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Home My WebLink About29438-ZFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No: Z-29519 Date: 06/13/03 THIS CERTIFIES that the building ADDITION Location of Property: 1250 ELIJAHS LA MATTITUCK (HOUSE NO.) (STREET) (HAMLET) County Tax Map No. 473889 Section 108 Block 3 Lot 5.11 Subdivision Filed Map No. __ Lot No. __ conforms substantially to the Application for Building Permit heretofore filed in this office dated MAY 29, 2003 pursuant to which Building Peztait No. 29438-Z dated MAY 29, 2003 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 DECK ADDITION TO AN EXISTING ONE FAMILY DWELLING AS APPLIED FOR. The certificate is issued to THOMAS P PILESKI (OWNER) of the aforesaid building. ~UFFOLKCOUIFI~IDEPARTME~TOFBEALTHAPPRO~i~L ELEU-rKICAL ~TIFICATE NO. PLUMBER~ CERTIFICATION DA'r~ N/A N/A N/A 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) PERbIIT NO. 29438 Z Date MAY 29, 2003 Permission is hereby granted to: THOMAS P PILESKI 1250 ELIJAH'S LANE MATTITUCK,NY 11952 for : DECK ADDITION TO AN EXISTING ONE FAMILY DWELLING (20, x AS APPLIED FOR. THIS PERMIT REPLACES 26580. at premises located at 1250 ELIJAHS LA MATTITUCK County Tax Map No. 473889 Section 108 Block 0003 Lot No. 005.011 pursuant to application dated MAY 29, 2003 and approved by the Building Inspector to expire on NOVEMBER 29, 2004. Fee $ 150.00 Authorized Signature COPY Rev. 5/8/02 FORM NO. 3 TOWN OF SOUTHOLD BUILDING DEPARTMENT Town Hall Southold, N.M. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) PERMIT NO. 26580 Z Date JUNE 14, 2000 Permission is hereby granted to: THOMAS P PILESKI 1250 ELIJAH'S LANE MATTITUCK~NY 11952 for : ~ INSTALLATION OF NEW 20'X~k' DECK ADDITION IN REAR YARD AS APPLIED FOR. at premises located at County Tax Map No. 473889 Section 108 pursuant to application dated MAY Building Inspector. 1250 ELIJAHS LA MATTITUCK Block 0003 Lot No. 005.011 19, 2000 and approved by the Fee $ 75.00 Authori z d~S~gnature COPY Rev. 2/19/98 APPLICATION FOR CERTIFICATE OF OCCUPANCY Form No. 6 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL 765-1802 This application must be filled in by typewriter or ink and submitted to the Building Department with the fbllowing: A. For new building or new use: 1. Final survey of property with accurate location of all buildings, property lines, streets, and unusual natnral 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. Conm~ercial building, industrial building, multiple residences and similar buildings and installations, a certificate of Code Compliance fi-om architect or engineer responsible for the building. 6. Submit Plamfing 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 suwey of property showing all property lines, streets, building and unusual natural or topographic features. 2. A properly completed application aud 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. Copy of Certificate of Occupancy - $.25 4. Updated Certificate of Occupancy- $50.00 5. Temporary Certificate of Occupancy - Residential $15.00, Cmnmercial $15.00 Date. New Construction: ~ Old or Pre-existing Building: Location of Property: ] 2~0 ~ ((T~ [~ot? House No. 'J Street Owner or Owners of Property: _'-T-Uo~A '~ ~,le~': Suftblk County Tax ~tion [ O~ Block ~ Subdivision Q ~q/~ Filed Map._ Pe~itNo. 26ff~0~'' Dat~fPe~it.~[lql O0 Applicant: Health Dept. Approval: Planning Board Approval: Request for: Temporary Certificate Fee Submitted: $ _ ~ 2. ~ C) O Underwriters Approval: Final Certificate: / (check one) Hamlet Lot: (check one) Applicant Signature BUILDING PERMIT REVIEW CHECK LIST Owners Name: 7'-~o,~.~.~ :/t-e3~, Reviewed: Architect/ /'-J O.~rc.~ Date Engineer: Submitted: SCTM #: Disl~ict: 1,000 Section: /O~' Block: ~ Lot: Location: /.,2~O ~'/Q)~ ~ Single & separate Requked certification: (Yes / No/ Zoning Dis~ict:r~O Req [Lin s~: Subdivision [Side Yard .]~'/-~/ Proposed: 7/t J [Rea~Yard -~'0 Proposed: AGENCY PERMITS REQUIRED FOR REVIEW N.A. Suffolk County Health Dept. ' ~/ New York State D.E.C. ~ Town Trustees permit NO YES Number Town Zoning Board approval: Town Planning Board approval: Flood Pla~ Elevation ??? Flood Zone: Notes: 765-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION 2ND [ ] ROUGH PLBG. ] INSULATION [ ] FRAMING [ ] FINAL []FIREPLACE&CHIMNEY REMARKS: ~/~__ DATE INSPECTOR 765-180Z BUILDING DEPT. INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLBG. ] FOUNDATION 2ND [ ]INSULATION FRAMING [~J~INAL [ ] FIREPLACE & CHIMNEY DATE BUILDING DEPT. INSPECTION FOUNDATION 1ST [ ] ROUGH PLBG. ] FOUNDATION2ND [ ] I~ON FRAMING [ ~ FINAL FIREPLACE & CHIMNEY DATE INSPECTOR ./~~ ~~'~ FIELD INSPECTION REPORT =DATE ,~ i COMMENTS FOUNDATION (2ND) II II INS~TION PER N. Y. STATE ENERGY CODE ADDITIONAL COMMENTS: FORN NO. TOWN OF SOUTItOLD BUILDING DBPAETHENT TOI~I BALL SOUTItOLD, N.Y. TEL: 765-1802 Disapproved alt ........... ........................................ (ltmldmg Inspector) BOARD OF BEALTB ...~. .......... 3 SETS OF.~LANS ............... ~ SURVEY'~*...~ ~ ~ ~, ............... CUBCZ ~..~.~0 ............... SEPTIC FOIOf ................... DEC ........................... TRUSTEES ...................... NOTIFY · CALL ;~.~. Y/~L_ .... HAIL TO: .................... APPLICATION FOR BUILDING PERHIT INSTRUCTIONS Date.. .(.lg ......... ,2o. .q a. ahis application mast be ct~pletely filled in by typewriter or in ink and suhnitted to rim Building Inspector wi 3 sets of plm~s, accurate plot plan to scale, Fee according to schedule. b. Plot plan s~ho, ring location of lot and of buildings on pre~aises, relationship to adjoining premises or tmblic streets or areas, and giving a detailed description of layout of property mast be draun un the diagran ~nich is part of this application. c. The ~rk covered by this application ~y not be cc~raeneed before issuance of lluilding Permit. d. Upon appr~al of this application, ~he Building Inspector will issue a Building Permit to the applicant. Surh permit shall be kept on the lm~ises available for inspection Onmughont the uork. e. No Imilding shall be occupied or used in uhole or in part for any purpose l~hatever until a Certificate of Oconpeecy shall have been granted by the Building Inspector. ~II~LICATII2N IS ~ ~ to the ltuilding Deparment for the issuance of a Building Permit puranant ro the Building Zone Ordinance of the To~m of Southold, Suffolk Court.j, ~ York, and other applicable L,~s, Ordinances or Re~alations, for the co~st~tlun of huildlx~s, additions or aIteratiofls, or for r~roval or demolition, as herein described. The applicant agrees to co~pl¥ with all applicable la~s, ordinances, building code, housing code, and regulatiuns, and to ac}nit asthorized inspectors on premises amt in building for necessary inspe~ ti~s. ... .................... (Signature of applicant, or na~, if a corporation) (Nailin~ address of applicant) State ~betber applicant is~e~, agent, architect, engineer, genaral contractor, electrician, plumber or buildm premi Iq Ram of mr of scs ................................................................. (as on the tax roi1 or latest deed) If applicant is a corporatim, signature of duly authorized officer. (Nam and title of corporate offiee~) ' ' Builders License No .......................... Pltmbers License No .......................... Blectricians License No ...................... Oiler Trnde's Lieenae No. . . I. Location of land on ~hi~ proposed ~ork will be done .............................................................. ~ Nmber Street ( O~ llanlet co~. T=~ NO. ~mO S~tlon .~... Bilk ....~. ........... ~ot ...~.:.tt ....... Subdivision ...................... ; ............... Filed Hap No ................ Lot ............... 2. State existing use and eeonpmcy of premisa~ ~d intended tree and occupancy of proposed construction: a. Existing use and occupen~ .................................................................. ................................................................. b. Intended F~t,re of ~ork (dk-~ck ~hid~ applicable): hl~a IkJilding .......... ~iti~ ..~ ..... Alter~ti~ .......... ~riptim) - -- Esti~mt~ ~st ~2~. ~ ....... f~ .............................................. ' (to ~ ~id ~ fili~ this a~lJ~ti~) fi~lli~, ~r of ~llJ~ onits ............ ~r of ~lllng mits ~ e~ flmr ................ ~rage, ~r of cars ...................................... Imimss, ~reial or ~ ~, ~i~ mture ~ ~teet of e~a ~ of ~ ...................... t r Dimosi~s of ~isti~ st~mS, if aq: .......... ~ar ............... ~pth ..[.¢v~'- ........ }blOat ......................... ~r o[ Stories ...................... , Dimnsi~ of ~ stn~e ~ith alteratlms or ~itions: ~t ...~.~ ......... ~ar ............... ~pth .... ~Qt. ........... ~i~t .................... ~r o[ Stories ............... Di~nsi~ of entire ~ ~st~ti~: ~t ................ ~ar ............... ~p~ .............. }~i~t ......................... ~r of Stories ..................... Si~ of lot: ~t .................... ~ar .................... ~pth .................... ~te of R~rdm~ ..................... ~ of Fomr ~r ........................................ ~ or u~ district in ~id~ pr~i~s am si~t~ .............................................................. ~s pro~t mt~tim violate a~ ~i~ 1~, o~i~e ~ re~latim: ...~.~ ................. ~ o[ ~d~it~t .................................... ~rese .............................. ~m ~ ............... ~ of C~tr~tor ................................... ~ress ............................... ~ ~ ............... fids p~r~ PLOT DIAGRAM I~cate clearly anti distinctly all buildings, ~e~ber existing or proposed, and indicate ail set-back dhnenslons ~r0 property lines. Give street ard block nonber or description according to deed, and r&o~ street nares and indicate ether interior or corner lot. Lot ~ of b~ivi~l si~ing c~tract) i, ........................ ........................................................ (C~tractor, ngeet~ cor~rate officer, etc.) ~id ~r or ~rs, ~ is ~ly ~thoriz~ to ~rfom or h~ ~rfo~ Om ~id ~ m~ to ~ ~ file this ~llcati~; that ~ll stat~nt~ c~tai~ in ~at ~e ~rk ~ill Im ~rfo~ in tim mm~r ~t forth in ~e a~li~ti~ fil~ t~. 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