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HomeMy WebLinkAbout23777-z FORM No. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No: Z-25270 Date: 09/17/97 THIS CERTIFIES that the building REPAIR Location of Property: 16015 NEW SUFFOLK AVE NEW SUFFOLK (HOUSE NO. ) (STREET) (HAMLET) County Tax Map No. 473889 Section 117 Block 6 Lot 24 Subdivision Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated JANUARY 9, 1996 pursuant to which Building Permit No. 23777-Z dated OCTOBER 23, 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 STRUCTURAL REPAIR TO THE FOUNDATION OF EXISTING ONE FAMILY DWELLING AS APPLIED FOR. The certificate is issued to ROBERT SLEDZIESKI (OWNER) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A UNDERWRITERS CERTIFICATE NO. N431166 09/09/97 PLUMBERS CERTIFICATION DATED N/A V f Build g Inspect Rev. 1/81 FORM NO. f 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? 23777 Z Date ................ . ... .. ...........��............. 19�� Permission is hereby gr nted to: 'v.�... rc`......lc5....................... ....... ............ .../.�. s.. to - .. . .... ..... ..... 1` ,ns!^^ . ..zGter.... ...... . Pte...... . ..... ... at premises located at .............................. .Y.0 .IS' ....`.../..Cv`.cG4�. ...................................................................I............ .. .... .... .......... ................................ ........................................................................................................ .. ..................................................... County Tax Map No. 1000 Section ..........l1..../... . . Block //0 G�33.......4 .......... Lot No. ... %L.......... pursuant to application doted ..................... •'r !.....(............... 19.(:S?cmd approved by the Building Inspector. Fee $.../... ... Building Inspector Rev. 6/30/80 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL 765-1802 OR APPLICATION FOR CERTIFICATE OF OCCUPANCY rk} ;This application must be filled in by typewriter OR ink and submitted to the building a i+r" ns�eatb r?�ai pti -tkie fglowi� ',.. for'net ,bud lc'int¢ or new use n l. Fiha survey of ,pr-opefty tyith fa�du ate lgc'at oc� o ally�b_uild`ings� p operoy 'Jives, streets, and unusual natural or topographic' "'features. , '01; 2. 2. Final A i 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 17 lead. 1 5. Commercial building, industrial building, multiple residences and similar buildings and installations, a certificate of Code Compliance from architect or engineer f 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 - $5.00 over 5 years - $10.00 4. Updated Certificate of Occupancy - $50.00 5. Temporary Certificate of Occupancy - Residential $/15.0000, Commercial $15.00 .� Date . . . A:1.��./4 5 . . . . . . . . . . . . . . . . . . . . . . . . . . . New Construction. . . . . . . . . . Old Or Pre-existing(Building. . . . . .. . . . . y Location of Property. (D.QB . . . . . . . . .e .:J� �11,. . . . . .ISO- .A. .-. . . . . . . .1� �0.�\y House No. 1Street 7 Hamlet Onwer or Owners of Property. . �WLA— . % ' @YZ ��S/�� `, County Tax Map No 1000, Section. ].0 . . . . . . . .Block. . . . . .r?. . . . . . . . .Lot. . . 'Q) J. . . . . . . . . . . . . . . Subdivisionii.��. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .Filed Map. . . . . . . . . . . ..Lot. . . . . . . . . . . . . . . . . . . . . . Permit No. .4S _?.7.T_4- .Date Of Permit. . /A/ .!>%. .Applicant.Ej/U. L/?oNh?. ;. .,. . .P..A Health Dept. Approval. . .%% . . . . . . . . . . . . . . . . .Underwriters Approval. . . .{l,/.//, . . . . . . . . . . . . . . Planning Board Approval. . . . . . . . . . . . . . . . . . v Request for: Temporary Certificate. . . . . . . . . . ...FIn Corticate. . . . . . . . . . ._ Fee Submitted: $. .� . . . . . . . . . . . . . . . . . . . . . APPLICANT o� Gyp CR x Town Hall, 53095 Main Road p • Fax (516) 765-1823 9yj�Ol 0� Telephone (516) 765-1802 Southold, New York 11971 OFFICE OF THE BUILDING INSPECTOR TOWN OF SOUTHOLD May 5, 1997 Environment East, Inc. P.O. Box 190 Peconic, N.Y. 11958 To Whom This May Concern: We are unable to complete your Certificate of Occupancy because of the following reasons: An application for Certificate of Occupancy is not on file. (Enclosed) XX No Underwriters Certificate on file. 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 # 23777-Z (SLEDZIESKI ) Please contact our office on this matter. Thank you for cooperation. SOUTHOLD TOWN BUILDING DEPT. PIlil.l- III-I'-- �OII ItISCUIt'I' DA'I�N ('OtIt1BN'1', (� --, „---- ,-..-,.,�„-._._____. PO(INDA1'LON (2ND) v: Itt)IIGII FHnNN, rl.urm I Nc ------------ - ... . ... _ ,.I 3'i'n'I'l7, IC IJIiRCY f.(1DI? �-I rlrinl. nl)OI'I'IONAI. CDNNI3N'1'!^,: N . . _.. . . _ _ . o � APR 2 1 1997 rectie' ` Environment East, Inc. 3075 Indian Neck Lane P.O. Box 190 -T Peconic,New York 11958-0190 j— 516-734-7474 April 17, 1997 Southold Town Building Dept. P.O.Box 1179 Southold,NY 11971 Re:Permit#23777Z Dear John, Enclosed is a photo taken 11/13/96 to include in the file of the above mentioned permit taken when the original inspection was requested. We will call your office to schedule a reinspection just as soon as we can coordinate with the home owner a time when someone will be there to give you access. If there are anyq stions,please givehne a call. Sincerely, \� � r d t Peter R. Stoutenburghn President Environment East, -'1-i-lAT AReN 'T' TO �5u Lp( NG Code c ��LL \ — iZE�AICL 01= CAF, \ l SLP _ . Ao ►KA5ON P----Y f:b O�ADA7 to ti c A" Q•m • SCALE:I Zr= �'0" APPROVED BY DRAWN BY J�(� DATE: klo.�. �b o a _ coNc. -�G. - - EDZIESI� I . _ EsSIC� - -`•< CHARRETTE PRO-FORM"OPF PRINTED ON 920H CHARPRINT VELLUM �,1 1 Ti Environment East, Inc. 3075 Indian Neck Lane P.O. Box 190 Peconic, New York 11958-0190 - r, _- – 516-734-7474 SI. GPZIG- SKI Kz--stper4cruau9 I�aNN Su r FOL-K �J &d"-,a,vL f(a `L'� (� �i� - ���,e �,vs �-b6�a a �z ' w o� r�Caee G a . a n� 7-� THE NEW YORK BOARD. OF FIRE UNDERWRITERS PAGE 1 1000343 BUREAU OF ELECTRICITY i f —G„d1.{ F 85 JOHN STREET,'�NEW YORK, NY 10038 1 J Date SEPTEMBER 09,1997 Application No.on file 1452009'7/97 N 43116 THIS CERTIFIES THAT only the electrical equipment as described below and introduced by the applicant named on the above application number in the premises of BOB SLAJESKI, N/W/C. �NEW SUFFO1�LLK7 AVE.& BUNNY LA. , NEW SUFFOLKNY ry in thefollowing location: LI Basement El Ise Fl. ❑ 2nd Fl. .Section Black Lot was examined on SEPTEMBER 02,1997 and found to be in compliance with the National Electrical Code, FIXTUR! FIXTURES RANGES COOKING DECKS OVENS DISH WASHERS 'EXHAUST FANS OUTLETS ECEPTACLlS SWITCHES INCWIDESCENTI FLUORESCENT I OTHER AMT I K W I AMT K.W AMT KW. AMI I K.W AMT. M.P. 2 DRYERS FURNACE MOTORS FUTURE APPLIANCE FEEDERS SPECIALREC'PT TIMECLOCKS I UNIT HEATERS MULTI-OUTLET DIMMERS SYSTEMS AMI K.W. OU M.P. GAS N r AMi NO. A.W G AMT AMP. AMT. AMvs TRANS. AMr. M.vNO.OF RET AMT WATTS SERVICE DISCONNECT No.OF S E R V I C E METER NO.OF CC.GOND A.W G. A.W.G. A.W.G. AMT. AMP. 1YPE EQUIP. 10 2W11 0 3W 30 3W 3X AW FPER 0CC. Of CC.COND. NO.OF MbIEG OF HbIEG NO.OF NFUTgAlS OF NEUWAL OTHER APPARATUS: REMOVE & RE--INSTALL EXISTING WIRING-1 AFTER STRUCTURAL REPAIRS WERE MAUE-1;. TO BUILDING-1 GOODALE ELECTRIC LIC.#7133 L L 7355 MAIN ROAD e rL MATTITUCK, NY, 11152 GENERAL MANAGER 11 - A Per < This certificate must not be altered in any manner; return to the office of the Board if incorrect, Inspectors may be identified by their credentials. COPY FOR BUILDING DEPARTMENT: THIS COPY.OF CERTIFICATE ,MUST NOT BE ALTCRED IN ANY MANNER„ T,�edmomg Ile Tait Environment East, Inc. 3075 Indian Neck Lane c� P.O. Box 190 Peconic, New York 11958-0190 _ L 516-734-7474 L a t LIT e 765-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] 1 ULATION [ ] FRAMING [ FINAL [ } FIREPLACE A CHIMNEY REMARKS: DATE 2s INSPECTOR r 22 765-1802 BUILDING DEPT, INSPECTION [ ] FOUNDATION IST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] INSULATJON [ ] FRAMING [ a,F KAL [ ] FIREPLACE & CHIMNEY REMARKS: . DATE INSPECTOR BOARD OF HEALTH . , . . . . . . . FORM NO. 1 3 SETS OF PLANS . . . . . . . . . . TOWN OFSOUTHOLD SURVEY . . . . . . . . . . .. . . . . . . . . BUILDING DEPARTMENT CIIECK . . . . . . . . . . . . . . . . TOWN HALL SEPTIC rORH . . . . . . . . . . . . SOUTHOLD, N.Y. 11971 TEL.: 765-1802 tiOTIFY CALL Examined . . ., 19 -� �r� NAIL TO : . . . . . . . . . . . . . . . Approved . . . ., 19 . . . Permit No. , . </ / `' � (11 / `` ti Disapproved a/c . . . . . . . . . . . . r. yV . . . . . ^e1,, �'' ' (Building Inspector " :,s;ala; PPLICATION FOR BUILDING PERMIT Date . . . 14N . 119%. INSTRUCTIONS 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. o 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- cati©n.. i 111 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 sliall 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. ��iy(2oN.rn . . 4s:V. . . t[Q.G . . . . . —, (Signature of 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. QrCa. . . . .CQ 0�_. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Name of owner of premises mak. Q 212 . . .. . . . , . , , . • . . . . . . . . . . . . . . . . . . . . . . . . . . . (as on the tax roll or latest deed) 0alme,and.titic c I a ' i iature of duly authorized officer. a'illd!'�i`s'd"��(IW BtS1lU�l of��coorporate off��iccfcr) Builder's License No. J`>�5 �. . .rl . . . . . . . . Plumber's License No. . . . . . . . . . . . . . . . . . . . . . . . . Electrician's License No. . . . . . . . . . . . . . . . . . . . . . . Other Trade's License No. . . . . . . . . . . . . . . . . . . . . . ' I. Location of land on which proposed work will be done. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .�QItJ . . �. o�I/ . . . . . Ilouse Number Street Hamlet County�Tax Map No. 1000 Section . . . . . �.� . . . . . . . . . Block . . . . . . . . . . . . . . I . Lot . . . . . Subdivision . . . . . . .,. . . . . . . . . . . . . . . . . . . . . . Filed Map No. . . . . . . . . . . . . . . Lot . . . . . . . . . . . . . . . (Name)i 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy . . ..l. . .lIC < . i • • • • " " " " " �J b. Intended use and occupancy . . (. . . ��. . . . . . . . . . . . t l . ,. ' u 3. Nature of wor • (check which applicable): New building . . . , . . . . . . Addition . . . . . . . . , . Alteration . . . . . . . . . . p. ' . . . . . . . ! . . . . . . . . . . . . . . Demolition . , . . . . . . . . . . . . Other Work . . . . . . . , . . . . . . . Re 1rr . . . . . Rcmova (Description) 4. Estimated Cost . .2)000.D�. . . . . . . . . . . . . . . . . . . . . . . Fee , . . . . . . . . . , , . . . . . . . . . . . . . . . . . . . . . . (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 . . . . . . .I. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5. If business, of existing structures, r�cupnncy, specify nature and extent of each type of use . . . . . . . . . . . . . . . . . . . . . 6. If business, canuncrcmrl or mixed o f any: Front . . .N.1 .'. , . . . . . Rear . . . . . . . . . . . . . . Depth . . . . . . . . . . . . . . . Height . . . . . . . . . . . . . . . NunibcrofStories . . . . . . . . . . , . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Dimension% of same structure with,alterations or additions: Front . . . . . . . . . . . . . . . . . Rear . . . . , . . . . . . . . . . . . . Depth . . . . . . . . . . . . . . . . . . . . . . Illcight . . . . . . . . . Number of Stories . . . . . . . . . . . . . . .. . . . . . . S. Dimensions of entire new construction: Front . . . N./�. . . , . . Rear . . . . . . . . . . . . . . . Depth . , . . . . . . . . . . Height . . . . . . . . . . . . . . . Numbc}of Stories . . . . . . . . . . . . . .. . . . . . . . . . 9. Size of lot: Front . . . . . . . . . . . . . . . . . . . Rear . . . . . . . . . . . . . . . . . . . . . . Depth . . . . . . . . . . . . . . . . . . . . . . 0. Date of Purchase . . . . . . . . . . , . . . . . . . . . . . . . Name of Former Owner . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1. Zone or use district in which premi�csmre situated . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2. Does proposed g , lg p any zoning law, ordinance or regulation: . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3. Will lot be regraded :. . . . . . . . . . . . . . . . Will excess fill be removed from premises: Yes No 4. Name of Owner of premises . . . . . . . . . . . . . . . . . . . . Address . . . . . . . . . . . . . . . . . . . Phone No. . Narne of Architect 1 ruction vro tel ddre . Phone No. . . . . . . . .'. . . . . . . A ss . NameofContractor Q%eAqT 'INC... . . . . . . . . . . Address 3P];, . i��: tk.AF:pPhoneNo.7.34.-7.4 ?¢: . . . . property 0 . . . . . . . i. Tc thiswithin 30Ui Leet of a tidal wetland? *Yes. , . . . . . . No. . . . . . . . . # Lf yes, Southold Towin 'Trustees Permit may be required. PLOT DIAGRAM Locate clearly and distinctly all buildings, whether existing or proposed, and.indicate all setback dimensions from"' roperty lines. Give street and block nur{nber or description according to deed, and show street names and indicate whether iterior or corner lot. APPROVED AS NOTED DAT • g j 771" _ ��B. 1# FEE- OCCUPANCY NOIFY Bu�DEP NT AT 765-1802 9 AM TO q, FOR THE UIDE IS UNIAWFUL FOLLOWING 1. FOUNDATIONPECTITWO REQUIRED tl T Cj T� � 6 PORED CONCRETE 2, ROUGH- FRAMING & PLUMBING � ° 3, INSULATION „L 'OCUPAN`�" 4 BE COMPLETE FORC.O. ON MUST ALL CONSTRUCTION SHALL MEET THE REQUIREMENTS OF THE N.Y. CERTI E STATE CONSTRUCTION & ENERGY REQUIRED CODES. NOT RESPONSIBLE FOR DESIGN OR CONSTRUCTION ERRORS 'ATE OF NEW YORK, S.S )UNf (Name of in(diivid� nim uual si , `. `x e , .� being duly sworn, deposes and says that lie is the applicant g g Zfitracl) ove named. is the . . . . . . . . . . . . . . . I . . . . . . . . . . . . ... . . Contractor nt, corporate officer,etc.) said owner or owners, and is duly or have performed the said work and to make and file this plication; that all statements containcdl in this application are true to the best of his knowledge and belief;and that the rk will be performed in the manner set forth in the application filed therewith. orn to before me this f. , . . . . .daj�of . � . . . . ., 19 lary Public, , . ... . . . . . . Cour y JOYCE M.WILKINS " " ' Notary Public,State of Now York (Signature of applicant) No.4952246,Suffolk Co Term Expires June 12,1 M —,— �' 4+A 4IFa+,'f.� Ki1f'''7 � �'9tit•' _. _. , - - f { , ih1'34xGtc 'lp4 i'D-' Mia .�iµ ti J.QtST-5 . - .,_, �c+.�-"^ 'r•}'� --^-„^ �: ---'�°.- f s_ ' �45��'}"'..w'�1 2x it? ilb`i�'�'S � � i .w4.,� � r�. „�p'a'�` ,. ��'�4k i�twxe:t,' �xac8 � ." v` � '� �.�., 4..Q'♦» '{tOT:�,'6' -, ., � .. � Rv �w . J 4 u- X %Lto a M ID N z a E'K tsT, sTE 4.L. C O 4 M I PY N Y r Sc:Q WW�,It dNY4.V rsr^�g-S TO E'X 1Sr, m . 51'{rJ4u{ .' A`4 p�sc.{�i.pID h�o.� , nlv, �TRucTUPn_ k } • l"'�' h1 + ,' �' L M�,l.'"I' 1"� 3? Ah Ar>tyo -ST FUC-Tu R.A4 � a,l ggLAENTS:. .(s,Vtti,AS CPLS.) , Nem (krcNtovsb. ti �� Yid r , - a 'IRY i 1Y,�PAf�YJ �e..§ ,tpvq- it . ,,�az.