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Home My WebLink About12962-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. Certificate Of Occupancy z. ..2626 Date ruly 19 ..a THIS CERTIFIES that thc building --new dw.elling ation of Property 3?=..5 Village Lane Mattituck Hou~e mo. Street Hamlet County Tax Map No. 1000 Section ...13,4 ....... Block .... .0.~ ......... Lot. 01 Subdivision .V.~.],~g.e. l~l~p.o.~. Filed Map No 3..6.6.9 Lot No 7 conforms substantially to the Application for Building Permit heretofore filed in this office dated ....... ~a,~13..2.2 .... ,198.4.. pursuant to which Building Permit No. 12 dated ...... ~r. qh. 3.0 ............. 19,8.4., 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 ......... ~. p.r. Lv..9~..e' qn.eTfam'.z.~.y' dw.e.l~.in.g.. ..... The certificate is issued to MICHAEL & BARBA .R~. K.ONA. RSKI of the aforesaid building. Suffolk County Department of Health Approval .1. 3. 7 .S.O.-~ 8..8 .,..7./..1.3/.8. 4. ,..R.o.b..t ....A. :..V.i.1.1..a !. UNDERWRITERS CERTIFICATE NO ..... ....N...6.5.0.7. $ ~ ............................. . Building Inspector Rev. 1/81 ~OR.~ NO. IB 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) 12962 Z Permission is hereby granted to: ..L~...~...E.~..9: .................................................. at premises located at ......... ~...~........~..~i~..~.. ........ .....~...~ .................. .............................................................. County Tax Map No. 1000 Section ........ .1../. ........... Block ...... ..~....~. ....... Lot No ...... .(~...!.....'~.. ...... pursuant to application dated ......~.....~......-.~,...~.. .................. , 19.~..~.., and approved by the Building Inspector. Rev. 6/30/80 FORM NO. 6 TOWN OF SOUTHOLD Building Depot'[mere: Town Hall 8outhold, N.Y. '~ APPLICATION FOR CERTIFICATE OF OCCUPANCY Instructions A. 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 ail buildings, property lines, streets, and unusual natural or tooograohi~ features. 2, Final approval of Heelth Dept. of water supply and sewerage disposal--iS-9 form or equal). 3, Approval of electrical installation from Board of Fire Underwriters. 4. Commercial buildings, industrial buildings, Multiple Residences and similar building~ 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 B. For existing buildings (prior to April 1957), Non-conforming uses, or buildines and "pre-existing" land uses: ~ 1. Accurate sunzey 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 [nspection of buildings or premises, or other pertinent informa- tion required to prepare a certificate. /, 1. Certificate of occupancy 85.00 2. Certificate of occupancy on pr~-exisdng dwelling c/r land use ¢;/ 5.00 3. Copy of certificate of occupaocy $1.00 Date . ,~. -- New Building ... Old or Pre-existing Buncoing,X) ......... :/Vacant Land ............ co, ~w ~ ~, o.~ 000 s~o,io, ..... 2/~ ..... s ~o~, .. ~ ¢. 6 ....... Lo~. ~ 1.~ ........ ~,~,,,,,,o~ ....v.¢.~.~.~ ~...¢. ~ ~. ¢...,,~ ~¢ ,o. ~ :C .~ .,o, ,o...7 ......... · ,~pphu~. ~ . .( ........................... ........... ......................... ' ....... ............. Reques~ for Temporary Certificate Final- Cartificat~ Fee Submitted S ..... Construction on abovedeecrlb¢o budding and permtt meets all a o[ -, ~ ' - ' ' ' ' ' P (cable~codes and regulations. TOWN OF SOUT~IOLD OFFICE OF BUILDING INSPECTOR P.O. BOX 728 TOWN HALL SOUTHOLD, N.Y. 11971 TEL. 765-1802 CERTIFICATION Date Building Permit No. / 0%` ~ Owner ~, KO ~/ ~RS ~ (please print) Plumber ~..DO · I certify that the solder used in the water supply system contains less than 2/10 of 1% lead. (plumber' s signature) Sworn to before me this' !~k day of ~l~ ' . Notary Public,~-~[~_ County Notary Public THE NEW YORK BOARD OF FIRE UNDERWRITERS BUREAU OF ELECTRICITY 85 JOHN STREET, NEW YORK, NEW YORK 10038 THIS CERTIFIES THAT only the electrical equipment as described be[~ and introduced by t~ applicant named on the above application nttmber in the preo~es of ~ict~l A. ~naoskl~ W/S Village ~ne~ ~' in the following location; ~ Basement ~ 1st FL ~ 2nd F{. Sectlott Block Lot was examined on J~ ~ ~ ~ a~td found to be in compliance with the requirements of ~his Board. 15 15 DRYERS OTHER APPARATUS: Motors~ Z-.F~ 1-G,I?.C.I. l~5~iDke Detec~or. 3 NO. OF;EUTRALS 5 P. 0. Box Mattituck, N.Y. 11952 Mc, 242 GENERAL MANA~/~//~ c~rtlficate must not be altered in any manner; return to the office of the Board if incorrect. Inspector~ may be identified by their credentials. COPY FOR B (LDING DEPARTMENT. THiS COPYOF CER~FICAT~ ~u~T NOT BEA TERED iN ANY MANNER 'FIEL~ INSPECTION COMMENTS FOUNDATION (1st) FOUNDATIOn! 2. (2nd) ROUGH FRAME & FLUMBING INSULATION FER N, STATE ENERGY C,ODE FINAL ~ ADDITIONAL COMMENTS FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N.Y. 11971 TEL.: 765-1803 Examined..\.~.~..'~..;~...., 19~.~!. Approved..'.~.~...¢~.c,~..~.!., 19 ~.~.. Permit No. )?~..? .~.¢..-~. Disapproved a/c ..................................... (Building Inspector) APPLICATION FOR BUILDING PERMIT INSTRUCTIONS Date ...3 ./.~...~r ......... 19 ~.- .~r a. This application must be completely filled in by typewriter or in ink and 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 laws, ordinanves, building code, housing code, and regulations, and to admit authorized inspectors on premises and in b.u. ilding for necessary inspections. , ' .,.~. 1~¢/.z..+.y.:...~.J.~ ~,,.?,.. <~..c .......... (Signature of alSplicant, or name, if a corporation) /~.~.,, ~..s. ~.. ~.~..r2~...-....~..~.'.. l l ~.~.~ (Mailing address of applicant) State whether applicant is owner, lessee, agent, architect, eno~neer, general contractor, electrician, plumber or builder. Name of owner of premises ./~../.C../~.~..~.~., ~.~../37/~.~/~2YA~4'....~/~. ~. ~V. ~.~.J~,/~./. ......... (as on the tax roll or latest deed) If applicant is a corporation, signature of duly authorized officer. (N----'O' ~ ~"ame and title of corporat,fficer) Builder's License No .... ~.' ~..: ................ Plumber's License No.. ~ {Y..y.~.. /. ¢ .............. Electrician's License No..~.~'.&~.~. ~. ......... Other Trade's License No ...................... 1. Location of land on which proposed work will be done. ~.~1,~... t./~..~.L,...~..~. ?~,..~., .~..~.'.~ ................ ............. / ~ /. ~ ..... ~. /c. ~.~.~.~ . . ,.n. . .~. .~ .............. /~.~ r:~. ... . . ~. ,y. ......... House Num bet Street Hamlet County Tax Map No. 1000 Section ..... i/./..~. ...... Block ~ Lot ?.~. ·. · Subdivision...~.2~.9~.~-..~.).~ ....... Filed Map No. .~ {-°(°.t~ .. Lot ...7. · '(iq'nme) ................. 2. State existing use and occupancy of promises and intended use and occupancy of proposed construction: a. Existing use and occupancy . 'l 'J~' '~' '/~' · '/'~r't .... ~' ~'~' ~' ~"/'~/'~' ....... ' ...................... b. Intended use and occupancy ............................... ;,. ;.. ....... :... ¢, :~..¢.:.~.', . g ................ 3. Nature of work (check which app'licable): New Building .......... Addition .......... Alteration .......... Repair .............. Removal .............. Demolition .............. Other Work ............... ,,<_j ~ (Description) 4. Estimated Cost ......... ~. ~¢~.! .O. f)..O., .~.O.. ........... Fee . .~..~.: .~.'~. ............................ ~l (to be paid on filing this application) 5. If dwelling, number of dwelling u'nits... ...... · ... . .. Number of dwelling units on each floor .............. .. If garage number of cars j[/iO 6. If business, commercml 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 .................... i · Height ........ ... .......... Number of Stories ...................... 8. Dimensions of entire new construction: Front ............. .~. ~ Rear ..... ~ .~.. .... Depth ., ~-~,~ ......... Height ...... Num er of Stories ..................................... 9. Size of lot: Front .... /. ¢~.. · i .......... Rear ...//.6 ..F'. .................... 10 Date of Purchase ' Name of Former Owner 11. Zone or use district in which premises are situated ..... ~ ........... , ................................. 12. Does proposed construction viol~te any zoning law, ordinance or regulation: ................................ 13. Will lot be regraded ..... A/..~ ................... Will excess fill be removed from premises: Yes No 14. Name Of Owner of premises ~'J~!.../~g~o. Ad. ~.~$.~'/. Address .. ~.~.'.T-,'77..: ..... Phone No ................ Name of Architect ' Address Phone No Name of Contractor/¢}... ~e./.~.~./.. ~..f.t~7'Aq~.'. Address ~.,~..~.~ ~./~7 ~ rt'Phone No. ~¢~. PLOT DIAGRAM Locate clearly and distinctly all (buildings, whether existing or proposed, an& indicate all set-back dimensions from property lines. Give street and block humber or description according to deed, and show street names and indicate whether interior or corner lot. STATE OF NEW ](,01~. ,~Z IS S COUNTY OF ~¢fif~.. (Name of individual signing con[ract) above named. ! (Contractor, agent, corporate officer, etc.) of'said owner or owners, and is duiy 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 mann0r set forth in the application filed therewith. Sworn to before me this ...................... dayof ........ 19 Notm~ Public~~g~..c~ dl,/Dffg T TERRY - - -,,~7' ' te of New York ~uffo~ Count~*~ County (Sigr~fture of applicant) 8 t 7 ,.,~ s,f' ///Z-~ ~.ot Do ~ 8 4rea -So L~ ~o~ TITLE NO. 8~08 - 274753 SLI~'~OL.~ 60UNTY HEALTH DEPARTU~NT ~UL 1 3 1884 ~ DATE ........... ~ ~' D. R~F, ~ The sewa~ dlspc~oa, and ~;ater supply facilit~ toy thl~ lor~tton have ~een inspec%~ by this de~r%men% and found HEALTH DEPARTMENT-DATA FOR APPROVAL TO CONSTRUCT B : MONU~NT 0 = PIPF ~: S~AKF SUBDIVISION MA~ FIZFD IN THFOFFICF OF THF C&FBF OF SUFFOLK COUNTY ON OCK ~4, 196~ AS FI&FNO. 5669 8RANOIS a SONS, INC. 1618 SURVEY FOR MICHAEL KONARSKI ~ BARBARA LOT NO. 7 , " VILLAGE MANOR " AT MATT/TUCK 'row. SOUTH, OLD ~dJFFOLK COUNTYi, NEW ~ KONARSKI dUNE zo, /984 MAY 4, 1984 MAY ~ , 1984 DATE: MAY I0, 1983 SCALE: I = $0 ' NO, 85- $/0 GUARANTEED T ~ARBAR,~ KON~RSKI YOUNG s YOUNG ALDEN W. YOUNG, PROFESSIONAL ENGINEER AND ~AND SURVEYOR NY.S. UCENSE NO. 12845 HOWARD W. YOUNG, LAND SURVEYOR N.Y. S~iLI CEN S E 'NO. 4589 $ 400 OSTRANDER AVENUE RIVERHEAD~ NEW YORK