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Home My WebLink About23802-z i FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No: Z-25480 Date: 01/12/98 THIS CERTIFIES that the building ADDITION Location of Property: 1150 JASMINE LA SOUTHOLD (HOUSE NO. ) (STREET) (HAMLET) County Tax Map No. 473889 Section 69 Block 3 Lot 24.13 Subdivision Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated NOVEMBER 8, 1996 pursuant to which Building Permit No. 23802-Z dated NOVEMBER 11, 1996 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 SECOND STORY ADDITION, ALTERATION TO AN EXISTING ONE FAMILY DWELLING AS APPLIED FOR. The certificate is issued to RICHARD P. & DENISE WITZKE (OWNER) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A ELECTRICAL CERTIFICATE NO. N-33004 10/13/94 PLUMBERS CERTIFICATION DATED 01/02/98 HENRY SMITH PLUMB.& HEAT. r Bu ding insr#ctor Rev. 1/81 FORK NO. a 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° 23802 Z Date ...1///........................................... 19.11JW /� * � 310r Permission is hereby gronte � .P...'.... ........................ /cSO .. to ��!'ly. .... !. I. . � .... ...... ... ... . ......ra.:�...... .... at premises located at ..../� .. .... . . .......4 ........................................................ ..........................................................U.!. ......................................................................... ................................................................................................................................................................. County Tax Map No. 1000 Section �,/�....... Block Lot No. pursuant to application dated .. .....9.................................., 19........, and approved by the Building/Inspector. Fee $...?,.... ilding nspector 0/30/80 FORM NO.3 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD,N.Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED)) Date ... ....... ......... ................................ 19. N2 22310 Z Permission Is hereby granted to; c �..1................rte.:..`.��........ to ........ .....f.;k:......:v� '..Q.v: 44.........�51. 0.iz>. ...................... 14:..�?..?�..1. 1 ..!..a.nl..y....(A..1.`7-�.r�..Af.t.0.ru.... �� ez.7'-�—.(..S�fc�?.n�.. c. . ..1 ...�,(',1.W4.A".1.r.......... G.wg.....�4 .5,...�4 .atz..................................................................................................................I............. ........... .................................c........................./,... r............... at premises located at....,....d•• ,J..�.......�,.J../�.,S.��./ e...... �If.7.. ��—............................. ..........................................�� .................................. County Tax Map No. 1000 Section ........ ........ Block.....�............... Lot No. r�.) �.•. 3........ pursuant to application dated ............ � 19.. .r�....... and approved by the Building Inspector, _ r Fee$..t.?..°`.!........ Building Inspector Rev. 6/30/80 1 rocm No. b y � TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL 765-1802 APPLICATION FOR CERTIFICATE OF OCCUPANCY A. 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. 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 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, Swimming 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 - .25C. 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.X. . . . . . . . . . . . . . y/ / Location of Property./Am. . . . . . . . . . .. . . . . . .� !�!� u ! . . . . . . . . ..SP.WA,?f.G,t . . . . . . . . House No. Street l Hamlet Onwer or Owners ofProperty./f.!�hd/t��'/ . . . . . . . . .`.. . . . . . . . . . . . . . . . County Tax Map No 1000, Section. .b 1 . . . . . . . .Block. . . �� . . . . . . . . . .Lot. . .�./:./-? . . . . . . . . . . Subdivision. . . . . . . . . . . . . . . . . . . . . . .. . . . . . . . . . . . .Fii(led Map. . . . . . . . . . . .Lot. . . . . . . . . . . . . . . . . . . . . . Permit No,?. Q•1 v.7.S2-r. .Date Of Permit.�-g:.�D. . ( . . . . .Applicant..•&G 4..4 . . 1 �� •`C HealthDept. Approval. . . . . . . . . . . . . . . . . . . . . . . . . .Underwriters Approval. . . . . . . . . . . . . . . . . . . . . . . . . Planning Board Approval. . . . . . . . . . . . . . . . . . . . . . . . Request for: Temporary Certificate. . . . . . . . . . . Final Certicate. . . . . . . Fee Submitted: $. . &..G U . . . . . . . . . . . . . . . . . . G!SnY . . . . . . . . . . . . . . . . . �(.. ADPL T THE NEW YORK BOARD OF FIRE UNDERWRITERS PAGE 1 1000744 BUREAU OF ELECTRICITY F 85 JOHN STREET, NEW YORK, NEW YORK 10038 Date OCTOBER 13,1944 Application No.onfile 06518894/94 N 33004 THIS CERTIFIES THAT only the electrical equipment"described below and introduced by the applicant named on the above application number in the premises of RICHARD WITSKI, JASMINE LANE, SOUTHOLD, N.Y. in thefollowinglocation; ® Basement ❑ Ixt FI. It 2nd Fl. Section Bloch Lot was examined on OCTOBER 11,1994 and found to be in compliance with the National Electrical Code. FIXTURE FIXTURES RANGES COOKING DECKS OVENS DISH WASHERS EXHAUST FANS OUTLETS ECFPTAClES SWITCHES INCANDESCENT FLUORESCENT I OTHER NAT. I K W. I AMT K W. AMT. I K.W. T. I K.W. AMT. H P 8 19 10 8 DRYERS FURNACE MOTORS FUTURE APPLIANCE FEEDERS SPECIAL REC'PT TIME CLOCKS I BELL UNIT HEATERS I MULTI-OUTLET DIMMERS NAT. K.W. OIL H.P. GAS I H.P. AMT. NO, A.W.G. AMT. AMP. AMT. AMPS, TRANS. AMT. H.P . SYSTF FEET EMS AMT. WATTS SERVICE DISCONNECT NO.OF S E R V 1 C E AMT, NAP, TYPE METER EQUIP. tW I,R tW 3,e'3W 3%AW NO.OF CC GOND. A.W.O NO.OF HbIEG A.4/G NO OF NEUTRALS A.W.G. EOWP. PER% OF CC.COND. OF HI-LEG CIA, f NEUTRAL OTHER APPARATUS: MOTORS11—F H.P. G.F.C.It-1 SMOKE DETECTOR:-1 RICHARD G. RELYEA LIC #2148—E P.O. BOX .372 LAUREL, NY, 11948 GENERAL MANAGER This certificate must not be altered'in any manner; return to the office of the Eoord if incorrect. Inspectors may be identified by their credentials. COPY FOR BUILDING DEPARTMENT. THIS COPY OF CERTIFICATE MUST NOT BE ALTERED',IN ANY MANNER. } fl ..■I I ii t�i i JAN 6 c Sof --__ w, �yOti� OG C s� }'_ ,� BLDG. DEPT. c . ` o Fax 516 765-1623 (, Town aall, • (n 2 s ( 1 P.O. Box 1179 j d .r} Telephone(516) 765 18 Southold, New York 11971 OFFICE OF THE BUILDING INSPECTOR _ , TOWN OF SOUTHOLD ` ' C E R T I F I C A T I O N 1: Date: January 2, 1998 Building Permit No. 32 8022 Owner: Richard Witgke Plumber: Hgmy Smith I certify that the solderused in the water supply system contains less than 2/10 0 1 " 1%lead. (P 1�01ers Signature) Sworn to before me this day of Cn _, 19 L3 Notary Public, Suffolk Co�lnty/] 11eMM� 1t � I �o��gUFFO(kcoGy� Town Hall, 53095 Main Road oy Z Fax(516)765-1823 P. O. Box 1179 u- nr Telephone(516) 765-1802 Southold, New York 11971 fig, dol � Sao OFFICE OF THE BUILDING INSPECTOR TOWN OF SOUTHOLD December 31, 1997 Richard P . Witzke 1150 Jasmine Lane Southold, N.Y. 11971 To Whom This May Concern: We are unable to complete your Certificate of Occupancy because of the following reasons : XX An application for Certificate of Occupancy is not on file. (Enclosed) No Underwriters Certificate on file. XX The check is (not on file. ) $25.00 No Health Department Approval on file. No final inspection has been made. XX No Plumber Solder Certificate on file. (All permits involving plumbing being issued after April 1, 1984) . BUILDING PERMIT # 22310-Z Please contact our office on this matter. Thank you for cooperation. SOUTHOLD TOWN BUILDING DEPT. DL�.. ��,'.� w �V�1 I'Jh 1 .. II ... . .......T q�..h.'_•-• C^Y.!-.. •• :T+.^� .-.�. .., M D i.•.. �..: • i:Oh(ML• NT� 111DATION fist ) �17DATI01! y (2nd ) m 'CH FRAME & '.rcurlBauc m ULATION PER N. Y. I y STATE ENEROy If CODE n •Y Ix IL m FINAL ADDITIONAL COMMENTS : x o rSS:•.,:—si..hr-aaSo:.wrr..:.., :•«.�liaii•:.-.;.e.:_•.. . .. -. .. . .. � _ .^ ... .., .. H .:J+):1.1i 765-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION IST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ;],�INLATION [ ] FRAMING [ FINAL [ ] FIREPLACE & CHIMNEY REMARKS: d �� DATE h �3 1�� INSPECTOR M-1802 ILDING DEPT. 1 SPECTION [ ] FOUNDATION IST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] INSU ION [ ] FRAMING [ INAL [ ] FIREPLACE & CHIMNEY REMARKS: J un G DATE INSPECTOR D LS nw�,k BOARD OF HEALTH . . . , O UV FORMN0. 1 3 SETS OF PLANS . . . . , '• TOWN OF SOUTHOLD SURVEY . . . . . _ . . . . . . _ Z 1994 BUILDING DEPARTMENT CHECK . . . . . . _ . _ _ , , , , TOWN HALL SEPTIC FORM _ Btu SOUTHOLD, N.Y. 11971 TEL.: 765=1$02 DEPT . 7. It0'c I FY ; Examined1. `f CALL 7A:':4??;7, . .4+0/? . / ..... / stnlL To: Approved . . . . . / . . . .. 19��Permit No. lqo `0 . . . . . . . . . . . . . . . . . . . Disapproved,a/c ./. . . . . . . . . . . . . . . . . . . . . . _ . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . g I . . . . . . ' (Building p cto r) AP (CATION FOR BUILDING PERMIT / Date X14? „//. . . . . . . . .. 19P INSTRUCTIONS a. This application must be completely filled in 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. I b. Plot plan showing location of lot and of buildings on premises, relationship to adjoining premises or public stieets s or areas, and giving a detailed description of layout of property must be drawn on the diagram which is part of this appli cation. c. The work covered by this application may not be commenced before issuance of Building Permit. d. Upon approval of this application, the Building Inspector will issued a Building Permit to the applicant. Such permit shall be kept on the premises available for inspection throughout the work. e. No building shall be occupied or used in whole or in part for any purpose whatever until a Certificate of Occupancy shall have been granted by the Building 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 comply with all applicable laws, ordinances, building code, housing code, and regulations, and to admit authorized inspectors on premises and in building for necessa sp ti _ . . . . . . . . . . . . . . . . . . . . . . (Signature of applicant, or name, if a corporation) /!s'9 J4 t?? (Mailing address of applicant) //4 7/ State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. QW. .>!?J . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Name of owner of premises //?!G, . . . . . . , . . . . . . . . . . . . . . . . (as on the tax roll or latest deed) If applicant is a corporation, signature of duly authorized officer. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . (Name and title of corporate officer) Builder's License No. . . . . . . . . . . . . . . . . . . . . . . . . . Plumber's License No. . . . . . . . . . . . . . . . Electrician's License No. , .?��e� ., • , , , . , • _ , . Other Trade's License No. . . . . . . . . . . . . . . . . . . . . . 1, Location of land on which proposed work will be done. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .J.i9 l ,l V . . . . . . . . . . . . . So U /e . . . . . . . . . . . . House Number . . . . . . . ... . . . . . . . . . . . . . . . Street Hamlet County Tax Map No. 1000 Section d.(2 . , , , . • , , , • Block . . . . . . . . : . . . Lot . . , , Subdivision . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Filed Map No. . . . . . . . . . . . . . . Lot . . . . . . . . . . . . . . . (Namc) , '_. State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy / C{�`: . U / . . . . . . . . . . . . . . . . . . . . b. Intended use and occupancy E ;r„2C r, to 3. Nature of work (check which applicable)- New Building . . . , � € •�'"" Repair . . . . . . . . . . . . . . Removal " Addition . .!� . . : . . Alteration . . . . . . . 4, Estimated Cost , , , / � vo p I' . . - ." ' ' Demolition . . . . : . . . . . . . . . Other Work . , , , , , , , , , , • . a (Description) . " " . . . . . . . . . . Fee . . . . . . . . . . . . . (to be paid on filingthisapplication) 5. If dwelling,number of dwelling unils . • . , If garage, number of cars ' ' ' • N. mfr of dwelling units on each floor .. 6. If business, commercial or mixed occupancy, s specify y p ' ' ' ' ' ' ' • g g rt y nature and extent of each tyke of use . r, 7 Height of existin stn.Martens, if any; Front . 3S y,'; , , , , , , . Rear 35r.... . . . ... . . .. 7 . . . . . . . . Depth .?5 O. :.'.13;'�f' . Number of Stories . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .Dimensions of same structure with alterations or additions: Front • ?X' 5! °, , r' Depth ZY i?" _ ?S `y; . . . . . . Rear .3i .3 . . . . . . . . . . . Height . . . . . .. , , , . . _ , . Number of Stories . . . : . Z.. 8. Dimensions of entire new construction: Front'. ' ' ' • ' , • • • Height . . . . . . . . Numt er of Stories . . • . . . . . . . . . . • Rear . . . . . . . . . . . . . . . Depth . . . . . . . . . . . . . . . 9. Size of lot: Front . Rear . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 10. Date of Purchase .�7.t�,v , >rpN` liy. . Rear Depth . . , . . . . . . , Name of Former Owner Ae 5V,✓ic 11. Zone or use district in which premises are situated . . . . . . . . . . . . . 12. Does proposed construction violate any zoning law, ordinance or regulation: . t r<2 . . . . . . . . . . . . . . . . . . . . : . . . . . . 13. Will lot be regraded . . .. . . , , , , , , , , , , , , , , , , , , Will excess fill be removed from premises: Yes 14. Name of owner of Name of Arch tect��}e �Se(v'! ke � � ' ' Address !!,fid,� ,�??/, e, , , , phone No. 7.�$ std y9 . . . . . . . . . Address f N . !c( a �1 LfL!�+�P14. . . Phone No.Y7,?:of!yt? 15. lasnthis f property Southold ,.`� . . Address 144VZ/Ul ;t.r . . . . . Phone No. . . . . . . . . . . . . . .. 00 feet of a tidal wetland? *Yes, • , , , , , , No. . . . . . . . . own Trustees Permit may be required. PLOT DIAGRAM Locate clearly and distinctly all buildings, whether existing or proposed, and,indicate all set-back dimensions from property lines. Give street and block number or description according to deed, and show street names and indicate whether interior or corner lot. PIr,�2sC S.FE copy � f' sli'cl.�w�'y� s k�js/ir.� I I j ;TATE OF NEW YQR 'OUNTYOF . �s ,c S.S • • . . . . . bein.-duly sworn, deposes (Name of individual si nin n ' ' ° ' Y p ses and says that he is the applicant bove named. g ¢contract) `e is the . ... . �eC�Nf✓. . . . . . . . . (Contractor, agent, corporate officer, etc.) F said owner or owners, and is duly sutltorized to perform or have performed the said work and to make and file this )Plication; that all statements containicd in this application are true to the best of Itis knowledge and belief; and that the ork will be performed in the manner set Torth in the application filed therewith. vom to before me this ay . . ttaryPublic, . . . . . . . . County . , , , , flOtAR6 9 Boaffffqq I� y (Signature of applicant) term res l y31,]9, J 1 4 OF HEALTH SUFFOLK COUNTY DEPARTMENT OF 14EALTH SERVICES SUFFOLK FOR APPROVAL OFCOUNTYRTMENT CONSTRUCTON ONLYERVICES t9 SINGLE FAMILY DPELLJ,� NLY Approval of onstruc e or H.S.s 6l � DATE � . REF. NO. H.D. Ret. 110. 'he sewage d;s^osal auu water supply facilities at this location ;ave been sa. , aae i1y ;nsaacted by this Department ano are APPROVED n compliance wah these as-mnit plans EC--0 21993 a . C07;�8 l Ff. DATE CHIEi OF. GENERAL ENGINEERING SERVICES SURVEY OF LOT13 }A/.4BLDG. DES / Oul,ra -WAP ViLAS� SEC770NTW0" TpS 4NN Or----..®OLP� FLED AUG 4,1993 F&ENO. A-434 A T SOUTHOLD TOWN OF SOU THOLD , SUFFOLK COUNTY; N. Y. , 1000 - 70 - 01 — P/06 Scale- 1" =40' Mar. 22, 1993 'Aug. 17, 1993 (foundation) Nov, 19, 1993 (final) The water supply and sewage disposal' systems for this residence will conform to the standards of The. Suffolk Counly Department of Health Services. tip�„M'af>'S- r � � Prepared in accordance wJlh the minimum '.,� " .V. rra LIC. NO. 496/8 standards for title surveys as establisheda f' by the L.GA.L.S. and approved and adopted PECONIC P.C. for such use by The New York Slate Land (516) 765 "�~Z , Title Association. P. O. BOX 909 MAIN ROAD ' SOUTHOLD, N.Y. 11971 Y _ , ` 4.. " T ZI �`rs s �O4) s� T 13 �� io IC J ' •'Y �. \tel zl tiy' 2,.( _ AREA = 15,630 � O •0o• qa 1L ti F \ J �p ��.. .r •� 3SS83, +�N Qom/ t b° Z41V lit =;The locations of wells and cesspools ECEva nous ARE REFERENCED shown hereon are from field observations TO V MONS AO REFS. and or 1Pom data obtalned from others. RE 'Wilt Zea zF x / 3 , 77zD LEI Xaa � =F 1 N 15- 4 11 - tui CxjTINW4 SS ,� tr 41 P4` _ Sze Cvw-n f . 7YTBR?'4P ,y- iu - STHGTt;tl,nir �!-T'R�1L W I C- L.7G N�i:G--3 'Cfi—2 t�0?-1-7 . - �-APk4 l4,3) _aK1.�TPRL 1 IISt SnShir+c Lrt.+0 hiSo•a'/F:oi'P tSl.c,C,H-T ��L `LF .'W A-Lc� �. ...__ t2k- �q •�< a.FT tl is'd�J�" "ANCY OR � ' USE IS UNLAWFUL h)"ITHOUT CERTIFICATE PLUMBER CERTIFICATION OF OCCUPANCY ON LEAD CONTENT BEFORE CERTIFICATE OF OCCUPANCY D I� SOLDER USED IN WATER l T ; SUPPLY SYSTEM CANNOT J,] t �R EXCEED 2110 of 1% LEAD. � hf:�7`�t�Pfr+P _ `I A /p D AS NOTED v I clT r DATE: �B.R kFOR FEEi ��- BY:NOTIFY BUILDINGEH OappN tubing it used785.7802 9 AM TD Q for water distributing - FOLLOWING INSPECTIONS. systmg piping shall be 1. FOUNDATION TWO REQUIRED pt" K OT L onlyt FOR POUR' D �hJS7 _ _ RE COM ETF F O PLUMBING ALL _ THE COO STF-h ENS STALL MEET ALL PLUMBING VWSIE p THE yREOUIREfEM1?5 OF Tt}E, N.Y. i WATER LINER NEED �tr f STATE\C.ONSTRJCT!GN & ENERGY t l A i .. TESTING BEFORE CDVERIN6 , -- ,. r' ; t ' CODES. NOT RESPONSIBLE FOR �y n - s�. I. 7a DESIGN OR CONSTRUL"m ERRORS i P11011r 477-0400 " ' fikil Itt,,t.} �4 . . ,r- UNDE WRITERSCERTIFICATF r}pracs�•-( —: ''W. -:"'"""' � .. REQUIRED y i - t ,t