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Home My WebLink About34581-ZFORM NO. 4 TOWN OF SOUTMOLD BUILDING DEPARTMENT office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No: Z-34581 Date: 05/15/09 T~IS CERTIFIES that the building DECK REPAIR Location of Property: 5500 ROCKY POINT RD EAST MARION (HOUSE NO.) (STREET) (HAMLET) County Tax Map No. 473889 Section 21 Block 3 Lot 1 Subdivision Filed Map No. __ Lot No. __ conforms substantially to the Application for Building Permit heretofore filed in this office dated MARCH 27, 2009 pursuant to which Building Permit No. 34581-Z dated APRIL 2, 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 DECK REPAIR TO AN EXISTING ONE FAMILY DWELLING AS APPLIED FOR. The certificate is issued to MICHAEL & PLOUM SKULKIDIS (OWNER) of the aforesaid building. SUFFOLK COLRFI~DEPARTME~TOFHEALTHAPPRO~-AL ~t-I-KIC~ CERTIFICA~ NO. PLNIW~ERS CE'RTIFICIATION DA'I'ED N/A N/A N/A /~/Ai o/ri~ed Signature Rev. 1/81 Form No. 6 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL 765-1802 APPLICATION FOR CERTIFICATE OF'OCCUPA/ This application must be filled in by typewriter or ink and submitted to the Building De A. Fornew building or new use: 1. Final survey of property with accurate location of all buildings, pr~porty lines, streets, and unusual natural or topographic features. Final Approval from Health Dept. of ~vator supply and sewerage-disposal (S-9 form). 3. Approval of electrical installation t~om Board of Fire Underwriters. 4. Sworn statement from plumber certifying that the solder used ia 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 enmpleted site plan reqmrements. For existing buildings (prior to April 9, 1957) non-conforming uses, or buildings and "pre-existing" land uses: 1. Accurate survey of property showing ali property lines, streets, building andunnsual natural or topographic £eatures. 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, Additious 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 2 $.25 4. Updated Certificate of Occupancy - $50.00 5. Temporary Certificate of Occupancy - Residential $15.00, Commercial $15.00 New Construction: Location of Property: ~-0 0 House No. Old or Pre-existing Building: (check one) Street Hamlet Owner or Owners of Property: i/~ { ~ ~ A- Suffolk County Tax Map No 1000, Section Subdivision Permit No. ~ ~ %"ff / Health Dept. Approval: Planning Board Approval: o 2-/ Block Filed Map. ~ DateofPermit. ~ - ~- o9 ' Applicant: Underwriters Approval: Lot ~ o I Lot: R~uest ~r: Tempo~ Certificate Fee Submitted: $ ~ ~, O ~ Final Certificate: (check one) 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. 34581 Z Date APRIL 2, 2009 Permission is hereby granted to: MICHAEL SKULIKIDIS 40-15 155TH STREET FLUSHING,NY 11358 for : REPAIR OF FRONT DECK AND INSTALLATION OF NEW RAILING AS APPLIED FOR. at premises located at County Tax Map No. 473889 Section 021 pursuant to application dated MARCH Building Inspector to expire on OCTOBER 5500 ROCKY POINT RD EAST MARION Block 0003 Lot No. 001 27, 2009 and approved by the 2, 2010. Fee $ 200.00 Authorized Signature ORIGINAL Rev. 5/8/02 TOWN OF SOUTHOLD BUILDING DEPT, 765-1802 INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] INSULATION [ ] FRAMING / STRAPPING [~]~t~AL [ ] FIREPLACE & CHIMNEY [ ] FIRE SAFETY INSPECTION [ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRATION REMARKS: COMMENTS ~,n ~S?ECT~ON m~ORT I DATE I FOUNDATION (1ST) FOUNDATION (2ND) PL~G ~SULATION PER N. Y. STATE ENERGY CODE ~D~ION~ CO~ENTS Town of Southold Erosion, Sedimentation & Storm-Water Run-off ASSESSMENT FORM PROPERTY' LOCATION: S.C.T.M. a: TNB FOLLOWING ACTIONS MAY REQUIRE THE SUBMISSION OF A STORM-WATER; GRADING; DRAINAGE AND EROSION CONTROL pLa_u C=KI,rlED BY A DESIGN PROFE~aI~NAL IN THE STATE OF NEW YOR~- Item Number:. (NOTE: A Check Mark [ ~') for each Otmstion is Required for a Complete Application) Yes Nc, 1 2 3 4 5 6 7 8 9 Will this Project Retain All Storm-Water Run-Off Generated by a Two (2") Inch Rainfall on Site? (This Item will include all mn-off oreated by site clearing and/or censtmction activities as well as all Site Improvements and the oermanent creation of impervious surfaces.) Does the Site Plan and/or Survey Show All Proposed Drainage Structures Indicating Size & Location? This Item shall include all Proposed Grade Changes and Slopes Controlling Surface WatetFIowi Will this Project Require any Land Filling, Grading or Excavation where ~here is a change to the Natural Existing Grade involving more than 200 Cubic Yards of Material within any Parcel? will this Appti~afion Require Land DisturblnffAcfivities Encompass ng an Area in Excess of Five Thousand (5,000) Square Feet of Ground Surface? Is there a Natural Water Coume Running through the Site? Is this Project within the Trustees jurisdiction or within One Hundred (100') feet of a Wetland or Beach? Will there be Site preparation on Existing Grade Slopes which Exceed Fifteen (15) feet of Veracal Rise to One Hundred (100'] of Horizontal Distance? Will Driveways, Pa.rking Areas or other Impervious Surfaces be Sloped to Direct Stsrm-Water Run~)ff into and/or in the direction of a Town right-of-way? 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 Floodp a n of any Watemourse? NOTE: If Any Answer to Questions One through Nine is Answered with a Check Mark in the Bex, a Storm.Water, Grading, Drainage & Erosion Control Plan is Required and Must be Submitted for Review Prior to Issuance of Any Building PermiU EXEMPTIONt Yes No Does this project meet the minimum standards for classitication as an Agricultural Project? Note: If You Answered Yes to this Question, a Storm-Water, Grading, Drathage & Erosion Control Plan is NOT Requiredl STATE; OF NEW YORK, ............................................................................... mg duly sworn, deposes and says that he/she is die applicant for Permit, And that he/she is the Owner and/or representative of the Owner of 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 Imowledge and belief; and that the work will be performed in the manner set forth in the application filed herewith. Sworn to before me this; Notary Public: .................................... TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, NY 11971 TEL: (631) 765-1802 FAX: (631) 765-9502 SoutholdTown.NnrthFork.net Disapproved ale Expiration MAR 27 2009 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.SD.E.C. Trustees Flood Permit Storm-Water Assessment Form Contact: Mail to: Building Inspector 'PLICATION FOR BUILDING PERMIT Date INSTRUCTIONS ,2007 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 tbr an addition six months. Thereat~ter, 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. OCCUPANCY OR USE IS UNLAWFUL WITHOUT CERTIFICATE w (Signature of applicant or name, Tfa corporation) (Mailing address of applicant) State wheth~)~l:Pl{~l~U~do~ee, agent, architect, engineer, general contractor, electrician, plumber or builder ALL CONSTRLiCTic,4 SHALL APPROVED AS NOTE,") MEET THE D~O~ ,RF~F~T~; OF THE DAT~ l/"~/g~ .. ~ .,~ ,/{~j COD~S OF NEW ~,.;~ ,r~ oT~TE. ~ N~eofowneroFpremises ~/~¢b ~oM ~/~/~EE:~u~'~u . ;v: b~ - (As on tho tax roll ~t ~e~j ~'.¢ ' ; "~': 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. RETAIN 51ORM WAtEH RUNOFF PURSUANI TO CHAPTER 236 OF 1Hk IOWN 60DE. 1. Location of land on which proposed work will be done: d-o ,40u, Awe House Number Street 765-1802 8AM TO ,;pM FOR THE FOLLOWING INSPECTIONS: t. FOUNDATION - TWO REQU!RED FOR POURED CONCRETE 2. ROUGH - FRAMING & PLUMB!NG 3. INSULATION 4. FINAL -OONSTRUOTION MUST BE OOMPLETE FOP O0 ALL OONSTRUCTION SHALL MEET THE REQUIREMENTS OF THE CODES OF NEW YORK STATE. NOT RESPONSIBLE FOR Hamlet County Tax Map No. 1000 Section Subdivision ~19~ Lot 0 a / Lot 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy .~¢ ~-~ ~7'~ .x/c-, ,q ~_ b. Intended use and occupancy_ 3. Nature of work (check which applicable): New Building Addition Alteration Repair ~ Removal Demolition Other Work 4. Estimated Cost ~'~ o . o o 5. If dwelling, number of dwelling units If garage, number of cars 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. 9. Size of lot: Front 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 o~,~?ies Dimensions of entire new construction: Front Rear t *Depth Height Number of Stories / ~ Rear / ¢ Depth 10. Date of Purchase Name of Former Owner 1 l. 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 ¢:~ A ¢o,q /q v~. 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. 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 -~-'¢> t-{ ~ '"~I~-A '¢ ~.- o % being duly sworn, deposes and says that (s)he is the applicant (Name of individual signing contract) above named, (S)He is the /3t 6 ~.~J 7' (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 to before me this ~,~'~l'l'x dayof (~ 2oC)q ~ Not~-Publie ~~,. ~ Signature of Applicant