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Home My WebLink About19422-zFOPd~I NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No Z-19480 Date OCTOBER 30, 1990 THIS CERTIFIES that' the buildin~ Location of Property 480 FRED ROAD House No. County Tax Map No. 1000 Section i17 Subdivision ADDITION NEW SUFFOLK~ N.Y. Street Hamlet Block 4 Lot i9 Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated SEPTEMBER 19r i990 pursuant to which Building Permit No. 19422-Z dated SEPTEMBER 26, 1990 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 TO EXISTING ONE FAMILY DWELLING AS APPLIED FOR. The certificate is issued to ROSALIE INZALACO (owner) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL UNDERWRITERS CERTIFICATE NO. PLUMBERS CERTIFICATION DATED Rev. 1/81 TOWH OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, No Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) NM i942'2 Z Permission is heredity grated to: // ~// ~ /~ ,~ /.,2 . . .... ~:...~..~.~~~ a:.:re~Tt, T~ at ......... ~.....~~...~:---: ................................. ............................. .................................................... co..~ ~. ~, ,o. ,~oo s.~,,o. ....... Z~.Z... ,,~, ....... ~ ........ ~,.o...Z~ ............ pu~uant to application dat~ ...... ~ .................................. , 19.~ and appr~ by the Building Inspector. Rev. 6/30/80 Form No. 6 TOWN OF SOUTHOLD BUILDING DEPARtTMENT TOWN HALL 765-1802 APPLICATION FOR CERTIFICATE OF OCCUPANC5 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 - $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 $i5.00~ Commercial $15.00 Date..~ ~./.~. ~../.L.q .0 ....................... New Construction ........... Old Or Pre-existinz_Building .... ~..., ......... Location of Property...~.~ .................. ~. ~.~.~__..~.. .... '.~..~.~..~...~..~..~..~...~;%?~..- House No. Street Hamlet Onwer Owners f Pr perty County Tax Map No i000, Section./XT. ........ Block. ~ ............ Lot.[ .~ .................. Subdivision ............................. i ...... Filed Map ............ Lot ...................... t Permit No.~.~.~.L'. · .~.....Date Of Permit.~. ~.~/.~ . ~.~.~.. i.~...Applicant~p...~..~..'' . [~...L~ .~ .~..~..~..~. / Health Dept. Approval..........................Underwriters Approval ...................... .. . Planning Board Approval ........................ Request for: Temporary Certificate ........... Final Certicate ........... Fe~ Submitted: $ ............................. ~- APPLICANT TOWN OF $OUTtlOLD OFFICI! OF BUILDING INSPECTOR ILO. BOX I179 TOWN IIALL SOUTIIOLD, N.Y. 11971 October 19, 1990 TEL. 765-1802 John Zurawskl Village Commons Main Rd. & DePot Lane Cutcho§ue, New York 11935 To Whom Kills May Concern, ROSALIE INZALACO We are unable to complete your Certificate of Occupancy because .of the following reasons. /fAn application for Certificate of Occupancy is riot on file. (ENCLOSED) /--_//No Underwriters Certificate on file. /._~ The check .£:;(~Xk~q~l~nut on file.) $25.00 /~/ No tlealth Dept. Approval on file. /~/ No final inspection has beeu made. Pi ease Thank you for your cooperation. lhiilcling PermJ_t Itl 9 4 2 2 Z gui ld (hq Dept. ***/_--/ No Plumber solder Certificate on file. ( all perm}ts involv(ng plumbing being issucd after April 1,1984 ) contact ()ur office on chis matter. FOUNDATION (1st) FOUNDATION (2nd) ROUGH FRAME & .PLUMBING e INSULATION PER N. Y. STATE ENERGY CODE FINAL ADDITIONAL COMMENTS: I ,5'0 ' ,Yo "k/. //g. 37 FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL $OUTHOLD, N.Y. 11971 C~.~.~.,} .~ TEL.:., 765-180:~ Examined ........ 19~;.~ /,/~ ~',~ 9 Approved ....... 19 .'~.~. Permit No..,c ,, .,. ~ ; Disapproved ale .......... · .. A~"~EO AS.O~£D .~ ...... FOLLOWING INSPECTIONS: APPLICATION FOR BUILDING PERM IT t. FOUNDATION TWO REQUIRED FOR POIJRED CONCRETE 2. ROUGH - FRAMING & PLUMBING 3, INSULATION INSTRUCTIONS BOARD OF HEALTH ........ 3 SETS OF PLANS ........ ~' SURVEY ~ ............... c.~,cK -.~'..LS.~5.q .......... ~'" SEPTIC FORM CALL . . MAIL TO: Date ................... 19... 4, FIN~.'~L - ~ONSTRUCTION MUST, , _ anE II~i~I~,~t~ ~.~.tbe completely filled in by Wpewdter or in ink and submitted to the Building Ihspector, with 3 se~L~t"~~l~ t~. Fee according to schedule. ,~ ~ffi~~c~En~lot and of buildMgs on premises, relationship to adjoining premises or pubUc streets or~, ~~ion of layout of property must be drawn on the diagram which is pa~ of t~s apph- ca~, NOT RESPD~SJBLE FOR D~'E'- _ ' '~tion may not b~ commenced before issuance of Building Permit. ~EEU~on approval ~this aEplication, the Building Inspector will issued a Building Pe~it to the appQc~t. Such pe~it shal~l~t~t~~te ~r inspection throu~out the work. ~6~gBi~Ol ~~ used in whole or in part for a9y purpose whatever until a Ce~ificate of Occup~cy shal~v~~O~ ~ uild~g Inspector. ~ 'IN ~ - . . . ALL CONSTRUCTION SHALL MEET THE REQUIREMENTS OF THE N.Y. STATE CONSTRUCTION & ENERGY CODES. NOT RESPONSIBLE FOR DESIGN OR CONSTRUCTION ERRORS (Signature oI apphcant, or fi~n~ e', if a cor~orat;~n') ..........' (Maili~i'''" ~Jre's~' ~}' ' ' '' ''applicant') ............ State) whether. ~'{ applicant..B, owner, lessee, agent, architect,, engineer, general contractor, electrician, plumber or builder. .........................................- Name of owner ofpremises 4..~ .................................... .... ,... ............ .. ... (as on the tax roll or latest deed) If appJlicant is a corporation, signature of duly authorized officer. ....... o..? .... k/ (Nak~e and title of corporate officer) ' Builder's License No..I.7~.7I L. d ..~.~. ....... Plumber's License No ......................... Electrician's License No ....................... Other Trade's License No ...................... I. Locat'on of land on which proposed work will be done: ' " .¢. .................... }louse Number Street, Hamlet .... County ...: ............ Lot ............ .... au°tuv~slon ..................................... F, ilcd Map No ............... Lot ............... (Name) 2. State existing nsc and occupancy of premises and intended use and occupancy of proposed construction: A. Existing use and occupancy...\......-~./~.;..~... .... ............ ... ,'-.,-., ...................... B. Intended use and occupancy ................... 3. Nature of work (check which apghcable): New Building .......... Addition .......... Alteration ......... '- · Repair ........ ~ ..... R~moval .............. Demolition .............. Soimming pool Tennis Court ......... ~ccessory~ Building .......... Femce ....... Other Work; ........... 4 Estimat6d Cost .~h(~]~ .t ~.~. Fee ~ i __ (to be paid on filing this application) .~ N mb fd Iii its each fl 5 If droll b fd II' ' ' , x ~ng, num ere we mgumts ............. u ere we ngun on oor ................. If garaee number of cars 4 .................... ' 6. If business, commercial or mixedioccupancy, specify ha3ure a~ extent of cac~pe o~se ..... ~'~'r ....... 7. Dimensions of existing stmcture~, if any Front Height..... . ......... Number of Stories.. Dimensions of Same structure wi{h alterations or additions: Front ................. Rear, ... ·., ........... Depth .................... ~. HeiSt ...................... Number of Stories .................... 8 Dimensions Of~ ....... constn~ction: Front Rear Depth . , nt}rei ?Sv ........................................... Height ' " . ...... N~be~f S~ofics ' .................. ............. ............... 9. or F o= .... ........... .............. 10 Date of Purchase ~ ' Name of Former Owner ' ' ' are situated 11 Zone or use district in which pre,roes · · · 12. Does proposed construct[o~viot~te any zoning law, ordinance or regulation: ..... .---.- · ~ Yes .... N~.. 13. WHI lot be regraded . ~ ~..., ............. . ...... Will excess fill be removed f r mi . ' Address Phone No 14. Nme of Owner of premises ..., ..................................................... N~e of I . . .~ ...... ~hone No ....... ~ .... Architect ~ ....................... Address N~e of Contractor ~ ~d~.~/~ ~-' Address . ~ ..... Phone No. . 15-Is this property located within 300 feet of a tidal wetland? *YES .... NO .... yes, Southold Town~ Trustees Permit may be required. ~ PLOT DIAG~M Locate cle~ly ~d dist~ctly Ml~buHd~gs, whether existing or proposed, ~d. indicat~ MI set-back d~ensions from prope~y Hnes. Giw street ~d block ~umber or desc~pfion according to deed, ~d show street n~es and ~dicat~ wh~ther interior or comer lot. STATE OF NEIV YORK, S.S COUNTY OF ................. ............................ , ................... being duly sworn, deposes and says that he is the applicant (Name of individual sigping contract) above named late is the ' (Contractor, agent, corporate officer, etc.) of said owner or owners, and is dtlly authorized to pegform or have performed the said work and to make and file this application; that all statements eon'rained in this application are true to the best of his knowledge and belief; and that the Work will be perfomaed in the manner set forth in the application filed therewith. Sworn to before me this , ~ ........ ', ture ora licant)~l . ~..47078'1~ $.uffo~.~u~nt~tt ~1 i ~ (Siena PP