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HomeMy WebLinkAbout18974-z FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No 219830 Date APRIL 3, 1991 THIS CERTIFIES that the building ONE FAMILY DWELLING Location of Property 680 DONNA DRIVE MATTZTUCK House No. Street Hamlet County Tax Map No. 1000 Section 115 Block 15 Lot 20 DEEP HOLE CREEK Subdivision ESTATES Filed Map No. 4256 Lot No. 27 conforms substantially to the Application for Building Permit heretofore filed in this office dated APRIL 18, 1990 pursuant to which Building Permit No. 189742 dated APRIL 24, 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 ONE FAMILY DWELLING WITH ATTACHED GARAGE & COVERED PORCH. The certificate is issued to JOHN JEROME AND JANET M. DUDEK (owners) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL 90-SO-27 MARCH 26, 1991 UNDERWRITERS CERTIFICATE N0. H020982 MARCH 1$, 1991 PLUMBERS CERTIFICATION DATED THOMAS JEROME MARCH 11 1991 ?r Bui ding Inspector Rev. 1f 81 gosas xo. s 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) 18974 N~ Z Date ...~~~.7 19..~1.Q. Permission is hereby grante o: Lis^%~1~-- ~ to ~ ..../~r~~.. ..r...... at premises located at ....S~..O...>~.....~.~~C.t.....~~G.C/.`.T1 i- County Tox Map No. 1000 Section Block .......~n`d......... Lot No..........~J.9........ pursuant to application doted 19./O, and approved by the Building Inspector. Fee 3..~i.Q..'Z,..,3tJ ...'~.~f ,~rn Bui ng Inspect Rev. 6/30/80 s~ ~ ~ ~ ~ fa Form No, 6 JJJ"' ~ j << li TOWN OF SOUTHOLD ~ ~ 3 _ e ~ L+ BUILDING DEPARTMENT TOWN HALL ~V, f7r; p~(` 765-1802 ~~0E;i:~1T.I41.0 APPLICATION FOR CERTIFICATE. OF OCCUPANCY A. This application must be filled in by typewriter OR ink and submitted to Che 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. ,~r~rl37na/Sur~e?r J 2. Final Approval from Health Dept. of water supply and sewerage-disposal. 3. Approval of electrical installation from Board of Fire Underwriters. rYf~~e, 4, Sworn statement from plumber certifying Chat the solder used in system contains ~F'~~(• dept less than 2/10 of 17 lead. Commercial building, industrial building, multiple residences and similar buildings and installations, a certi:ica,te of Code Compliance from architect or engineer responsible for the building. Submit Planning Board Approval of completed site plan requirements. 3. 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. v. 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 - $5.00 over 5 years - $10.00 4. Updated Certificate of Occupancy - $50.00 5. Temporary Certificate of Occupancy - Residentifa~l $15x.00, CormCm~egrcial $15.00 u Date ]~i®r~ 1 ( l ,l I ':ew Construction..,/\//''. Old O~~r'^^~~Pre-existi~jg Building.4.... ~ Location of Property.(Q~o FJ.G?~~.~tilY~l°~e........ Ma-~~/, ~~h`! House-••N~o. Street J~ ~,pHamlet lnwer or Owners of Property.J.u~n.~//~:~~G,...~..~'~.~je~.~•..S-1.~:^~~ :ounty Tax Ma No 1000, Sec ion. ~L~......Block...../: !........Lot... ~ jeep Hd1~. C?^ee~.f~~ Iubdivision.. ........................~.{.....uFiled Map.~~;.':"':"~.,.~Lot-q.~. ~..'~..,„._...u...n.. 'ermit No ....Date Of Permit.. 1.~~-!~~~'~...Applicant.J:'(~~.1e~~e ~-f:1t1~~ ?~!:I,d,~Ei` „„}~~,,rr((~~ ~}.5. 1?ers..j~ _.~j,~ j, A~Hca~l~n Ntl. ~n,~il~ lealth Dept. Approval`^t~::`!'~/.g~.~p ...Underwriters ApprovalQ`{t~;`.i:$~...:~.~.°~.I.'~~d~9d landing Board Approval equest for: Temporary Certificate........... Final Certicate..,l,~...... ee Submitted: sec,. ~l~.s'S ~i fly/~~ ' 1 ~ TEL. ?C,5-180 S~~Fq~ To~rrr ,or sou~or.u ~`"~,~p~~ !=~'~!7 ~+;i~ Y.+ 01'I'IC;1: C?F BUILDING INSP£CT'O o.. 4~;~4 z P.O. 310`C 1 t 79 ~~i 1~~`1.f ~a ~:ro. _ i ~ ~ 1"~;+~'~ ~ TOWN HALL ~ ' ° 0~,~~ ~ ~~~`t- SOIITItOLD, N.Y. 1 1971 ~ ~ 1~ p~ March 13, 1999 S1 1„; - - - ...zti3 ~ John Jerome ~ RD~3 Maple Avenue Southold, N.Y. 11971 'I'o 4.1hom This May Concern, 4Te are unable t.o complete your Certificate of Occupancy because of the follol•ring reasons. /_V/ An application £or Certificate of Occupancy is not On fll.c. ~ENCLDSED) .lo Undexwriters Certificate on fi1e._ / / fP}]e C1lCC:}: L1; { ~ t O11 f11C.) $2$.00 D:o 11eal.th Ucpt. Approval on file. ~i r Nn final inspect:ion hcls"bccu made. Pleasr. contact: our office on this matter. - Thank you for your cooperation. Ifu.ildirc) Pcrm.i.Y. it 1 5 9 7 4_ Z Building Dupt. ~Fkk/V/ `tC) Plumber Solder Ccr t.if icate on file. ' ( al.l permit:; illvolv.i.ng plumbing being iesucd after ~1pri.1 1,1)64 ) ~~y 802.3204 ~ ~ ~ PACE ] ~ t6 JOHN fT'~tT, Mf1N K4WNC 1Offf e_ - Du. HARCA 18,1941 .yMafca>.nw..onllir 70321440/90 H 020982 TXIf"GMIITtt~f 7lMT . ! only the dretrMd e~M'ttwwt r dtecri6rr 6eleu ewJ lwMttilleed 6y thr ~/NlMsdt tatptteltew dw 1il/ee wntritr he tM preolieee fp JOHN ,7EROHE, 680 DONNA DRIVE, MAT'CiCTUC^K, N.Y. in ekejallsmtwR ~ynt ~ let R. ~1111i R. CAR/QUT 9trtiow tKereh Lot wes eraninrd ~{CH 1.1~`il .~Mi6lY0e +eMt~rftk thengetue 4f tJtitr /rnd. Atli NMTt.716 _ - AMT. IL ft. ~ wa. t: w... eeu, t. ':IIMT. N. r. - 42 68 43 37 1 7.1 1 4.8 1 1.2 1 F DRYtfi i1MMAC~ ii9110K gM1w AtOMltpi , pLL uMi~ ! _~ilA/Ri. AMT. W. dl K r. RAf N. r. AMT. MtA A. W.0. AMT. AtY. ~ AMM 1RAif. NAT. n NAf. WAi16 ~ 3 Y 1 30 1 7MW0 t R V 1- C L tom. AMr. AIM. f61R i.e ew l l TV t i s« ~,e er rb. Mo. or n.lto ~ . v MYttAM p t ?,00 C9 ] x 1 210 1 2/0 oTnhi ei?A~Antzr ~z E1, 6('. YIATER HSATERS::1,-4.5 K.K. SMOR.E: DETECTOR:-1 t="' JOHN JERONE E80 DONNA DRIVE NATTITUCK, NY, ].L95?, ft~IL7AAMMr 11 111K This ~ pMNt ip ~ sue. T, W 4` TEL. 7GS-1802 ~~FFO1A'C TORN OF SO~TTH[Ob,D D, f ~r"~' 'y ,y,~l~c OFFICE OF BUILDII.7G INSPECTOR ~ ~ a} i~t 1 ~ r°• ~ P.O.-DOX 728 P i d 't r=r, o "tip u' .r TOWN HALL I ~ I~yI ; ~ r ~+O~~cp ~~~'r SOUTHOLD, N.Y. 11971 { n~ ~,.,~..~,~1--~ ~l ~ ~ tow~~0°°~ •sau ~ ~~r_t7 ~ C E R T I F I C A T I O N Date ~ BuildingJPe/rmit No.// Owner //all (/~h~r7 P (please print) Plumber'~p~r~ 5 /~P~-ri~'IP (please print) I certify that the solder used in the water supply system contains less than 2/10 of to lead. , ' (plumb ~ signature) Sworn to beforo me this j'~ ~ f ~_day of ~1 ~ J~~ 11 - N,~ C/d-~ 19-1x. Notary Public Notary Public,~Q~r County NEIEN K. OE VOE NOtARY P11811C, State of New York Na.47678'/8, SuffoVk Coon Term Eapiros March 30,19 a.. .r _ r. :P . ry~.rc Fx6,t..J~ 2NSi'EC7Ior> 11Dr~7~ q Co~c:?tiu~.S ~ FOUtlDATZ0:1 (1st) _ m~ FOUIIDATIOU (2nd) 2. 7/7 o ~ DOUGH FRkifE & ~ •PLUt4BING • /D 3. m IIISUL:.TZOt1 PER N. Y. • • "3 ST:.TE Et1ERGY CODE I ~ i, 4. ~m o .~©I ~ y j r I:1 A L ~ ~ ( . ~.e-v coati-. 0 AD ITIO L COt?MEtITS: x c s - ~ ~ ~ . n I~ (Y THE NEW VORKBOARD OF FIRE UNDERWRITERS • H \ O WE ARE IN THE PROCESS OF ISSUING A CERTIFICATE OF COMPLIANCE FOR THE ~ ELECTRICAL INSTALLATION AS COVERED ~ IN AN APPLICATI~yO-/N,~NOTED BEIAW. APPLICATION NO. ~`~~~'~u ~O Q LOCATION ~ ~v U~~ ~/JC INSpEC(OR ~ DATE ~ IBD (flEV B/90) ' m ~ Q Z • d ~ m ~ N fv,. ~ ~ rL( ~ c ~~~z 765.1802 BUILDING DEPT. INSPECTION [ ]FOUNDATION 1ST [ ]ROUGH PLBG. ]FOUNDATION 2ND [ ] iNS CATION [ ]FRAMING [ FINAL REMARKS: C-® _ zr ~ DATE ~ INSPECTOR ~~9~ ass-isoz BUILDING DEPT. INSPECTION [ ]FOUNDATION 1ST [ ]ROUGH PLBG. [ ]FOUNDATION 2ND [ ]INSULATION [ ]FRAMING [ INAL RE ARKS= ~~-~L=.- ~2 -c~-~--~~•.--~~-~s-z~ d-~-~ ~ ?s~ DATE ~ a~ ~ INSPECTOR 765-1802 BUILDING DEPT. INSPECTION [ ]FOUNDATION 18T [)ROUGH PLBG. ]FOUNDATION 2ND [y-tl~U-'CATION [ ]FRAMING [ ]FINAL REMARKS• CJC~~ ~.7~ Ct'~~ DATE IN8PECTOR 765.1802 BUILDING DEPT. INSPECTION ~f~ [ ]FOUNDATION 1ST [ ROUGH PLBG. [ ]FOUNDATION 2ND [)INSULATION [~RAMING [ ]FINAL REMARKS: -<-e r,r , ~ / DATE ! ~ of ~ INSPECTOR I. ~ ~ 765-1802 BUILDING DEPT. INSPECTION [ ]FOUNDATION 1ST [ } !ROUGH PLBG. [ ] FO NATION 2ND [ ]INSULATION ] FRAMING (]FINAL REMARKS: T DATE ~O ~ 3 INSPECTOR rss-i~O2 BUILDIN f DEPT. INSPECTION [ ]FOUNDATION 18TH [ ]ROUGH PLBG. [ ]FOUNDATION 2ND [ ]INSULATION [,FRAMING [ )FINAL /REMARKS: ~ i ii~ DATE ~ ~ INSPECT6R/• ~ ~ y 765.1802 BUILDING DEPT. INSPECTION [ ]FOUNDATION 1ST ( ] ROUGH PLBG. [FOUNDATION 2ND [ ]INSULATION [ ] FRAMINha ( ]FINAL REMARKS: - DATE ~ s ~ INSPECTOR rss-isoz BUILDING DEPT. f NSPECTION [ FOUNDATION i5T ( } ROUGH PLBG. [ ]FOUNDATION 2ND [ ]INSULATION [ ]FRAMING [ ]FINAL REMARKS: d. ~ ` ! P ~M ~ DATE O , ~ INSPEC~~~OR ' I , t 4, ~ 9 ~ ? ~ i ~ ~ ' Q 1 Q ~ ~ ~ ~a~ri~m d ~ ~J ~ ~ A ~ Z Q ••`OO•??." ~ O 4 ~ ~ ~ 2~ 4 Q 4 ~ j G ~ ~ ~ e~ J ~ d Z ~~a~~ IY ~ Y t,A ~{7~ ~ ~q 1 ~ n ~ ~ ~ ~ f~ ~ ~ ~ UI 4 CQ C~ \h 1n `vr ~ ~ ~ ~i ~ a . , n~ ~ 4 4 ~ a~ ~ A ~ ~ 4 4 ~n 1 . `7 M ~ ~ O O O Q 0 ~ Pl H ~ ~ ~ ~ Q ~ w a o Q ~ ___l ~ ~ ~ G` r_. c. ~ ~ ~ ~ S' ~ U q q ~ ~ ~ ~ e~ Q ~ ~ Q ~ ~ ~ ii Q ~ ~ , l7 ~ ~ v 4 ~ v ~ . a ,n p in i f V ~ ~ ~ ~ FE~ u. R ~ ~ 1 . U ~ d Q ~ ~ i i°~ ~ ~ r. r., fV 1.1 V' UI 41 w BO~1FD OF HEALTH i 3 SETS OF PL.1rIS , . D L~~C~,,,~_°~I~~`~~''i;`yl'r, } FORMN0.1 SURVEY . . . . ~..::.w...:. ~ TOWN OF SOUTHOLD CHECK . ~I~O BUILDINGOEPARTMENT SEPTIC r•oRrt TOWN HALL SOUTHOLD, N.Y. 11D71 NOT FY ; 765-3461 &3i.CG. t;~ TEL.: 7G5~1802. ~ CALL . ~ 19~ MAIL T0: atuincd 7 •~'~~p....... . proved • !9`x:0. Permit No..~~?~ ~ . .approved a(c ,...~..w. (Building I pec[or) APPLICATION FOR BUILDING PERMIT 'Date .`~:/i7..-........, 15.~(~ INSTRUCTIONS a. Tlus application must be completely Ctlled in by typetivriter or in ink and submitted to tfte Building Inspector, with 3 s of plans, accurate plot plan to scale. Fee according to schedule. b. Plot plan showin; location of lot and of buildings on premises, relationship to adjoining premises or public streets areas, and giving a detailed description of layout of property must be drawn on the diagram which u part of this appli- ion. 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 dl be kept on the premises available for inspection ihrou~tout the work. e. No building shall be occupied or used in whole or in part for any purpose whatever until a Certificate of Occupancy ill have been granted by the Building Inspector. APPLICATION IS HEREBY i4fADE to the Building Department for the issuance of a Building Permit pursuant to the ilding Zone Ordinance of the Town of Southold, Suffolk County, New York, and other applicable Laws, Ordinances or ;ulations, for the construction of buildings, additions or alterations, or for removal or demolition, as herein described. e applicant a;rees to comply with all applicable laws, ordinances, building Bode, housing code, and regulations, and to nit authorized inspectors on premises and in building for necessary inspe ti s. JOHN JEROME (Si, azure of licant, or name, if a corporation) RD#3, Maple Avenue, Southold,,NY „1,1.971,,,,,, (Mailing address of applicant) ie whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. ............................OWNER , .....~!~LZ L~. ~ °....:~'a'~', t. . tie of owner of prerk~~~ J~ROME and JANET M. DUDEK (as on the tax roll or latest deed) pplicant is a corporation, signature of duly authorized ofFicer. ; pla..:.. (Name and title of corporate officer) Builder's License No. . , . ~ P'~`. ".r4 r Plumber's Liccnsc No . . . Electrician's License No . . OtlterTrade's License No . ocation of land on which proposed work will be done; DONNA DRIVE;,MATTITUCK............ 'ouse Number Street Ham{ct ounty Tax \1ap No. 1000 S¢ction .....l.l.r'.:~~ • . • . • • . Block , , , , 15: 00. • • • Lot , , , 020:000 • , • MAP OF DEEP HOLE CREEK ESTATES 4256 21 abdivision . . . . , , , . fiilad f,1ap No. Lot , . (Name) ate existing use and occupancy of premises and intended use and occupancy of proposed construction: Existing VACANT LAND . ,uscand occupancy Intended use anti n~~,,,,,.,,-., . , , , , , ,1 FAMILY RESIDENCE . (luca?iddcJoasnlnu5!$) 0661 '0£ .zacpua~daS sazidx~ uozssitutuo~ 3 213f NH ~quno~ xro3~ng ui pat3rr~nJ Z69SL96 •oN xao~ MaN 3o a~p~S i~ ~trana ~zp~o ~x~ana.s~zr~~x~ ~tlunoJ ..lz6~~~~ b!Ignd,c.icti ;1.. 06~?........iT.~a~........JoAcp....r.(. uaLt...... snrl aw a~olaq of wog •gl!nw~agl pa1J uopca!(ddc aql u! gt~oJ las ~auucw atp u! patwoJiad aq If!m .y,~ ayi 7cy1 puc :Jagaq pue a9pa(nwuy st(Jo lsaq aip of anal arc uo!l~apddc s!yl u! pauicluoo sluauwlcls I(c lcyl :uo!lcayd s!tp a(J Pue a:(ecu of puc .y.~om p!cs,' aqI pauvoJ~ad ancq ~o wJOJiad of pazuotpnc ,S(np s! puc •sxxlaxa[xxxxaaaa>Dxp?txr (iala'~aaaJo alc~odioa'lua9c'~olac~luoJ) a~Nr~o.............. aql (laC]1UOa Su!u5!s Icnp?n!pu! 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