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Home My WebLink About17704-zFORM NO. 4 TOWN OF SOUTHOLD BUIlJDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No Z-17628 Date DECEMBER 21~ 1988 THIS CERTIFIES that the building ADDITION Location of Property 275 RAMBLER ROAD EXT. House No. Street County Tax Map No. 1000 Section 88 Block 5 SOUTHOLDr N.Y. Hamlet Lot 35 Subdzvis~on TERRY WATERS Filed Map No. 2901 Lot No. 17 conforms substantially to the Application for Building Permit heretofore filed in th~s office dated Bulldlng PermltlNo.i7704-Z DECEMBER 19, 1988 pursuant to whzch dated DECEMBER 21~ 1988 was issued, and conforms to all of the requirements of the applzcable provisions of the law. The occupancy for which this certificate ls · ssued is DECK ADDITION TO EXISTING ONE FAMILY DWELLING AS APPLIED FOR The certificate ls issued to JAMES J. CAMPBW. TI. (owner, X~) of the aforesazd bulldzng. SUFFOLK COUNTY ~EPARTMENT OF HEALTH APPROVAL N/A UNDERWRITERS u~TIFICATE NO. N/A PLUMBERS CERTIF~CJtTION DATED N/A Building fhspec~r Rev. 1/81 lvO~ NO. ~ TOWN O~ SOfT, OLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N. Y. BUILDING PERMIT (THIS PEI:qv~IT MUST BI:: KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) N~ b1770~ Z Permission is hereby granted to' ...~.~....,.....~ ..................... , ,~:, ~ , ...~~.......~4......~ :..~..*~.z.. ............................................................................ at prem,ses located o,; .................. ....~...o-~-m~..~ ...... ~..~t ............ .~~ County Tox Map No 1000 Section C:b~. ~, Block .q~..,.~'.. .... Lot No ...~.~'-~, . .~'~.CJ~c,:m.LM~ J.~. .., 19.~.~.., ond opproved by the pursuant to opphcohon dated . Building Inspector. Fee $...~..~,,.: ..~. Building Inspector Rev 6/30/80 FORM NO 6 TOWN OF SOUTHOLD Building Department Town Hall Southold, N.Y. 11971 765- 1802 APPLICATION FOR CERTIFICATE OF OCCUPANCY Instructions A. Thru apphcat~on must, be fdied in typewriter OR ink, and submttted aa -- to the Budding Inspec- tor w~th the following; for new buildings or new use: 1. Final survey of property w~th accurate location of all buildings, property lines, streets, and unusual natural or topographm features, 2.F~nal approval of Health Dept. of water supply and sewerage disposal-(S-9 form or equal). 3.Approval of electrmaI ~nstallat~on from Board of Fire Underwmters. 4. Commercml buddm~gs, Industrml buildings, Multiple Remdences and mmilar buildings and installa- tions, a certificate of Code comphance from the Architect or Engineer responmble for the building. 5.Submit Planmng Board approval of completed s~te plan requirements where applmabte. B. For existing buddings (pmor to April 1957}, Non-conforming uses, or buildings and "pre-extsting" land uses' 1. Accurate survey of'property showing all property lines, streets, buildings and unusual natural or topographic featureS. 2.Sworn statement of ,owner or previous owner as to use, occupancy and condition of buildings. 3. Date of any housm9 code or safety inspection of buildings or premmes, or other pertinent mforma- t~on required to prepare a certihcate. C. Fees: Additions 825.00 POOLS $25.00 ALTERATION $25.00 1. Certificate of occupancy New Dwellzng $25.00, Accessory ,$~0.00 Buszness $50.00 2. Certificate of occupancy on pre-existing dwelling $100.00 3. Copy of certlfmate qf occupancy $ 5.00, over 5 years $10.00 4. Vacant Land C,.O. $ 20.00 5.Updated C.O. $ 50.00 Date ,. 12/20/8.8 . NewConstruct~on :x OIdorPre-exlstmgBuildmg Vacant Land ROAD EXT, SOUTHOLD, NEW YORK Location of Property ,275 .RAMBLER . . . I-tous~'lNo Street Harnie~ Owner or Owners of Property JAMES J. CAMPBELL [- 88 35 Fded Map No. Lot No Subdivision ............ r .......................................... I ]2/19/88 EDSON& BRUER Permit No. ]7704Z D~te of Permit .......... ADp mant .. Health Dept, Approval ... r .................... Labor Dept. Approva~ ........................ UndenNrlters Approva; ..................... ! . . P~anmn§ Board Approva~ .................... .. Request for TemDoramf Cer~ihcate ..................... F~na~ Certihcata ....................... Fee Submitted $ ............................. Construction on above descrjbed bud ng and permit meets all apphcable codes and regulations. ! Apphcant ............ ' .................................. ... . Rev. 10 10 78 3 37£ 765-1802 3UILDING DEPT. INSPECTION FOUNDATION 1ST [ ] ROUGH PLBG. FOUNDATION ZND [ ] INSULATION [ ] FRAMING [~INAL REMARKS: DATE FOUNDATIO~ (1st) FOUNDATIO~ {2nd) ROUGH FRAME & FLUMBING 3. INSULATION PER N. STATE ENERGY CODE Ye FINAL ADDITIONAL CO~UMENTS: C~bell, J~nes J. P~mbler Road ExtenSion Southold, N~w York 1000-88-5-35 5 3/4 x 6 decking Floor joists made ~f 2 x t0 2 x 4 railLng 4 x 4 corners on railing Lolll col~nns - 16" footages 0C CCA material 400 square feet FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, NY 11971 TEL. 765-1802 Appro,'ed .<~o~~t, 191~2 Permit No Dmapproved a/c ............................. (Building Inspector) APPLICATION FOR BUILDING PERMIT BOARD OF HEALTH ......... 3 SETS OF PLANS ......... SURVEY .................. CHECK ................... SEPTIC FORM ............. NOTIFY CALL .................. MAlL TO: December 14 Date ........... 1 INSTRUCTIONS a 'Flus apphcation nmst be completely filled zn by typewriter or m ink and submitted to the Building Inspector, sets of plans, accurate plot plan to scale. Fee according to schedule. b. Plot plan showmg location of lot and of bmldmgs on premises, relationship to adjotmng premises or pubhc s or areas, and giving a detmled descnptlon of layout of property must be drawn on the diagram which is part of tins cation. c. The work covered by tins application may not be commenced before issuance of Building Permit. d Upon approval of this appbcation, the Building Inspector will ~Ssued a Bmldmg Permit to the appbcant Such p. shah be kept on the premises avadable for inspection throu~mut the work. e No budding shall be occupied or used in whole or m part for any purpose whatever unUl a Certificate of Occup shall have been granted by the ~mldmg Inspector· APPLICATION IS HEREBY MADE to the Building Department for the Issuance of a Bmtdmg Permit pursuant t, Building Zone Ordinance of the Town of Southold, Suffolk County, New York, and other applicable Laws, Ordmanc Regulations, for the construction of buddings, additions or alterations, or for removal or demohUon, as hereto desc~ The applicant a,,rees to comp!y with all applicable laws. ordmances.A:%kd~ung code, housing code, and regulanons, a~ admit authonzec~ inspectors on ~remlses and m budding for necessagy ~//~~~c~nt, or nan~e~ ~ f'a'..c'o~o~q'~ / · ,Fitdolph I. ~Bruer, arty rot o. ..... h~Ia3-n. P~, .P.O..Box.1466,. Southold, .~. (Maihng address of apphcant) State whether apphcant ~s owner, lessee, agent, arcint¢ct, en~neer, generaI contractor, electrician, plumber or buff ...... .at.torg.eY fg.r...o%~n..er ................................................ Nmmeofowner~fpre--mcs ~ J~mes J. Campbell (as on the tax roll or latest deed) If apphcant m a corporat~on,,shgnature of duly authorized officer (Name and title of cg~rporate officer) Budder's L~cense No '1 .......... Phunoer's License No ........ Electrician s License No Other Trade's License No ........... ' '~'~%'- '1 Road Extension, Sou*hold, NY LoCatlO~l of land on v~luch proposed work will be done ................................ House Number Street Hamlet County Tax Map No I000 Section 88 Block 5 Lot 35 Subd,vis,on . .lV~..p..o.f T.e ,r,~ Waters ...... F,led Map No 2901 .... Lot 17 I (Name) Stale e\lstmg use and occupancy of premises and intended u~e and occupan~.y of proposed construction- a Ex~ting use and occupaniy One fanu. ly dwellinq b. Intended use and occupancy s.a~ ............... ' X 3. Nature of work (check which applicable). New Budding .......... Addxtion ......... Alteration .... Repmr ............ , Removal ............. Demolition ............ Other Work .......... , (Descnpt,, 4. Eshmate'd Cost ...... ~ .......................... Fee .............................. I (to be paid on filing this application) 5. If dwelling, number of dwelling units ............... Number of dwe[hng umts on each floor ............ If garage, number of cars .................................................................. 6. If business, commercial or mixed occupancy, specify nature and extent o f each type of use .............. 7. Dmxenstons of ex tt ,, ctu e if an Fron 54.3 m,,r 54.1 D~.nth 34.4 ' lS no StiLl r S, y- t .................................... r ............. Height ............. Nmnber of Stones.. .P¢¢ .......................................... Dm, enstons of same struc!ture with alterations or additions Front ....5.4...3 ........ Rear .5~I:.~ ......... Dep tit .... 3.4.: 4. ............. Height ................... Number of Stones.. or~e ............. 8. Dimensions of entire new construction Front .............. Rear ............... Depth .......... Hmght ............. ~. Number of Stones .... ~/.a ....................................... 9. Size of lot. Front .l~w~-.Qq/.I~.!qq.fi.6. ..... Rear ],=.~.Q..3.4./.R.=17.5...0.0. .... Depth .1~ .0 .. .0 .0. ' ........... 10. Date of Purchase . ."//5/.7.9 .................. Name of Former Owner Anderm)n,.Joh~ ~md. LV~l:y,. l 1. Zone or use district in which premises are situated.. A Re~d.e.r~ti~l. ............................... 12. Does proposed construction wolate any zoning law, ordinance or regulation ........................... 13. W~it lot be regraded ..... nQ ................... Will excess fill be removed from premises' Yes 14. Name of Owner of premises ~..~.~q .~.... C. Am~.k~..1.1.. Address .4.6,3 .H..a'~...o.rp.e .Ay.e: Plmne No ............ Name of Architect .... . ..................... Address....¥°..r~,ers,.....~........ Phone No ............ Name of Contractor ......................... Address ................... Phone No ............ 15.Is this property located within 300 feet of a tidal wetland? ~YE$..X..NO... *If yes, Southold Town Trustees Permit may be r?quired. PLOT DIAGRAM Locate clearly and distinctly ~l! buddings, whether existing or proposed, and. lndicate ~iI set-hack dnmenslons property hues. Give street and block number or description according to deed, and show street nm'nes and indicate whe interior or coruer lot. See attached Survey GCCUPANC¥ OR OF oCCUPANCY FOLLOWh~G ~NSPCC ftO~S FOUNDATION ThVO REQUIRED FOR POURED CONCRETE ROUGH - FRAMING & pLUMBING INsU~TtON FINAL CONSTRU¢ION MUST ~ COMPLETE FOR C.O. ~ ~NSTRU~ION SHA~ ME~ ~E REQUIRFFIE~ OF ~E N,Y. STA~ ~N~~N ~ ~ERGY ~D~. ~ ~St8~ FOR D~IGN OR ~OH ~RORS STATE OF NEW YORK, S S COUNTY OF -. S~'F(7~< .... [. - ............. .l~ldcllDtl ~I, B..z~er ........... being duly sworn, deposes and says that he is the apph¢ (Name of mdlv~dual signing contract) above named lle Js the attorne,~ for .o~..er i (Contractor, agent, corporate ofhcer, etc ) of said owner or owners, and is duly authorized to perform or have performed the said work and to make and file application, that all statements c0ntamed m tins apphcaUon are true to the best of bls knowledge and behef, and that work wd! be periormed in the manner set forth in thc apphcat~on filed therewith Sworn to before me this ....... .].4~T. ......... of. December 19 aB .day[ ..................... NotaryPubhc ....... ' ...... ~Suffol~,~ ........... County//~ ~ /] /////~ NO. 52*4655242, SUFFOLK COUNTY 01~ FJhOlR~ AUGUST SL