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Home My WebLink About14798-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. Certificate Of Occupancy December 30 19 86 No. z- 15 ] 4 5 Date ................. ' ............. iJding Accessory garage in rear yard . Tills CERTIFIES that tile bu ................................................. 1015 Village Lane Mattituck, New York Location of Property ............................................................... H. ouse No. Street Hemle~ County Tax Map No. 1000 Section .... .I .1.4 ..... Block .... o..6 ......... Lot ..... ! .2 .......... Subdivision...M l o..v. ~. 11 a.g~. M~.n.q ~; ........ Filed Map No..8.3.-: .3 ./.0.Lot No ..... ......7 ... conforms substantially to the Application for Building Permit heretofore filed in this office dated Ap.ril 1.8., . . 19 . .8. ~ursuant to which Building Permit No ..14798z 2.6. 8?, dated ...... : ............. 19.. was issued, and conforms to all of the requirements of the applicable provisions of the law. The occupancy for which this certificate is issued ig ......... in rear yard MICHAEL & BARBARA KONARSKI The certificate is issued to ................................................ of the aforesaid building. N/A Suffolk County Department of Health Approval .......................................... UNDERWRITERS CERTIFICATE NO N / A . ~ing InspeCt;; ........... Rev. 1/al 1~0~ NO. ~ ?O~N OF SOfT, OLD BUILDING DEPARTMENT TOWN HALL $OUTHOLD, H. Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) No. 14798 Z Permission is hereb/granted to: ....~...o..~.../..~.~ ..................................................... ....... ,o .............. ..... ~-'~' ........... r' .................. '~' ....... i~'"',';;'~ ....... ~"'~L-;c~ ....... ~E~;"~'""£ ........... O' premises Jocated at ..J....O..../...~. ......... .~...~..O~..~. ...... .~..~....._~....~..~.~..~..(~.. .......... Count,/ Tax Map No. 1000 Section ...... /..(...~. ......... Block ...... ,,C~...,.~,. ....... Lot No ....... /,..?. ............ to ,pplication doted ..... ...~, .~ ....... /..~. ................. , 19.~...~.., and approved by the pursuant !3uiJdlng Inspector. Rev. 6/30/80 FORM NO. 6 TOWN OF SOUTHOLD Building Department Town Hall Southold, N.Y. 11971 765 - 1802 APPLICATION FOR CERTIFICATE OF OCCUPANCY Instructions This application must be filled in typewriter OR ink, and submitted t~ to the Building lnspec- to~llowing; for new buildings or new use: l¢~inal survey__~of property with accurate location of all buildings, property lines, streets, and unusual natural or topographic features.,,?')~A~¢ 'Y'/M/)A~/ II" /-~ ,') ~'(Z t" ~'$ /' .~i-¢~-/y'//~ 2. Final approval of Health Dept. of water supply and sewerage disposal-(S-9 form or equ~l), 3. Approval of e!~ctrical installation from Bqard of Fke Underwriters, --.TF' ,~,¢x,)/ 4. Commercial' buildings, [hdu~rial buildTngs, M~ltiple Residences and similar §uildings 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 p~operty showing all property lines, streets, buildings and unusua! 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: J I. Certificate of occupancy $5.00 2. Certificate of occupancy on pre-existing dwelling $1,5.0 0 3. Copy of certificate of occupancy $1.00 4.Vacant Land C.O. $5.00 ~ -- - 5. Updated C.O. $15.00 Date ../~ .~../.~..'~ ~'~ NewCons t~uc~'ion . Old or Pre-existing Building ............ Vacant Land ............. Location of Property .. ~.~..5 ................. ~ .............. House No. Street Ham/et Owner or Owners of Property ~. ~.~1~../~. 2~. .... .~... ~ .~.~. t~'~...~....../~./~.~..~..~ .~¢ County Tax 000 Section ..... B ock .... .... ..... ..... Subdivision . .V/.///~e....~. ?(~./1~../~. ..... Filed Map No.~. ~.. :~ .~../.~ot No .... '.~. ........ Permit No. ~.' .~. ~. ~.~ate of Permit..?~?~.'~.~pplicant Z~/~,,/~-~' r~../.Z~....~.~',~,/.~.'Z~.~.~... Health Dept. Approval ........................ Labor Dept. Approval ........................ Underwriters Approval ........................ Planning Board Approval ...................... Request for Temporary Certificate ..................... Final Certificate ....................... Fee Submitted $ ......................... Construction on above described building and permit meets all applicable codes and regulations. Applicant.. ~..~/,~2~....~.~.,... ~~g. ............. ~c. 31o ~3 co% 151~J~ 765-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] INSULATION [ ] FRAMING [ ] FINAL REMARKS: FIELC~INS~ECTION COMMENTS FOUNDATION (1st) FOUNDATION 2. (2nd) ROUGH FRAME & PLUMBING INSULATION PER N. STATE ENERGY CODE FINAL ADDITION[L COMMENTS: Examined . ~?'...~..¢.. Approved~...~..~. FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N,Y, 11971 TEL,: 765-1803 ., ., 19.~.(°. Permit No./..~.?.~..~..~.. Disapproved a/c ..................................... (Building Inspector) APPLICATION FOR BUILDING PERMIT lqece±~ed ........... ,19... INSTRUCTIONS a. Tiffs 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 ~ 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 inspections. ,, (Signature of applicant, or name, if a corporation) ....... (mailing add~'of tap~iicant) ..... State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. (as on the tax roll or latest deed) If applicant is a corporation, signature of duly authorized officer. (Name and title of corporate officer) Builder's License No .......................... Plumber's License No ......................... Electrician's License No ....................... Other Trade's License No ...................... 1. Location ofland on which proposed work will be done .................................................. ....../ ................. ................................. House Number Street Hamlet County Tax Map No. 1000 Section . .. //~7/ Block ~rSP~ Lot.. 67/..~w. Subdivision...~/[.[(~.~..' -- ..~...~-~...~.. ......... FiledMapNo...~..~..~-~./.~.. Lot .~. ......... ·~ '(i'4'a~) ...... 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy..· ~C.}..(~7...~t~..~...~7.~'. 3~.i' .~..~. ~.~ .~'~. .... .~.4?~... ~...~O~.~ ...... ¢ . . . , .............. b. Intended use and occupancy .~ ....... .~. ............. .3. Nature of work (check which applicable): New Building .......... Addition ' . .... Alteration : ...... Repair Removal Demolition I Other Work .~. ~.. 5~ ~'<-~ (Description) 4. Estimated Cost ..'~ ~-...f..--?.~9~P ......................... Fee ................................ (to be ~aid on filing this application) 5. If dwelling, number of dwelling units ............... Number of dwelling unit~ on each floor ................ If garage, number of cars ...... .':~g ................................................................ 6. If business, commercial or mixed occupancy, specify nature and extent of each tyEe 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 .... ~B~...rI ...... Depth ...~..~ ~. .. /. 7 / Number of Stories ,/ Height ........................................ ! ............................ 9. Size of lot: Front ...................... Rear ...................... Depth ...................... 10. Date of Purchase ..... ~C..'7 ./.O..-..~.~. .............Na,ine of Fprmer Owner . i ~O'~c.f...7~'~ (g.~ ....... I 1. Zone or use district in which premises are situated.. F.~.-~ t~..~tld:.t.~. .......... r ........................ 12. Does proposed construction violate any zoning law, ordinance or regulation: ..J'),,~. .......................... 13. Will lot be regraded .... ~l/~.5 .................... Will excess fill be remove~ from premises: Yes 14. Name of Owner of premises .. o<~o-a,r!~-.~ .......... Address ............... L.. Phone No .............. Name of Architect . Address ' . Phone No ............. Name of Contractor .......................... Address ............... [... Phone No... x,,, ........... 15. Is this property located withinli00 feet of a tidal wetland~ * ~es ..... No .~.. · If yes, Southold Town Trustees Permit may be required. 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 YORK, COUNTY OF ................. S.S ................................................. being duly sworn, deposes and (Name of individual signing contract) above named. says that he is the applicant He is the .............................................................. I ........................... (Contractor, agent, corporate officer, etc.)I of said owner or owners, and is duly 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 ........ /?..~.. da o .~ .......... ,19.~.~. Notary eu~lld,' i i i. i .~ .~.~ i ~..~...~..~..... County (Signature of applicant) LO t AreO TITLE NO. B30~- ! 3 -3 o - ~$ 6 bot SURYEY FOR MICHAEL t(ONARSKI 8 BARBARA KONARSKI ,~UN~ nO,/984 LOT NO. 7 "VILLAGE MANOR" NAr 4, ' MAY ~ , 1984 AT MATT/TUCK DATE: M~r I0, ~WN ~ SOU~HOLD sc~E: / " : ~o ' ~O~ CO~TY, NEW ~RK Ho. ~ - N U/MUTII(~IZEI) ALTERATION OR AOOITION IQ 1141S GUARANTEED # COP,ES ~ ms IONVEY Net leARme TNdr LA.O SURVETOR! INKED ~$AL'OfrEMIOEEED SEAL SHALL ffOTK CON$10ER~UTO K AVALID TRUE COPY ,.,..T,,, ."T,O .,.,ON ,--.UN ~,. MENTAL AKRCY AN0 LENOmS mST,TUT ON L ST$0 HEREON ANO TO T~E ASSIRN~S OF THE LENDING ,,0,,,.=,, ,.,..,R,. ,R. ,',,..ER,. ,,.. "~%.'..'". ;"~..~- :, TO EX,STUll STRUCTURES ARE FO~q A SP'C r C ~,.?,.s,~-~. · WERTY LIN~S OR FOR THE ERECT ON OF FENCES J ~. ~). ' _~ · -. Ifii YOUNG e, YOUNG I SUFFOLK COUN~ ON OC~ ~4, 196~ IS FIL~NO. 36E9 II ~ ~ I .... I II A ~ I ~wA~oW. YOUNG, LA~ SURVEYOR I ~ L~T~MKL(WI,~KICMK(~ICE~I(~)WNWEm I[ T B J H.Y.S. LICENSE HO. 45893 I ?, "- ~ ~ ~ ~ >- --witHOUT CERTIFICATE :' OF OCCUPANCY