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FORM NO. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Office of the Building Inspector
Town Hall
Southold, N.Y.
CERTIFICATE OF OCCUPANCY
No Z-22683 Date OCTOBER 27, 1993
THIS CERTIFIES that the building ADDITION & ALTERATIONS
Location of Property 1475 (a/k/a 4351 PIPES NECK RD. GREENPORT, N.Y.
House No. Street Hamlet
County Tax Map No. 1000 Section 53 Block 1 Lot 12
Subdivision Filed Map No. Lot No.
conforms substantially to the Application for Building Permit heretofore
filed in this office dated FEBRUARY 22, 1993 pursuant to which
Building Permit No. 21246-Z dated FEBRUARY 26, 1993
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 ADDITION & ALTERATIONS TO AN EXISTING ONE FAMILY DWELLING
AS APPLIED FOR & AMENDED TO INCLUDE WOOD DECK.
The certificate is issued to THOMAS & IRENE COSTAS
(owners)
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A
UNDERWRITERS CERTIFICATE NO. N-286141 - AUGUST 12, 1993
PLUMBERS CERTIFICATION DATED OCT. 26, 1993 - K&K PLUMB. & HEATING
Building Inspector
Rev. 1/81
WORM NO.
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)
NT49 21246 Z Date / 192
Permission is he b gr ted to,
/
".1
..J...
kAYl at premises located of ..,rrc///'
.............................................C
County Tax Map No. 1000 Section Block / Lot No...../
pursuant to application dated ......e~L 19./ and approved by the
Building Inspector.
Fee ; 3..f2..
Ing I for
Rev. 6/30/80
Form No. 6
t
TOWN OF SOUTIIOLD
BUILDING DEPARTMENT
TOWN HALL
765-1802
APPLICATION FOR CERTIFICATE OF OCCUPANCY
A. This application must be filled in by typewriter OR ink and submitted to the building
inspector with the following: 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.
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 a 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.
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 - $5.00 over 5 years - $10.00
4. Updated Certificate of Occupancy'- $50.00
5. Temporary Certificate of Occupancy - Residential $15.00, Commercial $15.00
/ Date ~)~r?~~ ~:..~.1 -s
~kw Construction........... Old Or Pre-existing B ilding.
-ocation of Property....'--j5- (P _~S' 6, 6 4 /e w f
House No. 7' l............
Street Hamlet
nwer or owners of Property. w &&
ounty Tax Map No 1000, Section..3........ Block Lot..... 1.2
dbdivision.................................... Filed Map............ Lot..........
rmit No..X°~L T,'4,,,,, Date Of Permit...(./,( f.3....Applicant, :ffde~J9~~~f~
2alth Dept. Approval ..........................Underwriters Approval.........................
tanning Board Approval
'quest for: Temporary Certificate........... Final Certicate............
2e Submitted: $
~R4 7 7~~Y APPLIC
Co
g ~ .
TEL, 16S-1 802
~a r TOWN Or SOUTHOLD ~ .
OFF1CB OF BUILb11•1C INSPECTOR
P.O. BOX 728
TOWN HALL
SOUTHOLD, N.Y. 11971
f"
G
0.
C E R T I F I C A T I O N
91•
:}AR
1
~ Date
r
r Building Permit No.
owner
p ease print)
Plumber
- NIvv
lp ease print)
I certify that the solder used in the water supply system'-' ,rt,r
'Contains less than 2/10 of 1% lead.
s'
(plumber's signature)
Sworn to befora mo this
12~11ay of 00-1
19, -I~Ca ~Q a~ n a
t.
Not ry Publ'ic
~11`flotary pubLia,
County tH
LINDA J. COOPER d
Notary Public, State of New York
No. 4S22M ,Suffolk County 9
K ' Term Expires Dec ;mbar $f , f 9- #
r,
r o
THE NEW YORK BOARD OF,FIRE' UNDERWRITERS" ^ PAGE''A
1001071 " BUREAU OF ELECTRICITY
BE JOHN STREET, NEW YORK, NEW YORK 10033 "
Date AUGUST 12,1993 AppliehildnNo.onfHt; `80501193/93 t.. ' . N 286191 •t
THIS CERTIFIES THAT 's
only the electrical equipment as described below and introduced by the applicant nomad on the obone application number in the premLea of
,
TOM COSTAS, 1475 PIPES NECK ROAD, GREENPORT, N.Y,
in thefoilowinR location; ® Basement ® ,st Fl. ® 2nd F'i. GAR/OUT Sertion Block Lot
ass examined on AUGUST 0 9 , 19 9 3 and found to be in compliance with the National Electrical Code.
FIXTURE ECEPTACtES SWITCHES FIXTURES RANGES COOKtND DECKS OVENS DISHWASHERS EXHAUST FANS
OUTLETS INCANDESCENT FLUORESCENT OTHER AMT. K. W. AMT. K. W. AMt. K.W. AMT. K, W. AMT. N. P. ,
DF e,
24 11 25 23 1 t i F
DRYERS FURNACE MOTORS FUTURE APPLIANCE FEEDERS SPECIAL KROFT TIME CLOCKS Elll UNIT HEATERS MULTI-OUTLET DIMMERS
AML C W. at H. P. GAS H. P. AMT. NO. A. W, G. AMt. AMP. AMT. AMPS. TRANS. Amt. H. P. N0, stems
FEET AMT. wAtiS
2 - C
7•
i SERVICE DISCONNECT NO.OF 5 E R V Y 1 C E
AMT. AMP, ryPE MITER IX 2W t .V 3W 3 Ar 3W 3,6 AW NO- OFCC. COND. A. W. G. NO Of HLlEO A. W' G' W. OF NEVipAlS A. W. G.
EQUIP. PER X Of CO C ND. OF H1. E0 OF NEUTRAL
1 200 CB 1 R i 4/0 1 2/0 .
OTHER APPARATUS:
FEEDER9tl-3 0 6 BASEMENT TO BASEMENT
MOTORStl-F H.P.
PANELBOARDStl-4 CIR: 100
ELEC. WATER HEATER9ttl-4.5 K.W.
G.F.C.It-4'
SMOKE DETECTORt-1 to
TRACK LIGHTINGi-32 "
G & 9 CONTRACTOR LIC.A578-E
BOB 215
SOUTHOLD, NY, 11911 K 1` ° Gft*+ MANAGER
-ule Per
This certificate must not be altered in any manner] return to the office of the Board if incorrect fnspetfotslihay, be` ident ied by their credentials.
FORM NO. 3
TOIVN OF SOUTHOLD
BUILDING DEPARTMENT
TOIVN CLERK'S OFFICE
SOUTHOLD, N.X.
NOTICE OF DISAPPROVAL
Date .....FHBIUTARY. 24,.........., 19.93. .
To ,:Thomas,&,Irene_Costas 6 Robert Brown Architect
Box 521_
Greenport, N.Y. 11944
PLEASE TAKE NOTICE that your application dated .FTBBIIARX .2?,............., to . 93
for permit to CONSTRUCT ADDITIONS TO EXISTING DWELLING
..........................................at
Location of Property 435 PIPES NECK ROAD GREENPORT, N.Y.
.
House No.Ham7er
Sheet
County Tax Map No. 1000 Section 53........ Block .A 12
Lot
Subdivision Filed Map No. Lot No.
is returned herewith and disapproved on the following grounds'. .UNQ$B.44T> QlA ,IIT , , , ,
SECTION 100-. ..32 PROPOSED CONSTRUCTION WILL EXCEED PERMITTED LOT COVERAGE.
.
I3uill g Inspector
THOMAS J. FISHER
RV 1/80
Fl D i:;S: c:tt•texr
® (
_H
19,
FOUI7DATION (1st) I °
JC
FOUND0.TI01~ (2nd) -
10
LOUGH FRAME &
.PLUMBING
C*1
17/1 m
INSULATION PER N. Y. I y
STATE ENERGY l~
CODE I T W
FINAL
ADDITIONAL COMMENTS: x
b n
H W
7]
O
_ a
• r
y
m
y
M-1802
BUILDING DEPT.
INSPECTION
[ ] FOUNDATION 1ST [ ] ROUGH PLBG.
[ ] FOUNDATION 2ND [ ] INSULATION
[ ] FRAMING [ ] FINAL
REMARKS: Gd
DATE -OM INSPECTOR
765-1802
BUILDING DEPT.
INSPECTION
[ ] FOUNDATION 1ST OUGH PLBG.
[ ] FOUNDATION 2ND [INSULATION
[ ] FRAMING [ ] FINAL O
REMARKS:
DATE 3 INSPECTOR
M-1802
BUILDING DEPT.
,INSPECTION
[FOUNDATION 1ST [ ] ROUGH PLBG.
[ ] FOUNDATION 2ND [ ] INSULATION
[ ] FRAMING [ ] FINAL
REMARKS: 4
DATE
3 ISM -INSPECTOR
768-1802
BUILDING DEPT.
INSPECTION
[ ] FOUNDATION 1ST [ ] ROUGH PLBG.
FOUNDATION 2ND [ ] INSULATION
[ ] FRAMING [ INAL
REMARKS:
-kT
DATE INSPECTOR k
61 11P I/& -t
THE NEW YORK BOARD OF FIRE UNDERWRITERS PAGE 1
1001011 BUREAU OF ELECTRICITY
I 85 JOHN STREET. NEW YORK, NEW YORK 10038
a90rJ01~19 %9S N 7.,RF,141
Date 11NGUC47' .12,1993 Application No. onfile
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
?OK COSTAS, 1475 PT?Eii NECK RO~AT), GRKNMPORT, N.Y.
in thefollowinglocation• I Basement LJ I.st Fl. LJ 2nd Ft. GAR 1011T Section Block Lot
AuGU"'P 09,1993
was examined on and found to be in compliance with the National Electrical Code.
FI%iuRE ECEPTACLES SWITCHES FIXTURES RANGES COOKING DECKS OVENS DISHWASHERS EXHAUST FANS
OUTLETS INCANDESCENT FLUORESCENT OTHER AMT K W AMT. K. W AMT. N.W WT KW AMT H P
24 it 25 ?a 1. 1 F
DRYERS FURNACE MOTORS FUTURE APPLIANCE FEEDERS SPECIALREC'PT TIMECLOCKS gELl UNITHEATERS MULTI-OUTLET DIMMERS
AMT. K. W OIL H. P GAS H. P AMT NO A W. G. AMT. AMP. AMT. AMPS TRANS. AMT H. P SYSTEMS qMi WATTS
NO. OF FEET
2
T77 i
SERVICE DISCONNECT NO-OF S E R V I C E
MfTE0. NO.OF CC COND. A W G A W G. A.W G.
AMT. AMP. TYPE H]UIF 110 1W I ,e' JW 3,R 3W130 4W PER .e" OF CC. COND. NO. OF HbIEG OF HI LEG NO OF NEUTRALS OF NEUTRAL
1 200 CB 1 X { 410 G/0'
OTHER APPARATUSI
FNN7DERu r 1--3 4 6 BASORENT 'CO BASF XEMT
KO'TORSt1-F H.P.
PANNLBOARDSI1.4 CER. 1.00
BLEC. HA9'E11 HEA53;I2.1rL1-4.5 H.W.
G.F•C.Er-4
SHORE DVTt1XT0 t r -.I.
P-RACr LT.GHTItMi-32
G Fc 5 CONTttACTO12 BOX 219
SOi1THOLD, NY, 11911 GENERAL MANAGER
11
.
per
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 7HI3 COPY OF CrFIT CaGCA Z DUST NOT BE ALTERED 1111 ANY MANNER.
FORM NO. 3
TOWN OF SOUTIIOLD
BUILDING DEPARTMENT
TOIVN CLERK'S OFFICE
SOUTHOLD, N.Y.
NOTICE OF DISAPPROVAL
Date FEBRBARY. 24..........., 19.93. .
To Thomas, 6, Irene,Costas tk Robert Brown Architect
....BOX .52.
.1
Greenport, N.Y. 11944
PLEASE TAKE NOTICE that your application dated . >.URUARX .??,.............11g..9.3..
for permit to CONSTRUCT ADDITIONS TO EXISTING DWELLING
.......................................at
Location of Property .,,435 PIPES NECK ROAD GREENPORT, N.Y.
House No Street ' .
Hamlet
County Tax Map No. 1000 Section 53........ Block 1 12
..............Lot
Subdivision Filed Map No. Lot No. ,
is returned herewith and disapproved on the following grounds' ..UN 44 ARTICIA .~Jl .
SECTION 100-32 PROPOSED CONSTRUCTION WILL EXCEED PERMITTED LOT COVERAGE.
U11 i' q Inspector
THOMAS J. FISHER
RV 1/80
FORM NO. 3
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN CLERK'S OFFICE
SOUTHOLD,N.Y.
1 -
NOTICE OF DISAPPROVAL
Date I90~ . .
To rte. . 'ry1 4W XeAAOV
~-a
PLEASE TAKE NOTICE that your eapplication dated %L 19 .
,s -
for permit to . ~ C.~ J.`........... at
Location of Property .
Nouse No. Street amlet
County Tax Map No. 1000 Section :47+l...... Block Lot
Subdivision Filed Map No. Lot No.~ .
is returned herewith and disapproved on the following grounds
Inspector
RV 1/80
3. Nature of work (check which applicable): New Building Addition ..1/ Alteration V~ .
Repair Removal , Demolition Other Work .
e cription)
4. Estimated Cost . cam. 7lUZ?a Fee .
(to be paid on filing this application)
5. If dwelling, number of dwelling units 1......... 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 2.S Rear ...Z Depth .1fo .
Height M1 Number of Stories ......'22............ .
Dimensions of same structure with alterations or additions: Front ~b........... Rear `F~
Depth ..........`i R.......... Height 23 . Number of Stories .
8. Dimensions of entire new construction: Front Rear Depth
Height Number of Stories .
1 ssl C.
9. Size of lot: Front ..i Rear 1~:........... 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 regraded iG/P Will excess fill be reT ved from premises: Yes o
14. Name of Owner of premises . yH . k(l Ed~G? Address PL3 ~ Phone No.. ~.(.?T .c?3oS. .
Name of Architect .~2t~fl. ~.C IttW? : Rk,V44Address 2~S.U.C<R t?t .IIWVPhone No..~/.7.Z
Name of Contractor Address Phone No............... .
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.
e
STATE OF NE I . S.S
`COU Y OF.. .A<-
: being duly sworn, deposes and says that he is the applicant
(Name of individual signing contract)
above named.
Heisthe Xlt ..(/~~i..................................
(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, County
CLAIRE I.. CLEW (Signature of applicant)
Notary Public. State of Newyork
14o.'4879606 My 1
QuatNiad ee Deem 8.191--
Cafroaiaslon Exp
FORM N0.1 3 O P o 9Q44V.Y
TOWN OF SOUTHOLD
t~ t`I i BUILDING DEPARTMENT
FEB 2
TOWN HALL
SOUTHOLD, N.Y. 11971
S PG. P
! To',r,i±±c;v,S,CsE)'~',;C,7E_ TEL.: 765-1802
Examined 19~ Received 19...
A roved 19 .Pe rmit No..2.. l!? yam!
Disapproved a/c xPP~~~ % . T .
(Buitdifig Ins or)
APPLICATION FOR BUILDING PERMIT
Date . ? ? .2~........ 19q2?
~I
INSTRUCTIONS
a. This application must be complct ~ly 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 applications the Building Inspector will issued a Building Permit to the applicant. Such permit
shall be kept on the premises available foci 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 !ito 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'I applicable laws, ordinances, building code, housing code, and regulations, and to
admit authorized inspectors on premises and in building for necessa ti
~ s-- . A :t.' A.:........ .
( ignature of applicant, or name, if a corporation)
(Mailing address of applicant)
State whether applicant is owner, lessee, ag t, architect ngineer, general contractor, electrician, plumber or builder.
Name of owner of premises .
(as on the tax roll or latest deed)
If applicant is a corporation, signature oQ duly authoriUd officer.
.
(Name and title of corporate I,
officer) . .
Builder's License No.~.
Plumber's License No.
Electrician's License No. ..T . .
Other Trade's License No. .
1. Locatio~n/ of lid on which proposed work will be done .
House Number Street Hamlet
County "fax Map No. 1000 Section 1, 05 Block . ~ Lot . 1 ?77
Subdivision Filed Map No. Lot...............
(Nacue)
2. State existing use and occupancy of premises and intended use and occupancy of proposed construction:
a. Existing use and occupancy ....Ci'!^~tP1~1 ~Q .
b. Intended use and occupancy . I yr .fr' f},;1''+>e?> fJ........ , .
l7rar,- ;'1