HomeMy WebLinkAbout27051-z FORM NO. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Office of the Building Inspector
Town Hall
Southold, N.Y.
CERTIFICATE OF OCCUPANCY
No: Z-27900 Date: 08/30/01
THIS CERTIFIES that the building ALTERATIONS
Location of Property: 4020 THE LONG WAY EAST MARION
(HOUSE NO.) (STREET) (HAMLET)
County Tax Map No. 473889 Section 30 Block 2 Lot 98
Subdivision Filed Map No. Lot No.
conforms substantially to the Application for Building Permit heretofore
filed in this office dated DECEMBER 7, 2000 pursuant to which
Building Permit No. 27051-Z dated FEBRUARY 9, 2001
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 "AS BUILT" ALTERATION TO AN EXISTING ONE FAMILY DWELLING AS APPLIED FOR
The certificate is issued to NANCY A LESTER
(OWNER)
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A
ELECTRICAL CERTIFICATE NO. H 070702 02/26/01
PLUMBERS CERTIFICATION DATED 08/22/01 CARMINE GALLETTA
,-,I f-/-(�
//th rized ignature
Rev. 1/81
123 Form No. 6 r0�7- Baa 3
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN HALL
765-1802
t
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 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 Buildine - $100.00
3. Copy of Certificate of Occupancy - .25ip
4. Updated Certificate of Occupancy - $50.00
5. Temporary Certificate of Occupancy - Residential $15.00, Commercial $15.00
Date . . . . . . . . IZA/,W . . . . . . . . . . . . . . . . . . . . . . . . .
New Construction. . . . . . . . . . . Old Or Pre-existing Building. . . . V . . . . . . . . . .
Location of Property. . . .ala;q. . . . . . . . . . . . . . ..Mf. .lqA WAy. . . . . . . . . . . . . . tj. . . . . . . . . .
House No. Street( Hamlet
r
Onwer or Owners of Property. . . . . . . , AWns.41Cos . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
County Tax Map No 1000, Section. . . 030..0*, , . . ,Block. . .0.?". . . . . . . .Lot. . 9�',°�� , , , , . , , , , , ,
Subdivision. . .PVAGS. A M2M.5. . . . . . . . . . .Filed Map. . . . . .Lot. . . . G3. . . . . . . . . . . . . . .
z 9JOi 7WsJ°.A/a A. PS441
Permit No. Z, . . . . .Date Of Permit. . .141/2POI.
,Applicant. .�j
�
Health Dept. Approval. . . . . . . . .�,I�'. . . . . . . . . . . . *Underwriters Approval. . . ..��/.��?I. . . . . . . . . . . . .
Planning Board Approval. . . . . . .
44 . . . . . . . . . . . . .
Request for: Temporary Certificate. . . . . . . . . . . Final Certicate. .K . . . . . . . .
Fee Submitt d: $. S
_ _ _
. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
L ` APPLICANT
A/,&i,46k M. AA4W W
FORM NO. 3
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)
PERMIT NO. 27051 Z Date FEBRUARY 9, 2001
Permission is hereby granted to:
THESPINA PONTISAKOS
PO BOX 594
EAST MARION,NY 11939
for
ALTERATIONS OF SPACE OVER A GARAGE TO HEATED HABITABLE SPACE
IN EXISTING SINGLE FAMILY DWELLING AS APPLIED FOR "AS BUILT"
at premises located at 4020 THE LONG WAY EAST MARION
County Tax Map No. 473889 Section 030 Block 0002 Lot No. 098
pursuant to application dated DECEMBER 7, 2000 and approved by the
Building Inspector.
Fee $ 75 . 00
Authoriz d Signature
ORIGINAL
Rev. 2/19/98
o��$pFFO���oG
Town Hall,53095 Main Road y Z Fax(516)765-1823
P. O. Box 1179 V . Telephone(516)765-1802
Southold, New York 11971 �!
OFFICE OF THE BUILDING INSPECTOR
TOWN OF SOUTHOLD
C E R T I F I C A T I O N
DATE
Building Permit No. I-Ios'l Z
Owner: ,oyT o S -mild NSF
(please rint)
4
Plumber: %,F- v •-^ � F-•
(please print)
I certify that the solder used in the water supply system
contains less than 2/10 of 1% lead.
1 Cwsv^", (Plumber ignature)
s S
Sworn to before me this /� ;'07
l60r r Z-00 NICHOL.A M NUDO, X
29 day of C-, , '�- Notary r'ubf: r New York
Iriu
Notary Public, County Commisswn
THE NEW YORK BOARD OF FIRE UNDERWRITERS PAGE 1
8�9�3`97S BUREAU OF ELECTRICITY
F 40 FULTON STREET, NEW YORK,NY 10038
FEBRUARY 26,2001 s >�'�: :��,!�'W H 970702
Date Application No. on file
THIS CERTIFIES THAT
only the electrical equipment as described below and introduced by the applicant named on the above application number is in the premises of
JOHN PONTIS_AKOS, 4020 THE LONG WAY, EAST 14P.RION, NY
in the following location• El Basement El 1st FL 0 2nd Fl. Section Block Lot
was examined on FEBRUARY 16,2001 and found to be in compliance with the National Electrical Code.,
FIXTUREFIXTURES RANGES COOKING DECKS OVENS DISH WASHERS EXHAUST FANS
OUTLETS RECEPTACLES SWITCHES INCANDE3CENJ FLUORESCENT OTHER AMT. K.W. AMT. K.W. AMT. K.W. AMT. K.W. AMT. H.P.
DRYERS FURNACE MOTORS FUTURE APPLIANCE FEEDERS SPECIAL REC'PT. TIME CLOCKS BELL UNIT HEATERS MULTI-OUTLET DIMMERS
SYSTEMS
AMT. K.W. OIL H.P. GAS H.P. AMT. NO. A.W.G. AMT. AMP. AMT. AMPS. TRANS. AMT. H.P. NO.OF FEET AMT. WATTS
SERVICE DISCONNECT NO.OF S E R V I C E
METER NO.OF CC COND. A.W.G. A.W.G. A.W.G.
AMT'.' AMP. TYPE EQUIP. 1 2W 1 0 JW J 0 JW J/4W PER 0 OF CC.COND. NO.OF HIAEG OF HI-LEG NO.OF NEUTRALS OF NEUTRAL
OTHER APPARATUS:
R001 1 ABOVE GARAGE-1
*NO VISUAL DEFECTS: "An electrical
survey has been made of the exposed
electrical equipment in the
.premises indicated." "No obvious
unsatisfactory condition was found.
2
HMN REALTY ATTN.HERBERT L
120 FRONT ST GENERAL MANAGER
P.O. BOX 744
GREENPOR'T, NY, 11944 Per 1
This certificate must not be altered In any manner;return to the office of the Board It Incorrect. Inspectors may be Identified by their credentials.
COPY FOR BUILDINGN I L IN ANY MANNER.
o�os�FFot�-�oG
0
y
Town Hall,53095 Main Road • Fax(631)765-1823
P.O.Box 1179 ,ji Telephone(631)765-1802
Southold,New York 11971-0959
BUILDING DEPARTMENT
TOWN OF SOUTHOLD
August 9, 2001
Nicholas M. Nudo, III
Attorney At Law
PO Box 803
Stony Brook, NY 11790-0803
RE: Thespina Pontisakos, 4020 The Long Way, East Marion, 1000-30-2-98.
TO WHOM THIS MAY CONCERN:
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)
No Underwriters Certificate on file.
The check is (not in file)$25.00
No Health Department Approval on file.
No final inspection has been made.
_XX No Plumber Solder Certificate on file.
(All permits involving plumbing being
issued after April 1, 1984) .
BUILDING PERMIT # 27051-2
Please contact our office on this matter. Thank you for
cooperation.
SOUTHOLD TOWN BUILDING DEPT.
BUILDING PERMIT REVIEW CHECK LIST
DATE REVIEWED: /-;i� /61
APPLICANT NAME: A-'��s.¢�s DATE SUBMITTED: is/>
SCTM# --- DISTRICT: 1,000 SECTION: ,3 o BLOCK: 2 LOT: 9
PROJECT LOCATION
STREET: _po2a T{e Lo.,G (,cJu CITY:�aT�,,,h SUBDIV. NAME:p1_6.,Sce�4
ARCHITECT/ENGINEER: CNoa0 FAST TRACK: YES ce
SINGLE & SEPARATE CERTIFICATION-REQUIRED: YES o N OTES:
ZONING: PERMIT ESUMATE AMOUNT:_$ S00 .00
ZONING DISTRICT: 4 R80 AC CONFORMING: YES OR NO REQUIRED LOT SIZE: SQF
WHERE ACTUAL LOT_ SIZE FROM?TAX CARD _ ACTUAL LOT SIZE: SQI
REQUIRED -- _.._...._.__.._ REQUIRED _
FRONT: ' PROPOSED:- SIDE YD: '/ ' PROPOSED: '/ ' REAR: ' PROPOSED:
OT COVERAGE: ALLOWED:—% EXISTING: sf % NEW: sf % TOTAL: sf
CORNER? YES o NO WAT ER FRONT? YES OR 0 DESCRIPTION:
LOTS 40,000SF --100-24. Lot recognition. (CREATED before June 30, 1983), UNDERSIZED LOTS FROM
JAN.1997 100-25. Merger. (A nonconforming at anytime after July 1, 1983.)
PROJECT DESCRIPTION: ADD.ALT AcC&R N/D: S� g /, -('� , 4, •+.,, /�c �
AGENCY PERMITS REQUIRED FOR REVIEW
NEEDED
TOWN SPETIC PERMIT: YES or
SUFFOLK COUNTY HEALTH DEPT: YES or O BED #): DTE: / / PERMIT #:R10-
NEW YORK STATE DEC: PRE-DEC 9/1n5 YES or
SOUTHOLD TOWN TRUSTEES: YES or
TOWN ZONING BOARD APPROVAL: YES orO
TOWN PLAN. BOARD APPROVAL: YES or
FLOOD COMPLIANCE ZONE: PRE-FIRM 3/18/80 PANEL #:�? _ FLOOD ZONE:,
NYS ENERGY: YES OR NO EGRES VE T: LIGHT: /
NOTES: 111.4 gliie ra sJ ca wcr us,
l. n��c it LO/—rOmer, G.AtAe l
FEE STRUCTURE: FOUNDATION: SF
FIRST FLOOR SF
SECOND FLR Ssf o SF INIT OTHER TOTAL
TOTAL: 3 F6 SF FEE FEE FEE
TOT( 3?0 SF)- ( SF)= SFX $ =$ +$ —+$ _$ 7!S —
BUILDING DEPT.
INSPECTION
[ ] FOUNDATION IST [ ] ROUGH PLBG.
[ ] FOUNDATION 2ND [ ] INSULATION
[ ] FRAMING [ FINAL
[ ] FIREPLACE & CHIMNEY
REMARKS:
DATE /&-/- INSPECTOR
6� 7r5 17-L
BUILDING DEPT.
INSPECTION
[ ] FOUNDATION IST [ ] ROUGH PLBG.
[ ] FOUNDATION 2ND [ 1 CATION
[ ] FRAMING 14;/FINAL] FINAL
[ ] FIREPLACE & CHIMNEY
REMARKS:
622 c-A
//-/, ooe&- - 4�
,DATE off- INSPECTO
COMMENTS
====asaaaass- aa¢xa=pxsa==c=scs=s=- •
H H
FOUNDATION ( 1ST)
H j t
FOUNDATION (2ND) -��
p N
ROUGH FRAME &
PLUMBING �----� �
II p j r
W
INSULATION PER N. Y.
STATE ENERGY
II �r
CODE
II H
II
II � II
it
FINAL
-
xs ass=
ADDITIONAL_COMMENTS:
/q -ss=r ssssas----s=�==aa�s=a=x-_-_- �=s==sasssaa- aaaaassxoasass-a
Ct s' %j5
w�
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y �
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7
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H
' BOARD OF HEALTH
i ' FORM NO. I
-* 3 SETS OF PLANS
TOWN OF SOUTHOLD eSURVEY
BUILDING DEPARTMENT ,CHECK . . . . . . . . . . . . . . ..... . . . . . .
TOWN HALL ' SEPTIC FORM
t-- SOUTHOLD, N.Y. 11971 PEC ... ... . . .. .. .... ......... . .
TEL: 765-1802 TRUSTEES . . . ... .. ............. .
NOTIFY:
CALL
Examined... ?......... MAIL TO: . . . . . . . . . . . . . . .. . . . .
/ ., C
Approved....1=�........, Zoo,.. Permit NO.�7 o?l ....................................
Disapked a/c .................................. ....................................
......................................................
...
..............
.(Building Inspector)
APPLICATION FOR BUILDING PERMIT
Date. . . . . . . . . . . . . . . 2C.
INSTRUCTIONS
a: This application must be oompletely filled in by typewriter or in ink and submitted to the Building Inspector wii
3 sets,of plans, accurate plok'plag to scale. ,?ee 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 application.
c. The work cornered by this application may not be com enced before issuance of Building Permit.
d. Upon approval of this application, the Building Inspector will issue a Building Permit to the applicant. Such
Permit shall be.kept on the 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 MALE 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 demolition, 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 inspections.
.........�..r . :,. .................
(Signature of applicant, or name, if a corporation)
NX.YJ ZIP-
(Mailing address of applicant)
State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder
...,� �'�.t'�. ..!s..�7�R.!✓. ..7Fdt..Ot.// ....7? W.!�Itl..—YX M/CoA.......................................
Namof owner of premises ........ -. ,f�n/�Si�IICo.S.......................................................
(as on the tax roll or latest deed)
If app�icant is a corporation, signature of duly authorized officer.
.........................................................
(Name and title of corporate officer)
Builders License No. .........................
Plumbers License No. .........................
Electricians License No. .....................
Other T'rade's License No. ....................
1. Location of land on which proposed work will be done......-.-.:...::r..:.�:......f...............................
......hvlq.....................7V .JA#.*..W111 ............................. kiT.. /."1!4R tQ.�l�.................
House Number Street / Hamlet
County Tax Map No. 1000 Section ,,...030.00.. Block ....Q2:°0.... Lot ...09, •,P?�?..
Subdivision ...P.£M�.(.. ..l:�lfl"1.�...... Filed Map No. ...�346...... Lot ...�!3........
(Name)
2. State exristing use and occupancy of premises and intended use and occupancy of proposed construction:
a. Existing use and occupancy ....�/.�G.Rr :'1.� .t � ..1�r4:r1...d1 1:1 ..� T..AAQ4.C:Q?-f L
b. Intended use and occupancy ....5!!`� l:►?!7!. ..!`: Jim-
/4s &41
im-.Y1..�+�.lr!u�.�.Yr"►��
/ s 641t� b Ndf SKowA1 0^1 04v'AL Aii sksm FA4
nc,fi ray &V1&
1
3. Nature of work (check which applicable): New Building .......... Addition ....• Alteration
Itepair ............ Removal ............. Demolition ............ Other Work rA7M—N 6... . A
(Description)
4. Estimated Cost ...."a.............. fee .. ..................................
(to be paid on filing this application)
5. If dwelling, number of dwelling units ....t....... Number of dwelling units on each floor ....A........
Ifgarage, number of cars .........t............................
6. If business, commercial or mixed occupancy, specify nature and extent of each type of use......
7. Dimensions of existing structures, if any: Front.......!Y ..... Rear ......(i.9..... Depth .411?.............
Height ......................... Number of Stories .....2.........
Dimensions of same structure with alterations or additions: Front ....•..� Rear
Depth .................... Height .................... Number of Stories ........................."�LT 4f"T -d *t
8. Dimensions of entire new construction: Front ................ Rear ............... Depth .............. A QAMO;J4
Height ......................... Number of Stories ..................... NW M'j t;,a„iS'nl.�G'�a,J
9. Size of lot: Front .......$0.......... Rear .......11........... Depth .3.74
10. Date of Purchase ....:fl?1AMT- Name of roamer Owner ......r!4�1...��iYA�..................
H. Zone or use district in which premises are situated ..............................................................
12. Does proposed construction violate arty zoning law, ordinance or regulation: .....A19 ...............
13. Will lot be regraded ........N.o.......... Will excess fill be removed from eaises• YES
geav 7"t L4W& W
14. Names of Owner of premises I�S�!^!'A.f? ;14. ......
Address ..04477..A.4. #-:4.&........... Phone No.
Name of Architect ..� .�i4S 4 .. � K4N i AtrE.wL
. ? ..... AddressTc one
Nae of Contractor .............................. .. Address ............................... No. .............
15. Is this property within 300 feet of a tidal wetland? * YES .......... NO ....✓..
....
*IF YES, SOUII1tH.D TOWN Titi]SIFLrS BRUT MAY BE REQTIR®.
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 deed, and show street names and indicate
whether interior or corner lot.
SPA.(T Or N3W YORK,
wmix or.
SS
............�! .. WJE„N+�Do . ...................being duly sworn, deposes and says that he is the applicant
(Name of individual signing contract)
above named,
Ileis the .....R:Tn itt✓ .. ( ...Q�..................................................................
(Contr or, agent, corporate officer, etc.)
of said owner or owners, and is (July 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 file&therewith.
Sworn to before me this
.......... ........day of ..Q�GL.M.t�......:29. ...
Notary Public J?-Y�::�.. .................
...........
(Signature of Applicant)
CHR!STINE NUDO ,
NOTARY PUBLIC, State of New York
No.432'91;1
' Qualified in Suffolk County
Commission Expires March 30,i"do Z
Jan 26 21 04: 31p Frederick Wood (516) 286-3384 p.1
Jaid 26 z5• WO
rr ' NY 11772
i 426 Kane Ave.,E•Patch 25�-3394(FAX)
(631)286-3394
P.E.License#042377 January 26,2001
Town of Southold
Building Department
Main Road
Southold,NY 11971
Atte: Mr.Bruno Simone,Building Inspector
Re: Thesp
ina pontisakos,4020 The Long Ways F -30-02-098
ast Marion,NY'SCTM# 1000
Dear Sir:
with regard to the"as is.' drawings dated of
2000 recenes tly since issuance o"he
referenced residence,this letter is in clarification of the Chang
original
Certificate of Occupancy. As originally constructed the spm over the one car attached
garage was only roughed in and unheated- This space was subsequently iceealso extended to this area
ed and finished
with V2,,drywall as living space. Heating and electrical sere
from the main systems at the same time.
view and section of the left side of this
Please refer to sheet#3 of 4 showing a plan a and is now shown as
residence. The area of concern is Is
directly above the built in garage
heated and finished living space.
Should you have any questions regarding this matter or require additional information
please do not hesitate to contact me.
Respectfully submitted,
C7
Frederick W w
t
r W
s�
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S.4/L?FASO/3TiE'/C T /000
sEcT/o/v 30 2 JOHN THESP/NA PON T/SIIA-0 $'
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APPROVED AS NOTED
..r DATE: Z� G� B.P. #Ell
. -- � . a0 � i c u P A
FEE:,
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C"), c Y NOTIFY BUILDING AT
1 - -- s 't1r ; �� G DE RT
r � t � PA MEN
f765-1802 9 AM TO 4 PM F a
t
- �, ..,.. �- ''�'� ' `
USEIS .c ��.- FOLLOWING INSPECTIONS: OR THE
I P� or OUT
C.—
FOR
_ _._ _�, -----�-- FOUNDATION - TWO REQUIRE[
5 t�' �`` � �� POURED}�(y A ` „ CONCRETE
} OF 2. ROUGH FRAMIP:u & PLUMBING
3. INSULATION
CONSTRUCTION MIUS„,
4. FINAL - T MIUST
BE COMPLETE FOR C.Q.
.� —.
” .�� UNDERWRITERS CERTIFiCAjE
ALL CONSTRUCTION SHALL ��FIwT
# _,. - t' THE REQUIREMENTS OF THE N Y
- ` --�- k REQUIRED
STATE CONSTRUCTION & ENERGY
CODES, NOT RESPONSIBLE
.' DESIGN OR CONSTRUC 9 ION EM-10
-...
1
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