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Home My WebLink About12209-zFORM NO. 4 TOWN OF $OUTHOLD BUILDING DEPARTMENT Office of the Building II~spector Town Hall Southold, N.Y. Certificate Of Occupancy THIS CERTIFIES that tile building .,. addi.~ioB..tQ ,dw.~llin.g. .................... Location of Property .... 2;[.9. 5 ................. R. ugk House No. Street t~arntot County Tax Map No. 1000 Section .... ~0.6. .... Block ....... .7. ...... Lot ...... Subdivision .... S..u.n.s.e.~..K.n.o. 1..1.s..S.c..c.,.I.I....Filed Map No. 5448 .Lot No. 9 conforms substantially to the Application for Building Permit heretofore filed in this office dated March 9 19 83 pursuant to which Building Permit No. ~22091a dated ....lVi?.r.?h...2.4. ............... 19 .8.3. ,was issued, and conforms to all of the requirements of the applicable prov~isions of the law. The occupancy for which this certificate is issued is ......... ....... Add. it. ion..t.o, exisL.ing, d~ellinq ...................................... The certificate is issued to GEORGE ZACHARIADIS (owner, le~ of the aforesaid building. Suffolk County Department of Health Approval ............ .... ~/.R. ...................... UNDERWRITERS CERTIFICATE NO. I'1606794 .... Building Inspector Rev, 1/81 BUILDING' TOWN ffHIS PEmIT MUST BE KEPT ON C~PL~ION OF THE WORK 12209 Z pert ~ission is hereby granted tO ~. at p~emises located at .............~ · .. ..... .....~; C°,ut~ty TaXx Map No. 1000 pijrS~lant !o application-dated · ................. , ....... .~..--~ ......... ,.... 6/30/,80 B I, ling I spector. ,~:~e *.:;....~: ............. ;19..?., and approved by the FORM NO. 6 TOWN OF SOUTHOLD Building Department Town Hat! Southold, N.Y. 11971 APPLICATION FOR CERTIFICATE OF OCCUPANCY Instructions A. This application must be filled in typewriter OR ink, and submitted in duplicate to the Building Inspec- tor with the foilowing; 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 disposat--(S-9 form or equal). 3.Approval of electrical installation from Board of Fire Ufiderwriters. 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 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. C. Fees: 1. Certificate of occupancy {. $5.0~/ ! / 2. Certificate of occupancy on pitting dwelling ~r land use $/g'/$5'00 3. Copy of certificate of occupancy $1.00 Date ....... New Building {~0~ I~-? ~'J' Old or Pre-existing Building(Z). _: .~/Vacant Land Location of Property .~.~... ~..O~.~.. ................ ~..U~ .-(.~. ?L.'\ .... .~.~..y~. ~.? ...... . .y?..~¢~.-~..-~..)~..~! House No. Street Ham/et Owner or Owners of Property ..... .~.~. ~ g ~ . .{/3[. )~ CountyTax Map No. 1000 Section ... ).0 fo Block --7 Lot. Subdvison...~.?..~..'.~'.~..*.'~....~f?.~.~.c.~':....?,.~?...~.~iledM~pN~. ~'~z/~ LotNo Health Dept. Approval ........................ Labor DePt. Approval ...................... ,.. Underwriters Approval ........................ Planning Board Approval .../ ............ ~ .. ~ Request for Temporary Certificate ..................... Final Certificat~ .. yt .... - ......... - . Fee Submitted $ .... ~¢ ....................... Construction on above described building and perm}'~ meet. s al)~app~,cabie+.code,s and regulations. Applicant..~.~:~... ~0. ~.~ ................... FIELD INSPECTION COMMENTS FOUNDATION (1st) FOUNDATION (2nd) 2. ROUGH FRAME & PLUMBING INSULATION PER N. STATE ENERGY q. ODE FINAL ADDITIONAL COMMENTS: 765-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION 1ST []ROUGH PLBG. [ ] FOUNDATION AND []INSULATION ~ FRAMING []FINAL REMARKS: DATE / INSPECTOR ic~oii~ THE NEW YORK BOARD OF FIRi UNDERWRITERS BUR~.AU OF ELEC. TR~IOtT¥~ , : THI~ CERTIFIES THAT in thefollowing location; ~ Basement ~ Ist FI. ~ 2nd Fl. Section Block Lot was exami~d on ~0 iG~ lSS:~ and found to be in com~lia~ce with the r~quirements of this Board. FIXTURE 3 ~ DRYERS SYSTEMS NO. OF FEET E Al~auider G, ltubbaz, d Aqu~jbogu~, N.Y. E R I C OF HI-LEG OF NEUTRAL This certificate Rust not be ahered in any manner; return to the office ' COPY F~ ~U LDiNG DEPARTMENT i TIfLE NO 376559-I .L.O~ .'~ · ~ '= MONUMEN 7' .,:,. - SU~OIFI$10N M~IP FILED IN THE OFFICE Lot .Ew$~o.$ YOUNG & YOUNG .-I~, 1971 400 OSTRANDER AVENUE, RIVERHEAO, NEW YORK M'AY ,JU~. P~,, /971 ALDEN W. YOUNG HOWARD W. YOUNG SUIWE~ FOR: INLAND HOMES, iNC. LOT 9" SUNSET KNOLLS," SECTION TWO AT MATT I TUCK $Ecumrr r/rLE a ~.uA/~#rr co. r~IVEF~HEAO $,~VING$ BANK Tow. o~= SOUTHOLD SUFFOLK CO., N.Y. FORM NO. 1 TOWN OF SOUTHOI~D BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N.Y. 11971 TEL.: 765-1803 Examined..'~..~..~...~.. ?.-.gl., 19~..~ Approved19 Pe it No..n Application No../..~..~. ?/. ...... Disapproved a/c ............................. ./5~ ..... APPLICATION FOR BUILDING PERMIT Date . .' ...... . .~./.~... iNSTRUCTIONS a. This application must l~e'~ompletely filled in by Wpewriter 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 issaed 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 issum~ce 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 eerie, housing, cod% and regulations, and to admit authorized inspectors on premises and in building for necessary in,ns, soP}_ /~ ..... .~.~..o~,.....-,. ?./A4~...v~. ~ .~5-5.' ............... (~igna~ure of applicant, or name, if a corporation) (Mailing address of applicant) State whether applicant is awne/c~ lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. Name of owner of premises ..... d.~70../~..~.4 .... .2.?..c..~, .ri. eL R. ,P/.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 .... ./~..0. 3.~.-ff././. ...... ./.Crier-d, ~ ~/ Plumber's License No.. ~).4:.rgf?./.~....~ff..~.':777~. Y~..~. Electrician's License No. Jg../.././!~.~47..4.~. ..... Other Trade's License No ...................... 1. Location of land on which proposed work will be done .................................................. ..... :'. e ................. ...... House Number Street Hamlet County Tax Ma~ No. 1000Section..'~J~ /0~::7 Block ..... ..... 7 ..... Lot .... ~)~...~.... . Subdivision ,~./'~.. ~..~... ~..Z~i '. i i Filed Map NO. X~ .~r..~.... Lot... iiiii 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy ......... ~.~...~?..~.~'.-.~,/.~..~..../'/~.. V.ff...i.q ............................. b. Intended use and occupancy ................................ .................................... 10. 11. 12. 13. 14. Nature of work (check which applicable): New Building .......... Addition ...... Alteration .......... Repair .............. RemoVal ............ Demolition .............. Other Wot, to ............... Estimated Cost , 0 0 .ff/.~..~.~. .......... ,.., ........... : ........... ..... .............. (to bo p~d on fil appli n If dwel~ng, number of dwelling Unit~ .,~ ............ Number of dwelling units on each floor ................ ~1~ If garage, number of cars ..... ~ ................................................................. If business, commercial or mixed~ occupancy, specify&at,re and extent of eac~ type of use ..................... D~ens~ons of ex~stmg structures ~f an Front. ~. .... Rear . ,~ Deoth Height .../~ ......... Number of Stories. Q.~( ........................................... Dimensions~9~f amc structure wi{h alterations or additions' Front . ~ ~ ~aar ~ ~ ' ' p .... ~ ............. +. He~t ..... /. ............... Number of Stones ............ ~ ......... De th ~ ' ~ ..................... ~'~ ........... D~ensions of entire new construction: Front ... 5~ ........ Rear ... ~ ~ ..... Depth .~. ........ Height . .~2 .......... Number of Stories... ~.~ ................................................ Size of lot: Front ...... /9.~. ~ .......... Rear ..................... ~0o Depth ..................... Date of Purchase ....... ~ q. 7~ ................ Name of Fomer Owner ............................. Zone or use district in which premises are situated ...~o.~y.~ ....... Does proposed construction violate any zonine law. ordinance or rem,lation' . '~ ............... ~ ....... ~ ,' ~ ~ , ~ ..................... ~ ....... Will lot be regraded .... [~J .~. ' ................ ~ .~ill excess fill be removed from premises: ( Ye~ No Name of Owner of premises .3~.~..2~.(~ffdress ~4~4. ~.~... Phone Name of ~chitect ......... ~ ................. Address ~/~ ~ Nme of Contractor . ~(~.. ~u/+e.~ .... Address ' ~;~ ')J~ '~ '¢~ ..... Phone No. ................ No. Locate clearly and distinctly all property lines. Give streef)nd block humber or descriptiml according to deed, and sho~ ![ PLOT DIAGRAM rbuild~ngs, w~eth'er existing or proposed, and. indicate all set-back dimensions from ~eet names and indicate whether / NI~ILL~ of f~eW ¥~ (Signature of applicant) ~OTARY Sworn to b6fore me this .......... ¢ .~.'7% .... day of.. Public, STATE OF NE~r'~K, J ~iS S cou_ r_ZLo .. :' . _ tw~ ~D c-lr~ iX /~ .. ............................ i .................... being duly~, deposes and says that he is the applic~t (Name of individual signing contract) above named. (Contractor, agent, corporate officer, etc.) of said owfler or owners, ~d is duly au~ofized to perform or have peffomed ~e said work ~d to m~e and file this application; that all statements contained ~ this application are tree to the best of his knowledge and belief; and that the work will b~ perfomed in the m~n6r set forth ~ the application filed therewith. FEE. : NoTIF~ ~'NG OEpART,M~J-NT AT 765-18~2 9 AM TO 4 FM FOR THE FOR POURED CONCRETE 2. ROUG'W - FRAMING & PLUMBING 3. [NSULAT~k~ 4. FINAL - CO>:?RUCT~ON MUST BE COh'4PLE~E FOR C.O. ALL CON~']-R~JCT[ON SHALL MEET THE REQUiREMEnTS OF THE N,Y. ~ATE CONSTRUCTION & ENERGY CODES. NOT RESPONSIBLE FOR DESIGN OR CONSTRUCTION ERRORS. ? I% < ~L.~ ~00 fF~o~ ~/~/" =1 ? ow- B I ¸.i