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Home My WebLink About8464-zFORM NO. · TOWN OF SOUTHOLD BU~.nING DEPARTIlRNT Town Clerk'B Office Southold, N. Y. Certificate Of Occupancy No..g.~..0.8.6. ..... Date ............. J.une ...... THIS CERTIFIES that the building located at . l~.S. Tasker. lane .........Street Map No..Eaat,. 8keeBlock No. ~ee. J;...Lot No. ~O .... Gl, eenpol~t. · I~.Y, ........ conforms substantially to the Application for Building Permit heretofore fried in thl.q office dated ............. l/a~ · .3f., 19.~6. pursuant to which Building Permit No~+61+Z... dated ..........Apl~i~ · .. ~.., 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 .Pl~i.~ate. lalle, family, dYelltng ....................................... The certificate is issued to . Chl~t,tos.. l/ous/~opgtl~oll ....... 0~rllev ................ (owner, lessee or tenant) of the aforesaid building. Suffolk County Department of Health Approval Jllne.. lt.. ~.9~.6. · blt .Ilo..'dlll~ .... UNDERWRITERS CERTIFICATE No. l~.elZ4~u8..~../~..~.~'~.~..0~..-..~../~..3./.7.~. ~. ..... HOUSE NUMBER ....Id+~ ....... Street . .T&llcer. Lane ........................... · l{0Tlla..houae, trap. box, .&. rather. &o~er. &~e&..re. be .ee~l>letell .~y. FOR~ NO. 2 TOWN OF SOUTHOLD 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? Z Permission is hereby granted to: Zlt. at~d...Heme.s ..~.ne...A~.C.. ¢ h~ ~s .....~ous~opoulo~ ......... ~a.tt.~.tuek ................................................. ~o ~4 t~.. ~e~ ..one-..~mni.%y.. ~3ee .1.t-~ng ...................................................................................... at premises located at L~,..#...~O....~a. gt, ezt~..S~o~'~8.....~ ........................................................... ................................... 9//fi.. ~.~ skew,.. ~u~ne .....6~, eenpoz~,e .............................................................. pursuant to application dated ................... f4&'Z'...-.~-I .................... , 19.~6..., and approved by the Building inspector. Fee $~'7'-~'~ ........... Building Inspector/ THE NEW YORK BOARD OF FIRE UNDERWRITERS [J t ~3UREAU OF ELECTRICITY 85 JOHN S~ ~ET, NEW YORK, NEW YORK 10038 , Christos Moustopoulos, Tas~ur Lan~ S~tton Place,:,..:G'reenpor~,, L. ;n ;h~/ollowi~g &~atlon; U~ B~emen~ ~ Ist FI. znd FI OU~S u,as examined on J u n e 17 19 7 6 ,..U,,und to he?. c,.t*pliatlce with tt~e requirements of this Board. OUTLETS ~RECEPfACLES: SWITCHES ~~" A[ff ~ -[-~ ~ ~. w. [ DRYERS _ FURNACE MOTORS, ~ BTURE APPLIANCE EEDERS ~SPECIALREC'PT TIMECLOCKS MULTI-OUTLET , I I i I 30 I [ ...... SE~ V~C~ DISCONNECT : NO. OF ~ ~ S E R V I C *~, ~" ~"~ ~QU~.,~ ~ ~ ~ ~.e Z o~ccc~o. ~ · ~ o~ .,-~o ~O.O~.EU~.~ ~ GFI RECP. ~-4.Skw hot water h~t~r Walter Finge~ Box 991 Mattituck, L.I. 11952 Lic 1845 TOWN OF $OUTHOLD , Building Deportment 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 DUPLICATE 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. C. Fees: 1. Certificate of occupancy $5.00 2. Certificate of occupancy on pre-existing dwelling or land use $5.00 3. Copy of certificate of occupancy $1.00 Date June 10~ lg76 New Building ..... ~.X...~.. Addition ................ Old or Pre-existing Building ................ Vacant Land .............. Location Of Property ..,.D..,q,C._..~.~..O.....~.~..s.~..e.~...S..~...°.?...e.?...~...~./,..~...T..&..s..k._e.~.,.~.~.?....~.~.~.~.t ....... Owner Or Owners Of Property ...C..~.~.~.s..~g.s...,~.q.g.s.~.9.g..q.q~.9..s....( ............................................................... Subdivision ..~.s...~.,e...z'..~,..,,~.b...°..z..9..s. ............................ Lot No..5...0. ....... Block No ............. House No ............. Permit No...,8.,~9..~..~. ...... Date Of Permit .~../...~../.?..9 ...... Applicant ....................... 6/8/76 - }-so-4s .. Health Dept. Approval ............................................ LabOr Dept. Approval ........ .~./..z. ................................. Underwriters Approval .............................................. Planning Board Approval Yes Request For Temporory Certificate ...nD. ................................ Fin(il Certificate yes Fee Submitted $ ..5..,...O.g ........................ Construction on Sworn to before ....... LZ. day Notary Public~ above described building and per,mit meets all applicable codgs and regulations. KENNETH W. THURBER - INLAND HOMES~ INC. ~~ .....County~'', v/P (stamp or Disapproved a/c .., a. ~is a~lic~,~ m~ ~ ~,,v~ i~,~ ~ i~~ ~iZ,~_~X~ ,~:, b. Pl~t plan ~i~ I~i~ of l~ 0~ ~ ~l~~; ~ati~ p t~ ~jb~i~im or areas, aha givi~ a a~ai{~ d~ript~ of ~ of~ ~ ~ drown ~ the di~mm ~ch c. ~ wa~ c~ ~ ~ a~{~ ~ ~ ~ ~ before/~uance of Buildi~ Pe~ff. d..U~ ~ol ~ ~is ~li~i~, ~ ~ I~r wifl i~ 6 Building ~all ~ ~t ~ ~ pmmi~ ~ail~le ~r i~i~ ~ ~ ~k. · ~1 h~ ~i~ ~ ~pi~.or ~ i~ ~e pr Ip ~for any pu~ whir until a ~lfic~ ~ ~c~ ~ ~PPL!~T~ IS ~REBY ~DE to the ~ll~ ~t ~r ~e I.ua~ of a . .~ ~ ~e of t~ T~ of ~, ~lk Cou ~ York. a . . ~, . ~u~, mr~ ~of bmldt ~ or al~mti~s, or ~ m ' , . . ~ . . ~1 or ~lt~, m ~ '~.i~. -- ,ne a~ ~ ~ c~y ~ all ~le I~, o~, ~i~ c~, h~ :~iLAND It(;MKS, Z]IC. """ t3 a~otu~'~t '~li~nt, or name, if. corporation) ~O~ 117, M&ttituck, N.Y. 11952 (Address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. Name of owner of premises ...(~_~..~..q.q ~ll;00g108 If applicant is a corporate, signature of duly authorized officer. (Name and title of corporate officer) Builder's License No ..................................................... Plumber's License No. 517-P Electrician's License No. 27'5-E, Other Trade's License No ............................................... Location of land on whk;h proposed work will be done. Map No.: ~l~..1;.ff..~.g...{~......: ...........Lot No....5.0. ................. Street and Number ~ll~t .~,~,d,,,e, ...o~...~..&...J. ke~ L&ne Municipality State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Exisiting use and occupancy b. Intended use and occur,,,',, 3. Nature of work (check which applicable): New Building.......,~;Z~.... Addition .................. Alteration ................. Repair .................. Removal .................. Demolition .................... Other Work ..................................................... ~ ~ (Description) (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 ..........2. .................................................................................................................................. 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 ............ .4.~. ................... Rear ........ ~. ............... Depth ....~. .............. 9. Size of lot: Front ................... .3....0..0.. ............................. Rear ........... .[..O...O. ........................ Depth ~,~. ........................ 10. Date of Purchase ........................................................ Name of Former Owner ........................................................ 11. Zone or use district in which premises are situated ..................................................................................................... ]2. Does proposed construction violate any zoning law, orSinonce or regulation: ....~..o. ................................................ 13. 'Wilt lot be regraded ............................ Will excess fill be removed from premises: ( ) Yes (z) No 14. Name of Owner _. ~. ................................................................................................. Phone No. ...................... Name o:F Architect .............................................................. Address ................................ Phone No ....................... ~oaress .....,....: .................... Phone No ....................... PLOT DIAGRAM , :~ Locate clearly and distih~tly oil buildings, whether existing or proposed, and indicate all set-bock dimensions from property 'lines. Give street and block number or description occarding to deed, and show street names and indicate whether interior or corner Iot,~'!r ...................... ~.~....~.-. ....... :,: ................... being duly sworn, d~oses and says t~t he is the applicam (Na~ ~id~. sign~ c~tmc~ able name. - ~ ' He is the ............ ~z~c~oz ................... camoret; o,i *r, *tZ ' ; ' of ~id owner or ~ners, and is duly aut~rized to perform o~o~ed the ~id work and to ~ke and file this application~ all ~em~t~nta~ in this appl~q are. t~ beC.of his kn~l~dge and belief; and t~ t~ow~~r~d ~ t~ manor set foffh in t~li~t~ fil~ t~th. ~ ~ ................. ............ ........ , ~ot~ ~ublic, ...................... ~ ........... ~n~ ~.....~.~ ............... g /~ (Si~otm~f 6pplic~ - ~ i TITLE NO. 75-5~20~.93,c "k ' - ~0" ' SUFFOLK COUNTY DEPARTMENT OF HEALTH SERVICES "; ~'~ t : ! ' ' ';o~ ' ~ '-' FOR APPROVAL OF CONSTRUCT ON ONLY , :~..~ .. ~ ' ~ · ~(~o~~/~Y~°~ / DATE /(/ 7',~ HS REF, NO. ' I I ~ ; . YOUN;G.8 YOUNG, 'LAND SURVEYORS ........ ~ ~ '" ,' ~' ~. / ?tV~RHE'AD 'NEW YORK TITLE NO, 75-5-2049;52 ~ONUME ~ ' 1954 ASFI~£NO. ~221 SUI~VE ¥ FOR OF N£VI YOBK