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HomeMy WebLinkAbout26634-z FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No: Z-27691 Date: 05/16/01 THIS CERTIFIES that the building ADDITION Location of Property: 960 WILLIS CREEK DR MATTITUCK (HOUSE NO.) (STREET) (HAMLET) County Tax Map No. 473889 Section 123 Block 10 Lot 1 Subdivision Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated MAY 12, 2000 pursuant to which Building Permit No. 26634-Z dated JULY 3; 2000 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 ALTERATION &ADDITION TO EXISTING ONE FAMILY DWELLING AS APPLIED FOR. The certificate is issued to PATRICIA GAZOULEAS (OWNER) , of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A ELECTRICAL CERTIFICATE NO_ 105379 04/04/01 PLUMBERS CERTIFICATION DATED N/A /-/Authorized Signature Rev. 1/81 FORM NO. 3 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) PERMIT NO. 26634 Z Date JULY 3, 2000 Permission is hereby granted to: PATRICIA GAZOULEAS 960 WILLIS CREEK DRIVE MATTI TUCK NY 11952 for ALTERATION AND ADDITION OF AN EXISTING ONE FAMILY DWELLING AS APPLIED FOR. at premises located at 960 WILLIS CREEK DR MATTITUCK County Tax Map No. 473889 Section 123 Block 0010 Lot No. 001 pursuant to application dated MAY 12, 2000 and approved by the Building Inspector. Fee $ 75. 00 Authorized Signature Rev. 2/19/98 ORIGINAL • Form No. 6 TOWN OF SOUTHOLD BUILDING DEPARTMENT Y 1 � i TOWN HALL 765-1802 APPLICATION FOR.CERTIFICATE OF OCCUPANCY A. This application must be filled in by typewriter OR ink and submitted to the building inspector with the following: for new building 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 from Health Dept. of water supply. and sewerage-disposal(S-9 form) . 3. Approval of electrical installation from Board off' Fire Underwriters. 4. Sworn statement from plumber certifying that the solder used in system contains less than 2/10 of 1% lead. 5. Commercial building, industrial building, multiple residences and similar buildings and installations, a certificate of Code Compliance from architect or engineer responsible for the building. 6. Submit Planning Board Approval of completed site plan requirements. B. For existing buildings (prior to April 9, 1957) non-conforming uses, or buildings and "pre-existing land uses: 1. Accurate survey of property showing all property lines, streets, building and unusual natural or topographic features. 2. A properly completed application and a consent to inspect signed by the applicant. If a Certificate of Occupancy is denied, the Building Inspector shall state the reasons therefor in writing to the applicant. C. Fees 1. Certificate of Occupancy - New dwelling $25.00, Additions to dwelling $25.00, Alterations to dwelling $25.00, Swimming pool $25.00, Accessory building $25.00, Additions to accessory building $25.00. Businesses $50.00. 2. Certificate of Occupancy on Pre-existing Building - $100.00 3. Copy of Certificate of Occupancy - _ .25V 4. Updated Certificate of Occupancy - $50.00 5. Temporary Certificate of Occupancy - Residential $15.00, Commercial $15.00 Date . ./ l3 . ./. G?:Qjql. . . . . . . . . . . . . . . . . New Construction. .. . . ....q.//. . . Old Or Pre-existing Building. . Location of Property../X:0. . . . . . . . . . . ... .1(/.( h�.!5. . .��'PP�'�. .`;�. ! . . . . .::�. ✓L�. l.�C!!� . House No. Street Hamlet • , • Onwer or Owners of Property. . .20.-i Vt, <<,q, ,�/,JQ (�cJ 1� . , . . . . . . . . . . . . . .. . . . . . . . . . . County Tax Map No . 1000, Section. . ..' d.3 . . . . ,Block. . . ./.O . . . . . . . .Lot. . . . L . . . . . . .�� ��: Subdivision.. .. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .Filed Map. . . . . . . . . . . .Lot. . . . . . . . . . . . . . . . . . . . . . Permit No O?��3:(. ..'L'� ,Date Of Permit. .. . . . . . . . . . . . .Applicant. . . . . . . . . . . . . . . . . . . . . . . . . . . . . Health Dept. Approval. . . . . . . . . . . . . . . . . . . . . . . . . .Underwriters Approval. . . . . . . . . . . . . . . . . . . . . . . . . Planning Board Approval. �43. ./. a 0. 0.d. . . . . Request for: Temporary -Certificate. . . . . . . . . . . Final Certicate. . . . . :!. . . . Fee Submitted: $. . . ,avo , , , , , , , , , , , , , , , , -511 . . . . � :t : . vig.4-0-1-o . . . . . . . . . . 0 . . ��Co t �?� 9 APPLIC LONG ISLAND ELECTRICAL INSPECTION SERVICE, INC. 670 Middle Country Road • Saint James, NY 11780 Tel: (631) 265-3075 Date 04/04/01 Application No.on File 105379 Building Permit No. THIS CERTIFIES THAT our local district inspector conducted an inspection of the visible portion of electrical installation described below and introduced by the applicant named on the above application in the premises of GAZOULEAS 960 WILLIS CREEK ROAD MA_TTITUCK in rhe following locations; ❑ Basement ❑ 1st Fl. CX 2nd Fl. ❑ Outside Section Black Las was esamined on 02/27/01 found to be in compliance with the current edition of the National Electrical Code. ❑ this certificate may be accepted as a"letter of Approval"that all circuits are in good working condition,not overloaded,and all wiring,fauns and other electrical equipment are in standard condition. FIXTURES RANGES COOKING DECKS OVENS DRYERS FINP FANS SWITCHES RECEPTACLES 6f1 DIMMERINCANDESCENT FLUORESCENT NI.D. AMT. SIZE ANT. SIZE AMT. T SIZE AMT. I SIZE EXHAUST PADDLE 3 5 6 DAV LAUNDRY HEATING EOUIP.MOTOR EXIT EMEK6. SUS FEED TILER TRANSFORItERi AIC EDUIP MOTORS GENERATORS AArt• SINE AMT. I SIZE AMT. N.P. SIGNS LIGHT AMT. SIZE AMT I SIZE AMT AMP I TYPE AMT. N.P. AMT. SINE m m M m POOLS MICRO WATER HEATER SMOKE TRACK ELECT SERVICE INF O ABV ❑ NOT DETECT LTG HEAT SINGLE MULTICONDUCTOR NO.OF TUI ❑ Ate• SINE AMT. SIZE -ORS I FT. TYPE AM1hWM PHASE PHASE VOLTS SIZE A TYPE METERS BLO ❑ roa ❑ 1 1 off IlG o: a h OTHER... 2nd flr rear addition W This is not innnded as an approval Ot puetamee of elect icol efficiency end N;OVers Orly to electrical equipment aid mWilabon oaf Mate. LU Upon tm illtr &cfon of additional equipment a almrrmiWis.application `x shad be promptly made lot inspection. SANDSTROM ELECTRIC o P.O. BOX 7 2 �A � W AQUEBOGUE, NY 11901 F GENE R 0 z WHITE-ORIGINAL COPY • YELLOW-MUNICIPAL COPY- PINK-AGENT COPY•GOLD-OFFICE COPY O�Og�FfF0j/r O c� Town Hall,53095 Main Road H Z Fax(631)765-1823 P.O.Box 1179 S .tC Telephone(631)765-1802 Southold,New York 11971-0959 *1 BUILDING DEPARTMENT TOWN OF SOUTHOLD Feb. 6, 2001 PATRICIA GAZOULEAS 960 WILLIS CREEK DR. MATTITUCK, N.Y. 11952 To Whom This May Concern: We are unable to complete your Certificate of Occupancy because of the following reasons : XX An application for Certificate of Occupancy is not on file . (Enclosed) XX No Underwriters Certificate on file . XX The check is (not on file . ) $25 . 00 No Health Department Approval on file . No final inspection has been made . No Plumber Solder Certificate on file . (All permits involving plumbing being issued after April 1, 1984) . BUILDING PERMIT # 26634-Z Please contact our office on this matter. Thank you for cooperation. SOUTHOLD TOWN BUILDING DEPT. M-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION IST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ INSULATION [ ] FRAMING [ ] FINAL [ ] FIREPLACE & CHIMNEY REMARKS: ,DATE I( INSPECTOR ^ 02 T65-180Z BUILDING DEPT. INSPECTION [ ] FOUNDATION iST [ ] ROUGH PLBG. [ ] F ATIOFr YND [ ] INSULATION [ FRAMING P.Q [ ] FINAL [ ] FIREPLACE 8 CHIMNEY REMARKS: L .DATE �� �� � INSPECTOR 765-1802 BUILDING DEPT. INSPECTION [ ] FOUNDA ION IST [ ] ROUGH PLBG. [ ] F DATION 2ND [ ] INSULATION ] FRAMING [ ] FINAL [ ] FIREPLACE & CHIMNEY REMARKS: ,DATE 6th INSPECTOR FIELD INSPECTION RFC'OR'C-- =DATE---�---- -----___ _______COMMENTS==-==___--__-___- -- ---II ----- --- - -_ II II b or II II FOUNDATION ( 1ST) n II u u 'l�-4� II II------ -- --- ------ ---- - II il-------- ----------------- ------------------------ FOUNDATION (2ND) tLmA- ________ _______ iidb _ — - -- tl/ � H Zo ROUGH FRAME & II II IT u PLUMBING II t u n .. =______------ ------ ---- u � 11 1 td INSULATION PER N. Y. STATE ENERGY lu---- 11 CODEu-- 1i II A if—//o y 1 II i II it FINAL I� N a ADDITIONAL COMMENTS: — c s r� H G H C z a rtw tzj ro BOARD OF HEALTH . . . . . . . . . . . . . . . FORM NO. 1 3 SETS OF PLANS TOWN OF SOUTHOLD SURVEY . . . . . . . . . . . . . . . . . . . . . . . . BUILDING DEPARTMENT CHECK . . . . . . . . . . . . . . . . . . . . . . . . . TOWN HALL SEPTIC FORM . . . . . . . . . . . . . . . . . . . SOUTHOLD, N.Y. 11971 DEC . . . . . . . .. . . . . .. . . . . . . . S TEL: 765-1802 TRUSTEE . . . . . . . . . . . . . .. ... . . . . NOTIFY �� — / 0 7/ CALL . . . . . . . . . . . . . . . . . . l (�- MAIL TO: . . . . . . . . . . . . . . . . . . . . Approved.. -24W. Permit No. .aY .l... .................................... Disapproveda/c .................................. .................................... ............................................... ..... - CV r--'r (y (: ........... t' (Building Inspector) APPLICATION FOR BUILDING PERMIT - Date ,S . . . . . . . 20,::2 k INSTRUCTIONS a. This application must be completely filled in by typewriter or in ink and submitted to the Building Inspector wit 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 application. 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 issue 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 MM MARL 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 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 inspections. . 4... ... ............ (Signature of applican or name, if•a corporation) ................................................... (Mailing address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. ........................................................................................................................ Name of owner of premises .. f? +P.Gi�, .�7.... /g T ./C!! ........................................... (as on the tax roll or latest deed) If applicant is a corporation, signature of duly authorized officer. ......................................................... (Nave and title of corporate officer) 4, Builders License No. ............... Plunders License No. ......................... Electricians License No. ..................... Other Trade's License No. .................... 1. Location/off land on which proposed work will be done... ... .G�l.�.Ci..�lr. .e-.4k'...2..9:.......... Ay . .�..,l/...V..../.. .�. ..�....'......................................................... House Number Street Hamlet County Tax Map No. 1000 Section .14.3....... Block ... ......... lot ../............. Subdivision ...................................... Filed Map No. ............... lot ............... (Name) 2. State existing use and occupancy of premise intended use and occupancy of tion: a. Existing use and occupancy .9 :.�........... b. Intended use and occupancy .. �,1.P.�c?.h!c........................• :�.:..:`.`.. .......... Y...... 3. Nature of worts (check which applicable): New Building ........ AdditionAlteration .Y .... ` Repair ............ Removal ............. Ik3hhalition ............ Other Work................. '•• 4. Estimated Cost ..d�,..�(7 f.Q�'1.�?....... fee (Description)..�7� •..r........ ........... .... (to be paid on filing this application)• 5. If dwelling, rnnber of dwelling units ...../.... Number of dwelling units on each floor ................ Ifgarage, ninber of cars ......3 ............................ 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 .................... Height .................... Number of Stories•.............................. 8. Dimensions of entire new construction: Front ................ Rear ............... Depth .............. Ileigbt ......................... Number of Stories 9. Size of lot: Front ...L.�./........... Rear ...... 3d.�............ .3. ./ Depth ... .. 10. Date of Purchase ...../.-� ..... Name of Former Owner .. � 11. Zone or use district in which premises are situated .4-G^ ................................................. 12. Does proposed construction violate any zoning law, ordinance or regulation: .../.':.©.. 13. Will lot be regraded .................... Will excess fill be removed from •.-•.•••.•-.. premises: YES ND 14. Names of Owner of premises .�i ra'.Z,a.t�4Ot;h..... Address .2--P..�!I/c �• �u�� •�p} /�. Name of Architect .................................... Address .............................. Phone No. ..... Name of Contractor .............................. ..... ... Address ...............................Phone No. ......... ........ 15. is this property within 300 feet of a tidal wetland? * YES ......... *IF YES, SOUII Z MM 1R MM-3 P flT MAY BE W!QMRED. ND .......... 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. S['A.li: OF Nil Y()TiK 00LINIY (T. U '( '(�ZS. 'il• SS y sworn, deposes and says that he is the applicant (Name of individual signing contract) above maned, Ile is the .................... _ (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 that the work will be perfonned in the manner set forth in the application filed therewith.applicatioh; that all statements contained in this application are true to the best of his knowledge and.belief; and Sworn to befo a me this ffiai ...... rn j Notary Public ............. LYNDA M.BOHN � �`... ... NOTARY PUBLIC,State of NOW (Signature of Appl . ant) No.01B06020932 Dualified in Suffolk Cou f Term Expires March 8,20 SAW l ro - ' a , 1. l ;/ r1 •' , ; \`'\�. `, jj Tv TIE L11\4E 17 2 !� 11.1•' �,t2` ro • - �:�' INV, £ t t 0, Z41 1� 416 \ I " ' t C..� �f/1� / /•l�}w\i' I �...�I 1 ' - / of / / ., :,.,,"' �-- / ►tiff ;J M'N.� ' lD O�ri rp^�•��J:>i:i ,. .\\ � ,... 1 •r ti jJ/ ' i' ,• r r `� ,�� ► 1 (VAcA T 1. 7 Ski UNDERWRITERS CERTIFICATE REQUIRED C_• PROVIDE '/ HR. FIRE Y. AS NOTE RATED SEPARATION TO �' S.R�► a�. Outi � r PART. 717.3 (f) (1) OF � `�' N.Y. STATE BUILDING CODE. AMTO4'PM PWI,M USE 1S UNLAWFUL WITHOUT CERTIFICATE PROVIDE SMOKE-DE!'ECTtNG FOR POURED CONC11EM ALARM OEVM Z. ROUGH - FRAMMIO • PkA> 111 f, (1� ` i AS TO PARI?t#.! s. INSULATION ` " " ��., ° ILU BUILDING CODE. 4. FINAL - CONSTRUCTION MNST BE COMPLETE FOR C.O. ALL CONSTRUCTION SHALL MINT If Copper wUn0 is umd PLUMBING THE REQUIREMENTS OF THE NAI f(w VI sw dis rbAnO AM PLUMBING WASTE STATE CONSTRUCTION i ENERGY gym;piping Shell be &WATER LINES NEED CODES. NOT RESPONSIBLE FOR Of Wpm Eyk2A TESTING BEFORE COVERING DESIGN OR CONST CTION ERRORS UwEpwR F0TR PL MBER CERTIRCA TION ON AD CONTENT BEFORE CER /GATE OF OCCUPANCY s us D IN=R CI swmm ED .2110 of 1%LEAD. -?6 Y-3 cJ jCJ C.<< k at tuc /4 /Vy r U 1 12 w � _--rte _ _LL o o I'r_.-_-._-_. u.un__-H ga41-11-1.----- k s ti K CX /Sint ,7X -- c! I i C! I I 1.�f�Ynt,n �_ r I �. �^ / �I h J 161�I l S OUL GG z' i i I i nP r r • J l it,r _7 k L7 r l i. LLLL L�rdy, BUILDING PERMIT REVIIJW CHECK LIrI� Applicant/ Date Owners Name: IGS+21 Reviewed: _ Architect/ Date Engineer: Submitted: SCTM #: District: 1,000 Section: Block: Lot: VV Project Subdivision Location: 'r'J Name: -- -- Sin'-le & ..separate Required (� Certification (Yes/No) 0'"" Req Req. Zoning Distrcl [Lot size. Actual_ I [Lot coverage _Proposed 1 Req /�G sy Yj—/1�n1 fi;1.77­r Req. Req [Front Yard Proposed: 1 [Side Yard _ Proposed: ] [Rear Yard Proposed. J Project Description: 7��^� jc� AGENCY PERMITS Permit REQUIRED FOR REVIEW N.A. NO YES Number Suffolk County Health Dept. New York State D. E. C. Town Trustees Town Zoning Board approval: Town Planning Board approval: Flood Plane Elevation??? Flood Zone: Notes: