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HomeMy WebLinkAbout23461-z FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No Z-24933 Date MARCH 17, 1997 THIS CERTIFIES that the building ACCESSORY Location of Property 5875 GREAT PECONIC BAY BLVD. LAUREL, N.Y. House No. Street Hamlet County Tax Map No. 1000 Section 128 Block 1 Lot 3 Subdivision Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated MAY 6, 1996 pursuant to which Building Permit No. 23461-Z dated MAY 21, 1996 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 STORAGE SHED IN THE REAR YARD AS APPLIED FOR. The certificate is issued to ANTHONY J. & DIANE M. BLADOS (owners) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A UNDERWRITERS CERTIFICATE NO. N/A PLUMBERS CERTIFICATION DATED N/A Building Inspector Rev. 1/81 FORK NO. f 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) 2 3 4 61 Z Date ....................y................................ 19. .. . Permission is hereby granted to: f7J��►I Hof ................... ./. ........................... ............ . . ... .... ... l.1FF ....., .. ..:....../. ..��.fc�,....... ..... ........�✓ c.... . . ........1 .J..........� .........,r .................. ....... ........ .... Y'��.... . atpremises located at ..... ............... . ....................... .. ... ...L�l... s..................... ......................................................................:.......g.�t.?f.` ............................................................... ................................................................................................................................................................. County Tax Map No. 1000 Section ....124P......... Block ........ l.......... Lot No. ...0 ............. pursuant to application dated ..........�i .. .............(sf Building Inspector. ............, 19.�,?, and approved by the y Fee $... �...`.. ` .... ... ......li&;o ........................... B ildir Rev. 6/30/80 Form No. 6 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL 765-1802 APPLICATION FOR.CERTIFICATE OF OCCUPANCY A. This application must be filled in by typewriter OR ink and submitted to the building inspector with the following: 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 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 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 Buildiniz - $100.00 3. Copy of Certificate of Occupancy - .25iq-, 4. Updated Certificate of Occupancy - $50.00 5. Temporary Certificate of Occupancy - Residential $15.00, Commercial $15.00 . Date . .��.� CLl . . . . . . . . . . . . . . . . . . . . . . . . : . . . . New Construction. . . :f. . . . ... Old Or Pre-existing Building. . .i. . . . . . . . . . . . . Location of Property. .�S�5 . . . . . �C'C.�s�li.�. . �. . �Uc.. . . . . . . . . . . 4. . . . . . . . . . . House No. Street Hamlet Onwer or Owners of Property D((�� `C �:��� �. . , tbl.;�:. ,{�^. �' . . . . . . . . . . . . . . . . . . . . . . . . . County Tax Map No 1000, Section. .1 .4_�$. . . . . .Block. . . .U� . . . . . . . .Lot. . .� . . . . . . . . . . . . . . . Subdivisi_on. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .Filed Map. . . . . . . . . . . .Lot. . . . . . . . . . . . . . . . . . . . . . Permit No.�3 �.�. . .Date Of Permit.e. .�Z�. .% . . . . .Applicant.i:-f�`�:NQV? . .�bt.a(sg: a�"�. Health Dept. Approval. . . . . . . . . . . . . . . . . . . . . . . . . .Underwriters Approval. . . . . . . . . . . . . . . . . . . . . . . . . Planning Board Approval.. . . . . . . . . . . . . . . . . . . . . . . . Request for: Temporary Certificate. . . . . . . . . . . Final Certicat-e.':/. . . . . . Fee Submitted. $ (9 5.:Q c). . . . . . . . . . . . . . . S3 . . . . �. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . c� � �4 1 3J APPLICANT o :c ca a Town Hall,53095 Main Road p • Fax(516)765-1823 P: 0. Box 1179 y� �� Telephone(516)765-1802 Southold, New York 11971 OFFICE OF THE BUILDING INSPECTOR .TOWN OF SOUTHOLD January 16, 1997 Anthony Blados 5875 Peconic Bay Blvd. Laurel, N.Y. 11948 To Whom This May Concern: We are unable to complete your Certificate of Occupancy because of the following reasons : XX An application for Certificate of Occupancy is not on file. (Enclosed) No Underwriters Certificate on' file. XX The check is (not on file. ) $25.00 No Health Department Approval on file. No final inspection has been made. .No Plumber Solder Certificate on file. (All permits involving plumbing being issued after April 1, 1984) . BUILDING PERMIT # 23461-Z Please contact our office on this matter. Thank you for cooperation. SOUTHOLD. TOWN BUILDING DEPT. 765-1802 BUILDING DEFT. INSPECTION [ ] FOUNDATION iST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] INS ION [ ] FRAMING [ FINAL [ ] FIREPLACE 8 CHIMNEY REMARKS• i %--1 N ol DATE / � INSPECTOR t"ut It 11".111 Ili Fo U I I P A,I,lull 2111)) tA 1(011(;11 !71 ------------------------- - ------------ ----------------- I IMIlI.ATI Oil 1,[-'1( 11 y STATE �:; e COOK ........... F I IIAI. ------ n4omw�mr�.o= ADDITIOIIAI. -------------------- ........... 1"J" -N, FR b h1T V i c vV 2 x ca R R FT►-ins ROF7e% -yes L `� ! ��' ahPYt� kllYlj 4-- go0r- RUU }- a C 10 ZXS MUCK yzcUx .5 brloox 7/i( OS U I Cq 'a a -Look s i5TI AL FLDo i, vie w ) ;DC vieW 1 1 ,4LL t(o o;C, HOARD OF IIEA rn FORM N0. 1 3 Sli'i'S OF I TANS . . . . . . . . . . . . . . . D 6 l�J t5 O U 'TOWN OF SOUTHOH) SURVi?Y . . . . . . . . . . . . . . . . . . . . . . . . s , BUMPING DEPAR'R11;N'r CI13CK . . . . . . . . . . . . . . . . . . . . . . . . . MAY c 1 [` �� 'TOWN iIAi,i. SEPTIC FORM . . . . . . . . . . . . . . . . . . . SOUTHOLD, N.Y. 11971 765-1802 IIOTI.FY: 70�WNMania cc 40-_1351. _ . . . . . I;x,>rrr i necl.........__... �., 19_( 0 // MA I I. TO: . . . . . . . . . . . . . . . . . . . . Alnrroved... ...Y-11 ...., 19/�ii_ Permit No. .. .3 l. .................................... Disa(nmured a/c .................................. .................................... ...................................................... (lkri Ic r g /Fe�, or) APPIACATiON FOR 111111MING P13RMI,T r Q� i NSTRUCTTONS a. Ibis appUcation must be collpletely filled in by typewriter or in ink aril sul"itted to the Wilding inspector with 3 sets of.plans, ,aceLirpLe,plot,-plan,,to scale. Fee according to schedule. b. T'lot iilan, O)OWirrg tocaticrrr of, lot arKI of Imildings rnt premises, relationship to adjoining prenises or public streets or areas, aril giving.a -detailed descr.iptim of layout of property Pust he drawn on the diagram wlridr is part' of Lhis application. . - . , .. �c. Tile work crnrered.lry;Chis,apliLicaCicm rely riot be cum enced before •ismiance of ,Building Permit. d. llpon approval'of this applicatiai, the )kail.oling inspector will issue *a iSuild.ing Permit to the applicant. :such pertnft shall be kept oil the premises available for inspection tlrrmomotrt Lhe work: e. No Imildirrg shall he occupied or used in wlxil.e or in part for any purixise whatever until a Certificate of: Occurnifxy slral l linve been grsirted Iry'the rkrilding Inspector. APPI.iCA'1'ION 1S 1➢--.10lY MAip's.to Lire Wilding Deikarlarrent for (he issuance of. a i during Permit pursuant to Lhe Wilding Torre Ordinance of the Tmni of: Scxrtlold, Suffolk UmnLy, New York, aril other applicable Ums, Ordinances or Regulations, for Lire corrstrocGun of buildings, mkliLims or alterations, or for removal. or demolition, as herein described. 'ib,e'applicant agrees' l'o cctrrlrly with all. api l icable laws, ordirkances, building code, Irousing code, arxl regulations, aril to adnit autl►orize(i inspectors oil prenises arxl in building for rrecesr•7ry inspections. -plw,v �.................. (Sigrkature of applicant, or Mane, if a corlm-atim) (t -riling rxklress of applicant) State wlreLher applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, pltidrer or- Imilder. Q.fW.AY. ............................ ..................._............................................... .._ Ntr v of caner of premises ....................... ............. (as cxr Clie Lax roll. or latest deed) If applicant is a corporatim, signature of duly au1_hori.7ed officer. ......................................................... (N<rne and title of corporate officer) Ikrilders License No. ...... Pl.urbers License No. .................. Electricians License No. .................. Other Tr:xle's License R). .................... 1. Location of l.arxl on x-Addr proposed work will he cone.. L _....._. ....................... ....................... J.1'5.... r7 .' 4��►.... .. �........................... t ......................... Ikxrse not per Street ltanlet Cotinty Tax MapNo_ 10()0 Sect icxt ..LZI ......... Block ......O_L.___.. iAot ...Q.3....... Sulxlivision ...........................:.......... Filed Kip No. ............... Lot ............... Millie) 2_ State existing use aril occupancy of prenises arKI interxled use arxl occrrparrcy of sed construction: a. Existing use and occxrparrcy ... A .......................... b. InLerxled use aril occupalicy rr'Q'�� �` 1 �..... .................................... 1. It'll'if xa of xn>tk (check IA,i(it a11)1iccdlle): Ikaj Iklildinl; . .... ... .. hWition Alteration ' ... . . . N!pair ............ Ilerexwal . ... ... ... 1)&Ixel il:ion .. . ......... Other Wolk ... .......... ... ........ . . T (Dencriplion) 4- Is:;1:illktlecl (:osl: G'•�/".w...... ... ..... fee ... .. .... .. . .. ..................... (to Ix' Ix;id on fil.inl;.11,is application) :i. If ekxel I inll, rRnJrer of: cL)ell ing tur!I:s ............ Umber of: A,,el I inl; units rxr ench Floor .. ...... .... . .. . 1 f garage, miter of carr: .. .... .... .... ..... . .. ............ ... . 6. If business, emmercial or mixed occupancy, slxacify nature mxl exLent of each type of use...... .... .. ... ....... 7. Dimensions of existing stmehrres, if any: I?rcxll:.. ..... ... .. . .. . Near ..... .... ..... . 1lepl11 . .. ........ . .. ... IkeiJ;It ...... ... ... IArtlxar of Stories . . . .. ....... ... .. . .... Dilly-msicxts of 'scree stru(:hrreJw!'llt alterations or additions: Frolic ..... ... .. .. ... Near ............... Ikalt(II ............... ..... .lleil)iL .. ................ . . Null.rer of Storim.; .. (I. I)inmnsirxts of: entire rx'cr coosl:mcticxt: Front .... . ...... . Naar . ... ... ........ I1epl.h .... . .. ....... Ileij)II: fAciber of Sl,ovie.y �E t♦�.. ra1Ms 9. Size of left: Froot ...36 ...... . ..... NLar ... ,3.5.. . ... ..... . . Depth .4.!.5o...... ..... . M. Mice of l\Irchase .b._?-p_.9A......... K-1kne of Romer 0,,,tter If. Zcxte or use dislriet in uh ic:lt pr©nises are s.4tiated .... .............. . .... ..... .................... ...... . .... . . . 12. Wes prolxu;ed cc>ttsl.rml-ion violate any zoxt!ng law, ordirk-tlx:e or rel;ulal.icxt: ................... ..... I'). Will lol: Ix- rel;rixked ...iUa.... ....... Will excess fill IKe rEmwed frcxn produes: YES Ix) 14. N:nles of Otmer of premise:; &/.r..Q.................... Acklress ... ._. ............... .... .. ... [ltcxx U.) ....... .. .. Nam of Arc:ltilect: �'e l � ....... Acklress .. . . . .... .... ..... .... .. ...... 11ione No. ... ... ..... llrrrx' of CotiLractor -?�.� ..... ... Acklress 1luxte No. ,. .,,.../............... . ...... .. .. I:i. is this property within 3(X) feel: of a 0(lal xoeLlaml7 * YES .... .. .... NC) .4'........ *11, YES, .1mi1Y)I1) 'IY> N '111INN il?S 11?14.11I' HAY 11t; 1(F1i1111(I?1). PLOT I))ACMAtf Lmale clearly- a(xl aial:ilx:tly all Imlil(linis, x.atell►er cxisLinl; or prol)Osed, mxl irxlit:ale all set-lrac c.dheqnr;.icnes I'rtrtt proixn'fy 1.!Ites. Give sLreel a(x1 blex:k rltrrber or clescripLim accordinl)' to ileed, arxt r•jI W. sLreel juries aiId irxiii:ate lAvether !nlerior or corner lot. APPROVED AS DOTED DATE: y B.P.# °' F 5 ^1 EE: — BY: NOTIFY BUILDING DEPARTMENT AT 765-1802 9 AM TO 4 PM FOR THE FOLLOWING INSPECTIONS: g� 1. FOUNDATION - TWO REQUIRED CCUPGG8���� OR FOR POURED CONCRETE USE I S ��y�A�Y FU 2. ROUGH - FRAMING & PLUMBING I 4. F3. INAL4- CONSTRUCTION MUST WITHOUT CERTIFICATE, E COMPLETE FOR ALB CONSTRUCTION CSHALL MEET OF OCCUPANCY THE REQUIREMENTS OF THE N.Y. STATE CONSTRUCTION & ENERGY CODES. NOT RESPONSIBLE FOR DESIGN OR CONSTRUCTION ERRORS SK.. .. ..... . .. . . . . . . .. .... . .. .... . . .. . ... ... . . .IK:inl; duly r arrlt, clr,Ixrsc.:; :ern! snyr; (flat he is lbe appl ic,nll. (Mviv of imliviomil r,ilnrinl; coal um.:t.) :IIx1Ve Ilixlx?(I, Ikain Ille .. . . ... . ..... . . ....... .. ... ..... ...... .. . ... . . ......... . . ...... ....... .. .. ...................... .... ((:cmlractor, agerlL, corlxlrnte officer, etc.) of said cxa(xer or owlx'r s, nlxl is duly anlllorized to Ix'rfonn or Ilrrve V'rfonlled t.lte said walk arxl Lo milce aril File Illis appl ication; lha1. n11. slaterx'rtls cnntaimd in 1.Itis alrlrl icalion are I nK' to file Item of hin klxxaledge and Ix+Lief; acxl 1ImL llle work will. IK' perforllx'd in the uvinner set: f0r111 in the application filed therewith. f;<xml to bete re Im 1.11in Q r �. ... . ... 19.9 110. . . Notary llebl.ic .......- . .. ..... SALLY BLADOS (!iil;mature of Appl icanl.) Notary pvmlc�State of New York No.4799955 C1W18d in Suffolk County Commtss(on F.4*ss June 30,19 27 P. Prepared in accordance with the minimum �i Z standards for title surveys as established �•,� Q� 20 by the L.I.A.L.S and approved and adopted De)O0 for such use by The New York State Land O Q Q s Title Association. goy. � o� OAF` C K Se_ de �0, 16 s ,5 1 �� �0& �8. N s� SUR VEY FOR ANTHONY J. .BLADOS & DIANE M BLADOS AT LAUREL TOWN OF SOUTHOLD SUFFOLK COUNTY, N. Y. CERTIFIED To, 1000 - 128 - 01- 03 ANTHONY J. BLADOS DIANE M. BLADOS . Scale. 1"r= 30' NORTH FORK SYNDICA TED BANK INSURANCE COMPANY }^r. May 19, 7994 I63 - 4995 o p 2 �,� A��• . •� -1b T. MFj�GAL ro LIC. NO. 49618 9 s Q� GO PECONIcS S, P.C. G (516) 765 - �� Q V P. O. BOX 909 MAIN ROAD SOUTHOLD, N. Y. 11971 94 - 199