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Home My WebLink About2818-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No Z18611 Date DECEMBER 5, 1989 THIS CERTIFIES that the buildin~ ADDITION Location of Property 245 FIRST ST. & 530 STILLWATER AVE. CUTCHOGUE House No. Street Hamlet County Tax Map No. 1000 Section 103 Block 07 Lot 04 Subdivision Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated JULY 21, 1965 pursuant to which Building Permit No. 2818Z dated JULY 21~ 1965 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 ADDITION TO AN EXISTING DWELLING. The certificate is issued to PETER & THERESA BROPHY-MARY LOZINSKI (owner, XX/4XXXXXXXXXXXXX) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL UNDERWRITERS CERTIFICATE NO. PLUMBERS CERTIFICATION DATED Building l~sPSct0r - ' Rev. 1/81 FOKM NO. 2 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) N? 2818 z Permission is hereby granted to: L~r~:,~iaski ................................................. ................... C.u.~ho~ ~.....li, Z, ...................... to ........... Rut. t d...a~i .. a~tdi.~i~ ..o~.. ~l.. exos tin~ ..d~l. tt~ ............................................... at premises located at ...... :l~t.&..~,ll,Lw~t;el'...ive. ....................................................................... ......................................................... C~ttah~ue s ....... ~-.~- ................................................................ pursuant to application dated ................................ ~tl,l,)r .......... l~O ....19.~.~., and approved by the Building Inspector Fee $..~.0~ ............ Building Inspector FORM NO. 6 TOWN OF SOUTtlOLD BUILDING DEPARTMENT TOWN HALL 765- lEO2 APPLICATION FOg CERTIFICATE OF OCCUPANCY INSTRUCTIONS 'This application must be filed in typewriter OR ink and submitted to the Building Inspector with the following; for new buildings or new use: ]. Final survey of property with accurate location of all buildings, property lines, streets, and unusual natural or topographic features. 2. Final approval of Bealth Dept. of water supply and sewerage-disposal(S-9 form). 3. Approval of electrical installation from Board of Fire Underwriters. 4o Sworn statement from plumber Certifying that solder used in system contains less than 2/10 of IZ lead. 5. Commercial buildings, industrial buildings, multiple residences and similar buildings and installations, a certificate of code compliance from the &rchitect or Engineer responsible for the building. 6. Submit Planning Board Approval of completed site plan reqniremen'ts. For existing buildings~.(Prlor to April 9, 1957~ non-conforming uses, or buildings and "pre-existing" land uses: ]- Accurate survey of property showing all property lines, Streets, buildings and unusual natural or topographic features. 2. A properly completed~Mapplication, a consent to inspect signed by the applicant and a certified abstract of title issued by a title cnmpauy which shall sh~w single and separate ownership of the entire lot prior to April 9, 1957. If a Certificate of Occupancy is denied, the Building Inspector shall state the reasons therefor in writing to the applicant. 3. Date of any housing code or safety inspection of buildings or premises, or other pertinent information required to prepare a certificate. For Vacant Land Certificate of Occupancy: ]. An application for vacant land Certificate of Occupancy shall be submitted, and a Certified abstract of title issued by a title company showing single and separate ownership of the entire lot prior to April 9, 1957 shall also accompany the application. If a Certificate of Occupancy is denied, the guilding Inspector shall state the reasons therefor in writing to the applicant. FEES: I. CERTIFICATE OF OCCUPANCY - New Dwelling $25.00, Additions to Dwelling $25.00, Alteration to Dwelling $25.00, Swimming Pool, $25.00. Accessory building $10.00 Addition to Accessory buildings, $10.00. - Businesses $50.00. 2. Certificate of Occupancy on pre-existing dwelling - $100.00. 3. Copy of Certificate of Occupancy - $5.00 - Over 5 years - $10.00 4. Vacant Land Certificate of Occupancy - $20.00 5. Updated Certificate of Occupancy - $50.00 6. Temporary Certificate of Occupancy - $15.00 'er, 10/14/88 TOWN OF SOUTHOLD BUILDING DEPARTHENT TOWN HALL SOUTHOLD, NEW YORK 765 - 1802 11971 APPLICATION FOR CERTIFICATE OF OCCUPANCY NEW CONSTRUCTION .. OLD OR PRE-EXISTING BUILDING-~-~---VACANT LAND .... HOUSE NO. STREET 0~oe~ o'r O~oers of P~op~r~,..~....~.. z~i~, .......... .~. . .. :.?.~,,~z ~.~.. ~ County ~Tax Map No. 1000 Section ..l~. Block . O~ LoC' .~.. Subdivision ....................... Filed Map Lot Health ?ept. Approval - Underwriters ................. Approval Plannio~ Board Approval Request. for Temporary Certificate .~.. .... Final Certificate rev. 10~14/88 Leen Dozinski Stillwater Ave. Cutchogue TOWN OF SOUTHOLD OFFICE OF BUILDING INSPECTOR TOWN HALL SOUTHOLD, N. Y. 11971 TEL. 765-1802 ~arch 13, 1981 Dear Mr. Dozinski, : This is to advise you that the job under Building Permit No. 2S!8Z issued to Lean Do~inski on .~,~,, ot lo~5 for A~ ~t~ appears to be ~ompI~$d-~g 6~-our last 5~s)~i~h. Before you can legally use or occupy this structure a Certificate of Occupancy must be issued. Please fill out the enclosed form and return same to the above office. There is a fee of $5.00 for a Certificate of Occupancy Thank you for your prompt attention. Very truly yours, GEORGE H. FISHER Sr. Building Inspector GHF: sm encl. BUILDING DEPARTMENT TOWN CLERK'S OFFICE" -- SOUTHOLD, N. Y. Exam,ned Disapproved a/c .................. ~,~.,~;;:':: ::~.~ ........................... ~...~:~.~ ............................. APPLIC~ FOR BUILDING PERMIT INSTRUCTION5 a. This application must be completely filled in by typewriter or in ink and submitted in duplicate to the Building Inspector. b. Plot plan showing location of lot and of buildings on premises, relationship to adjoining premiCes or public streets or areas, and giving a detailed description of layout of property must be drown on the diagram which is part of this application. 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 issue a Building Permit to the applicant. Such permit shall be kept on the premises avai able for inspection throughout the progress of 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 hove 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 lows, ordinances, building code and regulations. ..... .......... .................. (S~gnature of apphcont, or~iOme, if a corporation) ........................ ........ (Address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. 0~aer Name of owner of premises ....... :Leon....Lo~inski ................................................................................................................ If applicant is a corporate, signature of duly authorized officer. (Name and title of corporate officer) 1. Location al~ land on which proposed work will be done. Map No.: ........................................ Lot No.; ........................ Street and ,t~umber ~,J~.~, 8.~f~.~.~ ~f~.~ .9~. ~.~.%'~.$.~ k~..e., ..O..~..~.9..b;.o.~...e' .~...,.Z....N,Y. _ /fl - .............. Municipality 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy .~;T~$.V~f~ ~.~;L~O~g.~. ................................ b. Intended use and occupancy Private Residence 3. Nature of work (check which applicable): New Building .................. Addition ..~ .......... Alteration Repc!ir .................. Removal .................. Demolition .................. Other Work (Describe) 4. Estir~ated Cost ......~..?..0..0..,....~,o..~.8...0..0., ...................... Fee (to be paid on firing this application) 5. If d~elling, number of dwelling units ......... .o.~...e .............. Number of dwelling units on each floor one £'1ooz, If gg~rage, number of cars --'- 6. If business, commercial or mixed occupancy, specify nature and extent of each type of use 7. Dimensions of existing structures, if any: Front ..._2..6.! .................. Rear ......2..6..! ..................... Depth ....~3.6..! .......... · Th , He~ t ..... ~-;~ ............... Number of Stories ..... o~e, Dimensions of same structure with alterations or additions: Front ..2..6..!....~...]:.6..!..~..~.e,..a~-. Rear /+2! Depth ....~..6..! ...................... Height ..l~l~.e. .................. Number of Stories ....t313~ ...................... 8. Dim!e'nsions of entire new construction: Front .....3...6..! .......................... Rear ....... .3.2..! ............... Depth 20~ Height .~..e~...e. ........... Number of Stories .... g~...e. ...... 9. Size of lot: Front £'10t Rear 23.0t Depth l~.Ot 10. Dat~ of Purchase ..~.q~,]:......A..~...$..~...~..6.~. ................ Name of Former Owner ....~.e..o.~g.e...~...~...t~.. .......... i 1. Zon~ or use district in which premises are situated ...,~.9..~idencial 12. Doe~proposed construction violate any zoning law, ordinance or regutation? .......... ~f~ .... 13. Nar~e of Owner of premises ....:~,..o.~....J~..~..fi~...a..k.~ ............ Address ....]:~.*....S.~.e..e.~..~.~.~.q~.°.J~,,.ephone No. plii. l~O~e Name of Architect ...................................................... Address ............................................ Phone No. Norhe of Contractor ...~.~..°.~..~.~.~13fl~;l, ........................ Address .....~.9,~..~l..~,~f~YfJ ............. Phone No. L.ocat property whether in PLOT DIAGRAM ; dearly and distinctly all buildings, whether existing or proposed, and indicate all set~back dimensions fr nes. Give street and block number or description according to deed, and show street names and indic, :erior or corner lot. ~; STATE OF NEW. Y~)~I<;, ~ II .......................... ~z...~..c.c....,.'r:...x.~ge~/.,.wc~.'z.~ ............................ being duly sworn, deposes and says that he is the applicant [Name of individual ~F~i'gning app~licatign) above named. He is the .............. ~,~.~...~...~.~ ...................................................................................... L... ! (Contractor, agent, corporate officer, etc.) of said ow~ner or owners, and is duly authorized ta perform or have performed the said work and to make and this application; that all statements contained in this application are true to the best of his knowledge and belief; that the wprk will be performed in the manner set forth in the application filed therewith. Sworn to Eefore me this /q// ........... · ~.~.- 11 ...... day ~of .,...~. ......... , U . ...; ...................... ........ ....... J'~t~ ~',~(~/~C?.-~',/-~.~.~:~.~ .~...f..~.~..';.~; ...... County Stt:~fo].k (Signature of eppiicar(t) ,~1¢~ PUB~LIC, State of NeW ~ No 52-970372S