HomeMy WebLinkAbout18724-z FORM NO. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Office of the Building Inspector
Town Hall
Southold, N.Y.
CERTIFICATE OF OCCUPANCY
No Z19116 Date JUNE 7, 1990
THIS CERTIFIES that the building FIRE DAMAGE REPAIR
Location of Property 1700 NAUGLES DRIVE MATTITUCK
House No. Street Hamlet
County Tax Map No. 1000 Section 99 Block 005 Lot 022
Subdivision Filed Map No. Lot No.
conforms substantially to the Application for Building Permit heretofore
filed in this office dated JAN. 4, 1990 pursuant to which
Building Permit No. 18724Z dated JAN. 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 REPAIR FIRE DAMAGE IN EXISTING ONE FAMILY DWELLING.
The certificate is issued to SPIRO PYLARINOS
(owner)
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A
UNDERWRITERS CERTIFICATE NO. H015007 MARCH 28, 1990
PLUMBERS CERTIFICATION DATED N/A
ild ng Inspector
Rev. 1/81
rows NO. a
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)
a 18724
N— Z Date ....11f..........................................
Permission is hereby granted to:
�/11 d ......
.......+/H{J) r.. ......................
A , o � e
to A� ..... ....tnrl.... F2i .... ...,. ��
• t
. ... ........ ......,. .. . ..........:. . ...........
r ....
at premises located of ....../..�,r..Clld. . drt�........ l.!�o .. ..................................
. .......................... .
...................................................................................................................................I............................
County Tax Map No. 1000 Section ...........�41- .... Block Lot No. . ..
pursuant to application dated .............. .�P�............................... 1 fO.., and approved by the
Building Inspector.
Fee $........... x
Ilding ector,
Rev. 6/30/80
TEL. 765-1802
TOWN OF SOUTUOLD
OFFICI: OF BUILDING INSPECTOR
P.O. BOX 728
TOWN I IALL
`4,•�/ SOU I'1101.1), N.Y. 11971
April 3, 190
Spyro Pylarinos 31Jo af0
1700 Nau;les Drive
Mattituck, N.Y. 11952
TO Whom This May Concern,
We are unable to complete your Certificate
Of Occupancy becau,c of the following reasons.
An :.application for Certificate of Occupancy
not on file . (ENCLOSED)
Io tinder;writers Certificate on file .
/ 'I'll
c check .iS ((X'XUX 4/not oa file . ) $25. 00
Nn health Dept. Approval on file.
C1O final inspection ha. been made .
P) eaOe contact our Office on this matter.
Thank you.: for your cooperation.
Build .ng Permit 11 1 8 7 2 4 Z
Building UepL- .
No Plumber Solder Certificate on file.
( all permitO involving plumbing being
isOued after April 1 , 1984 )
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 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 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
1. Certificate of Occupancy - New dwelling $25.00, Additions to dwg�hinp25 300,jf,
Alterations to dwelling $25.00, Swimming pool $25.00, Accessory Sbii� di _g, 25'
Additions to accessory building $25.00. Businesses $50.00.
2. Certificate of Occupancy on Pre-existing Building - $100.00 MAY
3. Copy of Certificate of Occupancy - $5.00 over 5 years - $10.0 i 71990
4. Updated Certificate of Occupancy - $50.00 �� „
5. Temporary Certificate of Occupancy - Residential $15.00, Commerc d'p%�')YY'E
��p�/�gp�� ,UTHO €7
Date . . . . . .4�W.Frr. .T?!. . .I Vim. . . . . . . . . . . . . . .
New Construction. . . . . . . . . . . Old Or Preq-existing
Building. . . . . . . . . . . . . . . . .
Location of Property. . . . .t7 QQ . . . . 4V.� l.1 .. . . . . . . . . . . .
House No. pp Street nn.. Hamlet
Onwer or Owners of Property. . . . . . . . ..Q �JOW. . . . . . ,P P. R !l N.O�
County Tax Map No 1000, Section. . . . . . . . . . . . . .Block. . . . . . . . . . . . . . . .Lot. . . . . . . . . . . . . . . . . . . . . .
Subdivision.. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .Filed Map. . . . . . . . . . . .Lot. . . . . . . . . . . . . . . . . . . . . .
Permit No J. A 7 2.42. .Date Of Permit. . . . . . . . . . . . . . . .Applicant. . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Health Dept. Approval. . . . . . . . . . . . . . . . . . . . . . . . . .Underwriters Approval. . . . . . . . . . . . . . . . . . . . . . . . .
Planning Board Approval. . . . . . . . . . . . . . . . . . . . . . . .
Request for: Temporary Ci�e]]rtificate. . . . . . . . . . . Final Certicate. . . .Y. �/�a?.
Fee Submitted: $. . . . . . . :�i.,5.. . . . . . . . . . . . . . . . .
. . . . . . . . . . .s.T". � . . .?Ad,..—�- . . . . . . . .
APPLICANT
b
THE NEW YORK BOARD OF FIRE UNDERWRITERS PAG1
8011288 BUREAU OF ELECTRICITY
7 BS JOHN STREET. NEW YORK. NEW YORK 10038
Date MARCH 28, 1990 Application No.on file 67798690/90 I. (11h(r07 t
THIS CERTIFIES THAT
only the deetrkW equipment as described below and introduced by the sqq Li t named on the shove application number in the premises of
S. NYI.AR1NO3, 1100 NAMI.VS UR. , MA11( IUCK, N.Y.
inthefolloseinRlocation; ❑ Baeement ❑ iet Fl. ❑ Ynd Fl. MIT Section Block Lot
wasexaminedon MARCH 2O, 1990 undfound to be in compliance with the requirements of this Board.
Bf!
RKTEAE ACUS SWnCf1E5 R%TIMES RANOK COOKING DECKS OVENS DISH Ei(NAUST FANS -�
Ot nus NCANNSCENT.FLUORESCENT I OTHER MT. K.W. "T. K.W. AMT. K.W. MIT. K.W. ANT. X.P.
DRY9S FURNACE MOTORS FIIIURE A►NIAtNy RROEIK SF[OAl mmj 11ME CLOCKS.I EBL I U1Ri HEATERS I AWl1FOUT1lT . .
AMT. K.W. dl N.P. GAS X.P. AMT. NO. A.W.G. AMT. MV. MAT. AMPS: TRANS. M\T.I M.P. ply.OF NET WATTS
SERVICE OISCOlMlCf me.OF S E R V 1 C E
M\T. MV. 1TPE law. t/TW 1.f 3W 3 6 3W 3 f AW �'OPEgC�COND. OF A.W.G.
COND. NO.OF HI:IfKi „I' NO.OP NFNRM3 OF IEUiGRAL
OTHER APPARATUS:
5MOKii 0f..IF:C1pR : -6
5. WYI_ARINt18
39-'20 208 N1 .
BAY5IDI , NY, 1.1b61 0101"MBHAB
1] nY
Per
This cortificalb nnut not be altered in any manner; return to the office of the Board it kKonact.. inspectors m be ' by NIRiK»+trpdmtioIS.
.�...�_ CQPY FOR BWLDINC DEPARTM�lT. 7'MNS COPY OF CER - ;_ t101'!E A1.T�RlD 11!t#�l
765-1802
BUILDING DEPT.
INSPECTION
[ ] FOUNDATION 1ST ( I ROUGH PLBG.
( ] FOUNDATION 2ND [ ] INSULATION
[L,�FRAMING [ ] FINAL
REMARKS:
DATE 3� g0 INSPECTOR S
r
7GS-1802
BUILDING DEPT.
INSPECTION
[ ) OUNDATION 1ST ( ] OUG PLBG.
[ ) FO DATION 2ND [ ) I LATION
[ RAMI [ FINAL
REMARKS: _f a&A t LC C
A-g b R g A-a= it D o i2.
DATE (� INSPECTOR ✓
IELD II:SPECTiUN DATE COMMENTS \
ro
x
z
FOUNDATION ( 1st )
FOUNDATION ( 2nd ) _ _ ro
2 .
z
0 1.
V
ROUGH FRAME & \��
PLUMBING �l
ti
3 .
IIJSULATIOPJ PER N . Y. • • '�
STATE ENERGY \
CODE
x
a
4 . y
P
FI;JAL
0
z
ADDITIONAL COMMENTS :
x
x
ro 1A
H \x e.D
a \
H
H
O
2
. x
[h
a
• r
_ H
x
tl
"0
H
. ____ - ���� uc[aun vau[a[c any zonu,g tuw, uru u..au cc .r regula[wn: . .
13. will lot be regraded . . . . . . . . . . . . . . . . . . . . . . . . . . . . will excess fill be removed from premises-. . Yes . .. . No . .
14. Name of Owner of premises . . . . . . . . . . . . . . . . . . . . Address . . , • . • . . . . . . . . . . . . . Phone No. . . . . . . . . . . . . . . . .
Name of Architect . . . . . . . . . . . . . . . . . . . . . . . . . . . Address . . . . . . . . . . . . . . . . . . . Phone No. . . . . . . . . . . . . . . . .
Name of Contractor . . . . . . . . . . . . . . . . . . . . . . . . . . Address . . . . . . . . . . . . . . . . . . . Phone No. . . . ..,. . . . . . .. . , .
15.Is this property located within 100 feet of a tidal wetland? *YES . . . :NO. . . .
*If 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
property lines. Give street and block number or description according to degdAnd show street names and indicate whether
interior or corner lot. ��t5
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STATE OF NEW YORK, S S
COUNTY OF . . . . . . . . . . . . . . . . .
• • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • . . . . . . . . . `being duly sworn, deposes and says that lie is the applicant
(Name of individual signing contract)
above named.
He is the . . . . . . . . . . . . . . . . . . . . . . . . . . . .
(Contractor, agent, corporate officer, etc.)
of said owner or owners, and is duly authorized to perform or have performed the said work and to make and file this
application; that all statements contained in this application are true to the best of his knowledge and belief;and that the
work will be performed in the manner set forth in the application filed therewith.
Sworn to before me this
. . . . . . . . . . . . . . . . . . . . . . . .day of. . . . . . . . . . . . . . . . . . . . , 19 . . .
Notary Public. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . County
. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
(Signature of applicant)
t Memorandum from . . . .
BUILDING INSPECTORS OFFICE
TOWN OF SOUTHOLD
TOWN HALL, SOUTHOLD, N. Y. 11971
765.1802
JANUARY 9, 1990
Dear Mr. Pylarinos:
Please be advised that your building permit
has been written, however, we can not issue the
permit to you until you send us a check for -
$50.00. There will be a $25.00 fee for the
Certificate of Occupancy after all the work is
completed. We are returning your check #168
for $75.00. As soon as we recieve the new
check for $50.00 the permit will be sent to you.
Thank you for your cooperation.
Building Department
� � P',! f ✓
��. BOARD OF HEALTH . . . . . . . . . . . .
FORM 3 SETS OF PLANS . . . . . . . . . . . .
SURVEY
TOWN G DEPARTMENT
CHECK . . . . . . . . . . . . . . . . . . . .� BUILDING DEPARTMENT SEPTIC FORM
TOWN HALL
SOUTHOLD, N.Y. 11971 NOTIFY ,
TEL.: 765-1802 CALL 7I X ' 2Z5"a
l�(? 5. .
Exaniincd . . MAIL TO : /
Approved . . . . . .// . . . . . .. 199!�. Pennit No. .<T7
Disapproved a c
APP VED p$NOTED `
GATE:. B P.A '. . . . . . . . D
FEE:
NOTIFY BLIiL ING DEPA ' ' ' • • ��. . . . ��.s
765-1802 8 AM TO 4 PM FOR THE (B ddi Inspector)
FOLLOWING INSPECTIONS: APPLICA' ION OR BUILDING PERMIT 1. FOUNDATION - TWO REQUIRED ?OWN OF. DEP LD
FOR POU ONCRETE Date . . . . . . . . .. • , • • • , , , ly
R UGH - FRAMING.& PLUMBING
3.3NSULATI( � INSTRUCTIONS
FINAL - CCNSTRUCTION MUST
39E TbM0I20M9QlRtMst be completely filled in by typewriter or in ink and submitted to the Building Inspector, with 3
sr bf 90KT3auaai7dwj)l Ilb WEETle. Fee according to schedule.
tom• ipFQ4MMiffNT6inPFocTHE)rAIcTlot and of buildings on premises, relationship to adjoining Or`a,FBds, BfM 1 P 1 > Premises or public streets
§Tli1AlEIQytailedFdIF�36)ftion of layout of cation:S property must be drawn on the diagram which is part of this appli-
• � FOR
O 3T g"ication may not be commenced before issuance of Building Permit.
De1E'Ug �P •gPytl�is aggLcaSion, the Building Inspector will issued a Building Permit to the applicant. Such permit
sh p,,e kept on the PWises available for inspection throughout the work.- .
NpTI Rt7 sfW)3 RlM—E— —re Tor used in whole Orin art for an 1M,f t
P y purpose.A, •t C til a Certificate of Occupancy
sh*#apg�eegi aMri�l 1pyp(�+feF�ypjl Inspector. �:}�
F FgT
Build �8 to the Building Department for the issuance of a Building Permit pursuant to the
k of Southold, Suffolk County, New York, and other applicable Laws,Ordinances or
I O jt�q1,�QQ�,,��,�uildings, additions or alterations, or for removal or demolition, as herein described.
ad t�"'Nit all applicable laws, ordinances, building ad i "W-RawUN , code, housin, code, and regulations, and to
s and in building for necessary inspections.
BE COMPLETE FOR C.O.
ALL CONSTRUCTION SHALL MEETA- ' — : t • • • - • • . . . .
THE REQUIREMENTS OF THE N.Y. (Signature o app ica t, or name, if a corporation) '
STATE' CONSTRUCTION " ENERGY
CODES. NOT RESPONS LE FOR . . . . . . . . . . . . . .
DESIGN OR CONSTRUCTION ERRORS (Mailing address of applicant)
State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder.
Name of owner of premises . . . . . . . . . . /. /—.I�� r)k? (? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
F•
(as on the tax roll or latest deed)
If applicant is a corporation, signature of duly authorized officer.
(Name and title of corporate officer)
Builder's License No. ... . . �,x, , , Q)ti 1 C OC'CUPANCY OR
Plumber's License No. . . .N d.'• ,Q,� (�,ryi � 1/�9� tZe}` USE IS UNLAWFUL
pp
Electrician's License No. • D.�. , ,lJ w ]j j�-R—. f 10 9 ) g y V IC
Other Trade's License No. . 9 OCCUPA
1. Location of land on which proposed work will be done: r 1 y
.17 n.Q. . . .lv.A tr.&ES. . . Q PY A. . M. h.771.7� . .Ilouse Number Street " '
qq Hamlet
County Tax Map No. 1000 Section . . . . . .9. ./. . . : . . . . . Block . . . . . . ,S, , ,
. . . Lot . . .
Subdivision . . . . . . . . . . . . . . Filed Map No.
(Name)
Lot . . . . . . . . . . . . . . .
State existing use and Occupancy of premises and iin'tended use and Occupancy of proposed construction:
a. Existing use and occupancy . . . . . I . . . . . .r .1 �te - . . . . . . . . . .
b. Intended use and occupancy . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ... . . . . . . . . . . . . . . . . . . . . . . . . . .
AA
v c eck which aPPlicl . . . Addition . . . . . . . . . . Alteration . • • . . . . . . . .
3. Nature of work (�1 R�movat able): New building . . • . . • .
�' Demolition Swimming pool. . . . . . . ... . .
Repair . . . . . . . . . . . . . . . . . . . . . • •
Tennis Court . . . . . . . . . Accessory Building. . . . . . . . . .Fence . . . . . . .Other Work. . . . .. . . . . . . .
4. Estimated Cost . . . . . Q. c . . . . . . . . . . . . . . . . . . . . . . Fee . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . °
(to be paid on riling this application)
5. If dwelling, number of dwelling units . . . . . . . . . . . . . . . Number of dwelling units on each floor . . ... . . . . . . . . . . •
If garage, number of cars " " "
6. If business, commercial or mixed occupancy, specify nature and extent of each type of use . . . . . . . . . . . . . . . . . . . . . .
7. Dimensions of existing structures,if any: Front . . . . . . . . . . . . Rear . ... . . . . . . . . . . . Depth . . . . . . . . . . . . . . . .
Height . . . . . . . . . . . . . . . Number of Stories . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Dimensions of same structure with alterations or additions: Front . . . . . . . . . . . . . . . Rear . . . . . . . . . 6 .t . . . . . .
Depth . . . . . . . . . ..... .`.:a<7 r . . ,,Height . . . . . . . . . . . . . . . 6 . . . . . . Number of Stories'I
8. Dimensions of entire new edrnstniction: Front . . . . . . . . . . . . . . . Rear . . . . . . . . ...... . „�4F9�?c ....w- _•
Height . . . Npmbef of Stories . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .i.f,,. . . . . . . . . . . . .
�. Sl2C Of lOta. . . .,. Rear . . .'. . . . . . . . . . . . . . . . . . #f�1�h;`I!".. p . x. .•'.:.,.,:.v . . . . . • e
10. Date of Purchase 1 . . . Name of Former Owner f, t,.;. rs . . . . . . . . . . .
11. None or use district in,whic'I-i pr mises are situated . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ..... .
12. Does Proposed eonstrut�r ao tc any zoning law, ordinance or regulation: t �tft •°• ° °
13. 1Pbl lot be regraded . . . . . . . . . . . . .Will excess fill be removed from premises:, Yes : ::^ No; .
14. Name of Owner of premises . . . . . . . . . . . . . • • . . Address . . . . . . . . . . . . . . ... .. Plione No. . . . . . . • . . . • ' • . .
Name of Architect . . . . . . . . . . . . . . . . . . . . . . . Address . . . . . . . . . . . . . . . ,. . . Phone No. . . . . . .
Name of Contractor . . . . . . . . . . . . . . . . . . Address . . Phone No. . ....,• • • • • . .
feet of a tidal wetland? *Y) S . NO.
his property locat•' d within 100 .
I�.Is t p P g
*If yes , Southold Town Trustees PLOT DIAGRermit
be required.
Locate clearly and distinctly all buildings, whether existing or proposed, and.indicate all set-back dimensions from
property lines. Give street and block number or description according to depc` And show street names and indicate whether
interior or corner lot. kk�
UNDERWRITERS CERTIFICATE
REQUIRED �� ,t► �Qt. $ °��� ti
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Pofmop,l AwU rN57d�Ne
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STATE 01: NEW YORE. S,S
COUNTY OF . . . . . . . �
g• • . • . • • • . . • . • , , , , ,I. . . . deposes and says that he is the applicant
(Name of individual signing contract)
above named.
Heis the . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . I . . . . . . . . . .
(Contractor, agent, corporate officer, etc.)
of said owner or owners, and is duly authorized to perform or have performed the said work and to make and file this
application; that all statements contpined in this application are true to the best of his knowledge and belief;and that the
work will be performed in the manner set forth in the application filed therewith.
Swom to before me this
. . . . . . . . . . . . . . . . .y . . . . .day o(�./. . .j� ! . . . . . . . . .. 19yd
Notary Public, . . . . . . 1.. . . . . . jl,. . .!. . County
NEIEN K.BE dME . . . . .1, . . . .�V•/
NNARY PUBLIC,State°f NOW�tyYa�t� (Signature of pplicant)
Tom Expire TMatSuffolk
h 40,19fle—