HomeMy WebLinkAbout24370-z FORM NO. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Office of the Building Inspector
Town Hall
Southold, N.Y.
CERTIFICATE OF OCCUPANCY
No: Z-26025 Date: 10/13/98
THIS CERTIFIES that the building ADDITION
Location of Property: 3970 KENNYS RD SOUTHOLD
(HOUSE NO. ) (STREET) (HAMLET)
County Tax Map No. 473889 Section 54 Block 4 Lot 36
Subdivision Filed Map No. Lot No.
conforms substantially to the Application for Building Permit heretofore
filed in this office dated AUGUST 15, 1997 pursuant to which
Building Permit No. 24370-Z dated SEPTEMBER 22, 1997
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 SECOND STORY ADDITION WITH SECOND STORY DECK TO AN EXISTING ONE FAMILY
DWELLING AS APPLIED FOR.
The certificate is issued to ORESTES G VARVITSIOTES
(OWNER)
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A
ELECTRICAL CERTIFICATE NO. 21579 08/12/98
PLUMBERS CERTIFICATION DATED 07/31/98 MATTITUCK PLUMBING & HEAT
Building Inepec
Rev. 1/81 r
70$M NO. 2
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? 24370 Date ...........f,/„�.Z ............................ 19{ 7/
Permission is hereby granted to: /
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ta . -....... ,1�.......... ..... .. v .........
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... ..,... ,� .............. rP.t............................. ..................................................................
................................................................... ............
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... ... .... .........
at premises located at...al..M ....1./.r ..,. . . ... ....
. . . ...... . .. ..................
County Tax Map No. 1000 Section ...M:S- ............ Block
�.......401....... Lot No. ....Al ...........
pursuant to application dated .........,OAK—...... ?.................. 193.�7 and approved by the
Building Inspector.
Fee 5...� '�—.......
.............. ? rfi ...,........................
ildi Inspector
Rev. 6/30/80
Form No. 6
- �
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN HALL
k... _ 765-1802
tn
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 of Fire Underwriters.
4. Sworn statement from plumber certifying that the solder used in system contains
less than 2/10 of 12 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 85.00, _'
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 Buildin¢ - $100.00
3. Copy of Certificate of Occupancy - .25C.
4. Updated Certificate of Occupancy - $50.00
5. Temporary Certificate of Occupancy - Residential $15.00, Commercial $15.00
Date . . . . . . _. . . .f . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
New Construction. . . . . GG. e
77. . 0 d Or Pre- xistin,ppg Bui,l/dJing. . ✓ . . . . . .
Location of Property (. 0 V . .I,� GlF!�11. �. . . . 1 ``( . . . . . . . . . . . . . . . . . . .�
House No. Street Hamlet
Onwer or Owners of Property. .S!.Y. .. . Q! rr//.?�. !. .. . . . . . . . . . . . . . . . . . .'. . . . . .
County Tax Map No 1000, Section. . ... . ..Block. .?3?A . . . .. . .Lot. . . . .. . . . . . . . . . . . . . . . .
Subdivision. . . . . .``..�. . . . . . . . . . . . . . . . . . . . . ...�. . . . . .Fii��led Map. . . . . . . . . . . .(Lot
o. . . . . . . . . . . . . . . . . . . . . .
Permit No. . 2 .!.�� . . .Date Of Permit. l C !.5�. . .Applicant. .�r'•: - •r• . �l. . !... .
Health Dept. Approval. . . . . . . . . r. . . . . . . . . . . . . .Underwriters Approval. . . . . . . . . . . . . . . . . . . . . . . . .
Planning Board Approval. . . . . . . .^. . . . . . . . . . . . . . .
Request for: Temporary Certificate. . . . . . . . . . . Final Cer ate. . .
Fee Submitted: $. . . . . . '.. . . . . . . . . . . . . . . . . . .
SS���
APPLICANT
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Town Hall, 53095 Main Road w x = Fax (5 16) 765-1823
P. O. Box 1179 \•+� Telephone (516) 765-7802
Southold, New York 11971 a y !
ElmDOFFICE OF THE BUILDING INSPECTOR
+ Z � TOWN OF SOUTHOLD
LDG.DEPT. C E R T I F I C A T I O N
MOB
LD
DATE- 7 37 `rB
Building Permit No .
/� e4:
7o 2
: O
Owner �e��� �v1 pw t t-5; a
(please print) l
Plumber: e. � Plum
Vrv1iJ; -r -- ,Jn0
(please print)
I certify that the solder used in the water supply system
contains less than 2/10 of 1% lead.
AJ I
( ltunbers Signe ar >
Sworn to before me this
day of 19qL9
Notary Public, County
Term 41WIRL
OCY J i
ELECTRICAL INSPECTIO.N SER VICE'INC.
375 DUNTONA VENUE
EAST PATCHOGUE,NEW YORK 11772
(516)286-6642
21579
DATE: 8112198 APPLICATION.No.ON FILE
l7LIAGE: Southold ?OWN Southold
ADDRESS: 3970 Kennevs Road
ISSUED TO: Orestes Parvitsiotes
INTRODUCED By Lademann Electric Inc. LIC No: 4141E
was examined an 8112198 and found to he in wmpliance with the National Electrical Code
LOCATION: Base. 1st 2nd xx 3rd Attic
Det.Garage Hot Tub Pool
SWITCHES RECEPTACLES FIXTURES HEATERS PANS G.F.I. AIR.COND.
12 14 9 1 2-paddle 1
DISHWASHER DRYER CLOTHES WASH. GAR.DISP. RANGE OVEN SMOKE DETECTOR
FURNACE OIL GAS CIR. MOTORS BELL TRAN SERVICEDISCONNECT
AIETEE AMPS PILOSE
07TIER
EQUIPMENT
1-60 Amp. sub panel
HUGO S. SURDI
PRESIDENT
BUILDING PERMIT No. i �eawema:t�wtceamm;n+m nye
Insesmer beidaic5ed by th�admtie7s BLUE
ORIGINAL YELLOW COPYPINK COPY OFFICE
O�OguFfo(,�CO
Town Hall,53095 Main Road yam. Fax(516)765-1823
P.O.Box 1179 • �� Telephone(516)765-1802
Southold,New York 11971
BUILDING DEPARTMENT
TOWN OF SOUTHOLD
August 14 , 1998
Orestes Varvitsiotes
25 Irvington Ulare
Brooklyn, New York 11230
To Whom This May Concern:
We are unable to complete your Certificate of Occupancy
because of the following reasons :
An application for Certificate of Occupancy S
not on file. (Enclosed)
XX No Underwriters Certificate on file.
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 # 24370-Z
Please contact our office on this matter. Thank you for
cooperation.
SOUTHOLD TOWN BUILDING DEPT.
70
765-1802
BUILDING DEPT.
INSPECTION
[ ] FOUNDATION IST [ ] ROU PLBG.
[ ] FOUNDATION 2ND [ ] 1 ULATION
L l FRAMING [ ] FINAL
[ ] FIREPL CH M Ell'
REMARKSJ
DATE < INSPECTOR
765-1802
BUILDING DEPT.
INSPECTION
[ ] FOUNDATION 1ST [ ] ROUG PLBG.
[ ] FOUNDATION 2ND [ ] I LATION
[ ] FRAMING [ FINAL
[ ] FIREPLACE & CHIMNEY
REMARKS:
I !illy
�- e
DATE INSPEC
765_1802
BUILDING DEPT.
INSPECTION
[ ] FOUNDATION IST [ ] R GH PLBG.
[ ] FOUNDATION 2ND [ INSULATION
[ ] FRAMING [ ] FINAL
[ ] FIREPLA CHIMNEY
REMARKS:
.v
DATE INSPECTO
765-1802
BUILDING DEPT.
INSP'ECT'ION
[ ] FOUNDATION IST [ ] ROUGH PLBG.
[ ] F NDATION 2ND [ ] INSULATION
[ ]FRAMING [ ] FINAL
[ ] FIREPLACE A CHIMNEY
REMARKS:
17
DATE INSPECTOR
G�
765-1502
BUILDING DEPT.
1 NSPECTI7OUGH
[ ] FOUNDATION IST [ LBG.
[ ] FOUNDATION 2ND [ ] INSULATION
[ ] FRAM114G [ ] FINAL
[ ] FIREPLACE HIMNEY
REMARKS:
DATE INSPECTO
BOARD OF HEALTH . . . . . . . . . . . . . . .
FORM NO. 1 SETS OF PLANS . .. - -- - - - -
TOWN OF SOUTHOLD / SURVEY . . . . . . . . . . . . . . . . . . . . . . . .
BUILDING DEPARTMENT /: + HECK . . . . . . . . . . . . . . . . . . . . . . . . .
- , 5 TOWN HALL SEPTIC FORM . . . . . . . . . . . . . . . . . . .
SOUTHOLD, N.Y. 11971
TEL: 765-1802 NOTIFY:
,q; r �9
Examined------ - �ALL1.6 '=522,, - , , ,
�6...., I9yfy7 9 z MAIL T0:��51.t1�/ fl1F.oP`J/F`
Approved....... .., 19 ..;7 Permit No. P. C.70 --- -•-r �ICL"�.e!.- ---!•r�;
Disapproved a/c / ...................................
..............•--.---..........-....-.---..-....-.-...
_ ..... ..- .... .....7..--
(Buildi or)
APPLICATION FOR BUILDING PERMIT
Date. `j - - .f7. . . ,19��.
INSTRUCTIONS vv
a- This application must be conpletely filled in by typewriter or in ink and submitted to the Building Inspector wi
3 sets of plans, anisate 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 IE[Off 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 removal or demolition as herein
described. The applicant agrees to comply with all applicable ls, finances, buildi housing code, and
aw
regulations, and to admit authorized inspectors an premises and in W1ldi or necessary ions.
..... .. .-. ........-. .............
(Signa of applicant, or name, if a corporation)
m
(Mailing address of applicant)
State whether applicant is,(xv :T.)le:ssee, agent, architect, engineer, general contractor, electrician, plumber or builder
.............. .-/pp--....-.-.....-----...-..-....---.-..-.-....-.--....---.-............-.-....-...........
Nam of owner of premises .OJT:1. .- :.. � Vl T5( 0 . ................................................
(as on the tax roll or latest deed)
If applicant is a corporation, signature of duly authorized officer.
.........................................................
(Name and title of corporate officer)
Builders License No. .........................
Plumbers License No. .........................
Electricians License No. .....................
other Trade's License No. .................... /1 /� +'
I- Location of land an which proposed work will be done... 7.�Q.!!--/v�C
t
-- r - 1
House Number 9 7� Street�t�SNC"/� O Hamlet Q L 'j-}{--0 LL,-
Cocnty Tax Map No. 1/000 Section ..... ";V....... Block ...... ........ Lot 3
Subdivision ....................................... Filed Map No- ............... Lot ...............
(Nam)
2. State existing use and occupancy of premises and int%xied useandoccupancy of proposed construction:
a. Existing use and occcgr�xy .... Euh............. J-iC .-.....-......-...:.--.-.....-...-...
b- Intended use and occupancy .............................................................................
3. Klture of work (dueck wbidt applicable): New lkiilding .......... Addition .......... Alteration ..........
Itelxrir ............ Rmuoval . ............ Ik7n9 itiou ............ Otter Worl( ..................................
99--�� //�� (description)
4. Estivated Cost .Y..t�.......I. ...... fee ..............................................
(to be paid ar filing this application)
5. If okaelling, umber of dwelling units ..D ..... lie er of dwelling uniLs on each floor ...I-'.t........
Ifgarage, nnier of cars ......................................
G. If Ixusiness, umnarcial or mixed occupancy, specify nature and extent of each type of use......................
7. Dinensions of existing structures, if any: Front...ZS/...... Rear .`Zs ......... Depth .3.4':../......
Ikigut ......................... Mniier of Stories ..... ............ /
Dimensions of Bare structure with alterations or nkli Lions: Front .2"* / ... Rear .��.-.5.........
Depth ...32:�............ lleil;dut .................... Msiller of Stories .. .�✓.R......
tl. Il inensi(MA dt- entire new construction: Front . ... .`��Jjj. ..... Rear ...... [kpLh .�...........
Ikilout ......................... M■dier of Stories ..J..w ti....l 2.�.
9. Size of lot: Fran .....Zvl........... Rear ..ZdZ............ Depth —a................
c �
10. linea an-kor ....... .74........ Rare &F—__—__ •• ........................................
II. Zone or use district in wiuidu premises are situated ...............................................................
12. hoes profoiied rxxutnr.Lion violate any zoning law, ordinance or regulation: ......N--v..............
13. Will lot be regraded ........./............ Will excess fill be raiwed from
^^premises: YES ✓ No r ?
14. Nares of Owner of prere"mises a A14KY;.-M a.I ..... Aklress Ilnaue No.,R/,l: ,I.=
Hanle of Architect .(..e�-. J..�.(rf CM1�:i:1.G�.... Akwass fluore No. �.........
Mie of Contractor ................................... Aklress ...............................Thione No. ..........
15. Is this property within 300 feet of a tidal weLlacd7 * YES .......... NO ........,,
*IF YES, s urlyllD ium 7'RUSIPJ:S PE1341'r my RG RIiiX iru).
PLOT DIAGRAM
locate clearly and distinctly all buildings, whether existing or proposed, and indicate all set-back dimensions
fon property lines. Give street and block niaber or description according to deed, and slow street nares and indicate
ruhether interior or corner lot.
SI'ME M- NW YMK, ��
(XIlINIY O ....:-�l F'1[(y--�....1k........ SS
....being duly sworn, delx)ses and says that be is Lhe applicant
(Nene of individual signing corntract)
Axive honed,
Ile is Clue .................. ..........................................
..................................
((lonracLor, agent, corporate officer, etc.)
of said owner or owners, and is duly authorized to perform or have performed [lie said cork aid to mike and file this
application; that: sit s(atemen(s contained in this application are true to (lie best of his knowledge aid belief; and
that Lhe work willbe perforil—in the inamer set forth in the application filed therewith.
Sworn to before nr_ this
..... . . ..97.
Mnary Abulic y J
... .. � •..................
(Sig alure of AlipticarrL)
ROBERT I.SCOTT JR.
Notary Public,StatXal Now York
0"Na Otn SS061k Co�
Um Expires May 31, oe
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N W 1 N TE�t D E= P A T V T I o I LS CERTIFICATE OF OCCUPANCY PEE? BT: -y—
SOLDER USED IN WATER OCCUPANCY
NOI BUILDING DEPARTMENT AT
CANNIhISU UA1YOt-d -TO cONFo �Nr u1' N �I s e-t..Lf-e'-�r�^ .COJ7�. SUPPLYSV10OFSTEM 1%LEA I,EUPAT.ECY OR 703-7302 S AM TO 4 PM FOR THE
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I FOUNDATION - TWO REQUIRED if
FOR URED CONCRETE
PROVIDE SMOKE-DETECTING WITHOUT CERTIFICATE 2. ROUGH - FRWING PLUMBING
PROVIDE OPENINGS FOR ALARM DEVICES' a: wsuwnoN
AS TO PART.721.1 If copper tubing Is used'. ,OF OCCUPANCY 4,FINAL - CONSTRUCTION MUST 1
EMERGENCY ESCAPE AS N.Y.S BUILDING CODE. formater distributing, IL CONSTRUCTILETE ON
SH
l j REQUIRED BY PART. 714 Of syst(,m; piping shall be - ALL CONSTRUCTION SHALL MEET 11,'
' N.Y. STATE BUILDING CODE of typo.K or L only 'THE E,CONSTRUCTION
OF THEN V
STATE'CONST�IUCTION & ENERGYCODES
DESIGN OR CONSTONSIBLE FOR
RUCTION ERRORS
PLUMBING
. ALL PLUMOING WASTE,' .. {
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TESTING BEFORE COVERING '
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