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Home My WebLink About12564-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No Z17081 Date JULY 12t 1988 THIS CERTIFIES that the buildin~ Location of Property. 975 RAMBLER ROAD House No. County Tax Map No. 1000 Section 88 Subdivision TERRY WATERS ADDITION SOUTHOLD Street Hamlet Block 5 Lot 38 Filed Map No. 2901 ,Lot No. 14 conforms substantially to the Application for Building Permit heretofore filed in this office dated AUG. 19, 1983 pursuant to which Building Permit No. 12564Z dated SEPT. 4~ 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 DECK ADDITION TO EXISTING ONE FAMILY DWELLING. The certificate is issued to PANAGIOTIS J. GAZOULEAS & WIFE (owner, X~) of the aforesaid building. Suffolk County Department of Health Approval N/A UNDERWRITERS CERTIFICATE NO. ~/A PLUMBERS CERTIFICATE NO. N/A Rev. 6/88 Building Ins~ctor - TOW~ O~ $OUTHO~O B[JILDING D~PART~E~T TOWN HALL SOUTHOLD, N. Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLb-I'ION OF THE WORK AUTHORIZED) N? 1256~ Z Permission is hereby granted to: ~ ~ i .b.~.~....tL.::.: ....................................................... -~..~......,. ......... ~~.,....~....~.~ ............ ~ , ,o..,~.~. ............. ~. ~ .... ~' ,' ...... ~~Z..;.~ ....... pursuant to application dated .~.~..~'........!....~.. ................ , 19.~...:.~., and approved by the Building Inspector. Fee $ ........................ Building Inspector Rev. 6/30/80 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 Buildlng Inspec- tor with the following; for new buildings or new use: I. Final survey of property with accurate location of all buildings, property lines, streets, and unusual natural or topographic features. 2.Finat 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-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 featu res. 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 !Si0.00 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 4.Vacant Land C.C. $ 20.00 5.Updated C.C. $ 50.00 Date .~. ~ /~ -- ~ New C OhS truc t ion ...... Old or Pre-existing Building ...~... ...... Vacant Land .............. Location of Property ~ 2 .,~-. ./~./v~.. ~ /f/'~ ~ c.~4:9y,~<~ rD ~ House No. ' ...................... .. =z) ................... · ~...~/. _ s~. i Owner or Owners o, Property../2 . ./. County Tax Map NO. 1000 Section (~.~. .......... Block..a~'~. ..... Lot. ~. :(~. ..... Subdivisi°n '-~'~'m' '~'~' ~· · '~m?'~7'<~'~?7'"~' ........... Filed Map No.Z. ~ .0/; .Lot No..~ ~ PermtN°/c2 ~-&~. Date of Permit ~/<f~/~. .Applicant~'~,e, ?, /~--'-~' .~..~.J;..~..~ ~ Health Dept, Approval ............. :-T. ......... Labor Dept. Approval .... ,-- ................... Underwriters Approval ...... ~ ................ Planning Board Approval ,,, ~ ............... Request for Tem po rary Certificate ..... v ............... Final Certificate ....................... Fee Submitted ~,~.~, ....................... Construction on above described building and/~rmit meets all aD,qlicab e codes and regulations Applicant . .-../. ......................... ..~. ~o-,o.~a ~. , TOWN OF SOUTHOLD OFF/CE OF BUILDING INSPECTOR P.O. BOX 728 TOWN HALL SOUTHOLD, N.Y, ! 1971 TEL. 765.18O2 This is to advise you that the job under building permit no. 12564Z issugd to .Panaglotis Gazonleas on 9/4/83 ~ Addition ' '~ ~s completed a £T~nl inspection hns ( ) has not ( X Y-been done. and In order to complete this file, it is necessary that a Certificate of Occupancy be issued. Please fill out the enclosed form, return same to the above ofgice with a check for $25.00payable to the Town of $outhold. Please indicate to Whom the Certificate of Occupancy is to be mailed, and ~rrnnge with this office for an inspection date Occupnncy or use is nnlawful without a Certificate of Occupancy. Please, help us to clear up ~his ma~ter so that tegal action does not have to be taken, Thank you for your prompt attention. Very truly youths, Victor Lessard Executive Admlnie~rator VL:gar encl. TOWN OF SOUTtIOLD OFFICE OF BUILDING INSPECTOR P.O. BOX 728 TOWN IIALL SOUTIIOLD, N.Y. 11971 l ol r" Whom This May Concern, We are unable to complete your Certificate of Occupancy because .of the following reasons. TEL. 765-1802 /~/ An application for Certificate of Occupancy is not on filo.~ ~ /_--/ No Underwriters Certificate on file. ~/ The check i:;(.~.u~tdat,~,]?'not on file.) /~/ No Health Dept. Approval on file. /~/ No final inspection has been made. Please contact our office on this Thank you for yot~r cooperation. Building Dept.. ***/_-/ matter. Ho Plnmbar Solder Certificate on file. ( all po. traits involving plumbing being issuc'd after April 1,1984 765-1802 BUiLDiNGDEPT.!' ,~ INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLBG. FOUNDATION FRAMING AND [ ] INSU~TION DATE 765-1802 BUILDING DEPT, INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLBG. [ ] FOUNDATION ZND [ ] INSULATION / [ ] FRAMING [~]~INAL REMARKS: ~ , DATE, FORM NO, 6 TOWN OF SOUTHOLD 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 ~ ~--..~. 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-conforming uses, or buildings and "pre-existing" land uses: t. Accurate survey of p~operty 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 POOLS $25.00 ALTERATION $25.00 1. Certificate of occupancy New Dwelling,S25.00, Accessory';SI0.00 Business $50.00 2. Certificate of occupancy on pre-existing dwelling $ 50.00 3. Copy of certificate of occupancy $ 5.00, over 5 :years $]0.00 4.Vacant Land C.O. $ 20.00 5.Updated C.O. $ 50.00 Date .......................... NewConstruction ...... Old or Pre-existing Building Vacant Land Location of Property ................................................................... House No. Street Ham/et Owner or Owners of Property ......................................................... . .. County Tax Map No. 1000 Section ............... Block ............... Lot ................ Subdivision ................................. Filed Map No ........... Lot No .............. Permit No ........... Date of Permit .......... Applicant .................................. Health Dept. Approval ........................ Labor Dept. Approval ........................ Underwriters Approval ........................ Planning Board Approval ...................... Request for Temporary Certificate ..................... Final Certificate ....................... Fee Submitted $ ............................. Construction on above described building and permit meets all applicable codes and regulations. Applicant ................................................... . Rev. I0-10-78 ..tO-0. FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N.Y. 11971 TEL.: 765-1802 Examined...~....~. ..... , 19~.~. Approved ....~...~...., 19~$. Permit No.)..~.&..~..~..-~'.'· Disapproved a/c ..................................... (Building Inspector) APPLiCATiON FOR BUILDING PERNIlT 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 buildh~gs 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 ali applicable laws, ordinances, bj~ilding code, housing code~g~2ad regulations, and to admit authorized inspectors on premises and in building for necessary ir~s~gctions, t~,~d"~_...~----~- - .... ...... (Signature of applicant, or name, ifa corpd~ation) (Mailing address of applicant) State whether applicant is owner, lessee, agent, architect, en~neer, general contractor, electrician, plumb'er or builder. ................ ........... ................. Name of owner of premises .~)~..r~ ..... ~..~'..~. ................... t~j kJ (as on the ~ roll or latest deed) ~ If applicant is a corporation, signature of duly authorized officer. (Name and title of corpo, r~e officer) Builder's License No...~..I..~. .................. Plumber's License No ......................... Electrician's License No ....................... Other Trade's License No ...................... 1. Location of land on which proposed work will be done .................................................. .................... ......... .................. · House Number Street Hamlet County Tax Map No. 1000 Section ....~..~ .......... Blockr--~.~ Lot 3 ~ ...... ~hd~vis~on..11~.~ .~. ~....UP..~.~. ~S. ............. ~iled ~p No.~ ..¢. ~ .1 ....... Lo~.. I .~.l. ......... (Nmne) 2. State existing use and occupancy of~rem, ises and intended use and occupancy of proposed construction: a. l:xis[mg use ano occupancy ................................ b. Intended use and occupancy .................................................................... 3. Nature of work (check whmh apphcable): New Budding .......... Additio ... Alteration .......... Repair .............. Removal .............. Demolition .............. Other Work ............... , ~'..~ ~ (Description) 4. Estimated Cost....~..~) {~)'(~' .O....~.. ................... Fee..~. ............................. : (to be paid on filing this application) 5. If dwelling, number of dwelllng~umts ............... Number of dwelling units on each floor... ~ ......... If garage number of cars ~ 6. If business, commercml or mixed occupancy, spec nature and extent of each type of use .......... 7. D]mensmns of existing structures, if any: Front. . Rear ..... Depth ............ Height ...( ~-~ ......... Number of Stories ..... I .................................. ~.- ............ Dimensions of same structure with alterations or additions: Front .. ~ .{~). ......... Rear . .~..~. ........... Depth .......... · · · -. ....... i.. · ~eight ............. Num_~b~er of Stories ................. 8. Dimensions of ent~3e new construction Front .. ~..(D ..... Rear . ~ i~::~ ........ Depth .......... Height :: Number of Stories 9. Size of lot: Front ...t.[ .~.... 4 ........... Rear..../~. I ............... Depth .L~. {~ ................ 10. Date of Purchase .......... i .................. Name of Fenner 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 ..... ,~':' '.'~- -"~r .~,,c_...~ ~,.,o · Will egress gill be~r~n~ovg~l fi;qm premises: ~ No 14. ~m,~ · wn v ~ .~tO~'. ............... ~,aoress ................... vnone t~o ............... ~'"" Name of Architect ......... ; ................. Address .................... Phone No. Name ofContractora¢o(z~ ,3d~ ~.<r--r'~ '" Address g'c~0'~t('~/~' '~d' '~9 .... Phone No ........... PLOT DIAGRAM Locate clearly and distinctly ali 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 NEW YORK,^,~ S S COUOI~Y OF..'.~M~..~'V..t-J>... .... , ' · '~q'q~-~ 'c'i)' ~.M~', . .i .................. being duly sworn, deposes and says that he is the applicant (Name of indivil~ual 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 am true to the best of his knowledge and belief; and that the work will be performed in the mann(r set forth in the application filbd therewith. Sworn to before me this ........ J. .......... day o .......... , 19 .. dO, 52.452411). .......... ~ .... t.~. ~ ,~ ~'~,,~.~'~,~- .... ~ (Sig~l:fure of applicant) Qualified in Suffolk County, r Golllmissioni Expires March ~0t ~t98,J~