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HomeMy WebLinkAbout31993-ZFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No: Z-33097 Date- 06/16/08 THIS CERTIFIES that the building ACCESSORY Location of Property: 1250 BAYVIEW AVE GREENPORT (HOUSE NO.) (STREET) (HAMLET) County Tax Nap No. 473889 Section 52 Block 5 Lot 49 Subdivision Filed Nap No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated MAY 5, 2006 pursuant to which Building Permit No. 31993-Z dated MAY 11, 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 ACCESSORY UNHEATED ONE CAR GARAGE AS APPLIED FOR. The certificate is issued to WLODZIMIERZ & ANNA WISOR (OWNER) of the aforesaid building. SDPPOLR CODNTY DEPARTl~~N'P OF HEALTH APPROVAL N/A ELECTRICAL CERTIFICATE NO. 118367H 11/16/07 PLDUffiSRS CERTIFICATION DATED ~ / Rev. 1/81 m~ ~ I •~ ~ Form No. 6 L ~' TOWN OF SOUTHOLD ~ BUILDING DEPARTMENT I 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. Swom statement from plumber certifying that the solder used in system contains less than 2/10 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 ]ices, streets, building and wmsual natwal 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 b~spector shall state the reasons tlferefor in writing to the applicant. C. Fees I. 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 - $100.00 3. Copy of Certificate of Occupancy - $.25 4. Updated Certificate of Occupancy - $50.00 5. Temporary Certificate of Occupancy -Residential $15.00, Conunercial $15.0~0~ ~ Date. __ l CS/'3~ ~ ~~~L' ~tT ~ New Construction: ~ Old or Pre-existin,(g~Building: _ (check one) ~^ Location of Property: /2 TO 13 C2~'L~1~~L~ /r/~ _ ~fiCl~~~k~ House No. ~~ J /Street Hamlet Owner or Owners of Property: 17 ~U ~t% ~~,-~W ZJ i2L1 ~ y~Z ~j(~ ~ .~-G ~/tj Suffolk County Tax Map No 1000, Section C~ v Block 'DCC)~ Lot Subdivision _ _ Filed Map. _ __ _ Lot: _ PennitNo.__~~~'!~~_DateofPermit 5~~~ ~~ Applicant lJ/v~i,~n~l~rz ~/~DI~- Health Dept Approval _ Unden~~riters Approval. Plam~ing Board Approval: --- Request for: Temporary Certificate Final Certificate. (check one) Fee Submitted: $ ~ ~ ~ ~~~q~ ~~-~~ l ~ ~ Ci~ ~~~ I Applicant Signature Electrical inspection Certificate Issue Date Electrical Inspection Service, inc. Application Number 11/162007 375 Dunton Avenue 118367H East Patchogue, New York 11772 (6311266-6642 Issued To: Mr. Wisor Street: 1250 Bayview Avenue Village: Southold Section: Zip: 11971 Town: Southold Block: Lot: Contractor: Lic. # Was examined and found to be in compliance with the National Electrical Code. ^ Commercial ^ NV Defects ^ Pool [X] 1st floor 0 Indoor ] Basement ^ HotTub © Residential Cl Det Garege C~ Attic IX] 2nd Floor ©Outdoor ^ Addition ^ Survey Switches Receptacles Fixtures GF/ Heaters A/C Fans 61 60 75 13 2 5 Dishwasher Washer/Amps Dryer/Amps Oven Range/Amps Microwaves 1/20a 1 20 1 30 1 30 1/20a Furnace Oil Gas Circulators Smoke Detector Bell Transformer 1 x 2 6 Meter Amps Phase UG/OH Jacuzzi Television CO Detector ,' 1 /20a 2 Bldg. Permit: Other Equipment 1-20 amp Disc./ 2-Air Handlers 15 amp ! t ~/" ,~L"~~, Hugo S. Surdi President Rough Inspection: O6/22I2007 Inspector: John Mc Mahon III Fnal Inspection: 11 /14/2007 Inspector: John Mc Mahon III This cert~cate must not be altered in any manner. Inspectors may be ident'fiied by their credentials. 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. 31993 Z Date MAY 11, 2006 Permission is hereby granted to: WLODZIMIERZ WISOR 83-40 AUSTIN ST KEW GARDENS,NY 11415 for CONSTRUCTION OF AN ACCESSORY UNHEATED GARAGE IN THE REAR YARD AS APPLIED FOR at premises located at 1250 BAYVIEW AVE GREENPORT County Tax Map No. 473889 Section 052 Block 0005 Lot No. 049 pursuant to application dated MAY 5, 2006 and approved by the Building Inspector to expire on NOVEMBER 11, 2007. Fee $ 75.00 1 _ ` Auth~ ~ Signature ORIGINAL Rev. 5/8/02 3c~~~~ TOWN OF SOUTHOLD BUILDING DEPT. 765.1802 1 NSPECTION [ ]FOUNDATION 1ST [ ]FOUNDATION 2ND [ ]FRAMING /STRAPPING [ ]FIREPLACE 8~ CHIMNEY [ ]ROUGH PLBG. [ ]INS ION [ INAL [ ]FIRE SAFETY INSPECTION DATE ~ o INSPECTOR '`~~ [ ]FIRE RESISTANT CONSTRUCTION [ ]FIRE RESISTANT PENETRATION 3 I q 93 ~ TOWN OF SOUTHOLD BUILDING DEPT. 765-1802 1 NSPECTION FOUNDATION 1ST [ ]ROUGH PLBG. [ ]FOUNDATION 2ND [ ]INSULATION [ ]FRAMING /STRAPPING [ ]FINAL [ ]FIREPLACE 8~ CHIMNEY [ J FIRE SAFETY INSPECTION DATE Q ~( ~r ®~ INSPECTOR' ~ ` ~ %~ FIELD INSPECTION REPORT DATE COMMENTS ~~ FOUNDATION (1ST) ~ S n ,~ FOUNDATION (2ND) ~ n ~ 1 z o /i ~~ ROUGH FRAMING & PLUMBING ~ h7 -3 ~J / /// 1 `) INSUL TION P ~ y A ER N. Y. STATE ENERGY CODE i_ I O L ti (j i ~~ FINAL ~tj ~ _ r ADDITION COMMENTS (' a ~ ` ~ O z m.. ~~ ~ - k _ w .. ~ ~ O z x x d b H TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, NY 11971 TEL: (631) 765-1802 FAX: (631) 7b5--1502 3 ~ ~ R 3 ~ www. northfork.netJSouthold/ PERMIT NO. _ Examined / © 20~ Approved 1/,20 Disapproved a/c Expiration ~~ /~ , 20 ~ INSTRUCTIONS Do you have or need the following, before applying? Board of Health 4 sets of Building Plans_ Planning Boazd approval Survey Septic Form N.Y.S.D.E.C. Trustees Contact: Mail to: Phone: Date ~/pY~~j 2v , 20 O a. This application MUST be completely filled in by typewriter or in ink and submitted to the Building Inspector with 4 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 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 premis ~ din building for necessary inspections. /~ 1` ~ _ ! I" , ' '~ { I (Signature of applicant or name, if a corporation) - ' ~ (Mailing address of applicant) ~ __ _ State bvhetlier applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder 0~4GBd Name of owner of premises ~~~G~ fiU.6~"Z ~XC~ ~nna ~' /S 0 (As on the tax roll or latest deed) If applicant is a corporation, signature of duly authorized officer (Name and title of corporate 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: /2 So ~a vleW 14V~ Sou~~'ol~ NY 1197( House Number treet Hamlet County Tax Map No. 1000 Section 052 Block rOS Lot 4~,~0d Subdivision S4n'//y1PY ~lQUPq Filed Map No. //33 Lot/o7,/D X109, t/0 (Name) ~ BUILDING PERMIT APPLICATION CHECKLIST Building Inspector APPLICATION FOR BUILDING PERMIT 2. State existing use and occupancy of premises and a. Existing use and occupancy SyM M8Y b. Intended use and occupancy bu/ (iAr h9 c,al/Qt~ °~ Nature of work (check which applicable): New Building / Repair Removal Demolition Other Work (Description) 4. Estimated Cost ~ ~/ dr Otpt7 Fee ~'75 (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 ! 6. If business, commercial or mixed occupancy, specify nature and extent of each type of use. Dimensions of existing structures, if any: Front Rear Height Number of Stories Depth Dimensions of same structure with alterations or additions: Front Rear Depth Height Number of Stories Dimensions of entire new construction: Front /2 Rear /Z Depth Height /~~ Number of Stories 1 9. Size of lot: Front ~®~ Reaz / ~ D ' Depth / SO 1 25~' 10. Date of Purchase ll~l~~~998 Name of Former Owner ,~~Fi lyrl ~8/17~Z 11. Zone or use district in which premises are situated ~Gt ~~Gll'K9 hClC4t7~ ~Q /1 r•/' 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 W. ~• W1S0~ Name of Architect Name of Contractor Address No No. 15 a. Is this property within 100 feet of a tidal wetland or a freshwater wetland? *YES NO / 9 * IF YES, SOUTHOLD TOWN TRUSTEES & D.E.C. PERMITS MAY BE REQUIRED. ~~ 9 b. Is this property within 300 feet of a tidal wetland? *YES NO / * IF YES, D.E.C. PERMITS MAY BE REQUIRED. ~ `~ ~ C 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) SS: COUNTY OF~It~ENS ) (A/~oo~2!•/rit'E~2 (~(S D~ being duly sworn, deposes and says that (s)he is the applicant (Name of individual signing contract) above named, (S)He is the owyev bul'lcr'~Y (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 o before me this day of ~} P/Q ~•~ `0 D~G Q <~,Q~-.B-~GU Notary Public PAI.LA A. BENNETT Notary Public, State of New York No. 41-49G5830 Qualified in Queens County Commission Expires Apr. 30, a o ~ z7 use and occupancy of proposed construction: q - noT dceu~y ~r~ /(_/ Signature of Applicant 83 -40 /Ju1>4 n. f ;tl2k phone No. 7/8 -850 -3208