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Home My WebLink About31133-ZFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No: Z-30949 Date: 05/31/05 THIS CERTIFIES that the building ADDITION Location of Property: 15925 MAIN RD EM/ORIENT (HOUSE NO.) (STREET) (~LAMLET) County Tax Map No. 473889 Section 23 Block 1 Lot 11.3 subdivision Filed Map No. -- Lot NO. -- conforms substantially to the Application for Building Permit heretofore filed in this office dated MAY 12, 2005 pursuant to which Building Permit No. 31133-Z dated MAY 13, 2005 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" DECK ADDITION TO EXISTING SINGLE FAMILY DWELLING AS APPLIED FOR. The certificate is issued to CONSTANTINOS M ZERVOS (OWNER) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL EL~-£~ICAL CERTIFICATH NO. PLUMBERS CERTIFICATION DA'r~u Rev. 1/81 N/A N/A N/A Form No. 6 TOVvqN OF SOUTHOLD BUILDING DEPARTMENT TO~¥N HALL 765-1802 ' APPLICATION FOR CERTIFICATE OF OCCUPANCY 'i T~s application must be filled in bx t~ewriter or i~ and sub~tted to the Building Depaa~ent A. For new building or new use: ._ l. Final sun'ey of property with accurate location of all buildings, property lines, streets, and unusdal Katural o~ topo~ap~c features. 2. Final Approval fi'om Health Dept. of wmer supply and sewerage-disposal (S-9 fo~). 3. Approval of electrical installation from Board of Fire Undem, fiters. 4. Sworn statement from plumber ce~ifying that the solder ~ed in system contains less than 2/10 of 1% lead. 5. Conunercial building, industrial building, multiple residences and si~lar buildings and installations, a certificate of Code Compliance [?oln arc~tect or engineer responsible for the building. 6. Subnm Plmming 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 or' 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 Occnpancy is denied, the Building Inspector shall state the reasons therefor in writing to the applicant. C. Fees I. Certificate of Occupancy - New dwelling $25.00, Additions to dwelling $25.00, ,Mterations to dwelling $25.00, Swimming pool $25.00. Accessory buildiug $25.00, Additions to accessory building $25.00, Businesses $50.00. 2. Certificate of Occupancy on Pre-existing Building - $100.00 3. Copy of Cemficate of Occupancy- $.25 4. Updated Certificate of Occupancy- $50.00 5. Te~nporaD~ Certificate of Occupancy - Residential $15.00, Cot~ercial $15.00 ~o~ ~~ Date. 4~qO~ Old or Pre-existing Building: (check one) Street ~ Hanflet New Construction: ~ Locatiou of Property: __ I ~q ~)-~ House No. Owner or Owners of Property: C..~D Ix3.%"l-,XlV, lxl'l- k 10 t%~ 4~ Suffolk County Tax Map No 1000, Section (~53 "~ Block Subdivision Filed Map. Permit No. _'~ !~ o~ ~, Date of Pemfit. 4/~r1(5~ Applieanu Health Dept. Approval: ~J [,,4 I ' Undem,rit ers Approval: Plamng Board Approx al: ~ f~ Request for: ~lemporau' Cenificate Fee Submitted: $ ,~ .~ :0 0 Lot: Final Certificate: k// (check one) Applicant 8~?natnre 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. 31133 Z Date MAY 13, 2005 Permission is hereby granted to: CONSTANTINOS M ZERVOS PO BOX 382 ORIENT,NY 11957 for : CONSTRUCTION OF AN "AS BUILT" DECK ADDITION TO AN EXISTING SINGLE FAMILY DWELLING AS APPLIED FOR at premises located at 15925 MAIN RD EM/ORIENT County Tax Map No. 473889 Section 023 Block 0001 Lot No. 011.003 pursuant to application dated MAY 12, 2005 and approved by the Building Inspector to expire on NOVEMBER 13, 2006. Fee $ 300.00 Aushorized Signature ORIGINAL Rev. 5/8/02 765-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] IN~IJL~ATION [ ] FRAMING [~]~FINAL [ ] FIREPLACE & CHIMNEY [ ] FIRE SAFETY INSPECTION REMARKS: DATE FIELD INSPECTIO~ REPORT DATE COMMENTS FOUNDATION (1ST) FOUNDATION (2ND) PL~IB~G ~S~ATION PER N.Y. - STATE ENERGY CODE ~DITION~ COMMENTS ....... TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, NY 11971 TEL: (631) 765-1802 FAX: (631) 765-9502 w~v. northfork.net/Southold/ Examined Approved Disapproved a.c PERMIT NO. ~ ii 3 ~ ,Building Inspector BUILD1NG PERMIT APPLICATION CHECKLIST Do you have or need the tbllowing, betbre applying? Board of Health ..~ 4 sets of Building Plans Planning Board approval . Check Septic Fom~ N.Y.S.D.E.C. Trastees Contact: ~lK)~,5 ~_~}°x. kt(5 ~ Mail to: ~ ~. ~ ~ ~ APPLICATION FOR BUILDING PERMIT Date INSTRUCTIONS ,20 a. This application MUST be completely filled in b5 D?ewriter or in ink and submitted to the Building Inspector with 4 sets of plans, accurate plot plan to scale. Fee according to schedule. I:~ Plot plan showing location of lot and of buildings on promises, relationship to adjoining premises or public streets or areas, and watem'ays. I~ c. The work covered by this application may not be commenced before issuance of Building Pemdt. 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 tbr inspection throughout the work. e. No building shall be occupied or used in whole or in pan 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 fi.om 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. Thereal2er, a new permit shall be required. .~r'PLICATION IS HEREBY MADE to the Building Department for the issuance ora 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/hr necessary inspections. (Signa~re o f al~plicant o~ na-~ne, ifa corpora"'"tion) {Mailing address~ f apPffcan~)- State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder Nameofownerofpremises COB)%-I-PrK)WtNJO% ,¢ ~B~o[C~. 7_~o--MO (As on the tax roll or latest deed) If applicant is a corporation, signature of duly authorized officer (Name and title of corporate officer) Builders License No. Plumbers License No. Electricians License No. Other Trade's License No. Location of land on which proposed work will be done: House Number Street Hamlet County Tax Map No. 1000 Section Subdivision }4,Do~-o-c44~ ~,<om4- ~-It~:~t~ (Name) -~ Block ~ Filed Map No. P cc Lot II. Lot State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy ] 42o,.~L\~x~, ~r/r~t,~' - b. Intended use and occupancv ~ ~\a ~t~e --~'~,~_q~esvx c~ c~C~ 3. Nature of work (check which applicable): New Building Repair Removal Demolition 4. Estimated Cost ~0 5. If dwelling, number of dwelling ,ur)its If garage, number of cars Fee '~ A~eration Other Work e__g~re,,,_~i,~ e ~-- ckeo-~- (Description) (To be paid on filing this application) Number of dwelling units on each floor ~ If business, commercial or mixed occupancy, specify nature and extent of each type of use. Dimensions of existing structures, if any: Front ~ q ~ Rear ~ c~ t Height I'-/~ Number of Stories ~L Dimensions of same structure with alterations or additions: Front ] ~ Depth t ~ r Height Number of Stories Depth 8. Dimensions of entire new construction: Front Rear Depth Height Number of Stories 9. Size of lot: Front I l q. ~-'"/ Rear t ~- ~5.0 Depth L~/oi2 . ~D_ 10. DateofPurchase Name of Former Owner 1,4. hr)gOWHX/ F2LeO,~ 11. Zone or use district in which premises are situated. I~ I~°o~ O~NTIA--U 12. Does proposed construction violate any zoning law. ordinance or regulation? YES NO V/' 13. Will lot be re-graded? YES NO V' Will excess fill be removed from premises? YES NO V/ 14. NamesofOwnerofpremisesH ESP,, A. ddress'~.O,boXBS:~ 0~1~1 PhoneNet3[) t{7"/~35'8~g- Name of Architect Address Phone No Name of Contractor Address Phone No. l 5 a. Is this property within 100 feet of a tidal wetland or a freshwater wetland? *YES NO v/ * IF YES, SOUTHOLD TOWN TRUSTEES & D.E.C. PERMITS MAY BE REQUIRED. b. Is this property within 300 feet of a tidal wetland? * YES__ NO It/ * IF YES, D.E.C. PERMITS MAY BE REQUIRED. 16. Provide survey, to scale, with accurate tbundation plan and distances to property lines. 17. If elevation at any point on property is at 10 feet or below, must provide topographical data on sun'ey. STATE OF NEW YORK) SS: COUNTY O~-o\ E_,.-) {-~.,0~<:. '~_ t: ,.J 00~ being duly sworn, deposes and says that (s)he is the applicant (Name of individ'~ual signing contract) above named. ~qe is the _ ¢~t (Contractor. Agent, Corporate Officer, etc.) of said owner or owners, and is dui3, authorized to perform or have perforated the said work and to make and file this application: that all statements contained in this application are tree to the best of his knowledge and belief: and that the work will be performed in the manner set forth in the application filed therewith. Sworn to before me this ~ aw.t`` day of. ~f'h~ 2(Y,~ Notary Public Signature o f Applicant BARBARA ANN RUDDER Note~,' P.btln, ~t~te of Ne'*' York No. Quaiili0d in $uttolk Coun~ Commmsion Expire* April 14,~ \ CERTIFIED TO, CONS~'ANTINOS ZERVOS HEDIVlG ZERVOS FIDELITY NATIONAL TITLE INSURANCE AREA = 54,930 sqft. ANY ,4~ TER.4 TION OR ADDITION TO THIS SURVEy IS A VIOI. A TION OF ~ECTION 7~0~ OF THE NEW YORK STATE EDUCATION LAFI~ EXCEPT AS PER $~CTION ?~O~SUBDMSlON 2. ALL CERTFICA TIONS HEREON ~ VALfD F'O~ THIS MAP AND COPIES TI~EREOF ONLY IF' ~ MAP OR COPIES BEAR THE IMPRESSED ~EAI_ OF THE SURVEYOR I~ ~I~IA TUI~ APPEARS HEREON. ~Dt?'I~ALL Y TO COldLY WITH SAID lAW THE TERM '~I TE~ED BY' MUST BE USED BY ~NY AND ALL SURVEYORS UTILIZING A COPY CF' 4NOTPIER SURVEYOR'S MAP. TERMS SUCH AS 'INSPECTED' AND 'BRO~T-TO-D~ TE' ARE NOT IN CO~I_IANCE WITH THE LAW. MAP OF PROPERTY AT EAST MARION TOWN OF SOUTHOLD SUFFOLK COUNTY ,N Y. 1000 - 23 - 01- 1~.3 SCALE- Y' -~ 50' MA Y 11, Ig98 .11~ 24, l~ ( foumYation ) Ocl. 27~1998 (final) SCDHS ReL# R10-94-97 0.4_