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Home My WebLink About30539-Z FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No: Z-30456 Date: 09/21/04 THIS CERTIFIES that the building ACCESSORY Location of Property: 1115 SIGSBEE RD LAUREL (HOUSE NO_ ) (STREET) (HAMLET) County Tax Map No_ 473889 Section 144 Block 2 Lot 2 .1 Subdivision Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated AUGUST 2, 2004 pursuant to which Building Permit No_ 30539-Z dated AUGUST 3, 2004 was issued, and conforms to all of the requirements of the applicable provisions of the law. The occupanc_, for which this certificate is issued I is ACCESSORY ABOVE GROUND SWIMMING POOL WITH FENCE TO CODE IN THE REQUIRED PEAR YARD AS APPLIED FOR. The certificate is issued to PETER & DAISY HATZINIKOLAOU (OWNER) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF BEALTH APPROVAL N/A ELECTRICAL CERTIFICATE NO_ 201712 08/10/04 it i PLUMBERS CERTIFICATION DATED N/A r ed S'gnature Rev. 1/81 i 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_ 30539 Z Date AUGUST 3 , 2004 Permission is hereby granted to: PETER HATZINIKOLAOU 1115 SIGSBEE ROAD MATTITUCK,NY 11952 for INSTALLATION OF AN ABOVE GROUND SWIMMING POOL IN THE REQUIRED REAR YARD, FENCED TO CODE at premises located at 1115 SIGSBEE RD LAUREL County Tax Map No. 473889 Section 144 Block 0002 Lot No. 002 . 001 pursuant to application dated AUGUST 2 , 2004 and approved by the Building Inspector to expire on FEBRUARY 3 , 2006 . Fee $ 150 . 00 /y Authorized Signature ORIGINAL Rev. 5/8/02 Form No.6 TOWN OF SOUTHOLD BUILDING DEPARTMENT EP 2 0 2M TOWN HALL 765-1802 APPLICATION FOR CERTIFICATE OF OCCUPANCY This application must be filled in by typewriter or ink and submitted to the Building Department with the following: A. 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 loss 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: L Accurate survey of property showing all property lines,streets;building and unusual natural or topographic features. 2. A properly completed application and 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$215-00, Additions to accessory budding$25.00,Businesses $50-00- 2. Certificate of Occupancy on Pre-existing Building- $100.00 3. Copy of Certificate of Occupancy-$.25 4. Updated Certificate of Occupancy- $50.00 5. Temporary Certificate of Occupancy-Residential$15,00, Commercial $15-00 Date. New Construction: Old or Pre-existing Building:—(check one) Location of Property; Lc�� MNTk—i % U CAL House No. street Hamlet Owner or Owners of Property: --�r �k)N= -L.j NZ �o LAgu Suffolk County Tax Map No 1000, Section Block Lot oc Subdivision Filed Map. Lot: Permit No. Date of Permit. Applicant: A)ETM 4-_1Z7_, N_!kLZ-LA0U Health Dept.Approval: Underwriters Approval: IC j77R- Planning Board Approval: Request for: Temporary Certificate Final Certificate_ (cheek one) Fee Submitted: $ Applicant Sigtore Co BY THIS CERTIFICATE OF COMPLIANCE THE 5 NEW YORK BOARD OF FIRE UNDERWRITERS BUREAU OF ELECTRICITY 40 FULTON STREET — NEW YORK, NY 10038 e CERTIFIES THAT 5 Upon the application of upon premises owned by 5 PETER HATZINIKOLAOU PETER HATZINIKOLAOU 5 1115 SIGSBEE ROAD 1115 SIGSBEE ROAD 5 5 MATTITUCK, NY 11952 MATTITUCK, NY 11952 5 Located at 1115 SIGSBEE ROAD MATTITUCK, NY 11952 5 : - -Application Number: 2017712 Certificate Number: 2017712 Section: Block: Lot: Building Permit: BDC: ns11 r� Described as a Residential 0-599 square fL occupancy, wherein the premises electrical system consisting of electrical devices and wiring, described below, located in/on the premises at: 5 Outside,Pool,Spa, A visual inspection of the premises electrical system, limited to electrical devices and wiring to the extent detailed 5 herein, was conducted in accordance with the requirements of the applicable code and/or standard promulgated by the State of New York, Department of State Code Enforcement and Administration, or other authority having jurisdiction, and found to be in compliance therewith on the Day of 10th August, 2004. Name _QTy Rate Rakg Circnit Type Miscellaneous 5 GFCI protected line for storable pool Wiring and Devices Receptacle 1 0 GFCI _ (Swunntutg Pool):This certificate rovers compliance at the date of inspection only. Because of unusual enciroaments it is advisable to hate jae„t - auilc.-.epa,.s y-Ili a::ki .zdyeroa- -zeal S 1 of 1 5 This certificate may not be altered in any way and is validated only by the presence of a raised seal at the location indicated. r�r�rJ@PrJ@farJ9999EE9EJffJ200fflfflffl'QJ�ePr PLPCrJ'aCnd'L3'L3 dd'ar�farJ aePcPrJ ar�rl�rJ�� rJ�r nnnnmJ�c farJ�ePrJ�rJ�eP�PePr1��PU�ePcPr� Applicant/ Date. m Owners Name: oReviewed: Architect[ / Date Cagipeer Submitted SCTM fl: f District. 1000 Section: Block: Lot. _ Project ///�� n Subdivision Location: �� i-�F _. — Name:- Shi&[e R separate Required " certification: (Yes/No) nn Req. Req. 7-Ulringllistrtcr- !W IV [I.orsfze �d7� ° Anual: I [Lot cuvcrago PropGiTraL Req. Req. r Req. - f [L`mnr Yard _Proposed:J [Side Yard Proposed: 02—_J [Rear Yard Proposed Proj ect Description: &C, - AGENCWERW-TS Permit BW MED FOR REVIE MA• NO YES Number Suffolk County Health Dept New York State. D. E.C_ Town Trusteas _ Town Zoning Board approval: Town Plann_ino Hoard approval: l Flood Plane Elevation??? Flood Zone: 2 765.1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION 1 ST [ ] ROUGH PLBG. I [ ] FOUNDATION 2ND [ ] SOLATION [ ] FRAMING [ ] FINAL Pod } [ ] FIREPLACE A CHIMNEY [ ] FIRE SAFETY INSPECTION REMARKS: DATE INSPECTOR ' I I P 765.1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION 1 ST [ ] ROUGH P16G. [ ] FOUNDATION 2ND [ ] 1 IJLATION [ ] FRAMING [ FINAL [ ] FIREPLACE A CHIMNEY [ ] FIRE SAFETY INSPECTION REMARKS: �=� rnsC:�.�ces�C C3 -� DATE INSPECTOR FIELD INSPECTION REPORT DATE C01VlA ENTS ' 1 0 t m FOUNDATION(1ST) A n FOUNDATION(2ND) f�1 n O r H 7y ROUGH FRAMING& PLUMBING - N cp Y p � INSULATION PER N.Y. 3 STATE ENERGY CODE -� 31 h Lr�Ct tA-C Yea 1 FINAL -a– ADDITIONAL COMMENTS — nl Z_O 7C z O X — QJ W S o z x r z M T ^7 TOWN OF SOUTHOLD BUILDING PERMIT APPLICATION CHECKLIST BUILDING DEPART IL T Do you have or need the following,before applying? TOWN HALL Board of Health SOUTHOLD,NY 11971 4 sets of Building Plans TEL: (631) 765-1802 Planning Board approval FAX: (631) 765-9502 -Survey www. northfork.net/Southold/ PERMIT NO. a7;t: Check Septic Form N.Y.S.D.E.C. Trustees Examined �,206VContact: Approved ,20,V Mail to: Disapproved a/c Phone: Expiration 3_,20 eC_ Building Inspector 22004 APPLICATION FOR BUILDING PERMIT Date 200 INSTRUCTIONS a. This application MUST be completely filled in by typewriter or in ink and submitted to the Building Inspector with 4 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 public streets or areas, and waterways. c. The work covered by this application may not be commenced before issuance of Building Permit. d.Upon approval of this application,the Building Inspector will issue a Building Permit to the applicant. Such a 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 what so ever until the Building Inspector issues a Certificate of Occupancy. f. Every building permit shall expire if the work authorized has not commenced within 12 months after the date of issuance or has not been completed within 18 months from such date.If no zoning amendments or other regulations affecting the property have been enacted in the interim,the Building Inspector may authorize,in writing,the extension of the permit for an addition six months.Thereafter, a new permit shall be required. APPLICATION IS HEREBY MADE 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. "IMMEDIATELY' (5' ENCLOSE POOL TO CODE tell (Signa of applicant or name,if a corporation) UPON COMPLETION BEFORE "WATER" �r� � �Gl�/� �{� ,,C,� IVY UNDERWRITERS CERTIFICAlt r' (Mailing address of applicant) State whethRIpTicant is owner, lessee, aral contractor, electrician,plumber or builder M9ET'�HE REOk�IR ENT$OF TWE APPROVED AS NOTED CODES OF NEW YORK STATE. _ DATA B.P.i Name of owner of premises f - O U (As on the tax roll or latest ! BUILDING DEPARTMENT AT If applicant is a corporation, signature o0G06 7'iN&" 765.1802 8 AM TO 4 PM FOR THE FOLLOWING INSPECTIONS: (Name and title of corporate offi U,I. 1. MMOATION - TWO REQUIRED FOR POURED CONCRETE Builders License No. WITH, CERTIFICATE 2. ROUGH - FRAMING a PLUMBING Plumbers License No. OF 00GUEANCY, 3. INSULATION Electricians License No. 4. FINAL • CONSTRUCTION .MUST BE COMPLETE FOR C.O. Other Trade's License No. ALL CONSTRUCTION SHALL MEET THE REQUIREMENTS OF THE CODES OF NEW 1. Location of land on which proposed work will a doe: YOR STATE. NOT RESPONSIBLE FOR ,SIGs CZ � � In g TI rIAOR CONSTRUCTION ERRORS, House Number Street Hamlet 191 / CG► 00 County Tax Map No. 1000 Section �� Co Block Ga . C c Lot po :oao Subdivision Filed Map No. Lot (Name) 2. State existing use and occupancy of premises and intended use and occupancy of proposeAronstruction: a. Existing use and occupancy /tZ-V*7r b. Intended use and occupancy 3. Nature of work(check which applicable): New Building Addition Alteration Repair Removal Demolition Other Work Q.,'0ud e 4. Estimated Cost Fee (.S�Occ (Description) (To be paid on filing this application) 5. If dwelling, number of dwelling units Number of dwelling units on each floor If garage, number of cars 6. If business, commercial or mixed occupancy, specify nature and extent of each type of use. 7. Dimensions of existing structures, if any: Front Rear Depth Height Number of Stories Dimensions of same structure with alterations or additions: Front Rear Depth Height Number of Stories 8. Dimensions of entire new construction: Front Rear Depth Height Number of Stories 9. Size of lot: Front Rear Depth 10. Date of Purchase Name of Former Owner 11. Zone or use district in which premises are situated 12. Does proposed construction violate any zoning law, ordinance or regulation? YES NO ol, 13. Will lot be re-graded? YES NO 04 Will excess fill be removed from premises? YES NOc9 14. Names of Owner of premiseAE-X1J1�i -N1)(g .- Address-LK SiK6E7E Q-o" Phone No. AS-020�� Name of Architect Address Phone No Name of Contractor Address Phone No. 15 a. Is this property within 100 feet of a tidal wetland or a freshwater wetland? *YES NO c� * IF YES, SOUTHOLD TOWN TRUSTEES &D.E.C. PERMITS MAY BE REQUIRED. b. Is this property within 300 feet of a tidal wetland? * YES NQS 3 * IF YES, D.E.C. PERMITS MAY BE REQUIRED. 16. Provide survey, to scale, with accurate foundation plan and.distances to priiperty lines. 17. If elevation at any point on property is at 10 feet or below, must provide topographical data on survey. STATE OF NEW YORK) COUNTY O ,,..... being duly sworn,deposes and says that(s)he is the applicant ( ame,of elua signing c6 taaet) above named, (S)He is the - _ J ► ti 's " 3 3 .x �.. UT ki%.(IAfkoractor,Agent,Co �� of said i� 'bt>ners , nd is d yl thgrized:tb,p�rfbAOo�lii ve perforti�'tl� p £ l work and to make and file this application; that all statements contained ift';t isi.; plication are true to the t of his ltit Nyli A"d belief; and that the work will be performed'.sMh61,&a&1br"adtfdrthi0tt application filed then th. , .�,AA '�. l;8'20X`00' L Ftp000, ;tee� • Y.4i C`�.• 1. N+ ...f,.� Rotary Public Si a e of Applicant PATRICIA CORMN INZYork Public, o 000501785 Qualified in Suffolk Cou* .— Commission Evka Seg 13,!, So SURVEYED FOR �E7E2 OL!/�)/ N� Z/�C//LOLADC/ A / TOWN OF SCU77-JOXL> SUFFOLK COUNTY N Y j LOCATED AT 7 / C� LOTS B¢ e85 / /Z . ., MAP OF /I ,4TTITUCL PRe� ��r��eT/E '/ CO. CLK. NO. a 'O/ FILED/QN• { I ' a SCALE 111 = 30' SUFFOLK CO. TAX MAP DATA:- 6� Q�O DIST. 1000 SEC.Ida-190 I ELK. O,?Q0 LOT 002.Goo na�wa r AX77WL4Y 0u-o. 'I.'.. 'Jr.It / ILI :IFiC USE Uf•:LY, F,h.''' a Fig Z SbiC:ii''.0 PTCI EI. U`ID F(: t• n [r` 1 \ o'Ti ��{-'e':• G .SEL r«• � GUA��4rVTEEO TO (Gef W �r Z6.z Po.z I �✓ F�a,Jr.w»-C: [i F'e.ON2G. CoM�.4J�1y � �� •� Po �� CRGI FEnICF 10 I V .SURVEYED 5C-P7:':/'per.: 19W BY WILLIAM R SIMMONS :1R C/a _ AMEN R �' 1,194-7 FILE NO. 15,090 a Y T3RID.� DRAWN BYp/��