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Home My WebLink About13535-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. Certificate Of Occupancy Z-16169 September 15, 1987 No .................. Date ................................ THIS CERTIFIES that the building A D D I T I 0 N 2390 Bay Avenue Mattituck, New York Location of Property ............................................................... House No. Street Hamlet 03 032 County Tax Map No. 1000 Section 144 . .Block ...: ........... Lot Subdivision ............................... Filed Map No ......... Lot No .............. conforms substantially to the Application for Building Permit heretofore filed in this office dated October 16, 1984 pursuant to which Building Permit No. 13535 Z dated.........N°vember ...... 1/4......' 198/4 ........ 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 ......... ADDITION TO EXISTING ONE FAMILY DWELLING JAMES & DESPINA SIDERIS The certificate is issued to ..................... [oh;n.o,r,.~Tt~?t?x .................... of the aforesaid building. Suffolk County Department of Health Approval ........... ~/..A ............................ UNDERWRITERS CERTIFICATE NO. N8 17 16 1 N/A PLUMBERS CERTIFICATION DATED: lding Inspector Rev. 1/81 · 0~ NO. ~ TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL $OUTHOLD, N. Y. BUILDING PERMIT ¢DHIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF TIlE WORK ^UTHORIZED) N~ 13535 Z Permission is hereby granted to: .... ~.~...../.~....¢~...,..~:.....z~..~ · ,~. / t ..~ ....... /.. ......... :~..~ ........................ ~Z~ ............ ~ ............ ~.~.~....¢....~~.....~.~ ., ,,,,,,, ,~ed ., ..... ~a .......... ~.~...~:..r ........... ~~.=.~ County Tax Map No. 1000 Section ..../...~...~... ......... Block ...~....~.... ......... Lot No.....~..~....~ ...... pursuant to application doted ...Q .............. /....~.. .......................... , 19.~-...~., and approved by the Building Inspector. Fee $ .................... Rev. 6/30/80 FORM NO. 6 TOWN OF $OUTHOLD Building Department Town Hall Southold, N.Y, 11971 765 - 1802 APPLICATION FOR CERTIFICATE OF OCCUPANCY Instructions A. This application must be filled in typewriter OR ink, and submitted m ~.-..~,-- 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. B. For existing buildings (prior to April 1957), Non-conforming uses, or buildings and "pre-existing" land uses: 1. Accurate survey of p~operty 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 buildings. 3. Date of any housing code or safety inspection of buildings or premises, or other pertinent informa- tion required to prepare a certificate. C. Fees: 1. Certificate of occupancy $25.00 -- BUSINESS $50.00 ACCESSORY $10.00 2. Certificate of occupancy on pre-existing dwelling $ 50.00 3. Copy of certificate of occupancy $ 5.00, over 5 years $10.00 4.Vacant Land C.O. $ 20.00 // 5.Updated C.O. $ 50.00 Date ..... ?/?-, ?./. .¢..7. ............. NewC°nstruc%i°n ...... Old or Pre-existing Building ............ Vacant Land ............. Location of Property ...... ~,~. House No, Street Hamlet Owner or Owners of Property ~ = ~e~ S ~,~ -~-'/L. 5 County Tax Map No. 1000 Section.............../~/~/ Block ..... · '~. .... · ... Lot...... %.'.~'...... Subdivision ................................. Filed Map No ........... Lot No .............. Permit No. , .....~... Date of Permit .......... ~pp~mant .................................. Health Dept. Approvat ........................ Labor Dept. Approval ........................ Underwriters Approval.. ~./.}./AL ......... Planning Board Approval ...................... Request for Temporary Certificate ..................... Final Certificate ....................... Fee Submitted $ ............................. Construction on above described building and permit me, ets all applica.ble codes and regulations. Applicant .~ ~-, ................... Rev. 10-10,78 conillH . THE NEW YORK BOARD OF FIRE UNDERWRITERS BUREAU OF ELECTRICITY 8,5 JOHN STREET. NEW YORK, NEW YORK 10038 ~une ~6, 19~7 310325/85= FIXTURE FIXTURES RANGES OVENS DISH WASHERS EXHAUST FANS OUTLETS SWITCHES FLUORESCENT ORYERS SYSTEMS OTHER APPARATUS: S E R V I C NO OF HI-LEG ,: 4 4~5 ~on~l! ~.ane This cedlficate ~ust not be altered in any manner; return to the office of the Board If,incorrect. Inspectors may be~ide~tlf~y their credentials C9~ FgR?~ILg!N6 PEPARTMENT' THIS CO~Z O[ ~E~I[!~~;~E,~ ~.~?E~ED~,N ANY~NNER. TOWN OF SOUTHOLD OFFICE OF BUILDING INSPECTOR P.O. BOX 728 TOWN HALL $OUTHOLD, N.Y. 11971 TEL. 765-1802 CERTIFICATION Building Permit No. /gff3~ (please print) Plumber 0 Ovrro (please print) I certify that the solder used in the water supply system contains less than 2/10 of 1% lead. (plumber's signature) Sworn to before me this ~-' day of ,~-'q- , Notary Public, .~ County Notary Public TOWN OF SOUTIIOLD OFFICE OF BUILDING INSPECTOR ILO, BOX 728 TOWN llALL SOUTHOLD, N.Y. I t971 TEL. 765-1802 This is to advi~e you that the job under building permit no. 13535~ issued to James Sideris on __~/14/84 for Addition ia completed and a final inspection has ( ) has not ( x ) been do~e. An-~nderwriters Certificate is needed tn urder 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 wlth a .check for $25.00 payable to the Town of Sonthold. Please {ndlcate to Whom the Cercificatc of Occnpancy is to be mailed, and arrange wit]] this office for an .inspection date Occnpancy or nsc ia unlawful without a Certlf{cste of Occupancy. Plen~]e. help tis to clear up this matter so that legal action does not have to be taken. .. Thank you for year prompt attention. Very truly y~, Victor Lessard Executive Administrator VL:gar encl. FIELD INSPECTION '~ ~ COMMENTS FOUNDATION {1st) FOUNDATION 2. (2nd) ROUGH FRAME & PLUMBING INSULATION PER N. Y. STATE ENERGY FINAL ADDITIONAL COMMENTS: Memorandum from .... BUILDING INSPECTOR'S OFFICE TOWN OF SOUTHOLD TOWN HALL, SOUTHOLD, N. Y. 11971 765-1802 TOWN OF SOUTHOLD OFFICE OF BUILDING INSPECTOR P.O. BOX 728 TOWN HALL SOUTHOLD, N.Y. 11971 (~ Iq~? TEL. 765-1802 TO Whom This ~ay Concern, We are unable to complete your Certificate of Occupancy because ,of the following reasons. /~/ An application for Certificate of Occupancy is not on file. /~/-' No Underwriters Certificate on file. /_~ The check is(outdated/~.) /5/ No Health Dept. Approval on file. /Z/ No final inspection has been made. Please contact our office on Thank you for your Building Permit # Building Dept. ***/? of this matter. cooperation.. z No Plumber Solder Certificate on file. ( all permi_ts involving plumbing being issued after April 1,1984 ) 0~cupancy or use is unlawful without a Certificate Occupancy. Clear up this matter as soon as possible that legal action does not have to be taken. Thank you for your prompt attention. 'FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N.Y. 11971 TEL.: 765-1802 APPLICATION FOR BUILDING PERI"41T Date .../.ff/'/~. ....... INSTRUCTIONS a. This application must be completely filled in by Wpewriter 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 for the issuance of a Building Permit pursuant to the Building Zone Ordinance of the Town of Southold, Suffolk County, New York, and otlier 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, a~nd r, egula~ons, an~d to admit authorized inspectors on premises and in building for necessary inspections. (J // // ~.~./,¢~. &v.~:,.':. ?¢... ~ ~ (Signature of applicant, or na~e, if a corporation) %1 gg. . ~. . 3. ox .s. 5¢.~. . . . .w. ~v. /z4. .~¢.~.¢. . .,y:¢.,. . (Mailing address of applicant) State whether applicant is owner, lessee, agent, architect, en~neer, general contractor, electrician, plumber or builder. Nameofownerofpremises /'k//? ~ ,/~:25 J)D~/5 ., ~7~/d~ 7,~ ~. (as on the tax roll or latest deed) If a~lic~t isa ~poration~nature o~ly authorized officer. '~N~~rate officer) '' Plumber's License No ......................... Electrician's License No ....................... Other Trade's License No ...................... 1. Location of land on which proposed work will be done .................................................. .... ..,7...r. ~O.. .............. ~.~. ~...d¢~. .................... ~ .~..r.~?.~...,~,.. ........... House Number Street Hamlet County Tax Map No. 1000 Section .... (.?.~ ......... Block Subdivision...~/.~..o~...~7.~'..~..~.~.~.5~. ............... Filed Map No. 7. 7.O.. ....... Lot....~.7 ......... (Name) 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: a Existing use and occupancy ....... ~> .......................... -' .... ~ ......; .... Z ......... b. Intended use and occupanc~~...~.~. ?..~.~ .5/.0...~}... ~ ~./...~..'..~....~.....(?'?'.....~7.'.r~....~..../~ ..... ~Addition 3. Nature of work (check which apphcable): New Bufldmg ............... Alteration ........ Repair .............. Removal ............. Demolition ..... i... Other Work ........ /' ' (Description) 4. Estimated Cost ....... 2~./O~.dP .................... Fee ...... ~. a ............................. '~' (to be prod on filing this application) 5. If dwelling, number of dwelling units .............. Number o f dwelling uniis on each floor ............... If garage, number of cars 6. If business, commercial or mixed occupancy, specify nature and extent of each ty~e of use .................... 7. Dimensions of existing structures, if any: Front ............... Rear ....... I ....... Depth ...... ~ ....... Height Number of Stories ' Dimensions of same structure with alterations or additions: Front ............ ! ..... Rear ................. Depth ...................... Height ...................... Number ofi Stories ..................... 8. Dimensions of entire new construction: Front ............... Rear ....... ' Depth ............... Height Number of Stories .. ................ .' 9 Size of lot: Front Rear iDepth 10. Date of Purchase ......................... .... Name (>fF=.gix~, er Owmer .i ................... , ........ 11. Zone or use district in which premises are situated .......... ~.:...-.~.~.~.(..~7~4~......,4C~. ........ 12. Does proposed construction violate any zoning law, ordinance or regulation: i ............... 13. Will lot be regraded ............................ Will excess fill be removed from premises: y, es, 14. Name of Owner ofprenrises .................. Address ............... i ....Phone No. ~.~.~..~. ~o..~... Name of Architect Address ' Phone No Name of Contractor Address ~ Phone No 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. STATE OF NEW YORK, S.S COUNTY OF ................. ................................................. being duly sworn, dep6ses and says that he is the applicant (Name ofindividuai signing contract) above named. He is the ......................................................................................... (Contractor, agent, corporate officer, etc.) of said owner or owners, and is duly authorized to perform or have performed the ~aid work and to make and file this application; that ail statements contained in this application are [rue to the best ofhi~ 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 X!otary Public, .............. ... ......... Court '-'~ ' HELENK. DEVOE '~' ~ NOTARY J~UBI.IG, State of New Yod~ ........................... No./1707878. Stflfelk Camlv, ~- ature of applicant) 'b