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Home My WebLink About15941-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Bulldlng Inspector Town Hal~ Southold, N.Y. CERTIFICATE OF OCCUPANCY No Z19090 Date MAY 31r 1990 THIS CERTIFIES that the bulldln~ ONE FAMILY DW~J,ING Location of Propert~ 745 CASE'S LANE EXT. CUTCHOGUE House No. Street Hamlet County Tax Map No. 1000 Section 109 Block 05 Lot 14.26 ESTATE OF FRANK H. Subdivision CASE Filed Map No. Lot No. 2 conforms substantially to the Application for Building Permit heretofore filed in this office dated Bumldmng Permit No. 15941Z APRIL 17, 1987 pursuant to which dated APRIL 28r 1987 was issued, and conforms to all of the requmrements of the applicable provmszons of tke law. The occupancy for which this certificate is issued is ONE FAMILY DWELLING~ ATTACHED GARAGE AND DECK. The certlfzcate ils issued to HENRY & DEBORAH STASIUKIEWICZ (owner) of the aforesal~ building. SUFFOLK COUNTY D!PARTMENT OF HEALTH APPROVAL 87-SO-31 MAY 24r 1990 UNDERWRITERS CERTIFICATE NO. N067160 APRIL 17~ 1989 PLUMBERS CERTIFI~TION DATED ROBERT BUGDIN--MARCH 22~ 1990 Rev. 1/81 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N. Y. NO BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) 15941 Z Perrmssion is hereby granted to' ~.~~.....ar..~.~.L~ ...-ga.~.~...~ ~ I.. kC..~..~ . ............. ~ ........... ~..~ ......... ~..~ ............. at premises located at .~.~.~...~. ..~...~.. .¢ ............ ~ ....... County Tax Mop No '1000 Section ..... ./...0...~ ......... Block ...... ..C~...~-]. ...... Lot No .....t..~.e ..~....~.... pursuant to application dated .... ~L.A~(..../...'~. ....................... 19~..L.,~'~ and Budding Inspector. ~e ,..'2.t~......~.. ' approved by the Building In.~ector Rev 6/30/80 TO~ O~ SOfT,OLD ~O~N RALL SOUTEOL~, NEW YORK 765 - 1802 [197 ~! HAY t, 6~ ~ ~ TOWN OF SOUTF'OLD ~ APFLICATION FOR CERTIFICATE OF OCCUFANCY Subdivision ....................... Filed Hap ........ Loc .......... Permic No. . Date of Permig .. Applicant . ~ Approval .................. Underwriters Approval PlanninE Soard Approval ................ Fee SubmltEed: for Temporary Cer[~flcate ....... Final Cerciflca~e ................ 6/,/96 r~v- 10/14/88 FOEM NO. 6 ~Ol~I OF SOUTIIOLD BUILDING DEPARTHE NT TOWN I1ALL 765- lB02 /%PPLICATION FOR CERTIFICATE OF OCCUPANC~ INSTRUCTIONS This application must be filed in type~rriter OR ink and submitted to the Building Inspector with the fpllowing; for new buildings or mew use: I. Final survey of property with accurate location of all buildings, property lines, streets, and unusual natural nr topographic features. 2. Final approval of Dealth Dept. of water supply and sewerage-disposal(S-9 form). 3. Approval of electrical installation from Board of Fire Underwriters. 4. Sworn statement from plumber certifying that solder used in system contains less' than 2/10 of IZ l~ad. 5. Commercial buildings, industrial buildings, multiple residences and similar buildings and installations, a certificate of code compliance from the Architect or Engineer responsible for the building. 6. Submit Planning Board Approval of completed site plan requirements. For existing buildings (Prior to April 9, ]957] non-conforming uses, or buildings and "pre-existing" l~nd uses: I. Accurate survey of property showing all property lines, streets, buiIdings amd unusual natural or topographic features. Z. A properly completed 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 s~parate ownership of the entire lot prior to April 9, ]957. If a Certificate of Occupaucy is denied, the Building Inspector shall state the reasons therefor in writing to the applicant. 3. Date of any housing code or safety inspection of buildlugs or premises, or other pertinent information required to prepare a certificate. For Vacant Land Certificate of Occupancy: ]. An applicatiou for vacant land Certificate of Occupancy shall be suhmitte4, and a certified abstract of title issued by a title company showing single and separate ownership of,the entire lot prior to April 9, ]957 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: !. CERTIFICATE OF OCCUPANCY - New Dwelling $25.00, Addit_~ons to Dwelling Alteration to Dwelling $25.00, Swimming Pool, $25.00. Accessory building $25.00 Addition to A~cessory 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 - $10.00 4. Vacant Land Certificate of Occupancy - $20.00 5. Updated Certificate of Occupancy - $50.00 [o 6. Temporary Certmflcate of Occupancy -$ !5.00 Residential Comercial ~v. I0/1&/$$ THE NEW YORK BOARD OF FIRE UNDERWRITERS 1000418 BUREAU OF ELECTRICITY ~ APE] L, 1';, [')89 85 JOHN STREET, NEW YORK, NEW YORK 10038 Date /lpplication No. on file 5169248~/~7 N THIS CE~IFIES THAT o~y t~ e~t~ ~u~ment ~ ~ ~ a~ i~t~u~ by t~ ~nt ~ on t~ a~e ap~t~ numar in t~ p~ of Z ~ ~nt ~ Ist FI. ~ 2~ Fl, GAR .~,,on Bl.k in the fol~wlng ~&]H ~ examin~ o~ ' and found to be in compliance with the requi~ments qf th~ B~rd. RXTURES ~S OVENS ~$H W~HE~ ~HAUST FANS DRYERS FURNACE MOTORS APFtlANCB FIEOIRS TIPM CLOCKS MULTM)OTLIT SYSTEMS NO. OF FlIT DIMMERS SERVICE IXSCOflNICT S E R V I C E S~OK~; DETECTOR: - 3 TRACI( I,iGHTING: '1,4 210 AhEXANDgR BOX 222. AQUI~IIOGIIB hie. ~ 04g 1] This certificate must not be altered in any manner; return to the office of the Board if incorrect. Inspectors may be identified COPY FOI~ BUILDING DEPARTMENT. THIS COPY OF CERTIFICATE MUST NOT BE ALTERED IN ANY MANNER. TEL. 765-1802 TO~FN OF SOUTHOLD OFFICE OF BUILDING INSPECTOR P O. BOX 728 TOWN SOUTHOLD, N.Y. 1197 I ' C E R T ~ F I C A Date / (pleas~ print)' Plumber (please I certify that the solder used contains less than 2/10 of 1% lead. in the water supply system (plumber's signature) Notary Public, ~ ~A~ County NADIA MOOR~ Notary Pubhc, Sta~e of New York - ~) ~ No 4891294 Qualified ~n Suffolk County ~j Comm~ssmn Expires Apn! 27, 1~ OUNDATION ~ OUNDATION ( OUGH FRAME FLUMBtN~ NSULATION PER STATE ENERGY CODE FI~AL COMMENTS: 765-1802 BUILDING DEPT. INSPECTION FOUNDATION 1ST I ] ROUGH PLBG. ] FOUNDATION 2ND l ] INSULATION ]FRAMING [~FINAL REMARKS: -/ DATE INSPECTOR 765-1802 BUILDING DEPT. INSPECTION FOUNDATION 1ST [ ~)UGH PLBG. FOUNDATION ZND ['/] INSULATION [,~R~MING [ ] FINAL DATE 765-~.802 BUILDING DEPT. INSPECTION FOUNDATION 1ST [ ] ROUGH PLBG. [~OUNDATION 2ND [ ] INSULATION [ ] FRAMING [ ]FINAL REMARKS: DATE INSPECTOR 765-1802 BUILDING DEPT. INSPECTION [~FOUNDATION 1ST [ ] FOUNDATION FRAMING ROUGH PLBG. 2ND [ ] INSULATION [ ] FINAL DATE Examined ~ &~ Approved ~ ~/~ */ Dmapproved a/c FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL ~°OUTHOLD, N.Y. 11971 TEL.: 765-1802 ,19 , 19~-/Permit (Building Inspector) APPLICATION FOR BUILDING PERMIT BLPG I.,,E r r Date g/:~ r'~6~ , 19a~3 INSTRUCTIONS (Name and title of corporate officer) Builder's License No ...... Plumber s License No a. Tlus application must be completely filled in by typewriter or in ink and submitted to the Bmldmg Inspector, with sets of plans, accurate plot plan to scale Fee according to schedule b Plot plan showing location of lot and of buddings on premises, relationship to adjoming premises or public stree or areas, and glvmg a detailed description of layout of property must be drawn on the diagram which is part of th~s app cation. c. The work covered by flus apphcatlon may not be commenced before issuance of Building Permit d Upon approval of this application, the Building Inspector will issued a Bmldmg Permit to the applicant Such perm 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 untl~-a Certificate of Occupant shall have been granted by the Building Inspector· APPLICATION IS HEREBY MADE to the Budding Department for the issuance of a Bmldlng Permit pursuant to tl Building Zone Ordinance of the Town of Southold, Suffolk County, New York, and other applicable Laws, Ordinances, Regulations, for the constructsod of buddings, ad&tmns or alterations, or for removal or demolition, as hereto describe The apphcant agrees to comply with all apphcable laws, ordinances, building code, housing code, and regulations, and adnnt auth°rlzed mspect°rs °n pr~mlses and m bufldmg f°r necessarYT/]~ ' (S~gnature' of apphfffint, or nar0e7, if a corporation,) [ma±Jd. ng address or appJ.~_canl~5'' ' State whether applicant m owner, lessee, agent, architect, en~neer, general contractor, electrician, plumber or bmlde (as on the tax roll or latest deed) If applicant is a corporation, sign~ture of duly authorized officer 2 County Tax Map No 1000 Section Subdivision ~ '(N'am e)' Electrician s License No. Other Trade's License No ~ ...... Location ofland on wln~ ~r~posed work wdl be done {.3~e~-$ /~ ga-.Y/. House Number Street ' 'Hamlet ' /g ~ } Fried Map No Lot State exmtlng use and occupancy of premises and intended use and occupancy of proposed construction a Existing use and occupanc~ / ...... b. Intended use and occupancy .~09'[~_~¢5~ SIXthS.~'' }5/~. 14-~ . .2)/d'/~/m'~f'~.... 3. Nature of work (check whichlapphcable) New Budding / Addition Alteration Repmr ........ Removal ........ Demolition .......... Other Work ............ ~ ' (Description) Est ated cost.. . .. ............. Fee ......................... 4 (to be paid on filing this application) 5. If dwelling, number of dwelling units.., ! ...... Number of dwelling units on each floor ............ Ifgarage, numberofcars ... ~ ............................................ 6 If business, commercial or mixed occupancy, specify nature and extent of each type of use .............. 7 Dunensions of existing structfires, if any Front .--"'-" .... Rear ......... Depth ........ Height ...... Number of Stones ...................... Dunenmons of same structure with alterations or additions Front ........ Rear .......... Depth ..... ~ ... Height . (~9 . ~.~.,.~.. . Number of Stones .......... 8. DlmenmonsofenhrenewconStruction'Front~,< Rear .. ~..q, 6~ ~. Depth ff~,q Hel~at ......... Number of Stones . ,~ .... 9. Slzeoflot Front· /.7-fi" ...... Rear ~-~:~:'."'"'"''De'th".;~'.5-~.''-''''''''''' I0. Date of Purchase ..~./~-. .~'~k ........ Name of Former Owner . ~/-~3~-.- '~ ~ -' t~/r'tu3~ · ......... 11 Zone or use district in wklch premises are situated../~t~. ~1>~,f77'~/-, ......................... 12 Does proposed construction vmlate any zoning law, ordinance or regulation /~.~ 13. Will lot be regraded ~.~> ............. ,. , Will excess fill be removed fro. rri premises: .,, .Yes 14 Name of Owner of premises ~/~2/. ~J//~lT:~/r/.Address £~ ~,~. ~ .,/~Jl~?.~..F-~hone No ,~.~. 7~7.~-. . Name of Architect .............. Address . ~t,,{..r~] ~.~.... Phone No ............. Name of Contractor ............... Address .............. Phone No ............. · Yes . .../-z'~--. No ..... 15. Is this property located withinl00 feet of a tidal wetland? * If yes, Southold Town Trustees Permit may be required, PLOT D~AGRA~ Locate clearly and chstmctly all bufldmgs, whether existing or proposed, and indicate all set-back dnnenmons from property hnes. Give street and block number or descnptaon according to deed, and show street names and red,cate whether interior or corner lot STATE OF NEW YORK, S S COUNTY OF ..... (Name of indIwdual mgmng contract) above named. · being duly sworn, deposes and says that he is the applicant He m the ................... (Contractor, agent, corporate officer, etc.) of smd owner or owners, and is duly authonzed to perform or have performed the said work and to make and file thas apphcataon, that all statements contained m this apphcat~on are true to the best of ins knowledge and behef; and that the work wdl be performed m the manner set forth m the apphcatlon filed therewith Sworn to before me thru .............. day of .............. 19 .. Wotary Public, . ..... ................. County (S~gnature of apphcant) /~' _ /~ / / ~/ ~~ ,~~ S. eo -oS'~o,,~ ~se ~ . 3S~j3, 395.00' I- .~,. ~. ~'1 ~ ~~~' ~1 .,~' ~ t.~.'.~ ~,,~,: - ~ f / ~ ,r~, . / I ~ /. ~ r 30" / ~ /~ / ,' ~~/,/ /d / ,OOoo, / AREA TO TIE LINE :69049S F m T[ST ~LE0 O' EL · m2,~ AREA TO ~ CREEK: 75120 S f LOAM ----[0-- INDICATES CONTOUR LINE IS' COAESE ELEVATIONS SHOWN HEREON COARSE ARE REFERENCED TO NGVD 1929 13' SU~ FOR HEN~ STASIUKiEWiCZ ~ DEBORAH STASIUKIEWICZ~ARCH m, i987 )UFFOLK COUNTY DEPARIMEN~ OF HEALTH SERVICE5 JAN Z3~1986 DEC AT CUTCHOGUE DATE NOV 18, FOR APPROVAL OF CONS~UCTION ONLY ~N ~ SOUTHOLD SCALE I"= 60' SUFFO~ COUNTY, NEW ~RK NO ~-148~ ~ HEAL~ DEPARTMENT-DATA F~ APPR~ ~ C~STRUCT ~E ~R~ ~R WHOM THE SU~EY I$ ~' YOUNG 8 YOUNG ~R~AD~ NE~ ~RK RE LOT NO Z MINOR SUBDIVISION "ESTATE OF FRANK H CASE" ~DEN W ~UNG~ PROFE~IONAL ENGINEER ~ = STAKE AND ~ND SURVEYOR N YS MCENSE NO 12845 HOWARD W YOUNG, LAND SURVEYOR ~ ~ L~ ~ ~L(WJt~C TA~J~a CE~(~) ~N ~E~ N Y S LICENSE NO ~ ~ RE~ ~TI~$ ~OR DATA ~TN~D F~ OTHERI I , , I0~ ~, ~ ' · -50 - SU~Y FOR , ,..,,.r ,, t..",, , ,,-, "~ % ~ ,.,. HEN~ STASIUKIEWlCZ ~ DEBORAH STASIUK EW CZMARCH 18, 19S7 HhY ~ ~ 1990 ~~1 AT CUTCHOGUE DATE N~ 18,1985 ~ > ~ ,- .... ', ~ ' [ ~N ~ SOUTHOLD SCALE RE LOT NO 2 MINOR SUBDIVISION "ESTATE OF FRANK H CASE ' ~OEN W ~UNG~ PROFE~IONAL ENGINEER ~=STAKE ANO ~ND SURVEYOR N Y.S UCENSE NO 12~45 HOWARD W YOUNG, ~ND SURVEYOR N ~ L~ ~ ~W),~C TA~(~I C[~(~) ~N ~ N Y S LI~NSE NO 45893 [Li I , ,11 ~ tu~ is fei, ~t~ di~tributing ~tmn~ ¢~ing sf~ll I~, PLUMBER CERTIFICA T/ON ON LffAD CONTENT BEFORE CER~'IFICATE OF OCCUPANCY sOLDER USED IN W/~,,-R SUPPLY SYSTEM CANNOT EXCEED 2/10 of 1% LEAD. OCCUPANCY OR USE IS 'UNLAWFUL WITHOUT CERTIFICATE OF OCCUPANCY k ii ' ,¢ :'4, Phone 477~0400 Mai!! goad GREENPORT, N Y. l ! 944 LA ;I Zo -rs Phone 477-04 ~ MaiJl Road GREENPORT, N Y. 11944 /o'- Z" Phone4/?-0400 ~ ~ain Road ' J Il 17.' Phone 4.7~0400