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Home My WebLink About33096-Z FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY Date: 06/05/07 No: Z-32383 THIS CERTIFIES that the building ACCESSORY Location of Property: 240 FREEMAN (HOUSE NO.) County Tax Map No. 473889 Section 139 AVE (STREET) Block 3 MATTITUCK (HAMLET) Lot 43 Subdivision Filed Map No. Lot No_ conforms substantially to the Application for Building Permit heretofore filed in this office dated MAY 29, 2007 pursuant to which Building Permit No. 33096-Z dated JUNE 1, 2007 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 ELECTRIC UPGRADE TO ACCESSORY BARN AS APPLIED FOR. The certificate is issued to HALSEY GOLDSMITH (OWNER) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A ELECTRICAL CERTIFICATE NO. 3033095 OS/24/07 PLUMBERS CERTIFICATION DATED N/A ~ed!::!!:-- Rev. 1/81 . .i!OD1-Qi-151D:59 >> 2522474355 P4/4 Funn No.6 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 following: A. For new building or new use: I. Final survey of property with accurate location ofall buildings, property lines, streets, and unusual natural or topographic features. 2. Final Approval from Health Dep\. of water supply and sewerage-disposal (S-9 form). 3. Approval of electrical installation from Board of Fire Underwriters. 4. Sworn statement from plumber certit)ring thatthe solder used in system contains less than 2/10 of I % lead. 5. Commercial huilding, industrial building, multiple residenccs 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-conformlng UIeI, or buildings .nd "pre-existiog" land uses: I. Accurate survey of properly showing all property lines. streets, building and unusual natural or topographic features. 2. A property completed application and a consent to inspect signed by the applicant. If a Certificate of Occupancy is denied. the Building Inspector shall state the reasons therefor in writing 10 the applicant. C. Fees I. CertifICate of Occupaney - New dwelling $25.00, Auditions to dwelling $25_00, Alterations to uwelling $25.00, swimming pool $25.00. Accessory building 525.00, Additions to accessory building $25.00. Businesses $50.00. 2. Certificate ofOecupaney on Pre-existing Building - $100.00 3. Copy nfCertificate ofOccupaney. $25.00 4. Updated Certificate of Occupancy - $50.00 5. Temporary Certificate of Occupancy - Residential $15.00, Commercial $15.00 Date. Location of Property: -.)lj(j House No. Old or pr...existing Building: ~'('('ijCl'\ /\Jen,t:' Street f'ok:U ['0,11, I ~JL. . ..__ Blook v _.. (check one} HoWK Hamlcl New Construction: Owner or Owners of Property: _l-YA \){' ~ Suffolk County Tax Map No 1000. Section ~ Lot co Date of Permit. Filed Map. Applicant: lJnderwriters Approval: _.. Lot: Subdivision Pennit No.. 33nQl", Health Dept. Approval: Planning Board Approval:.. Request for: Temporary Certificate . ,....;:.' ,,,; '\ Fee Submitted: $ ()(.., )_;V\.J t--o :6. :,~.;~<(~ ~ c.:1). Ie 5'-t Final Certificate: V (check one) x. /3q.- 3:"" LJ.3 I!I.~I!I ~ BY THIS CERTIFICATE OF COMPLIANCE THE ~ ~ NEW YORK BOARD OF FIRE UNDERWRITERS ~ ~ BUREAU OF ELECTRICITY ~ ~ 40 FULTON STREET - NEW YORK, NY 1 0038 ~ ~ CERTIFIES THAT fLl) I~ ,"'" I ~ ~ I ~ ~ Upon the application of upon premises owned by ~ ~ ~ ~ PAUL PYLKO PAUL PYLKO ~ ~ 106 TEAK COURT 106 TEAK COURT ~ I PINEKNOLL SHARES, NC 28512 PINEKNOLL SHARES, NC 28512 I ~ Located at 240 FREEMAN RD MATTITUCK. NY 11952 ~ ~ = ~ Application Number: 3033095 Certificate Number: 3033095 ~ ~ 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: ~ ~ garage/shop, Detached Garage, ~ ~ 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 24th Day of May, 2007. ~ Fo!I Name OTY Rate Ratin. Circuit ~ ~ ~ Miscellaneous ~ ~ as built -pre1965 ~ ~~~~~ ~ Fo!I Furnace I 0 Gas Fo!I ~~~~ ~ ~ Outlet 9 0 Fixture ~ ~ Fixture 5 0 Incandescent ~ ~ Outlet 21 0 General Purpose ~ ~ Receptacle 13 0 General Purpose ~ ~ Switch 7 0 General Purpose ~ ~ Fixture 4 0 Flourescent ~ ~~ ~ ~ I Phase 3 W Service Rating 100 Amperes ~ ~ Service Disconnect I 100 cb ~ ~ Meters: I ~ ~ An as built inspection, of the delineated electrical installation, determined that an obvious hazard is not present and the installation is believed to ~ ~ be in comformance with the applicable reference standard for the estimated period of construction of the premises wiring sys~1 ~ I Continued on Next Page I of 2 I 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 1!I~@ffi!~1!I l!I~~~l!I ~ BY THIS CERTIFICATE OF COMPLIANCE THE ~ ~ 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 ~ ~ ~ ~ PAUL PYLKO PAUL PYLKO ~ ~ 106 TEAK COURT 106 TEAK COURT ~ ~ PINEKNOLL SHARES, NC 28512 PINEKNOLL SHARES, NC 28512 I ~ Located at 240 FREEMAN RD MATTITUCK, NY 11952 ~ ~ = ~ Application Number: 3033095 Certificate Number: 3033095 = I Section: Block: Lot: Building Permi!: BDC: ns11 I ~ Described as a occupancy, wherein the premises electrical system consisting of ~ ~ electrical devices and wiring, described below, located in/on the premises at: ~ ~ garage/shop, Detached Garage, ~ ~ 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 24th Day of May, 2007. ~ ~ Name OTY Rate Ratin. Circuit ~ ~ ~ No visual defects: an elctrical survey has been made of the exposed electrical equpment in the premises indicated. No obvious unsatisfactory ~ ~ condition was found. ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ seal ~ ~ ~ ~ 2 of 2 ~ 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 l!I~~l!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. 33096 Z Date JUNE 1, 2007 Permission is hereby granted to: HALSEY GOLDSMITH PO BOX 1091 MATTITUCK,NY 11952 for : ELECTRIC UPGRADE TO AN ACCESSORY GARAGE AS APPLIED FOR at premises located at 240 FREEMAN AVE MATTITUCK County Tax Map No. 473889 Section 139 Block 0003 Lot No. 043 pursuant to application dated MAY 29, 2007 and approved by the Building Inspector to expire on DECEMBER 1, 2008. Fee $ 100.00 A?t~ Wk L Authorized Signature ORIGINAL Rev. 5/8/02 iJ C IUU L '292[ >> 2522474355 WN OF SOVTHOLD DING DEPARTMENT N HALL LD, NY 11971 )763-18111 : (63 ) 76S.9~1 hfork.net/Southoldl P214 ti. u, ,l,c: , - ~''\I 0' C;~"THC; . PERMIT NO, }, :;;07'<-' BUILDING PERMIT APPLICATION CHECKLIST I')n }()u have or nted llit tollowing. bet'utt:: applying'.' ~oerd uf HeaUh_._.... .._ . .. stlS of Buildin S ?tans Pfanl\ina: 80ard awro....l__ S...,,__._...._.. Check Sept(l; 17~r"\ NY,$.I1I\C Tfl.JStttli ConUid: F.xaminL:'d Appmvod. ])i!lllppfO...cdall.: e,f 1fl.E::l ql,'0..a7 MElillO I r1;/,--, 2O.%j /:~clor ~~)'-X(~4 ."'O,C-",C'.O, (, T'Ir'/) ., "', /S ~ 'J .I :l / ~ \( ..'i"," ;,... 7 if:) ,....J" 12xpiriJtioo APPliCATION FOR BUILDING PERMIT Dare ,20 INSTRUCTIONS Il This appfj~Uon MUST be wmpleteb nllt<<! in by tYpI=writer or in ink and submincd ro the Building Insptl:l.ur \"jth 3 lets urplans, lll:i:umh:~ plot pJ8tI tu SCaJe. Fee llccurdin~ to !lichcdulc. b. Plot plan siwwir:lglo!;Qt.ion uflut rmd ufmuldmp on prc:mlsc5. rdfttionship to adjoining premise~ tlr public slrtets or areas.. and wtderND.)'S. c. The WQrk covered by thislpPhl;llion may not b~ oommenced before inWIDCt of Building Pcrmit. d. Upon Ilppru\llli uflhis opplicalion, the ~wldinEllmif"cctor will .ssU'; a Building Permit to dlC' applicanL SlKlh H pmnit !dIaU he kepi on .he ~kes 1IY.ilable tbr inspet;li(lf'llhroa,PaOllf 1he work. &::. NQl'milding ~hllil he: occupied I,Ir uST:1.i in who~c: Of il1 partlbr any pUl])OSi: what so ewr wuU the Building Il'l.spt~tut isJ~s III Ceniticatc of (k:i:upant;y, f. 1c:\lCf)' building permit s~all expire if the WOfk au!horized bas not commenced wilhin 12 mnruhs aUef the MIC of issuance or hu not b<<"n comple1l."d within 18 months from su.;h datt. If no ZlInin~ lI1Iendmenl:5 or other rqt\lhUions 8tl~<<ing 1I)l.': prop;rry have been c:naacd in the- irnCfim. the Building Insp:J;tor may authorizt. in writing. the cx~5i(m ofthc: permit tQr Rfl addition six months, Thereafter. fl new perm't shall be required. APPLICATION IS tlcRcBY MADE 'Gibe Buildi1l8 Depamn...lbr .he i".ance of. Buildiog Permll pu"...' to Ibe Buildirtg Zuue OtdiRll'lCe urilhcl Town of South old, Suffolk COunl)', New Yoril. and othct epphclblc Laws. Ordinancc:s nr Regulations. for the I:onstruction ofbuildin8s, additions, or tdtc:tatiUI15 or tOr rt;imO't'aJ OJ dcmolihon as herein dtsctibed The apphlo':8I1t agtll.:i 10 ~on)1)l)' Wtth Mil appli~uble law!!., ordinance$. hu.ildiflg code. housing code. and regulation&., tmd to admit .~honzcd in.p.~I""Octu p ANCY'OR~ry ;.'~'I;o:g . USE IS UNLAWFUL I~tfl:;; ;;;- _."'......,;f~ti.~RJ"/l- WITHOUT CERTIFICATE ;Msjhng"'d<<~"",) Slate whelh<'t apP1OP'OeCt1p,B:N'CVCl. en~iMer. genctlll con.ractor, e'ecA9lilr_lM6I#)T~D DATE:i-I'/7 APt 33o'i6;y Nameofownerofpremi,cs ~Y11~('I,' _GDj&mlrh. F':~: /'.'i).'.B'{~C;~ ~ (Asonth<~;ollorJa"""d&llllrrFY BUILDiNG DEPc;'WENT Ir.pplican. i, a corporation. signlllure of duly authorized officer 765.1802 8 AM TO 4 P'; '~O' R' AT '" r ,rHE FOLLOWiNG INSPECTlOi,S' 1 c~r""'n~TIOr" ' , '.JC''''" '" '. - TWO REQU'''m F.~,. 'l)i 1';1-:. C'-"'(",r-I'" ,.. "'" '(~ , -, C'.~-~ '- '., ..' 1'1:.. . ,'-' L. t1__,~) ,JH - t',~.r.!,"'G 8 :1'. .';;NG 3, IN~~ L';TJC,,~ ' . 4 FlU.',! ""''""''''-'T~' ,....'- . ,',' '.- - '. ',--" ,~:" (''.., '""'...! l,," rST 6" ,""'(...\,c'" ""'...,. .'. . ".1,,; t.: '.,::\","-.:::'tt.: FOl, .....:') .. Mc~~l#-tC@i~TRUCTlON SHALL MEET TFIF ~E~JTS OFTHECODESOFNEW . 1--zzQ . '2'.. 1K STATE'Lli.?" T:CSPONSIB.LE FO.A Counll' Tax MllPNo, 1000 Sc<:llon...~llloek 0~~.(\f;D ~ '" .~"~~ Suhdlvision hied Map No. ... . Lot ,~ f. .. ., (Nam~ and tilt.: Qf COrpollltc officer) U~DERWRITERS CERTIFICATE REQUIRED Build~rs License No. Plumbcn License Nn, Electricians Lic.:ns.: No,__ Other TllIdcfs License No. I. Location of land on whieh pro. ""sed w9rk will ~e done: ;'>lll~ __~'ie.:n'f16'" ~W'tl.le Ilous.: N ulII r Slreol (Nome) 2007-05-1510:59 >> 2522474355 P314 2. Stale ex isting U~ and OCCllpanCy or premises and intrndc:d use and occupancy of proposed constr~tion: a. Exiliting u.~c and occupancy ~. lnlended us. and occupancy 3. NaNce of work (check which applicable): New Iluildin&.. Rt:pftir ,-,,,~.~....___R:mo...al Demolition Addition Othor Work Alter.uion 11 1"( 1-il(. ..... . (Descriptinn) 4. listimated Cost ~'CC 5. If dwelling. numher of dwelling unil.< If garage. number of car. (To be paid on tiling this applieetinn) Numbc:r of dwC'lIing W1its on each floor 6, If h(lsi"css. commercial or mixed Ol:CUpancy, sJx:'Cit)l nature and extent of ~ach type of U~, 7. Dimensions of existing struclures. il'lIl1Y: front Height Number of Stories Rear Deplh _" Dimen,ion, of ..me structure with .I!erations or addlUons: Fronl Rear Depth Height Number of Storie. S. Dimensions ofendre new oonwuction: Front Helghl Number of Storie, Rl:lIT Depth 9. Size of 101: fronl Rear Depth 10. DOle of PurchllSc Name of fonncr Owner 11. ,..one or u~ district. in which prwliscs 8R situated 12. Does proposed eonslruction violatc ony loning law. ordinance Or regulation? YES_ 1'10_ ll. Willlnt he rc-graded" YFS_ NO_Will excess fill be removed fmm r",mi,e,? YES_ 1'10_ [4. NAmes of Ownr:r of premlscs Name of Architect Name ofCollcractor Address Add",.. AddrcllCi: Phone No. Phone: No Phone No. 1$ iI. Is this pro~rt)' withJn 100 feet of 0. tidal wetland or 8 freshwater wetlQJ1d" "'YES-----.NO _ . IF YES, SOlJTHOUHOWN TRUSTEES & D.E.C. PERMITS MA Y BE REQUIRED. h.l. this propeny within 300 t~et ol'a lidal wetl..d?' YIiS_ NO__ . IF YIiS. D.Ii.C. PERMITS MAY BE REQUIRIiD. 16. I'rovidt survey. 10 scalc. wilh ,",curate foundalion plan and dimances lO propeny Iincs. 1,. IfclCVllllon at any point On property is at 10 fuel 0' below. must provide topographical data on survey. STATEOFNE.....IIIU.j l\JoJUII ~4t-N\- ss: tfUNTY m_"m Q..M~J~T -~ 1A). /4:().._ beingduly.wom.deposcs..dsayslh>l(.)he;.'bcoppli.... (Name 11 individ.uB.I si8Ding contract) abu"c nlllned, (5.Hc is tilt (COnltactur. Agenl, Cnrporat-c Oflia,.. de.. of said owner UT UWDl':I's., 'lid is duly authorl<t:ed In pcrfurm or have ~rlhnncd the said wurk and to mau and file lhi5 application; that all Slaltltlentli contained in this appli~lI.tinn arc tme to the btSl. of hi,. knowlcdgt and hclief; and that the work will be: pcrtOnnoo' in tht: manFlCT 51.1 torth in ~ .pplicatioD tiled thetcwith. ~:t:: ~~ -- Siina. ....pph""nl '. - My Commission Expires July 31,2010