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Home My WebLink About12359-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT OffiCe of the Buildin§ Inspector Town Hall Southold, N.Y. Certificate Of Occupancy No. , .Z. 1, ! .8.3) ......... Date ...... A.u..g.u.s.~...5 .................. 19.8.3. THIS CERTIFIES that the building .- r.d.q ~..re.e?.. a..d .d.i.~. 5. 9P ............................ Location of Property 2205 Hobart Road SouthoZd House No. Street Hamlet County Tax Map No. 1000 Section 066 .Block 04 ,..Lot 004 Subdivision...F..o..u.n.d.e.p..s. ?.5~..a.~.e.s. ......... Filed Map No. 834 . .Lot No. 36-37 conforms substantially to the Application for Building Permit heretofore filed in this office dated .... ~a..y..2 ............ , 19.8.3. pursuant to which Building Permit No.. ? .2.3.5.9...g ............ dated ..... ~.u..n.e..~. ................ 19.8.3. , 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 ......... a dormer addition & bathroom to existing dwelling. The certificate is issued to DRAGUTIN & ALBINA GOBIC (owner,'t~t~t~l:~t~l'~) of the aforesaid building. Suffolk County Department of Health Approval N / A UNDERWRITERS CERTIFICATE NO. P e n d ± n g Building Inspector Rev. 1/81 12359 FO~M' NO. 0 TOWN OF SOUTHOI~D: BUILDING DEPARTMI~NT TOWN HALL SOUTHOLD, N. Y. BUILDING PERMI~ (THIS PERMIT MUST BE KEPT ON THE PREM,' IS~S COMPLETION OF THE WORK AUTHORIZED) Date ...~ UNTIL I~ULL permission is hereby granted to: ...... ................. i: ...... ~:.~.:......~ ~ 4/: .... ~, ,-.;' .............. ,..;...;.?:..? .......... .,:.. .. , ..... ~.~ ~Z~../,~...~...,,~,~!...,:.../~....7..Z .. ' ....... '/ ti .... ';' ,,,..~..-- ~ .~ ~ ./../~ .~ ~ ...... ~4...=......~~.~.,:~..~ .~. z.:~.~........~.~..c ......... at premi,es ,ooated at ..... J~.~..~?.~... ........ .~../.6`~..~...[~i...;~...~..~..~...~.~.~..~./~.~.~...?..~.:.~..`~~~~~~~~ ~...'.~.~.~~ ....... ~.~,~ ............ ?.......~..~d.....~... C~n~ Tax Map No. 1000 Section ..... C/.:~.~ ..... Bilk ,.~.~ .......... Lot No. L~,~.~ ........ pu~uant to application dat~ ...... ~.~Z:~..~ .................. ......, 19.~ and ~pprov~ by the ~.~ Building Inspector. Rev. 6/30/80 Building Insl:mctor FORM NO. 6 TOWN OF SOUTHOLD Building Department Town Hall 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 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 features. 2. Final approval of Health Dept. of water supply and sewerage disposal-(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. B. For existing buildings (prior to April 1957), Non-conforming uses, or buildings and "pre-existing" land uses: 1. Accurate survey of peoperty showing ail property lines, streets, buiidiogs 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: I. Certificate of occupancy $5.00 ~ 5-/$ 2. Certificate of occupancy on pre-existing dwelling land use ~/ 5.00 3. Copy of certificate of occupancy $1.00 Date..~..--....~... ~ . . .~...~. ..... New Buitdin ...- .... Old or Pre-existing Building ............ Vacant Land ........ Location of Property .'~..2..¢~..~.~ ............ ~..O ~).~.~'.."~.. ~, ........... .~.'..~ .~. ~..O./.~.. Owner or Owners of prH~rt/~°' ,'.~...J~.~'?~, .~.~.. {i .~. ~..~[.~..l~t~e~t.l~.~...~.~..~.. ;.~... i ......... CountyTax Map No. 10~00Section. Z~-~.~; ...... Block ..~..~.. ........ Lot..O..~.~...~. ....... Subdivision .~,~ ~, .0.*~I..~J~'.O/~YA;'. · ,~, ,~.Y. .... Filed Map Nd~ .(~.~,~ ...Lot IXl~. ~../¢~., ,~-3. Z. Permit No.~'.Z-.~...~.~,~..~'.. Date of Permit ~./~/~.Applicant .~...~. ~~ ....... Health Dept. Approval ........................ Labor Dept. Approval ........................ Underwriters Approval ........................ Planning Board Approval ...................... Request for Temporary Certificate ..................... Final Certificate ....................... Fee Submitted $ ............................. Construction on above described building anc~p.)t~r~t meets all ~eg~u lations. Applicant ,~.~*:'~t~,~. ~...[.... _ .~.~,-~..._. ~ ......... FIE~D 'I~SPECTION FOUNDATION ( 1 st) COMMENTS FOUNDATION 2. ROUGH FRAME & PLUMBING (2nd) INSULATION PER N. STATE ENERGY q~DE FINAL ADDITIONAL COMMENTS: _ FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N.Y. 11971 TEL.: 765-1803 Examined .... ,l Disapproved a/c .~ .... ~ ................ : ......... ~(Building Inspector) APPLICATION FOR BUILDING PERMIT INSTRUCTIONS Date ........ 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 necessary ~n;*pgctions. ~ 9?./ (Mailing address of applicant~ State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. .... e. .}. . . ........................................................ Name of owner of premises ...... Dra~;u.t i 1~...or. Alb:L~. a..Gob~ c ........................................ (as on the tax roll or latest deed) If applicant is a corporation, signature of duly authorized officer. (Name and title of corporate officer) Builder's License No.. ~../{.~..e~. ................ Plumber's License No. ~~P~ . Electrician's License ~ .~...dJ~.. ' Other Trade's License No ...................... Location of land on which proposed work will be done .................................................. ·..~... oc2d(J ~'~.'. ..... Bo]3?p.t..~p.~.d. .................... .S.qtlt,.hp.3.d...L.qq g. ~.~&a .n.d. ?., y ..... House Number Street Hamlet County Tax Map No. 1000 Section . .6~ .... 4 Block .................. Lot ................... Subdivision. ~a.~. 07..~'9.u~q.d. eAT..q. ~t .&~.e..q. ........ Filed Map No .... ~3.4 ........ Lot .~..-.37 ......... (Name) 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy . ~e.s.~..d.e.n.~.~.]?O..n..e.P.a. Tj ~.v. ....................... Rosident~ nl/One Famq ~ v ~/~rrz~z4~ ~z~ ~ b. Intended use and occupancy ............................ .. · · · . ~ . ,.-: .~. ::r; r-. .,,.'w':-.-: .-: .-. ~ . . *:.r ....... 3. Nature of work (check which applicable): New Building .......... Addition .......... Alteration ...X. ...... Repair ............... Removal .............. Demolition .............. Other Work ............... ,nf~ ,,~' ~. .~. . .~. .~. (Description) 4. F, stimatedCost ~ [.-~-. ........ Fee .................................. ........... : ......... (to be paid on filing this application) 5. If dwelling, number of dwelling units .... 0~e. ....... 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 structurss, if any: Front~Pg,. ?.5.' -4" . Rear .A~.~.,. ?3. ~..-~!k ])epth .~.pP.o..P..~! .~.~.'!. Height .... ?.4 '..-.0.".... Number of Stories .............................. ~ ........... · .... ; ......... Dimensions of same structure with alterations or additions: Front Apl), 231 -4". Rear A~o~0, 23 ' -4'" Depth Apl~. 28'-6" -~. ~ 2h'-0" ...................... - .......... .................... ... height ...... ? ............... Number of Stories ....2. ....... _ 8. Dimensions of entire new construction: Front ............... Rear ............... Depth ............... Neight ............... Number of Stories ........................................................ 9. Size of lot: Front .....75.'.-.0'.' .......... Rear.... 7,5.'.-.0!' ............ Depth ..... 2.20! .-.0'[ ........ 10. Date of Purchase .......... 1/7/+ ............... Nam? of Former Owner ............................. 11. Zone or use district in which premises are situated .....R.e.s.!d..e.n.~J.a..i/.A. gl~. ? 9.u.l.~..ufA1. ........... . ......... 12. Does proposed construction v.~oiate any zoning law, ordinance or regulation: ....N..q .......................... 13. Will lot be regraded ............................ Will excess.fall he.removed.from pr~mises:. _ ~Yes ~ D~a~ut~n Gob, c ~o~-~ ~u± ~.~ay~q~ (516)76~_9~7z~ 14. Name of Owner of premmes ...!.... ....................... ._. ................................. Name o f Architect . .V.e o e.q.. Be ~ ?.a, R, A. ....... Aauress ................... t'none r~o. ~..c..~.~ ~ .~..~ ._[. Name of Contractor .Geor~;e .iN,..T0rry. ....... Address 6.0.0..I~ F~l~. ~ ¢l..l~cl ~ Phone No. (.5~ 6.).7..65.-.~.4 ?? PLOT DIAGRAM Locate clearly and distinctly alll buildings, whether existing or proposed, and, indicate all set-back dimensions from property lines. G~ve street and block'number or description according to deed, and show street names and indicate whether interior or corner lot. STATE OF NEW YORK. ~ S .... ~~ ............... being duly sworn, deposes and says that he is the applicant (Nam~of individual si~i~contract) He is the..~~ (Contractor, agent, corporate officer, etc.) of said owner or owners, ~d is du~y autho~zed to perfom or have purloined the said work and to m~e ~d file this application; that ail statements contained ~ this application are true to the best of his knowledge and belief; ~d that the work will be purloined in the m~nqr set forth ~ the application filed therewith. Sworn to before me this ....................... day of ..... ~ ............ , 19... Notary Public,~,~ .f. W~...~.. ~Y .OTA~y PU~LiO, 8tato of ~ow Yo~ ~ ~gnature of applic~t) I NO~ 52'4524711 ~ualified' in .Commission ~p r~ March 30~. 198h~ 4 '~ 1T UZ,,,T ~' AT SOU TI. I0 L D I, V'Z~. 0 TO ~J$ SURVEy I$ A VIOLATION 1 EXI3T G/DE ELEVA TIOtY If copper tubing is used for water distributing system; piping shal! be of types K or Lo_n~ly I~o.o' -LOT 37 ~I~P. ROVEI~ A~' 'N'O~T-~'~ ----~NOTIFY BU~[~fNG 765-1802 9 A~ ~ ~M" F~H~ FOLLOWING rN~'~ ~ FOR POURE~ ~, ROUGH - ;:,,,qpee~tiO~S. , ~., ,"'-, , . ~.Provi~ sho~ d~g!s'ts archi~ect,¢o~ his ap~r0v~l ' p~r tq ma~uf. & ins~tall~tia~ef a~l,ca~inet~ ,worR"&,n~lumn enclpsures~N~,~~ ,, ~.0S~r~tc~r.,, m~e~ c~m~Zy ~lthailap~r~riat~ : .mun~c4pal and regulatory agencies codes and, '~' ~eQulsemente. ,5,Contractor.to submit cuts, samDlee & finishes ,',for architect's ~rit~en approval, p~-$~ to ;- or fa~ication. ~ ~ "~,~ ~6-'To~i~ur~ p~9~r & adequate grounding ~l g~ounds ~'ane ~oc~ing zo'r mi~lwerk,ltemm 'w~ll ~ '=esponsibiZity of~X~o'n~ra~tor~: ' ~a fixtures ~r~ to ~' prev~aed,by the cabinet ~ contr~tor.'Cuteuts~er switche~ &utlets, and wir~g ] devices for same as required, ~e b~cabinet ~ .cont~abter and are t8 be coerd. ZWi.t~¢~lec~centractor. ~:.,~.~n~ac~or sh~ll pro~eet-a~l su=facem fr*m a~l damage ~ ~d ~r~odically =emeve all =ubbish and waste t~om ~he job si~e. At ~he cemplatlon of work the contractor sha~l leave joh'~te fr~e of a~l dirt, ~ dust, ~aterial a~d broom clea~ p~ior to leaving. ~;Pl~mbing contractor shall verify cand&tions of ,e~st~ng waste lines and re~ort ~ t~e architect ~:k~to~e ~connecti~g neww~k ~here{o.. NOTES: THE CONTRACTOR SHALL VERIFY ALL CONDITIONS, ,AND MEASUREMENTS IN THE FIELD AND SHALL BE RESPONSIBLE FOR FIELD FIT AND QUALITY Of WORK THE ARCHITECT SHALL NOT BE RESPONSIBLE FOR THE ACTS CR OMISSIONS OF CONTRACTOR OR ANY SUBCONTRACTOR OR AN~ OF TR~ CONTP. ACTORS' OR SUBCONTR- AC3'_ORS A,~ENT$ OR EMPLOEE'S OR ANY OTHER RERSONS PERFORMING ANY OF T~ W~R~ T~SE ELA~ ARE A~ INSTRUMENT OF SERVICE AND ARE THE PROPERTY OF THE VENCI BENIC archffec ZONE 201 sfreef bayside 11360 DWG ND. CP/F: ) "' ×.: /.'/l ! NOTES: '- ' ' THE CONTRACTOR SHALL VERIFY ALL CONDITIONS AND MEASUREMENTS IN THEYFIELD AND SHALL 'BE RESPONSIBLE FOR FIELD FIT AND QUALITY OF WORK THE ,ARCHITECT SHALL NOT SE RESPONSIBLE FOR THE ACTS OR ~MISSiON~ OF CONTRACTOR OR ANY SUBCONTRACTOR OR ANY OF THE CONTRACTORS' OR SUBCO~ITR- ACTOR,S AGENTS OR EMPLOEE'S OR ANY OTHER PERSONS PERFORMI, N6 THESE~LA~JS_ARE A~L tNST~RUMENT OF SERVICE'~ND ARE THE PROPERTY OF THE REVISION PROJECT .:¢.,r r "-:.<'.'%, , ! ,}_~ .,, ,*~( ..... - VENCI BENIC orchilecr i , ¢9-32 ~ls~reef bayside n,y, 11360 · , ~, .'~'. ~ ~ ,.,':;: ,,, ~? , : ~ ~,~: