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HomeMy WebLinkAbout7882-zTOWN OF SOUTHOLD BUILDING DEPARTMENT Town Clerk's O//ice Southold, N. Y. Certificnte Of Occupnncy No. Z.?~c)6. ..... Date ........... I]ee ....'1 ......, 19..~'6 THIS CERTIFIES that the building located at R,0,~L,..S/8. ga/~a. Btl ...... Street Map No. ~ ......... Block No. Xx ..... Lot No, . ~.. E&st. 14~'io~ · · !~.,.¥, ..... conforms substantially to the Application for Building Permit heretofore filed in this office dated .......... Ma~.. 2 , 19.7%. pursuant to which Building Permit No..7.882Z. · dated ........ .1~. y...2.. , 19.~., was issued, and conforms to ~11 of the require- ments of the applicable provisions of the law. The occupancy for which this certificate is kssued is .Pl~lva~;e. oI~ f~ily..dwel~tug, with. addttian. (deck) .............. The certificate is issued to . .~lel~r 8~,~o,~a~kes.. ~wnely ...................... (owner, lessee or tenant) of the aforesaid building. Suffolk County Department of Health Approval N,H, ......................... UNDERWRITERS CERTIFICATE No.~?,3~+?~... ~.uly...$~...1.97~. .............. HOUSE NUMBER . . 11 ~20.. Street .... l~llt. P, oa~l .....E&~2.14~'io~ ......... ....... l~in~ ~n;;~t'o'r[ ' .... 'TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFfiCE SOUTHOLD, bi,. Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) N? 7882 Z Permission is herd:)y granted to: ~ ..'/A,ei~..,~t~r~k,e & ....................................... ...... ~& ~...Aez'-2~ ................................................... to ....,~'C~ ~...~..a~.dA.ti.on....( ~.ez.k.}...on..~,x.~.~fl;l~g..~w~l~ ........................................... at pref~ lacated at .G~/~..~Le~..~eaq~ ........................................................................................... .................................................................. ~ ws',l:. · .N.~,~,'l_.o rr .......................... ; ........................................ pursuant to applicatiofl dated ............................. ~' .......~. ........... 19,.~.~., and approved by the Building Irv~ector. Fee $.~.~G ........... FORM NO. 6 TOWN OF $OUTHOLD , Building Department 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 "pm-existing" land uses: 1. Accurate survey.of property showing all property lines, streets, buildings and unusual natural or topographic features. 2. Swam 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 ... ..... New Bqilding ................ Addition ...~ ........Old or Pre-existing Building ................ Vacant Land .............. $./,~. M in Ro.~d E~st Marion~ N. Y. Location Of Property ........... ~ ................. ~ ............................................................................................... Owner Or Owners Of Property ....... ~'Ick~..~S~'~'.O~,~.ke.s ....................................................................... Subdivision ............... ~ ............................................ Lot No..~ ...... Block No......~.. ..... House No....1..1..!.2..© Permit No..~.~2~ ....... Date Of Permit ..,,l~Y....~..~.Z~pplicant ..... ~.~.~....S.~.~,~..o..1...~.~...e..s. .................... Health Dept. Approval .~...~.. ..................................... Labor Dept. Approval .... .~..../~... .................................... Underwriters Approval ...~.....2.~..~..~.~. ........................ Planning Board Approval ...~,/.~ ............................. Request For Temporary Certificate ........................................ FinaJ Certificate ............. ~ ........................ Fee Submitted $ ...~...~.Q ........................ Construction on above described building and~L~?it r~eets all appl~,ble Applicant ............ .%~.~ ....... ~:~~ .................. Sworn to before me thi, ~ ~~ ....... ~7~. day of .................................... (stamp or ~l)~ FRED KOOBY Nota~ Public__ . ................................... Coun~ N=,~ ~u~4,~,N., ~0-zss~.ost~" ~' ?w Yo,~ ~ ~ Commsss~¢n [xp,ms M~rch ~0, ~TB ~ ak THE NEW YORK BOARD OF FIRE UNDERWRITERS BUREAU OF ELECTRICITY ~5 JOHN STREET, NEW YORK, NEW YORK 10038 ~"~ Juz.~ z% 1975 .~,,.,,~.,.o..,'o ow,,. 8o421o N 285479 THIS CERTIFIES THAT onl~ the electrt~l eq~ipn~en~ ~ dcacrlh~d below and lntroduced b~ the appllcant ~med on the above appllcat~on number ln the l~r~'m~e~ of V. Stavrolakes, s/side Route 25, e/o Trumans Path, East Marion, L.I. tn thefolh,u,ng loca,lon; ~ Basement ~ Ist Fl. ~ 2~d Ft outside s~ct~o~ mo~ ~,t ~..~..,,~.ao. July 10, Z975 attdfoundtobeln{ompha/zceu'tthlhorequtrementsofthtsBoard FIXTURE ~ J FIXTURES I RANGES ~COOKING DECKS ] OVENS ]DISH WASHERS ] EXHAUST FANS DRYERS I FURNACE MOTORS [ FUTURE APPUANC[ FEEDERS tSPECIAL REC'PTJ TIME CLOCKS I BELL J UNIT HEATERS [ MULTI-OUTLET I DIMMERS 2 20 SERVICE DISCONNECT [ NO OF { S OTHER APPARATUS (Swimming Pool) This certificate inspection only. to have frequent E - R V I - C E covers compliance at the date of Because of unusual e'nvironments it is advisable test and/or repairs made by a qualified person. Rocky Point Elec.Oonst. Co.Inc., RR #1, Box 197, King Road, Rocky Point, L.!. 11778 GENERAL Per D This cert,ficate must not be altered in any manner, return to the off,ce of the Board if incorrect Inspectors may be idenhfied by their credentials INSTRUCTIONS a. This application must be completely filled in by typewriter or in ink and submitted in triplicate to the Building Inspector, with 3 set~ of plans, accurate plot plan to scale. Fee according to schedule. b. Plot pl~.n showing location of lot and of buildings on premiSes, relationship to adjoining premises or public streets o, areas, and giving a detailed description of layout ofpraperty must be drawn on the diagram which is part of this application' c. The work covered by this application may nat 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 Deportment 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 buildlngs for necessary inspections. (Signature of a~lican~ or name-if a corporation) Mai~ Road East Mar~.~ (Address of applicant) State whether applicant is OWner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. o1~Ge r Name of owner of premises Vio...~. l tavrol e ............................................................ 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 ............................................. Other Trade's License No ............................................... 1. Location of land ~>n which proposed work will be done. Map No.: ............. ~ ................... Lot No ......XZZ ............ Street and Number ...S~..3~"~.~ ...... 'ea,~B~,i{a..~;~.~zi..4)~...~&]r. .............................................................. 2. State existing uSe and occupancy of premises and intended use and occupancy of proposed construction: dwell,..i~..~ with additig~ ~d~..~ .... o. Exisiting uSe and occupancy .............................................................................................................. b. Intended use and occupancy ......... ~.~l[IR...l~a..a,C]J~ .................................................................................... 3. Nature of work (check which applicable): New Building.. ................. Addition ......;~ ....... Alteration ..;[3[ .......... Repair .................. Removal .................. Demolition .................... Other Work ..................................................... (Description) 4. Estimated Cost ............................................................ Fee ~1~'o00 (to be paid on filing this applicat!on) 5. If dwelling, number of dwelling units ..... .o...~..? ................ 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 .......... ~g ................... '.. Rear ............. ,6..0. .......... Depth ....~..8. ................ Height .................... Number of Stories ...................................................................................................................... 9. Size of lot: Front ........................................................ Rear ...................................... .~,.~Depth ................................ 10. Date of Purchase ........................................................ Name of Former Owner ........... '~"~.~ ........................ 11. Zone or use district in which premises are situated ...~..~....~..~..~..~. ........................................ .I .............. ' ........................ 12. Does proposed construction violate any zoning law, ordinance or regulation: .... ~Q ............................................... 13. Will lot be regraded ........ .~...O. ............... Will excess fill be removed from premises: ( ) Yes ( ) No 14. Nome of Owner of premises ....~.~.~. ......... ~.~.~..'~'....o..]:...a~...e...s. Address ................................ Phone No ....................... Nome of Architect .............................................................. Address ................................ Phone No ....................... Name of Contractor ............................................................ Address ................................ Phone No ....................... PLOT DIAGRAM Locate clearly and distinctly oil 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 corner lot. ~ ~ Bee filed pla~ COUNTY OF .... I~.~,~ ~g. .......... ~'" ............................................. ~L{J~'.....J~.teJI33~D,].Ili~t~.~. ........ being duly sworn~es and sa~ ~~plicam (Name of i~ividual signing c~tmc~ above name. He is the ..................................... ~,~. .................................................................................................................... (Contractor, agar, corporate officer, etc.) of said owner or owners, and is duly aut~rized to perform or have performed the said work and to ~ke and file this application; t~t all statements contained in this application are t~e to the best of his knowledge and belief; and t~a~ the work will be performed in the manner set foffh in the application filed therewith. Sworn to before me this .................. .................. , ........ ............. ......... .................. p~res March 30, 7' i ]1 /