Loading...
HomeMy WebLinkAbout17398-z-. FORM N0. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No Z-19915 Date MAY 20, 1991 THIS CERTIFIES that the building ALTERATION Location of Property 1620 GRAND AVENUE MATTITUCK, N.Y. House No. Street Hamlet County Tax Map No. 1000 Section 107 Block 3 Lot 9.2 Subdivision Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated AUGUST 19 1988 pursuant to which Building Permit No. 17398-Z dated SEPTEMBER 8, 1988 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 ALTERATION TO FIRST & SECOND FLOOR OF EXISTING ONE FAMILY DWELLING AS APPLIED FOR. The certificate is issued to GEORGE & ADRIANA ROHRBACH (owners) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A CERTIFICATE NO. H-021933 - MAY 8, 1991 PLUMBERS CERTIFICATION DATED N/A f B ilding Inspector Rev. 1/81 a~oaas xo. a TOWN OF SOUTHOID 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~ 017 3 9 3 Z Dote ...:'.~%......a.. 1 g 0„G. Permission is hereby granted toR~,J_ ~ ~'~z .......... ~.~ 3.~ ............................................ .. ,~A~t ~.....::~.~.!~....~I..~:... ~~p.z,r ............. of premises located at ... ........../...~.:~.~............:~?/.L~+t.:G.,...............:',1................ ........................................................... ........................................................... County Tox Map No. 1000 Section ......................... ......................... ...~0.~........... ................................................ ................................................ ot No. Block .......~........... L ............................ ............................ .......~'..•Z...... pursuant to application doted ....... ..~.....~.~ .. ~/ ........................ 19..A.I.., and approved by the Building Inspector. Fee $...-5.~:.~:°..... .....1.. I .... .~1~!~.r ....................................... 'Building Inspector Rev. 6/30/80 ''ti Form No. G ~~ TOWN OP SOUTIIOLD BUILDING DEPARTMENT TOWN HALL 765-1802 APPLICATION FOR CERTIFICATE OF OCCUPANCY A. This application must be filled in by typecariter 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 insttillations, 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 Cherefor 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 ...`3~Jv~%.~ ........................... Vew Construction........... Old Or Pre-existing Building ................. Location of Property.. ~~0."~U........ ~i.E~/4n~.~~~e :................../~~~~.~~L~~......... House No. StreeC Hamlet )nwer or Owners of Property..~E;oti"~e.• ~/~c~/a~c~.na.,./-~dh2lar~CG, . ..............•...... ;ounty Tax Map No 1000, Section.....:3 .......Block...............Lot .................... subdivision ....................................Filed Map............Lot.... ............... 'ermit No.©.~.13.~.~~..:.Date Of Permit. ~,/~~~~.......Applicant../n.F.~~,°~ ~~h~hct~'~~ Iealth Dept. Approval ..........................Underwriters Approval....X.................... Tanning Board Approval .......................• equest for: Temporary Certificate........... Final Certicate,..x....... mitred: •/ J ee Sub $.::~."~........~:~...~fa~~~.~•• ..~ ............ APPLICANT C0~ 199/3 THE NEW YORK BOARD OF FIRE UNDERWRITERS PAGE 1 8024266 BUREAU OF ELEGTRICTTY 85 JONN STREET, NEW YORK; NEW YORK 10038 - 7x556991/91 H 0219.33 MAY O8 •) 991 ' (e A Iication No. op (, Dete 17398-2 MIT Nb . V TNIS CERTIFIES THAT rI;K Doty the alectrieal putpment a described helms and introduced by the applicant named on the shoos application number in the premises of M/M G. RONRBACH, 1620 GRAND AYE., MATT TUCK, N.X. I ~Y } in thefollorcinp location; ^ Basement ^ lAe Fl. L'I 2nd F'l. .Sertiun Block Lot APR 1.L 29, 1991 u~ss examined un andfound to he in complisnre with the requirements of thu Board. RXTUR! RXTURRS RANOB COOKIN G DECKti O VENS DISN WASINRS RXNAU ST FANS Rr OUTIETS AClES fYRTCNES I NGNIkSClNT PlUORESCENT OTNER NAT. K. W. AMT. K. W. M1i. K.W. AMT. K. W. AMT. X. P. 4 ao 4 s DRYERS RJRNACR MOTORS RJTURI AMIIANCE REDERS SK[gAt RlC'-T TIME CLOCKS MLL UNIT HEATERS /AISI~ ~ LET DIMMRRS AMT. K. W. pl N. P. CMS N. P. AMT. NO. A. W. C. AMT. AMT. AMT. AMPS. TRANS. AMT. N. P. ~. ~ RRlT AMT. WATTS a 600 SRRVIC! DISCONWECT NO.q S E R V I C E • AMi. AMP. TYPE ~ , I / t`M 1 / tW 7 / 3W 3 / AW ~' ~ `CYNeJ' (~ CC . a' a. NO. Or NI.LEG ~ NI ~~ N0. OF NFUTKAlS Of ~ EIITMAL OTHER AMARATUS: SMOKE DETECTOR:-1 ~ _ ~ ~/ ~A~ .f~° l ~ _ MR.&MRS. r,,kOHRBACH ~~% G 16x0 GRAND AYE. MATTI'PUCK, NY, 1x952 oRE1RAl MANAOU ~ 11. ~ U Per This carNficate must rat ba aherad in any manner; rNUrn to the office of the Roard if incorrad. Inspscton may be identified by their credeMals. COPY FOR BUILDING DEPARTMENT. THIS COPY OF CERTIFICATE MUST NOT BE ALTERED7N ANY HAIRIER. ~o~~~FO~k~o~ ;;a~ ~;~.,c.'~ i j,~` ~ 1'01VN OF SOUTIIOLD OrFiCE OF BUILDING INSPECTOR P.O. BOX 728 TOWN EIALL SOUTIfOLp, N.Y. 11971 May 2, 1991 George A. Rohbrach P.O. Box 1155 Mattituck, N.Y. ]1952 To Whom This May Concern, TEL~,765-1802 We are unable to complete your Certificate of Occupancy because of the following reasons. /~/ nn application for Certificate of Occupancy is not on Lilo. / ~/ No underw riters Certificate on file. / ~/ The check is (outdated/not on file.) J `/ No 1lcalth Dept. P.pproval on file. / ~/ No final ins.pc;ction has been made. Please contact our office on this matter. Thank you for your cooperation. Buildi.nq Permit if 1 7 3 9 $` Z Bu.ildi.ncl Dept. ***/ / No Plumber Sol.cler Certificate on file. ( all permits involving plumbing being icsucd after 11pri1 1,19II4 ) / ~3 ~~ 765-1802 BUILDING DEPT. 1 NSPECTION [ ]FOUNDATION 1ST [ ]ROUGH PLBG. [ ) FOUNDATION 2ND [ ]INSULATION [ ) FRAMING [ INAL REMARKS: ~/ q DATE "T ~9 ! l INSPECTOR II fl1 i .~. 2 019A0 ..~ -- ~v b~ar~ ,cam in r_ox-~.c- --- ~~ ~6.~, -- 1c;1.A Z;:S:'ECTIUt~ ~ ~llATE ~ ~OMMENT° ~ ~ m G 1 - 3 ~ . H - H FOUtSDATIO^7 (1stJ c ti FOUNDATIOtJ ( 2nd ) - -- m• _ I ROUGH FRAME & ?.+ O PLUMBING G I y `~ 3. ~ yC IfdSULATION PER N. Y, M STATE ENERGY CODE x ~ S 9 ~ ~- .~ I 4 . ~ GC ~ '-~ FIi~AL ~ C T 7 O p. ~ A z h r ADDITIONAL COMMENTS: x.?" .~ 1 ~/ ~ u' H ~ q a~ H ~' O O z 1 . ~ [s7 A r a ' d m -n H ~~= ~-~ 765-1802 Q~~~~~~ BUILDING DEPT. ~~ ~~ ~'INSPECTICaN [ ]FOUNDATION 1ST ( ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ]INSULATION [/ FRAMING [ ]FINAL REMARKS: ~~ ~, DATE ~~ INSPECTOR .~ 739P~ 7ss-1802 BUILDING DEPT. INSPECTION [ ]FOUNDATION i5T [ )ROUGH PLBG. [) FOUNDATION 2ND [~SULATION [ ]FRAMING [ )FINAL DATE ~ ~ 0 0 INSPECTOR ~ FORM N0. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL ~OUTHOLD, N.Y. 11971 TEL.: 765.1802 Examined .. ~((~~~~~t,,,,:[[. a..:..., 19 ~~o.~ pp Approved ...~"~!1.•. t~....., 190. ~ Permit No.. ~ ~r39o... . Disapproved a/c// ..................................... BOARD OF HEALTH ............ 3 SETS OF PLANS ./........... SURVEY ~.ii CHECK l~ .............. SEPTIC FORM ................ NOTIFY CALL ..................... MAIL T0: (~jpK 1a3~- ~0t~~` ............................... 1' .. ~ .. ~%~=~..........u ding•Inspector) APPLICATION FOR BUILDING PERMIT Date .... ~ ~..!.~....., 15.~g" INSTRUCTIONS a. This 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 Building Zone Ordinance of the Town of Southold, Suffolk County, New York, and other applicable Laws, Ordinances or Regulations, for the construction of buildin s, additions or alterations, or for removal or demolition, as herein described. The applicant agrees to 'cable laws, ordinances, building code, housing code, and regulations, and to admit authorized inspect,~~emtses and in b, ' g for necessary inspections. , ~Wl (Siggature of applica or name, rf a corpgrauon) }~P) 11M1 ~ +~ f~t~ .... ~ ~k is 3~ ~ti'~N,.~~j`. ~:.y.... . ~ ~ .ti (Mailing address of appljc~rtt State whether applicant i ~ clfiitect, engineer, general "contractoP;; electrieiati, :;plumber or builder. .. ., d ~ ,C~~r?;i,dnc;ra K; Name of owner of prey' •e .~ ~~lY ~i3~ ~''.:y ..............`......................... . aAI~MtlMYMt_ (as on the tax roll or latest deed) If applicant is a cor~~n ~ " Qd officer. Other Trade's License No . ..................... ~~ aQ 1. Location of land on which proposed work will be done. ...... ~,~fhN ~ '.. ,~U~.,+/u [T, ,,;~, lrt,~ frr. idc.e .............................. ~Q,~N?../.+.°.~:...................moo-.r~,TUerC.................. House Number Street Hamlet ~.~~ (Name and title of co orate officer) Builder's License No. .....~~~~.. umber s License No . ....................... . ~.2 Lw,C.C ,vw Electrician's License No . ..................... . County Tax r\lap No. 1000 Section ..... ~.~.7........ Block ..........:3...... Lot ......~.•. a, ...... . Subdivision ..................................... Filed T<fal~ No. .............. Lot .............. . (Name) 2. State ceisting use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy ......:Z.~s.5.%•'/a•4'• 4!'T `•`'•~-. • • ......... , .............................. b. Intended use and occupancy ......~ G°.5.%GJ,r.~.'.r?.9,~ , , , . (~~ - ' ....~~~1?~.~e;44??'~ ................... ~:r ~~~~•..« ors m°.....,p4~ r } € ~~~ 3. Napure of wort. (check wltiRhlapplicable): New building .....~... A~c~~tion ~ ttIn ~, , , , , Re atr moval .. • • ' Demolition ~~~or; Lr............ %"m r1Tr~c a~,,,s..cwcr / 03doao .a-*jwrm..Maa~...i. ~ t~,#(Description) ~,es,a ,g+j { 4. Estimated Cost .......... y/,$";O, ea .................. Fce ..... ';~•cs:ef~34~ rti~s.°-)T j (to be paid on filing this application units .. 7. ~ ....? .... Number of dwel ~ .. w...w ~w«aexesa.a»x~t.;i....... • .. • . 5. If dwe]lin~, number of dwelli o~,,, 5`."~oco srw-, s g Img units on each floor . a•.y~a~~,~txs, , , If garage, number of cars .. ~ ........ . . ....... . 6. If business, commercial or mired occupancy, specify nature and extent of each type of use . . 7. Dimensions of ex{s yll~structt~res, if any: Front ...a ~; ~ , . , . , .. Rear . , , ~ G, ; , , , , , , Depth .. ~'~,~ ~ , , , , n ~,~ 1 Hei~~ } i ~~ ,~~s ~;~ N~mber of Stories . , , . J ~1, sT~?~~s • ' Dirti$g of~st>~"str'uclu'ie 1vitlt alterations o a t t s: Front ? 9!'? ~ Rear .1_' , °r,q ,~ cr DeP ~ i.. s ar~~ ' Iro: .~ ~ ~,8~ ... ........ ..... . . IIeight $.~~~i.;•, ft^,~z,pyc , , Number of Stories .. .j =.. 8. Dim r ns yy "` `' I .. ..... . ~~(~ ~irc no-~ftu~ction: Front .... a,¢l....... Rear ... a~:....... Depth ..~q ' Hci 1, ~? '~lifb'",er of Stories . , , I r , s;r~;~ rps ~ ' • ' ' ' • • ' 9. Size o`("lo~' r ..', t~ , - ~ (o.~-:........ Rear ...... i g`.f,~. ! :~. ~ ...... Depth ... 1 S-(~ .'d. ; ........ . 10. Dat >~ ~' ~ ........ . • ur ..... ....................NameofFormer Owner ............................ 11. Zone or use district in w}ticlt premises are situated .....:~rr',s 1 ~s;v,TK!rc. ................................. p P olate any zoning law, ordinance or regulation : ......................... . 73. Will lot be re raded ~ ~ • • Does ro osed consptruction vt Will excess fill be removed from premises: ,Yes t~1 14. Name of Owner of remises fv. Name of Architect , , .......~4RbG. fin,/{ 2 ARCl4. Address I??/.*N!? d ~4/. MR ~•.... Phone No. '7FS"'.......... . ••••••••.....,Address ........ .........PhoneNo.. Name of Contractor`~8~~.~1e./mP~!!S, ,Address f~s~r4!???,.S?:^'?~a~~ .PhoneNo.2~~::~~gq,; P P y ............ IS.Is this ro ert located within 300 feet of a tidal wetland? =YES... A~,., *If yes, Southold Town Trustees Permit may be required. PLOT DIAGRAM Locate clearly and distinctly ajl buildings, whether existing or proposed, and, indicate all 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 corner lot. 5L~" kFFr.acotsa~ st'1c,si' i ,. OCCUPANCY OR ', USE IS UNL.AI~FUE WITHOUT CERTIFICATE OF' OCCUPANCY STATE OF NE1V YORK, COUNTYOF ...............•,• S.S ' ' ' ' ' • ' ' ' ' ' ' ' ' ' ' ' ' ' • • • • • • • • • • • • • • • • • • • • • . • • • ... , being duly sworn, deposes and says that he is the applicant (Name of individual si~nl o iitg contract) above named. He is the ......................'..... (Contractor, agent, corporate officer, etc.) • • • • • • • • • • • 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 this application are true to the best of his knowledge and belief; and that the work will be perforred in the mannet set forth in the application filed therewith. Sworn to before me this ................. °rr~'....day of~~!./...n.~q .........., 19 ~8 Notary Public, ...... ~.. 71.^. ^! ;C;[,/(l~... County < ... ~~ •' ~ ~i'.~ .. ................. . G~Signaturc of applicant) I,~Ps'rwtKS f-'~~^ot tp~Aa ~_ . .z c' - ---- __-_ ~..~w- ~H ~_ ~! KNEE WAiG STORP4~ ~~KNE(c Wa~L 7 3 5' u 3 KpEE ~+~' u. I ~ ~-reR?GE _____~ __,~a._~:. _._,_ n spa Oc@~A PTe QS - ~ JSiRw SKyU RJVt~~~ '~ ~. ~i '~~!~k ' l ' ~/ ' ~. i ~- i ~~Sr- i.' t,teUCC.. ~- tN `~ { `P~t 9R ooM ~~ -paoe `' ~ - ~ei.xD~-et (ink ~s~nt~ t '~ - Nr 3 y ~ ~ ~~ 36- ~ A~t~, i. do ~,es uPs 3~ -~'i»~+o srR~ -pewrca vt a 3otSTs. i $gocftG6 ,E~'lC~r~oUtt `fS~Rt±1uG- ^^~J+~t_ Nsr~-{~ ~i6 jsr~e~ ~c.~T~ ~~ ~QmvM ~ ?ECb F~t+o4 ~OtS'FS - 13 cl I~ ) s , j 'Dow.~~,pRAS'rE+t~j f 6 ~ pro @px ~ RJ414~ Sir aR-o6 --- -- ~ ~ ~ - rots« ~ - ~ y ' _~ C~35 Sltb' OF W~N'peW t_~rn~T~O ~y ~PaReN ~pp~ <LRt=~~y T,t~~E x 4 1 ~ \~ k~sk~ ~ ~ ~~a ' war ~ _ ~.. ~ ' 1.1 E !~ ~ - 1 .~ } ti 4 ., . _ f t ' 11 . , yam i ,~ -- O ,z ~ ~ ~ ; ~` ~ a ~ :.: t -l•.. ~ .. 4`r . ~ 0 , ~ f R r ' ' Y ~ .. ~ ~ ~ h N ~' Y' ~~ ~ l ~ ~ k ~ z-~ jai 4`~ ~ ~'. ~. ^Y4 ,..K .'R"v y p.r°r os V ~: _ _. _-_• ;-.,*• :,~ w ~ Eta M,~1flt ~ _ r i Y- - a ~ i , ', , __ i - - ! NOTET •+AADAf/MENT w , , - # .. - Y y ; - I j - T """"1O1'" ' ~ -, YOUNG d YOUNG ,,. ' 400 OSTRANDER AVENU E, RIVERHEAD, NEW YORK _ = ALDEN W. YOUNG MOWAWD W. YOUNQ ' -NOI[tt10NAL tNaiNttR AND LANG tYRY[YOI[ LAND fUIEVtT'ON, N.`/.t. LIC. NO, Iit4• N. Y. t. 40. NO. •tttt SURVEY FOR: UIIAUTIION¢ED KTdAt10N M ADDITION M N«t wNlr[T t • vwLAnoN or scetwN teM 0! TM GEORGE ROHRBACH ~ pF NEW Y ~s~. ,~Pt , ~,,,, y [ NEW YdtK STATE EOUCATpN y ~ ~ ~ O * 7 C COM[[ W TNIS WIN[Y MAK NOT tEANINO THE LAND tIMV[Y011~[ IMN[D 3[AL 011 ~.. _. _ 0 n -r. > [Nt0[RD t[AL WALL 1107 eE CON9IDFNED . TOt[ AYALID TNU[ WIT AT g /~y ~QTr~T~1.rIY to S tMI1AMT[[! INDIWT[D N[N[ON WALL 11UN OINX to rN[ KN~ON FON rNOt TN[ iw11[Y M MIE~AR[D AND OM M TowN of •SOUTHOL D @(/A , O. tO,TM[ TITI[ COYMNY. A~11D[ M LENDMN .: ,. ~. Y