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HomeMy WebLinkAbout21019-z FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No Z-22105 Date JANUARY 14, 1993 THIS CERTIFIES that the building ADDITION Location of Property 275 MAIER PLACE SOUTHOLD N.Y. House No. Street Hamlet County Tax Map No. 1000 Section 55 Block 6 Lot 24 Subdivision Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated OCTOBER 6, 1992 pursuant to which Building Permit No. 21019-Z dated OCTOBER 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 GARAGE & ROOFED OVER OPEN PORCH ADDITION TO EXISTING ONE FAMILY DWELLING AS APPLIED FOR. The certificate is issued to JOHN & DIANA LESICA (owner) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A UNDERWRITERS CERTIFICATE NO. PENDING - JANUARY 12, 1993 PLUMBERS CERTIFICATION DATED N/A //Iuilding Inspector Rev. 1/81 FORM No. a 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) NI 21019 Z Date .......l~41 19..9 Permission is hereby granted to: . /...-.6....... ~..i....1~ ~p- ~7~/ .,..j... ~.....,../l/..®s to .4:Akzi(1" u .'61'e. . CS?lr`s°it r . at premises located at ...P.7,. . . ~rl...................................................................................... . County Tax Map No. 1000 Section Block 6 Lot No.JR1" pursuant to application dated 19. and approved by the Building Inspector. Fee $ .5~... .4....... uildi Inspector Rev. 6/30/80 Form No. 6 i. TOWN OF SOUTHOLD BUILDING DEPARTMENT 13 1%3 TOWN HALL. 765-1802 APPLICATION FOR CERTIFICATE OF OCCUPANCY A. This application must be filled in by typewriter OR ink and submitted 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 17 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. B. 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, 7 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 $15.00 Date 1~. New Construction Old Or Pre-existing Building.. Location of Property..4~~.. M a 1,~~ ,~l py~,2p . c}S ..1.N 1160.1........... House No. Street Hamlet Dnwer or Owners of Property... C ! lLl. ,0", .5 1,i, (l (V 0; 5;9 „ , ",ounty Tax Map No 1000, Section... S5 Block Lot... Q.I subdivision...... 11 ...FiQled Map............ Lot.. ?ermit No.;i 01..Q . 2....Date Of Permit..1d14~`3~,...Applicantl_ ~ I„a wn, LeS(C~ lealth Dept. Approval ..........................Underwriters Approval......................... Tanning Board Approval request for: Temporary Certificate............ Final Certicate. X 'ee Submitted: as, ~ D ~ dPe C ec, S3q~ = . t ae ; r?.....:~ 1~p 11 ~ 1 APPLICANT THE NEW YORK BOARD OF FIRE UNDERWRITERS PAGE 1 80371.J1.1 BUREAU OF ELECTRICITY F 85 JOHN STREET, NEW YORK. NEW YORK 10038 Date JANUARY 2,0,1993 Application No. onfile 7923749U92 H 0329616 THIS CERTIFIES THAT only the electrical equipment as described below and introduced by the applicant named on the above application number in the premises of JOHN LNUCA, 275 RATFR PLACC, SOUTHOLD, N,Y. in thefollowing location; ? Basement El (hR/OUT lst Fl. [I 2nd El. Section Block Lot FANHARY 12,1.993 was examined on andfound to be in compliance with the requirements q(this Board. FIXTURE ECEPTACLES SWI7CHE5 FIXTURES RANGES COOKING DECKS OVENS DISHWASHERS EXHAUST FANS OUTLETS INCANDESCENT FLUORESCENT OTHER AMT K W AMT. K. W AMT. KW. AML K.W AML N.P. 1 3 4 DRYERS FURNACE MOTORS FUTURE APPLIANCE FEEDERS SPECIALREC'Pi TIMECLOCKS HELL UNITHEATERS MULTI-OUTLET DIMMERS AMT. K. W. Olt H. P. GAS H P. AMT. NO. A. W. G AMT. AMP PMT AMPS TRANS. "T H. P N6:'- FEET AMT. WATTS SERVICE DISCONNECT NO.OF S E R V I C E AMT. AMP. LYPE METER 1.0'2W 1,e 3W 383- 3A'OW NO OF C<.COND A W G. NO Of HI-LEG AW. G' NO.OF NEUTRALS A W EQUIP. PER A" OF CC COND. OF HbLEG OF NEUTRAL i II 77- OTHER APPARATUS: I 1 JOHN LF5T'CA 2106 2113T. }i0A17 ASTORIA, NY, 11105 p NE,R,A.L MANAGER Per This certificate must not be altered in any manner; return to the office of the Board if incorrect. Inspectors may be identified by their credentials. BUILDING DEPARTMENT. THIS COPY OF CERTIFICATE ST T BE LTERED IN ANY MANNER. INSPECTORS Victor Lessard ,~'SUFPD(~> Principal Building Inspector Curtis Horton SCOTT L. HARRIS, Supervisor Senior Building Inspector Southold Town Hall Thomas Fisher' r>r P.O. Box 1179, 53095 Main Road Building Inspector Gary aT Southold, New York 11971 Building Irurpector~~~ Fax (516) 765-1823 Telephone (516) 765-1800 Vincent R. Wieczorek Ordinance Inspector Robert Fisher Assistant Fire Inspector OFFICE OF BUILDING INSPECTOR Telephone (516) 765.1802 TOWN OF SOUTHOLD DECEMBER 23, 1992 JOHN tr DIANA LESICA 21=06 21st ROAD ASTORIA, NY 11105 RE: PREMISES @ 275 MAIER ROAD, SOUTHOLD To Whom This May Concern: We are unable to complete your Certificate of Occupancy because of the following reasons: ffi An application for Certificate of Occupancy is not on file. (Enclosed) x4Y No Underwriters Certificate on file.0IL %xx The check is tXKMWbVb0Wnot 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, 1984). BUILDING PERMIT # 21019-Z Please contact our office on this matter. Thank you for cooperation. SOUTHOLD TOWN BUILDING DEPT. m OUNDATION (1st) -i) 0UNDATION (2nd) z O OUCH FRAME & I -PLUMBING N H m m JISULATIO;1 PER N. Y. I • • •`3 STATE ENERGY r CODE H~ FINAL I-A ADDITIONAL COMMENTS: x ~J I cn ' x H 7] • H H O m -v H M-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLBG. FOUNDATION 2ND [ ] INSULATION [ ] FRAMING A~t,,FaAL REMARKS: i i I r DATE < i v INSPECTOR E BOARD OF HEALTH FORM NO. 1 3 SETS OF PLANS 4 TOWN OF SOUTHOLD SURVEY . . m OCT 13 iC92 ( BUILDING DEPARTMENT CHECK . . . . TOWN HALL SEPTIC FORM SOUTHOLD, N.Y. 11971 TEL.: 765-1802 PdOT'FY~ CALL Examined , , , l~z MAIL 0 : ~t~OU Approved ° , 19/.z Permit No./~77 Disapproved a/c (Build' gins p t ) APPLICATION FOR BUILDING PERMIT pp Date®CJl4)?c!V (a. t 190 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 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, building code, housing code, and regulations, and to admit authorized inspectors on premises and in building for necessary inspections (Signature of applicant, or name, ifna, corporation) (Mailing address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. D.Wto Name of owner of premises .r? Yd 1A PJ !_e- S t c_c~ (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. . 13.o.-7:7.. RT......... . Plumber's License No . Electrician's License No . Other Trade's License No . 1. Location of land on which proposed work will be done . a41?.~?.'.P I0,ce............. ©.a~ 914.1.N....1~`111....... House Number Street j Hamlet County Tax Map No. 1000 Section Block FP Lot rQ.4 Subdivision Filed Map No. Lot (Name) 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy? V.t.Kll . b. Intended use and occupancy aNS . FF1 , . 3. Nature of work (check which applicable): New Building Addition Alteration Repair . . . . . . . Removal Demolition Other Work (Description 4. Estimated Cost r 1 ) r50, ' Fee...................................... (to be paid on filing this application) i 5. If dwelling, number of dwelling lunits 1.......... Number of dwelling units on each floor.. , garage, number of r faflRAkt .,+a.b9'.hVtl+.bats~d. o.wfilais..q~~,l ca toN, 6. If business, commercial or mixed occupancy, specify nature and extent of each type of use . . . . Dimensions of f existing structures, if any: Front A5 Rear 05........ Depth Height ..lon.. of same structure with of Stories ...I . ith alterations or additions: Front y~ 5.?S. Rear .i V- Depth fo.G67 Height .....17.•S' Q6= crtrlNS~~ . Number of Stories l nt< cH*NqE~ 8. Dimensions of entire new construction: Front Rear ..4~rs........ Depth . fir r Height . !S. y Number of Stories ® . 9. Size of lot: Front ....loo . Rear (9o .F f , , . , • Depth . 10. Date 1. ...r.. .r1...... ......ru(... , 1 eno on in which 19~q • , , , . • Nap of Former Owner p mises are situated . ,1,2,.5 !Oen?;/;frl;~, , , , , • • , . ,1., .1 . . 14 N e proposed construction use district in which iea pierte any zoning law, ordinance or regulation: ° • • . Will excess fill be removed from premises: Yes Architect premisesai tii.t:r a a Q411V ~!i_%.ctnAddress-1l .9 k 2-f R,, Hgcoeiq Phone No.-I. 13. Will lot be re raded • • • • • • • • • Address ...................Phone No............... . Name of Name of Contractor".Vgb) 3~4ume f m~ xo~enl } T y{ddressa~ Y§~ MY:t!~§7phone No 5 Ik . 15. Is this property within. , * yes, 00 feet of a tidal wetland? *yes,,,,,,.. No.. If Southold 'down 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. j L57-C! A T -r (-4 0-o STATE OF NEW YORK, SI S COU~~~N---•~~TY OF : . b Q fee O° e_r~ • • ~ •ti~N-o~• being duly sworn, deposes and says that he is the applicant (Name of individual signing contract) above named. He is the . . A\pirnge9tgNje LS. ~Ti Ip'cj ~s ~~NeQ I U~aRCfw~S . . U (Contractor, agent, corporate o.fficer,.etc..). . . . . . . of said owner or owners, and is duly (,authorized to perform or have performed the said work and to make and file this application; that all statements contained in this application are true to the best of his knowledge and belief; and that the work will be performed in the manner set forth in the application filed therewith. Sworn to before me this MARY J. O•OONOONUIt ~ Notary PNo~ atSj80 3282aw Y®fk ..daY of. ' 199.x QuaNtled in queone O®unty oert{firate Filed in New York O Nfl Notary Public, commission Eearea,M~th~~g I COUnty L~veambvIl r•c • (Signature of applicant) 1 --m'<+? r(`.,; .a. 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