HomeMy WebLinkAbout18650-z FORM NO. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Office of the Building Inspector
Town Ha11
Southold, N.Y.
CERTIFICATE OF OCCUPANCY
No Z-18667 Date DECEMBER 21, 1989
THIS CERTIFIES that the building ADDITION
Location of Property 8680 MAIN ROAD EAST MARION, N.Y.
House No. Street Hamlet
County Tax Map No. 1000 Section 31 Block 7 Lot 6
Subdivision Filed Map No. Lot No.
conforms substantially to the Application for Building Permit heretofore
filed in this office dated NOVEMBER 16, 1989 pursuant to which
Building Permit No. 18650-Z dated NOVEMBER 16, 1989
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 ABOVE GRADE CONCRETE PATIO ADDITION & INSTALL NEW HEATING
SYSTEM & REPAIR FOUNDATION ON EXISTING ONE FAMILY DWELLING AS APPLIED FOR.
The certificate is issued to DIMITRIOS THOMATOS
(owner)
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A
UNDERWRITERS CERTIFICATE N0. PENDING - DECEMBER 21, 1989
PLUMBERS CERTIFICATION DATED N/A
Building Inspector
Rev. 1/81
soaai xo. s
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN HALL
SOUTHOLD, N. Y.
BUILDING PERMIT
(THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL
CgqOMPLETION OF THE WORK AUTHORIZED)
N p J. g 6 J ~ Z Date ../.f~.~x 19..
Permission is hereby aronte to: ~ , o ,
~ ~ ~
/y.......~.{G..~.. ~
..........,,~,.~......~1. ~i
County Tax Map No. 1000 Section Block Lot No...............~~.......
pursuant to application dated ...........~y~~.~ 1., and opproved by the
Building Inspector.
Fee 5...
s
uildin 1 tor..
. spea
Rev. 6/30/80
T ~ ~
TOt1N OF SOUTIIOLD
BUILDING DCCART:fENT ~ #
TONN HALL
SOUTAOLD, NEH YORK 11971
i Ifi5 - 11302
i
APPLICATION FOR CERTIFICATE OF OCCIIPANCY
/DATE..
HEtJ CONSTRUCTION ...OLD OR PRE-E%ISTINC IIUILDING._:;..VACANT LAND........
Location o£ Property
UOUSE NO_ ~ y-7-~//__ STREET UAMLET
Ovaer or Owners of Property...~:....L.v`~/~ ~ ~ C.~
c~ ~ ~
County Taz Map No. 1000 Section 3.I. Block ....1.. Lot'....
Subdivision Filed Ma p~9........Lot_..._..._.
l SU l(~! t`~~0 ~ Tl-lc+l~ od 1 GJ /
Permit No. ..._._..Date of Permit ._Applicant .~~(..:1:~~`_.~`. ~~~ClG~G~
Health DepC. Approval Underwriters Approval..._._........
Planning Board Approval
Request for Temporary Certificate Fiaal Certificate
i~
Pee Submitted: $._~.5
2 cc- ~
APPLICANT..
rev. 10/14/88
Q~.3877~ .
COQ, )6"66`7
' ~ /W r'.~.rl
~ ~ FORM N0. 6
~;C
i . ~ TOWN OF SOUTNOLD
t 3'
e:~.4 ~ I BUILDING DEPARTMENT
- ~ ~ TOWN iL1LL
i~ 765 - 1802 i '
"'tR'.'•ri ln~'~ ~ f '
APPLICATION FOR iCERTIFICATE OF OCCUPANCY INSTRUCTIONS
A. This application must b'e filed in typewriter OR ink and submitted to the Building
' Inspector with the following; for new buildings or new use:
i. Final survey of property with accurate location of all buildiogs, property lines,
streets, and unusual natural or topographic features. '
2. Final approval of Dealth Dept. of water supply and sewerage-disposal(S-9 form).
' 3. Approval of electrical installation from Board of Pire Underwriters.
4. Sworn statement from; plumber certifying that solder used in system contains les9'
than 2/IO of IZ lead.
5. Commercial buildingsj, industrial buildings, multiple residences and similar,
buildings and installations, a certificate of code compliance from the ArchitecC
` or Engineer responsible for the buil"ding.
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, buildings and
• unusual natural or topographic features.
2. A properly completedi application, a consent to inspect signed by the applicanC ,
and a certified abstract of title issued by a title company which shall
show single and separate ownership of [he entire lot prior to April 9, 1957.
• If a Certificate of Occupancy is denied, the Building Inspector shall state the `
reasons therefor in~',vriting to the applicant.
3. Date of any housing'~code or safety inspection of buildings or premises, or other
pertinent information required to prepare a certificate.
C. For Vacant Land Certifcate of Occupancy:
I. Aa application for vacant land Certificate of Occupancy shall be submitted,
and a certified absC~ract of title issued by a title company showing single and
separate ownership f~the entire lot prior to April 9, 1957 shall also accompany
the application. I~ a Certificate of Occupancy is denied, the Buildiog Inspector
shall state the reasons therefor in writing to the applicant.
D. FEES:
1. CERTIFICATE OF QCCUPANCY ew Dwelling $25.00, Additions Co Dwelling $25.00,
Alteration to Daellin $2 0 Swimming Pool, $25.00. Accessory building $25.00
Addition to Accessory u ings, $25.00 -'Husinesses $50.00.
2. Certificate of Occupancy on pre-existing dwelling - $100.00.
3. Copy of Certificate of Occupancy - $5:00 - over 5 years - $10.00 .
4. Vacant Land Certificate of Occupancy - $20.00 '
5. Updated Certificate of Occupancy - $50.00
6. Temporary Certificate of Occupancy - $15.0,0 Residential
Commercial
.
Cs.-~~'`~ art V~a-..N_.~c_
- ` ev, 10/14/S8 I
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INSULATION PER N. Y.
STATE ENERGY
CODE m~
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FINAL L / ~caf
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STIR V~ Y OF ~
_ PROPER T ~ ~
CERTIFIED TO*' .
A T ~ EAST MARION COMMONWEALTH LAND TITLE l
COMPANY
TOWN OF SDUTHOL`C3 rrrLE No. Esa2-uses
~ DlMITRIOS THOAIATOS
^ SUFFOLK COUNTY, 'lV. Y. ~
~ooo a1 - o~ - os ~
• . Scale 1" = 20' ~
Qct. 25, 1988. t
' 7 Prepared in accordance rllb fhs minlmum
s/endords for tNls survsrc ai plab/krbed
• by fbe L.LA.L.S, end'opproved and adopFs
~ T/ll~
AcsoelaNoya.Tbe Nor York Sla/e L ~y~
~~Y~INa j,G~
BOe\RD OF HEALTH
' 3 SETS OF PLANS
•FORMNO.1 SURVEY ....9/,~.,,
TOWV OF SOUTHOLD CHECK • • - - • . •
BUIL"D.ING DEPARTMENT SEPTIC FORM
TOWN HALL
SOUTHOLD, N.Y. 11971 NOCALL • .
9 TEL.: 765.1802 MAIL T0:
Examined . 1/ 19~/.
Approved ..l~~:~b......, I~~Pcrmit No.~P~:s.~~. D ~ Q
Disapproved a/c ~ ~
TOWN OF SOUrHOlD
(B~ding I ec or) ~
APPLICATION FOR BUILDING PERMIT r
~~/5 ~5
Date 19..
INSTRUCTIONS
a. This application must be completely filled in by typewriter or in ink and submitted to the Building 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
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 Petmit to the applicant. Such permit
shall be kept on the premises available for inspection throughout the work.
e. No building shall be occuoied or used in whole or in part for any purpose whatever until a Certificate of Occupancy
shall have been granted by the Building Inspector.
APPLICATION IS HEREBY IvfADE to the Building Department for 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 demoiition, as herein 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 insp 'o ~
(Simon tre ofa~plicant, or name, if a corporation)
A'><V!)#~1~1;~ (bfailing address of applicant)
9 3..i C
State whether apQli~nt..is•o>~n~~,~li!isee" agent architect, engineer, genezal contractor, electrician, plumber or builder.
flx}~`A.SyS,4otP elii}'Y lj
Name''of owner of premises r.7. ~'~rdrJ, :~'GC ",M as ~~.1 .
{t91g1tfO:aR tx>'` (as on the tax roll or latest deed)
i. is ~
a~ a ,
[f applicant is a cor~~porpationyy~tp~na~tufe of duly-aUfhorized officer.
*I~f'.~~, j u 9 Y"
(\ame ar:itl fi'tl'~ o'tz~orporate ofliecr)
ALL CONTRACTOR'S M~J~T, BB SUFPO~t.K COUNTY LICENSED
Builder's Licerts~~l~.' i~" ...~a ~
V kt dt:~ ~ • .
Plumber's Licc~~~J~f?!',;,,«..~:........:....... Q~
Electrician's Litb$fs~~~V~~`a1.~ r~~~
Other Trade's License No . "1
1. Location of land on which proposed work will be done . .
House Number Strcct Hamlet
County Tax Atap No. 1000 Section ~ ~ r....... Block ~,7.......... Lot ~ , , , , , , , ,
Subdivision Filed i\1ap No. Lot
..tNamcj .
State existing use and occupancy of premises and intended/ use attd occupancy of proposed construction:
a. Existing use and occupancy S~(Gc ~t ~~q ~z t(~... ~w ~GGr , ' . • . • , - • • • • • • • . • .
b.lntended use and occupancy
3. Nature of work • . eck which applicable): New Building Addition Alteration ~ , .
Repair , ..R~em'oval Demolition Other ~5'ork .t~.-.tP 1,K,~, t.(tt*~~
J ~ tl~ (Dcscripiion) . .
4. Estimated Cost...... !~'~0 Fee _
~ ito be paid on tiling this application)
5. If dwellin=, number of dwellinglunits . . . Number of dwelling units on cacti floor .
If garace, number of cars .
6. IC business, commercial or mine,
' d occupancy, specify nature and extent of each type of use , , , , , , , , , , , , ,
7. Dimensions of existin; struchir~s, if any: Front Rear Depth ,
Height ..+Nun~berofStarics.........................................,..............
D'
P~ sions of same sttvctur `with alterations or additions: Front Rear , ,
a ! Height Number of Stories
8. I)'tmensi e t ew c'onstauction: Front Rear Depth............... .
Height 'T~IuniberofStoties
9. Size of ]ot: Front . .fit ~ Rear Depth .
0. Date of Purchase . , , ...I, Name of Former Owner .
1. Zone or use district in which premises are situated . . .
2. Does proposed construction viol'i~~tt~~ any zoning law, ordinance or regulation : .
3. Rill lot be regraded ilSl~ . . \Vill excess fill he removed from premises: Yes
4. Name of Owner af,premises ...............Address ...................Phone No............... .
Name of Architect ................Address . ....Phone No. '~y ,
Name of Contractor , ..............Address . ~f4Z't`? X'"!:~''~ .....Phone No, `~:-4A : , ya~~ .
5. Is this property locate .within 300 feet of a tidal wetland? *Yes No '
*If yes, Southold Town Trustees Permit may be re uired,
PLOT DIAGRAM
Locate clearly and distinctly all (buildings, whether existing or proposed, and. indicate all setback dimensions from
roperty lines. Give street and block number or description according to deed, and show street names and indicate whether
iterior or corner lot. ~ I ~ ~ f~~~ ~ p, J~ _ ,
_ ;n,~A~~ ~
LG ~ d~
~ ~ ~ .
. ~ ~
APP p ~
I, DATS:.il~~~~... e.R via '
FEE:
NOTIFY SUI 6EPA AT
• 786-1802 8 AM 1b ; PM 'moo
FOLLOWING INSPECTIONS;
1. FOUNQATION TWO pEdU1gE0
FOR POURED CONCRETE
j 2. ROUGW -FRAMING dr PLUMSINQ
' 3, INSULATION
Q. FINAL CONSTRUCTION MUST
BE COMPLETE FOR C,O.
ALL CONST
RUCTI
ON
SHA
THE REQUIREMENTS OR ~ MEET
STATE CONSTRUCTION 8~1 N~Y
"A7'E OF NEIti' 1'ORI~, CODES. NOT RESPONSIBgE ~V
][i\~~jf
IS DcSIGN OR CONSTRUCTION ERROR8
. , ,'''6"'"' k ' G~~~. ~tl. being duly sworn, deposes and says that he is the applicant
t• t
(~amc of individual si=nmg contract)
oec named. I
~isthc
(Contractor, agen- t, corporate officer, etcJ
said owner or owners, and is duly .puthorized to perform or have performed the said work and to make and file this
alication: that all statements contained in this application are true to the best of his knowledge and belief; and that the
rk wilt be pcriormcd in the manner set forth in the application filed therewith.
om to before me this
~ .~~.G, .......day of..l~.~.~. G/.~.`.. . 19
tart' Public, ..1~:~ , ~ , A,J1.,(.,11~..~.... , . County
HELEN K. DE VDE ' '
HDT~ypIIgLIC,SlxtuofN@w York (Signature of applicant)
No. A107878, Su41o4kCuW~lrj/
Term Expires pAxceh 30,1,--"•-~
I