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Home My WebLink About11522-z sou Oo D BUILDING DEPARTMENT TOWN NALI~ sou o[ , BUILDING PE~ (THIS PERMIT MUST BE KEPT ON THE P E ISESUNT FULL COMPLETION OF THE WORK AUTHORIZED) Permission is hereby grant~ tg;.. ~ ....... ~.~ ..... , .................. ~......~ ...... ~ ............................ pursuant to applicaHon dated ..... ; ............ ~[...? ...... , 19 ,ond opproved by the Building ~spector. ~ Feei$ ................. Rev. 6/30/~80 , ; :~ ~ B;~ ud'ding~lnspector FORM NO, 6 TOWN OF SOUTHOLD Building Department Town Hall Southold, N.Y. 11971 APPLICATION FOR CERTIFICATE OF OCCUPANCY instructions This application must be filled in typewriter OR ink, and submitted in duplicate to the Building Inspec- tor with the following; for new buildings 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 of Health Dept. of water supply and sewerage disposal-(S-9 form or equal). 3, Approval of electrical installation from Board of Fire Underwriters. 4. Commercial buildings, Industrial buildings, Multiple Residences and similar buildings and installa- tions, a certificate of Code compliance from the Architect or Engineer responsible for the building. 5. Submit Planning Board approval of completed site plan requirements where applicable. For existing buildings (prior to April 1957), Non-conforming uses, or buildings and "pre-existing" land uses: 1. Accurate survey of peoperty showing all property lines, streets, buildings and unusual natural or topographic features. 2, Sworn statement of owner or previous owner as to use, occupancy and condition of buildings. 3. Date of any housing code or safety inspection of buildings or premises, or other pertinent informa- tion required to prepare a certificate. Fees: 1. Certificate of occupancy $5.00 2. Certificate of occupancy on pre-existing dwelling or land use 3. Copy of certificate of occupancy $1,00 $5.00 Date. New Building ..... .~ ...... Old or Pre-existing Building(X) ........ = fVacant Land '" ..,. Location of Property . .~.O,~-~, ,IL~, ,f~b~¢.~ .......... . .~,(~h'.~..~... ~~ Hou~ No, Street Hamlet Owner or Owners of Propert Dla F. , . ~f.~. .. ,. .. ~] Subdivision ..... ' ..... Filed Map No. ~ .Lot No. ~ Permit Dete of Permit .Applica~ .~1~:~.. f~.~e-. ,~,,S~'(,'. ........ Health Dept. Approval ........................ Labor Dept. Approval ......................... Underwriters Approval ........................ Planning Board Approval .................. , .., Request for Temporary Certificate. Final Certificat~ ~ - , Fee Submitted $..'~ .......................... Construction on above described building and perm}t~mee~s all app4~cabie~codes and regulations, Applicant ............................. C.O-' z August 13, 1982 Town of Southold Building Department Office of the Building Inspector Town Hall Southold, New York 11971 Attn: Mr. Victor Lessard, Administrator Re: Building Permit #11522 - DENNIS DEERKOSKI Dear Mr. Lessard: In response to your letter of August ll, 1982, please be advised that we have had the final inspection on our building and have been issued Certificate of Occupancy #Zll109, dated August 3, 1982. I have given this information, via the telephone, to Mr. Fischer of your office and have enclosed copies of our application, receipt and CO for your files. Very truly yours, Bernadette Abersmith Deerkoski P.O, Box 957, Elijah's Lane Mattituck, New York 11952 bad Encs. CC iooo7o8 THE NEW YORK BOARD OF FIRE UNDERWRITERS ~ BUREAU OF ELECTRICITY --- 8~ JOHN STREET, NEW YORK. HEW YORK 10038 THIS OERTI~IES THAT ~ly the electrical equJplBent ~ described below hud introduced by the applJcaJtt named on the ~bove ~pl~catio~ ~umber tn the premise~ of was examined on J~ Z~ ~ and fou~ to be in compliance with tl~ requirements off this Board. 19 33 19 DRYERS RANGES COOKING DECKS OVENS DISH WASHERS EXHAUST FANS SYSTEMS NO. OF FEET E OTHER APPARATUS: E 2 R V NO OF NEUTRALS 2 Wis~inzSal Pra~o,L~aeElec. ~ /~2''~¢/. greenI~rt, N.Y. 11944 lic.~04~E ~E.~.~t M~?OE. n ~' ,. / This certificate must not be altered in any manner; return to the office of the 8nard if incorrect, inspector{ may be identified by ~hei~ credentiaJs. FOUNDATION (1st) COMMENTS FOUNDATION 2. {2nd) ROUGH FRAME & FLUMBING INSULATION PER N. STATE ENERGY qODE FINAL t FORM NO, 1 TOWN OF $OUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N.Y. 1i971 TEL.: 765-1802 APPLICATION FOR BUILDING PERMIT · . /. Apphcatmn No ....... INSTRUCTIONS a. This application must be completely filled in by typewriter or in ink and submitted in triplicate to thc Buildi inspector, with 3 sets of plans, accurate plot pla11 to scale. Fee according to schedule. b. Plat plan showing location of lot and of buildings on premises, relationship to adjoining p~mises or publk: slre{ et areas, and giving a detnikd description of layout of property must be drawn on the diagram whic!~ is part of th~s apF t'3l JO.q, c, The work covered by this application may lief bo commenced before isstiance of Building Peru]it. d. UI)on apprc.'al of this application, thc ituikiing Inspector will issue a Building Pmmit to the applicant. Such pern shaU be kept on the premises available for inspecIion throughout the work. c. No buildi;]g shall be occupied or used in whole or in pa~ for any purpose whatever until a Certificate of Occupan shall have been granted by the Building Inspector, A}'PIdCAT1ON IS IIEREBY MADE to the Building Department for the issnance ora BuildingPennit pursuant to t Bailding Zone Ordinance of thc Town bf Southoki, 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 rhe applicant agrees to comply with all applicable laws, ordinances, buikling code, housing co~e, and regulations, admit ~tuihorized inspectors on premises and in buildings for necessa~ inspections. (Signature of applicant, or name, if a corporation) Oenn~ s 9aerkosk~ (Mailing address of applicant) .'-;tale whedter applicant is owner, lessee, agent, architect, en,.qz~cer, general contractor, electrician, plumber or build ....... Owner. .................................................................................. Dennis Deerkoski ~'~i;11c Of OWIlCr Of prculises ........................................................................ (as on the tax roll or latest deed) applicant is a corpora/ion, signature of duly attthorized officer. (Name and title of cou*orate officer) Builder's License No. To be determined at a later date. Plumber's License No. 869-P Electrician's License No. To be determined at a later date. Odter Trade's License No ...................... 1. Location of land on which, proposed work ',viii be done ................................................ NO Number ~o?~?~5~ Elijah's Lane Mattituck llouse Numbcr St reel Hamlet 100 04 lO County Tax Mai> No. I000 Section .................. Block .................. Lot ................. N/~ Subdivision ..................................... Filed Map No ............... Lot .............. (Name) ~!, State existing usc a~d occupancy of premises and intended use and occupancy of proposed consWaction: a. Existing use and occupatlcy... ...Vacant............. ,..............Land ............................... .. Single Family Dwelling b, Intended use and occupancy .................................................................. .".,:u~r~' o£v,'ork (check "~, ,h applicab!~): >~,~ B'.!~.,,,~:',,' ........... , Repair .............. Removal .............. Oemolinon .............. Oti~er Wot,: .......... k .... (Description) ..... . . . ....... arid Cost . $60,000 (to b~ paid on filing this application) 1 If dwelling, number of dwelling units ............... Nuinber of dwelling mets on each floor ................ Ifgara~e, numberofcars .. 2 ..... ' ................... ' If business, commercial or mixed occupancy, specJ£y ~atnre and extent of each type of nsc ..................... Dimensions of existing structures, if any: Front ..... J ......... Rear ...... ~ ........ Depth ..... ! ..... , lieight ............... Number of Stories ........................... i ................... ' ..... Dimensions of same structure with alterations or additions: Front ................. Rear ............. ptl ' 'gl De l ...................... Ite~ at ...................... Number of Stories ................. · , .... 4.9. 4,9. ' pth 2.6'. Dnncr~s~o~ls et entire new constructxon: Front ............. Rear .... i ....... De ....... Height .... 29' ..... Number of Stories .~ ]/.Z. } ., .... ""180 ................ ...... 389 .... Size of lot: Front , 1,50'. ' ' Rear ..................... Date 6i' Purchase ............. ,Name, of Eor~ner Owner ' aes~oenlhal ' ' ................ ..... Zone or use district in which premises are situated .... i . ;'.. D,oes proposed constru~g~ ' ' .................. !'N0 ............. ..... n violate any zoning law, ordinance or regnlation: . 'i ................... ' ......... V. ill lot be regraded .......... ' .................. Will excess fi!l be removed from premises: Yes x No Na~eofOwnerofprenses .B.eiq.n.i$,D!~erI<0~;{<j...Address Matt~tuck .. PhoneN,', 298--8121 Name of Arcltite~t . .'--,~.o..~...,~..~",~..~;/....~. ,'~.'*"f77,..,. , Address ...~..K.~..'.'.Y..~.. :, ...... Phone N . ~.?. .' . Name of Contractor ..... ; .................... Address .................... Phooe No ................ PLOT DIAGRAM Locate clearly and distinctly ail boildings, whether existing or pwposed, andlJndicate ~1 set-back dimensions from mperty lines. Give street and block ntlmber or description accm'ding to deed, and s!mw street names and indicate whether ~erior or corner lot. I'ATE OF NEW YORK, OUNTY OF, .S..u.~f. oJ.k~ .... ..., S.S De.erkosk~ ' ......... .s ............................... (Nanie of indMdual signing co~itrac1) ~ove named. being duly sworn,ldeposes and says that he, is the applicant Owner e is the ., ........................................................ i ......................... . ....... (Contractor, agent, corporate officer~ etc.) F said owner or owners, and is duly aufimrized to perform or imve performed !th,: said work and to make and file this )plication; that all statements contained in this application are true to the best lof his knowledge and belief; and that the ork will be performed in the rammer set forth h~ the application filed therewith, worn to before hie this 21 .De.c.ember 81 ....................... day of .................. ,19... Suffolk : o ' ' ' ' tary I ubl,¢.. ...................... ~nN,~,~m'i'~ AB£ .~}t~ , " · '// ' ;' ¢~'' ,I / NOTARY PUBLIC, StaJe of Now York ' ' Qu*~hfle. d in Suffolk Counl~ (Signature of applicallt) C<~""~i ~lon Expires March 30, 19~ J : ~ I' should be no e. .. ,. , r ,, t d that s~nce tbs ~ ~ nrnnertv is located m an agncu~ur? . ( C.R. 27) Ill ~*~"': " ..... ''~ SUR~EY~ FOR FOR APPROVAL OF CONSTRUCTION ONLY AT MATT~TUCK. DAT~ : dUNE38, 197'8 SUF~OL:K COUNTY, NEW 'YORK , NO. : 78-375 ~ ~ ~ ~ r APPROVED , , ~ ~URVE~ IS A VIOLATION OF SECTION 7209 OFTHE ~ cOP!E8 OF THIS SURVE;f NOT BEARIN8 THE LAND SURVEYOR'S ;NKED SEAL~0R EMBOSSED SEAC SHALL H~LT~ DEPARTMENT-UATAFORAPPROVA~TOCONSTRUCT ~ ~.g Pg:~so~ ~o; w~o~ ~.; su;v;~ ~s ;;;P~c~, ~SUFF. OO. TAXMAP DIS~SECT~ON(~ 8L0C~04 LOT~ ~ HER~O~,A~O TOTHE ASSIGNEES OFrTHE LENDING om......o....ow.....o.. . o.,..:... ,<%V~ / APPLICANT' * ?[L., Dqi--[J*lTl , ;I :; ] Vbll[l'¢ ~ V~II~I~ 400 0STRANDER AVENUE I : {]: I l~Ul~ ~ l~Ul~ RIVERHEAD NEW YORK ~ i m'~l/. ": I; J/ ALDEN W. YOUNG, PROFESS ONAL ENG NEER ~ ~J AND'~LAND SURVEYOR N.~S. LICENSE N0.12845 '~THE L~ATDN~WELL(W),SE~IC TANK(ST)aC~SP~LS{CP)~HO~ HEREON 1 [' ~ ~j N.~S~ LICENSE NO. 45893 A*~ FRO~ F~=Ce OB~RVAT~O~S ~ ~ O* DATA OSTA~ D F~OM OTHg ~~ ~ ~ '1 D~NNi~ 'DEER~OSKI a'BSRNAOETTE ASERSMITH ......... - ~T ~T~ITUCK ~ ~ D~TE . UUN~ 2a, 1978 ~a~tltt~es ~or tht~ loeat~o~ here bee~ '-J _~F~O~COUNTY~ NEW ~ORK NO. : X8-~Z5 las~eot~ by t~[s department NOt~a~.f ~O~R~O TO8[ L~LIb TR~E COPY. H~LTH DEPARTMENT_ DATA FOR APPROVAL TO CONSTRUCT ' T~E;~R~ORWHOMTR~:SUR~Eyf~pREPAREO, AND O~ ~ IS.~HALF TOTHE TITLE COmPANY, GOVERN' ~NEA~ST ~AT~RMA N MI.~ ~SOURSEOFWATER' PRIVATE~PUBLIG~ ME~T~ ~A~N~YAND LEN[ lNG INSTI~UTION L~STED ~SUF~CO. TAXMAP DIS~SECTION(OO BLOCK~ LOT ~ ~E~O~N0~TO THE ASS~G~NEES OFT~E LENDING ~TH~RE ARE NO DWE~LING~ WITHIN IOO FEET OF THIS PROPERTY I~.~;TJ~UTJON;~UAR~NTEES ARE NOT ~RANSFERABLE OTHER THAN THOSE ~OWN HEREON, - ', .~?l:],:;A~b~l * YOuNg, PROFESSIONAL ENGINEER ' , '~'~ J AND L "ND SURVEYOR N,S. LICENSE N0.12845. ~'~0 ' 'OM~0, ,AND SURVEYOR '* mE LFATION ~ WELL (W}, ~E~IC T~K (~ T) a C~SP~L~ (CP) ~H~ HERE0" ARiE FROM FIELD OB~RV~TIONS AND OR DATA OBTAIN E O FROM OTHERS. .~ ;~ ~ :~ j N,~S,_ ~ICENS~ E NO. 45 e9~