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Home My WebLink About21436-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT office of the Building Inspector Town Mall Southold, N.Y. CERTIFICATE OF OCCUPANCY No Z-23481 Date FEBRUARY 3, 1995 THIS CERTIFIES that the buildin~ Location of Property 1405 ANCHOR LANE House NO. County Tax Map No. 1000 Section 79 Subdivision ALTERATION SOUTHOLD NY Street Hamlet Block 4 Lot 4.1 Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated MAY 19, 1993 pursuant to which ~Building Permit No. 21436-Z dated MAY 26, 1993 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 ROOF OVER FRONT ENTRY STOOP OF ONE FAMILY DWELLING AS APPLIED FOR. The certificate is issued to ANTHONY & LINA FOROSICH (owner, lessee or tenant) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL UNDERWRITERS CERTIFICATE NO. PLUMBERS CERTIFICATION DATED N/A N/A N/A Rev. 1/81 FORM NO, S TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N. Y. BUILDING PER~IT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) Permission is hereby granted to: . ~.~'~ ~ ~ ~~......¢.....&.~.......~...~-. ~','~'~ ~ .~.,..~: ~. ~.~.~ .............................. . .~7~~..a..;.~-..~..a. _~/ .~~ ~ ~~.; .......... ,o ....... ~....~......-~~...~..~ .......... .~~ ....... ~ ......... ~~ ...... ~ ............................................................... ~, ~,,m,,,, ~t,~ ~, ..Z~e.~....'~~..../~.~ ............................................................... ............................................. ~~~ ................................................................................... Counly Tax Mop No. ,000 Section ...... ..?..?.. .......... Block ...... ...~... .......... Lot No.......~...~.../.. ......... pursuant to application dat~d ................................................. ~. , 19..?..~.., and approvc~l by the Building Inspector. · ~.. ,.z~. Rev. 6/30/80 Form No. 6 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL 765-1802 APPLICATION FOR CERTIFICATE OF OCCUPANCY BLDG. DEPT. TOWN OF BOUTHOt. D 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: i. 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 Buildinz - $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 .... o..~ .................... . . New Construction ........... Old Or Pre-existing Building ............. Location of Property...I.~.~ ..... ~.~-.. k..~.'. ............... .. ~? ................. House No. Street Hamlet Onwer or Owners of Property ........ County Tax Map No i000, Section ..... '~.~ ...... Block ...... ~ ........ Lot .... .~ ............... Subdivisi°n'''~Q~'~...~k~.~....~4~. Filed Map..~.g-~ .Lot. 3~ ......... Permit No, .~J .~.~. ...... Date Of Permit..~./..2~.l~ .... Applicant..~.~.~ ~....~.~ .~..~. ....... Health Dept. Approval ...... .~gJ.~ ............... Underwriters Approval ..... ~.~ ............... Planning Board Approval ....... .t~/.[~ ............. Request for: Temporary Certificate ........... Final Certicate. F mitted= $...%.f...,?. ..... Town Hall, 53095 Main Road P. O. Box 1179 Southold, New Yo~k 11971 Fax (516) 765-1823 Telephone (516) 765-1802 OFFICE OF THE BUILDING INSPECTOR TOWN OF SOUTHOLD January 27, 1995 Mr. & Mrs. Anthony Forosich P.O. Box 299 1405 Anchor Lane Southold, NY 11971 **** SECOND NOTICE **** 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 # 21436-Z Please contact our office on this matter. cooperation. Thank you for SOUTHOLD TOWN BUILDING DEPT. ** - ACCORDING TO THE CODE OF THE TOWN OF SOUTHOLD, IT IS UNLAWFUL TO OCCUPY OR USE SAID STRUCTURE UNTIL A CERTIFICATE OF OCCUPANCY HAS BEEN ISSUED. INSPECTORS Victor Lessard Principal Building Inspector Curtis Horton Senior Building Inspector Thomas Fisher Building Inspector Gary Fish Building Inspector Vincent R. Wieezorek Ordinance Inspector Robert Fisher Assistant Fire Inspector Telephone (516) 765-1802 OFFICE OF BUILDING INSPECTOR TOWN OF SOUTHOLD August 18, 1993 SCOTT L. HARRIS, Suger~is0~ Southold Town Hall P.O. Box 1179, 53095 Main Road SouthoM, New York 11971 Fax (516) 765-1823 Telephone (516) 765-1800 Douglas McGahan P.O. Box 602 Cutchogue, N.Y. RE: 11935 FOROSICH, ANTHONY & LINDA 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 %. 21436-Z Please contact our office on this matter. cooperation. Thank you for SOUTHOLD TOWN BUILDING DEPT. FOUNDATION (1st) FOUNDATION (2nd) ROUGH FRAME & ?LUMBING' INSULATION FERN. STATE ENERGY CODE FINAL ADDITIONAL COMMENTS: LC,,- 3~ D N.64 Oo ,~ 765-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLBG. FOUNDATION FRAMING REMARKS: ZND [ *) INSULATION [~FINAL DATE FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL ~OUTHOLD, N.Y. 11971 TEL.: 765-1802 19 . l ¢ Permit Disapproved a/c ..................................... BOARD OF HEALTH 3 SETS OF PLANS ..... SURVEY .......... ~. ......... CHECK ....... ::..: .... SEPTIC FGRH · .. CALL ............ HAIL TO: ... D... (4 ¢~.~ ....... ... P: ~...~9~.. ~ ..... APPLICATION FOR 8UILDING PERMIT Date .. ,:~...'7 .tB7 ......... 19q3. 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 public streets or areas, and giving a detailed description of layout of property must be drawn on the diagram which is pan of this appli- cation. ¢. 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. 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 unt I 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 z:emoval or demolition, as herein described. The applicant agrees to comply with all applical~e laws, ordinances, buildi)~ code,_~ousina code, and regulations, and to admit authorized inspectors on premises and in building for necessary inspq~io~sA [1 . /x · [' '(~ig~ature c~ppl~cant, or na~ll'~, ... l) -.o... .r ac. ,. t (Mailin~ address of applicant) State wh~ther applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. ............ .E-O..NTg.~}c,.-rr;:,R,,.. .................................................................. . Name of owner of premises ... ~A'~Ig.N..'~../~...~.[/5/. ~...~-9.~.~.~J..Q0 ............. , ....... (as on the tax roll or latest deed) If applicant is a corporation, signature of duly authorized officer. BuiUer'sLieense No .... Plulnber's License No Electrician's License No ....................... Other Trade's License No ' 1. Location ofland on which proposed work will be done; Il N b St ............... ouse um er reef Hamlet County Tax Map Nol 1000 Section ~.~. .... Block .'~ .t~..l Lot ~ Subdivision.. ~q .~,, .L.~.(..k~...., .~:~.%~'[ ~.,. Riled Map No. q ~o b'2... I..~-. ; (Name) .............. Lot ............ 2. State existing usc and occupancy of premises and intended use and occupancy of proposed construction: '~ Exis,,g use and 01-9.~ Efirm~c..~ ..... f-~5.1~-r6~. '~'.~ :' '" a. occupancy ............ . ;. ',' .. ~, ....... ii . · ;. !.' ,:, , ,, ~ ,' b. Intended Use and occupancy ,5~X/t~' -,~, ~": ., , k( h ppli ) Additi.. .. · · Air ti ........ 3. Nature of wot check whic a cable: New Building .......... on .... era on Repair Rsmova;l Demolition .............. Swimming pool ............. ...... ...__ Aclcessory Building Fence Other Wok Tennis Court ..................... r ; ........... 4. Estimated Cost ...... ~ .......................................................... I (to be paid on filing this application) .5. If dwelling, number of dwelling unlits ............... Number of dwelling units on each floor...; ........... If garage, number of cars ...... 4 ................................................................ 6. If business, commercial or mixed dccupancy, specify nature and extent of each type of use .................... 7. Dimensions of existing structures, ff any: Front.., ............ Rear ............... Depth .............. Height ............... Number of Stories ....................................................... Dimensions of same structure witl3 alterations or additions: Front ................. Rear ................. Depth ..................... 4 Height ..................... '. Number of Stories ..................... 8. Dimensions of entire new construction: Front ............... Rear ............... Depth ......... i .... Height ~umber of Stories ' 9.' Size of lot: Front ............ ~ ......... Rear ...................... Depth; ...................... 10. Date of Purchase .... , ........ i ................ Name of Fenner Owner ...... ~ ....., ................... I I. Zone or use lstrlct in w lC 1 pre lses are mtuate ............ ; ................... . .... ~ ........ ~ · · 12. Does proposed construction viola[e any zoning law, a ace regu on: ... ........................... ~' · 13. Will lot be regraded . ........ 'J ....' ....~ ........ Wiil excess fill be removed from premises: ~es .... No-h~ Name of Architect ........... I ............... Address ................ t.. Phone No.. .... -' ' ' ' 2~ ..... 15,Is this property locatled wxthin 100 feet of a tidal wetland? *YES .... 1~O~... ~If yes, Southold Town Trustees Permit may be required. PLOT DIAGRAM Locat.e. clearly and distinctly all 1 property lines. Give street and b!ock n interior or comer lot. mildings, whether existing or proposed, and. indicate all set-back dimensions from ~mber or description accord!ng to deed, and show street names and indicate whether STATE OF NEXV YORK. S,S ......... I~ 9,q ¢.PY~ .... .¢').; .~.q .(~9~ ......... being duly sworn, deposes ~d says that he is the ar (Name of individual signing contract) above nam'ed. ~ is the ................................................................................ ( n a , g , corporate officer, etc.) Co tr ctor a,ent of said owner or owners, ~d is dul~ authorized to pegform or have performed the said work and to m~e and application: that all statements cont¢ined in this application are true to the best of his knowledge and belief; and Work ~v~l bc performed in the m~ne[ set forth in the application filud therewith. ' Sworn to before me this i >licant lie this hat the