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HomeMy WebLinkAbout18693-zFORM NO. 4 No: Z-25790 Date: 06/23/98 THIS CERTIFIES that the building ADDITION Location of Property: 59475 MAIN ROAD/ROUTE 25 SOUTHOLD (HOUSE NO.) (STREET) (HAMLET) County Tax Map No. 473889 Section 56 Block 3 Lot 6 Subdivision conforms substantially to the Application for Building Permit heretofore filed in this office dated DECEMBER 6, 1989 pursuant to which Building Permit No. 18693-Z dated DECEMBER 13, 1989 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 ACCESSORY STRUCTURE AS APPLIED FOR. The certificate is issued to JOSEPH F. & MARILYN KRUKOWSKI (OWNER) of the aforesaid building. TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY Filed Map No. Lot No. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL ELECTRICAL NO. N/A PLUMBERS CERTIFICATION DATED Rev. 1/81 N/A Fosas xo. a 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) ~ ~. ~ ~ g ~ Z Date .....~.~~;3 ............. Permission is hereby gr ted to: ~~~ % m./ ~ ~ Y ~ .d7 2«G6. ct premis~ ................... ...` ../.A/y./~/.... .... at ...~~'~...~..~.,~~.~. , ............................... ., ~ %..QT.~. ................... County Tax .......................................... Map No. 1000 Section . .................... ....~~~...... ................................................... ... Block ............~.... Lot No. ............................ .......,tr..~........... pursuant to application dated ......... ~.~-/:~ ... ............................ 19..~,/..~, and approved by the building Inspector. r Da Fee $..~!~. ....,.. .. QDa Do l ......... .. ..... ....... .....:~i.r.............. Buil Inspector Rev. 6/30/80 ~~ TOWN OF SOUTHOLD Y BUILDING DEPARTMENT TOWN HALL . 765-1802 APPLICATION FOR CERTIFICATE OF OCCUPANCY A. 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. B. For existing buildings (prior to April 9, 1957) non-conforming uses, or buildings anc "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 - .25C_ 4. Updated Certificate of Occupancy - $50.00 5. Temporary Certificate of Occupancy - Residential $15.00, Commercial $15.00 Date~~.`a? `I~fi :.............................. New Construction.... .... Old Or Pre-existing Buil/ding ................. ,~/ r Location of Property..r~g~~:~...........~~~/Y ....................~Au.~.h.4~~/......... House No. / ~°° Street / Hamlet Onwer or Owners of Property.:J.~:se~h./,`;,,!~;,~/,97~,t'-,%~j/~/,,,~~C~/~-vr.,P~~. ......,.... County Tax Map No 1000, Section.....~~0......B1ock..~J .............Lot.. ~'.................. Subdivision ....................................Filed Map............Lot...................... Permit No.j.~6: ~ 3.:~~.Date Of Permit ................Applicant............................. Health Dept. Approval ..........................Underwriters Approval......................... Planning Board Approval ........................ Request for: Temporary Certificate........... Final Certicate........... Fee Submitted: $..~~ ©~ .................... i C ~.~ ~ ~~ V APPLICANT ~~PI>z 765.1802 BUILDING DEPT. INSPECTION [ ]FOUNDATION 1ST [ ] ROUGH PLBG. [ ]FOUNDATION 2ND [ ]INSULATION [ ]FRAMING [ INAL REMARKS: ~~ ~~] ~ ` DATE / y1 l INSPECTOR ~~ (/~ ~~ ~ T65-1802 V BUILDING DEPT. INSPECTION [ /J FAO DATION 1ST f ] ROUGH PLBG. [ FOUNDATION 2ND [ ~ INSULATION [ l FRAMING [~ FINAL REMARKS: DATE INSPECTOR Town Hall, 53095 Main Road P. O. Box 1179 Southold, New York 11971 ~OSUFFO(,~co ~° Gym y 2 oy~~l ~1`~°~ Fax (516) 765-1823 Telephone (516) 765-1802 OFFICE OF THE BUILDING INSPECTOR TOWN OF SOUTHOLD June 10, 1998 Joseph Krukowski 59475 Main Road Southold, N.Y. 11971 To Whom This May Concern: We are unable to complete your Certificate of Occupancy because of the following reasons: An application for Certificate of Occupancy is not on file. (Enclosed) No Underwriters Certificate on file. XX The checks are not on file$75.00 (3 CO'S) 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 #12813-2,12838-Z&18693-Z Please contact our office on this matter. Thank you for cooperation. SOUTHOLD TOWN BUILDING DEPT. Town Hall, 53095 Main Road P. O. Box 1179 Southold, New York 11971 h~o~~gUFFO(,~~, O~ ~ y~ 0 ti x W • oy~ol ~ ~ao~ Fax (516) 765-1823 Telephone (516) 765-1802 OFFICE OF THE BUILDING INSPECTOR TOWN OF SOUTHOLD February 6, 1998 Mr. Joseph Krukowski Main Road Southold, New York 11971 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) 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 # 18693-Z ADDITION Please contact our office on this matter. Thank you for cooperation. SOUTHOLD TOWN BUILDING DEPT. ACCORDING TO THE CODE OF THE TOWN OF SOUTHOLD, IT IS UNLAWFUL TO OCCUPY OR USE SAID STRUCTURE UNTIL A CERTIFICATE OF OCCUPANCY HAS BEEN ISSUED. OUIIDATI0;1 (1st) ~ `V' .- ., I 'OUISDATI0;1 (2nd) - a _ .. I o TOUGH FRAME & I ., c'n\ .PLUMBING .. y ~ 3. m m INSULATIOPI PER N. Y. .. ~ TATE EPJERGY ~ S 1 1 CODE ~~ ~ 4, L ~ ® f r FI;tAL • ( .. _ ADDITIOPIAL COhSMEtITS: :.~ • ~ ~ ~_ m ' H \ ~ C 9 H HV o~ a r\ a ~ • v• m b .d FORM NO. 1 TOW V OF SOUTHOLD BUIL"D.ING DEPARTMENT TOWN HALL , EOUTHOLD, N. Y. 11971 TEL.: 7G5~1802 E:camined~6°~.L.~s...... , 19~yr. /v . Approved ~ ~:3 ........, 1 `w/ .Permit No.~l.4.~~. ~ :3.~ Disapproved a/c ..................................... BOAKD OF HEALTH ~~-... 3 SETS OF PLANS ....... SURVEY ~~....... CHECK ••..... SEPTIC FORPI ,,,,,,,,,,,,,, NOTIFY CALL MAIL ............. .............. c';i .......~-.'; ~. . (Bull g Inspector) APPLICATION FOR BUILDING PERMIT INSTRUCTIONS T0: Date .~0.~~.'.-. ~P......... ., 1~~. a. This application must be completely filled in by typewriter or in ink and submitted to the Building Inspector, with 3 sets of plans, accurate plot plan to scale. Fee according to schedule. b. PIot 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 hfADE 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 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, an_d regulations, and to admit authorized inspectors on premises and in building for necessary inspections. ~ ~ /f 0~:~'`:~...~'..~,X.~-.~::'~~Bki:)? L: mac: (5ignatttrey~o,f applicanQt, or naame, if a~co~/rp~oration) . . ,,~~.~75.. `r~-a'~ ::.'` C"-e~ e(' sal-,-eu-fl-~~ ~,:~ . . (bfailing address of applicant) Staternw~heth`e"r ,applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. ..CTS;;:;;,,'~ :.............................................'.................................. Name of owner of premises ..~~1 . ~•. ~C~:-~'-~-~.~ . ~..... ~~.~.c~-e, ... . .............. (as on the tax roll or latest de ) [f applicant is a corporation, signature of duly authorized officer. (Name and title of corporate officer) ALL CO1tTRACTOR'S MUST BE SUFFOLK COUNTY LICENSED Builder's License No . ........................ . Plumber's Liccnsc No . ....................... . Electrician's Liccnsc No.....J. ~ .. ~. . Otlrcr Trade's License No . .................... . t. Location of rand on wftich proposed work tivill be done : .......... ........ . ... ................. , . House Number Street Hanilet County Tax plop No. l 000 Section ....~~ ........... Block .... 3 ........... Lot ... , V , , , , , , , , , , , , , Subdivision .............. ... .............. Filed hlap No. .............. Lot ............... ~(Namc) :. State existing use and occupancy of premises and intended use attd occupancy of proposed construction: 3. Existinguscand occupancy ............. ......................... ...................... ~ ~v--~_ b. Intended use and occupancy .. .. ................ .......... ............................... . ~~~I 3. Nature of work (check which applicable),: NewBuilding • •` • .. • .. Addition . r~• • • • .Uteration ... , , , , . • Repair .............. Removal ............ Demolition ... , ...... .. Other Work ....... , .. • , , 3 ~,~~ (Description) 4. Estimated Cost ~•• ........................ Fee .................................. ... ` (to be paid on tiling this application) 5. If dwelling, number of dwelling',units .: ..... ... Number of dwelling units on each floor ........:....... If garage, number of can ... a2.:~i :S' ~.w ~ .~ .................................................. . 6. if business, commercial or mixc 7. Dimensions of existing structur d occupancy, specify nature and extent of each type of use ................... . . o s, if any:' Front . ./. S:..:..... Rear ... ($'........ Depth . ~ ~' ..... . Hcigltt .... ,t,,,y';! ......Number of Stories .. ,1 :.............. .. , .............. .. .......... . Dintcnsions of same structure w}th alterations or additions: Front ....`~?? .......... Rear .. ,`~d ............ Depth ..:'... ?:4 .......:..:.. Height ...!-F~................. Number of 3torics ... /... ......... ...... 8. Dimensions of entire new construction: Front ...2.3':........ Rear . ~--.~........ Depth . ?°.......... , Height .. , .. _:. fs . Number of Stories ..! .. ........................ .................. 9. Size of lor. Front . l~ 3.9,3, ,~ ... Rear .~ ~.j.~G ............. Dept !~1~ .... .... 0. Date oC Purchase . /./.~~1~.-.~/ 9.~ 3.., ..... ....Name of Former Owner~i4. efa(L~r, r~~,l.~~~:~. , • , , , , 1. 2ortc or use district in which premises are situated .................................... . ................ 2, Does proposed construction violate any zoning law, ordinance or regulation : ............................... . 3. 1Vill lot be regraded .... .F . ........:...Will excess fill be rem ved from premises: Yes No 4. Name oC Owner of,premises ;-~e$ :~'.l'{l.~n-;~;v~'•$ /.<t-Address'?'I~l/.`:~~!~.~~~~~7~~'. Phone No s%& :7.rg-. ~?~:?$; Name of Architect ......... ..... '..........Address ...................Phone No.. ............ . Name of Contractor ........ .......:.........Address ....:...... .......Phone No.... ........ 5. Is this property located within 300 feet of a tidal wetland? *Yes ..... No .....`~•• *If yes, Southold Town Trustees Permit may be re uired. " PLOT DIAGRAM Locate clearly and distinctly al] ',buildings, whether exisiins or proposed, and. indicate all set-back dimensions from zoperty lines. Give street and block number or description according to deed, and show street names and indicate whether aerior or corner lot. ~ " -- __ ';- /~~...L_ (I'LL. "(~ ~~""~ ~~ t i~ ~ ~` U 3' 3 _ ~ A 13~ ~ ry u S ~ 1 D t • ... ~ ~ ' i i i ~ . i ,...._ r: ~''. ~" ' !~ t a i' ,~,~ i "ATG or• ~F«• Yoax, sis JGTTY OP ................. ~ ................... bcin~ duly sworn, deposes and says that he is the applicant (, `amc oC indiridual si_ning contract) ove named. ~isthc ............................. ....................... ..... ...':..........,.............. (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 Silc this ~lication: that all statements contairjed in this application are true to the best of ftis knowledge and belief; and that the ~ak will be performed in the manner set forth in flee application filed therewith. orn to bc(orc me this I tar)• Public, .....C'.`: ~;'.. (! :. /t/.G, K.f'e:'..... County NEl.EId K. DfiVOE. . (Signature of applicant) tlOTARY PURIIC, Stat¢ of t9ew York PJo. h71~1a/h, Sui olkCountL,. Terri Expires Ntaroh;90, 19 Y//.