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Home My WebLink About10950-z FORi~ NO; BUILDING TOWN HALL SOUTHOLD, BUILDING PERMIT ~ (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL F cOMPLETION OF THE WORK A, UTHORIZED) Ne, ~?0~ so z ULL Date ..................... , 19.. Permission is hereby granted to.~ /.~, /, C ",,~'~?~ ........ ../..:..~.7..,....~....: ........... ~...L:..i...'.~...,.,.:.~..,.. ...... ~./. ~...Z:/,c,x,~.;~.~ :. ................ ro ..:.~a.~.~.~...Z~.~..c.~ ...... .Q...~..:.~ ....... .~.~.~.~..~-~,..~./O.~ ............................... . /,~: '~. / / at premises located at .J...~....~.,.~. ......... ~ ........... .~,, · , County Ta~ Map No. 1000 'Section ..~.~.~./.--"~ ......... ~ ~'~ · ~IOCK ' ~,..,~ ............. BuilSing In~ spector. · -~5 ~ Fee ~..L./. ....... · , ' : Buddir · Rev.: 6130/80 Lot No. :'"~'("7 ,., and ~3pproved by the Inspecto? FORM NO. 6 TOWN OF SOUTHOLD Building Department Town Hall 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 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. 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 approva~ 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 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, Fees: 1. Certificate of occupancy $5.00 2. Certificate of occupancy on pre-existing dwelling or land use 3. Copy of certificate of occupancy $1.00 $5.00 Date.. 5 "/~.~. ....... 'i .... New Building ... ,~/. ....... Old or Pre-existing Building ............ Vacant Land ............. Location of Property . ,~, ,?.~',o,,,,, ,~..,~..~,, ,~,?.~.. House No. Street Ham/et Owner or Owners of Property . J~'.~, t.. ~.~,~ ~ .~....~T~.~.~.L..h .~.5.' .1.3~. ?.5~,...~;. ,~._.~J~. I'~.. L $ .'~.1.¥¢.'.%... County Tax Map No. 1000 Section . .~);~.-. ! ....... Block ...~. .......... Lot..,/~ ............ Subdivision..~.'{5~'>'.~.~'~...... ,, ..~., , .., ?~5"A e ~ . .~..A.~.~.A..Filed Map No, ~,)'.~,/~ ., ,Lot No, ... ¢( ?,~(~ ...... Permit No./~, ~.~.~, ,~7~-,, Date of Permit /?,/~,~./?~,'~Applicant ~, ,~. ,~,,. ,~1. , / Health Dept. Approval ~'~;' '--~'> ~'~)' , .....Labor Dept. Approval 3'i [,0, Planning Board Approval Underwriters Approval, .............................. ,,,,,,,. ...,,. Request for Temporary Certificate. ,~ ................... Final Certificate ..... ~ ............ Fee Submitted $ ............................. Construction on above described building and per~m~m/meets all applicable codes and regulations. Applicant .-~.~..~./'.~... :; . . .,/~.~ .................. Rev. 10-10-78 THE NEW YORK 'BOARD OF FIRE UNDERWRITERS ~;~'~ BUREAU OF ELECTRICITY ~- 85 JOHN STREET, NEW YORK, NEW YORK 10038 ,.re April 9~ 1981 102631 - 80 JppllcationNo. onfile N ~ .0 ~ .~ THIS CERTIFIES THAT only the electrical equ[ptnent as described below and ~ntrod~ced by the applicant ~med o~ ~he abo~e application nu~nber in the pretl~ises T.G.M. ~st;. (~., nlelc ~e ~ Way & ~ S~r~, ~ ~ in thefollowinglocation; ~ Basement ~ Ist Fl. ~ and FI. Section Block Lot was examined on ~9~ 6 ~ ~]~ and found to ~ in ~ompli.n~e with the ~q,ir~,nents of this aoord. FIXTURE OUTLETS 19 IECEPTACLES SWITCHES FIXTURES RANGES OVENS NCANOESCENT FtUORESC~NT DRYERS FURNACE MOTORS FUTURE APPLIANCE FEEDERS TIME CLOCKS MULTI-OUTLET DIMMERS SYSTEMS NO. OF FEET SERVICE DISCONNECT OTHER APPARATUS: S E R ;V I C NO. OF CC COND. A W G, 1 2/O NO. OF HI-LEG OF HI-LEG OF NEUTRAL 2/0 ['~rer~ Scott Elec. P.O. ~ 907, l~ke I~onko~oma, N.Y. 11779 lic. 498-[ This certificate must not be altered in any manner; return to the office of the Board if Iinco?rect. Inspectors may be identified by their credentials. COPY THIS OF IN ANY MANNER. OENEI~AI. MANAp~ FIELD INSPECTION FOUNDATION ( ~ s ~ ) FOUNDATION ( 2nd ) 2. ~ COY~EN~S ~ ROUGH FRAME & PLUMBING INSULATION PER N.Y. STATE ENERGY CO E FINAL ADDITIONAL COMMENTS: FORM NO. 1 TOWN OF SOUTHOI. D BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N.Y. 11971 TEL.: 765-180:3 Disapproved a/c ............ : ......... o/~ (Bull§lng Inspector) ' ' ~ APPLICATION FOR BUILDING PERM IT INSTRUCTIONS a. This application must be completely filled in by typewriter or in ink and submitted in triplicate 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 m..~tst be drawn on the diagram which is part of this appli- cation. c. The work covered by this app3ication 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 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, building code, housing code, and regulations, and to admit authorized inspectors on premises and in buildings for necessary inspections. :" .:. 7a,... c ..e. ......... (Signature of applicant, or name, if a corporation) ¢: n .c (Mailing address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. ... ~.~.:~.\ .c..~.c.P.-. .......................................................................... Nameofownerofpremises'.?:.:.~'{:.!.~__ ~"!Q b~'~ L-'(I.:... :~.'..~...'~.. ' ................. (as on the tax roll or latest deed) If applicant is a corporat~n, signature of duly authorized officer. · J /'! ., · ....... · (Name and litl~ of corporate officer) Builder's License No .......................... Plumber's License No ..... */..~.).~a..:.- -- --.~.: ..... Electrician's License No ..... ~../..~.'. .... ~ ..... Other Trade's License No ...................... · . //~ -, ti 1. Location of land on which proposed work will be done. ~'.~. i ..~:~ ......./9~.~.~..g.~...~ ./;.~. ~./~....~../..~/.~.l. .... ~.~. :~. . .... ..-'i:t4 ~. . . .~. n. ~. 4. . . .~ ~ '.L ....... ~"~ >: £ . . iq,.-1 g,. ~. .v. .~. . ............................ House Number Street Hamlet County Tax Map No. 1000 Section . :~. ;~l.i. .... ' ....... Block .... ~.i ........... Lot.. Jr.7. ............. Subdivision..~.~:~. i~./~ L~ ...~. '.~. t.' 14.....~7,...~...~q...~..... Filed Map No. ~..' .~. ~.~ ....... Lot..'.~..2 ~. ...... (Name) 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy ... V..~ .4¢.~.~.c. .~.~. .... .~ ~ ........................................ b. Intended use and occupancy ..-O-~. C.--i ..... ~..~..~. I .L.~.. .... .~..~.i. h~..~.~.*[.0 .tw.: ~ ............ 3. Nature of work (check which applicable): New Building .... .V/. .... Addition .......... Alteration Repair ~ .............. Remo?l .............. Demolitlon .............. other wor~: ..... 4. Estimated Cost . . :.,.2 ...................... Fee .......................... (to be paid on filing this application) 5. If dweliing, number of dwelling Units ..... .~..~...~.'... Number of dwelling units on each floor ..... . ........... If garage, number of cars ..... · .0.~).~ .............................. , ............................. 6. If business, commercial or mixed occupancy, specify nature and extent of each type of use . i.. :. ................ 7. Dimensions of existing structure~, if any: Front ............... Rear ; ............. Depth ............... Height: ............... Number of Stories ........................................................ Dimensions of same structure wiih alterations or additions: Front ................. Rear .................. Depth .................... .. Height ........ t. .. . Number o,f Stories 8, D~mens~ons of e~t~re new construction: Front .. 1~77. ~i. ;'..-:5 .... Rear . ~,% ~ -.~... Depth .'fi?) [..--'.. 3. Height . .'~?-'~-2.~. ~.-~ ..... Nulnber of Stories ....Q-r,.. ~.~.vg..o... f ................... ·... ~ ............... 9. Size of lot: Front .. 5.~.,~.~...~. O..,r~ ......Rear ......~"'2. l .'?-:'. ....... Depth . ~./O...~.~..~..tT-, :.--: ..... 10. Date of Purchase ...~.qOY.~;¢.. i .................. Name of former Owner . .~.O. V~O. V'./~-.~.. ............. 1 1. Zone or use district in which premises are situated... ~--J~J~.l~a'~.~ &.L-. ............................... 12. Does proposed construction yiqlate any zoning law, ordinance or regulation: . ~rt~... ~..~ ...................... 13. Will lot be regraded ...... ~ ~ ................. Will excess fill be removed from premises: Yes 14. Name of Owner of p.remise~.~7:'.~...0/- .~,'~.'. .~ .t~.' .~.~. .... Address ~11 ¢;.-lr'.~.lp.4~. t,4.,~. ,. :. Phone Name of Architect ~..,~!..u?.~ ,..c.~2 ............ Address . .e~...rt~A~?.. ¢?.~T.'..~. J(... Phone No.~g.' ~.7~/.6~. ..... Name of Contractor. 1. ~.'/~..(,~. M').). g-. Address /I']u'TN/fl4 ~-:/~. ~X ..... Phone Locate clearly and distinctly all ibuildings, property lines. Give street and block number or, interior or corner lot. LOT DIAGRAM existing or proposed, and. indicate all set-back dimensions from ~tion according to deed, and show street names and indicate whether deposes and says that he is the applicant SXAZE OF NEW COUmJ,,OF.. ....~'~.~.,....'~..' ../~.( ~5~...~0~ ~: ............... being d01y sworn, .~ (Name of i~dividual ~ig~g' co~[ract) above n~med. ~ ~ ' . .'~, k~ ', He is the .... lContractor agent corporate officer etc ) of said owner or owners, ~d is duly authorized to perform or have perfo~ed the said work and to m~e and file this application; that aiLstatements contained M this application are true to the best of his knowledge and belief; and that the work will b~ perfomed in the mann{r set forth in the application filed therewith. Sworn to bgfore me this .:' " ~ ,. .............. Nota~ Public, . '~ff~e~County, Nota ,. , ,. ........................ ............... , No, ~2-0344~6~ $offolk Coun~. ' ~mmis~lon Expired,March ~0, ~9~/ , '~isnature of applicant) TITLE NO. 7908-03616 " t 74 A rea ~' OPen 5paCe F SUFFOL]~ COUN~Y DEPARTMENT OF MEALTH SERVICES FOR APPROVAL OF CONSTRUCTION ONLY I=MONUMENT [3 = STAKE SUBDIVISION MAP FILEDINTHEOFFICEOFTHE CLERK OF SUFFOLK COUNTY N TH/[ LOCATI~ OF WELL(W)~SEPTIC TANK($T)~ CESSPOOLS(CP) SHOWN HEREON SURVEY FOR MICHAEL THALASSINOS ~ CHRISTINA THALASSINOS LOT 74 "MAP OF PEBBLE BEACH FARMS" AT EAST MARION TO~/N OF $OUTHOLD SUFFOLK COUNTY, NEW YORK OCT 21 , 1980 FEB. 14, 1980 DATE' NOV. 1,1979 SCALE: I": 40' NO. 79- 591 K UNAUTHORIZED ALTERATION OR ADDITION TO THIS GUARANTEED TO' CHICAGO TITLE INSURANCE CO* i;N YOUNG'a YOUNG ALDEN W. YOUNG, PROFESSIONAL ENGINEER AND LAND SURVEYOR N Y.S. UCENSE NO. 12845 HOWARD W. YOUNG, LAND SURVEYOR NYS. LICENSE N0.45893 400-O~"TRANDER AVENUE RIVERHEAD, NEW YORK TITLE NO. 7908-0.%616 THE 57'RANO OPen 5paCe "F" SUFYOLY,. OOUNTY H~ALTB D'EP~J{T~hq~ ~ho sewage disposal and wat6r supply f~cllttles for this location have been inspected bF this depa?~men% ~nd found Chief of ~eneral Engineerl~ HEALTH DEPARTMENT-DATA FOR APPROVAL TO CONSTRUCT AODRESS TEL. I~= MONUMENT D = STAKE SUBOIVIEION MAP FILED IN THE OFFICE OF THE CLERK OF SUFFOLK COUNTY ON dUNE II, 197G A8 FILE NO. GIGG ~ TH~ LOCATION OF WELL(W), SEPTIC TANK(ST)8~ CESSPOOLS(CP) SHOWN HEREON ARE FROM FIELD O~SERVATIONE AND OR DATA OBTAINED FROM OTHERS SURVEY FOR MICHAEL THALASSINOS 8~ CHRISTINA THALASSINOS LOT 74 "MAP OF PEBBLE BEACH FARMS" AT EAST MARION TOV/N OF SOUTHOLD SUFFOLK COUNTY, NEW YORK APR. 8, 1981 DEC. 19, 1980 OCT.21,1980 FEB. 14, 1980 DATE: NOV. I, 1979 SCALE: 1"=40' NO. 79- 591 GUARANTEED 10, CHICAGO TITLE INGURANCE CO. 1 YOUNG a YOUNG ALDEN W. YOUNG~ PROFESSIONAL ENGINEER AND LAND SURVEYOR NY.S. LICENSE NO. 12845 HOWARD W. YOUNG~ LAND SURVEYOR N Y.S LICENSE N0.45893 400 OSTRANDER AVENUE RIVERHEAD~ NEW YORK