HomeMy WebLinkAbout10953-zFORM NO. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Office of the Building Inspector
Town Hall
Southold, N.Y.
Certificate Of Occupancy
Nc.g.I.1.5. 3..~ ........... Date ...... .l~.~q .I¢, .~ ................... 19 .~.
THIS CERTIFIES that the building Accessa~y
Location of Property qSO0 Aquaview Ave / q05 Cedar Dr. East Marion N.Y.
House No. Street Ham/et
22 2 3z~
County Tax Map No. 1000 Section ............ Block ............... Lot .................
Subdivision ............................... Filed Map No ......... Lot No ..............
conforms substantially to the Application for Building Permit heretofore filed in this office dated
October 27 80
..................... , 19 . . . pursuant to which Building Permit No .... 10. 953.Z. ...........
dated November 3 80
............................ 19 .... 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 build an ingrcound pool enclosed by a ~c £t. high £ence
The certificate is issued to John &Flaria ~rikoukas
(owner, lessee or tenant)
of the aforesaid building.
Suffolk County Department of Health Approval N/A
502597
UNDERWRITERS CERTIFICATE NO ..................................................
............ ?.¥~..~...../2/. ,.~:..,-~¥~..~. ,.t....
Building Inspector
Rev. 1/81
TOWN OF SOUTH~L~D i
BUILDING DEPART~AdN3~
TOWH HALL
$OUTHOLD, H~ Y*
BUILDING PERMIT,
(THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL ~ULL
COMPLETION OF THE WORK AUTHORIZED)
N°. ~0953 Z Date ...... ~i:.:~._O..V.~.~,..~. ....................... ]9..~.O.
Permission is hereby granted to:
...... '~?~'",~"~'"~i~'fa"~ ........
......................................... :.......L.q~: ..~.~/.u.~.s.
P, O. ~OX 108
to build Z/O ~ool ~d eno~ose ~/~n~:~, h~ feno~
at premises located at . 10~ C~ ..~./a ~00 A( [g~..~, ......... : ...........................
County Tax Map No. 1000 Section ~ Block ~..,,.,..~ ........... Lot No. .......~ ............
pursuant ~o application dated . Oo~o~e~ 2~ : ~ , 19 ~, and :approved by the
Build~ng Ih~pector.
1~,00
Fee $ ........................
Building Inspector
Rev 6/30/80
THE NEW YORK BOARD OF FIRE UNDERWRITERS
BUREAU OF ELECTRICITY
~-~l~ 85 JOHN STREET, NEW YORK, NEW YORK 10038
D~t~ December 8, 1980 ~m, li~atlon~o.o,flo 101674
only the alee trlcal equipment as described below and introduced by the applicant named on the above application number itt the premises of
John Trikouicas~ Aquaview Drive & Cedar Drive, Ea~ Marion, lq.Y,
irt the followlng Ioeatio,z; [] B.se,nent [] ~t ~'t. [] 2nd rt. Ougside Sectlo. Block Lot
Dece~ber i, 1980
FIXTURE FIXTURES
OUTLETS RECEPTACLES SWITCHES
INCANDESCENT FLUORESCENT
1 1 2 I
and found to be in compliance with the requirements of this Board.
RANGES OVENS EXHAUST FANS
DRYERS
SYSTEMS
NO. OF FEET
E R V I C E
NO. OF CC COND A W.G. NO OF Hi-LEG A,W G NO. OF NEUTRA
OTHER APPARATUS:
(Swimming Pool) Wl~is certificate covers compliance a~ the da~e of
inspec~ion only. Because of u~usual environments ig i~ advisable
to have frequeng test and/or repairs made by a qualified person.
1. G.F.£o
AW, G
OF NEUTRAL
Glenn R. Bradley
RED 169-Horgon Avenue
~iat tituck, N.Y. 11952
Lic#1227
This certificate must not be altered in any manner; return to the office of the Board if incorrect. Inspectors may be identified by theh
COPY I!OR BUILDING DEPARTMENT, THIS OF CEItlIIqCATE ANY MANIfl
FORM NO. 1
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN HALL
SOUTHOLD, N.Y. 11971
TEL.: 765-1803
No.~....., ......
Disapproved a/c ...... .~ ................ ........
..................
(Building Inspector)
APPLICATION FOR BUILDING PERMIT
INSTRUCTIONS
a. This application must be completely filled in by typewriter or in ink and submitte~l 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 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 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 i~art 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, other applicable Laws, Ordinances or
Regulations, for the construction of buildings, additions or alterations, or or as herein described.
The applicant agrees to comply with all applicable laws, ordinances, and to
admit authorized inspectors on premises and in buildings for
(Signature of applicant, or name
(Mailing address of applicant)
State whether applicant is owner, lessee,(~arctiitect, engineer, general contractor, electrician, plumber or builder.
~ ~, :~ n~- // (as on the ta>~ roll or latest deed)
If appli~nt i~,,,~/)~prporat~n, sigr~u~ of duly authorized officer. ', · '
Builder's License No ..... '.~..~.. ...............
Plumber's License No ...................... ,..,
,-~) //
Electrician's License No .... .~.' .~, ?/.~...-'~. .......
Other Trade's License No ...................... /~ ,
1. Location o]~Aml,cl on w/hich propo~r~d work will be done ............. [~ ~>~ _,~; .~, ..... ~.~ ...............
! ..................
House Number /~'o0 AOUP, v'Itz-Od /qfftStre~,et / Hamlet
County Tax Map No. 1000 Section ....~% .~..'..¢.'..~.. ~.. Block.. ~ ............. Lot ...................
Subdivision ..................................... Filed Map No ............... Lot ...............
(Name)
State existing use and occupancy of premkse~and intende~puse and occupancy of proposed construction:
a. Existing use and occupancy ..... /j'~,~.~ ~.~.-- .~..~..~..~. ............ ~. ...........................
b. Intended use and occupancy ..... t:;~,~)~)...~.~.~.~....~.../~.~...~.:~.... .................
3. Nature of work (check which applicable): New Building .......... Addition .......... Alteration. ..........
Repair .... RemOval ........... . .. Demolition .............. Other Work .//.,'?./.4...~.~-/~--~O~.
4. Estimated Cost ..... ~e ................ Fee ............................
' (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, if any: Front ............... Rear .............. Depth ...............
Height ......... Number of Stories .. / ...................................................
Dimensions of same structure with alterations or additions: Front ................. Rear ..................
Depth I Height Number'of Stories
8. Dimensions of entire new construction: Front ............... Rear ............... Depth ...............
Height ............... Num~ber of Stories ...................................... ~_ ..............
9. Size of lot: Front .. :... ~.~..O.. ....... Rear ....... ~l[~...~ .~. Depth . ./.~. ................
10. Date of Purchase ............................ Name of Former Owner .............................
11. Zone or use district in which pr~mises are situated .....................................................
12~~ Does Prop6sed construction violate any zoning law, ordinance or regulation: .../~..(~. .......................
13. Will lot be regraded ....... .,~4/,. ~ .............. Will excess fill be removed from premises: Yes No
· Job ;
14. Name of Owner of prem~s~es ...i. · ~...T.~. ~.~. Address ................... Phone No ................
Name of Architect ...o .~.~ .... ~, .......... Address ................... Phone No .............. ~.
Name of Contractor .~...~. ! ~..'~. ~...'~.,:~.; ......Ad dress. ...... Phone
PLOT DIAGRAM
Locate clearly and distinctly all lbuildings, 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 ¥,~RK} ~ . ~ ~_e /~2 , ~
COUNTY O~~c~~~
~~r~.,~,~. c~. being duly sworn, deposes and says that he is the applicant
above named.
He ~s the .................. ~ .............. ~ ..............................................
' ~' (Contract, corporate offic~r,'e~c.) "
of said owner or ownem, ~ is duly authorized ~ perform or have perfo~ed the said work and to m~e and file this
application; that all statements contained ~ this application are true to th~ Ce~t of his ~owledge and belief; and that the
work will b~ perfomed in the m~ne~ set forth ~ the application filed therewit~
Swam to before me this [
Nota~lic, ... ~. t. ~ · ·. ~ County ~ //~/
~ ~ , , tEZAB~.ANN,UEiiLtE , -, .~~
~ARY PUBLIC,i 'Stato 0~ NoW J0~ ~ ~ - ~ignature ~ applicant)
~ No, 52-81258~0, Suffolk Co~ -- /'
~ ~ Term /xpires~March 30, 19 .........
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:
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:
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 rand use
;3. Copy of certificate of occupancy $1,00
$5.00
Date ..... ~ ..
New Building .~.4~.~ ....... Old or Pre-existing Building(Z) ............ = 'Vacant Land -i ............
Location of Property .... ~ ~,~.0.,, .~..~.O_~,l.i.~..~?..~ ~;
Hou~ No, ~ ~ Street Hamle~
Owner or Owners of Property .~.~ .~ ~.~0. ~}~.~.~ ................
Subdivision ................................. Filed Ma~ ~o ........... kot ~o. '~ ...........
~er~t No..t.O.I~.~ate of ~ermit ~ }~ .~...Applicant. ~.~.~
Health Dept. Approval ........................ kabor Dept. Approval ...................... ,..
rq7 , , .
Unde~riters Approval ..................... Plannin9 Board Approval ..................
Request for Temporary Certificate ..................... Final Certificat~ ,..
~ Sa~ ~ .............................
Constru~tio~n on above described building and permit'me~ets all app,~c~ble~co~es and regulations..
~ __ ~ ~ppllca t . ,/~.~C.~ ....... f ~ 2 ..... [~[ ..........
. , - ,- .; ...... , ....