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Home My WebLink About13652-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEP~R~7~ENT office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No Z-17672 Date JANUARY 12, 1989 THIS CERTIFIES that the building. Location of Property 38705 MAIN ROAD House No. County Tax Map No. 1000 Section 085 Subdivision ALTERATION PECONIC~ NEW YORK Street Hamlet Block 02 Lot 018 Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore flied in this office dated DECEMBER 19, I984 pursuant to which Building Permit No. 13652-Z dated DECEMBER 27~ 1984 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 ALTERATION TO EXISTING AGRICULTURAL BUIILDING TO OFFICE SPACE The certificate is issued to (owner) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL UNDERWRITERS CERTIFICATE NO. PLUMBERS CERTIFICATION DATED Rev. 1/81 FRANK CICHANOWICZ III N-849106 - JA~R3ARY 7t 1988 lVO~ NO. :B TOWN OF $OUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N. Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL PULL COMPLETION OF THE WORK AUTHORIZED) NB 13652 Z Permission is hereby granted to: ..... ~......~..~.~_~.~.~Z/~ ~ ........ ...................................... ...................... ~ ..~ ..~ .............. ~: ..~ ,o..~..~r~...~~~.~/~~..~.~~ ......... ....... ~......~.~......~~ .......... ~ ................................ ,.~ ............................ Z.. ......... at premises I.ated at .............. ~~ ....... .~ .......................... .~ ............................. Map No. ~ooo s..on ..... ~Z~.--...... B~o~k e,'Z--- Lot No. ~,'f.~. Building Inspector. Rev. 6130/80 FORM NO. 6 TOWN OF $OUTHOLD Building Department Town Hall Southold, N.Y. 11971 765- 1802 APPLICATION FOR CERTIFICATE OF OCCUPANCY Instructions This application must be filled in typewriter OR ink, and submitted m ~ to the Building Inspec- tor with the following; for new buildings or new use: 1. Final survey of property with accurate location of alt 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. For existing buildings (prior to April 1957), Non-conforming uses, or buildings and "pre-existing" land uses: 1. Accurate survey of p~"operty showing all property lines, streets, buildings 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: 1. Certificate of occupancy $25.00 -- BUSINESS $50.00 2. Certificate of occupancy on pre-existing dwelling $ 50.00 3. Copy of certificate of occupancy $ 5.'00, over 5 years $10.00 4.Vacant Land C.O. $ 20.00 5.Updated C.O. $ 50.00 Date .......................... NewConstruction ...... or Pre-existing Building ............ Vacant Land ............. Location of Property ................................ .............. House No. Street Hamlet Owner or Owners of Property .... ~.~1~,~. ....................... County Tax Map No. 1000 Section ...... ?..~. ..... Block ........ /. ...... Lot.../. 7 .......... Subdivision ................................. Filed Map No ........... Lot No .............. PermitNo /.~.¢.'-~Z-. Date of Permit /~/.~./-'/ cant ............... Appli .................................. Health Dept. Approval ........................ Labor Dept. Approval ........................ Underwriters Approval ........................ Planning Board Approval ...................... Request for Temporary Certificate ..................... Final Certificate ....................... Fee Submitted $ ............................. Construction on above described building and permit meets all applicable codes and regulations. Applicant .................................................... Rev. 10-10-78 lO0[~l THE NEW YORK BOARD OF FIRE UNDERWRITERS ~ k~t BUREAU OF ELECTRICITY THI~ 6ERTIFIE¢ THAT o~y t~ electrlc~l e~ulpment ~ ~scrlbed be~w and int~duced by t~ applicant ~med on the a~ve application n~ tuber in th~ premises of Frank Cichanowicz III~ in the following h,cation~ ~ B~se~nt ~ tat FL ~ 2nd FL Section Bilk Lot a~s examined on ~c~aber 2[, 198 ~ andflound to be in compl ance wi~h the require.tents q(thls Board. FIXTURE FIXTURES RANGES OVENS DISH WASHERS EXHAUST FANS 24 24 26 16 8 DRYERS FURNACE MOTORS ! T MECLOCKS* UNIT HEATERS MULTI-OUTLET DIMMERS SYSTEM5 SERVICE DISCONNECT 1-G.F.C,L S E R V I C E 21o Jody Pum:~lo Lane 11952 lic.#2300E This certificate must not.be altered ia any manner; return to the office of the 5oard if COPY FOR THIS GEt~RAL MANAGER be by their credent(a~s. ER. TOWN OF $OUTtlOLD 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 Certifica%e of Occupancy because .of the following reasons. /~/ An application for Certificate of Occupancy is not on file. /~- No Underwriters Certificate on file. The check is(outdated/~~.)~'OO /5/ No Health Dopt. Approval on file. /5/ NO final inspection has been made. Please contact our office on this matter. Thank you for your cooperation. Building Permit ~ ~_ ~ ~ ~ _~ Z Building Dept. ***/5/ No Plumber solder Certificate on file. ( all permits involving plumbing being issued after April 1,1984 ) FIELD IN~PECr£~ION FOUNDATION (1st} FOUNDATION (2nd) 2. ROUGH FRAME & PLUMBING INSULATION PER N. STATE ENERGY q~DE COMMENTS FINAL ADDITIONAL COMMENTS: 'FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL E'OUTHOLD, N.Y. 11971 TEL.: 765-1803 Examined .... .... , Approved .~-.¢r~. ~...<:.'...~. 7. .... , 1 .~.. Permit No../.~.~..~-..27-...~ ReceJ. ved ........... ,19... APPLiCATiON FOR BUILDING PERMIT Date INSTRUCTIONS a. Tins 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 tins appli- cation. c. The work covered by tins 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 c9~, ho/psing code,jtr~d regulations, and to admit auth°rized inspect°rs °n premises and in building f°r necessary inspe~~ ..... ........ (Mailing address of applicant) ~ State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. Name of owner of premises .'~1~. ~.[.~,.. ~'t .~r.~..-~c~dl~,x~?..~. ~ ..... ~.~ ................... (as on the tax roll or latest deed) v If applicant is a corporation, signature of duly authorized officer. (Name and title of corporate officer) ~', Builder's License No ....... ~ .......... Plumber's License No ......................... Electrician's License No ....................... Other Trade's License No ...................... 1. Location of land on which proposed work will be done .................................................. o . .L. ................ House Number Street Hamlet County Tax Map No. 1000 Section ... ~.~.~ ......... Block ... ~..:.. .......... Lot .... I.~. ............ Subdivision ..................................... Filed Map No ............... Lot ............... (Name) State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy . .~..~...Pl~ ...................................................... b. Intended use and occupancy . .--?~. . .~. . . .~. ...... ~. . ~. .I. ."c.~_~. ....... .~. [ ~.~. .~..[.'0.I~. ................... Nature of work (check which appiicable): New Building Estimated Cost ..... ' If dwelling, number of dwelling Uhits. ·. .......... Addition .......... Alteration ....... ......... Demolition .............. Other Work ............... (Description) .......... ...... Fee...................................... (to be paid on filing this application) ........... 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 structuresi 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 ............ i .......... Rear ...................... Depth ...................... 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 regulation: ................................ 13. Will lot be regraded ......... i .................. Will excess fill be removed from premises: Yes No 14. Name of Owner of premises ...; ................ Address ................... Phone No ................ Nmue of Architect .......... ~ ................ Address ................... Phone No ................ Name of Contractor ......... ~ ................ Address ................... Phone No ................ 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 humber or description according to deed, and show street names and indicate whether interior or corner lot. °rn(Name of individual signi~._~dontract) ........ ~.. (,-~J 'a-~. · · · .~.$~5~.~ ............. being duly sw , deposes and says that he is the applicant above named. He is the ............................................................................... (Contractor, agent, corporate officer, etc.) of said owner or owners, and is dul~ 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 manne~ set forth in the application filed therewith. Sworn to before me this ............. ....... day .............. ,,, ~/'~ ~/"~ County , ..... tELEN NOTARY PUBLIC. State of New ¥0rk 'x~ignature of applicant) ,~b. 4~07878, Suflolk feral f!xpl~as I I ,t