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Home My WebLink About10010-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No Z-17479 Date NOVEMBER 12, 1988 THIS CERTIFIES that the buildin~ Location of Property 1445 RUTH ROAD House No. County Tax Map No. 1000 Section 106 Subdivision ADDITION MATTITUCK, NEW YORK Street Hamlet Block 7 Lot 12 Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated OCTOBER 26~ 1978 pursuant to which Building Permit No. 10010-Z dated NOVEMBER 8, 1978 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 TO EXISTING ONE FAMILY DWELLING The certificate is issued to ZAHARIAS PERTSINIDES & WIFE (owner, X~) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A UNDERWRITERS CERTIFICATE NO. H005809 - OCTOBER 14~ 1988 . PLUMBERS CERTIFICATION DATED N/A Rev. 1/81 Building Inspector 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 CQMPLETION OF THE WORK AUTHORIZED) 10010 Z Permission is hereby granted to: ../:~.~::~>.:!,:. .......... f.(..'¥:.:.~..!: .............................. <;>' F~ ~"~ ~ ' I ' ...~ ...... : ~.:.: ......... ~.L >....:..~.:..:....~.... ~ ot premises located at /~! pursuant to application dated ................................... 4~.,C.~.....~.~ 19....~, and approved by the Building Inspector. Fee $ ........................ Building Inspector FORM NO. 6 TOWN OF SOUTHOLD Building Department Town Hall Southold, N.Y. 11971 765 - 1802 APPLICATION FOR CERTIFICATE OF OCCUPANCY Instructions A. This application must be filled in typewriter OR ink, and submitted .- ~ 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 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 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, B. For existing buildings (prior to April 1957), Non-conforming uses, or buildings and "pre-existing" land uses: I. Accurate survey of pzt3perty showing all property lines, streets, buildings and unusual natural or topographic features. 2.Sworn statement of owner or previous owner as to use, oectipancy 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: ~ POOLS $25.00 ALTERATION $25.00 1.~~.0~e~,~g New Dwelling $25 G0, Accessory'~$J0.00 Business $50.00 2. ~ert~flcate of occupancy on pre-exmting dwelljn§ $ 50.00 3. Copy of certificate of occupancy $ 5.00, ove~ 5 yea~s $10.00 4.Vacant Land C.O. $ 20.00 ~/'/'~'/~''~'/'- ,~.~. 5.Updated C.O. $ 50.00 Date .............. NewCons truc tion ...... Old or Pre-existing Building ............ Vacant Land ............. Hou~ No. Street m/e't Owner or Owners of Property . .2..~./?,~?, J .~.5.,, ff~.,l~T ~/.,~./. ~.~,.j. .... ,, .~.. f~)l~'~.. . . ... .......... County Tax Map No. 1000 Section ..../,0.~. ....... Block ...... ~.. ........ Lot ...... /~'..~. ...... Subdivision ................................. Filed Map No ........... Lot No .............. Permit No J "" ~ ~ ~ ¢~' Date of Permit ~ .,Z.~w ./~PApplicant Health Dept. Approval ........................ Labor Dept. Approval ........................ Underwriters Approval ........................ Planning Board Approval ...................... Request for Temporary Certificate ..................... Final Certificate ....................... Fee Submitted $ ............................. Construction on above described building and permit meets all applicable cc~des and regu ations. Aoolicant ..................... e~. 10-10-78 TnWN FIF SBUTHEILD OFFIOE OF BUILDING INE~PEOTOR TOWN I~.LEEK"S I-IFFIOE BOUTHnLD, N. Y. 11971 765-180:) BUILDING DIrPT. INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLBG. [. J FouNDATION ZND [ ] ~SULATION [ ] FRAMING [J/] FINAL ,,,~,^,KS.- ~/C- .-/4~- C~ ~3UILDING DEPT. INSPECTION [ ]FOUNDATION 1ST [ ] ROUGH PLBG. [_]FOUNDATION 2ND [ ] I.~,~ULATION []FRAMING [~lNJC ~ REMARKS: /~ ~~ DATE FOKM NO. ! TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. ................... ~:'"'~ 19..~.'~/~-rmit.,.. ~ r, No. t* 0 ~ f P Approved Disapproved a/c ............~...,..~.,. .................................................... {Building Inspector) Application No/O APPLICATION FOR BUILDING PERMIT INSTRUCTIONS a. This application must be completely filled in by typewriter or, in ink and submitted in triplicate to the Building Inspector, with 3 sets of plans, accurate plot plan to scale. Fee according to schedule. b. Plat plan showing location of lot and of buildings on premises, relationship to adjoining premises or public streets or creas, 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 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 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. ...... ................ .......... i.//....: ........................................ (Signature of applicant,?or name, if a corporation) ............ ........................ ........ :..,. ....... (Address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. Nome of owner of premises ........................................................ ~. ........................................................................................... If applicant is a corporate, signature of duly authorized officer. (Name and title of corporate officer) Bu Uer's Uc se No, ......... Plumber's License No ............................ ~.;,.~,, .......... Electrician's License No ............................................. Other Trade's License No ............................................... ~+oc/J/~' ? Location of land on which proposed work will be done. Map No.: .~..zC,',~,.,~./~..A(,,.~.,',..~,.~,~, ....... Lot No. ~.,,.,/, .~., .~. ........ Street and Number .../..?..~.. ...... ~.~.~.,~........~.(~...~..~........-~..~..'~...~.~./..~. ......... /Z...~'.;. ...... .//.~5:~.~.- ............................. Municipality State existing use and occupancy of premises and intended use and occupancy,of proposed construction: a, Exisiting use and occupancy ............. ..'~....,'.,~../f:~.~.'~,~ ........... /.~".~....~.././?..~.~...~...~ ................................................... b. Intended use and occupancy ............. %2.' ................ ~. ....................................................................................... 3. Nature of work (check which applicable): New Building.. ................. Addition ~ Alteration Repair .................. Removal .................. Demolition .................... Other Work ..................................................... ~// o ,o ~ (Description) 4. Estimated Cost .~. ;Z~) ¢3 -- Fee (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 ............................................................................................................................................. 6. If business, commercial or mixed occupancy, specify nature and extent of each ~pe of use ............................ 7. Dimensions of existing structures, if any: Front ..... ~.~ ................. Rear ....~..~. .................... Depth .~.~ ........... Height ...... ~.~ ............. Number of Stories ............... ~..~J..~ .................................................................................... . . . j · ~6 ~P D~mens~ons of same structure w~th alterahons or add tons Front .................................... Rear ............................ Depth ...~.~ ..................... Height ...... Z~ ................ Number of Stories ~ ~ ~ 7' ~/ 8. Dimensions of entire new construction: Front ....Z.~ .......................... Rear ....Z ...................... Depth .~ ................. Height ...~.~..~. ........ Number of Stories ............ ~..~ ............................................................................................. 9. Size of lot: Front ....... Z.~.fl..( ..................................... Rear ....... [~..~..~. ....................... Demh .... /~,~ / 10. Date of Purchase ........................................................ Name of Former Owner ........................................................ 11. Zone or use district in which premises are situated .......... ~.~.~ ............................................................. 12. Does proposed construction violate any zoning law, ordinance or regulation: .......... ~ ....................................... 13. Will lot be regraded. ...... ~..~. ........... Will excess fill be removed from premises: ( ) Yes ( ) No 14. Name of Owner of premises ~....~~'. ............ Addre~.~/~ ...... Phone No ....................... Name of Architect .............................................................. Address .............................. Phone No ....................... Name of Contractor ~4~....~..~ ...................... ~ Address ..~4.~f~ ........ Phone No.~.~2~.(~.... PLOT DIAGRAM Locate clearly and distinctly oil buildings, whether existing or proposed, and indicate all set-~ck dimensions from property lines. Give street and block number or description according ta deed, and show street names and indicate whether interior or corner lot. ~0~~~~OF ........ '~ (Name ~ indivi~al signing contrac~ above named. ~ - ~ ~ (Contractor, agent, corporate officer, etc.) of said owner or owners, and is duly authorized to perform or have performed the said work and to make and file this application; that all statements contained in this applicotien are true to the'best of his knowledge and belief; and that the work will be perfor~d in the manner set fo~h in the eplication filed therewith. PAMELA J. SCHINELL[,// -- ' ]Signature of applicant) Cemmiss,on Ex.i,es M~,c~ 30. ~