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Home My WebLink About14378-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. Certificate Of Occupancy No...Z.l.~..3.2.8 ......... Date .. ~ril I 19~.? THIS CERTIFIES that tbe building .... Qn~..f.. ~ m;~,l.y.. ~ti~.e.~..3_ .i.n~ ..................... Location o f Property ...... 2 l 0. j~a. v. r ~.q o. c) kc .a..4 a. 0 .e ............ .~. a..t .L .i.t.u..c .k ............ House No. Street Hamlet County Tax Map No. 1000 Section .1. 15 ........ Block ....... 3. ....... Lot .......... .1.1 ..... Subdivision ............................... Filed Map No ......... Lot No .............. conforms substantially to the Application for Building Permit heretofore filed in this office dated ..... 0 ¢ t....3 .......... 199.5 · pursuant to which Building Permit No ...... 1. 4. .3y.~.Z. ......... dated ...... O¢ ~;.,.. ~ ? .............. 19 .8.5., 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 ......... ..... ~ne. '~ami-l.y - ~w~t lin.~,- ................................................... The certificate is issued to ........ Z .~g.m c~ ~ d..T, · ,A..K a ~, ea~. V .. Ry. $ k.o ................... of the aforesaid building. Suffolk County Department of Health Approval ....... t 4. .-fi.0.~ $ .1 .......................... UNDERWRITERS CERTIFICATE NO ............... N 7~.4.~ l .4 ........................... ~lumbers Certificate 10/2/85 Buildhig Inspector Rev, 1/81 ~O]B~[ NO. it 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) N-o 14378 Z Permission is hereby granted to: ~ ...... ............ /. ~ . : . ff . . . . .l ..~ (~ . .l . . . . . t~x. ~. . ~ ............................. ...~.~/...:~:..~..../../..~ ~. ,o .... ..~_~~....:...L.~ ........ ./.~~.. at p,emises loc,ted ,t ....~./~. .......... .~:.~,.~.~....~:~.. ................. · .~,:...~-' ..,., ~. .......... !./,..~..~..~... ..... /., .... County Tox Mop No. 1000 Section ..../..Z.~... ...... Block ..... .~. ............ Lot No ..... /.j, ............ pursuant tO applic:atlon dated ..... ~... ....... ~...~.. .............. . '9..~ .,, .~*", '~Tncl approved by the Building Inspector, Rev. 6/30/80 FORM NO. 6 TOWN OF $OUTHOLD Building Department Town Hall Southold, N.Y. 11971 765- 1802 APPLICATION FOR CERTIFICATE OF OCCUPANCY Instructions BLDG, , TOWN OF SOU'fHOLD A. This application must be filled in typewriter OR ink, and submitted ,,. a....,.., 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 pZoperty showing all property lines, streets, buildings and unusual natural or topographic featu res. 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: 1. Certificate of occupancy $5.00 2. Certificate of occupancy on pre-existing dwelling $15 o 0 0 3. Copy of certificate of occupancy $1.00 4.Vacant Land C.O. $5.00 ~/'~'//'''~'~//~'~/ 5. Updated C.O. $15.00 Date ................ New Building . ./,~/ .......... Old or Pre-existing Building ............ Vacant Land ............. Location of Property . .~./.~. ~¢/~ze Z ~,,u) .;-- .. z. ................. .............................. House No. Street Ham/et Owner or Owners of Property 2/~,~.~..~.. /~/~'-q~'~. P~. ~...~.~..<. County Tax Map No. 1000 Section ../../~.. ....... Block -~ Lot /~/ Subdivision ................................. Filed Map No ........... Lot No .............. Health Dept. Approval . Z~.~. ,~..~..~?../ .......... Labor Dept. Approval ....................... Underwriters Approval ./f~.. ~.2 ~f..~../~ Planning Board Approval Request for Temporary Certificate ..................... Final Certificate ...................... Fee Submitted $. ~ ~. 0. ..................... Construction on above described building and permit meets all applicable codes and regulations. TOWN OF SOUTHOLD OFFICE OF BUILDING INSPECTOR P.O. BOX 728 TOWN HALL SOUTHOLD, N.Y. 11971 TEL. 765-1802 CERTIFICATION Date Building Permit Owner 2/~/~zo~D (pleWse print) Plumber Z/6/~,D (please print) I certify that the solder used in the water supply system contains less than 2/10 of 1% lead. ~ ~ (plumber'~ s~g~Wure) Sworn to before me this ~ ~a~ of ~b~-- , otar ublio, Notary Public THE NEW YORK BOARD OF FIRE UNDERWRITERS 00.~?~ BUREAU OF ELECTRICITY 85 JOHN STREET, NEW YORK, NEW YORK 1OO:~8 ..re ~.eb~'~,:~r~' 7 ~L9~ ~pp,i~.tio,.~o.o.~i,~ 3:~o4~41~s N734814 THIS CERTIFIES THAT only the el~ tricot equipment ~ described be~ and introduced by t~ applicant named on the above application number in t~ pre~nises of Z:~.~und ~. Rysko~ %~/~ Marratooka Rd~ 3~0' ~/o Route in the following Iocation~ ~ Basement ~ 1st FI. ~ Znd FI. Section Block Lot was examined on ~ ~ ~ ~ ~ ~. ~ ~ ~ and found ~o be in compliance wi~h the requirements of this Board. FIXTURE FIXTURES RANGES COOKING DECKS OVENS DISH WASHERS EXHAUST FANS OUTLETS SWITCHES FLUORESCENT 31 22. 24 DRYERS MOTORS FUTURE APPLIANCE FEEDERS TIME CLOCKS MULTI-OUTLET DIMMERS SYSTEMS NO, OF FEET SERVICE DISCONNECT OTHER APPARATUS: G,F.C.~,~I~ S~oke Deflector,~ I S E R V I C NO. OF CC, COND A W G NO, OF HI-LEG A~ W. G NO, OF NEUTRALS A W. G, .t, ~/o ~ Coram Bo~ 1ic.#733-E This certificate must not be altered in any manner; return to the office of the Board if incorrect. Inspectors may be identified by their credentials. COPY FOR BUILDING DEPARTMENT ,TH $ COPY OF CERT FICA?E ~US? NoT sE ALTERED IN ANY MANNER. FIELD INS[~ECTION COM~ENTS FOUNDATION (1st) FOUNDATION (2nd) ROUGH FRAME & PLUMBING INSULATION PER N. Y. STATE ENERGY CODE FINAL ADDITIONA~L COMMENTS: ' FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL ~OUTHOLD, N.Y. 11971 TEL.: 765-1802 ., ., 19~..~PPermit No./.~.~. ~..~. ? -- Disapproved a/c ..................................... ................................ (Building Inspector) APPLICATION FOR BUILDING PERMIT TOWN OF SOUTHOLD ,,, Date ................... 19... INSTRUCTIONS 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 ail applicable laws, ordinances, building code, housing code, and regulations, and to admit authorized inspectors on premises and in building for y,~cfe~ss, ary inspections,~. -~..~ ,/~"' .~. ~.,/,~ ~nature ~nt, or name, if a corp~ ' F...q..~ p.x..6.9.tj..~.a..t.t.i.t.u..o.k.,..~.. ¥..... ~..~.9.5.2. .... (Mailing address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. (Name and title of corporate officer) Builder's License No .......................... Plumber's License No.. ], ~ .2.2.-.P. ................ Electrician's License No ....................... OWNER ................................................................. APP OV O'A' 'NOYI O ......... N~me °f °wrier °f premises' ' 'Z 'I'G'~'q~P' '&~'D' ' 'KAg'E' K 'g'~'S' 'Kg(as on the ......... tax roll ~rD ]~'a~l¢~'~'-~'~''"P"~ ..~TY.~ .~ 'P'.,~ . , ~......, ! '~ [''~~' If applicant is a corporation, signature of duly authorized officer. ~F,~j~,~_ ~, ~,~,, _.,8¥: ~.~,~,~ NOTIFY BIJiL,(~,~,.~/(.; 2 t~OUGH F~AM~NG & 3. INStlLAT~Ot~ ~. FIN%L CO~qSTRUCTtO~ M¢ST [~ COMPi. ET[ FOR C.O, ALL CO~STRUCTION SHALL MEET ~HE REQUf~E~TS OF THE Other ~rade's License No ...................... STATE CONSTaUCrf~ & 1. Location of land on which proposed work will be done, .. ggXE ~ ~ pp. 75¢¢ ,:...': .... ................... .... '~A .~U¢~a.qr. ~¢. ............. ~gY.K6~PP%~. 5¢~q ............ gSgg.5.~UCk ................... House Number Street Hamlet County Tax Map No. I000 Section .... :[..1.5 ........... Block .... 3. ............. Lot .... .l.~ ............. Subdivision ..................................... Filed Map No ................ Lot ............... (Name) 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 ....S.5. n..g .1.% .F.a..m.~.l.y. R e s 5 d e n e e ( ' 'pi' ) ' 3. Nature of work check which ap; lcable: New Building . .g ....... Addition .......... Alteration .......... Repair .............. Removal .............. Demolition .............. Other W~ork ,4/ ~' (Description) Estimated Cost .~. i 4, rte be paid on filing this application) .... 1 Number of dwelling units on each floor 1 5. If dwelhng, number of dwelhng ~mts ............................... If garage, number of cars ..... i.~. ............................ 6. If business, commercml.ar-m~.xed occupancy, specify nature and extent of each type of use .................... 7 ' f ' ' · ~ 'f pth · Ihmensmns o existing struct~r s, ~ .any Front ............... Rear .............. Do .............. Height ; Number of Stories Dimensions of sam~e,.~llructure'w~th alterations or additions: Front ................. Rear ................. ~Depth ... ....... !":~,~... ~ .... !.. Height ...................... Number of Stories ..................... 8. ~Dimens~ons of entire new qonstruction: Front ...5. 9.: ..... Rear . .5.9, .... Depth . .2.8. ,. ... ~ " 15' 6" · ~ I O ' 1 Height ................ Number f Stones ........................................................ ! ~ 3 134 100 9. ~$~,zeof~ ot Front J- 4, Rear ........ Depth ...................... 10. DateofPurchase .4.[.2.5./.8.~.. I Name of Former Owner 3o.s.ep.h..E.. 11. Zone or use district in which pr~mises are situated .t~.S.I.g$lT;I:.I.6I~ ....................................... 12. Does proposed construction violate any zoning law, ordinance or regulation: . .N.Q ............................ 13. Will lot be regraded ...... YKS ................... Will excess fill be removed from premises: Yes (No) 14. Nam e o f Owner of premises ~ ¥.S.g Q ~..Z.....f..r...... Add tess ?... 0.: .B.qx...6.0.k, ..... Phone No. 2. .9 .8.-. 8. 0..2.0 ...... Name of Architect ................. Address .......... one No ................ Name of Contractor i Address Phone No. PLOT DIAGRAM Locate clearly and distinctly all, buildings, whether existing or proposed, and. indicate all set-ba~k dimensions from property lines. Give street and block !number or description according to deed, and show street names and indicate whether interior or con er lot. ' INTERIOR LOT 1000-115-03-11 Prbposed N/F Sobioray Bldg. co 40.,N, MARRATC OKA LANE STATE OF NEW/YORK .... COUNW oFxg .Zxd, ..... ............... -- *'(Name of ind~t, idual signing contract) above named. being 62' 134' 134' duly sworn, deposes and says that he is the applicant He is the ........................... ~...]b.~.. ...................................................... i (Contractor, agent, corporate officer, etc.) 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 contoined in this application are true to the best of his knowledge and belief; and that the work will be performed in the manngr set forth in the application filed therewith. Sworn to before me this ~ i ~..~.4~. f~ ................. /.da,fo ~: ..... ¢ ........ 19~. (Signature of applicant) VATION INSPECTION TEST BORING N/F 88° $7'40' E. F.S GAS ST,4 T/ON MARRA TO OKA CORP. I00.00' MON. FND. O.I'N. WOOD RETAINING N. 88~ 37'40'"W. / ? N/F . RHODES- / RESIDENCE TEST BORI .,~!8. 9 MON. FND. I00.~ MAP OF DESCRIBED PROPERTY .4 T MA T TI TUCK -~ TOWN OF S O U T H,O L 'Z~ ~:~ .,.~.~ ~U~,FOLK COUNTY, N2i~. ~:ELEV~TIONS ARE R~E~ TO AN ASSUMED DATUM. TO: .r TITLE INSURANCE COMPAN'I ZIGMOND T. RYSKO KAREN V RYSKO SITE PLAN ~-14-84 donock ossociotes 315 west moin street riverheod, new york 11901 (516) :569-1717 FEB. 14,1984 ,Job No. 84-425 MO~.F~D. S. TEST BORING TOPSOIL SAND SAND GA S STA TI ON N/F MARRATOOKA CORP. 88~ 37'40" E i00.00 SINGLE FAMILY uvwLLiNG ~.~'~ NAR 20 lgRR' .. ~. ~,. ~~ ~ac$ll~les for ~t; locati~n h~ beea [~pect~ by t~,is dep~t~nt PIPE FND MON, .FND. O I N. ~3"~IRREGULAR WOOD RETAIN/NS WALL 5O 0 DESCRIBED PROPERTY A T MA T TI TUCK TOWN OF SOUTHOLD LK COUNTY, N Y. CED TO AN ASSUMED DATUM. MON FND. 4~. 7 ~ CHICAGO TITLE INSURANCE COMPANY ZIGMOND T RYSKO KAREN V RYSKO F/NA£ & LOCATION SITE PLAN 2-14-84 donack associates :515 west main street riverhead, new york 11901 (516) 369-1717 FEB.14,1984 Job No. 84-425 I000- 115-05-11 Scole.l" =20' Jr _i PLUMBER CERTIFICATION ON LEAD cONTENT ,BEFORE: CERTIFICATE OF OCCUPANCy OCCUPANCY 0,~ USE IS UNLAW~:UL WffHOU[ CE.R'[IFJCATE OF Or.-,CU? NC¥ sOLDER uSEO IN wATER suPPLY sYSTEM cANNOT ExcEED 2/h3 o~, 1% LEAD. it. If oopper tubing la used for water distributing= system; piping shall be' of tYPes K~or L only 'i I OCCUPANCY OR USE IS UNLAWFUL WITHOUT CERTt[ICATE OF OCCUPANCY pLUMBER CERebrATION ON LEAD CON~'Elt~ B~mFORE CERTI?ICA TE OF O~.UPANCY soLDER usED IN wATER suPPLY sYSTEM CANNOT ExcEED 2/10 of 1% LEAD. '1 JI __L OCCUP/ ",-'~ USE IS [, .,dUL WITHOU; CERTIFICATE OF OCCUPANCy if copper tubing is used for Weter distrlbunng eystem; piping shau be of types K or L only LDER uSED IN wATER I SO -. - "~sTEM cANNOT b~ ~ -[ SUPPer o. L ~ I__ EXCEED 2/10 of 1% LEAD. ""'LAWFUL )L!~ CERTIFICATE (3/, PLUMBER cERTIFICA TiO7m . ON LEAD coNTENT,,,[ - ':- CA,' ~ ~ ,':'/CATE ©F C,,,.~ ,' ~h~t = o'1~: