The URL can be used to link to this page

Home My WebLink About27049-ZFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No: Z-28663 Date: 08/08/02 THIS c~TIFIES that the building ADDITION Location of Property: 850 AUGUST LA GREENPORT (HOUSE NO.) (STREET) (HAMLET) County Tax Map No. 473889 Section 53 Block 4 Lot 44.28 Subdivision Filed Map No. __ LOt No. __ conforms substantially to the Application for Building Permit heretofore filed in this office dated NOVEMBER 16, 2001 pursuant to which Building Permit No. 27049-Z dated FEBRUARY 8, 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 DECK ADDITION TO AN EXISTING ONE FAMILY DWELLING AS APPLIED FOR. The certificate is issued to KATHLEEN MASAITIS (OWNER) of the aforesaid building. SI/FFOLK CO~ DEPART~ENT OF t{EALTH APPROVAL ELEC~RICAL C~TIFICA~NO. PLD1WBERS CERTIFICATION DA'I'~U Rev. 1/81 N/A N/A N/A Authori zed ~nat~re FORM NO. 3 TOWN OF SOUTHOLD BUILDING DEPARTMENT Town Hall Southold, N.Y. BUIr~ING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) PERMIT NO. 27049 Z Date FEBRUARY 8, 2001 Permission is hereby granted to: for : KATHLEEN MASAITIS 11 CENTER ST WILLISTON PARK,NY 11596 CONSTRUCTION OF NEW DECK ADDITION TO EXISTING ONE FAMILY DWELLING AS APPLIED FOR. at premises located at 850 County Tax Map No. 473889 Section 053 pursuant to application dated NOVEMBER Building Inspector. AUGUST LA GREENPORT Block 0004 Lot No. 044.028 16, 2001 and approved by the Fee $ 75.00 Authorized Signature ORIGINAL Rev. 2/19/98 Form No. 6 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL 765-1802 APPLICATION FOR CERTIFICATE OF OCCUPANCY ~,:--I'_ This application must be filled in by typewriter or ink and submitted to the Building Department 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. Bo For existing buildings (prior to April 9, 1957) non-conforming uses, or buildings and "pre-existing" land uses: I. 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. Co Fees 1. Certificate of Occupancy - New dwelling $25.00, Additions to dwelling $25.00, Alterations to dwelling $25.00, Swinnning pool $25.00, Accessory building $25.00, Additions to accessory building $25.00, Businesses $50.00. 2. Certificate of Occupancy on Pre-existing Building - $100.00 3. Copy of Certificate of Occupancy - $25.00 4. Updated Certificate of Occupancy - $50.00 5. Temporary Certificate of Occupancy - Residential $15.00, Commercial $15.00 New Construction: Old or Pre-existing Building: Loeation of Property: ~V-t> /~/j ~ ~d-/-~ car/ & House No. Street Owner or Owners of Property: ~fi-~/ff tLE~/-~ /4 ~ Suffolk Gounty=T~xqvtap--No~00, Section ~ ~7' Subdivision Pernfit No. 2. -) O t/ ~ ~ Dale of Permit. Date. ~:/~/~ {J (check one) y Health Dept. Approval: Planning Board Approval: Request for: Temporary Cerlificate Fee Subtnitted: $ ~-5~ ~ Hamlet Btoek '~ 4~ot Filed Map. Lot: Applicant:~Sv't47',,q g ~,"~ ,4-. Undem, riters Approval: Final Certificate: (check one) Applicant Signature BUILDING PERMIT REVIEW CHECK LIST APPLICANT NAME: DATE REVIEWED: ! /~)/~! DATE SUBMITTED: /// /~/~ SCTM#--- DISTRICT: 1,000 SECTION: ~3 BLOCK: ~ LOT: PROJECT LOCATION STREET: ARCHITECT / ENGINEER: CITY: SINGLE & SEPARATE CERTIFICATION-REQUIRED: YES oR'NOTES: SUBDW. NAME: FAST TRACK: YES ob 'POX' SQl ZONING: PERMI~ATE AMOUNT:_$ ~.~ /~ .00...~...----.x1' ZONING DISTRICt80, AC, CONFORMIN~ NO REQUIRED LOT SIZE: WHERE ACTUAL LOT SIZE FROMTZ&-~.~ ACTUAL LOT SIZE: 910/~2 SQ REQUIRED ~-~ REQUIRED ~ REQUIRED FRONT: ~' PROPOSED: ~' ' SIDE YD: ~_~ '/~' ' PROPOSED:.~.~ '///0 ' REAR:~'0 ' PROPOSED:),~0 ? LOT COVERAGE: ALLOWED: ~ EXISTING: -~ sf % NEW: ~- sf % TOTAL:.~12o sf1~% CORNER? YES OR~) WAT ER FRONT? YES o~'~ DESCRIPTION: LOTS 40,000SF --100-24. Lot recognition. (CREATED before June 30, 1983), UNDERSIZED LOTS FROM JAN. 1997 100-25. Merger. (A nonconforming at any time after July 1, 1983.) PROJECT DESCRIPTION LT, ACC OR N/D: /,/ AGENCY PERMITS REQUIRED FOR REVIEW NEEDED TOWN SPETIC PERMIT: YES or ~.(~ SUFFOLK COUNTY HEALTH DEPT: YES or~__~ (BED #): NEW YORK STATE DEC: PRE-DEC 9/I/75 YES 0 N_,k,O~' SOUTHOLD TOWN TRUSTEES: YES or TOWN ZONING BOARD APPROVAL: YES TOWN PLAN. BOARD APPROVAL: YES FLOOD COMPLIANCE ZONE: PRE-FIRM 3/18/80 PANEL #: NYS ENERGY: YES OR NO · NOTES: DTE: / / PERMIT #:Ri0- ,a/,a EGRES,q' FLOOD ZONE: ,,~ VENT: . FEE STRUCTURE: TOT( ~'~ ~-SF)- ( FOUNDATION: SF FIRST FLOOR : ~'~O SF SECOND FLR : SF INIT OTHER TOTAL: ~ ~0 SF FEE FEE SF)= SF X $ -$ +$__ +$ TOTAL FEE :$ OWNER STREET <~ VILLAGE D~T~ .... =~sUB~-~:~ST ~ ~_~' ~ / FRONTAGE ON WATER TILLABLE FRONTAGE ON ROAD WOODLAND DEPTH MEADOWLAND BULKHEAD HOUSE/LOT TOTAL COLOR TRIM ,jS~ ~:-~ %~r~Idg' 25~ ~0=' ?SO'~ ~¢? 5~0 .~SJ~(O Foundation ~ Bath Dinette ~xtension _ ~ ~ Basement C"*WL Floors Kit. Extension Ext. Walls ~ ~,~v L ~ Interior Finish 5( ~ L' R. Extension Fire Place ~ Heat ~ D.R- Patio Woodstove B~ Porch ~Z~ :(~ I~ ' ~o~ ~ ~ .~-0 ~ Dormer ~),~, Deck Attic Breezeway Rooms 1st Floor Garage ~ X~ = ~ ~ I~ ~0~ Driveway Rooms 2nd Floor ~. [~.~ O.B. ~77 ~ ~~ 765-1802 BUILDING DEPT. INSPECTION ATION 1ST [ ] ROUGH PLBG. ATION 2ND [ ] INSULATION [ ] FRAMING [ ]FINAL [ ] FIREPLAC.~~IMNEY REMARKS~ INSPE ~ 765-t802 BUILDING DEPT. INSPECTION [ ] FOUNDATION I ST [ ] FOUNDATION 2ND [ ] FRAMING [ ROUGH PLBG. INSULATION FINAL ] FIREPLACE & CHIMNEY REMARKS: DATE g~,////~ ~- INSPECTOR 765-t802 BUILDING DEPT. INSPECTION FRAMING C~FIINAL FiREPLACE~.~MNEY DATE FOUNDATION (2ND) ROUGII FP, A~IE & PLUI~IBING INSULATION PER N. Y. STATK ENER~i' CODE II II -JI- ll Jr II II II II fl II il ii II F01LM NO. ! TOWN OF SOUTHOLU BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N.Y. 11971 TEL: 7~5- 1802 Disa~oved a/c .................................. (Building Inspector) BOARD OF HEALTH ............... ~3 SETS OF PLANS ............... '~, SURVEY ........................ '~ CHECK ......................... SEPTIC FORH ................... DEC ........................... TRUSTEES ...................... NOTI~'~: ~-I' "~'~ '~ ' ' CALL .. ?..~. ?../.~..~.~..O..~ MAIL TO: .................... APPLICATION FOR BUILDING PERMIT INSTRUCTIONS a. This ~g, lieaticn u,~t be cu~pletely filled in by typewriter or in ink and sul~nitted to the Building Inspector w 3 sets of plmas, accurate plot plsn to scale. Fee according to schedule. b. Plot plum sho~ing location of lot and of buildings on p,c~ises, relationship to adjoining premises or public streets or areas, ar~ giving a detailed description of lw2~at of property m,.ut be dr~an on the diagr~n ~&ich is part of this ~pplieation. c. The ~aork covered by this application rmy not be e~ueneed before issuance of Building Permit. d. U~on ~,c~al of this ~,lieation, the Building Inspector will issue a Building Permit to the applicant. Such permit shall be.kept on t~Se premises available for inspectioa throughout the ~rk. e. No building shall be occupied or used in ~hole or in part for any pm-pose whatever until a Certificate of Occup~cy' shall have been granted by the l~ilding Inspector. Av~LICATIC~I IS 'H~Y ~ to the Building Delr~b~nt for the issuance of a Building Penni. t pursuant to the l~ildlng Zone Ord~n~r~e of the To~ of Soatbold, S~ffolk County, New York, ~nd other applicable Laws, Ordir~ees or Regulations, for the construction of buildings, ~dditioas or alterations, or for ~oval or demolition, as herein described. The applieamt ~g~es to c~ly with all applicable laws, ordlnm~ces, building code, housing code, and regulations, ~xl to mdmit mathorized inspectors m p,-..~ses ~nd in building for necessary inspections. .... ...................... (Signature of ~licant, or na~, if a corporation) (Mailing ~ddress of a~licant) State ~hether ~pplica~t is ~r, les~, agent, ~i~t, e~i~r,'~ral ~tractor, el~trici~, pl~r or ~ of ~r of ~i~s ..~g ~ ~ /T/~ (~ ~ ~ t~ roll or latest d~) If ~limt is a ~atim, siam of ~ly ~t~ri~ officer. (l/rare and title of corporate officer) Builders Li~nse No .......................... Plm/~ers License No .......................... Electricians License No ...................... Other Tr~l~'s License No ..................... ]. Locatio~ of l~nd on ~hich proposed work will be dome .............................................................. ¥X T . y Bouse l~ ~her Street tl~mlet S~bdivision ...................................... Filed Mmp No ................ ]~t ............... 2. State existing use and occupancy of premises and intended use and oc~'h~f,~oposed'~fruction: ~. eamre or ~org (~t~ck ~,t~id~ applicable): Ne~ ~ildi~ .......... ~iti~ .......... ~[~ratiod .......... ~ir ............ ~l ............. ~liti~ ............ Od~r ~ ~K...~. .............. ~rip~i~) ~. Esti~m~ ~st ~ ~ ~ f~ (Co ~ ~id ~ fili~ this a~li~i~) i. If ~lli~, ~r of ~lli~ traits ..... ]. ..... ~r of ~lling ~its ~ e~ fl~r ................ If ~r~e, ~r of ~rs ..~ ................................... ~. If ~imss, ~ercial or M~ ~, ~i~ mture ~ ~tent of e~ ~ of ~ ...................... ~. Dimnsi~s of ~isti~ st~m~s, if ~: ~t .... {.~.'~ ...... ~ar .... ~ ..... ~ptl, $& ~ r l~i~t ......................... ~r of Stories ~ Di~i~ of ~ st~e ~ alterati~ or ~iti~s: ~t ............... ~ar ............... ~pth .................... ~i~t .................... ~r of Stories ............... L Di~nsi~ of entire ~ interim: ~t ...'.~.~*.~.~ .... ~ar :~ ~' i ~p~ . ~o / ~ist 4E(<~:...7..'. ........ ~ of Sto~i~, ..................... ,. si~ o~ ~ot: ~t ...l.i.~...e~.~ ..... ~ .L~.~:.~.~.~. ..... ~pth .4.~e.~.~ ....... I. ~ or ~ district in ~i~ p~i~s a~ si~t~ ~ ~ [ ~ ~/~ ~ 2. ~s ~ mt~tim violate ~ ~i~ 1~, oMi~e or ~lati~: . .~.~ ................. 3. ~ill lot ~ ~ ...... ~ .......... ~ill ~ss fill ~ ~ ~ ~M~s: ~ ~ .................... ~ ~~ ' '~ ' ~ ~ 'g O .............. ~ of.adt<t .................................... ~ss .............................. ~ ~ ............. ~ of ~tr~tor ................................... ~ress .............. ;~ ............... ~ ~ ............. 5. Is this p~thin ~ f~t of a till ~tl~? * ~ .......... ~ / PLOT DIAG~ ~ate clearly ~ disti~tly all ~ildi~, ~r ~isti~ or pr~, ~ i~i~te all ~t~ d~si~s = ~r~ li~s. gi~ st~t ~ bl~ ~r ~ ~ripti~ ~co~i~ to ~d, ~ ~ strut ms ~ i~i~te ~r interior or ~r lot. lane of individual signi~ contract) is the ................................................................................................... (Contractor, agent, corporate officer, etc.) said o~ner or o~ers, and is duly authorized to perform or have perform~l tim said ~ork and to make and file this 91ication; that all stat~rents contained in this application are true to the best of his kno~ledg~ and b~liefl and at the ~rk will be performed in tl~ manner set forth in the application filed therewith. om to before me this ... t <..~ ....... d~y of..~..¢ :: ~. f.C.~...~.~.0...~..~.. RAYMOND P. ' MJI,S.MTP3 No. ~ Qualified Iff ~U ~ (Signatur~ of ~ppllcaut) ~ , No AUG-26 TAX I.D. No. 1(X10-53-C~,-4428 LOT 16 LOT 25 LOT 32 SEPTIC TANK LP1 LP2 LP3 LOT17 AUGUST LANE [ 50°] THE LOCATION OF WELLS, WATER SERVICE LINES, SEPTIC TANKS AND CESSPOOLS SHOWN HEREON ARE FIELD OBSERVA- TIONS AND OR DATA OBTAINED FROM OTHERS. LP3 0 0 0LP1 OSEPTIC CORNER A CORNER LOT 31 FILE MAP bio. glO'/ .5'3,~1 . SURVEY OF: LOT 26 -' MAP OF AI.I~ST ACRES SEC 1 ARSHAMOMAQUE, TOWN OF SOUTHOLD SUFFOLK COUNTY, NEW YORK SURVEY DAT~ 1/28~00 SCALE: 1"=50' I CERTIFIED ONLY TO: ~ KATHLEEN MASAITIS _/~~?~X, DESTIN G. GRAF ~^.../~-_J r--';;: .... \ ~a~.ND SURVEYOR COMMONWEALTH LAND TITLE INSURANCE ,~___~ I ~~~; TITLE No. 7~ ~ W~ ROad /~.~~m~0~_~W~c~y Pont, N.Y. 11778 ~ ~ 5_5.~'', c APPROVED AS NOTED O^m ;/.~/", B.P. ffTFEE..~ '75, t,~ BY~ NOTIFY BUILDING DEPARTMENT AT 765-1802 g AM TO 4 PM FOR THE FOLLOWING INSPECTIONS: 1- FOUNDATION - TWO REQUIRED FOR POURED CONCRETE 2. ROUGH - FP~.MIt;G & PLUMBING )~3. INSULATION -4. FINAL - CONSTRUCTION MUST ~ RE COMPLETE FOR ~'.~HLL CONSTRUCTION SHALL MEET E REQUIREMENTS OF THE N.Y. STATE CONSTRUCTION & ENERGY CODES. NOT RESPONSIBLE FOR DESIGN OR CONSTRUCTION ERRORS DO NOT PROCEED WITH FRAMIN6 UNTIL SURVEY OF FOUNDATION LOCATION HAS BEEN APPROVED.