR C(IMISTRUCTION ERRORS FIRST AFRICAN TI'iLE INSURANCE ' 1000' - ' ' 018 - 06 - P/0 24
- COMPAI'.OF NEW YORK
TITLE N~ 605 S 5414 SCALE I 30
PECONI,ABSTRACT INCORPORATED
' 'B. 0. H. # 8B 197 ~ LONG LAND MORTGAGE CORP. AUG. 31 , 198 7
ROBER'A. KEHL Ocf. 2
sHELLE G. KEHL $ (987 f loundafion location )
• June 2, 1888 (final)
4~
pf ~ ~•+N~`Op~At
M ~ O O
~ r
~ ` - F -N.Y.S. LIC. N0.49668 ~ ~ "
H t
CO f5 RS 9 ENGINEERS , P.C. ~ ,.o,...l in occurdan<e with the mfntrfium
516) 7 02Q PLOT, NUMRPS REFER TO~~~M INOR SUfiDI VI SIOIN t ~r..~~d; hor title survey) m esiabli:h°d by '
P. O. BOX 909 MADE FORHOWARD L YOUNG. Iha L.LA. L.6. and approved and adopted
M A I N R O A D ~ for mch ule by iha Ner Ymdr State Land
I