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HomeMy WebLinkAbout20173-z 1~' FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No Z-20473 Date JANUARY 13, 1992 THIS CERTIFIES that the building ADDITION Location of Property 1415 MARLSNE LANE MATTITUC%, N.Y. House No. Street Hamlet County Tax Map No. 1000 Section 144 Block 3 Lot 5 Subdivision Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated SEPTEMBER 24, 1991 pursuant to which Building Permit No. 20173-Z dated SEPTEMBER 27, 1991 was issued, and conforms to all of the requirements of the applicable provisions of the law. The occupancy for which this certificate ie issued ie ADDITION & DSCR ADDITION TO S%ISTING ONS FAMILY DWELLING AS APPLIED FOR. The certificate is issued to LOUISS & VICTOR SAWICRI (owners of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A UNDERWRITERS CERTIFICATE NO. N-219674 - JANUARY 8, 1992 PLUMBERS CERTIFICATION DATED JANUARY 3, 1991 - Bu'lding~Inapector Rev. 1/81 FORM NO. 4 TOWN OF SOUTHOLD (.f BUILDING DEPARTMENT ' Gy p7~ Office of the Building Inspector I 1 Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No Z-20473 Date JANUARY 13, 1992 THIS CERTIFIES that the building ADDITION Location of Property 1415 MARLENE LANE MATTITUCK, NY House No. Street Hamlet County Tax Map No. 1000 Section 144 Block 3 Lot 5 Subdivision Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated SEPTEMBER 24, 1991 pursuant to which Building Permit No. 20173-Z dated SEPTEMBER 27, 1991 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 AN ADDITION TO AN EXISTING ONE-FAMILY DWELLING AS APPLIED FOR. The certificate is issued to LOUISE & VICTOR SAWICKI (owners) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL NfA UNDERWRITERS CERTIFICATE NO. N 219674 JANUARY 8, 1992 PhUMBERS CERTIFICATION DATED JANUARY 3 1991 ~2!//~ Building Inspector Rev. 1/81 roses xo. s 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~ 2 017 3 Z Date .....`'.~".am.~a,,.....~:1......., 19 R l.. Permission is hereby granted to: j~ ~ ~ ~ p ~--ro .~.°':!po4~l}:S:LS~...a:::t.....~iaQ.R4AMAve...~'t?......~J....~'~:~r.SNr4~...P..7.4:R... of premises located at ..~.x:..ati5.l...... ...S?:1,r1 ...~!.nq~ °4::4'.2.4................. LG...~it.l~':.t'~r..~s4. x..~> County Tax Map No. 1000 Secti ....f.~~ Block ......Q..s?~...... Lot No..d.~ pursuant to application doted ~?~'~.:ta-~r~!+.....°~.T........., 19.`~.~..., and approved by the Building Inspector. Fee ..44.~wt: Bull ing Inspector Rev. 6/30/80 ~ ~ I•'orm No. 6 TOWN OF SOUT[IOLD BUILDING DCPARTMBNT TOWN HALL ~ a~ C" ~~'a ~~~l,`{",``. ' 765-1802 ~ - `~"~3'., APPLICATION POR CHRTIPICATL; OF OCCUPANCY ~.~,.....,...~.e,.~~.. ~_~_;,::r This application must be filled in by typewriter OP, ink and su it rl~~ r~ `(iu',l ~ inspector with the following: for new building or new use: ~~-!t'_'' ~~~%r ~~;,~ing 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 L'oard of Pire Underwriters. 4. Sworn statement from plumber certifying that the solder used in system contains less than 2/10 of 17, lead. S. Commercial building, industrial building, multiple residences and similar buildings and installations, a certificate of Code Compliance from architect or engineer responsible for the building. G. Submit Planning Board Approval of completed site plan requirements. .i. For existing buildings (prior to April 9, 1957) non-conforming uses, or buildings and "pre-existing" land uses: 1. ,lc curate survey of property showing all property lines, streets, building and unusual natural or topographic features. 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. 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 - $5.00 over 5 years - $10.00 4, Updated Certificate of Occupancy - $50.00 S. Temporary Certificate of Occupancy - Residential $15.00, Commercial $15.00 Date ~n:,3,.t49 ':ew Cunstruction...~ Old Or Pre-existin Building., ~ I M !.ocation of Property.. I.f.S..... ~ ~ lrL~`~ZL'L1C.~... _ House No. Street hamlet ;nwcr or Owners of Property....::!~::y:,!!/t3:,~(,(":~'c?f;.~~t:,a7~~, :aunty Ta:< Map No 1000, Section.../ry ~.......Bloclc..., ~,,,,,,,,,,Lot....,,,,,,,,,,,,,, ~ubd[vision...... v~ .PGiled Map............/Lot.. T Pcrmlt :;o.a~~73„~,,,,,Date•Of Permit..9/°7~/(,~.....Applicant~iJ,/1~1.~~.(;~j/~~. ~~C~?~-Ld'7C~ :icallh Dept. Approval ..........................Underwriters Approval......................... ':.innin}; Board Approval......- ~egnest for: Temporary Certificate........... Final Certicate.,!;,,,.... ..oe Submitted: $...~.~:5. ~ ~aa7 APPLICANT '~/~3 rss-isoz BUILDING DEPT. INSPECTION [ )FOUNDATION 1ST [ ] ROUGH PLBG. [ J FOUNDATION 2ND [ ] INSU TION [ ]FRAMING [ FINAL REMARKS: DATE 1 Y ~ ~T ~ INSPECTOR J17~ Tss-1802 BUILDING DEPT. INSPECTIt~N [ ] FOUNDATION 1ST [ ROUGH PLBG. [ ]FOUNDATION 2ND [ ] INSULATfON [~~AMING [ ]FINAL REMARKS: ~~~`-~O c~ t DATE INSPECTOR N' x_ ~x a ~ _ ~ a ~ c N F ~ r p /for ~ ~ p ~~Yw. ~z~~~ X6 , G&rC~i ~ 2 A s, _ ~'~i~j ' rw r~sr 7~~~~ ~-A~~. ~F. X! sT ~ r~ G 9-amou'r' ~~1w c U,G r ~~Y~~ f emu tit 'Lof y3 ..fo ~,u t~~rziatit! ~U~c~r~u,. r xss-is02 BUILDING DEPT. 1 NSPECTION [FOUNDATION 1ST [ J ROUGH PLBG. [ ]FOUNDATION 2ND [ ]INSULATION [ ]FRAMING [ ]FINAL REMARKS ~ ~ ~ DATE ~d INSPECTOR ~~~3 765.1802 BUILDING DEPT. INSPECTION [ ]FOUNDATION 1ST [ ] ROUGH PLBG. [ FOUNDATION 2ND [ ]INSULATION [ ]FRAMING [ ]FINAL REMARKS: / C,~ DATE l INSPECTOR THE NEW YORK BOARD OF FIRE UNDERWRITERS ` 101r.t fY7'1 BUREAU OF ELECTRICITY K i Ig~S JOHN STREET, NEW YORK, N,E,!/V~fY~OfF~K 1.038 1`+'! i t)ki:i tl Date APPlicotion No. on file THIS CERTIFIES THAT only the electrical equipment as described belota and introduced by the applicant Homed on the above application number in the premises of - tr1C9'lNt SA4jl'l:K"I, ;ls{z{I,fTVP~I (,EdtU~;r YhA's,°P~±'i'f1rR: iI_Y, 0! f'1' en the folloteinq locat~a,~yr~~,~iBolsUerrtP~~1.1 ~ 1st Fl. ? 2nd Fl, Section Bloek Lot = uws examined orz and found to be in cornplianee with the regnirerrteats q(this Board. - FIXTURE ECEPTACLES SWITCHES FIXTURE5 RANGES COOKING DECKS OVENS DISHWASHERS EXHAUST FANS OUTLETS INCANDESCENT FIUORESCENi OTHER AMi K W. AMi K W AMi K.W AMi K W AMr H P t 1 °'7 5 'I t3 5 1, y ~ R' DRYERS FURNACE MOTORS FUTURE APPLIANCE FEEDERS SPECIAL REC'PT TIME CLOCKS gEtt UNIT NEATERS MULTI-OUTLET DIMMERS AMT. K. W Oll H P. GAS H. P. AMi NO. A W. G AMt. AMP AMT. AMPS TRANS. AMT. H. P SYSTEMS pMT. WAITS NO.Of FEET I. ~ SERVICE DISCONNECT NO.OF s E R V 1 C E AMT. AMP. TypE METER t tW I %9W 3 %3W dW NO OF CC. COND. A W G NO OF HI-LEG A W'' G NO. OF NEUTRALS A. W. G. EQUIP. PER % OF CC COND OF NIdEG Of NEUTRAL OTNER APPARATUS: tiP?Ql{.F, i)k~l'4l"i`(ikT-1 ,s t: h'T S T'~1U1`If~.CU'T>l~ r,l:C..11'sr~~f~~-E 'z flfYri, ?T.h L ;i±)t,17"ei(1i:b, i~f`f , ~I, i r17 GENERAL MANAGER f 7 (,fv 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 credentials. COPY FOR BUILDING DEPARTMENT. THIS COPY OF CERTIFICATE MUST NOT BE ALTERED IN ANY MANNER. INSPECTORS , . Victor Lessard Jam, r- ~ ~,~,,ri7t:r,;~_ Principal Building Inspectrn ~~((Y~~~,~ ~ : _ Curtis Horton Y k; ~ ' `'',"'.a SCOTT L. HARRIS, Supervisor ~ ~ ~.,;s r Senior Building Inspector ~ ; 1, c. ,tip - Southold Town Hall Thomas Fisher ` ~ P.O. Box 1179, 53095 Main Road Building Inspector r~"~ + , -:.,~;w' r~r~ ~ Southold, New York 11971 Gary Fish Fax (516) 765-1823 Building Inspector -~~~~yy' Telephone (516) 765-1800 V intent R. Wieczorek Ordinance Inspector Robert Fisher Assistant Fire Inspector OFFICE OF BUILDING INSPECTOR Telephone (516) 765-1802 TOWN OF SOUTHOLD DECEMBER 31, 1991 JOHN BERTANI BUILDER INC. 1380 OARWOOD DRIVE SOUTHOLD, NY 11971 R8: MR. 6 MRS. VICTOR SAWICRI To Whom This May Concern: We are unable to complete your Certificate of Occupancy because of the following reasons: RRZ An application for Certificate of Occupancy is not on file. (Enclosed) xxlc No Underwriters Certificate on file. xml 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 # 20173-Z Please contact our office on this matter. Thank you for cooperation. SOUTHOLD TOWN BUILDING DEPT. CC: MR. 6. MRS. VICTOR SAWICBI HENRY J. SMITH & SON, lnc. I~' PLUMBING. HEATING 8 FUEL OIL MAIN ROAD SOUTHOLD, N.Y. 11971 (578) 765-3690 C_E_R_T_I_F_I_C_A_T_I 0 N_ . , Building Permit No.__20173Z_______ j Owner__ Victor Sawicki i Plumber__Henry_J__Smith_&_Sony_Inc_ I certify that the solder used in the water supply system contains less than 2/10 0£ 17> lead. Henry P. Smith Sworn to before me this ~rd_ day of _January____r `~~r~~{,y~_~.~, 19_92_• Notary Public Notary Public, Suffolk County BERNADETTEL.TAPLIN NOTARY PUBLIC 84844893 State of New Yolk • Raidin& in Suffolk COUntY Commission Expires Sept. 30, 19~. ,an.. 1..1 i ~I~ e R's~s-. . 1cLD Ii:S:''C:'_U:J ~~Dni ~I i;ONMENT° 1 . ~ '4 ~ m a =J _ _ FOUIIDATTON (1st) y(!3 - ° it FOUNDATIOIJ (2nd) ~ - - ~ ~ 2. o ~ P,OUGH FRAME & ~ ~ U~ ~PLUMSING ti 3, y a m IJJSULATIOPI PER N. Y, m H 'moo STATE ENERGY CODE x~ a x 4 . li ftJ m ~i' y 1 ,FZiJAL s ADDITIOAJAL COMhfENTS: x • ~ - ' . ~ h, x . G,1 H J o _ z ~ W • > r • H x ~ ~ d - m - H ("~'r ~~~J/p ~ B0.\RD OF HE,\LT8 . D I °`""'~`~4~~~ 3 SETS OF PL.\NS f 1, FORrAN0.1 SURVEY SEP 2 4 +Q91 j~; TOWN OF SOUTHOLD CHECi; . ~ L3~4~ , , • , , ~ - BUILDING DEPARTMENT SEPTIC FOlirl . 6I-DG.~UCI3i~"_"`"~`"" ~ TOWN HALL T©INraUp;;t;,~~•Fit~l~ , $OUTHOLD.N.Y.11971 NOTIFY; TEL.. ~cs•IBOa cnLL ~b5- _1.~9y. Examine .~°Y"l:L:'tl.~t~,a~ 19 g.l r1AIL T0: - ~ ~ - Approvcf~.b.,_p?yl~lR.~ a`I., 199 ~ .Permit No.4?O f ,?,03,~ _ . Disapproved OUalc . (Bu dmg Inspector) APPLICATION FOR BUILDING PERDAIT Date IS:~`~ INSTRUCTIONS a. Tlris application must be completely filled in b rl, • sets of plans, accurate plot plan to scale. Fee accardinY typewriter or in ink and submitted to the Buildir~ Inupector, with j b. Plot plan showing location of lot and of buildin~ schedule. or areas, and giving a detailed description of layout of propertyemustsbeedra~ n on the di~gram whic ~ or public streets cation. part of this appli- e. 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 applignt. Such permit shall be kept on the premises available for inspection throughout the work. e. No building shall be occupied oc used in whole or in part for any purpose whatever until a CertiSgte of Occupancy shall have been granted by the Building Inspector. APPLICATION IS HEREBY MADE to the Building Department for the issuance of a Building Permii pursuant to the Building Zone Ordinance of the Town of Southold, Suffolk County, New York, and other applicable Laws, Ordinances or R~+gulations, 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 reguulatrons, and to admit authorized inspectors on premises and in building for necessary inspections. J.Q(:Ftrl ..~4 T?`~C#~t:~tl...~ii.!'~.6.YL, ..Lc ~t (Signature of applicant, or name, if a corpora><ron) • (Mailing address of applicant) (1~°t ",r State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. ~ u ~ (,f) L`fL Name of owner of premises ..M2`,l-,gvl(2~,,.~d~~2..,.g~~~K1,.....~•.•."'••_•....•••.•.•. (as on the tax roll or latest deed) lCapplicant is a corporation, signature of duly authorized ofIIcer. (Name and title of corporate offccr) Builder's Liccnsc No. . , , ,12,i,(~'~ ~ , , , , , Plumber's License No. ,~?-y,,,,.;~1hyt,(~ ~~ju'?,., - Electrician's License No. ..~t."l. S,,,J1,Q,2.,¢~t~ , , , , OtltcrTradc'sLicensc No. N~A,,,,,,,,,;,,,,, . 1• Location of land on which proposed work will be done; ' house Nuntbcr ~ ~ ~ • ~ ~ • . • ~ SAtrjee~t,~ ••.•••••Hatttlct County Tax ,Atop No. 1000 Section /•/J• Block 8~ • • b Lot Su division Afap i • . fiilcd No. • ~(Namc) Lot.............. 0 • State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existin^ ~ ~ use and occupancy .........~1~~?"..~~1~.lr-b • ~~dc~ b. Intended use and o ~.~~'1.1 • * ~ aura<5~• • . ccupancy ~~Aj~ ;~Lt 9~{~ Y+,V~i t;: ~<;:rt as3,~.., . q<at+ - a L'Y*."~'te a -1 - _ ~ „ 's ;,~,1~~:~5t#r9149J' et~.t s~.~st~"a`4 "P ~ls!~?~`E`{. S4s}~t,~, i! 3. Nature oC work (check which applicable): New Building , , Addition ~ Alteration . Repair , , , , , , , Rpmavial , Demolition ,Swianin ; pool.;... ' Tennis Cour[~ A'ccessor • • • • • • • ~ ~ • ~ • • ~ p y guilding.........,Fence .......Other lJork............ 4. Estimated Cost l~ .d73~ Fcc „ u'i (to be paid on filing this application) 5, 1Cdwcliin~ nuinbcroCdwclling nits Number of dwelling units on each floor . . ICgarace, number oC cars ~ ~ ~ ~ • • • 6. IC business, commercial or mixed it ccupancy, specify nature and extent of each t Qc of use . • • ~ ~ • • 7, Dimensions off existing structures~ iC an Frant . 3 • • ~ • Y: .Rear Depth . z~• . Hci_ht . Numdcr of Stories . ~ ~ • • . • • • . . Dimensions of samo,ctructure wit~t alterations or additions' Front .....•~(.r......... Rear • • • ~ ~ • Depth . Height ~ .........Number o~'Stoncs ....1..._ . . S. Dimensions of entire new constn:ction: Front , , Rear , . Depth . ~3; • • • ~ • Height ` • / • • ~l4....... Number of Slorics . 9. Sizcoflot: Front I Rear Dcpth.........__............ . 10, DatcofPurchasc „ ,NamcofFormcrOwner • 11. Zone or use district in which pret~tises ate situated . I2. Does proposed construction viola~e any zoning law, ordinance or regulation : . l3, 1Vi11 lot be regraded P, , \Vill excess (ill be removed from premises: Ycs ~`f , No~ l4. Name of Owner of premises Nil•(M!K+, UDC , Syau;tuu, ,Address ,77. A~ .Phone No. ~.~F; ;~?z7' . , Name of Architect ,Address .~?'~~E! ~%ty. , !!S~, Phone No.. . Name of Contractor ~'~~Aalt, •`$kt~(~C?S; ~te• , ,Address !~&4 !?@~' ~,Q?ii-r.. Phono No. 7`.~,•+~: lfrr"~:.... IS.Is this property locatled within 100 feet of a ti~c:(etland? ^YI:S._..ti0 *If yes, Southold Town~'ITrustees Permit may be required. PLOT DIAGRAh1 Locate clearly and distinctly all ¢uildings, 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 comer lot. ~ SYa ~_n_~.._.v_a i . . r Q ~2` N ` ~ N ~ 1 I 9 ~ t- ~ li ~ STATHOF\[1VY9RfC, SS COUNTY OF v.~`€~:~~: , . . • • • • • • • • • • • • being duly sworn, deposes and says that he is the applicant • • • • • • • • • •(Natnc oCindividual signitjo contract) above named. ~ ~ , Ffe is the .......~~~ro~~7~:. S9F.:~!4'C'7~. (Contractor, agent, corporate officer, etc.) of said owner or otvncrs, and is duly~~authorizcd to perform or have pcrfotmcd the said work and to make and Gle this application; that all statements contained in ibis application arc true to the best otitis knowledge and belief; and that the twork will be perComted in the manner Set forth in rite application filed lhcrcwith. Swom to bciorc me this i ~ .'P, V • !//j~ ~Z~C~7, .day~of~. : \y\p~.~/r 19 9J. Votary rF~~b~t~:.(aG.t'!!Xl?~~~^~~~..C~rW.. ~!f~fD!-!C• - County CLAIRE4OLEIN ~ ~8 ~9G 6~llbrk V (Si;nature of applicant) CuelMled in Suffolk ~~y _ ,v, ` Commkobti EStP4•e* Dsoemba 410L~ .