The URL can be used to link to this page

Home My WebLink About13080-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DE?ARTMENT Office of the Building Inspector Town Hall Southold, N.Y. Certificate Of Occupancy No. Z-15999 Date July 28, 1987 THIS CERTIFIES that the building PATIO & DECK ADDIT ION L .... 200 Willow Point Road Southold, N Y ocanon or t'roperry ................................................. '..: ........... House No. Street Hamlet County Tax Map No. ] 000 Section 0 56 .Block .05. Lot 0 3 2 Subdivision M/o Willow Point .Filed Map No. 4..65.2. .... Lot No. 28 conforms substantially to the Application for Building Permit heretofore filed in this office dated March 8, 1984 pursuant to which Building Permit No. 13080Z dated .... ~a.y.. 2. ,.. ! 9. 8.4. .............. 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 ......... PATIO & DECK ADDITION TO EXISTING ONE FAMILY DWELLING. The certificate is issued to STEVE & MARICA DONADIC ..................... ..................... of the aforesaid building. Suffolk County Department of Health Approval .... N/A UNDERWRITERS CERTIFICATE NO. N 574278 N/A PLUMBERS CERTIFICATION DATED: Rev. 1/81 FORM NO. 6 TOWN OF $OUTHOLD Building Department Town Hall Southotd, N.Y. 11971 765- 1802 APPLICATION FOR CERTIFICATE OF OCCI Instructions LDG, DEPT. A. This application must be filled in typewriter OR ink, and submitted m ~.~.- to the Building Inspec- tor with the following; for new buildings 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 of Health Dept. of water supply and sewerage disposal--(S-9 form or equal). 3. Approval of electrical installation from Board of Fire Underwriters. 4. Commercial buildings, Industrial buildings, Multiple Residences and similar buildings and installa- tions, a certificate of Code compliance from the Architect or Engineer responsible for the building. 5. Submit Planning Board approval of completed site plan requirements where applicable. B. For existing buildings (prior to April 1957), Non-conforming uses, or buildings and "pre-existing" land uses: 1. Accurate survey of p~operty showing all property lines, streets, buildings and unusual natural or topographic features. 2. Sworn statement of owner or previous owner as to use, occupancy and condition of buildings. 3. Date of any housing code or safety inspection of buildings or premises, or other pertinent informa- tion required to prepare a certificate. C. Fees: 1. Certificate of occupancy New Dwelling,S25.00, Accessory,St0.00 Business $50.00 2. Certificate of-occupancy on pre-existing dwelling $ 5 0.0 0 3. Copy of certificate of occupancy $ 5.00, over 5 years $10..00 4.Vacant Land C.O. $ 20.00 5.Updated C.O. $ 50.00 Date ....................... NewC°nstruction ...... Old or Pre-existing Building ............ Vacant Land ............. Location of Property ~! ~ ~ ~t~'- House No. f Street Ham/et Owner or Owners of Property ............. County Tax Map No. 1000 Section ............... Block Lot ..... Subdivision ................... , F ed Map No. Lot No . / ............. L: ........ Pem-lt No ~" -e ,-~ P~m t ~/'~ ~/A ..... · ~" ~ Health Dept, Approval ........................ Labor Dept, Approval ......................, , Underwriters Approval ,, :~ .... Planning Board Approval ...................... Reque f Tempo Ce tiff Fi I C tiff st or . raw r cate ..................... na er cate ..................... , , Fee Submitted $ ............................. Construction on above described building and permit meets all applicable codes a~C_~u Applicant ............................. t,d~,¢/-'~-"~, ,k~, ,~.. ,-,~,: % [-... 33;L FIEL~ INS~PECTION COMMENTS FOUNDATION (~st) FOUNDATION 2. (2nd) ROUGH FRAME & PLUMBING INSULATION PER STATE ENERGY CODE ADDITIONAL COMMENTS: TOWN OF $OUTHOLD OFFICE OF BUILDING INSPECTOR P.O. BOX 728 TOWN HALL SOUTHOLD, N.Y. 11971 March 6, 1987 TEL. 765-1802 Mr. & Mrs. Steve Donadic 189 25 45th Drive Flushing, New York 11358 Dear Mr. & Mrs. Donadic: This is to advise you that job under building permit no. 11512Z issued to E.Z. Construction on December 11, 198! for a one family dwelling for Steve & Marcia Donadic has expired and a final inspection has not been done. We also do not have your final board of health approval. Also on May 2, ~984 building permit no. 13080Z was issued to Steve Donadic to construct a patio and deck addition to existing one family dwelling. This building permit expired on November 2, ~985 and no final inspection has been made. In order to complete these files, it is necessary that Certificate of Occupancies be issued. Please fill out the enclosed forms, return same to the above office with a check for $50.00 payable to the Town of Southold. Please indicate to whom the Certificate of Occupancies are to be mailed, and arrange, with this office for an inspection date. We are also enclosing building permit, application and one set of plans along with your check #2539. Mrs. Donadic submitted this application and was to send us two more sets of plans that we never received. Occupancy or us~ is unlawful without a Certificate of Occupancy. Please h~lp us to clear up this matter so that legal action does not ~have to be taken. Thank you for your prompt attention. Very truly yours, VL:gar encls. Victor Lessard Executive Administrator ~ /'~ r'MARICKDONADIC' ' ' (('//~1' STEVE DONAD!C 1 ~;~N..~ t89 26 45TH DRIVE , · .,-~-~---,~LUSHING, NY 11358 ., r2539 '~ t'l~ 210, JAN2:::I987 eceived ........... ,19... I (Building Inspector) APPLICATION FOR BUILDING PERMIT 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 giving a detailed description of layout of property must be drawn on the diagram which is part of this appli- cation. 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 issued a Building Permit to the applicant. Such 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 whatever until a Certificate of Occupancy shall have been granted by the Building Inspector. 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~rem,o/val or demolition, as herein described. The applicant agrees to comply with ail applicable laws, ordinances, building'Z~, housin, g~ode, and regulations, and to admit authorized inspectors on premises and ~n building for necessary insp~i., J~~t'~ ~"~~ ' (Signature of applicant, or name, if a corporation) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. ' Name of owner of premises ................. .. ................... , .................... (as on the ta~ roll or latest deed) If applicant is a corporation, signature of duly authorized officer. ........... ........................ (Name and title of corporate officer) , Builder's License NO..O.O?..~?.'~.. ...... Plumber's License No ......................... Electrician s License No ....................... Other Trade's License No ...................... 1. Location ofland on which proposed work will be done. 0,~t~,.o~:~ ~Ot~t[" ~T~P~ House Number Street Hamlet County Tax Map No. 1000 Section .................. Block .................. Lot ................... Subdivision ............... Filed ~ap No ............... Lot ............... . (Name) 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 ..... ~ .... Addition i,, Alter~i_?t~,.~ ....... ., ............ Other Work ..... : .......... Repair 'c'..; · (' ua~,.. Removal .............. Demolition . ~ i , 4. Estimated Cost ..... ~.~ .................. Fee ............................. (to be paid on filing this application) ~)tV~~'' ~'1 Number of dwelling units on each floor 5 If dwelling number of dwelling units ' If garage, number of cars .......................................... : ............... ........... ; .. 6. If business, commercial or mixed occupancy, specffy~ nature and extent of each Wpe of use ........... /. ....... '. 7. Dimension~ of existing structures, if any: Fr. ont...~.~-..'?. ..... Rear . 2~t.~..'~. ? ..... Depth . .2~...~ ..... Height ~. T.~ .~ ........ Number of Stones ...{:>.h~.~'. ............. t ....~ ................ ~'...' ......... Dimension of same structure with alterations or editions' Front fl.~'- ~ R~ar si ul --, -- '~ ...... . ........................... De th ~ .",~. Height ~:~,.~--L'~.. , Numb~r of Stories ~r''t.-O't~ ! 8. Dimensions oft'entire new construction Front . ~.~.."~. ). , Rear ,~ ~'."9 Height ~..'"A~.,..~ ...... Number of Stories..~.1~.~. ................ ; .......................... 9. Size of lot: Front ./.~.. ~..;~'. ........... Rear...~t~.~..~. - .~-. ....... i. l~epth ~. ~.~..~...~-'. ......... 10. Date of Purchase /.~'~ Name of Former Owne~ 11. Zone or use district in w'hic' h premises are situated '~[.~.~ t ]).~'~l.t.-'/. t~-~... 12. Does proposed construction violate any zoning law, ordinance or regulation: ...~..~ ........... 13. Wilt lot be regraded ..... ~ .................... Will excess fill be rem6~ed from premises: Yes ' · / & - -! 14. Name of Owner of premmes ~)OJ~. ~. ~ . Address ./.. ..... Phone No.7(~ $$ ~ ~ .~ Name of Architect ....... ~?. !??. !~ .......... Address .~..'.'.'.'.'.'.'.'.'.~..~..~./.~-..~.i ...... Phone No ................ Nmne of Contractor ...... O.~...~t..~.. ........... Address /Off: ~. ,...././~. ~ .... Phone No.. ~ .......... 15. Is tills property located withinli00 feet of a tidal wetland? ]* Yes ..... ~...'.. · If yes, Southold Town Trustees Permit may be required. PLOT DIAGRAM Locate clearly and distinctly all buildings, whether existing or proposed, and~iindicate all set-back dimensions from property lines. Give street and block number or description according to deed, and show street names and indicate whether interior or corner lot. STATE OF NEW YORK, S.S COUNTY OF ................. ................................................. being duly sworn, deposes and says that he is the applicant (Name of individual signing contract) above named. itc is the (Contractor, agent, corporate officer, sic.) of said owner or owners, and is duly authorized to perform or have performed thb said work and to make and file this application; that all statements contained in this application are true to the best oi'lhis 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 ~.~/ -~/ ~q ~//day of ..... ~ ............. 19 ~"'~ tr~7 Note, Public, ounty : : ~fi2'~",, t~'l:~ ~ ~sinture°fs'~ x ( ig at reef applicant) ............ ~~-a.-.--.. .... ;.. imm Expires March 30, 1~ "FORM NO. 1 · 7. '/).~ TOWN OF SOUTHOLD BUILDING DEPARTMENT TOwN HALL ,~OUTHOLD, N.Y. 11971 TEL.: 765-1802 Examined ........... 1 .9~.. Approved ................ 1 ~..~. Permit No..r..~.O. ~ .-.~ Disapproved a/c ........................... '../.~ ..... (Building Inspector) APPLICATION FOR BUILDING PERI'IT Received .... , INSTRUCTIONS a. Tkis 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 giving a detailed description of layout of properW must be drawn on the diagram which is part of tlfis appli- cation. 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 issued a Building Permit to the applicant. Such 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 whatever until a Certificate of Occupancy shall have been granted by the Building Inspector. 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, Suffg!k 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, buflding/~oc,~e, hous. s.s.s.s.s.s.s.s.~g code, and reg~ulations, and to admit authorized inspectors on premises and in building for necessary inspectiqmi~~-~ .... .. . ............ . ......... : ...... · : ' ' (S~gnature ofapphcant, or name, ~f a corporanon) (Mailing address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. 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) Builder's License No...0...(~J. ff..~.. ............... Plumber's License No ......................... Electrician's License No .......... ' ............. Other Trade's License No ...................... 1. Location of land on which proposed work will be done ................................ : ....... ~.~ ........ .... z .o...o. .......... ................. House Number Street Hamlet County Tax Map No. 1000 Section ..... .~.~. ........ Block ...,~.~ ............. Lot... ~ .......... Subdivision ..................................... Filed Map No ............... Lot ...~.. ,~. ....... (Name) 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy .......... .~ .............. q' .... ............. 7 b, Intended use and occupancy ............................... ........................... ' ~/ . 'Addition Alteration 3 Nature of work (check which applicable): New Bnilding ' Repair ~ i Demolition : ~" '?' Other Work .............. ............. .. .... ................... 4. l:.st~mated Cost ............... (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 i 6. If business, commercial or mixed occupancy, specify nature and extent of each type of use .................... 7. Dimengions of existing structures, if any: Front ............... Rear .............. Depth .............. Height Number of Stories Dimensions of same structure with alterations or additions: Front ................. Rear ................. Depth ................... i"Height .................. ._.~ c .. Number of Stories ............ 0, ....... Height .. ~..~. [.~.~ ...... Nu~nber of Stories .............. 9. Size oflot: Front ...~(9~..,~ ........... Rear ..... /.°..~..ii.iiiiiiiii ~)~i~ iiiiiii ....... 10 Date of Purchase ~ Name of Former Owner 11 Zone or'use district in which premises are situated 12. Does proposed constrnction vioiate any z~oning law, ordinance or regulation: ............................ 13. Will lei be regraded ........ £ ..... ~. ............. Will excess fill_be remo¥.e~fr0m premises:' Y6s No 14. Name of Owner of premises .-~,7~.~.~. .~).o.rj~/-~(.~' Address/..~..-~.g.~.C.~.~.,~.f~..o'.~PhoneNo Name of Architect ......... i ................. Address ................... Phone No ................ Name of Contractor ~ Address Phone No .. i ' PLOT DIAGRAM Locate clearly and distinctl~ all' buildings, whether exilting or proposed, and indicate all, set-back dimensions from property lines. Give street and blqcklnumber or description .~ccording to deed, and show street nl~m~es and indicate whether interior or corner lot. \ ' I- , : , ' 7,~ ~"7, ~ - ~.~ 9. 8.73' STATE OF K, COUNTY OF. .................... ~ ............. being duly sworn, dep is the applicant signing contract) above named. He is the ............ ............................ .~..'.'.. ~.~.?..; .~.~. ~. ..................... ! (Contractor, agent, corporate officer, etc~ ' of said owner or owners, and is duly authorized to perform or have performe.d ~e 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 ~at the work will be performed in the manner set fbrth in the application filed therewith. Sworn to before me this ......... ' ......... day of ........... , ~ No 4707878, Saffo[k Ci)uliity l Te~m Exp*~es March 30,