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HomeMy WebLinkAbout16831-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. Certificate Of Occupancy Z16973 June 10, I988 No .................. Date ................................ THIS CERTIFIES that the building ......... .a $ .r .t .c .u .l .~ .u .r .a .1 ........................... Location of Property 38030 Main Road Cutchogue - - h3dsb ~'oi ....................... 'S't/e3i ....................... County Tax Map No. 1000 Section 85 .Block 3 .Lot 8 Subdivision ..... X .Filed Map No. X .Lot No. X conforms substantially to the Application for Building Permit heretofore filed in this office dated ....M.a.r.c.h..1.4.,..I.9.8.8 .... pursuant to which Building Permit No. 1683 Ig dated ....~.a?.e.h..1.7>. J.9.8.8 ........... was issued, and conforms to an of the requirements of the applicable provisions of the law. The occupancy for which this certificate is issued is ......... Agricultural stand. The certificate is issued to ALBERT J. KRUPSKI, SR. ..................... ?o¥,,'o;, ..................... of the aforesaid building. Suffolk County Department of Health Approval ............... .N/.A. ....................... UNDERWRITERS CERTIFICATE NO. N/A PLUMBERS CERTIFICATION DATED: N/A Rev. 1/81 ~OB~ NO. B TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N. Y. BUILDING PERMIT (THIS PEP,~IT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) County Tax Map No. 1000 Section ..... ..~..~...~'. ........ Block ...... .~ pursuant to application dated ..... ......~.~....~..~. ............ Building Inspector. )....~ ....... Lot No ...... . ,c?, ~.. ............ ..., 19..~..~..., and approved by the Rev. 6/30/80 TOWN OF SOUTHOLD Building Department Town.a, Southold, N.Y. 11971 765- 1802 APPLICATION FOR CERTIFICATE OF OCCUPANCY ' Instructions A. ~This application must be filled in typewriter OR ink, and submitted m ~ to the Building Inspec- tor with 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 feature{. 2.Final approval of Health Dept. of water supply and sewerage disposel-(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, a certificate 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: I. Accurate survey of p~'operty 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.OOALTERATION $25.O0 1. Certificate of occupancy New Dwelling $25.(10, Accessory.i$lO.00 Business $50.00 2. Certificate of occupancy on pre-existing dwelling $ 5 0.0 0 3. Copy of certificate of occupancy $ 5.0 0, over 5 years $]0.~0/ 4.Vacant Land C.O. $ 20.00 ~.~.~)/..~b.~. 5.Updated C.O. $ 50.00 Date ..................... NewC°nstz"ucti°n. . 4%~.. Old or Pre-existing Building ............ VacantLand .......... . . . Location of Property .-~..~0 ./~la/. ~o~.. ~..~-~.o..,~.! Nouse No. Street Nam/et Owner or Owners of Property t~../-~..c~.~, .7~. .~.,..,/~g,~O County Tax Map No. 1000 Section ...~ ~'.5". ....... Block ..... ~5 ......... Lot..~7 ............ Subdivision ................................. Filed Map No ........... Lot No .............. Permit No. /~'..~/.7-~. Date of Permit. ~)1~.1 ?..~..Applicant .................................. Health Dept. Approval ........................ Labor Dept. Approval ...................... . . Underwriters Approval ........... Planning Board Approval Request for Temporary Cer~:ificate ..................... Final Certificate ................. Fee Submitted $..~ .~,.¢~.. ~'..~t~..~(~ ~. ~2 ~.0... Construction on above described building and permit me.ets all applicable codes and regulations. ~'~ ~T~ ~]c19 Applicant .......................... ,..,o.,o.,, 3-7. TOWN OF SOUTtlOLD OlqqCE OF BUILDING INSPECTOR P.O. BOX 728 TOWN IfALL SOUTIIOLD, N.Y. 11971 May 11, 1988 TEL. 765-1802 Albert K. Krupski, Sr. 38030 Main Road Peconic, New York 11958 To Whom This May Concern, We are unable to complete your Certificate of Occupancy because .of the following reasons. ~ An application for Certificate of Occupancy is ~]ot on file. (ENCLOSED) /_--/ bio Underwriters Certificate on file. /~_/ The check i'~;(D~Y~Xb~not on file.) $25.00 /~/ No Health Dept. Approval on file. /_/ No final inspection has been made. this ~natter. P2easc contact our office on Thank you for your cooperation. ]h~[l(ling Permit t! 1 6 8 3 1 Z Build in~ Dept. **~/_--/ Uo Plumber solder Certificate on file. ( all permits involving plumbing being issued after April 1,1984 ) FOUNDATION ( ls t) FOUNDATION 2. ROUGH FRAME & ~FLUMBING (2nd) FINAL ADDITIONAL COMMENTS: INSULATION PER N. Y. STATE ENERGY CQDE USE. iS UNU\~FUL NOTI~ BdiLD~HG ~<'.PARTME~T AT FoUNDAqO~,~ T~'O ~EQUIR~ ROUGH ~;~t~N~N~ ~ pLUmBING ~,JN~I. t? ~'~TRUC'f ~ON MUST ' ' . ,,~ * MEET 765-1802 BUILDING DEPT, INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] INSULATION []FRAMING [~INAL INSPECTOR Examined..W .. .& .In.., I9 Approved .~¢IA~c(~. !.?. TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL $OUTHOLD, N.Y. 11971 TEL.: 765-18lj2 ., 19 .~.. Permit No. ! .~.~. ,%. [ .~... Ill)Alii) f)1,' Ill(Al/I'll ...... '1 ,ql,:'l';; OI? PI,AN2, ....... SLIRVE¥ SEPTIC FORM ' Disapproved a/c .............................. , ...... (Building Inspector) APPLICATION FOR BUILDING PERMIT NOTTFY MAIL TO: Date .................. , 19 INSTRUCTIONS a. This application must be completely filled in by typewriter or in ink ahd 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 det~led 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 iss.uance 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 inspectom on premises and in building for necessary inspections. (Signature of applicant, or name, if a corporation) 2 .v..C??.o... .... ...... (Mailing address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. (as on the tax roll or ~ar st ) If applicant is a corporation, signature of duly authorized officer. (Name and title of co,orate officer) . ALL CONTRACTOR'S MUST BE SUFFOLK COUNTY LICENSED Builder's License No ............. ~ Plumber's License No ......................... Electrician's License No ....................... Other Trade's License No ...................... Location of land on which proposed work will be done. House Number Street Hamlet County Tax Map No. 1000 Section ..... ?~.~. ......... Block Lot..~ Subdivision ..................................... Filed Map No ............... Lot ............... (Name) State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy . .~ o..~..'~./C'. ............................... b. Intended use and occupancy . . . .~..%f..'~~. 'g ~'"~ckV · ~ ~ 3. Nature 0fwork (check Winch applicable): New Building .......... Addition . ...... ... Alteration .......... Repair .............. Removal .............. Demolition .......... .... Other Work ............... ,~ (Descrip,tion) 4. Estimated Cost Fee ......... 1 ..... ' (to be paid on filing this application) 5. If dwelling, number of dwelling units ............... Number of dwelling units on each floor ................ If garage number of cars ' 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 ............... Number of Stories ....................................................... Dimensionsof same structure with alterations or additions: Front ................. Rear .................. Depth ...................... Height ...... i~' '; ........... Number of Stories ...................... · 8. Dimensions of entire new construction: Front .... ;l, ~... ..... Rear ..... 3....~. '. ..... Depth ....a..O..' ....... Height .... /. ,~- ........ Npmber of Stories ........................... 9. Sizeoflot: Front ....z/.Q.th .............. Rear ...................... i ............................. ~ Del>th ...................... 10. Date of Purchase i.. I .q'. 9.,,q". ................... Name of Former Owner i..'~'.q .~...."'~ i~.'~ .~ .......... 1 I. Zone or use district in which premises are situated.., fi.,~. ................. 12. Does proposed construction violate any zonin~ law ordinance or regulation' ' [ ............................ 13. WLi1 lot be regraded .~',~...~.,<e,..4~...(. ¥ .¥,.~,~.~.c5,L ~. Will excess fill be removed from premises: Yes 14. Name of Owner of premises ~. 14*.r.'b. .~.~.~. 10.a..]~;..~..r'Address .............. [ .... Phone No ............. Name of Architect ........................... Address .............. ~ .... Phone No ................ Name of Contractor .......................... Address .... : ......... } .... Phone No ................ 15. Is this property located within 300 feet of a tidal wetland? Yes ..... No . *If yes, Southold Town Trustees Permit maybe required. PLOW DIAGRAM 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 shov street names and indicate whether interior or corner lot. ~TATE OF NEW YORK, COUNTY OF .. ' S.S being duly sworn, deposes (Name of individual signing contract) above named. and says that he is the applicant He is the .............................................................. ! ............................ (Contractor, agent, corporate officer, etc.)I Cf said owner or owners, and is duly authorized to perform or have performed the s~id work and to make and file this application; that all statements contained in this application are true to the best ofhi~ knowledge and belief; and that the work will be performed in the manner set forth in the application filed therewith. $wom to before me this .............. ! .c/..., .... day of. .... ,~.~ ..... , 19 ~. WotaryPublic, . .... ~...~,...~.~..~...d~-~..... County ~.~i~ Pll~.lg s~ ~ ~ ~ (Signature of applicant)