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HomeMy WebLinkAbout17553-z FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No Z-17859 Date MARCH 17, 1989 THIS CERTIFIES that the building ALTBRATION Location of Property 2030 HOBAR'r ROAD SOUTHOLD, NEW YORK House No. Street Hamlet County Tax Map No. 1000 Section 64 Block 3 Lot 4 Subdivision Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated OCTOBHR 18, 1988 pursuant to which Building Permit No. 17553-Z dated OCTOBHR 21, 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 REPLACE HxISTILtG FIXTURES 1R4.STE 6 SUPPLY LIDS FOR SECOND The certificate is issued to GEORGE & FI.ORffiiCE LOEHR (owners) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A CERTIFICATE NO. PENDING - MARCH 17, 1989 PLUMBERS CERTIFICATION DATED MARCH 17, 1989 - GEORGE LOEHR _~ ~.~ , it ng" nspector Rev. 1/81 n~osns xo. s TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N. Y. BUILDING PERMIT (THIS PERMIT MU5T BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIXED) N~ G17553 Z Date .....~D..,~?-.L ............... Permission ereby granted to:~ ct premises located at .......................... .~.......r~9.?1 ......, 19~~ ......................... ......................................................................//......................................................................................... Caunty Tax Map No. 1000 Section ........1~.,~.~.....pBlock .............`-'~........ cL~ot No.......T............. pursuant to application doted .............~a~~.a........................, 19Q fJ, and approved by the building Inspector. Fee $•G/....". OD.. B d g I actor Rev. 6/30/80 ,' ~ TOWN OF SOUTHOLD ~ 1'~IR', ~ ~70~ BUILDING DEPARTMENT 7 TOWN HALL r„,.~.~-~G~_I?~~'T. ___._....,.v,,.... ,,,..,.., SOUTHOLD, NEW YORK 11971 765 - 1802 APPLICATION FOR CERTIFICATE OF OCCIIPANCY DATE--•'-•---........ NEW CONSTRUCTION .......OLD OR PRE-E%ISTIN6 BUILDING......VACANT LAND......_. Location of Property. ,y~.~a. ~.~.h~`."t..~~'............S~~t~O~~ HOUSE N/O}~,. yq STREET HAr/MLET Owner or Owners of Property `:.~? br7 :e. ~'?"..~ h(x v t:~s.4 ... ~`.6 SJ S~Y' .......... . County Taa Map No. 1000 Section ...... Block ._..... Lot ......... Subdivision ....................... Filed Map ........Lot.......... Permit No.~.7~~~.~`:.Date of Permit P©: ~f..YCApplicant~4d~~.6.J:"S.4~C'~!I?:. Health Dept. Approval ................. Underwriters Approval .............. Planning Board Approval ................ Request for Temporary Certificate ....... Final Certificate ................ ,,~~ff ~ ~~ Fee Submitted: $..!~'.:5......... „ „ „ APPLICAN~~ ~~zG~~Y:~' .............. . (~,. 3`833 c.o ~. i ~gs9 rev. 10/14/88 ,~''"~FF~C~-~o, TOWN OF SOYTT~OLD ~ ~~ ,_ ~~ < OFFICE OF BUILDING INSPECTOR ~ ~ rn P.O. BOX 728 4~~0~ ~ ~~o''r SOUTHOLD, N Y 11971 C E R T I F I C A T I O N TEL. 765-1802 Date ~ /~~$~ Buildirrng Permit Nppo. l $~f' Owner/~'rto'Y' .P eP-1• ~+a~Ji~ (p ease print) Plumber ~ k~"~1 t _ (please print) I certify that the solder used in the water supply system contains less than 2/10 of lg lead. , , ~~ " ( lumber's' signature~~ Sworn to before me this ~Z_day of /"~a'K-/~__~ eW4~J Z) . ~Q ~D-e-- 19~. -- Notary Public Notary Public ,_#?~~~_County . JI~J _ HELEN K. DE YOE NOTARY PUBLIC, State of New Yak No. 4767878, Suffolk CourdYq~ Term Expires March 30, 1g / / r'Ic:LD I::SPECTIO:J - IIDnTr, I i;UtYMEN7S ~ t. \ m V a ~ ` - - - H G ?OUIIDATICIV ( 1st ) ~' ~~ °OUNDATI011 ( 2nd ) _ - m~ 2 . ~'~ o ~ ROUGH FRAME & C PLUMBI C NG ~ ~ ~ 3. m I1ISULATIOP! PER N. Y. .. '~ STATE ENERGY CODE ... ~ ~~ ® ~a f y 4. ~ _.~-~-^ FI;1AL o~ ~ 000 ADDITIONAL COMMENTS: x .. ~ ~ ' m x, ~ • ^- .b \~ H N x „ A \\\ H H O [*] \ ' - . T ..\ . d m - v H -]~~ II~ FORM N0. 1 ~ ~ 819g~ a 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT y,•.i. -„-•,,~_,~ _ .-' ~l TOWN HALL BLDG. pEl'? SOUTHOLD, N. Y. 11971 WN OF SO~J1t40~_!:` T 6 02 BOARD OF HEALTH ............ 3 SETS OF PLANS :............ SURVEY ..................... CHECK ...................... SEPTIC FORM ................ NOTIFY ----••»- ---~- EL..7 5-18 CALL ..., 19 ... MAIL Examined ~~lyr.~~.ld Approved~rl,~~rl~~g .., 19 ... Permit No.~~i~~t~j. DisaPProve7l ~ ~{lI'Ag ~E~ ....................... . ...DATE: ~~ x/ ~~ B.P.,N, .7.5"5'3 FEE:__~BV: / N0T4FY 8U1 G OEPA AT•••••••• ••••• •• 765.1802 !3 AM TO 4 PM OR THE uil mg I ector) FOLLOWiNGINSPECTION3: PPLICATION FOR BUILDING PERMIT 1. FOUNOATWN - TVNO REQUIREd4 FORPOUREDCONCRETE 2. ROU(iM - FRANAIIid It VLAIMBINf3 ~• ~ INSTRUCTIONS 4. FINAL CONIITRIICIION IIM)ST d T0: ~4 30 >?-~ ~c Date ................... 15 .. . ly filled in by typewriter or in ink and submitted to the Building Inspector, with 3 t gee according to schedule. and of buildings on premises, relationship to adjoining premises or public streets of layout of property must be drawn on the diagram which is part of this appli- c`.C'v~~'d'tf~'1'1~ p tc ion 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 b~~~i r used in whole or in part for any purpose whatever until a Certificate of Occupancy shall have been grante~i~~y~~t~t~,~{c~~gh~~,ector. , 4 } ;~ APPLICATION ISM-g2LB~ 14,~_ tq.gt~e Building Department for the issuance of a Building Permit pursuant to the Building Zone Ordirr~~l'e~~o~4th~kTtsi+ir3 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 demolition, as herein described. The applicant agrees to comply with all applicable laws, ordinances, building code, housin code, and regulations, and to admit authorized inspectors on premises and in building for necessary nspection ~ ~Y .. _C.~ ....... ....... (Sign ture of applicant, or name, if a corporation) .............................................. (Mailing address of applicant) State whether applicant is owner, lessee, agent, azchitect, engineer, general contractor, electrician, plumber or builder. ............................................C.............,!.../................................... Name of owner of premises .<..... ••'•••••.•••••••••••• (as on the tax roll or' latest~i3edd) , .. If applicant is a corporation, signature of duly authorized officer. y .......... .. .. ..... .......... ........ ......... &R~ • . (Name and title of corporate officer) °-. t x , . =<x ~ , ' ,, .. Builder's License No. . ~ !~! /~/ ~ .1~ .............: ~ _ ~ -i ° - ;~- Plumber's License No . ....................... . Electrician's License No . ..................... . Other Trade's License No . .................... . 1. Location of land on which proposed work will be done. ~ ~~ ~~~ House Number Street Hamlet County Tax Map No. 1000 Section ...~. ~........... Block ~ ............... Lot ...'f ............. . Subdivision ..................................... Filed Map No. .............. Lot............... (Name) 2. Slate existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy .......1. ~~'^'? .'• ~ /• • •`~ ©!~ ~ ~ .......... . ........................... b. Intended use and occupancy ....... •~~. s7.??7 ~ • • • . • • • : • • • .CZE~e.~~,_•~.-4~??- ......................... . ~,f r _ 3. Nature of work check which a ~' ~ ~ ~ ~' '°~ tr ~ "~ ` ~ x_,- j'r,~ ( ~tplicable): New Building .......... Addition ... ; :.•.... Altera3Son ` -' ~'~' ...-,~it... p .............. Rem Re air ! ° o ° ova! .............. Demolition Other Wor~ t, , , ur ............. . . ~ (~~criptjoii) . . 4. $stimated Cost ........... ........................ Fee .......... ....... .. ,r s ... . ... .......-ri : .. . g g (to be paid on filing this application) a 5. If dwellin number of dwellin units ... . . . . . ....... Number of dwelling units on each floor .. , , , , , , , , , " If garaoe, num ber of cars ......... . ....... . . . .......... • • • • • 6. If business,commercralormixe ~••~•••~••~•••'••••• ' d occupancy, specify nature and extent of each type of use . ............. . ...... Dimensions of existing structurgs, if any: Front .............. . .Rear , , , , , , , , , , , , , , Depth . , ............ . ........ m Height ....... ber of Stories ............................................+........, Dimensions of same structureu~ith alterations or additions: Front ............ .tl'3i~~>1I186itttl~~St6;t~ Depth .. . ..... . .... . ........Height ...................... Number of Stori ~ ' :....... . 8. Dimensions of entire new const' Hei ht ............... Nu !action: Front .......... , .... Rear .............. Deptli ~. •.~....... ~ .... . g rpber of Stories . _. _. Y+9._ _ _ t 9. Size of lot: Front ......... ......... . ........~"'- ~+`N' ~Y'+'kiitt' ~i~kti'iiiisl •w i:,...... . ............. Rear.................., 10. Date of Purchase .. v!~'t •iiI{'~ i:•t7t •tWA• t+• °;.a`<`r .,,-r • • • • . • • • • • • ..Name of Former Owner . , .. p}ttYi7334~~:'rtrfrr4liV!'<>s•ai ~'r• • • • . 11, Zone or use district in which r p 'emises are situated .................... q~~p~yyt..,.. YI/NrAtTMtI:l:~..t.... . 12. Does proposed construction violate any zoning law, ordinance or regulation: ...... ~ , , , , , . • 13, Will lot be re raded g t•••••••••• .Will excess fill ber r~~. g No 14. Name of Owner of premises ..ly ,o,~.,/I ~,Y, , , , , , , , , , , Address rJ,.~ ~? , Hqb a,,`f; ,Q/rphone No ~~ , Name of Architect ....... . : ...........:.....Address . ,1~ J/1Nt~ b " ........ .. .r...... .... ame of Contractor ....... , P P Y a .................Address .......... .:~~ ~ ~ .. .: IS.Is this ro ert loc'ted within 300 feet of a tide ? +~ *If yes, Southold Town Trustees Permit may be requ>~ ~ PLOT DIAGRAM )M1~ Locate cleazly and distinctly all buildings, whether existing or proposed, ~pfrom property lines. Give street and block~number or description according to deed, and show street names and indicate whether interior or corner lot. ~ ~~~h,-ao~ o'ti,~ Seco'n`d ~~aO~" /1tR~N~1~ rr<wra~n wnes 1't8Y1NQ BEFORE OOVli:RItVQ ./' 6~ j7o ~: e WeYJt n ~ jt'e, 'move a-/t'el~la~.~. ~/1 !=~'xr~r~s y w~~-er1~`•„~ 5 ~ A~-a.-„s Ttl /~ ' ~ c. a 5 °t 1 r o n S'~" 3 77 d ('r~ P ~ : ~~.~.~~ „~:'!t ~~ ~~lalaa~d ~~'~'h Ea~~~r 'z/~~~m~ 0 IM~~•e' r I,~eed tU r~';'! t tae ~eP W r`~`A ~, V, C'. ,. 'l~r fie, f `a rat /.:1 ry"e, Y• ~ t l .W c1 J ~'c. /- ` ~t t f . , tl'~ ~ ~r~~'g1y(,` Vie,: t S,'~k PLU MBER C i ERT/F/CAT/ON m ~ r ~ ON LEAD CONTENT BEFORE ~ I`'3~ _~__ I ~r~' ~ ~~ CERT/F/GATE OF OCCIJPANCy \ ~.•t~yf~w~`^ SOLDER USED /N W TER ~~ ~ r 1=.~. SUPPLY SYSTEM CANNOT / EXCEEQ 2/~Q Of ~~ L~fA If Copper tubing is used ~'. for water distributi~~a, ,,,>` . ~... --___~ STATE OF NEW YORK, f3yStam: piping shall o L...J ,rr~fa COUNTY OF ................. ~'S of types K or l onl ,yo vs e (Name of individual si n ~ • • • • • ' ' ' ' ' • • • • being duly sworn, deposes and says that he is the applicant above named. g ing contract) He istha ......................' ......................................... (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 Gle this application; that all statements contained in this application are true to the best of ftis knowledge and belief; and that the work will be performed in tfte manner set forth in the application filed therewith, Sworn to before me this Notary Public, . ,~.1~:...tJr.. ~~~......... County .. HELEN K DE VOE ~No~47078L7& Suffolk Coeuoty~ • • • ~ Term Erptres Pperch 30,19 (Signature of applicant) 1C ~ IY/L ///C~ I ~ ~~ S3 765-1802 BUILDING DEPT. INSPECTION [ ]FOUNDATION i5T [ /'~OUGH PLBG. [~ FOUNDATION 2ND [ ]INSULATION [ ]FRAMING [ )FINAL DATE~I UO INSPECTOR, . ~ ffi _. .. ~. I 1 S G %y,. a.R..~rT'S~.iL.,~..,.~.......\ UNDERWRITERS PAGE 1 THE NEW YORK BOARD OF FIRE . 8014882 BUREAU OF ELECTRICITY BS JONN STREET, NEW YORK, NEW YORK 10038 Date MAkC;H 3!,1989 Application No. on file tii497I89J69 H 408752 TNIS CERTIFIES TNAT only the alectrled pulpment a. dsacr76ed below and in[roduced 6y thr appltcont nomad on the a6ow spplieation numker in tha promtws q/ _ M/M 0, lt1EHR, 2436 HO8AR1 RD., SOI,iTHOID, N. Y. _ in the following locution ^ Basement ^ I st Ff. ©End Fl. Section Block Lot MAR~H I t l 9 9 , 8 and found to 6e in compliance with the reyuiremenG of this Board. 8 loos etamined un COOKING DECKS OVENS_ _ qSN W _T_. c RKTYM RXTUR/f RA __ _... _ OUTLETS AQ~ EwITQ1EE INCANDlSClM HIKalSClNT OrNEa AMT. [. W. AMl. t. W. AMT. K.W. M1T. K. W. Mfr. ~ M. I. c L 1 G DEYEEE RMNACR MOTORS IUTUR! AMBIANCE FEES fMIC1Al RELIT TKAE CLOCKS ~Nt UNIi 1MATERS lAIMiI.W11RT fEIARAERRf - AMT. t. W. Oll N. ~. GAS N. r. AMT. NO. A. W. G. AMT. AMr. AMT. AMR. TRANS. AMT. N. 1. NO T Mtr. wA1it fRRVIt~ DIECONNRCi NO.OI S E R V 1 C. E AMT. AMr. TMP! ~, l A tW 1 / tw ] A 3w t A IW NO. ~ COND. ~ ~ . O NO. Ot N4lEG a'~'~, NO.Or NlU1tAlS Oi ~~ OTINR AMMRIITUS: ^ G. F. C.1=-1 `. -e'~ 8. LOEHR 24:4 HOlTART ROAD E~ SOIITHOID, NY, 11971 `.. ! 1 i ` Pn 'This tMificON mwt not ba OMarad in airy mennar; Morn to tlw offiu of tha rt) if incorrM. Impactors na be idaMi _ cradaMials. COFY FOR WILDING AR MENT. S E!F , 1 , A~ it AL IN ANY AMI#IER.