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Home My WebLink About17415-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPkRTMENT office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No Z-18883 Date MARCH 13, 1990 THIS CERTIFIES that the buildin~ Location of Property 4895 ELIJAH'S LANE House No. County Tax Map No. 1000 Section 100 Subdivision ACCESSORY MATTITUCK, N.Y. Street Hamlet Block 04 Lot Filed Map No. Lot No. 10 conforms substantially to the Application for Building Permit heretofore filed in this office dated SEPTEMBER 2~ 1988 pursuant to which Building Permit No. 17415-Z dated SEPTEMBER 13~ 1988 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 INGROUND SWIMMING POOL WITH DECK & FENCE AS APPLIED FOR. The certificate is issued to DENNIS & BERNADETTE DEERKOSKI (owners) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A UNDERWRITERS CERTIFICATE NO. N-038248 - OCTOBER 7~ 1988 PLUMBERS CERTIFICATION DATED N/A Rev. 1/81 FOUM NO. B TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL $OUTHOLD, N. Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) N~ 017415 Z County Tax Map No. 1000 Section ...... ~..~.. .......Block .......... ..~.....~.... Lot No ....... .x~.....~.. ......... pursuant to application doted ............ ~,,,'?~-. ........................... , 19~c"~., and approved by the Building Inspector. Fee $../..~ ~ .... ,(....~~ ................ ~B~ I~ector Rev. 6/30/80 TO~H OF $OffTHOL~ SOUTHOLD, NE~ ¥OI~K 765 - 1802 ~/ ~APPLICATION FOR CE~TIFICATn OF OCCUPANCY RE~; CO}~STRUCTIoN ....... OLD OE PRE-EXISTING BUILDING ...... VACANT LA~I) ........ .: Loc~iou of Property .................. ~ ........... ~ ..... (.~.~:_.~ ~ . HOUSE NO. STREET ' ~AMLET Owner or Ownars of Propert { ~ ' ~ ' ~o~ T~= ~ .o. ~000 ~o~ ~ ~o~ ~t.... Lo~' .I.Q ...... SubdiviSion ....................... Filed Map ........ Lot .......... .............. Underwriters Approva~ .............. Planning Board Approval ................ Raques~ for Temporary Ce ificace ..... r~, -. Final Certificate Fee Submitted: $ APPLICATION FOI TO'JN OF SOLITIIOLD BUILDIN(~ DEPARTNENT TOWN 1 lALr,. 765- 1802 CERTIFICATE OF OCCUPANCY INSTRUCTIONS This application muse ,be filed in type~rrltcr OR ink and submitted to tbe Building Inspector with tile oLlowxng; for new buildings or new use; f~ 1. Final survey of property with accurate location of all buildings, property lines, streets, and unusua}l natural or topographic features. 2. Final approval of U~altb Dept. of water supply and sewerage-disposal(S-9 form). 3. Approval of electrical Installation from Board of Fire Underwriters. 4. Sworn statement fro~ plumber certifying that solder used in system contains less' than 2110 of lZ lea~. 5. Commercial buildingS, industrial buildings, multiple resldcuces and similar.' buildings and installations, a eertiflcate of code compliance from the Architect or Engineer respons!ible for ,be building. 6. Submit Planning B0a~d Approval of completed site plan requirements. For existing buildingsj (Prior to April 9, 1957] non-conforming uses, or buildlegs and "pre-existing" lau~ uses: I. Accurate survey of property s ' , .hewing all property lines, streets, buildings and unusual natural or ~opographle features. 2. A properly complete~.applicacioa' a consent to inspect signed by the applicant . If a Certificate off'Occupancy is denied, the Buildln~ Inspector shall state the reasons therefor i~]writing to the applicant. 3. Date of any housing!code or safety inspection of b&ildlngs or premises, or other pertinent information required to prepare a certificate. For Vacant LandCertif{cate of Occupancy: 1. An application for ~acant land Certificate of Occupancy shall be submitted, and a certified abstract of title issued by a title company showing single and separate ownership ~f ,the entire l~t prier to April 9, 1957 shall also accompany the application. If a Certificate of Occupancy is denied, the Building Iaspector shall state the reasons therefor in writing to the applicant. FEES: 1. 3. 5. 6. CERTIFICATE OF 0CC~ANCY -- New ~elling $25.00, Additions to ~elling $25.00, Alteration to ~elling $2~.00, Swimming Pool, $25.00. Accessory building $25.00 Addition to Accessory buildings, $25.00 -'Businesses $50.00. Certificate ef Occupancy on pre-eximtlug dwelling - $100.00. Copy of Certmf~eate of Occupancy - $5.00 - over $ years - $10.00 Vacant Land Certificate of Occupancy - $20.00 Updated CertifiCate of Occupancy - $50.00 Temporary Certificate of Occupnncy -$15.00 Residential Commercial THE NEW YORK BOARD OF FIRE UNDERWRITERS ?: um ~0D'[ ~J BUREAU OF ELECTRICITY ~- BS JOHN STREET, NEW YORK, NEW YORK 1OO:38 Da te /Ipplica tion No. on file only the electrical equipment m ~scrlbed below and int~uced by the applicant ~med on the a~ve application number in the premises of in the followlr~ h catlon~ ~,Basfmen~, ~ Ist FI. ~ 2nd FL 0lit Section Bilk Lot FIXTURE FIXTURES RANGES OVENS DISH WASHERS FANS DRYERS SYSTEMS E R V I NO OF CC COND A W G. NO OF HFLEG NO OF NEUTRALS A,TM PER ~ OF CC. COND, OF HI,LEO OF NEUTRAL GENERAL MANAGER This certificate must not be altered in any manner; return to the office of the Board if incorrect. Inspectors may be identified by their credenfials, COPY FOR ~BUILDING DEPARTMENT. THIS COPY OF CERTIFICATE MUST NOT BE ALTERED IN AHY MANNER. FIELD FOUNDATION I~st) FOUNDATION ( 2nd ) ROUGH FRAME & PLUMBING INSULATION PER N. STATE ENERGY CODE Fi'NAL/ COMMENTS: ~e_cJc C~r~u~& p~l: ]900 ) ¥~'x 1~' ' dec& cs-a'z ¢t/~ HEALTH DEPART MENT - DATA FOR APPROVAL TO CONSTRUCT ROAD (C,R. 27) SURVEY FOR DE~IS DE[RKOSKI 8 BER~DETTE ABERS~ITH AT MATT/TUCK ~ DATE , JUNE 28, 1978 TOWN OF SOUTHO~D SUFFOLK COUNT~, NEW YORK NO, YOUNG a YOUNG 'ALDEN W, YOUNG~PROFESSIONAL ENGINEER AND LAND SURVEYOR N,~S. LICENGE N0.12845 HOWARD W. YOUNG, LAND SURVEYOR ~'R AVEI~IUE NEW YORK BOARD OF HEALTH ...... 3 SETS OF PLANS ....... 'FORM NO. 1 SURVEY .......... TOWN OF SOUTHOLD CHECK .......... BUILDING DEPARTMENT SEPTIC FORM ............. : TOWN HALL $OUTHOLD, N,Y, 11971 TEL.: 765-1803 Disapproved a/c ..................................... (Buffdin= ~rspector) "iMMl::r~l&'r~v,, APPLICATION FOR BUILDING PERMIT ENCLOSE POOL TO CODE UPON COMPLETION BEFORE "WA, TE,q" INSTRUCTIONS NOTIFY CALL ................ MAIL TO: a. This 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 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 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 Permi{. 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 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 regulations, and to admit authorized inspectors on premises and in building for necessary inspections. ~ M ~,~, .t9 .-..tg.~.?.~ F..r.. v.~.o..~.~, _5~...: .............. (Signature of applicant, or name, if a corporation) .o.,..o.e.d...q~'6 · · ~./.zcc/z ..,g. Y ..... (Mailing address of applicant) State whether apl~ltlll~fl~eir 'lds~[';..~e~rit,~fir~hitect, engineer, general contractor, electrician, plumber or builder. ........... ~~- ~. ~,~~g ~. ..................................................... Name of owner °f~d~i~?t'3U~~O}~'~, '' ~ "'k'~ '' v .... ~ . .~l~O5/~ l ....................... (as on the tax roll or latest deed) "IMMEDIATELY,, E"CLOSE POOL ~o co~,~ %o~N CO~PL~T, ON bFORE WATER" Plumber's License No ......................... Electrician's License No.. ~..0. ~...~}f~....~. ¢.C.. Other Trade's License No ...................... Location of land on which proposed work will be done; . .~-.~./..~'.~..Or..'.~.. ~../~..~.-~.~ . . . .~. · .~..~-~../~.~ ..... . . . g. .'~?.4'7. ................. .Z~.4 ./: ,r!ff,.. .4 . .~.,~. .,q. zc. ............ ~. .~. ' .z-~. ./:,. .'z~. .z< ~ .~ . v. ... ..... House Number Street Hamlet County Tax Map No. 1000 Section ..../O..O. ......... Block ..... .~..~. ......... Lot... Z.o. ............ Subdivision ..................................... Filed Map No ............... Lot ...... ~ ........ (Name) 2. State existing use and occupancy of premises and intended nsc and occupancy of proposed construction: a. Existing use and occupancy ....... ~. &.~../~.~. · .Z"/./~..t-:. .............. ~.%L,~.~.J ~l{.~,,.~ .................. b. Intended use and occupancy ............... "' ·; '~ ~,'- · t~- · 'r ..,~ .............. 3. N ture of work (check which applicable): New Building .......... Addition .......... Al?ration . . ..~ ...... Repair .............. Remo~ai .............. Demolition .............. Other Wo~k ....... /O, ..... (De$criplion) 4. Estimated Cost Co~ Fee .... ~. ..... ~. ....... ~ (to be paid on fili~lg~l~B~pplicatiqn) 5. If dwelling, number of dwelling finits ............... Number of dwelling units o ~ each~ ~' ;~ .~ ~;~ · · · iq ~. If garage, number of cars ..... i .......................................... .~'. ~.~ ...................... 6. If business, commercial or mixed occupancy, specify nature and extent of each type of use ..................... 7.. Dimensions of existing structure~, if any: Front ............... Rear .............. Depth ............... Height ............... Number of Stories ........................................................ Dimensions of same structure wi!h alterations or additions: Front ................. Rear .................. Depth .................... ~. Height ...................... Number of Stories ...................... Dimensions of entire new construction: Front .......... . ..... Rear ............... Depth ............... Height Number of Stories Size of lot: Front ...........: .......... Rear ...................... Depth 10. Date of Purchase ........... [ ................. Name of Former Owner ............................. 1 1. Zone or use district in which pre~nises 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 . ~)~'fZr:~./.~.q~<. ~ ..... Address .. ~.~.~..--~C.. ,~,., Phone No .............. . . ~ Name of Architect .... ,~ ..... i ............... Address ......... Phone No ...... ~ Nmne of Contractor. ~./:. ~'~.~.~. ~..~.., i. Address.. ,~,~~.~ i Phone Noli i,~.~.' ~ i/~ r ..(~. 15. Is this property located ~ithin 300 feet of a tidal wetland? *Yes ..... No .~.. · If yes, Southold Town TruStees Permit maybe required. ·l. 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 ~umber or description according to deed, and show street names and indicate whether interior or corner lot..' "IMMEDIATELY? ENCLOSE POOL TO CODE UPON cOMPLETION BEFORE"WATER" OCCUPANCY OR USE IS UNbAWFUL WITHOUT CERTIFICATE OF OCCUPANCY FouNDATION 2. ROUGH - FRAMII~, 3. IN8~ 4. FINAL ' BE cOM~ ALL STATE CONg~ CODES. N~ DESIGN OR C~ STATE OF NEW YORK, (Name of individual signiflg contract) above named ,' (Contractor, agent, corporate officer, etc.) of said owner or owners, and is dulyI 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 mannerlset forth in the application filed therewith. Sworn to before me this ............. of ...... , 1