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Home My WebLink About12551-z FOR~ NO. 4 TOWN OF sOuTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. Certificate Of Occupancy No. z-15575 Date April 3, 1987 ........ h ........ Construct outside entrance to exi, sting TH'~ CE t~ ~ilrlg~ [a[ [ae pUllO~g ............................................... foundation ce~lar or owe£LL~g. Location of Property 2800 Main Road Laurel, New York House No. Street Ham~t County Tax Map No. 1000 Section 125 .... Block 03 .Lot 006. I Subdivision ............................... Filed Map No ......... Lot No .............. conforms substantially to the Application for Building Permit heretofore filed in this office dated August 15, 1983 12551 Z ........................ pursuant to which Building Permit No ...................... dated Au g u s t 25, I 983 was issued, and conforms to ail of the requirements of the applicable provisions of the law. The occupancy for which this certificate is issued is ......... COHSTRUCT OUTSI'DE ENTRANCE TO EXISTING FOUNDATION CELLAR OF DWELLING. The certificate is issued to MITCHELL M. WILCENSKI ..................... joYn'o;, X ..................... of the aforesaid building. N/A Suffolk County Department of Health Approval .......................................... UNDERWRITERS CERTIFICATE NO ..... N / A N/A PLUMBERS CERTIFICATION DATED: Rev. 1/81 FOB~ NO. :~ TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN I'~ALI. $OUTHOLD, N. Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) 12551 Z Permission is hereby granted to: ........ ././~. .~ ~/. . ~ ~ . . . . ~. . . ~. . ,../. c~i ........ ~...~,~....~.~ ................................ ....... ............................. ~o ............ ~c~z,z.~..,/_d~.c~.......,~..~..~./.~. ~....~,~z~.~.m. ........ ~'...~_z~ ................................................ at prem,ses located at ....~.~. ............. ~'//'~.~.~..~ ....... ~.~'.~'-~: ................ County Tax Map No. 1000 Section ..../~. ~,~]']'. .... Block .....~,..~.. ...... Lot No. (~..~'..~../ ..... pursuant to application dated .... ./~_~?~..~.:..../..~i ......... , 19 ..~....~ and approved by the Building Inspector. Building Inspector Rev. 6/30/80 FORM NO. 6 TOWN OF $OUTHOLD Building Department Town Hall Southold, N.Y. 11971 765- 1802 APPLICATION FOR CERTIFICATE OF OCC[ IP.ANCY .... Instructions A. This application must be filled in typewriter OR ink, and submitted -, ~ 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 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 Engir/i~er 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: I. Accurate survey of p~operty showing all property lines, streets, buildings and unusual natural or topographic featu res. 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 Dwel[ing $25.Q0, Accessory,St0.00 Business $50.00 2. Ce~ificate of~ccupancy on pre-existing dwelling ~ 50.00 3. Copy of certificate of occupancy $ 5.'00, ove~ 5 yea~s ~]0.00 4.Vacant Land C.O. $ 20.00 5.Updated C.O. . $ 50.00 / ~ ~ Date ..~.~.]~ ............ NewC°nst~ucti°n ...... ~r Pre-existing Building ~/[~+:~. Vacant Land ............. Location of Promertv ~00 House No. Stree~ Owner or Owners of Property ~.., ~ ...... County Tax Map No. 1000 Section .......... Block ..... ~ ....... Lot .............. Subdivision ................................. Filed Map No ........... Lot No ........... Permit No ~.~.~/~.. Date of Permit ~ Applicant S .~.~ Health Dept. Approval ....................... Labor Dept. Approval ........................ Underwriters Approval ....................... Planning Board Approval .................... .. Request for Temporary Certificate ..................... Final Certificate .................. Fee Su mmd ................. Construction] on'above described building ~.l[njtjTleet~s al, apPlica.~.~//~7~ons' Rev. 10-10-78 TOWN OF SOUTHOLD OFFICE OF BUILDING INSPECTOR P.O, BOX 728 TOWN HALL SOUTHOLD, N.Y, 11971 TEL~ 765-1802 To Whom This May Concern, We are unable to complete your Certificate of Occupancy because of the following reasons. ( w~An application for Certificate of Occupancy is not on file. ( )No Underwriters Certificate on file. (~'/)The check is (~cut~re..tc~/not on file.)$~,O-d ( )No Health Department Approval on file. ( )No final inspection has been made. .Please contact our office on this matter. Thank you for your cooperation. Building Permit # ~ 5.5. ~ } Z )No Plumber Solder Certificate on file. (all permits involving plumbing being issued after April 1, 1984) TOWN OF SOUTHOLD OFFICE OF BUILDING INSPECTOR P.O. BOX 728 TOWN HALL $OUTHOLD, N,Y. ! 197l TEL. 765.1802 This is co advise you that the job under building permit no. 12551Z issued to M Wilcenski on 8/25/83 for Addition is completed ;, f]'7~'~i'~--~7~-sqp~f~tlon ha~; ( ) has n'o~ ~ X)' been done. and 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 check for $25.00paysble to the Town of Southold. Please indicate to Whom the Certificate of Occupancy is to be mailed, and arrange with tbls office for an iospection date Occupancy or uae is unlawful without a Certificate of Occupancy. Please. help u,s to clear up thio. matter so that legal action does not have to be taken. Thank you for yonr prompt attention. Very trul Victor Lessard Executive Administrator VL:gar encl. FIELD IN,~PECT~ON COMMENTS FOUNDATION (1st) FOUNDATION (2nd) 2. ROUGH FRAME & FLUMBING INSULATION PER N. STATE ENERGY qODE FINAL ADDITIONAL COMMENTS: TOWN OF SOUTHOLD OFFICE OF BUILDI2-,'G ENSPECTOR TOV, .~ HALL SOUTHOLD, N. Y. 11971 TEL.~-~ MEMORANDUM SUBJECT: Building Permi~ Applications Building Permit applications for all new buildings and additions to existing buildings shall include the £ollowing:~ ACCURATE PLOT SURVEY SHOWING: Eb:isting or proposed structure Dimensions of set backs from all boundries SETS OF BUZ_LDiNG PLAINS TO iNCLUDE: ounaa~zon plan Floor plans Elevations Cross Section showing: Foundation Floor joist Ceiling joist Insulation Rafters Ail construction de%ail'ing, shall meet New York State Building Construction Code and conform to New York State Ener~ Conservatio~ Construction Code. DATED: April 6, !979 FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N,Y. 11971 TEL.: 765-180;2 Examined fi~:fi'.. 2~7..., 190~.5~ ./1 t' ....... , 1 .~..Permit Ng.7.57.£-7./.~ Approved/~.~? (~...'~'...~. Disapproved a/c ........ -~ ..... ( ~ .... (Bd [ding Inspector) APPLICATION FOR BUILDING PERMIT Received... 0 . ,19 j~.,~ INSTRUCTIONS a. Tins application must be completely filled in by Wpewriter 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 wi/1 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, anti regulations, and to admit authorized inspectors on premises and in building for neces~ry,4/hspe.ctJgov~// (Signature of applicant, or name, if a corporation) .......... (Ma' i g ad s of app i a ~') State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. Name of owner of premises .......................................................................... (as on the tax roll or latest deed) If applicant is a corporation, signature of duly authorized officer. (Name and title of corporate officer) ~'s License No. Plumber s Lzcense No ......................... Electrician's License No ....................... Other Trade's License No ...................... I. Location ofland on which proposed work will be done ..... i .~....c:~.....~.~.....~ ................. House Number Street Hamlet County Tax Map No. 1000 Section ..... /..~...5. ........ Block '~ Lot .~:/ 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 ...[~ ..................................................... b. Intended use and occupancy &..~... ~.. ~.ff4/. .~..."~'f... 3. Nature of work (check which applicable): New Building .......... Addition .......... Alteration .......... Repair .............. Remloval .............. Demolition .............. Other Work ............... 4. Estimated Cost .......... ~.. e .o. i>. Fee I (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 mix0d occupancy, specify nature and extent of each type of use ..................... 7. Dimensions of existing structures, if any: Front ............... 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 ........................................................ 9. Size of lot: Front .......... ............ Rear ...................... Depth ...................... 10. ~ Date of Purchase ............................. Name of Former Owner ............................. 11. Zone or use district in which p~emises are situated ..................................................... 12., Does proposed construction violate any zoning law, ordinance or regulation: ................................ 13: Wilt lot be regraded ........ i .................... Will excess fill be removed from premises:~.., _ Yes. No 14. Name of Owner of premises .. :,. ................. Address ................... Phone No. a,[~.~...~ .~o~. ?:-.. Name of Architect ......... ; .................. Address ................... Phone No ................ Name of Contractor ........ .................. Address ................... Phone No ................ PLOT DIAGRAM Locate clearly and distinctly al! 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. STATE OF NEW'Y"6~K,. ~' S S COUNTY OF..~>v~Y.r~taOJ,~.. ! : , (Name of individual sig~ing contract) above named· being duly sworn, deposes and says that he is the applicant He is the ........... ~ ............................................................... (Contractor, agent, corporate officer, etc.) of said owner or owners, and is duiy 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 ~n the manner set forth in the application filed therewith. Sworn to before me this