HomeMy WebLinkAbout19979-zFORM NO. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Office of the Building Inspector
Town Hall
Southold, N.Y.
CERTIFICATE OF OCCUPARCY
No Z~22634
Date OCTOBER 1~ 1993
THIS CERTIFIES that the buildin~
Location of Property 775 SHORE DRIVE
House No.
County Tax Map No. 1000 Section 47
Subdivision
ADDITION
Block 2
Filed Map No.
GREENPORT~ N.Y.
Street Hamlet
Lot 20
Lot No.
conforms substantially to the Application for Building Permit heretofore
filed in this office dated JTJNE 20, 1991 pursuant to which
Building Permit No. 19979-Z dated JUNE 26~ 1991
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 DECK ADDITION TO EXISTING ONE FAMILY DWELLING AS APPLIED FOR
The certificate is issued to
(owners)
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL
UNDERWRITERS CERTIFICATE NO.
PLUMBERS CERTIFICATION DATED
NIKITAS & STAVROULA VAFAKOS
Rev. 1/81
~ ding Inspector
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN HALL
SOUTHOLD, N. Y.
BUILDING PERMIT
(THIS PER~IT MUST BE KEPT ON THE PREMISES UNTIL FULL
COMPLETION OF THE WORK AUTHORIZED)
Ne- 19979 Z
Permission is hereby granted to:
_ .~~.....~:~:. ...... ~.L.~.~.~ ........
~~..~.. ~, ........ ~..~ ............ / ..... .~ ........
~,~ .~-~~...~~,L~ ~ ............... ~ ........
,t p.mi.s I~.t~ et ...~.2.~......~...[).~ ................ ~.~~ .....................
County Tax Map No. 1000 Section ......C~....~.....'~. .......Block ....C~.....~.. ........... Lot No....~......0.. ...............
pursuant to application dated ............ ~ .......................... , 19...~.~.., and approved by the
Building Imipector.
Rev. 6/30/80
Form No. 6
TOWN OF SOUTtIOLD
BUILDING DEPARTMENT
TOWN HALL ·
765-1802
APPLICATION FOR CERTIFICATE OF OCCUPAN~
This application must be filled in by typewriter OR ink and.~s~itted to the buflding
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
"pre-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 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, Accessory 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
~ ~-~--~ Date .........
New Construction.~.~... Old Or Pre-existing Building ..... iiiiiii[iii~'~'~'''~b
Location of Property...U.¥.~....~.~q~-.~.~. ~.J-~...~.~..~.~. ..... ~'~.~ .~.?..~P..~..(.--.
House No. Street Hamlet
Onwer or Oweers of Property ............
County Tax Map No 1000, Section .............. Block ................ Lot ......................
Subdivision ................... Filed Map Lot . .
Permit No. ./..~.~./.~.~Date Of Permit ................ Applicant .
Health Dept. Approval ......................... · Underwriters Approval .................... .. . ..
Planning Board Approval ........................
Request for: Temporary Certificate ........... Final Certicate ......
Fee Submitted: $. '~-~. ...............
/
di .. ................ .....................
INSPECTORS
Victor Lessard
Principal Building Inspector
Curtis Horton
Senior Building Inspector
Thomas Fisher
Building Inspector
Gary Fish
Building Inspector
Vincent R. Wieczorek
Ordinance Inspector
Robert Fisher
Assistant Fire Inspector
Telephone (516) 765-1802
OFFICE OF BUILDING INSPECTOR
TOWN OF SOUTHOLD
Sept. 9, 1993
SCOTT L. HARRIS, Sul~erviser
Southold Town Hall
P.O. Box 1179, 53095 Main Road
Southold, New York 11971
Fax (516) 765-1823
Telephone (516) 765-1800
M&M Stavoula Vafakos
561 74th Street
Brooklyn, N.Y. 11209
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.
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 ~ 19979-Z (DECK)
Please contact our office on this matter.
cooperation.
Thank you for
SOUTHOLD TOWN BUILDING DEPT.
FOU~DATION (1st)
FOUNDATION (2nd)
2.
ROUGH FRAME &
.PLUMBING
INSULATION PER N.
STATE ENERGY
CODE
FINAL
ADDITIONAL
COMMENTS:
o
A j
.)
~. INSUL
4-. FINALi
__[[ ALL CO,
THE RE(
-- -- -- 817ATEr C
COOES.
iI
765-1802
BUILDING DEPT.
INSPECTION
[ ] FRAMING
FOUNDATION 1ST [ ]ROUGH PLBG.
FOUNDATION 2ND [ ]INSULATION
[ ]FINAL
REMARKS:
DATE . INSPECTOR
¢ONSUi.T YOUR LAWYER EEFORE SIGNING THIS INSTRUMENT--THIS INSTRUMENT SHOULI) ~E USE1D EY L~WYE~S ON~.Y.
Between ASPASIA ~L/~RTAt~IS, residing at 24-12 24th Avenue, Astoria, Queens,
New York 11102 and PHYLLIS SBEORIS, residing at 1117 Grayton Hoad, Grosse
Point Park, County of Wayne, Michigan, as joint tenants with right o~ survivorship,
party, ofthefirstpart, and NI~KITAS VAFAKOS~ residing at 561 74th Street, Brooklyn,
New :~ork 11209,
~rt¥ of the ~oo~d ~att,
Witnesseth, that the party of the first part, in consideration of Ten Dollars and other valuable consideration paid by
the party of the second part, does hereby grant and release unto the party of the second pert, the heirs or successors
and assigns of the party of the second part forever,
All that certain plot, piece or parcel of land, with the buildings and improvements thereon erected, situate, lying and
b.eing in the Town of Southold, County of Suffolk and State o£ New York, as shown and
designated on a certain map entitled, "Map of Greenport Shores, Section One,
Greenport, Town of Southo[d, New York", and filed in the Office of the Clerk of
Suffolk County on June 29, 1950, as Map No. 1759, as and by all of Lot number 7
and the northerly 25 feet of lot number 8, which lot and part of lot when taken together
are bounded and described as follows:
BEGINNING at a point on the easterly side of Shore Drive distant 277.7 feet
southerly from the corner formed by the intersection of the southeasterly side of
Shore Drive and the easterly side o~ Shore Drive; running thence south 83 degrees
40 minutes 40 seconds east 125.0 ~eet; thence south 6 degrees 19 minutes 20
seconds west 75.0 ~eet; thence north 83 degrees 40 minutes 40 seconds west
125.0 feet to the easterly side of Shore Drive~ thence north 6 degrees 19 minutes
20 seconds east along the easterly side ot'Shore Drive, 75.0 feet to the point or
place of BEGINNING.
SAID PREMISES being known as and by 522 Shore Drive, Greenport, LI, N.Y.
Together with all right, title and interest, if any, of the party of the first part in and to any streets and roads abbtting
the above described premises to the center lines thereof; Together w~th the appurtenances and all the estate and
rights of the party of the first part in and to said premises; To Have And To Hold the premises herein granted unto the
party of the second part, the heirs or ~ucces~ers and assigns of the party of the second part forever.
And the party of the first part covenants that the party of the firsi part has not done or suffered anything whereby the
said premises have been encumbered in any way whatever, except as aforesaid.
And the pa¢,ty of~t~fir~art~O, (~mpliance with Section 13 of the Lien Law, covenants that the party of the first
t-h~TJcon~'~.~'~or'e~"~.conveyance and will hold the right to receive such consideration as a trust
part
fund to I~'~'applied first fo'l~l~purpose'-x~ of paying the cost of the improvement and will apply the same first to the pay-
ment of the cost of the improvement before using any part of the total of the same for any other purpose.
The word "party" shall be construed es if it read "parties" whenever the sense of this indenture so requires.
In Witness Whereof, the party of the first part has duly executed this deed the day and year first above written.
In Presence Of:
FORM NO. 1
TOWN Of SOUTHOLD
BUILDIN~ DEPARTMENT
TOWN HALL
SOUTHOLD, N.Y. 11971
TEL.; 765-1802
~,~,,n,cd. ~...+e~....~., 19 ~.1.
pproved . '7/-J~l.....? ~.., 19~ J. Permit Ne..[
isapproved a/c ....................... , ......
..... ,.:. ....... 7-. ..............
(Iluilding Inspector)
gO,xliD OF HE,\I-I"II .........
3 SETS OF Pf..%tt2 ..........
SURV£¥ ...................
ClIEcK ....................
SEPTIC ['0 R:I ..............
CALL
.......
APPLICATION FOR BUILDING PERMIT
Date
INSTRUCTIONS / "'
a. This application must be completely filled in by typewriter orin ink and submitted to the Building Inspector, with 3
s or plans, accurate plot pIan to scale. Fee according to schedule.
b. Plot plan showi2g location of lot and of buildings on premises, relationship to adjoining premises or public streets
?teas, and giving a detMled description of layout of property must be drawn on the diagram which is par~ of this appli-
¢. The work covered by this application may not be cbmmeneed before issuance of Building Permit.
d. Upon approval of this application, the Building Inspector will issned a BuiId[ng Permit to the applicant. Such permi~
!1 be kept on the premises available for inspection throughout the work.
e. No building shall be occupied or used in ~vhole or in part for any purpose whatever until a Certificate of Occupancy
II ha:ye been granted by the Building Inspector·
AP~PLICATION IS HEREBY MADE to the Building Department for the issuance of a Building Permit pursuant to the
!ding Zone Ordinance of the Town or Southold, Suffolk County, New York, and other applicable Laws, Ordinances or
:ulations, for the construction of bu;ldings, additions or alterations, or for removal or demolition, as herein described.
: applicant agree~, to comply with ali applicable laws, ordinances, building code, housing Code, and regulations, and to
:e whether appI[cant is owner, Iessee, agent, architect, engineer, general contractor, electrician, nlumber ' ·
e t,~,~ roll or latest deed)
~plicant Js a corporation, s~snature o£duly author[zed of fleer.
(N d titl £ ffi ) .......
Builder's,License No...
Plumber's License No ........... :
Electrician's License No ................
Other Trade'$ License No
00r ......... .... ........ . .'" "'"'
' · ................... Filed Map No.
(Name) ........ Lot ..........
ate existing use and OCcupnncy of premises and in tended use ~nd occupancy of l~roposed construct[on:
Intended uSe ~nd occupancy . ~... dE~ ....
3. ot w r' check which a 'Plicablc): New Budding .......... Addition ........... \lteratmn ...
...... Removal .............. DelnoJition .......
· /. ..............
4. Estimated Cost... ~' ~ ~T~ (aescr, ption~
If dwelling, of dwelling ~ (to)c pa d on filing this appflcatmn)
5. number nits ............... Number on each floor.
. Ifgarage, numberofcars . , ofdwellingumts
' ' ....T'; .... ' .....
If business, commercla[ or mixe ....... . ............................ . ..........
7. Dimensions of existing occnp nc s,e fJ
stmctUres~,ifany: Front ............... Rear . Depth
Height ............... Num t~cr o f Stories ................ ' ............ · ..............
D~nensions o~same stm~ctnro wit'h alterations or additions: Front ..............................
Depth .....
. .' .......... ~ Hm,l~t.. . · ................ Rear. .
3. Dimensions onstm,ct~on: Front ~ ~ .~ffff.~. ' .... Numbar of Storms .... ' ..........
ment rcnewc ' ' .............. "
~mgh[,... Z ..... ~ .~ . Num b~cr of S~ofics ' ~ .............
' '' · Rear/.~.W~,.. Depth -~O.
9. ~lZa OIlOt: front '/,~. , i ...... ~.~ .........
0. g~o~u~,~ ' ................. ~.~.3 ........... "~[;'"7~"4 ............
3, W~llot be regraded
4. Nme of Owner of premises ~/ 1/~ ~ ~ '~'~' ' · ~VflI excess tall be removed from premises'
Name of Architect . .~ ~'7~ ~.3. Address ~3. Z · · ~&.L~e N~ q
' "'--~ ............... Address 7 ~' ,.~'~' 'F~.~.a.~
~. ~e of Contractor . .~&. ~ ................ lmone ~o . . . .
' · · ' ............... Address ................... Phone N% .............
zs cars property wzehzn 300 feet of a eida~ wetland? *Yes ........ No..~.~.. ''
· If yes, Sou~hold To~n Trustees Permit may be required.
· .-. . PLOT DIAGR~ ·
Locate clearly ~d distinctly ~1 b~ild~gs, whether existin o '
:opeay lines. Give street ~d block n-a ..... ' g r proposed, and. indicate al set-b
tenor or comer lot. m,ugr or neScnptlon according to deed, and show street nines ~ fl~ensions from
indicate whether
'FE OF NEW.YORK, '. ,
NTY OF.. l~l~.6;-._S ........ S,S '
(Name of indivklual signing conltract) '
named.
thc ...........................
J(Contractor, agent, corporate officer, etc.) ...........
d owner or owners, and is duly aufllo'rizcd to perform or ]lave performed the said work and to make and file this
at/on; that all statements cent;dried ltl! tills a, pplication are true to tile best of his knmvledgc and belief; anti that thc
',viii be perforated in thc ~nanncr set forlth in (he application flied therewith.
to before me this
.p?,,c. ......
County