HomeMy WebLinkAbout32168-Z
FORM NO. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Office of the Building Inspector
Town Hall
Southold, N.Y.
CERTIFICATE OF OCCUPANCY
No: Z-31802
Date: 09/13/06
THIS CERTIFIES that the building ADDITION
Location of Property: 205 CENTRAL
(HOUSE NO.)
County Tax Map No. 473889 Section 106
DR
(STREET)
Block ~
MATTITUCK
(HAMLET)
Lot 19
Subdivision
Filed Map No.
Lot No.
conforms substantially to the Application for Building Permit heretofore
filed in this office dated
JUNE 29, 2006 pursuant to which
Building Permit No. 32168-Z
dated
JUNE 29, 2006
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 ADDITIONS TO AN EXISTING SINGLE FAMILY DWELLING AS APPLIED FOR.
The certificate is issued to IRENE MOSHOURIS
(OWNER)
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL
N/A
ELECTRICAL CERTIFICATE NO.
N/A
PLUMBERS CERTIFICATION DATED
N/A
~~
Authorized Signature
Rev. 1/81
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 2/10 of I % lead.
S. Commercial building, industrial building, multiple residences and similar buildings and installations, a ceIiificate
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:
I. 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 $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
4. Updated Certificate of Occupancy - $50.00
5. Temporary Certificate of Occupancy - Residential $15.00, Commercial $15.00
Date.
~ I r /0 &,
Location of Property:
~o5'
C..:t~\
)( (check one)
~-\li1vJc]
01
d~5~
HamI et
New Construction:
Old or Pre-existing Building:
D ri\J'e
House No. Street
Owner or Owners of Property: _-::t: (eV\<- Mo <;'"'ou r. S
Suffolk County Tax Map No 1000, Section 41 38' flq / I 0 ~ Block
I
000 3
Lot Of q
Subdivision
-3;)'lfo!J~
Pennit No. lI~iJjfDate of Permit.
Health Dept. Approval:
Planning Board Approval:
Db /2.'1/0'"
Filed Map.
Applicant:
Lot:
..:r~")C. Mo..\ ho..Jr. ~
Underwriters Approval:
Request for:
Temporary Certificate
Final Certificate:
(check one)
Fee Submitted: $ ;;2.5'.00
Applicant Signature
fY-..~v .l\)~~\
Co ~ 3)JiJ.2
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.
32168 Z
Date JUNE
29, 2006
permission is hereby granted to:
IRENE MOSHOURIS
166-15 24TH AVE
WHITESTONE,NY 11357
for :
CONSTRUCT DECK ADDITION ON THE SIDE OF A SINGLE FAMILY DWELLING AS
APPLIED FOR. THIS PERMIT REPLACES BP 26097
205 CENTRAL DR
MATTI TUCK
at premises located at
County Tax Map No. 473889 Section 106
Block 0003
Lot No. 019
pursuant to application dated JUNE
29, 2006 and approved by the
Building Inspector to expire on DECEMBER
Fee $
150.00
ORIGINAL
Rev. 5/8/02
.3 d-l ~ 1) 7-
TOWN OF SOUTHOLD BUILDING DEPT.
765.1802
INSPECTION
[ ] FOUNDATION 1 ST [] ROUGH PLBG.
[ ] FOUNDATION 2ND [] INSULATION "
[ ] FRAMING/STRAPPING [~FINAL (p~
[ ] FIREPLACE & CHIMNEY [ ] FIRE SAFETY INSPECTION
REMARKS:
,F~~
'A~
~ OK,.
DATE 7-~ -00
INSPECTOR
~~
J-k&'t;-t:: ~'\ "3 d-\~~
765.1802
BUILDING DEPT.
INSPECTION
[ ] FOUNDATION 1 ST
[ ] FOUNDATION 2ND
[ ] FRAMING
[ ] FIREPLACE & CHIMNEY
(!)
REMARKS: S- #'M
/'fr.;2 cJ-Id' fa ~ /'f;o~ -cr cJ>.J
~~~70~,
~~olZ;:;,: ~ :<<H
If/<.-L-{..
[ ] ROUGH PLBG.
[ ] INSULATION
[~AL
DATE j; /)/ / ~ INSPECTOR
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;H FRAME ["
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STATE ENERGY
CODE
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MATTrT\JClIt. NY 11952
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.FORM NO. 1
TOWN OF SOUTH OLD
BUILDING DEPARTMENT
TOWN HALL
SOUTHOLD, N.Y. 11971
TEL: 765-1802
BOARD OF HEALTH ...............
3 SETS OF PLANS ...............
SURVEy........................
CHECK .........................
SEPTIC FORM...................
!d.i-7/f,6 3")-L~ 'i5 ~
:::::5~J~~: :::::: Pennit lb.rl~Q.1.7..~.
Disawroved alc ........ .... .......... ........ ...
NOTIFY:
CALL :.?7.r-::.'f. '?S--
MAIL TO: .&jc~6:7........
.......~
(;;,ii~i'!f~~..
LICATION FOR BUILDING PERMIT
~ate.. 4qt.t... ... ..,19.9:7.
INSTRUCTIONS
a. 'This awlication uust be CCJtt>letely filled in by typewriter or in ink and sulInitted to the Building Inspector wi,
3 sets of plans, accurate plot plan to scale. Fee according to schedule.
b. Plot plan slnring location of lot and of buildings on premises, relationship to adjoining premises or p.ililic
streets or areas, and giving a detailed description of layoot of property l1lJSt be drawn on the diagran which is part of
this awlication.
c. The "",rk covered by this awlication may not be camenced before issuance of Building Pennit.
d. Upon awroval of this awlication, the Building Inspector ,rill issue a Building Pennit to the applicant. Such
pennit shall be kept on the preoises available for inspection througboot the "",rk.
e. lb building shall be occupied or used in whole or in part for any purpose whatever mtil a Certificate of
Occupancy shall have been granted by the Building Inspector.
APPLlCATICtI IS IERE8Y MAlE to tbe Building llepartJrent for the issuance of a Building Penni t p.lrsuant to the
Building Zone Ordinance of the Town of Sootbold, Suffolk Coonty, New York, and other applicable Laws, Ordinances or
Regulations, for the construction of buildings, additions or alterations, or for rennval or damlition, as herein
described. The awlicant agrees to CCJtt>ly with all awlicable laws, ordinances, building code, housing code, and
regulations, and to acbrlt autborized inspectors on premises and in building for ~~ inspections.
. .(~:1~~:.if.~.~~~~~~i~).
.~..l.l7...!?~..~X./(!.~~..
(Mailing address of applicant)
I
~~~~~ .~~~~: .~~:. ~~~;~~: .~~~:~:. ~~~~~. ~~~~~~~~: .~~~~~~~~~:. ~~~~ .~~.~~~~~r
Nare of CMler of premises ..??!1.lf..~.. '???~...........................................,......
(as on the tax roll or latest deed)
If awlicant is a corporation, signature of duly authorized officer.
-'
(Nare and title of corporate officer)
\
.....\......................................................
Builders License lb.
PluIDers License No.
.. . ~f:.7. <i.:":. fl.I. ..
\0
Electricians License lb. .....................
Other Trade's License No. ....................
J. Location of land ~~: propo~~.......................................................
..........................~.........................................................................................
Hoose N.nber Street Hanlet
Coonty Tax Map lb. UID Section .JD.~........ Block ..1?.......... Lot ./3.._...
Subdivision ...................................... Filed Map lb. ............... J.Dt ...............
(Nare )
2. State existing use and occupancy of ~ses and intended use and occupancy of proposed construction:
a. Existing use and occupancy ......~.~.............................:.....'.:.::.....i..".....
b. Intended use and occupancy .........~...............................................:;'...'.'.
"'''tllre of work (d>eck ..hid, applicable): New &.Jilding .......... Mditioo .... .. (i-C1~:r~ioo .0:,:.......
llepair ............ Remval ............. ilenx>litioo ............ Other Work .W........~s:..............
(DescriPfioo)
Estillated Cost ....~ ,~'J~9R .~~.......
fee
...............................................
.~to be paid 00 filing this applicatioo)
If dl""lling, ruber of dwelling ,mits ............ tmber of dwelling wits 00 each floor ................
If garage, rUTi>er of cars ............................................................................
If business, canrercial or mixed occupancy, specify nature and extent of each type of use...........................................
Dinensions of existing structures, if any: Front................................ Rear .............................. Depth ...............................
lleight ......................... IbdJer of Stories ......................
Dil'lEnsions of sare structure with alterations or additions: Front ............... Rear ...............
Deptll .................... lIeight .................... tull>er of Stories ...............
Dimensions of entire new construction: Front ................ Rear ............... Depth
lie ight ......................... IbdJer of! Stories .....................
Size of lot: Front .................... Rear .................... Depth
O. !late of Purchase ..................... Nrn-e of Forner Omer ........................................
I. Zone or use district in .bich premises are situated ..............................................................
2. Does proposed coostruction violate any zoning law, ordinance or regulatioo: ........................
3. Will lot be regraded .................... Will excess fill be rE!JOVed fron premises:
YES
NJ
4.
Nrn-es of IMler of premises ........................... Address .....................:........ Phone lb.
Nrn-e of Architect .................................... Address.............................. Phone lb. ..............
Nrn-e of Cootractor W:ft.!Ir:../b.?:-IS7'.e:<<I!:-:... Mdress ..t:?/!~.(4-P.2..IltIt.1l:.......Phone lb;2.?f::.yb2~
5. Is this property within 300 feet of a tidal ""tland? * YES .......... NJ.. J..:::':'...
*IF YES, srnnnn nm 1mSlEE.,) PEIMlT M<\Y BE REQJ1RED:
PLOT DIAGRAM
IDeate clearly and distinctly all buildings, .bether existing or proposed, and indicate all set-back dimensioos
ran property lines. Give street and block ...wer or description according to deed, and shaJ street nares and indicate
hether interior or corner lot.
TA'fE OF 11~U<,
WIllY eX' ~ffi.{./{.... S8
.....ROr~.k..S..r0\\.~t.~..~..........being duly ....,m,
Nrn-e of individual signing cootract)
bove nmed,
deposes and says that he is the applicant
e is tbe -.... .F~~I~~:.~~~;~~~.~ffi~~;: .~~~:)....................... ........... ..............
.f said o.roer or owners, and is duly authorized to perform or have perforned Ule said work and to make and file this
pplicatiOll; that all statetents contained in this application are true to the best of his knowledge and belief; and
hat the work "ill be perfonred in the mam1er set forth in the application filed therewith.
\.10m to before"" this
...... 2.l.$.
HJLGlEW
~ .... of N_York
QuoINo. 01 LA879606
IIIecIIn Suffolk ~ \
Comml.... &pi.... Dec. 8. 'J1
.dA..k&:
~~fcant)
lbtary