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Home My WebLink About5729-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. ~PDATED CERTIFICATE OF OC~U,L-'ANCY No Z-23113 Date JULY 22, 1194 THIS CERTIFIES that the buildin~ Location of Property 53955 MAINROAD House No. County Tax Map No. 1000 Section 61 Subdivision ADDITION SOu'£~K)LD, N.Y. Street Hamlet Block I Lot 19 Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated M~R~H 6~ 1972 pursuant to which Building Permit No. 5729-Z dated MA~H 6, 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 ADDITION ON EXISTING BUSINESS BUILDIN~ (MIxm] O(~3UPANCY)* The certificate is issued to DANA & F,.A'£msKZNE SOCHACKZ (owners) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A UNDERWRITERS CERTIFICATE NO. N/A PLUMBERS CERTIFICATION DATED N/A *THIS UPDATES-CO S-4702 ISBug J~LY 6, 1972. / t - / Budding IntecOlor Rev. 1/81 FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Town Clerk's Office Southold, N. Y. Certificate Of Occupancy No..~. ~.. ...... Date ................ ~.11~.... &..., 19. ~ ~ THIS CERTIFIES that the building located at N/8'l~&~'St~ee~ .......... Street Map No. ~. ......... Block No..:IX ....... Lot No .... ~-.. 8~t1~o].4. · -1~.¥. ........ conforms substantially to the Application for Building Permit heretofore filed in this office dated ............ }4a~*eh .... 6 19~.. pursuant to which Building Permit No. dated ........... l~ta~eh ..... 6, 19~2_., was issued, and conforms to all o£ the require- ments of the applicable provisions of the law. The occupancy for which this certificate is issued is Bu~.l~e~s .bu~'Id~n~..(l~l:L~ed' occur, aney) ............................. The certificate is issued to .I, oo .Stack ....... ~1' ............................... (owner, lessee or tenant) of the aforesaid building. Suffolk County Department of Health Approval ~]&Ri ................................ UNDERWRITERS CERTIFICATE No... ~,R. ........................................... HOUSE NUMBER. 53965. ..... Street... I~.&:~Lii. RO~d. (Ii.~.~15) ........................... Building Inspector FOF, M NO. ~ TOWN OF $OUTHOII) BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) N? 5729 Z Permission is hereby granted to: ......... ~ee ..J~t~. e~..~h~.~.~de~...~ae.... &/~ ..Ibc e Bte41~ ................... C:l~tal:aJ&'ae ....... lleT. o ...................... to .... Jhl,Ll~t .. m~.. J~d~:Lt,.to:~.. ea.. ~x,t ~ .t.i~,..baa ,taaa s...b,,a,t2st raj .................................... at premises located at ........... ~'4~"~'~'"8~: ...................................................................................... ......................................................................... · e~thelaL...31~, ..................................................... pursua:n$ to application dated ..................................... ~ll~l~ ......... ~ 19..~., and approved by the Building Inspector. Form No. 6 TOWN OF SOUTHOLD BUILDING DEPARTbIENT TOWN t~LL 765-1802 APPLICATION FOR CERTIFICATE OF OCCUPANCY 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 lihes, 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. For existing buildings (prior to April 9, 1957) non-conforming uses, or buildings and Vpre-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. C. 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-existin~ Buildinm - $i00.00 3. Copy of Certificate of Occupancy - $20.00 4. Updated Certificate of Occupancy - $50.00 5. Temporary Certificate of Occupancy - Residential $15.00, Commercial ~t5.00 JULY 21 1994 Date ......... · .... ........................ New Construction ........... Old Or Pre-existing Building ....... ~.U~.~.TE~) Location of Property 53955 MAIN ROAD $OuT~OLD, N.Y. House No. Street Hamlet DANA & KA'i'~RINE S0CMACKI 0nwer or Owners of Property ..................... ty 1000 61 B1 I 19 Coun Tax Map No , Section ........... ock ...... . Subdivision ........................ · .. ....- - - .. Filed Map ............ Lot ...................... Perm ................ Date Of Permit ............. Applicant ........ Health Dept. Approval..i ................ -- · .... Underwriters Approval ....................... . . Planning Board Approval ........................ Request for: Temporary Certificate ........... Final Certicate ........... Fee Submitted: $ .......................... .. . BENETRIOS llallkias, Esq. APPLICANT FORM NO. 6 TOWN OF SOUTHOLD Building Department Town Hall Southold, N.Y. 11971 APPLICATION F,CR 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 disposel-(S-9 form or equal). 3. Approval of electrical installation from Board of Fire Underwriters. 4. Commercial buildings, Industrial buildings, Multiple ResiQences 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 unu~al natural or topographic featu res. 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: 1. Certificate of occupancy $5.00 er~ficate of occ"2~n~'¥ nn pre-existing dwelling or land opy of certificate of occupancy use $5.00 Date . ,I~%nua~y. 1;L,.. 1982 ..... New Building .... :~ :~ >, .;;. Old or Pre-existing Building .... x ....... Vacant Land ............. Location of Property .... -lv/ai~. Roa. d,.. Sp.u.t. bo.l.d ~. N~.w. ¥or.k ............................ House No. Street Ham/et Owner or Owners of Property . . . .~.e.o..S..t.ag.~...'7...4 ~.I.% .................................... County Tax Map No. 1000 Section .... 6...~ ......... Block . .~. ............ Lot....~.9.. .......... Subdivision. ~ .FiLed Map No. ~- .Lot No. '~' ~ ' ~' Permit No ..... · ...... Date of Permit .......... Applicant . . .L.e.q . .S.t.a.q~ ..................... Health Dept. Approval ........................ Labor Dept. Approval ........................ Under~.'riters Approval ........................ Planning Board Approval ...................... Request for Temporary Certificate ..................... Final Certificate . .X. .................... Fee Submitted $..-'~=~.....~.. (: .O.O....~.. ~ Construction on above described building / ~m~/I i~li~l~~regulation,. FORM NO. 8 TOWN OF SOUTHOLD Building Depmtment Town Clerks Office Southold, N. Y. 11971 APPLICATION FOR CERTIFICATE OF OCCUPANCY Instructions A. This application must be filled in typewriter OR ink, and submitted in triplicate to the Building Inspector 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 installations, 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 property 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 in- formation required to prepare a certificate. New Building .................... Old or. Pre-existing Building ...,~/-~.r~.~.~.~..... Vacant Land ............................ mocation Of Property ............ ............ .......... ...................................... Owner Or Owners Of Property .............. ........................................................ Subdivision ................................................................ Lot No ............. Block No ............. House No ............. pe rmit No...?.?...~.~.~.. ...... Date Of Permit ...~./....~.?..~..~....Applicant ~......~..../.....~...:........~...~...~....~....../...,~....c~ Health Dept. Approval ............................................ Labor Dept. Approval ................................................ Underwriters Approval .............................................. Planning Board Approval ........................................ Request For Temporary Certificate ........................................ Final Certificate ........ y~.. ........................ Fee Submitted $ .....'~. .............................. Construction on above described building and permit meet~cable codes and regulations. ' Applicant ........ ~ ................................................................................ Sworn to before me~is ....~..... day of ...~...J....~...~.~..t_l_ Notary Public ....... ~ ......................... County (stamp or seal) TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE $OUTHOLD, N. Y. Application No.....~....~...2...2. .............. Examined ..................... , 1~ ........ Approved .................. ./!. ................... , 19 ........ Pemit No. . .....~... ....... Disapproved a/c~ ................. . .......................... ................................ APPLICATION FOR BUILDING PERMIT Date ............................................. , 19 .~....~.. ..... INSTRUCTIONS o. 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 ofproperty must be drawn on the 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 appiication, 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. 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. (Signaturd~/of applicant, or name, if a corporation) ......... ......... ..................... (Address of applicant) V State whether applicant is owner, lessee, agent, architect, en. gineer, general contractor, electrician, plumber or builder. · / Name of owner of premises ..................~ .......... ~ ..~......'.~ .......................................................................................... If applicant is a corporate,.signature of duly authorized officer. -'.,g .......... ........ ......... ............. (Naf~e and title of corporate officer) 1. Location of land on which proposed work will be done. Map No.: ...................... ... ......... , ...... ,Lot No ......................... Street and Number ........ ..'~...~::~", ............................................................... ~ .,~~ ..................................... .~'_.~ ~ ~ _~- Municipality 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Exisiting use and occupancy ,,~..:.C~ ......... b. Intended use ond occupancy ............................. ~..~........~........~Z...~...~ ................................... 3,. ,-Nature of work (check which applicable): New Building .................. Addition ......~.... AIt-~ration ...."...~....~[:.~ Repair .................. Removal .................. Demolition .................. Other Work (Describe) ........................................ ~ 4. Estimated Cost ............ ..~'../..~....~.:...~:~... ........................... Fee c"~-~ ~ (to be paid on filing this application) 5. If dwelling, number of dwelling units ............................ Number of dwelling units an each floor ............................ If garage, number of cars ............................................................................................................................................. 6. If business, commercial or mixed occupancy, specify nature and extent of each type of use ..~Z.s~..~.~.....~..r.~ .... 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 .................... Number of Stories ...................................................................................................................... Size of lot: Front ....... ~.¢~.(,/. ........ Rear ......... .3...~....O...~/. ............. Depth ......... ~..O...~......~.~... O Date of Purchase ........................ ./.~.~.~. ...................... Name of Former Owner ..~....~...~ .......... 10. 11. 12. 13. Zone or use district in which premises are situated ~ Does proposed construction violate any zoning law, ordinance or regulation? ........ ~ ............................................. Name of Owner of premises .~.~...~../9.¢.~. ............... Address ~..c~.~. ...... .~..?..~..~..?../..~...... Phone No. ?..~}[.~?....~.. Name of Architect ...................................................... Address ............................................ Phone No ..................... Name of Contractor .~.~.....~JE[.$...../~.~.!.~.C( .........Address ..Z...b.'?....~..~.~...~.~.......~...~...~.?..... 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 comer lot. STATE OF NEW Y,42RI~ I~, ~-c c ................. 7~..~.~1~ ...... ~ ..................................... boino duly ~worn, deposes ond soys thor he is the ~pplicam ~Name of ~dividual signing application) ~.~~~. above named. 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 ~ke and file this application; that all statements contained Jn this application are true to the best of his knowledge and belief; and tha~ the work will be performed in the manner set fo~h in the application filed therewith. NOTARY PUBLIC, State~f New York No. 52 8125850, Suffolk Cou~ 'i ! i i! t