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HomeMy WebLinkAbout18013-z .t FORM N0. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No Z-19956 Date JUNE 7, 1991 THIS CERTIFIES that the building ADDITION Location of Property 4640 NEW SUFFOLK RD. NEW SUFFOLK, N.Y. House No. Street Hamlet County Tax Map No. 1000 Section I10 Block 8 Lot 25 Subdivision Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated APRIL 5, 1989 pursuant to which Building Permit No. 18013-Z dated APRIL 7, 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 2ND STORY ADDITION TO EXISTING ONE FAMILY DWELLING * The certificate >_s issued to THOMAS & MAUREEN NOVAK (owners) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A UNDERWRITERS CERTIFICATE NO. N-019903 - JANUARY 4, 1991 PLUMBERS CERTIFICATION DATED N/A *NOTE: PLUMBING HAS NOT BEEN INSTALLED IN FUTURE SECOND FLOOR BATHROOM. it ing Inspector Rev. 1/81 roaast xo s TOWN OF SOUTiiOLD 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°- 18013 Z Date 194` Permission is hereby granted to: ~ :I.....1 o..~;~u;a.ti.. Qu-4 . ~dk~,:~,...:fA....~.1..~..... nom. r~7~~~~..~..~...~..s..X...••~.-~~ ~".d... of premises located at ~.Q....... .:?:~.....tol~.~...1:'~ lK.t!~r~...~./ D County Tox Map No. 1000 Sectionn..~-.~.~n.... Block ......Q.~.......gqLot No...~.,.......... pursuant to application dated 19.1.., and approved by the Building Inspector. Fee s../, S 1 : 5" 2~. . wilding Inspector Rev. 6j30l80 Form No. 6 , r . i"""ti..~.....~.. . ~y~~ T0~ OF sOaTHOLD , BUILDING DEPARTMENT ~J ~ ~ ~ TOWN HALL ~f , Mqy 3 i 1991 765-1802 I~~ J APPLICATION FOR CERTIFICATE OF OCCUPANCY TOt.'c~ ~,c cam,.,-~,,~~ n j .a,_., xy..q.,.~d a. 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 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 and similar buildings and installations, a certificate of Code Compliance from archi_ect or engineer responsible for the building. ` 6. Submit Planning Board Approval of completed site plan requirements. 3. 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. 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 5. Temporary Certificate of Occupancy - Residential $15.00, Compmercial $15.00 Date ..D~.I~v" Jew Construction..... Olud O/r~,Prc~ti g Bui di j,~ •~Q ~ Q .ocation of Property..^.'.i ~{.tl...... ~/l, (.v,l^.^.~..1.'1~~1.1 . [l. { House No. Street Hamlet +nwer or Owners of Property.~o~~/S ,,rr/~~~cturPe~QQ.~.e~?41~1 . ounty Tax Map No 1000, Section.. .I~~~..Fv.v.Block...~0.!. ©~...Lot...~~~~..~.~... ubdivision .........................Filed Map........ ot.... ermit No..,+.K.~!~.. Date Of Permit.O.[~~!!J•...Applicant.• V~((~~.-?I}~:~~~q/.` .VFS~~g~~ ealth Dept. Approval ..........................Underwriters Approval ~U ~ Tanning Board Approval equest for: Tempo`r~ary er/t~ificate........... Final Certicate..~..... ee Submitted: $..Q ~ / ~n ~ ygg5rp APPLICANT j_.LtO 1;. 5:_ .~U;i ~~U~:E ~ ~Cd`1MCNT~ ~ L Ci] H y rOUtIDATIOtI (1st) v ! ~ - ~ - FOUNDATIOtd (2nd) 2. z o _ ROUGH FRAME & PLUMBIyG c ~ ~ ? H i 3. a~ n IIISULATIOtt PER N, Y. • • 'j t STATE ENERGY CODE ~ x G t FI;7AL Uy'T z. / L Gl& o ~ -~6~~- ADDITIOtIAL COMMEIITS: x ~ M ' x c H ~ - • a _ H H _ O ~ m < a ~ c, H Z a m -o H • a TEL.7G5-1803 S~~Fa~xc p Op TOWN OF SOUTIIOLD o~ y , ~ .~,c OPf iCE OF BU[LDING INSPECTOR o rn P.O. BOX 728 ~ ~1. ' ~ TOWN EiALL ~ ' oyol ~ ~ap~- SOUTfiOLp, N.Y. 11971 May 24, 1991 MR. THOMAS NOVAR P.0. BO% 296 NEW SUFFOLR, N.Y. 11956 To Whom This May Concern, we are unable to complete your Certificate oL- Occupancy because of the following reasons. /_v/ nn application for Certificate of Occupancy is not on file. CENCLOSED) / / No [lndcrwriters Certificate on file. T2ic check is (lIi$t~$I$i$~]/not on file. ) $25.00 / / No Ilcalth Dept. P:pproval on file. No Final inspection has been made. Please contact our office on this matter. 'Phanb: you for your cooperation. TSui]d~nq Permit I) 1 $ 0 1 3 2 [3utilclin~l pep L-. / D[o Plumber 5olcler Certificate on file. ( all permits im~olving plumbing being t ;sued after npril 1 , 19f39 ) 'I new-1+~: IK'M iMfr,4 ,Yn,NruW y; WRM ,Ir r, n 1 i 1 , i! 5i„ • i ~ eyr.,ry„r, i, '1•n r, I , w w„ ,,..+.a,rr.«..,,m,. { a1'.~ 1Pi~ err" a4w, q r fy Y`,, . i .r ,S\ s~'y}.^~' ,~:,<"ilA}s,~d,:',~.w yioy ,r~~ ~~,9~ ~'r'~w~tikN"'-~°' i~"~..yt+ .i~c, ~ .,iyt o''a~ :'y l~r~C.d r 'R.+~: ~l" .t,'r +rr r„y vU.?.'„~.'.. n~ rAd7NF wa~;'~~",,, tti"i` Cp F":+v+ fr°.~ "rr~+:' 'r '"~i4 qty', r,'rYr t ",r „ia a, . 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[)FOUNDATION 2ND [ ]INSULATION ~RAMING [ ]FINAL REMARKS: a~ DATE ~ fNSPECTOR tel. Aga 13 - , ~ i THE NEW YORK BOARD OF FIRE UNDERWRITERS PAt;E 7 (7021865 BUREAV OF ELECTRICITY 85 JOHN STREET. NEW YORK, NEW YORK 10038 Doty ,7ANUARY 04,199].q~~1irationNo.onJie 661bA?,&9/f*9 H O a90:# THIS CERTIFIES THAT PERMIT N0. 1.&C~1.3?. _ only the eleceriea! equipment oa descrihed hsbss and introduced 6y the eppBcant nomad on the shots applicstion number in the premises R/ THOMAS A NOVAK, 4440 NEW 5UFPOI,K ROAR, FOI,i: A 41 SECTION ~ 7.7.0.00, NEW SUFFOII$, N. Y. in t ollomin location; f)0'1' 0[S 0!~ 025.00 f g ®Baaement ®Gt FI. ®Ynd FI. Section Block ~,ot mss a amined bn 1)EI;ENAER 27 , 1.990 andfound to hr in complionce with the reyuirementa of this Busrd. gxrueE KBTAttlS SWI7CNE5 RXTURES RANOES tbOKINODKKS OVENS DISH W lXIIAUST TANS OUTLETS IPKANDESCEM ~ FIVORESClNT OTHEP NAT. K. W. AMT. W, qMT. R.W. AMi. R. W. NAT. X. P. 6 2O 9 6 1 P DRYERS RNtNACE MOTORS lUTUR! AhIIANCE RlOEK StMOALRK'?T TUAE GOOKS ENL UNIT HEATERS AWLT40UTLEi DIMMERS ~ AMT. R. W. dl M. P. GAS M. P. AMT. Pq. A. W. G. AMT. AMI. AMT. AMPS. TRANS. AMT. X. P. ~ e1 ~T AMT. WAtTt SERVICE DISCONNECT NO.OP S E R p V 1 C E AMT. AMP. TYPE t/[Vt 1/3W 7R3VI 9/aW ~~~EM;COND. OF CC CO'r+o. ~.a MIiEG ~~HI~~ uo.amVIM15 of 'NWFYIGIUI 1 150 CB 1 K 7 7 7, i OTHER AMARA7U5: G.F'.C.I: 7 SMGKR DF.TF,CTOR:-1 i I THOI4AS NOVAK YO BOX 296 NBW SIJFFOLK, NY, 11956 OENERAI RIANAQER 11 Psr 111 't~ This certificate must not be altered in ony manner; roturn to tM office of Me Hoard if incorrM. Inspectors may bs identified by their ctedRnfiah... COPY F ILDING ALTERED IN ANY MANNER. it i,~-~ ~w~1rd- ~~~n~~~ ~C~l~ ~D~ S)~~1/~ovJt~1n~ I,v~ ~ 4 ~ . 1 ~ ,n, vw~4S ~ ~v~~~ ~`YYv , S' ' ~ G f~~ S~~~L ~ ~-~I. 9 s-6 t t D ~ BOARD OF HEALTH iL~S cl ~ 3 SETS QF PLANS .Q•.~:... r I ~ FORM N0.1 SURVEY P: K.•.. . TOWN OF SOUTHOLD CHECK . ~~`3~ . APR - 511.t ~ BUILDING DEPARTMENT SEPTIC FORM TOWN HALL „ , ~ SOUTHOLD, N Y. 11971 NOTIFY ~~,TC' _ TEL.. 765-1802 CALL L.-.'..... H MAIL T0: Examined , 19~~. S 9 3 ~ Approved . 19~R Perini Disapproved a/c ' (BuddmgInspector) ~pa,,,;~ 3~3-7`f~3 APPLICATION FOR BUILDING PERMIT Date Ai4,F?~.. i~ r~...., 15 ~`T INSTRUCTIONS a. Tlus application must be completely filled in by typewriter or in ink and submitted to the Building Inspector, with 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 street ar areas, and giving a detuled description of layout of property must be drawn on the diagram which rs part of this apple catron. c. The work covered by tkus application may not be commenced before issuance of Budding Permit. ' d. Upon approval of this apphcatron, the Building Inspector will issued a Building Permit to the applicant. Such permv 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 buildmgs, additions or alterations, or for removal or demolition, as herein described. The applicant agrees to comply with all applicable laws, ordinances, buildmg code, housing code, and regulations, and to admit authorized inspectors on premises and in building for necessary ins~pe.Fc-tions (Signature ot° applicant, or name, if a corporauon) ~+ri.aaG.rov NoMa s ,Sr+a. ~fL~2'+1 r9 . Siy,GKBS.TtT,nL i.2.D.. !'Yi32~iNCa ~Rl v.~ (Mailing address of applicant) !!'J f Z State whether applicant is owner, lessee, agent, azchrtect, engineer, general contractor, electncran, plumber or builder ..31~l4t?Fi?- Name of owner of premisesTN,aM.NS- /tIAY/!iK- . - (as on the tar roll or latest deed) If applicant is a corporation, signature of duly authorized officer .VtTl"~lFLJd ,i~/i.GG% (Name and title df corporate officer) Builder's License No .~~-C~ . . . Plumber's License No .6'c'?'K?^' . . Electrician's License No , Other Trade's License No • ei/~ cf~ 1. Location of land on which proposed work will be done ,GJ/,~~. tl,/~/,~,t , ,.~{,~~~:pl,.K, -1~~1~ ! ~ . .J.~lo~.r~ of Ct1<r.,~~ s ~o~ ~ N~ tv Su~foG,rs~ . E[ouse Number Street Hamlet County Tax Map No 1000 Section IJD.. Block 08, , , Lot .Q.'~r.rJ!.44 . , - , Subdivision Filed ~fap No Lot . (Name) 2 Slate existing use and occupancy of premises and intended use and occupancy of proposed construction a Existing use and occupancy ,?!/t~.G f~ •N~G% /xs~e,,$/„D`C ~ C,~ b. Intended use and occupancy . /.7~/•OX. 7.-O. ~1I~/ ~ L~ ~q~~~~ ~,,~,C~ 3. Nature of work (check which applicable) New Building Addition ~ Alteration . Repazr Removal . , . , . Demolition .Other 1Vork . . . dd (Descnption) 4. Estimated Cost W. PP~O. Fee . (to be paid on filing this application) 5. If dwelling, number of dwelling units ..N.A 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 . 7. Dimensions of existing structures, if any Front Qrf. 5.f Rear ..Z!Z. Depth . ,~Z.•.4. ~ • . Height ,./8 ~ Number of Stones ! . t • . . . Dunensions of same structure with alterations or additions Front ..2!]•. J.`........ Rear 2 . .....Number of Stones . Z•.. Depth ......32.' Height Z O ~ . 8. Dimensions of entire new construction Front . ,2"/ •.5. ! Rear S Depth ?r~ . . Height ..Number of Stones . 9. Size of lot. Front .GrO • • Rear .Zo ` R1{,4•tauGrl2, . Depth /.9.3,.37f~~. , t/e~~.f 10. Date of Purchase ../9~'J.i ..Name of Former Owner . . 1 I. Zone or use district in which premises are situated . 12. Does proposed construction violate any zoning law, ordinance or regulation• drl,a . 13. Will lot be regraded alp ...Will excess fill be removed from premises Yes 14. Name of Owner of premises .........Address ...................Phone No... . Name of Architect ....Address ...Phone No . Name of Contractor Yt22'obt/p 1.~ •.CHluu.t..... Address IJAAIUCa . gtvt;,l~. .Phone No RZg'.'f:3(o!~. 15.Is this property located within 100 feet of a tidal wetland? *YES....NOJS.. *If yes, Southold Town Trustees Permit may be required. PLOT DIAGRAM Locate clearly and distinctly al], buildings„ vlhether existing or proposed, and, indicate all set-back dunensions fro, property Imes. Give street and block number or descnption according to deed, and show street names and indicate wheth.- mtenor or corner lol. No k~ •t~.nr• c,.eo.~cyyE~47S ~ . , STATE OF NE1V YORK, S.S COUNTY OF .Sli~~o.4.G,. . . Y!77v ~e.: o- • • L•-.'t~~ 4~ ~t being duly sworn, deposes and says that he is the apphca, (Name of individual signing contract) above named He a the +'~GE+..v ~.BtitG•, AE+•~r~.... . (Contractor, agent, corporate officer, etc ) of said owner or owners, and is duly authorized too perform or have performed the said work and to make and file th application, that all statements contained m this afplication are true to the best of his knowledge and belief; and that tt work will be performed in the manner set forth in the application filed therewith Sworn to before me this sT . ...day of . /y/I/Z. G!`f , 196q Notary Publ~~.ta.~a:,.~. e~14~!N~-! .County A 1 IILIIAN DAVIS BEGGS • • ~ • • ~ J~~ . HOiARY POBL{C, State of New Yak No aa29916 (Signature of applican Qualified in Suffolk County ~p C9mmisston Expires May 31, 1921