HomeMy WebLinkAbout24744-ZFORM NO. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Office of the Building Inspector
Town Hall
Southold, N.Y.
CERTIFICATE OF OCCUPANCY
No: Z-29022
Date: 10/28/02
THIS CERTIFIES that the building ADDITION
Location of Property: 270 RUTH RD
(HOUSE NO.)
County Taxx Map No. 473889 Section 106
Subdivision Filed Map No. __
MATTITUCK
(STREET) (HAMLET)
Block 5 Lot 34
Lot No.
conforms substantially to the Application for Building Permit heretofore
filed in this office dated FEBRUARY 18, 1998 pursuant to which
Building Permit No. 24744-Z dated MARCH 3, 1998
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 SECOND FLOOR ADDITION TO Alq EXISTING ONE FAMILY DWELLING AS APPLIED FOR.
The certificate is issued to JOHN ANTONOPOULOS & WF
(OWNER)
of the aforesaid building.
SUFFOLK COU1TI"f DEPARTMENT OF HE~J~THAPPROVAL
ELEt-rKICAL CERTIFICATE NO.
PLUMBERS CERTIFICATION D~r~a3
Rev. 1/81
N/A
1062019 07/02/02
07/22/02 REV JOHN D/~TONOPOULIS
"'~//z~d S ignat ur e
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. 24744 Z Date MARCH 3, 1998
Permission is hereby granted to:
JOHN & WF ANTONOPOULOS
22-25 29TH ST
ASTORIA~NY 11105
for :
CONSTRUCT A 2ND STORY ADDITION TO AN EXISTING SINGLE FAMILY
DWELLING AS APPLIED FOR.
at premises located at 270
County Tax Map No. 473889 Section 106
pursuant to application dated FEBRUARY
Building Inspector.
RUTH RD MATTITUCK
Block 0005 Lot No. 034
18 1998 and approved by the
Fee $ 75.00
-- Bu~i~~ctOr
ORIGINAL
Rev. 2/19/98
BUILDING DEPARTMENT
TO%~N HALl,
765-1802
APPI,I( 5\TION i;(}R CEI~,TIFI(TATE ()F OC(?UPANCY
This application must be filled in by typewriter or ink and subnfitted to the Building Department with the following:
For new building or new use:
1. Final survey of property with accurate location of alt buildings, property lines, streets, and unusual natural or
topographic features.
2. Final Al)proval fi'om llealth DepI ofv,'atcr SLll,ply arid sewerage-disl)osal (5;-9 form).
3. Approval ofdectrical installation from Board of Fire Undem'rilers.
4. Sworn statement fi-om plumber certifying tlmt thc solder used in system contains less than 2/10 of' 1% lead.
5. Commercial building, industrial building, multiple resideuces and similar buildings and installations, a certific
of Code Compliance from architect or engineer responsible for the building.
6. Submit Planning Board Approval of completed site plan requirements.
For existing buildings (prior to ·April 9, 1957) non-conforming uses, or buildings and "pre-existing" land us,
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 Occupam
is denied, the Building Inspector shall state the reasons therefor in writing to the applicant.
1..~2ertificate of Occupancy - New dwelling $25.00, Additions to dwelling $25.00, Alterations to dwelling $25.0(
Swimming pool' $25.00, Accessory building $25.00, Additions to accessory building $25.00, Businesses $50.0
2. C~dficate of Occupancy' on Pre-existing Building - $100.00
3. Photocopy of Certificate of0ccupancy- $ 0.25
4. Updated Certificate of Occupancy- $50.00
5. Temporary Certificate of Occupancy - Residential $15.00, Commercial $15.00
Date. ~
N/z~_.~ Old or Pre-exi~ng Buildln~ (chec& one)
House No. Stre~t
New Con~n~°m
Location of Propea-ty:
Owner or Owners of Pmperty:
Suffolk County Tax-Map No 1000, Section
Subdivision
Permit No. ~L4 ? (.ff q
Health Dept. Approval:
Plmmh~g Board Approval:
?
,] ~ _fi, - Block .S Lo~
Filed Map. Lot:
_ Date of Pel'mit._~t~ ~ ~/~Applicant:
Underwriters Approval:
Request for: Temporary Certificate . __ Final Certificate:
Fee Submitted: $ ~ ~"-~-'
(check one)
licant Signature
Town Hall, 53095 Main Road
P.O. Box 1179
Southold, New Ydrk 11971-0959
Fax (631) 765-1823
Telephone (631) 765-1[
BUILDING DEPARTMENT
TOWN OF 8OUTHOLD
CERTIFICATION
Building Permit No.
Owner: ~Z~, .~---~ot~-~
(please print)
Plumber: ' ,.~.ff ~
' ' ~/ (pleaseprlnt)
lead.
Sworn to before me this '~ ~
"Qualified in Queens County
Commission Expires July 31,200~..
Notary Public, (~ ~) t~ 1~ ~ County
I certify that the solder used in the water supply system contains less than 2/10 of 1%
(Plumbers' Signature)
BY THIS CERTIFICATE OF COMPLIANCE THE
NEW YORK BOARD Of FIRE UNDERWRITERS
BUREAU Of ELECTRICITY
40 FULTON STREET - NEW YORK, NY 10038
CERTIFIES THAT
Upon the application of upon premises owned by
B.J. ELEC. CO. JOAN AMTOPOULIOS
BOX 16 270 RUTH ROAD
STILLWATER AVENUE MATTITUCK, NY 11952
CUTCHOGUE, NY 11935,
Located at 270 RUTH ROAD MATTITUCK, NY 11952
Application Number: 1062019 Certificate Number: 1062019
Section: Block: Lot: Building Permit: BDC: NS11
Described as a Residential occupancy, wherein the premises electrical system consisting of
electrical devices and wiring, described below, located in/on the premises at:
Second Floor, Attached Garage, Outside,
was inspected in accordance with the National Electrical Code and the detail of the installation, as set forth below, was
found to be in compliance therewith on the 2nd Day of ]u1¥, 2002.
Nam.___.~e QTY Rate Rating Circuit T~qoe
Alarm and Emergency Equipment
Sensor 3 0 Smoke
A. pplianees and Accessories
~ Exhaust Fan I 0
~ Wiring and Devices
Receptacle 9 0 General Purpose
Switch 10 0 General Purpose
Fixture 4 0 Incandescent
Paddle Fan 1 0
Receptacle 1 0 GFCI
Service
1 Phase 3W Service Rating 150 Amperes
Service Disconnect: 1 150 cb
Meters: 1
seal
1 of l
This certificate may not be altered in any way and is validated only by the presence of a raised seal at the location indicated.
For
ENERGY CODE REVIEW
(non-electric)
7814 (Part 5) 6,000 deGree-days
~nvelope Component
R-Value
Exterior Wall
RoOf/Ceiling
Floor
Foundation Wall
Slab edge Insulation
GlazinG
Entrance Doors
R-18
R-19
R-19
R-10
R-10
R-1.7
R-2.5
Ail HVAC Equipment to meet requirements of 7814.11
All HVAC Control Systems to meet requirements of 7814.12
All Duct Systems to meet requirements of 7814.13
All Ventilating Systems to meet requirements of 7814.14
All Piping Insulation to meet requirements of 7814.15
All Service Water Heating Systems and Equipment to meet
requirements of 7814.21
All Electric Systems to meet requirements of 7814.31
To the best of my knowledge,
belief, and professional
judgement, these plans are
in compliance with the code.
~-***BU I~ NG DEPT.
FOUNDATION 1ST [ ] ROUGH PLBG.
[ ] Fou~u~iBATION 2ND [
[ ~]~ FRAMING [
[ ] FIREPLACE & CHIMNEY
REMARKS: .//~
] INSULATION
] FINAL
DATE
[ ] FOUNDATION l ST [ ],~ ROUGH PLBG.
[ ] FO~UN~TION 2ND [ ] INSULATION
[~ FRAMING [ ] FINAL
[ ] FIREPLACE ~CHJMNE~ ~ ~
DATE
INSPECTOR
765-1802
BUILDING DEPT.
INSPECTION
[ ] FOUNDATION 1ST [~ROUGH PLBG.
[ ]/F/OUNDATION 2ND [ ]INSULATION
FRAMING [ ] FINAL
[ ] FIREPLACE & CHIMNEY~
REMARKS: ~ ~ ~
DATE
/
INSPECTOR
765-1802
BUILDING DEPT.
INSPECTION
[ ] FOUNDATION 1ST [ P~ROUGH PLBG.
[ ] FOUNDATION 2ND [~ULATION
[ ] FRAMING [ ] FINAL
[ ] FIREPLACE & CHIMNEY
REMARKS:
DATE
INSPECTOR
765-1802
BUILDING DEPT.
INSPECTION
[ ] FOUNDATION I ST
[ ] FOUNDATION 2ND
[ ] FRAMING
[ ] ROUGH PLBG.
[ ]~I~LATION
[/] FINAL
[ ] FIREPLACE & CHIMNEY
REMARKS: ~
~DATE
INSPECTOR
765-1802
BUILDING DEPT.
INSPECTION
[ ] FOUNDATION 1ST
[ ] ROUGH PLBG.
[ ] FOUNDATION 2ND
[ ] FRAMING
[ ] INSU~TI~N
[~NAL
[ ] FIREPLACE & CHIMNEY
REMARKS:
INSPECTOR
FOU~DATiON ( 1 s t )
FOUNDATION (2nd)
ROUGH FRAME &
.FLUMBING
INSULATION PER N. Y.
STATE ENERGY
CODE
FINAL
FOR~ NO. I
TOI~N OF SOUTNOLD
BUILDING DEPARTHENT
TOI~N HALL
SOUTItOLD, N.Y. 11971
T~L: 765-1802
(Huild~/[nsp~tor )
APPLICATION FOR BUILDING PER~IT
INSTRUCTIONS
BOARD OF IlEAl,TH ...............
3 SETS OF PLANS ...............
SURVEY ........................
CHECK .........................
SEPTIC FORH ...................
'Date..d.'. ? ........... I ....
a. This application mint be cu,vletely filled in by typewriter or in ink and sulanitted to the Building Inspector wit}
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
streets or areas, and giving a detailed description of layrmt of property must be dra*m on the diagr~ ~ahich is part of
this application.
c. The ~k covered by this application may not be ~,,,~ed before issuance of Building Permit.
d. Upon app~u~al of this application, the Building Inspector will issue a Buildlng Permit to the ai~olicant. Such
permit shall be kept on the O,,a.lses available for inspection throughout the work.
e. No building shall be occupied or used in ~aole or in part for any purpose ~hatever ontil a Certificate of
Occupancy shall have been granted by the Building Inspector.
APPI.ICATI(}I IS ~ ~ to the Building Depa~tn~nt for the is.m~ce of a Building Permit porsu~t to the
Building Zone Ordinance of the To~n of Suuthold, Suffolk County, Ne~ York, and other applicable La~, Ordinances or
Regulations, for the construction of buildings, additions or alterations, or for r~a~al or derrolition, as herein
described. The opplic~t agrees to c~,~ly with all. applicable la, m, ordinances, building code, hotming code, and
regulations, and to ad, it authorized inspectors on premises and in building for necessary inspections.
(Sig~mture of applicant, or name, if a corporation)
(l~ailing address of applicant)
State ~hetber al~licant is mr, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder.
......... .... ..... I$. .?.4 .q x .............................................
(~ on tho tm~ roll or latest
If al~licant is a eorpo~ation~ signature of 8uly ~ut}~ri~ offlcer.
(N~r~ a~d title of corporate officer)
Builders
Ph~bers License No ..........................
El~trici~s Lie~ ~ ......................
I. ~ati~ of 1~ ~ ~i~ ~ ~ viii ~ ~ ....................................... ; ......................
................ ..................... ..........................
[~ ~r St~t ~et
~ T~ ~. I~ ~ti~ .L~.~ ........ Bl~ ...~,.. ......... ~t ..~.~ .... ' ......
~i~iai~ ........ [) ........ ~ ............. ril~ ~ ~ ................ I~t ...............
(~)
2. State ~sti~ ~ ~ ~ of ~i~s ~inte~ ~ ~ ~ of p~o~ ~st~tim:
. s[~ ~ ~ ~ ........ ~. ................ .~ .................................................
b. Int~ ~ ~ ~ ......... }' '~ ............. e ................... .:' '~~ .............
3. N;~tme of ~o~k (cbexk ~id~ al~licable): ~ I~dlding .......... ~i~ion .......... Alteration ..........
l~l~d r ............ ~al ............. !~1J~i~ ............ Other ~k ..................................
00 (~ripti~)
O dO~, ~ f~ ..............................................
4. Est i,~t:~l C~st ...] .......... F. .........
(to I~ ~id on filing this al~licati~O
5. If &roiling, Iil~t~r of ~lling units .... ] ....... t~l~r of &rolling ~mits (m ead~ D~r ................
If garage, ~l~r of cars ......................................
6. If lami~ss, ~ercial or mi~ nco~, s~ci~ ~ture and extent of ead~ t~ of u~ ......................
' " 5~U' -0" .~..~.q ........
1. I)i,,~nsiom of ~isting stnmtures, if any: Fr~t..~.~..~ ....... ~ar ............... ~pth
I~iO,t .t~.'. ................... ~,~r of Stories ..{ ...............
Oin~nsi~s of ~m ~tn~t~re with alt~s 0~ ~itions: Fret .... ~.~.~. ~ar .~..~0.t-"
I~plh .... ~.}~57~.'..~'... I~iO,t ..~..~.q ........ ~ml~r of Stories ...~ ........
.
8. Di,~nai~m O~ entire ~ ~mt~tio,: l~a,t 3.{'' O' t
, .. I~ar ............... ~pth . " If
.................... ~,l~r of Stories ..... ~ ...........
9.si~o~,o~. ,~t JI¢T . ~ 1~ ~p., I&~ ..........
' ':"' .............. , ...............
I0. l~le of IMr~lm~ .......... [..~ ..... g~ of Forint ~mr ......................................
,,. ........................................
12. I~a pro~l c~mt~tlm ~iolate any ~ming I~, ordinate or regularly: . .~.O .................
13. ~ill lot Im r~r~i ..~.O ............. ~ill e~:ess fill Im rm~l
· ,~ o~ c~to~ G .............................. 7.. ~u~ 2 .......... -~--/ ............... a~ m .............
15. Is Ibis p~rty within ~ ~t of n riehl tmtlm~l! ~ ~¢q ..........
PLOT DI^GRAH
locate clearly a[~l distinctly all I~Jil(lings, *t~ether existing or proposed, m~d indicate all set-lmck dimensions
prol~erty lines. Gi~ street and block a=]l~er or description according to deed, and sim street nwmes and indicate
x.4~etber interior or corner lot.
5'1~,'11~ 01:Fa,;1,4 ¥(N{K, /', /' //'
....
... >/ .. .~.... .Clming duly annam, delx)ses a,~l .says that he is tim apl)Ii(mat
(~ o[ i~ividml, signi g (:~ t act)
le is (he ....... ~ ..............................................................................
f/llkn,tractor,~ge,,t, corporate officer, ere'.)
,f said (~n~er or ('i'/mx"ff~s'~ a[~l is (hdy authorized to perform or have i)erl'on~twJ Ihe .m~id turk and to make ao<l file Ibis
ppi ication; Ihat all statonents c(a~l:ai~x~l in this alq)l ication are tn~e to the beat of his kno~ledgm
hat the ta,k ~ill be perfon~l in the .~s.~r set forlh in the applicati(m filed therewith.
^ppi leant)