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Home My WebLink About23584-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No: Z-25467 Date: 01/06/98 THIS CERTIFIES that the building ACCESSORY Location of Property: 745 SOUTHERN BLVD EAST MARION (HOUSE NO.) (STREET) (HAMLET) County Tax Map No. 473889 Section 22 Block 1 Lot 8 Subdivision Filed Map No. -- Lot No. -- conforms substantially to the Application for Building Permit heretofore filed in this office dated JUNE 26, 1996 pursuant to which Building Permit No. 23584-Z dated JULY 16, 1996 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 STORAGE BUILDING IN THE REQUIRED REAR YARD AS APPLIED FOR. The certificate is issued to DONALD & PEGGYLEE DZENKOWSKI (OWNER) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL ELECTRICAL CERTIFICATE NO. PLUMBERS CERTIFICATION DATED N/A N/A N/A Rev. 1/81 B~ding ~nspector FORM NO. ,s TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N. Y. BUILDING PERMIT ('rillS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) N. z3584t z ~a~e ......... ...~/~. .................. ,~.. o ~ Permission is hereby gron~) . ~ ~/" ,~ / /.. , ~/~/~ ~Z/..~.~Y.Y.z .................................. ...... ../.,.~,,?:~...4e/..:: ................ ...................... ~..2~., ........... ~././../, ~o~ _~..~~_ ..~.~~..~..~ ........... County Tax Mop No. lO00 Section ....... g~:'~.~...~....... Block .......... Z ........Lot No ....................... pursuant to application dated ............... ~....~ ........ , 19.ff~' and approved by the Rev. 6/30/80 Ao ! TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL 765-1802 CATION FOR CERTIFICATE OF OCCUPANCY This application must be filled in by typewriter OR ink and submitted to the building inspector with the foll6wing: for new building or new use: 1. Final survey of ~property with accurate location of ail 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 1% 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. Submit Planning Board Approval of c6mpleted site plan requirements. For existing buildings (prior to April 9, 1957) non-conforming uses, or buildings and "pre-existing" land uses: Accurate survey of property showing ali 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 Buildinm - $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 Date ..... .......................... . New Construction .......... 01d Or Pre-existing Building ................. Location of Property...~.~ ~.. ~-.qo~;~.~.~.~. ............... House No. Street Hamlet Onwer or Owners of County Tax Map No i000, Section...~.-~. ....... Block ...... ~ ......... Lot ..... ? ................ Subdivision ............................... .. , . . Filed Map............Lot..., .................. Permi Of Permit .... .......... Applicant ......... ' .................... Health Dept. Approval .......................... Underwriters Approval ......................... Planning Board Appr6vai ........................ Fee Submitted: $ ..... ~,|I~LI} iNSPeCTION REPOET DATE CONi'tENTS I~OIINI)AT I ON (IST) II II ROUGII FRAME & PLU~IBI NG I~SULA'rlo~ P~R ~. STATE ENEEGY CODE AI)I)~'FtONAL CO~ENTS: BLDG. DEP'% TOWN OF _S.q~UTHOLD 765-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATIONlST [ ] FOUNDATION 2ND [ ] FRAMING [ ] ROUGH~PLBG. II~ULATION [ ]× [~]/FINAL [ ] FIREPLACE & CHIMNEY DATE INSPECTOR FORM 1'10. I TOWbi OF SOUTItOI.D liUI 1,DIHG I)1~ PAI{THEFYr T0%41'1 IIAI,I. SOUTIIOLD, R.Y. 11971 TEL: 765-1/102 B(}ARD OF lll~.^l.'l'll ............... ~.~3 SETS OF PLANS ............... SURVEY ........................ clmc~ ......................... SEPTIC FORH ................... FlAil. TO: .................... l)ate dF .~.~:.S"- r., ............... , ~9 ?.~,. a. 'Ibis al~flicatims mint I)e c.o~lfletely filled in by tyl~riter or in ink arm md~nitt~ to the Ihfilding Ins~ctor x~ith ~3 mrs of plans, accurate plot: phm to ramie. Ir~ aecordi~ to sch~lule. h. Plot plaa ~il~ hmati~ of lot nt~l of Ndldb~ ~ pr~ntses, relationship to Mjoining pvc~uises or [x~blle slr~ts or areas, a~l givit~ a {htn{l~l dem:ripti~s of labatt of p~olmrl, y .~mt Im drmm ~ the dia.'an ~dch is lmrl: of Ihis a~)l icat ioa. c. 'lhe ~)rk c~ercul by this a~licatiou stay s~)t Im caam~:~l lmfore isstm~e of ~lild~?g Permit. d. U[~ a~m~M o~ tid~ al~fllcaCion, the I~Hd[~R ]nsl~CLor ~Jll ismm a [~ihHn~ Permi~ to the o~icant:. l~nnit shall Im kept cm Lira pr~ni~, agailnble for ins~cti~ I.hrcxi~(xlt Lhe e. ~ Imihli~ Jmll tm ~rcupi~l or used in ~lole or in imrt ~or a~ ¢~r~ x&atever ~mtll a (>rti[icnte oF (~oqm~g:y Jmll have linen granted by I.Im lkHldlng laslmetor2 At~q,l(~'l'l(~ IS IE~I1Y }~E to tlm ~Hlding I~lmrt~mnt for the ismla~:e of n l~dhling Pemit D~rmmnt to the Ikfildi~ 7z~ Onli~mrgm off tim '1'~ of ~t.lmld, ~[15olk {~mty, ~ York, m~ olher applicable I~., O~liim~es or l~gulatJ{ms, for tim t~mtnmti~l of hdldit~s~ mMitic~m or alteratioas, or for m~val or dmlition, as ImreJn L~seril~l. 'lira nFplJcant ngr~s ro ca~l}ly with all n~fllcable l~n, 0~na~mes, la~lldmg c~, Igmsl~ c~le, n~l r~,lati,.m, o,M to ~h, il: m,tloriml insl.ctors ~, prmises a,xl in I~l,~.[ (Signature of opplic~ or na~ if a COrl~ratimO ~ ~ ~./*~...~/~.. ~.. ~ < ~.. (~ilir~ ~klrea~ oE Stale Mmllmr a~fllcm~t ia ~r, leaae% agent, a~chitecL, en~i~mer, ~mral ]contractor,~'~' ~elee~rleiau' plmi~r or I~Hhler, .... ~.~ ..................................................................... n.,'.~~-:~ ...... . ~ N~ BUI~ING I. FOUNDATION ' ~O REQUI~ED (H~s~ a;~l tit leo[ COrlX>rate offlce.,,,.~l~= }O ] ~g~ g~/g~* s~ FOR POUREDCONCR~E 3. I~SU~TION 4. FINAL CONSTRUCTION MUST 8E COMPLETE FOR C,O, ,~ ALL CONSTRUCTION SHALL MEET THE REQUIREMENTS OF THE N.~. ST?¥rE CONSTRUCTION & ENERGY O[Imr l¥~le's License ~ ..................... CO~ES, NOT RESPONSIBLE FOR , ~./~¢~4 ~ .... ~-/~ ............ :~:~ .......... IIc~Jse lied)er ,qtreet Ih~nlet (~,,nty 1;,[ Hol, ~,. I~) ~ctJ,, ........ ~.~.. Bi(x:k ........ ~ ..... .. l~t...~.~..~. ~,,~m,,, .~¢~.~.~...&~/~ ........... ,,,~, m,-,..%5~ ....... ,,~ '...5.. ........ (~) 2. State existing u~ m~ ~qmmzy o~,/.Pr~nises arm inte~M~l use ami ~:cu~y of pro.)mi constructloa: ~,. l~isti,g urm at~l trc,l~a,my ...{~(¢[¢~ ........................................................... ........... .,...,.,. ....... ........,,, ................... h. 15. I~j.,i[- . ........... t~wal .... ~ ........ I~x]i ilion ............ Oiher T~)ik .................................. ! (h) I)~ paid on I:tlJn8 Ihh~ al~dlcal:[~m) ~nl~r o~ ,Iotleft ...... Fh~m o¢ archhect .............. ] ...................... ~kh-a,a .............................. 1~o~ ~ ............... prolmrLy wiLllin ~X) feet~ o~ n Lldal ~t:lai~l? a ~l~q .......... ~ ~. ...... this i I'I,OT I) TA(~RAH l~x:al.e clearly a(~l dlatii~:l'ly a(I I~dhllnga, xd~etl~et' exlat:Jn8 or prolxmed, m~l J~Mlcat'e all set-back I'Hxu prol)elly lh~. " bl(~:k ~]dmr or de. sCril~ti(~ accm~l[~8 ro dee(Ii taxi ah(aC atreeL ~,ea alii i~li(:ate f IJmL Ihe ~)rl~ ~ill I~ I~rl'otu~l Jlt Iii;{! ii~llll~]r ~[~lL forth ill lbo nppl lc.ilo, filed ,~% i '-'-' "' "'"'" "-"",,// i ROBaRTIL soo~ T, N~ARY PUBLIC, ~te of N.Y. No. 4725089. SuffOlk Term Expire ~31, !~ COUNTY HF~LTH DEPARTMEN2 d~aDosal and wate~ supply ['or this lo¢~,' ton have been