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Home My WebLink About12960-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No Z-18741 Date JANUARY 25, 1990 THIS CERTIFIES that the building Location of Property 7035 ELIJAHS LANE House No. County Tax Map No. 1000 Section 100 Subdivision ACCESSORY MATTITUCKt N.Y. Street Hamlet Block 4 Lot 9 Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated MARCH 22, 1984 pursuant to which Building Permit No. 12960-Z dated MARCH 30, 1984 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 INGROUND SWIMMING POOL FENCE & DECK AS APPLIED FOR. The certificate is issued to DONALD DEERKOSKI (owner) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL UNDERWRITERS CERTIFICATE NO. PLUMBERS CERTIFICATION DATED N-642878 - MAY 3, 1984 & PENDING SLIP 1/29/90 Rev. 1/81 ~~'~ding Inspector FORM NO. ~ TOWN OF $OUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N. Y. N? BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) ~ z ~o,e ..... ~..~......~..~.. .................. , ,,.~..!! ~ + d_....%.~-.~-~.~L......~.~.~..~.~..~. ......... , ~ ............ .... at premises I~ated at ..'.~..~. ....... ~ ............. Coun~ Tox M~p No. 1000 Section ...... /..~ ....... Bilk .......~ ........... Lot No.....~ ................. pursuant to opplic.tion d,t~ .... ~.~...:~ .................. , 19~.~.., ,nd ~,,rov~ by the Buildin~ inspector. Fee $ ........................ Building Inspector Rev. 6/30/80 Rev. 1/81 looo a THE NEW YORK BOARD OF FIRE UNDERWRITERS BUREAU OF ELECTRIC~ITY~ ~ ~, ),' , , THIS CERTIFIES THAT only the e~ctrical equipment as described below and introduced by t~ appllca~tt ~d on the abo~e application number in the prem~es of ~n~d D~r~l~, EllJ~ l~e, O~e~n ~ & Ibute 48, ~ttit~, N.Y. in the following location; [] Basement [] 1st FI. ,~ e~ami,~ed on &pril ~,6 ~ 19&l FIXTURE OUTLETS 1 RECEPTACLE~ 1 [] 2nd FI. O.~t~d(~ Section Block and fouud to be in compliance with the r~quirements of this Board. SWITCHES FIXTURES RANGES OVENS EXHAUST FANS 2 I Lot DRYERS FURNACE MOTORS FUTURE APPLIANCE FEEDERS TIME CLOCKS UNIT HEATERS MULTI-OUTLET DIMMERS SYSTEMS NO. OF FEET SERVICE DI~CONNEC S E R V I ' C E NO, OF CC COND A,W.G. NO OF HI-[EG A. WG, P~R ~ OF CCCOND OF NEUTRAL OTHER APPARATUS: 1-G.F.L A. W G NO. OF NEUTRALS OF HI-LEG ~eca~ of unusual envixonments it is advisable '~ have frequent te~t aml/o.~, rep~irs tnt~e by a qualified person. Glum R. tlradley Norton Avenue Mattituck, N. Y 1195E must altered ' manner;, return to the of the Board if ~ DEPARTMENT. THIS COPY OF CER~ F ( Lic. ].2-27 GENERAL MANASER may be by !MANNER. TOI/N OF SOUTIIOLD IIUILDING DEPART~IEHT T0!4N I1ALL SOUTHOLD, NEI4 YORK 765- 1802 lID71 BLDG. DEPT. [,,?°wN o~ sou_ OL~T~ APPLICATION FOR CERTIFICATE OF OCCUPANCY NE~ CONSTRUCTION ....... OLD OR PRE-EXISTING BUYLDINO ...... VACANT LAND ........ ~o~sz No. s~ZET ~A~LZT Subdivision ....................... Filed Hap Permi~ Realth Planning ........ Lot No. [%q~O ~ Date of Permit .......... Applicant ~ .., .... .~. .... Dept. Approval .................. Underwriters Approval .............. Board Approval ................ Request for Temporary Certificate ....... Final Fee Submitted: $ .................... Certificate rev' 10/14/88 FOP.~ NO. ~ TO~/N OF $OUTBOLD TO~ I~LY~ 765- ]8O2 ~PLICATION FOg ,CERTIFICATE OF OCC~AN~ INSTRUCTIONS application must be filed in type~iter OR ~nk and submitted to the Buildln~ Inspector ~i~h the following; for ,ew b~ildinss or new use: :/ Ce De Final survey of property with accurate location of all buildings, Uroperty lines, streets, and unusuali natural or topographic features. 2. Final approval of Health Dept. of water supply and sewernge-disposal(S-9 form). 3. Approval of electrical i~stallatlon from Board of Fire Underwriters. 4. Sworn statement fro~ plumber certifying that solder used in system contains less' tha~ 2/]0 of IZ lead. 5. Commercial buildings!, industrial buildings, multiple residences and similar.' buildings and installlations, a certificate of code compliance from tbe Arcbltect or Engineer responsible for the buil~ing. 6. Submit Planning Boarld Approval of completed site plan requirements. For existlng buildings i(Prlor to Aprll 9, 1957~ non-conforming uses, or buildings cud "pre-existing" laud uses: ]. Accurate survey of ~roparty showing all property lines, streets, buildings and unusual natural or topographic features. 2. A properly complete~ application, a consent to inspect signed by the applicant and a certified abstract of title issued by a title company which shall show single and sepdrate ownership of the entire lot prior to April 9, ]957. · If a Certificate ofiOccupancy is denied, the Building Inspector shall state the reasons therefor in iwziting to the applicant. Date of any housinglcode or safety inspection of buildings or premises, or other pertinent informatiqn required to prepare a certificate. Vacant Laud'Certificate of Occupancy: For I. An application for 9acant land Certificate of Occupancy shall be submitted, and a certified abstract of title issued by a title company showing single and separate ownership ~f,the entire Iht prior to April 9, ]957 shall also accompany the application. I~ a Certificate of Occupancy is denied, the Building Inspector shall state the reasons therefor in writing to the applicant. FEES: CERTIFICATE OF OCCUPANCY - New Dwelling $25.00, Additions to Dwelling $25.00, Alteration to DWelling $25.00, Swimming Pool, $25.00. Accessory building $25.00 Addition to Accessory buildings, $25.00 -Businesses $50.00. 2. Certificate of Occupancy on pre-existing dwelling - $100.00. 3. Copy of Certifidate of Occupancy - $5.00 - over $ years - $]0.00 4. Vacant Land Cerliflaate of Occupancy - $20.00 5. Updated Certificate of Occupancy - $50.00 6. Temporary Certificate of Occupancy -$]5.00 Residential Commercial 765.1802 BUILDING DEPT. INSPECTION FOUNDATION 1ST [ ] ROUGH PLBG. FOUNDATION 2ND [ ] INSULATION FRAMING ?'~INAL INSPECTOR FOUNDATION (1st) FOUNDATION (2nd) ROUGH FRAME & PLUMBING INSULATION PER N. Y. STATE ENERGY C,ODE COMMENTS FINAL ADDITIONAL COMMENTS: TOWN OF SOUTHOLD OFFICE OF BUILDING INSPECTOR P.O. BOX 728 TOWN IIALL $OUTHOLD, N.Y. 11971 TEL. 765-1802 'r~,is is to advise you that th~ job under,buildlng perrait no. 12960Z issued to Donald Deorkoskz on 3/30/84 for Accessory is completed o fi. ns} inspection has ( ) has not ( x ) beeu done. and In order to complete th{s file, it is necessary that ;t Certificate of Occupaacy be issued. Please fill out the enclosed form, return same to the above offlca with a check for $10.00 payable to the Town of Southold. Please indicate to Whom the Certificate of Occupancy is to be mailed, and arrange with this office for an inspection date Occupancy or use is unlawful without a Certificate of Occupnncy. Please bel, p ns to clear up this matter ~o tbat legal action does not have to be taken. Thank you for yo.r prompt attention. Very truly y~, Victor Lessard Executive Administrator VL:gnr encl. (Building Inspector) ., APPLICATION FOR BUILDING PERMIT INSTRUCTIONS a. This application must be completely filled in by typewriter or in ink ahd submitted to the Building 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 or areas, and giving a detailed description of layout of property must be drawn on the diagram which is part of this appli- cation. 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 issued 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 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 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 taws, ordinances, building code, housing code, and regulations, and to - - -----'---.,4 .... ~ ./... '+. (Signature of applicant, or name, if a corporation) ~.,,¢. ......................... ~ .... /../.~.s...-., (Mailing address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. /ff. ~t~->,~. ~. ..................... ........................................ . ................. ; ....... .,~:~ ,~ ~*~ · Name of owner of premises ... ~A~ .... ~C~.~. m~/ .... DATE; ~. B .~ .,~.. ~)..e, t; t, '~-' · ' (as on the tax roll or la~.de~' ' ~'~ If applicant is a corporation, signature of duly authorized officer. NOT~FY ~ . .. (Name and title of corporate~fficer) Builder's License No .......................... Plumber's License No ......................... 4. F}h,r,at "CON~?'""J"i~)N MUST BE C 4,4(:TE FOR C.O. Electrician's License No../~4 ~. ~.%~. ....... ALL CONS :RUCTION SP-~ALh MEET STATE CONSTRUCTtON& ENERGV O~her Trade's License No ...................... / CODES . ~OT RESPONSIBLE FOR 1. Location of land on which proposed work will be done. ~./a~:. P~ous~Ruc~toN. :aao~s: ' · ' ..... .... ~] :,-: ............ .... House Number Street Hamlet co~ ~x ~p ~o. ~000 s~io. ..... /.4':~ ....... ~o~ ....... ~[ ......... ~o~ ...... ~ ............ 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 .. ~.....~.~?].~. ?/../'~..../~..~..~../-..~./. dc'..~ ............................ 3. Nature of work (check which applicable): New Building .......... Addition .......... Alteration .......... pal ' koft~ /?.0 Re r Removal ........... Demolition ... Other Wot 4. Estimated Cost ............. : .O. O Fee (to be paid on filing this application) 5. If dwelling, number of dwelling[ units ............ Number of dwelling units on each floor ................ If garage number of , cars .... ~ ............. 6. If business, ommercml or m~xed occupancy, specify nature and extent of each type of use ..................... 7. DimeNsions of existing structures, if any: Front....~ ........... Rear .............. Depth ............... Height ............... Number of Stories ........................................................ Dimensions of same structure with alterations or additions: Front ................. Rear .................. Depth ...................... Height ...................... Number of Stories ...................... 8. ]Dimensions of entire new construction: Front Rear Depth Height ............... Number of Stories ........................................................ 9. Size of lot: Front .......... [ ........... Rear ...................... Depth ...................... 10. Date 0fPurchase .......... ~ .................. 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 ........ ~ ................ ,... Will excess fill be removed from premises: Yes No 14. Name of Owner of pre ~ses . c: D/,(./. Address ................... Phone No ................ Name of Architect ......... ~ ................. Address Phone No ................ Name of Contractor /].'~C/../~./.'~.j.e) .,445 ........ Address ~.'X.' i~.' ~iff' i ~'~)~."i i Phone No..Z.~. ~.. :. ~. ~..~.. PLOT DIAGRAM 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 or corner lot. STATE OF NEW Y.,ORIC~,/~..~/ ~S S COUNTY OF .~. i ' ...~.O..,~....,f~.../~..,~.'....~t~:....'~....~..'./..~'.~r .,~. .......... being duly sworn, deposes and says that he is the applicant (Name ofindividuaI signing contract) above named. He is the ........ /~../-4. ~.~. ~ .~ ~f~ .................................................................... ; (Contractor, agent, corporate officer, etc.) of said owner or owners, and is dul~ authorized to perform or have performed the said work and to make and file this application; that all statements contained in this application are true to the best of his knowledge and belief; and that the work will be performed in the manner set forth in the application filed therewith. Sworn to before me this ......... . ...c~.c~...~.-~.~......day o~... ~.~.~~,.., 19 .~..'~ Not P aw ublic ,~~,-~/. ~ ~-.x/~5~,~-County JUDITH T. TERRY .......... Notary Publl0, Stataiof New York ~ e of applicant) - No. 62-0344983 SUffolk Countyc~e,-~ j uomrni~lon Ex~rN March 30,