HomeMy WebLinkAbout24122-zFORM NO. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Office of the Building Inspector
Town Hall
Southold, N.Y.
CERTIFICATE OF OCCUPANCY
No: Z-25746
Date: 05/28/98
THIS CERTIFIES that the building ADDITION
Location of Property: 1895 ALDRICH LA LAUREL
(HOUSE NO.) (STREET) (HAMLET)
County Tax Map No. 473889 Section 125 Block 2 Lot 1.18
Subdivision Filed Map No. __ Lot No. __
conforms substantially to the Application for Building Permit heretofore
filed in this office dated APRIL 25, 1997 pursuant to which
Building Permit No. 24122-Z dated MAY 13, 1997
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 A ONE FAMILY DWELLING AS APPLIED FOR.
The certificate is issued to FRANK & DOREEN KRUPSKI
(OWNER)
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL
ELECTRICAL CERTIFICATE NO.
PLUMBERS CERTIFICATION DATED
Rev. 1/81
N/A
N/A
uilding Inspec~r
IPOP~M NO. ~
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN HALL
$OUTHOLD, N. Y.
BUILDING PERMIT
(THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL
COMPLETION OF THE WORK AUTHORIZED)
N.o 2q122 Z
to application dated ...... ~..~...~... ............. , 19Z.././.., *nd approved by the
pursuant
Building Inspector.
Building I '~'"t~
Rev. 6/30/80
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 UndeCwriters.
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
"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.
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 Buildin~ - $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 $15.00
Date ..
onstruction........... Old Or Pre-existing ~uilding........... ..... ~.~.~../.
ion of Property /,~.~.~. ~ld-~-~ .~.[-.~.. .............
House No. Street Hamlet
or Owners of Property .........................................
y Tax Map No 1000, Section..!~..~. ...... Block ....... ~ ........ Lot .... ~:.~.~ ............
............................... Fil&d Map ............ Lot ...........
t No Date Of Permit Applicant .. ·
h Dept Approval ... . Underwriters Approval ..................
lng Board Approval . ..
st for: Temporary Certificate ........... Final Certicate ...........
ubmitted :~ ~ ~Q~$ ............................. ~.~..4 /~ ~iz'J,-' ' "'
~q t.~ ~(~ ........... .~z.~.C~.AppbICANT '%~ '~' '~' J_Z.%: ...................
Town Hall, 53095 Main Road
P. O. Box 1179
Southold, New York 11971
Fax (516) 765-1823
Telephone (516) 765-1802
OFFICE OF THE BUILDING INSPECTOR
TOWN OF SOUTHOLD
January 26, 1998
Doreen and Frank Krupski
1895 Aldrich Lane
Laurel, New York 11948
To Whom This May Concern:
We are unable to complete your Certificate of Occupancy
because of the following reasons:
XX An application for Certificate of Occupancy is
not on file. (Enclosed)
No Underwriters Certificate on file.
XX The check is (not on file).$25.00
No Health Department Approval on file.
No final inspection has been made.
No Plumber Solder Certificate on file.
(All permits involving plumbing being
issued after April 1, 1984).
BUILDING PERMIT # 24122-Z
Please contact our office on this matter. Thank you for
your cooperation. Second notice.
SOUTHOLD TOWN BUILDING DEPT.
,11,
-iff.--
765-1802
BUILDING DEPT.
INSPECTION
~"~~~ [ ~FOUNDATION 1ST [
[, ]/~OUNDATION 2ND [
[ ~]' FRAMING [
] ROUGH PLBG.
] INSULATION
] FINAL
[ ] FIREPLACE & CHIMNEY
INSPECTOR
765-1802
BUILDING DEPT.
INSPECTION
[ ] FOUNDATION 1ST [ ] ROUGH PLBG.
[ ] FOUNDATION2ND [ ] I~LATION
/
[ ] FRAMING [~ FINAL
[ ] FIREP~HIMNEY
REMARK~:~ /~ ///~
DATE //r~//J~''/ ,NSPE~.
FORH NO. I
TONN OF SOUTHOLD
BUILDING DEPARTHENT
TOI~N BALL
SOUTBOLD, N.Y. I 197 I
TEL: 765-~802 ',
AP~/EICATION FOR BUILOIIIG PRRHIT
INSTRUCTIONS
BOARD OF HEALTH ...............
3 SETS OF PLANS ...............
SURVEY ........................
CHgCK .........................
SEPTIC FOR}I ...................
NOTIFY:
TO: .............
"Date ................ ,19 ....
· a. ~is application mst be completely filled in by typewriter or in ink and sOnitted to the Building Inst~tor ~ith
3 ~ts of plus, ~ate plot pl~ to ~le. F~ ac~i~ to ~le.
b. ~ot pla ~ lmtim of lot ~ of ~ildi~ m ~s, mlation~ip to Mjoini~ ~s or ~lic
~ts or ~e~, ~ givi~ a ~tail~ ~rlpti~ of l~t of ~ ~st ~ dr~ ~ t~ di~ ~i~ is ~rt of
~is ~li~ti~.
c. ~ ~ ~ ~ ~is ~licati~ ~ mt ~ ~ ~fo~ is~ of ~ildi~ ~t.
d. ~ uwtml of ~is ~limtim, ~ hildi~ Ingtor ~dll is~ a hildi~ ~t to the ~li~t2
~t ~all ~ ~t m ~ ~ms ~il~le for in--tim that ~ ~rk.
e. ~ ~ildi~ ~1 ~ ~i~ ~ ~ in ~le ~ in ~R f~ ~ ~ ~at~r mtil a ~rtifimte of
~ ~all h~ ~ ~t~ ~ ~ ~ildi~ Ingtm.
~I~ffi IS ~I ~ to t~ ~ildi~ ~t for ae isle of a ~ildi~ ~t ~t to t~
~ldi~ ~ ~i~ o[ ~ T~ of ~ld, ~folk ~, ~ Y~, ~ o~er a~li~le ~,
~lati~s, f~ t~ ~st~ti~ of ~ild~, ~itlms or ~terati~s, or ~ ~1 ~ ~litim, as ~reln
&turin. ~ ~lic~t ~s to ~ly ~ith all ~licable 1~, o~immes, ~ildi~ ~ ~si~ ~e,
Satires, ~ to ~t a~i~ imt~s m ~s ~ in~ildi~ f~ ~es~ i~tlms.
(Si~mm of ~)k~ ~ ~ if a ~ratim)
.................
~ili~ ~ress of ~licat)
State x~bether applicant is o~ner, lessee, agent, architect, engineer, general contractor, electrician, plmtmr or builder.
l~m of ~mer of pr~ns~s .......................................
(as on the tax roi1 or latest deed)
'If applimt is a corporation, signature of duly author'~offider. ~ ~0~[~)
': .......... ;':'"; ..................~ .............. V - ' UNO£RWRIT£R$ C£RTIFICkT£/ FEE:
iN~re and txtle or corporate officer/ [
~6,,-1802 9 AM TO 4 PM FOR ,"HE
FOLLOWaNG ~NSPECTIONS:
Builders License No .......................... 3. FOUNDATION - t~/0 REQUIRED
,t~.s Lie~ ~o .......................... OCCUPANCy O~ m, mU,SO CO~C~
~.~.~ ~ ~ ...................... BSE IS ~NLAWFUL z ROUGH- FRAMING
~NSULA~ON
~ff~0~ CERTIfiCATE ~: ~r~Ac co~smuc~o~
I. ~atim of 1~ m ~i~ ~ ~ viii ~ ~ ............................. AL~- ~$~-
...3.~.~ ......... ~T5~ ......... L~¢ ............................. ~{.~o~amumo~.~.
~ ~r St~t m~, N~ RESPONSIBLE FOR
/ ~lGa O~ CO~$~U~IO~
..... ........ .... , ............
~ivlslm ............ Fil~ ~ ~ ...... ~ ........
(~)
2. State ~sti~ ~ ~ ~ of ~s ~ inte~ ~ ~ ~ of ~
~. ~.tlm ~ ~ ~~9~q.C-- -- -- ................. ~ .........................................
........................ ...........
I~lmir ............ Ilemoval ...~ .......... l}e~olition ............ O~her l~ork ..................................
i .(l]escrtptio~)
6. ~sti,~t~l ~st .~ ~,.~ f~ ............................. ~...
If garage, ~r of car8 .... ~ .................................
6. If Imsi~ss, ~nmrcial br mi~ ~, s~cif~ ~ture ami ~tent o~ ead~ ~ of u~
7. I)iu~nai~s of ~iscing strt~awes, if any:
Dh~nsi~ o[ sam stricture ~[th alterati~s or ~iCions:
~pth ...... ' i~i~t .................... ~imr of Stories ...............
8. Di,ensi~m of entire ~ ~st tic~: I~t ................ ~ar ............... ~pfl~ ..............
..... ~r o[ Stories .....................
9.
o~
lot:
lO. l~te o[ h~rdm~ ............. ~ ....... ~ o~ Fo[mr ~r ........................................
.
12. ~s pro,mi ~mrn~ti~ violate m~ ~ing 1~.
... ~ ....................... ~klress
~ o~ Arddt~t ............ ~ ....................... ~ress .............................. H~ ~ ...............
~ of C~Cractor ........... ~ ....................... ~klress
15. Ts Lids p~rty within ~ f~t of a ~i~1 ~tl~?
P1.OT DIAGRAH
locate clearly and distinctly ~1l buildings, ~ettmr existing or pro~, a~ i~licate all ~t-I~k di~nsions
f~n pro~rty li~s. Oi~ st~ an bl~ ~*tmr or ~scrlpti~ acco~ing to ~, 8~ &~ street ~ms and i~icaCe
x~mtl~r interior or co~r
· . . ) ................. I~ing duly ~rn~ delx)~s and says [hac he is the
(~ of h~livkhml, signit~g c~Cract
said ~r or ~rs, at~ 18 dtlJy ~thorl~ to ~rfom or Jl~ l~rfon~ Lhe ~Jd ~rk alg] to ~ a~J file this
~[~1 icati~m; timt att sLata~nCs c~t ~i~l in this. al~)l icati(~ are trim to the Imat of his klg~[~ and I~[iefj
timt the ~)rk wltJ Im ~rfon~l iu tl~ e~mt~r ~C forth in Lhe appl. lcati(m fil~ tlmr~ith.
~m to I~fore ~ this f~ j
........ . . .d,, .
SUBDIVISION ~AP Eli ED IN THEOFFICE OF THE CLERK OF
SUFFO{ K COUNTY ON SEPT.~O~ 19B§ASFILE. NO ?9?5.
$ LH'tVEY
FRANK K~UPSKI &DO~EEN KRUPSKI
[o'rI NO 5, "MAP OF RICItARD d. CRON" JAr4 22, 1991
Af LAUREl i~r[ AUG 2U: 1990
l@ OSTRANDER AVEI~M,I[
YOUNG a YOUNG
ALDEN W YOUNG, PROFESSIONAL I~NGIN£ER
ANO LAND SURVEYOR N
HOWARD W YOUNG, LAND SUR¥£YOR
.......... NY$ LICENSF NO