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HomeMy WebLinkAbout17936-z FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Buildinq Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No Z-20589 Date MARCH 13, 1942 THIS CERTIFIES that the building ADDITIONS Location of Property 1185 LITTLE NECR ROAD CUTCHOGUE N.Y. House No. Street Hamlet County Tax Map No. 1000 Section 97 Block 8 Lot 1 Subdivision Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated MARCH 17, 1989 pursuant to which Building Permit No. 17936-Z dated MARCH 20, 1989 was issued, and conforms to all of the requirements of the applicable provisions of the law. The occupancy for wha.ch this certificate as issued is ADDITION WITH ATTACHED GARAGE & DECKS TO EXISTING ONE FAMILY DWELLING AS APPLIED FOR. The certificate is issued to RONALD & PATRICIA GARSIK (owners) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A UNDERWRITERS CERTIFICATE NO. N-202955 - SEPTEMBER 9, 1991 PLUMBERS CERTIFICATION DATED MARCH 10, 1992 - BERTSAND PLUMB & HEAT. -!/~Ci uilding Inspector Rev. 1/81 708M NO. ! 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) No 017936 Z Date a t9%.q. Permrssron rs hereby granted t Cy .....~...o ~ ~.,3 u :y.......r,t q s to ~.....~.~....:...~~...?.....~-af..~.A..~.,. n `~tf at premises located at ...u.~s:..... .....1VJ~~..!`.-~{.•........l~C County Tox Map No 1000 Section Q~,~ Block Lot No pursuant to appircatron doted ~ . ~ 7..... 19.~~.., and approved by the Building ~~I((nffs~~pte~ctor. Fee $.~T.l.'. . . 'L.Y'.~`' . uil ing Inspector Rev 6/30/80 Form No. 6 ~ y 5 TOWN OF SOUTHOLD /fir//~ fS~.~' ~~~.c BUILDING DEPARTMENT / 9 TOWN HALL ,,i` MAR i 21992 76s-lsoz U ~ ~ _ . BLDG.ue!"i. APPLICATION FOR CERTIFICATE OF OCCUPANCY 7pWN OF SOUi'HOLL? 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 a.n system conta7.ns less than 2/10 of 17 lead. s. 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, 19s7) 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 of Occupancy - New dwelling $2s.00, Additions to dwelling $25.00, Alterations to dwelling $25.00, Swimming pool $2s.00, Accessory building $2s.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 - $s.00 over s years - $10.00 4. Updated Certificate of Occupancy - $s0.00 5. Temporary Certificate of Occupancy - Residential $1s.00, Commercial $1s.00 Date r/ ~DII 0~ T~ New Construction........... Old Or Pre-existing B~ ilding... Location of Property.~I(~.`~'._.~I,~rL~~~C~,i~r7U~,,,l~l;'[rC'it-~O House N St[~ree c ~ / ~ Hamlet Onwer or Owners of Property!~!7~:~Cq~~``~~~~.~~~~t:). ~'.!:?~?tV\............ii County Tax Map No 1000, Section..Q.l.l......Block... © ~........Lot.... ®.J Subdivisionl .............................d......Filed Map............Lot...................... Permit No./ !.~~!~!..~..Date Of Permit ................Applicant......... Health Dept. Approval ..........................Underwriters Approval......................... Planning Board Approval Request for: Temporary Certificate........... Final Certicate........... , Fee Submitted: $ Q.Bc, y 3~f 7 2 } e o~ a os s q APPLICANT TEL, 765-1802 Qc~1FFOL,~~p~ TOWNi OF SO[JTHOLD ''c OFFICE OF BUILDING INSPECTOR ~ P.O. BOX 728 TOWN HALL "0~~ ~ ~~0~ SOUTHOLD, N.Y. l 1971 C E R T I F I C A T I O N Date 'fin C~. Buildin Permit No. /..S'{p/ Owner ~1J1V/'1 ~ ~ ~S ~ ~ ' ~ {please/print) Plumbe-'~j~,e;sa,~, / Lu,o•,Bi.t/E NF_AT..J6~ ~'eJC' {please print) I certify that the solder used in the water supply syststu contains less than 2/10 of 1~ lead. os J .~r.~.~-te-L~ plumger's signature) Sworn to before me this ~oL` day o! mQ,eeN / 19 y.2 ~r~f.Gc x~ he ~_eit<~ Notary Publa~c Notary Public , ~ u FF o L K County EILEEN M HQACHE Notary Public, State of Newyork No 9826942 Qualified in Suttoik County ' Comm~ssum EE~gtirea January 31, 78.~„ ~ THE NEW YORK BOARD OF FIRE UNDERWRITERS >'AC,r; 7 11957.12 BUREAU OF ELECTRICITY 85 JOHN STREET. NEW YORK, NEW YORK 10038 Date SEPTF;HARR 09,1997 APPlicationNo.unfile 63819089/89 N 7.0?355 s THIS CERTIFIES THAT only the electricd equipment a olsscrihed helots and introduced by the applicont nomad on the chose application, numher in the premises of = RON GARSIK, 17.$5 L7'PT7.F, NECK RO., NYT#8, (IU't'CNOC,UE, N. Y. in ehefdloreing location; ®Bosement ? !x[ FI. ? Ynd Fl. OUT .Sertiun Block Lot AUGUST 26,1991 rues examined on and found to 6e in cumplianrr reith the reyuiremenrs of this Ruord. - q%TUEE RXTURES RANGES COOKING DECKS OVENS DISH WASNlRf lXNAUST fAN1 OUTURS 11C1E5 SWITCNES INGNOESCENT RUGIIFSCEN7 OTNEP AMT. K. W. AMT. K. W. AMi. K.W. AMT. K. W. AMT. M. P. E DRYERS RJRNACE MOTORS RJTUM AMIIANd 1lEDERS 5?ECIAI RIC'~T TIMl CLOCKS Yll UNIT NlATERf fK1~ElA ~ DIMMERS AMT. K. W. Oll N. I. GAS N. P. AMT. Na. A. W. G. AMT. AMI. AMT. AMPS. TEANS. AMT. M. P. ~ 01 IEET AMT. WATTS SERVIC! DISCONNECT NO.Oi S E R V I C E AMi. AMI. TYPE 1 / tW I / tW ] A' JW ] / AW ffK dCOND. OE CC. COND. a NI-LEG ~ ~ HI NO. W NEUTKAIS Of ~NEUTR~L i 1 ?.00 CB ] X 7 2/(t I 7.ju oTNER AnAUrus: SERVICE ONLY-1 i r r==== SAGF. & 7,A0ENANN INC. LTC.#3635F. , P.O.BOX 1768 SOUTHQLD, NX, 7.7.971 OENRAE 17 I'. Per This certificate mUSt not M ahertd in any manner; rNurn to tha offits of fha Ibard if incorrect. Inspectors may bs identifi by their credentials. ~k C dUl IMG DEPARTMEEf`lT. THIS COPY OP CERtiFN:A~ ~Bf ALTERED IN At1Y NTAIi~ THE NEW YORK BOARD OF FIRE UNDERWRITERS wnrr: ' ~ 11951.12 BUREAU OF ELECTRICITY BS JOHN STREET, NEW YORK, NEW YORK 10038 ~ SEPTF;MBF.R 09,199.1 Application No. on file 704442.90/90 N 20?.95 i ~ THIS CERTIFIES THAT only the slectrleel equipment as olescrihed 6ebts and in[roduced by the appUcont named on the otiose opplieetion numher in the promises of RUNAlID GARSIN, 4'd,H f,1TTLF; NF;CK ROAD, CO'CC.HOGtlF;, N. Y. 1st Fl. ? Ynd P'I. Section Block Lat 1F' in ehefdloteinp locations ~ Basement 01)7' Teas examined un AUGUST 26 , 1,997. ondfound to he in complipncr with the reyuirementx of this Buard.. gxTUtl RXTURES RANGES COOKItEO DECKS OVENS DISH WASHERS EXHAUST FANS OLtrIeTS AC16 SWITCHES INGNDESCENT flUGI1FSC[NT OTHER AMT. K. W. AMT. K. W. AMi. K.W. AMi. K. W. AMT. X. P. it 13 20 12 13 1'' - DRYERS FURNACE MOTORS FUiIME AFKIANC! REDERS SFECIAI REC"?T TIME CLOCKS EEII UNIT NEATlRS IAUtiI-0UiIET DIMMERS AMT. K. W. Oll N. I. GAS N. I. AMT. NO. A. W. G. AMi. AMI. AMT. AMPS. TRANS. AMT. N. I. ~ ~T AMT. WAilS f t ?.0 SERVICE DISCONNECT NO.OF S E R V I C E AMi. AMI. Tn! ~ 1 / TM 1 / ]W ] A ]W 3 / AW ~R % ~D. Of CC. COND. NO. Of NI.LEG a'H '~G NO. Or NENRAl4 Of NFViMI OiNER AMARATUS: F,T,F,C. ROOM HFATF,R5:1-1.5 K.fi. PANSTIBOAADS:7-16 r7A. 700 - G.F.C.I:-3 / SAGE & C,ADRMANN 'TNC. LTC.~3635F ~ l P.O.BOX 7768 SOUTHOTd), NY, 1.1.977. OEIIIRAI RLANAOR 7 7 / ° Per This cerfificaM must not bs alNrsd in any manner; return to the office of the Boord if incorrod. Inspectors may be idemifiad br fheir,_tredentials. D AR I - - INSPECTORS Victor Lessard O gQFFO(,~- Pnnctpai Butidmg Inspector Cp Curtis Horton tiZ' Oy SCOTT L. HARRIS, Supervisor Sensor Butldmg Inspector y = Southold Town Hall Thomas Fisher P.O. Box 1179, 53095 Matn Road Butldmg Inspector ~ • d 0! Southold, New York 11971 ButGdmg Inspector ~~l * Fax (516) 765-1823 Telephone (516) 765-1800 Vincent R. Wieczorek Ordinance Inspector Robert Fisher Assistant Ftre Inspector OFFICE OF BUILDING INSPECTOR Telephone (516) 765-1802 TOWN OF SOUTHOLD August 14, 1991 Ronald & Patricia Garsik Box 302 New Suffolk, N.Y. 11956 To Whom This May Concern: We are unable to complete your Certificate of Occupancy because of the following reasons: XX An application for Certificate of Occupancy is not on file. (Enclosed) XX No Underwriters Certificate on file.°~• ~~ialq ~ XX The check is (~/not on file.}$25.00 No Health Department Approval on file. No final inspection has been made. XX No Plumber Solder Certificate on file. (All permits involving plumbing being issued after April 1, 1984). BUILDING PERMIT # 17936-Z Please contact our office on this matter. Thank you for cooperation. SOUTHOLD TOWN BUILDING DEPT. :1~"3LD 1:•~.GU.~U:J ~~U'nl:E ~i;c`1MCNTS 7 . Y' F OUIJDATION , (1~dt) ` FOUtdDATION (2nd) 2. „ P,OUGH FRAME & PLUMBING 3. / ~ IJJSULATIO~J PER N. Y. STATE ENERGY CODE FIifAL ADDITIONAL COMMENTS: T65-1802 BUILDING DEPT. INSPECTIaN [ ]FOUNDATION 1ST ( ] ROUGH PLBG. [ ]FOUNDATION 2ND [ ]INSULATION [ ]FRAMING INAL REMARKS: ~ C DATE INSPECTOR i~ a01,03dSN1 p ~ 31tla a ~ ~s~latlw3a ltlNl~ [ ) 'JNIWtla~ [ 7 NOI1tllnSN aNZ NOI1tlaNAOd [ 7 'JBId HJAOa [ ] 1ST NOI1tlaNA0~ [ 7 - NOI1~~dSN i •ld3a aNlallns zost-s9,c ~~~L' 765-1802 BUILDING DEPT. INSPECTION [ ]FOUNDATION 1ST ~ J ROUGH PLBG, FOUNDATION 2ND [ ]INSULATION [ ]FRAMING [ ]FINAL REMARKS: ~!~~~/?!vs,~(' P~~ DATE ~ INSPECTORS 765-1802 BUILDING DEPT. NSPECTIC~N FOUNDATION 1ST ( ] ROUGH PLBG. [ ) FOUNDATION 2ND [ ]INSULATION [ ]FRAMING ( ]FINAL REM RKS: /~s~~.-~,J~ DATE _ A INSPECTOR .,nf BOARD OF HEALTH 3 SETS OF PLANS • FORM NO 1 SURVEY _ f~. TOWN OF SOUTHOLD CHECK • • • - - .11- • - BUILDING DEPARTMENT SEPTIC FORM TOWN HALL NOTIFY , vOUTHOLD, N Y 11971 CALL - •'~Lr`~~ • - nn TEL.: 765.1802 / MAIL T0: Examined ~ R1-~?!~. ~ . , 19~~ _ ~s (~(J Approved ~ ~tXn . ~ , 19?~7 Permit No ~?9 3~~ . ~ ~ ~ v Disapproved a/c 1 his h~ i 7 i~S . ~ ~ BLDG. DEPT. TOWN OF SOUTHOLD (Building Inspector) APPLICATION FOR BUILDING PERMIT Date . , 19 . INSTRUCTIONS a. This apphcahon must be completely filled in by typewriter or m 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 stye. nor areas, and giving a detailed descuptron of layout of property must be drawn on the diagtaitt which is part of this app canon c. The work covered by this application may not be commenced before issuance of Building Permit. d Upon approval of this apphcatton, the Building Inspector will issued a Building Permit to the applicant Such perri shall be kept on the premises available for inspection throughout the work e. No building shall be occupied or used m whole or m pazt for any purpose whatever until a Certificate of Occupan~ shall have been granted by the Building Inspector. APPLICATION IS HEREBY MADE to the Butldmg Depaztment for the issuance of a Bwldmg Permtt pursuant to t. Building Zone Ordinance of the Town of Southold, Suffolk County, New York, and other applicable Lary , rdinances Regulations, for the construction of butldmgs, additions or alterations, or for removal or demolitroi~ as herein describe The applicant agrees to comply with all applicable laws, ordinances, build e, code a~n regulatio s, and admit authorized inspectors on premtses and in building for necessary mspe tin . (Signature of applicant, or nam if a corporation) l185 Ll~t.~. I~~~G ~o~ ~,T.~a (Mailing address of applicant) State whether applicant is owner, lessee, agent, azchttect, engineer, general contractor, electrician, plumber or butlde Name of owner of premtses ~Ql~l1'71.l3J 'N ~-{l.) Gr7 `-'T~`°'~i~ . (as on the tar roll or latest deed) If applicant is a corporation, signature of duly authorized officer (Name and title of corporate officer) ALL CONTRACTOR'S MUST_ BE ~S,IIFFOLR COUNTY LICENSED Builder's License No Plumber's License No //Sl l i l l~ Elec,tncian's License No 3~3SE Other Trade's License No 1 Location of land on which proposed work will be done . . House Number (~~j Street f~ ai let County Tax Map No 1000 Section -1 r Block C..1 Lot . I . Subdivtswn Filed Map No Lot (Name) 2 State existing use and occupancy of pr~em!nises and in'' tAAended use and occupancy of proposed construction a Existing use and occupancy r(~ArtM ~ ~.v? , I~iJC~ , . . b. Intended use and occupancy S.~['7 ~ ~ • • • • . - . 3. Nature of work (check which applicable) New Building Addition . . AlteraUOn v . . Repair . , Removal . , . Demolition .Other 1Vork . . . J I( (Descnplion) 4. Estimated Cost .~5. QQQ ~ ~D7 O~Q , Fee . ~`F~C'I a . ` (to be paid on filing this application) 5. If dwelling, number of dwelling units,, ~ Number of dwelling units on each floor If garage, number of cars ~ . 6 If business, commercial or mixed occupancy, specify nat~rre and extent of easJl,t~ype of use ~ . . 7. Dimensions of existing structures, if any Front ~J.~ .Rear ~~7~~ Depth .eCy . Height Number of Stones ~h ~ y Dunensions f dine structure with alterations or addrtiolns Front t.?. Rear C-rV . . Depth .'i. Height 3)y Numb~of~tones . ~ r. 8 Dmien ions of entue new constructron~ Front P. Rear . Depth . Heigh . Number of Stones . 9 Srze of of Front ~ Rear ..~iJ~ . Depth 10 Date of Purchase Jr I~Q~ ~7 ..,Name of Former Owner Sy"~. +L~~ . . 11 Zone or use distnct m which premises are situated *f„C.1~i~Y11,F,1,L,. . . 12 Does proposed construction violate any zoning law, ordinance or regulation NQ . . 13. Will lot be regraded /1rD .Will excess fill be removed from premises• Ye No 14 Name of Owner of pr ices ta` f}~,$IIG ..Address . ~cS"~r"fC.. ...Phone No .~i .Y'S.~os~ Name of Architect ~1.?A>~ ~s1R'i~~ .....Address ls>~.~~Od'T~. Phone No. . Nance of Contractor . S . , , , , , , ..Address ....Phone No.....ff . . 15. Is this property located within 300 feet of a tggiuudal wetland? *Yes No . Y.. *If yes, Southold Town Trustees Permi.tPLO~DIAGKAMed. Locate clearly and distinctly all buildings, whether existing or proposed, and indicate all set-back dunensions from property fines Give street and block number or descnption according to deed, and show street names and indicate whether intenor or corner lot. Sew ~~1~ ~~J~. ~ STATE OF NEW YORK, S S COLNTY OF being duly sworn, deposes and says that he is the applicant (Name of individual signing contract) above named He is the . . (Contractor, agent, corporate officer, etc ) of said owner or owners, and is duly authonzed to perform or have performed the said work and to make and file ttus application, that all statements contained m this application are true to the best of his knowledge and belief; and that the work will be performed in the manner set forth in the application filed therewith Sworn to before me this 1p/ ..da~y/of . ~!~4~t..!. , 19 ~/u. Notary Public, ~-i~.ti/.. l1 :.~1.!' 4!~-.... County HELENKBEVOE (Signature of applicant) NOTARY PUBLIC, State at New YaN Na 4767878, Sultelk CouniY Term frzpves Akrch 34,1V _ _ _ _ _ _._..__.__._._______.._____~..___-__._..r_._.___..~_ 1 , ~ i f~, j ~ j ' • C'i l - ~ 4 ' ' ~ 1 I*~ 1 ~ _ _ _ _ _ y j 3 {i ~ ~ ' 47 I (e _ - ~ J 1, it 1 ~ ~r ~ i z~ ~ t.~ N ~ ~ ,ii oo ~ ~ j ~ mo a~ j o ~ so ,o 0 N N ~ W1 f~ .9 ft..r R,ip.. . 'r-= 1 i . i ~ I i i SAAURVE YEU r-~k~ rUat:.a r:<~e~. rn Tr,_ TifIE C7VC1.•rn•i::r ::c~. ffI i a ~'1 ~i^ _..H~~~_It~,a~...`~ l * tc>+F~r. »4t~~Irr~IcJ 'i;w~::pr.L{Q~•k a,+ 1 f i