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Home My WebLink About21992-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUP~A~CY No Z-24361 Date MAY 14, 1996 THIS CERTIFIES that the buildin~ Location of Property 80 JACF~ON STREET House NO. County Tax Map No. 1000 Section 117 Subdivision Filed Map No. ADDITION NEW SUFFOLKw N.Y. Street Hamlet Block 10 Lot i Lot No. conforms substantially to the AppLication for Building Permit heretofore filed in this office dated APRIL 5, 1994 pursuant to which Building Permit No. 21992-Z dated A~RIL 5, 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 PORCH ADDITION TO EXISTING ONE FAMILY DWELLING AS APPLIED FOR The certificate is issued to (owner) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL UNDERWRITERS CERTIFICATE NO. PLUMBERS CERTIFICATION DATED KIMOGENOR POINT CO. ~/a N-330217 - OCTOBER 17, 1994 N/A Rev. 1/81 TOWN OF $OUTHOLD BUILDING DEPARTMENT TOWN ~ SOUTHOLD, N.Y. N_O BUILDING PERMIT [THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) 21992 Z Permission Is hereby granted to: ~~....~, ........~ ...... ..,~...~.......~ ................................................................ . ~.~.~.~ ......... ~ ....... ~z~....~ ..... ..~/Z~ ........ ~ ........ ~~.....,~..~ ...... ~..~ ........... ~.....~ .................... ~.~.~ ....... ~Z./;:~;:.J ...... Z:.G~.; ........................... ~ ................................................. .... = .............................................. Zfi......~ ............ ~~Z ....... ~ ........................................... ............................... ~ .............................. Building Inspector. F~ $l..~...: .............. //~' Building inspector Rev. 6/30/80 Form No. 6 765-1802 · BLDG. DEPI ' TOWN OFS APPLICATION FOR CERTIFICATE OF OCCb~ANCY ~ ........ ~wm OFSOUTHOLD 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 su~-vey of property with accurage location of all buildings, property lines', sgreecs, and unusual natural or topographic features. 9. Final Approval =~ _ ~om Health Dept. of water supply and sewerage-disposai(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. ' Submit Planning Board Approval of completed site plan requirements. For existing buildings (prior to April 9, t957) non-conforming uses, or buildings and 9pre-existing" land uses: 1. Accurate survey of property showing all property lines, streets, building and unusual natural or Topographic feanures. 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 ~o 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 $i5.00, Commercial $15.00 Date ...... ~.~.~.!?~ ....................... ~ew Construction ........... Old Or Pre-exis~£ng Building..B~.~O~¢h.g~¢nsioq ~ocat±on of Prooertv 90 Jackson Street East End Kimogenor Point New Suffolk House No. Street Had]et or Owners of Properuy. .... Tax Map No 1000, Section...~? ........ Block .... ~9 .......... Lot ...... ~ ............... 3ubdivision .................... Filed Map .......... Lot .................. ?ermit No.g~99~.g ........ Date Of Permit..~J~/~ ........ Applicant...¢PP~.L,.Pollio ............ ;{eaiuh Dept. Approval .......................... Underwriters Approval ......................... 'lannlng Board Approval ........................ ~sques~ for: Temporary CerTificate ........... Final Certica=e... ~ee Suomi~Ted' $ /25.25 ................ ..................... C O'"~°~L[~J .~PPLICAk7 Anne L. Pollio REDMOND, POLLIO & PITTONI ATTORNEYS AT LAW lz~61 I~2~ANELIN AVENUE G~I~DEN CITY, N.Y. ll6$o BLDG. DEPT. TOWN OF SOUTHOLD May 9, 1996 JOHN T. R~4OND Town of Southold Building Department Town Hall PO Box 1179 Southold, New York 11971 Attn: Ms. Viola Zeiss Re: Application for Certificate of Occupancy Addition to Rear Porch -Anne L. Pollio 90 Jackson Street. Kimogenor Point. New Suffolk. New York Dear Ms. Zeiss: I am enclosing nay wife's application for a Certificate of Occupancy in connection with a small addition to our rear porch, along with a $25.25 check in payment of fee for the same and a copy thereof. I believe you have all the consents and a survey which was previously submitted. If there is anything further you may require, please call me. Please send the copy of the Certificate of Occupancy to me in the envelope provided. Thank you again for your kind assistance. BJP/bjh Enclosures Sincerely, t J. Poqlio 14036 THE NEW YORK BOARD OF FIRE UNDERWRITERS P~, l 1 ~ 85~'7 7 ( BUREAU OF ELECTRICITY ~ ~5 JOHN ~TREET, NEW YORK, NEW YORK 1OO~8 Dete ~)C~0}~ ~.7 ~ ~f~ ~pplication ~o. ~y,~ 851 ~49~4/_ 4 ~ 33~217 THIS CERTIFIES THAT only the electric[ equipment ~ ~scr~ bolo~ intmduc~ by t~ applicant ~med on the a~ve application number in the prem~es of ANN~ POLLT~3, 8~ JACKSON o'IREET, N~ S~FOM{, N.Y. t~s exa,.i.ed o. O...TOBSR 13 ~ 1994 a.d found to be i. compHance with the NaMo.dI Elect~cal Code. 4 1 DRYERS SYSTEMS NO. OF FEET E R V I C OTHER APPARATUS: 140TORS~ 2--*Y tt,P. G.F.C:.I: '~1 ROSLAK ELECTRIC P,O.BOX 164 CUTCHOGLr~,, NY, 1~935 LIC. ~.3677-E 11 . 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 ALTERED IN ANY MANNER. Town Hall, 53095 Main Road P. O. Box 1179 Southold, NewYork 11971 Fax (516) 765-1823 Telephone (516) 765-1802 OFFICE OF THE BUILDING INSPECTOR TOWN OF SOUTHOLD May 7, 1996 Kimogenor Pt. Co. C/O Robert Fox 226 West Lane Ridgefield, CT 06877 To Whom This May Concern: We are unable to complete your Certificate of Occupancy because of the following reasons: xx An application for Certificate of Occupancy is not on file. (Enclosed) No Underwriters Certificate on file. xx 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 # 21992-Z Please contact our office on this matter. cooperation. Thank you for SOUTHOLD TOWN BUILDING DEPT. NEW yORK STATE DEPARTMENT OF ENVIRONMENTAL CONSERVATIOR OEC PENM,T NUMSER PE'-IT I 1-47'58-00872/00001-0 FACZLITY/PROGRAH NUMBER(S) ~ati~ L~ TYPE OF PERMIT g Ne~ ~ Rnne.aL ~ M~ific~tion B Pe~it to Construct Artec e 15, TitLe 5: P~otect~nn ~ ~YCRR ~8: ~ater Q~Lity EFFECTIVE DATE November 22, 1993 EXPIRATION DATE(S) November 30, 1996 Permit to Operate of Waters ArticLe 15, Title 15: Water Supply ArticLe 15, TitLe 15: Water Transport ArticLe ~5, TitLe ~5: LonB Island Wells Article 15, TitLe 27: Wild, Scenic and Recreational Rivers Other: PERMIT ISSUED TO Ann L. PoLLio ADDRESS OF PERMLTTEE 119 WhitehaLL BLvd., Garden City, MY 11530 Certification ArticLe 17, Titles 7, 8: SPDES Article 19: Air Pollution control Article 23, Title 2?: Mined Land Reclamation Article 24: Freshuater Wetlands Article 25: Tidal Wetlands Article 27, Title 7; 6NYCRR 360: Solid Waste Management Article 27, Title 9; 6RYCRR 37'5: Hazardous Waste Management Article 34: Coastal Erosion Management Article 36: F[oedp[ain Management Articles 1, 3, 17, 19, ZT~ 37; 6RYCRR 380: Radiation Control TELEPHONE NUMBER CONTACT PERSON FOR PERMITTED ~ORK TELEPHONE NUMBER Ann L. Pottio NAME AND ADDRESS OF PROJECT/FACLLITY Po[LiD Property - Jackson Street LOCATION OF PROJECT/FACLL[TY Nea Suffolk COUNTY [ TOUN Suffolk $outhoLd WATERCOURSE I Great Peconic Say NYTM COORDINATES Construct ~Z' B" x 11' B 1/2" addition to existing porch and screen entire porch. Ail ~ork shall be in accordance ~ith the attached NYSDEC approved plan. By acceptance of this permit, the permittee agrees that the permit is contingent upon strict compliance uith the ECL, aLL appLicabLe regulations, the General Conditions specified (see page Z} and any Special Conditions included as part of this permit. REGIONAL PERMIT ADMINISTRATOR: I ADDRESS Robert A. Greene BLdg. 40, SUNY, Room 219, Stony Brook, NY 11790-2356 AUTHORIZED SIGNJ~'URE. I DATE I Page 1 of /-/ DEPARTMENT OF THE ARMY NEW YORK DISTRICT, CORPS OF ENGINEERS JACOB K. JAVlTS FEDERAL BUILDING NEW YORK, N.Y. 10278-0090 25 October 1993 Eastern Permits Section SUBJECT: Joint Application with New York State Department of Environmental Conservation Ms Anne L. Pollio 119 Whitehall Boulevard Garden City, NY 11530 We have recently received a copy of the Joint Application for permit you filed with the New York State Department of Environmental Conservation (NYSDEC). Please be advised we have reviewed the copy of the Joint Application sent to this office by NYSDEC. Based solely upon the information provided, it appears that a Department of the Army permit is not required for your proposal. The Department of the Army regulates construction activities in navigable waterways and discharges of dredged or fill material into waters of the United States, including inland and coastal wetlands. If your proposal would involve such work, and has not been portrayed as such in your Joint Application, you should contact this office immediately so that a project-specific determination can be made as to whether a Department of the Army permit will be required. Any inquiries can be directed to this office at (212) 264- 3912, 3913, 6730, or 6731. Sincerely, ~ . e~s W. Haggert~' ~ 7 ~ief, Eastern Permits Section 1. FOUNDATION [ 2nd ) 2°' ROUGH FRAME & 'PLUMBING INSULATZON PER N. Y. STATE ENERGY CODE FINAL ADDITIONAL COM~ENTS · 765-1802 BUILDING DEPT. INSPECTION REMARKS: PART OF LARGER SURVEY SEPARATELY SUB~,~TTED' Pollio Residence Additions Pr~pared;b~: 'D~te: I Scale:'" , Benedict Poilt,o ¸I. OF Disapproved a/c ..................................... FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N.Y. 11971 TEL.: 765-1802 BOAKD OF HEALTIt ......... 3 SETS OF~,.,P'LANS . SEPTIC FORI'I 7 SY.-.5./.,;J. ........ i'IA I L TO; APPLICATION FOR BUILDING PERMIT INSTRUCTIONS a. This application must be completely filled in by typewriter or in ink and submitted to the Building Inspector, with 3 ets o1' plans, acm/rate plot plan to scale. Fee according to schedule. b.: Plot plan shqwing location of lot and of buildings on premises, relationship to adjoining premises or public streets ~r arqas, and giving a detailed description of layout of property must be drawn on the diagram which is part of this appli- :ation. c. The work covered by this application may not be cbmmenced before issuance of Building Permit. d. Upon approval of this application, the Building Inspector will issued a Building Permit to the applicant. Such i~errnit hall 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 hail 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 ~uilding Zone Ordinance of the Town of Southold, Suffolk County, New York, and other applicable Laws, Ordinances or ~.egulations, for the construction of buildings, additions or alterations, or for removal or demolition, as herein described. ?he applicant agrees to comply with ail applicable laws, ordinances, building code, housing code, and regulations, and to dmit authorized inspectors on premises and in building for necessary i~pections. -- (Signature of applicant, or name, if a corporation) (Mailinl adt~;e's~ ~}'a~ii~a~;) ............ ~tate whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. X/ame of owner of premises .... ~..l~.h?...L2 .... q...~.~ ..................................................... (as on the ta% roll or latest deed) if applicant is a corporation, signature of duly authorized officer. (Name and title of corporate officer) ,. Builder's License No.. J .~..'-~.~ .7,.-~ .,q..~ .~.'~-~. ........ Plumber s License No ..... ~. .~ .............. Electrician's License No... ~ ~ ~ o,..~..~ .......... -.. Other Trade's License No ...................... Location,of land on which proposed work will be done ..... I.~ (Bq .O .~.%Vv. iL'ff... ~,o.t.v!.T. ' ..................... <...g 5. .......................... House Number Street Hamlet County Tax Map No. I000 Section ..... }, l..~. ........ Block ...l{~. ............ Lot...l ............... Subdivision ..................................... Filed Map No ............... Lot . ./. ~ ........ (Name) · State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy I~ 5t ~ .¢--'a '~o,. L b. Intended use and occupancy .... e_ ,~ '~.. '~'-i 3. Nature of work (check which applicable): New Building .......... Addition .. Repair .............. Removal .............. Demolition .............. Other .~.,t ' ' (Description) (to be paid on 5. If dwelling, number of dwelling units ...... f ........ Number of dwelling units on each floor ............ · If garage, number of cars ..... ! ................................................................... 6. If business, commercial or mixe~ occupancy, specify naturg and extent of each ty,.pe of use ........ 7. Dimensionsofexistinestructure~ if an,,' Front _~cl ~.-.~ '~') ........ ° ~, ~ ................ Rear ........... Depth ............... H ~ght .... ~;1, ~-, .......Numlber of Stories ...... ~7.,... . ....... Dimensions of same structure with alterations or additions' Fr~)nt ..... '~ '" ' ' i .... R;ar''' i' ~2~ ...... 8. Dnnens~ons of entire new construction. Front /.dr Rear ^.~ t' ,-, .... /£'? ...... height ........ ~. f.-/.. Number of Stories ...... ~'. ............................................... ' 9. Size of lot: Front .... { ~.~.. · Rear ~/~%o Denth .~.~.~.... ' 10. Date of Purchase .... ~.; ' 1. ;.' .... .2. ..... - ............. ........... i .................. t'~ame mvormer uwner ............................. 1 1. Zone or use district in which preInises are situated ........ ~.C ~,~ c~ ~_~.'[-.o. L~ ............................. 12. Does proposed construction violate any zoning law, ordinance or regulation' . /'~. ¢ . . . 13. Will lot be regraded ~IZT I . -, .... ' .... ; ~' .................. ..... I ........... ~ ..... Will excess nu oe removed trom premises: Yes No 14. Name of Owner of premises /qla4~../~. J~.9./']~t~... Address ~'. ~.w.d,~' 'Ct '~ ...... Phone No ................ .N. ame o{~Arch, itect ..N. ...... i>' ....: .......... Address ................... Phone'No .......... rqameott, onrractor.~e~W.q¢ !~o.u~J-~vg"tp . Addressr-~..Ve).~ ,~ ....... ~-/~. ,-,,~ ..... 15. p [, y wzcu~n opu feet or atloa± wetland? *Y/es...A~.... No ....... · If yes, Southold Tpwn 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 lines. Give street and block n'umber or descriptioh according to deed, and show street names and indicate whether interior or corner lot. ;TATE OF NEW YORK, ~'OUNTY OF .............. ............................... ~ .................. being duly sworn, deposes and says that he is the applicant (Name ofindividual'signin contract bore named. is the ........................ , ......................................................... (Contractor agent~ corporate officer etc ) ...... said owner or owners, and is duly aathorized to perform or have performed the said work and to make and file this vplication; that all statements contain{d in this application are true to the best of his knowledge and belief; and that the 'ork will be performed in the manner se't forth in the application filed therewith. worn to before me this ...... q..'~. · ........... day, of.,.9~ ....... 19 No. ~952246, Suffolk Cou~W _ . .,r .......... ;i: .,--.-.-x~ ........... Term Expires June 1~, 19.,~~''- /~/ (Signature of aplSlicant)