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HomeMy WebLinkAbout10044-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y, Certificate Of Occupancy No. Z10466 Date .~p.z'.~.l. '.2.3. 19...81 THIS CERTIFIES that the building ................................................ Location of Property .. 25.0..$ .t?.a. ~. ¢.o.r'.'4..R 9~.d. ~ ...... .g.ap.~...H.a.r'.5:.q,.'3 j' .}{: .g.. ............ House No. Street Hamlet County Tax Map No. 1000 Section ...... 21 .... Block ....... l ....... Lot ... :1.0 ............ Subdivision ..... $.*ar. ag~or., t~a. tlat, e ........Filed Map No... 3.7.a3 .Lot No ..... 5 ........ conforms substantially to the Application for Building Permit heretofore filed in this office dated , .1. O 0 ~h.21. ·. D.ct;obe.r~. .2 ........ 19.7.8pursuant to which Building Permit No .... ' ......... dated...N°verabe t-. .... ...29 ...... ........ 19 , was ~ssued, and conforms to all of the requirements of the applicable provisions of the law. The occupancy for which this certificate is issued is ......... ...... ~ Pg~.q UP,ct. . P. OP.]-..¥ .t.~.h., 1'..e.n.qe. ............................................. The certificate is issued to ..... .Q~.a.~.q. pg.p.h..n.~.d.a.a...&..H. 9.19.n..D..ap.h.n.~..dg.a' ........... (owner,.l~;Sae.er.t~.l, .- of the aforesaid building. Suffolk County Department of Health Approval ..... ~q./.g ................................. UNDERWRITERS CERTIFICATE NO ..... ~1.63.7. I ~ ..................................... Rev. 1/81 FO~M NO. 2 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE P1~EMISE$ UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) No. 100~4 Z Date ........................................................ , 19. . Permission is hereby granted to: ...~A ........~ ....... ~.~....!h.?...~..'..-!'~...~...~ ........... .................................................................... 5.0..5! ......... ~L~.!~!..?..~.! ............................................... / pursuant to application dated ...................................... ~(.1~...~, 19Z~., and approved by the Building Inspector. .Fee $... J.~l ............... Building Inspector FORM NO, 6 TOWN OF $OUTHOLD Building Department Town Hall 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 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 natura~ 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 Apri~ 1957), Non-conforming uses, or buildings and "pre-existing" land uses: 1. Accurate survey of peoperty 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 informa- tion required to prepare a certificate. C. Fees: 1. Certificate of occupancy $5.00 2. Certificate of occupancy on pre-existing dwelling or land use 3. Copy of certificate of occupancy $1.00 $5.00 Date .... .A,P.R.~ .L..9~. ] .9.8] ......... New Building ............. Old or Pre~existing Building ............ Vacant Land ............. Location of Property ...... S.T. I~A. T.r.~0..RS.. ,R0. A. I~,. ~ .AS.T' H..A.P,]~0~I ~. ~.,. ~,o. [.1,. ¥ ..................... House No. Street Hamlet Owner or Owners of Property ......... .C)J ,R.~ .ST.O' ,&. I:.I.E,L ,E~t. DAP ~N)~ [~$ .......................... County Tax Map No. 1000 Section .¢P.~.~..'~'. ..... Block ............... Lot,..~. ........... Subdivision ................................. Filed Map No ........... Lot No .............. Permit No ........... Date of Permit .......... Applicant .................................. Health Dept. Approval ........................ Labor Dept. Approval ........................ Underwriters Approval ...a.~;.~;.a.c.h.e,d .............. Planning Board Approval ...................... · Final Certificate . .f.o.E .p.O.o.l.,..~e. ll.c.e. ...... Request for Temporary Certificate ......... ,/ .......... '¥~ ¢¢ ....fi" ..... ~[ Fee Submitted 5.00 Construction on above described building a ,le codes ~ ~ Rev. la-la-78 THE NEW YORK BOARD OF FIRE UNDERWRITERS pill BUREAU OF ELECTRICITY ~ 83 JOHN STREET, NEW YORK. NEW YORK 10038 .,,,. :u.. ~.~, :[~?~ ~,,.,~,,c.,,o. No.o./,,. o~?~ N 4371 THIS CERTIFIES THAT ~ only the el~ctriral egu~pment as d~scHbed belfry a~nd ~ntr~p~uced bx t~ p~olica~t.l~ qn the ejh~ve ~op~.atiqn number in~the premlses of in the following locati~n~; [] Basement [] 1st FI. [] 2nd FI. Sect;on Block Lot wos examined on ~1~7. X979 and found to be ln compliance with the requirements of this Board. SERVICE D~SCONNECT NO. OF S E R V I 0 "Ob RANGES COOKING DECKS OVENS DISH WASHERS k/~T. K.W. A~T. K, W. AI4T. K.W. ,*AT. K.W. SK'CIALREC'PT. TIMECLOCKS BELL UNIT HEATERS MULTI-OUTLET C EXHAUST FANS DIMMERS Amt Levene Eleo. Cont~. Ino. }[loksvllle~ N.Y. 11801 Lic.ll09 ePer 1] COPY FOR BUILDING DEPARTMENT. THIS COPY OF CERTIFICATE MUST NOT BE ALTERED IN ANY FORM NO. 5 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. ORDER TO REMEDY VIOLATION (owner or authorized agent of owner) .~...~...~.. ~x~.~ (address of owner or outHoriz~d agent of ow~r) PLEASE TAKE NOTICE there exists a violation of: Zoning Ordinance ...~ .......................... Other Applicable Laws, Ordinances'ar Regulotions ............................................ at premises hereinafter described in that .~..~/.Z'.~.Z./../.~. .... /~t4.~'../~.~.~-'~..~. ..... .~.....~..?.~.. (state character of violation) d~z ~.~.~ ~.[d~~....,m~....z~.~z~ ...... ~se....~.~....< ....................... ,. ............... ............ .................................................. (State section or paragraph of applicable law, ordinance or regulation) YOU ARE THEREFORE DIRECTED AND ORDERED to comply with the law and to remedy the conditions above~mentioned(~forthwith on or before the ............... ~.~/..~ ~x,~ . day of ....... ~.~ ............... , 1~. ~) O The premises to which this ORDER TO REMEDY VIOLATION refers are situated at .~....~...~, ~'~.~.~.Z~.~.~,,~C~..i ~,...~.. Count' of Surf , .' ....... /.~. ~ .......... ~ ........... .~ .............. y olk, New York. Failure to remedy the conditions aforesaid and to comply with the applicable provisions of law may constitute an offense punishable by fine or imprisonment or. both./ TOWN OF SOUTHOLD OFFICE OF BUILDING INSPECTOR TOWN HALL SOUTHOLD, N. Y. 11971 November 9, 1978 TEL. 765-1802 Seaboard of L.I. 13 Landing Road Rosyln, New York 11576 Re: Building Permit - C. Daphnides Dear Sir, I received all your paper work concerning the Building Permit application for C. Daphnides. Everything seems to be in order with one exception there was no fee included for the Building Permit ---$15.00 or the Home Improvement Contractor's License fee which is $10.00. As soon as you send me a check for the above amounts your paper work will be processed. Yours truly, PAM~,A J. SCHINELLER ~lilding Department Sec. BUILDING DEPARTMEN'T /~ ~/~/ TOWN CLERK'S OFFICE SOUTHOLD, N. Y. Examined //~_~...~....~.., ]9 ........ · ..... 'L/ ~--~.7 Application No. /....~Z...!.../... ..... ....................... · ..... ./..., ...~r'~ ' lq ..................................... / D'sappr6ved a/c .............. ~r ..................................... ; ......................... ...................................................... .............. ..................... · . (Budding Inspect6'r) . APPLICATION FOR BUILDING PERMIT ~,~ ........... ~,~......~.~.~. ...................... l~ ..... INSTRUCTIONS o. This application must be completely filled in by typewriter o~ in ink and submitted in triplicate to the Building ,!nspect0r, with 3 sets of plans, accurate plot plan to scale. Fee according fe schedule. -'~ b. Plot plan showing location of lotood of buildings on_premises relotioh~h'ip to adjoining premises or pub c streets m areas, and giving o detailed,description of layout ofproperty,must be drowmon -the didgrOm which is port of this application. c. The work covered by~ this application may not be commenced before issuance of Building Permit. - :d; 'Upon Opprovol of thi~ application~, the Building 'Inspector will issue o Building PeCtin'it 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 port for any purpose whatever until a Certificate of Occupancy shall hove 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 0fher applicable Laws, Ordinances or Regulations, for the construction of buildings, additions or alteratiohs', or fs~r remogal'or demblitJ'on, 'as herein described. The applicant agrees to comply with all applicable laws, ordinanc4s, building code, housing code, and regulations, and to admit authorized inspectors on premises and in buildings for nec;~ssary inspections. .., ' .~.,//' -: t .... '-~-~,'; ~¢' appl i :if ........ . . ....................... ........................ Sta e whether apphcant ~s owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder· . .:.,. Name of owner of p~emises : ........... ~ .................................................... If applicant is a corporate, signature of duly authorized officer. ,' : (Name and title of corporate office;r) Builder's License No..[.:i...~.....~...~'.:.~......~.....~....../, .............. ' Plumber's License No ............................. . .................... Electrician's License No ........................... ................. ~ Other Trade's License No ............................................... Location of land on which proposed work will be done._Map No.: ......... ~ ............ : ............ ~.... Lot No..., ...................... Street and Number ~7.J..~J.....~7...~..~..7..~.~.~.~.~j~....~/...~...~..:~.~..~;..~.~.~`.~`~%~.~...~.. __ ...... ~'7' ~ ~.~1~ A'/0 ~ ~ E -~7-.~ 7'-~-~'~ Mun,cipality State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Exisiting use and occupancy ..~.~//../~'...~..~..~ .~.~-~/.4~..~..~.. // /1 b. Intended use and occupancy ................................................................................................................................ 3. Nature of work (check which applicable): New Building.. ................. Addition ...... ~ ..... Alteration ................ Repair .................. Removal .................. Demolition .................... Other Work /..~....~.,.~...~..~....~.. / ~ ~ / (Description) F .................. l..? .............................................. : ................... J 4. Estimated Cost ............ (~,L.'~m¢.~4 ................................ ee (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?ature and extent of each type of use .............. y ............ 7. Dimensions of existing structures, if any: Front .........~.~. ............. Rear .....~..~...L .................. 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 ...... ~r..,.O..' · ............. Depth ....... Height ....... ~ ...... Number of Stories .................................... ~.:.'.: ............................................................................. o' ..... ...... 9. Size of lot: Front ....... ;~.J......,...O.. .................................. Rear .......... I~.,....~...~..~.. ............ Depth 10. Date of Purchase ........................................................ Name of Former Owner ........................................................ Zone or use district in which premises are situated ........................................................................................ 1 1. 12. Does proposed construction violate any zoning law, ordinance or regulation: ................. /~...~..~.~ .~....~. ...... 13. Wi at be regraded .......d~./~. .............. Will excess fill be removed from pre_mis,es: (~'~'Yes/'"f; ' "( ) No 14. Name of Owner of premises ~..'.:....~(~...~.~.tl..~ .~..I./).J~..~...._~ ........ AddresS' .~:~,~l.-/~../ld..~:~:J!~ Phone No. Name of Architect ./~..:..~.(/LJ),~Jk).~..~..J.,~.. ....... ~...:. Address j../~'...~...l~:~..~.?~.?~,.'~-'~-'--~ "- Phone No. ~)..~.L; .............. Name of Contractor .~l~..'i~-,~.....~.~....~..~/,.g~.-..~.~.~ddress ./~.J-~,~,~J,~-~.. Phone No. (~..~..~..~.~..~...O. PLOT DIAGRAM Locate clearly and distinctly all buildings, whether existing or proposed, and indicate all set-bock dimensions from property lines. Give street and block number or d~ cription according ta deed, and show street names and indicate whether interior or corner lot. '7 1 ~O'~ ~- ~ o /o-r- vo, 4 STATE OF NEW YORK, ~ ¢ S COUNTY 0~:// ................... ................... g.l...~..?. ........ .'-~l~..~(~J.~.. .......................... being duly sworn, deposes and says that he is the applicanl (Name of individual signing contract) above named. 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 and to make and file this application; that all statements contained in this application are true, to the best of his knowledge and belief; and thor the work will be performed in th~ manner set forth i~cation/filed ther, ewith. Sworn to before me this ~,/, ~1~ /~L~ ~z / .......... . Notary Pub li~'-,~... ,.~3~,~Coun-'~-~.~... ..... ..'~.....J ........... ~...~..~ ............................ 6--"'~~(s.j~."~l]l.,jW ~:~ (signature of applicant)-~-- {m' ~ ~" o.~, T"f PIC~L ~,~ E--CT'~ C)~ I~-- TSP.,oO~ P,%TR J SEABOARD POOLS :ro~5 uo .,II ~- I L .......... © ® k/,/'/NL L -CT' \ 0'1,,4