HomeMy WebLinkAbout31425-ZFORM NO. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Office of the Building Inspector
Town Hall
Southold. N.Y.
CERTIFICATE OF OCCUPANCY
No: Z-31203
THIS CERTIFIES that the building ADDITION
Date: 10/11/05
Location of Property: 1245 RUTH RD MATTITUCK
(HOUSE NO.) (STREET) (HAMLET)
County Tax Map No. 473889 Section 106 Block 7 Lot 14
Subdivision
Filed Map No. Lot No.
conforms substantially to the Application for Building Permit heretofore
filed in this office dated SEPTEMBER 2, 2005 pursuant to which
Building Permit No. 31425-Z dated SEPTEMBER 2, 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 FRONT ENTRYWAY ADDITION TO AN EXISTING SINGLE FAMILY DWELLING AS
APPLIED FOR.
The certificate is issued to CHRIS & ANGELIKI LAZARIDES
(OWNER)
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A
ELECTRICAL CERTIFICATE NO. N/A
PLUMBERS CERTIFICATION DATED
Rev. 1/81
N/A
Autfiorized Signature
0 2,A5 Form No. 6
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
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 less than 2110 of 1 ° b 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:
1. Accurate survey of property showing all property lines, streets, building and unusual natural or topographic
features.
2. A properl} completed application and consent to inspect signed by the applicant. If a Certificate of Occupancy is
denied, the Building hispector shall state the reasons therefor in writing to the applicant.
C. Fees
1. Certificate of Occupancy - New dwelling $25.00, Additions to dwelling $25.051, Alterations to dwelling $25.00,
Swimming pool $25.00, Accessory building $25.00, Additions to accessott building $25.110, 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, Conmmercial $15.00
Date.
New Construction: _� Old or Pre-existing Building: (check one)
Location of Property: /"Z v::) SCC, C q kb Al / ( / � 5 -2-
House
House TNo. Street Hamlet
Owner of Ownets of Property: C S
Suffolk County Tax Map No 1000, Section T/ '] '6 1 Block __ / 06 Lot 7 — ( q—
i
Subdivision Filed Nlap. I of /
Penmt No. 1/4 2 S}4 3/ . Date of Permit. c r Applicant:__
Health Dept. Approval Underwriters Approval:
Planning Board Approval
Request for: Temporal} Certificate
Fee Submitted: $
Q a -c-10 6 3)-
00 �31a03
Final Certificate: _ _I __ (check one)
Applicant SigvA
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. 31425 Z Date SEPTEMBER 2, 2005
Permission is hereby granted to:
CHRIS & LAZARIDES
PO BOX 393
MATTITUCK,NY 11952
for
CONSTRUCTION OF A FRONT ENTRYWAY ADDITION TO EXISTING SINGLE
FAMILY DWELLING AS APPLIED FOR.(THIS REPLACES BP #29009-Z)
at premises located at 1245 RUTH RD MATTITUCK
County Tax Map No. 473889 Section 106 Block 0007 Lot No. 014
pursuant to application dated SEPTEMBER 2, 2005 and approved by the
Building Inspector to expire on MARCH 2, 2007.
Fee $ 150.00
Authorized Signature
ORIGINAL
Rev. 5/8/02
FIELD INSPECTION REPORT
DATE
CON N[I N IS —
W
FOUNDATION (1ST)
.—e
,
-----------------------------------
FOUNDATION (2ND)
C
y
—
ROUGH FRAMING &
PLUMBING
O
y
_
INSULATION PER N. Y.
STATE ENERGY CODE
y
FINAL
ADDITIONAL CON MUM
LIS
z
z
m
W
rb
z
d
F-- -
u-.-
v ir" ROAD
17
:
Q,
I,j m b
.p v
�f
rL a YF' --1 j/EPS
CONC'2 STORY WOOL, jjtI
STEPS o FRAME RES. �I
f C 1 (jC I ' I� CHMFFY o
L
WOO DECK —
CONC. W VAILING
BLOCK
I PATIO
$ 12 BRICK
POOL
i
'a G FCA FM
ILL
ru l
t 22
CROUNO
L I ( POOL
+ aD X27 E
rR
fENtt i01
fakgr can
26.36' $,gyp w
LOT I Moo
FI;+ ^,r— Or SUNSET KNOLLS SLUT 2
F7,1.4/ 5448, FILED 4/9/70
nE •.
U)
O
h
W
L
N/F"
NICOVIC
FA d /6?2
SURVEY OF
Fr_ EO JANUARY 19. 1949
LOT 201
CHRIS AZARM:E
1N 7000—IOP—OT-14
OF
_r'CEL•A LAOA 1;p _
I Toxin n, souTfeaD
_
-,i. e/s D i� Ter •> l)
BLOCK 16
IN
rI
I.rcnt'cs I holed hr.F-cn SWAP
OF CAP TIN KIDD
ES TA TES
MA I RTUCK. TOWN Or
SOUTNOLD
n:, ',o :... '. ilr. c.., :, ,
S'. h ..• ;( cc -w, TY lv.
II,c I:: ., :crk Slaur EducoPon i.n:...
sM c:^..otos c' ,e.. Ic,- - . :.w:. 'c;.
�iuOrrnrees
Y0R
1'S W N O.
n. not
4927:
pddiicnul inc:rmios •.b• :,,. ""
SURVEYED 26 APRIL, 1999
SCALE I`=3O'
AREA- 15,849.375 SF
OR
0.364 ACRES
SuRveyur By
CHRIS AZARM:E
,e,.NO<L'• / f .. r ;
'AA'LEY J.ISAKSEN, JR.
_r'CEL•A LAOA 1;p _
I Toxin n, souTfeaD
_
-,i. e/s D i� Ter •> l)
;z,�, . BOX 294
SUFFOI.A; NY 71,556
5835
rvvr i.. c via uticq of :j!..'I 10ry of
. Ar uoor.d to bs a .• I f'
^_w"•\:
L;LE'lJ D AND URic
II,c I:: ., :crk Slaur EducoPon i.n:...
Y0R
1'S W N O.
..
4927:
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. 29009 Z Date DECEMBER 16, 2002
Permission is hereby granted to:
CHRIS & WF LAZARIDES
18-15 215TH ST APT 17J
BAYSIDE,NY 11360
for
CONSTRUCTION OF A FRONT ENTRYWAY ADDITION AS APPLIED FOR
at premises located at 1245 RUTH RD MATTITUCK
County Tax Map No. 473889 Section 106 Block 0007 Lot No. 014
pursuant to application dated DECEMBER 16, 2002 and approved by the
Building Inspector to expire on JUNE 16, 2004.
Fee $
150.00
zed Signature
ORIGINAL
Rev. 5/8/02.
I
I
i
u -117 ;° ROAD
i N 7; ?F.' F 104.25' nE-
1fGl?.6R'
_
I
v (q
I yr Y.• I"llrl ...^YICK (.1
I
b7 -
EP5 '
CONIC.2 S70HY {tic?ti
J,,
FRAME RES.II ^?
I J
i ,
EY
o
XID DECK
I L[PI
i„��
C. WIVAILING
NICO VIC
1 ie
I
(W eRrGK�
3
i
pon
.�
ICA MR&
FX
I
22
�U
;a!
I6
GROUND
PM
•k �
1
i � RLL9rR "�``sl
40'X2.
a\ D'x2. g ry
q[YA/NMG WN.LS �
tI
Mix 47LiY Naar . '
r7
S R? 40'
IJl
�W ^ PN[P
1 36.3 y' Fl
LOT i
Gr- SUNSET KNOLLS 5L CT z—
{ Fr 5448, FILED 4/9/70
FI p 1672 SURVEY OF
SURVEYED 26 APRIL, 1999
SCALE 1'=30'
Fl, SD JANU.;RY 19, 1949
LOT 201
AREAa 15849.375 5F
Ri 1700-10a-07-14 OF
OR
0.364 ACRES
BLOCK 16
IN
,,
,s ied he.e cn shhfA.P OF CAP TIN KIDD ES TA TES
cr tn kc^
. 1: 1n_ p •.. .h -r.. h- .,!,.y S/7UA 1E
A,(A I TITLICK. FOWN Or SOUTHOLD
! CC•11. T'/ rV.Y
�YfJLTIe
Bs N nGl ir. .. , 'e r'.
hddilP_nul in,. riuoa [ •.e• .,. ._..
SURVf Yc BY
. ChXS AZARIbL.i yC_Fr, L,. ;,r -.-
•'
2; -qAILEY J. ISM -SEI,' JR.
.=NCE_'h LAPAR/•�, CJ
1 TOWN O, SOU?H,,%D I d. (� i� t Y.r/,`y O
�', U. BOX 294
A,F;1'
SJPFOL'. NY ; is56
1L;/=510;-
p nu teorr.•
=p
T
=: ..::. �'• :.. Si
�.m:r2.d a'B�c �:'.. : � L.-.! r,::O,.nri IIASG istd n.
liN6'iET i��/
`'
"'.
v rY<,V :II• , 4� re..upurd b h.
rv•.r .. a f .k' <I 7
r ^ rI N�
$ima Educocon
•
'r'1'S !C NO. 4927.;-
9:P7QI
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN HALL
SOUTHOLD, NY 11971
TEL: (631) 765-1802
FAX: (631) 765-9502 R6b q
www. northfork.net/Southold/ PERMIT NO.
Examined /2 AIX
Approved
Disapproved a c
Expiration
BUILDING PERMIT APPLICATION CHECKLIST
Do you have or need the following, before applying.'
Board of Health
3 sets of Building Plans_
Planning Board approval
Survey
Septic Fc
N.Y.S.D.
Contact:
Mail to:
oP o..239 Cu4-eYrj1-eee, A/.Y.
Phone: /� 3 ! 34 576 7
20
Buil ng Inspector
_ - -------
APPLICATION FOR BUILDING PERMIT
f
Date /l�lL / , 20 �Z
INSTRUCTIONS
".r=is application cation e completely filled in by typewriter or in ink and submitted to the Building Inspector with 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 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.
i�ieirhG�
'(Signafild of applicant or name, if a corporation)
(Mailing address of applicant)
State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder
<�x17x, cr—,
Name of owner of premises Cl -(RIS Gil ZA R1 QC,St
(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. 0* 197-29
Plumbers License No.
Electricians License No.
Other Trade's License No.
L Location of land on which proposed work will be done:
12 y,s lec�' K Ay) _ �A Ti/i UCC . Al, Y.
House Number Street
Hamlet
County Tax Map No. 1000 Section -:J': 10(9 Block � Lot_
Subdivision_ CfE PT/.I /c -eon GS i {ITES Filed Map No. /000 ao6�o�-iyLot
(Name)
3/
2. State existing use and occupancy of premises and intended use and occupancy of proposed construction:
a. Existing use and occupancy
Intended use and occupancy
3. Nature of work (check which applicable): New Building Addition CtiT.e-YA4a�'Alteration
Repair Removal Demolition Other Work
4. Estimated Cost 4 7 C90--> " Fee
(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 0
6. If business, commercial or mixed occupancy, specify nature and extent of each type of use. o
Dimensions of existing structures, if any: Front G/ t Rear Depth 33
Height /8' Number of Stories t
.s4
Dimensions of same structure with alterations or additions: Front i41-7 4 Rear 7
Depth IB Height /6r3/—Number of Stories
8. Dimensions of entire new construction: Front I r7 Rear //, Depth
Height /6 3/� Number of Stories
9. Size of lot: Front 0l7 Z Rear q 63 6 Depth / J 3 76 I
10. Date of Purchase Name of Former Owner G R Z' ? i Dc -J
I L Zone or use district in which premises are situated
12. Does proposed construction violate any zoning law, ordinance or regulation? YES NO 1--'
13. Will lot be re -graded? YES NO Will excess fill be removed from premises? YES NO
14. Names of Owner of premises Ch.
Address
Phone No.
-25'0 q3,fa
Name of Architect rn1Qe-6f i />r-� 4,204.41
Address
(s Cd5z7.r-Poe r-
Phone No
4 7' 7' 9 7S.Z
Name of Contractor H,,rrIzYeZI ,2✓C.ic nt"
Address
Phone No.
73 4 s 7 6 7
15 a. Is this property within 100 feet of a tidal wetland or a freshwater wetland? *YES NO 4/
* 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 (�
* IF YES, D.E.C. PERMITS MAY BE REQUIRED.
16. Provide survey, to scale, with accurate foundation 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 survey.
STATE OF NEW YORK)
SS:
COUNTY OF )
/-r &" �'/ being duly sworn, deposes and says that (s)he is the applicant
(Name of irrdKidual signing contract) above named,
(S)He is the C C>�fYC% d 2
(Contractor, Agent, Corporate Officer, etc.)
of said owner or owners, and is duly authorized to perform or have performed the said work and to make and file this application:
that all statements contained in this application are true 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.
Swom to before me this
day of � 200.1_
Notary Pub tc
JOYCE M. WILKINS
Notary Public. State of New York
No. 4952246, Suffolk Countv
m
TerFrpires j,ne ,?, ;-003
ay�� — ]
at eApplicant
BUILDING PERMIT EXAMINER CHECK LIST
APPLICANT:
SCTM# DISTRICT: 1,000, SECTION: tQ(,::2-, BLOCK:
STREET ADDRESS:
PROJECT DESCRIPTION:
ESTIMATED PROJECT COST
DATE REVIEWED: Z/[(0/02
DATE SUBMITTED:_e/6/02
Lflus,
6
'r
FAST TRACK?
SINGLE & SEPARATE CERTIFICATION -REQUIRED? f -J ® NOTES:
LOTS 40,000SF -100-24. Lot recognition.(CREATED before June 30, 1983), UNDERSIZED LOTS FROM JAN.1997 100-25. Merger.(A nonconforming at anytime after 7/1/8:
ZONING DIST RI T: CONFORMING?
REQ. LOT SIZE: ACT. LOT SIZE: OS,`�REQ. LOT COV. ACT. LOT COV.
REQ. FRONT PROP. FRONT REQ SIDE a ACT. SIDE
REQ. REAR: — PROP. REAR REQ. EIGHT PROP. HEIGHT
WATER FRONT? NO DE,SCRIPTION:
PANEL je4 FLOOD ZONE:,
1
APPROVALS REQUIRED
SUFFOLK CO TY HEALTH DBP—TL—YES � _ NO (BED #): DTE:_/_/_ PERMIT #:RIO -
TOWN SEPTIC RECEIPT: Cc
NEW YORK STATE DEC:9/1/75 YES
SOUTHOLD TOWN TRUSTEES: YES
TOWN ZONING BOARD APPROVAL: YES
TOWN PLAN. BOARD APPROVAL: YESo
TOWN HISTORICAL PRE (SPLIA): YES
NYS ENERGY: YES 0.
I Ll
EGRESS (18 H min.? 4 T (SQ. FT. x 4%) LIGHT (SQ. FT. x 8%) C
BUILDING PERMITS OPEN/E IRED: BP -Z / C/0 Z- ,
HAVE PRE CO' S : Y OR N BP -Z /C/o Z- ,
NOTES:
FEE STRUCTURE: FOUNDATION: SF
FIRST FLOOR: SF
SECOND FLOOR: SF
OTHER: SF INIT OTHER TOTAL
TOTAL: 7<,— SF FEE FEE FEE
1. ( SF)- ( SF)=
SFX$ =$ +$ +$ =$ /�
2.( SF)- ( SF)= SFX $ =$ +$ +$ = $
a
J
H
G
F
E:
D
C
0
r
11