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HomeMy WebLinkAbout12381-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. Certificate Of Occupancy No. Z16788 Date April 12, 1988 THIS CERTIFIES that the building . .A..d.d.i.t.i..o.n ..................................... 803 R.0.W. Maple Lane Southold Location of Property ~t[~[~s~ 'do~ ....................... 'S'tr'o~i ....................... /t~/e~' County Tax Map No. 1000 Section 064 .Block 0 1 ...... Lot 030. I Subdivision ............................... Filed Map No ......... Lot No .............. eofiforms substantially to the Application for Building Permit heretofore filed in this office dated ..... .M.a.y...1.0.,. I. 9. {33... pursuant to which Building Permit No... 1. 2. .3 .8.l.Z. ....... - dated ..... June.......................15, 1983 . wasissued, and conforms to all ofthe requirements of the applicable provisions of the law. The occupancy for which this certificate is issued is ....... Addition to an existing, dwelling. The certificate isissued to I~IICROLAS & CORNELIA TItEOItARIDES {owner, ~l~ ]~)~FoX/X X X X X X X X Of the aforesaid building. Suffolk County Department of Health Approval ..... N./..A .................................. UNDERWRITERS CERTIFICATE NO..N..09.8.7. 2. 4...&..N..09.8.7. 3. .6...4./..5/.8.8. .................. PLUMBERS CERTIFICATION DATED: N/A Buildi~f~ InspectOr ( .... Rev. 1/81 FOR~ NO. 9 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? 12381 Z /'~.~'~' 19d?~' Dote ...... ....~..../':/.....~.. .................................... Permission is hereby granted to: ........ ~...~....~~..~...~.~2<../~. ......~..~.~..~ ...... ~..~.~ ................... .... ~z~.~..z~..,7,......zz~.z.~. ~o ..... ~'~~..~~.~..~.~...~e~~ ............ ...... ~ z~. . . . . . :~ ~.= . . . . ~ ~ ~ ~. .~. . . ~~ . . . ~_~,~ o ~uiiding Inspector. Building Inspector Rev. 6/30/80 FORM NO. 6 TOWN OF SOUTHOLD Building Department Town Hall Southold, N.Y. 11971 765 - 1802 APPLICATION FOR CERTIFICATE OF OCCUPANCY Instructions This application must be filled in typewriter OR ink, and submitted ~ ~ to the Building Inspec- tor with the following; for new buildings 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 of Health Dept. of water supply and sewerage disposal-(S-9 form or equal). 3. Approval of electrical installation from Board of Fire Underwriters. 4. Commercial buildings, Industrial buildings, Multiple Residences and similar buildings and installa- tions, a certificate of Code compliance from the Architect or Engineer responsible for the building. 5. Submit Planning Board approval of completed site plan requirements where applicable. For existing buildings (prior to April 1957), Non-conforming uses, or buildings and "pre-existing" land uses: 1. Accurate survey of property showing all property lines, streets, buildings and unusual natural or topographic features. 2. Sworn statement of owner or previous owner as to use, occupancy and condition of bu ildings. 3. Date of any housing code or safety inspection of buildings or premises, or other pertinent informa- tion requ ~;'ed to prepare a certificate. C. Fees: 1. Certificate of occupancy New Dwelling,$2$.00, Accessory ,,$t0.00 Business $50.00 2. Cart6icatc of occupancy on pre-existing dwelling $ 50.00 3. Copy of certificate of occupancy $ 5.00. over 5 years $10.00 5.Upd,~te~ C.O. $ 50.00 Date ................. 6.Alteration $25 · 00 NewCOns truction ...... Old or Pre-existing Building ............ Vacant rand ............. Location of Property ..~.. ~. '. ................ ~.. H~use No, Street Ham/er ,/ Owner or Owners of Property ~./.~.././~. ,~..~.. County Tax Map No. 1000 Section ............... Block ............... Lot ................ SL~bdivision ................................. Filed Map No ........... Lot No .............. Permit No../?.'.?.. ,~./'?. Date of Permit . .Applicant., ~ .~ .~.~/...... Health Dept. Approval ........................ Labor Dept. Approval ........................ Underwriters Approval ........................ Planning Board Approval ...................... Request for Temporary Certificate ..................... Final Certificate ....................... Fee Submitted $ .~...~, .~.~. .................... Construction on above described building and permit meets all apl~licaJ~code,,s,~qd regulations. ~WRIT RE S ~"~ ~ BUREAU OF ELECTRICITY ~ ~ ~,NEW YORK, N~RK~_O_O3E ......... ~ i ~~3i88 N 0087~4 ~l I! fiXTURE RXTUR~S OUTLETS ~ICEPTACLES] SWITCHES ,.C&NDESCENT FLLK~E~Efl~ ~Y flY~RS [ RJRNACE MOTORS I NTURI AKA~ HEH~ RANGES V I C EXHAUST FANS I~1 O1 '1 bO.LD ~ NYr This certificate must not be in Per ~,~ ) manner; return to the office of the Board if incorrect. Inspectors may be identified by their credentials. COPY FOR BUILDING DEPARTMENT. THE NEW YORK BOARD OF FIRE UNDERWRITERS BUREAU OF ELECTRICITY 85 JOHN STREET. NEW YORK, NEW YORK 10038 ~P~]'L 05 1.q~ 24~80183/83 N 00873~ Dat~ Application No, on file TI'liS CEI~'[FIE~t T~T ~y t~ e~t~ ~uipment ~ ~c~ ~w a~ i~t~ by t~ ap~i~t ~ on t~ a~ ~at~ numar ~ t~ p~m~ of TffEO~ARIDES~ IIAPLE LANE~ 5~UT~OLD. in t~ followln~ Ioc.tlo~; , ~s exemin~ on end found to be ~n compliance with the requiretnent* of th~ RXTURE RXTURES ~.ANGES OVENS DISH WASHERS EXHAUST FANS OUTLETS SWITCHES FtUO~ESC:ENT DIIyERS 11 1 ] TIME CLOCKS UNIT HEATEIIS MULTI-OUTtIT DIMMERS SYSTEMS NO. 0dB FEET SERVICE DIE¢ONNECT S E OTHER APPARATUS: c 5OUTHOLD, NY, 11931 eAr.At MaNA~ This certificate must not be altered in. , manner; return to the office of the Board if incorrect. Inspectors may be identified ~ their credentials. COPY FOR BUILDING DEPARTMENT. THIS ~ED IH AHY MAHHER. ,F I. EL% INSPECTION COMMENTS FOUNDATION FOUNDATION (2nd) 2. ROUGH FRAME & PLUMBING INSULATION PER N. Y. STATE ENERGY FINAL ADDITIONAL COMMENTS OWNER: ...... ~.. ,~EO.Z-/~ ~ I'D J O0.~T 2: ', OF JOOST BUILDING DEPT. INSPECTION FOUNDATION IST FOUNDATION 2ND [ FRAMING REMARKS ROUGH PLBG. INSULATION FINAL DATE .... ? INSPECTOR 765-1802 BUILDING DEPT. INSPECTION FOUNDATION 1ST []ROUGH P~BG. FOUNDATION 2ND []INSULATION FRAMING []FINAL DATE INSPECTOR TOWN OF SOUTHOLD OFFICE OF BUILDING INSPECTOR P.O. BOX 728 TOWN HALL SOUTHOLD, N.Y. 11971 TEL. 765-1802 This is Co advise you that the job under building permit no. ~J81,Z . issued to N. Theoharides on ._6/l~j___ for Additions is completed a final ~nspection has ( ) has not ( X ) been done. and In order to complete this file, it is necessary that a Certificate of Occupancy be issued. Please fill out the enclosed form, return same to the above office with a check for $22.00 payable to the Towu of Southold. Please indicate to Whom the Certificate of Occupancy is to be mailed, and arrange with this office for an inspection date Occupancy or use is unlawful without a Certificate of Occupancy. Please. help us to clear up this matter so that legal action dues not have to be take~. Thank you for your prompt attention. Very truly Victor Lessard Executive Administrator VL:gar encl. t~W YOP. d~ STATE DEPART~NT OF ENVIP. OR~,~.NTAL CONSERVATION Regulatory Affairs Unit Bldg. 40, SU~Cf--,Room 219 Stony Brook, NY 11794 (516) 751-7900 December 27, 1982 Mr. Nicholas Theoharl~es 2 R®~erick Lane Garden City, New York 11530 Dear Mr. Theehari4es: A review has been mode of your proposal to: construct an a~ition ont~ an existing home. Location T~wn Creek/Southol4 Bays Maple Ave., Town of S.uthel4 Suffolk C®unty. New York State Department of Environmental Conservation has found the __parcel X~,,proJect to be: Greater than 300' from inventoried tidal wetlands. ...... Landward of a substantial mon-mode structure greater than I00' in length constructed prior to September 20, '19~7. Lamdward of 10' contour elevation above mean sea level on a gradual, nat- ural slope. ,~,, Landward of topographical crest of bluff, cliff or dune in excess of 10 feet in elevation above mean sea level. Therefore, no permit under Article 25 (Tidal Wetlands of the Environmental Conservation Law) is required at this time since the current proposal is beyond State mondated ~(~risdiction pursuant to this act. However, any additional work or modifications to the project may require a permit. It is your responsibility to notify this office, in writing, if such additional work of modifications are contemplated. Very truly yours, Daniel J. ~arkin Regional gupervisor of ~gulatory lffatrs DJL:RNT:cz FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N.Y. 11971 TEL.: 765-1802 Approved .~/.~/~'~...F..fi7 .... 1 ~..?Permit No. / (Building Inspector) APPLICATION FOR BUILDING PERMIT INSTRUCTIONs Application NO.//e~5'~.~..~./- ........ 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 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 fore,the issuance of a Building Permit pursuant to the Building Zone Ordinance of the Town of Southold, Suffolk Counf?T'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 for necessary i,~, ections. (Signature of applicant, or name, if a corporation) (Mailing address of applicant) State whether applicant is owner, lessee, agent, architect, en~neer, general contractor, electrician, plumber or builder. ..................... .-bo, t.~..~ ............................................................ Name of owner of premises . .~.~. ~..~..~. ~. .... ~. ! .~..~.o..C,?. ~... ~.O.~k~, e~,t. a. g.5 ...... n .% ............ (as on the tax roll or latest deed) (~4~^ ~{~) If applicant is a corporation, signature of duly authorized officer. (Name and title of corporate officer) Builder's License No .......................... Plumber's License No.....'~...~.. ~..~.. ............ Electrician's License No....~..~..~...' ............. Other Trade's License No ...................... 1. Location of land on which proposed work will be done ..... ..'~...tp.,. ~ ...... ~ F. I~. ....bd~,~.~.~,.. ~t~ ..... .... ............................................................ . House Number Street Hamlet County Tax Map No. 1000 Section .... .O...~..5 ...... Block ....... ©.{ ........ Lot.....~3... r..t ...... Subdivision ~ 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 . . ~.~ .~...-~'. ~..~. ':~ ~' .... .'~..~u,l~4J~ t4'.~ ................................. b. Intended use and occupancy ...~.~ ......... ~.~. ............ ~.x. .......~ f...~.~ .................. 10. 11. 12. 13. 14. Nature of work (check which applicable): New Building .......... Addition...~.. .... Alteration .......... Repair .............. Removal .............. Demolition .............. Other Work ............... Estimated Cost ............................ Fee ................................. (to be paid on filing this application) If dwelling, number of dwellinglunits ............... Number of dwelling units on each floor ................ If garage, number of cars .... ~ ................................................................... If business, commercial or mixed occupancy specify nature and extent of each type of use I)anensmns of existing structures, ffany: Front .... ~ ....... Rear ....(* ~.~'. ...... Depth ...~,~.' ......... tteight .... ./..~'..~ ...... Number of Stories ....... ./ ................................................ Dimensions of same structure With alterations or additipns' Front ~..Z- . Rear . ~.~r. . .. Dimensions of entire new constrUction: Front .... ~.7 ........ Rear ....... 2-~7..t... Depth ...2-r,3.t ........ /.~'. · Number of Stories [{eight ................................................................. Size of lot: Front ........ ?~...V~..Z.~r~... Rear ...... 2Z~.~. .......... Depth . ..~,~.~. .............. Date of Purchase ............................. Name of Former Owner ............................. Zone or use district in which pr~mises are situated ..................................................... Does proposed construction rio!ate any zoning law, ordinance or regulation: ................................ Will lot be regraded ........ ,Z/g>. ..... , ........... Will excess fill be removed from premises: Yes 1~' No Name of Owner of premises /~tCq~$. ~At~t0atAddress Z ~. P~4.q{ .L.~... Phone No ................ Name of Architect ......... i ................. Address .~.~l~dam..St._TT.,~. .... Phone No ..... Name of Contractor ~o b/to. i~C~7'/~ol. · .~'~C~(b Address O~t,o~J~,.~-~9. · .. Phone No.7..~C.~. 1-~-~'.~. .... PLOT DIAGRAM Locate clearly and distinctly al! 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. STATE OF NEW YO..RK,t"t" . ? ~ COUNTY OF 'T' .~..O~.4~..L~.~,... ........... ~,) .o..~..~...~llLrv'8,~4 ................... being duly sworn, deposes and says that he is the applicant (Name of individual signing contract) above named. He is the .... '...~,..O..~.~..~.~..~ .!...~l.(,'E:l'~ .................................................... (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 knowledge and belief; and that the work will be performed in the mannei set forth in the application filed therewith. Sworn to before me this ............... [.? ..... day of ..... ~ l~q/ .... Notary Public, ~ ..... '.: · .-~.~~ Coun~ty ,~ ,~ /n ,,~ Notary Public, State of New York (Signature of applicant) , No. 52-0344963 SuffolR Cou~.~[ Commission Ex~ir~s; Marcl~ 30, · )OHN BERTANI BUILDER INC. JOHN BERTANI BUILDER INC. SOUTHOLD, NY 1 Xg?1, JOHN BERTANI BUILDER INC. Colonial Road SOUTHOLD, NY 11971