Loading...
HomeMy WebLinkAbout22168-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICAT~ OF OCuu~ANCY No Z-23093 Date J~3LY 12, 1994 THIS CERTIFIES that the buildin~ Location of Propert~ 4270 Oi~E~ON ROAD House No. County Tax Map No. 1000 Section 95 Subdivision ADDITION Street Block 3 Lot Filed Map No. Lot No. Hamlet 9.1 conforms substantially to the Application for Building Permit heretofore filed in this office dated J~NE 23, 1994 .pursuant to which Building Permit No. 22168-Z dated JULY 6, 1994 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 A DECK ADDITION "AS BUILT" AS APPLIED FOR. The certificate is issued to JANE RUSSELL (owner, lessee or tenant) cf the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL UNDERWRITERS CERTIFICATE NO. PLUMBERS CERTIFICATION DATED Rev. 1/81 N/A N/A ~Building ~ FORM TOWN OF $OUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N.Y. N-° 22168 Z BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) Date ......................... ~ ............................... ................................................... ~.~/......~.~." .~,..../.~...~ ................... . ........ CounlyTax Map No. 1000 Section ......... .~....~... ..... Block/......~.,...". .......... Lot No. ,.<~...~.,Z .............. pursuant to application dated ...... .......,~..~,.,~...,.~...,~..,...~.. ............ 1 9...~.....~...., and approved bythe Building Inspector. Fee,...~ .......... Rev. 6/30/80 // Building Inspector / No. ~ TOWN OF SOUTHOLD BUlLD%NG DEPARTMENT TOWN ~ALL 765-1802 APPLICATION FOR C£RTIFICATE 0F OCCUPANCY A. This application must be filled in by :ypewriter OR ink and submi[ted [o the buildin§ inspector with the following: for new buildin$ or new use: 1. Final survey o{ property with accurate legation of all buildings, property lines, streets, and unusual natural or topographic features. 2. Final Approval from Realth Dept. of water supply and sewerage-disposal(S-9 form). 3. Approval Of electrical installation from Board of Fire 4. Sworn statement from plumber certifying that the so!de~, used in System l~ss than 2/10 of lZ lead. $. Commercial building, industrial building, mul:iple residences and similar buildings aud installations, a certificate of Code Compliance from archl~e¢~ or engineer % responsible for =he building. 6. Submi= PlanninE Board Approval of completed site pled requirements. B. For exiscing buildings (priOr to April 9, 1957) non-conformtn~ uses, or buildings and Vpre-exis=in~" land uses: I. Accurate survey of property showing all property lines, s~ree~s, building and unusual natural or toposraphic features. 2. A properly completed application and a consent to inspect signed by [he applicant. If a Certificate of Occupancy is denied, the Building Inspector shall sta~e reasons therefor in writing to the applicant. C. Fees i. Certificate of Oc:upancy - New dwelling $25.00. Addi~ions to dwellin~ $25.00, Alterations to dwelling $~5,00, Swimmin~ pool $~5.00, Accessory building $25.00. Addf~ions to accessory building $25.00. Businesses $50.00. ~. Cer~ifieatc of Occupancy on Pre-existin~ Buildin~ - $100.00 '3. Copy of Certificate of Occupancy - 4. Updated Certifica~e of Occupancy - 5. Temporary Certificate of Occupancy - ~esidential $15.00, Commercial $15.00 Date June 21, 1994 Deck · 4270 Oregon Road Location of Property........ ......... .. .... ....................,.....,-.o .... '-''- ''~ .... '' , Arthur M. Russell & Jane H. Russell, his wife, Onwer o= Owners of Froperty ...... .......o............,...,...,,,......,-"' ..... · .......... '' 095.00 03.00 - - 009.001 County Ta~ Map No ~000. Section .............. Block ................ ucc ...................... Subdivision .................................... Filed Map ............ Lot ...................... Be[er S. Danowski, Jr. Permit No.. ............... Date Of Per, it ................ Applicaut ............................. , Attorney for the Russells Health Dept. Approval.' ......................... Underwriters Approval ......................... Planning Board Approval ........................ X Request for: Temporary Certificate ........... Final Certicate ........... Fee Submigted: APPLICANT PETER S. DANOWSKI, JR., ESQ. Attorney for the Russells LAW OFFIOES PETER ~;. DANOW--~KI, JR. 616 ROANOKE AVENUE P,O, BOX 779 RIVERHEAD, NY 11901 (516) 727-4900 FAX (516) 727-7451 'i O\¢VN OF SOU'F~OLD June 22,1994 Southold Town Building Dept. 53095Main Road Box 1179 Southold, NewYorkl1971 Att: Gary Fish, Building Inspector Re: Arthur M. Russell & Jane H. Russell Premises: 4270 Oregon Rd., Mattituck, NY SCTM # 1000-095-03-009.001 Dear Mr. Fish: I enclose herewith completed Application for a Certificate of Occupancy with reference to the deck on the above-referenced property. This document was inadvertently omitted from the package of documents and checks delivered to you by Suzanne Hahn yesterday. Kindly inspect the deck at your earliest opportunity and advise this office as to when the certificate of occupancy will be ready to be picked up. PSD/lis Eric. Very truly ~ JR. (lil} LAW OFFICES PETER .~. DANOW~;KI, JR. 616 ROANOKE AVENUE P.O. BOX 779 RIVERHEAD, NY 11901 HAND DELIVERED (516) 727-4900 FAX (516) 727-7451 June 21 1994 Southold Town Building Dept. 53095 MainRoad Box 1179 Southold, NewYork11971 Att: Gary Fish, Building Inspector Re: Arthur M. Russell & Jane H. Russell Premises: 4270 Oregon Rd., Mattituck, NY SCTM # 1000-095-03-009.001 Dear Mr. Fish: In accordance with your telephone conversation with my secretary, Linda, this date regarding the deck on the above premises, I enclose herewith the following: Copy of survey dated April 15th, 1994, showing the location of the deck on the premises; Completed Application for a Building Permit for the deck; Drawing of the deck in question indicating the size and construction of same; My checks in the sum of $75.00 representing the building permit application fee and $25.00 for the Certificate of Occupancy fee. Kindly process the enclosed documents and issue a Certificate of Occupancy for the deck as soon as possible. A closing on this house is imminent; therefore, kindly call my office when the Certificate of Occupancy is ready, and I will be happy to pick it up. Thank you. PSD/lis Encs. cc. Mr. & Mrs. Arthur Russell 765-1802 BUILDING DEPT. INSPECTION FOUNDATION 1ST [ ] ROUGH PLBG. FOUNDATION 2ND [ ] I~ULATION FRAMING ~/] FINAL DATE INSP 765-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLBG. FOUNDATION 2ND [..] ~.ULATION FRAMING DATE~/~/~ INSPECT~ FOUMD~TIOI! ROUGH FRAME ,'~ ~. '":~.,~ '-.' IMSULAT~ON PER'N. Y. STATE ERERGY CODE ADDITIONA'L COM~ENTS OREGON ROAO N ~$° 41' 40 "E e~/~ sroer WOOD 150. 00' Fd N/F OORSETT FARMS,/NC. DESCRIBED PROPERTY A4A TTITUCK, TOkVN OF SOUTHOLD ffUFFO/K COUNTY, N.Y. ' i SURVEYED FOR, THOMAS At, M4GUIRE ' ~RGAR£T MAGUIRE Fs ~,00~ FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N,Y. 11971 ~ ?.¢.~ TEL.: 765-1802 Examined .... ~ ~" 19 Approved 19 ermit No Disapproved a/c ..................................... APPkI~TION FOIl BUIkDING PEIlMIT BO~(i~D OF REALTII ~--'3 SETS OF' PLA;'~S ~""~ U R V E Y "'"'C 11 Ii E K SEPTIC FORH CALL .............. HAIL TO; - 0~1- .5.. O. ..... Date Jun? .2.1 19 .9.4 INSTRUCTIONS a. This application must be completely tilled in by typewriter or in ink and submitted to the Building Inspector, with 3 se~s of plans, accurate plot plan to scale. Fee according to Schedule. b. Plot plan showing location of lot and of buildings on premises, relationship to adjoining premises or public streets 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 th~s application, the Building Inspector will issued a Bui/d/ng 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 constmctinn of buildings, additions or alterations, or for removal or demolition, as herein described. lhe applicant agre~s~ ,t~,c~y ~w~thiall applicable laws, ordinances, building codon housing code, and regul~ions, and to dmJt authorized insp~c'fors b~'pr~ernises andin ,building for necessarT.~irr~ct4ons.~ / .... ~ (Ston~ a_p?licant,,gr/hafffle, if a corporation) '" "'.'"""":' , PETER S. DANOWS~LI/, JR., ESQ. ,, ,, ~, .0....b9 tq .7.7. ~ ~..R.i.v..e .r.h.e.a.d. ~..N...¥ ....1.1.9. 0..1 ..... (Mailing address of applicant) State whether applicant is owner, lessee, agent, architect, en~neer, general contractor, electrician, plumber or builder. Applicant, PETER S. DANOWSKI, JR., ESQ., is the attorney for the owners Nameofownerofpremises ARTHUR. M. RUSSELL and JANE.H. RUSSELL, his wife, (as on the tax roll or latest deed) If applicant is a corporhtion, signature of duly authorized officer. (Name and title' of corporate officer) · Builder's License No .......................... Plumber's Lice~se No ......................... Electrician's License No ....................... Other Trade's License No ...................... BLDG. DEPT. TOWN OF $OUTHOLD~ 1 · Loca'tion of land on which'proposed work will be done. ' 4270~Oregon Road ........... ' ............................ ............. Mattituck~ N.Y. 11952 House Number '"' Street Hamlet Caunty Tax Map No. 1000 Section -.. ........... 095.00 .... :;i Block 03.00 Lot 009..001. Subdivision ..................................... Filed Map No ............... Lot ............... (Name) 2. State existing use and occupancy of premises and intended Use and occupancy of proposed construction: a. Existing use and occupancy deck ~ - c~> .:~ .................. · ~ 4. ::' %~,&)$,~-,~, ~¥o ,., .~.'..' -' · ;'; -': ......... b. Intended use and occupancy . deck ...., .,~.~,~ ~ ,~a., 's 3. Nature of work (check which applicable): New Building .......... Add tion Other Work.. D.EC.K. ' ..... Repair .............. Removal .............. Demolition ....... ' ......... Alteration . .. · 4. Estimated Cost ........ (Description) ....... $75 09 (to be paid on filing this application) 5. lfdwelling, numberofdwellingunits . N/A Numherofdwellh~...' · If g B[A ............. -..-o -.ars on each floor N ./.&. . arage, nunlber of cars 6. If bus,ness, commercial or mixed ac pancy, Specuy nature and extent of each ne of use .. 7. Dimensions of existing structures, if any: Front ..... ty_ .N/.A ............ .......... Rear .............. Depth .............. Heig ~t . . -, ............ rqnmoer of Stories ......... ~ ............................... . ......... Dimensions of Same structure iwith alterat ons or additions. Front ...... Rear .. . . Depth ....... . Height . · · ' · · 8. mns,ons of entire new construction. Fr--' ~ .,,, .....: Din ' ' ............. ~6; ............ Number of Stones .................. Height . 2g". .......... Nimber of Stories ......................................... 9. Size allot: Front ......... ? ............ Rear ...... ' .............. 10. DateofPurchase .A.[qr±] 3, 1991 ,~,' ............... 'Depth ....... ........ , .......... ' ......... ~ame of Former Owner .J.?.a.n..a..e..n.~ .... ' ............ I 1. Zone or Use district in which p:remises are situated 12. Does proposed Construction viblate any zoni ..................................................... i ng law, ordinance or regulation' O ................... of Architect ... Name ...... ..... i .................. Address ................... Phone No .............. Name of Contractor ........i .............. ' :'..'. Address ................... Phone No ........... ' ' 15. Is this property within:300 feet of a tidal wetland? *Yes ........ No..~ ..... '~"" · If yes, Southold i. Town Trustees Permit may be required. _.. [ PLOT DIAGRAM Locate clearly and distinctly ali buildings, whether existing or pro osed and ' ' property lines. G,ve street and 1 k numb ...... P ' .~nd~cate all set-back dimensions . . , b ac .......... · u ~ · . fr_... interior or corner lot r escnpn°n acc°romg to deed, and show street names and indicate whether ~[L~WINO INSPECTIONS: ~)R POURED CONCRETE 4. FINAk ,,.' ,, STA;FE OF NEW YORK, '"' ' ' COUNTy OF.. SUlr?.qrJ~ ... S.S '''~ *s sR s. OANO S t,ja.., 9 .................. : being duly sworn, deposes and says that he'is the applicant (Name of individual signing contract) above named. , .. . attorney for the owlners, Arthur M Russell and Jane H Russell, his wifd, 'lc is the .. .............. . ' (Contractor, agent, corporate officer, etc.) .............. ,f said owner or Owners, and is duly ~uthbrized to perform or have performed the'said work and to make and 'file this pplication; that all statements contained in this application are true ~o the best of his 'knowledge and belief; and that the ,'ark will be performed in the manner s{t. forth in the application filed therewith.