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Home My WebLink About9699-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No Z-19136 Date JUNE 12, 1990 THIS CERTIFIES that the building Location of Property 2550 HAYWATF~RS ROAD House No. County Tax Map No. 1000 Section 111 Subdivision ADDITION CUTCHOGUE~ N.Y. Street Block 6 Lot Filed Map No. Lot No. Hamlet 19 conforms substantially to the Application for Building Permit heretofore filed in this office dated MAY 2, 1978 pursuant to which Building Permit No. 9699-Z dated MAY 2~ 1978 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 SCREENED IN PORCH ADDITION TO EXISTING ONE FAMILY DWELLING The certificate is issued to EDWARD BACHORIK (owner) of the aforesaid building. SUFFOLK CO~N~ DEPARTMENT OF HEALTH APPROVAL UNDERWRITERS CERTIFICATE NO. PLUMBERS CERTIFICATION DATED PENDING ~ JUNE 12~ 1990 N/A Building Inspector Rev. 1/81 FORM NO. 2 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, lq. Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) Ne 9699 Z Date ........................................................ , 19..x.C.., Permission is hereby granted to: at premises located at ......... .q:...,f..~.L. ......... !..!,-.~..~...!]..{.?,..:.~..:x.....;~ .......... .2. ......... ~.:~ ................................ .................................................................. .C~..!-:!..Z .~'f'.L.'..g.~..~,L!~ ........................................................ pursuant to application dated ................................ (. ....... /. ......... ~ 19./..~'.., and approved by the Building Inspector. 1~-~ Fee $ ........ ; ............... Building Inspector Form No. 6 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL 765-1802 APPLICATION FOR CERTIFICATE OF OCCUPA~ TOWN OF soUTHOLD ,, This application must be 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. 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 Vpre-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. 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 - $5.00 over 5 years - $10.00 4. Updated Certificate of Occupancy - $50.00 5. Temporary Certificate of Occupancy - Residential $15.00, Commercial $15.00 6 A1/9o Date . Xddl~Td~' ~ '~b~; .................. New Construction ........... Old Or Pre-existing Building.. Location of Property .... ~D~.Q .H~.gO~ ~. ~P~.Q~Og~ ,. ~.-..Y, ...................... . . . House No. Street Hamlet Onwer or Owners of Property ..... ~clwar~ .BM¢ILQ~i}I ........................................... County Tax Map No jO00, Section .............. Block ................ Lot ............. Subdi6ision ..... /~..//.~.~...~./.~/2.~.. ~¢'. ......// Filed Map...~..~.4 ..... Permit No...9.6.9.9.'~. ....... Date Of Permit.,gjfz. ~.~. ..... Appl Health Dept. Approval .......................... Underwriters Approval ......................... Planning Board Approval ........................ Request for: Temporary Certificate .... Final Certicate. . · ::, ....... :"x' ...... -- .... TOWN OF $OUTIIOLD OFFICE OF BUILDING INSPECTOR P.O. 13OX 728 TOWN IlALL SOUI'IIOLD, N.Y. 11971 APRIL 30, 1990 TEL. 765-1802 INLAND HOHES, INC. BOX HATTITUCK, N.Y. 11952 RE: EDWARD BACHORXK To Whom This May Concern, We are unable to complcte your Certificate of Occupancy because .of the following reasons. /~/An application for Certificnte of Occupancy ./is not on fil~. (ENCLOSED) /~,/~Io Underwriters Certificate on file. /~ihe check is(o~F~a~Ye~/not on file.) $25.00 /~/ Ho !Iealth Dept. Approval on file. /~/ No final inspection has been made. Pie]se contact our office on this matter. Thank you for your cooperation. Building Permit t[ 9 6 9 9 Buildin[~ Dept. ,,. ,/_-/ Z NO Plumber Solder Certificate on file. ( all permits involving plumbing being .issued after April 1,1984 ) TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE ~.$OUTHOLD, N. Y. ~proved ~ ............... ~......~...j19"~Permit No. ...~...~ Disapproved a/c ....................... ~... ~.~. ..................................................... {Bui~din~ Inspector) Application No ............................... APPLICATION FOR BUILDING PERMIT May 2 7 8 Date ................................................ , 19 ............ INSTRUCTIONS a. This application must be completely filled in by typewriter ox in ink and submitted in triplicate 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 ofproperty must be drawn on the diagram which is port 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 wffl issue 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 lows, ordinances, building code, housing code, and regulations, and to admit authorized inspectors on premises and in buildings for necessary inspections. INLAND HOMES, INC. (Signature of applicant, or name, if a corporation) Box 117, Mattituck, N.Y. 11952 (Address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. ........................................ .G.~.~ .e. ~;~ ~,...¢;.o. X~ .1;.~.~..c...¢. g.~ .... . ............. · r ' Edward Bachori~ If applicant is a corporate, signature of duly authorized officer. (Name and title of corporate officer) Builder's License No ............................ ~.. ..................... Plumber's License No. 51?-p Electrician's License No. Other Trade's License No ...................................... .~ ........ 1. Location of land on which proposed work will be done. Map Nob ....8..O..~ .............................. Lot No....3..6...5. ............... Street and Number 2550 Hay. waters Road; Cutcho~9..e~ N.y. (Nassau Point) Municipality 2. State existing use and occupancy of premises and in,~ended use and occupancy of proposed construction: a. Exisiting use and occupancy 1 Screened in Porch b. Intended use and occupancy ................................................................................................................................ 3. Nature of work (check which applicable): New Building'. ....... : ......... Addition ..~ ......... Alteration ................ Repair .................. Removal .................. Demolition .................... Other Work .................................................... ~ (Description) $1 800.00 Fee // ~ 4. Estimated Cost ..... ~. ............................................................................................................................................... (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 ............................................................................................................................................. 6. If business, commercial or mixed occupancy, specify nature and extent of each type of use ............................ 7. Dimensions of existing structures, if any: Front ............................ Rear ................................ Depth .................... Height ........................ Number of Stories ................................................................................................................. Dimensions of same structure with alterations or additions: Front ....................................Rear ............................ Depth ................................ Height ............................ Number of Stories ................................ 8. Dimensions of entire new construction: Front 16 16 .................................... Rear ............................ Depth ].4 Height .................... Number of Stories ...................................................................................................................... 9. Size of lot: Front ]-OO Rear ]-OO Depth ;38]. ........ 10. Date of Purchase ........................................................ Name of Former Owner ........................................................ 11. Zone or use district Jn which premises are situated ..................................................................................................... 12. Does proposed construction violate any zoning law, ordinance or regulation: .......... ..~..o. ......................................... 13. Will lot be regroded ....... ..Y.?.~ .............. Will excess fill be removed from premises: ( ) Yes (~) No 14. Name of Owner of premises .g...~..~...~.~..d...~.a...b..o...~.~.k.. ............... Address ................................ Phone No ....................... Name of Architect .............................................................. Address ................................ Phone No ....................... ...D. .......... .3....,....~.~.l;.:~J;~i~No..~.~..0..-:..9.(~?.~.. Nome of Contractor~..~..]-..~.~...d.....~..°..~...e..s..~....~-~.~:. .................. Address ox '1 2 M ' PLOT DIAGRAM Locate clearly and distinctly all buildings, whether existing or proposed, and indicate all set-back dimensions froro property lines. Give street and bloc/< number or description according to deed, end show street names and indicate whether interior or corner Io~. STATE OF NEW YORLQ~ (Nom;..;.~.~~_~....Seing duly sworn, deposes and soys that he is the applicant above named. I-le is the ................................................................................................................................................................................. (Contractor, ogent, corporote officer, etc.) of said owner or owners, and is duly authorized to perform or have performed the said work and to make end file this application; that all statements contained in this application are true to the best of his knowledge and belief; and tha~ the work will be performed in the manner set forth in the application filed therewith. Sworn t.~...e, fore me this .......... :~.... day of ........ .]g..~Y. ............................ , 19.-.~..8.. Nato rv/Fr~blic, ~._.~........~.~.~.~......, ............... County .. · .......................... DEED: U.7,1~8 , F ,:)~Z . SUFF. CO. HEALTH DEPT. APPROYAL TITLE '~,'/c~ 7'?//~. /~u/,.:.~-,<e Co. ~ ~ ~ '~,~' v',~'~,/~<:! ~J~ J. t 7, ! 9'77 RODERICK VAN TUYL, P. C. LIC. LAND SU RVEYORS.GREEN}:~5~T, ~, Y. DEPT. OF HEALTH SERVICES STATEMENT OF INTENT STANDARDS OF SUFFOLK CO. DEPT.