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Home My WebLink About32225-Z FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No: Z-31725 Date: 08/03/06 THIS CERTIFIES that the building HEATING SYSTEM Location of Property: 120 WALNUT (HOUSE NO.) County Tax Map No. 473889 Section 142 PL (STREET) Block 1 MATTITUCK (HAMLET) Lot 23 SUbdivision Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated JULY 20, 2006 pursuant to which Building Permit No. 32225-Z dated JULY 21, 2006 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 INSTALLATION OF NEW HEATING SYSTEM IN EXISTING SINGLE FAMILY DWELLING AS APPLIED FOR. The certificate is issued to BELLE RUTHINOSKI (OWNER) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A ELECTRICAL CERTIFICATE NO. 3001303 07/26/06 N/A PLUMBERS CERTIFICATION DATED '~ ~ Sig t~re Rev. 1/81 Form No.6 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL 765-1802 .' \ G \ \ 7' .,~---- APPLICATION FOR CERTIFICATE OF OCCUPANCY \ ' This application must be filled in by typewriter or ink and submitted to the Building DePllrtment with the following: ~.' A. For new building or new use: I. 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 I % 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 buildiugs aud "pre-existing" land uses: I. 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 4. Updated Certificate of Occupancy - $50.00 5. Temporary Certificate of Occupancy - Residential $15.00, Commercial $15.00 Date. ~~Io 10 (check one) IYl (J +If ~ (. 1<- , Hamlet New Construction: Location of Property: /J() House No. Old or Pre-existing Building: V lOa If) a f Rt7ct ~ Street Owner or Owners of Property: E ,,,,Ia t {" Suffolk County Tax Map No I 000, Section ox 13P (Ie lid- Ruift r'/1/) <;/{{ . Block l Lot ,;}.3 Subdivision Permit No. Date of Permit. Filed Map. Applicant: Underwriters Approval: Lot: Health Dept. Approval: Planning Board Approval: Request for: Temporary Certificate Final Certificate: (check one) Fee Submitted: $ /jp e;it:,,,,4J (r~ w.&) ~pplicant Signature ~. 70 ')IY CO :t:3J1,J..5 @].@] i BY THIS CERTIFICATE OF COMPLIANCE THE i ~ NEW YORK BOARD OF FIRE UNDERWRITERS ~ ~ BUREAU OF ELECTRICITY ~ ~ 40 FULTON STREET - NEW YORK, NY 1 0038 ~ ~ CERTIFIES THAT ~ ~ ~ ~ Upon the application of upon premises owned by ~ ~ ~ ~ LYDIA WELLS THE ESTATE OF BELLE RUTHINOSKI ~ ~ 306 JOHNSON CT 320 BRIDGE STREET ~ I GREENPORT, NY 11944 GREENPORT, NY 11944 I ~ Located at 120 WALNUT PLACE MATTITUCK, NY 11952 ~ ~ ~ ~ Application Number: 3001303 Certificate Number: 3001303 ~ ~ Section: Block: Lot: Building Permit: BDC: ns11 ~ ~ ~ ~ Described as a occupancy, wherein the premises electrical system consisting of ~ ~ electrical devices and wiring, described below, located in/on the premises at: ~ ~ ~ ~ ~ A visual inspection of the premises electrical system, limited to electrical devices and wiring to the extent detailed ~ ~ herein, was conducted in accordance with the requirements of the applicable code and/or standard ~ ~ promulgated by the State of New York, Department of State Code Enforcement and Administration, or other ~ ~ authority having jurisdiction, and found to be in compliance therewith on the 26th Day of July, 2006. ~ ~ Name OTY Rate Ratin. Circuit ~ ~ ~ Miscellaneous ~ ~ as biult-2000-inspeection of ~ ~ oil furnace ~ ~ Appliances and Accessories ~ ~ Furnace 1 0 Oil ~ ~~~~ ~ ~ Switch 2 0 General Purpose ~ ~ An as built inspection, of the delineated electrical installation, detennined that an obvious hazard is not present and the installation is believed to ~ rID be in comformance with the applicable reference standard for the estimated period of construction of the premises wiring system. ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ H~ i ~ ~ ~ 1 of 1 ~ ~ ~ I This certificate may not be altered in any way and is validated only by the presence of a raised seal at the location indicated. I @].@] 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. 32225 Z Date JULY 21, 2006 permission is hereby granted to: BELLE RUTHINOSKI 120 WALNUT PLACE MATTITUCK,NY 11952 for : INSTALLATION OF A HEATING SYSTEM AS APPLIED FOR at premises located at 120 WALNUT PL MATTI TUCK County Tax Map No. 473889 Section 142 Block 0001 Lot No. 023 pursuant to application dated JULY 20, 2006 and approved by the Building Inspector to expire on JANUARY 21, 2008. Fee $ 150.00 ~ CJL I Authorized Signature ORIGINAL Rev. 5/8/02 PERMIT NO. 3~~b BUILDING PERMIT APPLICATION CHECKLIST Do you have or need the following, before applying? Board of Health 4 sets of Building Plans Planning Board approval Survey Check Septic Form N.Y.S.D.E.C. Trustees Contact: TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, NY 11971 TEL: (631) 765-1802 FAX: (631) 765-9502 www.northfork.net/SouthoId/ 1/J-, ,20~ tp.-/ , 20..a..l- Examined Approved Disapproved ale Mail to: Expiration I 1/:>1 ,20~ I . Phone: _----:~~71 '~ r:' G f r ': ,,' ;, \ I t:.Jb , Building Inspector I L. l-l-C 1 r\PPLICATION FOR BUILDING PERMIT I J Date J~ Iy Jq , 20-0./.- IIJL 2 0 ,. - 1\-..--:JL'f') INSTRUCTIONS a. This application MUST be completely filled in by typewriter or in ink and submitted to the Building Inspector with 4 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 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 the Building Inspector issues a Certificate of Occupancy. f. Every building permit shall expire if the work authorized has not commenced within 12 months after the date of issuance or has not been completed within 18 months from such date. If no zoning amendments or other regulations affecting the property have been enacted in the interim, the Building Inspector may authorize, in writing, the extension of the permit for an addition six months. Thereafter, a new permit shall be required. APPLICATION IS HEREBY MADE to the Building Department for the issuance of a Building Permit pursuant to the Building Zone Ordinance ofthe 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. ~~ AlL CONSTRUCTION SH ( ignature of applicant or name, if a corporation) MeET THE REQUIREME~JTS OJ: THf;,. , CODES OF NEW YORK suMJ (:5'" Lp (<).{ ~ 1t""'''.J. /IN Iff '/Y LIT (Mailing address ~6ant) State whether applicant is owner, lessee, agent, archi~~.ct, engine, er, g,eneral,:ontractor, electrician, plumber or builder UNDERWRITFP~ ~"RTIACA'ff m,'n,' t-cclv,e.. , . ' , APPROVED AS N DATE:-J/-:?i ~ __ 3,- ~ g;;~ Name of owner of premises U.f.ht'AO sf;,' (As on the tax roll or latest If applicant is a corporatiol}, signature of duly authorize~ officer L "','TMENT AT E:.8{.-<te of' /j p II ( R.;,. -/{1 f .~ Fie', L. t, COR THE (Name and title of corporate officer) UI.;UUP '1 I r ) 1, ,<:3,,'ATIOI, " R:'>~QU'RED USE IS G" " , FOR POURED c~ "'~TE ~~~~:~sLi~~~;eN~~. ~~ II _ P ~~~~dl ~~~~~~C)~tf.~f"", ,PLUM8ING Electricians License No. O~ I:NHC/yF'ItA rt~~~~~~LC~:c_:7,... ,,;'.'ON. MUST Other Trade's License No. ~ c , - ALL CONSTRue I;>, SHALL MEET THE REQUIREMENTS OF THo CODES O~ NEW }/cd-h Y RK ATE. NOT Rl ;PONSIBlL FOR Hamlet i1. fir 1. Locit~ Ofland on which pro House Number Street County Tax Map No. 1000 Section 1 Y L Subdivision Block I Filed Map No. Lot ;z. :3 Lot (Name) 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy .. b. Intended use and occupancy 3. Nature of work (check which applicable): New Building Repair Removal Demolition Addition Other Work ExlSf-I) Alteration Ha n C{ c '< (Description) 4. Estimated Cost Fee 5. If dwelling, number of dwelling units If garage, number of cars (To be paid on filing this application) Number of dwelling units on each floor 6. Ifbusiness, commercial or mixed occupancy, specify nature and extent of each type of use. 7. Dimensions of existing structures, if any: Front Height Number of Stories Rear Depth Dimensions of same structure with alterations or additions: Front Rear Depth Height Number of Stories 8. Dimensions of entire new construction: Front Height Number of Stories Rear Depth \ \ , , Depth \. \ \ '- 9. Size oflot: Front Rear 10. Date of Purchase ~oO Name of Former Owner 11. Zone or use district in which premises are situated 12. Does proposed construction violate any zoning law, ordinance or regulation? YES_NO_ 13. Will lot be re-graded? YES _ NO_Will excess fill be removed from premises? YES_NO_ 14. Names of Owner of premises Name of Architect Name of Contractor Address Address Address Phone No. Phone No Phone No. 15 a. Is this property within 100 feet of a tidal wetland or a freshwater wetland? *YES _NO rt- * IF YES, SOUTHOLD TOWN TRUSTEES & D.E.C. PERMITS MAY BE REQUIRED. b. Is this property within 300 feet of a tidal wetland? * YES NO -- * IF YES, D.E.C. PERMITS MAY BE REQUIRED. '......, :.'~;' " 16. Provide survey, to scale, with accurate fOlll,ldation plan and distances to prqperty lines. ~ '. ,!..,.i (,,_ ..... 17. If elevation at any point on property is at 10 feet or below, must provide topographical data on survey. STATE OF NEW YORK) d...nL,', S,S: .., -, COUNTYO~ :::.' t-fc.JI ('~ E R u +M ,'/)o 5 f:/C' being duly sworn, deposes and says that (s)he is the applicant (Name 0 individual signing contract) above named, MYY\('n(~<;~ I<- (Contractor, Agent, Corporate Officer,.<;tc.)) of said owner or owners, and is duly authorized to perform or have performed ~he 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 manner set forth in the application filed therewith. ' (S)He is the Sworn to before me thi day of "I'......) !"- 20~ Notary Public t" ,H~t I?.~ Signature of Applicant REBECCA A. VILARDI NOTARY PUBLIC, STATE OF NEW YORK QUALIFIED IN SUFFOLK COUNTY NO: 01 W060391 06 COMMISSION EXPIRES MARCH 27, c;jP/O