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Home My WebLink About22576-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No Z-24159 Date FEBRUARY 8, 1996 THIS CERTIFIES that the buildin~ ADDITION Location of Propert~ 125 GROVE DRIVE SOUTHOLD NY House No. Street Hamlet County Tax Map No. 1000 Section 80 Block 4 Lot 14 Subdivision Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated JANUARY 24, 1995 pursuant to which Building Permit No. 22576-Z dated JAN*3ARY 27, 1995 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 A SINOLE STORY ADDITION TO A OWE FANIL¥ DWELLING AS APPLIED FOR. The certificate is issued to MARY & FRANK LEKICH of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL UNDERWRITERS CERTIFICATE NO. H048555 PLUMBERS CERTIFICATION DATED (owner's) N/A FEBRUARY 1, 1996 ~/A Rev. 1/81 /~ Bu~ilding Inspector F FORM NO.3 TOWN OF BOUTHO~,D 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£ 2257G Z Coun~/Tax Map No. 1000 Section .......... ...~....~.. ...... Block .......... ~ ..........LotNo .......~....~... ............. pursuant to application dated ................................................ .~.. ...... 19....¢....,~., and approved by the Building Inspector, Rev, 6/30/80 Form No. 6 TOWN OF SOUTHOLD TOWN HALL 765-1802 FORCERTIFICATE OF OCCUPANCY 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. Approvai 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 Ppre-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 writing to the applicant. 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. Ce=tificate of Occupancy on Pre-existing Buildin~ - $i00.00 3. Copy of Certificate of Occupancy - $20fOO 4. Updated Certificate of Occupancy - $50.00 5. Temporary Certificate of Occupancy - Residential $15.00, Commercial $15.00 New Construction .......... Old Or Pre-existin~ Buildin~ ................. Location of Property. I ............... '~ ............ ; .................. ~ ........... House No. S'treet Onwer Owners of Property ' County Tax Map No 1000, Section .... .~.(.? ...... Block ..... .~ .......... Lot ...... !.~ ............. Subdivision Filed Map Lot Permit No..~. ~.~.~ ..... Date Of Permit..(l .~.~. l~-~.---Applicant ......[~ .~..%'~. .. ........... ... .. Health Dept Approval Underwriters Approval .. · Planning Board Approval ...... Request for: Temporary Certificate ........... Final Certicate ........... FIELD 'I~PECTION REPORT }'3DATE }l COMMENTS /,,'"' ,,,'{1 ~ / ~~ ROU~ ~ ~ INSOLATION PER N. Y. S~A~ ~ l{ CODE I{ II ADDITIONAL COI,~IENTS: STATE OF NEW YORK ) ) COUNTY OF SUFFOLK ) SS o VERNON ACH and HAZEL ACH, his wife, being duly sworn, deposes and says: THAT they are the present owners of certain premises as shown on the attached survey made by Roderick Van Tuyl, P.C., dated May 14, 1984; THAT based on their knowledge and information, deponents can state that the structures shown on said survey were built in the year 1957 with the exception of an addition, built in 1977, ~hich is covered by a Certificate of Occupancy, No. Z8082, and that no other changes to said structures, other than normal maintenance, have been made since 1977. SAID deponents state that the use of the house since 1957 have been used as an one-family dwelling, and that the house in in e~cellent condition. Vernon Ach Haze~ Ach, his wife Sworn to before me this 17th day of May, 1984. ~ -~t~ .... //~ ///~-.~j~.~ NOTARY PUBLIC, State of New York FORM NO. 6 TOWN OF SOUTHOLD Building Department Town Hall Southold, N.Y. 11971 APPLICATION FOR CERTIFICATE OF OCCUPANCY Instructions A. This application must be filled in typewriter OR ink, and submitted in duplicate to the Building Inspec- tor with the following; for new buildings or new use: I. Final survey of property with accurate location of all buildings, property lines, streets, and unusual natural or topographic features. 2. Final approval of Health Dept. of water supply and sewerage disposal-(S-9 form or equal). 3. Approval of electrical installation from Board of Fire Underwriters. 4. Commercial buildings, Industrial buildings, Multiple Residences and similar buildings and installa- tions, a certificate of Code compliance from the Architect or Engineer responsible for the building. 5. Submit Planning Board approval of completed site plan requirements where applicable. B. For existing buildings {prior to April 1957), Non-conforming uses, or buildings and "pre-existing" land uses: 1. Accurate survey of peoperty showing all property lines, streets, buildings and unusual natural or topographic features. 2. Sworn statement of owner or previous owner as to use. occupancy and condition of buildings. 3. Date of any housing code or safety inspection of buildings or premises, or other pertinent informa- tion required to prepare a certificate. C. Fees: 1. Certificate of occupancy $5.00 / 2. Certificate of occupanc¥ on pre-existing dwelling/ landuse--?re-Existing C.O. '3. Copy of certificate of occupancy $1.00 Vacant. land C.O. $ 5.00 Date .M.ay. Z. 6. !.. 19~4 New Building ............. Old or Pre-existing Building .. ~: ......... Vacant Land ............. Location of Property 13DQ R¢~;.~o~. D~iV~., .$QuthQ~d, New York 11971 House No. S~ree t Ham/et -- ~ -~ Vernon Ach ~nd Hazel Ach, hi~ ~ife Coun~ Tax Map No. 1000 Section 80 Block 4 Lot 14 Subdivision ................................. Filed Map No ........... Lot No .............. Permit No ........... Date of'Permit .......... Applicant .V..W ~'~-p:A .~{:b..aj3~l. ~{~,[.'. ~'~C~ ..... Health Dept. Approval ........................ Labor Dept. Approval ....................... Underwriters Approval ........................ Planning Board Approval ...................... Request for Temporary Certificate ..................... Final~ertificate~. ................. /..... - Fee Submitted $ .~?.'. ......................... ' _ ~/'~,~ ~-~ _- Construct on on above de.r/bed building~it meets all ~plic~ble~es and regulations. ~ . A pllca~[ ..~/~ ...~, ............................... 765-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION 1ST [ ] ROUGHPLBG. I ] FOUNDATION2ND [ ]INSULATION [ ] FRAMING [~'~INAL [ ] FIREPLACE & CHIMNEY REMARKS~ DATE ' NSP£CTOR.~//~//~ 765-/,802 BUILDING DEPT. INSPECTION [ ] FOUNDATION 1ST [ ] FOUNDATION 2ND [ ] ~.~11~BG. ~]~INSULATION [ ] FRAMING [ ]FINAL [ ] FIREPLACE & CHIMNEY 765-~.1102 BUILDING DEPT. INSPECTION [ ] FOUNDA~...~.ST [ ] ROUGHPLBG. [ ] ~.NDATION2ND [ ] INSULATION [~FRAMING [ ] FINAL [ ] FIREPLACE & CHIMNEY DATE 765-1802 BUILDING DEPT. INSPECTION [/_~ F~UNDATION 1ST [ ] ROUGH PLBG. FOUNDATION 2ND [ I INSULATION [ ] FRAMING [ ] FINAL [ ] FIREPLACE & CHIMNEY DAT/~~INSPECT~ THE NEW YORK' BOARD OF FIRE uNDERWRITERS p~s ~_~058426 BUREAU OF ELECTRICITY 10038 .... ', ~,~ ~PEBRU~Y' O1,1996 "~pplication No. on file 11. C.6/96 5 , ~THIS CERTIFIES THAT , o~y the electric~ equipment F~ ~KICH, 1300 ~ON DRIP', SOU~O~,..N.Y ~ ~xamlned o. J~Y 29,1996 andfou'd to ~;x~u~ sw~c~ DRYERS FURNACE MOTORS FUTURE APPLIANCE FEEDERS TIME CLOCKS MULTI-OUTLET D~MMERS SYSTEMS NO. OF FEET OTHER APPARATUS: PADDI~ FA~- 1 MOTORS t 1-F H.p. TRACK LIGHTING t -8 . pRANK . LEKICH ' ....... ' ' ', ' .jFtI~A~ REMIT By C~ECK'QRHMONEYEN~ ' 13~ REiN DRI~ ,,~~ SOUTHOLD, ~, 11971 T~S~SY~t~SER~ :EREN~DAND~N~T~RT~CATE~F~M~AN~E~TH~AYAB~.ATTHEN~RK~F~C~`$~J~H~STREE~NEWY~RK N.Y.t~38 FORM NO. I TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL ,SOUTHOLD, N.Y. 1197~1 ·, ...., ).~ , TEL.: 765-1¢02 Disapproved a/c . A~JCATION FOR BUJLDING'PERMIT BLDG. DEPT. ~ [NST~UCT]ONS B~JARD~OF HEALTH 3 sETs OF PLANs SURVEY ................. CIIECK ......... t ........ Date .................. 19... a. Tiffs application must be ompletely filled in y typewriter or in ink an'd 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 sti'eett 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. Upoh approval of this application, the Building Inspector will i~sued 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 ih __ building for necessary in~ ~ ~ . - (Signature of applic~i~, or name, if a c;;~;r'a~io'n)'- (Mailing address of applicant) State whether applicant is owner, lessee, age , architect, engineer, general contractor, electrician, plumber or builder. N e of owner of premises · (as on the tax roll or latest deed) If applicant is a corporation, signature of duly ~uthori~ed officer.' (Name and title of corporateI officer) · , . Builder s Lmense No. · Q 7 / ' Plumber's License No ............... :. ......... Electrician's License No ....................... Other Trade's License No. ' Location of land on which proposed WOrk will be 'done. × 3 o O' . ..... ....................................... ........... House Number Street .......... Hamlet Co,tory Tax Map No. 1000 Section . . .(~..~..~...~..~.~../..C/Block .............. [... Lot ................... Subdivision /~c/~ ~ ....... · ............................. '. Filed Map No. (Name) .............. Lot ............... existing use and occupancy of premises .... , .. :,Ja¢ ~. occupancy of proposed construction: Useand occupancy ~..l~.Z..lF ............................ 7:'. and occupancy . . . · 3. Nature of work (check which an,qica~,,., ....... ' ' , . · Rr~ ~'~' mci: c~ew tmuamg ......... ~ Addition . ~ ..... Alteration .... Repmr .............. emoval .............. . Demolition ..... : ....... Other Work ...... 4. Estimated Cost ./.~/.,~O I , (Description) '''] ............................ Fee ............................. , . ' (to be paid on filing this application) 5. If dwelling, number of dwelling units .... ]. ' Number a£dwcIling units on each floor .... If garage, number of cars ' ' .......... ' ........... 6. If business, commercial or mixed no ............ ' ........................... r,,_ _. " . i ..... ~,,uuy, specny nature and extent of cac~- --.-- ' ~ ...... "' ' 7. ~-,uuenslons oI existing structures if any' Front .~,r . ,,)yp~ Ol use ........ / ......... Heieht /7/ ,, . ~' ":,',,: .......... Rear . .~.q'.. h~.,,~,,y~ ,-~o~' .............. rqumoer of Stories ././/.~ ....... ~%' ........ .'-'. ·. Dimensions e~f shme structur ......... d wHh alterations or adt.ditions: Front . '~'0 ......................... · /~ ' ..... /q~ ......... Rear '~_q Denth ~9 ~' ~ ' · ................. .... ' Hmght ........... ... . .......... Dimensions of entire new co~ · · · ' · · Number of Stories.. 8. struction: Front .. .g. qn,h~. · : Rear .~F~/ ...... Depth ~ ';t ........ Height .... /?. ....... Number of Stories . ./~ ....... · ' ..... . .... ~q .o7... 9. Size of lot:Front .................. '.. Rear. .. Depth ....... ' ........... 10. Date of Purchase ...... il ..... .... ' ........... · ............. ........... Name of Former Owner ............................. 11. one or use district ~n winch Premises are situated ......... ............. Does proposed construction.v n~; o'r're;t~ ion" ' ,~ ..... ' ' 12. iolate ~ny zoning law, ordina lat ............ 13. Will 10t be re A/o, o . , graded ,,., ~ . · ................... .................. Will excess II11 De removed from premises: 14. Name of Owner of premises ./r/.ng.t/(,~ /-~'/ddt Yes No , ........ ~ · · · ?. ~ · Address ' · ..... Phone No ............ Nam~ of Architect ....... i ......... ' ............... ....... " Name of Contractor a'7~,~- Address .................. Phone No ............ ~. . · ', ............ Address /9,~ ~oor,~<o ' .... "r'-g~'xq/ . Phone No. '7~ 15.' I.s this property withi~ 300 feet of a tidal 'wetland? *Yes ........ No. --'Z ...... -- .... · If yes, Southoldi Town Trustees Permit may. be required. ~''' I PLOT DIAGRAM Locate clearly and distinctly all buildings, whether existing or proposed, and. indicate all set-back dimensions from property lin.es. Give street and bloc c number or description according to deed, and show street names and indicate whether interior or corner lot. S~TATE OF NEW Y_ORK./J/" //., l O,U.N'rZ,OF, ax. F . / C. S.S (Name of mdwldual mgnipg contract) tbovenamed. I ~ ' ' being duly sworn, depose9 and says that he is the applicant · ' ' i ~x.tc'°ntractor,")agent, corporate onlcer, etc.) . . f said owner or owners, and is dulylauthon-%z.c~tc pm~orm or have performed the said work and to'make and file this pplication; that all statements contaihed in this application are flue to the best of his knowledge and belief; and that the .'ork will be performed in the manner iet forth in the application filed therewith. ' wom to before n~e tl~ otary Public,. ~~~ ~'~" ..... 19 Comity Qualified in Suffolk COunty c~-~ ( gnature of apph, Commission Expires TOWN OF SOUTHOLD OFFICE OF BUILDING INSPECTOR TOWN HALL SOUTtIOLD, NEW YORK CEPh% IFICA rE OF OCCUPANCY ?~ONCONFOI%MING PREMISES THIS IS TO CERTIFY that the No. Z12477 May 21, 1984 /~/ Land /~/ Building(s) I-I use(s) located at 1300 Reydon Drive Stree~ shown on County tax map as District 1000, Section Southold Hamlet 080 , Block 04 , Lot 014 , does[not)conform to the present Building Zone Code of the Town of Southold for the following reasons: the property has insufficient area~ the dwelling has insufficient front and side yard setbacks. On the basis of information presented to the Building Inspector's Office, it has been determined that the above nonconforming /_~/Land /~/Building(s) /Z/Use(s) existed on the effective date the present Building Zone Code of the Town of Southold, and may be continued pursuant to and subject to the appli- cable provisions of said Code. IT IS FURTHER CERTIFIED that, based upon information presented to the Building Inspector's' Office, the occupancy and use for which this Certifi- cate is issued is as follows: a private one-family dwelling. * This propert, y is located in the 'A' Residential-Agricultural Zone. The Certificate is issued to of the aforesaid building. VERNON ACH & HAZEL ACH (owner, Suffolk County Department of Health Approval no record UNDERWRITERS CERTIFICATE NO. no record NOTICE IS HEREBY GIVEN that the owner of the above premises HAS NOT CONSENTED TO AN INSPECTION of the premises by the Building Inspec- tor to determine if the premises comply with all applicable codes and ordin- ances, other than the Building Zone Code, and tt]erefore, no snch inspection has been conducted. This Certificate, therefore, does not, and is not intended to certify that the premises comply with all other applicable codes and regula- tions. *An addition was constructed per Building Permit 9523Z, issued 10~28/77. · Certificate of Occupancy Z8082 was issued for sam~, 12/22/77. Building inspector I ', TOWN OF SO~JTHOLD r L