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Home My WebLink About19049-z FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No 219337 Date SEPT. 6, 1990 THIS CERTIFIES that the building ADDITION Location of Property 50575 NORTH ROAD (RT 48} SOUTHOLD House No. Street Hamlet County Tax Map No. 1000 Section 051 Block 03 Lot 11 Subdivision Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated MAY 18, 1990 pursuant to which Building Permit No. 190492 dated MAY 25, 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 ADDITION TO EXISTING ONE FAMILX DWELLING. The certificate is issued to WOLANSKI, TELESPHORE & WF. (owners) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL NjA UNDERWRITERS CERTIFICATE N0. N145537 AUGUST 23, 1990 PLUMBERS CERTIFICATION DATED GREGORY S. ZALESKI AUG. 8, 1990 uilding Inspector Rev. 1/81 soatas xo. a TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN BALL SOUTHOLD, N. Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) N°- ~ ~ ~ ~ Z Date ..................''•V1...a.S..........., 19.g.fJ Permission is hereby granted to: l1 ...t~.R...!.P..~l . ti.:K.:.. ~!..Z.? to :'~1.......S7br.,.... G~dCS~GrsrS:4r.4ut.~s? ....~1....s~:~~ ...,1~...,.~.1.~.....~:1,R . of premises located at ..:.......~.~P-~X~..~.....lX ~Q X75 County Tax Mop No. 1000 Section Block .....Q.~........ Lot No... ~ ~ pursuant to opplication dated ........~!}.Qtr>`.~..~ 19.0.., and approved by the Building Inspector. (v\ Fee 5......~.~.......... Building (nspector Rev. 6/30/80 ~ . ~r IELD ~S:'EGTiU;7 ~~llnTE ~ COMMENT° H - - H ..O FOUIJDATION , ( 1st) ~ ' c FOUNDATIOIJ (2nd) ar Z 0 ROUGH FRAME & ' J~ .PLUMBING ~ y C. f~ ~ CYL 3. ~ ~ ~ rn IIJSULATION PER N. Y. • • STATE ENERGY ' CODE x r, r~ 4. y FIIJAL E ~ z ADDITIONAL COMMENTS: ~ • DS c- ro H Y 77 I ? H H O z ~ m A H ' 5 d [+1 b H . ~ r xss-1so2 BUILDING DEPT. INSPECTIC?N [ ]FOUNDATION 1ST [ ] ROUGH PLBG. [ ]FOUNDATION 2ND [ ]INSULATION [ ]FRAMING [ INAL REMARKS: _-~~'~1 1 DATE ~ INSPECTOR ry i r 765-1$02 BUILDING DEPT. INSPECTION [ ]FOUNDATION 1ST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND ]INSULATION [ ]FRAMING [ FINAL REMARKS: ~~~I ~ DATE ® INSPECTOR 765-1802 BUILDING DEPT. INSPECTION [ ]FOUNDATION i5T ( IROUGH PLBG. [ } FO NDATION 2ND [ ~ INSULATION [ FRAMING [ ]FINAL REMARKS: ~ ~ ~6 DATE ~ >I INSPECTO e 4 ~ ~a x~-1802 BUILDING DEPT. INSPECTfC?N [ FOUNDATION 1ST ] ROUGH PLBG. FOUNDATION 2ND [ ]INSULATION [ ]FRAMING [ ]FINAL REMARKS: DATE ~ ~ INSPECTOR THE NEW YORK BOARD OF FIRE UNDERWRITERS `'Afal; ' 1 ~ ~rT tl J 7 EIUREAU OP ELEC7RIGYTY 85 JOHN STREET. NEW YORK, NEW YORK 10038 Date Ai7ti:IJ~T 2{.'iK)<,it! APPlioationNo.onfile f3'~Pi221'?fl/~fQ hf "f9~`+~~?'T THIS CERTIFIES THAT only the electrical equipment as described below and introduced 6y the opp(icont named on the above opplicotion number in the premises of 'CNY;f7B<'tnl'; WI')L~,h1;K't, iAt>~"1'~ ~"1'~F, 'p("tfrk, ;~,1,9a, ,ICSII"1'1€t)Xd"r, hY..Y- in [hefolWwinq hwation• 4 8 to en[ ~-(st Fl. ? 2nd F1, .Section Blcek Lot H'aSht1~9 C)f~~, ~39tt woe examined an sad found to 6e in conLplimue with the regairernerzt.R of this Board_ FIXTURE ECEPTACLES SWITCHES FIXTURES RANGES COOKING DECKS OVENS DISHWASHERS EXHAUST FANS OUTLETS INCANDESCENT RUORESCENT OTHER AMT K W. AMT. K. W AMT K W AMi K W AMi H P. ll ~ IZ ~ { DRYERS FURNACE MOTORS FUTURE APPLIANCE FEEDERS SPECIAL REC'PT TIME CLOCKS SELL UNIT HEATERS MULTI-OUTLET DIMMERS SYSTEMS AMi. K. W. Oll H. P. GA$ H P qMi. NO A. W. G. AMi AMP AMT AMPS TRANS. AMi. H. P NO. Of FEET AM[ W AtiS SERVICE DISCONNECT NO.OF S E R V 1 C E AMi. AMP TYPE METER r 4W i ,H 0W ~ ~ ~ S¢, 4W NO. OF CC COND A W G NO OF H4lEG A' W G NO. OF NEVTRAlS A. W G EQUIP. PER 9 OF CG COND. OF HbLEG OF NEVTRAL ~ OTNER APPARATUS: f I 6CIKI1~6 T'OR 1VirW Alll'i'i'TTt>N-t I TST13?,CI. NU(7Ni HFR'~'t~.RS;'!-.7'+ Xa4d.,;t--l.!i K,I?,,i_.;fl A,bf, SAS«KF DP:"i'S~1tJ'i'i~R:--1 RQ51,AR t;h~fPl'i+.'~i" {,T1~~~35'P7-°~ N.~.~rax ~f;al 7>Il`CCHOtaSti, NYr 1.19'1? GENERAL MANAO~R xl Per This certificate must not be altered in any manner; return to the office of the Board if incorrect. Inspectors moy be identified by theirT' cPedentials. COPY FOR BUILDING DEPARTMENT. THIS CO OF CERTIFICA S NOT BE AL EKED IN ANY MANNER. C E R T I F I C A T I O N Bate ~ Building Permit No. ~~~9 ~ Z. ~~y Owner ~~.,Q Plumber ~ u rya-ee,a~.~~ I certify that the solder used in the water supply system contains less than 2/10 of 1! lead. rs sip ature ''-~~z~ Sworn to before me this day of , 1990. ( ~rrtc~ C~/2/~-- Notary Public Notary Public, Suffolk County BERNADETTE L.1'API.IN NOTARY PUBLIC M484,t893 State of New York Raid'mp in SoRdM Coordy Commission Expires Sept, 30, 19~' 1. Form No. 6 ~~~1 j/ (7 TOWN OF SOUTHOLD ~ l0 1 Co U BUILDING DEPARTMENT ~~~~,a2.i -t~~ TOWN HALL 1. ff 765-1$02 TOWN OFS0~7FIOLD APPLICATION FOR.CERTIFICATE OF OCCUPANCY ' .1. 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. Fittal Approval from Health Dept. of water supply and sewerage-disposal (5-9 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 17. lead. 5. Commercial building, indus.triaL 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 Tnspector shall state the reasons therefor in writing to the applicant. C. Fees 1. Certificate of Occupancy - New dwelling $25.00,(Additions to dwelling $25.p0,_7 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. L'p3ated Certificate of Uccupancy - $50.00 , 5. Temporary Certificate of Occupancy - Residential $15.00, Cy~omm/ercial $15.00 ~ Date .............l::.::r...~.~ :;ew Construction...,:.... Ol~~77d Or Pre-existi~,n~g/Bu~ilfding Location of Property..4~,~~.:s.l.`:5......,,~~,.~.~~.~.~.-~.,5!~~..~~°.'~.': :¢~°e>~.. House No. ~.~'Creet~ / Hamlet Onwer or Ownezs of Property,~C~~~z~:.:t.. ...D=~~2 County Tax Map No 1000, Section...:~,~.......Block....-3..........,Lot.,,. ? Subdivision/ ....................................Filed MaPPP:.........Lot.~/... Permit No. 1.~.U.7.~~..Date Of Permit....~:~~:~.~.A licant~yG4uh~.~::?4~:44u.~~ Health Dept. Approval ..........................Dnderwriters Approval.... i Planning board Approval 2equest for: Temporary Certificate........... Final Certicate.`:/ , , Fee Submitted: $,.~y:~:,2`: JJ~/'y"C! APPLLGANT, C C> ~ /C/c3~~ BOARD OF HEALTH 3 SETS OF P~y -AN FORM N0. 1 SURVEY /.1.T!~+ V• . TOWN OF SOUTHOLD CHECK . BUILDING DEPARTMENT SEPTIC FORD] . TOWN HALL SOUTHOLD,N.Y.11971 NOTIFY; / TEL.: 765-1802 CALL ..T~~. . 19 9,~ MAIL T0: Examined . i p Approved aY1..dA 19~A Permit No..1.9.0.~ J.~, . DisaPProved a/c ~i y C ~L~ , ! \ J~ ~ ° ~ I l~ !9 , . ~u r. , ~ ~ . ~C~'w . a,.~,,,,....... ~ MAY ! 81990 (But mg Inspector) ~ ~i,~~ ~ f31_GG. iJ~4'3'. APPLICATION FOR BUILDING PERPiIIT 1'OtN(J OP SO~Th 010 y Date 15 . INSTRUCTIONS a. 'I•]ris application must be completely filled in by typewriter or in ink and submitted to the Building Inspector, with ~ 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 shat] be kept on the premises available for inspection throughout the work. e. I3o 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 I5 HERESY MADE to the Building Department for the issuance of a Building Permit pursuant to the Building Zone Ordinance of the Town of Southold, Suffolk County, New York, and other applicable Lativs, 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 inspect~' npps. /~~1- (Signature o[ applicant, or name, if a corporatron) (Mailing addre of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. ........d (,J n(.~ Name of owner of premises ~,~~~~~'~/~~..~.~~••••••!iYD,I/~•~~°~~•~•••••••••••••.-•••••.•• (as on the tax roll or latest deed) !C applicant is a corporation, signature of duly authorized officer. • ~ (Name and title of corporate officer) ~ Builder's License No. Si: . Plumber's License No . ~ q r~5 P D Electrician's License No . Other Trades License No . . 1. Location of land on which proposed work will be done; 0 F1'1~ Ou.Te ~ mac? u r-( c~ L~ ..~:0.~7.~ .........:.........4~ .2 Ifouse Number Street, Hamlet County Tax p9ap No. 1000 Section ~ L Block Lot .....l ~ • 1... Subdivision Filed Alap No. Lot . ~(Namej . 2. State existing use and occupancy of premises and intended u~s-e~and occupancTy of proppsed construction: A. Existing use and occupancy... ~Cl.~.~'s•LS..1~`~.14~:..~,J.~:'r?w~N~ B. Intended use and occupancy....:?{~~44•..i~.~L,••••~~^?~•~!-:'~•r•••••••••••"•"• 'cattle :New [3uildin Addition , . Y. • . • • • • Alteration . Y...:... . ' gck which aPPlt ) S 3. Nature of work (ch Repair RRmoval Demolition ..............Swimming pool . Tennis Court'.. Acce§sory Building..........Fence .......Other Work:........... co 4. Estimated Cost.,..~ID~soD:;--, Fee..................................... (to be paid on cling this application) g 5. If dwclli(i~', number of d'wcllin units' ~ Number of dwelling units on each floor , s'........... IfgArage,numbcrofcars ' 6. If business, commercial or mixed occupancy, specify nature and extent of each''~~}}ype of use j-7 7. Dimensions of existin structures, if any: Front yp ail.... ~ Rear Y'..t~+.• • • • Depth .:7.~s(G(.t . . Height Number of Stories ........~N~..... . . Dimensions of same structure with al~crations or additions: Front Q. • • • • • . Rear ~ .aZ......... . . Depth .:f~.~7 Height l... Number of Stories . 8, Dimensions of entire new constntctio'n: Front Rear . Sw 8.33 ~ • • • , • Depth yS~ , , , , Hcigitt ../,.5,'.c~J~ Number of Stories . , . . 9. Size of lot: Front'. rMOD.. j , , Rcar•, ..''../.a9.'.....'..', De th . 10. Date of Purchase , .a~S .M.VI'2Gtf, . , ...Name of Former Owner , . ~4F~L~P• . 7~~V~S, , , , , , , , , , 11. Zone or use district in which premise's are situated . . 12. Does proposed construction violate a'ny zoning law, ordinance or regulation: 13. 1Vi11 lot be regraded ' IVill excess fill be removed from gs~~ , Yes ~ Dla . . 14. Name of Owner ofpremises%4/~/~/~. ~cr,~<9.ti2~/Address~/.z.'Aa ..~~r4'2/r~. ?,one No. .7.~~.5:'4*.~?!~: Name of Architect 50.~'rN.'tR Lt•':"."!dE!~..... , ,Address !°..""'x'R1e' ~°~h~td hone No, 74C'.LS{? , Name of Contractor . .•54~F ...Addressr4~.:`~~..~~".~0.1~i111:~hone No...7. ~,i3 . c?~J'~.. . IS.Is this property located within 100 feet of a tidal wetland? *YES....NO. K . *If yes, Southold Town Trustees PLOT DIAGRAM a required. Locate cleazly and distinctly all buildings, whether existing or proposed, and, indicate all set-back dimensions from property lines. Give street and block nurtjber or description according to deed, and show street names and indicate whether interior or corner tot. S _ ` ,n , ~I~ r _ J} ~ 4 ~ , W- ~ ~ ' _y'_ ~k4 M C, - 3i - ~ c`~ ~ ~ ~ {a v l 0 + ~ ~ n~Fw, ~ .Jit)bincr~ b I~ , ~vaK ? STATE OF NEN R ' ~ COUNTY O ; • . . . being duly sworn, deposes and says that he is the applicant • ~ (Name of individual stgnmg contFact) - vC named. (Contractor, agent, corporate officer, etcJ oC said owner or owners, and is duly (!authorized to perform or have performed the said work and to make and file this application; that all statements contaiticd in this application arc true to tl>c best of his knowledge and belief; and that the work will be performed in the manner Set forth in the application filed therewith. ; Sworn to before me tpphi--s I • . ~0.... ..day of I`~!~. 19~.~ r Notary Public, ...'1.flf . . County~~~ ,~L!•//` • 70^"..PH li. SltNllCKI • • • ,~tnpr~y f d`I"c, `;'.a'o cfi t:e4' Yo~fl - " -.~nty' (Signature of applicant) r,.-~.. a;,r: ir,~ Commission ~_ra;~~ ~.3a'"'~~f