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HomeMy WebLinkAbout31197-Z FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No: Z-31387 Date: 01/13/06 THIS CERTIFIES that the building ADDITIONS & ALTERATIONS Location of Property: 15305 NEW SUFFOLK AVE NEW SUFFOLK (HOUSE NO.) (STREET) (HAMLET) County Tax Map No. 473889 Section 117 Block 6 Lot 15 Subdivision Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated JUNE 13, 2005 pursuant to which Building Permit No. 31197-Z dated JUNE 13, 2005 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 ADDITIONS & ALTERATIONS TO AN EXISTING SINGLE FAMILY DWELLING AS APPLIED FOR. The certificate is issued to FRANK HAJEK (OWNER) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A ELECTRICAL CERTIFICATE NO_ N-227713 07/28/92 PLUMBERS CERTIFICATION DATED N/A Authorized Signature Rev. 1/81 Form No.6 1 17 rd IAN 12 TOWN OF SOVTHOLD BUILDING DEPARTMENT TOWN HALL _. 765-1802 APPLICATION FOR CERTIFICATE OF OCCUPANCY This application must be filled in by typewriter or ink and submitted to the Building Department with the following: A. For new building 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 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 I% 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 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 Building- $1W00 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: Old or Pre-existing Building: , V _(check one) Location of Property:_�__,�3_V•�� _ House No. ieet lVamlet Owner or Owners of Property: - --- Suffolk County Tax Map No 1000, Section— _ _Block Lot _ Subdivision Filed Map. Lot: __ Permit No. Date of Pernut._ Applicant: Health-Dept, Approval: Underwriters Approval: Planning Board Approval: Request for: Temporary Certificate-------Final Certificate: _ (check one) Fee Submitted: $ _ Applicant Signature Cod 313 � � cJ ar>gA�rJ�cPrJ�rJ1 �rrarJEPEnrJDOnc rJrrarJ:10011"arJ�r 11:11 311:11 JC (:IPrJc nrJ�cnc 11!I1i%:1i5 I acncnrJ acnc nr PrrlrnrlrJ a o BY THIS CERTIFICATE OF COMPLIANCE THE 5 5 NEW YORK BOARD OF FIRE UNDERWRITERS 5 5 BUREAU OF ELECTRICITY 5 40 FULTON STREET — NEW YORK, NY 10038 5 55 CERTIFIES THAT 5 5 Upon the application of upon premises owned by I r5 5 SRAYNOR FRANK L. FRANK HAJEK 5 1800 HARBOR LN./BOX 1065 15305 NEW SUFFOLK AVE. 5 5 CUTCHOGUE, NY 11935, SOUTHOLD, TN, NY 11956 5 5S 55 Located at 15305 NEW SUFFOLK AVE. SOUTHOLD, TN, NY 11956 5 5 Application Number: 2084646 Certificate Number: 2084646 �5 Section: Block: Lot: Building Permit: BDC: ns11 r� Described as a Residential occupancy, wherein the premises electrical system consisting of 5 electrical devices and wiring, described below, located in/on the premises at: 5 Basement, service only, Outside, 5 5 5 A visual inspection of the premises electrical system, limited to electrical devices and wiring to the extent detailed �5 herein, was conducted in accordance with the requirements of the applicable code and/or standard 5 5 promulgated by the State of New York, Department of State Code Enforcement and Administration, or other 5 5 5 authority having jurisdiction, and found to be In compliance therewith on the 5th Day of January,2006. Name QTX Rate Ratine Qircui[ Tvoe 5 5 Service 5 1 Phase 3W Service Rating 200 Amperes 5 5 Service Disconnect: 1 200 cb 5 5 5 S 5 5 5 5 5 5 seal 5 i of 1 �+D This certificate may not be altered in any way and is validated only by the presence of a raised seal at the location indicated. 5 5 ���� v 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. 31197 Z Date JUNE 13 , 2005 Permission is hereby granted to: FRANK HAJEK PO BOX 105 NEW SUFFOLK,NY 11956 for ADDITIONS AND ALTERATIONS TO AN EXISTING SINGLE FAMILY DWELLING AS APPLIED FOR. THIS PERMIT REPLACES EXPIRED PERMIT #14834Z . at premises located at 15305 NEW SUFFOLK AVE NEW SUFFOLK County Tax Map No. 473889 Section 117 Block 0006 Lot No. 015 pursuant to application dated JUNE 13 , 2005 and approved by the Building Inspector to expire on DECEMBER 13 , 2006 . Fee $ 150 . 00 1 Authorized ignature ORIGINAL Rev. '5/8/02 FORM N0. 2 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) N9 14834 Z Date ......... ?'L. ..C"A .......................... 19.x'4. Permission is hereby, granted to: .��...t- .a-Q:d.��. .....RR. ..... ............................................... . 1 ....... . . .... . . . . .............................................................. of premises located at 1.wi.apA4 ...!! .Qc'4? , .%19.!. .... ... :.......N.A.� ................................................................................. ................................................................................ ` �.. a.,. ....N..... . . . .......... ............... . . ..................................................................... County Tax Map No. 1000 Section ........113....... Block .......Q-6....... / . ... t. Lot No. .....1.5.......... pursuant to application dated .. ..... ...{....................... 19!A A, and approved by the Building Inspector. Fee $... .10o... . .G ... .. ..............:-...`"'`:.................. Building Inspector Rev. 6/30/80 t 1 THE NEW YORK BOARD OF FIRE UNDERWRITERS VAGH I 1000343 BUREAU OF 'ELECTRICITY 85 JOHN STREET, NEW YORK, NEW YORK 10038 Date �Il el' 28,39 2 Application No.onf le 4,7010087/87 'N 22713 THIS CERTIFIES THAT Ionly the electrical equipment as described below and introduced by the applicant named on the above application number in the premises of FRANK fid JEK, C/a NEW SUFFOLK AVE, -GRAI3F63OHL—, N99 SUFFOLK, 'NJ, in the following"location; El Basement ® Isi Fl,.° [:1 2nd Fl. Section Block Lot was examined on HARCH 02J992 .- aced found to be in car►eplance with the rPquirernents of this Board. FIXTURE OUTLETS: INCANDESCENT,FLUORESCENT OTHER 'RANGES COOKING DECKS __- OVENS aISH WASHERS EXHAUST FANS RECEPTACLES .SWITCHES T. K.W. AMT. K'.W. AMT. KW. . pp�� {{�� rr pp__.._ AMT. K.W: AMT. H.P.. 9 4A 1F .7 DRYERS FURNACE MOTORS FUTURE APPLIANCE FEEDERSSPECIAL'REC'PT TIME CLOCKS BELL UNIT HEATERS: MULTI-OUTLET DIMMERS " _ _ - _.. - AMT. AMP. AMT. AMPS. TRANS.I AMT. H.P: SYSTEMS AMT. WATTS OIL H.P. GAS '� H.P. AMT. � NO. � A.W.G: NO.OF FEET SERVICE DISCONNECT NO.OF S E R V 1 C EMETER d AML AMP. _ TYPE EQUIP. '1 X 2W PER . OF CC..G. O 'OF H W. GE - A.W.G. 1.�3W 3 A'3W 3:0'4W NO.OF CC.COND: A.W.G. NO.OF HI-LEG A.W.G, NO'OFNEUTRALS OF NEUTRAL OTHER APPARATUS: i j 7355 MAIN ROAD GENERAL MANAGER, RAT"Z'ITUCR', NY, 11952 11 Per This.certificate must not be altered in any manner; return to the office of the Board if'incorrect.. Inspectors may be identified by their credentials. f COPY FOR BUILDING DEPARTMENT.THIS COPY OF CERTIFICATE MUST NOT BE ALTERED IN ANY MANNER. THE NEW YORK BOARD OF FIRE, U'NDE'RWRITERS PROF, I 3075104 BUREAU' OF ELECTRICITY' F 85 JOHN STREET, NEW YORK, NEW YORK.10038 NhRCH 1 3.392 4.7410087187 N 2277 .3 a Date � Application.No.,on file THIS CERTIFIES THAT a s only the electrical equipment as described below and introduced by the applicant named on the above application number in the premises of FRANK HAJOK, C/O NEW SUFFOLK AVE, -GRAITKOHL, NEW SUFFOLK, N.Y in the following lac '❑ Basement ® l:st Fl. ❑ 2ndFt. Section Block Lot was examined an MARCH 42,13 9 2 and found to be in compliance with the requirements o this;Board. FIXTURE FIXTURES' RA EXHAUST FANS OUTLETS RECEPTACLES SWITCHES INCANDESCENT.FLUORESCENT OTHER AMT RANGES W COOKING K.W: AML K.W. DIASMT.WASHERS AT: H P f 9 6a. . NIT HEATERS MULTI-OUTLET .. AML AMP. TIME CLOCKS BELL �V DIMMERS SYSTEMS H.P. AMT. NO: A.W.G. I DRYERS w. OIL FURNACE MOTORS � FUTURE APPLIANCE FEEDERS SPECIAL REC'PT AMT. AMPS. TRANS. AMT. H.P. NO. FEET AMT', WATTS C } B SERVICE DISCONNECT NO.OF - S E 'R V 1' C E METER NO. CC.GOND: A.W.G: A.W.G. -W W,G: AMT. AMP. TYPE EQUIP T�0'2W 1,0'3W 3 0 3W 3,0'4W PER 0� OF CC.GOND. NO.OF:HIAEG _ OF.H1-LEG NO.'OF NEUTRALS OF NEUTRAL 9 OTHER APPARATUS: i r 4 F D GOODAI.LL CONTRACTING L"TC4783-N 651 STONY POINT, NY, 14980 GENERAL MANAGER s Per <, This certificate 'must not be altered in any manner; return to the office of,the Board if incorrect. Inspectors may be identified' by their credentials. COPY AOR BUFLDING DEPARTMENT.THIS COPY OF CERTIFICATE MUST NOT BE ALTERED IN ANY MANNER. aOF SOUryo� coum TOWN OF SOUTHOLD BUILDING DEPT. 765.1802 INSPECTION [ ] FOUNDATION 1 ST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] INSULATION [ ] FRAMING / STRAPPING [ J FINAL /G— ; [ ] FIREPLACE & CHIMNEY �[ ]�] FIRE SAFETY INSPECTION REMARKS: DATE l b INSPECTOR- ' Z, "� ll�l� 765.1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION IST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] IN ATION [ ] FRAMING [ FINAL [ ] FIREPLACE & CHIMNEY [ ] FIRE SAFETY INSPECTION REMARKS: of /� ,, / !! DATE 7 — INSPECTOR ITECNOLOGIES ARCHrIBC17M P ANNIM tC ONSMUCI'10N SERVICES 13405 MdnRaed,Meroteek,New Yoh 11952 631298.1129 6x:631.298.1128 December 23, 2005 Town of Southold Building Department Re: Mr. & Mrs. Frank & Rose Hajek 15305 New Suffolk Ave Cutchogue, N.Y. To Whom It May Concern: The following items have been addressed in response to final inspection dated July 1,2005: 1. Dryer has been removed 2, A self closing hinge has been installed on the interior garage door. If you have any additional questions please feel free to call our office at 631-298-1129. 5 KNOB cyr ro r R A - 'MELD INSPECTION JDATE COMMENTS v FOUNDATION ( 1st ) li uxt FOUNDATION ( 2nd ) m S�) 2 . z z ROUGH FRAME & PLUMBING 3 . � V% m o INSULATION PER N . Y. v� L STATE ENERGY CODE a 4 . 3 7 ! FINAL o � z ADDITIONAL COMMENTS : x (if x — ro H a H - -- H O 1 z � 1 �U 1 2 t-J -3 v nr-, ro H ft teti �L �slt ,s � . FORM NO. 1 TOWN OF SOUTHOLD I BUILDING DEPARTMENT TOWN HALL -OUTHOLD, N.Y. 11971 - - T E L.: 765-1802 i 3ttqExamined . . .�MGk . 4. . . ., 19Received . . . . . . . . . . . . 19 . . . Approved . . .° �. . . ., 19gt . Permit No. � 3 �, . -Ell Disapproved a/c 3,�� (J i— . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . (Building Inspector) APPLICATION FOR BUILDING PERMIT `I ���__// � Date . . . . . .? I Z.y. . . . . . ., 19�1fl 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, ordinances, building code, housing code, and regulations, and to admit authorized inspectors on premises and in building for necessary inspections?� �J . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . (S' e of a Lica or name, if a corporation) ' ��. . e. (mailing address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. ageUk . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Name of owner of premises . . . . . . . . . CC71JK . . .1�!C?.G.K. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . (as on the tax roll or latest deed) If ap scant is;acrorqtk'on, signature of duly authorized officer. (Name and title of corporate o r Builder's License No. Plumber's License No. . . AP. ?�� . . . . . . . . . . Electrician's License No. . :-�p���� Other Trade's License No. �?? \ . . . . . . . . . 1. Location of land on which proposed work will be done. . . . . . . . . �l4lu?h`. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . P. . . . . .- . . . . . . . . . . . . . . . . . . . . . . . . N. r�/ Sk Ff6c House Number Street Hamlet County Tax Map No. 1000 Section . �. . 11.7. . . . . Block . . . . . . . . . . . Lot . . Subdivision . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Filed Map No. . .QAAo r. . . . Lot . . . . . . . . . . . . . . . (Name) 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy T�"� \��l� g P Y . . . . ., )w' . . . . . . . . . . . . . . . . . ~ J. . . . . . . . . . . . . . . . . . . . . . . . . n r b. Intended use and occupancy . . . . a(�CCI�Q P�(dt31( . . . . . . . . . . . . . . . . . . 3. Nature of work (check which applicable): New Building . . . . . . . . . . Addition . .V1. . . . . . Alteration . . . . . . . . . . Repair . . . . . . . . . . . . . . Removal . . . . . . . . . . . . . . Demolition . . . . . . . . . . . . . . Other Work . . . . . . . . . . . . . . . (Description) 4. Estimated Cost . . . . . . . .t.C?vQc1Q. . . . . . . . . . . . . . . . . . Fee . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . (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 . . . . . . . . . . .. .. . . . . . . . . . . . . . I . . . . . . . . . . . . I . . . . . . . . . . . . . . 6. If business, commercial or mixed occupancy,specify nature and extent of each type of use . . . . . . . . . . . . . . .n. .!. . . 7. Dimensions of existing structures,if any: Front . . . . . . .43.-'CJ`. . Rear . . . .y$.-4-?. . . Depth . . . . .OHO. Height . . . . . . . . . . . . . . . Number of Stories . . . . . . . . . ..tD.k .. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Dimensions of same structure with alterations or additions: Front . . . . . . . . . . . . . . . . . Rear . . . . . . . . . . . . . . . . . . Depth . . . . . . . . . . . . . . . . . . . . . . Height . . . . . . . . . . . . . . . . . . . . . . Number of Stories . . . . . . . . . . . . . . . . . . . . . . 8. Dimensions of entire new construction: Front . . . .'.7.'`7-Q'' Rear . . . Depth . . . : .Q.'-Q". . . Height . . . . . . . . . . . . . . . Number ofStories . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . I . . . . . . . . . . . . . . . 9. Size of lot: Front . . . . . . . . . . . . . . . . . . . . . . Rear . . . . . . . . . . . . . . . . . . . . . . Depth . . . . . . . . . . . . . . . . . . . . . . 10. Date of Purchase . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Name of Former 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 11 emoved from premises: Yes No 14. Name of Owner of premises HaSe.K. . . . . . . Address \. . . . . Phone No.w!.e.-. .Co59 t. . . . Name of Architect . . . . . . . . . . . . . . . . . . . . . . . . . . . Address . . . . . . . . . . . . . . . . . . . Phone No. . . . . . . . . . . . . . . Name of Contractor . . . . . . . Address nc,'S�. Phone No. . . 9e-aC''1' 15. Is this property located within 100 feet of a tidal wetland? * Yes . . . . . No .?S. . * If yes, Southold Town Trustees Permit may be required. PLOT DIAGRAM Locate clearly and distinctly all buildings, whether existing or proposed, andindicate all set-back dimensions from property lines. Give street and block number or description according to deed, and show street names and indicate whether interior or corner lot. STATE OF NEW YORK, S.S COUNT.LOF . . . . . . . . . . . . . . . . . . /'. . :'?A� n x�(`.` 4. . . . . . . . . . . . . . . . . . . . . being duly sworn, deposes and says that he is the applicant (Name of!dividual signing contract) above named. Heis the . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .ctgjPA)�... . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . (Contractor, agent, corporate officer, etc.) of said owner or owners, and is duly authorized to perform or have performed the said work and to make and file this application; that all statements contained in this application are true to the best of his knowledge and belief;and that the work will be performed in the manner set forth in the application filed therewith. Sworn to before me this c Notary Public, _ ��/;, ,� ^ day of. . . F)l�k�f��'u-. . . . . . . ., 19 0.�' . . . . . . . .G. . .= e.k. . . . . of. . C V Coun . . . . . . . . . . Me f ow (S a -eof applicant) tri X i JF-_ P FSO P E J -T S.67�51 E. 1$1.16 OF 71 t7 r m i t > I 40.8' Z 40 _ �Y I 172, I — - - r. 1 - i_- It AMENDED Der—20.fcfS5 vne�nM,by�s�reradan rime i° o�r1CTEr _. _ — {r' r caoN.ar - --_ -� - L-/—t'- '-" t iJ - - ' 1. may. a � ' ` '_ , :Ti l� 1fA ' : r; ... Y : �.�. 1�ip. L� ..� �1 c--Jf2V E1�E '✓ an ory wYw � � 1 � f •r- /: f ^' a" mrltMr�nRldoegMAnd -- --- - ts be s vdm"o , Guwsntm We�A1 rm W .ir r- +. J� F." r� . t�.1J�.f i Iry- snbtotbe +�sh�aatt ._-------- 1, ._._..__-___------- ---- -- k,rapsrsry mbYwlM/btla tft te- -- -- -- - the 1.1AkJG `1 k Y�J(�,;... - .�44r+ 1 t c,i1�-T' ; J'Y �.�h€;itu6©ne weubrq�t X 15 . Iia, 14.4 j E-Ni- �t c, E0' EX IS T . H 0 tJ. S E KiT HEN I LIJ CL- "N N W 'C, A,1ZAC4E, 7 ° _ CXtST. , WALL . R,EmovL'.' 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