HomeMy WebLinkAbout28504-ZFORM NO. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Office of the Building Inspector
Town Hall
Southold, N.Y.
CERTIFICATE OF OCCUPANCY
No: Z-28969
Date: 10/08/02
THIS CERTIFIES that the building ALTERATION
Location of Property: 52325 CR 48 UNIT 20 SOUTHOLD
(HOUSE NO.) (STREET) (HAMLET)
County Tax Map No. 473889 Section 135.1 Block 1 Lot 20
Subdivision Filed Map No. __ Lot No.
conforms substantially to the Application for Building Permit heretofore
filed in this office dated JUNE 25, 2002 pursuant to which
Building Perndt No. 28504-Z dated JUNE 25, 2002
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 INSTALLATION OF A SINK IN AN EXISTING CONDOMINIUM {UNIT 20) AS APPLIED
FOR.
The certificate is issued to DEMETRIOU DEMPTRIOS
( OWNER )
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL
ELECTRICAL CERTIFICATE NO.
PLUMBERS CERTIFICATION D~rw~3 10/01/02
N/A
N/A
WALTER MARCZEWSKI
Rev. 1/81
FORM NO. 3
TOWN OF $OUTHOLD
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. 28504 Z Date JUNE 25, 2002
Permission is hereby granted to:
DEMETRIOU DEMPTRIOS
42-11 25TH AVENUE
ASTORIA,NY 11103
for :
INSTALLATION OF A NEW SINK AS APPLIED FOR
at premises located at 52325 CR 48 UNIT 20 SOUTHOLD
County Tax Map No. 473889 Section 135.001 Block 0001 Lot No. 020
pursuant to application dated JUNE 25, 2002 and approved by the
Building Inspector to expire on DECEMBER 25, 2003.
Rev. 5/8/02
COPY
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:
Ao
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 2/10 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. Accurate survey of property showh~g 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.
Co
New Construction: ~ Old or Pre-existing Building:
LocationofProperty: (~l:~ 14-~ (._)(h',4 ~.~CO
' ouse No. '
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- $25.00
$50.00
4.5.UpdatedTemporaryCertificatecertificateOf OccupanCYof Occupancy- - Residential $15.00, Commercial $15.00/ /t~
,/
Date. '~/~
_ (check one)
Street
Owner or Owners ofPropert~ ,~.A/~O~ ,~Lc. [ot )
Suffolk County Tax Map No 1000, Section 1~'''~ · /
Subdivision
Permit No.~ ~-~(~'- Date of Permit.
Hamlet
Block 1 Lot ~:~ ~
Filed Map. Lot:
Health Dept. Approval:
Planning Board Approval:
Request for: Temporary Certificate
Fee Submitted: $ ~'~
Underwriters Approval:
Final Certificate:
(check one)
- Xppll~a~ Signature
' '~ D
ToWn Hall, 53095 Main Road
P.O. Box 1179
Southold, New York 11971-0959
Fax (631) 765-1823
Telephone (631) 765-1802
BUILDING DEPARTMENT
TOVqN OF SOUTHOLD
CERTIFICATION
Date:
Building Permit No. ~5~.~ ¢ _7.
owner: J /4 '7't lOv bO4E T -IO
(please print)
Plumber: ~.//,,,~./~-/~'/Z /t"2 q, ~'~ (please print)
I certify that the solder used in the water supply system contains less than 2/10 of 1%
lead.
Sworn to before me this
dayof {~ .~_~. ,
Notary Public, County
(Plumbers Sigrl~ure)
UNDA J- COOPER
63, Suffolk County
No. ~.8225_ ~l~r $1, -~ z~,o~
TOWN OF $OUTHOLD PROPERTY RECORD CARD
OWNER I STrEeT ~ C~ .~ 5 ' W~.LA~
J DIST. J COUNTY TAX MAP NO.
LAN D IMP. TOTAL DATE REMARKS:
.. -: ---.- _ ~_ S
l
Demetrios Demetriou
42-11 25th Ave
Astoria, NY 11103
March 10,2002
To: Board Of Managers North Fork Beach Condominiums
As required by the North Fork Beach Condominium Declaration plan, I am
requesting permission to install a sink in unit # 20.
I am applying for a town permit, and will be hiring a licensed plumber who
will comply with all town code and specifications for the completion of the
job. I will pay for any inspection or permits needed.
Upon completion of the job I will provide the board of managers all
necessary permits and paperwork.
Thank You,
emetrios Demetnou
Presiden,s .Approval
765-1802
BUILDING DEPT.
INSPECTION
[ ] FOUNDATION I ST
[ ] FOUNDATION 2ND
[ ] FRAMING
[ ] FIREPLACE & CHIMNEY
[ ] ROUGH PLBG.
[ ] INSULATION
[ ~FINAL
REMARKS:___~~ ~- ~.
DATE ~;~ 7/S"-//~
FO~DATION (1ST)
FO~ATION (2~)
ROUGH F~G &
PL~G
~SU~TION PER N. Y.
STA~ E~RGY CODE
TOWN OF SOUTHOLD
BUILDIng; D~PARTMENT
TOWN HALL
SOUTHOLD, NY 11971
TEL: 765-1802
Examined I~' ,20__
Approved . ~ _, 20__
Disapproved a/c
~ JUN 2
BUILDING PERMIT APPLICATION CHECKLIST
PERMIT NO. ~
Do you have or need the following, before applying ?
Board of Health
3 sets of Building Plans
Survey
Check
Septic Form
N.Y,S.D.E.C.
Trustees
Contact:
Mail to:
Phone:
APPLICATION FOR BUILDING PERMIT
Date ~, 20
INSTRUCTIONS
a. This application MUST be completely filled in by typewriter or in ink and submitted to the Build~ng 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 a Certificate of Occupancy
is issued by the Building Inspector.
APPLICATION IS HEREBY MADE to the Building ~epartment for the issuance ora 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 ~ .,~::L,~.,....~ ,,~.~..,-,
USE IS UNLAWPoT (Si~re of applicant or name, ifa corporation)
WITHOUT CERTIFIC~ _//
APPROVED AS IIOTB) OF OCCUPANCY ' (%ai~g address of applicant)
architect, engineer, general contractor, electrician, plumber or builder
BUll.DING DEPARTMENT AT
FOLLOWING INSPECTIONS:
Z,-~,n v~un~ROUGH - FRAMING & PLUMBINt~ (as on the tax roll or latest deed)
a. INSULATION
If appli~l~l~l~ co~0~81~RU~l$ffi~r~ly authorized officer
~THE N,Y.
STATE CONSTRUCTION & ENERGY
°ES,O. o.
Plumbers L~cense
Electricians License No.
Other Tradds License No.
Location of land on which proposed work will be done:
6 q g 33v& la/, /
House Number Street Hamlet '
County Tax Map No. 1000 Section t/Ta83v~ Block Lot
Subdivision Filed Map No. Lot
(Name)
2. State exi§ting use and occupancy of premises and intended use and occupancy of proposed constructio,n:
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 z/ag,
If garage, number of cars
Addition
Other Work
Fee
Alteration
(Description)
(to be paid on filing this application)
Number of dwelling units on 'each floor/~//=be o~o
/
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
Rear
Depth Height
8. Dimensions of entire new construction: Front
Height Number of Stories
9. Size of lot: Front Rear
Number of Stories
Rear
Depth
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:
13. Will lot be re-graded
14. Names of Owner of premises ~m~-7',q/a5 Address
Name of Architect Address
Name of Contractor ~Cee~.l~CJr ~'! 01~_~o~.~ Address
15. Is this property within 100 feet of a tidal wetland? *YES
Will excess fill be removed from premises:
NO
YES NO
9/a' -aa'/~ 70---
Signature of Applicant
Sworn to before me this / _
'/'?A day°f /O/q'~ /%¢
Notary Public.~,~:;>' ~
MARIA GEOR.,~IOU
I~ &~-485095
Notary Pubf,c St ~te of New York
Qualified i ;;eeh$ Cour~ty
~mmissio. Exp,,es Feb. 17. ~00
· IF YES, SOUTHOLD TOWN TRUSTEES PERMITS MAY BE REQUIRED
16. Provide survey; to scale, with accurate foundation plan and distances to proper~'J~,t
l 7. If elevation at any point on property is at 10 feet or omow, must provme topograpmcal data on sUrVey.
STATE OF NEW YORK)
being duly sworn deposeE/a~S~ (s)he ts ,t~e.pplic~t
(Name of indi~dual si~ng contract) above rimed,
(S)He is the ¢~W¢
' (Contractor, Agent, Co.orate Officer, etc.)
ot said owner or owners, ~d is duly aumohzed to perfom or have peffo~ed the s~id,wor~ ~d't~ m~e and fildths application;
that all statements contained in t~s application are tree to the best of his ~owledg~ a~d.~lie~; and thru the W°r~'wfll be
perfo~ned in the m~er set fo~h in the application filed therewith.