HomeMy WebLinkAbout21373-zFOR~ ~0o 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
office of the Building Inspector
Town Hall
Southold, N.Y.
CERTIFICATE OF OCCUPANCY
NO Z-23954 Date OCTOBER 17, 1995
THIS CERTIFIES that the buildin~ ALTERATIONS
Location of Propert~ 900 MINNEHAHA BLVD. SOUTHOLD, NEW YORK
House No. Street Hamlet
County Tax Map NO. 1000 Section 87 Block 2 Lot 6
Subdivision Filed Map No. Lot NO.
conforms substantially to the Application for Building Permit heretofore
filed in this office dated APRIL 26, 1993 pursuant to which
Building Permit No. 21373-Z dated APRIL 28, 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 ALTERATION & REPAIRS TO ROOF OF EXISTING ACCESSORY GARAGE
AS APPLIED FOR.
The certificate is issued to
BORIS & VERA POLYAKOV
(owner)
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A
UNDERWRITERS CERTIFICATE NO. N/A
PLUMBERS CERTIFICATION DATED N/A
Rev. 1/81
~ / Buildfing Inspector /
TOWN OF SOUTNOLD
BUILDING DEPARTMENT
TOWN HALL
$OUTHOLD, N. ¥.
N~N'?
"UILDING PERMIT
(THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL
COMPLETION OF THE WORK AUTHORIZED)
~137~ Z Date ...~ ............................................ , ~.~
County Tax Mop No. 1000 Section ...... ~..iZ ......... Block .....~ .......... Lot No...~. ................
pursuant to application dated ...... ...~../....~...~.. ................................ , 19.?..~...., and
Building Inspector.
Fee $....~..
approved by the
Rev. 6/30/80
Form No. 6
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN HALL
765-1802
APPLICATION FOR CER] It ICATE OF OCCUPANCY
Tills application must be fll]ed in by typewriter OR ink and submitted to the building
inspector with the following: for new building or new use:
1. Final snrvey of property with accurate location of ali 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 contaius
less than 2/10 of l% 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.
For existing buildiugs (prior to April 9, ]957) 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 ~s denied, the Building Inspector shall state tbe
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 pooI $25.00, Accessory building $25.00,
Additions to accessory buildin~ Businesses $50.00.
2. Certificate of Occupancy on Pre-ex~sting~ Buildin~ - $100.00
3. Copy of Certificate of Occupancy - $20.OO
4. Updated Certificate of Occnpancy - $50.00
5. Temporary Certificate of Occupancy - Residential $I. 5.00, Commerci~$15.00
Date ..... /~/./.~..' .~f..... ................
New Construction ........... Old Or Pre-existJ~g Bui]jing.~ ............... ~ _=~__/~
ocatiou Propert .... .......
House~No.--,~, /Street z'~ ttamlet
Onwer or Owners of Property...__..~.~......~.~ ...................
i
County Tax Map No 1000, Section ...... O...~...B oc ................... ~ ...............
Permit No.~/. .. .Date Of Permit ........ pplican
Health Dept. Approval ........................ Underwriters Approval .........................
PIanning Board Approval .......
Request for: Temporary Certificate ........... Final Certicate ...........
Fee Submitted: $ .... ~.. ....... ~ .........
&w., ................
CO "~ ~?$~ APPLICANT
[ ] FOUNDATION 1ST [ ] ROUGH PLBG.
[ ] FOUNDATION 2ND
[ ] FRAMING~
[. ].~SULATION
[ g~ FINAL
[ ] FIREPLACE & CHIMNEY
REMARK S: ~/,.Z,,~2///~" ~~¢-~::~
DATE ~/~/~,/"// INSPECT
765-1802
BUILDING DEPT.
INSPECTION
[ ] FOUNDATION 1ST
[ ] FOUNDATION 2ND
[ ] FRAMING
[ ] ROUGH PLBG.
[ ]~SULATION
[ I/] FINAL
[ ] FIREPLACE & CHIMNEY
REMARK S:~~.~
I *SPECTO~~~~
~OUGH FRAHE &
.PLUMBING
(2nd)
~SULATIOH PER N. Y.
STATE E~IERGY
CODE
FI;~AL
ADDITIO~;^L COMME~;TS:
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
September 27, 1995
Mr. Boris Polyakov
900 Minnehaha Blvd.
Southold, NY 11971
Re: Building Permit %21373-Z
Premises: 900 Minnehaha Blvd
Suff. Co. Tax Map %1000-87-2-6
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
?
./
/
RECEIVED FROM 04.26.1993 09:3? P. 2
FORM NO. 1
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN HALL
SOUTHOLD, N.Y. 11971
Examined
^pproved ...//>¢. ....... Permit No.
Disapproved a/c .......................................
BOARD OF HEALTH
SETS OF PLA~IS
SURVEY
CIIECK
SEPTIC EOR~I
I'IA I L TO:
APPLICATION FOR BUILDING PERMIT
Date ............ 19ff~.
INSTRUCTIONS'
a. This application must be completely filled in by typewriter erin 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 sti'eets
or areas, and giving a detailed description of layout of property mu~t 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 applicanfi Such permit
~hall be kept on the premises available for inspection throughout the work.
¢. 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, or for removal or demolition, as herein described.
The applicant agrees to comply with all applicable laws, ordinances, buL!ding code, housing code, and regulations, and to
admit authorized inspectors on premises and in building for necessary inspections.
..... · , , (Signature o£ applicant, or name, it' a corporation)
(Mailing address of applicant)
State whether applicant !s owner, lessee,:agent, architect, engineer, generai contractor, electrician, plumber or built, er.
(as on the tax ~oll or latest deed)
If applicant is a corporation, signature of duly authorized officer.'
(Name and title of corporate officer)
Builder's License No...d~'---~... '
Plum ber's License No ............... . ..........
Electrician's License No .......................
Other Trade's License No ......................
Location of land on which proposed work w/ill be done ........................ · .
House Number . Street Hamlet
Cou'nty Tax Map No. 1000 Section · .,ff.. 7 ......... Block ..g ' Lot ~
Subdivision ' Filed Map No. . ..............
(Name) ·
State existing use and occupancy of premises and intended use and occupancy of proposed construction!
a. Existing use and occupancy ............ ..
b. Intended use and occupancy ..................... · ......... 1me ~ .... '., -,. -- ·, ......
.3. atu e. r check wh] cable): New Building . ~ .... '- · Addition .......... Alteration ... ~ ....
_sxep~r .............. Removal ...... ~ ....... Demolition .;...: ......... Other Work ........ [ .....
4. Estimated Cost ........ ' ' escr tion
j '. (to be paid on filing this application)
5. If dwelling, number of dwellin~ units ..... i ..... Number of'dwelling units on each floor ...........
Ifg .... ·
· arage, number of cars ...,... .............. ' ' '
If b i i 1 i id ify nat
7 Di us ness, commerc a or m.xe occupancy, spec ute and extent of.eacli type of use .....
· mensions of existing structuTes, if any: Front ..........
D of ct With lie ati additions, n; ............ ,~ .....................
~mens]ons samestm ure a r onsor Fro
D pth ' I-I ight . ' ................ ~car .............
· b fSt ri
8 Di ensions of nti conslructi F
R D pth ..........
· m e re new on: ront ......... ; .... : ear ......... . ..... e ..... ..... . ....
.Height ... 2 ........... Number of-Stories .' ........... . . .
10. Date of Purchase , i ..... u_ep_ .
~un~ ur use msmcr m which p~emises are situated ' ' 'r, '.'~'~ ~'~'-~ '. .......
12. Does proposed constructmn y]~13~te any zomng law, ordinance or ro,,-t~*' ~'~'~ .................
13. .; Will exc~ess f~ll b.e relnoyed fLom premises:" Yes "/~
14. r i
Name of Contractor 77.°.7.~..
........ ; ................. Address ............ c ...... Phone No ............ ' ....
15.' 19 th±s property w$-th~_n 300 feet: o£ a t±dal, wetland? eyes ........ Iqo .........
· If yes,' Southold ~own Trustees Perra~[t may be requ±red.
PLOT DIAGRAM
Locate dearly and distinctly alli buildings, whether existing or proposed, and. indicate all set ba
.prop.erty tines. Give street and block ~umber or descr/-*: .......... ' ok dimensions' from
g,uu accoramg ro aces, ana snow street names and indicate whether
interior or corner lot.. .
iTATE OF NEW Y_QRK~e-. , '~i"
20UNTY OF .... .~.~.~.'~.[.~... mia . .
......... .',.-t
(Name of md vidual's gnin~ co~'t~a'c'ti .........
bove named· !
IFY BL~ILOING DEPAR'rMIiNT A'~
7..6~-1802 9 AM TO 4 PM FOR THE
FOLLOWING INSPECTIONS:
1. FO}JIq~ATION ~ TWO REQUIRED
FOR POURED CONCRETE
2. ROUGH - FRAMING ~ PLUMBING ,,
3. INSULATION,
4. FINAL CONSTRUCTION MUST
~E COMPLETE FOR C.O.
ALL CONSTRUCTION SHALL MEET
THE REQUIREMENTS OF THE N.Y.
STATE CONSTRUCTION &, ENERGY
CODES. NOT RESPONSIBLE FOR
DESIGN OR CONSTRUCTION ERRORS
being duly sworn, deposeg and says that he i~ the applicant
' (Contractor agent corporate officer etc) ' ' '
f said owner or owners, and is duly Outhorized to perform o~ have performed the said work and to m~ke and file this
~plication; that all statements containpd ~ this application are true to the best of his knowledge and belief; and that the
ork will be perfomed in the ~n.oer s~t forth in the application filed therewith.
,yom to before me this .4 ~ ~ ~
v N~ARY PUBU~ ~M of ~ ' · ....
T~ ~r$ May ~ 19 ~ . '