The URL can be used to link to this page

Home My WebLink About21464-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CF~TIFICATE OF OCCUPANCY No Z-22496 Date AUGUST 4~ 1993 THIS CERTIFIES that the building ADDITION Location of Property 1095 WESTPMALIAROAD MATTITUCK~ N.Y. House No. Street Hamlet County Tax Map No. 1000 Section 141 Block 2 Lot 20 Subdivision Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated MAY 26~ 1993 pursuant to which Building Permit No. 21464-Z dated JUNE 7~ 1993 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 RAISED CONCRETE PATIO ADDITION TO EXISTING ONKFAMILY DWF3.LING & ACCESSORY FENCE TO CODE AS APPLIE~ FOR. The certificate is issued to E~9~%NVdELKONTOVEROS (owner) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A UNDERWRITERS CERTIFICATE NO. N/A PLUMBERS CERTIFICATION DATED N/A Rev. 1/81 FOI~M NO.3 TOWN OF $OUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N,Y. No 21464 Z BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) Date...~; .~..Z ................................................ Permsson s her,ebygranted to: .~~~.~., .~ ....~...: .................. .... :...~.~~,...~.,..,~..: ............ ~, ................ . . . . ~~.:/~.~.....~...~.~ ...... ~ ......... -.~....~ ..~/~ ....... ~., ............................................................................................................... CountyTax Map No. 1000 Section .....~..~.. ............ Block ....... ~ .............. Lot No. ~ .................... pursuant to application dated ..,..,,~../~. ....................................... 19.~..,~.... ...... f Building Inspector. Fee ~..l/~.~... and approved by the /~,/' "8ull~l~g In~pec or Rev. 6/30/80 Form No. 6 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL 65-18o2 APPLICATION FOR CERTIFICATE OF OCCUPAI ~his application must be filled in by t~pewriter 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-~isposal(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/lO.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 '.'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. Fees 1. Certificate of Occupancy - New dwelling $25.00, Additions to dwelling $25.00, Alterations to dwelling $25.00, Swimming pool $25.00, Accessor~ 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 - $5.00 over 5 years - $10.00 4. Updated Certificate of Occupancy - $50.00 , 5. Temporary Certificate of Occupancy - Residential $15.00, Commercial $15.00 Ne~ Construction ' Old Or Pr is'ti g B ildi .... · ..' .... e-ex n u ng ......... Location of Prop.erty..~.~.Y... ~f~.~..~?~.~.~//~%..~-~ ...................................... House No. Street Hamlet 0nwer or Owners of Property .................................................................. County Tax Map No 1000, Section.../~.~ ...... Block ..... ?.~ ........ Lot..~..~. ............... Subdivision .................................... Filed Map ............ Lot ...................... Permit No..%J.~.~. ~.~,Date Of Permit.. ~./..~/.~.~.Applic'ant..~. ~'~-t~. %~-~...~ ..... Health Dept. Approval .......................... Underwriters Approval ........... i ............. Planning Board Approval ........................ Request for: Temporary Certificate...~ ....... Final Certicate...~.o ..... 'Fee Submitted: $ ............................. ..... · ................. INSPECTORS Victor Lessard Principa! Building Inspector Curtis Horton Senior Building Inspector Thomas Fisher Building Inspector Gary Fish Building Inspector Vincent R. Wleczorek Ordinance Inspector Robert Fisher Assistant Fire Inspector Telephone (516) 765-1802 OFFICE OF BUILDING INSPECTOR TOWN OF SOUTHOLD SCOTT L. HARRIS, Sttperv(s0v · Southold Town Hall P.O. Box 1179, 53095 Main Road Southold, New York 11971 Fax (516) 765-1823 Telephone (516) 765-1800 al/l,¥ 27, 1993 EI~.AI~IEL KOI~OVEROS 1095 WESTPHALL~ ROAD MA~ITUCK, ~ 11952 To Whom This May Concern: We are unable to complete your Certificate of Occupancy because of the following reasons: xax An application for Certificate of Occupancy is not on file. (Enclosed) No Underwriters Certificate on file. The check is ~"zxt~a~/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 $ 21464-Z Please contact our office on this matter. Thank you for cooperation. SOUTHOLD TOWN BUILDING DEPT. FOUNDATION (1st) FOUNDATION I 2nd ) ROUGH FRAME & .PLUMBING INSULATION PER N. Y. STATE ENERGY CODE FINAL ADDITIONAL COMMENTS' / / .' 765-1802 BUILDING DEPT. INSPECTION FOUNDATION 1ST [ ] ROUGH PLBG. [ ] FRAMING REMARKS: FOUNDATION 2ND [ ] INSULATION [ ] FINAL DATE' ~//~/~_~ INSPECTOR ~?~ FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N.Y. 11971 TEL.: 765-1802 / Examined ff. ZT. ........... , 19 .~.~. ' ' Approved.--i~ .......... 19 ~. Permit No ~ ./', .~.~. '~ ~h~ ~'-umapprovec[_ a/c ................................ ~ .... BOARD OF HEALTH ......... 3 SETS OF PLANS ......... SURVEY .................. CIIECK ................... SEFTIC FOR~I CALL MAIL TO: ............................ ........ Z.1 1098 ' APPLICATION FOR BUILDING PE IM'IT : ' '" '::%': ate .. ..... INSTRUCTIONS a. This application must be completely filled in by typewriter or in ink arfd 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?cuts or areas, and giving a detailed description of layout o£ property must be drawn on the diagram which is part of this appli- cation. ¢. 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 tlie premises available for inspection throughout thc work. e. No building shall be occupied or used in whole or in part for any purpose wha(ever 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 thc Building Zone Ordinance of the Town of Southold, Suffolk County, New York, and other applicable Laws, Ordinances or Regulations, for tlie 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. -- (Signature of applicant, or name, if a corporation) ........... -~, ;~ ~,~ .................. :' ;~;~ (Mailing address of applicant) State whetherxa~m~n~ m,: o, wner~, lesse~, ,agent; architect, engineer, general contractor, electrician, plumber or builder. .................... '~,,; ...... :..;.; 2 ~ .'2~. ................' ......................................... Xam, or ow~,~ or p,,m~,~s . ~../~[~ ~ .~ ..................................... (as on the tax roll or latest deed) If applicant is a corporation, signature of duly authorized offioer. (Name and title of cgrporate officer) Builder's Licehse ,No .... ~/d~.~2~... ......... Plumber's License No ......................... Electrician s Lmense No ....................... Other Trade's License No ...................... 1. Location of land on which proposed work will be done. ' ........ 4>. x/) ' .'ITE.///?~. . ........ ' House Number . Street Hamlet cotmty Tax Map No. 1000 Section ...t.~-q.1 ......... Block .... ~ ...... :,., Lot .... Subdivision ........ . ...................... ' Filed Map No. Lot ............... (Name) 2; State existing use and occdpancy of premises and inJ~ended use and occupancy of proposed construction: ......" ................................ a, Existing use and occupancy b. l. ntended use and occupancy i..~'~' L/'bO/' ~ ~" ~> .... ~.. ,~..~.....~..~< ...... : ...................... '3. Nature of work (check which applicable): New Building . ~ ...... '. ·. Addition' ' ' ' (Desc on 4. Estimated Cost Fee · . . .... (to be paid on filing this application) 5. If dwelling, number of dwelling uhits · ..... Number of dwelling units on each floor ................ Ifgaag mb cfc ' r e, nu er ars . ' ' ' ' ' · xea'~ c'upa c,: ~p; if; 6 If b si ............................................................. · u ness, co.mmercial or mi c n c nature and extent of each type of use 7 D'mensio s of xi ting structure ! if any: F ~ · ] n e s s rent ........... :.. Rear .............. Depth ............... Hight N b;erofStoies ~...'.. ' Dim nsio of shin tru ith Itt atio addition F .................................. e ns e s cture w a r nsor Sl rent ................. Rear .................. D pth ' Hight ' ' e ..................... i' e ................... :.. Number of Stories ...... ' 8 Dimensio of nti w construed F ' ' ....... ' ........ ' Rea ' D pth · ns e re ne , on: rent .............. , r ..... ...... .. e .......... Hight Numbe of Stori ........ 9 Si f I Fr i ~ R .......................... · zeo ct: ont ............ '... ear .................... Depth ..... 10. DateofPurchase ............ ~ .... Na eofForrne Own ................. 11 Zen e di trict in ........... m r er ....................... wi i h p mis ituated ' ' ecrus s lc re es ares ................. ; ............................... 12 Do sp opes d cfi vi lat:e oni glow d."na6ce · Y gulation: e r e constru on o an z n ,or or re .................... 13 Will lot b grad d e ............ · e re e ....... ; .................... Will exc ss fill be removed from premises: Yes No 14. Name of Owner of premises ........... ; ....... Address ................... Phone No .... . Name of Architect ......................... Address ................... Phone No ................. Name of Contractor ........................ Address ............ ; ...... Phone No ................ 15. I.s this property within 30] feet of a tidal wetland? *Yes ...... No ......... · If yes, Southold Toqn Trustees' Permit may be required· '" PLOT DIAGRAM Locate clearly and distinctly all b~ildings, whether existing or proposed, and. indicate all set-back dimen property lines Give street and block number or deo'"~''*; ................... slons from · ,,~-v-u- u~urumg [o ueea, ana snow street names ano lnuicate whether interior or corner lot. . · . ' APJqlffEO AS NOTED -- ,. 765-1802 9 AM ~ 4 P~R THE FOLLOWING INSPE~IONS: 1. FOUNDATION - ~0 REQUIRED FOR POURED CONCRETE 2. ROUGH - FRAMING & PLUMBING 3. INSU~TION 4. FINAL - , CONSTRUCTION MUST BE COMPLETE FOR C.O.. ALL CONSTRUCTION SHALL ME~ THE REQUIREMENTS OF THE N.~ STATE CONSTRUCTION & ENERGY CODES. NOT RESPONSIBLE FOR DESIGN OR CONSTRUCTION ERRORS STATE OF NEW YORK coulwYOF.:.-h 2 l .., s.s! /_ .............. . . s :2ce .j. (Name of individual signing ~ontract) above named. being duly sworn, deposes and says that he is the applicant ~eis ~ntract0r the c;r'poiate officer,'e't~ ') ............................ , agent,. of said owner or owners, and is duly au ihorized to perform or have performed the said work and to make and file this application; that all statements containec in this application are flue to the best of his knowledge and belief and that the work will be performed in the manner set in the application filed therewith. Sworn to before me this . ~rm Expires October 3!, 19 v 5t '