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Home My WebLink About19067-zFORM NO. 4 TOWN OF SOUTEOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. ~ERTIFICATE OF OCCUPANCY No Z-24043 Date NOVEMBER 24, 1995 THIS CERTIFIES that the buildin~ Location of Propert~ 575 THERESA DRIVE House No. County Tax Map No. 1000 Section 115 ALTERATION MATTITUCK NY Street Block 15 Lot Hamlet 5 Subdivision Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated MAY 22, 1990 pursuant to which Building Permit No. 19067--Z dated JUNE 1, 1990 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 ALTER AN EXISTING ONE FAMILY DWELLING AS APPLIED FOR. The certificate is issued to (owner's) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL UNDERWRITERS CERTIFICATE NO. H047740 PLUMBERS CERTIFICATION DATED JOHN & DIANE DEFABRIZIO 13, 1995 N/A Rev. 1/81 l~ing Inspector FORM NO. O TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N. Y. BUILDING PEP. MIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL cOMPLk-rlON OF THE WORK AUTHORIZED) Permission is hereby granted to: (~ , ..~..~...(....~~..~.........~..~ ....................... ~_ . ~..~~....~.~.,....~., ~.~.~ ,~ County Tax Mop No. 1000 Section ...... J/..,~... ......... Block ..... ~...~... ......... Lot No...O..~. ............ Building Inspector. Fee $...~..~...:...~ Rev. 6/30/80 Form No. 6 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOW~ HALL 765-1802 APPLICATION 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 of property with accurate location of all buildings, property lines, streets, and unusual natural or topographic features. 2. Final Approval from Realth 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/I0 of 1% lead. 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. For existing buildings (prior to April 9, 1957) non-conforming uses, or buildings and '7pre-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 2. Certificate of Occupancy on Pre-existing Buildin~ - $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 $15.00 Date ..,./~/.~ ....?..~f. f .~.. .......................... New Construction ........ Old Or Pre-existing Building ....... ........................ Location of Property ...................... ~ .... House No. Street Hamlet Onwer or Owners of Property.. · .~.~.~.../~. · -~- .~./.¥.~- .~. · ~..~Z~...~. ~[~. ~.~. ............................. County Tax Map No 1000, Section...~. ...... Block .... 1.~2 ........ Lot.-.~.. ................. Subdivision .................................... Filed Map ............ Lot ...................... Health Dept. Approval .......................... Underwriters Approval.....~-./.~ ....... .~ ...... Pla ning Bard Approval . · Request for: Temporary Certificate ........... Final Certicate ~ N01/~4 ~99~ '/ ................... THE NEW YORK BOARD OF FIRE UNDERWRITERS P~c;~ .~ ~7287 EURE^U Or E'ECTRICITY ~ 85 JOHN STREET, NEW YORK, NEW YORK 10038 THIS CERTIFIES THAT JOHN DEF~R~ZtO, 575 T~RUSA DRI~ HATTtTUCK, N~Y, in the followlng location; ~ Basement ~ Ist Fl. ~ 2nd FI, Section Bilk Lot . NO~ER ~6,1995 and found to be in compliance with the NaHon~ Elect~c~ Code. ~ mRNACt MOTORS j FUTURE A~L,ANCE ~EDERS IS ECIALREC'~t Ti~ECt~S [ BELL )UNIIHEA?ERS MULTI-OUTLET DIMMERS ""~'~ "2Y°""'X'~~ ~~:~ , ~ ~ ~ ~oo, c~&~ ~ ~. ~, ~w~. ~ , ,~ ~, OTHER APPARATUS: JO}~N D}]FABRIZIO 575 THERES DRIVE ~$ATTITUCK, N~, 11952 This certificate must not be altered in any man,er; return to the office of the Board if incorrect. Inspectors may .be identified by their credentials. COPY FOR BUILDING DEPARTMENt. THIS COPY OF CERTIRCATE MUST NOT BE ALTERED IN ANY MANNER. Albert 5. Krupski, President John Hoizapfel, Vice President William G. Albertson Martin H. Garrell Peter Wencze! BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD Town Hall 53095 Main Road P.O. Box 1179 Southold, New York 11971 Telephone (516) 765-1892 Fax (516) 765-1823 November 16, 1995 Mr. & Mrs. DeFabrizio 575 Theresa Drive Mattituck, NY 11952 To Whom This May Concern: We are unable to complete your Certificate of Occupancy because of the following reasons: xx An application for Certificate of Occupancy is not on file. (Enclosed) No Underwriters Certificate on file. xx 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 # 19067-Z Please contact our office on this matter. cooperation. Thank you for $OUTHOLD TOWN BUILDING DEPT. 765-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION 1ST [ ]ROUGH PLBG. [ ] FOUNDATION2ND i ] INSU~.ATiON [ ] FRAMING [,.~NAL [ ] FIREPLACE & CHIMNEY REMARKS: ~/~~./-( DATE //////~//~"~-"/INSPECTOR 765-1802 BUILDING DEPT. INSPECTION FOUNDATION 1ST REMARKS: [ ] ROUGH PLBG. [ ] F~NDATION 2ND [ ] INSULATION [ ~]/FRAMING []FINAL DATE ?~ /~/~ · INSPECTOR ~//~ ~//!~/~2 FOUNDATION (1st) FOUNDATION (2nd) 2. ROUGH FRAME & PLUMBING 3. INSULATION PER N. STATE ENERGY CODE FINAL ~THE NEW YORK BOARD OF F RE UNOERWR{YERS WE ARE IN THE PROCESS OF tSSUING A CERTIFICAT~ OF COMPLIANCE FOR,THE ELECTRICAL INSTALLAYION AS COVERED IN AN APPLICATION N ED BELOW, ADDITIONAL COMMENTS'. FORM NO. 1 TOWN Of:: SOUTHOLD BUILDING DEPARTMENT TOWN HALL $OUTHOLD, N.Y. 11971 TEL.: 765-1802 Examined .... Approved .... -~ ~ J..., 19 .~.0. Permit No..]. Disapproved a/c ..................................... (Building Inspector) APPLICATION FOR BUILDING PERMIT BOARD OF HEALTH ...// ..... 3 SETS OF_..~.-;rNS t,<'. ....... ::: SURVEY ~ ................ .. CHECK SEPTIC FORM ...... ... NOTIFY CALL MAY 2 INSTRUCTIONS Date ................. a. This application must be completely filled in by typewriter or in ink and submitted to the Building Ihspeetor, with ~ 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 th/s appl/- cation. c. The york covered by this apphcatlon 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 apy purpose Whatevei~ until a Certificate of Occupancy shall have been granted by the Building Inspector. APPLICATI(~N ,IS' HEREBY/MADE-tbT'the Building Department for (he issu'ahce o'f a Btlilding P~rmit pursuant to the Building Zone Ordinance of the Town of Southold, Suffolk County, New Yet.k, and other applicable Laws. Ordinances or Regulations, for the cofistruction of bufldirJgs, additions or alterations, or for removal or demolition, as herein described. The applicant agrees to comply with all applicable laws, ordinances, building code, housing code, and regulations, and to admit authorized inspectors on premises and ldm,, fo, n~eo~ary~ ~.~ inbui '" ..... " '' ' ' - - . ' ~ . PP State wh~ther applicant is owner, lessee, agent, architect, elqgineer, general contractor, electrician, plumber or builder. ..... (as on the tax roll or latest deed) If applicant is a corporation, signature of duly· authorized officer. ( amc and title of corporate officer) Builder s L No. PI mber s L~cense No .................... Electrician's License No.. O. geq. .t~.~'../~.. .......... Other. Trade's License No ..................... 1. Location of land on which proposed work will be done; tIouse Number Street. Hmnlet '" //5" '. · /...,C. o7'.. County Tax Map No. 1000 S~ction ........ · .. · ... Block . .. · · ........ Lot ........... ~-";.. Subdivision ..................................... Eiled 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 i ~ B. Intended use and occupancy ............................. ~? '~ 3. Nature of work (check which appliqabie): New Building ........... Addition ....... ; · · · ......... 4. Estimated Cost ..'...%/~.~.'r'..~,..,',,, ...................... ......... (to be paid on filing this applicat!on) 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 o~cupancy, specify nature and extent o f each type of use . ~... ' !f any: Front Rear Depth 7. Dimensions of existing structures, · ·,. ? ....... , .................................... r of Stories ' Height ............... Numbe .......................................................... Dimensions of same structure with,,alterations or additions: Front. ............... . Rear ................... Depth . .. :Height ............ Number of Stories ....................... 8. Dimensions of entire new construe,rich: Front ............... Rear ............... Depth ................. Height Number of Stories ~ ' · .... Size of lot: Front ' Re,ir ' ' ' Depth Date of Purchase Name of Former Owner 1 I. Zone or use district in which premises are situated ..... ................................................. · ' ~ ordinance or regulation: 12 Does proppsed Constructton violate any zoning law . premises: . . 1'3. Will lot be regraded <. ......... , ................. Will excess fill be removed from Yes .. N~ 14 Name of Owner of premises .' .... Address .. . Phone No ........... Name of Architect ~ Address Phone No .... Name of. Contractor .......... i ....... i ........ Address ................... Phone No ..... ~ .... 15.Is th~.s property locatled within lO0 feet of a tidal wetland? ~1[t5 yes, Southold Town iTrustees Permit may be required. i PLOT DIAGRAM Locate cle~l¥ and distinctly all buildings, whether existing or proposed, and, indicate all set-back dimensions from property lines. Give street and block nBmber or description according to deed, and show street names and indicate whether interior or comer lot. ,, STATE OF NEW_YORK. , COUNTY OF..~J~..~7..O.~-v~ .... ....... SdS. .. (Name of individual signing contract) above named. .............. being dnly s~vom, deposes and says that he is the applicant lSte is tile ' ' ' ! (Contractor, agent, corpora'tO officer etc.) ' of said owner or owners, and'i~ drily ffutfiorized to pe,rform or 'have performed the 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 that the work will be pertbrmed in tile mann,er set forth in tile application filed ttmrewith. ,/ Sworn to bcfore me this , 1 ............... do~ ...... day of ..... ~ ........... 19 7.R. Notary Public,..~-~....~. ~.,'jO~ ~'/~F--?' .... Count, P Z P N 24.~' 21.1' ~ I STORY Fl:lAME HSE. EEEL. 2:~' GAR.EL. 20.7' 62.4' 31.1' ,00'0J 1 M ,,01:' ,01~'o'~ 0 c~ :m:)N':,a fin,,,-, ?~.~oe ,e I !r ,00'0~ 0 gO 0