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Home My WebLink About15903-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Halt Southold, N.Y Certificate Of Occupancy No... z. .... Date March 24, 1988 THIS CERTIFIES ihat the building ..... .O. qe. f.am..i.ly..d.w..e.l.l, in. g .. .............. Location ofProperW . .~85.0 ..Rut. h .Roa. d ........ M.a.t.t.i..tuck House No Street Hamlet County Tax Map No 1000 Sectzon l 0 6 ..... Block . .0.5 ........ Lot 29 Subdlmmon ......................... Filed Map No ....... Lot No ............ conforms substantmlly to the Apphcahon for Build~ng Permit heretofore flied m tins office dated .... .~I.a.r.c.h..3.0,.. 1.9.87 pursuant to wtuch Bmldmg Permit No . 1.59q3..Z ............ dated . .Alp r.z. 1..1.3.: .11.9.8.7. ........ was issued, and conforms to all of the requirements of the apphcable provm~ons of the law. The occupancy for which tlus certificate is issued is .. The certfficate ~s ~ssued tb DIMITRI & ALEXANDRA PAPADOPOULOS (o wner,~z!i~¢~ fjCr~f~f~ X X of the aforesmd bmldln§, Suffolk County Department of Health Approval ..8..7-.S. OT.5.1..M..a.r.'..2.2,,..l. 9.8.8 ........... UNDERWRITERS CERTIFICATE NO N854568 Feb. 29, 1988 PLUMBERS CERTIFICATION DATED:MICHAEL ALGOZZINO 2/29/88 Building Inspector Rev 1/81 FO'~'MF ~qO. S TO~N OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL $OUTHOLD, N. Y. BUILDING PEIUGIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) N°- 15903 Z Date Permission is hereby granted to: ....~..~ ....... .~ ......................... ~.~ ...~.~...~..~..o...?. .................................. .~~.....~.:.~..,...~..,...~...,..'..~,... UU~' r'~-4at premi,s located at ...l:,,.~.ff...~....~..,. ........ ..'~.~~w~ ................................ pursuant to application doted ......... I...~. .................... , 19. ., and approved by the Building Inspector. Building Inspector Rev 6/30/80 FORM NO. 6 TOWN OF SOUTHOLD Budding Department Town Hall Southold, N.Y, 11971 765- 1802 APPLICATION FOR CERTIFICATE OF OCCUPANCY Instructions A. Th~s apphcat[on must be fdled ~n typewmter OR ~nk, and submitted ~ ~ to the Build~ng Inspec- tor w~th the follow~ng; for new buildmgs or new use: 1. Fmal 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 electnc~[ mstallanon from Board of F~re Underwmters. 4. Commercial buddmgs, Industrial buddings, Multiple Remdences and slmdar buildings and mstalla~ t~ons, a certificate of Code comphance from the Architect or Engmeer responmble for the buildmg. 5 Submit Planmng Board approval of completed site plan requirements where apphcable. B. For ex~stmg buddings (pmor to Aprd 1957), Non-conforming uses, or buddmgs and "pre-existmg" land uses: 1. Accurate survey of property showmg all property hnes, streets, bulldmgs and unusual natural or topographic features, 2.Sworn statement of owner or previous owner as to use, occupancy and condition of buddings. 3.Date of any housm~ code or safety inspection of bui[dmgs or premmes, or other pertinent informa- t~on required to prepare a cert~fmate. C. Fees' Additzons $25.00 POOLS $25.00 ALTERATION $25.00 1. Cert~ficateofoccup~ncy New Dwellzng $25.00, Accessory .$]0.00 Business $50.00 2 Certificate of occupancy on pre-ex~stmg dwelling $ 50 00 3. Copy of cert~f~cate of occupancy $ 5 00, over ~ years $]0.00 4.Vacant Land C.O. $ 20.00 ~~/~, /.~.~..~. 5.Updated C.O. $ 50.00 Date. .~-,,.,, .... NewConstructlon · ' i ' ' Old or Pre-ex~stmg Building .......... Vacant Land ............ Location of Property .................................................... House No. , , · ~ Stre~ Harm/et Owner or Owners of Property .............................. i..... Lot .~,~. County Tax Map No 1000 Section . .. Block ................ Subdw~mon ...... , ........... Fded Map No ..... Lot No Perm,t No./..~.~.-~... Date of Permtt ...... Apphcant . .~/.'~./.~.~. '.~..~..~ Health Dept Approval . .~..'~...". ~..~. -- '~'/ .Labor Dept. Approval Underwmters Approval ................... Plannmg Board Approval ................ / Request for Temporary Certificate ............... F~nal Certificate ....................... Fee Subm,tted $ .~.~. -~. ............. Construction on above des Rev 10 10-78 Applicant ." ¥ ......... ~ ................ -/3 Is THE NEW YORK BOARD OF FIRE UNDERWRITERS 1C00062 BUREAU OF ELECTRICITY ~'tg 85 JOHN STREET, NEW YORK, NEW YORK 10038 THIS CE~IFIES THAT mitres Papadapoulos, Ruth RoaU, (BreaKwater ~&~en~ R~)Ma~tuc~, NY u~sexemmedon February 22, 1988 andfoundtohe,ncon,phan~eu~ththerequ~reme~t~ofth~l~oard RXTURE ~ I FIXTURES RANGES OUTLETS .~ECEPTACLES SWITCHES · DRYERS FURNACE MOTORS FEEDERS COOKING DECKS OVENS DISH WASHERS EXHAUST FANS TIME CLOCKS MULTI-OUTLET DIMMS:ES SYSTEMS NO O~ FEET SERVICE DISCONNECT S E R V I C o*~5~.~1- lhp Jacuzzi 4-G.F.C.I. 1-Smoke detector AWG OF CC COND 2/0 Gustav Bartra 227 E Breakwater Road Mattituck, ~Y 11952 Lic~f1529E GEf~,~A[ MANAGRR Th~s certificate must not be aJtered in any manner, return to the office of the Board if ~ncorrect Inspectors may be Jdenhf~ed by their credenhaJs COPY FOR BUILDING DEPARTMENT THIS COPY OF CERTIFICATE MUST NOT BE ALTERED IN ANY MANNER TOWN OF SOUTHOLD OFFICE OF BUILDING INSPECTOR P.O BOX 728 TOWN HALL SOUTHOLD, N.Y. 11971 TEL. 765-1802 CERTIFICATION Date I certify that the solder used in the water supply system contains less than 2/10 of 1% lead. (plumbS' s ~Jature ) Sworn to before me thzs ~ day of ~_~x~ , Notary publ~c,~j~ County TOWN OF SOUTtIOLD OFFICE OF BUILDING INSPECTOR P.O, BOX 728 TOWN HALL SOUTIIOLD, N.Y. 11971 TEL 765-1802 To whom This May Concern, We are unable to complete your Certificate of OccUpancy because .of the following re,sons. /_~/ An application for Certificate of Occupancy i~ not on fx!e. ~ /~__~N? Underwriters Certificate on file. The check is(outdated/not On file.) ~N~ }lealth Dept. Approval on file. /5/ N9 flnal inspection has been made. Please contact our office on this matter. Thank you for your cooperation. Building Permit # / ~ ~ ~ k Z Building Dept. ***/~No Plumber Solder Certificate on file. all permits involvmng plumbing being issued after April 1,1984 ) OUNDATION (1st) OUNDATIOi ( 2nd ) 0UGH FRAME & PLUMBING ~iSULATIO~ E~R N. Y~. STATE ENERGY CODE FINAL ADDITIONAL COMMENTS: 765-1802 BUILDING DEPT. INSPECTION FOUNDATION 1ST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND L ULATION FRAMING [ ]FINAL REMAR~KS: ~' .~_ ~ ~ INSPECTOR ~--~~ DATE × / / 765-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION 1ST [ ]ROUGH PLBG. [ ] FOUNDATION 2ND [ ]INSULATION [ ] FRAMING [ ]FINAL REMARKS: DATE 765-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION 1ST [/.-]"'ROUGH PLBG. FOUNDATION 2ND [ ] INSULATION 765-1802 BUILDING DEPT. INSPECTION FOUNDATION 1ST [~'*]~ROUGH PLBG. FOUNDATION ZND [ J INSULATION ~RAMING _~ J FINAL . ~AT[ :/~/~ ~ ~NSP~O~ ~~ / '/~ / , 765-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] INSULATION [ ] FRAMING ~r ~'/~INAL REMARKS: , ~_~**-~ , DATE INSPECTOR ~ ~.~ "-'*-~ 765-1802 BUILDING DEPT. INSPECTION /FOUNDATION 1ST [ ] ROUGH PLBG. FOUNDATION 2ND [ ] INSULATION FRAMING [ ] FINAL REMARKS: DATE INSPECTOR /~/~~ 765-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION XST [ ] ROUGH PLBG. [,~OUNDATIoN ZND [ ] INSULATION [ ] FRAMING [ ] FINAL REMARKS: ./ ,,- DATE Examined ~ Approved . ..~ Dmapproved a/c BOARD OF HEALTH 3 SETS o ./tSN: FORM NO I SURVEY ..~..j2~f.. TOWN OF SOUTHOLD CHECK .... t~. .... BUtLDINGDEPARTMENT SEPTIC FORM ...~ TOWN HALL NOTIFY ~ ~- ?> TEL . 765-~80~ CALL .............. MAIL T0: 7. a , 198../ (Building Inspector) APPLICATION FOR BUILDING PERM IT Date INSTRUCTIONS a Tins application must be completely filled in by typewriter or in ink and submitted to the Building Inspector, w~t 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 adjolnlng premises or pubhc strc or areas, and giving a detmled description of layout of property must be drawn on the dlagmm Much is part of ttus ap caUon. c. Thc work covered by fins application may not be commenced before issuance of Budding Permit d. Upon approval of this application, the Building Inspector will issued a Budding Permit to the apphcant Such per. shall be kept on the premises available for mspectlon throughout the work. e. No budding shall be occupied or used in whole or in part for any purpose whatever until a Certificate of Occupm shall have been granted by the Building Inspector APPLICATION IS HEREBY MADE to the Budding Department for the issuance of a Bmldlng Permit pursuant to Building Zone Ordinance of the Town of Southold, Suffolk County, New York, and other apphcable Laws, Ordinance- Regulations, for the construction of buddings, additions or alterations, or for removal or demolmon, as hereto descnb The applicant agrees to comply with all apphcable laws, ordinances, bp~l-d~ c~, hou~¢g cod~ and regulations, and admit anthonzed mspectors on pfemlses and m bmldmg for necessary ~~~ (Marling address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electncla~,, plumber or build (as on the tax roll or latest deed) If apphcant is a corporation, slghature of duly authorized officer (Name and title of corporate officer) ALL CONTRACTOR'S MU~ RE SUFFOLK Builder's L,cense No Plu,nber's License No ~D/~ .... Electncmn's hcense No . ~.~ Other Trade's License No ' 1. Loci_tlon of land on which proposed work will be done House Number Street County Tax Map No ,000 Section /: ~ Block . ...~ .... Lot ~ ~. ..... 2 Subdtwsion .... Filed Map No Lot (Name) State existing use and occupancy of premises and intended use and occupancy of proposed construction a. Existing use and occupancy /4/ff/qt/~ ..... b. Intended use and occupancy //~/~/'X~/. ~)~4//~'~/~/'//1~,~r'~7'7. ..... ~ .. "' 3. Nature of work (check which applicable) New Building . V Addition Alteration . Repar ..... Removal .......... Demolition Other Work ~ (Description) (to be paid on fihng this application) 5 If dwelhng, number of dwelling units ........ Number of dwelling units on each floor ............ If garage, number of cars ............................................... 6. If business, commercial or mlx~d occupancy, specify nature and extent of each type of use ................ 7. Dimensions of existing structures, if any Front ... Rear ........... Depth ........ Height ...... Number of Stones ........................... Dtmenslons of same structure with alterations or additions Front .. Rear ........... Depth .......... Hmght ......... Number of Stones .................. 8. Dunenslons of entire new construction Front ...... Rear ............ Depth ........... Height ......... Nu[Ober of Stones ................................ ~ .......... 9, S~zeoflot Front ~ I J /~DI ...... Rear .... ttS.~I ........ Dep~ .1~.~ ....... 11 Zone or use district ir/wi{ich premises are situated. ' ",~.". t(~W.$..22>~'c'A//2'.4s2~. 74'.. ~3~-'~,(. &o./ ~',~-.. ,'q...Z4' 12. Does proposed construction v?l~te any zoning law, ordinance or regulation x.4~/ ~. ................ 13 W,11 lot be re~raded . /~,V . . ,,~ ,,~.. ..., ~Vlll exc_ess Fill be removed from nrmmlses: _ Yes ~ Name of Arclutect~AIAtg~,~t'r~ /U.- ~7~t~7't~.Z~i . Address ............ i Phone No ........... Name of Contractor .......... Address ........... Phone No ,....,-? ....... 15. Is th~-s property located with~_n 300 feet of a tidal wetland? Yes ..... No . f.~f.. *If yes, Southold Town Trdstee$ Permit maybe reouired. PLOW DIAGKAM Locate clearly and d~stinctly a/l bufldmgs, whether existing or proposed, and indicate all set-back dzmenslons from )roperty hnes Give street and block number or descnpnon according to deed, and show street names and indicate whether ntenor or corner lot 3TATE OF NEW YORK, S S'~ 'OUNTY OF .,...,.r~ ,. .. , ....... ~ ~jt/ ~ / b y being duly sworn, aep~es and says that he ,s the apphcant (Name of ~nd~v~dual s~ing contract) te ~s the ................ ~ ............. (Contractor co,orate officer, etc.) )f said owner or ownem, ~d ~s duly authorized to perfo~ or have perfo~ed ~e said w~and to m~e~ fi~[~ pphcahon; that all statements contmed m th~s apphcatmn are true to ~e best ofh~s ~o~~-~ee ~ork will be perfo~ed ~n the m~ner set forth m the apphcatmn filed therewith. ,worn to before me th~s ...... ~...d yo . ....~ ........ , y t ....... oun,y It) /V/AT T/TO' K, A/. k/ The ~wage dls~ and wa~r supply fa~ ~ ~ Location have ~en m=~cted by tins ~Oad~nt ~t~ d ,- ~.. ,2.5 RODERICK VAN I]/YL. P.C LICENSED LAND SURVEYORS GREENPORT NEW YORK STATEMENT OF INTENT THE WATER SUPPLY AND SEWAGE DISPOSAL SYSTEMS FOR THIS RESIDENCE WILL CONFORM TO THE STANDARDS OF THE SUFFOLK CO- DEPT. OF HEALTH SERVICES APPLICANT SUFFOLK COUNTY DEPT O~ HEALTH SERVICES -- FOR APPROVAL OF CONSTRUCTION ONLY DATE- H.S REF NO APPROVED SUFFOLK CO TAX MAP DESIGNATION DIST. SECT BLOCK PCL OWNERS ADDRESS. DEED L ~¢ ii qr~vel SEAL C RODERICK VAN 'F_UYL, P C LICENSED LAND SURVEYORS GREENPORT NEW YORK H S NO .... STATEMENT OF INTENT THE WATER SUPPLY AND SEWAGE DISPOSAL SYSTEMS FOR T/J SUFFOLKS9 (si : su~ cou"~ ~H~djlj~ HCA SERVICES D I~OF HEALTH SERVICES -- for APPROVAL OF . s_ REP NO - '~ ~l APPROVED ~----~ ~ SUFFOLK~CO T~X ~P D[SI~N~TION DIST SECT BLOCK PCL OWNERS ADDRESS P .~ Z~c..~ ~,,.:,'7 TEST HOLE I STAMP I OCCUPANCY OR USE IS UNLAWFUL WITHOUT CERTIFICATE OF.OCCUPANCY SOLDER USED IN WATER SUPPLY SYSTEM CANNOT EXCEED 2/10 of I% LEAD. PLUMBER CERTIFICATION ON LEAD coNTENT BEFORE CERTIFICATE OF occUPANCY If eopl~'tublng la used for wat~ distributing al/~tam; piping shall be of types K or L only AtlPROV, ED AS NOTED NOTIFY ~UILD~NG 71~B-1502 9 A~ FO a PM FOR THE FOLLOWING ¸4, Fi OOT-4-. ELAP'--L 5'8 '0" Phone 47~0400 Road F j r