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HomeMy WebLinkAbout17958-z ~ FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Ha11 Southold, N.Y. CERTIFICATE OF OCCUPANCY No Z-20333 Date NOVEMBER 7, 1991 THIS CERTIFIES that the building ADDITION Location of Property 200 WILLOW POINT ROAD SOUTHOLD, NEW YORK House No. Street Hamlet County Tax Map No. 1000 Section 56 Block 5 Lot 52 Subdivision Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated MARCH 24, 1989 pursuant to which Building Permit No. 17958-Z dated MARCH 27, 1989 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 OVER ATTACHED GARAGE 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 N0. PENDING - NOVEMBER 4, 1991 PLUMBERS CERTIFICATION DATED NOVEMBER 1, 1991 - STEVE DONADIC Bu riding Inspector Rev. 1/81 !'08M NO. ~ TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N. Y. BUILDING PERMIT (THIS PERMIT MU5T BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) N o 017 9 5 8 Z Date ~..4~.:.'-[J....., 19..G.~ Permission ~s hereby granted to• ~ J tO ..C`.A, 5.11.....cl:~.~7r..... . ~:~:....5.4'(L(.~4.fvf'S.FrrOL.i..... 0....F.':......~..~.:~.. ~ ~ ~ tl .(..,3.q ~ . ct premises located at ...aoo.....,4..~2Va?..~J ~-8;~;..........~..~::~rfh,~!4~?`4. . County Tax Map No 1000 Section ~ 5~0 Block ~ ~ Lot No ,O SZ:.. pursuant to opplicat~on dated ...Y. P.\..~Sr.4-~c!:~. 19~~. ,and approved by the Building Inspector. t Fee S• ~ ~:~..rr. . Bui ding Inspector Rev 6/30/80 aosnt xa 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) N°- 15939 Z ' Date .................19.~7 Permission is hereby gwnted to: ro .('.:~....x-v~.,~:~F"...s~.~r~.....s'.,....4-!.w~:....4~`~.c~!a:&..~~4:a:q.r~.-.,aE-~.... at premises fixated at County Tax Map No 1000 Section ©.`~ZP....... Block ....Q~......... Lot No......~'~~ Z'. pursuant to application dated 19~.~., and approved by the Building Inspector. Fee 5.~.:• .,,t.. (~~yQ:.l..~ Building Inspector Rev 6/30/80 r Form No. ti / i~'~~"J" . To[~rr of SOUTIIOLD , ~ , / ~y _as c1S~R, ai. BUILDING DEPARThiGNT TO[JN i1t1LL ~ ~ ~ ~ ~ ~ ! f 3`r4' 765-1802 APPLICATION FOR CERTIFICATE OF OCCUP.\NCY 1. 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-O 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 0£ 17, lead. + 5. Commercial building, industr~.al building, multiple residences and similar buildings and installations, a certificate of Code C+.mp Nance from archi_ect or engineer responsible £or 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 "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 Euilding Inspector shall state the reasons therefor in writing to the applicant. Fees 1. Certificate of Occupancy - New dwelling $25.00, Additions to dwell utg $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.D0 4. Updated Certificate of Occupancy - $50.00 5. Temporary Certificate of Occupancy - KesidentiaT{/~~1$15.00, CommercQia~jl 515.00 ew Construction........... Old Or Pre-/e~nxisting Building. v ocation of Property... ~C3~..... t.JrC/Q(J~~ ~ tt/~.' House No, n' Str~e+et ~,~1 Hamlet ewer or Owners of Property..S l CUE... l...f 7~~ ~ `A.....LI.It~Jf~.~l~.~ ..Q . . runty Tax Map No 1000, Section ..............B1uck.......,.....,..Lot... 2: 5~.............. :bdlvision....... .Pil~eld7itap...........,Lot... •rmit No ~.~.9~~,....Datc Ot permit,`. r9~~..nppli.ant..:"::.'V.~,...~~~:~r~ alth Dept. Approval ..........................underwriters Approval......................... anni.ng Board Approval quest for: Tempo~~r//a//ra~y Certificate........... Final Curticate........... Submitted: $.°`~!.G?G' /y~/p/~ ~q ~ . ~ :.Y . "~'~C•"[al~~ APPLICANT Cl., 2 ~n~ 2~ Ldp ~l~~J ~/N~- ~OU f ¢te~DO ~j clh~~b~ ~r Ali ~~~~ottl ohl rjr~~v,r~ ~c~~ ~iS C~e~~js~ r erg' ~ . ci~iefi-Q ~Nt'~ar~7~1 UG~ ~7~ Gbi ~i (1 C~ ~2t G/it ~ ~NCAh'~ TEL.7G5-1802 ~oS~FFOi,S~ool2 TORN OI' SniJTIIOd.D ' Z f.:;.' ~ OFFICE OF BUILDII~IG INSPECTOR o° ~ P.O BOX 728 u' ~ TOWN HALL "O/,~Y SOUTHULD, N.Y. 11971 C E R T I F I C A T I O N Date r`F~"~N~Nr f~'~ Building Permit No. 1'7 q ~'s Owner ~~U~",Z~m~'}~-D1~' (pleasep/~r~int) 7~ Plur,.5er ~~GUG ,+-rd~j~'rJ~C (please print) I certify that the solder used ~.n the water supply system contains less than 2/10 of to lead. - (plumber's signature) 0 Sworn to befo me this ' day of 9 19~. Notary Pub 1C Rotary Public,~0 County GRACI:LA M GUTIERREL Comm~ssix~er of DxAs CM ~ Hex Yotk-No, S-32Ut (krtd¢ate FileO m ~jj~ Cammusion Fxpas ~Pxl 4 3 0 4 O~y 'TOWN Or SOUTIIOLD , ,a~ v,,t~:~t..c OPE'ICC OP BUILDING ENSPEC'tOR o :`r c::ji°nt~ ~ P.O. BO;C 728 ~ ~ TOWN HALL SOUTEIOL~, N.Y. 11971 of ~a /a, f 9 ~ To S~7hom This May Concern, We arc unablo to complete your Certificate of Occupancy because of the following reasons. An application for Certificate of Occupancy i ; not on file. CIO Underwritcin Certificate on file. Tlcc:' ~hcck i;; (outdated/not on file. ) No ficalL-fi Dcpt. lpproval on file. CIo tinal anspcct~.on has been made. Please coriLact our office on this matter. Thank you for your cooperation. Iluildincl Permit li ~ ~ ~ 3 ~ Z ~-c~--~-'-'~t'e-~`" flutld5nci Wept. ***/V/ D10 Plwnber Colder Certificate on file. ( all permits invalving plumbing being Laued after April 1,19II4 ) n / ~ w LLL ~L~~.... I~ v~. ^J ^ V a I H UIJDATi0:7 _ (1st) ~ ~r - - - ~ 1 - c U;JDATIO;J ( 2nd ) _ m o ~ UGH FRAh1E ix o PLUMBING c t ` C H IN ~ ~ M ~ SULATIOPJ PER N. Y. STATE ENERGY CODE 6 F 1J 4 m H ~ FI;dAL ( - o z ADDITIONAL C LENTS: m x ~ x ~ \ Q ~ ~ ~J ~ H~0 O 2 O a r \ H Z d v7 -a H 765-1802 BUILDING DEPT. 1 NSPECTION [ ]FOUNDATION i5T [ ~ ROUGH PLBG. [ ]FOUNDATION 2ND [ ]INSULATION [ ]FRAMING [ ]FINAL REMARKS: DATE CI ~ R INSPECTOR o > 765-1802 BUILDING DEPT. INSPECTION [ ]FOUNDATION 1ST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ }INSULATION ~MING [ ]FINAL REMARKS: dy1 ~"^o. DATE ~ ~ ~ INSPECTOR l ~~S-~ ~~-18UY BUILDING DEPT. 1 NSPECTION [ J FOUNDATION 15T [ ROUGH PLBG. [ , FOUNDATION 2ND [ ]INSULATION [~f/FRAMING [ J FINAL REMARKS: DATE ~ v INSPECTOR r ' FORM NO, t D~ MAR 2 4 TOWN OF SOUTHOLD 2 987 f~f3g BUILDING DEPARTMEN~~~ i~ TOWN HALL ~x ~ 1'~ BI-OG ~ t °OUTHOLD, N.Y. 11971 ` TO(W~N~C~~~~- ~.i,Vy~ TEL.. 765.1802 Exammedl3lt12J~~-?(.,,'27. 19~~ 17 9'$$~ Received........... , 19. Approved , 19~ 7 Permit No ~ ~ CQz ~ - a S ~ 9 t / r!- Disapproved a/c ~ ~-Q.a..~ , . ...~~3~/ (Building Inspector) ~'f APPLICATION FOR BUILDING PERMIT Date ~ , 19? INSTRUCTIONS a Tlus application must be completely filled in by typewriter or in ink and submitted to the Building Inspector, wit 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 adloinmg premises or public str or areas, and giving a detuled description of layout of property must be drawn on the diagram which is part of this ap cation. c. The work covered by this application may not be commenced before issuance of Building Permit. d Upon approval of this apphcatron, the Building Inspector will issued a Building Permit to the apphcant. Such pe, shall be kept on the premises available for inspection throughout the work. e. No building shall be occupied or used in whole or m part for any purpose whatever until a Certificate of Occupa, 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 Building Zone Ordinance of the Town of Southold, Suffolk County, New York, and other applicable Laws, Ordinance Regulations, for the construction of buildings, additions or alterations, or for rem al or demolition, as herein describ Tlie applicant agrees to comply with all applicable laws, ordinances, buildin c , housin,P~ode, and regulations, an~1 'mrt authorized inspectors on premises and in building for necessary insp cti n (Signature of ap hcant, or name, if a corporation) ~(mailing~address of~applicant)~ State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or build Name of owner of premises ~T~~G' . ~ ~/Y~'~i'73 ~ C (as on the tax roll or latest deed) If apphcant is a corporation, signature of duly authorized officer p W H~Y2_, . (Name and title of corporate officer) Bwlder's License No ~b1?1yz~' . ~ J t . Plumber's License No Electrician's License No. Other Trade's License No 1 Location of land on which proposed work will be done ~ 1 ~t . ~;'~T~t C" 1~~ , Ilouse Number Street Hamlet County Tax Map N/o`. 1000 Section .Q.~ `P...... Block ...B Lot ©S?-+. Subdi~iswn ~i,~~ 0~i 1~~H,-'•~"!~ Filed 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 ~.Q b Intended use and occupancy ~~-P , . 3 Nature of work (check which applicable): New Buildrng Addition 4! Alteratron . Repazr ~ . . ~ Removal Demolition ,i Other Work . t.0 - (Descnption) 4 Estimated Cost R~~(,k,,.... Fee . (to be paid on filing this application) 5. If dwelling, number of dwelling units ~N~ . R~'I ' Number of dwelling units on each floor . . If garage, number of cars • • • . • • . G If business, commercial or mixed occupancy, specrfy nature and extent of each type of use , , . 7 llunens~onq of existing structures, tf any' Front ~4'" .Rear ~ Depth 26 Height ~ y Number of Stones b~~ f v .N. Dunensionstof same structure with alteratrons or addpt~ons Front ~q"" .Rear .2 , , . Depth 2~.^. Height r-^ a ~ Numbrtr of Stones . "rw~ 1, , , 8. Dtmensrons ofrenhre new construcUOn Front . ~w?~ . .Rear ..Depth ~,•~^~r. Height Number of Stones ~ ~ ~ . . 9 Size of lot Front ~Q~ 7T ~ Rear l~~ , , , , , , epth 3 Q>~ [ . . ] 0 Date of Purchase I ~~8 Name of Former Owner ~ ~tl ufc~• , • . , ] 1 "Lone or use dzstnct m whrch premises are situated E f A t`'/;l i, I A{., , , , , , , , , , , . 12 Does proposed constructron vrolate any zoning law, ordinance or regulation ..fib . . . 13 Will lot be regraded gyp Will excess fill be removed from premises Yes = l4 Name of Owner of premises oNA1~./ .Address .~e9'2S .'1,~ D~ • .Phone No 35 3 23 7~' Name of Archrtect .......~W.~°~- Address ~"~y~ ~!h'"9 Phone No. Name of Contractor .....Q~K~ . Address /y! . /~3 ...Phone No / . 15. Is this property located within 100 feet of 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 dunensrons frl property lines. Give street and block number or descnption according to deed, and show street names and rdicate whetl mrtenor or corner lot i~ r mew ~ x 1 I- ' a I I~ ~ .i ~ ~ I ~ a i I I l . ~ I P1~~ I S"6 .I ~ I ~ / ~ ~ i 'Z4.o., J~ i 260 STATE OF NEW YORK, S S COUNTY OF . being duly sworn, deposes and says that he rs the apphc, (Name of individual signing contract) above named Hcisthe (Contractor, agent, corporate officer, etc ) of said owner or owners, and ~s duly authonzed to perform or have performed the said work and to make and fde t application; that all statements contained in thrs application arc true" to the best of hn knowledge and belief; and that work wdl be performed m the manner set forth m the application filed therewith Sworn to before me this ....4Z ~d/ay of „197 Notary Public, ~ k/L~ County .Y M HELEN ~ . y,,,NdI11RY PlIP~ , ,af lkw Yak ~ /(/`1r~{~/f///A ,y. Imo//'/~/~~/' /l ~ ` (S~gnature of apphca Ip{1p~FRt?•1 V] IWEI ~,1 JJ, l~~/ V C' / ~/U~~ ~ ~ a Ji ~ ~_i~~G ~L;'~t1\~ pp,c A,.,n,a R'i MEIJT Ii RFAL.7H p -y ~ Dw ELL(NG x111FI~IP r~ r "i Y r'' ~G ~ ~ D 'e4 r~nv 's ~ i i Z~ _ ~PTEfl MgIN ~ p~ I POIf~T ~ ROAD W1~~ 75 NA7°6~I0'IE. 7.5 T5• 70I00~ 223. aF \ 8,7 %o E 0, L. 29.73 \ AT. , nq,« I 1 N N.00 Y ~2 y 4 ~o-ya~._II~:~. ~o~, ( d 'o O so I !o p. F ~ y3ju M1i R:26.00' J,O, o ~ of " ' 1 L. 30.27' JO a°4p~ y,p ~ 1A <o ~ 1. ryM1' / / 0 ~o i Lz'Q / L,6 F p~~ / Cr ~ 'QO / Qa. ~o'~ ~ 3' ~ oc of 'o . + °b~ ~tiA f " u', T~F y~C,°~ I del ~j0~t I ~ agerc i e~e~' ~ c -t-_ !FR._J~1~ .~P--" , 40=,. «-T~-1t-1'---~--~,-L-~-X~rr^-rv-~,^r_v-i.: ~.v.n...-~.. IS l% ~ ~ V 15 ~I SEP - S 1989 ' BLDG. DEPT. 5 ~ 2r 82 ~I NAL TOWN OF SOUTFIOLO I II~S~aI bl r.-A~iU '~t%'PT 9a1a sIAOV1N SUI+POLIC COl7NTY FIEALTH ?EPAftTMLN: SURVEY FOR I DATE r1~Y: 1 1 19QQ [i, D. PEE. # I-Sl 0-~3o LOT 2BD' WALDLOW POI NITA DONADIC Thn sm, • I,-:., ,,,ler eupply AT ARSHAMOMAOUE GATE 00T. 26,1978 r, " ~ ~ . ~ ~ 1 h9vp boon TOWN OF SOUTHOL(D SCALE ~ I" = 60' inspr:~. b~ L. .a ,t q~, fo~{T /I - SUFFOLK COUNTY, NEW YORK No, 76-64e La be sa;.isfeotory~r~-(;.._,._~3 (f~-~F. P~L +un pu THDfl ¢ED ALreRpnpn aq ap Dlnpn rD rnls GUARANT EEO TO suflver Is p mLLAnan of sec nan Tzps DF rnf gMERICAN TITLE INSURANCE CO. Chief of Canernl Engineering nfw mflN srprE EDUCpnon Law R COPIES OF THIS SURVEY NOi pEAfl ING rnE LPNO SBrVSC09 SUq VE YOfl 5 INnEp SE4L Ofl ENpp SiED SEAL SHALL OF NOi pE CON SIp ERED i0 9f A VpL1O TPUE COPY N GUAflpN TEES InplCp TED XEflEOry $NALL qUN DNLY TO t'p~ fw HEALTH DEPARTMENT-DATA FOR APPROVAL TO CONSTRUCT THE PEHSDN Foq wnpM rHE sugvEr Is Pq EPaflep, S X09 pNp ON NIS BEXALF i0 TXE TITLE COM PpN Y,GOVEgN- O,~PWD R~, y0 ,r •NEANEIT WATFfl MAIN MI ~ µ]OVq]E OF WATEgr pql VpiE PUBLIC % MENTAL AGENCY ANO LENDING INSTITUTION LISTED iF9UFF CO TA%MAP DIST'ioo05 ELTION CSIa BLOC%C~i LOT 92 nE nEON, ANO i0 THE ASSIGNEES DF iMf LENDING ~ y' G3 iF THEflF AqE NO OW ELLINO! WITHIN 100 FEET OF iHl9 pgOPEfliY INSrIiU LION, GUAR4N TEES pflE NOT igpNSFEgA BLE L, OTNEq TXAN THOSE 9NOWfl HEfl EON. TO AOpI iIONAL INS iI TU TIONC Ofl SUp 5E0UENi 1t THE WpTEq SUPPLY pN0 SEWAGE pI0p09gL lY]TEM FOCI THIS gE51OENCf OWNEq S. * ' WILL CONFOflM TO THE 9TANOAflDS OFTHE SUFFOLN COUNTY OEPAgTMENT •DISiANCE55HOWN HEgEON FROM PgOPEgiY LINES `~,~f y' OF HEALTH 9Efl VICE] ID E%ISiING SLfl UCTUq ES AflE FOR p SPECIFIC APPLICANT _ PUfl POSE ANO PqE NOL i0 pE USED i0 ESip BLISM / ~ o - PROPERTY LINES OR FOq THE EgECTION OF FENCES N e ' pD0q E95 F fD TEL' YOUNG a YOUNG RIDVERHEAD, NEW YORK E ¦ =MONUMENT FOUND SUBDIVISION MAP FILED IN THE OFFICE OF THE CLERK OF ALDEN W. YOUNG,PROFES610NAL ENGINEER SUFFOLK COUNTY ON JUNE I6, 1966 AS FILE N0. 4652, AND LANG SURVEYOR NY. S, LICENSE N012845 HOWARD W. YOUNG, LAND SURVEYOR µTNE LOCATIONWWEIL(W),]I:PiIC TANNhi)G CESSP0OL](Cp)9MOWN HEgEON N.YS LICENSE NOA5B93 nF mnu ~ I p nn rn•ipTlnn. nnln nP Dn~n nn+n Rl~n rnnn~ nT~~~^^ -...~W_____ _ ~ - ..._._.~._......u_.r.,_ ._..,~-~,..~.e.,._~.e....,....~_ ~ 3 3 _ t I ~ i ~ ~ ~ / ~ ~ II j ~ i , I i ~ I - n ~ ~ ~ ~ ~ ~~I ~ i ~ ~ I ! ~ J ~ ( ' 1 ~ ~ 1 i ~ ~ i ~ I _ ' I' _ ~ - - I i - _ ~ - ~ ~I~ ii~~ ~ fi ~ ~ j~ ~ ~-~n coc ~ ~ I 1-I .I ~ ' ~ i [ b ~ - .I J L~ ' I. ~ ( '~a i ~ ~ r 1 --1- F r z i s G 1 II ~ ~ r' I F I ~Cl COQ i i -t ' r -~_~~'1 E' 1 I t a i ~ 1s_ ~ i, : _ I ; ~ ~ ~ ~ ~ ~~O ~ ~a I I, Iii -l t- ~1~1--t_=i L ~ y~ J ` i ~L. , Iii T~~y-~~~ / I ~ ~ 1~~~.. ~~T~ ' 1 I`l i I I{ ~J? ~i I ~ ~ _ 1 ~ _ i 11 - r -r i ~.~.==T»{ ~ul_~,i 1-;~., [ ~ ~ ~ moo' - _ i r~ - - _ ' _ I r~ E I p _ f. i.:' - ' r+ _ ZF 1 _ 611 'I ga oR I U ' ~ ~ ~._....r...~_. - i I - i - ~ ; I _ ~ i : / III-- f r i' R ~ s i ' i I ' I~ ~ I ~,r I I ~ I ,~i I ,I, i; I I I I~' I I ~ k f'/ ~ ~ r , ~ ' ~ I I I ~ i I 1 I I~ ' I f i i, I 1 ,t i 11 fj j ~ ,1 I ~ i ~ ti jf r-ii fjs s"~', ~ i z, ~ ! f I.. 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