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HomeMy WebLinkAbout19436-z FORM N0. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Ha11 Southold, N.Y. CERTIFICATE OF OCCUPANCY No 219790 Date MARCH 13, 1991 THIS CERTIFIES that the building ALTERATION Location of Property 55585 MIDDLE RD. C.R. #48 GREENPORT House No. Street Hamlet County Tax Map No. 1000 Section 44 Block O1 Lot 13 Subdivision Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated SEPT. 26, 1990 pursuant to which Building Permit No. 194362 dated OCT. 3, 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 ALTERATIONS TO EXISTING ONE FAMILY DWELLING INCLUDES BALCONY The certificate is issued to JOHN XIKIS (owner) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A UNDERWRITERS CERTIFICATE N0. N173686 FEB. 11, 1991 PLUMBERS CERTIFICATION DATED N/A Building Inspector Rev. 1/81 rossi 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 AUTHOR{ZED) N 1 9 4 3 E Z Dat® .....lo~ 19.90 Permission is hereby gra ed to„ , s taG~dQ7xr.~~/.:..~~4..~.%.~.....~~'%`' °.e!.~L..err.~.ti ...............r~.~~l~p.~.~rY..4G~~..r~rtr,(~ ......a..~:......... of remises +.xated at ..a................... p ~ /~7a',~ j County Tax Mop No. 1000 Section y~Y...~........ Block ......1........... Lot No...~`.3............ pursuant to application dated ........~9./~ 19~.'.Q.., and approved by the i Building Inspector. , I Fee 5..~:~..:~.. 'L. Buil g Inspector Rev. 6/30/80 ti ~ /.r.„~-'Form No. 6 0 D W ! Oi~- ~,a vU~' ^ TOWN OF SOUTHOLD ~~.'t~ TOWN HALL '\'I\lp~-''/V;"„,•/ BUILDING DEPARTMENT 7 65-1802 BLpG. pEPi: OFSDUTHDLD 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 17 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. 3. 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. C. Fees 1. Certificate of Dccupancy - 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 ~e~.:. G:~.~ ';ew Construction........ Old Or Pre-existing /~Building... Location of Property... .~(4. %A House No. Street Hamlet ')nwer or Owners of Property..... J(~~l~tf//l,//.~?~.l. k,~~ County Tax Map No 1000, Section.....7:~l......Block........~.......Lot....~.J Subdivision ..Filed Map............Lot...................... Permit No. ~b,~3~(~~......Applicant.:J.~~YI./:!Pr7~C?n:.. f. ....Date Of Permit.. ( fJ t'l~ !lealth Dept. Approval ..........................Underwriters Approval.. Planning Board Approval _ 2equest for: Temporary Certificate........... Final Certicate........... Fee Submitted: ~ S ~.J 3/~ 3/9/ ~ . APPLICANT 765-1802 BUILDING DEPT. INSPECTION [ ]FOUNDATION i5T [ ] ROUGH PLBG. ]FOUNDATION 2ND [ ]INSULATION [ ]FRAMING [ AL REMARKS: ~ _ DATE ~ INSPECTOR _:w.. l 9~~~ . . 765-1802 DUILDING DEPT. INSPECTION i [ ]FOUNDATION i5T [ ]ROUGH PLBG. [ ]FOUNDATION 2ND [ INSULATION [ ]FRAMING [ ] F/I~N-A~L~~" REMARKS: ~~!1--u.t'GZ~t,~,,,?'~` ~~r~P~ i DATE 0 3~ c~_INSPECTOR ~r`~f l 7" lei' 765.1$02 BUILDINGS DEPT. 1 NSPECTIQN [ ]FOUNDATION 1ST [ ]ROUGH PLBG. [ ]FOUNDATION 2ND [ ]INSULATION FRAMING [)FINAL REMARKS: ~ ~ ~ - ~ t t <<~ DATE ~ ~ ~ iNSPEC'TOR ~'wl~ a f y' HENRY J. SMITH & SON, Inc. o ~ a (Vf p PLUM9ING, HEATING & FUEL OIL ~j? MAIN ROAD _'~V 7 ~y~ U SOUTHOL.D, N.Y. 11971 ~~i (516) 765-3600 ~lOG a rowN of s eFr. aurHO~o C_E_R_T_I_F_I_C_A T_I_0_N_ Dat.e___NOv_._2~L 1~g,0___ Building Permit No. 194362 Owner Mr. John Xikis______________ Plumber__Aenry_J__Smith & Sons,_Inc_ I certify that the solder used in the water supply system contains less than 2/10 of 17 lead. _ fr r enry P. Smith Sworn to before me this 30th day of November ___r 19.90 _ • __~-,-1-~~_c~~ Notary ublic Notary Public, Suffolk County - BERNADETTE L. fAPLiN NOTARY PUBLIC kA844893 State of New York Residing in Suffolk County Commission ExD~res Sapt. 30, 19~. C '~~.~1~~ 4 1, ~l. 6!`f~ ~ t 1f ° 4. Li ~R~~t _ .y~f „rzr~r. y, TEL. 7C,5-180"_ ~~~FOt,~~ TO~I'N Ur SOUTLIOL~ ,?'~~[t;,.~~ ' + ~c Oi~i'IC;G CIF BUILDING iNSPC•.CTOR u ~~~~ti ~ P.O. BO'C 1 1 7 9 q, ~`~''7 ~ TOWNIIALL ` SOUTI IO1.D, N.Y. i 1971 yon . December 3, 1990 JOHN BERTANI, BUILDER 1380 OAKWOOD DRIVE SOUTHOLD, NEW YORK 11971 RE: JOHN %IKIS 'Po S4hom This, May Conccr7, 4Te are unable r.o complete your Certificate of Occupancy because•of the following reasons. An application for Certificate of Occupancy ~is not nn fil.c. (ENCLOSED) /_y?/ No tlnder~•~riters Certificate on file. 'rlie chccF: :i;:k~%!eKgt~~~%~/nut on file.) $2s.oo DIo llca].th Dept. Approval on file. No final insi-~ection has been made. Please contact: our office on this matter. - Thank you for your cooperation. Ilu.ildir•,<) Pcrur.i_t-. It 1 9 4 3 6 Z IIui1c]inq Dupt. *.k'k/-/ tlo P1L:mbcr Solder Cert.ificatc on L-ile. ( a].1 permits involvi-ng plumbing being .issued after ~~pri.l 1,1984 ) B0,\CD OF•HEALTN•:::::::::: • • ~ 3 SETS OF PL.\:1S FORM NO. t SURVEY • S~12fj~~p iI` TOWN OFSOUTHOLD Cttcct: 1 4 BUILDING DEPARTMENT SEPTIC PORN t r TOWN HALL BLDG..>e'r''t. OUTHOLD. N.Y. 11971 NOT • Y TEL.:7G5-1HD2 CALL t•IAIL T0: Exattrined .~d~3..... • 1994 . Approved . 19w. Permit No..~~! .`.3~~ ~ • . Disapprovedalc (8 dins pector) APPLICATION FOR B1JILDING PERPr1IT Date :~.~1'r ~ 15 ' ~ INSTRUCTIONS riz a. Tltis application must be completely filled in by typewriter or in ink and submitted to the Buildirr; 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 streets qr areas, and giving a detailed description of layout of property must 6e drawn on the diagram which isQars 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 applir~nt. Such permit shall be kept on the premises available for inspection ihroun}tout the work. e. No building shall be occupied or used in whole or in part for any purpose whatever until a CertiScate of Occupancy shall have been granted by the Building Inspector. APPLICATION IS HEREBY hIADE to the Building Department for the issuance of a Building Perntitpursuant to the Building Zone Ordinance of the Town of Southold, Suffolk County, New York, and other applicable Laws, Ordinances or Rc=ulations, for the constrvction of buildings, additions or alterations, of for removal or demolition, as ttciain described. The applicant agrees to comply with all applicable laws, ordinances, building code, housing code, and rtouiatrons, and to admit authorized inspectors on premises and in building for necessary inspections. (Signature of applicant, or name. if a corpora;wn) . • ~ (Mailing address ofapplicant) //~7/ State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. Name oC owner of premises !L(t~ . ~~il•Fr-d X~~/ S . (as on the tax roll or latest deed) - dfapplicantis ac-'onrpor/a~t~i~o~`Jn-, signature oCdu~ly~authorized officer. ' • • • • • ~ (Name and title ~ orate offcer~ • • Builder's Liccnsc No.... ~.~.9•~~•~• •%'/`Z •pp• • • • • _ Plumber's Liccnsc No. • ~5~~°•X!• • Electrician's Liccnsc No. ..~'+.~:5...~~~:~~~u'~'•'~`• ~"O• • _ Otltcr 7radc's Liccnsc No. U~p............ Location oCland on which proposed work will be done: ~.~.w? .................M.t.~!_) ~73..:~PP C'~'.`~~........ , c~u, :c',G~E.ls6 ~ a'~......... (louse Number ~ ,S>ttre~et Hamlet f ~ County Tax Atap No. 1000 Section r • ~ • • • • ~ Blbuk Lot y~ • Subdivision F.ilcd hiap No. Lot ..(Namcj State existing use and occupancy of premises and intended use and occupancy of proposed construction: ~ a. Existing use and occupancy .....~~~~..5~{• ..{~.G~e%/; :t:~ . b. Intended use and ~hal~."~..: ~Ul~• (~C • . occupancy 1 3. Nature of work (check which appl,icablel: New Ouilding • , . Addition ,Utetattan • • • • • Repair RFmov~tl Demolition ............Swimnin;, pogt:`r,._ Tennis Courc~.,•....... Accessory Building........,.Fence .......Other lJork............ v4. Estimated Cost ~.~.i.Jr~ . • Fec , (to be paid on (ilinl; this application) 5. IC dwelling, number of dtvclling units Number oC dwelling units on each floor , . . ICgaraBc,numbcrofcars • ^ pccupancy, specify natur and extent of each t pe of use • fi. If business. commercial or mixed ' yy 7. Dimcnstons of cxtst~y' ~P structures,; if any: Front Rear ...G~ 5:........ Depth , , . . Height ......:~7:..... Numb}:r oCStorics . . Dimensions oCsame structure with alterations or additions: Front , , • • • . • • - • . Rear , {x.51.,.....:... . . Depth , a'•':........ Ilcight 1C. Number of Stones . • S. Dimensions of entire new constriction: Front , , d©X, Rear . /.~lS.z'•t • • , • • • Depth . . Hcicht (`lumb'er of Stories _ . 9. Size of lot: Front vZ 42~.... Rear ......:'z~, • , , , , , , , Depth , 10. Date of Purchase . . Name of Fortner Owner • , _ . l I. Zone or use district in which prctniscs arc situated . . I Does proposed construction viola~e any zoning law, ordinance or regulation : . 13. Will lot be regraded : , . ~lQ, . ......Will excess fill be removed from premises: Ycs No~ l4. Name of Owner of premises..lat~;=, , .ri,/,G~' , , , , ; , , , ,Address /.u~?.~~.~ . e~O.~D.. ..Phone No..~r.1. .~Y.t~.. , Name of Architect • , ,Address • • ...........Phone No... _ Name of Contractor ?~Xee ./~ss,~:t%?+u ,~3•c'l~cf~d?- ,Address l36C~..~~~.. Phone No. 7.Er~w: lu:~l.J IS.Is this property located within (00 feet of a t>, a etland? ^YGS.?~.HO•... *If yes, Southold TownlTrustees Permit may be required. PLOT DSAGRA~i Locate clearly and distinctly all buildings, whether existing or proposed, and. indicate all set-hack dimensions frorn_ property lines. Give street and block number or description according to deed, and show street names and irtdiWte whether interior or comer lot. ' APt? 0 D AS NOTED C3ATE:~~ B.P tP l O-O FE ` BY:...~ NOTIFY RUI !NG OEPAR AT 785.-7802 S AM TO 4 PM F R THE ~ FE)LL.t)WINCy INSf~ECT10NS; 9. FQUNDATIOIJ . - 'T1f1/0 REQUIRED FOR POdJREI) CONCRETu 2. ROUGH -FRAMING Fi PLUMBING 3. INSUt.ATfON FtNAL - CONSTRUCTION MUST EiE COMPLETE FOR C.O. ALI. CONSTRUC710N SHALL. MEET THE RELIUIREMENTS OF THE N.Y. STATE CANSTRUCTION & ENERiiY ~ COOES. NOT RESPONSIBLE FOR • DESIGN OR CONSTRUCTION ERRORS STATE OP \EN YO,I~I%,,, r., S..S COUNTY 0~..., rf.~~?~C.. ~ ~/QCF~..,~~~~%~~~'• • • • • • • • • • • • • • • • • bcino duty sworn, deposes and says that 1te is the applicant (Name oCindividual signi~~; contract) • • above named. tl . tfc is the ~~~~`1i2-a~~.-r'".... QiE.E'_?:C~f . . (Contractor, agent, corporate officer, etc.) of sail otvncr or owners, and is duly;authorizcd to perform or have performed the said work and to make and Cle this application: that all statements contained in this application arc true to the best oC his knowledge and belief; and that the work wUl be pcrCornted in dte manner Set forth in thu application filed thert:with. o, Swom to beiorc me this ' ~'oFieoGlC - • _ otary Public, . p[+ . ~~4. • • • • • • • County HELEN K OE V0~ I /O) ,,,-'fria n~ • • NOT/1RY PUOIIC, State of New York •.av4 .Fa~.~•t• W/ Na.47018T8,Sotto{k('att~n(~~ IVI $I~natllrC OCa IlCantl Temp Expires Moroh 30, )9_~L ~ PP . ' . • ' THE NEW YORK BOARD OF FIRE UNDERWRITERS ~A`i"• InOto71 BUREAU OF ELECTRICITY BS JOHN STREET. NEW YORK, NEW YORK 10038 Dote f'k;RRl1AFY 'i1,[~'al APPlicationNo.onftle ~113$'169i1/90 N 1'734sRG THIS CERTIFIES THAT only the electrical equipment as described 6ekno and introduced by the opp!lcont named on the above application number in the premises of :IOHN ;i't.R7S, R(3UT}: 9$; S(itlTHl~i,ll, td.Y- - in the following loco~~fI' nn B ~ ! f I IT F~~}'It1i.iKRY i let Fl. ~ 2nd FI. .Sertion Block Lot woe examined on and found Cu 6e in complianrr with the reyuirementa of this Boord. HXTURE RXTURES RANGES COOKING DECKS OVENS DISH WASHlRS EXHAUST FANS OUTLETS KEITACUiS SWITCHES INCANDESCENT-iIUORESCENi OTHEN AMi. K. W. AMT. K. W. AMi. K.W. AMT. K. W AMi. N. P. .~l) ~I) 11 I ti 1 I DRYERS RIRNACE MOTORS FUTUR! AFFUANCE FlFDERS SPECIAIRK7T TIME CU%KS ~U UNIT HEATERS MUtTI.OUTIET pIA1MER5 AMT. K. W. Oll N. P. GAS N. P. AMT. NO. A. W. G. AMT. NAP. AMT. AMPS. TRANS. AMT. N. P. SYSTEMS AMi. WAITS NO.OF i!!T SERVICE DISCONNECT NO.OF 5 E R V I C E AMT. AML. TYPE METER 1 p tW I 1 TV 3 d 7W 3 X AW NO. OF CC COND. A. w G. NO. OF XELFG A' W' G' NO. OF NEUTRALS A. w. G. EOWF. PERC Of CC. COND. OF NLLEG a NEUfNAI OTHER AMAl1ATU5: '1'RA!'K L4C;H'I'IN6~-lF.. / ~~''l G & S t.lryTkAC'POH i,'1('..@'i!$-E; BtJX i.15 Si1U'PHOI~I), NY, 7 '17 I Eif11EERAl MANAGER 11 Per This certificate must not be altered in any manner; return to the office of the Eoard if incorrect. Inspectors may be identified by their credentials. A N ~ u:K~~ N r ~ `S~ a 's: ilua.~ q ~ •L JtIDATION ~(tst) C~! N UNDATION f2nd1 . a o o' )UGH FRAi•!E & ( ~ .PLUMBING N / ~ H [T7 C-7 / ~ .-3 :IISULATZOiI PER N. Y. {~r~ STATE EPIERGY I T y~`-r~~~~ CODE a 4. r Fz;IAL I o o' m ADDTTIOPIAL COMMENTS: x ro\ • x ro H 9 • O 1 ' ~ x m a ~ m . ~ 'v y a ;