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Home My WebLink About25189-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No: Z-26038 Date: 10/19/98 THIS CERTIFIES that the building ADDITION Location of Property: 4640 NEW SUFFOLK RD NEW SUFFOLK (HOUSE NO.) (STREET) (HAMLET) County Tax Hap No. 473889 Section 110 Block 8 Lot 25 Subdivision Filed Map No. __ Lot NO. __ conforms substantially to the Application for Building Permit heretofore filed in this office dated AUGUST 17, 1998 pursuant to which Building Permit No. 25189-Z dated OCTOBER 8, 1998 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 & BAY WINDOW INSTALLATION TO EXISTING ONE FAMILY DWELLING AS APPLIED FOR "AS BUILT" The certificate is issued to THOMAS A & MAUREEN NOVAK (OWNER) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL ELECTRICAL CERTIFICATE NO. PLUMBERS CERTIFICATION DATED N/A N/A N/A Rev. i/8i 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. 25189 Z Date OCTOBER 8, 1998 Permission is hereby granted to: THOMAS A NOVAK & WF PO BOX 296 NEW SUFFOLK~NY 11956 for : AS BUILT DECK ADDITION AND BAY WINDOW INSTALLATION TO CODE FOR A SINGLE FAMILY DWELLING AS APPLIED FOR. at premises located at County Tax Map No. 473889 Section 110 pursuant to application dated AUGUST Building Inspector. 4640 NEW SUFFOLK RD Block 17 1998 NEW SUFFOLK 0008 Lot No. 025 and approved by the Fee $ 75.00 VBUilding Inspect~ ORIGINAL Rev. 2/19/98 Form No. 6 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL 765-1802 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 of 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. For existing buildings (prior to April 9, 1957) non-conforming uses, or buildings and Vpre-existing" land uses: 1. Accurate survey of property showing ail 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 wziting to the applicant. 1. Certificate of Occupancy - New dwelling $25.00, Additions to dwelling ~ Alterations to dwelling $25.00, Swimming pool $25.00, Accessory buildi~g-~$~5~00, Additions to accessory building $25.00. Businesses $50.00. 2. Certificate of Occupancy on Pre-existin~ Buildin~ - $i00.00 3. Copy of Certificate of Occupancy - 4. Updated Certificate of Occupancy - $50.00 5. Temporary Certificate of Occupancy - Residential $15.00, Commercial $15.00 Date . New Construction ........... Old Or Pre-exist~ng Buildin~. ~..i .... 3. ~ ~ ~ , ~/ __~ Onwer or Owners of Property....~.~f~?.~.-~...~.....~.~....~..0..~...~,~/. ........... County 1000, ection..Xl.O.. ..... ......... .... ", ....... Subdivision ............................... i~' ' .Filed Map ...... ~.. ~..Lot~ ..... ~ ~ ...... ;.' ....... Permit No...~..~./g.?~ .Date Of Permit Z~.. ~.~.~-...Applican~- .~...~O.V~:~ ..... Health Dept. Approval .... ~,~.~ .............. Underwriters Approval...~./~..[ .............. Planning Board Approval....~.~./~ ............. . Request for: Temporary Certificate ........... Final Certicate...'~ ~OUNDATION (lst) FOUNDATION 2. (2nd) ROUGH FRAME & .PLUMBING' I~SULATION PER N. STATE ENERGY CODE COMMgNTE 'FINAL ADDITIONAL TS: 765-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLBG. [ ] FOUNDATION2ND [ ] INS/ULATION [ ]FRAMING [/.~*FINAL ~//~:.~_c..~/~ [ ] FIREPLACE & CHIMNEY REMARKS: DATE /~/-~//~ IllSTRUCTIOR8 a. 'Ibis application mu~C be ¢onpletel¥ filled in by LT~riter or in ink ~1 ~uhmitted to tim l~dlding Inspector 3 sacs o~ plar~,, accurate plot plan to ~ale. F~ according to ~hedule. b. Plot plan st~tng locattcm o1~ lot and o1~ buildings on l~¢adaa, r~lattoe~dp to adjoining praises or streets or areas, and giving a d~tailed de~rtpCt~ o1~ laying o[ pro~rty mint ~ dr~ ~ tim titian ddd~ la ~rt of d. U~ a~al of fids a~l.t~cia~, tim l~lldt~ lns~ctor ~tli is~ a ~ildi~ ~mlt to Om applier, e. ~ ~ildi~ ~mll ~ ~pi~ or ~ tn ~la or in ~rC ~r ~ ~ ~mC~er ~ttl a ~rtilicate ~H,l~'rt~ IS ~ ~ to tl~ lkdldl~ ~rtmnt for ~ ia~a o~ n ~tldl~ ~mlt ~r~t to ~laCi~s, Lot tl~ ~t~Ct~ o~ h~ildt~, ~ltt~s or alCeraci~, or for r~al or ~llti~, a State d~d~r a~ticant ts ~er, lea~. ~ent, 'ard~it~t, cagier,' get--rat c~tr~or, el~trict~, pl~r or IxHl.<le .................... x...~.~.*~ ........ ~ ..................... ~ ......... :'v ....................... 'o;Z ...... .... .......................... (~ ~ tl~ C~ mit or lo~e~C d~) l~ a~Aican~ i8 a co.ratio, si~re of duly ~tl~ri~;.of~ic~[:,,,,,..,,, , .... ~,,; , APPROVED AS N~ED ......................................................... (~ .~ tttt~ o~ ~0,~ om~O OCCUPANCY OR DATE: ~ ~:~ ' USE IS UNLAWFUL FEe N~IFY BUILDING DE~T ~,n~. ~,~~ .......................... WlTHO~T CERTIFICATE 765-1802 9 AM ~ 4 ~ F~ THE 1 FOUNDATION .,~0 REQUlRE~ ~-~-~ L~ce~ ~ ..................... ~ FOR ~URED CONCR~ ......... 2 R GH--~ I & ~ BING ~ ~ ~ BE COMPL~E FOR C.O. .......... 8 r~t T~BEO . . r t~r t ~,~0 ~* 00 - ~ ~O~T~CTION & ENERGY ~l7 Tax~p ~, I~ ~Cl~ ,,~,,~,,~,,, Bl.~k ,~ ........... t~c '~O~E~:'~' RESPONSIBLE FOR ~ivisim ...................................... ~t ]~ ~p ~ ......... :,... priSON. 9~.~9~¢n°~ ERRORS (~) 74m ............... ..................... b, ln[e~ [m a~ ~ .............. . ............ r-- . 3. ~',Li,re (d?~uo/r~ (d,~Jt ~lilch a~[l~bla)t ~ ~ll~ln8 ........ ,. ~ltl~ .~ ..... Alteration ....... ' .... ...'... ' ' ~ru j .......... ~'t .............. 13. ~il[ lot I~ **.,..,,,** ..... ~ ........ , ............. .,.. .............................. .__. ............. ~.~ ,* ~**~**,, ..}/-~.~.~.~ ............ ,u,,, ..... J.~ ................ ,**, ............. I~. t, thin p~rty ~lBfln ~ ~t;o~ n ~t~l ~tln~? * ~J .......... ~ ..~ ..... . (C~tractqr, n~tent~co~porn~e of, l~ee~, etc.) ...... 4 J~,.,~ ~,~ ....... ?x,~..~ .... ' NOt~fy PUb o, ~tmte ~ NewYo~ . No, (7917~ Qu~Jl[Io~ in Suffolk Coun~ SLOG, TOWN 0~: FORM NO. TOWN OF SOUTIIoLD SOUTIIOLO, H.Y. Tgi,: 765-1802 BOARD OF UgALTll .....~ ~ ..... SURVIIY ....... , ................. c,,,c, .............. SEPTIC I~ Olllt ................... NOT1FY '. GALL .................. MAIl, TO: ................. : · - INSTRUCTIONS a. 'lids application ~ust be conpletely filled in by t~p~riter or in Ink taxi m~lxal'tted to the Ik, ilding Inspector w 3 sets o~ plans, accurate plot plan to scale. Fee according to ~:l~lule. b. Plot plan ~ho~ing location al' lot and of buildings on preni~es, relatio~hip to adjoining premises or pti)lit streets or areas, anti $iving a detailed deacriptto~ oi~ layont oF property mist be drtm~n on tim diagran ddcl* la part of lids application. c. 'lhe ~rk covered by this application ~ay no~ be cmroenced be~or~ tssuanca oi ltoildlng Permit. d. Upon epptx~al of ~J)im application, the Ik~ilding Inspector will issue a Buildir~ Pemtt to tim applicant. ,tk~ch pemit al)all be.bepC on Om premises available For inspection throat;out tim ~rk, e. blo boildlng sim11 be occupied or treed in ~hole or in part for any parpo.se ;imtever until a Certificate Oc~.,pancy shall Imve been granted by the lkdldiug Inspector. /WPLICATI~ IS D~[~iII~ ~ ~;o the {}uildln8 Department for Cite iasuauce of a liullding Pemit parsuan~ to the Ikiildiu§ Zooe Ordinance of the l'o~ o[ 8o~lthold, ~uifolk Ccamty, ~ York, and ocimr applicable I,a~a, Ordt~mncee or ~gulatio~s, for ~be construction of hflldi~s, additions or alterations, or fo~ r~ovsl .or .~o.liti.on, as.berein. re~flattoos. ,a~xl to ad. it ~oChorized inspectors on pram, sea and in bulldi~/~/r/nec~F~7 (Stgm~ture of applicant, or oa~e. t~ ~ corporal{on) ..... ....................... (Hailing address o~ applicant) . · / (as on the tax roll or latest deed) If apph Ip~a~ure of duly au~l~)r~z~! ~..: (l~k~re and title o~ corporate officer) Ik~ilders l,icer~e No .......................... Pltrabers License Iqo .................. · . .--- -- '-. Electricians loicerme Ho ...................... 0tier ~a'. U~e.~ Ho ..................... LO+ 15 V4~ q-'e, .g.q..c. I. location of land on ~hich prolx)sed ~ork will be dooe ................. . ......................... ~'~ .......... ...... t. &0 ................................................ ............... .. Ilonse Nu~er Street ilar. et .... ..... l.oc ....(.o. ......... ,.o,: ~ f~---~ -*/'/~ '. ' . ri,- ~.~ Ho ......... :, ..... l~t ...... i,~ ..... 2. State existing use and occupancy o[ premises and intendc~ ~se a~ oco~nc~' of proposal camtn~ction; ~. I~m,.e of ~ork (d~J~ ~lilch apptie, bteh ~ ~iJdi~l ...... ~l~i~ .......... I~lmir ............ ~t ......... ' ....I~1 ttl~ ......... O~her (to ~ Did ~m ~llh~.tlH~ ~l~llca~) ' if flarafle, ~.~tmr of ~ra ......... .... 7, I)i.~n, lo~a of ~t.~in8 atnm~s, 1~ any: ~C ................ ~ar ............... ~pitt ................. ~.~ ~ '~o~, ~ ...l~.~.~ .... ~ .... ILo..~ ..... ~,,,, ..~.0.:.~.... ,,. ~. o~ .. ~... ~. ~.~, ~.~...~.,~ ............................. ~ ........................... 12. ~ propel ~1~ ~ a~ ~lnB 1~, ordl~m~ or re~ulaCl~ .... ~,, ~,~ ............. 13. ~111 lo~ I~ r~r~ ~ ..... ~ .... ~ill ~eaa ~111 Im r~ 14, ~a of ~r o~ i,vo.l~a~[/ ....... , .................. ~kl~e~o .............................. · ~ of C~r~or ................................... &~re~a ............................... I~m~ ~ ............. 15, la ll~la p~r~y vithln ~ f~.oE:a ~tl~l ~t~a~? * ~ .......... ~ ,~ ....... I*I,OT D~AOR~H, t~a~e ctearl~ ~ di~l~tl~ all ~tldi~a, ~mr ~la~ln~ or pro~, Pr~ prol~rty tl~a. Gi~ a[~[ ~ bl~ ~ml~r or ~ncrlpCf~ acco~ln~ ~o ~, n~ ~ ~rreet ~s n~l t~licaCa ~dmt[mr ].~erior or co~r 5'IWIE (X~ FI','M Y(X~K, ·, , /5 ,SS .............. ................ I~in/l duly ~rt}. delx)~ etxl ~y8 LImC Im J8 the appl.ltmnl: (~ o~ ilxlivi~h~l, eignl,8 c~ract) o~ sn~d (~r or ~r~. m~l ia (ktty ~Ll~rJ~ ~o i~onn or h~me l~rfl)rf*~l the ~[d ~k al~H [cn[ic~; Lime a.t[ eCate~,t8 c~[a[~ in [hie nlq)ticatim~ are tn~ ~o the t~c o~ thoL th~ ~rk ,itt I~ ~r~o~l i~ d~ ,~m~r ~t forth in the n~l. lc~d(~ [[l.~ ....... z .......... ,,,,,,,, ....// / ' NOIa~ Publio, Stata of ~ew York / ~'.~ (/f No. 4951364 Quell'lied In ~uff,,~k ~ounty.~ ~ Commission Expires M~,/ 22, ~ , /_~ ~/ ~ ~~