HomeMy WebLinkAbout34132-ZFORM NO. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
office of the Building Inspector
Town Hall
Southold, N.Y.
CERTIFICATE OF OCCUPANCY
No: Z-33645
Date: 04/14/09
THIS u~KTIFIES that the building ACCESSORY
Location of Property: 1975 sTANLEY RD MATTITUCK
(HOUSE NO.) (STREET) (HAMLET)
County Tax Map NO. 473889 Section 106 Block 8 Lot 4
Subdivision Filed Map No. __ Lot No. __
conforms substantially to the Application for Building Permit heretofore
filed in this office dated SEPTEMBER 2, 2008 purs~t to which
Building Permit No. 34132-Z dated SEPTEMBER 3, 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 ACCESSORY IN GROUND SWIMMING POOL WITH FENCE TO CODE AS APPLIED FOR.
The certificate is issued to KATHY PANAGOULIAS
( OWNER )
of the aforesaid building.
Suw~I~ C~)~qTYDEp~/~TOF~TH~PRO%5~L N/A
~t-r~IC. AL c~TIFICATE NO. 127723C 04/10/89
PLU~ERS c~KTIFICATION DA'r~zo N/A
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
A. For new building or new use:
1. Final survey of property with accurate location of all buildings, property lines, streets, an;
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 1% lead.
5. Commemial 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 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. f Certificate of Occupanc.y - 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, Commereial $15.00
New Construction: ~
[ocation ofprope y: \qW5
Old or Pre-existing Building:
(check one)
House No.
Owner or Owners of Property:
Street
Suffolk C?mty Tax Map No 1000, Section
Sub~l~vision
PermitNo.Date of Permit.
Health Dept. ~d~proval:
Plann~g Board Approval:
Request for: Tempora~ Certificate
Fee Submitted: $ t~ '~
Hamlet
Filed~lap.
Applicant:
Underwrite~/~pproval:
Final Certificate: ~/ (check one)
Applicant Signature
Issue Date
4/10/2009
Electrical Inspection Certificate
Electrical Inspection Service, Inc. Application Number
375 Dunton Avenue 127723C
East Patchogue, NewYork 11772
(63t) 286-6642
Issued To:
Street:
Village:
Evans Panagoulias
1975 Stanley Road
Mattituk
Section: Block:
Contractor: North Eastern Electric (L)
Zip:
Lot:
11952 Town: Southold
Lic.# 4658-E
Was examined and found to be in compriance with the National Electrical Code.
Commercial ~ NVDefects [] Pool [] lstFIoor [] Indoor r~ Basement [] HotTub
Residential ~ Det. Garage [] Attic [] 2nd Floor [] Outdoor [] Addition ~ Survey
Switches Receptacles
1 1
Dishwasher Washer/Amps
Furnace Oil Gas
Meter Amps Phase
Bldg. Permit: 34132
Other Equipment
UG/OH
/
Fixtures GFI Heaters A/C Fans
1
Dryer/Amps Oven Range/Amps Microwaves
Circulators Smoke Detector Bell Transformer
Jacuzzi Television CO Detector
1-Raintight Subpane130 ampi 1-20 amp Spec.
Recept./1-Poo L ght/1-T me Cock
Hugo S. Surdi
President
04/08/2009
III
This certificate must not be altered in any manner. Inspectors may be identified by their credentials.
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. 34132 Z Date SEPTEMBER 3, 2008
Permission is hereby granted to:
EVANS PANAGOULIAS
35-45 28TH STREET
ASTORIA, NY 11106
for :
CONSTRUCTION OF AN IN-GROUND SWIMMING POOL AS APPLIED FOR IN THE
REQUIRED REAR YARD
at premises located at 1975 STANLEY RD MATTITUCK
County Tax Map No. 473889 Section 106 Block 0008 Lot No. 004
pursuant to application dated SEPTEMBER 2, 2008 and approm~d by the
Building Inspector to expire on MAR~ !/Fee $ 250.00.
ORIGINAL
Rev. 5/8/02
TOWN OF SOUTHOLD BUILDING DEPT.
765-1802
INSPECTION
[ ]FOUNDATION 1ST
[ ]FOUNDATION 2ND
[ ]FRAMING / STRAPPING
[ ]FIREPLACE & CHIMNEY
[ ] ROUGH PLBG.
[ ] INSULATION
[ ] FIRE SAFETY INSPECTION
[ ] FIRE RESISTANT CONSTRUCTIOn. [ ] FIRE RESISTANT PENETRATION
REMARKS: f~- ~~
INSPECTOR
DATE
TOWN OF SOUTHOLD BUILDING DEPT.
765-1802
INSPECTION
[ ]FOUNDATION ¶ST [ ] ROUGH PLBG.
[ ]FOUNDATION 2ND [ ] INSULATION
[ ]FRAMING / STRAPPING [~]/FINAL
[ ] FIREPLACE & CHIMNEY [ ] FIRE SAFETY INSPECTION
[ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRATION
DATE
FOUNDATION (2ND) "~ ~
PL. IUMBING
,
~D~ON~ CO~S
:
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN HALL
SOUTHOLD, NY 11971
TEL: (631) 765-1802
FAX: (631) 765-9502
www. northfork.net/Southold/
Examined (~le~ ,20~L~
Approved 1 [ ~_) ,20~
Disapproved a/c
Expiration ,20
PERMIT NO. ~q [,~'~2;
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
Contact:
M ail t o &~/'~q-t~/~/,t~ ~/QOd¢
Phone: 7o')~') -- ~ ~/c,9- fl(~_5~
APPLICATION FOR BUILD~
INSTRUCTIONS Date'~""'~ '~~
,20c~
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 afier 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.~' ~ ~'~
~ ~f applic~..~e, i~ a corporation)
(Mailing address of applicant)
State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder
Nameofownerofpremises(?~f/~/~/~ n~- /~//~/-]]&/ ~-~,/'lJ/~] ~j6~-~.~
(As on the tax roll or la{est deed)
If applicant is a corporation, signature of duly authorized officer
(Name and title of corporate officer)
Builders License No. /{5
Plumbers License No.
Electricians License No.
Other Trade!s License No.
1. Location of land on which proposed work will, be done:
House Number Street Hamlet
County Tax Map No. 1000 Section /~'; Block 7 sl?_¥,:Lot
Subdivision Filed Map No. v ~ ~t '
2. State existing use and occupancy of premises and intended use and occupancy of proposed construction:
a. Existing use and occupancy
b. Intended use and occupancy
3. Nature of work (check which applicable): New Building_
Repair Removal Demolition
4. Estimated Cost
5. If dwelling, number of dwelling units
If garage, number of cars
Addition Alteration
Other Work
Fee
(Description)
(To be paid on filing this application)
Number of dwelling units on each floor
6. If business, commercial or mixed occupancy, specify nature and extent of each type of use.
7. Dimensions of existing structures, if any: Front
Height_ Number of Stories
Rear
Depth
Dimensions of same structure with alterations or additions: Front
Depth_ Height. Number of Stories
Rear
Dimensions of entire new construction: Front
Height Number of Stories
Rear Depth
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~-~
13. Will lot be re-graded? YES ~( NO__Will excess fill be removed from premises? YESX NO__
14. Names orOwner of premises ~M/}~'~t~ Address~TD 3~6q~fi°~//d/~ Phone No. '7/3: -5-r//'~/?/o~
Name of Architect Address Phone No
Name ofContractor~$r~-~o~ P~a£~ Address/s6c/~/~et- /k/~;~dPhone No. '),.T~-~/2 ~
15 a. Is this property within 100 feet of a tidal wetland or a freshwater wetland? *YES * 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.
NO
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 )
'-~O ftr~o "~..~ZL)l~,O~'z~'~ being duly swom, deposes and says that (s)he is the applicant
(Name of individlaal sigfting contract) above named,
(S)He is the ~'r~MPr~~
(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 to before me thi~-~ --
~ day of ~
Notar~ Publi~~-
VALERIE UNDQUIST
Ne~my Public State Of New York
No. 01LI6051821
Ouelifled In Suffolk County tG
200 (
Erosion, Sedimentation and Storm-water Run-off Control Plan ASSESSMENT FORM
.E.,X~MPTION S:
A. Does this project meet the mmimum standards for classification as an Agricultural Project.
.Note: If you answered Yes to any o[ th~ above, a Storm-water, 6fading, Drainage & Erosion Control Plan is not required.
ACTIONS REQUIRING THE SUBMISSION OF A STORM-WATER~ GRADING~ DRAINAGE & EROSION
CONTROL PLAN CERTIFIED BY A DESIGN PROFESSIONAL IN THE STATE OF NEW YORK.
Item Number: (A Check Mark (,/) for each question is required for complete application)
1. Will this project retain all Storm-Water Run-off generated on Site?
Yes No
(This. will include all m-off created by site clearing and/or construction activities as well as all
Site Improvements and the permanent creation of impervious surfaces.) ~k- ~
2. Will this project require any land filling, grading or excavation where there is a change to the ~
natural existing grade involving more than 200 cubic yards of material within any parcel? ~
3. Will this application require land disturbing activities encompassing an area
of five thousand (5,000)square feet of ground surface or more? ~ A
4. Is there a Natural Water course nmning through the site or is this project within
One hhndred (100) feet of wetlands or a beach? ~ ~,,
5. Will there be site preparation on slopes which exceed fifteen (l 5) feet of vertical rise to ~
One hundred (100) feet of horizontal distance? /~
6. Will driveways, parking areas or other impervious surfaces direct Storm-Water Run-off
into and/or in the direction of a Town Right-of-Way? ~ ~
Will this application require the placement of material, removal of vegetation and/or the
congtruction of any item within the Town Right-of-Way or road shoulder area?
(This item does not Include the installation of driveway aprons.)
8. . Will there be site preparation within the one hundred (100)year floodplain of any watercourse? ~'] .~
Note: If any answer to questions ~)nn through eight is answered, with a check mark in the Box, a Storm-water, Grading,
Drainage & Erosion Control Plan is required and must be submitted for review prior to issuance of any building permit.
STATE OF NEW YORK,
COUNTY OF .............................................. SS
That I, ..7x_~.~2~.. .5 .~'~.72{~. .'. ........... being duly sworn, deposes and says that he/she is the applicant for Permit,
(Name of individual signing Document)
And that He/She is the ....... ~'~O.l,~ff./~/~5_ Cdt'(._ ~ . ..............................................................
(Owner, Contractor, Agent, Corporate Officer, etc.)
Owner and/or representative of the Owner or Owner's, 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 belier; and that the
work sill be performed in the manner set forth in the application filed herewith.
Sworn to bef~e~e this;
~.r--' · dayof ~~- 200[(
VALERIE UNDQUIST
Nofllry Public State Of Ne~/Yo~k
No. 01LI6051621
ComOUalified In Suffolk County tO
mission Expire~ Del3 4, 20~
D
~reO
45~95
REVIEION$
~AY1~1972
MAY~I~I972
dU~13,1972
YOUNG & YOUNG
400 OSTRANDER AV£NUE, RIVERHEAD, NEW YORK
ALDEN W. YOUNG'
SURVEY FOR: NISSIIvi ALHADEFF,
PETER DEMETRIOUS, HELEN DEMETRIOU
LOT 24 "SUNSET KNOLLS,SECTION 2"
AT
MATT/TUCK SOUTNOLO SAVIN($$ BANK
TOWN OF' SOUTHOLD SECURITY TITLE & GUARANTY CO.
= 40'
MAR.15~I972 . 72-181
~PICAL POOL PLAJV
T~PICAL cROss ' SECTION
ALL
D~stGN
ISLANDIA: POOLS ~r Jos~ J, m~socz~sx~
108 F1SHEL AVD~JE, Rfl'ERHEAD. NEW YORK 11901 (516)727-6312
',,'i .~HOUT CERTIFICATE
OF OCCUPANCY ,-
OR
OWNER:
OPTIONAL STEP
N.S.P.I..TABLE OF DIMENSIONS
s~zE A S C O r F o HI~-I
I'~x32 I't,~152 I ~ I1~1 · 141418 I 512 I 17.~
';IMMEDIATELY"
ENCLOSE POOL TO CODE
UPON COMPLETION
BEFOI~E "WATER"...
NOTES: