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Home My WebLink About21987-z w t FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No Z-23081 Date JULY 5, 1994 THIS CERTIFIES that the building ADDITION Location of Property 2005 OLD NORTH ROAD SOUTHOLD, NY House No. Street Hamlet County Tax Map No. 1000 Section 54 Block 3 Lot 26.4 Subdivision Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated MARCH 30, 1994 pursuant to which Building Permit No. 21987-Z dated APRIL 1, 1994 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 SCREEN PORCH ADDITION ON THE REAR OF A SINGLE FAMILY DWELLING AS APPLIED FOR. The certificate is issued to MARKO & LINDA ANTICEV (owner, lessee or tenant) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A UNDERWRITERS CERTIFICATE NO. N/A PLUMBERS CERTIFICATION DATED N/A Building Inspect Rev. 1/81 FORM NO.3 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 AUTHORI~ZZE`D)' W IV® 21987 Z Date 19....... Permisslon Is hereby anted to: 4,~../~1!~! d7~9~r~eis~/day ~D~JS°.....)G/......!?..T`......-... to....X~ ~5r........e.~ Se:.......`.!J s l/~ /G T% : G 2 f pG.J ~Ti~ at premises located at v v...................................... ..............................................................................!j .......Y;... County Tax Map No. 1000 Section Block ......-?............Q... Lot No...... pursuant to application dated ...........3/. 19.../ and approved by the Building Inspector. Fee S.../,.Y............. Building Inspector Rev. 6/30/80 Form No. 6 0 TOWN OF SOUTHOLD BUILDING DEPARTMENT 01 L~ JUI_ ~94 Ei.11r TO1,7N HALL ' 765-1802 ®td OLD APPLICATION 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 = $20.00 4. Updated Certificate of Occupancy - $50.00 5. Temporary Certificate of Occupancy - Residential $15.00, Commercial $15.00 Date New Construction ..v...... Old Or Pre-existing Building Location of Property... '7 .-`j . ~rZTft .2'b So~eE~vL 4 House No. A, Street Hamlet Onwer or Owners of Property .:Z .....,...,R County Tax Map No 1000, Section..f 'i(........Block.,4 Lot.:?.10.'.2}.............. Subdivision .................................Fi/lyed Map............ Lot...................... Permit No.. ........Date Of Permit../ ,,.Applicant............................. Health Dept. Approval ..........................UUnderwriters Approval......................... Planning Board Approval.. 2;! Z®.7-.Z Request for: Temporary Certificate........... Final Certicate........... me Fee Submitted: $ 5, z 0 APPLICANT Paw • n ' m. , ~F 1 1cL I,. E.,: ;7 _ ~~DhiL ~ OMMENTS ~ m a FOUNDATION (1st) U FOUNDATION (2nd) mwt 2. o~ DOUGH FRAME ~ Q PLUMBING C5 3. y S1 m INSULATION PER N. Y. m STATE ENERGY CODE a 4. ~~heg~ m 1 y~( I a'2 ttvGc FINAL ADDITIONAL COMMENTS: m N1 An zc~ m ^c H 77 O CN) H _ T V\W H m-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] IN LATION [ ] FRAMING INAL REMARKS: IJ7 &e-- a DATE INSPECTOR IqF) 765.1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLBG. [ ] FO DATION 2ND [ ] INSULATION FRAMING REMA DATE < 7 INSPECTO ,,2 M-1802 BUILDING DEPT. MPECTION [ OUNDATION 1ST [ I ROUGH PLBG. [ ] FOUNDATION 2ND [ ] INSULATION [ ] FRAMING [ ] FINAL REMARKS: DATE INSPECTO BOARD OF HEALTH . FORM N0.1 3 SETS OF PLdVS TOWN OF SOUTHOLD SURVEY. BUILDING DEPARTMENT CHECK .`az TOWN FALL SEPTIC FORM SOUTHOLD, N.Y. 11971 TEL.: 765.1802 NOITIFY CALL 581-4020 ' . i Examined . 19 CCC}}. p p MAIL TO: ' • . Approved .....T.// 19 !~.-~Permit No..°~ I (Q . Disapproved a/c (Building Inspector) APPLICATION FOR BUILDING PERMIT Date .3/28/94....... ! 19 . 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. b~~ Plot plan showing location of lot and of buildings on premises, relationship to adjoining premises or pt~blic streets or art'as, and giving a detailed description of layout of property must be drawn on the diagram which is part o this appli- caVfna. 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. S,luch permit shall be kept on the premises available or 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 purs ant to the Building Zone Ordinance of the Townl, of Southold, Suffolk County, New York, and other applicable Laws, Or finances or Regulations, for the construction of buildings, additions or alterations, or for removal or demolition, as herein described. The applicant agrees to comply with 411 applicable laws, ordinances, building code, housing code, and regulations, and to admit authorized inspectors on premise's and in building for necessary inspections. Law Bros. Homes, Inc. (Signs N&; a 1'cant or me, if a corpor otion) ur> se flyway Islip Terrace, N.Y. 11752 (Mailing address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. Name of owner of premises MorkP. and. Li nda. ft4cpy . ,(as on the tax roll or latest deed) If applicant is a corporation, signature of duly authorized officer. Frederick K. Abrams V.P., - (Name and title of corporate officer) Builder's License No. 300.7111 Plumber's License No. ........I Electrician's License No. Other Trade's License No. 1. Location of land on which proposed work will be done. F/A M05, 0,1d, No phr>Zoad, .4.5.6...6.7.'. West, of Ligh.thouse.Road•,.Sopxhold,.N..Y........................................................ House Number Street Hamlet County Tax Map No. 1000 Section -54 Block 3... Lot , , , , , , , Li hthouse Subdivision $ A . .s.so. .bates , , , , , , . Filed Map No. Discribed Lot (Name) 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy Ore family, dwelling . . . . . . .N;_, t. , . b. Intended use and occupancy x 14'; 0", screened porch on rear of house'. 3. Nature of work (check which applicable): New Building Addition . X........ Alteration . Repair Removal Demolition Other Work . G (Description) 4. Estimated Cost «i. 0.~~. Fee (to be paid on filing this application) 5. If dwelling, number of dwelling units Number of dwelling units on each floor If garage, number of cars 6. If business, commercial or mixed occupancy, specify nature and extent of each type of use 7. Dimensions of existing structures, if any: Front . .5.9.1.-.4.11 Rear 59'.-4", , , , , Depth . 2.8.', A. 30' Height 24 Number of Stories Dimensions of same structure with alterations or additions: Front ...59'.:4"......... Rear . AV.-A." . Depth .30..& .42" • • • • • . • • • Height ..24 Number of Stories . 8. Dimensions of entire new construction: Front 25'.-Q'! , . , , . Rear ...W.-.q Depth . , 14'; . , . Height Number of Stories ....Ome .....4,........ . . . 9. Size of lot: Front ..27.0,',,,, , , , , , , , , , , , Rear 30,71', , , , , , , , , . Depth .42.5...42.'. & 327.71' 10. Date of Purchase ...July.,. AR8.6 Name of Former Owner Lighthouse Associ.a.t.e.s 11. Zone or use district in which premises are situated AC . . . . . . . . . . . . . . . . . . . 12. Does proposed construction violate any zoning law, ordinance or regulation: ...No 13. Will lot be regraded .....Pin Will excess fill be removed from premises: NOTIVes No 14. Name of Owner of premises MAr;kQ .A11t;tggM . , , . , , Address Brooklyn , . , , . Phone No?18 .836-0656 Name of Architect Address Phone No. Name of Contractor Law .Bras. ,Homes, Aric..... Addresislip ,Terrace , , , , , , , Phone No. 581--4020 15. Is this property within 300 feet of a tidal wetland? *Yes........ NoVP....... *If yes, Southold Town Trustees Permit may be required. Y PLOT DIAGRAM Locate clearly and distinctly all buildings, whether existing or proposed, and, indicate all set-back dimensions fr(orn property lines. Give street and block number or description according to deed, and show street names and indicate whether interior or corner lot. 0 0 2a Q 4 O STATE OF NEW YORK, S .S ~zZSE.P0a0e, COUNTY OF .....8u££alk Frederick. Abrams being duly sworn, deposes and says that he is the applicant (Name of individual signing contract) above named. ' He is the ...........................Corporate Officer (Contractor, agent, corporate officer, etc.) of said owner or owners, and is duly authorized to perform or have performed the said 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 t ......day of 19 Notary Publi County 4 CLAIRE L GLEW Notary Public, State of New York . No.4879505 (Signature of applicant) Qualified in Suffolk County Commission Expires December 8,19, SUFFOLK CO. HEALTH DEPT. APPROVAL 40 H.S. NO. 91-SO-30 117 n -TEST FrCi£ ~ ~ ) ' ~ • h ~ I K `t'1- --O - - _ - ny~ I STATEMENT OF INTENT ° - THE WATER SUPPLY AND SEWAGE DISPOSAL SYSTEMS FOR THIS RESIDENCE WILL ' CONFORM TO THE STANDARDS OF THE SUFFOLK CO. DEPT. OF HEALTH SERVICES. 1 ^ (S) 45 APPLICANT 50 > SUFFOLK COUNTY DEPT. OF HEALTH 1 \ ! / f I SERVICES _ FOR APPROVAL OF - / I CONSTRUCTION ONLY 4'i~y ~lM1s I' nCRATE: H. S. REF. NO.. 9)-SO-30 ? , APPROVED: 40 J(,ALE KG ! SUFFOLK CO. TAX MAP DESIGNATION: ~~I ? (j t 1Ci`t r! DIST. SECT. BLOCK PCL. V ; i AL: A, 2302 A . low 54 3 262 y - - - OWNERS ADDRESS - j IO2d GgTH. ST2EE; w ~t - B 2 0 C } I Y N, ^•J Y' i Z I q .I r ~ -30 'Z 45~6~- - ,/~Jr1J - - - _ 22 998 2935• "tt cESSVOOCI w a', DEED: L.590S P.567 ,REF ~ ~ - TEST HOL ST Ri • o TID 'S i t 3 J H avv ~k a; LOAM uu"'l - SAW p 4 ~Q- % MAP AMENQEL- APR.4,Ig9i . APQ.18 1991 6 ; - - '----1--- - JU?tE 2Q 1 UCT.8,1991 Ci7A12Sf. f e ~ to m.r.iticns ur .,u • NVY•Gtir.VE SEAJ, 1. ! i2~E e ~r, _e~ tGri AME tTtE kt~IC~'hfC r iw\ tFdt?iL 4F _Ui V 1- r•,Arzsr MA17F G fE. 4t H T _ - . _ kjt t ~AY4f 3L1 A 2d 1 ~f 3 "5 tf t . 7'~J 1` 1 aAtat EAR t Qvc-a- AN TUY WnT 5UFf Cif T•-"al MAC PATH: 1000 54-3 UCIMD LAND VEYOIRS 17' GRE1111lIPORT NEW YORK `inm~rron wtxw SUFFOLK CO. HEALTH DEPT. APPROVAL 40 llH. S. NO. 91- SO 3Q (QE5fPENiCE) '0 2VEY'ED FJCZ -TirsT. HOLE, MA"IdDOUNDA } " V AT STATEMENT OF INTENT THE WATER SUPPLY AND SEWAGE DISPOSAL ~~~~J{G1•f? SYSTEMS FOR THIS RESIDENCE WILL TOWN OF `WLITHQLD CONFORM TO THE STANDARDS OF THE SUFFOLK CO. DEPT. OF HEALTH SERVICES, f (S) 45 APPLICANT SUFFOLK COUNTY DEPT. OF HEALTH SQ'`. ~3! ` SERVICES - FOR APPROVAL OF CONSTRUCTION ONLY VIR~`ti"r 3 f DATE: H. S. REF. NO.. 91 - 50-30 \ I APPROVED: ` LE: ZJ 40 t? f i SUFFOLK CO. TAX MAP DESIGNATION: l G / : 2C,/"`4 P1 " DIST. SECT. BLOCK PCL. J A2EA -2,7Q2 AG low a~ 3 2f :,Z OWNERS ADDRESS: J 1024 G4 TH. STREET' BQ-WZLYN.NY i219 301 J .ti 4l , i° 1(Q - - CE951'OOl'} ; - DEED: L.5905 P.567 ,2EF 3 i ~;1j ~Q~ -'r'~~ TEST HOLE T IIII - {~Y1 Y 7JPSO!. L Cr3n s as nis u / Avv 'Td `'E!id SfU7 LOA 1 to .~J~~,??? !"".r 'l OSE9: lhi+C.^,^:C h@Peoni 4 ! . O or ly i0 th.^„" ban 7r v r,r r SQ ~ rhhsh~ o -.7AN D tftla clri. zn'I gatey~m~n1 a 6r 4 h•1" ~ MAP AMEN DEV • APR i9 1 APQ,1$ 1991 _ 1 u um li r h r to the • ~.II - a tu7i n ,.f@ not tf rI -----_JUI•!E Gp OCTT'.8.~991 AQ to ~ :;i r~s*0?ufiens a s • SrEA ; ? ' f s~}_ My Qf _NClt U ~~i,V S{~'+^itit AME CAN TITLE 1N~~ 1kAlt1~ 'CQAFZS Avlt4'3 V `,i('T W 0EWICK VAN TUY P.C. ~ ' i 11 r1 S yT 4 f ~ i Cy a ~0. V sSFF. t!i TAJ' MAC'Ar/q 000 LICENSED LAND URVEYORS GREENPORT NEW YORK Tfl'.PV,Nf POST N6,239 a I,I r C• I I Y I' i i i i I UNDERWRITERS CERTIFICATE of REQUIRED i I ~ i OCCUPANCY OR USE IS UNLAWFUL WITHOUT CERTIFICATE OF OCCUPANCY i w APPROVED AS NOTED - DATE: S` 9 B.P.N a 9 7~ I - - FEE: ;7f-,W BY:- I____ NOTIFY BUILDING DEPARTMENT AT AM TO 4 PM FOR THE / - FOLLOWING INSPECTIONS: TWO REQUIRED FOR 765-1802 9 POURED CONCRETE j 1. FOUNDATION onnau coneunir n on anaiur 3 INSULATION,^...~ _ 4 FINAL - CONSTRUCTION MUST BE COMPLETE FOR C.O. i,f w ALL CONSTRUCTION SHALL MEET 17- REQUIREMENTS OF THE N.Y. THE STATE CONSTRUCTION 14 ENERGY I CODES. NOT RESPONSIBLE FOR DESIGN OR CONSTRUCTION ERRORS, I - - 1' 007 i i II l i I r i Ryv i<~.,4i#a I I /r6 i r I gLUrLM. _x ~c I 1 ' I I p SK.M f3f i r I 1 ! ~ K i X71 I P,C• u'+'•' 'I 4- I i f I i I I I , 'o 1 r,