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Home My WebLink About12805-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southoid, N.Y. Certificate Of Occupancy No. ZI6097 Date August 26, 1987 THIS CERTIFIES that tbe building .... N.e..w..o.n. ?..f.a.m..i .ly..d.w..e.l.l.i..n .g.. ................ Location of Property .... .3.8.0...S.t.a.n..1 .ey..R. 9.a.d., ...... M.a..t .t.i.t.u..c .k ....................... House No. Street Hamlet County Tax Map No. ]000 Section I 06 .Block 0 7 . .Lot 0 2 8 Subdivision..8. u..n .s.c.t...K .n.o. 1.1..s .............. Filed Ma p No..5. O..2.3...Lot No...0.6 .......... conforms substantially to the Application for Building Permit heretofore flied in this office dated ..... D.e..c.... [2. ~..I.9.8..3. pursuant to which Building Permit No. 12805. z dated ..... D.c..c:..1.5.:, .I.9.8. ? ........ 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 ......... ..... Oue..f~,3~,i.l.y.. ql.w.e.! 1/.i p.E.,...a p.d.. g.a.! a. g.e' .qn..d.e.r.. .............................. The certificate is issued to ANASTASIA GRICORATOS (o wt) er,Tfdz~,~t( ~l~tX X X X of the aforesaid building. Suffolk County Department of ttealth Approval ... ! .3 :.S.O. '7 .2.1.8.. A..u.g.... 2. .4 .,. I. 9. 8..7 ............. UNDERWRITERS CERTIFICATE NO. N641829 April 25, 1984 PLUMBERS CERTIFICATION DATED: N/A Building Inspector Rev. 1/81 FOF, M NO. ~ 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? 12S05 Z Permission is hereby granted ~ , __ / ot ,rem'., 'o,,ted ,, ...... J~ ............ ~~Z~.....~....,. ................................... ................................................................................................ ~~.~,.=.~ ........ ~ /.....~.~ ..................... ~ .................................................................... CounW T~x M~p No. 1000 Section/~.~ .......... Bilk ..... ~ ............ Lot No. ~ ...~.~ ...... Building Inspector. Fee $...'.~....~.....~ Rev. 6/30/80 ~oo.~:~'~ THE NEW YORK BOARD OF FIRE UNDERWRITERS [~ BUREAU OF ELECTRICITy ~ 85 JOHN STREET, NEW YORK, NEW YORK 1OO3B B~t~ ,~ ~, ~ ~,,~.~..~-~.~,,S.~ Z~/~ N 641829 THIS CERTIFIES THAT only the electrical eq[dpment ~ dezcribed be~w and int~duced by the op~llcant ~med on the above Fppl~cation number in t~ premises of in the following location; [] Basement ~ /st FL ~ 2nd Fl. Section Block Lot 4 was examined on ~)~J'~ ~ ~ ~ and found to be in compliance with the requirements of this Board. FIXTURE FIXTURES OVENS. DISH WASHERS EXHAUST FANS OUTLETS F~ECEPTACLES SWITCHES FLUORESCENT 25 DRYERS OTHER APPARATUS: o ~ 1-~°m~k~ Detector $ E R C AW.G OF HI-LEG Dem~is D~ Claire, Jr. P, O. Box 2~4 L~urel~ N.Y. llg~S This certificate must not be altered in any manneh return to the office of the Board if incorTect. Inspector~ may be identified by their credentials. · FOR B:UILDING DEPARTMENT. THIS COPY OF I , MANNER. F i ~LD t~N S p E~.~T i O~ COMMENTS FOUNDATION (1st) FOUNDATION 2. (2nd) ROUGH FRAME & PLUMBING INSULATION PER N. STATE ENERGY qODE FINAL ADDITIONAL COMMENTS: CAI TAIN Ell)I) WATI:I CO kI ANY, INC. BOX 1180 RIVERHEAD, N.Y. 11901 Telephone: 516 727-7411 SUFFOLK COUNTY DEPARTMENT OF HEALTH SERVICES Engineering Department Count~ Center Riverhead, New York 11901 August 18, 1987 ,~UC 18 1987 S C. D[PT. OF HEAl'IH S[RVICES RE: Grigoratos Residence 380 Stanley Road Mattituck, N.Y. Gentlemen: Be advised that the referenced location is now serviced with water b~ us. The connection was made on August 16, 1987. Also, be advised that the lateral is set a minimum of 4 1/2' below grade. SGT/bp Yours Truly, Steve G. Tsontakis SUFFOLK COUNTY DEPARTMENT OF HEALTH SERVICES Check List of hrs~pections of Private Sewage Disposal Facilities SOIL INSPECTION REFERENCE Excavation 1. Inspection ,'_--~. 4f-~-7/ Reference Number I~'-~ 0~ ~ Exca. Insp. approved by. SlTE INSPECTION 5. Facil. to p.1. & ~-~-uilding ...... (------) 6. Dist. to other wells & pools ...... (~ 7. Covers clear, walks & drives ....... (-----~ 8. Safe distance to surface waters...(-------) WATER ~-~J~--~2~'--~J~ ................... lO. Water line to edge of facilities(/(/~ 12. Lateral line (~ Dia. SEPTIC TANK INSPECTION 14. Manufacturer 15. Shape of tank ~-]-~ Mat'l ~ 16. Waste line ~ Size___~L'' 17. Air space 19. Drop tees 20. Manholes 22. Covers 24. To grade (--) 18. Number of Compartments ( ~---~(~--~----) 2l. Traverse wal {~ ( ~-~ 23. Liq. level (~--~ 25. Tank level BLOCK AND PRECAST LEACHING POOL INSPECTION #1 POOL #2 POOL #3 POOL I#4 POOL #5 POOL 26. # sects./dia./top- .,//~/~ ~ Blks/course-# coursesll~ /~/A,D. 27. Total leaching of ~ each pool installed I 28. Waste line size & type of raaterial I 29. Chimney provided (--~]~) ( , () () ( ) 30. Covers approved (~(~ (-----~ !~ (------) (--~ 31. Distance to __ ,----3 (---3 (..---3 fin. grade REINSPECTION TOTAL SQUARE FEET ITEM NUMBERS OF LEACHING Date Supervisor Date Inspector S-7 Revised 8/72 LABORATORIES, INC. ENVIRONMENTAL TESTING 377 SHEFFIELD AVE. · N. BABYLON, N.Y. 11703 ® (516) 422-5777 OF 1 LABS, INC. Environmental Testing Laboratories 575 Broad Hollow Road, MeMlle, New York 11747-5076 · (516) 694-3040 LABORATORY R EPO RT CLIENT'S NAME AND ADDRESS ECOTEST LABS, INC, 377 SHEFFIELD AVE, NO* BABYLON NY 11703 Water/Waste Water Laboratory · Hazardous Waste Laboratory · Air Testing LaboratorV Pilot Plant Studies and Other Analytical Services TYPE OF SAMPLE - POTABLE WATER DATE COLLECTED - 5/21/87 TEMIK ANALYSIS C871054-7 - ORIGORATIS P.O. %2413 LAB NO, 755609 ~mn!mCT wn, OPR COLLECTED BY CL 99 DATE RECEIVED - 5/22/87 PARAM- ETER RESULT ALDI- CARB <2,00% 4LL RESULTS IN (MO/L) EXCEPT AS NOTED BY % (UG/L) OR % (PERCENT) AND T.COLI BACT. ~ FECAL COLI (MPN/IOOML) COLOR, ODOR, TURBIDITY S PH (UNITS) APC & FECAL STREP (COUNTS/ML) I SPEC.COND. (UMHOS) SETT~SOLIDS(ML/L) LIABILITY OF H2M LABS, INC. SHALL BE LIMITED TO THE PRICE OF THE SERVICE RENDERED AND PAID, DATE REPORTED 5/28/87 TO~N OF SOUTHOLD OFFICE OF BUILDING INSPECTOR P.O. BOX 728 TOWN ttALL $OUTtlOLD, N.Y. 11971 TEL. 765.18O2 This is to advise you that the job under building permit no. 12805Z issued to A Grigoratos ou 12/15/83 for ~New Dwe±iing is completed and a final {nspection has ( ) has not '( ~ )''bee. done. An Underwriters Certificate is needed 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 $25.00 payable to tile Town of Southold. Please indicate to Whom tile Certificate of Occupancy is to be mailed, and arrnnge with this office for an inspection date Occupancy or use ia unlawful without a Certlf{cate of Occupnncy. l'lea0e help us to clear up thi$~ m~tter so thst ]ega! action does not have to be taken. Thank you for yo,r prompt attention. Very truly Victor Lessard Executive Administrator VL:gar encl . ~eaezrz/' Gon&'ao/or,.v P.O. BOX ~3~ ]AM~PORT, N.Y. 1 I947 548-9821 Ce7 5, ro c.-.pt~'k, a7 o~'L.~ ,'.' -..3 o.~ P.O. BOX ~3I ]AM~PORT, N.Y. 11947 548-9821 FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N.Y. 11971 TEL.: 765-1802 Disapproved a/c .............. ----T.....~ ............. . ,' ~ ................................ APPLICATION FOR BUILDING PERMIT Date..../.?/. Z INSTRUCTIONS Received. f. ~.~?.~.... ,19..~ a. Tkis 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 shail 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 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 remgv, al or demolition, as herein described. The applicant agrees to comply with all applicable laws, ordinances, building coj;!~/housing code, and regulation~s, and to admit authorized inspectom on premises and in building for necessary inspecti~~ ' --/.~ (Signgt~Ldb~l~Plicant, or name, if a corporation) ........ ~,~Y, .~,~,~ d, ~./, . ~,o??,< ~,~4~,~, ~. . .$, . .~. .~ .... (Mailing address of aplSlicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber o er..) .................. ..................................................................... Name of owner of premises ... .~.c.L~[{.~i.c¥ .... .~.h.~.. .O.~.c/ .... ' ...................................... (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... ~.. ?..? !~./.~?..~. .......... Plumber's License No.../.~}.,.C.~.., ./.).~.5:-.~ ........ Electrician's License No ....... mc ..... ~¢~... Other Trade's License No ...................... 1. Location of land on which proposed work will be done ..... ?~>. ..... [ ........... ..... ................ .... ............... ..................... House Number Street Hamlet County Tax Map No. 1000 Section / O~ Block '~2 Lot ~ Subdivision ....... ~,5:~'~..~9.t~¢ ............. 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 ..... ~9.D ~ .......................................................... b Intended use n~ncv /~c~ O~ r~~~ - and occu~___~ ................... ~ :~ ~ ..... ,. ....................... 3. Nature of work (check which applicable): New Building .....P~..... Addition .......... Alteration .......... Repair .............. RemOval ............ Demolition .............. Other Work ............... .o. 2~. 7~....~' (Description) .. .... 4. Estimated Cost ..... o ...................... Fee ..................... (to be paid on filing this application) 5. if dwelling, number of dwellinglunits ...... /. ........ Number of dwelling units on each floor ................ If garage, number of cars .... i ......... / ......................................................... 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 .............. Depth ............... Height ............... Number of Stories ........................................................ Dimensions of same structure With alterations or additions: Front ................. Rear .................. Depth ................... i · · Height ...................... Number of Stories ...................... 8. Dimensions of entire new construction: Front ..... ~/~..., ..... Rear .... ~..~. ....... Depth ....~..~. ........ Height .... !.~..r ....... Number of Stories ...... /. .............................. ~. .................. ' ! 9. Size of lot: Front ..... ..j/tr.. i ........... Rear ..... /O. .............. Depth ../~.~. ................ 10. !)ate of Purchase ..../,/.7.o../~2~' ................. Name ofFormerOwner ........................... 11. Zone or use district in which premises are situated ................................................ i.. i. 12. Does proposed construction violate any zoning law, ordinance or regulation: ...il[.~ ....................... .~ 13. Will lot be regraded ........ !. ~? ..... . ........... Will excess fill be removed from premises: Yes (~ 14. NameofOwnerofprem~ses .(,~...~/~la..q'['O3 ....... Address ................... PhoneNo ................ Name of Architect ......... ' .................. Address ................... Phone No ................ Name of Contractor .. 4~.~...~IT~(q .~.~. ....... Address . (~.o...O~.~ .I.2 1 ....... Phone No. '7,~F ~ '41~ 6 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 inte~or or corner lot. according to deed, and show sleet names and indicate whether STATE OF NE~RK, · COUNTY OF /-~/(Name of individffal signing contract) above ~med. ........ being duly sworn, deposes and says that he is the applicant He is the ~ ..~. .~ (,~ntracto~ agent, corporate officer, etc.) of said owner or owners, and is duly authoriz~erform 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 this .... ' .... .:../.~..'.-:..day o!~.....-~...~ .'~ .... l~.f/ Nota~ Public .............. !. · · County ~'~ ~ - ~..~ ~ .................... . ......... ;. · ... TOWN OF SO .... ~ L .~ now or f~merly d~s~ow/~ now or formerly Waselews~/ sT~~ FAMIL~ ~tLUNG THE S~AGE DISPOSAL ANO WAT~ SUPPLY FACILITIES FOR THIS ~ LOCATION HAVE BEEN' INSPECTED BY THIS DEPARTMENT AND k FOUND TO BE O~I~CTORY.. ,.~ ~. ~ SURVEY FOR . ~ ~ ~ ANASTASIA GRI00RATOS R [~- ~ ~" R~.,~ ~. ._.. LOT 4 "MAP OF SUNSET KNOLLS" MAR. 27, 1987 ~'~./'~ AT MATTITU~K DATE . JAN. 30,1979 ~ ¢. -. TOWN 0F SOUTHOLD SCALE: .~ ,~,o ~, SUFFOLK, COUNTY NEW YORK NO. : 79-22 c(~ ~ UNAOTHdNIZED ALTErATiON OR ADDITION TO THIS GUARANTEED TO:~ SUR~70R'S [NKE0 SEA[ OR EMBOSSED SEAL SHALL NOT BE- CONSIDERED TO BE A VALID TRUE COPY ~GUARANTEES INDICATED HEREON SHALL R0N ONLYTO DEPARTM'eN~ ~ THEPERSON FOR WHOM ~HE SURVEY IS PREPARED, ~- DATA FOR APPROVAL TO CONSTRUCT AND ON HIS eEHALF TO THE TITLE COMPANY, GOVERN- H~LTH *NEAREST WAyERMAIN__MI.~ ~SOURSEOFWATE., PRIVATE PUBLIC__ MENTAL ~ENCYAND LENDING INSTITUTION LISTED ~__J ~SUFRCO, TAXMAP'OIST. SECTION BLOCK ; LOT-- HEREON, AND TO THE ASSIGNEES 0F THE LENDING 1 - , ~ ADDITIONAL INSTITUTIONS OR SUBSEQUENT ' RIVERHEAD, NEW YORK m= MONUMENT ,~ ' 'AL~N ~W. YOUNG, PROFESSIONAL ENGINEER SUBDIVISION MA~ FILED IN THE OFFICE OF THE CLERK OF L.~,~,e~i~V~V~ SUFFOLK COUNTY ON ~AN. 5~ 1968 AS FILE NO. HOWARD W. YOUNG, LAND SURVEYOR '~E ~AT~ ~ WEL[(W),3E~IC T~K(~T)~SP~ (CP)~H~ HEREON N,Y.~, LICENSE NO. 4589~ now or formerly Jo$#owiak , now or formerly WoselewsM ~ ' Lot 4 ~ Area=3~O3Os~ft / ' · ,11~00 ~' ~ '.'~ '~ ' ~ ~ . STaNLEy. ~OAD SURVEY FOR ANASTASIA GRIGORATOS SUFFOLK COUNTY DEPA~'fI~E~.JT OF HE~LH-~ ~;~'.~ LOT 4 ,"MAP OF SUNSET KNOLLS" ~ AT MATTITUCK DATE . ~AN. 30,1979 FOR APPROVAL OF CONSTRUCTION ONLY ~ 'Town OF ~ouTH~LD ~ SCALE: I"=~0' ~ HS ,~..o. [~'~-~.~ SUfFOlK COUNTY, N[W YOR~ .o. . ~S-~a survey ~s~ ~io~&~oN ~ s~c~o~ 7~ o~ ~H[ GUARANTEED TO: ~PROV~ , ~ ~ NEW XORK:STATE EDUCATION LAW: ANASTASIA GRIGORATOS THE PERSON FOR WHOM ,HE SORVEY IS PREPARED, H~LTH DEPARTMENT-DATA FOR APPROVAL ~O CONSTRUCT AND ON MiS BEHALF TO THE TITLE COMPANY, GOVERN- --, ,~ .~- ~L., -..--~-;~:/ · I' . ' 1 V~l IKI~ ~ V~I IKI~-4~--VENUE t~,.~,~/ ~o ~ ' ~ ~/ .g I , I /~UI~'O ~ /~Ul~t~ RIVERHEADcNEW YORK SUBDIVISION MAP F LED IN THE OFFICE OF THE CLERK OF ' ~ ' SUFFOLK COUNTY ON JAN, 5, 1968 AS FILE NO. 5023 "' :~ i :1/ HOWARD W. YLUNG,u LAND SURVEYOR '~E~T~W~LL(W),~E~IC T~K(ST)a~SP~LS(CP)SH~ HERE~ ~ r N.~S. LICENSE NO. 45895