HomeMy WebLinkAbout18115-z FORM N0. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Office of the Building Inspector
Town Hall
Southold, N.Y.
CERTIFICATE OF OCCUPANCY
No Z-20338 Date NOVEMBER 12, 1991
THIS CERTIFIES that the building ACCESSORY
Location of Property 7645 BRIDGE LANE CUTCHOGUE NEW YORK
House No. Street Hamlet
County Tax Map No. 1000 Section 84 Black 1 Lot 6.2
Subdivision Filed Map No. Lot No.
conforms substantially to the Application for Building Permit heretofore
filed in this office dated MAY 9, 1989 pursuant to which
Auilding Permit No. 18115-Z dated MAY 15, 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 ACCESSORY STORAGE SHED AS APPLIED FOF~.
The certificate is issued to RAYMOND & DIANE KRUK
(owners)
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A
UNDERWRITERS CERTIFICATE NO. N/A
PLUMBERS CERTIFICATION DATED N/A
d i
6„~~~
Bu lding Inspector
Rev. 1/81
sows 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 O ~ O ~ Z Date 19...~.~.
Permission is hereby granted to:
to . ~"d. ...~-t~..... ~~~r.~ "'.e
at premises located of ..?.:6~:~ :.~::Y~" ~.`.x`
.........................................................................l!./~....................................................................................
County Tax Map No. 1000 Section .........(4../.......... Block Lot No......~~..t...~~........
pursuant to application dated ........c.~r~r~.~ 19.~~, and approved by the
Building Inspector.
Ga
Fee $...rrl~...
uil g I for
Rev. 6/30/80
Form 6'0. 6 _ ~ ,~^c
7 ~iy5 Q~.(,t6 ~,w , ~,j'~, f4 ~j~
G^-~~+~ ~V.R~ ~ TOWN OP SOUTIIOLD ~ ~1~'°~ ~ ~ ~~5 ; t ^,S
BUILDING DGPARTMCNT ~;ri
~pl~
TOWN BALL ; 5~t ~ ~ ~G Ig9~ I F~ a,~~
765-1802 r~ P. ~4_.~
~R df \ ~')t P
APPLICATSON POR CI:RTIFICATL'. OF OCCUPA C _ ~ ° ~
1~_X ~
This application must be filled in by typewriter OP, 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 L'oard of Pire 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 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.
.S. For existing buildings (prior to April 9, 1957) non-conforming uses, or buildings and
"pre-existing" land uses:
I. ,lc curate survey of property showing all property lines, streets, building and
unusual natural or topographic features.
r1 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.
Fees
1. Certificate of Occupancy - New dwelling $25.00, Additi ns-to {iceellings_$2-5:00,-~~
Alterations to dwelling $25.00, Swimming pool $25.00, Accessory building $25.00,
Additions to accessor buildin 1
y g $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, Updated Certificate of Occupancy - $50.00
5. Temporary Certificate of Occupancy - Residential $15.00,1 Commercial $15.00
Date /123?' q1.~.`~~.~
'(ew Construction..........//. Old Or Pre-existing Building., '
!.ocacion of Property..., ~lu~~s„~';~wr~l
House No. 1 Street 1~ Hamlet
~;nwcr or Owners of Property...~.~.~.~-~~:
u:.. ~.1 ~~'~_c...'!~.r V"~,~
~:uuncy Tax Map No 1000, Section... .......Block....... ~
! ......Lot...... a
Subdivision ..............................Filed Map...........).Lot..
i'ermt[ :;o....l,~,~'j7, ......Date OE Permit. ; ; /.~:5,/ ~w, , , , ,Applicant.. ~`,~.VVu>?ti~'. ~~..~),l~e,, .~'1~(h,~L.
°iealth Dept, Approval ..........................Underwriters Approval.........................
~'l.uviin}; Board Approval
~~e9uest For: Temporary Certificate........... Final Certicate...`:,,,,,,,
~ee Submitted: r~cS. ~-n.~
~ ~ ® ~,3 ~y APPLICANT
THE NEW YORK BCxiAR~ OF FIRE UNDERWRITERS Nncr;
Bo29]70
sufeliwu sa? ELaeTfllcm
SS JOHN STREET. NEW YORKr N!W YOflK 10033
DECEEMBER 09,1991 ~icoHonNo.onJile •1552ri841/9] N ()25914
THIS GERTIFIES THAT rr KM7T N0. 7$729
awly ehe obetrlcol ogoipwtent d dsseribsd holote end lntroeSucsd 6Y tho opplicowt ttorwod ow the chose opp/kotiaA nowt6sr in the premises of
s ~
RAYMOND KHUK, 7645 BR(DC.E; 1,A., CIITC.ROGUF, N.Y.
in thefdbtclnp /enebn; ? B~.ement ? Ist Fl. ? 4nd FI. 0i1T SerNonE4 Bloeltl Lot
DECEMBER 03,1.991
loos esomined un and found to lx in compliance rrifh the reyuireotsnM of thb Boord.
11XTYtl ACIK SYVITOIES flXTll~f fAMIN10 DRCKf OV61f WAEKERS E%MAUST F
Gttt{t?Tf INCANDlSCENT nUOtlttlNT OTiKR AMT. K. W. AMT. K. W. AMT. R.W. AMT. K. W. NAT. N. I.
!r
DRYfRE FYYiACE MOTORS 1YTIIRR A/MIANd IrORRf fMdAI RRC'et TMM G06tlf Ml 11NII RRA1Mf Mntfl-0YT1lT OMAItIRRS
AMT. R. W. dl N. I. OAS N. I. AMT. NO. A. W.O. AMT. AMI. AMT. AMTS. TMI/f. AMT. IA I. IIO~ffimT AMT. WAITb
lERVff~ OIE60fOfECT t10. W f ! R. V! C E
AMT. AW. TYI! 1 / tW 1 / SW ] / SW S / AW NO. d CC. COND. . W. NO. OF M41t0 A'MW,' O' /q. 0! NFYTIINS y . W. AAl
OTeRm ANAl1ATUf: RK
' G.P.C.I:-1
t`lSWIMMINC: YOOC,) This certii'icata
covers compliance of the date uf,
inspaction only. Because of unusual
enviromnents it is advisable to
have frequent teat and/or repairs
made by a qual,fi.ed person, ,
RAYMOND KRUK
7695 BRTDGE l,A.
a CUT(;ROGUE., NY, 11.935 MKMANAOER ~
11
Per
This eMilicalo mutT not 6t alt~d in aoy ttatwrl Mum 10 the ofEu of tM Miglrt~,N_:,w~A
tll• _pnpM~r}y n1a~_Ipo.y~.by tMir cndsnhoh.'
~ COP1f FOR IUtL@IIIG D!#ARTM@IT. TTIRS COPY Q!t TE M{fS~ ~LTI~~ N~ Add' MANNER
L_~a.. _~~LL
INSPECTORS
Victor Lessard I/''`~~JFFa(~~~,
Principal Building Inspector \`a,..,,- Lp
Curtis Horton F.~ ~ SCOTT L. HARRIS, Supervisrn
Senior Building Inspector ~ ~ ~ 1
Thomas Fisher ~ b-s~_. z Southold Town Hall
Building Inspector v, ~ P.O. Box 1179, 53095 Main Road
Gar Fish Southold, New York 11971
• Building Inspector ua Fax (516) 765-1823
Vincent R. Wieczorek Telephone (516) 765-1800
Ordinance Inspector
Robert Fisher
Assistant Fire Inspector OFFICE OF BUILDING YNSPECTOR
Telephone (516) 765-1802 TOWN OF SOUTHOLD
NOVEMBER 8, 1991
RAYMOND KRUR
7645 BRIDGE LANE
CUTCHOGUE, NY 11935
To Whom This May Concern:
We are unable to complete your Certificate of Occupancy
because of the following reasons:
xxx An application for Certifica~~of Occupancy is
not on file. (Enclosed)
No Underwriters Certificate on file.
xxx 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 # 18115-Z
Please contact our office on this matter. Thank you for
cooperation.
SOUTHOLD TOWN BUILDING DEPT.
iELD I;:.S: L~:'_uti ~~llniE ~ i;OaYMENT°
-v C~
_r ~ ~
H
_ H
?OUNDATION (1st)
c
?OUNDATION (2nd) _ _ mC\ T~
o
ROUGH FRAME &
PLUMBING
y
H
3. ~
m
CIJSULATIOAI PER N. Y. .a
~
STATE ENERGY e
CODE
+ , c~
~ r
H
FIidAL ~ 'i
o
ADDITIOPlAL COMMENTS: _
x
' x
ro
H
? '
H
H ~
O
C*1
A
r
x
m
-o
H
ll / \
V V ~ y
~w.aMavpn~
f I~, ~ .u.. ^ ~ Ve v
+1
II
~ ? I ~
~ ~
C ~ w... , <
s I ~
i I
1 I k
v~r i
~ I~'+ APPROVED AS NOTEDS
~
FEE: ~ BY:
NOTIFY U) ING DEPAR E T AT
785-1802 8 AM TO 4 PM FOR THE
FOLLOWING INSPECTIONS:
1. FOUNDATION - TWO REQUIRED
FOR POURED CONCRETE
2. ROUGH -FRAMING & PLUMBING
3. INSULATION
4. FINAL - CONSTRUCTION MUST
BE COMPLETE FOR C.O.
ALL CONSTRUCTION SHALL MEET
7HE REQUIREMENTS OF THE N.Y.
~ STATE CONSTRUCTION & ENERGY
c ~ CODES. NOT RESPONSIBLtE FOR
S I DESIGN OR CONSTRUCTION ERRORS
i
f~,~ i f Cl
G\ ~ NG
y - t r
IgT
~
:ES
~ i Y.
GY
jj
I
t
I
K~a~~°~ R.,
Liu ~`~-I -God
~s/ tss-iso2
BUILDING DEPT.
1 NSPECTION
[ ]FOUNDATION 1ST [ ] ROUGH PLBG.
[ ] FOUNDATION 2ND [ ]INSULATION
[ ]FRAMING [ ]FINAL
REMARKS: ~
DATE ~ G~/ INSPEC"1~
BOARD OF HEdLTH
3 SETS OF PLANS
FORM N0.1 SURVEY
TOWN OF SOUTHOLD CHECK ~ , , , , ,
BUILDING DEPARTMENT SEPTIC FORPI .
TOWN HALL
SOUTH,OLD, N.Y. 11071 NOTIFY ~y
• TE`L.:7651802 CALL ...`~(,,'~,~0,~.,,,,
Examined : r~~......., 19up1. / G A MAIL T O
.\pproved 190.~Pcrmit Not. 0. _
1
Disa Proved a c s ~ ~ r
- I p~ 9~
(BGildi Inspector) TOWNLOF SOUTHOLb
APPLICATION FOR BUILDING PERMIT
Date 15 .
INSTRUCTIONS
a. Tltis 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-
-yation.
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 Buildin; 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
Re;ulations, 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 ins ections.
(St ature of applicant, or name, if a corporation)
' (Mailing address of applicant)
State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder.
........~~..Vr!N. rlk
i '
Name of owner of premises ^?~r:?~e°.v?.....~t :~`.`f( .
(as on the tax roll or latest deed)
If applicant is a corporation, signature of duly authorized officer.
(Name and title of corporate officer)
Builder's License No. t~--~. !~?P`!? .
Plumber's License No . .
Electrician's License No . .
Outer Trade's License No . .
1. Location of land on which proposed work will be done. '
Elouse Number S,tLreet ...Hamlet
County Tax Map No. 1000 $eCtlOn ......~7 Block ......1........... Lot ..l~.: ~ .
Subdivision Filed (\tap No. Lot .
(Name)
State existing use and occupancy of premises and intended use and occupancy of proposed construction:
a. Existing use and occupancy
6. Intended use and occupancy ....TGOG
3. A'ature of work (check which lapplicable): New Uuildin "
Re air g • • • • • • • Addition .Vtcration .
p • • • Re~m1oval Demolition ..............Other 1Vork .
4. Estimated Cost Y.l..O~ -~s~, , , , , , • • . • • • • • • (Description)
.Fee
5. If dtvellin~ number oC dwelliri (to be paid on filing this application)
g units , ! Number of dwelling units on each floor .
If garage, number of cars . . • • •
6. If business. commercial or mixed occupancy, specit~y nature and extent of each type of use •
7. Dimensions of existing structu~•cs, if any: Front , . .Rear • • ' ' ' ' ' ' ' '
Hci_ht . Number of Stories ..'>t~, , Depth .
Dimensions of same structure with alterations or ~ ddi[ions: Front ~ • • • • • " " " '
Depth......... .Height. Rear..................
' Dimen ' ~f a ew construction: Front . ' ' ' ' ' • • • • Nuntbcr of Stones , , , , • •
Height Rear /.h:........ Depth .
..Nu;nberofStorics.
9. Size oflo[: Front Rear,
10. Date of Purchase ~ Depth
......~•'••••••••••.•••...NameofPormcr Owner
11. Zone or use district in which premises are situated , , , , , , , , , , , , , • • ' ' ' ' ' ' ' ' ' ' ' ' ' ' '
I2. Does proposed construction viglate any zoning law, ordinance or regulation: .
3. Will lot be regraded , , , , • • . •
' ' ' ' ' ' ' Nill excess fill be removed from premises: Yes No
14. Name of Owner of premises , , , , , , ,Address .
Name ofArchitcct "••••••••••••••••PhoncNo..........
Name of Contractor . • • . ~ • • • ~ • • ~ ~ ~ ~ ' ' ' ' ' • • • Address ...................Phone No.............. .
If yes, Southo ow'
..................Address ...................PhoneNo........'....:...
IS.Is this property located with in~00 feet of a tidal wetland? *YES....NO....
* in Trustees Permit may be required.
Gr PLOTDIAGRAM
Locate clearly and ist' I alb buildings, whether existing or proposed, and. indicate all set-back dimensions from
property lines. Give stre t and bloc bar or description according to decd, and show street names and ' dicate whether
interior or c ~ lot
.
i
Q ~ ¢~ouf~
rr
I
~q~ G a+~
STATE OF KE1V YORK,
COUNTY OF .
S'.S
(1\amL of individual si nin ' ' ' ' ' ' ' • • being duly sworn, deposes and says that he is the applicant
about named. ~ . • • • • • • ~o contract)
IIc is the
(Contractor, agent, corporate officer, etc.) • ~ ~ • • • " " "
~f said owner or owners, and is duly ,authorized to perform or have performed the said work and to make and file this
tpplication; that all statements contai~jed in this application arc true to the best of ltis knowledge and belief; and that the
,vork will be performed in the manner set forth in the application tiled therewith.
>tvom to before me this '
rotary Public, /1 .•.,.~/..li.U1~:../. ~i~`~~G~'' " G~i~'
. County
HELEN K DE YOE • • ,
NOTARY PUBLIC, State of New Yak • • • • • • . • • • . .
No.4701878,SuOelkCounty (Signature of applicant)
Tam Expires March 30,19...