HomeMy WebLinkAbout19594-z FORM N0. 4
TOWN OF SOUTHOLD
~ - - ~ - ~-'$UILDING DEPARTMENT
Office of the Building Inspector
Town Ha11
Southold, N.Y.
CERTIFICATE OF OCCUPANCY
No Z-20289 Date OCTOBER 17, 1991
THIS CERTIFIES that the building ADDITION & ALTERATION
Location of Property 240 CAPTAIN KID DR. & 60 INLET DRIVE MATTITUCK NY
House No. Street Hamlet
County Tax Map No. 1000 Section 106 Block 3 Lot 23
Subdivision Filed Map No. Lot No.
conforms substantially to the Application for Building Permit heretofore
filed in this office dated OCTOBER 16, 1990 pursuant to which
Building Permit No. 19594-Z dated DECEMBER 20, 1990
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 ADDITION & ALTERATIONS TO EXISTING ONE FAMILY DWELLING AS
APPLIED FOR.
The certificate is issued to NICHOLAS & ANGELIKI KOPANOS
{owners}
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A
UNDERWRITERS CERTIFICATE N0. N-205523 - SEPTEMBER 26 1991
PLUMBERS CERTIFICATION DATED OCTOBER 9 1991 - JOHN SIDERIS
. l.i
Building Inspector
Rev. 1/81
zos~s xo. s
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN HALL
SOUTHOLD, N. Y.
BUILDING PERMIT
(THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL
COMPLETION OF THE WORK AUTHORIZED)
N 1 9 5 9 4 Z Date 19~~
' Permission is hereby gra ed
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at premises located at
.......................................~~...p.
County Tax Map No. 1000 Section ......~.Q.~?........ Block Lot No...sz~...~............
! pursuont to application doted,.,.f.L..,l~~~.~? 19,~'~.p, and approved by the
' Building Inspector.
'"'S
Fee S•%.Y..'•r....
Builds Inspector
Rev. 6/30/80
r
JUDITH T.. TERRY ~ Town Hall. 53095 Main Road
TOWN CLERK - ' P.O. BoX l 179
REGISTRAR OF VITAL STATISTICS ~ ~ ; $OU[hold, NeW YO[k 11971
SIARRL4GE OFFICER Fax (516) 765-1823
y Telephone (5161 765-1801
1 '
OFFICE OF THE TOWN CLERK
TOWN OF SOUTHOLD
October 28, 1991
1k~ ~C~C~~i,~',,
CERTIFIED MAIL ; '1 ~ 2 S !9~'
RETURN RECEIPT REQUESTED
Nicholas & Angeliki Kopanos ~ T
22-09 Steinway Street
Astoria, N.Y. 11105
Dear Mr. b Mrs. Kopanos:
Please be advised that your check no. 451 in the amount of $25.00
dated August 22, 1991 has been returned by the bank unpaid due to
your accounts being closed. I am enclosing a photocopy of the check
and the advice of charge from the bank.
This office is required to collect a returned check charge in the
amount of $15.00 to be added to any amount owing on the check when
checks are returned by the bank unpaid.
Please remit $40.00 cash, money order, or certified check to this
office before 4:00 P.M. closing on Thursday, October 31, 1991. If it
is not received by this date, your certificate of occupancy no. Z-20289
will be cancelled and will not be reinstated until such time as payment
is received. Your failure to pay this amount in a timely manner will
result in referral to the Town Attorney for collection. Thank you for
your anticipated cooperation.
Very truly yours,
'e'
Judith T. Terry
Southold Town Clerk
~r0,~> A,y,,..~~- e.BRl-a~ ~1~..7T.~ "~jU1~.1-~e~ 1o~30~Q~~
Enclosure """_~_J
cc: Town Attorney
Building Dept.
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V Form No. 6
• r~ r~c~l{
TOWN OF SOUTHOLD
BUILDING DEPARTMENT AA~~~~
TOWN HALL ~lJl~ ~ 6 ~99~ F ~
765-1802 ~1~
APPLICATION POR CERTIFICATE OF OCCUPANCY `~C3Lf?
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(5-9 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.
'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 r,
1. Certificate of Occupancy - New dwelling $25.00, Additions to dwelling 25. ,
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 ~ ~,i 1.~
New Construction........... Old Or Pre-existing Building
Location of Property .......:.......~~:~~.Q i.n...~G.~..~AE!1~`::-............................
House No. Street Hamlet
Onwer or Owners of Property. Q0~(~ r. ~ ~:m Q A` ~ ~p ~
2 rC--
County Tax Map No 1000, Section.~`.'~~.-r`j,tBlock~ `..Lot. X. ~
Subdivision ....................................Filed Map............Lot......................
Permit No..!.a S ~y:Rr...Date Of Permit ................Applicant.............................
Health Dept. Approval ..........................Underwriters Approval.........................
Planning Board Approval
Request for: Temporary Certificate........... Final Certicate...........
Fee Submitted: $ ~
e O r~ qc~~ APPLICAN`~
TEL. 765-1802
~~c~NFFQI,/~-~~`~ T01Y+N Or Sf~tJTII~]LD
F; " _ 1 ~c OFFICE OF BUIlDII4G INSPECTOR
~ 1°- P.O. BOX 728
O qty ~'n
cnE~%•' d~~ TONNHALL
"Q ! SOUTHOLD, N.Y. 11971
1 ,ro
~ ~ `e a i~ \Li.'..
~ 51~9~
C E R T I F I C A T I O N i' is
Aate~_f~ g/
Building ~~Prermit No,. I95~iY'Z
Owner /~-TGB/u~,45 ~co(<.~t-u~ j
{please print)
Plusher CJdh~ ~5l~c~;s
iplease print)
I certify that the solder used in the water supply system
contains less than 2/10 of 1~ lead.
} `
- (plumber's signature)
Swo to before ~Q~tris j
day of ___~~~-=~I~~'p'~`~
19 CiiR13ivEj 1'-~ $Public
Notary Pudic, gtate of New York
Plotary Public, County Quald~ied n ~y
Commission Expires June 30, 1883
COMMENTS
1ELD I1:SPCTiU~~ UATn m
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~OUtJDATION list)
FOUNDATION f2nd)
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ROUGH FRAME & ~ ~ ~
.PLUMBING s
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IIJSULATIOP3 PER N. Y. ~
STATE ENERGY x
CODE ~
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ADDI7 NAL C MMENTS: "C
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THE NEW YORK BOARD OF .FIRE UNDERWRITERS '`'F,a:,` '
iQ1)0 fJA" BUREAU OF EI.ECTRIGTY
85 JOHN STREET,.NEW YORK, NEW YORK 70038 '
.±'t~,k't'^"4Uit•:14 Tb. li~cD'i )rx;l ,i Fi F, yD;I%?J tV Ai)ri ~I;{~
Date App(ieation Nu, un file
THIS CERTIFIES THAT
only the electricol equipment oa described below and introduced by the applicant named on the above opplicotion number in the premises of
?di,(1KnTIAI". P:nrilptil;,,, c'AP't'~ tail) ir~ttfs+;, i~'ctLE :fin, ~IiIE"i.,r?')iCK, tU t'•
~~--II ntl`~.
in the following location; ? Raxement- ~ lxt F'i. LJ 2nd F!. Sertion Block Lot
$,(ti L'9'i?(-iFF;(i 1, s.Nt)I
uws examined alt arzd found to 6e in caneplimtrr with the requirements o/thin Roard•
FIXTURE FIXTURES RANGES COOKING DECKS OVENS DISH WASHERS EXHAUST FANS
OUTLETS ECEPTACIE$ SWITCHES INCANDEJCENi fWORE$CENT OTHER AMT K.W. AMT K.W PMi N.W qMT K W AMi H P
f I
DRYERS FURNACE MOTORS FUTURE Af7lIANCE FEEDERS SPECIAL REC'PT TIME CLOCKS BELL UNIT HEATERS MULTI-OUTLET DIMMERS
AMi. N. W. On H P GAS H. P. AMT. NO A W. G. AMi AMP. AMi. AMPS TRANS. pMi H P SYSTEMS AMi. WAiiS
NO.OF FEET
SERVICE DISCONNECT NO.OF S E R V I C E
METER NO.OF CC. COND A W G. A W G A.W G
AMi. AMP TYPE EQUIP 1~0'YW 1,e 3W 3%JW 3%dW pER% OF CC. COND NO. OF HbIEG OF HbLEG NO OF NEUTRALS OF NEUTRAL
- 1 j139 a'A I X 7 /s. f tL
OTHER APPARATUS: '
P~LN1tiI'tSTf)p~'p5; -1 t i' 14{ , I Ct0
- Xt9la$3+ ItAPP.'i~,(."fQl{: -I
~.~'!~~~:C..C~t..J .cam" l
RdCJH%IFa) RN;tI`l'$Ir# fII(7,~?7.lLi£a~t
T,AUEh;h, tt}', 1.'I.<l/d Ft ~ GBNFRAI MANAGER
Per
This certificpte must not be altered in any manner; return to the office of the Board if incorrect. Inspectors may be identified by their credentials.
I DING DE A MENT. THIS
INSPECTORS
PrincipaltBuilding Inspector ~O~OSUFFO(~-COG
Curtis Horton = y~ SCOTT L. HARRIS, Supervisor
Senior Building Inspector y x Southold Town Hall
Thomas Fisher u- P.O. Box 1179, 53095 Main Road
Building Inspector ~ • `F
d Southold, New York 11971
Bu G~ar~ Fi~h tm '~0,( ~ .~`a Fax (516) 765-1823
Vincent R. Wieczorek Telephone (516) 765-1800
Ordinance Inspector
Robert Fisher
Assistant Fire Inspector OFFICE OF BUILDING INSPECTOR
Telephone (516) 765.1802 TOWN OF SOUTHOLD
August 14, 1991
Mr. & Mrs. Nickolas Kopanos
420 Captain Kid Drive
Mattituck, N.Y. 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)
,XX No Underwriters Certificate on file.
XX The check is (mod/not on file.)$25.00
No Health Department Approval on file.
No final inspection has been made.
XX No Plumber Solder Certificate on file.
(All permits involving plumbing being
issued after April 1, 1984).
BUILDING PERMIT ~ 19594-Z
Please contact our office on this matter. Thank you for
cooperation.
SOUTHOLD TOWN BUILDING DEPT.
r
765-1802
BUILDING DEPT.
iNSP~CTIQN
[ ]FOUNDATION 1ST [ ] ROUGH PLBG.
FOUNDATION 2ND NSULATION
[ ]FRAMING [ ]FINAL
REMARKS: ~ ~ ~G~
a~~ ` ~
Irk-i., yJ- _C`_
~I
DATE 9 INSPECT
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765-1802
BUILDING DEPT.
INSPECTION
[ FO NDATION i5T [ ] ROUGH PLBG.
[ FOUNDATION 2ND [ ]INSULATION
[ ]FRAMING [ ]FINAL
v
REMARKS:~u
G~~e
DATE ~ INSPECTOR ~ _ ~'°h
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765-iso2
BUILDING DEPT.
INSPECTION
[ FO NDATION 1ST [ ] ROUGH PLBG.
[ " FOUNDATION 2ND [ ]INSULATION
[ ]FRAMING t ]FINAL
REMARKS: ~'q`-
DATE INSPECTOR ~~fi
BOARD OF HEALTH
3 SETS OFjPL.1NS
FORMN0.1 SURVEY ? •
TOWN OF SOUTHOLD C11EC1; +1•~'~• •r~ •ry~1• • • , , , ,
BUILDING DEPARTMEPIT SEPTIC FORrt . . . .
TOWN HALL
. $OUTH4LD..N..Y_1t~Z1 rI~T`FY °..~~L. n:
TEL.:7G5-1B02 CALL ! LSx3 j 4~X~
MAIL T0: t~
Examined . f.°~ 19 .7.~ G _O . ;I.~~.fP .
Approved ...~P~7.~......, 1996 Permit No. 1/.~?! ~ .
Disapproved a/c " l l o^t d`~1
~~~r~_~r~r_e~
• . uw i 61990
~aa
(Bui ng nspec[or)
BLDG.D[P7
APPLICATION FOR BUILDING P RN11~OWrdOFS0U7N lD Q~
Date Ct IS k v
INSTRUCTIONS
a. Tlus application must be completely filled in by typewriter or in ink and submitted to the Building Inspector, v~ith
sets of plans, accurate plot plan to scale. Fee accarrting to schedule.
b. Plot plan showing location of ]ot and of buildings on premises, relationship to adjoining premises or public strcet~
or areas, and giving a detailed description of layout of property must be drawn on the diagram which is pan of this appli
cation.
c. The work covered by this application may not be commenced before issuance of Building Permit.
ti. 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 Occupanc}
shall-have been granted by the Building Inspector.
APPLICATION IS HEREBY MADE to the Building Department far 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.
Tlie applicant agrees to comply with ail applicable laws, ordinances, building co e, housing code, and regulations, and to
admit authorized inspectors on premises and in building for necessary inns
(Signature of a plicant, or name, if a corporatron)
(Mailing address of applicant)
State/rwhether applicant(( is~~ ownLer~, l-essyee_, agent, architect, engineer, general contractor, electrician, plumber or builder.
Name of owner of premises . N.~.U~..-) ='YJ.Pt'~-M.~(~.5... a:.l'1 V.`Q.('s~1.*`,'....~@!~Q^.A.Q~............
(as on the tax roll f}} latest deed)
If applicant is rpo lion, si nature of duly authorized officer.
'4~~p''.,?z .
(Name and title of corporate officer)
BuildeC s License No.......... _~a-'.'~"~-Qe~-':
Plumber's License No . . . .
Electrician's License No. .
Other Trade's License No. r-:-.......... ~ Q ~ n~! p
I. Location of land on which proposed work tvill be done', ~i'y~.~~" '
Etouse Number Street, tt ~j Hamlet
County Tax \1ap No. 1000 Section .~~l.V ~3' •'2-~ • . Block ......1. . • • Lot ~.~t , , ,
Subdivision Filed 1`Sap No. ~ ~ ~.!S Lot ~ .
~(N:unej .
State existing use and occupancy of premises and i(n(tended us~~ecq~a`n-d1occupancy of proposed construction:
A. lixisting use and occupancy..... ~;•••Y.t!~!•~'~.'~•••••••••••••••••••••••••••••••••.•
(J!~ v. a' a t°~t
B. Intended use and occupancy.... • • • • ~ • • • •?q,~q}9,;;1¢,'stt~~. d• • ' • •
Ytrttrny'y"- ~5~~5`lu'~ .7 ~2LSa~ .a y
o~ ~ S . ALA ~i~'~h ~#'"`;S~ {`~7i~i
- .
3. Nature of work (check which applicable): New puilding Addition • • .Uteration .
Repair Removal Demolition ..............Swiaaain~ pool.......... .
Tennis Court Accessory Building...'- ....Fenlce .-~....0[her Work:........
4. Estimated Cost ~.Q ~~a 49'°............ Fee . s J. ~
' (tp be paid on Ciling this application
S. IC dwcllin„ number of dwelling units • Number oC dwelling units on each floor , .
ICgaracc,numbcrofcars ~
6. If business, commercial or mixed occupancy, specify nature and extent oC each [y a oC use
7, Dintcnsions oC existing structures, if any: Front ...~.g.~. Rear Z • • Depth , , , , . .
Hci^_ltt Number of S[orics .
Dimensions oC same structure with alterations or additions: Front Rear .
Depth LIcight Nuntbcr C Stogy cs d r , , , , . .
Dimensions of e~}~re new constntction: Front Rear 3 .•.Jr...... Depth . ~ .
Hcigltt .....F. rG Number oC Stories 2..... ~~pp •'')..f~. 1 .
9. Size of let: F'iort(j~C;w.Q...t~.~~ Res- ........f.~........... Depth ~ ~L 1"t • • • • • • • •
10. Date of Purc;isse ~ ~,!':~4c~ ~ •tme of Farmer Owner .
1 1. Zone or use iiistrict in tvhiclt premises arc situated ....~`V?! ~rf.,~:4~~........ .
L2. Does proposed construction violate-a y zoning law, ordinance or regulation: ~ • • • • • • • • • • •
13. Will lot be regraded .......-l F! O. ...will excess fill b rQmoved f om premises: Yes x..:..
l4. Name of Owner of premises 1v.~ 51E+.1~A.P4~1^o Address ~ ~Q.~c
.^'t.
~Y~•~~•Pltone No.. - • • - • -
Name of Architect ` Address Phone No. - • • ~ ~ -
Name of Contractor !~!Ml.We~`~; .:~r~.~dress t~-'~,65'~ .}~(~,I~phone No. ~yl~'.Q 1~
IS_Zs this property located within 300 eet of a tidal wetland? *YGS..--NO-~•
*Zf y`es, Southold Tovn Trustees Permit may be required.
PLOT DIAGRAM
Locate cleazly and distinctly all buildings, whether existing or proposed, and. indicate all set-back dimers:o-• '
property Gnes. Give street and block number or description according to deed, and show street names and indicate
interior or cornez lot. /J
p ~ G<r4i' : J 1
~tLC -
F ~ RMIZ INCLUDES APPROVR,.
TO REMOVE EXCESS FILL
FROM ABOVE PREMISES BY
GRADING LOT
d+9MVEWPY CON`.,'TRl3CT10N
EESSPCipI CONSTRUCTION -
~.~LAR CONSTR(>CTION -
t~ c
STATL- CiF tiE\V~ORI: S.S
COUyTY OF - - .
. , ~41
: A N u e~ • • !--:RR'~kS • . • being duly sworn, deposes and ssys that he is the applica:
(Name oCindividual signitto contract)
above named.
Ffc is tltc ~,ON~-J2c;{,~^r
(Contractor, agent, corporate officer, etc.)
oC said owner or owners, and is duly autltorizcd to perform or ltavc performed [Ito said work and to make and file tl::
application; that all statements contained in [his application arc true to the best oC his knowledge and belief; and that t:~
work will be perl'omtcd in tltc manner set forth in the application Glcd therewith.
Sworn to bciorc me this
I lo-(~~ ; ~ ..day of v.... ~ e t3c~_ f o
:.~'.........19.`.
n ~~r,tk-
Notary Public, o . ~d _ County
p~KK (Signature oC applican t
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