HomeMy WebLinkAbout19003-zFORM NO. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Office of the Building Inspector
Town Hall
Southold, N.Y.
CERTIFICATE OF OCCUPANCY
No Z19131
Date JUNE 11, 1990
THIS CERTIFIES that the building
Location of Property 51090 NORTH RD. &
House No.
County Tax Map No. 1000 Section 51
Subdivision
ACCESSORY
120 RICHMOND RD.
Block 06
Filed Map No.
SOUTHOLD
Street Hamlet
Lot 15
Lot No.
conforms substantially to the Application for Building Permit heretofore
filed in this office dated NOV. 24, 1989 pursuant to which
Building Permit No. 19003Z dated MAY 9, 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 STORAGE SHED AS APPLIED FOR.
The certificate is issued to
(owner)
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A
UNDERWRITERS CERTIFICATE NO. N/A
PLUMBERS CERTIFICATION DATED N/A
KONSTANTINOS KOUKOUNAS
Rev. 1/81
lVO~ NO. ~
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN HALL
SOUTHOLD, N. Y.
BUILDING PERMIT
CT'HIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL
cOMPLETION OF THE WORK AUTHORIZED)
19003 Z
County Tax Map No. 1000 Section ...... ¢.~/... ......... Block ........ ~.. ......... Lot No ......... ../...~.....~......
Building Inspector.
and approved by the
Rev, 6/30/80
FOU!IDATIO:! (2nd)
2.
ROUGH FRAME &
-?LUMBING
INSULATIO,~; FERN.
STATE E~';ERG Y
CODE
F_~::AL
ADDITIO~A'L COMMEHTS:
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:
1. Final survey of property with accurate location of ali 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 contm~ns
~ less than 2/10 of 1% lead.
5. Commercial building, indus.trial 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 reeuJrements.
B. 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 properiy 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 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 - $i00.00
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 $15.00 ·
I .L .o
Date .~..£ .... ~ .............................
New Construction ........... Old Or ~re-existing Building. .
~ous~ No. Street Hamlet
Onwer or Owners of Propert .. . ......................................... · ...........
County Tax Map No 1000, Section .............. Block ........ Lot ...................
Subdi$ision ......... ' ....
........................... ~%zee Map ............ Lot ...........
No.. ~.. ~.~..~..~.~.~.. Date
P.ermit Of Permit...~.L .~..~ .~..~... Applicant...~. ~ .~[~ ~ ~.~f. ~ '../.~..c~..~.TM
~ealth Dept Approval
Underwriters Approval
Planning Board Approval
Request for:.Temp°rary Certificate ........... Final Certicate ...........
Fee Submitted: $ .......... · ...
TOWN OF $OUTHOLD
OFFICE OF BUILDING IN~PECI'OR
P.O. BOX 728
TOWN HALL
SOUTItOLD, N.Y. 11971
June l, 1990
Konstontinos Koukounas
24-13 35th Street
Astoria, N.Y. 11103
TEL. 765-1802
To Whom This May Cogcern,
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)
/~//~o Underwriters Certificate on file.
/~ The check is(~X~XX~/not on file.) $25.00
/~/ No Ilea~th Dept. Approval on file.
/5/ No final ins.pcction has been made.
Please contact our office on this matter.
Thank you for your cooperation.
Bui]dJ. ng Permit tt I 9 0 0 3 Z
Building Dept.
***/5/ No Plumber Solder Certificate on file.
( all permits involving plumbing being
issued after April 1,1984 )
N/OIF JOSEPH ~ SA WIGKI
SAt
Prepared In a¢¢ordanca w#lt Iha minimum
b~ I~e L.I.A.L.~. ~d ~pr~ved ~ adopled
ROMANO
FORM NO. 3
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN CLERK'S OFFICE
SOUTHOLD, N.Y.
NOTICE OF DISAPPROVAL
PLEASE TAKE NOTICE that. your application dated ..... /.//(...,~.,..~. ............,19 P~.?..
~o~a~o~ o~o~ ~:~o'...~.~ .~..~.~~~~ .....
co~ ~ M~ ~o. ~00o s~t~o~ ...... ~Z... ~oc~ ...... ~. ...... ~t .. ~ .......
Subdivision ................. Filed Map No ...... Lot No ..................
. d'.~,,~ . . . x ~ ~ .-. /~. . . .~. ...... ~. . ~?~, . . . . ~~ -
.,,_ ~."-,~ _ .-Z ..<. ~ ',,/."..~d',.L ~.,_ --/-~ . x.,..~ ~
· -~..~~~~.d~,~.) .......................
Rv 1/8o
COPY
VICTOR LESSARD
PRINCIPAL BUILDING INSPECTOR
(516) 765-1802
FAX (516) 765-1823
Town Hall, 53095 Main Road
P.O. Box 1179
Southold, New York 11971
OFFICE OF BUILDING INSPECTOR
TOWN OF SOUTHOLD
November 30, 1989
Konstantinos Koukounas
24-13-35th Street
Astoria, New York 11103
Re: Premises: 51090 North Rd.
Southold, N.Y.
Suffolk Co. Tax Map ~1000-51-6-15
Dear Mr. Koukeunas:
Enclosed please find herewith notice of disapproval for
the construction of an accessory shed on the above vacant lot.
Please contact the undersigned to discuss possible
alternative as to placement of shed.
Very truly yours,
SOUTHOLD TOWN BUILDING DEPT.
Thomas Fishe/,
Building I~pector
TF:gar
FORM NO. 3
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN CLERK'S OFFICE
SOUTHOLD, N.Y.
NOTICE OF DISAPPROVAL
....
PLEASE TAKE NOTICE that. your application dated ..... /././.~.,..~. ............ ,19 ~..?.
County Tax Map No. 1000 Section ...... ~... Block ...... ~. ...... Lot .. ~ .......
Subdivision ................. Filed Map No ................. Lot No ..................
is xeturned he.rewith and disapproved on the following grounds../~.~.~......~...~..~ ~ ~
.~...~.../~.-./~.....~. ...... .~~L... ~~/~,. -.~"- ~
,__ ,~ .~ ~ ~, ~,~.. ~-~:"~
.~.. ~...~~~... ~_..~.. ~.~~ .... ~~
[in pector
RV 1/80
./
N/O/F JO~F. PH t~ SA WICKI
SAt ROMANO
LOLLS P'
~ .
BOARD OF HEALTH
3 SETS OF PLANS
'FORM MO. 1 SURVEY . ~/
TOW~ OF SOUTHOLD CHECK .... .~. ....
BUIL'D, INGDEPARTNIENT SEPTIC FORM
TOWN HALL
SOUTHOLD, N.Y. 11971
NOTIFY
MAILCALL ;d: .............. ' '
BLDG. DEPT,
TOWN OF SOUTHOLD ....
Date .
INSTRUCTIONS
a. This application must be completely filled in by typewriter oriri ink and submitted to the Bmldmg Inspector, with £
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 prem scs or public street:
or areas, and giving a detailed description of layout of property must be drawn on the diagram which is part 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 applicant. Such permit
shall be kept on the premises available for inspection throughout the work.
¢. No building shall be occupied or used in whole or in part for any purpose whatever until a Cegt/fic~te of Occupa.ncv
shall have been granted by the Building Inspector. 5, ' -
APPLICATION IS HEREBY MADE to the Building Department for the issuance of a Building Permit purxuant to the
Building Zone Ordinance of the Town of Southold, Suffolk County,'New York, and other applicable Laws, Ordinances or
Regdlations, for the construction of buildings, additions or alterations, or for removal, or demolition, as hereLn described.
The applicant agrees to comply with all applicable laws, ordinances, building code, housing code, and regulations, and to
admit authorized inspectors on premises and in building for necessary inspections.
( ign u p lc t na if c
&~t~ l'F~ -Y ~/:° ~/r. )q~A.~-,~ ~-'z-. y rt r o~
' "' " ' .......... W=i i.g ..... address
.... of abbii~;) ............
State W~2'{fi~plic~nt is owner lessee, agent, architect, engineer, general contractor, electrician, plumber or builder.
N~e of os~r. of p=mises ........
,'~ ~ ~',.' ' (as on the tax roll orlatest deed)
If appl'ca,nt'a~:~ ebr~o)aii6n, ~gnature~ o,f duly authorized officer.
...... '.;.. ;'.-;?.'.. ~..' ....
(Name and t~tle ofc0,~orate officer) ·
Electrician s Lzceme No .......................
Other Trade's License No ......................
Location of land on which proposed work will be done~ ...........
/ ......................" ' "' '" '
H N be St ' '
ouse um r reel Hamlet
Subdivision
Filed Map No Lot '
State existing nsc and occupancy of premises and intended u~e and occupancy of proposed construction:
a. Existing use and
occupancy .....
.3. Nature of work (che~k which iaPPlicable): New Building .......... Addition .... AJteration
Repair ......... . ..... Removal .............. Demolition .... ' ..... '
2}7o05'o >,- " ........ OtherWo,k.. ............
4. Estimated Cost ........... ,... ~ 3. _~p ~L~'. F_)O (Descriplion)
i ........................ Fee ......... : ...........................
' (to be paid on filing this application)
$. If dwellin= number of dwelling units
" Number of dwelling units each floor
If garage number of cars ................
' on
6;,' If business. Commercial or mixled occupancy, specify nature and extent of pe of use ....................
7. Dimensions~o~xisting structures, if any: Front ..... ~ .... Re '
He:ght ..~ ........ NumberofS ,-i~ ~ ar .e~..! ....... Depth...~'~.. ........
Dmlenslons of same structuro xt, ltl, nlt,.v-.: ........ :-¢" '-' * ..............................
--. ..........,.,u.~ ur aumuons: vront . - '
· D.epth 't~l~-~.~ .~:4'~ ....... ... Height ............. ., ....
8 Dtrnensl~l~o~ tvht~r~V~ew co--; -' '~ .'5'~ · ....... rmmo~er of Stones ....................
~ ,~mcuon: vront ... ,,-c:, . ,, ,,,. -. , .
· H" .~5~' , "/~ ......... ~ear...~
eight ..· ........ Nu nber of Stom'e .......... Depth ~
9.,S~zeo or. Front ... t~ .i~,~/r5 -,,w ....................................
' .----- '., · .. ,,car - ~" ./..'7..~.-.d,p ..~...'~. ~
0. Date of Purchase . ..2.~, /% ~q ~ . · .~,'.'. a: .... <,ff. ......... Depth, . .
1. Zone or use district in which premises are situated ........... ' ............. 55/ .........
2. Does proposed construct on violate any zoning law. ordinanc , ' · .
3. Will lot be re,,r-,~-a . e or r%ulatmn....~.~ ..............
4. NameofOwn,~-~r,, ,' '"7~-~,~,3,(~ ¢ ~,'.~,: ;/~_<; Wfll excess fill_be removed from prem,ses: _ .Yes
Name of Architect ............... .~ r-~4ff:~,~ ~,~';,,g'e' · ,on .............. ..,... ....
Name of Contractnr I ................ Phone No.: ........... ·
5. Is this .......................... Address ................... Phone No ..... "
property locatediwithin 300 feet of a tidal wetland? *Yes ..... No .~: ..........
i*If yes, Southold Town Trustees Permit may be reouired. '::''
; PLOT DIAGRAM
Locate clearly and distinctly all buildings, whether existing or proposed, and. indicate all set-back dimensions from
roperW lines. Give street and block:number or description according to deed. and show street names and indicate whether
:terior or comer lot.
DATE: .,, _ R.R # .....
FEE: BY: ....
NOTIFY BUILDING DEPARTMENT AT
76~4802 9 AM TO 4 I~M FOR THE
FOLLOWING ~NSPECTION$:
1, FOUNDATION . TWO REQUIRED
FOR POURED CONCRETE
2. ROUGH - FRAMING & PLUMBING
3, INSULATION '
4, FINAL CONSTRUCTION MUBT
~' H~' BE COMPLETE FOR C.O.
ALL CONETRUCTION 8HALL MEET
THE REQUIREMENTS OF 1HE N.Y.
' STATE CONSTRUCTION & .ENERGY
:,vr s.s .... coo s. ,or RESPO, mU:
Ot:XTV .................. D S GN OR CONSTSUCnO~ ERRORS
.. · .~,~'/~'~t/t~:,c ' ~.t..:...~. . being duty s ~orn. deposes and says that he is the applicant
' (Name ofindMdual signing contract) .
: is the ...........................................
(Contractor agent ..............................................
, , corporate officer, etc.)
said owner or owners, and is duly authorized to perform or have performed the said work and to make and file this
.~lication: that all statements contained in this application are true to the best of his knowledge and belief; and that the
,ri: will be performed in thc manner set forth in the application filed therewith.
'om to before ,ne this :
.., .....I .......
, HELEN K.
I'!OTARY PUSL C;, Stott~ of ~e~ Yprk ..................... ~,. . · ·
No. 4707878, Suffolt Count~b t a~-
[ Term [xpkes ~mcl~ 30, 15-.-l/~ ~ ' (Sign