Loading...
HomeMy WebLinkAbout18062-z FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No Z-22338 Date MAY 19, 1993 THIS CERTIFIES that the building ADDITION Location of Property 580 WILLOW POINT ROAD SOUTHOLD, N.Y. House No. Street Hamlet County Tax Map No. 1000 Section 56 Block 5 Lot 29 Subdivision Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated APRIL 20, 1989 pursuant to which Building Permit No. 18062-Z dated APRIL 21, 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 DECK ADDITION TO EXISTING ONE FAMILY DWELLING AS APPLIED FOR The certificate is issued to NEVIO BLASKOVIC (owner} of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A UNDERWRITERS CERTIFICATE NO. N/A PLUMBERS CERTIFICATION DATED N/A ui'ding Inspector Rev. 1/81 rosae< 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°- 18062 Z Date .......~.1 .9.~.~ Permission is hereby granted[to: to ..~.~M^sA~.d,L.t~.:..Li.....~R:~...... - ...~...~i:+...~.,~r~.rsi,:q....c~T:1,~,........ "~1'- at premises located at ..~.B.p......~ :4?...p.~......~,.......4;1~-~!!~!-~f2:-~ . .I County Tox Map No. 1000 Section .....4?S~l....... Block ..~~~/QLot No . . pursuant to application dated se~.d.... 19.~ and approved by the Building Inspector Fee 5...~~ / . .c cS1-~s-~ ............~:P~.-.-,...... Building Inspector Rev 6/30/80 _ Form No. 6 - :3~ TOWN OF SOUTHOLD ~F~Y 17 i~; J ~ 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 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 den~ed> the Building Inspector shall state the reasons therefor in writing to the app la cant. 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 Euilda.ng - $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 Date iJew Construction........... Old Or Pre-existing Building..... Location of Property House No. 'y~ ~ ~ ~ n Str(e,,et ~ Hamlet Onwer or Owners of Property........d.ll~'1/!~~_~...~.1C~011~..~":Cid:'VW.t/ . .................q............ County Tax Map No 1000, Section..~iF:........Block.... Q:Z........Lot......./ 3Ubdivision ........1l.~~.//. ...jFilegd Map............Lot...................... 'ermit No.,l~~~ ...Date Of Per~nit.T,/~.~I,~/.....Applicant -lealth Dept. Approval ....................//......Underwriters Approval........,................ Tanning Board Approval tequest for: Temporary Certificate....,...... Final Certicate.........., 'ee Submitted: $ti'2'~~~..~ ~ APPLICANT C'iS.~ 2 2 4Z' INSPECTORS _ Victor Lessard , i u~ Pnnctpal But(dtng Inspector Curtis Horton ~ SCOTT L. HARRIS, Supervisor Sensor 8utldtng Inspector 7 0 Thomas Fisher ~ " ~ ~ " ~ Southold Town Hall Butldtng Inspector ~ ~ ~ ` ~ P•O. Box 1179, 53095 Main Road Y Southold, New York 11971 Butidang I tpector ?1 e? Fax (516) 765-1823 - Telephone (516) 765-1800 Vincent R. Wieczorek Ordinance Inspector Robert Fisher Assisrant Fire Inspectrn OFFICE OF BUILDING INSPECTOR Telephone (516) 765-1802 TOWN OF SOUTHOLD MAY 5, 1993 NEVIO BLASROVIC S ANO 203-29 28th AVENDE WAYSIDE, NY 11360 RE: PREMISES @ 580 WILLOW POINT ROAD, SOUTHOLD 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) No Underwriters Certificate on file. ffi 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 # 18062-Z Please contact our office on this matter. Thank you for cooperation. SOUTHOLD TOWN BUILDING DEPT. ILL17 1~.~: L~..-Ui IDh1C. ~ vl. LK44;~N1.~. I 1 . n ~ c H _ - - - y l FOUtIDATI0:1 _ ( 1st ) ~ c ?OUNDATIOIJ (2nd) z o ROUGH FRAME & ~ PLUMBING ~ F ti 3. a m rn ; II7SULATION PER N, Y. STATE ENERGY ' CODE x 4 . m L H f A FIIJAL F o b E ADDITIOPJAL COMMEIJTS: x c t c m x H 7] ~ • a ~ H H O O • m a < _ H ~ T b m H 1~~~ Z~- T65-1802 BUILDING DEPT. INSPECTION [ ]FOUNDATION 1ST [ ] ROUGH PLBG. [)FOUNDATION 2ND [ ]INSULATION [ ]FRAMING [ FINAL REMARKS: ~ Z DAT INSPECTOR d~ 1- ~O~ \ r A VO a V 1OU 0 vp ~ ~p a Aa ~ pJ'. J u, cos F { Z O D 1 ~ m w ~n~~ O yrc ~mm s C zxoo C oo< ~ z _ ATN; r N C 2 2 0 o O N T; OOU os a rv xm m or cm z~ ~z z w w m `co ~ mr Z n d~ f mm o o w. w ~ mm °~Q: m ~ -a m n= ~ i wm ~ ~ /a~~ ~ ~ ~ 2 ~ L 7 2° ~ t i0 s, \ `~il 0700 , ~ r~ / n n A / - w O 7p~ / ,p ~ ~ m~ co~~-nDC r 3 n D ~ cn - n ~ foo ~°S ~ -Lim ~ZD~ o~m \~e ~ r _ _ c~ O ~ o -I ~7 ~ ~l+ ~ 6+ r _ O -n ~ B ~ ° ~ ~ N~ ~ \/PP 01 ~ O ZCD o ADO C,FP~ v _ C O ~ ~ . CO ~ A_ z m N ~sf~p Ges9 O ~ < z o f fop' Aom ~ CO Z N me AAO O Z ,,yy zar~\ 1 'il ~ _ Nm r'^ zD o z _o N W A U BOARD OF HEALTH 3 SETS OF PLANS FORM N0.1 SURVEY TOWN OF SOUTHOLD Cl1ECK . BUILDING DEPARTMENT SEPTIC FORPf ' TOWN HALL EOUTHOLD, N.Y. 17971 N71X . -~C TEL.. 765-1802 CAL" . ~ . AIL TO: Examined . r?:1..., 19~"~. ~ Approved .~d~-t-R..:t-~... 19~~. Permit No. j.~a r~i~.~ , Disapproved a/c qp~, ~ ~.U caw. E~{I ~ (Building Inspector) TOWN~~l1~FT~tOLD APPLICATION FOR BUILDING PERMiT Date ...y.".: 15 8. INSTRUCTIONS a. Tltis appltcatton must be completely filled in by typewriter or to ink and submitted to the Butlding 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 premtses, relationship to ad}ommg premtses or public stree~ or areas, and giving a detailed description of layout of property must be drawn on the diagram which is part of this appl cptron. c. The work covered by this application may not be commenced before tssuance of Building Permit. d. Upon approval of tltts appltcatton, the Butlding Inspector will issued a Buttdmg Permtt to the applicant. Such permi shall be kept on the premtses available for inspection throughout The work. e. No buildm; shall be occupied or used to whole or to part for any purpose whatever until a Certificate of Occupant shall have been granted by the Butlding Inspector. APPLICATION IS HEREBY MADE to the Butlding Department for the tssuance of a Butlding Permtt pursuant to th Building Zone Ordinance of the Town of Southold, Suffolk County, New York, and other applicable Laws, Ordinances o Re¢ulattons, for the construction of buildings, additions or alterations, or for removal or demoittton, as herein described The appltcant agrees to comply with all applicable laws, ordinances, building code, housing code, and regulations, and t~ admit authorized tnspecton on premtses and m building for necessary inspectio ~~~~t . (Signature of applicant, or name, tf a corporation) ..P.©Br~x.. ~y.3r..~o~r~DLo.... /!97t...... • (Mailm~ address of applicant) State whether appltcant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. rp~G-NER................... Name of owner ofpremtses /YEV~D ~~S,~DY~C (as on the tav roll or latest deed) IF appltcant is a corporation, signature of duly authorized officer (Name and title of corporate officner) Builder's License No Plumber's License No . Eicctncian's License No. ~ Oilier Trade's License No. . 1. Location of land on watch proposed work will be done . . ~`•~O /y~L~Dc~ ~D/ivT ~P_D/i'/J S6'crT~Dlp I{ouse Number Street Hamlet County Tai hlap No 1000 Section ` ~l°.. Blvck Q. ~ Lot • , Subdivision • Filed Afap No Lot . (Naive) State c~isting use and occupancy of premises and intendefid use aid occupancy of proposed construction: a. Existing use and occupancy ~d~f • • •~M/Ls ~g~{sp b. Intended use andoccupancY 3. Nature of work (check rvhrch applicable). Nety I3uildmg Addttton .Uteratton . Repatr Removal Dcmohtton Other 1Vork ....Q~G~i (Descnpttor / ~ ~e 4. Esttmatcd Cost 1 Fee . (to be patd on fiitng this appltcatson) 5. If dwelling, number of dwelling unrts Numbct of dwelling untts on each floor , . , . Ifgara;e,numbcrofcars 6. If business, commercral or mixed occupancy, spectty nature and extent of each type of use 7. Dimensions of existing structures, tf any: Front Rear Depth , • , • Hetcht ...............NumberofStoncs..................................... Dimensions of same structure wdh alterations or adddtons: Front Rear . Depth IIctgltt ......................Number of Stones . 8. D s~nttre new constivction• Front Rear Depth . q~1 ....NumbcrofStones .+lr......... Size of lot. Frog(„ ~t Rear Depth . ' YTI"D"a"!a~•nf.~urchase,p... ~ ....................Name of Former Owner ,},d,,,"Lone o"~.use•drstnt~n (chub prcmtses are sduated 12. Does proposed construction violate any zoning law, ordinance or regulation : . l3. ~VdI lot 6e regraded Will excess Gll 6e removed from prcmtses: Yes 14. Name of Owner of prcmtses ....................Address Phone No............. . Name of Architect • Address ...................Phone No............. . _ Name of Contractor ..........................Address ...................Phone No............. . 15.Is this property located with in 300 feet of a tidal wetland? *YES....NO.... *If yes, Southold Town Trustees Permit may be required. PLOT DIAGRAhI Locate clearly and distinctly all buildings, whether existing or proposed, and. indicate alI set-back dimensions fry property Gnes. Give street and block number or descnption according to deed, and show street names and indicate wheth intenor or comer lot. STATE OF \E1V YORfi' S S COUNTY OF . being duly sworn, deposes and says that he is the applica (Name of indrvtdual signing contract) above named. Clcisthe (Contractor, agent, corporate officer, etc.) of card owner or owners, and is duly authorized to perform or have performed the said work and to make and file t1 ~pphcauon, that all statements contained m this application arc true to the best of fus knowledge and belief, and that t vork wdt be performed m the manner set forth to the application filed thcrcwith. >worn to bctore me this . . • v70 . .....day of 19~y. rotary Public, , .P~.4~C u._.. ~ .':`::t-• • • • • • • • • Caun[y f// NELENi4DEtlUE • . • ...f • -t,`.J•"• • •G: . • . • ~a~470 87&SuaBu~kCouMll (Signature of applicai Term Ezpins Much 30,1 ~