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HomeMy WebLinkAbout18703-z FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No Z-20491 Date JANUARY 21, 1991 THIS CERTIFIES that the building NEW DWELLING Location of Property 215 ROCKY POINT ROAD EAST MARION N.Y. House No. Street Hamlet County Tax Map No. 1000 Section 31 Block 1 Lot 5.2 Subdivision Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated DECEMBER 14, 1989 pursuant to which Building Permit No. 18703-Z dated DECEMBER 22, 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 ONE FAMILY DWELLING WITH ATTACHED DECK, GARAGE AND CELLAR GARAGE AS APPLIED FOR. The certificate is issued to A.P. SEPENOSKI (owner) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL 89-SO-124-NOV. 12, 1991 CERTIFICATE NO. PENDING - JANUARY 16 1992 PLUMBERS CERTIFICATION DATED JAN. 21, 1992 - A.P. SEPENOSKI /w/ B ilding Inspector Rev. 1/81 BoBas xo. s 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) N °- 18 7 0 3 2 Date .../.~,~~. ~ ................................... a 9 Permission is hereby grante~dJto: ~,,(` ra .L~.~P......~~......,... ...... .. ....... Gam.. ..... ........>~~~~. ... ... ... .... ...... ~.. ,p~ ... ct premises located at .,~~x~..~~~ ......~~~ /1"~ _ ".~ . .. ... . .... ...... .. . ... .... .... .... .. .. . . . . .. , . ~~ f -l...... ..~ ~ ' ............ .. ...... .... ........ . ... .. ... . ........ . ... .... ... . . .......... . County Tox Map No. 1000 Section .........~1......, Block ........~.......... Lot No.......~.G~....... pursuant to application dated .....o.~~.~..~ .................................. 19...~~..., and approved by the Building Inspector. Fee $...rv.4l.~f.. . c=. e~~ • ~i. .. .... .........i .~......... Buil g Inspector" Rev. b/30/80 S! .~ r(^~ pry "7 /7' ~ ~a j Form No. 6 - r ~ - ~ :~ ~1.' °e~~ w~, TOWN OF SOUTIIOLD yI ~~ ~; swr 2 ~ ~r~t~B i~ BUILDING DEPARTMENT ~dy~; ~ TOWN HALL ~ ~ ~a,~-, _ - ~. „~..~~ w~ e L ,. 765-1802 ~~__, ~~`,.`.."~~; _ ., b~':i,~ APPLICATION FOR CERTIFICAT); OF OCCUPANCY .1. This application must be filled in by typewriter OF, ink and submitted to the building inspector with the following: for new building or new use: 1. Final survey of property caith 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 Pire Underwriters. 4. Sworn statement from plumber certifying that the solder used in system contains less than 2(10 of 19 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. lc curate 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 Euilding - $100.00 3. Copy of Certificate of Occupancy - $5.00 over 5 years - $10.00 4, Updated Certificate of Occupancy - $50.00 S. Temporary Certificate of Occupancy - Residential $15.00, Commercial $15.00 Date ::ew Construction....... Old Or Pre-existin~gpBuildi/ng.~J-........... • Location of Property......vC ?.~ ......... ~C11:~~..P"l; .. {t.~J':..........~~ `~. , ./,!`.~'.~'d ~ .... House No. Street Hamlet ~Snwer or Owners of Property.....,.<:.~...e:~"2~5~~-1.yy ................................... Councy Tax Map No 1000, Section....Q ~1.....E1ock...../..........Lot...~ .~ ............. :;ubdivision.r/.G~ ..................................Filed gqMaP............Lot.. ................... i'crmit :1o..t .U. ~~..J.....D,arrte Of P(~e/rmitq.. /~/ 22~8J..Applicant...~:`.~.. •~-~`."~..~a•.~'•~• iealth Dept. Approval.....N.~J..f (/Q~~1./~J/4••••••Underwriters Approval ......................... 'lanning Board Approval....:!Gfe.. • t~ •C : •! ~• request for: Temporary Certificate.......... ~ . Final Cert icate..Y........ .............. 'ee Submitted: $.....~~:. ~ ~~ ~. ~ aJ U~~] C~~ ~~ 1-`~ -- . ~j .~:5.. .~.~. _ S ,/~ o..`. .. `'l.. APPLICANe~~~. .o ............. - --- _ , ,~"c~~FFOG('~0~ TORN OI' SOJTE3Oi.7J ~,~' Of.;," `j;~}. ~ OFFICE OF BUILDII.IG INSPECTOR ~ ~ .. ,ryj , =- P.O. BOX 728 p'' E=Y'' ~~~~`+~~ z TOIVN HALL O/~~~ ~~- SOUTFiOLD, N.Y. i 1971 p~ ~, yb C E R T I F I C A T I O N Date Building PermCit No. ) ~~~J C)wnnr ~~ ~ .as,n /~~~~ 3.t~/ /1(ple~se print) Plucber !`~ '~' ~~~~ (please prink) TEL. 7G5-1802 ~~ ~l ~ 195 I certify that the solder used in the water supply system contains less than 2/10 of to lead. Sworn~p-to before me this °Z'~5! day of ~ ~l~ ~ 19 ~~: ~j-, f tlotary Public, ~ ~ ~ "` ~ County {plumbc 's siynaturel ., `~ ~~e.-eti--V~ N are Publ~-~~' of 1 ' (xAiRE 4 O4E1Ai Notary Public, State of New Yotlt No.48~86Q6 Quelffied in Suffaik Coumy Commission Expkes December 8,19..~.~/ INSPECTORS Victor Lessard Principal Building Inspector Curtis Horton Senior Building Inspector Thomas Fisher Building Inspector Gary Fish Building Inspector Vincent R. Wieczorek Ordinance Inspector Robert Fisher Assistant Fire Inspector Telephone (516) 765-1802 ~p'~~ j~i•~B(~ i hC g to `~;~'s~; ~';=1~,'~ ~' ~ `~;a ~ .,t.,y~,~. M ~T~;~ ~~' ~~ OFFICE OF BUILDING YNSPECTOR TOWN OF SOUTHOLD NOVEMBER I, 1991 A. P. SEPENOSRI, JR. 215 ROCRY POINT ROAD BOR 34 EAST MARION, NY 11939 To Whom This May Concern: SCOTT L. HARRIS, Supervisor Southold Town Hall P.O. Box 1179, 53095 Main Road Southold, New York 11971 Fax (516) 765-1823 Telephone (516) 765-1800 We are unable to complete your Certificate of Occupancy because of the following reasons: roc An application for Certificate of Occupancy is not on file. (Enclosed) xR 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 # 18703-Z Please contact our office on this matter. Thank you for cooperation. SOUTHOLD TOWN BUILDING DEPT. `~~~~ [ ]FOUNDATION 1ST [ ] ROUGH PLBG. INSPECTION [ ] FOUNDATION 2ND [ ]INSULATION [ ]FRAMING [ FINAL REMARKS: 7ss-1802 BUILDING DEPT. DATE/~ - ~ INSPECTOR ~~703 T65-1802 BUILDING DEPT. INSPECTION [ ]FOUNDATION i5T [ ]ROUGH PI.BG. REMARK5: DATE ~ INSPECTOR ~~,f ] FOUNDATION 2ND [ ] IN CATION [ ]FRAMING [ FINAL ~~ ~~ 765-1802 BUILDING DEPT. INSPECTI®N [ FOUNDATION 1ST ( ] ROUGH PLBG. (] FOUNDATION 2ND (]INSULATION [ ]FRAMING (' ]FINAL REMA KS: ~ ---~~~~ DATE 1 ~~ l~?a3 765.1802 BUILDING DEPT. tNSPECTiON [ ] FOUNDATION 1ST [ ]ROUGH PLBG. [ ] FOUNDATION 2ND [ SULATION [ ]FRAMING [ ]FINAL REMARKS: ~-l'Gr~,,' DATE fNSPECTOR ~~ ~\ ~~~ rsS.iso2 t BUILDING DEPT. INSPECTION [ ]FOUNDATION 1ST [ ] ROUGH PLBG. [FOUNDATION 2ND [ ]INSULATION \ DATE ~ r~ CJ INSPECTOR ~ ,tiaj ~. [ ]FRAMING [ ]"FINAL f Z ~S: c . _~:. III„. - Ij ~ ~ -~"__ -' Pi ~ a ~ _ ~ y 0 )UIIDATIO'.I (1st) ~~' -__---- f ~, y~ OU1dDATIO;J i 2nd 1 a • I .r o~ 1 OUCH FRAME & .PLUMBING ~~ ~~i'+~ N y~,~v ~ `~ [+7 ~ 3. .. y IIISULATIOPI PER . N . Y. , STAT£ EIl£RGY CODE I ,~ •-~ ~ I 4. ~y u i/ ~_ FZ;IAL AA ' ., o ~,~, m ADDITIOf•IAL COMMEIITS: " ~~ ~~ y - _ ..; . _, X ~' ~ H ~\ y • H O a _ ~ 1 M . ,' y~ N,13Jt ,5'JW - ~~~~ ~- , , m, - nl ~ n' l . 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I1.1 a ICI ~< m i~ ~ m f i I-N{ c,o 3~tn ,T T, - r. ~~ o n p - v ~ ~~, r ~\ 0 9 a ~' ~. ~•..,~ i~ ~S '- ~~ - i __ L7 ~ Ire D ~til~ r _m ~'o _ o,~_ y~l=, ~S' ~ 3 ~~ ~ ~ D :~ u~ ~ ~. I -i ~ m m T7 ('~I 1 ' I ~L.S~r n~ n-J i I-+ - 0 G Ir ~r it l~ ~~ ~b~z iU) ,aim ~~ I~ ~ << _ --~ ,{ L. ~~ O O D a pnin in in Holy __-_._ ~~ (~ N r 111 y m r^ r^ w F n~ Z ' O N - ~ v rn D O m C y Z A '~ C O '< 2 T Z~ m Vt a y _ Irl ~I ~~ A n x ____~. L m N n- p t l n O n r y y m ~, a. a, n ZIS°~ m '~~m O Z I~ O A O D ' in - ~A - _F"ICr ~P D i - O _ .C) Ui y G m ~ 'i r x D y 3 .. .: ~9' : ~"~ 3 IJ - p 'I m vy O ^ ' m 3 e 1 [~:;'1=~~;'_ (1E._" S m D f m O m ~ ~ rr, A m ~Z D m y D :; a - j' ~ ~ ~ x O C" O A O D m ' y y s i G' ~ ~ R 3 v z _ ~ ~ < I O m Gl 2 m y y .. m Z 0 v ' .~ -.. a i-:n 2 ~ ~ m y 0 ~'o ~~~ ~ " ' Nr r n -~ F ~ D O -a m 2 r D r '~ x '^ m r r Y~ i1 (T V~.h 41 N/~• ~ ~ ti ~ x~ro~~~y ~ ~ Z~~ d b k y C M~~~H D ~nnz~,~~~ ~ ~~ r~ N p p a r7 spy ~ H ~ 1~pZ-~ ~ {^,t ~ ` n ~ ~1 Z C` H G~'1 J 7~ ~-~'~~ .. ~ ~ l ~ ~j ~ .~ V ~ l y~ ~ ~ A `~ A ` A ~ ~~~w~~~~ ~ ~ & o G ~. ~~~~ ~ p ~ • ~ ~ .o ~, m 3 nCi :° ~ ~ . " ~ ~ ~~ N A- , „_~,,, ~,~,~~ o .~ ~ ~ w s__ r' .~ o`. ~ ..~ ~- ~~ ~ S ~~ ~7 ~~~::=,~ - n ~ _ .~ t~ .~ ~~ 0 h v, ~_-- ~ ~~ H C., .~ r ~ ~,jM~tlO ^`Np3 M' N HK' ~~~~~ ~~ n~r'~ ~' `1 ~` lA' ~L `-.s d a a o P a ° V ro r+ ~ 'c G, ,.o w ~.,, o ~., G -C .,{ O ~ ~ V G ~, L V. ~~ w` 0 ~~ Q; `,~ i"'~ `° ~7 ~ ~ ~. ~1 O ~ ~ ~l b~ ~ p b D D Y M ~ j` ~ ~ .. .. ~~ r ,~ , D -.~ o ~~ _ C ~ ca • ~ ,~ ~ ~ cV 1> 'h ~ O n a p b ~ ~~ i 0 ~~ ~ Z ~F m ~ c °, ~ ~1 ZD D; A o ~ ~. ~. ° ~ 0 0 ,. ~P +~ M ;; ~ b ~ .. ~' a~ ,,. - ~ FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N.Y. 11971 TEL.: 765-1802 Examined .~.'~`~. ~'...., 19 .~.9 Approved .~/.~l.~.-'~......, 19 .~~. Permit No. ~~~O.a .~ Disapproved a/cc .......................... BOARD OF H LTH ': 3 SETS OF PLANS ~.... SURVEY .......... CHECK •-•...,... SEPTLC FORM t~.,.,__ NOTIFY a CALL •~'.~.~...'-~..'~.. MAIL T0: ~, -~ f~/" ,P~~,g/t:.' 7~7r3e~ ~. / ~~ p,~r~~7' .~-M /r9S7 ...................................... ........... .... .. ~. :....... ~~c... ( uildi spec or) APPLICATION FOR BUILDING PERMIT INSTRUCTIONS l,~h u,o ~.., tl i fa~~ UEC ~t~4 ~gq ' j Date . ~~-Fr.,..1.~...., 19 9. / 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. 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 ehall be kept on the premises available for inspection throughout the work. e. No building shall be occupied or used in whole or in pazt for any purpose whatever until a Certificate of Occupancy shall have been granted by the Building Inspector. APPLICATION IS HEREBY MADE to the Building Depaztment 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 c de, housing c ,and regulations, and to admit authorized inspectors on premises and in building for necessary i s eon . (Signature of applicant, or ame, if a corporation) .............................................. (Mailing address of applicant) State whether applicant is owner, lessee, agent, azchitect, engineer, general contractor, electrician, plumber or builder. ... ~u~net' ................................................................................... Name of owner of premises ...~ < . P...5~..'~-.{?~~. S?S.~`? ~.....~ ......... . (as on tax roll or latest deed) If applicant is a corporation, signature of duly authorized officer. .............................................. . (Name and title of corporate offcer) ALL CONTRACTOR'S MUST~R~.SUFFOLK COUNTY LICENSED Builder's License No . ... ..................... . ' ~ Plumber s License No. .. ...:°. ............. . Electrician's License No. .~ ~ !{.3 " ~,J Other Tr de's L' N a icense o . ..................... 1. Location of land on which proposed work will be do~ !~. R oe,Ky .. ~"~ . ~~:........ ~~ ,~GJ~,~` House Number Street Hamlet County Tax Map No. 1000 Section .. ~~~........... Block .... ~. o'Z ............ Lot...$~ .............. Subdivision ..................................... Filed Map No. .............. Lot .............. . (Name) 2. State existing use and occupancy of prem~ises~a~nd~intended use nd oc 'upanc oseu on~~ct~n~~~ a. Existing use and occupancy ....•~ +'~`~--~~~7 ..~ut i~.,,4~~... , .. . b. Intended use and occupancy ...1-1 XLn~ .. Q~~O~-..~... ~.~=~...~ J$~ „ ... , . _ „ ... . ............ . Nature of work (check which applicable): New Building ...Y...... Addition .......... Alteration ......... . Repair .............. Removal ..... , ........ Demolition ..............Other Work .............. . (Description) 4. Estimated Cost ....7~ ~ .'' ...............:........ Fee ...................... . g application) (to be paid on filin this 5. If dwelling, number of dwelling u~tits ..... ~ ......... Number of dwelling units on each floor . { .~ ........... . If garage, number of cars ..... ~',. G'.p.(.'.......... , 6. ' If business commercial or mixed occu arc s ecif nature and extent of each t e of use ...... ~ , P Y> P Y YP ...... Depth' .............. 7. Dimensions of existing structures; rf any: Front ...............Rear . , ...... ; • ............ . Height ........ erofStories .........................................:.............. Dimensions of same structure wit~t alterations or additions: Front ................. Rear ... j ............. . Depth .... Height ......... ~............ Number of Stories ...... . ' coon: Front ...~~ . ...... Rear ...J~.B......... Depth , ~ ~ . 1.Q ..... , 8. 'Heinhtstons oftinew c I~u b' x~ ~ e. ....... ~ .....,... ~~ ... . „~, g .. er of Stories ... ...oSntP(:. ;S .................. ~............. . 9. Size of lot; Front ....~~ .... • • • • • • • • • . Rear .... Ia•S~ ............. Depth ..1o0Z2 ~ ............. . 10. Date of Purchase ............', .................Name of Former Owner .............. j ............. . 11. Zone or use district in which pret~rises are situated .......................... . ........... 4 • • • • 12. Does proposed construction violate any zoning law, ordinance or regulation: ..../.~C? ......... j ........ . ~ 13. Will lot be regraded ....... 11~O .................. Wili excess fill be removed from premises: I Yes L~9' 14. Name of Owner of premises ff•.1~. ,~~WJQs:e'..Sr. Address .?~fd.~F?. ~, oR~t`'~Photle No. '..3. ? 3 ; 3b !2-. . Name of Architect ...... N ~ ................ Address ...................Phone No............... . Name of Contractor ..... /U!~.'i ................ Address ....:..............Phone No............... . 15. Is this property located u+;ithin 300 feet of a tigidal wetland? *Yes ..... No ..... *If yes, Southold Town Trustees PermitPLO~ DIAGKAMed. Locate clearly and distinctly all buildings, whether existing or proposed, and, indicate all set-back dimensions from property lines. Give street and block number or description according to deed, and show street names and indicate whether interior or corner lot. ~~~ ~-- STATE OF NEW YORK, $ S COliNTY OF ................. ............................ g • ~tg contract) (Name of individual si ni above named. ........ being duly sworn, deposes and says that he is the applicant Heisthe ..................... ......................°............... .. .................:....... (Contractor, agent, corporate officer, etc.) of 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 contained in this application are true to the 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 this q ............. /.~...'/~,~n,.day ofd,/. .. ~ //~:........, 19 ~/ Notary Public, ...... 11. !! :...~~: N.~• County .`~'f'' AeN/.lI`. ....... r. ............... HELEN K. DE VOE u scant NOTARY PlI0t10, Stete of, Now York 'gnature of appl ) No. A707878, Sutfelk CountYn , Term Expires March 30,1,19--ZF J Q > 0 2' a a Q Y- a W ~ Q = z J ~ W S 2 O V Y J O w rn J J w ~ Q J = W 0 ~ H U O U ~ W vi, i ~ W o = W Q ~ Z W W ~ Q LL ~ ~ Q S ~ ~ ~Q~nu~i p w ~ r = a ~ a ~ ~ ~ ~ O ~ ~ W ~ ,[ Q ~ ~ J ~ ~ O O wuFZ u. S ~- O O rams /r t1b<J?1 ~'~'{~~ i.. S~ w v i,p I M '~ ~6,-_„ ! ` .~ M ~.~ ; -~ _ (~ ~ ~ ~ \ ' V _..u ~? Wj Cy. Cl~ - ~~ 4-.=. ._ Ni 1 ~ ~l ~ ,~ ~, til {~:~ ~~ C1'` ~.~ 1- ._~ `~ 1// i ~`` l ' J ~_`~.: ~,5. tr ~~ W .~ ~L Y~ t' ~^) 1 f\ t~ 1 ;~~ l~ ~0. ~. 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