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HomeMy WebLinkAbout32242-Z FORM NO.4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY Date: 08/16/06 No: Z-31769 THIS CERTIFIES that the building ROOF REPAIR Location of Property: 58330 MAIN RD (HOUSE NO.) County Tax Map No. 473889 Section 66 (STREET) Block 2 SOUTHOLD (HAMLET) Lot 3 Subdivision Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated JUNE 26, 2006 pursuant to which Building Permit No. 32242-Z dated JULY 26, 2006 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 ROOF REPAIR OF AGRICULTURAL BUILDING AS APPLIED FOR. The certificate is issued to JOSEPH F KRUKOWSKI (OWNER) of the aforesaid building. N/A SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL ELECTRICAL CERTIFICATE NO. N/A N/A PLUMBERS CERTIFICATION DATED Rev. 1/81 . Form No.6 TOWN OF SOUTHOLD 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 2/1 0 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 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 appli"ant;/_ ---- eo'. r -.-- (7 \. ' C. ~.ee~ertificate of Occupancy _ New dwelling $25.00, Additions to dwelling ;2i~O~~teratio~to dwelling $45.00, Swimming pool $25.00, Accessory building $25.00, Additions to accessory building ~5.Q(\, Businesses $~O.OO. 2. Certificate of Occupancy on Pre-existing Building - $100.00. \ 3. Copy of Certificate of Occupancy - $.25 \' \_~_.-J 4. Updated Certificate of Occupancy - $50.00 \r . 5. Temporary Certificate of Occupancy - Residential $15.00, Commercial $15.@---=" -- Date. ~ Location of Property: $<631l0 House No. Owner or Owners of Property: ~'Se f ~ r. Suffolk County Tax Map No 1000, Section o~0 New Construction: Old or Pre-existing Building: .~ VVl a..,: 1\ {( oa r~ Street r;,,^ (nUJc:.)<.,' Block 000 01. ( check one) !;oLlrh tJ fJ Hamlet Lot 003 Subdivision Filed Map. Applicant: Lot: Permit No. Date of Permit. Health Dept. Approval: Planning Board Approval: Underwriters Approval: Request for: Temporary Certificate Final Certificate: ( check one) Fee Submitted: $ _M~~~p~' Appli t Signature &-.~. 7()8\l3 Qo C1f7&, 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. 32242 Z Date JULY 26, 2006 permission is hereby granted to: JOSEPH F KRUKOWSKI MAIN RD SOUTHOLD,NY 11971 for : REPAIR (ROOF) AGRICULTURAL BUILDING AS APPLIED FOR. REPLACES BP 28528 at premises located at 58330 MAIN RD SOUTHOLD County Tax Map No. 473889 Section 066 Block 0002 Lot No. 003 pursuant to application dated JUNE 26, 2006 and approved by the Building Inspector to expire on JANUARY 26, 2008. Fee $ 150.00 ORIGINAL Rev. 5/8/02 3 2..-2..- V- L i::: TOWN OF SOUTHOLD BUILDING DEPT. 765.1802 INSPECTION [ ] FOUNDATION 1 ST [] ROUGH PLBG. [ ] FOUNDATION 2ND [] IN ATION [ ] FRAMING I STRAPPING [. FINAL [ ] FIREPLACE & CHIMNEY [ ] FIRE SAFETY INSPECTION REMARKS: ~ DATE . TOWN OF SOUTHOLD BUILDING DEPT. 765.1802 INSPECTION [ ] FOUNDATION 1 ST [ [ ] FOUNDATION 2ND [ [ ] FRAMING I STRAPPING [ [ ] FIREPLACE & CHIMNEY [ ] FIRE SAFETY INSPECTION REMARKS: pO /d<c.L.S5"' ,10rc j& r..J~;J(e_(7;j Cd1;/ DATE INSPECTOR 'i I ~ , FIELD INSPECTION REPORT DATE FOUNDATION (1ST) FOUNDATION (2ND) '.. *~. ROUGH FRAMING & PLUMBING INSULATION PER N. y, STATE ENERGY CODE FINAL IrlP Inl I I . ('<hf-- If'.,. (j) / / A.IJ ~ v.~ , // ' t/ . ADDmONAL COMMENTS . .. .' COMMENTS ~.Y~ ;;:7 / , ,< ..,......:~. '- " ~~OJ \.i~?v ~-~ ,~ ~~ T'" -& iii ~ :;;, i', 2: ::s 9 ~ on ..., ~ ~ t, ~ J; N .~ ~ \i I> rl' t t'; ~ ..., ~:'< . \;, ~ ,} :;~ , " "" ~ ~ 1'\~ ~, z m .J ;:0 ~ ~ - ~ ?< hl ~ "- -"'=. o-~' I.. ::l ~ ~~ r;;. =: t ~ I;:j ~ ~ RES. I SEAS_ VL. -LAND-=-+= IMP_--1 TOTAL !} I' ii I I .:;;/, tf/) ---..-+----------- I d' () Ii -- rO OWNER b.ser:' b J <>>1 Ie.. FORMER OWNER " L(- / i 1-),: 210 .::s ,:_~', .:_ "J 1..- ( ()-iJ 3-u' i) AGE NEW I I Farm Tillable 1 Tillable 2 Tillable 3 I Woodland_+-_ Swampland I 1"""- --- Brushland I ~ouse~lot-_~-- I --r----- Total I TOWN OF SOUTHOLD PROPERTY STREET 583." 0 RECORD CARD I . f< i i lit. VILLAGE - I- " /l + //1 . ,,<. ", .(? " " , j DISTRICT SUB. LOT N if~ E -1 i' W. I , I M" i , ...~t ~;~'" .,. "..,_; I f." TYPE..QF BUILDING ;:/- _N COMM. --~ MISe. ".;J : _ /' L1/{ ,4..6" (;-:t.;L, Iv 7:" ,~ REMARKS (' (j (..., 53= Ii - y -if... Aj _ . ,i;' y ,',; 1 ~o';: ,k/ <:.1pc~ f)J t~ - 7?191v S I~ /i' 9;d/E 5" 13;J / y~ 99 ('",uA ~>'" hJ([~ .k;c. #'10, <>-<>-" ! . i/~' , l" I /PI.:>_I '141./ll' -1-- I 2'l:' -r-.. f~ 1.-:-; - '1' iAk ''l:/-,--~ k f h <::,' /":"; k'f ;-~- c3/1 C(4-fl(f E, Jr,d;-4 O-:;.{) - c2 (D6 -3 / 0/). Jv..d If,; I':;2coo ABOVE ./:;' ,-' . M ' 3 Ii Ifb -,tc, Dts+- ;;2{.;;: ~ ;":~,,.~ r~ cl' _;; /1 147 Iv /( ,,,:::P(,,-"",, .311 J 91f (( (,"2 c ( U Crl l( -Z C':-.) ! I :?Oi') (j Z-O~ C' ,."?9, l-? NORMAL BUILDING CONDITION BELOW Acre Value Per Acre Value &-1iI II fc'J -.- r"'i af 1 250 -. ~-~; If 3Jlb 95 ZiP=" ~J..I.o.;! if (I '.~'~ ~ - C.Of 10;: 1-. /\. . ~:r I -----------+---.- , ---1 ---I I /C' 0 () -- C' '-0 OWNER TOWN OF SOUTHOLD ~ROPERTY RECORD CARD STREET 5 83. 0 VILLAGE DISTRICT SUB. LOT rO~t:.I-( J-<nl i<..ci'}0 FORMER OWNER if;;: . " i /' (..... ;:1 " ~ ,. (! Nrv S fL E i) , ,'_i~Q_,-."/_.!"~ I t . L( I (v;;\ I .'--, ...-<-- t: "'.- RES. o y, ,_ ,_ ,x I-'xl.l/C/' " v. ;-) ~\J "\.:;,. SEAS, VL COMM.i LAND I I TOTAL ~~~/ REMARKS IMP, ! ! I c.){ :- ~"-:....) .) : ()<_..' 2- ( ,'). L) 53= II, - {":'e,.' Jt:;:, 91'.>/f5" (3;J / Y~?f ':y, . 1 ,.osk,' (lpc~f/': t" c!- TRI3Iv! /-~/i~--tf;~- !f~~L<,':-~_~'-~' /~;'_~r/ ('J<ilsly fh,,,,,)Jd;' .b;c#/o,(t--U-o i . . f ' --- ---- -Z,b ~1) )-- -- -- 1:~~E 18, 3 - TYPE..-QF BUILDING 'z~ .~),/;.,1_, I CB, & , MISe. I ~' ,,..A f!' ((, " (./ ;L . _..~ "'"':#"'. ..-i' '-,f. J ~"'.r.... '" ,f ..Ll"..L-... V 77.. ' r0i-- - .['~/ (-f-r: kr ~"".:? c, i::~ .!c" I' /'",: 17 3d .If :::cc) . (~17k t ,~:P/"L-C_ If n__ _ 2C. U II 1f----'2..€LC~ 'r ,- It 2--0( tJ If ~,n,.~g~~.~~( AGE I BUILDING CONDITION ..3/; h4 - fie'! ~ ."It,d ) - 3/1 h), :k.d t:::" A i T5/J c2 lee) If ! j 3'-::5 ~-_./ 3/; i~i(., -Je, t)!< NEW NORMAL BELOW ABOVE ,3>0' f?1 . 'v;, ,.:;/ 0; ;. 1<;- 7 ItJ , ~ I Per Acre Value &ll.t/i 311 HE- II I Form Acre I Value Ie pc) - 3 1 'In?) I( '1 I I ~~,",,<""'/ ~' '( (r Tillable 1 r~~n~=-_ I 250 2J.?~"'. .3/, pO 1--- l Tillable 2 3jrif9s 'P~ Ad:/ r~j-h- ~) t:, l' ;).')...1..0:1 c, . COI\'"+ c. rl'c''-'I . u""~ --. ~" . '-:'~ . j Tillable 3 L -------.------- -...------- ---~_._.-.__. Woodland I .. ----- . -0--__.- Swampland .. -------- "--- ----- . Brushland - --....- --, House Plot -- __n __ - ----.--- -- -- ------ Total I H- b P ,?, :;A 10 :;"1 ,-' ,cr,;;<, OOc - A'j t- . G;..e e", ~ 0 0( ~<:: . , 04 12. , n l I 0 ,~ ..-,- I ~F:' I, 1 U .~ ! - i 1-4 C- ! \ '()'[ 1-'\ "- Foundotion J Both <I, Bldg. <L.-::> .' ,) i.-. ;2.52.0 T:'~ -- "- .' -.-. ~ ~ :xtension 2- Iq (% I Bosement , Floors ()(Jc/j " ,- DO - C\;i.'. .,c,.S, ~ ----- -, :xtension 3 '" 100 Ext, Walls 1\3 ! I Interior Finish \ ')\..,.f:, :=-;(1', V",", ) he,),,"''-C .' ~l-'...;.;;; .:.,,--.. I' t' - ------_._-._--~-- ;xtension Fire Place - Heat -- - - ,''-~- Porch Attic , -- --- Porch Rooms 1 st Floor - -- --~.'--- lreezewoy Patio Rooms 2nd Floor ;orage Driveway - ----- _ ---~---~ :H5, t,..'- <60 . / (. ,'c- ~ --- 322-0 ('/1& PERMIT NO. ~~ BUILDING PERMIT APPLICA nON CHECKLIST Do you have or need the following, before applying? Board of Health 3 sets of Building Plans Planning Board approval Survey Check Septic Form N.Y.S.D.E.C. Trustees Contact: TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, NY 11971 TEL: (631) 765-1802 FAX: (631) 765-9502 Examined Approved Disapproved alc 20 '). '- ,20~ ..--.-.--...-. . '\ Phone: 7 {,J-. ;:u; ?-.f' Expiration '/~ I ,204- . C;'\ r: ! --.-..-- lJ'I) . PPLICATION FOR BUILDING PERMIT JUN 2 8 2002 ...J I Date ~ - ;<' Y' l- ';,-;;:-r-'-:;-r- INSTRUCTIONS 1():~i, '-'10~l') 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 waterways. 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 throughout the work. e. No building shall be occupied or used in whole or in part for any purpose what so ever until the Building Inspector issues a Certificate of Occupancy. f. Every building permit shall expire if the work authorized has not commenced within 12 months after the date of issuance or has not been completed within 18 months from such date. If no zoning amendments or other regulations affecting the property have been enacted in the interim, the Building Inspector may authorize, in writing, the extension of the permit for an addition six months. Thereafter, a new permit shall be required. 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 South old, 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. ,. ,I ~, \'- 0'9'/1J' /}1Cl.,i'r} ~) ) Sou ~ol "I, I?;Y (Mailing address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder Nameofownerofpremises ldeUJO')/,)<<,Ici' ~s~",,1 r -L P?1a.tt?//L/A../ (As 6n the tax roll or latest deed) If applicant is a corporation, signature of duly authorized officer (Name and title of corporate officer) Builders License No. 3/55"3 - H Plumbers License No. Electricians License No. Other Trade's License No. I. Location of land on which proposed work will be done: S 'fJ 31<:> J11 Cl/f\/ Kd House Number Street Hamlet ~ ~ '".., !" ,- 'J "<[_,;Ai-CA County Tax Map No.1 000 Section '/7 3 9 $I <; Subdivision '1.,""""11:0'1 Block t t Filed Map No. ..t,.., I Lot - 7- - 3.... Lot -, (Name) 2. State existing use and occupancy of premises and intended use and occupancy of proposed constructioI!: a. Existing use and occupancy \)'!-" ., ' ',' '. '" " . b. Intended use and occupancy , 3. Nature of work (check which applicable): New Building Repair \/ Removal Demolition Addition Other Work Alteration (Description) 4. Estimated Cost Fee 5. If dwelling, number of dwelling units If garage, number of cars (To be paid on filing this application) Number of dwelling units on each floor 6. Ifbusiness, commercial or mixed occupancy, specifY nature and extent of each type of use. . .' j <: ,( ( ') 7. Dimensions of existing structures; if any: Front " ) Height /( Number of Stories Rear " ') Depth )i Dimensions of same structure with alterations or additions: Front Rear Depth ), Heighti: Number of Stories (I) 8. Dimensions of entire new construction: Front 'J ') Height If. Number of Stories Rear 'j 1 ) ) Depth /' / 9. Size oflot: Front Rear Depth 10. Date of Purchase Name of Former Owner II. Zone or use district in which premises are situated 12. Does proposed construction violate any zoning law, ordinance or regulation? YES_NO ~ 13. Will lot be re-graded? YES_ NO~ Will excess fill be removed from premises? YES_ NO~ 14. Names of Owner of premises Name of Architect Name of Contractor Address Address Address /Sj; ,i, it') I 4" \' ( n" "~I' t- IS a. Is this property within 100 feet of a tidal wetland or a freshwater wetland? *YES _ NO ~ * IF YES, SOUTHOLD TOWN TRUSTEES & D.E.C. PERMITS MAY BE REQUIRED. b. Is this property within 300 feet of a tidal wetland? * YES_NO ~ * IF YES, D.E.C. PERMITS MAY BE REQUIRED. Phone No. Phone No Phone No. 117? C\.\ ~'""\ . ) \, 'j , , ,.f'\-::',"'---- -; ....cl 16. Provide survey, to scale, with accurate foundation plan and distances to property lines. 17. If elevation at any point on property is at 10 feet or below, must provide topographical data on survey. STATE OF NEW YORK) COUNTYOF~ -:fr:>s t!:P^ I-: /R LLkb 'IPS Ie.' being duly sworn, deposes and says that (s)he is the applicant (Narrte of individual signing contract) "bove named, (S)He is the t'? ~t'l e r (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. 206 -z.-- Signature of Applicant tary Public LYNDA M. BOHN NOTARY PUBLIC, State of New Yorlc No. 01 B06020932 Qualified in Suffolk Cou~ "2 Term Expires March 8, 20 4A:r-' i~ ' . ~ '''7: ~~'j~~~~QL f'.r~?UPf;r.'r:i' ,', (:;It:) , H (r, " > \ ': ,/:~,~~~~ C.' 'oF ~gJpitiNifC:"!C/'~E r 'II, 'iN!'''EGTIO'& 1'\ Y , '''IILOIII . TWO.au rl~,_________________n___ , ,'':: "v",ilEO CONCRII'I ~"' "'AMING uunllM ~ ~ ....,.,.., " ,-anrtt ... . ..._ . CON8TRUCnGII _ ~ : :liPLETE FORC.Q. . ,. '_L CONSTRUCTIOII 1HMl.... i HE REQUIREIIEIQI OIl _ II.~ S1 A 1E CONITRUCTIOII . IfIEMY CODES. NOT RIIPONIIIU POll DESIGN OR ~IIWC1'lo. a a.. T , I I I , ,J ~ ... ~- -! Vl }l ~ , l ,~_____~--L 't-l <;) ~ -~ f" ~_d -r --1..- __.__.._,_~~n~ ..".. , 1f'"'2:,...~,1'I1<:,lfl.'~'g'f~~--~,~"-;,. _........___.<:~,;l; ~ "Ri',t ______"-f,~JI!II.l.'_:::_:::~ :; . . ^~..~--- . 'Pes, 'f"; pJ-l~~Ct-- LPO",v.... ~eelt:lL~o O\Q,\ ~($ l0"~ }X/cX dO f-~rz tt<.e('\cct'-o ~-'L~l~~ o'^- ~ce- (,) ~ \h ~~ CA)X . Fx-fe-.r;oK. PI ywooi) , CJ^ GRl6 \ €_ nlJ v/lh r]elU , /Ie ;~ !7ew ~ . - -. .