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Home My WebLink About21513-zNo Z-22696 FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY Date NOVEMBER 4~ 1993 THIS CERTIFIES that the building. Location of Property 64920 NORTH RD. House No. County Tax Map No. 1000 Section 40 Subdivision ACCESSORY (CTY RO~D #4B) Street Block 3 Filed Map No. GREENPORT{ N.Y. Hamlet Lot 10.3 Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated JUNE 22, 1993 pursuant to which Building Permit No. 21513-Z dated JULY 2r 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 ACCESSORY STORAGE SHED AS APPLIED FOR. The certificate is issued to (owners) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL UNDERWRITERS CERTIFICATE NO. PLUMBERS CERTIFICATION DATED Rev. 1/81 CHARLES & JUDY KOZORA N-293662 -OCT. 26r 1993 N/A //%ildlag Inspector FORM NO.3 TOWN OF $OUTHOLD BU)LDiNG DEPARTMENT TOWN PALL $OUTHOLD, N.Y. 21513 Z BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED} Date Permission Is hereby granted to: Cfi itC_/__E._¢ o .......... .............. ~'7'"'%";" ........ ........ ..~,~......c,~,....~,,, .......... ........ ~ ..........~z~.. .......... ~~._,~ ................................................................. c ~'~r~ /~7JP-~q~ ~~.~ .......... ....................................................... ~.~ ..................................................................................... ~, ~ ~oo o, ............... :~.~..~ ................................................. Building Inspector, Fee 0.....~.~,.. and approved by the Rev, 6/30/80 Form No. 6 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL 765-1802 , 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. 3. : 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. ~. 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 - $5.00 ever 5 yea~s - $10.00 Updated Certificate of Occupancy - $50.00 Temporary Certificate of Occupancy - Residential $15.00, Commercial $15.OO Date ................................ ew Construction .... Old Or Pre-existing Building ................. House No. Street Hamlet ~wer or Owners of Property-.... .. ..... ~unty Tax Map No i000, Section.. ,~lock.. ...................... Map.. Lot :'rml~ No ............... Date Of Permit... ..Applicant.. UD~ ~alth Dept Approval ..................... Underwriters Approval ......................... anaing Board Approval ...... ~ .............. quest for: Temporary Certificate ........... Final Certicate,. INSPECTORS Victor Lessard Principa[ Building Impector Curtis Horton Senior Building Inspector Thomas Fisher Building Inspector Gary Fish Building Inspector Vincent R. Wieczorek Ordinance Inspector Robert Fisher Assismm Fire Inspector Telephone (516) 765-1802 OFFICE OF BUILDING INSPECTOR TOWN OF SOUTHOLD October 29, 1993 SCOTT L. HARRIS, Supervisor Southold Town Hall P.O. Box 1179, 53095 Main Road Southold, New York 11971 Fax (516) 765-1823 Telephone (516) 765-1800 Chayle~ & Judy Kozora 64920 North Road Greenport, N.Y. 11944 To Whom This May Concern: We are unable to complete your Certificate of Occupancy because/~f the following reasons: ~/~Xx An application for Certificate of Occupancy is not on file. (Enclosed) ~ No Underwriters Certificate on file. ~/XXX The check is (~utdat~d/not on file.)$25.00 No Health Department Approval on file. No final inspection has been made. No Plumber Solder Certificate on file. (Ail permits involving plumbing being issued after April 1, 1984). BUILDING PERMIT $ BP # 21513Z Please contact our office on this matter. cooperation. Thank you for SOUTHOLD TOWN BUILDING DEPT. 'OUNDAT~O~ (2nd) ~OUGH FBAHE & .PLUMBING ~SULATIO:$ PER N. STATE E~IERGY CODE FI;IAL · II ADDITIO}IA'L COMME~;TS: d2~OdO2d~'~ ss~aa¥ j ~JOJ. V~ J. SlNIV,/a.V '~!LuJed 9!qJ JO ~.J'ed s~' pepnlou! suoR!puo0 i'e!oeds ~ue pue (epj$ asJe^el::l ee$) p@!j.oeds suop,!puoO 18Jeue~ eq~ 'suo!l. etnbaJ elq'eo!ldd~ I1~ "103 eq~. qllM eOUe!ldLUO0 ~.oIJlS uodn ~,ueSuRuoo s! l!LuJed aql. ~,~q), saeJ6~ ee~4!Lu.ied eql ':HLuJed s!q~ ~.o eoue~.deooe ~8 · paAoadde OMaSXM padmeas puc ~6/[[/6 ~ozoM sala~q9 iq paaedaad SUeld @q~ aad s~ §uipI~nq ~no pu~ Moap e nonaasuoo ~N ~ ploq~nos ~Io~ns ( ) ff¥611 AN ~aodu@a/O "P~ q~ON 06~9 ~!sWQN ]NOMd:f'~L oi O]QSSl ilw~ Z66l ~Z '~das (]:)3) ,'/,'e*~ uo!ll~,',JasuoD ii~lua~uuoJ!^u3 aql Japu("l 0-[ 0000/08~00-9~;L~-[ q!P: ~tgI£ JSA%~ ~ ~U~O sss%sn=A ~o p;~os u~o~ pioq~noS @q~ ~q; poAIOSSM £'0I-£-0~-000I% X~DS :sM S~ p~oM A~unoD 06E~9 ~ozoM Kpn£ 9 ssI=~qO E66I '~E xsqo~oo Gq[OHiQOS ~I0 N3AO£ 765-1802 BUILDING DEPT. INSPECTION FOUNDATION 1ST [ ]ROUGH PLBG. ] F/~NDATION 2ND [ ]INSULATION FRAMING [ ]FINAL 765-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLBG. FOUNDATION 2ND [ ] INSULATION FRAMING [~AL DATEr ///~)/~/~/~ INSPECTOR THE NEW YORK BOARD OF FIRE UNDERWRITERS ~ ~ ~[ [ 9 S ~} r/~ BUREAU OF ELECTRICITY '/' ~- B5 JOHN STREET, NEW YOR~ NEW YoRK tOO38 THIS CE~IFtE$ THAT '~ o~y t~ el~t~c~I ~uipme~t ~ ~scrib~ be~ ~ i~t~c~ ~y t~ ~pplic~nt ~med o~ the e~ applic~tlon ~u~b~r in the prem~ oJ Lot FIXTURE / I I RXTURES I RANGES SERVICE DISCONNECT I NO. OF I OTHER APPARATUS: R V t C EXHAUST FANS DIMMERS 80UI'H0hl) , }1¥~ 11921 GENE~.AL MANAGER This cert;fi¢ote must not be altered in any manner; return to the office of the Board if in¢oriect. Inspectors may be identified by their credentials. COPY FOR BUILDING DEPARTMENT, THIS COPY OF CERTIFICATE MUST N~OT BE ALTERED IN ANY MANNER, FORM NO. I TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N,Y, 11971 TEL,: 765-18ff3 Examined Approved Disapproved a/c ..................................... APPLIcATIoN FOR BUILDING'PERMIT BOARD OF~ HEALTH ::::: .... h'OT I PY $ CALL HAIL TO: ,Date ...................... INSTRUCTIONS '" ~ a. Tiffs 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 st3eets or areas, and giving a detailed description of layout of property must be drawn on the diagram which is part 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 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, dr for rem6val or demolition, as herein described. The applicant agrees to comply with all applicable laws, ordinances, building code, housing code, and regulations, and to admitauthorizedinspectorsonpremisesandin bu?ding fornecessaryinsp~ /~,4j~ ~ (Mailing address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. ............ "' ' APPROV£D' AS NOlti:l ....... NJme of owner of premises ,., .J.~.g).~.. l~/..C?.~..~.~.~.F.~...../~..~1~.. ?..~,4. ............. (as on the tax roll or latestF~..d?'~57a~ a~,:~'~ If applicant is a corporation, signature of duly authoriied officer. · N~)~IFY BUILDING ~~'EpA~ENT AT ,,ilder's icense No ............ USE. iS. UNLAWFUL Plumber's License No ........... W'ffNOUt CERTIFICATE =lectrician's icense No ......... OF'OCCUPANCY Other Trade's License No ...................... 765~1802 9 AM TO 4 PM FOR THE FOLLOWING !NSPECTIONS: 1. FOUNDATtO~J TWO REQUIRED FOR POURED CONCRETE 2. ROUGH - FRA~ING & PLUMBING 3. INSULAI~ON 4, FINAL - CONSTRUCTION MUST ~ COMPLETE FOR C,O. AL~ CONSTRUCTION SHALL, MEET THE REQUIREMENTS, OF THE N,Y. STATE CONSTRUCTION & ENERGY COOLS, NOT RESPONSIBLE FOR Location of land on wliich proposed work will be done ............................. ~ .~ ....... House Number Street Hamlet County Tax Map No. 1000Section .. ' .~O Block ~,~ ' Lot. ' /~:.'~. St bd vision ~"~'~/ ~°'4/'/d~a/ ~ ' Filed Map No. . J Lot ........... '.-.. (Name) State existing use and occupan~ of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy ....................... b. Intended use and occupancy ... ~.~4~. ~/~7~. ~ ~~' ~] ~/~ZX ' · .' ~ ..,qb ~, * ~ ' · 3.Nature of work (check which applicable): New Building . ..~/. ..... Addition .......... AlteratiOn .' ...... ~.. Repair .............. Removal .............. Demolition .... : ......... Other Work ............... · ' '~ q~ ~ ' '"' ' ''~"~t~ ~l/ti~,'~ ~(Descril]~{ ,on) 4. Estimated Cost .......... ........ .................. Fee ........... · ' .'~..,...... ,: . ~, ;._~ . . · (to be paid on fih~l~~n) [ 5. If dwelling, number of dwelling units ..... i.."~.~ ...... Number of dwelling units on each If garage number of cars 6. If business, commercial or mi.xed occupancy, specify nature and extent of.each type of use .. '-'"' 7. Dimensions of existing structures, ifany: Front..,~.af..~. ........ Rear .............. Depth ............... Height ............... ~umber of Sto.~ ........................................................ Dimensions of shine structur~ with alterations~r~dditions: Front ................. Rear .................. Depth .... [ .................. Height ..... * .... ' ........ ;.. Number of Stories ........... ~..~...: .... 8. Dimensions of entire new construction: Front .............. ; Rear ............... Depth .......... ' .H. eight ............... Number of Stories .................. 2. ........... · - ' ; ;'iiiiii i /.iiiiiii:... Depth 9. :Size of lot: Front .... ,~,.~..O ........................ 10. Date of Purchase . t~4~., t',~'/. ............... Name of Former Owner . 4~.l.Ot'O~..~.. ~. 41~'~'.~..4~45 ......... 11. Zone or use district in which premises are situated ..... ~'.~./~..~?¥~'./.W'(--. ....................... 12. Does proposed construction violate any zoning law, ordinance or regulation: ...A~.O ......................... 13. Will 10t be regmded ....... : .Al'..~. ................ Will excess fill be removed from. premises: Yes (~ 14. Name of Owner of premises .~..~V..~..P--r~/.~..t~..-q. .~'~ddress ...~. ~7~t.~. . .~...~.~... Phone No....~?.'O~?..6.7';...' Name of Architect ...... n~'.. ,~' ,~A-.4~... .......... Address ................... Phone No ................ Name of Contractor ~....~4-~. · Address Phone No ..... 15.' ~.s th±s property within 300 feet of a tidal wetland? *'/es..' ...... 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. ...... .~.At(~.,~...Z.~.. .... .~.o?..o..~. ........... '.. ........ being duly sworn, deposes ~d says that he is the applicant (Name of individual signing contract) above named. He is the ..... . ..................................................................... ' .............. (Contractor, agent, cofporate officer, etc.) of said owner or owners, ~d is duly authored to perfom or have perfo~ed the mid work ~d to m~e ~d file this application; that all statements contained ~ this application are true to the best of his ~owledge and belief; and that the work will be perfo~ed in the m~ner set forth ~ the application filed therewith. Sworn to before me this Nota~ Public, ~ County . ~.~ ............ .