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Home My WebLink About12916-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hail Southold, N.Y. Certificate Of Occupancy No. Z-16277 Date October 9, 1987 THIS CERTIFIES that the building ONE FAMILY DWELLING WITH ATTAHCED GARAGE · ' '~;' ~/b'dfi ' ~'d~ ................................ LocationofProperty 1055 Bay Home Road Southold, New York House IVo. $~ree! Hamlet County Tax Map No. ] 000 Section 05 6 .Block 5 ...Lot 3 5 Subdivision ............................... Filed Map No ......... Lot No .............. conforms substantially to the Application for Building Permit heretofore filed in this office dated February 27, 1984 pursuant to which Building Permit No. 12916Z dated Ma r c h 6, 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 ......... ONE FAMILY DWELLING WITH ATTACHED GARAGE & WOOD DECK The certificate is issued to EDWARD & MARIA NACINOVICtt ..................... ?o¥.'o'r, ~,'lr~:~t~ ..................... of the aforesaid building. Suffolk County Department of Health Approval ... 14 - S O- 37 UNDERWRITERS CERTIFICATE NO .... iq 803956 PLUMBERS CERTIFICATION DATED: January 2, I987 Bmldlng Inspector Rev. 1/81 FOE~ NO. I~ TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N. Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) 12916 Z Permission is hereby granted to: ] ..~:~......!~.~.;.~.~ ........... L ~'." '~ '~/~ .../,~...~ ........ ./...u...~ ....... ~ ................. .~.~~.,...~., .~,.. ~ ~..~ ~ - ' ~,~ I ..... ; ..... ~' ................. ~', ~ ~ ~ ~ ~ .~..~.~ ........ ~ ....... ,o.. c~ ........................................ :~ ........ ~ ............... :~ ..................... ,, ,,..,~, ,~.,ed., ....L..~::....~..~ .................................................................... County Tax Map No. lO00 Section ...... ,C~)...~,,,~.. ..... Bilk ........~---~, ......... Lot No ......~,.,~,.-~, ......... pursuant to application dated ...~.~...~.~ .............. , 19.~...~.., and approved by the Building Inspector, Building Inspector Rev. 6/30/80 FORM NO. $ TOWN OF $OUTHOLD Building Department Town Hall 8outhold. N.Y. 111)71 765- 1802 APPLICATION FOR CERTIFICATE OF OCCUP/ Instructions A. This application must be filled in typewriter OR Ink, and sub~nitted ~ ~ to the Building Inspec- tor with the following; for new buildings or new usa: 1. Final survey of property with accurate location of all buildings, property lines, streets, and unumal natural or topographic features. 2. Final approval of Heatth Dept. of water suppty and sewerage disposal-iS-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 Coda compliance from tho Architect or Engineer 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: 1. Accurate survey of p~perty showing all property lines, streets, buildings and unusual natural or topographic features. 2. Sworn statement of owner or previous owner as to use, occupancv 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. Certificata of occupancy Neu Dwelt~.ng.$25,00, Acce~.~ory ,$10,00 Bu~.ne.~:~ $50.00 2 Certificate of ~ccupancy on pre-existing dwelling $ 50.00 3. Copy of certiflcate of occupancy $ 5.'00, over 5 year~ ~10.00 5.~gdated ¢.0. $ 50.00 Date ........................ 6, hleeratzon $25,00 NewCons %yuc~on ...... Old or Pre-existing Building ............ Vacant Land ....... ~,.~.. LOCBBOn gl vropcfJy ........... .... .... ../* ....... .,..-,,.. ......................... Owner or Owner~ of Property .............. ;' ...................... County Tax Map No. 1000 Section ........................ Lot ............ ' ' ' Filed Map No Lot No Subdw~sion .......................................................... .... .mu ,,,..n, /- Health Dept, Approval ........................ Labor Dept. Approval ........................ Underwriters Approval ........................ Planning Board Approval ...................... Request for Temporarv Certificate ..................... Final Certificate. ...................... Fee Submitt0d $ ............................. Construction on above described building and perml~meats all applicabJ¢ codes ar~ regulations. Applicant ............................. "I' ................... Ilar. 10'10'78 ZOOlO?~ THE NEW YORK BOARD OF FIRE UNDERWRITERS BUREAU OF ELECTRICITY _r~ ~ ~, ~? ~ ~o.. ~T.EET..~W ¥0"", "~W~e~'~~,,~ THIS ~ERTIFIE$ THAT ~y the electrical equipment, ~ ~cribed b.~ ~nd introduced by t~ applicant ~med on the a~e application number i. the premises of ~s examined on and found to be itt compli6nce .'ith the ~equirements of this Board. SWITCHES FIXTURES RANGES OVENS EXHAUST FANS SYSTEMS NO. OF FEET 1 ~oke Det~-~tor Motors: 1-1hp~ 1-3/4bp E R OF CC, CONO 2/0 ' C E 2/0 S ~lectric 215 Sou~/~)ld, N.Y. 11971 L/~ %578E This certificate must 0at be ahered in any manner; return to the oftice of the Board if )ncorrect. Inspectors may be identified by their FOR BUILDING DEPARTMENT. THiS COPY of CERTIFI~,TE~,ML~ST NOT'BE ANY MANNER, HENRY J. SMITH & SON, MAIN ROAD SOUTHOLD, N.Y. 11971 (516) 765--3690 lDO. CERTIFICATION D a t e Building Permit No._12~l~~ ....... Owner Edward NacinovichL_~d Plumber Hen~ J. Smith & Sonz_~[~ I system certify that the solder used in the water supply contains less than 2/10 of 1% lead. Sworn to before me this ~nd__day of _~mnma~_--, 19_22_. Notary Public, ~Suffolk County NO'IARY PUBLIC, S?te o~ New YO~& ] Residing In Su,lo~k County 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. /~ate of Occupancy /--/ No Underwriters Certificate on file. /-~ No Health Dept. Approval on file. /~/ No final inspection has been made. Please contact our office on this matter. Thank you for your cooperation. Bu, i lding Dept. ~ issued/fter April ~,1984 ) ~ Please be advised that another building permit is re- quireS for the Greenhouse Addition which you added to the house, since the issuance of the a.bove building permit. You are in violation of southold town code. Please correct this at your earliest convenience. TOWN OF $OUTHOLD OFFICE OF BUILDING INSPECTOR P.O. BOX 728 TOWN ItALL $OUTHOLD, N.Y. 11971 TEL. 765-1802 This is to advise you that the job under building permit no, 12916Z issued to Edward Nacinovich on ~_~.6_/~4 for New Dwelling i'~ eo'~pleted and a final xnspection []as ( ) has not ('x ) been done. An Underwriters Certificate is needed [n order to complete th~s file, it is necessary that a CcrCiflcatc of Occupancy be issued. Please fill out the enclosed form~ return same ~o the above office with a check for $25.00 payable to ~he Town of Southold. Please indicate to Whom the Certificate of Occupancy is to be mailed, and arrange with this office for an inspectlo~ (late Occupancy or tine la unlawfsl wlthout a Certificate of Oecupnncy. Please help ti. to clear lip th~a matter .o that legnl action does not have to be Laken, Thank you for yot~r prompt attention. Very truly y~, Victor Lessard Executive Administrator VL:gar eno 1 . FIELD INSPECTION FOUNDATION FOUNDATION ROUGH FRAME & PLUMBING INSULATION PER N. STATE ENERGY C,ODE (1st) (2nd) 765-1802 BUILDING DEPT. INSPECTION FOUNDATION 1ST [ ] ROUGH PLBG. FOUNDATION 2ND [ ] INSULATION [ ] FRAMING [~NAL BUILDIN~ DEPT. INSPECTION FOUNDATION 1ST [ ] ROUO# pLBQ." FOUNDATION 2ND [ ] INSULATION Examined ..~..~..~ .4 .... , 19~ .~. Approved...~....0.~..~...~.. FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N,Y, 11971 TEL,: 765-1803 ., 19~.~. Permit No.). .~.CJ ].~...-~.. Received ........... ,19... Disapproved a/c ..................................... (Building Inspector) APPLICATION FOR BUILDING PERMIT Fe, 7 Date ..... .~.. ~. ...... , 19 ~.L/ 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 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 cbmmenced 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 code, housing code, and regulations, and to admit auth°rized inspect°rs °n premises and in building f°r necessary i~'..< .,z~'e../.' .~..~...~...~.&t../Z (Signature of applicant, or name¢ if a corporation) 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) Builder's License No .......................... ' Plumber's License No .... ~.' .~,./~.~../.~...67. ....... Electrician's License No. Y~°~lr~) ?fi)~ Other Trade's License No ...................... 1. Location of land on which proposed work will be done ................................ .................. House Number Street Hamlet County Tax Map No. 1000 Section ........ .oQ.~.. ...... 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 / :~ X*d~< '"" ' '' 3. Nature of work (check which a~plicable): New Building . ~ ....... Addition .......... Alteration .......... Repair .............. RemOval .............. Demolition .............. Other Work ............... 4'. Estimated Cost ..... i Fee ; (to be paid on filing this applica~9.~)° , /. g. 5. If dwelling, number of dwellinglunits ...... umber of wellin units on each floor . .. If garage, number of cars .... ~ ........................................... 6. If bus~ness, commercml or mixeld 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. ])ate 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 ........................... Will excess fill be removed from premises: Yes No 14. Name of Owner of premises ................... Address ................... Phone No ................ Name of Architect .......................... Address ................... Phone No ................ Name of Contractor ......................... Address ................... Phone No ................ PLOT DIAGRAM Locate clearly and distinctly alt buildings, whether existing or proposed, and, indicate all set-back dimensions from property lines. Give street and blocklnumber or description according to deed, and show street names and indicate whether interior or corner lot. ~ STATE OF NF~OR._~.~7 /~, . COUNTY OF-~ .~:,/./. ?./../\.. ,S.S ............ ~'-.cx/.?d.q-~r-~.. ,. .~. C-~/W.g~.~,'{~.. being duly sworn, deposes and says that he is the applicant (Name of individual sig~'ing 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 conthined 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 . .....c~...~../. .......... day o~..~ ~. ....... ~( ..... 19.~. County NOTARY I)UIILIC, ~t_~ of New Yod~ Term ExplJ'e~ M?h $0. 15~--' bJ ~ Z h ~oz ~ Z~ ~