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Home My WebLink About33912-ZFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No: Z-33056 THIS CERTIFIES that the building ACCESSORY SHED Date: 05/28/08 Location of Property: 895 HOLBROOK LA MATTITUCK (HOUSE NO.) (STREET) (HAMLET) County Tax Map No. 473889 Section 113 Block 6 Lot 14.5 Subdivision Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated MAY 15, 2008 pursuant to vPbich Building Permit No. 33912-Z dated MAY 15, 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 ACCESSORY NON-HABITABLE POOLHOUSE AS APPLIED FOR. The certificate is issued to PAUL PAWLOWSKI (OWNER) of the aforesaid building. SIIFFOLR COONTY DEPARTMENT OF HEALTH APPROVAL R10-08-0011 05/09/08 ELBCTRICAL CERTIFICATE NO. 7918 10/22/07 PLDMIDERS CERTIFICATION DATHD 04/10/08 MATTITUCK PLUMBING uthorized Signature Rev. 1/81 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: 1. 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 [he 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 Apri19, 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 $25.00, 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. i%~/kci /~ 2~~ New Construction: ~ p~ Old or Pre-existing Building: ,,~/ (check one) Location of Property: ~> S ~ /`iisv ~_ Gam(/ /~/~.~i~/~~ C ~_ ~ ~~ House No. Street Hamlet Owner or Owners of Property: / i`' ~ Suffolk County Tax Map No 1000, Section ~ ~~ ~~//Bttl~~ock ~ ~r~ ~ Lot ~l y p ~ ~ `eJQ% Subdivision ~ /~ ')~j~(~ 'Ffled~ap. Lot: Permit No. ~ ~ Date of Permit. Applicant: /~.aLGG l-~~~ c9v/~ ~L a oeio -Og -o~i/ Y Health Dept. Approval: , /e< Underwriters Approval: ~~i'/~ , X~F 5 Planning Board Approval: _y~ S Request for: Temporary Certificate g8 Fee Submitted: $ ~S <] o Final Certificate: (check one) ~ ~ ~-~ Applic Signature "o~.cn Hall, 53095 Main Road P O. Box 1179 -~ -_.~.a. ~z~.~ York 11971-0959 =,~SUFFO(,~co~ c `~~'' G N = ~oy • ~~ ~l '~ ~~~ BUILDWG DEPARTMENT TOWN OF 50UTHOLD CERTIFICATION Fax (631) 765~9iG, Telephone (631) 76=-. ~~,_ Date: %/ /O OS~ Building Per((m~~it No. ~ ~'~/~{ ( ~ 0~.~ ner TG.~,J~ ~ws~l (Please pe{n~t) Pl~.unber ~~~~ ~uc~~ A ~um~:nQ ~k ~.e.•.-~n~ (Please pant) lead 1 certify that the solder used in the water supply system contains less than 2/10 of L% (Plum azure) S~~ orn 1o before me this ~0?~ dwo((~~ 200 ~~~ Nolary Public,~~~~~°' Cow~ty DENISE KING Notary Public, State of New York Registration #01 KI6047757 Duali'ied in Suffolk County My Commission Expires May 15, 2 y,o Nassau Suffolk Electrical Inspections,Inc. P.O. Box 549, Aquebogue, New York ~ 11931 Te1:631-591-3097 Fax:631-591-3098 Application: 7918 Date: 10/22/07 Issued to: Pawlowski Address: 895 Holbrook Lane Introduced By: Modern Electric East Village: Mattituck Residential Commercial The following was examined and approved up to the above date and found to be in compliance with the NEC: Attic 1" Floor ® 2"° Floor 3r0 Floor Garage Conversion Basement Hot Tub Addition Detached Garage Pool Switches Receptacle Fixtures G.F.I. Range Hood Smoke Detectors II 17 8 2 Fans Dishwasher Washer/Amps Dryer/Amps Oven Range/Amps Carbon Monoxide 1-Bath Fan Furnace Oil Gas Hea[ Zones Whirlpool Bell Transformers Rough Insp. Final Insp. Meter Amps Phase Motors 10/18/07 her Equipment: IOOA Sub Panel 4.5 KW Water Heater Jl.ann¢u C~7u~u~c. gam., &y,: ~~;aer,x This certificate must not be altered in any manner 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. 33912 Z Date MAY 15, 2008 Permission is hereby granted to: PAUL PAWLOWSKI 1785 CROWN LAND LANE CUTCHOGUE,NY 11935 for CONSTRUCTION OF AN ACCESSORY SHED IN REQUIRED REAR YARD AS APPLIED FOR. REPLACES EXPIRED BP # 31499 ~~ (~ - -POO~ r\D U~ ~Dfl- I ~ at premises located at 895 HOLBROOK LA MATTITUCK County Tax Map No. 473889 Section 113 Block 0006 Lot No. 014.005 pursuant to application dated MAY 15, 2008 and approved by the Building Inspector to expire on Fee $ 150.00 ORIGINAL Rev. 5/8/02 339~~-z v TOWN OF SOUTHOLD BUILDING DEPT. CC~a~~.~~ 765.1802 ~ 1 NSPECTION ~- [ ]FOUNDATION 1ST [ ]ROUGH PLBG. '~~L`~QG~ [ ]FOUNDATION 2ND [ ]FRAMING /STRAPPING [ ]FIREPLACE & CNIMNEY [ ]INSULATION [FINAL [/ ~] FIRE SAFETY INSPECTION [ ]FIRE RESISTANT CONSTRUCTION [ ]FIRE RESISTANT PENETRATION o~ueQ~rc. ~~ DATE ~~'7`~ ~ ~ ~ INSPECTOR ~~ / -'ti i~ 3 t~~9 z TOWN OF SOUTHOLD BUILDING DEPT. 765.1802 1 NSPECTION [ ]FOUNDATION iST [ ]FOUNDATION 2ND [ ]FRAMING /STRAPPING [ ] FIREPLACE ~ CHIMNEY [ ]ROUGH PLBG. [ ]INSULATION FINAL /~ ; [ ]FIRE SAFETY INSPECTION DATE INSPECTOR [ ]FIRE RESISTANT CONSTRUCTION [ ]FIRE RESISTANT PENETRATION 3J't99Z TOWN OF SOUTHOLD BUILDING DEPT. 765.1802 INSPECTION [ ]FOUNDATION 1ST [ ]ROUGH PLBG. [ ]FOUNDATION 2ND [ ]INSULATION [ ]FRAMING /STRAPPING [FINAL /~2 ' [ ]FIREPLACE & CHIMNEY [ ]FIRE SAFETY INSPECTION RF~AARKCe DATE J ~ l ~ ~ ~ b INSPECTOR J ~ ~ ;s~ 3i~~~~ TOWN OF SOUTHOLD BUILDING DEPT. 765.1802 INSPECTION [ ]FOUNDATION 1ST [ ]ROUGH PLBG. [ ]FOUNDATION 2ND [ ]INSULATION FRAMING /STRAPPING [ ]FINAL [ ] FIREPLACE A CHIMNEY [ ]FIRE SAFETY INSPECTION REMARKS: ~ ~ ~ra-L 1~o-d-2 0-~ ~ o ~. ~~ ~~ ~ Ci.~ d c D _ ~~ ~ + J / ~l _ ~L n 'J DATE ~~ ~) _ ~S INSPECTOR~~ "'''~ ~} 3l't99 z TOWN OF SOUTHOLD BUILDING DEPT. 765.1802 INSPECTION (~ FOUNDATION 1ST [ ]ROUGH PLBG. /[ ]` FOUNDATION 2ND [ ]INSULATION [ ]FRAMING /STRAPPING [ ]FINAL [ ]FIREPLACE 8~ CHIMNEY [ ]FIRE SAFETY INSPECTION DATE INSPECTOR 3 i ~~~ ~ TOWN OF SOUTHOLD BUILDING DEPT. 765-1802 INSPECTION [ ]FOUNDATION 1ST [ J ROUGH PLBG. [ ]FOUNDATION 2ND [ ]INSULATION [ ]FRAMING /STRAPPING [FINAL ~ ' [ ]FIREPLACE & CHIMNEY [ ]FIRE SAFETY INSPECTION n /~„ :..0 DATE I ~~~~ -~S INSPECTOR ~- ;~ ~r~~~ ~ TOWN OF SOUTNOLD BUILDING DEPT. 765.1802 1 NSPECTION [ )FOUNDATION 1ST [ ]ROUGH PLBG. [ ]FOUNDATION 2ND [ ] IN ATION [ ]FRAMING /STRAPPING [ FINAL REMARKS: DATE ~ ~ INSPECTOR [ ]FIREPLACE & CHIMNEY [ ]FIRE SAFETY INSPECTION FIELD INSPECTION REPORT DATE COMMENTS ~ FOUNDATION (1ST) , a _ t ------------------------------------ FOUNDATION (2ND) y z ~ O,r ~ - ~ o ~~ y ROUGH FR MIN ` A G & PLUMBING ~ Q ~ ~ INSULAT r ~ ION PER N. Y. STATE ENERGY CODE ~ 3 FINAL -~: -o ~- D ~~ _ ~~-- ~.6 ' ~ DITIONAL COMMENTS ~ r. ~ - - - = - jZ.' ~~ U - __ O `C' ~ ~~ Z m ~. t~ - ~ ---'e `- O z x ~, _ --- ~c H i x& d y C 'O 0 r r U RI TOWN OF SOUTHOLD BUILDING PERMIT APPLICATION CHECKLIST BUILDING DEPARTMENT Do you have or need the following, before applying? TOWN HALL Board of Health SOUTHOLD, NY 11971 4 sets of Building Plans / TEL: (631) 765-1802 Planning Boazd approval FAX: (631) 765-9502 ~q Surveys www. northfork.net/S thold/ PERMIT NO. ~~/ /~~ Checlti}} ~0 y' S Septic Form ~ r7 N.Y.S.D.E.C. ..~. i TTC}PPC ' 20~~ V ,20~ Disapproved 20~- ____ _ Mail Phone:_ l03 1- a rf f5 -~j/~ ~~ 2 9 2~~~ APPLICATION FOR BUILDING PERMIT ~ ~ Date ~/ ' ~- 20 ~ b ILLL_~~ - ~ 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 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. ~Z~-~l-~~t~ t I.~,g-~-t~~.~ i ,~- (Signature of a icant or name, if a corporation) a~cL ~9,~~~ i~~ d~wl-~t~~~ ~y (Mailing address of applicant) t t 5~ L State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder ~e n ~ n „a~t3~Tn Ja~+~Y~ 11 Name of owner of premises ~qv ` ~~AuJ \ ~cy.16~. t (As on the tax roll or latest deed) If applic~iYis a cor orapon, signature of duly authorized officer (Name arid title of corporate officer) Builders License No. ~ Z ~S ~7 7 Plumbers License No. ~ 3/ GS. ~~r¢r.t.~~ Electricians License No._ ~ 3 x,11 Other Trade's License No. 1. Location of land on which proposed work will be done: Contact: House Number Street Hamlet County Tax Map No. 1000 Section 113 Block (, ~,; ., „ 'u ; Subdivision~p,~,Q ~~,~~ C~.S Filed Map No. e (Name) -- :: n^ 2. State existing use and occupancy of premises and a. Existing use and occupancy S i n r ~ b. Intended use and occupancy S use and occupancy of proposed construction: 3. Nature of work (check which applicable): New Building Addition Alteration Repair Removal Demolition Other Work ~~ / ~,,,,^_~e tied (Description) Estimated Cost ~/~ ~ ~ pp Fee (To be paid on filing this application) If dwelling, number of dwelling units d~~ 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. 7. Dimensions of existing structures, if any: Front Rear Depth Height Number of Stories Dimensions of same structure with alterations or additions: Front Depth Height Number of Stories, 8. Dimensions of entire new construction: Front Rear Depth Height /I Number of Stories 9. Size of lot: Front Z C90 -Fi- Rear o7 (~ 7 f -~ Depth Z ~ S { -~ 10. Date of Purchase 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 l~ Will excess fill be removed from premises? YES_ NO~ 14. Names of Owner of premises ~ ~ ddress ,~,I v,~, ~~~1 hone No. G ~!-o'~ir6 - S3t~K Name of Architecty~ol _,o+~ ~`! rsv.z Address S 11., I-~-~ e T~ l~,.Cl Phone No e a (. X/S' - 3 3 f~~~ Name of Contractor 5i, Lo `2 o ah Addres, T ~ n ('„~ AJ~~yi Phone No. ~ '~ 1- a.~ ~'~ ~f a~Z 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 MAYBE REQUIRED. b. Is this property within 300 feet of a tidal wetland? *YES NO * IF YES, D.E.C. PERMTI'S MAYBE 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` ~ ~ ~/-~ ~~ being duly sworn, deposes and says that (s)he is the applicant (Name of indi 'dual sigmng contract) above named, (S)He is the 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 therewit~ Swort3~~to before me thi o(9 day of ~°~ 20 U5 -~ G< G. Notary Public -..._~_...^3.3Aiti~T i!lo>an wbsc, stale a w. ron~ ~In M~ GountY commagon°~. 20,. ------------ ~~ r-- - ------ ~ -- ~ i ~ ~ ~ ~ ~ ~ i i I~ , i i ~~ , i 11 i i i ~ llr i i i i i i ~ i ', '~ i ii ~ ~ ~ ~ ~ ~ ~ ~ I L________-- --- i .~ `f, ~f ~--- ~ ~ r ~ 4~`C - -~ , ----- li i i ~, ~ ~ ~~ 4' CONC SLAB W/ 6X6 - WL4 X W1.4 ~I ~i ~ WELDED WIRE FABRIC REINFORCEMENT ~ 1 / ~ I~ III ~ ~ OVER POLYETHYLENE VAPOR BARRIER 0_ ~ ~ I i~ ~ ~j i ~ I I~ ~~ ~I I ~ ~ ~ I, - - - - _ . - _ - - - - L - - - - - - - - - - - - - - - - - - - - ~.__ ~~ (Pang ~ausL~ LAND NOW OR FORMERLY OF I HAZEL KAHAN _ _ _ _ S 82'58'30" E DF; 30.a STAKE ~ - - 20.6 FOUND ~-~ ~ / I 1~~ ' CESSPOOL 1 O 92'll J K O Z Cpp p D C ~ ~ ~ c o c I ° U ~ p ~ ~~ 1 Q .CT W 1~,6m ~m/ _ N q / ~ ES~WO~J. ~ } ` .4 ~ I ~ 0 E - at ;~;, O ~ Ys te. u 'CS ~ O ~, m _ ~ J ~~ a _` R zj ~~~ 'io 1 +~ ( C °V o ~' ~' i > N . . ,_ rn T~ ~ a ~ ~g~ _O T _ ~~Ea P Q 25.1' ~ ' NI N I ~ r. J ~ aw K C1 '~- w aw z~ zo am w~ KF O o Z N= 1 + 3 16.3 r W +5.6 0 W w O ~ R 1 6~ 0 Z a N~ O ~ Z t 1 ]. ' 19.9 WOOD ~• "~~ J Q ~~$ V 0 2 K ~ N ~ ~0= V_ 264.06' p~~~~~C~ APR 1 ~ 2f~08 D I I I 7 2D.,+I I ~~~~~ ' S 83'1 19.2 _ - - & Van WPele / AV0. !_AND NOW OR FORMERLY OF JAMES MANOS gREA DEED 1 sus ,26.4 267.52' ~ -_~-- -- S tt!v_r ~~~ fi53 \ /\ ~ 1-~ INGROUNU POOL O I MASpA'RY (//\ SS O tfi.a o, 23. ~ POOL ~ EOUIP. woo®Ea zD.3+ BURIED FUEL TANK 24,3 / 3 2 .5 3~~, 21.9 ry ~al ~i ELECTRIC 26.1 METER 21. a O~ OOSO~ 3 4 vy~P 25.1 +~~t,Y~P. ?O 3P 2 YReO~. / 2].O P PC MASONRY WPS) 1• 3 h WOOD G - LANDING ~ _.., 2].5 2 STORY DWELLING (FULL BASEMENT) F.F. EL. a 31.50 ~0. CESSPOOL ~_• ~_ 2~3 23.1 i 25.9 n 30. \ m4<\ \\ f^y~'N\\ STAKE \ \ O \ FOUND - -I 27,0. __-__ 31.3 1' 0. 1 STORY 6.a' gU1LDING F.F. EL ~ MASONRY m 33.44 31.2 ' 30.] 28.1 WOOD rREUIs 28. 2].5 ® RIM 21.08 4/.8~ m W 26.0 ¢ 9.1 0 3 29.5 O > 3 o p s 3 O tt N w 0 N 1. 9.9 3v1 IPE FOUND 32 26.9 22.5 zs.l+ ~~ ~~ 26.3 E GRAVEL + ROADWAY 26.2 20.00' LAND 3 _ _ 31.1' 31 Q 1 Q J K ~ o Z ~ ~ Z LL Q O ~ } O J } ~ w 0 Z Z Q J O THE OFFSETS OR DIMENSIONS SHOWN FROM Try STRUCTURES TO THE PROPERTY LINES PRE FOR P SPECIFIC •PUFPOSE AND USE ADD • THEREFORE PRE NOi INTENpED TO GVIOE THE ERECTION OF FENCES. RETAINING W POOLS. PA1105, PLANTNC AREq E~ gODITIONS i0 BUILDINGS qNp q Y OTHER CONSTRVGTION. $UBSVRFgCE CONOITONS NOT SHONIJ.LLS EASEMENTS, R!GHIS-OF-WAY OF FECORO, iIF qNy NOT SHOWN. ropeHy rome. menumenis we•e n paces as a pnrl of Inl9 su vey. I.PN MER W pNNELL FORK MGO PETER 0.3"W / 1 ~ i O p- ` O O~~ A O 7~c ~ i°z m Z -C -~A O STAKE O FOUND ~ O s PIPE 31.] W FOUND ~ -~~ OJ'S \ ~ p -C N4p OT A m 0.3'W \ NOTES 1. LOT AREA = 53,365 SOFT. OR 1.2251 ACRES. 2. DEED REFERENCE: LIBER 11871 PAGE 773. 3. THE PROPERTY IS ALSO KNOWN AS PARCEL NO. 4 AS SHOWN ON MINOR SUBDIVISION MADE FOR JAMES MANOS AT MATTITUCK. 4. THIS SURVEY WAS PREPARED FOR A SPECIFIC PURPOSE AND IS NOT INTENDED FOR ANY OTHER PURPOSE. 5. THE LOCATION OF SANITARY SYSTEM & WATER SERVICE PROVIDED BY OTHERS. TAX MAP DISTP7CT 7000 SECTION 173 BLOCK 8 LOT 14.6 Barrett, Bonacci & VanWeele, P.C. CNR. ENGINEERS/SURVEYORS/PLANNERS 175A Commerce Drive, Hauppauge, NY 11788 TEL 631/435-11 I1 FAX 631/435-1022 www.bbvpc.mm Ii4vlun nemlM Mm agnh Nol tlu anw .m 1ma s,...FWw h n. x,. mnl mu Aim "~®°°'°'~"°~"~~°""~"° PROPERTY naloala ae s..tn. saa c.rrl~. is mr m un Gn>^ w .Iwm en ..wr w wwe.a SITUATE n. wal. m un lnk mnpmy gown.ll.ne me Irving YoLlulm xw Mm, ~tl 1o tlp f+yxee M Ne hMng WIIbW. Glifiwlvns >e '~""~""°~'~"""°""" MATTITUCK _____... _._..~~ __,:_ r..._ J POOL HOUSE `._ .~~.~~~ ~ "FINAL SURVEY" °F . .\ , . .. uTrsAr LILEN4D PN(YES IN ALC0.4NANCf MIIH $FCIILN ] IY NK y CWLAIIM' LAW I51(IfGA( ~ Fq, al1flID T' FRAM BT OE07D BC M1E SOME IM16T Iq F.Z A.M. JANUARY 4, 2002 1'~ 30' A071093