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Home My WebLink About14825-zFORM NO. 4 TOWN OF 5OUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall 5outhold, N.Y. Certificate Of Occupancy No. Z-16056 Date Au.gust 14, 198~ THIS CERTIFIES that the building ONE FAMILY DWELLING WITH ATTACHED GARAGE & · ' ' 3.TT~CHED' DECKS ............................... Location of Property 1090 Latham Lane Orient, New York House No. Street Ham/et Connty Tax Map bio. 1000 Section . ...0.1.5. ..... Block . . . 9.9 .......... Lot ..... 1...6. ......... Subdivision· .M / .o . .L .a .n .d .s . .E .n .d ................. Filed Map No..5.99.9 .... Lot No...6 ........... conforms substantially to the Application for Building Permit heretofore filed in this office dated April 23, 1986 pnrsuant to which Btfilding Permit No. 14825 z dated May 3, I 986 . 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 ......... ONE FAMILY DWELLING WITH ATTACHED GARAGE & ATTACHED DECKS AS APPLIED FOR The certificate is issued to JOSEPH PAVICH ..................... id~,r;e'r,'ld~*~ro~;e~ ..................... of the aforesaid building. Suffolk County Department of Health Approval .... 85 - $ O- 2 I 7 UNDERWRITERS CERTIFICATE NO. N 79321 I PLUMBERS CERTIFICATION DATED: February 20, 1987 Rev. 1/81 Braiding Inspector FORM NO. ~ TOWN OF $OUTHOLD BUILDING DEPART/~ENT TOWN HALL SOUTHOLD, N. Y. BUILDING PER~IT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) 14825 Z Permission is hereby granted to: ..~7~......~.~.....~....~......~... ......... _.~..._.~. ~ ~ ..... ~c~..~. ........ ,o ..... County Tax Map No. 1000 Section ...... .,~,..I.~.. ........ Block ....... ..~....~. ....... Lot No...)...'....~ ............. pursuant to application dated ..~.....~..~ ...................... , 19.~..~.., and approved by the Building Inspector. Building Inspector Rev. 6/30/80 FORM NO. 6 TOWN OF SOUTHOLD Building Department Town Hall ~outhold, N.Y. 11971 APPLICATION FOR CERTIFICATE OF OCCUPANCY Instructions A. This application must be filled in typewriter OR ink, and submitted in duplicate 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 peoperty showing all property lines, streets, buildings and unusual natural or topographic featu res. 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. Fees: Certificate of occupancy $5.00 1. / Certificate of occupancy on pre-existing dwelling / land use 2. 3. Copy of certificate of occupancy $1.00 ~ --Pre-Existing C.O. $15.00 Vacant ~nd ~C.O. $ 5.00 Date .... ~. / ,~7'J~Y .......... New Building ............. Old or Pre-existing Building ............ Vacant Land .... 4~__-,~.; .... Location of Property...~..~...~...~.'~..~k'[ ..... !~. · .~..~')...~ ............... 9g~.~.Q .J~-. ......... House No. Street Ham/et Owner or Owners of Property .. % . .le. . .°:. ...................... County Tax Map No. 1000 Section ..... (, ,c~-. ~ ....Block ....... 7? ...... Lot .... /: ,.~.~ ...... Subdivision. b ,c~: ,~) ,c~, ~ .... ,(~.'~.~_~ ......... Filed Map' No.*~-~, ,~, ~-% ,~..Lot No .... 9, ........ Permit No ........... Date of Permit .......... Applicant ~ .f~...~... ~-¥'Q.~;~p.).N. · · Health Dept. Approval ........................ Labor Dept. Approval ........................ Underwriters Approval ........................ Planning Board Approval ...................... Request for Temporary Certificate ..................... Final Certificate ....................... Fee Submitted $.. ~.)., ....................... v Construction on above described building and permit meets all applicable codes and regulations. ~ Applicant .... ..................... FORM NO. 6 TOWN OF SOUTHOLD 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 aa~ 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 Hea~th 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- lions, 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 pzoperty 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 ACC~.SSORY $I0.00 2. Certificate of occupancy on pre-existing dwelling $ 50.00 3. Copy of certificate of occupancy $ 5.00, over 5 years $]0.00 4.vao nt c.o. 20.00 5.Updatecl C.O. $ 50.00 Date ........................ NewC°nstz~uc~;ion ...... Old or Pre-existing Building ............ Vacant Land ............. Location of Property .................... ........................ House No. i~) Street Hamlet Owner or Owners of Property ....'~..~.~ .~...~..b...'~:.~. ....................................... dl ~.?'-~ County Tax Map No. 1000 Section ..... /.~. ...... Block ...... ..~. ...... Lot .... /.;..~. ....... Subdivision.,. ,~.. ,~, ,/~,. [)~.....~...i?. ........ Filed,Map No ...... Lot No .............. Permit No. I.L{(~ . .~...~.. Date of Permit .......... 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 permit meets all applicable codes and regulations. A p p , ,c a n t . >. '.Z . . . : . . . . . .:. : ,I ..... Rev. 10-10-78 TOWN OF SOUTHOLD OFFICE OF BUILDING INSPECTOR P.O. BOX 728 TOWN HALL $OUTHOLD, N.Y. 11971 TEL. 765-1802 CERTIFICATION Building PerMit No. owner (~iease prin~) (please print~) I certify that the solder used in the water supply s~,stem contains less than 2/10 of 1% lead. ~ - ~plumber's signature) Sworn to before me this 19 ~>~_. otary Public,, / ounty ~JARBARA STEPI~OWSKI f~,~tat~ Public, State of New York No. 4~44752 Qualified in Suffolk County Cemmissio~ Ev4~ires ~'~arch 30, / THE NEW YORK BOARD OF FIRE UNDERWRITERS 100107~L BUREAU OF ELECTRICITY ~--J~ 8S JOHN STREET, NEW YORK, NEW YORK 10038 ..re ~'~=~a~ :L0. 1987 ~pp,ic.,io. No.o. Si,e 4~8~5/a6 N 793211 THIS CERTIFIES THAT only the electrical equipment aa described below aoxJ introduced by the applicant named on the above application number in the premises of Joseph Pavich~ 1090 Latham Lane, Orient, N.Y. in t~ foliowing location~ [] Basement [] I~t FI. Lot [] 2nd FI. Section Block and~ound to be itt compliance with the requiretnents qf this Board. FIXYURE 38 FIXTURES 39 54 4~ DRYRR$ FURNAC~ MOTORS [ FUTURE APPLIANCE FEEDER'. SERVICE DISCONNECT RANGES OTN A PARATUS: ~ 2- GF.C. 1. SPECIAL REC'PT IO, OF S E R ~ETER · 1 X/ i 4/0 2 Smoke Detector Track Lighting 8'-0'~ 4 lites 1-70 watt F~DS 1 6.85 TIME CLOCKS BELL ANT AMPS T~AN$ OVENS DISH WASHERS [ KW ~.MT K,W 3.8 I 1.2 UNIT HEATERS MULTI-OUTLET V SYSTEMS NO. OF FEET ¢ E A W O, NO OF NEUTRALS OF HI.LEG EXHAUST FANS DIMMERS AWG OF NEUTRAL 4/0 Box 215 SO%.lthOld, N.Yl1971 Lt.C~578E ~1. MANA;~R maPer- This certificate must not be altered in any manner; return to the office of the Board if incorrect. Inspectors y be id~nfifled by their credentials. coPY FO~ SUiLm~O PEPA~T~E~T. TH~S COPY O~flE~T~F~CAT~ ~UST~OT ~ ALTERED ~ A~y ~E~ TOWN OF SOUTHOLD OFFICE OF BUILDING INSPECTOR P.O. BOX 728 TOWN HALL $OUTHOLD, N.Y. 11971 T£L. 765-I 802 ~To Whom This May Concern, We are unable to complete your Certificate of Occupancy because.of the following reasons. is not on ~/~L~ No Underwriters Certificate on file. The check is(outdated/Do~t ~n f_~.) No Health Dept. Approval on file. /Z/ No final inspection has been made. An ppllcatlon for Certificate of Occupancy Please contact our office on this matter. Thank you for your cooperation. -Building Permit # ~ 4 ~-c~ Z Building Dept. Io9o ko~ (~R,~ ~.y, ***/~/ No Plumber Solder Certificate on ( all permits ' · involving plumbing being issued after April 1,1984 ) 765-1802 BUILDING DEPT. INSPECTION FOUNDATION 1ST []ROUGH PLBG. FOUNDATION 2ND []INSULATION FRAMING []FINAL REMARKS: BUILDING DEPT. INSPECTION FOUNDATION 1ST [ ] ROUGH PLBG. FOUNDATION 2ND [ ] INSULATION FRAMING [~NAL 765-]L802 BUILDING DF. PT. INSPECTION FOUNDATION 1ST [ ] ROUGH PLBG, £ ] FOUNDATION 2ND [ ] INSULATION [ ] FRAMING /,~ t.~/~] FINAL REMARKS: DATE INSP'-ECTOR ~ 7GS-1802 BUILDING DEPT. INSPECTION FOUNDATION IST [ ] ROUGH PLBG. FOUNDATION 2ND [ ] INSULATION [ ] FRAMING REMARKS: [ ] FINAL DATE , INSPECTOR 7GS-'"802 BUILDING DEPT. INSPECTION /~UNDATION 1ST [ ] ROUGH PLBG. [//] FOUNDATION 2ND [ ] INSUI..ATION [ ] FRAMING [ ] FINAL DATE INSPECTOR .,, FIELD INSPECTION FOUNDATION ~(2~d) ROUGH FRAME & PLUMBING "~TAT E ENERGY CODE ION[L COMMENTS: NEW YORK STATE DEPARTMENT OF ENVIRONMENTAL CONSERVATION PERMIT NO, 10-84~1295 PERMIT UNDER THE ENVIRONMENTAL CONSERVATION LAW ARTICLE 24, (Freshwater Wellands) [~J ARTICLE 36, (Construction in Flood Hazard Areas) PERMIT ISSUED TO Joseph Pavich ADDRESS OF PERMIT]'~ Douglaston, NY 11363 Latham Lane Long Island Sound DESCRIPTION OF PROJECT Construct a single family dwelling, sanitary system and terrace within the pre- scrz e ul ~ng ~6pe approx~ma~l~IS~-~ mean ~ water as per sup- plied plans. Sanitary system is to be located a minimum of 100' from mean ~-f~ water. COMMUNITY NAME (City, Town, Village) Southold DAM NO. COUNTY Suffolk GENERAL t. The permittee shall tile in the office of the appropriate Regional Permit Administrator, a notice of intenlion to commence work at least 48 hours in advance of the time of commencement and shah also notify him promptly in writing of the completion of the work, 2. The permitted work shall be subject to inspection by an authorized ~epiesentative of the Department of Environmental Conservation who may order the work suspended if the public interest so requires. 3. As a condition of the issuance of this permit, the applicant has ac- cepted e×p~essly, by the execution of tbe application, the full legal respon- sibility for all damages, direct or indirect, of whatever nature, and by whom- ever suffered, arising out of the project described herein and has agreed to indemnify and save harmless the State from suits, actions, damages and costs of every name and descripUon resulting from the sa~d project. 4. Any material dredged in the ~osecut~on at the work herein permitted shall be removed evenly, wilhout leaving large refuse piles~ ridges across the bed of the waterway or flood plain or deep hates that may have a tendency to cause injury to navigable channels or to the banks of the waterway. 5. Any material lo be deposited or dumped ~nder this permit, either in the waterway or on shore above high-water ma~k, shaU be deposrted or ~umped at the locality shown on the drawing herein attached, and, if so prescribed thereon, within or behind a ~ood a~d substa~tia~ b~l~hea6 or bulkheads, such as will prevent escape of the material into the waterway. 6. There shall be no unreasonable interference with navigation by the work herein aulhorized. ~. That if future operations by the State of New York require aa aiterat[o~ in the positron of the structure or work herein authorized, or if, in the opinion of the Department of Environmental Conservation it shall ca,se, m~re~sonabIe obstruction to the free navigation of said waters or floC.flows .or endanger the health/ safety or welfare of the ~ople of the State, or loss or destruction of the natural resources of the State, the owner may be ordered by the Depart- ment to remove or alter the structural work, obst[uct[o~s, or hazards caused thereby without expense to the State; and if, upon the expiration or revocation of this permit, the structure~ fill~ excavaUon, or other m~ihcatlon of the watercourse hereby authorized shah not be completed, the owners shaH, without expense to the State, and ~o such extent and in such time and manner as the Department of Environmenta~ Conservation may reqmre~ remove all or any portion of the uncompleted structure or (iH and restore to its former condition the navigable and flood capacity of the watercourse. No claim shall be made against the State of New York on account of any such remova~ or alteration. CONDITIONS g. That the State of New York shall in un case be liable for any damage or iujory to the slructure or work herein authorized which may be caused by or result from future operations undertaken by the State for the conservation or improvement of navigation, or for other purposes, and no claim or right to compensahon shall accrue from any such damage. 9. That if the display of lights and signals on any work hereby authorized is not otherwise provided fat by law, such lights and signals as may be pre- scribed by the United States Coast Guard shall be mstaHed and maintained by a~d at the expense of the owner. 10. AH work carried out under this peimit shah be performed in accor- dance with established engmeering practice and in a workmanlike manner. lt. If granted under Articles 24 or 25, the Department reserves the right to reconsider this approval at any time and after due notice and hearing to continue, rescind or modify thfs permit in such a manner as may be found to be just and equitable. If upon the expiration or revocation of this permit, the modification of the wetland hereby authorized has not been completed, the applicant shall, without expense to the State, and to such extent and in such time and manner as the Department of Environmental Conservation may require, remove all or any portion of the uncompleted structure or fill and restore the site to its former condition. No claim shall he made a§aiust the State of New 12. This permit shall not be construed as conveying to the applicant any right to trespass upon the lands or interfere with the riparian rights of others to perform the permitted work or as author[zing the impairment of any rights, htle or interest in real or personal property held or vested in a person not a party to the permit, 13. The permittee is responsible for obtaining any othe~ permits, apo provals, lands, easements and ri§his-of-way which may be required for this project. 14. If ~ranted under Article 36, this permit is granted solely on the basis of the requirements of Article 36 of the Environmental Conservation Law and Part 500 of 6 NYCRR (Construction in Flood Plain Areas having Spec[a[ EIoo~ Hazards - Building Permits) and in no way si§riffles that the project will be free from flooding. 15. gy acceptance of this permit the permittee agrees that the permit is co,tingent upon strict compliance with the special conditions on the 95-~0-4 (9/75) (SEE REVERSE SIDE) ' S~ECJAL C0NDI~IONS 1. There is to be no disturbance to 50'. of mean high water. the vegetation or topography within SPECIAL CONDITIONS A THROUGH J ATTACHED~ iSSUE 1~/26:/84 ~ER~IT AI~MINI~TRATOR g%lternate]. , · Charles T. F~ilton~, ~l.dg.40,Suny,StonyBrook,NY 11794 'FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N.Y. 11971 TEL,: 765-1802 Examined...%(7).% .~. .... , 19~..~. Approved....~ .~. ..... 19g.(°. Permit No. ) .~.?.&.~...~-.. Disapproved a/c ..................................... ...... (Building Inspector) APPLICATION FOR BUILDING PERMIT BLDG, OEPT, Date .................. , 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 ~t 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 regulations, and to admit authorized inspectors on premises and in building for necessary inspections. ..... (Signature of applicant, or name, if a corporation) ... ~.~. ?...O..~:.w...~4~'~r~..,f. o. ~¢..~..s.o?.r.,/??... (Mailing address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. ....... ........................................................... ¢ ro. Name of owner of premises ..... .~..~.... ~.t. ,.5.~.~ff...../~?. ?../..e .~. ........................................ (as on the thx roll or latest deed) If applicant,s/3 c~orporation,/s,j~gnature of duly authorized officer. ...... ...... ......... (Name and title of corporate officer) Builder's License No .......................... ', Plumber's License No ........... , .............. Electrician's License No ....................... Other Trade's License No ...................... 1. Location of land on which proposed work will b~ done .................................................. House Number Street Hamlet County Tax Map No. 1000 Section ....... /..~i ........ Block ..... ~ ............ Lot .... Subdivision .... .~4~e..~....~-7..a/.~. .......: ......... Filed Map No...c?.~..O. ~. ..... Lot ....~i .......... (Name) 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy {/X4 ~,¢~,, r ~ b. Intended use and occupancy ........ ,w£w ~9~ cc,~o 5= ...... ,3, 10. 11. 12. 13. 14. Nature of. work (gheck which applicable): New Building ... ~ ..... 'Addition .......... Alteration .......... .... ~ ~ Rem val , Demolition Other Work ...... (Description) .?..o ...................... .................................... , ~ (to b~ paid on filing this application) If dwe ~ng, number of dwellmg ~mts. o ~ F~ Number of dwelling units on each floor.. If garage, number of cars ..... ~. · .~P ............................................................ If business, commercial or mixeO occupancy, specify nature and extent of each type of use ..................... D~ensions of existing stmcturqs, if any: Front ............... Rear .............. Depth ............... Height ............... Number of Stories ........................................................ D~ensions of same structure with alterations or additions: Front ................. Rear .................. Depth ................... ~.. HeiSt ......... ~ ............ Number ~f Stories .............. ~ ...... Dimensions of entire new construction: Front ... $.g 7~ ....... Rear .... 6' ~ ~ ...... Depth .... ~ ~:.. g.¢.. Height .... ~ ........ Number of Sto~es .: .~ Size of lot: Front .. Ofl.~... ~ ¢7~ 7~ ....... Rear ...................... Depth ..; ~8~ ............... Date of Purchase ........ '~ ~... ~[~ .......... Name of Fomer Owner ............................. ..... ~ Zone or use district in whmh premises are s~tuated.., ............................................... Does proposed construction violate any zoning law,, ordinance or regulation: ................................ Will lot be regraded ....... ~q .................. Will ex.ss fill be removed from premises: Yes Nme of Owner of premises .................... Address~./ ............... hPhone No..7. ~ ....... Nme of Architect ........................... Address~~ ................ '~Phone No ................ PLOT DIAGRAM Locate clearly and distinctly ali buildings, whether existing or proposed, and, indicate all set-back dimensions from property lines. ~tion according to deed, and show street names and indicate whether interior or corner ~ot. STATE OF NEW YORK, COUNTY OF ........... S.S ........... ............... (N~lme of individttal signing contract) above named. ~ ...... being duly sworn, deposes and says that 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 said work and to make and file this application;that all statements cofitained in this application are true to the best of his knowledge and belief; and that the work will be performed in the mantlet set forth in the application filed therewith. Sworn to before me this .......... day Of ............ Notary Public, ..... : un . KAREN W. BOEROESSON Notary Public, State of lqow Yorl~ ............................. qualifledlqio~ ,1842180 (Signature of applicant) Suffolk County Commis~l?n Expire~ March 80~ 10~'7 Chief OCaUPANC¥ OR USE I~ UNLAWFUL WITHOUT CERTIFICATE OF 0~UPANCY If =°PPer tubing Is used for w~tef distribu~ing -w ! , PLUMBER CERTIFICA T/ON ON LEAD CONTENT EEFORE CERTIFICATE OF OCCUPANCY SOLDER USED IN WATER SUPPLY SYSTEM CANNOT APPROVED AS NOTED FEE: ~/'(' &'~ e¥, V, ¢, NOTIFY' BUILDING DEPARTMENT AT 765-1802 9 AM TO 4 PM FOR, THE FOLLOWING INSPECTIONS: 1 FOUNDATIDN TWO REQUIRED FOR POURED ~ONCRE~'E 2 ROUGH ~;HAMING & PLUMBING [ Ph!,ne 4774}400 , i ¢[.): ,~one 497-0400