HomeMy WebLinkAbout26026-Z 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. 26026 Z Date CTO ER 13 1999
Permission is hereby granted to:
EDWARD &IAUDR Y CIELATKA
260 CEDAR DRI ' E a
SOUTHOLD NY 11971
for
ALTERATION TO EXIST=ONE ONE FAMILY WELLI G FOR AC SSORY
APARTMENT AS PER ZBA #45 9 .
at premises located at A01 CE AR DR SOUTHOLD
County Tax Map No. 473889 Section 9,8 Block 0009 Lot No. 029
pursuant to application dated AUGUST 27 98 and approved by the
Building Inspector.
Fee $ 75 . 00
9a�el�
Authori Signature
COPY
Rev. 2/19/98
BOARD OF HEALTH . .. . . . . . . . .. . . .
• FORM NO. I o3 SETS OF PLANS . .. . . .. . . . . . . . .
TOWN OF SOUTIIOLD SURVEY ...... . . . . . . . . . . . . . . . . . .
7 BUIi.DING DEPARTMENT CHECK ... .. . . . . . . . . . . . . . . . . . . . .
'GOWN HALL SEPTIC FORM -
SOUT11OLD, N.Y. 11971
TEL: 765-1802 NOTIFY:
CALL . . . . . .
)mmined................• 19.... MAIiTO: . . . . . . . . . . . . . . . . . . . .
AIlhrvet.......... ' O. oa6 -0- ..........
. .
....... 19.... Perti tN .
...................................
Disapproved a/c
......................................................
................................
(Ikuilding Inspector) .
APPLICATiON FOR BUILDING PERMIT
.Date. . . . . . . . . . . . . . . . . 19. . . .
INSTRUCTIONS
a. 'Alis application oust be completely filled in by typewriter or in ink and auimitted to the if;:il.ding inspector wt
3 sets of plans, accurate plot plan to scale. Fee according to adiedule•
b. Plot plan allowing location of lot and of buildings on premises, relationship to adjoining premises or lx8nlic
streets or areas, and giving a detailed description of layout of property Haat be dram on tlhe diagram milicit is part of
this application.
C. 'the work covered by this application may not be a=wnced before issuance of Building Permit.
d. Upon approval of this application, tike Building inspector wilt issue a Building Permit to tike applicant. loch
permit shall be•kept on the premises available for inspection thrahgimt the work.
e. No building alhall be occupied or used in ole or in part for any purpose Whatever until a Certificate ofd
wh
Occupancy shall have been granted by die lkhilding Inspector.
.• APPI.ICN1710N IS iL7[aM MAIL' to tine lkuilding Department for the issuance of a lkuilding Permit pursuant to tlhe
Building Zone Ordinance of the Town of Southold, Suffolk County, New York, and other applicable Laws, Ordimhances or
Regulations, for the construction of Wildings, additions or alterations, or for removal or demolition, as herein
described. 1be 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 nsceasary inspections.
....................:................................
(Signature of applicant, or name, if a corporation)
R16iling address of applicant)
2A 14AllI MINI"
State a Her ap�l'icant9 ° ' lessee, agent1(?ft A W1 !i al contractor, electrician, plumber or Wilde
........................... . , OiNUH'S RAR- �. .............................................
.............................................. ..................
S`iR l�tauo Wk atas•on Lite tax null or latest deed) f"'I
ITTQ• � fl 1:f {
l•.�Qyq aF!'
if appr1dWTNWfttiotlVWi"glnature of duly autitoriauecl officer. 1331V30 MRA1A
24......i.�i�i Y'• .1..Y..1.....i V.rti f..................... LISTAM#T
(Naifie A tilt•of 664066te officer) 3400 aiilOM 81.1
...........................
Plunders License No. \
Electricians License No. .....................
Other Trade's License No. ...
I. ivcation of land on 6Add, proposed work will be ckxte..................................................�.............
........ . .. .4:S m .... 'Q�. � . ...�.: .... . .......
Ikxuse Number Street'' hamlet
County Tax Map No. 1000 Section ..,70........... Block ...�'�............ int P.S7...........
Subdivisi
,U%PGH ,e��!f?<.�......... Filed Map No. ........:...... Lo a•�:. ..
.. (Name)
2. State existing use and occupancy of premise and intended use and occupancy of proposed construction:
a. Fadsting use and occupancy ....�1.�7..�.1 �.Y......... •....................................
,��
b. Intended use and occupancy �/►'�/::. ...../��;�itJ. 1/c;;';o, S, �(..��(�:a.....� �5'SOl
3. Nature of work (dheck iiihidh applicable): New Building .......... Addition ........ Alteration``
Kelm ir ............ Removal ............. Demolition , ........... Other Work ..................................
(Descr i pt i oxh)
G. Esti,,,atecl Cost .. fee .. ..........................................
(to be paid on filing this application)
5. if (kralling, n►„i,er of dwelling units ............ Kober of dwelling units on each floor ................
Ifgarage, ►xnber of care ......................................
6. If. Ix,sl►►ess, cannercial or mlxe&occupancy, specify nature and extent of each type of use......................
7. Dinx:nsions of existing structures, if any: Dont'................ Rear ............... Deptl► .................
Ik:lght . Biller of Stories ......................
Dh►ensions of sane structure with, alterations or 'additions: Front ............... Rear ...............
Depth .................... lleiglht .................... N,►ber of Stories ...............
8. Di►aensions of entire new construction: Dont ................ Rear ............... Depth ..............
Ileito►t ......................... Nrd,er of Stories .....................
9. Size of lot,. Front .................... Rear .................... Depth ........ . .........
Ip. hate of Purchase .(�.� ............ Name of Fortner Owner .11104.Cf e ..�
II. Zone or use district In which premises are situated ..............................................................
12. Does proposed construction ,violate any zoning lar, ordinance or regulation: ........................
13. Will lot be regraded ...../.::.td......... Will excess fill be removed from premises: YES
14. Nana of Owner of premises ........................... Address .............................. None No. ............
r
Nuie of Architect ......................i............. Address .............................. PI►one No. ...........
�Ne.ne of Contractor ................................... Adklress .... ............... ........Nhone No. ............
15. is this property Within 300 feet,of a tidal wetlarxl? * YES .......... Na
*IF YES, SWnK1D 7nl,M 7111ST101 P1111MIT MAY BE RC(XIIMM.
PLOT DIAGRAM
Locate clearly and distinctly all buildings, wlhether existing or proposed, and indicate all set-back dimensions ~
frcn► property linea. Give street pnd block mmber or description according to deed, and show street neves and indicate
%kether interior or corner lot.
-eplc' C✓ S'�� 7�CXAPPROVED AS NOTED
DATE: f 2 99 B.P. D6
PROVIDE OPENINGS FOR BY:
fNERGENCY ESCAPE AS FEE:
NOTIFY BUILDING D PART ENT AT
REQUIRED BY PARE 714 Of 765-1802 9 AM TO 4 PM FOR THE
N.Y. ITA71 BUILDING CODE. FOLLOWING INSPECTIONS:
1 FOUNDATION - TWO REQUIRED
FOR POURED CONCRETE
2. ROUGH - FRAMINO & PLUMBING
PROVIDE SNOKE-OMMINGOCCUPANCY 0 R 3. INSULATION
ALARM H VICU 4. FINAL - CONSTRUCTION MUST
BE COMPE FOR C.O.
AS 16 PARE 721,1 U SE IS UNLAWFUL ALL CONSTRUCT ON SHALT. MEET
B.Y.Satfll,DtNt1C4DE' EQUIREMENTS OF THE N.Y.
WITHOUT CERTIFICATE s ATE CONSTRUCTION Et ENERGY
srnn; (1 N1J ,
0 F 0 CC U PA N CY DESIGN OR CONSTRCODES. NOT UONSIBLE FOR
CTION ERRORS
(XXINIY U
h
•••��.........................being; duly sworn, delx►ses and says that' be it Lh ,nC
y rm
(Nae,e of ie vi
signing contract)
alxwe neat ,
Ileis the .. ... ....... .... ..............................................
(Cahtract r, agent,-corporate officer, etc.)
of eu-iid owtnr or owners, and is duty authorized to per.fonn or hfrve l,erfonued the said work and to make and file thin
4114,1 icatio n; that all statements contained in this application are true to the best of his luxxwledg;e and belief; a,xl
tl►at the wurk will In performed in the manner set forth in Lhe application filed therewith.
.%x)n%hhto//before me this
�GW..`. f-.....day of ...... .. .
Notary Public .. ... ..;.........
(Sigunnture of lhiAlcant)
HELENE D.HORNE
Notary Public,State of New York
No.4951364
Qualified in Suffolk County 99,
Commission Expires May 22, 19�G
O
o�O Gy1
CA
Town Hall,53095 Main Road � Fax(516)765-1823
P.O.Box 1179 ?i �� Telephone(516)765-1802
Southold,New York 11971
BUILDING DEPARTMENT
TOWN OF SOUTHOLD
October 16, 1998
Mr. & Mrs . Edward Cielatka
270 Cedar Drive
Southold, New York 11971
Dear Mr. Cielatka:
In order to process your recent request for an accessory
apartment at 260 Cedar Drive, Southold, we request the
following: an elevation drawing showing floor to grade
measurements and a floor plan showing window sizes, existing
provisions emergency egress, smoke detectors, and label all
spaces . All to be prepared by a New York State licensed
architect or engineer.
Please submit the above to Southold Town Building Department,
P.O. Box 1179, Southold, New York 11971, Attention Gary Fish.
Very t my yours,
Sout ' down Building Dept.
Gar is
Building Inspector
GF/cs
:LD INSPECTION REPORT DATE COMMENTS
----------------- �-
------------------
u
INDATION ( I ST)
II JI
C
1� II
JNDATION (2ND) rid
II II
II
JGH FRAME &
tt II
PLUMBING
111- II
II �
II II
t=i
SULATION PER N. Y.
STATE ENERGYit
CODE n 11-A A
u "
if u�
11 y
ji- 11
IIS jj
1111 11
II
FINAL i Ii r
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ttn9,,thari7^y altereti,m or addition
thi survey is violation of
n+,>n 720f`of the N"York ft"J. - c.^.von Lew.
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riI , j Qrs rr�I. . i C of thtc
� survey r?"nrt ba
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_-L .;,•, ,surveyor's Inked seal or
llrl��� ;E _d seal Shall nest be oonsWertd
T t r to be. lidtrue copy.
i Y i Guaren Indiaatee!heroon eho run
cr!!v tot neon for whom the survey
Q � � is prepare nri On his behalf t0 t1t61
i�, Q lrA1t1P �OL eZ" tl tete^compA ovemm-tel atl�y and
lznding ins" t llsoad hbroan and
V .o the sszign tho lendirta insti-
tuuon.Guaran are not transferoblo .
'ions)in 'ons or subsequent
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