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Home My WebLink About31044-Z FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY NO: Z-30887 Date: 04/28/05 THIS CERTIFIES that the building ADDITIONS & ALTERATIONS Location of Property: 1000 THERESA DR MATTITUCK (HOUSE NO. ) (STREET) (HAMLET) County Tax Map No. 473889 Section 115 Block 13 Lot 16 Subdivision Filed Map No. Lot No_ conforms substantially to the Application for Building Permit heretofore filed in this office dated APRIL 11, 2005 pursuant to which Building Permit No. 31044-Z dated APRIL 11, 2005 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 ADDITIONS & ALTERATIONS TO EXISTING SINGLE FAMILY DWELLING AS APPLIED FOR. The certificate is issued to WOJTEK R MAJEWSKI (OWNER) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A ELECTRICAL CERTIFICATE NO. 65844C 12/10/03 PLUMBERS CERTIFICATION DATED 04/27/05 BRETT SINCLAIR PLUMB&HEAT A o zed ignatur Rev. 1/81 --n q Form No.6 11 TOX'I'N OF SOUTHOLD U!1 BUILDING DEPARTMENT .1 )P 2 T ,'P05 ` 1� TOWN HALL j 765-1802 �1W( n. o f APPLICATION FOR CERTIFICATE OF OCCUPANCY This application must be tilled 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 forth). 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°/o 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: L Accurate sun ey 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 L Certificate of Occupancy - New dwelling$25.00, Additions to dwelling $25.00, Alterations to dwelling$25.00, Swithming 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 4. Updated Certificate of Occupancy- $50.00 5. Temporary Certificate of Occupancy -Residential $15.00, Commercial$15.00 Date. 05 New Construction: X —Old or Pre-existing Building: (check one) Location of Property: /000 The rem T rt Ike MQ-gi (X f Y 1195Z M 41 k e k House No. Street Hamlet Owner or Owners of Property: _ 1 L'C�t �_^/_]ql i Q W S�L_ _ Suffolk County Tax Map No 1000, Section_ I I Wo Block 1300 Lot 016000 Subdivision_ _ Filed Map. p L�o�tp�_ Permit No. _310 y 4 _ Z Date of Permit._ _ Applicant: k, �}(w P T k �V I � Health Dept. Approval: Underwriters Approkal: 1 " Planning Board Approval: Request for: Temporary Certificate _ Final Certificate: �C (check one) Fee Subniitted: $ nlicant Sign ire �-• toy o 3 C) wl�Tw�o�'w�wl�ii►��► � . . .4211 AM, Aeft, Lieciricui -inspection Cerigicaie Issue Date Electrical Inspection Service, Inc. Application 12/10/03 375 Dunton Avenue 65844C `• East Patchogue, New York 11772 (All 19AA.AAd7 Issued To: Mr. Wojtek Majewski Street: 1000 Terese Drive Village: Mattituck Zip: 11952 Town: Southold f. Section: Block: Lot: , Contractor: John J. Wade (L) Lic. # 4664-E ' Was examined and found to be in compliance with the National Electrical Code. Commercial l] NV Defects L_I Pool LK 1st Floor LXI Indoor LX Basement ' Hot Tub XJ Residential _I Det. Garage L Attic LJ 2nd Floor X Outdoor i Addition - Survey Switches Receptacles Fixtures GFI Heaters A/C Fans 22 30 47 4 I n . o wo . arm-.." - 6;lc:orra.as vrmrvammr on"ru v�rai�:.]iiV. 1-20A 1 30 1 20 Furnace Oil Gas Circulators Smoke Detector Bell Transformer x 5 1 Meter Amps Phase UG/OH Jacuzzi Television CO Detector I 'UU I IA, ' Bldg. Permit: Other Equipment 11-200A Panel q y 12-20A Air Handlers Hugo S. Surdi President i Rough Inspection: 08/13/2002 Inspector: Ed Scavelli Final Inspection: 12/09/2003 ` Inspector: Sean P. Hightower �r �'- This certificate must not be altered in any manner. Inspectors may be identified by their credentials. -� =o�gUFFO(A,co�� 0 W s Town Hall,.53095 Main Road O Fax(631)765-9502 P.O. Box 1179 'yifol �aQ� Telephone (631)765-1802 Southold, Nein York 11971-0959 BUILDING DEPARTMENT TOWN OF SOUTHOLD CERTIFICATION Date:_Building Permit Perrmit /No. �� J� 7 Z /.31O�l q—Z Owner: �1�01tC�C R Mafel')s kl nn (Please prit) t� Plumber: lJvL-if Sil3c AIJL 910MV34- t 1tcF► Tt �� (Please print) I certify that the solder used in the water supply system contains less than 2/10 of l% lead. lumbers Signature) Sworn to before me this a day of 20 20 06 Notary Public. WIU --C:'ount} — YEI.AME V.BROWN NdWY lti k 81W al New T61k Ab.4OW12 oidw is&M*Cordy C0MMbdonE 04.19,avv5 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. 31044 Z Date APRIL 11, 2005 Permission is hereby granted to : WOJTEK R MAJEWSKI 1000 THERESA DR MATTITUCK,NY 11952 for ADDITIONS & ALTERATIONS TO EXISTING SINGLE FAMILY DWELLING AS APPLIED FOR. (THIS REPLACES BP #28114-Z) at premises located at 1000 THERESA DR MATTITUCK County Tax Map No. 473889 Section 115 Block 0013 Lot No. 016 pursuant to application dated APRIL 11, 2005 and approved by the Building Inspector to expire on OCTOBER 11, 2006 . Fee $ 547 . 80 Author ze gnature ORIGINAL Rev. 5/8/02 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. 28114 Z Date FEBRUARY 27 , 2002 Permission is hereby granted to : WOJTEK R MAJEWSKI 1000 THERESA DR MATTITUCK,NY 11952 for ADDITIONS AND ALTERATIONS TO AN EXISTING SINGLE FAMILY DWELLING AS APPLIED FOR at premises located at 1000 THERESA DR MATTITUCK County Tax Map No. 473889 Section 115 Block 0013 Lot No. 016 pursuant to application dated JANUARY 23 , 2002 and approved by the Building Inspector. Fee $ 547 . 80 Zg 1u1h.,<,zZ5TSignature ORIGINAL Rev. 2/19/98 765-1802 INSPECTION [ ] FOUNDATION 1 ST [ ] ROUGH PLOG. [ ] FOUNDATION 2ND [ ] INSU ATION [ ] FRAMING [ INAL [ ] FIREPLACE & CHIMNEY [ ] FIRE SAFETY INSPECTION REMARKS: DATED INSPECTOR ill fG� 70-11W2 BUILDING DEPT. INSPECTION [ ] FOUNDATION IST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ NSULATION [ ] FRAMING [ ] FINAL [ ] FIREPLACE & CHIMNEY REMARKS: /✓,�7 �,�,� DATE ( C? INSPECTOR ,c.�% M-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION IST [ ROUGH PLBG. [ ] FO ATION 2ND [ ] INSULATION [ FRAMINGFINAL [ l [ ] FIREPLACE & CHIMNEY REMARKS: C � DATE 911949� INSPECTOR 765_1802 BUILDING DEPT. INSPECTION [ ] FO DATION IST [ ] ROUGH PLBG. [ FOUNDATION 2ND [ ] INSULATION [ ] FRAMING [ ] FINAL [ ] FIREPL & HIMNEY REMARKS: DATE t4'� !/ INSPECT M-1802 BUILDING DEPT. INSPECTION [ FOUNDATION IST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] INSULATION [ ] FRAMING [ ] FINAL [ ] FIREPLAr-LvA E & CHIMNEY REMARKS: idl o/ DATE 3 � �1i INSPECTOR` TOWN OF SOUTHOLD PROPERTY RECORD CARD OWNER STREET C �� VILLAGE DIST. SUB. LOT /c OR, t- FOR R OWNER N E ACR. / TYPE O S WF BUILDING �. � u �2E :ES�Ip I SEAS. 'VL. FARM iCOMM. CB. MISC. Mkt. Value — ✓ � _ LAND IMP. TOTAL t REMARKS'7.-G G J3 J J3am? S. FSZfi�ESK� b,yjs J '• G l/ s"aao s`Sao 6 1 Sale aDOYIr o U zE�JN ER `� W)f yon �' 7�/ Soo v �aoao. G, E ni r R + b✓h in r �.i .r H AGE BUILDING CONDITION /�0/F sa/� 39000 Yr 1 . i}'9�/ �� Gd Lre as Z/ _ 1 4 NEW NORMAL BELOW ABOVE 1�8 - Up`7S i — hee �o IHewSk.` £ al �s9i 50c — FARM Acre Value Per Value Acre o — Fillable 2 — — "illable Voodland — wampland FRONTAGE ON WATER rushland FRONTAGE ON ROAD /00 louse Plot DEPTH V. / 8s BULKHEAD 'otal DOCK i �1 COLOR All TRIM + /3 . , FFT- M. Bldg. _ ��2 ✓ Foundation C Bath i�Z Dinette Extension V �/ ri}' = y2Z D- 9y 3� Bdsement �� Floors V/ K. Extension s 330 Ext. Walls 60/ !n i Interior Finish -'�;;; LR. Q i Extension Fire Place 6n e Heat DR. Type Roof // i Rooms lst Floor BR. Porch Recreation Room Rooms 2nd Floor FIN. B. Porch Dormer Breezeway Driveway Garage X 7: f p d y ✓ Patio O. B. Total w � s FIELD INSPECTION REPORT DA E CONINIENTS W alu FOUNDATION (I ---------------------------------- _ FOUNDATION ) z r a A i7 ROUGH FRAMING R PLUMBING S INSULATION PER N.Y. STATE ENERGY CODE r C-0 FINAL ADDITIONAL COMMENTS - O z Z m o� 4 -3 � z - z s _ � a S b �e .3 TOWN OF SOUTMOLD BUILDING PERMIT APPLICATION CHECKLIST BUILDING DEPARTIYIENT Do you have or need the following,before applying TO` NfLiLL Board of Health SOUTHOLD, NY 119713�6 y y� 3 sets of Building Plans TEL: '765-1802 �n ��#65-1802 Survey PERMIT NCS T Check —' Septic Form N.Y.S.D.E.C. Trustees E_xaminzd z `� , 'o ° Z Contact. Approved a YIN/05 Ma//il��//to:�/��0//00 Theirsa.A file Disapproved a c /� t? /!UCJ< /VV //f„SZ / Phone: 91,P7 CeZl,�f(63/) 03/ —//38 .` `� r Buil ector B / ICATION FOR BUILDING PERMIT Date 20D�2 o INSTRUCTIONS a. This application MUST be completely filled in by typewriter or in ink and submitted to the Building Inspector with 3 sets of plan,, 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 waterways. 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 a 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 what-so-ever until a Certificate of Occupanc is issued by the Building Inspector. :APPLICATION IS HEREBY MADE to The Building Deparmreut for the issuance of a Building Permit pursuant to the Building Zone Ordinance of the Town of Southold, Suffolk County,Nev.,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. (Si of app or name,if a corporation) /000 gefeS-a1)f4�t, /fia«ilua�Nl"1119.52 (Mailing address of applicant) State whether applicant is � lessee, agent, architect, engineer, general contractor, electrician, plumber or builder Name of ovvmt-r of premises Z? /°/C? vrJSKi1 (as on tfie 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. �P Electricians License No. clql. Other Trade's License No. 1. Location of land on whichroposed work will be done: /000 her z I&ive /%a�fi uclC House Number Street Hamlet County Tax Map No. 1000 Section_ //500 Block 1300 Lot 0/6000 Subdivision Filed Map No. Lot (Name) 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction. a. Existing use and occupancy /1 DrnP b. Intended use and occupancy 3. Nature of work(check which applicable):New Building Addition Alteration Repair Removal Demolition Other Work (Description) 4. Estimated Cost JrS 6J f,DO Fee (to be paid on filing this application) 5. If dwelling. number of dwelling units i Number of dwelling units on each floor / If garage, number of cars aZ 6. If business. commercial or mixed occupancy, specify nature and extent of each type of use. -� Dimensions of existing structures,if any: Front J 8� 9 Rear .l9 �� Depth �8 02 Height Number of Stories_____Z_ v i Dimensions of same structure with alterations or additions: Front Rear / ),q // Ajo Depth X Height Number of Stories / � r i 8. Dimensions of entire new construction: Front ,31/ Rear 3y Depth 3=Z Height Number of Stories / 9. Size of lot: Front /00 Rear //D Depth 19W,V ' V0, 10. Date of Purchase 1,L2Q/ g(!? Name of Former Owner /q/ ,7 / 11. Zone or use district in which premises are situated SO a A 0 L OL d� // 12. Does proposed construction violate any zoning law, ordinance or regulation: /VG 13. Will lot be re-graded o Ir-del /int,2eGf Will excess fill be removed from premises: YES NO 14. Names of Owner of premises k qn e MO;v"t ;Address /000 Aereso.Dri✓r°Phone No. g2 Vd0- t?/,P Name of Architect — I �—Address Phone No Name of Contractor e e r m n e Address Phone No. 15. Is this property within 100 feet of a tidal wetland? *YES NO /10 • IF YES, SOUTHOLD TOWN TRUSTEES PERMTTS MAY BE REQUIRED 16. Provide survey, to scale, with accurate foundation plan and distances to property lines. 17. If elevation at any point on property is at 10 feet or below,must provide topographical data on survey. STATE OF NE1,V YORK) SS: COUNTY OFS� /( '- / Alw,7�h/S/ N'/ 0LJ being duly swam, deposes and says that(s)he is the applicant (Name of individual signing contract)above named, (S)He is the Otoye/' Contractor, Agent, Corporate Officer, etc.l A of said owner or owners,and is duly 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 matter set forth in the application filed therewith. Sworn to before me this day ofr 20Q. _ �_ G4 /L-7 1 Notary Public C1 JURE E rAYr& Signature of __licant Ift"Pao 49gOCINerrYO& SS QW&d in Suffolk cougy J�02 NEW SUFFOLK AVE. �r U v I LOT 13 N/o/F 110/L erN. 89° 3200E. 182.28' +0.2E. SPLIT RAIL FORCEo.3wLAND OF TOPPING N/S CN. CN. °° CONC., $RIVE W ° SURVEY OF —37.6'- LOT 12 13TT. " MAP OF DEEP HOLE CREEK ESTATES " LOT 12 FR.NSE. 170' 37.9' i W/GAR. ' " ' -- --- FILED . JAN. 28 , 1965 FILE NO. 4256 W a;N - o AT MATTITUCK 1�,2a°`"n0 �W TOWN OF SOUTHOLD N v a 28.2' - SUFFOLK COUNTY, N.Y. 1- 0 r o W _ - 0 4 a o i vi = 1000 - 115 13 16 \ ry a N m ` N ° SCALE I = 30 o Z , FENCE Ftn. Z FEN. CN' 0.3'!. ai'4t SPLIT RML N. JULY 11 , 1988 azs o.e'! 0.S'W. WIRE p[ncE 183. l0 ' March 19, 2002 (foundaftonl S. 86° 24' 20" W• ` I LOT 11 AREA = Ib, 110 SQ. FT. CERTIFIED TO NEWyO� AMERICAN TITLE INSURANCE CO. Q, t,METIOE `f OR TO TIM SLOVEY Si A VIOLATION CENTERBANK MORTGAGE COMPANY , INC. sA= Of T� rowc srATE EDUCATION TFICATroHs WO J T E K MAJ E W S K I l °ra # CElT AS PER SECTION 2. ALL M��V"coM�� T1MAIL � �� JEANNE MAJEWSKI 1I11OSE SNMATURE APPEMS H MOM TITLE N0. OT 113619 R 711 NO. 496/9 AMT04ALLY TO COMPLY WITH SAD LAw TDMI ALTERED BY ^ MUST !E USED BY ANY AIr1 ALL �OR1S UTLRlIi A COPY , COMC TO -Als ARE NOT N GOI�Lu E ��THELLAW- 7� 763 - 1797 P. 0. BOX 909 1230 TRA vELER S/t �7 88 - 470 D.K. .BUILDING PERMIT EXAMINER CHECK LIST DATE REVIEWED: __/_/x/02 DATE SUBMITTED: / /3/02 APPLICANT NAME: :��ra1Li SCTM# DISTRICT: 1,000 SECTION: 115- BLOCK: LOT: 16 �bGG STREET:loo--75qwrw�i�e/ve- CITY: SUBDIV. NAME:eC' PROJECT DESCRIPTION: ESTIMATED PROJECT COST: �rod —1 ARCHITECT/ENGINEER::fSUejC.ow FAST TRACK? SINGLE & SEPARATE CERTIFICATION-REQUIRED? A-�'G NOTES: LOTS 40,000SF-100-24.Lot recognition.(CREATED before June 30,1983),UNDERSIZED LOTS FROM JAN.1997 100-25.Merger.(A nonconforming at any time after 7/1/8. ZONINGDISTRICT: 'R—L46 CONFORMING? NU REQ. LOT SIZE: yo i o o� ACT. LOT SIZE: REQ. LOT COV. �� ACT. LOT COV. REQ. FRONT' 55- PROP. FRONT L REQ SIDE /o ACT. SIDE REQ. REAR -3r PROP. REAR -� WATERFRONT? '10 DESCRIPTION: PANEL #: FLOOD ZONE:_, APPROVALS REQUIRED c) 77 SUFFOLK COUNTY HEALTH DEPT:-- YES or NO, (BED #): DTE:_/_/_ PERMIT#:R10- TOWN SEPTIC RECEIPT: Y or N NEW YORK STATE DEC: PRE-DEC 9/1/75 YES o N SOUTHOLD TOWN TRUSTEES: YES or TOWN ZONING BOARD APPROVAL: YES o TOWN PLAN. BOARD APPROVAL: YES o TOWN HISTORICAL PRE (SPLIA): YES o NO NYS ENERGY YE OR NO : -r q EGRESS 18 H min.? 4 s total VENTS . FT. x 4% LIGHT . FT. x 8% BUILDING PERMITS OPEN/EXPIRED: BP -Z/C/0 Z- HAVE PRE CO'S : Y OR N BP -Z/C/o Z- - NOTES:� FEE STRUCTURE: FOUNDATION: /p g $ SF FIRST FLOOR ® $ SF SECOND FLR SF INIT OTHER TOTAL TOTAL: „�; 1 ;a6—SF FEE FEE FEE COT o? / ( SF)- SF)= W/ SF X $.3 =$ +$_l 5-a +$ _$ .��