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Home My WebLink About24060-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF O~CUPANCY No Z-25061 Date JUNE 2, 1997 THIS CERTIFIES that the building Location of Property. 1160 DONNA DRIVE House No. County Tax Map No. 1000 Section 115 subdivision ADDITION MATTITUCK, N.~. Street Block 15 Lot Filed Map No. Lot No. Hamlet 16 conforms substantially to the Application for Building Permit heretofore filed in this office dated APRIL 8, 1997 pursuant to which Building Permit No. 24060-Z dated APRIL 22, 1997 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 DECK~%DDITION TO EXISTING ONE FP24IL¥ DWELLING "AS BUILT" The certificate is issued to (owners} of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL UNDERWRITERS CERTIFICATE NO. PLUMBERS CERTIFICATION DATED Rev. 1/81 WALTER & RUTH KOCH N/A N/A N/A Build~ Ihspec~ /roK~ NO. ~ TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL $OUTHOLD, N. Y. BUILDING PElt. MIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) NY 2t050 7.. Permission is hereby granted to:// // j.~ / ./ ........................................................................ ~ ................... ~ ......... ~....~.~....~ ................ et premises located at ............. Z~.~.....~...........~..,.~...~......~..: ....... ...~...~...~i ...... County Tax Map No. 1000 Section ..... //,~, ..... Block ... ,/.,.,.~.,.. ....... Lot No.. ,/.,,,~,. .............. pursuant ,o application dated ................ ~....~........, 19.~...~.~ and approved by the Building Inspector. Rev. 6/30/80 h TOWN ',. ,,';! D Form No. 6 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL 765-1802 LICATION FOR CERTIFICATE OF OCCUPANCY This application must be filled in by typewriter OR ink and submitted to the building inspector with the following: for new building or new use: 1. Final survey or.property with accurate location of all buildings, property lines, streets, and unusual natural or topographic features. 2. Final Approval from ~ealth Dept. of water supply and sewerage-disposal(S-9 form). 3. Approval of ~lectrical installation from Board of Fire Underwriters. 4. Sworn statement from plumber certifying that the solder used in system contains less than 2/10 of i% 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 c6mpleted site plan requirements. For existing buildings (prior to April 9, 1957) non-conforming uses, or buildings and '3pre-existing" land uses: i. Accurate survey of property showing all property lines, streets, building and unusual natural or topographic features. 2. A properly completed application and a 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. ~ Fges 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 Buildin¢ - $100.00 3. Copy of Certificate of Occupancy - 4. Updated Certificate of Occupancy - $50.00 5. Temporary Certificate of Occupancy - Residential $15.00, Commercial $15.00 Dete ...... /./.~.~.~.7- ..................... .~. Old Or Pre ex~sting Building New Construction - Lo~ation Of Property ~./~ ~.~..~.g ~V.Z~..~.~/¢.~ ~.'~ ..... House No. Street Hamlet Onwer or Owners of Property..~z~.~/.--~.z~..~7.~..~.'~f.../~.¢~//. ................................ County Ta~ ~p No ~000, Sect~on...~¢..X?. ...... Blo¢~../¢.'%.. ......... ~ot.../..,4' ............... Subdivision ............................... .. . . . Filed Map ............ Lot ..................... . Permit No.. ~. ¥~.~. ~..Date Of Permit.. ~.P-/.~. ?....Applicant.....~..~. :/..-~--..-/.~¢. -~-/~ ..... Health Dept. Approval .......................... Underwriters Approval. ~ ................. Planning Board Approval ........................ Request for: Temporary Certificate ........... Final Certicate....~. ..... Fee Submitted: $ ....... ~.'..~. .............. III~;Ill.^TII)II I'1~11 II. Y. ~l'l'^'l'l~ I~IIEIIII¥ :¥o~o~ 765-1802 BUILDING DEPT. INSPECTION [ ] [ ] [ ] [ ] FOUNDATION 1ST FOUNDATION 2ND FRAMING [ ] ROUGH PLBG. [ ] I/NSULATION [ ~J/~INAL FIREPLACE & CHIMNEY REMARKS: DATE: INSPECTOR 765-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION 1ST [ ] FOUNDATION 2ND [ ] FRAMING [ ] FIREPLACE & CHIMNEY [ ] ROUGH PLBG. [ ] IN/SULATION [ ~/~INAL REMARKS: DATE 765-t802 BUILDING DEPT. INSPECTION FOUNDATION 1ST FOUNDATION 2ND FRAMING FIREPLACE & CHIMNEY [ ] ROUGH PLBG. [_ ~'LATION [~/] FINAL REMARKS: INSPECTOR :® BLDG. DEPT. .*c,w~, .Q.F..? ' 'i;:!q[.r'. ...... AI'I'~I(~HON FOIl BIJII,IIlN(, I'I[ItHIT FOlltl I'IO. I TOWN OF !R)UTIIOI*II IIU 1 I.I) I N(I I)I!I~I\RTHF. HT 'I'OI,!FI Jl^l,I. ,Sou'rlIOI,J), N.Y. I J97 I 'rlil,: 765- Jll(}2¢ I N!~'I'i~BC'i' 1 ()Fl,q n. 'lhl. olq)lJcntJ(xt.~mt be c(~lfleteJy (:ilh:d in by tyl~.~riter or in ink m.I mflxnitt~l Lo the I~lihllng hmlmetm- b. Plot plm, ~l~ll~ h~otl(.* o[ lot mvl of I~il(Ih~Be (hi pr~,d.en, relntlotmhlp I:o ~ljolnlng I~rt~ul~. or i.,l~l{c thio nl~fl ienl:l~. e. 'lhe ~rk e~'~l by thJ. off~lJe~tion t,~y t.~t Im m~m~med Imfore J.mm~e DE ~lldh~ Peunlt. d. I}lx~l a~n~ol DE thio npplJcnti~, tl~e l~lildJnl~ ln.lmCtor will i6mm n I~,tldi~*g Permit to the nl~licm,t. ~uch e. ~) I.,lhllng ~mll Im ~:cupt~l or u.ed lu ~J~ole or iu imrt For uny D~rlx~e ~mte~r until a (~rtJfJcnte of (X:(:Ulmi.:y ~mll hove linen 6rm~ted by the I~l(I(ling [imle~St~r. ' Ik~ihlln8 7x.m Ordirm,me DE tim 'l~m o~ ~tl~ld~ ~]l:folk (~u~t.y. ~,~ Ymk. mvl other nl~llcnble I~u, O~li,m~me. or [~l~uhith. m~ for II~ c~stnmtl~ o[ Ixdhlh~g., ~klltl~m. or nltezntiouD, or for midol or (~1 ition~ ne herein (Sig.nture off Olqflicnnt, or nm~, if n corlx)rnl ion) (~}lll IIIJ~ IKld~eUO of n~d icnuL) 1/~ ,~}llll'e sJ~ether nplflicmst Jo (m~er. lelmee, ;igent, m'(:lsilecL, engi~umr, i~el~ral rollLrnctor, eleetrJcJnn, plmimr or I.IJhlel (n~ (xl Ihe Ii,. roll or lnlenL deed) If nl~l] J(:nnt ltl (I coqx~rution~ .l~mture of duly nuLhoriz~d officer. (N~,,~. m.] LiLle o1: ¢orlx)tnte o£fh:er) Jo '). I'~tlUlll ul; ~,~)1|'. (l:l~cl( ',Jiiih lq~piilmhiu); II,..',.~ l~dhlilql .......... /~l'lhil)'i~ ..~.. ...... /\llt~i.til,I .......... ii, ti,tlr . ........... I~t,~t~l ............. i)..ix)l it.t[)ti ............ Olhdi' IA! k (Il) I.~ p~lht I)lt ltl hill Iltl~ Ill,ill hud ................. ~ ............ I~l)lh I~il~ ......................... llJli~l' ()1~ til'[)r iiJit ..................... ~lll~ u~I ~l'{:hlla{:~ ...~ ................................ ~ldlaltll . I ......... ~ ................... I~ ~[)~ I~) ........... I AS OTED NOTIFY BLIILDING DE~ 7L~-t80~ 9 AM ~ 4 PM FOR THE FOLLQWING INSPE~ION8; FOB POURED CONCRETE ~ ROUGH ~ FRAMING & 3, IN~ULATION ,~ FJ~/~L ,- CONSTRUCTION BE: ~O~JPLE E FOR C.O. ALL ~;ONSTBUCTION 8HALL ~IEET THE ~EQU ~EMENTS. OF THE ~;T~'EI CONSTRUCTION & ENERGY C,,(J)F8, Nm RESPONSIBLE FOR ~ ~'[ HELENE O. HORNE Notary Public, State of NewYork ~ ~:~ , N0.'49513~)4 ~ ~u~iifiedlnSuffolkCounty ~ ~ission Expires May 22, 19 ~( LOT 50 LOT 5G 0 LOT ~5 LOT 31 N.87° 19' 20" tV. M. PARSONS REF£1::EtJCE r ,DAP OF DEEP HOLE FIL r:O ,JAN. 2C,~ I'DG3~ OUAP, AI:TE;;:"D TO ~ Atfr,",RICAl'l TITLE I;~SU,"Lq'g~C'Z CO;,;PANY $OUTHOLD SAVI;'JGS WILLIAM S, ~ EVELYN M. PARSONS LA/tO /LY,'~. t.h';,; 5.:' ;,'~';