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Home My WebLink About19721-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No Z-20716 Date MAY 11~ 1992 THIS CERTIFIES that the building. ADDITIONS Location of Property 490 AQUAVIEW AVE1FOE House Noo Street County Tax Map No. 1000 Section 21 Block 3 Subdivision Filed Map No. EAST MARION, N.Y. Hamlet Lot 5 Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated MARCH 18, 1991 pursuant to which Buildinq Permit No. 1972t-Z dated MARCH 19~ 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 & OUTSIDE SHOWER ADDITION TO AN EXISTING ONE FAMILY DWELLING AS APPLIED FOR. The certificate is issued to MARIA G. BULIS (owner) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A UNDERWRITERS CERTIFICATE NO. N/A PLUMBERS CERTIFICATION DATED N/A Rev. 1/81 / ~uilding Inspector l~)~,,~ NO. ~ 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° 19721 Z Permission is ~erebyj~ant~ed to: / .../..~.~.....~/.~.....~..~.. ........... ~' ~- ~ ~o ~ ..... ~' % ~--~ ~' ' .... at premiss f~at~ at ...~.~ ...... ~~......~ .................................................... ............................................... ~~...~ ................................................................. County Tax Map No. 1000 Section .......... ...~..../.. ..... Block ....... ~ ......... Lot No.....~ ......... ~./...~ ................................ . ,,..~.. o,,.~ ~ ~. pursuant to oDplication Building Inspector. Rev. 6/30/80 Form No. 6 TOW~I (.~-~OU~'MOLD .APPLICATION FOR CERTIFICATE OF OCCUPANCY TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL 765-1802 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. 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 - $i00.00 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 .... ...................... New Construction ........... Old Or Pre-existing Building....~.<~ ....... Location of Property .... .~.~.~. .......... ~...~.~t~..6~... J~. ..... ~.~]...~...~.~./~%~P.f ...... House No. Street Hamlet Onwer or Owners of Property .... ,/~..~.~.1.~ ............................................ County Tax Map No 1000, Section....~.J' .......: Block ..... ............ ~ Lot ...... .~.~. ........... Subdivision .................................. . . Filed Map ............ Lot ................. ... .. Permit No.~ .~. 7. ~ .L..~..Date Of Permit.~.~./.']. ~/. ,~. J ..... Applicant .t~/}.~...~.~..~....~.?~ .~.~*.~. ~ [. Health Dept. Approval ...................... .. .. Underwriters Approval ........................ . Planning Board Approval ..... Request for: Temporary Certificate ........... Final Certicate ....... Fee Submitted: $.~..~. .................. .................. FOUNDATION FOUNDATIO~I ROUGH FRAME & (1st) (2nd) PLUMBING INSULATION PER N. STATE ENERGY CODE YJ FI~AL ADDITIONAL COMME~TS: 4.. 1000 CEDAR DRIVE · EAST MARION, DZENKOWSKI HOME IMPROVEMENT 1939 · PHONE 477.2465 KlM T. DZENKOWSKI HOME IMPROVEMENT 1000 CEDAR DRIVE · EAST MARION. NEW YORK 11939 - PHONE 477-2465 KlM T. DZENKOWSKI HOME IMPROVEMENT ~.000 CEDAR DRIVE · EAST MARION. NEW YORK 11939 o PHONE 477°2465 ~ ,4'aT To ! % 765-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLBG. FOUNDATION 2ND [ ] I~JLATION FRAMING [/~INAL DATE INSPECTOR Examined ·-~ ~.-~ .. Appro~cd ...~-W/:/.. FORM NO. 1 TOWN OF souTHOLD IUILDING DEPARTMENT ~- 61~ ~ TOW~.~LL ..... ~ TEL.: 765-180~ Disapproved ...................... BOARD OF HEALTH SURVEY s~.,~: ~o~,, .............. NOT I FY; CALL ................... MAIL TO:. .-F,~¢~,. T.. 05~.. Date ...... I9. INsI'I~,UCTIONS ..,. a, Tltis application must be completely filled in by typewriter or in ink and submitted to the Building I~p~tar, wit! sets of p!n~, ~cc,,rate plot plan to scale. ~ =coon:ting to schedule. b. Plot plan showing location of lot and of buildings on premises, relationship to adjoining premises or public stree or areas, and giving a detailed description of layout of property must be drawn on the diagram which is par[ of tkis apl: cation. c. The work covered by t~s application may not be commenced before issuance of Building Permit. -cl. Upon approval of this application, the Building Inspector wi/l issued a Building Permit to the applico, nt. Such perrr 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 m3y purpose whatever until a Certificate of Occupmn: shall have been granted by the Building Inspector. APPLICATION IS HEREBY MADE to the Building Department for the issuance of a Bu/Iding Permit pursuant to Building Zone Ordinance of the Town of Southold, Suffolk County, New York, and other applicable Laxvs. Ordinances Regulations, for the construction of buildings, ad. ditions or alterations, or for removal or demolition, as herein describe: The applicant agrees to comply with all applicable laws, ordinances, bu/Iding code, housin~ code, and regulations, and admit authorized inspectom on premises and in building for necessary, inspcction~ ~ . .. ............. · (Signature et app~ant, or name. if a corporanon) (Mailing address of applicant) State wh~ther applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder (as on the tax roll or latest deed) /i'applicant is a corporation, signature of duly authorized officer. Plumber's License No Elcctricia,'s License No Other Tradc~ License No ................. .. . · · Location of land on which proposed work ,.rill be done: .~.¢.¢ ........... ~,,c... ..... ,'~'v/ .......................... ~.~..*.0 A.O,. ~ b, Iz t~ ................................ llousc Number Street. ' ' Hamlet .2..1 · · s.'.T County Tax Map No. 1000 Section ............ Block .............. Lot ........... Subdivision ..................................... Eilcd Map No. . ............. Lot .............. (N:uue) SIzIc existing u~c and occupancy of prcmiscs and intended use ~.d occupancy or proposed construction: A. ExLst£ng use and occupancy ........... . .................................... B. Intended use and occupancy.; ...... 3.Nature o£ work (check which applicable): New Building ...... Addition .... /dictation ......... Repair ............. ~ movat .............. Demolition .......... Swimming pool.. . · . Tennis Court .. ...... Accessory guilding ........ 'Ft~ ~ ~ ..... Other 4. Estimated Cost . .~. ~..C~..o.: O O ' ' .. . ....... ............... ° ........... Fee ..................................... $. Ir.d~e (m b= oaid on filing this apolication} mt, nUmber of dwelhng umts ............... Numbe ~' elling units on each floor ........ ' . . . If~ara e, number of cars ............................. v .................. . .......... 7. Dm~enmons of ex' tin- ~,,,~,, ~ ;r . ~ · lent of each tvoe of usc ........ ......... ~sumoero[atones. . J '/O~ ' ............... Dimensions or*amc structure with alterations or additions: Front ~:: ~;;~;/;~ R=~ .... . '.. Depth ...................... }Icier .............. Sro : .... .... ; ....... 8. Dimemion$ of entire new Construction: Front ...........Rear ........ De th HcA=hr .......... Number of Stohe$ ..... 9. Sizeoflot: Front J 7~2 ......... : .............. ' .......... : ...... ...... ......... ....... ,0. ... . ............ .............. ......... .. Name ruler Owner ........ ' ' 11. Zone or use district in which premises are situated .... ; .......................... 12. Doe~ proposed Construction vi~late any zoning law, ordinan 13. W~I lot b= re-rna~a ~/~j ce or re elation. ........ ~ ....... ~hone No .............. N~e of Architect .................... , ....... Address ..... Phone No . N~e of Contractor ~t~. ~e~o~t . . ' .... ' : ......... . ............ ,~ ~ ~ ~o.~y ~o~d ~h~. 300 f~ o~ ;"iia;'f ~i~'f~ ~If 7es, Southold Town Trustees Permit may be required. PLOT DIAG~M Locate cle~ly ~d distNctly ~I bu~d~gs, whether existing or proposed, ~d. indieate ~1 set-back d~en:ioa: ::. prope~y Hues. Give Street ~d block number or description accord~g to deed, ~d show street nines and ~dicatc w:::::. interior or COmer lot. ' AP/PROUD AS NO, ,~O N OTI F .Y,~., U.~I .E~.. ~ O EPART~IENT~T 7~f,-~802 9 AM ~ 4 PM ~ ~E FOLLOWING INSPECTIONS: ~. Ff~UNDATION ~0 REQUIRED FOi;: POURED CONCR~E ~ R~'.JG~ * FRAMING & PLUMBING ~ ~Nql ~LATIO~ ,:-~:~,.',-. CONSTRUCTION MUST ~. COh0~L.ETE FO~ ,~. CON~TRUCTION SHALL ME~ 'tlr F,[OIJIREMENTS OF THE N.Y. -~;.',?'~ ~N~TRlJCTION & ENERGY · :' ~ n~OT ~ESPONSIBLE FOR - '~:' G~ CQ~TrRUCTION ERRORS STATE OF NEW YORK, COUNTY, OF ................. S.S · , (Name o£indiv~ilual signing contract) above named. (Contractor, agent, corporate officer, etc.) of said owner or owners, and is duly aut mrized to perform or have performed the said work and to make and file Ih application: that all state,neats contained in Ibis application are true to tile best of his knowledge and belief; and that t:: work will be performed in tile manner set forth in thc application filed therewith. ...... 1..-TT.: ........... dayof. .Q~ .... ~./. No. 4898779, Term Expir~ .tanuar~ (Signature of applicaJa' 4