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Home My WebLink About20627-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCuUmANCY No Z-23123 Date JULy 27, 1994 THIS CERTIFIES that the buildin~ Location of Property 1445 RUTH ROAD House NO. County Tax Map No. 1000 Section 106 Subdivision ADDITION M~TTITU~K, NY Block 7 Filed Map No. Lot No. Street Hamlet Lot 12 conforms substantially to the Application for Euilding Permit heretofore filed in this office dated MAY 15, 1992 pursuant to which Building Permit No. 20627-Z dated MAY 15, 1992 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 REPAIR EXISTING DECK AS APPLIED FOR. The certificate is issued to ZACHARIAS PERTSINIDES of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL UNDERWRITERS CERTIFICATE NO. PLUMBERS CERTIFICATION DATED (owner) N/A N/A I~spector Rev. 1/81 F~e NO. ~ TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N. Y. BUILDING PERMIT FI'HIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL cOMPLETION OF THE WORK AUTHORIZED) N~-N? 20627Z Dote / Permission is hereby granted to: - ...... /...~.~: ......... ~ ........ ,~.... .............. ......... ~~ .......... ~:j, . ....... //.~.~J: . to ........ ~ ..... ' ....... ~ .... at premises located at .......... ./.~....,~..~..~.. ........... ~...~; ....................................................... County Tax Map No. 1000 Section .../.t~.~.. ........... Block ..... .~.. ............. Lot No ....../.....~.. ........... pursuant to application dated ................................................ ~..~ /0~'~ , 19..~....'~..~ and approvt~:l by the Building Inspector. Fee $ ............ : ........... Rev. 6/30/80 Form No. 6 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL 765-1802 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 I% 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 $25.00, 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 - $20.00 4. Updated Certificate of Occupancy - $50.00 5. Temporary Certificate of Occupancy - Residential $15.00, Commercial $15.00 Date ............ 7'''' ~' ....................... New Construction ........... Old Oz Pre-existing Building ........ Location of Property ..... House No. Street ~et Onwer or Owners of Property...~aCJ~f~f~{..~[(.~/.~i.. ~?~;~.~ County Tax Map No 1000, Section .... ~.2~ .... Block...~ ........... Lot. Subdivision .................................... Filed Map ............ Lot ...................... Permit Pe~it ...................................... Applicant ....... Health Dept. Approval.' ......................... Underwriters Approval ......................... Planning Board Approval ........................ Request for: Temporary Certificate ........... Final Certicate ........... Fee Submitted: $ ....................... ZB ............... ................. '~OU?__~D~'_.T~O__N ---. _ (l~t_~) '~OUNDATION (2nd } '~OUGH FRAME & ·PLUMBING [NSULATION PER N. Y. STATE ENERGY CODE FI:IAL ADDITIONAL COMMENTS 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 July 11, 1994 Mr. Zacharias Pertsinides 199 Ruth Road Mattituck, NY 11952 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 # 20627-Z Please contact our office on this matter. cooperation. Thank you for SOUTHOLD TOWN BUILDING DEPT. FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N.Y. 11971 TEL.: 765-1802 Examined...~./..,~. ...... , 19 Approved ...~./../~-. ........ 19 ~2f. Permit No.,~..~. ~...~.~ Disapproved a/c ..................................... . (~u'~ino Inspector) APPLICATION FOR BUILDING PERMIT INSTRUCTIONS BOARD OF HEALTH ......... 3 SETS OF PLANS .......... SURVgY ................... CIIECK .................... SEPTIC FORH .............. 0 ~ a. Tlfis application must be completely filled in by typewriter or in ink and submitted to the Building Inspector, with 3 s?ts 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 streets 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 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, or for removal or demolition, as herein described. The applicant agrees to comply with ail 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 whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. (Name and title of corporate officer) Builder's License No ..... ~./..CJ.~.~A ........... Plumber's License No ......................... Electrician's License No ....................... Name of owner of premises 20C~)O[F-/C~-~ /~-/~/f~)/c'f[~y~~Bo~#,,;,~,Z.7, (as on the tax roll or late~ed~ If applicant is a corporation, signature ofduly authorized officer. N~ BUILDING D~PA~TM~ A~' 7654802 9 AM ~ 4 PM FOR THE FOLLOWING INSPECTIONS: ~. FOUNDATION ~0 REQUIRED FOR POURED CONCRETE 2, ROUGH - FRAMING & PLUM~ING 3. IMSU~TION 4. FINAL CONSTRUCTION MUST ME COMPL~E FOR C.O. ALL CONSTRUCTION SHALL THE MEQUIREMEN~ OF THE N.Y. STATE CONSTRU~ION & ENERGY Other Trade's License No ...................... /¢~ ~ 1. Location of land on which proposed work will be'done ......... f~ ~'~N O ON House Number Street Hamlet County Tax Map No. 1000 Section .................. Block ............... Lot ................... Subdivision ..................................... Filed Map No ............... Lot ............... (Name) 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: b. Intended use and occupancy ..... .~...~-~- .......... ~.'.. ~....~. ....... 3. Nature of work (check which applicable): New Building .......... Addition .......... Alteration .......... Repot . ./?..~....._..: ]g, Clno~l ........... Demolition ............ Other Work ~" ~' 001 ~,.~ f C (Description) 4. Estimated Cost... · .... Fee ...... · ~ / (to be paid on filing this application) 5. If dwelling, number of dwelling Units ............... Number of ~Telling units on each floor ................ If garage, number of cars .. ~.. ' ,m ' ' i oecu f business, co mercml or mixed panty, spec nature and extent of each type of use ..................... 7. Dimensions ot existing structure~, if any: Front ............... Rear ....... .' ...... Depth ............... Height ............... Number of Stories ........................................................ Dimensions of same structure with alterations or additions: Front .................. Rear .................. Depth i Height Number of Stories 8. Dimensions of entire new constr~ction: Front Rear .............................. Depth ............... Height ............... Number of Stories ........................................................ 9. Sizeoflot: Front i . Rear -' ..... .............................. .ep n '"h' 5(0.' .............. 10. ate of Purc ase ..... /.'~./..~. ~ ........· ......... Name of Former Owne, r ....... ,f..Q 11. zone or use uistrict in which premises are situated ......................................... ' ........... 12. Does proposed construction viol{re any zoning law, ordinance or regulation: ........... . .J,~.O.. 13. Will lot be regraded ................ ..... ' ...................... Will excess fill be removed from premises: Ye~ No 14. Name of Owner of premises~..o,h.o.r.~'x. '~..?.s.~.q/.N.e..~.. Address/.~? .,?yf.~. ?.d. Phone No...~.?~.: f./?.~. .... Name of Architect ~ Address Phone No Name of Contractor .......... i ................ Address .................. Phon~jNo ................ 15. Is this property within 300 feet of a tidal wetland? '*Yes ........ No.. · If yes, Southold T9wn 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 nbmber or description according to deed, and show street names and indicate whether interior or corner lot. qotary Public, .~ ~ .. .~ ~ ~ ELIZAr~TH ANN NE~J.F.- Notary Public, State of ~ewiY~ No. 52-8125850, Suffolk C( 'l~rm ~xpires October 31, 1.( (Signature of applicant) [~ame oI maiviauat signing conrrac[) :lbove named. [-[e is the ~r , agent, corporate officer, etc.) )f said owner or owners, and is duly ~uthofized to perform or have perfo~ed the said work and to m~e and file this ~pplicafion; that all statements contained ~ this application are true to the best of his knowledge and belief; and that the .york wHl be perfo~ed in the m~ner s~t forth in the application filed therewith. ;worn to before me this ~