Loading...
HomeMy WebLinkAbout11628-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y, Certificate Of Occupancy No.Z. J J).1.5. .......... Date ..... .J.a.n.u..a.~.y..7. ................. 19.8.3. THIS CERTIFIES that the building .atqlcl.i.t.J~olu ...................................... Location of Property 1365 Aquaview Drive East Marion h~s~ k/ol ................ Street Ham/et County Tax Map No. 1000 Section . 9.2.2. ....... Block . 9.2 ............ Lot ...0.0fi. ........... Subdivision....X ........................... Filed Map No. X .Lot No. X conforms substantially to the Application for Building Permit heretofore filed in this office dated · .P~ p r' %.1. l 9 .......... , 19 ¢ .2. pursuant to wtfich Building Permit No..1.1.~..2 .8..g. ............ dated .... ./ip?.~, ~..2.6 ............... 198..2., 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 ......... .a.s. 9.con. d' ~.lqo..p .a.n.d..d.e.c.k...~t.d.~.~.o.n t.o..one .family dw?.l, lin.g.. ........ The certificate is issued to FRED H. & GEORGIA LAMBROU ..................... ?o¥.'& ~;~'~;,,¢~ ...................... of the aforesaid building. Suffolk County Department of Health Approval ...n./.a. .................................... UNDERWRITERS CERTIFICATE NO .......... ~.. 5 ? .2.3.2.6. .............................. Rev. 1/81 Building Inspector FORM NO. 2 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTH'OLD, Ni. Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) N°. 11628 Z Date ..4.. ........ ..... .............. Permission is hereby granted to;—� ..............i. . '........................................ .�c r..... ` ..f... ��' � /: � .... ............. �:..: ... / tJ........... ............ CG � �� � : /� Aoto ... ... atpremises located at .!....................... ...:......... ' .................................... ...................................................... . ..... ............. .............................. ................... .............................' ' ................................................................................................................................................................. County Tax Map No. 1000 Section .... Qw�.. . ...... Block .....v�................ Lot No. ....... pursuant to application dated ... ... ' 19<!k and approved by the Building Inspector. Fee $.. .................. ............................................................ Building Inspector Rev. 6/30/80 FORM NO. 6 TOWN OF SOUTHOLD BuiMing Departmen~ Town Hall $outhoid, N.Y. 11971 APPLICATION FOR CERTIFICATE OF OCCUPANCY Instructions This application must be filled in typewriter OR ink, and subr~itted in duplicate to the Building inspec- tor whh the following; for new buildings or new use: 1. Final survey of property with accurate location of ail buildings, property lines, streets, and unusual natural or toaograohic features. 2, Final approval of Heaith 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 building~ 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. For existing buildings (prior to April 1957), Non-conforming uses, or buildings and "pre-existing" land uses: I. 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 8nd 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. '/ Fees: 1. Certificate of occupancy $5.00 2, Certificate of occupancy on pre-existing dwelting or land use $5.00 3. Copy of certificate of occupancy $1.00 Date New Building .......... Old or Pre-existing Building(X) ......... =/Vacant Land - Location of Property ................ ~¢..i.~..~.. Hou,~e No. ' ........ -"' Owner or Owners of Property.,........ County ~ax Map No ~000 Section .Q~?-, ........ BIo~ ...~..-~. ........ Lot ................ SubDivision .......~ .................. 'P ...... Filed Map'No...; ....... Lot No, .~-~.// ....... Oateof."ermit Health Dept. Approval ........ ; .......... Labor Dept. Approval ...................... ~.. Underwriters Approval ........................ Planning Board Approval Request for Temporary Certificate ..................... Final Certificat~ ........ - Fee ~ubmitted $.. ,~:% .(~..(~.' .................... Construction on above described building and~p~r~'i~'meets all a~p~cable~Codes and regu ations. ¢o- ~- z~ '. ' 1000221 THE NEW YORK BOARD OF ~FIRE UNDERWRITERS Zl{~ BUREAU OF ELECTRICITY 85 JOHN STREET, NEW YORK, NEW YORK 1OOS$ ~ A~glls~ 10~ 1982 171185 - 8~ ~.,~.c,,.o.. ,,,o. o..s,,e N 572326 THIS CERTIFIES THAT F~r~, n/s ~1~ ave. ~ ~'~. ~. ~ ~..~ ~. ~ ~ ~10~ N;~. A~t 5, 1982 FIXTURE FIXTURES RANGES OVENS EXHAUST OUTLETS FLUORESCENT MEI~CURy SYSTEMS NO. OF FEET S E OTHER APPARATUS: Eleo. Rocml Heater/s~ 2-1.5, 2-1.0, 1-.5 K.W. 2-Smoke Detectors AWG, OF CC COND. C NO. OF HI-LEG AWG OF Hr-LEG NO. OF NEUTRAL A. WG OF NEUTRAL retorter Elec. Co. P.O. Box 452 ~liverhead, N.Y. 11901 lic. 643-E COPY FOR ANY MANNER. FIELD INSPECTION.~ COMMENTS FOUNDATION (1st) FOUNDATION 2. ROUGH FRAME & PLUMBI (2nd) INSULATION PER N. STATE ENERGY pDE FINAL ADDITIONAL COMMENTS: FORM N0: 1 TC0V'I GF S0UTH0LD BUILDING DEPART,IViENT TOWN HALL SOUTHOLD, N.Y. 11971 TEL.: 765-1802 19 lel /Examined F Application No /e we. . . . . . Approved&1117 , 19z�Permit No. ./. ev. ? Disapproved a/c . . . . . . . .. . . . . . . . . . . . . . . . . . . . . . . . . . . . ... . . . . . . . . . . . ... . . . . . . . . . . . . (Building Inspector) APPLICATION FOR BUILDING PERMIT Date . :� /9 . : . . . . . . . < .r I9r INSTRUCTIONS a. This application must be completely filled in by typewriter or in ink and submitted in triplicate to the Build Inspector, with 3 sets of plans, accurate plot plan to scale. Fee according to schedule. b. Plot plan s':iowin- location of lot and of buildings on premises, relationship to adjoining premises or public strb or areas, and giving a detailed description of layout of property must be drawn on the diagram which is part of1this ap- cation. c. The work covered by this application may not be commenced before issuance. of Building Permit. d. Upon apprc-.al of this application, the Building Inspector will issue a Building Permit to the applicant. Such per. sliall 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 Occupar shall have been granted by the Building Inspector. APPLICATION IS HEREBY 1 ADE to the Building Department for the issuance of a Building Permit pursuant to Building Zone Ordinance of the Town of Southold, Suffolk County, New York, and other applicable Laws, Ordinances Regulations, for the construction of buildings, additions or alterations, or for removal or demolition., as herein describ The applicant agrees to comply with all applicable laws, ordinances, din; code, ho is, ; code, and regulations, and admit autlorized inspectors on premises and in buildings for necessa i pe�ti ns. 2 AAlP,l/.CO, lr4'll� (Signatu of applica t, or name, if a corporation) (Mailing address of applicant) State whether applicant is owner, lessee, agent, arc'iitect, engineer, general contractor, electrician, plumber or built . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Name of owner of premises .�`<c �?. .J' : . . . .� l�4f :�!'�. . :Ci����?tr, . . . . . . . . . . . . . . . . . . . . . . . . . (as n the tax roll or latest deed) If applicant is a corporation, signature of duly authorized officer. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . (Name and title of corporate officer) Builder's License No. . . . . . . . . . . . . . . . . . . . . . . . . Plumber's License No. l� . . , , . , . , , . , . Electrician's License No.' Other Trade's License No. ./vt�. fi/2o, ✓�2r�/1.�.�j�ri�� . 1. Location of land on which proposed work will be done. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. . . . . . . . . . . . . . . . . . . . . . . . .�� . U� fir... . . . . . . . . . . . . T . ��, �� . . . . . . . . . . House Number Street Hamlet County Tax Map No. 1000 Section .�vt'.��.�a . . . . . . . . Block . . C�a'.�, .O. U. . . . . . . . Lot .0.4. .,. jtM, . . . . Subdivision . . ... . . . . . . . . . . . . . . . . . . . Filed Map No. . Lot . . . . . . . . . . . . . (Name) 2. State e,C sting use and occupancy of premises and intended usk and occupancy of proposed construction: a. Existing use and occupancy . . . �, . ,c!/7/, / /GV � • b. Intended °; Ct , use and occupancy . . . . . . . 3. Nature of work (check which applicable): New Building . . . . . . . . . . Addition . . . . . . . . . . Alteration . . . . Repair . . . ... . . . . . . . . . Remo".-al . . . . . . . . . . . . . . D moliti;;n . . . . . . . . . . . . . . Other Work- . . . . . . . . . . . . . (Description) Estimated Cost . . . - " .�S ,��� Fee i6J . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . (to be paid on filing this application) S. If dwelling, number of dwelling units . . . . . . . . . . . . . . . Number of dwelling,units on each floor . . . . . . . . . . . . . . If barge, number of cars _ G. If business, commercial or mixed occupancy, specify n�?ttire and extent of each type of use . . • . 7. Dimensions of existing strictures, if anv: Front . . /�. � . . . . . . . Rear . . . . . . . . . . . . . . Depth . : .. . . . Hei-lit . ZV. . . . . . . . . . Number of Stories . .��t> . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Dimensions o ie structure witli alterations or additions: Front � . . . . . . . . . . Rear . . . Depth . ,4 x . . . . . . . . . . . . . . . . Height . . . . . . . . . . . . . . . . . . . . . . Number of Stories . . . . . . . . . . . . . . . . . S. Dimensions of entire new construction: Front . . . . . ,y© Rear . . . . . . . . . . . . . . . Depth �. p. . . . . . . . . . Number of Stories . 9. Size of lot: Front . . ./�`.?? . ... . Rear . . . . . . . . . . . . . . . . . . . . . . Depth . . . :�� . . . . . . . . . . . 10. Date of Purchase . , , , . , , , , , dame of Former Owner /l,,mAe . . ���/ ::� . . . ... . . . . . . (1. Zone or use district in which premises are situated . . . . . . . . . . . . . . . . . . . 12. Does proposed construction violate any zonim, law, ordinance or regulation: • . • . . • • • . • . . . . 13. Will lot be rcgradtd . . . . . . . . . . . . : . . . . tiVill excess fill be removed from premises: •Yes • • � N (4. Name of Owner of premises �'?��a �iPo��u i r%G+:� . Addressi'�nw (�r�•e,/f/k,�, ,wPhone No. Name of Architcct . . . . . . . . . . . . . . . . . . . . . . . . .Address . . . . . . . . . . . . ev: . . . . . . . . . . . . . . . . . Phone No . . Nance of Contractor . . . . . . . . . . . . . . . . . . . . . . . . . . Address . . . . . . . . . . . . . . No' . . . . . . . . .. . . . . Phone . . . . . . . . . . . . . . . PLOT DIAGRAM Locate clearly and distinctly all btii!:lir os, whether existing or proposed, and.indicate all set-back dim-znsions froi Property lines. Give street and block nuinber or description according to deed, and show street names and indicate whethc 'interior or corner lot: STAT NEW YOR ' COU F .��•S (� . being duly sworn, deposes and that he ' h i says P S is the ..ppltc_.n me o individual signing contract) abov•r named. Ne is the .. . . . . . . . . . (Contractor, agent, corporate officer, etc.)• . . . . . . . . of said owner or ow;icrs, and is duly atithorizf:d to perform or have performed the said work and to make and file thi, rziWication; that all statements contained in this application are true to the best of his knowledge and belief; and that th, work will be performed in the manner set forth in the application filed therewith. -Sworn to before me this . . . . . . . . F'. day of. . . . . . . . . . . . . . . . 1 Notary Public, , , • . . County 41 Ke 52 25850,:Suftofk l C . . . . . . . . ... r�r,n E oiresVMarGh 30 t� - (Signature of applicant