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30981-Z
FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No: Z-32046 Date: 12/04/06 THIS CERTIFIES that the building ALTERATIONS Location of Property: 2305 YENNECOTT DR SOUTHOLD (HOUSE NO.) (STREET) (HAMLET) County Tax Map No. 473889 Section 55 Block 4 Lot 17 Subdivision Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated FEBRUARY 24, 2005 pursuant to which Building Permit No. 30981-Z dated FEBRUARY 28, 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 ALTERATIONS TO AN EXISTING SINGLE FAMILY DWELLING AS APPLIED FOR. The certificate is issued to MICHAEL F & BONNIE DOROSKI (OWNER) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A ELECTRICAL CERTIFICATE NO. 2053590 10/26/06 PLUMBERS CERTIFICATION DATED N/A Aut orized Signature Rev. 1/81 Form No.6 Mad TOWN OF SOUTHOLD 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 foxing: A. For new building or new use: 1. Final survey of property with accurate location of all buildings, property lines, streets, and unusual natural 67 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$25.0Qh.. Swimming pool $25.00, Accessory building$25.00, Additions to accessory building $25.00, Businesses $50.0 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. 1Ty�p 6 New Construction: / Old or Pre-existing Building: (check one) /L I Location of Property: 2 3 o S /vEQ1 AF oT T he i�c Sou-#C o L D House No. Street Hamlet Owner or Owners of Property: W C,( k�Lj a, 3 a n n) a JO/Lo Cde Suffolk County Tax Map No 1000, Section 53' Block Lot / 7 Subdivision Filed Map. Lot: Permit No. 0 2,91 ; Date of Permit. Z�x (6e r Applicant: &A,,,d ,jour!( " Health Dept, Approval: Underwriters Approval: Planning Board Approval: Request for: Temporary Certificate Final Certificate: (check one) Fee Submitted: $ ZSo� Applicant Signature eo �s�o�� 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. 30981 Z Date FEBRUARY 28, 2005 Permission is hereby granted to : MICHAEL F DOROSKI 2305 YENNECOTT DR SOUTHOLD,NY 11971 for ALTERATIONS TO AN EXISTING SINGLE FAMILY DWELLING AS APPLIED FOR at premises located at 2305 YENNECOTT DR SOUTHOLD County Tax Map No. 473889 Section 055 Block 0004 Lot No. 017 pursuant to application dated FEBRUARY 24 , 2005 and approved by the Building Inspector to expire on AUGUST 28 , 2006 . Fee $ 150 . 00 "Authoze Le ORIGINAL Rev. 5/8/02 DcnL3rL3r3rJ 3rL3r Pcnr� L3rL3r3r@r cnr r@ o 5 BY THIS CERTIFICATE OF COMPLIANCE UNDERWRITERS 5 5 NEW YORK BOARD OF FIRE 5 5 BUREAU OF ELECTRICITY c5 5 40 FULTON STREET — NEW YORK, NY 10038 5 5 CERTIFIES THAT S Upon the application of upon premises owned by 7C ROSLAK ELECTRIC MICHAEL DOROSKI 5 P.O. BOX 164 2305 YENNECOTT DRIVE S l5 CUTCHOGUE, NY 11935-2453, SOUTHOLD, NY 11971 C� Located at 2305 YENNECOTT DRIVE SOUTHOLD, NY 11971 5 Application Number: 2053590 Certificate Number: 2053590 Section: Block: Lot: Building Permit:30981 BDC. ns11 5 5 Described as a Residential 0-S 9 ua a ft. occupancy, wherein the premises electrical system consisting of electrical devices and wiring, oescrite&Weafow, located in/on the premises at: 5 First Floor,Outside, 5 A visual inspection of the premises electrical system, limited to electrical devices and wiring to the extent detailed 5 5 herein, was conducted in accordance with the requirements of the applicable code and/or standard 5 5 promulgated by the State of New York, Department of State Code Enforcement and Administration, or other 5 authority having jurisdiction, and found to be in compliance therewith on the Day of 5 rj 26th October,2005. �5+ Name 2 Rate Rating Circuit Tyne 5 Miscellaneous closed in screen porch 5 5 Wiring and Devices 5 Outlet 3 0 Fixture 5 5 Fixture 3 0 Incandescent 5 Outlet 7 0 General Purposes 5 Receptacle 6 0 General Purpose 5 5 Switch 3 0 General Purpose 5 5 Paddle Fan I 0 5 5 5 5 SS c7 seal 5 5 5 I of , OIrl 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. o s�����s�s� ��sss �� �����@���LrE _rl LI v *SOF SOUT�o* TOWN OF SOUTHOLD BUILDING DEPT. 765.1802 INSPECTION [ ] FOUNDATION IST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] INSULATION [ ] FRAMING / STRAPPING XFINAL [ ] FIREPLACE & CHIMNEY [ ] FIRE SAFETY INSPECTION REMARKS: DATE ( � ( 7� INSPECTOR ` 765.1802 BUILDING DEPT. INSPECTION [FOUNDATION IST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] INSULATION [ ] FRAMING [ ] FINAL [ ] FIREPLACE & CHIMNEY [ ] FIRE SAFETY INSPECTION REMARKS: DATE �� INSPECTOR 765-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION IST [ ] ROUGH PLBG. [ IF NDATION 2ND [ ] INSULATION [ FRAMING [ ] FINAL [ ] FIREPLACE & CHIMNEY [ ] FIRE SAFETY INSPECTION REMARKS: �JI A L/",) � -��s 8 ` DATE INSPECTOR 765.1802 BUILDING DEPT. INSPECTION [ ] FOUND N 1ST [ ] ROUGH PLBG. [ ] FO DATION 2ND [ ] INSULATION [ RAMING [ ] FINAL [ ] FIREPLACE &/C/HIIIMNEY [ ] FIRE SAFETY INSPECTION REMARKS- v DATE ©� INSPECTOR 765.1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION IST [ ] R GN PLBG. [ ] FOUNDATION 2ND [ INSULATION [ ] FRAMING [ ] FINAL [ ] FIREPLACE & CHIMNEY [ ] FIRE SAFETY INSPECTION REMARKS: O/ DATE �� INSPECTOR Ofsoils 6 3 ° 9717- TOWN OF SOUTHOLD BUILDING DEPT. 76S-1802 INSPECTION [ ] FOUNDATION 1 ST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] INSULATI [ ] FRAMING / STRAPPING ] FINAL [ ] FIREPLACE & CHIMNEY [ ] FIRE SAFETY INSPECTION REMARKS: ,�p , / DATE �� �3�o G INSPECTOR FIELD INSPECTION REPORT DATE COMMENTS 3116 - -0 FOUNDATION (1ST) _ - --- 00 y - - - ------------------------------------- FOUNDATION (2ND) - - z 0 i�E tkP�Y�rt� - UW ROUGH FRAMING& PLUMBING 3 INSULATION PER N.Y. - - - �1 y STATE ENERGY CODE a-13- AQ _ FINAL ADDITIONAL COMMENTS m oC� O 0 TOWN OF SOUTHO10D BUILDING PERMIT APPLICATION CHECKLIST BUILDING DEPARTMENT Do you have or need the following,before applying'? TOWN HALL Board of Health SOUTHOLD,NY 11971 3 sets of Building Plans TEL: (631) 765-1802 Planning Board approval FAX: (631) 765-9502 Survey PERMIT NO. ,3057:��7 _ Check Septic Form N.Y.S.D.E.C. Trustees Examined ,20 Contact: Approved ,20 Mail to: Disapproved a/c Phone: Expiration ,20 - Building Inspector APPLICATION FOR BUILDING PERMIT Date FAI 20®5- �B Z 4 INSTRUCTIONS a. This application MUST be completely filled in by typewriter or in ink and submitted to the Building Inspector with 3 sets of plans, accurate plot plan to scale. Fee according to schedule. b. Plot plan showing nutation 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 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, and to admit authorized inspectors on premises and in building for necessary inspections. (Signature of leant or name,if a corporation) Altzs \IeAoff_b Q— SoAA4l (Mailing address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician,plumber or builder 42x1,1/111r7 Name of owner of premises 1[ Z D /-w J /Cl/L{J�IC l (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. 1. Location of land on which proposed work�will be done: a-1 o s q -fT `)f soCtaw House Number J Street Hamlet Sir-F. Co . t�?�j_� County Tax Map No. 1000 Section S� Block ' Lot /7 Subdivision Filed Map No. Lot (Name) l 2. State existing use and occupancy of premises and intended use and icupancyof proposed construction: a. Existing use and occupancy Sn a 2 b. Intended use and occupancyLicAe-D rt2cA WA L S/oma s 3. Nature of work(check which applicable): New Building Addition_Z Alteration Repair Removal Demolition Other Work (Description) 4. Estimated Cost ��O or Fee (To be paid on filing this application) 5. 1 f dwelling, number of dwelling units Number of dwelling units on each floor If garage, number of cars 6. If business, commercial or mixed occupancy, specify nature and extent of each type of use. i 7. Dimensions o existing structures, if any: Front Rear 4O Depth Height Number of Stories / Dimensions of sane structure with alterations or additions: Front Rear 6 0 Depth,2-1t f- (2 PWS Height fa Number of Stories 8. Dimensions of entire new construction: Front RearDepth �a Height l-. I Number of Stories 4 9. Size of lot: Front J6 .—(-4- Rear I S+ 6`` Depth . �II 10. Date of Purchase SI 0 Name of Former Owner �DMQ 0 11. Zone or use district in which premises are situated 'P, qd 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_NOV/ 14. Names of Owner of premisesM' b Po Rc5 k- Address�3°S �� Phone No. Name of Architect Address Phone No Name of Contractor Address Phone No. 15 a. Is this property within 100 feet of a tidal wetland or a freshwater wetland? *YES NO/ * 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 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 NEW YORK) S: COUNTY OF S � being duly sworn, deposes and says that (s)he is the applicant (Name of individual signing contract) above named, (S)He is the G(� (Contractor,Agent, Corporate Officer, etc.) 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 manner set forth in the application filed therewith. Swom to b fore me this /' day ^ ' L Notaryblit NJ ature of Applicant Claire L. Glow Notary Public, State of New York No.01OL4879505 Qualified in Suffolk Coun Commission Expires Dec. 8 ( LO TL:: :'J-YtY IS A 'ICG. STATE i •. 61:5 Cl vii TIT'::Y .'."i NOT CFA:J:.'G \ \J ' / THE LAt 0 S TO CEA •..... .. r. r G!'l.fAf:-; . ... •!rel-i;.l TIRE C .../ .\BG - 1 156 U.7.;.G .Tn d CI. . -::1 .; A -AZLE PEUY 5�, f 5IJUVEYED F0V_ ` u 39 :Ar �S3 i - nro�v r=aAkns p SOUTHE3CD ��� a7' NousE � TOWN OF `OUTHOMN,Y LU / y . s as � au yR . ,�'°°°' '•' ' .-'' SCALE . 0`° •i� i; `li lA `O LP EI*MONUMENNr' ------ -- �� 30``a `tv� j.F.NNECCIT- T + GU&Q&MTEED TO THE COMMONWEALTH 1-AN TITLE AND uV8_12PANCe COMPANY OF W` 012K:: . 1 �a51�t2,yEYED .:' JAN". 1 78 �r ,QOTDEQI G UAP TUYL,PPC NOTE-LOT NO'S.REFEP1'O"MAP OFYENNFCOTTVAikpONFILE INTHC . , SVFFOLK COUNTY CLECtWS OFFICE A5 MARNa $7. 3 cl /oao - - - TOWN OF SOUTHOLD PROPERTY RECORD CARD O NE f STREET Z3Q� VILLAGE DIST.E SUB. LOT 3 S 1t_ FORMEROWNERA VQn N E ACR. — wiz° �QAhfb4?c S W TYPE OF BUILDING f- REtyl D SEAS. VL. _ FARM COMM. CB. MICS. Mkt. Value LAND IMP. TOTAL DATE REMARKS SG 0 o p oz i d_0 y S; 5'o u 3 130 L D00 D ° J �/ ,�a ISLE Ste- Doov co to R }ha ir.G 'r° ao aaa ✓ )-/Y- � 74 n ,r *' a5, eoQ �� 3 ys 7 w, z 33 B D V19a 'kA�a,ri,�4yo'—R IOV 4?R w� 8 I AGE BUILDING CONDITION NEW NORMAL BELOW ABOVE FARM Acre Value Per Vclue Acre Tillable FRONTAGE ON WATER Woodland FRONTAGE ON ROAD Meadowland DEPTH House Plot BULKHEAD T40I DOCK v ME 0 ION NEENE NNW MOON ■■■■■■■■■■■■■■■■■■■■■■■■MEMOS „ ■■■■■■■■■■■■■■■■■■■■■■■■■■■■■ ". ENE■MEN■■■■■■■■■■■■■■ ■■MEMO � ■■■■M■■■■■■■O■■■■■■■■ ■■MOON ■■■N■■■■■��E�I■■■■■■■■■■■■■■■■■ a ■■■■■■■■E�, m SIO■■■■■■■MEMOS■■■■ ■■■■■■!!��� -*"I■■!�l!■■■■■■M■O■M■■ ■■■■■■495'ii A NON■■O■i ON so ME SAM- 211 .22 N IN ■■■■■vl likO■f3"m■1�17la=i��■■■■■N■es ■■■�nl >!■■■N�NA■■■■i a■■■■■■■■■N " � � : ' No INMENNEENNEEME ON MEN Basement Fu Type Roof e Ext. Walls Interior Finish'Fire Placeormer WVtr .. ■■■ _� APPROVED AS NOTED G DATE• f B.P.4 o FEE: 152 .. BY: NOTI BUILDING DEPARTMENT AT 765-1802 8 AM TO 4 PM FOR THE FOLLOWING INSPECTIONS: 1. FOUNDATION - TWO REQUIRED FOR POURED CONCRETE 2. ROUGH - FRAMING & PLUMBING 3. INSULATION 4. FINAL - CONSTRUCTION MUST BE COMPLETE FOR C.O. ALL CONSTRUCTION SHALL MEET THE REQUIREMENTS OFTHECODESOFNEW YORK STATE. NOT RESPONSIBLE FOR DESIGN OR CONSTRUCTION ERRORS. CERTIFICATION OF NAILING & CONNECTIONS REQUIRED. COMPLY WITH ALL CODES OF NEW YORK STATE & TOWN CODES AS REQUIRED AND CONDITIONS OF SO,T'HOLD TOWN ZBA BOUT-RD T',As=-INNING BOARD SOJ I HOLD TOWN TRUSTEES N.Y.S.DEC ALL CONSTRUCTION SHALL MEET THE REQUIREMENTS OF THE CODES OF NEW YORK,STATE. OCCUPANCY OR USE IS UNLAWFUL Ina;T HOUT CERTIFICATE OF OCCUPANCY FLOOD ZONE COMPLY WITH CHAPTE "46" FLOOD DAMAGE PREVENTION SOUTHOLD TOWN CODE. 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