HomeMy WebLinkAbout19836-z FORM NO. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Office of the Building Inspector
Town Hall
Southold, N.Y.
CERTIFICATE OF OCCUPANCY
No Z-20401 Date DECEMBER 10, 1991
THIS CERTIFIES that the building ADDITION
Location of Property 50 LINDA RD. & 2225 CENTRAL DR. MATTITUCK N.Y.
House No. Street Hamlet
County Tax Map No. 1000 Section 106 Biock 1 Lot 17
Subdivision Filed Map No. Lot No.
conforms substantially to the Application for Building Permit heretofore
filed in this office dated APRIL 24, 1991 pursuant to which
Rui.lding Permit No. 19836-Z dated MAY 3, 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 SCREENED PdRCH ADDITION TO E%ISTING ONE FAMILY DWELLING
The certificate is issued to CHRISTOS KATOS
(owner)
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A
UNDERWRITERS CERTIFICATE N0. N/A
PLUMBERS CERTIFICATION DATED N/A
uilding Inspector
Rev. 1/81
FOEM NO.
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN HALL
SOUTHOLD, N. Y.
BUILDING PERMIT
(THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL
CQMPLETION OF THE WORK AUTHORIZED)
N° 1 9 8 3 Z Date ....:L:1,/...~ 19.~/
Permission is hereby anted to: _ J~
.~,....~1..% ~ l.~ . ~
~XJw, r
...~.~t~
at premises located ot ........~.P.......~l~e/~9r........
~.2...~.:~~~~~~.~~...<I..:.................................................................
County Tox Map No. 1000 Section .........~Q...Ga.... Block ..........1......... Lot No......./...~.........
pursuant to application dated 19. and approved by the
Building I/nspector.
Fee $>~~i~
sLG.r
uildl Inspector
Rev. 6/30/80
91~ ~w ~ ~ Forin No. 6 ~ ?
' • ' U ~n ti~d~/
TOWN OT SOUTIIOLD ~ Cl ~ ~ ~ 2G
BUILDING DEPARTMENT (1~V`
TOWN HALL ~ `r
765-1802
t~
APPLICATION POR 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 19 lead.
S. Commercial building, industrial building, multiple residences and similar buildings
and installations, a certificate of Code Compliance from arctii:ect 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 duelling $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 - Residentia/l~ $15/.00, Commercial $15.00
Date W..4~-t. 9~
ew Construction...Y/...... Old Or Pre-existing Building
ocation of Property.....>~.C~ ..............~~..)n1l~A 1:EBr~.........'~~?:''H L~°2~Zr~w..
House No. Street Hamlet
awer or Owners of Property...-; `!~;1;iS~vS... ~r~~(~.5 . . . • .
aunty Tax Map No 1000, Section...~.4.~,,,,, ~
.Block..... .Lot..
~bdivision....,
qq ...Filed Map........ .`Lot......................
ermit No.l.l~~~~,,,,,,Date Of Permit..y~L~~9,),,,,Applicant.:~t~~t:!';f'~~1,!\~,,,,,,,..,
:alth Dept. Approval....,,, //,,,,Underwriters Approval...,
anning Board Appraval.......J^,~
quest for: Tempor ry Certificate........... Final Certicate...........
e Submitted: $..~„S:P.:~
C~~c~ `Ind ~'L r~~~~i .
~C1 ~ aU~U ~ . • APPLICANT
INSPECTORS
Victor Lessard i~i;l,
Principal Building Inspector ,'jp~~,~~ -A
Curtis Horton ~
ff , L~~, SCOTT L. HARRIS, Supervisor
Senior Building Inspector ~ a 1;M - '
r.t r' , 5,~',, , ~ Southold Town Hall
Thomas Fisher . G n ,
P.O. Box 1179, 53095 Main Road
Building Inspector ;Z is ~
Gar Fiah v `.~'?n ~ <J•''",~i~ Southold, New York 11971
Building Inspector ~ ='4 ~`'dy~ Fax (516) 765-1823
Vincent R. Wieczorek Telephone (516) 765-1800
Ordinance Inspector
,~an~e_"
Robert Fisher
Assistant Fire Inspector OFFICE OF BUILDING INSPECTOR ~ ~
r{
Telephone (516) 765-1802 TOWN OF SOUTHOLD
NOVEMBER 25, 1991 r
)
a. ~~r.,
ROBERT BORN
BO% 55
PECONIC, NY 11958
REe CHRISTOS KATOS S WF
• To Whom This May Concern:
We are unable to complete your Certificate of Occupancy
' because of the following reasons:
An application for Certificate of Occupancy is
not on file. (Enclosed)
No Underwriters Certificate on file.
xxx 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 plumhing being
issued after April 1, 1984).
BUILDING PERMIT # 19836-Z
Please contact our office on this matter. Thank you for
cooperation.
SOUTHOLD TOWN BUILDING DEPT.
CC: CHRISTOS KATOS 6 WF
INSPECTORS
Victor Lessard i'i?(,;•
Principal Building Inspector -%o
i~"., -s,, ~ SCOTT L. HARRIS, Supervisor
Curtis Horton ~ ~
ti.,,,:
Senior Building Inspector ~ < -
„ as <<, i ~ ~ Southold Town Hall
Thomas Fishec ~ , .^r ~ P.O. Box 1179, 53095 Main Road
Building Inspector ~ i
° ,•?±~y„/. ~'C~ri Southold, New York 11971
Gary Fish t - Fax (516) 765-1823
Building Inspector ~ ~ ';,f~
Vincent R. Wieczorek ~"'"-=~F`' Telephone (516) ?65-1800
Ordinance Inspector
Robert Fisher
Assistant Fire Inspector OFFICE OF BUILDING INSPECTOR
Telephone (516) 765-1802 TOWN OF SOUTHOLD
NOVEMBER 25, 1991
ROBERT BORN
BO% 55
PECONIC, NY 11958
RE: CflRISTOS RATOS S WF
To Whom This May Concern:
We are unable to complete your Certificate of Occupancy
because of the following reasons:
An application for Certificate of Occupancy is
not on file. (Enclosed)
No Underwriters Certificate on file.
%3[% 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 # 19836-Z
Please contact our office on this matter. Thank you for
cooperation.
SOUTHOLD TOWN BUILDING DEPT.
CC: CHRISTOS KATOS 6 WF
=1::LD II:SPEC7ION ~~UATE ~ i:Oh1MENT°
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ISJSULATION PER N. Y. y
STATE ENERGY
CODE
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ADDITIONAL COMMENTS: x
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765-1802
BUILDING DEPT.
1 NSPECTION
[ ) FOUNDATION i5T [ ] ROUGH PLBG.
[ ] FO NDATION 2ND [ ]INSULATION
FRAMING [ ] FIN-A4L
REMARKS: 4~_ ~-~rn~,,,_,,,,~
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' 60,1RD OF HEALTH
FORM NO. 1 } SETS OF PL lyS .
TOWN OFSOUTHOLD SURVEY
BUILDING DEPARTMENT CIIECI: . . . .
TOwN HALL serrzc road
SOUTHOLD, N.Y. 11971
TEL.: 765-1802 ttDT ~FY ; . ~ J~
CALL
Examined ..J.. 3........., 199./. CC,~ G P L TO
Approved !~/i~ , 19~. Permit No. ~(,~J~~ . .
Disapproved a/c/
~ ~
(B ildi e I pector)
APR 241991 ~ i
1 APPLICATION FOR BUILDING PERMIT
TCiVUid C~~ t;e:~tr~'~-';,,.;~~ Date . 19 .
~,.,._...~..,.-...W.~_,,..,.
INSTRUCTIONS
a. This application must be completely filled in by typewriter or in ink and submitted to the Building Inspector, with 3
ets 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
~r areas, and giving a detailed description of layout of property must be drawn on the diagram which is part of this appli-
:ation.
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
hall 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
hall 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
,3uilding Zone Ordinance of the Town of Southold, Suffolk County, New York, and other applicable Laws, Ordinances or
tegulations, for the 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
dmit authorized inspectors on premises and in building for necess insp ctions.
(Signature of applicant, or name, if a corporation)
(Mailing a ress of applicant)
hate whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder.
Jame of owner of premises \.1~'t :-1 Tess , '~yS ,
(as on the ta~X roll or latest deed)
f applicant is a corporation, signature of duly authorized officer.
(Name and title of corporate officer)
Builder's License No. ..r~. 7, . , , , , ,
Plumber's License No. ~ , , , , - , , , - , ,
Electrician's License No. ~ .
Other Trade's License No . .
Location of land on which proposed work will be done. ~ ~ , , . ~".y:/~ .
House Number St//reet / Hamlet
County Tax Map No. 1000 Section ~ U........ Block 4
Lat.f.7
Subdivision . Filed Ma No. Lot .
P
(Name)
State existing use and occupancy of premises and intended use and occupancy of proposed construction:
~ ~y~ 1
a. Existing use and occupancy .....4<.:. ~,~7 ~!?',1,~/ , , .
b. Intended use and occupancy _ ~ ~a
i 1
3. Nature of work (check whiRemo~licable): New Building Addition Alter ion . .
Repair . , al . Demolition ~ . , .Other Wo~16~s
./~.p~~/~
q~ (Description)
4. Estimated Cost ~ ,
5. If dwellin number of dwel[m u (to paid on flung this application)
g> g nits....... , . 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 t
ype of use , .
imenstons of existin structures;
, B ' if any: Front . Rear Depth .
g Num b
Dimensions of same structure wit er of Stories , , , , , , , , , , , , , , , , , • • •
alterations or additions: Front .Rear .
g ...............Numb,. Height , Number of Stories .
Hepht .....................ction:Front............... Rear.,............. Depth
8. Dimensions of entire new constru,er of Stories . . . . . . • , , , • , , , , , , , , , , , .
9. Size of lot: Front i " " " " " " " " •
p Rear Depth
10. Data of Purchase
............'i Name of Former Owner f.~~,~:.: Si j(, .
1 1, Zone or use district in which realises are situated , , , , , , , , , • , , , , , • , .
12. Does proposed construction viola~e any zoning law, ordinance or regulation: .
Name of Architect Q ' ' ' Will excess fill be removed from premises: Yes
of be regraded ~tr3~S Address . ..................Phone No.
Vii, .Address ...................Phone No...........:... .
4 Name of Contractopr~ise ~~/i'• • •~~~L~r~Address ..~osY.:r,~, , . , ne No..Z ~?J-:
,1/.~, p . .
15. Is thi* property within 30 .
If yes, Southold Too feet of a tidal wetland? eyes...... No..
wn Trustees Permit may be required.
j 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 n tuber or description according to deed, and show street names and indicate whether
'interior or corner lot.
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;TATE OF NEW YO~I~ ' ~ ~ l7 ~
-OUNTY OF . • • S S
' ' ' ~ • • • • ~ • • • • • • • , . being duly sworn, deposes and says that he is the applicant
(Name,of individual signing contract)
hove named.
e is the ~~.v,?;~Y;~ c~!'V, , , , .
(Contractor, agent, corporate officer, etc.)
f said owner or owners, and is duly authorized to perform or have performed the said work and to make and file this
~plication; that aH statements contained in this application are true to the best of his knowledge and belief; and that the
ork will be performed in the manner set forth in the application filed therewith.
Nom to beforegqme this
..........n5.'~"~'" . .day q~.. w~... 19 .
t,/~... '
otary Public, s~~~
• .Count
ROBERT 1. SCOTT, JR. . .
NOiARIf
P~UBLISte~ of N.. .
ig47ExpIres~Y~~+P z (Signature of applicant)
tloJ ,
i i i i i FEE.
DATE: p gV:
NOTIFY 8 IIL !NG DEPA NT AT
765-i£3C1 AM TO 4 PM FOR THE
FOLLl~ti9~I~~C'!NSPcCTI ~REOUIRED
V~` t. Fo_i;v~~aTtaN
v FCt+< POURED CONCRETPLUMBING
~ ^~+~~~~0'y j 2. RO':4s,~ - fRAMIN(~ a
~ ~ `p@[~`„ 3.INSttiJ>TION NMUST
` ~ 4. BE COMPLETE FOR C•U'O
~ V ALL CONSTRUCTION SHALL MEET
v THE N.Y.
'(HE REOUIREMEIR ON & ENERGY
t ~ i STATE CONSTR
~pONSIBLE FOR
~ ; "E . , ' 'P ` U~ ~~V i O~~ES. NOT VON ERRORS
e ~4~~ DESIGN OR CONSTR
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