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Home My WebLink About21211-zFORM NO. 4 TOWN OF SOUTEOLD BUILDING DEPARTMENT Office of the Building Inspecto~ Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No Z-23976 Date OCTOBER 23, 1995 THIS CERTIFIES that the building ADDITION Location of Propert~ 16500 MAIN ST. & 775 FOURTH ST. House No. Street Hamlet County Tax Map No. 1000 Section 117 Block 9 Lot 13 Subdivision Filed Map No. Let No. conforms substantially to the Application for Building Permit heretofore filed in this office dated FEBRUARY 1, 1993 ~ursuant to which NEW SUFFOLK, N.Y. Building Permit No. 21211-Z dated FEBRUARY 4, 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 FOUNDATION UNDER EXISTING ACCESSORY BUILDING AS APPLIED. The certificate is issued to (owners) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL UNDERWRITERS CERTIFICATE NO. PLUMBERS CERTIFICATION DATED JOSEPH H. & JOAN M. FUDJINSKI N/A OCT. 10, 1995-PERFECTION PLUMBING & HEAT. Rev. 1/81 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N. Y. BUILDING PERJvtlT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIl FUlL COMPLETION OF THE WORK AUTHORIZED) N~T°. 21:~11 Z Dote..~.../..~.. ......................................... , ~.~. Permission is hereby, g,r~/l~ted to: , / ~ / . v ~ /fl (/ , ~, ,' ..~.::.....~~.....~ ............................... , ,o . .,~.¥,~...~ ........ ,~,/~.. .~(:... ...... ..~,....~~...~...~~ - ............. ~=. ........ ~ ...... ~~ ............... .................................................. ........................................................... co,~w T~, ~ ~o. ~o0o Se~,o~ ..... /~ ....... B~k ....~ .............. ~o, ~o....~ ........... Building Inspector. & .......... Rev. 6/30/80 FOUH OF SOUTIIOLD BO I. LD [ NC- OEP ARTHEHT TOI4N HALL 765-[802 APPLICATION FOR CERTIFLCA'I'E OF OCCUPANCY A. This application must be filled in by typewriter OR ink and submitted to the building inspector with the following: for new buildi~g or new use: 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 goard of Fire Under~rit~ts. 6. Sworn statement from plumber certifying that the solder used in system contains less than 2/IO of i% lead. 5. Commercial b~ilding, industrial building, multiple residences and similar buildings and installations, a certificate.of Code Compliance from architect or engineer ~esponsible for the building. . 6-Submit ~lanning Board Approval of comoleted site Dian requirements. B. For existing buildings (prior to Anril 9, 1957) non-conforming uses, or buildings and "pre-existing" land uses: [. Accurate survey of property sho~¢ing 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 Occupa,cy is denied, the Building inspector stlell state the reasons therefor in writing to the applicant. Certificate of Occupancy - Ne~ d~elling $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-existin~ ~uildine - $100.00 3. Copy of Certificate of Occupancy - $20.00 Updated Certificate of Occupancy - $50.00 5. Iemporary Certificate o[ Occupancy - Residential $15.00, Commercial Jaunty ]'ax Hap No 1000, Sactio. ............. BI.ok ............... Lot ..................... ~ubdivision ................................... Fi led Ndp ............ Lot ................. :'ermLt No ................ Du~e Of PeFlnlt ............... App[Lc;mt ................... ,ieaith Dept, Approvnl ................. Undet-lor!t°~rs Approval ................. Town Hall, 53095 Main Road P. O. E~ox 1179 Soulhold, NewYork 1~971 Fax (516) 765-1823 Telephone (516) 765-1802 OFFICE OF THE BUILDING INSPECTOR TOWN OF SOUTHOLD CERTIFICATION Building Permit No. ~/~// Owner: ~- ~ ~4j,,~' (please print) (please print) I certify that the solder used in the water supply system contains less than 2/10 of 1% lead. (~P~i U ~b~~nature) Sworn to before me this t0~b~ day of ~cT~-_ , 19~. Notary Public, ~ County NOTARY PUBLIC, State of N.Y. N~. 4725089. Suffolk Coup~y~ Term Expires May 31.19_'/.(o 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 September 27, 1995 Mr. Joseph Fudjinski 564 First Street Brooklyn, NY 11215 Re: Building Permit #21211-Z Premises: 16500 Main Street, New Suffolk Surf. Co. Tax Map #1000-117-9-13 During a review of our files it was noted that the above building permit has expired, and a Certificate of Occupancy has never been issued. According to the Code of the Town of Southold, Article XXVIII 100-284, it is unlawful to occupy or use a structure until a Certificate of Occupancy has been issued. Please contact this office as soon as possible so that we may clear up this matter. Thank you for your cooperation in this matter. Very truly yours, SOUTHOLD TOWN BUILDING DEPT. Thomas J. Fisher Senior Building Inspector POUNDA'TION ( lst)~ ~OUGH FRAME & .FLUMBING i~SU~ATION PER N. STATE ENERGY CODE FINAL ADDITIONA'L COMMENTS: INSPECTION ] F/OUNDATION 1ST [ ] ROUGH PLBG. FOUNDATION 2ND [ ] INSULATION 765-1802 BUILDING DEPT. ~NDATION 1ST [ ] ROUGH PLBG. FOUNDATION 2ND [ ] INSULATION FRAMING [ ] FINAL INSPECTOR FE N(. 76 FO 1. 3 AL r$~ 'CC Y' E~UIILDING DEP, A~D.T'Jq~ENT AT 1802 9 AM TO 4. P,M FOR THE .OWING INSPECTIONS: UNDATION TWO REQUIRED R POUR[:D CONCRETE IUGH , FRAN'tff, IG 8.~ PLUMBING SUL A'f IOf~ NAI. CONSTRUCTION MUST ~ COMPLETE FOR CONSTRUCTION SHALL MEET REQUIREMENTS OF THE N.Y.~-"~ E CONSTRUCTION & ENERGYI. ,' DS. NOT RESPONSIBLE FOR'L:---f-'4 GU.OR.C. ONS;RUCT, ION E BORS FEB - 2 1993 FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N.Y. 11971 TEL.: 765-1802 Exanlined ., 19 .,~... · Approved ,~,, ',~, ,~, ......... 19%~,, permit No. ~,/,~, ./,// Disapproved a/c ..................................... BOARD OF HEALTH ......... 3 SETS OF PLANS .......... SURVEY ................... ClICCK . .. t:OTl ~Y; c.. ' . . HAIL TO: APPLICATION FOR BUILDING PERMIT INSTRUCTIONS Date . .~.//... 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, relatioh:ship 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. ¢. The work covered by ttHs 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 Certilicate of Occupancy shall have been granted by the Building Inspector. APPLICATION IS HEREBY MADE to the Building Department for the issuance of a Buitding 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. I'he applicant agrees to comply with all applicable laws, ordinances, building code, housing code, and regulations, and to (Signature of applicant, or name, if a corporation) " .... (Mailing address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contraftor, electrician, plumb~er or builder. Name of owner of premises ............... ~ ....................................... (as on the tax roll or latest deed) [f applicant is a corporation, signature of duly authorized officer. (Name and title of corporate officer) B~ilder's License No.. ~..O...~.~..~.-].~.j~ ...... Plumber's License No Electri?ian's License No ................. '.'T .... Ct er Trade s L cense No ..................... · Location of/and on which proposed work wiIl be'done .................................................. House Number Street Hamlet County Tax Map No. 1000 Section .~/f9r ~;~' J/~o- 9-[ ~ .................. Block '. ................. Lot ................... Subdivision .............. ..-:- ...................... Filed Mhp No Lot '- (Name) ..... '~ ....................... State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy . .~.~..~.q,..zft. 4~' .~...,.~..'2 .~. ~ .~. ~z..z-/~.gA('77..~... b. Intended use and occupancy .w/:t..,~..~. .. ,q~7'.,q-/ ,; .... ,"/ - ~' 3. Nature of work (check which a plicable): New Building .......... Addition Alteration ...... Repot m .......... .............. Re oval .............. Demolition .............. Other Work. ~'.~. 4~ Estimated Cost . .q ~.~ ...... Fee .......................... : (to be paid on filing this application) 5. If dwelling, number of dwelling~ units ... ~ .......... Number of dwelling units on each floor...~ ............ . If garage numberofcars ..~ ..... 6. If business, commercial or mi~'~o~,,~ -' ..... .; .................................................... Y' ~-' .~: .... ' .......Rear . ~ Depth . He ght ...... Number of St~- D~ensions of same st~cture w}th alterations or additions: Front ~. Rear ............... Depth HeiSt ......... ~ ......... 8 .......................................... Number of Stories Dimensions of entire new construction: Front Height Number of Stories ............ ' Depth Rear 9. Size of lot: Front /q q ~ ~ ~ . ~ · · · ~..: ........... meat ...... Z..~ ............ Depth ..~ ........ .... i ....... 10. Date of Purchase ~ .... ' ......... Name of Fomer Owner .. ~. ~ ~. 1 I. Zone or use district in which promises are situated ........... . . ............. 12. Does proposed construction violMe any zoning law, ordinance or regulation ~. 13. Will lot be regraded ~O ~ . . : .................... x,~ ~.._ ~ '' . · ~: '.~?> ........... Will excess fill be removed from ~remises' ' ~' 14. ,,m,,~ u~wner olpremlses ~p~.<~ ~, P~/~JlJa _~.~ / ~ ~ ~/] / __ - .~ Nme of Architect ~ ........... ~ auures~wt.q~ e~..~.t{ {~qt~[Phone No. ........................... Address ................... Phone No ................ N~e of Contractor .~ff~. -~0r~Z~...... Address . 7/~..ff~A~. Phon~ No.. ~TZ. 15. ~s th~s property wSth2n 3:00 feet of a trdal wetland? *Yes.' ....... No. J.' ..... · If yes, 8outhold Town Truatees Permit may be requSred. .... PLOT DIAG~ .Locate clearly ~d distinctly ~1 buildings, whether existing or proposed, ~d. indicate ~I set-back d~ensions from prope~y ~nes. Give street ~d block humber or description accord~g to deed, and show street nines and indicate whether ~tefior or comer lot. : ...... ~ .............. r .- .... + .......... . ....... being duly sworn, deposes and says that he is the applicant (Name of individual signing icontract) bore named. (Contractor agent corporate officer etc ) .......................... f said owner or owners, and is duly at'thorized to perform or have performed the said work and to make and file this )plication; that all statements containe( in this application are true to the best of his knowledge and belief; and that the ork will 'be performed in the manner se~ forth in the application filed therewith. ~om to before me this . aovc;..'.. ?., Netary Publto, State of Now Yom ;/' ............ /,, -e,- ...........t .......... No, 4952246, Suffolk Coursty _ ~ ' ~ ' ' ' ' Term Expires June 12~ 1~ (Signature of applicant) 'Ii>' '.: c.... o ":-IH " zl olw ct) L: ~I!I ' 0- ~. 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