HomeMy WebLinkAbout15631-zFORM NO 4
TOWN OF $OUTHOLD
BUILDING DEPARTMENT
Office of the Bmldln§ Inspector
Town Hall
Southold, N.Y
Certificate Of Occupancy
Z 16905
No
THIS CERTIFIES that the braiding
~ · t 7325
Location otyroperry . .
. House No
County Tax Map No. 1000 Section
Subdivision .S. yl~r e t .E.s.t. ate s
84
May 24, 1988
Date ...........................
one-famzly dwell lng
Bridge Lane Cut chogue
...... 's'rre~t .......... Har. bl
1 6.4
Block ....... Lot .....
6390 4
.Filed Map No .... Lot No .......
conforms substantially to the Application for Building Permit heretofore filed in this office dated
· . .D.e.c. em.b.e.r .2~2, 1986 pursuant to which Building Pemm No 15631Z
dated . J. anu. ar.y ', 1.6, . 1987 .. was issued, and conforms to ail of the reqmrements
of the applicable provisions of the law. Tile occupancy for wluch tins certificate is issued is .....
One.-.~am.~.l.y.d. we.l.l.l.n.g..wir, h a[ta.c, he.d ga. rage: ................
The certificate is issued to .lOltll lg. & ~ P. ZIIRAWSKI
' ' ' ' ' ('o'wner, ~1 .........
of the aforesaid budding.
Suffolk County Department of Health Approval !4-50.-24.... ga.y 1.0, .1.9.88. ......
UNDERWRITERS CERTIFICATE NO, , N848523
PLUMBERS CERTIFICATION DATED:
John E. Walters 4/6/B8
Rev 1/81
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)
N~ 15631'
Z
Permission is hereby granted to:
.~.~.~....~.~.~ .....
...-~-; - ~ -£~. -..~.;.;.-..:,..~ ......
_ ' ..~.....~.~.~_~.:.7......z/.z.s::z,, ~
'" ~" - .'J~L.'LTCb ,, , ,. '. i
.....
pursuant to application d;ted~...~t~-...........~:.....3~.. ....... , 19..~...(~., and approved bt/ the
Budding Inspector.
Building Inspector
Rev. 6/30/80
FORM NO 6
TOWN OF SOUTHOLD
BU ddlng Department
Town Hall
$outhold, N.Y 11971
765- 1802
BLDG DEPT,
TOWN OF SOLrfHOLO
APPLICATION FOR CERTIFICATE OF OCCUPANCY
Instructions
A Th~s apphcat~on must be filled in typewriter OR ink, and submitted .-.~ to the Budding Inspec-
tor with the following, for new buildings or new use
1 F~nal survey of property w,th accurate IocaUon of all buddings, property lines, streets, and unusual
natural or topograph~c featu res
2.Fmal approval of Health Dept of water supply and sewerage d.sposal-(S-9 form or equal)
3Approval of electrical installation from Board of Fire Underwriters.
4 Commercml buddings, Industrial buddings, Multiple Residences and similar buildings and installa-
tions, a certthcate o,f Code comphance from the Architect or Engineer responsible for the budding
5Submit PIanmng Bo~rd approval of completed s~te plan requirements where apphcable
B. For ex,sting bufldmgsl (prior to April 1957), Nomconformmg uses, or buildings and "pre-existing"
land uses
1. Accurate survey of ,property showing all property hnes, streets, buddings and unusual natural or
topographic features
2.Sworn statement of owner or prewous owner as to use, occupancy and condition of buddings.
3. Date of any houmng code or safety mspecUon of buddings or premises, or other pertinent mforma-
t~on required to prepare a certificate
C Fees Additions $25 00 POOLS $25.00
I Certlflcateofoccup~ncy New Dwellzng $25 00, Accessory ,$10 00 Business $50 00
2 Cert~hcate of occupancy on pre-ex~stmg dwelhng $ 50 00
3 Copy of cert~hcate of occupancy $ 5.00, oYer 5 years $10.00
4.Vacant Land C.O. $ 20,00
5.Updated C.O. $ 50 00 Date ....................
NewConstt'uctzon ..... Old or Pre-ex~stmg Building ...... Vacant Land ........
Locat.on of Property '~
House No, Street Hamlet
ounty Ta× 000 eet,on Bloc ............. ..........
Su bd iw s~o n ,/~/~,~
Health Dept Approval ...... Labor Dept. Approval ....................
Underwriters Approval .......
Request for Temporary Certificate
Fee Submitted $ . ,
· . .Planning Board Approval .................
Final Certificate ..... .//~.. ............
Construction on above described budding ~.nd pe/~mlt meets all apphcable codesend regulations
-- ~ppttcant v~
Rev 10 10 78
TOWN OF SOUTHOLD
OI:FICE OF BUILDING INSPECTOR
P O. BOX 728
TOWN IIALL
SOUTtIOLD, N.Y. 11971
December 29, I987
TEL. 765-1802
Mr. John Zurawskz
K~ng Street Box 226
New Suffolk 11956
To Whom This May Concern,
,
We are unable ~o complete your Certmficate
of Occupancy because of the following reasons.
/5/ An application for Certificate of Occupancy
is not on file. ENCLOSED
/~/ HO Underwrzters Certificate on file.
/~/ The check is(~a/not on file.) $25.00
/2/ N6 IIealth Dept. Approval on file.
/~/ No final mnspectmon has been made.
Please contact our office on this matter.
Thank you for your cooperation.
Buzld~ng Permit ~ I ~5- -~ ~- 0-- Z
Buzldmng Dept.
***/~ 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
SOUTHOLD, N.Y. 11971
TEL. 765-1802
CERTIFICATION
Building Permit, No. 15~l~
(please print)
Plumber
(please print)
I certify that the solder used in the water supply system
contains less than 2/10 of 1% lead.
(plumber s signature)
Sworn to before me th~s
19 ~ .
Notary Public,~~__~County
Notary Publ~
UNDAJ coOPER
Notary Pubhc, Sta'~e of New Yo~kF.>
No' 4822563, Soffotk
~ooo79t THE NEW YORK BOARD OF FIRE UNDERWRITERS
BUREAU OF ELECTRICITY
~, EB JoH. ST.EET..EW YO.K. HEW YO.. ,OO3B 8o23
THIS CE~IFIES THAT
Mr. & Mrs. J. Zur~ski~ 7325 Bridge L~e, Cutchog~, N.~.
DRYERS ~ ~RNACE ~TORS ~ FUTURE A~IANCE ~E~RS S~aALR~ PT TIMECL~ ~tt UNITHEATERS M~J~]~T DIMMERS
1 30 _6~
~ x [ 2/0 ~ 21o
~rac~ L£ghting 8 0 6 ices
MedfordN.Y. 11763 Lie. 870E
This cerhf~cate must not be oJtered m on)' manner, return 1o the office of the Board if incorrect Inspectors may be ~dentlfled by their credenflaJs
COPY FOR BUILDING DEPARTMENT THIS COPY OF CERTIFICATE MUST NOT BE ALTERED IN ANY MANNER
TOWN OF SOUTHOLD
OFFICb OF BUILDING INSPECTOR
P O. BOX 728
TOWN HALL
SOU'ItIOLD, N Y. I I97I
December 29, 1987
Mr. John Zurawskz
Kxng Street Box 226
New SUffolk 11956
To Whoa This May Co~cern,
W6 are unable ~o complete your Certificate
of Occupancy because .of the following reasons.
TEL. 7654802
/~/ An applzcation for Certzflcate of Occupancy
is not on file. ENCLOSED
/~/ NO Underwriters Certificate on file.
/~/ The check ms(~/not on file.) $25.00
/~/ No Health Dept. Approval on file.
/~/ No final znspcctlon has been made.
Please contact our office on this matter.
Thank you for your cooperation.
Building Permit ~ ~ ~_ ~.~ ~ ~. Z
Building Dept.
***/~ No Plumber Solder Certificate on file.
( all permits involving plumbing being
issued after April 1,1984 )
765-1802
BUILDING DEPT.
INSPECTION
FOUNDATION 1ST
FOUNDATION 2ND
FRAMING
ROUGH PLBG.
INSULATION
~ ~FINAL
INSPECTOR
765-1802
BUILDING DEPT.
INSPECTION
FOUNDATION 1ST [ ] ROUGH PLBG.
FOUNDATION ZND [/~INSULATION
7G5-1.802
BUILDING DEPT,
INSPECTION
FOUNDATION 1ST [ ] ROUGH PLBG.
FOUNDATION 2ND [ ] INSULATION
FRAMING [ ] FINAL
REMARKS:
DATE
IN:
765-1802
BUILDING DEPT.
PECTION
FOUNDATION 1ST [ ] ROUGH PLBG.
FOUNDATION 2ND [ ] INSULATION
DATE /~/~///~/'? ..... INSPECTO~~
765-1802
BUILDING DEPT.
INSPECTION
[/~UNDATION 1ST [ ] ROUGH PLBG.
[ ] FOUNDATION AND [ ] INSULATION
[]FRAMING []FINAL
REMARKS:~
OUNDATI~ /~(lst)
OUNDATIO:; /~( 2nd )
OUGH FRAME &
PLUMBING
NSU~ATION FERN.
STATE ENERGY
CODE
FI~;AL
ADDITIONAL COMMENTS:
Approved ~0~¢°~. l ~
Disapproved a/c
FORM NO 1
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN HALL
SOUTHOLD, N,Y 11971
TEL.: 765-1802
(Building Inspector)
APPLICATION FOR BUILDING PERMIT
Received ........... ~19..
Date , 19.
INSTRUCTIONS
a Tlus application must be completely filled in by typewriter or ,n mk and subm,tted to the Bufldmg Inspector, with
sets of plans, accurate plot plan to,scale Fee accordmg to schedule
b Plot plan showmg location of lot and of bufldmgs on premises, relatmnshlp to adjommg premises or public streel
or areas, and glvmg a detmled description of layout of property must be drawn on the diagram which is part of flus appl
cation.
c The work covered by flus application may not be commenced before issuance of Building Permit
d. Upon approval of this application, the Building Inspector wall issued a Bufldmg Penmt to the appbcant Such perm
shall be kept on the premzses avaflgble for mspection throughout the work·
e No bufldmg shall be occupied or used in whole or in part for any purpose whatever unh~a Certificate of Occupanc
shall have been granted by the Bmldmg Inspector
APPLICATION IS HEREBY MADE to the Bufldmg Department for the issuance of a Bmldlng Permit pursuant to th
Bmldlng Zone OrdNance of the Town of Southold, Suffolk County, New York, and other applicable Laws, OrdNances c
Regulations, for the construction! of bufldmgs, additions or alterations, or for removal or demolition, as herein describe,
The applicant agrees to comply with all applicable laws, ordnances, bufldmg code, housing code, and regulations, and t
admit authorized mspectors on pr~m~ses and m buddmg for necessary inspe~t~on,%~.
~Slgnature d.f~pphcant, or name, if a corporation)
1¢ (o ...
State whether apphcant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or budder
(as on the tax roll or latest deed)
If apphcant is a corporation, signature of duly authorized officer
(Name and title of corporate officer)
Builder's License No
Plumber's License No
Electrlclan's License No ,~;r 70 ~ .
Other Trade's License No
Location of land on which proposed work will be done.
House Number Street
County Tax Map No I000 Sei~tion ~J/, -]--~t ~
Subd~v~slon ~ ~
/ ' (Name) '
Hamlet
Block ...... Lot.
Fried Map No g ~ ~'~. Lot
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 Budding . , . Addition .... Alteration .....
Repmr ........ Re~noval .......... Demohtlon .......... Other Work ........
4. Estmaated Cost ~. ............. Fee ...................................
(to be paid on filmg thru 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 mixed occupancy, specify nature and extent of each type of use ..........
7. Dimensions of existing structures, if any. Front Rear ........... Depth ......
Height ......... Nfimber of Stories ..............................
D~menslons of same structure,with alteratmns or additions Front ......... Rear . .
Depth ...... .... , Heaght .. . . ~ ...... Numbe[ of Stones . ........ ,~ .....
8 l/Dimensions of entire new construction Front . 7'~ '. .... Rear . ~.&.' ....... Depth g.~.~r' '" ......
Height ....... Nt~mber of Stories ./
9. Size of lot Front /~4~..~ ...... .z-' '' Rear /.~ ......... Devth .'~.. .........
11 Zone or use district in winC~h p. remmes are situated . ~.. 7~,~.~ ~. ...... I ..............
12 Does proposed construction vaolate any zoning law, ordinance or regulation ./gt .~? ...................
13 Will lot be regraded .. tO.d> ... .......... Will exce~s fill be removed from pTemmes Yes
Name of Architect ............... Address ............ Phone No ..............
Name of Contractor . ~ ~ ~t~.~.. ~ ~..eff.,~ .~kx~..' ~;. Address .~.~g,r. ,,g.$ ,p'~..dW Phone No ..........
i5. Is this property locate~ w~thinl00 feet of a t~dal wetland? * Yes ..... No .~
· If yes, Southold Town Trustees Permit may be required.
I PLOT DIAGRAM
Locate clearly and distinctly all buildings, whether ex~st~ng or proposed, and, re&cate all set-back dnnenslons from
property hnes. G~ve street and bloc
interior or corner lot.
number or description according to deed, and show street names and red,cate whether
STATE OF NEW YORK,
COUNTY OF..
SS
(Name of ~ndlv~dual s~gnmg contract)
above named
·.. being duly sworn, deposes and says that he lS the applicant
He m 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 tins
~pphcatlon, that all statements contained m thru application are true to the best of lus knowledge and belief, and that the
~ork wdl be performed in the manner set forth m the apphcabon filed therewith.
gworn to before me this
........... [~., . day of.. ~. ....... ,
qotaryPubhc, ..~-¢:'~... ~
~r~.¥ ~m.~ ~t,t,~ ~",,.'~,~ '. '//:
(Signature of applicant)
/
,
should be no~e~ ~h~ s'~ce
p~op~dy JS located in aq agncuJturo;
j the gossibJlCy
wote~ supply ma;/ coq*u~n
S~cial analysis ~)~
Cont~t this Dn%artmen+
CLEARE
FND
46'--'-".z,~ ,~u "W. 140 0 sT/(
N
PA ~ K AR£A
sET
STK
CE/~TIFIED TO
AREA) rye TITLE GUARANTEE COI~PANY
(
PARK
FOR
HENRY RAYN06~
J 4 Ilsealand-
I ON MAP OF I I I
ISYtORET EsrAr~s II/Il Isurveyincj
J FILE NP 6890, FILED dUNE ~, l~q?6 J J
I SlTU~FEDA~ I1 ~ engineering p.c.
I CU~HOGUE II ~ west main street
I TOWN OFS~__~ _ II riverhead, new york 11901
I
10~-84-01-64 S~al~: I '- 40'
NASSAU SUFFOLK
CL EA RED
VACANT
SET N 4~ °PS '20 '"W
PA R K AREA
140 0
FND
FNO
STK OI'S
MAP OF
LOT 4
SYLORET ESTATES
AF CUTCHQGU£
FOWN OF ~OUTHO~_D
SUFFOLX CO, N Y
~ILED ~IN 8,~ ~6~
~-LE/AT~O~S ~RE LV ~SJME~ I~AT'/~
CERTIFIED TO'
THE TITLE GUARANTEE
HENRY RA YNO~
Ildo-c
II
~13 west moin street
II
riverhead , new york 1~901
11(5,e)
II Jan 30,1984 Job No. e4-43e
~1~0 -84-01- 6.q Scale:l"
· pAVEMENT)
SUFFO~OoUNT¥
S
~ location have been respected
' er e~c~es a~d
~ Bureau oi Was .
(PARK AREA`)
FOR
FIRb'~AMERICAN TITLE INSURE CO OF NY
JOHN E ZURAWSK/
, sealand
I srLo/~r ~srAr~/,~. :~ <...~,,,\ II
,/il J surveying
J S/rUATEOAT ~/' ~ ~'~ Il ~ enqineerina p.c.
CU~HOGU~",:'~ "'--,"-e:/ II ~ west ma,n street
I TOWN OFS~ '-._t-~D_~G'~ Jlr~verhead, n~ york 11901
I ~c~, ~. ,~ ~ ]]~,u s~[~369-1717 ~
Job Nj 84-436~
Scale: I"= 40'
NOTES:
1. ALL WORK SHALL COMPLY WITH THE NEW YORK STATE UNIFORM FIRE
PREVENTION AND BUILDING CODES.
2. ALL LINTELS SHOWN ARE MINIMUM SIZES.
3. DOUBLE LINTEL JACKS FOR ALL OPENINGS GREATER THAN 6 FEET.
4. DOUBLE FLOOR JOISTS UNDER PARTITIONS.
5. DOUBLE RAFTERS AT SKYLIGHTS AS APPLICABLE.
6. THE NEW YORK STATE ENERGY CODE SHALL BE COMPLIED WITH ON
THE BASIS OF PART 5 (ACCEPTED PRACTICE AND IN F~/tTICULAR
AS FOLLOWS:)
7. PROVIDE SEPARATE HEATING ZONE CONTROL 'FOR EACE%~LOOR.
8. FIREPLACE DAMPERS SHALL HAVE A LEAK RATE OF LESS THAN 20
C~M OR BE FITTED WITH A GLASS DOOR & EITTED WITH AN EXTERNAL
COMBUSTION AIR SOURCE.
9. THE KITCHEN EXHAUST ~AN SHALL BE FITTED WITH A DAMPER"OR
BE NON-VENTING.
10. ALL HEATING, NOT WATER, AND ELECTRICAL EQUIPMENT SHALL BE
AS APPROVED BY THE NEW YORK STATE CONSERVATION
INSULATION SCHEDULE (MINIMUMS)
CEILING ~--~ WINDOWS - u ~ 0.69
WALLS ~%~1 DOORS ~ U ~ 0.40
FLOOR ~ ~1 HOT WATER PIPES - R ~' 4.6
~-~ ~?~RIMETER GLASS VENTILATION ENERgy
FIRST
TOTALS
DRAWING #
STEVE G. TSONTAKIS ASSOC.
P.O. BOX 1180 632 ROANOKE AVE.
RIVERHEAD, NY 1901 ,,., . , ,
(516) 727-7411 ".~,
o
for water distributing
system; piping shall be
~ ~es K or L only
~OLDER USED IN WATER
CLC5, [~
: CC~s. ii
21LiO"
ditlon to this document is a
~.?:Z _
~0¢5,6 .-~'C,E~ ck, C,U'TCHOCI.)E
FLOOF?. '""
'L-J
,I
70 -o
addff;on ,o this document is a
vlolaflon of secHon 7209 of
the New York State Education
Copies of th~s document not
beadng tho engineer% inked
seal or embossed seal shall not
he considered valid copies,
-1
,.'~" F,C, F'L. O012
o 5~CT,"A-A"o ° SECT."5-I5'' °
~/4%~ ~ '- 0" 3/4%
f
b
S LC T, 'C - C" o
L
%_SF~CT, D-D''.
~.% I ' 0"
addition to this document is a
violation of secHon 7209 of
the New York State Education
Copies of this document not
hearing the engineeFs inked
be considered valid copies.
addition to this dacument ~ a
violation ef section 7209 of
the New York State Education
Cop{es of fbi= document not
benr~ng the engineers inked
seal ar embossed seal shall nat
be considered va~id copies,
~42s~1 ~
!1,
SECq'-t 0 k..J $