HomeMy WebLinkAbout22279-zFORM NO. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Office of the Building Inspector
Town Hall
Southold, N.Y.
CERTIFICATE OF OCCUPANCY
No E-23294 Date
THIS CERTIFIES that the buildin~
Location of Property 680 STARS ROAD
House No.
County Tax Map No. 1000 Section 31
Subdivision
OCTOBER 19, 1994
ADDITION
Street
Block 4 Lot 7
Filed Map No. Lot No.
EAST MARION, NY
Hamlet
conforms substantially to the Application for Building Permit heretofore
filed in this office dated AUGUST 1, 1994 pursuant to which
Building Permit No. 22279-Z dated AUGUST 25, 1994
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 TO CONSTRUCT A GREENHOUSE ON EXISTING DECK ADDITION OF A ONE
FAMILY DWELLING AS APPLIED FOR.
The certificate is issued to
ATHANASIOS & STELLA DRENIS
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL
UNDERWRITERS CERTIFICATE NO.
PLUMBERS CERTIFICATION DATED
Rev. 1/81
(owner's)
N/A
N/A
FORM NO.3
TOWN OF BOUTHOLD
BUILDING DEPARTMENT
TOWN HALL
$OUTHOLD, N,Y.
BUILDING PERMIT
(THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL
COMPLETION OF THE WORK AUTHORIZED)
N-~ 22279 Z
Permission Is hereby granted to:
.Lo.q~...s.~.s..9~..s...~9.~.o.P.~,....~.~.c.: ......... ~./.~.....~:...q~EIs
5005 VETERANS I~Et{ORIAL HIGHWAY
HOLBROOK, N .Y. l 174 1
tO CONSTRUCT GREENHOUSE ON EXISTING DECK AHDITION OF A ONE FA}qILY
DWELLING TO COUE AS APPLIED FOR.
ANTHANSIOS 4, STELLA DRENIS
at premises located at ............ .6..8..0...S. ~.A..H..S..., .R..O..~..~. ........................... .g.~.S. ~.. ~ .I..O.~ :....N..: .Y..: ........................
CountyTax Map No. ] 000 Section .......... .3..I ............ Brock ....... .4. ................. Lot No ..... .7. ......................
pursuant to application dated AUGUST 1.
......................... ~ ................................ 19....9,.4. ......... and approved bythe
Building Inspector.
Fee $.,/~',c~, ~ ....
Rev. 6/30/80
Form No. 6
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
765-1802
APPLICATION FOR CERTIFICATE OF OCCUPANCY
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 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.
For existing buildings (prior to April 9, 1957) non-conforming uses, or buildings and
Vpre-existing" land uses:
i. 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 applicank.
If a Certificate of Occupancy is denied, the Building Inspector shall state the
reasons therefor in writing to the applicant.
Fees
1. Certificate of Occupancy - New dwelling $25.00, Additions to dwelling $25.00,
klterations 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 - $20.00
4. Updated Certificate of Occupancy - $50.00
5. Temporary Certificate of Occupancy - Residential $15.00, Commercial $15.00
ew Construction ........... Old Or Pre-existing Building .................
ocation of Property ......................................... .. .
House No. Street Hamlet
nwer or Owners of Property ......... ~.~-~/~
......................................... . .. .
ounty Tax Map No i000, Section .... 3. [ .... Block ..... .~ ......... Lot .... .~... .
ubdivision .................................· . . Filed Map ............ Lot .................... ..
ermit No..~.~.~.~..~..Date Of Permit~...?..~..].?.~Applicant .............................
~alth Dept. Approval ......... Underwriters Approval
lanning Board Approval ...............
equest for: Temporary Certificate ........... Final Certicate.. ' .......
ee Submitted: $~.~ ~ ?~'~' ........................ ~ ..... · ~..~.~ ~.~~...~
~ ~ APPLICANT
7GS-'f 802
BUILDING DEPT.
INSPECTION
FOUNDATION 1ST [ ] ROUGH PLBG.
FOUNDATION 2ND[! ~.ATION
FRAMING [,~YTINAL
REMARKS:
FOUR SEASONS SOLAR PRODUCTS CORP.
_ I
7'-10 1/8'
FOUR SEASONS SOLAR PRODUCTS CORP
FOUNDATION
FOUNDATION
2.
ROUGH FRAME &
.PLUMBING
(1st)
( 2nd )
iNSULATION, PER N.
STATE ENERGY
Ye
Z
CODE
FI~AL
ADDITIONA'L COMMENTS:
Z
'dHO9 SJ~DfI(IOHd HVIOS S/qOS¥,WS %tflO~I
d~IOO S~31laO~Ic[ }tFIOS SNOSV~S ~flO~
CZ
~ ~ ~ ~,¢)9/~ ~t_,~ BUILDING DEPARTMENT
il'ti J[ ' ' '-- [ ,TOWN HALL
~ ~ SOUTHOLD NY 11971
~ 1'0~ ..... TEL.,;, ~1802/-~
.... ~/.,.. ......... , l~... ~,'~' :z'7 -, ./~/,¢. .
Disapproved a/c
B~ARD OF HEALTH
'/suRv~ .........
~c.~.c~ .... ,: .....
/SEPTIC FOR,I
CALL ..................
· .t~l~
............
· (Building Inspector)
APPLICATION FOR BUILDING' PERMIT
INSTRUCTIONS
Date .[ ......... 1 .
a. This application must be completely filled in by typewriter orin 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 sti'eets
or,areas, and giving a detailed description of layout of property mu~t be drawn on the diagram which is part of this appli-
cation. '
' o. The work covered by this application may r/or 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 Certificate of Occupancy
shall have been granted py the Building Inspector.
~ APPLICATION IS HEREBY MADE to the Building Department for the issuance ;uildin Permit ursu
Building Zone Ordinance of the Town of Southold, Suffolk County, New ~[k, an othe, licffble Laws.POrd'ant to the
Regulations, for the construction of.buildings, additions or alterations, or fio~rem~ lPmPo~litinn, as ho'rein ~nesa~i;s~°r.
The applicant agrees to comply with all applicable laws, ordinances, bufldin~'~delhousin .[code, and regulations, and tclc;
admit autho~zed inspectors on premises and in building for necessary inspectiok~.~k [ / ·
.._: ' · ..: ........ .~q,~.~ I.,:-. ......... '...
· . (Signatur~ ot~'ppnxcantl or name, if a corpora'tion) ' ' '
· (Mailing addre~ss of applicant) '
State ' ' ' -
whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder.
.............. ~.~....~.~~.. .......... · .................. . ....
eo'oXxo, 'rexes '
.. c'~-_~2,~, i~ ............... ' ........
~\\\ / ,.\' tmm-~,~si~g (as on the ta~ roli orlatest deed) ..............
If applicant i )clratiol0, signature,of duly au horized officer· . . .
( amc td tt~l~fco/porat~-of~cer)
Plumber's License No ............... . ..........
Electrician's License No .........
Other Trade's License No ...........
1. Locationoflandonwhicbproposedworkwillbed(o~e..~..~.~.~ .... ; ........ . ...............
.......... ~ .¢~... .... ,~...a..~..~.,~ ~ '~.~ ..04.:~ tS~..h ·
House Number Street ' ' ' : .... ' ....
.' Hamlet
............
Subdivision ........ . ............................ '. Filed Map No. Lot
(Name) .............................
2. State existing use and occupancy of premises and inteudcd use and occupancy of proposed construction:
a. ~,,,s,ng U~e and occupanc, ........ : .~-?~.~... :--e~. .......................................
b. Intended Use and occupancy . ' ....
'3. Nature of work (check which 9Pplicable): New Building ........ Addition . .
Repair .............. RemovaI .............. Demolitio~ ' ' "'
· I .. .... . .... '. ......... Other Work...~..
4. Estimated Cost. . ; . '~ ' - s (Description)
....... ,.. ........ Fee .....
s. i - . , (to be pa,
fdwelhng, number ofdwelhng units ...... ~ ...
.... . Number ofdwelhng un ts on each i~oor . . .' ........
·If garage, number ofcars . !
If business, commercial or mixed eec ............ :"-- - . ' ................................
· -, .... .' ? ,q,--,~y, ~t, uc,y nature alu extent of each type of use ..............
.u.nenmons el ex,sting structures, if any: Front ..... ~ .... Rear ~.~. · Depth ' ' .....
7. Height ............... NuinberofStories ..... 2 .... '~.'. · . '~"i .... j~. .. ~ .....
Dimensions ofs me st ictur *'th alterations o .,ddi.ons: Front ..... ii .......... Rear .......
Depth.. ~ . . . [ ..... .
.......... llCigll[ ...... · .
8. Dime ' · , . · ..... :..NumberofStones ....
nslons of entire new colls~ructlrln. [:~vr~nt' ~ I t .......
.~e,ght ....:. ~('.t ....... Number of Stories .... ~ . . '1'' Rear ..... 2~1 ...... Depth . ....~,'~? .......
9. ~qze of lot Front ..... [O~9 · · ,. ............ '-' · · ~ .......... : ......
· '- ............ ~ear ...... r .........
10. DateofPurchase ..... -"Ta~ ]~.> ,, · -lO~ ........ Depth ..... ~ .
7~__ .. , ..... -.-. · · ·; f./, o,-~... ......... l~ame of Former/O,, .... ' t ..........
1 1. ~vnc or use alsrrlc~ ~n winch preinlses are situated . ~ ~,-. ~["CU'~'~ .... t ........................
12. ~oes pror>osed construct,s, ,,;,,!~ · · · ' ' ' .' '" .... I~'~"~c~-".L~r'r~*~k .............. '
'la. Will lot be re~raded- - -:,?ate a~nbt_zomng mw, ordinance or regulation: .......... ,/V~O... ,.. ' .......
.... ~l,;tt ~'~ ' "~ ........ Will excess fill be r move m premises:
14. inane oiOwner of premises ~r'It'frththq~.. ~'~l~ddress..~:>....~ ~. Phone No..'
Name of Architbct e,, . ! . , ..
.. ~ ~ ..... ~ .......... , ....... .~aaress ... · · ·, Phone
marne of Contractor A~w,.e7...'~qao.~lm~,, e, --~ ' ' ' '.;~','r 'ZT' ~l · '"' ............ '...
15. ' ' . · ' · ~.",~ ...... ... aaoress .~..~-d~. ,V~x.'O~ . Phon No. . '
19 thz~s~p?operty wzthin BO0 feat of a tzda e ~ '
· ,. . : 1 w tland. *Yes ...... ·
zr yes, Southold Town Trustees Permit ma be o ' o,q
... I PLOT DIAGRAM . [ . ,
Locate clearly and distinctly all buildings, Wt~eth~r existing or Proposed, and, indicate all set-back dimensions /Iota
property lines. Give street and block number or description according to deed, and show street names and indicate whether
interior or corner lot.
APJ~ROI/EO AS NOTED ' _
FEE: ~BY: ~
NOTIFY Bull,DING OEPA~
FOLLOWING
']. FOUNDATION ~ ~O
FOR ~OURED CONCR~E
~.. ROUGH -FRAMING ~ PLUMBING
3. INSU~TION
~. F~AL CONSTR~CT~N MUST
8E COMPLETE FOR C.O.
ALL CO~U~ON SHALL ME~
THE REQU1REMEN~ OF THE
SIA~ ~NSTRU~ON & ENERGY
CODES. N~ R~N8IB~ FOR
DESIGN OR ~NBT~ON
/TATE OF NEW YORX',. , _ _.
:ou ¥
...................... '~['~' .l~'~.'°.'Q-~'''. ...... being duly sworn, deposes and says that he is the applicant
(Name of individual signin co~tract
bore named. '
i (Cent agent ......................... ' .............
ractor, , cor'porate officer, etc.) '
r~ s..a,d .ow.ne.r or owners, and is duly ~uth;rized to perform or have performed the said work and to make and file this
~.c~; thea/f alI statements contained in this application are true to the best of his knowledge and belief; and that the
· P lormed in the manner set :forth in the a lica' ' therewith.
yom to before me this , PP t~on filed .
........... ! ..........
CI.~IRE [..llt.[~l i ' --.
NotaW Publlo, Brute otNe~ /
No. 4879505 . /~/'J~
Qualified in Suffolk CeuntY [ '~/'~/
(Sign;itir'e'or -~pl;li~n'ti
0 ':PO/
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