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HomeMy WebLinkAbout20029-z FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No Z-20446 Date JANUARY 2, 1992 THIS CERTIFIES that the building ALTERATION/RENOVATION Location of Property 58670 COUNTY RD #48 GREENPORT NY House No. Street Hamlet County Tax Map No. 1000 Section 44 Block 4 Lat 4 Subdivision Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated JULY 17, 1991 pursuant to which Building Permit No. 20029-Z dated JULY 19 1991 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 RENOVATE & ADD 2nd FLOOR TO EXISTING ONE-FAMILY DWELLING AS APPLIED FOR. The certificate is issued to ESTATE OF ALBERT SLEDJESKI owner of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A UNDERWRITERS CERTIFICATE NO. N 215398 DECEMBER 4 1991 PLUMBERS CERTIFICATION DATED DECEMBER 18 1991 ~_L~ Building Inspector Rev. 1/81 108![ NO. >t ' 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~ 29~e~! Z Date 19.q.1. ? Permission is hereby granted to: j ..%.~::.~.....R:.~rr.~ . ~+ae . ...~1?,~ 4.~.. 1a .7 . ..5~.... l of premises located at ..~..$.~R.. 0.........~'..:`:......~~ E County Tox Map No. 1000 Section 0.~'~.......... Block Lot No...d..1 E pursuant to opplieation doted ~ ~ 19.....~.., and approved by the Ike Buildin~glpplnspector, Fee S...l...l.:.. ~ i ? i j B ing Inspector i { K f Rev. 6/30/80 - , ~ _ Form No. 6 " ~ ~ TOWN OF SOUTIIOLD ~ . Z S~]~ ui ~I BUILDING DEPARTMENT ' _ J ~~'9) ~!i~~~ TOWN HALL ~ n ~r3- ~ 765-1802 ~ APPLICATION FOR CERTIFICATE OF OCCUPANCY This application must be filled in by typewriter OF, ink and submitted to the building inspector with the following: for new building or new use: 1. Final survey of property caith 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. :i. 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 S. Temporary Certificate of Occupancy - Residential/$15.00; fCa~ommercial $15.00 Date ....1.~:.~-~..~..!~ ::ew Construction....... Old Or Pre-existin//g Buil.di~.,.,~''~ ' Location of Property... 5.~~7k............~~~ ~ ,,,..,,,..'rfl!.e~w{~•°Y. House No. Street Hamlet ~ Onwur or Owners of Property... ~ County Tax Map No 1000, Section..t/. L/.....,Block..... ot....~.~,,,,,,,,,,,, Subdivision~.7 ...................................Filet~d qN'ap............Lot..........,./. Permit :Io.O.t~~~.~.,~-;Date Of Permit...J.~~~.~,1,~,`/APPlicant..~~~..~1/ew`P~.. E{eal tti Dept. Approval ..........................Underwriters Approval.L/.~. ;Tanning Board Approval ~~e9uest for: Temporary Certificate........... Final Certicate.... :'ee Submitted: ~ ~ ..................................~P. ICA T THE NEW YORK BOARD OF FIRE UNDERWRITERS ` 't 145'11 3 BUREAU OF ELECTRICITY 85 JOHN STREET, NEW YORK, NEW YORK 10038 I7rXY~MH.FR Cl~i,'L~92 7d7 ~Cti~14(191 Pi J75:29£t - Date APYlica[ion No. on file THIS CERTIFIES THAT only the electrical equipment as described 6eloty oral introduced 6y the applicant named on the above application number in the premises of - RSTp~'f; CYF' A,SI~ltitliS.lF;.S'i~,:C~ !°iR4i'1f1 R`T'.~.YJ. F'tl.~.fitf t;l2~:n,NPC1RT, N,Y. olf~h in the fallarcinq loca~ilga~_i~ Bgr~,em~ 4~t,1 ~ Ist Fl. ~ 2nd Fl. Sertion Block Lot uas examined on and found to 6e in compliance with the requirentenLC a/this Board. FIXTURE ECEPTACLES SWITCHES FIXTURES RANGES COOKING BECKS OVENS DISH WASHERS EXHAUST FANS OUTLETS INCANDESCENT FWOREJCENi OTHER AMT. K.W. AMi K.W AMi. K. W, AMi K.W. AMi H P. _ ~I L~ a(i !v - DRYERS FURNACE MOTORS FUTURE AP IIANC ,FEE ERS SPECIAL REC'PT TIME CLOCKS BELL UNIT HEATERS MUITI.OUTLET DIMMERS = SYSTEMS ° AMT N.W. Oll H. P. GAS H. P AMT. Y AO "A. W. G AMi AMP. AMT AMPS. TRANS. AMT. H. P NO. OF FEET AMT. WAT15 _ ~ `I u SERVICE DISCONNECT NO.OF ~ ~ S E R' V 1 C E AMT. AMP. rvPE METER 1,e' ]W ,e' J 3 $ JW 3 d1iA NO.OF CC CONO A. W G NO OF NbLEG A W' G' NO OF NEUTRALS A. W G EQUIP. I PER A" OF CC. COND. OF HbIEG Of NEUTRAL i t)0 CF I X~ 1 i'. 7 4 OTNER APPARATUS: G.F'.C. C.-5 I_ St4Q2Os Ll:F:9'~C9'(1R;-2 t. ~a; ® ~ III€ :ik(a; k 1~{LpI~~MAt~YId ZAiC'. L7:(..,~d~35~~; I P.t).NO?; 7'762 SC)U'C'FJOtIf), le"./, f 97~ GENERAL AOER ~1 {{Y l')/ t PeY F This certificate must not be altered in any manner; return to the office of the Board if incorrect. Inspectors may be identified 6y their credentials. ~ COPY'POR BUILDING DEPARTMENT. THIS COP; , E'EERTIFICATE MUST NOT BE ALTERED IN ANY MANNER. F~ TEL.76S-1802 0~05~~~~1 ~O~ TORN OF SOYJTH[ObD 1="~ ~ ~ OFFICE OF BUILDING INSPECTOR -e TOWN HALL SOUTHULD, N.Y. 11971 1 C E R T I F I C A T I O N Date ~'9,e~ /g~~/y9 / Building Permit No. ~C7G~9'Z. owner L S~n~~ r$ A I P~-' k,' , (plc. se print/) / Plumber_~~/'ridJ!/' //jyl~//~/~. ~ /~~°i~/ /l?~ (please print) I certify that the solder used in the water supply system contains less than 2/10 of 1, lead. (plum er's 'ynature) Sworn to before me this _Lday of ~e~', - Notary Publi Notary Public, .~Uf~~K County ~ttt3xaas~trPNOwsus No4ury Pubtir'. Strreo 04 New York ' No.~84~762 llualifiord irr SuFfodk County Commission Exgrires.AFiurc{t 36, ~ b'1c:I<<D I;:S:`EC;iU;J ~~Ui„E I COMMENT° t 1 . ' ~ ~ /P' _ H N FOUiJDAT20N ( 1st ) ,D ~ N FOUNDATIOtJ (2nd) e - - mx 2. ~ ~ 0 P,OUGH FRAME & J PLUMBING ~ ti ~o 3. y .G ~ ~ IIJSULATIODI PER N. Y. ~ "3 STATE ENERGY CODE ~e ' S ,!x H FI;JAL ~ • ~ ADDITIONAL COMMENTS: s . ~ • ~ - x .b , H >7 p ...,p y • H ~O O ~ 2 i Z m ~ Z. _ r _ ~ ~ o:',• m -o . . INSPECTORS Victor Lessard SpFFII~,~ Principal Building Inspector ®i® ~p~ ' Curtis Horton `'z' ~„a SCOTT L. HARRIS, Supervisor Senior Building Inspectrn o s~~' ~ ' as fia x Southold Town Hall Thomas Fisher w ~r p,0. Box 1179, 53095 Main Road Building Inspector ~,f, « .rte' ~ Southold, New York 11971 Gary Fish 'f',?,( ~ .~q1o® I Fax (516) 765-1823 Building Inspector Telephone (516) 765-1800 Vincent R. Wieczorek Ordinance Inspectrn Robert Fisher Assistant Fire Inspector OFFICE OF BUILDING INSPECTOR Telephone (516) 765-1802 TOWN OF SOUTHOLD June 21, 1991 Albert Sledzieski, Estate RFD Box 354 Greenport, N.Y. 11944 RE: Unsafe Building @ 58670 County Road #48, North Road, Greenport, N.Y. Suff. Co. Tax Map #1000-44-04-04 Estate of Albert Sledzieski: The dwelling at the above address is considered an unsafe building due to the fire damage that occured on June 20, 1991. According to Chapter 90 of the Code of the Town of Southold the building must be made safe and secure immediately and then repaired or removed. Please be advised that before any repair work or demolition is started you must first obtain permits from the Southold Town Building Inspector and other concerned agencies. In order to avoid possible legal action by the Town of Southold you must comply with the Code immediately. Thank you for your coop0eration in resolving this matter. Sincerely, SOUTHOLD TOWN BUILDING PT. U ~2.c~ Vincent R. Wieczore Ordinance Inspector VRW:gar ~~zzrh~- Ham.. ~ T65-1802 BUILDING DEPT. INSPECTION [ ]FOUNDATION 1ST [ ] ROUGH PLBG. [ ]FOUNDATION 2ND [ ]INSULATION [ ]FRAMING NAL REMARKS: C~_. I I s DATE ~ ~ INSPECTOR i rss-iso2 ~ BUILDING DEPT. NSPECTtON [ ]FOUNDATION 1ST [ ] ROUGH PLBG. [ ] FOU LION 2ND [ ]INSULATION [ FRAMING [ ]FINAL i REMARKS: 4 4 f ~ 1 DATE INSPECTO ~ f e~_~ ~ B0,\aD OF HEALTH ,~SU 1J„L-~ 3 SETS OF PL 1`7S ..U'.I'C.=.. FORM NO. 1 , , .SURVEY TOWN OF SOUTHOLD ~ ' ' ' ' ' ~ BUILDING DEPARTMENT sErrlc rDahl TOWN HALL p~°"""~,p,~°, p~P~ ~ SOUTHOLD, N.Y. 11971 TOWN OF SAUTh10LI7 TEL.: 765-1802 t: or I FY ; l/ ' CALL :7 !.I.. _ ~a Examined „ 19 ~ 1 • • . q h1AIL T0: Approved ~ . ~ . 1 19 Pernait No. s~ 00 0"1 ~ . . Disapproved a/c (Building Inspector) APPLICATION FOR BUILDING PERMIT ' Date . ~.v,~ .7.. 19~ ~ ~ INSTRUCTIONS a. This application must be completely filled in 6y typewriter or in ink and submitted to the Building Inspectoz•)viyth 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 pr in pazt 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 Ordnance 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. .-'k . r~..~~'..Nome .~+r.?prc~vsr.~ew~:~r .81~c~~..Z!,?a, (Signature of applicant, or name, if a corporation) (Mailing address of applicant) State whether applicant its owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. Name of owner of premises E.$~~1-e.... g: 1.., l~~Y~ ...J~.~~ ~'.ral~l .1: !rkt'!bA . (as on e tax roll or latest deed) If applicant is a corporation, signature of duly aut r' e e 5 ~.+G~S8S~1 9(Name and title of corporate officer) Builder's License No...~~~eQ~„k~T., . Plumber's License No. ~~:Gph+\~..P,~,YtM~~!'~q ~~~w~ Electrician's License No. . ,~jl~1,'S, . Other Trade's License No . . 1. Location of land on which proposed work will be done . . U House Number ``//Street Hamlet / County Tax Map No. 1000 Section .......r.~........ Block Lot . Subdivision Filed Map No. Lot . (Name) 2. State existing use and occupancy of premises and intended use and occupane of_ /p oposed construction: .e a. Existing use and occupancy ~ rtl`!~ ti 1 ~ ~ -Sv , , , , . ~/11 . b. Intended use and occupancy ..~A.K~!! ? `Y? [2~eS\ c~,t t,~;~'~ _ " . J ` . p ' , ~i.~;.i~ f'1 3. Nature of work (check which a plicable): New Building Addition , , Ater do f .:~,ai; P Removal . . . Demolition Other Work . e air ~1 ~yy~ 4. Estimated Cost~~ ~O.O.C/ . ~ . . . ..................1~! ~ ~Diption) . . " .Fee . (to be paid on filing this application) 5. If dwelling, number of dwellin nits , Number of dwelling units on each floor , , , , , , , sq _ If garage, number of cars . . . 6. If business, commercial or mixed occupancy, specify nature and extent of each type of use imensions of existing structures, if any: Front ..a ~i. i , , .Rear ~g Depth ..eZ.~........ . Height a.q......... Number of Stories ~ lTr h alterations or addi i ns: Front ~ ~ t ~ 9 38........... Rear ....3fs........... . De th . pensions o same s ructure wit Height ......................Number of Stories ~ ~~'S-•, , , , , , , , , , , , .Rear . $ Heightsions o~ ~ tare new c Nu~~ctian: Front ~ g' ~ , , , , , ,Depth ..'Z,~ , , , , , , , , • • • • der of Stories ~ .Iz:.... Size of lot: Front : Rear Depth . 11. Zone or use district in which re • ' • Name of Former Owner . 13. WIll lot be p miser are situated : . 12. Does oro osed construction viola,, • • • • • • • • re raded , , , to any zoning law, ordinance or regulation: p M I ....7 , .Will excess fill be rgmoved from,~ premises: Yes .~Io-~ 14. Name of Owner of remises . flY., Name of Architect ~ • ~ kWyeS~i ..Address ~~a.1S?a.Jy ,~Y4~~~pu!IPhone No. Y7.7:.!3.7,,3, . , . , ~ • • • • ..Address . Phone No... Name of Contractor R~.I~....~t?,tW:~r.Y , .........Address P.O.B~.,y76t,~,~, ,N j,phone No. y77-.1.2S.S... 15. Is this property within 300 feet of a tidal wetland? ~~yes••,,,,,• No --r *If yes, Southold Town Trustees Permit may be required. PLOT DIAGRAM Locate clearly and distinctly all l7uildings, 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. STATE OF NEW YORK, S $ COUNTY OF . (Name of individual si nin ~ ' • ' ' ' ' • • ~ • being duly sworn, deposes and says that he is the applicant g g contract) above named. He 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 ~PPlication; 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. iworn to before me this day of.., 19 ~y/ % Votary Public, . , ~.../.1.•..~~.:K~.... 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