The URL can be used to link to this page

Home My WebLink About12306-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No Z-21117 Date OCTOBER 28, 1992 THIS CERTIFIES that the building Location of Property 720 BUNGALOW LANE House No. County Tax Map No. 1000 Section 123 Subdivision ADDITION MATTITUCK, N.Y. Street Block 2 Lot Filed Map No. Lot No. Hamlet 11 conforms substantially to the Application for Building Permit heretofore filed in this office dated APRIL 13, 1983 pursuant to which Building Permit No. 12306-Z dated MAY l0t 1983 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 & DECK ADDITION TO EX~STING ONE FAMILY DWELLING The certificate is issued to GENE DOROSKI (owner) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL UNDERWRITERS CERTIFICATE NO. PLUMBERS CERTIFICATION DATED H-031678 - OCTOBER 22, 1992 N/a - / ~ ~ding inspector Rev. 1/81 TOWN O~ sou~o~ TOWN HALL ,SOUTHOLD, N. Y. BUILDING PERMIT! (THIS PERMIT MUST BE KEPT ON THE PREMISES uNTIL ~JJLL COMPLETION OF THE WORK AUTHORIZED) N'? ~o, z °o,e ...... ~~.?....., .................... ,,,.~ permission is hereby granted to: ......... ~.zz~:z~.~..~...N~,.L,'.,.~:~ . ,o ..... ~....~.C~z~......~?~......~L....e~.~L...~~ ..~....~ ............. ~~ .......... ~~~...~. ............... ~ ............. ,: ......................... .,~,em,,.',~,t,~ ,,.....:Za ......... :~:~...::~e., ........ ~ .......................... ....... : .......... .............................................................. :..~ ...: ......... :...:~.: ~,..~ .................... , ....................................................... ...~., .............. {t .......................... , ............ Building I~spector. ..................... ?.~,~: ~.~;~ ....... ........... Rev, Form No. 6 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL 765-1802 A~PLICATION FOR CERTIFICATE OF OCCUPANCY A. 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 i% lead. 5. Commercial building, industrial building, multiple residences and similar bui%dings and installations, a certificate of Code Compliance from architect or engineer responsible for the building. 6.Submit Plauning Board Approval of completed site plan requirements· B. For existing buildings (prior to April 9, 1957) non-conforming uses, or buildings and "pre-existing" land uses: 1. Accurate survey of property showing all property lines, streets, building and unusual natural or topographic features· 2. A ~roperly 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 i. 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 - $i00.00 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 New Construction .......... Old Or Pre existing Buildin ........ House No.' Street Hamlet Onwer or Owners of Property ..... ~.~ County Tax Map No 1000, Section .... ~?'. ~ ..... Block· O~,~ .Lot .... ~/~ .... Subdivision ............................... Filed Map ............ Lot .............. Health Dept. Approval .... .~.~. ........ Underwriters roval..~..~.~Z~.~... · · ........ App Planning Board Approval....~f//~. ............ Request for: Temporary Certificate ........... Final Certicate. Fee Submitted: $ .~ ......................... 0.,<, qsos f THE NEW YORK BOARD OF FIRE UNDERWRITERS ~,a<~ ~ BUREAU OF ELECTRICITY 85 JOHN STREET, NEW YORK. NEW YORK 10038 only the electrical equipment ~ ~scribed below a~ interlaced by t~ applicant ~med on the a~ve application number in the premises of ~s examined on 0 C ~'0~ ~ ~( ~9 ~ ~.9~ and found to be ln compllance wlth the ~equlrements ~f th s Board jR-?w Ia,t EUR.,. CE M OfOES... EU2.,EA,%?C, :O:E S $ERVICE DISCONNECT NO. OF 2 ~~ METE~ S 1.~2W 1.~3W 3~3W 3~'4W NOOF CC COND, AWG, - PER ,~ OF CC COND, RANGES cOOKING DECKS OVENS DISH WASHERS R V I C Per This certificate must not be altered in any manner; return to the office of the Board if incorrect, fnspectqrs may be identified by their credentials, F~ELD'~NSPECTION FOUNDATION (1st) COMMENTS F, OUNDATION 2. (2nd) ~OUGH FRAME & PLUMBING INSULATION PER N. Y. STATE ENERGY %ODE FINAL ADDITIONAL COMMENTS: VICTOR LESSARD PRINCIPAL BUILDING INSPECTOR (516) 765-1802 FAX (516) 765-1823 OFFICE OF BUILDING INSPECTOR TOWN OF SOUTHOLD Town Hall, 53095 Main Road P.O. Box 1179 Southold, New York 11971 NAME: AGNES ADDRESS: RE: DATE: February 2, 1989 LINDSAY 720 BUNGALOW LANE, HATTITUCK, N.Y. 11952 BUILDING PERMIT ~ 12306Z ADDITION SEC. 123 BLOCK 02 LOT !1 This Building Permit has expired. You are now in violation of the Town of Southold Zoning Code. Please contact our office, this matter must be corrected. Yours truly, Victor C. Lessard Principal Inspector ** INSPECTIONS AND C.O. REQUIRED. TOWN OF $OUTHOLD OFFICE OF BUILDING INSPECTOR P.O. BOX 728 TOWN HALL SOUTHOLD, N.Y. 11971 TEL. 765-1802 This i~to advlae you that the jo~ under building permit no. xz306Z issued to Agnes Lznasay on 5/10/83 for Addition is completed a final ~n.'spectlon bas ~ ~ has not ( X ) been done. and In order to complete this file, it is necessary that a Certlflc~te of Occupancy be issued. Please fill out the enclosed fgrm, return Same to the above office with a check for $25.00~- payable to the Town of Southold. Please indicate to Whom tbe Certificate of Occupancy is to be mailed, and arrange with tb~a office for an inspection date Occupancy or use is unlawful without a Certificate of Occupancy. Please. help us to clear up this matter ao that legal action does' not have to be taken. ,: Thank you for your prompt attention. Very trul)~, Victor Leaaard Executive Adminia~rator VL:gar encl. FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N.Y. 11971 TEL.: 765-1803 ' (Building Inspector) APPLICATION FOR BUILDING PERMIT Date . .4.'T. ,I."~ ......... 19g.~ INSTRUCTIONS 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 app!icant agrees to comply with all applicable laws, ordinances, building c~de, housing,.zode, and regulations, and to admit authorized inspectors on premises and in building for necessary inspe,~. ~u~icantl or name, if a corporation) (Mailing address of applicant) State whether applicant is owner, lessee, a~nt, architect, engineer, general contractor, electrician, plumber or builder. f/ (as odJhe tax roll or late ) If applicant is a corporation, signature of duly authorized officer. (Name and title of corporate officer) Builder's License No .......................... Plumber's License No ......................... Electrician's License No ....................... Other Trade's License No ...................... 1. Location of land on which proposed work will be done .................................................. ...... ............ .................... House Number Hamlet County Tax Map No. 1000 Section ...1!.'.~..~. Block ~ Lot. ~ Subdivision ..................................... Filed Map No ............... Lot ............... (Name) 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy .... . .~..~ ./. ~.-~t-~.I. i ................................................. b. Intended use and occupancy .... / ...... '.O. ~..~....~...~..~..~....~.~'. ! .~. ........... 3. Nature of work (check which applicable): New Building .......... Addition ......1~.... Alteration .......... Repair. ............. Remo~ai .............. Demolition .............. Other Work ............... 4. Estimated Cost ............................ Fee . / ---~---~? (Description) (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 eacl~ tdtpe,of use .... · 6. ...... 7. D~mens~ons of erecting ~ructure~, ~f any: Front. ,,1~,~..:3 ....... Rear .~~Depth ~ ~t Height .... /.~...~..'.. Number of Stories ..... /. .................................................. Dimensions of same structure with alterations or additions: Front ................. Rear .................. Depth ................... . Height ........ Number o,f Stories ............. 7. · ',~ .... 8. D~menslons of entire new constmctton. Front , ./~.0...~ .... Rear . .~.O .:~ .... Depth ,,~ .5(. (~ Height ...... [ .~.~. (~... Number of Stories ................................................... Size of lot: Front ..... /,c;),O/.i ........'... Rear .... ~.q'..,.~.~. .......... Depth ...~..~..O..~. ........... Date of Purchase ' Name of F Owner ........... .................. ormer ............................. Zone or use district in which premises are situated ..................................................... Does proposed construction violate any zoning law, ordinance or regulation: ...~ ........................... Will lot be regraded .... ~.o. .................... Will excess fill be removed from premises: ~ No Name of Owner of premises ... ................. Address ................... Phone No ................ Name of Architect .......... i ................. Address ................... Phone No ................ Name of Contractor ......... i ................. Address ................... Phone No ................ 10. 11. 12, 13. 14. Locate clearly and distinctly all I buildings, property lines. Give street and block interior or corner lot. PLOT DIAGRAM whether existing or proposed, and, indicate all set-back dimensions from mmber or description according to deed, and show street names and indicate whether STATE OF NEW YORK, ......... .~.~.~3~.....~.0..~*M?. ~.1..(--~.. ............... being duly sworn, deposes and says that he is the applicant (Name of individual signling contract) above named. , He is the.. .................................................... ~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 conthined 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 ............. .~. · ~...day o? ...... ~ .... 19..~..~ No. ~2-034496a Suffol~ County9(/,~-.-- (Signature of applicant) Commmslon Expires Marc~ 30, SURVEY FOR GENE DOROSKI A T MA TTITUCK TO WN OF SOUTHOLD mo/) s. 86'57'00' w. 88.96' CENTER STREET AREA = 25,818 sq. ft. SUFFOLK COUNTY, N. Y 1000- 123- 02- 11 Scale: l' = 30' Oct. 21,1992 CERTIFIED TO' GENE DOROSKI Prepered in occordence wilfl the minimum stenderds for lille surveys os esleblished ~Y_o the L.I.A.L.S. m~d ~l~proved end ndopted r such use. by The New York Stole Lend Tille Assoc~ofion. P.O. MAIN ROAD SOUTHOLD, 1197/ LIC. NO. 49618 P.C. SURVEY FOR 88.96' ~ S. 8~57'00' ~ CENTER STREET AREA = 25,818 sq. ft. GENE DOROSKI A T MA TTITUCK TOWN OF SOUTHOLD SUFFOLK COUNTY, 1000 - 123 - 02- Scale, 1"= 30' Oct. 21,1992 C£RTIFIED TO' GENE DOROSKI Prepured in occordence wifh fhe minimum sfondords for Erie surveys ns estnb#shed ?o lhe L.I.A.L.S. end epproved end edopted r such use by The New York $iclte Land T/tie Associotion. MAIN ROAD SOUTHOLD, :S. LIC. NO. 49618 P.C. N.Y. 11971 OF OCCIJPAH,CY