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Home My WebLink About27207-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No: Z-27627 Date: 04/18/01 THIS CERTIFIBS tb~t the building R3d4P Location of Property: 390 GILLETTE DR EAST MARION (HOUSE NO.) (STREET) (HAMLET) County Tax Map No. 473889 Section 38 Block 2 Lot 4 Subdivision Filed Map No. __ Lot No. __ conforms substantially to the Application for Building Permit heretofore filed in this office dated APRIL 3, 2001 pursuant to which Building Permit No. 27207-Z dated APRIL 3, 2001 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 RAMP ADDITION TO EXISTING ONE FAMILY DWELLING AS APPLIED FOR. ~ne certificate is issued to LEO LE¥INE & ANO. (OWNER) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF ~ALTH APPROVAL ELECTRICAL CERTIFICATE NO. PLUMBERS CERTIFICATION DATED Rev. 1/81 N/A N/A N/A Authoriz~ S~gnature FORM NO. 3 TOWN OF SOUTHOLD BUILDING DEPARTMENT Town Hall Southold, N.Y. BUILDING PERMIT {THIS PERMIT MUST BE KEPT ON THE PREMISES LrNTIL FULL COMPLETION OF THE WORK AUTHORIZED) PERMIT NO. 27207 Z Date APRIL 3, 2001 Permission is hereby granted to: LEO I & ANO LEVINE PO BOX 246 EAST MARION,NY 11939 for : CONSTRUCTION OF A P~AMP AS APPLIED FOR at premises located at County Tax Map No. 473889 Section 038 pursuant to application dated APRIL Building Inspector. 390 GILLETTE DR EAST MARION Block 0002 Lot No. 004 3, 2001 and approved by the Fee $ 75.00 Authori ~Sign~re Rev. 2/19/98 ORIGINAL Form No. 6 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL 765-1802 4?? ~ APPLICATION FOR CERTIFICATE OF OCCUPANCY This application must be filled in by typewriter OR ink and submitted to the building inspector with the following: 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 oh Fire Underwriters. 4. Sworn statement from plumber certifying that the solder used in system contains less than 2/10 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. B. 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 , unusual natural or topographic features. 2. A properly completed application and a consent to inspect signed by the applicant. If a Certificate of Occupancy is denied, the Building Inspector shall state the reasons therefor in writing to the applicant. C. Fees 1. Certificate of Occupancy - 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 of Occupancy on Pre-existing Butldin~ - $100.00 3. Copy of Certificate of Occupancy - , .25~ 4. Updated Certificate of Occupancy - $50.00 5. Temporary Certificate of Occupancy - Residential $15.00, Commercial $15.00 Date ....................................... Location of Property ........... House No. Street Hamlet Onwer or O~ers of Property...~.~. .... ~.~.~ .................................................. cou t 000, .... ..... ............. su~tvi~to~ ~6.~ ;~ .................... Filed Map ..... .. .....Lot ...................... ~m~t ~o ............. ~at~ o~ ~t .... A~t.~.. ~.~.~KO.~A~.' ..... ~t~ ~t. A~ova~ ....~.~ ................ ~te~ A~row~. Planning Board Approval..~ ................ Request for: Temporary Certificate ........... Final Certicate.. ~ ..... ................ 765-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLBG. [ ]FOUNDATION 2ND [ ] INSULATION [ ]FRAMING ~_~]~F! NAL [ ] FIREPLACE & CHIMNEY FIELD INsP-ECTION REPORT ' DATE L,' COI~ENTS FOU~ATION (IST) II II II *o~a~o~ (2~) ......... ~ .... ROU~ FRAM~ & PLIn~IBIN~ INSULATION PER N. Y. STATE ENERGY CODE , su,~'~. ~o: ~PT-~" H~AL't'~ ,e~V:,tc~ ' ' .,; ~~~"' ' ' .... :' '"- ' '"' ,:.,,,~ ~ .... FOR APPROVAL ~ ~U~ ONLY - ' ~' W~ ' '~ ' ' ' ' , "'.-, ,,' ....... " ~uw~n uv o,ov~tr~u,.u BUILDING DEPARTMENT TOWN HALL SOUTHOLD, NY 11971 TEL: 765-1802 Examined ~,' .~ ,20 O[ Approved .20 Of ! Disapproved PERMIT NO. ~'7~'O 7 ~ Do you have or need the following, before applying Board of Health 3 sets of Building Plans Survey Check Septic Form N.Y.S.D.E.C. Trustees Contact: Mailto: ~b~}~.~ ~Ze.*,'R~J~'6~ ~ Building ~spector Phone: C]77- Z-c~&5~ APPLICATION FOR BUILDING PERMIT INSTRUCTIONS Date~ 3 ,200 ] / a. This application MUST be completely filled in By/ypewriter or in ink and submitted to the Building Inspector with 3 sets o,,f 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 area&, and waterways. c. The work covered by this application may not be commenced before issuance of Building Permit. d. Upon approval of this application, the Building Ins3ector will issue a Building Permit to the applicant. Such a permit shall be kept on the premises available for inspection throughogt'the work. e. No building shall be occupied or used in whole or in part for any purpose what-so-ever until a Certificate of Occupan ~s issued by the Build!ng Inspector. OCCUPANCY OR USE IS UNLAWFUL APPLICATION IS HEREBY MADE to the BuildiBgDepartment for the issuance cfa Building Permit pursuant to the Building Zone Ordinance of the Town of Southold, SuffolkCounty, 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 coinply 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 appli~h~ or name, if a corporation) ·" (Mailing address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder WITHOUT CERTIFICATE OF OCCUPANCY Name of owner ofpi'emises /~ d- 0 Lc tx i -'..-' e (as ..,on the tax roll or latest If applicant is a corporation, signature of duly authorized officer (Name and title of corporate officer) Builders License No. ~ ~- ~' cd ~' Plumbers License No. Electricians License No. Other Trade's License No. 1. Location of land on which proposed work will b~ done: FOR POURED CONCR~E 2. ROUGH - FRAMING & PLUMBING [ INSULATION · FINAL - CONSTRUCTION MUST BE COMPLETE FOR C.O, ALL CONSTRUCTION SHALl MEET THE REQUIREMENTS OF THE~N.Y. STATE CONSTRUCTIO~:~ ENERGY CODES. NOT RESPONSIBLE FOR D~R CONSTRUCTION ERRORS House Number Street Hamlet County Tax Map No. 1000 Subdivision (Name) Section ~ ~5' ' Block '~- ~I ~-~ t/~ Filed Map No. Lot Lot State existing use and occupancl a. Existing use and occupar b. Intended use and occupm of premises and intended use and occupancy of proposed construction: Fee Nature of work (check which apl .~ Repair Removal Estimated Cos[. ~ G--oo ~!~ o if dwelling, number of dwell,ng ~mts If garage, number of cars_ I Addition Other Work .cy 5 dicable): New Building Demolition Alteration ~ A' "~'(D/9 escription) (to be paid on filing this application) Number of dwelling units on each floor If business, commercial or mixec~ occupancy, specify nature and extent of each type of use. lmens~ons ofex~stmg structure~ if any: Front '7 ~- Rear '7 2. I Height, [ ¢- r .~umber of S{orie~ / Dimensions of same structur{ with alterations or additions: Front Depth Rear Depth_ iHeight Dimensions of entire new construct,on: Front Height i Number of Stories Size of lot: Front / O O 'i Rear I O o t 0. Date of Purchase i ) / 2- ~ / 7 7 Name of Former Owner 1, Zone or use district in which premises are situated jr~ - 2. Does proposed construction viol{re any zoning law, ordinance 3. Will lot be re-graded '/t'"iO Number of Stories Rear Depth Depth 6. Provide survey, to scale, with ac< 7. If elevation at any point on prope TATE OF NEW YORK) SS: ;OUNTY OF ) C-/O or regulation: Will excess fill be removed from premises: YES NO 4. NamesofOwnerofpremisesL¢O I..¢t/l~. AddressSq°~'{t'letTC ¢& PhoneNo. q7'7- IO~ 3 Name of ~chitect i Address Phone No NameofContractor ~1~ ~e~l&o~/x,, Addresslooo~o,~ O~ PhoneNo. ~7 7 ' %q~ ~ 5. Is this propeay within 100 feet ora tidal wetland7 *YES .... ~::~ .... ~ · · YES, SOUTHOLE TRUSTEES PS'ITS MaY urate foundation plan and p pe~}~,~ ~ =.~ ~y is at 10 feet or below, must provide topo~aphical data on suwey, being duly sworn, deposes and says that (s)he is the applicant ,~me=o£dm ~/-~ ~'h~l~g~'i't'rg"erm ~ ~ t ) 'ab o ve named, [':.' ~". ¢' ¢': (ConOa~t6},Agent, Co~orateOffioer, eto.) f s~d'!O~8r oi o~ers;' ahd is duly authorized to perfom or have perfomed the said work ~d to make and file this application; ~at all statements c6n{ained in this application are ~e to the best of his ~owledge and belief', and that the work will be erf~ed"n the man,dr set fo~h inthe '~ppbcatmn' filed therewith. 4~'/~' ~Signature o~f A~~ KlM, T. DZENKOWSKI HOME IMPROVEMENT 1000 CEDAR DRIVE · EAsT MARION, NEW YORK [1939 - PHONE 477-2465