HomeMy WebLinkAbout18450-z FORM N0. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Office of the Building Inspector
Town Hall
Sotxthcld, N.Y.
CERTIFICATE OF OCCUPANCY
No Z-20280 Date OCTOBER 16, 1991
THIS CERTIFIES that the building ADDITION TO ACCESSORY
Location of Property 3970 KENNEYS ROAD & 45 NORTH SEA DR. SOUTHOLD N.Y.
House No. Street Hamlet
County Tax Map No. 1000 Section 54 Block 4 Lot 36
Subdivision Filed Map No. Lot No.
conforms substantially to the Application for Building Permit heretofore
filed in this office dated JULY 24, 1989 pursuant to which
Building Permit No. 18450-Z dated SEPTEMBER 1, 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 DECK ADDITION TO EXISTING DETACHED ACCESSORY SWIMMING POOL
The certificate is issued to ORESTES & EVELYN VARVITSIOTES
(owners)
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A
UNDERWRITERS CERTIFICATE N0. N/A
PLUMBERS CERTIFICATION DATED N/A
Building Inspector
Rev. 1/81
' vosan xo. s
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN HALO
SOUTHOLD, N. Y.
BUILDING PERMIT
iTHI$ PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL
COMPLETION OF THE WORK AUTHORIZED)
N~ 1 g ~ ~ ~ Z Date 19..~~
Permission is hereby gra~nt~ed~,,• s
to
................:..............:.............~.....................................ry:.....
at premises located at
...........................................s`~
Caunty Tox Map No. 1000 Section ........,.G.gpl
f'~...... Block ..............y~~..... Lot No........~.~.....
pursuant to opplication doted .......,°~.~,Y 19..~.r.,l.., and approved by the
Building Inspector.
~
Fee 5...,1~7•:i.
wilding Inspector
Rev. 6/30/80
INSPECTORS
Victor Lessard ~~?FF~,~c
Principal Building Inspector Q~
Curtis Horton ~ 'it~ SCOTT L. HARRIS, Supervisor
Senior Building Inspector ~ Southold Town Hall
Thomas Fisher P.O. Box 1179, 53095 Main Road
Building Inspector ~ a'~' Southold, New York 11971
Gary Fish ~ Fax (516) 765-1823
Building Inspectar Telephone (516) 765-1800
Vincent R. Wieczorek
Ordinance Inspector
Robert Fisher
Assistant Fire Inspector OFFICE OF BUII.DING INSPECTOR
Telephone (516) 765-1802 TOWN OF SOUTHOLD
August 14, 1991
Orestes & Evelyn Varvitsiotes
3970 Rennyss Road
Southold, N.Y. 11971
To Whom This May Concern:
We are unable to complete your Certificate of Occupancy
because of the following reasons:
XX An application for Certificate of Occupancy is
not on file. (Enclosed)
No Underwriters Certificate on file.
1;?C The check is (ewbd~ed/not on file.)#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 # 18450-Z
Please contact our office on this matter. Thank you for
cooperation.
SOUTHOLD TOWN BUILDING DEPT.
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II7SULATIOPI PER N. Y.
STATE ENERGY
CODE
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BUILDING DEPT.
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INSPECTION
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( ] F DATION 2ND [ ] i CATION
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BOARD OF HEALTH
FORM N0.1 3 SETS OF PLAN , .
SURVEY
TOWN OFSOUTHOLD CHECK .........r~,.....,,,,,
BUILDING DEPARTMENT SEPTIC FORM
TOWN HALL
SOUTHOLD, N.Y. 11971 NOTIFY -
TEL.: 705~1II02 CALL 7~:~.
~~~p:~, , , , , ,
E~atttincd.a~~'~-~. ....,19p~~ ~~AIiR T0: ~ -~~L~*~
.\pprovcd 194.~Pennit No. ~~f~.~~~ ~ ~nJQ~ U
Disapproved arc ~~/~1~..... ~ . , , , , , , , ,
(v/ p [~~[~Od~
~ D
. ~ ~ JUL 2 ~ ~
iiild' g Inspector)
APPLICATION FOR BUILDING PERMIT BLDG.bEPT,
TOWN OF SOUTHOLD
Date 3'tAG.Y..~q........., 15'~`t.
INSTRUCTIONS
a. Tltis 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. T}te 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 petntit
shall be kept on fire premises available for inspection throughout the work.
e. No building shall be occupied 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 MADE 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 cQ~ctibfi~if`lxu~ldjrtgs, additions or alterations, or for removal or demolition, as herein described.
The applicant agrees to comply with all applicable laws, ordinances, building code, housing code, and regulations, and to
admit authoriz'ER!'>?1Sp'CC'tUrs`on premises-artd inlbu$ding for necessary insp ons.
+ii M1~.' It 3t1 Y'i•'ti k.<
?I}tt (Signature of app tcan , or name, if a corporation)
' (Mailing address of applicant)
State whether applicant is owner, lessee,, agent„architect, engineer, general contractor, electrician, plumber or builder.
~tifiN~6Z..... ~
.4,.
3'33'JS ,l+z~~'= ~
' ~CF'- VI~C;YN••./f/~(L(/t°i'~lc~,(~S
Name of owneY df ptremi9&S <'.:~«~;€~~>tt%'~~~ ~ • • • • .
);'I•Pt.13 ~S .+;':i`i, t/1*~:p„_,,; -Ire., (as on the tax roll or latest deed)
If applicant is a~.c~g~~c~r~,ftaR signatt~,re of drily authorized officer.
(Name and title of corporate officer)
Builder's License No. ~.~(J.~R •
Plumber's License No . .
Electrician's License No . .
Outer Trade's License No . .
I. Location of land on which proposed work will be done. ....TJ~. ~¢ZZ ,f°~" , ~~/.~c.. ~~~s~(..... .
O
1{ouse Number Street. ~ • • • • • " "
~~jj L(. Hamlet
County Tax Alap No. 1000 Section Block , , , , , , , Lot ......,~i
Subdivision Filed malt No. Lot .
....(Name)
State existing use and occupancy of premises and intended use and occupancy of proposed construction:
a. Existing use and occupancy . !tL~ ~)urz,N C,~!~t: • • • • •~'}:Cf'.G S O ~ r, L
..........t .
b. Intended use and occupancy L:^:'~
3. Nature of work (check whicf>i applicable): New 13uilding , , , • • Addition . t/ Alteration ,
'
e air
P t Ri.moval D •molitio'n Other 1Vork .
' ~~o ~ ~ (Description)
4. Estimated Cost . ~.5 a°9. . . . Fee .
5. If dwelling, number of dwclli (to be paid on filing this application)
}tg units Number of dwelling units on each Cloor .
If gara;e, number of cars ' , .
6. If business, commercial or mid ed occupancy, specify nature and extent of each type of use ,
~mens~ons of existing strut[
H~l_!lt ° Nures, if any: Front . Rear , . .
Depth'..........
Dmmenstons of same structure~mber of Stories . ' ' ' '
',with alterations or additions: Front Rear . • •
Depth r,~ • , , , , ,I .height . .Number of Stories . .
'(~f ~irh'ensions of entire,new con~'~tntction: Front , Rear . .Depth • • •
It"
Hcig]tt . Number of Stories .
m ;9.: Sit~~Front Rear . .
Depth
I.b; D chase .
'•••••••••••••••....NameofFotmerOwner
1 1. # Zone or use district in which premises are situated . . • • • • • • ' ' ' ' ' '
12. boe9, proposed construction violate any zoning law, ordinance or regulation: •
l3. • ill lot be re°raded I
° p ' ' ' ' ' ' ' • • • • • • • • • • • • • . , 1Vi11 excess fill be removed from premises: Yes Nc
14. Name of Owner of remises
.Address ...................Phone No... , , .
Name of Architect ,Address
Name of Contractor. "'•••••••••••••••PhoneNo
..................Address .......Phone No........... '
15.Is this property logated with in~00 feet of a tidal wetland?, *YL+S....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 frotr
property hues. Give street and block number or description according to deed, and show street narrtes and indicate whether
interior or corner lot. I
~I
i
AV Q AS Md1E~a sQ
I DATE: B.R #
,gs
FEE: L~?~ tN 9Y:
NOTIFY BUILD 0 DEPARTM
765-1802 B AAA TO A PM FC)R TN!
' - FOLLOWING IP' CTiUNS:
T. FOUNDATIUIV TWO REOUtREO
FOR POURED CONCRETE '
2. RQUGH • FRAMING & PLUMBING
3. INSULATION
Q. FINAL - CONSTRUC710N MUST
BE COMPLETE FOR C.O.
ALL CONSTRUCTION SHAD. MEET
7HE REQUIREMENTS OF THE N.Y.
STATE CONSTRUCTION ~ ENERQV
OQSIGN OR CONSTRUCCTION ERRORB
I
STATE OF NE\V YORK,
COUNTY OF . . IS.S
' ' ' • • • • • • • • • • • • being duly sworn, deposes and says that he is the applicant
(l\~amL of individual signing contract)
above named.
He is tltc
•I•
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 contained in this application are true to the best of his knowledge and belief; and that the
work will be performed in the manner se[ forth in [he application filed therewith.
Sworn to before me this I
~ .......~da/y o/f~'i.. 19
Notary Public, . t`~e;CCe-,.;- . !1 : , Klijz .(J . .
. County
NEIEN K DE VOE -Lj .
(Signature of applicant)
~N~e~~~078
8 3uHaIk6Nbu_ Mypj • • • • . • • • • • • •
Term Ez rez PA'irch 30,1 f
_ _ _ _ _ _ _ _ ISB,17'
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' ~ a o ~ ENCLOSE POOL TO CODE
UPON COMPLETION
- -I k 5~ ~ ~ ~ BEFORE "WATER"
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RAMP- ;v K i - _
k- _-s~'-n"--- M-- ~ ~ EMMEDrNAETrION
E.. S
7,,0,.E 4 FEf.ICE
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o CC~"y~ ~ ~ rt f ~ iE~ ILE
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I T~~ 1,~1TI~ ~ Z~~-o,.-----._._~ ~~~U~'ANCY ~R
N ~ D]'
w~ ~S~°~T~~UT CERT9~lCATE'
w ~ ~ ~ ~~CU~ANCY
~ ~ ~
~ ~~'~J
~ ~ APR ED AS NOTED
oaTE: ~ B.R a / y'~ ~
FEE: BY~
NOTIFY 8U DING DEPART NT AT
765-1802 a AM TO 4 PM FOR THE
f-OLLOWING IN SiCTIONS:
~ 1. FOUNDATION - TWO REQUIRED
I u1 ~w1, 2. ROUGHURFRAMINGR&TPLUMBING
'~5p~~'~' ~ 3 INSULAT~-~
Z~' ~ 4. FINAL - CONSTRUCTION MUST
GAF,, PGKT„_) BE COMPLETE fOR C.O.
~ ALl CONSTRUCTION SHALL MEET
THE REQUIREMENTS OF THE N.Y.
' STATE CONSTRUCTION 9 ENERGY
COPES. NOT RESPONSIBL`'~ FOR
DESIGN OR CONSTRUCTION ERRORS
I
175'
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