HomeMy WebLinkAbout35193-ZFORM NO. 4
TOWN OF SOUTHOLD
BUILDING DEP~LRTMENT
office of the Building Inspector
Town Hall
Southold, N.Y.
CERTIFICATE OF OCCUPANCY
NO: Z-34198
Rte: 02/17/10
THIS c~aTIFIES that the building SWIMMING POOL
Location of Property: 1090 CIRCLE DR
(HOUSE NO.) (STREET)
County Tax ~4ap No. 473889 Section 21 Block 3
Subdivision
Filed ~4ap NO. __ Lot No. __
EAST MARION
Lot 11
( HAMLET )
conforms substantially to the Application for Building Permit heretofore
filed in this office dated DECEMBER 3, 2009 pursuant to which
~ilding ~I~nit No. 35193-Z dated DECEMBER 3, 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 IN GROUND SWIMMING POOL WITH FENCE TO CODE AS APPLIED FOR.
The certificate is issued to KALLIOPE MENAKIS
( OWNER )
of the aforesaid building.
S~FOI~K CO[~qTYDEPAR~TOF~A~THAPPRO~FAL N/A
~at-rKIC~ CERTIFICATE NO. N 826179 08/11/87
PLIERS CERTIFICATION DA'rmu N/A
+/~t~r l~Z ~/e~S i gna t u r e
Rev. 1/81
Form No. 6
TOWN OF SOUTHOLD
BUILDING DEPARTMENT --
TOWN HALL
765-1802 --
APPLICATION FOR CERTIFICATE OF OCCUPANCY
T~i~app~icati~nmust~e~inb~typ~riter~inkan~submitte~t~t~eB~i~ingDepartment~itIi~i >Il°wing: I'~' ' '
A. For new building or new use.
1. Final sup,ay of property with accurate location of all buildings, property lines, streets, and u~l~sut [ natal orl~'~
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 unusual natural or topographic
features.
2. A properly completed appIication and consent to inspect signed by the applicant. Ifa Certificate of Occupancy is
denied, the Building Inspector shall state the reasons therefor in writing to the applicant.
C. Fees I. 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:
Location of Property:
OwnerorOwnersoferoperty: l attio,
Suffolk County Tax Map No 1000, Section ~l~OO
Old or Pre-existing Building:
House No. Street
Date. i0 ~0¥t4~.~ S010
(check one)
Hamlet
Block Q,[ Lot ~ · [[
Subdivision
Permit No. ?~__ Date of Permit.
Health Dept. Approval:
Filed Map. Lot:
Applicant: ~'~t~[ ~e~, ~g~t-~6~
Underwriters Approval:
Planning Board Approval:
Request for: Temporary Certificate
Fee Submitted: $ ~l~,l~
Final Certificate:_/
(check one)
App~hnt signature
THE NEW YORK BOARD OF FIRE UNDERWRITERS
August 3, 1987 andfoundtobelnco.,plloncewlththerequireme.~,ofthls~rd.
fiXTURE FIXTURES
OTHER APPARATUS:
RANGES COOKING DECKS OVENS DISH WASHERS
SI~CIAL REC'PT, TIME CLOCKS TRANsRELL~UNIT HEATER~ MULTI-O~fT~T
SYSTEMS
1 40
S E R V I C E
EXHAUST FANS
DIMMERS
1-G.F.C.I.
*(~) THIS CERTIFICATE COVERS COMPLIANCE AT THE DATE OF
INSPECTION ONLY. BECAUSE OF UNUSUAL ENVIRONMENTS IT IS ADVISABLE TO HAVE
FREQUENT TEST/AND OR REPAIRS MADE BY A QUALIFIED PERSON.
Famous Electric
18 Graham Rd.
Hampton Bays, N.Y.
11946 Iic.~2347E
This certificate must not be altered in any manner; return to the office of the Board if incorrect. Inspectors may be identified by their credentials.
COPY FOR BUILDING DEPARTMENT. THIS COPY OF CERTIFICATE MUST NOT BE ALTERED IN ANY MANNER.
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)
PER~IT NO. 35193 Z
Date DECEMBER 3, 2009
Permission is hereby granted to:
for :
KALLIOPE & DEMOS MENAKIS
20-50 36TH ST
ASTORIA,NY 11105
CONSTRUCT AN IN-GROUND SWIMMING POOL W/FENCE AS APPLIED FOR.
THIS PERMIT REPLACES EXPIRED BP # 16154
at premises located at
County Tax Map No. 473889 Section 021
pursuant to application dated DECEMBER
Building Inspector to expire on JUNE
1090 CIRCLE DR
EAST MARION
Block 0003 Lot NO. 011
3, 2009 and approved by the
3, 2011.
Fee $ 250.00
Authorized Signature
ORIGINAL
Rev. 5/8/02
TOWN OF SOUTHOLD BUILDING DEPT.
765-1802
INSPECTION
[ ] FOUNDATION 1ST
[ ] ROUGH PLBG.
] FOUNDATION 2ND
] FRAMING / STRAPPING
[ ] ~I.ATION
[/..~FI NAL
[ ] FIREPLACE & CHIMNEY [ ] FIRE SAI-,-, 'l' INSPECTION
[ ] FIRE RESISTAWr CONSTRUCTION [ ] FIRE RESISTANT PENETRATION
DATE
INSPECTOR
TO~N 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)
Permission is hereby granted to:
.......~...~....~.).~ ................................................
..6...~.~......~.......~.. ~,...~....~.,....u..~.~ .
,o ~~....~...,~,~...~.~..~.~.....~...~....,~
at premises located at ..C~..~.~).....~.O..~
~/.~....~.~~ ..~~ .............................................................................
County Tax Map No. 1000 Section .....C~....,,~.,,.J. ......... Block ......(~...~. ...... Lot No.
pursuant to application dated ........ ...~...~..~,,~?.....: ........... , 19.~..,~.,.., and approved by the
Building Inspector.
Fee $.~.. .............
Rev. 6/30/80
TOWN OF SOUTHOLD BUILDING DEPT.
765-1802
INSPECTION
[ ] FOUNDATION 1ST [ ] ROUGH PLBG.
[ ] FOUNDATION 2ND [ ] INflATION
[ ] FRAMING / STRAPPING [,~J' FINAL
[ ] FIREPLACE & CHIMNEY [ ] FIRE SAFETY INSPECTION
[ ] RRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRATION
REMARKS:
DATE
INSPECTOR
UNDATION (1st)
UNDATION (2nd)
UGH FRAME &
PLUMBING
SULATION PER N. Y.
STATE ENERGY
CODE
FINAL
Ii,
' '1
- ADDITIONA'L COMMENTS:
HAP OF P 2OPEF2_TY
· 1.! AQU'AVIEW AVENUE
.......... ,,- ,- 34.0 ~LF..',/ '~T'
NEW VC~K
SUFFOLK CO. HEALTH O[PT,
H.S, NO, i1-~:O-~)'2 "
ST NT Oir INT NT
TI4~ WATLrR SUIq~Y AND SEWAGE DISliOSAL
SYSTEMS FOR THIS RESIDEK[ WILL
CONF(:)~M TO THI STANDARD4J OF THE
~IFleOLK CO. DEPT. OF HEALTH SERVICES.
APIILICANT
· UFPOt. K COUNTy GEPT, OF HEALTI,
SERVICES -- FOR APPROVAL OF
CON~TR UCT ION ONLY
N. S. RI~Ie. NO,.
AIq~OVED:
SUFFOt. K CO. TAX MAP DESIGNATION:
DIST. eeCT. II.OCK PC:L.
IQOO ~.1 :~ I I
OWNERS ADDRESS:
· ASrO r~ ~ ^ ~_¥_.y._U Lq5
O~ED: L. 7. P.
~J~AL
'FORM NO. 1
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN HALL
SOUTHOLD, N.Y. 11971
, TEL.: 765-1803,, · '
/
Examined
Approved..~...~.,,~.....~.¢]_L~., 19~.~.. Permit No.. ~.(-' I ~--~"~.. .....
Disapproved a/c .......................
(Building Inspector)
APPLICATION FOR BUILDING PERMIT
BOARD OF HEALTH .
c~ECR ~
SEPTIC FORM.......'" ...... :
NOTIFY
CALL ~:'(ff'~" .....
MAIL TO:
BLDG. DEl'T.
TOWN OF SOUTHOLD .....
Date ................... 19...
INSTRUCTIONS
a. Tins application must be completely filled in by Wpewriter 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 giving a detailed description of layout of property must be drawn on the diagram which is part of tins appli-
cation.
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 issued a Building Permit to the applicant. Such 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 whatever until a Certificate of Occupancy
shall have been granted by the Building Inspector.
APPLICATION IS HEREBY MADE to the Building Department for the issuance of a Building Permit pumuant to the
Building Zone Ordinance of the Town of Southold, Suffolk CounW, 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.
..... ........................
(Sign~,~re of applicant, or name, if a corporation)
~. o. $~q ~mC:~.o~ ~_ .c9...~: .....
~lailing address of applicant)
State whether applicant is owner, lessee, agent, architect, en~neer, general contractor, electrician, plumber or builder·
· .~ .~.: .,-. 9.~.a,. .................................................................................
Name of owner of premises . .~..~..rD 9.~....cD. ?..~..h?~.~..~., ~..~. q. :.~. 9...3.fo.'r..~.5. g'. 1' · '~r~'~ 'rq" ~ 'h3'"~[ ........
(as on the tax roll or latest deed) I I I ~,~'
If applicant is a corporation, signature of duly authorized officer.
~J (Name and title of corporate officer)
ALL CONTRACTOR'S MUST BE SUFFOLK COUNTY LICIgNSgD
Builder's License No ..........................
Plumber's License No .........................
Electrician's License No .......................
Other Trade's License No ......................
1. Location of land on which proposed work will be done ..................................................
....q¢.O ........ .~..q ~ .n..uy~..,~....q .o~. ............... .~.q..s.-[.,, .c~..~73. ~..~.~. ....... : .............
House Number Street Hamlet
County Tax Map No. 1000 Section .... O~[ .......... Block ...... ~_~ .......... Lot .... [] .............
Subdivision ..................................... Filed Map No ............... Lot ...............
(Name)
2. State existing use and occupancy of premises and intended use and occupancy of proposed construction:
a. Existing use and occupancy ....... .~..u~..~.~..~.\~. ~ ...............................................
b. Intended u~'-eeeupam;y ..... ~b0 3..cB.. ~ ) .~...c~... ~ 00 ~,,.. ..... i...: .......................
3. Nature of work (check which applicable): New Building .....' ..... Addition .......... Alterati~.~ ..........
Repair .............. Removal .............. Demolition .............. Other Work.. ~,".~ 0-.'-~ .......
,/~~,/~ _-- (Description)
4. Estimated Cost... ~/~a.0.o?. ........................... Fee ......................................
(to be paid on filing this application)
5. If dwelling, number of dwelling units....~..~ ........ Number of dwelling units on each floor ................
If garage, number of cars ........................................................................
6. If business, commercial or mixed occupancy, specify nature and extent of each type of use ...~[gl .............
7. Dimensions of existing structures, if any: Front...P3 ~ .& ....... Rear .............. Depth ...............
Height ............... Number of Stories ........................................................
Dimensions 'of same structure with alterations or additions: Front ................. Rear ..................
Depth ...7-~e~i .~.~ ~ ~ ........ Height ...................... Number of Stories ......................
-8. Dimensions o~ ~hfii'e new construction: Front .......... ..... Rear ............... Depth ...............
Height ............... Number of Stories ..... o2.~., x..%..c~.....~. 3.Q ?..%~x:p. .............................
9. Size of lot: Front ...................... Rear ...................... Depth ......................
10. Date of Purchase ....... (~ .~. ~ 9/7..~..~. ......... 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: .~.fX3:~) .........................
13. Will lot be regraded ............................ Will excess fill be removed from premises: ~ No'
14. Name of Owner of premises .................... Address ................... Phone No ................
Name of Architect .... .~. ~..c9.~ ................ Address
Name of Contractor %,,~rn f~..~,rl..= I~ ox'. , ~'~0c,.. Address ~,~.i ~.'L~i i'~ ~.~i iiiii Phone No ....
................... Phone No. ~.~. ~.4 ~.' ~i~.' ~.'
15. Is this property located within 300 feet of a tidal wetland9. *Yes ..... No .
*If yes, Southold Town Trustees Permit maybe required.
PLO~ DIAGRA~
Locate clearly and distinctly all buildings, whether existing or proposed, and. indicate all set-back dimensions from
property lines. Give street and block number or description according to deed, and show street names and indicate whether
interior or corner lot.
STATE OF NEWoYO~.~(, . . S S
COUNTY OF. ~... '
..... .,...~...~....q.~.t)~,~'l-lt:t..~. ~. ~.T.t.'l..~. ~ ............... being duly sworn, deposes and says that he is the applicant
(Name of individual signing contract)
above named.
He is the ................. .Q .Q ~.yi ~-,~ ~'-fD ~ ....................................................
(Contractor, agent, corporate officer, etc.)
of said owner or ownem, ~d is duly authorized to perfom or have perfo~ed ~e said work and to m~e ~d file t~s
application; that all statements cont~ned ~ this application are true to the best of his ~owledge and belief; and that the
work will be perfomed in the m~ner set forth ~ the application filed therewith.
Sworn to before me this ~~~
..... ~ ............. dayof.~ ............ ,19~.~~~~~_. ~
...........
~. ~ (Si~ature of applicant)
_ ~:~26~,S~k~u~) ~
le~ ~ires ~r 31, 19,,~ ~
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