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Home My WebLink About9260-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No Z-19282 Date AUGUST 8~ 1990 THIS CERTIFIES that the building. ADDITION Location of Property 2575 SOUND AVENUE House No. County Tax Map No. 1000 Section 120 Block 2 Subdivision Filed Map No. MATTITUCK ~ N.Y. Street Hamlet Lot Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated MAY 24, 1977 pursuant to which Building Permit No. 9260-Z dated MAY 24~ 1977 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 PORCH ADDITION TO EXISTING ONE FAMILY DWELLING The certificate is issued to (owners) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL UNDERWRITERS CERTIFICATE NO. H-017361 PLUMBERS CERTIFICATION DATED Rev. 1/81 GENE DOROSKI & OTHERS - AUGUST 2t 1990 N/A '~~~~~~pector FOF~ NO. 2 TOWIq OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y; BUILDING PERMIT CT'HIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) N? 9 60 Z Permission is hereby granted to.~ J, See~e ~.~-.: · · .,~'~ · · .~.~ak- · .I) o~sk~. ............. ............ ~.t~ .~.~u.e.~ ........................................ g~iJdi~g Inspector. Fee $. :.?..~.k~ .~ ......... premises located at .... _~,: .~T~J3JJ-;,A~B ................................. . ......... : ...... : ................................................ ............................................... F~tnck .......................................................................................... p_?suant, to application dated .... ;.:. .............. i...~...,~,~,....i ....... , 19V.~. .... and approved by the aLDG. DEPT. BLDG. , TOWN OF $OUTHOLD Form Mo. 6 APPLICATION FOR CERTIFICATE OF OCCUPANCY TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL 765-1802 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 contm~ns less than 2/10 of 1% lead. r 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. For existing buildings (prior to April 9, 1957) non-conforming uses, or buildings and "pre-ex~sting" land uses: 1. Accurate survey of property showing all proper~y 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 o£ Occupancy is denied, the Building Inspector shall state the reasons therefor in writing to the applicant. 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 - $i00.00 3. Copy of Certificate of Occupancy - $5.00 over 5 years - $10,00 4. Updated Certificate of Occupancy - $50.00 5. Temporary Certificate of Occupancy - Residential $15.00, Commercial $15.00 °. ....................... ,,/ · w Construction .... ~. .....Old Or Pre-exis~ing Building ............... House No. Street Hamlet .:'-'er or Owners of Property....--~.~.~~~ ................. ~ ....................... ~nty T,~ ~p No ~000, Section.../~ ..... ~loc~ ..... .--9,.~ ....... Lo~ .... ~ .............. ubdivision .................................... Filed Map ............ Lot .................... .. .......... Applt .............. ;h.alth Dept Approval Underwriters Approval ?fanning goard Approval.....·... ........... . ... Request for: .Temporary Certificate ..... Final Certicate ........... ~_.q~q0 ........ I ....... APPLICANT THE NEW YORK BOARD OF FIRE UNDERWRITERS PAGE 1 8019205 BUREAU OF ELECTRICITY I - 85 JOHN STREET, NEW YORK. NEW YORK 10038 Oa,~ AUGUST 02,1990 Appllcat~on Mo. o,f~le 00397490/90 H 017361 THIS CERTIFIES THAT ordy The electrical equipment as described below and introduced by the applicant named on the above application number ~r~ the premlaea of D.GENE DOROSKI, 2575 SOUND AVE., MATTITUCK, N.Y. in the following location: [] Bas.re.hr [~ Ist FI. [] 2nd FI. ~ecti,,n Block u~s exa.lined on JULY 06,1990 and found to be tn co.~phant.e utth the reqnirernent~ of thts Boord. Lot RXTURE FIXTURES RANGES ICOOKING DECKS OVENS DISH WASHERS FANS OLITLETS SWITCHES FLUORESCENT OTHER DRYERS FURNACE MOTORS FUTURE APPUANCE F~EDERS SPECIAL RECPT TIME CLOCKS UNIT HEATERS MULTI.OUTLET SYSTEMS NO OF FEET S~RVICE DISCONNECT OTt4e:~APPARAIUS. PORCH-1 *NO VISUAL DEFECTS: "An electrical aurvey has been made of tLe exposed electrical equipment in the premises indicated." "No obvious unsatisfactory condition was found. D.GENE DOROSKI 720 BUNGALOW LANE MATTITUCK, NY, 11952 DIMMERS WAITS S E R V ! C E GENERAL MANAGER cerhf,cate must not be altered in any monner; return to the off~ce of the Board if incorrect. Inspectors may be idenhf~ed by their credentials. Examined Approved l~O~M NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. Permit No. ~.. c~ 0 ~ Disapproved a/c ............................................................................................ APPLICATION FOR BUILDING PERMIT INSTRUCTIONS Application No...~....c~....~.'..O...~ ..... a This apphcation must be completely filled in by typewriter or ~n ink and submitted in triplicate to the Buildi[ !nspector, with 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 adjmmng premises or public streets areas, and giving a detmled description of layout ofproperty must be drawn on the diagram which is part of th~s apphcatio 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 pern 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 Occupan, shall have been granted by the Building Inspector. APPLICATION IS HEREBY MADE to the Building Department for the issuance of a Building Permit pursuant to tl Building Zone Ordinance of the Town of Southold, Suffolk County, New York, and other applicable Laws, Ordinances Regulations, for the construction of buildings, additions or alterahons, or for removal or demolition, as herren describe The opphcant agrees to comply with all applicable laws, ordinances, building code, housing code, and regulations, and admit authorized inspectors on premises and ir) buildings for necessary inspections. .......-'-" ............................ State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electricmn, plumber or budd.~ ........ ........... ............................................................................................................ Name of owner of premises ...J~..,...~.....~.. ~..S. ............ ~t~..(-]..'~..~...,[..l~q.~.~.~.[; .......................................... If applicant is a corporate, signature of duly authorized officer. (Name and title of corporate officer) Builder's License No ........ .~../.~... ................................... Plumber's License No .......................... · ....... ~.;......-. .... EJectncian's License No ............................................. ~ Other Trade's License No ............................................... Locahen of land on which proposed work will be dane. Map Ho ............ , ......................... Lot No ..................... Street and Number ......................... ~.D.~..t~..f:J ....... /.~..~..,.....~..~.F..~..~..?...~...~..C..~., ............................................ Municipality State existing use and occupancy of premises and intended use and occupancy of proposed construction: b. Intended use and occupancy ........ ..~..~.?.,~...~,~ J~..-.~ ............................................................... ;ture of work (check which applicable): New Budding ................ Addition ........J~....... Alteration ............... .... .J~......Removal .................Demohhor. --~r~epa~r ................. Other Work ............................................... , ,~, ,/,~. ~ (Description) 4 Estimated Cost ............ .:..=....~.--..-- ................... Fee . ---' (to be pa~d on filing th~s opplicahon) 5. If dwelhng, number of dwelhng units ......................... Number of dwelhng un,ts on each floor .......................... If garage, number of cars ............................ 6 If business, commercial or m~xed occupancy, spec,fy_ nature and extent of each type of use ........................ //% 7 Dimens,ons of ex,sting structures, if any Front . . ?...{'. ........... Rear .......... ............... Depth ...~t...~.. ......... I1~ He,ght ....t;~.~.. ............ Number of Stones ........... !...t..~... ........................................................................................ ), .Dimens,ons of same structure with alterat,ons or add,t,ons. Front ........ .~.. ....................... Rear ........~...-....- ........ Depth ....~--,~...~..: .................. He,ght... ~-...~. ........... Number of Stories ..... ./...'/..~,~ ............... 8 D~mens~ons of entire new construction. Front ................................... Rear ............................ Depth ..................... Height ................... Number of Stories ..................................................................................................... 9 S,ze of lot Front ........ ..03....~ .~ ......................... Rear ........ /.~.~...../. .................. Depth .J.~..~...~......~..~ 10 Date of Purchase .......................................... Name of Former Owner ...................................................... 1 1 Zone or use district m whmh premises are situated .................................................................................................. 12 Does proposed construction violate any zomng law, ordinance or regulation: ...................................................... 13 Wdl lot be regraded ...... ~..~. ........... Will excess fill be removed from premises: ( ) Yes (/,~o 14 Name of Owner of prem,ses ....~. J.:..~/~.,...'~..q. 4 ./g..~....~.~£.~.SJ~'Address .../~.¢/.~...~..~f~C~.. .... Phone No.~l'~...'T..~...~..J.~ Name of Architect ............................... Address ................................ Phone No ..................... Name of Contractor ....................................... Address ................................ Phone No ..................... PLOT DIAGRAM Locate clearly and d~stmctly all-budd~ngs, whether ex~shng or proposed, and =nd~cate all set-back dimensions fro~ propcrty hnes Gwe street and block number or descnpt~on according to deed, and show street names and ind~cal whether inter,or or corner lot OF N W¥O K -- S S COU N~T~ OF :.' ~r~/~'.~"~...0 ~ ~ ..... .... ~....~~~.' .............................. bmng duly sworn, deposes and says that he ~s the applica f ~ (~ame of individual s~gn~ng contract) abo~amed He is the ...................... .~~.~. ......................................................................................................... (Contractor, agent, corporate officer, etc.) of sa~d owner or owners, and ~s duly authorized to perform or have performed the said work and to make and f th~s application, that all statements contam~ ~n this applicchon are true to the best of h~s knowledge and behef; a that the work wdl be performed m the manner set fo~h m the apphcahon filed therewith. Sworn to before me thru ........ o, ................... , oto. ...... ........... ........... .................................. ~ DAWS0~ ~OTARY~UBLIC, Sta~e o~ ~ew York ~o 52-464372[, Suffolk Co ~rch 30,