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Home My WebLink About15068-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No Z~17243 Date AUGUST 29, 1988 THIS CERTIFIES that the building Location of Property 4250 BERGEN AVE. House No. County Tax Map No. 1000 Section 113 Subdivision ACCESSORY MATTITUCK ~ N.Y. Street Hamlet Block 07 Lot 1.2 Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated JULY 3, 1986 pursuant to which Building Permit No. 15068-Z dated JULY 9, 1986 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 ABOVE GROUND SWIMMING POOL AS APPLIED FOR The certificate is issued to JOHN & CATHERINE SIMICICH (owner, Yd~) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A UNDERWRITERS CERTIFICATE NO. PLUMBERS CERTIFICATION DATED N-822893- JULY 28, 1987 N/A nspector Rev. 1/81 lgORM NO. 0 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N. Y. BUILDING PERJ~IT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) N9 15068 Z Permission is hereby granted to: ...... ~.~..~......~.~.~;~ .~......../.~..w..~... .... ~.~.~..~..~.~..~.,...~.~.....~,.....u..ct...5~ ...... ~..~..~as.~..i.~.~..~."LZ......5.~.~..~ ...~.~.~.~.t~"~.....~. ....... .~,~t~,~....~ ....... at premises located at ..v~. ,..*~**~**~.......l**~. *~*~.**~***..~***~......***~-* *~*. .~*- ........................................ ........................................................................................... 64~.~.~.T....~.~.~... _~ ....... Building Inspector. Rev. 6/30/80 FORM NO. 6 TOWN OF SOUTHOLD Building Department Town Hall Southold, N,Y. 11971 765 - 1802 APPLICATION FOR CERTIFICATE OF OCCUPANCY Instructions A. This application must be filled in typewriter OR ink, and Submitted m ~aa,.aa~m 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. B. For existing buildings (prior to April 1957), Non-conforming uses, or buildings and "pre-existing" land uses: 1. Accurate survey of property 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. C. Fees: Additions $25.00 POOLS $25.00 ALTERATION $25.00 1. Certificate of occupancy New Dwelling,$25;QO, Accessory',,$10.00 Business $50.00 2. Certificate of occupancy on pre-existing dwelling $ 5 0.0 0 3. Copy of certificate of occupancy $ 5.00, over 5 year~ $10.00 4.Vacant Land C.O. $ 20.00 5.Updated C.O. $ 50.00 Date .......................... tP u c t i on Old or Pre existing Building Vacant Land NewCons . . - Location of Property ~o~.u4~ ~o..(j). .... . .~..d~..~,~j~..~../~...../~...//..~. ...... . ./~..~ .~../:..T..~. Owner or Owners of ProperW ~.~/'~ /~. ~-,. ~' _~./7//~) ~/~)-~/~-./'4'. 0.7 CounW Tax Map No. 1000 Section ..... (!~.. ..... Block ............ Lot. Subdivision ................................. Filed Map No .......... Lot No ........ Permit No ........... Date of Permit ..... Applicant He,~lth Dept. Approval ........................ Labor Dept, Approval ........................ ............. Planning Board Approval ....... Underwriters Approval ~'..~..~..~. ?,.~.. Request for Temporary Certificate ....... Final Certificate Fee Submitted $ .............. Construction on above described building and permit me, ts all applicable codes and regulations. Applicant . ~ ' ' . ................... Rev. 10-10-7a THE NEW YORK BOARD OF FIRE UNDERWRITERS BUREAU OF ELECTRICITY ~'~ 85 JOHN STREET, NEW YORK, NEW YORK 10038 ,... N 822893 ~s examined on ~ ~ ~ ~ ~ ~ and found to be in compliance u~ith the requirements ~ this Board. FIXTURE FIXTURES RANGES OVENS DISH WASHERS EXHAUST FANS OUTLETS SWITCHES FLUORESCENT DRYERS SYSTEMS NO, OF FEET OTHE APPARATUS[ ~ d~F,Co E R V I C NO OF HI-LEG NO, OF NEUTRALS (~w~lnE Pool) This eerti~ica'te covers compliance at the date of inspec- tlo~ o~ly. Because o~ unusual environments it is advisable to h~ve Catherine SitaJ, cJ. ch Ma-¢t:Ltuck, N.Y 11~52 ~,NERAt a'~NA~ER This certificate must not be altered ia any maa~er~ return 1o the office of the Boatd if incorrect. Inspeclors may be identified by their credent;als. COPY FOR BUILDING DEPARTMENT. THM I ANY ~NNER. TOWN OF SOUTHOLD OFFICE OF BUILDING INSPECTOR P.O. BOX 728 TOWN HALL SOUTHOLD, N.Y. 11971 TEL. 7654 802 April 15, 1987 TO WHOM IT MAY CONCERN Property on Bergen Avenue, Mattituck, County Tax map numbers 113-07-1.2, has an above ground pool that meets requirements of construction code. Certificate of Occupancy will be issued immed- iately upon receiving the underwriters certif- icate which is being held up due to construc- tion back-log. Very truly yours, . Victor G. Lessard VGL:hdv Exec. Admin. FIELD INSFE,CTION, DA'i'~ C O~ltvl~t~ l;j >,, m~ ~OUNDATION (2nd) ~ ROUGH FRAME & ~ ?LUMBING INSULATION FERN. Y. STATE ENERGY ~'y 76S.1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION '~ST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND '~INSULATION [ ] FRAMING~[ ] FINAL REMARKS: ,,, TOWN OF SOUTHOLD OFFICE OF BUILDING INSPECTOR P.O. BOX 728 TOWN HALL 8OUTHOLD, N.Y. 11971 TEL. 765-1802 TO Whom This May C ncern, We are unable~to complete your Certificate of Occupancy because ,of the following reasons. /_/~/'An application for Certificate of Occupancy s not on file. /_ o Underwriters Certificate on file. /5/ The check is(~L~d/not on file.) /~/ No Health Dept. Approval on file. /Z/ No final inspection has been made. Please contact our office on this matter. Thank you for your cooperation. Building Permit ~ ~ ~ F Z Building Dept. ***/5/ No Plumber Solder Certificate on file. ( all permits involving plumbing being issued after April 1,1984 76S-180Z BUILDING DEPT. INSPECTION FOUNDATION 1ST [ ] ROUGH PLBG. FOUNDATION 2ND [ ] INSULATION [ ] FRAMING [ ] FINAL DATE ///~/'~ INSPECTOR /~/-~/~ GHAliLE$ R. GI~DD¥ RIVERHEAD, NY 11901 April 7th, 1987 Mr. Victor Lessard Building & Zoning Administrator Southold Town Hall Main Road Southold, NY 11971 Re: Simicich - Bergen Avenue, Mattituck, New York Dear Mr. Lessard: Mr. and Mrs. John Simicich have applied for a certificate of existing use for a barn and various sheds for tbeir farm property located at Bergen Avenue in Mattituck. In this connection they submitted to you an affidavit of William Lindsay, a long-term area resident, to confirm that the barn and other out buildings had pre-existed the zoning ordinance. It is my understanding that since they have an above-ground pool they will require a fire underwriters certificate in connection with the electrical hook-up for ~be pump. Would.you please. confirm that except for the requirement of the f~re underwriters certificate, you would issue a certificate of existing use for the barn and the other out buildings. Mr. & Mrs. Simicich are in the process of obtaining fire underwriters approval but this will takeapproximately' sixty (60) days. In the meantime they wish to complete refinancing and the bank wishes to confirm that a certificate of existing use will issue once the fire underwriters certificate is supplied. Very truly yours, Charles R. Cu~d~y~ CRC:cz P Southold, N.Y. 11971 (516) 765-1938 TOWN OF SOUI'HOLD February 17, 1988 Charles R. Cuddy Attorney at Law 180 Old Country Road P.O. Box 1547 Riverhead, NY 11901 RE: Minor Subdivision of John and Catherine Simicich Dear Mr. Cuddy: The following action was taken by the Southold Town Planning Board, Monday, February 8, 1988. RESOLVED that the Southold Town Planning Board take final action on the minor subdivision of John and Catherine Simicich. Board authorized the Chairman to endorse the final surveys for this minor subdivision of 2 lots on 45.229 acres off Bergen Avenue in Mattituck. SCTM# 1000-113-7-1.2, 19.161. If you have any questions, please don't hesitate to conCact our office. Very truly yours, NNE ORLOWSKI , JR. [~CHAIRM~ SOUTHOLD TOWN PLANNING BOARD jd ~e.' oc# \ \ 'FORM NO. 1 TOWN OF SOUTHOLD · BUILDING DEPARTMENT TOWN HALL $OUTHOLD, N.Y. 11971 TEL.: 765-1803 E×amined. ,,T'c,c.~.. ~..,1 ~ ^pproved. l -- Permit No. I Dzsapproved a/c ........ ~ ................. ~ .......... ~ (B~ilding Inspector) APPLICATION FOR BUILDING PERMIT INSTRUCTIONS Received ........... ,19... Date...7~. .......... 19..~. 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, ordinances, building code, housing code, and regulations, and to admit authorized inspectors on premises and in building for necessary ins , . . . (Signature of applicanf, or name,j.fi~ corporation) (Maffing acgdress of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. Name of owner of premises .......................................................................... (as on the tax roll or latest deed) If applicant is a corporation, signature of duly authorized officer. (Name and titie' if corporate officer) Builder's License No .......................... Plumber's License No ......................... Electrician's License No ....................... Gmc/ liau, ~ License No ...................... 1. Location of land on which proposed work will be done~ ................................................. · ~.~. ~ .............. ~.e.~..~.~.~../.e..a... ........... . .,~...A~....¢/.-/-..e~. ............... House Number Street Hamlet County Tax Map No. I000 Section ...~?.~. ........... Block ..... ~. ~. ......... Lot ./~.~. -/~../..~ · · . 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 .' .... ~ ............................... ,...; ................... b. Intended use and occupancy ..... ~... ,~...~.~',~1~!4:'!ii?~; ............ 3. Nature of work (check which app!icable): New Building ' Addition .......... Alteration .......... Repair .............. Removal .............. Demolition .............. Other Wor~~ ~ ~'~- ~Jescr~tm~on) 4. Estimated Cost....~/...ff'?A'~.....i ........................ Fee.. ~..~....~...'~. ......................... (to be paid on filing this application) 5. If dwelling, number of dwelling uhits ............... Number of dwelling units on each floor ................ If garage number of cars ' 6. If business, commercial or mixed 9ccupancy, specify nature and extent of each type of use ..................... 7. Dlinensions of existing structures,iif 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 construgtion: Front .......... '. · .,.. Rear ............... Depth . ........ Height ............... Numbpr of Stories ........................................................ 9 Size of lot: Front ' Rear " Depth 10. Date of Purchase ............ i ................. Name of Former Owner ............................. 11. Zone or use district in which premises are situated ..................................................... 12. Does proposed construction violat!e any zoning law, ordinance or regulation: ................................ 13. Will lot be regraded ......... t~:' · '. .... : '.~, ........ Will excess fill be removed from premises: Yes No 14. Nmne of Owner of premises. ~ ..... Address ................... Phone No.~,~ .~. c~.}F~. ~ Name of Architect ........ '. .................. Address ................... Phone No ................ . Nmne of Contractor · · · Address : .......... Phone No. 15, Is this property located w~thin 300 feat of a tidal wetland? *Yes ..... No ..... · If yes, Southold Town Trustees Permit may be required. PLOT DIAGRAM Locate clearly and distinctly all bluildings, whether existing or proposed, and. indicate all set-back dimensions from property lines. Give street and block nc tuber or description according to deed, and show street names and indicate whether interior or corner lot. ;TATE OF NEW YORK, S.~ (Name of indi~'dual signing contract) being duly sworn, deposes and says that he is the applicant bore named ' te is the (Contractor, agent, corporate officer, etc.) ~f said owner or owners, and is duly ~uthorized to perform or have performed the said work and to m~,~ke and file this pplieation; that all statements containled in this application are true to the best of his knowledge and belief; and that the ~ork will be performed in the manner spt forth in the application filed therewith. .worn to before me this. totary Public, ..... -; -~. ~. . County \ '%% LOCATION MAP I" = 600' IBUFFOLK CQUNIY DEPARTMENT O~ HEALTH not reeulfed under the ~s of ~ ~ ~ AI~ II~atle~ molt ~ re&ds for al)l~oval of eon~truGtlon of ~l i~ atanda~s of the de~, el ~ I ~l . s~l~, must be satisfi~. [~ ~ MINOR SUBDIVISION PREPARED CATHERINE SIMIClCH AT MATTITUCK TOWN OF SOUTHOLD SUFFOLK COUNTY, NEW YORK FOR DATE JU~ 27,1987 SCALE I":lO0' NO 87-1247 YOUNG ~ YOU 400 OSTRAN[ AVE ,N Y ALDEN W )NYS PE ~ L S LIC NO 12845 HOWARD W YOUNG]NYS LS LIC NO 45893