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FORM NO. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Office of the Building Inspector
Town Hall
Southold, N.Y.
CERTIFICATE OF OCCUPANCY
No Z-24184 Date FEBRUARY 26, 1996
THIS CERTIFIES that the building ADDITION & ALTERATION
Location of Property 1645 MARRATOOKA ROAD MATTITUCK, NEW YORK
House No. Street Hamlet
County Tax Map No. 1000 Section 123 Block 3 Lot 1
Subdivision Filed Map No. Lot No.
conforms substantially to the Application for Building Permit heretofore
filed in this office dated AUGUST 2, 1993 pursuant to which
Building Permit No. 21589-Z dated AUGUST 13, 1993
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 ALTERATION & 2ND STORY ADDITION TO EXISTING ONE FAMILY
DWELLING AS APPLIED FOR.
The certificate is issued to WALTER & MARY RAKE
(owners)
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A
UNDERWRITERS CERTIFICATE NO. N-355844 - JUNE 22, 1995
PLUMBERS CERTIFICATION DATED JULY 7,1995-CUTCHOGUE EAST PLUMBING & HEAT.
BL lding Inspector
Rev. 1/81
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FORM NOA
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 Date 19.9-3...
21589 Z
Permisslon is hereby granted to:
~:....../1!~
,v.
!~,9......
to 4.y,......... . 11~ . .......z?!c1y,..,....,f~.........
f~ Ex,lsr: G.~ /.s•aai/y i?~ ir/~......
fps....... %r° PL,E..
at premises located at.......... l.4 ' 1!5W ~t~
000,
.........-y...... 02 sz
County Tax Map No. 1000 Section /1J .;3............ Block .....3 Lot No.
pursuant to application dated X. 19 1.-~...., and approved by the
Building Inspector.
Fee $.3lo am
..l-rrct....
Bui -ding Inspector
Rev. 6/30/80
~ I'otm Ili,. f, ~ i `10N;I OF 'SOUfDOI.u FEB ? 3 1996
BUILDING nrrAlrrtlr.rrr
765-1107 TnWBLDG. JLPT
j N01 SOUTHOI.11
.r..
APPI•I.CA'fION FOIL CBIC'1'JPICAI"1; OF OCCIIPAMY
A. Mir aPpllcatioo must lie filled fit by I.ypor-,rltnr OR ink and sobmltted Co th" huildint
i. rlspector with I:htt fol lowlnl;: for nnw bttIid G,g or new use:
1. final, survey of. property with :lcctI1'n l.rt locnt-foa of n1.1 bul.ldi.ngs, ploporty Iines
streets, find Ifnornn 1. 11r11:U rat. or topogrnph Ir f.entures.
7.. Final Approval.' from Ilviltl.lt Dept, of wafer supply and sewerage-d i.sposnl(S-9 foirn)
7. Approval of e.lectr ic:ul iusta.lln Ci.on from llorrtd of Fire IJnderwrikers.
4. Sworn statement from ipJrnnber cert..ifyimg that: the solder used in system cool.ait's
less than 7/10 of 17, lead.
5. Commercial. buildinjj;, industrial bui.lding, tnulti.pl.u residencer, and simittlr buildl
and instal lations,1" a cerl- ficnt:e of Code Compl.i.ance from architect or engiflenr
r responsible for Lbe Imildi.og. "
6. Submit P1,11 ling Board Approval or. completed s,{t:e plan tequ.iretnunts.
il. For existing ,ui.ldings (prior to A17rl.1. 9, 1957) non-cottf0rtnlug uses, or h1t).lIf i.ngs a
"pre-exi_;t:i_tip" 1-mid uses:
1. Accurate survey of property showfnF all, property 1.ines, streel:s, building gild
unusual na CUt if or top OFra p, is fea tl11 es.
2. A properly completed application nud it consent: to inspect: signed by the opplican
1( a CorLfficot:e of Oc:cupnncy i.r, denied, Ole, Bulldi111; Lnspectur shall sl.nle th"
reasons therefor III wri.t.ing Lo Lhe opplfcnnt. .
C. Fees
1. CerLifica tP. of Occupancy - New dwell.inF $75.00, Additions to dwellITIP,, $75.()0,
Al Ce rati.ons to dweI11.ng $7_i.00, SW i111m)ng pool. c75.00, Accessory build fnl; 575.00
Additions to accessory bui.idiwll $7.5.00. I}nsinesses $50.00.
7. certif.icnle or Uc.cllpallcy on Pre-exi.stiog Buildi.ne - $100.UO
3. Copy of certi.r~cate or Occupancy - $71).00
4. Updated certificate of Occupancy - $50.00
5. Temporm y Certificate of Occupancy - Ices Identinl. $15.00, Commercial $15.00
Uat(, ....)W..z!./../gvI
New constructi.on........... Old Or Yre-exi.sCin> 1SuJIM.n! ,s.........
L
Locat.ioll of l'tullerty..... 1(1.... 1.64.5 M4Cn4f.L?pkq...6
ilouse No. Street p hamlet
Onwer or Owners •E Property..., arY...~. k!o,(tIrx.... X.r'.'t.N.c
County 'Pax 11n1) 1'I0 1000, sectinn.... 23......Block...............Lot........ j........
nbdivisinn......q... .............................Filgqed 14f1p............ Lot.................
PermLL fit) ...2.~.5.$ .7Z,Uate of Permit. .<FM/.r!3..App1{cTnC.:S*Ql]/ey...7! 70rz
11",110, Dept. Appiovnl ..........................Undct'wriCers Approval....................
'tanning Ilo:lyd Approvnl
lequest for: Tcmporlry Certificate......,.... 17 J.nnl Cort 1.c at e... 5...
ed
6V,C-S 81 : J ~ J V
THE NEW YORK BOARD OF FIRE UNDERWRITERS PAGE 1
1135021 BUREAU OF ELECTRICITY
85 JOHN STREET, NEW YORK, NEW YORK 10038
Date JUNE 22,1995 Application No. onfile 82712193/93 N 355844
THIS CERTIFIES THAT
only the electrical equipment" described below and introduced by the appficant named on the above application number in the premises
WALTER KANE, 1645 MARATOOKA ROAD, MATTITUCK, N.Y.
in thefolloming location; ® Basement ® )xt Fl. ® 2nd Fl. GAR/ATTIC/OUT Section Block Lot
urns examined on JUNE 19,1995 and found to be in compliance with the National Electrical Code.
FIXTURE ECEPTACLES SWITCHES FIXTURES RANGES COOKING DECKS OVENS DISH WASHERS EXHAUST
OUTLETS INCANDESCENT FWOIIESCENT OTHER AMT. K. W. AMT. X. W.. AMT. K.W. AMT K.W AMT. 1
42 48 46 1 11.8 1 1.5 2 F
DRYERS FURNACE MOTORS FUTURE APPLIANCE FEEDERS SPECIAL REC'PT TIMF ClOCRS BELL UNIT HEATERS MULTI.OUTLET DMI
AMT, K. W Oft H. P. GAS N. P. AML NO A. W. G. AMi. AMP AMT. AMPS. TRANS. AMT. R p SYSTEMS AMT N
NO, OF FEET
2 1 :1 -1 1 3 1
SERVICE DISCONNECT No. OF S E R V I C E
AMi AMP TYPE METER 10 3W 10 3W130 3W130 4W NO. OF CC COND. A. W. G. NO OF HLIEG A. W' O' NO Of NENRALS A, W.
EOUM. PER a Of CC. COND. OF HFIEG Of NEI_
1 200 CB 1 X 1 2/0 1 2/0
OTHER APPARATUS:
MOTORSt3-F H.P.
G.F.C.I:-6
SMOKE DETECTOR:-1
THREE "C" ELECTRIC LIC,#3325
RT, #1, BOX 45M
SOUND AVENCTE GENERAL MANAGER
RIVERHEAD, NY, 11901 .1I
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 cre,
COPY FOR SUiLDiNG DEPARTMENT. T,'-VS COPY OF CZ':TIFICA.TE MUST NOT RE ALTE'Rra tN ANY MAINVE9.
'TEL. 765-1802
S~FF( TOWN OF SOUTHOLD
H ~ ~r
or{-tcE 017 nUILD{iIG JNSPI.CTOR
`"•rt. ,j P.O. IIOX 1179
TOWN HALL
CD J
SOUT{ tULD, N.Y. {1971 .
C E R T I F I C A T I O N
` Cate /70L
i
` i
I ,
Building Permit No.
Owner
(please print)
Plumber i S mo .c t " C vtL`~oG ve ~45~
(please print) J
i
I certify that the solder used in L-he water supply system
i contains less than 2/10 of to lead.
- (plumber's signature)
Sworn to bePor^ me this
--?-day oL- Tc i.--7 A ,
~
19r Not ry Public
.
t1lotar7 Public, 5~ Fw4r County r:'. JvRCW
Notary- ci Now York
No. 2902160
Qualified in Suffolk County
Term Expires JWtuary 31, 396
I
765-1802
BUILDING DEPT.
INSPECTION
[ ] FOUNDATION iST [ ] ROUGH PLBG.
[ ) FOUNDATION 2ND [ ) INSULATION
[ ] FRAMING [ FINAL
[ ] FIREPLACE CHIMNEY
REMARKS:
DATE 6 L INSPECTOR
765-1802
BUILDING DEPT.
INSPECTION
[ I FOUNDATION 1ST j OUCH PLBG.
[ ] FOUNDATION 2ND ] INSULATION
[ ] FRAMING j ] FINAL
REMARKS:
DATE L l~ INSPECTO
c 2l 765-1802
BUILDING DEPT.
INSPECTION
[ ] FOUNDATION 1ST f J ROU LBG.
[ ] FOUNDATION 2ND INSULATION
[ J FRAMING [ ] FINAL
REMARKS:
p
r
DATE INSPECTO
M-1802
BUILDING DEPT.
INSPECTION
[ ] FOUNDATION 1ST ( ] RO PLBG.
[ ] FOUNDATION 2ND [ INSULATION
[ ] FRAMING [ ] FINAL
REMARKS:
cp i~
4~-
DATE INSPECTOR '
765_1802
BUILDING DEPT.
INSPECTION
[ ] FOUNDATION 1ST [ ROUGH PLBG.
[ ] F NDATION 2ND [ ] INSULATION
FRAMING [ ] FINAL
REMARKS: 5-0,4
pj,j
12 4
DATE /LP)/Mb 3 INSPECTOR 66tA A 74A4Z
r
o~osuFFOC~c
o~
c
Town Hall, 53095 Main Road p _ Fax (516) 765-1823
P. 0. Box 9197i Telephone (516) 765-1802
Southold, NewYork 1
OFFICE OF THE BUILDING INSPECTOR
TOWN OF SOUTHOLD
July 13, 1995
Mr. Stanley Sitarz
71 Hart Avenue
Riverhead, NY 11901
Re: Mary & Walter Kane - SCTM#1000-123-3-1
Prem: 1645 Marratooka Road, Mattituck NY
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 # 21589-2
Please contact our office on this matter. Thank you for
cooperation.
SOUTHOLD TOWN BUILDING DEPT.
o~oSUFFOt,~oo
o~ Gyp
rn x
Town Hall, 53095 Main Road p • Fax (516) 765-1823
P. 0. Box 91971 Telephone (516) 765-1802
Southold, New York 1
OFFICE OF THE BUILDING INSPECTOR
TOWN OF SOUTHOLD
July 13, 1995
Mr. Stanley Sitarz
71 Hart Avenue
Riverhead, NY 11901
Re: Mary & Walter Kane - SCTM#1000-123-3-1
Prem: 1645 Marratooka Road, Mattituck NY
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 # 21589-Z
Please contact our office on this matter. Thank you for
cooperation.
SOUTHOLD TOWN BUILDING DEPT.
~'bUZIDATION _(1st) I
-OUNDATION (2nd} e
ZZ,
2. O / I~Ae -1
ZOUGH FRAME &
-PLUMBING
INSULATION PER N. Y.
STATE ENERGY y - i6
CODE - C%~ cdx~ ! No7 -
• ~ ~ R r
LCP ( L
A, 76-
L
FINAL
ADDITIONAL COMMENTS:
F
c
r
H
v
H
3. Nature of work (check which applicable): New Building Addition Alteration
Repair . Removal Demolition Other Work. tP-btte,l
(Descript
4. Estimated Cost - lw... . Feel
(to be paid on filing this application
5. If dwelling, number of dwelling units Number of dwelling units on each floor
If garage, n :tuber of cars .
6. If business, commercial or mixed occupancy, specify nature and extent of each type of use . .
7- Dimensions of existing structures, if any: Front .....t10 Rear ~dQ Depth 6... .
Height ...25...... - Number of Stories I.- .
Dimensions of same structure with alterations or additions: Front vzmC........ Rear
Depth Height Number of Stories .
8. Dimensions of entire new construction: Front Rear Depth
Height Number ofStories
J1LGOflot: Front Rear Depth
10- Date of Purchase Name of Former Owner .
11. Zone or use district in which premises are situated . .
12. Does proposed construction violate any zoning law, ordinance or regulation: . .
13. Will lot be regraded Will excess fill be removed from premises: Yes
14. Name of Owner of premises Address Phone No- .
Name of Architect Address Phone No.......... .
Name of Contractor 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 distinctly all buildings, whether existing or proposed, and, indicate all set-back dimensions
property lines. Give street and block number or description according to deed, and show street names and indicate wh
interior or corner lot.
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STATE OF NEW YORK, p
COUNTY OF ....SYJ PF> ?4 . _ R . .
Z being duly sworn, deposes and says that he is the app]
(Name of individual signing contract)
above named.
He is the T/~/a / DID . . .
(Contractor, agent, corporate officer, etc.)
of said owner or owners, and is duly authorized to perform or have performed the said work and to make and fill
application; that all statements contained in this application are true to the best of his knowledge and belief; and tha
work will be performed in the manner set forth in the application filed therewith.
Sworn to before me this
..day of ...19 . 9
Notary Pub Lf Jlounty
JOANN MAME IMLLViMS
. . .
Notary public. Stato of New York
No. 52.491&439 (Signature of f ap appli
ovals&d in Suffolk County
Cammisdcn F.>ntlt~s Feb. S„ 9,~- -
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•3. Nature of work (check which applicable): New Building . Addition Alteration
Repair Removal , Demolition V.......... Other Work . ! P4?etf.l "1~
(Description)
4. Estimated Cost I.. Fee 1~...................
(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, specify nature and extent of each type of use
7. Dimensions of existing structures, if any: Front ....."10 Rear ° 1) Depth 44
Height ...•2.5......... Number of Stories ....l.-
Dimensions of same structure with alterations or additions: Front .....n oAC Rear
Depth Height Number of Stories
8. Dimensions of entire new construction: Front Rear Depth
.Height Number of Stories , .
Sizcoflot:Front Rear ......................'Depth
10. Date of Purchase Name of Former Owner
11. Zone or use district in which premises are situated .
12. Does proposed construction violate any zoning law, ordinance or regulation:
13. Will lot be regraded Will excess fill be removed from premises: Yes No
14. Name of Owner of premises Address Phone No............:... .
Name of Architect Address Phone No............... .
Name of Contractor 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. v
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.
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STATE OF NEW YORK,
4.
COUNTY OF ....Sjj PP42
S' yy{ ~ y • • • , R('"2 • - • , being duly sworn, deposes and says that he is the applicant
(Name of individual signing contract)
above named.
He is the... .~/vT/~f~ ! D/~
(Contractor, agent, corporate officer, etc.)
of said owner or owners, and is duly authorized to perform or have performed the said work and to make and file this
application; that all statements contained in this application are true to the best of his knowledge and belief; and that the
work will be performed in the manner set forth in the application filed therewith.
Sworn to before me this ?
o~'. ..day of ...((gGti'~.. r4.. 19 . 9 2.
Notary Public t. • / ounty
U r J!
,IOAN+'1 MARIE WlU .~,~l.s .
Notuy Public, state of New York
No 62-4918439 (Signature of applicant)
Qualified In Suffolk Coil by
Comml3ft E*#% Feb.1~18_c~_
I
s-,
of
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UNDERWRITERS CERTIFICATE
APPROVED AS NOTED 1 REQUIRED
DATE: B.Rf L i 3
I BY' 6a NOT'IFY E: BUIL INCA DEPARIM AT FE AT
4 765.7902 9 AM TO 4 PM FOR THE
FOLLOWING 1. F0 NDATIONP- TWO REQUIRED OCCUPANCY. OR ~I
FOR POURED
2. ROUGH GH - • FRAMING G & PLUMBING USE IS UNLAWFUL
3. INSULATION
4 FINAL-& CONSTRUCTION MUST BE COMPLETE WITHOUT CERTIFIC
BE FOR C.O. I~-{I ALL CONSTRUCTION SHALL MEET
THE REQUIREMENTS OF THE N.Y. OF OCCUPANCY `i
STATE CONSTRUCTION i ENERGY 'MI
CODES. NOT RESPONSIBLE FOR
DESIGN OR CONSTRUCTION ERRORS
PLUMBING
ALL PLUMBING VIASM
i VAnR UNEY NEED n- y
UP TESTING NEFORE COVERING
PLUMBS RT/F/CAT/0N
ON LEA 0 ENT BEFORE ~i
CERTI 70 0 CUPANCY I'
EB11ILSE n-~
I~-
EXCEED 2110 of I% LEAP. cb
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