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HomeMy WebLinkAbout33402-ZFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEP~=RTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No: Z-33683 Date: 05/01/09 THIS CERTIFIES that the building ADDITIONS I~cation of Propez~y: 290 GILLETTE DR (HOUSE NO.) (STREET) County Tax Map No. 473889 Section 38 Block 2 Subdivision Filed Map No. __ Lot NO. __ EAST MARION (HAMLET) Lot 3 conforms substantially to the Application for Building Permit heretofore filed in this office dated SEPTEMBER 17~ 2007 pursuant to which Building Permit No. 33401-Z dated SEPTEMBER 17, 2007 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" COIrERED PORCH AND DECK ~DITIONS TO AN EXISTING ONE FAMILY DWELLING AS APPLIED FOR. The certificate is issued to MIHAIL G & PETER G MIHALOS ( OWNER ) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL ELECTRICAL CERTIFICATE NO. PLDIMBRRS C~TIFICATION DATED N/A N/A Signature Rev. 1/81 FORM NO. 4 TOW/~ OF SOUTHOLD BUILDING DEP~RTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No: Z-33684 Date: 05/01/09 THIS CERTIFIES that the building ACCESSORY Location of Property: 290 GILLETTE DR (HOUSE NO.) (STREET) County Tax Map No. 473889 Section 38 Block 2 subdivision Filed Map No. __ Lot No. __ EAST MARION Lot 3 (HAMLET) conforms substantially to the Application for Building Permit heretofore filed in this office ~ted SEPTEMBER 17, 2007 pursuant to which Building Permit NO. 33402-Z dated SEPTEMBER 17, 2007 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" ACCESSORY IN GROUND SWIMMING POOL WITH FENCE TO CODE AS APPLIED FOR. The certificate is issued to MIHAIL G & PETER G MIHALOS (OWNER) of the aforesaid building. SIIFFOLK COUI~I"f DEPAR~4E/~T OF }~EALTH APPRO~3%L N/A RLRC'~RICAL C~ERTIFICATH NO. 4003442 06/26/08 PLL~WBERS CERTIFICATION DA'r~u N/A Signature Rev. 1/81 Form No. 6 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL 765-1802 APPLICATION FOR CERTIFICATE OF OCCUPAB Tiffs application mast be filled in by typewriter or ink and submitted to the Building Depar A, For new building or new use; I Fin]l storey of piope~ty with accurate location of all buildings, property' lines, streets, and mmsual natural or topographic f~atures. 2 Final Approval from Health Dept. of water supply and sewerage-disposal (S-9 form). 3 Approval ofe}ectrical installation from Board of Fire Unde~dters S worn statement fi'om plmnber cemifying that the solder us~ in system contains less than 2/l 0 of 1% lead, 5. CoImnercial building, indus~al building, multiple residences and si~lar buildings and installations, a ce~ificate of Code Compliance from archit~t or engineer responsible for the building. 6. Submit Pla~ng Board Approval of complet~ site plan requirements. B. Fo~ existing b~ 'ld'ngs (prior to April 9, 1957) non-couforming uses, or buildings and "pre-existing" land uses: I Accurate su~,ey of propeay showing all propeNy lines, s~eets, building and unusual na~ral or topo~aphic features 2 A p~ oper[¥ cmnpleted application and consent to inspect signed by the applicant. Ifa Ce~ificate of Occupancy is denied, lhe Building h~spector shall state the reasons therefor in whting to the applicaut. C. Fees I Certificate of Occupancy - New dwelling $25.00, Additions to dwelling $25 00, ~terations to dwelling $25.00, Swinumng pool $25.00, Accessou building $25.00, Additions to accesso~ buildmg $25.00, Businesses $50.00. 2 Cetetificate oFOccupancy on Pre-existing Building - $100.00 3 C°py o f Certificate of Occuloancy $.25 4 [ Jpdated Cel¢ificate of Occupancy - $50.00 5 I cl{aporo~y CcrtiGcaio of Occupancy - Residemial $15.00, Coimneicial I15 0O Location of Prope~ ty: Old or Pre-existiug Building: House No Street (check one) Suflblk Cornel> Tax Map No 1000, Section Hamlet - -- Filed Map __ let Health £)ep~ Aplo~oval Plalunng Boad Approval: Requesl [o~; 'l-e/rqoc~a~ 5' Undelwriters Approval: Final Celtificate: / __ (check Applicartt Signature Form No. 6 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL 765-1802 APPLICATION FOR CERTIFICATE OF OCC] c FEB 24 2009 BLDG. O£Pi. TOWN OF $OUTHOL§ This application must be filled m by typewriter or ink and submitted to the Building 'Department with the Iotlowlng: A. For, new building or new use: 1. Final smwey 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-disposai (S.9 form). 3. Approval of electrical installation fi'om 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. Cmmnercial 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 Pla~ming 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 Occupaacy 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 Occupaocy- $50.00 5. Temporary Certificate of Occupancy - Residential $15.00, Commercial $15.00 New Construction: Old or Pre-existing Building: Location of Property: _'~ (~ ~:21L~g_..'~"('~ [~IP-..I~' I~; House No. Street (check one) Owner or Owners of Property: Mti4A-It..-- 6,. Mtl4- c,o.r Suffolk County 'Fax Map No 1000, Section O'9~ ~ Block ~ Subdivision Filed Map. ~_ DateofPem~it. q/l'~O'/ _Applicant: Pem-dt No. ~,.~ Health Dept. Approval: Planning Board Approval: Hamlet Lot Lot: Underwriters Approval: Request for: Temporary Ce~lificate Final Certificate: V' (check one) Applicant Signature FORM NO. 3 TOWN OF SOUTHOLD BUILDING DEPARTMENT Town Hall Southold, N.Y. (THIS BUILDING PERMIT PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) PERMIT NO. 33401 Z Date SEPTEMBER 17, 2007 Permission is hereby granted to: for : MIHAIL G MIHALOS 290 GILLETTE DR EAST MARION,NY 11939 "AS BUILT" ADDITIONS TO AN EXISTING SINGLE FAMILY DWELLING at premises located at 290 GILLETTE DR County Tax Map No. 473889 Section 038 Block pursuant to application dated SEPTEMBER 17, 2007 Building Inspector to expire on MARCH 17, EAST MARION 0002 Lot No. 003 and approved by the 2009. Fee $ 400.00 Authorized Signature ORIGINAL Rev. 5/8/02 BY THIS CERTIFICATE Of COMPLIANCE THE ~7o --.2_ --~_~ NEW YORk BOARD Of FIRE UNDERWRITERS BUREAU OF ELECTRICITY 40 FULTON STREET ~ NEW YORK, NY 10038 CERTIFIES THAT Upon the application of upon premises owned by B.J. ELEC. CO. 4300 STILLWATER AVE CUTCHOGUE, NY 11935, MIKE MIHALOS 290 GILETTE DRIVE EAST MARION, NY 11939 Located at 290 GILETTE DRIVE EAST MARION, NY 11939 Application Number: 4003442 Certificate Number: 4003442 Section: Block: Lot: Building Permit: . BDC: ns11 Described as a Swimming Pool occupancy, wherein the premises electrical system consisting of electrical devices and wiring, described below, located in/on the premises at: Outside, Pool/Spa, .~ A visual inspection of the premises electrical system, limited to electrical devices and wiring to the extent detailed herein, was conducted in accordance with the requirements of the applicable code and/or standard promulgated by the State of New York, Department of State Code Enforcement and Administration, or other authority having iurisdiction, and found to be in compliance therewith on the 26th Day of J..e, 2008. Name OTY Rate Appliances and Accessories Pool / Spa Bonding I 0 Time Clock Switch 1 0 Panels Rating Circuits Tvvc 1 50 2 Wiring And Devices Fixture I 0 pool GFCI Circuit Breaker I 0 Receptacle 1 0 20a-pool Switch I 0 Special I twist lock C-en, Purpose (Swimming Pool): This certificate covers compliance at the date of inspection only. Because of unusual environments it is advisable to have frequent test md/or repairs made by a qualified person. ] of 1 seal This certificate may not be altered in any way and is validated only by the presence of a raised seal at the location indicated. FORM NO. 3 TOWN OF SOUTHOLD BUILDING DEPARTMENT Town Hall Southold, N.Y. BUII~)ING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) PERMIT NO. 33402 Z Date SEPTEMBER 17, 2007 Permission is hereby granted to: for : MIHAIL G MIHALOS 290 GILLETTE DR EAST MARION,NY 11939 "AS BUILT" ACCESSORY INGROUND SWIMMING POOL IN THE REAR YARD, FENCED TO CODE at premises located at 290 GILLETTE DR County Tax Map No. 473889 Section 038 Block pursuant to application dated SEPTEMBER 17, 2007 Building Inspector to expire on MARCH 17, EAST MARION 0002 Lot No. 003 and approved bythe 2009. Fee $ 500.00 Authorized Signature ORIGINAL Rev. 5/8/02 TOWN OF SOUTHOLD BUILDING DEPT. 765-1802 INSPECTION [ ]FOUNDATION 1ST [ ]FOUNDATION 2ND [ ]FRAMING / STRAPPING [ ]FIREPLACE & CHIMNEY [ ]FIRE RESISTANT CONSTRUCTION [ ] ROUGH PLBG. [ ] ~.ILATION [ ,/]~FINAL [ ] FIRE SAFETY INSPECTION [ ] FIRE RESISTANT PENETRATION d DATE INSPECTOR TOWN OF SOUTHOLD BUILDING DEPT. 765-1802 INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] INSUL~A,T~I~~ [ ] FRAMING / STRAPPING [ [ ] FIREPLACE & CHIMNEY [ ] FIRE SAFETY INSPECTION [ ] FIRE RESISTANT PEkc i ~ATION REMARKS: ] FIRE RESISTANT CONSTRUCTION DATE INSPECTOR_~~'~ F]lgLD INSPECTION REPORT I DATE I COMMENTS FOUNDATION (1ST) FO~ATION (2~) ROUGH F~G & pL~G ~S~ATION PER N. Y. STATE E~RGY CODE r ~DITION~ COUNTS FW~LD I~SPECTIONRF_,PORT [ DATE FO~ATION (2ND) PL~G .......... ~8~ATION PER N. Y. STATE E~RGY CODE F~ ~DI~ON~ COUNTS JAMES G. COCKINOS, A.I.A. ARCHITECT, P.C. 180 Manor Avenue - Westbury, New York 11590 Phone: 516-333-5169 - Fax: 516-333-8745 E-mail: jgcarchl~yahoo.com September 5, 2007 Town of Southold Build'mg Department Southold Town Hall PO Box 1179 Southold, NY 11971 290 Gillette Drive East Marion, NY 11939 Suffolk Co. Tax Map #38.-2-3 To Whom It May Concern: I, James G. Cockinos, AIA hereby certify that the construction of the raised patio deck at the above referenced premises is structurally sound. Very truly yours, J ~A~MES G~CK1NOS, ARCHITECT, ~.~C~ockinos, AIA Member, American Institute of Architects NY$ Lic.# 18119 TOWN OF SOUTHOLD BUILDING DI~PARTMENT TOWN HALL SOUTHOLD, NY 11971 TEL: (631) 765-1802 FAX: (631) 765-9502 SoutholdTown. NorthFork.net Examined ~//7 ,20 O 7 PERMIT NO. ~ 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 Fom~ Contact: Approved ¢/// 7 , 20 D7 Mail to: Disapproved a/c Phone: Expiration 4 / 7 ,2(3[9 ~/ SEP -'5 :. 5 i Building Inspector i APPLICATION FOR BUILDING PERMIT ; ~- ~ ~ Date _, 20 ~ __ ~..'L .._ INSTRUCTIONS 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 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. (Signature of applicant or name, ifa corporation) (Mailing address of~applicant) State whether applicant is owner, lessee, agent, architect, en~neer, general contractor, electhci~, plumber or builder Nameofownerofpremises ~ {~g&; [ ~, ~q~.iho~[,o,j' (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: Coil l e. House Number Street Hamlet County Tax Map No. 1000 Section Subdivision (Name) Lot Lot '3 State existing use and occupancy of premises and intended use and occ. upancy, of proposed construotion: a. Existing use and occupancy - ~t~l~1 fi'Cs ftl-~w~-{O~'~ b. Intended use and occupancy -' ~'~m;~,q f~.% t~-o-v~Jl-~o,I Nature of work (check which applicable): New Building_ Repair Removal Demolition Estimated Cost ~ O©O. If dwelling, number of dwelling units If garage, number of cars ~ Addition Alteration Other Work 17-C4 i &et~ ~o~ 4 ~ (Description) Fee (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 OO Rear 0 Depth Height [Jr" Number of Stories '~ Dimensions of same structure with alterations or additions: Front Depth Height Number of Stories Rear. 8. Dimensions of entire new construction: Front Height Number of Stories Rear Depth 9. Sizeoflot: Front iOO Rear [oo Depth 1'7-o 10. Date of Purchase lq,'/ let ~1 Name of Former Owner ¢O ~*' 3r 11. Zone or use district in which premises are situated 12. Does proposed construction violate any zoning law, ordinance or regulation? YES __ NO v// 13. Will lot be re-graded? YES__ NO 7Will excess fill be removed from premises? YES__ 14. Names of Owner of premises ['/~;¼~:1 ~hi~Ol°~Address ~'C/° (~°i~/~'~'~rpt' Phone No. Name ofArchitect xJt2ox,'.5' 6o. Cock:i,,~j Address I ~o t~,,~*¢ ,~,tt PhoneNo ~---~-~- Name of Contractor Address Phone No. 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. 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~,'~"[o I L) Mih~;\ &. ~-~ ~ ~ I~d being duly sworn, deposes and says that/(~s')he is the applicant (Name of individual signing contract) above named, (~He is the (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 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 ~.before me thi~ ~ I day of ~ ~ Notaw Public NOT~ Y~ //' :Tow____n_n o_f Southold Erosion, Sed,mentation & Storm-Water Run-off ASSESSMENT FORM PROPERTY LOGATION: S.C.T.M.#: THE FOLLOWING ACTIONS MAY REQUIRE THE suBMISSION OF A \'I~C) C) '~ ~ ~'~ STORI~WATER~ GRADING~ DRAINAGE AND EROSION CONTROL PLAN District Section Block Lot CERTIFIED BY A DESIGN PROFESSIONAL IN THE STATE OF NEW YORK. Item Number: (NOTE: A Check Mark (~) for each Question is Required for a Complete Application) Yes No Will this Project Retain Ail Storm-Water Run-Off Generated by a Two (2") Inch Rainfall on Site? / r'~ (This item will include all run-off created by site clearing and/or construction activities as well as all Site Improvements and the permanent creation of impervious sun'aces.) Does the Site Plan and/or Survey Show All Proposed Drainage Structures Indicating Size & Location? .f r~ This Item shall include all Proposed Grade Changes and Slopes Controlling Surface WatarFIowl -- 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 Matedal within any Pamel? ~ __v Will this Application Require Land Disturbing Activities Encompassing an Area in Excess of Five Thousand (5,000) Square Feet of Ground Surface? .V_ Is there a Natural Water Course Running through the Site? Is this Project within the Trustees jurisdiction or within One Hundred (100') fee ora Wetland or Beach? ~ -- v Will there be Site preparation on Existing Grade Slopes which Exceed Fifteen (15) feet of Vertical Rise to One Hundred (100') of Horizontal Distance? ~Z_ Will Driveways, Parking Areas or other Impervious Surfaces be Sloped to Direct Storm-Water Run-Off r~ ./ into and/or in the direction of a Town right-of-way? ~ v__ Will this Project Require the Placement of Material, Removal of Vegetation and/or the Construction of any Item Within the Town R ght-of-Way or Road Shoulder Area? ~ -- (This item will NOT include the Installation of Driveway Aprons.) Will this Project Require Site Preparation within the One Hundred (100) Year Floodplain of any Watercourse? NOTE: If Any Answer to Questions One through Nine 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 Permifl EXEMPTION: Yes No Does this project meet the minimum standards for class ficat on as an Agricultural Project? Note: If You Answered Yes to this Question, a Storm-Water, Grading, Drainage & Erosion Control Plan Is NOT Requiredl ~/ -- STATE OF NEW YORK, COUNTY OF ....~......O~...~ ..................... SS That_ I .... ). .~,.~ .......... 2 ..... ). ........... being duly swam, deposes and says that he/she is the applicant for Permit, {Name of individual signing Document) And that h;/~e is the ............................................ l~.0kJ~..~... ..................................................................... (Owner, Contractor, Agent, Corporate Officer, etc.) Owner and/or representative of the Owner of Owner's, and is duly authorized to perform or have performed the smd 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 herewith. Sworn to before me this; ....... · ~. .................................... day of ...~...~.... ................ 20..~ ~"~ R08~ ~AI~ (Signature of Applicant) FORM - 06/07 ,. '~.~ r ~/ Cam ~ ,-,,.~ras 03/03~?' ...... :l I 100, 0 ~ Woo~" 1¢o¢--_--_--_--_--_--_¢¢ o¢ ica., . I o ~ ~ p, tAN GPL-AH op 'WOOD OWNER: MIt][ALOS RESII)ENCE 290 GILLETTE DRIVE EAST MARION, N.Y. 11939 PROFESSIONAL OF RECORD: JAMES G. COCKINOS, ARCHITECT, P.C. 180 Manor Avenue Westbury, N.Y. 11590 Tel: 516-333-5169 PROFESSIONAL SEAL: ~_ ~/?/~ REV'D # DATE DECSKIPTION PROJECT DESCRIPTION: 290 GILLETTE DRIVE EAST MARION, N.Y. 11939 DRAWING DESCRIPTION: PLOT PLAN RAISED DECK PLAN & DETAIL~ DATE: 8-31-07 DRAWN BY: .~GC CHECKED BY: ICC SCALE: AS NOTED DRAWING NUMBER: A-1 iI .¢, fi. ::~L~ P, T, WOOF.; jOl¢7 IOl4 TH I%"" ItO': {eAL',./AH ~ Ze o 4- ~.~7, I'/V'; 0" C OMi¢C,©I 1'6 O -4 %4" o~l co Hc.i~."T E 11 OWNER: MIHALOS RESIDENCE 290 GILLETTE DRIVE EAST MARION, N.Y. 11939 PROFESSIONAL OF RECORD: JAMES G. COCK1NOS, ARCHITECT, P.C. 180 Manor Avenue Westbury, N.Y. 11590 Tel: 516-333-5169 PROFESSIONAL SEAL: 4- d 1%/u v REV'D # DATE DECSRIPTION PROJECT DESCRIPTION: 290 GII,LETTE DRIVE EAST MARION, N.Y. 11939 DRAWING DESCRIPTION: PLOT PLAN RAISED DECK PLAN & DETAILS DATE: 8-31-07 DRAWN BY: JGC CHECKED BY: JGC SCALE: AS NOTED DRAWING NUMBER: A-1