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Home My WebLink About17500-zt FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No Z-18455 Date OCTOBER 11, 1989 THIS CERTIFIES that the building ADDITION Location of Property 1075 INLET ROAD GREENPORT N.Y. House No. Street Hamlet County Tax Map No. 1000 Section 036 Block 02 Lot 21 Subdivision Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated OCTOBER 3, 1988 pursuant to which Building Permit No. 17500-Z dated OCTOBER 4 1988 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 ADDITION_TO EXISTING.ONE FAMILY DWELLING AS APPLIED FOR. The certificate is issued to MARIA GRZESIK (owner) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A UNDERWRITERS CERTIFICATE N0. N-081636-JULY 19 1989 PLUMBERS CERTIFICATION DATED N/A ~~ Bu lding Inspector Rev. 1/81 r~oaaz xa 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 ~ Q ~. 7 ~ Q Q Z Date ...~..~~-~!v.4....... ~ .................. 19 f~..,g Permission is hereby granted to: ~o.~,(~ ......~S~r!:~.....X11..~/..~ ....~-cam :................ .... ,A4,...~..$..~~ (VJ .....C~ ..........-..~.:.y..:....r.1.9..~.~f... ~: , to ..~~ :a'^-~a.M. ,,~.,!"....4rh..... .. ...~4....4. irr.,....,Qi~~-A.r.W..a.~ ..Q.~.k.:.... .. at premises4~at ...~ ~.~...Q?"ix-4~ ~?~-~. ~ .................................. ................................................................................................................................................................ ................................................................................................................................................................ County Tax Map No. 1000 Section .....Q..~~n-~P........ Block .....C'a.,~,:....... Lot No...+~: ~ ................ pursuant to application dated ...l~J..~l~-?~R.t.......~~ ................... 19.~.~., and opproved by the Building Inspector. fee $..4~. u.:..'~..... .. .... . /~ ~~. .....a- :................ Bui ding Inspector Rev. 6/30/80 i.• TOWN OF BUILDING TOWN SOUTIIOLD 765 SOUTIIOLD DEPART?LENT HALL NEW Y0I2K ! 1971 1802 APPLICATION FOR CERTIFICATE OF OCCIIPANCY . DATE ~G~./.:~~,zS,~... i NEW CONSTRUCTION .......OLD OR PRE-E%ISTING BUILDING_..._.VACANT LAND..._.... y- Location of Property.../C~7.~...:......~~~~~...4_[~<.(nc'a<f~.l~/,~~~2•v/nrrRC', :. HOUSE N0. STREET UAMLET / Ovner or Ovvers of Property..!Lf~~~~F~~:~.Q~~S//~ .................... County Taa Map No. 1000 Section~3~¢;~BLock ~..... Lot" 2 /..... Subdivision....._.._.. _... Filed Map ........Lot. ry ~,a~/, ./.'/J 1 G~'.G Permit No. 0~ (~~~Qpgate of Permit O~/,.o: ~~Applicant .. Health DepC. Approval ................. Planning Board Approval ................ Underwriters Approval/Y _~,$16.,3~ ,.. Request for Temporary Certificate ._..... Final Certificate Fee Submitted: ~f ~ 1 APPLICANT.~i::t.~!~'~; .,. ... ._.-.'• rev• 10/14/88 ~~.3g~rao C 0 ~ IB~IS$ I: J ~~ '' FORM N0. 6 .• ~~ ~?~~ ....' ~ TOWN OF SOUTE[OLD ,,, 1 R ,f !~ BUILDING DEPARTMENT ' ~..._, ' TOWN HALL ~ ~...~...F„,., ..- i g,-. -`:fib 765 - 1802 APPLICATION FOR CERTIFICATE OF OCCUPANCY INSTRUCTIONS A. 'This application must bo Filed in typewriter OR ink and submitted to the Building Inspector with the following; for new buildings 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 of Health Dept. of water supply and sewerage-disposal(S-9 form). 3. Approval of electrical installation from Board of Fire Underwriters. 4. Sworn statement fromplumber certifying that solder used in system contains less than 2/10 of IZ lead: 5. Commercial buildings industrial buildings, multiple residences and similar buildings and installations, a certificate of code compliance from the Architect or Engineer responsible for the building, 6. Submit Planning Board Approval of completed site plan requirements. B. For existing 6uildings,,(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, buildings and unusual natural or topographic features. 2. A properly completed`~application, a consent to inspect signed by the applicant and a certified abstract of title issued by a title company which shall show single and separaa[e ownership of the entire lot prior to April 9, 1957, If a Certificate of OFCUpancy is denied, the Building Inspector shall state the reasons therefor in writing to the applicant. 3. Date of any housing code or safety inspection of buildings or premises, or other pertinent information'irequired to prepare a certificate. C. For Vacant Land Certificate of Occupancy: 1. M application for vacant land Certificate of Occupancy shall be submitted, and a certified abstract of title issued by a title company showing single and separate ownership of '', the entire lot prior to April 9, 1957 shall also accompany the application, If a Certificate of Occupancy is denied, the Building Inspector shall state the reasons therefor in writing to the applicant. D• FEES: 1. CERTIFICATE OF OCCUPANCY - New Dwelling $25.00, Additions to Dwelling $25.00, Alteration to Dwelling $25.00, Swimming Pool, $25.00. Accessory building $10.00 Addition to Accessory buildings, $10.00. - Businesses $50.00. 2. Certificate of Occlupancy on pre-existing dwelling - $100.00, 3. Copy of Certificate of Occupancy - $5.00 - over 5 years - $f0.00 4, Vacant Land Certificate of Occupancy - $20,00 5. IIpdated Certificate of Occupancy - $50.00 6, Temporary Certificate of Occupancy - $15.00 I rev, 10/14/38 0~,,, CC~ T0~'N Ur S0UTII0I,d3 OPFiCE OF fSUILDING INSC'ECTOR I'.O. BOX 1 ] 7 9 TOWN HALL SO(J'I'IIOLD, N.Y. 1 1971 October 4, 1984 MARIA GRZESIK P.0. BOR 485 GREENPORT, N.Y 11944 To P7hcm This, May Concern, 4.e are unable ro complete your Certificate of Occupancy because of the follo~~ing reasons. i$ / nn application for Certificate of- Occupancy is ;yot on fil.c. (ENCLOSED) he / DIc7 Undero:riters Certificate on file. /_x/ 'rhe chcc:}: .i:: (~4$a~I9Fi~~X17rv~=~-mn file.) $25.00 /_/ i`:o ltcal.th Dept. Approval on file. /_/ P:o final insl~~ect:ion has been made. Please contact: our office on this matter. Thank you foz your cooperation. Ilu.ildir,g Perm.iY. 1! F3uilcling Dept-. 1 7 5 0 O Z "*k/_/ t!o Plumber ;;older Certificate on file. ( al.l permits involving plumbing being icsucd aft.cr ,1pri.1 1,1984 ) lELD Ii;SP C.iUii ~~llATE ~ OOMMENT° 1 • ~ ~ , .:= -n [~ L I ~ __ ~_ H 1 rOUNDATION (1st) _ _ H ( c FOUNDATION (2nd) _ m ; z. P z O h ROUGH FRAME ~ ~ PLUMBING u ti ~ 3. c~ m IIdSULATI0t1 PER N. Y. .. y STATE ENERGY CODE x a 4. ~~ ~ .-~ ~ r "3 . FIidAL ADDITIONAL COMMENTS: z x . ~. x '~° ~~ H ? 1 H `O H O O Z . ~ r 'L - ~ v m ro H .,: - ~~ , - _~ _.~+ f ~'', ,f -rur~~~~ ~°505tJ~E. 22772 ~ $7 ~ r _. _ T 1 5xan-~ ~, ~ ~~~ i 0 8' _ '~ - r ~ ~ Sd..ATE l? f~p._ __ PQUF D. AGG N. --+g~ ~ :.. ~ 33, r L+~ t -" 71i1'+ ~ b1 -....~._..~_..._~.__.._:r_1....._~__ _~ __._._-. LK.tAND' StJ~t7~i~ ` .:~~f.NY: .~ -~- MAP ~ Pf~CJ ~EC~~T~ Y y_ ___. ~UCZV~Y~; fiQ~Z AT vt~~E!tii-~G~;_ _.__ i r ~ MCI?. (!CM1 M tdr!?t1YR 'S ~ Y'NAIiOn O( ~~. of the New York Sett "i nr,pW +h F s rvav mad not bl8lhlq ~~+` r r , inxed seat a ' .hh~ not re conaiAend Ct J9 f.0y. xn+ 4 5 `h eaon !hall lull r r wY fm +ha eatwt- _ l rr hi! tiF`!3 f SO t't!B 't MPl LI E]PnCY 11IId 1 ~ 1 9 i2..1 bl &On Sn/ + of re at np!nsti- f ere not cansfanhl+• ~-=-~ ~- % ~u n ~. Y, l . ,, '~o~ tidy ~'13~ . ~£F._~k.'t;Ptilti'P~;lf]fX?-D3b•~- C ~~~~ 76.5-1802 BUILDING DEPT. [ ]FOUNDATION 1ST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND (//]INSULATION [)FRAMING [ ]FINAL REMARKS: DATE ~~ ~J INSPECTOR /V ~ ~~s~o rrs-isoz BUILDING DEPT. INSPECTION [ ]FOUNDATION i5T ~ ] ROUGH PLBG. [ ] F UNDATION 2ND [ ]INSULATION [ FRAMING [ ]FINAL REMARKS: ~%~ ~/ DATE ~ ~ ~ g O INSPECTOR - - .. ~~ ~~~ T6S-1802 BUILDING DEPT. [ FOUNDATION 1ST [ } ROUGH PLBG. ]FOUNDATION 2ND [ ]INSULATION [ ]FRAMING [ ]FINAL REMARKS: ~c~~~~ DATE ~ INSPECTOR ,. FORM N0. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N.Y. 11971 TEL.: 765-1802 Examined .Q~.K~. ~ ..., 194. Approved . P:~lr-!^":4 . ~..., 19 ~~. Permit No. ~?.5~ ~. . Disapproved a/c ..................................... .............................. ..I.n.~,iv.'~'...... (Building Inspector) BOARD OF HE~ALTH .~.......... 3 SETS OF~e~.ANS .......... SURVEY ................ CHECK ...................... SEPTIC FORM ................ NOTIFY ~nn ,~A~~ GA~I. ...~ 6`14 .~?' :~^~ . . . MAIL T 0 : ~q~ U..t-Orrn'°^'Z~~VV ~`e~C.~ .Jv}gD.lir~n~'t ~ y - , APPLICATION FOR BUILDING PERMIT 4 INSTRUCTIONS Date ................... 19 .. . a. This application must be completely filled in by typewriter or in ink and submitted to the Building Inspector, with 3 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 streets or areas, and giving a detailed description of layout of property must be drawn on the diagram which is part of this appli- cation. c. The work covered by this application may not be commenced before issuance of Building Permit. d. Upon approval of this application, the Building Inspector will issued a Building Permit to the applicant. Such permit 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 Occupancy 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 Southold, Suffolk County, New York, and other applicable Laws, Ordinances or Regulations, for the construction of buildings, additions or alterations, or for removal or olition, as herein described. The applicant agrees to comply with all applicable laws, ordinances, building code, hou node, and regulations, and to admit authorized inspectors on premises and in building for necesss~ctions. ~ ® ~ ~~ ig ,atu i ap.. art, or. ~, ?f a cerporar+_on).. . • (Mailing addr of applic ) ~~~~ `/C~~ State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber builder. ........... ......... ................................................ Name of owner of premises ... ~~.2. !/L .~`7~ ~ :~.~./. ~ .......................................... . (as on the tax roll or latest deed) If applicant is a corporation, signature of duly authorized officer. (Name and title of corporate officer) Builder's License No. ..~~~ (om8l~z . • Plumber's License No. ..~ns .I/z11~u. SP.!~1..... . Electrician's License No. .r' ................... . a Other Trade's License No. ~rJ:c. C62~•N,~/~,~ w, , /I,~:JS'o.tJ Location of land on which ro osed work will be done. ..~2~e'Q'n' tl2~ 7~n'~~ ufyto r!d •(/< P P ..P.... ~ :..............~....... .................................. House Number Street Hamlet County Tax Map No. 1000 Section ....... a.......... Block ... ~ ............. Lot ..~`.~............. . Subdivision ..................................... Filed Map No. .............. Lot............... (Name) 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use andoccu anc ~W.~~~~ ~.~~ d,,,,,,,,,,,,,,,,,,,, P Y ... ................ s~~u' j~ ~ ~ / ~/~ . ~ /} ~~ Q 7~is!~ ~A~t lltEltt~ .:«9•^sa~ y'Sai,4o?tk b. Intended use and occupancy .. {/ U!l.E........ ... "y~f.'- ............. t,",r';~"t,a~ .:w .... .............. . 4%.}, a_"': udra'ft.S p ~aii ".+, ti},t ..tea. . ar;;~ .. 3. Nature of work (check which aQplicable): New Building .....'..... Addition . ~~.... Alteration ......... . Repair .............. Removal ..... , , , , , , , , , Demolition Other Work .............. . .............. (Description) 4. Estimated Cost ...!`;~C Q',6~ , . .Fee . (to be paid on filing this application) 5. If dwelling, mm~ber of dwelling!units ..../......... Number of dwelling units on each floor ... ~ , , . , , , , , . , , If garage, number of cars .... ! .................................................... . .............. If business, commercial or mixed occupancy, specify nature and extent of each ~ pe of use ....... . . . . . . . . 7. Dimensi nso~~s,cis~¢y s~t~u~sttu~resp•-'f•~fiy: Front .... , ~•4.~ .: , .. Rear ...fir.. , , ...... Depth .. ,x6.~IM -... . Height 1.I ~i~o ~.'.''='d•fi, , i °' ~~m 15 Storks ... ~/, ,>, ...... . Dimensi{it~sipf same structure wit~a~rations or additions: Front ...6. G! , • • • , d' ~ ~ ~ • • • .. .. Rear .. ~ ............. . De th .: .~ ~{~ I p ~~ ~ ~/)~'~r•'"• '~ ` ~ fight .....f. ~.` ............. Number of Stories ....C/..~............. . 8. Dimensi 's pf en new construF ~~; Front ............... Rear ............... Depth Height `::«.,:~».:M 'Stories . ............... 10. Dateofl t: Fr ~r•:i ~~...... Rear ......,r:P~.`......... Depth .09,.~!ya.~/. ~•.... ... • • • • • .......Name of Former Owner ~.......... ' ................. 1. Zone or use district in which premises are situated ....%:~.sy, 12. Does proposed construction violate any zoning law, ordinance or regulation: .. 1{/p.y.Y........... . 3. Will lot be regraded .... au~tK ./.v,~;~,~,/,,, ~, • , • • , , ,Will excess fill be removed from premises: LYE No 14. Name of Owner of premises ../.1A.KRgQ/.(ro,~,e,S,)Q, Address :.~jn-?~~............ Phone No.....1,.. . ........ Name of Architect ......... . . . . . . . .Address .............. , ....Phone No. Name of Contractor ......... , .......Phone No..... • . • • • • • . • • • If es So thold Towrr '•.Address ............ ,,,,,,,;, 15.Is this ro ert loca~,ted within 300 feet of a tidal wetland. YES...'.NO.~' * Y , Trustees Permit may be required. PLOT DIAGRAM Locate clearly and distinctly all' buildings, whether existing or proposed, and, indicate all set-back dimensions from property lines. Give street and block pumber or description according to deed, and show street names and indicate whether interior or corner lot. STATE OF N :~~4'OI3~{r'j r~ $.S ~ O(,' / ~ ~ 2 /(,~ CO c,~'lT•P~ l ' ' ~' • ' ' ' ' • • • • • • • • • • • • • • • . • .... being duly sworn, deposes and says that he is the applicant (Name of indl dual sig g contract) above named. K __ eisthe.........~ .. ....... ..... ......................... ~~~ ' ontractor, a ent, corporate officer, etc.) • • • • • • • of said owner or owners, and is duly, authorize o perform or have performed the said work and to make and file this application; that all statements contaihed in this application are true to the best of Itis knowledge and belief; and that the work will be performed in the mannerset forth in the application filed therewith. Sworn to before me this Notary Public, .. .. •- ' ounty ~ QualMled In 8uHol County ~ ignature of applicant) Commission Expires December 8, 19..,,,,