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Home My WebLink About8425-zFO'e,M NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Town Clerk's Office Southold, N. Y. Certificate Of Occupancy THIS CERTIFIES that the b-gding located at Eentral. & .Summit .Dr. .... Street Map No..Cap.t.. K.i.d.d.. Et~o~c~k No ........... Lot No, . .6~ .... ~.',a.t.t i t.u.e.t~., rI.,.Y., ...... conforms substantially to the Application for Building Pemit heretofore filed in this office dated .......... l~[s.r. .1.6.., 19.7.6. pursuant to which Building Pemit No..8..br2.5.~. dated . .~l.ar.. 1.6..., 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 ...P.r.i..v.a.t.e... gar. a. g.e. Mi..t.h..b..r.e.e$.e.~(a.y ............................ The certificate is issued to .Geor. ge. Nakos ... 0w~er ............................. (owner, lessee or tenant) of the aforesaid building. Suffolk County Department of Health Approval ....N...R.., ........................... UNDERWRITERS CERTIFICATE No. N27.527.7. · · ~ar...2~...1.976 ................. HOUSE NUMBER .... 1.7.90 .... Street ...C.e.n..tF.a.1.. D.r.i.v..e ........................ FORM NO. 2 TOWN OF $OUTHOLD 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? 8425 Z Dote ........................................................ 1 . Permission is hereby granted to: ~..,..'.~..~(~../. ...... ..Z..~.L~ ........ ~.~. ........... at premises located at 17~'~'~ ~' ~T J~)~ 1._ ~ji~t ~' ........................................... ; .......................... .--~. .......................... = ................. .......................................... ~ ............ .... ~*'~ ....... :"?'"" .......................... ._~ ..... 7"7:',~. ~_ .............. :"~,~'~ ............ ~ .................................................. ) ................. ; ................. ~'"'; ..................... )L;:"t ........... ~ ......... ;"t ........... ~ ~, pursuont to opp icotion doted ........................................................ , J' ........ , ppr~ by Budding lnspe~or. ' '" ~ ' FORM NO. ~ TOWN OF $OUTHOLD , Building Depaffment Town Clerks Office Southold, N. Y. 11971 APPLICATION FOR CERTIFICATE OF OCCUPANCY Instructions A. This apphcation must be filled in typewriter OR ink, and submitted ~n 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 formation required to prepare a certificate. C. Fees: I. 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 New Building ................ Addition ........ ~ ..... Old or Pre-existing Building ................ Vacant Land .............. Location Of Property ..... ~.7.~5.~'~..e..n..t~.~`.]`~'.D...r'.i'Y'.e'~.'M~.~..~c.t-.i.t.~`~.~[~ ............................................ Owner Or Owners Of Property ......... ..~..¢.9.~..e....~..~...c..k..o...~. ............................................................................... Capt. Kidd Estates Map 1672 & Subdivision ..~iJ[ig, Q~..~q~12¢l,~.y.~,~j,.o.D..~..6] .................. Lot No ....~ ....... Block No ............. House No....].7.95 Permit No....8..4..2...5.....Z..... Dote Of Permit ..3./..1..6,/..7..6.....Applicant ..... ..A...d..e..1.P..h.i...L..~...n..d....C..9.~.-. ..................... Health Dept. Approval ............................................ Labor Dept. Approval ............................................... Underwriters Approval ....... ~,.?,,5.7~.'/.7. ...................... Planning Board Approval ........................................ Request For Temporary Certificate ........................................ Final Certificate .......~ ............................... Fee Submitted $ ......~..~.0. ..................... Construction on above described building and permit meets all applicable codes and regulations. Applicant .......... ~ f~.e..],1~,..~u~,..~.~ ~'.1~ ............................... ~. ........................ Sworn to before me ~is ~~, ~,: ~ ~- f (Y sta~ o) seat ................ day o ............................................ ' ( ~ ) Noto .................................... THE NEW YORK BOARD OF FIRE UNDERWRITERS BURF. AU OF ELECTRICI'rY ~-- d~L 8~ JOHN STREEt, NEW YORK. NEW YORK 10038 m,,. March 2/4, 3-976 4~.~.z,co,.,,,~ .... -~ ~0 N 75277 THIS CERTIFIES THAT -- o~ly the electr~al equipment ~s ~s~ri~d hel~v a~d intr~ced ~y the applicant ~ed on the a~re appt~cat~on n~mt~r ~n the presses of George Nackos, Central Drive cot. of Central ~rive & Zena Road, Mattitu?k, L.I. - th,, folhnr~n~ location' ' Ba~ntent ~ ~n ~ l~t ~'1 ~ End FI. garage,omtside Sec.o. RI,wk Lot . ..... tum~n..d..n March 22~ 197~ a~fot~ndtobe~n ..... .plmncou~thttterequiren~..nt. qtth~.,oard O~EE A~A~. ~ Gustav Bartra 227E Breakwater Rd. ~NERA' ~A~ Mattituck, L.I. 11952 LIC# E1529 ~ x '~ Per___ D ~__~_~ This cert*f*cofe must not be olter~ *n any manner; return to the off,ce of the Board tf incorrect Ins~ctors may be ~denhf,ed by ~elr credentials FO~M NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. Approved ................. .~,..~ ......,/.~., 19Z~ Pomit No ..... .?...,t.,/.**~.....?.......-~,..***~. Disapproved o/¢ ..............~. ....... ....~.. ,.. ...... :.....~. ..................................... (Building Inspector) Application No. ~?('-/"~:.2 b APPLICATION FOR BUILDING PERMIT ......... ........... , INSTRUCTIONS a. Th~s apphcat~on must be completely filled in by typewriter or ~n ~nk and submitted ~n tnphcate to the Budding Inspector, ~. 3 sets of plans, accurate plot plan to scale Fee according to schedule b. Plot plan showing location of lot and of buddings on premises, relationship to adloinmg premises or pubhc streets or areas, §~vmg a detaded description of layout of property must be drawn on dtagram which ~s part of this apphcat~on. c. The work covered by this apphcat~on may not be commenced before ~ssuance of Budding Permit. d. Upon approval of this application, the Budding Inspector will ~ssue a Budding Permit to the applicant. Such permit,shall be kept the premises available for inspection throughout the work. e, No budding shall be occupied or used in whole or in part for any purpose whatever until a Certificate of Occupancy shall have ~ granted by the Budding Inspector APPLICATION IS H[:REBY MADE to the Budding Department for the ~ssuance of a Budding Permit pursuant to the Building Z Ordinance of the Town of Southold, Suffolk County, New York, and other apphcable Laws, Ordinances or Regulations, for the construct~c buildings, additions or alterations, or for removal or demoht~on, as hereto described The apphcant agrees to comply w~th all apphcable I; ordinances, building code, housing code, and regulations, and to admit authorized inspectors on premises and m buddings for necessary inspecti, (S~gnature of apphcant, or name, ff a corporation) {Address of apphcant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or bull Name of owner of premises .............. ..(-~.....~-~..~.,...(~....~...?.. ....... ...b:~....~....C:.l..c:...~...~.. ................................................................... If applicant is a corporat~gnature of duly authorized officer. INa'me ancTtitle of corporate officer) Builder's License No ............ ,.~-~.4~&: ........................... Plumber's License No ......................................................... Electric,an's L,cense No...~.~...~...¢::.'..~..P7,...~.. ..... ..~-..-~:....~...c:....~T:....t...~r... Other Trade's License No ................................................... I. Location of land on which proposed work will be done. Map No..~5~'~:.!2.)~.....~)...'Z~..~...~.. Lot No .... ~....)~... ....... Street and Number ..~./ ..........,.~;.~...?,~...~T.~.~...~.,.'~z.. ....... ~. ...... .?...,:f,.,.t~....~....t....~......~....~...: ....... .~....~....~..?-,..q~....~...T.,~....ct.!..~' .... Municipality 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy /~ ~'-'-~'~ b. Intended use and occupancy ............... ~>,V:~r...(~....~....C.~..,~. .................................................................................... 3. - NatuCe of work (check which applicable): New Building ~ Addition V/ Alteration:. ............. Repair ......................... Removal ......................... Demolition ........................ Other Work ................................... (Description) 4. Estimated Cost ' ~ ~"o ~. ~ o ~-~ Fee / ~ (to be paid on hhng th~s 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 .................... I..~ ........... 7. D,mensions of existing structures, if any: Front .... .~..1.~ ...... 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 ........ ..Z.....'~... ............... Height ............. J...~....~..?.. ..................... Number of Stories ................. .~...>:'.....~. .......................................................... 9. Size of lot: Front .............. ~...I..? .................. Rear ............. J..?..?. ..................... Depth .....:..Z:~....?......~, ............................ 10. Date of Purchase ..................................... Name of Former Owner ....~..:.~..~.!..'~.. ....... .~.~.?...~..~ ...................... 11. Zone or use district in which premises are situated ..... .~.......~....~.~..~.~.[..'7..?..!.~....~.. ................................................... 12. Does proposed construction violate any zoning law. ordinance or regulation: ............ ...t~....:..~.. .................................. 13. Will lot be regraded ....... ..~....O... ................ Will excess fill b_e removed from pJ:emises: [ ] Yes ~ 14. Name of Owner of premises ....... ..~....~.~..~...~...~. ..... ..~....~...c..!.~...c..~.. .......................... .~.Z..i...~..). ...... ..~....~..:.(?...?.....~..~.!.! .......... (Address) (Phone No.) Name of Architect .................................................................................................................................................... (Address) ~ (Phone No.) _ Name of Contractor ..... ~.~.....~7....~....~.,.~. ........ .kt:...,~....t~,....~.. .... ..C;..= jr- t:~ ~6'~, P~I4L'I-TCtv c ,1~'/, /.?~'-N~-'~ .......................................(Address) ' .................... ~'[F¢l~'~'~;:i ............. PLOT DIAGRAM Locate clearly and distinctly all buildings, whether existing or proposed, and indicate all set-back dimensions property lines. Give street and block number or description according to deed, and show street names and indicate whe er interior or corner lot. (Name of md/v/dual $lgT, llllg contract) being duly sworn, deposes and says that he is the apphcant above nan (Contractor, agent, corporate offtcer, etc ) of smd owner or owners, and ~s duly authorized to perform or have performed the sa~d work and to make and [de th~s apphcatmn; th. statements contained in this appl,catlon are true to the best ol~ll~i~.n~.~t~ge and behef; and that the work wdl be performed in the rn~ set forth m the apphcat~on fried therewith NOTARY PUBLIC, Sfa~'e of New York -II