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Home My WebLink About29900-ZFORM NO. 4 TOWI~ OF SOUTHOLD BUILDING DEP~TMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPAi~CY No: Z-30386 Date: 08/30/04 T~{IS CERTIFIES t~t ~he building ACCESSORY Location of Property: 895 KOLBHOOK LA (HOUSE NO.) (STREET) Cou/lty Tax Map No. 473889 Section 113 Block 6 subdivision Filed Map No. Lot No. -- MATTITUCK (HAMLET) Lot 14 - 5 conforms substantially to the Application for Building Permit heretofore filed in this office dated DECEMBER 1, 2003 pursuant to which Building Permit No. 29900-Z dated DECEMBER 4, 2003 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 INGROLTND SWIMMING POOL WITH FENCE TO CODE AS APPLIED FOR_ The certificate is issued to PAUL PAWLOWSKI of the aforesaid building. (OWI~ER) SUFFOLI{ COUNTer DEPARTMENT OF ~EALTIq APPROVAI~ N/A ELECTRICAL CERTIFICATE NO. 3933 04/29/04 PLUMBERS CERTIFICATION DATED N/A ~-/kunhori z 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) ~O'. 29900 Z Date DECEMBER 4, 2003 Permission is hereby granted to: PAUL PAWLOWSKI 1785 CROWN LAND LANE CUTCHOGUE,NY 11935 for : INSTALLATION OF AN INGROUND SWIMMING POOL IN THE REQUIRED REAR YARD FENCED TO CODE at premises located at County Tax Map No. 473889 Section 113 .pursuant to application dated DECEMBER Building Inspector to expire on JUNE 895 HOLBROOK LA MATTITUCK Block 0006 Lot No. 014.005 1, 2003 and approved by the 4, 2005. Fee $ 150.00 Authorized Signature ORIGINAL Rev. 5/8/02 Form No, 6 TOWN O~ soUTHoLD BUILDING;DEpARTMENT , .. TOW'~ I]ALL 765-1802 ~. APPLICATION FOR CERTIFICATE 0F OCCUPANCY Tkis application must be idled in by typewriter or ink and submitted to the Building Department with the follox~dng: For nenv building or ne~v use: l. Final mrvey o f property with aecm'ate location of all buildings, property lines, streets, and unnstml natural ox topographic features. 2. Final Approvat from Health Dept. of water supply and sewerage-disposal (S-9 form). 3. · Approval of electrical installation from Board of Fire Underwriters. 4. Sw0m statement ~rom plumber cert~Sng that t~e solder ~edi~ ~ystem C0ntain~ !ess than 2/10 of 1% lead, 5. COn~rnercial bdt[ding, i nd'us trial buildmg, mulfil3I~ resi,den~es, ~ si~i.tar bull, dings and inst dilatiOnS, a certificate of Code Cbmpliagce from architect 0r mgin~r responsible fo~ ~ buit~g, 6. Submit Plarming Board Approval of e0mpleted site plan requirementS: "5 For ex~sting buildings (prior to April 9~ !95~ non-conform!ng uses, ,~r buildings and "pre,existing" land uses: 1. Accurate sm'vey o f properB' shoufng all prop~ lines, streets, building and unusual natural or topograph/c features: 2. A prope[,Iy completed application and consent to iuspect signed by the applicant If a Certificate of Occupancy is denied, fie Building Inspector shall state the reasons therefor m w'ntmg to the apphcant. 1. Certificate of Occupancy. - New dwelling $25.00, Additions to dwe ling $25.00, Alterations to dwelling $25.00, Swimmi~, g poo1,$25..00, Accessory building $25.00, Additions to accessory building $25_00, Businesses $50.00. 2. Certifie~teofOccap-'~an¢3ronPre-exi~fingBuilding- $100.00 3. Copy of Certificate of Occupancy- $.25 4. Updated Certificate of Occupancy- $50.00 5_ Temp0mry Certificate of'Occupancy - Residential $15.00, Commercial , D~te. New Construction: Old or Pre-existing Building: Home No. Ow-net or Owners of Property: (check one) Suffolk County Tax Map No 1000, Section Subdivision Date of Permit. /~2/q~ } Filed Map. Lot: Applicant: ~4g~[ /--~'-t~ Health Dept. Approval: Planning Board Approval: Request for: Temporary Certificate .S.bmi.edi s Underwriters Approval: Final Certificate: (check)~9 W' /~ 0Street ~ Nassau Suffolk Electrical Inspections, Inc. 5A Canal Street * Center Modches, New York i1934 * Tel: 631-878-3500 * Fax: 631-878-3764 Application: 3933 Date: 4/29/04 Issued to: Dawlowski Address:. 895 Holbrook Lane Village: Maftituck Introduced By: Avey Electric Lic#: 5120-E was examined and approved up to the above date and was in compliance with the NEC Switches Recept. acles Fixtures G.F.I. Pool Panel Heater 1 2 I 2 1 1 '"-. Oven Carbon Fans Dishwasher Washer/Amps Dryer/Amps Range/Amps Monoxide Furnace Oil Gas HeatZones Smoke Bell Detectors Transformers Meter Amps Phase Mo[ors 2 Dther Equipment: Inground Pool 3ut,Res Permitg:29900-Z This certificate must not be altered in any manner 765-1802 BUILDING DEP~ INSPECTION [ ] FOUNDATION 1ST [ ] FOUNDATION 2ND [ ] FRAMING [ ] FIREPLACE & CHIMNEY [ [ ] ROUGH PLBG. [ ],~ISULATION [~FINAL ~o ~ ] FIRE SAFETY INSPECTION REMARKS: DATE Owners Nature: z Reviewed: Architect/ Date Engineer: Submitted: SCTM #: District: l,O00 Section: //5 Block. ~ Lot: /~ ~ · Single & separa[e Required cemlSca[iml: (Yes / No) ~.011111~. Dislricl:~.~ffj Il ~( size: __ [j':rom Yazd -- Proposed: __] Project Description: Nanle: AGENC~,oP EI'OVIIT$ REQUIRED FOR REVIEW 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: NOtes: N.A. NO .Permit· · Number zo O0 [~- 0 0 >- L~ 0 0 0 0 I~,~o'OOE ~[~ V0 00~ ~t~N o ,9E'6fE s3qoIMO '~N Nvs~S :~ -:1 SV~NoH-L .JO .LqM3~NMO3 MO AAON ONV~ ~,~Nf~OA (ovou s~O~A)