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Home My WebLink About9804-zFORM NO. ~ TOWN OF SOUTHOLD BUILDING DEPARTMENT Town Clerk's Office Southold, N. Y. Certificate Of Occupancy THIS CERTIFIES that the building located at ¢.87.Q...B.e.o..b.c...1~'. Sy.e. ....... Map No. ~;2'51 Block No. .Lot No. .7. conforms substantially to the Application for Building Permit heretofore filed in this office dated . .MAY...3? ............ , 19..7..8 pursuant to which Building Permit No.. 9.~0.~Z. dated ...J.~..~...2%. ........... , 19.7..8., was issued, and conforms to all of the require- ments of the applicable provisions of the law. The occupancy for which this certificate is Private One Family Dwelling issued is ...................................................................... The certificate is issued to ....... .~.e..s.l.ex..O.r.l.o.w..s.k,i. .............................. (owner~t) of the aforesaid building. Suffolk County Department of Health Approval .... Feb~cuary. ,2 ,..1.979 .... Robert A, Villa UNDERWRITERS CERTIFICATE No ..... N../4.~.2.2.0.~ ................................ HOUSE NUMBER 2810 Street Beebe Drive Cutcho~..e, New York t. : . -:4 '~/. f'?. .............. Building Inspector County Tax Number TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, iq. Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) N? 9804 Z Permission is hereby granted to: ..... .~an~es...P~.~.e...~.~..e..s. ............................... ..... ~/~ ....... Y.~s~e.y...E....D~.low~ki ................ to ........ .bu$~..a.. Prl~a~a..On e.. ~. ~ily... ~.el %i~lg ............................................................... at premises located at ......................... .~...8..!.0........~..e..e...~..e.....g..~...J:.y..e. .......................................................... ............................................................. Cutchogue.,...N.ew...~o~.~ ...................................................... ...... ~uo~ ..~-..7.~...S~m~y..~,heFes-r ..F.i.l.~ ..Nal~..~.~g.~.~ .................................................................. pursuant to application dated ............. .~,,~,~, ....... ~,~ ....................... , 19.....~...8, and approved by the Building Inspector. Fee $ ......... 1000-103-3-14 H.S. 8-S0-25 Building Inspector I~ORM NO. S TOWN OF SOUTHOLD , Building Department Town Clerks Office Southold, N. Y. 11971 APPLICATION FOR CERTIFICATE OF OCCUPANCY Instructions A. This application must be filled in typewriter OR ink, and submitted in DUPLICATE to the Building Inspector with 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 dispasal--(S-9 form or equal). 3.Approval of electrical installation from Board of Fire Underwriters. 4. Commercial buildings, Industrial buildings, Multiple Residences and similar buildings and installations, a certificate 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 property 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 in- formation required to prepare a certificate. C. Fees: 1. Certificate of occupancy $5.00 2. Certificate of occupancy on pre-existing dwelling or land use $5.00 3. Copy of certificate of occupancy $1.00 ~-~ ~ , Date .,,..~. ..................................... New Building ................ Addition ........ ( ....... OJ~)or Pre~existing Building ................ Vacant Land .............. ~ner ur ~ners Of ProPe~y ..~ .......... ;,l;..~..~..:; .......... .~. ...... ~ ............. ~'~; ....... '~..,~. ........................................ .......... ...................... Lo ....... ........... ............. Health Dept. Approval ............................................ ~bor ~pt. Approval ................................................ Unde~riters Approval .............................................. Planning B~rd Approval ........................................ Request For Temporary Certificate ........................................ Final Certificate .......................................... Fee Submitted $ .................................... Construction on above described building permit .meets all ~o~plicoble codes and regulations. PP .-\..~.....:..: .......................... 7q~,T7..,...~. .................. .. ............... ~., Sworn to before me this ................ day of ............................................ .................................... co.. . / TEL. 7G 5-"~ 6 613 TOWN OF SOUTHOLD [2~FFICE OF RUILDINEi INSPEOTOR TOWN DLE:RK'D OFFIEE SOLITHBLD, N, Y, 119'71 Mr. Wesley Omlowski Box 266 Cut~hogue~ New Yo~k Dear Mm. Orlowski: The tnadvem~ant use of 2" x 6"'s as ae£~ng beams tn the famlly ~oom of you~ h~me may be com~e~t%d by ~he ~nstalla~on of hangers f%,om the ~aftefs to each ceil[n~ beam at approximately m~d span. A ~ont[nuous 2" x ~'~ should also be added ~unn[n~ a~oss the top of all ce~l~n[ beams at m~d span. Yours %~uly ~ James Kosloskf FO~M ~0. ! TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Yo Examined .........~..t~.....e..,....2,~. ........... , 19.,7....8... Application No .............. ~,,8.0.~ ......... Approved JLm~....,~6 ..................... , 19.,..~.f~ Permit No ........... .cjf~,Q.~ ............. (Building Inspector) APPLICATION FOR BUILDING PERMIT Date l~[,~,ay c31 ,, 19 INSTRUCT ONS o. This application must be completely filled in by typewriter or 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, re)ationship to adjoining premises or public streets or areas, and giving a detailed description of layout ofproperty 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 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 ir~ buildings for necessary inspections. FH~I~CES i~OSE H0~E£, I~C. B~jg~/~r~oO~,z~p?ic.~l~tef~.r name, if a corporation) ..... ............ (Address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. BUILDER Name of owner of premises ,,..?!..e...~..];~..Y....,~,;....0, E.~..°...w.M..k..z. .................................................................................................... if applicant is a corporate, signature of duly authorized officer. Ben MeJ'~d~rBe~E9d ~,l~,f corporate officer) Builder's License No ..................................................... 263 P Plumber's License No ................................................. Electrician's License No. ~O7 J~ Other Trade's License No ............................................... "Sunny 2 1 ~ " · ' o 3 3 ~hores 7 1. Location of land on which proposed work wdl be done. Map N .: ........................................ Lot No ......................... ~est side of Beene Drive, 100' south of Emory Road, Street and Number ........................................................................................... .~ti,.~e~,~,~l.,~m~....i~A.~.~.i.~i~;ji~ ........ 2. State existing use and occupancy of premises end intended use and occupancy of proposed construction: a. Exisiting use and occupancy ................................................................................................................................ b. Intended useandoccupancy ........... 0..t't.~....~..~...~.~..1.~...d..w.e..~.?'...~..~...g. ....................................................................... 3. Nature of work (check which applicable): New Building.. ................. Addition .................. Alteration Repair .................. Removal .................. Demolitior. .................... ~ Other Work~_,~,~ '"~'~' ............................................ (Description) 4. Estimated Cost ..... ~.~.~ ............................................................................................................................................. (to be paid on filing this application) 5. If dwelling, number of dwelJing 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 .................... Neight .,..~ ...................Number of Stories ................................................................................................................. Dimensions of same structure with alterations or additions: Front .................................... Rear ............................ Depth .... '.....: ...................... Height ............................Number of Stories ................................ 8. Dim~nsion~ of entire new construction: Front "~' 6~,n,,, ~' , .................................... Rear ........ .~..%. ............Depth ........................ 9. Size eof Ipt: Front ........ ~.~9 ......................................... Rear ...... ~.~ .......................... Depth ...... ~.~ ................... 10. Dbte of Purchase ........................................................Name of Former Owner ........................................................ 11. Zone or use district in which premises ore situated ..................................................................................................... 12. Does proposed construction violate any zoning Iow, ordinance or regulation: ...... ~. ............................................. 13. Will lot be regraded ...~.~ .................. Will excess fill be removed from premises; ( ) Yes (~) No Nome of Architect .............................................................. Address .......................... Phone No ....................... ['rances Rose Homes. PLOT DIAGRAM LocQte c~early and distinctly ~[I buildings, whether existing or proposed, ond indicate ail set-back dimensions from properly lines, Give street and block number or description according to deed, and show street names and indicate whether inferior or corner lot. STATE OF NEW YORI<, [ c c COU N'FY OF ...... Suf.fo.l.k ......... f ~'~ ................................... Be, n.....~n~J~.za ............................... being duly sworn, deposes end says that he is the applicam (Name of individual signing contract) above named. He is the ...................................................... ¢czn.~z~&¢t:or ................................................................................................... (Contractor, agent, corporate officer, etc.) of said owner or owners, and is duly authorized to perform or ~ve performed the said work and to make and file this application; that all statements contained in this applicatio a~}e true to the best of his knowledge and belief; and thor the work will be performed in the manner set forth in the apl c~btJon filed therewith. Sworn to before me this (_.J ELIZABETff ANN NBVILLB NOTARY PUBLIC, S'I~le of N~w York No, 52-8125850, $lJffoik Coun,ty Term ExBires March 30, ~mcK wa TUy., ~,,,c, · .. ,ec .t tOEJ SUFF. cO, D~: OF ~AL?H 10 THIS SURVEY VIOLATJON.O,~ E NEW YOJ(~ H.8. REF. NO.: , , 4(6) . ~.~- ,,/ .- ~.,. ~ ~ ~/ ~l r~ ~'i , , ~ ~ ~ mUCA~O~LAW. DATE: ......... ' ,: <S) ~ : ,,,,AppLicANT ' ' NOTI,FY BUILDING DEPARTMENT AT . ' / r ' : "'" ,',, ' 1. BEFORE BACKF LLING F~NDA , -: , , ~ , ~ FINAL WHE~ JOg' C,OMPLETE~ , '~ ' ' .... OR CONSTRUCTION ER~O~s S. ALL :CO~T~U~Ti~N M~ M~T,, I ~ J ~ r~ I W ~ J ~ ., ,, ~L ,/ KOSLC ~4~ 003 ( ! F~EA~ I H-OO3. 00,3