HomeMy WebLinkAbout6693-zFORM NO. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Office of the Building Inspector
Town Hall
Southold, N.Y.
CERTIFICATE OF OCCUPANCY
NO. Z17506
DATE November 10~ 1988
THIS CERTIFIES that the buildin~
Location of Property 1820 WELLS AVE.
House No.
County Tax Map No. 1000 Section 70
Subdivision
SWIMMING POOL
Street Hamlet
Block 03 Lot 20
Filed Map No. Lot No.
conforms substantially to the Application for Building Permit heretofore
filed in this office dated JUNE 18r 1973 pursuant to which
Building Permit No. 6693Z dated JUNE 28~ 1973
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 SWIMMING POOL WITH REQUIRED FENCE & LOCKING GATES.
The certificate is issued to
WILLIAM & ~.I.mN GRIGONIS
(owner,
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL
UNDERWRITERS CERTIFICATE N0.11/4/88 H006291
PLUMBERS CERTIFICATION DATED N/A
Building Inspector
Rev. 1/81
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
'TOWN CLERIC'S OFFICE
SOUTHOLD, K. Y.
BUILDING PEP,~IT
(THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL
CC)~PLETION OF THE WORK AUTHORIZED)
6693 Z
Permission is hereby granted to:
t~...l~tar.~..at ...........................................
........... &mima_lmme.....l~.~ ..............................
at premises located at~/~.....'J~.L.,~,~t~..~..~.*L..~o~,~, ................................................................
....................................... Jml~o~.~L....]~.,~'., ......................................................................................
pursuant to application dated ............................ ~:~aa~_....~ ........ 19..1~.~., and approved by the
Building Impector.
Fee $...~.,~a) .........
B ng
THE NEW YORK BOARD OF FIRE UNDERWRITERS
~007q'79 BUREAU OF ELECTRICITY
88 JOHN STREET, NEW YORK, NEW YORK 10038
Date Application No. on ]il~
G~I~I~S THAT
H~ (;~:(~()~X:S~ 3000 W~;h_,S AW.., So0't'HOf,~) N.Y.
SWlTCI~
RXTURES
[] 2nd FI. POOl, Section Block Lot
and found to be in compliance with the requirements of this Bo~rd.
RANGES OVENS DiSH WASHERS EXHAUST
DIMMERS
$~RVlC~ DIS~qNECT S E II V I C E
OF CC. COND.
~rvey ha~ been made
electrical eq~l~ pment
prem~se~ i~dicated."
u~sat'~sfactory cond~
tOf)O W)lht,S
,gt).ltHO{,O, NY, 119'71
This certific~to must not be altered in any manner; return to the office of the Board if incorrect, inspectors may be identified credentials.
COPY FOR BUILDING DEPARTMEHT. THIS COPY OF CERTIFICATE MUsT HOT BE ALTERED IH AHY MAHHER.
765-1~02
BUILDING DEPT.
INSPECTION
[ ] FOUNDATION 1ST [ ] ROUGH PLBG.
[ ] FOUNDATION ZND [ ] INSULATION
[ ] FRAMING ~ FINAL
REMARKS: }'~/,,~' ~),:,~-. ,~*~ P-0~,~: ~
DATE
INSPECTOR /~'/- L,
~/ILLIAM
MAP OF:' L.&ND
14. & IdELI:;;N
AT
Disapproved O/c ~.-..~
APFMC:ATION FOR BUILDING PERMIT
INSTRUCTIONS
a. This application must be completely filled in by typewriter oe in ink and submitted in triplicate to the BuildingS'
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
areas, and giving a detailed description of layout ofproperty must be drawn on the diagram which is port of this applical~%.
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 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, building code, housing code, and regulations, and to
admit authorized inspectors on premises and in buildings for necessary inspections.
State whether applicant is owner, lessee,, agent, architect, ehgineer, general contractor, electrician, plumber or builder.
Name of owner of premises ....~..l~...~..J.~R.~:l ...... -~.~.....J~..~-../.....&~.....~.../..~.. .............................
If applicant is a corporate, signature of duly authorized officer.
(Name and title of corporate officer)
Builder's License No ........................ ; ............................
Plumber's License No .................................................
Electrician's License No ........ /.E.~L.~.-. ......................
Other Trade's License No ...............................................
Location of land on which proposed work will be done. MaP No.: ...i:hR.R..t...~..e..~......~...~....~:. Lot No .........................
Street and Number ...... .~.~....~(~....~. ....... ..~....r..~..: .......................................................................................................... $ o u ~ ~ ~
Municipality
State existing use and occupancy of premises and intended use and occupancy of proposed construction:
o. Exisiting use and occupancy ............. ..~....S..L..b..~..'Y....c'~.. ......................................................................................
b. Intended u~e end occupancy ...... /.~.~...A~..(e....~T~.~.~.~.~..~.....`q.sL~.~......~.-~.-x:~.....~:~'~29.~..2~......~.~ ......
; Nature o~..v~rk-(checkwhlch Op~pfiC~ble): 'New~BGil~i~rt~ ::;,,',, ,~,,;,,,,,', Addition ~,,.,,;,,,,: ...... Alteratio~ .................
- (Description)
(to'be paid on filing ,~t~is application)
5~ If dwelling,-number ~f dwelling units ............................ Number of aWel!!~ units'on ~ch floor-, ..........................
'-: If garage, number of cars ........................... L ........ ~. ............................. :....~ ...............................................
%~, 6. If business, commercial or mixed occuPancy, specify natu;e and. e~ten~t'o~'e~,~:h type of Use ..... . ..........
Height ........................ Number of StOries- .............. /., ..................................... ~... ...............
~ Dimensions of some structure with alterations or oddffions: Front .................................... Rear ............................
Depth ................................ Height ............................ Number of Stories .................................
T~ 8. Dimensions of entire new construction: Front .......... ..~..~. ................... Rear. .......... ~..~. .......... De~th ..:..~',.~.. ............
.,~ "-- . Heigl~t .................... Number of Stories ......................................... ; ...........................................................................
10....Date .of PurchaSe ...................................................... Name of Former Owner ........................................................
~.,~ :1,3.; Zone or use district in which premises are situated ...................................................................
' ;' 12. Does proposed COnstruction violate any zoning law, ordinance or regulation: ........... .~....0. ...... ; ....................... ;....,
~., -'~]3.: Wdblot~be~regra~ed:.,...~....~. ...... : ...... Will excess fil be removed fr6rn premises: (~-Yes [ :)~ No
"'Locate clearly and distinctly' ~11 bud ngs, whether exPtina or nronosed, and nd cote ai~ ~-" i,~,~ ,4~ .... J,,,,, ~,,_
-, prope ~nes. Gwe street and block number or descnphon accord ng to deed and show street ~ames and m:licate
whether interior or comer lot.
................................. ..'?../..~...~..~t~J~....../~.;....;..?X'~.~d~,~g duly sworn, depee~'~d says that ~'l~ ~e applicant
(Name of individual signing contract)
above name.
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 ~d to ~ke and file
this application; that ali state~ents contained Jn this application om tree to the best of hJ.s knowledge and belief; and
thor the work will be performed'in the manner set fo~h Jn the application fil~ therewith.
Swam to be~ me this
...... /~... dov~~ ............ ,
..............................
~c.~o ~. ~ (Signature of ~pplicant)
aOT~ pUBUC, ~te ef
~: 5~-~S~3,
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