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Home My WebLink About23364-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OC=umANCY No Z-24277 Date APRIL 11, 1996 THIS CERTIFIES that the building Location of Property 51680 MAIN ROAD House No. County Tax Map No. 1000 Section 63 Subdivision ALTERATION BOu'£uOLD, NEW YORK Street Hamlet Block 6 Lot 3 Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated APRIL 11, 1996 ~ursuant to which Building Permit No. 23364-E dated APRIL 11, 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 INBT~T~.%TION OF WINDOW IN 2ND FLOOR BEDROOM OF BED & BREAKFAST AS APPLIED FOR. The certificate is issued to WM.F.QUIEK JR. & JOHN CZARTOSIESKI (owners) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A UNDERWRITERS CERTIFICATE NO. N/A PLUMBERS CERTIFICATION DATED N/A Rev. 1/81 ding InSpector/ FORM NO.3 ToWN OF $OUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N.Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLE'[~ON OF THE WORK AUTHORIZEDI Date ........ .A..P..~...i..1... ,!..I. a ................................... 19... 23364 Z Permission Is hereby granted to: The Tern Inn Bed & Breakfast 3~n Czartosleskz P.O. Box 781 ~out~iolS, N.Y. 11971 t INSTALL WlNDOT~ IN' SECOND FLOOR BEDROOM OF B&B AS APPLIED FOR. at premises located at ........ ~ ~....1~...~..~...~,0...~1~.. ............... ~.O....~....O...~..D.~...~a~.~ ............................................ CounhtTax Map No. 1000 Section ........ ~ ............. Block ...... .6. .................. Lot No ........ ~ ................... pursuant to application dated .......... .A.p~...!.!,~ .............................. 19..,.~.§. ........ and approved bythe (Received 8/2/95) Building Inspector. Rev. 6/30/80 / Form No. 6 TOWN OF SOHTHOLD 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 'Tpre-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 ..... ~PF~.JJ~.J~)~ ...................... Qew Construction ........... Old Or Pre-existing Building ................. ocation of Property 5J680 MAIN ROAD SOUTHOLD~ N.Y. House No. Street Hamlet WM. F. QUIRK, JR. & JO~R~ CZARTOSIESKI )nwer or Owners of Property .................................................................. 3ounty Tax Map No 1000, Section...~ ......... Block 6 ~ ................Lot... .................. ~ubdivision...................... ........... ... Filed Map ............ Lot ...................... ........ A rll 1J~1996 .......... Permit No..lB364-~ ..... Date Of Per, nit.. P ............ Applicant..~-~.I~. ~ ..... Health Dept. Approval ........................ .. Underwgiters Approval ......................... '~lanning Board Approval ........................ ~equest for: Temporary Certificate ........... Final Certicate ........... Submitted: $ 75.00 FIELD I=NSFECTiON REFDRT DATE ~ , -, COMMENTS ql FOUNDATION ( 2ND ) i{ II INSULATION PER N. STATE ENERGI CODE ADDITIONAL COMMENTS: FORH biO. I TOWN OF SOUTIIOLI) Bll II,DlltG DEPAR'II4ENT TOWN IIALL $OUTllOLD, N.Y. 1197 I TEl.: 765-1802 Disapproved alt .................................. BO^lID OF IIE^LTII ...,,.,-- ........... 3 SETS OF PI,ANS ............... SbiEVEY ........................ Cll~C~ ak. o~ ~ O. .................. E:EPTI C FORH ................... NOTIFY: (lk~Xlldivg hmFecto ) APPLICATION FOR BUII.DING PERMIT INSTRUCTIONS Date ................ ,19 .... a. 'lhls application mast be conpletety filled in by tyl~a.rciter or in ink aed m~l~itt~ to fl~e ~ildltg lnsl~ctor with 3 ~ts of plus, ~rate plot plan to ~ale. F~ accordi~ to sch~fle. b. Plot plan ~i~ l~ati~ of lot aed of tadldi~s ~ praises, relatlooship to Mjoinlng pr~i~s or poblic struts or areas, a~ givltg a dotait~ ~scrlptia~ of laM~t of pro~rty ntlst I~ dram ~ tile di~m~ ddd~ is ~rt of this silliest i~. c. 'lhe ~>rk c~r~ I~ this a~llcati¢m t,~ s~t I~ cm~mtred ~fore ismm~e of ~ildlt~ Pemit. d. U[~ a~al of this a~ieati~, the Ihfilding lnslector will is~ a l~ildi~ Pemit to the a~llcaat. ~ch ~mit ~mll I~ kept: ~ tim pai~s available for ios~ctia~ th~t the x~rk. e. ~ hdldi~ ~mll Im ~pi~ or n~l in ~le or in ~rt for a~ g~r~ ~mtwer ~tll a ~rtificate of (~m~ M~al1 have I~n gr~ted I~ tim ~Hldlng hm~tor. ~,ICA'I'I~ I8 I~BY ~ to tl~ ~ildi~ l~rt~nt for the is~q~e of a ~ilding Penfit ~amnt to the ~ildi~ g~e O~li~e of tim 'l'~m of ~tl~td, ~ff~olk C~mty, ~ Yo[k, at~ other a~llcable l~s, O~it~es or ~gulati~ts, for tim ~mtn~ti~ of Indldlt~s, ~kliti(~s or alterations, or for ~al or de~lition, as I~rein ¢~scril~. 'fin applic~t agree to c~ly with all at~llcable re~latiam, m~ to ~nit mitl~rlzed ios~tors ~ pmni~s aed in I~ildiag for secessa~ ins~ti~s, ..... (Si~ure o[ nl~llcant, or ~, ii a cor~rari~) (~[aili~g a(klress of al¥llcant) State ~tmtlmr applicant is cn,n~r, lessee, agent, architect, engiseer, general contractor, electrician, plunimr or la)ilder. Nane ol7 owner of premises WILLIAM QIJIRI JR. & JOHN CZARTOSIESKI (as tm the tax roll or latest deed) applicant is a corporatio~, signatnre of duly antborlz~exl officer. (N~ne a~d title of corporate officer) lluilders License No .......................... Ph~ibers License No .......................... Electricians License NO ...................... Other Trade's l.icense No ..................... I. l~catlon of land on ~ddch proposed work will be done .............................................................. Ilouse l~nl)er Street ll~nl et _ ...... ..... .......... ............ S~lxtivlsion .............. ~ ....................... Filed }~all NO ................ Lot ............... 2. State existing use a,wl occn~pancy of premises ar~l inte~led rise an<l occulmncy of proposed construction: a. ,,se ...... C kt. ............................................. o I,. n~teeded tt~e aaa sec~pa~y ....... -.44~ '1. II. lO. ]1. 12. f:('~n laoperly lilies. (;lye stn~-el' m~l I)hx:k ~lK~i~er or des(:riptic~ acco~din8 to deed clearly m~ dJsti~l'ly all laHIdi~s, xA~elher exiatlng or prolx~sed, m~l h~licate all set-lmck dh~enaions ~.~rn~ delX),esj taxi a.y, tlmt he is the oppl Ik: il; lite ....................... ,~. .................................... : .......................... apl*licatio.; Lhal: ull ,tnt~ntfl cont~iiKatl in Ihi~ ~pplje~tlon ~lre tn~ to tile Im,t.~ OF Iii, kix~l~l~e m~l Ix~Jiefj taxi I ImL the ~)~k ~ill I~ I~rl:on~c~l i~ I Ira n~..~r neL I:o~tl~ in Ihe opplicm:ion filed tl~r~iU~'. I~,~)rn to I~el'~lhin A ~>tm-y lS~b ' .~. ....... CLAIRE L GLEW Notary Public, State of New York No. 4879505 ..~. Qualified in Suffolk County Commission Expires December 8, 19/~