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Home My WebLink About29570-ZFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No: Z-29600 Date: 07/25/03 THIS CERTIFIES that the building ADDITION Location of Property: 1055 WELLS RD LAUREL (HOUSE NO.) (STREET) (HAMLET) County Tax Map No. 473889 Section 126 Block 8 Lot 24 subdivision Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated JULY 10, 2003 pursuant to which Building Pez~nit No. 29570-Z dated JULY 14, 2003 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 "AS BUILT" DECK ADDITION TO AN EXISTING ONE FAMILY DWELLING AS APPLIED FOR. · ~ne certificate is issued to THOMAS & JOAN SLEDJESKI (OWNER) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF BEALTH APPROVAL ELE¢~£KICAL CERTIFICATE NO. PLUMBERS CERTIFICATION DA'rmu N/A ~/A Signature Rev. 1/81 FORM NO. 3 TOW/q 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) PERMIT NO. 29570 Z Date JULY 14, 2003 Permission is hereby granted to: THOMAS & JOAN SLEDJESKI PO BOX 738 MATTITUCK,NY 11952 for : AS BUILT DECK ADDITION AS APPLIED FOR at premises located at 1055 WELLS RD LAUREL County Tax Map No. 473889 Section 126 Block 0008 Lot No. 024 pursuant to application dated JULY Building Inspector to expire on JANUARY Fee $ 300.00 10, 2003 and approved by the ~A~i ~ignature Rev. 5/8/02 COPY Form No. 6 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL 765-1802 APPLICATION FOR CERTIFICATE OF OCCUPANCY This application must be filled in by typewriter or ink and submitted to the Building Department with the following: A. For new building 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 from Health Dept. of water supply and sewerage-disposal (S-9 form). 3. Approval of electrical installation from Board of Fire Underwriters. 4. Sworn statement from plumber certifying that the solder used in system contains less than 2/10 of 1% lead. 5. Coinmercial building, industrial building, multiple residences and similar buildings and installations, a certificate of Code Compliance from architect or engineer responsible for the building. 6. Submit Planning Board Approval of completed site plan requirements. B. For existing buildings (prior to April 9, 1957) non-conforming uses, or buildings and "pre-existing" land uses: 1. Accurate survey of property showing all property lines, streets, building and unusual natural or topographic features. 2. A properly completed application and consent to inspect signed by the applicant. If a Certificate of Occupancy is denied, the Building Inspector shall state the reasons therefor in writing to the applicant. C. Fees 1. Certificate of Occupancy - New dwelling $25.00, Additions to dwelling $25.00, Alteratious to dwelling $25.00, Swi~raning pool $25.00, Accessory building $25.00, Additions to accessory building $25.00, Businesses $50.00. 2. Certificate of Occupancy on Pre-existing Building - $100.00 3. Copy of Certificate of Occupancy - $.25 4. Updated Certificate of Occupancy - $50.00 5. Temporary Certificate of Occupancy - Residential $15.00, Commercial $15.00 House No. Owner or Owners of Property: Suffolk County Tax Map No 1000, Section New Construction: Location of Property: Date. Old or Pre-existing Building: Street (check one) Hamlet Block Lot Subdivision Permit No. ~ 7~-'70 Health Dept. Approval: Planning Board Approval: Request for: Temporary Certificate Fee Submitted: $ Filed Map. DateofPermit. ~,3/~,.~ Applicant: ~ Underwriters Approval: Final Certificate: Lot: (check one) BUILDING PERMIT EXAMINER CHECKLIST APPLICANT: .~gc~_N~% ~_'A SCTM# DISTRICT: 1,000, SECTION: 12.6 , BLOCK: ~ BUILDING PE~ITS OPEN/EXPI~D: P~ CO: Y OR N BP -Z / C/0 Z- , ~O / BP SINGLE & SEP~TE CERTIFICATION-~Q~D ~o , LOT: ,~ ZONEqG DISTRICT: DATE REVIEWED: ~ /~/03 DATE SUBMITTED: tic )1~*~03 . SUBDWISION: t,~ ~ CONFORMING? tiro -z / c/o z- 5-, toFO_ ~Z / C/0 Z- INFO NOTES LOTS 40,000SF -100-24. Lot recognition.(CREATED before June 30, 1983), UNDERSIZED LOTS FROM JAN.1997 100-25. Merger.(A nonconforming at any time after 7/1/82 REQ. LOT SIZE: ACT. LOT SIZE: I6, 0,,~ REQ. LOT COV..Yo ~o ACT. LOT COV. J REQ. FRONT ~5 PROP. FRONT ..-"' REQ SDE r,~f~ c' REQ. REAR 3 ~ PROP. REAR ..~ REQ. HEIGHT PROJECT DESCR1PTION: ~ ~. !4~ ~F~¢,_ [c ESTIMATED PROJECT COST: ~ ARCHITEC~R: _ WATERFRONT? [~ DESCRIPTION: ~ ACT. S1DE .~ PROP. HEIGHT PANEL# ff~[ FLOOD ZONE: APPROVALS REQUIRED SUFFOLK COUNTY HEALTH DEPT: YES o~ED #): __ TOWN SEPTIC RECEIPT: Y o~-') NEW YORK STATE DEC: PRE-DEC 9/1/75 YES SOUTHOLD TOWN TRUSTEES: YES or~_,~Q) TOWN ZONING BOARD APPROVAL: YES o~} TOWN PLAN. BOARD APPROVAL: YES or~:~ TOWN HISTORICAL PRE (SPLIA):' YES o~ NEW YORK STATE CODE COMPLIANCE (SEE PAGE ~.' YES) NO NOTES: DTE: / / PERMIT #: DTE: / / PERMIT #: DTE: / / PERMIT #: DTE: / / PERMIT #: DTE: / / PERMIT #: FEE STRUCTURE: FOUNDATION: FIRST FLOOR: SECOND FLOOR: OTHER: TOTAL: 1.( ~0~/ SF)-(_ _SF)= SFX$ 2. ( SF)- ( SF)= SF X $ 3. ( SF)- (~_ SF)=_ SF X $__ SF SF SF SF SF INIT OTHER TOTAL FEE FEE FEE =$ +$ +$ : $ [ <-O =$ +$ +$ = $ =$ +$ '+$ FINAL TOT~$ 765-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION 1ST [ ] FOUNDATION 2ND [ ] FRAMING [ ] FIREPLACE & CHIMNEY [ ] ROUGH PLBG. [ ] INSULATION [ ~]/~NAL REMARKS: DATE INSPECTOR FOUNDATION (IST) ~.~ m: FOUIXrDATION (2~,'-D) ROUG~ & TOWN OF SOUI'HOLD BUILDING DEPARTMENT TOWN HALL - SOUTHOIcD, NY 11971 TEL: (631) 765-1802 FAX: (631) 765-9502 www. northfork.net/Southold/ Examined Approved Disapproved a/c Expiration BUILDING PERMIT APPLICATIQN CHkECKLIST Do ~vou have or need the following, betbre applySng? / 3 sets of Building Phns PIPIT NO. ~q~ ~ ~ s~y_ Check /' / / /~ Phone: ,20 i -~r~,?;'7,''''7 ..... ~LICATION FOR BUILDING PERMIT Date_ 20 a. Th s ap~i~at~g MUST be b~ple ly filled in by typewriter or in i~ m~d sub~tted to the Building ~pector wtth 3 sets of plus, bcc~okpl~ t0 s6al~. Fee ~ccording to schedule. b. Plot pl~ showing location of lot and of buildings on presses, relationship to adjoining presses or public streets or ~eas, ~d wate~ays. c. The work covered by ~s application may not be co~enced before issu~ce of Buil~ng Pe~t. d. Upon approval of this application, the Building ~spector will issue a Building Pemfit to the applicant. Such a pemt sh~l be k~t on the presses available for ~spection tI~oughout ~e work. e. No building shall be occupied or used in whole or in pan for any pu~ose what so ever ~til the Building ~spector issues a Ce~ificate of Occup~cy. f. Eve~ building pemt shall expire if the work authorized has not co~lenced within 12 months after the date of iss~nce or has not been completed wit~n 18 mont~ from such date. If no zoning amen~ems or other re~lations affecting the prope~y have been enacted in the interim, the Building ~spector may authorize, in writing, the extension of the pe~t for an addition six months. Therea~er, a new pemt shall be required. ~PLICATION IS HE'BY M~E to the Building Depa~ment Gr the issuance of a Build[ng Pm~t purser to the Bulling Zone Ordinance of the Town of Southold, Suffolk Co~ty, New York, ~d other applicable Laws, Ordin~ces or Re~lations, for the construction of buildings, additions, or alterations or for removal or demolition as herein described. The applicant agues to comply with all applicable laws, ordinances, building code, housing code, and re~lations, m~d to a~t authorized inspectors on pre~ses ~d in building for necess~~ inspections. ~ / (Signature ofapplic~gor name, ifa co~oration) (Mailing address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder Name of owner ofpremises _ )'~¢'ma~..$ o~ ,~--,~,,~' ~'Z&'~ J--Z-~--qf-, ' (As on the tax roll or latest deed) if applicant is a corporation, signature of duly authorized officer (Name and title of corporate officer) luilders License No. lumbers License No. lectricians License No. ~ther Trade's License No. Location of land on which proposed work will be done: House Number Street County Tax Map No. 1000 Section Subdivision (Nme) Hamlet Block ~7~ Fi/ed Map No. Lot Lot ROBERT H. WHELAN, P.E. FLOOD ZONE _//~,, COMPLY WITH CHAPTER "46" FLO0~ DAMAGE PREVENTION SOUTHOLD TOWN CODE, P.O, Box 590 *Maqltuck, NY 11952 Tel: 631.871-1369 ALL CONSTRUCTION SHALL IEET THE REQUIREMENTS OF THE July 9, 2,~I~}E.~ ~ NEW YORK STATE. Town of Southold Building Department Main Road Southold, New York 11971 Att: Building Official Re: Sledjeski Residence Wells Road Mattituck, New York 11952 Dear Sir: AP~OVED AS NOTED ~ ~UILOING 7~1~ 8AM TO 4PM FO~ THE ~ING INSPECTIONS: ~R POURED CONCRETE 2, ROUGH. FRAMING & PgUMBING 3. INOU~TION 4. FINAL. CON.."'r~UCTiON MUST Pursuant to the granting of a Certificate of Occ~a~J[~:'ga~ll~il},~leck related to the almve residence, please find enclosed a plan ar~S~t~l~°d~g~d~d~Fu~/8n. A field inspection on July 8, 2003 took place to ~m~j~.t~l~-~'~~could be considered structurally sound. DESIGN OR CONSTRUCTION ERRORS. It is my professional opinion that the as-built construction is adequate to support the intended loads and is in conformance with the general intent of the New York State Uniform Fire Prevention and Building Code. Thank you for your time and cooperation on this matter, If there are any questions relative to the above please do not hesitate to call. COMPLY WIT/-/ALL ( NEW YORK STATE REQUIRED AND CONDITI( , /// s.o~ ow~,~,~~ ~;ry T~y Yours) . Robert H. Whelan, P.E. OCCUPANCY OR USE iS UNLAWFUL WITHOUT CERTIFICATE OF OCCUPANCY ROBERT H. WHELAN, P.E. CONSULTING ENGINEER RO. BOX 590 MATTITUCK, NY 11952 SH~I~ NO' / OF JO~ ~o. CHKD. BY DATE SUBJECT ~ '* Z~J~"~ ROBERT H. WHELAN, P.E. CONSULTING ENGINEER RO. BOX 590 MA']-rlTUCK, NY 11952 SHEET NO. JOB NO.