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Home My WebLink About22043-zFORM NO. 4 TOWN OF SOUTMOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No Z-23627 Date MAY 11, 1995 THIS CERTIFIES that the buildin~ Location of Propert~ 38675 MAIN ROAD House NO. County Tax Map No. 1000 Section 15 Subdivision ALTERATION ORIENT, NE~4 YORK Street Block 2 Filed Map No. Hamlet Lot 17.4 Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated APRIL 21, 1994 .pursuant to which Building Permit No. 22043-Z dated MAY 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 ALTERATION~TO EXISTING ONE FAMILY DWELLING AS APPLIED FOR. The certificate is issued to STEPHEN A. KELENEN (owner) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL UNDERWRITERS CERTIFICATE NO. PLUMBERS CERTIFICATION DATED Rev. 1/81 N/A N-345628 - MARCH 17, 1995 N/A FO~M NO.$ TOWN OF $OUTHOLD BUILDING DEPARTMENT TOWN HN.L SOUTHOLD, N.Y. N~ ~2043 Z BUILDING PERMIT ITHIS PERMll MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) Date....~ ........................................... Permission Is hereby granted to: , ..~ .............................................. at premises located at.,.~.. ~. ~....~..,,-~ ,...~.... ,~...~..". ................................................................... CountyJaxMap No. 1000 Section ....... ./..,~... ......... Block ......... ~ ...........Lot No ...... ./..Z.._~... ....... pursuant to application dated .......~...;~../..; ..................................... 19...?...,~... ..... and approved by the . Building nspeo'ror. Rev. 6/30/80 / TOWN OF SOUTtIOLD f 2 BUILDING DEPARTMENT 'Pi~ TOWN HALL /:,.-.~ ~ ' - 765-1802 ~PLICATION FOR CERTIFICATE OF OCCUPANCY ~ ': A. This application must be filled in by typewriter OR ink and submitted to t~e 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 contairs less than 2/t0 of 1% lead. 5. Comercial 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. F~r existing buildings (prior to April 9, 1957) non-conforming uses, or buildings and Vpre-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, Swiming 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 - $20.00 4.Updated Certificate of Occupancy - $50.00 5.Temporary Certificate of Occupancy - Residential $15.00., Comercial/~15.00' Date ...... New Construction ...... i .... Old Or Pre-existin~ Buildi~....~. ............. Location of Property...~ ~:~.. ....... ~-~- :~6D ..~.t~..~..i House No. Street Hamlet Co,nty Tax Nap ~o lO00, Saa¢~on ........ Block ...... ~ ....... Lo~ ........ ~ ....... Subdivision .................................... Filed Nap ............ Lo~... Permit . · Date O~ ........ · . Appl~caat ...................... Hea~th Dept. App~ova~ ................... Uade~u~i~a~s App~ova~ .................... BlaanZn¢ Board App~ova~ ............... Town Hall, 53095 Main Road P. O. Box 1179 Southold, New York 11971 Fax (516) 765-1823 Telephone (516) 765-1802 OFFICE OF THE BUILDING INSPECTOR TOWN OF SOUTHOLD April 26, 1995 Mr. Stephen Kelemen P.O. Box 811 Main Road Orient, NY 11957 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) xx 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 # 22043-Z Please contact our office on this matter. cooperation. Thank you for SOUTHOLD TOWN BUILDING DEPT. 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 March 17, 1995 Mr. Matthew Hallock 4365 Wells Road Peconic, NY 11958 Re: Stephen Kelemen - BP#22043-Z (Alteration) Prem: 38675 Main Road, Orient 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. xx No final inspection has been made. No Plumber Solder Certificate on file. (All permits involving plumbing being issued after April 1, 1984). BUILDING PERMIT # 22043-Z Please contact our office on this matter. Thank you for cooperation. $OUTHOLD TOWN BUILDING DEPT. ** - ELECTRICAL INSPECTION NECESSARY IF ANY ELECTRICAL WORK DONE. SINCE FINAL INSPECTION HAS NOT BEEN DONE, WE DON'T KNOW YET. OUNDAT!ON (1st) OUNDATIOI; !. ~OUGH FRAME & .?LUMBING [NSULATION FERN. (2nd) STATE ENERGY CODE Fi:IAL ADDITIONA'L COMMENTS: ]65-1802 BUILDING DEPT. INSPECTION [ ]FOUNDATION 1ST ( ] ROUGH PLBG. [ ]FOUNDATION 2ND [ ] I~ULATION ./ ]FRAMING [//] FINAL REMARKS: ~, /~/ ~ '~/ DATE: INSPECTO~ 765:1802 BUILDING DEPT. INSPECTION FOUNDATION 1ST [ ] ROUGH PLBG. FO~ND]~:~ND [ ] INSULATION ~]'~RAMING [ ] FINAL 7~5-X802 BUILDING DEPT. INSPECTION [ ] FOUNDATION IST [ ] ROUGH PLBG. [ ] FOUNDATION ZND ~LATION DATE [JUI m 2~1 MIl ~iL~ TOWN OF SOUTHOLD SOUTHOLD, N.Y. 11971 TEL.: 765-180:2 Examined . .., .....· ...., 19 ........ Disapproved a/c ..................................... BOARD OF HEALTH ......... 3 SETS OF PLANS .......... SURVEY ................... CHECK .................... SEPTIC FORH .............. HAIL TO: A. UILDING PERMIT INSTRUCTIONS a. This application must be comp!etely filled in by typewriter or in ink and submitted to the Building Inspector, with 3 sets of plans, accurate plot plan to scal~. Fee according to schedule. b.v Plot plan showing location of lot and of buildings on premises, relationship to adjoining premises o~ 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- cation. c. The work covered by this apphgahon may not be commenced before issuance of Building Permit. d. Upon approval of this application, the Building Inspectorwill issued a Building Permit to the applicant. Such permit shall be'kept on the premises available ~or inspection throughout the w6rk. e. No building shall be occupied or used in wholo or in part for any purpose whatever until a Certificate of Occupancy shall have been granted by the Building Inspector. ~' ':::~ :. '.'~i' ~ :.~%~ APPLICATION IS HEREBY MADE to the Building Department for the issuance of a Building Permit pursuant to the Building Zone Ordinance of the Townl 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 dl applicable laws, ordinances, building code, housing code, and regulations, and to admit authorized inspectors on premise s and in building for necessary i!~spec~?..~,. · .~.~. --' (Signature of applican~.m"~me, if a corporation) .... ?. ,..q: (Mailing address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. . D . +rac.P.o.c .......... [ ............................................................... Name o£ owner or premises .. ............................................. (as on the tax roll or latest deed) I.f ap%ant is a corporat..ion, signature o_f duly auth~orized officer. · .... .......... (Name and title of corporat~ officer) .~. 77~.' Builder's License No ...... I .......... Plumber's License No ......... l ................ Electrician's License No. Other Trade's License No ...... i ............... 1. Location of land on which propose~l work will be' done ................................................ House Ng~ber Street County Tax Map No. I000 Section ..... }..~. ......... Block and intended use and occupancy of proposed construction: Subdivision ................ (iq'~ ~) ..... 2. State existing use and occupancy o~ premises a. Existing use and occupancy.., i.../..../~"..~... G.C~;.. b. lntended use and occupancy . i../ .... ........... Filed Map No ............... Lot ............... Hamlet ........... Lot../.7.,..q .......... 3. Nature of work (check which applicable): New Building Addition ...... Alterat~i~... Repair .............. Removal .............. Demolition .............. Othe~r~-'~ork-.. ggg~,..~ ....... X.~. ?. 10,7-9 ' . ~,'~' ~ iD~cription) 4. Estimated Cost t (to be paid on 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 ............... Rear .............. Depth ............... Height ............... Number of Stories ........................................................ Dimensions of same struct'ure with alterations or additiOns: Front ................. Rear .................. Depth Height Number of Stories 8. Dimensions of entire new construction: Front ............... Rear ............... Depth ............... Height ............... Number of Stories ............................................. i .......... 9. Size of lot: Front ...................... Rear ...................... Depth ......... I0. Date of Purchase ............. .... . ........... : ....' ......... Name of Former Owner .................. 11. Zone or use district ih which premises are situated .......................................... 12. Does proposed construction violat~ gny zoning law, ordinance or regulation: 13. Willlot be regraded ................................ ............................ Will excess fill be removed from premises: Yes (~ 14. Name of Owner of premises .................... Address ................... Phone No ................ Name of Architect .. ,<3.. ~ , Name of Contractor ~A4. ~ ./~:~.' .~.'/.' ~'~-~ i ....... Address ................... Address '~.'~7.' ~i~.'~. i i i i i iPhOne No. Phone No..'?~'.' ;-' .-.-.~..~/'~.',~ Is this property within 300 feet of a tidal wetland? *Yes ........ No..; ...... *If yes, Southold Town Trustees Permit may be required. 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 number or description according to deed, and show street names and indicate whether interior or corner lot. ~E(~LIIRED FOB POURED CONCRETE 3, ~SU/,ATIOk~ BE COMPLE'fTE FOR ALL COaSTRUCTiOa SHALL MEET S?/~ff~ CONSTRUCT~O~ CO~3ES. ~OT RESPOnSiBLE FOR STATE OF NEW YORK, COUNTY OF ............... S.S .......... ' ....................................... being duly sworn, deposes and says that he is the applicant (Name of individual signing contract) above named. He is the ......................................................................................... (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 am 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 this · .. '~ / """""""""~¢~ day ne C~/,4¢-''~'-''1~ o ¢,9/ JOYCE M. WILKINS . .. Notsry PubliCo State of NowYork i ~l~t~l~e ' No. ~952246, Suffolk CounW_, ( g of apphcant) Term Expires June ~2, II)--.~-¥