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Home My WebLink About15227-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No Z-20709 Date MAY 8~ 1992 THIS CERTIFIES that the building. ADDITION Location of Property 910 VANSTON ROAD CUTCHOGUEr N.Y. House No. Street Hamlet County Tax Map No. 1000 Section 104 Block 12 Lot 10.2 Subdivision Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore f~led ~n this off~ce dated AUGUST 13r 1986 pursuant to which Building Permit No. 15227-Z dated SEPTEMBER 3r 1986 was mssued, and conforms to all of the requirements of the applicable provlslons of the law. The occupancy for which this certificate is issued is DECK ADDITION TO AN EXISTING ONE FAMILY D~ATuLING AS APPLIED FOR The certificate is issued to (owners) of the aforesaid building. SUFFOLKCOUNTY DEPARTMENT OF HEALTH APPROVAL N/A UNDERWRITERS CERTIFICATE NO. N/A PLUMBERS CERTIFICATION DATED N/A DANIEL & LINDA SAItNOWSKI Rev. 1/81 ~ulldlng Inspector lt'OeM' NO. O TOV/N OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N. ¥. BUILDING PEI~,4 IT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) 15227 Permission ts hereby granted to: ..-~. ~.~..~._..~.~.~ ..~......C,.'~...?..~,.~.. ~ .....?...,~,.~.. ~.~~~ .... ~.:..~.,....~,~ ~~..~~...~...~ ...~. ~...~...~.....~. ............ =_...........' , .................. ~, p,,~,,e, ,~te~ ,, ...9 .............. ~_~ .. ~ ........ ~~~ ............... pursuant to appl,cat,on dotecl~.~&'~4~ '~ /4~,~'~'' l.~ Bu,ldlng Inspector. J 3. Lot No. ..., 19.~ (~, grid approved by the Fee $ ~)' / Building Inspector Rev 6/30/BO Form No. 6 TOWN OF SOUTHOLD BUILDING DEPARTMENT 765-1802 APPLICATION FOR CERTIFICATE OF OCCUPANCY This application must be filled in by typewriter OR ink and submitted to the building inspector with the following: for new building or new use: 1. Final survey of property with accurate locatmon of all buildings, property lines, streets, and unusual natural or topographic features. 2. Final Approval from Health 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 certifylng that the solder used in system contains less than 2/10 of 1% lead. 5. Commercial building, industrial building, multiple reszdences and similar bumldings and installations, a certzficate of Code Compliance from architect or engineer responsible for the building. 6. Submit Planning Board Approval of completed site plan requirements. For existing buildings (prmor to April 9, 1957) non-conforming uses, or buildings and "pre-existing" land uses: 1. Accurate survey of property showing all property lines, streets, building and unusual natural or topographic features. 2. A properly completed application and a consent to znspect signed by the applicant. If a Certificate of Occupancy is denied, the Buildmng Inspector shall state the reasons therefor in writmng to the applicant. C. Fees i. Certificate of Occupancy - New dwelling $25.00, Additions to dwellmng $25.00, Alterations to dwelling $25.00, Swimming pool $25.00, Accessory bumlding $25.00, Additions to accessory building $25.00. Businesses $50.00. 2. Certifzcate of Occupancy on Pre-existing Buzldmng - $i00.00 3. Copy of Certificate of Occupancy - $5.00 over 5 years - $10.00 4. Updated Certificate of Occupancy - $50.00 5. Temporary Certificate of Occupancy - Residential $15.O0, Commercial $15.00 Date ~1~ .......... New Construction ...... ~. Old Or Pre-existmng Building ........... Location of Prope;t;i.,..~.'.~.....~.,.~?~...-C~.....~.'~?,..~... ] .... ] 7~.~--.~?.-~-...~-. ..... House No. Street Hamlet Onwer or Owners of Property. .~rS.....~. .... ~'~'?..'~.... ~... ~...~..,?.'~'~ ..... County Tax Map No i000, Section.../.~..~. .... Block..../..~-f ........ Lot. /. .~.% .............. Subdivision ............................... ... .. Filed Map ............ Lot .................... .. Permit No /..~"..~..~', 7 ~ . Of Applicant ......... ~,.~.,ua[e Permit ..................................... ... . ... . Health Dept. Approval.......... ............... . Underwrmters Approval ....................... .o Planning Board Approval ........................ Request for: Temporary Certificate ........... F~nal Certlcate ........... FIELD INSFECTION DATE COMMENTS FOUNDATION (1st) FOUNDATION (2nd) 2. ROUGH FRAME & PLUMBING INSULATION PER N. Y. STATE ENERGY CODE FINAL ADDITIONAL COMMENTS: DANtl TOWN OF SOUTI/OLD OFFICE OF BUILDING INSPECTOR P.O. BOX 728 TOWN }[ALL SOUTItOLD, N.Y. 11971 A~gust 9, 1990 Daniel & Linda Sarnowski P.O. Box 23 Cutchogue, N.Y. 11935 TEL. 765-1802 To Whom This May Co¢cern, We are unable to complete your Certificate of Occupancy because of the following reasons. /--/~/An application for Certificate of Occupancy is not on file. (ENCLOSED) /~///No Underwrzters Certificate on file. /Z/ The check ls(~xRaK~/not on file.) $25.00 /5/ No llealth Dept. Approval on file. /5/ No f~nal Inspection has been made. Please contact our offmce on this matter. Thank you for your cooperation. Dui]ding Permi~ ~ I 5 2 2 7 Z Duilding Dept. ***/5/ No Plumber Solder Certificate on file. ( all permits involving plumbing being issued after April 1,1984 ) FORM NO 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL $OUTHOLD, N.Y 11971. TEL.: 765-1802, Examined .~'~-~.&..%. , 19~ Approved ~'~r ,}.~x~.'~ Disapproved a/c .......... (Biuldmg Inspector) APPLICATION FOR BUILDING PERMIT ..... . Date .................. 19... INSTRUCTIONS a Tlus apphcatlon must be completely filled ~n 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, relatmnshlp to adjoining premises or pubhc street~ or areas, and g~wng a detailed descriptmn of layout of property must be drawn on the dmgram which ~s part of th~s apph. cation. ¢. The work covered by flus application may not be cominenced before issuance of Building Permit d. Upon approval of tins application, the Bmldmg Inspector wilt 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 m whole or in part for any purpose whatever until a Certificate of Occupancy shall have been granted by the Braiding Inspector APPLICATION IS HEREBY MADE to the Bmtdmg Department for the msuance of a Bmld~ng Permit pursuant to the Burring Zone Ordinance of the Town of Southold, Suffolk County, New York, and other applicable Laws, Ordinances o, Regulations, for the construction of bmldmgs, addmons or alterations, or for removal or demohtlon, as herein described The applicant agrees to comply with all applicable laws, ordinances, building code, housing code, and regulations, and to admit authorized inspectors on premises and m budding for necessary ~n~spections ,-, (Signature of apphcant, or name, if a corporation) · ?...9 (Maihng address of apphcant) ~ [. ~.o[-~ State whether apphcant ts owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or bmlder Nameofownerofprcmmes '~.-.%e~..9 . ~.. L~¢'~.~Px-...~.~,r ~x.<>..,-~.~L3- ......... t. (as on the tax roll or latest deed) If apphcant ~s a corpomtmn, s~gnature of duly authorized officer (Name and t~tle of corporate officer) Braider's License No. ~ ...... Plumber's License No .......... EIectrlc~an's License No Other Trade's License No ....... Location of land on which proposed work will be done...C~ IQ)....~. 15~'T~O.....x~ O~.~ ....... Itouse Number Street Hamlet County Tax Map No lO00Sect,on [0 ~. Block .... [~ .... Lot...~.t.~ .~. Subd~vis~on ....... Fred Map No ....... Lot ........... (N'a~ne) 2. State existing use and occupancy of premmes and intended use and occupancy of proposed construction. a. Existing usc and occupancy . ', o~, ...... .t ~ ~ .......... b. Intended use and occupancy ............. ~ ........ --..../(...O.~..~. 3. Nature of work (check which applicable) New Bufldmg . . . Addition./. ~.~C-.r[(~Alteration .. Repmr ........ ~/,Removal ......... Demoht~on .... Other Work .......... ~ , (Descnptmn) ....... ............ 4 Estimated Cost 5. If dwelhng, number of dwelhng umts .. ~.~... Number of dwelhng umts on each floor ...... If garage, number of c~s .................................... 6 If bus~ness, commercml or m~xed occupancy, specify oalure and extent of each t~pe of use ...... ~ ....... 7. D~mens~onsofexmingst~ctures,~fany Front .~.l ..... Rear .. ~ ...... Depth .~ .... Height .... ~.~ .~ .. Number of Stones . ~.~ ~ D~ens~onsofsamest~cturew~thalteratmnsoradd~t~ons Fron~ .' ~'.[~''~i;'~ ....... Depth ................... He~t ....... ... ·:: ..... Number of Stones ......... ~ ~ · i ...... 8 D~mensmnsofent~rene~const~ctmn:Front .... ~ . . Rear ..%~ ........ Depth ~ ....... Height . .~O-- Number of Stones ~ ~ ...... , · S,ze oflg;: ~;g~t..&~' .{D~t. ..... R~ar ........ ~{.~'''. ~'b~tl;.' mt ofV : as . . sam orFo= Ow r .. Zone or use d~stfiet m which premmes are s~tuated .............................. Does proposed construetmn wolate any zomng law, ord,nance or Wall lot be regraded '~dob;' ~ ....... -' Will ex~ess fill be removed from prenuses Yes N N~e of Owner of premises . .~.~~ Address qtO ...... ~ v~. rhone l~o ~.h% v .~.k~.~ Name of Arclntect ..................... Address ............ Phone No .......... N~e of Contractor ................... Addre~ ............ Phone No ............. 9 10 !I 12. 13 14 15. Is this property located within 300 feet of a tidal wetland? *Ye~ *If yes, Southold Town Trustees Permzt maybe required. PLOT DIAGRAM Locate clearly and dmtmctly all buildings, whether existing or proposed, and,~nd~cate all set-back dunenslons fro~ oroperty hnes. G~ve street and block number or descnpt,on according to deed, and show street names and mdmate whethc ntenor or corner lot. iTATE OF NEW YORK, S.S 'OUNTY OF ........... (Name of individual signing contract) ~bove named· being duly sworn, deposes and says that he is the apphca~ le Is the (Contractor, agent, corporate officer, etc ) d' smd owner or owners, and is duly authorized to perform or have performed the said work and to make and file tt~ q>phcatmn, that all statements contained tn this application are true to the best of ins knowledge and belief, and that tt york will be performed in the manner set forth in the application filed therewith ~wom to before me thru ~.x.s,.~ ......... (S~gnature of apphca~