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Home My WebLink About49969-Z °f$ft/jy°� Town of Southold * * P.O. Box 1179 o� 53095 Main Rd 00UrNMV Southold, New York 11971 CERTIFICATE OF OCCUPANCY No: 46560 Date: 10/09/2025 THIS CERTIFIES that the building HVAC Location of Property: 900 Donna Dr Mattituck, NY 11952 SecBlock/Lof: 115.4 5-18 Conforms substantially to the Application for Building Permit heretofore,filed in this office dated: 10/19/2023 Pursuant to which Building Permit No. 49969 and dated: 10/30/2023 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: "As built" HVAC system as applied for. The certificate is issued to: Anagnostakos P N Rev IV Trt ,Anagnostakos V V Rev IV Trt Of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL: ELECTRICAL CERTIFICATE: 49969 3/4/2024 PLUMBERS CERTIFICATION: Autiurized Signat e FF04 TOWN OF SOUTHOLD SUEFa�,� BUILDING DEPARTMENT ao Gyp x TOWN CLERK'S OFFICE o . SOUTHOLD, NY y� �s BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES WITH ONE SET OF APPROVED PLANS AND SPECIFICATIONS UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) Permit#: 49969 Date: 10/30/2023 Permission is hereby granted to: Anagnostakos P N,Rev IV.Trt 41-19 248th St Little Neck, NY 11363 To: legalize "as built" HVAC system as applied for. At premises located at: 900 Donna Dr, Mattituck SCTM # 473889 Sec/Block/Lot# 115.45-18 Pursuant to application dated 10/19/2023 and approved by the Building Inspector. To expire on 4130/2025. Fees: AS BUILT- SINGLE FAMILY ADDITION/ALTERATION $500.00 ELECTRIC $200.00 CERTIFICATE OF OCCUPANCY $100.00 Total: $800.00 Building Inspector OF so�ryol � o Town Hall Annex Telephone(631)765-1802 54375 Main Road P.O.Box 1179 sean.devlin(D-town.southold.ny.us Southold,NY 11971-0959 Q�yCOU�'�� BUILDING DEPARTMENT TOWN OF SOUTHOLD CERTIFICATE OF ELECTRICAL COMPLIANCE SITE LOCATION Issued To: Anagnostakos P N Iv Trt Address: 900 Donna Dr city:Mattituck st: NY zip: 11952 Building Permit#: 49969 Section: 115 Block: 15 Lot: 18 WAS EXAMINED AND FOUND TO BE IN COMPLIANCE WITH THE NATIONAL ELECTRIC CODE Contractor: Electrician: Homeowner License No: SITE DETAILS Office Use Only Residential X Indoor X Basement Service Commerical Outdoor X 1st Floor X Pool New Renovation 2nd Floor Hot Tub Addition Survey X Attic Garage INVENTORY Service 1 ph Heat Duplec Recpt Ceiling Fixtures Bath Exhaust Fan Service 3 ph Hot Water GFCI Recpt Wall Fixtures Smoke Detectors Main Panel A/C Condenser 2 Single Recpt Recessed Fixtures CO2 Detectors Sub Panel A/C Blower 5 Range Recpt Ceiling Fan Combo Smoke/CO Transfer Switch UC Lights Dryer Recpt Emergency Strobe Heat Detectors Disconnect 2 Switches 4'LED Exit Fixtures Sump Pump Other Equipment: Minisplit (2) Blower Head (5) Notes: " AS BUILT NO VISUAL DEFECTS " HVAC Inspector Signature: Date: March 4, 2024 S.Devlin-Cert Electrical Compliance Form #*rjf SO TOWN OF.SOUTHOLD BUILDIN DEP . cou 631-765-1802 . . . INSPECTION [ ] FOUNDATION 1ST/ REBAR [ ] ROUGH PLBG. [ .] FOUNDATION 2ND [ ] INSULATION/CAULKING [ ] FRAMING /STRAPPING [ ] FINAL [ ] FIREPLACE & CHIMNEY [ ] .FIRE SAFETY INSPECTION : [ ] FIRE:RESISTANT-CONSTRUCTION [ ] FIRE RESISTANT PENETRATION. [ ] ELECTRICAL (ROUGH) ELECTRICAL (FINAL) [ ] CODE VIOLATION [ ] PRE C/O [ ] RENTAL REMARKS: L l C��' /I✓l�`/�'t . ��— —0l, DATE Z�I INSPECTOR 1 �aQf SOGIyo TOWN OF SOUTHOLD BUILDING DEPT. IOU rm��' 631-765-1802 INSPECTION ' [ ] FOUNDATION 1ST/ REBAR [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] INSULATION/CAULKING [ ] FRAMING /STRAPPING [vi""FINAL /404& [ ] FIREPLACE & CHIMNEY [ ] FIRE SAFETY INSPECTION [ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRATION [ ] ELECTRICAL (ROUGH) [ ] ELECTRICAL (FINAL) [ ] CODE VIOLATION [ ] PRE C/O [ ] RENTAL REMARKS: ok- -�r� C,a % DATE INSPECTOR MELD INSPECTION REPORT DATET COMMENTS to FOUNDATION (1ST) ------------------------------------- � c) I,OUNDATION (2ND) 7. C> .......... ROUGH FRAMING& PLUMBING -------- 0() INSULATION PER N. Y. STATE ENERGY CODE 44 --44114 FINAL ADDITIONAL COMMENTS ;Z 12 Paid 0 po ---------- ------ -- --------- y Ad� TOWN OF SOUTHOLD—BUILDING DEPARTMENT y Town Hall Annex 54375 Main Road P. O. Box 1179 Southold,NY 11971-0959 �v Telephone (631) 765-1802 Fax(631) 765-9502 https://www.southoldtowmy.izov Date Received APPLICATION FOR BUILDING PERMIT -D For Office Use Only PERMIT NO. Building Inspector: \ OCT 1 9 2023 Applications and'forms must be filled out in their entirety.Incomplete applications will not be accepted. Where the Applicant is not the owner,an BUILDP,IG D177T° Owner's Authorization form(Page 2)shall be completed. '" 'b"W`"; C, q 'T =' Date:, `OWNER(S)OF PROPERTY: Name: SCTM# 1000- Project Address: Phone#: Email: Mailing Address:. yl_ CONTACT PERSON: Name: Mailing Address: Phone#: Email: DESIGN PROFESSIONAL INFORMATION:'. Name: Mailing Address: Phone#: Email: CONTRACTOR INFORMATION: Name: Mailing Address: Phone#: Email: DESCRIPTION OF PROPOSED CONSTRUCTION DA Structure ❑Add* i n ❑Alteration ❑Repair ❑Demolition Estimated Cost of Project: Other it S � pu,,,-. W ff 1 $ Will the lot be re-graded? ❑Yes El No Will excess fill be removed from premises? ❑Yes El No 1 } PROPERTY'INFORMATION Existing use of property: Intended use of property: Zone or use district in which premises is situated: Are there any covenants and restrictions with respect to this property? ❑Yes ENO IF YES, PROVIDE A COPY. ❑ Check Box After Reading: 'The owner/contractor/design professional is responsible for all drainage and storm water issues as provided by Chapter 236 of the'Town Code:.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,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(s)for necessary inspections.False statements made herein are punishable as a Class A misdemeanor pursuant to Section 210.45 of the New York,State Penal Law. Application Submitted By(print name): ❑Authorized Agent ❑Owner Signature of Applicant: Date: STATE OF NEW YORK) SS: COUNTY OF ) being duly sworn, deposes and says that(s)he is the applicant (Name of individual signing contract)above named, (S)he is the (Contractor,Agent, 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/her knowledge and belief; and that the work will be performed in the manner set forth in the application file therewith. Sworn before me this (� , q�day of C+ / ,, , 20 --" � Ll Notary Public PROPERTY OWNER AUTHORIZATION (Where the applicant is not the owner) I, residing at N/-1 9 02 q9 S4 - LtZt&,/y-,2ct-4r111362 do hereby authorize to apply on my behalf to the Town of Southold Building Department for approval as described herein. I o%9/z3 wner's ignature Date CONNIE D.BUNCH J �� Notary Public,State of New York No.01 BU6185050 Print Owner's Name Qualified in Suffolk County Commission Expires.April 14,2 � 2 BUILDING DEPARTMENT- Electrical Inspector Oro CGG TOWN OF SOUTHOLD � y ' Town Hall Annex- 54375 Main Road - PO Box 1179 y Southold, New York 11971-0959 r Oti,�� aplY�. Telephone (631) 765-1802 FAX (631) 765-9502 rogerr(cD-southoldtownny gov - seand(cD-southoldtownny.Qov APPLICATION FOR ELECTRICAL INSPECTION ELECTRICIAN INFOR IATION (All Information Required) Date: Ja� 19 ? 3 Company Name: o h ve- Electrician's Name: License No.: Elec. email: Elec. Phone No: ❑I request an email copy of Certificate of Compliance Elec. Address.: JOB SITE INFORMATION (All Information Required) Name: C n1 j S P)P/,61G o S T A Kd S Address: 106 10 .t_;\� { A}v Z Cross Street: O-U Phone No.: 0 Bldg.Permit #: qvllqm - email: Tax Map District: 1000 Section: 116 Block: Lot: BRIEF DESCRIPTIO OF WORK, INCLUDE SQUARE FOOTAGE (Please Print Clearly): Square Footage: Circle All That Apply: Is job ready for inspection?: ❑ YES ❑ NO ❑Rough In Final Do you need a Temp Certificate?: ❑ YES❑NO Issued On Temp Information: (All information required) Service Size❑1 Ph❑3 Ph Size: A # Meters Old Meter# ❑New Service❑Fire Reconnect❑Flood Reconnect❑Service Reconnect❑Underground❑Overhead # Underground Laterals 1 2 H Frame Pole Work done on Service? Y N Additional Information: PAYMENT DUE WITH APPLICATION *gyp Lk S ArtMITSUBISHI ter. ELECTRIC k r SPLIT-TYPE AIR CONDITIONERS INDOOR UNIT MSZ-GL18NA OPERATING INSTRUCTIONS For user • To use this unit correctly and safely, be sure to read these operating in- ' structions before use. MANUAL DE INSTRUCCIONES Para los clientes • Para utilizar esta unidad de forma correcta y segura, lea previamente' ' ' ' estas instrucciones de funcionamiento. NOTICE D'UTILISATION A I'attention des clients • Pour avoir la certitude d'utiliser cet appareil correctement et en toute APP0 ED AS N TED securite,veuillez lire cette notice d'instructions avant de mettre le clima- tiseur sous tension. DATE --B.P. F 6 BY: NOTIFY BUILDING DEPARTMENTAT COMPLY WITH ALL CODES OF 631-765-1802 8AM TO 4PM FOR THE NEW YORK STATE& TOWN CODES FOLLOWING INSPECTIONS: AS REQUIRED AND CON N I. FOUNDATION- 1�!O r E-00Ii'Fp IONS OF FOR POURED c:;O �uRE i SOUTHOLD t N ZBA j 2 ROUGH-FRAM0 G•�—K Y SOumo / & INSULATION` OWN PLANNING BOA,40 k 4. FINAL.-CONSTRUCTION mw T SOUTH TOWN TRUSTEES ! BE COMPLETE FOR C.04, N,Y EC ALL CONSTRUCTION Sl jALL Iulp�t s✓��' - aLCHPc . =ISTAOE VfSOFTEE GOMI' - HDT NOT REST` �» R , DESIGM,OR CON'S�tTE� �� ,.•. -; I OCCUPANCY OR ELECTRICAL SE IS UNLAWFUL INSPECTION REQUIREF TROUT CERTIFICA- OF OCCUPANCY MITSUBISHI ELECTRIC SPLIT-TYPE AIR CONDITIONERS INDOOR UNIT MSZ—GL18NA s OPERATING INSTRUCTIONS For uses To use this unit correctly and safely, be sure to read these operating in- structions before-use. MANUAL DE INSTRUCCIONES Para los cliehtes • Para utilizaresta unidad de forma corrects y segur'a, lea previ'amente,, • • • - ;estas instrucciones.de funcionamiento.I f NOTICE D'UTILISATION J.A I'atte'ntion des clients Pour=aVoir la certitude d'utiliser cet appareil correctemerit et"en'toute` Frangais securite','veaill'ez lire'cette'notice d'instructions avant de mettre le'clima-' tiseur sous tension.: �(- �� fib• �:s r - .:{2 is % - - ""�'�, r ff�' "• J ,e At V. Il ITSUBISHI ELECTRIC SPLIT-TYPE ARR CONDITIONERS ? INDOOR UNIT MSZ-GL18NA M o-� ------------ �•tt $ 11 Wk a OPERATING INSTRUCTIONS For.user To use this unit correctly and safely, be sure to read these operating in- structions.before-use. . r, WANUA'L®E INSTRUCCIONES " Para!os`clientes' •, Para utilizar•esta unidad de forma corrects y segur'a, lea!previamente ' ' hol estas instrucciones de funcionamiento, NOTICE`D'UTICISATION` f Al'attention=des clients" Pour avoir to certitude-d utiliser cet appareil correctement et'en`'toute � secunte;;veuiHezlire cette noticed'ipstructions avanf de mettre le cGma tiseur-sous tension. ' i h - • t w x a, 41 Ak ? d f � Y" i i fi'S+. ,cam hv. �� '" � •.� r '�s �'Asa"' � „� �ti. 6 P1l MITSUBISHI kf { ELECTRIC ' ,a SPLIT-TYPE ANR CON®ITEGNERS Aw- INDOOR UNITI 25 OPERATING INSTRUCTIONS For ti`ser ® To use this unit correctly,and safely, be sure to read these operating in- structions before.use. MAf+IUAi:DE,INSTRUGGIONES `•. Para los,clientes' .Para'utilizar esta,uhiclad.de`form,a,cor'recta y segur'a, lea,previamente.,, estas instruc' es-de-funcionamiento, NOTICE D'UTILISATlON A l'eittentiondes clients •`Pour avoir is°certltudeA utiFiser cet app'areil correctemerit et"ens touter 'secunt& ve`uillez,lire cette notlee d instructions avant de mettre le clima- tiseur sous.tension: . yy �f ' 'i t t r A i l •{= s¢� ,. � "* � ak,�.7;1.^r age .�' i v. ,.xr _