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Home My WebLink About20381-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No Z-21009 Date SEPTEMBER 11~ 1992 THIS CERTIFIES that the building ADDITION Location of Property 550 CEDAR POINT DRIVE EAST House No. Street County Tax Map No. 1000 Section 90 Block 2 Subdivision Filed Map No. 8OUTHOLD ~ N. Y. Hamlet Lot 16 Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated JANUARY 10~ 1992 pursuant to which Building Permit No. 20381-Z dated JANU~RY 14, 1992 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 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 CHARLES & BETTINA DANILCZYK Rev. 1/81 FO~ NO. ~ TO¥~N OF SOUTItOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N. Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE pREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) N~ 20381 Z Data Z 'S'/ ...~ ............................................. , ~9.~Z Permission is hereby gr. gnted to: . ~ .~,...~..~.~...~.~ ........................................... ,o ........ z~Z.. .~.,., , _ , '~ ...... ...~/~. ,~>:,.,.~._]~,~ ............... ,,'"'~ ........... --,'~~ ..... .~......~..~> ....... ,~'..~.. ....~ ....... ~~ ...... :~ .......... at premises locate/ ' d at ...(/...~.~.~.......~.-~ ..... :~ ~).~....,~'~.~: .................. cou,~ Tox Ma, No. 1000 Sec,on ......... ~ ....... .~o~k ............ ~. ..... Lot No ....... ~. .......... pursuant to application dated .... ./.>..~.. ...................................... , 19.....~..~ and approved by the Building Inspector. Fee S..,~..~ Rev. 6/30180 Form No. 6 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN 765-1802 APPLICATION FOR CERTIFICATE OF OCCUPANCY A. This application must be filled in by typewriter OR ink and s~bmitted 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. Subm%t Planning Board Approval of completed site plan requirements. 8. 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. 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, Commercial $~5.00 Date .... .~ L~./.~..~. ] .......................... New Construction ...... ~. .... Old Or Pre-existing Building.~ ............ Location of Pronertv;~.'.~..~..~.~-~J~g-])~M~ ~-'-~.~r, ~ ' · ' House No. Street ' Onwer or Owners of Pro-err· County 000, ..... ...... Z .............. Lot.. Permit No~.~'~ ~..Date Of Permit f//~/~'~ .Applicant~~..'~{~'~..~ Health Dept. Approval .......................... Underwriters Approval ......................... Planning Board Approval ........................ Request for: Temporary Certificate ........... Final Certicate,~ ....... Fee Submitted: ~ ~ ~PLIC~T INSPECTORS Victor Lessard Principal Building Inspector Curtis Horton Senior Building Inspector 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 Telei~hone (516) 765-1800 OFFICE OF BUILDING INSPECTOR TOWN OF SOUTHOLD ' JIIL¥ 30, 1992 CHARLES V. BANILCZYK P. O. BOX 200 S0o'r~iOLD, NY 11971 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 im~x~/not on file.)$25.00 No Health Department Approval on file. No final inspection has been made. No Pluntber Soider Certificate on file. (All permits involving plumbing being issued after April 1, 1984). BUILDING PERMIT ~ 20381-Z Please contact our office on this matter. Thank you for cooperation. SOUTHOLD TOWN BUILDING DEPT. FOU:~DATION FOU:;DATIO:~ 2. f2nd) EOUGH FRAHE & .PLUMBING I~;SULATIO~'~ FERN. Y. STATE ENERGY CODE Fi;;AL ADD AL COMMENTS // 765-1802 BUILDING DEPT. INSPECTION FOUNDATION ~.ST [ ] ROUGH PLBG. FOUNDATION 2ND [ ] INSULATION FRAMING FINAL DATEt/'~/~""~'//?/'/'''' INSPECTOR 765-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLBG. [ J FOUNDATION 2ND [ ] INS~ULATION FRAMING ~FIN~L REMARKS: I NSPECTOR~/~/'~ FORM NO. 1 ! TOWN OF SOUTHOLD BUILDING DEPARTMENT · TOWN HALL SOUTHOLD, N.Y. 11971 Examtn'ed. Approved . .~/.,~. ..... , 19 .~.' Permit No...'~..~..~./~ Disapproved a/c ..................................... BOARD OF HEALTH survey ~.". .... SEPTIC FORH .............. HAIL TO: , (B~ildin~)fispector) ' 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, 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 cbmmenced 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 Buildhng 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 buildifigs, additions or alterations, or for removal or demolition, as herein described. The apphcant agrees to comply with all applicable laws, ordinances, buil~ling code, housin~ code and re-,,1-*;,,-o admit authorized inspectors on premises and in building for necessary inspections. -- 2--° -~; ..... ~- (Signature of applicant, or name,~if a corporation) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. ..... ~...u,.. ~. ~....~<....~:, .c..c., ~e. ~ .~..r..~. ~ ~..rT.,, ~.~. ~ .~.. ............................. Name of owner of premises ...................................................... (as on the ta% roll or latest deed) ..-q--- If applicant is a corporation, signature of duly authorized officer. (Name and title of corporate officer) Builder's License No. ~ ....................... Plumber's License No ............... Electrician's License No.'7. .................... Other Trade's License No ...................... Location of land on which proposed work will be done. C ~' ~' ~,e. go ;,,~ £oO~o t ~ House Number Street Hamlet County Tax Map No. 1000Section~Oo--~--/~ Block 0'~"OO Lot 01~, "~ -- (Name) (~ ' ~1~ ~'~ ~'/~~ ....... State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy P~'~l.~'. ~.,;,~ / I~ ~'~..~; ~} b. Intended use and occupancy D'~ ~¥ ~k~ ~.-~a ~i'd;~ ................ %~gt.~2, ~,,, ~., ,8 ~ ~*,~,,,~.c~ ..... 3. Nature ofwo.~rk (check which appiicable):_.New Building ..... ~... Addition... ~ ..... Alteration . ~ ..,,. Repair .............. Removal .............. Demolition ..... ~ ........ Other Work '~ l~'~ription ) 4 Estimated Cost ~l~.t3e~, ........................ Fee ...................................... ~ (to be paid on filing this application) 5. If dwelling, number of dwelling units ~ Number of dwelling units on each fioor. · If garage, number of cars ......................................................................... 6. If business, commercial or ff~ixed Occupancy, specify nature and extent of each type of use ..................... 7 ...... if any: Front ; Rear Depth · Dlmenmons of existing structures,, Height ............... Number of Stories ........................................................ Dimensions of same structure with alterations or additions: Front ................. Rear .................. Depth ..................... ;. Height ........... ~ ........ Number of Stories . 8. Dimensions ~of1~n,ti,r,e,.~,ew,j;:onstruction: Front ..... ~..~....... Rear.. ....... i j Height .. Lz...O.t~.~.l/~'.e-..l~ Number of Stories.....--L'-. ....... ............................................ 9. Sizeoflot Front Io~ ' : . ' Rear ~l~ a~'O~' ~ .~ -a.~. ~- ~ .... f&;g ia' ' '. ......... ~.r~..,- ............ Depm .~. ~. ~. ............... 10. Date of Purchase .... ,. -.s.~ .1 ................... Name of Former Owner ~. ~/~ U.~..~ ~ {,,I,.O..~t~ ..... 11. Zone or use district in which premises are situated 12. Does proposed construction violafe any zoning law, ordinance or regulation: ..~t~.l~ ................. 13. Will lot be regraded .../..~ .... : ........ ........... Will ex~ess fill be removed from ~remises:' Yes 14. Name of Owner of premises~..~. ~,,,... ~9.1..%. Address ne N '. Name of Architect ...... ~.14/..h. ·/~ ......... Address ................... Phone No ................ Name of Contractor ~...~R. tni[ ~.q Address Phone No 15. Is this property within 3020 feet of a tidal wetland? *Yes ........ 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 descriptioh according to deed, and show street names and indicate whether interior or corner lot. ~U{L.~IG OEPAR~ 765-~802 9 AM TO g PM FOR THE FOLLOWING ~MSPMC'RONS; 3. ~OUNDAT~ON '~0 REQUiReD ~O~ POURED CONCRETE 2~ ROUGH - FRAMING & PLUMBING $. {NSLILATIO~ = ~. F~NAL CONSTRUCTION MUST BE COMPLETE FOR C,O~ ALL COP~STRUCTION SHALL ME~ TME REQUIREMEN~ OF THE ~N,~ STATE CONSTRUC~ON & ENERGY CODES. NOT RESPONSIBLE 'FOR DESIGN OR CONSTRUCTION ERRORS STATE OF NEW YORK, s.S 7OUNTY OF ................. ............................... : .................. being duly sworn, deposes and says that he is the applicant (Name of individual signing contract) ~bove named. te is the ' : (Contractor, agent, corporate officer, etc.) ff 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 ~ork will be performed in the manner set forth in the application filed therewith· ;worn to before me this ry ............ No. 491~224e, Suff~i~ ~oun~. [Signat~ure of applicant)