HomeMy WebLinkAbout29125-ZFORM NO. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Office of the Building Inspector
Townn Hall
Southold, N.Y.
CERTIFICATE OF OCCUPANCY
No: Z-33689
I~te: 05/05/09
THIS ~RTIFIES that the building ELECTRIC UPGRADE
Location of Property: 650 TASKER LA
(HOUSE NO.) (STREET)
County Tax Map No. 473889 Section 33 Block
Subdivision
Filed ~ap No. Lot NO.
GREENPORT
LOt 40
( HANLE T )
conforms substantially to the Application for Building Permit heretofore
filed in this office dated JANUARY 27, 2003 purs~u~nt to which
B~ilding Permit No. 29125-Z dated J~R~UARY 27, 2003
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 ELECTRICAL UPGRADE TO AN EXISTING ONE FAMILY DWELLING AS APPLIED FOR.
The certificate is issued to JAMES PAPPAS
of the aforesaid building.
(OWNER)
SUFFOI~K C~DII~wI"fDEPAR~TOF ~J~TH~PRO~F~J~ N/A
ELEC~£~ICJ%L [I~RTIFICJ%TH NO. 1183911 12/08/03
PLIghtERS CERTIFICATION DATED N/A
Rev. 1/81
Form No. 6
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOV~N HALL
765-1802
APPLICATION FOR CERTIFICATE OF OCCUI
This application must be filled in by typewriter or ink and submitted to the Building ]
A. For new building or new use:
1. Final survey of property with accurate location of all buildings, property lines
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. 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.
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 nnusual 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 . /'
New Construction: Old or Pre-existing Building:
Location of Property: ~,_CO '~fl~, ~ad,.~ff
-House No. Sti:eet --
Owner orOwnersofmroperty: J6~4.~ ~.~ /~'l~'r4~
Suffolk County Tax Map No 1000, Section '-t73
Subdivision
Permit No)q.
(check one)
Hamlet
Block I~)~ Lot
Health Dept. Approval:
Planning Board Approval:
Date of Permit.
Filed Map.
Applicant:
Underwriters Approval:
Lot:
Request for: Temporary Certificate
Fee Submitted: $
Final Certificate: (check one)
p- ,~licant Signature
FORM NO. 3
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Town Hall
Southold, N.Y.
BUILDING PEP~IT
(THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL
COMPLETION OF THE WORK AUTHORIZED)
PERMIT NO. 29125 Z
Date J~kNUARY 27, 2003
Permission is hereby granted to:
for :
JAMES PAPPD S
PO BOX 61
MASPETH,N~f 11378
ELECTRICAL UPGRADE (60 AMPS TO 200 AMPS) AS APPLIED FOR.
UNDERWRITER'S CERTIFICATE REQUIRED FOR C.O.
at premises located at
County Tax Map No. 473889 Section 033
pursuant to application dated J~NUARY
Building Inspector to expire on JULY
Fee $ 150.00
650 TASKER LA
Block
GREENPORT
0004 Lot No. 040
27, 2003 and approved by the
27, 2004.
Rev. 5/8/02
ORIGINAL
BY THIS CERTIFICATE OF COMPLIANCE THE
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
JAMES PAPPAS
P. O. BOX 61
MASPETH, NY 11378
JAMES PAPPAS
650 TASKER LANE
GREENPORT, NY 11944
Located at 650 TASKER LANE GREENPORT, NY 11944
Application Number: '1183911
Certificate Number: 1183911
Section: Block: Lot: Building Permit: 0 BDC: ns11
Described as a Residential
occupancy, wherein the premises electrical system consisting of
electrical devices and wiring, described below, located in/on the premises at:
Basement, Outside,
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 jurisdiction, and found to be in compliance therewith on the Sth Day of December, 2003.
Name QTY Rate RatinA Circuits Type
Service
Service Disconnect: 1 200 cb
Rating200Amperes
seal
I of I
This certificate may not be altered in any way and is validated only by the presence of a raised seal at the location indicated.
TOWN OF SOUTHOLD PROPERTY RECORD CARD
OWNER STRE~ ~SO WL~,GE D~ST. SUB. LOT
~OR~ER OWNE~' ' -- ,~ N E
~n/os ~p~s ~
~ ~, :r~~ , S W ~PE OF BUILDING
RES. ~ ~ O S~S. VL : FARM COMM. CB. MISC. Mkt. Volue
~ND IMP. TOTAL DATE '
REMARKS ~/~
' ~ I I ~ / f l/ /
AGE BUILDING CONDITION
N~ NORMAL BELOW ABOVE
FARM Acre Value Per Value
Acre
Tillable 1
Tillable 2
Tillable 3
Wo~land
Swampland FRONTAGE ON WATER
Brushland FRONTAGE ON ROAD
House Plot DEPTH
BULKH~D
Total DOCK
· Bldg.
:tension
Foundation
f
Basement
Both
Floors
:tension Ext. Walls Interior Finish
(tension Fire Place y~'_~ Heat
Rooms 1st Floor
j
)rch
)rch
reezeway
oroge
Type Roof
Recreation Room
Dormer
Driveway
2rio
.B.
otal
Rooms 2nd Floor
Dinette
DR.
iBR.
FIN. B.
Examined
Approved
Disapproved a/c
Expiration
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN HALL
SOUTHOLD, NY 11971
TEL: (631) 765-1802
FAX: (631) 765-9502
www. northfork.net/Southold/
/
cF ,20 ,~_
BUILD1NG PERMIT APPLICATION CHECKLIST
Do you have or need the following, before applying?
Board of Health
3 sets of Building Plans
planning Board approval
Survey_
Check
Septic Form
N.Y.S.D.E.C.
Trustees
Contact:
Building Inspector
APPLICATION FOR BUILDING PERMIT
Date
INSTRUCTIONS
_, 20
a. This application MUST be completely filled in by typewriter or in ink and submitted to the Building Inspector with 3
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, if a corporation)
APpROYEDA$ NOTED
t. i Z '" - (Mailing address of applicant)
DATI;- . ,/z ?/~/ B.R~,....~,~ t~ :~"¥
State whether ,,l~_~_qw/l~t~~h~er, general contractor, electrician, plmnber or builder
NOTI~=Y BUILDING DEPARTMENT AT
765-1802 9 AM TO 4 PM FOR THE
1. FOUNDATION
Name of owner ~0ilttl~Olj~
Z 8OUGfl. ~Rl~lNa ~ PE~81~O (As on the t~ roll or latest deed)
If applicant is~ ~ si~ature of duly authorized officer
-~ ~.w'"' ~.~, ~., ~.O~-
THE flE~U~MENTa OF THE N,y.
Builders Lice~.CO~SIfl0C~lON
Other Trade's License No.
Location of land on which proposed work will be done:
House Number Street
Hamlet
County Tax M~ap No. 1000~7~~'-~'STti'°n~3'~' --£ [- c]_
Subdivision
(Name)
Block ~ ~)
Filed Map No.
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
5. If dwelling, number of dwelling units.
If garage, number of cars
Fee
Addition Alteration
Other Work ~f f'~9/~z)~t~-f_f~:r',~'c ~d,~c~--
(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
8. Dimensions of entire new construction: Front
Height Number of Stories
Rear .Depth
9. 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? 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 NO __
* 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 iopographical' data on survey.
STATE OF NEW YORK)
SS:
COUNTY OF )
being duly sworn, 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.
Swo~ ~m~;h:s~, ~, , 20. _C,*%
LYNDA M. BOHN
NQTARY PUBLIC, State of NeW York
No, 01 BO6020932
Qualified in Suffolk County_
TermExpires March 8, 20 ~
,// ,/~ig~ o f ~.'ppticant