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FORM NO. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Office of the Building Inspector
Town Hall
Southold, N.Y.
CERTIFICATE OF OCCUPANCY
Date: OS/28/08
NO: Z-33052
THIS CERTIFIES that the building "AS BUILT" ADDITIONS
Location of Property: 245
(HOUSE NO.)
County Tax Map No. 473889 Section 100
WAVECREST LA
(STREET)
Block ~
MATTITUCK
(HAMLET)
Lot 13
Subdivision
Filed Map No.
Lot No.
conforms substantially to the Application for Building Permit heretofore
filed in this office dated
DECEMBER 28, 2007 pursuant to which
Building Permit No. 33619-Z
dated
JANUARY 8, 2008
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" FRONT AND REAR DECK ADDITIONS AND SUNROOM ADDITION TO AN
EXISTING ONE FAMILY DWELLING AS APPLIED FOR.
The certificate is issued to PAUL & ASPASIA CONTOVEROS
(OWNER)
of the aforesaid building.
SUFFOLK COUIIITY DEPAR'l'MEIlT OF HEALTH APPROVAL
N/A
ELECTRICAL CERTIFICATE NO.
N/A
N/A
PLUMBERS CERTIFICATION DATED
~"..1::::e.-
Rev. 1/81
.
Form No, 6
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN HALL
765-1802
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APPLICATION FOR CERTIFICATE OF OCCUPANCY
22
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Tills apphcation must be filled in by typewriter or ink and subnlilled to the Building Department with the following:
L__- .
A, For uew building or new use:
I. Final survey of property with accurate locatIOn of all buildings, property hiles, streets, and unusual natural or
topographic features.
2. Fmal Approval from Health Depe of water supply and sewerage-disposal (S-9 fonn).
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.
5. COlIunercial building, industrial building, multiple residences and sinlilar 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:
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 Celiificate of Occupancy 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, AJterations to dwelling $25.00,
Swinuning 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 $1500
Date. s..ZZ ,08___
New Constl1lctlon:
Location of Propcliy: 2- '-I S-
House No
Old or Pre-existing Building: rJ
(check one)
WA\J6~ (.-A
Street
--L'11\--TTl ...... 4<
Hamlet
Owner or Owners of Propeliy' _:2~._ r ~rV -r:=c)l..J,i::?-, I"":) ~
Suffolk Counly Tax Map No 1000, Section /[?O
Block ---1-_____ LOI_' ~__
SubclIVISIOll______ ----____________FileclMap. __________ LOl________
Pennll No 3. 3"'..11..L___ Date ofPcnll1l---.1_.8..,__~_ AppltcanL_ e-:~_ JVI~&N
Health Depl Approval __
Underwriters Approval:
Plalming Board Approval
Request fOI .
Temporary CClilficale __ _____ Final Certificate _ -L- (check one)
Fee Sublllilled. $ _;Z...~ crO_
Ce) ~~3D5'~
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Applicant Signature
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.
33619 Z
Date JANUARY
8, 2008
permission is hereby granted to:
PAUL CONTOVEROS
245 WAVECREST LA
MATTITUCK,NY 11952
for
"AS BUILT" ADDITIONS TO AN EXISTING SINGLE FAMILY DWELLING AS
APPLIED FOR
at premises located at
245 WAVECREST LA
MATTITUCK
County Tax Map No. 473889 Section 100
Block 0001
Lot No. 013
pursuant to application dated DECEMBER 28, 2007 and approved by the
Building Inspector to expire on JULY 8, 2009.
Fee $
400.00
Ift.A.O~ &
I Authorized Signature
ORIGINAL
Rev. 5/8/02
33t f1 2-
TOWN OF SOUTHOLD BUILDING DEPT.
765.1802
INSPECTION
[ ] FOUNDATION 1 ST [ ] ROUGH PLBG.
[ ] FOUNDATION 2ND [ ] INSULATION
[ ] FRAMING I STRAPPING N FINAL
[ ] FIREPLACE & CHIMNEY [] FIRE SAFETY INSPECTION
[ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRATION
REMARKS. r~ ~ ~
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FIELD INSPECTION REPORT DATE I COMMENTS v:,
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FOUNDATION (1ST) . ~~
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TOWN Of SOUTHOLD
BUlLI)ING DEPARTMENT
TOWN HALL
SOUTHOLD, NY 11971
TEL: (631) 765-1802
FAX: (631) 765-9502
SouthoIdTown.NorthFork.net
PERMIT NO.
33~19C;'
BUILDING PERMIT APPLICATION CHECKLIST
Do you have or need the following, before applying?
Board of Health
4 sets of Building Plans
Planning Board approval
Survey
Check
Septic Form
N.Y.S.D.E.C.
Trustees
Storm-Water Assessment Form_
Examined
i I & , 20 Sl.L
(~,200g
Approved
Disapproved ale
Contact:
Mail to:
Expiration
T1/g ,20-4
Phone:
fC-fv0-
I Building Inspector
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'. APPLICATION FOR BUILDING PERMIT
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Date
,20_
INSTRUCTIONS
a. This ~pplication 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 ofthe 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.
t:::e,c-- NiCc-de_v
(Signature of applicant or name, if a corporation)
'YC.(<',...:-x ljj M~TTrTt..",,< ,0YII'i(\"Z.
(Mailing a dress of applicant)
State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder
AGi?A5-"\
Name of owner of premises c?v'-C ~ C...., >-l Tl'Vr-I2-O'"
(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.
I. Location of land on which proposed work will be done:
l-t-f;;' t..J PrvtrC(J.z~-r /'1~ IL\ '-Ie...
House Number Street
\\"'~
Hamlet
County Tax Map No. 1000 Section J DO
Subdivision
Block I
Filed Map No.
Lot J '"7
Lot
(Name)
.
2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: .
a. Existing use and occupancy e<\~",'~ \ ~ Av"..U.~ f ~. C-... '. '"e.-.r c!.4J<::. /~V<\ra''''': t.A -h.....~ly
b. Intended use and occupancy,q.......",j \ "'-''':J ~\\.~ 1 ~.\-~~.. ><:'t"~r- j --=/......^""""- -.-b.-..'I-
3. Nature of work (check which applicable): New Building
Repair Removal Demolition
Addition
QtherWorlU 1>.->>
Alteration
Cb-,:\\- ~ /.'''''''''11<>".....
(Description)
4. Estimated Cost
Fee
5. If dwelling, number of dwelling units
If garage, number of cars
(To be paid on filing this application)
Number of dwelling units on each floor
6. Ifbusiness, commercial or mixed occupancy, specify nature and extent of each type of use.
7. Dimensions of existing structures, if any: Front bi" 0" Rear hi' 0"
Height \ 5''' \" Number of Stories_' ~.....~
Dimensions of same structure with alterations or additions: Front (..,j' 0"
Depth :S'''/' ?-" Height IS") ..' Number of Stories
Depth 5Lf' 7~"
Rear 01' 0"
I :s.ro.,,;
Depth
8. Dimensions of entire new construction: Front
Height Number of Stories
Rear
I
9. Size oflot: Front qq. b
,
Rear <::fCJ.sB
Depth "'Z.-<to.bB"
10. Date of Purchase
Name of Former Owner
11. Zone or use district in which premises are situated \2..-'-10 ~,'l:>....."'J'I-L-
12. Does proposed construction violate any zoning law, ordinance or regulation? YES_NO-/--
13. Will lot be re-graded? YES_ NO -/.... Will excess fill be removed from premises? YES_ NO '-f-
Il MA'1""~
14. Names of Owner of premiseRAv~ l:oNT1>"'e1Z0 Address 2-";;" 1.I~ Phone No.
Name of Architect ~N"" ~,')TKLC> Address ('"0, C}(~ cr3. 1-1..... ir~e No (..'I.'" V'l8-t'~'"
Name of Contractor Address Phone No.
15 a. Is this property within 100 feet of a tidal wetland or a freshwater wetland? *YES _ NO L
* 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,
18. Are there any covenants and restrictions with respect to this property? * YES_NO ~
* IF YES, PROVIDE A COPY.
STATE OF NEW YORK)
SS:
COUNTY OF.s....~)
Efl..,c- A), Ifft--08,.,J being duly sworn, deposes and says that (s)he is the applicant
(Name of individual signing contract) above named,
(S)He is the A G, 8...:. -r
(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.
Sworn \ll, before me this.._ I. _ .
a li day of ~~ 20 o-:t .
~i!i'~'TANDY ~ ~a~~
Notary Public, Stale 01 New York
No, OHA60B6001
Qualified In Su~ County
Commission Expires 01/13/20 1.1-