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34470-Z
FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEP~RTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No: Z-34057 Date: 11/06/09 THIS CERTIFIES that the building ADDITIONS/ALTEP-ATIONS Location of Property: 200 WILLOW PT RD SOUTHOLD (ROUSE NO.) (STREET) County Tax Map No. 473889 Section 56 Block 5 Lot 32 Filed Map No. __ Lot No. __ Subdivision (HAMLET) conforms substantially to the Application for Building Permit heretofore filed in this office dated MARCH 3, 2009 pursuant to which Building Permit No. 34470-Z dated MARCH 3, 2009 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 ALTEP~ATIONS AND ADDITIONS, INCLUDING PORCH AND SECOND FLOOR BALCONY, TO AN EXISTING ONE FAMILY DWELLING AS APPLIED FOR. The certificate is issued to STEVE & MARICA DONADIC (OWNER) of the aforesaid building. SUFFOI=KCO~FI"fDEP~/~q~ENTOF}~ALTHA~FRO%rAL N/A ~t-rKICAL c~KTIFICATH NO. 4026663 04/16/09 PLI]~ERS C~KTIFICATION DA'i'sD N/A //t ho r/zed Si gna ture Rev. 1/81 Form No. 6 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL 765-1802 APPLICATION FOR CERTIFICATE OF OCCUPAN/ This applieation must be filled in by typewriter or ink and submitted to the Building Depa -A. For new building or new use: TOWN OF SOU[HOLD 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 o f electrical installation from Board of Fire Underwriters. 4. Sw0m statement from plumber certi.fyin~ that the solder used in system contains less than 2/10 of 1% lead. 5. Commercial building, industrial building, multiple residences and similar buildings and installations, a certificate of Code Compliance.from arckiteet or engineer responsible for the building. 6. Submit PIarming Board Approval of Oompleted site plan requirements. 'B. For eaisfing 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 consent to inspect signed bythe applicant. If a Certificate of Oecupancy is deuied, the Building Inspector shall state the reasons therefor in writing to the applicant. -C. ]Fees 1. Certificate of Occapancy - New dwelling $25.00, Additions to dwelling $25.00, Alterations to dwelhng $25.00, Swimming pool $25.00, Accessory building $25.00, Additions to accessory building $25.00, Businesses $50.00. 2. Certificate o£Occupancy on Pre-existing Building - $100.00 3. Copy of Certificate ofOecupaney - $.25 4. Updated Certificate of Occupancy - $50.00 5. Temporary Certificate of Occupancy - Residential $15.0G, Commercial $15.00 Date. ~' : ~ New Construction: 'Location of Property: House No. Street Owner Or Owners of Property: %'~ [f~' Suffolk CountyTax Map No 1000, Section .t~--~ Block Subdivision 'Filed Map. Permit No. 'Yd d~7t9 Date of Permit. Applicant: Health Dept. Approval: Underwriters Approval: Old or Pre-existing Building: (check one) Hamlet Lot Lot: Planning Board Approval: .Request for: Temporary Certificate Fee Submitted: $ Final Certificate: (check one) Applicant Signature BY THIS CERTIFICATE OF COMPLIANCE THE NEW YORK BOARD OF FIRE UNDERWRITERS BUREAU OF ELECTRICITY 40 FULTON STREET ~ NEW YORK, NY 10038 ~'(~, - % _ ~ ~. r~ CERTIFIES THAT Upon the application of upon premises owned by STEVE DONADIC STEVE DONADIC 180 BAYVIEW RD 180 BAYVIEW RD MANHASSETT NY 11030 MANHASSE'I-r, NY 11031 Located at 200 WILLOW POINT RD SOUTHOLD, NY 11971 Application Number: Certificate Number: 4026663 4026663 Section: Block: Lot: Building Permit: · BDC: ns11 Described as a Residential occupancy, wherein the premises electrical system consisting of electrical devices and wiring, described below, located in/on the premises at: First Floor, Second Floor, Attached Garage, Outside, A visual inspection of the premises electrical system, limited to electrical wiring devices and to the extent detailed herein, was conducted in accordance with the requirements of the applicable code and/or standard promulgated by the State of New York, Department of State Code Enforcement and Administration, or other authority having jurisdiction, and found to be in compliance therewith on the 16th Day of April, 2009. Name QTY Rate Rating Circuits Miscellaneous short addition to front of house Wiring And Devices Fixture 11 0 Low Voltage Fixture 12 0 Incandescent Outlet 17 0 Gan, Purpose Outlet 23 0 Fixture Receptacle 11 0 Gan, Purpose Switch 9 0 Gan, Purpose seal This certificate may not be altered in any way and is validated only by the presence of a raised seal at the location indicated. FORM NO. 3 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) PERMIT NO. 34470 Z Date MARCH 3, 2009 Permission is hereby granted to: STEVE & WF DONADIC 180 BAYMIEW RD MANHASSET,NY 11030 for : ADDITIONS & ALTERATIONS TO AN EXISTING SINGLE FAMILY DWELLING AS APPLIED FOR. REPLACES EXPIRED BP # 31675 at premises located at 200 WILLOW PT RD SOUTHOLD County Tax Map No. 473889 Section 056 Block 0005 Lot No. 032 pursuant to application dated MARCH 3, 2009 and approved by the Building Inspector to expire on SEPTEMBER 3, 2010. Fee $ 173.40 Authorized Signature ORIGINAL Rev. 5/8/02 FORM NO. 3 TOWN OF SOUTHOLD BUILDING DEPARTMENT Town Hall Southold, N.Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES COMPLETION OF THE WORK AUTHORIZED) UNTIL FULL PERMIT NO. 31675 Z Date DECEMBER 15, 2005 Permission is hereby granted to: STEVE & WF DONADIC 180 BAYVIEW RD MANHASSET,NY 11030 for : ADDITIONS AND ALTERATIONS TO AN EXISTING SINGLE FAMILY DWELLING AS APPLIED FOR at premises located at County Tax Map No. 473889 Section 056 pursuant to application dated DECEMBER Building Inspector to expire on JUNE Fee $ 173.40 200 WILLOW PT RD SOUTHOLD Block 0005 Lot No. 032 14, 2005 and approved by the 15, 2007. ~orize~/ S ~gnature .~ Rev. 5/8/02 ORIGINAL TOWN OF SOUTHOLD BUILDING DEPT. 765-1802 INSPECTION ] FOUNDATION 1ST [ ] FOUNDATION 2ND FRAMING / STRAPPING [ ] FIREPLACE & CHIMNEY i ROUGH PLBG. NSULATION [/~INAL ] FIRE SAFETY INSPECTION [ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRATION REMARKS: /1~ ~ ~ ~ ~ - ~- D c/ INSPECTOR ~ ~ TOWN OF SOUTHOLD BUILDING DEPT. 765-1802 INSPECTION [ F~~OUNDATION 1ST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] INSULATION [ ] FRAMING/STRAPPING [ ] FINAL [ ] FIREPLACE & CHIMNEY [ ] FIRE SAFETY INSPECTION REMARKS: ~ DATE I NSPECTOR~~ TOWN OF SOUTHOLD BUILDING DEPT. 765-1802 INSPECTION [ ]FOUNDATION 1ST [ ]FOUNDATION 2ND [ ]FRAMING / STRAPPING [ ] ROUGH PLBG. [ ] IN~TION [ k']' FINAL [ ] FIREPLACE & CHIMNEY [ ] FIRE SAFETY INSPECTION [ ] FIRE RESIn_ANT CONSTRUCTION [ ] FIRE RESISTANT PENETRATION REMARK .S.S.~~r6,~_ h-~ ~','l~s_~'- DATE TOWN OF SOUTHOLD BUILDING DEPT. 765-1802 INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND ] FRAMING / STRAPPING [ ] IN~Ut~ATION [ ~'~NAL [ ] FIREPLACE & CHIMNEY [ ] FIRE SAFETY INSPECTION REMARKS: ] RRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRATION DATE INSPECTOR~ 'FIELD INSPECTION REPORT ] DATE I COMMENTS FOUNDATION (1ST) FOUNDATION (2ND) ROUG~ F~G & PL~B~G ~$ULATION PER N.Y. ~ STATE ENERGY CODE ~ ~DITION~ CO~ENTS TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, NY 11971 TEL: (63I)~765-1802 ' BUILDiNG PERMIT APPLICATION CHECKLIST Do you have or need the following, before applying? Board of Health 4 sets of Building Plans Planning Board approval FAX: (631) 765-9502 www. northfork.net/STthold/ PERMIT NO. Examined /"Z//,,,Z 20 Approved / ~//9 , 20 -~ Disapproved aJc Survey. Check Septic Form N.Y.S.D.E.C. Trustees , ' Contact: .. Mail to: Expiration i ¢- APPLICATION FOR BU!LDIN.G PERMIT Date ,20 D ~' INSTRUCTIONS a. This application ~IJST be. qoCpletely filled in by i~pew~ter or in ink and sub~i~ted ti> the Building Inspector with 4 sets of pl~s, accurate plot plan to scale. Fee according to schedule. b. Plot plan showing locatio~ o~ tot a~d 9f ~ildings on premises, relationship,to adjoiniCg?remises or public streets or areas, and watenvays. c. The work covered by this applicafipp may not be commenced before issu~ce of Building Pemit. d. Upon approval of this application, the Building ~s~ector will issue a Building Pemit to the applicant. Such a pe~it shall be kept on the premises available for inspection throughout the work. ' e. No building shall be occupied or used in whole or in pa~ for any pu¢ose what so ever until the Building ~spector issues a Ce~ificate of Occupancy. f. Eve~ building pemfit shall expire if the work authorized has not commen~ed within 12 months a~er the date of issuance or has not b~en completed within 18 months from such date. If no zoning amen~ents or other re~lations afI~cting the .~prope~hav~ been enacted in ~e interim, thff Building ~ector may ~uthvfize, ~n writing, the extension of the pe~it for an additioa.s¢ months~ Thereafter, a new p~tash~ll Be mquked. .-~PLiU&T!OM IS HE,BY M~E t~ ~the Building Depa~ment for the issuance of a Building Pe~t pursuit to the Building Zone Ordin~ce of the Town of Southold, Suffolk County, New York, and other applicable Laws, Ordin~ces or Regulations, for the construction of buildings, additions, or alterations or for removal or demolition as herein described. The (Signature of app~nt or name, ifa co~oration) (Mailing address of applic~t) -- State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder Nmeofownerofpremises 200 ~'//~ P*'~-- gd -- &"r~ ~ ~ (As on the tax roll or latest deed) If applicant is a co~oration, signature of duly authorized officer (Name and title of corporate officer) Plumbers License No. ~ttq~ . Electricians LicenseNo. ~' ,~". Other Trade's License No. 1. Location of land on which nroDosed work will be don,e: House Number Street County Tax Map No. 1000 Section Subdivision Hamlet 5(42 Block ~ Filed Map No. (Name) 'Lot Lot 3. Nature of work (check which applicable): New Building Repair Removal Demolition 4. Estimated Cost ~ ~ ! ~O ~o 5. If dwelling, number of dwelling units O &/~'" If garage, number of cars ._7%o0 State existing use and occupancy of premises~nd intended use and occupancy of proposed construction: a. Existing use and occupancy! %~tt/.-~ (~C~ff~c,~/ , b. Intended use and occupancy ~,N~¢.~ ~["pe~l,i/~ .. tL'to~ ~¢¢~.,.1~ ~ Addition ~ Alteration Other Work (Description) Fee (To be paid on filing this application) Number of dwelling units on each floor If business, commercial or mixed occupancy, specify nature and extent of each type of use. ~ $~! ;~e ?~ 7"t'A (.., Dimensions of existing structures, if any: Front ~"4 2 ~) ~ Rear Height. Number of Stories Dimensions o_f ~ame. structure with alteratio.ns or additions: Front Depth. ~'~/-5 ~ Height. .Depth 8. Dimensions of entire hew 6onstruction: Front Height 10. Date of Purchase Number of Stories Rear ~ tc,,vl ~' _Depth Number of Stories 9. Size of lot: Front ~[?" Rear [O~ - ~ _Depth ff'qJYt~e''ate' [q~Name of Former Owner ~. ~ 11. Zone or use district in which premises are situated 12. Does proposed construction violate any zoning law, ordinance or regulation? YES 13. Will lot be re-graded? YES 14. Names of Owner of premises Name of Architect Name of Contractor NO /Will excess fill be removed froln premises? YES '~lP~',~)l:~)~ddress ~o ~ ~ Address ~ ~ Address ~.~, ~O~O No Phone No. ~'/(~ tt.~'-/f~t6 PhoneNo ?t'g ~.l-~8g$ Phone N.o. 6~1 '/& ~'- ¢'1 ~ 15 a. Is this property within 100 feet of a tidal wetland or a freshwater wetland? *YES NO M" * IF YES, SOUTHOLD TOWN TRUSTEES & D.E.C. PERMITS MAY BE REQUIRED. b. Is this'property within 300 feet of a tidal wetland? * YES NO__ * IF YES, D.E.C. PERMITS MAY BE REQUIRED. 16. Provide survey, to scale, with accurate foundation plan and distances to property lines. 17. If elevation at any point on property is at 10 feet or below, must provide topographical data on survey. STATE OF NEW YORK) ~-~I~ ,4S: COUNTY OF ,):. ~:~'T~' ~.~ ~ ~'I ~ i~ ~ . . being duly' Sworn, dep0kes and says that ts)he is the applicant (Name of individual signing contract) above named, tS)He is the (Contractor, Agent, Corporate Officer, etc.) of said owner o¢ owners, ~d is duly authorized to perform Qr hav.¢ p6rformed the said work and to make and file this application that all statements contained m th~s apphcanon are tree to the best oflns 'knowledge and behef; and that the work will be performed in the manner set forth in the application filed therewith.' Sworn to.be~bre me t~ ~%] 3'q'Y' day oM ~ 206tO Notary Public Signature of Applicant BARBARA ANN RUDDER Notary public, State of New York Qualified i~ Su{io%k Oou~ty~ Oommisaion Ex;Ilea April 14,~ Z :d ........... · ~ ...................... Address ...... ,: of Contractor .................... ' ....... dd[ess zs this propert~ within 300 feet of a tidal wetland~ ~-~'~ ...... ' .... '~c~--- ~ .................. ,~._~.~.?~ ...... No ........ Locate cle=ly and dis~cflA ~ bu"d~, .he.er exi~t~g or proposed, ~d, indicate Ml~set-back d~.emions fro propc~y ~cs. Give s~cct ~d'bl~ck number o~ desc~pfion ~ccord~g to deed, ~d show street n~cs ~d ~d~catc whe~ ~.tefior or comer lot. FOR: ENEIIGY CODE CALCULATIONS IFor Non-Electric lleat) Design Criteria 6,000 Degree'.Days O.A. IO"F i.A. -- - DESIGN TtlEIIMEL REMARKS . SUBSYSTEM AREA "U" RATING [.1×teriu,: walls (Opaque) Glazing ZI % ceilim]/1~oo~ (Opaque) Skylights . ..~ Floor ~t ~ , Of O ~ounda tion Wails slab Insul~tion · I ? .... Notes.: Building Euvelope Systems to meet requirements of 7815.2 IIVAC Equipement to lU~et requirements of, 7815.11 IlVAC Systems to meet regufrements of 7B1~.1'2 Duct Systems to meet reguiremei~ts of 7815,13 Ventilations Systsms to mee~ requirements of 7B15.14 Insulation of Piping Systems to meet requzre~e~ ts of 7815 15 Service Water Ilsating Systems & Equipment to meet requzreuent of 7015 21 of 7U].5.31 ]~lectr~.cal & Lighking Systems & Equ~p~ent to meet requirements To ~he best of my knowledge, ~,/.. ''" ' TOWN /d t,~ - ~'- ~ -,.ff" ,~.L OWNER FORMER N OF SOUTHOLD PROPERTY RECORD CARD VI LLAGE E S W RES. ~,~/D LAND IMP. FARM Tilloble Woodland FRONTAGE ON ROAD Meaclowl~3nd DEPTH SEAS. VL TOTAL ~00 ooo Acre Value Per Ac re FARM DATE CO,MM. CB. MICS. REMARKS Mkt. Value Value I/~/4~-~ff* zi 2~ -Co, 3/?/~,~. ~ t ?~ ? -~ ~ FRONTAGE ON WATER DIST. SUB. LOT ~ ~ ACR. Extension TRIM Porch 13 r ee~e~hgy.~-- Walls Place / Heat Dinette LR. DR. Total 2.(17_ RoOf Room Rooms 1st Floor Rooms 2nd Floor Driveway BR. FIN. PO I .I{1 T · ROAD R= 25-00' L: 39.27" DAT. '' NOT,~Y' BUILDING DEPARTMENT AT 76~1802 8AM TO 4PM FOR THE FOLLOWING iNSPECTIONS: 1. FOUNDATION - TWO REQUIRED FOR POURED CONCRETE 2. ROUGH - FRAMING & PLUMBING 3. INSULATION 4. FINAL - CONSTRUCTION MUST BE COMPLETE FOR C.O. ALL CONSTRUCTION SHALL MEET THE REQUIREMENTS OF THE CODES OF NEW YORK STATE. NOT RESPONSIBLE FOR DESIGN OR CONSTRUCTION ERRORS. FLOOD ZONE ~/~. COMPLY WITH CHAP7~ER 46 FLOOD DAMAGE PREVENTION SOUTHOLD TOWN CODE. COMPLY WITH ALL CODES OF NEW ,. ~K STATE & TOWN CODES AS REQd,~ED At ~:.... ,Ti ~r4D , ,ONS OF // ~lit /v/ ,/] F~2, ~C'LDTS'F,,"~TRUSTEES /¥ N '~ $ L)EC OCCUPA,~:Cv CA USE IS U!!. ~',;iFUL WITHOUT CERTIFICATE OF OCC'JPANCY CERTIFICATION OF NAILING & CO!,,NECTIONS REQUIRED. RETAIN STORM WATER RUNOFF PURSUANT TO SECTION 45-I0C OF THE TOWN CODE. ALL CONSTRUCTION SHALL MEET 7~4E ,~ ~:~ '~ ~ UIREMENTS OF THE COD~S OF NEW YORK STATE. UNDERWRITERS CERTIFICATE REQUIRED CONNECTION USP PRODUCT NUMBE~ R~- [~P,/RIDGE/RAI,. I~R WITH CT* LSTA 21 RAP i I::R,/PJDGE/RAP I~R WITHOUT CT LSTA 21 + LSSH179 RAI- p-R/PLATE/STUD RT20 RAt- I ~-R/PLA'rE RTl 6 PLATE/STUD SPTH4 HEADER/STUD RT3 HEADER/JACK STUD LS'~A12 FLOOR TO FLOOR KLFTA STUD/PLATE/SILL MSTA36 or RS16-R STUD/PLATE MlW18 or L'rw18 PLATE/SILL MP6F ANCHOR BOLTS STB16 POSTANCHOR FOR DECKS PAU SERIES POSTANCHOR FOR COVERED PORCHES CBE SERIES * 1~ OR2X4 - 16" O/C COLLAR TIES MIN. ITUD RAFTER/RIDGE/RAFTER wn'. cr USP LSSH17~ ~~' 2ND. FLOOR WALL STUD l-ST. FLOOR WALL STUD - ~o,~,:,~u~ ~?^== ~,~:q:::~:]~j : '""'J~l~ IXl~ '""~!.':' :' ':'~: ::" HEADER/STUD '-lEADER/JACK ~"~ FLOOR TO FLOOR STUD/PLA;'E/S ILL RAFTER/PLATE/STUD )STUD/PLATE. PLATE USP RTl8 TOP PLATE USP 81~H4 WALL b~,JD ~R/PLATE PLATE/STUD D EL~VATIO~ '3 © l '2.> I.L .I J FINISH SCHEDULE HARDWARE SCHEDULE 36'34 35~ ST., L J.G., N.Y. REVISIONS: DATE REF, DWG. '1 \ _) I I I FINISH SCHEDULE HARDWARE SCHEDULE CONI~AOTOR: :F::::o u ¼ ~ ~ T :'I' ,:'I /il ¸ FINISH SCHEDULE A B C D E HARDWARE SCHEDULE 2 4 5 6 7 S. DONADIC WOODWORKING INC. 36-34 35 ST., L.I.C., N.Y. 11106 TEL. 718-361-9888 FAX 718-729-3101 REVISIONS: ARCHITECT: CONTRACTOR: SCALE DATE ARCH. REF. DWG.