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HomeMy WebLinkAbout23765-z FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No: Z-25837 Date: 07/23/98 THIS CERTIFIES that the building ADDITION Location of Property: 1625 SHIPYARD LA EAST MARION (HOUSE NO. ) (STREET) (HAMLET) County Tax Map No. 473889 Section 38 Block 1 Lot 17 Subdivision Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated OCTOBER 1, 1996 pursuant to which Building Permit No. 23765-Z dated OCTOBER 22, 1996 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 FRONT PORCH ADDITION & BAY WINDOW TO EXISTING ONE FAMILY DWELLING AS APPLIED FOR. The certificate is issued to CONRAD C. VOLINSKI, JR. (OWNER) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A ELECTRICAL CERTIFICATE NO. 14203 11/21/96 PLUMBERS CERTIFICATION DATED N/A Building spect Rev. 1/81 FORK xo. s 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) Date ........ ......................... N° 23765 Z ................. Permission is hereby granted t :. ......... .. . .. .+:.................... ........H .. ...................... /ate-- / , to at premises located at .... .... ...... . .. ...lk. .? >?P`�....... ................ . ... -............................ r^^. .................................................... County Tax Map No. 1000 Section .......... d....... Block ........1...........G. Lot No. ..../.............. pursuant to application dated ......................C��...c�. ..................1 195. and approved by the Building Inspector. Fee $........... '•...•... in g nspec. ... .. BuildI for Rev. 6/30/80 �y► nm Form No. 6 TOWN OF SOUTHOLD ! ` BUILDING DEPARTMENT �a f 5X998 4✓ 765-1802L BI0G. 0 ' r,ry PLICATION FOR CERTIFICATE OF OCCUPANCY A. 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. 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 Building - $100.00 3. Copy of Certificate of Occupancy - - .25C. 4. Updated Certificate of Occupancy - $50.00 5. Temporary Certificate of Occupancy - Residential $15 OO, Commercial $15.00 jDate . . . . � � �I.Q. . . . . . . . . . . . . . . . . . . . . . . . . New Construction. . .-K. . . . . . Old Or Pre-existing Building. . . . . . . . . . . . . . . . . Location of Property. . . . . . ..... . . .1..1 �V�I .G�. . .:. L c � . . . . . . . . . . . . . . . . . . . . . House No. /,, nn/��� Street- Hamlet Onwer or Owners of Property. . . . . . . :.Y.� ?sem . . . . °. -na` 4. . . . . . . . . . . . . . . . . . . . . . . . . . . County Tax Map No 1000, Section. .�8 .. .. . .Block. .. ) . . . . . . . . . . .Lot. �.?. . . . . . . . . . . . . . . . Subdivision. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .�.. .... .Filed Map. . . . . . . . . . . .Lot. . . . . . . . . . . . . . . . . . . . . . Permit No. . . .3.�6 Date Of Permit. . Applicant. . . : . :. . . . . . . . . . Health Dept. Approval. . . . . . .. . . . . . . . . . . .Underwriters Approval. . . . . . . . . . . . . . . . . . . . . . . . . Planning Board Approval. . . . ....... . . . . .. . . . . . Request for: Temporary Certificate. . . . . . . . . . . Final Certicate. . . . . . . . . . . Fee Submitted: $. . . . . . . . . . . ... . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Qom.54 7 APPLICANT co.�S 0`3 JUL *508 { ELECTRICAL INSPECTION SERT�I�"E INC. WN LITH LD BLDG.DEPT, 375DUNTONAVENUE EAST PATCHOGUE,NEW YORK 11772 (516)286-6642 142'43 DATE: 11121196 - APPLICATIONIVaONFILE VILLAGE' EASTMARION TORN., SOUTHOLD ' AADRESS, 105,12 IPEARj)TANF ISSUED TO: CONRAD V01INSKF IRMODUCEDRY LADEMANNELECTRIC INC. LICNo: 4141-E.,. wasexamrnadon. II-21-96 ., andfoundio be in compliancewlththeNattonal Electrfcal Cade - - - - LOCATION,. Base„ 10 �vc 2nd - 3rd - Attic - Det Garage Hot Tub , Pool - - SWITCHES RECEPTACLES FIXTURES HEATERS FANS - GFT. AIR.GOND. 3 2 t . DISHWASHER DRYER CLOTHES WASH. GAR.DISP RANGE OVEN SMOKEDETECTOR FURNACE OILGAS .i CTR. MOTORS .BELL IRAN, SERVICEDISGONNECT - a .S�zax ,u3rs rrusa OTHER - EQWPMFNT ., HUGO S. SURDI PRESIDENT - 13U1LU3'NG P1:ItMXT No, 'rnia e Yn&caeemusinntt�au�eamw maw�� - - - -Snspa9ommagbeidendfiaLM'Q'ariardeaifials-_ - _. BLUE OPUGINAL YELLOW COPY PINK COPY OFFICE P UI,U- INS I'EG I'IUII -- --P __ ,UA;1'@.._-- (:UHP11iNTS ---- - -f---- _..- -- L ruuunn r ION In r) I'UUNDATION unur.n F1lANN 6 rf.ifrm t NO - -- InsuLnrfoN rr•.tt N. v . � �, ;'I'nl'1? IONIC IlUY CObR. r• I NAT. r F 's^ -_ -. .. . ............ _. - tri r • ' 3 ' 4 _ imp Awr AT PIZ 9 LLf7'(�W!ri�a" wr F."'<a I a ... z ,a : iNnoa i �,- F' P �. Qac �� t"Suxa►�'cxrti-F�.Cd ^ti► *rks '$+tr�R.trit� `oo°�o� <sii Tifls cxr+d 4ut►r+�t'af ��r�,sgdtn}# �+yl at '.stars WKX+'tsr to bt supptiCd b+µy GSYtCs'ipar4 �;:: ��' MWA14tpat WatCV- 3%S-t*tK . l,.tCs"%*A L4wod VA"Aftmanwo ?o War 19 1 . led- 7 71 41 j y V i 1 .S fl l�•CT f� t.F. � r � '� y yi_�' � .. • t , M1 :/ MOW Fi;OORINCENTERS 5444=7 M-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION IST [ ] ROUGH LBG. [ ] FOUNDATION 2ND [ ] 1 LATION [ ] FRAMING [ FINAL [ ] FIREPLACE & CHIMNEY REMARKS: (� r DATE INSPECTO 765-1802 BUILDING DEPT. INSPECTION [ ] FOU ATION IST [ ] ROUGH PLBG. [ ] UNDATION 2ND [ ] INSULATION ] FRAMING [ ] FINAL i [ ] FIREPLACE & CHIMNEY REMARK S4 DATE INSPECTOR 7 765.1802 UILDING DEPT. INSPECTION [ ] F DATION IST [ ] ROUGH PLBG. ] FOUNDATION 2ND [ ] INSULATION [ ] FRAMING [ ] FINAL [ ] FIREPLACE A CHIMNEY i REMARKS: DATE lNSPECTO BOARD OF HEALTH . . /. . . . . . . . . 3 SETS OF PLANE ✓ FORM NO. 1 SURVEY , TOWN OFSOUTHOLD CHECK . . . BUILDING DEPARTMENT SEPTIC FORM . . . . . . . . . . . . . . . . TOWN HALL OCT I, (� �Og6 G. SOUTHOLD, N.Y. 11971 NOTIFY � TEL.: 765-1802 CALL . 7 �7.... �F MAIL T0 : Exa e4LrtT �Us� ' t40 Approved . . . :r ., 19� Permit No.e�374� � Disapproved a/c . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . (Building Ins ector AP LICATION FOR BUILDING PERMIT Date . . . . . Oct:: . 2. . . . . ., 1996• INSTRUCTIONS A a. This application must be completely filled in by typewriter or in ink and submitted to the Building Inspector, 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- cation. 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 ot°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. . . . . . . . . . . . . . . ago'nt. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Name of owner of premises .CoI1Fad. and .Max.jjorie .Vol.inski. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . (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. ...131.0.5 ,tlZ. . . . . . . . . . . . . . Plumber's License No. . . . NA . . . . . . . . . . . . . . . . . . Electrician's License No. . . . . . . . Other Trade's License No. . . . . . . . . . . . . . . . . . . . . . 1. Location of land on which proposed work will be done. . . .1625. .Shipyard. L.ane. I;.ast. M.arloln. . . . . . . . . . . . . . . . . . . . . . .1.525. . . . . . . . . . . Shipyard .Lane . . . . . . . . . . . . .Eagst, .Max.i o .. Aly.. . . . . . . . . . . . . . . .. House Number Street Hamlet County Tax Map No. 1000 Section . . . . . 3.8. . . . . . . . . . . Block . . . . 1. . . . . . . . . . . . . Lot . . . .17. . . . . . . . . . . . . Subdivision . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . : . . . . . Filed Map No. . . . . . . . . . . . . . . Lot . . . . . . . . . . . . . . . (Name) 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy . . . ane. fa-m!].y -residence • • • . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . b. Intended use and occupancy . . Bay window and porch addition . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3. Nature of work (check which applicable): New Building . . . . ... . . . . Addition . . . X. . . . . Alteration Repair . . . . . . . . . . . . . . Removal . . . . . , . . . . . . . . Demolition . . . . . . . . . . . . . . . . . . i . . . . Other Work . . . . . . . . . . . . . . . (Description) 4. Estimated Cost . . . $,500.0.0 . . . . . . . . . . . . . . . . . . . . . . . . . . Fee . . 75.•,99, . . . . . . . . . . . . . . . . . . . . . . (to be paid on filing this application) 5. If dwelling,number of dwelling units . . . . . . . . . . . . . . . Number of dwelling (units on each floor . . . . . . . . . . . . . . . . Ifgarage, number of cars . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6. e and . Rear . .ac1. ype of . e . . . . . . . . . . . . . . . . . . . . . 7 Dimensions of existingstructures if an Front . 40, , , 40 �Ype of use . . . . . . . , . . . . .13. . . Number of Stories . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Depth . . ¢ . . . . . . . . . . If business commercial or mixed occupancy, specify nature and extent of eachi Height Dimensions of same structure with alterations or additions: Front . .40.'. . . . Rear . . .40,', • , Depth Height 12 of Stories . . . . . . . . . . . . . . . . . . . . . . 8. Dimensions of entire new construction:Numberof SFories . Z5 •4• Rear . . .25.�4': . . . . . . Depth . 1.6.7 , , , . , , . p . . . . . . . . . . . . . . . . . . . . Flei t . . . . . . . . . . . . . Number' ront Height . . P 9. Size of lot: Front . .88 . . . . . . . . . . . . . . . . . . Rear . . 90 . . . : . . . . . . . . . . :. .Depth 167. . . . . . . . . . . . . . . . . . 10. Date of Purchase o • o " er ' • • • " " " . . . . . . . . . . . . . . . . . . . . . . . . . . 11. Zone or use district in which premises are situated , ; Name of Former Owners . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 12. Does proposed construction violate any zoning law, ordinance or regulation: . 13. Will lot be regraded " ' • " " " " " : " g • • • • • • • • • • • • • • • • • • • . . . . . . . . . Will excess fill be removed from premises: , Yes No 14. Name of Owner of premises .0&. .M .Vol.mnski . . , Address . ,$ame, phone No. . . . . . . . . . . . . N . Name of Architect . . . . NA . . . . . . . . . . . , Address . . . . . . . . . . . . .I,. . . . . . Phone No. . Name of Contractor-.Ed. Wi 1]_ .Attu. , . Address . . Phone No. 15 .Is this property located within 100 feet of a tidal wetland? *YES . . . .NO. . . . *If yes , Southold Town Trustees Permit may he requireid. PLOT DIAGRAM Locate clearly and distinctly all buildings, whether existing or proposed, and,indicate all set-back dimensions from property lines. Give street and block number or description according to deed, and show street names and indicate whether interior or corner lot. i r STATE OF NES� �, COUNTY OF . . . . . . .15 • Yl. J . . . . . . . . being duly sworn, deposes and says that he is the applicant above named.(Name of individual signing contract) Heis the . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . (Contracto agent, orporate officer, etc. of said owner or owners, and is duly authorized to perform or have performed the $aid 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 manner set forth in the application filed`therewith. Sworn to before me this �!L . dayof. .11. 19! . , Notary Public , , , ��. . . . . ountY �� � CLAIRE L. a of N � E �. , . . Notary Public,State of New York (/// No.4879505 Qualified in Suffolk county �p (Signature of applicant) Commission Expires December 8,18 tie, m15 �'l A,­1 11 6. KA, V­ k > f: M, '9- fusHwwy> . .... Ow 7� 71 irll t. f N e,l YI 7' k —Aw �-7 �ocain rm of the tftwywsmet. F-Jucation La k gg A90 "AandSurveyoftWamleealm Lobe avaGd -Z Or)i,to the person for v r tot6w , �lrjs Lon conp=y, ,�vernmntd agar.CVW4 f, fliVdherNn end tothe c the "j 4 fo 4 Of"O "g �A*nm raw *OW— , ov� AN 7TQYAUT. C­ `x c ­ if As v 0 f;EZ lei Wa, 7 "t ITPTII�Z��,,.. KERS CERA 77 : r FMATE - [[ �4 REQUIRED 9 P � A�'�CY ldR _ IWT— sS � APBROV AS NOT 7 1, CAT DATE': I TI ..BUILDING 13 NOTIFY BUIB 785-1802 FOLLOWING NSPE�C'D _ 7 - OR THE FOUNDATION NS: . - FOIA POURED CONCRETE EOUIRED _ 2. ROUGH . FRAMING a PLUMBING - 3. INSULATION 4. FINAL CONSTRUCTION MUST - C ALL CONSTRE Ci TE qry C.O. 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