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Home My WebLink About12321-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Buildin§ Inspector Town Hall Southold, N.Y. Certificate Occupancy No. zi6605 Date Janu. ary 22, 1988 THIS CERTIFIES that the building ....... .A.d.d.i.t..i pp. ............................... Location of Property ... ! .9.3,3.5...S?.u.n.d.y.i.e.w...~y.e.n.u..e .... Southold House No, Street Hamlet County Tax Map No, 1000 Section ,,. 0..5 .I ...... Block . .0.4. ........... Lot...0, .0 .9 ........... Subdivision ............................... Filed Map No ......... Lot No .............. conforms substantially to the Application for Building Permit heretofore filed in this office dated Apr£1 14, 1983 pursuant to which Building Permit No. 1232 l.Z dated Hay 12, 1983 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 ......... .. to. ......... The certificate is issued to NICK THEOPHILOS of the aforesaid building. Suffolk County Department of Health Approval ...... .N./A. .......................... UNDERWRITERS CERTIFICATE NO ............ Pending 1/22/88 PLUNDERS CERTIFICATION DATED: N/A Rev. 1/81 TOWN OF ~OU BUILDING DEPARTJ~EN~ TOWN HALL SOUTHOLD, N.. Y~. BUILDING FERMIT (THIS PERMIT MUST BE KEPT ON ~HE P~EMI~ES~;~UNTIL C~PL~ION OF THE WORK AUTHOAIZED) FULL Permissio~ is hereby granted to: ......... ~.~..cZ~ ....... z~...i. ....... ,~..~...~~~4~ ,,_ ~.~ ........ ~~ ................ ~. ,o.: ....... ~~.~;.~...~~.....~.~.~~~...~..~. .......... ...... e~.Z~..~/~.~z~...~= ................. ...::; ................ ~=. ..................................... .,,,.m,,~ ~.~.,.~ ....... Z.~.~ ....... ~~~.~-. ............... ~.. ....................... ~.: .... ~~.[~;..~.~ ~u~ T~x Map No. 1000 Section ..~,...J ..... "l~k ~,..~.~ ....... ; ~L~ No...~ .......... application dated ...... ~.~......4~...,.¢,,,,~],.,,., 19~ and approv~ by the put,ant Building I~spector. Fee $...~.: ........ BLDG. OEP'r, · TOWN OF $OUTHOLD FORM NO. 6 TOWN OF SOUTHOLD Building Department Town Flail Southold, N.Y. 11971 APPLICATION FOR CERTIFICATE OF OCCUPANCY / OdL5 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 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-co~fforming uses, or buildings and "pm-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. 1. Certificate of occupancy (' ~ ~ ~ / 2. Certificate of occupancy onyfe,ex-istii~g dwelling / land Use 3. Copy of certificate of occupancy $1.00 --Pre-existing C.O. $15.00 Vacant land C.O. $ 5.00 Date ~ ......................... New Building .7~. ,~-(~,,,6~, ..... Old or Pre-existing Building ............ Vacant Land ............. Location of ProperW ./, t,~ ......... ~,~;¢ U~(~2. ~.,~f,~', ..... ~, · .~ . flou~ No, St~et Ham/et Owner or Owners of Proper~ ...... - ., ~ , ; Cou,w 000 S, tio, ...... .... Q .... Lot.. :C. ...... Subdivision,.. ~ ...................... Filed Map No. '~ Lot No. J~ ....... ¢/ PermitNo. [2~:¢,[.¢. Date of Permit __la,~ A Iicant .~]'.~ ~O~.k~.~..[PX ..... .......... pp .. ... Health Dept. Approval ..... ~.~ ~ ............ Labor Dept. A~rO~[... .... ~.~ ............... Unde~riters Approval ........................ Planning ~,~pproval ................. Reque~ for Temporary Certificate ................... ~al Certificate ............... Foe Submitted $ ....................... . '~ demribed building and permit meets all app~able co~s a~ regulations. Con~ruction on above ~ ~~ ~~ ~pl[ca .................. ~ O. 2/~d~ s~ F%ELD INSFECTIO~N COMMENTS FOUNDATION (1st) F~OUNDATION (2nd) 2. ~OUGH FRAME & PLUMBING INSULATION PER N. STATE ENERGY qOD FINAL ADDITIONAL COMMENTS: TOWN OF SOUTffOLD OFFICE OF BUILDING INSPECTOR P.O. BOX 728 TOWN HALL $OUTHOLD, N.Y. 11971 January 4, 1988 Mr. Nick Thaophilos 19335 Soundview Avenue Southold, New York TEL. 765-I 802 To Whom This May Cohcern, We are unable ~o complete your Certificate of Occupancy because,of the following reasons. /5/ An application for Certificate of Occupancy is not on file. /~/ ~p U~W~_~e_~r~ Certific~9 ~n.. fil~e. /~/ The check is (~~not on file.) $25.00 /~/ No Health Dept. Approval on file. /~/ Ho final ins~pection has been made. Please contact our office on this matter. Thank you for your cooperation. Building Permit Il ~_ ~ ~_ ~. ~_ Z Building Dept. ***/~/ No Plumber Solder Certificate on file. ( all permits involving plumbing being issued after April 1,1984 ) .~ OCCUPANCY OR USE IS UNLAWFUL WITHOUT A CERTIFICATE OF OCCUPANCY. CLEAR UP THIS MATTER AS SOON AS POSSIBLE SO THAT LEGAL ACTION DOES NOT }{AVE TO BE TAKEN. Thank you. 765-~.802 BUILDING DEPT. INSPECTION [] FOUNDATION ~.ST th(~ ROUGH PLBG. [ ] FOUNDATION 2ND ,~ INSULATION ,~, FRAMING,~ [ ] FINAL REMARKS: 1 DATE INSPECTOR FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N.Y. 11971 TEL,: 76§-1803 E,amined...//. <4..., Disapproved a/c ...... ~.- ........................ ~ .... / (Building Inspector) APPLICATION FOR BUILDING PERMIT INSTRUCTIONS 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 apphcant. Such permit shail 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 rite 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 Reguiations, for the construction of buildings, additions or alterations, or for removai 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 building for necessary inspections. ......~..~..~-.¢.'~-.~ ........... (Signature of applicant, el~ name, if a corporation) · , . ,t, ...........v.w/. ~ ........... ~, .... .; ......... (Mallin~ address of applicant) State whether applicant is lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. Name of owner of premises ....~...(-.~.'....~.~-. 2~.-'.~..O..~.}~..~.~: .~..~. ................................ (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. ~ ..... ~,~..~: ....... Other Trade's License No ...................... ..... ..... .... l. Location of land on which proposed work will be doue. - ' ~ ~C) U / ' ................................................... ~..o..~.'r. 1.4. ~ ..I~.. .......................... House Number Street Hamlet County Tax Map No. 1000 Section ...... .~.~./ ......... Block ....... .~. ......... Lot .... 7. ............. 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 ........ ~X¢~' ' ' ~' '~?~"~d"z' (~'~' ' ' ~64~' '{'~'~'kG~-~/ c ~, ......................... b. ~,~t~n~t~d,,se an~ occupancy ... ~:~.~./~....-~../(... ~..~.L?..~¢.~. ~.~ ! .r~....~.. ~;~..&~.: ......... 3. Nature of work (check which applicable): New Building .......... ~'~ ......... Alteration .......... Repair . ...... Removal .............. Demolition .............. "'~ ~'~ Other Work ............... ~ ~_ (Description) 4. Estimated Cost ~..~ ~ :'c) c_.) .~.~.'~.~.~ I (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 type of use ..................... 7. Dimensions of existing structures, ff any: Front ............... Rear .............. 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 ............... Depth ............... Height ............... Number of Stories ........................................................ 9. Size of lot: Front ............ ~: ......... Rear ...................... Depth .. ~,j~ .............. 10. Date of Purchase ........ .' ............. Name of Former Owner .... .~.~...r~./. ~/~ .' ........... I l, Zone or Use district in which premlises are situated ........... (/~. ~ . 12. Does proposed construction violat~ any zoning law, ordinance or regulation: ..... ~.. ........ .......... 1 3. Will lot be regraded .......... i ................. Will excess fill be removed from premises: Yes (N~9) 14. Name of Owner of premises .... i ............... Address ................... Phone No ................ Name of Architect ........... ~ ............... Address ................... Phone No ................ Name of Contractor .......................... Address ................... Phone No ................ PLOT DIAGRAM Locate clearly and distinctly all buildings, whether existing or proposed, and, indicate ail 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. ..~z~ (7 [e-,~; ,(~- (.X:u,~ STATE OF NEgf'~-~RK, COU_T, .~..~.~~N Y OE..~~~ being duly sworn, deposes and says that he is the applicant above na~dual signinl~' contract) He is the ...................... ~ .................................................. ., (Contractor, ~gent, 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 that the work will be performed in the manner set forth in the application filed therewith. Sworn to before me this