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HomeMy WebLinkAbout29052-ZFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No: Z-29170 Date: 01/07/03 THIS CERTIFIES that the building ADDITION Location of Property: 570 DONNA DR MATTITUCK (HOUSE NO.} (STREET) ~HAMLET) County Tax Map NO. 473889 Section 115 Block 15 Lot 21 slibdivision Filed Map No. -- Lot No. -- conforms substantially to the Application for Building Permit heretofore filed in this office dated DECEMBER 26, 2002 pursuant to which Building Permit No. 29052-Z dated DECEMBER 31, 2002 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 ROOF OVER PATIO ADDITION TO EXISTING SINGLE FAMILY DWELLING AS APPLIED FOR "AS BUILT" The certificate is issued to ANGELO & MARIE MILAZZO (OW~;ER) of the aforesaid building. SIIFFOLK COUNT"f DEPARTMENT OF ~EALTH APPROVAL ELEL'~RICAL CERTIFICATE NO. PLUMBERS CERTIFICATION DA'i'~U N/A N/A N/A Rev. 1/81 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. 29052 Z Date DECEMBER 31, 2002 Permission is hereby granted to: ANGELO & WF MILAZZO 570 DONNA DR MATTITUCK,NY 11952 for : "AS BUILT" ROOF OVER PATIO AS APPLIED FOR at premises located at County Tax Map No. 473889 Section 115 pursuant to application dated DECEMBER Building Inspector to expire on JUNE Fee $ 300.00 570 DONNA DR MATTITUCK Block 0015 Lot No. 021 26, 2002 and approved by the 31, 2004. Rev. ORIGINAL Form No. 6 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL 765-1802 APPLICATION FOR CERTIFICATE OF OCCUPANCY This application must be filled in by typewriter or ink and submitted to the Building Department 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 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 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. Bo 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 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. Co 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 ofOccupancy on Pre-existing Building - $100.00 3. Copy of Certificate of Occupancy - $.25 4. Updated Certificate of Occupancy- $50.00 5. Temporary Certificate of Occupancy - Residential $15.00, Commercial $15.00 New Construction: ('. Old or l~e-existing Building: /~/rx (check one) LocationofProperty: ~'TC_) ~,~l~i~G ,~'x)[-., C~c~('~ ~r-~c~,~ House N~. - _ - f~Street' ~'- ~ Owner°rOwners°fer°pertY: ~C~(°--~/(D ~/ i~(~C~}~--~ Suffolk Cou0ty Tax Map No 1000, Section~ ~'~' c~/ (r'~ ~-~ ~(.~ Blockx Lot Subdivision ~_ to ~ , _ Filed Map. Lot: Permit No. Date of Permit. Applicant: Underwriters Approval: Health Dept. Approval: Planning Board Approval: Request for: Temporary Certificate Fee Submitted: $ Hamlet Final Certificate: ,.~.~') (cheqk one) 765-1e02 BUILDING DEPT. INSPECTION FOUNDATION 1ST [] ROUGH PLBG. ;ORAU'N'D*A:'°''- DATE: INSPECTOR FOUNDATION (IST) ~S~ON P~ N. Y. STAi'E ~ CODE TOWN OF SOUTHOLD BUILDING D]~IiARTMENT TOWN HALL SOUTHOLD, NY 11971 TEL: (631) 765-1802 FAX: (631) 765-9502 www. northfork.nTSouthold/ Examined Approved Disapproved a/c Expiration ~{~7~ , 20/ BUILDING PERMIT APPLICATION CHECKLIST Do you have or need the folllywing, l~efore applying? Board of Health 3 sets of Building Plans Planning Board approval Survey_ Check Septic Form N.Y.S.D.E.C. Trustees Contact: Mail to: Building Inspector Phone: APPLICATION FOR BUILDING PERMIT Date~_~ INSTRUCTIONS ,2009, a. This application MUST be completely filled in by typewriter or in ink and submitted to the Building Inspector with 3 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 waterways. 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 issue a Building Permit to the applicant. Such a 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 any purpose what so ever until the Building Inspector issues a Certificate of Occupancy. f. Every building permit shall expire if the work authorized has not commenced within 12 months after the date of issuance or has not been completed within 18 months from such date. If no zoning amendments or other regulations affecting the property have been enacted in the interim, the Building Inspector may authorize, in writing, the extension of the permit for an addition six months. Thereafter, a new permit shall be required. APPLICATION IS HEREBY MADE to the Building Department for the issuance of a Building Permit pursuant to the Building Zone Ordinance of the Town of Southold, Suffolk County, New York, and other applicable Laws, Ordinances or Regulations, for the construction of buildings, 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 in building focary~n~(5~& O/ k~ "-- {3 ~ignatture. of applicant or name, if a corporation) v - (Mailing add~s of applicant) [ [ q 5~- State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder Name of owner ofpremises ~_ .C~..~/C3 W ~C',c°_ (~,/CX.~E--~-O "- (As on the tax r~ll or latest deed) If applicant is a corporation, signature of duly authorized officer (Name and title of corporate officer) Builders LicenseNo. Plumbers LicenseNo. Electricians License No. Other Trade's License No. 1. Location o,f~and on which prolaosed work will be done:.~x~ (-T'~ House Number Street "~ Hamlet Block I~- "Lot C.)~., t Filed Map No. lq~L~',~ Lot ¢,~ ~ 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy ~3x'-q (°"rvx.'~ ~ (~e_Ci~x.~ b. Intended use and occupancy ~.., C3xo~Cffz- ?C) f 3. Nature of work (check which applicable): New Building Addition-~'~ Repair Removal Demolition Other Work 4. Estimated Cost 5. If dwelling, number of dwelling units If garage, number of cars Alteration 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. Dimensions of existing structures, if any: Front Height Number of Stories Rear Dimensions of same structure with alterations or additions: Front Depth Height Number of Stories Depth 8. Dimensions of entire new construction: Front Rear Height Number of Stories Rear Depth 9. Size of lot: Front Rear 10. Date of Purchase Depth 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 __No z. 13. Will lot be re-graded? YES__ NO Will excess fill be removed from premises? YES NO 14. NamesofOwnerofpremiseslqa~,m. 0~,[c~v~c~ AddressS~C3~e:acx-.j¢~-~ehoneNo.~9.~q Nme of ~c~tect Ad&ess Phone No Nme of Con,actor Address Phone No. 15 a. Is this property within 100 feet of a tidal wetland or a freshwater wetland? *YES NO __ * 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) SS: COUNTY OF~D /~/' D ~mO~e !f~-nl vi]~dua(/O -2--2-- ~ being duly sworn, deposes and says that (s)he is the applicant · '(1~ ' i ' signing contract) above named, (S)He is the (~) (Contractor, Age~t, Corporate Officer, etc.) of said owner or owners, and is duly authorized to perform 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 performed in the manner set forth in the application filed therewith. Sworn to before me t~l~ '-~_ 652>day o fJ----x~'dt ~,/-.c F~ ~ 20 ~ ~ No~blic ELIZABETH A STATHI$ NOTARY PUBLIC, State of New ¥o~ No. 01ST6008173. Suffolk ?o~u(nty Term Expires June 8. 20 ~_.~_~ N 2°40'40" E 110.00' BASED ON ORIGINAL SURVEY BY: YOUNG & YOUNG ,~00 OSTRANDER AVE. RIVERHEAD, NY m "D O -/ .'~ / - '"00, ©."-,, ~ .::-"'"'~;---../. '.,  ,,, ,&'.. -Hm ---.. -... '... "';' :~ -- ' .... ' "'"~)-PATIO ,.~ ......... 26.4' ~o ~ ~~4~' , ~ 322'. ? 7.7 r g~ ~3.~' ~ ......?,....,-- 28.9' PORCH 8 2~40'40" W ~ ~ ~.00' DONNA DRIVE PAGE 30E3 NORTH ROAD MATrlTUCK NEW YORK 11952 631-298-8559 FAX 631-299-8561 JOS COVERED PORCH MILAZZO RESIDENCE 1"=20