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HomeMy WebLinkAbout34620-ZFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building.Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No: Z-33670 Date: 04/23/09 THIS u~TIFIES that the building ACCESSORY Location of Property: 105 RHODA RD (HOUSE NO.) (STREET) Co%u~ty Tax Map No. 473889 Section 106 Block 1 subdivision Filed Map No. __ Lot No. MATTITUCK Lot 9 ( HAMLET ) conforms substantially to the Application for Building Permit heretofore filed in this office dated APRIL 3, 2009 pursuant to which Building Permit No. 34620-Z dated APRIL 17, 2009 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 SHED AS APPLIED FOR. The certificate is issued to ELENI E & JIMMY D TSERPELIS (OWNER) of the aforesaid building. SUFFOLK CO[~11~f DEPARll~ENT OF }{F~%LTH APPRO~-AL ELEC~I~ICAL CERTIFICATE NO. PLIERS C~KTIFICR%TION DA'£~U 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 subnfitted to the Building Department with the following: A. For new building or new use: 1. Final sorvey of property with accurate location of all buildings, pn3perty lines, streets, and unusual natural or topographic features. 2. Final Approval from Health Dept. of )rater 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 eonta'ms less than 2/10 of 1% 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~ For existing buildings (prior to April 9, 1957) non-conforming uses, or buildings and "pre-existing" land uses: 1. Aceurate survey ~f preperty sh~wing a~~ pr~perty ~ines~ streets~ bui~ding and unusua~ natura~ ~r t~p~graphic features. 2. A properly completed applicatinn and consent tu 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 dwelllng $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 Occapancy - Residential $15.00, Commercial $15.00 Dat . 13 9r',, i New ConstructiOn: old or Pre-e~sting Building: C,/ (check one) LocationofProperty: [0~'¢ cka Ko _ct-- .' House No. Street Hamlet Block ~ Lot ~ Owner or Owners of Property: Suffolk County Tax Map No 1000, Section Subdivision Permit No. Health Dept. Approx)al: Planning Board Approval: Request for: Temporary Certificate Date of Permit. Filed Map. Applicant: Underwriters Approval: Final Certificate: (check one) Fee Submitted: · 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. 34620 Z Date APRIL 17, 2009 Permission is hereby granted to: E & J TSERPELIS 105 RHODA RD MATTITUCK,NY 11958 for : "AS BUILT" CONSTRUCTION OF AN ACCESSORY SHED AS APPLIED FOR at premises located at County Tax Map No. 473889 Section 106 pursuant to application dated APRIL Building Inspector to expire on OCTOBER 105 RHODA RD MATTITUCK Block 0001 Lot No. 009 3, 2009 and approved by the 17, 2010. Fee $ 200.00 Authorized Signature ORIGINAL Rev. 5/8/02 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, NY 11971 TEL: (631) 765-1802 FAX: (631) 765-9502 SoutholdTown.NorthFork.net Exmnined Approved Disapproved a/c ,20 Expiration /afl/, 20 BLDG. DEPT. TOWN OF SOUTHOLD 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 Flood Permit Storm-Water Assessment Form Contact: Mail to: Phone: Building Inspector APPLICATION FOR BUILDING PERMIT Date 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 pem~it 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 lbr 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 n bu ld ng for necessary inspect ons (Signature of applicatnt or name, ifa corporation) (J(}vlaih~Jg address of applicant) State whetber applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder Nameofownerofpremises ~-1~']' ' 5Lc¥\I'Y'V'q /~e(' (3t~,\"S (As on the tax roll or lhtest 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. 1. Location ofland__.on which pro4coseg work will be done: House Number Street Hamlet County Tax Map No. 1000 Section lC)k2 Block 7~ Subdivision Filed Map No. Lot C/ Lot 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 Fee 5. If dwelling, number of dwelling units If garage, number of cars Addition Other Work Alteration (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 Rear Depth Height. Number of Stories Dimensions of same structure with alterations or additions: Front , Depth. Height Number of Stories 8. Dimensions of entire new construction: Front Rear p~pth Height Number of Stories 9. Sizeoflot: 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? YES NO 14. Names of Owner of premises Name of Architect Name of Contractor Address Phone No. Address Phone No 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. ls 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 · IF YES, PROVIDE A COPY. NO STATE OF NEW YORK) SS: COUNTY OF. ~"¢~d) ~' ['~{,-.~' 7~M//[,-..~ being duly swom, deposes and says that (s)he is the applicant (Name of individual signing contract) above named, (S)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 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&jo~ beIbre daymeofthis ~' ~ VICKI TOTH ~ -r,.~ Notary Public Stateof NewYork otary Publi " ~ignature oJ/Appli~nt TOWN OF SOUTHOLD BUILDING DEPT. 765-1802 INSPECTION ] FOUNDATION 1ST [ ] ROUGH PLBG. ] FOUNDATION 2ND ] FRAMING / STRAPPING ] FIREPLACE & CHIMNEY [ ] INSULATION ~"FINAL [ ] FIRE SAFETY INSPECTION ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRATION REMARKS: DATE FIF, I,D INSPECTION REPORT [ DATE [ COMMENTS ~.~ FOUNDATION (1ST) FOUNDATION (2ND) PL~G ~SULATION PER N. Y. STATE ENERGY CODE ~DITION~ CO~ENTS LOT 168 N77'26'OO"E 149.74' CHAIN LINK FENCEu 0.7'S . CONC ASPHALT DRIVE 27,0' ~ CONC pORCH ~ 56.10' 56,15' ~ LOT 169 CONC ~ ~ BRICK 2 STORY ~ F~ME ~ ~ RESIDENCE ~ 5,1' WOOD ~ ~105 ~6.15' 56.1' CONC 0.7'N16'0' ,'~ CHNN UNK FENCE 0.8'N ~ DATE: 157.13' S77'26'00"W NO~ / E ALLCONS7 '", :',!SHALL Lo~i~B,~, F~[_~ ¢ TITLE No, 09-7405-53809 -SUFF GUARANTEED TO: ELENI E. TSERPEUS JIMMY D. TSERPELIS FIDEMTY NATIONAL TITLE INSURANCE COMPANY HSBC MORTGAGE CORPORATION (USA) 0 ~ LOT 1($9 MAI= OF= OAPTAIN KIDD E~TATE8 F=ILED ~ANUAIRY lg, lg4g 0 F=ILE No. 1~72 AT MA ~ ~ FrUCK TOWN OF= ..~OUTHOLD 8UF=~OLK OOUNTY N.Y. REQU: ~ :, OFTHE ~ '""- ME:': ~,~ :,. ~_{ .... ~ ~.~, ,:- r~ , ,, CERTIFICATE PE N, ~. ALL CON~inu;,;,;~, o?t.~LL MEET THE ~Y L REQUIREMEHTS OFTHECCDESOFNEW P.O. BOX 6~ 8A~LLE N~ ~ ~UTH ~0~ YORK STATE. NOT RESPONSi3LE FOR DESIGN OR CONSTRUCTION ERRORS. (~) 2~-60~ ~782 SURVEYED MARCH 51, 2009 S.C.T.M. No. 1000-106-1-9 BARGAIN AI~ CAUTION: THIS AGREE THIS INDENTI BE'I'WEEN Cl Mi party of the first pa EL Flu party of the secon¢ W1TNESSETH, ($10.00), lawful mm release unto the part forever; ALL that certail situate, lying and bei York, being known a of the Clerk of the C described as follows: BEGINNING at a northerly end of a Road; THENCE south 77 THENCE north 22 THENCE north 77 THENCE south 12 feet to the point or ph BEING AND INTEN dated April 15, 2004. Liber 12315, Page 59i NYSBA's Residential Real E ACTS (INDIVIDUAL OR CORPORATION) FORM 8002 (short version), FORM 8007 (long version) lENT SHOULD BE PREPARED BY AN ATTORNEY AND REVIEWED BY ATTORNEYS FOR SELLER AND PURCHASER BEFORE SION'lNG. RE, made the day of ,2009 RISTOPHER T. SISINO, of 300 So. Biscayne Boulevard, Apt. LL02, ami, Florida 33131 and --'NI E. TSERPELIS and JIMMY D. TSERPELIS, of 32-22 162nd Street, shing. New York 11358, ~art; that the pan'y of the first part, in consideration of Ten Dollars and No Cents ey of the United States, paid by the party of the second part, does hereby grant and of the second part, the heirs or successors and assigns of the party of the second part plot, piece or parcel of land, with the buildings and improvements thereon erected, ~g in the in the Town of Southold, at Mattituck, County of Suffolk and State of New ; Lot 169 on a certain map entitled "Map of Captain Kidd Estates" filed in the Office ~unty of Suffolk on January 19, 1949 as Map No. 1672, said lot being bounded and )oint on the westerly side of Rhoda Road, distant 52.66 feet northerly from the trve connecting the westerly side of Rhoda Road with the northerly side of Ruth ~grces 26 minutes 00 seconds west 137.13 feet; ;grces 06 minutes 40 seconds west 76.05 feet; ~grees 26 minutes 00 seconds east 149.74 feet to the westerly side of Rhoda Road; legrces 34 minutes 00 seconds east along the westerly side of Rhoda Road, 75.00 ce of BEGINNING. DED TO BE the same premises conveyed to the party of the first part by DEED, and recorded in the Office of the Clerk of Suffolk County on April 26, 2004, in Forms (9/00) 2008 Matthew Bender & Co., a member of the LexisNexis Group.