Loading...
HomeMy WebLinkAbout11928-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. Certificate Of Occupancy No. z16076 DateAugust 19, 1987 THIS CERTIFIES that the building . .A.d.d.i.t. ~ .on. ...................................... 1230 AQUAVIEW AVE. EAST YukRION Location of Property ................................................. House No. 'S't/e~i .... h~iel County Tax Map No. 1000 Section .. 9.2 .2 ....... Block ...0 J ........... Lot 002.001 Subdivision ............................... Filed Map No ......... Lot No .............. conforms substantially to the Application for Building Permit heretofore filed in this office dated .... .S .e p .t : . .2 .2 ~. J .9.8.2 .... pursuant to which Building Permit No..1.1 '9.2.8.Z ............... dated ...8.ep.t:..2.22..1 ,9.8.2 ............. 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 ......... Add to existing dwelling--enlarge room and add deck. The certificate is issued to .. GEORGE KIOUZELLUS ................... ?oYn'o;, ...................... of the aforesaid building. Suffolk County Department of Health Approval ~q./A UNDERWRITERS CERTIFICATE NO ......... Pending 8/17/87 PLUMBERS CERTIFICATION DATED: N/A Building Inspector Rev. 1/81 Permissior ~ TOWN OF $~0U~FIOLp ~ BUILDING DEPARTMENT. TOWN HALl.; SOUTHOLD; N~ Y. ~ : BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON T~HE PP.E~IS~S UNTIL COMPLETION OF THE WORK AUTHOR[ZED) { ~1928 Z hereby granted ULL at premise~ located at Coun~ To× Mop Uo ~000 S,~t,o~, ..~ ........... ~o,k ,C~.Z .......... ~Lot No. ~:..~/ pursuant fo application dated ...... ~.~..:~.~.:;.~-.L~:;...~,~ 19,-.n~-,, end ,pprov~ by the Building l~spect0r. ..... ~ .'~,~,~;~;;~ ...... :. ................. FORM NO. 6 TOWN OF $OUTHOLD 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 m ~-.,-.---. 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--iS-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: 1. Accurate survey of p~:t~perty 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: Additions $25.00 1. Certificate of occupancy New Dwelling,S25.00, Accessory",$ |0.00 Business $50.00 2. Certificate of occupancy on pre-existing dwelling $ 50.00 3. Copy of certificate of occupancy $ 5.'00, over 5 years $10.00 5.Updated C.O. $50.00 Date ........................ New C ohs truc t i on ...... Old or Pre-existing Building ............ Vacant Land ............. J. 2,3 .>1 ..:, m ' Location of Property .............. V.~ ~./~. ~ House No, Street Ham/et Owner or Owners of Property .~'.'~.~.. .d~.~. ¢. .l.~. ~ .~ ./f-.~. .......................... County Tax Map No. 1000 Section O.~.~, ~.. ~. .... Block . ,Q. ], ff.).~. .... Lot .~..~..~..,..0.~..-). [... Subd~v~mon ................................. Filed Map No ..... '~ .....Lot No... '; .......... Permit No. I.).a~. ~ Date of Permit .Applicant ......................... Health Dept. Approval ........................ Labor Dept. Approval ........................ Underwriters Approval ~ Planning Board Approval Request for Temporary Certificate ...... --. .............. Final Certificate ..................... Fee Submitted $ ,2~ ~ ~)[.~ .................... Construction ~ ~. p~_ ~._ on above described buiJding and e t meets II ap 'cable codes and regulations AppHcan ,.. ~.~,d'.. ................... FIELD INSPECTION COMMENTS FOUNDATION (1st) FOUNDATION 2. (2nd) ROUGH FRAME & PLUMBING INSULATION PER N. STATE ENERGY qODE FINAL ADDITIONAL COMMENTS: MOTI~ BUILDING D[PARTM~ AT ~65-1802 9 AM TO 4 PM F0~ THE NOLLOWING ~NSPECTIONS: i. FOUNDATION - TWO REQUIRED FO~ P,.,UR~D ~. ROUGH - FRAMING & PLUMBI~ 4, FINAL - CONSZRUCTION MUST ALL ~ON~T~UCTtON ~HALL M6~ · HE ~U}~MENT$ OF THE N, Y, ~A~ CONSTRUCTION & ENERGY C~. ~T ~ESPONSI~L[ FO~ iii FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N.Y. 11971 TEL.: 765-1802 .... ,19 2/ Approved.. ~ 7..?<..2.. .... 19~..~. Permit No.././..~..~oc~./ (Building Inspector) APPLICATION FOR BUILDING PERMIT Date..~./.Z..2. .......... INSTRUCTIONS Application No.././..~.~..?. ........ a. This application must be completely filled in by typewriter or in ink and submitted to the Building Inspector, with 3 sets of plans, accurate plot plan to scale. Fee according to schedule. b. Plot plan showing location of lot and of buildings on premises, relationship to adjoining premises or public streets or areas, and giving a detailed description of layout of property must be drawn on the diagram which is part of this appli- cation. 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 issued 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, bt~ding code, housing code, and regulations, and to admit authorized inspectors on premises and in building for necessary in~p,h~tions. .? ......... , ....... ~ (Signature-._.- _,a_. of applicant, or name~~tion) (Mailing address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. ........................................................................... Name of owner of premises...~Y.~.~..o..~i ~.e....~.~. ~.'t..~. !-.% .~.~.. [.[ .c%..~.. ................................... (as on 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 ......................... Electrician's License No.~.t. ~>. i.~.kO .,~..~.~' .c, .~. .... Other Trade's License No ...................... 1. Location of land on which proposed work will be done ................................................... ........ 3.9. ................... /%e. ...... ........ ............ House Number Street Hamlet County Tax Map No. 1000 Section 9..Z. ~... ~ ~% ....... Block . ~ J. ~ .~% ....... Lot.. ~) Subdivision ..................................... Filed Map No ............... Lot ............... (Name) 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy ...... ~ .~ .... ¢. . .~.~.O~ t.~ ....... : .............. b. Intended use and occupancy . .~.~.,.. ~...~...~...~..-~.. ~O~..- ..... 3. Nature of work (check which applicable): New Building .......... Addition...~:/' . Alteration .......... Repair .............. RemOVal .............. Demolition .............. Other Work ............... 4. Estimated Cost .......... : · .~ ................. 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 lmture and extent of each type of use ..: .'":.. "; ............. 7, Dimensions of existing strncturds, if any: Front....~. O ........ Rear .. ~ ~j~ ........ Depth..~"~a..2 ........ Heaght . . ] ~ .......... Number of Stones . . . ~ ............ ff.~ .................... ~ ............... Dimensions of same structure with alterations or additions: Front .... ¢) ........... Rear . .fie..O. ........... Depth ...................... Height ...................... Number of Stories ...................... 8. Dimensions of entire new construction: Front ....... i ....... Rear ............... Depth ............... Height, . ~.O .... : .... Number of Stories ....... ,~ ..... , ...................... ~... 9, Size of lot: Front . .~,.©.o.~]...: ........... Rear .,: .-[~.~'. ............. Depth .~ ?.~. ................'* ............... 10. r)ate 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 premisesG: .~.,a ,. ~,~ ~. [(.k ~... Address I~. t~::0*.~ .xl.~c.,.~..}~v~. Phone No ................ Nme of Architect .......... i. ................ ~ctress ............ t ...... Phone No. Name of Contractor .......................... Address ................... Phone No ................ PLOT DIAGRAM Locate clearly and distinctly all: 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. STATE OF I~g/~O. R~_,/'~ ~/ ~ ~ .. .......... being duly individual s above named. (J He is the ....................... ~ ................................................... : : (Contractor)gent, corporate officer, etc.) of smd owner or owners, ~d is duly ~~orm or have perfomed the said work ~d to m~e and file this application; that ail statements cont~ned ~ this application are true to the best of his knowledge and belief; and that the work will be perfomed in ~e m~ner set forth in the application filed therewith. Sworn to before me this sworn, deposes and says that he is the applicant (Si~fature of applicant)