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Home My WebLink About21310-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No Z-22317 Date MAY 11, 1993 THIS CERTIFIES that the building Location of Property . 900 DONNA DRIVE House No. County Tax Map No. 1000 Section 115 Subdivision ADDITION MATTITUCK~ N.Y. Street Hamlet Block I5 Lot 18 Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated MARCH 31, 1993 pursuant to which Building Permit No. 21310-Z dated APRIL 6, 1993 was issued, and conforms to all of the requirements of the applicable~ provisions of the law. The occupancy for which this certificate is issued isCHIMNEY ADDITION TO EXISTING ONE FAMILY DWELLING AS APPLIED FOR The certificate is issued to (owners) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A UNDERWRITERS CERTIFICATE NO. N/A PLUMBERS CERTIFICATION DATED N/A PATRICK & MICHAELEEN ST. JOHN //Bu f lding Inspector Rev. 1/81 FOB3a[ NO. ~ TO~N OF $OUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, bi. Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) N-°N? 31310 Z Permission is hereby g~rjted to: / ,~ /7 . ' ............... ri' ............ ~ .......................... ..... ~.~...:.~...~.~.....~...: ................. ....... ......... .:~.~..~ ...... ~./.~:;~.........~ ....... ~ ......... ..:~..~ ........................... ~ot oren ,ses I ate //...~,,--~..'~...~ ..~--~..--~..~ at pr m' oc d at ....~..~ ............................................................................................................ .............................................. .................................................................................... ./../.~ ../.~. /~ Count~ Tax Map No. 1000 Section ................ Block ............. Lot No ....................... pursuant to application dated ~ ./~.~.. 19~...-~...., and approved by the Building Inspector. Inspector Re~ 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 figled 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 f~rm). 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 2½10 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-~onforming uses, or buildings and '-'pre-existing" land uses: . 1. Accurate survey of property showing all property lines, streets, buildimg 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 i. 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 t9 accessory building $25.00. Businesses $50.00. 2.Certificate of Occupancy on Pre-existing Building - $100.00 3.Copy of Certificate of Occupancy - $5.00 over 5 years - $i0.00 ,4. Updated Certificate of Occupancy - $50.00 5.Temporary Certificate of Occupancy - Residential $15.00, Commercial $15.00 Date .......... IO ~ ~ New Construction ........... Old Or Pre-existing Building...~.?~cl..~.k~B~y Location of Property...~ ............... b. ............ LTM. ~t~l'~C]¢ House No. Street Hamlet ty 1000 - ~oun Tax Map No , Section ....... Block .... Lot ... ;ubdivision ........................ ............ Filed Map. . Lot [ealth Dept. Approval ....................... Underwriters Approval ...... 'lanning Board Approval equest for: Temporary Certificate.. . Final Certicate...~ ...... ee Submitted: $ ............................. INSPECTORS Victor Lessard Principal Building Inspector Curtis Horton Senior Building Inspector Thomas Fisher Building Irapector Gary Fish Building Inspector Vincent R. Wieczorek Ordinance Inspector Robert Fisher Assistant Fire Inspector Telephone (516) 765-1802 OFFICE OF BUILDING INSPECTOR TOWN OF SOUTHOLD SCOTT L. HARRIS, Superviso~ Southold Town Hall P.O. Box 1179, 53095 Main Road Southold, New York 11971 Fax (516) 765-1823 Telephone (516) 765-1800 I.~Y 5, 1993 PATRAICK ST JOHN & 14F 900 DONNA DRIVE HATTITUCK, NY I 1952 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) No Underwriters Certificate on file. The check is ~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 $ 21310-Z Please contact our office on this matter. cooperation. Thank you for SOUTHOLD TOWN BUILDING DEPT. ~OU~D^~O.~ _., (3 ~t__L fOUMDATIO:~! (2nd IOUGH FRAME & ·PLUMBING [~SULATION PER N. STATE ENERGY CODE FI:;AL ADDIT]~ONA'L COMMENTS 765-t802 BUILDING DEPT. INSPECTION FOUNDATION IST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] IN/~j~TioN [ ] FRAMING [v]~INAL DATE INSPECTOR Examined . .~.~.~: . , Approved ~'/~ ......... , <~'" ' { SOUTHOLD, N.Y. 11971 TEL.; 765-1802 ~fl.. Permit No.~/-~/O ~ ?. §OA'RD OF HEALTtt ......... 3 SETS OF PLA~,'S ......... SURVEY .................. CII~CK ................... SEPTIC F 0 R,~I ............. Disapproved a/c = ' · , ' ' ol~.g,,Z~sp ) . a. Tiffs application must be cc sets of plans, accurate plot plan to ~ b. Plot plan showing location qr areas, and giving a detailed desc qation. c. The work covered by this al , d. Upon approval of this appli shall be kept on the premises availal e. No building shall be occupi shall have been granted by the Built APPLICATION IS HEREBY M Building Zone Ordinance of the Tc Regulations, for the construction The applicant agrees to comply wi admit authorized inspectors on pren APPLICATION FOR BUILDING PERMIT , INSTRUCTIONS Date....d. mpletely filled in by typewriter or in ink and submitted to the Bi~ilding Inspector, with 3 cale. Fee according to schedule. of tot and of buildings on premises, relationship to adjoining premises or public streets ription of layout of property must be drawn on the diagram which is part of this appli- plication may not be commenced before issuance of Building Permit. ' :ation, the Building Inspector will issued a Building Permit to the applicant. Such permit ,lc for inspection throughout the work. ~'d or used in whole or in part for any purpose whatever until a Certificate of Occupancy lng Inspector. ~.DE to the Building Department for the issuance of a Building Permit pursuant to the wn of Southold, Suffolk County, New. York, and other applicable Laws, Ordinances or f buildings, additions or alterations, or.for removal or demolition, as herein described. ~.h all applicable laws, ordinances, building code, housing code, and regulations, and rises and in building for necessary inspections.. State whether applicant is owner, Name of owner of premises .. If applicant is a borporation,.signatt (Name and title of corpo: ate officer) Builder's License No ........ ~ ................. Plumber's License No ........................ Electrician's License No ....................... Other Trade's License No. 1. Locatio, n of land on which propo~ ed work will be'done. ............... House Number County Tax Mal) No. 1000 Secti Subdivision . . . .~. ~-r~tO../.~./.~ 2. State existing use and occupancy (Signature of applicant, or name, if a corporation) (Mailing address of applicant) lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. ~ ................. (as on the tax roll or latest deed) :e of duly auttprized officer. . Street '~]~o.~ ~ .~- Hamlet /~q,4 ?~-~'7"~'0~'6', .~''kJ t / ~. o ~ Block /~ - / ~ ~ ................. ' ................. LOt . ~ ~ ............... .~5 .......... Filed Map No ............... Lot ~ .......... premises and intended use and occupancy of proposed construction: Existin~~ use and occupancy . t ........................................... : .......~ ............... b. lntendeduseandoccupancy .I .................................. .. ,...· '3. Nature of work (check which tPplicable): New B ilding ........... dditlon .......... Alteration ..... ' ..... Repair .............. Ret ~oval .............. Demolition .... '.'.. Other Work ........ 4 Estimated Cost / .~0. '.. ' r.j~f~.~~ (Description) ' ' .......... ' .... · ............... Fee .... (to be paid on filing this application) 5. If dwelling, number of dwellin: units ............... Number of dwelling units on each floor ... · Ifgarage, numberofcars . ..1 ........ .......... 6. If business, commercial or mixed occupancy' ~,~iJ~.~ '..'-: .... ', ....................................... :.. ~ ~, ~'~,~-1 y .arum eno extent of each type of use 7. Dimensions of existing structures, if any: Front ............... ' ..................... Height ' . Rear .............. Dcpth ..... ............... Number of Stories ............. · ....... V alterations or additions: ........................................... Dimensions of srime structure. ~ ith Front D pth ' ' ................. Rear... e ................... [. Height . 8 Di ( ' 'ti ..................... '..'Number of Stories ........ '.~, ~ .. .... R pth ' mensions of entire new cons mc on: Front ........... .. ear ............... De ......... Height .............. Nm,nber of Stories ..... - ' i pth ..................... 9. Size of lot: Front ......... . ............ Rear ..................... De ............ 10. Date of Purchase ...... Name of For/ncr Owner ............................... Z d .... hp! ' · 12 one or use mtnct in wtuc r mines are muated ............................ . ' I gl ................. ocs proposed construction rio ate any zonin aw, ordinance or regulation: 13. Will lot be regraded .~ .......................... · , .............. Will excess fill be removed from premises: Yes No 14. Name of Owner of premises .. i ................. Address ................... Phone No ............. Nmne of Architdct ... i · · · ' ...... i ................. 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 DIAG RAM Locate cleariy and distinctly allI buildings, whether' existing, or proposed, and. indicate all s'et-back dimensions fron~ property lines. Give street and block humber or description according to deed, and show street names and indicate whether, interior or corner lot. AI[ PP VED AS NOTED NOTIFY BUILDING DEPARTM~A~ '. ' 765~1802 9 AM TO 4 PM FOR THE FOLLOWING INSPECTIONS: 1. FOUNDATION TWO REQEIIRED FOR POURED CONCRETE . 2. ROUGH ~ FRAMING & PLUMBING 3. INSULATION l 4. FINAL CONSTRUCTION MUST BE COMPLETE FOR C,O, ALI. CONSTRUCTION SHALL MEET THE REQUIREMENTS' OF THE N,Y. STATE CONSTRUCTION & ENERGY CODES. NOT RESPONSIBLE i FOR DESIGN OR CONSTRUCTION ERRORS ~TATE OF NEW YORK, S.~ .......... a ..... being duly sworn, deposes and says that he is applicant (Name of individual signing contract)' ' ' bore named. le is the ' ~ (Contractor, agent, corporate officer, etc.) f said owner or Owners and is duly ?thorized to perform or have performed the said work and to make and file this pplication; that all statements contained in this apphcation are true to the best of his knowledge and belief; and that the 'ork will be performed in the manner sit forth in tf~e application filed therewith· worn to before me this .................... day of.. i 19 otary Public, '. ·.. Cou ' L~JOYC~ M. WILKINS Notary Public, ~tate of New york ....................... No. 4952246, Suffolk County ignature of applicant) Term Expires June 12, 19~ ...... l'l- ....... 1600 11993