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Home My WebLink About20077-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY NO Z-23506 Date FEBRUARY 23, 1995 THIS CERTIFIES that the building ALTERATION Location of Property 330 DOGWOOD LANE SO~3THOLD NY House NO. Street Hamlet County Tax Map No. 1000 Section 54 Block 8 Lot 3 Subdivision Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated AUGUST 6, 1991 pursuant to which Building Permit No. 20077-Z dated AUGUST 9, 1991 was issued, and conforms to ail of the requirements of the applicable provisions of the law. The Occupancy for which this certificate is issued is INSTALLATION OF WINDOWS IN AN EXISTING ONE FAMILY DWELLING AS APPLIED FOR. The certificate is issued to of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL UNDERWRITERS CERTIFICATE NO. N210499 PLUMBERS CERTIFICATION DATED SUSAN CANEJA OCTOBER 22, 1991 N/A Rev. 1/81 / Bui, ng In,.ector FORM NO. ~ TOWN OF SOU334OLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N. Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) 20077 Z Permission is hereby granted te: ,~ / _ / ~ ,o '' Z ~..~_~ ~ / at premises I~d at ..~.~..~~...~ ........................................... County Tax Map No. 1000 Section ...... . .~...../... ..... Block .......... ~.... ..... Lot No....-~.. ................ pursuant to application dated ........... ~./..~.. ................................. , 19.~../.., and approved by the Building Inspector. Fee ~,~.. Rev. 6/30/80 Form No. 6 TOWN OF SOUTIIOLD BUILDING DEPARTMENT TOWN HALL 765-1802 APPLICATION FOR CERTIFICATE OF OCCUPANCY :EB 2 3']995 , BLDG, D[P'f. 1'OWN OF SOU'i~® 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. Commercial building, industrial building, multiple residences and similar buildings and installations, a certificate of Code Compliance from architect or engineer responsible for the building. 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 - $100.00 3. Copy of Certificate of Occupancy - $5.00 over 5 years - $10o00 4. Updated Certificate of Occupancy - $50.00 5. Temporary Certificate of Occupancy - Residentia~ $15.00, Commercial $15.00 Date.. ?/.~.~..1. fi j ........................... ,'Jew Construction ........... Old Or Pr_~e-existin~ Building ................. Location of Property ...... . ............................. House No. Street Hamlet Onwer or Owners of Property....~..~...~.~.~v~ .~..~.. ~ ~ County Tax Hap No 1000, Section .......... Block ................ Lot ...................... Itealth Dept. Approval .......................... Underwriters Approval..~ ...... ; ......... Planning Board Approval APPLICANT THE NEW YORK BOARD OF FIRE UNDERWRIT.ERs ~01093 BUREAU OF ELECTRICITY 85 JOHN STREET. NEW YORK. NEW YORK 10038 OCTO~ 30,199~ ~ppll~etion~o. onflle 74846291/91 N 210499 THIS CE~IFIES THAT ~USAN CANEJA, 330 DOGWOOD LANE, PL.~3, SOUTEOLD, N.Y. '[ SIIRVIC~ DISCONNIE~T NO. OF ~ ' ' S OTHER APPARATUS: R OF CC, COND. G.F.C.I:-i GARY DOROSKI 425 MONSELL LANE CUTCHOGUE, NY, 11935 I, IC.~2941-E 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. Town Hall, 53095 Main Road P. O. Box 1179 Southold, NewYo~k 11971 Fax (516) 765-1823 Telephone (516) 765-18o2 OFFICE OF THE BUILDING INSPECTOR TOWN OF SOUTHOLD January 5, 1995 Ms. Susan Caneja 3900 Graystone Avenue Riverdale, NY 10471 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 ~ 20077-Z Please contact our office on this matter. cooperation. Thank you for SOUTHOLD TOWN BUILDING DEPT. ** - ACCORDING TO THE CODE OF THE TOWN OF SOUTHOLD, IT IS UNLAWFUL TO OCCUPY OR USE SAID STRUC~3RE UNTIL A CERTIFICATE OF OCCUPANCY HAS BEEN ISSUED. fiELD .... ' ......... 1,~ ~ FOUNDATION (1st) FOUNDATION 2. (2nd) ROUGH FRAME & PLUMBING INSULATION PER N. STATE ENERGY CODE FINAL ADDITIONAL COMMENTS 765-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLBG. FOUNDATION 2ND [ ] INSULATION FRAMING ~/~FINAL REMARKS: I NSPECTOR~/~/~// 765-1802 BUILDING DEPT. INSPECTION FOUNDATION 1ST []ROUGH PLBG. J FO~ATION 2ND []INSULATION [~']'FRAMING []FINAL REMARKS: INSPECTOR~__~/~/ BLDG. DEPT, TOWN OF SOUTHOLD Approved :¢ ............ 197/Per,nit No.. ~ ~..~. ~. ~../ Disapproved a/c ..................................... 76fi-1802 9 AM ~ 4 PM FOR THE ' FOLLOWING INSPECTIONS: APPLICATION FOR BUILDING PER~ IT 3. FOUNDATION '[WO REQUIRED ~OR POURED CONCRETE 2 ROUGH - FRAMING ~ PLUMBING 3. ~h~St~L.AT~O~ INSTRUCTIONS FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N.Y. 11971 TEL.: 765-1803 BOARD OF HEALTH ......... 3 SETS OF PLANS .......... SURVEY ............... '~... CIIEEK .................... SEPTIC FORH .............. CALL ......... FLAIL TO: D~te .......... 19 q. .t, ,c~ ~l[~J,~[. - ~ONSTEUCrlON MUST a. T~sc.~zi3C.J~_~r~t~e completely filled in by typewriter orin ink and submitted to the Building Inspector, with 3 ets 6[~¢fi~X~~p~.sc~ee according to schedule. b..r~o~[~t~%~g~o~i~f ~.and of build~gs on premises, relationship to adjoining premises ox public stxeets ~r areg~A~d ~_y~t~d ~e~g of layout of prope~y~ust be drawn on the diagram which is pa~ of this appH- ;atio~:C D[.S. NfYr RESPONSIBLE FO~ c. O~h~O~ ~G~e ~on may not be c~mmenced before issu~ce of Bu~ding Permit. e. ! ~bui~s~ll ~ $ccu~ed_o[_used in wkole or in p~t for any purpose w~atever until a Ceffificate of Occup~ey hall hgE.~:been granted b~>$~e Building Inspector. /mldm,,Zdne Otdlgg~;e..d~{~ {~n ~Southold, Suffolk County, New York, ~d other appUcable Laws, Ord~ces or [egula~,.~iitg~.coh~t'~lbn of buildings, add,boLs or alterations, or for removal or demohtmn, as herem described the app~,g¢~2qg~ ~pphcable laws, or&Lances, bufld~g code, housing code, and regulations, and to tdmit ~¢~0~'~8~'~,~,~d ~ bulldog for necessa, inspections~ T~E ~EOUIREMENTS OF THE N.Y. (Mailing address of applicant) CONSmU o. architect, engineer, general contractor, electrician, plumber or builder. State . t ........................... - ................. Same of owner of premises .......... ........................................... (as on the t~ roll or latest deed) If applicant is a corporation, signature of duly authorized officer. (Name and title of corporate officer) Builder's License No ....... I.O/.'~%.-q .......... Plumber's License No. ' ............... Electrician's License No ....................... Other Trade's License No ...................... Location of land on which proposed work will be done ...................... ' .... House Number Street Hamlet County Tax Map No. 1000 Section ........ :~/ ....... Block ..... .~. ........... Lot... ~ Subdivision ..................................... Filed Map No ............... Lot ............... (Name) State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy ............................................ ~,~; ~ ~ ~, ;~. ~.,. ...... b. Intended use and occupancy . . . ~ .................. ~. ,~,~.~ .~, &:.~ ~..~. .... t ~ ..2''' ~'' .~ ,'?~',v'"'-~ 3. Nature of work (check which applicable): New Building .......... Addition .......... 'Alte~atfoh: :~1~;-~:,. ~ .... Repair .............. RemoVal .............. Demolition .............. Other Work ......... ~ ( .... , ~ ~ (D~npt~on) 4. Estimated Cost ........... /.~./?s~-.t~. ........... ........ Fee . ............................. . " (t id ppli ) ; o be pa on filing this a cation 5. If dwelling, number of dwelling u~its ............... Number of dwelling units on each floor ................ Ifg b I. · arage, num er of cars ................................................................... 6. If business, commercial or mixed ~ccupancy, specify nature an'd extent of each type of use ..................... 7 Di io f e ' ' res,i ifa y F .R. ear Dep. th. · mens ns o xmnng structu n rent .... Heigl t N b f Storie '! .................................... 1 ............... um ,er o s ..................................... Dimensions of same structure with alterations or additions: Front ................. Rear .... pth ~ ight ' '\ ........... De ..................... J. He ...................... Number of Stodes ........ (. ......... ~ti pth ~ ' ' '" 8. Dimensions of entire newconstru on Front I~ ' ~ . · .......................... .~ De . ... ~ .x. ,., ...... Height ............... Number of Stories 9 Si e of lot: Front i 'I~ ...................................... ' p~h q{~ .............. .. z ...................... ear ...................... ' De ........ - .............. I0. Date of Purchase ... I .... Name of Former Owner ............................. ....... ;;i is'ire'si ii 1 I.Zone or'use district in which pre st ................................................... 12. Does proposed construction viola(e any zoning law, ordinance or regulation: .... : ............. , .............. 13. Will lot be regraded ....... :~. · ] .................. Will excess fill be removed from premises: Yes No 14. Name of Owner of premises . .5.u. ~d~...~4h~.~V..A-.. Address ................... Phone No .............. . - Name of Architect ... ~ .... ~! ................ Address ................... Phone No ................ Name of Contractor .~.OA-O. [3..q~/.q~ .~..r~.~./~.xAddress ................... Phone No. ?./, 15. Is this property within 3~0 feet of a tidal wetland? *Yes ........ No ......... 7~- · 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 fron~ property lines. Give street and block nfimber or descriptioh according to deed, and show street names and indicate whether interior or corner lot. [~#~z~ ~c~sr~ 0ou~ct7 t/~o6 : ? yS°_ o4t -2_ o ;rATE OF NF~7-~Ih~ .OUNTY OF..~. .... ~'~'~' '~" '~.~. ~.~ ............... being duly sworn, deposes and says that he is the applicant (Name of individual signing; contract) bore named. le is the ~ (Contractor, agent, corporate officer, etc.) f said owner or owners, ~d is duly. ~utho~zed, to perform or have peffo~ed the said work and to m~e ~d file this pplication; that all statements contmned ~ this application are true to the best of his knowledge and belief; and that the /ork will be perfomed in the m~ner set forth in the application filed therewith. worn to before me this ] k - .......... ~.. 'ota~ Public, . . County ~ h~ll~ ~ ¢l~f~ ........ ~.' ................................... ~o. 48~f0~ i ¢ (Signature of applicant)