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Home My WebLink About25151-Z FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No: Z-28270 Date: 03/13/02 THIS CERTIFIES that the building ACCESSORY Location of Property: 3615 DEEP HOLE DR MATTITUCK (HOUSE NO. ) (STREET) (HAMLET) County Tax Map No. 473889 Section 115 Block 16 Lot 19 Subdivision Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated JULY 16, 1998 pursuant to which Building Permit No. 25151-Z dated SEPTEMBER 1, 1998 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 SHED AS APPLIED FOR. The certificate is issued to EILEEN ORLOWSKI (OWNER) of the aforesaid building. SUFFOLK COUNTY DEPARTtiENT OF HEALTH APPROVAL N/A ELECTRICAL CERTIFICATE NO. N/A PLUMBERS CERTIFICATION DATED N/A -4 y- ;�Z- or' ed Signature Rev. 1/81 FORM NO. 3 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) PERMIT NO. 25151 Z Date SEPTEMBER 1, 1998 Permission is hereby granted to: EILEEN ORLOWSKI 3615 DEEP HOLE DRIVE MATTITUCK,NY 11952 for CONSTRUCT AN ACCESSORY BUILDING IN THE REAR YARD AS APPLIED FOR. at premises located at 3615 DEEP HOLE DR MATTITUCK County Tax Map No. 473889 Section 115 Block 0016 Lot No. 019 pursuant to application dated JULY 16 1998 and approved by the Building Inspector. Fee $ 35 .00 B 1 n Inspector ORIGINAL Rev. 2/19/98 - D 0 Form No.6 TOWN OF SOUTHOLD i jo8 BUILDING DEPARTMENT TOWN HALL 765-1802 APPLICATION FOR CERTIFICATE OF OCCUPANCY This application must be filled in by typewriter or ink and submitted to the Building Department with the following: A. 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. 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, 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 applicant.If a Certificate of 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. Photocopy of Certificate of Occupancy-$0.25 4. Updated Certificate of Occupancy- $50.00 5. Temporary Certificate of Occupancy- Residential$15.00,Commercial$15.00 Date. D New Construction: 1/ Old or Pre-existing Building: (check one) Location of Property:,� � �!°_c°D 6 � ,✓e_ l ig; House No. Street Hamlet r Owner or Owners of Property: '�,o Suffolk County Tax Map No 1000, Section /�� Block z 62 Lot / Subdivision Filed Map. Lot: Permit No. Date of Permit. Applicant: , �e.v Di�/D/�SiG Health Dept.Approval: — Underwriters Approval: Planning Board Approval: Request for: Temporary Certificate Final Certificate: (check one) D Fee Submitted: $ �� 1 o G `� pplicant Signature JJDATE COHMENTS R3 -v _ m =OUNDATION ( 1st) 91?OUNDATION _ (2rrd)-- _-- 0 Gs . s ROUGH FRAME & -PLUMBING ' • y'0 3 M INSULATION PER N . Y. .1 STATE ENERGY CODE x a 3 r J 4 . FINAL .00 E x M ADDITIONAL COMMENTS: x` . M ov Z H T .. C7 M ,b rn 9 M BOARD OF UZALMI . . . . . . . . . . . . . . . Il FORM NO. 1 3 SETS OF PLANS . . . . . . . . . . .. ... TOWN OF SOUTUOLD SURVEY .. .. .. . �tk i b BUILDING M PARTMENT CHECK ....... . . . . . . . . . . . . . . . . . . TOWN HALL SEPTIC FORM . . . . . . . . . . . . . . . . . . . BLLLG. DEPT. SOUTI101,09 N.Y. 11971 TOWN 01:SOUTHOLD J TEL: 765-1602 NOTIFY: CALL . . .. . . . . . . . . . . . . . . Exanined...... /-w. l.l.. 19. iMAIi. TO: . . . . . . . . . . . . . . . . . . . . A}>fhrovcYl.......l[ 19 .� Penni t No. 5� / ..........I........................ . Disapproved a/c ........... ................................... . (lush lns Cor) , APPLICATION FOR BUILDING PERMIT INSTRUCTIONS a. '[his application must be completely filled in by typewriter or in ink and sainitted to the Building inspector wi 3 sets of plans,.accurate plot plan to scale. Fee according to sdhedule. b. Plot plan shoving location of lot and of buildings on premises, relationship to adjoining premises or phdhlic streets or areas, and giving a detailed description of layout of property neat be drawn on the diagram Which is pnrt of this application. c. 'llie work covered by this application rosy not be conmenced befora issuance of Building Permit. d. Upon approval of this application, the Building Tnspector will{ issue 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 viiole or in part for any purpose whatever until a Certificate of Occupancy shall have been granted by the Building Inspector. APPLICNrION IS lEIiI:iIY MADE to the Building Department for the issuance of a building Permit pursuant to the Iluilding 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,jand to admit authorized inspectors on premises and in builds necessary i Cigna. ... .. ................. (Si rtieture to!§lapplicant,,,oc.Mfto if a corporation) 7. Y a } ra State wlhether applicant is owner, lessee, agent, architect, enginee> ¢�p�s 5 i.clan, plumber or lxmilde f !'-1TT;`.3.+ + f "SJR+ES'�,C T ............ y ¢ 1 y ..................... Name of owner of premises ..... J. l-tV... . ........................ (as on the tax roll or latest deed) if applicant is a corporation, signature of duly authorized officer. ................................................ (Name and title of corporate officer) Builders License No. ......................... Plumbers License No. ......................... Electricians License No. ..................... \ Other Trade's License No. ................... n �7 1. i[xation of land on wllidh proposed work will be deme....,Gt�P �C.�.I.C..yJ<�..,./C:./. ..... ........... lalS.....................Pnr. /�r, Jr................... �`�'1.:.�:?:a.l�............... ....... lbuse Number Street hamlet County Tax Hap No. 1000 Section ....4 11 .... Block ...../.A...... hot .....,�.�7...... Subdivision ...................................... Filed Map No. ............... lot ............... (Name) 2. State existing use and occupancy of premises and interred use,ard occupant' of proposed construction: a. Existing use and occupancy ...... .TP1: ?�.7e......... ......................................... b. Inteoded'use and occupancy ........... :e........................................................ Y, 3. Kuure of work (d%eck wiiid% appliC6108 New Iluilding ...X...- Addition .......... Alteration .......... helm i r ............ Removal .............. Ikmol i tion ............ Other Work .......... ................... (Description) �.. 4. Eathieted Cost .1.�.w/.......... fee ........ (to be paid no filing tills application) S. if &telling, txni*r of d+elling %,nits ...... .... lksiber of dwelling units an each floor ....... Ifgarage, tx■ther of caro ...................................... 6. 1f Ixtshtess, commercial or mix edoccupancy, specify nature and extent of eadt type of use...... 7. Dittensiops of existing strictures. If any- Front......//.ZZ.... Rear .../ZL� ..... Depth ./4) ........... IlulgltC ..........4,F............ Nutber of Stories ....I....... Dinensiops of sous stnucture with alterations or 'adlitionst Front ......r /`^�, Rear Depth ................ . tri tt .... •�• gl ... Nunlper of ?tortes ............... S. Mettensiops of new ew eonetructiont Front ^-. / .....1 rZ.:..... hear l A.�.... Depth ... Ilei tC !� ..........t3.............. N;niter of Stories ..... 9. Size of lort Front ........ ... Rear ......... ,D .� Z 1(l. Date of Purchase .....7,.1'1��.�-Name of Footer Owner .....' Depth ...... 11. Zone or use district In %bid% premises are situated .........1 /.�2..............`.............................. 12. Does proposed co%stnrtion viola a any zoning law, ordinance or regulation: ........!)!o............ Ia. Will lot he regraded .,.,., O....... W 1 excess fill be removed �from premises: YES , ND 14. Nares of Owner of premises !��t:�!. /�JS.c; Wrese ..... .. ...... Ntope No. .7,��:�� Nate of Architect .........................' ........... Address .............................. Name of Contractor ................................... Address .................. I5. Is this property within 300 feet.of a tidal wetland? * YES .......... *LF YIDS, swat m ma 14Zi1SIl s mmrr MAY m Itil pIRM- . hLOT DIAGRAM - locate clearly and distinctly all buildings. w6etlter existing or proposed, and Indicate all set-beck dimensions from property lines. Give street and block ember or description according to deed, and allow street nares arxl indicate %Atether interior or corner lot. AP ROVED AS NOTED DATE: 3/ B.P.B o2 S'/ FEE: 3 " _BY TIFY NOBUILDING DEPARTM AT 7811-1802 8 AM TO 4 PM THE O IFOUNDATION - TWO REQUIRED OCCUPANCY OR FOR RED CONCRETE 2. ROUGH- FRAM & PLUMBING USE IS UNLAWFUL 3.4 FINAL�� CONSTRUCTION MUST WITHOUT CERTIFICATE BE COMPLETE FOR C.O. OF OCCUPANCY ALL CONSTRUCTION SHALL MEET �Jv THE REQUIREMENTS OF THE N.Y. S'^TE CONSTRUCTION & ENERGY t . T S NOT RESPONSIBLE FC'i SI'Alli Ur N•,1► Y(MoQtStGN OR CONSTR C.TION ERRORS ()7lINIY (Mr ..............s(�GFUL/c Ntue-T7—. /L�'...fj.:................lxing duly sworn, deposes arxl says that he is Ute appl.ienw. (Mie of Individual signing contract) above natted, Ile is lite .......1�./ ! ...................... ................. • ........................................ (Contractor, agent,-corporate officer, etc.) of said (m)er or owners, mud is duly authorized to perform or have performed lite said work axl Co make and file this 1117tl leattot; that all statettettts contained in this application are true Co die beat of his larowledge and 1)61ief; mtxl that lite work will be performed in tine manner set forth in Lite application filed therewith. Jworn to before me this /.5 '.......day of ..iT(:L:�.......19..y .. Notary Public ..................................... SS / 7 y'` (5hgont:ure of Appl.lcaot) / NON ATE OF NN YORK �69FFOLK COUNTY - COMMISSION EXPIRES JUNE 30,lilt7`� DEEP .� 140 1020'10"W. 29 4-+0 7'heresa prive C ,t Ol � L N 14 �.— oo U Is � `' � �- tn ON- D I