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HomeMy WebLinkAbout14430-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. Certificate Of Occupancy No. zi5205 Date Jan. 15, 1987 THIS CERTIFIES that the building One family dwe 11 ing. Location of Property//~j ~'o' .I.8.9.5. p.A.U.G?..[.S ROAD }~/e~t' MATTITUCK s . Hamlet County Tax Map No. 1000 Section ...0.9.9. ...... Block 04 .Lot 21 Subdivision ............................... Filed Map No ......... Lot No .............. conforms substantially to the Application for Building Permit heretofore flied in this office dated ocr. 7, 1985 , gp 14430z ... pursuant to wlfich Buildin ermit No. dated Nov. 14, 1985 ............................. , 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 ......... One family d.w.e..lli, n..g including deck. The certificate is issued to JULIAN & FELICIA ZURAWSKI ..................... ..................... of the aforesaid building. Suffolk County Department of Health Approval .. ~ P..B.o..a.r.d..°..f..}I.e.a..1 .t.h..n..e.e.d.e.d. .......... N783545 UNDERWRITERS CERTIFICATE NO .................................................. PLUMBERS CERTIFICATION DATED: 12/ 15/86 ~/ /~/Building Inspector ......... Rev. 1/81 FOF~ NO. ~ TO~N OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N. Y. BUILDING PERMIT El'HIS PERMIT MUST BF KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) NB 14430' Z Permission is hereby granted t~. ....... ¢. ~x'./. ~.~.~,.¢m~ ............. ..... .¢.....O..,...../~.~......~./.. .......................... ..'~.~ .r-~/z...~.c.....,.cc~..,...~....Y.,....~_ _ ,o ...... db~..¢..~¢/,,~.~...,~.~..~m~...,..~.k ...~;~,.~- /z~....-.. ~.~~, ..... ....~..~.~*.....&~.~x~`~.~.~.. . .~.~.~:..-........~z~../~/.~.~...~`~ ~ ~:~ ,t premises located at ...Z'~...~. ......... ~/~.,~./.~-,~-r~.....~.,~.~.. ............................................ ............................................................................................................. ,~.~...¢,-~....~........, .... County Tax Mop No. 1000 Section ...~....~..,? ..... Block ...~...~... ......... Lot No. ~..(~.. ,/. ........... pursuant ,o application dated ....~..~'..~... ~ ...... ~ ............ , 19~and approved by the Building Inspector. Fee Rev. 6/30/80 765-1802 'BUILDING DEPT. INSPECTION [~UNDATION IST [ ] ROUGH PLBG. FOUNDATION 2ND [ ] INSULATION [ ] FRAMING ~ ] FINAL REMARKS: DATE INSPECTOR BUILDING DEPT. INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] INSULATION ["~RAMING [ ] FINAL REMARKS: ~ _ DATE INSPECTOR THE NEW YORK BOARD OF FIRE UNDERWRITERS BUREAU OF ELECTRICITY ~0002.~8 BS JOHN STREET, NEW YORK, NEW YORK 1OO~38 '~..,e ~eoe~,~= ~.~, 19~6 ~...c.,io. No.~.~.~ ~0/~ N 783545 THIS CERTIFIES THAT Zurawski, e/s Naugles Drive,ol)~. Rose La., Mett£tuck, in the followlng locatlon; [] Basement [] Ist FI. [~ 2nd FI. Section Block Lot r4XILt~E SWITCHES OUTLETS FLUORESCENT 27 25 ORYER$ SYSTEMS OTHER APPARATUS: 1- smoke Detector 1-G.F .C.I. S E R NO ~[C~CONO O~ CC, CO~O · 4 I C NO OF HI-LEO A. w G Eleotrioal Ventures P. O. Box 151 Center ~orichos, N.Yl1934 GENERAL MANAGER This certificate must not be altered in any manner; return ~o the office of the Board if incorrect, inspectors may be identlfled'~0y their credentials. COPY FOR BUILDING DEPARTMENT. THIS COPY- OF CERTIFICATE MUST:NOT BEcALTERED IH ANY MANNER. TOWN OF SOUTHOLD OFFICE OF BUILDING INSPECTOR P.O. BOX 728 TOWN HALL SOUTHOLD, N.Y. 11971 TEL. 765-1802 CERTIFICATION Date Building Permit No. /~ ~ (pleas~ print) Plumber ~ ¥ ~ ~C6~N (please print) I certify that the solder used in the water supply system contains less than 2/10 of 1% lead. Sworn to before me this f~ day of 19fg Notary Public, County ~r~'s signature) Notary Public FIELD INSPECTION 1. :FO_ UNDATIO_ - [~OUGH FRgME & PLUMBING / ISSULATION PER N. Y, STATE ENERGY C,ODE FINAL ADDITIONAL COMMENTS: FORM NO. 6 TOWN OF $OUTHOLD 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 I ~ 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 p~operty showing ail 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: l. Certificate of occupancy $25.00 -- BUSINESS $50.00 2. Certificate of occupancy on pre-existing dwelling $ 50.00 3. Copy of certificate of occupancy $ 5.00, over 5 years $]0.00 4.Vacant Land C.O. $ 20.00 5.Updated C.O. $ 50.00 Date .......................... NewConstruction XX Old or Pre-existing Building ......... Vacant Land 895 NAUGLES ROAD MATTITUCK Location of Property ...... ! ............................ ~ ............................... House No, Street Ham/et JULIAN & FELICIA ZURAWSKI Ow.er or Ow.ers of Property ............................................................ County Tax Map No. 1000 Section 099 Block 04 Lot 0. 2 1. Subdivision ................................. Filed Map No ........... Lot No .............. PermitNo.. 144307.. Date of Permit 11/85 .Applicant 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. FELICIA ZURAWSKI Applicant .................................................... Rev. 10-10-78 'FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N.Y, 11971 TEL,: 765-1803 Examined~.¢f~. ....... , 19 .~..~'''''' Approved ..... Received ........... ,19... Disapproved a/c ......................... ~ .......... ..... ~<~. ~....,~-~...c'. 5~...~...,~.~.~ .. (Building Inspector) APPLICATION FOR BUILDING PERMIT 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 q~r. 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 necessa~ i_~.speetions. /7 _ · (Signature of applicant, or name, if a corporation) · ~ ..~. ~. ,x'.d..,. d.~r../~....~..~.~.~, .~'.y.-. (Mailing address of applicant) I / (~,5'~/ State whether applicant is owner, lessee, agent, architect, en~neer, general contractor, electrician, plumber or builder· ....... ~;.~.,r~... m,z.,'~x, .......................................................... ~ ..... Name or owner of premises . .~'~.~.Y.~./ff~....~..~.~..t~.~'..~. / ............................................. (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.. ~,~.~..7.~...~.'.'~.: ........... Plumber's License No...L.o.../~ Electrician's License No. 1. Location of land on which proposed work will be done ......~2./~. ~./~. .~..~..~..~... ~...~..~. ..................... .... /. ~.7.~ ................................................................................. House Number Street Hamlet County Tax Map No. 1000 Section .. ~. ........... Block . .~.~. ............ Lot...~.~. .............. 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 ...... [ ...... ~] ..... 2 ............ 5..~*. b. lntended use and occupancy ...~.~(~.~ .... ~. ...... .~. ~d~. ~,7~m~. ~'~'.. ppli ) 3. Nature of work (check which a cable: New Building .......... Addition .......... Alteration . Repair .............. Removal .............. Demolition .............. Other Work ............... : ~ (to be paid on filing this application) 5. If dwelling, number of dwellin~ units .. J. ........... Number o£dwelling units on each floor ................ If garage, number of cars . O~. ................................................................. 6. If business, commercial or mixled occupancy, specify nature and extent of each type of use .~.~ $.: ~../'q..~./.~/..,~.&?. 7.Dimensions of existing structures, if any: Front ............... Rear .............. Depth ............... Height ............... Number of Stories ........................................................ With It ti dditi F Rea Dimensions of same structure a era ons or a ons: rent ................. r .................. Depth .................. i · · · Height ........ .~ ............. Number of Stories .......... , ........... Dimensions of erlti{~ new construction: Front.,fi.. ~. ~..~... i i' Rear .,~.:~;}.* ..... '. Depth . 10. Date of Purchase ......... ~ ................... ~lame gf Former Owner ............................. 11. Zone or use district in which premises are situated ~. ~.~'~'Z ~..~/V.~/.~. ~ 12. Does proposed construction violate any zoning law, ordinance or regulation: . ~.t~ ........................... 13. Will lot be regraded . .n&7~. t_~. ~".~__. .............. Will exc~ess fill be removed from premises: Name of Contractor .... '~..6' .r~M~-.. .......... .~ .... Address ................... Phone No ................ PLOT DIAGRAM Locate clearly and distinctly all property lines. Give street and bloc: interior or corner lot. build'rags, whether existing or proposed, and. indicate all set-back dimensions from number or description according to deed, and show street names and indicate whether STATE OF NEW YORK, COUNTY OF .,~UI~?-*.~ ..... i S.S ..../~----(~.~...~.r'~..~. ~../~.~.....g~.. ..... being duly sworn, deposes and says that he is the applicant (Name of individual sighing contract) above named. : He is the ...... ' .................................................... 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 con'tained in this application are true to the best of his knowledge and belief; and that the work will be performed in the man,er set forth in the application filed therewith. Sworn to before mc. this i -- ...... ..... ! ~lo!ary Public, State of ~lew York ....... ~ ................. ' ........ Iluahfied in Suffolk Cnty. 4741..~7 ~ (Signature of applicant) Comm. Exp. March 30, 19,~"~~ COMBUSTION AIR SOURCE. THE KITCHEN EXHAUST WAN BE NON-VENTING. ALL HEATING, HOT WATER, AS APPROVED BY THE NEW YORK STATE INSULATION SCHEDULE (MINIMUMS) SHALL BE FITTED WITH A DAMPER OR AND ELECTRICAL EQUIPMENT SHALL BE CONSERVATION CODE. CEILING ~ WINDOWS - u ~ 0.69 WALLS ~ H DOORS - u ~ 0.40 FLOOR ~ H HOT WATER PIPES - R ~ 4.6 SLAB EDGE - ~ I ~ AREA ANALYSIS PERIMETER I GLASS VENTILATION ENERGY DRAWING ~ 1_1,,18~C ]-- STEVE G. TSONTAKIS ASSOC. P.O. BOX 1180 632 ROANOKE AVE RIVERHEAD, NY 11901 (516) 727-7411 q4\\~xO~ ' Coow NOTEI I. g=MONUMENT ~'. SUFFOLK COUNTY TAX MAP Ols"r ~ooo SECTO~ BL 04 LOT mi . SURVEY FOR JULIAN P. ZURAWSK! AT MATTITUCK TOWN OF SOUTHOLD SUFFOLK COUNTY,. NEW YORK '~~ YOUNG 8~ YOUNG ALDEN W. YOUNG, PROFESSIONAl. ENGINEER DATE : SEPT. 17, 1984 SCALE: I"= 50' NO. ; 84- 918 400 OSTRANDER AVENUE RIVERHEAD, NEW YORK SUPPLY SYSTEM CANNOT PLIER CERTIFICATION ON LEAD CO]'~TENT BEFORE CERTIFICA~E Q~ OCCUPANCY · ' ' '~.hina is used Copper .... for Water disfrlbuting i~ystem~ piping shall be o~C types K or L only NO'~TFY BOILDING '~EP~,'P.'~MENT AT 76§-1802 9 AM TO 4 pA4 FOR THE FOLLOWING INSPECTIONS: 1, FOUNDATION - TWO REQUIRED FOR POURED CONCRETE 2, ROUGH - FP.~MING & pLOMBING 3, INSULATION ,4, FINAL - ~ON'STRUCTiON MUST BE COMPLE~-_E FOR C.O. ALL CONSTRUCTION SHALL MEET THEr REQUIREMENTS OF THE N, Y, STATE CONSTRUCTION & ENERGY CODES· NOT RESPONSIBLE FOR DESIGN OR CONSTRUCTION ERRORS. '1 ST. P~oor-,.