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HomeMy WebLinkAbout19347-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF O~CUPAN6"f No Z-23782 Date JULY 19, 1995 THIS CERTIFIES that the building Location of Property 4310 HORTONS LANE House No. Street County Tax Map No. 1000 Section 54 Block 3 Subdivision Filed Map No. ACCESSORY SOuT~OLD NY Lot 21.3 Lot No. Hamlet conforms substantially to the Application for Building Permit heretofore filed in this office dated J~/LY 25, 1990 ~ursuant to which Building Permit No. 19347-Z dated AUGUST 24, 1990 was issued, and conf~rms to all of the requirements of the applicable previsions of the law. The occupancy for which this certificate is issued is AN ACCESSORY AGRICULTURAL SHED AS APPLIED FOR. The certificate is issued to JAMES & POTA PLEVRITIS of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL UNDERWRITERS CERTIFICATE NO. PLUMBERS CERTIFICATION DATED N/A N/A Rev. l/B1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, iq. Y. BUILDING PEPu~IT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) N9 '~34'/ Z Permission is hereby granted to: .... .... ~.,..~~_~ ................................... ~ .................. ~_~ ........................................ at premises ,~ated a~ .-~'-~...o~....~ ......... ....~........................... ...... County Tax Map No. 1000 Section .... ...C~....~....~. ..... Block ..... ..(~.....~... ...... Lot No....~.1..:.~ ..... pursuant to application dated ...... ~....~......~....~.. ................ , 19..~...~.., and approved by the / / Building Inspector. 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: I. Final survey of property with accurate location of ail 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 ~lectrieal installation from Board of Fire Underwriters. 4. Sworn statement from plumber certifying that the solder used in system conings ~ 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. Submi~ Planning Board Approval of completed site plan requirements. B.- For existing buildings (prior to April 9, 19~) non-conforming uses, or buildings and ~ pre-exzstlng land uses: 1. Accurate survey of property showing all property lines, streets, building amd ' unusual natural or topographic features. · -,, 2. A properly completed application and a consent"to inspect signed by the applicant. If a Certificate o£ Occupancy is denied, the Building Inspector shall state the reasons therefor in writing to the applicant. C. Fees 1. Certificate of Occupancy - New dwellimg $25~00, Additions to dwelling $25.0O. 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 - $I0.00 4. Updated CErtificate of Occupancy - $50.00 5. Temporary Certificate of Occupancy - Residential $15,~, Commercial $15.00 Date ~ ' :;ew Construction .... ~ ...... Old Or Pre-existing Building ................. Location of Property... ..... ......... House No. ~treet Hamlet .... Onwer or Owners of Property ..... . ................................. County Tax Ma'p NO 1000, Section .... ~..~-~....Block .... 3.'. ........ Lot .... ~ ~ .... SubdiVision ' .................................... Filed Map ............ Lot ...................... Permit Z..Date of X....,pp"cant ............................. [{ealth Dept. Approval .......................... Underwriters Approval ......................... App ' " Planning Board royal ...................... ,, Request for: .Temporary Certificate ........... Final Certicate....~.. Fee Submitted: c>~---~ .~~ " Town Hall, 53095 Main Road P. O. Box 1179 Southold, New york 11971 Fax (516) 765-1823 Telephone (516) 765-1802 OFFICE OF THE BUILDING INSPECTOR TOWN OF SOUTHOLD July 10, 1995 Mr. James Plevritis 147-66 7th Ave. Whitestone, NY 11357 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. xx The check is outdated. $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 # 19347-Z Please contact our office on this matter. cooperation. Thank you for SOUTHOLD TOWN BUILDING DEPT. ** - ACCORDING TO THE CODE OF THE TOWN OF SOUTHOLD, IT IS UNLAWFUL TO OCCUPY OR USE SAID STRUCTURE UNTIL A CERTIFICATE OF OCCUPANCY HAS BEEN ISSUED. 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 SEP~E~IB~R 21~ 1992 SCOTT L, HARRIS, Supervisor Southold Town Hall P.O. Box 1179, 53095 Main Road Southold, New York 11971 Fax (516) 765-1823 Telephone (516) 765-1800 14R. &. 14RS. JAI4ES PLEVRITIS 4310 HORTON's LANE SOUTHOLD, lqY 11971 Remailed to 147-66 7th Ave., ghitestone, NY 11357 To Whom This May Concern: We are unable to complete your Certificate of Occupancy because of the following reasons: xxx An application for Certificate of Occupancy is not on file. (Enclosed) No Underwriters Certificate on file. The check is ~_~not o~ file.)$25.00 No Health Department Approval on file. No final inspection has been made. No Plumber Solder Certificate on file. (Ail permits involving plumbing being issued after April 1, 1984). BUILDING PERMIT ~ 19347-Z Please contact our office on this matter. cooperation. Thank you for SOUTHOLD TOWN BUILDING DEPT. I[DATE COMM£NT$ FO,UN DA TION ( 2nd ) ROUGH FRAME & PLUMBING INSULATION PER N. Y. STATE ENERGY CODE FINAL ADDITIONA'L COMMENTS: REMARKS: FORM NO. 3 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N.Y. NOTICE OF DISAPPROVAL Date ....................... , .. - PLEASE TAKE NOTICE that your application dated ., .,. ,~.~.'~...~.. .............. 19 ~'~ for permit to ~~'. ~..~~..~~ .... ' ..... at Co~ty z~ m~ ~o. ~0o0 s~tio~ ... ~ ...... mo~ ...... ~ ...... ~ot ...~{,..~... Subdivision ................. Filed Map No ................. Lot No .................. is returned herewith and disapproved on the following grounds ......... . .~'~., RV 1/80 JAMES PLEVRITIS 37-02 30TH AVE ASTORIA HORTONS LANE SOUTHOLD ,qUFFOI,K COUNTY DEPARTMENT OF HEALTH SERVICES REF. NO. COMPLETION REPORT - LONG ISLAND WELL DEFTH OF WELL SELOW SURFACE I DEHH TO GROUND WAIER ~ROM SURFACE 90 ft.I 43 ft. CASINGS blAMETER LENGTH 85 ft. j SEALING In. ft. ~ CASINGS REMOVED ft. J fro SCREENS OPENINGS COOK 14 DIAMETER 5 I..J i..J in.I in. ~NGTH DE~H TO TOPFROM TOpOI:CASiNG PUMPING TEST DATE STATIC LEVEL PRIOR TfO.TEST~ J hours TEST OR PERMANENT PUMP1 MAXIMUM DISCHARGE In below LEVEL DURING MAXIMUM PUMPING to~of casingI ft. I Rations per min. below top of casing J Approximate time of return to norm I level after cessation of pumping J PUMP INSTALLED ! ~I'YPE ' MAK~ J MODEL NO. SUBMERSIBLE MAKE MYERS j J1535 'MOTIVE POWER H.P. ELECTRIC I CAPACITY 35 g,p,m, against J t1. o~ dlscharRe head NUMBER BOWLS OR STAGES fl. of total head DROP LINE SUCTION LINE DIAMETER DIAMETER 1 ~ In. LENGTH 60 .. It. METHOD OF DRILLING [] rotary [~0 cable tool [] other WORK STARTED 2/7/89 ~ATE LENGTIf USE OF WATER ~RRIGATIO~ COMPLETED 2/8/89 7/18/90 J KREIGER WELL & PIMP CORP DRILLER J UCENSE M~(~ Show log of well - materials encountered, with depth below ground surface, walf~r bearing beds and waler levels in each, casings, screens, pump, additional pumping tests and other matters of interest. Describe repair job. See Instructions as lo Well DrJ]le['s'"Licenses and Reports. Pages 5 - 7. S-93532 Well No. ~ LOG Ground Smface El. ,A, V TOP OF WELL '20 COARSE 30 40 50, COARSE STO~ES 60 70 ~.~, 80~' COARSE 83 lC 87 5 91 5 ft, above sea ft. SAND/STONES SAND/GRAVEL SAND/STONES 1 of 2, 18-1359:7/86 Well Yield: 35, g.p.m. Casing: Type of Material ~LACK ZRON Drop L~ne: Type of Material If plastic, torqu~ arrestor used? YES was 3/16" S.Si:. cable installed? NO Sanitary Seal: Type iUsed WELL SEAL Storage Tanks: Sizei' gals.; Type Inside Material Typelof Tank Drain Pres§ute Gauge Installed. Shut, Off Valve Prior to Tank Samplling Tap Provided Shut!-Off Valve Wit~ Bleeder Line Installed on Outflow of Tank Method of Disinfectiion: CHLORINATION Well Lateral: Depth Below Grade 5' Material lO0# POLY Water Treatment Equipment Installed For Treatment oW Make Type Model Number · Well Driller's Signature Print Name ~OBERT G. LAURIGUET KREIGER WELL & PUMP CORP Print Company Name Mailing Address Telephone Number BOX 101 MATTITUCK 298-4141 2 of ~ 3. Nature'ofwork (check which applicable): New Building ........ Addition .......... Alteration ...... .'. .... Repair .............. Rbmoval .............. Demolition .............. Swzmm:mg.,t~J~J~ ,.,. ~, . . '~ .... Tennis Court ......... Accessory Building .......... Fo~ee ....... Other Work ....... "~.,.'.. ) Estimated Cost /( ~)~ ?. Fee (to be paid on filing this application) · ' ~. If dwelling, number of dwelling units .............. Number o f dwelling units on each floor .......... If garage, number of cars ..................................................... '...' .............. 5. If business, commercial or mixed occupancy, specify nature and extent of each type of use .................... 7. Dimensionsofexistingstructures, ifany: Front .............. : Rear ............. Depth Hck'ht ........ Num her of Stories ............................. Dimensions of same structure with alterations or additions: Front ................. Rear ................ Depth ................. Height Number of Stories <l. Dimensions of entire new construction: Front ............... Rear ............... Depth .......... Heieht Number of Stories · 9 Size of lot: Front Rear Depth 3. Date of Purchase ............................. Name of Former Owner ............................ I. Zone or use district in which premises are situated ........................ .'~' ~,.,¢ ....................... 2. Does proposed construction violate any zoning law, ordinance or regulation: .. :~. ~.. -/<. ...................... 3. Will lot be regraded ........ I~,J .O ................ Will excess fill be removed from premises: Yes , 0~ · No. t. Name of Owner of premises ~'~1~1~..~.[~¢'gt~i.r~... Address j.cl'~--:~ .b. Name of Architect ......................... . . Address .... ........... . ...PhoneNo.... ........ ..... Name of Contractor ................. i ........ Address ................. Phone No .......... 7r: .... .5.Is this property located within 300 feet o~'a tidal wetland? *YES .... }IO.~/.. mil yes, Southold Town Trustees Permit may be required. PLOT DIAGRAM Locate clearly and distinctly.all buildings, whether existing or proposed, and. indicate all set-back dimensions from roperty lines. Give street and block number or description according to deed, and show street names and indicate whether .~terior or corner lot. TATE OF NEW YORK, S.S :OUNTY OF ................. ................................................ being duly sworn, deposes and says that he is the applicant (Name of individual signing contract) bore named. is tile (Contractor, agent, corporate officer, etc.) said owner or owners, and is duly authorized to pe,rform or have performed the said work and to make and file this aplication: that all statements contained in this application are true to the best of his knowledge and belief; and that the 'ork w~l be perfommd in the re=ncr set forth in the application qlcd therewith. ~vom to before me this FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL $OUTHOLD, N.Y. 11971 TEL.: 765-1802 Disapproved a/c ................................... .................. (Building Inspector) APPLIOATION FOR BUILDING PERMIT BOARD OF HEALTH ............ SURVEY ...... ' .... CHECK ...................... .... /%. .... MAlL TO: :..74. 7:: Date .................. , 19 ... (Signature of ~pplicant, o n r orat (Mailing address of applic~/) grate wh~ther applicant is owner, lessee, agent, ~chitect, engineer, general contractor, electrician, plumber or builder. i (as on the tax roll or latest deed) ff applicant ~s a corporation, signature ~fduly authorized officer. BIder s L~cense No .................. Plum bet's License No ' Other Trade's License No Location of land on which proposed~ work will be done; House Number .................................. ; ' Street ..................... Ham/et County T.x M~p No. 1000 S~ction . ~ .~' :~ ~Bl~ck ...... ~ ...... Lot .... 2ZA~ ..... ,' (Nnn}e) ......... E,lud Map No. /~.~,~x.. Lot .. ~ ........ Slate existing use and occupancy of premises and intended use and Occupancy of proposed construction: B. Intended use and occupancy ............................ INSTRUCTIONS a. This application must be comp!letely filled in by typewriter or in ink and submitted to the Building li~spector, with :3 sets of plans, aeanrate plot plan tO~calb Fee according to schedule. b. Plot plan showing location of lot and of buildings or areas, and giving a detailed descripiion on premises, relationship to adjoining premises or public streets cation. . of layout of property must be drawn on the diagram which is ping of this appli- , ¢. The work covered by this application may not be commenced before issuance of Building Permit. d. Upon approval of this applicat{on, the Building Inspector will issued a Building Permit to the applicant. Such penmit skall be kept on the premises available ifor inspection throughout the work. ~ e. No building shall be occupied for used in whole or in pnrt 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 Towa of S~Bthold, Suffolk County, New York, and other applicable Laws. Ordinm'~ces or .~legulati.O. ns, for the construction of buildings, ad. ditions or alterations, or for iemoval or demolition, as herein described. ~e appncant agrees to comply with ¢II applicable laws, ordinances, building code, housing code, and regulations, and to admit authorized inspectors on premises and in building for necessary inspections.