HomeMy WebLinkAbout34800-ZTown of Southold Annex
54375 Main Road
Southold, New York 11971
7/13/2011
CERTIFICATE OF OCCUPANCY
No: 35060
Date: 7/13/2011
Tills CERTIFIES that the building OTHER
Location of Property: 1335 Sound Beach Dr, Mattituck,
SCTM #: 473889 Sec/BlockfLot: 106.-1-29
Subdivision: Filed Map No.
conlbrms substantially to the Application for Building Permit heretolbre
6/11/2009 pursuant to which Building Permit No.
Lot No.
filed in this officed dated
34800 dated 6/17/2009
was issued, and conforms to all of the rcquirements of the applicable provisions of the law. The occupancy for
which this certificate is issued is:
fence (to code) tbr an existing swimming pool as applied lbr.
The certificate is issued to
Pavlou, Andreas & Pavlou, Theophanis
(OWNER)
of thc aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEAl. TH APPROVAL
EI,ECTRICAL CERTIFICATE NO.
PLUMBERS CERTIFICATION DATED
FORM NO. 3
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Town Hall
Southold, N.Y.
(THIS
BUILDING PERMIT
PERMIT MUST BE KEPT ON THE PREMISES UNTIL
COMPLETION OF THE WORK AUTHORIZED)
FULL
PERMIT NO. 34800 Z
Date JUNE 17, 2009
Permission is hereby granted to:
ANDREAS PAVLOU
164-16 14TH ROAD
WHITESTONE,NY 11357
for :
FENCE SURROUNDING A/q INGROUND SWIMMING POOL AS APPLIED FOR,
FENCED TO CODE
at premises located at 1335 SOUND BEACH DR
County Tax Map NO. 473889 Section 106 Block
pursuant to application dated JUNE 11, 2009
Building Inspector to expire on DECEMBER 17,
MATTITUCK
0001 Lot No. 029
and approved by the
2010.
Fee $ 100.00
Authorized S i-~n~ t u r e
COPY
Rev. 5/8/02
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 submitted to the Building Department with the following:
A. For new building or new use: 1. Final survey 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-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/I0 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 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 $50.00, Additions to dwelling $50.00, Alterations to dwelling $50.00,
Swimming pool $50.00, Accessory building $50.00, Additions to accessory building $50.00, Businesses $50.00.
2. Certificate of Occupancy on Pre-existing Building - $100.00
3. Copy of Cmlificate of Occupancy - $.25
Updated Cellificate of Occupancy - $50.00
5. Temporary Certificate of Occupancy - Residential $15.00, Commercial $15.00
Date.
New Constrnction:
Location of Property:
Old or Pre-existing Building:
(check one)
House No. Street Hamlet
Owner or Owners of Property:,~-,'~ o~Z. ( ~ ¢- ~ 2~ ('o ~.,~"W/>¥v 7'/.,?.., LC4~'~]~ ~ ~'~: //~] v'~c~ ~
Suffolk County Tax Map No 1000, Section }~ ~ Lot ~'
Subdivision Lot:
Pe~it No. 5'[ ~", '[ Date of Pe~it.
Health Dept. Approval:
Block
Filed Map.
Applicant:
Underwritem Approval:
Planning Board Approval:
Request for: Temporary Certificate
Fee Submitted: $ _.'~5_ LW~, ~ ¢: tq,
Final Certificate:
(check one
Applicant Sigoatmc
TOWN OF SOUTHOLD BUILDING DEPT.
765-1802
INSPECTION
[ ]FOUNDATION 1ST [ ] ROUGH PLBG.
[ ]FOUNDATION 2ND [ ] INSULATION
[ ]FRAMING/STRAPPING [~'~FINAL
[ ] FIREPLACE & CHIMNEY [ ] FIRE SAFETY INSPECTION
[ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRATION
[ ] ELECTRICAL (ROUGH) [ ] ELECTRICAL (FINAL)
REMARKS:
FIELD INSPECTION REPORT I DATE I COMMENTS
FOUNDATION (1ST)
FO~ATION (2ND)
ROUGH F~G &
PL~G
~S~ATION PER N. Y.
STATE ENERGY CODE
, / // ~ ~. ~?~
~DITION~ CO~ENTS
TOWN (~F SOETHOLD
TOWN HA+,-a/I-
SOUTHOL ~['~ 11971
TEL:(631) ~80~ 1 I 2~
FAX: (631) 765]~502
SoutholdT¢ a'n.Nm
TOWN OF SOUTHOLD
I xpirafion /
JOt 11
BLO& DEPT.
1'OWN DF $OUTHOI_D
BLJILDING PERMIT APPLICATION CHECKLIST
Do you have or need the following, before applyiug~
Board of Heahh
4 sets of Building Plans
Planning Board approval
Survey
Check ~:~/~'~ ·
Septic Form
N.¥.S.D.E.C.
Frustees
Flood Permit
Storm-Water .&ssessmcnt Form
Mail to:
' Building Inspector
APPLICATION FOR BUILDING PERMIT
Date
INSTRUCTIONS
a. I ms application MUST be completely filled in by typewriter or in ink and submitted to the Building luspector with 4
sets ol'p]ans, accurate plot plan to scale. Fee according to schedule.
b. Plot plan showing location of lot and of bnildings on premises, relationship to adjoining premises or public streets or
areas, and waterways.
c. The work covered by riffs application may nol bo colnmenced belbre issuauce of Building Permit.
d. Upon approval of this application, the Building inspector will issue a Building Pennit to the applicant. Such a permit
shall be kept on the premises available fbr inspection throughout the work.
c. No building shall be occupied or used in whole or m part tbr any purpose what so ever until the Building Inspector
issues a Cenil'icate of Occupancy.
fi Every building permit shall expire if the work authorized has not commenced within 12 months after the date of
issaance or has not been completed within 18 months thom such date. If no ×oning amendments or other regulations affecting thc
property have been enacted m the interim, the Building Inspector may authorize, in writing, the extension of the permit for an
additiou six months. Thereafter, a new perlnit shall bc required.
APPLICATION IS HEREBY MADE tu the Building DcpaKunent for the issuance cfa Building Pel-mit pLu'suant to the
Building Zone Ordinance of thc Town of Soulhold, Suftblk County. New York, and other applicable l,aws, Drdmances or
Regulations, For the construction of buiIdiugs, additions, or alterations or for remox al or demoIition as herein described. Thc
upplicant agrees lo comply with all applicable laws, ordinances, building code, housing code, and regulations, and to admit
authnri×ed inspectors on premises all(] in building t'or necessary inspectioas.
(Signature ofapplica 1 or name. ifa corporation)
MEET
~r - + ,'~r-' ,--,,~- ~ (MaduvzaddrcssOtapplicaut)
State x(q~b~f apphcant ~s 6M~vlessee, agent, arctfftedt, engineer, general contractor, electrician, plumber or builder
Name ofovcner of premises Oo'~,e ~,q %
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 Tradc's License No.
Location of land on which proposed work will be done:
Duse Number Street '
County Tax Map No. 1000 Section
Subdivision
?O'JY, DATIc;i . :;
~ "" L! PLUk4E,
DE,.,ot',I OR , c'~-~-¢ ,,..., ,-:,r
Hamlet
Block [
Filed Map No.
Lot
Lot
Statea. cxistingExisting use and occupancyUSe and occupancy of premisess~./~altd intendeds/}ppd occupancy of proposed construction:
b. Intendeduseandoccupancy__ A)O/.(JT~i/i..~.(? ffd("a~q(?~c- ~
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
Addition Alteration
Other Work
Fee
(Description)
(To be paid on filing this application)
Number of dwelling units on each floor
6. Il'business, COlmncrcial or mixed occupancy, specit}' nature and extent of each type of use.
7. Dimensions of existing structures, it'any: Front
Height Number of Stories
Real'
Depth _
Dimensions of same structure with alterations or additions: Front
Depth Height. Number of Stories
8. Dimensions of entire new construction: Front Rear
HeigN Number of Stories
Rear
Depth
9. Size oflnt: Front Rear .Depth
1 0. Date of Purchase
Name of Former Oxvner
1 I. Zonc 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 t'rom prelnises? YES NO
14J(NamesofOwnerofpremises.4,'~s&% P~qv~.~ Address ~8~0 C~,vve,*z :~.¢ Phone No. ((.: *j
Name of Architect Address /4,*Tvm4ahone No
Name of Contractor Address Phone No.
lq,5 a. Is this property within 100 feet oE a tidal v, etland or a fi'eshwater wetland? *YES __ NO * IF YES. SOUTHOLD TOWN TRUSTEES & D.E.C. PERMITS MAY BE REQUIRED.
b. Is this property within 300 fcct ot'a tidal wetland? * YES NO
* IF YES, D.E.C. PERMITS MAY BE REQUIRED.
16. * 'ovidc survey, to scale, with accurate foundation plan and distances to property lines.
17. If elevation at any point on property is at l0 t'cet 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 N~-~V Y~5~,~).
COUNTY Oli_) [/,¢?/~
'h"c.~[ -~ ~ ~ Ob y3 V ~ ~ ~ beingdulyswom, deposesandsaysthat(s)heistheapplicant
(Name of individual signing contract) above named,
CS)He is lt~e
(Contractor, Agent, Corporate Officer, ccc.)
of said owner or owners, and is duly attthorized to pcrtbrm or have perlbnned the said work and to lnake and file this application;
that all statements comained in this application arc true to thc best of his knowledge and belief; and thal the work will be
performed ill thc maimer sc/ lbl'tll ia the application filed thercv~ith.
Town Hall Annex
54:;75 Main Road
PO. Box 1179
S~mlhold. New York 11971-0959
July 1, 2011
BUILDING DEPARTMENT
TOWN OF fiOUTHOLD
Telephone(631)765 181)2
Fax {631} 765
Andreas Pavlou
164-16 14th Rd
Whitestone, NY 11357
Re: 1335 Sound Beach Dr, Mattituck
TWO WHOM IT MAY CONCERN:
The Following Items Are Needed To Complete Your Certificate of Occupancy:
Application for Certificate of Occupancy. (Enclosed)
Electrical Underwriters Certificate.
//A fee of 50.00.
__ Final Health Department Approval.
Plumbers Solder Certificate. (All permits involving plumbing after 4/1/84)
__ Trustees Certificate of Compliance. (Town Trustees #765~1892)
__ Final Planning Board Approval.
__ Final Fire Inspection from Fire Marshall.
Final Landmark Preservation approval.
BUILDING PERMIT: 34800- Pool Fence
0
SUFFOLK CO. HEALTH OEPT, APPROVAL
STATEMENT OF INTENT
THE WATER SUPPLY AND SEWAGE DISPOSAL
SYSTEMS FOR THIS RESIDENCE WILL
CONFORM TO THE STANDARDS OF THE
SUFFOLK CO. DEPT. OF HEALTH SERVICES.
(si
APPLICANT
SUFFOLK COUNTY DEPT. OF HEALTH
SERVICES -- FOR APPROVAL OF
CONSTRUCTION ONLY
DATE:
H. S. REF. NO.: Il:D- E~C)- ~1
APPROVED:
SUFFOLK CO. TAX MAP DESIGNATION:
DIST, SECT. BLOCK laCL.
OWNE*~S ADDRE~: -"
OI~FD: L.