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HomeMy WebLinkAbout23025-z FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No Z-24038 Date NOVEMBER 20, 1995 THIS CERTIFIES that the building ADDITION Location of Property 840 ROSEWOOD DRIVE MATTITUCK, N.Y. House No. Street Hamlet County Tax Map No. 1000 Section 113 Block 2 Lot 20 Subdivision Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated SEPT. 13, 1995 pursuant to which Building Permit No. 23025—Z dated SEPTEMBER 25, 1995 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 DECK ADDITION TO EXISTING ONE FAMILY DWELLING AS APPLIED FOR The certificate is issued to HAROLD J. & JOANNE PONZIO (owners) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A UNDERWRITERS CERTIFICATE NO. N/A PLUMBERS CERTIFICATION DATED N/A J' ild'ng Inspector 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) 7 9 . Date 9 19....<... ........................ .......................... NK° 23025 Z Permission is hereby granted to: I A��� � ... �A......4AaF............................................. . B.a.cc ,..�..... 1............................. to... :...........A........ 5,1 J rU. 1. <.4 W......... 0............. ................... .14). ..L ..........1= /./ s ....... .. ................. ...... . ........................................................................................................................................... .................................................................................................................................................................. ... ................. ............................................. a . y / ..................................... at premises located at.............. .w....... . .5.��/,1��........( .r��� ...................... .........................................� c..............I..................I........... ............ County Tax Map No. 1000 Section .....!4f......... Block....C,2...........: .Lot No. ...` ®.............. pursuant to application dated ............. ........., 19... J. —... ., and approved by the Building Inspector. Fee$.... �?...`.. ...... .. .... ............................... uilding Inspector Rev. 6/30/80 Form No. 6 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL 765-1802 APPLICATION FOR.CERTIFICATE OF OCCUPANCY A. 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-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. t B. 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. 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 $50.00. 2. Certificate of Occupancy on Pre-existing Buildins - $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 . l7.�. . /.�./. �.�1.�- . . . . . . . . . . . . . . . . . . . . New Construction. . . . . . . . . . . Old Or Pre-existing Building. . . . . . . . . . . . . . . . . Location of Property. . . 9��. . . . . . . . . . . . . . . . .��s4/a/a�� . �Rl� . . . . . . . . . . . .mel v?�tl.vr(�. . . . . . House No. Street Hamlet Onwer or Owners of Property. . . . . . . . .rr . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . County Tax Map No 1000, Section. . c.t'�5. . . . . . .Block. . . . . . . . . . . . . .Lot. . !x.'�J. . . . . . . . . . . . . . . . Subdivision. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ... . . . .Filed Map. . . . . . . . . . . .Lot. . . . . . . . . . . . . . . . . . . . . . Permit No<.3V q, . .,Z. . .Date Of Permit. . .J.�a-5:19,;5:� . •Applicant. :B °: :•QN��d• Health Dept. Approval. . . . . . . . . . . . . . . . . . . . . . . . . .Underwriters Approval. . . . . . . . . . . . . . . . . . . . . . . . . Planning Board Approval. . . . . . . . . . . . . . . . . . . . . . . . Request for: Temporary Certificate. . . . . . . . . . . Final Certicate. . . . . . . . . . . Fee Submitted: $. . . . .�. �. . . • . . . . . . . . • • • • • Ric . AX:' ICANT M-ieoz BUILDING DEFT. INSPECTION [ ] FOUNDATION iST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] INSULATION [ ] FRAMING [ [ ] FIREPLACE 8 CHIMNEY REMARKS: �c�i�rJ7 C452 DATE INSPECTOR IIit.D INSI'fiC'fIUN Rl;l'UR'f _ DATE ------------------- ----GUMPIL-N'1S �+ :O i I N D A:f t O N -- ( I S l ) -- II lII ------- II cC ly QUNDATION UND) II hi t==-==------_____________ I �I ------IIII-- -------- ------- -- ------------.. o { ---------------------------- --- I NO O NSULAT..ION PER N. Y. STATE: rtlrRGY --- II ----- — ---- CODE I` II PINAI, �I -- -�I - --- - - _ ©� --------------- -------- -------- -------- /1DUITIONAi.. COMMENTS: O a in i OCCUPANCY OR SE IS UNLAWFUL ITHOUT CERTIFICATE, lUo- ,^fsol , iA A ,x ,. ks -TM isa Of C i rT L I - 4 ---- BOARD ' OF HEALTH . . . . . . . . . FORM NO. 1 ,- 3 SETS OF PLANS . . . . . ... . . TOWN OFSOUTHOLD — SURVEY . . . . . . . . . . . . ... . . . . BUILDING DEPARTMENT " CHECK . . . . . . _ . _ . . . . . . . . TOWN HALL SEPTIC FORM _ _ . . . . . . . . . . . SOUTHOLD, N.Y. 11971 _ TEL.. 765 1802 t•OT I FY 6l . . . . L�/� n CALL . v� . . . . . . . . . . Examined . . . . . . . ., 19 75 MA I L TO . Approved . . . . . . . /oZ.J�. ., 19/)Permit No. ©oZ . - . . . . . . . . . . . . . . . . . . . . . . . . _ . . . . . . . . . . . Disapproved a/c . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . B ding Inspector) APPLICATION FOR BUILDING PERMIT Date ,. �. 3 : . . . . . . . . . ., 19��7 INSTRUCTIONS 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 street or areas, and giving a detailed description of layout of property must be drawn on the diagram which is part of this appli• cation. 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 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 whatever until a Certificate of Occupancy 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 the ]wilding Zone Ordinance of the Town of S'oiithold,Suffolk°County, New York, and other applicable Laws, Ordinances of Regulations, for the construction of bhh1d116, additions'or-altex;atioris, or for removal or demolition, as herein described. The applicant agrees to comply with ail•.applicable laws, ordinances;_,building code, housing code, and regulations, and to admit authorized inspectors on premises and-in li_uildhng.for.necessary hrispe tions. (Sigzu�re'!Tapplicant, or ame, if a corporation) 93 Mailing address of applicant) State whether applicant is owner, lessee, agent, architect, engineer; general contractor, electrician, plumber or builder. Name of owner of premises . . . . (as on the tax roll or latest deed) If applicant is a corporation, signature of duly authorized officer.* . . . . . . . . . . . . . . . . . . . . . . . (Name and title of corporate officer) � $ Builder's License No. Sip 3199`� ! pG,DE4�i. Plumber's License No. . . . . . . . . . . . . . . . . . . . ... . . . BL F .0 " Electrician's License No. . . . . . . Other Trade's License No. ... . . . . . . . . . . . . . . . . . . . l. Location of land on which proposed work will be done. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .� 05,,£ ©�1 .'. . . . . . . . . . . . . . . . . . House Number Street Hamlet D County Tax Map No. 1000 Section . . '. �.1.�. . . . . . . . Block . . . . . . . . . . . . . . . . . . Lot . . . . . . . . . . . . . . . . . . . Subdivision . ./`S�dSFGIJ000/ 'S��/g"�. ...,File.d 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 . . . . . . . . . . . . . . . . b. Intended use and-,occupancy . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . : . . . . . . . . . . . . . . . . . . . . . . . . . . . . . -3. Nature of work (check which applicable). New Building . : . . . . . . . : Addition Alteration Repair . . .. . . . . . . . . . . Removal . . . . . . . . . . . . . . Demolition . . . . . , , , • , , , Other Work . . . 4. Estimated Cost (Description). . . . . Fee . . . . . . . . . . . . . . . . . . . . . . . . . . : . (to be paid on filing this application) 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 occupancy, specify nature and extent of-each type of use 7. Dimensions of existing structures, if any: Front . ., Rear. z��• , �, Depth . .�,� Height . . . .'X . , . . . . Number of Stories . . . , . .2 , J' ' ' ' ' ' ' ' Dimensions of same structure with alterations or additions: Front Depth . . . .. . . . . . . . . . . . . . . . . . . Rear . . . . . . . . . . . . . . . . Height . . . . . . . , , Number of Stories . . . . . . . . . . . . 8. Dimensions of entire new construction: Front . . , Rear Depth Height . . . . . . . . . . . . . . . Number of Stories . . . . . . . . . . . . . . . 9. Size of lot: Front . . . . . . . . • . . . . . . . . .... . Rear. . . . . me . . . . . . . . . . Depth. . . . . . . . . . . . . . . . . . . . . . . 10. Date of Purchase 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: 13. Will lot be regraded" . . . . . . . . . . . . . . . . . . . . . . . Will excess fill be removed from remises: Y 14. Name of Owner of premises . . . . . . . . . . . . . Address p es i�. . . . . Phone No. Name of Architect . . . . . . . . . . . . . . . . . . . . . . . . . . . Address . Phone No. Name of Contractor . Address . Phone No. 15. " Is this property within 300 feet of a tidal wetland? *Yes„ No. *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 dimensions from property lines. Give street and block number,or description according to deed, and show street names and indicate whether interior or corner lot. APPROVED AS (NOTED DATE: B.P.# -�d!5vj s FEE: ' h' BY: NOTIFY BUILDING DEPART ENT AT 765-1802 9 AM TO 4 PM FOR THE FOLLOWING INSPECTIONS: 1: FOUNDATION - TWO REQUIRED FOR POURED CONCRETE 2. ROUGH - FRAMING 8i PLUMBING. 3. INSULATION `4. FINAL - CONSTRUCTION MUST BE COMPLETE FOR.C.O. ALL CONSTRUCTION SHALL MEET THE REQUIREMENTS OF, THE N.Y. - STATE CONSTRUCTION &.;ENERGY. CODES. NOT RESPONSIBLE FOR DESIGN OR CONSTRUCTION :ERRORS., A iTATE OF-NE �jR r.;'�.RY-�-.:'s ' :OU Y OF ` ti7 •e `� I =:,S:S" . . . . . . . being duly sworn, deposes and says that he is the a 1' CName of individual signing contract) pp scant bove named. 'e is the . ... . . . . . . . . . . . . . . . . . . . . . .. Contracto�, ag nt, corporate officer, etc.) f said owner or owners, and is duly autho ' orm or have performed the said work and to make and file this pplication; that all statements contained in this-application are true'to the best of his knowledge and belief;and that the •ork will be performed in the manner set forth in the application filed therewith. worn to before me thi� / \ . . day of. . . . . . .". . ., 19 . U 'otary Pub ' . . . . County CLAIRE L. G Notary Public,Statea of of New York ' ' • • • • • • • • . . . . . . . . . No.4879505 ( applicant) ture of a Qualified in Suffolk County pp ) Commission Expires December 8,19 IIIGH NITRATES: later not to be used for preparation o:(' baby formula or- consiv,ption by in.f'srlLs _under 6 months of age. 7 -�� o''E' pZIESKI S.Z30 to �13 . 5 LE 2 0,2 N/ 0 ��� g6.1 N G J A �Soto, � O NECK LANE a t;>" d h ` 4 + ^ r• p ra h STRy' N O 8 W 1 •M � �v ��� t02 0 O 0 � z o • =M � o M u 0 011 '. Z V. 220 26`5 �R`v� E'g 000 o� w� Unauthorized alteration or addition to this survey is a vfolafion of SEF 13 Ig section 7209 of ilia 1-1ry York Slcto Eduzctien low. a 95 Copies of this suracy seal or embossed s:al 1 f L L t.f< BLDG. DEFT, Gucr.:n.,s or rc:li,i:• `.: .'.t .! 1 60 t r TOWN OF SOU7fi p<:rr�n cr wltxn tho Ol_f1 n tiiln ccm� .t,/, :rrra r.trenl l cy cu'.<i lr.�':u inn inok , ;c} hereon,and In rtbu cssi„nc: c•f the le;idini'immulion. (;-w. .;;es or certifications are not transferable to additional institutions or subsequent owners. SURVEY FOR REFERENCE , ALFRED DAUDERT 8 JAYE J. DAUDERT MiO ROSEWOOD ESTATES FILED JAN.24,1969 FILE NO. 5240 AT MATTITUCK Of NEfv TOWN OF SOUTHOLo GUARANTEED TO, SUFFOLK COUNTY N. Y. 5 oa�nT A. �� SECURITY TITLE&GUARANTY CO. SOUTHOLD SAVINGS BANK SCALE : I 30 n ' �� R A LFRED 9 JAYE J.DAUDERT = f `l .r`''! JUNE 16, 1 977 JUNE27, 1977 AUG . 30 1977- c� lS 2f372h `'�r � LAND SURVEYOR, ,N 0 V. 3 Of 1977 tis�o LAND S�`,` RIVERHEAp20725 QNV-7N OFFOUNWw' tT 141 1-4 in u Numm"Oft PPPRR,O�,ED AS NOTED PLUMBER CERTIFICATION DATE: 8 q OCCUPANCY OR ON LEAD CONTENT BEFORE PLUMBING CERTIFICATE OF OCCUPANCY NOTIFY BUILDING DE USE t� ��0 .���� ALL PLUMBING WASTE 765-1802 9 AM TO 4 FOR THE e4 Y A✓A A WATEfl LINES NEED SOLDER USED IN WATER FOLLOWING INSPECTIONS: t, � �QUT _ TESTIN(Zi BEFOflE COVERING I. FOUNDATION - TWO REQUIRED �`6 ` r� CERTIFICATE SUPPLY SYSTEM CANNOT FOR POURED CONCRETE EXCEED 2190 Of 1% LEe-?D. 2. ROUGH - FRAMING R PLUMBINGflf%p �f 3. INSULATION '� i,d".1 YfUEG1 4. FINAL - CONSTRUCTION MUSTBE COMPLETE FOR C.O. ALL CONSTRUCTION SHALL MEET THE REQUIREMENTS OF THE N.Y. If copper tubing Is used STATE CONSTRUCTION )f ENERGY for water distributing CODES. NOT RESPONSIBLE FOR _ eyetoln; piping shell be DESIGN OR CONSTRUCTION ERRORS - of types K or L onl fi ,51 /J WALL BRACE I ' 3 000 Ft 9 I -7 r I soli - — �-- ; '�_, �.'- —. _,� i.. -- — ��, ._E �._ _ -a- -� -.i— — — � •� 4Plra ;COL ON N or Yi N c Ll nl r-r r A 0\ 7 E lG 1 � Wx 6 rp1 a � is i N z-ace, zK • '� -�--` � Dca�- ea�E�"/z„ to I 1 TEMP, .$`(E-Y% -- 304 0 ?E3o 3D (o .. _ G•o "SL. 3g30 _ 2- 2 X 1 LI p zi rn q DE OPENINGS FOR dp . ERGENCYESCAPEAS R ULl IRED BY PARE 714 O N. STATE BUILDING CO 1) t° w X /4 yo q I hx a . � CI. - eAF:AG PROVIDE 1L 01. FINE N< 1 I LIQ RATED SEPARATION 11 l C PAIL 7173 m(I)OF 8L D R U G �` o• Lk STATE BUILDING COBE. PFFa-To. M EMERGENCY ESCAPE AS p j I REQUIRED BY PAR[7140E �j b,V.'4 - 3"ZXIU N.Y.STATE BUILDING CODE. � X to I o ' , o J w/kni� it z-zkiz � _� 1'8'FtlOvIF bRnpe^ sTTpCs) . � `v IN LFhlp -PLAKI S5�f-1 T W n?y Zia 2T�I2 , AFiT1(3 y }'�t$ T39H"'c 2UJi � - r ' •"� �� � fir. J {- If Ut Gf IS OVER IE•hbeYG GRPG� I ' , I ,v I �n• 1 IAu1r --_.T �� —_._,., n ,n•ip r; —_._— it ' il.0 _ _ � r �R � •,; ' .ins r�: _-- .—�_.___— __ .�.._ .. 2 c 3 r ---------- —_ - Ci r I I i • r7 ,,i • , I I 2 H I I' Ci is , I i 2 r % t