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Home My WebLink About16840-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No Z17797 Date FEB. 24, 1989 THIS CERTIFIES that the building Location of Property 1260 FACTORY AVE. House No. County Tax Map No. 1000 Section 142 Subdivision ALTERATION Block 01 Filed Map No. MATTITUCK Street Lot 08 Lot No. Hamlet conforms substantially to the Application for Building Permit heretofore filed in this office dated MARCH 18, 1988 pursuant to which Building Permit No. 16840Z dated MARCH 21, 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 ALTERATIONS TO EXISTING SINGLE FAMILY DWELLING. The certificate is issued to JOHN J. BERDINKA (owner,)iY~) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A UNDERWRITERS CERTIFICATE NO. N023249 JULY 26~ I988 PLUMBERS CERTIFICATION DATED N/A Building Inspector Rev. 1/81 TOWN OF $OUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N. Y. BUILDING FERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) No_l 6840 Z ......... ,~7.-.~ ..... , ...................... :, ............ County Tax Map No, 1000 Section ..Z~. ......... Bilk ......~ ............ Lot No .......... ~ ......... Building Inspector. Rev. 6/30/80 FORM NO. 6 TOWN OF SOUTHOLD Building Department Town Hall SouthoJd, N.Y. 11971 765 - [802 APPLICATION FOR CERTIFICATE OF OCCUPANCY Instructions A. This application must be filled in typewriter OR ink, and submitted m 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 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, 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: 1, 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 $25.00 ALTERATION $25,00 1. Certificate of occupancy New Dwelling~$25.00, Accessoryi$10.00 Business $50.00 2. Certificate of occupancy on pre-existing dwelling $ 5 0.0 0 3. Copy of certificate of occupancy $ 5.00, over 5 years $]0.0~0 4.Vacant Land C.O. $ 20.00 °ate 7. . ?.:.-¢Y. . : 5.Updated C.O. $ 50.00 ................ NewCons tz~uc tion ...... Old or Pre-existing Building . j~ ........ Vacant [-and .......... Location of Property ................... ~ ........................................ House No. Street Owner or Owners of Property ~--O/f' AY ~'--' ~ ~T~ ~,/~/.z~ ~-~'~ Ham/et County Tax Map No. 1000 Section ../~..~. ....... Block .... /. ......... Lot...~. ............ Subdivision ................................. Filed Map NB ........... Lot No ......... Permit No .... Date of Permit ...Applica . Jr. Health Dept. Approval .............. .. ..... .,...Labor Dept. Approval ........ ' .......... Underwriters Approval .A .~. ........... ; .Planning Board Approval .................. Request for Temporary CerT:ificate ..................... Final Certificate ....................... Fee Submitted $ ............................. Construction on above described building an/c~permit?~e?ts al/¢pplicable codeff and regulations. R~. 10-10-78 FOUNDATION (1st) FOUNDATION (2nd) ROUGH FRAME & .PLUMBING INSULATION PER N. Y. STATE ENERGY CODE FINAL ADDITIONAL COMMENTS: 765-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION ZST [ ] ROUGH PLBG. [ J FOUNDATION ZND [ ] INSULATION [ ] FRAMING [~FINAL REMARKS: ~-~ (~~ ,,/// 765.1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLBG. [ J FOUNDATION 2ND [ ] INSULATION [~]/~INAL FRAMING REMARKS:~_~, 0, DATE 765-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLBG. FOUNDATION ZND [ ] INSULATION FRAMING FINAL GLENN fi'. P. O, BOX I AI)t~'E!.,, NY, LIC{NSI~ NO. t227 return to the africa ef the Beard i~ BOARD OF HEALTH ...... 3 SETS OF PLANS ....... FORM NO. I SURVEY . . TOWN OF SOUTHOLD CHECK ~'~(~..' ~ BUILDING DEPARTMENT SEPTIC FORM ............. : TOWN HALL NOTIFY C, OUTHOLD, N.Y. 11971 , TEL.: 765-1803 Examined ~. ~'~ ., 19~'..~. Approved ~./,7--.) i i i i i i., 19 .~. Permit No./.~..~..~..~..~ Disapproved a/c ..................................... CALL .... ~ ........... MAIL TO:w/ APPLICATION FOR BUILDING PERMIT 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, ordinance§, building code, housing code, and regult~tions, and to admit authorized inspectors on premises and in building for necessary ~tspection~ ............ ' C~'g~i~}r'~ ;~ applicant, or name, if a corporation) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. Name of owner of premises ~I~N ~ (as on the tax rbJl'or ]ates~ d~ed~ If applicant is a corporation, signature of duly authorized ofhcer. (Name and title of co,orate officer) - A~ CO~AC~OR~S ~S~ ~ SU~O~ CO~ ~C~ Builder's ~ice~se 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 Section .../.~..~. .......... Block....] .............. Lot...~. ............... 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 . . '., ............ ' .... ~ .'...~4 .'7..'~./~ . ............... b. Intended use and occupancy . .~ta"F~,/z~ ~ ~ .- " 3. Nature of work (check which applicable): New Building ............... ..... Addition : Alterat' 'forf~--~:'~ .......... Repair .,~ ........... RemoVal ........ ' ...... Demolition .............. Oiher Worlit. [ ....... .::~1. · · 4. Estimated Cost //O~a ,, L .................. Fee ............... '"" ',a~,:;'; .......~l'"~l~[ ~ ' (to be paid on.fi~i~'~n) ~ 5. If dwelling, number of dwelling ~nits ............... 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 D~ nsions of 'stingst e~ 'fany: Front Rear Depth Height NumbeFof Stories D~ensions'of same structure with alterations or additions: Front Rear Depth .................... ~. Height ...................... Number of Sto~es ...................... Dimensions of entire new const~ction: Front .......... ..... ' Rear ............... Depth ............... Height ............... Number of Sto~es ........................................................ 9. Sizeoflot: Front ........... ~ .......... Rear ...................... Depth ...................... 10. Date of Purchase ........... ~ ................. Name of Foyer Owner ............................. 11. Zone or use district in which premises are situated ..................................................... 12. Does proposed construction violate any zoning law, ordinance or regulation: ................................ 13. Will lot be regraded ......... ~ .................. Will excess fill be removed from premises: Yes No 14. Nme of Owner of premises , . .... ; .... Address . Phone No. N~e of Architect .......... ~.. .............. Address ................... Phone No ................ ~ N~',e of Conu'ac~or ........ '. ~ ....... :?. ....... Address .. ~.: .............. Phone No ................ 15. Is th~s p~operty locatad ~ch~n 300 faet of a tida~ wetland? *Yes ..... No .~.. · ~f yes', Southold To~ Tru~teas Permit ma~ be required. PLOT DIAG~M Locate clearly ~d distinctly ~I bufld~gs, whether existing or proposed, and. indicate ~1 set-back d~ensions from property lines. Give street ~d block ~umber or description according to deed, and show street names and indicate whether interior or corner lot. ~ OCCUPANCY OR USE IS.UNLAWFUL . WITHOUT CERTIFICATE OF OCCUPANCY STATE OF NEW YORK, COUNTY OE ................. S.S NOTIFY BUILDING DEPA~MENT AT ~5-1802 9 AM TO 4 PM FOR FOLLOWING INSPECTIONS: ]. ~OUNDATION - ~O ~O~ POURED CONC~ET~ 2. ROUGH ~ FRAMING & PLtJMBIN~~ 3. INSULA'FION ~. ~INAL - C~N'5'r'PUCTION B~ CO~AP~ r:TE FO~ C, 0. ALL CONSTm~CTION SHALL TH~ R~OI.P~r~NTS OF TN~ h~ V STATE CONSTRUCTION & ~ .... ~': CODES. N~T RESPONSIBI_F .... ! ~'c .......... being duly sworn, deposes and says that he is the applicant y above named; , ' He is the ....................... i .................................................................. i (Contractor, agent, corporate officer, etc.) of said owner or owners, and is dulyi authorized to perform or have performed the said work and to make and file this applicai;ion; [hat all statements contaihed in this application are true to the best of his knowledge and belief; and that the work will be performed in the mannerlset forth in the application filed therewith. Sworn to before me this ............ day of.i,.. 19 Notary Public ...... ~ .... y · ! HELEN K. DEiVOE ............. I NOTARY PUllLIC, State of New York (Signature of applicant) . No. 47078'18, SuffOlk County mrm Expires U~ch 30, 19 d /