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Home My WebLink About25331-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No: Z-27545 Date: 02/05/01 THIS u~TIFIES that the building ALTERATION Location of Property: 1535 PARK AVE MATTITUCK (HOUSE NO.) (STREET) (HAMLET) County Tax Map No. 473889 Section 123 Block 2 Lot 31 Subdivision Filed Map No. LOt No. conforms substantially to the Application for Building Permit heretofore filed in this office dated OCTOBER 29, 1998 pursuant to which Building Permit No. 25331-Z dated NOVEMBER 17, 1998 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 INTERIOR ALTERATION & DECK ADDITION TO EXISTING SINGLE FAMILY FAMILY DWELLING AS APPLIED FOR. Tg~e certificate is issued to FRANCINE FIELD of the aforesaid building. (OWNER) SUFFOLK CO~ DEPARTMENT OF ~ALTH APPROVAL ELEC~fRICAL CERTIFICAI'E NO. PLUMBERS C}LRTIFICATION DA'r~3 N/A H-066172 02/02/01 WM.J. DROSKOSKI 11/03/99 Signature Rev. 1/81 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. 25331 Z Date NOVEMBER 17, 1998 Permission is hereby granted to: DONALD SCHOLL & ANO. 350 ROBINSON LANE PECONIC~NY 11958 for : INTERIOR ALTERATION TO AN EXISTING SINGLE FAMILY DWELLING AS APPLIED FOR. at premises located at 1535 County Tax Map No. 473889 Section 123 pursuant to application da%ed OCTOBER Building Inspector. PARK AVE Block 29 1998 MATTITUCK 0002 Lot No. 031 and approved by the Fee $ 75.00 Buildin~ I nspec~'or ORIGINAL Rev. 2/19/98 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 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 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 buildings and installations, a certificate of Code Compliance from architect or engineer responsible for the building. 6. Submit Planning Board Approvai 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, C. Fees 1. Certificate of Occupancy - New dwelling $25.00, Additions to dwelling $25.00, Alterations to dwelling $25.00, ~wimming pool $25.00, Accessory building $25.00, , Additions to accessory building $25.00. Businesses $50.00. 2.Certificate of Occupancy on Pre-existing Buildin~ - $100.00 3.Copy of Certificate of Occupancy - 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 Building....~.. .......... House No. Street Hamlet Onwer or Owners of Property ..... .~?..~..~3..~..~...~-,,.~.~,~.I~. .................................... County Tax Map No 1000, Section...J.~.~ ..... Bfdck....~. ........... Lot..~.J ................ Subdivision ............. ~...~.. ................ Filed Map ............ Lot ...................... Permit No..~.~.~..~.{.~....Date Of Permit .... I~.l.~/?.~...Applicant. f~.~.~?.~.A~..~_...?.~.~.~. .... Health Dept. Approval .......................... Underwriters Approval ......................... Planning Board Approval ........................ Request for: Temporary Certificate .......... Final Certicate..~. ........ · Fee Submitted: ~ ¢ 5"' ~ ' .~ '//. ~.f~.. 7 .................... ¢ 0 ~ ~ ~ ~/-~ APPLICANT Town Hall, 53095 Main Road P. O. Box 1179 Southold, New York 11971 Fax (516) 765-1823 Telephone (516) 765-1802 OFFICE OF THE BUILDING INSPECTOR TOWN OF SOUTHOLD CERTIFICATION Building Permit No. ~5 ~51'''~' Owner: ~¢__~_ ¢~d~t~ (please print) Plumber: (please print) I certify that the solder used in the water supply system contains less than 2/10 of 1% lead. (Plumbers Signature) Sworn to before me this ~DJ day of N/~ Notary~Public, ~9 ~Ld~f County LINDA J. COOPER Notary Public, State of New York No. 4~22563, Su~fol~(,C~unty - Term E~ires Oecembe~ ~, ~)~'_ ~_~o THE NEW YORK BOARD OF FIRE UNDERWRITERS 8~73561 BUREAU OF ELECTRICI~? ~-- 40 FULTON gT~EET, NEW ¥O~K, NV 100Se D~e NOVE~ER 03,1999 Appl;catio, No. o, file ~3258898/98, ~ -, H 066172 THIS CERTIFIES THAT '' only the electrical equipment as described below and introduced by the appIicant named on.the allow application number is in the premises of DROSKOWSKI, 1535 PARK AVE., MATTITUCK, NY in the following location; [] Basement [] 1st FI. [] 2nd Fl. OUT Section Block Lot was examined on OCTOBER 28,1999 and found to be in compliance with the National Electrical Code.. OUTLETS RECEPTACLES SWITCHES INCANDESCENT OTHER 15 DRYERS FURNACE MOTORS FUTURE APPLIANCE FEEDERS AMT. K,W, OIL H.P. GAS H.P. AMT. NO. A. W, G, SERV CE D SCONNECT NO. OF ' S E AMT. AMP. WPE ~n~l~l~;. 1 e 2W I (~ 3W 3, SW 3 S 4W NO. O~ECRC~COND. OTHER APPARAIUS: G.F.C.I:-4 SMOKE DETECTOR: -2 RANGES SPECIAL REC'PT AMT. AMP. R V I OVENS I DISH WASHERS UNIT HEATERS MULTI-OUTLET NO, OF FEET C E EXHAUST FANS AML H.P. DIMMERS NO. OF HI-LEG OF NELIIRAL D&D CYCLES (DROSKOWSKI) 22355 RTE.48 CUTCHOGUE, NY, 11935 This certificate must not be altered In any manner; return to the office of the Board ii incorrect. Inspectors may be identified by their credentials. Per llGENERAL M?A~ER COPY FOR BUILDING DEPARTMENT, THIS COPY OF CERTIFICATE MUST NOT BE AETERED IN ANY MANNER, Disapproved a/c ........................... .. . . .. ...................................................... APPLICATION }'OR BUILDING PERHIT INSTRUCTIONS BOARD OF HEALTH ~ ....... ~.J .... 3 SETS OF PLANS ............... SURVEY .................... . · · · SEPTIC FORH ................... Ct L I~IL TO: Date ................ ,19 .... a. 'Ibis applicatico ~,~t be c~pletely filled in by ~iter or in i~ ~ 3 ~ts of pl~, ~ate plot pl~ co ~le. F~ ~i~ to ale. b. Plot pla a~ l~ti~ of lot a of hildi~s ~ ~s, mlati~ip ~ ~joiui~ pr~s or ~lic s~r~ts or aec, ~ givi~ a ~tail~ ~rip~i~ of laymt of pm~ ~t ~ ~ ~ ~ di~ ~i~ is ~ of ~is a~li~d~. c. '~ w~ ~r~ ~ ~ia a~li~ti~ ~y ~t ~ ~ ~fore isle of ~ildi~ Pe~t. d. U~ a~al of ~is a~liacia, a ~ildi~ ~ctor ~11 i~ a ~ildi~ e. ~ ~ildi~ ~11 ~ ~i~ ~ ~ in ~le or iu ~r~ for ~ ~ ~er mci1 a ~rtifi~e of ~m~ ~11 ~e ~n ~ ~ ~ ~ldi~ ~wr. aiwa IS ~Y ~ to t~ ~ildi~ ~ac for ~ isa of a ~ildi~ ~ldi~ ~ ~i~ of ~ T~ of ~ld, ~ffolk ~ ~ Yo~, ~ o~r ~li~le ~s~ ~i~s' or ~la~i~, for ~ ~ci~ of ~ildi~, ~i~i~ or alteraci~, or ~r ~ or ~liti~, a ~iu &~ri~. ~ a~limc ~s ~o ~ly ~a dl a~li~le 1~, ordi~, ~ild~ ~la~i~, ~ ~o ~i~ ~ri~ i~rs ~ ~as ~ ia ~ildi~ for ~ (Signature of applicant, or ~-~, if a corporation) Rature of ~nk (check ~tdch apple '~ble)~ ~ I~ildtn8 .......... /~kiiti~ .......... ~terati~ ~ir ... ~. ...... ~1 ............. ~liti~ ............ Ot~r ..... ................ ~ti~ ~ .... I~p~.~.,.,..... ~ .............................................. ' (to ~ ~id ~ fll{~ this ~li~ti~) If ~lli~, ~ of ~11i~ nits ............ ~r of ~lling ~its ~ ea~ fl~r ................ IE ~r~, ~r of ~rs ...... ~ ............................... If ~i~ss, ~ial ~ ~ [~, ~i~ ~ ~ ~tent of ea~ ~ of u~ ...................... m ~t~,,~, o~ ~,~ ~, ~, ~, ~.~ ........... ~ .~ ............ ~" .~ ........... ~i~..~?.~!. .............../~ ~, o~ s~o,t~, .... .~ .............. , ' _., ~pth ...~. ............. ~t~{ .... ~ ............. ~r of Stories .... ~ ........ Di~nst~ of ~tt~ ~ ~s~ti~: ~t . ..~.~ ....... ~ar ..... ~ ..... ~p~ · .~.~ ...... ' ~i~t ....... ~ ............. i~r cE Stories .............. ........ ~ar . l.O0 .............. ~pth ...~.~ ........ ...... ~ o~ ~o~ ~ ,.~,~....~.~,~ ........... ~{~s a si~t~ . ~'. ................ :. ~ ........................................ Ce ~ ~I~ 1~, o~i~ ~ ~latt~ ........................ ~ ........ ~ill ~ss fill ~ ...................... ~ress .............................. ~ ~ ............... .................... ~ress ............................... ~ ~ ............... cea tt~l~tl~V *~ .......... ~ ..~ ..... Locate clearly a~d distinctly al fram p~uperO] lines. Give street ~aether interior or comer lot. OCCLJ?ANCY OR USE IS UNU WFU[ WITHOUT CERTIFK OF OCCUPANCY PLOT DY iOlllH · bulldlnSs, ~hether existin~ or proposed, a~d indicate all set-b~ek di~nsions )lock ribber or descriptioa according to &H~d, ~ sl~ street names ~xl i~licate PROVIDE SMO~E-DETECTING Al. AR. D£VICES APPROVED AS NOTED . N~' 'U~'"O DEPA~EN~T 7~-I~ 0 AM ~ 4 ~ FOR THE FOL~NG i FOUNDATION - ~0 REOUIRED PLUMBING ~R ~D ~R~ A~ ~UMBING W~T~ 2. ROU~ - ~ I ~MBING UNDERWRITERS CERTIFICATE ~ WATER UNES NEED 3. INS~ REQUIRED TESTING BEPORECOVERING 4. FINAL- CONSTRUCTION MUST BE COM~ FOR C.O. ALL CONSTRUCTION SHALL MEET s,rA~ m ~ ~, PRO~ ANTI-SCALD AND/OR THE REOUIREMENTS OF THE N.Y. STATE CON6TRUCTION ~ ENERGY ~ ~ ............. ,: ...... ~ERMAL SHOCK PREVENTING CODES. NOT RESPONSIBLE FOR DEVICE9 AS TO PART, 902.6(K~. DASIGN OR QONS~ION pR~gRS ,. (~ of i~ivi~ si~i~ ~TATE BUILOIRG CODE, (~tractor, ~t, ~ate o~c~, etc,) BRENDA M. ~ZCZOTKA.. NMMy PubllO, Bta~e Gl New YMk No, 01$ZSO~2Oel l QuMifisd in SuNolk Couml Commission Expltlm June 24, (Sisnat'ure o1~ Applicaut) 585.00' 8 N86'57'OO~E 100.00 I NO PHYSICAL 80UND$ LAND NOW OR FORMERLY PARKER 33,2' J2.6' 100.00 PARK A VENUE AREA: 25,000 SF / 0.25 CERTIFIED TO: DONALD SCHOLL EASEMEN7~ AND/OR SUBSURFACE STRUCTURES RECORDED OR UNRECORDED ARE NOT GUARANTEED UNLESS PHYSICALLY E~IDENT ON 1HE PREMISES AT THE TIME OF THE SURVEY, GUARANTEES INDICATED HEREON SHALL RUN ONLY TO THE PERSON(S) FOR WHOM THE SURVEY IS PREPARED, AND ON HIS BEHALF TO THE TITLE COM- PANY, GOVERNMENTAL AGENCY AND LENDING INSTITUTIONS LISTED HEREON, AND TO THE ASSIGNEES OF THE LENDING INSTITUTION. GUARANTEES ARE NOT TRANSFERABLE TO ADDITIONAL INSTITUTIONS OR SUBSEOUENT OWNERS. THE OFFSETS (OR DIMENSIONS) SHOWN HEREON FROM THE STRUCTURES TO THE PROPERTY LINES ARE FOR A SPECIFIC PURPOSE AND USE AND THERE- FORE ARE NOT INTENDED TO GUIDE THE ERECTION OF FENCES, RETAINING WALLS, POOLS, PATIOS. PLANTING AREAS~ ADDITIONS TO BUILDINGS AND ANY OTHER CONSTRUCTION, JOB NO, F1261 REVISIONS: SURVEY OF PROPERTY SITUATE AT MA 7-TI TUCK TOWN OF SOUTHOLD SUFFOLK COUNTY, NEW YORK SCALE; 1"=40' DATE: JUNE 15, 1998 S,O,T.M, DISK 1000 S£0. 125 BLK, 2 LOT 51 H~hway 11946 Marc E. Charest, L$. With the records of: Paul T. Canalizoo L.S. 765-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION I ST [ ] FOUNDATION 2ND [ ] FRAMING [ ] ROUGH PLBG. [ ] INSU~.ATION [.~NAL [ ] FIREPLACE & CHIMNEY REM~R#S: .... DATE INSPECTOR 765-1802 BUILDING DEPT, INSPECTION [ ] FIREPLACE & CHIMNEY REMARKS: y~} /~~"~' DATE INSPECTOR 76SJ.802 BUILDING DEPT. INSPECTION FOUNDATION 1ST FOUNDATION 2ND FRAMING FIREPLACE & CHIMNEY [ ] ROUGH PLBG. [ ~.SULATION [,."] FINAL/~ DATE INSPECTOR 765-t802 BUILDING DEPT. INSPECTION [ ] FOUNDATION t ST [ ] ROUGH PLBG. [ ] FOUNDATION2ND [ ] INSULATION [ ] FRAMING [,~INAL [ ] FIREPLACE & CHIMNEY ._~_~:~/'/~~ - DATE INSPECTOR 765-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION IST [ ] ROU~aH-PLBG. [ ] FOUNDATION 2ND [ ,,~INSULATION [ ] FRAMING [ ] FINAL [ ] FIREPLACE & CHIMNEY _ REMARKS: ' ~-- DATE INSPECTOR BUILDING DEPT. INSPECTION [ ] FOUNDATION 1ST [ ]~JGH PLBG. [ ] FOUNDATION 2ND [ i/J INSULATION [ ] FRAMING [ ]FINAL [ ] FIREPLACE & CHIMNEY REMARKS: '"~'~_ DATE /J//7/ I~;:~,,, 'NSPECTOR4(~i~~ 765-1802 BUILDING DEPT. [ ] INSPECTION ' FOUNDATION 1ST [~ROUGH PLBG. [ ]/~JNDATION 2ND [ ] INSULATION [ ~ FRAMING [ · ] FINAL [ ] FIREPLACE & CHIMNEY -----/~-- 1~ ~ I. DATE /~~ INSPECTOR & ~~ 765-1802 BUILDING DEPT. INSPECTION FOUNDATION 1ST [* R~~OUGH PLBG. FO~DATION 2ND [ ] INSULATION ~,]"'FRAMING [ ] FINAL [ ] FIREPLACE & CHIMNEY INSPECTOR 765-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLBG, [ ] FOUNDATION 2ND [ ] FRAMING [ ! .~ULATION [ /~]~' FINAL [ ] FIREPLACE & CHIMNEY DATE/'/'~~/,~/~ INSPECTO~~ PROVIDE SMOKE-DETECTING ALARM DEVICES AS TO PART. 721.1 N.Y.S BUILDING CODE. PROVIDE ANTI-SCALD AND/DR THERMAl. SHOCK PREVENTING DEVICES AS TO PART. 90~.G(K) N.Y. STATE BUILDING CODE. PLUMBING ,'ALL PLUMBING WASTE & WATER LINES NEED TESTING IBEFORE COVERING ,r-x FIELD IS$~'8CTION .I.~__L_-FOET ,.DATE -, ., = ~- ............ ~CO_I'~J~___N~_S_ ............... ~2-' FINAL