HomeMy WebLinkAbout32571-Z
FORM NO. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Office of the Building Inspector
Town Hall
Southold, N.Y.
CERTIFICATE OF OCCUPANCY
No: Z-32621
Date: 09/24/07
THIS CERTIFIES that the building ADDITION/ALTERATION
Location of Property: 195
(HOUSE NO.)
County Tax Map No. 473889 Section 97
DEERFooT PATH
(STREET)
Block 7
CUTCHOGUE
(HAMLET)
Lot 22
Subdivision
Filed Map No.
Lot No.
conforms substantially to the Application for Building Permit heretofore
filed in this office dated
DECEMBER 8, 2006 pursuant to which
Building Permit No. 32571-Z
dated
DECEMBER 14, 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 ADDITION & ALTERATION TO AN EXISTING ACCESSORY GARAGE AS APPLIED FOR
& AS AMENDED TO INCLUDE OUTDOOR SHOWER.
The certificate is issued to DONALD & NATALIE WILCENSKI
(OWNER)
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL
N/A
ELECTRICAL CERTIFICATE NO.
3029442
09/14/07
PLUMBERS CERTIFICATION DATED
N/A
~riZ~
Rev. 1/81
.
-.
Form No.6
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN HALL
765-1802
AI'PLICATION 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 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).
~ Approval of electrical installation from Board of Fire Underwriters.
~ Sworn statement from plumber certifying that the solder used in system contains less than 2/1 0 of I % lead.
. 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:
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. G/ZCf /07
Location of Property:
,qs
House No.
Owner or Owners of Property: ria fa Irf
-:Deer +;'jof
Street
/
t:b-fh
(check one)
CC-tkhoCfUL
J Hamlet
New Construction:
Old or Pre-existing Building:
Suffolk County Tax Map No 1000, Section
Cf UJY1a /rI
117
u/ / (t'n sIc,
,
Blockf
Lot 27
Filed Map.
Lot:
Subdivision
PemLit No.
31-. '5" 11- Date of Permit.
Applicant: 0.' \ c. p "" S \:::. I
Health Dept. Approval:
Plarming Board Approval: _ _
Underwriters Approval:
Request for: Temporary Certificate
"\ 00
Fee Submitted: $ d-. c:..
Final Certificate:
t//
(check one) ,
/1PtU4 ~
Applicant Signature
~ 731\D
"O.c 5)G.2./
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.
32571 Z
Date DECEMBER 14, 2006
Permission is hereby granted to:
DENLEA (WILCENSKI)
195 DEERFOOT PATH
CUTCHOGUE,NY 11935
for :
ADDITION/ALTERATION TO AN EXISTING ACCESSORY GARAGE AS APPLIED FOR
Et rvvJ. +n ~d 1A olt
OLd-door .sJ.-~ :d-oJJ I c;;t/:-o. d\d/fd
,
at premises located at
195 DEERFOOT PATH
CUTCHOGUE
County Tax Map No. 473889 Section 097
Block 0007
Lot No. 022
pursuant to application dated DECEMBER
8, 2006 and approved by the
Fee $
75.00
d Signature
Building Inspector to expire on JUNE
ORIGINAL
'/8/02
0/7. . 7 ~ 2...2-
I!I.I!I
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 ~
~ ~
~ SABAT ELECTRIC DONALD WILCENSKI ~
~ 50 PAT LANE 195 DEERFOOT PATH ~
~ MATTITUCK, NY 11952, CUTCHOGUE, NY 11935 ~
~ ~
~ Located at 195 DEERFOOT PATH CUTCHOGUE, NY 11935 ~
~ 3029442 3029442 ~
~ Application Number: Certificate Number: ~
~ Section: Block: Lot: Building Permit: 32679 BDC: n511 ~
~ ~
~ Described as a occupancy, wherein the premises electrical system consisting of ~
~ electrical devices and wiring, described below, located in/on the premises at: ~
~ Basement, First Floor, Second Floor, Detached Garage, Outside, Attic, ~
~ 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 14th Day of September, 2007. ~
~ Name OTY Rate Ratin. Circuit ~ ~
~ Alarm and Emergency Equipment ~
~ Sensor 2 0 Carbon Monoxide ~
~ Sensor 7 0 Smoke foil
~ Appliances and Accessories ~
~ Dish Washer I 0 1.2 KW ~
~ Exhaust Fan 3 0 F.H.P. ~
~ Hydro Massage Tub (Therapeutic) I 0 ~
foil Furnace I 0 Gas foil
~ Air Conditioner I 0 42.000 BTU ~
~ Panels ~
~ I 30 4 ~
~ ~~~~~g and Devices 40 0 Fixture ~
~ Fixture 37 0 Incandescent ~
~ Fixture 3 0 Flourescent ~
~ Outlet 81 0 General Purpose ~
~ Receptacle 51 0 General Purpose seal ~
~~ %0 ~~ ~
~ Continued on Next Page I 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
I!I.I!I
I!I.@]
I' BY THIS CERTIFICATE OF COMPLIANCE THE I
i NEW YORK BOARD OF FIRE UNDERWRITERS i
~ BUREAU OF ELECTRICITY ~
~ 40 FULTON STREET - NEW YORK, NY 1 0038 ~
~ CERTIFIES THAT ~
~ ~
I Upon the application of upon premises owned by I
~ SABAT ELECTRIC DONALD WILCENSKI ~
~ 50 PAT LANE 195 DEERFOOT PATH ~
~ MATTITUCK, NY 11952, CUTCHOGUE, NY 11935 ~
i 195 DEERFOOT PATH CUTCHOGUE, NY 11935 i
~ Located at ~
~ Application Number: 3029442 Certificate Number: 3029442 ~
~ ~
~ Section: Block: Lot: Building Permi!: 32679 SDC: n511 ~
~ Described as a occupancy, wherein the premises electrical system consisting of ~
~ electrical devices and wiring, described below, located in/on the premises at: ~
~ Basement, First Floor, Second Floor, Detached Garage, Outside, Attic, ~
~ ~
~ 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 14th Day of September, 2007. ~
~ Name ' OTY Rate Rating Circuit ~. ~
~ Receptacle 1 0 20a Laundry ~
~ Paddle Fan 6 0 ~
~ Disconnect 1 0 60a Air Conditioner ~
~ Receptacle 8 0 GFC1 ~
~ Se"i~ ~
~ 1 Phase 3 W Service Rating 200 Amperes ~
~ Service Disconnect: 200 cb ~
~ Meters: 1 ~
I !
~ ~
~ ~
~ ~
~ ~
~ 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. ~
@]~~
3~S1/;L
TOWN OF SOUTHOLD BUILDING DEPT.
765.1802
INSPECTION
[ ] FOUNDATION 1 ST [ ] ROUGH PLBG.
[ ] FOUNDATION 2ND [ ] INSULATION
[ ] FRAMING I STRAPPING ~ FINAL ~ ~
[ ] FIREPLACE & CHIMNEY [] FIRE SAFETY INSPECTION
[ ] FIRE RESISTANT CONSTRlJCnON [ ] FIRE RESISTANT PENETRAT10N
REMARKS:
~
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,
~
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DATE 7'/Y-() 1
INSPECTOR
~PL-
; -;-S7/ Z-
TOWN OF SOUTHOLD BUILDING DEPT.
765.1802
INSPECTION
[ ] FOUNDATION 1 ST
[ ] FOUNDATION 2ND
[ ] FRAMING I STRAPPING
[ ] FIREPLACE & CHIMNEY
[ ] FIRE RESISTANT CONSTRUCTION
[ ] ROUGH PLBG.
[ ] INSULATION
~FINAL
[ ] FIRE SAFETY INSPECTION
[ ] FIRE RESISTANT PENETRATION
REMARKS:
~~~~
~ ~-11'''
,
DATE
r~/O-1)1
:52- ,5'"/ I .z:.
TOWN OF SOUTHOLD BUILDING DEPT.
765.1802
INSPECTION
~UNDATION 1 ST [ ] ROUGH PLBG.
[ ] FOUNDATION 2ND [ ] INSULATION
[ ] FRAMING I STRAPPING [] FINAL
[ ] FIREPLACE & CHIMNEY [] RRE SAFETY INSPECTION
[ ] RRE RESISTANT CONS1RUCT1ON [ ] RRE RESISTANT PENETRATION
REMARKS: ~t~2- ~:
,/D 7~/
DATE /! {Fyi 07
!
INSPECTOR
.,o~
JAMES J. DEERKOSKl, P.E.
260 Deer Drive
Mattituck, N.Y. 11952
(631) 298-7116
To: Town of South old Building Dept.
Re: Foundation! Framing! Strapping Inspections
Wilcinski
195 Deerfoot Path
Cutchogue, NY 11935
Permit#3257I
To Whom It May Concern:
After a Foundation, Framing, Strapping and Insulation inspection was preformed on the
above mentioned property, it is deemed that all work performed was completed to plans
and meets all state and local codes. Any other questions please call.
es ):\D~erkO.Ski
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COMMENTS
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PLUMBING
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TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN HALL'
SOUTHOLD, NY 11971
TEL: (631) 765-1802
FAX: (631) 765-9502
www.northfork.net/Southold/
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:
PERMIT NO. 38'J?-i"2-
Examined
/2../'4
12..!I'f
,20~
, 20--.k-
Expiration
,20_
1:>o..-,c;".'d J. W ,)c..f'...... Sl::.....I.
Mail to: 7...,. ("" \* Po ~"v- 0.;:1-, p"..-.:......e
c-"-'<<--(,.~S.J'<. / ;..>':1. \ 1"i:3"-
Phone:(i:.') 7~ 'f - (. ~\o (" .
@ 1~-I- ?.....,J?
G..u SIIo- qfJ,?,<"O'-f1
Approved
Disapproved alc
Ii
"
8
.,
)
APPLICATION FOR BUILDING PERMIT
Date &CR~~ ~ ,200 b
INSTRUCTIONS
,
___...2...... ,- ...J
a. This application MUSfbe 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 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.
01--1 uS' r:;....rwA1 i:)r,,,,-,- ~l~\_ jji-
(Mailing address of applicant) \ ,'11}
State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder
Ow~
Name of owner of premises \).,V\",l~ J. ..t ttJ ,,1-.:. \:~ '\. Lj : \c...(~ 1" \.::. :
(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\1\
1M)
I. Location ofIand on which.-1![oposed work willlle done:
/q~ LlEE'ilH,O,/ VATI+
House Number Street
e,JicA 0 <1 {j <e.-
Hamlet
County Tax J1. No.1 000 ~)ction
Subdivision a..e of' f/l()o,se
(Name)
17
Cove,
Block '1
Filed Map No.
3cJ3o
Lot
Lot
Jg
4
b. Intended use and occupancy
2. State existing use and occupancy of premises and intended use and occupancy of
a. Existing use and occupancy fu
~-'\
3. Nature of work (check which applicable): New Building
Repair Removal Demolition
4. Estimated Cost 1f I ~ I 0.) ;)
Addition y
Other Work
Alteration )(
(Description)
Fee
5. If dwelling, number of dwelling units ----
If garage, number of cars '1w 0
(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 O'/!)- 1 Rear---.d !!;}- ( _Depth
Height_' I 't ( ,. Number of Stories I
d~'
Dimensions of same structure with alterations or additions: Front ~ l.f I
Depth () D \ Height lS ' \ \ " Number of Stories
Rear rJ l{
f\~'
Depth ;) 0 1
8. Dimensions of entire new construction: Front ;H' Rear ~~\
Height \ c; \ \, " Number of Stories ,
/&0 ( I (PO I /7CJ.1
9. Size oflot: Front Rear Depth
10. Date of Purchase J 1/1-0 JLuo (, Name of Former Owner Es-h-rn:: c-F F/JINllrLf':> UtE'".JV L';:-I-\.
. /
11. Zone or use district in which premises are situated
12. Does proposed construction violate any zoning law, ordinance or regulation? YES_NO-X-
13. Will lot be re.graded? YES_ NO~ Will excess fill be removed from premises? YES_ NO~
W,h.....c\::.i
14. Names of Owner of premises i)._v..l.(- .,J<.-I..I.. Address l..-\:..s'
Name of Architect JOIMt,s ~"t.,,,-: Address'(
Name of Contractor '103 D Address
f<t;r""..., 1)...- Phone No.
Phone No
Phone No.
'\. _1?'1_ '1. 'lIt
15 a. Is this property within 100 feet of a tidal wetland or a freshwater wetland? *YES _NO ':I
* 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)
SS:
COUNTY OF J.. a; lit)
1)O"4J~ .1, "" I" t~nJ r " being duly sworn, deposes and says that (s)he is the applicant
(Name of individual signing contract) above named,
(S@Jis the
-.- - Pl'u;(e eJwn~
(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.
Sworn t9 before me this
"i'+" day of 7Je.c~",^J:u,... 20~
~A~ {Jf. ~
Notary Public
?Y~~
SHARON L. BAlEK
Notary Public, Stale of New Yolk
No. 4863757
Qualified in SufIuIk Cougty ,,,. J 0
Commission Expires October 20, ~
J:I 1,,-.') .,.
3~1\
TOWN OF SOUTHOLD PROPERTY RECORD CARD
95
l
/1- It
OWNER
VILLAGE
DISTRICT
SUB.
LOi #- $I
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E. 2Jt:'.)) ka.
FORMER OWNER
cI e<-t
IA
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~ES. d / i)
LAND
IMP.
N ACREAGE 6'7
.-
S W TYPE OF BUILDING
FARM COMM. I MISe. I Est. Mkt. Value
TOTAL DATE REMARKS
~~
SEAS.
'700 I
[00(;:) ,
1I0o I
C <L A~'9S
*7 ~
. 2. "<Xl.
100 "3 b ( -4\Q0 I
AGE
NEW
NORMAL
BUILDING CONDITION
BELOW
ABOVE
Form
Acre
Value Per Acre
Value
FRONTAGE ON WATER
FRONTAGE ON ROAD
BULKHEAD
DOCK
.
/GO
rill able 1
-jllable 2
-jllable 3
v. Ofl.fll:
/2.5
Vaodland
.wampland
:rushland
louse PI~
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M. Bldg. IZ4x~o:..9(Po 13,25 6\2-01 Foundation V. c... -LBoth \ ,
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Extension Basement +1..JL.-L Floors \I-J v...1 i
Extension I Ext. Walls ALUM ":;I\)\U( Interior Finish "5. \<- !
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i T
Extension I Fire Place - Heat ~(\-lwl
, ~ CASLE-I
I I Porch Roof Type
, ..
Porch 1 st Floor I
h"l) I Z. >< \~ ;::: \68- .\0 \71 Rooms I
3 ree;1:eway I I '-1-- I
Patio Rooms 2nd Floor ,
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:;oroge \2.><.2.0 - .':2.40 i \2..~ 300/ Driveway Dormer
J. B. I' I
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34-37 / J
.
SURVEY OF LOT 4
"MAP OF MOOSE COVE"
FILED AUGUST 30, ICf60 AS MAP NO. 3230
SITUATE: EAST CUTCHOGUE
TOHN: SOUTHOLD
SUFFOLK COUNTY, NY
SURVEYED, OCTOBER 25, 2006
SUFFOLK COUNTY TAX MAP NUMBER
1000 - '11 - 1- 22
CERTIPIIID TO:
NATAUB WlLCENSKi
DONAlD WlLCENSKI
OHIO SAVINGS BANK
FlDEUTY NATIONAL 1TI'LB INSURANCE
COMPANY OF NEW YORK
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NOTES
. MONUMENT
AREA = 20,223 SF OR 0.4643 ACRE
GRAPHIC SCALE
~
1"= 30'
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JOHN C. EHLERS LAND SURVEYOR
6 EAST MAIN STREET
RIVERHEAD, N,Y, 11901
369-8288 Fax 369--8287
N,Y.S. LlC. NO. 50202
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