HomeMy WebLinkAbout21402-zFORM NO. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
office of the Building Inspector
Town Hall
Southold, N.Y.
CERTIFICATE OF OCCUP;~NCY
No Z-22845 Date JANUARY 21, 1994
THIS CERTIFIES that the buildin~ ADDITION
Location of Property 2945 SOUTH HARBOR ROAD
House No. Street
County Tax Map No. 1000 Section 78 Block 3
Subdivision Filed Map No.
SOUTHOLD~ N.Y.
Hamlet
Lot 4
Lot No.
conforms substantially to the Application for Building Permit heretofore
filed in this office dated MAY 5~ 1993 .pursuant to which
Building Permit No. 21402-Z dated MAY 11~ 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 DECK ADDITION TO EXISTING ONE FAMILY DWELLING AS APPLIED FOR
JOHN & ADRIENNE PECHA
The certificate is issued to
(owners)
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
1~0~ NO. ~1
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN HALL
SOUTHOLD, N. ¥,
BUILDING P E~J~IT
(THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL
COMPLETION OF THE WORK AUTHORIZED)
N~-N? 21lOJ~Z
Date
Permission is hereby granted to: ~
.~..~...../..~.~.. ............... i ..........
, , ...... ~Y......~,,..~,~...,..~..,.~ ......... ../.../.f..~--
., -/ -/ _//.
,o ~/...~.....~ ....... .~/~......~.~...~..~..~_~...~ .........
...... ............................................
at premises ,('/ ocated at .,~..~..~....~...,~ .~..~~.,(~.~..~ .......................................
County Tax Map No. 1000 Section ............ ,'.~..~..... Block ........... .~ .... Lot No ......... ~ ..........
pursuant to application dated ....~..../.~... .................................... , 19..~., and approved by the
Building inspector.
/ ~.ilding Im.~:~ector
Rev. 6/30/80
Fo~m No. 6
i4f TOWN OF SOUTtIOLD ·
BUILDING DEPARTMENT
· APPLICATION FOR CERTIFICATE OF OCCUPANCY
This application must be filled in by t~pewriter OR ink and submitted to the building
inspector with the following: for new buildin~ 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.
For existing buildings (prior co April 9, 1957) nonzconforming 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 Building - $100.00
3. Copy of Certificate of Occupancy - $5.00 over 5 years - $10.00
'.4. Updated Certificate of Occupancy - $50.00
5. Temporary Certificate of Occupancy - Residential $15.00, Con~ercial $15.00
~onstruction. L~..--.. ;~.. Old Or Pre-existing Bu,,ilding .................
....
ou No. . Street ~Hamlet
Onwer or Owners of Property .... i [.~ ). . y .
County Tax Map No 1000, Section .............. Block ................ Lot ......................
Subdivision ................................... · Filed Map ............ Lot ................... ...
tleat'th Dep~, ApprovaZ....,..,,.,,,,... · Usder~r&ters ApprovaZ
Ptann2ng Board ApprovaZ
Request [o~: Te~poy4ry Cort&fZcaCe ........... P&naZ CerE~CaEe
Fee Submitted. $. (' -
$
' Lessard
Principal Building Inspector
Curtis Horton
Senior Building Impector
Thomas Fisher
Building Inspector
Gary Fish
Building Inspector
Vincent R. Wieczorek
Ordinance Inspector
Robert Fisher
Assistant Fire Inspector
Telephone (516) 765-1802
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
OFFICE OF BUILDING INSPECTOR
TOWN OF SOUTHOLD
ANTONE E. BE,P, KOSKI
P. O. BOX 1091
CUTCHOGUE ~ NY I 1935
Rg: /~lllglfl~ PgCIIA
AI1LY 30, 1993
To Whom This May Concern:
We are unable to complete your Certificate of Occupancy
because of the following reasons:
xxx An application for Certificate of Occupancy is
not on file. (Enclosed)
No Underwriters Certificate on file.
The check is k~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, 1954).
BUILDING PERMIT ~ 21402-Z
Please contact our office on this matter.
cooperation.
Thank you for
SOUTHOLD TOWN BUILDING DEPT.
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
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
JIJLY 30, 1993
ANTORg g. BgRKOSKI
P. O. BOX 1097
CUTCHOGL~E, NY 11935
RE: ADRIENNE PECHA
To Whom This May Concern:
We are unable to complete your Certificate of Occupancy
because of the following reasons:
An application for Certificate of Occupancy is
not on file. (Enclosed)
No Underwriters Certificate on file.
The check is ~not on file.)$25.00
No Health Department Approval on file.
No final inspection has been made.
No Plu~er Solder Certificate on file.
(Ail permits involving plumbing being
issued after April 1, 1984).
BUILDING PERMIT $ 21402-Z
Please contact our office on this matter.
cooperation.
Thank you for
SOUTHOLD TOkeN BUILDING DEPT.
'OU~D~TIO:! (2nd)
(OUGH FRAHE &
.~SU LATION
·PLUMBING
PER N. Y.
STATE ENERGY
CODE
FI;;AL
~DDITIONA'L COMMENTS:
7r~-1802
BUILDING DEPT.
INSPECTION
765-1802
BUILDING DEPT.
INSPECTION
[ ] FOUNDATION 1ST [ ] ROUGH PLBG.
FOUNDATION
[ ] FRAMING
2ND [ ]/~LATION
[~J FINAL
REMARKS:
/
DATE
INSPECTOR
FORM NO, 1
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN HALL
SOUTHOLD, N.Y. 1197:1
TEL.: 765.1803
( ildingd'hspector)
APPLICATION FOR BUILDING'PERMIT
Date ' ' 19
INSTRUCTIONS
by typewriter or in ink and submitted to the Buiid/ng Inspector, with 3
, a. Tiffs application must be com'pletely filled in
sets of plans, accurate plot plan to schle. Fee according to schedule.
b. Plot plan showing location oi lot and of buildings on premises, relationship to adjoining premises or public st?eets
o~ areas, and giving a detailed description of layout of property mu~t be drawn on the diagram which is part of this appli-
cation, i
c. The work covered by this application may not be commenced before issuance of Building Permit.
d. Upon approval of this applicfftion, the Building Inspector will i~sued a Building Permit to the applicant.' Such permit
shall be kept on the premises availabl~ 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 Buildifig Inspector.
' APPLICATION IS HEREBY MAIDE to the Building Department for the issuance of a Building Permit pursuant to the
Building Zone Ordinance of the To~vn 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 premi~es.a~d in building for necessa~ ' Re_ct'.
-- ~,. (Signaturp of applicant, or name, if a corporation)
(Mailing address of applicant)
State whether applicant is owner, l~ssee, agent, architect, engineer, genemi 'contractor, electrician, plumber or builder.
N~me of owner of prem, ises., j.C),b,Y~I,..'~, ,-.T.~, ,b, ,0~,. ,%-, · · ,(~, · ,~i,-~, ,0~.~.' , ,/~, .,.,
.... , .., (as on the tax roll or latest deed)
If applicant is a corporati?n, signaturi of duly authorized ~fficer.'
(Name and title of corporate officer)
' · '
B rider s Lmense No ................
Plumber's License No . '
Electncmn s Lmense No ...... ! .................
Other Trade's Liceuse No ..... i .................
1. Locatio~n of land on which pr~opos~ed work will be done ......................... ..........
..............
House Number , Street Hamlet
'
Cou'nty Tax Map No. 1000Sectiofl ...: .......... Block .......... :... Lot .
Subdivision ........ , ......... ~ .......... . ......... '. Filed Map No ............... Lot ...............
(Name)
2: Stat(~ existing use and occupancy of premises and intended use and occupancy of proposed construction':
Existing and occupancy '..~.. ~
a. use .
b Intended use and occupancy ·
· 3. Nature of work (check which applicable): New Building .......... Addition .......... Alteralion .... ,.. ' .
Repair .............. Removal ............. : Demolition .... : ......... Other Work .J~__~ .....
~ [0 0OO ~ ~ (Description)
4 E ti dC '
· s mate est ......... ~
(to be paid on filing this application)
5. If dwelling, number of dwelling units ............... Number of dwelling units on each floor ............
· If garage, number of cars ................ ' ....
6. If business, c°mmercial or mixed occupancy, specify nature and extent of.each type of use ....
7. Dimensions of existing structures, if any: Front ............... Rear .............
ight ..... pth ......
He ............... Number of Stories ................ ' ......... De .........
Dimensions of shme structure with alterations or additions: Front ............. Rear ..........
D.epth ....0 ~ .................. Height ....... i., .' ....... . N ...... .
8. Dzmens~ons of entire new construction Front . ~=~.~-t .~ um~e~o~ ~tones .......... .'-' ._.) .....
Size of lot: Freest .................... ~.. Rear ...................... Depth ..........
10. Date of Purchase : ::~.
.................... ' ......... Name of Former Owner .................. :- '
11. Zone or use district in which premises are situated ....................... 7~ ....... ' · ·
.12. D°es pr°p°sed construction violate any zoning law, ordinar[ce or regulation: ..~'~.' ........................
13. Will 10t be regraded ...... .p~.;. .... ,-, .............. Will express,/ill be re_moved from premises'_ Yes
Name of Architect ................ , ...... ~. · .'... Address ~ Phone NO ..... · .
i5. Is this property within 300 feet of a tidal' wetland9 *Yes. . . 1; ;-7' ' ,
i . *If yes, Southold Town Trustees Permit may he'require~:' "' ao.
· .'. 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 fo deed, and show street names and indicate whether
interior or corner lot.
APPROVED AS NOTED '
DATE:~ B.R # ~/'-~'0 ~ ~"
FEE:
NOTI~ DEP~
765-1802 9 AM TO 4 PM FOR THE
FOLLOWING INSPECTIONS:
· 1..FOUNDATION . 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 _E OR
DESIGN OR CONSTRUCTION ERRORS
STATE OF NEW YO~RK, ,
....... ~/~..(~-.~.,'~. f.-. a~.t...~..~.'-~ .~...~ ~ ( ......... being duly sworn, deposes and says that he i~ the applicant
(Name of individual signing contract)
xbove named.
(Contractor, agent, corporate officer, etc.) " ............
,f said owner or owners, and is duly authorized 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
turk will be performed in the manner set forth in the application filed therewith.
.worn to before me this MIOHAELR. EGAN
' I~ . ' ..,~..~.. ' ¢.2.~ Notmy Publio, State of New York
. · .......... ,19 /:. No. 4739.518, Suffolk Oount~
·, (Signature of applicant)
519138
,)
0
N.85°59' O0"E.
Z
now or tormer,y
Edwnrd Probe ~ Lydia d. Probe
STOCKADE
I
Area
= 20318 s.f
zOO. 57'
2oo. o o'
HEDGE
S.85 o40'O0'W.
now or formerly
Joseph Elak I~ DaleA.
m
HIAwATH/~S PAT H
SURVEY. FOR
,JOHN E PECHA & ADRIENNE'W. PECHA
AT soUTHOLD ....... '?~O:A~"E-,; ....... AUG. 8,
TOWN OF SOUTHOLD SCALE: 1":.40'
SUFFOLK COUNTY, NEW YORK NO. 91- 0636
NU#~UTHOF~IZEO ALTES&TION ORAOOITION TO TNiS CERTIFIED~.
su.vE¥ ~ * v~oc,¥no, o~ sEcr~o. ?zos o~ T.E JOHN .i~'~. ~%~'~ "~V ~
PUI~posE &#O 'RE NOT 1'0 BE USED TO ESTIllLiSN ~'
I fi] YOUNG
YOUNG YO.K
ALDEN W.YOUNG, PROFESSIONAL ENGINEER
AND LAND SURVEYOR N;Y.'S, UCENSE NO. 1284.5
HOWARD W. YOUNG, LAND SURVEYOR
N.Y,S. LICENSE N0,45893
NOTE: I. ~I:MONUMENT 0 : PIPE
2. SUFFOLK COUNTY TAX MAP
DIS'E I000 SECT. 78 BLK. 3 LOT 4
DRANDIS & SONS INC.