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HomeMy WebLinkAbout17646-z FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCDPANCY No Z-22922 Date MARCH 29, 1994 THIS CERTIFIES that the building ADDITION Location of Property 985 OAR AVENUB SOUTHOLD, N.Y. House No. Street Hamlet County Tax Map No. 1000 Section 77 Block 1 Lot 11 Subdivision Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated NOVEMBER 28, 1988 pursuant to which Building Permit No. 17646-5 dated NOVEMBER 30, 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 DORMER ADDITION TO HEISTING ONS FAMILY DWSLLING AS APPLIED FOR The certificate is issued to LAWRSNCB G. OSTERMANN (owner) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A UNDERWRITERS CERTIFICATE NO. N-063892 - MARCH 29, 1989 PLUMBERS CERTIFICATION DATED MARCH 25, 1994-PECONIC PLDlIDING & HEATING Building Inepecto Rev. 1/81 roast 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 AUTHORITED) N4 G17646 Z Date .........~1~30 19..~}.,_,~ Permission ~s hereby granted to. C tiia1- G Q...,.......~~.~ a~ to ...~t~..kGLc,~.a.:........~''~-t-/?ivy-~i.... ~~-'.`1~........ ~l~.........~~1~...~'!'~! ct premises located at C~~d.-~ Counhj Tax Map No 1000 Section 7...7 Block ....1.....,..r,L~ot No ....,~.1. pursuant to application doted . ~-f~.... 19.Q(! and approved by the Bui ld~ ng /fI n'spector, Fee $.~0..©Y" S~T.~~,~~1~~ Buil g ! for Rev 6/30/80 Form No. 6 ~P. ' ~ }~y~0. ' ~ TOWN OF SOUTHOLD 410~4'E~s BUILDING DEPARTMENT TOWN HALL ~ ~ Z ~ C 765-1802 y~ APPLICATION FOR CERTIFICATE OF OCCUPANCY ~ Q, U 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 lOCatLOn 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 alI property lines, streets, building and unusual natu~or topographic features. 2. A properly completed~apppplication and a consent to inspect signed by the applicant. If a Certificate of dccupancy is denied, the Building Inspector shall state the reasons therefor in writing to the applicant. G. 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. Certificate of Occupancy on Pre-existi~ Euildine $100.0_0_ 3. Copy of Certificate of Occupancy - $20.00 4. Updated Certificate of Occupancy - $50.00 5. Temporary Certificate of Occupancy - Residential $15.00, Commercial $15.00 Date New Construction......... Old Or Pre,-~exis/ting Bu®ilding....,~.'...l,.~.~ / f t Location of Property......~:~......../.dC:Cdxt"f.~~/.J•FVw....c143:4'L.?.4'.~,~~..,ryyy.l~./.r,~.~?•-.. House No. i Street' Hamlet Onwer or Owners of Property...~$.'k'!`.°.!~.~: 5:. ~ ..kr.4~:`'~1.44~............// County Tax Map No 1000, Section..... J:,l......B10Ck....... 1.......Lot...~~.( Subdivision ....................................Filed Map............Lot.... Permit No..~.~d~..~N'. ~•Date Of Permit. ~~/.J.~~~~...Applacant..~".Qmd`.~2°S".a'P.'3. FP.~....... Health Dept. Approval......~A .................Underwriters Approval...~!~~..~: Planning Board Approval... Request for: Temporary Certificate........... Final Certicate...~..... 'ee Submitted: $ . r(~ JJt/' ,~y///(//~ QA.C i ~ ~ Y ....~,C:: fEr.J:~i~~cc'. n.:`. L."f:'.2~ ,t`7?:~%Y:'~c . r ~ ~ J Q ~ .L APPLICANT '1'EL.7G5-1802 ~o~~~FaLS Cllr TO'~irN OI' S~itT13f1'1..~ ~~•~,y ~ bFF1C1: OF BUILb11dG INSPCCTOIt o ~t i;t ~ P.O. BUX 1179 , cr `t,1 '2~"~*r- TO1VN HALL ay ~ `C O/~.m~n,.~~'~- 5UUTHULD, N.Y. 119! , gyp, ~ C E R T I F Y C A,T TON ~ ~ bate ~ ~`L/ 13uildirg Permit No. / 7Ir ~'G ~ Owner fia. tx-~t2e ~ ~~i~rr.~~ - (please print) l Plur..5er~~~~j//,(", /~f~ilrJ~7rt/4 ~,'%C=1'~~~/(,IY (please print) I certify that the solder used in the water supply system contains less than 2/10 of 1~ lead. „ ~ - 1 er~~y~gnature) Swarn~to before c this ( ~ q~ S day of ( ~4~J~.~d 19.~ \"1~)7 Notar Pu Lic notary Public ~ ~ County r BA[tBkRASTEPNDNSKI IJaarY P~kw Skde of Naw Yak Nc. OtSTI8M752 Qu24iCwd w Suffdlc C ~Y19cJ _nihissfm Expves Sept f- t - _ _ _ _ _ 176 THE NEW YORK BOARD OF FIRE UNDERWRITERS FADE 1 l OUt093 BUREAU OF ELECTRICITY 83 JOHN STREET, NEW YORK, NEW YORK 10038 pate MARCH 24,19$9 gpplicotionNo.onfile 60254989/89 N iib3$92 THIS CERTIFIES THAT only the slectrlcal pu(pment es described bdoty and introduced by [he applicant named on the above application number in the premiess of MR. OSTERMAN, HICKOkY RG, ;aULElt9, SOUTHULG, N. V. in the follouinp location; ? Besement ? /st Fl. ®Ynd FI. Sertlun Block Lot cps examined un MARCH 07,19$5' sndfound to be in compliance with the requirements of thu Board. IIXiURE TACIRS SWIrONf RXTURK RANGES COOKNIO RRCKS OVENS qSN WASNRRS lXNAUST FANS Our1ET5 INCANDFSCEM.PIVCMfbCIM OTHEn MAT. K.W. AMT. W. AMT. K.W. AMt. K.W. AMT. M. P. 12 9 4 12 2 f BITERS 1YRRIACE MOTORS FUTURE AMl1ANCE IERRYS SFROAL RRC?T rIME CIOCRS RNL UNIT IIRATlRS ARI111.0YTlR gMMERS AMT. x. W. Oll H. P. OAS N.I. AMT. NO. A. W.O. AMf. AMP. AMT. AMK. TRANS. AMT. n. P, tM tl ~r AMT. WATTS SRRVICT! DISCONNECT tq.t)f S E R V 1 C E AMT. AMI. TTPt ~ t / 7w t / tw ] ~ TY J / AW ~ COND. Of CC COND. OF X4U:G Oc ~ NO. GP nE11TRM5 O~ ~NEUIRAI ! IS+i Cd t X a t t t OTINR AP?MATUf: !3t40Y.E GE(ECTUk:-1 GARY OOROSKI LIC.Ik2941 E 42~i MONSELL LN. CUTCHOGUE, NV, 119.?5 ti/sIRRu Il Psr This urtificaN must not M altered in a+ry manner; roturn to 1M offin of tM Roord if incorrscl. Inspectors may be identified by their crodenNoh. COPY FOR 6llILDING DEPARTMENT. THIS COPY OF CERTIFIGTE MUST NOT BE ALTERED IN ANY MANNER. ~ 7~~ T65-1802 BUILDING DEPT. INSPECTION [ ]FOUNDATION 1ST [ ] ROUGH PLBG. [ J FOUNDATION 2ND [ ] IN TION [ ]FRAMING FINAL REMARKS: t~ DATE ~ / INSPECTOR l7~ y~ 765-1802 BUILDING DEPT. INSPECTION [ ]FOUNDATION i5T ROUGH PLBG. [ ]FOUNDATION 2ND ~ ]INSULATION [ ~RAMING [ ]FINAL REMARKS: ~ ~ /vr~ y~~ . /ltit.ir.~.. sA'~wa~-cJ / DATE ~ INSPECTOR 1 ~ ~ 765-1802 BUILDING DEPT. INSPECTION [ ]FOUNDATION 1ST ( ] ROUGH PLBG. [ ] FOUNDATION 2ND [INSULATION [ ]FRAMING [ ]FINAL REMARKS: ~,~~c.~sti, DATE ~ ~J ~ ~ INSPECTOR - i~LD I:,s: ~c.,u;~ I~u„Ta q co~wMCUrs . r ~ _o H H FOUIIDATION (1st) ~ - c~ 20UNDATIOII ( 2nd ) _ q~.~ m 2 . ~ i ~A.' W 19 _ _ - zo ROUGH FRAME ~ / ~ PLUMBIIP'G 4 t H 3f 3. ~ m n IIISULATION PER N. • • STATE EPIERGY ` CODE x ~ / c~'Z.. f ~ cr*~ 4 . FIIJAL o s ADDITIOPIAL COMMENTS: m ' x . •v N 1~ a~ l • 9 H - - a~ r ~ - y b C+1 H ~C~U~~~~Y a~ it ~Ld~ I k1~~~~~~~P1t c_ G"x~sl.a~ • ~ At NOtEDG ~ aAT,w:~ ar.11 FEE. ~ At NdFtFY --'~J" 786.1801 8 ~ i ~ FCIR TF~ FOI,I,pWIN13 ~~a t. FOU 1. ROUGH . }RAMt1Ki 9. MISULATI ryltygT A FINAL - CONSTRt1Cf1aN { BE COM FOR C.Oi~ 1rAEFT ALt CONS 111E N Y THE REOUfREME~ ~ STATE CON$7RUCn0~'I i ENE ~ i^ I CODES. N RESPONSItM.E ~ ~ ~ I DESIGN ORSTR~K ~~RS ~ 1 ` a I,~- 4 N ! _ ! ° " ~'f ~',~!HFfS RS NOTEQ ` q, ~ :~~~sPa ~ _ Ev •~+:o`_~ _ithmi~ DEPAR7MEN7 AT ` ~ ~ rr ~ Tp 4 PM FOR THE j ~o t; v:.IMSPECTtpNS i ~ ! ~c)UNpATION T+nroREaaREa ~ FOR Pput~EO CONCRETE ~ 2 ROt1GH - AMING i PLU11181g0 3 INSIEIATI _ A fINAI - NSTRiICTIpM MIST O i I SE COM FOR C.O. y ALL CONSTI >]1MLL MEET ~ ` ~ THE REaVNt i1f 111E N.V. ro STATE M ~ib16Y ~ ~ !.,_--a- cooES. I+1~ etsro~u fort ¢ ~ DESIGN CNt CmN8T111lC11011lIY1011~ s / .r ~ ~---=r I s~ _r 11 r ~cc~ ~2c nt t- rn 'y, p, ~ W~ ~~C mOe~^~ ~ u4+ ~ w ~ ~ O Z tt~ r-~ ° ~h4 p2'n n~~ a ~ o 9~ ~ s S c r S S ~ C~ k'" (t' rl C" ~ s ~,y5 c~ ~ ~ s i C t f ~ ' ~J x ~ h a V e ~ ~ ~ ~ P S ~ s ' Ppr. N{ r ~ f ~ S -F`t l~Vi~ _t ~ N ~ ?5 ~ ~ ~ S' ~ %t r gyp/ s ca x -ti ~ cY ~ ~ % q ~ ~ =~-t v+ ° a o A ~ ~ ~ "S'.y. s rr ..til ~ o` y.~ ~ r _ ~ .s 51 ~ ~ -t j ~ "i1 ~ ~ ~ ti `~`+l Q ti ~ ~ - v'S. ~ T,.. p j R S I ~ ~ ~ ~ A S ~ H 0 tr" ,,,,....."''"......r r--' 41, ~~r.. D l5 D~I ~ i BOARD OF HEALTH t~ ~i f 3 SETS OF PLANS FORM NO 1 SURVEY TOWN OF SOUTHOLD CHECK • • Fj • - ~ BUILDING DEPARTMENT SEPTIC FORM BLCG UEP7 TOWN HALL NOTIFY TOWN OF SOUTNOLD SOUTHOLD, N.Y. 11971 TEL.. 765-1802 CALL MAIL T0: P() ~p11 Examined ~f~~30.. , 19~~ Approved , 19~~Permrt No. Disapproved a/c (Buddm nspector) APPLICATION FOR BUILDING PERMIT Date ~ot/_ 19 INSTRUCTIONS ~ a. This apphcatron must be completely filled in by typewnter or m ink and submitted to the Building Inspector, wi; 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 adlommg premises or public str or azeas, and giving a detailed description of layout of property must be drawn on the dragnm which zs part of this at cation. c. The work covered by this apphcatron may not be commenced before issuance of Burldmg Permit d Upon approval of this apphcatron, the Burldmg Inspector will issued a Building Permit to the applicant Such per shall be kept on the premises available for inspection throughout the work e. No building shall be occupied or used in whole or m pazt for any purpose whatever until a Certificate of Occupy shall have been granted by the Building Inspector APPLICATION IS HEREBY MADE to the Burldmg Depaztment for the issuance of a Burldmg Permrt pursuant to Btulding Zone Ordinance of the Town of Southold, Suffolk County, New York, and other applicable Laws, Ordinance Regulations, for the construction of buildings, additions or alterations, or for removal or demolition, as herein descril The applicant agrees to comply with all applicable laws, ordinances, building code, housing code, and regulations, an~ admit authonzed inspectors on premises and in building for necessary m 7e~cCti~o'n~s{y- d" . (Srgnatrire of applicant, or name, if a corporation) ~Q~ ~ - ~~re~ro (Mailing address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or buil~ . . u ~ ~--cl< e r - h,.,~ . - . . Name of owner of premises ~°`~YY_~, QS.r~rs-Haul, (as on the tax roll or latest deed) If applicant is a corporation, signature of duly authonzed officer . . . . . . . (Name and title of corporate officer) ALL CONTRACTOR`S M ST EpSUFF L OUNTY LICENSED Builder's License No / ~'7~~'~ . Plumber's License No J r°p~~ Electrician's License No 1. ~.l Other Trade's License No - . . 1 Location of land on which proposed work will be done - . , 9~~ - d~ . - . House Number Street Hamlet County Tax Map No 1000 Section ~ 7 Block ~ Lot Subdivision - Filed Map No - Lot . . (Name) 2 State existing use and occupancy of premises and intended use and occupancy of proposed construction a. Existing use and occupancy 5 r ~~-x `f o~ L . , _ , . _ , , , , , , , b Intended use and occupancy - - ,,~.gScor°JS70.L T Lu"cA~ t-E'~4ox... . 3 Nature of work (check which applicable) New Building .Addition Alteration . . Repazr Removal , . Demolition Other 1Vor,]~,,, Qr~" ton) 4 Estimated Cost ~ e~-1. (30 ~ • . Fee . . . (to be paid on filing this appltcahon) 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,,t}'p~g of use . 7 Dimensions of xt tii}g structures, tf any Front .`h.~. Rear A. Depth ,,`ham ~ . . Height Number of Stones ~ ~2 Dimensions of same~tructure with alterations or addyttons Front . Rear ~ ~ r . Depth ~f... Height ~.l . Number of Stones ~ly ,Y 8. Dtirienstons of entire new construction Front Rear ..v~. Depth ~ Height ...Number of Stones . 9. Size of lot }Front ~ U.U Rear C 6d Depth lp. Date of P urc:uase Nam of For,-~er O er . 11 Zone or use dtstnct m which premises are sttuatea . ~'C.St£!'~>1 1 `t , 12 Does proposed construction v~ip late any zoning law, ordinance ~r regulation . 13. Will lot be regraded IV'Q 1Vt11 excess fill remov d from premtses• Yes ~ 14. Name of Owner of premises ~QYY.`3. d3.7'?~' "t.`S'Address p?' ~ 4~~ c~ ~ ...Phone No ~:G,j <.~3 .tj. Name of Architect ti.. Address .Phone No Name of Contractor GB.GY'~~Q-. P4tt.Tx d ..Address Cle.'~'6(gogGe,4~ ...:Phone No,~,~~.'?`~jz. 15. Is this property locate within 300 feet of a tggidal~~ wetla d? *Yes No 1~ *If yes, Southold Town Trustees PermitPLO~ DIAGKAMed. Locate clearly and distinctly all buildings, whether exustYng or proposed, and indicate all set-back dimensions fro property fines Grve street and block number or descnphon according to deed, and show street names and mducate wheth intenor or corner lot PY'rua.i~~ Q,aad ~ ; t d~ r ~ l f 1 ~ ~ / ~t•w ~QYrrtt~ I ~ 0 r N STATE OF NEW YORK, f- i COUNTY OF , , S.S being duly sworn, deposes and says that he is the appltba (Name of individual signing contract) above named . . . Hetsthe (Contractor, agent, corporate officer, etc ) of said owner or owners, and is duly authonzed to perform or have performed the said work and to make and file t} application, that all statements contained m this apphcatton are true to the best of fits knowledge and belief, and that t work will be performed m the manner set forth m the apphcatton filed therewith. .r Sworn to before me this vZ ~ . day off/ . ! t4t`o~"" 19 fig. Notary Public, . T !Y ~ 1~.~ .County ...i~G~~-:-~....~~ HELEN K DE YOE IMTARYPUBttC,StateotNewYod (Signature of apphca, Tor~m Ezpres Mi~c h3Uk,19-a-,r