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Home My WebLink About15645-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Buildln~ Inspector Town Hall Southold, N.Y. Certificate Of Occupancy No Z-16827 Date Aprzl 28, 1988 THIS CERTIFIES that the buridmg . . . .A C.qE. S. Sp.R.Y. .................... House lye Street Hamlet County Tax Map No 1000 Section 0.75. . . .Block . .0.! .......... Lot . .I. 7. ........... Subdivision .... [ ............. Fried Map No ....... Lot No ............. conforms substantially to the Application for Burid~ng Permit heretofore fried in this office dated January 2 I, 1987 pursuanttowt'achBu~IdingPennitNo. ~5645 Z dated.......January.. 29.., . 1987.. ... was issued, and conforms to all of the requirements of the applicable provisions of the law. The occupancy for winch this certificate is issued m ....... STORAGEI SHED AS APPLIED FOR The certificate is Issued to FRANK C ICHANOWICZ I I I of the aforesaid building Suffolk County Department of Health Approval N /A UNDERWRITERS CERTIFICATE NO N849106 - January 7, I988 N/A PLUMBERS CERTIFICATION DATED: Rev 1/81 TO~N OF SOU'II'IOLD 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~ 15645 Z Permission is hereby grcnted to: ......... ............ ~.~.~....~.:~,......u..~.~.~. ............ . .--., o, premises loc,ted Qt ...'~...~..~.~.~. ...... ...~....~.......~....-......Z...'~...~..~..~[..~f.. ............................... County Tax Map No. 1000 Section ...... ..O..~..~.''~ ...... Block ....... ..~...! ......... Lot No ........ ~..] ....... pursuant to application dated ....%J..~......~.~l .... Budding inspector. Fee $...J.! ..~... :..~. ..... , 19.~..~., ond approved by the Building Inspector Rev. 6/30/80 FORM NO. 6 TOWN OF SOUTHOLD Building Depar [i~ient Town Hall i Southold, N.Y. 11971 765- 1802 APPLICATION FOR CERTIFICATE OF OCCUPANCY Instructions A. This application must be fdled ~n typewriter OR ink, and submitted m~ to the Budding Inspec- tor with the fo lowing; for new buddings or new use: 1. F~nal survey of property w~th accurate location of all buildings, property lines, streets, and unusual natural or topogr~phm features. 2.F na[ approval of IHealth Dept. of water supply and sewerage disposal--{S-9 form or equal). 3.Approval of electrical installation from Board of F~re Underwriters. 4. Commercmi buildings, Industrial buddings, Multiple Remdences and similar buildings and installa- tions, a certlflcat~ of Code compliance from the Architect or Engineer responmble for the building. 5.Subm t P ann ng Board approva of comp eted s~te plan renu,rPmer~ where appl cab e B. For exmtmg buddings (prior to April 1957), Non-conforming uses, or buildings and pre-ex~sting land us~s: I. Accurate survey of p~operty showing all property lines, streets, buddings and unusual natural or topographic features 2.Sworn statement of owner or previous owner as to use, occupancy and condition of bu ddings. 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: ~ Additions $25.00 PO0%S $25.00A%TERATION $25.00 l. Certificate of occdpancy New D~e[I~ng $25.00, Accessory ,$]0.00 Susi~ess $50.00 2. Cemflcate of occdpanc¥ on pre-exist~ng dwelling $ 50.00 3. Cop¥ofcertlflcateofoccupanc¥ $ 5.00, ove~ 5 ~ea~$ $10.00 4.Vacant: Land',C.O. $ 20.00 ~ ~.O~.C 5.Updated C.OJ $ 50.00 Date... fZ..J.~ .... .~..~....I .... NewConstruct zon ...... Old or Pre-e×tsting Budding ............ Vacant Land ............. Location of Property ......... .y~.4',~ ~ £ ~.~., C ¢~ .~ ~F. .................................................... Hodse No. Street Hamlet Owner or Owners of Property ...................................................... ?Y ! t7,/. County Tax Map No. 1000 Section .............. Block .............. Lot ........... Subdiwsion ............................. Fded Map No ......... Lot No .............. Perm,tNo. !.~.~fl.f.%.. Date of Permlt . .~. ')..Appl,cant .~..¢.,~.v'.o./)?.~. .... 5..c.~.. ..... HeaJthDep, Approval ............. I o ~J/~-- ....... LaborDept. Approva, ....../~.l./~. ...... ...... . Underwriters Approval ....~ ................ Planning Board Approval ...................... Request for Temporary Certificate .................. Final Certihcate ....~.. ................ Fee ~ubm,tted ~ ....... .z.t..o..,..-'....¢~./~ .~. ~ Construction on above described budding and permit meets all. applicable codes and regulations. App ,oa,t L ............. ...... Rev 10-10-7a THE NEW YORK BOARD O~ FIRE UNDERWRITERS .].00].3~1 BUREAU OF ELECTRICITY ~ ~ ['-- kh 85 JOHN STREET, NEW YORK, NEW YORK 10038 Oat~ January 7, 19818 ~pph~at,o. ;vo ..f,:~ 457080/87 THIS CE~IFIES THAT ~ Frank Cichanowlcz ~I, Rt. 25, Holly Hollow Mur~rie~, Peconic, N.Y. ,.~, fiXTURE FIXTURES Z4 24 26 16 8 DRYERS FURNACE MOTORS SERVIC~ DISCONNECT OTHER APPARATUS MOTORS: 1-i½hp. 1-G.F.C.I. MUm-6UTU~ TIME CLOCKS [ DIMMERS SYSTEMS 2/0 _ 2/0 Jody Pumillo Pat Lane Mattituck, N.Y. 11952 1ic.#2300E GENERAL MANAGER TOWN OF SOUTLIOLD OFFICE OF BUILDING INSP£CTOR P O. BOX 728 TOWN HALL SOUIIIOLD, N.Y. 11971 April 8, 1988 TEL. 765-1 I?;02 Brzarcliff ~andscape Route 25 i Peconzc, N.y. 11958 To Whom; This May Concern, WOI are unable to complate your Certificate of Occut~ancy bccause .of the following reasons. /_~/ An application for Certificate of Occupancy is. not on file. (ENCLOSED) /~/ :IoIUnderwriters Certificate on file. /~/ The check is(~l~,~Yt~not on file.) $10.00 Lol!Ioalth Dept. Approval on f~le. /~/ ~:o final inspection has been made. Please contact our office on this matter. Thank you for your cooperation. Buildznq Permit t~ ~ 5 6 4 5 Z Buildin¢i Dept. ***/~/ No Plumber Solder Certificate on file. ( all permits znvo!ving plumbing being ls'.med after April 1,1984 ) 765-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLBG. FOUNDATION ZND [ ] INSULATION / FRAMING [ *~INAL t/ INSPECTOR ~ ~/~ 765-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] INSULATION FRAMING [ ] FINAL REMA~-- DATE, INSPECTOR ~¢~ 765.1802 BUILDING DEPT. INSPECTION FOUNDATION 1ST [ ] ROUGH PLBG. FOUNDATION 2ND ['~INSULATION FRAMING [ ] FINAL DATE 765-1802 BUILDING DEPT. INSPECTION FOUNDATION 1ST ~ ~ ROUGH PLBG. FOUNDATION 2ND [ ] INSULATION FRAMING [ ~AL OU~.D A T I 0.~ '3UNDATIO:~ {~2nd ) OUGH FRAME & PLUMBING ~'~SULATION PER N. Y. STATE ENERGY CODE FINAL ADDITIONAL COMMENTS Approved '4 a.~.~..~ Disapproved a/c BOARD OF HEALTH- 3 SETS OF PLANS FORM NO I SURVEY ~ TOWN OF SOUTHOLD CHECK ! 0 ~(v BUILDING DEPARTMENT SEPTIC FORM-- ~J/Pr TOWN HALL NOTIFY SOUTHOLD, N.Y. 11971 TEL 765-1802 CALL MAIL TO: / (Building inspector) APPLICATION FOR BUILDING PERMIT INSTRUCTIONS a. This application must be completely filled m by typewriter or in ink and submitted to the Building Inspector, with 3 sets of plans, accurate plot plan to s~ale Fee according to schedule b Plot plan showing location Of lot and of bmldmgs on premises, relationship to adjoining premises or public streets or areas and giving a detailed desc}iphon of layout of property must be drawn on the dlagmm which is part of this appli- cation. I c. The work covered by ttus a?phcatlon may not be commenced before issuance of Building Permit d Upon approval of this appbcatmn, the Building Inspector will issued a Budding Permit to the applicant. Such permit shall be kept on the premises avaflal~le for inspection throughout the work e. No budding 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 Bml~lng Inspector APPLICATION IS HEREBY M~DE~ to the Buddmg Department for the Issuance of a Bmld~ng Permit pumuant to the Braiding Zone Ordinance of the Town of Southold, Suffolk County, New York, and other applicable Laws~ Ordinances or Regulations, for the construction 9f braidings, additions or alterations, or for removal or demolition, as herein described The applicant agrees to comply with all apphcable laws, ordinances, budding code, housing code, andre~ulat~gn$,~and to admit authorized inspectors on prermses and m bmldmg for necessary inspections // (Signature of applicant, or/flame, if a corporat?6n) (Mailing address of applicant') State whether applicant is owner,I lessee, agent, architect, enDneer, general contractor, electrician, plumber or builder . ........... Nameofownerorpremises .~,~.1~).~--. C_..~.t~.,0~..tc~ ~ ............. (as on the tax roi1 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 Iai PI'. Electnman's License No 09 Other Trade's License No .... Location of land on which proposed work will be done. House Number 73c-- Street ) County Tax Map No 1000 Section ~ Block . . . ~ Subdw~sion ~-~"? \~\\~l,~ ~--~J~* ~e..5 .... Fried Map No (Name) ...~C~o~ \e~e. ......... Hamlet .. Lot Lot ......... 2 State existing use and occupancy of premmes and ~ntended use and occupancy of proposed construction a Existing use and occupancy .. b. Intended use and occupancy, . ,~F~q ~% {..~g....~ .~.'.'.~. 3. Nature of work (check which applicable) New Building j5¢' . Repair ... Removal .. Demolition 4. EstlmatedCost ~J~/ 4 t)O'D' ........... · Addition .. Alteration ....... Other Work (Descnpnon) Fee ............... " (to be prod on fihng this 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 m~xe~y, specify nature and extent of each type of use . p,J/,~.r, .//,4~ .,.~.~[]~r'~ 7 Dlmensmns of ex~~s, lfa~y Front ........ Rear ......... Depth ......... Height .. ~%~-~7.... .. Numb. er,of Si.ones ................................ Dumen. s~of same structure with alterations or additions Front ........... Rear ......... ~ .......... Hmmht ........... Number of Stones ..... , .... '- 8. Dlmensmns of entire new construction Front . ?-----------------~.~.. Q. .. Rear . .5 ~ :.O. .... Depth ...~.~ .. q ..... Height ~h ~ .. ' 9. Size of lot~ront' Number of Stones [ .............................. I ....... Rear .............. Depth .............. 10 Date of Purchase . '477~; ]~ e ........ Name o f Form er Owner ~.' .~. ~d~¥,,.L3 ?., ~.,-, .~.k. / . . 1 1 Zone or use dmtnct in wh,ch premises are situated . . . 12. Does proposed constructmn wolate any zoning law, ordinance or regulation .. .4, C> ............... ... 13. Will lot be regraded .~.~ ~ . . . Will excess fill be removed from premises' Yes I4 NameofOwnerofpremlses¥1/~,~At C~h~."~w-.~.~.~Y-. Address L~.q~u,..l~.v.~(¥,,.~.PhoneNo' .."7..~:~:?.o.~1¥.. · Address ...... Phone No ........... Name of Architect .... [ /- ....... .. Address Phone No Name of Contractor ................. -/ .................... 15. Is th~s property located within 300 feet of a tidal wetland? *Yes ..... No .~y~-i.... *If yes, Southold Town Trustees Permit may be required. I PLOT DIAGRAM Locate clearly and d~stmctl~ all bmldmgs, whether exmt~ng or proposed, and ~ndmate all set-back dmaensmns fro property hnes Give street and block number or description according to deed, and show street names and indicate wheth STATE OF NEW YORK, S.S C 0 U NTI~-,OF'-,, ' ...... . '~dt4,l~.- ~/d~Z~r~c:~..¢l.C"?.. ~ be~ngdulysworn, deposesandsaysthathe~stheapphca (Name of individual slgmng contract) above named . .......... (Contractor, agent, corporate officer, etc ) of said owner or owners, and m duly authorized to perform or have performed the sa~d work and to make and file tl apphcatmn, that all statements contained m this application are true to the best of his knowledge and behef, and that t work will be performed in the manner set forth m the apphcation filed therewith. Sworn to before me this c~d.,"~-~,~ff~,~,t/,/~' .. day of~~''' ., 19~ Notary Pubhc, ...~~.. County JUthlH B ~/OhlZ ~ NOTARY PttBLIC, State o~ Ney' Yo'~ /k No 4787124, Suflol~ Co~.~ ~ ............... (Signature of apphca COPYRIG, HT ~ OCCUPANCY OR USE IS UNLAWFUL WITHOUT CERTIFICATE OF OCCUPANCY I BOTANICAL NAME COMMON NAME SIZE QUANTITY CONDITION