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HomeMy WebLinkAbout17757-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTI~NT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No Z-18056 Date MAY 25, 1989 THIS CERTIFIES that the building. ALTERATION TO ACCESSORY BUILDING Location of Property 43635 MAIN ROAD House No. County Tax Map No. 1000 Section 075 Block 01 Subdivision Filed Map No. PECONIC~ NEW YORK Street Hamlet Lot 17 Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated JANUARY 12~ 1989 pursuant to which Building Permit No. 17757-Z dated JANUARY 12, 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 ENCLOSE PORCH ENTRANCE & CONSTRUCT 8TORAG~ SHED TO EXISTING ACCESSORY FARM BUILDING. The certificate is issued to of the aforesaid building. FRARK CICHA~OWICZ III (owner) SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL UNDERWRITERS CERTIFICATE NO. PLUMBERS CERTIFICATION DATED Rev. 1/81 Inspector TOWN OF $OUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N. Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL PULL COMPLETION OF THE WORK AUTHORIZED) NO- Ul?'F57 Z Permission is hereby granted to: ...~.~ ....... ~.1~.~....~4. ~..~..~..~. ................................................. ~..~ ............... ~ ~.~, ,,~ ......... at premises located at .../~....~....~....~.....'~.. ........ .~...~....~. ........ ...~, ...'~..~...~.. ............................ County Tax Map No. 1000 Section ........ .~...~..~. ..... Block ....... .(~..I ........ Lot No ...... J..-/. .............. pursuant to application dated ..~..~~...l....-~.. ................ 19.~.~., and approved by the Building Inspector. ~ee ,..~?....~ Building Insgector Rev. 6/30/80 TOWN OF SOUTHOLO BUILDING DEPARTMENT TOWN HALL SOUTHOLD, NEW YORK 765 - 1802 APPLICATION FOR CERTIFICATE OF OCCUPANCY NEW CONSTRUCTION ..-.~...OLD OR PRE-EXISTING BUILDING ...... VACANT LAND ........ Location of Property ...... : .. . .... .............. .... .... HOUSE NO. STREET Owner or Owners of Property ..... County Tax Map No. 1000 Section ...... Block . OI Lot [7 '. Subdivision ....................... Filed Map ........ Lot .......... Health Dept. Approval ....... ~.//~. ........ Underwriters Approval...ff/~ ......... Planning Board Approval ..... ~l~. ........ Request for Temporary Certificate .~ ..... Fee Sub~i~ted: $.., .'~.~.~_)"., .... ~ .... Final Certificate rev. 10/14/88 rev. 10/14/88 FORM NO. 6 TOWN OF 80UTHOLD ~ BUILDING DEPARTMENT · ! TOW~ m~LL j 7 5- mo2 APPLICATION FOR qERTIFICATE OF OCCUPANCY INSTRUCTIONS 'This application must b~ filed in typewriter OR ink and submitted to the Building Inspector with the foll~wlng; for new buildings or new use: i. Final survey of propMrty with accurate location of all buildings, property lines, streets, and unusua~inatural or topographic features. 2. Final approval of Hedlth Dept. of water supply and sewerage-disposal(S-9 form). 3. Approval of electrical installation from Board of Fire Underwriters. 4. Swor~ statement from Iplumber certifying that solder used in system contains less than 2/I0 of IZ ~ead.j 5. Commercial bu£1dxngs,I industrial buildings, multiple residences and similar. .. buildings and installlations, a certificate of code compliance from the Architect or Engineer responsib,'le for the buildlng~ 6. Submit Planning Boardi Approval of completed site plan requirements. For existing buildings (prior to April 9, 7957] non-conforming uses, or buildinss and "pre-existing" laud ~ses: 7. Accurate survey of prpperty showing all property lines, streets, buildings and unusual natural or topographic features. 2. A properly.c~mpleted ~pplication, a consent to inspect signed by the ayd a [ert~f~ed abstract of title issued by a title company which sha~'[ mnow sxngle and separate ownership of the entire lot prior to April 9, 1957. · If a Certificate of O~cupancy is denied, the Building Inspector shall state the reasons therefor in writing to the applicant. 3. Date of any housing cpde or safety inspection of b~ildlngs or premises, or other pertinent informationlrequired to prepare a certificate. For Vacant Land Certificate of Occupancy: 7. Am application for vacant land Certificate of Occupancy shall be submitted, and a certified abstract of title issudd by a title company showing single and separate ownership of Jthe entire lot prior to April 9, 7957 shall also accompany the application. If ~ Certificate of Occupancy is denied, the Building Inspector shall state the reasons therefor in writing to the · applicant. FEES: l CERTIFICATE OF OC~?~.ANCY ~ New Dwelling $25.00, Additi'ons to Dwelling $25.00, Alteration to Dwe~lzng $25.00, Swimming Pool, $25.00. Accessory building $25.00 Addition to Accessory buildings, $25.00 - Businesses $50.00. 2. Certificate of Oc$:upancy on pre-existing dwelling - $100.00. 3. Copy of Certificate of Occupancy - $5.00 - over 5 years - $70.00 ' 4. acant Land Certz~xcate of Occupancy - $20.00 5. Updated Certlfica~e of Occupancy - $50.00 6. Temporary Certificate of Occupancy - $25.00 Residential $50.00 Commercial FOUNDATION (1st) FOUNDATION ( 2nd ) ROUGH FRAME & -PLUMBING INSULATION PER N. STATE ENERGY CODE '4. FINAL COMMENTS: TOWN OF $OUTHOLD OFITICI~ OF BUILDING INSPECTOR P.O. BOX 1179 TOWN IfALL SOUTnOLD, N.Y. ,,97, TEL. 765-1802 To whom This May,. Concern, We are unable r.o complete your Certificate of Occupancy because .of the following reasons. /Z( An application ~or Certificate of Occupancy is aDZ on file. ~,r~m.~ ,~2a.~ ) / / blo Underwriters Certificate on file. /~" The check i:;(.~not on file.) ~.f,~ /~/ No Health Dept. Approval on file. /-~/ No final inspection has been made. Please contact our office on this makter. T!lank you for your cooperation. lhL[ltlin(j Perm.it i! .C..~L _~ ;-~' ~ Z Duildtn9 Dept. *'**/]/ Ho Plumber Solder Certificate on file. ( all permits involving plumbing being issued after April 1,1984 .) FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N.Y. 11971 TEL.: 765-1802 BOARD OF HEALTH 3 SETS OF PLANS ~''~'~ ....... SURVEY CHECK SEPTIC FORM NOTIFY CALL Exanlincd . .~t~/~a.~(~ ! .~., 19 ~ MAIL TO: Approved-'~0~.'.'.,19~.PcrmitNo ............ (Building Inspector) APPLICATION FOR BUILDING PERI, IT INSTRUCTIONS a. Tlfis 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: or areas, and giving a detailed description of layout of property must be drawn on the diagram which is part of tkis appli cation. c. The work covered by tlfis application may not be commenced before issuance of Building Permit. d. Upon approval of this application, the Building Inspector wL!i issued a Building Permit to the applicant. Such permil 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 Occupanc~ 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 Sou!hold, Suffolk County, New York, and other applicable Laws, Ordinances o~ Regulations, for the construction of buildings, additions or alterations, or for removal or demolition, as herein described. The applicant agrees to comply with all applicab')e laws, ordinances, building code, housing code, and regulations, and to admit authorized inspectors on premises and in building for necessary inspections. ' '2- (Mailing address of applicant) ...... [ ' State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. ~ame o~ o,vner o~,remises...--{. ~ ~l.C.,...C,~..q .!/~...~b.'..~.~.C~...~X~, ......................... (as on the tax roll or latest deed) If applicant is a corporation, sJgnafbre ofdulylauthoriz'~d officer. (Name and title of corp6f~'te 0ffice~)' ' ' ' ;' Builder's License No .......................... Plumber's License No ......................... Electrician's License No Other Trade's License No ...................... / '~ ~'~ ~"'~,~O *~ ~?~"~ ~ ': ' Location of land on wli/ch proposed work will be done ..... ?.~ ;~,C~'~'~ ,.;~ :. , House Number Street\ Hamlet County Ta~ ~l,p No. ~ Sc,t~o,, ....~...~....) ..... ~¥ck ...... 1 ....... . .... ~ot ..... 1...~ .......... Subdivision ..................................... (Name) F~led~ ........... Map No ............... Lot ..... 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing Use and occupancy ...... . .--~.:~ .~.. ..... .-~.. ~ 1.~..~ .~. ~-~ ~ if .,~C ....... W ..................... b-l"'e~dedu~ea~doeeupaney ........ ~.~.~-~.~¢ .... ''%- ---?~/ .--~...~.~¢~' 3 Nat reef ork (check whi h ~ppli able) N B ildi Addition Alteration Repair...... .. .... Renloval Dcmoliti0n 0therWork ' .x'~-T~...,..//~ ' (J5 (2~ ee '. (Description) 4. Estimate'd Cost · . F (to be paid on filing this application) 5 If dwelling number of dwellin~ units Number · ' ............... of dwelling units on each floor If garage number of cars ............... 6 If business commercial or mixOd occupancy specify nature and' .......................................... · ' , extent of each type of use ..................... 7 Dimensions of existing structurles if any: Front Rear ' Depth Height Number of Stor/es ...... iii .... Dimensions of same structure With alterations or additions: Front Rear ' Depth i Height ................................... ................... , ..................... ;... Number of Stories ................... Dimensions of entire new construction: Front Rear ' ' Height Number' of Stones' ............................... Depth .............. ate o utc lase .......... ~ ................. Name of Former Owner ................ Zone or use district in which ~ ' premises are situated ....................... Does proposed construction rio ate any zoning law, ordinance or regulation: ............................... Will lot be regraded ........ ~· · · .............. · Will excess fill be removed from premises: Yes No Name of Owner of premises . Address Name of Architect ' ' '[ .................................... Phone No ................ .......... . ................. Address ................... Phone No ................ Name of Contractor ' . Address Phone No ..... 15.Is this property locaited within300-'feet of a tidal wetland? ~YES .... NO .... · If yes, Southold Towr Trustees Permit may be required. PLOT DIAGRAM buildings, whether existing or proposed, and. indicate all set-back dimensions from mmber or description according to deed, and show street names and indicate whether · 8. 10. 11. 12. 13. 14. Locate clearly and distinctly all property lines. Give street and block interior or corner lot. FEE: ~ '~.~2._...~ BY ~ NOTIFY BUILDING DEPARTMENT AT 765-1802 9 AM TO 4 PM!FOR THE FOLLOWING INSPECTIONS. l 1. FOUNDATION - TWO REQUIRED S'r'~ '¢*' "' ~ N'~B'~RED CONCRET~ couNTY O~' RqUGH - FRA~ING a ~.~ 3. '~hs~YlO~ ...... :. ......... 4: FINAL..-~ CQNST. RUCTIO.N .MqS. T. ........... being duly sworn, deposes and says that he is the applicant ~ ( N8 B~C~ f01~l~'El i!i01~ ~ u g. contract) above namet~tA CONSTRUCTION t~HALL MEET THE flEQUIREMENT~ OF ITHE N.Y. P n: t all tatement c ia'hud in this application are true to the best of his knowledge and belief; and that the work will be performed in the manner s~t forth in the application filed therewith. Sworn to before me this i iNotary Public .................... I .............. County (Signature of applicant)