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Home My WebLink About26932-Z FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No: Z-29081 Date: 11/14/02 THIS CERTIFIES that the building ALTERATION Location of Property: 625 MARRATOOKA LA MATTITUCK (HOUSE NO. ) (STREET) (HAMLET) County Tax Map No. 473889 Section 115 Block 4 Lot 5 Subdivision Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated JULY 13, 2000 pursuant to which Building Permit No. 26932-Z dated NOVEMBER 16, 2000 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 ALTER EXISTING GARAGE TO LIVING SPACE IN AN EXISTING ONE FAMILY DWELLING AS APPLIED FOR. ("AS BUILT") The certificate is issued to MARY K KOLAKOWSKI (OWNER) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A ELECTRICAL CERTIFICATE NO. 1052811 05/17/02 PLUMBERS CERTIFICATION DATED 11/01/02 EDWARD R SCHILLER c t ri d Sig ture 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. 26932 Z Date NOVEMBER 16, 2000 Permission is hereby granted to : MARY TYLER PO BOX 733 MATTITUCK,NY 11952 for . AS BUILT ALTERATION OF EXISTING GARAGE AS APPLIED FOR. at premises located at 625 MARRATOOKA LA MATTITUCK County Tax Map No. 473889 Section 115 Block 0004 Lot No. 005 pursuant to application dated JULY 13 , 2000 and approved by the Building Inspector. Fee $ 75 . 00 Authorized Signature COPY Rev. 2/19/98 jForm No.6 L 3 2002 TOWN OF SOUTHOLD a J BUILDING DEPARTMENT TOWN HALL ✓`^� `� v `1, 1� 765-1802 T '.'>`d CA 'o'IiJSNOLD APPLICATION FOR CERTIFICATE OF OCCUPANCY S S�"3 �, S 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 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. Copy of Certificate of Occupancy-$25.00 4. Updated Certificate of Occupancy- $50.00 5. Temporary Certificate of Occupancy-Residential $15.00, Commercial $15.00 Date. q / Z-A O Z New Construction: Old or Pre-existing Building: (check one). Location of Property: (So a S /'"' r2t r r -w 4-oz�, o lz House No. Street Hamlet Owner or Owners of Property: CV S J� Suffolk County Tax Map No 1000, Section ) 1 S , U o Block ( y - 0 D Lot (0 (D J'• O f Subdivision Filed Map. Lot: Permit No. 'L (p g 3 2 Date of Permit. Applicant: /t r-7 Health Dept. Approval: Underwriters Approval: Planning Board Approval> Request for: Temporary Certificate Final Certificate: (check one) Fee Submitted: $ (__ 0 Lagog ) n n G (o).9-/� Applicant fdre_ ' MARY K. KOLAKOWSKI 625 Marratooka Lane Mattituck, NY 11952 (631) 734-5127 (631) 734-5142 fax (631) 284-1801 pager May 8, 2002 Southold Town Building Department 53095 Main Street Southold, NY 11971 Re: Premises 625 Marratooka Lane, Mattituck Building Permit No. 26932Z Formerly owned by Mary Tyler Gentlemen: I am now the current owner of the above referenced premises. I hereby request that you extend our building permit for a few months. Our final inspection is scheduled for 5/16 and we are due to expire soon. Very truly yours, MARY KOLAKOWSKI /mk I � rr nY 9 2j 2 1 HOLD F04 Town Hall, 53095 Main Road C* Fax(516)765-1823 P. 0. Box 1179 W- Telephone (516)765-1802 Southold, New York 11971 OFFICE OF THE BUILDING INSPECTOR TOWN OF SOUTHOLD C E R T I F I C A T 1 0 N DATE: JI- )- e5a, Building Permit No. 26 23-) Owner: &,&2 (please print) Plumber: Z-,Ootlwo (please print) I certify that the solder used in the water supply system contains less than 2/10 of 1% lead. JPlumbei7s -S1`gnature) - Sworn to before me this 'A day of 41;� , i4-106'1' Notary public, Count LYNDA M. BOW NOTARY PUBLIC, State of New No.0 1 B06020932 Volk C7 Qualified in Suffolk Counly Term Expires March 8, 20�a O rJ�rJ�rJ��Pr�rJ�rJ�cn�nrJ��PrJ�i PrJ�rJ�r:ll li J�rJ�rJ�rJ�rJ�rJ�r�rP�Pr nrJ�rJ�rJ�rJRRPfflffl-PLffl EJr nr�r:111:1 J�rJ�rJ�rJcPcPr�i r�1-r�rJ�rJ��nrJ�r rr rPrJLPLII o SBY THIS CERTIFICATE OF COMPLIANCE THE 5 5 NEW YORK BOARD OF FIRE UNDERWRITERS 5 SBUREAU OF ELECTRICITY 5 5 40 FULTON STREET — NEW YORK, NY 10038 C� 5 CERTIFIES THAT 5 Upon the application of upon premises owned byMARY 5 5 5 5 I RI 625 MARRA OOLALANE 25MARRATOOLA LANE S 5 MATTITUCH,NY 11952-3509 MATTITUCK, NY 11952 5 5 55 Located at 625 MARRATOOLA LANE MATTITUCK, NY 11952 5 Application Number: 1052811 Certificate Number: 1052811 5 5 5 C5 Section: Block: Lot: Building Permit: BDC: NS11 55 Described as a Residential occupancy,wherein the premises electrical system consisting of 5 electrical devices and wiring, described below, located in/on the premises at: 5 First Floor, 5 5 5 5 was inspected in accordance with the National Electrical Code and the detail of the installation, as set forth below,was 5 5 found to be in compliance therewith on the 17th Day of May, 2002. 5 5 Name OTY Rate Ratine Circuit Twee 5 5 rj Alarm and Emergency Equipment Sensor 2 0 Smoke S 5 5 5 5 5 5 5 5 5 5 5 5 5 5 5 5 5 5 5 Sea, 5 5 5 5 1 of 1 5 5 This certificate may not be altered in any way and is validated only by the presence of a raised seal at the location indicated. 5 5 o ��r�� IW . - --- -- - Aag3a- - THE NEW YORK BOARD OF FIRE UNDERWRITERS rAGE 1 BUREAU OF ELECTRICITY 40 FULTON STREET, NEW YORK, NY 10038 Date i'. .' �-��1 _rj,�;r,i 1- 0d/0 , 5 Application No. on file i'�J. '�,t�! !'1 E1 .� THIS CERTIFIES THAT only the electrical equipment as described below and introduced by the applicant named on the above application number is in the premises of HAARY '17UP., +;2` t APYA 'OrKP:, RATTITUCK, N7Y in the following location; ❑ Basement 91 Ist Fl. ❑ 2nd Fl. Section Block Lot r7i:L ,�OOa was examined on -� and found to be in compliance with the National Electrical Code., FIXTURE RECEPTACLES SWITCHES FIXTURES RANGES COOKING DECKS OVENS DISH WASHERS EXHAUST FANS OUTLETS INCANDESCE FLUORESCENT OTHER AMT. K.W. AMT. K.W. AMT. K.W. AMT. K.W. DRYERS FURNACE MOTORS FUTURE APPLIANCE FEEDERS SPECIAL REC'PT.I TIME CLOCKS BELL UNIT HEATERS 11 MULTI-OUTLET DIMMERS SYSTEMS AMT. K.W. OIL X.P. GAS H.P. AMT. NO. A.W.G. AMT. AMP. AMT. AMPS. TRANS. AMT. N.P. NO.OF FEET AMT. WATTS SERVICE DISCONNECT NO.OF S E R V I C E METER No- CC GOND. A.W.G. A.W.G. A.W.G. AMT. AMP. TYPE ECUIP. T ZW 1 O 3W J JW S R 4W ►ERR OF CC.COND. NO.OF HI-LEG OF HI-IEG NO.OF NFUTRAlB OF NEUTRAL OTHER APPARATUS: GARAGE CO.*NVERSION-1 "NO VISUAL DEFECTS: "Ate electrical survay has been made o,+_ the exposed electrical equipment in the premi;aes indiC ited. " "No obvious unsatisfactory condition was found. LL MARY M. TTLER 625 MUMTOCKA GENERAL MANAGER iLATTITUCK, NY, 11952 MPer44-�Y 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. 0=1 11111i go to Imp 111119 I=IBM IIIIII FM IN imi HE to iml IN so 11111111 COPY FOR BUILDING DEPARTMENT.--TI41S COPY OF -CERTIFICATE MUST NOT BE ALTERED IN ANY MANNER. THE NEW YORK BOARD OF FIRE UNDERWRITERS PAGE BUREAU OF ELECTRICITY 40 FULTON STREET, NEW YORK, NY 10038 "TIBER 1.6,2000 112:3440�1i00 +7 5.39400 Date `� Application No. on file THIS CERTIFIES THAT only the electrical equipment as described below and introduced by the applicant named on the above application number is in the premises of D`NNA L. BRXITENBr'C'r(, 6500 NEW SUFFOLK AVE, 14ATTITUCK, N`Z in the following location; El Basement [K] Ist FL ❑ 2nd Fl. OUT Section 115 Block15 Lot 1 nrTOBER v05 2000 was examined on ° and found to be in compliance with the National Electrical Code.- FIXTUREFIXTURES RANGES COOKING DECKS OVENS DISH WASHERS EXHAUST FANS OUTLETS RECEPTACLE$ SWRCHES INCANDESCE FLORESCENT I OTHER I AMT. I K.W. I AMT. I K.W. I AMT. I K.W. I AMT. I K.W. DRYERS FURNACE MOTORS FUTURE APPLIANCE FEEDERS SPECIAL RECPT. TIME CLOCKS BELL UNIT HEATERS MULTI-OUTLET DIMMERS SYSTEMS AMT. K.W. OIL X.P. GAS X.P. AMT. NO. A.W.G. AMT. AMP. AMT. AMPS. TRANS. AMT. H.P. NO.OF FEET AMT. WATTS SERVICE DISCONNECT 110.OF1 S E R V I C E METER NO.OF CC GOND. A6A10- W.G. A.W.6. AMT. P. TYPE EQUIP. 1 ZW 1 SW O SW 4W PER• OF CC.GOND. NO.OF HI-LEG OF NI-LE6 NO.OF NEUTRALS OF NEUTRAL OTHER APPARATUS: SUN ROODS-1 SELF CONTAINED HOT TUB-1 50A DISCONNECT-1 F.AIDDLE FAN F-1 FANELBOARDS L 1--1 CIR. 50 ALAN HUBBARD, ELECTRICIAN LIC.#42$5E GENERAL MANAGER P. G. BOX 2241 1 AQUEBOGUE, NY, 11931 Per �I LcertThIsBcate must not be altered In any manner; return to the office of the Board if Incorrect. Inspectors may be idgbtified by their credentials. COPY FOR BUILDING DEPARTMENT. THIS COPT' OF CERTIFICATE MUST NOT BE ALTERED IN ANY MANNER. MARY K. KOLAKOWSKI 625 Marratooka Lane Mattituck, NY 11952 (631) 734-5127 (631) 734-5142 fax (516) 443-5872 cell (631) 284-1801 pager Hand Delivered September 23, 2002 Southold Town Building Department Main Road Southold, NY 11971 Re: Building Permit No. 26932Z Premises - 625 Marratooka Lane, Mattituck Formerly owned by Mary Tyler Gentlemen: You will find enclosed a letter from my engineer with respect to the insulation for the garage conversion. Please forward the certificate of occupancy to me at the property address. Thanks. ery %KOWSKI n + MAR hnk Enclosure ® AmeriSpec Home AMERISPEC Inspection Services HOME INSPECTION SERVICE 251 Butter Lane ;Vnmber One in North America P.O. BOX 1284 Bridgehampton, NY 11932 631/537-7064 Fax: 631/537-5860 September 16, 2002 Mary Kolakowski 625 Marratooka Lane Mattituck NY 11952 Re: 625 Marratooka Lane Dear Mary, At your request, an inspection was performed to determine the existence of insulation in the home which was originally built around 1962. The garage area was later converted to living area. At the time of construction, 31h fiberglass was standard procedure as the sidewall studs were 2 x 4".As per our original report dated 4-12-00, we stated that was the thickness of the insulation in the attic. There was no material in the basement, as it was not required until the 1980's. Material can be added there if desired, and additional material can be added in the attic if desired. Applied and installed correctly, proper insulation can save on energy consumption. One wall in question, was the previous exterior wall of the garage which has now been converted into living area. A small portion of the outer wall was removed to reveal 31/2 fiberglass. AmeriSpec is pleased to submit the following partial report. Please feel free to contact us for any other questions or inspection needs. Thank you for your confidence. Cordially, Ameri - 'Le e Dome Inspections Brad Beyer Services provided by independently owned and operated franchises or corporate owned offices. nEC ( 5 A'rf( PROFESSIONAL ENGINEER HOBART ROAD/PO Box 616 SOUTHOLD, NEW YORK 11971 PHONE 631—765-2954 FAX 631—614-3516 Date: December 13, 2000 Reference: 625 Marratoka Lane/269322 Gary Fish Building Inspector Town of Southold Main Road Southold, NY 11971 Dear Mr. Fish, Please find enclosed the Energy Code Calculation for 625 Marritoka Lane (26932k you requested. If you have any questions regarding this matter please call. jp htruly yours, Fischetti,PE NEW YORK STATE ENERGY CONSERVATION CONSTRUCTION CODE Building Address: Mary Tyler Per: Plans 625 Marratoka Lane Dated: 12/13/00 Design Criteria: Non Electric Heat 6,000 Degree Days O.A. 10 Degrees F I.A. 70 Degrees F One or two family dwelling SUBSYSTEM AREA DESIGN THERMAL REMARKS s.f. "U" RATING Exterior Walls 438 .083 +28 R-11 Insulation Glazing 32 .33 -4 Andersen HP or Equal Doors 21 .40 -8 U 40 Rated Doors Ceiling(flat) 364 .053 -2 R- 19 Insulation Ceiling(Cathedral) R- Insulation Skylights .33 Andersen HP or Equal Floor 364 .053 -2 R- 19 Insulation Foundation Walls R- Insulation Slab Insulation R- Insulation Total: +12 OF NEw NOTES: �Q.t� f1SC y0 Building Envelope System to meet requirements of 7815.2 HVAC Equipment to meet requirements of 7815.11 HVAC Systems to meet requirements of 7815.12 w Duct Systems to meet requirements of 7815.13 m2 2 Ventilation Systems to meet requirements of 7815.14 ��OA yO. 05250 Insulation on piping systems to meet requirements of 8715.15 9oFEgSI:)t, Domestic water systems & Equipment to meet requirements of 7815.21 Electrical & Lighting Systems to meet requirements of 7815.31 To the best of my knowledge, and belief & professional judgement, these plans are in Signed compliance with the code. Date I WoMb- V Permit Number MECcheck Compliance Report Checked By/Date New York State Energy Conservation Construction Code MECcheck Software Version 3.3 Release lc Data filename: Untitled TITLE: Garage Conversion COUNTY: Suffolk STATE:New York HDD: 5750 CONSTRUCTION TYPE: Detached 1 or 2 Family HEATING TYPE:Non-Electric DATE: 10/21/02 PROJECT INFORMATION: 625 Marratooka Lane COMPLIANCE: Passes Maximum UA=85 Your Home=84 1.2%Better Than Code Gross Glazing Area or Cavity Cont. or Door Perimeter R-Value R-Value U-Factor UA Ceiling 1: Flat Ceiling or Scissor Truss 364 19.0 0.0 19 Wall 1: Wood Frame, 16"o.c. 440 13.0 0.0 32 Window 1: Vinyl Frame,Double Pane 24 0.330 8 Door 1: Solid 21 0.400 8 Floor 1:All-Wood Joist/Truss,Over Unconditioned Space 364 19.0 0.0 17 CON MPLIATATEMENT: The proposed building represented in this document is consistent with the building plans,specifi tic. and other -• 'ations submilUed with this perm-.it application. The proposed systems have been designed to m t the ew Yor State rgy Conservation Construction Code requirements. When a Registered Design Professi nal h stamp and sign this page,they are attesting that to the best of his/her knowledge,belief, and professional dgm t,such laps or spe 'fications are in compliance with this Code. /� Builder/Designer Date ZI 5;%SC CC) �9f 9 ¢ m w 2 ��OA ~O. 0525�� 9DFESslo BUILDING PERMIT REVIEW CHECK LIST j DATE REVIEWED: /�/ AFG0 APPLICANT NAME: / z en DATE SUBMITTED: / / SCTM# --- DISTRICT: 1,000 SECTION: //S BLOCK:_ LOT: _ PROJECT LOCATION STREET: CITY: r r SUBDIV. NAME: ARCHITECT/ENGINEER: �S�h�7 �c, FAST TRACK: YES go SINGLE & SEPARATE CERTIFICATION-REQUIRED: YES OR NO NOTES: ZONING: PERMIT r IMATEAMOUNT:_$ /SK• 00 ZONING DISTRIC . R4 R80 AC CONFORMING: YES oKe REQUIRED LOT SIZE: `F� SQFT. WHERE ACTUAL LOT SIZE FROM?TAx CARD �;sv �5 / od ACTUAL LOT SIZE: 45aaa SQFT. REQUIRED /-E REQUIRE .rte ,rE REQUIRED FRONT: .'PROPOSED:-ed ' SIDE YD: /O '/?6 ' PROPOSED:/'? / REAR:35' 'PROPOSED:itE' LOTCOVERAGE: ALLOWED:Z6 % EXISTING:29W sf/$s% NEW: sf % TOTAL: sf % CORNER? YES o O WAT ER FRONT? YES oqjo DESCRIPTION: LOTS 40,000SF --100-24. Lot recognition. (CREATED before June 30, 1983), UNDERSIZED LOTS FROM JAN.1997 100-25. Merger. (A nonconforming at anytime after July 1, 1983.) �04 BctiT PROJECT DESCRIPTION: ADD Ai ACC OR N/D:_ AGENCY PERMITS REQUIRED FOR REVIEW EEDE TOWN SPETIC PERMIT: S or 4 SUFFOLK COUNTY HEALTH DEPT: YES o (BED #): DTE: / / PERMIT #:R10 - NEW YORK STATE DEC: PRE-DEC 9/1/75 YES o SOUTHOLD TOWN TRUSTEES: YES o TOWN ZONING BOARD APPROVAL: YES o TOWN PLAN. BOARD APPROVAL: YES oIEL FLOOD COMPLIANCE ZONE: PRE-FIRM 3n8/8o #: 4-8Z FLOOD ZONE: X NYS ENERG S OR=-: EGRESS: VENT: LPGHT• NOTES: Z/-4 '7i'( �T;r�cr Al. /4-- 0600JKJ «•C1 Y rr a.c Cep FEE STRUCTURE: FOUNDATION: SF FIRST FLOOR 368' SF SECOND FLR SF 1NIT OTHER TOTAL TOTAL: SF FEE FEE FEE TOT( 36$ SF)- ( 6-w SF)= SF X $ =$_ +$ 7-!S' +$ = $ S BUILDING PERMIT IZEVJ W CHECK LIST Applicant( M Date Owners Name: 1 \L�-X� S�N Reviewed: Architect/ Date Engineer: Submitted: 143 — 03 SCTM #: 1 District. 1,000 Section: Block: q Lot: Projecthash Subdivision Location: ��--__—_ _ Name: Single&separate Required certification: (Yes/No) Req Req. 7_011ing DistrictJl,ot size Actual_ J JLot coverage Proposed. l Rey Req- Req. (Front Yard Proposed_ J [Side Yard Proposed. 1 [Rear Yard Proposed. J Project Description: AGENCY PERMITS Permit REQUIRED FOR REVIEW N.A. NO YES Number Suffolk County Health Dept. New York State D. E. C. Town Trustees Town Zoning Board approval: Town Planning Board approval: Flood Plane Elevation ??? Flood Zone: to 765-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION IST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] INS ATION [ ] FRAMING [ FINAL [ ] FIREPLACE & CHIMNEY REMARKS: ,-lc zz ,DATE �� a aro INSPECTOR 765-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION IST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] IN ULATION [ ] FRAMING [ FINAL [ ] FIREPLACE & CCHHI-MNEY REMARKS: � - DATE_ INSPECTOR , ELD INSPECTION REPORT DATE COMMENTS .=xxexeae=====x=axxexxxx�xxxxexexli=cxxx�xx=xo=======eeaaxxeece===x=x==a===xxxxxx=xx=xxxxx _^ +UNDATION ( IST) p I� — - - -- tt-----{ u I t 0 — 11 — �1 )UNDATION (2ND)--------------- u n ii o +UGA FRAME h n n - PLUMBING II�I Ifi it II _II SULATION PER N. Y. --moi H STATE ENERGY CODE ri ii u xxxxxxxxx_xxxa==a==aee ---- xx�xee=a-==a=aa=ax=xxxxxxxxc=xxxexaaa-----------xe-------- l� II H 11 II jj I O 1+ V 1 FINAL IIu _A_DD_ITIONA__COMMENTS: 7 H � 6 N z � q ro BOARD OF HEALTH . . . . . .. . . . . . . . . FORM NO. 1 3 SETS OF PLANS . . . . . . . . . . . . . . . TORN OF SOUTHOLD SURVEY . . . . . . . . . . . . . . . . . . . . . . . . BUILDING DEPARTMENT CHECK . . . . . . . . . . . . . . . . . . . . . . . . . TOWN HALL SEPTIC FORM . . .. . . . . . . . . . . . . . . . SOUTHOLD, N.Y. 11971 TEL: 765-1802 NOTIFY: CALL J , Examined.....AI/X...... 20.N. !J MAIL TO: . . .�.'. . . . . . . . . . . . . . . . Approved.... ........;2�. Permit No. ................. ......... .................. Disapproveda/c .................................. ................................... (Building Inspector) r nnmroul1 JL I 3 20MAPPLICATION FOR BUILDING PERMIT. u� 4 _.____. --I Date. .?/�?. . . . . . . . . . 20ee) L.-a i __ITRUCTIONS a. 'this application must be completely filled in by typewriter or in ink and submitted to the Building Inspector wi 3 sets of plans, accurate plot plan to scale. Fee according to schedule. b. Plot plan sharing 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 application. 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 issue a Building Permit to the applicant. Such permit shall be kept on the premises available for inspection tbroL4=t 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 MALE to the Building Department for the is of a Building Permit pursuant to the Building Zone Ordinance of the Tam of Southold, Suffolk Canty, New Yo and o applicab s, Ordinances or Regulations, for the construction of buildings, additions or alterati r f 1 demoli ion, as herein described. The applicant agrees to comply with all applicable laws, ord , buil ng code, housing code, and regulations, and to admit authorized inspectors on premises and in build o1 r erode, ... . .. .... .....................�........ (Si ur f 1' t, or name, if a corporation) ................................................... (Mailing address of applicant) State whethericant rs pwner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder ..............a� ...... ....... ` ........................................................... Name of owner of premises ...... �.J .../..( /?. ................(as on 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. .................... 1. Location of land on which proposed work will be done............... ..................... .......................................... House Nmber Street Hamlet County Tax Map ND. 1000 Section ..0 5......... Block ... .4 ...... lot .....��S Subdivision ...................................... Filed Map No. ............... lot ............... (Name) 2. State existing use and occupancy of / aniseslnd �intended use and occupancy of proposed construction: a. Existing use and occupancy ......(�.we!.'. J. ................................................. b. Intended use and occupancy ...... Q� !f ....... ....... ................................................... ! Noture of .,ark (check which applicable): New Building .......... Addition .......... Alteration .. Repair ............ Removal ............. Demolition ............ Other Work ........ .............. /Soot/ sc p hon) Estimated Cost ... ..../................. fee ........................................ ...... De ri t' / (to be paid on filing this application) If dwelling, number of dwelling units ....1....... Naber of dwelling units on each floor ................ Ifgarage, number of cars ...................................... If business, commercial or mixed occupancy, specify nature and extent of each type of use...................... Dimensions of existing structures, if any: Front................ Rear ............... Depth ... .............. height ......................... Naber of Stories ...................... Dimensions of same structure with alterations or additions: Front ............... Rear ............... Depth .................... Height .................... Number of Stories ............... Dimensions of entire new construction: Front ................ Rear ............... Dep ....... ....... �,'P t Height ......................... Number of Stories ..................... Size of lot: Front .................... Rear .................... Depth .................... 0. Date of Purchase ..................... Name of Former Owner ....................................... . I. Zone or use district in which premises ane situated .............................................................. 2. Does proposed construction violate arty zoning last, ordinance or regulation: ........................ 3. Will lot be regraded ..................... 1 excess fill be removed from premises- YES NO Names o owner of premises .. .f P6AV733,1)'4Y/ZC pthahe No. t9d�9s61 Address �r S............................... Address /Cad. .�rl vli� Phone No. ?.Tog.. Name of A�iMt Name of Contractor ................................... Address .............II....//..............Phone No. ............. 5. is this property within 300 feet of a tidal wetland? * YES .......... NO Y:..... *IF YES, swilm ma TRDSTFSS PERMIT MAY HE REQUIRED. PIAT DIAGRAM Locate clearly and distinctly all buildings, whether existing or proposed, and indicate all set-back dimensions rom property lines. Give street and block number or description according to deed, and show street names and indicate Nether interior or corner lot. 12pwa4 k4z,7 fA'Ir Or Nu Y(IRK, S.S )UNIT OF ........./......./... r . . ... ^Tb` 7 S..`...t ........................being duly swonh, deposes aril says that he is the applicant 14-me of individual signing contract) hove named, isthe ......................................................................... (Contr tor, agent, corporate officer, etc.) f said owner or owners, and is duly authorized to perform or have performed the said work and to make and file this pplication; that: all statements contained in this application are true to the best of his knowledge and belief; and haC the work will he performed in the manner se[' forth in the appli ed Cherewith, worn to✓before this j.c�l..�t.Gt�,...dagJ of .. .. '200D... Notary Public .. . .... A J.............. HELENE D.HORNE (Sre pplicant Notary Public,Stats of Now Yo* No.4961364 Myr Commiss QualifiedExpir MDY22, N( sion OCT/ MAIN ROAD (S.R. 25) o o 0 LAND NOW OR FORMERLY ALVAN H. and CAROL TERRY PIPES88.37'40"E 150.00' HEDGE \\\ 0.0' N. HEDGE 0.8' S. 0.2' E. 2.5' S. ASf 25.2" APA CONCRETE DRIVEWAY W + OLLJ 23.0' o Q O ^ 50.0" 2.0' Z ^ o � J FENCE .4" STEPS O b 1.2' W a + O (v Q 4' CHAIN LINK FENCE N � U O N WOOD DECK N 3 35.2" �^ 25.0' 16" x 32` Z IN GROUND . 2 N POOL EQUIP. SWIMMING POOL a S 6 ENCLOSURE � FENCE END 4' WIRE FENCE R, n-v�"-vvvv� 2.0' W. HEDGE 1.5 N. BOLT N88.37'40"W 150.0 0.51 W. LAND NOW OR FORMERLY EUGENE H. MISKA AREA: 15,000 S.F. = 0.344 AC. CERTIFIED TO: SURVEY OF WELLSO AKOWSKI RGO HOME MORTGAGE, INC. DESCRIBED PROPERTY LAWYERS TITLE INSURANCE CORP. SITUATE AI' ASEMENTS AND/OR SUBSURFACE STRUCTURES RECORDED OR UNRECORDED MATT/TUCK RE NOT GUARANTEED UNLESS PHYSICALLY EVIDENT ON THE PREMISES AT TOWN OF SOUTHOLD HE TIME OF THE UARANTEES INDICA EDV HEREON SHALL RUN ONLY TO THE PERSON(S) FOR SUFFOLK COUNTY, NEW YORK MOM THE SURVEY IS PREPARED, AND ON HIS BEHALF TO THE TITLE COM- 'ANY, GOVERNMENTAL AGENCY AND LENDING INSTITUTIONS LISTED HEREON, NO TO THE ASSIGNEES OF THE LENDING INSTITUTION. GUARANTEES ARE „ , IOT TRANSFERABLE TO ADDITIONAL INSTITUTIONS OR SUBSEQUENT OWNERS. SCALE: 1 --JO DATE: MAY 12, 2000 HE OFFSETS (OR DIMENSIONS) SHOWN HEREON FROM THE STRUCTURES TO HE LINESAND USE AND ORE ARE£RTY NOT INTENDEDETOOGUIDEPTHEECIFIEREC IONSOF FENCES, RETAININGE S.C.T.M. DIST. 1000 SEC. 115 BLK.04 LOT005 IALLS, POOLS, PATIOS, PLANTING AREAS, ADDITIONS TO BUILDINGS AND NY OTHER CONSTRUCTION. )OB N0. F2871 o C y9 UV O L�=t1 Lrl] O EV INIONS: �9 132 ;: ... h way L" Ha on Ba ""; N.Y. 46 (631) 8-5330 ys 50� J Marc E. Charest, L.S. FOLA�p guQ' Successors to Paul T. Conolizo, L.S. Robert A. Kart, LS. license no. 050149 Good Ground Surveyors, P.C. s � 0 IAJ 6 .� APPROVED AS NOTED 73 ' BY: - NOTIFY BUILDING DEPARTMENT AT u 765-1802 9 AM TO 4 PM FOR THE l FOLLOWING INSPECTIONS: 1 1 FOUNDATION - TWO REQUIRED FOR POURED CONCRETE - - 2. ROUGH - FRAMING & PLUMBING 3. INSULATION 4, FINAL - CONSTRUCTION MUST , BE COMPLETE FOR C.O. 1 ALL CONSTRUCTION SHALL MEET ' THE REQUIREMENTS OF THE N.Y.. STATE CONSTRUCTION jp� ENERGY,' CODES. NOT RESPONSIBLE FOR DESIGN OR CONSTRUCTION ERRORS, OCCUPANCY OR USE IS UNLAWFUL WITHOUT CERTIFICATE OF OCCUPANCY PROVIDE OPENINGS.FOR EMERGENCY ESCAPE AS }� --------•------ REQUIRED BY PART. 714 OF N.Y. STATE BUILDING CODE. PROVIDE SMOKE-DETECTING C - - - - - - ALARM DEVICES AS TO PART. 721.1 0 NAS BUILDING CODE. i �V D�v 3 B �� UNDERWRITERS CERTIFICATE _._._ - - -- -- - `- -__--�•, T �i )�CI'D("I U i�/,nhl f`1'I'AI T.1 fi'(� „ REQUIRED %-14iL1F-f E�fD 2)&. F J. 0 PROVIDE ANTI-SCALD AND/OR THERMAL SHOCK PREVENTING. DEVICES A'S TO PART. 902`.6(x) N.Y.STATE BUILDIN%COUE.. PLUMBING I P' - - ��j ALL PLUMBING WASTE &WATER LINES NEED V TESTING BEFORE COVERING l� If copper tubing is used / 2 for water distributing f - h(I`_ "� system; piping shall be of types K orL only C UNDERWRITERS CERTIFICATE - -- -- -----`--------'—^�-� -�-' REQUIRED I PLUMBER CERTIFICATION I ON LEAD CONTENT BEFORE fi pI a C ii; cr ot'l ISI CERTIFICATE OF OCCUPANCY f16° SOLDER USED IN WATER h lb SUPPLY SYSTEM CANNOT 6912 HAr412-4-1-cc h,,,- /SU'JXCEED2110OF1%LEAD. i � 7pyErD9� F a � W a 1 0525�� gOFESSIONP a