HomeMy WebLinkAbout17884-z FORM N0. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Office of the Building Inspector
Town Hall
Southold, N.Y.
CERTIFICATE OF OCCUPANCY
No 218468 Date OCTOBER 16, 1989
THIS CERTIFIES that the building ALTERATIONS ANB ADDITION
Location of Property 7930 SOUNDVIEW AVE. SOUTHOLD
House No. Street Hamlet
County Tax Map No. 1000 Section 59 Block 09 Lot 13.1
Subdivision Filed Map No. Lot No.
conforms substantially to the Application for Building Perm~.t heretofore
filed in this offace dated MARCH 1, 1989 pursuant to which
Building Permit No. 178842 dated MARCH 2, 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 ALTERATIONS AND ADDITION TO EXISTING ONE FAMILY D6VEI,LING.
The certificate is issued to WILLIAM & PHYLLIS JAROSZ
(owner, )
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A
UNDERWRITERS CERTIFICATE NO. N091875 SEPTEMBER 15 1989
PLUMBERS CERTIFICATION DATED WILLIAM JAROSZ OCT. 3, 1989
Buil ing Inspector
Rev. 1/81
F08~i NO. f
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)
01788ti Z Date ...53.~P.Z 19G../..
Permission is hereby grant//ed to: o
.~9..,3..a....~
~ 1 ,
ro .C~tl~. ....C~..eilali~-.ate. . ~.....~?c~~~..~7........~d....~
ct premisesYocated of .....,1 .~CJ.......~''ll.~x/uG. ..LLd.(,/..'.'....S~c.4/.`.{
..............................................~A'~.fr.T'^~`•~...............................................................
/3./
a 1 a= _V~-"~=~
Caunty Tax Mop No 1000 Section /~,1. Block ~.........~/Lot No .
pursuant to opplicotion dated ...,,r~ 1 ~ 19..Q~~., and approved by the
Building~yinspectar.
Fee l../.!..~..
.i~
Rev 6/30/80
y. -
R<~. TOHN OI' SOUTDOLD
BUILDING DEPART2SENT
TONN HALL
SOUTIIOLD, NEi7 YORK 1197i
765 - 1802
APPLICATION FOR CERTIFICATE OF OCCIIPANCY
DATE_.~.~/.3~0
NEi7 CONSTRUCTION .......OLD OR PRE-EBISTING BUILDINC..._..VACANT LANO..._....
Location of Property~l3d. V J7f/dv.~.1~~CN. _~D.t~ ~ ~ f Sh?
HOUSE NO/.' STRCET/~ IIAHLET
Owner or Owners of Property~IJ!~~~AM f ~~~I~LC~.~A/4~~~~.-_..
County Taz Map No. 1000 Section Bloc[c Lot ~3'/
SubdivisionJJ..pptt.. Jr^......... Filed Map ..~^....Lot...~/-~.._. n~
Permit Ho./~9a.~`Date of Permit?~~~~~Applicant~u~~/_~~~..~"~[:~Z
Underwriters A royal. ~J
Health Dept. Approval - pp ~ '
PlanII lII b' Board Approval . _ . ~
Y
Request for Temporary Ce`rrtificaCe Final Certificate
Fee Submitted:
APPLICANT
, r,
~ o ~ r ..r-
~~I
4CT 12199
v. !0/i4 /88 FSLDG.DFa7
T0~' « OF S ~t}SciOLD
+ TEL.7G5-1882
O ffc~VFF011~-~0~~ TORN OF SO HOJLI7
(ti'• ~ ~c OFFICE OF BUILDIi•IG NSPECfOR
C~^ti P.O BOX 72
t..a.., TOWN HAL
~ f Ot- SOUTHOLD, N.Y 11971
C E R T I F I C A T I O N
Date__~C~7/~~ { ~t~
Building Permit No. / + p
Owner ~//~~j SL
Tpleasg pri/t)
(please print)
I certify that the solder used in the water supply system
contains Less than 2/10 of 1g lead.
(plumber's ignature)
Sworn to befor^_ me this
4tH day of ~CfOdER
19~.
iotary Pu li
ttotars Public, ~ Fdl. County ~-~,-R ~-7~
al~ r',f~L~~I1111~
A ~
_ ~ x tsss
n°~^i y
~ ~ .SJCi y,., f
i«~ a suty a) 1~9R) .
TEL. 7G5.18r,~
~,~~~I,o-.Q~
c;~ xowrr or sou~o~.u
~+~r3t~:~~ OPE'iCI:OF BUILDING INSPECTOit
;~~':i~4 z I'.O. BOX 1 ] 7 9 ,
~ TOWN HALL
SOU'I HOLD, N.Y. 1 1971
~~~1 rLi r ~ Q.~' / 9~
~ 4 3 0 ~dwrr~.tr~ti,1 6~.-~
~du~.d- , 'y1 ~ .
To S~ihom Tliis May Concern,
H
4;e arc unable r-o complete your Certificate
of~OCCUaancy because of the follo~~nng reasons.
r1n application forr Certificate of Occupancy
is 'lMfot nn file. ~I?~~~-~
/_?/~*!o Under;•~ritcrs Certificate on file.
I^?1 't'he check i:.Ivwtr3~nut on file.).$~S.GF'~
DIO t~~ai.th Dept. (approval on file.
[:o final ~nsl7ection has been made.
Please contact: our office on this matter. -
Thank you for your cooperation.
I1iiilc]Lr,cJ F'crcnit- 4 1_ ~ ~ ~ 2
IIuilQinc DupL•.
tlo Plumber :,older Certificate on file.
( all p~rmiLC involve-ng plumbincl being
iasucd after .1pr51 1,1984 )
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1 ^0
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FOUI7DATION ( 1st ) I
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FOUNDATIOIJ ( 2nd } _ m....~
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P,OUGH FRAME ~ ~ ~ ~
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PLUMBING ~
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I1dSULATION PER N. Y, I '
STATE ENERGY
CODE
x
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4 . ~ O y
0
FIidAL
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ADDITIOPIAL COMMENTS: x~c
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~ ~ THE NEW YORK BOARD OF FIRE UNDERWRITERS PAGE 1
190i1~5 BUREAV VF ELECTRICITY
Ei5 _iOHN STREET. NEW YORK. NEW YORK 1003&
7kr?' ~$PT~;1'IBER '15r1[ih9 -q>pli ~uri~nl '1o. :,r, jity~ Ei29i989/8y Pi ON1875 _
't'H 15 CEf2TIFIES THAT
.rnl•the el.•ctri.'alege.ipv>lent¢vrk.w ribeJ hri.nr and bvtnrdl~rrt by Nw app(L-artt nn rn+d wl Nr'n ufirne aF~ylirntiun number in Lheprensiser of
WSLCLAMJfki~ i ~9,Iv SOUJG':IEA AVh YJLE,66, SGIITriC@.I Li; "J.Y, ~
in !hr (.dlu¢ir Lrratnm'. Dnerr.u r,r 1 r F'. F 'ud F1. fir.-ti. u. Nlw~k l.ul ~p~.
r~r. rromined nr~ /lUtii)~`(' 1[3r ~J~f9 1ruJ(rn.>,J Yr b. :n r+. nplin.:~. :..rt, [Irv«~yro ~rne.v.re of Jli"Rmrrd. S
E! CECRS OVENS DISN WASNER51 EXNAUSi FAN_ 5~
N>lURF ~R ECEPl AClES SWfICNES r1X iVRES RANGES ~'CCW NIN _
~ OVONS i acn ! .:.~~I~ '.r _ _ .unl I nv_.~
I a. h K r. nl I P~ R y
''1 i v L~S MUSFI OUIEEt ¢
~ _ . THE CI4CN; UNti NEATElS DIMMERS C
•~DRYERS RIRNACE MOTORS Fl:1URE APPU~ _ _ _
I
n e ~ o,i ANCt I. REl4 i + NO. OF fEEi n-nl r w"Its
1- i ~ v G~c ~ p n+r rr ~ .wr ~ w. .r•og ~ 1RAN5 ~ owr r. n i SYSTEMS ~
_ I .u IF
.
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SERVICE DISCONNECT _ Ne'oK h-" 4 E R V 1 l` E F
{hi' nMi Y1'eP r l.e rvr ~ 0 ~ R r ,niU Or A i- A W O ~ `P
I f _ t EQUIP + .N twi i a ):+I e i~'i c « w..,, I :o r:r r [i_ or _ _ ' s cr ~e nau.
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4rNER r,ePAP ArUS i ~ ~
G . r . c . I . UCf 121989 R~
11' ` ~
BLDG. DEPT E
TOWN OF SOU7F{OLD ~
5
41L.UNOOL7 ELEI"T2iC , ,-._~~,.~;..z, ~
GENERAL ~APIAOER ?
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AAGINC F:r'EfP, 7.'i, i'~ "
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cer:L,.ute .*•USl nur t.e ute.ad m o+'., mw~r<~~ cert..- r,: !h. 'i•ce of tFC 1c:md i4 i rcn rect. Ir .r,;ilore mny be ~aenlified by (heir uedenliuis. c
. ;i7t3iSSflSEfl~2Y£'"ri'i67`~7"~$liel7l`a7-~"&P~mi°:$"cd. H. :nfvu':ii.`.~:
Iti'~m.`I'E"~. 3.'ii7'l37`;ul~$i°r~.~`5~'
l ~ 765-iS02
BUILDING DEPT.
INSI~ECTION
[ ]FOUNDATION 1ST ( ] ROUGH PLBG.
[ ] FOUNDATION 2ND [ ]INSULATION
[ ]FRAMING ( FINAL
REMARKS:
~c~~~
DATE ~U ~J INSPECTO
~ ~ Y~~`
765-1802
BUILDING DEPT.
INSPECTION
[ ]FOUNDATION 1ST r ] ROUGH PLBG.
[ ] FOUNDATION 2ND [ ]INSULATION
[ y~FRAMING [ ]FINAL
l
REMARKS:
6/
DATE ~ ~ INSPECTOR
/ ~(~U I
765-1802
BUILDING DEPT.
INSPECTION
[ FOUNDATION i5T [ ] ROUGH PLBG.
[ ] FOUNDATION 2ND [ ]INSULATION
[ ]FRAMING [ ]FINAL
_ ~ ~
REMARKS: ~ , , z7"~--`6c
DATE ( ~ INSPECTOR
lUFF. CO. HEALTH DEPT. APPROVAL H. 8 NO
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LIC. LAND SURVEYOR!-GREENPOIRT. N. V -
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T<!IT HOL! SUFF COD OF HEALTH lICRViCE6 E.TATEMENT OF INTENT
O'
1rO~3Ct/ FOR APPROVAL Of CONSTRUCTION ONLY
/.'K~'tir THE WhTER SUPPLY AND sewwaE
1 M
Syt+~ pAZg. DISP094AL SYSTEMS FOR THIS RE31•
p~, irr,
DENCE WELL CONFORM TO THE
G/v'~ H. S. LIEF NO ~ STANDARDS OF SUFFOLK CO. DePT
OF HE/.LTH. SERVICE!
APPROVED:
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BDARD OF, HEALTH .........r
3 SETS OF PLAN,¢ , ,
FORM NO. 1 SURVEY . . .
TOWN OFSOUTHOLD CHECK ?
BUILDING DEPARTMENT SEPTIC FORD[
• TOWN HALL
SOUTHOLD, N,Y 11971 NOTIFY rl (~,lc., /f
TEL. 7G5-1802 CALL
E~aniined ~ 19~~ ~i MAIL T0:
Approved 19~r%Pcrmit No ~ ?U ~J ~
Disapproved a/c ~ L~
P MAR - i i98~~
U
TOWN
OFSOU~fH~OLD
/ (B t g Inspector)
APPLICATION FOR BUILDING PERMIT
Date ~ ~2. f 15
INSTRUCTIONS %77~~•
a. Tlus application must be completely filled to by tppewnter or in ink and submitted to the Building Inspector, wit
sets of plans, accurate plot plan to scale Fee according to schedule.
b. Plot plan shown; location of lot and of buildings an premises, relationshsp to adjwmng premises or public str.
or areas, and giving a detailed descnphon of layout of property must be drawn on the diagram which is part of this ap
cation.
c. The work covered by this application may not be commenced before issuance of Building Permit.
d. Upon approval of this apphcanon, the Building Inspector will issued a Building Permit to the applicant. Such pei
shall be kept on the premises available for inspection throughout the work.
e. No building shall be occupied or used m whole or in part for any purpose whatt:ver until a Certificate of Occupai
shall have been granted by the Buildmo Inspector.
! APPLICATION IS HEREBY h1ADE to the Building Department for the issuance of a Building Permit pursuant to
Building Zone Ordnance of the Town of Southold, Suffolk County, New York, and other applicable Laws, Ordinance=
Regulations, for the construction of buildings, additions or alterations, or for removal or demolition, as herein descnb
The applicant agrees to comply with all applicable laws, ordinances, building e, hou ~ code and r arsons, and
admit authonzed inspectors on premises and in building for necessary inspects
s??..
~+(S natu/re~ of appf~hrant, r n//ajj~~_'e, ,ifj,~~/a Corp aeon)
7..1.~~.fQ!>^!4':~!~Y'cI~J,Q'~f.r!!49~
(Mailing address of apphcant)
State whether applicant is owner, lessee, agent, architect, engineer, General contractor, electrician, plumber or build
t.~.n.].°~~.
,
Name of owner of premises LU•~. ri~~~... F... f'~
.1.~?.. .
(as dfi the tax r 1 or latest deed)
If apphcant is a corporation, signature of duly authonzed officer.
(Name and title o£ corporate officer)
Builder's License No .'S ~ CP.. .
Plumber's License No. ~ . b ~ P. „ .
Electncian's License No ~ .
OtherTradc's Liccnse No. I~.4n1. .
I. Location of land on which proposed work will be done . .
......~`L3 ~.°.uw~,.VIeP.-? ~ So.~~.0.1.01..............
House Number Strcet~ Hamlet
County Tai 11up No 1000 Section ~ 5 4 Block ~ Lot ../.z .f.
Subdivision .Filed I<fap No . Lot
(None) i'
2 Sate e~isun~ use and occupancy of premises and intended use end occupancy of proposed construction
a. Existin; use and occupancy 2 5 I, d C?.N C. .
b. Intended use and occupancy ............:501 f~.'~•........... k~Cr V `s s;; { Yey .~?I .
c.
4
3. Nature of work (check whtch appltcable). New Budding Addttton Alteratton .
Repair Removal Demolttton Other SVork .
(Dcscnptton)
4. Esttmatcd Cost .°Z.S 000: 4.~ Fee .
(to be patd on filing flits apphcauon)
5. If dwelbng, number of dwelimg units r....... Number of dwelling units on each floor , , . , , , , , ,
If garage,numbcrofcars
6. 1f business, commercial or mtved occupancy, specify yt~c and extent of each type of use .
7. Dtmenstons of existing structures, if any Front Rear Depth ...-`-i. , , , , _ ,
Height c~.L) Number of Stones . y .
' Dtmenstons of same structure with alterations Qr~ddttions Front `t`I Rear . .
Depth ....-~aZ IIcight z....:s Number of Stones
8. Dtmenstons ol:errttre new constnictian Front . . S~!`~~..... Rear Depth .
Hetght Number of Stones .
9. Size of lot: Front ...!D D Rear P Depth ..a.
10. Date of Purchase `.f. ?(p ................Name of Former Owner
11. Zone or use district to whtclt premtses are situated .
12. Does proposed construction violate any zoning law, ordinance or regula[ton. ~ d .
13. 1Vt11 lot be regraded N. t7 . 1Vi11 excess Fill be removed from premtses: Yes N
14. Name of Owner of premtses ::::Address Piione No... .
Name of ~rchttcct Address 117`~~i.. f~'hone No
Name of Contractor ...~l~.~C'?.'4.Q Address C~-+.XS.". ~N~y'{~pPhone No ~7.(h~v.?. _
15.Is this property located within X00 feet of a tidal wetland? *YES... _NO.
*If yes, Southold Town Trustees Permit may be required.
PLOT DIAGRAb1
Locate clearly and distmctl}~ al] buddmgs, whether existing or proposed, and. Indicate all set-back dimensions £ro
property fines. Give street and block number or description according to deed, and show street names and mdtcate wheth
tntenor or corner lot.
STATE OF XE~V YORI: S S
COU;~TY OF . Su#'fo7k.. , , . ,
, , , , ~J~..7,liam Jaros2 , , _ , , , , , _ , , , , , , , bang duly sworn, depcscs and says that he is the applic
(1\ame of individual si~nutg contract)
above named
Ile is the OWNER _ .
r
of said owner or owners, and is duly authorized to perform or~have performed the said work and to make and file r
appbcauon, that all statements contained in this application are true to the best of hr. knowledge and belief, and that
work will be performed in the manner set forth in the application tiled tttcrewtth
Swom to before me t}us
, , _ .28th. _ _ _ day of February 1989
\otar}~ Pubitc, _ ~fQlk, , , , .County
]OEFJN tl G
t~6uC. ~ ~ Yom ~ (Si,nature o pplic
pudlfLA U Suffolk Caut>a
Me. 52.2232676
rr. Fxprm Saty sr3r•- lam