HomeMy WebLinkAbout10138-zFORM NO. 4
TOWN OF 5OUTHOLD
BUILDING DEPARTMENT
Office of the Building Inspector
Town Hall
Southold, N.Y.
Certificate Of Occupancy
Z10719
Date ....... O¢~.h~.5 ................ 1~.1..
THIS CERTIFIES that the, building ................................................
3540 Manhasset Avenue
Location of Property fid~s'e ~q'd .56.5- .Inle.t..Lan.a r ....... Gr.e. enpoJ~.t, ~. N.o.'4. Y9.r.k .......
Street Hamlet
County Tax Map No. 1000 Section 043 .Block 04 . .Lot 034
Subdivision ........................ ! ....... Filed Map No ...... :..Lot No ..............
conforms substantially to the Application for Building Permit heretofore filed in this office dated
..... Marc.b, .22 ....... , 19.7.9 pursuant to which Building Permit No ..... .1.0.1.3..8..Z. ........
dated .M..a?.qh...2.2 .................. 19 ?.9. , was issued, and conforms to all of the requirements
of tl~e applicable provisions of the law. The occupancy for which this certificate is issued is .........
Inground Swimming Pool and Fence
Tile certificate is issued to .... .N.q~l...a.n.d.. ¥.i.qgi..n.i.a..I:,..u}~o?..~.k.i .......................
( o w n e r ,y[~ ~l~r~ ~t~ X X
of tile aforesaid building.
Suffolk County Department of Health Approval N/R
UNDERWRITEICS CERTIFICATE NO ...... ~.4.3. 8, .~ .3.7. ...................................
Building Inspector
Rev. 1/81
FO]~I NO. ~
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN CLERK'S OFFICE
SOUTHOLD, N. ¥.
BUILDING PERMIT
(THIS PERMIT MUST BE KEPT ON THE PP. EMISES UNTIL FULL
COMPLETION OF THE WORK AUTHORIZED)
N? 10138 Z
pursu(mt to ~ppl]cotion d~ed ...................... ' .................................. , ]9_~.., ~nd opproved by the
Building Inspector.
,Fee $..../..~ .............
/coo
Building Inspector
. TOWN OF SOUTEIOLD
OFFICE OF BUILDING INSPECTOR
TOWN HALL
SOUTHOLD, N. Y, 11971
TEL. 76.5-1802
August 1, 1980
Orient Truck & Construction Co.
Orient, New York 119~7
Dear Sir:
This is to notify you that Building Permit No.
issued March. 22, 1979 to Noel Lutkowski
will expire on .... Sept~-m~er'" 22, 19U0 ......
10138Z
If more time is required to complete the
Certificate of Occupancy, you may apply,
six (6) month extension.
job and obtain a
kY lette~, for a
If the work is not complebed and the Certificate of Occupanby
not issued after the six (6) month extension period, you are
than required to apply for a new building permit.
Very truly yours,
GEORGE H. FISHER
Sr. Building Inspector
BCOMMONWEALTH LAND
TITLE INSURANCE COMPANY
P,O. BOX 419, 209 W. MAIN STREET, RIVERHEAD, NEW YORK 11901
WESTERN SUFFOLK 51~31-B666 EAS*fERN SUFFOLK' 516727-7760
October 2, 1981
JOSEPH C INTRAVAIA
Branch Manage~
KAZIMIERZ LOJKO
~O~q OF SOUTHOLD
BUILDING DEPARTMENT
Re: Title No.
Premises:
R-947 156-S
158 Inlet Lane, Greenport
Built Approx:
Orig. Owner:
Present Owner:
1973
NOEL & VIRGINIA LUTKOWSKI
same
Gentlemen:
We have enclosed a check in the amount of $ 5.00 for
Certification as to whether a Certificate of Occupancy and/or
Building Permit is available for the above captioned premises.
If so, the date ~hereof and limitations of occupancy.
Very truly yours,
COMMONWEALTH LAND TITLE
INSURANCE COMPANY
KAZlMIERZ LOJKO
Assistant Branch Manager
KL=rl
encls.
PLEASE SEND C/O for the swimming pool
District
1000
Section 043.00 Block 04.00
Lo%34. 000
TITLE INSURANCE SINC~ 1876
THE
THIS GERTIFIES THAT
NEW YORK BOARD:' OF FIRE UNDERWRITERS
BUREAU OF ELECYRICITY
85 JOHN STREET, NEW YORK, NEW YORK 10038
only the electrical equipment as described belo~ and introduced by the applicant named on the abo~e application number i~ the premises
Noel J. LuTkowskl. inlet Lane, c/o HanhasseT, Greenport, L.I.
in the follotvlng location; [] Basement [] 1st FI. [] 2nd FI. Section Block Lot
was examined on J U n · [ 4 ~ ~ 9 7 ~ and found to be in compliance o~ith the requirements of this Board.
FIXTURE
OUTLETS
IECEPTACLES SWITCHES
fiXTURES RANGES :~OOKING DECKS OVENS DISH WASHERS EXHAUST FANS
DRYERS 'FURNACE MOTORS FUTURE AI~UANCE FEEDERS TIMECLOCKS UNITHEATERS MULTI-OUTLET
SYSTEMS
DIMMERS
SERVICJ DISCONNECT S E R V I C
OTHER APPARATUS:
(Swimming Pool) This certificate covers compliance at the date of
Inspection only. Because of unusual environments it Is advisable
To have frequent test and/or repairs made by a qualified 9erson.
G&S Contract I n9
SouThold, N.Y.
1197I ; !c.578 E
~This certificate must not be altered in any manner; return to the office of the Board if incorrect. Inspectors may be
their credentials.
COPY FOR BUILDING DEPARTMENT. THIS COPy OF CERTIFICATE MUST NOT BE ALTERED IN ANY MANNER.
FORM NO. 1
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN HALL
SOUTHOLD, N.Y. 11971
TEL.: 765-1802
Disapproved a/c ..... ....................
................................
(Building Inspector)
APPLICATION FOR BUILDING PERMIT
ate .....
INSTRUCTIONS
a. This application must be completely filled in by typewriter or in ink and submitted in triplicate 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 issue 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 buildings for necessary i~spections.
~'~ ~::~- ~/~o~.~_ .~, (Signature of applicant, or name, ifa corporation)
,~~x "~° ~5. (Mailing address of applicant)
State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder.
(as on the tax roll or latest deed)
If applicant is a corporation, signature of duly authorized officer.
(Name and titlg'of corporate o~tficer)
Builder's License No ....... ~..y. ............
Plumber's License No ............ ~..~..~.~... ~ ,
Electrician's License No ........ ~..~.~-
Other Trade s L~cense No ...................... ~ ¢) t.[ 0j
1. Location of land on which proposed work w~ill be done .... .~... · ·
House Number '"~' .~q'g-~ Street Hamlet
County Tax Map No. 1000 Section ....... .~. 5. ..... 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 ...... . .~....~....~~..~~ ................
b. Intended use and occupancy ............ ~ .....................................
3. Nature of work (check which applicable): New . Addition .......... Alte,~ . ~~
Repair .............. Removal .............. Demolition .............. Other Wor~,~r~..
. .,~... ~ ./,ff~. (Description)
4. Estimated Cost . . ~. ~tl~.,. ~. .............. Fee ........ ~ .......................
(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 ...................................................... i.... ..............
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 ...~Nr~ ........
Height .... ~..l~. ..... Number of Stories ...... ./..~.,~ ............................................
Dimensions of same structure with alterations or additions: Front . ..~ff~. ~..~.. :~... Rear ..................
Depth ...................... Heig~at ...................... Number of Stories ......................
8. Dimensions of entire new construction: Front .. ~-~'r~.,~kL .~. Rear ............... Depth ...............
Height ............... Number of Stories ................ ? .................................. ) ....
9. Sizeoflot: Front~/~.~..( ~.. ~ /, Rear ~. ~':.~?~.' De th /~.~,
..... ........... ......... p ..............
10. Date of Purchase ............................. Name of Former Owner .............................
11. Zone or use district in which premises are situated .... ~...~... ~.. ....................................
12. Does proposed construction violate any zoning law, ordinance or regulatinn: ....... .~.~' ....................
13. Will lot be regraded ...... ~ ~, ...... ~..,.. Will excess fill be removed from premises: Yes ~
14. Name of Owner of premises ~. ~ Address t~t~--~. · ~'~-~ · Phone No. ~.~. ,>..~. ~. ~..~. ~'
Name of Architect ...m.~. ~-~,.~,~r-'-r-. '~. : · ... ~ · ·. Address ................... Phone No ................
· .~Phone~ ·
Name of Contractor ~~ ~-,~. do Address . ~~.~. No. ~,2 .y..~.~.~'.~
PLOT DIAGRAM
Locate clearly and distinctly all buildings, whether existing or proposed, an& 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.
STATI~QF NLe'q/ ~ ~ S
COU~~.~T ...... ' - ~
............ being duly sworn, deposes and says that he ~s the apphcant~
/
(Name
of
in dividual~gni/}g
contract)
above named. '"-w--, -~-~.k ~, J
He is the ..... ~Q~(~.~....................~;.:':-. .....................................................
(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
.day
Notar~
County
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