HomeMy WebLinkAbout21960-zFORM NO. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Office of the Building Inspector
Town Hall
Southold, N.Y.
CERTIFICATE OF OCCUPANCY
NO Z-23688 Date ~ 7, 1995
THIS CERTIFIES that the buildin~ ADDITION
Location of Property 3300 NORTH SEA DRIVE ORIENT NY
House No. Street Hamlet
County Tax Map No. 1000 Section 15 Block i Lot 4
Subdivision Filed Map No. Lot No.
conforms substantially to the Application for Building Permit heretofore
filed in this office dated MARCH 18, 1994 ~ursuant to which
Building Permit No. 21960-Z dated MARCH 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 A BE~OND STORY ADDITION TO A SINGLE FAMILY DWELLING AS
APPLIED FOR.
The certificate is issued to
DIMITRIOB & IP~ENE ANTONIADIS
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL
UNDERWRITERS CERTIFICATE NO. H045338
PLUMBERS CERTIFICATION DATED
Rev. 1/81
N/A
MAY 4, 1995
JUNE 19, 1995 E~9~%NUEL PEPERAKIS
Building Inspect/
FORM NO.3
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN HAU.
SOUTHOLD, N.Y.
N°- 21960 Z
BUILDING PERMIT
(THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL
COMPLETION OF THE WORK AUTHORIZED)
Date .................. /, .........................................
Permission Is hereby grq~nted to:
~..,.i~.,'.~.~,;o~.....~~.,.~..~ ................
..~..?..~...:....~&%.~.,.~ ......................
.......... . .
~.....~~.~ .............. ~. ........... ~.~.,...~......~~. ...................
.~ ....... ~..,...~ ........ ~.~ ........ ~.~....~.....~~
CounlyTaxMap No. 1000 Section ,,.,,..~?../...~,.. ......... BIock....~...~. ............... LotNo ...... ..(~.....~.~. ............
Building Inspector.
~ee ~......2..~:.~. ......
/ ~// Building Inspector
Rev, 6/30/80
Form No. 6
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN NALL
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 or.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-diJposal(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
Ppre-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, Swin~ning 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
.... 7 ......
Date
New Construction ......... Old Or Pre-existin~ ~ildingA. ...... ~'"'''!i!!{iil;ii'~i'.~.' i ii
Location of Property.. ][ ~.QP.~ .............. ~o)~...~% ..... /4q'~ ....
House No. Street Hamlet
Onwer or Ownerm of Property ...... ~ ...... ~ ............................................ . .....
000, .... ...... .... ......... ..................
Subdivision . Filed Map ............ Lot .....................
~ I ?~O ~ ~..Applicant.. (....~.~ a~.
Permit No...~- ............ Date Of Permit ....
- ....
Health Dept. Approval.' .... ~..~... .............. Underwriters Approval .................
Planning Board Approval .... ~..~ ................
Request for: Temporary Certificate ........... Final Certicate.....~ .....
Fee Submitted: $~ q~ ............................. [ ,~'(A~ f/~ ~ . .~.~..~.: .
, . ...... ~ .w%..~.~ ... ,~-,~, ~. ~f ..................
Town Hall, 53095 Main Road
P.O. Box 1179
Southold, New York 11971
Fax (516) 765-1823
Telephone (516) 765-1802
OFFICE OF THE BUILDING INSPECTOR
TOWN OF SOUTHOLD
CERTIFICATION
Building Permit No. 2/
Owner:
(please pr±nt)
Plumber: ~/7~/~9 ~/1/~ '~/'-
(please print)
I certify that the solder used in the water supply system
contains less than 2/10 of 1% lead.
' ('Plumbers ~ignatdre) , ; '}:'?:
Sworn to before me this
Iqr~ da~ of 'J~ ,v~ ,
Notary Public, ktA.,/~.~' County
THE NEW YORK BOARD OF FIRE UNDERWRITERS PAtS
~(~781~. BUREAU OF ELECTRICITY
~ 85 JOHN STREET, NEW YORK, NEW YORK 10038
Oat* MAY 04,1995 ~pplication ~o. o..fit~ 84436394/94 ~l 0~533g
~I:T NO. 21960Z
THIS CERTIFIES THAT
o~y the electrical equipment ~ ~scribed below a~ int~uced by the ap~icant ~ed on the a~ve application number in the pre~es of
D~ITR:I:OS ~NI~IS, 3300 NORTH SEA DRIP, ORIENT,
in the fottowlng location; ~ B~sement ~ Ist FI. ~ 2.d FI. OUT Section
~ms examined on APRIL 03,t995 a.d found to be in compliance wHh the Na6o.al Elect~c~ Code.
FIXTURE FIXTURES RANGES COOKING DECKS OVENS DISH WASHERS EXHAUST FANS
OUTLETS
16
DRYERS
OTHER APPARATUS:
FEEDER- :[
JACUZZI-- 1
PANELBOARDS: 1-8 CIR. 100
G.F.C.II-3
SMOKE DETECTOR ~ "1
E R V I C
~ RCC~. A,W.G. NO OF HI.LEG A.W.G.
NO.OE COND OF CC. COND, OF HI-L~G
AWG.
DIMITRIOS ANTONIADIS
3300 NORTH SEA DRIVE
ORIENT, N'~, 11957 GENEIIAL ~AGER
This certificate must not be a~tered in any manner; return to the office of the Board if incorrect. Inspectors may be identified by their credentials.
COPY FOR BUILDING DEPARTMENT. THIS COPY OF CERTIFICATE MUST NOTBE ALTERED IN ANY MANNER.
765-~.80Z
BUILDING DEPT.
INSPECTION
FOUNDATION 1ST [ ] ROUGH PLBG.
FOUNDATION 2ND [,] IN~TION/.
FRAMING ,-[//] FINAL
REMARKS:
! I'1
INSPECTO~
BUILDING DEPT.
INSPECTION
76S-1802
BUILDING DEPT.
FOUNDATION 2ND [~:j/INSULATION
FRAMING //')/? [ ] FINAL
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
December 12, 1994
Ward Associates, P.C.
1500 Lakeland Avenue
Bohemia, NY 11716
Re: Antoniadis Dimtrios
Prem: 3300 North Sea Drive, Orient NY
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).
Thank you for
BUILDING PERMIT ~ 21960-Z
Please contact our office on this matter.
cooperation.
SOUTHOLD TOWN BUILDING DEPT.
FOUNDATION f2nd )
2.
ROUGH FRAME &
.FLUMBING
e
INSULATION PER N.
STATE ENERGY
CODE
Ye
FINAL
~ ADDITIONA'L COM~E~.fTS:
FORM NO. 1
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN HALL
SOUTHOLD, N,Y, 11971
TEL,: 765-1803
Approved .' .~/~.~... 19~.~ermit No ~/~Z
Disapproved a/c .................... ~; ...............
(~fiilW(ng Inspector)
APPLICATION FOR BUILDING' PERMIT
1994
INSTRUCTIONS
SURVEY ............. .~...
CHECK ....
NOT I P¥:
CALL ..................
HAIL TO:
a. Tiffs application 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 btiildings on premises, relationship to adjoining premises or public sti-eets
or areas, and giving a detailed description of layout of property must be drawn on the diagram which is part of this appl/-
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 issued 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 HEREBY 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, o[~r removal or demolition, as her~i,n descr/b~d.
The applicant agrees to comply with all applicable laws, ordinances, buil~In~,~oj::[e, hou/giBgt~pd~ a, nd, regul~ttons, and to
admit authodzed inspectors on premises and in building for necessary
· ... ,.. ........
-- (Signature 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 [231~V[ t'T~,AO~ ' '
(as on the tax roll or latest deed)
If applicant is a corporation, signature of duly authoriied officer.
(Name and title of corporate officer)
Budder s License No ..........................
Plumber's License No ........................ :
Electrician's License No .....................
Other Trade's License No ......................
I, Location of land on which proposed work will be'done.
.......... ' ...........' .........
ltouse Number Street Hamlet
Con'nty Tax Map No. 1000 Section........~[~ .... ...... Block ..' .....O~. ' Lot .................
Subdivision G~ ~. '. ' Filed Map No. Lot
(Name)
2: Stat~ existing use and occupancy of premises and intended use and occupancy of proposed construction:
a. Existing use and occupancy %1'~
b. Intended use and occupancy ..................... · ................ . ...............................
k ( appli bi ) B ' Additi (~ '
· 3. Nature of wot check which ca e: New uilding ....... on ...... Alteration .........
Re r .............. Removal Demolition .............. Other Work .............
. SCF
4. Estimated Cost .
! ~'I(\~ [k-~-._~' (to be paid on filing this application)
5. If dwelling, number of dwelling units ............... Number of dwelling units on each floor ................
If garage, number of cars .... i .................. ' .................................. .........
6.' If business, commercial or mixed occupancy, specify nature and extent of.each type of use ...[9.~. .................
Dimensions of shine st~cture With alterations or~dditions: Front ~J3..~..."i' l~r' ~.' .t<.I ..
s~ons o~enure new cons~ruchon: Front ...[Ml Ii' ....... ; Rear ............... Depth .... ...........
~.eight ............... Nu.mh0r of Stories ....... .................
10. Date or Purohase .......... ! .......... , ......... or Fo mer 6wne;' LL'(4'"
11. Lone or use district in which premises are situated .... .r.~.~$l .~_,~.]~, .....
Does proposed construction vi~o~l~te any zoning law, ordinal{ce or regulation: ....b:).Q ....................
13. Will lot be regraded tx4t¢ ........ Will excess fill be r-m
14. . .... . ...... . · · · uwu ~rom premises: 'Yes
Name of Owner of premmes ./M'O, .W..C2J'd, .l~.O. L~. Address .~>;~~/O
Name of Contractor .... Address ............ ,,.~. ..... Phone No ..... ; ..........
15.' I~; this p,roperty with±n 1300 feet of a t±dal wetland? ~Yee...Jh.... No ......... ' '
· If yes,'Southold ~own Trustees Permit may be required. '
.'-. ' 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.
STATE OF NEW YORK, S S ' ' ' '
COUNTY OF....~..~...c~... .
..... ~'L~' ~A"~'~" 'X%)'' '~"' ?' · "~'" '~' -~.~- · being duly sworn, deposes and says that he is the applicant
(Name of individual signing contract)
above named, i
He is the ..,... ............
(Contractor agent corporate officer etc ) ' ' .......
~f said owner or owners, and is dulyi authorized to perform or have performed the said work and to make and file this
application; that all statements contaihed in this application are true to the best of his knowledge and belief; and that the
work will be performed ~ the manner set fortlt in the application filed therewith.
Sworn to before me this
. /? . ~
..................... . ay or.; ............... .... , .q..q
gotary Publ c .
.............. ? .. ...... :-.~t:.; :.-'. county
KARIN t STALTER '
Notary Public, State of New York ....... · .... .........
No. 4973546 i (Signature of applicant)
Qualified in Surfak CounW ' ..
~lmmir~lon Expires Ootol~r
Z
APPROVEDASNOTED
BUILDING DEPARTMENT AT
9 AM TO 4 PM FOR THE
INSPECTIONS:
- TWO REQUIRED
FRAMING & PLUMBING
INAL - CONSTFiUCTION MUST
E COMPLETE FOR C.O.
CONSTRUCTION SHALL MEET
REQUIREMENTS OF THE N.Y.
CONSTRUCTION & ENERGY
PLUMBER CERTIFICATION
ON LEAD CONTENT BEFORE
CERTIFICATE OF OCCUPANCY
SOLDER USED IN WATER
SUPPLY SYSTEM C/1NNOT
EXCEED 2/10 of 1% L£AD.
If ~opper tubing ia used
for water distributing
~/stem; piping sbell be
OCCUPANCY OR
USEIS UNLAWFUL
WiTHOUT CERTIFICATE
OF OCCUPANCY
PLUMBING
~ Iq3.1MBIN6 ~
WATER LINES NEED
"~$TIN6 BEPORE COVERINQ
/,L4e, U ~V/
ref. no.: