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HomeMy WebLinkAbout17945-z ' - FORM N0. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Ha11 Southold, N.Y. CERTIFICATE OF OCCUPANCY No Z-19517 Date NOVEMBER 19, 1490 THIS CERTIFIES that the building ALTERATION Location of Property 155 GOLDIN LANE SOUTHOLD, NEW YORK House No. Street Hamlet County Tax Map No. 1000 Section 135 Block 2 Lot I6 Subdivision F11ed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated MARCH 19, 1989 pursuant to which Building Permit No. 17945-Z dated MARCH 23, 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 ALTERATION TO EXISTING SEASONAL ONE FAMILY DWELLING (NON-HEATED) AS APPLIED FOR. The certificate is Issued to FRANCES ADAMOWICZ (owner) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A UNDERWRITERS CERTIFICATE NO. N-139254 - JULY 5, 1990 PLUMBERS CERTIFICATION DATED 9/28(90-PERFECTION PLUMBING & HEATING Building Inspector Rev. 1/81 1fOEM NO. ~ TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N. Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTlL FULL COMPLETION OF THE WORK AUTHORIZED) c No 017945 Z Date 19...~/ Permission is hereby granted tp. , 7. . P. . f'. ~ . ~ l . . 5,.~ ............:..73 to .~v-~,~~ ..~.,~''..~.~`'`'°,~.Y~..~...... ~~~3 ct premises located at ....,lk:l.Y.......~~li/.J...... . County Tax Map No. 1000 Section . Block Lot No ...~~E?......... pursuant to application dated :3~!,/. ,1~ 19~~, and approved by the Budding Inspector. ~ Pee S • ildin for Rev 6/30/80 TEL. 76s-1802 o~oS~FF~~~~o~ TOWN OF S(~tJ'TIIOd.D " , .c OFFICE OF BUILDIPIG INSPECTOR ;T P.O. BOX 728 'r' TOWN HALL D ~ O~~ ~ ~ SOUTHULD, N.Y. 11971 "~41 SEP 2 g 199Q ~,~e F3LDG 'JEPT 4 S 7GV1+N OF SQUTNULD t C E R T I F I C A T I O N Date g/o~-~/9a Building Permit No. O~79yS~ Owner~i9sVc'c.S f~! ~yy~Dw~C ~ ~(pnlease print) j P 1 umb e r /C! fiEC~o~r j~/V +Vi,G~ `ti(~'i?-TiAIq (please print) •J I certify that the solder used in the water supply system contains less than 2/10 of 1~ lead. (plumber's signature) Sworn to before me this day of ~g~. 14~. Notary Public 12otary Public, County HELEN K DE 40E ~R470187& Su~}lolk C~a~~ Tam Expires M:nh 30.18 1.0.c~' Z/~...IJ~~ K}f~{.. `"_tl • Form No. 6 ~fis- S 7 5 3 Sden~- TOWN OF SOOTHOLD • BUILDING DEPARTMENT ~ ~1 TOWN HALL 7b5-1802 O• APPLICATION FOR CERTIFICATE OF OCCUPANCY ' .1. This application must be filled in by typewriter OR ink and submitted to the bviiding inspector with the following: for new building or new use: 1. Final survey of property with accurate location of all buil~ngs, property lines, streets, and unusual natural or topographic features. 2. Final Approval from Health Dept. of water supply and sewerag -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~gystem contains ~ less than 2/10 of lz lead. ~ Commercial building, industrial building, multiple residences and similar buildings and installations, a certificate of Code Compliance from architect or engineer responsible for the bua.Iding. 6. Submat Planning Board Approval of completed site plan requiremepts. B. For existing buildings (prior to April 9> 1957) non-conforming users or buildings and "pre-existing" land uses: ' 1. Accurate survey of property showang all property lines, streets, building and , unusual natural or topographic features. 2. A properly completed application and a consent to inspect signed by tH'e 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 $25.00, Additions to dwelling $25.00, Alterations to dwelling $25.00, Swimmang pool $25.OD, Accessory building $25.00, 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 - $5.00 over 5 years - $10.00 4. Upua[ed Certificate of Occupancy - $50.00 , 5, Temporary Certificate of Occupancy - Residential $15.00, Commercial $15.00 Date ::ew Construction........... Old Or Pre/-e~x~,i~s~t/ping Bulilndi~n/g Location of Property.......+~:5.~...5-t`':::i~:~W. ^Y1!':E,.....:~dvl:C~y,'~"'~ ~U l~~/ House No. Gp Street Hamlet Onwer or Owners of Property.....<.17~//~~r.ES.....~~~~~71L+.~ County Tax Map No 1000, Section...l.~~...Block.......°.`:......Lot....~~ Subdivision..........,q.y.~ ...................I...).Fiqled Map............Lot...................... Permit N~~~.'~~~~~'"~-~,/j~1J?.Date Of Permit..Jl~~J.~.L.....Applicant {tealth Dept. Approval ..........................Underwriters Approval...................... i Planning Board Approval Request for: ,Temporary Certificate.........,. Final Certicate........... Fee Submitted: (~p,C,, ~ bg(S'f APPLICANT ~ ' . o~~SUFFO(,S-BOG y~ 0 Town Hall, 53095 Mam Road ~ ~ Fax (516) 765-1523 P O Sox 1179 ~ Telephone (516) 765-1802 Southold, New York 11971 ~Ql ~ BUILDING DEPARTMENT TOWN OF 50UTHOLD Tune 14, 1999 Frances Adamowlcz 155 Goldln Avenue Southold, NY 11971 To Whom It May Concern Please be advised that as of the date a Certificate of Occupancy is issued after all violarions have been remedied Regards, Edward Forrester Director, Code Enforcement It11t4yAf(131L/1~:}li..1 NIklHiii1gN11b314NiNitil7NiSY NINiMMUfl1A~i1i6ii4iMiltlR) 7ii•NEINNI1INt' 7 o A 4a ys 1 G y m hlp k A Z ~ N S n N N T C O ~ m (i O C a m x cy c 3 S t~ p - A~ U 4 G a 'C x~ 9 T O N _.m z - ~ m ~ T ? E y~ T T ^ ~ m ` c m ~ C `x ~ O y~ m ~ £ ~ > n m ~ ~5. Z c ID o y = a A -Njm -d c F m o v ~ ro mC W Z O S o £ A n c G a ~ ZC .p ~ zn Ll ~n y F ~ P m O O Ak ~n I11 9 3 0.T.. a ~ G ~ O v -N a ~ = ~ ~ 5 jm .Ti O ~ p ~ ~c N } n T ~ v na A 9 y E c' A z-1 ~ $ =Fad o a< ~ ~ ~g ~ a ^p< rn R ~ b -~c ~ a '.x C p N n m ~i S Q ~ m ~O z o R Z - t $ m 1` 2 m y y Y~ y 'f ~O ~ ~ m ~ - m N rl tr ^ x ~>i £ j c a ~ 1 m n a 4 c 7 o~ - g m o~3 ~ z a m Z m ~ o oUT s x' o- ~ ~ a. T'O n a W m a ~ z ;y = c n 3~ ~ c m'^ E ~ R 3 s D ~ i _ ~ ~ N it ~ ~ ~ " ~ K ~ U Z n ~ H ~ G S h A o. ~ Q's _ 3 c ~ 3 ~ m ~ rt v cy N 9 s ` N r.,. . Oc~urr ~~C~ VICTOR LESSARD ~ r Town Hall, 53095 Mem Road PRINCIPAL BUILDING INSPECTOR ~ ~ P.O Box 1 179 (516) 765-1802 `Z Southold, New York 11971 FAX (516) 765-1823 &VO ~.p~' ql 1 .J. OFFICE OF BUILDING INSPECTOR TOWN OF SOUTHOLD March 13, 1989 Frances Adamowicz 58-53 77th P1. Elmhurst, N.Y. 11373 Dear Mr. Adamowicz: In order to process your Building Permit application for alteration to your seasonal one family dwelling, we need more information on the window changes and interior alterations. Also the type of heating to be installed if any. Yours truly, G~`~ <c_===~~d'G Thomas J. Fi er TJF:hkd Building Inspector 4 TOSVN OF SOUTIiOLD BUILDING DEPARTMENT SOUTFiOLD, NEW YORK STOP WORK ORDER TO: FRANCES ADAMOWICZ Owner, Owner's Agent or Person Pertorming Work 58-53 77th Place Elmhurst, NY 11373 Ad ress o above-named person YOU ARE HEREBY NOTIFIED TO SUSPEND ALL WORK AT: I55 Goldin Avenue, Southold, N.Y. Address where work is to a stopped TAX MAP NUMBER 1000-135-2-16 Pursuant to section 100- 14 1 of the Code of the Town of Southold, New York you are notified to immediately suspend all work and buildrng activities until this order has been rescinded. BASIS OF STOP WORK ORDER: Doing alteration work without a building permit. CONDITIONS UNDER WHICH WORK MAY BE RESUMED: When a building permit has been issued by the Building Inspector. Failure to remedy the conditions aforesaid and to comply with the applicable provisions of law may constitute an offense punishable by Eine or imprisonment or both. DATED: January 29, 1989 ~ ~`~f~a~~ BUILDING [NSPECTOR / C E ENFORCESIENT OFFICER Vincent R. Wreczorek . 1 i ~ t~~~-~ 765-1802 BUILDING DEPT. INSPECTION [ ]FOUNDATION 1ST [ ] ROUGH PLBG. [ ]FOUNDATION 2ND [ ]INSULATION [ ]FRAMING [~INAL REMARKS: ©r , ~d L- nC © .,q__ DATE L (o ,QINSPECTOR l{O 1 ~ ` 765-1802 BUILDING DEPT. 1 NSPECTION [ ]FOUNDATION 1ST ( ] ROUGH PLBG. ( ] FOUNDATION 2ND ( ] 1 ULATION [ ]FRAMING ( FINAL REMARKS: ~ ~ t- Co DATE ~ T INSPECTOR 7 ~ ' 765-1802 BUILDING DEPT. INSPECTION [ ]FOUNDATION 1ST ( ] RO GH PLBG. ( ] FOUNDATION 2ND ~ INSULATION [ ]FRAMING n[ ]FINAL ll REMARKS: G'1z- '-TI DATE r~f INSPECTOR 765-1802 BUILDING DEPT. INSPECTION [ ]FOUNDATION i5T [ ) ROUGH PLBG. [ ] FOUNDATION 2ND ~ ~ INSULATION [ ~ FRAMING [ INAL REMARKS: ` _ DATE INSPECTOR sue! ' 765-1802 19~~ BUILDING DEPT. / INSPECTION [ ]FOUNDATION 1ST [ ~OUGH PLBG. [ ] FOUNDATION 2ND [ ]INSULATION FRAMING ~ [ ]FINAL REMARKS: `-F,~_ " - CJ-K.iz s-- DATE ~ INSPECTOR T65-1802 7 ~ C~~~~ BUILDING DEPT. 1~ INSPECTION ~ _ [ ]FOUNDATION 1ST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ]INSULATION [ ] FRAMIN~ ~ [ ] FINFINiZ~ B RE ARKS: ~C - _ _ - DATE INSPECT -ldLD ILS:c...iV:+ ~~U;,TE ~ OOMMLNT° .a 7: m _a ~ y H H\ FOUtJDAT2077 (1st) c =OUNDATIOt7 (2nd} m / ~ z 0 ROUGH FRAME & < PLUMBING ~ - v' 3. ~ m n IIJSULATIOPJ PER N. Y. STATE ENERGY ~ CODE _ a 4. ~ y ~ FIidAL 7 o ADDITIOPIAL COMMENTS: x ~Qo- yt~, C Q- x~ H • a~ H ~ H O V r `m c^ _ H Z b m H o~~FFn~r~o VICTOR LESSARD ~ L Town Hall, 53095 lddtn Road PRINCB'AL BUILDING INSPECTOR ~ ~ P.O Box 1 179 (516) 765-1802 ~ Southold, New York 1 1971 FAX (516) 765-1823 yO"~[/ ~~0~ 1 D ~ - ~ c:. OFFICE OF BUILDING INSPECTOR TOWN OF SOUTHOLD ~ ' 7 (J March 13, 1989 TOWN OFSO(1~TF Frances Adamowicz 58-53 77th Pl. Elmhurst, N.Y. 11373 Dear Mr. Adamowicz: In order to process your Building Permit application for alteration to your seasonal one family dwelling, we need more information on the window changes and interior alterations. Also the type of heating to be installed if any. Yours truly, Thomas J//. Fi er TJF:hkd Building Inspector ~3-1~5 ~}s Od,2 %~Phoni~ LD/?uF~S~o~? o~r~y~ ~Necntc=0 ~G~95E ~NO /ny C'a,~/ oFPLHnIS G'r? /~/fficfl ~ ffi9>!E / j~niaE,o //j7P,Pau~iij~~, 7rfi~,?r~s yo~~ /71ss,sT,~~ yoU~s Tay is B~ 3~r N~ w \ ~r Orr E trt2~5 ~o 5 p1 88 ~ r N 18 ES OD p~K ~ . 2t 4• 'p Iri Wj ~ ~ / 1 4T~AcY a j8~ 3j_ ~ i~ IaAM L ~ Z,~(( 7~ ~ ro .fi;5r O V.~ ~ ~ ' gE a \ ~ J N 1 <i~ q~qF. ~ ~ 3 ~ 1 Z ink Ir V' fr fRP~,~ 9 ~ Oar 5~ 0 = SKEC ~3 Ry?' 88 4 r CJ 'z ~g9~ ;p a, • R qa E \ i ~5 ~ tJ oZs \ X16 \ \ $1 k PQ l~~ PrepureJ In ncordanre with me minL+~rr n0 ranixis rcr 1'!le survoys ac esfabllrtei C'~ 7}~ 'ho (lA.i.S, and u//rc +ei and adap red rcr such use Ly the rleH YcrA Fora r rnd Tr11s ,assocla Non l o SURVEY OF Z O T,~' r7 & 18 SUBDIVISION OF PROPER T Y OWNED BY CERTIFIED TOr NA THAN G OL DlN T~TLUE INO S T96B666UARANTY COMPANY FILED NOV 22, 1932F1LE NO 1106 FRANCES ADAMOWICZ A T SOUTHOL D SHERYL ADAMOWICZ TOWN OF SOU~HOL D SUFFOLK COUNTY, N. Y. ~ea~-aM°rc.9 1000 - 135 - 02 - 16 Uw2oy~e~ ~FCti~,".c Scale 1" = 30' ~ ' ~ IIY S. LlC. NO. 496 June 1, 1988 ~ o, R~ aY fRS, P. C. / - 5 M Fen 6$ -l SC L . Y. 119 i1 B8 - 352 BOARD OF HE.ILTH 3 SETS O~L<1N5 FORM NO. 7 SURVEY TOWN OF SOUTHOLD CHECK ~.h2~.7-Z....... . BUILDING DEPARTMENT SEPTIC FORM • TOWN HALL EOUTHOLD,NY 11971 NOTIFY TEL.. 7651802 CALL o~ MAIL T0: Examined ?`J • • . • , 19 \PProved 1f3~ Permit No~o~S.``~~ ~ ~ ~ O U ~ {l Disapproved aJc ~7. ~ I{!j . . . . ~L F3LOG O~rT 4 T T41't'N OF•_e,. ~,,,i7:ST`Sbi p ~~..,a ~Q d nspector) G/f~j p~o.~ / A IC ION OR BUILDING PERA/IIT M Date /~//~K^C.lf.:~:., I5 INSTRUCTIONS a Tlus apphcatton must be completely filled m by typewriter or to ink and submitted to the BuAdmg Inspector, with sets of plans, accurate plot plan to scale. Fee according to schedule. b. Plot plan sho`vmg location of lot and of bwldmgs on premtses, reiattonshtp to adlotnmg premises 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 app ca4on. c. The work covered by t}us apphcatton may not be commenced before issuance of Building Permit. d. Upon approval of tlus apphcatton, the Building Inspector will issued a Buildutg Petmrt to the applicant. Such pe u shall be kept on the premtses available for inspection throughout the work. e. No building shall be occupied or used an whole or to part for any purpose whatever unto a Certificate of Occupan~ shall have been granted by the Building Inspector APPLICATION IS HEREBY MADE to the Building Department for the tssuance of a Building Permtt pursuant to ti Butldtng Zone Ordinance of the Town of Southold, Suffolk County, New York, and other applicable Laws, Ordinances Regulations, for the construction of buildings, additions or alterations, or for removal or dcmolttton, as herein describe The applicant agrees to comply with all appiicatile laws, ordinances, budding code, houstn~ code, and regulations, and admit authorized inspectors on premtses and m building for necessary mspecttorys. ~'4G . (Signature of applicant, or name, tf a Corp ton) ,Sg _.S3 •~7 PL.~• ~unrrur~sT /f~. 11373• (Mailing address of appltcant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builde QcJn/,E~ ~j~ ;Jame of owner of premtses .1~~7~C~5 . /!.~~/~D[tllC Z , . (as on the tax roll or latest deed) If appitcant is a corporation, signature of duly authorized officer . (Name and title of corporate officer) Builder's License No . . Plumber's License No . . Electrician's License No. /~~u~.,l3.r~,~~!s #O?~c?-~ Other Trade's License No. l.1D~Ei2T. ~p~l?.~ 7S~lN 1. Location of land on winch proposed work will be done . . I S~ . . ~au1/i~. f~u~~d~~ .........~a!~!~? ...l!fY. //9~I.... . House Number Strcet Hamlet ~ / County Tar St.tp Nno~/10~00 Section ...,,.(~~.f`~. • Block Lot . Subdivision /~~~Y .~Q~!'"• . Filed 1<tap No. ~I ~G.... Lot . ~ .I . (Name) 2. State existing use and occupancy of premises andCinten~ded use end occupancy of proposed construction a. Existing use and occupancy ~/~~!-f-. IImI L~ ~~'i,~y............. b. Intended use and occupancy • • • • • • • • . , _ . 3. Nature of work (check hich applicable) New Budding , , . Addition Alteration . Repair ........~f Removal . . Demolition .Other 1Vork . CLEFYn(-GfP, /CE~forlH7E t/rlUl.+E~/~!I'?-E ~XIST/tlG ,~U/GO/itlG (Dcscnpuon 4. Estimated Cost ~'lQC, OC. Fee ..........?.(it<(~'.Q.............. . ([o be paid on Fling this apphcaUOn) 5. If dwelling, number oC dwelling units Number of dwelling units on each t7oor . . If garage,numbcrofcars 6. IC business, commercial or mired occupancy, specify nature and extent of each type of use . 7. Dimensions of existing structures, if any Front .Rear pth e Height ...............NumberofStones Dimensioryspf name ~,~~cture with alterations or additions Front Rear , , , . Depth Height Number of Stones . 8. Dimensions of entire necv construction. Front . Rear Depth Height Number of Stones . . 9. Size of lot Front Rear De,pSh . 10. Date of Purchase ........Name of Former Owner ~'Bt~C1nfE . ~K~TG , . 11 Zone or use district in which premises are situated . 12. Does proposed construction violate any zoning law, ordinance or regulation• . 13. 1Vi11 lot be regraded 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 ........Address ...................Phone No . IS.Is this property located within X00 feet of a tidal wetland? *YES....NO.S".. *If yes, Southold Towa Trustees Permit may be required. PLOT DIAGRA14f Locate clearly and distinctly all buildings, whether existing or proposed, and. indicate atl set-back dunensions fro property lines. Give street and block number or descnphon according to deed, and show street names and indicate wheth intenor or corner lot. STATE OF NE1V YORk, S S COUNTY OF ~~(J~S ! ~~1~m4~%~~~ 2--.... being duly sworn, deposes and says that he is the applica (Name of individual signing contract) above named He is the . Qu~i1fE~ . . (Contractor, agent, corporate officer, etc.) of said owner or owners, and is duly autlionzcd to perform or have performed the said work and to make and file ti application, that all statements contained m this application arc true to the best of his knowledge and belief; and that t work will be performed m Ute manner set forth m the appticauon filed therewith. Sworn to before me this . day of ;~fti~C/f...., 19 Votary Public, ....~,~..~~~E~~~~-.-4'~~-G.li.'7~?Lat.''~.~1(.. County ~ ~~Mp, yhte of New York i 1N.44-ABt1724 .ur,puwnsco~„« vLi (Si;nature phca 1gt~imWlen 6pns Nov 2, is_°-f