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Home My WebLink About27033-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No: Z-27547 Date: 02/05/01 THIS CERTIFIES t~at the building ADDITION Location of Property: 15955 MAIN RD (HOUSE NO.) (STREET) County Tax Map No. 473889 Section 115 Block 1 Filed Map No. __ Lot No. __ Subdivision MATTITUCK Lot 6 (HAMLET) conforms substantially to the Application for Building Permit heretofore filed in this office dated JANUARY 10, 2001 pursuant to which Building permit No. 27033-Z dated JAN-GARY 26, 2001 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 DECK A/DDITION TO EXISTING ONE FAMILY DWELLING AS APPLIED FOR "AS BUILT" The certificate is issued to ROBERT F & MARILYN RUTKOSKI (OWNER) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL ELECTRICAL CERTIFICATE NO. PLUMBERS CERTIFICATION DATED N/A N/A N/A uth~ized S~gnature Rev. 1/81 FORM NO. 3 TOWN OF SOUTHOLD BUILDING DEPARTMENT Town Hall 8outhold, N.Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) PER~IT NO. 27033 Z Date JANUARY 26, 2001 Permission is hereby granted to: ROBERT F RUTKOSKI PO BOX 1143 MATTITUCK,NY 11952 for : CONSTRUCT DECK ADDITION TO EXISTING ONE FAMILY DWELLING AS APPLIED FOR "AS BUILT". at premises located at 15955 County Tax Map No. 473889 Section 115 pursuant to application dated JANUARY Building Inspector. MAIN RD MATTITUCK Block 0001 Lot No. 006 10, 2001 and approved by the Fee $ 75.00 Authored Signature Rev. 2/19/98 ORIGINAL 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 inspector with the following: for new building or new use: 1. Final survey of property with accurat-e--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 o{ Fire Underwriters. 4. Sworn statement from plumber certifying that the solder used in system contains less than 2/10 of 1% lead. 5. Commercial building, industrial building, multiple residences and similar building 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. 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 a 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. Ce Fees 1. Certificate of Occupancy - New dwelling $25.00, Additions to dwelling $25.00, Alterations to dwelling $25.00, Swimming pool $25.00, Accessory building $25.00, Additions to accessory building $25.00. Businesses $50.00. 2. Certificate of Occupancy on Pre-existinK Buildin~ - $100.00 3. Copy of Certificate of Occupancy - , .25%9 4. Updated Certificate of Occupancy - $50.00 5. Temporary Certificate of Occupancy - Residential $15.00, Commercial $15.00 Date ..].~..~.%.~Q~ ......................... New Construction ........... Old Or Pre-existing Building ................. Location of Property. ~ .~.~..~.~. ...... ~ J~...~0.~. ........ ~/~] .~..~. 7~K ............ House No. Street Hamlet Onwer or Owners of Property.~.O..~..~..~..-~.~..~. ~.~.~.~...f~.~..~..~ .................... County Tax Map No 1000, Section...l~.~. ...... Block .... O~ ......... Lot...O~. ............. Subdivision ................................... · Filed Map ............ Lot ..................... Permit N~.~0~.~. ..... Date Of Permit. ;/~.~0~ ...... Applicant ............................ Health Dept. Approval .......................... Underwriters Approval ........................ Planning Board Approval .................. .. ... . Request for: Temporary Certificate ........... Final Certicate ........... Fee Submitted: ~29f~'~ ~~ ........................... ~" .-_ ~ ~ ~ , ~,.~ - FIELI) II~PECTION REPORT DATE CONI~NTS FOUNDATION (IST) ROUGH FP, At4E & II INS~TION PER N.Y. JJ CODE ~DITIONAL CO~S: ROBERT H. WHELAN, P.E. P.O. Box $90 ~ Mattltuck~ NY 11952 Tel: 631~722-5875 ~ Fox: 631-722-7835 January23,2001 Town of Southold Building Department Main Road Southold, New York 11971 Att: Building Official Re~ Rutkoski Residence Main Road Mattituck, New York 11952 Dear Sir: Pursuant to the granting of a Certificate of Occupancy for the as-built deck related to the above residence, please find enclosed a plan and section of the existing construction. A field inspection on January 20, 2001 took place to determine if the as-built construction could be considered structurally sound. 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. ~ Yours:w Robert H. Whelan, P.E. cc: Mr. Robert Rutkoski 765-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLBG. [ ] FOUNDATION2ND [ ] INSUL~ATION [ ] FRAMING [/~'I~AL [ ] FIREPLACE & CHIMNEY ROBERT H. WHELAN, P.E. P.O. Box 590 ~'Matlilttcl~ NY 11952 Tel: 631-722-5875 · Fax: 631-722-7835 January 23,2001 Town of Southold Building Department Main Road Southold, New York 11971 Att: Building Official Re: Rutkoski Residence Main Road Mattituck, New York 11952 Dear Sir: Pursuant to the granting of a Certificate of Occupancy for the as-built deck related to the above residence, please find enclosed a plan and section of the existing construction. A field inspection on January 20, 2001 took place to determine if the as-built construction could be considered structurally sound. 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. Robert H Whelan, P.E. cc: Mr. Robert Rutkoski BUILDING DEPARTMENT TOWN HALL SOUTHOLD, NY 11971 TEL: 765-1802 Exam/ned 20__ Approved ([O--~ ,200~ [ Disapproved Wc 15 U II~DIIN U F~t<IVII 1 A2~FLIL~A DON CHECKLiS Do you have or need the following, before applyin~ Board of Health 3 sets of Building Plans Survey Check Septic Form N.Y.S.D.E.C. Trustees Contact: Mail to: ." ' Phone: ----r..-/ APPL I C ATI ~:il;i~gR B~UPI:t~;N G PERMIT Oate - 134 _, INSTRUCTIONS [. This application MUST be completely filled i~ 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 building~ on'premises, relationship to adjoining premises or public streets or areas, and waterways. c. The work covered by this application may not be commenced before issuance of Building Permit. d. Upon app,,oval of this application, the Building Inspector will issue a Building Permit to the applicant. Such a permn shall be kept on the premises available for inspection throughoPt'the work. e. No building shall be occupied or used in whole or in part for any purpose what-so-ever until a Certificate of Occupan is issued by the Build!ng 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 coinply with all applicable laws, ordinan6.es, building code, housing code, and regulations, and to admit authorized inspectors on premises and in building for necessary inspections. / (Si~a~'e ofappt~an~or name, ifa corporation) (Mailing address of apphcant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder Name of owner of pi'emises (as pn ~he tax roll or latest deed) If applicant is a corporation, signature of duly authorized, o,fficer (Name and title of corporate officer) Builders License No. Plumbers License No. Electricians License No. Other Trade's License No. 1. Location of land on which proposed work will b4 ,d. or~e: /._h-9.5'A-- ,rD, House Number Street County Tax Map No. 1000 Section Subdivision (Name) /';o,q Filed Map No. Lot Estimated Cost ~:"~_'~t~ If dwelling, number of dwelling If garage, number of cars I£business, commercial or mixec Dimensions of existing stmcture~ Height State existing use and occupanc) a. Existing use and occupar cy..., b. Intended use and occupm cy. Nature of work (check which applicable): New Building.. . Repair .Removal Demolition of premises and intended use and ccupancy of proposed constmctmn: O tnits Fee Addition Other Work. Alteration '"~_ t )1 LT (Description) (to be paid on filing this application) Number of dwelling units on each floor occupancy, specify nature and extent of each type of use. , if any: Front Rear Depth ~umber of S~ories Dimensions of same structurei with alterations or additions: Front Depth He ght Dimensions of entire new const~ction: Front Height , Number of Stories Size of lot: Front 0. DateofPurchase. r7/elO Rear Number of Stories Rear Depth .. Rear . Depth Name of Former Owner 1. Zone or use district in which pren ?ises are situated _ ""~5\ 2. Does proposed construction viola!e any zoning law, ordinance or regulation: 3. Will lot be re-graded NO i 4. Names of Owner of premises~[~il~Address /~PrTTITOi3:~ Name ofArchitect"~i=k>r/ Xod i--~-L-~ ~1,,5 Address J~r~'~ Name of Contractor Address 5. Is this property within 100 feet of~ · I:FYES, SOUTHOLD' 6. Provide survey, to scale, with accu 7. If elevation at any point on propert TATE OF NEW YORK) SS: 'OUNTY OF ) (Name of individual signing contract ¢)l-te is the Will excess fill be removed from premises: YES NO Phone No. ~9~- Phone No r)~_ .Phone No ' 9 . t~dal wetland. *YES. NO X ]OWN TRUSTEES PERMITS MAY BE REQUIRED :ate foundation plan and distances to property lines. is at I0 feet or below, must provide topographical data on survey. being duly sworn, deposes and says that (s)he is the applicant above named, (Contract ~r, Agent, Corporate Officer, etc.) said owner or owners, and s duly authorized to perform or have performed the said work and to make and file this application; ~at all statements contained in this application are true to the best of his knowledge and belief; and that the work will be erformed in the manner set forth in the a ~plication filed therewith . worn to ~fore me this~ I (~ Notary~Public "t,*"'-~ ~ Si gn~e6're of A~p"iicant ELIZABETH A STATHi8 NOTARY PUBLIC, State of .No._O1ST6008173 Suffolk Co~un_ty ~erm Exp res June 8, 20;;27_.- NiOIF i~Lt,'ll~R O. RUI'AND Jr. 258. E~' \ MAIN (S.R. 25) SURVEY OF -- PROPERTY A T MA TTITUCK TOWN OF SOUTHOID CERTIFIED TO: HARTFORO FUNDING, LTD ROBERT RUTKOSKI .................... MARIL YN RUTKOSK! SUFFOLK COUNTY, N Y. I000- 115- 01- 06 ~ Scale 1" = 50' July 3, 1990 Prep_ ared in ~.,.~.ord~r~e with ~e mi~mum .$. LIC. NO. 49818 · ,ta~.~ar, d~, .for~ ~veye ~ eet~d ~ C Dy ~ ~gA.~. ~ ~oved ~d ~pMd SOUT~ ~N ~ ~71 90- 237 ROBERT H. WHELAN, P.E. CONSULTING ENGINEER ~'(',,2 ;h~o/ P.o. sox~90 BY DATE 160 BUNGALOW LANE MA'i-rlTUCK, N.Y. 11952 CHKD. BY DATE /§16)298-5770 SUBJECT ~"~/w/t~P._~/ ~"',~""~'~/,,/)~,,'4' ,~'"~' SHEET NO. '~ OF '~ JOB NO. Z/OO&' ROBERT H. WHELAN, P.E. CONSULTING ENGINEER B~ :~/~ ~A~E ',~h ,.O..OX590 · _ 160 BUNGALOW LANE MATTITUCK, N.Y. 11952 CHKD. BY DATE (516)298-5770 SUBJECT ~,~,~',~;'-~'¢'//~-~/~/~- ~-~/~ J~ ~'~ ' __ u(,CUPANC¥ O~ USE IS UNLAWFUL ~7,ffHOUT ~I:'DTIF]P ~,~ OCCUPANCY S,EEtNO. JoB NO. NOTIFY BUILDING '765-1802 9 AM ~ 4 PM FOR THE FOLLOWING INSPECTIONS: 1, FOUNDATION - 1~/O REQUIRED FOR POURED CONCRETE 2, ROUGH - FRAMING ~. PLUMBING 3. INSULATION 4. FINAL - CONSTRUCTION MUST h BE COMPLETE FOR C.C. ALL CONSTRUCTION SHALL MEET THE REQUIREMENTS OF THE N.Y. STATE CONSTRUCTION 8~ ENERGY cODES. NOT RESPONSIBLE FOR DESIGN OR CONSTRUCTION ERRORS ~?..~'~'~' ,, ,..,, ,,