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Home My WebLink About30251-Z FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No: Z-33602 Date: 03/19/09 THIS CERTIFIES that the building ACCESSORY Location of Property: 4790 WESTPHALIA RD MATTITUCK (HOUSE NO. ) (STREET) (HAMLET) County Tax Map No. 473889 Section 113 Block 11 Lot 15 Subdivision Filed Map No_ Lot No_ conforms substantially to the Application for Building Permit heretofore filed in this office dated APRIL 20, 2004 pursuant to which Building Permit No.. 30251-Z dated APRIL 21, 2004 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 IN GROUND SWIMMING POOL WITH FENCE TO CODE AS APPLIED FOR. The certificate is issued to JAMES F & NANCY L MILOWSKI (OWNER) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A ELECTRICAL CERTIFICATE NO_ 2009746 06/29/04 PLUMBERS CERTIFICATION DATED - N/A A thorized Signature Rev. 1/81 f'n�Q 066X 6 E • Form No.6 / D � D TOWN OF SOUTHOLD ". BUILDING DEPARTMENT OEC 2 TOWN HALL 765-1802 bi,Da aw. APPLICATION FOR CERTIFICATE OF OCCUPANCY L9 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 the solder used in system contains less than 2/10 of l%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$25.00, 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. 10 - Ig -do New Construction: Old or Pre-existing Building: (check one) Location of Property: y796 Wts ST(}IAIIA 0 /47rzTUek House No. Street A Hamlet Owner or Owners of Property: JAMFrt 4 MAnlcy NT-t4t4SYS Suffolk County Tax Map No 1000, Section j 1 3 • l96 Block W o o Lot O 1 S. 000 Subdivision Filed Map. Lot: Permit No. Z 0 a 5 I Date of Permit. q ' a ' Oy Applicant: S W I"n Ki N4 &4 for JAwb` t!� / Wco -0, Health Dept. Approval: Underwriters Approval: Planning Board Approval: Request for: Temporary Certificate Final Certificate: (check one) Fee Submitted: W V—k C_ —7 5 � pp scant Signature 17 rJ�rJ'rJ'cPrJ'rJ�r.n�nrJ�cncnr�cl-rJ�rJ'rrrJ�rJ�rJ�cnrrdScnrJ�r.PcnrJ�rJrJ�rJrJr�rJ'rJ'rJ�r�rJ'rJ�rJ'rJ�iJ'�c.rrnrJ�r.1�rJ@Prr�.nrrcnrJ�rrr.PrJ'rJ'cnrft:nr��n�l-� o 5 BY THIS CERTIFICATE OF COMPLIANCE THE 51 5 NEW YORK BOARD OF FIRE UNDERWRITERS 5 5 BUREAU OF ELECTRICITY 5 5 40 FULTON STREET — NEW YORK, NY 10038 5 CERTIFIES THAT 5 Upon the application of upon premises owned by DOUBLE R. CONTR./R. RAGEN JIM & NANCY MILOWSKI 5 ee5e 165 EADS ST. 4790 WESTPHALIA RD 5 W. BABYLON, NY 11704, MATTITUCK, NY 11952 Located at 4790 WESTPHALIA RD MATTITUCK, NY 11952 5 eS Application Number: 2009746 Certificate Number: 2009746 5 Section: BELOW Block: Lot: Building Perm it: 30251Z BDC` ns11 5 Described as a Residential 600-1199 square ft. occupancy, wherein the premises electrical system consisting of 5 electrical devices and wiring, described below, located in/on the premises at: 5 Basement,Outside,Pool/Spa, 5 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 5 5 authority having jurisdiction, and found to be in compliance therewith on the Day of 5 29th June,2004. 5 Name OTY Rate Rating Circuit Tae 5 5 5 Miscellaneous C5 SEC: 1000/BLK: 113-11 C� 5 LOT: 15 5+ 5 Appliances and Accessories �S 5 Pool/Spa Bonding 1 0 5 �j Time Clock/Switch 1 0 55 5 Wiring and Devices 5 5 Fixture 1 0 Pool/Spa 5 Switch 1 0 General Purpose 5 S5 Receptacle 1 0 20 amp Pool/Spas Receptacle 1 0 GFCI 5 S (Swimming Pool):This certificate covers compliance at the date of inspection only. Because of unusual environments it is advisable to have 5 5 frequent test and/or repairs made by a qualified person. 5 5 5 seal 5 5 5 5 1 of I 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. 5 5 5 o rJ'r�rJ-rJ�rJ��.rcn�.nrJ@PrJ�cPrJr�rJ�r� � rlr� �n�sr�� 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. 30251 Z Date APRIL 21, 2004 Permission is hereby granted to: JAMES F MILOWSKI PO BOX 681 MATTITUCK,NY 11952 for CONSTRUCTION OF AN ACCESSORY IN-GROUND SWIMMING POOL IN THE REQUIRED REAR YARD AS APPLIED FOR at premises located at 4790 WESTPHALIA RD MATTITUCK County Tax Map No. 473889 Section 113 Block 0011 Lot No. 015 pursuant to application dated APRIL 20 , 2004 and approved by the Building Inspector to expire on OCTOBER 21, 2005 . Fee $ 150 . 00 jaord natu ORIGINAL Rev. 5/8/02 TOWN OF SOUTHOLD PROPERTY RECORD CARD N' wT'q-i of/ � OWNER STREET CID VILLAGE DIST.1 SUB. LOT W of/// D i Wtss/°NaL/ /1�a� p /l1 pT i/ :u K D ew , !1// / l"173/- FORMER OWN R [epi 5h 4) arta N E ACR. �y 1 b e- (A) e /Q U/Y t n S W TYPE OF BUILDING RES. 2/0 SEAS. VL. FARM COMM. CB. MICS. r Mkt. Value LAND IMP. TOTAL DATE REMARKS M7 2— r4 114 v 2IJ71�2 - 00 6, Roof gva / /y 77&& / s/so �y ,y /6 t }113 /30- $300 e i ` /NQ.. l71) e)- Dq �cR F Gga/ 7Ur zCo - Algd.o-e �p Al ew l� ouSP L-', C, 2 - �c�41a. d-- rr ✓�� +fir �C!'F �t�F+ ��'7�C� /017/ SOLS r'7fSoo. TpP t P! d.t,a, .p � ` F+"f V ti Tv /. aCGLfI/KORf4N% r`..tY9 /2 t, 3SG // �(+ .Se�d'�� 000 l ✓'�n r !.?. oellnYne✓f- P. 3 7� Qc/�a""e fe g")k� P AGE BUILDING CONDITION .�- _NEW NORMAL BELOW ABOVE 1q)- L'I�GI5 PIN 15- �o Mdoosk, -!165 zb FARM Acre Value Per Value / Acre Io 13 75 P � 3pfa5 - COktSL ACTeeYVC) Tillable FRONTAGE ON WATER I Woodland FRONTAGE ON ROAD Meadowland DEPTH - House Plot __ __ _-----._----- _ BULKHEAD v Total DOCK ONE MENNE NEEMENESEEMONIONEMEN MMINMEN ■■■Ii��Gl■■■■■■■11111� � ENO OMEN■ . : � �� ■■N■'OMEN■■Io��■■�E�■,■■�rlJNN■�C ■■■ ■■■■■■I■■■■■■■■■■■l��7W OEM ■■■■■■! ■■■■■■■■■■■■■ONE.■■■■ . _ ,s• ■■■■■■■■■■■■■■■■■■■■■DOC'! ■■■ ■�■■■■■■■■■■■■■■■■■■�wn3.■■■■■ • - iiiiiii■iiiiiiiAiii�� iiiiii� Foundation :. Basement ®� tom = Fire Place Interior®�� Type RoofRecreation Room .. _� l��Dormer �� o�yoe souryo� �rcou , TOWN OF SOUTHOLD BUILDING DEPT. 765.1802 INSPECTION [ ] FOUNDATION 1 ST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ) INSULATION [ ] FRAMING / STRAPPING FINAL [ ] FIREPLACE A CHIMNEY [ ] FIRE SAFETY INSPECTION REMARKS: DATE INSPECTOR w FIELD INSPECTION REPORT DATE COMMENTS ro d � FOUNDATION(1ST) D-� ------------------------------------- J� y ac FOUNDATION(2ND) \ z s (7 ROUGH FRAMING& PLUMBING y INSULATION PER N.Y. � STATE ENERGY CODE 0 0 , FINAL e ADDITIONAL COMMENTS -------------- s �O z Z m X A v 4� T y d .. `7 z° I � x d ro y GOWN OF SOUTHOLD BUILDING PERMIT APPLICATION CHECKLIST 3UILDING DEPARTMENT Do you have or need the following,before applying? COWN HALL Board of Health iOUTHOLD9 NY 11971 3 sets of Building Plans CEL: (631) 7.65-1802 Planning Board approval ?AX: (631) 765-9502 Survey PERMIT NO. n �—S Check Septic Form N.Y.S.D.E.C. Trustees xamined120-4 20� Contact: approved 20-4- 20--' Mail t OI )isapproved a/c 1 �• 1 1778 Phone: 7� ixpiration20 Inspector 0O APPLICATION FOR BUILDING PERMIT Date - ��_, 20 INSTRUCTIONS \i a. This application MUST be completely filled in by typewriter or in ink and submitted to the Building Inspector with 3 ets of plans, accurate plot plan to scale.Fee according to schedule. b. Plot plan showing location of lot and of buildings onpremises,relationship to adjoining premises or public streets or real, 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 hall 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 ;sues a Certificate of Occupancy. f. Every building permit shall Wcpire if the work authorized has not commenced within 12 months after the date of suance or has not been completed within 18 months from such date.If no zoning amendments or other regulations affecting the -operty have been enacted in the'intetim,the Building Inspector may authorize, in writing, the extension of the permit for an idition six months. Thereafter,a now permit shall be required. APPLICATION IS HEREBY MADE to the Building Department for the issuance of a Building Permit pursuant to the uilding Zone Ordinance of the Town of Southold, Suffolk County,New York, and-other applicable Laws, Ordinances or egulations, for the construction of buildings,additions,or alterations or for removal or demolition as herein described. The Tlicant agrees to comply with all applicable laws, ordinances,building code,housing code, and regulations, and to admit ithorized inspectors on premises and in building for necessary inspections. /) (Signature of applicant or11name,if a corporation) Aba SWIM V IAO, 015 LI71 R�. asA (Maihn&ddress of a plicant)-�?,,,_k'/ P} ate whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder 1177 c)PalIC 1)AV'a c�O� ane of owner of premises i �ygt (As on the tax roll or latest deed) applicant is a corporation, signature of duly authorized officer (Name and title of corporate officer) alders License No. i•{ 1 „? E-F ambers License No. ,ctricians License No. her Trade's License No. Location of land on which posed wor, a done: 9_2go 10P_ + off �; ' House Number Street Hamlet County Tax Map No. 1000 Section Block Lot Subdivision Filed Map No. Lot a. Existing use and occupancy (-�5 2y1 b 0-J b. Intended use and occupancy, IA - A r u V4 I MM I A (X �?01)I I ex ;!(o 3. Nature of work (check which applicable): New Building Addition Alteration Repair Removal Demolition Other Work�1 (Description) 4. Estimated Cost 0 Doo — Fee (To be paid on filing this application) 5. If 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. 7. Dimensions of existing structures, if any: Front Rear Depth Height Number of Stories Dimensions of same structure with alterations or additions: Front Rear Depth Height Number of Stories 3. Dimensions of entire new construction: Front Rear Depth Height Number of Stories 9. Size of lot: Front Rear Depth 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—Will excess fill be removed from premises?YES_NO t I 14. Names of Owner ofpremiseslP It1xO5k.lAddress p one No. oqg1?- Name of Architect Address llfj1 hone No ?�1 dlv.� Name of Contracto 1. Hodee Address 471 A y hone No. 7 Y y- ?/DO 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. �6. 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 'n Vid q T ( r?C I C p r- being duly sworn,deposes and says that(s)he is the applicant (Nam6 of individual signing contract)above named, (S)He is the l�C1 T ra c+n (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 applicatic that all statements contained in this application are true to the best of his knowledge and beliet- and that the work will be performed in the manner set forth in the application filed therewith. Swo before me this nt —day of ?R1c_ 200 aA�- Notary Public Signature of Applicant KOLEEN P. RODECKER NOTARYPNoL01R05099540EWYORK OUALIFIED IN SUFFOLK COUNTY NIYCDMMISSION E%PIRES SEPT.29,200 J lJ Q z o py--"-0ASN0D O � P2 0- Z r 36' aTE: tel— B.P.S _ �2 10 �- -E: 1sO BY:�� I I U w Z Gd2AY� z o t �G DEPT IM dT AT WA1E1?LINE _ O 0 ,54802 - `A TO 4P�.. F' ' THELn O OLLOw ^. "SPECTIO( ;: ROLLED FOAM 6ETMEN \ CC ~ ca' FOUN- �N - TWC EC RED LINERAN12CONOTfE E �/ < c w >_ 10' FOR rJurlED CON' -TE � Z O O 4' 12' e' -;2' 2. ROU- FRAMIN( PL 'GING QQ \ d �[ �✓ vi m 0 3. INS ON )N :BUST — — 4. FIN CONSTRL BF �IPLETE F( 0. ° a A ALL -RUCTION %LL MEET THE FOP.M ilE5 \\� =0 AEC tNTS OF " _ CODES OF NEW 3500P51 POUTP CONCRETE .� YORK ',ATE. NO PONSIBLE FOR VINYLUNER oV1DES:�u OR COP:: TION ERRORS. 2" TO 4" 5ANP a / e PLAN WALL SECTION UNDERWRITE°C RTIFICATE 2"to 4"5AN19 COFfOM ALL CONSTRUCTION SHALL MEET THE REQUIREMENTS OF THE u, SECTION A CODES OF NEW YORK STATE. OCCUPANCY OR USE IS UNLAWFUL ..,> *• ` j'ATr• 5' 10' S' E;., _ _ Poe- COMPLY WITH ALL CODES OF � UPON COMr-= .vu � WITHOUT CERTIFICATE BEFORE"`NATER" NEWYORK STATE & TOWN CODES OF OCCUPANCY A UIRED AND CONDITIONS OF x SOUTHOLD TOWN ZBA `Q SOU,HOLD TOWN PLANNING BOARD SECTION B SOUTHOLDTOWN TRUSTEES f0 FLIER FROM F N.Y.S.DEC �FROM`X.W�ER NOTES I.slR.ucmRE IS DEUPED FGF usE DELov aah u.D aN.vwA�As wkRE ae aaw � / WAi&fNkE ISAAVNMIM LF 9'-8"DELGW IIE FROPOEEDFW9ED 6'I�E. 2OAfSF0.L f0 E%aFAAE NN01f OF AE WArtR IN ME Pxl DY MCH II WJ8",CP.4R FLOOD ZONE f0WASiE ✓/ " WAfER QExaWPAaFILLfn MREnLwe". - COMPLY WITH CHAPTER" 6" 3.WMUfODE5WOM.WN%0D .%OE AWAYFR6 Wa PLUMBING SCHEMATIC FLOOD DAMAGE PREVENTION 4.WARE 05.O5&5VLL DE UMTV 10()N}.EF.$WR W fO Wif LOCI RENaAf{n6 SOUTHOLD TOWN CODE- 05-22-03 y 519108 L°t 3`L t 33 �o t 3� N7\0 0 °\ \6 1 3252C scn o m \ L°t \a o \O. o � 1 CC +a \ N Ln x1 e + N p U 1j. PP 2 fl. 5Zp0 GPab H N 6, J N, N 25E \V. � G V\ W ' N \ 56VVI`2g o o m z 39 0 Lu QD Lz: 566029 0 o cc�PNP�\ P IF 6 SURVEY FOR WALTER J. BIALESKI a AUDREY L. SCHMITT NOTE: AT MATTITUCK DATE MAR. 4, 1991 I. 8z MONUMENT 2, SUFFOLK COUNTY TAX MAP TOWN OF SOUTHOLD - SCALE: 1"- 40' DIST. 1000 SECT. It Lor Is SUFFOLK COUNTY NEW YORK NO. 91 - 0122 3. LOT NUMBERS REFERER TO TO SUBDIVISION MAP � LOT OF TOLLEWOOD" FILED IN THE OFFICER UNAUTHORIZED ALTERATION OR ADDITION TO THIS OFTHE CLERK OF SUFFOLK COUNTY ON SURVEY e A VIOLATION OF SECTION 7209 OF THE JAN.25, 1927 AS MAP NO. 175. NEW YORK STATE EDUCATION LAW SE OF N6-IV0 COPIES OF THIS SURVEY NOT BEARING THE LAND S'lP r SURVEYOR'S INKED SEAL OR EMBOSSED SEAL SMALL 0' NOT BE CONSIDERED TO BE A VALID TRUE COPY PRD W MGUARANTEES INDICATED HEREON SHALL RUN ONLY TO �Q THE PERSON FOR WHOM THE SURVEY IS PREPARED 6 AND ON HIS BEHALF TO THE TITLE COMPANY, GOVERN- MENTAL AGENCY AND LENDING INSTITUTION LISTED HEREON, AND TO THE ASSIGNEES OF THE LENDING INSTITUTION. GUARANTEES ARE NOT TRANSFERABLE TO ADDITIONAL INSTITUTIONS OR SUSSEOUENT OWNERS M DISTANCES SHOWN HEREON FROM PROPERTY LINES 40. 9 TO EXISTING STRUCTURES ARE FOR A SPECIFIC PURPOSE AND ARE NOT TO BE USED TO ESTABLISH Se-� y0 PROPERTY LINES OR FOR THE ERECTION OF FENCES �A pR�E DER YOUNG a YOUNG RRIVOERHEAp NEW YORKE ALDEN W.YOUNG,PROFESSIONAL ENGINEER AND LAND SURVEYOR N.Y.S.LICENSE NO. 12845 HOWARD W.YOUNG, LAND SURVEYOR N.YS. LICENSE NO.45893 BUILDING PERMIT EXAMINER CHECKLIST DATE REVIEWED: /b /04 APPLICANT: DATE SUBMITTED: /x/04 SCTM# DISTRICT: 1,000, SECTION: II , BLOCK: -IL_, LOT: If SUBDIVISION: tc,lk4o4m ADDRESS: 411y CITY: ZONING DISTRICT: CONFORMING? BUILDING PERMITS OPEN/EXPIRED: PRE CO: Y OR N BP -Z/C/0 Z- , INFO /BP -Z/ C/0 Z- , INFO BP -Z/C/0 Z- , INFO /BP -Z/C/0 Z- , INFO SINGLE & SEPARATE CERTIFICATION-REQUIRED NOTES: LOTS 40,000SF-100-24.Lot recognition.(CREATED before June 30,1983),UNDERSIZED LATS FROM JAN.1997 100-25.Merger.(A nonconforming at any time after 7, REQ. LOT SIZE: ACT. LOT SIZE Q Q. LO OV. ACT. LOT COV. REQ. FRONT �—PROP. FRONT ACT. SIDE QAR_ �.r- PROP. REAR RE IGHT PROP. H GHT PROJECT DESCRIPTION: ESTIMATED PROJECT COST: CHITECT/ENGINEER: WATER FRONT? IDES kIPTION: pQL-#- FLOOD Z APPROVALS REQUIRED SUFFOLK COUNTY HEALTH T: YES or ED#): DTE: / / PERMIT#: TOWN SEPTIC RECEIPT: Y NEW YORK STATE DEC: Pip-DEC YES o 0 DTE: / / PERMIT#: SOUTHOLD TOWN TRUSTEES: YES or DTE /_/_ PERMIT #: TOWN ZONING BOA RD-APPROVAL: YES o DTE: /___I PEjF-MIT#: � TOWN PLAN. BOARD APPROVAL: YES or DTE: TOWN HISTORICAL//PRE (SPLIA): YES or / NEW YORK STATE CODE COMPLIANCE fSEE PAGE : Y or NO NOTES: FEE STRUCTURE: FOUNDATION: SF FIRST FLOOR: SF SECOND FLOOR: SF OTHER: SF 1NIT OTHER TOTAL TOTAL: SF FEE FEE FEE 1. _SF)- (_ SF)= SFX$ =$ +$ +$ _ $ 2. ( SF)- ( —SF)= SF X $ =$ +$ +$ _$ 3. ( SF)- ( SF)= SF X$ —=$—+$—+$ = $ FIN OTAL: $ ��