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Home My WebLink About33747-Z FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY Date: 03/18/08 No: Z-32930 THIS CERTIFIES that the building ACCESSORY SHED Location of Property: 4100 ALDRICH (HOUSE NO.) County Tax Map No. 473889 Section 120 EXT (STREET) Block 6 MATTITUCK (HAMLET) Lot 1 Subdivision FHed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated MARCH 17, 2008 pursuant to which Building Permit NO. 33747-Z dated MARCH 18, 2008 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 "AS BUILT" ACCESSORY 10 X 12 STORAGE SHED AS APPLIED FOR. The certificate is issued to JOHN KOROLESKI (OWNER) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A N/A KLECTRICAL CERTIFICATE NO. PLUMBERS CERTIFICATION DATED N/A ~~~ Rev. 1/81 ! ~~" I ulL ivlAR I 7 ' i L- j I i 1('" ____-L-:" 'J Form 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 of all buildings, property lines, streets, and unusual natural or topographic features. 2. Final Approval ti-om 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 2/1 0 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 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. 3 / 1 7 /0 8 "As BIt Shed" New Construction: xx Old or Pre-existing Building: ( check one) Location of Property: 4 1 00 AId ri chI.. a. Ex t . House No. Street Mattituck, N.Y. Hamlet Owner or Owners of Property: JOHN J. KOROI..ESKI, JR. Suffolk County Tax Map No 1000, Section 120 Block 6 Lot Subdivision Filed Map. Lot: Permit No. 337 Ll 7 -r- Hcalth Dept. Approval: Date ofPemlit...}j /\5' 0 8' Applicant: Underwriters Approval: Planning Board Approval: Request for: Temporary Certificate Final Certifica e Fee Submitted: $ 25.00 8.u:.. 7Yf~ 7 Co 'C. 3.:< Do 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. 33747 Z Date MARCH 18, 2008 permission is hereby granted to: JOHN KOROLESKI 4345 WONDER HILL ROAD CHAPPELL HILL"TX 77426 for "AS BUILT" ACCESSORY 10 X 12 STORAGE SHED AS APPLIED FOR. at premises located at 4100 ALDRICH EXT MATTI TUCK County Tax Map No. 473889 Section 120 pursuant to application dated MARCH Block 0006 Lot No. 001 17, 2008 and approved by the Building Inspector to expire on SEPTEMBER 18, 2009. Fee $ 200.00 j-j'~ C~ Authorized Signature ORIGINAL Rev. 5/8/02 "'C0ei 3 37Lr 7 ~~~-- -,- - " - f10 &J=t 0-C0j ~ TOWN OF SOUTH OLD BUilDING DEPT. 765.1802 INSPECTION [ ] FOUNDATION 1 ST [ ] FOUNDATION 2ND [ ] FRAMING I STRAPPING [ ] FIREPLACE & CHIMNEY [] FIRE SAFETY INSPECTION [ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRAnON REMARKs:~ ()7< :;"(f") Co -[fa 'II~) [ ] ROUGH PLBG. [ ] INSULATION [ --rRNAL DATE ..3./ (" J oC6 INsPECTOR~~ PERMIT No.33 7'17- i:.. BUILDING PERMIT APPLICATION CHECKLIST Do you have or need the following, before applying? Board of Health 4 sets of Building Plans pr..n+o Planning Board approval ~Survey w ~. \ \ .""'-k~ ce',,' '\ I Check ~CX:' (' D Septic Form N.Y.SDEC. Trustees Flood Permit Storm-Water Assessment Form TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, NY 11971 TEL: (631) 765-1802 FAX: (631) 765-9502 SoutholdT own.NorthFork.net ,;lw ~I J~ ,20~ Examined Approved ,200< Contact: de I ) J Mail t. OriN kOro/cosk Disapproved ale Phone: b 3/- '1'8'71-/633 Expiration 'i II ~ ,20A Pce~ Building Inspector ~J ) I i ... '\ L:L:1AR I 7 . L APPLICATION FOR BUILDING PERMIT Date c..3! 7 INSTRUCTIONS I 20 ct '- 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 oflot 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, regulations, and to admit authorized inspectors on premises and in building for necessary inspectio natur of applicant or name, if a corporation) 1315iilJnci;J I!ZI Ci?pdl 4f(/~ng;~ress;/;PJ/;at State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder (Jcvner Name of owner of premises (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: '1100 A t.ORic)..1 f:;1T. House Number Street rn rt-t-t,' 1""11 c !<- Hamlet County Tax Map No. 1000 Section Subdivision 1:20 Block fa Filed Map No. Lot t Lot 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' A, p,- 1 'I Alteration ~(_-(-'/ C;!:(J.-i (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. Depth 7. Dimensions of existing structures, if any: Front Height Number of Stories Rear 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 9. Size oflol: Front Rear Depth 10. Date of Purchase Name of Former Owner II. 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_ Phone No. Phone No Phone No. 14. Names of Owner of premises Name of Architect Name of Contractor Address Address Address 15 a. Is this property within 100 feet ofa 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. 18. Are there any covenants and restrictions with respect to this property? * YES_NO_ * IF YES, PROVIDE A COPY. STATE OF NEW YORK) ~S' COUNTYOFS~ . -=S-O~ r\ :::s . Ilo V- ~ I e:...S ju being duly sworn, deposes and says that (s)he is the applicant (Name of individual signing contract) above named, (S@ is the 64Arn e V (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 to before me th\~ ^ /'. __ A^ ...., 5<- ~ \ day of 1 V\L.VY L/V \ 20~ C. ~.j{. :;J~j J.\ BARBARA H. TANDY '----- Notary Publi~'~llry Public, State Of Ne No. 011 A6086001 Qualified In Suffolk countyJL Commission Expires 01/13/20 e of Applicant ~ (?/1/QY) I:J Co - b - I TOWN 'T;;p...I---" . OF SOUTHOLD PROPERTY RECORD CARD /000 - OWNER VILLAGE DIST. SUB. . , c...--,.. .J...I.--I: />'/'.1./ j~-/ (..{{' /0 J \./ ' i "o'(~-;Y';;' \:-1 E Cn!elJfm;, 1> W ~ ~_ Y't_--P 1.1Y TYPE OF BUILDING ,.'.< ,~",. ,,<,J \ / -- 1'-. () '..,,-/_,( , 8.'8' ( S ~ ' I' "'::>OI-lH'Ve H RES~ LAND SEAS. VL. COMM. MICS. CB. Mkt. Value IMP. TOTAL DATE ;<1()() C:;n v~ov I L,t.c.',;>-(;) DO D \Q.j;;;.,nOllt>:D ( rr~/;j c: !> c; ;~ ,f " ~ ""J/. 4-0 Jc::lHr' -'n- ,. ,/.-- AGE NEW FARM BUILDING CONDITION NORMAL BELOW ABOVE Acre Value Per Acre Value Tillable '~Ll ,.,. FRONTAGE ON WATER FRONTAGE ON ROAD M'- Woodland Meadowland DEPTH ~oo /~ . ~ r / qL '0 /e; 00 / $,-,0 House Plot BULKHEAD - f/~ DOCK Total ~ ---- ex0<10 /~ ~ ~ Cj/n~ t> . 7(! I.-' Jr) }.1 . . . ~;-~ ,I ,Af<.- ,1 . OR /. ':1.:1. TRIM ) f~ , "- , I. I . 11': .... , ! 3 - ~ i ,- .- S., . '. , . . 1 . .. . . , , .- S I 1'\ / " I . .... 1 . I. . . [, :1 / " '7 IV 120.-6-1 9/06 .,.~ ~ r--- ~- . - /'7a-_ S /,:, F-_~.Y,. . '" .' M. Bldg. ~#"x 33 ::; '7 ?.," " 'r.D 3/6 R V r !I 2- ~<f Extension "- ~ IS-.x / ~-'_ .2 J.." ) .. , 1 Extension ~ Qfo6 3.00, 1965 :!J S;<J..o .- (, 5'.~~ ~ ' r; " .. . /00 , cO, J 1 Extension crt ex; .'17l1w ~ A. '1 .. . /LJ )( 33 '. 3:'So ..d' 5/33 ~ ;;.67~ f]" , '-'-11=;;,';'.' cfc . !:loth crt 06 rd. Dinette . un at/on X"'J 'Ii y,." ~ $0 ') . ,--. =- B~~~,;e;;-t Floors j-lt I t , ::.. ~~;,,;;A' r .P./" .......- K. ~I~rl . H'/ ( .3"7 p 3~~Y ~ ,~Walls F;~' 0 w ,:.,[) Interior Finish wl-,;t'.f- 6'/) , LR. OX''' ~ Breezeway \ ((37 IFire Place Heat IDR. tiel 51'[j' //-: - Garage 17 xJ,.'-/ ~ '-Ius / ~.>~. . './ ;pn5'e Roof " ; ", .' Rooms 1 st Floor SR. (:' f' , . .. Patio I Recreation Room Rooms 2nd Floor FIN. B O. B. tf3a.J&-'" p..... ' ~e"'l1'J ~ Dormer Drivewoy , , Totol ,;t tJ--rf .// I !. '(/ " 'J . ~h //6""5 "Ilo~ . .. '" . ~"'" . "'" -~"1:" .~ "",,-,.,' ''C - "'--->'''''....'....;"" j' A DR, :'-1. TRIM '~tt';' , ~~- '-f...~ " .,..- - - ot~. \ , ~ 1- :3 ~ ~ - .;[T :: I, , , [" [. [,.- 6- " ~ [ I )T V J "'" i=' l~ I " -r . i 120.-6-1 9/06 "'~ = - i : [ , , , [ , ;(.. I , i 'I M. Bldg. i i r-: -W i i : i i I - [ " I ,,' :? " -, ,/ 1 J i 1 i .- ,.0 , , , ! 1 II "' ~ - ;.~ ' ,~/?C~~~ ~ .f " ''\-' . , ;<;. i t,-' L;} , , , J,. ,I, ,I I . ~~ .: '." ., ;' "I ~ n .. ' I "~~.....-. , -" -- ~ ~~~ COLOR J. 'L}, " - I ,\ t;flll-' \ TRIM t..r1 "--- '. \ . \ '\ 1- ~ :3 ~ ~ - ~ , " . \ ~. , h~ 1)1 I I, f. """ l- I!) I I . f'~ ~ I- . H- I i II , I I ! , I : I I I I ! I , T I 1 ! I , I I, i Town of Southold PROPERTY LOCATION: S,C,T.M. #: Erosion, Sedimentation & Storm-Water Run-off ASSESSMENT FORM 0iSiiiCt ~ ~ ~ THE FOLLOWING ACTIONS MAY REQUIRE THE SUBMISSION OFA STORM-WATER, GRAOING, DRAINAGE AND EROSION CONTROL PLAN CERTIFIED BY A DESIGN PROFESSIONAL IN THE STATE OF NEW YDRK. Item Number: (NOTE: A Check Mark (..f) for each Question is Required for a Complete Application) ~------------------ -------------- No Yes 1 ----------------------------------.------------ 2 3 4 5 6 7 8 9 Will this Project Retain All Stann-Water Run-Off Generated by a Two (2") Inch Rainfall on Site? (This item will include all run-off created by sile clearing and/or construction activities as well as all Site Improvements and the permanent creation of impervious surfaces.) Does the Site Plan and/or Survey Show All Proposed Drainage Structures Indicating Size & location? This Item shalllnclude all Proposed Grade Changes and Slopes Controlling Surface WaterFlow! Will this Project Require any land FWlng, Grading or Excavation where there is a change to the Natural Existing Grade Involving more than 200 Cubic Yards of Malerial within any Parcel? Will this Application Require Land Disturbing Activities Encompassing an Area In Excess of Five Thousand (5,000) Square Feet of Ground Surface? Is there a Natural Water Course Running through the SUe? Is this Project within the Trustees jurisdiction or within One Hundred (100') feet of a Wetland or Beach? Will there be Site preparation on Existing Grade Slopes which Exceed Fifteen (15) feet ofVertica! Rise to One Hundred (100') of Horizontal Distance? Will Driveways, Parking Areas or other Impervious Surfaces be Sloped 10 Direct Storm-Water Run40ff into and/or in the direction of a Town right--of-way? Will this Project Require the Placement of Material, Removal of Vegetation andtor the Construction of any Item Within th8 Town Right.of-Way or Road Shoulder Area? (This item will NOT include the Installation of Driveway Aprons.) Will this Project Heq\lire Site Prep<Jr<llion within the One Hundred (100) Yem Floodplain of any Watercourse? [J D Id / Id t/ [J t/ [J t/ [J V' [J V [J V NOTE: If Any Answer to Questions One through Nine is Answered with a Check Mark In the Box, a Storm-Water, Grading, Drainage & Erosion Control Plan is Required and Must be Submitted for Review Prior to Issuance of Any Building Penn it! EXEMPTION: -- --- - -- - -~ ---- --~------- ---- --. - - ------------------- No Yes Does this project meet the minimum standards for classification as an Agricultural Project? Note: If You Answered Yes to this Question, a Storm-Water, Grading, Drainage & Erosion Control Plan is NOT Required! v/ -------------------------------------------------- STATE OF NEW YORK, c"- (D\ ~ ~ ('(JUN j'Y uL.:?"'~o. / ;j I ' ( Tit:ll C~y CJHI/.q'JWK'J~kl lI'j;'jfW'" olindi','id'Jillsiqnir1':IOOCi.JrT"''11'1 :SQhn 'J. .. .os , .. . . . being- duly swum, dVjluscs ;tn(l says tb;lt he/she is (h(' appl1cant for PC1l11it, tOL1) \~>ILi And lL;tG :Iil'! IIi(' (U.<,'ner, Contraclor, Agenl, (;""1"_">*' (Jlflcer, ("(ei (}wlln <lnd,,'or rClilCSC!ll;\IJ\'c ()f Ille ()Wller ()f O\\'r1CI's, and is duly authmiled 1.0 p('rform 01 have performed the sajcJ work and to make Cl1ld file !Jus applicatIOn; that aJ! sll.tcllJcnls contained in this application arc true to the best of his knO\vlcdge and belief; and that the work will he perCullllcd in dH" lll;mllcr set !lxlh in lhe application filed hercwilll. SWU!ll 1(1 \"CldlC J)j(' tJlI';' qJ] ..... ... . ... ........ dOl' urYVltt/(Cft.. .... ,20Cl8" C NotarYPUbIiC"~~~~'~.~ FORM - 06/07 No.oiTA60B6001 Qualified In Suffolk County I I Commission Expires 01/13/20 ..LL. COPIES OF THIS SUR'vFY MAP NOT BEARING THE LAND SUR'vFYORS EMBOSSED SEAL SHALL ,\'CT BE CONSIDERED TO BE A VALID TRUE COPY. ?2~ ""6 <o;U C;Vl enO OJ o <' i/i o z o ~ () ::!J~ r;u f'lr Of'l Vl ;':: " " -<. ,,'0 en;,:: - ;':: -0 <oz -Vl N/F KOROLESKI N 72'40'30"E 212.32' N <D Z -l' '..J <q 55' 20.)' 7.7' 0 fRAME > N "DC C. 0 . 0 WOODEN PERGVL.A >. :<: 35.7' [.f) J/I 'J / ~ <D LN O. f fTi 7) lJ1 lJ1 lJ1 <D ~ z 18' '-. - ~ ~ .. ^ ~ 0 ;U ~ 0 r f'l BA,RN Vl ^ GUARANTEES INDICA TfD HERE ON SHALL RUN ONL Y TO THE PERSON FOR WHOM THE SUR'vFY IS PREPARED, AND ON HIS BEHALF TO THE nTLE COMPANY, COVERNMENTAL AGENCY, LENDtNG INsnrunON, IF LlSTFD HEREON, AND TO THE ASSIGNEES OF THE LENDING INsmUnON (:UARANT[ES ARE NOT TRANSFERABLE TO AOOtnONAL INSnTUnONS OR SUBSEOUENT OWNERS UNAUTHORIZED AL TERA nON OR ADOlnON TO THIS SURVEY IS A VIOLA TlON OF SEcnON 7209 OF THE NEW YORK STATE EDUCATION LAW N en z 'J <D LN o :<: :u '-. '" N :--J <D <D i 3 . 1.2' Sou: 'NlJ -l' O'l ;P- O N 1\1 81'J: <t' J"O" Ir <1 Vb/l ~ 16J" <';"VI'. ,81' Ue ," ," ,. OJ '" :u <;) '" Z " ;;i Z C '" FM# 10938 DATE FILED APRIL 25, 2003 SURVEY OF LOT 2 SURVEYED: 17 JANUARY 2008 TM# 1DOO-120-06-001 IN MAP OF PROPOSED SET-OFF FOR JOHN J, KOROLESKI SCALE 1"= 40' AREA = 86,612 S.F. OR 1.988 ACRES SITUATE MATT/TUCK, TOWN OF SOUTHOLD SUFFOLK COUNTY, N,Y, SURVEYED FOR: DEBORAH S. REBELL JOSEPH CAMASTRO SURVEYED BY STANLEY J. ISAKSEN, JR. P.O. BOX 294 NEW sur OLK. NY 631-73 [,5835 GUARANTEED TO: DEBORAH S. REBELL JOSEPH CAMASTRO COMMONWEALTH LAND TITLE INS. CO. PEOPLE'S UNITED BANK >;:i.~tfjil.~~~~l~~~~~,~~:-~t;, "' . _.........-..; ..'~.........;,. .-...r......I'"--v.r..~~r...v 17......~~.,.. ..--1