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34724-Z
FORM NO. 4 TOWN OF SOUTROLD BUILDING DEPARTMENT office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No: Z-33751 Date: 06/02/09 THIS CERTIFIES that the building SECOND STORY DECK Location of Property: 1460 TOWN HARBOR LA SOUTROLD (ROUSE NO.) (STREET) (HAMLET) County Tax Map No. 473889 Section 64 Block 5 Lot 12.1 subdivision Filed Map No. __ LOt No. __ conforms substantially to the Application for Building Permit heretofore filed in this office dated MAY 29, 2009 pursuant to which Building Permit No. 34724-Z dated MAY 29, 2009 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 ALTERATION WITH SECOND STORY DECK ADDITION TO AN EXISTING ONE FAMILY DWELLING AS APPLIED FOR. · ~ne certificate is issued to STANLEY J & TRERESA A SZYMCZAK (OWNER) of the aforesaid building. SUFFOLK COUNq"fDEPARTMENT OF }{EALTHAPPRO~-AL ELEci~IC3%L CERTIFICATE NO. PLUMBERS CERTIFICATION DATED N/A N/A Rev. 1/81 Form No. 6 TOV~I OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL 765-1802 APPLICATION FOR CERTIFICATE OF OCCUPA~ This application must be filled in by typewriter or ink and submitted to the Building De TOWN DF SOUTHOLD 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 feature& 2. Final Approval fxom Health Dept. of water supply and s~verage-disposal (S-9 form). 3. Approval of electrical installation from Board of Fire Underwriters. 4. Sworn statement from plumber ceaifying that the 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 rea'ponsible for the building. 6. Submit Planning Board Approval of completed site plan requirements. For existing'buildings (prior to April 9, 1957} non-conforming uses, or buildings and "pre-existing" land uses: 1. Accurate survey of property showing ali property linc~, street~, building and*unusual natural or topographic features. 2. A properly completed application and couscat to inapoct signed by the applicant. If a Certificate of Ocanpancy is denied, the Building Inspector shall state thc reasons therefor in writing to the applicant. C. Fees (~ 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-e[isting 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 New Construction: Location of Property: Date. Old or Pre-existing Building: ~r~ (check one) House No. Street Owner or Owners ofProperty: g~,,[o~ ~ SUffOlk County Tax Map No 1000, Section ~x~/~ Block Hamlel Subdivision Filed Map. PermitNo. ~ 72~5~'~DateofPermit.--~/~) ~ Applicant: Health Dept. Approval: Undenvriters Approval: Planning Board Approval: Request for: Temporary Certificate Finai Certificate: (check one) Fee Submitted: FORM NO. 3 TOWN OF SOUTHOLD BUILDING DEPARTMENT Town Hall Southold, N.Y. (THIS BUII~ING PERMIT PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) PERMIT NO. 34724 Z Date MAY 29, 2009 Permission is hereby granted to: STANLEY J SZYMCZAK PO BOX 1010 SOUTHOLD,NY 11971 for : CONSTRUCT AN ALTERATION WITH A SECOND STORY DECK ADDITION TO A SFD AS APPLIED FOR. THIS REPLACES P#25041 at premises, located at 1460 TOWN HARBOR LA SOUTHOLD County Tax Map No. 473889 Section 064 Block 0005 Lot No. 012.001 purst~qalt to application datedMAY 29, 2009 and approved by the Building Inspector to expire on NOVEMBER 29, 2010. Fee $ 200.00 Authorized Signature ORIGINAL Rev. 5/8/02 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. 25041 Z Date JULY 15~ 1998 Permission is hereby granted to: for : STANLEY J SZYMCZAK PO BOX 1010 SOUTHOLD~NY 11971 CONSTRUCT AN ALTERATION WITH A SECOND STORY DECK ADDITION TO A SINGLE FAMILY DWELLING AS APPLIED FOR. at premises located at 1460 County Tax Map No. 473889 Section 064 pursuant to application dated JUNE Building Inspector. TOWN HARBOR LA SOUTHOLD Block 0005 Lot No. 012.001 3 1998 and approved by the Fee $ 75.00 &/Building l~spect~ ORIGINAL Rev. 2/19/98 TOWN OF SOUTHOLD BUILDING DEPT. 765-1802 INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH. PLUG. [ ] FOUNDATION 2ND [ ].~gULATION [ ] FRAMING / STRAPPING [J/] FINAL [ ] FIREPLACE & CHIMNEY [ ] FIRE SAFETY INSPECTION [ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRATION REMARKS: DATE C///~ ~OUNDATION (1st) ~OUNDATION (2nd) hOUGH FRAME & .PLUMBING INSULATION PER N. Y. STATE ENERGY CODE FINAL ADDITIONAL COMMENTS: BLDG. DEPT, ~/VN OF SOUTHOLD FORH HO. I TOI~N OF SOUTIIOLD BUILDING DEBAR'DigHT TOWN II^L1, SOUTIIOI.D~ N.Y. 1197 I Tgi.: 765- 1802 BOARD OF HEALTH ......... : ..... 3 SETS OF PLANS ............... SURVEY ........................ CHECK ......................... SEPTIC FORH ................... INS*f RUCTIONS a. 'Ibis aFpllcatio~ mu~t be conpletely filled in by ~riter or in i~ ~ ~dn[tt~ to am ~dldi~ T~ctor 3 ~ts al pl~, acetate plot pl~ to ~ale. V~ ~rdi~ to b. Plot pl~ d~i~ l~ti~ of loc ~ of ~ildiags ~ ~s, mlati~dp to ~joini~ p~i~s or ~iflic struts or areas, a~ givi~ a ~ta[l~ ~ri~i~* of la~C of p~rty mist ~ dr~ ~ tim divan ~tid* la ~rt of chis a~fl i~ti~. d. U~ a~al al fids a~llca~ia~, tim l~lldl~ I~ccor will ls~ a ~ildt~ ~mi~ to tim a~llc~t. ~i~ ~mll ~.~pC ~ Om i*.m,d~s ~ail~le ~or i~ct~ th~C tim ~rk. ~.I~'~ IS t~ [~ to tim ~dldi~ ~rt~at lot ~m ls~ al a ~lldl~ ~mlt ~ to tim ~la~i~s, for tim ~t~tl~ al bfildi~, ~itl~s or alteraCi~, or ~r ~l or ~lltl~, (~ill~ ~ss of o~li~t) State ~t~ether applicant is O~er, lessee, agent, ard~iteet, enltineer,' ge~eral cootractor~ electrician, plmber or I~ilde~ w/..,= .................................... (as m tie tax roll or latest deed) If applicant is a corporation, sil~ature of duly antl~rlzed oEEieer. lhfilders l.ice~se No ............. Pluubers License No .............. Electricians License No ...................... Other Trnde's License No .................... . I. l~cotion of la~l on ~Idch propoae<l york will be. (Iaaa ............................................ .. . . . . · .. .. , ...... Ilouse Il.abet Street ~ II,let County TaxNap It,. 1000 8action ..... ~0./l/~. ...... BI.ack ....~.. ......... l~t ../~. ......... S~livisio~ ,~],~'~....~-..~-~..~3. ~/- ............ Filed Nap Ho..i~..~..~.~ ..... LOt ...~ ........... 2. Scare exlstln~ use and occupancy o[ pr~nises a~d inter~k'd use a~l ocaq~mcy of piot,,,aed constructi~; a. r stlag .. ........................ ........................... ~e7 ~/~>~:~.~ ./T~'~- ................................... b. Intended tree and occupancy 3. i%tm'e of Mark (cl~-,e.k diids al~licable)z Ne~ ~ildl~ ........... ~iti~ ......... ~i~ ............ ~t ............. ~i~l~ ............. od,~ ~ ...... t..-.~ ........ ;.,,:,-,.,~.. J 4. ~ldm~l alt ._/ ....~ ............ [. ........................ (to ~ ~id I~l filing this al~licatl~) 6. If hminess, ~mrci~l or m[~qm~, s~ei~ ~Lure m~ ~tent of en~ ty~ of u~ ...................... ?. IHn~nsi~m of ~lstl~ stnm~res, if any: ~mt ................ ~nr ............... ~pfl~ ................. I)ineneimm of ~m stnm~ ulth alteratl~ or m~iti~s: Fret ' I~pth .................... l~J~t .................... Kmi~r oi 8tories ............... 8, I)luensJ~m Of ~tire ~ ~t~ti~: l~t ................ I~ar ............... ~pth .............. I~t~t ......................... Kmlmr of Stories ............ ,o. ~,", ,,r ~,~,~,~ ..Z/..?.< ......... ~ o~ ,o.~ ~ ..~m~./~zm .... ........... II. ~ or u~ district in ~td~ pr~l~s a~ si~t~ .............................................................. 12. ~s propel ~mt~tl~ violate a~ ~ln8 I~, onll~e or regularly: ..~. .................. I]. ~ill lot M ~r~~...~............... ~ill ~ss fill Im r~ ~ o~ ~,~ .... ~.~ ....... 'J .... ~,~ .............. ~'~ Of C~tr~tor ~ ............ ~ress ............................. 15. Is this p~rty ~ithln ~ f~t. ofa till ~tla~7 · ~ .......... ~ ..~ .... PI.OT DIAGRAH. locate clearly and distinctly all L~ildin~s, ~hetlmr existing or proposnd, ~d indicate all ~et-back dinensions i)ro[mrty lines. 6t~m otrlec and block nu~lzr or descriptio~ aecordinll to deed, and elK~t street n~nes ami indicate interior or corner loc. ,~1'^'11~ (;ir I~'~d ~ (~a~ o[ it~livi~hml signi,g ca,tract) o[ ~aid (~er or ~ts~ IIIKI j8 I[I[~ ~Llerl~ CO ler[onn or h~e I~r[o~.~ Lhe ~ld ~[k 8nd Co fl~ke end [ile I. hi~ nl~Jl icad~m; LlmC ali ~8~1[8 ml[8[~ in cid8 OlqfllaCj~l are ~n~ limC Lhe ~[k ~JJl J~ ~r[o~l in Ll~ nm[.~r ~ [orLh in the al~llcaci(~ [i1~ tler~[~l. ...... ...... ,~,,~ ,,~ ?. ~... ~...~(. ...... (8iB[ml:ure ( pi ic~ LINDA J- COOPER Note~ Public, Sta8 of N~Y~/~ No. 4~22~63, Suff$k_~ ~ ~ Term Expires De~m~ al, 1~ ~ad-~Y-J"-/~.I© OF $OUTHOLD PROPERTY RECORD CARD OWNER LAND IMP. VL. TOTAL N FARM DATE AGE BUILDING CONDITION NEW NOR.MAL VILLAGE BELOW Farm Acre Value Per Acre Tillable 1 Tillable 2 Tillable 3 Woodland Swampland Brushlond Hou, se ,~'la~t. ' ~' E W DISTRICT SUB. ACREAGE TYPE OF BUILDIN(~' COMM. IND. J CB. REMARKS ~"r~'x ~, ~ ~ MISC. [ Est. Mkt. Value ~m,~- /b.,,',.z / ~.~, ABOVE FRONTAGE ON WATER Value FRONTAGE ON ROAD Jg. ~Jon ion ion Foundation Basement Ext. Walls Fire Place C~- ..... ~ Bath -- ,,n~,f. f._ Floors Interior Finish -Torch /~ Heat Roof Type ~vay r Patio Driveway Porch Rooms 1st Floor Rooms 2nd Floor Dormer NOTES: SL)BP~ViS[O~ NAP H^[~E l~ t~[ 5UF~ CO, CL~'~'S 2.~U'FF ~O,TA~ M~P DATA~ APPROVED ~ NOTED 3 INSUI.~TION 4 FINAL o CONS'rRUCTION MUST BE COMPLETE FOR C.O, ALL CONSTRUCTION SHALL MEET THE REOUIREMENTS OF THE N.Y. STATE CONSTRUCTION & ENERGY CODES. NOT RESPONSIBLE FOR DESIGN OR CONSTRUCTION ERRORS OCCUPANCY 08 _ IISI[ IS, UNLAWFUL wrI'_HOUT CEI~TJ FI CAT. E~-~,..~ OF OCCUPANCY ~ ~"-0" '"1 · t 1' '1 JOFFI