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Home My WebLink About28871-ZFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No: Z-29087 Date: 11/20/02 THIS CERTIFIES that the building ~JDDITION Location of Property: 290 OAK ST (HOUSE NO.) County Tax Map No. 473889 Section 141 Subdivision Filed Map No. __ (STREET) Block 1 MATTITUCK (HAMLET} Lot 16.1 Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated OCTOBER 28, 2002 pursuant to which Building Permit No. 28871-Z dated OCTOBER 28, 2002 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" REAR DECK A2DDITION TO EXISTING SINGLE FAMILY DWELLING AS APPLIED FOR. The certificate is issued to JOHN & DOROTHY V ZAWASKY (OWNER) of the aforesaid building. SUFFOLK COUN~i~f DEPARTMENT OF H]~ALTH APPRO~_L ELEC~ICAL CERTIFICATE NO. PLUMBERS CERTIFICATION DA'r~ N/A N/A ~/h~~ gna ture Rev. 1/81 FORM NO. 3 TOWN OF SOUTHOLD BUILDING DEPARTMENT Town Hall Southold, N.Y. BUIT~ING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) PERMIT NO. 28871 Z Date OCTOBER 28, 2002 Permission is hereby granted to: JOHN & DOROTHY V ZAWASKY 7519 M00RGATE CT NEW PT RICHEY FL, 34654 for : "AS BUILT" REAR DECK ADDITION AS APPLIED FOR at premises located at 290 OAK ST County Tax Map No. 473889 Section 141 Block 0001 pursuant to application dated OCTOBER 28, 2002 and approved by the Building Inspector to expire on aP~~ Fee $ 300.00 ~~/ Autho~d Sig_~n~nat_ure MATTITUCK Lot No. 016.001 Rev. 5/8/02 COPY 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: Ao 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 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. Bo 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 New Construction: Location of Property: Old or Pre-existing Building: ~?0 Oiqlr S T~eeF~ House No. Street Owner or Owners ofProperty: t.~o/~,~ LT' Suffolk County Tax Map No 1000, Section !/~ / Subdivision Permit No. Date of Permit. Health Dept. Approval: Planning Board Approval: Request for: Temporary Certificate Fee Submitted: $ a~ 5'. ~o (check one) fF_,~ ~ ~. x. l*"~,,~ Hamlet Block I Filed Map. Applicant: Lot Lot: Underwriters Approval: Final Certificate: v/ (check one) ~/ Ap~lic Signatu~'e OWNER FO3RMER OWNER ~ES. ~/.~ VL. LAND TOTAL /~.~. y/-/_~ ~ TOWN O__F SOUTHOLD PROPERTY RECORD CARD AGE NEW Farm 'ilia,hie1 'illable 2 illable 3 foodland ~ampland rushland louse Plot 'Z rC~ ~ SEAS. IMP. 2-6 ~,o NORMAL VILLAGE Ac re E ~to I DISTRICT SUB. LOT ABOVE Value BUILDING CONDITIOI~ BELOW Value Per Acre FARM ' COMM. IND. CB. MISC. DATE ACREAGE- 0 TYPE OF BUILDING M. Bldg. ~/T ~ : 7 ~'O fl · ,?,2 ,C' ~ ~]~ Foundation ~ /~ Bath _ ~,~ ~ . ~ ~ ~Basement Fl~rs Extension ~t. Walls ~. ~ .~/.~ Interior Finish ~orch Rooms ]st Floor Breezeway Patio Rooms 2nd Floor Garage Driveway O.B. BUILDING PERMIT EXAMINER CHECK LIST APPLICANT: DATE REVIEWED: ~o_/.-~ DATE SUBMITTED: t._~a/eS~ SCTM# DISTRICT: 1,000, SECTION: } q I , BLOCK: I , LOT: 1 6,, ~ STREET ADDRESS: 2-'~o_ ("~ c~'Z-rz__CITY: ~-wiTgc~t- SUBDIVISION: ~0 ZO~G DISTraCT: g-¢ COmOmmG?- ~0 ~Q. LOT S~E: _~0. o~ o ACT. LOT S~E~L~O ~Q. LOT COV. ~o ~o ACT. LOT COV. ~Q. ~RONT ' ~P~OP. FRONT ~0 S~ ,~/~ ACZ. S~ ~ ~Q. ~ ~ PROP. ~ ~ ~Q. HEIGHT PROP. HEIGHT ,,rt/O WATER FRONT? DESCRIPTION: PANEL #: ~ FLOOD ZONE: t/~ , APPROVALS REQUIRED SUFFOLK COUNTY HEALTH D~._.~T: YES or OED #):__ TOWN SEPTIC RECEIPT: Y ~ NEW YORK STATE DEC: PRE-DEC 9/1/75 YES $OUTHOLD TOWN TRUSTEES: YES or TOWN ZONING BOARD APPROVAL: YES TOWN PLAN. BOARD APPROVAL: YES TOWNHISTORICALPRE (SPLIA): YES NYS ENERGY: YES ORq to~)~ F_,GRF_~S (18 H min.? 4 s VENT (SQ. FT. x 4%) BUILDING PERMITS OPEN/EXPIRED: BP HAVE PRE CO'S: Y OR N BP -Z / C/0 Z- NOTES: DTE: / / PERMIT #:RI0- v'/-Or---LIGHT (SQ. FT. x 8%) -Z / C/0 Z- , FEE STRUCTURE: FOUNDATION: SF FIRST FLOOR: SF SECOND FLOOR: SF OTHER: SF TOTAL: SF 1. ( ~o SF)- ( SF)= 2. ( SF)- ( SF)= INIT FEE SF X $ =$ SF X $ =$ +$ +$ +$ +$ OTHER TOTAL =$ CUSTOM VIEW CUSTOMER -- JOHN ZAWASKY DATE 10/01/02 REF Deck02274 OCCUPANCY OR USEI$ U~L~V~FUL OF OCCUPANCY NOTED ~~ '\~: ! .. BUILDING O PARTMENT AT '~~'~ 9AM TO4 P~..M FOR THE ~~ 1. FOUNDA FOR POURED ~ 2. ROUGH . FRAMI, & INSULATION · FINAL . CONSTI BE COMPLETE ALL CONSTRUCT, THE REQUIREMEI~ STATE CON~ CODES. NOT RE :D ~N MUST MEET N.Y. ENERGY LE FOR ERRORS PENNY LUMBER PO 1440 MATTITUCK, NY 298-8559 CUSTOM VIEW CUSTOMER -- JOHN ZAWASKY DATE 10/01/02 REF Deck02274 PENNY LUMBER PO 1440 MATTITUCK, NY 295-8559 ~Sd OI~ ~$d OI ~$c~ 0~ (I~fOq[ ~AI~I' (]tfoq~ (ItfZG (]RfOq £08 NOISS~d~OD 0EE hnf~HS ~9£ DNI~N~ ~Sd 0IE ~Sa 0I ~S~ 0~E g~O~ ZAI~ (~rO~ Q~O~ T~f~O~ ~S~ L08 NOISS~O~ ~S~ 0EE M~f~HS ~Sd E9£ DNIQN3~ MSd 0I ~0~ MSd ~9 (ItfO% :~Z~ ~Lgg0NOM~ :NDISZ~ AMS~M~Z g0/I0/0I :ZI~g NHO£ :MZNOiSflO SISXT~fN%f SSMMLS *UOsJedselD$ ®]o~s ]no/~ uuo]~ elqDI!DAD I!D:lep uo!:~:)nJ:lSUO:) ~ep eql 1~to~1 o:~ ems eli *eJI3:l~nJ~s ell:I u! SlD?JO:~DUJ JO esn pul:) uo!:~=nJ:~Suo:) JedoJd Jolt :~38~!q3JD JnOJ~ ~lnsuo= OSl¥ *:l:)e:i!q3JD JnoJ{ q~?~ ul~?sep eq~ 'o),!s uo?,onRsuoo eql ~,D suoR?puo= qt?~ ~,uo),s!suoo s! 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[ ] FOUNDATION 2ND [ ] FRAMING [ ] INSULATION [F~~I~L ~__ ~9 [ ] FIREPLACE & CHIMNEY DATE INSPECTOR~ ~~ 765-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION I ST [ ] FOUNDATION 2ND [ ] FRAMING [ ] FIREPLACE & CHIMNEY REMARKS: [ ] ROUGH PLBG. [ ] IN~SU.I.ATION I~'~INAL INSPECTOR,~ FOUNDATION (1ST') ROUGH FRA3'IING & PL~G ,I ~S~ON ~ N. Y. STA~ ~ CODE ~D~ON~ CO~S : , TOWS Or SOU'mOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, NY 11971 TEL: (631) 76S-1802 FAX: (631) 765-9502 www. northfork, net/Southold/ / Examined /V~ ,20 ^pproved a Disapproved a/c Expiration qt/.~ __,20 q pERMIT NO. BUILDING PERMIT.APPLICATION CHECKLIST Do you have or,,~eed th.e. following, before applying? Board of Health 3 sets of Building Plans planning Board approval Survey. Check Septic Form N.Y.S.D.E.C. Trustees Contact: e tar Mail to: Phone: APPLICATION FOR BUILDING PERMIT Date IOlab' ,200~. INSTRUCTIONS a. This application MUST be completely filled in by typewriter or in ink and submitted to the Building Inspector with 3 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 prem/ses 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 here'm 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. 19' ~8~ig~re of appl~ant or name, ifa corporation) (Mailing address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder Name of owner of premises ~altltO ~ttoD Dor'o~l)r ,Zt~ ,/~qcl~,/ (A s on the tax fall 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: ~9~ o~qA~ ~r-~er ¢u,aTW~'Fc.,c~h: tt,,}, It House Number Street County Tax Map No. 1000 Section Subdivision (Name) Iql Hamlet Block ! Filed Map No, Lot /$, / Lot State existing use a~nd ocr, upancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy /4o,~e._ b. Intended use and occupancy /'(o,~ 3. Nature of work (check which applicable): New Building. Repair R~n,oval Demolition 4. Estimated Cost On 5. If dwelling, number of dwelling units If garage, number of cars Fee Addition Alteration Other Work/~t-e E~,,;7',- q (Description) (To be paid on filing this application) Number of dwelling units on each floor 6. If business, commercial or mixed occupancy, specify nature and extent of each type of use. 7. Dimensions of existing structures, if any: Front Height Number of Stories Rear Dep~ Dimensions of same structure with alterations or additions: Front Depth Height ~ ~ 1~'~'2,o ~'u,,,~e~/g . It'/` , imensions ox entire new construction: ~ront~" · ~ - ~ Height. Number of Stories Size of lot: Front [00, o Rear /o ~-t ~o 10. Date of Purchase Name of Former Owner Number ctf Stories Rear Depth Rear Depth 11. Zone or use district in which premises are situated 12. Does proposed construction violate any zoning law, ordinance or regulation? YES NO .~ 13. Will lot be re-graded? YES NO v" Will excess fill be removed from premises? YES__ NO t,-'/ 14. Names of Owner of premises ta,~-t-t/ Name of Architect Name of Contractor Address,~/o c~k c,,-~,~-- PhoneNo. ~qff Address Phone No Address Phone No. NO 15 a. Is this property within 100 feet of a tidal wetland or a fi-eshwater wetland? *YES * IF YES, SOUTHOLD TOWN TRUSTEES & D.E.C. PERMITS MAY BE REQUIRED. b. Is this property within 300 feet ora tidal wetland? * YES__ NO f * IF YES, D.E.C. PERMITS MAY BE REQUIRED. 16. Provide survey, to scale, with accurate foundation plan and distances to property lines. 17. If elevation at any point on property is at 10 feet or below, must provide topographical data on survey. STATE OF NEW YORK) SS: COUNTY OF ) ~'~//'~I/ ~)-' ,~--~P~$~y being duly sworn, deposes and says that (s)he is the applicant (Name of individual signing contract) above named, (S)He is the (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 this & f~ day of (~ 200 JOY'CE M. W1LKINS Note~ Public, State of New York ~e. 4952246, Suffolk County · errn Expires June 12, ~1..OO _.~ ff 9' ~'1~plicant