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HomeMy WebLinkAbout14975-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. Certificate Of Occupancy Z-15752 May 13, 1987 No .................. Date ................................ , Addition to existing one family dwelling THIS CERTIFIES that the building . .~. ~'e'~rhl't' 'Jrh&h'fffi d' 't'd ' ih'c'l'dd~' 'd~bk'. ....... Location of Property ...5.0..~..u.~.l. Pond Lane Greenport, New York House No. ' .................. 'S'deJi ....................... hJ~3iol County Tax Map No. 1000 Section 035 .Block 03 .Lot 004 Subdivision ............................... Filed Map No ......... Lot No .............. conforms substantially to the Application for Building Permit heretofore filed in this office dated June 5, 1986 14975Z ....................... pursuant to which Building Permit No ...................... June ]1, 1986 dated ............................ 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 ... ADDITION TO EXISTING ONE FAMILY DWELLING & DECK ADDITION AS APPLIED FOR. STANLEY F. SKREZEC, JR. The certificate is issued to ..................... [o'~'n'dr,~'i4,~X'~I?~F¢ ...................... of the aforesaid building. Suffolk County Department of Health Approval N/A N/A UNDERWRITERS CERTIFICATE NO .................................................. N/A PLUMBERS CERTIFICATION DATED: : ' '~' '~Bu~ector Rev. 1/81 FOE~ NO. 0 TOWN OF SOUTHOLD BUILDING DEPARTA4EJ4T TOWN HALL SOUTHOLD, N. Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) N.o 14~7~ Z Permission is hereby granted to: ..... ...... .~...~..~_....~?..~.~.,.z./~.~.~ ..... ..... .~~~o~......-..~......~..../.z:? ~ ~ r0 .... ~.,~5, ~ ~..... ~.o.~.zL~..o~........~o......~'$ zS.~...~... ~ .~G..(/..~ ......... I ........................................................................................................... ~'. ~:..e--~y.~.~.T....-..~. ._~ Lot No.....0..0....~.. County Tax Map No, 1000 Section ...1~..~.. .. Block ...;0..~.......~._ pursuant to application dated ........... .~./~(~-.....~ .............. , I~...'~...., and approved by the .Building Inspector. Fee $...~,.(~ .......... / Building Inspector Rev. 6/30/80 FOUNDATION FIELD INSPECTI~q ~ DATE COMMENTS (1st) FOUNDATION (2nd) ROUGH FRAME & PLUMBING Y. ~_,. ., ~:>~..:.,-~,., _.__%_ ~/~/ ~ ~ , . ±,.__,.__., ADDITIONAL COMMENTS: INSULATION PER N. STATE ENERGY C,ODE TOWN OF $OU/ttOLD OFFICE OF BUILDING INSPECTOR P.O. BOX 728 TOWN HALL $OUTHOLD, N.Y. 11971 TEL. 765-1802 To Whom This May Concern, We are unable to complete your Certificate of Occupancy because ,of the following reasons. /~ An application for Certificate of Occupancy is not on file. _~/_ No Underwriters Certificate on file. /5/ The check is(outdated/not on file.) /5/ No Health Dept. Approval on file. /5/ No final inspection has been made. Please contact our office on this matter. Thank you for your cooperation. _Building Permit # ~ .2~ _~._~ ~_."~g (/g~ ¥ ~LT?) Building Dept. ***/5/ No Plumber Solder Certificate on file. ( all permits involving plumbing being issued after April 1,1984 ) 76S-1802 BUILDING DEPT. INSPECTION [~FOUNDATION ~.ST [ ] ROUGH PLBO. [~FOUNDATION 2ND [ ] INSULATION [ ] FRAMING [ ] FINAL DATE 76S-1802 '~ BUILDING DEPT. INSPECTION FOUNDATION 1ST [ ] ROUGH PLBG. FOUNDATION 2ND [ ] INSULATION FRAMING ~NAL DATE '¥/// THE NEW YORK BOARD OF FIRE UNDERWRITERS 1001093 E~UREAU OF ELECTRICITY ~--~.~ 85 JOHN STREET, NEW YORK, NEW YORK 10038 ~.~ ~ay o~. ~9~ ~w~,,o.~o.o.~,~ ~/oo N 807522 THIS CERTIFIES THAT S~a~y Skrezec, Gull PO~ Lane#50, Green~o~t, [~Y in theyollowlng location; ~ B~,ement ~ Ist ~7. ~ 2nd Fl. Section Bilk Lot ,ril 27, 1937 FIXTURE OUTLETS FIXTURES RANGES OVENS EXHAUST FANS DRYERS OTHER APPARATUS: 1-G.E.I. T~ack lighting: 8 f~et E R V t NO, OF CC, COND. C E OF NEUTRAL Gary Doroekt 425 Monsell Lane Cucchogue, NY 11935 ~ GENERAL MANAGER Per *'<J~/ t ...... 11 This certificate must not be altered in any manner; return to the office of the Board if incorrect. Inspectors may be identif;ed by their credentlafs. COPY FOR B~ILDING DEPARTMENT. THIS COPY OF CERIIF;CA!.E MUST~I0,T BE, ALTERED IN ANY MANNER. FORM NO. 6 TOWN OF $OUTHOLD Building Department Town Hall $outhold, N.Y. 11971 765 - 1802 APPLICATION FOR CERTIFICATE OF OCCUPANCY 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 $]0.00 2. Certificate of occupancy on pre-existing dwelling $ 50. O 0 3. Copy of certificate of occupancy $ 5.'00, over 5 years $I0.O0 4.Vacant Land C.O. $ 20.00 5.Updated C.O. $ 50.00 Date .......................... NewC°nstruction ...... Old or Pre-existing Bu,.qdjng ,O .......... Vacant Land ............... ©3: ...'L~. County Tax Mep No. 1000 Section .......... o. .... Block ......... Lot Subdivision.: · · ' .F,ed Map No. ~.. ;/.7'..Lot No ........ ._.¢~ Permit No, /.~..~.~./..~, Date of Permit .......... Applicant ~../~ <-; ;'. HeaKh Dept. Approval ........................ Labor Dept. Approval ........................ Underwriters Approval........................ Planning Board Approval ...................... Request for Temporary Certificate .................. _....Final'Certificate ....................... Fee Submitted $ ....................... .~/ ~ Construction o n above described building ~i~_r~L,t, meets adZ~nd r,e.~u lations'~-'~ Rev. 10-10-78 FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL EOUTHOLD, N,Y, 11971 TEL,: 765-1802 Examined .Y~'Zt~'.~7.../. (..., 19~.. ..... l .Pe itNo.. Disapproved a/c ......... . . .~-~.../i/.. ~..f~ ........ APPLICATION FOR BU~LD~NG PERNIlT Received ........... ,19... INSTRUCTIONS a. This 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 lot and of buildings on premises, relationship to adjoining premises or public streets or areas, and giving a detailed description of layout of property must be drawn on the diagram which is part of this appli- cation. c. The work covered by this application may not be commenced before issuance of Building Permit· d. Upon approval of this application, the Building Inspector will 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 in whole or in part for any purpose whatever until a Certificate of Occupancy shall have been granted by the Building Inspector. APPLICATION IS HEREBY MADE to the Building Department for the issuance of a Building Permit pursuant to the Building Zone Ordinance of the Town of Southold, Suffolk County, New York, and other applicable Laws, Ordinances or Regulations, for the construction of buildings, additions or alterations, or for removal or demolition, as herein described. The applicant agrees to comply with all applicable laws, ordinances, building code, housing code, and re,$ulations, and to admit authorized inspectors on premises and in building for necessary inspe ~. (Signature of apFIicant, or n~am~e, if jlgcorpora"fion) ... .............. State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, pmmoer or builder. (as on the tax roll or latest deed) If applicant is a corporation, signature of duly authorized officer. (Name and title of corporate officer) Builder's License No ....... '.~4. ....... Plumber's License No ....... ~ ......... Electrician's License No ....................... Other Trade's License No ...................... House Number Street Hamlet ~ County Tax Map No. 1000 Section .... O.~.~.. ...... Block ...... ~.. ......... Lot .... '~...7:.'. Subdivision ..................................... Filed Map No ............... Lot ............... (Name) State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy ...... ./.~/ ..... '.~.r--t..~. ~~ ............................... b Intended use and occu anc ~ ~. ~'/~ ~ 2~5~,(' · : P Y ............ ''7 ...... 't' ......................................... 3. Nature of work (check which applicable): New Building .......... Addition..., ...... Alteration ..... Repair .............. l~moval ............ .. Demolition ............ i' Other Work ........ ' ....... ~ % i (Description) I .(re be. p.ald, on filing this appli~tion) 5. If dwelling, number of dwelling units ............... Number of dwelhng units :on each floor ...... !. ........ If garage, number 6'f cars ' 6. If business, commercial or mixed occupancy, specify nature and extent of each typei of use ..................... f if I pth 7. Dimensions o existing structures, any: Front ............... Rear ........ : ...... De ............... Height Number of Stories Dimensions of same structure with alterations or additions: Front i . Rear Depth ...................... Height ...................... Number of S,tories ...................... 8. Dimensions of entire new construction: Front ............... Rear ......... i ...... Depth ............... Height .............. , Numl~er of Stories ........................... 10. Date of Purchase . 1 1. Zone or use district in,yin'ch preffiises are situated ............ ~ ...................... 12. Does proposed construction violate any zoning law, ordinance or regulation: ..... i ................ '~' ....... 13. Will lot be regraded ...... . .~_ ~-J ........... ~ ...... '¢~ill exc_ess fill be removed ifrom premises: ~ No Name of Architect ........................... Address ................ i. · · Phone No ................ Name of Contractor .......................... Address ................ ;... Phone No ................ 15. Is this property located within t.00 feet of a tidal wetland? * Y'es ..... No . .~-~'?.. · If yes, Southold Town Trustees Permit may be required. PLOT DIAGRAM Locate clearly and distinctly all buildings, whether existing or proposed, and~ ind!cate all set-back dimensions from property lines. Give street and block number or description according to deed, and showlstreet names and indicate whether interior or corner lot. STATE OF NEW YORK,r, · .'--}. ~'/'~ fl,/.,,f..~' .~. -.~. ~..) ./.C'..~ .~..,~.~'.~. ................. being duly sworn, deposes and says that (NOme oi~ individual signing contract) . : above named· he is the applicant He is the ' (Contractor, agent, corporate officer, etc.): of said owner or owners, and is duly authorized to perform or have performed the s~id work and to make and file this application; that all statements contained in this application are true to the best of his knowledge and belief; and that the work will be performed in the manner set forth in the application filed therewith· Sworn to before ~m,.~s4"Z /~___ ..... ,../~-.'(~.../..~.~...fl..day of. ! . .~./.'~-- .W~..'~.. ..... rW 19~.~ ~ ~ NotaryP ............... o .~/-; ~ 5/ , (,,...FO u ~ D/h7 ~ ~ ',,q, --¢L.,,~ N, , ....... LiX/ INi,~, c -F. o ¢r'1 , 'NOTED 9 · i. is used j~: copper tub g [or water distributing system; piping sba~l be 0ftypes,~K orL only ~XC~~ LDING ,~: 765.1802 9.,AM FOLLOWING ,INSPECTIONS', L~.' FOUMDATION; ' FOR POORED' CONGRETE 2. ROUGH" FRAM~ING 5~ INSULATION"' ,4. FINAL :' BE CQM~E:TE ~LL CONSTRUCTION: '[HE REQU, STATE CONSTRUGT ON CODES, NO]' DESIGN' Ol