HomeMy WebLinkAbout17226-z FORM NO. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Office of the Building Inspector
Town Hall
Southold, N.Y.
CERTIFICATE OF OCCUPANCY
No: Z-25368 Date: 11/25/97
THIS CERTIFIES that the building ADDITION/ALTERATION
Location of Property: 275 WATERS EDGE WAY SOUTHOLD
(HOUSE NO.) (STREET) (HAMLET)
County Tax Map No. 473689 Section 88 Block 5 Lot 58
Subdivision Piled Map No. Lot No.
conforms substantially to the Application for Building Permit heretofore
filed in this office dated JUNE 13, 1988 pursuant to which
Building Permit No. 17226-Z dated JULY 18, 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 ENCLOSED DECK ADDITION & ALTERATION TO EXISTING ONE FAMILY DWELLING AS
APPLIED FOR. THIS C/O WAS CORRECTED FOR BUILDING PERMIT NUMBER AND ELECTRIC
UNDERWRITERS NUMBER ONLY.
The certificate is issued to EDGAR DEBANY
(OWNER)
of the aforesaid building.
SIIFFOI,R COUNTY DEPARTMENT OF HHALTH APPROVAL. N/A
ELECTRICAL CERTIFICATB NO_ H 057928 12/01/97
PLUMBERS CERTIFICATION DATED N/A
_ r ~/'C.~
Aut o zed Signa re
Rev. 1/81
FORM NO. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Office of the Building Tnspector
Town Hall
Southold, N.Y.
CERTIFICATE OF OCCUPANCY
No Z-25386 Date NOVEMBER 25, 1997
THIS CERTIFIES that the building ADDITION & ALTERATION
Location of Property 275 WATERSEDGE WAY 50UTB:OLD, N.Y.
House No. Street Hamlet
' County Tax Map No. 1000 Section 88 Block 5 Lot 58
Subdivision Filed Map No. Lot No.
conforms substantially to the Application for Building Permit heretofore
filed in this office dated JUNE 13, 1988 pursuant to which
Building Permit No. 25386-Z dated NOVEMBER 25, 1997
was issued, and conforms to all of the requirements of the applicable
provisions of the law. The occupancy for which this certificate is
issued ie ENCL05ED DECR ADDITION & ALTERATION TO E%ISTING ONE FAMILY
DWELLING AS APPLIED FOR.
The certificate is issued to EDGAR DEBANY
(owner)
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A
UNDERWRITERS CERTIFICATE NO. PENDING - NOVEMBER 21, 1997
PLUMBERS CERTIFICATION DATED N/A
B lding Inspector
Rev. 1/81
roses xo. a
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~ 017 2 2 6 Z pate ..7.,1.. ~ 19d..~
Permission is hereby grynted ,
...~,.~.~Q......~.......,~~...
ro_.. .r~ ..C`n7~C.rte-...4?:+~~~/~~......f~.....
.:~~Gra: .....~k~. -t... s~ ..u,.~,.~ ...~C...
. .
~ ' /
ct premises located at ...u~~...7gt~~....~/ ..~E*.'.".__I__.....~?.~
................................................~Y~................................................................................
Caunty Tax Map No. 1000 Section Block ..............J.~.... Lot No.....~(~
y
pursuant to application doted .....n.~~./~,~,/~ 19G1..~ and approved by the
Building Inspector. ~''~r
00
Fee $..~d
. ,t..~~C~~w
B ilding for
Rev. 6/30/80
BUOLDING ~,L ~ V
; ~ ~r~o~
i6sN ~R IvJV 2 0 X997 ~ ~
~ rt~
APPLICATION FOR CERT PIC
TOWN OF S UTN LD
A. This application must be filled in by typewriter OR i.nk and submitted to Che 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 in system contains
less than 2/10 of 17 lead.
5. 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. Submi~Plan ing Board Approval of completed site plan requirements.
B. For existin buildings (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, 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 $25.00, Additions to dwelling 25.00
Alterations to dwelling $25.00, Swimming pool $25.00, Accessory building $25.00,
Additions to accessory building $25.00. Businesses $50.00.
2. Certificate of Occupancy on Pre-existing Buildine - $100.00
3. Copy of Certificate of Occupancy - .25~
4. Updated Certificate of Occupancy - $50.00
5. Temporary Certificate of Occupancy - Residential $15.00, Commercial $15.00
1 Date
New Construction........... Old Or Pre-existing Building... ,
Location of Property....~~.~~.... ~ ~TL-`r~_S„ .~rr.~-4'=c .~1~{-~~....... ~~~hd1 ~a1........... .
House No. Street Hamlet
Onwer or Owners of Property.......p~.4 ~
County Tax Map No 1000, Section... .~`.~~'lock......a.........Lot..~~
Subdivision..........//
........................//..Fil~~jjed Map...........(~~./~Lot......../..............
Permit No...~~.~:~.b.te Of Permit...~.!(~.(.D.~.Applicant...."`"'5-~:4~.~4~,..~,••
Health Dept. Approval ..........................Underwriters Approval.........................
Planning Board Approval
iequest for: Temporary Certificate........... Final Certicate..
%ee Submitted:
APP CANT
~ ~~3 S~
THE NEW YORK BOARD OF FfRE UNDERWRITERS ~~r
^~ewi~~~;.;
`BUREAU OF ELECTRICITY
85 JOHN STREET, NEW YORK, NY 10038
Lt;~s"'~pf311;'R~i}1,Y.`a`i~7 2".i~3€i4'7c)!'_a7 11 t:1t:`7r.','_i3
Date A~'!'~~~~tf}'lr AICe"+ onT r~2267,
THIS CERTIFIES THAT ,
yo~ny~fpy~ rt~My`/electrical eq~~~~yulIipmelnt arre~~d
Cese*r~~i )beyyd belowial~ny
yd tin yt}roduce/d 6y the applicant named on the obove opplicotion number in the premiaea of
1JA'lA]LYl'l2f 7~C YYEI:.[~IJE{r'J~~tJ',FI'i k~C,Yr >~4.~LJ]IRj1~.1L/J ~3
in thefolloFCinR Incation• Basement ~ !st F!. ? Pnd F'l. Section Black Lat
waa examined on I~U~'S,`~~ l , 1 and found to be to compdiancs wdth the Na[ional Electrical Code.
FI%TURE FIXTURES RANGES COOKING DECKS OVENS DISHWASHERS EXHAUST FANS
OUTLETS LCFPTACLFS SWITCHES INCANDFSCFNi FLUORESCENT OTHER ANT K W. AMT. N W AMT K.W, AMt. K.W AMC N.P
DRYERS FURNACE MOTORS FUTURE APPLIANCE FEEDERS SPECIAL REC'PT TIME CLOCKS BELL UNIT NEATFRS MULTt.OUiIET DIMMERS
AMT N. W. Oll H. P. OAS H P AMT. NO A W G AMT AMY AMT. AMPS TRANS. AMi N P SYSTEMS AMT WAITS
NO.Of FEET
SERVICE DISCONNECT NO.OF S E R ~ V 1 C E
AML. AMY. ME METER I p'tW 1 X 9W J.6' 7W 3d Aw NO OF CC COND A. W G. NO Of HbIEG A W' G NO Of NEU1RAl5 A. W G.
FOUL?. PER Of CC. COND. Of HI" EG OF NEUTNAI
OTHER APPARATUS:
x;NCLO;;PIC~ ~'UkCF~-1
~`~`II`) T./3?~C)~;~_I ~iPiF`j$!"'S`.i; "~Il `l~c~T'1.:C.LC.c3~.
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11TI;ir7L; 1.S j°d'df"i,Cr is V' it+all(_ILf:J.OTI PIe4E; 9.: w`tUllt:~.
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?1HSTi hf.A7Rf ~(t,~17 GENERAL MANAGER
cu~ITcrlc~r,lrr,, ~:d
~ Per .1'f
This certificate must not be altered in any manner; return to the office of the Board if incorrect, Inspectors may be identified by their credentials.
COPY FOR ¢VILDING DEPARTMENT. THIS COPY OF CERTIFICATE MUST, NQT OE ALTERED IN AN7 MANNER.
_
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BUILDING DEPT.
INSPECTION
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REMA KS: ~~~lel ~G7~ B'~--
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BUILDING DEPT.
INSPECTION
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REMARKS:
DATE ( INSPECTOR
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BUILDING DEPT.
INSPECTOON
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BUILDING DEPT.
tNSPE~TION
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'
1 New York State Department of Environmental Conservation
Building 40-SUNY, Stony Broak, New York 11794
Regulatory Affa~i(/rs (516) 751-7900
NO P1•:RMI'P NECESSARY - TIDAL WL;TLANDS AC`P
Thomas C. Jorling
nn 'J 1 ~7 Commissioner
l~"`\7.~F. t~\~h~ 1 ~ Date: _-_~~1~7j~
~-hLrU,~ ,Q~C1 ~ Application No. f Q-Rg- 1
~3~ ~ Ua~ Se 1,00.
O ~~h~~t~ovS~.. Q
~ ' Location:
Sov~o~~,,\~Yy tlg'11 V\~uJ - Sb~~oi r
Dear
A review has been made of your proposal to: CtJ~cJ~~C~ O.~C~,~~1
6ve~ , e~~s~~~~ ~o~-c1~ ~ ~~~\vr~vm o~ `f Si 10.h~w~.v~
p\~n ~Q~.~~~c4 b~ ~l~s~~~ ~h ~~t~~~f
Based on the information you have submitted, the New York State
Department of Environmental Conservation has determined that the project
is listed in Part 661.S~of 6NYCRR (Tidal Wetlands Land Use Regulations)
as a use not requiring a permit or notification letter of approval.
Therefore, no permit is required under the Tidal Wetlands Act (Article 25
of the Environmental Conservation Law).
Please note that any additional work, or modification to the project
as desr_ribed, may require authorization by this Department. Please con-
tact this office if such are contemplated.
Please be further advised that this letter does not relieve you of
the responsibility of obtaining any necessary permits or approvals from
other agencies.
Very truly yours,
r'^r~*~ Regional Permit Administrator
h. C~ ,
Cam`..
- . _...,,_~.~.„~w~~...... s.
®~v~~~
~ ,
FRANK A. KUJAWSKI, ,1R., President ~a f;4
o - ~ TELEPHONE
ALBERT J. KRUPSKI, JR., Vice-President ~ ~ (516) 765.1892
JOHN M. SREDEMEYER, II[ ~J ~ ~
JOHN L. BEDNOSKI, JR, "~~1
HENRY P. SMITH
BOARD OF TOWN TRUSTEES
TOWN OF SOUTHOLD
Town Hall, 53095 Main Road
P.O. Box 728
Southold, New York 11971
June 28, 1988
Mr. Mark Finne
General Carpentry
1370 Lighthouse Road
Southold, New York 11971
Re: Edward Debany - Waters Edge Way, Southold
Dear Mr. Finne:
Please be advised that the project you propose for the above
referenced has been determined to be out of the Trustees
jurisdiction.
After review by the Bay Constable and the Trustees this
determination was rendered.
Should you have any questions or concerns, please do not
hesitate to contact this office at the telephone number listed
above.
ery truly yours,
Frank A. K awski, Jr.
President
Board of Town Trustees
FAK:ip
cc: Bldg. Dept.
Board of Appeals
Edward Debany
file
~~c,UF~019~~~
°=R
VICTOR LESSARD ~
EXECUTIVE ADMINISTRATOR iP' i1 "a ~ TDWri Hall, 53095 Main Road
(516) 765-1802 ~ af`t' P.O. Box 1179
~°'~9 Southold, New York 11971
OFFICE OF BUILDING INSPECTOR
TOWN OF SOUTHOLD
DATE: 7u1y l4, 1988
Sent to Mr. Debany and Mark Finne
Dear
In order to issue a Building Permit for your
proposed construction, for buildings located on lots
adjacent to tidal water bodies, we will need a det-
ermination by the Board of Town Trustees and a waiver
of jurisdiction or a permit from New York State Dep-
artment of Environmental Conservation,
Yours truly,
~ ~
Building In pector
Phone ~ of D.E.C. 751-7900
phone ~ of Town Trustees 765-1892
_ _ BOARD OF HEALTH
..,,~,„a,...._.._,.~.a..~
~-~~J G' 3 SETS OF PLANS
~ . a,,..~,-v~•- FORM NO. 1 SURVEY .
TOWN OF SOUTHOLD CHECK • • • • • • • • • -
~,~5~~$ BUILDING DEPARTMENT SEPTIC FORM
TOWN HALL NOTIFY
R'L- p~t;T, vOUTHOLD, N.Y. 11971 CALL
TOWN~OF SOUTWOLO TEL.: 765-1802
~y C/ ® MAIL T0:
Examined 1.~0 19fJyy'.~l
Approved 19Q~Permit No.~~°?
Disapproved a/c
?
. / C~-7~ .
( ildin ector)
APPLICATION F BUILDING PERMIT
Date ~ ~ 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-
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 demolition, as herein described.
The applicant agrees to comply with all applicable laws, ordinances, din code, housin ode and regulations, and to
admit authorized inspectors on premises and in building for necessa ipspe ons.
. d'..-~z
(Signature o~applicant, or name, if a corporation)
(Mailing address of applicant)
State whether applicant is owner, lessee, agent, arc itect, engineer, eneral contractor electrician, plumber or builder.
~
Name of owner of premises .!Y(yC,Q?.~...~e • Qi2.'-/ .
J / (as on the tax 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 SUFFOLK COUNTY LICENSED
Builder's License No. ..~.~4.g~//-~ .
Plumber's License No . .
Electrician's License No . '
Other Trade's License No . ~ .
1. Location of land on which proposed work will be don~~.~.>~X~Jltf,~:~~re-.. ,~Gw~...~~18E~:~ .
House Number Street Hamlet
County Tax Map No. 1000 Section Block ~ Lot ...fJ. .
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 and occupancy .....`J~.//~G•LG1.. ~/fy~~l?!11.4'`/~~,.,o~~~°.'SIG...........~../...._./~..~L...... .
b. Intended use and occupancy • • • • • •i~~~~?~.. f..~,°`."`!/. .
3. Naturr of work (check which a lica 6~,~~~~/ '
Addition .
era
pp ble): New Building ,Other Work tion ~
Repairt.¢~~*.t<~~dPac`c-: Removal Demolition
s~ Fee .......................:',.i(r~e~c ' ion)
4. Estimated Cost ~ ~ ~
...a~~~ y.........
5. Tf dwellin , number of dwellin units' ~ (to be paid on filing this application)
g g ~ Number of dwellin units on each floor .
Tf garage, number of cars / g .
6. If business, commercial or mixed occupancy, specify nature and extent of each type of use .
7. Dimensions of existing structures, if any: Front ...............Rear , . Depth .
Height ...............NumbergfStories........................................................
Dimensions'of same structure with alterations or additions: Front Rear .
De th ......................Height Number of Stories .
8. Dimensions of entire new construction: Front/¢.AY.~~........ Rear ...............Depth .
Height ...............NumberofStories........................................................
9. Size of lot: Front .
Rear Depth
10. Date of Purchase ..............Name of Former Owner .
11. Zone or use district in which premisers are situated .
12. Does proposed construction violate ajay zoning law, ordinance or regulation: .
13. Will lot be regraded ° ' .Will excess fill be removed from premises: Yes ~No.
p
14. Name of Owner of remises .~c1`~czri . ~eban Address ...................Phone No. 7lus
Name of Architect r~ Address .............Phone No............... .
m k .
Name of Contractor rnn
15. Is this property lo~ ted wit~f enetb~~+`pen~i~Address l370 ~g~~ .45,x,
:~?~Phone No.7~.`f:3 3S? .
'in 300 feet of a tidal wetland? *Yes No
yy~ r
*If yes, Southold Town Trustees PermitPLOXI'DIAGRAMed.
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. *v
~
- _ _ _ _ _.L-_.
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STATE OF NEW YORIC, S.S ~
~OUNTY OF , , , bean dul sworn, de oses ands
....1. ~l.~f~ . f'-'r(.~'!!~ g y p says that he is the applicant
(Name of individual signing contract)
above nama;d. '
3e is the Cr.U!y! ...~C~.!~C~iL~ .
(Contractor, agent, corporate officer, etc.)
~f said owner or owners, and is duly authorized form 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 knowl~dge and belief; and that the
Nork wIll be performed in the manner set'~forth in the application filed therewith.
iwom to before me this ~a
.................`r ,~of... .........,19p~
• Y
rotary Public, ~ ..~R:.. County
HELEN K. DE YOE I ~~!6C~L'f-i
N07ARY PUBLIC, State of New Yak ~ (Signature of applicant)
Ne. 470787k, Suffolk Coun
Term Expires Merch 30,1