HomeMy WebLinkAbout3018-zFORM NO. 4
TOWN OF SOUTHOLD
BUILDING DEP~YRTMENT
Office of the Building Inspector
Town Hall
Southold, N.Y.
UPDATED
CERTIFICATE OF OCCUPANCY
No: Z-31087 Date: 08/05/05
THIS CERTIFIES t~t the building NEW DWELLING
Location of Property: 5800 ALVAI~'S LANE CUTCHOGUE
(HOUSE NO.) (STREET) (HAMLET)
County T~x Map No. 473889 Section 101 Block 2 Lot 17
Subdivision FiledMap No. Lot No. __
conforms substantially to the Application for Building Permit heretofore
filed in this office dated MARCH 17, 1966 pursuant to which
Building Permit No. 3018-Z dated ~ARCH 17, 1966
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 ONE FAMILY DWELLING. THIS CERTIFICATE OF OCCUPANCY REPLACES COZ-2642
ISSUED 1/31/67. UPDATED FOR NAME CHANGE ONLY.
The certificate is issued to BAR/FEY V & DOROTHY OVISINAK
(OWNER)
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF H]EALT~ APPROVAL
ELE~-I'KICAL CERTIFICATE NO.
PLUMBERS CERTIFICATION DA'rED
N/A
N/A
N/A
Authorized Signature
Rev. 1/81
_..~-,.~ ~- - ;,~ /13 ! Form No. 6
\'~ a~N'~ aCiD ~ ~ ~ ~.d\ TOWN HALL
~ ~ s ~):? ?~e~ICATION FOR CERTIFICATE OF OCCUeANCY
Th~c~tio~ must be filled in by ~ew~ter or ink and submitted to the Building Depaament with the following:
A. 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.
2. 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 1% lead.
5. Commercial building, industrial building, multiple residences and similar buildings and installations, a certificate
of Code Compliance from architect or engineer responsible for the building.
6. Submit Planning Board Approval of completed site plan requirements.
For existing buildings (prior to April 9, 1957) non-conforming uses, or buildings and "pre-existing" land uses:
I. 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.
C. Fees 1. Certificate of Occupancy - New dwelling $25.00, Additions to dwelling $25.00, Alterations to dwelling $25~00,
Swimming pool $25.00, Accessory building $25.00, Additions to accessory building $25.00, Businesses $50.00.
2. Certificate of Occupancy on Pre-existing Building - $100.00
3. Copy of Certificate of Occupancy - $25.00
4. Updated Certificate of Occupancy- $50.00
5. Temporary Certificate of Occupancy - Residential $15.00, Commercial $15.00
Date. March 31, 2005
New Construction:
Location of Property:
Old or Pre-existing Building:
5800 Alvah's Lane
(check one)
Street
Barney V. Ovisinak and Dorothy A. Ovisinak
Cutchogue
House No.
Owner or Owners of Property:
Suffolk County Tax Map No 1000, Section
Subdivision
Permit No.
Health Dept. Approval:
Planning Board Approval:
Request for: Temporary Certificate
Date of Permit.
Hamlet
101 Block 02 Lot 017
Filed Map. Lot:
Applicant: Anthony B. Tohill, As Attorney
Underwriters Approval:
(Updated)
Final Certificate: X (check one)
Applicant Signature
Anthony B. Tohill
FOE~ ~0. ~
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN CLEP, K'$ OFFICE
SOUTfiOLD, N. Y,
BUILDING P~:RMIT
(THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL. FULL.
COMPLETION OF THE WORK AUTHORIZED)
N? 3018 Z
Permission is hereby granted to:
A~e...~hl.t~-.....~/¢ ...,.~ .t.t.a., ~ .i~c h~k
to ...... .B~. t4 .. ~e~.- ~ne...:~a~i.3:~-.'d~e'Z'~:i~ ................................................................................
ct premises located at .~/~..~,l~'b~t.~,TL, a,.&..~/.~'.....~{'~'r].d3~..~oa~ ...............................................
............... ~.. ........ , ............... ~ ~.t,.~.~.~.~e...'...........: ..................... ............................................. .
pursuant to opplicotioi( da~ed . ...... ~ ....... ?. ...... L.....}~a;~.~Bh..:.....~.~. ...... 19..~., and approved by t~e
· Building Inspector
Fee $..~-.t~. * .g..O. .........
"~ ~' B~Jlding Inspector t~,
FO~ ~0. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
~'OWI~ CLEBK'S OFFICE
SOUTHOLD, N. Y.
OI~RTIFIOATI~ I~F O00UPANr.¥
No. ~;. 2642 .... Date ........... ~I~U&~F' '3~. ....... ' 196~7'
THIS CERTIFIES that the building located at 'l~Y'~ 'A'~'V~'~' 'Y~a~e ......... Street
Map No. ~ ...... Block No.. '~]C~ ..... Lot No ....... ~ ........ '(~il~l~' ' '
conforms substantially to the Applicatl, on for Building Permit heretofore filed in this office
dated ............. ~h' '].~'" 19. ~6 pursuant to which Building Permit No. 3Ol~'Z'
dated ............ ~a:g~h' '3~'~'" 19'66" was issued, and conforms to all of the ,require-
merits .of the .applicable provisions of the law. The .o.ccupancy for which this certificate is
issued is .... NeW' Olle' ~i'~Ir' 'd~'~'], ~1'1~ .............................................
The certificate is issued to ' 'A~el:l.'~'S':lL,~lll]~" (owner, lessee or tenant)
of the aforesaid building.
.Suffolk County Department of Health App.~oval .........................................
OWNER
FoRME~, 6WN£R
~ES~/~ S~S.
LAND IMP.
TOWN OF SOUTHOLD
, ~ ~.~ ~ ,.. r ,' ~
S
PROPERTY
VILLAGE
RECORD
CARD
SUB. LOT
ACR. I
TYPE OF BUILDING
VI- I FARM 1 CB. MISC. Mkt. Value
TOTAL
DATE REMARKS
'~0
BUILDI )ITION ~/,~,
FARM Acre
Value Per
Tillable 1
Tillable 2
Tillable 3
~Voodland
Swampland
3rushland
House Plot
total
FRONTAGE ON WATER
FRONTAGE ON ROAD
DEPTH
BULKHEAD
DOCK
M. Bldg.
Extension W~e ~/~,~;~//~ Interior Finish
Extension
Heat
Roams 1st F)oor
rcn
Porch
Ext. Walls
Fire Place
Type Roof
~t:reation Room
Dormer
Driveway
LR.
DR.
BR.
Total
Breezeway
Garage
Patio
Rooms 2nd Floor FIN. B.
FOI~M NO. 1 ,~
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN CLERK'S OFFICE
SOUTHOLD, N. Y.
Examined ............. ..:..:...., ............. , 19
(
Approved ..................... .~.x. ................ , 19.....~!.. Permit No................. ~'~ ~Z.~ ............
Application No.
Disopproved o/c ~ .... ~ ..................................
'\"'"'""'"L~-~,n:.'"'z I~pecto~) -~'~'"
APPLICATION FOR BUILDING PERMIT
Date .......................... ~a~.¢h.....1.7. ........... , 19.66 ......
INSTRUCTIONS
a. This application must be completely filled in by typewriter or in ink ~nd submitted in duplicate to the Building
Inspector.
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 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 available 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 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 alt applicable laws, ordinances, building code and regulations.
(Signature of applicant, or name, if a corporation)
(Address of applicant)
State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder.
............................................... g.o.n.t.r, s,a.t~r. ..........................................................................................................................
Name of owner of premises ....... ~me.l.i~..C.i. meh.i:k ...........................................................................................................
If applicant is a corporate, signature of duly authorized officer.
(Name end title of corporate officer)
1. Location of land on which proposed work will be done. Map No.: .......... ZLv, XX .................. Lot No.: ............. X~ ......
Street and Number E~8*.....A3~z&h.!.$..I~a~e..~q/...J~.i. ct, d.le...R(~ad ..........C.~.~h(~l.~ ........................................
Municipality
2. State existing use and occupancy of premises and intended use and occupancy of proposed construction:
a. Existing use and occupancy ...V..~.c~q~...~r.~...P-r..P.D~r.~r. ................................... ~ ..................................
b. Intended use and occupancy ........... P.t~.~...~'.~iIt,C.~r...~.'~'f~-]-.l:LZ~g ........................................................................
3. Nat~re of work (check which applicable): New Building ..... ~;Y~ .....Addition .................. Alteration ..... , .............
Rep~ir Removal Demolition .................. Other Work (Describe)
(to be paid on filing this application)
5. If dwelling, number of dwelling units .....o.b.e. ................. Number of dwelling units on each floor .............. i .............
If g~rage, number of cars ................................................................................. .............................................. ¢ .............
6. If ~usiness, commercial or mixed occupancy, specify nature and extent of each type of use ...........................
7. Dimensions of existing structures, if any: Front ............................ Rear ................................ Depth
Hei~lht ........................ Number of Stories ...............................................................................................................
D~m,ens~ons of same structure with alterations or additions: Front .................................... Rear .............. t .............
Depih ................................ Height ............................ Number of Stories ................................
8. Dimlensions of entire new construction: Front ............... ~ ................ Rear ........... ~.~ ............ Depth .3.~..../...~.6 ......
Hei,~ ht .................... Number of Stories' qt'~ ...............................................................................................................
9. Size of lot: Front ........ ],.LI:g. ............ Rear ......... 3-.b¢0. ................... Depth .,.'J.6..~ ......................
10. Dat~ of Purchase ........................................................ Name of Former Owner .......................................... ~ ..............
11. Zon or use district in which premises are situated ........ !!~.!!...cl.;~.S.I; ............................................................ ' .............
12. Doe~ proposed construction violate any zoning law, ordinance or regulation? .................... Zo,,O ..................... iL .............
13. Na~ he of Owner of premises ..Am.e.],;1,.~...~J.m~b_J.k....Address .........(~Lt.tz, e. tzag~e ............. Phone No,
Na~ ~e of Architect ...................................................... Address ............................................ Phone No .....................
Na~ of Contractor ...,~B.I;.o.~....Q~;L~lf; .................. Address ............ CLtt,~o~tte. ..........Phone No .......: ..............
PLOT DIAGRAM
L.ocat,~ clearly and distinctly all buildings, whether existing or proposed, and indicate oli set-back dimensions from
property I nes. Give street and block number or description according to deed, and show street names andi indicate
whether in ;erior or corner lot,
STATE aFl NEW ~YORK, _. 1 S S
............................... ~o~fl...~ ................................. berg duly swor~, deposes an~says that he is the applicant
Name of individual signing application) x
above na~ ed. He is the ...................... .QP~.fl.O.~P~ ...........................................................................................................
(Contractor, agent, corporate officer, etc.)
of said owner or owners, and is duly authorized to perform or have performed the said work and to ~keiand file
this applic ~tion; that all statements contained in this application ore true to the best of his knowledge and belief; and
that the w~,rk will be performed in the manner set forth in the application, filed therewith.
Sworn to ,~f°re me this ~ _
Term Expires March 30, 19~ i
SURVEY FOR
BARNEY, ,JR. 8~ DOROTHY
AT CUTCI*'IOGUE
TOWN OF SOUTHOI_D
SUF'F*OLK COUNTY, N.Y.
SCAL~ I";
JUNE 6, 1972
OATES
REFERENCE
8UARANTEED TO'
AMERICAN TITi E' INSURANCE COMPANY
SOUTHOLD SAVINGS BANK
BARNEY, JR. a DOttOTHY OATES
765-18O2
BUILDING DEPT.
INSPECTION
[ ] FOUNDATION 1ST [ ] ROUGH PLBG.
[ ] FOUNDATION 2ND [ ] INSULATION
[ ] FRAMING [ ] FINAL
[ ] FIREPLACE & CHIMNEY [ ] FIRE SAFETY J~SPECTION
REMARKS: .~~
INSPECTOR