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HomeMy WebLinkAbout17025-z FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No Z-25259 Date SEPTEMBER 11, 1997 THIS CERTIFIES that the building ALTERATION Location of Property 5405 MAIN BAYVISW RD. SOUTHOLD, N.X. House No. Street Hamlet County Tax Map No. 1000 Section 76 Block 3 Lot 33 Subdivision Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated APRIL 26, 1988 pursuant to which Building Permit No. 17025-Z dated MAY 24, 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 EXISTING ONS FAMILY DWELLING AS APPLIED FOR The certificate is issued to ROBERT & MARY ALICE OHLMANN (owners) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A UNDERWRITERS CERTIFICATE NO. PENDING - SEPTEMBER 9, 1997 PLUMBERS CERTIFICATION DATED SEPT. 4, 1997-EDWARD M. SANDORA f B ild' ng Inspectorp-ec--to-r Rev. 1/81 rows xo. a 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 AUTHORIZED) N fl ~ 7 0 2 Z Dote ~.....s~ 19.Y1..C.+ Permission is hereby ro ed t . ct premises located at ...~.T...o.~...... ,Aillfil.C..'.... ....1.4.. ,1~ . _ !i.7~... Caunty Tox Map No. 1000 Section ...~e0 .Block Lot No.....~~......... pursuant to application doted ~y~ 19~~,, and approved by the Building Inspector. ~ O~ Fee ,7 / Builnspector Rev. 6/30/80 TOWN OF SOUTHOLD L BUILDING DEPARTMENT TOWN HALL 765-1802 APPLICATION FOR CERTIFICATE OF OCCUPANCY A. This application must b'e 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 location of all buildings, property lines, streets, and unusual natural or topographic features. 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 installations, a certificate o£ Code Compliance from architect or engineer responsible for the building. 6. Submit Planning Board Approval of completed site plan requirements. B. For existin ~ 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 therefor in writing to the applicant. U.. C. Fees 1. Certificate of Occupancy - New dwelling 525.00, Additions to dwelling 525.00, Alterations to dwelling $25.00, Swimming pool $25.00, Accessory building 525.00, Additions to accessory building 525.00. Businesses 550.00. 2. Certificate of Occupancy on Pre-existing Buildine - $100.00 3. Copy of Certificate of Occupancy - .25~. 4. 'Updated Certificate of Occupancy - 550.00 5. `Temporary Certificate of Occupancy - Residential $15.00, Commercial $15.00 Date New Construction........... Old Or P`r~e-exis~7ting Building.~.p.....,.y......... Location of Property..~~p~. ~~~Y~~.~.17~ f ! A 1~~4~ . House Nf~o. 'S(~t`reet Hamlet Onwer or Owners of Property.!.15-.y.~.~~~.!.~1~~...4?.!!1m~~ County Tax Map No 1000, Section....! ~......B1ock.....~.........Lot......~~ Subdivision ..................................t.~.Fil~e-+d,Map.......... .Lot......\...(~.~.......:.:. Permit No.~~.~b~~. ....Date Of Permit. 5.~z~.~. QSS...Applicant~~~,~:(...10.: ~J`.~.~~~1~. Health Dept. Approval.. ...................Underwriters Approval...!s~................... Planning Board Approval Request for: Temporary Certificate..........;~E.nal--6exxicate... s~ O ~ Fee Submitted: A PI~iCANT ~g-c,• 5 33 ~ ~ - ~~~~as~ o~~gUfF01~-~D ti~ yea J~ _.c~ Town Hall, 53095 Main Road y N x ~ Fax (516) 765-1823 P. O. Box 1179 ~ ~ ~ ,n,+ Telephone (516) 765-1802 Southold, New York 11971 .j% a0!° ~c ~ OFFICE OF THE BUILDING INSPECTOR TOWN OF SOUTHOLD C E R T I F I C A T I O N DATE: ~ I~~7 Buildin`~g~,~Permit ~iN~o(.~(~,~(~~~~Z~Z Owner: f 1V~ ~1 ~ ~ IW 1..1 ~\~~SL (please print) Plumber: ~a~z~pT' ~ ~ ~a (please print) I certify that the solder used in the water supply system contains less than 2/10 of 1~ lead. f~ " ' (Plumbers Signature) Sworn to before me this - day o f S2-~(~~-re..,,.., lo-ei , 19 ct1 Notary Public, County DEBORAH A.DONEGAN NOTARY PUBLIC, Sta4e of New YorN No. 4978909 Qualified in Suffolk County ~,-,Q g~,~~ ~ R"~,_ _ Commission Expires March I8, ~ ~ a--- 'luLU J.I.J..-. ?rl'~Y IIV •u ~ l.. L~:~~i~f.l~~.-i ~ ~ 1 • w `O` ' H J~ 'OUNDATION (1st) - - - - - ! C N r 'OUNDATIOW (2nd) ~ 'y / o TOUGH FRAME t~ N' ~ o "T' ~u'~ PLUMBING ~ ' S ti r y 3• m rn H =NSULATIOPI PER N. Y. ~ 1 STATE ENERGY CODE ~ ~ ' x s r I 1 ~ k y V i FI;JAL ~ ADDI P]AL COMMENTS: x`~ a. ao C.li. ~ p ' x H a H H O z . x m d -n H > ~~zs' ~~-~soz BUILDING DEPT. INSPECTION [ ] FOUNDATION 1ST [ ]ROUGH PLBG. [ ] FOUNDATION 2ND [ ]INS TION [ ]FRAMING [ FINAL [ ] FIREPLACE A CHIMNEY REMARKS: DATE INSPECTOR 765-1802 BUILDING DEPT. INSPECTION [ ]FOUNDATION 1ST [ ]ROUGH PLBG. [ ] FOUNDATION 2ND [ ]INSULATION [ ] FRAMING [ ~NAL [ ] FIREPLACE S CHIMNEY REMARKS: ~ a.~... ~.,.,c ..~a t --f= ~g / ~ .,(i~f,~~ O~ J ~ DATE / INSPECTOR l°20~~~ ass-iso2 BUILDING DEPT. INSPECTION [ ]FOUNDATION i5T [ )ROUGH PLBG. [)FOUNDATION 2ND [INSULATION [)FRAMING [ ]FINAL Q~ jj~~ ~ ~ REMARKS: t~l G~Y"~' GD~~~' DATE ~ 8'~ INSPECTOR © o BUILDING DEPT. [ ]FOUNDATION 1ST [ ] ROUGH PLBG. [ ]FOUNDATION 2ND [)INSULATION [~MING [ ]FINAL l" REMAR!(S C- _ _.~ttl c DATE ~ ~O INSPECTOR~~/ /~Q~~~ 7ss-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION 7ST [ ]ROUGH PLBG. 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(~/~.~V ~~~~T~/j.t M`~/~~ f J~ \yl ~ r~ Crx~c , .l.xtrs .Sut'ti+'~c~c~ ~ , THE NEW YORK BOARD OF FIRE UNDERWRITERS r.'nci t3~(i'77~7 ~ ~ - BUREAU OF ELECTRICITY' 85 JOHN STREET, NEW YORK, NY 10038 Dote ,`7laT~Ttu'TffSE'R YSTa.~l~a7 gpplicadonNo.onfile L!rE,~i3u71~'7 H VYr.li91S; THIS CERTIFIES THAT T'GRMIT N(a, 0Y7@25 only the electrical equipment as described 6ebw and introduced 6y the applicant named on the obove opplicotion number in the premises of rtoarrm ~ rraax OIII,ktANN, ssr~~5 r;AVV~aari Tt~+A[a, :~~uxrtr~r.,?, rr~ in thefolloarinp locationq ®Boaement © Ist Fl. ? 2nd F'l. T>~~t~l-I~ Section Block Lat ceas examined un "'N'p~'f,rf~u'r~ ~y ~ and found do be in compdiance with the National Electrical Coda. FIXTURE ECE?TACLE$ SWITCHES FIXTURES RANGES COOKING OFCK$ OVENS DISHWASHERS EXHAUST FANS ' OUTLETS INUNDESCENT fIUOPESCENi OTHER AMi K W rVAi~ K W AMT KW AMi K W. AML. H P. DRYERS FURNACE MOTORS FUTURE APPLIANCE FEEDERS SPECIAL REC'PT TIME CLOCKS BEtI UNIT HEATERS MULTI-OUTLET DIMMERS AMi K. W OIL H, p GAS M p AMI NO A. W G AML AMp. AML AMPS TRANS. AMT R p SYSTEMS NO.OF FEET AMT. WATTS SERVICE DISCONNECT ~ NO.OF $ E R V 1 C E MIT AMp ttPE METER lam, tW ~9W ~~DW ~%.W NO OF CC COND AW, G. EOOIP• PER a OF CC COND. NO OF HIAFG ~ N LEG NO.Of NEUTRALS Oj 'NEV NAl OTNER APPARATUS: *IJt7 VT~iUP:G ?EL'~f'TS: "ALA ele~<rtc:cxal NuY'VaKd- tia~ l~e.~Ix m;xsle i~f 1.1't~ ~xrTUrvapd e1rvr~Gaac~t egLrl,larRl~ni: i.aA t;lt~ ~ximi~~s ,irLCiic~~~C.e~d," "No ol;vlcruaT az7:~~ytitf~c~ory c+~r~d9.t;~,oTi ~rcts ~aiand. PAULA J. QI-IL,r4ftNN ~ ~ ~ ~ ~`wL 545 F~AYV:Tk,W ItbA? `~?UR`HOTJ~, h7Y, YY97Y GENERAL MANAGER x~. This certificate must not be altered in any manner; return to the office of the Board if incorrect. Inspectors may be identified by iheir~credentials. COPY FOR BUI LOING DEPARTMENT, 7HI5 COPY 'OF'CERTIFICATE MUST ROT BE ALTERED IN ANY MANNER. r BOAftD OF HEALTH ~J • 3 SETS OF PLANS~.rA1_wlJ ~FORMN0.7 SURVEY ~~lj' ° ~ ~ TOWN OF SOUTHOLD CHECK ~7~: ~5 l BUILDING DEPARTMENT SEPTIC FORM , - . : TOWN HALL NOTIFY ;j .°,OUTHOLD, N.Y. 11971 CALL • - ~G~• ~~i..7.~ TEL.: 765-1802 G MAIL T0: Examined ~ 19D s~ Approved 19~Permit No. 1.7~~~~ t Disapproved a/c ~ ~s/z"! Builds Inspector) APPLICATION FOR BUILDING PERMIT Date . ! v? 19~~ 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 buildings, additions or alterations, or for removal or demolition, as herein described. The applicant agrees to comply with all applicable laws, ordinances, building code, housing code, and regulations, and to admit authorized inspectors on premises and in building for necessary inspections. (Signa~f applicant, or name, if a corporation) (M ding address of app scant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. Name of owner of premises . /K..~D./D1°,~E'Tf.7` ~~r//~~G•' 6~i~~?~Y• . • • • • • • (as on e tax roll or latest deed) If applicant is a corporation, signature of duly authorized officer. (Name and title of corporate officer) ALL CONTRACTOR'S MUS BE SUFFOLK COUNTY LICENSED Builder's License No....1.,~,~/.7../!l ~ Plumber's License No. Electrician's License No. J~. ~.J.~?..C..... v Other Trade's License No. ? ] . Location of land on which proposed work will be done . . House Number ~ Street Hamlet County Tax Map No. 1000 Section Block Lot ......:3.'J, • • , • , , , . Subdivision Filed Map No. Lot............... (Name) 2. State existing use and occupancy of premises and iffnt_~end_~edQuse and oncecup~anocy~of proposed construction: a. Existing use and occupancy ...~.~'r!r/~...%1'~""l, .....~1/.~~^,'~!~`• . b. Intended use and occupancy r~••~ •UU• j~"r~ q . i I gr 3. Nature of w k (check which applicable): New BuildingDemolition .Addition ; •Other Work~tion Y......'. . Repair . ; Removal , . , , , , , • ' (Description) 4. Estimated Cost ~ ar k. 4. p . ~ Fee . ` (to be paid on filing this application) 5. If dwelling, number of dwelling units Number of dwelling units on each floor . If garage, number of cars . Y . 6. If business, commercial or mixed occu anc s ecrf nature and extent of each t . P Y. p Y pe of use 7. Dimensions of existing structures, rf any: Front Rear Depth . Height Number of Stories . Dimensions'of same structure with alterations or additions: Front Rear . Depth . ....................Height ......................Number of Stories . 8 Hemh~sions of entire new construction: Front :Rear . • .Depth . g Number of Stories , , 9. Size of lot: Front Rear t Depth . 10. Date of Purchase .............................Name of Former Owner . 11. Zone or use district in which premises are situated . 12. Does proposed construction violate any zoning law, ordinance or regulation : : . 13. Will lot be regraded . .r... , .....Will excess fill be removed from premises: Yes No 14. Name of Owner of premises , ...Address ; ....Phone No............... . Name of Architect ...........................Address ..............:....Phone No............... . '....Phone No . 15. Is thisCproperty located within 300 feet of a tigidal wetland? *Yes No *If yes, Southold Town Trustees PermitPLO~DIAGKAMed Locate clearly and distinctly all 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. J gZ ~ ~L ' STATE OF NEW YORK, S S COUNTY OF . , bein dui sworn de a g y p sesandsaysthatheistheapplicant (Name of individual signing contract) above named. ~ He is the (Contractor; agent, corporate officer, eXcJ, 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'i knowledge and belief; and that the work will be performed in the manner set forth in the application filed therewith. ' ' Sworn to before me this dray of .....CI~./.~w..~, 19 Notary Public, , , , , County HELEN K DE VOE . q~GZ'~~~~~'1~~~~~ tc._.-... . ~H~476 878, Sum9(nik C u ~ • Term Expires March 30,19. (Signature of applicant) ` ' nP 0 °R~ ~ °T~Kz ~ 4L-o - CW 2J5 T L.k X135 r 1 u, a5 C34-bowl PSW~ V r ' } ~ v h i ~ _ v ~ ~ ~ ~ - - v / v M ~ n .1--_~ SLfcF GLo.slil_G- o`I SNmNfM„~ ; ~ ~ ~~RCA~~ TO 61 HIti M ~ EcII~, - . i 1 ~ I I - _ -a ~ ml Scn ROOM I ~ Kett Here _ j I "I .0 1 !1 r I ~ I~ j i ~ V ~ _ I ~ _ I I ~ I ~ I ~ ~ r 21~,~.IS ~ _ ~ I I J. - - - ~ryw` o'sneKe n~ra+^ rv _ - - = L---------- I _a Exis-n~tx-f=na;n~Ee' ° ~ - - - - 1. I ~ n w ~ ~ I ~ ~ 910 x b~S:~ 3 m~a Cu. o o l ~ ~ ~ I i 2~~x Llb 3o x ble - c AP?fOYED AS NOTED " ~ - DAT'E,~ ~ - y B.RN ~ - - ~ •I~---- - I - - NOTIFY !Y• _ _ - W n' _ FEE: _ ~ I • 766-1802 8AM 70 4PPM~ T / In FOR THE FOLLOYVING INSPECTjONS: - '°c~i - 'o ~ ~ ~ • ~ 1. FOUNDA EDIRRED FOR POURED ~ TWOR v Tae URoarn h~LOrsiea~,r` of q ~I ~o~ _LI KIrJG R~ool'-x I Z• ROUGN . CONCRETE ~ ~ - ~ 3. INSULATIO~ING 8 PLUMBING I , o ~ ~ - _ - 4. FINAL I y - I - CONSTRUCTION MUST J / BE COMPLETE F " 1 4 ~ •./D ~ OR C.O. T ALL CONSTRUCTION SHALL MEET ~ d~o~~~s ^~O° GW 24 -19 (6AY} THE REpUIgEMENTS OF 7HE N.Y. - v~r { CW z5S ' COOES.C NOT RRES ON BLE FOR- - ' ' - - _ - I i ~ ~ -Q 49 ' DESIGN OR CONSTRUCTION ERgpgg ~ ~ ~ I ~ ~ - i 910-0, Pl:.l'rv~~1- IIY TGR'10 0~ LXI:TIIJ IS . csry~C-3nzR'l RA n(LK kou Sc' _1 ~54'Ln'fior~ _ ' I.J IALLS - 31i ~ R II Foil ~E~SU~KTI°.J CEILLn?4- R 1~ Fl..'P_~6- /4 z~(- ~ R- II /•y - SE Qf FE4V y h S.YP NLE nr t~ 9~1. A}~ f-~o•• Tou A,.o u~~-1r~-n- r-12EE7 No~~}~ f l ~~~.4;ziH0oE.~- Artc~'rt-SEN fl f' cLn ss EA« DIn~.NS, nx= prr. er nWa . • - i - Sy1.4.~~19 (3E fHecKCn 1^Ia eoN r„e~ai> ~ ~ x 0F1LMA1'1 A? S ttK' W . D II SC'( WLIOO~.a H~"AryPµ, nt G, b AG+JC / Z ` _ SG1E MMOVEO er oI1xWN OY .E D Grninrwn ('I_==a, To wacT ttr,.-;. ;ens % Op 4~ :J Dorf xEwtseo . 4 ~ JjoTP~^ of Gu2SC MrN 41e AOu ue [ Iws n 9pFESSION~~ MAY 18, rl~.~; \iSTi.l fr I~~uo~- Teitf 2 o~ FIR~1" FLOC) P+ PLAN PAT['u WHG1.J' i a /-r! /~'1,3~OL7 BLDG. D!IiPT. Rer~au> J / TOWN OF SDIJfHOLO eluwwe NuweE StiL7Y 11C L~ WMDECL C.J.1 INC. _ _