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Home My WebLink About14849-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspecter Town Hall Southold, N.Y. Certificate Of Occupancy g-16240 October 2, 1987 No .................. Date ................................. THIS CERTIFIES that the building D E C K AD D I T I 0 N 1025 MIDDLETON ROAD GREENPORT, NEW YORK Location of Property P~s~ ~V'ol ....................... ~/e~t' ....................... County Tax Map No. 1000 Section 040 .Block 05 .Lot 26 Subdivision ............................... Filed Map No ......... Lot No .............. conforms substantially to the Application for Building Permit heretofore filed in this office dated July I, 1986 . pursuant to which Building Permit No. 1/4849 z dated Ju 1 y 9, 1986 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 ......... DECK ADDITION TO EXISTING ONE FAMILY DWELLING The certificate is issued to .... HARRY BONDARCHUK ................. ?o¥.'e;, x .................... of the aforesaid building. Suffolk County Department of Health Approval Iq / A UNDERWRITERS CERTIFICATE NO. Iq/A N/A PLUMBERS CERTIFICATION DATED: Rev. 1/81 ~FORM NO. ~ 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 AUTFIORIZED) Permission is hereby granted to: ~.~.~..~.....~.~....:~ .................... .(2..~~..;..~.:~..:...u..~..~.~ .......... ~. , q..~....-b...~.:.~......~ ..~.' ....~ .............................................................. at premises located at ...J...O...~...,~........~....~,...~.: ...... .~...~ ......... County Tax Map No, 1000 Section ..... .~...~...O,. ...... Block ...... .,(~...~..'~... ..... Lot No ..... ,'"~,.~. ........... Building Inspector. Fee $.~....,~..~ ..... Building Inspector Rev. 6/30/80 FORM NO. 6 TOWN OF SOUTHOLD Building Department Town Hall Southold, N.Y. 11971 765- 1802 APPLICATION FOR CERTIFICATE OF OCCb Instructions A. This application must be filled in typewriter OR ink, and submitted ~ ~ to the Building Inspec- tor with the following; for new buildings or new use: 1. Final survey of property with accurate location of all buildings, property lines, streets, and unusual natural or topographic features. 2. Final approval of Health Dept. of water supply and sewerage disposal-(S-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 Code compliance from the 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~operty showing all property lines, streets, buildings and unusual natural or topographic features. 2. Sworn statement of owner or previous owner as to use, occupancy 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. Certificate of occupancy $25.00 -- BUSINESS $50.00 ACCESSORY $10.00 2. Certificate of occupancy on pre-existing dwelling $ 50.00 3. Copy of certificate of occupancv $ 5/00, over 5 years $10.00 4.Vacant Land C.O. $ 20.00 5.Updated C.O. $ 50.00 Date ~.Z~. .... .% ....... NewCons tz*uct ion ...... Old or Pre-existing Building ............ Vacant Land ............. Location of Property ,~'; .~d/~. ~¢~. ~.~. ...... . .~.~..~2,~E/.~¢,~;~/¢~; ........... Mouse/vo. / ~ Street - ~ (/ Nam/et County Tax Map No. I000 Section ..... ~ ...... Block .... ~L,% ........ Lot ..... '~P~4 ....... Subdivision ................................. Filed Map No ...... Lot No .............. Permit No/~f'~,¢y,, Date of Permit .~-,~?,~¢,7,..Applicant '~~,~~.,~_~,,,, Health Dept, Approval ....................... Labor Dept. Approval ....................... Underwriters Approval ........................ Planning Board Approval ....................... Request for Temporary Certificate ..................... Final Certificate ....................... Fee Submitted $ ............................. Construction on above described building and pcrFfit meets all applicable codes a, pd regulations. Rev. 10-10-78 TOWN OF SOUTHOLD OFFICE OF BUILDING INSPECTOR P.O. BOX 728 TOWN HALL SOUTIIOLD, N.Y. ! 1971 TEL. 765-1802 To Whom This May concern, We are unable to complete your Certificate of Occupancy because 5)f the following reasons. /_--~ An application for Certificate is not on file. / / /2/ /-/ of Occupancy No Underwriters Certificate on file. The check is(outdated/not on No Health Dept. Approval on file. No final inspection has been made. Please contact our office on this matter. Thank you for your cooperation. Building Permit # h.!_ ~ .~ L_~ ~ Z Bui ].ding [)opt. ***/~/ No Plumber Solder C~rtificate on file. ( all permits involving plumbing being issued after April 1,1984 ) Occupancy or use is unlawful without a Certificate of Occupancy. Please clear up this matter so that legal action does not have to he taken. Thank you for your prompt attention. OUNDATION ( 2nd ) IOUGH FRAME & FLUMBING iNSULATION PER N. STATE ENERGY CODE FINAL ADDITIONAL COMMENTS __ . 765-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLBG. FOUNDATION 2ND [ ] IN~ILATION FRAMING [ ~'~FINAL REMARKS: U DATE INSPECTOR 'FORM NO, 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL $OUTHOLD, N.Y. 11971 TEL.: 765-1802 Examined. ..... ,19 Approved....~4~ .~ .... , 19 ~.~. Permit No. Disapproved a/c ..................................... (Building Inspector) APPLICATION FOR BUILDING PERMIT Received ........... ,19... Date ................... 19 ... INSTRUCTIONS a. Tiffs 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 ~nd of buildings on premises, relationship to adjoining premises or public streets t~r areas, and giving a detailed descripll'~L~f__~~,~lil~i~t.of tl,ntq2erty must be drawn on the diagram which is part of this appli- c. The work covered by c mmence efo e 'ssuan e of Building Permit. d. Upon approval o f_t~l~a.~t~a~'~ ~i~nspector will issued a Building Permit to the applicant. Such permit shall be kept on the prCk~'IJ~alv~ili~t~ll~Yn~l~iL~ throughout the work. e. No building t~ b.~p~_ p~%r ~l~n"w_,liL}le or in part for any purpose whatever until a Certificate of Occupancy shall have been gra~1~e'~ld, iq~nL~l~"t~ ~'~ ~ APPLICATION IS~l~L~f~&'~%~'~ilding Department for the issuance of a Building Permit pursuant to the Building Zone Ordinan'~[~'~n~a&~u~hold, Suffolk County, New York, and other applicable Laws, Ordinances or Regulations, for the con~ la~l~gs, additions or alterations, or for removal or demolition, as herein described. The applicant agrees to co'~x~p1~?~'~fll applicable laws, ordinances, building code, housing code, and.regulations, and to admit authorized inspectors o~emises and in building for necessary~~~ ~/~~// . · ~i~ f applicant, or name, ifa corporation) ' (Mailing address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. '" ~ ................ : '/ ........... ) ..... ~ ..... )f' '? ............. '.~;~0 Name of owner of premises ~ ~. ~.~~ ....... · · m.x.~ ....~/~ ~..~ ¢ .~..] ~ ~.~ / -- (as on the tax roll or lat~s~e~) If applicant is a corporation, signature of duly authorized officer. ~65-1~2 g.~ rO * P~ ~R THE Builder's License No .......................... 2 ~UGH 3. I~ULATION Plmnber's License No ......................... 4. ~NAL BE COM~E FOR C.O Electrician's License No ....................... ALL ~NS~U~N T~ ~QUI~TS ~ ~E N.Y Other Trade's License No ...................... ~A~ CONS~U~ON & ~GY ~. NOT ]. ~1~ OR C~S~CTION ~RORS. Location of land on which proppsed work will be done ................................................... House Number Street Hamlet ~o~*a~ ~ No. ~000 S~c~ion ..... .¢~ ........ ~in~k...~ ........... ~ot..~ ~ ......... 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. ~.t~d~ ~ and o~upancv ........~ .... ~ .... ,.'/f? f:~,~:.1(~}:~ ......... 3. Nath~e ofwor~ (check whi¢~ ~ppIlcable): New Building .......... Addition .......... Alteration .......... Repair ........ :.. .... Rb'~0vhl ...... Demolition ........... Other Work ............... 4.E 'stlmated' Cost., [.~,..~577. '.'.!. ~! ............. ........... Fee . .~..'....~..~ .......................... ~i '~ (to be paid on filing 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 mixed occupancy , specify nature and extent of each type of use ..................... 7. Dimensions of existing structures,lif any: Front ............... Rear .............. Depth ............... Height ............... Number of Stories ........................................................ Dimensions'of same structure wit~ alterations or additions: Front ................. Rear .................. Depth 'Height Number of Stories 8. Dimensions of entire new construdtion: Front .......... . ..... Rear ............... Depth ............... Height . .............. Numb?r of Stories ........................................................ 9 Size of lot: Front ' Rear Depth 10. Date of Purchase ............ ~ ................ Name of Former Owner ............................. 11 Z d' ' ' wh'hp " ' ted · one or use lstmct in lc remlses are sltua ................... 12. Does proposed construction violatb any zoning law ordinance or regulation: 13. Will lot be regraded .......... ? ....... . .......... Will excess fill be removed from premises: Yes No 14 Nmne of Owner of premises ' Address Phone No Nmne of Architect ........... i ............... Address ................... Phone No ................ Name of Contractor ' Address : Phone No 15. Is this property located within 300 feet of a tidal wetland? *Yes ..... No ..... *lf yes, Southold Town Trustees Permit may be required. PLOT DIAGRA~ Locate clearly and distinctly all buildings, whether property lines. Give street and block number or descri!c interior or corner lot. all set-back dimensions from and indicate whether ;TATE OF NEW YORK, JOUNTY OF ................ s.S .............................., . . , . I' ......... ......... being duly sworn, deposes and says that he is the applicant (Name of individual signing contract) hove named. te is the ......................................................................................... i (Contractor, agent, corporate officer, etc.) ,f said owner or owners, and is duly authorized to perform or have performed the said work and to make and file this pplicatkm; that all statements contained in this application are true to the best of his knowledge and belief; and that the ~ork will be performed in the manner set forth in the application filed therewith. .worn to before me this ................ ]. ...... day of..i...~ ........... 19~.~ ,~otaryPublic, ....~.'.~...//J~.-g?.~/~. Count~ ./// ~1~{~ ~,,..)~ (Signature of applicant)