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HomeMy WebLinkAbout18351-z FORM NO. 4 TOWN OF SOUTHOLD ' BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No: Z-26939 Date: 02/22/00 THIS CERTIFIES that the building ALTERATION Location of Property: 2500 SOUND DRIVE GREENPORT (HOUSE NO.) (STREET) (HAMLET) County Tax Map No. 473889 Section 33 Block 1 Lot 13 Subdivision Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated JULY 24, 1989 pursuant to which Building Permit No. 18351-2 dated AUGUST 4, 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 ie ENCLOSE EXISTING PORCHES ON AN EXISTING ONE FAMILY DWELLING AS APPLIED FOR. The certificate is issued to GEORGE A. PAVLICIN & WF. (OWNER) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A ELECTRICAL CERTIFICATE NO. H 065980 10/14/99 PLUMBERS CERTIFICATION DATED N/A Authorized Signs re Rev. 1/81 gosai xa 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) O $ J Z Date ....5~~/ 19.~~ Permission is hRerGeby,grant to: ~ of premises located at ...~S~f ~..........d~~Gl~ ..............................................S:i.>~~~ County Tox Map No. 1000 Section ...a.~.,~........ Block Lot No.......~~........ pursuant to application doted ....................;1../.~..lf......................, 19..~~, and approved by the Building Inspector. / Fee $~®~i. ,Q"r.... ~ uildnspector Rev. 6/30/80 Form No. 6 TOWN OF SOUTHOLD ' 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 17 lead. 5. Commercial building, industrial building, multiple residences nd 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 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 Buildin¢ - $100.00 3. Copy of Certificate of Occupancy - .25C. 4. Updated Certificate of Occupancy - $50.00 5. Temporary Certificate of Occupancy - Residential $15.00, Commercialqq$15.00 Date :~~.~P7 /~9< . New Construction........... Old Or Pre-existing Building Location of Property...7SOa..........~~1./!N.Q.~IVE.......~'QE~TfIdO/t.7".....~-~~........ House No. Street Hamlet Onwer or Owners of Property.~?.E2!e.6~ L~;,~,!j1d~y, E;,.P,g~L/C %I?,,,,,,,,,,,,,,,,,,,,,,,,,,,, County Tax Map No 1000, Section...`'~:~........Block. ~ .............Lot..~,.~................. Subdivision...........^.~ ........................Filed Map............Lot...^................... Permit No.... ~ ~ I..S-.Date Of Permit ................Applicant.~,.eoh~6~ N :~sj1//~.ig , , , , , , Health Dept. Approval ..........................Underwriters Approval......................... Planning Board Approval Request for: Temporary Certificate........... Final Certicate........... G ~ Fee Sub fitted: P.: J ~o ~ ~(aq 39 ~ ' °v-?~-- . ~ ~ ~ ~ APPLICANT' rss-iso2 BUILDING DEPT. 11VS~ECTIOIV [ ] FOUNDATION 9ST [ ] ROU PLDG. [ ]FOUNDATION 2ND [ ] 1 ULATION [ ]FRAMING [ FINAL [ ] FIREPLACE ~ CHIMNEY REMARKS: DATE ~ ~ INSPECTOR H.S~..lJu s 9._ .fir : v~0 50 ~ ~ ~ r ~ MAP ~1 F' PQOFa~t~!"Y ~O 4o~+~a ~ surzvEV~o aor~ q~^• . C r~~'~'nt~~'~_ G a? iAw~~ b'sd UI TG>wN' tam ?L)tJ7°Ht3C.C~y N.Y. A ~ ° uwwnrwaEO AuRwTaN Oa Auomee. _ ~r I ro nn wave a A vauna+ a A.8 5d ~a+ ~ uenor+ nor a na raw roue smlt e toucATww uw. z ~ ` m cone aF nxs wave ww not eTAM15 wN ~ ~ J ~ 7ryt MIIlI SURVEYOR'S Na(~ SML 91 • VI i f dAEOSS[O SFK SxALL nDT N.CON41@€IFB s 10 M A YAIID RUE C01Y, Lot' I15~ - b ~ _ ,r- onEY To na nssoa Eoa wn®M iq€ 4FH?Y6i a reaw~. A1D aN roe uaettr i® tp€ © ~ ' Rr ua •ma~ OBE 19a E MSiA~ Fs. Mo• ~ - ~ - _ ~ ~ "luPd~+ t?f ,Gas~+rrn Sees-- x~~f,,%4; ~ ~!lt+d in.flrA ~uffofk G~r+Fcj G'garl~s . ~'~-I~'• ~ ~ci~f.G•o. 7slrc hta~i ~?etsPyrYCr~hi~s ' ~ ~ ' ~ ~ °9D ~ Ci ~ t ;-It~a 5vPc't $~!f 4fhwk J,L,#t l'.l.~ , ' ~ T/t1~ lNu. /2~9~G'f~ ~ - - _nlo~'~:.f'~e,ay~asa~ ark araf~fdj 6MrpgI~I..t. - , , . IDD~.-.__ - eA a arry saaam~rrfs m~~ r~~dt!'~~ . ~.~,~.,yv. - of ot/fsr pfo~mrf~,~Nsracra-rig ffi,e '~'a~~rn ~ara~ rtes. _ - ' - ~~t~N~ ~ ._..---~".._.~l"if?~' rae.rs y"'a Er,~a~irrat•'~• k~~ , • l~trntrcxfY~d 'f+o ?'Ftd> 7'rfl~ ~ivvr~ Ccr, , ~ ~ ~ ~1C:ic~'n#r~' .L.+snraf ~s~.+rrymrr~~ ~ ~ L r'~ ~r~ u k Y n r' S1 ~3 J~/ rss-iso2 BUILDING DEPT. INSPECTION [ ]FOUNDATION 1ST ( ] ROUGH PLBG. [ ] F NDATION 2ND [ ]INSULATION ] FRAMING / [ ]FINAL REMARKS: / ~~~"c---~~ o DATE ~ INSPECTOR J~. o~~S~FFO(~-c ~°y~ Town Hall, 53095 Main Road o Fax (516) 765-1823 P.O. Box 1179 W ~ Telephone (516) 765-1502 Southold, New York 11971-0959 Oy ~ col ~ Sao BUILDING DEPARTMENT TOWN OF SOUTHOLD October 1, 1999 George Pavlicin P.O. Box 402 Greenport, NY 11944-0402 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) XX No Underwriters Certificate on file. The check is (not on file.)$25.00 No Health Department Approval on file. No final inspection has been made. No Plumber Solder Certificate on file. (All permits involving plumbing being issued after April 1, 1984). BUILDING PERMIT # 18351-Z Please contact our office on this matter. Thank you for cooperation. SOUTHOLD TOWN BUILDING DEPT. m'lELD IGS:'EC::U:i Il)ni I~ ~OtkMGNTS \ - ~ m ((u • H rOUtJDATION._.. (1st) c ~OUtJDATIOtJ (2nd) m~ ,/yy - ~ O ' r 2. / z ROUGH FRAME f$' o Q' Q PLUMBING N 3. ~ m m IIJSULATION PER N. Y. y STATE ENERGY , CODE 3 4, ~ / r ^ ~ H FI:JAL J ADDITIOPJAL COMMENTS: ~ x ~1~~' ~ \ ro \ x' H H O O C+] - r \a\ H ~ `I~ ~y . bJ b H i - f- ,-}--I-- -E- I--- - - II - - - C' ~ ~ - ~ ~ a e= i CU,,v o , I i ~ I--~--~-- - 3 ~ 7olf~~lc7~D 1_ i -.4-i-- ~QtJ is do irPY.a„ _ I _ ~ a47 - - t ~______1_ ,.__1_.._ _ til ta~D ~~d'G~-~r~1> W ~z/- ~ Y1~i~ - -f- - ~ alc ecfn~l ~E~ ~ - ~ _ M~' Nft, - ~1 _ _ 2 8 /6 ~`t> i ' ~ - - r t,.< ' ~ - - -.~lb~C._~_Gr,e_ ~ -y~sr ac _P c, I - - i _ - ~d~ P~ ~ G GG to ' - c , ~ ~ ~ 4 _ i . _ _ ~ rh MO~GC N c JF dL e: /r_ I-- ~ , - _ .l_ _ - ' - a._ - - - - - yy,, ~ - / . ~ I ~ _ - - _ i raL/~S ADS` I G ~ . - - - - r' _ 11 YYY i _..i L__--+-..(~C~-~.G. I ,D~ f "'1 ;!VGA' .l~ ~ _ I i I I ~ - - - - - - - - - - i ~ -I - i J - _ i ~ f - THE NEW YORK BOARD OF FI~R~ `U.ND.E.R~WRITERS PAGE 1 $077402 BUREAU OF ELECTR1~17~Y, ' ~ 40 FULTON STREET, NEW YORKy,NY 1QD3B Date OCTOBER 14,1999 App~~tication No. on~le 1~~`4?199F9£3 H 0659ti0 THIS CERTIFIES THAT t'L~RMIT N0. 18351 - ~ e ~ ~ ondy the edectrecoZ equipment as described below and introduced by the applicant nam'ed~on the kbaYe`appdicadon number is to the premises of GEORGE PAVLICIN, 2500 SOUND DRIiPE, GREENPORT, NY in the followirsg location; ? Basement ~ ® Ist Fl. ? 2nd F[. ~ OUT Section Block Lot was examined on OCTOBER rZl7 ,1999 and found to be in com Hance with the P National Electrical Code.. FIXTURE RECEPTACLES SWITCHES FIXTURES RANGES ~ COdKING DECKS OVENS DISH WASHERS EXHAUST FANS I OUTLETS INCANDESCENT FIUORESCENi O/HER AMi. K.W. qMi. K.W: qMT. K.W. AMi, K.W. AMT, H.P. ' DRYERS FURNACE MOTORS FUTURE APPLIANCE fEEDERS SPECIAL REC'PL TIME CLOCKS ~ BELL, UNIT HEATERS MULTI-OUTLET DIMMERS AMT. K.W. OIL H.P. GAS H.P. AMi. NO. A. W. G. AMT. AMP. AMi. AMP5. .TRAMS.' AMr. H,P, SYSTEMS NO. OF FEET AMi, wATrs 4...:. a . SERVICE DISCONNECT NO. OF } ~ Y METER S E R 1. ' ~..V a? d'' ~ C E AMT. AMP. 1YPE E6UIP, r 0 2W 1 0 3W 9 0 3W 3 B 4W NO OF CC COND. A. W. G.' NO,.OF-HI- 0.W. G, PFR 0 OF CC. COND: ' LEG > . A. W G. ' OF NI-LEG NO OF NEUFRALS OF NEUFRAL ~g " OTHER APPARATUS: *NO VISUAL DEx'ECTS: "A1T electrical survey has been made of the exposed electrical equipment in the premises indicated." "No obvious unsatisfactory condition was found. GEORGE PAVI,IC°IN (J ~ ~~L P 0 BOX 402 ~~ww,..,.e "`III~~~ G1lEENPORT, NY, 11944 GENERAL MANAGER ' ~ Per l1 , 'rA'~ This cerfiflcafe muaf not be altered In any manner; return fo the olllce of the Board It.;incprrgcY. Inspetlfors-may be itlenfilled by their credentials. COPY~OR :BUILDING DEPARTMENT THIS COPY OF CERTIFICATE +MU3T,'NOT /9L ~Ak.T~, ED IN ANY MANNER. BOARD OF HEALTH 3 SETS OF PLANS FORM NO. 1 SURVEY . TOWN OFSOUTHOLD CHECK BUILDING DEPARTMENT SEPTIC FORM ' TOWN HALL SOUTHOLD, N.Y. 11971 NOTIFY TEL.: 765-1802 CALL C$~c~ MAIL T0: ~(j, Examined . / 19 Approved 19 0.! Permit No. Disapproved a/c _ ~ ...b...., .~=t Buil n In ctor .APPLICATION FOR BUILDING PERMIT i Date J i? , l~'~. INSTRUCTIONS S 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 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 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 Laws, Ordinances or Regulations, for the construction of buildings, additions or alterations, or for removal or demolition, as herein described. The appiicant 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. . ~~•d2, 1-~-ovv,~ 2e•~ rc~v~1.~~,~~~~n B.,:l~~~ :I,~uc, (Sigt)ature of applicant, or name, if a corporation) ..P...C`?..tad.~•~`z~•,C;~:eL,ti~o~rt;,?~:?:.)?q~!Y • - (Mailing address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. R ~v,lcJ~yzr Name of owner of premises ..eZ i:~`C~.e..4. ~:~Y'? v t- 0 c ~ 1~3- (as on the tax roll or latest deed) If app • t is a co 'gnature of duly authorized officer. Pies!d~;~... ( ame and title of corporate officer) Builder's License No. . A •3 ;3 Q , I , , •j-}'~; - , • , , Plumber's License No . . Electrician's License No . . Other Trade's License No . . 1. Location of land on which proposed work will be done . . ~ SO G SO y.l". c,l. is i,J ~............17.`C. ~ t-~- ry.p ov,`,j" . House Number Street Hamlet County Tax Map No. 1000 Section .......J.~.....y. Block 1 Lot ......l.---~.......... . Subdivision ~.flS~,er rl..~J.~ic.r, se~# ~ Filed Map No. d~.'S. ~ (a.... Lot ......~.3...... . (Name) 2. State existing use and occupancy of premis[e~s and intended use and occqupancy of proposed construction: a. Existing use and occupancy ]...r..~.W:~.9.~.~,1.... ~~'.Sv CJei~~~!4 ~ . 1 b. Intended use and occupancy : •~•5 • • • • S ~ e.~, t•~ : " ' 3. Nature of work (check which ap'plicable): New Building Addition Alteration ..41.... . Repair , , , , , , , Remgval Demolition Other Work . L,losir.~ d'-x~S`F~:~ ~Pa,mh (Description) ~ ©00' 4. Estimated Cost (..1..... Fee . (to be paid on filing this application) 5. If dwelling, number of dwelling units Number of dwelling units on each floor . If garage, number of cars . 6. If business, commercial or mixed occupancy, specify nature and extent of each type of use . . Hei ht g.... Nu s, if any: Front ..5~~.. S~ rv;e~/ Rear Depth . 7. Dimgensions of existin structurrre;,ber ofStories ......................._..p..~.. . De th , th alterations or additions: Front . l~.a'..4~J~tY. Rear . 8. Dimensions of entire new const ~ • ~ Height ......................Number of 6tories . pensions o same structure wruction: Front Rear ...............Depth . Height ..Nu~berofSkories 9. Size of lot: Front $.;4v ~ Rear Depth , . 10. Date of Purchase ..~....y..`~ \ Pr ....Name of Former Owner 11. Zone or use district in whidtt Gmises are situated ~ . 1~:Yrr:. . ~~'s~.~`.~'1~.~ . ' 12. Does proposed construction y late any zoning law, ordinance or relation : . 13. Will lot be regraded i~U ,f~ ..........Will excess fill be rempved from premises: Yes No 14. Name of Owner of premises 4a~t?r~, ,Pay ~.aci I+, , , ,Address ?b ~4.. 5.°Y.'~,d . ~r~:"? Phone No. y e? ~ Lam.. Name of Architect ' . ............Address ..Phone No.. . "r Name of Contractor f?~ 1~..~~~u :~~~5 Address P b :f3q~(~76 Phone No. 4 : ~ ?s~`~.:.. . j.~:... 15.Is this property loca',ted within 300 feet of a tidal wetland? *YES.~"NO..~ *If yes, Southold Town} Trustees Permit may be required. ~ PLOT DIAGRAM Locate cleazly and distinctly all~i, buildings, whether existing or proposed, and. indicate all set-back dimensions from property lines. Give street and biock'number or description according to deed, and show street names and indicate whether interior or corner lot. 5e~. ~urv~y ICI I i STATE OF NEW YORK, ~S.S COUNTY OF • • • • • • • • • • • • • • • • • • • • • • • being duly sworn, deposes and says that he is the applicant (Name of individual sign}ng contract) above named. He is the (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 ..............a1. ~ ..day of~'~i.... 19 Notary Public, , lw~K~?f! . (11.~1~ QO'~:.... County lbgRY VBLISf,,~Sta~Da b ~M Yak . No.4701878,SutlolkOwMy (Signat of applicant) Tani Etpires hMroh, 30,19 9 t E 4 ~ ; [ I ~ F ` ~ ~ ' ~ € E t ( ~ 3 _._._..e._.._._~_...._..,........._~._._.._;__.._...e........._G._._..~. _i_.__... ~ ..........A........... ~..........1.,... 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