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29610-Z
FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY NO: Z-29625 Date: 08/06/03 THIS CERTIFIES that the building ADDITION Location of Property: 1300 MINNEHAHA BLVD SOUTHOLD (HOUSE NO. ) (STREET) (HAMLET) County Tax Map No. 473889 Section 87 Block 2 Lot 11 Subdivision Filed Map No. Lot NO_ conforms substantially to the Application for Building Permit heretofore filed in this office dated JULY 28, 2003 pursuant to which Building Permit No. 29610-Z dated JULY 28, 2003 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 AN EXISTING ONE FAMILY DWELLING AS APPLIED FOR. The certificate is issued to JOHN C & KATHY CHESKA (OWNER) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A ELECTRICAL CERTIFICATE NO. N/A PLUMBERS CERTIFICATION DATED N/A L Authorized Signatur Rev. 1/81 FORM NO. 3 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 AUTHORIZED) PERMIT NO. 29610 Z Date JULY 28 , 2003 Permission is hereby granted to : JOHN C & KATHY CHESKA 161 88TH STREEET BROOKLYN,NY 11209 for REPLACE EXISTING DECK ADDITION WITH NEW DECK AS APPLIED FOR, THIS PERMIT REPLACES BP#16231 . at premises located at 1300 MINNEHAHA BLVD SOUTHOLD County Tax Map No_ 473889 Section 087 Block 0002 Lot No. 011 pursuant to application dated JULY 28 , 2003 and approved by the Building Inspector to expire on JANUARY 28 , 2005 . Fee $ 150 . 00 Authorized Signature COPY Rev. 5/8/02 FORM N0. 2 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 AUTHORIZED) N° 16231 Z Date ..........1. �..1.. .............. 1al Permission is hereby granted to: .moi.:). .... ..�.�-�:....G.�..c......... Lf ..1...-..7.,z�....�, .h .......tom. .. --..... ;y. 1 x.9..7.L........ to .. a...---- .;4AA . �...i* 2 A .. ... ... ................ at premises located at .. .......... .. a.. ...................................! ..... 1.. ..../.. ..... ..............................................................................................I.............. County Tax Map No. 1000 Section .......0A-)....... Block .....o. Lot No. ......0..�ti pursuant to application dated .......... .�5t !�.L0.................... 19 ..I., and approved by the Building Inspector. ` Fee /... . . .. ............. Bu ding Inspector Rev. 6/30/80 ' ic� 5 lgdo Form No.6 TOWN OF SOUTHOLD FJ BUILDING DEPARTMENT TOWN HALL - 6 (1 765-1802 APPLICATION FOR CERTIFICATE OF OCCUPANCY This application must be filled in by typewriter or ink and submitted to the Building Department with the following: A. For new building 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 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 certifying that the solder used in system contains less than 2110 of 1% lead. 5. Commercial building, industrial building, multiple residences and similar buildings and installations, a certificate of Code Compliance from architect or engineer responsible for the building. 6. Submit Planning Board Approval of completed site plan requirements. 11. For existing buildings (prior 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 amusual natural or topographic features. 2. A properly completed application and consent to inspect signed by the applicant. 11'a Certificate of Occupancy is dUMCd, the 13111](11111 Inspector shall state the rca.sons therefor in writing to the applicant. C. Fees L Certificate of Occupancv- New dwelling $25.00, Additions to dwelling$25.00, Alterations to dwelling $25.00, Swimming pool $25.00, Accessory building $25.00, Additions to accessory building $25.00, Businesses $50.00. 2. Certificate OfOccupancy on Prc-existing Building - $100.00 3. Copy of Certificate of Occupancy -$25 4. Updated Certificate oCOccupancy - $50.00 5. Temporary Certificate of Occupancy - Residential $15.00, Conunacial $15.00 New Constriction: Old or Pre-existing Building (check tie) Iocationoi'Property: (?b� M(P9/���,t�l� t3G-,(�� -50 03 House No. Strect Hamlet Owner or Owners ofProperty: IztLo —, • *- Suffolk -Suffolk County Tax Map No 1000, Section dg Block c) 2- I-ot p i 1 Subdivision Filed Map. Lot: Permit No. 2--7610 _Date of Permit. 7 2___P/03 Applicant: :ofi*)e- , -tIK f, e1w�K 4 Health Dept. Approval: Underwriters Approval: Planming Board Approval: Request for: Temporary Certificate Final Certificate: (check one) Fee Submitted: $ Appliea r ignature 765-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION 1ST [ I ROUGH PLBG. ( J FOUNDATION 2ND ( ] INSULATION [ ] FRAMING ( FINAL REMARKS: -12 DATE INSPECTOR s M-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION IST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] INS ION [ ] FRAMING FINAL [ ] FIREPLACE HI NEY REMARKS: C"z_o ` DATE �� INSPECTO a J3 3 U;JDATION _ ( 1st ) pu c UNDATIO;J ( 2nd ) z o UGH FRAME & PLUMBING " ti d1 SULATION PER N . Y. yT STATE ENERGY CODE x H FINAL i ADDITIONAL COMMENTS : m X" x P tq x H (Y� a -1 H H Z L m a H a x c7 m H BOARD OF HEALTH . . . . . . 3 SETS OF ANS . . . . . . . FORM NO. 1 SURVEY . TOWN OF SfTHOLD CHECK BUILDING DEPARTMENT SEPTIC FORM . . . . . . . . • . - TOWN HALL NOTIFY SOUTHOLD, N.Y. 11971 CALL • • • • - • - TEL.: 765-1802 MAIL TO : :amined 19g 7 a-���� •'' rpj proved . . xn ••( �S 19V3 Permit No./&.. . . . . . . sapproved a/c . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . JL 111 low . . . . --•�. . . . . . d (Building Inspector) BLDG1 EPT. TOWN OF SOUTHOLD APPLICATION FOR BUILDING PERMIT Date . .',/. . . . . . . . . . .. 19�� INSTRUCTIONS a. This application must be completely filled in by typewriter or in ink and submitted to the Building Inspector, with 3 s 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 areas, and giving a detailed description of layout of property must be drawn on the diagram which is part of this appli- cion. c. The work covered by this application may not be commenced before issuance of Building Permit. A. Upon approval of this application,the Building Inspector will issued a Building Permit to the applicant. Such permit ill 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 ill 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 gilding Zone Ordinance of the Town of Southold, Suffolk County, New York, and other applicable Laws,Ordinances or .gulations, for the construction of buildings, additions or alterations, or for removal or demolition, as herein described. ie applicant agrees to comply with all applicable laws, ordinances, building code, housing code, and regulations, and to mit authorized inspectors on premises and in building for necessary inspections. . . . . .`f��!!�.�. .�.::`:tit:. . . . . . . . . . . . . . . . . . . . . . (Signature of applicant, or name, if a corporation) (Mailing address of applicant) ate whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. I'me . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ame of owner of premises 4/ (/. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . (as on the tax roll or latest deed) applicant is a corporation, signature of duly authorized officer. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . (Name and title of corporate officer) ALL CONTRACTOR' S MUST BE S FFOLK COUNTY LICENSED Builder's License No. 130 5Y • •## . . . . . . . . . . . Plumber's License No. . . . . . . . . . . . . . . . . . . . . . . . . Electrician's License No. Other Trade's License No. . . . . . . . . . . . . . . . . . . . . . 411 Location of land on which proposed work will be�done. . . . . . . . . . . . . . . r_� • • • • • • • • • . /- J ftu . . . . . . . . . . �/J W..4 P?. . �!� . . ,-X/,c- 114.lYN. . . �L" r/fj. . . . . . . . . . . . . . . . . . . . . . . . . . . . House Number Street Hamlet County Tax Map No. 1000 Section . . . . e.7: . . . . . . . . . Block . . . . . ?�. . . . . . . Lot,, . . .U. r . . . . . . . . . . Subdivision .&U!''!I/!�J/�<�.�}"�1�. � � +S . . . . 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 b. Intended use and occupancy . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ilk - - �. ature bf wont (check which applicable): New Building , , , . ., AdditiOR , , , , , , Altorati©n . . . . . . . Repair . . . . . . . . . . . . . . 'Removal . . . . . . . . . . . Demolition . . . . . . . . Other Work . . . . . . . . . . . . . . (Descrjpxion) 4. Estimated Cost . . . . �. . .e cT . . . . . . . . . . . . . . . . . . . . . . Fee dt�. . . . . . . . . . . . . . . . . . . . . . . . . ` (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,if any: Front . . . . . . . . . . . . . . . Rear . . . . . . . . . . Depth. . . . .. . . . . . . . . Height . . . . . . . . . . . . . . . Number of Stories . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. . . . . . . ... . . . . . . . . Dimensions of same structure with alterations or additions: Front . . . . . . . . . . . . . . . . . Rear . . . . . . . . . . . . . . . . . . Depth . . . . . . . . . . . . . . . . . . . . . . Height . . . . . . . . . . . . . . . . . . . . . . Number of Stories . . . . . . . . . . . . . . . . . . . . S. Dimensions o1 a re new construction: Front . . . . . . . . . . . . . . Rear . . . . . . . . . . . . . . . Depth . . . . . . . . . . . . . . . Height . . .1.{. . .I ..AX. Number of Stories . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .,. . . . . . . . . . . . . . 9. Size of lot: Front . . . . / U . . . .S - . . . . . . . . . Rear . . .!.5 . .°. . . . . . . . . . . . . Depth . . a. .6. . . . . . . . . . . . . . . 10. Date of Purchase . . . ./ . . . . . . . . . . . . . . . . . . . . . . . . Name of Former Owner . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11. Zone or use district in which premises are situated . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 12. Does proposed construction violate any zoning law, ordinance or regulation: . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 13. Will lot be regraded . . . . . . %1.0 . . . . . . . . . . Will excess fill be removed from premises: Yes No 14. Name of Owner of premises & /S. .(��- A! 4<'4. . Address . . . . . .Phone No. . . . . . . . . . . . . . . . Name of Architect . . . . . . . . . . . . . . . . . . . . . . . . . . . Address . . . . . . . . . . . . . . . . . . . Phone No. . . . . . . . . . . . . . Name of Contractor . . . . . . . . . . . . . . . . . . .. . . . . . . Address . . . . .. . . . . . . . . . . . . . .Phone No. . . . . . . . . . . . . 15. Is this property located within 300 feet of a tidal wetland? *Yes . . . . . No 1�. . *If yes, Southold Town Trustees Permit ma be required. PLO DIAGRAM Locate clearly and distinctly all buildings, whether existing or proposed, and.indicate all set-back dimensions from -3roperty lines. Give street and block number or description according to deed, and show street names and indicate whether nterior or corner lot. i ;TATE OF NEW YORK, S.S .OUNTY OF . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . being duly sworn, deposes and says that he is the applicant (Name of individual signing contract) -bove named. T e is the . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . (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 -pplication; that all statements contained in this application are true to the best of his knowledge and belief;and that the vork will be performed in the manner set forth in the application filed therewith. worn to before me This . . . . . . . . . . . . . . 0. . . . .day of. . . . . . . . . . . . ... 19U. lotary Public, . .I . .ham . K: . . . . . County . . . . . . . . . . . . . . K (Signature of applicant) NW&PUBLIC,Sots d Nw Mork , NL 'Is�`c* �RDR PRIET N/ 0 F , RICH) S PRIETO ' , Ln yr to o Prepared in accordance with the minimum 4 fc s �� ` to W siondards for title surveys as establish p95ed by o E 101. 20 _ the L.I.A.L.S. and approved and adopted o.z3for such use by The New York State Land 51jec;6 065 40 800 57,p0��l_ _r ,-- - �,u.r R1 N �A Title Association. D q �, o �y O - O 30 3 at e ?� O C O C s �" r-In z res w�14 --1r Z � 2 � z C = 15' T Ot o z :J 30"3 - m n hoil D �1 qK5_ I z o'' 9Qr w ;" z few 40 SURVEY FOR "�' W ANTHONY CRACCHIOLA � 80 ° '�3RY LQ ' 30W ae jOHN L aEL S $AR f LN N/o � F ISAKATHY CRACCHIOLA I,�' �.'E. AT SOUTHOLD t. MErzcyO�1r SWAM WAY TOWN OF SOUTHOLD ° W SUFFOLK COUNTY, N.Y 1000 - 087 — 02 - Oil CER71F►EO TO : SCALE : 1 ° 20 ' -� COMMONWEALTH LAND � OCT. 4, 1.985 N . r TITLE INSURANCE COMPANY FD N. Y, S. LIC. N0. 49618 TITLE NO . 487 - 601 - S PECON EYORS & ENGINEERS , P. C. ANTHONY CRACCHIOLA (516 ) 765 - 5020 KATHY CRACCHIOLA 540RFF c4nttu engin jl. V I ' I I OCCUPANCY OR USE IS UNLAWFUL --- To --r°' or `�' "'� 1iTH0UT CERTiFiCATE L' OF OCCUPANCY I i II?r •,� '3"9FY IS�!.^`-.li�h"� 13f c�rGr'[T4�F 9 AT [�H Y6NE l Yl u. ^t_LIV'.;NPING MUSI tPaltM IV�e 1. �r. 7.V 'Y - ) ; Ffr•F�i! `J I 1_J -ti I Y `J CI I I l .�..al... i^ y , s rv '• q. * y ± ,TAIL- Off HAMl KAII--