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HomeMy WebLinkAbout20355-z FORM NO. 4 TOWN OF SOIITHOLD BUILDING DEPARTMENT office of the Building Inspector Town Ha11 Southold, N.Y. CERTIFICATE OF OCCUPANCY No Z-20775 Date JUNE 8, 1992 THIS CERTIFIES that the building ALTERATION Location of Property 58605 MAIN ROAD SOUTHOLD NY House No. Street Hamlet County Tax Map No. 1000 Section 56 Block 2 Lot 2 Subdivision Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated DECEMBER 24, 1991 pursuant to which Building Permit No. 20355'Z dated DECEMBER 30, 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 PERMANENT ROOF OVER KENNELS AS APPLIED FOR The certificate is issued to WILLIAM E. ZITEK (owner) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A UNDERWRITERS CERTIFICATE NO. N/A PLUMBERS CERTIFICATION DATED N/A Building Inspector Rev. 1/81 l0$M NO. TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N. Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UN71L FULL COMPLETION OF THE WORK AUTHORIZED) N 2 0 3 5 5 Z oater..~.~; ~.....3° 199. Permission is hereby granted to: , ~~9.:~..r to ...~~"!1~9~t~.s..s~'-...i'.R~.wK~.9r~a,~'... h'~S?~?'!.~...4?:4~,.......'~.4~!~1.~.....~r~.2......... at premises located at..r~...........~.....fK.lea.......~.:.........~l~ast~S.Y~ x...?:~.:~:~..:.~...t~.f.:k............ County Tax Map No. 1000 Sec~tion~..... Q.s4'.ZP........ Block Lot No.. Q: pursuant to application dated ..A._.~LC.!.^..'.?..`.^..'~..... a.~..........., 19.9..x.., and approved by the ' Building Inspector. Fee S,g~..'.....~.-. Bui ding Inspector Rev. 6130/80 Form No. 6 '•~~j~"R'_ -~.Yti~~'3--- ~~i TOWN OP SOUTIIOLD ~-v~' ~P "'Q~ BUILDING DEPARTMENT `'~o2c~ d/" °~~YC TOWN HALL ~/~~JJ/ f 765-1802 ~ APPLICATION FOR CERTIFICATE OF OCCUPANCY A. 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 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 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 Dace ~~:C! 2_-............ New Construction........... Old Or Pre-existing Building.... a Location of Property...~dtr-y......... ~v,!H!:...s~! Ps!9~~c~............ House No. ,S~t+reet Hamlet Onwer or Owners of ProperCY..../~~-.:~i..~ ~ ~7.'1,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, County Tax Map No 1000, Section.....~'~':G....Bloclc......~.°Z°......Lot.... ¢:L Subdivision .............~.J......................Filed Map............Lot...................... Permit No...."P.6j,'~,'~ ~R,pate OP Permit.. ~r~~-~. a/y.~....Appl icant...:. r/~....°ZLT~.~ llealth_Dept. Approval ..........................Underwriters Approval......................... Planning Board Approval Request for: Temporary Certificate........... Pinal~Curticate....~.~... Fee Submitted: $ ~0~~ -.~2o'J7~ • • ....APPLICe~ . tea/ INSPECTORS Victor Lessard ~SUFFD(~-~ Principal Building Inspector Curtis Horton E`'' rk SCOTT L. HARRIS, Supervisor Senior Building Inspector d i Thomas Fisher t ' z Southold Town Hall ~ ink`; "'r P.O. Box 1179, 53095 Main Road Building Inspector ~ ~ Gar Fish ~9~ Southold, New York 11971 Building Inspector Ol ~ Fax (516) 765-1823 Vincent R. Wiecmrek Telephone (516) 765-1800 Ordinance Inspector Robert Fisher Assistant Fire Irupectrn OFFICE OF BUILDING INSPECTOR Telephone (516) 765-1802 TOWN OF SOUTHOLD MAY I5, 1992 NORTH FORK ANIMAL..HOSPITAL 38605 MAIN ROAD SOUTHOLD, NY 11971 To Whom This May Concern: We are unable to complete your Certificate of Occupancy because of the following reasons: R%% An application for Certificate of Occupancy is not on file. (Enclosed) No Underwriters Certificate on file. ~ • xxx The check is not on file.)$ 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 # 20355-Z Please contact our office on this matter. Thank you for cooperation. 50UTHOLD TOWN BUILDING DEPT. c'lELD il:Si'EO::U:J ~~'Jr,:E ~ ~OMi`1LNT° < ..e... ~ 1 i ^"O Q a W H V FOUIJDATION (1st) i~ c FOUiJDATI0IJ (ppd~ ti - - m 2. `o~ P,OUGH FRAME & •PLUMBING (rj y 3. ~ ~ y~ m IIJSULATIOhJ PER N. Y. ~ y STATE ENERGY CODE 4 . Y m H FIJJAL ~ £ l~ ADDITIOh]AL COMhfEhJTS: m xa ' s v ' n • ~ x.S b " H A - ~ H ~ • H ~ O z W m r ' ~ H S m.. _ ~o H INSPECTORS Victor Lessard ~g~FfD(~- Principal Building Inspectrn Off. f.+-~; ~'d Curtis Horton " SCOTT L. HARRIS, Supervisor Senior Building Inspector a ~k va Southold Town Hall Thomas Fisher ry L P.O. Box 1179, 53095 Main Road Building Inspector `,~':~'d~~, Gary Fish .;,~^v Southold, New York 11971 " Building Inspector ~ 1 a; ";x Fax (516) 765-1823 Vincent R. Wieczorek Telephone (516) 765-1800 Ordinance Inspector Robert Fisher Assistant Fire Inspector OFFICE OF BUILDING INSPECTOR Telephone (516) 765-1802 TOWN OF SOUTHOLD MAY 15, 1992 NORTH FORK ANIMAL~.HOSPITAL 38605 MAIN ROAD SODTHOLD, NY 11971 To Whom This May Concern: We are unable to complete your Certificate of Occupancy because of the following reasons: I~ An application for Certificate of Occupancy is not on file. (Enclosed) No Underwriters Certificate on file. xxx 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 # 20355-Z Please contact our office on this matter. Thank you for cooperation. SOUTHOLD TOWN BUILDING DEPT. BO.1RD OF HEALTi1 FORMN0.1 J SETS OF PL.1:iS TOWN OFSOUTHOLD SURVEY BUILDING DEPARTMENT CSICCI: _ . . . TOWN HALL SEPTIC FOft:I . SOUTHOLD, N. Y. 11071 TEL.: 7G5-1II02 t7oTI F'1 ; - CALL ..~~',..~=d~@~....... . Lxamincd~~~-r.~~µ, . 3.0.. 19 . Mn I L TO lpproved LY,~..~.(~~ `t,_ 0}0.35 ~ • 19.1 Pcnnit No. . isapproved a/c , . , , . C (Building Inspector) APPLICATION FOR BUILDING PERMIT Date .~t. L'~ 19 . INSTRUCTIONS a. This application must be completely filled in by typewriter or in ink and submitted to the Building Inspector, with 3 ets 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 ~r areas, and giving a detailed description of layout of property must be drawn on the diagram which is part of this appli- .ation. 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 hall be kept on the premises available for inspection throughout the work. e. No building shall be occupied or used in whole or in par[ for any purpose whatever until a Certificate of Occupancy hall have been granted by the Building Inspector. APPLICATION IS HEREBY MADE to the Buildin; Department for [he issuance of a Building Permit pursuant to the 3uilding Zone Ordinance of the Town of Southold, Suffolk County, New York, and other applicable Laws, Ordinances or Zegulations, for the construction of buildings, additions or alterations, or for removal or demolition, as herein described. he applicant agrees to comply with all applicable laws, ordinances, building code, housing code, and regulations, and to dmit authorized inspectors on premises and in building for necessary inspe ons. (Signature ~ap cant, or name, if a corporation) ~ ..1~1....Qiyz;r~?kdF~j ..N~:..j)`kll (;ifailing address of applicant) Mate whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. \ame of owner of premises ~..~N.,~~,.dxvx ..~..~,~~k , , . „ . . . (as on the t:n roll or latest deed) :f applicant is a corporation, signature of duly authorized officer. (Name and title of corporate officer) Builder's License No....~Nnu~:,,,,•„•,,,,. Plumber's License No. . Electrician's License No . , Other Trade's License No . . Location of land on which proposed work will be done. ~Q.G.~~'1 , .71~~,a~lc~ 1~c $5r M~ 1 Ilousc Number Street Hamlet County Tax lfap No. 1000 Section .....Q.~Zv... , , Block Q, 2r, • . Lot.. Subdivision Filed ~11ap No. . (Name) Lot State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occu anc b. Intended use and occupancy ..~.uYRb...~>,YCr; ...~~,.~L:R'ilst.lC ~~...~so-jcc)^: ~.6.o:,a.. ,'S,C'i" n ;vJ• -~..~:.s:.S \ i 3. Nature of work (checlgwhich applicable): New Building y Repair Removal ' • • Addition Alteration . • • • • • Demolition Otherl4ork 4. Estimated Cos[ , ,~Qj (Description) Fee 5. If dwelling e (to be paid on filing this application) o, number of dwelling units Number of dwelling units on each floor . If garage, number of cars . 6. If business, commercial or mixed occupancy, specify nature and extent of cacti type of use 7, Dimensions of existing structures, if any: Front . Heigh[ Number of Stories Rear............... Depth . Dimensions of same structure with alterations or additions: Front , , • • , Depth........... Rear Iicight Number of Stories . 8. Dimensions of entire new constnrction: Front . Height Number of Stones . . . . • .Rear Depth . 9. Size of lot: Front l0. Date of Purchase Rear..........., Depth ............................NameofFormcr Owner 11. Zone or use district in which premises are situated . 12. Does proposed construction violate any zoning law, ordinance or regulation: ~ • ~ • ~ • ~ • ~ • ~ • 13, ~Villlotberegraded 1Vi11 excess fill be removed from premises: Yes No 14. Name of Owner of premises ~ • ~ ~ • • • Address Name of Architect "••••••••••••.....PhoneNo. Name of Contractor .....................Address ...................Phone No........ , , . ......................Address Is this property within 300 feet of a tidal wetland? * " " ...Phone No. *If yes, Southold Town Trustees Permit may be required. ~ " No......... ~ PLOT DIAGRAM Locate clearly and distinctly ail 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. H TATL OF N O OUN"I Y OF~t,t.I.~.. S.S~..,o r~ • ~ ~ ~~'•'~t"1' ' t • • • • • • • • • , being duly sworn, deposes and says that he is the applicant (Name of dividual signing contract) rove named. :isthc (Contractor agent; orporate off~cer,etc.) said owner or owners, and is duly authorized to perform or have perforated the said work and to make and Cile tftis plication; that all statements contained in this application arc Iruc to the best of his knowledge and belief; and that the 'rk will be Performed in the manner set forth in the application filed therewith. om [o before me th's dayo~f... , L 1~.~, tary Public, . • County NotaY Iublk; Sets of NewYak No. 4979608 t]usllNed In Su}fdk CouMY ~ J . ConnMplonEt~kssDecember9.1 v \ (Signature ofapplican[) i. ~~`F~ ~ - ~ - . . ' . .1 w C' f 4j9rYk@Y - ! 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