HomeMy WebLinkAbout17567-z
~yy,,~~ _ FORM NO. 4
1~~" , .
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Office of the Building Inspector
Town Hall
Southold, N.Y.
CERTIFICATE OF OCCUPANCY
No Z-18366 Date SEPTEMBER 13, 1989
THIS CERTIFIES that the building ADDITIONS
Location of Property 550 CEDAR POINT DIRVE EAST SOUTHOLD N.Y.
House No. Street Hamlet
County Tax Map No. 1000 Section 90 Block 2 Lot 16
Subdivision Filed Map No. Lot No.
conforms substantially to the Application for Building Permit heretofore
filed in this office dated OCTOBER 28, 1988 pursuant to which
Building Permit No. 17567-Z dated OCTOBER 28, 1988
was .issued, and conforms to alI of the requirements of the applicable
provisions of the law. The occupancy for which this certificate is
issued is ADDITION & ATTACHED GARAGE ADDITION TO EXISTING ONE
FAMILY DWELLING AS APPLIED FOR.
The certificate is issued to CHARLES & BETTINA DANILCZYK
(owners)
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A .
UNDERWRITERS CERTIFICATE NO. PENDING - SEPT. 7 1989
PLUMBERS CERTIFICATION DATED AUG. 3 1989 - HENRY J. SMITH & SON INC.
~?~Z,%
Building Inspector
Rev. 1/81
rosat< xo. s
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN HALL
SOUTHOLD, N. Y.
BUILDING PERMIT
CfHIS PERMIT MU5T BE KEPT ON THE PREMISES UNTIL FULL
COMPLETION OF THE WORK AUTHORIZED)
0
~ _ U 17 5 6 7 Z Date ...../..o 19..~t.~
Permission 's hereby gran
e~ 7 b//~
.....G~ ........................~.~..i j1436~i
Q ~ ,
.....~~?~~~..~sl... ..y.~f'... u~f....G.~..
~ses located of ~
J"' ~
Cvunty Tax Map No. 1000 Section ..........~A....... Block ...........~i..... Lot No............1,~......
pursuant to application dated 19........, and approved by the
Building Inspector.
Fee $...~~i.. x,r.~ i
t~:l.
Q~XxJR.'7r....
/ Bu g Inspector
Rev. 6/30/80
~ ~ FORM NO. 6
TOWN OFSOUTHOLD
Building Department
Town Hall
Southold, N.Y. 11971
765 - 1802
APPLICATION FOR CERTIFICATE OF OCCUPANCY
Instructions
A. This application must be filled in typewriter OR ink, and submitted to the Building Inspec-
torwith 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 or equal?.
3. Approval of electrical installation from Board of Fire Underwriters.
4. Commercial buildings, Industrial buildings, Multiple Residences and similar buildings and installa-
tions, acertificate of Code compliance from the Architect or Engineer responsible for the building.
5. Submit Planning Board approval of completed site plan requirements where applicable.
B. For existing buildings (prior to April 19571, 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. Sworn statement of owner or previous owner as to use, occupancy and condition of buildings.
3. Date of any housing code or safety inspection of buildings or premises, or other pertinent informa-
tion required to prepare a certificate.
C. Fees:
1. Certificate of occupancy $5.00
2. Certificate of occupancy on pre-existing dwelling $15 .00
3. Copy of certificate of occupancy $1.00
4.Vacant Land C.O. $5.00 5-~&,~
5.Uodated C.O. $15.00 Date......d
New Building Old orPre-existing Building Vacant Land
Location of Property .~^v
4 `:r :vc:°!!... V :rr-f~^.f!`!'~. ~:'e~.~.' . .
House No. l(~~ Street j~ Hamlet
Owner or Owners of Property '~.~.fi..4.. ~ S../e!G:~r~I~.C.~,y,fL .
County Tax Map Nppo. 10yy0~~0 Section .....n%.~...... Block .....~-p........ Loot/....r ~ .
Subdivision .~R~+:.17j ~R.c..~s-. ~o~n~,X~L..p......Filed Map N(o'~ ~..4. Uy.~.....Lot No.
Permit No.l~~ 7 Date of Permit ~`/F~pplicant .1~,~.~'°°-!^..~
Health Dept. Approval 2. "............Labor Dept. Approval .
Underwriters Approval .~l.d.5. t~'~-~:~^':':Planning Board Approval
Request for Temporary Certificate . ........Final Certificate ..G~~'./~-.`..°........... .
Fee Submitted $ .(1'?~
Construction on above described building and permit meets all app(li~cable codes and regulations.
Applicant 4dr.3:~~.~5-~~,--:- .
Rev. 7040.78
Qac~ 3gal~
L o ~ 1836f~
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HENRY J. SMITH & SON, Inc.
PLUMBING, HEATING & FUEL OIL
MAIN ROAD
SOUTHOLD, N.Y. 11971
(518) 765-3690 '
C_E_R_T_I_F_I_C_A_T_T_0_N_ ,
Z
Dat•e_ August 81 ~8g
Building Permit No._17~67Z
Owner Chaff
s_pa n i l ryy]L___________
Plumber__Aenry_J__Smith_&_Son2_Inc_
I certify that the solder used in the water supply
I system contains less than 2/10 of 1% lead.
I
i
Henry P. Smith
Sworn to before me this
8th__day of _Au_gust_____r '
Notary ublic
Notary Public, Suffolk County gERNADERELTAPLIN
NOTARY PUBLIC N484b893
State d New York
Residing ~n SuAdk County ~q
Commission Expires SeOL 30, 1981
*u
C•{1
HENRY J. SMITH & SON, Inc.
PLUMBING. HEATING & FUEL OIL
MAIN ROAD
SOUTHOLD, N.Y. 11971
(616) 766-3690
C_E_R_T_I F_I_C_A_T I C N
~
D a t e~-y~yy,~t_.3_,_1~----
Building Permit No. 1~~6ZZ
Owner__Charles-Danilc~k
Plumber__Henry_J__Smith_&_SonL_Inc_
I certify that the solder used in the water supply
system contains less than 2/10 of 1% lead.
i ~ d`.'
enry P. Smith
Sworn to before me this
~grcL_day of .A).zgus'~-----' (
Notary ublic
Notary Public, Suffolk County
BERNADEitE L. iAPLIN
NOTARY PUBLIC N484A893
State of New York
Residin¢ in Suffolk County
Commission Expires Sept 30, 19~
1
~ as:.-
f;n
TEL. ?f,5-18Q2
~O,L TO~tI`1 OIL SOUTL'Oi.i~
j~~7 ~`t$~ ~ ~c OPI'TCL' C)[' 13U1LD1NG INSPECTOR
; a~,;~,f P.o. riot ns ,
~ 'SS°i.'j ~ TOWN BALL
~~y~ ~ SOU7'ItOLD, N.Y. i 1971
C'~{ta~~ O~iQd~i~
e.~.~.~a~.~-4~ ~
Cu~~~~,~e., . 4 3.r
Qom`. ~'`~-~u
'I'o P]hom Thin May Concern,
Vie are unable r.o complete your Certificate
of~Occuaancl~ because oL• the following reason:;.
An application for Certificate of Occupancy
is not nn £il.c. 1"i~..~-~c
/s/ No tlnder~oritcrs Certificate on file.
The chec)•: .ia'^crT/nut on file.) )jc2S'.(fU
C:o tleal.th Dept. Approval on file.
No final insT'~ection has been made.
Pleasr, r_ontact-. our office on this matter. -
Thank you foz your cooperation.
nuilding Permit. i! ~ ~ Z
T3uilcl`i/nq Dcp1..
**k/~/ tlo Plumber Soldez~ Cert.ificatc on file. •
( al.l permits .i.nvolvi.ng plumbing being
i~succl afL-er :~pri.l 1,1984 )
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ADDITIONAL COMMENTS: ~
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Anclersen• STURTEVANT MILLWORK CORP.
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f.OtBC~tOtI1C[O DEER PARK, N.Y. 11729
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COpIChOp1Cf0 Uhl DEER PARK, N.Y. 11729
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765-1802
BUILDING DEPT.
swsPECT~oN
[ ]FOUNDATION i5T [/~]~OUGH PLBG.
[ ]FOUNDATION 2ND [ ]INSULATION
[ ]FRAMING (]FINAL ~
REMARKS: tt'Gy
? G
DATE J o~~ INSPECTOR
765-1802
BUILDING DEPT.
iNSPECT~oN
[ ]FOUNDATION 1ST [ ] ROUGH PLBG.
[ ] FO DATION 2ND [ ]INSULATION
[ FRAMING [ ]FINAL
REMARKS:
_ ~
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I
DATE ~ INSPE#rTOR ~
765-1802
BUILDING DEPT.
INSPECTION
~O NDATION i5T [ } ROUGH PLBG.
[ FOUNDATION 2ND [ }INSULATION
[ 7 FRAMING [ ]FINAL
REMARKS:
DATE I ~ a~ INSPECTOR r
7~`~ / 765-1802
BUILDING DEPT.
1 NSPECTION
[ ]FOUNDATION i5T ( ~ ROUGH PLBG.
[ ] FOUNDATION 2ND [ ]INSULATION
[ ]FRAMING ( FINAL
REMARKS:
DATE ~ INSPECTOR '
BOARD OF HEALTH
3 SETS OF PLANS
FORM N0. 1 SURVEY . ~ .
TOWN OF SOUTHOLD CHECK .~i•N.$I~•
BUILDING DEPARTMENT SEPTIC FORM
TOWN HALL NOTIFY
vOUTHOLD, N.Y. 11971 CALL ~`'v- y-~- r°- 7~'•~-:•
TEL.: 765-1802
/ G MAIL T0: r,~
Examined ..1,12•. 19 ~4 ~~1~ - "I
r~
Q ~ 7Jr(o ! ~ (~f
'~-am.. ~ fOLI
Approved ..1~~.~:....., 19~~Permit No........... ~ / I~P
~
Disapproved a/c !~•kJ
i.1 U
7 WN
OF SO '
~r~i~~
/ (B ding nspector)
APPLICATION FOR BUILDING PERMIT
Date .~.":'../.~~~0•.> 19...
INSTRUCTIONS
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-
c2tion.
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 demolition, as herein described.
The applicant agrees to, comply,.t~~t(r all, applicable laws, ordinances, building code, housing code, and regulations, and to
5 oaipremrses ~frd in building for necessary ins a 'ons.
admit authorized insp0'arto`P•
(Signature of applicant, or name, if a corporation)
, - . ~ y
(Maili address of applicant)
'S''s' .'i b.~'., r"t J e ~ - -
State whether applican4~ i's'~o'~Vrier; lessee, agent, architect, engineer, general contractor, electrician, plumber or builder.
~~r/~. `~t~
• '
Name of owner of remisCS' .4R.:
(as on the tax roll o atest deed)
If applicant is a aolpg9raBiorJgtslgnatur~ of-duly authorized officer.
(Name and title of corporate officer)
ALL CONTRACTOR'S MUST BE SUFF LK COUNTY LICENSED
Builder's License No. . ~ ~ • .
Plumber's License No....5. ~..7~`.-.~......... .
Electrician's License No. . a• . • • .
Other Trade's License No . .
1. Location of land on which proposed work will be done. -~M..%~~>L'sv. • • • • • • • • • • • • • •
.v~ ~ ~ ~
House Number Street Hamlet
County Tax Map No. 1000 S)ecti~on , .~nQ Block ~ Lot .j~ .
Subdivision f • C• • • • • Filed Map No.` .C~.. Lot . 1.G .~0........ .
(Name)
2. State existing use and occupancy of premises and intended use and occupancy of proposed construction:
c
a. Existing use and occupancy
b. Intended use and occupancy ..CI..G.~GI.-Q!~~5• :-Yt'~:~?"n~!~:. ' ~,ie~~
3. Repazr of work check whicRh~ plicable): New Building Addition Alteration .
' ( oval Demolition ..............Other Work .
(Description)
4. Estimated Cost ~ .Fee .
` (to be paid on filing this application)
5. If dwelling, number of dwellin~ units :e-'..... Number of dwelling units on each floor .
If garage, number of cars ....',:C`~l.~l~' . .
' ,6,' ~If business, commercial or mixed occupancy, specify nature and extent of each type of use .
7. D,'men 'of fisting structures, if any: Front ; ~ Rear 3 .5~.'......... Depth :Z... r. co .
. ,,''Height +~~~7~r.., Nu~ber of Stories . G.k4-Z .
Dimen ' of s me structure ith alterations or additions: Front . 3 .4~ Rear ..y.~ .
"Depth . i ,Height ~ Number of Stories . rn~.¢_................ .
8:' Dimen f entire new construction: Front Rear ...:':..........Depth .
Height Number of Stories .
9. Size of ot: id`,':4.',1f <l: z{, , ,
p.:.:.....e. Rear /aJ:7J.~^.......... Depth ~y r, .
10. Date o rc ass ~ ,(.g 7 . ....Name of Former Owner .
1 1. Zone or use district i hich p#emises are situated .
12. Does proposed construction viglate any zoning law, ordinance or regulation :
13. Will lot be regraded ~.,n!~"p'..~.p ~ p .Will excess fill be removed from premises: Yes
14. Name of Owner of premises~.al.aiw~. ~ N'>`~Address .~-vut~-~ci?./.1Z Phone No...... .
Name of Architect i... Address Phone No .
Name of Contractor 5~-`.......Address Phone No. ~1,~ycc~.7. 2... .
15. Is this property located q
*If es, Southold Town Tr within 300 feet of a tidal wetl nd? *Yes ToJ.....
y µstees PermitPLO~ DIAGRAM ed. ,
Locate clearly and distinctly all buildings, whether existing or proposed, and, indicate all set-back dimensions from
property lines. Give street and block number or description according to deed, and show street names and indicate whether
interior or corner lot.
~ ,
l~ ~ J~ ! f ~ S
arPaov a As aat~o
DATE: ~ 2 $ B.R it '/'`367
NOTIFY 8 I I G DEPART TAT
786-1802 8 AM TO 4 PM FOR THE
FOLLOWING INSPECTIONS:
~ 1. FOUNDATION TWO REQUIRED
FOR POURED CONCRETE
2. RQUGH • FRAMING ~ PLUMBING
S. INSULATION
4. FINAL - CONSTRUCTION MUST
~ BE COMPLETE FOR C.O.
ALL CONSTRUCTION SHALL MEET
THE REQUIREMENTS OF THE N.Y.
STATE CONSTRUCTION & ENERGY
CODES. NOT RESPONSIBLE FOR
DESIGN OR CONSTRUCTION ERRORS
STATE OF NE R ~
COUNTY ~r~."(,,1.~'T.-.(~. S.S
being duly sworn, deposes and says that he is the applicant
(Name of individual sigtting contract)
above named.
Heisthe....,........i
(Contractor, agent, corporate officer, etc.)
of said owner or owners, and is duly authorized to perform or have performed the said work and to make and file this
application; that all statements contained in this application are true to the best of his knowledge and belief; and that the
work will be performed in the manger set forth in the application filed therewith.
Sworn to before me this
.day of 14~f.
Notary Public, .County
CLAIREL,OLEW
N~YPU~I~b,~B~N~rlrYak (Signature of applicant)
GualMied ink County ~Y .
Commission Expirei mbar 8, 7