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HomeMy WebLinkAbout20721-z FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No Z-23935 Date OCTOBER 5, 1995 THIS CERTIFIES that the building ACCESSORY Location of Property 5535 OLD NORTH ROAD SOUTHOLD NY House No. Street Hamlet County Tax Map No. 1000 Section 51 Block 3 Lot 6.1 Subdivision Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated JUNE 11, 1992 pursuant to which Building Permit No. 20721-0 dated JUNE 15, 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 AN ACCESSORY GARAGE AS APPLIED FOR. The certificate is issued to WALTER & ALBINA SAWICKI (owner's) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A ELECTRICAL INSPECTION SERV. 9067 SEPTEMBER 14, 1995 PLUMBERS CERTIFICATION DATED N/A ilding inspector Rev. 1/81 rORM N0.2 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) N°-M 20721Z Date 19./..° Permission is hereby granted to: . to - . 5y . . at premis s located at .........f at .FF.~................................... r County Tax Map No. 1000 Section arl/.......... Block O,S........... Lot No....... 4. pursuant to application dated ................../~l ll............... I......... , 19..1. and approved by the Building Inspector. Fee vk% Building Inspector Rev. 6/30/80 r ~(J I Dorm No. 6 ,1•, 'I'Ot•1N OF SOU'PIIOLD 9'~.- •~StSn_ OCT 3 BUILDING DEPARTMENT s TOWN HALL o~~ n615 V2cQ t 43;:, 765-1 802 TovdNC)t..s.~Jl6OLD SuSholco ~I ~S ~ 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 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. 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, Additions to accessory building $25.00. Businesses $50.00. 2. Certificate of Occupancy on Pre-existing, P,uildine - $100.00 3. Copy of Certificate of Occupancy - $20.00 4. Updated Certificate of Occupancy - $50.00 5. Temporary Certificate of Occupancy - Residential $15.00, Commercial $15.00 Date If'3~K New Construction...."....... Old Or Pre-existin Building......... 140 gyp ~ ..Location of Property.... VWX 1/ lefio .I 404T (louse No. Street Hamlet Onwer or Owners of Property.... IIG.GL.'..!„~~ County Tax Map No 1000, Section...eJ..\........ L'luck... 3 ,........Lot.......! Subdivision...//..y ................................Filed Map............ Lot...................... Permit No.,,,,Date of Permit Appltcnnty'' !!L/4. Uealth Dept. Approval ..........................Underwriters Approval.......................... Planning Board Approval Request for: Temporary Certificat.e........... Final Certi.cate.... Fee Submitted: 5oao8 . . e~~a3935......-c~........... APPLICANT crLtLD iI L. i~;i i~D . iti'i NT^ 1, m a d lO y(y ~j v r'OUNDATION (1st) c FOUNDATION (2nd) 2. o ~ ROUGH FRAME & PLUMBING y m m INSULATION PER N. Y. y STATE ENERGY CODE I t r a, J y d .g 'Ce~y FI;IAL ADDITIONAL COMMENTS: ro ~ x ^n H 77 9 (A O \-1 \pw~o,JJ` m r H O m ^c _ H K gpFFO(k~ y~ G H x Town Hall, 53095 Main Road p • Fax (516) 765-1823 P. O. Box 1179 Telephone (516) 765-1802 Southold, New York 11971 OFFICE OF THE BUILDING INSPECTOR TOWN OF SOUTHOLD July 31, 1995 Mr. Walter Sawicki 5535 Old North Road Southold, NY 11971 SECOND NOTICE To Whom This May Concern: We are unable to complete your Certificate of Occupancy because of the following reasons: xx An application for Certificate of Occupancy is not on file. (Enclosed)** xx No Underwriters Certificate on file. xx The check is 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, 1984). BUILDING PERMIT # 20721-Z Please contact our office on this matter. Thank you for cooperation. SOUTHOLD TOWN BUILDING DEPT. - ACCORDING TO THE CODE OF THE TOWN OF SOUTHOLD, IT IS UNLAWFUL TO OCCUPY OR USE SAID STRUCTURE UNTIL A CERTIFICATE OF OCCUPANCY HAS BEEN ISSUED. SOFFanti k~oGy Z Fax (516) 765-1823 Town Hall, 53095 Main Road co P. O. Box 1179 0 • Telephone (516) 765-1802 Southold, New York 11971 .j. col ~ ~a OFFICE OF THE BUILDING INSPECTOR TOWN OF SOUTHOLD December 21, 1994 Mr. Walter Sawicki 5535 Old North Road Southold, NY 11971 To Whom This May Concern: We are unable to complete your Certificate of Occupancy because of the following reasons: xx An application for Certificate of Occupancy is not on file. (Enclosed) xx No Underwriters Certificate on file. xx The check is 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, 1984). BUILDING PERMIT # 20721-Z Please contact our office on this matter. Thank you for cooperation. SOUTHOLD TOWN BUILDING DEPT. BOARD OF HEALTH . FORM NO.1 3 SETS OF PLANS JUN I 11992 TOWN OF SOUTHOLD SURVEY . . BUILDING DEPARTMENT CHECK . TOWN HALL SEPTIC FORN SOUTHOLD, N.Y. 11571 ~y TEL.: 765-1802 t10T I FY 7~ f pQ . J O Examined ~ /A 9i CALL 19 (J.. t1AIL TO: Approved 49 ~f Permit No. de)Z fz'.. . . Disapproved a/c (B ding Inspector) APPLICATION FOR BUILDING PERMIT Date .G~/~/(.........., 19 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 >hall 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 in ct, .ions (Signature of applicant, or name, if a corporation) (Mailing address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. Name of owner of premisesY • ,1`d• l S!~ t ` C (as on the tax roll or latest deed) If applicant is a corporation, signature of duly authorized officer. 11 (Name and title of corporate officer) Builder's License No. 3 9.7 ~ . Plumber's License No . Electrician's License No . a Other Trade's License No . J~~~ oo 1. Location of land on which proposed work will be done. House Number Street Hamlet County Tax Map No. 1000 Section 0.6_1........ Block 3 Lot t .1..... . Subdivision......... Filed Map No. Lot............... (Name) State existing use and occupancy of premises and intended use and occupancy of proposed eonstruction: a. Existing use and occupancy ...../©-/VL ...F~~l l Ly ,Jf ° Pd,S,~Fl b. Intended use and occupancy ....4? 1Q1~~r . 3. Nature of work (check which applicable): New Building , Addition Alteration . • al Demolition Other Work G.A?r f -r:. . Repair . . . .Remoq (Descrip?,tion) 4. Estimated Cost }S-i Fee . S. If dwelling, number of dwelling u'1. (to be paid on filing this application) its Number of dwelling units on each floor , . garage, 6, If business mbar o coal s mixed Q ~y ' ' ' ' ' ' ' ' ' ' ' ' occupancy, specify nature and extent of each type of use . . . Dimensions of existing structures,) if any: Front . . Rear Depth Height Number of Stories . Dimensions of same structure with alterations or additions: Front . . . . . . . Rear . . . . Height Numb ' Height Number ofStories $ Dime sions of entire new construction: Front v7.4........ Rear Depth . oZ ! , , er of Stories P?~ 9. Size of lot. Front /QP.~ . Rear /.D>? r:........ Depth ~~Q.! 10, Date of Purchase .........p , . • , , , , , , , , , , , • , , Name of Former Owner 11. Zone or use district in which remises are situated . . 12. Does proposed construction violate any zoning law, ordinance or regulation: , , .0. , , , , , , , 13. Will lot be regraded A2 0 , , , , , Will excess fill be removed from premises: e No , 14. Name of Owner of promises . t4.StR~?i r.!1 t • , Address . Smtt;~o lot Phone No.?~~. , v??ti5A Name of tractor j ' ' • ' ' ' • • . Address .......'y Phone No...... . Name of Arc 1 . F . . ~ ~Ci?Ow .Address . SA4i~AC'?'.i Phone No.7c5 6` ga 15, Is this property within 300 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 description according to deed, and show street names and indicate whether interior or corner lot. I II STATE OF NEW YORK, S COUNTY, OF signing . ' ' ' ' ' • ' ' • • being duly sworn, deposes and says that he is the applicant (Name of individual contract) above named. Ile is the . (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 application; that all statements contained in this application are true to the best of his knowledge and belief; and that the ,vork will be performed in the manner set forth in the application filed therewith. ;worn to before mje this t.:....... day of.. l', . 9 u!X z? 19 y OZ Jotary Public, ...C.... ...h~...... County /'E'o 144: LINDA J. COOPER Notary Publfo. Stela of Now Yotk (Signature of applicant) No. 4822583, uHolk County Q-' Term Expires Dec mbar 31.1 .11 Al fem.. p "lt •Y f ~ ~ I u ` i h w ! r ~ W •rvJ„o 9s f°'s g~ t,~ ) e 311 ~ o Sd- I b F ! IS { `o oar I o,• a! ~ ff I w~ •y S V ~ i 3 ~ 11 ma'y' ~ ITZ v ' m « c 2, C, 1~ a M-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] INSULATION [ ] FRAMING [ ] FINAL REMARKS: 4,'_ i DATE S INSPECTOR i i; Off-3 o o 0 0 o 0 0 0 0 0 VOWW**_Wvle ° (516) 286-6642 ELECTRICAL INSPECTION SERVICE INC. 375 DUNTON AVENUE c EAST PATCHOGUE, NEW YORK 11772 9067 qqq~~~° APPLICATION NO. ON FILE DATE: q-14-99 ° ADDRESS: 5535 Old North Road VILLAGE: Southold TOWN: Southold ISSUED TO: Bea Sawicki j~ INTRODUCED BY: Lademann Electric LIC. NO. c ° AREAS LISTED WERE INSPECTED ON: 9-14-9 AND WERE FOUND TO BE IN COMPLIANCE WITH THE > NATIONAL ELECTRICAL CODE. LOCATION: -BASE XX 1ST 2ND -3RD _-ATTIC -POOL RES. -SMOKE DETECTOR XX DETACHED GARAGE 2 Switches 1 Receptacle 3 Fixture/Outlets 1-G.F.I. SERVICE DISCONNECT ° METERS AMPS PHASE ~ THIS CERTIFICATE MUST NOT BE ALTERED IN ANY MANNER. ~ HUGO S. SURDI ~ INSPECTORS MAY BE IDENTIFIED BY THEIR CREDENTIALS. PRESIDENT I\ 4 y ~ i. T:s o mu ~ n•s.. ' l W Gy a. ~ '',r A _ o I ay 14 J .11 ~ ~ ~ - t lp~ •Y t+' S~ fit " hY ^t C± N R i ' ~ try I~ ~ ~ l7i 40 I l J O -ofzr. r p fi i `a ' ~ p{1 Q ~ .1 yL~ ~ Z t~, n i to ` CA th ? ~ r.,, r n d'^`«~tf:p n ~ ~C~ .`y.-ate,,. C ~1~~ 77 APP OV AS NOTED DATE: l~ B.P. # 10 2" - f FEE:-aZ~' IM BY: - _ - -'n f NOTIFY BUILDING DEPART `l FOR -THE. OCCUPANCY OR 765-1802 9 AM TO 4 PM LLOWING INSPECTIONS: FO 1. FOUNDATION - TWO REQUIREb AI 1A' J {ni 1 FOR POURED CONCRETE USE IS UNLAWFUL - 2. ROUGH - FRAMING & PLUMBING 3. "NAB" CONSTRUCTONMUBT WITHOUT. CERTIFICATE BE COMPLETE FOR OF OCCUPANCY ALL CONSTRUCTION SHALL MEET THE REQUIREMENTS OF"THE N.Y. STATE CONSTRUCTION, B, ENERGY CODES. NOT RESPONSIBLE FOR DESIGN OR CONSTRUCTION ERRORS i I#r£S- _ y .-G-av'~*7-.~£FF LI!ffi['.O,'J - - „'~.F.L.._~•~~.,..~iJ~~bR`_. _ 1 _ ` , it - i I e-5' ~ a i { T'rtZ-"- .f"rA.~.AGr,'. . i i (DI O ~ i •-A i ~ I I . I ~ ~ ^.fc.. 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