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Home My WebLink About14512-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. Certificate Of Occupancy No. Z34365 Date Jan. 37 .................................................. 19 86 THIS CERTIFIES that the building ....... fi. c. 9.e.s.s. 9 FY ............................... Location of Property .. .... 5..SQ..B.u..ri.n.y....L.a.n.e. ............... New Suffolk rtouse NO, Street ..................... h3r~/el County Tax Map No, 1000 Section . . .1.1.7. ...... Block ....0.6. ......... Lot ...... 2. .9 ......... Subdivision ............................... Filed Map No ......... Lot No .............. conforms substantially to the Application for Building Permit heretofore filed in this office dated · .D.~ c....~fi ........... , 19.8.5. pursuant to which Building Permit No..1.4.5. ! .2.Z .............. dated ...J.a..n..1.7. .................. 198..6., 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 ......... · .Ac ca.~s or¥..she.d ............................................................... The certificate is issued to .... EEL~X .F ,. ~S.¢/~ g.T.QG .H.~..g.N.. D...F.~ .t.t.g .~.~.S...~... SWIATOCHA (owner, ~ tt't'~ff x of the aforesaid building· Suffolk County Department of Health Approval N / ~ . UNDERWRITERS CERTIFICATE NO ................ ~./. g .............................. Rev. 1/81 Building Inspector FOR~ NO. ~ TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N. Y. BUILDING PER~IT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) ~T.o 14512 Z Permission is herebt granted to: ....~.~~.....~.,..~.:..~.!a.~ .... ~t premises located at ....~....~. .............. ~... ..~0.. ............. ......................................................... County Ta× Map No, lO00 Section ........ .I.!3. ......... Block ........ ..O...I.~ ...... Lot No ..... ..a...~ ............. pursuant tO application dated .....~"~..~..~T-~..~..~ .................. , 19..~...~..~', and approved by the Building Inspector. Building Inspector Rev. 6/30/80 FORM NO. 6 TOWN OF SOUTHOLD Building Department Town Hall Southold, N.Y. 11971 APPLICATION FOR CERTIFICATE OF OCCUPANCY Instructions 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. 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. Fees: 1. Certificate of occupancy $5.00 2. Certificate of occupancy on pre-existing dwelling 3. Copy of certificate of occupancy $1.00 4.Vacant Land C.O. $5.00 $15.00 ' Date December 26, 1985 ·. o'~ ...... Vacant Land ............. New Building ..... Mi ...... Old or Pre-existing Building Location of Property ............ Bu[zm¥. [.a[te ........... ~e~. Suffolk ......... House No. Street Hamlet Owner or Owners of Property . ?.~.~. ~.X..~: .~.~[..A..T~..~.A..a~.d..F..R~..C.~.S..A;..S.W~A .r~. U~. ............... County Tax Map No. 1000 Section ...1.1.7. ......... Block ....6 ........... Lot .... ~9 .......... Subdivision ................................. Filed Map No ........... Lot No .............. Frances A. Swiatocha Permit No ........... Date of Permit .......... Applicant .................................. Health Dept. Approval ........................ Labor Dept. Approval ........................ Underwriters Approval ........................ Planning Board Approval ...................... Request for Temporary Certificate ..................... Final Certificate ..... ~ ................. Fee Submitted $ ..... .5,00 .................... Construction on above described building and permit meets all applicalple codes and regulations. Applicant . . . ........... Frances A. Swiatocha $f3f 734-5100 AREA CODE 516 December 26, 1985 Southold Town Building Department Att: Helen Town Hall Main Road Southold, N.Y. 11971 Re: (no #) Bunny Lane, New Suffolk Owner: Frances A. Swiatocha Dear Sirs: Relative to the above captioned, enclosed please find application for building permit and certificate of occupancy, together with my check in the sum of $31.00 to cover the cost of same and a copy of the existing certificate of occupancy for said premises. Thank you for your giving this matter your prompt attention and reply. Very truly yours, CRON AND CRON, ESQS. James J. Cron Enclosures P.S. Also enclosed is photocopy of survey of the subject premises. FIELD INSPECTION FOUNDATION (1st) FOUNDATION (2nd) COMMENTS ROUGH FRAME & PLUMBING INSULATION PER N. STATE ENERGY CODE Ye FINAL ADDITIONAL COMMENTS: 0 'OOI ~ .,00.6-~' .c~ 'hi . ~ NVq ' FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N.Y. 11971 TEL.: 765-1B0~ Examined .~..c~.,.~ ~4~.~ P.., 19~. ~ Approved Disapproved a/c ..................................... (Bu~ffg Inspector) ~PP~IC~TIO~ FOR BHIk~I~G ?E~MIT INSTRUCTIONS a. This application must be completely filled in by typewriter or in ink and submitted to the Building InspectoL 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- catinn. 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 regulations, and to admit authorized inspectors on premises and in building for necessary inspections. /] ~ (Signature of applicant, or name, if a corporation) (Mailing address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. FELIX F. SWIATOCHA and FRANCES A. SWIATOCHA, his wife Name of owner of premises .......................................................................... (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 .......................... Plumber's License No ......................... Electrician's License No ....................... Other Trade's License No ...................... 1. Location of land on which proposed work will be done .................................................. .... ~ . .-~..~..~ .... BunBy' .B.a.n.e. . ~e.w. ~.Llf. f.o.l,k ...................... House Number Street Hamlet County Tax Map No. 1000 Section .... 1.1.7. ........... Block .... 6. ............. Lot...29. ............ Subdivision ................ (~q'a~) ................ Filed Map No ............... Lot ............... 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy .Residence... ...... .. ............................ b. Intended use and occupancy .. Tool Shed 3. a licable): New Building ..... ' ..... ddition .......... Alteratiol;. ,., ...... l~ephl,r ...'.'.~'. ........ Rem~oval .............. Demolition ............. OtherTiY,~kX.. ~oMS~.~hed.. t' ~¢I ~I~'S 0Ill ~ -.~ (Description) 4. Estimated Cost ....... ,asQi( a .......................Fee ............................... t ~ ............ } r' '; ~. ~ ~' (to be paid on filing this application) 5. I~.~twa~It~b~r.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, if any: Front ............... Rear .............. Depth ............... Height ............... Number of Stories ........................................................ Dimensions of same structure With alterations or additions: Front ................. Rear .................. Depth ................... ... Height ...................... Number of Stories ...................... '" 8. Dimensions of entire new construction: Front . .9: .x .8~ ~. ..... Rear ............... Depth ............... Height ............... Number of Stones ............................................................. 9. Size of lot: Front ].QQ'.! Rear lC)~.84' Depth . .a. ppr. qx.-. 200' 10. Date of Purchase .. ~J!~;I.y. 7J. ;%9.69 ............... Name of Former Owner .B.r.e.n.t..8....B.r.a.n.O.e.~..&..C.t.a.r.a..a.e.a.n 11. Zone or use district in which premises are situated. "h" Residential Br..andes, his .w. ife 12. Does proposed construction viqlate any zoning law, ordinance or regulation: No. 13. Will lot be regraded ........ i .................... Will excess fill be removed from premises: Yes No fp ' 14. Name of Owner o remises .. .................. Address ................... Phone No ................ Name of Architect ......... : .................. Address ................... Phone No ................ Name of Cent to i Addre Fha No rac r ...... .................. ss ................... ne ................ PLOT DIAGRAM Locate clearly and distinctly all buildings, whether existing or proposed, and, indicate all set-back dimensions from property lines. Give street and bloc] interior or corner lot. : number or description according to deed, and show street names and indicate whether STATE OF NEW YORK, COUNTY OF....S.U.P?.O.~.K ...... S.S .............. ~b~q~I3$. ~:. ~,~C..H.At .............. being duly sworn, deposes and says that he is the applicant. (Name of individual signing contract) above named. SHe is the ....... oxmor ............................................................................. (Contractor, agent, corporate officer, etc.) xq{fx~igx~w~a~x~x~ and is duly authorized to perform or have performed the said 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 man,er set forth in the application filed therewith. Swam to before me this .......... 2151;h. ......... day 9f .... Docsmber, ........ ,19 85. Notary Public,~. ........... -'~ ii' ' ' guf folk ........... County ~ ~ ,NOTARY PUBL[C, State ~ Ney/York Frances A. Swiatocha (Signature of applicant) I No. 52-4665418, Suffolk Couin[Yff,~-