HomeMy WebLinkAbout22787-zFORM NO. 4
TOWN OF SOUTEOLD
BUILDING DEPARTMENT
Office of the Building Inspector
Town Hall
Southold, N.Y.
CERTIFICATE OF OCCUPANCY
No Z-23676 Date JUNE 1, 1995
THIS CERTIFIES that the buildin~ ACCESSORY
Location of Propert~ 3360 ROCKY POINT ROAD EAST MARION NY
House No. Street Hamlet
County Tax Map No. 1000 Section 21 Block 4 Lot 9
Subdivision Filed Map No. Lot No.
conforms substantially to the Application for Building Permit heretofore
filed in this office dated MAY 15, 1995 pursuant to which
Building Permit No. 22787-Z dated MAY 24, 1995
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 AN "AS BUILT" ACCESSORY STORAGE SHED IN THE REQUIRED REAR
YARD OF A SINGLE FAMILY DWELLING AS APPLIED FOR.
NICHOLAS & HELEN BABALIS
The certificate is issued to
(owner)
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL
UNDERWRITERS CERTIFICATE NO.
PLUMBERS CERTIFICATION DATED
N/A
N/A
N/A
Rev. 1/81
FORM Ne.3
TOWN OF $OUTHOLD
BUILDING DEPARTMENT
TOWN HALL
$OUTHOLD, N.Y.
N.0,
BUILDING PERMIT
(THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL
COMPLETION OF THE WORK AUTHORIZED)
Date ............. 1 ....
22787 Z
Permlssi°n Is herebygrar~i~./~.,~ .~,~.....~....~.. ~.~../.~..~.'. .................
........... ~....~ ~~......z!~...~. ,
...................................................... ~.~..~~..,.~.~....~ ..............
seo,,on ......... ~.~ ...... ,,oo~ .............. 7. ...... ~o...~ .....................
Coun~Tax Map No. 1000 .
~ur~u~n,,o~pp,,c~,,o,d~,ed ............ ~~.~ ......... ~..a..(... ~,d~pp,owdb~,h~
Building Inspeotor,
Rev. 6/30/80
'fOl,'N OF SOUTII()I,D
BUI 1.,DIN(; I)EPARTIllf,"Ff
TOWN II^l,L
765-1BO2
APPLLCATION FOR CERTIFICATE OF OCCUPANCY
A. This applicatiou must be filled in by type~riter OR ink and submitted to the building
inspector with the follow,lng: for ne~ building or net~ nsc:
1. Final survey of property with accu~ate location of all buildings, property liecs,
streets, hud unnsuul uatural or topographic features.
2.Final Approval iron }{ehlth Dept. of water supply and sewerage-disposal(S-9 form).
3.Approval of electric~ installation from l~oard of Fire Underwriters.
4.Sworn statement fromQ)lumber certifying tbat the solder used in system contairs
less than 2/10 of 1% lead.
5. CO~ercial buildiez, industrial b~ildin~,
· nd lnstallat~ons,~a certificate of Code multiple residences and similar buildings
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
nnusual eatural or topographic features.
2. A properly completed application and a coosent to inspect signed by the ap%~licant.
If a C~rtificate of Occupancy is denied, the Building Inspector shall state the
reasons therefor ie writing to the applicant.
C. Fees
~. 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,
Additious to accessory building $25.00. Businesses $50.00.
2. Certificate of Occupancy ou Pre-existing Buildine - $100.00
3. Copy of Certificate of Occupancy - $20.00
4. Updated Certificate of Occupancy - $50.OO
5. Temporary Certificate of Occupancy - Residential $15.00, Co~erci~l $15.00
.... ....................
New Construction...~ ...... Old Or Pre-existing Building .................
~o~on o~ ~o,~ ~ ..... ~, .... ~ .3. ~..~ ....... J.~ <gW.M=Z ~ %. f.~ ~...~ f~.g,¥
House No. Street Hamlet '
Onwer or Owuers uf Property .............................................................
~o,n~y '~ ~p ~o ~000, ~ion...~..I ....... ~od~ ..... ¢.f. ........ ~o~ ..... ~ ...............
Subdivision .................................FJ I d M
.... c ap ............ Lot ......................
Permit F'o~t~. ..Date Of Permit..~/.~.~/. / ~ ' '
· .. ....
liealtb Dept. Approval... ' ............. Underwriters Approw~l ...........
Planning Board Approval .... ~ ..........
qequest for: Temporary Certlficote ........... Fiual Certicate ...........
fee Submitted: $ .................. ~ ~
~~3 L~ " : ..............
Town Hall, 53095 Main Road
P. O. Box 1179
Southold, NewYork 11971
Fax (516) 765-1823
Telephone (516) 765-1802
OFFICE OF THE BUILDING INSPECTOR
TOWN OF SOUTHOLD
May 26, 1995
Mr. Nicholas Babalis
3360 Rocky Point Road
East Marion, NY 11939
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)
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 # 22787-Z
Please contact our office on this matter.
cooperation.
Thank you for
SOUTHOLD TOWN BUILDING DEPT.
Town Hall, 53095 Main Road
P. O. Box 1179
Southold, NewYork 11971
Fax (516) 765-1823
Telephone (516) 765-1802
OFFICE OF THE BUILDING INSPECTOR
TOWN OF SOUTHOLD
May 26, 1995
Mr. Nicholas Babalis
3360 Rocky Point Road
East Marion, NY 11939
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)
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 # 22787-Z
Please contact our office on this matter.
cooperation.
Thank you for
SOUTHOLD TOWN BUILDING DEPT.
765-1802
BUILDING DEPT.
INSPECTION
[] FOUNDATION 1ST [] ROUG~.BG.
ii :°.L.?UN ND '°"
DATE ',.,~'~~*""* INSPECT~
FORM NO, 1
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN HALL
SOUTHOLD, N.Y. 11971
TEL.: 765-1803
^pproved...< me=it No ............
Disapproved a/c '
" ' APP~:~CATION FOR BUILDINGPERMJT
SURV£Y ...................
CIIECK .........
CALL ...................
HAIL TO:
Date ...' .... : ........... 19...
INSTRUCTIONS
a. This apl~lication must be completely filled in by typewriter 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 st?eets
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 i~sued 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 Certificat~ 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
Buildihg Zone Ordinance of the Town of South6ld, 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.
(Signatur~ of applicant, or name, if a corporation)
(Mailing address of applicant)
State whether applicant is owner, lessee, 'agent, architect, engineer, generai contractor, electrician, plumber or builder.
Name of owner of premises
(as on the tax roll or latest deed)
If applicant is a corporation, signature of duly authoriied officer.
(Name and title of corporate officer)
Builder's License No .......................
Plumber s License No ..... . ..........
Electrician's License No.
Other Trade's License No.../~..~. ....... ......
1. Location of land on which proposed work wil, kbe'done
............... [ Street Hamlet
ltouse Number
Cotmty Tax Map No. 1000 Section . 2.: .............. Block ' Lot ...................
Subdivision..: ..... . ................... ' .... ' Filed Map No ............... Lot ...............
(Name)
2: Stat~ existing use and occupancy of premises and intended use and o~cupancy of proposed construction:
a. Existing use and occupancy . ' ~-- ' '
b. Intended use and occupancy .~.~../t .x..',. 7.n.: ~/ ............ ~i:..i: .: .......
.3 Nature of work (check which fipplicable) New Building Addition
· ' Alteration
Repair Removal Demolition Other Work ..........
..............,,,_ . .............
o. ' ....
4. Estimated Cost. 0 ~"' .,, escription)
......................... Fee ~'~ '
' ~ tD ''~ · (to be paid on filing this application)
5. If dwelling, number of dwellin~,~u~its/t..., i.~r~ ...... Number of dwelling units on e, ach floor......~..~. ....
· If garage, number of cars ... ~/L./.e//. .............. ' ............. i ........... :...:t ~, ............ ..
6. If business, co,mmercial or mixed o. ccupancy, specify ,nature, and extent of.each type of use .~. 4'~ ...........
7. Dimensions,gl ?,xi§fing structures if any: Front...~, , ] .~q..'.... Rear ..l~'. .. r~,,th ] ~ ....
Hei-ht~ .... , .6Fid Num'eer o[~ Stories' ... .,! · . . · ............. ,-.u ..........
Dimensions.cf shine structure with~ alterations or fidditions:. Front ................. Rear ..................
Depth .................... !.. · Height .......... 'd ........ .., Number of Stories ' '
8. Dimensions of entire new construction: Front ..... /,~ ·.. ;. Rear .../.,)~,t ..... ''''"'''''"';''"''"Depth...1~,~.. .........
Height . oc~.7.r,.~ ........ Number of Stories .'.. ! .......................................... ; ..........
9, Size oflot: Front .......... ; .......... :..iRear·..,..., ........... i Depth ......................
10. Date of Purchase ......... ~/~9../g· ..... '.' ....... ... Name of Former Owner .............................
I 1. Zone or use district in which p~emises are situated .... ;/~. · .'~ ..... ' .............................. i ~ .......
12. Does proposed construction violate any zoning law, ordlnar~ce or regulation: ..., fi/J'/ .........................
'13. Will 16t be regraded ....... ; ;..~..Z/.· .~.. .... ., ....~.. Will excess fill be removed from premises: Yes No
14. Name of Owner of premises . ./~.t.C.~...~0~J!I .... Address ... ................ Phone No..q. ?~..-.~. ,2..o~i. '
Name of Architect ......... ] ............. ' ....Address ................... Phone No ............ : ....
Name of Contractor . '
. · ...... ~ ................. Address ............. . ...... Phon~No .................
15. 19 this property within 1300 feet ,of a tidal wetland? *Yes ........ No.~ ....
· If yes, Southold %own Trustees Permit may be required.
PLOT DIAGRAM
Locate clearly and distinctly al! buildings, whether existing or proposed, and, indicate all set-back dimensions from
property lines. Give street and blocklnumber or description according to deed, and show street names and indicate whether
interior or corner lot.
.2:'
r
COUNTY OF...'-,~...~. ][i .'~.~, .... ,' ', '
..... /~..t.'~e. (~'.~.... ~..~j ~¢..('. ~... .....
(Name of individual signi~ng contract)
above named.
7t;5~18C)2 9 AM TO 4 PM FOR THE
~ MFI.ET~ FOR C.O.
ALL CONs~OCrlO~V SHALL
~TAT~ CONSTRUCTION &
DES/G~ OR CONSTRUCTION ERRORSi
being duly
depose9 and says that he is the applicant
He 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
application; that all statements contaibed in this'application are frue to the best of his knowledge and belief; and that the
work will' be performed in the manner ~et forth in the application filed therewith. '
Sworn to before.me, this, / ~
/..:.:..w2.._ ,.....
....... . .... .......
.. .......... :
~um~ NO 4879505 ~. ' '(Signature of applicant)
. (}ualif~d in Su~fl01k Count,,Y'
' [;ommissi0n expires uecember n, ig.t...