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Home My WebLink About4472-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Town Clerk's Office Southold, N. Y. Certificate Of Occupancy No..Z. 1+985 .... Date ........... Ja~a~...2~...., lg?~. THIS CERTIFIES that the building located at . ~/S. Ruth. Road ........... Street Map No.. xx ........ Block No. X~x ....... Lot Nom.. ga.ttituok ·. 1/.,¥, .......... conforms substantially to the Application for Building Permit heretofore filed in this office dated ........ Sept .... 20..., 19.69. pursuant to which Building Permit No..1~72Z.. dated ........... Sep.t ~.. 2~., 19.6~, was issued, and conforms to all of the require- ments of the applicable provisions of the law. The occupancy for which this certificate is issued is .. Pr. ivaf.~ .one..fataLly. d~elltl~g .......... (ap~reveA .by. ~kl. Appeals) The certificate is issued to . .Se.v~riua .. Lambros ...... 0wne~' ...................... (owner, lessee or tenant) of the aforesaid building. Suffolk County Department of Health Approval .A~lg- · '3' 19rt~0· · · by. R....Villa ..... UNDERWRIT£RS CERTIFICATE No .................................................. HOUSE NUMBER..~8~1 ........ Street ....Ruth. Road .................................. lrOmM NO. ~ TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, No ¥o BUILDING PERMIT (THIS PERMIT MUST BE 'KEPT ON THE PREMISES UNTIL FULL COMPLk'TION OF THE WORK AUTHORIZED) 4472 Z Permission is hereby granted to: to ........... ~,~I.L~,.. ne~ ..nne...,,e~LLa'...~a~e~ ........................................................................ at premises located at ...................... .~.....~Lt~.4~ .................................................................. .................................................................. ~t~,taok ...... ~.q~., ....................................................... pursuant to application dated ......................... ,~1~, t~ ......... ~ .......... , 19..6~., and approved by the Building Impeetor. Building Inspector INSTRUCTIONS a. -This application m~t be completely fll~4n by typew'r~l~or-tn,ink and\s.,u~, mitted, in duplicate to the Building InspectOr. b. Plot plan showing location of lot and<of buildings on premises, relationship to adjoining pmmJees or public streets or areas, and giving a detailed description of I~ of prapef~,.mmt be driWm, on the diagram which is pa~t of ~hle application. c. The work covered by ,this application may not be commenced befdre Issuae~ce.of Building Permit. d. Upo~.epprcwal of this application, the Building In~peotor will Issue a Building Permit to the applicant. Such permit shall be kept on the premises available for inepection throughout the pragre~ of the work. e. No building shall be occupied or used in whole or in part for any puqx~e 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 pureuant to the Building Zone Ordinance of the Town of Southold, Suffolk County, New York, and other applicable Lawa, Ordinances or Regulations, for the construction of buildings, additions or alterations, or for removal or dmrl:dltlon, os herein described. The applicant agrees to comply with all applicable laws, ord~ad~atlons. (Signature of applicant, or name, if a coq~oration) State whether applicant is owner, lessee, agent, architect, engineer, germml contractor, electrician, plumber or builder. .................................................. I, ai:~licant is a corporate, sigt"~t~re of duly c~zed offer.A' ~ ~ ~ 0 _.~ ~'~ ~" ~ 1. Loc~fion of I~d on which prq:~! ~ will be do~. ~ No.: ~ .................................. LOt. No.: .t~ .......... ~ ........ Street and Number ...... J~. ....... ~ ....... ~....:.~T...,,~ ........ .~...~...~..~.. .............. C,~:....,~..~..~......~.. ............ 2. State existing use and occupancy of premises and intended use and occupancy of prepoeed construction: o. E~ing me and occupancy ........ ,. ............................................................................................................. ¢ ......... b. .. and ........ ....... ,:; ................ 3.Nature of work (check which applicable): NeW Buildi~' ~;..~.~. ...... Addition .................. Alteration .................. Repair ................ v Removal .................. 'Demoli~io~.i...'~i....L...;. Other Work (Describe) s~ :~,,~ ~ ~- -" · -'~.~ ~'- ~ '' 4. Estimated Cost .'.~..../....~.7..a-:'~:~..:....~... ............. ~¥..~,~...,~ee ~.::=.~...,..~c~ .................................................................... (to be paid on filing this application) 5. If dwelling, number:of dwelling units ...... .~..~Number of dwellin, g.,un!ts on eachfloor ......................... ..~.~ If garage, number of cars ............................... 6. If business, commercial or mixed occupancy, specify.~na~ure and extent o~f each type of use ...................... ~....~ 7. D~mens,ons of e.x,st,ng structures, ,f any. Front .....~.'~.. ......... Rear ...... ~....~...~...: ...... Depth ..~..~..:.~.~. · Height ....... Number of Stori~ ......... ]. ....................................................................................................... Dimensions of sam~ structure with alterations or additions: Front .................................... Rear ............................ D~pth ................................ Heiaht ............................... hh.lmbe[ of Storie, ..................... i ........... ~. D~mens~on$ o* eh, re n~ const~,on: ~ron;'..~.g....¢~....: ........ Re~r..~&..~.. .......... ~,th..~.~: ~:..~.. Height ../.~.. Number o.f Stories .......... I. ........ .; ................................................... ~.~ .......................................... 9. Size of lot: Front/..../~.~..._.~.~.... Pear ..... ./.~J....~..:~'' ......... Depth ........ /.~.~.~..~.w~.. a 10. Date of Purchase ..~'~.~..~ ..................... Name of Former Owner ..~.~....~.~ 11. Z0r[e or use districtC~n-~ "/~%~ -- whi~ ~l:~-emiS~ am situated ....... ~J~ ................................................................................ ~]'~:~ Does proposed conSt~ruction vio~te any zoning Iow, ordinance or regulation? ......... .~0...~ ....................................... Nameof Owner ....... No. Name of Architect ~.~..~.....~Address ........................................... Phone No ..... Name of Contractor .~.....~...~.~.... :~...~.. ....... ~Ad~..ress ....~...'~":~..~.~. ~lN~m~e No. DIAG Locate clearly and distinctly all buildingS/whether exist_lng _~'___p~; and' indicate all set-back dimensions from' property lines. Give street and blOCk number or descripti~oly~cordi'~;j qb,,~dl~l, and show street names and indicate whether I~terior or comer lot. / STATE OF NEW YORK _ ~,. ,. " ' '!: " ' ~"~: ......... 1 ................. being duly swam, dl~x~ and s~ fi'mt h~ i$ ~ applicant (Nameo'rin'Zli~iduatsigningapplication.~ ' ; ..' ,: .~:. ;:. .... : above named. He is the ........... .r~..../~.~ ........................................................................................................................ ..... (Contractor, agent, co~porote officer, etc.) of said owner .or .owne[s, .an.d.is.du!y ayt.~!zed ~'0 perform or have perle~ th~. said .work and to make and file this applic&h0n; thaf all statements contained in this application are true to the best e~f his knowledge and belief; and that the work'Wil! be performed in the manner set forth in the application filed therewith. 'Swam to be~e me this (-- ~ ~ , ........ ' ),~. ~ ~£'~'£ '~.l~t.~:tg~l~% ..... .-x>~""~"~'"~'~"~?'~"~'-;~.. "~".'~~''~'~' ..................... Natary Public, ......~~ _~l~m..Slll~ll~. ~7~oun~ (Signature o? applicant) ~ommilr~ion ~l~res Ma~e# ~ · . FORM NO. 6 TOWN OF SOUTHOLD Building Department Town Hall ,~outhold, N.Y. 11971 APPLicATioN FOR CERTIFICATE OF OCCUPANCY Instructions · Iication must be filled in wpewriter OR ink, and submitted in duplicate to the Building Inspac- A. This a..p,p. _ A ' · r new buildings or new use: tor with the f,,llowlng, fo 1. Final survey of property with accurate location of all buildings, property lines, streets, and unusual natural or topographic feature[ ealth Dept. of water supply and sewerage disposal-(S-9 form or equal)· 2. Fina approval of H ........ ,-^-, r~0ard of Fire Underwriters. 3. Approval of electrical insta at 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. B. For existing buildings (prior to April 1957), Non-conforming uses, or buildings and "pre-existing" natural or land uses: 1. Accurate survey of peopertY showing all property lines, streets, buildings and unusual topographic features· n statement of owner or previous owner as to use occupancy and condition of building[ 2. Swor, - · - -n~l, ar safeW inspection of buiidings or premises, or other pertinent informa- 3. Date oT any housing ~ lion required to prepare a certificate. ~g /landuse __?re-i~×±st, ing C.0. $15.00 Vacant land C.0. $ 5.00 Date ........ New Building .......... Old or Pre-existing Building ............ Vacant Land ............. ..... ._ Location of Property · · · , S~reer · · Owner or Owners of Property .' ' Co~nW ~ax Map"O. 1000 Section .../. O.(~,.O..O.. B~oc~ .. . .. Lot .... " Lot No .............. Filed Map No ........... Subdivision ................................. Applicant .................................. Permit No . . Date of Permit .......... Approval ' ' ' Approval ...... Labor Dept. Health Dept ..... Planning Board Approval ....... Underwriters Approval ........... Request for Temporary Certificate ..................... Final Certificate ....................... Fee Submitted $ ..... ; .......... Construction on above described building and permit meetS all applicable codes and regulations. Applicant .................................................. Rw. 10-10-78 SUFFOLK COUNTY DEPA~THENT OF HEALTH Date ~/~ TO WHOM IT MAY CONCERN: The sewase disposal facilities for a structure located (Give d~ed location) / ' have been inspected by this department and found to be satisfa~tory. District Engineer District Engineer T ~,Th O~eR~ N. ~7' H'O0" ~V. 100.0 P~UTH i /AnD OF ~ U IAV E Y ,T:I:, TI~V N L~ kJF), ~ I1 U ~TF... /A~ITITUC ~; OF SOUIWOLFJ,N.Y. ~T~ ~RO0~ ~: Of'Ill,,,, I 10'2"x8' 8" 12'x10' BATH I--LII HALL CL CL LIVING ROOH 18~2Ux12,2,, DINING ROON KITCHEN i0,x8,2,, .... CL IDr, GARAGE