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HomeMy WebLinkAbout18535-z FORM N0. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No 219376 Date SEPT. 20, 1990 THIS CERTIFIES that the building ACCESSORY IN-GROUND POOL Location of Property 385 MARYS ROAD MATTITUCK House No. Street Hamlet County Tax Map No. 1000 Section Y40 Block OZ Lot 33 Subdivision Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated SEPT. 20, 1989 pursuant to which Building Permit No. 185352 dated SEPT. 22, 1989 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 DETACHED ACCESSORY INGROUND POOL WITH FENCE ENCLOSURE. The certificate is issued to JOHN WILCENSKI (owner) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL 14/A UNDERWRITERS CERTIFICATE NO. N108384 DEC. 27, 1989 PLUMBERS CERTIFICATION DATED N/A B lding Inspector Rev. 1/81 108M N0. TOWN OF SOUTHOLD 6UILDING DEPARTMENT TOWN HALL SOUTHOLD, N. Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) N~ .J.. $ 5 3 5 2 Date ...~„1...~~...~ 19.R.(. Permission i~ ereby grant to•a ~ ~ ~ L~~~ ~ to ~,~P ~ p,o at premises located at .....:3ft..'J.~.l......./.' ...{Ac.......tF. County Tax Map No. 1000 Section Block ......2............ Lgort No....r~J...3........... pursuant to application dated ......./~'a 19.~(.., and approved by the Building Inspector. Fee S..~A Vii............... uil 1 to Rev. 6/30/80 Form No. 6 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL 765-1802 ' APPLICATION FOR.CERTIFZCATE OF OCCUPANCY ' .1. This application must be filled in by typewriter OR ink and submitted to the building inspector with the following: far 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 Fixe Underwriters. 4. Sworn statement from plumber certifying that the solder used in system contains ~ less Chan 2110 of LR 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. B. For existing buildings (prior to April 9, 1457) 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 applicant. If a Certificate o£ Occupancy is denied, the Building Inspector shall state the reasons therefor in writing to the applicant. C. 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. L'puated Certificate of Uccupancy - $50.00 5. Temporary Certificate of Occupancy - Residential $15.00, Commercial $15.00 - Date ..~°.C"~:.:.~.t.-s.~...J.9.r...1.g3o....... ::cu Construction........... Old Or Pxe-existing Buil,(d~i~ngg......... Location of Property..,t~8~.......~ ~~a'~. .FI.Jq .............f.!.d.~.....,., House No. n (1, D .Street}, Hamlet Onuer or Ouners of Property., ~J?~wra.~./.W V.A~S~~.r:~M :~i+ County Tax Map No 1000, Section.....! D.....Block.....fl .Lot...w~ ~ Subdivision ....................................Filed Map............Lot.............':... p ! permit No. 9/,?:~~~,,,,Date Of Permit.'. ~~..3+5.,...Applicant.:~RRtA/)~/./. j4~-!I~E~.S'C,S~.. Fieal[h Dept. Approval ..........................Underwriters Approval..,!."..f.~ ~ 3~ Planning Board Approval...... ~j ~ Request for; .Temporary Certificate........... Final Certicate...:....... Fee Submitted: V , p af3~ /l!/,C~J ~/L~ , .APPLICANT .n-r n z ~ S3 7~a a_ THE NEW YORK BOARD OF FIRE UNDERWRITERS f'Ar;r, 1 1UU1}R1 BUREAU OF ELECTRICITY 85 JOHN STREET. NEW YORK, NEW YORK 10038 DECEMHER 17,99N9 APPlicationNo.onfile bblKlkkylk9 N 9~k3k4 THIS CERTIFIES THAT only [ha eleetrteol puipment w dsecrihed 6s/oto and Introduced 6y the applicont nolned on the ohooe applicotion numher in the promLaa q( .)t1MN N1Lt;lENSR'[, MARYS R.17., P09.,F-t, MAT'T9TUt:K, N.Y. in the fo!lowinR ktcation; ? Bosentent ? /xt Fl. ? Ynd Fl. (1IIT Section Block Lot OEQEMSBR 9.1,9.9k9 mae esomined on endfound to 6e in rontplianre with the reyuirementx of thu Buard.~ gXTUM NiAC16 RXTURES RAN6lS COOKING DRCKS OVENS DISH WASHERS EXHAUST FANS WTIRTf INQINDESCEN/ I1V011ESCENi OTNEn AMT. K. W. AMT. K. W. AMi. R.W. AMT. R. W. AMT. N. P. 9 1 L 1 DRYlRS RNt1tAQ MOTORS IUTUIIE At#IANCE tIIORRf fRpAIR K i1PAE CLOCKS Mll UNIT NRAiMS MII111.0UT1lT DIMMERS NAT. R. W. dl N. P. GAS N. P. AMT. NO. A. W. G. NAT. AMP. AMT. AMPS. TRANS. AMT. M. P. ~Of qRT AMT. WAT15 ,r1..ft ~ Ql9 SlRVICE DISCONNECT NO.O? S ! R V 1 C AMT. AAV. TIP! ~ 1/]V/ 1/tW S/1VI 3/AW ~'aER +COND. Of CC COND. NO. OE HI.LEG NO.OP NENxALS Oi ~m11TGMl OiNgt Ar?ARATUS: G.F.C. L:-9 A(SYIMMING PlJOi,) This cc-.rtifirair c~cwers cr~mpli.~ance at r,he data <,1 insper_tic~n only. Because at unusttal environDents it i.a advisable to have frequent test antilar repairs Ix+ed«: by a qua9ified persnn. ~A~ JOUY PUMLLLO [.1.C.~7,10U-E PAT I..ANE MATT9:TtICK, NY, 1.7.951: OEt11RAt. MANAWR 11 Per ~ 1" This certificate mUSt not be altered in Ony manner; return to the office of tM Board if iltcorrad. Inspectors tlwy be identified by tlwir credentials. t0 FOR BUILDING DEPARTMENT. THIS C OP RTIFN:ATE MUdT NOT BE ' TERED IN ANY MANNER. 1Lf. J, 1...... .1:.• tlJh II I::ICi I: IV Ir 1, 1 • ~ II 1 ~ II ?OUtIDAT20:I1 (1st) - ~ _ ?OUWDATIOIJ (2nd} - - I c .'.OUCH FRAI~lE & •PLUMB21J0 c 3 . m n I17SULATION PER N. Y. I -a STATE EPIERGY CODE I V H ' _ FILIAL 41 40 o-~ ~ ~ C.o. ~ ~G ADDITIOIIAL COM*fEtITS: L Ln. ~4n A_ _U A~iiA~+O W AIL T • b ' H a . H H O m } _ r • - ~ y. . • v m .9 -a ' ~ TEL. 7G5-182 p`}~~FO~ ~~G';~ TOWN Ur SOUTfi0Li3 ,?'(;r;~j'~(?,,"~~ 4< orr1cl. or• ~uILDiNC trrsrrcrorz O~ O~ SOIIT~IiOLD, N.Y. 1 1971 Sept. 19, 1990 JOHN WILCENSKI 385 MARY'S ROAD MATTITUCK, N.Y. 11952 To Plhcm This May Concern, 4.e arc unable r.o con:pletc your Certificate of Occupancy because oL the folloc~ing reasons. An application for Certificate of Occupancy 15 not cn fil.c. (ENCLOSED) /^I No Undcr;ariLcrs CcrL•ificatc on file. /,'t'he ctiecF; .i:: (~i4R7EXi~not nn file.) $25.00 D:o Ilcal.th Dept. Approval on file. / / C:o final in~I'•~c:t:ion hn:: becri made. Please contact: our office on this matter. ' Thank you for your cooperation. f;uil<lir:q Pcrm.i,t-. Ik I 8 5 3_5 Z Builclinq Dept-. +*kJ~/ t!o Plt:mtcr Solder Cert.ificatc on file. ' ( all poLrtiiC:; involving plumbing being .issued after <~Yri.l 1,1984 ) . - ~ _ , . e w t Mt' LS. ^Y _'rv. A p~i Tw i >Ny.. £ dM I^" ,~y` ,.A d ~_ry r ~{`r 1 } y a ~ ' c M Y+ d } ) ~ ~ i s w . } r ' r! ~ t er +:k a: n a ~ t ) 4 4 ~L'. 1 r S r i A f 4d' zz„ '~Y ~~x r t v * b . ~~Y. 1n . ~ r r x'~., ~a - ' Ub P _ _ ~{j~] ) f' ; ` .l `"M,.".,Af xlad i~¢...~~ b~k~~~Mrq+t. 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IUD BUILD.iNG DEPARTMENT SEPTIC FORM T©WN HAL•L NOTIFY B;.DG. DEp7; SOUTHOLD, N.Y. 11977 . . . . . . . TQWNOFS30TH0-p~.~ TEL.:7G5-1802 MAIL T0: Examined q/n 2........., 19 .~t. /~T Approved 19~. Permit Nol- Disapproved a/c ~~IMMEDIATELY" / ~ ENCLOSE POOL TO CODE ^ UPON COMPLETION of BEFORE "WATER" o. Bu- m Inspector) APPLICATION FOR BUILDING PERMIT c~ ry Date ....././XC' 19 INSTRUCTIONS a. Tltis application must be completely filled in by typewriter or in ink and submitted to the Building Irspector, with 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 street or areas, and giving a detailed description of layout of property must be drawn on the diagram which is part of this appl catitan. c. 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 applicant. Such peTTtt 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 Occupant 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 th Building Zone Ordinance of the Town of Southold, Suffolk County, New York, and other applicable Laws, Ordinances c Regulations, for the construction of buildings, additions or alterations, or for removal or demolition, as herein describes The applicant a,rees to comply with all applicable laws, ordinances, building code;~tousing~cgc~~zand regulations, and t admit authorized inspector; on premises and in building for necessary inspections. tilt l#.B .........r.-~.~, ' . '~I'+`= (Signature of applicant, ot;'naFrte, if a corporation) ~~..,f.~..,....r..- , j ~ ; .n~~.. Y~ L~~.. i~l~~~f~ rX...~.~ Legs ~A TVi~A+1TISA`ITt1 r~N!!],ltk-_`. Y-Y"';. y,~~ ~~jr w;~r, 4th ~ ca` (l~failing address of applicant) State whether~~~~tvner„,leaskefag~r~t,farchitect, engineer, general contractor, electrician, plumber or builder ...........~tp} s.,r11.. L~~ Name ofownefi8~:Rsi[+>!S~xL4=? .:~~iC7:)fN........~~i.4cE?y~l~s ~ vi ~ : 5~;arar}". (as on the tax roll or latest deed) - N.i.. IqT"~t'1) ~ If w pile n is ~~o ~ s ~ ~ ~ afuthorized officer. (Na ` to fficci•) ALL CONT tJST- 6 ~SUFFOL~t, COUNTY LICENSED Ut~~°i~~~b„B~ Builder's License No. ....`~..',12, ~ , , Plumber's License No . t ~~,3~~ ~J~t((\~~''i ~~~~A~~ Electrician's License No . ®6do,1~~d~~~VY Otltcr Trade's License No . . r_ 1. Location of land on which proposed work will be done. .......~~~j= /c.~J~rr ...?r1j ~:~7 <<L~~r'C • - ? i ' 'T House Number Street ~ Hamlet County Tax hlap No. 1000 Section Lot - l yU....... Block Subdivision .Filed \1ap No. Lot . (Name) State existing use and occupancy oC premises and intended use and occupancy of proposed construction,:~~~,,,) a. Existing use and occupancy ~'!-%r: ~ ~C~;~;! , , , , , _ , , b. Intended use and occupancy .................rl. ~ ~.~~-~'r,!!?~- - ,w, ? , , , ~~1J L; 3. Nature of work (check which applicable): New BL (ding Addition Alteration , ' Removal Demolition Other }Vork~`td`.'???pv Rcpau (Deserip t) 4. Estimated Cost .....~,-~.......y............ Fee ` (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. It business, commercial or mixed occupancy, specify nature and extent of each type of use . 7. Dimensions of existing structures, if any: Front Rear Depth . Height ...............NuntberofStories.................,..................................... Dimensions of same structure with alterations or additions: Front Rear . Depth ......................:Height Number of Stotics . 8. Dimensions:of en¢Ye.nety construction: Front Rear Depth , . Height . ~ . i"..C'; ~'~'_F ~ :Number of Stories . 9. Size of lot: )~Ypnt Rear Depth . 0. Date of Purchase ......:......................Name of Former Owner . Zone or use district in which premises are situated fu.L: . Does proposed construction vioiate any zoning law, ordinance or regulation: t~:1~ ...............,..~x 3. \Vill lot be regraded Ni11 excess fill be removed from premises: a~ Nc 4. Name of Owner of. premises I~:.tL.C~:: tt ~ ...Address ~2l.~T.x.~T~4 fC.. Phone No . Name of Architect Address ...Phone No.... . Name of Contractor CL SOlL--~ d~ • ~ 1 .............Address /C~9.. .Phone No. l: 5. Is this property located within 300 feet of a tidal wetland? *Yes No *If yes, Southold Town Trustees Permit may be reqgu~ired. PLOT DIAG1tAM Locate clearly and distinctly alI buildings, whether existing or proposed, and. indicate all set-back dimensions froirl roperty lines. Give street and block number or description according to deed, and show street names and indicate whethei tterior or corner lot. "{MME©{ATEL.Y" ENCLOSE pOOLTO CODE r~~r'y,~,GG.~~.RN~... 33S UPON COMp1,ETi01$ DATE: BEFORE WVATER'~ NOTlFY3o 0 6W 766-t8t32 9 AM t0 4 P111F FOLLOWING lNSPECTlON3: accu~A~cv oR 1. FOUNDATION - T'WeDWEWMEQ FOR POURED CONCRETE ~ n`~r 2. ROUGH -FRAMING ?R PL(lMSING US~ ~S UNfAWFUL 4, flNALA~ coNSTRUCT1pNMtlsr BE COMPLETE FOR C.O. li~ITH4UT CERTI~tCATE ~E~~R'~ QF OcCUPANGY s` DESIGN OR CONSTRi1CTlON EAT10R8 iATE OF NEW ~RI:~r~ `rte S.S ~~~zY(/or- .....4.t , , , , , (y ~}ta~kM tts,`..... ~-f=.?.4 L.`'1......~'.Z , being duly sworn, deposes and says that he is the applicant (tiatnc of individual signing contract) ovc named. ;s the ...................C~:"`.T. Ft:•7.~'?~:~2............................'.......................... (Contractor, agent, corporate officer, etc.) ' said owner or owner, and is duly authorized to perform or have performed the said work and to make and file this plication; that alt statements contained in this application are true to the best of Itis knowledge and belief; and that the irk will be performed in the manner set forth in the application Glcd therewith. ;orn to before me this nary Public, /7`S-~?r~ , , ,~~?:rl~'....... County NO1tWYPU&~1C~Sh~Mot~fden~ (Signs a applicant) Na 470787& Suffolk Taw Expires Msrcl~ 30,1