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HomeMy WebLinkAbout22390-z FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No Z-24744 Date NOVEMBER 15, 1996 THIS CERTIFIES that the building ADDITION Location of Property 200 WLLLIOW POINT ROAD SOUTHOLD, N.Y. House No. Street Hamlet County Tax Map No. 1000 Section 56 Block 5 Lot 32 Subdivision Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated SEPTEMBER 29, 1994 pursuant to which Building Permit No. 22390-Z dated OCTOBER 17, 1994 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 2ND STORY ADDITION & ALTERATION TO EXISTING ONE FAMILY DWELLING AS APPLIED FOR. The certificate is issued to STEVE & MARICA DONADIC (owners) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A UNDERWRITERS CERTIFICATE NO. N-396692 - SEPTEMBER 10, 1996 PLUMBERS CERTIFICATION DATED N/A din Inspector Rev. 1/81 FORM NO.3 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N.Y. BUILDING PERMIT (THIS PERMIT M T,BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) QV bate 19.../,. f•. N°_ 22390 Z Permission Is hereby granted to; S7~r/f_ / /f aa-t~G !1 ~ttJ71/i?G ...:.......//~',r~ to....r_-s ! s 4 .......~r~....~......... A... .........e ~l~lT . ~"'/'!!Gr/ at premises located aT....... County Tax Map No. 1000 Section CC.... ` Block Lot No.....! ! pursuant to application dated 1..~! 19...9 and approved by the Building Inspector. Fee .y( Building Inspector Rev. 6/30/80 Form No. 6 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL 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 17 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 Building - $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 New Construction........... Old Or Pre-existing Building Location of Pro ert 2'6 QIIn • • Ins W3 House No. Street Hamlet Onwer or Owners of Pro pert C?1EU~ M\7 ~~CR "b !OtC- County Tax Map No 1000, Section..r~ 4?........Block....5..........Lot... Subdivision ....................................Filed Map............ Lot...................... Permit No...~~.j S1E~~ C M~d~\CAt~11~~1c F.0'ZZ..... Date Of Permit................Applicant..................... Health Dept. Approval ..........................Underwriters Approval......................... " anning Board Approval Request for: Temporary Certificate........... Final Certicate........... Fee Submitted: 5...~ `.®b p &Zz l 5 aV-1 APPLICANT ~o~a~~gy o~~gOFFO~~-co c~ Gy2 W 2 Town Hall, 53095 Main Road O O Fax (516) 765-1823 P. 0. Box 91971 Telephone (516) 765-1802 Southold, NewYork 1 OFFICE OF THE BUILDING INSPECTOR TOWN OF SOUTHOLD December 6, 1995 Mr. & Mrs. Steve Donadic 189-24 45 Drive Flushing, NY 11358 To Whom This may concern: We are unable to complete your certificate of occupancy because of the following reasons: An application for Certificate of occupancy is not on file. (Enclosed) xx No Underwriters Certificate on file. The check is (outdated/not on file.)$25.00 No Health Department Approval on file. No final inspection has been made. No Plumber Solder Certificate on file. (All permits involving plumbing being issued after April 1, 1984). BUILDING PERMIT # 22390-Z, 21204-Z & 21937-Z Please contact our office on this matter. Thank you for cooperation. SOUTHOLD TOWN BUILDING DEPT. ,L'J'3i~:.,,._ua - ` • 'IID~~~ q corrMCUr~ ~ 111DATION ,(1 s t) ` c 1NDATION (2nd) _ m zr 'GH FRAME m n \ ULATION PER N. Y. II y \I. STATE ENERGY I~ CODE 1-3 y4q FINAL ADDITIONAL CO!-IMENTS: m ' x - H a m 's.~l:'}-p;.+y/i•^~lt•Ls~eF.:..:+:. w'aa.. t•s~:1?i+..%~t'u.. ~ ~ -».+iin. _ - . 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 o: 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.,;,; s PLOT DIAGRAM and ,f . ""yQtid" ,i,.~ .."a+.E, l~ ~8f~ r,.i{° t .:e ~~''t,.; ?1ES ,,~:~4..San Locate clearly and distinct! all buildings, whether exi ting or proposed, and. indicate all set-back, dimensions from property lines. Give street'and`bl' cknumber or description ccording to deed, and show streetn " eearidiffndibafiwhether ."interior or corner lot..-. O //t FsotN I' -_._ROA D u. la£u_ Ft< orb t R~22375 7 ooF P p F e „ ttZd`~` ~p500' ,Raze' y S ~9 ~a39.27F , ~0 4 . `0. d4 ~ Fro ~ Ft?r4 fi't' ,h '3' 0 0~ Go, a . 'p0 STATE OF NEW YORK, oyM ~ySo COUNTY OF S.S 71 OP ~6 being duly sworn, depo d aya that-, he is the applicant (Name of individual signing contract) above named. He is the.............'................`.... . : gVe .,z (Contractor, agent, corporal officer, etc of said owner or owners, and is duly authorized to perform or have performed the said work-and to' and, file this application; that all statements contained in this application are true to the best of his kno vje ge an¢ Te d that the work will be performed in the manner set forth in the application filed therewith. © Sworn to before rae this ........................day of............... 19...~a cc7 Notary Public, County (Signature of applicant 7651802 BUILDING DEPT. INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ INSULATION FRMING [ ] FINAL REMARKS: C z DATE 7 -INSPECTOR/ ' THE NEW YORK BOARD OF FIRE UNDERWRITERS PAGE 1 r1991071 BUREAU OF ELECTRICITY I 85 JOHN STREET, NEW YORK, NY 10038 Date SEPTEMBER 10,1996 Application No. on file 12421096/96 N 396692 THIS CERTIFIES THAT PERMIT NO. 223902 only the electrical equipment os described below and introduced by the applicant Named on the above application number in the premises of STEVE DONADIC, 209 WILLOW POINT ROAD, SOUTHOLD, N.Y. in thefollowing location; ? Rosemont ? Ist Fl. ® 2nd Fl. Section Block Lot was examined on SEPTEMBER 95 ,1996 and found to be in compliance with the National Electrical Code. FIXTURE FIXTURES RANGES COOKING DECKS OVENS DISHWASHERS EXHAUST FANS OUTLETS ECEPTAGLES SWITCHES INCANDESCENL FLUORESCENT OTHER MIT. K W. AMT. 9. W. "T K.W AMT. K W AMT. H. P. 14 8 11 14 DRYERS FURNACE MOTORS FUTURE APPLIANCE FEEDERS SPECIAL REC'PT TIME CLOCKS BELL UNITHEATERS MULTI.OUTLET DIMMERS AMT. K. W. OIL H. P. GAS H. P. AMT. NO. A. W. G. AMT. AMP. AMT. AMPS TRANS. AMT. N. P SYSTEMS AMi. WA1T5 NO.OF FEET SERVICE DISCONNECT NO. Of S E R V I C E . I TYPE METER 1 p TW 1 03W130 3W 3 p' d NO.OF CC COND. A. W. G. NO OF HI LEG AF W G NO OF NEUTRALS A. W G. AMT M EQUIP. PER .B' 2'-CC .COND Of HbIEG Of NEUTRAL I OTHER APPARATUS: WHIRLPOOL BATH-1 G.I'.C.Io-•1 G & S CONTRACTOR LIC.#578-E tdw"....., l_.. L BOX 215 ANN SOUTHOLD, NY, 11971 GENERAL MANAGER 11 S5 Per This certificate must not be altered in any manner; return to the office of thitBoard if incorrect. Inspectors may be identified by their credentials. COPY FOR BUILDING DEPARTMENT. THIS COPY OF CERTIFICATE MUST NOT BE ALTERED IN ANY MANNER. BOARD OF HEALTH FORM NO. 1 3 SETS OF PLANS . 2 9 ~a i; TOWN OF SOUTHOLD SURVEY BUILDING DEPARTM ENT CHECK TOWN HALL SEPTIC rORH BLDG ~ SOUTHOLD, N.Y. 11971 BLDG DEPT DEPT . , _a TOWN OFSOUTHOL;O 1 TEL.: 765-1802 NaT I F Y -361 -788& CALL Examined .....l.Q/.... 1__9 ~r MAIL TO: ?/9~!'3`237,y Het-,e_ Approved f.U o...I 19~ Permit No. v~370 . Disapproved a/c Vin(,a Inspector) APPLICATION FOR BUILDING PERMIT Date ...........2,/...., 1997 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. t 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 removal or demolition, as herein described. The applicant agrees to comply with all applicable laws, ordinances, building c e, ousin code, and regulations, and to admit authorized inspectors on-premises and in building for necessary inspections AID /Y.6_04 (Signature of applicant, or name, if a corporation) Iff-Z" 4~ ~sci(rir FAA1lu AY (Mailing address of applicant) -3 Te State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. Name of owner of premises ~V~ . . . 0. . . . (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. Plumber's License No. j Electrician's License No. &-U a4 ~Y_Z((o Other Trade's License No . 1. Location of land on which proposed work will be done. 2, . . . .(dlr/lbed ~mrlXT . . . .IQ c~-(3yu%t~.Geuf..................,.. House Number Street Hamlet ?~Z S County Tax Matp/N,,o. 1/000 Section Block W........... Lot .K...... . Subdivision ...Le-.. ( 4/ w . A 7_1" Filed Map No . Lot (Name) 2. State existing use and occupancy of promises and intended use and occupancy of proposed construction: a. Existing use and occupancy .......I,'~,~.~?.`........................ b. Intended use and occupancy . r.;;.. Y' ` . 3. Nature of work (check which app}icable): New Building Addition, Alteration Repair hl............ Removal . Demolition Other Work 0 4. Estimated Cost C!t?lor2 f~iltlr ^ 6 ~On ~ (Description) Fee . (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 . . . . 6. If business, commercial or mixed occupancy, specify natu;e ay~d extent of eac tlvpe of use pp r , , y. , . 7. Dimensions of yisting structures,,if any: Front ~??-'.a9, Rear Depth .";6 . Height 10.. (0 Number of Stories PVC... , , , Dimensions o same structure with alterations or additions: Front , . I.3.. Rear . s! , . . Depth ,'rci i, Height to :7~ Number of Stories ...CT Ce 8. Dimensions of entire new construction: Front . Rear , Depth , . , . Height rU0 ~ ~ of Stories >111, . y . 9. Size of lot: Front Rear NP ......F Depth 4.a 10. Date of Purchase .....f 9 premises ~ . , , . , Name,of Former Owner . . . 11. Zone or use district in which aresituated, 12. Does proposed construction violate any zoning law, ordinance or regulation: . . i 13, Will lot be regraded , , , , , , , , , , Will excess fill be reproved from premises: Yes ~d6 14. Name of Owner of premises . D.s? N ~ . Address -rA ? . Phone No. 7/8, A S" ,-2377- Name of Architect V~1 . . Address . . . Phone No... , . Name of Contractor . Cjb qe7 Address , ..Phone No 15. Is this property within 30'i0 feet of a 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, 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. t to 'Y'INvDrrecpa XI vw t?' is t~ . i ~ i r STATE OFNEWY R ' slid, COUN,JY OF. S'~I,i,l1`), = ' I... ignin be ng u y s M, deposes and says that he is the applicant of individual contract) above named. He is the ©~?!qre (Contractor, agent, corporate officer, etc.) of said owner or owners, and is duly #uthorized to perform or have performed the said work and to make and file this application; that all statements contained in this application are tru to the best of his knowledge and belief; and that the work will be performed in the manner set forth in the application file therewith. Sworn to before me this y of 19 Notary Public, County ROBERT I. Mot NOTARY PUBLIC Ste of N,Y. . No A]2508B,SuffoA{ (Signature of applicant) Term FxDlres May 3k19 i r iF r I! K t!t {q ? 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REOUIR,ENIENTS' OF `BENVRAY f:fr+ f ' TRgi, ,ra 'gTATE EONS-RESE!ON.~IeLE FOR "NOT y t t 3 ~S VIA K p I I DESIGN''OR CONSTRUCTION ERROft$ I' I , y f ~ 5 l 3 r 1 Y r i r -I x ~ r, 1 x y' if - t{ C j. f x t e (~((~t1.((,~~ AN A I It, QGGUPANCY OR sv . ,MA(e . ~QCI q~ } ~ USE W, IS UNLAWFUL .15 - , , WITI w~w~ palms to r . v~tiw~bw ~alr i 71 WITHOUT CERTIFICATtw . •'t{ll.t-'<7p! r~.tigCJ . UZ 1"r's,1a i~ Ev't 1lrS [{dG 'Ntj P S Y A- yY` K b (vi% ,.`F e u~yf lY ~~V f;d 4 ~0~4~ 1 rtiz t .'rt>-;ri t A alt { ~".t~~a x lfek U s4 ( - i G i ~ t Y Y r 4 rta ~ t p a9 1 1 i. ~ v f (.'4k ! yea I C iV 1 OgTB APPAGY6Q 0Y A Any Y f N it ~ s i D '