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Home My WebLink About25626-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT office of the Building Inspector Town Hall southold, N.Y. CERTIFICATE OF OCCUPANCY No: Z-26603 Date: 07/29/99 THIS CERTIFIES that the building ADDITION Location of Property: 605 ROSEWOOD DR MATTITUCK (HOUSE NO.) (STREET) (HAMLET) County Tax Map No. 473889 Section 113 Block 2 Lot 9 Subdivision Filed Map No. __Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated MARCH 9, 1999 pursuant to which Building Permit No. 25626-Z dated MARCH 19, 1999 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 ADDITION AND SCREENED PORCH ADDITION ON EXISTING DECK TO AN EXISTING ONE FAMILY DWELLING AS APPLIED FOR. The certificate is issued to WILLIAM R CIECHANOWSKI (OWNER) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL ELECTRICAL CERTIFICATE NO. PLUMBERS CERTIFICATION DATED Rev. 1/81 N/A N/A N/A Building In~ec~or FORM NO. 3 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) PERMIT NO. 25626 Z Date MARCH 19~ 1999 Permission is hereby granted to: WILLIAM R CIECHANOWSKI PO BOX 1617 MATTITUCK~NY 11952 for ~ CONSTRUCTION OF A DECK ADDITION AND SCREENED-IN PORCH WITH ROOF ENCLOSURE FOR AN EXISTING SINGLE FAMILY DWELLING AS APPLIED FOR. at premises located at 605 County Tax Map No. 473889 Section 113 pursuant to application dated MARCH Building Inspector. ROSEWOOD DR MATTITUCK Block 0002 Lot No. 009 9 1999 and approved by the Fee $ 75.00 re ORIGINAL Rev. 2/19/98 J OLDG. D,:P'r. ' / I ' TQ'~~OLD ,/ Form No. 6 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL 765-I802 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 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. Commercial 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. 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 to~pographic features. 2. A properly completed application and a consent td--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, 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 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 Date .................... New Construction ........... Old Or Pre-existing B~uilding .... .~'..[ ......... Location of Property. ~.o.~.....~ ~.~...o.~9. ...O..~. ~ ~ ...... .~...~.~ .T~..v..~.. j.q ...... . . .. House No. Street Hamlet Onwer or Owners of Proper y ............................................. County Tax Map No lOOO, Section. . .'t !,~. ....... Bi~Jki~i .... i~iii Lot~ ..... .~ ,, ' ..... Subdivision ................................... _ Filed Map ......... ,...Lot ...................... ~-J--9~ ~L~C · ~--~S, .'~..?~ ..... Applicant....~....+?.~ .~.~ .~..~.~.~., Permit No .......... .~ .... Date Of Permzt ...... Health Dept Approval .. ..........Underwriters Approval ........ . Planning Board Approval ....... Request for: Temporary Certificate ........... Final Certicate......~F~..[.. ~c 5'~u/.5 ~LrCAfrr ........... INSPECTION RI~PORT )UNDATION (IST) )UNDATION (2ND) )UGH FRAME & PLYING II asm~noN Pgg N.x. II II coo~ 11 . ADDITIONAL COI,9~NTS: 765-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] IN~ATION / [ ] FRAMING [ ~j' FINAL [ ] FIREP~ACE~ CHIMNEY ~ a__,O% ×% :, %e APPROVED AS NOTED H ?~B-]802 ~ AM TO 4 PM F~ THE FOLLO~N~ 1, FOUNDATION - ~O ~EOUI~ED FO~ ~U~ED CONC~E 2. ~OUGH - F~ING & PLU~ 3. INfUSiON 4. FINAL - CONSTRUCTION MU~T BE COMPL~E FO~ ALL CONSTRUCTION ~HALL THE ~EOUtBEMENTS OF THE ~TATE CONSTRUCTION & CODE~. NOT ~E~PON$1BLE FO~ DESIGN O~ CONSTRUCTION OCCUPANCY OR USE IS UNLAWFUL WITHOUT' CERTIFICATEr OF OCCUPANCY FORM IlO. I TOWN OF SOUTHOLD BUILDING DBPARTMENT TOI~I HALL SOUTHOLD, N.Y. 1197 I TEL: 765-1802 Disapproved a/c .......................... ~ .... ~' . ! . ./..'r:;:..:..~_ .~z...v: :..-,~..... ~ ' '/ / (Building Inspector) ~'~ PLICATION FOR BUILDING INSTEUCTIONS BOARD OF HEALTH ............... 3 SETS OF PLANS ............... SURVEY ........................ CHECK ......................... SEPTIC FORH ................... NOTIFY: , CALL ................. NAIL TOt .................. .. a. Tais application ,~qt be ec~letely filled in by type~iter or in ink and sul~itted to the l~filding Inspector wi~ 3 s~ts of plans, ancurate plot plan to ~eale. Fee sceording to scbedule. b. Plot plan sbe~ir~ leeatiun of lot and of l~aildings an pr~aises, relationship to adjoining premises or public str~[~ or areas, and giving a detailed description of layout of property mast be dr~an on the diagram daich is part of Chis application. ~. ~he ~ork covered by this application may not be co--riced before issuance of 1]oilding Permit. d. Upon approval of this application, the Building Inspector will issue a l~ilding Permit to the applicant. Such permit shall be l~ept on the premises available for inspection throat the x~rk. e. No Imilding shall be occupied or used in whole or in pert for any pta~ose ~hatever until a Certificate of Cecnpancy shall have been gronted by the B~ilding Inspector. API~ICATI~ IS ~ ~ to the B~ildlng Delmrlmmnt for the isst~nce of a B~ilding PemMt p~rs~ant to the I~l~ldlng Z~me Ordinance of the Town of So~thold, Suffolk County, New York, and other applicable I~ws, Ordinances or P~llatio~s, for the co~structiou of Imildi~gs, mdditiuns or alteratloms, or for removal or demolition, as herein described. The applicent agrees to ccmply with all spplicable laws, ordinances, h~ilding code, housing code, and ..~...~~ ........... (Signature of applicant, or na~e, if a corporation) .~.~.%..~.. ?Z..r.~. ~ f~,. f.~,~ .............. (Mailing addrese of applleant) State ~daether applicant is onser, lessee, agent, architect, engineer, general contractor, electrician, plunber or builder ..... .~.¢..~ ..... .c.~. ~ .................................................................................. ~ o~ ,~,: o~ pr,~se~ ~ ta.ts.. .V.~z~ .% :. .~r..,. clw~ ...................................... · :... ..[. ..... (as on the .tax roll or latest deed) If applicant i~ a eo~poratlon, algnature of daly anthorlzed officer. (l~a~e and title of corporate officer) Phm~ers License No ........... Electricians License No ......... ..................... I. Location of land on ~taach proposed ~ork w~ll be done.. ~ .... Lo.c_ ................. ......................... ............... : ....... ~ Number Street "¢ Bmulet Coanty TaxMmp NO. 10(30 Sectiun ..~.~ ......... Block ..~)..~.. ....... Lot ...~..~ ......... St~bdivisiun ..................... Filed Map No ....... 2. State exlst~ng ~se ~nd occupancy of premises mhd intended tree and eccupancy of proposed cunstrsction: a. E~dsting use and occupancy ....qk.~ .................................................. ~%'T;~;;'" .............. ,,. ~ten,~ ~ ~ ee,~,,,,-,-',, ...,,,,'...,-.,.-- ................................................................ 3. Fntnre of ~rk (d~,:k ~dd~ applicable); Ne~ l~filding .......... ~ldition..........~ Alteration .......... Repair ............ Re~oval .... ~ ........ l~liti~ ............ Other ~ .................... 4. Estimt~l ~st l~ ; ~ (to ~ ~id ~ filing this a~ti~ti~) 5. If &rellim, ~r of ~lli~ traits ............ ~r of ~lli~ ~ita ~ e~l fl~r ................ If ~rage, ~br of ~r$ ~ ........ 6. If ~i~ss, mrclal or ~<~, ~i~ m~re ~ ~tent of ea~ ~ of ~ ...................... ~. Di~nsi~s of ~isti~ st~9, if ~: ~t ................ ~ar ............... ~pth ................. ........................ . ~r of 8torien ...................... D~nsi~ of ~ atone ~tfi nlternt~8 or ~{tlona: ~nt ............... ~nr ............... ~pth .................. ~i~ 8. Di~n$1~ of entire ~ ~nt~t{~: ~t }~i~t ......................... }~r of 8toriea ..................... 9. Si~ of lot: ~t ......... ~ ....... ~ar .............. ~pth ................. I0. ..... ..... ..... , ............. II, ~ or ~ diatrlet in ~i~ ~i~a a~ $1~tM ............................................................. . 12. ~s p~l mt~ti~ violate a~ ~i~ , 15. Is Odop~in~ f~t~o~ati~lmrl~ ~ .......... ~ .......... PLOT l~ate clearly ~ di~timrly ali ~[ldi~, ~tMr ~i~ti~ or pro~, ~ i~icate ail ~t-~ d~n~ion8 ~m~r interior or cmr lot. (Nam of zndtvldu~, slgnin§ contract) i O I~ is the .... ~ ................................. (~tr*ctor, agent, e~r~rat~ o[[tcer, etc.) of ~id ~r or ~ra, ~ is duly ~thorlM to ~rfom or h~ ~rfo~ Om ~id m~ md to m~ ~ file this a~hcatx~; that all stat~nts c~ta~ in ~is a~l. lcatlm are t~ to ~e ~,t of his ~1~ a~ ~hef, a~ ,. .......... .... ......... ..... mo, Ul u~79505 ~ Qual~ In Suffolk Co~t~ ¢~ Commt~ion ~ires Dee. 8, ~C~ ~ ~ duly ~*a~m, deposes and ,~wja that he ia the appl. lcant