The URL can be used to link to this page

Home My WebLink About30607-ZFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEP~TMENT Office of the Building Inspector Town Hall Southold, N-Y. CERTIFICATE OF OCCUPA~ICY No: Z-30409 Date: 09/09/04 TI{IS ~ERTIFIES that the built, lng ADDITIO~ Location of Property: 1525 SHIPYARD LA (EOUSE ~0.) (STREET) County Ta~Map No. 473889 Section 38 Block 1 Subdivision Filed Map No. __ Lot No. __ EAST MARION Lot 16 (HAMLET) conforms substantially to the Application for Building Permit heretofore filed in this office dated AUGUST 31, 2004 pttrsuant to which Building Permit No. 30607-Z dated AUGUST 31, 2004 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 TO EXISTING SINGLE FAMILY DWELLING AS APPLIED FOR "AS BUILT". The certificate is issued to JOHN VOLINSKI of the aforesaid building_ (OWNER) SUFFOLK COUNTY DEPARTMENT OF ELEC~I~_AL CERTIFICATE NO. PLI~BEIt~ CERTIFICATION DATED N/A N/A N/A Rev. 1/81 t ho/i z ed'S ignature TOm 0F SOUTHOLD BUILDING DEP~TMENT Town Hall Southold, N.Y. (THIS PERMIT MUST BE KEPT ON THE PREMISES ~TIL F~ COMPLETION OF THE WORK AUTHORIZED) PERSiI T lqO. 30607 Z Date AUGUST 31, 2004 Permission is hereby granted to: JOHN VOLINSKI RR 01 1525 SHIPYARD LANE EAST MARION,NY 11939 for : CONSTRUCTION OF A DECK ADDITION "AS BUILT" TO Ai~ EXISTING SINGLE FAMILY DWELLING AS APPLIED FOR at premises located at 1525 SHIPYARD LA EAST MARION County Tax Map No. ~73889 Section 038 Block 0001 Lot No. 016 pursuant to application dated AUGUST 31, 200A and approved by the Building Inspector to expire on FEBRUARY 31, 2006. Fee $ 300.00 Authorized Signature ORIGINAL Rev. 5/8/02 Form No. 6 TOWN OF SOUTltOLD BUILDING DEPARTMENT · TOWN IIALL 765-1802 APPLICATION FOR CERTIFICATE OF occUPANcY . This application must be filled in by typex~riter or ~ and submitted to the Building DePm'~n(~h th6 following{' A. For new building or new use: 1. Firml survey of property with accurate location of all buildings, property lines, streets, and unusual rmtural or topographic features_ 2. Final Approval from Hca/th DeptL of Water supply and sewerageqtLsposal (8-9 form). 3. Approval of electrical imtallatinn fi:om Board of Fire Underwriters. 4_ Sworn statement fi:om plumber certifying that the solder nsed i~ sTstem contains less thaa 2/10 of 1% lead. 5. Commercial building, industrial building, multiple residances and sinular buildings and installatio~xs, a c ertific ate or Code Compliance from architect or engineer responsible for the building. 6. Submit Plmming Board Approval of completed site plan requirements · ~ B. ~lr existing buildings (prior to April 9, 1957) non-conforming uses, or buildings and "pre-existing" land uses: 'k~,J Acanrate survey 0fproperty sh6wing all property lines, sweets, budding and unusual ~_atural or topographic ~ features. ' 2. A properly completed application and consent to inspect signed by the applicant. If a Ce~ficate of Occupancy is denied, the Building Inspector shall state the reasons therefor ia 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 po¢l ~25.00, Accessory building $25.00, Additions to accessory btfilding $25.00, Btminesse~ $50.00. 2. Certificate of Occupancy on Pre-existi~g Building - $100 00 3- Copy of Certificate of Oecupaney- $_25 4. Updated Certificate ofOeeupaney - $50.00 5. Temporary Certificate of Occupancy - Residential $i5.00, Commercial $15.00 New Coastruction: Location of Property: Old or Pre-existing Building: Ho~e No. Strut (check one) H~mlet SuffolkCotmty TaxMapNo 1000, Seetion /~OOC> ff Block~ ~Lo~ Subdivision Filed Map. Lot: Permit No. Health Dept. Approval: Planning Board Approval: Date of Permit. Applicant: Undema-iters Approval: Request for: Temporary Certificate Fiml Certificate: (check one) Fee Submitted: $ Applicant Signature · TOWN OF sOUTHOLD ,BUILDING DEPARTMENT ';tOWN HALL ;SOUTHOLD, NY 11971 TEL: (651) 765-1802 FAX.~(63t) 765-9502 ,www. northfork.net/S onthold/ Examined Approved Disapproved a.'c ,20 Expiration BUILDING PERMIT APPLICATION CHECKLIST Do you havq or need the folloxdng, before applying'? Boar~ of Health 3 sets of Building Plans P larmmg Board,~l~proval__ Check Septic Form N.Y_S.D.E.C. Tm~ees Mailto:ME ~q'-- ~/~t. Phone: ~i, ~77, ~3 ' Buildin~ Inspector .kPPLICATION FOR BUll,DING PERMIT Date INSTRUCTIONS J 3 -4o uxr- 20 04 a. Tiffs application MUST be completely filled in by tS,pexx~iter or in itzk and suNrdtted to the Building Inspector with 3 sets of plans, accurate plot plan to scale. Fee according to schcdule¢ b. Plot pl~ show~g location of lot and of bfil~gs on pre~ses, rehtions~p to adjoining premises or public streets or areas, ~d watenvay8. c. The work covered by tls} application nmy not be co~enced be~bre issum~ce of Buil~g Petit. d. Upon approval oft~s app~cadon, the Buit~g ~pecmr w~l issue a Budding PemSt to the applicant. Such a pe~t s~ll be k~pt on tko prenSses available for i~pection t~'o~out the work. e. No bulldog shall be occupied or used in whole or in p~ for any p~ose ~l~t so ever ~til the Building hspector issues a Ce~RScate of'Occupancy. f. Ex eD, buit~g per~t shah expke iffiae work authorized has not con~enced witNn 12 months after the &t~ of issuance or has not been completed wlt~ 18 months from such dgte. if no zomg anxendments or other reg~ations affectNg the property ~ve been mmcted in the imam, the Bui1&g ~pector may authorize, in x~ting, the extension of~e pe~t for an addition six moults. Thereafter, a new pemt shall be zeqt~d. .~PL[CATION IS }~P~BY Nfi~E to the B~lding Dpp~nm~t for the issuance of a Buik~g Pemrt p~s~t to the Build~g Zone Ordiuance of the Town 0f. Southold, Sukb~ Co~s New York, ~d o~er apphcable Laws, Or~nances or Relation. for the construction of buil~gs, additions, or alterations or ~br removal or demolition as herein described. The applicant agees to cgmply w[~ all applicable laws, ordN~ces, b~iding code, housNg code, and re,lading, ~d to a~t amho~ed inspectors on presses ~d N building for necessa~ inspections. (Si=nature ~plic~gr nmne, if~n) ~ ~ t~lal~Jddress ofapphc~) ~ t ~ State whether applicant is~[essee, agent, architect, en~eer, genial con.actor, elec~ci~, plumber or b~lder Nameofownerofpremises MP---~ ~t~. '~-~ X]Ob-,,-~Sk--[ (As on the tax roll or lateit deed) If applicant is a corporation, signature of duly authorized officer (Name and title of coq*orate o~5 car) 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: 1525- ~.p c~q~_~ L.q~ }louse Nmnber Street Hamlet Coullty Tax Map No. 1000 Sabdixdsion (Name) Section '38 Block ] Filed Map No. Lot / 42 Lot State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy ~3crc.~ _~-~m:,.-] b. Intended use and occupancv .~ t,-}C-~.~ ?~-,,a~.~__ h~' ~ ~- 3. Nature of work (check which applicable): New Building Repair Removal Demolition 4. Estimated Cost "~ '2 ~O~ Fee 5. If dwelling, number of dwelling units If garage, number of cars n (Description) (To be paid on filing this application) Number of dwelling tufits on each floor 6. If business, corrm~ercial et mixed occupancy, speciPynature and extent of each t33oe of use. _____ Dimensions of existing structures, if any: Front '4<7'-0" Rear ~.--Q .-o" Height Dimensions of same structure with alterations or additions: Front Depth '3-q-'-~- Height l¢~?'r~?e..¢~ Number of Stories Dilriensions of entire new construction: Front tl'2j~ G Height :21" Number of Stories c--/O. O' Rear c/O, O* .Depth 9. Size of lot: Front 10. Date of Pnrchase Depth '52.4 Depth } O'~ 5-" Name of Former Owner 11. Zone or use district in which premises are situated 12. Does proposed construction xdolate any zoning law, ordinance or regulation? YES NO 13. Will lot be re-~'aded? YES NO ~,, V¢ill excess fill be relnoved from prc~nises? TES NO 14. Names of Owner ofpremises~a, g M~s. ~u,~$~ Address ~. ~ ~ to~ Phone No. ~3~.4~7. 2~3b NameofArcNtectfi~t ~ ~,c~,~) Address~.~,t~qg ~o~ Phone No ~1t.7~.~/c~ Nm~e of Con,actor Address Phone No. 15 a. Is this property.' within 100 feet of a tidal wetland or a fi:eshwater wetland? *YES * IF YES, SOUTHOLD TOX,VN TRUSTEES & D.E.~7 PERMITS lX&&Y BE REQUIRED· b. Is this property within 300 feet of a tidal wetland? * 5TS__ NO * IF YES, D.E_C. PERMITS MAY BE REQUIRED. __NO ~ 16. Provide survey, to scale, xxSth accurate foundation plan and distances to property lines. 17. If elevation at any point on property is at 10 feet or below, znust prox4de topo~aphical data on survey. STATE OF NEW YORK) SS: COUNTY OF /Z)t4I ,/'?-'f~ t¢ ~',~ ..J. P~O ~/(m/~,.~/~/ being dul3, sworn, deposes ~.nd s~vs that (s)lze is the applicant (Name of indixSduaI si=rating contract) above named, (S)He is the (Contractor... ~ .= ~=en* .. Corporate et'fie er, etc.) of said mx her et owners, and is dui), authorized to pertbrm or have performed tb.e said work and to make and fde this application; that all ~atements contained in this application are true to the best of his lcnowledge aud belief; and that the work will be performed in the mariner set forth itt the application filed therewith. Sworn to before lne this 20 oSz SiL~atlffe of Applicam r~mmissiun Exp~res2//Y_:I.,i~/o ..~ i.// ,/' ,/ // t,10RTH,~oT ELE-'TF di,,l CERTIFICATION OF NAILING g APPROVED AS NOTED g^~'.NOTIFY BUILDIN~ 3EP~TMENT AT 765.1~03 8 AM .,30.4 ~- FOR~E, FOLLOWING t~SP~f~S: · 1. FOUNDATIO~4'~ ~IRED 3. INSL'.AT~'~~' ~ ~ 4, FINAL - CON~~ ~TIO~ M~ BE COM~E~'~'~ FOR C,O. ALL OONS~ION SH~L ME~ ~E YORK S~TE. ~OT RES~S~E ~ r "' "~F~---T' C 2 3OPAflC, Y OR '- I$ UNLAWFUL WITHQUT CERTIFICATE ,L)F OCCUPANCY IT IS A VIOI..A'noN OFTHE 'LAW FOR ANY PERSOIC UNLESS ACTING UNDER'TIlE O;RECTION OF A LICEI"I~EO ARCHITECT, TO ALTER ANY ANYWAY. ANyALITHORIZED ALTERATION ~UST BE NOTED, .SEALED, AND DESCRIBEO IN ACCORDANCE WtTH THE LAW.