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HomeMy WebLinkAbout12813-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No: Z-25789 Date: 06/23/98 THIS CERTIFIES that the building ACCESSORY Location of Property: 59475 MAIN ROAD/ROUTE 25 (HOUSE NO.) (STREET) County Tax Map No. 473889 section 56 Block 3 SOUTHOLD (HAMLET) Lot 6 Subdivision Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated DECEMBER 19, 1983 pursuant to which Building Permit No. 12813-Z dated DECEMBER 28, 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 RELOCATE EXISTING ACCESSORY STRUCTURE TO REAR OF PROPERTY AS APPLIED FOR. The certificate is issued to JOSEPH F. & MARILYN KRUKOWSKI (OWNER) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL ELECTRICAL CERTIFICATE NO. PLUMBERS CERTIFICATION DATED N/A N/A N/A ~ '~ui ~ ln~ctor Rev. 1/81 TOWN OF $oUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N. Y. BUILDING FERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) pursuant to application date~~.....~.......),..~. ............ , 19..~.~;~ and approved by the Building Inspector. Building Inspector Rev. 6/30/80 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL 765-1802 APPLICATION FOR CERTIFICATE OF OCCUPANCY 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 ali buildings, property lines, streets, and unusual natural or topographic features. 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 t6 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 Buitdinm - $I00.00 3. Copy of Certificate of Occupancy - , .25~ 4. Updated Certificate of Occupancy - $50.00 5. Temporary Certificate of Occupancy - Residential $15.00, Commercial $15.00 .............................. New Construction ........... Old Or Pre-existing Building ................. Location of Property..~.~7..~. ........... ~-~. ................... SP.~.~.~/~. ......... House No. Street Hamlet Onwer or Owners of Property..~..~.+.~.~ County Tax Map No 1000, Section ..... Subdivision .................................... Filed Map ............ Lot ...................... Permit No., ~l~'~-~. . ~-~.Date Of Permit ................ Applicant ........................... .. Health Dept. Approval........ ............... . .. Underwriters Approval ......................... Planning Board Approval ........................ Request for: Temporary Certificate ........... Final Certicate ........... Fee Submitted: $. ~. ~. '..~.~. .................... -'gl5 '. :. .................... 765-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION 1ST [ ] FOUNDATION 2ND [ ] FRAMING [ ] FIREPLACE & CHIMNEY [ ]ROUGH PLBG. [ ] INSULATION [ ~l~JC DATE ? INSPEC~~~:~ Town Hall, 53095 Main Road P. O. Box 1179 Southold, New York 11971 Fax (516) 765-1823 Telephone (516) 765-1802 OFFICE OF THE BUILDING INSPECTOR TOWN OF SOUTHOLD March 19, 1998 Joseph Krukowski 59475 Main Road Southold, New York 11971 ****SECOND NOTICE**** To Whom This May Concern: We are unable to complete your Certificate of Occupancy because of the following reasons: XX An application for Certificate of Occupancy is not on file. (Enclosed) No Underwriters Certificate on file. The check is (not on file.)$25.00 No Health Department Approval on file. XX No final inspection has been made. No Plumber Solder Certificate on file. (All permits involving plumbing being issued after April 1, 1984). BUILDING PERMIT #12813-Z SEE ATTACHED Please contact our office on this matter. Thank you for cooperation. SOUTHOLD TOWN BUILDING DEPT. Town Hall, 53095 Main Road P. ©. Box 1179 Southold, NewYork 11971 Fax (516) 765-1823 Telephone (516) 765-1802 OFFICE OF THE BUILDING INSPECTOR TOWN OF SOUTHOLD June 10, 1998 Joseph Krukowski 59475 Main Road Southold, N.Y. 11971 To Whom This May Concern: We are unable to complete your Certificate of Occupancy because of the following reasons: An application for Certificate of Occupancy is not on file. (Enclosed) No Underwriters Certificate on file. XX The checks are not on fileS75.00 (3 CO'S) No Health Department Approval on file. No final inspection has been made. No Plumber Solder Certificate on file. (All permits involving plumbing being issued after April 1, 1984). BUILDING PERMIT #12813-Z~12838-Z&I8693-Z Please contact our office on this matter. cooperation. Thank you for $OUTHOLD TOWN BUILDING DEPT. CTION 1. FOUNDATION (lst) FOUNDATION (2nd) ROUGH FRAME & PLUMBING INSULATION FER N, STATE ENERGY ~ODE FINAL COMMENTS ADDITIONAL COMMENTS: VICTOR LESSARD PRINCIPAL BUILDING INSPECTOR (516) 765-1802 FAX (516) 765-1823 Town Hail, 53095 Main Road P.O. Box 1t79 Southold, New York 11971 OFFICE OF BUILDING INSPECTOR TOWN OF SOUTHOLD DATE: ~A~E: -~o~ ~ ~U~<O~s~, ADDRESS: S~q~ Y~H~ ~o~ RE: BUILDING PERMIT # BLOCK ~ LOT 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 trq.l~y, Victor ~. Lessard Principal Inspector TOWN OF SOUTHOLD OFFICE OF BUILDING INSPECTOR P.O. BOX 728 TOWN ttALL SOUTHOLD, N.Y. 11971 Ti'.'L. 765-1802 This is to advlne you that the job under building permit no. 12813Z issued to ..~osep,~ Krukowski on !~f28/~_~___ for Acce~or~ ia completed ;] final inspection has ( ) has not ( ~ ) been done. and in order to complete this file, it is necessary that ;~ Certificate of Occupancy be issued. Please fill out the enclosed form, return same to the above office with a cheek for $10.OOpayable to tho Town of Southold. Please indicate to Whom the Certlficnte of Occupancy is to be mailed, and orrange with tibia office for an inspection date Occupancy or nsc i.q un].awful without a Occupancy. Plenne help us to clear up this legal action does not have to be taken. Certificate of matter so that Thank you for your prompt attention. Very truly ~y~, Victor Lessard Executive Administrator VI.: p~a r encl . Town Hail, 53095 Main Road P. O. Box 1179 Southold, NewYork 11971 OFFICE OF THE BUILDING INSPECTOR TOWN OF SOUTHOLD May 5, 1998 Fax (516) 765-1823 Telephone (516) 765-1802 Mr. Joseph Krukowski Main Road Southold, N.Y. 11971 To Whom This May Concern: We are unable to complete your Certificate of Occupancy because of the following reasons: An application for Certificate of Occupancy is not on file. (Enclosed) No Underwriters Certificate on file. The check is not on file. No Health Department Approval on file. XX * No final inspection has been made. No Plumber Solder Certificate on file. (All permits involving plumbing being issued after April 1, 1984). BUILDING PERMIT # 12813-Z Please contact our office on this matter. Thank you for cooperation. SOUTHOLD TOWN BUILDING DEPT. · AN INSPECTION REGARDING THE ABOVE BUILDING PERMIT WAS SCHEDULED FOR APRIL 15, 1998. THE INSI~ECTOR HAD ~O ACCESS. PLEASE CALL TO SET UP ANOTHER APPOINTMENT SO THAT WE MAY CLEAR UP YOUR OPEN BUILDING PERMITS & ISSUE THE CERTIFICATE OF OCCUPANCIES. Town Hall, 53095 Main Road P. O, Box 1179 Southo~d, New¥~3~k 11971 Fax (516) 765-1823 Telephone (516) 765-1802 OFFICE OF THE BUILDING INSPECTOR TOWN OF SOUTHOLD March 24, 1995 Mr. Joseph Krukowski Main Road Southold, NY 11971 To Whom This May Concern: We are unable to complete your Certificate of Occupancy because of the following reasons: An application for Certificate of Occupancy is not on file. (Enclosed) No Underwriters Certificate on file. The check is (outdated/not on file.)$25.00 No Health Department Approval on file. xx No final inspection has been made. No Plumber Solder Certificate on file. (All permits involving plumbing being issued after April 1, 1984). BUILDING PERMIT # 12813-Z Please contact our office on this matter. cooperation. Thank you for SOUTHOLD TOWN BUILDING DEPT. · FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N.Y. 11971 TEL.: 765-1802 tx. Examined .'~..~..c.o.~....~...~.~.., 19 ~ .'~. c ).~.. ~..~. ~'~ , 19~..~. Permit No. ).~..'8./..-~... Approved .... Disapproved a/c ..................................... (Building Inspector) APPLICATION FOR BUILDING PERMIT Date /..%..-7../..~... ' 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 scaie. Fee according to schedule. b. Plot plan showing location of lot and of buildings on premises, relationship to adjoining premises or pqblic 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. ~uch permit shall be kept on the premises availible 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 HEREBYMADE to the Building Department for the issuance of a Building Permit pursuant to the Building Zone Ordinance of the '['own 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~s. /J /9 ~ ~4 /'; /i~i'g~ai~r'e'of ~pplicant, or name, ifa corporation) (Mailing address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber br builder. (as on the tax roll or latesD~Lq~) 'xj,i]7:~ B.P. ~ I If applicant is a corporation, signature of duly authorized officer. FEE: ] 0, ~ BY: .~/. ~,'~ .~ · NOT~ '6,7fLBING DEPAR -MENT AT .............................................. ,765-1807 9 /sM TO 4 Pb FOR THF (Name and title of corporate officer) FOLL(3,,VHx~G !h'FDECTION ' 1. FF)tJb!m~Tlr')h'l - TWO. 'REQUIRED Builder's License No ..... ~ For, ~-, ~r~ CONCRE FE 2. Rc~t~C~ - FPAM!N~ o >I.UMBING Plumber's License No ......................... 3 Ib'cl J! ~ ........ t '~"N MUST Electrician's License No. ~ BF ~' ........ ~ '~2 Other Trade's License No ...................... T~r - ."~-S c,F THE N.Y. 1. Location of land on which proposed work will be done tg(1 o~ [ ~' /~-c) CO? ~c "'T RESPONISIBLE House Number Street Hamlet Subdivision ..................................... Filed Map No ............... Lot ....... i ....... (Name) 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: ' a. Existing use and occupancy . - - -r32~' .%.~. ~ ................................................ i ........ 3. Nature of work (check which applicable): New Building .......... Addition .......... Alteration .... i .: r.. Repair .............. Removal .............. Demolition .............. Other Work .'~.. o..~.q .~49..~.... ~t~ (Description) 4. Estimated Cost ..... .~.. ,3 ~ ........................ Fee / O, ~-~ (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 .... .-3,. .................................................................. 6. If business, commercial or mixed occupancy, specify nature and extent of each type of use ..................... 7. Dimensions of existing structures, if any: Front .... .t'/ ......... 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 ......... , ..... Rear ............... Depth ............... Height ............... Number of Stories ........................................................ Size of lot: Front ...................... Rear ...................... Dt e~pth ...................... Date of Purchase ............................. Name of Former Owner .~. ,.. ~X/.;,~. ::.,-:6 .............. Zone or use district in which premises are situated ..................................................... Does proposed construction violate any zoning law, ordinance or regulation: ................................ Will lot be regraded ............................ Will excess fill be removed from premises: Yes No Name of Owner of premises .......... .......... Address ................... Phone No ................ Name of Architect ............... ~ ............ Address ................... Phone No ................ Name of Contractor ............... ~-. ......... Address ................... Phone No ................ 10. 11. 12. 13. 14. PLOT DIAGRAM Locate clearly and distinctly all buildings, whether existing or proposed, and. indicate all set-back dimensions from property lines. Give street and block number or description according to deed, and show street names and indicate whether interior or corner lot. 1'7 7~7t- STATE OF NEW Y, ORK_,, ./. / ~ S S t~-3 'q5 COUNTY O~ ' ................................................. being duly sworn, deposes and says that he is the applicant (Name of individual signing 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 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 ......... ..... dayof ..... . No..62 _03,~l.963 Suffolk County~/ // ,/ (Signature of applicant) ~mn~ek~ BY~kei MM~h ~0, tS ~? ~