HomeMy WebLinkAbout17721-z
No Z-20573 Date MARCH 9, 1992
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Office of the Building Inspector
Town Hall
Southold, N.Y.
CERTIFICATE OF OCCUPANCY
THIS CERTIFIES that the building ADDITION
Location of Property 65795 NORTH ROAD GREENPORT, NEW YORK
House No. Street Hamlet
FORM NO. 4
County Tax Map No. 1000 Section 40 Block 2 Lot 6.4
Subdivision
Filed Map No
Lot No.
conforms substantially to the Application for Building Permit heretofore
filed in this office dated DECEMBER 21, 1988 pursuant to which
Building Permit No. 17721-Z dated DECEMBER 23, 1988
was issued, and conforms to all of the requirements. of the applicable
provisions o€ the law. The occupancy for which this certificate is
issued is DECK ADDITION TO E}LISTING ONE FAMILY DT~D~~?G AS APPLIED FOR
The certificate is issued to RIZOS A. PALIOURAS
(owner)
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A
CERTIFICATE N0. N/A
PLUMBERS CERTIFICATION DATED N/A
~ylB+f7/~ Y; -~~~
uilding Inspector
Rev. 1/81
!O&M NO. f
TOWN OF SOUTHOLD
BUILDING DEPAIRTMENT
TOWN HALL
SOUTHOLD, N. Y.
BUILDING PEitMIT
(TH I S
NQ x17721
Permission is hereby
~~~,-~...-r. nncQ:s,E..~.~. s~
cr premises located at
Caun Tax a No
tY P
pursuant to
Building Inspector.
Fee $. ~~ ! -/
IT MUST BE KEPT ON THE PREMISES UNTIL FULL
V OF THE WORK AUTHORIZED)
Z Date ......1.,1.:4:S.a.'!.".:i.S~i~G.....~,.~s........., 19.~.~
ted to.
.. 1?~~.~.~- .~.:....N.:Rz4-t-sS~ ..................
........1?~s~.).t,...~..Sit ........................................
K,....c~,v.-c.~... a~..d~.s~.~c.th.. ~:sa....g-rl....~.~a~.....i?74a,...
~o.~. ~..9. ~........,(~:1.~R .........:..........~.~:a ..~....................
....................................................
.......,.T,r.,. .................T-. ................. ....................................rr.......... .....
00 Se'c'tion .C?`~: a......... Block ......5~.,~:...... Lot No .....!~9.! ~.... ..
dated ..t ..JSt CA~I~r:l.~.. 1-:~ .........~, 19.~.~., and approved by the
1 C./I dL
........................ .............................................
wilding Inspector
Rev 6/30/80
. y
Form No. 6
TOWN OP SOUTHOLD
BUILDING DEPARTMENT
TOWN HALL
765-1802
FOR CERTIFICATE OF OCCUPANCY
A. This application must~be filled in by typewriter OR ink and submitted to Che building
inspector with the fo lowing: for new building or new use: -
1. Final survey of p operty with accurate location of all buildings, property lines,
streets, and unusual natural or topographic features.
2. Final Approval frgqm Health Dept, of water supply and sewerage-disposal(S-9 form).
3. Approval of elect~`ical installation from Board of Pire Underwriters.
4. Sworn statement f~om plumber certifying that the solder used in system contains
less than 2/10 of 17 lead.
5. Commercial building, industrial bu~,lding, multiple residences and similar buildings
and installations, a certificate of Code Compliance from architect or engineer
responsible for tie 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 o£~ prop arty showing all property lines, streets, building and
unusual natural o topographic features.
2. A properly completed application and a consent to inspect signed by the applicant.
If a Certificate diIf Occupancy is denied, the Building Inspector shall state the
reasons therefor i!n writing to the applicant.
C. Fees
1. Certificate of Occpancy - 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 Oec pancy on Pre-existing Building - $100.00
3. Copy of Certificate of Occupancy - $5.00 over 5 years - 510.00
4. Updated Certificat~~e of Occupancy - $50.00
S. Temporary Certific to of Occupancy - Residenti~alp $15.0,0 n, Commercial q$1t5~.00
Date ...` : i'~IJV"~ . ~:...~~ .\Lr ............. .
New Construction..-.z O`Ld\ \Or Pre-existi\ng Building..:' ('~~.. -, `c
Location of Property..:. C~~-J~~--.~+~~.,..~~~15 Q:~-~~1~-~~~~"~ • •Fv~+ ~,~~
House No. treet Hamlet
Onwer or Owners of PropertyL....C~~~~...F.~~.-.~~~~~•••••••••••••••••••••
County Tax Map No 1000, S~ction ........:.....Block................Lot..~A.'`11gFtj~iO+~(
Subdivision ............... I ..................Filed Map............Lot...,vs'a.e ~S,~,~~
Permit No.~`~':~.~j.-~. e Of Permit ................Applicant..~.\4~-~.~..~:~:~...~~~~
Health Dept. Approval...... ...................Underwriters Approval.........................
Planning Board Approval .... ...................
Request for: Temporary Certificate........... Final Certicate.L~..
.ao
Fee Submitted: $..~~~~_ ..............
APPLICANT
<n.~• 1nc~2
r
INSPECTORS
(516) 765-1802
VICTOR LESSARD,
CURTIS HORTON,
VINCENT R. WIECi
ROBERT FISHER, A
Building Inspectors
THOMAS FISHER
GARY FISH
o~~gUFFD(kc~
gal q 'F~
y S
C, Ordinance p
t Fire 'lj~~ ~ ~~®!~
OFFICE OF BUILDING INSPECTOR
TOWN OF SOUTHOLD
March 2, 1992
SECOND NOTIEI.CATION
Rigos A. Pal
37-17 20th R
Astoria, New
To Whom This
We are un
because of the
~- An
X~ Thy
No
No
No
BUILDING P:
Please con'
cooperation.
11105
Concern:
~~~ - - __
=.....w_
MAR ~ 61992
BLf3L`, dE PT ~ 7
WN CF S[3U7N0,
to complete your Certificate of Occupancy
owincl reasons:
ication for Certificate of Occupancy is __
on file. (Enclosed)
No~Underwriters Certificate on file.
cheek is not on file: $25.Q0_
Health Department Approval on file.
final inspection has been made.
Plumber Solder Certificate on file.
;A11 permits involving plumbing being
issued after April 1, 1984).
# 17721-Z (DECK)
our office on this matter. Thank you for
SOUTHOLD TOWN BUILDING DEPT.
*THE ABOVE BUIL~IING PERMIT HAS EXPIRED. IT IS UNLAWFIIL TO USE
OR_OCCUPY SAID DECK UNTIL A CERTIFICATE OF OCCUPANCY HA5 _BEEN-
ISBUED: PLEASE~SUBMIT THE ENCLOSED APPLICATION & YOUR CHECK IN'
THE AMOUNT OF $15.00 SO THAT THE CERTIFICATE OF OCCUPANCY MAY
BE ISSUED.
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
?~:~ ~ti~
~ gµta
C~ti~
~.yya°~aa~
To~trl or suu~o~.~
''c~ OPI'ICIi OC FsUILDING INSPECTOR
z P.O. I20X 1 1 7 9
~ TOWN HALL
~~ SOUZ HOLD, N.Y. i 1971
OCTOBER 11, 1989
PETER ~ s. HEARD
BOA 35
PECONI N.Y. 11958
To Idhc. Thin May Concern,
1
TEL. 7G5-i 8(;'_
RE: RIGOS A. PALLIOIIRAS
47~ are unable to complete your Certificate
of Occ~nancy becauso oL the follov~.ng reasona.
!%/ ~'~~ application for Certificate of Occupancy
i not on fi3c. CENCLOSED)
/ / N [Indcr~tr~ters Certificate on file.
11%/ 'r'! e ct~cc}: i:, (i4Yai.;erot on file.) $25.00
/_/ D: o, Health Dept. Approval on file.
(_/ C:q f>_nal ~nsl~cct>_on hay been made
Plea~c contact- our office on this matter.
Thank •~eu for your cooperation.
I}uilcitrfr3 }'crmLt tk 1 7 7 2 1 Z
fluildit{y Dupt.
~tk/_/ Otto Plt:mber Solder Certificate on file.
3 ~- y
( all pnrriiLu involving plum}~ing bring
iasueci after .1pri1 1,184 )
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~, ~~ Ilaa.S
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FOUt]DATI0:1, (1st)
c~
FOUNDATI011 (2nd) to -
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P,OUGH FRAME &
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ra
Il1SULATIOPI PER N. Y. , "~
STATE ENERGY -
CODE
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ADDITIOPIAL COMhfENT~: ti
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FORM NO. 1
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN HALL
SOUTHOLD, N Y. 11971
TEL.. 765-1802
Exam mcd~c.aw.~un.. ~.3.. ,~
Approved .r?3:
19~
19~. Permit No. ~ ..~ ~.3.1. ~
Disapproved a/c .......... .
BOARD OF HEALTH /........
3 SETS OF~PLe1NS ........
SURVEY ................
CRECK ....................
SEPTIC FORM ..............
NOTIFY X77_8-Q,~n
CALL ...................
MAIL TO:
. .......................
.. ..... -~~.p...~.......
(Building Inspector)
APPLICATION FOR BUILDING PERMIT
Date ................... 15
INSTRUCTIONS
a. TIus application must h
sets of plans, accurate plot plan
b. Plot plan showing local
or areas, and giving a detailed ~
patron.
c. The work covered by th
d. Upon approval of this a
shall be kept on the premises av
e. No building shall be oc
shall have been granted by the ]
completely filled in by type~vnter or in ink and submitted to the Building Inspector, wi
~o scale. Fee according to schedule.
n of lot and of buildings on premises, relationship to adjoining premises or public str
escnption of layout of property must be drawn on the diagram which is part of this a;
application may not be commenced before issuance of Building Permit.
dication, the Building Inspector will issued a Building Permit to the applicant. Such per
,able for inspection throughout the work.
pied or used m whole or in part for any purpose whatever until a Certificate of Occupy
ildmg Inspector
APPLICATION IS HEREBY MADE to the Building Department for the issuance of a Building Permit pursuant to
Building Zone Ordinance of the Town of Southold, Suffolk County, New York, and other applicable Laws, Ordinance
Regulations, for the construch n of buildings, additions or alterations, or for removal or demolition, as herein descril
The applicant agrees to comply with all apphcab~e laws, ordinances, building de, housmR code, and regulations, an~
admit authorized inspectors on premises and in building for necessary mspecti ~
.. .may.-.~~1:~-
ignature of applica f, r name, if a corporation)
...~: Q~X..3-~:G. .f~1!..1~.~~~!9.
(Mailing address of applicant)'
State whether applicant is
--.~-c~..~..,
Name of owner of premises
If appiicant is a corporation,
,lessee, agent, architect, engineer, general contractor, electrician, plumber or built
'Z~s....~... ~,~l~~cc~~~s:~ ........................................
(as on the tax roll or latest deed)
of duly authorized officer.
(Name and title of co'z~prorateo11fficer)
Builder's License No. .. ~`~'.,.~ f7~...........
Plumber's License No. ... 1 ................... .
Electrician's License No . ..................... .
Ot}ier Trade's License No . .................... .
1. Location of land on which pr posed work will be done . .... ....... . . . . . . . ..................... .
.....
~1~ ro579s ~.
...............
EEouse Number ~ Strce~ Hamlet
Count Tax Afa i No 1000 Section ~
Y 4 {1'~.......... Blpck .....L~..... Lot .....~ ! ¢ . _ .. .
Subdivision .. 1.~r:44~ .: ~`:~!- - - -t-i ~~"`~....... Filed Map No. ..v~.~i.~~
1 ..._...... Lot....,.......
(Name)
'- State evicting use and occupy cy of premises and intended use and occupancy of proposed constnictron•
a. Existing use and occupancy . ~..5~!~~ ~{~?'~.J'G ...................... . ...:................ .
b. Intended use and occupancx ....................................................... . . . .. . ... .
-~.;~= --
.~,~~
3. Repair of work check which applicable) New Building ....'..... AddiUOn .......... Alterauo~Lt .. .
( Removal .............. Demolition .............. Other IVork . ~ty„-~1,1.
,, ~ (Descnphon)
4. Estimated Cost .. .
5. If dwelling, number of dwell
Tf garage, number of cars . .
6. If business, commercial or m
7. Dimensions of existing strut
Height .. ''C~f......... 1
Dimensions of same structur
Depth .................
8. Dimensions of entire new co
Height ...............1
9. Size of lot: Front ....... .
10. Dale of Purchase ....... .
11. Zone or use distnct m ivhicl
12. Does proposed construction
13. Will lot be regraded ..... .
14. Name of Owner of premises
Name of Architect
Name of Contractor .~~'°
IS.Is this property li
*If yes, Southold T
f ~ ...... .................. Fee ............ ........ ..............
([o be paid on Filing this application)
ng units ............... Number of dwelling units on each floor ...... ...... .
....................................................................
seed occupancy, specify nature and extent of each tyyke of use ........... .
ores, if any Front .. ~~~...... .Rear ... ~Sv........ Depth ..~~,-.3jf
.......
[umber ofStoncs...... z .............................................
with alterations or additions• Front ... ...... .... Rear ............... .
..... Height ..................... Number of Stones ....................
astruction Front ............... Rear ............... Depth ........... .
fumberofStones .......................................................
.............. Rear ..................... Depth ..........
..........
............. .......Name of Former Owner .......................... .
.................. .
premises are situated . ..................... ....... .
iolate any zoning law, ordinance or regulatron. ...... Q ....................
~' ............ 1Vil! excess fill be removed from premises: Yes
R{ 2 Zo, ~ l~uuaa5 .. Address .................. Phone No............. .
1 Address ~} .. ~ ....Phone No. .
Tt~=.R Address .6:~: ~~.~~t!IIC:... Phone No ..~"~~..0~.~y~-
~cated within 300 feet of a tidal wetland? *YES...,NO.il.,'
awn Trustees Permit may be required,
PLOT DIAGRAM
Locate clearly and distinctly all buildings, whether existing or proposed, and. indicate all set-back dunensions frrs~
property fines. Give street and block number or descnption according to deed, and show street names and indicate whetli.
intenor or corner lot.
STATE OF NE~V YORK,
COUNTY OF .... ......... .
.. .......................
(Name of mdn'idual s
above named
fie is the ... .............. .
of said owner or owners, and is
application; that all statements c
work wdl be performed in the ma
Swom to before me this
...... ....°31..... ..
j(~ ~~ ..lda~y
Notary Public, .. `~'~'+L!..~5: .
S.S
• - • .................. being duty sworn, deposes and says that he is the applica:
ung contract)
....................... ..........................................
(Contractor, agent, corporate officer, etc.)
ly authonzed to p5rform or have performed the said work and to make and file tl'.
tamed m this applicatoon are true to the best of his knowledge and belief; and that tl
er set forth m [he application filed therewith. ~1
.per /~.~-...
... County 2'-,~/l G~
... ~%!. ~if1~._ ~..~~ ... ....... l .... .
ignature of appIicar
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