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Home My WebLink About9260-z zz�—, ✓ a K FORM NO. Y TOWN OF SOUTHOLD BUILDING DEPARTMENT/ 7� TOWN CLERIC'S OFFICE SOUTHOLD, N. Y. Examined ............. ..J/t.... ....... ., 192Z Application No. ...d....... a. ...� Na. ............... ,7.. Permit I............... Approved ................. � 1 � ................ � Disapproved a/c .... ..... .........................`............................... ... ..................................... . ...... . ............ ............................ .... ...:..... .............................. (Building Inspector) APPLICATION FOR BUILD NG PERMIT 4: Date ....................... 19. s . .�. .`r INSTRUCTIONS C � C a. This'"application must be completely filled in by typewriter or in ink and submitted in triplicate to the Building z Inspector, with 3 sets-of plans, accurate plot plan to scale. Fee according to schedule. t 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 n 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. f 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 orb 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 buildings for' necessary 'inspections. .. (Si ................ gnature of applicant, or name, if a cor oration) ..IA..!4...................................... (Address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, 'electrician, plumber or builder. .l............'.,la._.'1Q. .-e_ ..................................... ................. ..................................................... Name of owner of premises ...N.(... �C.L.a..m.�... ....barPA[� .....:..................... . .V. S.r......... .. ......................... If applicant is a corporate, signature of duly authorized officer. .................................................................... .................... (Name and title of corporate officer) 1 Builder's License No. ...... ................................... /-2 D —� Plumber's-License,-,No.......................................:...:..:.... Electrician's License No. ............................................ ej OtherTrade's License No. .............................................. 1. Location of land on which proposed work will be done. Map No.: ..................... .............. Lot No. Streetand Number .........................s,.J-0m.1V I......&......f... l' � ..L! � ................................................... Municipality 2. State existing use and occupancy of premises and inttendedr-use and occupancy of proposed construction:. a. Exisiting use and occupancy .....T pr. 0.0.YI! ...:...1. 49Cc,"lr..................................... b. Intended use and occupancy ........�5. -m.°e....... ......................................:. , ` 3. Nature of work (check which applicable): Nmw-136i|di �g.-.----- Addition —...,--- Alteration ............ � � Repair ---.—.,' Removal —.----.. Oe��o �ion�.�^—^__-- Other Work ........................................ '_ � (Description) ' 4. in�otad Cost ---.--'��'__--.-----'.�e� --.—.-��'s_-_----.----_..--.'''.-________.. --' (to be paid on filing this application) 5. If dwelling, number of dwelling units --------.—Number of dwelling units on each floor ............................ |fgarage, number -of cars ............................................................................................................................................... 6 |f business, con�n�aocio! or nnhuy� occuponcy� specify ' and extent of each �peofuse ------`----. ' ' —` ' �/«9 ' _---,.-' �a t� ---.. 7. Din�ensionsofax�tngstructures, if any: Front ---..�-�----' �eor -_--'.�'��. o 'r:��. Height '/� r7 �'. Number of Stories ............. �--.-{/.�Y.2 ..........................................................................................------_'__---______.__—_. `� ^ �° ^ Dinnensionsnfoonna structure with alterations �r additions:, Front ..........��-��-__-_-- Rear __-.��----. Depth ......�.�Y../.................... Height --A.3..............Nun`bar'o Stories --/..,/? -----' 8. Dimensions of entire new construction: Front —.-----,—'^--.- Rear ............................ Depth ........................ Height ------- Number of �Stories ----------...--'--.----�—--.-----.--—�—.—^�_^~.'_� ...................... 9. Size of lot: Front ---- Reo' = — Depth '110. Date of Purchase ........................................................Name of Fbrmor Owner ---------.-'..~'..- .................... ll. Zone or use district in which premises are situated ---.----_---__-_.---_.---------.---.------ l2. Does proposed construction violate any zoning |ovv ordinance or regulation: ......................................................... 13. Will lot be regraded ......IV.0............. Will excess fill ba removed from�p : ( ) Yes. ��°�~Nho - /M^ �x8^' �-- ^-J�� M' ^ ��x2 ~ ^� Phone, �� l�� NonneofD�nerufprennisao ..,..,^..�xv�x../�x/x/:/�.../��x8��'�uJgra�s '�x� �'c�za��^... .pwnp«��.-m..u�`�, ' � Nome of Architect ---------------------' Address -''..-.-'.-......... f»hone No ...................... Non`e of Contractor ......................................... Address .................................. Phone No. ...................... ' PLOT D|/\GR/\kA Locate clearly and distinctly all buildings, whether existing or proposed, and indicate all set-back dimensions from property lines. Give street and block number or description according to deed, and show street names and: indicate whether interior orcorner |o*. ` � � « u ` � � ^ � "N i �~ ya �� ' ' x� . ^~�� ~ � h FORM 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 MATTITUCK, N.Y. House No. Street Hamlet County Tax Map No. 1000 Section 120 Block 2 Lot 2 Subdivision Filed Map No. 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 GENE DOROSKI & OTHERS (owners) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A UNDERWRITERS CERTIFICATE NO. H-017361 - AUGUST 2, 1990 PLUMBERS CERTIFICATION DATED N/A Bu lding Inspector Rev. 1/81 FORM NO. 2 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTH'OLD, N. Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) N49260 Z Date ..........................y r..... 1{.............. 1'77... Permission is hereby granted to' * 0Waw*se-±.....*VQ.. ..Dorcrski.......... ... ............MAU.ulok.................................. .... ...................................................................... . ..... . totxirl.tta••a�cld � •• aY3;�.. s9Ttg dW6 # t ....................................... . .................. • ... .. .... ..i,. ! .t ................................................................................................. atpremises located at .... y�1i„'i ..$ 18.................................................................................................. ...............................................leS�t,''�at1;ck.......... ................................................................................ - ..............................I................._ ..................... ...,....................................................................I... ........... pursuant to application dated .................... ............, 19`. ..., and approved by the Building Inspector. t Fee AI Ik 110......... g ....... Bu"tidin~g ectar. ...................... aQ�� g(o Form No. 6 t f ( 7- 1 g _ W 14 TOWN OF SOUTHOLD P BUILDING DEPARTMENT ja TOWN HALL 765-1802 7TOWN C. 0£PT. F S LOT LO APPLICATION FOR CERTIFICATE OF OCCUPANCY 1 X. 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 12 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. 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. 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. Copy of Certificate of Occupancy - $5.00 over 5 years - $10.00 4. Updatcd Certificate of Occupancy - $50.00 5. Temporary Certificate of Occupancy - Residential $15.00, Commercial $15.00 Date 90 w Construction. . . . . . .. . Old Or Pre-existing Building. . .. . .„� . ... . . . . . • •• • +. • ' •••'•.,. , •• • _.ition of Property.. .aZS.,?) . ... V.. . . . . . . .. l?:�.t ,{ �.;cP.. . . . ........ .. . House No. �p Street Hamlet :wer or Owners of Property...47 er1r:l/ ... .�1:. : g. . . . . .. . . . .ems. . . . . . ........ . ... .,unty Tax Map No 1000, Section. .. l �.. . . .Block. . . .. . .. . . . . . .Lot. . .. .. ........... . ubdivisi,on.. . . . . . ... ... .. ...... ... . . . . . .. .. .. .Filed Map. . . . .. . . . .. .Lot. .. . . . .. . . .. ..... . .. 'ernit No A. .//P.0. . . . .Date Of Permit. . .... . . .. . �tf._ V0t!�,c�CC (_ . . . . r . .. . .Applicant. . . . .. .. ;:ealth Dept. Approval. . . .. ... .... . .. .. .. . ... .Underwriters Approval... . . .. . . . . . ......... . i 'lanning Board Approval... .......... .... ....... 2equest for: Temporary Certificate. .... . ..... Final Certicate.. .. .... .. . Fee Submitted: $.... ........ . .0............ .. APPLICANT - - - - - - - - - - -- - - - - - - - - - --- THE NEW YORK BOARD OF FIRE UNDERWRITERS PAGE 1 8019205 BUREAU OF ELECTRICITY h 85 JOHN STREET. NEW YORK. NEW YORK 10038 5 Date AUGUST 02,1990 Application No.on file le 00397490/90 H 017361 THIS CERTIFIES THAT only the electrical equipment as described below and introduced by the applicant named on the above application number in the premises of D.GENE DOROSKI, 2575 SOUND AVE. , MATTITUCK, N.Y. in the following location; ❑ Basement U 1st Fl. ❑ 2nd Ft. Section Block Lot was examined on JULY 06,1990 and found to be of compliance u ith the regnirentents of this Board. OUTLE FIXTURES RANGES COOKING DECKS OVENS DISHWASHERS EXHAUST FANS OUTLETS FCEPTACLES $WITCHES INCANDESCENT FLUORESCENT OTHER AMT K W AMT K W AMT (W AMT KW AMT H P DRYERS FURNACE MOTORS FUTURE APPLIANCE FEEDERS SPECIAL RECPT TIME CLOCKS gELL UNIT HEATERS MULTI.OUTLET DIMMERS AMT K W 011 H P GAS N P AMT NO A W G AMT AMP AMT AMPS TRANS AMT H P SYSTEMS AMT WATTS NO OF FEET SERVICE DISCONNECT NO OF S E R V I C E , _ AMP TYPE METER 1 X YW 1 X 7W 3 X 3W 7 X 4W NO OF CC COND ACC G NO OF HI LEG A W G NO OF NEUTRALS A W G EQUIP PER X OF CC COND OF HI LEG OF NEUTRAL OTH" APPARATUS. PORCH-1 *NO VISUAL DEFECTS: "An electrical survey has been made of the exposed electrical equipment in the Premises indicated." "No obvious unsatisfactory condition was found. D.GENE DOROSKI 720 BUNGALOW LANE MATTITUCK, NY, 11952 GENERAL MANAGER 11 Y ST Per. T1i`A certrflcate must not be altered in any manner; return to the office of the Board if Incorrect. Inspectors may be identified by their credentials. ,,. -MOW FORM NO. Y TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHHOLD, N. Y. Examined ............ ......... ... .., 19 1..(.. Application No. ../..° ....... ..... v� yy oZ 0 `L— Approved .......................�.........1....., 19..��.. Permit No. .... ............................... Disapproveda/c ............................................................................................ ...................... _..... ........,1...,y ....T.::.......... QO ........................... (B Idin.. Inspector)...-'�-t ..... APPLICATION FOR BUILDING PERMIT T r Date ....................... .. Iq ...., 19..)..( INSTRUCTIONS a This application must be completely filled in by typewriter or in ink and submitted in triplicate to the Buildir Inspector, 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 adjoining premises or public streets areas,and giving a detailed description of layout of property must be drawn on the diagram which is part of this applicatio 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 perry 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 Occupam 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 alterations, or for removal or demolition, as herein describe The applicant agrees to comply with all applicable laws, ordinances, building code, housing code, and regulations, and admit authorized inspectors on premises and in buildings for necessary inspections. c,rti ... (Signature of applicant, or name, if a corporation) .......rn. ................................. (Address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or build. C�c.N...�.r.�..l...........CO-4. ...... ......... ... ..................i........................................................................... Name of owner of premises ...1..".S.i!.-A...n!LiIS.:..........i�t2..!�.�.J�.-. .}...l��.l .D.,j.K. 1...... ... .. ........... ...... .............. i If applicant is a corporate, signature of duly authorized officer. .. ..................................................................................... (Name and title of corporate officer) Builder's License No. .......i[.AM................................... Plumber's License No. .........................T.......::..:....:.... Electrician's License No. ............................................ , Other Trade's License No. ..............................6............... 1 Location of land on which proposed work will be done. Map No ............ ........................ . Lot No ..................... Street and Number ...... ...................�..J.Q III..��...... V.•........IV�,► �-�. C .... ........ .......... ...................... Municipality 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: a Exisiting use and occupancy ......Ff no!v ......d..d.r�.'4............ .............. /j b. Intended use and occupancy ....... Pm: .11... ............................................................... r ature of I�work (check which applicable): New Building ...... .......... Addition ......�... Alteration .............. _-----Kepair ....Jl...... .... Removal ............ ..... Demolition . .... . ...... Other Work ................ . ......... .......... ........ ... hyf�Q� r7� o (Description) 4 Estimated Cost Fee W— ..............I................ . ...... �:5.......... .... ...... ....... ....... . ............ .... .... . ..... .... ..... . . (to be paid on filing this application) 5. If dwelling, number of dwelling units ..... ............... . ....Number of dwelling units on each floor .... ..................... Ifgarage, number of cars .. .. ... .. ..... . . ............ .. ............................................................................................... 6 If business, commercial or mixed occupancy, specify nature and extent of each1type of use ...........�.ry......... .. . 7 Dimensions of existing structures, if any Front . . �............... Rear .......... q............... Depth .��...F....... .. Height ....s ......... Number of Stories . .......... ...Z".........................!../......................... .. ......7..0.......... .. Dimensions of some structure with alterations or additions. Front .. ......7.. ................... Rear r Depth ....s�..j..... ............... Height . .. a2.�....... .... Number of Stories . ....r... �..,............... 8 Dimensions of entire new construction. Front ............ ....................... Rear ............................ Depth ..................... Height ...... ............. Number of Stories . ............... .. ... ....... ...... ................................ ......... . . ........................ 9 Size of lot Front ........ 3..�r... . . . . ...................... Rear . .......4cF.4...I................... Depth Wg 10 Date of Purchase ............. .............. .. . ........ ....Name of Former Owner ...................................... ................ 11 Zone or use district in which premises are situated ... ............................................................................................... 12 Does proposed construction violate any zoning law, ordinance or regulation: ...................................................... 13 Will lot be regraded ......0.0.. ... ...... Will excess ]fill be removed from premises: ( ) Yes 011 No 14 Name of Owner of premises .. /.:. fS....[:.ft.f�t? ..tJP.�4.5AU Address .1.e./.A: S:tC.*.... Phone Noo�W:7P'24(i Name of Architect . ..... . . ..... . . . .. ........ Address ................................ Phone No. .................... Nome of Contractor ........... .. .... .... .. . ... .... ........ Address ................................ Phone No. .................... PLOT DIAGRAM Locate clearly and distinctly all-buildings, whether existing or proposed, and indicate all set-back dimensions fro, property lines Give street and block number or description according to deed, and show street names and indica; whether interior or corner lot '6 r �0 _T 2r A Dp "ot v 5awf� Aij STATE OF NEW ORJS i SS COUNT OF ...... . ..... �!! ?7 Q'. .. .................... ... . . .... being duly sworn, deposes and says that he is the applica (Name of individual signing contract) abo amed �j He is the ..................... . t.:oh1 ?71T..Q.. ........... ......... ..................... . ............................. ............................. ...... . (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 f this application, that all statements contained in this application are true to the best of his knowledge and belief; a tl-iar the work will be performed in the manner set forth in the application filed therewith. Sworn to before me this .VIA........ day of (.y /V.. 19M. Notary Public, .... ...�....�...�..................... County !t �.....�.1 -f....... .................... ........... ....... (Signature of applicant) ( RY E DAWSON NOTARY UBLIC, State of New York No 52.4643721, Suffolk Cou�y Term Erpup; Aurch 30, 19%% T