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Home My WebLink About17283-z FORM N0. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Buildinq Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No 217149 Date AUGUST 2, 1988 THIS CERTIFIES that the building ALTERATION Location of Property 1525 RAMBLER ROAD SOUTHOLD House No, Street Hamlet County Tax Map No. 1000 Section 88 Block O5 Lot 44 Subdivision TERRY WATERS Filed Map No. 2901 Lot No. 09 conforms substantially to the Application for Building Permit heretofore filed in this office dated JULY 22 1988 pursuant to which Buildinq Permit No. 172832 dated AUGUST 2, 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 ENCLOSE AN EXISTING SCREENED IN PORCH AS APPLIED FOR. The certificate is issued to BRACHOCKI, EDWARD M. & VIRGINIA S. (owner, xxxxxxxxxxxxxxxx) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A UNDERWRITERS CERTIFICATE NO. N482766 June 12 1980 PLUMBERS CERTIFICATION DATED N/A K uildinq Inspector Rev. 1/81 ` FORM N0. 6 TOWN OF SOUTHOLD Building Department Town Hall Southold, N.Y. 11971 765 - 1802 APPLICATION FOR CERTIFICATE OF OCCUPANCY Instructions A. This application must be filled in typewriter OR ink, and submitted ~ 9~r to the Building Inspec- torwith the following; for new buildings 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 of Health Dept. of water supply and sewerage disposal-(S-9 form or equaU. 3. Approval of electrical installation from Board of Fire Underwriters. 4. Commercial buildings, Industrial buildings, Multiple Residences and similar buildings and installa- tions, acertificate of Code compliance from the Architect or Engineer responsible for the building. 5. Submit Planning Board approval of completed site plan requirements where applicable. B. For existing buildings (prior to April 1957), Non-conforming uses, or buildings and "pre-existing" land uses: 1. Accurate survey of pxbperty 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 housing code or safety inspection of buildings or premises, or other pertinent informa- tion required to prepare a certificate. C. Fees: Additions $25.00 POOLS $25.00 ALTERATION $25.00 1. Certificate of occupancy New Dwelling,$25.00, Accessory~$I0.00 Business $50.00 2. Certificate of occupancy on pre-existing dwelling $ 50.00 3. Copy of certificate of occupancy $ 5.00, over 5 years $]0.00 9. Vacant Land C.O. $ 20.00 -7 ~J ~ 5. Updated C.O. / $ 50.00 Date .....1.-: '3 NewConstruction„~!„Old or Pre-existing Building Vacant Land Location of Property 1525.diarnblaz:.Roa.c1,.T~zxy.In[atexS.,..$O,u,tY}q~~l,,•,LVew York , Nouse No. Stree[ Namlei Owner or Owners of Property Edxra~d• M. • Br.acL~ocki . Virgin.f.a. . pchocki,, ,his wif e County Tax Map No. 1000 Section gg........ Block Lot ..44 , , , , , , , , , , , Subdivision .........TERRY •WATERS • • • • • • ....Filed Map No. .29PJ.....Lot No. ..9........ - - Permit No. Date of Permit ..........Applicant . Health Dept. Approval . .......Labor Dept. Approval . Underwriters Approval ....Q.~'..Q ~!h,.e-gQ , .Planning Board Approval . Request for Temporary Certificate .....................Final Certificate x . Fee Submitted $ •25.00 . Construction on above described building and p mit meets )all appl//ic le c~od/Jes and regulations. Applicant I ate. io.,oaa ~ ~a •-30~ ~I C.a. zi7j~~ THE NEW YORK BOARD OF FIRE UNDERWRITERS BUREAU OF ELECTRICITY ~'F 85 JOHN STREET, MEW YORK, NEW YORK 10038 Date .I }ITLE* ~'C7,l~i3 i} Application No. on file N THIS CERTIFIES THAT only the e[ectric¢t equipment as described below and introduced by the ¢pplieant Hamer] ofe. tike a,~b-ooe application number in the pre>nises of Jadwarll ~rackacsch.lR1~:~~ lt~TSfk~~.~r kLd,,Sautkaa , in the following locations ? 6asemerzt ~T 1st F(. ? 2nd Fl. Section Bloc-k Lot was examined on ~UTIk: s 1' and found to be in complionce with the requirements of this Board. FIXTURE RECEPTACLES SWITCHES FIXTURES .xex unv RANGES COOKING DECKS OVENS DISH WASHERS EXHAUST FANS OUTLETS ( INCANDESCENT FIVORESCENL vnvae AML K.W AMT K.W. AMi K.W pMT. K.W AMT. H.P U DRYERS FURNACE MOTORS FUTURE APPLIANCE FEEDERS SPECIAL REC'PT TIME CLOCKS BELL UNIT HEATERS MULTI-OUTLET DIMMERS SYSTEMS AMT. K W, OIL H P. OAS H. P. AMT. NO. A W. G. AMi AMP AMT, AMPS. TRANS. AMT N. P. NO.OF FEET AMT WAii$ SERVICE DISCONNECT NO.OF 5 E R V 1 C E AMT. AMP TYPE METER I ATW 1 %3W 3,e' 3W 3 p" 6W NO OF CC COND A. W. G NO. OF HbLEG 0. W~ G NO. OF NEUTRALS A W.O EOUtP. PER d OF CC. COND. OF HI-LEG OF NEUTflAL OTHER APPARATUS: Eleac rvesmhta~ex~s:L~-l.~iis ``f~ `''a Sal ~'tuta Wio~;iix~ Lra. ~ 1 iira~n~orttN.Y. 11944 G F. N ER I.$c.104~ 1 fy. Per ' This certificate must not be altered in any manner; return to the office of the Board if incorrect. Inspectors may be identified by their dentials. COPY FOR 81D1LDtN6 DEPARTMENT. THIS COPY OF CERTIFICATE MUST NOT BE ,ALTERED IN ANY MAN~~~{E U T65-1802 ~,j"~,~'~~t~=~~/,~ r BUILDING DEPT. tNSPECTlC~N [ ]FOUNDATION i5T [ ]ROUGH PLBG. [ ]FOUNDATION 2ND [ ]INSULATION [ ]FRAMING INAL REMARKS: DATE ~ ~ INSPECTOR ~ ' ~ ,'^^j{1 BO=\RD OF HEALTH ; ; V FORMN0.1 3 SETS OF PLANS #@' VVV SURVEY J~~ TOWN OF SOUTHOLD CHECK . BUILDING DEPARTMENT SEPTIC FOR:I TOWN HALL L DEPT, SOUTHOLD, N.Y. 11971 NOTIFY aatOW OFSOUTHpLD TEL.:7G5-1802 CALL Examined ~pp°.~//. , 19~. MAIL T0 . Approved P.,l.°.z:...... „ 19 Pcnnit No. pl Disapproved a/c/...., Ql<~- ~~aT1p~ (wilding Inspector) tLr APPLICATION FOR BUILDING PERMITGD-l - Date .July, 21 _,•,,,,,,1588. INSTRUCTIONS a. Tltis 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 Builtiin~ Permit pursuant to the Building Zone Ordinance of the Town of Southold, Suffolk County, New York, aatdl'o~her`;apptica6le Laws, Ordinances or +Regulations, for the construction of buildings, additions or alterations, or for removal or demolition, as hereQh described. The applicant agrees to comply with all applicab'te laws, ordinances, building-codt^; "tiousin~ code,•and regulat{ons, and to ,.ddmi[ authorized inspectors on premises and in building for necessary i ecLOns. f- r i ? . j. 1 r ~ ~ (Sign~tttre of applicant; gt;~tame;~if a corporation) ~~Yi9~t3 $a 'r idt; ~4,~, ...11+.64.1~1'iun.Is~axl~,[?'~t~=,~.sE:ast.M.eado~ NY ~~Mailigg~ek$~5.~~~$p1iEa'itt) 1155+. f~€'i!"fs1 State whether applicant is owner, lessee, agent, architect, engineer, generatl.contraetop,,,t\ryitician, plumber or builder. OWNER t.).~1 Ht~t 6 }'t : ~ ~ . , r ~atl" Q~} B'T~43h':~'.,€'1441? ?ag~ Name of owner of premises ..>^,dtaaxd .M.. Bxachp~ki , &..V,irginia. 5.,, : s , a (as on the tax roll t~~kc~°,tt'kf~~: ' ~ ' ' ' ' ' [C applicant is a corporation, signature of duly authorized officer, B'' (Name and title of corporate officer) b~ Builder's License No. (Bill) Verity Plumber's License No . . Electrician's License No. 1049 (SAL PRATO,~., - ~ Ih Other Trade's License No. ~ ~ i. Location of land on which proposed work will be done. , ..#.1525......... Rambler..Road............ Southold....l~~~r~~,ggK . house Number ~ Strcet~ - ~ Hamlet ' 1 , County Tax i41ap No. 1000 Section $.8........ Bluek 5• Lot..44 TERRY WA3'ERS 2901 g Subdivision Filed ntap No. (N:unc) Lot...... • State existing use and occupancy of premises and intended use and occupancy oCproposed Construction: ~ a. Existing use and occupancy Ona-.£ama..Ly. residenc.~ , , , b. Intended use and occupancy Enclgge,;ggj.St,i,t}gy screened-in porch of residence l . 3. Nature of work (check which applicable): New Duildin t""" Repair Removal . s .....'.....4t.t r 'o . ' ' ' ' ' • • • • • • • • • • Demolition $ ' ' ' ~ lion , , 4. EsIimatcd Cost lF t~a4; , "tf~ ~ ~ ~ . i' {Description) "t-t S. If dwelling, number of dwelling units , . ,°,o, ~(o.bc paid'on rtl~i'h~,this~application) ~ * • • • • Number of dwelling units an cacti floor , , . , If garage, number of cars 1/, ~~r, de.tached, , , , , 6. If business, commercial or mixed occupancy, specify nature and extent of each type of use . . . . . . . . Dimensions of existing structures, if any: Front ......44, f t... ,Rear Height . Numbcj of Stories . •£t• • Depth . , 3p„fit„ Dimensions of same structure with,'al teratio • 1~~ " ~ " " " " " " ' • ' • • ~ ~ • Depth . ns or additions: Front S,dm~.. ...Rear , e........ • • . • same.. .jFlcight . • •~~m.. 8. Dimensions of entire new cons[nrction: Front , ' ' ' ' ' ' ' • • • • Number of Stories . , ,g~tpg, , ' ~ ' ' ' ' ' ' ' Height ~ Rear . . 9. it . .Depth . ~ 7, f t ' . 9. Size of lot: Front . Numbek of Stories Pne • , ' ' ' • • • , , , , , , , ..99.4, Rcar. ~'?3:21'+'75"'••"""'i5b':64'N"157:37 's' IQ. Date of Purchase y Depth . • f 28,/•73 Name of Former Owner .Wa7..t,Gx . J,., ,.TUtI~-ox , ~ . NLf . 11. Zonr. or use district in which premises are situated ,z`'atae... 1.., Does proposegd construction violate any zoning law, ordinance or re ulation: _ .........XX. 13. Will lot be re raded i, s . 14. Name of Owner of premises , , ' ' ' ' ' ' ' ' ' ' 'Tall excess till be removed from premises: yes No Name of Architect •i" " " " " " • • • Address ...................Phone No. , Name of Contractor ..~!,i,/ d• ~ ' ' ' ' ' ' ' ' ' ' ' ' ' • • • Address ...................Phone No... ~ • ~ ~ • 15.Is this propert ~~'•""""•••..Address .Phone No. y' located with in 300 feet of a tidal wetland? *YES....NO....~ *IF yes, Southold Town Trustees Permit may be required. PLOT DIAGRAM Locate clearly and distinctly all bµildings, whether existing or proposed, and, indicate all set-back dimensions from property $nes. Give street and bloc]; nu{nber or description according to deed, and show street names and indicate whether interior or comer lot. i APP OV~D AS NOTED ~ , DaTE: B.P a~~ ~ ' FEF~ r5"y gY: _ NC"~rIFY BUILDING DEPq~tT E AT 7F`; 1802 Q AM TO 4 PM FOR THE Ft).. LpWING INSPECTIONS. i 7. FpUNDAT14dl - TWQ RHQUIRED . FOp POURED CONCRETE ' 7 RgUGH - FRAMING. ~ PLUMBING ' 3. tNSULAT1gN 4. FINAL CON9TRtICTIQN ARU$T SE COMPLETE' FOR C.Q. ALL CONSTRUCTION 8HALL MEET THE REQUIREMENTS QF THE N.Y. STATE CONSTRUCTION ~ ENERGY CODES, Ndr ~ IrOR DES1CiN DR CON8IAUC!lCJN ~IRpp>~ ~T.'1TE OP \LN YORK, =OUNTY OF ..S,UEFOJ JC S'S ...Edwazd.M...l3xaChock,?....... bcin dui (Name of individual signing contract) s Y sworn, deposes and says that he is the applicant ~bovc named. le is the ~~$.1',`rf . . (Contractor, agent, corporate officer, etc.} ~ ' • " " " " • f said owner or otvncrs, and is duly :iuthorized to perform or have performed the said work and to make and file this >plication; that alt statements contain~:d in Ibis application arc true to the best of his knowledge and belief; artd that the ork wilt be pcrfonncd in the manner set forth in the application filed therewith, •vom to before me this .........:..21st .....day of ..~..Iu].y 19 .88 Mary Public, , S{x££o11i . County 'MADEI.YN M. <3AKER NOTAhY fUBtIQ Shah: of hlew York L?.. . No.iG7: U13133U0, Suflnik Cuunty > Term Expires Aprd 3U, 19139 ($i;nature ofapplicant)