HomeMy WebLinkAbout10631-zFORM NO, 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Town Clerk's Office
Southold, N.Y.
Certificate Of Occupancy
THIS CERTIFIES that the braiding ..............................................
h~ds'o'~0'9,vu. R°okx Point Road East Mavion~
Location of Property
· ' ................... 's't/o~i ......................
County Tax Map No. 1000 Section ....0~3.1 ...... Block ....~ ........... Lot ...... 1.3. .........
Subdivision .............................. Filed Map No ......... Lot No ..............
conforms substantially to the Apphcahon for Building Permit heretofore filed in this office dated
· . .A.p. ~.1..~. ......... 19~.O. pursuant to which Building Permit No ...... ~..C).6.3.1.Z. .........
dated . , .AXq.~ .5.1..2.~. ................ 19~.O. . , was issued, and conforms to all of the requirements
of the apphcable provisions of the law. The occupancy for which this certificate is issued is .........
................. 6.~.~.e.V. 9.a.~. g.e..t.o...~.~ ~..~.O.~.e.. ~p?.~..e .............. : ...........
The certificate is issued to ......... y.e.n..t..z?.l.o. ~...~.n.d..~. g.~.E~, p.e.m.J:..~.~.~. .................
of the aforesaid building.
Suffolk County Department of Health Approval ........ .N/.I~. ...........................
UNDERWRITERS CERTIFICATE NO.. hl 48..27.67.
Building Inspector
Rev 4/79
FOR~I NO. 2
TOWN OF $OUTHOLD
BUILDING DEPARTMENT
TOWN GLERK'S OFFICE
SOUTHOLD, N. Y.
BUILDING PERMIT
(THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL
COMPLETION OF THE WORK AUTHORIZED)
N? 10631 Z
Permission ~s hereby granted to:
..~zz...~..~..~.~,~r~,~- ~
.~.../~ ........ ~.~.~ ..........
~o ..~z.~.....~.~~....z~.....~zz~....~zzz~.....~ ......
.... ~z~Z~.~.....~~~__ ....................................... Z~ ..............................................
~ ~,~,oca~e~ ~..Z.~.O ...... ZC~V.....~.:~....~ ...........................
......................................................................................................-- ~.~.~.?..~
pursuant to application dated ,~~......~--~/. ....................... ! c~.4~1, and approved by the
Building inspector.
Fee $l ........ ~[~ ......
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 Wpewriter 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 featu res.
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 requ!rements 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 alt property lines, streets, buildings end 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 $5.00
2. Certificate of occupancy on pre-existing dwelling or land use
3. Copy of certificate of occupancy $1.00
$5,OO
Date .... A. ~;.~. e..~..~.,.. 1. .c).~.0. .....
New Building ............. Old or Pre-existing Building ..... ~ ..... Vacant Land .............
Location of Property .... .1.7.0.0, ]~p.c.]~T3'. ~.o.:J,z~¢. ~c~ ..........~..~.s,~...~.~.z'.~o.~..~. ~¥~ ........
House No, Street Ham/et
Owner or Owners of Property ....... ~. ~ .~.:]..~.e..~ ,o.~...e~..~..A.i~ .~p~' .D..e~.:[~J, ~] .....................
County Tax Map No. 1000 Section .... 0.3,1 ........ Block ...... 2. ........ Lot ....... .1 ~ .......
Subdivision ................................. Filed Map No ........... Lot No ..............
Permit No. ? .0.~..~1. .~... Date of Permit . ~/.2.2./..~.0.Applicant ..... ~.e. ~.:[.~.e..]..op..~.e..~.~. ~ .........
Health Dept. Approval ........ ~t'.~. ............ Labor Dept. Approval ........................
Underwriters Approval ...... .~'..)-~..2.7.~.7. ........ Planning Board Approval ......................
Request for Temporary Certificate ..................... Final Certificate ......... ~, ............
Fee Submitted $. ~;.0.q .......................
Construction on above described building and permit meets all app~cable codes and regulations.
Applicant . ¢ ..................
TOWN OF SOUTHOLD
OFFICE OF BUILDIi~G INSPECTOR
TOWN HALL
SOUTHOLD, N. Y. 11971
TEL. 765-1802
July 31, 1980
Venizelos Demiris
422 Elizabeth Street
Fort Lee, N.J.
Dear Mr. Demiris: :
This is to advise you that the job under Building Permit
No. 10631Z issued to Demiris, V. on
April 22, 1980 for alterazzon on garage appears to be
completed as of our last inspection. Before you can legally
use or occupy this structure a Certificate of Occupancy must
be issued.
Please fill out the enclosed form and return same to
the above office. There is a fee of $5.00 for a Certificate
of Occupancy
Thank you for your prompt attention.
Very truly yours,,
GEORGE H. FISHER
Sr. Building Inspector
encl.
FIELD
I.
iNSPJ£G ] i0: [
FOUNDATION
FOUNDATION
2.
ROUGHFRAME &
PLUMBING
FINAL
INSULATION PER
STATE ENERGY
COpE
THE NEW YORK BOARD OF FIRE UNDERWRITERS
BUREAU OF ELECTRICiTY
85 JOHN BTREET, NEW YORK, NEW Y~RK 10038
Date Jull~ ]C~,t. gbO ApplicatlonNo. onfile 075227
,, N 4827~;7
THIB CERTIFIEB THAT
only the elec trlcal eouipment as described belotv op.t~l introduced by.~he ppp?cttn[ nat~zed on the above application number in the premises of
Venizelos Demiris,1700 Rocky Point R~. ,E~.zt MariO~,N.Y
in the following location; [] Basement
was examined ou ,Ytll~e 12~1980
[] lstg7. Lot
[] 2nd FI. Section Block
and found to be tn compliance with the requirements of this Board.
FIXTURE FIXTURES RANGES OVENS EXHAUST FANS
OUTLETS SWITCHES
6 6
DRYERS
SYSTEMS
E
NO OF CC COND
PER
OTHER APPARATUS.
1-GFA
R V I
AWG
OF CC COND
NO OF HI LEO
C
A W G NO OFNEUTRALS
OF Hi-LEG
1
AWG
OF NEUTRAL
gal Prato
Wiggins I,a~
11944
Lie. 1049
GENERAL MANAGER
FORM NO. 1
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN HALL
SOUTHOLD, N.Y. 11971
TEL.: 765-1803
Examined2- .. .. 19 Application ........
(Building Inspector)
APPLICATION FOR BUILDING PERMIT
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 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 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. ' / ~
'/S~ign~ '1~'~~o~'oration) ..........
(Mailing address of applicant)
State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder.
Name of owner of premises 27~g7"~ '4~
(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 ..... 7 .~. 7.-~..t~. ........
lectrician's Lioense No. ...........
Other Trade's License No ....................
1 Location of land on which proposed work will be done ..................................................
House Number Hamlet
County Tax Map No. 1000 Section ... ~[ .......... Block ....... ~ ........ Lot...~ ............
Subdivision ..................................... Filed Map No ............... Lot ..............
(Name)
2. State existing use and occupancy of premises and intended use and occhpancy of proposed construction'
a. Existing use and occupancy ...~ .......... 7.,~ .......... C~~.~... ~ ..........
b. Intended use and occupancy ~~'~. ~~. ~ .~~-. ~ ......
3. Nature of work (check which applicable): New Building Addition Alteration
Repair .............. Removal .............. Demolition .............. Other Work ...............
,'
, __ (Description)
4. Estimated Cost ....... ' ~ Fee .....
, (to be paid on filing this application)
5. If dwelling,'number of dwelling Units ............... Number of dwellin nits on each floor ................
If garage, number of cars ..... ~ ...................................................................
6. If business, commercial or mixed occupancy, specify ~ture and extent of eac~_~pe of use ........ ~ .~-~-i i ......
7. Dimensions of existing stmcture~, if any: Front .... ~ ........ Rear ... ~ ....... Depth ......
Height ............... Num~ber of Sto~es ...... ~ ................................................
D~ensions of s~ structure with alterations or additions: Front .... ~.~. ........ Rear ...~ ............
Depth ...................... He~t ...................... Nmber of Stones ....................
8. D~mens~ons of entire.new construction: Front ............... Rear ............... Depth ...............
Height ........... ~ .... Number of Stories ................................................... ~ .....
9. S~ze of lot: Front ........... 7 .,O ....... Rear .......... ~ ~ ~d~gMA~fi...
........ Dept .... ...................
10. Date of Purchase ...... ~/.~}.~.7.~ ............ Name of Fo~ owner ~ ...............
11. Zone or use district in which premises are situated ........ ~f~&~f~ .........................
12. Does proposed construction violate any zoning law, ordinance or regulation: .... ~ ........................
13. Will lot be regraded ............................ Will excess fill be removed from premises: Yes No
14. Nme of Owner of premises fl~ ~. ~ .~fAl~Address ................... Phone No ...............
Nme of ~chitect ........................... Address ................... Phone No ................
Nme of Contractor ........................... Address ................... Phone No ................
P~T DIAGRAM
Locate clearly ~d distinctly ~1~ bulldogs, whe~er exist~g or proposed, ~d, indicate all set-back dimensio~ from
prope~y lines. Give street and block humber or desc~ption according to deed, and show street nines and indicate ~hether
interior or corner, lot. i
1 l IL mxe% s
STATE OF NEW YORK, iS.S / --
COUNTY OF [
': 7 ..... b ing duly sworn, deposes and says that he is the applicant
(Name of individual sign!lng contract)
above named. :
He is lhe ~'
(Contractor, agent, corporate officer, etc.)
of said owner or owners, and is duiy authorized to perform or have performed the said wor~ and.to make and file this
application; that all statements contained in this application are true to the best of his knowle~dge a~,,d belief; and that the
work will b~ performed in the manner set forth in the application filed therewith. _
Sworn to before me this i
19 .~.~
Notary Public, .. ~ .... : ........ County_ _
:'lA ...........
i '~c.~?'Z~",?Z~ · '~ ....
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