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HomeMy WebLinkAbout21732-z . FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No Z-23178 Date AUGUST 23, 1994 THIS CERTIFIES that the building ADDITION Location of Property 1680 HENRYS LANE PECONIC, N.Y. House No. Street Hamlet County Tax Map No. 1000 Section 74 Block 2 Lot 5 Subdivision Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated OCTOBER 8, 1993 pursuant to which Building Permit No. 21732-Z dated OCTOBER 23, 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 ADDITION & DECK ADDITION TO EXISTING ONE FAMILY DWELLING AS APPLIED FOR. The certificate is issued to ANTHONY & PHAEDRA SAVAS (owners) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A UNDERWRITERS CERTIFICATE NO. N-322685 - AUGUST 5, 1994 PLUMBERS CERTIFICATION DATED JULY 13, 1994-KING PLUMBING & HEATING INC. 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 AUTHORIZED) Q Date rte........ 19./~~... N® 21732 Z {4C f C Permission is hereby granted to: ara....C...... ~AP, nxte to. .A4<zC 1 ........i : I at premises located at....... 141e.1Z I County Tax Map No. 1000 Section .........,7..*..`.... Block........ 4;? Lot No. . { pursuant to application dated 0 19..,x3..... and approved by the j Building Inspector. ...~1.... Fee $ I i Building Inspector F Rev. 6/30/80 i FORM NO. 6 TOWN OF SOUTHOLD Building Department Town Hall Southold, N.Y. 11971 APPLICATION FOR CERTIFICATE OF OCCUPANCY Instructions A. This application must be filled in typewriter OR ink, and submitted-in duplicate to the Building Inspec- tor with the following; for new buildings 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 of Health Dept. of water supply and sewerage disposal-(S-9 form or equal). 3. Approval of electrical installation from Board of Fire Underwriters. 4. Commercial buildings, Industrial buildings, Multiple Residences and similar buildings and installa- tions, a certificate of Code compliance from the Architect or Engineer responsible for the building. 5. Submit Planning Board approval of completed site plan requirements where applicable. B. For existing buildings (prior to April 1957), Non-conforming uses, or buildings and "pre-existing" land uses: i 1. Accurate survey of peoperty showing all property lines, streets, buildings and unusual natural or topographic features. 2. Sworn statement of owner or previous owner as to use, occupancy and condition of buildings. 3. Date of any housing code or safety inspection of buildings or premises, or other pertinent informa- tion required to prepare a certificate. C. Fees: 1. Certificate of occupancy $5.00 2. Certificate of occupancy on pre-existing dwelling or land use $5.00 3. Copy of certificate of occupancy $1.00 22 JUL 94 Date „ New Building Old or Pre-existing Building(X) --,'Vacant Land Location of Property 1680 Henrys La. Peconic House No. . _ .................Street ..........:........:.....Hamlet Owner or Owners of Property Anthony Sava$ County Tax Map No. 1000 Section 74.......... Block Lot .....5......... . Peconsc Homes 5001 43 Subdivision , ,Filed Map No. ..........Lot No. Permit No. 73~ ..Z 23 . Date of Permit OCT 9Applicant . Kim T. Dzenlcowski Health Dept. Approval ........................Labor Dept. Approval Underwriters Approval ........................Planning Board Approval • . Request for Temporary Certificate .....................Final Certificate XX............. Fee Submitted Construction on above described building and p miCmeets all a •cabltcodes and regulations. Applicant . , - . Rev. 10.10-78 ~:rg3 3~./Ca a3-I78: °lELD If:S7 ON JIDAiE I~ COMMENTS 1 . ~ a V - ~ - - - yN FOUNDATION (1st) FOUNDATION (2nd) - _ m 2. /y ROUGH FRAME & r o PLUMBING 3. 1,4/ a 3 x ra INSULATION PER N. Y. m H 1 STATE ENERGY CODE x 4, m FINAL c) ADDITIONAL COMMENTS: r C 25 C7 'V H H m~ - c-i N ~~nn p Q i F ~ ~ t 0 i Cw ~e 3 ° c N W ;E Z r a Q v 0+ 0. " M a 6, of +n c Z y w a S d = 3 2 z ink ~ N Y LL N N t 3t N ~W x C6a ~ a s z z C ; < s 3i w gel = " 2 V 46 O W c £ a G1 O rn m =1 z 1 Z O^ try 3 $ = O ` V ' u H W o Z Y $ tq 0 Y LLI (,so, ~C 4 F uo tt w w r 3~ W p F F Z y N; S C dV {n c U { LL. U Y O .S Y m S LL Q m o A i « { J i w .4c o' W o U t u 0 t Q0W 2 y ~7 u~ a °u O 4 Q z z g z N 'y a ' 3 $o~ O Q rcW .02 ` N Z « v Q 0 a© ¢ 2 g 3 d Z N ~ E ri i F w W m 0) z z ? o yy H a ?N $ 3' H Y H C <a m FC •y o Y IC x E 0 n C g O y~ 3y 5 8 e a ~s Nm U. m LL .3 ° m b 7 t1 E O W 6 N; b C.1 a'i V c V t INSPECTORS Ste`':r'f-: c isr SCOTT L. HARRIS, Supervisor Thomas Fisher Building ' s`a5 = Southold Town Hall Ins pector P.Q. Box 1179, 53095 Main Road Gary Fish ;•j~~'•:,ay Southold, New York 11971 Building Inspector Y Fax (516) 765-1823 Telephone (516) 765-1800 Robert Fisher Assistant Fire Inspector OFFICE OF BUILDING INSPECTOR Telephone (516) 765-1802 TOWN OF SOUTHOLD C E R T I F I C A T I O N DATE:? / 3 9`f Building Permit No.% 732^ Owner: /3,a%!/v.uy~ p~ 4p~~?J- 13,S - (please print) p Plumber: Q, r 1 (pleas print) L/ I I certify that the solder used in the water supply system contains less than 2/10 of 1% lead. ~i (Plumbers Signature) Swor2 t before me this 3 day of > 111. Notary Public, 3" W-0 County Notary Public CLURE L CLEW NNo 487980BNewYprlt QuelNiW in Suffolk County Cummieslon EVIres December 8,1~ M-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION 1ST [ } ROUGH PLBG. FOUNDATION 2ND [ I INSULATION lh~ [ ] FRAMING ( INAL REMARKS: i R i ` DATE INSPECTO F i pp~_ . i -7 765.1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION 1ST ROUGH PLBG. [ ] FOUNDATION 2ND [ ] INSULATION FRAMING [ ] FINAL REMARKS: t f E s 'K t t DATE INSPECTO r -7 32, 765-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION 1ST [ J ROUGH PLBG. [ J FOUNDATION 2ND [ ] 1 ULATION [ ] FRAMING FINAL REMARKS:. AV r 71 DATE /S INSPECTOR M-1802 BUILDING DEPT. INSPECTION [Vj FOUNDATION 1ST [ I ROUGH PLBG. [ FOUNDATION 2ND [ ] INSULATION [ ] FRAMING [ ] FINAL REMARKS: G~ i i I 4 tl DATE I INSPECTOR ~-~73 Z M-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLBG. [ ] F NDATION 2ND [ ] INSULATION [ FRAMING [ ] FINAL REMARKS:`' r r i DATE ~ ~ INSPECTOR (~17 3 2- 765-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLBG. FOUNDATION 2ND 7`}"SULATION FRAMING [ J FINAL t REMARKS:' t x i E f l i C DATE f INSPECTOR s vi e4tlai of 5,~ ct rfi rr ~ , tr d,~ ~7K '~fil loam, ~itaftlb a Y z ~ y~ ~4 ~r ¢dk 3 ~a:J q~ ~ ~ ~ ~l~ 1 5 t~h IfYyWlry W+,p7 .S~J~llq~ i^ dMy (k? Ar In9 a Wq J , i- 'r ,i!§~P ti, c r a~ , ~ g~ WM A hw bkbbil l SIB t;~ : ~ , , S ya ,tn 5 '¢rr y t d ~ r , i [ x' a,El Ownl~ ~ i rp Fy t~{N 6,1 x~t~ ri ~y ~ibb 1`?il,1sM'9CklIY`fbit~ y ,fir, .d j l"" r 7F $ q"rS~f}1:.i 7 7 3~yi'i 1~`hJ ~'~iti ~ ~ 1, JfT r g~ 9 ~ ~rf ex'dV '`^r `t l ~r ~Et(~i 1 > V 7 r~. z f - ~u ~ k~ r ~ J d t7 ^s ~ ~~F I ti.+2P?~P, f ut ~y t ~ ~ i iE+~~~ Kr i u ~ t 4 f l ~ Ar 'a3 ff' azgg, ~`S£~lZ srr i r v. .,r l1Xr~ Gt ds s" s t % " Arr1 tYa! a t5~: _ 12- 0 44 ON, o5 S~ r F,. / AT" ~'~/2 Ncrt~~e^r i. 7-h 6'ii l vol G 4~~rlcfmf ~'Y ~ic,inil~ Bdn~Y ~riv C d1i~GIt1~7. : Z> rjf NF ee-lo c i NfW IGJI" f A ~ 5 AlC { I t 2 ~ t ~ S { BOARD OF HEALTH FORM NO. 1 3 SETS OF PLANS TOWN OF SOUTHOLD SURVEY . . a1s CIIECI. BUILDING DEPARTMENT TOWN HALL SEPTIC F0RCI SOUTHOLD, N.Y. 11971 TEL.: 765-1802 ::DTI r-Y ; Q~~•.3 rJn CALL • . Examined . .Q11, Approved / r 19 . Permit No.......:.. . Disapproved a/c . lit _ r I9,14 huig- nspector) APPLICATION FOR BUILDING PERMIT OCT-0 cc2. . . 19q.3 Date . 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 part of this appli- cation. 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. 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 shill 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 removal or demolition, as herein described. The applicant agrees to comply with all applicable laws, ordinances, building code, housing code, and regulations, and'to admit authorized inspectors on premises and in building for necessary inspects. (Signature of a icant, or name, if a corporation) ~r~o® CcDrr2..,D .Rs..Fhs~ /Lfg13,1 ...ti".y (Mailing address of applicant) I c(3 q State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. Name of owner of premises fix!-~ . , , 7i~, • P,14 S A V4 s (as on the tax roll or latest deed) If applicant is a corporation, signature of duly authorized officer. (Name and title of corporate officer) Builder's License No. .el.Z..~. 1;f T Plumber's License No . Electrician's License No . Other Trade's License. No . 1. Location of land on which proposed work will be done . . 1.6 rho ........)+elv A. y..S.. . . . . . .Pcco,,I ~ House Number -7 Street Hanilet County Tax Map No. 1000 Section U. I......... Block Z Lot.. ..i ..0./1.1.G Subdivision ...P.5..4..0.4~ .C ......40/11 e ..S....... Filed Map No.r. 3 (Name) Lot 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: IVG~L a. Existing use and occupancy Y. b. Intended use and occupancy .......d10"- .E ls~w: 3. Nature of work check which a ( applicable).: New Building Addition Alteration . Repair Rempval Demolition Other Work c (Description) 4. Estimated Cost r~ O dV Fee (to be paid on filing this application) ' 5. If dwellino", 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 . . ' Dimensions of existing structures, if any: Front 5-.3 , , , , ,Rear •'a......... Depth 2 77,., , , , , . Height . , N, , , , , , , , , , Number of Stories „1 . Dimensions of sale structure with alterations or add'tyons: Front ....x ..~3 Rear ....?.`J , , , Depth Number Height J*e5-3 Y, , , , , , , , , ,Number of Stories . . . of ruction: Front Rear 5 3......... Depth ...'3 y . 8. Dimensions of entire new constber of Stories ....1... , . , , , L.* , , ' ' • ' ' • ' ' ' ' Ha C7 3 9. Size of lot: Front A j.1.11.7.3 A S , , , , , Rear ...1. 5_, r / , Depth JA? q t o, .q 10. Date of Purchase A,v ¢ • • • • • • • • • • • • • • • • • • • ..Nam of Former Owner 11. Zone or use district in which promises are situated - 4U , , , , , • • . • ' • • • ' ' • • 2. Does proposed construction violate any zoning law, ordinance or regulation: .:!I! , , , , , 13. Will lot be regraded . :~I~ d ! . Will excess fill be removed from premises: Yes No . . . . . 14. Name of Owner of premises t. 17 , .SA(44S , , Address .A5,f-Y R 0 y v. Phone No. 73,t/,'-,$-66.1 , , Name of Architect Address . . . Phone No........ , . Name of Contractor .0z' ti...... K9w N . 5. Is this . sC*r?, Dlts • i,`- y Phone No. y74, p. 5. , . Y'a property within 300 feet of f a a tidal l wetland?* e wet tlandd?? eyes,••,,,~,• No. . * S/'•.••• 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. T svR ~y t, STATE OF NE " RK S COU Y OF ' ' • • , • • • • • • • • being duly sworn, deposes and says that he is the applicant (Name of i rvidual signing! contract) ibove named, le is the...... Co.v7(Zi{ S T. 9 .'R... I (Contractor, agent, corporate officer, etc.) f said owner or owners, and is duly apthorized to perform or have performed the said work and to make and file this pplication; that all statements contained in this application are true to the best of his knowledge and belief; and that the fork will be performed in the manner set forth in the application filed therewith. worn to before me this day of 19 . Gt 3 Jtary Pu oic County LAIR Notary Public, State of NNowYork / No.4879505 ll Qualified in Suffolk County (Signature of applicant) (4f Commission Expires December 8, 10 OccuPANcY OR - USE Is UN0 IFU IMITHOUT GERTIFICA E EAST- API)ITION > I T I O N F40 R 0 CUPANCY _ NA F? - - Y MR-4-MRS. 5AVA5 R I'IR 61111 AS NOTED ~J DAYD DATE 3 B.R #~~y~~y~Y sy~ - - crE - nioTl€ N~O+TI _ NG DEPART N!T AT/ 746, 1802 S AM TO A PM FOR THE FOLLOWING INSPECTIONS: F - - Fouc 1. FOUNDATION - TWO REQUIRED FOR POURED CONCRETE 2, ROUGH - FRAMING S PLUMBING 3. hq~ FIN 3?~. INSULATION ~4. FINAL - CONSTRUCTION MUST BE BE COMPLETE FOR C.O. ALL ALL CONSTRUCTION SHALL MEET 7HE THE REQUIREMENTS OF THE N.Y. STATE STATE CONSTRUCTION & ENERGY CODE CCDES. NOT RESPONSIBLE FOR DESIGN OR CONSTRUCTION ERRORS DESK _ fFRNFIGItE i D 34 SBP 93 ? S6P 43 ME HOME -FMrRovEMr&Nr M. F-0 2 S AU(r. v ( C ` Z E 4' AuG Strf~1 50p'fot-H Clc: .-t: .z.. i i i DscK AuGi oN NEVV WALLS EXI:-PING- DEL - I p(n r Cl05 C a ~ N I'VN t ~ 1V~AST 1V~RSTE, I BE U f - - - 1 I(''S t, MIG+eo:hN~ v' GWH I - - f+EAP Eft W W SHEET {fir I GARAGE DINING KITCHEN OF BAT ~4 GLO. I P2EN WOW SRI SCAL C : 114` ADDITION FOR M1~. d M R5. SAVAS 7 SF-F q3 Not NOME tMPROVEMENT 3;.:r SEP 3 17 AUK R3 4MENDE-0 25 AuGr93 5t 5UFFIDLk LI G. # 1298g RZ ASPµALT 5HgNGLES , it 157 FELT c D X PLY 2 ACV M 1'Y FASCIA It 0, C, 1x12' SOFFI T Ir2 5 R•' 3/8' S. R, 2xl WENT n I BL 2x I 1 _ . t, ~Z INS. R Iq RE vSE F-KISTimr, Cg1EMENT SHEET R- S. 4- R -PAP,Y 13ARN SNAKES a I LvA Ply, of 115 PELT 2 TrlS. FttSInl PXj 1R _ '/4' cox Pt_y oAK RooRtm& VENT £3 01K 6 CouRSES T'EE~k+~1TE SHIi=LD FR Iq INSULaTloti WATER PROo,Fwc pzV-rtKO vv s~(1 HOME -rWPROVW M(~s HTfi~i ~S IAN 9.3 ~~Q S~P93 M SuPFpLK Lic. yi2.4OX SCALE . ~~4 =1 _ =WAS_UN~_ G EY,I 5 7'IN' J~ GTR Il T~f : r 1~ , ;r is 2 l4 , ao6a~ z O r- N h W. ~r r SCALE: 1 =1 1 =1 V~ SREF7 Q~ D DZ E N Ko W S K 1 I40 ME rM p I Ru V~ M L N r 7 :E('9 I+OME SUFFOLK LIC. # 1,2486141 MF-NDEA 2S Avc 3 n scP `T 17 Avg, q3 ` sv ~ 1 r*{R 4KV FiK APO I4- r 2/K.e 111 I I i [3ENGH GH t11 i ^~r1 11 1 11 1 IYI 1'1 1 +tl III +II I11 I 1 { ~ +'1 I 111 111 i !II 111 ,II III ,u u{ III I I ~ i pjti?bfi~ IL~6~93 HQM HQME IMPROVEMENT 3o NoV 93 svi SUFFQL1< LI C, I2.9$$4+'.t