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Home My WebLink About19270-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No: Z-25466 Date: 01/06/98 THIS CERTIFIES that the building ACCESSORY Location of Property: 745 SOUTHERN BLVD EAST MARION (HOUSE NO.) (STREET) (HAMLET) County Tax Map NO. 473889 Section 22 Block 1 Lot 8 subdivision Filed Map No. __ Lot No. __ conforms substantially to the Application for Building Permit heretofore filed in this office dated JULY 20, 1990 pursuant to which Building Permit No. 19270-z dated JULY 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 ACCESSORY INGROUND SWIMMING POOL WITH DECK AROUND & FENCE ENCLOSURE AS APPLIED FOR. The certificate is issued to DONALD J. & PEGGYLEE DZENKOWSKI of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF NEALTH APPROVAL N/A ELECTRICAL CERTIFICATE NO. N147878 09/07/90 PLUMBERS CERTIFICATION DATED N/A Buil ding Inspe%or Rev. 1/81 TOWN OF $OUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N. Y. No_ (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) 9 2 7 0 Z Oote ,..~../~. ....................................... , 19.~.....~' Counh/ Tax Map No. 1000 Section .......~.......'~.. ...... Block ....... l ........... Lot No ........ .(~'... .......... pursuant to application dated ...... .~/:~.--'/~"'~ .................................... , Jg~.~..., and approved by the Building Inspector. Rev. 6/30180 TOm OF SOUTHOLD 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 c6mpleted 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 Buildine - $100.00 3. Copy of Certificate of Occupancy - 4. Updated Certificate of Occupancy - $50.00 5. Temporary Certificate of Occupancy - Residential $15.00, Commercial $I5.00 Date ........ ....... ............... ~ew Construction ........... Old Or Pre-exiating Building ................. Location of Property...~..~.~... ~-~.. ~-/~-~. ................................... House No. Street Hamlet or O =ers of County Tax Map No i000, Section...~..~. ...... Block ....... ~ ........ Lot....~. ................. Subdivision .................................... Filed Map ............ Lot ...................... Per=it ~o..~.2.20 ....... Date Of Permit ........... Applicant ~." .. e~.°.~ ... Health Dept. Approval .......................... Underwriters Approval...~ .................. Planning Board Approval ........................ Request for: Temporary Certificate ........... Final Certinate...-~..- .... Fee Submitted: THE NEW YORK BOARD OF FIRE UNDERWRITERS ~,00~I '~'L BUREAU OF ELECTRICITY ~- ~ ~ ~,, , -~ ;~ 85 JOHN STREET, NEW YORK, NEW YORK 10038 Date ~ppllcatlon No. on file THIS CERTIFIES THAT in the following l,,ca}~ ,~,~as~t ~ Ist FI. ~ 2nd Fl. 01,~' Section Bilk FIXTURE OUTLETS SWITCHES DRYERS FIXTURES RANGES COOKING DECKS OVENS DISH WASHERS EXHAUST FANS SYSTEMS NO. OF FEET E E V I C E OTHER APPARATUS: * (S~]2'l~d POOt,) ThJ.q cert~f'ioate eow~rs emnl'.>lJanee at tim da~:e ,~: have frocfue~H' tesL and/o~: L'~paJ,rs 301)Y ]PUI4T J,lxO hJ(C. i~23( )Ii. OF CC COND, HO OF HI-LEG A W G. NO OFNEUTRA[$ A.W O OF HI-LEG OF NEUTRAL GENERAL MANAGER This certificate must not be altered in any manner; return to the office of the Board if incorrect. Inspectors may be identified by their credenti~als. COPY FOR. BUILDING DEPARTMENT. TNIS COP~' OF CERTIFICATE MUST NOT BE ALTERED IN ANY MANNER. FOUNDATION (1st) FOUNDATION f 2nd ) 2. ROUGH FRAME & .PLUMBING 3e INSULATION PER N. STATE ENERGY CODE FINAL ADDITIONA'L COMMENTS'. 765-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] FRAMING [ ] INS~!.ATION [ ] FIREPLACE & CHIMNEY DATE INSPECTOR CIIRTIF, , RODE! ~NO ~Ul SUFF. CO, DEPT, OF' HB:ALTH FOR APPROVAL OF CONSTRUGTIC)N ONLY j/-//¢ a/ APPROVED: / UNDERWRITERS CERTIF/~IE RE~UIR~ 'OFINTENT THE WATER SUPPLY AND SEWAGE ~SPOSAL SYSTEM~ FOR TNI§ RESI- DENCE WILL CONFORM TO THE STANDARDS OF SUFFOLK CO. DEPT. OF HEALTH, SERVICES, 765-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION 1ST [ ] FOUNDATION 2ND [ ] FRAMING [ ] FIREPLACE & CHIMNEY REMARKS: ~ ~ [ ] ROUGH PLBG, [ ] IN.~SULATION [/~INAL DATE INSPECTOR ,\ q ) 'k. TI'ILl( BLDG. DEFT. I 'tOWN OF SOUTHOLD J , Examined .............. 19. Approved ........ , 19 .~ermit No ............ D -- isapproved a/c .......................... APPLICATION FOR BUILDING PERMIT BOARD OF HEALTH ...... 3 SETS OF' PLANS ....... FORM NO. 1 SURVEY .......... ToWN OF SOUTHOLD CHECK .......... BUILDING DEPARTMENT SEPTIC FORM ............. : TOWN HALL NOTIFY $OUTHOLD, N,Y. 11971 TEL.: 765-1802 CALL ................ MAIL TO: INSTRUCTIONS ~ a. This application must be completely filled in by typewriter or in ink and submitted to the Building h[spector, with 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 or in part for any purpose whatever until a Certificate of Occupancy shall have been granted by the Building Inspector. APPLICATION IS HEREBY blADE to the Building Department for the issuance of a Building Permit pumuant to the Building Zone Ordinance 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. .../5[. :..FO. gy.c.c..~.r...~.'.o~S....~'....~: ........... (Signature of applicant, or name, if a corporation) · . ., .. ~o.:../j..~...7.2~....~...,~..~./.~..c./.q...,~.g. ; ..... · (Mailing address of applicant) State whether appli!a~t .is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. ............... 67.'.z.~..~ Name of owner of premises ...... i .~p.'.~../~..c'/Q ..... ,~. Z.~14'.o. c4. ,~..~Y,7. I .................................. (as on the tax roil or latest deed) If applic~s/fi corporation, sfig, natu.,re of duly authorized officer. ALL CO~!TRACTOR'S MUST_B~ SUFFOLK COUNTY LICENSED Bu ders L cense No .'~'.~.~./:4-~.. Plumber's License No ......................... Electrician's License No.. Other Trade's License No ...................... I. Location of land on which proposed work will be done~ 7.O..~..7'7.~ ~.L,. ?..~.~.'. ~ /'~o~v ... 9. ~. . .5. ............. &~wzm. .~ . . 4~.uo. z'~ .~...~..,.,,..s.,. · .'~... House Number Street Hanllet Map NO. 1000 Section c2 ."? Block / Lot ~. County Tax Subdivision.. ~ .bS.l~..Wj ~.'7,W... ~. ~/-/,~ .......... Filed Map No ............... Lot (Name) ............... 2. Stateexatm,.. ' ' o use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy /~ /~.~ /...//:70. · Intended use and occupancy .......................... 3. Nature of work (check which applicable): New Building ' Additi~ Rep~ .............. Removal .............. Demolition ....... [~[.. Other Work .. ~ ~ '" npllon) 4. ........... ............... ...... · . :.:--. ....... (t be paf~ ~n fi.lto;g.th~s apphcr ion) ' 5. ff dwelling, number or dwellin~ units ............... Number or dwelling ~,~n ca~ floor: :-:~ ........ Ir~araee,~ number ofc~s ....................................................................... 6. Ir business, commercial or mixed occupancy, specify nature and extent of each type of use .............. 7. Dimensions of ~xisting structures, if any: Front ............... Rear .............. Depth ........ ' ..... Height...............Nu~)berofStohes ................................................. ' ..... D~ensions of same structure with alterations or additions: Front ~ear ..... Dep~ HeiSt ............................................ Number of Stohes ................ 8 D~ensions of e~tire new construction: Front Rear Depth ' ' ' Height ............... Nmnber of Stohes ....................................................... 9. Size of lot: Front .................... ,.. Rear ...................... Depth ...................... '.0. Date of Purchase .............................. Name of Fomer Owner ............................. [ 1. Zone or use district in which premises are situated ..................................................... 12. Does proposed construction violate any zoniug law, ordinance or regulation: ................................ :3. Wm lot be regr~aea ............................ Will excess fill be removed from premises: Yes No 4. N~e of Owner or, premiSes . .~~S~4 .... Address ~.~K~ .... Phone No ................ N~e of Architect .......................... Address ................... Phone No ............... Nme orContrac*or .~r~'-/~.~. ~¢... ~d~ress . .~.~~.. :5. Is t~ properey located ~thSn 300 feet ~ a t~dal we~and~ ~es ..... ~o ..... ?* " ~ yes, Souebold ro~ Trustees ~em~t may be required. PLO'T DIAG~M Lo*ate cle~ly ~d distinctly ~1 bu~d~gs, whether existing or proposed, and. indicate ~I set-back d~ensions from ~ropeny ~nes. Give street ~d block number or deschption accord~g to deed, ~d show street nines and indicate whether ntefior or comer lot. APPJIOVED AS NOTED Nb~IF'Y BUILD[NO DEPA_I~ _~NT AT 765-1802 9 AM ~ 4 PM FOR THE FOLLOWING INSPEC~ONS: 1. FOUNDAT~ - ~ REQUIRED FOR ~URED CONCR~ 2. ROUGH- FRAMING & PLUMBING 3. INSU~TION 4. FINAL CONSTRU~N MUST BE COMPLETE FOR C,O, ALL CONSTRUC~ON SHA~ ME~ THE REQUIR~E~S ~ ~E N,Y, STATE CONSTRUCTION ~ ENERGY · CODES, N~. RESPONSIBLE FOR D~SIGN OR CONSTRUC~ON ERRORS TATE OF NEW YORK, OUNTY OF ............ ..... S.S .... ~-~..~.-P~-~-..- .~-.:.- .~-~.~?~.~....~.' ..... being duly sworn, deposes and says that he is the applicant · (Name of indMduat signing contract) ~ove nalned. (Contractor, agent, corporate officer, etc.) ' said owner or owners, and is duly authorized to perform or have performed the said work and to make and file th. is 'plication: that all statements contained in this application are true to the best of his knowledge and belief; and that the ork will be performed in the manner set forth in the application filed therewith. vorn to before me this ....................... day ..... NOTAIW PUBtlC, State~NewYe~ t~/l~gnature of applicant) . No. 4707878, Suffolk Cevl~ty ~/f/ le,;m F. xp~res I~rch 36,19 - /