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HomeMy WebLinkAbout2330-zFO~ NO. 4 TOWN OF SOUTNOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. CERTIFICATE OF OCCUPANCY THIS CERTIFIES that the building located at ~/..S....~...a..~...~....~..~.e...W...~.e. ........................... Street M0ap~o.~.~.,...~..~....~..~..~..~l~oack No ....... ~.e..~.~ ....... Lot No. ~.,. ....... ,0..?..~.~.,L...~.t.~..~. .......................... conforms substantially to the Application for E~uilding Permit heretofore filed in this office dated ................................... .~..~ ....... ;~.~. ....... , 19.~.~... pursuant to which Building Permit No ...... .2..~...~...0.. Z dated ................................ ..~.~.~.....;~.~...., 19.~.~..., was issued, and conforms to oil of the requirements of the applicable provisions of the law. The occupancy for which this certificate is issued is ........ ...... ........................................................................................... The certificate is issued to ...,iL .......................................................................................................... (owner, lessee or teno~t) of the aforesaid building. H.D. Approval 196t~ FOK~ ~0. ~ TOWN OF SOUTHOLDr, BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. BUILDING PERMIT (THIS PERMIT MUST BF' KF'PT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) N? 2330 z Permission is herebY granted to: .......... ~.~e,,~t, ........... : .................................... ,.....~. ' at p~emises located at ,..J~.....~l~ ....... J~Lee'~$~"3'r'"'BpSen'~"~'"t,h-e"~ee.":''' ..................... .............................................. ~...,,,,,,, ;,,,~u.....,~,~V....~...~ ~ ...................... .] ................. pursuant tO application dated v ........................ ~.J~B~..OJ~...Jt..~' ......... 1~..., ~i~d apP~'oved by the Building Inspector Fee $... ~ ~/,,0.~.00. ....... % %., ~"~hi,~ Indenture, made the / ~ day of ~-,~"~'u nineteen hundred and BetWeen GEORGE DZAKOUHAI(OS and ELAINE D~AKO~OS~ hi~ bo~h resid~n8 a~ 264 92nd Street, Brooklyn, New York party of the first part, and STEPHEN HACIURA/and SANDRA MACIURA, his wife, both residing at 308 Main Street, Greenport, New York pa~¥ ortho second part, Witneseeth0 that the party of the first part, in consideration of Ten Dollars end other yaiueble consideration paid by end assigns of the pa~y of the second pa~ fo~wL All that ¢~ain plot plec~ or parcel of I~nd, with the buildings and improvements thereon erected, ~ituate, lying and belngln~ at Orient, tn the To~] of Southold, County of Suffolk and State of New York, known and designated as Lot No. 2 om a eertaln map entitled Orient-By- The- Sea,. Section On~, situated at Orient Feint, Town of Southold, Suffolk County. New York, OCtober 29, 1957" by Otto W. Van Tuyl & Son, Licensed Land Surveyors, Greenport~ New York, filed in the Office of the Clerk of the CoMnty of Suffolk on November 21, 1957 under file number 2777. ,..,..,.. George D[akoumakos and Elaine Diakoumakos, the eg~ifted ~wners herein, executing the deed herein are the same p~£$ons in.deed ' as grantees t~ deed dated July 13, I981, reeord~d'~,July 23, 1981.:';" in Liber 9040 'ap 484, be~n~ the same premises conveyed to grantors by deeds, recorded zn Liber ',9040 cp 484~, :. RECEIVED '" / REAL ESTATE. Together with ell r~g hr, tide end interest, If any, of the party of the first p~r[ jt~ and to any streets end roads sbuttlng the 8bore described premlse~ to the center lines thereof; Together with the eppu~enanc~ and all the estate rig hts of ~h e party of th e h ret pa~ in a~d to sald pre m see; To Have And To Hold the premises herein granted unto the pady of the second Pa~, the heirs or successors and ageless Of the pa~ of the second pad forever, ~,~*, ,',,4~'~.¢~M,,,,, ,~ ....... ' .... ',' ', "',, '.., ', , .~, ., ,.,. . ,v,,~ ........ ~., ,.,,v .,,,,..~;, FORM NO. 6 TOWN OF $OUTHOLD Building Department Town Hall Southold, N.Y. 11971 APPLICATION FOR CERTIFICATE OF OCCUPANCY Instructions A. This application must be filled in typewriter OR ink, and submitted in duplicate to the Building Inspec- tor with the following; for new buildings 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 of Health Dept. of water supply and sewerage disposal--(S-9 form or equal). 3. Approval of electrical installation from Board of Fire Underwriters. 4. Commercial buildings, Industrial buildings, Multiple Residences and similar buildings and installa- tions, a certificate of Code compliance from the Architect or Engineer responsible for the building. 5. Submit Planning Board approval of completed site plan requirements where applicable. For existing buildings (prior to April 1957), Non-conforming uses, or buildings and "pre-existing" land uses: 1. Accurate survey of peoperty showing all property lines, streets, buildings and unusual natural or topographic features. 2. Sworn statement of owner or previous owner as to use, occupancy and condition of buildings. 3. Date of any housing code or safety inspection of buildings or premises, or other pertinent informa- lion required to prepare a certificate. Fees: 1. Certificate of occupancy $5.00 2. Certificate of occupancy on pre-existing dwelling or land use 3. Copy of certificate of occupancy $1.00 $5.00 Date . .Jul[z..7.,. 1.9.8~. .......... New Building ............. Old or Pre-existing Building .... ,~, ...... Vacant Land ............. Location of Property ... ;~. ~P.~.z;']~..~..~e..w. ~.~.~..e,..Q~$.eR.t;,.. ~.e.w.. ¥.o.r.~. ....................... House No. Street Ham/et Owner or Owners of Property . .~t.~;c, Gr~. ~,e,~. ,$ ,e~,p.q~....~.~.e..~,u.~.~. ~ .~..o.~., ,~.m~..~,o..s.c..~,. D.q~ .e.r. ,~st. County Tax Map No. 1000 Section ...],-~ .......... Block ....7 ........... Lot .... ~6. .......... Subdivision...O,~. $,e,~,~, ,,~y, ,~.h..e. ,S.e.~. .......... Fi~ed Map No.. ,27.7.7. .... Lot No, .~. ........... Permit No ........... Date of Permit .......... Applicant ...Cze. o..~g.e..D..L.~.~.o.g .m.~.~.o.s. ........... Health Dept. Approvai ........................ Labor Dept. Approval ....................... .~ Underwriters Approval ........................ Planning Board Approval ................. ~ ~I r:~ Request for Temporary Certificate ..................... Final Certificate .... .~. ..... Fee Submitted $. ]-.-.qQ ....................... Construction on above described building and p~et~.a~l/~p,p~able~o.~ and regulations. Applicant ....... Rua~h~'~:'-~'~'//Attorney for George D~akoumakos Rev, 10-10-78 s~9 SCHD SUFFOLK COUNTY DEPARTMENT OF HEALTH Building Permit No. ...... TO WHOM IT NAY CONCERN: The sewage disposal facilities for a structure located at have been inspected by this Department and found to be satisfactory. District Engineer FORM NO. ! TOWN OF $OUTHOLD BUILDII~4G DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. 19..~.~.(. [xomined ......... (.?~....~..-......-..., Approve~ ........................................ , 19....~...Permit ~o ..... ,~?..~..~ ...... ....................... ............. .................. ................. ................. (Buildin0 I~spector) Application No. c~..~..~...,~..~). .......... APPLICATION FOR BUILDING PERMIT INSTRUCTIONS a. This application must be completely filled in by typewriter or in ink and submitted in duplicate to the Building Inspector. 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 bedrawn on thediagram which is part of this application. 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 permit shall be kept on the premises available for inspection throughout the progress of the work. e. IX[o b~ilding shall be occupied or used in whole or in pa rt 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 and regulations. .......... ........................... (Signatu~ of applicant, or name, if a corporation) ........................ ....... . ............... (Address of applicant) State whethers, applicant is owner, lessee, agent, architect, engineer, general contractor,' electrician, plumber or builder. .............. .............. i .................................................................................................................................. Name of owner of premises ...... ~._~...~.....~.'..~....~...'.~..~Z..~..~. .............................................................. If applicant is a corporate, signature of duly authorized officer. (Name and title of corporate officer) 1. Location of land on which proposed work will be done. Map No: ........... .,.~...~.?..~::?....../.. ........... Lot No: ......~... ........... Street and Number ............................... : ............................................................................... m,m.. .............................. Municipality 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy .................................................................................................................................. b. Intended use ond occuponcy ................... ¢ ......................................... 3. Nature ~f work (check which applicable): New Building.._...._..../'J ........... Addition . .......... Alteration .................. Repair .............. ~. Removal .................... Demolition .................... Other Work (Describe) ........................ 4. Est mated Cost ..'~../...~...,..O....O...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 natureand 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 ................................ Number of Stories ........................................ 8. Dimensiohs of entire new construction: Front......'.~...~..~/',.~..:! ......... Rear ...~..-'..~-..~.../...~...~.~ ..... Depth ....~....?..,~..~/.~..~. ...... Height ..i ......................... Number of Stories....../. .......................... 9. Size of Idt: Front ...... /..~'...~.. ............... Rear .~........~.. ............... Depth ../.. ...... ~. ........................ ~.. 10. Date of Purchase ........................................................ Name of Former Owner ...~...~.,.../..~ 11. Zone or use d str ct n wh ch pram ses are s tuated ~..* .......................................................................... ~' 12. Does pro'posed construction violate any, zoning law, ordinance or regulation~ i~.~.... . 13. Name ofiOwner of premises ~.....~.~....~..~...,_.Address ..~...~.,..'~..:~r~'....~..~'~ Name of Arch tect,~,~', ..~..~.j~.~......,.~...;,½.......,,Address ................ .~ ........................... Phone No ..................... Name of Contractor'~.....~ ..~.~./...~.~'"'~'"'"Address ...... ...~.....'"~?..~ ............... Phone No.~...~..'.~,..~./.~_..~./ PLOT DIAGRA,M Locate clearly and distinctly all buildings, whether existing or proposed, and indicate all set-back dimensions from property lines. Give street and block numbers or description according to deed, and show street names and indicate whether interior,or corner lot. If4" STATE OF NEW Y/PRI ,~',~, ~) _ _ COUNTY OF .~...'~..) ......................... ~_~~~ ...................... bei~ d~,y swo~n, ~o~ ~n~ ,~ ,h~, ~ ~ the ~p, (Name, of indTviduai~~~signin~lication) above named. He is the ...~~~ / (Contractor, agent, corporate officer, etc.) of said owner or. owners, and is duly authorized fo perform or have performed the said work and to make and file this application; that all sJateme~l?~q~a~ in this application are true to the best of his knowledge and belief; and that the work will be perfor~ed¢i~t~ se~ forth Jn the application filed therewith. ~ Sworn to befoT~/~e this C~,~m~Z:O3z]~96.3, SUffolk Coun~ . ~ / ........... ~..Z.....~a~f ....... :,.../Z/~ ....... , 1~.: .... I ~/ //~ ,o,~,, ~,,,c,. ,~~~~.. ......... , ....... (,,~no,.~' .......................... o, ~,,~,)~ .....................................