HomeMy WebLinkAbout23561-z FORM NO. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Office of the Building Inspector
Town Hall
Southold, N.Y.
CERTIFICATE OF OCCUPANCY
No Z-24680 Date OCTOBER 8, 1996
THIS CERTIFIES that the building ALTERNATION
Location of Property 1700 CAPTAIN KIDD DRIVE. MATTITUCK, N.Y.
House No. Street Hamlet
County Tax Map No. 1000 Section 106 Block 2 Lot 41
Subdivision Filed Map No. Lot No.
conforms substantially to the Application for Building Permit heretofore
filed in this office dated JUNE 14, 1996 pursuant to which
Building Permit No. 23561-Z dated JULY 3, 1996
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 ALTER & RENOVATE EXISTING ONE FAMILY DWELLING AS APPLIED FOR.
The certificate is issued to NICOS STAVRINOS
(owner)
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A
UNDERWRITERS CERTIFICATE NO. PENDING - SEPTEMBER 30, 1996
PLUMBERS CERTIFICATION DATED OCTOBER 2, 1996-GREENPORT PLUMBING & BRAT.
/,IE2
ilding Inspector
Rev. 1/81
Max NQ
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)
N° 23561 Z Date ................./. ............................., 19F..>
Permission is hereby granted to:
J.041&71t44....MA....m��r)./...... . ....��r J�,,4fl�war
r��ir✓...<� ..............
�l�sf .....NJ.. ...........,1.".1".9r .
to ..4� �'sm..... .Au..../ Clr fir..... . <.`..,-L•%f„.,7"r.. ............ .................
^ ..........
°7�/
, ,.... ..... ... ll . .. .......��'�........1�. i�?...... ;... ........
at premis located at ........�•. NZ2........J. f/ 1.1� �!11.......,l�lQ�1....... tU.�9lst�L..................
............................................................... cj�................................................................
......................................................................... .....................................................................l../..............
County Tax Map No. 1000 Section ....�Q.1(/.../ ........ Block ....5L......... Lot No. .......1' !..........
pursuant to application dated ...............�/� ......................, 19/&., and approved by the
Building Inspector.
Fee i••..31d•g
....... ... r.'... 1....................................
ding Inspector
Rev. 6/30/80
_. . �1. 1 -..C-- 3.? 3 — 13c2 S
3C_-3 NG -
OCT -7• _ wN --_
. Pr _-. 'ICV FQft „'c3^_= _.,��_ C- �C:,.;P=_-=
Al ,..,_o aoolicatlon must be _-__2d in .J7 evpewr___- 'O in& ana Sc Dmitt_- the
_nSDeceJr :v4 C 'e =o 1 owing: :or new Jui_ding or naw use:
Sur-vev C_' Dcouert"' w--Z:.. n..___-__ _CCat ion JL ___ JL'ilCin'_s , _ roper'? __n25 .
srreets, and unusual natural or CJDograurfz reatures•
3 . r1nal ADuroval from HeaiC1 Oenc. of water suDDi'7 anc sewErage-Q1sucsa3
3. ADprova'_ of ___,._r`-cal _.stair=Cion from 3oara o-, U:a 2-^dT_tars .
Sworn stat=_ment _ram JiUMbe_ Ler '7_ng _72C ::he 30_aer USed iLl 3?309:1 Concains
less ciao "!0 o'_ Leaa.
S . 3ammerc'_ai :uila=2, industriaiSui'_diag, au_c_pla rasicencas anc simi_ar :uii-ii72s
and-insta.Laclons, ' ger:._ -cat=_ of Coag Compliance =.em a_oai:.act o ang_near
responsible for thecbui'_ding.
b. Submit ?tanning 3oard dnoroval of camptet=_d s_ta DLan recuiremencs.
3. or existing Suilaings (Prior to April 9, _03i) :OIl-Canra=l_7g uses, or Jui_dings and
rlJr2-exiStlClg° idRQ uses:
L . Accurate sur-7ey Cr 2ropert snowing all Proper_. _-nes , st__-.t' bll it C.ng and
unusual na Cural or topograpnic •=_'atures.
v
2. DTCDeT! COt1D ie"ea 3DDliCatiCnand a _C P.52nt Ca _:spec= by the app-_calit.
a Carti�iCaCe JL Occup aIl C;: is neIIieC tn2 3ni.ding LP.SpeCtJT s, stale the
reasons cherefor _a. _o the aDDI___nt.
O . ?ees
! . Cart f+ cora of Occupancy - New .:ceiling 52_5.00, 'dc' ' a s `o aaea 00
-Prat+ n to dwe Ling 525.00, Swi=mming -jooi 325.00, iccass or-7 bui_c_ng 5_5 .00 ,
dd4t4ons to accessory building 325.00. Businesses -50.'70.
2. CaTtificaca of Occupancy an e 3ui7a4R2 - 3i00. 10
3 . Cony of Carti=icata of 0O'�ccupanc•7 - .25c
UDdataa ''.'.ertiflCata at CC1DanC'7 - 350.00
5. -emnorar-7 Carti---Cate of OccupanC'7 - lesidencia 313.00 , Commercial SL3.00
Cate . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
New Construction. . . . . . . . . . . Old Or Pre-existing 3uilding. . .`4`.�. . . . . . . . . . .
Location of Property, X30 . . . . . . . . . .(,'PgTfA :^, . . .Ktd� . . 7C. . . . . . . .T,(�• 4�r:
. . . . . . . . . . . . . . . . . . . . .
House Ao/.� ;� street Haml=_c
Onwer or Owners of Propert.7, . r:`:Y1,`/, .g-,!n":`,"`. . . . . . .S ;^.0.5
Caunt-7 rax Hap No 1000 , Sect-ion. , . SG�. . . . . .3iock. . . .� . . . . . . .Lot. . . . . . . . . . . . . . . . . .
Suba4_7is_on. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .T- Hao . . . . . . . . . . . .Loc, . . . `3 o. . . . . . . . .`. . . . .
DeT'1iC No. . ?.�I. . .L. . _ .17aC2 0f ?e2-Rit. . . �`. . . . . . . ._-OD iCsnL. . :Y.D 44t SIAd.. . . .
?ea-=h 0e?t. 3ppr-val. . . . . . . . . • . . . . . . . . . . --Jnca_w.-=_rs =pp-.. ,__ . . . . ' . . . . . . . . . . . . . . . .
11 =47g 3car1 Aooroval:. . . 0.5 . . . . . . . . . . . . . . . �//�
S'.eaL_o-- _jr. --^:.Dar_ �aT`._=__a tc. . . .. . . . . . -_nc_ -er=1c_C,:. . . . x. . . . .
'3 . . . .� .v. . . . . . . . . . . . . . . . . . '
. . . . . . . . . . . .
-
co� ay,�so
i - -
THE NEW YORK BOARD OF FIRE UNDERWRITERS 11ACE 1
I
I�—1 BUREAU OF ELECTRICITY
F- 85 JOHN STREET, NEW YORK, NY 10038
Date OCID)HER iA7,19 6 Application No.ort file 1.220?596196 N 39�A272
THIS CERTIFIES THAT
only the electrical equipment as described below and introduced by the applicant named on the above application number in the premises of
J N iC()S FSTi+WRDx ^)S, 17+V CAPTAIN KIDD DRIVE, MATTITUCK, N.Y.
in thefollowinR location. 2 Basement 9 Ise Fl. ❑ 2nd FI. OUT 8ertion Block Lot
CWTOBER 02;199
wasexaminedun .T° and vend to be in compliance with the National Electrical Code.
NXTURE EC[PTACLE3 SWITCHES RXTURES RANGES COOKINO DECKS OVENS DISH WASHERS EXHAUST FANS
OUTLETS INCANDESCENT-RUC111 CENT1 OTHER AMT. K.W. AMT. K.W. AMT. K.W. /JAI K.W. AMr. I N.P.
1,! �3 �I 2 i i. 1. -
DRYERS FURNACE MOTORS FUTURE A"UANCE FEEDERS SFECIALREC'PT TIMECLOCKS ULL UNIT HEATERS MULTI-OUTLET DIMMERS
SYStEMS
AMr. K.W. 01 N.P. GAS H.P. AMT. NO. A.W.G- AML AMP. AMT. AMPS. TRANS. AMT H.P. NO.OF FEET AMT. WATTS
SERVICE DISCONNECT OF S E R V I C E
METER NO.Of CC COND A.W G. A.W.G A.W G.
AMT. NAP. TYPE (aU1P, T A PW 1.11
]W ]6 3W 7 X JW PfR X OF CG COND. NO.Oi HIIEG OF H1 LEG �_OF NEUTRALS NfUTRAI
21 n
OTHER APPARATUS:
PAE:DIAE FANS-5
MOTORS:5-F H.P.
4
SMOKE DETECTOR. 5
VIUMM
' R
JIM SAGE ELEC. INC. LI+'".#3 35-E s d c� 1... L
350 MINE PLACE
GREENPORT, NY, 11944 GENERAL MANAGER
1.1
S Per
This certificate must not be altered in any manner; return to the office of the Board if incorrect. Inspectors may be identified by their credentials.
COPY FOR BUILDING DEPARTMENT. THIS COPY OF CERTIFICATE MUST NOT BE ALTERED IN ANY MANNER.
1
ANIEZ
Town Hall, 53095 Main Road _' .� V. Fax (516) 765-1823
P. 0. Box 1179 Telephone ;516)765-1802
Southold, New York 11971 a 4PPI M *,
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 . 'C 3 5 �z
Owner: s�AYkINd
(please print)
Plumber: C7��h/�aBT �LGL/t1�/!✓i7 �{� �T//�C7
(please print)
I certify that the solder used in the water supply system
contains less than 2/10 of 1% lead.
(Plumbers Signa " re)
Sworn to before me this G�
_ day of 19 `
No ry Public , county
CLAIRE L.GLEW
Notary Public,State of New York
No.4879505
Qualified in Suffolk County
Commission Expires December 8,19
FLEI.f) INSPECTION REPORT DATE COMMENTS
------
-------------—----- ~
FOUNDATION ( IST) 'rc_11��-/- ✓_-_� _ _-O'7C._. �i,,, . ._ iC ��./_- _-qy,
Irc___—____
FOUNDATION (2ND)___ _
- --- ------------
I'
II /
ROUGH FRAME 6
ii
PLUMBING
II II
II II f.
INSULATION PER N. Y. II
STATE ENERGY
CODE
II p
fl--------it---- --
-
y
u�
n
FINAL
ADDITIONAL. COMMENTS:
M
ra
H
C
x
a
r
l+1
ro
;L 1 :.1
l
0�6 I.,- i, c1!;' L--*r"? r,
SURVEY FOR
IVICUS P. 8 ADRIANA STAVRINOS CAPI'AIN XIJ>D f
AT MATT fTUCK FILED 1. 19- .9 9 el x ),z
0
TOWN OF sour"OLO'
UUARANT fr y A.
N. Y.SUFFOLK COUNTY, USILIFE TI, jr INSU�fANtC Co PA VY OF IVEW yo
HARRY a VSt IKI
SCALCa Jn= 3Or 'VICOS P 8 D )A
DEC. NA 57AVN)NO
28, 1976
L 7
t I 1F-Vf I Wit
HYS. I IC NO, 207ZO
M Y.
4 Pl�h
BLDG DPPT
TOWN OF sr.i jTt,r,,
FF1:011
t
s I
I
L_or 157
100'0 m ^
fV.
a P w
1
21
LOT 130 rn
*� N
• m
6 a' L O �Y K !O
b
129
t°i o
LOT
�s � j,�ri9e ro• O
� N
<. �?
j 3
75.0,
O t
if 26, W. V
C) RI
K� 00
GAprAiN
OnoWt+orixed aPlnrall0n nr oddldon to this svrv°y is o viofal;On of
sbciion 7207 of !ba N,r. York 5'a'o Cc vco;:an (aw.
Ccpros 0! IF4 cu:.cy n.ep net L.o�lr+ rt:- L-•d +os Cyei s Fred
�j seo7 or Cm6ee::d trcl 1h0! rrt +,; �..✓ Fa a ve4dyepy�
o, C ..._ �_r.. .
765-1802
BUILDING DEPT.
INSPECTION
[ NDATION IST [ ] ROUGH PLBG.
[ ] FOUNDATION 2ND [ ] INSULATION
[ ] FRAMING [ ] FINAL
[ ] FIREPLACE & CHIMNEY
REMARKS:
DATE INSPECTOR
765-1802
BUILDING DEPT.
INSPECTION
[ ] FOUNDATION IST [ ] ROUGH PLBG.
[ ] FOUNDATION 2ND [ INSULATION
[ ] FRAMING [ ] FINAL
[ ] FIREPLACE A CHHIMNEEEY
REMARKS:,
DATE INSPECTOR
G
765-1802
BUILDING DEPT.
INSPECTION
[ ] FOUNDATION IST [ ] ROUGH PLBG.
[ ] FOUNDATION 2ND [ ] IN LATION
[ ] FRAMING ( FINAL
[ ] FIREPLACE & CHIMNEY
REMARKS: 4!Z
DATE ___f[_ INSPECTOR
BOARD OF UEALTU
FORM NO. 1 3 SETS OF PIANS . . . . . . . . . . . . . . .
TOWN OF SOUTHOLD SURVEY
BUILDING DEPARTMENT — CHECK . . . . . . . . . . . . . . . . . . . . . . . . .
TOWN HALL SEPTIC FORM . . . . . . . . . . . . . . . . . . .
SOUTHOLD, N.Y. 11971
TEL. 765-1802 NOTIFY:
2 / CALL . , . . .. 13 . . . .
Examined........?P7 / ...., MAII. TO: . . . . . . . . . . . . . . . . . .
Approved.........�,[-3..., 19.'rfe Permit Nv. .d� ( �... ................................
Disapproveda/c ..//............ .................... ................................
......................................................
114
(Building I s for
APPLICATION FOR BUILDING PERMIT
i
Date. . . . . . .�t. . . . . , 19 9:-
INSTRUCTIONS
a. This application mist be completely filled in by typewriter or in ink and submitted to the Building Inspector
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, relatiornsbip to adjoining premises or public
streets or areas, and giving a detailed description of layout of property mist to drawn on the diagran which is part o
this application.
c. The work covered by this application may not be am,.enced before issuance of Building Permit.
d. Upon approval of this application, the Building Inspector will issue a Building Permit to the applicant. Sue
permit shall be kept on the premises available for inspection throughout tine wrk.
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 iERMY MADE to the Building Department for the issuance of a Building Permit pursuant to the
Building Zone Ordinance of the Tam of Southold, Suffolk County, New York, and other applicable Laws, ordinancesor
Regulations, for the construction of buildings, additions or alterations, or for removal or demolition, as herein
described. The applicant agrees to comply with allapplicable laws, ordinances, building code, housing code, and
regulations, and to admit authorized inspectors on premises and in building for necessary inspections.
.... .... ...i�'1e4SE^P.............
(Sb tore of applicant, or name, if a corporation)
YA 4.h n....�?1.4...0 .%:snJ.f:.. l w).5.J
(Mailing address of applicant)
State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or buil
............. ............zt-"1.�. e-,(7......................................................................
Nave of maser of premises .P.i`'.a .P...-1 ..C?r.. .c 1.'R%sl.et.......�.`�:'!A;\.J..�Z.+.'n ci5....................
(as on the tax roll or latest deed)'
If applicant is a corporation, signature of duly authorized officer.
....................................................
(Nave and title of corporate officer) ZOL"r.Builders License No.Plurbers License No. ......................... p'Electricians License No. .....................
Other T'rade's License No. ....................
I. location of land on which proposed work will be done....1!i4.P- J:4,.r!
......................................
house Nuduer Street lladet
County Tax Map No. 1000 Section ................ Block ................ Int ................
Subdivision ......- Filed Map Na. ............... Int ...............
(Name)
2. State existing use and occupancy of premises and intended use and occupancy of proposed construction:
a. Existing use and occupancy ... n�i... �!Wc15 S C'v . 'P ' M
b. intended use and occupancy ......................5 i.. M ..........................................
I I.-dute of wuuk (dueLk wldch algdicable)t Pkv Ikrildiol. ..... ... .. Adlit icxr .......... Alteration ...:T. ...
1(elxuir ...K...... Raunval ............. Lenin iLion ............ Other bunk ...... ................. ..........
(Ilescription)
4. Estiseted Cast ... r!5�Q.t.Cl CIO......... fee ............................ .. ..
..............
(to be Iraid of filing this application)
5. If dwelling, nunlier of dwellh% units .. ..1....... tlnber of dwelling tants to each floor .....Q......
..
If garage, tanber of ears ........Q............................
6. If lxnsitess, cnmercial or mixed occupancy, specify nature and extent of each type of use....... /0..... ... .....
7. Diaensiaus of existing structures, if ally: Fnxtt..OAV.13.. Rear �. 3. .... . Ik:pch
Ikigl it: .....�.�11J0................. Ntrd>er of Stories ...... .... ....... ....
Dimensions of saw structure with alterations or addiLions: Front .. t9:l 'Cn.. Ilear
Depthy3�... Ikiglit ... .tT.q./... ...... .. Nadx:r of Slorier. .. ..r....... ... p }� l �,
..-C). �s f Y I .:1.�.-K l.l. .7
B. Diur.nsiausof entire rav cotstnx:f icxr Frtxrt - hear ..�. .�XS.w� I�tln �.
Iki[jtl ...+,7r-1�.,�........ Nniuer of stories ... .t`.... .... ... ... ..
9. Size of ]ot: Front .APP,.O.......... Rear .-- I.L.' ........ . Depth. .2..C.>.".Q.
10. Date of l'ttrtilase .... e............ of Fonter (wirer .. .�....._... ...... ........................_.-. .-.................
11. Zone or use district in uluidn pranises are situated ...►.`�'M?q-: d LY. ?,,.... ........................ ....
12. Does prnlnsed axusl rota ion violate any zoning law, ordinance or regal aCiai: Q..
13. Will lot Ire regraded ....0 Cl............ Will excess fill Le ranAgd,Lr °'r"lg—"' YES
t.4. Nates of ()aver of prenises ...... Atkiress t� JI 1. Pllone No. ......
Wne of Ardnite t A.^.•dw:h. 7,1'.SCi..[�d':?'. -!fl�... Address .V :F V.L:°1n�.4�..r. `2Rlytf"l'?�I1one Pb.�(OS"
Ware of Contractor ....... Auktress
15. is this prolert.y within 300 feel of a tidal weLlan '! *. ... d/0 ...x...
*IC YES, "Ill"" 1C1m .1y DSIIZ., tucl.l' IMY ISI: IU? Intl.).
PLOT DIAGRAM
Incate clearly and distinctly all (xtildings, ultellter existing or proposed, and indicate all set-hack dimension
ficin prolerty lines. Give street: and black naduer or description according to deed, and show street runes and inlic
whether interior or conn IoL.
SI'A'lii M- N31 Y(XdK, SS
-��J�-g�- Y.!.`:.7.:. .L,` .lx:ing duly corn, cdclnses and says Mutt he is the applicai
(Wine of inPiv4dal signing ecxiUact)
alxuve tuned,
Ik is the ....
.. .............. ... ......... ..................
................. ... ...............................
(Qntract r, agent, corinrate officer, el.c.)
of ;:aid outxr or of , and is duly authorized to perforin or have lerfontl'td (lie said work and (o tmke and file tlui:
alq)lication; Ura all s(alareui.s contained in this application are true to the less of his IuKVIedbe and Ixa11eN, an
that. the work will lie lerforned in the aaone.r set: I-otlh in (be application filed therewith.
sworn to tfhieff fooQr��e{aae this �� /
.......�.�L..4.....day of. .�l�t..rN/ ...... 19
Notary D§ublicG9L. .. .-. .... K
ELIZABETH ANN NEVILLE (Sinature of Applicant)
Notary Public,State of NZW York
No.52-8125850.Suffolk Co
Term ExpirIOct beer 31,19
— -- _ - ---
PROVIDE OPENINGS FOR
EMERGENCY ESCAPE AS
REQUIRED BY PART 714 OF
N.Y. STATE BUILDING CODE.
L PLUMBING
V - - - - .. - ---- -- -- - - - - ---- - - - _-- -
FBI - ALINLL PLUMBING WASTE
— -� &WATER LINES NEED
TESTING BE E S NEE INGD
N
F- - - -
�Pper tubing
sed
l _
J
for water dl
—
stnbuung
gYstem;piping shell be
Of tYPes K or 1
omi
J UNDERWRITERS CERTIFICATE
REQUIRED
PLUMBER CERTIFICATION
ON LEAD CONTENT BEFORE
CERTIFICATE OF OCCUPANCY
SOLDER USED /N WATER
SUPPLY SYSTEM CANNOT
" EXCEED 2/10 of 1% LEAD.
OCCUPANCY OR
USE IS UNLAWFUL
WITHOUT CERTIFICATE
OF OCCUPANCY
APPROVED AS NOTED
DATE: 7 a"P.a
3 r a
FEE: 3/ , IN
- NOTIFY BUILDING DEPART ENT AT
765-1802 9 AM TO 4 PM FOR THE
FOLLOWING INSPECTIONS:
1. FOUNDATION - TWO REQUIRED
FOR POURED CONCRETE
2. ROUGH - FRAMING & PLUMBING
S. INSULATION
4. FINAL - CONSTRUCTION MUST
BE COMPLETE FOR C.O.
- ALL CONSTRUCTION SHALL MEET
- THE REQUIREMENTS OF THE N.Y.
STATE CONSTRUCTION & ENERGY
CODES. NOT RESPONSIBLE
DESIGN OR CONSTRUCTION ERRORS"
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