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Home My WebLink About28030-Z FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No: Z-28248 Date: 03/06/02 THIS CERTIFIES that the building ACCESSORY Location of Property: 38030 MAIN RD CUTCHOGUE (HOUSE NO.) (STREET) (HAMLET) County Tax Map No. 473889 Section 85 Block 3 Lot 8 Subdivision Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated JANUARY 23, 2002 pursuant to which Building Permit No. 28030-Z dated JANUARY 23, 2002 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 GREENHOUSE AS APPLIED FOR. The certificate is issued to ALBERT J & HELEN A KRUPSKI (OWNER) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A ELECTRICAL CERTIFICATE NO. N/A PLUMBERS CERTIFICATION DATED N/A A tho r' ed Sign ture Rev. 1/81 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. 28030 Z Date JANUARY 23 , 2002 Permission is hereby granted to: ALBERT J KRUPSKI RT#3 38030 MAIN ROAD PECONIC,NY 11958 for REPLACE EXPIRED BP# 25743Z FOR CONSTRUCTION OF AN ACCESSORY GREENHOUSE at premises located at 38030 MAIN RD CUTCHOGUE County Tax Map No. 473889 Section 085 Block 0003 Lot No. 008 pursuant to application dated JANUARY 23 , 2002 and approved by the Building Inspector. Fee $ 75 . 00 Aut orized Signature ORIGINAL Rev. 2/19/98 Form No.6 s TOWN OF SOUTHOLD rR "` 62002 BUILDING DEPARTMENT TORN HALL �--_-� F COY--r 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 1%lead. 5. Commercial building, industrial building,'multiple residences and similar buildings'and installations, a certificat4 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 a 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- $100.00 3. Photocopy of Certificate of Occupancy-$0.25 4. Updated Certificate of Occupancy- $50.00 5. Temporary Certificate of Occupancy- Residential$15.00,Commercial$15.00 Date. 2 2-,Q' /,o New Construction: Old or Pre-existing Building: ' (check one) Location of Property: 391 3 0 �^��• i2�J? P� o House No. Street Hamlet Owner or Owners of Property: /- b •4 e 14-e 1 S k Suffolk County Tax Map No 1000, Section S Block 3 Lot Subdivision Filed Map. Lot: Permit No. .2 P63 O Date of Permit. Applicant: Health Dept.Approval: Underwriters Approval: Planning Board Approval: Request for: Temporary Certificate. Final Certificate: ✓ (check one) Fee Submitted: $ S_ L. Applicant Signature( - [ELD INSPECTION REPORT DATE COMMENTSsaaaaaaasassaasaaaasss :a::aaa:�aa:Ass:saaaaaasaaa::asaassaaasaaaaaassas:=saasaas:nstas H OUNDAT ION OST) q M q OUNDATION (2ND) a _a p VJ OUCH FRAME PLUMBING N W p � a n y INSULATION PER N. Y. p STATE ENERGY n CODE n p n n p n FINAL �-----�---�N N N _ ADDITIONAL COMMENTS: tv • BOARD OF HEALTH . .. . . . . . . . . . . . . FORM NO. 1 3 SETS OF PLANS TOWN OF SOUTHOLD SURVEY . . . . . . . . . . . .. . . . .. . . . . . . BUILDING DEPARTMENT CHECK . ... . . . . . . .. . . ..... . . . . . . TOWN HAIL SEPTIC FORM . . . . . . . . . . . ... . . . . . SOUTHOLD, N.Y. 11971 TEL: 765-1802 NOTIFY: � CALL . . . . . . . . . . . . .. . / F.xamined...:!Y?:i........ 19 9 MAIL TO3� b i . .. . . . . . Approved...�� ........ 199 9 Permit No. S. .l�3�� .................................... Disapproved a/c .................................. ................................... .......................................... . ........ —=-,. - (Building ) 23199.9 U PPLICATION FOR BUILDING PERMIT q Date. . ../1 (a . . . . . . ., 19. . /. BLO TOWN OFSOUTHOt.D INSTRUCTIONS a. This application must be completely filled in by typewriter or in ink and submitted to the Building Inspector wi 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 mist be drawn on the diagram which is part of this application. 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 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 MATE to the Building Department for the issuance of a Building Permit pursuant to the Building Zane 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. ..................................................... (Signature of applicant, or name, if a corporation) ................................................... (Mailing address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builde .................................................................................................... Name of owner of premises ....A J.6. ! .4.....T*... ................................................... (as on 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. ......................... Plumbers License No. ......................... Electricians License No. ..................... Other Trade's License No. .................... 1. Location of land on which proposed work will be dome.............................................................. ...3$. . a...........`.!.....'.......'!.�.......................................... ............... Hasse Kimber Street Hamlet ?.Canty Tax Map No. 1000 Section ..... : ..... Block .....:3......... Lot ..4?........... Subdivision ...................................... Filed Map No. ............... Lot ............... (Name) 2. State existing use and occupancy of premises and intended use and occupancy of prq?osed construction: a. ihcisting use and occupancy .... Q,r Y:...............?`. ...................... b. Intended use and occupancy .2 e o... .................... 3. Nature of work (check which applicable): New Building .....Z.. Addition .......... Alteratior .......... Repair ............ Removal ............. Demolition ............ Other Work .................................. (Description) 4. Estimated Cost fee .............................................. (to be paid on filing this application) 5. If dwelling, number of dwelling units ............ Number of dwelling units on each floor ................ Ifgarage, rxnber of cars ...................................... 6. If business, commercial or mixed occupancy, specify nature and extent of each type of use...................... 7. Dimensions of existing structures, if any: Front................ Rear ............... Depth ................. Height ......................... Number of Stories ...................... Dimensions of same structure with alterations or additions: Front ............... Rear ............... Depth .................... Height .................... Number of Stories ............... B. Dimensions of entire new construction: Front ................ Rear ............... Depth .............. Height ......................... Number of Stories ..................... 9. Size of lot: Front .... Q........ Fear ........ S..... Depth 10. Date of Purchase ......1 S.S-72....... Name of Former Owner ...v.4 z.?--A�................ If. Zone or use district in which premises are situated ....e�.'.gU................................................ 12. Does construction violate zoning law, ordinance or regulation: r1 O proposed arty ng regu ......................�. 13. Will lot be regraded ............... Will excess fill be removed from prenisps: YES 14. Names of Owner of premises ........................... Address ...........:.................. Phone No. .............. Name of Architect .................................... Address .............................. Phone No. ............. Nameof Contractor ................................... Address ...............................Phone No. ............. 15. Is this property within 300 feet of a tidal wetland? * YES .......... NO ....✓..... *IF YES, SOIMM ME TMISIEES PERMIT HAY BE MprRED. PLOT DIAGRAM Locate clearly and distinctly all buildings, whether existing or proposed, and indicate all set-back dimensions from property lines. Give street and block comber or description according to deed, and show street names and indicate whether interior or corner lot. 1g 3 � h Z k 00 „eH SPATE: Or NIW YORK, ours S,jN1t, 3o�WfY ,O(FF ..............6.?�......, SS K / "' �' ....f• (! `�!.` /...............being duly sworn, deposes and say that he is the applicant (Name of individual signing contract) above named, Ileis the ................... ° ................................................................... (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 m;day ...23.c.Q ... ... .. . ... .Notary Public .... ...... �........... ROBERT 1.SC JR. (Signature of A licant) Notary Public,State New York Qualified in Suff County No.01SC4 50892 Term Expires May 31,