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Home My WebLink About6169-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No Z17296 Date SEPT. 14~ 1988 THIS CERTIFIES that the building. Location of Propert~ 725 OAK AVENUE House No. County Tax Map No. 1000 Section 77 Subdivision GOOSE BAY ESTATES DECK Street Hamlet Block 01 Lot 15 Filed Map No. 1176 Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated SEPT. 30~ 1972 pursuant to which Building Permit No. 6169Z dated OCT. l0w 1972 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 DECK IN REAR YARD. The certificate is issued to THOMAS VIOLAGIS (owner, X~) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A UNDERWRITERS CERTIFICATE NO. N/A PLUMBERS CERTIFICATION DATED N/A Building Inspector Rev. 1/81 I~ORM NO. ~ TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PP. EMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) N? 6169 Z Permission is hereby gronted to: ..... .~/~....~...~.~......E..~.~.~..~.~.Lc. ~ .................. o. ......... ~ ............. O. ................................................... premises Iocoted O' ................................. ~A.'/'~'~' ......... A'~'~'~'' ................................................... .............. , ............................................ ...-~.o.~...~..~.~.L~. ................................................. 'Z~ ~ ~,~/'7- 7~ ~w . ~0a~e' ~¥ ~-S~'aT~ ........ ~...'...l. L7..~ ~ur~-p~[~co~i~n~e~f~~"~~~-~.~-~:;~'r~.-.~`~"~;~."~.~.-~"~'-~-~ ';'~.'.'~ ond opproved by the Building Ins~.~.or. Fee $ ......................... Building Inspector FORM NO. 6 TOWN OF SOUTHOLD Building Department Town Hall Southold, N.Y. 11971 765 - 1802 APPLICATION FOR CERTIFICATE OF OCCUPANCY Instructions A. This application must be filled in typewriter OR ink, and submitted m ~ 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. B. For existing buildings (prior to April 1957), Non-conforming uses, or buildings and "pre-existing" land uses: 1. Accurate survey of p~operty 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- tion required to prepare a certificate. C. Fees: Additions $25.00 POOLS $25.00 ALTERATION $25.00 1. Certificate of occupancy New Dwelling. S25.00, Accessory,S10.00 Business $50.00 2. Certificate of occupancy on pre-existing dwelling $ 5 0.00 3. Copy of certificate of occupancy $ 5.00, over 5 years $10.00 4.Vacant Land C.O. $ 20.00 c.o. o.oo ..... ........ New Cons truc t ion~.. Old or Pre-existing Building ............ Vacant Land ............. Location of Property ~ . .~..~,.~.' .~-~. ~ .~...~....~~ House No. ' ' ' ..... ' · · . . .~ Street. . Ham/et Owner or Owners of Property .... ~ ~ ........... ~7..~. ~ County Tax Map No. 1000 Section ...... ~ .7. ..... Block ........ l ...... Lot ..... Subdivision ............................. Filed Map No .......... Lot No .......... Permit ..... *S~'... Date of Permit~.-~.~.'~-- Applicant ~x,.~-~q~ Health Dept. Approval ........................ Labor Dept. Approval .......... Underwriters Approval .............. Planning Board Approval Request for Temporary Cern:jr,cate ........... .~nal Certificate...~.. ~'~ .~./-~ Fee Submitted $ .... ~ ..... Construction on above described building and perr~e~ets~l applicab~ codes and ragu lation,. A p p l ica n,. ~.~...~.C~/].~.~. ~.. ~/. ~ ...~'~...,.~ .... / T i; ...... ......... t WILLIAM W. WEtMORE Carper*ret arid ~ilder BAYgHORE ROAD {~REENPORT, N. Y, 11944 i FORM, I~0. 1, TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. I9 ........Pemit Na ..................................... Disapproved a/c ............................. /.~.~.~._. ,:.. ..................................... ......................................................................... Application No ............................. (Building Inspector) APPLICATION FOR BUILDING PERMIT ~ Date ..... ....... ........ , INSTRUCTIONS ~ a. This application must be eompletely filled in by typewriter or in ink and submitted in triplicste to the Building Inspector, with 3 sets of plans, accurate plot plan to scale. Fee according to schedule. b. Pict plan showing location of lot and of buildings on premises, relationship to adjoining premises or public streets or areas, aR giving a detailed description of layout of property must be drawn on diagram 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 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, Suffo{k 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 ~aws, ordinances, building code, housing code, and regulations, and to admit authorized inspectors on premises and in buildings for necessary inspections. (Signature of applicant, or nar~e, if a corporation) of ........................... State whe~t~__~applica~is~lesse,~ agent,~_.~ - ~ ~,~--J~ _~-~4~7-~. architect, engineer, general contractor, electrician, plumber or builder; Name of owner of premises --~'~'.~...f~..~.~ ........ ~..~/.,~/..~.../'..C...~... .................................................... If applicant is a corporate, signature of duly authorized officer. (Name and title of corporate officer) f 1. Location of land on whio~.osed ~or~ill be done. Map No.: .~...~...~...~..ch prop kw ...... L, tN . Street and Number ........... ../~..../~......./.~...~.~... ...................................................... ~%.(~. ,~..z~.~.~.~....Z14~--;~&..~..~ ............ -~. ~ Municipality 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy ......... ~....~.5..(/~.~.../~..~.~,~.;~_~ ..................................................................................... b. intended use and occupancy ........ ./..~....~.~.~.~./..~.~..../.~../..~.;. .............................................................................. 2. ' Nature of work (check which applicable): New .Buildin[I ....................... Addition ..................... AItera,tionmc...~ ...... :.. Repair ......................... Removal ......................... Demolition ........................ Other Work .....~....~....c.....~. ............. ~ (Description) 4. Esti mated Cost ............ .~..Z.,~..;....~.. ~ ........... Fee ................ ;..~...../....0. .................................................................... (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 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 ......................................... Number of Stories ........................................ 8. Dimensions of entire new construction: Front .../.~.. .............. Rear ..... ~'.~....../. ........... Depth .....~...~......~.. ............... Height ....... o~.....~.....~ ......................... Number of Stories ......................................................................................... 9. Size of lot: Front ....... .~..~....~....~ ............. /' /' ! ................... Rear ....j~..4. ...... ...-~....~.~....'/...~.... Depth .......................... Height .................................................... Number of Stories ..................................................................................... 10. Date of Purchase ~.......~...~...~.Z ........... Name of Former Owner ...~..~.~./~... ~.~......~..~.'.~...~/,./~..'~......~.?...~...~....¢~.- .ff~... ........ 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 ....... ...~...~.. ................. ; Will excess~fill be re, moved from premises: [ ] Yes 14. N~me of Owner of premises ..../~..~,,,~..7..(..~.....~...~..~.~ ....... ~c~~v~;~L~?~-~ ........ (Address) (Phone No.) Name of Architect ................. ~,.~.....~<.. ..................................................................................... i~;~'~"~l'~'.i ............... (Address) Name of Contractor .................................................................................................................... [~'l~'~'~l~i ............... (Address) 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 wheth- er interior or corner lot. STATE OF NEW YORK. ) SS COUNTY OF ................................................. 2...) .......................................................................................................... being duly sworn, deposes and says that he is the applicant above named. (Name of individual signing contract) He is the ................................................................... : ............................................................................................................................................. (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 ~tatements 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 therew;th. ...................................... ~YA~ p~la U£.. St a ih..w ....,.x ::..". :;'.': ............... 19 ............. Notary Public.. ............. ~,~mi~oa.~rdq~uas..MaffJ)..$O..).9..'l..~ ...... County '~. ........................................................................................................... (Signature of applicant)