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HomeMy WebLinkAbout11520-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No. Z18615 Date DECEMBER 5~ 1989 THIS CERTIFIES that the buildinq Location of Propert~ 1015 OLD NORTH ROAD House No. County Tax Map No. 1000 Section 054 Subdivision ACCESSORY 80UTHOLD Street Hamlet Block 03 Lot 24.3 Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated NOV. 16, 1981 pursuant to which Building Permit No. 11520Z dated DEC. 18~ 1981 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 ACCESSORY STORAGE BUILDING. The certificate is issued to ALE~-ANDER STEPNOSKI (owner, of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL UNDERWRITERS CERTIFICATE NO. N/A PLUMBERS CERTIFICATION DATED N/A -~~ ulldlng Inspector Rev. 1/81 . TOWN OF SD~ HGL~ T TOWN HALL SOUTH'OLD, N', Y. BUILDING p£RMiT~ (THIS PERMIT MU~T BE KEPT ON THE PP, E/VtlSES COMPLETION OF THE WORK AUTHORIZED) UNTIL FULL Bqild,' lng I~spector. Fee $..~'..'~ ............... .-, ~ Build!ng}lnSPecto? Per~issio~ ~s here~ granted to: at pEemise~ located at .............. Cou~W Ta~ Ma~ No 1000 Section .... Block ~ ........ ~Lgt No, APPLICATION TOWN OF $OUT~OLD BUILDING DEFART~IENT TOUN HALL SOUTHOLD, NEW YORK 765 - 1802 11971 FOR CERTIFICATE OF OCCUPANCY NEW CONSTRUCTiONXF~ ..... OLn oR PRE-EXISTING BUILDING ...... VACANT LAND ........ Location of Property ...... ]9~ OLD Sq~T~ HOUSE NO. STREET HAMLET ALEXANDER STEPNOSKI Owner or Owners of Property ........... County Tax Hap No. 1000 Section ...... Block ....... Lot' . ........ Subdivision ....................... Filed Map ........ Lot .......... Permi~ No ........... Date of Permit .......... Applicant ................... Health Dept. Approval .................. Underwriters Approval .............. Planning Board Approval ................ Request for Temporary Certificate ....... Final Certificate ................ Fee Submitted: $ .................... rev. 10/14/88 Be De FORHNO. 6 TOWN OF SODTIIOLD BUILDING DEPARTHENT TOWN ~ALI. 765 - 1802 APPLICATION FOR ~CERTIFICATE OF OCCUPANCY INSTRUCTIONS This application must ble filed in typewriter OR ink and submitted Co the Building Inspector with the foil!owing; for new buildings or new use: I. Final survey of proplerty with accurate location of all buildings, property lines, streets, and unusual, natural or topographic features. 2. Final approval of He!alth Dept. of water supply amd sewerage-disposal(S-9 form). 3. Approval of electrical iustallation from Board of Fire Underwriters. 4. Sworn atatement from plumber certifying that solder used in system contains less' than 2]10 of 11 lead. 5. Commercial buildings, industrial buildings, multiple residences and similar · build,rigs and Installations, a certmficate of code compliance from the Architect or Engineer responsible for the building. 6. Submit Planning Boar'd Approval of completed site plan requirements. Forlexisting buildings l(Prlor to April 9, 1957~ non-couforming uses, or buildings andl"pre-existing" land uses: I. Accurate survey of ~roperty showing all property lines, streets, buildings and unusual natural or ~opographic features. 2. A properly complet~d application, a consent to inspect signed by the applicant and a certified abstract of title issued by a title company which shall show single and separate ownership of the entire lot prior to April 9, · If a Certificate of.!Oceupancy is denied, the Building Inspector shall state the reasons therefor iniwriting to the applicant. 3. Date of any housing!code or safety inspection of buildings or premises, or other pertinent informati6n required to prepare a certificate. ForiVacant Land Certificate of Occupancy: I. An application for vacant laud Certificate of Occupancy shall be submitted. and a certified abstract of title issued by a title company showing single and separate ownership Of the entire l~t prior to April 9, 1957 shall also accompany the application. If a Certificate of Occupancy is denied, the Building Inspector shall state the reasons therefor in writing to the applicant. FEES: i~. CgRTIFICATE OF OCCUPANCY - New Dwelling $25.00, Additions to Dwelling $25.00, Alteration to Dwelling $25.00, Swimming Pool, $25.00. Accessory building $25.00 Addition to Accessory buildings, $25.00 - Businesses $50.00. 2. Certificate of Occupancy on pre-existing dwelling - $100.00. 3. Copy of Certificate of Occupancy - $5;00 - over 5 years - $~0.00 4. Vacant Land Certificate of Occupancy - $20.00 5. Updated CertifiCate of Occupancy - $50.00 6. Temporary Certilficate of Occupancy - $15.0,0 Residential Commercial ,er, 10/14/88 FIE~D IN~FECTION FOUNDATION (1st) FOUNDATION (2nd) 2. ROUGH FRAME & PLUMBING INSULATION PER N. STATE ENERGY QODE FINAL ADDITIONAL COMMENTS: Approved'~..~C .... /~. ~.. FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, H,Y. 11971 TEL.: 765-1~02 Disapproved a/c ....... (Building Inspector) ' -i APPLICATION FOR BUILDING P~RMIT Date.././ .... ',9 INSTRUCTIONS a. This application must be completely filled in by typewriter or in ink and subm'itted in triplicate to the Build Inspector, w~tl: 3 sets of plans, accurate plot plan to scaIe. Fee according to schedule. b. Plot l'lan showing location of lot and of buildings on premises, relationship to adjoining premises or pnblic stre or areas, and giving a detailed description of layout of property must be drawn on the diagram which is part of this ap' cation. c. The work covered by this application may not be commenced before issuance of Building Permit. d. Upon apprc'.'aI of this application, the Building Inspector will issue a Building Permit to the applicant. Such pen 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 Occupar shall have been granted by the Building Inspector. APPLICATION IS ItEREBY M^DE to the Building Department for the issuance ora Building Permit pursuant to Building Zone Ordinance of the Town bf Southold, Suffolk County, New York, and other applicable Laws, Ordinances Regulations, for the construction of buildings, additions or alterations, or for removal or demolition, as herein describ The applicant agrees to comply with all applicabIe laws, ordinances, building code, housing code, and regulations, and admit authorized inspectors on premises and in buildings for nece.s, sary inspections. (Signature of applicant, of name, if a corporation) .. ~.,~¢.. d,/~/~. ?'~... ,P. ~,,,. ~ ._.,7. ~. ~..7'~.~ (Mailing address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or bnild ... ~ .la'.~..£~...~. Z~.,,,/. ~¢.q ............................................................... Name of owner of pr~m~sc~..,4'./-, ~' ..... .~ Z~,,e.,r,:.~. :;../t"..~ .......................................... (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 .... .~.~ .................. Plumber's License Nv ......................... Electrician's License No.-"'..ff.~.--7'(.-..~...'.-~...' ........ Other Trade's License No ...................... 1. Location of land on which proposed work will be done ......... - .....[.~..' ......... .... ~ - House Number Street Hamlet 0 ~.3 ~- ~ ~ ~_ /'R <" /( ............... /' County Tax Map No. ~000 aectio~...,,-:.9...~': ....... BlockK.. ~? Lot~..~ ¢~. [-.~ .~... Subdivision .... ~ Filed Map No Lot ~ (Name) 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: Repair Rc~i~oval Demo" 'ion Other Work ' (Description) : , (to be paid on filing this application) 1. If dwelling, number of dwellinlg units ............... Number of dwelling units on each floor ............... If garage, number of cars ... Z...~, .~'.~/.~. · .~.~'.~' ............................................... i. If business, commercial or mixed occupancy, specify ~ature and extent of each type of use ..................... t. Dimansions of existing structu, res, if any: Front .......... , ..... Rear .............. Depth ............. Height ............... Nt ~ber of Storms ...................................................... Dimensions of same structure ivitb alterations or additions: Front ................. Rear ................ Depti~ ' Height Number of Stories ~ Dimensions of entire new construction: Front ,/.~.~ ' Rear 16.~. ..... Depth t.~t~. ....... Height .'~ Ntimber of Stories ! ) Size orlot: Front ! ' · Rear Depth ). Date 6fPurchase ......... ' .................... Name of Fenner Owner ........................... Zone' or use district in which pxemises are situated ' ). Does proposed construction violate any zoning law, ordiaance or regulation: .,,'f/.~ .................. I. Will lot be regraded .... .~.J~ $. ,' .................. 'Will excess fill be removed from premises: Yes Nc L NameofOv.'nerofpremises .& ...... /.Address ~(--O.d/o ...... PhoneNo. 1..~ ..... Name of Architect i. . Address So,~'tt,,/.l Phone No. Name of Contractor ....... g/. ......... t~ ....... Address ..... ,,~ ............ Phone No.. t~,.. ?. ...... PLOT DIAGRAM Locate clearly and distinctly all buildings, whether existing or proposed, and. indicate all set-back dimensmns frorc roperty lh~es. Give street and block number or description according to deed, and show street names and indicate whethe: :terior or corner lot. ~ rATE OF NEW YORK. . s.s ' ·. ..... .............. (Nanie of indMdual" si~ning contract) rove .nam.ed. ... being duly sworn, deposes and says that he is the applican is the ' (Contractor, agent, corporate officer, etc.) f said owner or owners, and is dhly authorized to perform or have performed the said work and to make and file thL )plication; that all statements cofitained in this application are tree to the best of his knowledge and belief; and that th 'ork will be performed in the manfler set forth h~ the application filed therewith. worn to before me thist ........... .... .... Lm~A~ ,.~. . . _~ / . :., No, 5.~.,,-,,, -,~~: ....... , , ~, Qelttl~in$ut~olk~, ' '