The URL can be used to link to this page

Home My WebLink About24394-zFORM NO. 4 TOWN OF SOUTHOLD EUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No: Z-25388 Date: 11/26/97 THIS CERTIFIES that the building ACCESSORY 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 Nc. __ conforms substantially to the Application for Building Permit heretofore filed in this office dated SEPTEMBER 4~ 1997 pursuant to which Building Permit No. 24394-Z dated OCTOBER if 1997 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 ACCESSORY STORAGE SHED IN REQUIRED REAR YARD 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 Bulidi~ z~ls~/~to% 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) N? 2439t Z Permission is hereby granted, to: /7,4~ . ~/~.~.~_~.,~.~/..~ ............... ,~:.:_/...4~/..~...../.Z.....: ....................... ,~.f~...~../..~.4~......~...,..~. ...... z../..~.~ ........ ........... : .............................. ...:... ..................................... at premises located at .............. County Tax Mop No. 1000 Section ......... Z.~,..'~....~. Block .......... ~ ...... Lot No....ff ................ pursuant to application dated .............. ~ .~... ....... , 19...~...Tand approved by the Building Inspector. Fee $ ........................ Rev. 6~30~80 TO~ OF $OUTHOLD BUILDING DEPARTME.NT TOWN HALL 765-1802 APPLICATION FOR CERTIFICATE OF OCCUP~YCY This application must b~ filled in by typewriter OR ink and submitted to the building inspector with the following: for new building or new use: i. Final survey of property with accurate location of all buildings, property lines, streets, and unusual natural or topographic features. 2. Final Approval from ~ealth 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 i% 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 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 dweliimg $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-~xistinR Buildinm - $100.00 3. Copy of Certificate of Occupancy - ~ .25~ 4. Updated Cartifica~e of Occupancy - $50.00 5. Temporary Certificate of Occupancy - Residential $15.00, Commercial $15.00 Date ...~.'t.~.~. ~).¢,t~ ...... ,.. ~D New Construction ........... 01d Or Pre-existing Building ................. ~ocation o~ Prope=y..G. 9.$...¢q'~ .~.~.~...~. g..~.'4..~ .............. . .~..~.TY.~.T..'~..~; ......... House No. Street ~amlet Subdivision .................................... Filed Map ... ......... Lot..,. .................. Health Dept. Approval .......................... Underwriters Approval ......................... Planning Board Approval ........................ Request for: Temporary Certificate ........... Final Certicate.. ~ APPL tCA~N~f 765-1802 BUILDING DEPT. INSPECTION [ ] FOUNn~ATION 1ST [ ] ROUGH PLBG. [ ] FOUNr~ATION 2ND [ ] FRAMING [ ] IN~TION [ ~]"~1NAL []FIREPLACE&CHIMNEY REMARKS:~/~/ ~ S 22'26'50" E ,,, 116.00' ou' · ' 0 d 1-1/2 STORY FRAME ~ HOUSE ~ GARAGE ..... TOI~N OF SOUTHOLD BUILDING DEPARTNENT - 4 TOWN BALL SOUTtlOLD, N.Y. 1197 ! TEL: 765- 1802 Oisepproved a/c .................................. ................................................ A~PLICATION FOR BUILDING PEP, HIT INSTRUCTIONS BOARD OF HEALTH ............... ~-~3 SETS OF PLANS ............... /'SURVEY ........................ /CH~C~ ......................... SEPTIC FORM ................... NOTIFY: Z98- OoWl HAIL TO: .................... a. ~is application n~st be conpletely filled in by type~rlter or in ink ~ submitted to the l~Hldlng Inspector wi 3 sets of plans, accurate plot plan to scale. Fee aconrdit~ to schedule. b. Plot plas sbe~ing l~catian of lot and of buildings on premises, relationship to adjoining premises or publ ic streets or areas, a~d giving a detailed description of layer of property mast be draan an the diagra~ which is part of this application. e. The ~ork covered by this application my not be con~encad before issuance of Building Pemit. d. Upoa approval of this applicatico, the I~ildir~ Inspector will issue a l~aildi~ Pennlt to the applle~,~t. Such pemit shall he kept on the premises available [or inspection thronghout the ~ork. e. No building shall be oeetrpied or used in whole or in part for ~ay purpose whatever until a Certificate of Occutmncy shall have been granted by the l~ilding Inspector. APPLICATIC~I IS t~i ~ to the Building Oepartment for the isananee of a bailding Pennlt pursuant to the Building Zone Ordinance of the Town of Sonthold, Suffolk County, New York, and other applicable Laws, Ordinances or Reg~latieea, for the ecostructico of beildings, additioas or alterations, or for x-~voval or dem01ition, as herein described. The applicant agrees to comply with all applicable laws, ordinances, buildlng code, housing ¢ode,.~. (Signature of applic~t, or r~me, if a corporation) (Mailing address of at~plicant) ~ I fl~ State x4nether applicant is owner, let, see, agent, architect, engineer, general c~trector, electrician, phmber or builder N~e of owner of premises . · (as on the tax roll or latest deed) If applicant is a corparatiou, slgnaL'ure of duly anthorizJed o[flcer. and title of corporate officer) Builders License No ........................... Plumbers License No .......................... Eleetricians License No ...................... Other Trade's License No. ................... 1. lncatlon of land on ~id~ prop~'~d ~ork will be done .............................................................. }louse Number Street It~nlet County Tax Hap NO. 1000 Sectiot, ..... {.\ ~ ..... B1oc.k ...... .~..~.o .... Lot ....~. .......... Subdivision ...................................... Filed Map No ................ Lot ............... (N~e) 2. State existing use and occupancy of premises and intqu~ed use and ocqupancy of proposal construction: a.. ,ting ' .Pat .... ................................ b. Inter.led t~se and oeeupa~--y ........................................ J~¥6',¢~ 18 i~,i~ ;¢d~6q'¢l~t~l~ ......... / 3. Fnmte of work (d~eck ~hid~ al~licable): Ne~ l~Jilding ..~.. ..... ~iti~ .......... Alteratien .......... l~l~li r ............ ~al ............. I~1 it ion ............ Other ~ .................................. ~ript (to Im ~id ~ filing this at~licati~) If garage, ~m~r of cars ...................................... 6. If Ixmhmss, ~mrcial or mi~ ~oq~, s~ci~ ~ture a~vl ~tent of ead~ ty~ oi u~ ...................... =o' =" .~ a'.' .... ~BJ..~.'.~ ...... 7. Di,~nai~s o~ ~i*ring 8rnmtum~, if m~y: ~t..¢ .... .~ ....... ~ar ..... ~pth I~i~t ~ ~ ~t~r of Stories .[.~.. Din~nsi~ of ~m st~re ~ith alterations or a~itions: Front ............... ~ar ............... ~plh .................... t~i~lt .................... ~ld~r of Stories ............... ~9.~.~.. 8. Di,ensia~6~ entire ~ ~sc~ci~: l~t ..... ~ar .... ~pfl~ ..~..~.[.. ~iz,, ..... ..~..,...,. ......... ~,~ of ~,o~i~ ..................... ~. si~ o~ lot: ~t .... U~. ........... ~,~ ..~.~ ............. ~d, ..~} .............. / ,0. .. .. ... ..... ........... .......... II. ~ or ~ district in ~dd~ pr~i~s are simr~ .............................................................. 12. ~s pro,mi comr~ti~ ~iolare any m~i~ 1~, onli~e or mgularim: ..~ ................ I~. ~ill lot t~ ~r~ ...~.~ .......... ~ill ~ss Jill t~ r~ rrm ~ of Ardnlt~C .................................... ~lrcss .............................. ~ ~ ........... ~ of Cmtr~tor ................................... ~ress ............................... ~m ~ ........... 15. ls this p~rCy ~iOdn ~ f~t of a Ci~t ~1~ * ~ .......... PI.OT DIAGRAH I~cate clearly a~xl distinctly all Ix]ildiogs. ~hether existing or proposed, slx! in~]icate all set-lmck di~,easica~s frown property lines. Give Stl~t ant block r~sdmr or descriptic~ according to deed, and shc~ street s~nes a~xl ir~licate t ~f~5 'iaO~ 9 AM ~ 4 PM FO~ FOa POU~D ~ONCRETE ~ ~O~C;H - FRAMING & PLU~4~fNG ~. ,'- :'~:~,L CON~TRUq~ON MUST B~ COMPLETE ~OR C.O. ALL CONf3TRUCTION SHALL TF~E REQUIREMEN~ OF THE CO~P;~S, NOT RESPONSIBLE FOa DEStGN OR CONS~UCTION ERRORS a]xl ~ys that he is the nppl leant I~ is the ....... ' ........... .~..'~...~:~. ....................................................................... · (Cxmlractor~, agent · c~r~)rate officer, ele.) of nald (~er or i~crs, at~l is ~hlly m,thoriz~l to ~rfi.m or ha~i l~rfo~l lira ~aitl ~rk ai.I Lo nnke a~xl file Ibis alq~l icati~n,; that all state~mnts c~tai~.~l in lids al~)licntiou are IhaL the ~k ~ill Im i~rfom~ itQIhe ~mn~r ~t forth in the al~licati<n~ fil~ / ~rn tol~roren~tl,ls // ~O~E~ L ~ O& ~' ............ ~ ~ PuM~ State M ~ ( S i gl ual:t Ir e Of Appl i callt ) ~~ 31. /~