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Home My WebLink About27342-Z FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No: Z-28060 Date: 11/14/01 THIS CERTIFIES that the building ADDITION Location of Property: 325 LIGHT HOUSE RD SOUTHOLD (HOUSE NO. ) (STREET) (HAMLET) County Tax Map No. 473889 Section 54 Block 3 Lot 26.6 Subdivision Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated MAY 21, 2001 pursuant to which Building Permit No. 27342-Z dated JUNE 4, 2001 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 DECK ADDITION WITH TRELLIS TO AN EXISTING ONE FAMILY DWELLING AS APPLIED FOR. The certificate is issued to FRANK R & LAUREN J KRUSZESKI JR (OWNER) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A ELECTRICAL CERTIFICATE NO. N/A PLUMBERS CERTIFICATION DATED N/A 7/ze Signat6re Rev. 1/81 FORM NO. 3 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) PERMIT NO. 27342 Z Date JUNE 4 , 2001 Permission is hereby granted to: FRANK R JR KRUSZESKI PO BOX 1411 SOUTHOLD,NY 11971 for r CONSTRUCTION OF A DECK ADDITION AS APPLIED FOR at premises located at 325 LIGHT HOUSE RD SOUTHOLD County Tax Map No. 473889 Section 054 Block 0003 Lot No. 026 . 006 pursuant to application dated MAY 21, 2001 and approved by the Building Inspector. Fee $ 150 . 00 Author' ed SignaCure ORIGINAL Rev. 2/19/98 . Form No. 6 f�^ TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL 765-1802 n 1Q f APPLICATION FOR-CERTIFICATE 0CUPANCY ' 720, A. This application must be filled in by typewriter OR in and submitted t e building inspector with the following: for new building or ew use:BLOG.DEPT. 1. Final survey of property with accurate location o rty 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 completed site plan requirements. B. For existing 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 Copy of Certificate of Occupancy - z .2 ssp Updated Certificate of Occupancy - $50.00 5. Temporary Certificate of Occupancy - Residential $15.00, Commercial $15.00 Date . A(l(ato. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . New Construction. .... .. . ��11old Or Pre-exis g Buildin�� . . . .�,�,- - - - - - Location /� of Property. . . . .Y.�C.-?. . . . . . . . !1.�!�0.4. . .�itti. . . . . .,-�c!'.c:�:f917910 . . . . . . . . . . . . . . . . House No. IJ Street Hamlet Onwer or Owners of Property. . . .I. !.�:�.1 .:�-. SJv!. . :`r. . . . . . . . . . . . . . . . . . . . . . . . . . . . 6)574 O County Tax Map No 1000, Section. . . . . . . . . . . . . .Block. . . .��3 . . . . . .Lot. .(2�4:PP�. . . . . . . . . Subdivision. . . . ..... e . . . . . . . . .. . . . . . . . . . . . . . .Filed Map. . . . . . . . . .Lot. . . . . . . . . . . . . . . . . . . . . . Permit No. �f..�.3. :A :'. .Date Of Permit./V'R/ . . . .Applicant. . . . . . . . . . . . . . . . .. . . . . . . . . Health Dept. Approval. . . . . . . . . . . . . . . . . . . . . . . . ..Underwriters Approval. . . . . . . . . . . . . . . . . . . . . . . . Planning Board Approval. . . . . . . . . . . . . . . . . . . . . . . . Request for: Temporary Certificate. . . . . . . . . . . Final Certicate. . . . . . . . . . . Fee Submitted- $. . . . . %0.� . . . . . . . . . . . . . . y -:ia v.8o 4�' AUPT.T!'AT 7 X65.1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION IST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] 1 TION [ ] FRAMING [ ' FINAL [ ] FIREPLACE & CHIMNEY j REMARKS• ,O/�� DATE /'✓ � IN8PECT0 FIELD INSPECTION REPORT DATE COMMENTS II H FOUNDATION ( 1 STY II I I Q I N FOUNDATION (2ND) I I� III II O G! ROUGH FRAME & I� N PLUMBING I Qc INSULATION PER N. Y. ! ? H STATE ENERGY CODE I H FINAL ADDITIONAL COMMENTS: (� I UILDIN.G DEPARTMENT uuu.uUvu rrKMll A FLJCAfl0N CHECKLIS' TOWN HALL Do you have or need the following,before applying SOUTHOLD, NY 11971 Board of Health TEL: 765-1802 33 sets of Building Plans-T- PERMIT NO. v2�37e>2 Survey Check Septic Form N.Y.S.D.E.C. Examined —,20 Q/ Contact: Trustees Approve ,20� Mail to: Disappro a/c Phone: Building , ' Spector Ak LICATION FOR BUILDING PERMIT Date , 20 -- 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 areas, and waterways. ... premises, relationship to adjoining premises or public streets or 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 issue a Building Permit to the applicant. Such a permit shall be kept on the premises available for inspection throughopt*the work. e. No building shall be occupied or used in whole or in part for any purpose what-so-ever until a Certificate of Occupan is issued 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,building code,housing code, and regulations, and to admit authorized inspectors on premises and in building for necessary inspections. (Signature of applicant or e, if a c oration) (Mailing address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder Name of owner of premises (as on the tax roll or latest deed) If applicant is a corporation, signature of duly authoriz6d officer (Name and title of corporate officer) Builders License No. Plumbers License No. Electricians License No. Other Trade's License No. 1. Location of land on which proposed work will be'done: J� J.11al�l'/�6�1c' T�i7 J6v House Number Street roG� Hamlet County Tax Map No. 1000 Section Block D Subdivision Lot (Name) Filed Map No. Lot State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy � ear /TIA-t-- ��N(r L� 11. �Afe4 51-- ' b. Intended use and occupancy f14 44cr 1\.w— cy_�Ak AA:+V\ Nature of work (check which applicable): New Building Addition Alteration Repair Removal Demolition er k—' (Description) Estimated Cost �� Fee (to be paid on filing this application) If dwelling, number 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 type of use. Dimensions of existing structures, if any: Front Rear Depth Height Number of Stories Dimensions of same structure with alterations or additions: Front Rear Depth Height Number of Stories Dimensions of entire new construction: Front .o? /S Rear ,,Z P Depth o2� Height /� " Number of Stories Size of lot: Front Rear Depth 0. Date of Purchase Name of Former Owner 1. Zone or use district in which premises are situated 2. Does proposed construction violate any zoning law, ordinance or regulation: /` e 3. Will lot be re-graded Will excess fill be removed from premises: YES NO 4. Names of Owner of premises k4UA&cS4-1Address "?'?5-- Phone No. 76 L fs-Z Name of Architect Address Phone No Name of Contractor Address Phone No. 5. Is this property within 100 feet of a tidal wetland? *YES O • IF YES, SOUTHOLD TOWN TRUSTEES PERMITS MA REQUIRED 6. Provide survey, to scale, with accurate foundation plan and distances to property lines. 7. If elevation at any point on property is at 10 feet or below, must provide topographical data on survey. TATE OF NEW YORK). SS: :OUNTY OF fur,-:; 4 J2 being duly sworn, deposes and says that(s)he is the applicant (Name of individual signing contract)above named, 3)He is the (Contractor,Agent, Corporate Officer, etc.) f said owner or owners, and is-duly authorized to perform or have performed the said work and to make and file this application; iat all statements contained in this application are true to the best of his knowledge and belief, and that the work will be erformed in the manner set forth in the application filed therewith. worn/oe me this day of CLA4 200 / Notary Public Signature of Applic HELENE D.HORNE Notary Public,State of New Yo* No.4951364 Qualified in Suffolk County Commission Expires May 22, oda 3 BUILDING PERMIT REVIEW CHECK LIST ApplicanU �� _ Date Owners Name: v Reviewed: / ArchitecU Date Engineer: Submitted: SCTM t1: District: 1,000 Section: S�I31ock _ Lot: Project Subdivision r� I.ocation: 3�s � Name: Single&_ separate Required certification: (Yes/No) � _ Req. Req. /.onoue District:-1-4--e— 11,0t size: ��Actual (/v 4A'3. 40I,ot coverage _;7 hoposed 3 Rey f Req �f Req. r/ d (Front Yard 16d Proposed: J (Side Yard _�L_ Proposed: J (Rear Yard 75 Proposed Project Description: AGENC)VERMITS Permit REQUIRED FOR REVIEW N.A. NO YES Number Suffolk County p Health Dept. V New York State D. E. C. Town Trustees Town Zoning Board approval: / Town Planning Board approval: ✓/ Flood Plane Elevation ??? Flood Zone: /,s8 Notes.: Ak'� GON6 "L;-,�`', " �C1. OVXIJGAaLy � sL F1 bu r. I ;tc�_—� 1 fealtics at L`.Is location found t -T;w. Y 0 t"w CT a'encies and �+yti':�sL)CpBttTC� AS ,�IZE1Cl S• 1{I fry NOTED (� 1 i:t$l�rct: i f,!1Cjr3Y � 2 3 1 be stisfactoiy Fvoltr ,,,..}-r ,.. •=--•_.�.----r � � Water and Wa�•e M�gement /�� NOT BUILDING EPA A Office of 765-1802 8 AM TO 4 PM FOR THE FOLLOWING INSPECTION t FOUNDATION • TWO REQUIRED VZZ.�hVAA —XIB IRED CONCRETE 2 ROUGH - FRAMING B PLUMBING 3. 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