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HomeMy WebLinkAbout15303-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. Certificate Of Occupancy No. z-t620q. .. Date . Se.p. temb. e.q 2.4. x !9.87 ........ THIS CERTIFIES that the building . .qN.E .F. AM!LY' DWE. LL. IN.q ...... 3025 Stars Road East Matron, New York Location of Property ~[~use 'tVo ' ' St/eet ........ County Tax Map No 1000 Section 022 Block 02 Lot . 20 '' Hamle~ Subdivision Filed Map No ...... Lot No ............ conforms substantially to the Application for Braiding Permit heretofore filed in this office dated Se.p.t.e. mb. er., 1.0, 1986.. pursuant to which Bmlding Permit No . 1.5.3.03. .z. ..... dated . .Sep. te.m.b, er 2.2. ,.. 198.6. ..... was issued, and conforms to all of the reqmrements of the apphcable provmtons of the law The occupancy for which this certificate is msued ~s .. ONE FAMILY DWELLING AS APPLIED FOR The certificate ~s issued to JOHN SGOUROS ~ow. er,~&a~a~'~ ........... of the aforesaid braiding Suffolk County Department of Health Approval .... 14 - S O- 2 58. ................... UNDERWRITERS CERTIFICATE NO. PENDING PLUMBERS CERTIFICATION DATED: September 17, 1987 Rev 1/81 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N. Y, BUILDING PER~,~,IT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) Permission ~s hereby granted to .... ....%~........~.~.~~ ................... ..... ! ~ .~.~. !.¢....~..~.....~...~,. ..... ~;~ .......... ~,~.,...u~.~*~. ............... ~-, ................................ ii~ii~i~.~.ii ~ ii'~ ........................................................... ~~ ~.- at premises Io~ated at ................................. ~unty Tax Map No 1000 Sect,on .(~ ~.,;~ Bilk .... ,,O..,.'~... .... Lot No ....~....O. ...... i~'~..~..~4, .. ..... , and approved by the Y.~ 19.? pursuant to apphcahon doted Building Inspector Fee $.~.(~ ,L,J*..~. Building Inspector Rev 6/30/80 FORM NO. 6 TOWN OF SOUTHOLD Building Department Town Hall Southold, N.Y. 11971 765 - 1802 BLDG, DEPT. T~,~N OF SOUTHOLD APPLICATION FOR CERTIFICATE OF OCCUPANCY Instructions A. This application must be filled in typewriter OR ~nk, and submitted t~ to the Budding Inspec- tor with the follow~ng; 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 buddings, Industrial buddings, Multiple Remdences and mmilar buildings and ~nstalla- t~ons, a certffmate of Code comphance from the Architect or Engineer responsible for the budding. 5. Submit Planmng Board approval of completed s~te plan requirements where apphcable. For existing buddings (prior to Aprd 1957), Non-conforming uses, or buddings and "pre-existing" land uses: 1. Accurate survey of p~operty showing all property hnes, streets, buddings 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 housing code or safety inspection of buddings or premises, or other pertinent ~nforma- t~on required to prepare a cerbfmate. C. Fees' 1. Cert~ficate of occupancy $25.00 -- BUSINESS $50.00 ACCESSORY $I0.00 2. Certificate of occupancy on pre-existing dwelling $ 50.00 3. Copy of cert[fmate of occupancy $ 5.00, over 5 years $]0.00 4.Vacant Land C.O. $ 20.00 5.Updated C.O. $ 50.00 Date ...................... NewConstPuctzon. F/ Old orPre-ex~stlng Budding Vacant Land Location of Property .~. c?. Z.~. ...... .~. ,q~. ?..~, .~. ..... ,~1~) . .....~.~[~-.,. , ~..~. ?.. j.?.~ ...... House No. Street Hamlet Owner or Owners of Property . .~.?,~..,~. ...... %..~. ~ ~ .~.?. ~ .............................. County Tax Map No. 1000 Sect,on .~, ~.?- .... Block ,. ,o., .~:. ........ Lot .... ~ ........ Subd,v,slon .%~/~.g~ .... ~-:I..A.~ o ~ ...... F,led Map No g,.~..~..~.. Lot No...~. ,~. ...... Perm,tNo .I..~.~~-~ DateofPermtt~.l~>.l?.~..Appl,cant ~-~-'~ ¢~:~o~R.m% Health Dept. Approval .................... Labor Dept. Approval ....................... Underwriters Approval ................... Planning Board Approval .................. Request for Temporary Certffmate .................... F~nal Certificate ....................... Fee Submitted $ ....................... Construction on above described budding ancOpe~m~t m~e't'x)all applicable codes and regulations Rev 10 lO 78 HENRY J. SMITH & SON, PLUMBING, HEATING & FUEL OIL MAIN ROAD SOUTHOLD, N Y 11971 (516) 765--3690 lDo, CERTIFICATION D a t e- S e p t_.e_mb e_ r_ _12~ _1_9_~- Buildmng Permit No.__l~O3_~ ...... Owner__J_ohn_U~_o_u~ ..... Plumber Hen~z J. Smith & Sonz Inc. I certify that the solder used mn the water supply system contains less than 2/10 of lZ lead. Henry 2. Smith Sworn to before me this 17th d a y o f _S_e~te_m_b_er___, 19 87 , '~ ~ #4B"~4893 Notary Pdblic Notary Public, Suffolk County N~TARY PUBLIC, State at lCew York SUFFOLK COUNTY DATE~ The sewage disposal location have been ~n other, OF H DWELLING REF NO. SERVICES Chief, of Wastewater Maria OUNDATION (1st) OUNDATION ( 2n~ ) OUGH FRAME & ?LUMBtNG NSULATION PER N. STATE ENERGY CODE FINAL AL COMMENTS: A 1~ P--..A 2'2,OO¢ 5,F. ,~ I~OM PIPE [] HOl'-4 U M F--..N T NO% ES: [.I.7OTNO'$SHO ,, PI (~--"~')~_E,.FE~T~IVl,APOF 5TA~fSt'.dArdO~ ~, StJRVE¥ I%z,,p oE '¢¢NIS',~P-.~I?,~IR'rT 15 ATTA~HEP. 5F-F...,~OTE ]65-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLBG. FOUNDATION ZND [ ] INSULATION 765-1802 BUILDING DEPT. INSPECTION FOUNDATION 1ST FOUNDATION 2ND FRAMING [ ROUGH PLBG. INSULATION FINAL DATE 'z'///~ z*-/~ ~ INSPECTOR ~. ~ ~,~ 765-1802 BUILDING DEPT. INSPECTION FOUNDATION 1ST [ ] ROUGH PLBG. FOUNDATION ZND [ ] INSULATION [ ] FRAMING [~NAL REMARKS: 765-~802 BUILDING DEPT. INSPECTION FOUNDATION 1ST [ ] ROUGH PLBG. FOUNDATION 2ND [ ~NSULATION FRAMING [ I FINAL DATE 765-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION 1ST ~ROUGH PLBG. [ ] FRAMING FOUNDATION 2ND [ ] INSULATION £ ] FINAL REMARKS 7GS-~802 BUILDING DEPT. INSPECTION [ ] FOUNDATION ZST [ ] ROUGH PLBG. FOUNDATION ZND [ ] INSULATION FORM NO. I TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N.Y. 11971 TEL.: 765-1803 Approved~9,1~laa-a-- ~.1,, 19~(0 Permit No Disapproved a/c .......... ................. (Buildmg Inspector) APPLICATION FOR BUILDING PERMIT Date ............. 19 INSTRUCTIONS a Tins application must be completely filled m by typewriter or in ink and submitted to the Budding Inspector, w~; sets of plans, accurate plot plan to scale. Fee according to schedule b. Plot plan showing location of lot and of buddings on premises, relationship to adjoining premises or pubhc str or areas, and giving a detailed description of layout of property must be drawn on the diagram which is part of this a! cation. c. The work covered by tins apphcatlon may not be commenced before issuance of Budding Permit d. Upon approval of this application, the Building Inspector will issued a Building Permit to the applicant Such peJ shall be kept on the premises avadable for inspection throughout the work. e. No building shall be occupied or used m whole or in part for any purpose whatever until a Certificate of Occup, shall have been granted by the Building Inspector. APPLICATION IS HEREBY MA~DE to the Budding Department for the issuance of a Bmlding Permit pursuant to Bmldlng Zone Ordinance of the Town of Southold, Suffolk County, New York, and other applicable Laws, Ordinance Regulations, for the construction of buddings, additions or alterations, or for removal or demolition, as hereto descril The applicant agrees to comply .with all applicable laws, ordinances, bufldml~ code, ho_using code, and regulations, an, admit authorized inspectors on premises and in building for necessary lnspecti{~nsI ~ ~ , o (Slg~ai~r~ of ~ppl~a~il ;r ~ame, i; ~ 'c;;~;rai;o~)' State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or buil Name of owner of premises 51. o{4 r--, ~A r0e e~ ~-~c,o~ c,% (as on the tax roi1 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 ........... Electrician's License No Other Trade's License No House Number Location of land on which proposed work will be done ............ Street Hamlet ~ ~'~ Block .~ ~ . . Lot ~ o County Tax Map No 1000 Section Subdivision ~-%TA ¢ c~ ¢5 ~, N' ~ ~ ....... Filed Map No ~ &'(' c{ (Name) State existing use and occupancy of premises and intended use and occupancy of proposed construction a ExIsting use and occupancy ~Ac ~ t~'r Intended use and occupancy Lot . V Z 3. Nature of work (check which applicable) New Budding .....~.... Ad&tlon... .... Alteration Repmr ...... Removal .......... Demoht~on ......... Other Work ......... ' ~ (Description; 4 Estimated Cost .............................. Fee ............ (to be paid on flhng this application) 5. If dwelhng, number of dwelhng umts . t ..... Number of dwelling units on each floor.. ./. If garage, number of cars ..................................................... /5 If business, commercial or mixed occupancy, specify nature and extent of each type of use ................. 7 Dlmenmons of existing structures, ~f any. Front ...... Rear ........... Depth ........... Height ......... Number of Stones .................................... Dh~nenmons of same structure w~th alterations or ad&t~ons Front .............. Rear ............ Depth ........ Height ............. Number of Stones ................. 8. Dimenmonsofant~renewconstmction. Front'~('~ ~o%--{ Rear Depth Height .... i' N~m?er of Stones ......................................... 9. Size of lot' Front ~.e?..,~.¢. ,~t ....... Rear .................. Depth ................. 10. Date of Purchase .............. Name of Former Owner ................ 11 Zone or use district in which premises are situated ~, a ¢ ~ ~ ~. ~'r .t.~..~. ......................... 12. Does proposed construction violate any zoning law, ordinance or regulation ....................... 13. Will lot be regraded ........ Will excess fill be removed from premises Yes 14 Name of Owner of prem~ses X?.'!/. ~,c~o~2~,5 Address ffg. IS..~ff?.t2~c?..?.~.. Name of Architect ?' ~ a ~ ~ ? u.~,.~ ,.x ~. i' ]. ] ] . Address ct t..e. t,..~,7...~.':/' Phone No ~z ,.2....~.%.~! j.o Name of Contractor Address ................. Phone No .......... * Yes .. . No .~. 15. Is this property located withinl00 feet of a tidal wetland? * If yes, Southold Town Trustees Permitmay be required. PLOT DIAGRA~ Locate clearly and distinctly all buildings, whether existing or proposed, and~indicate all set-back dtmenmons fr property lines. Give street and block number or descnphon according to deed, and show street names and indicate whet interior or comer lot. STATE OF NEW YORK, COUNTY OF ~. F~Tc't~ ... SS .~.'--~ 5~./O . ~. ~ t? ~.~ ~c, ~ ..... being duly sworn, deposes ~d says that he is the apphc (Name of mdawdual m~ng contract) above nmed He ~s the 0 ~o ~ ~ ~ (Contractor, agent, corporate officer, etc ) of smd owner or ownem, ~d ~s duly authored to perfom or have perfomed the smd work ~d to m~e ~d ~e apphcatmn, that all statements contmed m thru apphcat~on are true to the best of ins ~owledge and behef, and that work will be perfo~ed ~n the m~ner set for~ m the apphcatmn filed therewith. Sworn to before me th~s .................. ,19.5 .¢ $ota~Pubhc .... ~. ~...~3 ~... County _~ ~ ,"'I 7,~3G 30 F_ 120.O ? 579° P,A NTEL $ coQOUROS ~.~AST PIA~IO~ OF' 5OJT HO.D N.Y. A~A ~2OO~ 5,E m IF~OM PIPF- u HOMUMSNT 5TATEH.ENT OF iHTEH'f ~ TH~-WATERSUPPL'f'AHD 5EWAd~E D~ISPOSAL 5TSTIEHS F~R THIS ,~-SiD1EHC-E Wlbb GOHFO__~H TO, '[HE 5'fAHDARD5 d~F THE 5LIFF~K ~HT¥ I~EPT, ~F ~P_.ALT'H ~NSTRUC~Io~ O~Y./r~- 5U~FO.~ ~ TAX NAP DESIGMATI~ ~o ~ ~ ~o ~A[~ N.T, T~T HO~ blOaT ES,: HIGHPoIN T"- 5UFF. LOT 23 pl~T, tooO OD. ~dA P No, / · IROM PiPE I, LOT N0'5 SHOW~ THUS ~ ~EF~ TO ~p OF 5TARS ~A~O~. "'HAP OF' A~UAV¢=W / 6L/FF. ~O. MAP. NO Residence Pantelis Sgobros LOT, 22 EAST MARION TOWN OF SOUTHOLD, NEW YORK OCCUPANCY OR USE IS UNLAWFUL WITHOb~ CERTIFICATE OF ocCUPANCY APPROVEDI A~ NOTED NOTI~ BUILDING OEPARTMENT AT 76~1802 9 Afl4 TO 4 ~ ~R THE FOUNDATION l~JO ~EQ~RED 2 ROUGH FRAMING & PL[JM~ING 3. INSULA FION ALL CONSTRUCTIO~ SHALL MEET THE EEQUIREMENT~ OF THE N.Y ~ CONSTRUCTION & ENERGY ~6~;GN OR CONS~U~ION ERRORS. eoA~el"tUblng II used dbtributlng aha//b~ 41 East 11th Street New York, N.Y. 10003 Title: PbOa' PbAH ~hto7~ Drawn Check Scale Date .,/ j/ / / COLUMN VbHT ~ltO" 17'-0" NIE.CI'I' L GLo Residence Pantelis Sgouros LOT 22 EAST MARION TOWN OF SOUTHOLD, NEW YORK Mark B, Sullivan, R.A., R.L.A. Architects/Landscape Architects 41 East 11':h Streelt New York, N.Y, 10003 '~tle: Drawn 5PL, Check SPt, Sca;; f/~' )< ~L. 5GDo UP E.L WOOD ~LSZo IOLO" '% Residence Pantelis Sgouros LOT 2 2 EAST MARION TOWN OF SOUTHOLD, NEW YORK Mark B, Sullivan, R.A:, R~L.A. Ar '~hil~,~ ~Lands~al~ Amhlteets 41 '-East,Il th Streat , New York, N.Y. 10903 ' Title: , : Drawn 'Se't'/U:'t1' : ' ' Check.-~'g' ~ ~ I~, ~ :, ' ': sc~e 1/43 ltd' ' DaJe :~1 ,AUG' '1~,~,: A,,+ 2 l-- _ AKc~ W^T Residence Pantel. is Sgom'os LOT 22 EAST MARION~ TOWN OF SOUTHOLD, NEW YORK Mark B. 8'ulliva6,, R.A., R.LA. Architects/Landscape Architects 41 East 11~1 Street N~'w 'York, N.Y. 10003 Title: Drawn Cheek Scale Date oD Residence Pantelis Sgouros LOT 22 EAST MARION TOWN OF SOUTHOLD NEW YORK Mark B. Sullivan, R.A., R.L.A. Architects/Landscape Architects 41 East 11th Str~eet New York, N.Y. '10003 Title: I~I.F.V/'kTtO~ ~^Clh~C~ EAST Drawn Check s~am Date ILO`' A-4 4 _ j Residence PanteliS Sgouros LOT 22 EAST MARION TOWN OF SOUTHOLD, NEW YORK IsT FL~O~ P.-L meca4 EL., ~L. -I-C~ I~'~ FUCON LivING ' I Mark B. Sullivan, R.A., R.LA. Architects / Laedsca~pe Architects 41 East 11th Streelt New York, N.Y. 10003 Title: :- b~vATIO~ FACII~G 50UTI~-F. AST Drawn 5PL,/th'/, C, eck Scale Date CE. IL~& EL. 17L2"~ Fo~ I~LEyAT IOi~ $~ ~W~: A-7 ~ 17L2I~ Residence Pantelis Sgouros LOT 2 2 EAST MARION TOWN OF SOUTHOLD, NEW YORK Mark B. Sullivan, I;I.,A:, R.LiA. '- Architects/Landscape Al~chilects 41 East 11th Street New York, N.Y. 10003 '~fle: Drawn_ Check_.S~L/ Scale ~ Date ~ FOl~ ~k, -ILG" J LIVlI~G RooH ~EVE.~. Residence Pantelis Sgouros LOT 22 EAST MARION TOWN OF SOUTHOLD, NEW YORK Mark B. Sullivanl, R.A., R,L.A. Amhitects/L~ndscalPe Architects 41 East 11th Street New York, N,Y. 10{))03 Title: f~L~VATIOI~-F~Oi'-Id~ W~_~T, A-7 I1, LIVIMG ~OM LE. VF...L b Residence Panteli,,, Sgouros LOT 22 ' EAST MARICN-. TOWN, QF S~UTI~OED, NEW,:YORK Mark B. Sullivan~ .R,A., R.L.A. A?ohit~ts/Land,~ap,/~u'chitect~ 41 East llth Street New York, N;Y. 100[~3 Title: Drawn Scale Date II · Residence Pantelis Sgouros LOT 22 EAST MARION TOWN OF SOUTHOLD, NEW YoRK ~ ~ ~ ~EHT . Mark al Sullivan, R.A., R.LA Architec~/~dsc~e ~ehitec~ ,. 41 East 11~ Streel New Yo~, N.Y. 1~ T~le; Drawn Check ~PL/H~5," ", Residence Panteiis Sgouros LOT 22 EAST MARION TOWN OF $OUTHOLD, NEW YORK Ma~ B. Sull van~ 'R;A, R.LA . Archit~ts/~n~ ~ Che~ Residence Pantelis Sgouros LOT 22 EAST MARION TOWN OF SOUTHOLD, NEW YORK Archfl~ts/Land~ Archll~ I 41 Ea~ 11th ~re~ New Yo~, N.Y. Drawn 5PL~.d.T. ,"l[:1 I // 14'- 0u {750" :I I- Residence Pantelis Sgouros LOT 22 EAST MAR~ON TOWN OF 8OUTHOLD, NEW YORK Mark B. Sullivan, R',A., R.LA." Archftects/LandSCaP~ Architects 41 East 11th Streel New York, N.Y. 10003 Title: Drawn. Check 5PL.~ Residence Pantelis Sgouros LOT 22 EAST MARION TOWN OF SOUTHOLD, NEW YORK Mark B. SUlflvan, 'R.A., .'R.I~ Architects/Landscape ~r~hffects 41 East 11th Street New York, N.Y. Drawn Residence Pantelis Sgouros LOT 22 EA~iT MARION TOWN OF SOUTHOI~D, NEW Y'ORI~ Mark B. Sullivan~ 'R',A., R.'L,A. Architects/Landscape Architects 41 East 11th Slreet New Yo~, N.Y, 10~3 Check ~HDAq'HING, Residence Pantelis Sgouros LOT 22 EAST MARION' TOWN' OF SOUTHOLD, NEW YORK Mark B, Sultiva, ni:R:A., R.L A. A~t~ct,~/Lar~ .a~~ 41 East1,1th Street New' Yol% N.Y. 1~003 , Title: ,~ o,,*, :4:.s~ /: ,';~.":' '.v" . ~ q"¥PI..d/AL SCAB[. I'= I~0I' ¸%. TYP- M/~LL ~ coHl'~,UCTIOt~ C. z2~l S'l' ~ ~CTI ON ILo`' DF?Al L. WALL ~ToH~- LI~IHG F-,H- ¢- [2' o c. WALL V,,~oop bASE.~ F..H T Residence Pantelis Sgouros LOT 22 EAST MARION TOWN OF SOUTHOLD, NEW YORK Mark B. Sullivan, R.A., R.L.A. Architects/Landscape Architects 41 Easl 11th Street New York, N.Y. 10003 Title: WALL SEC~']O~ 5 Drawn S~L. /,~ R Check 5PL // hl 65 Scale /~S 5fl©WN. Date ~ AUG ~ . ~ ~" b'~l~t~'~" ~ ': _ II ~"~ ~ I1~11 ' .. . ~ ~, . ;..p~,, , N I1~*'~*'~a~.,~ ~ ' ' ~ ~ I IL.