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HomeMy WebLinkAbout22239-z FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No Z-23240 Date SEPTEMBER 20, 1994 THIS CERTIFIES that the building ADDITION Location of Property 210 BENNET ROAD EXT., GREENPORT, NEW YORK House No. Street Hamlet County Tax Map No. 1000 Section 40 Block 5 Lot 1.2 Subdivision Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated JULY 19, 1994 pursuant to which Building Permit No. 22239-Z dated AUGUST 8, 1994 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 PORCH ADDITION TO EXISTING ONE FAMILY DWELLING AS APPLIED FOR The certificate is issued to CHRIS & LORRAINE STAVROPOLIS (owners) ) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A UNDERWRITERS CERTIFICATE NO. N-325383 - AUGUST 30,' 1994 PLUMBERS CERTIFICATION DATED N/A Building Inspector Rev. 1/81 t 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) N® 22239 Z Date........... Q 04c-..� ..... 19.....V.. Permission Is hereby gr ted to: OZIS ...... ..a... � ....a P3 ......................... to ....eow..S'7�./ .. ,. ...... .4...... ` .ove..C.�.... .A.�.�/..,�1��....... ' ...... .......... ..`7 i ............. l�L�.�'........ ...7` ......................... //".-0V'k7...........47's........ vr ..............................................................................................................rf-- ..0.101,.. ......................... ................................................................. ................................r............ . ............ ,//�� at premises located at.......... � � ........ ...... ....,/,\, /• ................ .................................................... ..... �.....��..... '.e��. ,. .Z..X..:.y.............................. County Tax Map No. 1000 Section ........ ... ....... Block.... ............ Lot No. .®...2............ pursuant to application dated ..............Y. .. V........ ./'. , 19./. .j ..... and approved by the Building Inspector. Fee$.../c7 ..''?`.... . . ..................*?................... .......... .. 1 , Building Inspec Rev. 6/30/80 Form No. 6 T014N OF SOUTIIOLD �. BUILDING. DEPARTMENT 1994 TOWN HALL 765-1802. TOWlyO SOUTHOLD APPLICATION FOR.CERTIFICATE OF OCCUPANCY A. This application must be filled' in b t e buildypewring OR ink and submitted to the building Inspector with the following: for new building or new use: Final survey of ro P P y with accurate location of all buildings, property lines, streets, and unusual natural or topographic features. 2. Final Approval from Health Dept, of water s - is 3• Approval of electrical- installation from Board ofaFireewerage Underrwriterssal(S-9 form) . 4. Sworn statement from plumber certifying that the solder ed in system contains less than 2/10 of 1% lead. us S. Commercial building, industrial building, - and installations, a certificate of Code Cmpliancer from earchitectan 'sorllar engineerdings responsible for the building. 6. Submit Planning Board Approval of completed site plan requirements. ;• � For existing buildings �' gl� (prior to April 9, 1957) non-conforming uses, or buildings and preexistin land uses: 1. Accurate survey of property showing all property lines, streets, buildin and unusual natural or topographic features. g 2• A properly completed application and •a consent to inspect signed by the a pplicant. If a Certificate of Occupancy is denied, the Building Inspector shall' state the reasons -therefor in writing to the applicant. • Fees 1. Certificate of Occupancy - New dwellin g' $25.00, Additions to dwelling $25.00,' Alterations to dwellin g $25.00, .Swimming pool $25.00, Accessory building $25.00, Additions to accessory building $25.00. Businesses 2. Certificate of Occupancy on Pre_existin Building $50•00. 3• Copy of Certificate .of Occupancy 0 gea - $10 4. Updated Certificate of Occupancy _ $5.00 over 5 years - $10.00 $50.00 5. Temporary Certificate of Occupancy - Residential $15.00, Commercial $15.00 Date S"-%k : . �. � d. Construction. . . . . . . . Old Or Pre-existing Building. V. �,� ��p . xxn � cation of Property: . �a. . . .. . . .. . l7�;Ylr1OC�o .: .� jG`�1} (3� enG6�Ee� ONCL . • '•• House No. Street / } amlet aer or Owners of Property.. . �fi�•;�i-S:. �I1ti:is . . S��v,r0.�0�• . . . . . . . . . . . Inty Tax Map No 1000, Section. ... s •• • _ . •• • . . • . .. . . . . .Block. . . . .Lot. . t ' )d1viyion. . .CEI�:�(2 . . . . . . . . . . . . . . . . . . . . . . . . .. . . .. .. .. . .. . • .Filed Map. . . . . . . . . . . .Lot. . m i t No. ;l �3� .Date Of Permit. .gS � . . . . . .Ap �• plicant.P 1NOS . . zER 1th Dept. Approval. . . . . . � , }},�� • • . . . .Underwriters Approval. E;. 3� 3 g3 nning Board A [ PProval. . . . . . . . . .. . . . . . .. . . . . . -1cst for: Temporary Certificate. . . . Final Cert ,/.. icate. . . .. . Submitted: $. .°�,5; �� . . .. .. . ..... ... .. oA o ..o ... . . . . .. . . .. . . .. . ... .. ... . . . .. .. ...... Co PLICANT THE NEW YORK BOARD OF FIRE UNDERWRITERS PAGE 1 1001071 BUREAU OF ELECTRICITY F 85 JOHN STREET. NEW YORK, NEW YORK 10038 Date AUGUS!^. 30,1994 Application No.on file 06332394/9 r N 325383 THIS CERTIFIES THAT only the electrical equipment as described below and introduced by the applicant named on the above application number in the premises of Ck{RIS STAUROPOULOS, 210 B NNE`1'T ROAD, GREENPORT, N.Y. in the following location; ❑ Basement ❑ ist Ft. ❑ 2nd Fl. OUT Section Block Lot was examined on AUGUST 22,1994 and found to be in compliance with the National Electrical Code. FIXTURE RECEPTACLES SWITCHES FIXTURES RANGES COOKING DECKS OVENS DISH WASHERS EXHAUST FANS OUTLETS IN ANDESCENTI FLUORESCENT I OTHER AMT. I K.W. I AMT. K.W. AMT. K.W. I AMT. I K.W. AMT. H.P. 2 1 1 2 DRYERS FURNACE MOTORS FUTURE APPLIANCE FEEDERS SPECIAL REC'PT TIME CLOCKS BELL UNIT HEATERS MULTI-OUTLET DIMMERS SYSTEMS AMT. K.W. OIL H.P. GAS H.P. AMT. NO. A.W.G. AMT. AMP. AMT. AMPS. TRANS. AMT. H.P. NO.OF FEET AMT. WATTS SERVICE DISCONNECT NO.OF S E R V I C E AMT. AMP. TYPE METER �,4W .0 3W 3,0.3W 3,0'4W NO.OF CC.COND. A.W.G. NO.OF HI-LEG A•W G• NO.OF NEUTRALS A.W.G. EQUIP• PER.0' OF CC.COND. OF HI-LEG OF NEUTRAL OTHER APPARATUS: FORCIi-1 LBOX NTRACTOR LTC.-t578 , 11Y, 11971 GENERAL MANAGER Per tered 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. JA COMMENTS N - m eA )UNDATIOV ( 1 s t) _•t U11DAT.IO,II '.�• •� o (2nd ) _ UGH FRAME - - •PLUIIBING rn • I 1TJ SUL,,TION' PER N. Y. II , • •n STATE ENERGY _ II CODE .._ c=- •FINAL • ADDITIONAL COMMENTS : x �© . i M aGSiL►1!.►�'tiww.�lyYw�i��LyJat1; ...•l,v.. 5 S`Y.:ti�'Y..1•.wr't'.a .- .•).. .. .. .. .. .. . _ .. .. .. .... ,.,,... •. ..I .,. .., .. �.•-✓+.ilYe[.,.. BOARD OF HEALTH . . . . . . . . . FORM NO. 1 3 SETS OF PLANS TOWN OF SOUTHOLD SURVEY . . . . . . . . . . . . . . . . . . . 19 BUILDING DEPARTMENT CIIECK TOWN HALL SEPTIC FORM . . . . . . . . . . . . . . TOWN OF S OF T.OUTHO LD " SOUTHOLD, N.Y. 11971 TEL.: 765-1802 N D<<FY ; . . . !, CALL - �. .� Examined . . . ,'I9� . . . . . . . . .t1A I L T 0 . Approved 19��Permit No. / . . . . . . . . . . . . . . . . . . . . . . . . .. . . . . . . • - . . . . _ . . . . . . . . . . . . . Disapproved a/c . . . . . . . . . . . . . . . . .. . . . . . . ... . . . . . . . . . . . . (Building Inspector) LICATION FOR BUILDING PERMIT Date . .3. .U. .- . . . . . ..�. . ., 19��: INSTRUCTIONS 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 giving a detailed description of layout of property must be drawn on the diagram which is part of this 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 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 necessa i ss ee ns. . ������a��� osv®s - "TtL.E n)cos eoNsT (Signature of applicant, or name, if a corporation) (Mailing address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. . . . . . . . . . . . . . . . C Q bTT RAC7TT0.W . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Name of owner of premises . . . .C~1} Fz1 �- Lo R R A 9 N F 57-A-V R.d PO L1 S . (as on the tax roll or latest deed) If applicant is a corporation, signature of duly authorized officer. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . (Name and title of corporate officer) 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. �- l �, . . S Eta NTO./� — CEO RF I EL'DS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. ... . . . . . . . . ... . . . . . . . . . .Ca �EENQOR`.. . . . . . . . . . . . . . House Number Street Hamlet County Tax Map No. 1000 Section . . . . . .. . . . . . . . . . Block . . . . 4 S. . . . . . . . . . Lot . . . . o.91.1 . . . Subdivision . Lp S . . . . . . . . . . . . . . . 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 . . : . . . . . I. . .r?�:1�I,I i.4 S(--9EEQ ED I N b. Intended use and occupancy . . . . . . . . . . .�. VKI ��. . . .C>. ? LJI�;l;i�1, . .C ;bi,H .$;C( �(\(Ep. PO R.c H . 3. Nature of work (check which applicable): New Building . . . . . . . . . . Addition . �/. .. Alteration . . . . . . . . . . Repair . . . . . . . . . . . . . . Removal . . . . . . . . . . . . . . Demolition . . . . . . . . . . . . Other Work.. . . . . . . . . . . . . . . (Description) 4. Estimated Cost A `.-7 5C)0� 75 . . . . . .. .. © . . . . . . . . . . . . . . . . . . . . . Fee . . . . . . . . . . . . . . . . . . . . . . . . . . . (to be paid on filing this application) 5. If dwelling,number of dwelling units . . . . . .I. •TAM l�Y 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 . . . . . . . . . . . . . . 7. Dimensions of existing structures,if any: Front . e.3 . . . . . . . Rear . . .3?r.�. . . . . . Depth 1d 0 I Height . . �2�°. !-. . . . . . Number of Stories . . . . �. . . . . . . . . . . . Dimensions of same structure with S� 3� •s or additions: Front . �. �.. . . . . . . . . . . . Rear . . . Depth . . . . ..J.D. . . . . . . . . . . . Height . . . . . l V .{ ... . . . . . . . . . . Number of Stories . . �. 5$o R y. . . . . 8. Dimensions of entire new construction: Front . . . . . . . . . . . . . . . Rear . . . . . . . . . . . . . . . Depth . Height . . . . . . . . . . . . Number of Stories . 9. Size of lot: Front 5...f?o . . . Rear . . .' 'Z&. . . . . . . . . . . . Depth . .�$y...a`f. . . . . . . . . . . 10. Date of Purchase . . l,! `t d. . . . . . . . . . . . . . . . . . . . . Name of Former Owner 11. Zone or use district in hich premises are situated . . . .f-!�;-Az.)J(MT:1.M, 12. Does proposed construction violate any zoning law, ordinance or regulation: . . . . 4. 13. Will lot be regraded . . . . . . . N.Q. . . Will excess fill be removed go� nos s: Yes �o 14. Name of Owner of premisesC�?RlS. .�3T�4V�•o•PoilsAddress4I AAMNEiT.PQ, . . one o. . . . . . . . . . . . . . . Name of Architect • .Address QRNT. P�ne No. �FZ� :.O.�f¢A Name of Contractor!D1TV(2S.Z� V OS• . , , • • • • . . Address i A,$®X_ i3s . .. .. fione No. 3: 3• . 15. Is this property within 300 feet of a tidal wetland? *Yes;. . . . . . . No. .✓ . . . .. • •*If yes, Southold Town Trustees Permit may be required. PLOT DIAGRAM Locate clearly and distinctly all buildings, whether existing or proposed, and.indicate all set-back dimensions from property lines. Give street and block number or description according to deed, and show street names and indicate whether interior or corner lot. M 191>t_E RD. CCop-, ` ) ---15.o Y 7 SC,EM G 06FF812 �WTe 10Rl LO �l — LOT3 1-0 l �, . � 8 -^ 0 C? PoR cy •� —33.3 J M Yd to o 4 'i$.00 STATE OF NEW YORK, S.S COUNTY OF . . . . . . . . . . . . . . . . . • • • • • • •� • . . . . . . . . . . . . . . . being duly sworn, deposes and says that he.is the applicant (Name of1ividual signing contract) above named. Heis the . . . . . . . . ..4 G.ENT . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . :. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . (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. Sworn to before me this . . �. . . . . . .day of. . . . . . . . . . . . . .. 19 . .� Notary Public,• . . . :. . . . . ...:`:�. . . . Count JOYCE M.iMII.KINS . . . . . . . . . . . . . .�. . . . . . . . . . . . . . . . . . . . . . . . . . . . Notary Public,State of New York (Signature of applicant) ,No.4952246,Suffolk Cou� Term Expires Jun®:12,1:9 MIDDLE ROAD (C• R• 48) NORTH OR MAIN ROAD 75.04' FND 1242.89' N 71' 28' 20" E MON ,Q 1225.14' 1 �� o a o� N W Uj SCENIC J � o o BUFFER ct O LOT LOT( LOT AREA = 21, 112 sq. f t. CO?TIFIED TO, CHRIS JOSEPH STA VROPOLIS LORRAINE STAVROPOLIS FIRST AMERICAN TITLE INSURANCE COMPANY OF NEW YORK . ARCS MORTGAGE, INC. 605-S 9448 STEPS Prepared in accordance with the minimum 35.3- standards for title surveys as established b the L.I.A.L.S and approved and adopted _ ;� 2 SrCRY for such use by The K*Pw York State Land N FRAME Title Association rrausE-=-•_ -a v 5 25_0' 20.0' 15.4• WS Z P z� Z I 75.00', 5 750 31'23" W PUBLIC WATER MAIN SUR VE Y OF BENNE T T ROAD LOT 2 SUBDIVISION OF CEDA RFIEL DS H S. REF NO. 90 - SO - 51 FILED JUNE 27, 1990 FILE NO. 8966 A T GREENPOR T TOWN OF SOUTHOLD ��� °ZQR`��o SUFFOLK COUNTY, N. Y. 1000 - 40 - 05 - P/O 01 Scale 1" = 30' July 11, 1990 s',� "0.49g��yoQ N1 July 25, 1990(found. loc.) OF Nov. 16, 1990(final) Feb. 12 , 199 I(finol ) N.Y.S. LIC. NO. 49618 NOV. 13,1991 (CERTIFIED) ' ECONIC SURVEYORS, P.C. (516) 765 - 5020 P. O. 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