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Home My WebLink About12425-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. Certificate Of Occupancy DECK ADDITION THIS CERTIFIES that the bulldog ................................................ 500 Tuckers Lane Sbuthold Location of Property ,q~s~ ~/o] ................... Street Hamlet County Tax Map No. 1000 Section 0 6 3 .Block 0 5 .Lot 0 03 Subdivision M/o HunCinghurst .Filed Map No. 612 .LotNo. p/o 6 & 7 conforms substantially to the Application for Building Permit heretofore filed in this office dated June 8, 1985 · . pnrsuant to which Building Permit No. 12425 z dated .... J.u.l.y.. !5. ,.. [9.8.5. ........... 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 ......... DECK ADDITION TO EXISTING ONE FAMILY DWELLING The certificate is issued to CARL & JEAN A. STEPNOWSKY (owner, f/~Ft~XX Of the aforesaid building. Suffolk County Department of Health Approval ....... N/A . UNDERWRITERS CERTIFICATE NO. . .~/.A. PLUMBERS CERTIFICATION DATED: N/A Rev. 1/81 ffO~ NO. ~ TOVIH 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? 12425 Z Permission is hereby granted to: ........ ..~c~_~.......:.~...~.w...~.k~x':. ....... ....... ~..c~.....~.~*~.....L~.~.~ ....... ........... ,o ....... ~C~..~ ..~..~.-/.~..~..c~.-E......~m.c,/<~... ,~.~..~....~....-~......'-~. -~......,~.~. .............. .......... .~.~.~.-~.~..~...~.......o..~..~-i. ~,..~.~ ....................................................................... at premises located at ......... ...-~.~.~.~ ~J~--/~-~ ........ ? ..... ~.t..~.~l..t.,.~..r~..~t.u.~.~........--~.......~.t.....~... ......................... .~.~.~..~.....~/....~.....~.....~ ............ County Tax Map No. 1000 Section ..~.~.~..~.. ......... Block ....(~.~. ....... Lot No.....~....~,. ..... pursuant to application dated ........ ~./,~.l-~d.~...,.,~ ................. , 19,~.~and approved by t~e Building Inspector. Fee $..£.~.~.) ............ Rev. 6/30/80 FIELD 'II~P~C~ION COMMENTS FOUNDATION (1st) FOUNDATION (2nd) ROUGH FRAME & PLUMBING INSULATION PER N. STATE ENERGY ~,ODE FINAL ADDITIONAL COMMENTS TOWN OF $OUTHOLD OFFICE OF BUILDING INSPECTOR P.O. BOX 728 TOWN HALL SOUTHOLD, N,Y, 11971 TLL. 765-1802 This is to advise you that the job under bnilding permit no. ~_~j~ issued to Carl Stepnoski on ~/_~_83 _ for _~ddition is completed and a fi,]al inspection has ( ) has not ( X ) been done. in order to complete this file, it is necessary that a Certificate of Occupancy be issued. Please fill out the enclosed form, return same to the above office with a cheek for $25.00 payable to the Town of Southold. Please indicate to Whom the Certificate of Occupancy ia to be mailed, and arrange with this office for an inspection date Occupancy or use is unlawful without a Certificate of Occupancy. Please. help us to clear up this matter so that legal action does not have to be taken. Thank yon for your prompt attention. Very truly~, Victor Lesaard Executive Administrator VL:gar enc] . FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N.Y. 11971 TEL.: 765'1803 Examined..~.c).t~.. I .~-~.., 19~.'.~ Approved .~.td.(..~.. J.~...., 19~.~. Permit No.. [ .~..~...¢'~..~ (Building Inspector) APPLICATION FOR BUILDING PERIVIlT INSTRUCTIONS Application No. J..~..~.. ?.. ~.~. ...... 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 necesi~ .rf~ns..~ ... (Mailing address of applicant) State whether applicant is owner, lessee, agent, architect, en~neer, general contractor, electrician, plumber or builder. Name of owner of premises... ~. ~.~ ...... ~/~ ./~..~..~..O. ?.5.' ................. (as ontJhfi4ax roll or latest deed) If applicant is a corporation, signature of duly authorized officer. "4 (Name and title of corporate officer) Builder's License No ........ *~.~'£~. ........... Plumher's'~License No ......................... Electrician's License No ....................... Other Trade's License No ...................... 1. Location of land on which proposed work will be done .... ¢~...O~....~..~ ................. House Number Street Hamlet County Tax Map No. 1000 Section .... ~ ..... Block .................. Lot ................... Subdivision .~.~ r~'[ ~.)~_~rJ.O.L~-. ~..'~.. ... Filed Map No.. ,~.l~-. Lo~-.~./~ .-...-/.. ~ (Name) .................. 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy ..... ~.~..~.' ....... .~..kJ*, .~.~ i&.~.C ~ b. Intended use and occupancy . . . ~..~l~.-'. ~V( ./T'..f-[ , .' ,/,>..~=~3.l.~....~..D.~.t."~-~. ~.(~.~. ....................... 10. 11. 12. 13. 14. Nature of work (check which applicable): New Building .......... Addition ... ~... Alteration .......... Bepair .............. Removal .............. Demolition .............. Other Work ............... : .~. ~..D~r q.~. ,~ c~_?~O (Description) Estimated Cost ............................ Fee ................................... (to be paid on filing this application) If dwelling, number of dwelling ~nits ............... Number of dwelling units on each floor .............. If garage, number of cars ..... i ................................................................. If business, commercial or mixed occupancy, specify nature and extent of each type of use ..................... Dimensions of existing structure~, if any: Front ~ .............. Rear .............. Depth ............... Height . .............. Number of Stories ......................... , .................. } ...... Dimensions of same structure with alterations or additions: Front .... .~. ~ ......... Rear ... ~-~.. .......... Depth ........ ~ .......... i.. Height .... .c~. ~. .............. Number of Stories...-~...iiii i Dimensions of entire new construction: Front ..... ~ .~. f .... Rear ....~-..qt.' ....... Depth .../f. ~. ........ Height .... '3,,°~ ff ......Number of Stories .... ~ .................................................. S~ze of lot: Front ...... ./'.~..i ........... Rear .... ~., ................ Depth .. ~. ......... o-~ . ......... Date of Purchase ...... ~./..~.. 7.~. .............. Name of Former Owner . ~.. ~...~ ..... Zone or use district in which premises are situated ..... .~.~.~../?.<,? r.'.~..~ ................................ '~ ' ............. Does proposed construction violate any zoning law ordinance or regulation: ..... .~?. ........................ Will lot be regraded ......... .~of. .................. Will excess fill be removed from premises: Yes No Name of Owner of premises ~.~ .~... Address .'~..~..,-~-r..... Phone No...~..~'.~ .,~..7.,~.... Name of Architect .......... ................. Address ................... Phone No ................ Name of Contractor ......... ' ................. Address ................... Phone No ................ PLOT DIAGBAM Locate clearly and distinctly alii buildings, whether existing or proposed, and. indicate all set-back dimensions from property lines. Give street and block humber or description according to deed, and show street names and indicate whether interior or 6orner lot. STATE OF NEWrYO)RK, CO (Name of indivtduaI~ntract) above named. sworn, deposes and says that he is the applicant He is the ............. ~ ................................................................. i (Contractor, agent, corporate officer, etc.) 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 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 .......... .... .... ..... Notary~Public, .......... ~ .,.. _/~. ~County c_/ ~~~(~ N~V~.2 / (Sign~ure of apphcant) ~o. 52 ~z~u. ~u,m~ ~o~.~ - / ' , r~rm t?x~tres M~rch ~, ~ FORM NO. 6 TOWN OF SOUTHOLD Building Department Town Hall Southold, N.Y. 11971 765 - 1802 APPLICATION FOR CEFIT~FICATE OF OCCUPANCY Instructions This application must be filled in typewriter OR ink, and submitted ~ ammmama to the Building Inspec- tor 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 featu res. 2. Final approval of Health Dept. of water supply and sewerage d[sposal-(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 installa- tions, 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. For existing bbildings (prior to April 1957), Non-conforming uses, oF buildings and "pre-existing" land uses: 1. Accurate survey of p~operty 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 informa- tion required to prepare a certificate. C. Fees: 1. Certificate of occupancy New ])welling, $25.00, 'Accessory ,~ 10.00 Business $50.00 2. Certificate of occupancy on pre-existing dwelling $ 50 ~ 00 3. Copy of certificate of occupancy $ 5.00, over 5 years $10.00 4.Vacant Land C.O. $ 20.00 ///.~/4~'./..~.. 5.U~dated C.O. $ 50.00 Date ............. 6. ~lteration $25.00 NewCons%ruc%ion ...... Old or Pre-existing Building ............ Vacant Land ............. LoeetionofProperty... 7... ..... ....................... _ House No. Street Hamlet Owner or Owners of Property ... __ .?. ...................... County Tax Map No. 1000 Section ............... Block ............... Lot ................ Subdivision Filed Map No ;'Lot No Permit No~.c~ ,~, ,~-~. ,~ Date of Permlt cent ....... Health Dept. Approval ........................ Labor Dept, Approval ........................ Undem~riters Approval ........................ Planning Board Approval ...................... Request for Temporary Certificate ..................... Final Certificate ....................... Fee Submitted $.. ,~..~.~. ,~. ~ ................ Construction on above described building and~eets all applicable codes and regulations. Applicant ................................... R~. 10-10-78