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FORM NO. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Office of the Building Inspector
Town Hall
Southold, N.Y.
CERTIFICATE OF OCCUPANCY
No Z-18971 Date APRIL 17, 1990
THIS CERTIFIES that the building ONE FAMILY DWELLING
Location of Property 960 GREENFIELDS LA. SOUTHOLD, N.Y.
House No. Street Hamlet
County Tax Map No. 1000 Section 63 Block 5 Lot 21
Subdivision Filed Map No. Lot No.
conforms substantially to the Application for Building Permit heretofore
filed in this office dated MAY 8, 1986 pursuant to which
Building Permit No. 18147-Z dated MAY 30, 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 GARAGE & ATTACHED DECK AS APPLIED FOR
The certificate is issued to JOSEPH RADICH
(owner)
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL 86-SO-28-APRIL 11, 1990
UNDERWRITERS CERTIFICATE N0. N-840491-OCTOBER 29, 1987
PLUMBERS CERTIFICATION DATEDOCTOBER 11, 1989-PECONIC PLUMBING & HEATING
.1~~ _
Building Inspector
Rev. 1/81
'oaas xa ~
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 1814 7 Z Date ..~,~~3q 19.r~~
Permission is hereby grant d to:
.S i~~~~
to . ...~.........~.~~:::::::.~,~,1~.~~.....~:....
at premises located at .........~.,,~.i,.Qr....~.... f.~
County Tax Map No. 1000 Section Block ..........~....~iL//Lot No.......~~...,t...........
pursuont to application doted 19.~1.la, and approved by the
Building Inspector.
6 f`
F/fee S.s3T .b..~~
O'er:....
Builds Inspector
Rev. 6/30/80
Foaas rro. 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)
N° 14877 Z Date .........~:Y.)....l.y 19.~.~
Permission is hereby granted to:
~ e-°....~°~'~
...a:.o.~:a-~-~?....
-y- ..~.~:~,...~.:.y.....r.~..-~~ ,
.....q.. . ...n ..n..... . . . . . . C.
.
j . . , . . . . .
of premises lorated at ..!.~.U......~,J?~?r?M..#n4F-~:4~-a...k~~.......~d:!r:fCU'~:~.~,.ar
.......................................................................l....2....................................................................................
County Tax Map No. 1000 Section .....Q.SP.w2..... Block ......Q.~..../Lot No....~:.1
pursuant to application dated 19~.W., and approved by the
Building Inspector.
Fee $..a~i..~+~ :f..~...
Building Inspector
Rev. 6/30/80
G Form No. 6
TOWN OF SOUTHOLD D ~I,J~U~~~~
BUILDING DEPARTMENT
TOWN HALL ~ ~ ? ~y~ j
765-1802 i ti's.7U
F3l.DG.
DFP`t. .~y~_~t~~
APPLICATION FOR CERTIFICATE OF OCCUPANCY TOVdfV OF 30C1TpdOI ~J
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 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 cf 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 - $5.00 over 5 years - $10.00
4. Updated Certificate of Occupancy - $50.00
5. Temporary Certificate of Occupancy - Residential $15.00, Commercial $15.00
per' Date ~ .
New Construction....lt,.q... Old Or Pre-existing Building
Location of Property..../..~-'.d .~R~~NS~~~GL7 ,j~j~L`~tO C ~ L.,~..h~
. . .
House No. Street Hamlet
Onwer or Owners of Property... :~.°.J`.~~:~..~~D~C~,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,
County Tax Map No 1000, Section... 6:~.......B1ock...:~r...........Lot.... 2 ~
Subdivision/
................................/....Filed Map.G.~ ~.?....Lot.... /1.................
Permit No.1~8~~,,,,,,,,Date Of Permit. 5:1/:~..
~6....Applicant.:~ ~ SC,(?~.~~7~~/C~l..
Health Dept. Approval.,k,P,S,,,,,,,,,,,,,,,,,,,,Underwriters Approval~t'C:$....................
Planning Board Approval .~lP.`d
Request for: Temporary Certificate........... Final Certicate.../.~......
Fee Submitted: '„~`,~,5,,,,,,,,,,,,
@.~. 3 931 ~
APPLICANT
acfvUa~a THE NEW YORK BOARD OF FIRE UNDERWRITERS
~ BUREAU OF ELECTRICITY
{k~.~fJ6JL;Y` ~Ly,> a~7, 85 JOHN STREET, NEW YORK, NEW~~~Q~F~I(aQ038
Date Application Nn. on file 4~°~ 44~~~~ //&&33fF~J
THIS CERTIFIES THAT
only the electrical equipment as deacrihed below orEd introduced b the ap~liwnt nomad on the above application number in the premises of
Nto~,~th k'. H:zdiwtlP C'ra°r?Ean:C.~e3].cpp----T~.<t i3~rl.t~y ~a., aoutYiOld, SI.Y.
in thefollowinq location; ®Batemen[ 2+J Ist Fl. ? 2nd Fl. .Section Blcek Lot
was exornined on <~G;TtL743E:.K' ~`~t 1Js~'$7 aadfound to 6e in compliance with the reyuireneenta q(this Board.
FIxTURE ECEPTACLE$ SWITCHES FIXTURES RANGES COOKING DECKS OVENS DISHWASHERS EXHAUST FANS
OUTLETS INCA?N~DIESCENT FLUORESCENT yA a AMT K W AMT. K. W AMi N.W p}Mi yK. Why AMT. ~{Nl P.
6A! Jp u? ,[JiJ 1 .L.G ~ .i.'
DRYERS FURNACE MOTORS FUTURE APPLIANCE FEEDERS SPECIAL RECPT TIME CIOCKi gELI UNIT HEATERS MULTI.OUTLET DIMMERS
AMT. K. W. Oll H. P. GAS H P MIT. NO. A W. G. AMT. AMP MIT. AMPS TRANS. AMi N P. SYSTEMS AMT. WATTS
NO.OF FEET
w
SERVICE DISCONtYEC#` ~ METER ~ $ E - R ~ - - V I _ ~ -'C E ~ I
AML. AMP TYPE EDUIP 1,0' ]W I ,6' JW 3 $ ~W 3,e' 4W NO. OF CC. COND A. W. G NO. OF HbLEG A. W. G NO. Of NEUTRALS A W G.
PER A' Of CG COND OF HI-lEG Of NEUTRAL
1 sou (:lt 3C 1 2 1 4
OTHER APPARATUS:
a~rsu~,~: a.ia~t~a., 1-~3~4k>~< (~ac;u<:at)
3-tr.~•.c> z.
is TJr~'II:t;°A~Swaxri'-1
I~iA1.i.L ~L. UYn tiU ~~Jw' L~~C~ ~
ai`/ti :(t3Wll ~A%lY'r;'ITJY' .~.w'~7..
Sbuthol.a,.,iv.Y, 114371 alt;»H~E3~t;
6ENERAI MANr~ER
al
Per `%'t,,,~•^,t"""w„`~
This certificate must not be altered in any manner; return to the office of the Board if incorrect. Inspectors may be identified by their credentials.
COPY FOR-BUILDING DEPARTMENT. THIS COPY OF CERTIFICATE Ml~$T NOT BE ALTERED IN ANY MANNER,
Q~Oc~VFFO(h ~,l/ TEL. 7G5-1802
~l O_, TORN OF SOYJTDO~D
+~1.:~"• ~ti>~:}' ~c OFFICE OF BUILDII.7G INSPECTOR
~
o ,~t~, P.O. BOX 728 i
-c TOWN HALL
~ 0~ SOUTHULD, N.Y. 11971
O%~! ~ ~b
C E R T I F I C A T I O N ,
pate%l~/
Buildirq Permit No.11~'c , ! r
Owner ~ '
please print)
q
(please print)
I certify that the solder used in the water supply system
contains less than 2/10 of to lead. ,
~ G _e5/nJ
plumber's signature)
Sworn to before mo this
~_day of yc~//
19~, r
Notary/ Pu is
BAflBARA STEPNO~NSKI
Notary P11b11C,~ ~ C COllnty RtotBCy PUbiia, Stato o4 Now Xoek
No. 4tf4A752
®ualifigd in Suffolk County
, Commiosion Eupires~30, 98...L.f
h'lELL;a Ifd$1'ECTION ~llATE COhiME11TS I~
1.
FOUNDATION 1st) ~'s~;~ _ ,zz.~ m y
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~ 777000
INSULATION PER N. Y. _ ~ '3 ~
STATE ENERGY
CODE
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DDITIONAL COMMENTS: ~
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765-1802
BUILDING DEPT.
INSPECTION
[ ]FOUNDATION 1ST ~ ] ROUGH PLBG.
[ ] FOUNDATION 2ND [ ]INSULATION
[ ]FRAMING (l,~INAL
REMARKS: 7"~ r l~,t r3c ~ l ~ b. l acCs {~o(JLLc °TD o
Coo 'i D C~wc.~3+~s i t ~~a~-~ (,t11oo~ Sio~1~~
L41 t ec.~ol,~ a 1 K t2.re~4 02 l~ ti~ ~ ~ibtt 'D O ~(o~
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DATE ~ `(i INSPECTOR
765-ili02
BUILDING DEPT.
INSPECTION
[ FOUNDATION 1ST [ ]ROUGH PLBG.
[ ]FOUNDATION 2ND [ ]INSULATION
[ 7 FRAMING [ ]FINAL
,~i
REMARKS
j ,
~ G / as
DATE ~ ~ INSPECTOR
v~ ass-iso2
7 BUILDING DEPT.
INSPECTI®N
[ ]FOUNDATION 1ST [ ] ROUGH PLBG.
[ ]FOUNDATION 2ND [ ]INSULATION
[ ]FRAMING [ ]FINAL
REMARKS: l
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DATE ~ ~ INSPECTOR ~F~
ass-i80Z
BUILDING DEPT.
NSPECTION
[ ]FOUNDATION 1ST [ ]ROUGH PLBG.
[ ]FOUNDATION 2ND [ ]INSULATION
[ ]FRAMING [ ]FINAL
REMARKS:
~4N s
cS/~ ~,a
DATE ~ ~ INSPECTOR ~~f~
765-1802
BUILDING DEPT.
INSPECTION
[ ]FOUNDATION i5T [ ] ROUGH PLBG.
[ ]FOUNDATION 2ND [ ]INSULATION
[ ]FRAMING [ .FINAL
REMARKS: ~ l~~-- o
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DATE ~ z3 INSPECTOR /'~~~>"Ov
oS~FFO~~o
VICTOR LESSARD ~ < Town Hall, 53095 Main Road
PRINCIPAL BUILDING INSPECTOR ~ P.O. Box 1179
(516) 765-1802 yi ~ Southold, New York 11971
FAX (516) 765-1823 Oi~'
jo~ ~ ~~0~
OFFICE OF BUILDING INSPECTOR
TOWN OF SOUTHOLD
May 17, 1989
Mr. & Mrs. Joseph Radich
960 Greenfield Lane
Southold, New York 11971
Re: Suffolk County Tax Map #1000-63-05-21
BUILDING PERMITS #14877-Z (NEW DWELLING)
#16087-Z (STABLE & FENCE)
Dear Mr. & Mrs. Radich:
This letter is to notify you that the above building
permits have expired.
According to the Code of the Town of Southold Article
XXVIII Chap. 100-281 "no building in any district shall be
constructed without a building permit." In addition according
to Chapter 100-284 it is unlawful to occupy or use a building
without a Certificate of Occupancy.
in order to avoid legal action you must contact this office
immediately to resolve the violations.
Thank you for your cooperation in this matter.
Very truly yours,
SOUTHOLD TOWN BUILDING DEPT.
Vincent R. Wieczorek,
Ordinance Inspector
VRW:gar
(Cert.Mail)
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i~.a`r`'~n" ~...:'ke'kro u~~,.x. F~,T FORM NO. 1
%ialt b'"~ LF iK
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN HALL
SOUTHOLD, N.Y. 11971
TEL.: 765-1802
Examined . ~ 19~~ Received........... , 19.. .
Approved ~.°i. 19$~. Permit No..1.~~~~
dk vil
Disapproved a/c ~ bL
ct,.t
(Building Inspector) ~ -
APPLICATION FOR BUILDING PERMIT ,,3//Re-~ Q
Date Z. ~ . 2.8 19
INSTRUCTIONS
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- I
i 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. ~iispection throughout the work.
e. No building shall be occupied'or used in whole of in part ~qr any purpose whatever until a Certificate of Occupancy
shall have been granted by the Building Inspector.
h
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 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.
( ignatu e of applicant, or name, if a corporation)
o!~.K.LAWN...A.!!e,.~'~'I'.,.so~tL•oL.°.~.-..
(Mailing address of applicant)
State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder.
~3v~Ld..G'R
Name of owner of premises tr=t~!/!, . " .
~y'. ' ' ' , (as on the tax roll or latest deed)
If applicant is a corporation, signature of duly authorized officer.
(Name and title of cor~p/orate officer)
Builder's License No. ,
Plumber's License No. .~.C'. y
a a' z r .
Electrician's License No . .
Other Trade's License No:'
1. Location of land on which proposed work will be done . .
House Number Street Hamlet _~j
County Tax Map No. 1000 Section 6.3.x...... Block ....J~............ Lot
Subdivision Filed Map No. Lot .
(Name)
2. State existing use and occupancy of premises and intended use and occupancy of proposed construction:
a. Existing use and occupancy .
b. Intended use and occupancy ...~.~.S.I. D.~. ~ C~-° .
3. Nature of work (check whiRemoval able):.N.ew.~uilding~emolitiOn Addition 1 ~ • then Workation I.
Repair O
(Description)
4. Estimated Cost ~..5~. Q00 Fee i
(to be laid on filing this application)
5. If dwelling, number of dwelling units Number of dwelling unit's on each floor .
If garage, number of cars ~ .
6. If business, commercial or mixed occupancy; specify nature and extent of:each typ',e of use .
7. Dimensions of existing structures, if any: Frorit :.............Rear . Depth .
Height Number of Stories .
Dimensions of same structure with alterations or additions: Front ',c.... Rear , .
8. D mensions of entire new constnaction: Front ..6/.~', , , { , :....Re •r umb~Zo Z
g ~ g f rtories r.
Hei ht ; ~ ber of Stories ~i • .~ro .,.......Depth, d.'......... .
9. Size of lot. Front ..5 Rear Depth ~ .
10. Date of Purchasel~j~1P.C~1..~1/... r.9 ~.y.......... Name of Former Owner IP1 ~'I?~ /y~~/vSJ"l9~'f'I. Co R.P. .
EMrLdY~e~~tNS/o,V t'(gy,S`T'
11. Zone or use district in whichp're~hi@8s are situated . . .
12. Does proposed construction violate any zoning law, ordinance or regulation: ,!1! P .
13. Will lot be regraded s ..........Will excess fill be remove from remises: Yes No
14. Name of Owner of premises, F?':.R. AO/ CH.
, ..Address n~{K L D Ol'(V , !4 vi , ~Xp~one No. 7~5.' 3 S7/
Name of Architect ..t.....-, ~ Address Phone No......... , .
Name of Contractor VP.L°.RA:Df<N............Address .~QV~.~4L °~...PhoneNo.7.45`?.3~~....
' PLOT DIAGRAM I'
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.
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STATE OF NEW YORK, S S
COUNTY OF
being duly sworn, depo~es and says that he is the applicant
(Name of individual signing contract) r
above named.
Heisthe
(Contractor, agent, corporate officer, etc.)'
of said owner or owners, and is duly authorized to perform or have performed the skid work and to make and file this
application; that all statements contained in this application are true to the best of his''iknowledge and belief; and that the
work will be performed in the manner set forth in the application filed therewith. I
Sworn to before me this
Notary Public, ....l'""`"~.../.v.... ~ ~ (J~--.o... County C_..,, ~
NdA1RY~~i
1 w~ (Signature of applicant)
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