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Home My WebLink About23025-z s ' FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No Z-24038 Date NOVEMBER 20, 1995 THIS CERTIFIES that the building ADDITION Location of Property 840 ROSEWOOD DRIVE MATTITUCK, N.Y. House No. Street Hamlet County Tax Map No. 1000 Section 113 Block 2 Lot 20 Subdivision Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated SEPT. 13, 1995 pursuant to which Building Permit No. 23025—Z dated SEPTEMBER 25, 1995 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 ADDITION TO EXISTING ONE FAMILY DWELLING AS APPLIED FOR The certificate is issued to HAROLD J. & JOANNE PONZIO (owners) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A UNDERWRITERS CERTIFICATE NO. N/A PLUMBERS CERTIFICATION DATED N/A 1ldi g Inspector Rev. 1/81 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) Date.................. N�' 23025 Z {..` ...................., 19...d...`� / Permission Is hereb granted to: ...........,�.. .A.....!A,F............................................ to... 4,e ...... . ....... ......... ........ ...............,... .fit =.......... f1 7.1. .Uj...........�...5 ! ............ s .......�J!°(° ................. !� :........................................................................................................................................... .................................................................................................................................................................. -n~ uQ..................../... . at premises located at.............(!..1 4�....... (�P�14�� ................................ ................................................................�1l .r�.... ..........f.................. County Tax Map No. 1000 Section .....11,;F......... Block (....4!2o............... Lot No. ... .............. pursuant to application dated .............`S. ..1. r1...:........... 19..�`�..�..., and approved by the Building Inspector. ^7 as Fee 5...../.. ...`. ..... ... .,... '?................................... wilding Inspector Rev. 6/30/80 Form No. 6 r TOWN OF SOUTHOLD BUILDING DEPARTMENTLl' �� / 7f/f� TOWN HALL 7 /p (J ( / 765-1802 APPLICATION FOR CERTIFICATE OF OCCUPANCY A. 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 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. 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 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. 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 Buildine - $100.00 3. Copy of Certificate of Occupancy - $20.00 4. Updated Certificate of Occupancy - $50.00 5. Temporary Certificate of Occupancy - Residential $15.00, Commercial $15.00 Date . 1144-, . /..{.J. /. . . . . . . . . . . . . . . . . . . . . New Construction. . . . . . . . . . . Old Or Pre-existing Building. . . . . . . . . . . . . . . . . /kdSGG do>j 7�RJr < 7fr7'' Location of Property. . . t�.2�. . . . . . . . . . . : . . . . . . . . . . . . . .. . . . . . . . . . . . . . . . . . . . . .�. . . . IC7.k4 . . . . . . House No. Street ,// Hamlet Onwer or Owners of Property. . . . T ,/,7 r?-C ce w 0-H IQ& 1"-'s J• A>^/ Z 1G . .rr. . . . . . . . . . . . . . . . . . . . . . . . . .+. . . . . . . . . . . . . . . . . . County Tax Map No 1000, Section. . l.t�. . .. . . .Block. . . ..�. . . . . . . ..Lot. .Pte. . . . . . . . . . . . . . . . Subdivision. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ... . . . .Filed Map. . . . . . . . . . //.Lot. . . . . . . . . . . . . . . . . . . . . . Permit No A3.C.�i.Jr. .Z. . .Date Of Permit. . ././ ��.91� . .Applicant.y. 41;,tr}S T �gN1/d. . . . . . Health Dept. Approval. . . . . . . . . . . . . . . . . . . . . . . . . .Underwriters Approval. . . . . . . . . . . . . . . . . . . . . . . . . Planning Board Approval. . . . . . . . . . . . . . . . . . . . . . . . Request for: Temporary Certificate. . . . . . . . . . . Final Certicate. . . . . . . . . . . f Fee Submitted: . . . . . . . . . . . . . . . . . CQc • So y3 v`� ��:�. . . . . . . . . . . . . . . . . . . . . 3 A"tICANT C 0 -?_a1o3S u:l.li OU FECILON W-WORT DAH GUMIC17T5 f n ro i`OMMAT ION ( IST) n OUNDALION (2ND) 1 i IS N) t01101 FRAME 6 NIUMI{I Nr, 1 i I NSIILA"CION PER N. Y . __-_—�`----�.— � i 1--------_ s,rATG, P.:NLRCY C I it it t, I FINAL II Q Z ADDITIONAL. COMMS: \t� M x O 7t 1{ r;� ii OCCUPANCY OR 5E IS UNLAWFUL ITHOUT CERTIFICATE F OCCUPANCY 44 ��oN, gso - 1 44 3 ��pG PEQT�n�' i I L 765-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION 1 ST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] INSULATION [ ] FRAMING [ INAL [ ] FIREPLACE &�CHHIIMMNEY REMARKS:: Ce,-7 DATE // b7 INSPECTOR IIIGM NTTRA'T S: hater not to be used for preparation oh baby Formula or consurption by i.nt'aIILS under 6 months of age. ZtEyK I et6 3U'E S�EO 5.9 2021 N! 0 prT 96.1 my SAL ��Tse2 CpX NECK LAN m o23S. 3DYE 2�'II�O ;2• f NIS) w ryPS�' ;f r r2 a� . 'rA, ,r t 0 Go {� 0 p l \ of otO un !¢ Sony VA o rY- 5A'I \ V \ Ap2,0 O T\ ap �V11 \ o\ try O o � 5 ZQe V. 0 05 f, A j N (] Unauthorized alteration of addition to this survey is a vialnhon of q section 7209 of Ilo I!c;; Y::r.: `iclo Edu_cticn Low. SEP 1 319% Copies of Ihis cuvoy o r {.:c:r.: %I10 1a;-S iseal or c.nbossod BLDG.DEPT, c x :r •s I i TOyV7N OF$(JUT}-M fl heienn,aiJ to ILu esr i;i:.-'- -�!�t:u le;rdr,d imlltulion. r_ a•vs or certilicolions aro not Iwri4eratle to additional instilutions or subsequent owners. SURVEY FOR REFERENCE ' ALFRED DAUDERT 81 JAYE J. DAUDERT M/0 ROSEWOOD ESTATES FILED JAN.24,l969 FILE NO. 5240 AT MATTI TUCK \E OF NEIV { TOWN OFSOUTHOLD htA Of GUARANTEED To, SUFFOLK COUNTY N.Y. ooEtIT A. k, t sEcuRlrYr/rLE&OUARANrYCo. COUNTY, `F SOUTHOLDSAVINGSBANK SCALE 1s.x 30' k ALFRED 6 JAPE J.DAUDERT 'i' ijfi c{; 1 JUNE 16, 1977 , '.ly JUNE27, 1977 AUG . 30, 1977 ti <S 12872` ' LAND SURVEYOR NOV 30, 1 977SF0 LANA 5�;.\ N.Y$. LIC.NO.90725 RIVERHEAb N.Y. BOARD OF HEALTH . . . . . . FORM NO. 1 -• 3 SETS OF PLAYS . . . . . . TOWN OF SOUTHOLD — SURVEY . . . . . . _ _ . . . . . . . BUILDING DEPARTMENT " C11EC1: . . . . . . . . . . . . . . . . TOWN HALL SEPTIC CORN . . . . . . . . . . SOUTHOLD, N.Y. 11971 TEL.: 765-1802 r;pTIFY ; _ qq 9q CALL . .7. . . . . . . . . . Examined . . . . . . . 1 19 !.5 MAIL TO : Approved . . . . . . . �.J�. . ., 19p . Permit No. . . . . . . . . . . . . . . . . . . . . . . . . Disapproved a/c . . . . . . . . . . . . . . . . . I . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . e Inspector) APPLICATION FOR BUILDING PERMIT pp Date . ! 3 : . . . . . . . . . ., 1 INSTRUCTIONS a. This application must be completely filled in by typewriter or in ink and submitted to the Building Inspector, sets of plans, accurate plot plan to scale. Fee according to schedule. b. Plot plan showing location of lot and of build-wigs on premises, relationship to adjoining premises or public or areas, and giving a detailed description of layout of property must be drawn on the diagram which is part of this 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 1 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 Occu shall have been granted by the Building Inspector. APPLICATION IS HEREBY MADE to-the Building Department for the issuance of a Building Permit pursuant Building Zone Ordinance of the Town of Southold, Suffolk County, New York, and other applicable Laws, Ordinan Regulations, for the construction of buildings, additions or alterations, or for removal or demolition, as herein desc The applicant agrees to comply with all applicable laws, ordinances, building code, housing code, and regulations, admit authorized inspectors on premises and in building for necessary mspe tions. -- (Sign of applicant, or ame, if a corporatior `(Mailing address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or bt . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Name of owner of premises . . .1,5!!ett . . !v?�Q. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . (as on the tax roll or latest deed) If applicant is a corporation, signature of duly authorised officer. �. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . (Name and title of corporate officer) em Builder's License No. . . . . . . . . . . . . . . . . . . . . . . . . . 31985 Plumber's License No. . . . . . . . . . BWC WN OF-- Electrician's License No. . . . . . . . . . . . . . . . . . . . . . . Other Trade's License No. . . . . . . . . . . . . . . . . . . . . . 1. Location �jof land on which proposed work will be done. . . . . . .... . . . . . . . . '. . . . . . . . . . . . 1-1 ,el�. . . . . . . . . . . . .��P.S£W° '. . . . . . . . . . . . . . . . . . .,fY�iy`/l.I fC/C��... . . . . . . . . . . house Nur Street Hamlet County Tax Map No. 1000 Se/ction1. . . : . �.�. . . . . . . . . Block . . . .1�7 . . . . . . : . . . Lot . . . . . . . . . . Subdivision . ./~�oSfGCIDUG £S. . . . . . . . . . . . . Filed Map No. . . . . . . . Lot . . . . . . . . . . . (Name) , 1 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 . . . . . . . . . . Alteration . . . . . . . . . . Repair . . . . . . . . . . . . . . Removal . . . . . . . . . . . . . . Demolition . . . . : . . ... . . . . . Other Work . . .Q.4'<. . . (Description) . . 4. Estimated Cost .�3 . . . . . : . . . . . . . . . . . . . . . . . . . . . . . . Fee . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . (to be paid on filing this application) 5. If dwelling, member of dwelling units . . . . . I. . . . . . . . . Number of dwelling units on each floor . . . . . . . . . . . . . . . . If garage, number of cars . . . . . . . . ./. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6. If business, commercial or mixed occupancy, specify na ure and extent of each type of use . . . . . . . . . . . . 7. Qimensions of existing structures, if any: Front . . . .q . . . . . . . . Rear °f . . . . . . Depth . . 4 . . . . . . . . . . Height . . . . . . . . . . Number of Stories . . . . . .2 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Dimensions of same structure with alterations or additions: Front . . . . . . . . . . . . . . . . . Rear . . . . . . . . . . . . . . . . . . Depth . . . . . . . . . . . . . . . . . . . . . . Height . . . . . . . . . . . . . . . . . . . .. . . Number of Stories . . . . . . . . . . . . . . . . . . . . . . 8. Dimensions of entire new cpnstnlction: Front . . . . . . . . . . . . . . : Rear . . . . . . . . . . . . . . . Depth . . . . . . . . . . . . . . . Height . . . . . . . . . . . . . . . Number ofStories . . . . . . . . . . . . . . . . . . . . . . . , . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 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: . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 13. Will lot be regraded . . . . . . . .. . . . . . . . . . . . . . . . . . . . .Will excess fill be removed from premises: Yes No 14. Name of Owner of premises . . . . . . . . . . . : . . . . . . . . Address . . . . . . . . . . . . . . . . . . . Phone No. . . . . . . . . . . . . . . . ' Name of Architect . . . . . . . . . . . . . . . . . . . . . . . . . . . Address . . . . . . . . . . . . . . . . . . . Phone No. . . . . . . . . . . ... . . . Name of Contractor . . . . . . . . . . . . . . . . . . . . . . . . . . Address . . . . . . . . . . . . . . . . . . . Phone No. . . . . . . . . . . . . . . . 15. Is this property within 300 feet of a tidal wetland? *Yes. . . . . . . . No. . . . . . . . . *If yes, Southold Town Trustees Permit may be required. PLOT DIAGRAM Locate clearly and distinctly all buildings, whether existing or proposed, and,indicate 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. APPROVED AS NOTED DATE: a B.P.H FEE: � s' BY- NOTIFY BUILDING DEPARTMENT AT 765-1802 9 AM TO 4 PM FOR THE FOLLOWING INSPECTIONS: 1. FOUNDATION - TWO REQUIRED FOR POURED CONCRETE 2. ROUGH - FRAMING & PLUMBING 3. INSULATION 4. FINAL - CONSTRUCTION MUST BE COMPLETE FOR C.O. ALL CONSTRUCTION SHALL MEET THE REQUIREMENTS OF THE N.Y. STATE CONSTRUCTION & ENERGY CODES. NOT RESPONSIBLE FOR DESIGN OR CONSTRUCTION ERRORS 'TATE OF NE RI¢, + -OU Y OF LI . . .�. / /_ �.0 ll. Y� .lk�. . . . . . . being duly sworn, deposes and says that lie is the applicant Name of individual signing contract) bove named. ieis tile . . . . ... . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ontracto , ag nt, corporate officer, etc.) f said owner or owners, and is duly autho ' or in or have performed the said work and to make and file this pplication; that all statements contained in this application are true to the best of his knowledge and belief;and that the ,ork will be performed in the manner set forth in the application filed therewith. worn to before me this / day of . . . . . . . . . . . ... . . . .1 19 .� !otary Pub ' yr • . . . . . . . . . . . . . . County CLAIRE L GLEW , , , , . . .::�L'%�? � Notary Public,State of New York No.4879505 ( ture of applicant) Qualified in Suffolk County Commission Expires December 8,19 QNV-7N OFFOUNWw' tT 141 1-4 in u Numm"Oft PPPRR,O�,ED AS NOTED PLUMBER CERTIFICATION DATE: 8 q OCCUPANCY OR ON LEAD CONTENT BEFORE PLUMBING CERTIFICATE OF OCCUPANCY NOTIFY BUILDING DE USE t� ��0 .�� ALL PLUMBING WASTE 765-1802 9 AM TO 4 FOR THE e4 Y A✓A A WATEfl LINES NEED SOLDER USED IN WATER FOLLOWING INSPECTIONS: t, � �QUT _ TESTIN(Zi BEFOflE COVERING I. FOUNDATION - TWO REQUIRED �`6 ` r� CERTIFICATE SUPPLY SYSTEM CANNOT FOR POURED CONCRETE EXCEED 2190 Of 1% LEe-?D. 2. ROUGH - FRAMING R PLUMBINGflf%p �f 3. INSULATION '� i,d".1 YfUEG1 4. FINAL - CONSTRUCTION MUSTBE COMPLETE FOR C.O. ALL CONSTRUCTION SHALL MEET THE REQUIREMENTS OF THE N.Y. If copper tubing Is used STATE CONSTRUCTION )f ENERGY for water distributing CODES. NOT RESPONSIBLE FOR _ eyetoln; piping shell be DESIGN OR CONSTRUCTION ERRORS - of types K or L onl fi ,51 /J WALL BRACE I ' 3 000 Ft 9 I -7 r I soli - — �-- ; '�_, �.'- —. _,� i.. -- — ��, ._E �._ _ -a- -� -.i— — — � •� 4Plra ;COL ON N or Yi N c Ll nl r-r r A 0\ 7 E lG 1 � Wx 6 rp1 a � is i N z-ace, zK • '� -�--` � Dca�- ea�E�"/z„ to I 1 TEMP, .$`(E-Y% -- 304 0 ?E3o 3D (o .. _ G•o "SL. 3g30 _ 2- 2 X 1 LI p zi rn q DE OPENINGS FOR dp . ERGENCYESCAPEAS R ULl IRED BY PARE 714 O N. STATE BUILDING CO 1) t° w X /4 yo q I hx a . � CI. - eAF:AG PROVIDE 1L 01. FINE N< 1 I LIQ RATED SEPARATION 11 l C PAIL 7173 m(I)OF 8L D R U G �` o• Lk STATE BUILDING COBE. PFFa-To. M EMERGENCY ESCAPE AS p j I REQUIRED BY PAR[7140E �j b,V.'4 - 3"ZXIU N.Y.STATE BUILDING CODE. � X to I o ' , o J w/kni� it z-zkiz � _� 1'8'FtlOvIF bRnpe^ sTTpCs) . � `v IN LFhlp -PLAKI S5�f-1 T W n?y Zia 2T�I2 , AFiT1(3 y }'�t$ T39H"'c 2UJi � - r ' •"� �� fir. J {- If Ut Gf IS OVER IE•hbeYG GRPG� I ' , I ,v I �n• 1 IAu1r --_.T �� —_._,., n ,n•ip r; —_._— it ' il.0 _ _ � r �R � •,; ' .ins r�: _-- .—�_.___— __ .�.._ .. 2 c 3 r ---------- —_ - Ci r I I i • r7 ,,i • , I I 2 H I I' Ci is , I i 2 r % t