HomeMy WebLinkAbout11813-zFORM NO. 4
TOWN OF SOUTHOED
BUILDING DEPARTMENT
Office of the Building Inspector
Town Hall
Southold, N.Y.
Certificate Of Occupancy
No.. ZI5678 Date April 22, 1987
THIS CERTIFIES that tile building .... ~.c.c.e.s..s p.r.y. .................................
Location of Property ...~.1.5... §.l.~.r..k..R.o..a.6 ............ .S.o.u..t.h.o.l?. .....................
House No. Street Hamlet
County Tax Map No. 1000 Section ...53 ........ Block . . .3 ............ tot ,...2.] ............
Subdivision ............................... Filed Map No ......... Lot No ..............
conforms substantially to the Application for Building Permit heretofore filed in this office dated
· .,... J~.l.y.. ] 2 .... [9.82. pursuant to which Building Permit No ...... I 1813Z
dated , .J.u.l.~, .2.0.,.. ! .9.8..2 ............ was issued, and conforms to all of the requirements
of tile applicable provisions of the law. Tile occupancy for which this certificate is issued is .........
..... 6.c.c.~ s..s g.r.y...s.t.o.r.a.g.e. ?. V .~.~.~.~. n. g.. ...........................................
The certificate is issued to ALEX & EUGENIA SPIRIDAKIS
..................... /o¥,,'~;,~ ~3f/h~ ~'X'× ~ $~ ~ ..............
of the aforesaid building.
Suffolk County Department of Health Approval ........ ~/6 ...............................
UNDERWRITERS CERTIFICATE NO ................ .N./.A. ..............................
PLUMBERS CERTIFICATION DATED: N/A
Building Inspector
Rev. 1/81
(THIS PERM T MUST BE KEPT ON ~HE PR£~ S~S;LINTIL I~ULL
COMPLETION OF THE woRK AUTHORIZED~ ~ ~ :
is hereby granted to:
Per~nissior
a~ Premise~ located at
~oiJ~ty rc~x Mop No. 1000 ~oc'tion
pLit's~uant ~0 application dated
BB I~lng. I~spector.
NO; ~..~ ~..~/. .........
}roved by the
?
FORM NO. 6
TOWN OF SOUTHOLD
Building Department,
Town Hall "
Southold, N.Y. 11971
765- 1802
APPLICATION FOR CERTIFICATE OF OCCUPANCY
Instructions
This application must be filled in Wpewriter OR ink, and submitted ~. ~ to the Building Inspec-
tor with the followincj; for new buildings or new usa:
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-(St9 form or equal).
3. Approval of e~ectricM 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.
For existing buildings '(prior to April 1957), Non-conforming uses, or buildings and "pre-existing"
land uses:
1. Accurate survey of property 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 bu ildings.
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. Certificato of occupancy $5.00
2. Certificate of occupancy on pre-existing dwelling $15.00
3. Copy of certificate of occupancy $1.00
4.Vacant Land C.O. $5.00
5.Updated C.O.~ $15.00 Date
NewConatr~cgion ...... Old or Pre-existing 8uildin~ ............ Vacant Land .............
Location of Property ............................................. .. ..
Hou~ No. Street Hamlet
County Tax Map No. 1000 Section . .~ ...... Block ............... Lot .....
Subdivision ................................. Filed Map No ........... Lot No .............
Permit No, ,//[, .~ ,/, .~Oate of Permit .Applicant ~ ~.. :.., /.C/df2~,~'./. .'~ ....
Health Dept. Approval ........................ Labor Dept, Approval .......................
Underwriters Approval ........................ Planning Board Approval .....................
Request for Tempor~ Certificate ..................... Final Certificate ......................
Fee Submitted $..~.. ~'.'.. ff .................
Construction on above described building and pe~it meets all applicab~e codes and regulations.
Applicant ,y
FIELD INSPECTION
1.
FOUNDATION ( 1 st)
FOUNDATION
2.
(~nd)
ROUGH FRAME &
PLUMBING
INSULATION PER N. Y.
STATE ENERGY
~ODE
COMMENTS
ADDITIONAL COMMENTS:
storage problems.
Our to,..,, ~ .... ~" that this ~,. ....
qew breakthrough provides a(
~{}% moro r~s~ rorstance when ,~ppliod
'wet our electro-galvanized steel.
*'~step pro<mss combines ihorm]01~
,orepm'ation wiS'h el~ctro-galvani~inq,
or add}tion~l woratherproofi~t~. ~ddod
&ii Arrow buildingn start wRh ri hot dipped, h~}av? - ,:.~;, ~,l zed ¢ ,5~ :',< ,'\dd fo t~af our exciting Peml&.Piate XL~'improved
~ictsn with a b~kod on polyester paint ~hRt ~os~.', , '; '~;, ¢ q~PF, h'~g, or peeling. Finish witll ovedapBing, doubl~dbbed,
9alvmHzed steel panels and you've got a mg9¢:', ,',¢, ,.o '=~4~,mmd hd~;ding~ Only with Arrow buildings do you get. the "3-D
Never, FailOoorSystem"withhe~w/-dutysliO>,p,~ ;' .¢-;,>o:~top,,:~,~dmid..doorbrace. B~tlding panels mount on the rrame,
not the ground, to preveht corrosion ~nd ~dd si(,., ,{,;, :'?, ~;c ",4.:n':,~s'¢r¢ used 8rotmd ail screw holes Ocr added pro~ec-
tion. Once aoaerno~od, au t~rrow bHildin¢ wit} gk-' '.,,' , ,~ ~; b¢~::,: y ~¢ld:p~oIection With mi!~imum maintenance.
EASY TO ASSrE~¢~BLE~
Constructed of complete}y prefabrinatod ~nd pre, h;'h~ d ~'. ri;, th,-'?~:.'.~ ho c,,tting; snipping, hammering, special tools, or
special mechanic:~l abitiW neadnd fo~ .:~ssemb}y ,,~¢ I ('; ,,.c ' ¢,;=;~ (, pferumbored, and preellgned for simpte assembly
765-1802
BUILDING DEPT.
INSPECTION
[ ] FOUNDATION 1ST
[ 'I FOUNDATION 2ND
[ ] FRAMING
REMARKS:
ROUGH PLBG.
INSULATION
FINAL
DATE
INSPECTOR
FORM NO. 1
TOWN OF $OUTHOLD
BUILDING DEPARTMENT
TOWN HALL
SOUTHOLD, N.Y. 11971
TEL.: 765-1802
Examined . ~.(.-'~"?.~.. ~D. ..... 190~.~ .~
Approved z.o. .....
/ (Bfiild~g Inspector)
APPLIGATION FOR 8UILDIN(I PERMIT
Application No.././.~../..'~-. ......
Date . .x)..o....~ ...... r" 19 .~..2,
INSTRUCTIONS
a. This application must be completely filled in by typewriter or in ink and Submitted.-~z-~.!'-.~tt- to the Building
Inspector, with 3 sets of plans, accurate plot plan to scale. Fee according to schedule.
b. Plot plan showing location of lot and of buildings on premises, relationship to adjoining premises or public streets
or areas, and giving a detailed description of layout of property must be drawn on the diagram which is part of this appli-
cation.
c. The work covered by this application may not be commenced before issuance of Building Permit.
d. Upon approval of this application, the Building Inspector will issue a Building Permit to the applicant. Such pein'fit
shall be kept on the premises available for inspection throughout the work.
e. No building shall be occupied or used in whole or in part for any purpose whatever until a Certificate of Occupancy
shall have been granted by the Building Inspector.
APPLICATION IS HEREBY MADE to the Building Department for tile issuance of a Building Permit pursuant to the
Building Zone Ordinance of the Town of Southold, Suffolk County, New York, and other applicable Laws, Ordinances or
Regulations, for the construction of buildings, additions or alterations, or for removal or demolition, as herein described.
The applicant agrees to comply with all applicable laws, ordinances, building code, housi~hg~ode, and regulations, and to
admit authorized inspectors on premises and in buildings for necessary inspections.
· (~ignature of apldicant, 8'(name, if a crorporation)
~$...~.,r~ .%.g...o...~o...~5o....,~.' ..... \x..q..n. ~...
(Mailing address of applicant)
i~'~, lessee, architect, engineer, general contractor, electrician, plumber or builder.
State whether applicant agent,
Name of owner of premises ~..~. · · .~. ·..~..~.~..~.1~.~.~.;..~....~__~..e.[..l~.~..~....F~%..~. ~,~, ......... (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 .....................
Plmnber's License No .........................
Electrician's License No .......................
Other Trade's License No ......................
1. Location of land on which proposed work will be done ............ ......................................
.4.. ..................... . .......... ................
House Number Street Hamlet
County Tax Map No. 1000 Section . ..~.[ ............ Block : '~ 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 .....................................................................
b. Intended use and occupancy~...~1~;~.~,. ~...~ .~'.~. t .~....~...~..~t~. ! .~.
3. Nature of work (check which applicable): New Building ..........
Repair .............. Removal .............. Demolition
4. Estimated Cost .............................. Fee
Addition ..........Alteration ........
............ Other
(Description)
...........................
(to be paid on filing this application)
5.If dwelling, number of dwelling Units ............... Number o f 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 .......
i t ~o '~.o. ' ......~.~.'" .....
7. Dimensions of existing structure , if any' Fron ' t Rear D~pth
Height .; ............. Number of Stories .... .~ ...................................................
Dimensions of same structure wi~h alterations or additions: Front ................. Rear ..................
Depth .................... ~.. Height ...................... Number of Stories ......................
8. Dimensions of entire new construction; Front ............... Rear ............... Depth ...............
Height
Number
of
Stories
Rear ....... ~ 0 ............. . r)epth~, t'/~/?.'. Lr, ,~,.~.. ! .'t.~;'/~.'g
9. Size of lot: Front ... i D~. t~,~/· ~',~ ...... ' .............. ~' ..........................................
10. Date of Purchase .... ~6~/.. ~;!..~7~ .............. Name of Former Owner,J~t/.
11. Zone o~r use district in which promises are situated .....................................................
12. Does proposed construction violate any zoning law, ordinance or regulation: ................................
13. Will lot be regraded ........................... Will ~xcess fill be removed from premises: Yes No
14. Name of Owner of premises ...~ ................. Address ................... Phone No ................
Name of Architect ...... ~ ............. Address ................... Phone No ................
Name of Contractor ..... -~, :". i ................. Address ................... Phone No ................
Locate ~learly and distinctly all,buildings, whether existing or proposed, ~icate all s~ d~' ensions from
property lin~es. Give street and block flumber or description~accord!ng to-deed, and show street names and indicate whether
interior or corner Ioi. ~ ~ ~--
STATE OF NE~R~ ·
COU~Y OF .~.
......... ~O-~; '~" &"n': C~d~l~... being duly sworn, deposes and says ~e is the applicant
(Name ~ individual sig~g 6ontract)
above named.
is the :. .
(Contractor, agent, corporate officer, etc.)
of said owner or owners, ~d is du~y autho~zed to perform or have perfo~ed the said work and to m~e ~d, file this
application; that all statements contained ~ this application am true to the best o~nowledge and belief; anti'that the
work w~l be perfomed in the manner set fo~h ~ the application filed therewith.
Sworn to before me this
.........
........
t, ~m~P~gLIC,, StYe ~ N~ ~ immature o~ appfic~t)