HomeMy WebLinkAbout23491-zFORM NO. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Office of the Building Inspector
Town Hall
Southold, N.Y.
CERTIFICATE OF OCCUPANCY
No: Z-26234
Date: 01/26/99
THIS CERTIFIES that the building ALTERATION & ADDITION
Location of Property: 425 SKUNK LA MATTITUCK
(HOUSE NO.) (STREET) (HAMLET)
County Tax Map No. 473889 Section 97 Block 4 Lot 1
Subdivision Filed Map No. __ Lot No. __
conforms substantially to the Application for Building Permit heretofore
filed in this office dated MAY 13, 1996 pursuant to which
Building Permit No. 23491-Z dated JUNE 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 ALTER KITCHEN & OPEN PORCH ADDITION TO EXISTING ONE FAMILY DWELLING
AS APPLIED FOR.
The certificate is issued to GREGG M KONARSKI
(OWNER)
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A
ELECTRICAL CERTIFICATE NO. N469331 10/23/98
PLUMBERS CERTIFICATION DATED 01/11/99
J.ZEES PLUMBING & HEATING
Rev. 1/81
· 0~ NO.
TOWN OF
BUILDING DEPARTMENT
TOWN HALL
$OUTHOLD, N. Y.
BUILDING PERMIT
(THIS PERMIT MUST BE KEPT ON THE PP, EMISE$ UNTIL FULL
COMPL£TION OF THE WORK AUTHORIZED)
N.° 23491 Z Date ....~...~. ................................. , 19.~.~
Permission is hereby granted to , // -- /
..... ~,,.~_:_~ ........ ___.._
,~ ~,.~ ~..~~....~~..~~ ..........
.~~.~...~,...~~~....- ~ ~~/~..~~...~
rem~ses J~ate at /
~,~ ~ .~~~~ ..........................................................................
....... ~.....~ ~.~: ......................................................................................
~,,~ ~.~ ~ ~o. ,000 ~.~,,~ ..... ~.2. ......... ,,~ ...... ~ .......... ~, No....Z ................
pu~uant to application dat~ ..... ~ .................................... , 19..~a.d app,ov~ by ~e
Building Inspector.
Fee $.~.~.~...
Rev. 6/30/80
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 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
Ypre-existing" land uses:
· . 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.
1. Certificate of Occupancy - New dwelling $25.00, Additions to dwelling $25.00,
Alterations to dwelling $25.00, Sw{~ming pool $25.00, Accessory building $25.00,
Additions to accessory building $25.00. Bueinesses $50.00.
2. Certificate of Occupancy on Pre-existing Buildinz - $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
~w Construction...~ ...... Old Or Pre-existing Building .................
tion of roperty .... Vi¥ ........................................ .......
House No. Street
O ers of Property. ......
,n~ty Tax Map No 1000, Section .... .~.2 ...... B!ock...~. .......... Lot...~ ..................
'", ~bdivision . Filed Map Lot ................
lalth Dept. Approval....... ......... . ....... .. Underwriters Approval ..................... .. ..
.arming Board Approval ........................ /
:guest for: Temporary Certificate ....... Final Certicate...
Submit~ed: $ ~ ~PP. · ·
Town Hall, 53095 Main Road
P. O. Box ! 179
Southold, NewYork 11971
Fax (516) 765-1823
Telephone (516) 765-I 802
OFFICE OF THE BUILDING INSPECTOR
TOWN OF SOUTHOLD
C E R T,I F'I C A T I O N
Building Permit NO. '2.3
(please print)
(please print)
I certify that the solder used in the water supply system
contains less than 2/10 of 1% lead.
~l~Sl ~nnatU~re~ ~% '
( 'g )
Sworn to before me this
II day of
Notary Public,
JAYNE P. MARTIN
Notary Public, State of New York
No. 7738285
Quah~ied in Su££olk Cow~;y
Commission Expires Jan. 31, 19 Q
County
THE NEW YORK BOARD OF FIRE UNDERWRITERS
1195197 BUREAU OF ELECTRICITY
-- 40 FULTON STREET~ NEW YORK~ NY 10038
Date OCTOBER 23,1998 Applicatlo. No. o. ~le 13393097/97 N 469331
THIS CERTIFIES THAT
only the electrical equipment as described below and introduced by the applicant named oft the above application number is in the premises of
GREG KONARSKI, 425 SKUNK ~, CUTCHOGUE, NY
in the following location; [] Basement [] fst Fl. [] 2nd FI. OUT Section Block Lot
was examined on OCTO]~EI~ 20,1998 and found to be in compliance with the National Electrical Code.
FIXTURES RANGES COOKING DECKS OVENS DISH WASHERS EXHAUST FANS
FIXTURE RECEPTACLES SWITCHES
OUTLETS NCANDESCEN' FLUORESCENT OTHER AMT. R.W. ANT, K,W. ANT, K.W, AMT. K.W, AMT. H.P.
14 29 20 13 1 1
DRYERS FURNACE MOTORS FUTURE APPLIANCE FEEDERS SPECIAL REC'PT. TIME CLOCKS SELL I UNIT HEATERS MULTI-OUTLET DIMMERS
SYSTEMS
AlVa. K.W. OiL H.P. GAS H.P. AI~IT. NO. A. W, G. AMT. AMP. AMT. AMPS. TRANS, ANT, H.P, NO, OF PEET ANT, WATrS
2 - 2 6~
SERVICE DISCONNECT NO. OI S E R V I C E
METER
AMT. AMP. TYPE EQUIP. 1~2W 1~3W 3;tSW S~4W NO. OFCCCOND A.W.G. NO A.W,G. AW, G,
OTHER APPARATUS:
PADDLE
G.F~C.I:-5
SMOK~ DETECTOR: -4
SA. BAT ELECTRIC LIC, #4204-
50 PAT LANE
MATTITUCK, NY, 11952 ~
llGENER L MANAGER
Per
This certificate must not be altered in any manner; return to the office of the Board If Incorrect. Inspectors may be identified by their credentlal..~.~
COPY FOR,BUILDING DEPARTMENT. THIS COPY OF CERTIFICATE MUST NOT BE ALTERED IN ANY MANN
Town Hall, 53095 Main Road
P.O. Box 1179
Southold, New York 11971
Fax (516) 765-1823
Telephone (516) 765-1802
BUILDING DEPARTMENT
TOWN OF SOUTHOLD
December 28, 1998
Mr. & Mrs. Gregg Konarski
425 Skunk Lane
Cutchogue, New York 11935
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.
No Plumber Solder Certificate on file.
(All permits involving plumbing being
issued after April 1, 1984).
BUILDING PERMIT # 23491-Z
Please contact our office on this matter. Thank you for
cooperation.
SOUTHOLD TOWN BUILDING DEPT.
ROUGII FRAHE &
PLUblBING
INSULATION PER N. Y.
STATE ENERGY
CODE
FINAL
ADDITIONAL
765-1802
BUILDING DEPT.
INSPECTION
[ ] FOUNDATION I ST
[ ] ROUGH PLBG.
[ ] FOUNDATION 2ND
[ ] FRAMING
[ ] INS~ULATION
[-~NAL
[ ] FIREPLACE & CHIMNEY
RrMARKS: /~ ~ ~
N765.1802
UILDING DEPT.
SPECTION
[ ] FOUNDATION 1ST [ ] ROUGH PLBG.
[ ] FOUNDATION 2ND
[ ] FRAMING
[ ] I NS~JL-.A*'r~ON
[//~NAL
[ ] FIREPLACE &~C~JIMNEY
REMARKS:
DATE
INSPECTOR
765-~.802
BUILDING DEPT.
[ ]FOUNDATION 1ST
[ ]FOUNDATION 2ND
[ ]FRAMING
[ ]FIREPLACE & CHIMNEY
REMARKS:
INSPECTION
[ R~~OUGH PLBG.
[ ] INSULATION
[ ] FINAL
765-1802
BUILDING DEPT.
INSPECTION
[ ] FOUNDATION 1ST [. ]//.~GH PLBG.
[ ] FOUNDATION 2ND [//J INSULATION
[ ]FRAMING [ ]FINAL
[ ] FIREPLACE ~/~CHIMNEY
REMARKS:
DATE
INSPECTOR
765-1802
BUILDING DEPT.
INSPECT N
[ ] FOUNDATION I ST [ ] ROUGHPLBG.
[ ] FOUNDATION2ND [ ] INSULATION
[ ] FRAMING [ ] FINAL
[ ] FIREPLACE & CHIMNEY
REMARKS: ,~Y.~--~ ~ ~ ~
DATE
INSPECTOR
765-~.802
BUILDING DEPT.
INSPECTION
[ ] FOUNDATION I ST
[ ] FOUNDATION 2ND
[ ] FRAMING [
[ ] FIREPLACE & CHIMNEY
[ ~ROUGH PLBG.
INSULATION
FINAL
REMARKS:
DATE
INSPECTOR
765-1802
BUILDING DEPT.
INSPECTION
[ ] FOUNDATION IST [ ] ROUGH PLBG.
[ ] F/J)U~DATION2ND [ ] INSULATION
[y/J FRAMING [ ] FINAL
[]FIREPLACE&CHIMNEY
DATE
INSPECTOR
765-1802
BUILDING DEPT.
INSPECTION
/
[ ~//OUNDATION 1ST [ ] ROUGH PLBG.
/
[ ~/~ FOUNDATION 2ND [ ] INSULATION
[ ] FRAMING [ ] FINAL
[ ] FIREPLACE & CHIMNEY
DATE ~~//~/?~ ' NSPECTOR //~ ~//~
OCCU[
USE IS
WITHOUI'
BLDG DEPT.
TOWN QF SOUTHOLD~,,~j~
TE~T NG
PLUMBER
CERTIFICATE'
EXCEED 2/;
;(
CANNOT
ON;LEAD
BLD'G. DEP~
b ,.~TOWN OF SOUTHOLD t
:-~.~/~ 1 ~- ..........
~ ...... ~WAS~
~. NEEO
I
FORt4 NO. I 3 SETS OF PLANS ...............
TONN OF SOUTHOLD SURVEY' ........................
BUILDING DEPAR'I~ENT CI1ECK .........................
TOh'N UA1,L SEPTIC FORbl ...................
SOUT, OLO. N.Y.
~LI~hTIO~ FOR B~ILDI~G PgR~IT
INSTRUCTIONS
3 ~ts of p~ans, ac~ra~e plot pl~ to ~ale. F~ accordi~ ~o
struts or areas, ~1 8iv~ a (~ta{]M ~r~pCi~ o~ l~t of ~r~ mst ~ dr~ ~ the di~ ~id~
d. U~ a~al of ~fis a~[~cati~, t~ ~ildi~ ]ns~ctor will is~ a ~ilding ~t to the ~lJcanC.
~iC shall ~ kept ~ tl~ ~s ~ailable f~ {ns~cti~ th~t the ~rk.
A~3~FI~ IS I~BY ~ to~]tlm ~ildlng ~lmrt~nt for the issue of a ~ildi~ Pe~[t ~rmmnt to the
(Si~[e of a~l~cant, or n~, ~f a corl~ra~l~)
(~i[i~ ~rees of ~licanO
.~.~E~ . . ..................
(~ ~ tl~ t~ mi1 or latest d~l)
If a~licant is a ~atim, si~t~m of ~ly ~tlmrir~l officer.
(~ aM title of co--ate officer)
I0;~lure o~ m~k (dwck ~,4dch al~licahle): I~ lk, ildi~g .......... /~klidon ..~. ..... Alter~Hgn
(~ripti~)
l!stl.u~t~l Cost ..ff~/~ ................. f~
(Io Im ~id ~m filing this al~lic~ti~O.
I~i~t ......................... ~dmr o~ Storie~ ......................
l)inen~i~s o~ ~mG stnmture ~ith nlter~ti~ or ~ition~: l~ont ............... l~nr ...............
~pll* .................... I~i~t .................... ~dmr of Stories ...............
l)i,ensi~s of entire ~ ~lst~l-J~: ]~lt ................ I~nr ............... ~pth ..............
I~ilO~t ......................... K~Imr d Slorie, .....................
si~ o~ ~o~: t~ ../~.~.,~ ........ ~ ..lg.~.,.~ ........ ~,,~ .~.~zT..
?~m or u~ diet:riot in ~dd~ pmni~e~ ~ ~it~t~l . J~9.~ ......................................................
~ propel emstnmd~ violnte a~y ~fing 1~. or(li[m~me or regul~ri~: ...~.~. .................
~ill lot Im regr~ ...~ ............ ~ill exee~ eill Im r~] ~(xn pr~ni~8: YES
PI.OT I)I'AGRAH
locate clearly and distinctly all buildings, ~etlmr existing or proposetl, a~l iMicare all aetqmck dimnaiona
property lites. Give stn°.et and block n~Imr or &scription according I:o deed, and Mso~ atreet ha,es a~xl ip~licate
DAT
FEE: ~ BY: ~
NOTIFY BUIL~G OEPAR~T
765d802 9 AM ~ 4 PM FOR THE
FOLLOWING INSPECTIONS:
1. FOUNDATION ~O REQUIRED
FOR POURED CONCRETE
Z ROUGH ~ FRAMING & PLUMBING
3. INSULATDN
FINAL CONSTRUCT{ON MUST
BE COMPLETE FOR C.O.
ALL CONSTRUCTION SHALL
THE REODREMEN~ OF THE N.Y,
~TATE CONSTRUCTION & ENERGY
CO,ES. N~ RESPONSIBLE FOR
OES!GN OB CONS'rRUCT~ON EnRORS
....... ....................... ,,,,,,
(~ ef indivi~udsigni,g corltract)
,~ i,, ,,,~ ............. ~.~.(. ......................................................................
(Cz~nlracter. nl~enl:~ corlx~rate officer, etc.)
of ~mld (~.~r er ~rn. a~d is duly mllll()rizc~l Io ix~rfon, or have i~rl'o[u[~d Ihe ~;aid ~rk a~,l Io nnke a~xl file Ihis
appli(:~tio,; that all statements centair~l in Ibis nHfl icat io, are t n~i to Ihe Imst o[ his k~x~lc~ge
IhaL the ~rk ,itl I~ Imrfon~l ie Ihe ,[ll,~r ~t forth in the al~plical, io, fil~l tl~r~ith.
~[-n, delx)r,e.,~ aM say~; that he is the appl i(~n~l.
~)rn to beg~re.t, I.his J /] _
CLAIRE L. GLEW
Notary Public, Stare of New York
No 4879505
Qualified in ~uflolk Coun~
Commission Expires {)~cember 8, ~ 9
(8ig.at:ff[ff'of ^pl)l ica.t)
103.00'
SKUNK LANE ( BAY AVE. )