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Home My WebLink About17251-z FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No 217206 Date AUGUST 18, 1988 THIS CERTIFIES that the building ACCESSORY Location of Property 850 3rd STREET NEW SUFFOLK House No. Street Hamlet County Tax Map No. 1000 Section 117 Block 08 Lot 07 Subdivision Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated JULY 20, 1988 pursuant to which Building Permit No. 0172512 dated JULY 20 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 ACCESSORY BUILDING AS APPLIED FOR. The certificate is issued to NICHOLAS MANDUSIC (owner, XXXXx:~:~C{XX7CXXXXXj of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A UNDERWRITERS CERTIFICATE NO._ N/A PLUMBERS CERTIFICATION DATED N/A V / CCLL..~~.G_`___iii___J~C'-~ ? lding Insp ctor Rev. 1/81 r~oaai 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 0 ~ 17 2 5~ Z Date ~ 19..k.g Permission is hereby granted to: A1.~~.h~Q~ ~..N.......~.'a.~,.~'s-.. to ..~~:~?1~M.41.!........Qrr.~....~......?!~-!a:ttF..rBF.!~!^~......~....54:~2~...... ct premises located at ..~.~~.......,~.!z°}.....1?^..:".;'.!...,........!~.,?c'.:4~.......sc~!%~e,,.. County Tax Map No. 1000 Section ........~~..7........ Block Lot No....~..i....•••••••.•• ~ V pursuant to application dated 19.~.A.., and approved by the Building Inspector. fee aS ~~Bu ding~~lnspector Rev.6/30/80 (~(~(1???jjj ~ .y FORM NO. 6 ~ t~W TOWN OF SOUTHOLD t~W I ~ Building Department Town Hall TOWN OF §Ot HOLD Southold, N.Y. 11971 765 - 1802 . APPLICATION FOR CERTIFICATE OF OCCUPANCY l4^^Q'~ w~- 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 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. 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: Additions $25.00 POOLS $25.00 ALTERATION $25.00 1. Certificate of occupancy New Dwelling, $25.00, Accessory 10.00 Business $50.00 2. Certificate of occupancy on pre-existing dwelling $ 50.00 3. Copy of certificate of occupancy $ 5.00 , over 5 years $ 10 .00 . 4. Vacant Land C.O. $ 20.00 mII S.Updated C.O. $ 50.00 Date ..~4 NewConstruction„~OldorPre-existing Building Va11cantLand Location of Property ,z'~,';5 G ~!`~.•~:...:?d,'.°.........~°."~-.::~.. SC,°,,~rt'~r;~......... . House No. ~ Street Ham/et Owner or Owners of Property ,,~~//~e, "!:~?d~`t'... ;~,~~''~'d.•~°:~'~~ ~ . . W:-... County Tax Map No. 1000 Section ~ ~ Block Lot . ,d~...... . Subdivision .................................Filed Map No. ../.......Lot No. . Permit No. Z-Date of Permit . ~:'?:(dd~~, gAPPlicant , : ; i : , . , , , Health Dept. Approval ........................Labor Dept. Approval . , . Underwriters Approval ........................Planning Board Approval . Request for Temporary Cer`ti~fi}c-ate ....................Final Certificate . Fee Submitted $.~~~.Y`^.~v,~,,,,,,,,, Construction on above described building and permit meets ally,applicable codes and regulations. APPlicant ~d :~cri°i':.... ~r`;ff~,~; ~~at~.:".:~:~ . Rev. 10-10-78 X35"y~~ zr7aa~ ~/i~ j . r1cLD ICSPcCiiU17 ~~UATE COMMENTS r d 1 i, m J 1 . ~ Jl1 H vI H ~ rOUtJDATION (1st) f1'' FOUNDATIOIJ (2nd) m c~ 2. z 0 ca d ROUGH FRAME & PLUMBING ti H ~ 4 3. m c m IIJSULATIOfI PER N. Y. y STATE ENERGY Q~ CODE x a 4, y FI;JAL o z ADDITIOfIAL COMMENTS: x . ~ X 'ti • H ~ tl 9 H ~ H O O z W m a • r ~ H ~i d R7 ^o y BOARD OF HE.ILTH , 3 SETS OF PLANS or FORM NO. 1 SURVEY . TOWN OFSOUTHOLD CHECK BUILDING DEPARTMENT SEPTIC FORM TOWN HALL SOUTHOLD, N.Y. 11971 NOTIFY - TEL.:705-1802 CALL MAIL T0: Exantincd 19 ~~pproved ZQ, „ 19~~. Permit No.~ 7 Disapproved a/c (Building Inspector) APPLICATION FOR BUILDING PERMIT Date 19 . INSTRUCTIONS a. Tltis 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 Bepartment 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, building code, housing code, and regulations, and to admit authorized inspectors on premises and in building for necessary inspe~ro s. ~y~ , (Sipgatttre of applicant, or name, if a corporation) (Mailing address of applicant) //9S(., State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. o.w'N~~ Name of owner of premises /.V/C~fB~I~-1•.../~Ii7Ni7)rl,S{~~ (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 . . Plumber's License No . Electrician's License No . Other Trade's License No . . 1, Location of land on which proposed work will be done . . House Number ~ Street\ Hamlet County Tax Map No. 1000 $eCliOn ~j.~............ Block , , , , , , , , , , , Lot , , , /J/fr"CEL J Subdivision .~/.5~... ~ D .J.Q.. ,f~'C:.~J7, Filcd t,tap No. Lot . (Name) 4 State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existin^ u p y =,s,:,r t :3 sa'x<:. a se and occu anc 1~,'i;~:k:~t:.~3>."r:*i~::::'.:.... °~.i _ t.ii'~ b. Intended use and occupancy 1, , , ~e''}}~~ >~~~d~j~ ~ ~ __F_ ""LJO ~ e..~? i%ow R` .Sjf~f>.~ R S/O~PI'fGF' ~ ~P ^/bo/s C~rc~ 3• Ret air of worn chec6 whichmoval ' " p • • • . • . • • • applicable • New Building Addition Alteration . Demolition Other Work . 4. Estimated Cast Op (Description) . Fee."?S ~ (to be paid on filing this application) 5. If swelling, number of dwelling,units . . Number of dwelling units on each floor , If ara,e, number of cars . 6. If business, comrnercial or mi~cd occupancy, specify n tore and extent of each type of use 7. Dimensions of existing structures, if any: Front . ,Rcar • ~ ~ • • • • • • ' Elcigltt Ntximbcr of Stories . • Depth . Dept} with alterations or additions: Front . Rcar , , , , , ^ t • Ilcight . ' ••••••••.......NuntbcrofStorics.........., 8. H`ni Ystons of entiresnety constnrction: Front . . Rear ~ • • ~ ~ • • ' ' Nu~'nbcr of Stories . • Depth 9. Size of lot: Front Rcar . 10. Date of Purchase Depth ....NameofFormerOwner 1 1. Zone or use district in which p'emises are situated • ~ • ~ • • ~ • • • ~ ' ' ' ' ' ' ' ' ' ' ' ' 2. oes proposed construction vtplate any zoning law, ordinance or regulation: , ~Y p ~ • 13. '1Villlotberegraded .......J,.,, ~f/!e . 1Vi11 excess fill be removed from premises: Yes No ame of Owner of remises . Name of Architect P ~ ~ • ~ • ~ • ' LufiC Addressp~ ;QOX?z9 : v~G,s„~~~,hone No. ~13~t~ . Name of Contractor .................Address , ...........Phone No............... . If es Southold Tow '•.Address ...................PhoneNo....... 15.Is this property looted within'$00 feet of a tidal wetland? *YES..,, O y > n Trustees Permit may be required. I, PLOT DIAGRAM Locate clearly attd distinctly al,l buildings, whether existing or proposed, and. indicate alt set-back dimensions from property lines. Give street and blocl5 number or description according to deed, and show street names and indicate whether interior or corner lot. I ~G P.v~'E ~~a....w~ m_..._ ~~'~~D idG~r~ I (7 C T P~~ . i ~ i ~ ~ o STATE OF NE\ 01 COUNTY OF , , , , , , , S•S ` 2,°t2,1.."L" S~ r Name of individual signii'tg contract) ~ • • ' ' emg duly sworn, deposes and says that he is the applicant above named. l!c is the ..yc..i?iL_,_~......... (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 arc 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 ....day of , l94 0 Notaryl'ublic, ounty Note PubI1TN T. 71:kRY ~ No. B1'Stats of NYw York /F~;4, f'G~y. ~~,a ~ommfssioln ~Iitp rea May St, (Signature of applicant)