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Home My WebLink About22250-zNo Z-23249 FORM NO. 4 TOWN OF SOUTEOLD BUILDING DEPARTMENT office of the Building Inspector Town Hall southold, N.Y. CERTIFICATE OF OCCUPANCY Date SEPTEMBER 27, 1994 THIS CERTIFIES that the buildin~ Location of Property 930 OLE JULE LANE House No. County Tax Map No. 1000 Section 114 Subdivision Block Filed Map No. ACCESSORY MATTITUOK, N.Y. Street Hamlet 12 Lot 13.7 Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated JULy 21, 1994 Suilding Permit No. 22250-Z dated pursuant to which AUGUST 11, 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 ACCESSORY STORAGE SHED AS APPLIED FOR. The certificate is issued to (owners) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL UNDERWRITERS CERTIFICATE NO. PLUMBERS CERTIFICATION DATED JOHN P. & LINDA KOWALSKI N/A N/A N/A -- B~ldl~ Inspector Rev. 1/81 FORM NO.3 T01~ OF $OUTHOLD BUILDING DEPARTMENT 1'OWN ~ NO_ 22250 Z BUILDING PEgMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) Permission Is hereby granted to: ..... .............................. ......... .¢.~......~./~..~.....Z...~ .... ....... ~.~. ..~....~~%.~........~, ............ ,o ........ ~.~¢....~...~......~ ~¢--~...,s...o.~.F...,..~. '..C...o...~.,e....~: ~... ....... ',; .......... '~'"', ............................... Z'"",' ';-""7"-'7~, "7' ........................... ...... ~ "~' " "~" /' "/~ ' "7 ........ ~' " '~' ...... '~ f ~'//~ ~i' ~' ~ '~' ' ' ' ' ~' ........................... at premises located ~ .................................................................................................................. ................................................... ~..'~z.~c~ ........... ~.~Z~ ........................... Coun~Tax Map No. 1000 Seofloo..../~ ...... Block.,...d.~ ...........Lot No. .Z.~t...Z ......... pursuant ,o application dated ........................ ~ ~...,..~.~ ....... ~ 9...~.~..., and approved bythe Building Inspector. Fee $...<;~...."rd/.... ~ ..... Rev. 6/30/80 Form No. 6 APPLICATION FOR CERTIFICATE OF OCCUPANCY TOW~N OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL 765-1802 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. Commercial building, industrial building, multiple residences and similar buildings and installations, a certificate of Code Compliance from architect or engineer responsible for the building. 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 applicanl. If a Certificate of Occupancy is denied, the Building Inspector shall state the reasons therefor in writing to the applicant. ~ Fees i. 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 Buildinm - $100,00 3. Copy of Certificate of Occupancy - $20.00 4. Updated Certificate of Occupancy - $50.00 5. Temporary Certificate of Occupancy - Residential $15.00, Commercial $15.00 ew Construction.../.7 ..... Old 05 ilding ................. ocation of Property ..... ?.~.~. ........ O.7~..~-...x~..~..J-.~--...~..~.~ .... .'.f~.~.~.~j. House No. Street Hamlet nwer or Owners of Property..~.O~...~...~Z.~-. .... .~Q~...~.~'2 ................ ounty Tax Map No 1000, Section ..... ((~'.....Block .... 1%'.........Lot ...... {~{P....... erm%t ~o ................ Date Of Pe~t ealth Dept. Approval ........... .. . ....... ... .. Underwriters Approval ........................ . lanning Board Approval ...................... . . equest for: Temporary Certificate ........... Final Certicate...~. ....... ee Submitted: ~kPPL 1 CJ~NT )UltDATION ,.(.~st) 1Uf~DATIO~'! ' (2nd) UGH FRAHE &. .. '.':;.~-"...,-.PLUMBING - .: SULATIO}~ PER'~. STATE ENERGY CODE FI;;AL · ADDITIO~';A'L COM~ENTS: oo Town Hall, 53095 Main Road P. O. Box 1179 Southold, NewYork 11971 Fax (516) 765-1823 Telephone (516) 765-1802 OFFICE OF THE BUILDING INSPECTOR TOWN OF SOUTHOLD August 17, 1994 Mr. John Kowalski 930 Ole Jule Lane Mattituck, NY 11952 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 # 22250-Z Please contact our office on this matter. cooperation. Thank you for $OUTHOLD TOWN BUILDING DEPT. I0 K-. I,R ~f-~ Examined ....~.~//. ....... , Approved ..../.¢~. ...... 19S .~Permit FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N.Y. 11971 TEL.: 765-1802 Disapproved a/c ..................................... ......... I;41 [[ii[ //. (Buildinglnspector) · --,...~.w INSTRUCTIONS BOARD OF HEALTH ......... 3 SETS OF PLANS .......... SURVEY ................... ClIECK .................... SEPTIC FORH .............. NOTIFY= CALL ................... MAIL TO: Date duly 19 19 94 a. Tiffs 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. ~ 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 tiffs application may not be commenced befor~ 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 buildingg, additions or aiterations, or for removal or demolition, as herein described. The applicant agrees to comply with all applicable laws, ordinances, building c_ode, ]lousing code,and regulations, and to admit authorized inspectors on premises and in building for necessa~iop ,~¢~ ~ .9.~q . .Q%e. .J.u.],e. .L.a.n.e.,. M.a.t.1;~..g.u.c.k.,. N.Y. 2,1..9.52 ....... (Mailing address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. Name of owner of premises . .dp.hO..P,. K. pya. 1. s. k.i., .d.r.: .&..a.n.q .. ....................... lt~t~[~t~f[l}.j~S ~}1[~ (as on the tax roll or latest deed) .~'j "~,~.~-~ ~O9_ IFil) DATE: r'2'///~_~2B E #~'~'-~" ~ ' If applicant is a corporation,.signature of duly authorized officer. ~_' ...................................... NOTIFY BUILO[NG DEPARTCgENr (Name and title of corporate officer) 765-1802 9 AM TO 4 PM FOR THE FOtADWING INSPECTIOf'IS: Builder's License No ....... .n~.~. ~pp.l.ic.~b[~¢}~'. ~ ~'~ .~ i:r.~,~}U[:*~T{ON BNO , · " ,, 2 ~%~tI(',I. FF;AM~NG 8t PLUMBING Plumber s L~cense No. ~.n ~:'F'~ ~ ~!~' ~:¢~"W~ cr~ 8~'~ ~ %~¢v ....' ..... ,, ~ o U ~ ~ ~¢~,~;¢ ~ ~-.~,~ ~ ~ 8%~ ~'il~t. CONSTRUCTION MUST lectncmn s Lmense No ................ ¢*~[[}~ '~w~tf~¢'~¢j :¢t¢ , ~ ~, Mt¢~¢, ,s a *~. .~ ,¢~*. ME COMPLETE FOR C.O. Other Trade's L~cense' No. ,, ~¢~¢ ~;**;';~ *¢~¢ ~'~¢ ~'' ~ i':'~"-~' ~ "~' ALL CONSTRUCTION SHALL MEET ..................... THE REQUIREMENTS OF THE 930 0lc dule Lan~, M~T~u~N~RUCTION & ENERGY 1. Location of land on which proposed work will be done ....................... CODES...NOT..~ESeONMI~[~. eEmaU OR CO SmUCnOU ERgO House Number Street Hamlet County Tax Map No. 1000 Section ..... l! .¢ ......... Bleck ...2~ ........... Lot...~'.7 ............ Subdivision Map J:ff. E. hm&a.t&ne. K&ng ................ Filed Map No ............... Lot .... 4 .......... (Name) 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy ...R.e.s.i.dp.n.t~..a.1..apO. hptn¢, ppPpp~;[o0, u~ ...... ,,~, .' m.. · ~; ~ -, ................ b. Intended use and occupancy Residential, home occupation, w.lth acce~se?g(~sl~ed¢ 3. Nature of work (check which applicable):. New Building . ..~. ...... Addition ... ....... Alteration .......... Repair .............. Removal .............. Demolition .............. Other Work ............... 4. Estimated Cost '"rg'~9'L ...... ,.... .......... Fee ..' .................................... I (to be paid on filing this application) 5. If dwelling, number of dwelling !units ............... Number of dwelling units on each floor ................ If garage number of cars ' 6. If business, commercial or mixed occupancy, specff, y nature, and extent of each type of use ..................... 7. Dimensions of existing structureis if any: 'Front Rear .... ; .......................... Depth ............... H.eight .. ............. .. Nungber of Stories .............................................. . .......... Dtmens, ons of same struc0are with alterations.or additions: Front ................. Rear ................ Depth ............. i ...... ~.. Height ...................... Number of Stories .................... 8. Dimensions of entire new construction: Front .... '.~. ~- ....... Rear . . ./..~-. .....Depth ..... !.~.. ,,'. ,, ..... I0. Date of Purchase ~ ~i .......... .'' g~'o' ' ' 11. · ......... ~ ......... ' ........ rmer uwner ................. , .......... Zone or use district in which premises are situated .... /~ Fff..Q ...................... ¢.,(![. .............. 12. Does proposed construction viollate any zoning law, ordinance or regulation: '... ~ 0 ~ .. ~ ... ....... , ................... Will excess fill be removed from preml~'~e,T ,No 14. Name of Owner of premises . ~.~..Q.L t.CA t\'T~. ..... Address . Phnn~l~ Name of Contractor .O. ~ ~6.~( Address Phone No 15. Is this property within 300 feet of a tidal wetland? *Yes ........ No ......... · If yes, Southold Town Trustees Permit may be required. PLOT DIAGRAM Locate clearly and d~stlnctly alllbuildings, 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. oY, ~ o c re~ STATE OF NEW YORK, ~.S COUNTY c~ .-qu ..... 3ohr} .P... 4(~a.l~.k.i.,. dr.. ..... i ................... being duly sworn, deposes and says that he is the applicant (Name of individual signing contract) above named. I1'6 j~ the'. ', qu, ner (Contractor, agent, corporate officer, etc.) of said owner or owners, and is dulYlauthorized to perform or have performed the said work and to make and file this application; that all statements contaihed in this application are true to the best of his knowledge and belief; and that the work will be performed in the manner get forth in the application filed therewith. Sworn to before me thi's ! .! 0