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Home My WebLink About23502-z r' FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No Z-24634 Date SEPTEMBER 19, 1996 THIS CERTIFIES that the building REPAIR Location of Property 320 (a/k/a) 319) CHAMPLIN PLACE GREENPORT, N.Y. House No. Street Hamlet County Tax Map No. 1000 Section 34 Block 3 Lot 41 Subdivision Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated JUNE 13, 1996 pursuant to which Building Permit No. 23502-Z dated JUNE 13, 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 REPAIR FIRE DAMAGE OF EXISTING ONE FAMILY DWELLING AS APPLIED FOR. The certificate is issued to HENRY E. RUTHINOSKI, JR. (owner) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A UNDERWRITERS CERTIFICATE NO. N-384345 - APRIL 26, 1996 PLUMBERS CERTIFICATION DATED N/A e Building Insp ctor Rev. 1/81 FORM NO. 9 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) N? 23502 Z Date ............... 19...... Permission is hereby granted 6Z:2 ... .......... ... ..... r 6) 0 Q>0)- ..... . ..... ............ .......7"�- - Sz............... ...... ... . . ..ter..... .. ....w- . .........7 ...... ....... to .............. ... ........... .. . ...................................................................................... at premises located at .(. .. ......... . ... ....... ..... .. . ............................................... ....................................................................... ............................................................... ................................................................................................................................................................. z County Tax Map No. 1000 Section .....�7�4........... Block ....... ........ Lot No. .....5'e�� w............. pursuant to application dated ....X!gkf�?....................................... 19,,411�., and approved by the Building Inspector. Fee $....25 .... .... .......... ...... ......... .......... ...... .. ........ ..... ............. uildi Inspector Rev. 6/30/80 -- TOw�' OF SOGT3oLD BUILDING DEPARTMENT 4 TOUN Hr1LL SEP I BLDG. T DEPT. PLiCATION FOR CERTIFICATE OF OCCUPANCY TOWN OF SOUTHOLD A. This application must be t111ed in by typewriter OR ink and submitted to the building inspector with the following: for nest budding or new use: 1 . Final survev of 7roDerty with accurate location of all buildings, oropert7 in 2S, streets, and unusual natural or topographic features. 2. Final Approval from Health Dent. of water supply -and sewerage-disposal(S-; form) . 3. Approval of electrical irstallacion _'From Board or Eire Underwritars. 4. Sworn statement from plumber certifying that the solder used in system contains less than 2/10 of 17--lead. Commercial building, industrial building,. multiple residences and similar buildings and-installations, a certificate of Code Compliance from architect or engineer responsible for the building. o. Submit Planning Board Approval of completed site plan requirements. B. For existing buildings (prior t0 :ipr11 9, 1957) non-conforming uses, or buildings and ore-existing" land uses: I . 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 Certif icace of Occupancy is denied, the Building Inspector shall state the reasons therefor in writing to the applicant. C. Fees 1 . Certificata of-Occupancy - New dwelling 325.00, Additions to dwelling 325.00, Alterations to dwelling 823.00, Swimming pool S25.00, Accessory building 325.00, additions to accessory building S25.00. Businesses S50.00. 2. Certificate of Occupancy on Pre-existing Buildina - $100.00 3. Copy of Certificate of Occupancy - .25-,;, %. Updated Cernlf icace of Occupancy - $50.00 5. Temporary Certificate of Occupancy - Residential 515.00, Commercial S15.00 Date . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . New Construction. . . . . . Old Or Pre-existin Building. . . . . . . Location of Property. . .. . . . . . . ... . . . . . . . . . . . 0 House No. Street Hamlet / 9 Onwer or Owners of Property. . � :�:. . . �lj . . . 1 � . . . . . . . . . . . . . . County Tax Map No 1000, Section. . . V . . . . . . .Bloc'_{. . .3. . . . . . . . . . .Lot. . 91. . . . . . . . . . . . . . . . . . Subdivision. . .<. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ailed flap. . . . . . . . . . . .Lot. . . . . . . . . . . . . . . . . . . . . . Permit No Ur� Date Of Permit. �I./ y � AoDli ca-at.LCCIII�c� Healch Deoc. AoDroval. . . . . . . . . . . . . . . . . . . . . . . . . .Unde`-writers Approval. . . . . . . . . . . . . . . . . . . . . . . . . Planning 3oard Approval. . . . . . . . . . . . . . . . . . . . . . . . Request for: Temoorar-% Certificate. . . . . . . . . . . _inai Car=icaca. . . . . . . . . . . IA4 e 1DpT.Tr,�\ Qom, -5f�3 THE NEW PORK BOARD OF FIRE UNDERWRITERS PAGE 1 1195099 BUREAU OF ELECTRICITY 85 JOHN STREET, NEW YORK, NY 10038 Date APRIL 26,1996 Application No.on file 11543096/96 N 384345 THIS CERTIFIES THAT only the electrical equipment as deaeribed below and introduced by the applicant named on the above application number in the premises of HENRY RUTHINOWSKI, 319 CHAMPLAIN PL. , GREENPORT, N.Y. in the following location; ❑ Basement ❑ 1st Fl. ❑ 2nd F!. OUT Section Block Lot was examined on APRIL 22,1996 and found to be in compliance with the National Electrical Code. FIXTURE FIXTURES RANGES COOKING DECKS OVENS IDISHWASHERS EXHAUST FANS OUTLETS RECEPTACLES SWITCHES INCANDESCENT FLUORESCENT OTHER MAT. K.W. AMT. K.W. AMT. K.W. I AMT. K.W. AMT. H.P. DRYERS FURNACE MOTORS FUTURE APPLIANCE FEEDERS SPECIAL REC'Pi TIME CLOCKS BELL UNIT HEATERS MULTI.OUTLET DIMMERS AMT. K.W. OIL H.P. SYST GAS H.P. AMT. NO. A.W.G. AMT. AMP. AMT. AMPS. TRANS. AMT. H.P. - EMS A No.OF FEET MT. WATTS SERVICE DISCONNECT--- NO.OF $ ..... E R V I C E METER NO- CC.COND. A.W.G. ;"A.W.G.' A.W.G. AMT. 'AMP. TYPE - EQUIP. 1,i'7W 1,Ft 9W 3,B'3W 3 p�W PER.6' OF CC.COND. NO.OF HI•LEG OF HI-LEG NO.OF NEUTRALS .OF NEUTRAL OTHER APPARATUS: FIRE RECONNECT ONLY-1 JIM SAGE, ELEC. INC. LIC.#3635 E l_ t 350 ,MARINE PLACE GENERAL MANAGER GREENPORT�j'NY', 11944 11 � Per _ This certificate must not be altered in any'manner; return to the office of the Board if incorrect.' Inspectors''may be identified by their credentials. li'it"sLD' INSPECTION REPORT DATE COMMENTS _===== __________________ G ro FOUNDATION ( IST) Ir------�i- ------ ----- - ------ ci FOUNDATION (2ND) ° II -------------------------- II p II II ROUGH FRAME & it----II PLUMBING II II II jj —II II ii H INSULATION PER N. Y. II STATE ENERGY II CODE II II II II II ---------------------------- qA II II FINAL II II _-II ------------- -------- ADDITIONAL COMMENTS:tv --- H H O x a � N — ro H z � 765-1802 BUILDING DEFT. INSPECTION [ ] FOUNDATION iST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND LATION [ ] FRAMING [ FINAL [ ]. FIREPLACE & CHIMNEY REMARKS 94�? 0 DATE � INSPECTO 710 �- ry r� l f A 1 {}} n f. , t ------------- t d La�`Mr UNDERWRITERS CERTIFICATE === � fit Gs -90 XY .,•,r,-�c,;r„x-rs:,.;��- ---------------- / - ---'--�:.�:�:v.,=.ace �a.�r.�.n..ur-�- _ ..o.�ay L"'.-,.-. BOARD OF HEALTH . . . . . : . . . . . . . . . FORM NO. 1 r�3 SETS OF PLANS . . . . . . . . . . . . . . . TOWN OF SOUTHOLD SURVEY . . . . . . ... . . . . . . . . . . . . . . . . BUILDING DEPARTMENT CHECK . . . . . . . . . . . . . . . . . . . . . . . . . TOWN HALL SEPTIC FORM . . . . . . . . . . . . . . . . . . . SOUTHOLD, N.Y. 11971 TEL: 765-1802 NOTIFY: CALL . . . . . a- irk,c Ski'` ..... �.'- c !r, - Pmined. ., 19/^y' MAII. T0: . . Approved.. �d ...... 19�G✓. Permit No.d.'w� . .........6 f... 17%J............ Disapproveda/c .................................. .................................... ....................................................... -(Building .n4, r) APPLICATION FOR BUILDING PERMIT Date.�,� ./ . . . . , 19 INSTRUCTIONS a. this application must be c letel filled in -. t ,ewri.ter or in ink and.submitted.to the-_Bui_ld_in_g Inspector with - - --- — _- —_.y ..__ _�r _ 3 sets of plans, accurate plot plan to scale. Fee according to sdnedule. 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 must 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 BEREBY 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 premises and in building for necessary inspections. .. .. .� ......... (Signature of applicant, or name, if a corporation) (Mailing addreseof applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. .....(�c,..yr:......................... ..... ...................................................................._ Name of owner of premises ACM.. ......... 1�..1.f�:.G.rJ..�!.J�.......:................................. as on the tax roll or latest deed) I£ applicant is a corporation, signature of duly authorized officer. ......................................................... (Name and title of corporate officer) D JUN 1 3 ,9 Builders License No. ................. m Plumbers License No. ......................... f3LGr.l�EPY.. r, 70WN OF SOUT1 OOLO- . a .�10 Electricians License No. ..................... Other Trade's License No. .................... 1. Location of .land onwhich proposed work will be clone... ..�! a.�':!z�.41 ..// ct ............... .... �.�4�. �.�........ ............. ............................................................. House Numimer Street llade+t County Tax Map No. 1000 Section .... ....... Block .......3....... Lot %.... !....... Subdivision ...................................... Filed Map No. ............... Lot ............... (Name) 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: ......................................................a. Existing use and occupancy ......... b. Intended use and occupancy .......� .............. 3. N•rLure of cork (d►edc uhicl► applicable): New Wilding .......... Addition .......... Alteration .......... Repair ` ! �'�............ Desmlition ............. Other Work .................................. . � (Description) 4. Estimated Cost ....... ,........ fee .............................................. (to be paid on filing this application 5. If dwelling, nudier of dwelling units ..r.... iha►ber of ckaelling units on ead► floor ................ If garage, number of cars .................................. .. G. If business, commercial or mixed occupancy, specify nature and extent of eadi type of use..........�../.-.�...... 7. Dimensions of existing structures, if any: Front.,.O.0........ hear ...6:0........ Depth .`..../.,�........ Ikigl►t .. yC �.................. Umi)er of Stories ....../............. Dimensions of sane structure with alterations or additions: Front ............... Rear ............... Depth .................... Ileigl►t .................... Nud)er of Stories ....0' ........ 8. Dimensions of: entire new construction: Front ................ Rear ............... Depth .............. Ileiij►t ......................... Uxifter of St:ories ..._ ............. 9. Size of 1 of: lrrx►t .......�1..J/........ Rear ....J.. ......... I)ep-it .....?/ ........ 10. Date of lurchase ..................... Nam of Former Omer ... ..mod i.l? II. Zone or use district in wl►id► premises are situated .............................................................. 12. Does proposed ccm►struction violate any zoning law, ordinance or regulation: ........................ 13. Will lot he regraded .................... Will excess fill be removed from premi se s : YE,S 13D 14. Na►>es of Owner of premises .P.CJ!►:(l .. � � %ks. r/ess �1 r C(!c ��'7l�: �:. Plxx►e No. -r 7 7:[f� Name of Ard►itect ................./................... Arklress ....1.......................... PI►one No. .............. Mane of Contractor ` :$ !..A(!�;Gth,C.................. Arklress 1. 11ke:,;Vecf,C ,2c ,Pi►or►e No.7 a.'-9'O.0 15. Is Lhis property within 300 feet of a tidal wetland? * YES .......... N0 .. . *IF YES, SOUTIM) IMN 1XISIM-9 PERMIT MAY IC- IlayllIi). P1.0'r DIAGRAM Locate clearly and distinctly all buildings, whether existing or proposed, and indicate all set-back dissensions from property lines. Give street and block number or desrcription according to deed, and slow street names and indicate ►nether interior or corner lot. AP 0 ED AS NOTED 4 DATE: B.P # 2 FEE: % BY.. NOTIFY I DING DEPART T 765_1802 S AM TO 4 PM FOR THE FOLLOWING INSPECTIONS: 1. FOUNDATION - TWO REQUIRED FOR POURED CONCRETE 2. ROUGH e FRAMING & PLUMBING 3. INSULATION 4. FINAL - CONSTRUCTION MUST BE COMPLETE FOR C.O. m.-.... .. _. ALL CONSTRUCTION SHALL MEET THE REQUIREMENTS OF THE N.Y. STATE CONSTRUCTION & ENERGY MME, OF Mid YORK, CODES. NOT RESPONSIBLE FOR DESIGN OR CONSTRUCTION ERRORS yl•• . V being duly sworn, deposes six] says Lhal• he is Lite appl.ica;►L (N.-ine of isxlividual sigrPing contract) alxwe named, Ile is Lite ..........:...... Y . (Contractor; arenY corlx)raLe officer., eLc.) ... .. .. .. .. . of said owner or owners, aril is duly audiorized to perform or have performed the said work and to naike and file Lhis appticaLicm; Lhat: all. sLaleneuts conL-ai.ned in this gppl.icatior► are true to the best of his knowledge mid lxil.ief; asxl Lhat Lite work will be performed in Lite mr►nner set forth in Lite application filed Lherewith. fkaorT► Co be^f�'`e me Lh.is ........l..J. ... .. day o f: ... .�...",�9 NotaryPubl .............. ... .. C. CLa41RE L.GLEW (sic r re of Appli.canL) Notary Public,State of New York No.4879505 Qualified in Suffolk County Commission Expires December 8,1 .._